Zeitschrift fur Erkrankungen der Atmungsorgane最新文献

Branhamella catarrhalis, previously named Neisseria catarrhalis was known as a saprophytic inhabitant of the human respiratory tract. The importance as a facultative pathogen has increased during the last years. This study demonstrates the presence of B. catarrhalis in sputa and bronchial secretions of adults as well as children with bronchopulmonary diseases in a part of Berlin. From March 1989 to July 1990 in routine examinations in the bacteriological laboratory of a lung hospital 46 isolates (from 32 patients) of B. catarrhalis were identified. B. catarrhalis was found in pure culture and in mixed culture usually in association with Haemophilus sp. 75% were positive for beta-lactamase. B. catarrhalis is oxidase- and catalase positive and does not produce acidification of sugars. The strains reduce nitrate and hydrolyze tributyrin. The tributyrin hydrolysis proved to be useful for differentiation Branhamella from Neisseria.

The direct effect of the upper laparotomy on the ventilation were examined in 23 patients without and in 22 patients with preexisting disorders of breathing. During the first 3 postoperative days the parameters FVC and FEV1 were decreased for 50-20% in an inverse relation to the preexisting degree of respiratory dysfunction and the arterial PO2 decreased about 2 kPa (15 mm Hg). Clear hypoxaemia (without hypercapnia) were only found in the group with a high degree of preexisting respiratory dysfunction (FEV1 less than 1.4 l). Especially pretreatment and aftercare are recommended for this patients in the case of laparotomy.

The bronchial hyperreactivity alone does not stand for illness but it is typical of asthma. Nonspecific tests are on a low level of standardization and the results of various research groups are difficult to compare. We used the free running provocation test compared with the inhalation test of acetylcholine in a routine lung function laboratory. Using the flow-volume curve both methods were of a comparable value although not absolute equal. Running-provocation seems to be especially qualified for the ascertainment of exercise-induced bronchospasm. A preexisting obstruction more often led to a positive result with increased reaction. The MEF values on low level of FVC proved to be especially sensitive. Free-running using the flow-volume curve for evaluation of ventilation is a cheap, noninvasive, natural, and in our opinion qualified method for the estimation of nonspecific bronchial hyperreactivity.

On the basis of a questionnaire the therapy of 2285 patients with tuberculosis was evaluated for the years 1987-1989. The data of the GDR National Tuberculosis Register (9827 patients) were used for statistical comparison. 85% of the patients had a pulmonary tuberculosis, 947 patients (41% of all) excreted tubercle bacilli in the sputum. The average duration of treatment was 31.8 weeks, 94.7% of the patients were hospitalised for treatment for an average time of 12.4 weeks, the following outpatient treatment was 19.4 weeks in average. The initial phase (daily-treatment) in all cases of tuberculosis was 8.6 weeks, the follow-up phase was 23.2 weeks (all data are averages). The intermittent outpatient drug administration was made in 95% of cases under nurse control in outpatient departments. The initial treatment was started in 92.1% with 3 or 4 drugs (H/R/Z/S or E). Isoniacid and rifampicin were prescribed in 89.7% and pyrazinamide was used as a 4th drug. In the follow-up phase the combination isoniacid and rifampicin was employed intermittent in 75.7%. The delaytime for the evaluated cases was 38.8 days in average. The result of study shows, in most cases the patients were treated according to the recommendation of therapy. The clinical stay of patients is too long.

The degree of accuracy of the plethysmographic and oscillatory method in determining respiratory resistance has been examined on a mechanical lung model. At this model different levels of the resistance could be reproducibly adjusted and exactly determined with sensitive measuring instruments. The plethysmographic method allows a precise estimation of the resistance. It was found that the absolute variation of the plethysmographically measured values is not greater than 5%. The Ros pointer scale of the Siregnost FD 5 yields systematically incorrect curve diagrams. In the lower range of the resistance the measured values are to high while the measured results of the resistance become progressively to low with an increasing resistance. The reason is the Ros pointer scale which does not show the real component of the impedance at a phase angle of 0 degree. The values of the real component of the respiratory impedance (Rreal) which yields the Siemens standard set show a great coincidence with the lung model resistance (R(aw)). The coincidence could be even improved by use of electronic data processing. With a computer program developed by us it is possible for the first time to indicate and registrate consecutively individual and average values of the real component (Rrealcomp) and the reactance of the respiratory impedance as well as the phase angle between the alternating pressure delta p and the oscillating flow (V). Thereby the accuracy of measurement is improved and the long winded analysis with the "phase diagram" is not necessary anymore. Further experimental and clinical investigation have to show whether the oscillatory method in the way described above will offer new possibilities for the assessment of the pulmonary function. The phase angle and its course during the respiration cycle is in this connection of special importance as a possible new parameter.

Electrical field stimulation induces cholinergic concentrations of isolated guinea pig tracheal preparations. Glycerol trinitrate increases these contractions at concentrations ranging from 10(-5) M to 10(-6) M, whereas a concentration of 10(-4) M induces strong inhibition of these reactions.

Since 1974 in a follow-up study 54 still exposed and 29 formerly exposed workers of a carbon black producing factory (Oranienburg, FRG) were asked anamnestically and investigated clinically including lung function tests and E.C.G. Evaluating our results we did not hardly find out any important pathological findings. Considering different periods of exposition there was no fundamental yearly decrease of the ventilation values of still exposed and formerly exposed workers in comparison to the normal population. An additional pulmonary care is not to be required beside the demanded occupational medical check-up.