Background and objective: Acute exacerbations (AEs) of idiopathic pulmonary fibrosis (IPF) and other idiopathic interstitial pneumonia (IIP) have a poor prognosis. This study aims to clarify the incidence and prognosis of AE in IPF and the other IIP. Methods: A total of 229 patients were enrolled, of whom 92 had IPF and 137 had 'IIP other than IPF' based on

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The theoretical equations for the C02 dissociation curve derived by MocHIZUKI et al. (1983) have made it possible to estimate the C02 contents in blood at any Pco2 by putting the intra-and extracellular bicarbonate contents at a certain Pco2 into them. Moreover, according to their Haldane effect equation, the carbamate and bicarbonate contributions are evaluated, when the Haldane effect and its plasma component are known along the PCo2 range. In order to accomplish the above calculation the water shifts due to the Pc02 and 02 saturation changes were measured as the changes of hematocrit. The hematocrit of oxygenated blood was linearly correlated to pH with a factor of -0.037, and the difference in hematocrit between oxygenated and deoxygenated bloods was 0.004 in terms of fractional hematocrit. The blood and plasma C02 contents measured at four different Pco2's were compared with the ones calculated by use of the intra-and extracellular bicarbonate contents at 42 Torr Pco2. The measured and calculated C02 contents coincided fairly well with each other. Using intra-and extracellular bicarbonate contents in oxygenated blood together with the Haldane effect and its plasma component, the carbamate contribution was then calculated. The carbamate content was about 1.2 mmol/liter blood over a Pcp2 range of 20 to 100 Torr, and its ratio to the total Haldane effect decreased from 50 to 40 %, as PC0, was increased. The ratio of the bicarbonate shift to the total bicarbonate change due to the Haldane effect, ranging from 0.82 to 0.66, was significantly greater than that measured by changing PCO2.

Although information on the PD-L1 expression and EGFR mutations in non-small cell lung cancer (NSCLC) is important for therapeutic strategies, the effect of these factors on postoperative recurrence and the association between each factor have remained unclear. We retrospectively assessed the PD-L1 expression and EGFR mutations in 280 NSCLC patients, and analyzed the associations by multivariate analyses. The hazard ratio (HR) of postoperative recurrence in cases with high (≥ 50%) PD-L1 expression regarding negative expression was 4.83 (95% confidence interval [CI] 1.51–15.5). The HR for the PD-L1 expression, considered a continuous variable, was 1.016 (95% CI 1.01–1.03). The HRs in cases with EGFR major and minor mutations were 0.42 (95% CI 0.14–1.25) and 0.63 (95% CI 0.18–2.15), respectively. The high PD-L1 (≥ 50%) expression was significantly associated with exon 21 L858R mutation (Ex21) of EGFR (odds ratio, 0.10; 95% CI 0.01–0.87). The risk of postoperative recurrence increased 1.016-fold for every 1% increase in the PD-L1 expression, and a marked increase in risk was observed for expression levels of ≥ 50%. Whereas EGFR mutations were not an independent risk factor. The high PD-L1 (≥ 50%) expression was negatively associated with Ex21. These findings may help identify NSCLC patients with an increased risk of postoperative recurrence.

Dendriform pulmonary ossification (DPO) is a rare condition characterized by metaplastic bone formation in the lung parenchyma. It has been reported to be often associated with primary lung diseases, such as usual interstitial pneumonia (UIP) or chronic aspiration of gastric acid; however, its clinical features and pathophysiology remain unclear, especially in idiopathic cases. We herein report five DPO cases, including three with an idiopathic origin. In all cases of idiopathic DPO, the pathological and radiological examinations showed localized pulmonary lesions suggesting inflammation or hemorrhaging.

The nutritional state of a TB patient can be used to predict Tn.

Sarcoidosis is a systemic granulomatous disease of unknown etiology with characteristic pulmonary lesions, which are often distributed in the upper lung fields. We describe a unique case of sarcoidosis with lower lung field-dominant reticular shadows. Three years after the diagnosis of sarcoidosis based on histologic findings of the mediastinal lymph nodes and transbronchial lung biopsy specimens, the patient developed acute respiratory failure and died. The autopsy showed usual interstitial pneumonia (UIP), with honeycombing and superimposed diffuse alveolar damage of the lungs. The findings suggest that the patient had both sarcoidosis and UIP, and that the UIP later progressed to acute exacerbation.

The Haldane effect coefficient in vivo and arterial-venous 02 content difference ((a-v)Co2) are, more or less, influenced by the contact time (ta), Po2 and P~o2 differences between venous blood and alveolar air. To increase the accuracy of the (a-v) Cot and the cardiac output measured by means of the rebreathing technique, factors to correct the Haldane effect (F(H)) and (a-v)Co2 (F(avCo2)) were obtained theoretically from the numerical solutions of simultaneous 02 and C02 diffusions in the red blood cell. Both the factors were complicated functions of t~, the difference in P~o2 between venous blood and alveolar air, as well as (a-v)Co2. For simplicity, we eliminated t~ from the above functions by using the standardized relation between the t~ and (a-v)Co2 measured from a rebreathing experiment in man. The F(H) was a linear function of (av)Co2. The (a-v)Co2 was calculated by dividing the product of F(H) and the slope of the C02 dissociation curve by that of a gas exchange ratio against the P~o2 in rebreathing air. The F(avCo2) was given by a ratio of (a-v)Co2 at any alveolar P~o2 to the standard one, in which arterial blood has the same intracellular pH as that in venous blood. It was a linear function of the difference in P~o2 between venous blood and alveolar air, whose slope was inversely related to the (a-v)Co2 itself.Key words : 02 and C02 diffusion in RBC, Haldane effect, arterialvenous 02 difference, R-P02 relation, contact time.MocHizuK! and KAGAWA (1986) clarified that the coupled 02 and C02 diffusions in the red blood cell (RBC) are not so fast, that the C02 equilibrium is hardly established between alveolar air and capillary blood during the contact time (ta).•The venous-arterial C02 content difference due to the Haldane effect ((va)C~o2(H)) has hitherto been expressed by multiplying the slope of the C02 dissociation curve (a') by the difference between the true-and oxygenated-venous Pco2 (oxPv~o2 -trPv~o2) (CHRISTIANSEN et al., 1914). Using this relation,