摘要:

Maximal inspiration may produce a transient fall in airway conductance in asthmatic subjects. Since most forced expiratory maneuvers are preceded by maximum inspiration, a study was undertaken to determine how this conductance change or other effects of a maximum inspiration might alter the maximum expiratory flow rate. We measured airway conductance before and after maximal lung inflation and compared forced expiratory flow at 25% of the vital capacity (FEF25) measured from full (MEFV) and partial (PEFV) flow-volume curves in 6 asthmatic and in 6 normal control subjects. The PEFV curves were done in two ways: (1) expiration was initiated after a 5-sec breath-hold from approximately 50% of the vital capacity without prior deep inspiration (PEFVA curves), and (2) after inspiring to total lung capacity (TLC) and breath-holding for 2 sec the subjects slowly to 50% of the vital capacity, held their breath for 5 sec, and then forcibily expired (PEFVB curves). All 6 asthmatic subjects had lower FEF25 in the PEFVB curves than PEFVA curves (mean reduction 19.9%; p < O.Ol). The decrease in PEFVB flow was prevented by prior administration of isoproterenol. No significant difference was found in FEF25 between PEFVA and PEFVB curves of control subjects. In addition, no significant difference was found between FEF25 from MEFV and PEFVA curves of asthmatic subjects. We found that peak changes in airway conductance occurred approximately 15 sec after maximum inspiration in the asthmatic; since MEFV curves were performed immediately after inspiring to TLC, failure to observe a reduction in FEF25 in MEFV curves may be attributed to a delay in the development of increased bronchomotor tone. The results suggest that changes in bronchomotor tone induced by maximum inspiration may produce time-dependent changes in maximum expiratory flow.

ISSN:0025-7931    

DOI:10.1159/000193927

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

Equivalent (effective) values of airway resistance were determined for total breaths, inspiration and expiration in spontaneously breathing patients by means of an off-line processing system. An improvement in the alveolar pressure determination was achieved by subtracting thermal pressure drifts of the pressure plethysmograph and by taking into account instantaneous values of the intrathoracic gas volume. Equivalent resistance values were compared with the results of several simulated routine evaluations. It was found that the equivalent resistance is best approximated by the graphical procedure using average pressure points at ± 0.5 liter/sec flow levels

ISSN:0025-7931    

DOI:10.1159/000193928

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

An inhalatory bronchodilatory test was performed in two groups of 130 healthy and 89 asthmatics comparable in age, height and weight. All were males aged about 20 years. The bronchodilatory response was assessed by the percent increase after bronchodilation of FEV15 MEF200-1200, MMEF23-75 MEF50-75 (E30-75) and MEF75-90 – at last three flow rate percent increases measured before and after bronchodilation at the same level of control FVC. It was found that only MEF75-90, measured as described, could probably significantly improve the diagnostic value of a bronchodilatory test if used in cases in which the FEV1 percent increase remains within the normal rang

ISSN:0025-7931    

DOI:10.1159/000193929

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

Continuous recording of the respiratory cycle with the simultaneous or sequential radionucleic exploration (gamma camera) of ventilation (133Xe) and perfusion (MAT-99) was performed to determine the V/Q index in regional areas (Polaroid photography, mini-computer, memory visualization system, Benson incremental tracer, etc.) from the level of 1,024 points. An average ratio per sector was calculated and onyl three median sectors were retained. The wash-in and wash-out curves were traced by computer, and the calculation of the average T 1/2 for the different compartments of each median sector (apex – middle and base) was done in about 22 observations: in 18 diffuse emphysema, 11 of which were associated with giant cystic emphysema (spirometric, plethysmographic and radiographic data), T 1/2 values were greater than those of normal subjects (compartments C1 and C2) in diffuse emphysema and can become indefinable in zones of cystic emphysema. The values of the index V/Q approach the normal in diffuse emphysema with a tendency toward equalization of the ratios from the apex to the base. Extremely large divergence is observed in the elevated V/Q ratios in cystic emphysema. The values of the index V/Q approach the normal in diffuse emphysema with a tendency toward equalization of the ratios from the apex to the base. Extremely large divergence is observed in the elevated V/Q ratios in cystic emphysem

ISSN:0025-7931    

DOI:10.1159/000193930

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

An improved modification of the photometric micro-method according to Niesel and Thews is described, which employs the diffusion principle. The O2-Hb binding curves of whole blood or concentrated Hb solutions (0.1–30 g%) can be measured within 0.5 h. Sample volume is approximately 1 μ\, wavelength is 578 nm. Several reproductions of the curve may be measured with one sample. The reproducibility of P50 is 0.5 Torr. In comparison with the Van Slyke method no systematic error is fou

ISSN:0025-7931    

DOI:10.1159/000193931

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

The acute effects of thoracentesis on arterial oxygenation were observed in 19 studies on 17 patients. Arterial blood samples were obtained prior to, immediately after, and 1 h after thoracentesis. Unpredictable changes in the arterial oxygen tension, ranging from – 22 to + 19 mm Hg were found immediately following thoracentesis. It was concluded that significant hypoxemia may result from thoracentesis due to aberration of ventilation-perfusion relationships. It is further suggested that oxygen therapy be routinely administered during and immediately after the procedu

ISSN:0025-7931    

DOI:10.1159/000193932

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

Allergic bronchopulmonary aspergillosis (ABPA) is not a common condition, even though asthma due to sensitization to Aspergillus antigen is very common in many countries because of the ubiquitous distribution of the fungus itself. During the course of 14 years, the Mycology Department of the V. P. Chest Institute, Delhi, has confirmed the diagnosis of ABPA in 46 patients. The present study is based on the follow-up of 17 patients for understanding the evolution of the disease. All of them had Aspergillus jumigatus (AF) in the sputum with positive type I and type III skin reaction to AF antigen. 7 patients were treated for 10 days with oral administration of Hamycin, an antibiotic isolated from one of the streptomycete species. Immediate results were very good, with marked alleviation of subjective symptoms and absence of fungi in the sputum. The drug deserves further trial.

ISSN:0025-7931    

DOI:10.1159/000193933

出版商:S. Karger AG    

年代:1978

数据来源: Karger

摘要:

Reasoning from known effects of salbutamol on the bronchial smooth muscle cell and their enhancement in asthmatics through steroids, this communication proposes a method employing these substances in such a way as to prevent bronchospasm during fiberoptic bronchoscopy. Following split-dosage administration of 100 mg prednisolone prior to bronchoscopy, a total of 3.75 mg salbutamol in a diluted saline solution is instilled intrabronchially through the biopsy channel. Transnasal fiberoptic bronchoscopy incorporation this method was performed in 15 asthmatics with neither laryngospasm nor bronchospasm being observed. In fact, comparison of FEV1 and FVC rates before and after bronchofiberscopy showed increases of 17% (t = 6.5513, p < 0.0005) and 12% (t = 5.2718, p < 0.0005), respectively. In a control group of 17 chronic bronchitics showing an improvement of 15% in flow rates after bronchodilators, no significant change was seen in FEV1 and FVC following fiberbronchoscopy. This procedure not only renders the diagnostic bronchofiberscopy relatively safe in asthmatics, but may be of use within the context of intensive care in serious bronchospasm refractive to conventional therapy.

ISSN:0025-7931    

DOI:10.1159/000193934

出版商:S. Karger AG    

年代:1978

数据来源: Karger