Showing papers in "Respiration in 1990"
TL;DR: There is sufficient evidence from cross-sectional studies, as well as evidence from one longitudinal study to support the concept of the 'healthy smoker' as an individual who takes up the habit because his/her lungs are relatively resistant to the effects of smoking.
Abstract: The detrimental effects of smoking on lung function have been recognized for several decades Evidence comes from cross-sectional studies which emphasize that damage, certainly at the level of the sma
153 citations
TL;DR: Tuberculosis remains a health problem of extraordinary magnitude, especially in developing countries, although to a lesser extent, in developed countries among those groups of patients with HIV infection in which there is also a high prevalence of remotely acquired tuberculosis.
Abstract: Tuberculosis remains a health problem of extraordinary magnitude, especially in developing countries. Unfortunately, many of the same countries have the additional burden of a remarkably high prevalence of HIV infection. Because of the inherent capacity of tubercle bacilli to take advantage of deficiencies in cell-mediated immunity, tuberculosis has become an extremely important infectious complication of HIV disease in those developing countries in which the two infections coexist; the same is true, although to a lesser extent, in developed countries among those groups of patients with HIV infection in which there is also a high prevalence of remotely acquired tuberculosis. Prof. Chretien helped call attention to the link between tuberculosis and HIV infection in France. Now, it is obvious that his cogent observations extend to much of the rest of the world.
60 citations
TL;DR: Findings indicate that orally administered BV modulates disordered local and systemic immune functions in patients with chronic bronchitis.
Abstract: In 28 adult patients with nonobstructive chronic bronchitis we investigated components of the immune system of the lower airways and the effects of treatment with Broncho-Vaxom (BV). An analysis of the washing from bronchoalveolar lavage (BAL) showed, in comparison with healthy controls, an elevation of total cell count (p = 0.003) as well as the IgA/albumin values (p = 0.02) and a reduction of the macrophage activity (p less than 0.001) in patients with chronic bronchitis. After BV a reduction in the total cell count (p = 0.05), an increase in the helper/suppressor T lymphocyte ratio (due mainly to the reduction in the suppressor cells; p = 0.04), a modulation of the IgA/albumin ratio, a stimulation of the impaired alveolar macrophage activity (p = 0.03) and increased concentrations of gamma-interferon (p = 0.03) were found in the BAL fluid of patients with chronic bronchitis. The salivary IgA/albumin ratio remained unchanged, the serum IgE concentration fell (p = 0.02) and the urinary IgA concentration rose (p = 0.002). Bronchial mucosa lesions, evaluated endoscopically in terms of structural damage, hyperemia and mucus production, were improved (p less than 0.01). These findings indicate that orally administered BV modulates disordered local and systemic immune functions in patients with chronic bronchitis.
49 citations
TL;DR: The rheological behavior and clearance of bronchial mucus samples collected by protected expectoration from 24 out-patients with simple chronic bronchitis suggest the presence of some type of 'post-mucoactive' effect.
Abstract: The rheological behavior and clearance of bronchial mucus samples collected by protected expectoration from 24 out-patients with simple chronic bronchitis were investigated before, at the end of a sho
34 citations
TL;DR: The results show that sensitivity to transient hypercapnia and its interaction with hyperoxia are weaker in women than in men.
Abstract: CO2 single breaths have been performed in 7 men and 7 women in conditions of normoxia (FICO2≈0.13; FIO2≈0.21; FIN2 6≈ 0.66) and of hyperoxia (FICO2
30 citations
TL;DR: The data suggest that severe oxygen desaturation may alter the circadian rhythm of testosterone secretion, and that those who suffered less desaturation were classified as the free to mild oxygen Desaturation group.
Abstract: To investigate the influence of nocturnal oxygen desaturation on the circadian rhythm of testosterone secretion, polysomnography was performed on 2 consecutive nights in 24 male subjects who complaine
27 citations
TL;DR: The increase in Es,L and dEs,L/dPL in COPD and alpha 1-AD compared to normals probably represents two distinct abnormalities in the elastic properties of emphysematous lungs: an increase in resting length of alveolar walls accounting for hyperinflation, and a decrease in extensibility of alVEolar walls once they become stressed.
Abstract: We calculated specific lung elastance (ES, L) as the change of lung elastic recoil pressure (Pel L) required to produce a given fractional change in lung volume (ΔVL/V
24 citations
TL;DR: It is suggested that the excitatory effects of the tachykinins on the vagal neuro-effector transmission may be modulated by neutral endopeptidase in the guinea pig.
Abstract: To elucidate the effect of endogenous tachykinins on neuro-effector transmission of vagal nerves, we performed in vitro experiments using guinea-pig tracheal smooth muscle. The subthreshold dose (the
22 citations
TL;DR: The content of Co and W in blood and urine and particularly in pubic hair and toe nails of the patients was significantly higher than the normal values, suggesting that these biological specimens could be used as indicators of chronic exposure to hard metal dusts.
Abstract: Four subjects working in sharpening and grinding operations of hard metal tools were examined. Only 1 worker, a 37-year-old female exposed for 7 years to hard metal dusts, developed hard metal pneumoconiosis, which rapidly progressed to death. Cytology of the bronchoalveolar lavage (BAL) showed a high number of eosinophils, more than 30% of the cell population. Biopsy of the lung revealed interstitial fibrosis with hyperplasia of the pneumocytes of the second type and inflammatory cellular infiltration of the interstitium. High tungsten (W) and tantalum concentrations were determined in the admission BAL and in the biopsy 4 months later by neutron activation analysis while cobalt (Co) levels were near to normal values. The content of Co and W in blood and urine and particularly in pubic hair and toe nails of the patients was significantly higher than the normal values. This suggests that these biological specimens could be used as indicators of chronic exposure to hard metal dusts.
22 citations
TL;DR: The case of a 33-year-old woman in whom the overlap of TS, pTS and LAM is demonstrated is presented, and treatment with medroxyprogesterone was initiated, but without success.
Abstract: Pulmonary involvement in tuberous sclerosis (pTS) is very rare and seems to be associated with a more benign course, compared to tuberous sclerosis without pulmonary manifestation (TS). Furthermore, pTS seems to be related to lymphangiomyomatosis (LAM). We present the case of a 33-year-old woman in whom the overlap of TS, pTS and LAM is demonstrated. Treatment with medroxyprogesterone was initiated, but without success
21 citations
TL;DR: Patients with seasonal asthma due to grass pollen were studied by means of allergologic evaluations, methacholine inhalation test and sBPT, outside the pollen season in all patients and, in 10 of them, also during the pollenSeason, to evaluate the pattern of airway response to a specific bronchial provocative test.
Abstract: In order to evaluate the pattern of airway response to a specific bronchial provocative test (sBPT) with an extract of Phleum pratensis standardized in biological units (BU), we studied 27 patients with seasonal asthma due to grass pollen by means of allergologic evaluations, methacholine inhalation test and sBPT, outside the pollen season in all patients and, in 10 of them, also during the pollen season. We used a DeVilbiss 646 nebulizer with a dosimeter, giving increasing doses (0.01–2.5 BU) of the allergen solution and we monitored FEV1 to assess early (EAR) and late (LAR) airway responses. Outside the pollen season sBPT elicited an isolated EAR in 16 and a dual asthmatic response (DAR) in 11 patients. We observed no significant difference between EAR and DAR patients as regards the provocative dose causing a 15% fall in FEV, (PD15FEV1) methacholine, EAR (expressed by PD15FEV1, allergen) or allergologic data. There was a significant relationship between PD15FEV1 allergen and PD15FEV1 methacholine (r = 0.43, p 15FEV1 allergen; r = 0.95, p 1 during LAR. Ten patients repeated all tests during the grass pollen season. PD15FEV1 methacholine and baseline FEV1 decreased significantly during the pollen season, but PD15FEV1 allergen did not change significantly during the season. Although 6 patients with a DAR outside the pollen season showed an isolated EAR during the season, the mean percent fall in FEV1 during EAR and LAR was not different between seasons
TL;DR: An overview of the pathophysiology, clinical risk assessment, and treatment of severe acute asthma is given.
Abstract: Bronchial asthma is characterized as a disease with recurrent, reversible, and generalized airway obstruction and an increased airway responsiveness to nonspecific stimuli. Besides symptoms of airway
TL;DR: In 36 patients with cystic fibrosis, aged 6.2-26.4 years, the relationship between functional lung deterioration and gas exchange characteristics was studied by backward stepwise discriminant analysis of 22 dependent variables, within 3 clinically defined severity degrees of the disease.
Abstract: In 36 patients with cystic fibrosis (CF), aged 6.2–26.4 years, the relationship between functional lung deterioration and gas exchange characteristics was studied by backward stepwise discriminant ana
TL;DR: A 52-year-old woman with Sjögren's syndrome presented with a dense lymphocytic infiltrate around the bronchial gland disclosed by a transbronchial lung biopsy specimen, two and a half years after the initial evaluation, her pulmonary status had deteriorated and multiple bullae had developed at both lung bases.
Abstract: A 52-year-old woman with Sjogren's syndrome presented with a dense lymphocytic infiltrate around the bronchial gland disclosed by a transbronchial lung biopsy specimen. Two and a half years after the initial evaluation, her pulmonary status had deteriorated and multiple bullae had developed at both lung bases.
TL;DR: In 10 patients who required extracorporeal circulation (ECC) during surgery, damage induced by surgery to the pulmonary surfactant and the effectiveness of ambroxol in preventing changes in the phospholipid pool were studied.
Abstract: In 10 patients who required extracorporeal circulation (ECC) during surgery, we studied the damage induced by surgery to the pulmonary surfactant and the effectiveness of ambroxol in preventing change
TL;DR: The results indicate that lipolysis is decreased in patients with advanced COPD with chronic respiratory failure and an altered glucose metabolism may also exist in these patients.
Abstract: Eighteen patients with advanced chronic obstructive pulmonary disease (COPD), 8 with chronic respiratory failure (CRF group) and 10 without (NCRF group) were investigated using arterial blood analyses before, during and after progressive exercise. Dynamic spirometry was also performed. The arterial blood was analyzed for free fatty acids (FFA), glycerol, 3-hydroxybutyrate, alanine, glucose and lactate concentrations as well as PO2 and PCO2. In the CRF group the concentrations of FFA, glycerol and 3-hydroxybutyrate were lower and the concentrations of glucose and lactate higher than in the NCRF group. Analysis of the whole material revealed that the arterial FFA, glycerol and 3-hydroxybutyrate concentrations correlated positively to arterial PO2 and negatively to arterial PCO2 at rest, as well as during exercise and recovery. The results indicate that lipolysis is decreased in patients with advanced COPD with chronic respiratory failure. An altered glucose metabolism may also exist in these patients
TL;DR: Data indicate that PTX has direct actions on isolated rabbit PA which are not blocked by indomethacin nor require the presence of intact endothelium, and PTX can suppress norepinephrine-induced constriction of isolated PA.
Abstract: Pentoxifylline (PTX) is a methylxanthine derivative which improves systemic microvascular flow and tissue oxygen delivery, presumably through actions on platelet aggregation and erythrocyte deformability. Although PTX also improves pulmonary vascular flow, recent evidence suggests that part of this improvement may be due to pulmonary vasodilation. To evaluate these effects we studied isolated rabbit lobar pulmonary artery (PA) ring segments to determine if PTX had direct effects on PA tissues and whether these effects could be modulated pharmacologically or by endothelial disruption. PTX had no effect on PA at resting tension. However, if the PA tension was actively increased by norepinephrine (5 μM), subsequent PTX application caused concentration-dependent PA relaxation. Relaxation occurred promptly and was maximal within 45–60 s. The threshold PTX concentration necessary for relaxation was 1 μM. PTX-induced relaxation was not affected by pretreatment with the cyclo-oxygenase inhibitor indomethacin (1 μM). Endothelial disruption by gentle rubbing of the intimal PA surface abolished relaxation of preconstricted PA by acetylcholine, but had no effect on relaxation by PTX. Although PA at resting tension displayed no response to PTX, PA constriction by norepinephrine in the presence of PTX concentrations > 10 μM was significantly decreased. These data indicate that PTX has direct actions on isolated rabbit PA which are not blocked by indomethacin nor require the presence of intact endothelium. Furthermore, PTX can suppress norepinephrine-induced constriction of isolated PA
TL;DR: There was considerable overlap in values for serum lactate dehydrogenase, alveolar-arterial oxygen difference and percentage of bronchoalveolar lavage neutrophils in patients dying within 14 days, but an excellent discrimination between the two groups was found.
Abstract: Sixty episodes of Pneumocystis carinii pneumonia in 59 patients were evaluated for risk factors predicting fatal outcome within 14 days after bronchoscopy. We found significantly higher values for serum lactate dehydrogenase (p less than 0.001), alveolar-arterial oxygen difference (p less than 0.001) and percentage of bronchoalveolar lavage neutrophils (p less than 0.001) in patients dying within 14 days, but there was considerable overlap of these variables between the two groups. Using a score system combining the three parameters allowed however an excellent discrimination between the two groups.
TL;DR: The clinical spectrum of illness was similar to that of other groups studied worldwide and cigarette smoking was associated with a poorer outcome and is a potentially preventable cause of deterioration.
Abstract: Cryptogenic fibrosing alveolitis (CFA) has not been described previously in any large group of indigenous African patients. This was a retrospective study of 46 such patients diagnosed as having CFA d
TL;DR: Mycobacterium gordonae is rarely pathogenic in humans and was cultured from the tissue of a resected pulmonary nodule in an immunocompetent patient and one year after completing 12 months of chemotherapy, the patient remains disease free.
Abstract: Mycobacterium gordonae is rarely pathogenic in humans. In this case it was cultured from the tissue of a resected pulmonary nodule in an immunocompetent patient. One year after comp
TL;DR: In a double-blind randomized study 60 patients with either irritative cough due to seasonal respiratory disorders or chronic cough of any etiology were treated with either butamirate citrate linctus or with clobutinol syrup for a period of 5 days at a dose regimen of 3 tablespoons daily, demonstrating the effectiveness of both treatments.
Abstract: In a double-blind randomized study 60 patients with either irritative cough due to seasonal respiratory disorders or chronic cough of any etiology were treated with either butamirate citrate linctus (Sinecod, Zyma) or with clobutinol syrup (Silomat, Boehringer, Ingelheim) for a period of 5 days at a dose regimen of 3 tablespoons daily. Efficacy was assessed based on the reduction of the severity as well as frequency of the cough and on the global opinion of the physician. Both groups showed highly significant improvements for the severity and frequency parameters (p less than 0.001), thus demonstrating the effectiveness of both treatments. No significant differences between groups were detected globally for the whole collective. For cough due to carcinomas (n = 14), however, a significantly better effect of butamirate on the frequency of cough (p = 0.026) was found which originated other significant differences in the global scores (p = 0.013) and in the physician's opinion (p = 0.026). Seven patients in both groups complained about side effects (mainly nausea and drowsiness).
TL;DR: 1 patient, who had unilateral pulmonary involvement and has been treated with segmental resection and cyclophosphamide, has survived greater than 18 years without relapse and is the first patient reported with such a long survival.
Abstract: We describe 2 patients with rare primary pulmonary manifestation of Hodgkin’s disease. Our 1st patient, who had unilateral pulmonary involvement and has been treated with segmental resection and cyclophosphamide, has survived > 18 years without relapse. He is the first patient reported with such a long survival. Our 2nd patient had bilateral pulmonary involvement and B symptoms and has been treated with an aggressive chemotherapy regimen. She is alive after 3 years without evidence of disease
TL;DR: The comparatively low incidence of pleural lesions in the cohort is probably due to the low mean age (36 years), and further follow-up could give clues to the pathogenesis of malignant mesothelioma.
Abstract: Ninety-four persons from the village of Karain, Turkey, now residing in Stockholm, were investigated clinically and radiologically. In this village, environmental exposure to erionite, a fibrous zeolite, occurs, and there is an extremely high risk of mesothelioma among the villagers. Since an earlier investigation of the cohort in 1980, another 4 young persons have fallen ill with malignant mesothelioma in this group, where the incidence thus approaches 1%/year and is the most common cause of death. Solitary pleural plaques were found in 6%, thickening of the interlobar pleura in 4% and other radiologic signs of affection of the pleura in 2%. Thickening of the interlobar fissures were observed in 1 patient as the first sign of mesothelioma which has remained asymptomatic until 1 year later. The comparatively low incidence of pleural lesions in the cohort is probably due to the low mean age (36 years). Further follow-up could give clues to the pathogenesis of malignant mesothelioma.
TL;DR: The results suggest that the state of LAA is not an epiphenomenon and represents the tendency of the white blood cells to stick to the endothelium which facilitates their migration into the tissues.
Abstract: The state of leukocyte adhesiveness/aggregation (LAA) in the peripheral blood has been employed as a marker of inflammation. In the present study we examined patients with varying intensities of inflammation caused by respiratory tract infections to further investigate the reliability of the state of LAA for the detection and assessment of the severity of disease activity. The study includes 140 controls, 46 patients with upper respiratory tract infection, 30 with bronchitis, 27 with suspicion of pulmonary infiltrate, and 39 with small and 18 with large pulmonary infiltrate. Assessment was based on assuming an increasing severity of inflammation from the 1st to the 6th diagnostic category and by making use of discriminant analysis. It was found that the state of LAA proved to be the best variable to classify the patients into their diagnostic category (F to enter 27), followed by erythrocyte sedimentation rate at the 1st h (F to enter 20.8) and total white blood cell count (F to enter 8.3). These studies were followed by animal experimentation. A highly significant correlation (p = 0.005) was found between the state of LAA in the peripheral blood and the degree of pulmonary leukostasis in a model of endotoxemia in rabbits. These results suggest that the state of LAA is not an epiphenomenon and represents the tendency of the white blood cells to stick to the endothelium which facilitates their migration into the tissues.
TL;DR: It is concluded that the lack of significant differences suggests similar mechanisms and sites of production of inspiratory and expiratory vesicular breath sounds, as well as three methods of heart sound cancellation, are suggested.
Abstract: Unfiltered breath sounds (NF) from the apical area of the heart, lung volume and ECG signals were recorded in 5 normal subjects. The signals were digitized and subjected to three methods of heart soun
TL;DR: A male patient with tuberous sclerosis, who presented with chylothorax, constitutes an extremely rare finding.
Abstract: We report on a male patient with tuberous sclerosis (adenoma sebaceum and digital fibromas, renal angiomyolipomas and subependymal brain calcifications), who presented with chylothorax. Chest CT scan
TL;DR: A 2-month study to compare the efficacy and safety of Berodual (B) (Boehringer Ingelheim) and salbutamol (S) in asthma found B achieved the same effects though containing less beta-2-agonist agent.
Abstract: A 2-month study was carried out to compare the efficacy and safety of Berodual® (B) (Boehringer Ingelheim) and salbutamol (S) in asthma. B is a combined agent with 20 µg of ipratropium bromide and 50
TL;DR: Immature newborn rabbits with a gestational age of 27 days were paralyzed and kept in body plethysmographs and the values of trs after 10 min were significantly higher in surfactant-treated animals than in controls, indicating stabilization of the alveoli.
Abstract: Immature newborn rabbits with a gestational age of 27 days were paralyzed and kept in body plethysmographs. They were ventilated for 10 min with a tidal volume of approximately 10 ml/kg, with or without previous surfactant treatment via the airways. Tidal volumes and flow were recorded with a pneumotachograph connected to the body plethysmograph, and the expiratory time constant of the respiratory system (trs) was determined from flow-volume diagrams. The values of trs after 10 min were significantly higher in surfactant-treated animals than in controls (50 ± 7 vs. 23 ± 4 ms; p rs and the compliance values calculated from tidal volumes and ventilator pressure (r = 0.80; p rs and the alveolar volume density in histological lung sections, determined by automated image analysis (r = 0.71; p
TL;DR: Nine cases of intrathoracic lipoma are reported and CT scan proved to be helpful in the diagnosis and management of these cases, recommending investigation with CT scan for the diagnosis of lipoma.
Abstract: Nine cases of intrathoracic lipoma are reported. Computed tomography (CT) proved to be helpful in the diagnosis and management of these cases. The attenuations of the masses ranged from -70 to -140 Ho
TL;DR: The case of a young woman presenting productive cough and arthralgia in the left ankle and definitive diagnosis of an intravascular bronchoalveolar tumor was reached by an open pulmonary biopsy.
Abstract: We report the case of a young woman presenting productive cough and arthralgia in the left ankle. Chest radiography revealed multiple bilateral pulmonary nodules and abdominal echography and computeri