Objective-A study was performed to produce reference standards for spirometric lung function in white children and to calculate standard deviation scores adjusted for gender and pubertal stage.Methods-A cross sectional study was made of 772 white children aged 4-6 to 18-8 years (455 male) tested on an OHIO 840 spirometer and assessed anthropometrically and pubertally.

Objective-A study was performed to determine reference ranges for whole body plethysmographic gas volumes and single breath gas transfer in healthy prepubertal and pubertal schoolchildren. Methods-The study was performed in 772 white London schoolchildren (455 male) who were clinically examined, assessed auxologically and, in 63% of cases, pubertally staged. Regression equations for the calculation of standard deviation scores were derived. Results-Male lung function variables showed a discontinuous pattern of increase with standing height. Linear increases until puberty were followed by a sudden pubertal rise and a further increase with height which was more marked than before puberty. Correction for varying thoracic dimensions eliminated these changes. In females a smoother curvilinear relationship was observed with no correction possible for thoracic size. Conclusions-Male puberty leads to profound changes in pulmonary function mostly related to thoracic size, an effect not observed in females. (Thorax 1993;48:803-808) by a single breath technique in healthy white UK schoolchildren. Spirometeric measurements have been dealt with in the previous This paper is concerned with whole body plethysmographic measurement of thoracic gas volumes and the assessment of both functional gas transfer and accessible gas volumes Methods The children have been fully described elsewhere' but briefly comprised 772 white schoolchildren of UK origin (455 male) from

Background: Irreversible airflow obstruction in Chronic Obstructive Pulmonary Disease (COPD) is thought to result from airway remodelling associated with aberrant inflammation. Patients who experience frequent episodes of acute deterioration in symptoms and lung function, termed exacerbations, experience a faster decline in their lung function, and thus over time greater disease severity However the mechanisms by which these episodes may contribute to decreased lung function are poorly understood.

To explore the hypothesis that there is an increased metabolic rate in cystic fibrosis, resting energy expenditure was measured by indirect calorimetry in 23 subjects with cystic fibrosis in a stable clinical state and in 42 normal control subjects. Resting energy expenditure was found to be elevated by an average of 0.45 MJ/24 h [95% confidence interval (CI) = 0.26-0.64, t = 4.91, P less than 0.001] (108 kcal/24 h), or 9.2% above expected values derived from the regression relating resting energy expenditure to whole body weight and sex in control subjects. When related to lean body mass, values were still elevated by 0.36 MJ/24 h (95% CI = 0.18-0.53, t = 4.15, P less than 0.001) (86 kcal/24 h), or 7.2%. The increased values were found to be independent of age, sex, or body size. There were significant correlations between increased values and poor pulmonary function as measured by the ratio of the forced expiratory volume in 1 s to forced vital capacity (r = -0.44, P less than 0.05) and subclinical infection as indicated by the blood leukocyte count (r = 0.40, P less than 0.05). However, the correlations were low, suggesting that other factors may contribute to the increased resting energy expenditure, possibly including the putative metabolic defect in cystic fibrosis.

Summary We report the case of an 8·5‐year‐old girl with oro‐facial granulomatosis associated with clinical atopy, in whom relapse of her granulomatous disorder was shown to be related to exposure to specific food additives, viz. carmoisine, sunset yellow and monosodium glutamate. Treatment with a restricted diet resulted in considerable regression in the facial swelling which has been maintained for 6 months. A brief account of the histological features, both under light and electron microscopy, is given, together with a description of the use of nuclear magnetic resonance scanning in the assessment of this disease. The patient had no evidence to support a diagnosis of sarcoidosis or Crohn's disease.