Years Of Clinical Observation Research Articles

Histological evaluation of esophageal mucosa in children with acid gastroesophageal reflux.

histological evaluation of esophageal mucosa in children, with regard to the duration of primary acid gastroesophageal reflux (GER) and acid GER secondary to cow's milk allergy and/or other food allergy (CMA/FA) (prospective study). 264 children of both sexes suspected of GER were enrolled in the study. The age of examined children was 1.5-102 months, mean age 20.78+/-17.23 months. Pathological acid GER was confirmed with pH-monitoring in 138 children (52.3%). Taking into consideration complex differential diagnosis, including oral food challenge test with potentially noxious nutrient (open or blind study), children were assigned into study groups 1 and 2 (primary and secondary GER). Group 1: 76 patients (28.8%) aged 4-102 months (x=25.2+/-27.28 months) with primary GER. Group 2: 62 patients (23.5%) aged 4-74 months (x=21.53+/-17.79 months) with GER secondary to CMA/FA. Children with GERD underwent preliminary and control (after 1 year and 2 years of GERD diagnosis) endoscopic examination of the upper gastroinestinal tract. Intensity of esophagitis was assessed initially in 25 children from group 1 (32.9%), in 29 children from group 2 (46.8%), and in 9 children from group 3 - reference group (28.1%). Histological evaluation revealed infiltration of inflammatory cells, mainly neutrophils and intraepithelial lymphocytes, and also eosinophils in 10 children (13.2%) with primary GER. Infiltration of eosinophils and lymphocytes was found in 5 children (8.1%) with secondary GER. In 8 children (25.0%) with food allergy there were only lymphocytes. Infiltration of neutrophils and lymphocytes and basal zone hyperplasia or infiltration of eosinophils and lymphocytes with elongation of lamina propria papillae was found in 10 children (13.1%) with primary GER and in 20 children (32.2%) with secondary GER. Differentiation of particular types of inflammatory cells in mucosal infiltration characterized histological picture in the following way: neutrophils in 21 children (27.6%) with primary GER, eosinophils in 22 children (35.5%) with secondary GER, lymphocytes in 15 children (19.7%) in children with primary GER and in 15 children (24.2%) with secondary GER. Histological examination of esophageal mucosa after 1 and 2 years of clinical observation and periodical conservative treatment in children with primary and secondary GER revealed significant alleviation of inflammatory abnormalities (with regard to the type of abnormalities and the number of particular types of inflammatory cells). The value of histological findings obtained in own studies comprises the role of food allergy in pathogenesis of GER and is related to GER's contribution, both direct (primary reflux) and indirect (secondary reflux), to triggering off morphological results and clinical outcomes of esophagitis.

Adalimumab safety in global clinical trials of patients with Crohnʼs disease

Adalimumab, a fully human anti-tumor necrosis factor (anti-TNF) monoclonal antibody, is approved for the treatment of Crohn's disease (CD) in adults. We evaluated the overall safety profile of adalimumab in global clinical trials in patients with CD. Patients who participated in these trials, which included randomized induction and maintenance trials, Phase IIIb trials, and open-label extension studies, had moderately to severely active CD and were evaluated for safety at regular intervals. Rates of adverse events of interest were assessed per 100-patient-years of adalimumab exposure. Standardized mortality rates and standardized incidence rates (for malignancies) were calculated using population-matched data. As of April 15, 2008, 3160 patients with CD had been treated with adalimumab in clinical trials, representing 3401.9 patient-years of adalimumab exposure. Serious infection was the most frequently reported serious adverse event of interest in the CD trials; abscess (intraabdominal and gastrointestinal related) was the most common serious infection. Low incidences of malignancies, lymphomas, opportunistic infections (including tuberculosis), demyelinating disorders, and lupus-like disorders were reported in the CD trials. The standardized mortality rate for adalimumab-treated patients with CD, 0.44 (95% confidence interval [CI], 0.12-1.12), is less than the rate of 1.52 (95% CI, 1.32-1.74) reported in a recent meta-analysis of patients with CD. The safety profile of adalimumab in patients with CD was similar to that of other TNF antagonists in CD populations, and the rates of adverse events were comparable to other approved indications for adalimumab spanning >10 years of clinical observation. No new safety signals were identified.

Persistent Hyperprolactinemia and Bilateral Galactocele in a Male Infant

Galactocele is a benign breast lesion, usually occurring in nursing women. This lesion is a rare cause of breast enlargement in children. In this paper we describe the case of an infant with hyperprolactinemia (which persisted throughout 15 years of clinical observation) and bilateral galactocele. We speculate that a congenital midline defect in our patient might have impaired the normal dopaminergic inhibitory tone on pituitary lactotroph cells, thus leading to an increased prolactin secretion by the pituitary gland; this, in turn, might have favored the development of the galactocele.

René J. Muller, Doing Psychiatry Wrong: A Critical and Prescriptive Look at a Faltering Profession

Doing Psychiatry Wrong: A Critical and Prescriptive Look at a Faltering Profession by Rene J. Muller powerfully challenges the current paradigm of mental illness. Muller’s arguments are the culmination of 10 years of clinical observation and frustration in three urban psychiatric hospitals. Muller successfully compels professionals of all levels of expertise to examine psychiatric diagnosis and treatment from what has become an unconventional angle. Muller reemphasizes the significance of the human being and free will into a practice that has become so heavily reliant on brain dysfunction. Initially, Muller describes the evolution of the Diagnostic and Statistical Manual of Mental Disorders. To support his arguments, Muller integrates various case examples. In addition, misconceptions about schizophrenia, bipolar disorder, paranoia, and depression are explained. Muller proposes a novel and refined method of conceptualizing mental disorders that emphasizes a dimensional approach. A major strength of Muller’s Doing Psychiatry Wrong: A Critical and Prescriptive Look at a Faltering Profession is the relevance of his perspective to a wide-range of individuals. In his writing, Muller is not afraid to go against the grain of current societal beliefs. The radical approach that Muller adopts gives his stories universal appeal. Although the arguments are most specifically directed towards psychiatrists and psychologists, all mental health and medical professionals may be influenced by Muller’s arguments. Furthermore, Muller’s perspective has the ability to challenge how mental health patients and lay members of society view personal struggles with mental illness. Muller effectively confronts the role of marketing and sales in the current conceptualization and treatment of mental illness. Consequently, Muller’s extreme arguments also have relevance to business and legal professionals. Muller’s perspective is supported by theory and knowledge gathered from various realms of scholarly work. He criticizes the current approach to mental diagnosis and treatment on the grounds that biology is overemphasized and psychology is underemphasized. In contrast, Muller successfully integrates theories of the mind, philosophical ideas, and biological science into a comprehensive theory. Muller manages to raise questions about the biological evidence being used to support current theories. Furthermore, Muller emphasizes that true understanding of mental disorders cannot be accomplished without accepting a multidisciplinary approach. In Doing Psychiatry Wrong, Muller effectively reintroduces the importance of understanding the distinctiveness of each patient. Muller argues that in psychiatric practice, human beings have been reduced to neurons and brain structures. Although Muller believes that symptoms are relevant to diagnosis, he argues that the meaning underlying symptoms is of greater importance. Muller suggests that symptoms should be understood before a diagnosis is given. In addition, he argues that patient motivation and free will should be assessed. Muller successfully emphasizes the importance that patients’ unique life stories have to a profession dedicated to helping individuals. In the final chapter of the book, Muller provides an alternative approach to diagnosis that can be implemented by psychologists or psychiatrists. Muller emphasizes a dimensional approach in his model. The guidelines provided are simple, straightforward, and encompass transtheoretical approaches. Despite the practicality of these A. L. Marquart (&) Psychology Department, Case Western Reserve University, Mather Memorial Building #103, 11220 Bellflower Road, Cleveland, OH 44106-7123, USA e-mail: Abby.marquart@gmail.com; abby.marquart@case.edu

Children with gender identity disorder: Is there a best practice?

Abstract Almost 50 years of clinical observation and research on children with gender identity disorder have provided useful information on phenomenology, diagnostic and assessment procedures, associated psychopathology, tests of etiological hypotheses, and natural history. In contrast, best practice guidelines and evidence-based therapeutics have lagged sorely behind these other domains. Accordingly, the therapist must rely on the “clinical wisdom” that has accumulated and to utilize largely untested case formulation conceptual models to inform treatment approaches and decisions. Because of this state of affairs, dogmatic assertions about best practice should be avoided.

A New Data-Based Motor Subtype Schema for Delirium

A New Data-Based Motor Subtype Schema for Delirium

Manometric study of lower esophageal sphincter in children with primary acid gastroesophageal reflux and acid gastroesophageal reflux secondary to food allergy

The comparison of values of selected lower esophageal sphincter (LES) manometric parameters measured in children suspected of gastroesophageal reflux disease (GERD) (preliminary study) and in children with primary acid GER and acid GER secondary to cow's milk allergy and/or other food (CMA/FA) in relation to the duration of the disease (prospective study). A 24-hour esophageal pH monitoring was performed on 264 children of both sexes suspected of GERD (mean age x=20.78+/-17.23 months). Pathological acid gastroesophageal reflux (GER) was diagnosed and divided into primary and secondary reflux in 138 children (52.3%). 76 patients (28.8%) (x=25.2+/-27.28 months) with primary GER made up Group 1. Group 2 consisted of 62 patients (23.5%) (x=21.53+/-17.79 months) with GER secondary to CMA/FA. 32 patients (12.1%) (x=23.7+/-12.63 months) with CMA/FA symptoms made up Group 3 (reference group). Prospective assessment of LES manometric parameters, i.e. resting LES pressure and LES length, was performed on 138 children with GER. Manometric parameters, resting LES pressure and LES length, measured at the preliminary study (0) and control studies (after 1, 2 and 8 years), were prospectively assessed in 138 children. The assessment resulted from clinical observation and/or conservative treatment. The mean value of resting LES pressure (mm Hg) before treatment was x=11.75+/-3.98 in Group 1, x=11.05+/-3.31 in Group 2, and x=14.17+/-3.86 in Group 3 (reference group). After 2 years of clinical observation, the mean value of resting LES pressure accounted for x=13.71+/-3.88 in Group 1, x=13.01+/-2.94 in Group 2, and x=17.92+/-3.36 in Group 3. The mean LES length (cm) before treatment accounted for x=1.68+/-0.72 in Group 1, x=1.78+/-0.70 in Group 2, and x=2.0+/-0.86 in Group 3. After 2 years of clinical observation, the mean LES length was x=2.80+/-0.40 in Group 1, x=2.76+/-0.40 in Group 2, and x=2.97+/-0.48 in Group 3. 12 children with persistent GERD (Group 1) and 8 children with persistent GERD and food allergy (Group 2) underwent manometric evaluation of LES after 8 years. No statistical differentiation of the mean values of resting LES pressure and LES length were shown in examined children of Groups 1 and 2 during prospective studies. Manometric studies of LES assessing only resting LES pressure and its length in the examined children with acid GER do not clearly differentiate GER into primary and secondary refluxes to food allergy.

Long-Term Follow-Up of Free-Floating Epithelial Inclusion Cyst After Radial Keratotomy

To report the benign seven year follow-up on a free-floating anterior chamber epithelial inclusion cyst that did not require treatment. Retrospective observational case report. Seven years of clinical observation of a patient who had radial keratotomy in 1998. The free-floating cyst showed no growth or untoward effects on the eye and required no treatment during the observation period. The long clinical course of our patient shows that epithelial inclusion cysts may be managed without treatment for many years with careful and frequent follow-up.

Combination chemotherapy with 5-fluorouracil, methotrexate and etoposide for patients with high-risk gestational trophoblastic tumors: A report based on our 11-year clinical experiences

To evaluate the efficacy, toxicity, and survival of patients with high-risk gestational trophoblastic tumors (GTTs) treated with the 5-fluorouracil (5-FU), methotrexate (MTX) and etoposide (VP-16) regimen. Between 1992 and 2003, 26 consecutive patients with FIGO-defined high-risk GTTs were treated with 5-FU, MTX and VP-16 regimen. Among them, 9 patients had received prior chemotherapy. Remission rate, causes of treatment failure, and toxicity were analyzed retrospectively. After treatment with 5-FU, MTX and VP-16 regimen, 21 of 26 gained complete respond (80.8%). Two patients were performed adjuvant hysterectomy and both cured ultimately. Five developed resistance (19.2%), and 1 died of widespread metastases (3.8%). All 5 patients who developed resistance were treated with multidrug regimen of etoposide, methotrexate, and actionmycin D alternating with cyclophosphamide and vincristine (the EMA/CO); 4 were salvaged and 1 died of refractory disease. No ones relapsed. WHO grade 4 leukocytopenia and thrombocytopenia with the 5-FU, MTX and VP-16 regimen occurred in 9.0% and 2.4%, respectively, of the total 167 cycles; other toxic effects were acceptable and manageable. With mean follow up of 37 months, neither relapse nor secondary tumor was observed. According to our 11 years of clinical observation, 5-FU, MTX and VP-16 chemotherapy is one of effective multiagent regimen for patients with high-risk GTTs. Its toxicity is mild and manageable. For patients with high-risk and refractory GTTs, this new triple salvage chemotherapy regimen may be an effective alternative.

Volkow May Have Uncovered Answer to Addiction Riddle

Volkow May Have Uncovered Answer to Addiction Riddle

Cardiovascular involvement in thalassaemic patients with Pseudoxanthoma elasticum‐like skin lesions: a long‐term follow‐up study

Congenital haemolytic anaemia may be associated with pseudoxanthoma elasticum (PXE)-like clinical manifestations. The cardiovascular system of 14 homozygous and double heterozygous beta-thalassaemia patients with skin and retinal vessel alterations similar to those in genetic PXE was analysed over a period of 12 years and compared with that of 13 relatives (five sets of parents, one single parent, two thalassaemic brothers), and that of the control group composed of 16, age- and sex-matched, thalassaemic patients. All patients with clinical PXE-like skin lesions exhibited, by light and electron microscopy, dermal alterations and mineralization of elastic fibres identical to those typical of inherited PXE. None of the relatives and none of the control group showed clinical or structural findings of PXE. The follow-up started in 1988. After 12 years of clinical observation, six patients showed dramatic progression of skin involvement, angioid streaks had progressed in two subjects. One patient had recurrent gastrointestinal bleeding and underwent partial stomach removal for gastric artery aneurysm, one underwent colon resection for intestinal infarct, one patient had a transitory ischaemic attack, one died after an intracranial haemorrhage, two patients died from cardiovascular disease and one from neoplasia. Thalassaemic patients with PXE-like skin lesions also manifest PXE-like vessel alterations that progress with time. Considering the severe outcome of these lesions, accurate monitoring should be routinely performed on the cardiovascular system of thalassaemic patients with PXE-like skin manifestations.

The Pathophysiology of Necrotizing Enterocolitis

After completing this article, readers should be able to: 1. Describe the basic epidemiologic aspects of neonatal enterocolitis (NEC). 2. List the major risk factors that predispose neonates to NEC. 3. Delineate the current views on the mechanisms involved in the pathogenesis of NEC. 4. Discuss the various models used to study NEC. 5. List the major mediators believed to be involved in the pathogenesis of NEC. Despite many years of clinical observation and experimental investigation, the pathogenesis of neonatal enterocolitis (NEC) remains elusive. The multifactorial theory suggests that four key risk factors—prematurity, formula feeding, intestinal ischemia, and bacterial colonization—are important prerequisites to the initiation of intestinal injury in neonates (Figure⇓ ). Current hypotheses suggest that these risk factors stimulate activation of the inflammatory cascade that ultimately results in the final common pathway of bowel necrosis that is the hallmark of neonatal NEC. Figure 1. Schematic of NEC pathomechanism. Prematurity is the most consistent and important risk factor associated with neonatal NEC. The disease occurs in 10% of babies born in the United States who weigh less than 1,500 g, but it is extraordinarily infrequent among term newborns and almost never is diagnosed in older infants or children. Furthermore, data clearly show that the more preterm the infant, the higher the risk of NEC. Nonetheless, the specific reason(s) for this particular predisposition are not well understood. Evidence from animal and human studies have shown significant differences between term and preterm neonates in several aspects of intestinal development and function. The mucosal barrier matures throughout gestation and even remains deficient in the term neonate during the first few weeks of life. It is well known that several mucosal enzymes and gastrointestinal hormones are suppressed or deficient in preterm animals/humans. Many aspects of the intestinal host defense system, a complex and important cascade responsible for limiting the invasion …

Prótese de carbono de disco basculante com revestimento de material biológico em posição mitral com baixa dose de anticoagulante oral: 3 anos de experiência

Introducao: Analise clinica apos tres anos de observacao com a valvula de disco Magalhaes - HP. Casuistica e metodos: Receberam alta hospitalar, a partir de 1994, um total de 34 pacientes. Todos os sobreviventes foram contatados nos ultimos tres meses e o tempo medio de observacao foi de 24,5 meses (variacao de 2 a 35 meses), somando 834 meses-paciente (69,5 anos-paciente). Resultados: A curva atuarial de sobrevida foi de 85,3%. Houve uma complicacao fatal nao relacionada com a valvula (insuficiencia renal) (0,98 por 100 pacientes-ano) (PCPA) e tres complicacoes fatais relacionadas com a valvula (trombose - 2,9 PCPA) (1 caso em outro hospital, 1 caso reoperado e 1 caso tratado por estreptoquinase com bom resultado inicial evoluindo com complicacao pulmonar). Houve tres complicacoes hemorragicas (2,94 PCPA) de importância, sendo uma fatal (0,98 PCPA), uma complicacao de grau moderado (0,98 PCPA) e 8 casos de menor importância (7,8 PCPA). Houve nove complicacoes nao fatais relacionadas com a valvula (8,8 PCPA): sopros, 6 casos (5,8 PCPA); Tromboembolismo sem sequela, 2 casos (1,96 PCPA); trombose, 1 caso (0,98 PCPA), reoperado com boa evolucao. Conclusao: O revestimento da valvula de disco com material biologico heterologo com uso de menor dose de anticoagulante parece reduzir apos o 1o ano a incidencia de trombose, tromboembolia e acidentes hemorragicos. Nos tres primeiros meses houve maior incidencia de trombose e acidentes hemorragicos devido a desvios no protocolo de anticoagulacao, quando ha necessidade de anticoagulacao plena e efetiva para propiciar minima deposicao de fibrina e cicatrizacao lenta e fina. A dose media semanal segura de fenprocumona foi de 4,5 comprimidos (minimo de 2,5 e maximo de 7 comprimidos). O excelente resultado nos tres ultimos anos de observacao clinica justifica plenamente o uso da valvula, porem redobrada atencao deve ser tomada nos tres primeiros meses para protecao anticoagulante efetiva.

Evans's Syndrome with Positive Lupus Anticoagulant and Antiphospholipid-Protein Antibodies

We report a case of a 34-year-old Caucasian man with Evans's syndrome, first manifested in childhood as autoimmune thrombocytopenia. Besides anti-erythrocyte antibodies and platelet-associated immunoglobulins, this patient's serum showed also the presence of antiphospholipid-protein antibodies detected by coagulometric (lupus anticoagulant) as well as immunoenzymatic methods (anticardiolipin, antiprothrombin, and anti-β2-glycoprotein I antibodies). Over 25 years of clinical observation the patient never experienced any thromboembolic events. We suggest that in the pathogenesis of Evans's syndrome and related disorders a major role is played by an autoimmune reaction with a predilection to various cell phospholipid-containing membrane structures, possibly damaged by a yet unknown primary insult. The significance of these various antiphospholipid-protein antibodies as predictors of thromboembolic complications in such patients remains, however, to be established. Key Words: Evans's syndrome-Lupus anticoagulant-Antiphospholipid-protein antibodies.

Asymptomatic oligoclonal CSF IgG and progressive increase of intrathecal IgG synthesis in a patient with myasthenia gravis treated with thymectomy — A 4-years follow-up

A young woman is described who had myasthenia gravis which was favourably influenced by thymectomy. Although there was no evidence for another neurological disease over 7.5 years of clinical observation and computed tomography as well as visual evoked response were normal, CSF studies over 0.5 years prior to and 3.5 years after thymectomy revealed persistent mononuclear pleocytosis, high CSF IgG index, oligoclonal IgG bands in CSF, and increasing IgG synthesis rate within the CNS, reflecting a continuous local humoral immune response. CSF/serum ratios of antibodies to acetylcholine receptors (AChR) were continuously lower than CSF/serum IgG ratios, contradicting intrathecal AChR antibody production. Proportion of total T cells was slightly higher in CSF than peripheral blood, while active T cells were lower in CSF. CSF lymphocytes did not proliferate on PHA stimulation but responded in allogeneic mixed lymphocyte culture. B cells were 4% in CSF and 4.5% in peripheral blood, but 227 IgG, 0 IgA and 0 IgM producing cells were detected among 20 × 10 3 CSF lymphocytes, compared to 5, 4 and 0 in 20 × 10 3 peripheral blood lymphocytes. This patient represents an in vivo ‘experiment’ regarding influence of thymectomy on CSF compartment constituents. The present study also shows that an individual can be clinically healthy despite continuous and pronounced intrathecal immune response.

Pleural Diseases

Pleural effusions are common in clinical medicine. Patients with pleural effusion may be seen by the internist (cardiologist, congestive heart failure; gastroenterologist, pancreatitis) or surgeon (cardiothoracic surgeon, post— cardiac injury syndrome; gynecologist, Meigs' syndrome). Indeed, pleural effusions are a mirror of systemic disease. Dr Light has written this book on pleural disease based on years of clinical observation and research. There are 24 chapters in this book, three chapters devoted to anatomy of the pleura, physiology of the pleural space, and radiology of pleural disease. An additional two chapters concentrate on clinical manifestations of pleural disease and the usefulness of pleural fluid analysis and the general approach to a patient with a pleural effusion. The two concluding chapters discuss thoracentesis, pleural biopsy, and chest tubes. In between there are chapters on the specific etiologies of pleural effusions covering the spectrum from congestive heart failure to malignant pleural effusions to chylothorax.

Three-year observation of a myasthenic syndrome concurrent with other autoimmune syndromes in a patient with thymoma

The authors present the results of 3 years of clinical observation and of concurrent immunopathological investigations in a case of myasthenia, in which skin lesions of pemphigus erythematosus and symptoms of lupus erythematosus developed soon after thymectomy. No correlation was demonstrated between the level of circulating antibodies on the one hand and the severity of the clinical myasthenic symptoms on the other. In spite of marked clinical improvement after thymectomy the titre of muscle antibodies did not decline; on the contrary it rose significantly at the time of the most pronounced clinical improvement after treatment with azathioprine (Imuran). The level of antibodies to the intercellular substance of the epidermis (“pemphigus” antibodies), however, clearly correlated with the intensity of the skin lesions and these antibodies are, in the authors' opinion, of pathogenetic significance, whereas the role of antibodies in myasthenia seems to be secondary. The diagnostic significance of nuclear antibodies, and the favourable therapeutic effect of Imuran are also discussed.

Diagnosis of biliary atresia: Relative accuracy of percutaneous liver biopsy, open liver biopsy, and operative cholangiography

Following necropsy or a minimum of three years of clinical observation an ultimate diagnosis of either biliary atresia or neonatal hepatitis was established in 108 infants with obstructive neonatal jaundice. In this group, the diagnostic accuracy of contemporary percutaneous (needle) liver biopsy and operative (open) liver biopsy was approximately the same. One third of the cases were not correctly identified. Operative cholangiograms usually dictated a correct course of clinical management, but 20 per cent suggested the incorrect diagnosis.

Untreated syphilis in the male Negro: X. Twenty years of clinical observation of untreated syphilitic and presumably nonsyphilitic groups

This report is one of a series in a continuing study of untreated syphilis in the male Negro by the United States Public Health Service. The study consists of 600 men who have been followed clinically, serologically, and pathologically (to post-mortem examination in over 63 per cent of the deceased patients). This study is unique because of the inclusion of nonsyphilitic individuals of comparable ages to the syphilitic patients at the onset of the study; furthermore, these “controls” have been followed as intensively for the past twenty years as have the syphilitic men. In this report, methods and problems in diagnosis of clinical syphilis are described as they were encountered in the collection of the statistical data obtained. Clinical findings are reported from physical examination, medical history, x-ray and fluoroscopy, serologic testing, electrocardiography, and neurologic examination; comparisons between syphilitic and nonsyphilitic individuals are shown usually by age groups; these comparisons have been subjected to statistical tests for significance. 1. 1. Findings in this study seem to confirm the impression that, in male Negroes with untreated syphilis, the cardiovascular system frequently is involved. 2. 2. Among the 23 living men who have developed some form of late syphilis, not one has received adequate therapy prior to the recent survey. 3. 3. Problems of diagnosis of syphilis among the aged are complex, especially in evaluating findings related to the cardiovascular system.

Untreated syphilis in the male Negro: Background and current status of patients in the Tuskegee study

1. 1. This report, one of a series relating to the effect of untreated acquired syphilis in the male Negro, contains a history of the study and a description of the current status of the study population. 2. 2. Included in the present study group are 408 syphilitic individuals and 192 nonsyphilitic controls who have maintained their status since the beginning of the study. Of the 408 in the syphilitic group, 51 per cent are living, 39 per cent are dead, and 10 per cent are of unknown status. In the nonsyphilitic group, 65 per cent are living, 26 per cent are dead, and 9 per cent are of unknown status. 3. 3. On the basis of the individuals examined during the 1951–1952 survey, it is estimated that 70 per cent of the syphilitic group have remained untreated, 22.5 per cent have had inadequate treatment, and 7.5 per cent have been adequately treated. However, in terms of man-years, the study represents an aggregate of 5,494.5 man-years of untreated disease, 122 man-years of inadequately treated disease, and 28.5 man-years of adequately treated disease. 4. 4. Physical examinations in this survey consisted of a review of the body systems, blood pressure determinations, funduscopic examinations, and neurologic examinations. Stethographic and electrocardiographic records were obtained on the patients. 5. 5. Blood was drawn from syphilitic and nonsyphilitic patients for VDRL and Kahn quantitative testing, as well as for the TPI test. 6. 6. This report has been prepared for the purpose of presenting information relating to the study group, which will serve as a basis for the discussion of the results of twenty years of clinical observation, to be presented in a subsequent report. 7