Zeitschrift fur Erkrankungen der Atmungsorgane最新文献

The data of documentation of 267 operatively treated patients with lung cancer are shown in a retrospective study. The patients were treated in the clinic for tuberculosis and respiratory diseases of the faculty hospital Plzen. In 50% of the cases the results of histological and cytological examinations correspond with the surgical observations. Results of the pneumomediastinography and the computed tomography of the lung and mediastinum correspond with findings through the operation in 71% and 73% respectively. Through out the last three years the reliability of the cytological diagnosis was increased significantly (p less than 0.01).

It is reported about two pig-breeders with the typical symptoms of an exogen allergic alveolitis after having worked in a pigsty. The diagnosis "Pig-Breeders'-Lung" was confirmed by the prove of precipitating antibodies against pig-epidermis components (scales) and pig-serum.

The primary giant-cell tumour is a semimalignant bone tumour which occurs primarily on the epiphysis of the long tubular bones and the methaphysis. The present case report describes the bilateral occurrence of this tumour in the region of the osseous thorax. The paper also deals with diagnostic, therapeutical and prognostic problems.

Functional disorders and efficacy of treatment with a beta-2-agonist salbutamol (Ventolin), 0.225 mg/kg bodyweight, systemically given, were evaluated by infant whole-body plethysmography in 60 infants (64 data sets) with broncho-pulmonary disease belonging to three diagnostic groups: 24 survivors after respiratory distress syndrome, 21 patients with recurrent wheezing, and 15 infants with cystic fibrosis. The values of thoracic gas volume (IGV) and airway resistance (Raw) prior to the drug administration showed a scattered distribution, which was unrelated to the 3 diagnostic groups. Therefore, stratification into 4 functional groups was performed. In 25 tests (22 infants) normal lung function (TGV less than 130% pred., Raw less than 130% pred.); in 16 tests pulmonary hyperinflation (TGV greater than 130% pred., Raw less than 130% pred.); in 10 tests hyperinflation and bronchial obstruction (TGV and Raw greater than 130% pred.); and in 13 tests (12 patients) bronchial obstruction (TGV less than 130% pred; Raw greater than 130% pred.) were found. The response to beta-2-agonists was evaluated by vector analysis (circular statistics) revealing different response groups. With respect to the initial lung function abnormality and due to a stratification into different "response groups", beta adrenoreceptor agonists showed a volume-response (decrease in end-expiratory level) in 63% of infants with pulmonary hyperinflation, a flow response (improvement of airway resistance) in 54% of infants with predominantly bronchial obstruction and a mixed-response (decrease of TGV and Raw) in 70% of infants with mixed functional abnormalities, at least if the drug is given systemically. However, distinction into functional groups and its response to a sympathomimetic agent is only possible when both, changes in TGV and concomitant changes in Raw are accurately assessed.

A simple test for demonstration of smoker cells was verified on bronchoalveolar lavage (BAL) and cytological smears of lung tissue. Alveolar macrophages exhibit in 81% (BAL) respectively 86% (surgical material) of the smokers with Fettrot 7B a red colouring of the cytoplasm. Only few non-smokers show a positive reaction for smoker cells. In ex-smokers this positive reaction disappears after 7 month. We conclude, that this method is very sensitive but not absolutely specific for detecting smokers with a simple cytological test.

We compared the airway responsiveness to beta 2-agonist aerosol inhalation with two breathing techniques for bronchodilator testing in 25 patients with COPD. Open breathing technique showed better results than closed breathing technique. Causes for these results like optimization of volume and flow conditions for aerosol deposition are discussed.

As to the examination of pulmonary haemodynamics the microheartcatheterization for sounding the right ventricle and the pulmonary artery should be found more acceptance in numerous pulmological and cardiological laboratories for verifying pulmonary hypertension, in preliminary examinations for vitium cordis, in intensive medical care for the continuous registration of haemodynamic parameters or to obtain expert opinion in connection with an occupational disease. Feasible measuring technique and method are put forward for making comparable evaluations. Reference values of haemodynamic parameters at rest and during bicycle exercise in sitting and lying position and regressions calculated on oxygen consumption and on age dependence are set forth. Critical suggestions on obtaining variables are given.

The results of the investigations to reference values for Na(+)- and Cl(-)-concentrations in sweat of adults are as follows: The normal range of electrolyte values in sweat in adults is up to 70 mmol/l (Na+) and 55 mmol/l (Cl-) respectively in infants (40 mmol/l for Na+ and Cl-). There are no sex and age differences. Adults with chronical bronchitis and bronchiectasis don't show different results in comparison with healthy persons. Adults with cystic fibrosis have significantly increased sweat electrolyte concentrations (90-120 mmol/l). Variations in the electrolyte values of a day or of a month are important and much higher than the analytical one.

In an industrial region respiratory morbidity of children was studied in 3 localities with different levels of air pollution within maximal permissible concentrations (average monthly SO2 0.35 mg/m3, 0.25 mg/m3 and less than 0.15 mg/m3 and correlating concentrations of CO, NO2 and particles). It was shown that acute respiratory morbidity and prevalence of recurrent bronchitis did not correlate with SO2 level and was highest in a big city. There was however a correlation with SO2 level of bronchial asthma prevalence (3.0, 2.7 and 2.1), as well as morbidity with acute bronchitis (45.1, 23.3 and 10.6) and acute obstructive bronchitis (15.0, 5.4 and 2.4)--all figures per 1,000 children. Daily acute respiratory morbidity also did not correlate with peaks of SO2 during 3 preceding days, but acute bronchitis correlated with such peaks 2 days before (r = +0.5). Passive smoking and stove heating were significantly more frequent in families of children with respiratory complaints as compared to those without such complaints. Since these differences were more pronounced in industrial towns than in rural areas, it well may be that industrial pollutants potentiate or aggravate the effect of indoor air pollution.

Clinical observations indicate that beta-adrenergic drugs may increase bronchial reactivity in asthmatics. To find out possible reasons for this phenomenon the beta-adrenergic receptor function of isolated lymphocytes of asthmatic patients treated with clenbuterol alone or with ketotifen and clenbuterol together were studied. The cAMP levels of lymphocytes stimulated by different doses of isoproterenol were measured by radioimmunoassay and have been compared in the groups of healthies, and asthmatic patients after 3-months running of clenbuterol (Spiropent, Sandoz), as well as in the same asthmatics after one-week running of parallel administration of ketotifen and clenbuterol. There was no difference between the beta-adrenergic receptor function in asthmatic patients treated with clenbuterol alone vs. untreated healthies. Applying ketotifen and clenbuterol together the beta-adrenergic receptor function increased compared to the values obtained after application of clenbuterol alone (intraindividual-control) as well as vs. the group of healthies (control). Data presented support the view that therapeutic doses of selective beta 2-agonists do not lead to damage of the beta-adrenoceptor function. The improvement of receptor function after parallel administration of clenbuterol and ketotifen may be a consequence of the participation of ketotifen in the control of beta-adrenergic receptor system. Thus it seems unlikely that down-regulation of beta-adrenergic receptors is responsible for the beta-agonist induced bronchial hyperreactivity. That's why TXB-2 levels in the plasma of the same asthmatic patients and healthy volunteers were determined by RIA.(ABSTRACT TRUNCATED AT 250 WORDS)