85 WOMEN IN MEDICINE: MRS CASTLE’S CONFERENCE SiR,—The Department of Health and Social Security organised a conference on Women in Medicine on July 4 and 5. Participation was by invitation only and consisted of representatives of the statutory bodies and, to quote a member of the D.H.S.S., of "people we know". A group of women doctors, concerned by the present lack of career prospects for part-time work in the N.H.S., held a meeting recently at which a number of recommendations were drawn up; these, together with a request that two nominated representatives be allowed to attend the conference, were sent to Mrs Castle. Neither she nor the D.H.S.S. even acknowledged the letters, and the representatives were not invited. It is difficult to understand the Department’s wish to keep proceedings secret. The Press was excluded, and articulate people, who have demonstrated that they have a positive contribution to make, are denied the opportunity to attend, even as observers. As a sop to International Women’s Year the conference might be worthy of mention, but if it was genuinely intended to improve women doctors’ opportunities it has clearly failed if it takes no cognisance of the views of those most concerned. NINA ESSEX AMANDA HERBERT BRIDGET JACK ISABEL SMITH
CHRISTINA WILLIAMS ANNE LAKIN DOROTHY WEST.
POSTOPERATIVE THROMBOSIS IN THAI WOMEN
SIR,-In the Asiatic hospitals which I have visited, both male and female patients appear to spend most of their postoperative waking hours bolt upright, with frequent variation of the squatting position. Patients in this country are either flat in bed under restrictive bed clothes or fixed in a chair with rather flexed hips and knees (so-called early ambulation !). Might it be that the relatively low incidence of postoperative thrombosis in Thailand is related to some difference in postoperative activity or posture ? Are there radiographic studies which reveal the effect of the oriental squatting position on the venous flow from the lower limbs ? 31 Rodney Street, Liverpool Ll 9EH.
JOHN SHEPHERD.
POLYMERIC TYPE-III COLLAGEN IN INFLAMED HUMAN SYNOVIA SIR,-Four different molecular species of collagen are now known. Type i is found in skin, tendon, bone, and synovia, and until quite recently was considered to be the only form. Type 11 appears to be unique to cartilage, and type IV is the collagen of basementmembrane. Type-III collagen, which has been identified most recently, appears to be an embryonic form which persists in certain tissues into adult life. It is found in small quantities in adult skin and is also present in vascular tissues and intestine. Normal synovial tissue contains type-i but no demonstrable type-m collagen; in contrast, we1 have been able to show that inflamed synovial tissues contain a proportion of type-ni collagen, the amount of which appears to reflect the degree of inflammation as assessed clinically and by the vascularity and thickness of tissue obtained at syno1.
Weiss, J. B., Shuttleworth, C. A., Brown, R., Sedowofia, K., Baildam, A., Hunter, J. A. A. Biochem. biophys. Res. Comm. (in the press).
This abnormality is present in all fifteen vectomy. rheumatoid synovia and in the seven cases of inflammatory,
non-rheumatoid synovitis
(traumatic, septic, spondylitic,
and gouty) which we have examined. It is not present in osteoarthritic synovia. Type-111 collagen can be demonstrated in inflamed synovia not only in a soluble form but also as a polymer, constituting up to 15% of the total insoluble collagen matrix. As far as we are aware this is the first report of a polymeric form of type-m collagen. Polymeric type-in collagen, which contains disulphide bridges,2 is resistant to catheptic attack, in contrast to the polymeric form of type I, which is susceptible to those enzymes.3 This poses the interesting question as to whether one of the body’s defence mechanisms in inflammation is to synthesise a form of collagen resistant to lysosomal attack. The process cannot be looked on simply as a healing one, since scar
tissue contains
no tvne-TTT
Departments of Rheumatology and Medical Biochemistry, University of Manchester, Stopford Building, Manchester M13 9PT.
2. 3. 4.
collagen.4
JACQUELINE B. WEISS C. ADRIAN SHUTTLEWORTH R. BROWN JOHN A. A. HUNTER.
Milsom, D., Steven, F. S., Hunter, J. A. A., Thomas, H., Jackson, D. S. Conn. Tiss. Res. 1972, 1, 251. Chung, E., Miller, E. J. Science, 1974, 183, 1200. Shuttleworth, C. A., Forrest, L., Jackson, D. S. Biochim. biophys. Acta, 1975, 379, 207.
Obituary WERNER SCHULEMANN
Dr.Med.Breslau, Dr.Phil.Freiburg, Dr.Rer.Nat. Prof. Werner Schulemann, professor emeritus of pharmacology in the University of Bonn, Germany, died on June 20 at the age of 87. He was born in Neisse, Upper Silesia, and obtained his medical degree in 1914 at the University of Breslau after graduating DR.PHIL. at the University of Freiburg. After the 1914-18 war, in which he served with distinction, he joined the research department of I. G. Farben AG in Elberfeld, and remained in charge of the pharmacology section for 18 years. From 1937 to 1958 he held the chair of pharmacology and was the director of the Institute of Pharmacology at the University of Bonn. He retired from this post in 1958, but continued working on the chemotherapy of protozoan diseases for the Luc following diseases iui following 15 years; not until 1973 did he begin to curtail his activities. For his pioneering work on synthetic antimalarial drugs he received in 1928 one of the highest German scientific honours-the Emil Fischer medal. In 1938 he was awarded the Mary Kingsley medal of the Liverpool School of Tropical Medicine, and 2 years later the Bernard Nocht medal of the Hamburg Institute of Tropical Medicine and the von Klebersberg medal of the University of Szeged in Hungary. In 1963 the Royal Swedish Academy of Sciences honoured him with the Linnaeus medal and prize for his research on Tibetan culture. Professor Schulemann was
CHRISTINA WILLIAMS ANNE LAKIN DOROTHY WEST.
POSTOPERATIVE THROMBOSIS IN THAI WOMEN
SIR,-In the Asiatic hospitals which I have visited, both male and female patients appear to spend most of their postoperative waking hours bolt upright, with frequent variation of the squatting position. Patients in this country are either flat in bed under restrictive bed clothes or fixed in a chair with rather flexed hips and knees (so-called early ambulation !). Might it be that the relatively low incidence of postoperative thrombosis in Thailand is related to some difference in postoperative activity or posture ? Are there radiographic studies which reveal the effect of the oriental squatting position on the venous flow from the lower limbs ? 31 Rodney Street, Liverpool Ll 9EH.
JOHN SHEPHERD.
POLYMERIC TYPE-III COLLAGEN IN INFLAMED HUMAN SYNOVIA SIR,-Four different molecular species of collagen are now known. Type i is found in skin, tendon, bone, and synovia, and until quite recently was considered to be the only form. Type 11 appears to be unique to cartilage, and type IV is the collagen of basementmembrane. Type-III collagen, which has been identified most recently, appears to be an embryonic form which persists in certain tissues into adult life. It is found in small quantities in adult skin and is also present in vascular tissues and intestine. Normal synovial tissue contains type-i but no demonstrable type-m collagen; in contrast, we1 have been able to show that inflamed synovial tissues contain a proportion of type-ni collagen, the amount of which appears to reflect the degree of inflammation as assessed clinically and by the vascularity and thickness of tissue obtained at syno1.
Weiss, J. B., Shuttleworth, C. A., Brown, R., Sedowofia, K., Baildam, A., Hunter, J. A. A. Biochem. biophys. Res. Comm. (in the press).
This abnormality is present in all fifteen vectomy. rheumatoid synovia and in the seven cases of inflammatory,
non-rheumatoid synovitis
(traumatic, septic, spondylitic,
and gouty) which we have examined. It is not present in osteoarthritic synovia. Type-111 collagen can be demonstrated in inflamed synovia not only in a soluble form but also as a polymer, constituting up to 15% of the total insoluble collagen matrix. As far as we are aware this is the first report of a polymeric form of type-m collagen. Polymeric type-in collagen, which contains disulphide bridges,2 is resistant to catheptic attack, in contrast to the polymeric form of type I, which is susceptible to those enzymes.3 This poses the interesting question as to whether one of the body’s defence mechanisms in inflammation is to synthesise a form of collagen resistant to lysosomal attack. The process cannot be looked on simply as a healing one, since scar
tissue contains
no tvne-TTT
Departments of Rheumatology and Medical Biochemistry, University of Manchester, Stopford Building, Manchester M13 9PT.
2. 3. 4.
collagen.4
JACQUELINE B. WEISS C. ADRIAN SHUTTLEWORTH R. BROWN JOHN A. A. HUNTER.
Milsom, D., Steven, F. S., Hunter, J. A. A., Thomas, H., Jackson, D. S. Conn. Tiss. Res. 1972, 1, 251. Chung, E., Miller, E. J. Science, 1974, 183, 1200. Shuttleworth, C. A., Forrest, L., Jackson, D. S. Biochim. biophys. Acta, 1975, 379, 207.
Obituary WERNER SCHULEMANN
Dr.Med.Breslau, Dr.Phil.Freiburg, Dr.Rer.Nat. Prof. Werner Schulemann, professor emeritus of pharmacology in the University of Bonn, Germany, died on June 20 at the age of 87. He was born in Neisse, Upper Silesia, and obtained his medical degree in 1914 at the University of Breslau after graduating DR.PHIL. at the University of Freiburg. After the 1914-18 war, in which he served with distinction, he joined the research department of I. G. Farben AG in Elberfeld, and remained in charge of the pharmacology section for 18 years. From 1937 to 1958 he held the chair of pharmacology and was the director of the Institute of Pharmacology at the University of Bonn. He retired from this post in 1958, but continued working on the chemotherapy of protozoan diseases for the Luc following diseases iui following 15 years; not until 1973 did he begin to curtail his activities. For his pioneering work on synthetic antimalarial drugs he received in 1928 one of the highest German scientific honours-the Emil Fischer medal. In 1938 he was awarded the Mary Kingsley medal of the Liverpool School of Tropical Medicine, and 2 years later the Bernard Nocht medal of the Hamburg Institute of Tropical Medicine and the von Klebersberg medal of the University of Szeged in Hungary. In 1963 the Royal Swedish Academy of Sciences honoured him with the Linnaeus medal and prize for his research on Tibetan culture. Professor Schulemann was
