摘要:

Airway disease in cystic fibrosis (CF) is characterized by neutrophil-dominated chronic inflammation with an excess of uninhibited neutrophil elastase (NE), which is regarded as an important factor in progressive lung destruction. Therefore, inhalation of α1-proteinase inhibitor (α1-PI) seems to be a reasonable therapeutic approach. To estimate its therapeutic potential, we quantitatively investigated the in vitro interactions of exogenous α1-PI with CF sputum samples (n = 28). High NE and α1-PI concentrations were detected in CF sputum (6.03 ± 0.78 and 2.56 ± 0.16 µmol/l, respectively). There was significant NE activity (2.6 ± 0.4 U/l) due to both the surplus of NE and proteolytic degradation of α1-PI. Addition of exogenous α1 90% inhibition was achieved at 10 µg/ml α1-PI. Purified NE as well as CF sputum potently induced secretion from porcine tracheal glands. Corresponding to inhibition of NE activity, CF sputum-induced secretion was also inhibited by exogenous α1 90% inhibition was also achieved at 10 µg/ml α1-PI. Incubation of exogenous α1-PI with CF sputum for 24 h did not reduce the inhibitory effects. From our in vitro results we conclude that inhalation of α1-PI might effectively inhibit both NE activity and airway gland hypersecreti

ISSN:0025-7931    

DOI:10.1159/000196405

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Fibronectin (FN) and hyaluronan (HA) in bronchoalveolar lavage fluid (BALF) and FN released by alveolar macrophages (AM) were examined in 7 nonsmoking healthy control subjects, and 20 smoking patients with chronic obstructive pulmonary diseases (COPD). All patients and subjects were no more than 40 years old. According to the 95 % confidence limits of HA and FN in BALF from nonsmoking healthy control subjects, the smoking patients were divided into two groups, those who had HA and FN levels within the limits for nonsmoking controls were classified as the first group (group 1) and those with levels above the control limits were classified as the second group (group 2). Our data showed that the concentrations of HA and FN in BALF and FN released by AM were significantly higher in group 2 than in group 1 patients. There were also significant differences between the two groups in pulmonary function measurements (DLCO, FEV1, and FEV1/FVC) which were lower in group 2. HA levels in group 2 patients correlated directly with counts of inflammatory cells in BALF (BALF cells/ml, and numbers/ml of total cells, macrophages, neutrophils and lymphocytes), and the concentration of FN released by AM, and showed an inverse correlation with pulmonary function (DLCO and FEV1/FVC). Our results suggest that the inflammatory repair response and fibrosis may play a role in the development of emphysema in young patients with COPD.

ISSN:0025-7931    

DOI:10.1159/000196406

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Inhaled 3-carene at a concentration of 5,000 mg/m3 caused bronchoconstriction in isolated, ventilated and perfused guinea pig lungs. This effect was inhibited by the cyclooxygenase inhibitor diclofenac (100 µM) and the thromboxane/prostaglandin endoperoxide-receptor antagonist L-670,596 (1 µM). 3-Carene exposure also increased the amount of thromboxane in the perfusate from the lungs. In cultured calf pulmonary arterial endothelial cells 3-carene caused a dose-related release of arachidonic acid. Thus, the results obtained in this experimental model may have implications in the understanding of the pathophysiology of 3-carene-induced obstructive pulmonary disease in human

ISSN:0025-7931    

DOI:10.1159/000196407

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

An increased (p < 0.001) frequency of bronchial hyperreactivity (BHR) was found in sarcoidosis patients as compared with healthy volunteers. The patients had more mast cells (p < 0.001) and tryptase (p < 0.001) in their bronchoalveolar lavage fluid, but there were no differences between BHR-positive and BHR-negative patients. Furthermore, the bronchoalveolar lavage fluid concentrations of macrophages, lymphocytes, and of the soluble components albumin, fibronectin, and vitronectin were also elevated in the sarcoidosis patients, indicating an ongoing inflammation in the airways and/or in the interstitium. We observed no significant differences in the parameters when the sarcoidosis patients were subdivided into BHR, clinical activity, or chest X-ray stages. Our findings may indicate a multifactorial background to the hyperreactivity.

ISSN:0025-7931    

DOI:10.1159/000196408

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Recently ethanol-induced bronchoconstriction associated with elevated serum levels of acetaldehyde and histamine was reported in Japanese asthmatic patients, but there is no investigation of the airway response to intravenous injection of acetaldehyde. We therefore performed a study in guinea pigs to test the hypothesis that intravenous injection of acetaldehyde has bronchospastic action via histamine release. At first, we investigated the airway response to increasing doses (8.0, 26.4, and 80 mg/ml) of injected ethanol or acetaldehyde in guinea pigs. Secondarily, increasing doses of acetaldehyde were injected in guinea pigs pretreated with an intraperitoneal injection of 20 mg/kg diphenhydramine or saline (control). Finally, injection of acetaldehyde was performed after intraperitoneal injection of 0.5 mg/kg atropine sulfate or saline (control). Injected acetaldehyde caused bronchoconstriction in a dose-dependent manner, but ethanol did not. The bronchoconstriction induced by injected acetaldehyde was completely prevented by pretreatment with diphenhydramine. Atropine had no preventing effect against the acetaldehyde-induced bronchoconstriction. In conclusion, intravenous injection of acetaldehyde causes bronchoconstriction via histamine release in guinea pigs.

ISSN:0025-7931    

DOI:10.1159/000196409

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Extraluminal tumour compression can be treated with the use of stenting. In 8 patients with end-stage malignant tumours of the tracheobronchial tree, tumor compression of the major airways became apparent after Nd-YAG laser debulking. Dumon-type stents (Endoxane®), were inserted under general anaesthesia. There were no complications during and after stent insertion. All stents were well tolerated, with significant symptomatic relief in all patients. This symptomatic relief was considered worthwhile, despite the limited duration of palliation and the pre-terminal stage of the patients. Tumour progression after stent insertion was usually beyond any treatment possibility, except additional laser coagulation. The median survival was 2 months and the longest palliation was 11 months

ISSN:0025-7931    

DOI:10.1159/000196410

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Tracheobronchopathia osteochondroplastica (TPO) is a rare condition of unclear cause. Sporadic cases have been published from all over the world, but some geographical differences in the occurrence may exist. The condition is characterized by cartilaginous or bony outgrowths into the lumen of the tracheobronchial tree. Clinicians should include this disease in the list of differential diagnoses when confronted with symptoms like persistent and often productive cough, haemoptysis, dyspnoea and wheeze. If the condition is extensive, there may occur unexpected and acute clinical problems. We describe the case of a young man in whom we diagnosed a severe form of TPO while examining him for asthma. This patient suffered also from ozaena and the combination of these two conditions is rather common. We also retrospectively reviewed our material of 18 cases with this condition.

ISSN:0025-7931    

DOI:10.1159/000196411

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

A cerebral infarction of the left occipital lobe developed in a 6 5-year-old man with squamous cell carcinoma of the right lung. Neurological examinations and brain CT showed findings typical of ordinary infarction. Postmortem examination revealed a tumor embolus within the posterior cerebral artery. Such spontaneous tumor emboli large enough to obstruct a larger-sized artery are rare.

ISSN:0025-7931    

DOI:10.1159/000196412

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Recent results of basic research on regulation of surfactant secretion and surfactant physiology not only in the alveolus but also in peripheral small airways allow the conclusion that disorders in surfactant homeostasis may contribute to the pathophysiology of airway obstruction and hyperinflation. We therefore hypothesized that patients with respiratory failure due to obstructive lung disease may benefit from exogenous surfactant. Here we report a case that indicates the clinical situation to be considered for treatment with exogenous surfactant. The benefit for the patient was successful weaning from the ventilator. Improvements in effective compliance, resistance and blood gas parameters were observed following surfactant application.

ISSN:0025-7931    

DOI:10.1159/000196413

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

A glomus tumour situated at the posterior wall of the trachea in a 65-year-old man presenting with dyspnoea and haemoptysis is described. The tumour was excised with an Nd-YAG laser, with no visible recurrence a year later. This is the fifth reported case of tracheal glomus tumour.

ISSN:0025-7931    

DOI:10.1159/000196414

出版商:S. Karger AG    

年代:1995

数据来源: Karger