A mechanism involving pions in the intermediate state is considered for the process $\ensuremath{\gamma}+\ensuremath{\gamma}\ensuremath{\rightarrow}\ensuremath{\nu}+\overline{\ensuremath{\nu}}$. Fixed-momentum dispersion relation methods are employed to evaluate the cross sections and luminosities for both electron-type and muon-type neutrinos. Comparison is made between this mechanism and previous results involving intermediate bosons.

The increased frequency of diabetes in patients with cirrhosis was investigated by performing oral and intravenous glucose tolerance tests (GTT) and glucose clearance rate (K o) in 145 cirrhotic patients, including some with overt diabetes and some with portacaval anastomoses (PCA) as well as in appropriate normal and diabetic control groups. The oral GTT was abnormal in 80% of the patients with cirrhosis; the intravenous GTT was impaired in only 19% and K G values were abnormal in 68%. Conventional intravenous GTT was clearly too insensitive to detect even moderate degrees of glucose intolerance. The oral GTT and glucose clearance rate, which are too sensitive for the clinical detection of diabetes in the presence of cirrhosis, demonstrate that some aspect of cirrhosis is systematically responsible for impaired glucose metabolism in the great majority of cirrhotic patients. Abnormal glucose tolerance was associated with several clinical and laboratory features of cirrhosis which are manifestations of portal hypertension and portalsystemic shunting. Statistically significant correlations were found between impaired glucose tolerance and the presence of ascites, esophageal varices, impaired ammonia tolerance and hypoalbuminemia. There was no apparent association with other features of cirrhosis such as jaundice, spiders, or hepatosplenomegaly or other tests of liver function which reflect less closely portal hypertension. In 15 cirrhotic patients who were studied before and after PCA, improvement in glucose tolerance was observed after PCA in all 3 who had overt diabetes. In the other 12 patients, glucose tolerance became more abnormal after PCA than before.

The frequency of diabetes, defined as persistent fasting hyperglycemia, was evaluated in a consecutive group of 240 cirrhotic patients. A randomly selected group of 411 noncirrhotic patients of similar age, admitted to the hospital during the same period, served as a control group. Diabetes was significantly more common in the cirrhotic group (40 of 240, 16.7%) than in the noncirrhotic group (29 of 411, 7.1%). In the majority, cirrhosis was apparent before the diabetes was detected; in 18% the diabetes was noted first.

1.1. A case of permanent 2:1 auriculoventricular heart block following German measles is reported. 2.2. A review of the literature revealed no similar case report, although reference was made to two cases of temporary heart block following measles. 3.3. The effects of the following drugs were noted through electrocardiography: (1) The average rate was accelerated from 72 to 88 per minute at two hours after the oral administration of 0.8 Gm. of quinidine sulfate. (2) The intramuscular injection of 1 mg. of prostigmin slowed the average rate twenty-five minutes later from 73 to 59 per minute. (3) Atropine sulfate 0.0013 Gm., injected subcutaneously, slowed the average rate within fifteen minutes from 70 to 61 per minute, and forty minutes after the injection the average rate accelerated to 78 per minute.