摘要:

In a group of 245 patients with clinical suspicion of pulmonary embolism we analyzed the ECG for 22 signs that have been associated with this disease. Subsequently, the patients were divided into two groups: those with confirmed embolism and those in whom embolism was not confirmed. The occurrence of the ECG signs was assessed separately for the two groups. Furthermore, we related ECG features to severity of embolism as estimated at lung scan. Tachycardia and S-T depression were the commonest findings in both groups. P-R displacement, late R in aVR, S1Q3T3, S slurred and T inversion in V1-V2 were more frequent in embolic than in nonembolic patients (p < 0.05 or less). All the abovementioned signs were more frequent at diagnosis than at recovery in embolic patients (p < 0.05 or less), whereas only tachycardia was more frequent at diagnosis than at control in nonembolic patients (p < 0.001). S-T depression and T inversion in V1-V2 were also associated to severity of embolism.Since some ECG signs are very frequent or specific in pulmonary embolism, this condition should always be suspected when they are found and, particularly, when previously absent in the same patients and/or not explained by other conditions

ISSN:0025-7931    

DOI:10.1159/000194933

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The bronchospasmolytic and cardiovascular effects of fenoterol hydrobromide and ipratropium bromide alone and in combination were investigated using metered aerosols in guinea pigs and dogs and intravenous injection in dogs. The additive effect of the combination on bronchospasmolysis could be demonstrated. The slight cardiovascular side-effects of fenoterol hydrobromide alone were reduced to an insignificant level with the combination administered as a metered aerosol, but were still present when the combination was administered parenterally. Ipratropium bromide in both forms of administration had no effect on the cardiovascular system

ISSN:0025-7931    

DOI:10.1159/000194934

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Ten patients with fibrosing alveolitis were treated in a simple random design initially with either a high dose of methylprednisolone (5 patients) or a conventional dose of prednisolone (5 patients) followed by a maintenance dose of 30 mg prednisolone daily. The patients were followed for 6 weeks. No significant (p > 0.05) differences were observed between patients with high and low initial dose of glucocorticosteroids, as regards forced vital capacity, transfer factor for carbon monoxide or symptom scores after 3 and 6 weeks of treatment. After 6 weeks the dyspnoea score and the 67Ga uptake decreased, on average, by 74 and 85%, respectively, while forced vital capacity and transfer factor increased by 15 and 29%

ISSN:0025-7931    

DOI:10.1159/000194935

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The potential influence of dietary caffeine on bronchoprovocation challenges with carbachol was examined in 7 patients with asymptomatic asthma. In a double-blind fashion placebo or caffeine (6 mg/kg body weight; equivalent to approximately 4 cups of coffee) solved in orange juice was administered, and carbachol challenges were performed. The average peak serum concentration achieved 60 min after dosing was 7.6 ± SD 2.1 mg/l. These caffeine levels did not produce any appreciable attenuation of the bronchoconstrictor response to carbachol inhalations. It thus appears that dietary caffeine is barely a cause of erroneous interpretations of bronchoprovocation challenges with carbachol

ISSN:0025-7931    

DOI:10.1159/000194936

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The calcium-dependent constriction of bronchial smooth muscle cells and release of mediators derived from mast cells is important in the pathophysiology of asthma. We hypothesized that nifedipine, a slow calcium channel blocker, would inhibit or attenuate acetylcholine-induced bronchoconstriction in asthmatics. Because one consequence of mast cell activation is the release of platelet-activating factor, we wondered whether thromboxane levels would be increased during acute bronchial constriction in asthmatics. Bronchoconstriction was induced in 8 asthmatics (6 men, 2 women) by acetylcholine; each subject was pretreated either with placebo or nifedipine (20 mg sublingually) on 2 separate days. Vital capacity, forced expiratory volume in 1 s, peak expiratory flow rates and oscillatory resistance were measured prior to and after the intake of placebo or nifedipine as well as after an acetylcholine challenge. Pretreatment with nifedipine significantly attenuated acetylcholine-induced changes in all four lung function parameters studied, but did not significantly influence the increase in thromboxane B2 plasma concentrations observed after the acetylcholine challenge. From these data we conclude that nifedipine inhibits the acetylcholine-induced bronchoconstriction in asthmatics. This effect may be either a direct action on bronchial smooth muscle or may be due to the inhibition of mediators other than thromboxane.

ISSN:0025-7931    

DOI:10.1159/000194937

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The longitudinal dispersion of gas in the upper airways (oropharynx and larynx) was studied in 5 healthy subjects by measuring the response after injection of a bolus of 133Xe into the inspired airstream. The radioxenon concentration was measured during inspiration and expiration with two counter probes, one in front of the lips and one under the glottis. Assuming that the output tracer concentration follows a Gaussian distribution, the dispersion is expressed by the variance. The dispersion coefficient for the upper airways can then be readily computed with a simple mathematical model. This coefficient is found to be a function of the Peclet number

ISSN:0025-7931    

DOI:10.1159/000194938

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

In order to reduce the effects of functional inhomogeneities on the determination of pulmonary diffusing capacity (transfer factor) for CO (DLc0), DLco was measured by a rebreathing method in 5 awake chronically tracheostomized dogs (mean body weight 28 kg) during high ventilation (15–25 times above normal) induced by hypoxia, hypercapnia, exercise, or their combinations. The animals rebreathed for 15 s a mixture containing 1% He, 0.1% C180, with CO2 and O2 concentrations adjusted to maintain end-tidal PCO2 and PO2 close to their prerebreathing values. Gas partial pressures in the trachea were continuously monitored by mass spectrometry. DLco was calculated from C18O equilibration kinetics, effective ventilation (obtained from He mixing kinetics) and lung volume (obtained from He dilution). Each of the factors, hypoxia, hypercapnia and exercise, contributed to increasing DLco. During exercise in combined hypoxia and hypercapnia, DLco (mean ± SE) was 71.7 ± 1.8ml/(min · Torr). The mechanisms for increases in DLco might have involved improvement of diffusion conditions, decrease of functional inhomogeneities and reduction of the effects of functional inhomogeneities. The highest DLco values were close to values derived from morpho

ISSN:0025-7931    

DOI:10.1159/000194939

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The records of 63 patients with acquired immune deficiency syndrome (AIDS) and respiratory infection comprising 78 hospitalizations over a 36-month period were reviewed to ascertain the etiology of the respiratory infection and to identify the factors influencing short-term survival. Pneumocystis carinii pneumonia (PCP) was diagnosed on 56 occasions in 46 patients. Fifty percent of patients with PCP died with respiratory failure; of these, all but 1 were diagnosed using fiber-optic bronchoscopy. In 18 patients in whom PCP was hot identified by bronchoscopy, the in-hospital mortality was 17%. Of the clinical and laboratory findings on admission, only the arterial PO2 and the alveolar-arterial Po2 (AaPO2) difference were significantly different between the survivors and nonsurvivors. In patients with PCP and a AaPo2 60 mm Hg, 92% died. The demonstration of P. carinii by fiber-optic bronchoscopy and the presence of markedly abnormal gas exchange are associated with high in-hospital mortality

ISSN:0025-7931    

DOI:10.1159/000194940

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

To compare the degree of clinical manifestations and bronchial obstruction in acute asthma, we correlated lung function tests with the clinical symptoms in 33 patients during acute attacks of bronchospasm induced by specific and non-specific inhalation challenge tests and compared the results with similar challenge tests in 12 healthy subjects. It could be shown that about 60% of the patients did not reveal wheezing or dyspnoea despite marked bronchial obstruction, thus indicating a poor sensitivity of clinical symptoms in relation to the objective alterations in the lung function tests. We therefore conclude that the degree of bronchospasm may be seriously underestimated if it is related only to the subjective complaints and the physical sign of expiratory wheezing. In particular, during inhalative bronchial challenge tests the asthmatic airway reaction should be carefully monitored by serial or continuous lung function tests in order to avoid major complications

ISSN:0025-7931    

DOI:10.1159/000194941

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Penicillin and its derivatives are known to cause several dermatologic and pulmonary hypersensitivity reactions. This report describes a patient who presented with combined generalized exfoliative dermatitis and severe pneumonitis caused by penicillin and aggravated by ampicillin, methicillin and mezlocillin. Antibiotic challenges with penicillin caused immediate reappearance of the dermatological manifestation; reactivation of the pneumonitis was probably prevented by immediate discontinuation of the drug

ISSN:0025-7931    

DOI:10.1159/000194942

出版商:S. Karger AG    

年代:1986

数据来源: Karger