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Classical Kaposi's sarcoma and angiosarcoma are rare malignant tumours arising from vascular tissue. However, they have distinct histological features and appear also to differ in their epidemiology and pathogenesis. We present the case history of a patient in whom both these tumours occurred simultaneously. The relationship between these events is discussed in the light of the new virus, human herpes virus 8.

The effects of increasing the fractional concentration of oxygen in the inspired gas to 1.0 on intrapulmonary shunting (Qsp) was evaluated in 82 intubated cardiovascularly stable patients in intensive care, regardless of airway pressure therapy or preexistent pulmonary pathologic abnormalities. Intrapulmonary shunting following administration of 100 percent oxygen increased in 132 of 140 measurements, decreased in seven, and remained unchanged in one measurement. The direction of change of Qsp with 100 percent oxygen shows no correlation with either airway pressure therapy or preexisting pulmonary disease.

We describe how to prepare, store, and use a hemolyzed blood product for simultaneous pH, pCO2, and pO2 quality control. Tonometry of the blood product with two oxygen and two carbon dioxide concentrations resulted in consistent and reproducible values during 38 weeks. The resulting pH values were consistent and reproducible, demonstrating the metabolic acid-base stability of the blood product. We conclude that the proper preparation, storage, and use of the product results in consistent, reproducible, and economical quality control for pH, pCO2 and pO2 blood measurements.

In 100 critically ill patients, intrapulmonary shunts (Qsp/Qt) calculated by assuming a carboxyhemoglobin (HbCO) of zero and a hemoglobin saturation (HbO2) derived from the Severinghaus nomogram were compared to shunts calculated utilizing measured values of HbCO and HbO2. The differences were statistically significant (p less than 0.001). These 100 patients had a mean Hb of 11.9 g/dl and a mean HbCO of 1.7%. Measured shunt calculations in 30 critically patients were prospectively compared with shunt calculations utilizing the mean assumed values derived from the 100 patients initially studies. No statistically significant differences occurred between these two shunts. It is, therefore, concluded that errors attributable to the common practice of assuming zero HbCO and deriving HbO2 from nomograms will produce falsely high calculated intrapulmonary shunt values in critically ill patients. It is, therefore, important to measure accurately HbCO and HbO2 concentrations when monitoring intrapulmonary shunting in critically ill patients. However, if such measurements cannot be obtained, utilization of an assumed value of 1.5% for HbCO and HbO2 nomogram values will minimize errors in the shunt calculation.