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the Census; and because they are professionals they acceptthe blame for the wrong answers that their survey revealed.It is less easy for doctors, trained in other disciplines, torealise that even what appears to be a sensible questionmay yield a misleading answer.

TUBERCULOSIS IN HONG KONG

THE eradication of tuberculosis throughout the worldis now medically possible. But the emergence of moreand more tubercle bacilli resistant to the older anti-tuberculous drugs makes the clinical trial of new drugsof continuing importance. It is not now justifiable totreat any patient with active tuberculosis by a single drug,so trials of new drugs must be carried out by comparativemethods. An important comparison recently reported 1

by Citron is that carried out by the research committeeof the British Tuberculosis Association and the tuberculosisservices in Hong Kong.Treatment with ethionamide and isoniazid was com-

pared with treatment with p-aminosalicylic acid andisoniazid. 136 tuberculosis patients in Hong Kong weretreated daily with either 500 mg. of ethionamide and 300 mg.of isoniazid or 12 g. of p-aminosalicylic acid and 300 mg.of isoniazid. All had sputum cultures initially sensitiveto the drugs being given. The two groups were similarin age, sex, and bacteriological condition. The ethion-amide group had slightly more cavitation. After twenty-eight weeks’ treatment, 810 of the group receivingethionamide and isoniazid and 87 °o of the groupreceiving p-aminosalicylic acid and isoniazid were

sputum-negative. At fifty-two weeks the respectivefigures were 85",, and 87%. These are percentages ofthe number initially accepted for treatment and thereforetake count of those patients withdrawn for reasons suchas drug resistance or toxicity as well as for treatmentfailure. In fact both drug regimens were well tolerated,and differences in the two as regards radiographicimprovement and weight gain were not great. After one

year’s treatment 92",, of all the 149 patients who hadstarted treatment were sputum-negative on culture.The conclusion is that 500 mg. of ethionamide and

300 mg. of isoniazid given in a single daily dose arehighly effective in the treatment of newly diagnosedpulmonary tuberculosis in which cultures are sensitive tothese drugs.

ANÆSTHETIC-ROOMS

THE role of the ansesthetic-room and its architecturalfeatures were discussed at a meeting on Jan. 27 at theHospital Centre in London, attended by anxsthetists,architects, administrators, and others concerned in the

hospital rebuilding programme. The policy of the

Ministry of Health to provide an anxsthetic-room forevery operating-room must be carried out if the needs ofpatients and anxsthetists are to be met and the risk ofcross-infection is to be curtailed.

The most important requirement for the patient inthese days of light premedication is a quiet room, wherethe atmosphere is not too clinical, and the lighting is subduedexcept at certain focal points. A straight trolley-run fromentrance to operating-room is advisable, but the roommust not be regarded as the natural entrance to the

operating-room for all and sundry. The anaesthetist

1 Tuberc, Lond. 1964, 45, 229.

needs a room where he is in control and in which there is

plenty of space to manoeuvre: figures of up to 290 sq. ft.are now being recommended. Local storage of equipmentsuits British methods far better than the American" cart system " and central storage. A case was madefor performing all preliminaries to the operation in theanaesthetic-room, to ensure the least possible disturbanceof the atmosphere in the operating-room. The meetingemphasised the need to break away from the traditionalutilitarian decor.

VIRAL INHIBITION OF MOUSE LEUKÆMIA

Molomut et al.1 reports a virus active against a trans-plantable mouse lymphoid leukaemia and Ehrlich’s ascitescarcinoma, thus adding another to the list of oncolyticviruses. Apart from the intrinsic interest in these agents,there is always the hope that they may be useful in thetreatment of malignancy.The unidentified virus described by Molomut et al.

has a lymphocytopenic action in vivo. It was isolated froma non-tumour-producing line of Ehrlich’s ascites carcinomamaintained in tissue culture. When inoculated into adultmice it initiates an acute infection in 7-10 days, withreduction of lymphocytes in lymph-nodes, thymus, andspleen. There is also some fatty degeneration of the liverand a slight ascites. When a lymphoid leukxmia, originallyinduced by treating mice with the carcinogen 3,4,9,10-dibenzpyrene, is transplanted into normal mice, it causesdeath of the host in 7-12 days, according to the numberof leukaemic cells introduced. Molomut et al. infectedmice with a standard dose of lymphocytopenic virus atthe time they implanted leukaemic cells. Control animals

given 500 cells were all dead in 12 days: half the animalsgiven 500 cells plus virus survived; and in the other groups,given virus and larger numbers of cells (up to 5 million),the median survival-time was longer, by a third or more,than in controls given leukaemic cells only. Mice givenvirus and Ehrlich’s ascites carcinoma cells also had a

longer survival-time as well as some complete remissions.Mice which had recovered from infection by the lympho-cytopenic virus were immune to a second infection but fullysusceptible to the lymphoid leukaemia.

Experimental work, much of it undertaken by Loveand his collaborators, has shown that such diverse virusesas Newcastle disease, Coxsackie B3, and several of thearthropod-borne viruses can be so adapted, by serial

passage through the appropriate tumour, that they becomestrongly oncolytic. Clearly, however, many factors mustbe considered before embarking on treatment of cancerby selective infection with viruses. The patient should, ofcourse, not be put in hazard by the virus infection; norshould the possible efficacy of other methods of treatmentbe jeopardised. Tests of virus therapy have, reasonably,been confined to patients with advanced and even inoper-able cancer. The chance of a cure may be better if thenumber of malignant cells to be destroyed is not enor-

mously large. During many replication cycles in a tumourmass it is not improbable that virus and malignant cellsmay become so adapted as to abolish the destructive

potential of the virus, with the establishment of either achronic or a latent infection. Such infections have beeninduced experimentally in cell cultures by balancing virusagainst antibody and interferon. Although antibody hasto be introduced into the experimental system, we must, in

1. Molomut, N., Padnos, M., Gross, L., Satory, V. Nature, Lond. 1964,204, 1003.