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In a random sample of sera from a predominantly male group of hospital patients with an average age of 67, complement-fixing antibodies were found in 20 per cent to M. hominis type 1, in 16 per cent to Unknown Strain CE 5, in 1 per cent to M. pharyngis and in 2 per cent to M. pneumoniae. These percentages are lower than those reported in the literature for younger populations of patients. Thus the immunological experience with mycoplasmas (pleuropneumonia-like organisms) varies from one population to another. In general, however, the incidence of mycoplasmal infection seems to be lower in older than in younger populations. The findings also indicate that the mere isolation of these organisms from the sera of patients who manifest a disease process does not constitute evidence of an etiological relationship unless other correlates can be established.

These studies demonstrate that for clinical purposes bedside tests for timed and total vital capacity are as valuable as the more time-consuming pulmonary function laboratory tests. The bedside method has the additional advantage that the clinician in charge of the patient observes the test, can watch the movement of the dial and can determine the degree of cooperation of the patient. The wide variations between paired tests in patients with emphysema make judgment of the effects of therapy difficult. These patients respond subjectively to attention and frequently report improvement which cannot be demonstrated objectively. Objective evidence of improvement requires differences of at least 20 per cent in timed or total vital capacity. One cannot use the standard error figures for normals for the evaluation of therapy in patients with emphysema. Our studies additionally demonstrate that the height and movement of the diaphragms can be measured at the bedside with sufficient accuracy for clinical purposes and that recourse to elaborate x-ray examinations yields no more significant information.

SummaryThe Fyrite CO2 Indicator Model CND is a satisfactory instrument for bedside measurement of carbon dioxide content of expired air.

The capacity of elderly persons to tolerate a standardized heat-work load was measured under rigidly controlled conditions on a group of 32 females, average age 69 years, and a group of 68 males, average age 72 years, who lived in the St. Petersburg area; age range was 60-93 years. The standard test consisted of five minute seated rest followed by four five-minute work periods on a bicycle ergometer. Each work period was followed by a ten minute rest period while seated on the ergometer. The four work periods were at progressively increasing levels of severity with average O2 consumptions of 10, 13, 16 and 19 cc/kg per minute at 92F dry-bulb and 82F wet-bulb temperatures. Pulse rates, ventilation rates, O2 consumption and oral temperatures were measured during the last minute of each work period. Twelve lead EKG were taken and blood cholesterols were measured. Those with abnormal EKG's did not have higher cholesterol levels. Ability to tolerate the heat-work load was surprisingly good. Under conditions of heat and at a level of work that required an O2 consumption four times resting values pulse rates were 119 for the females and 105 for the males. The pulse rates for the females were 10-15 beats per minute lower than those observed in a group of young and middle aged women performing the same rate of work at 'comfort temperatures.' For the males the work pulse rates were only slightly (2-6 beats per minute) lower than those observed in a large group of young and middle aged coal miners. It appears that elderly persons who are free from active disease processes can tolerate a moderate heat-work load without difficulty. (Author)

The inflammatory response to histamine was studied in ten atopic and ten nonatopic control patients by a skin-window technique. All of the atopic individuals responded in 45 minutes with the exudation of large numbers of polymorphonuclear leukocytes and significant eosinophils. Only an occasional cell was exuded by the nonatopic individuals in the same time period, despite the fact that the whealing response in both groups was similar. This immediate inflammatory response to histamine is another evidence of the unique constitutional capacity of atopic individuals.