European journal of respiratory diseases. Supplement最新文献

Nasal fluid is a heterogeneous substance. It consists largely of a secretory product derived from the 100,000 small seromucous glands. The anterior part of the nose has a relatively high secretory capacity, but this does not seem to be caused by secretion from the 200 anterior serous glands. Compared to sputum, nasal secretion has a lower viscosity, but comparable spinability; it has a lower dry weight, and content of sulphate, sugars and most proteins, but a comparable level of albumin. Watery rhinorrhoea is mainly reflex-mediated. Watery, but not purulent nasal discharge can be reduced by the cholinoceptor antagonist, ipratropium, administered in a dose which matches the degree of the symptoms. It seems likely that the nose, in some respects, can serve as a model for the analysis of airway secretions, but a comparative study of nasal and of bronchial secretions sampled in an identical way is warranted.

Increased pulmonary proteolytic (elastolytic) activity is thought to be the primary cause of emphysema and may also play a rôle in the pathology of bronchitis. These diseases are common amongst tobacco smokers. Serum-derived alpha 1-proteinase inhibitor (alpha 1PI) and locally produced protease inhibitors normally protect the pulmonary epithelium from proteolytic attack, but tobacco smoke can inactivate these antiproteases by oxidative and non-oxidative mechanisms. Bronchoalveolar lavage fluid (BALF) samples lung surface components and most studies show that there is elevated elastolytic activity in smokers' BALF. Whether antiproteolytic capacity is reduced in these samples remains debatable. A selective lavage technique is described which independently samples central and peripheral epithelium from the same subject. Analysis demonstrates a protease-antiprotease imbalance which can differ in central and peripheral lavage and which could be significant in the development of obstructive airways disease. Therapeutic approaches include augmenting antiprotease potential using genetically engineered, oxidant-resistant alpha 1PI or synthetic peptide inhibitors.

Adult Respiratory Distress Syndrome is a catastrophic disease which is characterized by tachypnoea, arterial hypoxemia, reduced pulmonary compliance, and diffuse alveolar infiltrates. The pathology is that of diffuse alveolar damage which includes injury to both endothelial cells and type I epithelial cells. The major physiological abnormality is reduced pulmonary compliance. The available data indicate that one of the causes for the reduced compliance is altered surface tension in the distal airspaces. Pulmonary surface material isolated from patients with Adult Respiratory Distress Syndrome has an altered phospholipid composition. Part of the current therapy is to overcome the reduced compliance by mechanical ventilation while allowing the lung time to heal. In the future, exogenous surfactant may also be used as part of the therapy in selected severely ill patients.

A postal survey was used to investigate the characteristics of farmers who have acquired dust respirators. In 1979 about a quarter of the farmers were using dust respirators, men more often than women. The more vocational training the farmer had and the larger the area of land under cultivation the more likely he was to own a dust respirator. Grain producers had purchased the protective devices more frequently than other farmers had. Farmers who participated in the occupational health intervention during 1980-82 had acquired dust respirators considerably more often than those in the control group. In the intervention group men under 30 years had most frequently purchased the dust respirators. Participation in the intervention influenced the acquisition of dust respirators more than did occurrence of symptoms of chronic bronchitis or farmer's lung.

Monoclonal antibody based immunohistochemistry is a very powerful tool for the establishment of a pathological diagnosis of lung cancer. Applying a panel of intermediate filament antisera and an antibody recognizing neuroendocrine differentiation we have tested about 240 human lung tumors and 15 human lung tumor cell lines. Our results can be summarized as follows: a differential diagnosis between neuroendocrine and non-neuroendocrine lung tumors can be obtained by the application of the monoclonal antibody MOC-1 directed against neuroendocrine antigens. Immunohistochemistry can lead to a better recognition of lung tumor heterogeneity within the established histologies. Examples of this phenomenon are: the presence of neuroendocrine and/or neural components within non-neuroendocrine tumors. The presence of squamous cell or adenocarcinomatous differentiation in non-SCLC can be detected by chain specific anti-cytokeratin antibodies. The degree of differentiation towards the variant type within SCLC can be detected by the monoclonal antibody directed against neurofilaments. lung cancer cell lines can serve as an in vitro model for immunohistochemical studies on different lung cancer subtypes.

Occurrence of storage mites was studied in cow houses and hay stores on 19 farms, most of which were located in eastern Finland. On two farms we did a monthly follow-up. Mites were extracted from hay by sieving, using the so-called "water trap" and for longitudinal analysis, with a warm extractor. The mites isolated in the water trap were identified under a microscope. Contrary to previous Finnish findings, there apparently were more mites in cow houses than in hay stores. In cow houses there were an average of 1,650 mites per gram of dust and in hay stores about 1,100 mites per gram of dust. Acarus siro was most abundant in cow houses (67% of all the mites found in cow houses) and more than 1,000 mites/g of sample material. The second most numerous was Tydeus spp. (178 mites/g of sample material). After that, Lepidoglyphus destructor, Tyrophagus longior, Glycyphagus domesticus occurred in about equal numbers. In hay stores Tydeus spp. was slightly more common (341 mites/g of sample material) than Acarus siro (317 mites/g of sample material). Lepidoglyphus destructor (64 mites/g of sample material), Glycyphagus domesticus (60 mites/g of sample material) and Mesostigmata (57 mites/g of dust) occurred in about equal numbers. According to the analysis based on one farm the number of mites in hay stores decreased considerably from September to February. Based on four measurements in the cow house of another farm, however, no steady trend of longitudinal variation could be found. Mites were most abundant at the beginning of January. There were few or no mites in bales of dry and unmoulded hay.