摘要:

In order to determine whether the alterations of immunoregulatory T cells described both in smokers and in patients with lung cancer occur in the deep lung as well as in peripheral blood, we analyzed T lymphocyte subpopulations in bronchoalveolar lavage (BAL) and in the blood of 12 patients with untreated lung cancer and of 8 controls. The immunocompetent cellular population of BAL fluid analyzed by differential cell count of alveolar macrophages, lymphocytes and neutrophils did not show considerable differences in the two groups studied. By contrast, the analysis of BAL T lymphocytes and their subsets showed significant alterations in patients compared with controls: a percentage increase of OKT3+ and OKT8+ lymphocytes and a decrease of the OKT4+/OKT8+ ratio was found in both the involved and uninvolved lung of patients. The immunologic pattern of T lymphocytes in blood did not show significant differences between patients and controls. Our data indicate that alterations in immunoregulatory T cells in lung cancer are more pronounced in BAL fluid obtained from both lungs than in peripheral blood.

ISSN:0025-7931    

DOI:10.1159/000195198

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Eighty consecutive patients with pulmonary non-oat-cell carcinoma and a single cerebral metastasis were followed for at least 5 years after therapy. Forty were treated by surgical excision at both sites of disease plus whole-brain irradiation in most cases (group 1). The remaining 40 patients, an observational cohort, were treated either by surgery at only one site of disease (usually craniotomy), whole-brain irradiation, chemotherapy, or some combination of these modalities (group 2). The 1-year survival in group 2 was 15%, and all were dead at 2 years. In group 1, hospital mortality was 1.5%, the 1-year survival rate 35%, the 2-year survival rate 25%, and the 5-year survival rate 12.5%. All the five year survivors were patients with No disease. In this subgroup of group 1, the five year survival was 20%. All patients surviving for more than 2 years were in group 1 and had a Karnofsky rating greater than 50 and No disease after staging. These data indicate that a combined surgical approach can be accomplished with low morbidity, low mortality, and increased survival rates, especially for patients with No disease who are vigorous enough to undergo the combined treatment.

ISSN:0025-7931    

DOI:10.1159/000195199

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The present study contains the review of 30 patients with malignant mesothelioma of the pleura, examined and treated at our institution. In an attempt to compare various methods of diagnosis in this entity, emphasis was laid on specific abilities and limitation of investigations such as pleural biopsy, pleural fluid cytology, diagnostic thoracoscopy and thoracotomy and radiological studies including computed tomography and magnetic resonance imaging. Clinical management problems encountered in this neoplasm are also discussed.

ISSN:0025-7931    

DOI:10.1159/000195200

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Proteinase inhibitor (PI) phenotyping and clinical investigations were performed on 20 persons in three generations of a family with α1-antitrypsin deficiency. Two persons were homozygotes and 9 were heterozygotes for the Z allele; one is the first reported IZ phenotype; 11 were common M-types. Both homozygotes and 5 of the heterozygotes, including the IZ individual, had suffered from recurring or chronic respiratory diseases. However, only mild to moderate impairment in lung function tests was observed in some of these patients (DLCO steady state, 3 subjects; FEV1, 3 subjects; FEF25–75, 2 subject; elevation of RV, 2 subjects). The rare IZ type, a 35-year-old female, smoker, showed normal lung function except for an elevated RV. Our results indicate that PI deficiency is not necessarily associated with severe lung destruction if noxious inhalants are abse

ISSN:0025-7931    

DOI:10.1159/000195201

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

2 h after the inhalation of monodispersed 99mTc-labeled autologous spherocytes and of commercial human albumin microspheres (HAM), 7 patients with chronic bronchitis underwent bronchofibroscopy. The fate of organic particles along the tracheobronchial tree was verified by scanning electron microscopy and the proteolytic activity (trypsin and PZ peptidase) in mucus samples was assessed. Significant proteolytic activity was detected in bronchial secretions. Thereafter in vitro digestion of labeled spherocytes and HAM was verified after exposure to increasing concentrations of trypsin. While in vitro a similar time-course of tryptic digestion of both particles was observed, in vivo spherocytes seem to be less vulnerable to enzymatic digestion. These findings add another unexpected variable, which may influence the reproducibility of radioaerosol lung mucociliary clearance measurements, and improve its standardization.

ISSN:0025-7931    

DOI:10.1159/000195202

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The protective effect of clenbuterol on exercise-induced asthma was studied in 14 patients with aspecific bronchial hyperreactivity. The selectivity of clenbuterol for β2-receptors was also studied. Patients were selected according to spirometric criteria: reduced dynamic indexes of respiratory function after exercise and, particularly, forced expiratory volume at 1 s (FEV1) decreased by at least 20% compared with initial values. A polycardiographic study was simultaneously carried out for the evaluation of systolic time intervals and polycardiographic indexes (Weissler index, Blumberger index and QT/QS2 index). After the preliminary measurements (CI), oral clenbuterol was started (0.02 mg × 2/day) and measurements were repeated after 30 (CII) and 60 days (CIII) of therapy. During treatment, physical exercise did not significantly influence the indexes of respiratory function (FEV1 decreased by 4.7 ± 5.8 and 9.8 ± 10.5% in CII and CIII with respect to initial values). Similarly systolic time intervals and polycardiographic indexes did not change significantly with respect to the initial values. A small increase in heart rate at rest was observed in CII (+7%, p < 0.05): however, no significant changes were recorded in CIII compared with the initial values. Clenbuterol thus seems to offer an effective protection against exercise-induced asthma without the negative effects on the cardiovascular system which may arise from activation of β1-adrenergic recep

ISSN:0025-7931    

DOI:10.1159/000195203

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Static and dynamic spirometric tests were performed in 21 healthy subjects (21–61 years old, 8 smokers and 9 ex-smokers) on 3 different days within 2 weeks. The design of the study allowed separation of the influence of learning and diurnal changes between 09.00 and 17.00 h. In addition, the reproducibility of the tests and the effect of inhalation of 2.5 mg of terbutaline sulphate were studied. No learning effect was observed. There were slight, but statistically significant differences between morning, noon and afternoon measurements. Thus, the residual volume and flow in the early phase of forced expiration were highest in the afternoon, while maximal voluntary ventilation was lower at noon than in the afternoon or morning. The intraindividual variabilities (defined as standard deviation of difference between first and second measurement) of total lung capacity, vital capacity and forced expiratory volume in 1 s (FEV1) were about 3 % of the predicted values. The ratio of intra- to interindividual variability was 0.2–0.3. The remaining tests showed higher variability and a higher intra- to interindividual variability ratio. Terbutaline inhalation caused a significant increase in most forced expiratory flow variables. A 10% increase in FEV1 corresponded to a 50–60% increase in endexpiratory flow. In spite of this, the endexpiratory flow and mean transit time were better discriminators of the effects of bronchodilatation in normal sub

ISSN:0025-7931    

DOI:10.1159/000195204

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

It has recently been reported that blood and muscle lactate increased exponentially during incremental exercise, casting some doubt upon the concept of ‘anaerobic threshold’. To gain further insight into this controversy, we examined the relationships between minute ventilation (VE), time and oxygen uptake (VO2) in normal subjects during incremental exercise. During exercise, the relationship of VE to either time of exercise or to VO2 appeared curvilinear; VE was reliably described as an exponential function (y = axb + c) of both time of exercise (r2 = 0.96) and VO2 (r2 = 0.92). We also compared variables from 30-second incremental tests with variables obtained from quasi-steady-state incremental tests using cycle and treadmill ergometry. With the exception of heart rate, variables measured at maximum exercise were similar during short-duration and quasi-steady-state incremental tests. These data support the ideas that: (1) there is no abrupt change in metabolism and oxygen availability during progressive exercise, and (2) results of rapid incremental and quasi-steady-state exercise tests are generally comparable in normal individu

ISSN:0025-7931    

DOI:10.1159/000195205

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The metabolic response of fetal and neonatal lung tissue to maternal nicotine exposure (0.25 and 1.0 mg/kg body weight/day) was investigated. White virgin female rats (Wistar) of 200–250 g were used. The rats were mated overnight and were afterwards randomly assigned to control and experimental groups. The experimental group was subdivided into two groups. One group received nicotine during pregnancy and lactation. The second group received nicotine only during lactation. The suckling rats were killed 24 h after the last dose of nicotine was administered to the mother. The lung tissue was surgically removed and the in vitro utilization of exogenous glucose and endogenous glycogen determined. Lactate production was also determined to assess glycolytic activity. Maternal nicotine administration during pregnancy and lactation stimulated total glucose turnover by 21.6 and 86.4% respectively but suppressed glycogenolysis (32.7%) and glycolysis by 24.6% (p < 0.01). Nicotine administration during lactation only enhanced total glucose turnover by 19.1% (p < 0.01) and glycogenolysis by 30% (p < 0.01) but inhibited glycolysis by 25.8%. After 4 weeks of nicotine withdrawal when the rats were 7 weeks old, glycogenolysis and glycolysis of those animals exposed to nicotine via the placenta and mother’s milk were still inhibited to the same extent as during exposure. Glycogenolysis and the glycolytic flux of lung tissue of rats exposed to nicotine via mother’s milk only returned to normal. Since rat lung tissue has reached maturation at this stage, it is conceivable to assume that exposure to nicotine during pregnancy will have a permanent adverse effect on carbohydrate metabolism in lung tissue and thus on the aspects of lung development and differentiation dependent on these pat

ISSN:0025-7931    

DOI:10.1159/000195206

出版商:S. Karger AG    

年代:1987

数据来源: Karger