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Ninety adults with "mountain cedar" pollen allergy were started on coseasonal immunotherapy regimens in December 1979. At season's end, there were 20 whose starting antigen dose was based on serial dilution end point titration (SDET), 1:2,500 or 1:12,500 weight by volume (w/v); 28 in a "traditional" group started at 1:62,500 w/v; and 28 who had been double-blind placebo control subjects. Injections twice weekly were pushed aggressively toward maintenance. The SDET group received 11 times more antigen than the traditional group; both showed a trend for fewer symptoms than the placebo group. As compared with the other groups, SDET subjects had substantially blunted total and specific IgE responses in season, lower specific IgE level at season's end and less shift of skin end point toward higher dilutions. The findings demonstrate that substantial immunologic effects are possible in the first months of aggressive coseasonal immunotherapy.

1 Until recently, phenotyping the N-acetyltransferase enzyme had been restricted to distinguishing the slow acetylators from the rapid. Further separation of the heterozygous rapid phenotype from the homozygous rapid phenotype has only been possible by detailed pharmacokinetic studies using sulphadimidine and necessitating prolonged plasma sampling. 2 A simple method of deriving the basic pharmacokinetic parameters is presented. In this study of ten healthy volunteers, one urine sample and hourly plasma sampling over only 5 h enabled calculation of the total body (TBC) and metabolic clearances (MC) wih enough accuracy to distinguish the three (slow, intermediate and rapid) acetylator phenotypes. The spread of the distribution for the elimination rate constant was however too wide to enable their clear separation.

The cortex, intermediate zone, and nucleus of 19 normal human lenses between the ages of 3 and 77 yr were investigated. The freezable water content of the lenses was obtained by differential scanning calorimetry. The total water content was measured by vacuum dehydration. The nonfreezable water content was calculated from these two measurements. The total water content of the nucleus and intermediate layers decrease with age, while that of the cortex does not vary appreciably. The nonfreezable water content of all three regions of normal human lenses decreases with age.

A random population sample survey in Singapore 1975 revealed that a relatively high proportion of active pulmonary tuberculosis patients remained undiagnosed, mainly in the older age groups. Previous studies disclosed the cause to the lack of symptoms of concern in these patients. A new programme was devised to discover hidden elderly patients by mass chest X-ray screening of population aged 45 years and older living in areas with known high incidence of tuberculosis. The yield of cases was less than expected mainly due to the dislocation and dispersion of population from recent extensive urban re-development in Singapore. Nevertheless the results were comparable to the most productive case finding programme carried out in this department.

There is a need for more detailed information on the relative merits of the culture and direct sputum smear examination methods, separately and in various combinations, using one or more sputum specimens. The efficiency and relative cost of different bacteriological measures for the detection of cases of pulmonary tuberculosis, in the conditions of the Singapore tuberculosis control programme, are demonstrated. The findings provide guidance for deciding how, and in what order, these bacteriological measures should be used, and may assist planners and executives of national tuberculosis control programmes in the rational commissioning of laboratory facilities that already exist or are to be established.