[Relationship between measurements of tidal volume and thoracic inflating volume by pressure plethysmography in mice].

OBJECTIVE: To evaluate the accordance of tidal volume (TV) with thoracic inflating volume (TIV) measured by pressure whole-body or double-chamber plethysmography in mice. METHODS: TV and TIV by double-chamber plethysmography were simultaneously measured in 6 mice with spontaneous respiratory frequencies 90 - 120/min; TV and TIV by whole-body plethysmography were measured in 8 paralyzed mice ventilated by fixed frequency. RESULT: TIV value by double-chamber plethysmography was significantly higher than TV [(0.369 +/- 0.014) ml vs (0.356 +/- 0.012) ml, P < 0.01)] in 6 spontaneously breathing mice. TIV value by whole-body plethysmography was significantly lower than TV[(0.233 +/- 0.003) ml vs 0.3 ml, P < 0.001] in 8 paralyzed mice. CONCLUSION: The TV value assessed by TIV measurement can not be accurate, because of the humidifying and heating of inhaled air and negative thoracic pressure during the measurement.

Comparison of low-molecular-weight-heparin and unfractionated heparin for acute PTE.

OBJECTIVE: Acute pulmonary thromboembolism (PTE) is a serious high mortality pulmonary vascular disease whose effective treatment decreases morbidity and mortality. To determine if low-molecular-weight-heparin (LMWH) is clinically as efficient and safe as unfractionated heparin (UH) in patients with diagnosis of acute non-massive PTE, our study compares the efficacy, adverse effects and costs of LMWH and UH. METHODS: One hundred and fourteen patients with non-massive acute PTE were randomly divided into LMWH (nadroparin calcium) and UH groups. Oxygenation index, D-dimer, fibrinogen (FG), lung ventilation/perfusion (V/Q) scan and computed tomography pulmonary angiography (CTPA) were observed before anticoagulation and on day 14 after anticoagulation. RESULTS: In both groups, the ABG (arterial blood gas) analysis showed PaO(2) and PaCO(2) were elevated, P(A-a)O(2) was decreased and oxygenation index (PaO(2)/FIO(2)) was elevated, D-dimer and fibrinogen were decreased, lung V/Q and CTPA showed embolized segments reduced (P<0.05). Hemorrhage and thrombocytopenia occurred in 3.5% of the LMWH group. Hemorrhage occurred in 5.3% and thrombocytopenia occurred in 7.0% of the UH group. The average cost in the LMWH group was RMB 1218.60 Yuan and RMB 1541.40 Yuan in the UH group. CONCLUSION: LMWH and UH are equally effective for treatment of non-massive acute PTE, but LMWH may have a lower prevalence of complications and is less expensive.

[Pulmonary cryptococcosis: analysis of nine cases].

OBJECTIVE: To investigate the diagnosis and treatment of pulmonary cryptococcosis. METHODS: A total of 9 cases of pulmonary cryptococcosis, diagnosed at Sir Run Run Shaw Hospital of Zhejiang University from January 2002 to August 2004, identified by pathological examinations, were retrospectively studied. RESULTS: The patients consisted of 7 males and 2 females aged from 28 to 69 years. Pulmonary nodules, either solitary or multiple, present in 8 of the 9 cases, were the most common CT finding. The diagnosis was confirmed in all cases by pathological study. The lung specimens of 5 cases were obtained by CT guided transthoracic needle aspiration lung biopsy, and these 5 cases were treated with fluconazole, after 0.5 - 1 year of follow-up, the pulmonary lesion essentially vanished. The other 4 cases were confirmed after surgery. CONCLUSIONS: Most pulmonary cryptococcosis presented as pulmonary nodules or masses on CT, either solitary or multiple. Pathology was essential to the diagnosis. Fluconazole is active against cryptococcus neoformans, and appears to be effective in the treatment.

[Large-volume whole lung lavage in the treatment of severe pulmonary alveolar proteinosis].

OBJECTIVE: To evaluate the efficacy and safety of large-volume whole lung lavage in the treatment of severe pulmonary alveolar proteinosis (PAP). METHODS: Five severe PAP patients underwent large-volume whole lung lavage under general anaesthesia using a double lumen endotracheal tube. Suction was used for returning fluid. The volume of lavage and return volume and the return rate were calculated. The efficacy was evaluated according to the improvement of symptoms, amelioration of chest radiograph or chest CT scan and the changes of pulmonary function and artery blood gas analysis. RESULTS: After lavage, the symptoms, pulmonary function and artery blood gas were markedly improved, and the chest radiographs showed dissipation of lung consolidation. No severe complications were observed in the 5 cases. CONCLUSION: Large-volume whole lung lavage is an effective and safe therapeutic method in the treatment of PAP.