Summary Purpose: To analyze the association between solid tumors and the occurrence of factor VIII antibodies and the response to treatment. Patients and Methods: Published case reports describing the association of a solid tumor and a factor VIII antibody retrieved from 20 data bases. 40 cases were reported and 27 cases were analyzable. Results: Factor VIII antibodies occurred in a close temporal relationship with the detection of the tumor in most cases. No association with a specific type of tumor could be identified. Immune suppressive treatment with prednisone ± cyclophosphamide was successful in the majority of cases. Conclusion: It is likely that there is a causal association between some solid tumors and factor VIII antibodies, but it is an extremely rare complication of cancer. The immunoglobuline nature of the inhibitor and the good response to immune suppressive treatment suggests that it is an autoimmune phenomenon. The pathogenesis is unknown.

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SummaryIn a retrospective study 51 published cases of post-partum factor VIII inhibitors were analyzed with regard to the outcome according to treatment. The overall outcome was favorable with 97% survival at two years. The probability of complete remission (CR, absence of the inhibitor and normalization of factor VIII activity) was almost 100% at 30 months. Steroid treatment appears to be not superior to no treatment, but patients treated with immunosuppressive drugs (cyclophosphamide, azathioprine, 6-mercaptopurine) had a significantly shorter time to CR. In the absence of a randomized trial this analysis may be helpful for decision-making in women with factor VIII post-partum inhibitors. Because of the retrospective study design, conclusions have to be regarded with caution.

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There has been continued controversy among members of the medical profession as to the effectiveness of "cold vaccines" in immunizing against the common cold or even in abating its severity and preventing serious complications. Whereas a general survey of the literature points to rather encouraging results, there are outstanding, progressive physicians who feel that nothing is accomplished by such vaccines.In the year 1935-1936 there were some 10,000 students enrolled in the University of Michigan. At the student health service during this period, approximately 4,000 of these students were treated for infections of the upper part of the respiratory tract on more than six thousand separate occasions. In the same year almost 600 students were confined to the health service for treatment of the common cold or its complications for a total of nearly four thousand days, the average period of confinement per patient being six and two-tenths days. The number of additional days spent at home in the treatment of infections of the respiratory tract is incalculable.During the past years numerous students had sought our advice about "cold vaccines." They were never encouraged to take such vaccines, but if a student was anxious to try a vaccine a stock or an autogenous preparation was given in the generally accepted fashion. No attempt was made to determine definitely whether or not the student considered that this preventive measure had been of any benefit.Because the literature was merely suggestive of beneficial results and because we ourselves felt from superficial observations and from the teachings handed down to us that "cold vaccines" were of little value, we decided to undertake a controlled experiment. Our objective was a definite experience of our own tending to determine the value of such vaccines.Although it would have been highly desirable to try various stock vaccines and autogenous vaccines on different groups of persons, it seemed perhaps better, in view of the limited number of subjects coming to us, to concentrate on one stock preparation and to administer it to

Cognizant of results being obtained in the treatment of streptococcic and staphylococcic infections with penicillin, we believed that this drug should also be effective in the therapy of certain types of sinusitis. During the past year we used penicillin in some of the many cases of suppurative sinus disease which came to our attention. It is desirable to describe at the very beginning the manner in which this study evolved and the experiences which eventually led us to employ penicillin in selected cases of suppuration of the paranasal sinuses. Because of the rather striking results which followed its use, we decided to report our observations in those cases in which penicillin was employed either alone or in conjunction with surgical treatment. Data were obtained which, we believe, enable us to begin to suggest the indications for its use in the treatment of suppuration of the sinuses. FIRST CASES IN WHICH PENICILLIN WAS TRIEDIn the first case in which we treated suppurative sinusitis with penicillin it produced a rapid and dramatic cure.A 27 year old aviation cadet suffered multiple frac¬ tures of the maxillas and nasal bones in an airplane crash. One month later a draining fistula developed immediately above the bridge of the nose. On Aug. S, 1943, fifty-eight days after the accident, this cadet came under our care. He still had at the glabella a drain¬ ing fistula through which a probe could be passed into the right frontal sinus, and pus was coming from the frontal and ethmoid sinuses bilaterally. Prior to coming to us, he had had intensive treatment with sulfonamide compounds without any apparent effect on the suppuration. While it was our opinion that a bilateral external frontoethmoidectomy would probably be required to eradicate the infection, we were reluc¬ tant to resort to this radical procedure because of the relatively short duration of the sinus disease. We treated him conservatively for nine weeks, adminis¬ tering local treatments to the nose, irrigating the sinus through the external fistula and then insufflating sulfanilamide powder-all without effect. Because cul¬ tures of the exúdate from the fistula revealed Strepto-coccus viridans, which proved to be penicillin sensitive in vitro, and since we had just received our first supply of penicillin, we decided to try it in this case. The penicillin was given intramuscu¬ larly, 10,000 units every three hours for six days and then 5,000 units every three hours for five days-a total of 695,000 units. After thirty-six hours of treatment the fistula was closed and there was only a minimal amount of exúdate in the nose. At the end of three days of treatment all discharge had disappeared, and it never recurred during the three months that he was kept under observation. Roentgenologic studies at the completion of the penicillin therapy showed clearing of the involved sinuses ( fig. 1 A).The second case in the trial series was that of a soldier who had a lifelong history of nasal allergy and purulent nasal discharge.There was pus on the floor of the nose a...