JAMA

doi: 10.1001/jama.1964.03070050063042pmid: N/A

Social Security Amendments to House.— The House Rules Committee cleared for expected quick House approval the $1 billion, 5% increase in Social Security cash benefits approved by the House Ways and Means Committee. The bill came before the House under a "closed rule" meaning that no amendments could be offered. This is traditional with legislation out of the Ways and Means Committee. Five hours of debate were slated. It appeared certain the bill would pass the House before August. In approving the bill, the Ways and Means panel rejected the Administration's King-Anderson bill calling for a Federal program of limited hospital-medical benefits. The measure provides increases in Social Security cash benefits and other changes, including placing physicians under Social Security for the first time. Under the legislation, the Social Security tax would be increased, starting next year, to 3.8% for both employers and employees on the first $5,400 of employee

doi: 10.1001/jama.1964.03070050065043pmid: N/A

Implantable pacemakers in humans and in dogs have significantly lowered blood pressures in essential, renal, and neurogenic hypertensive states. Internal electrostimulation of the carotid sinus nerve effects return to near normal and prehypertensive levels, two physicians reported to a research forum on cardiovascular and respiratory problems at the AMA Annual Convention. Seymour Schwartz, MD, Rochester, NY, who worked with one group, told of initial clinical experience with antihypertensive pacemakers implanted in two patients at the University of Rochester School of Medicine. In another project, Aydin M. Bilgutay, MD, Minneapolis, related effects of baropacers on hypertensive states induced in dogs at the University of Minnesota School of Medicine. Both research groups — Schwartz and Lawrence Griffith, MD, University of Rochester, and Bilgutay and C. Walton Lillehei, MD, Minneapolis —plan further clinical experiments in the near future. The main criteria for selection of patients for implantation of the devices is lack of

doi: 10.1001/jama.1964.03070050067044pmid: N/A

Immediate ambulation following inguinal and femoral hernia repair under spinal anesthesia and a return to normal activity within 24 hours after surgery is a procedure advocated by Irving L. Lichtenstein, MD, Los Angeles surgeon. Lichtenstein reported at the AMA Annual Convention on results with this technique in 90 herniorrhaphies. Patients ranged in age from 16 years to 78 years; all but six were men. Direct and indirect inguinal hernia were found in 80% of the patients. All 90 patients have been followed for periods of from six months to four years. There have been only two recurrences. "One resulted from failure to recognize a femoral component," Lichtenstein said. "The other was due to reluctance to utilize a reinforcing screen when grossly inadequate fascia was presented." In describing the technique, Lichtenstein explained that "The patient sits up and walks out of the operating room, after putting on slippers and robe. This

doi: 10.1001/jama.1964.03070050068045pmid: N/A

Patients undergoing cytotoxic drug therapy for psoriasis in a controlled test of 30 subjects exhibited two distinct and unique immunological defects, two dermatologists told the annual meeting of the American Dermatological Association meeting at Kaanapali, Hawaii. William L. Epstein, MD, and Howard I. Maibach, MD, both of the University of California School of Medicine, said the patients showed "a striking inability to develop delayed hypersensitivity to simple chemicals and a depressed ability to respond with circulating antibodies to the one antigen studied (plague vaccine)." The 30 test subjects ranged in age from 23 to 78 years. Five had psoriatic arthritis and the others had extensive, disabling psoriasis vulgaris. In the test for delayed hypersensitivity, sensitization was induced by exposure to 2,4-dinitrochlorobenzene (DNCB), and paranitrosodimethylaniline (NDMA) in acetone applied to uninvolved skin of the forearm. In 30 days the patients were challenged with 1:1000 concentrations of DNCB and NDMA in acetone

doi: 10.1001/jama.1964.03070050069047pmid: N/A

Four Mayo Clinic physicians have advanced the opinion that systemic lupus erythematosus (LE) is the end stage of a process, probably genetically conditioned, which may remain latent until induced by drugs or other provocative agents. D. Alarcon-Segovia, MD, reported to the annual meeting of the American Rheumatism Association in San Francisco in June on the results of a study of 50 patients exhibiting hydralazine syndrome. This syndrome which, when fully developed, is indistinguishable from systemic LE, sometimes appears in patients undergoing treatment for hypertension with hydralazine hydrochloride. "Although data on the history and subsequent course of patients with this syndrome is limited, it has been assumed that it occurs in the absence of antecedent LE and that it is reversible upon discontinuation of the drug," Alarcon-Segovia said. "It is our opinion that overt systemic lupus erythematosus, as it is presently known, is only the end stage of a long standing,

doi: 10.1001/jama.1964.03070050069046pmid: N/A

Arthritic children as a group may be more physically active prior to [ill] onset of symptoms than the averge child, a study at Texas Children's [ospital, Houston, indicates. Sidney E. Cleveland, PhD, reorted on the study of 30 arthritic hildren at the June meeting of the merican Rheumatism Association in an Francisco. Cleveland said the urpose of the study was to determine if arthritic children exhibited personality patterns similar to those detected in arthritic adults. The children ranged in age from ½ years to 16 years with a mean age of 101/2 years. They had exhibited symptoms for periods of from 6 months to 10 years. The average was years. Sixteen of the children were girls and 14 were boys. "In respect to general personality here does not appear to be any uni[ill] among arthritic children," [ill] said. "Unlike an earlier [ill] with adult arthritics, no unique [ill] single

doi: 10.1001/jama.1964.03070050070048pmid: N/A

Aportable electrocardiograph device is being used by the US Public Health Service in Alexandria, Va, to take an automated communitywide cardiac survey. The Alexandria Health Department and the PHS Heart Disease Control Program collaborated with Honeywell, Inc., in the development of a 7 lb, battery-operated electrocardiograph machine and a magnetic tape system for recording the electrocardiograms (ECG's) at a receiving station in Washington, DC. The ECG's are taken in the patient's home by Public Health nurses who transmit the data by special telephone hook-up to the magnetic tape system. After the electrodes have been positioned, the nurse dials a telephone number at the receiving station at George Washington University which is self-answering and which automatically starts the tape recorder. Then the telephone mouthpiece is inserted into a Bell System Dataphone which transmits high frequency signals to a similar set at the field station. The portable ECG machine produces the standard,

doi: 10.1001/jama.1964.03070050071050pmid: N/A

Seven new tobacco research grants have been announced by American Medical Association Education and Research Foundation President, Raymond M. McKeown, MD. First-year grants for the seven projects totaled just under $183,000. Duration of the projects ranges from one to five years, and full commitment (subject to annual evaluation by the five-member committee of scientists directing the program) will total about $440,000. The seven projects were the second group approved by the Foundation. In June, McKeown announced approval of ten project grants—the first under the Foundation's research program on tobacco and health authorized last December by the AMA House of Delegates. If the 17 projects approved so far are carried through, the Foundation will expend more than $1,300,000 toward their support. Following are the seven grant recipients and their projected studies: • G. Douglas Talbott, MD, medical director of the American Medical Research Foundation, Dayton, Ohio (a private organization which has

doi: 10.1001/jama.1964.03070050071049pmid: N/A

Rose bengal labeled with131I is used with a high degree of accuracy to distinguish between surgical and nonsurgical causes of jaundice in a method employed by Robert A. Nordyke, MD, Straub Clinic, Honolulu. Reporting at the 113th Annual Convention of the American Medical Association in San Francisco in June, Nordyke said the technique permits simultaneous determination of biliary tract patency and quantitation of liver injury. Both sets of data are obtained by scintillation counting external to the body. Applied to 181 patients, the technique has provided about twice the accuracy of standard liver function tests carried out at the same time, Nordyke said. Biliary tract function is tested by observing whether131I labeled rose bengal enters the intestine after cholecystokinin is given intravenously in 2 ml of saline over a one-minute period 30 minutes after dye injection. The scintillation probe, with a wideangle collimator, is placed in

doi: 10.1001/jama.1964.03070050073052pmid: N/A

The average adult, regardless of body weight, must incur a loss of at least three liters of fluid from the body before dehydration becomes apparent, Richard B. Bourne, MD, University Hospital, Ann Arbor, Mich, told the AMA Annual Convention. Bourne reported on an experiment at University Hospital in which seven male volunteers were placed on a fluid deficient diet. The volunteers ranged in body weight from 52 kg to 128 kg (114.4 lbs to 281.6 lbs), and in age from 33 years to 69 years. Each patient was weighed accurately on a metabolic scale and then placed on a diet which included 1,500 calories and 360 ml of fluid intake per 24 hours. The weight loss due to dehydration was calculated by subtracting the estimated weight loss due to calorie deficiency from the total weight loss. The diagnosis of dehydration was based on physical signs. "In our experience the most