Summary: Eight patients were treated with two 80-mg.doses of methylprednisolone acetate (Depo-Medrone), given at an interval of two weeks. Pituitary-adrenal function was assessed before, during, and after treatment.Plasma cortisol levels were depressed maximally 72 hours after each injection of methylprednisolone acetate, and then gradually returned to normal. The adrenocortical response to administered corticotrophin was similarly affected; in seven patients normal values were again recorded three weeks after the second injection of methylprednisolone acetate. One patient whose adrenal function had returned to normal still showed some degree of pituitary suppression eight weeks after his second injection. Several side-effects were noted, and clinically the patients fared less well than a larger series studied during the previous year. IntroductionMethylprednisolone acetate (Depo-Medrone), a slow-release steroid for injection, is used in the treatment of allergic and other disorders but no information is available to indicate the effect of this treatment on the hypothalamicpituitary-adrenal axis. It seemed desirable, therefore, to assess hypothalamic-pituitary-adrenal function in a group of patients receiving methylprednisolone acetate in the dosage used for a recent trial of hay-fever treatment (Ganderton, Brostoff, and Frankland, 1969), when two 80-mg. injections of methylprednisolone acetate were given at an interval of two weeks. The effect on the resting plasma cortisol level, on the response of the adrenal gland to synthetic adrenocorticotrophic hormone (Synacthen), and on the plasma cortisol response to the stress of insulin-induced hypoglycaemia was studied.

The toe-nail dust produced in chiropodial practice causes allergic hypersensitivity and Trichophyton rubrum is the most common fungal cause of nail dystrophy. Use of drills and burrs to reduce the thickness of hyperkeratotic nails generates dust and chiropodists develop precipitins to T. rubrum. A survey into the prevalence of these antibodies in 11-2% of state-registered chiropodists is described and 14% of the profession estimated to have antibodies to T. rubrum. In response to a questionnaire 49% stated that toe-nail dust troubled them; complaints of nasal and eye symptoms were 72 and 41% respectively. In 384 chiropodists ventilatory function was tested with a vitaiograph. Restrictive lung disease appears to be more common in chiropodists than other sedentary workers.

The 12 cases with asbestos body counts of over 10 were all males, and a definite history of industrial asbestos exposure was obtained in 10 cases. The exceptions were an electrician (count 95) and a painter and decorator (count 98). On inquiry by the pathology department it was found that asbestos exposure was a distinct possibility in these cases also.We are indebted to Dr. A. A. M. Gibson for making the results of his asbestos body count survey freely available to us.

Summary The pollen of Parietaria species is a well‐recognized and important inhalant allergen in the Mediterranean area. Parietaria judaica (Pellitory‐of‐the‐Wall) is native to the U.K., flowering from June to September, but is not usually considered to be of any clinical importance by U.K. allergists. We skin tested 62 patients with a clinical history of summer seasonal respiratory symptoms and a control group of 11 patients with perennial respiratory symptoms only. Each was skin tested in duplicate with extracts of grass pollen, birch pollen, Parietaria pollen, Dermatophagoides pteronyssinus, Cladosporium, Alternaria, nettle pollen and negative and positive controls, and serum samples were collected for RAST assays for Parietaria and nettle. Eight of the 62 patients in the main group showed skin reactivity to Parietaria. Five of these eight had never visited the Mediterranean area and therefore it is possible that sensitization occurred in the U.K. Thirteen of the 62 patients were skin reactive to nettle but there was no correlation between skin reactivity to Parietaria and nettle. This supports a recent report that, despite their close botanical relationship, no antigenic cross‐reactivity exists between the two species. No correlation was seen between skin reactivity and serum RAST activity to Parietaria or nettle. It is not known whether exposure to Parietaria pollen contributes to the seasonal symptoms of the patients found to be skin reactive. None of the 11 patients in the control group was skin reactive to Parietaria.

BRIrTH 507 of a needle pick it out. It is the simplest of procedures: the mite clings to the point of the needle, it can be placed on a slide, and its lively antics watched with great amusement under the microscope. This technique takes no more than a few minutes to master and yet I rarely see it practised. It is most impressive to teacher, student, nurse, and patient, and serves good purpose. The problem is quite different for the management of that very rare variety called Norwegian, or crusted, scabies of course.-I am, etc.,

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dose "until intolerable side-effects are provoked or a total daily dose of about 8 g. is attained" should be modified. Experience in starting three to five new patients weekly on treatment with L-dopa has shown that many months are needed to become familiar with the drug's actions, its foibles, and the range of patients' responses to it. Some of our patients have done well on as little as 1-5 g. per day, and only rarely was it necessary to exceed 6 g. per day. In a group of 88 patients we found the average effective therapeutic dose to be 4-5 g. per day. This is in agreement with the average dose used