[Evaluation of pulmonary arterial hypertension by Doppler echocardiography in chronic respiratory insufficiency]. / Evaluation de l'hypertension artérielle pulmonaire par échocardiographie doppler dans l'insuffisance respiratoire chronique.

The usefulness of doppler-echocardiography for the assessment of pulmonary arterial hypertension in patients with chronic respiratory failure was evaluated in 24 consecutive patients with chronic obstructive lung disease. Seventeen of these 24 patients (71 p. 100) who had tricuspid valve regurgitation analysable by the continuous wave doppler technique were selected as study group; they included 15 men and 2 women aged from 33 to 78 years (mean 63 years). The highest maximum velocity value (method A) or the maximum velocity value averaged on several cycles (method B) of the tricuspid regurgitation jet was used to calculate the right ventriculo-atrial pressure gradient, using Bernouilli's equation. Right atrial pressure was determined by three methods: haemodynamic measurement, clinical evaluation or attribution of an arbitrary 10 mmHg value. The pulsed doppler study of the pulmonary ejection flow included measurement of the acceleration time and calculation of the acceleration time/ejection time ratio. The usual echocardiographic parameters were measured. Catheterization was performed 2.5 days on average after the doppler study. Correlations between doppler examination and catheterization to evaluate the right ventricular systolic pressure were significant (p less than 0.001) and better with method B than with method A. Depending on the method employed to evaluate the right atrial pressure, the correlation coefficients obtained with method B were: 0.93 (haemodynamic measurement), 0.91 (clinical evaluation) and 0.88 (arbitrary value of 10 mmHg). The right ventricular systolic pressure evaluated by doppler ultrasound using method B and by clinical evaluation of the right atrial pressure was 47 +/- 12 mmHg (22 to 70 mmHg), as against 51 +/- 13 mmHg (28 to 74 mmHg) measured by catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)

[What are the implications of high pulmonary compliance?]. / Qu'implique la découverte d'une valeur de compliance pulmonaire élevée?

We studied 19 patients with abnormally high static lung compliances, which had been discovered during a routine pulmonary function test, changes in elastic lung properties and smoking habits after 4 years. We did not observe, as is usually reported in the literature, that cessation of smoking normalizes lung compliance. A falsely normalized lung compliance may be due to lung zones that cease to ventilate. High lung compliances in nonsmoking patients, without clinical and radiological pulmonary abnormalities, are not always pathological but must be supervised.

[Brushings and bronchial biopsies in small-cell cancer. Comparison of results]. / Brossages et biopsies bronchiques dans les cancers à petites cellules. Confrontation des résultats.

The typing of bronchial carcinoma is important for therapeutic decisions and may be made on bronchial brushings. Sixty six small cell and poorly differentiated squamous cancers were studied. Our personal method of preparing brushing is suggested. The cytological criteria which characterise the two tumour types were analysed. The results from the biopsies and particularly the brushings were related to the quality of the technique and the experience of the Pathologist. There is a good correlation between biopsy and brushing such that brushings may be considered reliable. In cases where the biopsy was not feasible or uninterpretable, brushings confirmed a cancer in all the cases and the type of cancer in eleven. The examination is inexpensive and avoids the need for ultrastructural studies in the majority of cases.

[Effects of latency time on the type of bronchial response in specific provocation tests]. / Effets du temps de latence sur le type de réponse bronchique au cours de tests de provocation spécifique.

21 asthmatic patients with atopic asthma were studied. Their clinical history, skin tests and bronchial reactivity suggest the responsibility of an allergen (mites). Carbachol induced bronchospasm in all patients after doses varying from 100 to 1000 micrograms. The bronchial response was determined 10-60 min after mite challenge using the following parameters: lung volume, forced expiratory flow, total lung resistance and elastic properties. The measurements were performed using an open whole-body plethysmograph. 14 patients had an early bronchospasm (from 10 to 15 min after the mite challenge), the others had a late reaction (from 20 to 60 min after the mite challenge). The early responses were principally characterized by an increase in pulmonary resistance, suggesting proximal bronchoconstriction. The late reactions were characterized by a decrease in MMEF without a notable increase in pulmonary resistance. These differences between bronchial responses are due to a number of modifications in lung elastic properties. Initial obstruction or intercurrent bronchial infections seem to have no effect on the bronchial reaction in these patients.

[Ventilation mechanics as an aid to diagnosis of early emphysematous disease (author's transl)]. / Aide au diagnostic de la maladie emphysémateuse débutante. Arguments fournis par la mécanique ventilatoire.

Respiratory function in 27 subjects with at least one anomaly in ventilation mechanics suggestive of emphysema was compared with that of a control population by means of plethysmographic indices. Results showed that static compliance to CRF and compliance for a volume nil for the elastic properties of the lung on the one hand and alveolar compression for dynamic properties on the other hand, appear to be valid criteria for early diagnosis of emphysema.