Summary Forty‐two patients with chronic lymphocytic leukaemia (CLL), serum IgG levels < 5.5 g/l and a history of two or more recent infections, were randomized to receive infusions of 18 g human intravenous immunoglobulin (IVIg) or human albumin placebo every three weeks. During the 12 month study 122 infections were documented but only four were associated with neutropenia. Ten patients (24%) with IgG levels < 3.0 g/1 experienced 65% of the infections. In response to IVIg there were immediate and accumulative increases in serum IgG levels and an associated decrease in total and serious infections. If three further infections occurred, placebo patients were commenced on 18 g IVIg, and IVIg patients were increased to 24 g IVIg. Approximately 50% of these cases subsequently remained infection free. The study shows the usefulness of prophylactic Sandoglobulin in CLL patients with hypogammaglobulinaemia, and suggests that this may be justified in those with recurrent infections and serum IgG levels < 3 g/1.

Thin films of elemental iron and nickel, plus a wide composition range of iron-nickel alloys, have been deposited by atmospheric pressure metal organic chemical vapor deposition at a growth temperature of 200 "C, using iron pentacarbonyl and nickel tetracarbonyl as the source precursors. Detailed magnetoresistance measurements of the permalloy layers showed that the maximum value of magnetoresistance occurred at a composition of approximately 90 %Nil0 %Fe, and the maximum sensitivity occurred at approximately 80 %Ni20 %Fe, in accordance with literature values. In addition, both the application of an 80 mT magnetic field during deposition and the annealing of samples at temperatures higher than the growth temperature of 200 "C improved the magnetic properties

Different exercise protocols elicit variable transcriptional responses in key exercise relevant genes in equine skeletal muscle due to variation in metabolic demand.

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Segmental colonic transit has been measured in 101 patients. Two MBq of ll'Indium absorbed on resin pellets and encapsulated in an enteric coated capsule was given at 700 am. Hourly images during the first day, and three images during each subsequent day were acquired for up to three days. Using all scan and patient data the scans were categorised in one of the five patterns of colonic transit: normal, rapid, right delay, left delay, or generalised delay. The geometric centres and per cent activity at each time point was compared between the five groups of colonic transit patients to find the best time for imaging and so to distinguish the five groups. During the first day, early images did not help in diagnosis of patterns of transit, however, in the later images (six hours onwards after the ingestion of the activity) the rapid transit groups could be identified. Images at 27 and 51 hours were both required to distinguish all five groups of patients from each other. Only in the 'normal' transit patients was there some excretion of the activity during the course of the second day, otherwise there was no difference in the images taken in the course of a day (second or third day). A simplified protocol requires a minimum of three images to distinguish all five patterns of colonic transit. The activity should be ingested in the morning (7 00 am) and the first image taken at the end of the working day (8-10 hours after ingestion), the second image on the morning of the second day, and the third image during the course of the third day. This simple protocol would provide all the clinically relevant information necessary for correct classification of the colonic transit. (Gut 1994; 35: 976-981) There has been an increasing interest in the assessment of normal and abnormal large bowel function using manometric, electrophysiological, volumetric, x ray, and scintigraphic methods, some of which are invasive and most are time and labour intensive. 1-3 Radiology has established itself as the main method of measurement of colonic transit. Elaborate x ray techniques, however, have been abandoned in favour of simplified tests for routine clinical use.4 Scintigraphy is one of the least invasive of these procedures, and yet can supply clinicians with important functional information.5 6 As with many new investigations the early protocols entail extensive monitoring over prolonged time to obtain the fullest possible information.5 7 Krevsky et al has instilled radioactivity directly into the caecum.7 This permits detailed and accurate measurement of the transit through the colon. It may not be entirely physiological, however, because of intubation and it is not practical for routine clinical use. Most other studies5 6 8 have used multiple imaging during the first day followed by several images in the following three to seven days. Some centres have already used a simplified method for clinical practice,9 but there is no study that evaluates and rationalises the use of this simplified method for routine colonic transit s...