[Spectrophotometric assay of angiotensin I-converting enzyme (author's transl)]. / Le dosage de l'enzyme de conversion de l'angiotensine I par méthode spectrophotométrique.

The method of chemical assay of angiotensin I-converting enzyme described is a modification of the previously published spectrophotometric assay based on quantitation of hippuric acid released from hippuryl-L-histidyl-L-leucine. The new procedure involves extraction of hippuric acid with ethylacetate, evaporation to dryness of the extract, solubilization of the residue with 1 mol/l NaCl and purification with petroleum ether before measurements of the absorbance at 228 nm of the aqueous phase. Under these conditions, hippuric acid insoluble in petroleum ether remains in the aqueous phase, whereas other A228-absorbing materials, readily soluble in the ether and able to interfere with the assay, are eliminated.

[Application of the distal bronchial brushing technic to the bacteriological diagnosis of pulmonary tuberculosis]. / Application de la technique du brossage bronchique distal au diagnostic bactériologique de la tuberculose pulmonaire

The tubercle bacillus was sought in samples obtained by bronchial brushing in 36 patients whose tuberculosis was demonstrated and in whom a direct examination of the sputum had given only negative results. In 5 cases, the tubercle bacillus was demonstrated only in the sample obtained by brushing, by direct examination and positive cultures in one case and in the other cases, culturutum coughed up after brushing.

Effects of P2Y(1) receptor antagonism on the reactivity of platelets from patients with stable coronary artery disease using aspirin and clopidogrel.

BACKGROUND AND PURPOSE: P2Y(1) is a purine receptor that triggers platelet aggregation. Its inhibition was studied in patients with stable coronary artery disease (CAD) receiving standard anti-platelet therapy. EXPERIMENTAL APPROACH: Blood samples from 10 patients on aspirin therapy (ASA, 80 mg·day(-1) ) were withdrawn before and 24 h after the administration of 450 mg clopidogrel (ASA/C) and were anti-coagulated with citrate or hirudin/PPACK in the presence or absence of the P2Y(1 ) inhibitor MRS2179 (M, 100 µM). Platelet responses to ADP (2.5 µM) and TRAP (2.5 µM), and collagen-induced thrombosis under flow conditions were analysed. KEY RESULTS: Compared with ASA, ASA + M strongly inhibited ADP-induced peak platelet aggregation (88%), late aggregation (84%), P-selectin expression (85%) and α(IIb) ß(3) activation (62%) (28%, 65%, 70% and 51% inhibition, respectively, for ASA/C vs. ASA). ASA + M also inhibited platelet/monocyte and platelet/neutrophil conjugate formation by 69% and 71% (57% and 59% for ASA/C vs. ASA). In TRAP-activated blood, ASA + M unexpectedly inhibited α(IIb) b(3) activation by 30%. In blood perfused in collagen-coated glass capillaries (shear rate of 1500 s(-1) ), ASA/C prevented thrombus growth beyond 5 min in relation to thrombus fragments embolization. ASA + M with or without clopidogrel completely prevented thrombus formation. Finally, ex vivo addition of MRS2179 and ASA to the blood of healthy donors markedly blocked thrombus formation on collagen in flow conditions, in contrast to ASA plus the P2Y(12) inhibitor 2-MeSAMP. CONCLUSIONS AND IMPLICATIONS: Through particularly efficient complementarities with ASA to inhibit platelet activation and thrombus formation, the inhibition of P2Y(1) in the blood of patients with CAD appears to play a more important role than previously anticipated.

[Acute, lethal miliary tuberculosis due to Mycobacterium bovis]. / Miliaire aiguë mortelle due a Mycobacterium bovis.

The authors report a case of lethal acute miliary with bovine tuberculous bacilli. They stress the main characteristics of this exceptional observation :--difficulties in isolating and identifying,--favourable disposition linked to age and to a depressed cellular immunity,--pathogenic interest in the mechanisms of late endogenous reinfestation and of suffocating acute evolution.

[Male sterility and bronchial dilatation (author's transl)]. / Stérilité masculine et dilatation des bronches.

Male infertility in patients with bronchial dilatation is related to the progressive obstruction of the epididymo-deferential loop. When bronchial dilatation is diagnosed early enough, a spermogram should be performed to conserve the quality of the semen before it starts to deteriorate. In cases of excretory azoospermia it is essential to consider the diagnosis of bronchial dilatation and possible mucoviscidosis among the various etiologies.

[Pneumocystis carinii pneumonia after kidney transplantation. Early diagnosis by distal bronchial brushing]. / Pneumopathies à Pneumocystis carinii après transplantation rénale Diagnostic précoce par le brossage bronchique distal

Distal bronchial brushing is one of the methods used in the in vivo indentification of Pneumocystis carinii, a parasite associated with severe pneumonia, the development of which is induced by immuno-depression, particularly after renal transplantation. In three patients the pathogenic agent was demonstrated in alveolar material obtained in this way. The technique is simple and risk-free. It may be used early and repeatedly.

[Activity and safety of fenspiride in bronchial hyperexudation (author's transl)]. / Efficacité-tolérance du fenspiride dans les hyper-exsudations bronchiques.

This clinical trial of fenspiride (injectable and sustained-release 80 mg tablet) was carried out on patients selected because their bronchopathy was of a hypersecretory type. Interesting results were observed in 20 out of 37 cases, but they were often delayed. This group of patients included a high proportion of patients with major hypersecretion; the efficacy of fenspiride is often evident, (in 8 out of 11 cases) but it is unpredictable individually. It can be concluded from this trial that a long term treatment with fenspiride, well tolerated, can usefully be tried in patients with predominant signs of bronchial hyperexudation.

[One case of severe tracheobronchopathy with immune depression : herpetic disease?]. / Un cas de trachéobronchopathie grave avec immunodépression : maladie herpétique?

The authors report a case of severe obliterating laryngo-tracheo-bronchitis without any evident etiology in a young patient with depressed immunity. A herpetic virus was isolated by distal bronchial brushing and by larynx biopsy. The level of specific antibodies rose significantly. These facts together with the clinical history and unsuccessful microbiological searches, suggest the herpetic nature of this affection, albeit exceptional. At this opportunity, a review of the literature is presented showing the imprecision of diagnostic criteria in this field of pathology.

[X-ray pictures in pneumonia caused by Pneumocystis carinii. Nine cases of immunodepressed patients (author's transl)]. / Aspects radiologiques de la pneumonie à Pneumocystis carinii. A propos de 9 observations de patients immunodéprimés.

The authors analyse the pulmonary symptoms found by X-Ray in nine immunodepressed patients who were hosts to Pneumocystis carinii. The radiological abnormalities do not generally appear early nor are they specific; the syndrome of diffuse alveolar consolidation only appears at a late stage, it is most serious in the base and the peri-hilar regions, but does not affect the apex. It would appear that no prognostic value can be ascribed to the radiological results. The authors therefore suggest bronchial scanning for tracking down the Pneumocystis whenever suspicious clinical symptoms appear.

Sensitive determination of ephedrine and norephedrine in human plasma samples using derivatization with 9-fluorenylmethyl chloroformate and liquid chromatography.

A high-performance liquid chromatography procedure for the determination of ephedrine and norephedrine using fluorimetric detection in plasma samples is described. A double liquid-liquid extraction was performed, followed by derivatization with 9-fluorenylmethyl chloroformate. The extracts were chromatographed with a 5-microm C18 (150x4.6 mm I.D.) column using a mobile phase composed of acetonitrile and water (52:48; v/v). The excitation and emission wavelengths were respectively 264 nm and 313 nm. Calibration curves were linear over the range 0 to 300 ng/ml for each analyte. The specificity of the method was demonstrated with several FMOC-reacting drugs. The limits of quantification are similar to those obtained with the reference method: 2 ng/ml for ephedrine and 5 ng/ml for norephedrine. This method has been successfully applied to the determination of ephedrine and norephedrine plasma levels after administration of low doses of ephedrine to healthy subjects.

[Serum level of angiotensin-converting enzyme in sarcoidosis. Attempted correlation with the clinical activity of the disease (author's transl)]. / Taux sérique de l'enzyme de conversion de l'angiotensine dans la sarcoïdose. Essai de corrélation avec l'activité clinique de la maladie.

Serum levels of angiotensin-converting enzyme (ACE) were measured in 111 healthy subjects and in 117 adult patients with mediastinal and pulmonary sarcoidosis. The patients were followed up for 3 years. Detailed clinical investigations and ACE level measurements were performed every three months. The activity of the disease was assessed in 94 patients without treatment and in 23 patients under corticosteroid therapy. Mean ACE levels were significantly higher (p less than 0,0001) in all patients with sarcoidosis than in controls. They were also high (greater than 35 units/ml) in 32 patients with active forms of the disease. In 19 patients with inactive forms ACE levels were either moderately raised on normal, while considerable variations were observed in those with stable, persistent sarcoidosis. Complete spontaneous or therapeutically induced remission were accompanied by a return of ACE to normal values, but this was not the case for incomplete remission. There was no correlation between ACE levels and the radiological stages of the disease. Measuring ACE levels in patients with sarcoidosis may therefore contribute to diagnosis and surveillance and help to distinguish between complete and incomplete remissions.

[Alveolar proteinosis and acute leucosis. One observation (author's transl)]. / Protéinose alvéolaire et leucose aiguë. A propos d'une observation.

The authors observed a pulmonary alvelolar proteinosis in an 11 years old child with acute leucosis. They underlined the exceptional character of this association in a child, while it is known in the adult and almost always with a bad prognosis. A dysimmunity context linked to a hematological disease and/or its treatment, is favoured among the pathogenic hypotheses.

[Extensive Wegener's granulomatosis: treatment with immunodepressants and complicated by pulmonary aspergillosis (author's transl)]. / Maladie de Wegener extensive sous immunodépresseurs et compliquée d' aspergillose pulmonaire.

The case reported is of Wegener's granulomatosis which responded only temporarily to immunodepressant treatment and complicated by pulmonary aspergillosis. This combination poses a diagnostic since the respiratory manifestation of the two conditions may be confused, and a therapeutic problem because of contradictions in the drugs indicated.