European journal of respiratory diseases. Supplement最新文献

The in vitro effects of different pure proteins: IgA, IgM and human airway lysozyme (HAL) on rheological and transport properties of airway secretions from patients with chronic bronchitis, were studied. The proteins were added to the reconstituted sputum samples in concentrations within the range present in sputa (IgA: 4% HAL: 1% and IgM: 0.5%). A significant (p less than 0.05) positive increase in apparent viscosity and in elastic modulus was observed after adding IgA or HAL. This suggests that these two secretory proteins contribute to the viscoelastic properties of airway secretions and may act as restructuring molecules. After protein overload of the sputum samples, opposite changes in mucociliary transport rate were observed according to whether the initial values of protein concentration and rheology were abnormally low or high. These results suggest that, as for mucus rheology, there is an intermediate range of IgA and HAL optimal for mucociliary transport rate.

An infra-red thermometer has been used to monitor the surface temperature of double-sided surfactant films and excised sections of rabbit lung parenchymal tissue as their areas are changed by 2:1. The temperature fell upon expansion by 5.43 degrees C for the films and by 2.42 degrees C for the tissue secretions and rose upon compression. Upon removal of surfactant from the tissue sections, temperature changed in the opposite direction. The thermodynamic significance of these findings is discussed as providing a basis by which waste metabolic heat might be re-used in the lungs to provide the "engine" phenomenon previously deduced (1) on the basis of the inversion of the hysteresis between surface tension and area. This contribution to the work of breathing from a surface engine could be vital when there is a delicate balance between work demand and work supply for breathing in certain pathological states, e.g. with RDS.

Chronic obstructive bronchitis and emphysema are two chronic lung diseases closely associated with cigarette smoking. Early pathological changes in the lung in asymptomatic smokers affect the alveoli and bronchioli, sites where surfactant production is centred. Bronchial lavage work has demonstrated a reduction of 'free' extra-cellular surfactant in smokers. In this report the interaction between the 'tar' of tobacco smoke and surfactant is described from in vitro studies. Also using an isolated rat lung model tobacco smoke 'tar' appears to increase lung compliance. These observations may help explain why young asymptomatic cigarette smokers have increased lung compliance and suggest the way in which 'tar' interacts with the lung surface.

This study was based on data provided by 9,483 farmers from a larger sample of 12,056 Finnish farmers. The data were gathered in two postal surveys (with a 3-year interval between surveys) conducted by the Social Insurance Institution of Finland. When age, sex, atopy, and smoking habits were controlled, neither the family structure nor the level of vocational education significantly affected the occurrence of either chronic bronchitis or farmer's lung. The prevalence of farmer's lung was smallest on farms with the largest area under cultivation; the difference in prevalence between the area categories was statistically significant. An opposite trend, although not statistically significant, was present in the incidence rate of but not in the prevalence of chronic bronchitis. The incidence of farmer's lung was largest (p less than 0.05) on the farms with the most intensive cattle raising. Other chronic diseases occurred more often among farmers with chronic bronchitis or farmer's lung than among farmers without respiratory symptoms. Our results imply that factors associated with farm work may be more involved in the occurrence of chronic bronchitis or farmer's lung among farmers, than the socioeconomic background per se.

Prevalence and incidence of chronic bronchitis and farmer's lung in the Finnish farming population were studied by cross-sectional and follow-up surveys of 12,056 farmers. Occurrence of both these diseases varied greatly according to geographical location of the farm. The incidence of chronic bronchitis (2,687 new cases annually per 100,000 farmers) was twice as large in southwestern as in northern Finland. Chronic bronchitis was more common among farmers in livestock production than among those in grain production. The definition of farmer's lung adopted confined the occurrence of the disease among farmers engaged in animal tending. In livestock production, chronic bronchitis was strongly associated with swine tending, but farmer's lung with both cattle and swine tending. Use of a harvester with a sack loader turned out to be characteristic of the chronic bronchitis cases, and the number of new cases was largest among farmers who used a batch type cell drier. The farmers with grain driers that use unheated air most frequently suffered from farmer's lung. Of all (147) the characteristics of farming occupation analyzed, the methods of grain handling and drying were the most important factors for predisposing farmers to chronic bronchitis and farmer's lung.

High-dose etoposide (1.0-1.5 g/m2) was given to 17 small cell lung cancer (SCLC) patients with metastases in the central nervous system. In 4 out of 9 evaluable patients with brain metastases and 4 out of 5 patients with meningeal carcinomatosis a response was seen. In all patients severe myelosuppression was observed. Three patients died of septicemia during the aplastic phase. Despite severe toxicity high-dose etoposide is potentially useful for CNS metastases of SCLC.

Atopic sensitization was studied using skin tests on 93 randomly selected, non-smoking dairy farmers. The farmers lived in the municipality of Pielavesi, in eastern Finland. The reference group consisted of 84 non-smoking teachers randomly selected from all the teachers employed by the city of Kuopio, which is in the same administrative district as Pielavesi. Thirty-four allergens were included in the test panel. For testing these allergens, we used the prick technique with disposable precision lancets. The prevalence of a positive skin-test reaction (weal size at least 3 mm X 3 mm) was 19.4% among the farmers and 15.5% among the teachers. The number of positive reactions to cow epithelium was significantly greater among farmers than among teachers. Only to mugwort pollen did teachers have significantly more positive reactions than farmers. Teachers had stronger reactions than farmers to cat, dog, and horse epithelium. Farmers had significantly stronger reactions than teachers to cow epithelium and oat pollen. Our results emphasize the importance of cow epithelium and oat pollen as occupational sources of allergens among dairy farmers.

A chromosome analysis of three cell lines derived from SCLC showed deletions of the short arm of chromosome 3 with bands p21-p23 as the shortest region of overlap. Hybridization of a polymorphic 3p21 probe to DNA from leukocytes of seven SCLC patients revealed heterozygosity for two of them. In the tumours of both these patients the probe detected homozygosity. This suggests the presence of a mutant cancer gene in the short arm of chromosome 3 which might express itself and/or activate some oncogene(s) after deletion of a suppressing normal allele. Amplification of the oncogene C-MYC was found in four cell lines including the ones cytogenetically analyzed. Amplification of C-MYC, though to a lesser degree, was also found in an available pleural effusate from which one of these lines had been established. As shown by in situ hybridization, the amplified oncogene was present in double minutes in three of the cell lines. In the remaining line it was in a homogeneously staining chromosome region. All patients from whom cell lines with C-MYC amplification were obtained had a negative response to chemotherapy. The observed correlation between amplification of C-MYC, occurrence of so-called variant type SCLC-derived cell lines, and negative response to chemotherapy indicates that a genome analysis of SCLC might provide further criteria for the characterization and subdivision of this highly malignant cancer and thereby a base for an optimal selection of therapy for distinct cases of SCLC.