In-vitro antibacterial activity of levofloxacin against hospital isolates: a multicentre study.

The objective of this study was to evaluate the activity of the fluoroquinolone, levofloxacin, against hospital isolates of bacteria. MICs of levofloxacin were determined for 2154 strains by agar dilution. Breakpoints for susceptibility testing were calculated using the agar diffusion technique with 5 micrograms discs. The activity of levofloxacin against nalidixic acid- and pefloxacin-susceptible Enterobacteriaceae (n = 668) was higher (MIC50/90 0.06-0.12 mg/L) than previously reported for ofloxacin. As seen with other fluoroquinolones, this activity was reduced against nalidixic acid-resistant and pefloxacin-intermediate and -resistant strains (MIC 1-8 mg/L). MICs for Pseudomonas aeruginosa (n = 104) were between 0.12 and 128 mg/L. Levofloxacin had good activity against nalidixic acid- and pefloxacin-susceptible Acinetobacter baumannii (n = 12; MIC 0.06-0.25 mg/L), but the activity was reduced against nalidixic acid- and pefloxacin-resistant strains (n = 80; MIC 1-32 mg/L). Haemophilus influenzae (n = 70), Haemophilus parainfluenzae (n = 47) and Moraxella catarrhalis (n = 64) were inhibited by low concentrations of levofloxacin (MICs 0.016-0.03 mg/L, 0.03-0.12 mg/L) and 0.03-0.12 mg/L, respectively). Clostridium perfringens (n = 23; MIC 0.25-1 mg/L) was more susceptible than Bacteroides fragilis (n = 60; MIC 0.5-4 mg/L). Levofloxacin showed superior activity compared with ofloxacin against methicillin-susceptible staphylococci (n = 107; MIC 0.03-0.5 mg/L); the resistant strains (MICs 2-32 mg/L) were usually also resistant to methicillin. Levofloxacin was less effective against enterococci (n = 105; MIC 1-32 mg/L), but streptococci (n = 192) and pneumococci (n = 129), including 58 penicillin-non-susceptible strains, were inhibited by low concentrations (MICs 0.5-2 mg/L). According to the regression curve, zone diameters were usually 20-22 mm, 17-19 mm and 15-16 mm for MICs of 1, 2 and 4 mg/L, respectively. In conclusion, this study, performed on a large number of strains, confirms the superior anti-bacterial activity of levofloxacin compared with ofloxacin, especially against pathogens isolated from respiratory tract infections.

Effects of a potent platelet-activating factor antagonist, SR27417A, on allergen-induced asthmatic responses.

Platelet-activating factor (PAF) is a lipid-derived mediator that has been implicated in the pathophysiology of airway inflammation in asthma. Its actions include chemotaxis and activation of inflammatory cells, particularly eosinophils. Inhaled PAF causes bronchoconstriction and increased airway responsiveness in human subjects. However, PAF antagonists have so far failed to show benefits in allergen challenge or in the treatment of chronic asthma. SR27417A is a novel PAF antagonist with increased potency compared with previously tested compounds. Twelve asthmatic subjects received treatment with either SR27417A or placebo for 1 wk in a double-blind crossover study. After treatment each subject underwent allergen challenge. Effects were assessed in terms of early and late asthmatic responses and allergen-induced effects on airway responsiveness. Baseline lung function and airway responsiveness were also examined. Treatment with SR27417A significantly attenuated the late asthmatic response (AUC LAR4-10h: 107 +/- 24 after placebo, 79 +/- 17 after SR27417A, p < 0.05; mean maximal percent fall in FEV1 LAR: 29 +/- 6% after placebo, 23.5 +/- 5.4% after SR27417A, p < 0.05). There were no effects on early asthmatic responses, allergen-induced airway responsiveness, or baseline lung measurements. SR27417A is the most potent PAF antagonist to date, and it has a modest inhibitory effect on the late asthmatic response. This suggests that PAF has a small role in allergic inflammation.

[In vitro antibacterial activity of a new fluoroquinolone, sparfloxacin, against nosocomial bacteria, and concordance curve]. / Activité anti-bactérienne in vitro d'une nouvelle fluoroquinolone, la sparfloxacine sur les bactéries hospitalières et courbe de concordance.

Minimal inhibitory concentrations (MICs) of sparfloxacin (SFX) were determined by agar dilution for 3,164 bacterial strains isolated in 10 university hospitals; in addition, antibiograms by agar diffusion were performed with 5 micrograms disks. Activity of SFX against nalidixic acid (NAL) susceptible (S) Enterobacteriaceae was close to that of other fluoroquinolones (FQ) (MIC 50 and 90: 0.06-0.5 microgram/ml); like for other FQ, this activity was reduced against NAL intermediate and resistant (R) Enterobacteriaceae (2-16). MICs of SFX against P. aeruginosa were between 0.12 and 16 (1-32). SFX had also a good activity against NAL-S A. baumannii (CMI < or = 0.25) but this activity is reduced against NAL-R Acinetobacter (16). SFX was highly active against Haemophilus (0.016-0.06) gonococci (0.008), meningococci (0.008) and B. catarrhalis (0.008-0.03). SFX showed activity superior to the currently available FQ against methicillin susceptible staphylococci (0.06); the resistant strains [8] are usually methicillin resistant. SFX is more effective against enterococci (0.5), streptococci (0.25-0.5) and particularly pneumococci (0.25-0.5) including penicillin-resistant strains. The coefficient correlation of the regression curve is 0.876; for MIC breakpoints of 1 and 2 micrograms/ml, zone diameter breakpoints should be 20 and 16 mm.

Molecular cloning and expression of alpha parvalbumin in the guinea pig cochlea.

We have cloned and sequenced an alpha parvalbumin cDNA from the guinea pig cochlea. The deduced amino acid sequence shows greater identity with the rabbit sequence (86.3%) than with other mammalian sequences (< 82%). Using in situ hybridization and immunohistochemistry, alpha parvalbumin mRNA and protein were found in primary auditory neurons and inner hair cells, in agreement with RT-PCR data showing alpha parvalbumin mRNA expression in the spiral ganglion and the organ or Corti.

[In vitro antibacterial activity of a new fluoroquinolone, enoxacin against hospital bacteria and regression curve]. / Activité antibactérienne in vitro d'une nouvelle fluoroquinolone, l'énoxacine sur les bactéries hospitalières et courbe de concordance.

Minimal inhibitory concentrations (MICs) of enoxacin (ENX), a new fluoroquinolone indicated for the treatment of urinary tract infections, was determined by agar dilution for 703 bacterial strains isolated in 1993 in 3 university hospitals in order to study its activity against urinary pathogens; in addition, antibiograms by agar diffusion were performed with 5 micrograms disks to calculate the regression curve and the breakpoints for sensitivity testing. Activity of ENX against nalidixic acid (NAL) susceptible (S) Enterobacteriaceae was close to that of other fluoroquinolones (FQ) (MIC 50 and 90: 0.25-0.5 microgram/ml); like for other FQ, this activity was reduced against NAL intermediate and resistant (R) Enterobacteriaceae (8-64) MICs of ENX against P. aeruginosa were between 0.5 and 128 (2- > 128). ENX had also a good activity against NAL-S A. baumannii (0.06-2) but this activity is reduced against NAL-R Acinetobacter (0.5- > 128). ENX showed activity close to the currently available FQ against methicillin susceptible Staphylococci (0.5-8); the resistant strains (32- > 64) are usually methicillin resistant. ENX is less effective against Enterococci (4-128). The coefficient correlation of the regression curve is 0.906. For MIC breakpoints of 1 and 2 micrograms/ml, zone diameter breakpoints should be 22 and 19 mm.

[In vitro antibacterial activity of a new fluoroquinolone, fleroxacin, against hospital bacteria and regression curve]. / Activité antibactérienne in vitro d'une nouvelle fluoroquinolone, la fléroxacine, sur les bactéries hospitalières et courbe de concordance.

Minimal inhibitory concentrations (MICs) of fleroxacin (FLE) were determined by agar dilution for 1261 bacterial strains isolated in 1992 in 4 university hospitals; in addition, antibiograms by agar diffusion were performed with 5 micrograms disks. Activity of FLE against nalidixic acid (NAL) susceptible (S) Enterobacteriaceae was close to that of other fluoroquinolones (FQ) (MIC 50 and 90: 0.12-0.25 micrograms/ml); like for other FQ, this activity was reduced against NAL intermediate and resistant (R) Enterobacteriaceae (4-32). MICs of FLE against P. aeruginosa were between 1 and 128 (8-128). FLE had also a good activity against NAL-S A. baumannii (0.12-0.5) but this activity is reduced against NAL-R Acinetobacter (64-128). FLE was highly active against Haemophilus (0.06-0.12), Gonococci (0.03-0.25), Meningococci (0.016-0.03) and B. catarrhalis (0.12-0.25). FLE showed activity close to the currently available FQ against methicillin susceptible Staphylococci (0.25-1); the resistant strains (32- > 128) are usually methicillin resistant. FLE is less effective against Enterococci (4-128), Streptococci (8-16) and Pneumococci (4-8). The coefficient correlation of the regression curve is 0.93; for MIC breakpoints of 1 and 4 micrograms/ml, zone diameter breakpoints should be 20 and 15 mm.

Alveolar macrophage accessory cell function in bronchial asthma.

The capacity of peripheral blood monocytes and alveolar macrophages (AM) obtained by bronchoalveolar lavage (BAL) to present recall antigens, namely, tuberculin purified protein derivative (PPD) or streptokinase-streptodornase (SKSD), to highly purified autologous T-cells has been studied in 11 asthmatic and 11 healthy, nonatopic normal subjects. In the asthmatic group, AM accessory cell function was variable, and most subjects were unable to present either recall antigen as effectively as blood monocytes, although one asthmatic subject demonstrated larger proliferative responses than blood monocytes for both antigens. AM accessory cell activity was not antigen-specific, and there was a correlation between accessory cell efficacy for the two antigens (r = 0.92; confidence interval, 0.53 to 0.98). Furthermore, a correlation existed between the percentage lymphocyte count in the BAL fluid and the ratio of macrophage to monocyte antigen-presenting capability for both PPD (r = 0.92; 95% confidence interval, 0.83 to 0.99) and SKSD (r = 0.90; 95% confidence interval, 0.45 to 0.98). In the normal subjects, AM were also unable to act effectively as accessory cells for the presentation of PPD and SKSD in the majority of subjects. No correlation existed between the percentage lymphocytes in BAL fluid and the ratio of AM to monocyte accessory cell function. These results suggest an association between AM accessory function and the presence of BAL lymphocytes in bronchial asthma.

Recent advances in our understanding of the biochemical interactions between platelet-activating factor and arachidonic acid.

In the last few years, it has become increasingly apparent that the biochemistry of PAF (platelet-activating factor) and that of arachidonic acid are interrelated in a number of inflammatory cells. Experiments presented here further point out that arachidonic acid plays a crucial role in the catabolism and biosynthesis of PAF. In addition, they suggest that the same phospholipid molecular species may serve as a source for both arachidonic acid and 1-alkyl-2-lyso-sn-glycero-3-phosphocholine during cell activation. Finally, they reveal that there may be common regulatory mechanisms for the biosynthesis of PAF and arachidonic acid metabolites. Taken together, studies examining the relationship between PAF and arachidonic acid suggest it may be difficult to consider the biochemistry of PAF without considering arachidonic acid metabolism and vice versa.

Dynamics of platelet-activating-factor release and uptake in a human neutrophil suspension.

The present study has examined the dynamics of platelet-activating-factor (PAF) synthesis, release and uptake in order to understand better the trafficking of PAF between cells and medium. Initial experiments indicated that the amount of PAF found on the outside of the cell remained constant well after the synthesis from a precursor had apparently stopped, and in spite of a continued capacity of the cell to take up and catabolize PAF. These results suggested that PAF produced and stored within the cell is eventually released to the outside of the cell at a rate proportional to that of cellular uptake. In order to estimate the amount of PAF released from the cell, the processes of PAF release and uptake were modelled using simple mathematical functions. It was found that, under the experimental conditions used in this study, the uptake of PAF could be expressed as an exponential function tending to a non-zero baseline. Utilizing this rate constant for the uptake of PAF with the amount of PAF outside the cell, the amount of total PAF released from the cell was estimated. Data from the model suggested PAF was released in amounts 10-fold higher than could actually be measured over 30 min. In fact, the model predicted more PAF could be released from the cell than is synthesized, suggesting that a portion of the PAF which is released is taken up and then released again to the outside of the cell. The potential for PAF and/or its intermediates to be recycled was verified by demonstrating that a large proportion of exogenously provided 1-alkyl-2-lyso-sn-glycero-3-phosphocholine is taken up by the neutrophil, converted into PAF and then released again by the cell. These results suggest that PAF trafficking between the cell and medium is complex and involves many processes, which include synthesis, release, uptake, catabolism and recycling.

Histamine acting on a histamine type 1 (H1) receptor increases beta-glucuronidase release from human lung macrophages.

The effects of histamine on lung macrophages have been studied by both biologic and radioligand experiments. After overnight adherence, lung macrophages spontaneously released beta-glucuronidase (beta-G) at a rate of approximately 7 nmol of hydrolyzed substrate/h/million cells. Histamine at low concentrations (10(-9) to 10(-8) M) resulted in a consistent potentiation of this release. The concentration-effect curve of histamine was bell-shaped, reaching an optimum at 10(-9) M, with concentrations greater than 10(-8) M having no significant effect. At a maximally effective concentration (10(-9) M), histamine evoked a 135 +/- 9.6% (mean +/- SE; n = 8, P less than 0.001) potentiation in the total amount of beta-G released during the first 60 min of incubation. This increase in beta-G release represented both a slight increase in beta-G synthesis as well as an increase in the percentage of beta-G released. When the secreted beta-G is expressed as a percentage of total content, histamine (10(-9) M) evoked a 125 +/- 3.2% (mean +/- SE; n = 27, P less than 0.0005) enhancement. The potentiation of beta-G release by histamine was evident after 45 min of incubation and persisted for up to 6 h. The potentiation of beta-G by histamine was sensitive to inhibition by pyrilamine (10(-7) M).(ABSTRACT TRUNCATED AT 250 WORDS)

[Piperacillin-amikacin combinations: killing curves]. / Associations pipéracilline-amikacine: cinétique de bactéricidie.

Bactericidal activity as a function of time of piperacillin (PIP) and amikacin (AKN) alone and in combination was evaluated by killing curves technique on 23 clinical isolates: E. coli (6), K. pneumoniae (5), E. cloacae (6) and P. aeruginosa (6), for which the minimal inhibitory concentrations ranges of piperacillin were 0.25 to 64 mg/l and of amikacin 1 to 8 mg/l. For each species, the strains were chosen according to the most frequent phenotypes: beta-lactams susceptible, penicillinase (Pase), cephalosporinase (Case) and Pase + Case producers. Killing curves were carried out with the following concentrations (mg/l): piperacillin (2, 16, 64); amikacin (4, 8, 16); piperacillin (2) + amikacin (4); piperacillin (16) + amikacin (8); piperacillin (64) + amikacin (16). Antibiotic concentrations corresponded to pharmacokinetics and/or to critical values of piperacillin and amikacin. Bactericidal activity was defined as a 4 log 10 decrease in CFU/ml between 2 and 24 hours. When piperacillin (64) was combined with amikacin (16), the bactericidal effects were nearly the same as those with amikacin alone. But piperacillin (16) + amikacin (8) combination had bactericidal effect for the majority of strains (21/23) and it prevented for some of them the bacterial regrowth observed with amikacin alone at the same concentration. A bactericidal activity without regrowth (until the 24th hour) was obtained for 9 strains; 2 susceptible E. coli, 3 K. pneumoniae (chromosomal Pase producer) and 4 cefotaxime susceptible E. cloacae, with low dose combination piperacillin (2) + amikacin (4). Finally, only combinations piperacillin (64) + amikacin (16) or piperacillin (16) + amikacin (8) had bactericidal activity on 2 Ticarcillin-resistant P. aeruginosa, the two antibiotics being separatedly bacteriostatic.(ABSTRACT TRUNCATED AT 250 WORDS)

[In vitro antibacterial activity of clarithromycin, a new macrolide antibiotic, and regression curve]. / Activité antibactérienne in vitro d'un nouveau macrolide, la clarithromycine, et courbe de concordance.

This study was set up to establish the regression curve for clarithromycin inhibition zone diameters (disks 15 micrograms) and MIC to create a strain distribution plot, in order to allow accurate interpretation of the disk diffusion method for testing susceptibility to clarithromycin. 430 bacterial strains were studied in three university hospital. Clarithromycin was active against erythromycin sensitive Staphylococcus aureus and coagulase negative Staphylococci at concentrations of 0.12 to 0.25 microgram/ml (mode 0.25). Erythromycin resistant strains were also resistant to clarithromycin. Enterococci could be divided into two populations, one resistant (MIC greater than 128 micrograms/ml) and the other with MIC of 0.06 to 2 (mode 0.25). This was also the case for Streptococci and Pneumococci with MIC lower for susceptible strains (mode 0.03 to 0.06). Clarithromycin was active on Haemophilus at concentrations of 4 to 64 micrograms/ml (mode 16); MICs for beta-lactamase producing strains were comparable to those of strains not producing. MICs for Neisseria were 0.12 to 16 and for B. catarrhalis 0.016 to 0.5. MIC were 0.5 and 1 (mode 1) for Clostridium perfringens; Bacteroides fragilis strains were inhibited by 0.12 to 8 micrograms/ml (mode 0.5-1). So, antibacterial activity of C was similar to that of E; it was sometimes slightly superior, particularly on Gram positive cocci. For MIC breakpoints of 1 and 4 micrograms/ml, zone size breakpoints should be 23 and 17 mm and for 2 and 8 micrograms/ml, 20 and 15 mm.

Ambulatory long-term subcutaneous salbutamol infusion in chronic severe asthma.

Although most patients with asthma improve with currently available drugs, there appears to be a subset of patients with asthma resistant to intensive treatment, including large doses of systemic corticosteroids. In 10 patients with asthma difficult to treat, a double-blind, placebo-controlled, crossover study was performed to evaluate whether long-term, continuous subcutaneous infusion of large doses of salbutamol, in addition to steroids, could improve pulmonary function, compared with intermittent nebulization of salbutamol. Four weeks of administration of large doses (greater than 14 mg/day) of beta 2-agonists were well tolerated, elicited a significant decrease of corticosteroid consumption (p less than 0.01), and were associated with an improvement in pulmonary function (p less than 0.01), compared with run in or the placebo administration period. Mean morning and evening peak expiratory flow rates were similar during all periods, and the variability between morning and evening peak expiratory flow rates was only slightly and nonsignificantly reduced during the period when salbutamol was administered subcutaneously. Both nebulized and subcutaneous salbutamol elicited similar metabolic and muscular side effects, but these untoward reactions never caused any patient to stop the treatment. Local infection at the injection site was observed in two of 10 patients with continuous subcutaneous infusion. Tachyphylaxis to beta 2-agonist, as measured by the reversibility of FEV1 to inhaled salbutamol 12 hours after the end of each period, did not occur. In conclusion, large doses of beta 2-agonist administered to patients with severe, chronic, and steroid-dependent asthma were able to improve respiratory function and to decrease corticosteroids requirements.

Release of platelet-activating factor and the metabolism of leukotriene B4 by the human neutrophil when studied in a cell superfusion model.

Stimulated human neutrophils are known to synthesize large quantities of 1-0-alkyl-2-acetyl-sn-glycero-3-phosphocholine (PAF) and 5,12-dihydroxy-6,14-cis-8,10-trans-transeicosatetraenoic acid (LTB4). However, in an isolated cell suspension the majority of synthesized PAF appears to remain cell associated. In addition, LTB4 is rapidly metabolized to an omega-oxidation product (20-OH-LTB4). Experiments were designed to test the hypothesis that the degree of association of PAF with the neutrophils and the metabolism of LTB4 by the neutrophils is a result of the in vitro condition used during cell activation. Here we have compared in paired experiments ionophore A23187-induced production of PAF and LTB4 by human neutrophils in a concentrated cell suspension, a diluted cell suspension and in a system in which the cells are placed on a matrix and superfused with buffer at a constant flow rate (dynamic system). There was little difference in the amount of PAF synthesized in the concentrated cell suspension and the dynamic system. However, less PAF was produced by neutrophils in the dilution system. The percent of PAF released was consistently greater in the dynamic and dilution systems than in the concentrated cell suspension. For example, more than 40% of PAF measured by incorporation of [3H]acetate or gas chromatography/mass spectrometry was released in the dynamic system and dilution systems. In contrast, less than 15% of the PAF synthesized was released from the cells in the concentrated cell suspension. 1-0-Hexadecyl-2-acetyl-3-GPC was primarily released from the neutrophils. By contrast both 1-0-hexadecyl and 1-0-octadecyl linked species of PAF were found within the cells. Exogenous PAF added to neutrophils in the dynamic or dilution systems was taken up and metabolized at a significantly lower rate than that added to cells in the concentrated cell suspension. Most of the leukotrienes synthesized by the neutrophil during A23187 stimulation were released from the cells. However, studies of LTB4 metabolism revealed differences between the dynamic and concentrated cell suspension designs. By 20 min, most of the LTB4 was recovered as 20-OH-LTB4 in the concentrated cell suspension, whereas in the dynamic system little 20-OH-LTB4 was found in the superfusate over 20 min. These experiments suggest that a large proportion of PAF synthesized by neutrophils may be released. They also suggest that the omega-hydroxylation of LTB4 by neutrophils occurs after synthesized LTB4 is released and taken back up by the cell.

Comparative in-vitro activity of meropenem against clinical isolates including Enterobacteriaceae with expanded-spectrum beta-lactamases.

Meropenem, a new parenteral carbapenem, was tested in vitro by an agar-dilution method against 373 standard strains (aerobes and anaerobes) and against nine expanded-spectrum beta-lactamase-producing strains and their transconjugants (5 CTX-1, 2 CAZ-1, 2 CAZ-2). Meropenem was compared with methicillin, imipenem, piperacillin, cefoxitin, cefotaxime, ceftazidime, gentamicin, chloramphenicol, clindamycin, ciprofloxacin, vancomycin and metronidazole. Meropenem and imipenem exhibited an extended spectrum of activity, with low MICs. Only methicillin-resistant staphylococci, and Pseudomonas (Xanthomonas) maltophilia were resistant. Of the carbapenems, imipenem was more active against methicillin-susceptible staphylococci, streptococci and Enterococcus faecalis, but meropenem was markedly more active against all the Enterobacteriaceae and some pseudomonads. Both had similar activity against Ps. aeruginosa, Acinetobacter spp. and anaerobes. The carbapenem MICs were very low for Enterol acteriaceae producing the expanded-spectrum beta-lactamases. Against CTX-1-producing strains resistant to cefotaxime and ceftazidime and against CAZ-1 or CAZ-2-producers highly resistant to ceftazidime meropenem was the most active, with MICs lower (0.03-0.12 mg/l) than those of imipenem (0.06-0.5 mg/l), for wild type producers and their transconjugants.

Phagocytosis induction of chemiluminescence and chemoattractant increased superoxide anion release from activated human alveolar macrophages in asthma.

Human alveolar macrophages (AM) were demonstrated to generate reactive toxic derivatives of oxygen in many pulmonary disorders. These cells are involved in local inflammation which characterizes bronchial asthma. In the present work, we studied the ability of stimulated macrophages from healthy volunteers, and asthmatic patients to generate oxygen species in vitro. AM obtained by bronchoalveolar lavage were purified by adherence. The production of oxygen species was measured by luminol-enhanced chemiluminescence (CL) after challenge with opsonized zymosan. The maximal values were significantly (p less than 0.03 and p less than 0.01) higher in AM from asthmatics than in AM from healthy subjects. A significant correlation (p less than 0.01) was observed between maximal value of CL and the severity of asthma as assessed by the clinical score. But, no difference was observed between AM from asthmatics in a stable state and healthy subjects. On the other hand, assays for superoxide anion generation emphasized the activation state of these macrophages stimulated by formyl-peptides.

Approaches to the diagnosis of viral pneumonias in the immunocompromised host: the importance of assaying cytopathogenic viral effects in bronchoalveolar lavage cells.

Pneumonopathic conditions in the immunocompromised host (IH) are frequent and often serious. Rapid diagnosis is essential and is made possible by bronchoalveolar lavage (BAL). Sixty-two pneumonopathic episodes in 53 immunocompromised patients were examined by BAL, for viral cytopathogenic effects (CPE) in isolated cells, with appropriate viral culture techniques. Viral culture was positive in seventeen of the eighteen episodes in renal allograft recipients and AIDS patients as against eight of the fourty-four episodes in other causes of IH (p less than 0.001). CPE was found thirteen times; in seven cases it was characteristic of cytomegalovirus. Positive viral culture and CPE were shown simultaneously during thirteen episodes in eleven patients. Ten patients died (autopsies performed in three cases confirmed viral presence). Positive viral culture with absence of CPE was observed in twelve cases. There were only four fatalities in this group (the autopsies performed in three cases did not establish the presence of a virus in the pulmonary parenchyma). The percentage of lymphocytes was high in both groups of patients (18.6 +/- 2.8%). CPE is a simple and rapid examination for the diagnosis of viral pneumonopathology in the IH. Prognosis at present is gloomy; more complex examinations such as viral cultures and/or identification of the virus by immunofluorescence will be indicated only when effective antiviral agents become available.

[Value of x-ray CT used in thin sections for evaluating sarcoidosis. Apropos of 57 cases. Comparison with other methods]. / L'intérêt de la TDM en coupes millimétriques pour l'évaluation des sarcoïdoses. A propos de 57 cas. Comparaison aux autres méthodes.

The authors have staged by CT 57 cases of sarcoidosis. In all cases CT has given superior semiologic pattern in comparison with plain-films which are the classical baseline references (Turiaf)...up to date. 30% of type I sarcoidosis are staged as type II by thin-section CT slices. This radio-clinic evaluation must be continued on months to find if this group is an homogeneous one in the prognostic meaning and if cortico-therapy is useful. The authors propose a systematic CT evaluation of sarcoidosis in 1987 and a CT actualization of the radiologic classification of the disease.

[Oxygen free radicals and bronchial asthma]. / Radicaux libres de l'oxygène et asthme bronchique.

Oxygen free radicals are released generally by many cells during phagocytosis and cell activation. In asthmatics, some experimental evidence indicates that oxygen free radicals may be considered to be chemical mediators of anaphylaxis. They are released by macrophages, eosinophils and neutrophils, the cells that are found in bronchoalveolar lavage. They may explain some pathological changes, such as hardening of the airways, bronchial hyper-reactivity and inflammation. Therapeutic implications are discussed.