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The authors report three cases of tuberculosis affecting the liver and hematopoietic system. The difficulty in diagnosing the chronic progressive forms of the disease and the severity of the acute forms is stressed. Liver biopsy is considered to be the most effective examination for confirming the nature of the disease. Acute and chronic forms can also be distinguished histologically, as the former produce nectotic lesions rich in tubercle bacillus but with only slight surrounding cellular reaction, while the latter lesions are productive and are rich in epithelioid histocytic cells.

In a group of 14 patients (7 males and 7 females) ventilated artificially for acute respiratory distress syndrome, the authors defined a level of optimal expiratory positive pressure giving an FiO2 = 1, an arterial pO2 greater than or equal to 400 mmhg and/or an intrapulmonary shunt less than or equal to 15%. Improvement in arterial pO2 under such conditions would appear to be related to maximum alveolar recrutment. This optimal level of expiratory positive pressure would appear to be independent of values of total static pulmonary compliance. The long term use of this technique would seem to be encouraging.

We defined a new optimal positive end expiratory pressure (PEEP) in the adult respiratory distress syndrome (ARDS). The optimal PEEP is the one which allows to obtain a PaO2 greater than or equal to 400 mmHg and/or an intrapulmonary shunt less than or equal to 15 p. cent, the cardiac output being held constant. 14 cases of ARDS have been treated by this method with encouraging results. The earlier optimal PEEP was applied, the more effective it was.