Edith E. Parris

THE growth of solid neoplasms is always accompanied by neovascularization. This new capillary growth is even more vigorous and continuous than a similar outgrowth of capillary sprouts observed in fresh wounds or in inflammation.1 Many workers have described the association between growing solid malignant tumors and new vessel growth.2 3 4 5 6 However, it has not been appreciated until the past few years that the population of tumor cells and the population of capillary endothelial cells within a neoplasm may constitute a highly integrated ecosystem. In this ecosystem the mitotic index of the two cell populations may depend upon each other. Tumor cells . . .

ALTHOUGH it has been known for over a century that fat is the principal storage form of energy, only in the past two decades have the physiologic mechanisms for its deposition and mobilization been partially clarified. Benedict,1 in his classic study on Mr. L., a normal man who over 50 years ago fasted experimentally for 30 days, noted that fat provided more than 75 per cent of the calories utilized after the first few days of food deprivation. He also observed a progressive decrease in daily urinary nitrogen excretion that suggested an increasing conservation of body protein. In this review . . .

ALTHOUGH we usually think of the small intestine in terms of its absorptive functions, it also has the capacity to secrete water and electrolytes. Its secretory capacity is impressively demonstrated by the diarrhea of cholera, which is almost entirely of small-bowel origin.1 An afflicted person at the height of his disease may excrete by rectum more than 1 liter of fluid every hour. It is not uncommon for patients to require fluid replacement in excess of their body weight over a period of several days.2 Probably an even greater amovint of fluid passes from the ileum into the colon, as . . .

STUDIES during the past decade have indicated that lysosomes mediate, at least in part, acute and chronic inflammation in joints.1 2 3 4 This association in no way implies that etiologic agents have been identified in human arthritis, except in such discrete entities as crystal-induced or infectious arthritis. Two main points have been appreciated, however. First of all, it is clear that materials present in lysosomes can provoke inflammation, tissue injury and breakdown of connective tissue. Secondly, it is the normal function of lysosomes, as part of the "vacuolar apparatus" described by DeDuve,5 to extrude enzymes from cells into surrounding tissues.Since many . . .

MODERN therapeutic agents have contributed favorably to the physician's ability to influence the course of many diseases. Their use has also created a formidable health problem: 18 to 30 per cent of all hospitalized patients have a drug reaction,1 , 2 and the duration of their hospitalization is about doubled as a consequence.1 2 3 4 In addition, 3 to 5 per cent of all admissions to hospitals are primarily for a drug reaction,1 , 5 and 30 per cent of these patients have a second reaction during their hospital stay. The economic consequences are staggering: one seventh of all hospital days is devoted to the care . . .