摘要:

In 8 anesthetized mongrel dogs, we studied the effects of carbachol-induced bronchoconstriction (BC) on the cardiovascular system. Inhalation of carbachol in an amount sufficient to produce at least a 50% decrease in lung conductance (GL) did not lead to significant changes in cardiac output, mean transmural left atrial (Pla) or right atrial pressure, end-diastolic left ventricular septal-lateral dimension, left ventricular apex to base dimension, or in end-diastolic right ventricular septal to lateral dimension during expiration. Mean transmural pulmonary arterial pressure rose and mean transmural aortic pressure (Pao) fell during BC. During inspiration, there were significant increases in transmural left atrial pressure, Pla, associated with decreases in end-diastolic left ventricular septal-lateral and apex-base dimensions. End-diastolic right ventricular septal-lateral dimension increased during inspiration. Beat-to-beat aortic flow (Qao) decreased during inspiration, while pulmonary arterial flow increased. There were no changes in transmural Pao during inspiration measured at the nadir of aortic flow. During BC, these changes were exaggerated, but remained qualitatively the same. The magnitude of the inspiratory decrease in pleural pressure (Ppl) was shown to be linearly related to the magnitude of the change in GL, and the magnitude of the inspiratory decrease in Pao and Qao (pulsus paradoxus) was shown to be linearly related to the magnitude of the inspiratory swing in Ppl. Although vagotomy significantly altered the pattern of respiration such that tidal volume increased and respiratory rate decreased, it did not substantially alter the responses of the cardiovascular system to breathing during BC. We conclude: (1) the inspiratory decrease in Pao and Qao (pulsus paradoxus) is associated with a decrease in left ventricular end-diastolic filling, and a stiffening of the

ISSN:0025-7931    

DOI:10.1159/000195164

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

In a 6-month, double-blind multicenter trial conducted over the winter, the effects of daily administration of ambroxol retard (75 mg) were compared with those of placebo in preventing exacerbations and improving symptoms and clinical signs in chronic bronchitis patients. The trial was completed by 110 patients in the ambroxol group and by 104 in the placebo group. Initially, there were no significant differences between the groups. By the end of the 2nd month of treatment, 67.2% of the ambroxol group had had no exacerbations compared to 50.4% in the placebo group. At the end of the 6-month trial, 45.5% of the treatment group had had no exacerbations, compared to only 14.4% of the control group. These differences were statistically significant. Patients in the treatment group lost significantly fewer days through illness (442) and had fewer days when they needed antibiotic therapy (371) compared to the placebo group patients (837 and 781). Ambroxol also produced statistically significant symptomatic improvement, measured as difficulty in expectoration, coughing, presence of dyspnea and the auscultatory signs as compared to controls. Since ambroxol was well tolerated and compliance was good, it appears like a drug of choice for pharmacological prophylaxis of chronic bronchitis.

ISSN:0025-7931    

DOI:10.1159/000195274

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The protective effect of the calcium antagonist nifedipine (20 mg sublingually) on methacholine-induced bronchospasms was investigated in 14 mild asthmatics, 8 extrinsic and 6 intrinsic, in stable situations and with FEV1 ≥80% of the one predicted. On separate days cumulative dose-response curves to methacholine were constructed, basal and 20 min after nifedipine administration; on both occasions basal FEV1 varied less than 5%. The sensitivity threshold (PD20) and reactivity (slope of the curve) were obtained. The shape of the curves analyzed from the PD20 point on, was linear (r2 = 0.99). There was a strong hyperbolic correlation between sensitivity and reactivity (r2 = 0.89). Nifedipine did not modify basal FEV1. After nifedipine, the sensitivity to methacholine decreased from 36.7 ± 10.5 to 61.0 ± 15.8 SEM (p < 0.01) and likewise the reactivity from 2.2 ± 0.7 to 1.1 ± 0.5 SEM (p < 0.02). Protection was greater when the basal sensitivity was higher (r = 0.59, p < 0.05) but no such correlation was found for reactivity. Protection is explained by the blocking effect of nifedipine of calcium flux through voltage-dependent channels, provided that muscarinic agonists, at low doses, act preferentially through electromechanical coupling. These results indicate that a distinction between sensitivity and reactivity does not provide more information than each separate para

ISSN:0025-7931    

DOI:10.1159/000195165

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Animal studies showed the presence of a surfactant substance in the Eusta-chian tube. On the premise that alteration of surfactant-like substance might cause pathology of the middle ear in man, a multicenter (24 ENT hospitals) double-blind trial versus placebo was carried out in 435 adults and children with secretory otitis media. Treatment was ambroxol, a drug that changes the bronchial secretions and promotes surfactant synthesis. The dosage regimen was as follows: adults – one 30-mg tablet of ambroxol 3 times/day; children – 9 mg of ambroxol syrup, 4 times daily. The treatment lasted 15 days. The clinical signs and symptoms (hypoacusis, conduction deafness) and the otoscopic and rhinoscopic findings of treated patients improved. The differences in these parameters between patients given ambroxol and the controls were statistically significant (p < 0.05). The symptomatological amelioration was supported by improvement in tympanometric findings and hearing threshold. Drug tolerance was excell

ISSN:0025-7931    

DOI:10.1159/000195275

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The relationship between the electrical and mechanical activity of the nasal dilator muscle was assessed in 8 pentobarbital-anesthetized, tracheostomized, supine dogs. Alae nasi electromyograms (EMGs) were recorded with bipolar fine wire electrodes, and respiratory changes in muscle length were recorded contralaterally using sonomicrometry. During both resting and stimulated breathing, the intrabreath pattern of muscle shortening closely paralleled the intrabreath pattern of EMG activity. Increases in both alae nasi EMG and alae nasi inspiratory shortening occurred in response to single-breath airway occlusions, brief periods of asphyxia, progressive hyperoxic hypercapnia, and intravenous nicotine sulfate administration. With all interventions, the increases in mechanical activation of the alae nasi paralleled the increases in alae nasi electrical activity. These results indicate that alae nasi EMGs, closely reflect respiratory changes in alae nasi length under conditions in which no mechanical load is placed in the nasal muscle.

ISSN:0025-7931    

DOI:10.1159/000195166

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

In a double-blind multicenter study versus placebo, the therapeutic effects of ambroxol (10 mg/kg, i.v. twice daily for 7 days) were studied in an appropriately selected population with severe respiratory failure. Treatment was given to 28 neonates with birth weight ≤ 2,000 g, appropriate for gestational age with idiopathic respiratory distress of such severity as to require assisted ventilation (IMV or IPPV) within 12 h of birth. The preliminary results showed that ambroxol treatment, and not placebo, increased survival, reduced the time during which mechanical ventilation was required and improved the FiO2/PaO2 ratio and the biochemical indices of pulmonary maturity. This latter improvement suggests that the amelioration of the IRDS clinical picture and the reduction of ventilatory requirement might be due to an increase in pulmonary surfactant. No side effects attributable to ambroxol therapy were observed in the treated infant

ISSN:0025-7931    

DOI:10.1159/000195276

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The purpose of this study was to determine the relationship between inflammation, increased alpha-1-acid glycoprotein (AAG), and lidocaine tolerance during fiber-optic bronchoscopy. Previous studies indicate that serum lidocaine levels vary widely from one individual to another. One reason for these variations may be the presence of an ongoing inflammatory process, which enhances serum AAG, a major binding protein of lidocaine. To test this hypothesis, we assayed free and bound lidocaine as well as AAG in the blood of 12 patients after administration of 9 mg/kg of lidocaine during fiber-optic bronchoscopy. Some of the subjects had clear evidence of inflammation or infection. A correlation was found between AAG and total and bound lidocaine but not between AAG and free lidocaine (which remained almost constant). Thus, in spite of the high total levels of lidocaine observed in some patients with inflammatory processes, the free fraction (which is the active and toxic fraction) remained low.

ISSN:0025-7931    

DOI:10.1159/000195167

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Over a period of 3 years, 224 laser treatments were performed on 105 patients. 84% were carried out under local anesthesia and 16% under general anesthesia. A neodymium-YAG laser (MBB-AT) was used. In 74% of the cases complete or partial tumor removal was possible. 72% of the successfully recanalized stenoses were still open after 4–6 months. In 19% of the cases low-grade complications occurred. The mortality was below 1 %. The chief indications for endobronchial laser treatment are exophytic endobronchial tumors in the area of the trachea and primary bronchi. Endobronchial laser coagulation is indicated when surgery is no longer possible. It serves primarily to improve ventilation and bronchial drainage and in particular to prevent retention pneumoni

ISSN:0025-7931    

DOI:10.1159/000195168

出版商:S. Karger AG    

年代:1987

数据来源: Karger

ISSN:0025-7931    

DOI:10.1159/000195169

出版商:S. Karger AG    

年代:1987

数据来源: Karger

ISSN:0025-7931    

DOI:10.1159/000195268

出版商:S. Karger AG    

年代:1987

数据来源: Karger