摘要:

The present investigation was performed on 64 randomly chosen never-smoking patients, 40–60 years old, with nonallergic bronchial asthma with an average FEV1 of 69–73 % of predicted, a positive methacholine test, a normal serum IgE level, and a negative RAST or skin test to common allergens and not receiving oral steroid treatment. Sensitive spirometric tests were used to evaluate the dose-response effect of inhalation of 0.08, 0.15 or 0.25 mg of ipratropium bromide. The drug caused bronchodilatation with a nearly linear dose-response relationship for static lung volumes, while the total lung capacity was unchanged after this inhalation. Airway resistance decreased and specific airway conductance increased after all doses. Ventilation and flows were better after doses of 0.15 and 0.25 mg than after 0.08 mg. The intrapulmonary gas distribution improved only after inhalation of 0.25 and 0.15 mg. The currently recommended dose of 0.08 mg seems to be suboptimal for dilatation of both small and large air

ISSN:0025-7931    

DOI:10.1159/000195297

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

We compared determinations of anaerobic threshold (AT) made from measurements of arterial lactate concentration with AT determined from ventilatory response measurements of subjects with chronic airflow obstruction (CAO). Six untrained subjects with CAO performed incremental maximal cycle ergometer tests. Ventilation (VE); O2 uptake (VO2), CO2 output (Vco2); end-tidal CO2 fraction (FETCO2); and end-tidal O2 fraction (FETO2) were measured breath by breath. Arterial lactate concentration was sampled at rest and every 30 s during exercise from an indwelling arterial catheter. For three subjects with more severe airflow obstruction, plots of VE/Vo2 and FETO2 failed to detect AT. In contrast, a systematic increase of the respiratory gas exchange ratio across the lung (R) accompanied increasing arterial lactate concentrations in all 6 subjects. We conclude that progressive increases of VE/VO2 and FETO2 cannot be relied upon for the measurement of AT in patients with severe CAO. Progressive increases of R unaccompanied by decreasing FETCO2 detect AT in CAO

ISSN:0025-7931    

DOI:10.1159/000195298

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The effect throughout the day of inhaled fenoterol on the bronchial responsiveness to inhaled histamine was evaluated in 8 asthmatic patients. The airway response to increasing concentration of histamine aerosol was assessed by measurement of forced expiratory volume in one second (FEV1). The provocative dose of histamine needed to cause a 20% fall in starting FEV1 was calculated from the cumulative log dose response curves. Histamine challenges were performed in duplicate, on separate days, after premedication with placebo or fenoterol given by metered dose inhalers in the morning and in the afternoon. The mean starting FEV1 in the morning and in the afternoon did not change significantly after placebo inhaler, but fenoterol caused a mean increase in FEV1 of 11.11 % in the morning and 4.92% in the afternoon. Geometric mean histamine PC20 was significantly higher after fenoterol than after placebo. After fenoterol there was no significant difference between morning and afternoon geometric mean histamine PC20• 0.05). There was instead a significant relationship between starting FEV1 and histamine PC20 in the morning and in the afternoon both after placebo and fenoter

ISSN:0025-7931    

DOI:10.1159/000195299

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Peak expirator flow rate (PEFR) and forced expiratory volume in 1 s (FEV1) were measured in 630 asthmatics at routine attendance (actual function). The highest potential PEFR and forced vital capacity (FVC) were established with corticosteroids if necessary (maximum function). Maximum function assesses the persistent component, and the ratio of actual maximum function is a measure of the potentially reversible component of obstruction relieved at attendance. Actual PEFR and FEV1 were closely related (r = 0.85), and maximum PEFR and FVC somewhat less so (r = 0.58). Mean values for actual/maximum function were similar in both sexes by both methods. Persistent obstruction and control of reversible wheeze were not closely related, particularly in long-standing asthma. In routine clinics, spirometry adds little to PEFR although in females it was more sensitive than PEFR in detecting persistent obstruction. Dissociation between control and persistent obstruction, particularly in long-standing asthma, suggests that poor control is not important in determining the development of persistent obstruction

ISSN:0025-7931    

DOI:10.1159/000195300

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Respiratory sensitivity was evaluated in 10 patients with schizophrenia and 10 normal control subjects utilizing a rebreathing system and measurements of the changes in the mouth occlusion pressure in 100 ms and ventilation in response to the increase in end-tidal PCO2 (PetCO2). Although ventilation response was similar in both groups, we noted that the occlusion pressure response was more variable (coefficient of variability, CV = 17.5%) and the correlation coefficient (r = 0.75 ± 0.13) lower in the patients with schizophrenia compared to controls (CV = 4.6%; r = 0.90 ± 0.04). Apnea threshold was also lower in patients with schizophrenia (29.03 ± 12.73 Torr, mean ± SD) compared to controls (39.5 ± 4.5 Torr). Furthermore, schizophrenia patients showed a significant positive and negative correlation between occlusion pressure response and age (r = 0.73; p < 0.001) and estimated duration of schizophrenia (r = 0.65; p < 0.05). We conclude that the apnea threshold is lower and the respiratory sensitivity to CO2 is more variable in patients with schizophrenia compared to normal sub

ISSN:0025-7931    

DOI:10.1159/000195301

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The ability to detect added resistance at rest was compared to the magnitude of breathlessness (evaluated by a modified Borg scale) during bronchoconstriction in 27 stable asthmatics. Threshold for resistive load detection was analyzed in terms of the Weber fraction (ΔR/R0) and mouth pressure (P) at the threshold. Bronchoconstriction was induced by inhalation of aerosolized acetylcholine. Both ΔR/R0 and P correlated inversely with the Borg score during bronchoconstriction (r = -0.537 and r = -0.689, respectively; p < 0.01). On the other hand, during bronchoconstriction the Borg score did not correlate with increased lung volume, acute changes in arterial blood gas composition and drive and timing component of ventilation during bronchoconstriction, although bronchoconstriction caused significant changes in these variables. These results indicate that central processing of afferent stimuli rather than peripheral sensor contribute both to the ability to detect added resistance at rest and to the magnitude of breathlessness during bronchoconstriction in asthmati

ISSN:0025-7931    

DOI:10.1159/000195302

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The antitussive effects of dextromethorphan (30 mg) + salbutamol (2 mg), dextromethorphan (30 mg) alone and placebo on artificial cough induced by citric acid were compared in 19 healthy non-smoking volunteers in a double-blind crossover study. The method using inhaled citric acid with increasing concentrations to establish the cough threshold level showed an acceptable reproducibility and proved to be suitable for comparison of antitussive drugs. The cough threshold level was assessed before as well as 90 and 180 min after each medication. After placebo the cough threshold level showed no statistically significant rise. However, significant rises were shown following dextromethorphan (p < 0.001) and the dextromethorphan-salbutamol combination (p < 0.001). Between the treatments significant differences were shown in favour of the dextromethorphan-salbutamol combination. The results indicate that salbutamol has antitussive action enhancing the effect of plain dextromethorphan

ISSN:0025-7931    

DOI:10.1159/000195303

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

A fatal massive pulmonary embolus developed in a patient treated with streptokinase for acute deep vein thrombosis. This fatal complication occurred despite a careful selection of the patient and the presence of a lytic state. Embolization of a fragmented thrombus or/and attenuation of the lytic state leading to fresh embolization is/ are the possible mechanism(s). Although rare, massive pulmonary embolus must be considered to be a major risk of thrombolytic therapy for deep venous thrombosis

ISSN:0025-7931    

DOI:10.1159/000195304

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

The acute effects of a single intravenous Prostigmin injection (0.5 mg) on lung function and gas exchange during rest and bicycle ergometry were measured in 26 patients with myasthenia gravis. The mean age of the patients was 44.6 ± 17.6 years and the mean duration of myasthenia gravis 5.4 ± 6.3 years. Lung function parameters obtained from 15 patients showed a normal total lung capacity with an increase in functional residual capacity and residual volume, while vital capacity was diminished. While the application of Prostigmin showed no acute effects on these lung volumes, there was a significant increase in airway resistance, even into the pathologic range. Data obtained during spiro-ergometry concerning gas exchange, circulation and muscle metabolism correspond to those expected from healthy individuals; application of Prostigmin did only influence the heart rate, which can be explained by parasympathomimetic activity. We conclude that dyspnoea in patients with myasthenia gravis need not necessarily be a symptom of the illness itself but can also be caused by therapy; in the latter case bronchodilatators are requir

ISSN:0025-7931    

DOI:10.1159/000195305

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

In this study, nasal mucociliary clearance is investigated in patients with primary ciliary dyskinesia, patients with other respiratory tract infections and healthy persons. Mucociliary clearance is established with a drop of albumen labelled with 99m-Tc. From this study it appears that measurement of mucociliary clearance in the nose can serve as a reliable screening method. If a patient with respiratory tract infections shows a normal mucociliary clearance rate there is no primary ciliary dyskinesia, and a biopsy of ciliated epithelium is not necessary. If, after repeated examinations, a normal clearance rate cannot be demonstrated, a biopsy of ciliated epithelium should be taken for studying ciliary activity and ciliary ultrastructure

ISSN:0025-7931    

DOI:10.1159/000195306

出版商:S. Karger AG    

年代:1987

数据来源: Karger