Zeitschrift fur Erkrankungen der Atmungsorgane最新文献

Oscillatory measurement of resistance can get more practical relevance including the phase angle (PSI) and the volume dependence. Different findings during deep inspiration in patients with pulmonary emphysema (PSI unchanged) and with pulmonary fibrosis (PSI-Negativation) are known. To explain these findings transpulmonary pressure (Ptp) was measured parallel to PSI in 85 subjects. PSI-negativation was found in 31 of 43 patients with pulmonary fibrosis and in 10 of 19 healthy subjects. Patients with pulmonary emphysema have nearly constant or slight positive phase angles. Subjects with negativation of phase angle have significantly higher Ptp-levels at 100% TLC. This high pressure is reached by an in comparison to volume overproportional increase of pressure in the end part of the lung expansion curve. It is proposed to estimate the PSI-V-dependence in ranges from middle level of breathing to 75% of vital capacity VC and from 75% to 100% VC separately. By this modification the qualitative noninvasive assessment of lung compliance could be more efficient. Several findings indicate, that the observed secondary periodic of PSI are dependent from heart rhythm and therefore from intrathoracic blood volume.

The purpose of the study was to determine the role of lymphocyte subsets (Ly) and reactive oxygen metabolites RSM, concerning the activity of BAL cells, in the pathogenesis of lung involvement in 12 patients with systemic sclerosis (SS) and 4 with systemic lupus erythematodes (SLE) in comparison with 10 control subjects. The cellular activity was measured by means of cytofluorometry (CFM) and chemiluminescence (CL). In SS/SLEY CD3+, CD4+, CD4/CD8-ratio, CD25 + T-Ly and luminol-dependent CL are increased (p less than 0.05). Correlations exist between CD3+, CD4+, CD8+ and CD25 + T-Ly and both luminol-dependent CL and neutrophils (p less than 0.01). The results suggest, that increased secretion of RSM by BAL-cells may be caused by local release of lymphokines by these activated T-Ly. Therefore CFM and CL seem to be useful in addition to BAL cell differentiation in characterizing the BAL cell activity in the diagnostic of lung involvement in SS and SLE.

Acute effects of Trapidil (Rocornal, Deutsches Hydrierwerk Rodleben) on pulmonary hemodynamics were studied in 47 patients. A marked decrease of pulmonary artery pressure, pulmonary vascular resistance and of right ventricular stroke work at rest and during exercise in different degrees of severity of pulmonary hypertension was shown. Especially the influence on stable pulmonary hypertension is of interest, but there was no statistical significance during exercise because of the small number of patients. Considerable objective or/and subjective side effects were not noticed. Possible multifactorial mechanisms of these effects including the left ventricular function and the role of prostaglandins are discussed. The effect of trapidil is compared with other investigated pulmonary vasodilators, such as nitrates and nifedipine. Because of hitherto there are no other studies with Rocornal in patients with COPD, further acute studies and placebo controlled long term studies with monitoring of pulmonary hemodynamic are necessary. Than it will be possible to clarify the role of trapidil in therapeutical concepts of pulmonary hypertension.

It is reported about 6 patients suffering from sarcoidosis with splenomegaly. In these cases indication for splenectomy was given by symptoms of hypersplenism, abdominal pain and ineffective cortisone therapy. In general after operation activity of sarcoidosis is unchanged. Different markers of activity were used after a time interval of 2-11 years. In one case it has to be discussed an overwhelming postsplenectomy infection (OPSI).

The importance of lung diseases caused by nontuberculous mycobacteria is increased. Clinical findings in 54 patients of the former GDR and 110 patients from Hungary were investigated. Most of the patients were men in average age of 55 years. More than 80% of the patients had an exposition and disposition, for instance, pre-existing pulmonary damage, such as healed tuberculosis, chronic bronchitis or emphysema. X-ray findings are presented and discussed. Signs and symptoms of disease are very similar to the pulmonary tuberculosis.

To study the physiological response to cold air challenge, the "flow-volume-loop" method was used. Fifty-one healthies (31 males and 20 females, mean age 30 +/- 9 years) served as the subjects. Measurements were done before and subsequently 5 and 30 min after challenge. In normal subjects it were observed both an increase and decrease of the airway obstruction. All registered changes were statistically significant. The range of normal alterations of parameters as a response to the cold air challenge was calculated on the base of obtained data.