medication was changed to sulfacetimide she had none. Three patients could not tolerate either sulfanilamide or sulfathiazole but had no ill effects from sulfacetimide. Seven patients with acute pyelonephritis of pregnancy were treated. All were given an eight day course of 30 tablets (15 Gm.). In each case the urine became sterile three days after treatment was started, and after the course was finished the patients required no repeti¬ tion of sulfacetimide. Chills, fever and pain disappeared immediately after the first day. Repeat stains of urinary sediment have all been negative, and deliveries have been uncomplicated. Two other patients treated post partum, and 1 after cesarean section, recovered.Three children are included in this series. One child aged 5 years had been treated with mandelates, sulfanil¬ amide and intramuscular azosulfamide with no reduc¬ tion of the temperature nor elimination of the chills and fever. A dose of 0.25 Gm. of sulfacetimide was given twice a day for two days, and the course was completed with 0.25 Gm. once a day for five days. The chills, fever and costovertebral pain disappeared on the third day. The urine became sterile-after hav¬ ing had many pus cells and gram-negative bacilli for four months-and remained sterile on repeated exami¬ nations over a period of nine consecutive months. Two patients, each 10 years of age, recovered from acute attacks of infection of the lower part of the urinary tract with the administration of sulfacetimide and have been without symptoms for eight months.In this group of 200 patients we found that 21 had been on sulfanilamide before sulfacetimide was given. Sulfanilamide was discontinued, either because of no response to the drug or because of reactions. After treatment with sulfacetimide, 17 patients were classed as recovered, 3 showed improvement and 1 did not respond. This is an 80.9 per cent improvement over sulfanilamide. Eleven patients who did not respond to the mandelates recovered with sulfacetimide, while 4 did not respond-a 73.3 per cent improvement over the mandelates. Three patients who did not respond to azosulfamide recovered on sulfacetimide therapy. Table 5.-Summary Number Per Cent Total number oí cases. 200 100.0 Recovered. . 171 85.5 Improved". 25 12.5 Unimproved. 4 2.0 Reactions. 8 4.0Six patients had previous sulfathiazole therapy : 2 could not tolerate it and 4 did not respond to it. These 6 patients recovered when placed on sulfacetimide therapy. Nine other patients who had taken some other form of oral therapy without response recovered when placed on sulfacetimide therapy. SUMMARY Two hundred cases of bacillary infection of the uri¬ nary tract were treated with sulfacetimide. The per¬ centage of recoveries was 85.5; 12.5 per cent showed improvement and 2 per cent showed no response to the drug.Sulfacetimide has been more effective in the treat¬ ment of these infections of the urinary tract than has sulfanilamide and the mandelates. In 80.9 per cent of the sulfanilamide-resistant cases recovery occurred when sulfacetimide...
The development of bilateral tension cysts in a 6-month-old child suffering from inborn honeycomb lung resulted in acute cardiorespiratory insufficiency. First of all, we succeeded in controlling the recurrent rises in intrathoracic pressure by puncturing and chest draining performed by suction and by the Bülau method. The child thus became fit to be operated on. The right lower lobe, and, 7 days later, the left upper lobe, were resected and multiple single cysts excised from both residual lungs. The postoperative course of the disease was not free from complications, but five years of follow-up showed that the child's general development had become normal. Possibilities of treatment of pulmonary insufficiency, a typical symptom of polycystic lung malformation, are discussed, and the necessity for an early operation is emphasised.
Diagnostic pneumotliorax is not a new procedure, but most of the publications which have appeared since Brauer (1) first advocated its use in 1912 have dealt with the demonstration of mediastinal and pulmonary parenchymal lesions. The eaRe with which pleural adhesioiis could be visualized suggested the use of this technic in the diagnostic study of non-inflammatory diseases of the pleura, but only a few authors have presented cases wherein roentgenograms of the chest made after artificial lung collapse clearly revealed pleural neoplasm (2, 3 j. Artificial pneumothorax would seem particularly applicable to the study of pleural effusions of obscure origin because of the virtual worthlessness of ordinary roentgenograms in the face of massive opacity. I n view of the common associatioii between intrathoracic neoplasm and pleural effusion (4) it is probable that diagnostic opportunities are lost through failure to pse a procedure which is simple and safe in competent hands.The following case report is a pertinent illustration of the worth of this method. Moreover, it presents a death from metastatic sarcoma thirteen years after the appearance of the primary bone lesion, an event which seems worthy of emphasis in view of Crowell's recent analysis of the Bone Sarcoma Registry data (5). Case ReportR. H., a white male aged twenty-eight, was admitted to the University Hospital in July 1931, stating that f o r approximately one year he had been troubled by a conwtant sense of pressure in the right chest, associated with attacks of severe pain in the same location, non-productive cough, and excessive fatigue. He believed that he hail had occasional fever but denied hemoptyYis and loss of weight. In 1919, following mild trauma to the left wrist, a tender swelling appeared a t the distal end of the left radius, but x-ray examination at the time W I~R understood by the patient to have been negative. The swelling disappeared within approximately one month.I n 19%1, however, a fracture was sustained at this site following a trivial blow, and x-ray studies then revealed definite osteoporosis in the region of the fracture site. Open reduction was performed, and upon a portion of the removed tissue Dr. Alfred Scott Warthin returned the following opinion : "Alveolar spindle-cell sarcoma" (Fig. 1). Radium implantation and deep x-ray therapy in unknown quantity were employed, but by 1923 SO large a mass had developed that amputation through the mid-shaft of the humerus was carried out. The operative site healed primarily, and the patient was without 1 We are indebted to Dr. John B. Barnwell for permission to report this came. 334
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