Oral and intramuscular phenytoin

After presenting the topographical and pathological basis for the habitual luxation of the shoulder joint, our experience with the Bankart-Müller operation on 38 of our own patients was described. The results are characterized as very good, particularly two years and longer after the operation.     

The importance of dietary control in metabolic studies of manic-depressive patients

Diet control of electrolyte intake appears to diminish day to day variation of urinary electrolyte output. Urine sodium concentration is more affected by diet control than potassium, possibly due to the greater variation in sodium ingestion on uncontrolled diets. The coefficient of variation of urinary sodium excretion on the controlled diet was not significantly greater than the variation in sodium ingestion. These experimental results suggest that controlled diets reduce random variation in sodium and potassium excretion and therefore enhance the possibility of observing illness-related biological changes.     

Abnormal tryptophan metabolism in a family with a history of bladder cancer

Tryptophan metabolism was studied in a family in which a sister and brother had bladder cancer. Urinary tryptophan metabolites after administration of 2 g L-tryptophan were measured in 4 sisters and 1 brother, all free of disease when studied. One sister with and 2 without histories of bladder cancer had significantly elevated levels of kynurenine, acetylkynurenine, and 3-hydroxykynurenine. Administration of 100 mg pyridoxine hydrochloride returned the tryptophan metabolism to normal in these 3 individuals. One brother with a 1 sister without bladder cancer had normal metabolism. A repeat study 2 years later confirmed the abnormal metabolism in the 3 sisters. Two sisters with abnormal tryptophan metabolism were given 200 mg L-kynurenine sulfate orally to bypass the effects of tryptophan oxygenase activity. Both excreted elevated levels of kynurenine and 1 excreted elevated levels of 3-hydroxykynurenine.     

The effects of chemical injury on the ocular surface

Chemical burns of the eye may destroy all of the corneal epithelium and large portions of conjunctival epithelium into the fornices. Restoration of the ocular surface after a chemical burn depends on the centritedal movement of conjunctival epithelial cells and their adherence to the altered corneal stroma. Epithelial movement after a corneal burn is normal for 72 hours after a burn, but persistent epithelial defects thereafter commonly are not resolved until total corneal vascularization occurs. Although this fresh epithelium may be protected by a bandage soft contact lens, more promising and far-reaching approaches may follow epithelial supplementation and even replacement. The link between the health and integrity of the epithelial layer as it relates to the corneal substratum and its cellular constituents remains to be forged.