ABsTRAcr Maximal respiratory pressures at the mouth (PEm. and PI,M.) have been measured in 370 normal caucasian children and adults. Age, height, and weight were recorded for all subjects and incorporated in a stepwise multiple regression analysis to determine prediction equations for the maximal respiratory pressures in the children and adults for both sexes. In men Pi,. and PEmax were significantly correlated only with age (p < 0-001 and < 0-035 respectively), whereas in women they were correlated with height (p < 0-035 and < 0-03). In both boys and girls PN., was related to weight (p < 0-0001 and <0-01 respectively) and PEma. to age (p < 0-001 for both). The values for PImax and PEmax in adults were lower than in previously reported series, but in children the values obtained were similar to those reported for several smaller series.In recent years interest has been rekindled in methods for measurement of respiratory muscle function in patients with neuromuscular disease. One of the simplest non-invasive measurements is that of maximal pressures, generated at the mouth, after full inspiration and full expiration-that is, maximal expiratory pressure (PE,,,C) and maximal inspiratory pressure (PI n).

In 1983 a postal survey of the bronchoscopic practice of chest physicians in the United Kingdom produced a 90% response rate. Two hundred and thirty one physicians were carrying out bronchoscopy; they had performed about 40 000 bronchoscopies in the preceding year, 87% of these being fibreoptic procedures with topical anaesthesia. The mortality rate of fibreoptic bronchoscopy was 0.04%, with a 0.12% incidence of major complications. Transbronchial biopsy carried both an appreciably higher mortality rate of 0.12% and a major complication rate of 2.7%. There is wide variation in the use and choice of sedative drugs for fibreoptic bronchoscopy. Many of the drug combinations could be criticised on pharmacological grounds. The mean dose of lignocaine was 342 mg, most operators exceeding the usual maximum recommended dose; but adverse reactions were rare. Routine supplemental oxygen was given by only 18% of bronchoscopists. Basic resuscitation equipment was often inadequate. Radiological screening was used for transbronchial lung biopsy by 53% of respondents and significantly reduced the incidence of pneumothorax from 2.9% to 1.8%. Both the number of bronchoscopies performed and the complication rate were higher than previous estimates. Bronchoscopists should re-examine their policy on drugs and safety precautions to minimise the risks of the procedure.

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FIBRINO-PEPTIDE 203 2. A peptide appears in the fibrinogen-thrombin system. 3. It is suggested that this hitherto unknown substance should be called 'fibrino-peptide', since it is believed to be derived by splitting off part of the fibrinogen molecule. 4. A method for isolating apparently pure fibrino-peptide is given. 5. The release of fibrino-peptide is correlated with previous results, and the clotting of fibrinogen is discussed in the light of the new finding. Iwish to thank Prof. W. T. Astbury, F.R.S., forthe benefit of discussions, and Dr W. R. Middlebrook for his valuable help in the chromatographic experiments.