摘要:

Despite occasional case reports, vasodilator therapy of primary pulmonary hypertension remains unsatisfactory. Nifedipine, a calcium channel antagonist, has recently been recommended for the treatment of primary pulmonary hypertension. Transient mild side effects to this drug have been known. In this report we describe a case of primary pulmonary hypertension in whom oral nifedipine use was followed by fatal pulmonary edema. We suggest that nifedipine has the potential of causing life-threatening complications of pulmonary edema in patients with severe primary pulmonary hypertension, and in this condition it should be used cautiously.

ISSN:0025-7931    

DOI:10.1159/000194763

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

12 patients (9 males, 3 females; aged 35–63 years, mean 55) with chronic obstructive pulmonary disease (COPD) were studied in order to determine the correlation between the values of pulmonary arterial pressure and the M-mode echographic size of the right pulmonary artery (RPA) from the subxiphoid approach. Both the largest (systolic) and smallest (diastolic) size of the vessel were considered, and both were corrected for body surface area (‘index size’ – PA/BS A). The reliability of this echographic size is supported by the evidence that the tract of the pulmonary artery considered in this study is perpendicular to the ultrasonic beam. Both the systolic and diastolic size of RPA correlated with the systolic, diastolic, and mean pulmonary arterial pressures, detected by catheterization. Measurements of RPA size were made from the suprasternal approach in 8 patients out of 12. The size of RPA from the subxiphoid approach was also estimated in 21 normal subjects, serving as controls. Measurements of RPA size from the suprasternal approach were made in 12 of these subjects. Both the systolic and diastolic size of RPA from the subxiphoid approach correlated with the systolic and diastolic size of the suprasternal view in patients and in normal subjects. Subxiphoid M-mode echocardiography seems to be a valuable noninvasive technique in assessment of pulmonary hypertension, particularly in patients affected

ISSN:0025-7931    

DOI:10.1159/000194764

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

210 patients were screened for pulmonary embolism after total hip replacement with chest radiography and perfusion-ventilation scintigraphy using a new, dry 99mTc-microaerosol and a detailed system for coding scintigraphic abnormalities. Chest radiography did not contribute significantly to the diagnosis of pulmonary embolism. In spite of careful evaluation, false-negative and false-positive scintigraphic diagnoses of PE are still possible.

ISSN:0025-7931    

DOI:10.1159/000194765

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

The authors describe the ultrastructural alterations of the pulmonary parenchyma produced in dogs by endotoxic shock, and they examine the effects that a ‘secret-olytic’ drug (bromexine) has in modifying those changes. In the animals under shock there is a complete breakdown of the normal structure of the pulmonary parenchyma. According to the authors, these lesions are caused by the damage of the lining layer and of the cells which produce the constituents of the surfactant system. In dogs under shock and treated with bromexine the authors have seen a better organization of the pulmonary parenchyma: the cellular limits of the pneumocytes of types I and II were more clearly defined and the osmiophilic bodies were increased both in number and volume. The authors conclude that the damage of the lining layer and of the pneumocytes of type II plays an important role in the development of the ARDS and they say that bromexine can improve clinical and morphological aspects of that syndr

ISSN:0025-7931    

DOI:10.1159/000194766

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Submaximal histamine dose-response curves were obtained on 34 dogs divided into six groups. These groups were: A (n=6) untreated; B (n=6) after atropine (1 mg/kg); C (n=5) after verapamil inhalation (10 mg total dose); D (n=5) after verapamil inhalation (100 mg total dose); E and F (n=6) as for C and D but pre-treated with atropine (1 mg/kg). Total lung resistance (Rl) was measured in each case at increasing delivered concentrations of inhaled histamine and expressed as a ratio of baseline valve. For each group a composite mean curve was obtained and the maximal recorded responses (mean maximal resistance ratios) for the various groups were compared. It appears that the combination of verapamil inhalation (low dose) and atropine reduced the anticholinergic effect of atropine causing marked bronchoconstriction. This unexpected result depends on the verapamil dose since it was not present at the higher dose (group F).

ISSN:0025-7931    

DOI:10.1159/000194767

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Kerosene aerosol (32.5 mg/l; 20 min), when administered to guinea pigs 1 h before exposure to acetylcholine (Ach), induced potentiation of cumulative dose-response curve of this agonist on isolated tracheal strips as well as a decrease of the lethal doses of Ach. This enhanced response was absent or greatly reduced when kerosene aerosol was administered to guinea pigs 24 h previously or just before Ach challenge. This airway hyperreactivity was also lacking when carbachol or histamine were used as spasmogens instead of Ach. Possible explanations of these results are discussed.

ISSN:0025-7931    

DOI:10.1159/000194768

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Measurement of the acute phase response in patients suffering from bronchiectasis, emphysema, bronchus carcinoma and various benign space-occupying lesions was undertaken, using sensitive immunoradiometric assays for C-reactive protein (CRP) and serum amyloid-A protein (SAA). In some patients with bronchiectasis, clinically judged to be in remission, the results show a major ongoing acute phase response. Such a response could predispose these patients to the development of reactive secondary amyloidosis. In bronchus carcinoma the application of these measurements to judge the extent of tumor growth is limited as infection-complicating obstruction is a more potent initiator of the acute phase response than the neoplastic process per se.

ISSN:0025-7931    

DOI:10.1159/000194769

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

Ventilation inhomogeneity was assessed in asthmatic subjects before and after antigen-induced bronchoconstriction and bronchodilator administration. As an index of inhomogeneous distribution of inspired air, the mean dilution number (the ratio of the first to zero moments) was calculated from each multibreath nitrogen washout during spontaneous breathing. This index was compared to plethysmographic, spirometric, and lung volume indices. In the baseline state, a weak relationship existed between the mean dilution number (MDN) and indices of mechanical abnormality, FEV1/FVC and SRAW· Antigen-induced bronchoconstriction led to increases in the MDN, SRAW, and RV/TLC, and a decrease in FEV1/FVC. The reverse effects were found by administering bronchodilators. No statistically significant correlations were found between changes in MDN and changes in the other indices of pulmonary function. Thus, the maldistribution of inspired air resulting from acute bronchoconstriction cannot be quantified from common indices of pulmonary function

ISSN:0025-7931    

DOI:10.1159/000194770

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

We describe a perplexing asthmatic patient who had chronic lymphatic leukemia that developed recurrent severe and prolonged attacks of asthma which required almost continuous hospitalization. Clinical findings of fever, leukocytosis, right lower lobe infiltrate and mouth candidiasis were suggestive of bronchopulmonary candidiasis. No further diagnostic tests were done and the patient responded favorably to amphotericin B therapy. A review of bronchopulmonary candidiasis in adults is discussed briefly. Lung biopsy should be reserved only for the most obscure and problematic cases.

ISSN:0025-7931    

DOI:10.1159/000194771

出版商:S. Karger AG    

年代:1985

数据来源: Karger

摘要:

This study was designed to reevaluate the effectiveness of the lungs in taking up lipids from the blood, and to establish whether or not the blood triglycerides so extracted are metabolized. 8 normal human males were studied. With the subject fasting and supine, a percutaneous catheter was placed in the pulmonary artery, another in the superior vena cava, and a third in the brachial artery. Samples of mixed venous and arterial blood were drawn by syringe from the pulmonary and brachial arteries, respectively. Infusion of a triglyceride emulsion (20% Intralipid®) into the superior vena cava was begun at 4.7 ml/min. After 12 min of infusion, mixed venous and arterial samples were taken and infusion was discontinued. 15 min following termination of infusion, blood samples were again drawn. Analysis showed the lungs to be retaining about 25% of available triglyceride. Cholesterol concentration was unaffected. Arterial-venous differences in glycerol and free fatty acid were insignificant, suggesting no metabolism of triglyceride by lungs. The lungs apparently serve as a mechanical screen to triglyceride

ISSN:0025-7931    

DOI:10.1159/000194772

出版商:S. Karger AG    

年代:1985

数据来源: Karger