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In studies of calcium metabolism in 13 unselected patients with untreated sarcoidosis all were normocalcaemic but five had hypercalcuria. All had normal renal function. Calcium absorption was indexed by a double isotope test. 45Ca hyperabsorption occurred in six patients. Ten kinetic studies were carried out with 47Ca and in six bone turnover was increased. 45Ca absorption correlated well with the calculated bone uptake rate of calcium, and with urine calcium excretion. These results suggest that in sarcoidosis abnormalities in calcium metabolism are fairly common although they rarely result in sustained hypercalcaemia.

Twelve asthmatic patients with nocturnal wheezing were given a single nocturnal oral dose of slow-release aminophylline or matched placebo in a double-blind crossover trial. A dose of slow-release aminophylline (mean 683 mg; 10.4 mg/kg) gave a therapeutic plasma-theophylline concentration 10 h later (mean 10.9 mg/l). This was not associated with any adverse effects. Mean peak expiratory flow on waking was significantly greater with aminophylline (332 +/- 31 l/min) than placebo (283 +/- 32 l/min), whereas evening values did not differ. There was a significant difference between morning and evening peak flow on placebo (mean 22%) but not on aminophylline (5%), indicating abolition of the morning fall in peak flow. This was not at the expense of response to beta-agonists, since the response to inhaled salbutamol was the same for both treatments. The use of extra metered doses of inhaled beta-agonist during the night was significantly less with aminophylline, and there was a subjective improvement in nocturnal symptoms in all patients. Slow-release aminophylline in adequate dosage appears to be the most effective treatment yet demonstrated for nocturnal asthma.

A continuous-flow sampling system (CFS) for convenient and rapid determination of respiratory gas exchange during steady-state exercise was described. CFS was compared to the classical bag collection system (BCS) by utilizing both methods concurrently during exercise for analysis of 32 1-min gas samples. The gas collected by BCS was analyzed by chemical absorption. The error in the gas mixing and sampling technique of CFS contributed to the absolute error of the gas analysis but did not adversely affect the reliability. The linear regression analysis on the data suggests that CFS is a relatively accurate and reliable system for use at light and moderate levels of steady-state work. However, it is hypothesized that unsteady-state conditions and heavy exercise, which elicits high ventilation rates, would compromise the accuracy and reliability of CFS. Therefore, it is recommended that the traditional BCS be utilized for determination of maximal oxygen uptake.

The potential value of indium-labelled bleomycin as a diagnostic scanning agent has been investigated in patients with a variety of malignant neoplasms involving the thorax, abdomen or pelvis. Sixty-five patients were scanned on 72 occasions, the optimum time to perform the examination being 72 hours after the intravenous injection of 2 mCi 111-In chelated to 2 mg bleomycin. Tumour uptake was visualized in 53 out of 62 scans in which tumour was present, but the extent of tumour was underestimated in seven cases, and over-estimated in five others. The latter were mostly due to uptake in infective lesions. These results indicate that the situations in which indium bleomycin is most likely to provide clinically relevant information are the distinction between recurrent tumour and post-radiotherapy changes in the thorax and pelvis, the diagnosis of recurrent carcinoma within the pelvis, and the distinction between bony metastases from carcinoma of the prostate and Paget's disease. Further clinical trials are necessary to assess these situations.

The physiological characteristics of 32 elite Canadian synchronized swimmers were studied. The variables examined included aerobic power (VO2 max), anaerobic power measured by a maximal 30 second effort on a bicycle ergometer (AN30) and pulmonary function including forced vital capacity (FVC) and forced expiratory volume in one second (FEV 1.0). As a group, they were superior to non-athletic (untrained) women in VO2 max, with a mean of 44.4 ml . kg-1 . mon-1 or 2.39 l . min-1 but lower than competitive women swimmers of similar age. FVC and FEV 1.0 values were also higher than non-athletes and lower than competitive swimmers. AN30 was unremarkable, being identical to that of non-athletes. Comparisons were made between junior and senior competitors and between the 2 senior teams that made up the Canadian national team. Correlations between the athletes' performance scores in the 1977 Canadian national championships and VO2 max, AN30, FVC amd FEV 1.0 failed to yield any significant relationships. However, VO2 max in ml . kg-1 . min-1 related to solo performance scores was very close to the accepted level of significance (r = .41, p = 06). Precision techniques and skills are undoubtedly of major importance in this sport. However, a level of aerobic power sufficient to prevent fatigue during a performance and to allow long hours of training on technique would be prudent.