H. A. BIRD Rheumatism Research Unit, University ofLee*s. References Bird H A, Ring E F J, Bacon P A. A thermographic and clinical comparison of three intra-articular steroid preparations in rheumatoid arthritis. Ann Rheum Dis 1979; 38: 36-9. 2 Bird H A, Ring E F J, Daniel R, Bacon P A. Comparison of intra-articular methotrexate with intra-articular triamcinolone hexacetonide by thermography. Curr Med Res Opin 1977; 5: 141-6. 3 Hollander J L. Intrasynovial corticosteroid therapy in arthritis. Md State MedJ 1970; 19: 62-9.

Clinical and pathological studies indicate, that sarcoidosis rarely affects the thyroid gland. The diagnosis of sarcoidosis in the lung and in the thyroid has been established by biopsies taken during surgery in a case of a 53 year old female. The manifestation of thyrotoxicosis in sarcoidosis-involvement of the thyroid has been analysed and compared with the 15 patients exhibiting sarcoidosis-involvement of the thyroid and thyrotoxicosis described in the literature.

In 4 patients with juvenile idiopathic thoracic scoliosis an atelectasis as part of the convex-sided lungs was found. In all cases there was a small sagittal diameter of the chest; the atelectases were situated in the right lower and middle lobe and caused by the close topographical relation of large bronchi and scoliotic spine (sometimes compression of the bronchus) demonstrable by tomography, bronchoscopy and bronchography. The therapeutic approach of these atelectases is discussed. Thoracic casting either for conservative correction and treatment of scoliosis or as postoperative immobilisation after fusion was done. In all cases, it may influence the occurrence of an atelectasis.

We can conclude that the combination of high FEV2/1 index and a "peak-flow-less" flow-volume loop is characteristic for the presence of proximal airway stenosis and is a reliable means for differentiation against bronchospasm and emphysema. In comparison, the measurement of airway resistance, FEV1 alone, inspiratory shift of mid-breathing level etc., indicate only the presence of airway obstruction, but fail to give specific information for functional differentiation of bronchial obstruction and morphological evidence of proximal airway stenosis.

Pulmonary function tests were performed in 15 patients with Sjögren's Syndrome (SS). All patients presented with rheumatoid arthritis (RA) as well as with sicca syndrome. The mean values of residual volume, compliance and diffusion capacity were found to be abnormal. Vital capacity was abnormal in 40 percent of patients with SS, residual volume in 46 percent, compliance in 60 percent, and diffusion capacity in 66 percent respectively. The lung function was apparently affected more severely in SS than in rheumatoid arthritis. Thus in addition to the well known changes of lung function occuring in rheumatoid arthritis, progressing fibrosis might also contribute to a more extensive impairment of the lung function in SS. Although symptoms of chronic bronchitis and coughs were prevalent in our patients, obstruction was only observed in a comparatively small number.

Detailed pulmonary function analysis was performed in 20 patients with juvenile-onset diabetes mellitus and in 20 age- and sex-matched control subjects. No significant differences were found in comparisons of all lung function data obtained from these two groups. Even the parameters of lung recoil, which recently have been reported to be decreased in juvenile-onset diabetes, were within the normal range. These data indicate normal pulmonary function in patients with juvenile-onset diabetes mellitus, a finding that is in accordance with clinical experience.

Radiology is the basic factor in diagnosis of emphysema. Further differentiation is possible by assessment of the concomitant cardio-vascular changes. By these means, the type of emphysema (accompanying emphysema in chronic bronchitis, or primary emphysema) can be established.

Lung function analysis and chest X-ray was performed in 84 patients with rheumatoid arthritis. The group of seropositive patients showed a significant (p < 0.01) lower mean value of diffusion capacity than the group of seronegative patients. There was no correlation between the lung function and duration of disease and Steinbrocker-staging, respectively. Patients treated with corticosteroids had more frequently abnormal values of vital capacity, functional residual capacity, and compliance. Patients under chrysotherapy showed more frequently abnormal values of residual volume but less frequently an impairment of maximal breathing capacity, resistance, and compliance.

Radiology is the basic factor in diagnosis of emphysema. Further differentiation is possible by assessment of the concomitant cardio-vascular changes. By these means, the type of emphysema (accompanying emphysema in chronic bronchitis, or primary emphysema) can be established.

Sixty-two patients with classical or definite rheumatoid arthritis were subjected to lung function analysis. The various parameters--spirography, plethysmography, blood gas analysis, measurement of lung compliance, and diffusion capacity--were correlated with duration and stage of disease, and with rheumatoid factor titres. A statistically significant correlation was found to exist between Rose-Waaler titre and specific diffusion capacity. Similar results between Rose-Waaler titre and lung compliance, however, were not statistically significant.