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Cyanoacrylates are a rare cause of occupational asthma, there being only six cases reported previously. High humidity has been implicated to be protective in the pathogenesis of the asthma. This is a case report of occupational asthma due to cyanoacrylate glue after working three years in a factory manufacturing doors. Diagnosis was made by history, serial peak flow measurements on and off work and specific inhalation challenge which elicited a delayed bronchoconstrictive response. An unusual feature of this case was the positive reaction to cyanoacrylate despite the high ambient humidity in Singapore.

We report a case of occupational asthma due to barley grain dust, species Hordeum Vulgare L, in a 32-year-old storeman of a trading company's department that dealt with packaging of flour, barley and peanuts. He developed immediate symptoms of sneezing, cough and dyspnoea on exposure to barley only. These symptoms showed work relationship. He became asymptomatic after his transfer to another department dealing with sales only. Bronchial provocation testing to the barley confirmed the diagnosis.

We report a case of late dumping syndrome in a 49-year-old lady who had partial gastrectomy for bleeding peptic ulcer 11 years ago. She presented with unexplained syncopal attacks which did not have any apparent relationship to meal or posture. An unusual reaction to oral glucose tolerance test ordered by her gynaecologist who was seeing her for uterine fibroid led to the diagnosis. Late dumping syndrome was confirmed by a repeat oral glucose tolerance test. At the second hour of the test, she developed hypoglycaemic coma with a blood glucose level of 50 mg/dL and a hypocount of 47 mg/dL. She regained full recovery after dextrose infusion which raised the hypocount to 123 mg/dL. The dizzy spells and syncopal attacks disappeared with dietary adjustment.

Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR), single-breath diffusion capacity measurements (effective alveolar volume (VA), carbon monoxide transfer factor (DLCO) and transfer coefficient (KCO)) were determined in 452 healthy Singaporean adults (277 males and 175 females) aged 20-70 years. The ratio of Chinese, Malay and Indian subjects was 5:2:3 in both sexes. Age, height and weight in the males were all significantly correlated with FEV1, FVC, DLCO, VA and PEFR. However, for females, only age and height were significantly correlated with the studied lung function parameters. Significant ethnic differences were observed for most of the pulmonary functions (except KCO and PEFR) among the Chinese, Malays and Indians for both males and females. The predicted FEV1 and FVC values (specific age and height) for both sexes were highest among the Chinese followed by the Malays than Indians, in that order. Regression equations, with age and height as independent variables, were derived for males and females in each ethnic group to predict normal pulmonary function for the Singapore Chinese, Malay and Indian populations. The predicted values of various pulmonary function measurements obtained from these regression equations for subjects of specified age (30 years) and height (165 cm for men, 155 cm for women) were compared with those reported in other studies. Differences were observed among the different races.

The clinical significance of pulmonary pseudolymphoma remains unresolved. We report a case which highlights the lymphoma versus pseudolymphoma dilemma. An elderly lady followed up for more than ten years with a slowly enlarging right lung mass had on biopsy, lymphoid hyperplasia consistent with a lymphoma or pseudolymphoma. Laboratory investigations revealed hyperglobulinemia due to a biclonal gammopathy with elevated serum immunoglobulin M and G fractions. Monoclonal production of immunoglobulin is today considered more indicative of a neoplasia than a hyperplasia.

We report a 61 year old man with motor neurone disease who presented with dyspnoea and ventilatory failure when the limb and bulbar muscles were relatively spared. This unusual pattern of predominant respiratory muscle involvement persisted throughout the twenty-one month course of his illness.

Noninvasive oximetry has been shown to be a reliable and convenient way of estimating arterial oxygen saturation. Studies have shown that skin pigmentation did not affect the accuracy of oximetry. However, these studies were performed on healthy subjects and the number studied was small. Our study on 31 pigmented patients in the clinical situation showed that the Biox III oximeter gave readings that closely approximated oxygen saturation measurements from arterial blood (y = 4.75 + 0.93x, r = 0.91, p less than 0.001), confirming the usefulness of noninvasive oximetry even in pigmented patients.

Cavitation in pulmonary metastases is unusual. We report a 78 year old lady with primary squamous cell lung cancer and multiple cavitating pulmonary metastases.

The lung function status of workers in a cadmium-nickel battery factory was re-examined 3 years after an initial study which showed a mild restrictive effect. During this period, further measures were taken to reduce the cadmium exposure. Of the 44 'original' cadmium-exposed workers, 17 were still exposed to cadmium. Another 13 were transferred to non-cadmium work at least 6 months and 14 left the company at least 1 year before the present study. Blood and urine cadmium concentrations were considerably lower than previously, consistent with the decreased cadmium-in-air levels. The total lung capacity increased both in the workers who were still exposed to cadmium and those who ceased exposure. The latter group also had increased vital capacity and forced expiratory volume in one second. The prevalence of respiratory symptoms decreased particularly in the workers who were no longer exposed to cadmium.