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A case of primary adenoid cystic carcinoma of the esophagus is reported and a total of 15 cases was reviewed. There were 9 men, although earlier reports indicated the disease was more common in women. The lesion was located in the middle third of the esophagus in 10 cases. The possibility of tumor development from embryonal rests of the tracheobronchial tree in the esophagus is discussed. The prognosis of adenoid cystic carcinomas is not well known, but the treatment and prognosis appear similar to those of epidermoid carcinomas of the esophagus.

The periodic acid—Schiff stain is one of the most valuable methods now available for the demonstration of fungi in tissue.1 In our hands this method has proved superior to the routine hematoxylin and eosin stain for this purpose, and on more than a few occasions it has permitted us to demonstrate the presence of pathogenic fungi that were invisible in routine sections. Because of the failure of this staining method to win widespread acceptance, we are prompted to cite additional instances in which a correct diagnosis was not made until the periodic acid—Schiff stain was used. We are convinced that wider use of this method in the study of bacteriologically negative tuberculomas and nonspecific pulmonary granulomas will result in an increase in frequency of identification of the deep mycoses. The development and the various applications of the periodic acid—Schiff stain have been described in detail by Gomori.2 The

During 35 years of practice devoted largely to the diagnosis and treatment of diseases of the chest, I have indeed been gratified to witness the individual targets of disease come one by one within the range of our medical guns. Diagnostic methods have nearly attained the accuracy of a complex sighting device, while therapeutic artillery has wreaked havoc among most of the once formidable micro-organic enemy hosts. How poorly manned and ill equipped were the ranks of the medical profession in the days of my early practice. Osler1 was depicting pneumonia (one of the most fatal of all acute infections), as a disease that could neither be aborted nor eliminated by any means at our command. Bleeding and hydrotherapy were advocated, and x-ray therapy was considered the most effective treatment for delayed resolution. It was estimated that tuberculosis accounted for at least one out of every seven deaths. Rest,

WITHIN the confines of the mediastinum arise a heterogeneous group of tumors which, by reason of their peculiar derivation, their striking radiographic appearance, and their complex pathology, have long possessed a fascination far exceeding their incidence. Over the past 25 years, coincident with the advancement of thoracic surgery, these curious tumors have ceased to hold a purely academic interest and have assumed a more practical importance. Many reports have appeared stressing the hazards inherent in most mediastinal tumors and the minimal risk attending their excision. Yet, there somehow persists an unreasonable tendency to view them with complacency. In reviewing the records from three large hospitals of all patients with the diagnosis "mediastinal tumor" we repeatedly encountered patients in whom a radiographically demonstrable mediastinal mass had been inadequately investigated and therapeutically ignored. Since more and more of these tumors are being discovered in the asymptomatic stage as a result of x-ray

DIFFUSE interstitial pulmonary fibrosis of the type originally described by Hamman and Rich1 remains a most perplexing process, which, despite its striking histological appearance, may well represent a reaction peculiar not to one but to several inciting factors. Obscure in etiology and supposedly rare in occurrence, this syndrome is nevertheless so conspicuous by the extent of pulmonary involvement, so vicious in its relentless, usually unresponsive course, and so often fatal in its outcome that it is not surprising to note the current display of interest in the subject, as a growing number of case reports and a recent editorial in The Journal of the American Medical Association attest.2Contrary to an erroneous concept being perpetuated in the literature, the original paper by Hamman and Rich appeared not in 1944 but in 1935.1 Fully nine years elapsed before they published what has come to be regarded as the

1)Since Loeffler's syndrome was first described in 1932, a large number of cases have been reported in the foreign literature and a small number in the English-American literature. Whether all of the reported cases are true instances of the syndrome is open to decided doubt.2)The syndrome is best described as a transitory, migratory pulmonary infiltration, demonstrable by roentgenologic examination and associated with eosinophilia, which may be very marked. The severity of the roentgenologic findings is in surprising contrast to the physical examination, which is frequently entirely negative, and to the minor symptomatology and mild clinical course.3)The pathogenesis is still undetermined, but the disease is now generally believed to develop on an allergic background, and intestinal parasitism has been identified as the causative agent in the few cases in which any identification at all has been possible.4)Diagnosis rests upon the radiologic picture, the transience of the roentgenologic findings, and the degree of eosinophilia. It cannot be made upon a single film. Pulmonary tuberculosis is the most frequent differential diagnostic consideration, and for therapeutic reasons the differentiation is extremely important. Therapy is directed toward the allergic disease, Loeffler's syndrome, in itself seldom requiring treatment.5)An additional case of Loeffler's syndrome is herewith added to the American literature of the subject.

Bronchoscopy has advanced far beyond the original indication for its use, the removal of foreign bodies from the bronchi, and is now recognized as a procedure that is, in experienced hands, neither difficult nor dangerous. In such conditions as atelectasis, bronchiectasis, bronchial stenosis, asthma, lung abscess, malignancy, unexplained hemoptysis and tuberculosis, bronchoscopy serves a definite purpose both in diagnosis and treatment. The specific functions of the bronchoscope in the management of these diseases are discussed. In the suppurative diseases its purpose of aspiration is stressed, keeping in mind that an obstructed bronchus might be the causative factor of the suppuration. In neoplastic disease its function is the early establishment of the diagnosis in order that the lung may be resected before metastases develop.

`Kiosks' Get Employees Involved The phones in many companies' human resources departments start ringing first thing in the morning and don't quit all day. Appointments with employees run throughout the [...]