ISSN:0025-7931    

DOI:10.1159/000195960

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

We examined the roles of enzymes from mast cells and from neutrophils in stimulating airway submucosal gland secretion. To avoid effects on surface epithelial cells and goblet cells, we studied a line of cultured bovine tracheal gland serous cells. We discovered that mast cell chymase and neutrophil elastase are the most potent secretagogues of airway submucosal glands described. Mast cell chymase markedly stimulated serous cell secretion in a concentration-dependent fashion with a threshold of 10-10M, whereas tryptase had no effect. The response to 10-8M 10-10M. Elastase was more potent than cathepsin G, causing a maximal secretory response of 1,810 ± 60% over baseline at 10-8M. Secretion by the 3 proteases was noncytotoxic and required catalytically active enzymes. These findings suggest a potential role for neutrophil and mast cell proteases in the pathogenesis of increased and abnormal submucosal gland secretions in diseases associated with inflammation of the airwa

ISSN:0025-7931    

DOI:10.1159/000195961

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Although a quite precise clinical definition was given to the term ‘chronic bronchitis’ in the early sixties, the terminology related to nonasthmatic, nonemphysematous obstructive airway disease remains a continuous source of confusion, as indicated by a recent international survey. Although histological studies point to the presence of widespread bronchial inflammation in this condition, preference should be given to simple and descriptive terminology in which the presence of airflow limitation is clearly and predominantly indicated, since it mostly affects prognosis. There would be no need to redefine ‘chronic bronchitis’, but simply replacing it by ‘chronic mucus hypersecretion’, to which it actually refers, would be the preferr

ISSN:0025-7931    

DOI:10.1159/000195962

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The aim of this study was to determine the effects of captopril combined with oxygen therapy on pulmonary hemodynamics and gas exchange in chronic obstructive pulmonary disease (COPD) patients with pulmonary hypertension. Eleven subjects, with severe airflow obstruction (FEV1/FVC: 42 ± 11%) and chronic respiratory failure (PaO2: 54 ± 6 mm Hg, PaCO2:46 ± 8 mm Hg) treated with long-term oxygen, underwent two successive hemodynamic and arterial gas studies, at rest and during exercise. All the studies were performed whilst the patients were breathing oxygen, at rest and during exercise and 1 h after intake of 12.5 mg of captopril. The second study was performed in 9 out of the 11 patients after 8 weeks of treatment with 12.5 mg captopril 3 times daily. At rest, there was no significant effect of captopril. Mean pulmonary arterial pressure (PAP) showed a trend towards decrease after 8 weeks treatment. During exercise, there was a statistically significant decrease of mean PAP, pulmonary capillary wedge pressure and total pulmonary vascular resistance, without any deleterious effect on blood gases. However, the clinical significance of these variations during exercise is poor. We conclude that a low dose of captopril associated with oxygen therapy has no significant clinical effect on pulmonary hemodynamics at rest and during exercise in C

ISSN:0025-7931    

DOI:10.1159/000195888

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Among the risk factors for chronic bronchitis and chronic obstructive lung disease, only smoking and α1-antitrypsin deficiency effects have been well demonstrated. Other factors, as air pollution, occupational exposure and childhood lung diseases may have an influence, but on a lower scale. The prevention of chronic bronchitis and chronic obstructive lung disease remains mainly based on antismoking programs

ISSN:0025-7931    

DOI:10.1159/000195963

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The lungs possess several mechanisms for cleansing themselves from locally produced biological debris and inhaled, deposited soluble and insoluble materials. Insoluble particles deposited on the conducting, ciliated airways will be primarily removed by mucociliary clearance, over a period of several hours, with cough acting as a back-up clearance mechanism. Insoluble particles deposited in the non-ciliated, alveolated regions of the lungs will be cleared primarily by the macrophages very slowly, with a biological half-life of several months. Soluble substances can pass through paracellular pathways and be cleared via the blood stream.

ISSN:0025-7931    

DOI:10.1159/000195964

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

An analysis of the risk factors for pertussis and the possible respiratory sequels was carried out in a sample of 499 children and adolescents aged 10–16 years from the general population in north-eastern France. 44 subjects (8.8%) had pertussis during childhood; and the sex ratio was 1 in these cases. Pertussis was significantly associated with a maternal history of respiratory disease, residence in a rural area and coal heating. In a multiple logistic regression model, a maternal history of respiratory disease was the only significant factor (p = 0.01), the number of siblings being of borderline significance (p = 0.06). No increase in respiratory symptoms or asthma prevalence was found in our subjects who had pertussis during childho

ISSN:0025-7931    

DOI:10.1159/000195889

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

To determine the importance of airway inflammation for exacerbation and prognosis of asthma induced by toluene diisocyanate (TDI), we first examined sensitized subjects during asthmatic reactions induced by exposure to TDI in the laboratory. We observed that late and dual, but not early, asthmatic reactions induced by TDI are accompanied by a transient increase of airway responsiveness, bronchoalveolar neutrophilia followed by eosinophilia and by an increase of LTB4 and albumin in bronchoalveolar lavage fluid. All these effects were prevented by pretreatment with prednisone. In addition, we examined the lung pathology of 1 sensitized subject who died after exposure at work. The pathologic features of fatal asthma induced by TDI and of chronic asthma induced by TDI suggest the importance of inflammation for the exacerbation and prognosis of the disease

ISSN:0025-7931    

DOI:10.1159/000195965

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

To characterize asthma emergencies, all patients attending the hospital because of an asthma attack in 1 year were studied. Of the 212 patients concerned, 148 attended the hospital once, 34 twice and 30 three times or more. The total number of visits was 351. The mean age of the patients was 50 (15–85) years, and 32% of those under 65 years were receiving a pension because of asthma. Eleven patients (5%) had drinking problems, and 62 (29%) had treatment for other diseases. Atopy was diagnosed in 83 patients (39%). Of the patients with one, two or more numerous visits 39, 74 and 90%, respectively, were taking oral steroids, whereas the corresponding figures for those using inhaled steroids were 34, 71 and 61%. Medical treatment seemed to be inadequate more often among the frequent visitors. Seasonal variation in visits was evident, the rates being lowest in July and highest in March. Time-of-day variation was also found, visits being most common from 10 to 11 a

ISSN:0025-7931    

DOI:10.1159/000195890

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The last decade has seen lung and heart-lung transplantation move from experimental procedures to clinical treatments. Innovative surgical techniques combined with the use of ciclosporin as an immunosuppressive agent have enabled successful transplantation in a wide range of end-stage lung diseases. Exclusion criteria for selecting recipients have relaxed, and improved preservation techniques have facilitated distant donor organ procurement and decreased peri-operative mortality. A range of techniques for the physiological monitoring of the graft as well as diagnosis of major complications such as rejection and opportunistic infection have been introduced. Obliterative bronchiolitis remains a major challenge to the immunologist and to the chest physician in terms of etiology, pathogenesis and treatment. As survival rates improve with improved management, lung and heart-lung transplantations are contributing towards effective treatment of end-stage pulmonary disease as well as providing new insight into pulmonary physiology and into mechanisms of lung disease

ISSN:0025-7931    

DOI:10.1159/000195966

出版商:S. Karger AG    

年代:1991

数据来源: Karger