The patients with respiratory dysfunction usually suffer from dyspnea similar toasthma with oppressed feeling in the chest, and they need a deep inspiration before expiration. The author has in recent years used t... The patients with respiratory dysfunction usually suffer from dyspnea similar toasthma with oppressed feeling in the chest, and they need a deep inspiration before expiration. The author has in recent years used the modified Sheng Xian Tang (升陷汤Decoction for Elevating the Sunken Qi) for treatment of the disorder with good therapeutic results. A report follows.
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Background Respiratory failure is the main cause of death in acute organophosphorus pesticide poisoning. In this study, a pulse-induced contour cardiac output monitor was used to evaluate the respiratory status in a p...Background Respiratory failure is the main cause of death in acute organophosphorus pesticide poisoning. In this study, a pulse-induced contour cardiac output monitor was used to evaluate the respiratory status in a pig model of acute dichlorvos poisoning. Methods Twenty female pigs were randomly allocated to dichlorvos （n=7）, atropine （n=7）, and control （n=6） groups. In the dichlorvos group, pigs were administered 80% emulsifiable dichlorvos （100 mg/kg） via a gastric tube. In the atropine group, pigs were similarly administered dichlorvos, and 0.5 hours later, atropine was injected to attain and maintain atropinization. The control group was administered saline solution. Arterial blood gas was measured at 0, 0.5, 1, 2, 4, and 6 hours post-injection. The extravascular lung water index and pulmonary vascular permeability index were recorded by the pulse-induced contour cardiac output monitor. At termination of the study, the animals were euthanized, the lung wet-to-dry weight ratio was determined, and histopathology was observed. Results In the dichlorvos group, the extravascular lung water index and pulmonary vascular permeability index were substantially increased from 0.5 hours and were particularly high within 1 hour. In the atropine group, these indices increased initially, but decreased from the 1-hour mark. The control group exhibited no obvious changes. In both the dichlorvos and atropine groups, the extravascular lung water index was negatively correlated with partial pressure of oxygen/fraction of inspiration oxygen （POz/FiO2） and positively correlated with the pulmonary vascular permeability index. Compared with the control group, the lung wet-to-dry weight ratio markedly increased and the histopathological findings obviously changed in the dichlorvos group, but only mildly increased and changed, respectively, in the atropine group. Conclusion The extravascular lung water index is an appropriate and valuable parameter for assessment of respiratory function in acute dichlorvos poisoning.展开更多
BACKGROUND Pulmonary tumor thrombotic microangiopathy(PTTM)is a rare condition in patients with hepatocellular carcinoma(HCC);to date,few cases have been reported.While hepatic dysfunction has been focused on the late...BACKGROUND Pulmonary tumor thrombotic microangiopathy(PTTM)is a rare condition in patients with hepatocellular carcinoma(HCC);to date,few cases have been reported.While hepatic dysfunction has been focused on the later stages of HCC,the management of symptoms in PTTM is important for supportive care of the cases.For the better understanding of PTTM in HCC,the information of our recent case and reported cases have been summarized.CASE SUMMARY A patient with HCC exhibited acute and severe respiratory failure.Radiography and computed tomography of the chest revealed the multiple metastatic tumors and a frosted glass–like shadow with no evidence of infectious pneumonia.We diagnosed his condition as acute respiratory distress syndrome caused by the lung metastases and involvement of the pulmonary vessels by tumor thrombus.Administration of prednisolone to alleviate the diffuse alveolar damages including edematous changes of alveolar wall caused by the tumor cell infiltration and ischemia showed mild improvement in his symptoms and imaging findings.An autopsy showed the typical pattern of PTTM in the lung with multiple metastases.CONCLUSION PTTM is caused by tumor thrombi in the arteries and thickening of the pulmonary arterial endothelium leading to the symptoms of dyspnea in terminal staged patients.Therefore,supportive management of symptoms is necessary in the cases with PTTM and hence we believe that the information presented here is of great significance for the diagnosis and management of symptoms of PTTM with HCC.展开更多
Ambient particulate matter(PM)is the major environmental concern in Tehran,Iran.Exposure to such particles is a serious global health concern and substantial evidence indicates that exposure to particulate matter cont...Ambient particulate matter(PM)is the major environmental concern in Tehran,Iran.Exposure to such particles is a serious global health concern and substantial evidence indicates that exposure to particulate matter contributes to cardiovascular and respiratory disease.Here,we provide a detailed health impact of ambient air pollution in Tehran by linking PM pollution with mortality caused by cardiovascular and respiratory disease.Air quality data of PM obtained from Tehran Air Quality Monitoring Stations(TAQMSs)during 2012–2017.Data mining methods conducted by Spatio-temporal outlier detection and“Air Pollution and Health:a European Approach(APHEA)project”was applied to impute missing values.Time-series data were analyzed to estimate the associations between PM pollution and cause-specific mortality at different lags in Tehran.Based on descriptive analysis,PM_(2.5) is expected to be a major influencing factor in the increased cardiovascular-related death(CVD)and respiratory dysfunction related death(RD)deaths.The cross-correlation analysis showed the same source for PM_(2.5) and PM_(10) in the ambient air of Tehran.Also,the results indicated delays of about 7-15 days from the increased concentrations of PMs and the observed rising in CVD and RD death.Trend analysis showed a more decreasing trend for PM_(2.5) pollutions than PM_(10) pollution and a slightly increasing trend for cause-specific deaths during 2012-2017.Long term exposure to high PM levels increases the CVD and RD deaths and control strategies along with control regulations should be considered to control PM.展开更多
文摘 The patients with respiratory dysfunction usually suffer from dyspnea similar toasthma with oppressed feeling in the chest, and they need a deep inspiration before expiration. The author has in recent years used the modified Sheng Xian Tang (升陷汤Decoction for Elevating the Sunken Qi) for treatment of the disorder with good therapeutic results. A report follows.
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文摘Background Respiratory failure is the main cause of death in acute organophosphorus pesticide poisoning. In this study, a pulse-induced contour cardiac output monitor was used to evaluate the respiratory status in a pig model of acute dichlorvos poisoning. Methods Twenty female pigs were randomly allocated to dichlorvos （n=7）, atropine （n=7）, and control （n=6） groups. In the dichlorvos group, pigs were administered 80% emulsifiable dichlorvos （100 mg/kg） via a gastric tube. In the atropine group, pigs were similarly administered dichlorvos, and 0.5 hours later, atropine was injected to attain and maintain atropinization. The control group was administered saline solution. Arterial blood gas was measured at 0, 0.5, 1, 2, 4, and 6 hours post-injection. The extravascular lung water index and pulmonary vascular permeability index were recorded by the pulse-induced contour cardiac output monitor. At termination of the study, the animals were euthanized, the lung wet-to-dry weight ratio was determined, and histopathology was observed. Results In the dichlorvos group, the extravascular lung water index and pulmonary vascular permeability index were substantially increased from 0.5 hours and were particularly high within 1 hour. In the atropine group, these indices increased initially, but decreased from the 1-hour mark. The control group exhibited no obvious changes. In both the dichlorvos and atropine groups, the extravascular lung water index was negatively correlated with partial pressure of oxygen/fraction of inspiration oxygen （POz/FiO2） and positively correlated with the pulmonary vascular permeability index. Compared with the control group, the lung wet-to-dry weight ratio markedly increased and the histopathological findings obviously changed in the dichlorvos group, but only mildly increased and changed, respectively, in the atropine group. Conclusion The extravascular lung water index is an appropriate and valuable parameter for assessment of respiratory function in acute dichlorvos poisoning.
文摘BACKGROUND Pulmonary tumor thrombotic microangiopathy(PTTM)is a rare condition in patients with hepatocellular carcinoma(HCC);to date,few cases have been reported.While hepatic dysfunction has been focused on the later stages of HCC,the management of symptoms in PTTM is important for supportive care of the cases.For the better understanding of PTTM in HCC,the information of our recent case and reported cases have been summarized.CASE SUMMARY A patient with HCC exhibited acute and severe respiratory failure.Radiography and computed tomography of the chest revealed the multiple metastatic tumors and a frosted glass–like shadow with no evidence of infectious pneumonia.We diagnosed his condition as acute respiratory distress syndrome caused by the lung metastases and involvement of the pulmonary vessels by tumor thrombus.Administration of prednisolone to alleviate the diffuse alveolar damages including edematous changes of alveolar wall caused by the tumor cell infiltration and ischemia showed mild improvement in his symptoms and imaging findings.An autopsy showed the typical pattern of PTTM in the lung with multiple metastases.CONCLUSION PTTM is caused by tumor thrombi in the arteries and thickening of the pulmonary arterial endothelium leading to the symptoms of dyspnea in terminal staged patients.Therefore,supportive management of symptoms is necessary in the cases with PTTM and hence we believe that the information presented here is of great significance for the diagnosis and management of symptoms of PTTM with HCC.
文摘Ambient particulate matter(PM)is the major environmental concern in Tehran,Iran.Exposure to such particles is a serious global health concern and substantial evidence indicates that exposure to particulate matter contributes to cardiovascular and respiratory disease.Here,we provide a detailed health impact of ambient air pollution in Tehran by linking PM pollution with mortality caused by cardiovascular and respiratory disease.Air quality data of PM obtained from Tehran Air Quality Monitoring Stations(TAQMSs)during 2012–2017.Data mining methods conducted by Spatio-temporal outlier detection and“Air Pollution and Health:a European Approach(APHEA)project”was applied to impute missing values.Time-series data were analyzed to estimate the associations between PM pollution and cause-specific mortality at different lags in Tehran.Based on descriptive analysis,PM_(2.5) is expected to be a major influencing factor in the increased cardiovascular-related death(CVD)and respiratory dysfunction related death(RD)deaths.The cross-correlation analysis showed the same source for PM_(2.5) and PM_(10) in the ambient air of Tehran.Also,the results indicated delays of about 7-15 days from the increased concentrations of PMs and the observed rising in CVD and RD death.Trend analysis showed a more decreasing trend for PM_(2.5) pollutions than PM_(10) pollution and a slightly increasing trend for cause-specific deaths during 2012-2017.Long term exposure to high PM levels increases the CVD and RD deaths and control strategies along with control regulations should be considered to control PM.
