摘要:

We studied 117 patients with chronic obstructive pulmonary disease (COPD) to evaluate (1) the frequency and magnitude of postural changes in resting arterial oxygenation and (2) the relationship of these changes to other measures of pulmonary function and exercise arterial blood gases. Compared to the supine measurement, room air PaO2 measured while standing increased more than 3 mm Hg in 28 patients (group 1), did not change ( ± 3 mm Hg) in 57 patients (group 2), and decreased more than 3 mm Hg in 32 patients (group 3) (range = 31 mm Hg increase to 20 mm Hg decrease). Patients in group 1 had significantly less severe disease than patients in the other two groups. There were no significant pulmonary function differences between groups 2 and 3. Supine PaO2 was similar for all groups, suggesting that standing PaO2 accounted for the postural change in PaO2. Because of unpredictable postural changes in PaO2 in patients with COPD, we believe that body position should be noted for arterial blood gas measurements and should be kept constant for valid comparison of serial measurements. These findings may also be important for other diffuse lung diseases

ISSN:0025-7931    

DOI:10.1159/000196080

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

A randomized double-blind cross-over study was performed to compare the bronchodilator effects of a fenoterol/ipratropium bromide combination (Berodual) when inhaled as a dry powder and by metered dose inhaler (MDI) in an equal dosis (fenoterol 100 µg + ipratropium bromide 40 µg). Thirty-eight patients (29 male, 9 female, mean age 53 years) with reversible chronic obstructive airway disease were studied on 2 separate days by employing the double-dummy technique. The effects of the two modes of administration of the fixed combination were followed by pulmonary function tests [forced expiratory volume (FEV1), forced vital capacity (FVC)] from 15 min up to 6 h after administration. In addition, the pulse rate was recorded just before each pulmonary function test. The FEV1 and FVC time-response curves showed that the dry powder had an overall efficacy profile similar to MDI. Both formulations produced clinically significant improvements in FEV1 in approximately 10 min. Peak effects occurred in 1 h while at 6 h after test drug inhalation there was still an increase in FEV1 of 14%. No safety problems were observed after the use of the test drugs and no clinically significant changes in pulse rate were found. It is concluded that the dry powder of the fenoterol/ipratropium bromide combination provided effective bronchodilation of similar degree and duration to that achieved with the MDI. It would appear, therefore, to be a valuable alternative to MD

ISSN:0025-7931    

DOI:10.1159/000196081

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

We studied the relationship of deterioration of cardiorespiratory function with respect to degree and localisation of apex of spinal curvature. The study comprised 33 patients (27 females and 6 males) aged 15 (11-21) years, surgically treated for an average scoliotic angle of 72 ° (55-129 °, after Cobb) which was postoperatively reduced to 32.6 ° (13-74 °). The static and dynamic cardiorespiratory function parameters were tested (pre-operatively and 24 months after surgery) by spirometry and plethysmography, arterial blood gas analysis, and the exercise tolerance test. In terms of the site and apex of the thoracic curve as determined by spine X-ray, patients were divided into two groups: upper thoracic scoliosis with the apex between T5 and T8 and lower thoracic scoliosis with the apex between T9 and Til. Only upper thoracic scoliosis with Cobb angle of more than 70° correlated (r = -1) with restrictive ventilation disorder (vital capacity 68%) and latent hypoxaemia (uptake O2 0.05). The results of the test have demonstrated that surgically obtained 54% correction of the scoliotic curve improves pulmonary function (p < 0.05). However, the improvement does not match the degree of achieved scoliotic curve correction, what means that even in surgically treated high-angled thoracic scoliosis exists an increased risk of morbidity and morta

ISSN:0025-7931    

DOI:10.1159/000196082

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

We studied the comparative modification of histamine- and methacholine-induced bronchoconstriction by a calcium antagonist, gallopamil, in 8 subjects with bronchial asthma. Dose-response curves to aerosolized methacholine or histamine were performed, without and following pretreatment with inhaled gallopamil (10 mg), on 6 different experiment days to determine the cumulative provocative dose (PD50) of each agonist in breath units which caused a 50% decrease in specific airway conductance (SGaw). Baseline values of SGaw were similar on different experiment days and gallopamil had no significant effect on SGaw. PD50 values for histamine on control and placebo days were 6.8 ± 2.8 and 5.2 ± 2.8 breath units (mean ± SE), respectively. Pretreatment with gallopamil increased histamine PD50 to 19.8 ± 7.5 breath units, which was significantly greater than on control and placebo days (p < 0.01). PD50 values for methacholine on control and placebo days were 9.5 ± 5.6 and 8.8 ± 5.8 breath units, respectively. Gallopamil pretreatment had no significant effect on methacholine-induced bronchoconstriction; methacholine PD50 increased to 13.4 ± 5.5 breath units (p = NS). The mean dose ratio (ratio of PD50 for the agonist in the presence and absence of gallopamil) for histamine was 6.9, which was 3.7-fold higher than the dose ratio of 1.9 methacholine in the same subjects. These data suggest that gallopamil causes greater inhibition of histamine- versus methacholine-induced bronchoconstriction. This suggests that calcium influx in airway smooth muscle through voltage-dependent channels primarily occurs in response to histamine and not to methac

ISSN:0025-7931    

DOI:10.1159/000196083

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

Pneumonia is a rare but serious and occasionally fatal complication of varicella. Two cases of varicella pneumonia were successfully treated with acyclovir in our department. We reviewed the pulmonary manifestations of varicella, the risk factors and the effect of acyclovir on varicella pneumonia on immunocompetent adults. Early, aggressive therapy with acyclovir seems to abort the catastrophic consequences of varicella pneumonia, while oral acyclovir chemoprophylaxis is probably beneficial in high-risk populations with chickenpox.

ISSN:0025-7931    

DOI:10.1159/000196084

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

We report a rare case of squamous cell carcinoma located in the middle mediastinum as a solitary mass. Histologically, lymphatic tissues remained together with nests of squamous cell carcinoma which were occupying the greater part of the mass. Examinations of the whole body failed to detect a primary site of the squamous cell carcinoma. It is considered that the carcinoma cells reflect metastasis from a primary-unknown carcinoma (most likely TO lung squamous cell carcinoma) or that they originated from benign epithelial inclusions in a mediastinal lymph node.

ISSN:0025-7931    

DOI:10.1159/000196085

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

This is a case report of an asymptomatic, 65-year-old white female who was evaluated for multiple pulmonary nodules. This patient’s presentation, clinical course and pathologic specimens are consistent with benign metastasizing leiomyoma. A review of this rare disorder is included in this report with emphasis on past cases, clinical overview and treatmen

ISSN:0025-7931    

DOI:10.1159/000196086

出版商:S. Karger AG    

年代:1992

数据来源: Karger

摘要:

We present a case with gigantic carcinosarcoma (the largest described to date, diameter of 20.5 cm), located in the right upper lobe, in which the discordance between the brief clinical course with limited symptoms and its large size were remarkable. Preoperative diagnosis by bronchial biopsy, as used to be the case in this malignancy, was incorrect (epidermoid), and the define histological characterization was made by thoracotomy. The controversy about pathology, diagnosis and treatment of the carcinosarcoma is discussed.

ISSN:0025-7931    

DOI:10.1159/000196087

出版商:S. Karger AG    

年代:1992

数据来源: Karger

ISSN:0025-7931    

DOI:10.1159/000196088

出版商:S. Karger AG    

年代:1992

数据来源: Karger

ISSN:0025-7931    

DOI:10.1159/000196089

出版商:S. Karger AG    

年代:1992

数据来源: Karger