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Seven patients with advanced forms of mediastino-pulmonary sarcoidosis (involvement of the pulmonary parenchyma, and restrictive respiratory syndrome), confirmed by histopathologic investigation, have been treated with a new SV-rifamycin derivative, 1246-EH, or "Reprimum" without any other association. Reprimun was given in daily doses of 10 mg/kg of body weight for a period of two weeks, then, for another 4-5 weeks, the drugs was given intermittently in doses of 15 mg/kg of body weight twice weekly. Between two cycles of therapy a period of 14 days was free of drug administration. In all patients the treatment with the new derivative was well tolerated. The treatment was not followed by adrenal deficiencies, neither was noted obesity, bone decalcification, gastric ulcers, etc., which are commonly associated with prolonged corticoid therapy. The treatment with "Reprimun" efficient for all patients. A clear clinical and X-ray improvement was noted after the first three months of treatment with the new drug. Respiratory function, as well as clinical and radiological signs improved, the serum immunologic parameters, and the biochemical ones were also significantly improved (Ig, C3 total serum proteins and gammaglobulins). All parameters which were tested were finally improved and became normal. In only two of the seven patients the radiological aspects of the lung suggested the presence of sequellae at the end of the treatment. In these two patients there was a persistant reduction in the respiratory volume, as well as a discret hypoxemia. However, both these patients had a more advanced form of the disease, with extensive pulmonary fibrosis, and in these cases prolonged corticoid therapy which had previously been applied had failed. Reprimun had an immunological-modulatory effect in all patients, resulting in normal levels of IgG, IgA, and C3 in the first three months of therapy. There was a direct correlation between the normalization of immunological indicators and the good evolution of the diseases, a fact which suggests once again the existence of some immune mechanisms involved in the maintenance of sarcoidosis.

The authors have studied the evolution of serum parameters of iron metabolism in patients with tuberculosis during the standard chemotherapy. The results are discussed, in the perspective of a model of natural resistance depending on iron. No strict correlation was found between the bacteriostatic capacity of the serum and the process of saturation with iron of transferrin, probably due to participation in the bacteriostatic effect of other factors beside transferrin. The results have demonstrated that the imbalance between the serum values of copper (that are increased), and those of iron (that are low) tends to become normal during the recovery, as evaluated by a negativation of the sputum cultures. These results suggest that the use of a ratio between copper and iron in the blood serum as a method for assessing the recovery of the balance in the tuberculous organism during therapy is justified.

The authors present, in the light of their personal experience acquired in the performance of surgical interventions on the trachea (a total of 13 interventions in 11 patients), some particularities of the surgical technique, as well as of the anesthetic procedures capable to improve the immediate and the late results of these interventions. The techniques suggested are aimed at preventing the operatory risks in the surgical procedures on the trachea, which is classified by the authors in three groups: tracheal risks, vascular risks, and anesthetic risks. The validity of these techniques is confirmed by the success of the surgical procedures applied, followed by the definitive recovery of the patients which were operated with the most recent experience of the authors. Two clinical observations are presented: a case of circumferential resection of the trachea in the mediastinal portion for cicatriceal stenosis, followed by termino-terminal anastomosis, and a case of cuneiform resection of the trachea in its supracarenal section for tumoral stenosis.

A study was carried out on the incidence of E. coli serogroups 01--025, under different clinical and epidemiologic conditions, with a view to evaluating their etiopathogenic significance and the efficiency of immunofluoresence as a rapid laboratory method of diagnosis. A total number of 1542 samples were collected from humans (1075 feces samples and 467 urine samples from cases of urinary infection), and 387 from animals. The samples were collected from cases of enteritis and from healthy children and adults: 285 samples from infantile enteritis cases; 200 samples from adults with enteritis; 31 samples from healthy children: and 559 samples from healthy adults. These E. coli serogroups were found in humans, in both pathologic and normal conditions. The proportion of isolations of E. coli serogroups 01--025 was greater in the feces samples from healthy subjects than in the samples from enternal or urinary infections (48.80% as against 23.21%), demonstrating the opportunist character of these germs. Positive results were obtained in 30.23% of the products of animal origin (monkeys, dogs, chickens), pointing to the wide spread of these serogroups in nature. Serogroups 04 and 025 were predominant in both the human and animal products. The rapid immunofluorescence diagnosis cannot be applied to these serogroups owing to the multiple and varied antigenic fractions. The laboratory diagnosis can only be established in pure cultures by identification of the groups, by biochemical and serolgic methods, by agglutination reactions on slides and in test tubes.

Transcriptase activities were investigated in cell extracts of human circulating lymphocyte cultures stimulated for proliferation with polyclonal mitogens like PHA, PPD, and endotoxin from Salm. typhimurium S, and also with two polynucleotides. Enzymic activity of the cell extracts was tested differentiatelly for direct (DNA/RNA) and reverse (RNA/DNA) transcription, using appropriate template-primers: activated DAN and poly (dA). r(pU)10 for direct transcription, and poly (rA.rC. rU), poly (dA) x d(pT)10, and poly (rA). d(pT)12-18 for reverse transcription. All lymphoproliferative stimulators are able to enhance simultaneously the cellular mitosis and the direct transcriptase activity in the cell. There is a good correlation between the two effects. Enzyme affinity to natural DNA is higher than to synthetic poly (dA) r(pU)10 PHA, a mitogen for T lymphocyte, enhances the eukaryote type of reverse transcriptase, while among the mitogens for B lymphocyte the PPD enhances an intermediate (viral-eukaryotic) type of reverse transcriptase, and ENDO is not stimulatory for reverse transcription. Duplex polyribonucleotides have an adjuvant activity: they intensify the action of stimulators but they have not a direct enhancing activity. The different transcriptases involved in the lymphocyte differentiation and proliferation may be targets for clinically useful immunosuppressive drugs differentiated for T and B cells.

A total of 591 cases were studied, with perforated gastroduodenal ulcerations, who underwent surgery in the Emergency Clinic of Bucharest in 1978-1979. Of the 591 patients 528 had duodenal perforations, 58 had gastric perforated ulcers, 4 had perforated duodenal ulcers and gastric ulcers penetrating in the pancreas, and one patient had a peptic perforated ulcer. Several factors are studied in this paper, including: age, the interval from the onset of the symptoms to hospitalization, the duration of preoperative preparations, the anatomo-clinical forms of the perforated gastro-duodenal ulcers, the type of surgical treatment, the evolution and the complications after surgery. The surgical interventions were individualized, from one case to the next, according to the general and the local condition of each patient.

Basal and stimulated (after a standard meal) serum gastrin was determined by means of the radioimmunoassay method in 27 patients with epigastric pain that could not be diagnosed in the outpatient departement. An individual study of the patients with high (up to 300 pg/ml) basal and stimulated serum gastrin levels showed that most gastroduodenal diseases are situated within this range while levels of 500 pg/ml suggest Zollinger-Ellison syndrome. The test of serum gastrin stimulated with a standard protein-rich meal was proved more valuable than the basal one. Further investigations would be necessary to demonstrate the value of this test in the diagnosis of gastroduodenal ulcer, gastrites or gastric cancer.

From among the 2813 E. coli strains isolated from various specimens (urine, feces, pharyngeal exudates, organs from fowls) in the course of two years, the authors selected and carried out a complex study on the strains exhibiting atypical features, considered to give rise to errors of diagnosis. Of the 2813 strains studied, 599 (21.29%) presented different atypical traits : 45 (1.59%) morphological and cultural (very small pulvurelent colonies or extremely mucous, oily colonies), 21 (0.74%) morphological, cultural and enzymatic atypical aspects and 533 (18.96%) only enzymatic (non-indolegenous strains, strains giving a methyl red reaction, H2S positive strains, lactose-negative and adonite or inosite-positive strains).

Favourable results were obtained by treatment with Reprimun alone or in association with low doses of Prednisone in 112 patients with sarcoidosis (59% with active sarcoidosis and 33% failures of a previous corticotherapy). Treatments were applied during 3-6 series each one of 6 weeks at intervals of 2 weeks between series. In comparison with the classical corticotherapy, treatment with Reprimun has better results, namely: absence of any major adverse reactions; reduction of the treatment period to 6-12 months (3-6 series); 95% lasting remissions in the sarcoidoses with initial treatment and 78% remissions in the case of failures of a previous corticotherapy.