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143dications for the various regimens available for the treatment of tumours of the head and neck. Until this evidence is available inappropriate management will continue to be given in some cases. A patient's first treatment is vital and dictates the whole prognosis of his disease, but at present this is selected by the clinician who first examines him and who, lacking data from controlled trials, usually chooses the treatment with which he is most familiar.Fast neutrons are at present the subject of such a controlled clinical trial, and consultant radiotherapists and aural surgeons in London, Birmingham, and south-east England are collaborating. The early results of this trial will be the subject of a separate paper.

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Resolution of alveolar edema depends on clearance of serum protein, as well as liquid from the alveolar space. Protein clearance is slower than liquid clearance and may take days to weeks. Our earlier studies presented evidence for the importance of paracellular removal of soluble protein from the air spaces. However, long-term protein clearance may also depend on uptake by alveolar epithelial cells or macrophages. This study examined cellular uptake of soluble human albumin and insoluble colloidal gold-albumin from the lungs of anesthetized rabbits. Native albumin was endocytosed by both alveolar type I and type II cells and appeared in vesicles and endosomes. Neither cell type took up colloidal gold-albumin over periods as long as 8 h. Alveolar macrophages took up native albumin and colloidal gold-albumin to a greater extent and more rapidly than alveolar epithelial cells. The tracer proteins were found in vesicles, endosomes, and phagolysosomes. Similarly, cultured alveolar macrophages took up native albumin more rapidly than cultured type II cells. Thus macrophages may be important in clearing precipitated protein from the air spaces, and they may have a role in completing the clearance of soluble protein. The potential for transepithelial transport of soluble alveolar protein exists, but based on this work and our prior studies, it appears to be a low-capacity pathway.