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Pulmonary valve echography was technically possible in 44 of 120 patients with chronic lung disease (CLD). Mean pulmonary arterial pressure (Ppa) was significantly correlated with right ventricular isovolumetric relaxation ratio (RVIRT/RVET) as derived from the movement of cusps in valves of the right heart (r = 0.842; p less than 0.001). Prolonged RVIRT was found in 52% of patients with Ppa greater than 20 mmHg and in all ten patients with Ppa greater than 35 mmHg. Other echographic signs, including abnormal right ventricular systolic time intervals (STI), 'a' wave amplitude, right to left ventricular ratio (RV/LV) and interventricular septum diastolic bulging (IVS-B), were less sensitive, but found more often; when higher Ppa was recorded at catheterization in a given patient (r = 0.869; p less than 0.001). Approximate echographic estimation of Ppa in patients with chronic lung disease is possible if right ventricular systolic and diastolic time intervals can be measured and if abnormalities in right ventricular dimensions, interventricular septum motion and pulmonary valve echogram are considered. In contrast to pulmonary fibrosis, technical problems in adequate visualization of right heart valves in chronic obstructive lung disease limit the use of M-mode echo assessment of Ppa to a clinically unacceptable 22% of subjects.

Several steroidal analogues were synthesized as potential gamma-emitting radioligands for the progesterone receptor. Each of these compounds was tested as an inhibitor of the specific binding of [3H]-17 alpha,21-dimethyl-19-nor-4,9-pregnadiene-3,20-dione (R5020) to the progesterone receptor in rabbit uterine cytosol. R5020 is a well-known progestin with high affinity for the receptor. Of the compounds synthesized, aromatic N-substituted C-17 steroidal carboxamides inhibited the binding only poorly. Three compounds, 16 alpha-iodo-4-estren-17 beta-ol-3-one, 17 alpha-[2(E)-iodovinyl]-4-estren-17 beta-ol-3-one, and 17 alpha-[2(Z)-iodovinyl]-4-estren-17 beta-ol-3-one were excellent competitors, each having a Ki less than or equal to that of the natural progestin, progesterone. Since similar iodinated analogues of estrogens have been shown to be extremely stable both in vivo and in vitro, these compounds are potentially useful ligands for the progesterone receptor.

The sterol mixture isolated from the marine alga Eutreptia viridis consists mainly of delta 5,7-dienes which account for 80% of the free sterols. Eighteen different sterols were detected, including a novel sterol with the rare delta 23-unsaturation, viz. 24-ethylcholesta-5,7,23Z-trien-3 beta-o1.

We studied pulmonary haemodynamics in 34 patients with idiopathic pulmonary fibrosis (IPF). The diagnosis was established clinically and confirmed by a lung biopsy in 13 subjects. At rest pulmonary hypertension was found in 21 patients, the mean pulmonary artery pressure (PPA) for the group being 23.8 +/- 7.7 mmHg (means +/- SD). In 19 patients subjected to steady-state physical exercise, PPA rose from 23.1 +/- 7.7 mmHg to 40.3 +/- 16.6 mmHg and arterial oxygen tension (PaO2) fell from 77.7 +/- 10.1 mmHg to 62.5 +/- 14.3 mmHg. There was a significant correlation between the rise in PPA and fall in PaO2 on exercise. We found no correlation between pulmonary artery pressure referred to barometric pressure at rest and lung function data, except for a weak correlation between PPA and PaO2. However, pulmonary artery transmural pressure correlated more strongly with PaO2, and additional correlation with VC, FEV1, and lung compliance were found. Our results suggest that pulmonary intravascular pressure and pulmonary hypertension in patients with IPF are affected not only by anatomical restriction of the pulmonary vasculature and alveolar hypoxia but also by the negative intrathoracic pressure.

The following measures contribute to the decrease of lethality in the crush-syndrome: 1. possibly rapid rescue measures with simultaneous infusion therapy, if technical difficulties delay them, 2. beginning of the infusions on the spot, particularly solutions of sodium bicarbonate, concentrated glucose solutions, remedies of blood substitute, but no blood transfusions, 3. transport into a hospital with possibilities of dialysis, 4. early fasciotomy or amputation, 5. early haemodialysis, 6. adequate antibiotics, 7. sufficient supply of calories and protein, perhaps infusions of amino acids.