Aix-les-Bains and Barcelona Our attention has been drawn to an ankylosing disease of the spine developing in old people, with a painless onset and clinical, pathological, and radiological features distinguishing it from ankylosing spondylitis. Some descriptions of anatomical specimens in the literature seem similar to those we have found, but no clinical or radiological studies on this subject have been published. Leri (1904) describes pathological changes in the spine of a patient suffering from a condition to which Marie and Astie (1897) gave the rather unsatisfactory name of " heredo-traumatic kyphosis of Bechterew ", and these coincide with our observations; but in Leri's case the patient, an old man, had an angular kyphosis of the Kummel-Verneuil type consequent upon a fall. Meyer and Forster (1938) have described a similar anatomical condition under the name of "moniliform hyperostosis " affecting the right side of the dorsal spine. Oppenheimer (1942) noticed some ossification of vertebral ligaments in old people without involvement of the joint facets. These patients had adequate vertebral mobility and no symptoms. He considered that these features belonged to the type of ossification associated with ankylosing spondylitis. Lacapere (1949) in his study of osteophytosis of the spine in dried bones often mentions outgrowths which he calls " melorheostosis of the spine ", a term that may lead to confusion with the disease described under this name by Leri. The anatomical description given by Lacapere coincides roughly with those of the other writers and also with that here presented. Present Investigations The clinical and radiological study of nine cases, combined with necropsy findings in two specimens, has enabled us to set out some of the clinical, pathological, and radiological features, and to form a picture of a specific condition among the ankylosing diseases of the spine. Clinical Examination Age.-The disease has been seen only in persons between 50 and 73 years of age (average 65), an incidence quite different from that of ankylosing spondylitis, which is usually seen in young and middle-aged persons. The age of onset is difficult to fix precisely (except in cases with a clear history of trauma) in view of the insidious evolution of the disease. * This paper was presented at the joint meeting of the Ligue Frangaise contre le Rhumatisme and the Heberden Society held in Paris, June, 1950.

SUMMARY Seven patients (five male and two female) with chronic renal failure (CRF) treated by periodical haemodialysis presented with swelling and effusion of more than three months' duration in knees (four bilateral), shoulders (two, one of them bilateral), elbow (one), and ankle (one). Four had a carpal tunnel syndrome both clinically and electromyographically (three bilateral). All patients had hyperparathyroidism secondary to their CRF, which was not due to amyloidosis in any of them. The dialysis duration period varied from five to 14 years, with an average of 8-6 years. Amyloid deposits (Congo red positive.areas with green birefringence under polarising microscopy) were shown in six of the seven synovial biopsy specimens of the knee, in five of the sediments of the synovial fluids, and in specimens removed during carpal tunnel syndrome surgery. No amyloid was found in the biopsy specimen of abdominal fat of six of the patients. The finding of amyloid only in the synovial membrane and fluid, and carpal tunnel, its absence in abdominal fat, and the lack of other manifestations of generalised amyloidosis (cardiomyopathy, malabsorption syndrome, macroglossia, etc.) and of Bence Jones myeloma (protein immunoelectrophoresis normal) raises the possibility that this is a form of amyloidosis which is peculiar to CRF treated by periodical haemodialysis.

From 1927 to 1955 a series of 174 consecutive cases of brucellosis due to Brucella melitensis (sometimes called "Malta fever") was studied at the Barcelona University Medical Clinic of Prof. A. Pedro Pons. The duration and intensity of each case varied, but all showed or had shown a stage of acute brucellosis on which the clinical diagnosis was based. The laboratory diagnosis was based on the sero-agglutination, blood culture, intradermal reaction, and, in the latter cases, on the complementfixation test and the test of incomplete antibodies.Osteo-articular signs appeared in 148 cases (85 per cent.). This figure is about the same as that given by other writers who have studied this organism (Cantaloube, 1911; Ruiz Castafieda, 1954; Betoulieres and Maleki, 1948;Rimbaud and Serre, 1947), whereas it is clearly above those obtained by writers studying brucellosis produced by Br. suis (Hardy, 1929(Hardy, , 1937Harris, 1950), and far above those found by writers studying the disease produced by Br. abortus (Hardy, 1929;Dalrymple-Champneys, 1935 Sylvest, 1951).Sex.-Our series comprised 130 men and 44 women. Osteo-articular signs appeared in 89 per cent. of the men and in only 67 per cent. of the women; this greater incidence in men was due to a greater incidence of vertebral lesions.Age.-The locomotor system was more frequently affected in patients over 50 years of age, and the invasion of the spinal column was also more frequent in elderly people.Site Dechaume, 1930;Harris, 1950).

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SUMMARY Fifty one patients with ankylosing spondylitis (AS) were typed for HLA-A, B, C, DR, and DO antigens. The antigen frequencies were compared with those of a normal population and with a B27 positive control group. All but one of the patients with AS were HLA-B27 positive. A positive linkage disequilibrium between Cwl, Cw2, DR1, and the B27 antigen was observed. Patients with AS showed a significant increase in DQw2 antigen compared with the B27 positive control group. No differences in antigenic frequencies were observed in patients having peripheral arthritis and patients with only axial involvement. Seven out of nine patients (78%) with an erosive peripheral arthritis were DR7 positive, suggesting that DR7 or genes closely linked could be related with a more aggressive peripheral joint involvement in patients with AS.