A simple technique is presented for rapid screening of leukocytes of patients suspected of having a defective intracellular mechanism for the bactericidal and digestive disposal of bacteria.

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Summary The role of general and suppressor T‐cell function was investigated in a group of twelve children with atopic asthma and ten non‐atopic control children. Studies of active E rosettes, lymphocyte stimulation, and delayed type skin responsiveness revealed no statistically significant group differences. Data obtained employing a concanavalin A‐induced, suppressor T‐cell assay revealed that the asthmatics generated significantly less suppressor cell activity than did the normal control group. There was no correlation between lack of suppressor cell function and serum IgE levels. The results of this study support the concept of suppressor T‐cell dysfunction in atopic disease.

Seventeen patients with cystic fibrosis (CF) and pulmonary exacerbations were randomly assigned to two treatment groups: piperacillin 600 mg/kg/day (P), and piperacillin 600 mg/kg/day plus tobramycin (PT), in order to determine the safety and pharmacokinetics of high-dose piperacillin and whether piperacillin alone was effective for the treatment of Pseudomonas infections. The mean half-life of piperacillin was 0.54 hours, with a peak concentration of 232 micrograms/ml. No differences between P and PT groups were noted in clinical assessment, as judged by Shwachman scores, pulmonary function testing, or weight gain. However, during the course of treatment, quantitative sputum cultures decreased by greater than 10(2) colony-forming units in only 5 out of 19 Pseudomonas isolates from the P group, compared with 12 of 19 isolates from the PT group (P less than 0.03, Chi-square). Although emergence of resistance was not seen, one isolate had an increase in minimum inhibitory concentration from 8 to 128 micrograms/ml. There were no serious adverse reactions to piperacillin; only one patient developed fever possibly related to piperacillin. Therapy with high-dose piperacillin was safe in children with CF. Treatment with piperacillin alone was less effective than combination therapy with gentamicin for reduction in titer of Pseudomonas in sputum. However, the role of antimicrobial agents in the treatment of CF remains undefined. A double-blind placebo-controlled trial is indicated.

Polymorphonuclear leukocytes (PMNL) from children with atypical chronic granulomatous disease (CGD), their mother and siblings, and normal controls were studied in regard to glycolytic and hexose monophosphate shunt activities in the resting, methylene blue-stimulated, and phagocytizing states. PMNL from the patients with CGD had normal glycolytic and hexose monophophate shunt activities in the resting state and after stimulation with methylene blue. However, stimulation of the hexose monophosphate shunt after phagocytosis was greatly decreased. These data were correlated with studies of both initial rate and integral counts of chemiluminescence. The chemiluminescent response from patients with atypical CGD was also greatly decreased. This decreased response probably reflects a defect in the oxidative destruction of the phagocytized microbe and correlates well with the decreased activity of the phagocytically activated hexose monophosphate shunt. The defect in generation of radical species of oxygen, singlet oxygen, and chemiluminescence by leukocytes from patients with CGD is discussed.