Pancreozymin in man as in animals appears to act as a specific enzyme stimulant. The preparations of pancreozymin used in these experiments also contain cholecystokinin, which causes the gall bladder to contract, and a smooth muscle stimulant, possibly substance P.The (Lagerlof, 1939(Lagerlof, , 1942 Diamond, Siegel, Gall, and Karlen, 1939;Diamond andSiegel, 1940, 1941;Comfort and Osterberg, 1940;Pratt, Brugsch, and Rostler, 1940;Pollard, Miller, and Brewer, 1942;Lake, 1947;Dornberger, Comfort, Wollaeger, and Power, 1948;Dreiling and Hollander, 1948, 1950;Friedman and Snape, 1950;Dreiling, 1950Dreiling, , 1951Dreiling, , 1953Dreiling, , 1955 Dreiling and Janowitz, 1957;Wenger and Raskin, 1958).In anaesthetized animals secretin produced a large volume of pancreatic juice of constant alkalinity and low enzyme content. Harper and Raper (1943) isolated from the small intestine a second material, other than secretin, which increased the enzyme output by the pancreas without affecting the volume of juice. This material they named pancreozymin. Crick, Harper, and Raper (1949) later published a revised method of preparing secretin and pancreozymin and preliminary experiments showed that pancreozymin had the same effect on man as in animals

Current therapy for condylomata acuminata (genital warts) is not consistently effective. Therefore, we conducted a randomized, double-blind trial to compare interferon alpha-2b with placebo in the treatment of this disorder. Our rationale was that interferon has both antiproliferative and antiviral properties. The placebo or interferon (1 X 10(6) IU) was injected directly into one to three warts three times weekly for three weeks. The injections were well tolerated by both groups of patients. The side effects of fever, chills, myalgia, headache, fatigue, and leukopenia occurred more commonly in the interferon group than in the placebo group, but such effects rarely disrupted daily routines. Only 13 of 296 patients (4 percent) discontinued therapy because of side effects (11 in the interferon group and 2 in the placebo group). Twenty-six other patients were excluded from analysis because of a loss to follow-up or other deviations from protocol, thus leaving 257 patients in the final evaluation. At one week after the completion of therapy, interferon had produced a large and significantly greater reduction in mean wart area (a 62.4 percent decrease), as compared with placebo (a 1.2 percent increase in mean area) (P less than 0.001). At the conclusion of the study (13 weeks after the completion of therapy), the mean wart area was still decreased 39.9 percent below the initial size in the interferon group, whereas it had increased by 46 percent over base-line measurements in the placebo group (P less than 0.001). At the same time, all treated warts had completely cleared in 36 percent of the interferon recipients and in 17 percent of the placebo recipients (P less than 0.001), whereas treated warts progressed in 13 percent of the interferon recipients and in 50 percent of the placebo recipients (P less than 0.001). We conclude that injection of interferon alpha-2b directly into genital warts appears to be an effective and fairly well-tolerated form of therapy.

Vulvitis chronica plasmacellularis (Zoon's vulvitis) is rare. We describe a case in whom all the typical features, as delineated by Zoon, are demonstrated.

Summary.We report a case of oral squamous cell carcinoma (SCC) originating in the buccal mucosa of an 18-year-old female patient with chronic graft-versus-host disease (GVHD) 9 years after HLA-identical sibling bone marrow transplantation (BMT) for Fanconi anaemia (FA). The case highlights the problems of malignant change in FA and also the increased risk of second malignancy after BMT. The literature is reviewed with regard to previous cases and the possible aetiology of tumour formation. A high index of suspicion to any epithelial lesion in FA is appropriate so that early diagnosis may lead to improved prognosis. Keywords:Fanconi anaemia, squamous cell carcinoma, bone marrow transplantation, immunosuppression, microvascular free flap.An 8-year-old girl presented with mild hypoplastic anaemia and was found to have FA after a positive mitomycin C stress test on peripheral blood lymphocytes. Her parents were not related and there was no family history of FA. She underwent BMT the following year with marrow donated by her HLAidentical sister who did not have FA. Pre-transplant conditioning consisted of low-dose cyclophosphamide (5 mg/kg/d × 4 d) and total body irradiation (TBI) 600 cGy, with oropharyngeal shielding. Severe acute GVHD of skin and gut was followed by chronic cutaneous and hepatic GVHD with an associated sicca syndrome. This was still being treated with cyclosporin A and azathioprine at age 18 years when the patient presented with a swollen right cheek and a large painful ulcer of the buccal mucosa. Biopsy confirmed a moderately well differentiated SCC. There was no clinical lymphadenopathy and nothing to suggest local or systemic dissemination. Full blood count was Hb 13 . 9 g/dl, WBC 7 . 1 × 10 9 /l, neutrophils 4 . 3 × 10 9 /l and platelets elevated at 436 × 10 9 /l. Chest X-ray was normal. A decision was made to treat surgically; the size and position of the tumour suggested that it was locally resectable, and it was considered desirable to avoid further radiotherapy or chemotherapy. The lesion of the right buccal mucosa was resected with a full thickness excision which included the right commissure and part of the maxillary alveolus with attached molar and premolar teeth. An ipsilateral supraomohyoid neck dissection was carried out. The intra-oral defect was reconstructed with a left radial forearm free flap. A full thickness abdominal skin graft was used to cover the arm donor site, and primary closure was achieved on the cheek. All the grafts remained viable and healed well, and the patient was discharged on the 15th post-operative day.Histopathological examination of the operative specimen showed a moderately differentiated invasive squamous cell carcinoma with perineural and vascular spread (Fig 1). The absence of lymphocytic response to tumour in the surrounding tissues was particularly striking. Histological features of chronic GVHD were evident in the buccal mucosa, though less than on the preoperative biopsy specimen. Two cervical lymph nodes contained metastatic deposits.One month after...

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