Completed questionnaires were received from 208 patients on whom 245 operations for ingrowing toenails had been performed at King's College Hospital. Avulsion of a strip of nail had an 83 per cent recurrence rate, total nail avulsion 70 per cent, Zadik operations 28 per cent and wedge resections 29 per cent. It is recommended that immediate avulsion of ingrown toenails should not be a routine practice.

This work suggests that in many patients with IBS there is a physical ano-rectal disorder amenable to physical treatment. Patients with IBS should all be proctoscoped carefully, with and without the patient straining, looking for abnormalities. Correcting mucosal prolapse and other anal problems produced an improvement in IBS symptoms in 86% of patients. This suggests that ano-enteric reflexes are a significant factor in irritable bowel syndrome, if not the major cause.

No abstract

The very fit man had the highest rise, from 0 9 to 10 9 ,ug/I. In contrast, the level in the older Greek runner remained virtually unchanged (0-8 and 1-0 ,g/l). Our investigation confirms the significant rise of plasma GH previously reported after physical exercise.'-3 This work is one of a series of studies on the effects of physical exercise on plasma hormones and muscular metabolism. We hope to find tests to distinguish in advance between men who are fit enough to run the marathon and those for whom it may be dangerous.4 That such tests may be necessary has already been demonstrated by the case of Philippides, the dispatch-runner who died on arrival at Athens after the Battle of Marathon on 22