摘要:

In 11 normal subjects (mean age = 22.8 years) and 8 patients with pulmonary emphysema (mean age = 70.4 years), the role of chemosensitivity in determining ventilation, cardiac output, lactic acid, and cyclic AMP and GMP was evaluated quantitatively during 150 or 30 W exercise and simulated exercise. Simulated exercise was done while the subjects took a rest by regulating arterial blood gases at exercise levels in patients and at PaO2 = 65 mm Hg and PaCO2 = 48 mm Hg in normal subjects. In normal subjects, the role of arterial blood gases in determining exercise ventilation, cardiac output, cyclic AMP and GMP are large, while those contributed much less to lactic acid. In patients, PaO2 contributed only half of the exercise ventilation. It accounted for a negligibly small portion of exercise cardiac output, lactic acid, and cyclic GMP.These results indicate, by deduction, that either augmentation of chemosensitivity, pH, or humoral factors is responsible for about half of the changes of exercise ventilation in patients with pulmonary emphysema. These factors seem to influence cardiac output, lactic acid, and cyclic AMP and GMP more strongly than PaO2 alone in exercising patients

ISSN:0025-7931    

DOI:10.1159/000194352

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

The clinical significance of respiratory-system load-compensation is unknown. We have measured the responses to random presentation of single, elastic inspiratory loads in 36 subjects: 8 normal personnel (N), 9 with obesity (O), 10 with chronic renal failure under hemodialysis (H), 5 with pneumonia (P), and 4 with interstitial lung disease (CILD). We have expressed these responses as: (1) the ratio of elastance (or rigidity) of the system during loaded breathing to the elastance without loading (E’RS/ERS); (2) the ratio of tidal volume (Vτ) achieved when breathing from an inspiratory load to the Vτ predicted in the absence of load compensation (VTL/VTP); (3) the ratio of inspiratory flow rates during loaded and unloaded breaths; (4) the ratio of inspiratory time of loaded and unloaded breaths. We found E’RS/ERS in the O2 H and P groups less than that of either CILD patients or N controls (F = 6.79; p < 0.001). Passive elastance (ERg) although greater in groups·and H than in N (F = 3.88; p < 0.025) did not account for the difference in E’RS in all groups. When expressed as VTL/VTP, the response to a 37-cm H2O/1 load for groups H,·and P was less than that for N (F = 5.51; p < 0.05). Diminished inspiratory time was observed in H,·and P patients when inspiring from this load. In contrast, inspiratory flow did not differ from that of normal subjects. Nerve conduction velocity was slightly reduced or normal in the H patients. Respiratory load compensation is deficient in H,·and P patients. The mechanism, which does not involve peripheral neuropathy

ISSN:0025-7931    

DOI:10.1159/000194353

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Forced oscillatory resistance (RF0) and compliance (CF0) were measured in 3 groups of adult beagle dogs. Group I (n = 12) had undergone a left pneumonectomy at 6–10 weeks of age; group II (n = 11) underwent a similar procedure at 1 year of age; and group III (n = 8) served as unoperated controls. The mean value of RFO for group II was significantly higher than corresponding values for groups I and III. Similarly, the mean value of CFO was significantly lower for group II. Mean values for RFO and CFO between groups I and III were not statistically different. When RFO and CFO were normalized by functional residual capacity, mean values for all three groups were similar. However, when RFO and CFO were normalized by body weight, mean values for groups I and II were significantly different from those of group III. These findings cannot be explained directly by postoperative hyperinflation of the remaining lung. They suggest that there is an adaptive change in the mechanical characteristics of the remaining lung following pneumonectomy and that the degree of adaptation varies with the age of the animal undergoing resecti

ISSN:0025-7931    

DOI:10.1159/000194354

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

The hemodynamic adaptation during exercise was evaluated in 19 patients suffering from chronic obstructive lung disease. They were divided into two groups according to cardiac size on the X-ray (group 1, small; group 2, normal). A small cardio-thoracic ratio could be correlated with ‘emphysema’ assessed on the basis of hyperinflation and a low transfer test for CO. No clear-cut difference could be found between the two groups concerning the hemodynamic data at rest or during exercise. However, for all subjects, the cardiac output was found to be slightly related to the cardiac size (smaller cardiac output for smaller cardiac size). During exercise, a low cardiac output was characterized by a low oxygen transport and a high level of lactate. From this it is suggested that a small cardiac size, a classical feature of hyperinflation and emphysema, may lead to a low cardiac output. The explanation for these results is speculative, but variable hemodynamic profiles in chronic obstructive lung disease with or without hyperinflation may be related to the morphology of the cardiac chambers and to variable intrathoracic pressure regimes during respirat

ISSN:0025-7931    

DOI:10.1159/000194355

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

16 patients suffering from a hyperventilation syndrome were treated with metoprolol 2dd 100 mg and an identical placebo in a double-blind, cross-over trial. Before therapy and after metoprolol and placebo therapy a ventilatory response to CO2 was taken, VC and FEV1 a hyperventilation provocation test, blood gas values, and the subjective experiences of the patients were documented. The ventilatory response to CO2 was described in terms of decrease or increase of ventilation: before therapy ventilation decreased in 10 out of 16 patients, after metoprolol ventilation decreased in 3 of 16 patients (p < 0.01). The end tidal Pco2 increased with a mean of 3.86 mm Hg (p = 0.0005) after metoprolol as compared to placebo. No differences were found in respiratory frequency or depth, base excess, provocation test. It is concluded that the cardioselective beta-blocker metoprolol is a useful drug in the therapy of the hyperventilation syndrome

ISSN:0025-7931    

DOI:10.1159/000194356

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

51 male patients with mild degree chronic airway obstruction underwent detailed evaluation of pulmonary function tests, blood gas analysis and exercise tolerance test before and after a short-term therapy. The patients were randomly assigned to medical therapy alone or to medical and rehabilitative therapy. 23 patients treated with medical and rehabilitative therapy showed a significant decrease of respiratory rate and PaCO2 and a significant increase of TV, FEV1.0, FEV0.75×4.0, paO2, SaO2 and exercise tolerance after a month of therapy. 28 patients treated with medical therapy alone showed a significant increase of VC and FEV0.75x4.0. These data suggest that rehabilitative therapy is a valid adjunct to medical therapy in the short-term treatment of chronic airway obstruction

ISSN:0025-7931    

DOI:10.1159/000194357

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

We have studied the ability of four H1 antihistamines, ketotifen, oxatomide, clemastine and promethazine, and of disodium cromoglycate (DSCG) to inhibit in vitro histamine release mediated by antigen from passively sensitized human lung and from basophilic leukocytes. Anaphylactic histamine release from human leukocytes is inhibited in a comparable fashion by oxatomide, clemastine and promethazine at concentrations just below those inducing histamine release in the absence of antigen. Ketotifen causes a significantly weaker inhibition without inducing histamine release and DSCG is not at all active in this model. On human lung, oxatomide, clemastine and promethazine give a strong and similar inhibition which is linearly related to the dose. Ketotifen markedly differs in this respect, inhibiting according to a bell-shaped dose-response curve and at concentrations closely comparable to that of DSCG. Thus, we confirm that H1 blockers, such as clemastine and promethazine, inhibit anaphylactic histamine release from baso-phils and human lung but only at high concentrations which may be cytoioxic. Oxatomide behaves very much like these antihistamines. Ketotifen, on the other hand, gives in both models a different pattern of inhibition, closely mimicking that of DSCG. This suggests that the antianaphylactic activity of ketotifen is not related to its H1 blocker properties and that this effect may be relevant to its therapeutic activity

ISSN:0025-7931    

DOI:10.1159/000194358

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

Lung function was studied in 10 patients with Crohn’s disease during and after an attack of the disease. Pulmonary volumes and lung transfer factor were not impaired but functional residual capacity was greater during the attack than during remission; it was also greater than in normal subjects. FRC values and disease activity decreased concomitantly during remission as well as finger clubbing. The etiology of this impairment was unknow

ISSN:0025-7931    

DOI:10.1159/000194359

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

The incidence of pulmonary emphysema in patients with alpha-1-antitrypsin (α-1-AT) deficiency associated with the protease inhibitor (Pi) phenotype ZZ is increased. To determine wheter less severe deficiency states of α-1-AT (i.e. Pi phenotypes other than ZZ and MM) might predispose to the development of pulmonary disease, Pi phenotypes were determined in a group of patients in whom the incidence of chronic pulmonary disease is high. The proportion of 52 patients with Sjögren’s syndrome who had Pi phenotypes other than ZZ and MM was not significantly greater than that for populations of normal subjects. Mean values for tests of pulmonary function, including estimates of both restrictive lung disease and airway obstruction in patients with the MM phenotype were not significantly different from corresponding means for patients with non-MM phenotypes. These findings suggest that the increased susceptibility of patients with Sjögren’s syndrome to develop chronic obstructive pulmonary disease is not attributable to an abnormally high frequency of non-MM phenotypes and associated moderately reduced serum levels o

ISSN:0025-7931    

DOI:10.1159/000194360

出版商:S. Karger AG    

年代:1981

数据来源: Karger

摘要:

This is a report of a case in which multiple primary malignancies involving the larynx and the lung were initially suspected by means of cytologic examination of sputum specimens and bronchial aspirate. Such multiple cancers, once considered to be highly unusual, are now being reported with increasing frequency. It is emphasized that when two distinct cellular morphologies are present on cytologic smears, the possibility of multiple primary cancer could be considered.

ISSN:0025-7931    

DOI:10.1159/000194361

出版商:S. Karger AG    

年代:1981

数据来源: Karger