No abstract

In two asymptomatic patients, routine preoperative radiographs revealed three pennies in the esophagus in one patient and a spring from a toy in another patient. In contrast two symptomatic patients, one with a flip-top cap from a beer can in the esophagus and the other with a piece of photographic film in the larynx, had negative findings on their radiographs. Salient points of the cases are that diagnosis can be delayed by inadequate history, misinterpretation of signs and symptoms, and unexpected radiographic findings. Special attention should be focused on the flip-top cap ingestion case. Sixty-five percent of 677 people polled have placed flip-top caps into full cans. Fifty-two people almost swallowed a flip-top cap. Otolaryngologists should be alerted about the radiolucency of this metallic foreign body, and the general population should be discouraged from this dangerous practice.

Acute epiglottitis is a disease with significant mortality. The patient, usually an otherwise healthy pre-school child, develops a sore throat and muffled voice from swollen supraglottic structures, and may progress rapidly to respiratory arrest. Early diagnosis and airway maintenance can prevent these fatalities. Whether to secure an airway by tracheostomy or endotracheal intubation is the subject of much discussion. Nineteen series totalling 738 cases of epiglottitis plus 11 new cases are reviewed. These patients were treated as follows: Tracheostomy = 348 (3 deaths - 0.86%); Endotracheal intubation = 216 (2 deaths - 0.92%); medical management with no artificial airway = 214 (13 deaths - 6.1%). The difference in morbidity and mortality between tracheostomy or nasotracheal intubation is so slight that the choice should be determined by local factors. Medical management with no artificial airway should not be used in children.

No abstract

As Buller (1909 ct scq.) has pointed out, some species of the genus Copriniis sow their spores once during a short interval of time and the fruiting body disappears shortly thereafter by auto-digestion. Characteristically the small buds will, all in one clay, go through a period of rapid expansion and elongation, shed their spores, and deliquesce. This rapidity is no doubt related to their small size, for larger species of hymenomycetes will go through many days of continued production and shedding of spores.The origin of the gills and their individual lamellae has been described in detail by Atkinson (1916). They are formed at an early stage by the orientation of hyphae and the final result ( which is illustrated in Figure 1 ) has a number of distinguishable component parts : the outside is covered with the hymenium which consists of a mixture of basidia and sterile paraphyses ; below this there is a subhymenial layer of small hyphae ; and finally the central portion of the gill lamella, the tramal layer, which is composed of large hyphae. Borriss (1934) has shown that the development of Coprinus occurs in two distinct stages, one in which cell division and the initial cell orientation takes place, and it is during this stage that the gill primordia are formed. The second stage consists of rapid cell elongation and in the latter phase of this period the spores bud from the basidia. It may be inferred, from the recent results of Madelin (1956), that this period of rapid expansion involves the transfer of material from the vegetative mycelia. Such a transfer is in keeping with the views of Buller as well as with the situation in Agaricns canipcstris ( Bonner, Kane and Levey, 1956).Using histochemical techniques, it has been possible in this study to follow the distribution of certain groups of substances in the fruiting body. It could be demonstrated that these substances accumulated at specific locations in the gills and that they were all transferred into the spores, so that by the advent of auto-digestion there were virtually no demonstrable substances left within the cells at the time of the final destruction. Not only does this indicate an efficiency, an economy in the