Diligent Search Research Articles

Surgery for the Ruptured Abdominal Aortic Aneurysm

In an eight-year interval, 40 consecutive ruptured abdominal aortic aneurysms were surgically resected in a community hospital. The resulting 43% mortality (18 patients) compares favorably with those reported from the larger university hospitals. A review of cases suggests that a successful surgical outcome depends on many variable factors, but speed in diagnosis and operation still remain the mainstays of success. Since a survival rate of 98% for elective aneurysm resection was obtained in 100 patients during the same eight-year period, we proposed a diligent search for all asymptomatic aneurysms and elective resection.

Dermatomyositis and associated lesions of the gastrointestinal tract.

Dermatomyositis is an uncommon disease which produces, in addition to its well-known skin and musculoskeletal symptoms, variable gastrointestinal complaints. When it first appears in adult life a diligent search should be made for an associated neoplasm, since they occur in more than 50 per cent of such patients over 40 years of age.

What Points Are Equidistant from Two Skew Lines?

One spring my twelfth-grade analytic geometry students were restless. They were surfeited with the bite-sized pieces of theory parceled out in their text. What they needed was an interesting problem whose solution would require them to organize and fit together some of the facts they had been learning. This required a fairly diligent search, but we finally located the necessary problem. The statement of this problem has the double advantage of being brief and easy to understand. I found the problem intriguing myself. Here it is: Find the points equidistant from two skew lines. (Two lines in space are skew if they do not lie in a single plane.)

Age Estimation, Growth Rates, and Population Structure in Missouri Bullfrogs

vocal sac; ovary packed with heavily pigmented eggs each approximately 1.5 mm in diameter. Skin of head not co-ossified with skull, roof of skull not exostosed. Dimensions.-Head and body 57.0 mm; head length 20.5 mm; head width 19.8 mm; femur 32.3 mm; tibia 32.2 mm; heel-to-toe 40.0 mm; hand 17.0 mm. Color in alcohol.-A dingy white with tiny melanophores scattered over all dorsal surfaces but restricted to a narrow band on top of the thigh. Notes.-When we examined this specimen in Paramaribo just a few weeks after it was preserved it still retained some of the dark green dorsal pigmentation it had in life but by the time it was shipped to us from Pittsburgh nearly a year later the green coloration had completely faded and all that remained of pigment or pattern was minute, scattered melanophores on the dorsum and dorsal surfaces of the limbs. These have the effect of making the specimen a dirty white rather than clear milky white. The type was taken at night from a large aroid plant beside a house in the Arawak village of Powakka. A diligent search by five of us in the same area a few weeks later failed to turn up any more specimens. Mr. Walter Polder of Paramaribo, who is well acquainted with the local fauna, told us that he caught an individual of what he believes is the same species in the suburbs of Paramaribo but that it escaped before he was ready to preserve it. The type-specimen is filled with mature, pigmented eggs and apparently was ready for amplexus. The species is named in honor of our friend, Murray de la Fuente, who collected the type.

Familial endocrine adenomatosis with associated zollinger-ellison syndrome: Wermer's syndrome

A case of Wermer's syndrome with a familial background of islet cell adenocarcinoma is presented. The need for a diligent search for such multiple endocrine adenomas is stressed. A brief review of the literature is followed by a discussion of surgical treatment.

Nunc Dimittis

John Robert Smyth, Professor Emeritus of Poultry Science at the University of Maine, Orono, died at a Bangor hospital on August 9. He had retired from the University in 1961, after nearly 32 years as Head of the Department of Poultry Science.“Prof.” Smyth, as he was affectionately known by his thousands of friends and former students, was an exceptional teacher and counselor. He guided hundreds of poultry majors through their college programs to later positions in graduate schools and industry. Many of the opportunities for placement of majors in poultry science were the result of his diligent search for suitable positions. He received recognition by his fellow teachers in the Poultry Science Association in 1959 when he was awarded the Ralston Purina Resident Award of a plaque and $1,000.00.As Head of the Department of Poultry Science, Prof. Smyth directed poultry research and publication of results of the Maine .

Recurring St. Louis encephalitis virus infection at an urban homesite.

THE serial outbreaks of urban St. Louis encephalitis in Florida, starting in Miami in 19581 and then occurring in the cities adjacent to Tampa Bay in 1959, 1961 and 1962,2 , 3 indicated great activity of St. Louis encephalitis virus within the State. It was not determined whether the episodes reflected the presence of the virus then resident within the region, annually amplified and disseminated, or, alternatively, resulted from seasonal reintroduction of virus by migratory birds. At the time of the 1962 Tampa Bay outbreak we detected only 1 case of St. Louis encephalitis in Miami despite diligent search.4 , 5 This case, however, . . .

Chronic Urethrocystitis In Women

To the Editor:— In Treatment of the Urethral Syndrome in Women ( 184 :984, 1963), Robert Zufall, MD, described a group of patients with urinary frequency, dysuria, and other symptoms of inflammation of the lower urinary tract in whom corroborative physical and laboratory findings were minimal if not absent altogether. He wrote, The urethra has been commonly blamed for this syndrome, and many experienced observers find urethral stenosis, edema, hyperemia, granularity, polyps at the neck of the bladder, or exudate on the trigone, but noted himself, For the majority of patients in this series, diligent search revealed nothing at all different from the urethras, bladder necks, and trigones of patients who were cystoscoped for unrelated conditions, who had no 'urethral' symptoms. About one third of his patients improved for more than 12 weeks with any form of treatment tried, including intramuscular injections of sterile water. To determine quantitatively whether or not

Tryptophan metabolites in hypoglycemia associated with neoplasia.

Studies on tryptophan metabolites in the blood and urine of 5 additional patients having symptoms of hypoglycemia associated with neoplasia are reported. Three patients having islet cell tumors and hypoglycemia had normal levels of tryptophan metabolites in the blood and urine during hypoglycemia. A patient with metastatic carcinoma of the breast and a patient with metastatic adrenal carcinoma also had normal values for tryptophan metabolites in the blood and urine during hypoglycemia. These patients are compared with 2 previously reported patients who had extrapancreatic neoplasms, hypoglycemia and high levels of tryptophan metabolites in the blood and urine. The findings suggest that, when a patient has high levels of tryptophan metabolites in the blood and urine during hypoglycemia, a diligent search for extrapancreatic neoplasm should be undertaken. When tryptophan metabolites in the blood and urine are normal during hypoglycemia, a careful search for an islet cell neoplasm is indicated.

Redescription of Amphisbaena pretrei Dumeril and Bibron and A. leucocephala Peters, with a Discussion of Their Relation and Synonymy (Amphisbaenia: Reptilia)

The present paper reviews A. pretrei on the basis of available specimens, including the types of three of the four named forms. It shows that the names subocularis and brachyura belong properly in the synonymy of pretrei. It speculates on the status of A. leucocephala, which represents either a southern race or a distinct species, but leaves the form species inquirenda. INTRODUCTION Amphisbaena pretrei Dumeril and Bibron, 1839, was described on the basis of two specimens collected by M. Poyer in Bresil. It was characterized by the high number of body annuli and precloacal pores and by the presence of a small preocular segment (between supralabial and prefrontal). Guichenot's report (1855) on the Castelnau collection first listed Bahia as a definite locality for this form. Three other forms must be referred to here. A. subocularis and A. leucocephala were both described by Peters (1878) based upon specimens from Pernambuco and Bahia respectively. A. brachyura was described by Amaral (1932) based on a specimen with an apparently autotomized tail from Maceio, Alagoas. He relied primarily upon the shortness of the tail and the shape of the occipital segments and compared the form only with A. mertensi Strauch. Amaral later (1937) placed both A. subocularis and A. leucocephala into the synonymy of A. pretrei. Few other recent references to these names exist except in collection reports and checklists, probably due to the scarcity of material in collections; diligent search disclosed only 40 specimens of this grouping, of which 12 lack all data, and ten others are assigned to states only. Distributional records are shown in Figure 1. I am grateful to the following curators of institutions (identified by abbreviations in parentheses) for loan of specimens in their care: Alice G. C. Grandison, British Museum (Natural History) (BM); Alan Leviton, California Academy of Sciences (CAS); Hymen Marx and Robert F. Inger, Chicago Natural History Museum (CNHM); Paulo E. Vanzolini and A. Stanley Rand of the Departmento de Zoologia, Sao Paulo (DZ); Lucia Rossi, Istituto e Museo di Zoologia della Universita di Torino (IMZUT); F. W. Braestrup, Universitetets Zoologiske Museum, Copenhagen (KM); Ernest E. Williams, Museum of Comparative Zoology (MCZ); Jean Guibe, Museum National d'Histoire Naturelle, Paris (MHNP); Antenor L. de Carvalho, Museu Nacional, Rio de Janeiro (MN); L. 0. Capocaccia, Museo Civico di Storia Naturale Giacomo Doria, Genoa (MSNG); Doris M. Cochran, United States National Museum 1 Notes on Amphisbaenids. 18.

With the Wandering Regiment: The Diary of Captain Ralph Ely of the Eighth Michigan Infantry , and: Back Home in Oneida: Hermon Clarke and His Letters , and: Dear Belle: Letters from a Cadet & Officer to His Sweetheart, 1858-1865 (review)

308CIVIL WAB HISTOBT seaports. In all of these ports but Galveston, torpedoes were an important part of the defense. The bibliography is adequate but not exhaustive. One wishes that a more diligent search had been made of available manuscript sources. For example, Mr. Perry cites Record Group 109 (War Department Collection of Confederate Records) in the National Archives, but he apparently failed to find or use a very lengthy (over sixty pages) document written by Francis Lee concerning his activities in building torpedo boats. The diary of General George A. Mercer (Southern Historical Collection, University of North Carolina) sheds some light on the origin of spar torpedoes. The illustrations are excellent particularly the photos taken of various torpedoes in the collection of the West Point Museum. An appendix on Union vessels sunk or damaged by mines is also included. Wtlliam N. Stell, Jr. Mississippi State College for Women With the Wandering Regiment: The Diary of Captain Ralph Ely of the Eighth Michigan Infantry. Edited by George M. Blackburn. (Mount Pleasant: Central Michigan University Press, 1965. Pp. 73.) Back Home in Oneida: Herman Clarke and His Letters. By Harry F. Jackson and Thomas F. OOonnelL (Syracuse, N.Y.: Syracuse University Press, 1965. Pp. ix, 212. $6.00.) Dear Belle: Letters from a Cadet 6- Officer to His Sweetheart, 18581865 . Edited by Catherine S. Crary. (Middletown, Conn.: Wesleyan University Press, 1965. Pp. xviii, 256. $5.95.) One of the principal dividends of the now-concluded Civil War Centennial was the discovery of a number of unpublished soldiers' reminiscences. Some of the collections unearthed and printed—such as the journals of Colonel Charles S. Wainwright and the letters of General Robert McAllister-wüI stand as reference works for years to come. Others are but pleasant footnotes to the saga of Civil War GI's. These three works under review belong to the latter class. Ralph Ely was a farmer residing near Alma, Michigan, at war's outset In May, 1861, he joined the 8th Michigan Infantry as a captain; he eventually attained the rank of brigadier general Ely's first service was with Thomas W. Sherman's expedition in South Carolina. The farmer-turned-soldier next joined the newly formed Ninth Corps and fought with Bumside at Antietam , Knoxville, and in the final campaigns for Richmond. Unfortunately, the diary inexplicably ends with an April 1, 1864, entry. For the most part, Ely's journal of military service consists of short daily notations that tend to be meaningless and too often are monotonous. Typical of such entries is that for November 15, 1861: "Company on guard at the Fort I remained BOOKREVIEWS309 at camp writing home." Even Ely's summary of Antietam runs to but nine hues. The letters are well-edited, and the annotation is exceptionally good; but the lack of an index seriously restricts the usefulness of a diary that is more a brief travelogue than an incisive commentary on war. Back Home in Oneida is a narrative history based on the seventy-two letters of Hermon Clarke, a central New York farmer who managed to avoid the magnetisms of war for a year. Then, in August 1862, the twenty-fouryear -old Clarke left his region for the first time and journeyed southward with the 117th New York Infantry. After initial duty in the Washington defenses, the regiment participated in the Suffolk, Fort Wagner, Bermuda Hundred, and Petersburg campaigns. Clarke's letters to his family are highly observant treatises on officers, movements, country scenes and people. Of General B. F. ("Beast") Butler, for example, Clarke wrote: "Butler may be a very smart man in some things, but if I have got to fight I want to do it under a man that knows more about war than he does." A basic weakness in this work is its format Authors Jackson and ????nell contributed as much—if not more—text than did Clarke. The book seems undeservedly padded. Needed annotation for many points in Clarke's letters is missing. The publisher also contributed to the shortcomings by omitting an index. In short, Back Home in Oneida may make a good volume for popular consumption, but it lacks the makeup to be a...

The Essentialty of Boron for Dryopteris dentata and Selaginella apoda

The essentiality of boron for angiosperms has been recognized for about 50 years, but, despite a diligent search of the literature, the authors are unaware of any investigation of a possible requirement of boron for Pteridophytes. In order to determine whether any of the Pteridophytes require boron, a true fern, Dryopteris dentata (Forsk.) C. Chr., and a club moss, Selaginella apoda (L.) Fern., were selected. For the former, very small sporophytes, with well-developed roots and a degenerating prothallus still present, were obtained in the University greenhouses. For the latter, terminal pieces of growth, approximately 5 cm. in length, were collected, taking care to use pieces whose aerial roots had not made contact with the soil. This precaution avoided the necessity of removing soil particles which might have contained boron. Both types of plants were raised on quartz sand in plastic containers. The sand had been treated with 10% sulfuric acid, and then thoroughly leached with demineralized water and, later, quartz-distilled water. Quartz-distilled water was also used in the nutrient solutions. The cultures were placed under a plastic-covered frame in the greenhouse to increase the humidity around the young plants and to prevent possible contamination of boron from dust or from the tap water spray applied to nearby plants. The four stock solutions contained 0.5M concentrations of

THE PREVENTION OF CHRONIC PYELONEPHRITIS.

SUMMARYThere seems to be a definite relationship between urinary tract infection in childhood and chronic pyelonephritis in the adult. The infection may become established in the renal parenchyma of a child and become apparent only after puberty when it is recognised by a late sign such as uraemia, hypertension, or flare‐up of active infection during pregnancy. A survey utilising cinefluorographic voiding cysto‐urethrography and direct cystometry made on 186 children resulted in positive findings in 103. The majority of these children appeared to have a dysfunction of the bladder outlet similar to that not infrequently seen in the gastric pylorus, oesophagocardial junction and ureteropelvic junction. Correction of this defect by myotomy resulted in improvement in the clinical picture, bacteriological findings, cinefluorographic appearance of the outlet and voiding pressures in most of the children. Reimplantation of ureters which demonstrated vesicoureteral reflux was successful as determined by voiding cysto‐urethrography and bacteriological study.Prevention of chronic pyelonephritis can be best accomplished by a diligent search for the lesions predisposing to and facilitating infection in children and correction of these when they are found.

Telemedicine: Is Ben a Boon?

To the Editor:— The old saying that nothing is so bad there isn't some good in it may even be true of TVmedicitis (A New 'Disease', JAMA 187 :307 [Jan 25] 1964). A foreignborn woman on whom 1 operated had a cholecystectomy and stones were removed from the common bile duct. Unfortunately, in spite of a diligent search and the use of cholangiography during the operation, a stone was left in the duct. The resulting biliary fistula was a source of great concern to the patient and her family, and with each visit to the office no effort was made to conceal their dissatisfaction with the way the operation had been performed. My repeated explanation of how it all happened was made noeasier by the presence of some language difficulty. Finally the day came when the decision for a second operation had to be made. To my surprise the patient's

Histology and Cytochemistry of Human Skin: XXIV. Further Observations on the Axillary Organ

In contrast to the usual fragmentary material used for studying the skin of the axilla, we have heen able to survey a large number of specimens, removed at the same time, from selected subjects of comparable age and sex, and the material treated exactly alike and at the same time. This wealth of excellent specimens has given new dimension to our understanding of the sweat glands of the axilla. We are now able to point up many of the older observations, and to reemphasize those details which have been largely neglected. The skin of the axilla is unique for the study of both apocrine and eccrine sweat glands. Nowhere else on the body are these glands so intimately associated, and in no other animals is this mixed population of sweat glands so plentiful. There is here further documentation of the fact that the axillary apocrine sweat glands of the Negro are surrounded by varying numbers of nerves that contain acetylcholinesterase (Montagna and Ellis 1). After diligent search and improved technics, however, we have also found such nerves around some of the apocrine glands of Caucasian subjects.

Comparison of Modern and Ancient Beaches, Central Georgia Coast: GEOLOGICAL NOTES

Although not many ancient beaches have been described from the geologic record, they are environmentally significant and worthy of diligent search. Characteristics of a modern beach at Sapelo Island, Georgia, as seen in section are illustrated and compared with a similar Pleistocene beach 5 mi inland. In general the stratification of the beach conforms to the slope of the beach surface. Individual laminae are thin, parallel, and may be traced for several feet. Departures from parallelism of surface and stratification occur in areas of bar and trough development and near the beach crest. In general, the seaward dip of beach stratification in this area is less than 4 degrees . The upper limit of the diagnostic burrow features made by the marine decapod Callianassa major Say marks the approximate position of mean sea level in both the modern and Pleistocene beaches.

On Rational Decision Making

The occasion of this meeting marks one more incident in peaceful international existence. The very spirit of the meeting itself, in which intellectuals and managers of different nations meet to discuss their mutual problems, is a sign of our times. We of Canada and the USA have learned to develop sound international relationships just as we are learning to establish sound relationships between science and management. Management science and the profession of operations research are both based on the general supposition that sound relationships between different parties in a decision making situation do exist and can be found by diligent search and research. We follow the pathway of a great historical precedent, which generally goes under the name of rationalism. The precedent says that sound relationships between different parties in a decision making situation can be established by means of reason. It goes on to say that reason is something that all men share, and that when men come to understand clearly, they inevitably will decide in the same ways. Management Technology, ISSN 0542-4917, was published as a separate journal from 1960 to 1964. In 1965 it was merged into Management Science.

A Disquisition on Punch and Judy Attributed to Charles Lamb

TN JANUARY and February of I837, a little more than two years after 1 the death of Charles Lamb, there appeared in the pages of the Monthly Repository a long essay entitled Analytical Disquisition on Punch and Judy' followed by the statement Found among the Papers of the late Charles Lamb' It may be recognized at the outset that this phrase does not necessarily mean this essay was written by Lamb; however, such an inference can certainly be drawn. This essay has never been collected with Lamb's works, nor has any biographer or commentator on Lamb taken any notice of it in print. So far as I am aware, only one scholar has pointed out the existence of the essay, and that not in connection with Lamb but as a bright spot in the periodical.2 A diligent search of contemporary newspapers and periodicals has failed to produce any reference to this essay. Had there been any question in the minds of Lamb's associates as to its authenticity, some such query or objection might well be expected to have appeared in the periodical press. Because of Lamb's habit of using his letters as a sort of proving ground for the expression of ideas that later went into the formation of some of his essays, one would think that some mention of the subject of this essay would be found in his correspondence; there is none in those letters written by Lamb which survive. It might further be expected that some reference to this treatment of the puppet show would be made in the rather considerable literature that has appeared on the subject; again, I have found no such reference. One very good reason why no such references were made in 1837 or since, by either Lamb's associates, Lamb students, or devotees of the puppet show, is that the Monthly Repository was not what one

On certain identities involving basic spinors and curvature spinors

The spinor analysis of Infeld and van der Waerden [1] is particularly well suited to the transcription of given flat space wave equations into forms which constitute possible generalizations appropriate to Riemann spaces [2]. The basic elements of this calculus are (i) the skew-symmetric spinor Γμν, (ii) the hermitian tensor-spinor σκ(img)ν(generalized Pauli matrices), and (iii) the curvature spinor Ρμνκι. When one deals with wave equations in Riemann spaces V4 one is apt to be confronted with expressions of somewhat bewildering appearance in so far as they may involve products of a large number of σ-symbols many of the indices of which may be paired in all sorts of ways either with each other or with the indices of the components of the curvature spinors. Such expressions are generally capable of great simplification, but how the latter may be achieved is often far from obvious. It is the purpose of this paper to present a number of useful relations between basic tensors and spinors, commonly known relations being taken for granted [3], [4], [5]. That some of these new relations appear as more or less trivial consequences of elementary identities is largely the result of a diligent search for their simplest derivation, once they had been obtained in more roundabout ways.

Liatris provincialis, sp. nov., (Compositae), Endemic in Western Florida

Liatris provincialis is newly described from western Florida. It is allied with the three species of Series Pauciflorae and is most nearly like L. chapmanii. L. provincialis, so far as now known, is restricted to Franklin and Wakulla counties, Florida. (Illustrated.) Gaiser (1946) in her revision of 'the North American genus Liatris states that of the thirty-two species recognized by her the largest number for a single state, 12, occurrs in Florida. Three of the twelve are endemic in Florida: L. garberi A. Gray, L. pauciflora Pursh, and L. laevigata Nutt. L. garberi and L. laevigata are restricted to peninsular Florida, whereas, L. pauciflora occurs generally across rthe northern part of the state and in the upper peninsula. The distinctiveness of the plant described below was first noticed when it was observed in great abundance on sand dunes along the Gulf of Mexico between Lighthouse Point and Peninsular Point, Franklin County. There it occurred from the crest of the fore dunes shoreward on more stabilized dunes and into the evergreen oak-sand pine scrub adjacent. This area is a small narrow peninsula more or less paralleling the mainland on the seaward side of Alligator Harbor and is sometimes referred to as Alligator Peninsula. Later the plant was found to occur in evergreen oak-sand pine scrub along the coast from nearby Ochlockonee Bay generally southwestward to Carabelle and a little beyond, a distance of about 30 miles; also on sandy ridges of turkey oak-longleaf pline about two miles back from the coast in this vicinity and for about two milesnorth of Ochlockonee Bay in the vicinity of Panacea. Diligent search in areas of coastal dunes and evergreen oak-sand pine scrub near the Gulf westward of the Apalachicola River and on sandy ridges of turkey oak-longleaf pine elsewhere throughout the Florida Panhandle failed to reveal any other places of occurrence for this new Liatris. Liatris provincialis Godfrey, sp. nov. Fig. 1 Liatris chapmanii affinis, sed capitulis (plerumque lato-divaricatis nec anguste adscendentibus) flosculisque minoribus. Cormi variabilis globosi vel ovales vel unco-elongati. Caules solitarii vel plures ad 8 dm alti simplices vel pauci-vel multiramosi striati dense breviterque 1 This investigation was supported (in part) by a research grant, RG-6305, to the author from the Division of General Medical Sciences, Public Health