[The pulmonary aspiration-washing: new treatment of severe bacterial pneumopathies (author's transl)]

Over the last few years, the apparition of severe broncho-pulmonary suppurations in relation with an often poly-immune bacterial flora presents intricate therapeutic problems. The use of broncho-fibroscopy to enable several focussed cycles of broncho-pulmonary aspiration-washing perfusion, gave us interesting results.

[Capillary sample and blood gas analysis. Technic and validity]

The authors have developed a technique of sampling and analysis of capillary blood which they describe here. Applied to 34 patients, it gives excellent correlations, both for PO2-PCO2 and pH. The advantages of capillary methods and their disadvantages are discussed.

[Idiopathic pulmonary hemosiderosis. Apropos of 1 case]

Idiopathic pulmonary hemosiderosis gives rise to anemia, due to repeated intra-alveolar hemorrhage, the reabsorption of which leads to hemosiderin deposits in the lung parenchyma. The authors report a case in a young woman aged 24 years whose illness started with anemia, then two months later, with hemoptysis and a broncho-pulmonary syndrome with a low grade fever. On the 6th month, there occurred a hazy infiltrate of both lung bases which was fleeting, mobile and recurrent. In the light of this triad of anemia, hemoptysis and infiltrates, the diagnosis of idiopathic pulmonary hemosiderosis was made and confirmed by three examinations:--Lung biopsy: siderophages were found in the sub-mucosa,--Radio-isotope examination, using Fe 59 which revealed iron deposits in the lung,--A surgical lung biopsy which showed a congestive area and a fibrous area. The congestive area was the site of recent hemorrhage, the alveolar limits were filled with siderophages. The fibrous area was the site of chronic repair of older hemorrhage. It was mutilating. The course was complicated by massive bleeding which led to acute recovering respiratory failure. The patient is at present stabilised by corticosteroids. Three hundred cases of idiopathic pulmonary hemosiderosis have been reported in the world literature. Although the main characteristic is intra-alveolar hemorrhage, its course has not yet been determined. It seems however, to be due to an immunologic process as shown by the relationship between this curious disease and Goodpasture's syndrome.

[Pulmonary metastasis from Vater's ampullomas]

The authors report two cases of carcinoma of the ampulla of Vater with numerous pulmonary metastases. This carcinoma is a malignant tumour with a very poor short-term prognosis. This tumour develops at the expense of the ampulla of Vater and may give rise to numerous pulmonary metastases and carcinomato,s lymphangitis. Authors are not unanimous concerning the course and prognosis of these tumours. In fact, one may note two tendencies, one optimistic, which seems to us erroneous, the other pessimistic, which we share.