Zeitschrift fur Erkrankungen der Atmungsorgane最新文献

The primary pulmonary hypertension is a severe disease with bad prognosis. It can be subdivided into three subtypes with various vasoreactive properties of the arterial lung blood vessels what is important to know concerning the medicamentous therapy. Long term effects of vasodilators are still in dispute, although, recently some drugs with vasodilating properties seem to be promising in the treatment of primary pulmonary hypertension. The heart-lung-transplantation could be an alternative in therapy.

The various methods for the evaluation of the efficacy of chemotherapy in pulmonary and extrapulmonary tuberculosis that have been developed over time are described, and their rationale is discussed. With growing experience and improvement of efficacy an ongoing need for change of techniques is to be observed, in the end always leading to higher specificity, sensitivity and reproducibility of evaluation.

Reference values published by the Section Pathophysiology of Breathing in the Society for Pulmology and Tuberculosis of the GDR and reference values of European Community for Coal and Steel (EGKS) were compared on example of FVC and FEV1. It was found a relative well accordance of reference values of FVC and FEV1 in younger and middle-aged men of a height from 160-200 cm (between -5 to +15%). In women with a body height of 150 to 200 cm a well correlation for FVC and FEV1 is also given (-10 to +10%). Reference values are showing a more important difference with increasing age and independent of sex. There are problems concerning the reference values in male and female lower than 155 cm body height.

The number of new cases of tuberculosis decreased hardly during the last seven years in the GDR. This is especially seen in the age group of 20 to 29 years. The percentage of immigrants with tuberculosis in the age group named above increased from 24% (1982) to 41% (1988). Special attention is to pay to the case finding of tuberculosis among the GDR citizens at the age of 20-29 years as the number of new cases of tuberculosis did not change in the last years.

Calcium antagonists may provide an effective approach to the treatment of pulmonary hypertension disorders. Under this aspect we examined 44 patients by right heart catheterisation at rest and at exercise before and after sublingual application of a single dose of 20 mg nifedipine (Corinfar) as well as under continuous dosage of 30-60 mg daily. In patients with latent pulmonary hypertension we ascertained an efficient significant decrease of PAP, 15 of 18 patients were responders. This protective effect persists in the longterm studies after 1 year as well as after 2 years at equal magnitude. In patients with manifest pulmonary hypertension the influence on pulmonary hemodynamics was not so efficient. This behaviour is caused by morphological fixation of pulmonary hypertension. Therefore the determination of magnitude of pulmonary hypertension by right heart catheterisation is necessary for evaluation of nifedipine therapy.

From 1984 to 1988 in the industrial area Most (70,000 workers) an analysis was performed in 138 patients with lung cancer (ICD-Nr. 162). From the results of analysis conclusions with relevance for medical opinion were derived. There are opportunities to incorporate a part of patients in the working process without difficulties, if the patient is free of signs of recidivation. The aim of our procedure is to improve the psychological situation of the patient, to reach a complete resocialization, to ensure the economic standard and to optimize the grant of sick-pay.