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Preliminary evaluation of thyroid function, utilizing total serum thyroxine (T[sub 4]) and triiodothyronine (T[sub 3]) resin uptake, was assessed following delivery in three groups of babies and their respective mothers; 40 premature newborns with respiratory distress syndrome (RDS), 39 prematures comparable by gestational age who failed to develop RDS, and 22 full-term normal babies. The group of premature newborn infants in whom RDS occurred, as compared to the other two groups, had significantly lower mean total serum thyroxine levels and "free thyroxine index" (T[sub 4] x %T[sub 3] uptake/100). When matched by gestational age, the differences were also significant. Two days following delivery, the total serum T[sub 4] in the surviving prematures with RDS as compared to prematures without RDS was also significantly lower. The mean values for total T[sub 4] and "free thyroxine index" in the respective mothers of the three groups were not significantly different. Since L-thyroxine has been shown to increase the production of lung surfactant, widely accepted as deficient in RDS newborn infants, an association between lung immaturity and fetal thyroid function is postulated. [ABSTRACT FROM AUTHOR]

To assess small airway disease in cystic fibrosis (CF) patients with minimal pulmonary involvement, maximal expiratory flow volume (MEFV) curves were obtained while the patients were breathing first aid and then an 80% helium-20% oxygen gas mixture. Fifteen CF patients and 24 controls were studied. Flow rates at 50% and 25% vital capacity (VC) were calculated from the air and helium-mixture MEFV curves and were compared to give flow ratios at these lung volumes. At 50% VC, the helium/air flow ratios were similar in CF patients and normal subjects. At 25% VC, the flow ratio was significantly lower (p<0.05) in the CF patients. The air and helium MEFV curves were superimposed and the point where the curves crossed (point of identical flow, PIF) was determined and expressed in % VC. For the CF patients, the mean PIF was 17% and for the controls, 5% (p<.001). Nine of the 15 CF patients had PIF values greater than 2 standard deviations (SD) from the normal mean. None of the following tests were abn1ormal in more than three patients: FEV[sub 1]/FVC, MMEF, RV/TLC, Vmax 50% TLC (TLC/sec), and Vmax 25% VC (TLC/sec). Arterial oxygen tensions were below 86 mm Hg in four patients. Closing volumes by the 100% helium bolus technique were normal in all patients. Determination of the PIF appears to be a simple, noninvasive, and sensitive test for the detection of early small airways involvement. [ABSTRACT FROM AUTHOR]

Recent enthusiasm concerning hydrocortisone therapy to prevent respiratory distress syndrome in human infants has aroused natural concern over possible untoward effects. There are both ethical and experimental reasons why human infants are not suitable for well-controlled investigation of untoward effects of steroid treatment. Therefore, we studied the effect of hydrocortisone injection on the lung cell number of the rabbit, an animal whose pulmonary development has been studied extensively. Fetal rabbits treated with single injections of hydrocortisone in utero had a lower number of lung cells when compared to similar weight controls. The decreased cell number, reflected by decreased DNA per lung, was also associated with lower lung weights and lower body weights but was not associated with significant changes in lung water or protein content. After birth, with adequate nutrition, "catch-up" in body weight occurred by 30 days' postnatal age. Animals killed at that time and at 60 to 65 days had lung DNA content similar to untreated rabbits. Although lung cell number and body weight were decreased in fetal animals treated with a single dose of glucocorticoid late in gestation, with adequate nutrition growth of both body and lung recovered by 30 days' postnatal age. [ABSTRACT FROM AUTHOR]

Erythroderma is described in a 2-year-old child with coeliac disease, who died of fungal pneumonia. The skin eruption commenced the day after a gluten-free diet was instituted and proved intractable to treatment, whereas the signs of malabsorption were swiftly controlled. We could establish no connection between the cutaneous and intestinal disorders. [ABSTRACT FROM AUTHOR]

Discusses the pathology and management of chronic sinusitis in children. Secondary signs and symptoms including chronic nasal discharge and chronic nasal obstruction; Intracranial symptoms such as headache, stiff neck and seizure; Seasonal symptoms of rhinorrhea, episodic sneezing and itchy eyes and throat when allergy lies behind chronic sinusitis; Nasal examination; Radiology; Description of sinusitis related to cystic fibrosis and to large adenoids; Sinusitis in the newborn, Medical and surgical management.

The article presents a patient's view of asthma. It describes allergic conditions the author has suffered since childhood. A look back was made on other medical conditions including a major disability caused by eczema. Treatment alternated between no baths or frequent baths, which were medicated and caused pain. The first really severe attack of asthma experienced by the author was discussed in detail including symptoms and treatment.

A boy with the whistling face syndrome or cranio-carpotarsal dysplasia is described. He had severely limited respiratory excursions, which apparently predisposed him to atelectasis and respiratory infections following general anesthetics. A review of the natural history and variability of the syndrome is presented. [ABSTRACT FROM AUTHOR]

Comments on articles related to internal medicine. Loss of symptoms of pulmonary hypertrophic osteoarthropathy after laparotomy; Information on the occurrence of hypertrophic osteoarthropathy with abdominal aortic prosthesis and infection; Presence of synovial fluid in sarcoid arthritis.

Fifty-nine patients with chemical intoxication evoking pulmonary edema were seen in the past several years. In addition, environmental pulmonary edema from heroin intoxication, edema associated with cerebral trauma arid that due to post-traumatic pulmonary insufficiency were also encountered. Most patients recovered. Treatment included inhalational therapy utilizing 40-60 percent oxygen with intermittent positive pressure breathing, endotracheal intubation or tracheostomy in the most severe problems. Digitalis and diuretics may he beneficial in a limited number of patients. Curticosteroids, hexamethylentetramine and ammonium carbonate are effective in specific types of intoxications. Morphine sulfate and other narcotic agents are to be avoided in those patients with respiratory depression due to hydrogen sulfide. hydrogen cyanide. ozone, carbon monoxide and heroin intoxication. As previously mentioned, assisted or controlled ventilation mas he of considerable benefit in the latter problem. Most of these patients should be treated in intensive care units and appropriate monitoring of the cardiopulmonary system should he implemented. since the majority of these patients are acutely ill. [ABSTRACT FROM AUTHOR]

Elevation of the left dome of the diaphragm occurred in 43% of cases with left lobe amoebic liver abscesses. It was rarely seen in patients with an abscess in the right hepatic lobe. Elevation of the right dome of the diaphragm, which occurred in 36% of cases, is also compatible with a diagnosis of left lobe abscess. This radiological sign was present in 75% of cases with right lobe abscesses. Pleuro-pulmonary changes in the left chest, when associated with an elevation of the left dome of the diaphragm, favours the diagnosis of an amoebic abscess of the left lobe of the liver. Radiological changes in barium studies are usually confined to patients with large hepatic abscesses. In clinical practice the information obtained from simple radiology can provide adequate diagnostic confirmation of the presence of a left lobe liver abscess. [ABSTRACT FROM PUBLISHER]

The P-K titre of a donor serum in different recipients was found to be inversely related to the serum IgE level of those recipients. The median serum IgE level of subjects who gave a negative P-K reaction with a 1:2 dilution of the donor serum was 3325 units/ml; patients who reacted positively to dilutions of 1:2, 1:8 and 1:32 of the test serum had median serum IgE levels of 1950, 410 and 155 units/ml respectively. Recipients included normal adults and selected patients with allergy, helminthiasis or tuberculosis. Most individuals with very high serum IgE levels had helminthiasis. All subjects gave normal reactions when skin-tested with histamine, codeine and anti-IgE antiserum. The inverse relationship between P-K reactivity and serum IgE level may be due to saturation of mast cell IgE-binding sites by endogenous serum IgE. Other possible mechanisms are discussed. [ABSTRACT FROM AUTHOR]

Studies were carried out to detect and quantitate humoral antibodies to components derived from Mycobacterium tuberculosis. Using both quantitative and qualitative primary tests; binding was observed by all sera obtained from normal as well as from tuberculous subjects. There was a significant difference, however, in the amount of binding by sera from controls. There was a high incidence of both IgG and IgM antibodies in all sera. The universal occurrence of humoral antibodies demonstrated in this study suggests that most, if not all, persons have been sensitized to the tubercle bacillus to one degree or another. Evidence is presented that the immunogens involved may be derived from saprophytic and/or avirulent mycobacteria. [ABSTRACT FROM AUTHOR]

Pigeon droppings are known to constitute a highly potent source of antigens involved in the interstitial pulmonary disease known as 'pigeon breeder's lung'. Among the heterogeneous mixture of components in extracts of the droppings, a powerful enzyme was encountered which exhibits hydrolytic activity on proteins and synthetic ester substrates. Some characteristics of the enzyme in crude extracts have been established. Preliminary results indicate that human blood serum contains no inhibitors for the enzyme. [ABSTRACT FROM AUTHOR]

Studies of the serum level of IgD in patients with tuberculosis and sarcoidosis reveal evidence of a difference in humoral immunity. Radial diffusion measurements were done of IgD in serums from fifty patients with active tuberculosis, fifty-three patients with sarcoidosis and 103 age, race and sex matched healthy controls. IgD was detected in serums from 20% more tuberculosis patients (P< 0-0250) and 20-7% fewer sarcoidosis patients than respective controls (P<0-0005). Multivariate statistical analysis of loge transformed IgD serum levels revealed significantly lower geometric mean IgD levels in sarcoidosis patients (P=0-0018). The age dependence of serum IgD was highly significant (P<0-0001). Age dependent disease effects were detected. High levels of IgD occurred predominantly in older tuberculosis patients while depression of IgD occurred in middle-aged sarcoidosis patients. It is suggested that the elevated levels of serum IgM in patients with sarcoidosis may represent a compensatory change associated with low levels of serum IgD. [ABSTRACT FROM AUTHOR]

In population samples in England. and. Wales a greater frequency of positive sheep cell agglutination tests has been Found in Leigh and the Rhondda than in Wensleydale, the Vale of Glamorgan or Watford. The urban population of Leigh had more X-ray evidence of lung pathology than the rural population of Wensleydale. Seropositive persons in both the urban populations of Leigh and the Rhondda and the rural populations of Wensleydale and Glamorgan had more X-ray evidence of lung pathology than seronegative individuals, the difference being. significant For healed tuberculosis of the lungs, thickened basal pleura and increased basal vascular markings. The association between the first two and rheumatoid factor was equally present in those with and without arthritis but in the third it was limited to those with arthritis. A history of bronchitis was no more common in persons with a positive sheep cell test than in those with a negative lest and the indirect maximum breathing capacity showed no significant relationship to rheumatoid factor titre. No association was found between cigarette smoking and the sheep cell titre, it is concluded that parenchymal lung and. pleural disease may act as a stimulus to the production of rheumatoid serum factor and that this stimulus is independent of the presence or absence of arthritis. [ABSTRACT FROM AUTHOR]

The intravenous injection of rabbit anti-rat kidney cortex serum into rats produces an acute pulmonary oedema, The first symptom to appear is dyspnoea followed by cyanosis and death. The most important pathological abnormalities were oedema and haemorrhage of the lungs. There was an apparent correlation between the onset of the acute pulmonary oedema and a drop in the total haemolytic complement titre in both normal or bilaterally nephrectomized rats. When rats were rendered complement deficient before the injection of rabbit anti-rat kidney cortex Iserum, the symptoms of pulmonary oedema do not appear. The nature of We mechanism through which the complement system induces these lung lesions is not yet clear. Since the vasoactive substances, histamine, 5-hydroxytryptarnine and kinins or other mediators derived from leucocytes are not relevant in the pathogenesis of this lung oedema, it seems likely that the complement system acts directly. [ABSTRACT FROM AUTHOR]

The article describes an integrated research effort aimed at obtaining an Minnesota Multiphasic Personality Inventory (MMPI) scale for predicting irregular discharges among tuberculosis patients. None of the standard MMPI scales consistently discriminated between regular and irregular disc charge patients. However, an Irregular Discharge Scale, consisting of 57 MMPI items, effectively discriminated discharge groups at two of the hospitals.

This article discusses a staff-centered clinical psychology in a tuberculosis hospital. From a psychological point of view, the problem of tuberculosis rests in the nature of the conditions this disease imposes on the patient and the readjustments the patient must effect to radical changes in his way of life. Such conditions are common to most chronic illnesses and are not peculiar to tuberculosis alone. The key word here is not this or that illness, but rather the chronicity of the illness. Tuberculosis is a problem worthy of psychological study because of the long, protracted periods of hospitalization it entails.

The article presents information on a clinical appraisal of the use of non-directive therapy in the care of the chronically ill. One of the fruitless activities that seems to engage much of the time of clinicians is concerned with their endeavor to convince other clinicians that they have found the best if not the only effective method of dealing with a clinical problem. A non-apparent chronic illness is one such as diabetes or tuberculosis or heart disease in which, though the patient may be permanently limited in his capacity to carry on daily activities, nothing is visible to the outside world which suggests such a limitation. Those with apparent illness effects such as is found in some poliomyelitis, tuberculosis of bones, cerebral palsies or in accident-produced bone and joint trauma have visible evidences of their limitations which at least suggest to the onlooker that the individual may not be able to carry on all ordinary activities.

The amounts of firmly bound γ-globulin (i.e. resistant to elution by Tyrode's solution) showed marked differences when the adsorption of various heterologous γ-globulins on chopped guinea-pig lung was compared [Sheep>pig >bovine>horse>human>rabbit]. This suggests that non-sensitizing γ-globulins were more readily adsorbed than the sensitizing γ-globulins. Only about 30–40 per cent of 131I-labelled protein could be removed from the firmly bound γ-globulin-tissue complex using 8 M urea, suggesting that covalent bonds play a major role in the fixation of γ-globulins to tissues. [ABSTRACT FROM AUTHOR]

The affinity of a glycopeptide from culture filtrates of Mycobacterium tuberculosis for guinea-pig serum component, first observed as an alteration of electrophoretic mobility of γ2-immunoglobulin in agar has been explored by a variety of techniques. It was shown that such changes in mobility were produced more readily with γ2-globulin (Fraction I from DEAE cellulose chromatography) than with γ1-globulin (Fraction III from DEAE cellulose chromatography). It was estimated that the treatment resulted in a rise of carbohydrate associated with γ2-globulin from 1.3 per cent to 38–40 per cent. [ABSTRACT FROM AUTHOR]

Fourteen vaccines, ten of which had been tested in the field in the M.R.C. trials, were assayed in the laboratory by the intracerebral (IC) and the intranasal (IN) routes. The IC test arranged the vaccines in quite a different order of potency to the IN test. A satisfactory and reproducible assay can be made by either method, though the dose response curves about the 50 per cent protection point have very different slopes. The field trails have shown that whereas the mouse potency test using the IC challenge corresponds remarkably well with the field results (M.R.C. Report), potency tests with the IN challenge do not. Experiments with four different vaccines were consistent in showing that the IC antigen is heat labile and will not stand 100° for 1 hr., the IN antigen is heat stable and can be so heated for relatively small loss of potency. Our results with vaccine K205 are similar to those reported by Fisher (1955), except that we were more fortunate in getting a graded dose response with the heated vaccine against the IN challenge, probably owing to the larger number of assays we carried out. We would agree with Fisher that individual experiments may give very odd results, and on the whole the dose response curves of individual IN assays are not as consistent as IC assays; this may be due either to differences in the antigens involved, for two different antigens must be responsible, or to differences in the course of infection in the lung and brain. [ABSTRACT FROM AUTHOR]

The type and severity of underdevelopment of the lungs in infants with three congenital malformations were studied in histologic sections. The mean lung weight:body weight ratios were significantly decreased in infants who had diaphragmatic hernia, anencephaly, and a group of renal anomalies. Radial alveolar counts of the distal airways were also significantly decreased, although the range for each group included normal values. The data suggest that decreased proximal branching is a component of pulmonary hypoplasia in these malformations, because in the majority of infants, the decrease in lung weight was greater than could be explained by the decrease in the number of peripheral air spaces. No apparent qualitative differences in the type of hypoplasia were found in these infants; changes in the histologic appearance were correlated with severity and were independent of the type of associated malformation. [ABSTRACT FROM AUTHOR]

Focuses on a study which examined the intermittent endotracheal intubation technique for the treatment of recurrent atelectasis. Methodology of the study; Results and discussion.

The liquid which occupies the potential air spaces of the fetal lung is, at birth, displaced by air and removed by the pulmonary blood and lymphatic circulations. Delayed resorption of this liquid from the interstitial spaces may be associated with decreased lung compliance and be the cause of the syndrome "transient tachypnea of the newborn." Chest roentgenograms of these infants have shown the presence of alveolar and interstitial edema and pleural effusions which cleared during the first few days of life. We chose to test the possibility that a delay in clearance of lung liquid might occur and be associated with tachypnea and radiologic evidence of pulmonary edema in newborn lambs. Serial chest radiographs were obtained in 18 newborn lambs delivered at term by Caesarean section. The radiographs demonstrated the presence of lung liquid which gradually cleared in an average time of 2 hours following onset of breathing. Lung weight-body weight ratios obtained following sacrifice at various stages of clearing-decreased as pulmonary aeration increased. Microscopic examination of the lungs showed no evidence of inflammatory exudate or squamous debris but distension of perivascular tissues with liquid was demonstrated. An association between increasing lung aeration and decreasing respiratory rates was found. [ABSTRACT FROM AUTHOR]

Presents a case report on an infant with respiratory distress produced by an accessory lower lobe of lung. Physical condition of the infant at birth; Results of the chest x-ray made on the child; Pathological description of the child's lung tissues.

Tracheobronchiomegaly and acquired cutis laxa are described in a 14-year-old boy. Marked dilatation of the tracheobronchial tree associated with recurrent lower respiratory tract infections has been reported chiefly in the adult medical literature as the Mounier-Kuhn syndrome. Cutis laxa is a rare elastic tissue disorder that involves the skin and other systems. While the etiology of tracheobronchiomegaly is unknown, the coexistence of two rare conditions in the same patient suggests a common fundamental elastic tissue defect. The investigative studies revealed abnormal elastic fibers in the skin, increased thoracic gas volumes, abnormal pulmonary elastic recoil, and a normal immunologic status except for increased serum and parotid IgA levels. [ABSTRACT FROM AUTHOR]

Eighteen acute lower respiratory tract infections in 16 young children in Calcutta, India, were investigated for bacteria, viruses, and mycoplasmas by methods which routinely included lung tap. Cultures of the nasopharynx, throat, and tracheal aspirate yielded moderately helpful but imprecise data, whereas the lung tap was quite specifically informative and was relatively safe. Seven lung taps were culturally positive for recognized pulmonary pathogens; six of these yielded Hemophilus influenzae alone or accompanied by other organisms. Poliovirus, type 1, was an unexpected lung tap isolate and was the only virus recovered from a bacteriologically sterile lung tap. A complex interaction of bacterial and nonbacterial agents was suggested by the evidence in all but 3 of the 18 instances of more than one potentially pathogenic organism. Since the population studied was definitely abnormal by North American standards of length, weight, and subcutaneous fat thickness, the authors suggest that the microbiologic data should be applied cautiously to well nourished populations. [ABSTRACT FROM AUTHOR]

Cardiopulmonary function was studied at rest and during exercise in 17 patients with Fallot's tetralogy who had systemic-pulmonary anastomoses to determine the factors which limit their work capacity (Wmax) and produce their limiting symptoms. The patients stopped exercise at a mean work rate of 355 kg-M ⋅ min¹ because of dyspnea or leg pain. The average pattern observed in room air was: a fall in arterial pO[sub 2], from 64 mm Hg at rest to 47 mm Hg during exercise due to increased right-to-left shunting; alveolar hyperventilation at rest (arterial pCO[sub 2] = 31.6 mm Hg) and during exercise (arterial pCO[sub 2] =35.2 mm Hg); a progressive fall in arterial pH during exercise to pH = 7.369; and increased levels of wasted ventilation (V[sub D]:V[sub T] = 50.6) during exercise. Wmax was directly related to pulmonary blood flow, anaerobic threshold, and O[sub 2] pulse, and inversely related to the size of right-to-left shunt during exercise. Exercise response during O[sub 2] breathing in 16 patients studied showed decreased hypoxemia, decreased acidosis, and decreased minute ventilation. These results suggest that the excessive ventilation observed in these patients when they breathed room air was partly due to a chemoreceptor drive. Exercise response in the supine posture in seven patients studied was improved with decreased dyspnea, decreased minute ventilation, and decreased wasted ventilation without changes in the right-to-left shunt. These results suggest that the excessive ventilation observed was partly due to an increased wasted ventilation. Dyspnea appeared to be related to the inappropriateness of the level of ventilation relative to the metabolic needs of exercise. [ABSTRACT FROM AUTHOR]

In countries with a high incidence of tuberculosis and where BCG vaccination at birth is a routine procedure, the diagnosis of tuberculosis in infants and young children may be exceedingly difficult. A point system is proposed in order to evaluate all the available data when tuberculosis is suspected. This approach offers the advantages of a uniform criterion for diagnosis and treatment and a useful guide for completing diagnostic procedures. This point system carried out on each individual case gives four possible answers: (1) tuberculosis unlikely; (2) tuberculosis possible, requires further investigation; (3) tuberculosis probable, may justify therapy; (4) tuberculosis appears unquestionable. It is a great help in clarifying a dubious diagnosis of tuberculosis based on vague x-ray shadows and positive tuberculin tests of doubtful interpretation in the absence of positive sputum or gastric washings. This point system has the limitations of all rigid point systems of evaluation. However, if priority is given to clinical experience, it is an additional tool in a difficult diagnosis. [ABSTRACT FROM AUTHOR]

One hundred sixty-four cases of agenesis of the lung are reviewed, including 36 not previously reviewed and 8 not previously reported. Agenesis, affecting both hemithoraces and both sexes almost equally, should be separated for physiologic reasons from hypoplasia by the total absence of lung parenchyma, bronchial tree, as well as supporting vasculature. Genetic, teratogenic, and mechanical factors may have a bearing on etiology. Chest roentgenograms suggest the diagnosis initially, but careful bronchographic and angiocardiographic studies are necessary for confirmation. The electrocardiogram is helpful in differential diagnosis of the patients with dextrocardia. Severe respiratory infections are common in infancy and may lead to pneumonia and death. The condition, however, is not uniformly fatal; 24 to 36 patients reported since 1954 were alive at the time of reporting. There is no evidence at present that resting pulmonary artery hypertension or emphysema develops in patients with agenesis of the lung and an intact cardiovascular system. Diagnostic studies reveal pulmonary artery hypertension in a number of patients with a combination of systemic -pulmonary communication and agenesis of the lung. Coexisting abnormalities may involve the skeletal, cardiovascular, gastrointestinal, and genitourinary systems. [ABSTRACT FROM AUTHOR]

Twenty-six premature and five full-term infants, ranging in birth weight from 860 to 4,040 gm and in age from 3 hours to 98 days, were the subjects of this study. Measurements of thoracic gas volume and determination of alveolar-arterial oxygen gradient and arterial-alveolar carbon dioxide gradient were performed. All infants showed a decrease in thoracic gas volume in the first days of life. The initial high thoracic gas volume is thought to be due to trapped gas. The ability to trap gas was demonstrated in a number of infants. In the full-term infant the decrease in thoracic gas volume is associated with improvement in lung function. In the premature infants the decrease in lung volume is associated with a persistently elevated alveolar-arterial oxygen gradient and in an inequality of perfusion and ventilation, as evidenced by the large arterial-alveolar carbon dioxide gradient. In a small group of infants increase in functional residual capacity produced by negative pressure around the chest resulted in a decrease in the carbon dioxide and oxygen gradients, indicating that the infant's lung volume is less than optimum. These observations characterize in physiological terms some of the respiratory difficulties in small premature infants. [ABSTRACT FROM AUTHOR]

Grunting was investigated in 22 infants with hyaline membrane disease. It was demonstrated to be a modified Valsalva maneuver, as during expiration intrapleural pressure was increased by closure of the glottis and contraction of the abdominal muscles. Grunting could be prevented if the trachea was intubated; but, during this period the arterial oxygen fell. After detubation grunting recommended and arterial oxygen tension rose to previous levels. Therefore, grunting appears to be a protective form of breathing, aimed at raising the PaO2. This is probably achieved by improvement of alveolar ventilation, but the exact mechanism is not known. [ABSTRACT FROM AUTHOR]

Chronic lung disease in children may present a perplexing diagnostic problem. While open lung biopsy usually will provide a diagnosis without excessive morbidity, we believe that pulmonary alveolar proteinosis can be diagnosed radiographically, and we wish to point out the early age at which this disease can occur. The clinical course of three infants is described together with the necropsy findings. Two 3-month-old and one 23-month-old infants are reported. The radiographic appearance of diffuse alveolar consolidation and the progressive respiratory involvement should alert physicians to the true nature of this disease. Recovery is reported in adults, but results of treatment in infants is disappointing. [ABSTRACT FROM AUTHOR]

Reports on the diagnosis and management of bronchiolitis in infants in Great Britain. Facts on the development of bronchiolitis; Radiological features; Treatment.

The article focuses on the occurrence of tuberculosis in every institution maintained for the mentally defectives in the U.S. Effective control program should be needed to protect the patients as well as the personnel. The prevention of the spread of tuberculosis in institutional personnel may save institutions from unnecessary financial burden. Tuberculosis workers have become aware of the importance of tuberculosis plays in mental institutions.

The article highlights the results of a tuberculosis survey in an institution in Elwyn, Pennsylvania. The survey was conducted at Elwyn Training School over a period of three years, 1939, 1940, and 1941. A group of inmates, ranging in age from seven to forty-one years, was tested for susceptibility to tuberculin by the Mantoux intradermal method.

The article presents a case report of a 26-year old patient suffering from the chronic pulmonary disease associated with an unusual dysgammaglobulinaemia. The patient had had chronic atopic dermatitis since approximately age one month. Shortly after the onset of the atopic dermatitis, his mother noted the first appearance of wheezing. Since that time, the patient has had multiple attacks of wheezing. At the age of 6 years, he had pneumonia for the first time. Since then he has had repeated bouts of pneumonia.

The article focuses on a study related to the lung-reactive antibodies in immunoglobulin A fractions of sera from patients with pneumoconiosis. Prior investigations have shown that antibodies, reactive with components of normal human lung tissue, exist in the serum of patients with certain chronic respiratory diseases. Here, the author presents a more specific approach towards characterizing anti-lung antibodies in humans with chronic lung disorders. Quantitative measurements of immonuglobulin levels were made in an effort to associate these globulin levels with lung reactivity.

This article reports that abnormally high total serum globulin values have been reported in 40% of patients with fibrosing alveolitis and a range of one or more nonorgan specific circulating autoantibodies which have been found in over 50%, of patients with this condition. Thirty-two patients were studied in whom the diagnosis of fibrosing alveolitis was made on clinical, radiographic and physiological grounds. The presenting symptoms were increasing breathlessness often accompanied by an unproductive cough. On examination finger clubbing was present in the majority and widespread fine crepitations were heard in all except two of the patients.

The relative frequency of cutaneous tuberculosis in children and adolescents in Vietnam is an indisputable fact, but its incidence seems small in comparison with the many cases of pulmonary tuberculosis. Clinical pathology and symptoms must be studied in diagnosing cutaneous tuberculosis, especially since it is not always easy to find Koch's bacillus and typical tuberculous lesions in the biopsy. In the majority of cases, cutaneous tuberculosis lesions are primary. The prognosis of these lesions is generally good. It is only guarded in cases of complications. [ABSTRACT FROM AUTHOR]

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Seven cases of tuberculosis verrucosa cutis were treated by the intermittent (twice weekly) fully supervised regimen of streptomycin and high dosage isoniazid. Responses were very impressive-6 months of treatment produced complete healing, leaving residual scars. [ABSTRACT FROM AUTHOR]