摘要:

This study was designed to investigate the relationship between the cellular components of lung lavage fluid and the presence of airways disease and emphysema in resected lung specimens, primarily from current and ex-smokers. Since standard bronchopulmonary lavage cannot be performed on these specimens, an intrapulmonary lavage technique was developed and compared to the results of bronchoalveolar lavage performed prior to surgery on the lung or lobe opposite to the one resected. The specimen lavage produced inflammatory cell differential counts similar to those obtained by bronchopulmonary lavage, and studies on postmortem lungs showed that the fluid washed alveoli, respiratory and membranous bronchioles, and small cartilagenous bronchi. The results show that the variation in peripheral airways inflammation and extent of lung destruction by emphysema did not correlate with the variation in cell content observed in the lavage fluid. Similarly, the differential counts performed in the lavage fluid did not correlate with the smoking habits of the patient. We conclude that the changes in cell content of the lavage fluid do not reflect the extent or severity of the inflammatory disease and lung destruction present in the lungs of this group of patients.

ISSN:0025-7931    

DOI:10.1159/000194900

出版商:S. Karger AG    

年代:1986

数据来源: Karger

ISSN:0025-7931    

DOI:10.1159/000195081

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Studies in experimental animals suggest that oxygen-derived free radicals are playing an important pathophysiologic role in cell and tissue damage. Systemic activation of the complement system or deposition of immune complexes in alveolar spaces results in activation of phagocyte-dependent NADPH oxidase and subsequent release of oxygen radicals that cause acute lung injury and appearance of lipid peroxidation products in lung tissue and plasma. Since pretreatment of experimental animals with catalase, iron chelators or scavengers of hydroxyl radical results in protection from pulmonary damage, it is assumed that the hydroxyl radical is the most likely mediator of phagocyte-dependent acute lung injury

ISSN:0025-7931    

DOI:10.1159/000195082

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

We measured pulmonary parenchymal tissue volume (Vt) and pulmonary capillary blood flow (Qc) in 11 normal subjects by a rebreathing technique and end-tidal, dead-space correction (ETDS) method, using two soluble gases, acetylene (C2H2) and dimethyl ether (DME). We assessed the results using different intervals of measurement, inspired volumes and rebreathing frequencies. The mean values ± SD of Vt were 559 ± 58 and 511 ± 52 ml, with C2H2 and DME, and of Qc were 3.67 ± 0.44 and 4.18 ± 0.54 liter/min/m2, respectively. Measurements with the interval between the 1st and the 6th end-tidal points and within the first 15 s yielded the best reproducibility. Data obtained from two satisfactory recordings from the same subject are sufficient to calculate Vt and Qc. Inspired volume shows a significant correlation with Vt values measured with both tracer gases, especially with DME. Rebreathing frequency also affects this latter gas. Despite some problems which are not easily explainable (dependence upon the inspired volume, rebreathing frequency and test gas species), we conclude that the methods allow measurements of Vt and Qc with acceptable reproducibility but that different variables may affect the re

ISSN:0025-7931    

DOI:10.1159/000194901

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

The mechanism(s) causing emphysema in the cigarette smoker are still poorly understood. However, circumstantial evidence is beginning to provide a tenuous link between smoking and the protease-antiprotease imbalance hypothesis. Independent effects on elastin synthesis may also be important. This triad of chemical and cellular events (leukocyte recruitment, inhibitor inactivation, depressed tissue repair) constitutes a reasonable first approximation from which to approach this complex question

ISSN:0025-7931    

DOI:10.1159/000195084

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Five healthy subjects were challenged with methacholine on 2 different days, 1 week apart, the second day after acute intravenous 30 ml/kg 0.9% saline infusion. After infusion, we observed a significant reduction in vital capacity (VC), maximal expiratory volume in 1 s (FEV1), provocation dose producing a 35% fall in SGaw (PD35SGaw) and in 25% of maximal expiratory flow (MEF25), and an increase in the slopes of log dose-response curves. Our results suggest an increased bronchial reactivity in acute minimal interstitial lung edema.

ISSN:0025-7931    

DOI:10.1159/000194902

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Right-heart catheterization and ergometry with arterial and mixed venous blood gas analysis were performed in 27 patients with a wide range of chronic obstructive pulmonary diseases. The purpose of the examination was to evaluate the risk in patients for lung surgery or to detect additional heart diseases. Patients who developed ex-ertional hypoxia (group 1) were compared with others who did not (group 2). In all patients the steady-state maximal workload was determined by ventilatory dysfunction. Both groups had normal values for mixed venous pO2 and normal increase of the circulatory parameters during exercise. The patients with exertional hypoxia differed from the others in that they showed no decrease of venous admixture and alveolar-arterial oxygen gradient. In addition, these patients had increasing pCO2 values at rest compared with exercise, indicating alveolar hypoventilation and ventilation-perfusion mismatching. Because of the good correlation of the absolute values of FEV1 (forced expiratory volume in 1 s) with pulmonary artery pressures, parameters of gas exchange and working capacity, this lung function parameter seems to have a central role in predicting the functional state of patients with chronic obstructive disease. Ergometry and blood gas analysis should be performed in addition because these values cannot be predicted with the calculated postoperative FEV1

ISSN:0025-7931    

DOI:10.1159/000194903

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

N-acetylcysteine (NAC) possesses a free sulfhydryl group that can rupture disulfide bridges. Although it is considered to be a mucolytic, its mucokinetic actions include expectorant, bronchorrheic and mucoregulatory contributions. New uses include the management of acetaminophen poisoning and the scavenging of free radicals liberated by cancer chemotherapy drugs. The antioxidant effects may be of prophylactic value in lungs at risk from smoking, pollution and infection. Other uses proposed for NAC include the therapy of connective tissue diseases and its use as a component in life extension diets

ISSN:0025-7931    

DOI:10.1159/000195085

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

N-acetylcysteine (NAC) is a thiol-containing compound which nonenzymatically interacts and detoxifies reactive electrophiles and free radicals. NAC was shown to effectively protect human bronchial fibroblasts against the toxic effects of tobacco smoke condensates and the isolated perfused lung against the glutathione (GSH)-depleting effect of tobacco smoke. NAC was also shown to reduce the reactive oxygen intermediate hydrogen peroxide (H2O2) and protect against the toxic effects of H2O2. In vivo studies, however, demonstrated that NAC when administered orally has very low bioavaibility due to rapid metabolism to GSH among other metabolites. Thus, even though NAC is very effective in protecting cells of different origins from the toxicity of reactive components in tobacco smoke and reactive oxygen species, a direct scavenging effect by NAC in vivo, particularly when administered orally, does not seem likely. The bioavailability of NAC itself is very low when given this route. A more relevant mechanism in vivo for any protective effect NAC may exert against toxic species may be due to NAC acting as a precursor of GSH and facilitating its biosynthesis. GSH will then serve as the protective agent and detoxify reactive species both enzymatically and nonenzymatically

ISSN:0025-7931    

DOI:10.1159/000195086

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

In order to evaluate the possible effects of respiratory muscle training in patients with neuromuscular disease, we trained a group of 12 patients and 6 normal subjects for 8 weeks with 4 weeks of strength training and 4 weeks of endurance training of the respiratory muscles. We measured static and dynamic lung volumes and maximal expiratory flows in a whole-body plethysmograph and endurance in an original set-up. The main finding was a significant rise in vital capacity and respiratory muscle endurance in the patient group; therefore, daily specific training of the respiratory muscles can improve strenght and endurance in patients with neuromuscular diseases as well as in normal subjects

ISSN:0025-7931    

DOI:10.1159/000194904

出版商:S. Karger AG    

年代:1986

数据来源: Karger