摘要:

The effect of electrical stimulation of the cut cervical vagal nerves in dogs on airway resistance and circulating catecholamine concentrations was determined before and after propranolol. Airway resistance increased after 1 min of stimulation and decreased after 9 min of stimulation. The circulating catecholamine levels increased significantly in the pulmonary artery after 1 min of stimulation. After 9 min of stimulation the increase in the femoral artery was relatively more than in the pulmonary artery. This late increase most probably represents catecholamine supply from lung structures.

ISSN:0025-7931    

DOI:10.1159/000194510

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

In the upright individual the apex of the lung receives relatively little blood. This has often been explained by the low pulmonary arterial pressure which is said to be just sufficient to raise the blood to the apex. It is believed that pulmonary arterial pressure must overcome the pressure due to gravity.This misconception overlooks the fact that the siphon principle applies to the vascular system in which the gravitational pressure of venous blood counterbalances the gravitational pressure of blood in the arteries and vice versa. Accordingly, the perfusion or driving pressure (P1-P2) between arteries and veins at any horizontal level of the lung remains unchanged, irrespective of body position.Intravascular pressure at any point is the algebraic sum of dynamic pressure causing flow (cardiogenic) and the pressure of blood due to gravity which does not cause flow. In the upright position, since the dynamic pressure in the pulmonary circuit is low, the drop in gravitational pressure at the apex of the lung reduces significantly the intravascular and, consequently, the transmural pressure in these vessels. The pulmonary microvessels being highly compliant undergo collapse and increase their resistance to flow. The reduction in apical flow is, therefore, a consequence of increased vascular resistance and not a matter of raising the blood against gravity. Gravitational pressure of blood per se neither hinders upward flow nor favors downward flow.

ISSN:0025-7931    

DOI:10.1159/000194511

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

The compliance of the respiratory system was determined at an average of 2.89 h (range 45 min – 8 h) after birth in 82 newborns who were retrospectively divided into group 1: healthy newborns (mean gestational age 37.1 weeks, range 30–41 weeks); group 2: newborns with respiratory distress (RD) needing no ventilatory support (mean gestational age 37.3 weeks, range 35–40 weeks); group 3: newborns with RD needing ventilatory support and surviving (mean gestational age 34.3 weeks, range 30 – 39 weeks), and group 4: newborns with RD who needed ventilatory support and died (mean gestational age 30’.8 weeks, range 28 – 37 weeks). Respiratory compliance was measured by the airway occlusion technique in spontaneously breathing babies and by injecting a known volume of gas into the closed airway system and measuring airway pressure in intubated babies. The difference in postnatal compliance was statistically significant (p < 0.01) in those four groups and was correlated with the severity of the disease in groups 2 and 3. In infants with RD, compliance was highly predictive for the need for ventilatory support (93% correct and 7% erroneous) and in infants with ventilatory support, for the mortality (83% correct and 17% erroneous). We conclude that postnatal compliance measurements are very useful to predict the course and outcome as well as to classify the sev

ISSN:0025-7931    

DOI:10.1159/000194512

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

12 patients suffering from severe extrathoracic tracheal stenosis mainly caused by long-term artificial ventilation were investigated by comparing their airway mechanics before and after tracheal sleeve resection and during long-term follow up. The investigations included body plethysmography, flow-volume relation, effect of bronchodilator, bronchial challenge and endoscopic estimation of the tracheal diameter. Tracheal sleeve resection in stenosis doubles the tracheal diameter from 5.9 to 11.0 mm. Resistance parameters and forced expiratory flow values reflected the significant improvement best. Airway structure remains stable during long-term follow-up, and effort-dependent parameters improve further. Compared to normal volunteers with artificially induced stenosis patients show a higher tolerability for airway narrowing. A tracheal diameter of 5 mm produces severe complaints and distinct functional distortions which are shown in specific airway resistance of 7.5 cm H2O-1•s, specific airway conductance of 0.02 cm H2O•s-1 and FEV1 of 1 l•s-1. These values are absolute indications for resection. Tracheal stenosis after long-term artificial respiration can be influenced slightly by bronchodilator therapy. Nonspecific bronchial hyperreactivity is present, suggesting increased reagibility of the bronchial smooth mu

ISSN:0025-7931    

DOI:10.1159/000194513

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

Transtracheal potential differences and sodium and chloride fluxes in the tracheal epithelium were assessed in normal and bronchitic rats. The results showed that (1) the potential difference was lower in animals with bronchitis; (2) net movement of Na+ and Cl- towards the lumen increased in bronchitis, and (3) the transtracheal potential difference in vivo and in vitro ranged from 4 to 15 mV with the lumen negative to submucosa. It is postulated that changes in the interciliary fluid layer is closely related to the net movement of ions, the number of microvilli-bearing cells and the cholinergic secreting effects of these ions.

ISSN:0025-7931    

DOI:10.1159/000194514

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

In 58 patients with chronic obstructive pulmonary disease, pulmonary gas exchange efficiency was assessed by the ratio: arterial to mixed venous PO2 difference (efficient part) versus alveolar to mixed venous POa difference (driving pressure for O2 transport). Patients with PaO2, below 75 mm Hg had a ratio lower than 50%. Patients with PaO, below 60 mm Hg had lower values for arterial to mixed venous O2 content difference and higher blood lactic acid concentration than patients with PaO2 over 60 mm Hg. Arterial to mixed venous PO2 difference decreased linearly against PaO2 till PaO2 reached 60 mm Hg from which the difference began to attenuate.These figures in PaO2 are in close agreement with the criteria for pulmonary failure presented by the Ciba guest symposium (PaO2 below 75 mm Hg) and for respiratory failure by the National Heart, Lung and Blood Institute (PaO, below 60 mm Hg).

ISSN:0025-7931    

DOI:10.1159/000194515

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

A 13-year-old boy suffering from celiac disease (CD) developed shortness of breath at exercise and episodes of malaise, fever and acute dyspnea following contact with pigeons. Lung function testing and chest X-ray suggested interstitial lung disease. Serum precipitins and a combined systemic and pulmonary reaction 4 h after challenge with an extract of pigeon droppings confirmed bird-fancier’s lung. This case exhibits two points of interest. Extrinsic allergic alveolitis was found in childhood in combination with CD and it may be considered that both these diseases are based on one common immunologic disorder; HLA-typing of the boy’s family showed that he carried HLA-DR 3 in a double dose and was therefore homozygous for HLA-DR 3. This is of some interest because extrinsic allergic alveolitis and CD are both associated with HLA-D

ISSN:0025-7931    

DOI:10.1159/000194516

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

A patient is reported with progressive pulmonary fibrosis, who suffered a spontaneous pneumothorax which resulted in an immediate relief of breathlessness. The possible pathways involved are discussed. On account of this discussion it is concluded that in this case the proprioceptive somatic pathway was the most important one. The authors are inclined to extrapolate this conclusion to all those cases of breathlessness, in which the muscles of breathing meet with a pressure volume inappropriateness.

ISSN:0025-7931    

DOI:10.1159/000194517

出版商:S. Karger AG    

年代:1982

数据来源: Karger

摘要:

The bronchodilatory effect of Neo-Biphyllin Mikroklysma® (400 mg Theophylline [T], 600 mg Diprophylline [D], 600 mg Proxyphylline [P], corresponding to 5.2 mg/kg bodyweight of T, and 7.8 mg/kg of D and P, respectively) was studied on 5 consecutive days with one daily rectal application in a double-blind crossover design in 8 patients with chronic obstructive lung disease. Serum levels following rectal application are lower than after oral administration. On the 5th day they are only slightly higher than on the 1st day. The mean serum levels (μg/ml) achieved after 2 h are 6.1 for T, 1.0 for D and 7.7 for P, after 8 h 3.5 for T, 0.9 for D and 4.8 for P. The pulmonary function parameters (FEV1, VC, RV, TLC and Raw) show an improvement, however, in comparison with placebo the results are statistically not significant. A correlation between the serum levels and the functional improvement cannot be established, even after taking into consideration the equipotency on a weight-for-weight basis according to the in vitro effect of the three compounds on the isolated guinea pig trachea [Boardman, 1980]. No side effects or local intolerance were reported. The use of the combination enema is particularly suitable for children or self-application by adults. Yet according to our findings larger doses or more frequent applications are require

ISSN:0025-7931    

DOI:10.1159/000194518

出版商:S. Karger AG    

年代:1982

数据来源: Karger

ISSN:0025-7931    

DOI:10.1159/000194519

出版商:S. Karger AG    

年代:1982

数据来源: Karger