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In the out-patient tobacco detoxication unit created, in 1977, within the pneumology department of the Hotel-Dieu hospital, Paris, the method used is a combination of acupuncture and group psychotherapy. Its effectiveness has been evaluated, over a 2-year period, by means of a questionnaire mailed to each patient and followed, if necessary, by up to 3 reminders. A computer-assisted assessment of the data thus collected provided a follow-up of varying duration of the 555 patients concerned; 488 patients were treated, then contacted, and 371 (76 p. 100) answered the questionnaire. Weaning--defined here as complete detoxication with a 2 to 28 months follow-up when the questionnaire was filled--was obtained in 24 p. 100 of the patients who answered. Other evaluation criteria would have given figures ranging from 18 p. 100 to 58.6 p. 100. The main reason for failure mentioned by the patients was lack of will. An exhaustive study of 84 publications concerning more than 10,000 candidates to weaning showed that similar results are obtained with several types of psychotherapy, acupuncture and auriculotherapy: a success rate of about 60 p. 100 at the end of treatment, 40 p. 100 at 3 months and 30 p. 100 at 6 months and one year. The results obtained with drugs are not as good, perhaps because their use betrays a lesser desire to give up smoking.

resume La doxycycline et l'amoxicilline ont ete comparees dans une etude randomisee en double aveugle (utilisant le double placebo) concernant 150 patients presentant une poussee infectieuse de bronchite chronique. Cet essai multicentrique porte sur des patients des deux sexes ambulatoires ou hospitalises qui recoivent de maniere aleatoire un antibiotique actif et le placebo de l'autre pendant 10 jours (doxycycline : 200 mg/jour en une prise — amoxicilline : 1 g/jour en 2 prises). L'efficacite, appreciee sur l'evolution clinique est satisfaisante et comparable dans les deux groupes. La tolerance est meilleure chez les patients recevant la doxycycline. La gravite des effets secondaires rapportes reste moderee.

Resume La Doxycycline et la Josamycine ont ete comparees au cours d'une etude clinique randomisee en double aveugle concernant 140 patients presentant une poussee de surinfection de bronchite chronique. Dans cette etude multicentrique les patients ambulatoires ou hospitalises des 2 sexes ont ete repartis de facon aleatoire en deux groupes et ont recu soit la Doxycycline active et le placebo de Josamycine, soit l'inverse pendant 10 jours. Les resultats montrent une bonne efficacite pour les deux medicaments ; la tolerance est satisfaisante. Aucune difference statistiquement significative n'a ete mise en evidence en terme d'efficacite entre les deux groupes.

Drying is a very important phase of papermaking. Both the energy consumption and investment costs required by this process are high. This paper describes a method giving systematic analysis of industrial drying sections during their run and based on a mathematical model of paper cylinder drying. Working on measurements data, it is possible to compute the heat and mass transfer coefficient values to get the complete identification of the considered drying section. Then, it is possible to test by simulation, the effect of new investments (increasing the number of cylinders, moving the size-press location, etc) or of operating point changes (increase of steam-pressure or moisture content at the entrance... etc) on the machine production and on the steam consumption. This method has been used for an industrial printing paper machine. Computer simulations have allowed to get the optimal size-press location in the drying section and the machine speed variations obtained after the increase of the number of cylinders and this for three different basis weights.

A non interacting multivariable papermachine headbox control is discussed and compared with some classical loops. The control design is based on quadratic optimization criterion with a discrete state variable process model. Two reference models are used in this control structure : Tracking model and Perturbation model. Integrators have not been used to remove steady state error. Different results are obtained on an experimental headbox, controlled by a process control computer.

Snow mold infection by an unidentified low-temperature basidiomycete and Typhula spp. developed best under artificial conditions when inoculated plants in pots were incubated for 2 months at 2 °C with 80 to 90% R.H. in the special cabinets described or with other covering. A saturated atmosphere was detrimental to mycelial growth and infection. Freezing temperatures and complete host dormancy were not required but greenhouse-grown plants benefited from prior conditioning for 2 weeks at 2° to 5 °C with light for 8 hours daily. The reactions of alfalfa varieties, creeping red fescue, Kentucky bluegrass, red top, timothy, and winter wheat to the low-temperature basidiomycete were similar to those previously observed in the field. T. idahoensis Remsb. caused moderate to severe damage and T. itoana Imai caused slight to moderate damage to the grasses and winter wheat. Typhula sp. from alfalfa was highly virulent to that host. The low-temperature basidiomycete was the only snow mold organism tested that synthesized HCN in culture or in the plant tissues.Sclerolinia borealis Bub. & Vleug. caused slight damage to winter wheat and grasses after 3 months at 2 °C but did not develop well under any of the conditions employed.

Isolates of an unidentified low-temperature basidiomycete, associated with snow mold in Western Canada, were divided into three types, A, B, and C, on the basis of their general cultural appearance. Support for this classification was obtained when representative isolates of each type were examined to determine: the effect of temperature and pH on growth; tolerance of antibiotics and HCN; ability to liberate HCN in culture and in the host plant; pathogenicity.Type A isolates grew slowly under most conditions and were least tolerant of the extremes of temperature and pH employed, moderately inhibited by antibiotics, and strongly inhibited by HCN. They produced HCN in large quantities in host plants and none in culture. They were moderately pathogenic on grass and highly pathogenic on alfalfa. Type B isolates grew somewhat more rapidly than type A, especially at the upper and lower temperatures, and grew over a wider pH range. These isolates were more tolerant of antibiotics and HCN. They produced smaller quantities of HCN than type A in infected alfalfa plants but released large amounts in culture. They were less pathogenic than type A on alfalfa but similarly pathogenic on grass. Type C isolates were fast-growing forms which were strongly inhibited by antibiotics and HCN. They did not liberate HCN under any conditions and were not pathogenic.

Chemical tests for control of snow mould of turf grass and alfalfa were conducted at Edmonton from 1945 to 1957. Of a number of chemicals tested, inorganic mercury salts provided the best control. Mercuric chloride was more effective than mercurous chloride for treating alfalfa but no difference in control was observed from the two chemicals on turf grass. Sodium tetraborate sprays applied to the foliage of alfalfa in early fall gave remarkable control of the disease but are not recommended because of the low margin of safety from boron injury.

Summary The controllers designed during recent years overcome dead time from the point of view of loop stability; however, the dead time limits the dynamic properties of the closed loop. Feed-forward control requires the measurement of the main disturbances. In the case of basis-weight control, it was been judged preferable to reduce dead time by means of consistency control in the head-box, the sensor being the one perfected by Mr. SILVY (Communication n° 79). This loop is under cascade control through the basis-weight control.

Hydrogen cyanide production by two pathogenic isolates of an unidentified basidiomycete was studied in shake culture in synthetic and natural media. Both isolates release HCN in infected host plants but one isolate (type A) failed to produce HCN in culture. Curves for growth and HCN production by the second isolate (type B) indicated that HCN is a product of autolysis and is not dependent on the provision of specific substrates in the medium.

Between March 1978 and May 1981, 219 patients suffering from non-small cell primary bronchial carcinoma underwent surgical excision which was intended to be curative. Three weeks later the patients were randomised into two groups: 1. A control group, with no other treatment following excision (110 patients). 2. A non-specific immunotherapy group (109 patients). The immunostimulant used was an aqueous suspension of heat killed mycobacterium smegmatis administered subcutaneously once a month. The trial was analysed on December 1, 1982. There were 117 recurrences and 112 deceased. There was no significant difference as regard survival without relapse or overall survival; all causes of death were included.

Data yielded by bronchial and transbronchial biopsy specimens removed during fiberoptic bronchoscopy in 53 patients with sarcoïdosis (24 stage I, 27 stage II, and 2 stage III) was analyzed. Bronchial biopsies (3 to 5 specimens) were positive in 49% of patients (41,6% stage I, 55,5% stage II, 1/2 stage III). Transbronchial biopsies removing bronchiolar and alveolar specimens yielded 88,6% positive results (91.6% stage I, 85,1% stage II, 2/2 stage III). Lymphocyte counts bronchioalveolar washings exceeded normal values by 15% in all 42 patients studied. We conclude : 1) that transbronchial lung biopsies yield significantly more information than proximal bronchial biopsies ; 2) that results of bronchioloalveolar washings reflect granulomatous immunologic changes in the lung and do not allow unequivocal diagnosis.

Presentation of a case of Wegener syndrome with two remarkable atypisms: multiple visceral localizations and evolution lasting over 17 years without any chemotherapy. Discussion of these abnormalities, particularly of the importance, in this slow evolution, of an early exeresis of the granuloma in the upper airways.

Three hundred and four cases of small cell lung cancer diagnosed histologically were included in a randomised multi-centre trial (23 centres) from 1st January 1983 to the 30 September 1985, with no clinical criteria for exclusion. The clinical and laboratory data were taken from the initial assessment of the patients in the trial, and were compared with those in the literature. The sex ratio was 10:1, only 27 were women (9%) and all were less than 70. The mean aged was 60 +/- 10 (extremes 33 to 84 years) and 80% of the population was from 40 to 70 years. Tobacco consumption was virtually constant, only 7 were non-smokers and 7% of patients smoked less than 20 packs/year; indeed consumption was very heavy with a mean of 44 +/- 23 packs/years. 14% of cases were discovered on systematic radiological examination, but 39% of these asymptomatic patients already had disseminated disease. For the 304 patients overall, despite a very variable degree of dissemination from one patient and one centre to another, 163 (54%) had disseminated disease at the outset and 141 (46%) were apparently localised. The initial metastases were often multiple: extra-thoracic nodes (21%), hepatic (23%), osseous (20%), bone marrow (23%), cerebral (9%), and others (9%); these frequencies are underestimated in view of the fact that the investigations were not over-extensive. The serum carcino embryonic antigen levels were abnormal in 32% of cases. Fibroscopy remains the main diagnostic method to provide the histological proof for 90% of patients, but 4% had thoracotomies (of whom 3% were diagnostic thoracotomies).(ABSTRACT TRUNCATED AT 250 WORDS)

A retrospective study of sixty-six case-reports confirmed the traditional factors described in this histological type of cancer, particularly the age, a slight predominence of males, and the very poor prognosis. A selection was made of 42 cases in which extensive investigations had been carried out to search for a possible extrapulmonary primary adenocarcinoma, but only one case of renal cancer and one of thyroid cancer were demonstrated. Autopsy had revealed the presence of 3 prostatic lesions and their relation to the pulmonary affection is discussed. Thyroid cancer had been found in 2 cases, which emphasizes the value of scintigraphy for this organ, whereas the authors felt that other investigations were of no value in the absence of clinically oriented signs.

Our purpose was to test the efficacy of IgG detection against Aspergillus fumigatus antigen by an enzyme-linked immunosorbent assay (ELISA) and to compare the results with those obtained by counterimmunoelectrophoresis (CIE) and indirect immunofluorescence (IIF). Our method was standardized using 157 sera. To sensitize the microtiter plates we used a somatic and metabolic antigen. The adsorbance values were compared with a reference positive control serum (aspergilloma).

Multiple intracerebral aspergillus abscesses in a 5 year old boy with a Burkitt's lymphoma are described. The disease was fatal despite antifungal treatment. The diagnostic and therapeutic problems, the risk factors and preventive care are discussed.

320 patients were included in a trial fo chemotherapy with cyclophosphamide/adriamycin/etoposide/CCNU. A first randomization tested the effect of acetyl-salicylic acid as an anti-aggregant agent. The second randomization studied the result of maintenance chemotherapy. Patients were treated by prophylactic central nervous system irradiation. The results are analyzed according to different prognostic factors such as age, performance status, histological pattern and the center.

A new case of erythrocytosis associated with a high oxygen affinity hemoglobin is reported : the substitution of beta 99 of aspartic acid by glycine, characterized this abnormal hemoglobin, named "hemoglobin Hôtel-Dieu". An important associated smoking habit, probably responsible of an abnormal lung X-ray and of a disturbed CO transport, contributed to increase the difficulty of diagnosis. Familial inquiry, the search of an abnormal hemoglobin by standard or isoelectrofocusing electrophoresis, and the 2,3-DPG assay should be systematically performed in case of polycythemia in young people or in the absence of obvious aetiology. A corpuscular abnormality can be thus detected in about 10 p. cent of such polycythemias.

The retrospective study of 102 epidermoid carcinomas of bronchial radically treated by surgery enables a survey of various prognostic factors, assessing the post-operative evolution over 2 years for 98 patients and over 5 years for 68 others. Some signs are ominous: chest pains or a worsening general condition in the preoperative symptomatology. On the other hand, the effect of the delay between the first symptoms and the intervention has not been demonstrated. Two factors, so far not much valued, have also been studied: the condition of the bronchial section of little prognostic value and, on the other hand, the TNM systematic classification which seems valuable for all operated bronchial cancers.

Ketotifene is a new preventive treatment for asthma possessing the main advantage of being administered orally. Results were analyzed after treatment of 1 791 patients with allergic paroxysmal asthma, at a daily dose of 2 mg for a minimum duration of 3 months. Ketotifene was found to be effective both against asthma attacks (no further episodes in 30% of cases, and reduction in their frequency by at least a half in 35%), and by the fact that associated anti-asthma medication could be suppressed. Positive effects were noted after two weeks of treatment, with improvement increasing during the observation period (3 months). Tolerance was good, the principal side effect being somnolence (13% of cases), which occurred early in treatment but was reversible in more than one-third of these patients.

A case of Pneumocystis carinii pneumonia is presented. Following presentation a chronic alveolitis was uncovered, which was due to ultimately repeated and prolonged inhalation of sweets containing gum arabic. The diagnosis was confirmed by a trans-bronchial biopsy and by chemical analysis of centrifugation of the alveolar lavage deposit. After cessation of the inhalation the progress was satisfactory both in terms of clinical status and lung function measurement.

The authors studied seven patients with sarcoidosis and tuberculosis: the affections co-existed in 3 cases but were separated by varying intervals of time in the 4 other patients. They discuss the diagnostic, therapeutic, and nosological problems posed by these cases, and review the various hypotheses that have been suggested to explain these associations in relation to the pathogenesis of the sarcoidosis.

This article presents the results of a prognostic study of primary resected lung cancer (non-small cell). The data result from a randomised clinical trial of immunotherapy with a non-specific adjuvant; the follow-up was between four to seven years. Thirty-five clinical, biological and anatomo-pathological parameters were gathered at the time of inclusion in the trial. The response criteria used were survival without recurrence and total survival. A multivariate analysis using the Cox's model was carried out for each criterion. At the reference date of the 1st April 1985, 125 relapses and 132 deaths were counted amongst 219 patients; there was only one patient lost to follow-up and only 39 missing data were observed. The negative therapeutic results of the immunotherapy used were confirmed by this new intermediate analysis. The rate of survival without recurrence at 5 years was 43% and the overall survival at five years was 42%. The use of Cox's model to show the prognostic information at the 5% level for survival without recurrence could be summarised by five factors: main staging (the prognostic factor), leucocytosis, the cutaneous reaction to proteus, Karnofsky index and presence of physical signs. For stages I and II the outcome was identical and no factor was predictive at the 5% level. For stage III the cutaneous reaction to proteus and leucocytosis were prognostic. For overall survival, the prognostic information at the 5% level could be summarised by five factors: staging (main prognostic factor), leucocytosis, Karnofsky index, presence of physical signs and lymphocytosis. For stages I and II whose outcome was identical only Karnofsky index and lymphocytosis were predictive at the 5% level.(ABSTRACT TRUNCATED AT 250 WORDS)

The different anatomical zones of the lung show a high degree of variation in metabolic function, involving many protein molecules and complex enzyme systems. Recent data in the literature concerning such activity are described with respect to bradykinin, fibrinolysis, haemostasis, angiotensin, serotonin, catecholamines, prostaglandins, vaso-active amines, the protease-antiprotease system and benzopyrene-hydroxylase.

Summary A case of lymphomatoid granulomatosis arising in a patient with a long history of dysimmunity is reported. The autopsy reviewed the final evolution into a high grade malignant lymphoma with IgM K immunoglobulin production and discovered in deep lymph nodes modifications similar to angio-immunoblastic lymphadenopathy.

Lebeau B. Le cristal apériodique . In: Linx, hors-série n°1, 1980. Les sciences humaines : Quelle histoire !/ vol I. Actes du colloque de Mai 1980. pp. 75-78.

Seven hundred and fourty-eight subjects from the general population were included in a transversal epidemiologic survey. The aim was the determination of a possible relationship between functional profile and Pi phenotype. Seric levels of alpha 1-antitrypsin (alpha 1 AT) and phenotypes were determined in all subjects. All underwent clinical examination, chest X-ray and functional tests (flow-volume curves and single breath nitrogen test). Distribution of the various phenotypes appeared similar to those described in other studies. No homozygote Z was found. Typologic analysis allowed identification of 7 functional profiles, among which 3 were normal and 4 had various levels of obstruction. The comparison between functional impairment and the phenotypes or smoking habits showed that smoking played the major part in the onset of obstructive disease. Mean age of the population surveyed was however rather low, which led to questions about rapidity of onset of chronic obstructive lung disease. This survey thus will lead to a longitudinal study.

Two hundred and nineteen patients with resected lung carcinoma were randomized 3 weeks after surgery between two treatment arms: a control group (110 cases) and an immunotherapy group (109 cases). The immunostimulant was a nonviable saprophytic mycobacterium, M. smegmatis, given monthly by subcutaneous injection in four sites. The two groups were equivalent in terms of prognostic factors, including a nonsignificant difference favoring the control group based on the N (node) classification. This interim analysis was carried out on June 1, 1981. Treatment comparison by the log-rank test did not show any significant differences between these two groups in regards to disease-free interval and overall survival. There was no significant difference between the two groups after stratification of the comparison according to the N classification or adjustment with a subset of eight prognostic parameters through the Cox model. The initially expected difference (20% 1-year survival) will probably not be achieved, given these interim results, but patients will continue to be treated and followed-up according to the protocol as to allow further evaluation of this nonspecific immunotherapy.