Gold salts have been used in the treatment of rheumatoid arthritis for nearly 40 years. Their effectiveness, while not consistent, has been well established (Freyberg, 1966) and their use continues. Recently, conflicting results concerning the effectiveness of gold salts on adjuvant arthritis in rats have been reported (Newbould, 1963;Jessop and Currey, 1968). Adjuvant arthritis, a crippling deformity resulting from diffuse connective tissue involvement, is considered by some authorities to be the best available experimental model of rheumatoid arthritis because of its strong clinical and pathological siinilarities to the human disease (Pearson, 1963) HINDLEG VOLUME This was determined by a modified method of VanArman, Begany, Miller, and Pless (1965). On the day of assay (3 to 4 hours after drug administration), the hindlegs were immersed to the anatomical hairline into a mercury reservoir. The mercury column was connected to a Statham pressure transducer (Model P23BB, 0-5 cm. Hg.). The output from the transducer was led through an amplifier to a Hewlett-Packard digital voltmeter (Model HP-3440A), and a high gain/auto range unit (Model 3443A), and finally to a digital recorder (Model J74562A). The digital recordings were calibrated, and a linear relationship between MV and ML was obtained by placing cylinders of known volumes into the mercury reservoir. ARTHRITIC SCOREThe severity of secondary lesions in the uninjected hindleg was graded 0 to 4, depending upon the area and magnitude of involvement. DRUG ADMINISTRATIONGold sodium thiomalate (Myocrysine() was prepared at various concentrations in 0 5 per cent. benzyl alcohol and injected intramuscularly (right thigh) in a volume of 0 5 ml./kg. The drug was administered once daily (exclusive of weekend days indicated in the text) starti either on Day 0 or one week before adjuvant injection and continuing until the termination of the experiment (Day 16). Control animals were treated in an identical manner using 0 5 per cent. benzyl alcohol for the intramuscular injections. The benzyl alcohol solution was prepared with either 0 * 9 per cent. saline or water for injection.The level of significant difference between hindleg volumes, arthritic score, and body weight of drug-treated and control groups was determined by the Student's 't' test. SERUM GOLD LEVELBlood samples were obtained after the decapitation of the adjuvant arthritic rats. 0 5 mJ. aliquot of serum was diluted to 3 0 ml. with distilled water and absorption measured in a Perkin-Elmer Model 303 atomic absorption spectrophotometer (wavelength 243 -3 mjt slit 4,

Studies on head injury-induced pituitary dysfunction are limited in number and conflicting results have been reported. To further clarify this issue, 29 consecutive patients (24 males), with severe (n = 21) or moderate (n = 8) head trauma, having a mean age of 37 ± 17 years were investigated in the immediate post-trauma period. All patients required mechanical ventilatory support for 8-55 days and were enrolled in the study within a few days before ICU discharge. Basal hormonal assessment included measurement of cortisol, corticotropin, free thyroxine (fT4), thyrotropin (TSH), testosterone (T) in men, estradiol (E2) in women, prolactin (PRL), and growth hormone (GH). Cortisol and GH levels were measured also after stimulation with 100 µg human corticotropin releasing hormone (hCRH) and 100 µg growth hormone releasing hormone (GHRH), respectively. Cortisol hyporesponsiveness was considered when peak cortisol concentration was less than 20 µg/dl following hCRH. TSH deficiency was diagnosed when a subnormal serum fT4 level was associated with a normal or low TSH. Hypogonadism was considered when T (males) or E2 (women) were below the local reference ranges, in the presence of normal PRL levels. Severe or partial GH deficiencies were defined as a peak GH below 3 µg/l or between 3 and 5 µg/l, respectively, after stimulation with GHRH. Twenty-one subnormal responses were found in 15 of the 29 patients (52%) tested; seven (24%) had hypogonadism, seven (24%) had cortisol hyporesponsiveness, five (17%) had hypothyroidism, and two patients (7%) had partial GH deficiency.These preliminary results suggest that a certain degree of hypopituitarism occurs in more than 50% of patients with moderate or severe head injury in the immediate post-trauma period, with cortisol hyporesponsiveness and hypogonadism being most common. Further studies are required to elucidate the pathogenesis of these abnormalities and to investigate whether they affect long-term morbidity. P2Cortisol reserve in head trauma victims: evaluation with the low-dose (1 µ µg) corticotropin (ACTH) stimulation test To investigate cortisol reserve in head trauma, 35 consecutive patients (30 men) with a mean age of 36 ± 16 years were studied 5-60 days after physical injury. Patients were enrolled in the study within a few days before ICU discharge. First, a morning blood sample was obtained to measure baseline cortisol, and ACTH plasma levels. Subsequently, 1 µg synthetic ACTH was injected intravenously and, 30 min later, a second blood sample was drawn to determine stimulated plasma cortisol. Patients having stimulated cortisol levels below 18 µg/dl were defined as nonresponders to the low-dose stimulation test (LDST). Mean (± SD) values for ACTH, baseline, and stimulated cortisol concentrations were 49 ± 27 pg/ml, 19.7 ± 5.5 µg/dl and 23.6 ± 6.7 µg/dl, respectively. Six of the 35 patients (17%) failed the LDST. Nonresponders were similar to responders with regard to age, gender, and severity of head injury. However, nonresponders more frequently required vasopres...