MIGRAINEBRTnSH 825 MEDICAL JOURNAL possibility of constitutional factors, as illustrated by a family tree which shows that four members of a family received fatal damage to their kidneys in connexion with medication against migraine. REFERENCES Ask- Upmark, E. (1929). Acta path. microbiol. scand., 6, 383. (1953). Acta med. scand., 147, 191. (1957). Life, Death, and Disease in Sweden. Almqvist and Wiksell, Stockholm. Dahmen, H. (1958). Munch. med. Wschr., 100, 1846. Essen-Moller, E. (1956). Social-med. T. 33 271 Jasiiiski, B., and Wuhrmann, F. (1958) (1955) showed that 55% of such children will still have eczema at the age of 13 years and 50% will have asthma. Purdy (1953) states that a similar percentage will still be affected at the age of 20. Meenan's (1959) investigations of older subjects showed that about 30% of the skin lesions never clear up We have had an opportunity of assessing a group of children who were admitted some years ago to the skin dep;A-t:eint of the Belfast City Hospital suffering from infantile eczema. We were interested in the outlook for these children, through the years, from both the skin and the respiratory viewpoint. MethodsThe records of the skin department for the years 1947-50 were searched, and 43 cases of infantile eczema were found. Similar criteria to those of Purdy (1953) were used in the selection of cases: (1) the diagnosis must have been either infantile eczema or dermatitis (note: during the period the term seborrhoeic was not used in this unit for any child); (2) the face must have been clearly involved; (3) the patient must have been 24 months old or younger when first seen with the disease; (4) the patient must have been 12 months old or younger at the onset of the disease; and (5) there must have been no obvious acquired predisposing facto! such as scabies, pediculosis, or antecedent napkin erythema.Letters were sent to the parents requesting the attendance of these children for interview. If they did not attend and lived within 30 miles (48 km.) of Belfast, they were visited in their homes by one of us. If they lived at a greater distance the parents were provided with a form on which they could indicate the child's present state of health. This was necessary in only two of the 43 cases.An independent observer who did not know the present state of the children reviewed the case-histories and separated the cases which he considered to indicate a diagnosis of seborrhoeic eczema from those in which a contact factor probably played a part.Of the 43 cases of infantile eczema, three could not be traced by any means at our disposal, including visits to the last known address, contact with their family doctors, and, finally, the help of the General Health Services Board. Of the remaining 40 patients, one had died of leukaemia and one had emigrated. The cases were further subdivided as in Table I. In attempting to assess the respiratory complications, 23 children were selected from the above group of 29 with true infantile eczema, and solely on the basis of their...

The effect of transpulmonary pressure (Ptp) on gas exchange in the dog lung was studied in 10 open-chested dogs. Rates of pulmonary perfusion and ventilation were held constant (right heart bypass and pump respirator) while Ptp was varied. Alveolar dead space ventilation and alveolar shunt perfusion were calculated from CO2 and O2 gradients. The results are finally expressed in terms of a three-compartment lung model. It is shown that a misinterpretation is possible if alveolar dead space or alveolar shunt compartments are expressed as fractions, respectively, of all ventilated or all perfused alveoli, therefore each has been expressed as a fraction of the whole lung. It is concluded that the alveolar shunt compartment decreased as Ptp was increased, over the lower range of Ptp studied. No significant change was detected in the alveolar dead space compartment, as Ptp was varied. alveolar-arterial O2 gradient; anatomical dead space; arterial-alveolar CO2 gradient; distribution of pulmonary perfusion; distribution of pulmonary ventilation; right heart bypass preparation; ventilation/perfusion relationships Submitted on February 16, 1965

Properties of carotid chemoreceptors were evaluated in anesthetized dogs by measuring transient change in breath-by-breath minute ventilation (Ve) produced by brief (15–60 sec) infusion into common carotid arteries of blood of known Po2, Pco2, and pH while stopping blood flow from below. Evidence is presented that the preparation permits studying behavior of carotid chemoreceptors alone, no response to infusion of hypercapnic blood occurring after carotid body denervation. The carotid bodies reacted to infusion of hypercapnic blood as promptly as to cyanide, and responded significantly to increments in Pco2 of only 2 mm Hg. Ventilatory response curves to increments in Pco2 were obtained. Approximate magnitude of carotid chemoreceptor drive was evaluated by infusion of hyperoxic, hypocapnic blood (Po2 > 500, Pco2 < 10 mm Hg) which did not reduce Ve during O2 breathing, reduced it 24% during air breathing, and from 62 to 100% (apnea) during hypoxia.

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