摘要:

Pulmonary diffusing capacity (measured by the steady-state method according to Bates) was measured in 18 normal subjects and in 40 patients both in supine and upright position; right heart catheterization was performed in 33 of the subjects. In normal subjects the mean value of DLCO was 26.6 ± 8.0 % lower in the upright than in the supine position. In patients with mitral stenosis and in patients after pneumonectomy the DLCO did not change with body posture. In patients with interstitial pulmonary fibrosis the DLCO was 20.6 ± 11.3 % lower in upright than in supine position. The postural changes in DLCO correlated with the pulmonary arterial pressure, left atrial pressure and with pulmonary vascular resistance. The value of DLCO is influenced by the lung volumes and by the quality of alveolocapillary membrane, the postural changes of the DLCO are the indicator of the level of the pulmonary arterial pressure. In patients with severe postcapillary pulmonary hypertension (50 mm Hg) the DLCO may be higher in upright than in supine positio

ISSN:0025-7931    

DOI:10.1159/000192807

出版商:S. Karger AG    

年代:1971

数据来源: Karger

摘要:

The reproducibility of the diffusion capacity of the lungs during steady state at rest using end-tidal determination of carbon monoxide was studied during repeated examinations of DLCO in 136 patients with diverse pulmonary diseases. The correlation coefficients between these sets of values for determination of carbon monoxide in the inspired, expired gas and at the end of the tidal volume were high (0.996–0.963). Thus the correlation coefficients for extraction of CO for the DLCOss2 were excellent (0.951 and 0.932 respectively). This indicates that DLCOss2 is highly reproducibl

ISSN:0025-7931    

DOI:10.1159/000192808

出版商:S. Karger AG    

年代:1971

数据来源: Karger

摘要:

Besides the central chemo-reflexes in breathing and next to the peripheral chemoreceptors, which both regulate the action of the lungs via the ratio systemic circulation, another regulating system must exist, localized in the lung itself. The author arrives at this conclusion as a consequence of a literature study completed with his own observations. He believes this regulating system to be situated in the acinus, defined as that part of the lung, distal to the terminal bronchiolus. In this area the ‘receptor substance’ must be located in the alveolar wall structures and in the post-alveolar capillaries. This control system should be capable of adapting the ventilation-perfusion ratio to a wide variety of circumstances. This system is thought to be guided by the partial pressures of oxygen and carbon dioxide in the alveolar gas, and by the resulting hydrogen ion concentration in the acinar tissues. Probably the muscle proteins as well as the endothelial cells of capillaries and venules are to be considered as the ‘receptor substance’. Consequences of this conception as to the functional fate of a transplanted lung are in

ISSN:0025-7931    

DOI:10.1159/000192809

出版商:S. Karger AG    

年代:1971

数据来源: Karger

摘要:

The cause of confusion, delirium and coma in patients with chronic bronchitis and emphysema in respiratory failure is still unclear. There is disagreement in the literature as to its etiology. It has been ascribed to hypoxia, systemic acidosis or to severe cerebrospinal fluid (CSF) acidosis. Since the clinical manifestations resemble hepatic encephalopathy, glutamine in CSF was determined concomitantly with acid base balance and PO2 in arterial blood and CSF. The patient material was divided into a control group (10 cases), chronic bronchitis and emphysema in respiratory failure but alert (10 cases), chronic bronchitis and emphysema – drowsy or comatose (8 cases), hepatic encephalopathy (7 cases) and patients with coma due to a cerebrovascular event (4 cases). It could be demonstrated that the ‘bronchitic drowsy’ group did not differ from the ‘bronchitic alert’ group in terms of acid base balance and PO2 in arterial blood and CSF. However, the ‘bronchitic drowsy’ group had a significant elevated glutamine level in CSF as compared to normal or ‘bronchitic alert’ group. This level was significantly less than the mean of the ‘hepatic encephalopathy’ group. There were 14 patients with signs of congestive heart failure in the hypercapnic group, 6 of these with mild signs of congestive failure were amongst the ‘alert’. All the 8 patients in the ‘drowsy’ group were in an advanced state of right sided cardiac failure. It is concluded that respiratory failure encephalopathy does not correlate well with acid base disturbances of either blood or CSF and correlates well with the glutamine levels of CSF which are raised in patients with concomi

ISSN:0025-7931    

DOI:10.1159/000192810

出版商:S. Karger AG    

年代:1971

数据来源: Karger

摘要:

A double-blind study was carried out with 100 young men suffering from latent bronchial asthma diagnosed by histamine provocation, and the potency and duration of the protective effect of Alupent® and Th 1165a against histamine-provoked bronchospasm was investigated. Alupent in oral doses of 15 mg and 20 mg, and a dose of 1,500 µgadministered by inhalation (metered aerosol) provided partial protection against histamine provocation lasting 3 h after oral administration and 6 h after inhalation. Th 1165a in all doses was superior to Alupent in its potency and duration of effect. The protective effect of Th 1165a was correspondingly greater than that of Alupent. The total mean values calculated for the whole duration of the experiment for Th 1165a were 73% (vital capacity) and 67.4% (maximum voluntary ventilation), although the dose of each inhalation of Th 1165a was not more than approximately ¼ of the Alupent dose. The effect of the Th 1165a metered aerosol was still statistically significant after 6 h. The potency and duration of effect of the metered aerosols of both preparations were superior to those of the oral doses, but the former exerted less pronounced effects on the heart and circulation and fewer unpleasant subjective side-effects (tachycardia, tremor). This fact indicates that the effect of Alupent and Th 1165a administered by inhalation is primarily loc

ISSN:0025-7931    

DOI:10.1159/000192811

出版商:S. Karger AG    

年代:1971

数据来源: Karger

摘要:

Daily variations of plethysmographic measurements of airway resistance were studied in normal subjects and in patients with obstructive respiratory disease. Airway resistance seems to be highest at 7 a.m., immediately after awakening, and decreases in the first hour by about 20% in normal subjects and more than 60% in pathological subjects. No significant variations of RAW were noted during the day in normal subjects, while bronchitics and asthmatics showed an increase of airway resistance in the afternoon. In these patients the difference between airway resistances measured in the morning at about 10 a.m. and in the afternoon at about 4 p.m. is statistically significant (P < 0.05).

ISSN:0025-7931    

DOI:10.1159/000192812

出版商:S. Karger AG    

年代:1971

数据来源: Karger

摘要:

The experiments in this paper pertain to theory developed in a preceding article of Respiration Recording of expiratory gas concentration curves yield parameter values with good reproducibility, e. g. RHe, MHe, He1.5, measures for several aspects of uneven ventilation, and Rco2 a measure for unequal distribution of ventilation-perfusion ratio in the lung. The minimum radius of curvature of He and CO2 curves, RHe and Rco2 resp., is compared with clinical diagnoses and a correlation is shown of RHe, Rco2 and emphysema. The values of RHe and Rco2 correlate significantly with other lung function parameters. The pathological slope (M) of the alveolar plateau is suggested to be caused by a gradual change in ratio between the flows from individual lung regions. This is proved with bronchospirometry. With the parameter He1•5 it might be possible to reveal disturbances in small parts of the lun

ISSN:0025-7931    

DOI:10.1159/000192813

出版商:S. Karger AG    

年代:1971

数据来源: Karger

摘要:

Pressure volume diagrams (pV diagrams) were taken from isolated atelectatic rat lungs filled either with air or fluid. Each kind of filling showed a different form and course of the curve depending on body weight with a shift of the pV diagrams to the right in lighter animals (50–100 g) and statistically higher values of the ‘opening’ pressures in these animals compared with heavier rats (200–400 g). In addition, in the lungs of the lighter animals surface tension tissue elasticity formed a larger part of the total retraction of the lungs. The lung compliance calculated from the ratio of the total volume and the pressure changes increased in both kinds of filling with increasing body weight of the animals, but in lungs filled with air it was always less than in those filled wit

ISSN:0025-7931    

DOI:10.1159/000192814

出版商:S. Karger AG    

年代:1971

数据来源: Karger