摘要:

A double-blind trial was performed to investigate the effects of RU 41740, a glycoprotein extract from Klebsiella pneumoniae, on host defenses and its efficacy in reducing the number of exacerbations in 29 evaluable patients with chronic bronchitis, out of 36 patients who entered the study. The drug enhanced the phagocytosis indexes of both polymorphonuclear and mononuclear phagocytes. Increased candidacidal activity of monocytes was also observed. These effects, already detectable after one course of therapy and during the entire period of treatment, were no longer detectable when tested 6 months after the end of treatment. A significantly (p < 0.05) larger number of patients in the treated group than in the placebo group had no exacerbations during drug administration (0–3 months). Moreover, patients treated with RU 41740 had significantly fewer and shorter episodes of acute exacerbation. The positive decreases in these two parameters persisted throughout the follow-

ISSN:0025-7931    

DOI:10.1159/000195515

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

In 10 patients with chronic renal failure (CRF), undergoing hemodialysis, we studied respiratory muscle strength and endurance. The data obtained was compared with those acquired from 10 age-, sex-, weight- and height-matched normal volunteers. Maximal static inspiratory pressures (PImax) measured at residual volume and maximal static expiratory pressures (PEmax) measured at total lung capacity were significantly lower in the CRF group, 58.2 ± (SD)24.9 and 50.8 ± (SD)24.2% of predicted, respectively (p < 0.005, p < 0.01). There was a significant correlation between PImax and PEmax (r = 0.827, p < 0.001), indicating similar involvement of both inspiratory and expiratory muscle groups. Maximal voluntary ventilation (MVV), although 84.4% of the predicted value in the CRF group, was significantly lower than in the control group, where it was 114% of predicted (p < 0.001). MVV also correlated significantly with PImax and PEmax (r = 0.764, p < 0.001 and r = 0.807, p < 0.001, respectively). All but one CRF patient had elevated serum inorganic phosphorus levels, and a significant correlation was found between the serum inorganic phosphorus levels and PImax and PEmax (r = 0.718, p < 0.001). These data indicate that there is an impairment of respiratory muscle strength and endurance in patients with CRF which may predispose the patient to respiratory muscle fatig

ISSN:0025-7931    

DOI:10.1159/000195516

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Dissolution of pulmonary emboli with heparin and urokinase is ascribed, respectively, to anticoagulation and fibrinolysis. Since truly independent assessment of these effects in man is lacking, we administered each drug alone. Fibrinogen and plasminogen plasma levels and the resolution of pulmonary emboli were measured in three randomized groups of 10 patients each: groups A and C infused with small repeated doses of urokinase and a large single dose of urokinase, respectively, and group B who received heparin. After 6 h of treatment, fibrinogen fell in all the groups, while, after 12 h, remained equally reduced in groups A and B and declined further in group C. Plasminogen behaved similarly. Up to 60 h, statistical analysis showed that these effects were related to timing and amount of urokinase and heparin infusion. These observations suggest that heparin may induce a lytic state. As to signs of pulmonary emboli resolution, no differences between groups were found in lung perfusion and gas exchange recovery at any time (from 1 day to 1 year) and in pulmonary artery pressure reduction at 1 week. The greater angiographic and scintigraphic recovery observed with urokinase, versus heparin alone, after 1 day of treatment in the Urokinase Pulmonary Embolism Trial may be ascribed to a synergistic effect with urokinase of heparin administered during the diagnostic work-out. The indications of heparin and urokinase should be evaluated in the light of these results

ISSN:0025-7931    

DOI:10.1159/000195517

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

We studied 18 asthmatic patients over an 8-week period. Each patient received for 4 weeks continuous and for 4 weeks intermittent salbutamol rotacaps (400 μg) using a double-crossover technique. No significant differences were found between the two treatment regiments as judged by daily card scores and daily PEFR (both a.m. and p.m.). Lung Function tests performed monthly in the hospital showed no significant differences between two treatments or the development of bronchial beta-adrenoreceptor resistance Persons with asthma often use inhaled sympathomimetic drugs for the relief of their illness. Inhaled salbutamol rotacaps may be given regularly 3 or 4 times daily, but is often administered intermittently when symptoms occur. Asthmatic patients do not develop bronchial beta-adrenoreceptor resistance easily after 4 weeks of salbutamol treatment [1, 2]. In contrast, normal subjects showed a progressive reduction in bronchodilator response during salbutamol treatment, indicating the progressive development of resistance [2, 3]. The present study was designed to compare the clinical effectiveness of continuous inhalation of salbutamol rotacaps with salbutamol rotacaps given only when symptoms occur

ISSN:0025-7931    

DOI:10.1159/000195518

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Regional distribution of ventilation was assessed in 5 normal volunteers, and 19 patients with symptomatic chronic obstructive lung disease (COAD) using the technique of gated lung ventilation imaging with 127Xe. The results of this technique were compared with the more conventional assessment of regional ventilation by analysis of 127Xe wash-out curves. Both techniques demonstrate loss of the normal gravitational distribution of ventilation in patients with severe CO AD which is significantly reduced from normals in upper, middle and lower zones of each lung, being most marked in the lower zones (p < 0.01). Gated lung imaging also shows a significant reduction of regional ventilation in patients with mild to moderate CO AD compared to normals but only in the lower zones (p < 0.05). Gated lung imaging provides a better quantitative method of assessing regional lung function than wash-out analysis and confirms loss of the normal gravitational distribution of ventilation in patients with obstructive lung disease and relates this to severity of disease. The distribution of ventilation was also assessed in 6 patients with severe COAD before and after placebo or salbutamol. There was a significant improvement of the distribution of ventilation to the lung bases after salbutamol (p < 0.05)

ISSN:0025-7931    

DOI:10.1159/000195519

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Twelve subjects with stable asthma each inhaled two puffs (200 μg) of salbutamol on 2 separate days 3 h after double-blind oral administration of ketotifen (two 1-mg capsules) or identical placebo. FEV1 was recorded before and at intervals for 4 h after inhalation of salbutamol. Overall, the FEV1 was significantly greater during the 4-hour period after premedication with ketotifen (p < 0.02) and the difference between the effect of placebo and ketotifen was statistically significant at 120, 180 and 240 min after salbutamol (p < 0.05) Ketotifen, a benzocycloheptathiophene derivative, is an orally active compound with antianaphylactic and antihistaminic properties [1], which was found to be effective in the treatment of asthma [2, 3]. However, no acute bronchodilation has been demonstrated in asthmatics after administration of ketotifen, whereas a potentiation of the bronchodilator effect of aminophylline was reported by Hendy et al. [4] and a steroid-sparing effect was observed by Lane et al. [5]. We therefore investigated the effect of ketotifen on the acute bronchodilator action of salbutamol in a group of asthmatic subjects

ISSN:0025-7931    

DOI:10.1159/000195520

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

One year after treatment with corticosteroids for sarcoidosis, a patient presented with biopsy-documented tuberculous pleural effusion while characteristic histo-pathological findings of sarcoidosis coexisted in many tissues of peripheral organs. Tuberculous pleurisy developed in the presence of disseminated persistent sarcoidosis. Although the interaction of the pathophysiological mechanisms between these two entities is not clear, it is possible that the existence of one does not allow the clinical expression of the other

ISSN:0025-7931    

DOI:10.1159/000195521

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Rigidity of the thorax with relatively ‘normal’ lungs can show typical changes in the flow/volume curve that could be diagnostic. These changes caused by ‘entrapment’ of the lungs are described and illustrated by means of a case report of a patient with bilateral fibrothorax caused by bilateral tuberculous pleural e

ISSN:0025-7931    

DOI:10.1159/000195522

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

A patient with sarcoidosis with elevated 1,25-dihydroxy vitamin D levels, hypercalcemia, nephrolithiasis, and moderate azotemia is presented because of development of metastatic pulmonary calcification which was diagnosed by radioisotope scanning and tissue biopsy

ISSN:0025-7931    

DOI:10.1159/000195523

出版商:S. Karger AG    

年代:1988

数据来源: Karger

ISSN:0025-7931    

DOI:10.1159/000195524

出版商:S. Karger AG    

年代:1988

数据来源: Karger