Zeitschrift fur Erkrankungen der Atmungsorgane最新文献

About a rare benign tumor of the lung of a fifty-nine years old woman is reported. The possible relation to the group of the pulmonary hamartomas is discussed. The tumor was benoted as "Benign angiohamartomatous tumor".

An epidemiological study was performed in the county of Erfurt including all lung cancer patients of the years 1963, 1968, and 1972 to 1977, together 2,585 males and 358 females. The following results were found: 1. The incidence of lung cancer increased significantly from 1963 to 1977. 2. About 60% of all lung cancer patients were younger than 70 years. 3. In male patients squamous cell carcinomas prevailed with 44.8%. Small cell cancers came up to 34.6% and adenocarcinomas to 10.1%. Large cell cancers reached 10.5%. These types in female patients had a proportion to each other like 26.9%: 30.8%: 30.4%: 11.9%. The proportion of adenocarcinomas increased significantly during 1963 to 1977. 4. We found a non significant age relation of histological types. The adenocarcinoma and the small cell cancers dropped with rising age. 5. The classification of histological types and the conditions of detection of lung cancers did not change in the study interval. Therefore the altering of patterns of histological types, especially the increase of adenocarcinomas was attached to the beginning of cigarette smoking in younger ages and the increasing proportion of filter tipped brands as well to a variation of exposition against professional cancerogens. 6. Patients with adenocarcinomas have the highest survival rate after 5 years: 8.1%. Squamous cell lung cancer patients have a 5 year survival rate of 6.8%. Patients with small cell cancers and large cell cancers ranged at 2.7% or 2.6%. 7. Peripheral tumors of each histological type will be detected earlier by fluorographic screening than central carcinomas. Therefore the 5 year survival rates of peripheral cancers always are more favourable than that of central cancers. 8. For the problems in exact typing and staging we propose an internationally adjusted definition of tumor localization as a third parameter for prognosis.

Starting from diagnostic relevance of non specific bronchial challenges the principles and experiences of a screening type acetylcholine test which is recommended as a standard in GDR since 1974 are discussed. For special tasks like longitudinal studies and clinical pharmacology a threshold method using histamine was derived and modified from literature. Special attention is paid to diagnostic, prognostic and expertizing relevance of non specific bronchial hyperreactivity.

Evaluations of lung function parameters were carried out in underground miners with outstanding exposition to diesel exhaust by diesel-driven machines. Data obtained over a three year period were compared with the results of a non-exposed population. There were no differences between both groups following to the influence of diesel exhaust.

360 volunteers were recruited for the investigation from a homologous collective. 174 were immunized parenterally with "Influmun" from SSW Dresden, GDR. 176 volunteers were immunized twice orally with an interval of 60 days with an influenza vaccine inactivated by x-ray using enteric-coated capsules. In an interval of six months ARI-symptoms were investigated. Between 13th and 17th week 1988 an increased ARI-morbidity in the Greifswald-region was observed in which influenza A viruses were involved. In comparison with 312 non-immunized persons of the same age, sex and living area the immunized volunteers of the two groups showed 83.4% less sickness days. 30 persons of the non-immunized group got ill for totally 217 days, whereas only nine persons of the two immunized groups were put on the sicklist for totally 36 days. No significant differences concerning the occurrence and duration of acute respiratory infections (ARI) between the two differently immunized groups could be observed.

In a multicentric trial 350 persons (19-24 years) were immunized with influenza vaccines containing the following virus antigens: A/Singapore/6/86, (H1N1); A/Mississippi/1/85, (H3N2); B/Ann Arbor/1/86. 174 received an i.m. injection of 0.5 ml "Influmun" vaccine from SSW Dresden/GDR. 176 persons were immunized twice within 60 days with enteric-wated capsules each containing approximately 60 micrograms hemagglutinin of all three virus strains. The volunteers were clinically observed in an interval of 6 months. The majority of orally immunized persons with low pre-immunization titers responded with fourfold or higher IgA antibody titer rises in nasal secretions, but no significant IgG antibody titer increase in sera could be observed. Secretory antibody titers remained elevated for 2 to 4 months. Parenterally immunized persons showed antibody titer rises in sera but not in nasal secretions. In both groups the highest antibody titer increases were observed after application of the A/Singapore/6/86 virus antigen. Volunteers with high pre-immunization titer did not show an antibody increase neither after parenteral nor oral immunization.

Reported are the results of cytostatic treatment in 32 patients with inoperable metastasized small cell bronchogenic carcinoma. With regard to the therapeutic effects 3 groups (A: limited disease, stage I-IIIa; B: extensive disease, stage IIIb; C: extensive disease II, stage IV) are compared. The application of a combined chemo-radiotherapy depends on the age, the general state and the stage of extension of the tumor. The polychemotherapy followed by the radiotherapy should be preferably applied to patients with tumors of the disease group A, because in this group the best results were obtained with an average survival time of 21.3 months, a remission length of 13.4 months, an improvement of life quality for 12.5 months and a high remission rate. The above mentioned therapy scheme is justifiable and practicable.

The case of a 57-year-old man is reported, who worked as a plasma welder about 15 years. Chronic recurrent bronchitis was diagnosed 12 years after beginning of this work. The patient changed the place of his employment but the course of disease was uncommonly progressive. He died of right ventricular heart failure 10 years later. One year before death, the chronic obstructive pulmonary lesions were acknowledged as occupational disease. The post-mortem histological and chemical analysis of lung tissue yielded a mixed dust pneumoconiosis. These findings supported additionally the diagnosis of occupational disease.

We analyzed theophylline serum levels in steady state of 10 subjects (out of them 7 patients with chronic obstructive lung disease (COLD) and 3 volunteers). Serum theophylline concentrations were measured after oral application of 3 X 280 mg theophylline (Theophyllin retard 280 mg) and in a second condition after accessory administration of 3 X 20 mg nifedipine (Corinfar). No significant difference was found concerning theophylline levels before and after nifedipine application. The ventilation parameters FVC (forced vital capacity) and FEV1 (forced expiratory volume in one second) were not altered during nifedipine dosing. The results are discussed in comparison with data of literature.