Early involvement of the bronchi in patients with malignant lymphoma.

Fibreoptic bronchoscopy in previously untreated patients with malignant lymphoma provided diagnostic information in 8 of 25 cases with radiological evidence of intrathoracic involvement. There was a marked difference in the pattern of endobronchial involvement between Hodgkin's Disease (HD) and Non Hodgkin's Lymphoma (NHL) which specifically infiltrated the bronchus-associated lymphoid tissue. Bronchoalveolar lavage was abnormal in only one patient with Hodgkin's Disease in whom the presence of many Sternberg-Reed cells suggested occult dissemination of otherwise localised disease.

Routine antibiotics in hospital management of acute asthma.

The value of antibiotics was assessed in a randomised, double-blind study of amoxycillin and placebo in sixty adults admitted to hospital with acute exacerbations of asthma. 37 exacerbations were treated with amoxycillin and 34 were treated with placebo. Response to treatment was closely monitored but no significant difference in improvement was demonstrated between groups for length of hospital stay, time taken for 50% improvement in symptoms, patient's self assessment and respiratory function, and symptoms and respiratory function at time of discharge from hospital. Antibiotics should not be given routinely to patients admitted to hospital with acute exacerbations of asthma.

A comparison of antibody responses to Admune inactivated influenza vaccine in serum and respiratory secretions of healthy non-smokers, healthy cigarette-smokers and patients with chronic bronchitis.

Admune inactivated influenza vaccine was administered intramuscularly to 31 healthy subjects (18 non-smokers and 13 cigarette smokers) and 30 patients with chronic bronchitis. Homologous haemagglutination inhibition (HI) antibody titres were measured in serum and respiratory secretions over a three-month post-vaccination period. Clinical reactions to the vaccine were recorded during the week following vaccination. Among healthy subjects cigarette smoking did not influence HI antibody responses in serum and nasal secretion following vaccination. Chronic bronchitics produced at least as much serum and nasal antibody as healthy subjects and their sputum and nasal secretion antibody responses were comparable. Clinical reactions to the vaccine were mild and well tolerated in all groups but seven patients with chronic bronchitis (23%) experienced increased respiratory symptoms during the week following vaccination.

A standardized filter paper technique for assessing nasal secretory activity.

A simple filter paper technique for estimating nasal secretory activity (NSA) was studied in 179 healthy adults. The technique was reproducible and NSA correlated independently with age and race (P less than 0.001 in each case) but not with sex or smoking habits. Subjects with a past history of atopic disease (asthma, rhinitis or eczema) produced significantly more nasal secretion than those without such a history (P less than 0.03). Among the former there was no significant difference in quantity of secretion recovered between those with and those without a past history of rhinitis. Increased NSA appears to be a marker of the atopic state and its measurement could be of value in the management of patients with allergic nasal disorders.

Pneumocystis carinii pneumonitis: a serological study.

Sera from 23 proven or clinically suspected cases of Pneumocystis carinii pneumonitis (PCP) in immunosuppressed patients predominantly with acute lymphoblastic leukaemia, and from 91 normal people, were examined for antibody to P. carinii by indirect immunofluorescence. Low levels of antibody were found in 51 of 91 normal people and elevated or rising titres of antibody in 18 out of 21 cases from whom paired or serial convalescent sera could be obtained.

Potassium supplements in patients treated with corticosteroids.

1. Preliminary studies are reported on 8 patients with lung disease given prednisone both with and without potassium supplements. 2. There were no abnormalities of plasma potassium but there was a relationship between the dose of prednisone and the urinary excretion of potassium whilst off supplements: higher doses were associated with increased potassium excretion. 3. Patients who had been on treatment for a short period retained more of their supplements than did those who had been on treatment for several years. 4. It is suggested that with prolonged treatment control of potassium homeostasis may be altered, and that more detailed metabolic studies should be carried out.