Small though significant differences (P < 0-05) were found only between the changes in FEVy after placebo and the reductions after each drug at one, two, and three hours, and there was no significant difference beween the effects of the two drugs. This study supported the suggestion that betasympathetic stimulation contributes to the bronchodilatation evident during exercise. Moreover, it emphasizes the importance of assessing airway resistance both at rest and during exercise and of comparing the pulmonary effects of different drugs when their cardiac beta-blocking activity is equivalent.

The effect of lobectomy on lung function was investigated in 16 patients in whom comprehensive lung function tests were performed before and between six weeks and six months after lobectomy. The operation was well tolerated even by patients with quite severe airways obstruction. The effect of lobectomy on forced flow rates was in keeping with the change in lung volumes. There was no alteration in the distribution of ventilation and the diffusion capacity remained unchanged. The changes in the pressure volume curves were difficult to explain. All patients, even those with nearly "complete" hyperinflation of the remaining lung, had appreciable increases in maximal intrapleural pressure at full inspiration.

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Bronchial mucosal biopsy specimens were obtained during fibreoptic bronchoscopy in 30 patients receiving a new oral cephalosporin antibiotic, cefaclor (10 had 250 mg, 10 had 500 mg, and 10 had 1000 mg every eight hours). In 10 patients (from all dosage groups) cefaclor was undetectable in the bronchial mucosa but in every case the serum concentration was low, suggesting incomplete absorption. The mean (SD) bronchial mucosal concentration after 250 mg was 3-78 (1-77) ,ug/g (range 2-1-5-8 pug/g, n = 4), after 500 mg 4-43 (2.04) ug/g (range 2-0-7-1 ,ug/g, n = 8), and after 1000 mg 7*73 (2.76) ug/g (range 5-012-7 ,ug/g, n = 6). A significantly higher concentration in the bronchial mucosa was achieved with 1000 mg than with 250 mg (p < 0.05) or 500 mg (p < 0-025). These concentrations should be effective against Streptococcus pneumoniae, most strains being inhibited below 10 ,ug/ml. The concentrations were within one dilution of the minimal inhibitory concentration for Haemophilus infuenzae, most strains being inhibited below 4 0 Zg/ml. Some strains of H injflenzae will not be inhibited by the concentrations of cefaclor found in the bronchial mucosa, particularly those that are ampicillin resistant.

No abstract