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An association between a genetically determined deficiency of the serum enzyme al antitrypsin and pulmonary emphysema is now well established. Serum antitryptic activity was measured in 103 patients suspected of having emphysema. Eighty-seven fulfilled the diagnostic criteria for emphysema and, of these, 16 had deficient levels, 5 had intermediate levels, and 66 had normal levels. The results of clinical, radiographic, and physiological studies in each group were then compared. Characteristic features noted in the deficient group included onset of dyspnoea during the third or fourth decades and uniformly symmetrical radiographic lower zone involvement. Other factors such as sex distribution, cigarette smoking, and chronic bronchitis are discussed.Sixty-eight relatives of the 16 patients with deficient levels were also studied. The findings in these are compatible with an autosomal recessive mode of inheritance although difficulties in identifying the heterozygous state were encountered. Six relatives had deficient levels and of these three had emphysema.Emphysema is most commonly diagnosed in men with chronic bronchitis in the fifth or sixth decades (Talamo, Blennerhassett, and Austen, 1966 This paper presents the findings in a selected series of patients attending the Brompton Hospital with chronic respiratory disease in whom levels of serum antitryptic activity were estimated. DIAGNOSIS OF EMPHYSEMAEmphysema is defined on an anatomical basis as a disease characterized by structural changes in the lung causing increase, beyond the normal range, in the size of air spaces distal to terminal bronchioles (Scadding, 1969). In life, however, histopathological specimens are not usually available and therefore the diagnosis depends on clinical, radiological, and physiological criteria. For the purpose of this study the following radiological and physiological criteria were adopted, the former having been shown to be strongly correlated with moderate to severe emphysema (Reid and Millard, 1964): 1. Radiological (Simon, 1964).

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Purpose: To obtain information on characteristics, management, current objective nutritional status and perception of nutritional status of children with cerebral palsy (CP) from healthcare professionals (HCPs) and caregivers. Materials and methods: A detailed survey of several items on eight main topics (general characteristics, motor function, comorbidities, therapies, anthropometry, feeding mode and problems and perceived ARTICLE HISTORY

Although the relationship between 25-hydroxy (25-OH) vitamin D and asthma is known, it is unknown if 25-OH vitamin D levels are correlated with asthma severity in pediatric patients. The aim of this study was to compare the blood 25-OH vitamin D levels of asthma patients and healthy control groups and to evaluate any correlation between asthma severity and blood 25-OH vitamin D levels in pediatric asthma patients. Methods This is a cross-sectional study which shows the 25-OH vitamin D levels of asthma patients and compared to healthy controls followed by a tertiary pediatric clinic. We investigated the effect of 25-OH vitamin D levels on the severity of asthma. The severity of asthma was determined mainly by the duration of asthma diagnosis, a number of attacks in the previous year, antiinflammatory medication usage in a previous year, atopy presence in the family, skin prick test positivity, and immunoglobulin E (IgE) levels of asthma patients. Results Compared with control groups, asthma patients had significantly lower 25-OH vitamin D, calcium (Ca) levels, and higher number of patients who had a 25-OH vitamin D deficiency, (p<0.0001, p<0.0001, p<0.0001, respectively). We found a correlation between blood 25-OH vitamin D levels and force expiratory capacity in one second (FEV1) and forced vital capacity (FVC) respectively (p< 0.001, r=0.512), (p< 0.001, r=0.513). There was an association between FEV1, FVC and blood 25-OH vitamin D levels in terms of deficient levels (<20 ng/mL) or insufficient levels (≥20 and <30 ng/mL) (p<0.001, r=0.459), (p< 0.001, r=0.450), respectively. Conclusions The 25-OH vitamin D levels were lower in pediatric asthma patients with worse spirometry results. Effects of Vitamin D supplementation need to be evaluated by well-designed studies.

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The case of a patient with Wegner's granulomatosis who died with haemorrhagic adrenal infarction is described. Thyroid involvement, another feature not previously reported in this disease, was also noted.

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