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This study involved 14 cases or pleural effusions or ascites rich in amylase and unrelated to chronic pancreatitis, a pseudo-cyst of the pancreas or acute pancreatitis. A pleural effusion rich in amylase may be secondary to a pancreatic neoplasm but this possibility seems rare. Amylase-containing effusions related to a nonpancreatic neoplasm are more common. The lesion is in general an advanced pleuro-pulmonary carcinoma, frequently an adenocarcinoma. The amylase activity of neoplastic effusion fluid is significantly increased but although levels similar to those of certain pancreatic effusions may be seen, very high figures would appear to be rare. Finally, two cases of amylase-rich pleural effusions were related to a pleuro-digestive fistula and one left-sided effusion was secondary to abdominal trauma.

If mediastinal lymph-node calcifications are frequent, the "hodgkinian" origin of these calcified adenopathies is unusual; less than 30 cases are reported in the literature. A new observation is described here. These lymph-node calcifications occur most often after radiotherapy; exceptionally "hodgkinian" adenopathies can appear ready-calcified.

A cyclic and sequential combination of adriamycin, vincristine (or VM 26) and cyclophosphamide was used, with a follow up of 4 to 33 months in 38 patients with a "micro-cellular" carcinoma of the lung. Radiotherapy was used in association in a variable manner. Chemotherapy alone resulted in marked regression of the lesions (regression is greater than 50%) in approximately 65 per cent of cases and a level of complete regression which varied from 31 to 45 per cent according to the degree of diffusion of the lesions at the time of admission. In this study, survival in apparently localised forms was 70 per cent after one year and 55 per cent at eighteen months, whilst it was 34 per cent at one year and nil at eighteen months in patients with evidence of metastatic disease at the time of entry. These encouraging results indicate a hope for improvement, in certain patients reacting favourably to this protocol, in the still grave prognosis of "small cell" carcinoma of the lung.

In 200 young patients with apparently idiopathic spontaneous pneumothorax, the following radiologic features were analyzed: degree of collapse on the initial chest film, areas of atelectasis, and presence of blebs, apical opacities, fibrous adhesions, pleural effusions, and controlateral shift of mediastinal structures. Confrontation of apical changes with pathologic findings in operative specimens suggests that mesothelial rupture with reactive hyperplasia results in a "pneumatization chamber" visible as a bullous image. Following drainage, homolateral shifts of mediastinum and four cases of pulmonary edema were recorded. Risk factors for pulmonary edema include severe pulmonary collapse with areas of atelectasis, persisting for more than 48 hours and an aspiration which either exceeded 1.5 l. of air or was performed with a depression of more than 30 cm of water.

A part from the interest aroused by the exceptional nature of this case of sarcoma of the right superior pulmonary vein, it enabled definition of the angiographic appearances of the affection of the vein. Physiopathological examinations, including vascular redistribution, development of a systemic collateral circulation, and the reflux of hematosed blood into the pulmonary trunk, were able to establish the diagnosis in vivo.

The pleurisies rich in amylase of the chronic pancreatitis and of pancreatic pseudo-cysts, studied in 20 cases, are quite unfrequent (0.5% of pleurisies of all kinds in the medical milieu). A pseudo-cyst was found 12 times out of 20 and a chronic pancreatitis without pseudocyst was found 8 times out of 20. Pleural effusion has a definite diagnostic valve, because in 70% of cases pancreatopathy cannot be recognized before it happens. The pleural liquid is rich in proteins and haemorrhagic in 2/3 of cases and its amylasic activity is either high or very high. Amylase level in pleural liquid is usually superior to amylasemia. The injection of lipiodol in the pleural cavity enables the visualization of a transdiaphragmatic fistula but this examination is not always well tolerated. The preoperatory cystography can opacify the pleura. In the absence of pseudo-cyst, medical treatment can dry the pleurisy in 70% of cases but does not modify the evolution of the pancreatic affection which will require surgery. Where a pseudo-cyst is concerned, surgery will often and quickly be the remedy.

Two case-reports are presented to support the hypothesis that bronchiectasis may occasionally be associated with a partial deficiency of T lymphocyte functions. This deficiency would represent another etiology of the heterogenous sino-pulmonary syndrome of which several causes have been identified or postulated: immunoglobulin deficiency, alpha-1-antitrypsin deficiency, mucociliary abnormality, phagocytosis or bactericidia abnormalities, etc.

The study of 9 cases of agammaglobulinemia in the adult shows the classical symptomatology of these diseases. The evolutive study deals with too small a series to demonstrate statistically the superiority of the substitutive treatment over a simple chemo-therapeutic prevention of the infection, but nevertheless it shows : 1) that prognosis is bad only in cases of gross anatomical and physiological alterations and when they are the sole responsible for a fatal evolution; 2) that the substitutive treatment is only really efficient when given at high doses; the minimum dose of 250 mg per day seems advisable.

In two brothers treated for severe pulmonary emphysema, was demonstrated an alpha-1-antitrypsin deficiency associated with a ZZ phenotype (Pi system). The authors carried out a genetic study of the family including 60 members spread over 4 generations. In all, were demonstrated 4 subjects of phenotype ZZ, 29 of phenotype MZ, 3 of phenotype MS ; one subject had a phenotype SZ and 23 members of this family had normal levels of alpha-1-antitrypsin and were of phenotype MM. The disease was transmitted in all cases as an autosomic codominant. The interest of a study of the phenotype in alpha-1-antitrypsin deficiency is emphasized together with the practical steps to be taken on discovery of a subject with the allele responsible for a reduction in serum levels of alpha-1-antitrypsin.