Scandinavian journal of respiratory diseases最新文献

The effect of coughing on the elimination of inhaled 6 micrometer radioactively tagged teflon particles in humans was studied by external measurements of the radioactivity retained in the lungs before and after 1--2 min of voluntary coughing. In six healthy subjects coughing produced no substantial elimination of the particles. Six out of eight patients with lung disease produced expectorate and also eliminated particles from the lungs by coughing. The other two patients had no phlegm, did not produce any expectorate and did not eliminate particles by coughing. An increased amount of tracheobronchial secretion thus seems to be necessary for coughing to be effective. In the patients, the elimination of particles by coughing was fairly reproducible, suggesting that the test model may be useful for investigation of the influence of physiological and pharmacological factors on the elimination process.

The concentration of immunoglobulins, lactoferrin and lysozyme we compared in bronchial secretions obtained from children with various chronic lung diseases. The IgG, lactoferrin and lysozyme, but not secretory IgA, concentrations were shown to be increased during chronic inflammatory response.

In this double blind study, 10 patients with bronchial asthma underwent exercise challenge on five occasions. The first of these was a control test carried out without prior drug administration; the other tests were preceded by the administration, in random order, of a sodium cromoglycate (SCG) capsule, a placebo capsule, an ampoule of sodium cromoglycate solution, and a placebo ampoule. Comparisons of the largest falls in PEFR after exercise showed statistically significant inhibition of exercise-induced bronchospasm, compared with control, with both SCG inhalation solution (P less than 0.01) and SCG powder (P less than 0.01). SCG powder was more active, but the difference was not significant. A significant difference in protection was found between SCG powder and its placebo (P less than 0.01). SCG inhalation solution was also more effective than its placebo, but the difference did not reach significance, since the latter conferred some protection.

A specific and quantitative immunological method for the determination of human erythrocyte carbonic anhydrase (HCA) isoenzyme B has been used to determine the contents of enzyme in the erythrocytes from healthy persons and from subjects with chronic obstructive lung disease. The investigations have shown a statistically significant increase of HCA type B in the erythrocytes of subjects suffering from chronic obstructive lung disease and hypercapnia. Subjects with chronic obstructive lung disease and normal PaCO2 showed no difference from normal subjects. No correlation was found between PaCO2 and human erythrocyte carbonic anhydrase.

Cardiac output, using dye-dilution technique, and intra-arterial blood pressure at rest and during exercise on a bicycle ergometer were determined in six boys with bronchial asthma, mean age 11.9 years. Intra-arterial blood pressure was also measured in another group of eight boys with bronchial asthma. Cardiac output, stroke volume, arteriovenous oxygen difference, blood pressure and total peripheral vascular resistance at rest and during exercise up to maximal level were within the normal limits of healthy boys of the same age. At maximal exercise, cardiac output averaged 12.4 l/min, stroke volume 66 ml, systolic, diastolic and mean blood pressures 128, 81 and 107 mmHg, respectively, and total peripheral vascular resistance 10.9 mmHg/l/min. The maximal arteriovenous oxygen difference amounted to 14.1 ml/100 ml blood which is similar to that in healthy adults.

The blood volume and arterial blood gases of 18 patients with chronic obstructive lung disease were studied over a period of 1/2 to 5 years, including 35 acute exacerbations of the lung disease. Treatment during exacerbation was directed at infection, bronchial obstruction and hypervolemia. Long-term diuretic therapy was instituted during the follow-up period. On admission all patients suffered from severe dyspnoea, all but two had signs of peripheral oedema and/or liver congestion and one-third had increased jugular venous pressure. Blood volume was increased in all patients and eight of them had a hematocrit above 50%. PaCO2 was severely reduced and PaCO2 increased on admission. At discharge, these symptoms and signs had all diminished or disappeared. Blood volume had fallen an average of 11 and a further reduction of 0.41 was noticed during the follow-up period. Blood gases had improved by discharge and a further improvement accompanied the reduction of blood volume during the follow-up period. It is suggested that 1) hypervolemia is common in patients with advanced chronic obstructive lung disease; 2) hypervolemia may impair arterial oxygenation; 3) long-term diuretic therapy seems to be necessary for maintaining a normal blood volume.

A method is described for correlative radiological and pathological studies of the lung post mortem, including radiography after air inflation, fixation with formalin-polyethylene glycol-alcohol solution, air drying and systematic histological sampling of lung tissue. For morphometric studies the total lung capacity during life is determined from radiograms and compared with the volume of the excised lung after fixation. The method is simple, relatively inexpensive, and with some experience gives good results both in radiography and histology. With this method the test lungs seemed to assume during fixation a fairly constant volume, a little higher than functional residual capacity.

A case of sarcoidosis of the stomach in a 76-year-old woman is described. Fiberoptic gastroscopy and roengenograms presented the appearance of an infiltrating carcinoma. It was possible to follow the spontaneous behaviour or roentgenograms during a period of 4 years. A preceding, spontaneously remitted lesion of the lungs is described, and the lack of parallelism between the two lesions is discussed. The case is seen in the light of other cases described in the literature, and the difficulties concerning the differential diagnosis are discussed.

A case report is presented of a 50-year-old man with severe haemoptysis. The exact source of the bleeding was not known and medical treatment had no effect. Selective angiography of the bronchial arteries showed extravasation of the contrast medium into a bronchus. Embolisation of the bleeding bronchial artery caused the haemoptysis to stop immediately.

A pneumopericardium was seen in a 25-year-old man each time he developed a right-sided pneumothorax. The chest roentgenograms were suggestive of a pleuropericardial defect. This was confirmed by subsequent thoracotomy.