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Prognosis of B-cell chronic lymphocytic leukemia (CLL) is based on clinical staging whose limitation is the failure to assess whether the disease will progress or remain stable in early stage (Binet A, or Rai 0, I, II) patients. We previously reported that soluble CD23 (sCD23), a protein derived from the B-cell membrane CD23 Ag, is selectively elevated in the serum of CLL patients. This prospective study assessed the predictive value of serum sCD23 level measured at study entry on the overall survival of all CLL patients and on disease progression of stage Binet A patients. Prognostic value of repeated measurements of sCD23 over time in stage A patients was also analyzed. One hundred fifty-three CLL patients were prospectively followed with a median follow-up of 78 months. Eight clinical or biological parameters were collected from the date of the first sCD23 measurement. At study entry, by Cox model, Binet staging (P = .0001) and serum sCD23 level (P = .03) appeared as prognostic factors for survival. Patients with sCD23 level above median value (> 574 U/mL) had a significantly worse prognosis than those with lower values (median survival of 53 v 100+ months, P = .0001). During follow-up, sCD23 doubling time increased by 3.2 the risk of death (P = .001). Among stage A patients (n = 100), sCD23 determination at study entry was the sole variable predictive of disease progression, patients with sCD23 level above 574 U/mL had a median time progression of 42 months versus 88 months for those with lower levels (P = .0001). Stage A patients who doubled their sCD23 level exhibited a 15-fold increased risk of progression (P = .0001) and, in addition, the sCD23 increase preceded by 48 months disease progression. We conclude that in CLL patients, serum sCD23 level provides significant additional prognostic information in terms of overall survival. Most interestingly, among early stage patients, sCD23 determination at diagnosis and during the course of the disease may help to the early identification of patients who will rapidly progress to upper stages.

The effectiveness and safety of the difluoroquinolone sparflo (sparfloxacine) used in combined therapy for drug-sensitive and drug-resistant pulmonary tuberculosis were studied. Clinical trials were carried out in 60 patients with severe pulmonary tuberculosis. The more effective combinations of sparfo and other antituberculous drugs were determined. Data on the satisfactory tolerability of sparfo used in various combinations of first- and second-line agents are presented.

The origin of introduction of the cabbage root fly, Delia radicum Linnaeus to the north-eastern coast of North America in the 19th century has been assumed to be from Europe. From that point of introduction, D. radicum gradually spread westward to occupy available ecological niches. DNA fingerprinting and egg micromorphology were used to determine the most likely geographical origin of the North American populations of this species. Forty-five informative RAPD loci obtained from ten primers and three criteria for egg micromorphology were studied. These characters indicated a common origin for the North American populations and a high similarity between populations from North America and north-western Europe. The results suggest a single entrance point of D. radicum into North America, probably via the north-eastern coast (New York area) from north-western Europe. The implications of this study in assisting selection of natural enemies of this important agricultural pest are discussed.

In our previous studies, we reported that the sera from CLL patients contain 3 to 500 times more IgE-BFs (or soluble CD23) than the sera from normal individuals (Sarfati M., Bron D., Lagneaux L., Fonteyn C., Frost H. & Delespesse G. (1988) Elevation of IgE-binding factors in serum of patients with B cell-derived chronic lymphocytic leukemia. Blood 71, 94). In the present study, we have investigated some of the mechanisms accounting for this observation. We report that the density of CD23 expression per cell is significantly higher on the B-CLLs than on the control cells, although the proportion of CD23+ B cells is comparable in both groups (70-90% of CD20+ cells express CD23 antigen). We have next examined the influence of IL-4 on the CD23 expression, the proliferation and the differentiation of B-CLLs. The results indicate that IL-4 (i) increases CD23 expression and IgE-BFs production by normal and CLL B cells; (ii) does not promote B-CLLs proliferation or differentiation, neither by itself nor in costimulation with either anti-IgM or PMA; (iii) significantly potentiates PMA-induced IgM and IgE-BFs production by B-CLLs. It is further shown that anti-CD23 Mab does not interfere with B-CLLs proliferation or differentiation. It is concluded that: (i) the excessive production of IgE-BFs in CLL patients results not only from the enlarged pool of CD23+ B cells but also from an over-expression of CD23 on B-CLLs; (ii) CD23 is not constitutively expressed on B-CLLS and it is upregulated by IL-4; and (iii) by contrast to normal B cells, CD23 on B-CLLs may not be associated with the functional LMW-BCGF receptor.

To establish the risk of tuberculosis reactivation in subjects who had severe somatic conditions, 103 patients were observed in a multiprofile general hospital and followed-up for 1-3 years after their discharge. A potential and actual risk (estimated to be 78.0 +/- 6.5 and 7.3 +/- 4.0% of the cases, respectively) for recurrent tuberculosis was recorded as a result of the excretion of conditionally stable and unstable M. tuberculosis L-forms. The importance of the nature and the degree of residual tuberculous changes in view of a specific process reactivation risk for the patients was confirmed. It was indicated that the persons with severe somatic conditions and residual tuberculous changes in respiratory organs made up a tuberculosis risk group to be observed by a phthisiologist.

An inactivated poliovirus vaccine prepared from cultures of Vero cells has been tested on 61 infants from two to 11 months of age (mean age, 4.3 months) for tolerance and serologic potency. Three doses of vaccine were given one month apart at the same time that diphtheria-tetanus-pertussis vaccine was injected at another body site. Poliovirus-neutralizing antibody titers were measured before the first and third injections and one month after each. The titer was considered positive when the dilution was greater than or equal to 1:4. The tolerance has been good. Thirty-one infants were assessable for serologic efficacy; all had significant serologic responses after two injections of polio vaccine, regardless of the titer of maternally transmitted antibodies before the immunizations. The third injection did not significantly increase the antibody titer observed after the first two doses.

The control was performed by a unic systemic autumn treatment on heifers and repeated topical spring treatments on dairy cows. After a four years programme, limited success are obtained. No difference in the efficacy are observed in isolated or grouped farms. A good estimation of infestation cannot be obtained by only one or two numerations of warbles in spring. Repetitive of topical spring treatments on dairy cows appears to be the major limitating factor of success in these programmes.

Clinical, x-ray, morphological and microbiological findings have been analyzed for 106 patients who died at hospitals of severe somatic diseases. The data have been obtained on the incidence of residual effects of healed tuberculosis, that of recurrences of the specific process and isolation of L-transformed agents from the residual foci. This evidence supports the assumption that severe somatic diseases mask subclinical activity of residual tuberculosis.

The authors present a disposable device which may be used for skin tests studying delayed cellular hypersensitivity with 7 antigens and a glycerin control. With the aim of more objective evaluation of the results, they suggest the establishment of a score taking into account the number of positive reactions and the degree of the reactions. Finally, they describe the results of a large multicentre study involving 830 subjects considered to be healthy and divided into 4 groups according to the response to the tests.