Compression bandages are normally applied for 6 weeks after sclerotherapy. The changes in pressure exerted by such bandages have been measured over 8 h. The results show that different surgeons applied bandages over a wide range of pressures but the range for each individual surgeon was surprisingly narrow. The pressure falls with time and approaches zero at 6--8 h of normal activity by the subject, but more slowly if the knee and ankle joints are excluded from the bandage. The initial pressures were higher when STD compression pads were used, although the rate at which the pressure fell was the same.

It is well known that on straight leg raising (Lasegue's test) traction is exerted on the sciatic nerve, the lumbo-sacral nerve roots, and the dura. The roots move through their intervertebral foramina for distances which may amount to several millimetres. If, however, dissection is made from the front instead of from the back (which is the usual approach) the course of the nerves and their changes with leg movements can be followed to the sciatic notch. This more extensive examination reveals several points not generally appreciated in descriptions of the sciatic nerve or in consideration ofthe significance of the straight-leg-raising test. In particular, it shows that nerve movements become progressively greater with increasing distance from the intervertebral foramina, and it establishes the existence of multiple points of pressure against the bone. Alterations in tension and the degree to which the roots are adherent to the intervertebral foramina are open to inspection. All of these changes can readily be examined and correlated with age. This paper incorporates the objective findings and the conclusions reached after a considerable number of dissections made by an anterior approach after routine necropsy, and it records measurements of the movements of those nerves commonly implicated in sciatic pain in a smaller series of 30 cases. TERMINOLOGYIn this paper the elements of the cauda equina are referred to as filia. From the point at which these evaginate the dural sheath around the cord to the point of fusion of the dorsal and ventral components distal to the ganglion, they are called roots. More distally again they are termed nerves, at first forming part of the lumbo-sacral plexus. The lumbosacral cord is that segment of the anterior primary division of the fifth lumbar nerve extending from the 'Present address: Pathology Department, Metropolitan General Hospital, Cleveland, Ohio, U.S.A. point at which it receives a contribution from the fourth lumbar nerve until its junction with the first sacral nerve, or that part of the fifth lumbar nerve which runs over the ala of the sacrum. MATERIAL AND METHODSCadavers were selected from routine necropsies as time and circumstance permitted. Although an attempt was made to obtain these as soon as possible after death and before refrigeration, a wide range of body temperatures was encountered, varying from warm fresh bodies to others which were very cold. Rigor mortis was present in varying degrees in most of these and had to be broken down by forcible ventroflexion of the hips and dorsiflexion of the knees. The ankles were not mobilized and were left at approximately 90 degrees to the leg.To retain anatomical stability and avoid loosening of the spinal dura, filia and nerve roots which, in the lumbosacral region, run with a ventral convexity in the spinal canal, and to afford exposure of the nerves running over the ala of the sacrum, a technique of anterior dissection with minimal interference to neural structures was devised. After removal of abdominal viscera, t...

A study was performed to determine whether the pressures routinely produced by bandaging for compression sclerotherapy of varicose veins are adequate to maintain the superficial veins almost empty of blood. The results suggest that well-applied bandages can provide sufficient support to combat the high distending pressures found in varicose veins. The large variation among different surgeons, however, indicates that any clinical assessment of compression sclerotherapy should include measurement of the pressure at which the bandages are applied.

adding a renin-depressing agent. The range where the pressure effect of the two drugs was uncorrelated to the PRA-levels (1-0-2 0 fig AI 1-' h-1) might represent the normal range of PRA.We conclude from this controlled investigation with propranolol and spironolactone in primary hypertension that both drugs have valuable antihypertensive properties, but their combination results in a further reduction in blood pressure. Our findings also support the concept that patients with high renin concentrations respond more favourably to beta-blocking agents-that is, propranolol-and that those with low renin concentrations respond better to spironolactone. The data also suggest that the renin-angiotensin-aldosterone system may be implicated in primary hypertension.We thank Mr Bo Bergman for skillful and painstaking statistical aid and Miss Inger Larsson for performing the PRA-determinations.Propranolol (Inderal), and propranolol placebo tablets were supplied by ICI Pharma AB, Gothenburg, and spironolactone (Aldactone) and spironolactone placebo tablets by G D Searle AB, Malmo, Sweden.