INHIBITION OF TRANSPLANTABLE MOUSE TUMOR GROWTH BY TISSUE EXTRACTS AND THEIR PROTEIN FRACTIONS

1. Mammary tissue of pregnant rabbits is found to contain an agent which inhibits the growth of Bashford Adenocarcinoma 63 in mice but this material is without effect on the Crocker Sarcoma 180. 2. Of the tissues so far studied the mammary gland of rabbits has yielded the most active product. 3. From the results it is probable that pregnancy enhances the production of the agent but this cannot be considered as established beyond doubt. 4. The factor is found, with diminished activity, only in the protein fraction obtained from the aqueous extract by full saturation with ammonium sulfate.     

Embryoma of the kidney (Wilms' tumor)

To summarize this subject of embryoma of the kidney which unfortunately carries such a poor prognosis, one usually has to deal with a somewhat pale, fretful, young child running a silent, painless, symptomless course finally coming for a check-up, or because of an accidently discovered abdominal mass whose surface is smooth but nodular and extending one-half to two-thirds down one or other of the flanks. The differential diagnosis is briefly considered and the treatment of preoperative irradiation followed by surgical excision discussed.An almost classical text book type of case is reported; however, the usually fatal outcome came a little more abruptly than was anticipated and was thought, because of the operative finding, to be due to massive metastatic pulmonary embolus. The treatment with no evidence of metastasis is nephrectomy with or without preoperative irradiation, the latter still somewhat of a moot pointEmbryoma of the kidney carries a grave prognosis, death within a few years at best.     

AN ELECTRON MICROSCOPE STUDY OF ISOLATED MITOCHONDRIA : METHOD AND PRELIMINARY RESULTS

1. The present paper constitutes a preliminary study of the morphology of mitochondria by means of electron microscopy. 2. The mitochondria that were the subject of this investigation were obtained from a lymphosarcoma of the rat. They were separated from the other components of the leukemic cells by a method of differential centrifugation, and thus made available for direct examination in the electron microscope. 3. In the purified form the mitochondria appeared as spherical bodies, the majority of them varying in size approximately from 0.6 to 1.3 µ in diameter. 4. Certain aspects of mitochondria in the electron microscope suggest that these elements are surrounded by a differentiated membrane. In some cases the limiting membrane seemed to be responsible for maintaining the general shape of the mitochondria, even when most of the mitochondrial substance had been lost. 5. By means of the electron microscope, it is possible to distinguish small elements, 80 to 100 mµ in diameter, within the body of certain mitochondria. Further work is suggested to establish whether these small granules are normal constituents of mitochondria, and what relation may exist between them and ordinary microsomes. 6. The nature of mitochondria as morphological units is discussed. Present evidence indicates that mitochondria constitute definite physical entities which can persist in the absence of the cytoplasm.     

Benefits of implementing a rapid access clinic in a high-volume inflammatory bowel disease center:Access,resource utilization and outcomes

BACKGROUND Emergency situations in inflammatory bowel diseases(IBD)put significant burden on both the patient and the healthcare system.AIM To prospectively measure Quality-of-Care indicators and resource utilization after the implementation of the new rapid access clinic service(RAC)at a tertiary IBD center.METHODS Patient access,resource utilization and outcome parameters were collected from consecutive patients contacting the RAC between July 2017 and March 2019 in this observational study.For comparing resource utilization and healthcare costs,emergency department(ED)visits of IBD patients with no access to RAC services were evaluated between January 2018 and January 2019.Time to appointment,diagnostic methods,change in medical therapy,unplanned ED visits,hospitalizations and surgical admissions were calculated and compared.RESULTS 488 patients(Crohn’s disease:68.4%/ulcerative colitis:31.6%)contacted the RAC with a valid medical reason.Median time to visit with an IBD specialist following the index contact was 2 d.Patients had objective clinical and laboratory assessment(C-reactive protein and fecal calprotectin in 91%and 73%).Fast-track colonoscopy/sigmoidoscopy was performed in 24.6%of the patients,while computed tomography/magnetic resonance imaging in only 8.1%.Medical therapy was changed in 54.4%.ED visits within 30 d following the RAC visit occurred in 8.8%(unplanned ED visit rate:5.9%).Diagnostic procedures and resource utilization at the ED(n=135 patients)were substantially different compared to RAC users:Abdominal computed tomography was more frequent(65.7%,P<0.001),coupled with multiple specialist consults,more frequent hospital admission(P<0.001),higher steroid initiation(P<0.001).Average medical cost estimates of diagnostic procedures and services per patient was$403 CAD vs$1885 CAD comparing all RAC and ED visits.CONCLUSION Implementation of a RAC improved patient care by facilitating easier access to IBD specific medical care,optimized resource utilization and helped avoiding ED visits and subsequent hospitalizations.