279 patients with 285 episodes of bacteremic pneumococcal pneumonia (Pnb), treated at the 2 departments for infectious diseases in Stockholm, Sweden, were reviewed retrospectively. Almost half of all episodes were caused by serotypes 3, 9 and 4 (in that order). The overall mortality rate was 7% and as low as 5% if patients with extrapulmonary complications were excluded. As in other studies male sex, alcoholism and absence of leukocytosis on admission to hospital were all associated with a higher mortality rate. However, the prognosis for old patients was much better than in most other studies. This was true also when the infecting strain was of serotype 3. For 89 consecutive patients out of the 279 ones with Pnb the clinical, laboratory and chest X-ray data were compared with those of 44 patients with non-bacteremic pneumococcal pneumonia (Pn) and 27 patients with Mycoplasma pneumoniae pneumonia (MP). Within the pneumococcal group almost all non-bacteremic patients had respiratory tract symptoms compared to less than half of the patients with bacteremic disease. High age, alcoholism, chills, pleuritic chest pain, a leukocyte count of greater than 15 x 10(9)l and an elevated CRP were factors significantly more common among those with pneumococcal pneumonia than among the MP patients. On chest X-ray an alveolar pattern was seen in all but 2 of the totally 133 patients with a pneumococcal pneumonia, but also in half the patients with MP.

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The present investigation was undertaken to compare the neurotoxic effects of subarachnoid application of the new water-soluble contrast medium metri zamide with those of meglumine iocarmate, which is considered to be the best and least injurious of the water-soluble contrast media now in use for myelo graphy.In preliminary tests on 4 dogs, in which 1.5 to 2 ml of metrizamide in a concentration of 170-300 mg I/ml was injected into cisterna magna, no definite effects on the ECG and the arterial blood and CSF pressure were found, neither were any neurologic signs observed. The contrast medium was run from the cisterna magna to the basal cisterns in all the dogs, and in one dog was subse quently brought into contact with the cerebral cortex for a brief interval, leaving small remnants to be absorbed in this region.The dogs were anaesthetized, intubated and kept on artificial respiration. Anaesthesia was induced with Nembutal (Mebumal Sodium) and continued with Fluothane (Halothane). Three of the four dogs were still alive 10 months later and in excellent condition. The fourth dog initially was free from neurologic 102

One single clinical complication of grand mal seizures in conjunction with the subarachnoid administration of the new non-ionic contrast medium metrizamide is reported in a patient who had been taking chlorpromazine. An interaction between the contrast medium and phenothiazine derivatives is considered probable.