摘要:

We studied the bronchial response to exercise and ultrasonically nebulized distilled water (UNDW) challenge in 19 normal controls (3 females and 16 males; age 6–13 years) and in 44 asthmatic children (12 females and 32 males; age 6–13 years) in order (1) to determine the sensitivity and specificity of the two challenges and (2) to evaluate the relationship between bronchial responses and clinical and functional characteristics. A 20% fall in FEV1 was regarded as a significant bronchial response. The specificity of both challenges was high (100%), whereas the sensitivity of exercise (77.3%) was twice that of UNDW (38.6%). The combination of the two challenges increased the sensitivity to 81.8%. There was no correlation between the magnitude of bronchial response to exercise and UNDW (rs 0.05). Exercise responders were not different from nonresponders in regard to gender, age, resting lung function, length of asthmatic history and treatment requirement to control symptoms. However, the UNDW responders were different from nonresponders in regard to age (p < 0.05) and length of asthmatic history (p < 0.001). Children younger than 9 years old are unlikely to show a bronchial response to UNDW inhalation, since only 9.5% of them developed a significant bronchoconstriction. We suggest that the two stimuli recognize some different pathways or subjects have basic biological differen

ISSN:0025-7931    

DOI:10.1159/000195419

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

A maximal lung inflation is known to alter airway tone in man. Recent investigations, examining how this phenomenon relates to bronchial provocation testing, suggest that a deep inspiration will decrease airway resistance and underestimate the subsequent decrement in lung function following airway challenge. Because the recovery of baseline tone is rapid following a deep inspiration, we evaluated the consistency of three consecutive partial and maximal expiratory flow-volume maneuvers performed at approximately 45- to 60-second intervals. Functional parameters including the forced expiratory volume in 1 s and the maximal expiratory flow at 60% of the vital capacity below total lung capacity on the partial curve (MEF40%P) were constant at each measurement point following induced bronchoconstriction or bronchodilation in both healthy and asthmatic subjects. We suggest that with 45 s between maneuvers, repeatable parameters can be attained from three consecutive flow-volume curves.

ISSN:0025-7931    

DOI:10.1159/000195421

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

In order to determine the bronchodilating activity and safety of two beta-2-receptor agonists, broxaterol and procaterol, compared with a placebo, 12 patients with reversible airway obstruction were tested in a double-blind cross-over study. The drugs were administered orally and the dosage of broxaterol was 0.5 mg, that of procaterol 0.05 mg.Measurements of forced expiratory volume in 1 s (FEV1), heart rate and blood pressure were performed before and 30, 60, 120, 240, 360, and 480 min after each treatment. Both drugs produced bronchodilation but broxaterol was statistically 30 min faster in producing this effect than procaterol (p < 0.05). Moreover this effect for both drugs persisted significantly for up to 480 min compared with the effect of the placebo (p < 0.005). There were no significant side effects with either drug. Heart rate and blood pressure did not show any changes in clinical significance for broxaterol or procaterol. In our study, broxaterol showed a faster bronchodilating effect than procaterol, and tolerance was the same for both drugs.

ISSN:0025-7931    

DOI:10.1159/000195423

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

Eucapneic hyperventilation of cold air (EHCA) provokes bronchospasm in asthmatics. Although inhaled cromolyn powder and sympathomimetic solutions have attenuated the bronchospasm induced by EHCA, comparison of both drugs in solution has not been performed. We performed a prospective double-blind study comparing cromolyn solution, metaproterenol solution, and placebo (normal saline) given prior to EHCA. Eight asthmatics defined by a 20% reduction in forced expiratory volume in Is (FEV1) after EHCA consented to the study. Patients were tested on 3 separate occasions at a similar time of day. Each session began with a determination of FEV1 followed by a randomized double-blind treatment. A repeat FEV1 (pre-EHCA) was performed 20 min after drug inhalation. Twelve minutes of EHCA was performed consisting of 4 min of tidal breathing, 4 min of eucapneic hyperventilation (60–70% of the predicted MVV) and a final 4 min of tidal breathing. FEV1 was performed immediately, 5 min, and 10 min after EHCA. The lowest value was defined as the post-EHCA FEV1 The pre-EHCA FEV] was significantly larger after metaproterenol pretreatment compared to the pre-EHCA FEV1 following cromolyn (p = 0.01) and saline (p = 0.04). Metaproterenol pretreatment had a significant protective effect in comparison to placebo pretreatment (p < 0.01). No other paired comparisons (cromolyn vs. placebo, cromolyn vs. metaproterenol) achieved statistical significance at a 0.05 level. In conclusion, metaproterenol is superior to cromolyn in protecting against cold-air-induced bronchospas

ISSN:0025-7931    

DOI:10.1159/000195426

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

In order to study the role of neutrophils in hyperoxic lung edema, we induced a sustained granulocytopenia in rats by giving them a single intraperitoneal injection of 50 mg · kg”1 cyclophosphamide (CY) (CY-injected rats). Hyperoxic lung damage (FIO2 = 1.0, 60 h) was assessed by measuring pulmonary water (PW). Exposure to hyperoxia coincided with the granulocytopenic period. After exposure to hyperoxia, the difference in PW between CY- and 0.09% saline solution-injected (S-injected) rats was not significant (PW (g) (x ± 1 SD): CY-injected rats: 1.49 ± 0.09; S-injected rats: 1.68 ± 0.09, NS). If neutrophils have a pathogenic role in hyperoxic lung injury, the absence of edema reduction in neutropenic rats could be explained by pulmonary infection, insufficient neutrophil depletion or cumulative lung toxicity of CY and oxygen. No pulmonary infectious agents could be detected in lung and bronchoalveolar lavage cultures. Although already severe, the neutrophil depletion was intensified by a second injection of CY (50 mg · kg”1). After exposure to hyperoxia, the number of neutrophils in lung lavage was much lower in these neutropenic rats (156 · 103 ± 33 · 103) than in S-injected rats (571 103 ± 100–103) (p < 0.001), but no significant reduction of PW was observed. No significant increase was observed in either PW or dry lung weight in CY-injected rats not exposed to hyperoxia. CY alone might not be responsible for the absence of edema reduction, but might amplify the toxic effects of oxygen on the lung. In conclusion, we could not demonstrate any reduction of lung edema due to granulocyte depletion. The role of neutrophils in hyperoxic lung injury has yet to be fu

ISSN:0025-7931    

DOI:10.1159/000195428

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

During a 3-year period, 19 physicians performed 271 transthoracic fine-needle aspirations (FNA) in 199 patients, using a 23-gauge aspiration needle with an 18-gauge guiding needle. The diagnosis was confirmed by cytological examination of the needle aspirates in 90 out of 122 patients with malignant tumors, giving a sensitivity of 74%. The specificity of the cytological diagnosis was 100%. Both cytological and histological material was available in 49 patients. The tumor typing from the FNA specimens and the biopsies was in agreement in all but 3 cases. Pneumothorax occurred in 27% of the patients, but only 3.5% required tube drainage. Small variations (p > 0.05) in number of diagnostic punctures and rate of complications were evident among the participating physicians and between two fluoroscopic equipments.

ISSN:0025-7931    

DOI:10.1159/000195430

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

We report on a patient with febrile illness, right unilateral paratracheal widening, pulmonary infiltrates, pleural effusions, exanthema and diarrhea. The right paratracheal widening was due to lymph node enlargement confirmed by CT scan. Symptoms disappeared subsequently without specific treatment. On the basis of serological tests, we are able to diagnose a coxsackie B3 virus infection. No previous case report of unilateral mediastinal nodal enlargement contemporary to a coxsackie B3 virus infection was found in our review of the literature.

ISSN:0025-7931    

DOI:10.1159/000195432

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

One hundred nonsmoking patients with rheumatoid arthritis, including 63 with rheumatoid arthritis alone (RA group) and 37 who also had secondary Sjögren’s syndrome (sSS group), underwent a detailed evaluation of their pulmonary function. The results were compared with those of 110 age-matched nonsmoking controls. Normal function was significantly less common in both patient groups than in the controls. A significant percentage of patients had small airways disease (SAD) which was observed with similar frequency in the control group. If this were excluded, then isolated impairment of carbon monoxide diffusing lung capacity (DLCO) was the most commonly detected significant abnormality in both patient groups. Restrictive disease was following in frequency in the RA group, but was absent in the sSS group. Obstructive disease was very uncommon in all of the patients.In general, there were no significant differences in the frequency of the various respiratory function abnormalities between patients with RA only and those with concomitant sSS, whereas between patients and controls, the only statistically significant differences were the higher frequencies of isolated DLCO impairment and restrictive disease in the RA gro

ISSN:0025-7931    

DOI:10.1159/000195434

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

An unusual case of disseminated Kaposi’s sarcoma with endobronchial lesions is presented; these localizations are quite uncommon in the course of the disease, particularly in kidney transplant recipients. Some of the multifactorial etiologies of Kaposi’s sarcoma are present: immunosuppression, ethnic origin and CMV infection. We emphasize that the diagnosis of bronchial involvement can be made during fiberoptic bronchoscopy and confirmed by biopsy without excessive complicati

ISSN:0025-7931    

DOI:10.1159/000195436

出版商:S. Karger AG    

年代:1988

数据来源: Karger

摘要:

A 49-year-old woman presented with pulmonary hypertension, profound arterial hypoxemia, and a single-breath carbon monoxide diffusing capacity (DLco) which was 17% of predicted. History, physical examination, and chest roentgenograms did not suggest the presence of parenchymal pulmonary disease. Spirometry and lung volume measurements were within normal limits. Pulmonary veno-occlusive disease was diagnosed by lung biopsy. This case illustrates the severe reduction of DLco which can be associated with pulmonary veno-occlusive disease.

ISSN:0025-7931    

DOI:10.1159/000195438

出版商:S. Karger AG    

年代:1988

数据来源: Karger