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Bronchoscopic observations in asthmatic children
518
THE
JOURNAL
OF
ALLERGY
berculosis that present symptoms of asthma. He reports the case of a woman, aged thirty-nine years, in whom a diagnosis of chronic tuherculous tracheobronchitis was made. There was a mural stenosis caused by a granulomatous hyperplasia of the mucosa. Stokes believes that cases of known pulmonar) tuberculosis complicated by signs and symptoms of bronchial asthma should have the benefit of a diagnostic bronchoscopy before resorting to allergic investigation.
Tuberculous Bugher,
Tracheobronchitis. J. C.:
J. A.
M.
A. 108:
Samson, P. 1850, 1937.
(‘.,
Barnwell,
J.,
Littig,
J.,
and
In discussing the subject of tuberculous tracheobronchitis, Samson and his coworkers call attention to the varied symptomatology of this condition. Among the various signs and symptoms, it is noteworthy that persistent inspiratory or expiratory wheezing is not infrequently present. Attacks of asthmatoid breathing with prolongation of one or both respiratory phases, they state, are frequently mistaken for asthmatic bronchitis. Bronchoscopy is considered not to be contraindicated in active pulmonary tuberculosis. Bronchoscopically, the following types of tracheobronehial lesions are recognized although any patient may show a combination of lesions: (1) Nonulcerative and nonstenotic, characterized by circumscribed infiltration and thickening and often by submueosal tuberculoma formation; (2) hyperplastic, characterized by xubmucosal proliferation and tuberculoma formation; and (3) ulcerat,ive, Iv-ith diffuse or circumscribed loss of mueosa. Indications 1937.
for
Radical
Sinus Surgery.
John
G. McLaurin.
South.
hl.
J. 30:
633,
In discussing the matter of indications for radical sinus surgery, McLaurin expresses the following opinion regarding chronic hyperplastic sinusitis with polypoid formation. He believes that the presence of these conditions is a definite indication for radical surgery. At the same time, he believes that allergic therapy should be carried out. Regardless of the type of surgery employed, he does not expect much permanent benefit unless general measures directed toward relieving an essential allergic tendency are employed. Attention is called to the former belief that hyperplastic changes in the sinuses are primarily of infectious origin. He emphasizes now, however, that these conditions should be considered primarily of allergic origin with few exceptions. In some cases of hyperplastic ethmoiditis with polyps, only the removal of polyps with proper control of the allergic state, is advised. The presence of secondary infection, however, McLaurin believes, is an indication for radical types of sinus surgery.
Pediatrics UNDER
Bronchoscopic Rhin.
THE
DIREWION
Observations
& Laryng.
45:
881,
OF Wrr.r,~nar
in Asthmatic
C. DEAMER,
Children.
M.D.,
SAX
E'RANPIS~V~
Van Loon, E. L.:
Ann.
Otol.,
1936.
Over a two-year period, 18 asthmatic children were examined and treated bronchoscopically. The procedure was of apparent value in removing obstructing secretion and for obtaining secretion for the preparation of vaccine. The organisms obtained differed from those of the sputum and nasal smears in the same patient. In order of frequency they were nonhemolytic streptococci, mucus catarrhalis, nonhemolytic staphylococci, hemolytic streptococci, pneumococci, and
519
ABSTRACTS
influenza. In the four instances where roentgenogram bronchiectasis, lipiodol installation did not confirm the dicative of bronchospasm was seen, but an accentuation bronchial narrowing was an almost constant observation, rigidity of the bronchial walls. Only one patient was of the procedure.
suggested the need for impression. Nothing inof the normal expiratory suggesting a lack of not improved as a result
Research on the Variation in Acid-Base Balance in the Blood of Infants With Exudative Diathesis Treated With Hemotherapy. Tatafiore, 1%: atria
44:
881,
Affected La
Pedi-
1936.
Continuing work along similar lines done since 1931, Tatafiore reports on 12 breast-fed infants presenting eczema as the manifestation of their exudative diathesis. Each had proved refractory to the ordinary methods of treatment and presented as evidence of acidosis a lower than normal plasma carbonate. From 6 to 15 injections of maternal blood were given in doses of 1 C.C. to 5 C.C. Improvement was noticed after the second injection usually, and in 10 of the 12 a complete cure was obtained. Two patients were lost track of. A check at the end of treatment of the remaining 10 showed that their plasma carbonate had risen to normal. The total duration of treatments is not stated in this report.
Serum
Lipids
in Eczema
Am.
J. Dis.
Child.
53:
and in Other 933,
Pathologic
Conditions.
Hansen,
A. E.:
1937.
The cholesterol content, total fatty acid content, and iodine absorpt.ion of the serum of about 140 infants, children, and young adults were determined. Half of this group were normal controls, the remainder included 31 cases of eczema and various other pathologic conditions. Almost all of the eczematous subjects showed a significant lowering of the iodine number of the fatty acids, in contrast with the other pathologic subjects, and with the normal group. The findings were independent of such influencing factors as age, previous diet, and infection. Following the administration of large doses of oils of high iodine number, there was unmistakable improvement in the eczematous subjects as well as an increase in the iodine number of their serum lipids. The author believes that these observations suggest a fundamental relationship between disturbance in lipid metabolism and the pathogenesis of eczema.
Allergic Child.
Tuberculous 53:
1277,
Purpura.
Wright,
H. P., and
Racal, H. I~.:
Am.
J. Dis.
1937.
An apparently healthy thirteen-year-old boy from a tuberculous family was tested on the forearm by the Mantoux method with 0.1 C.C. of the l:l,OOO dilution of old tuberculin. Two days later the test was markedly positive and had a necrotic center. The following day a purpuric rash appeared on the same forearm and gradually spread to all of the extremities and to the trunk. There was a marked leucopenia and an eosinophilia of 29 per cent. One year later another Mantoux text was done on the opposite forearm. This was markedly positive within twenty-four hours, and within forty-eight hours both forearms showed petechiae. At no time did the chest plate show evidence of active t,uberculosis in the lung parenchyma.
The Treatment Nourrisson at
of Asthma 24:
225,
A group of 36 infants the “master point”
in Infants
by Chinese Acupuncture.
Lavergne,
M.:
1936. were treated at the base
of
by acupuncture. the sternum
at
The the
needles nipple
were level,
applied and, if
THE
JOURNAL
OF
ALLERGY
berculosis that present symptoms of asthma. He reports the case of a woman, aged thirty-nine years, in whom a diagnosis of chronic tuherculous tracheobronchitis was made. There was a mural stenosis caused by a granulomatous hyperplasia of the mucosa. Stokes believes that cases of known pulmonar) tuberculosis complicated by signs and symptoms of bronchial asthma should have the benefit of a diagnostic bronchoscopy before resorting to allergic investigation.
Tuberculous Bugher,
Tracheobronchitis. J. C.:
J. A.
M.
A. 108:
Samson, P. 1850, 1937.
(‘.,
Barnwell,
J.,
Littig,
J.,
and
In discussing the subject of tuberculous tracheobronchitis, Samson and his coworkers call attention to the varied symptomatology of this condition. Among the various signs and symptoms, it is noteworthy that persistent inspiratory or expiratory wheezing is not infrequently present. Attacks of asthmatoid breathing with prolongation of one or both respiratory phases, they state, are frequently mistaken for asthmatic bronchitis. Bronchoscopy is considered not to be contraindicated in active pulmonary tuberculosis. Bronchoscopically, the following types of tracheobronehial lesions are recognized although any patient may show a combination of lesions: (1) Nonulcerative and nonstenotic, characterized by circumscribed infiltration and thickening and often by submueosal tuberculoma formation; (2) hyperplastic, characterized by xubmucosal proliferation and tuberculoma formation; and (3) ulcerat,ive, Iv-ith diffuse or circumscribed loss of mueosa. Indications 1937.
for
Radical
Sinus Surgery.
John
G. McLaurin.
South.
hl.
J. 30:
633,
In discussing the matter of indications for radical sinus surgery, McLaurin expresses the following opinion regarding chronic hyperplastic sinusitis with polypoid formation. He believes that the presence of these conditions is a definite indication for radical surgery. At the same time, he believes that allergic therapy should be carried out. Regardless of the type of surgery employed, he does not expect much permanent benefit unless general measures directed toward relieving an essential allergic tendency are employed. Attention is called to the former belief that hyperplastic changes in the sinuses are primarily of infectious origin. He emphasizes now, however, that these conditions should be considered primarily of allergic origin with few exceptions. In some cases of hyperplastic ethmoiditis with polyps, only the removal of polyps with proper control of the allergic state, is advised. The presence of secondary infection, however, McLaurin believes, is an indication for radical types of sinus surgery.
Pediatrics UNDER
Bronchoscopic Rhin.
THE
DIREWION
Observations
& Laryng.
45:
881,
OF Wrr.r,~nar
in Asthmatic
C. DEAMER,
Children.
M.D.,
SAX
E'RANPIS~V~
Van Loon, E. L.:
Ann.
Otol.,
1936.
Over a two-year period, 18 asthmatic children were examined and treated bronchoscopically. The procedure was of apparent value in removing obstructing secretion and for obtaining secretion for the preparation of vaccine. The organisms obtained differed from those of the sputum and nasal smears in the same patient. In order of frequency they were nonhemolytic streptococci, mucus catarrhalis, nonhemolytic staphylococci, hemolytic streptococci, pneumococci, and
519
ABSTRACTS
influenza. In the four instances where roentgenogram bronchiectasis, lipiodol installation did not confirm the dicative of bronchospasm was seen, but an accentuation bronchial narrowing was an almost constant observation, rigidity of the bronchial walls. Only one patient was of the procedure.
suggested the need for impression. Nothing inof the normal expiratory suggesting a lack of not improved as a result
Research on the Variation in Acid-Base Balance in the Blood of Infants With Exudative Diathesis Treated With Hemotherapy. Tatafiore, 1%: atria
44:
881,
Affected La
Pedi-
1936.
Continuing work along similar lines done since 1931, Tatafiore reports on 12 breast-fed infants presenting eczema as the manifestation of their exudative diathesis. Each had proved refractory to the ordinary methods of treatment and presented as evidence of acidosis a lower than normal plasma carbonate. From 6 to 15 injections of maternal blood were given in doses of 1 C.C. to 5 C.C. Improvement was noticed after the second injection usually, and in 10 of the 12 a complete cure was obtained. Two patients were lost track of. A check at the end of treatment of the remaining 10 showed that their plasma carbonate had risen to normal. The total duration of treatments is not stated in this report.
Serum
Lipids
in Eczema
Am.
J. Dis.
Child.
53:
and in Other 933,
Pathologic
Conditions.
Hansen,
A. E.:
1937.
The cholesterol content, total fatty acid content, and iodine absorpt.ion of the serum of about 140 infants, children, and young adults were determined. Half of this group were normal controls, the remainder included 31 cases of eczema and various other pathologic conditions. Almost all of the eczematous subjects showed a significant lowering of the iodine number of the fatty acids, in contrast with the other pathologic subjects, and with the normal group. The findings were independent of such influencing factors as age, previous diet, and infection. Following the administration of large doses of oils of high iodine number, there was unmistakable improvement in the eczematous subjects as well as an increase in the iodine number of their serum lipids. The author believes that these observations suggest a fundamental relationship between disturbance in lipid metabolism and the pathogenesis of eczema.
Allergic Child.
Tuberculous 53:
1277,
Purpura.
Wright,
H. P., and
Racal, H. I~.:
Am.
J. Dis.
1937.
An apparently healthy thirteen-year-old boy from a tuberculous family was tested on the forearm by the Mantoux method with 0.1 C.C. of the l:l,OOO dilution of old tuberculin. Two days later the test was markedly positive and had a necrotic center. The following day a purpuric rash appeared on the same forearm and gradually spread to all of the extremities and to the trunk. There was a marked leucopenia and an eosinophilia of 29 per cent. One year later another Mantoux text was done on the opposite forearm. This was markedly positive within twenty-four hours, and within forty-eight hours both forearms showed petechiae. At no time did the chest plate show evidence of active t,uberculosis in the lung parenchyma.
The Treatment Nourrisson at
of Asthma 24:
225,
A group of 36 infants the “master point”
in Infants
by Chinese Acupuncture.
Lavergne,
M.:
1936. were treated at the base
of
by acupuncture. the sternum
at
The the
needles nipple
were level,
applied and, if