A case of Boeck's sarcoidosis is descriptionbed in a white South African male. The patient had suffered from a chronic lung affection for the past 10 years and for 5 years before admission to hospital he complained of generalized glandular enlargement, dysphagia, loss of weight and general malaise. On examination there were atrophic skin lesions on the forehead and neck and considerable enlargement ï¿½of the axillary and inguinal glands. Radiograms of the lungs showed widespread bilateral fibrotic changes together with enlargement of the hilar glands. Swallowed barium showed a partial obstruction of the oesophagus due to pressure by the mass of hilar glands. Histological examination of a lymph node and of a skin lesion revealed the epithelioid follicles and giant cells of sarcoidosis. Treatment with cortisone caused a marked diminution in size of the enlarged glands and skin lesions within 2 weeks. There was also a well-marked improvement in the patient's general"" condition and, although no radiological improvement in the lung lesions could be demonstrated, his maximal breathing capacity showed a distinct increase.
(Concluded from page 773.) The significance of the blood iodine, the proteinbound fraction (PBI) of which appears to be identical with the thyroid hormone, is discussed, and the results recorded in 60 patients and 10 normal subjects. An attempt has also been made to correlate these findings with the basal metabolic rate and the radioactive iodine uptake where these studies were also carried out.
*A paper read at the South African Medical Congress, Johannesburg, September 1952. The meaning of the 'prediabetic state' is discussed; its only evident manifestation is the production of large babies and stillbirths in a woman who later develops overt diabetes. This condition certainly exists in the Cape. It is considered important to diagnose this prediabetic state and the rather similar ï¿½asymptomatic diabetes"" since it may be possible to safeguard the life of future babies by special management of the mothers' deliveries. In Groote Sehuur Hospital our attempts to reduce the foetal loss rate of diabetic pregnancies are encouraging. Factors leading one to suspect the existence of asymptomatic diabetes or pre-diabetes are considered and it is emphasized that glycosuria is not always present during pregnancy in such patients. The glucose-tolerance curve is discussed. A single high 2- or 2 1/2-hour reading is regarded as being a warning of pre-diabetes, and in our series these slight aberrations of carbohydrate tolerance have been found closely connected with large babies and stillbirths. We suggest that 'pre-diabetes' can frequently be diagnosed and should be heeded.