Scandinavian journal of respiratory diseases最新文献

Study of the relationship existing between in vivo and in vitro correlates of cell immunity has revealed that there is no marked correlation between the magnitude of skin induration of the tuberculin skin test and the degree of inhibition of migration of blood leukocytes stimulated by PPD in patients with newly detected, bacteriologically confirmed pulmonary tuberculosis.

The effects of oral administration of the guaiacolic ester of acetylsalicylic acid (ASA-G) on the ventilatory function were studied by means of a body plethysmograph, in a group of nine ASA-asthmatic patients. No differences in specific airway resistance were observed between ASA-G and placebo. It is concluded that ASA-G is tolerated by patients with ASA-induced asthma.

The activity of serum angiotensin converting enzyme (ACE) was repeatedly measured together with serum lysozyme (LZM) in patients with untreated sarcoidosis. Changes in the clinical picture were registered using chest X-ray, forced vital capacity (FVC), diffusing capacity for carbon monoxide (DLCO) and appearance of extrapulmonary lesions. During a clinically unchanged period the highest ACE activity and the corresponding LZM value (not the highest value) were used for the calculation. A statistically significant change in ACE was noted when a normal chest X-ray changed to a stage II lesion or vice versa, and when a signficant change in FVC occurred. All other changes were insignificant. On the other hand, statistically significant changes in ACE were found during stable periods according to chest X-ray, FVC or DLCO. ACE is frequently elevated in serum of patients with active sarcoidosis. The fluctuations in activity mostly parallel the clinical course of the disease. The behaviour and metabolism of the enzyme need further investigation. An increased concentration of serum LZM is frequent in patients with active sarcoidosis. The highest LZM values are not always seen simultaneously with the highest ACE values, indicating that they probably express different dimensions of the disturbances in the sarcoid granuloma.

Consecutive serum samples from 26 sarcoidosis patients were examined for circulating immune complex (IC) activity. Fifteen (58%) gave IC-positive reactions in a complement consumption (CC) test and a significant difference as regards anticomplementary was observed when comparing patients in clinical stages 2 and 1 respectively (P less than 0.01) The serum alpha 1-antitrypsin levels were not correlated (r=0.36) to the results of the CC-assay. The duration of IC-occurrence was studied, by two IC-assays, over 1 1/2 to 2 years. The majority of the positive reactions were registered in patients in clinical stage 2. Isolated IC was used for immunization of rabbits. Absorbed immune sera produced a single precipitate of postalbumin mobility with seven out of 36 sarcoidosis sera. In two cases a tailing of the recipitate suggested that the antigen was in complex formation. Immunoelectrophoresis indicated identity between the antigen detected in different sarcoidosis sera. No precipitates were observed using 130 sera from other patients, and screening of 100 blood donors revealed one positive reaction. The antigen, which eluted in the first protein peak on Sephadex G-200, has not been identified serologically.

Two patients suffering from rheumatoid arthritis developed respiratory symptoms during sodium aurothiomalate treatment. Chest radiographs showed bilateral diffuse pulmonary infiltrates in both cases. In one patient the symptoms subsided and the chest radiograph became normal within 6 months after gold therapy was discontinued and steroids added. In the other patient the condition resulted in an irreversible lung damage.

The mean values of serum angiotensin-converting enzyme (ACE) activities and lysozyme (LZM) concentrations measured during different phases of sarcoidosis coincided well with the clinical evaluation of the state of the disease. However, both enzymes, especially LZM, decreased before improvement was detected. Changes in these enzymes were in accord with the simultaneous clinical development in three fourths of cases. Incompatibility between clinical observations apnd LZM fluctuations was most frequently seen during active stable or inactive disease. LZM often decreased during the active stable phase and fluctuated irregularly during inactive disease. During the former phase LZM decrements possibly reflect decreasing activity of granulomatous macrophages and, in fact, precede detectable improvement. During inactive disease, on the other hand, cells were not connected with the disease process dominate LZM production. ACE changes paralleled the clinical development more often than corresponding LZM changes during stable sarcoidosis. This may have been misleading and due to a delayed reaction of serum ACE, compared with LZM, inreflecting the activity of granylomatous cells. This delayed reaction was also observed in connection with erythema nodosum. Stable ACE activity during inactive sarcoidosis indicated the usefulness of measurements when trying to predict a relapse. We conclude that ACE may be a secondary feature of sarcoidosis rather than a primary funtion of macrophage activity.

Mucociliary clearance was measured in 19 healthy non-smoking male subjects, aged between 21 and 69, by analysing the decrease in bronchial radioactivity of an aerosol of resin particles (mean diameter 7.4 +/- 1.5 micrometers) labelled with 99mTc. The mucociliary clearance was expressed as the percentage of radioactivity eliminated after 1 h. The measurements were made on two occasions with an average time lapse of 5 weeks. The intra- and inter-individual coefficients of variation were 15.6% and 41.5% respectively. The mucociliary clearance was significantly lower (P less than 0.05) (mean 21.8 +/- s.d. 7.8%) in the older subjects (greater than 54 years) than that observed (mean 34.1 +/- s.d. 14.1%) in the younger subjects (21 to 37 years). A significant negative correlation (r=-0.472, P less than 0.05) was obtained between the ages of the healthy subjects and their mucociliary clearance. However, the fact that the results varied considerably within each age group suggests that factors other than age may have an effect on the mucociliary clearance.

Pulmonary function in Behçet's syndrome has not received much attention, although sporadic cases of airways obstruction have been described. In this series of five cases one had abnormal results with reversible airways obstruction and emphysema. These findings were likely to have been associated with asthma, previous smoking habits and pulmonary tuberculosis, and not another manifestation of Behçet's syndrome.

Tablets containing 250 mg of microcrystalline theophylline were given at 6-hourly intervals for 6 days. Minimum plasma theophylline concentrations in eight patients averaged 36.6 +/- 5.4 mumol/l (1 mumol = 0.18 mg), and the corresponding maximum concentration were 81.8 +/- 10.6 mumol/l. In 11 patients, studied after a single 250 mg dose, significant improvements in PEF and FEV1 were observed, in spite of maximum concentrations averaging only 38.8 +/- 2.2 mumol/l, which is below the commonly regarded lower limits of the therapeutic range. Nine of the 11 patients complained of side effects and in three patients a reduction in dose was necessary. In four volunteers given a single dose of 250 mg the plasma concentration of theophylline were not particularly affected by whether the tablets were taken fasting or postprandial.

A case is described in which a large tumour was detected in the posterior mediastinum on a routine chest X-ray. Although the parathormone level was very high, no clinical nor radiographic signs of hyperparathyroidism were present. The tumour was removed by lateral thoracotomy and proved to be a parathyroid adenoma. Postoperatively the serum calcium returned to a normal level.