55

JAMES BRUCE JOHNSTONM.B. Aberd., F.R.C.S.E., F.R.A.C.S.

Dr Johnston, formerly associate professor of surgeryat the University of New South Wales, died on April 27at the age of 54.

He was born at Towie, Glenkindie, in Aberdeenshire andgraduated from the University of Aberdeen in 1947, winningthe Murray gold medal and fellowship for the most dis-

tinguished medical graduate. His talents as a cardiothoracicsurgeon were developed at the Mayo Clinic and this trainingwas emphasised during his senior registrarship at the Bromp-ton Hospital, where he was first assistant to Sir Clement PriceThomas. From there he went to the University of New SouthWales to accept the challenge of designing and developing aunit for cardiothoracic surgery within the new medical schoolat the Prince Henry Hospital.He was responsible for setting up a surgical team for the

clinical service, which included a heavy commitment to a res-piratory unit and the establishment of a hyperbaric unit in thehospital. His research was inventive and thorough and hemade significant contributions in the areas of profoundhypothermia, prosthetics, thrombosis, and pasdiatric cardi-

ology. In 1968 he completed a world tour for the evaluationof cardiac transplantation. Shortly after his return to Austra-lia, a serious illness forced him to retire. This disability did notdampen his spirit; rather it seemed to calm that restless cour-age with which he had applied himself to cardiac surgery withsuch remarkable skill. In 1974 he returned to the United King-dom to live in Sussex. He will be remembered as a generousand dedicated Scottish doctor as well as a pioneer of open-heart surgery. He leaves a widow, three daughters, and twocnnc

G.F.M.

A service of thanksgiving for the late Dr Alan Trevor Jones,former Provost of the Welsh National School of Medicine, willbe held in the University Hospital of Wales Chapel, HeathPark, Cardiff on Thursday, July 19,1979 at 12 noon.

International Diary

lst international conference on Sexuality and Disability: SussexUniversity, July 10-13, 1979. (Ann Darnborough, 42 Fulready Road,London E 10 6DU).

Conference on Endocrinology ’79: Royal College of Physicians,London, July 16-19, 1979. (Conference Secretary, Endocrinology ’79,Endocrine Unit, Royal Postgraduate Medical School, Ducane Road,London W120HS.)

17th meeting of European Association Against Virus Diseases:Munich, Sept. 5-7, 1979. (Professor F. Deinhardt, Pettenkofer-Insti-tut, Pettenkoferstrasse 9a, D 8000 Munchen 2, West Germany).

International conference on Atypical Myobacteria: Denver, Sept.5-8, 1979. Conference on Management of Asthma and OtherChronic Lung Disease: Denver, Oct 7, 1979. (Conference Director,Office of Regional Seminars, National Jewish Hospital/NationalAsthma Center, 3800 East Colfax Avenue, Denver, Colorado 80206,U.S.A.).

14th Harden conference on the Delivery and Targetting ofTherapeutic Agents with Particular Reference to Liposomes:Wye College, Ashford, Kent, Sept. 9-14, 1979. 15th Harden confer-ence on Sequence Organisation and Transcription in Eukaryotes:Wye College, Sept. 16-21, 1979. (Meetings Officer, Biochemical So-ciety, 7 Warwick Court, High Holborn, London WCIR 5DP.)

Symposium on Addiction : Biochemical Aspects of Dependenceand Brain Damage: Magdalen College, Oxford, Sept. 13-14, 1979.(Miss Nina Little, Alcohol Education Centre, 99 Denmark Hill, Lon-don SE58AZ.)

Notes and News

REDUCING POLLUTION FROM ROAD VEHICLES

MOTOR vehicle manufacturers in the West are being pushedsimultaneously in two directions. The restriction of oil supplieshas stepped up the need for fuel economy, while public concernabout the health effects of air pollution has been backed up byever more stringent legislation to govern exhaust emissions. Ata workshop on pollution from road vehicles held by theNational Clean Air Society at the University of Warwick inApril, it became clear that these demands frequently conflict.Analysis of exhaust emissions reveals a formidable array ofsubstances. Many have biological effects, in the Ames test forexample, but in the concentrations emitted from exhausts onlyoxides of nitrogen (NOJ, carbon monoxide (CO), unburnthydrocarbons, and lead qualify at present as possibly harmfulto health. Road vehicles contribute massively to the concentra-tions of these substances in the urban air, accounting for 90%of airborne lead and CO, 30% of hydrocarbons, and 25% ofN0. Evidence of the clinical effects of these substances toooften may have been judged uncritically but in the face ofdemands to reduce their emission, what can be done? The pro-duction of CO, N0, and hydrocarbons is a function of the air/fuel ratio at which the engine runs. The levels of all three pol-lutants can be reduced if the mixture is sufficiently rich in fuelto give theoretically complete combustion, and the exhaust isrun through a catalyst to reduce CO and NOx to CO2,nitrogen, and water. This strategy is adopted in the

U.S.A.-indeed, it is the only way to achieve the emissionlevels demanded by the pollution laws, which were enactedfirst in California to cope with the photochemical smog prob-lem and are now, inappropriately some say, applicablecountrywide. But catalysts are poisoned by lead-based anti-knock additives in petrol, so that the octane number of Ameri-can fuel is low, forcing lower compression ratios, low effi-

ciency, and wasteful fuel consumption. The progressivereduction in emission over the next few years which isdemanded by the less harsh European regulations will beachievable without catalysts, by running engines on a mixturelow in fuel. Because of the low temperature of combustion theemission level of N0, although not the other pollutants, willbe high. New engines are being designed to reduce this levelbut they are still at the prototype stage; among the leaders,Ford have only just started to get their version into produc-tion. The necessary investment has been prolonged and willhave to be recouped in the selling price, which will be furtherraised by the sophisticated fuel injection and ignition systemsthese new engines will need. So pollution from road vehicles,and thus its potential health risks, can be reduced, but notwithout loss of efficiency of fuel consumption or increased costto the motorist.

CLOSURE OF MIGRAINE CLINIC

THE decision by the Migraine Trust to close the PrincessMargaret Migraine Clinic in Charterhouse Square, London, atthe end of the year reflects the financial difficulties faced bymany privately funded organisations in the U.K. Acting onprofessional advice, the trustees reluctantly decided that "toogreat a proportion" of the Trust’s income was being spent onthe unit-the running costs amount to some 55 000 perannum. They were advised that the N.H.S. should assumefinancial responsibility for the treatment of present patients atthe clinic, and agreed that the clinic would close on Dec. 24,1979. In 1976 the D.H.S.S. gave the clinic an annual grant-in-aid of 10 000, which came to an end in April, and theD.H.S.S., the regional board, and the area health authoritydecided to withdraw their support (although the Department

56

has given a grant-in-aid of L15 000 to cover the non-researchcosts of the clinic until its lease expires at the end of the year).The clinic was founded in 1970 and was the first of its kind

to treat and observe patients during an acute attack of

migraine. Research carried out by the director, Dr Marcia Wil-kinson, and a small team has been concerned with the manage-ment of an attack, recognition and prevention of ergotamineintoxication, and the trial of prophylactic agents. The clinichas also collaborated in research with the department of clini-cal pharmacology at St Bartholomew’s Hospital and with theWellcome Foundation on catecholamines and platelet functionin relation to migraine. In addition to providing a base for theorganisation of research, the clinic offers access to largenumbers of well-documented patients with chronic and acutemigraine. Its premises in the City of London have been a valu-able centre for the observation and treatment of acute

migrainous attacks in people working in the small area

(between 5 and 8 patients are treated for acute migraine eachweek). Over 4000 patients receive treatment for chronic andacute migraine each year, of whom about 1500 are new pa-tients. Many are referred by G.P.S from other parts of thecountry.

In a letter to the Daily Telegraph (June 16) deploring theclosure of the clinic, Dr Wilkinson and Prof. Paul Turner, pro-fessor of clinical pharmacology at Barts, argue that the annualcost of running the clinic could be found, "thus enabling thisservice to migraine sufferers to continue--shared perhaps bya grant from the Department of Health and Social Security topatients and partly by money from the pharmaceutical com-panies and the Migraine Trust for continuing research". Theyhope that the trustees will reverse their decision "so that treat-ment and research can be furthered into this distressing condi-tion".

WARNING ABOUT BRAZILIAN CORNED BEEF

THE Department of Health and Social Security has hadreports of six incidents of staphylococcal food-poisoning, in-volving 25 people, associated with the consumption of cornedbeef produced at a Brazilian cannery. Investigations at thiscannery have disclosed deficiencies which cast doubt on the

safety of its products imported into the UK. These products(corned beef in 12 oz and 6 lb cans and ox tongue in 6 lb cans)are marketed under various brand names. They can be identi-fied by the embossed code at one end of the can which includesthe marking BRAZIL SIF2.

REFERENCES IN THE LANCET

WITH a few lapses of the teething-trouble type, all sectionsof this week’s Lancet carry references in the so-called Van-couver style. Details are given in our issue of Feb. 24, the maindepartures from previous Lancet practice being the provisionof the titles of papers and book chapters, the inclusion of thenames of book publishers, and the provision of the first andlast pages of a cited paper or chapter. Typescripts should havetheir references set out in this way. No contribution to the

journal will be rejected solely on the grounds of non-confor-mity with the Vancouver style.

Awards for Medical JournalistsThe 1979 annual awards for medical journalists, sponsored

by Reckitt & Colman Pharmaceutical Division in conjunctionwith the Medical Journalists Association, have been made toRobert Eagle, for his book Alternative Medicine-A Guide tothe Medical Underground; Colin Tudge, for his column

"Scavenger" in World Medicine; and Isabel Walker, for herreporting of medical politics in General Practitioner.

University of Birmingham Professor John Stuart hasbeen appointed head of a newdepartment of haematologyfrom Oct. 1 1979. The new

department has been made pos-sible by a grant of L110 000from the Leukaemia ResearchFund.

i Professor Stuart has held pre-vious appointments in Edinburghand London as well as visiting fel-lowships in the Universities of

Cambridge and California. He is amember of the Medical ResearchCouncil working party on adultleukaemia and the medical advisorypanel of the Leukaemia ResearchFund. He has been an honoraryprofessor of haematology at Birm-ingham since January this year.

Welsh National School of Medicine

Dr Robert Harvard Davis

has been appointed as theSchool’s first professor of

general practice.He graduated from the Univer-

sity of Oxford and Guy’s Hospitalin 1947. Following house appoint-ments, he became a principal ingeneral practice in Cardiff, and in1968 he became senior lecturer in

general practice and honorary di-rector of the general-practice unitof the Welsh National School ofMedicine. In 1977 he was

appointed to a readership in theUniversity of Wales.

The annual conference of the British Student Health Associationwill take place on July 15-20, 1979 at the University of Manchester.Details may be had from Dr M. S. Bourne, University Student Health iService, University of Manchester, Crawford House, Precinct Centre, Oxford Road, Manchester M13 9QS. ,

The British Association for Psychopharmacology will hold a sum-mer meeting at Birmingham University on July 16-17, 1979. Detailsmay be had from Dr David Wheatley, 325 Staines Road, TwickenhamTW2 SAX.

Correction

Gastric Cancer in Patients Who Have Taken Cimetidine.-We

apologise to Dr P. W. Mullen for errors in his letter (June 30, p. 1406).Reference 5 is Douglass M L et al.] Soc Cosmet Chem 1978,29,581;reference 6 should have read Goldberg M L et al. Biochem BiophysRes Commun 1975, 62, 320.

Diary of the Week

JULY 8 TO 14Wednesday, llthNORTHWICK PARK HOSPITAL, Watford Road, Harrow, Middlesex HA1 3UJ

1 P.M. Dr C. Booth: The Use of Gluten-free Diets.ROYAL COLLEGE OF SURGEONS OF EDINBURGH, 18 Nicolson Street, Edinburgh

EH89DW4.30 P.M. Dr John Sturrock: The Edinburgh Royal Maternity and Simpson

Memorial Hospital 1879-1939. (Sir James Young Simpsonlecture.)

Friday, 13thROYAL COLLEGE OF SURGEONS OF EDINBURGH

4.30 P.M. (Queen Elizabeth Military Hospital, Woolwich.) Major-GeneraN. G. Kirby: How Fertile the Blood of Warriors. (McCombelectUre