bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term treatment of chronic obstructive lung disease by Nifedipine: an 18-month haemodynamic study
Authors: Saadjian AY , Philip-Joet FF , Vestri R , Arnaud AG
Published: November 2022

This long-term controlled study was undertaken to assess the haemodynamic effects of chronic administration of Nifedipine (N). Twenty patients suffering from pulmonary hypertension secondary to chronic obstructive lung disease were divided into two groups. One group (treatment group) was instructed to take 30 mg of N daily and the other (control group) did not take N. Haemodynamic measurements were recorded before and after an 18-month observation period. For patients in the treatment group, Nifedipine was stopped 24 h prior to the second investigation. Acute response to a single dose of Nifedipine (10 mg sublingually) was also evaluated in all patients during the first and second investigations in order to estimate a possible tachyphylaxis. No significant modification in heart rate, mean pulmonary pressure, mean arterial pressure or blood gases was observed. Conversely, a 10% decrease in cardiac output (p less than 0.05) occurred in the control group. Pulmonary vascular response to acute administration of Nifedipine was the same in both groups before and after the observation period. These results suggest that while long-term administration of Nifedipine to patients with chronic obstructive lung disease does not improve pulmonary pressure, it may prevent a decrease in cardiac output. No tachyphylaxis was noted.
Periodic leg movement, sleep fragmentation and central sleep apnoea in two cases: reduction with Clonazepam
Authors: Guilleminault C , Crowe C , Quera-Salva MA , Miles L , Partinen M
Published: November 2022

Two subjects presented with periodic leg movement (PLM) syndrome during sleep that was characterized by marked sleep fragmentation and repetitive short central apnoeas. Treatment of PLM using Clonazepam, a benzodiazepine with hypnotic properties, markedly reduced the sleep fragmentation due to PLM and, despite its depressant properties on the central nervous system, controlled the repetitive central apnoeas. These two observations, although rare, give insight into the role of non-ventilatory variables in the development of sleep apnoea. Significant sleep fragmentation should be considered when assessing factors leading to respiratory instability during sleep and/or the pathophysiology of sleep apnoea syndromes.
Massive melanoptysis: a serious unrecognized complication of coal worker's pneumoconiosis
Authors: Mosquera JA
Published: November 2022

Black sputum is produced when cavitation of progressive massive fibrosis occurs due to mycobacterial and anaerobic bacterial infections (67%) or ischaemic necrosis. The blackish or greyish sputum suggests cavitation of conglomerated masses; the acinar shadows in gravity dependent areas together with cavitary pneumoconiosis, make us suspect an insufficiency of bronchial clearing. Bronchoscopy confirms the diagnosis by showing the airway blocked by dark material. During melanoptysis the patient suffers respiratory failure which can be fatal. Close vigilance of the arterial blood gases is essential. Measures must be taken to maintain clear airways. Melanoptysis should be listed with the other complications of coal worker's pneumoconiosis.
Tea-dust induced asthma
Authors: Roberts JA , Thomson NC
Published: November 2022

A 55-yr old female worker in a tea-packing production line developed asthma to tea-dust. She had no previous history of chest disease, and skin prick testing to a solution of tea-dust and to a variety of common allergens were all negative. Diagnosis was established by serial peak expiratory flow rate readings. Bronchial provocation challenge with tea-dust demonstrated a late asthmatic reaction.
Mechanism of pulmonary function changes after surgical correction for funnel chest
Authors: Derveaux L , Ivanoff I , Rochette F , Demedts M
Published: November 2022

In 24 subjects with pectus excavatum we evaluated whether the previously detected unfavourable effects of corrective surgery on the ventilatory capacity were attributable to pulmonary or to chest wall factors. We found that 12.2 +/- 3.7 yrs postoperatively (i.e. at the age of 23.3 +/- 5.4 yrs) the vital capacity was decreased from 89 +/- 10% predicted (pred) preoperatively to 64 +/- 6% pred (p less than 0.001) and forced expiratory volume in one second from 88 +/- 17 to 66 +/- 11% pred (p less than 0.001). At total lung capacity (TLC; 69 +/- 5% pred) we found an obvious reduction in transpulmonary pressure (59 +/- 23% pred) and in transdiaphragmatic pressure (30 +/- 17 cmH2O) postoperatively. This indicated an extrapulmonary cause of the restrictive defect, attributable to abnormal chest wall mechanics secondary to the extensive surgery on the sternum and parasternal zones.
Methods for obtaining specimens from the nasal mucosa for morphological and biochemical analysis
Authors: Pipkorn U , Karlsson G
Published: November 2022

The nose is the part of the airway system which is most easily accessible for morphological and pathophysiological evaluation of changes occurring as a response to various stimuli. During recent years several new atraumatic techniques for harvesting cells for morphological and biochemical analysis have been introduced, in addition to the more well known surgical biopsy procedures and nasal smears. Such techniques include nasal lavage, scrapings from the nasal mucosa, brush techniques and imprints. Several of these techniques allow repeated samplings, obtaining quantitative as well as qualitative information as to the cells present on the surface of, as well as within, the epithelial lining of the nasal mucosa. Some techniques provide the investigator with a method for obtaining information on the cellular content of certain biochemical markers such as histamine. The present review describes the merits and disadvantages of the old and new methods and provides guidelines as to when each method should be considered.
Inhalation rate of sodium cromoglycate determines plasma pharmacokinetics and protection against AMP-induced bronchoconstriction in asthma
Authors: Richards R , Simpson SF , Renwick AG , Holgate ST
Published: November 2022

We have investigated whether the inspiratory flow at which sodium cromoglycate (SCG) is inhaled influences the efficacy of SCG. Seven atopic asthmatic subjects (age 25 +/- 2 yrs) inhaled dry powder SCG from a Spinhaler on separate occasions at three flow rates, maximum (V1), 100 l.min-1 (V2), and 50 l.min-1 (V3), or placebo, according to a double-blind structured study. Thirty minutes after administration a bronchial provocation test was performed with adenosine 5'-monophosphate (AMP). Blood samples for measurement of plasma SCG concentration were taken and the area under the plasma concentration-time curve (AUC) calculated for each flow rate. Both inspiratory flow rate and AUC correlated significantly with the degree of protection afforded against AMP-induced bronchoconstriction (r = 0.73, p less than 0.001; r = 0.66, p less than 0.001). These findings indicate that the flow rate used to inhale powdered SCG is a major factor in determining the protective efficacy of this drug against bronchial challenge and therefore has important clinical implications.
Pulmonary epithelial permeability in ARDS and cardiogenic pulmonary oedema
Authors: Todisco T , Dottorini M , Rossi F , Baldoncini A , Palumbo R
Published: November 2022

Clearance of inhaled 99mTechnetium-labelled diethylene triamine pentacetate (99mTc-DTPA) from the lung, an index of pulmonary alveolar epithelial permeability (PAEP), was measured in 13 patients with cardiogenic interstitial pulmonary oedema (CIPO) and in 7 patients with adult respiratory distress syndrome (ARDS). Thirty-five normal subjects (22 nonsmokers and 13 smokers) were evaluated as controls. Half-time clearance (t0.5) values in ARDS patients (mean +/- SD: 15 +/- 2 min) were significantly lower than in CIPO patients (62 +/- 9 min). This PAEP increase in ARDS was impressive, even in comparison to heavy smokers. Loss of the PAEP vertical gradient (apical PAEP greater than base PAEP) was observed in both cardiogenic and ARDS lungs and among smokers.
Gram stain and culture of morning and 24 h sputum in the diagnosis of bacterial exacerbation of chronic bronchitis: a dogma disputed
Authors: Medici TC , von Graevenitz A , Shang H , Bohni E , Wall M
Published: November 2022

Bacteriological results from microscopic and cultural examinations of morning and 24 h sputum were compared in an attempt to optimize the diagnosis of bacterial exacerbations of chronic bronchitis. Twelve patients collected sputum randomly on two consecutive days, either fresh morning sputum (3 h sputum) first, followed by 24 h sputum or vice-versa. Sputa were washed three times in 0.9% NaCl and then examined microscopically before and after homogenization with 2% pancreatin. Cultural examinations were performed on homogenized sputum. Haemophilus influenzae, pneumococci and neisseriae were identified more often in Gram stains than in cultures; staphylococci and Gram-negative rods less frequently so. About 50% of organisms microscopically identified as pneumococci failed to grow in cultures. Microscopic examinations revealed a marked reduction of cells and bacteria after homogenization with pancreatin. Gram stains of 24 h sputum show comparable results to those of morning sputum. No differences were found in cultures. Microscopic examination of the Gram stains was found to be superior to cultural examination. The value of microscopic examination was impaired by the addition of pancreatin.
Phenotypes of peripheral blood lymphoid cells in patients with asbestos-related pleural lesions
Authors: Ozesmi M , Hillerdal G , Karlsson-Parra A , Forsum U
Published: November 2022

Asbestos-related parietal pleural plaques develop slowly and are of little clinical significance. Other asbestos-related pleural reactions, for example acute exudative pleurisy and progressive pleural fibrosis, are of clinical importance. The pathogenesis of these reactions is unknown, but one hypothesis is that immunological disturbances are involved. To investigate this hypothesis a phenotypic characterization of lymphoid cells was performed in the peripheral blood of 45 patients with asbestos-related pleural lesions; 20 with pleural plaques (PP), 15 with diffuse pleural fibrosis (DPF), and 10 with benign asbestos pleural effusion (BAPE). Twenty-four healthy blood donors were used as controls. All asbestos groups together had a significantly higher percentage of B-cells than the controls. The percentage number of "helper/inducer" T-cells was significantly lower in the BAPE and DPF groups than in the control and PP groups. Thus, significant aberrations in peripheral blood lymphoid cells were found in patients with DPF and BAPE. This differed from patients with PP only who were similar to normals.
Effect of different volumes of BAL fluid on arterial oxygen saturation
Authors: Pirozynski M , Sliwinski P , Zielinski J
Published: November 2022

We monitored arterial oxygen saturation (StcO2) continuously using the OHMEDA Biox 3700 oximeter. We studied seven patients undergoing a 100 ml bronchoalveolar lavage (BAL-100), seven patients undergoing a 200 ml bronchoalveolar lavage (BAL-200), and seven patients during diagnostic fibreoptic bronchoscopy alone. Immediately following insertion of the bronchoscope a brief increase in StcO2 level (0.3-0.5%) was seen, followed by a gradual decline, never exceeding 2-5% during the diagnostic bronchoscopy. Introduction of lavage fluid into a segmental bronchus always produced a further decline in StcO2. In the BAL-100 group the fall did not exceed 7%, whereas in the BAL-200 group a fall of up to 15% from the baseline level was observed. Return to initial values was seen in most of the patients within 10 min following completion of the procedure. Only in those patients with the most profound StcO2 fall was this period increased, up to 30 min.
Broncho-oesophageal fistula with vascular malformation
Authors: Verleden G , Verschakelen J , Deneffe G , Demedts M
Published: November 2022

We present a patient with a type III congenital broncho-oesophageal fistula and a connection between the systemic and the pulmonary circulation. The congenital fistula caused chronic bronchopulmonary suppuration with bronchiectasis which in turn was the cause of a left-to-right shunt, probably through multiple precapillary or capillary anastomoses.
Portable oxygen therapy: use and benefit in hypoxaemic COPD patients on long-term oxygen therapy
Authors: Vergeret J , Brambilla C , Mounier L
Published: November 2022

In 159 chronic obstructive pulmonary disease (COPD) patients (139 males, mean age 62 +/- 8 yrs, arterial oxygen tension (PaO2) 7.2 +/- 0.9 kPa), on long-term oxygen therapy (LTOT), we evaluated the effects of portable oxygen therapy both on the daily duration of oxygen therapy and on daily activities. They were given two types of LTOT at random: group A (n = 75), oxygen concentrators only (OC); group B (n = 84), either small oxygen cylinders plus OC (B1 = 51) or liquid oxygen (B2 = 33). The patients were followed-up for one year by means of: a) medical examination every three months; b) monthly home interviews concerning the daily duration of oxygen therapy, the utilization of the devices and the daily activities of the patients; c) a measurement of the daily oxygen usage. The results show that: 1) there are no significant clinical and functional differences between groups A and B at the onset of and throughout the study; 2) in group B the daily use of oxygen therapy is significantly longer than in group A (17 +/- 3.5 h.day-1 vs 14 +/- 3 h.day-1, p less than 0.01) without any difference between groups B1 and B2; 3) outdoor walking activities are different between groups A and B, at least in those patients using oxygen more than 18 h.day-1. Only 60% of patients in group B (55% of B1; 67% of B2) use their portable devices outdoors and for walking. No strict predictive criterion of this use is found in our study.(ABSTRACT TRUNCATED AT 250 WORDS)
A comparison between the airway response to isocapnic hyperventilation and hypertonic saline in subjects with asthma
Authors: Smith CM , Anderson SD
Published: November 2022

We compared the response to isocapnic hyperventilation (ISH), where both cooling and drying of the mucosa occur, with the response to inhaling aerosols of hypertonic saline (HS), where airway osmolarity increases without airway cooling. We studied nine subjects on two days. For ISH, subjects ventilated at 70% of their estimated maximum voluntary ventilation (MVV). For HS, they inhaled aerosols of 2.7, 3.6, or 4.5% saline. The concentration that was used depended on the rate of ventilation during ISH. For both challenges the stimulus was given for one minute. Forced expiratory volume in one second (FEV1) was measured once between each minute, and the challenge ceased when the FEV1 did not change for two successive minutes. A plateau in FEV1 occurred after 8.1 +/- 2.4 (mean +/- 1 SD) min of ISH, and 8.3 +/- 2.4 min of HS. The lowest FEV1 (% predicted) after ISH was 45 +/- 16% and after HS was 51 +/- 18% (r = 0.93). However, the maximum responses occurred after the final challenge and were not the same as the plateau. For HS, the plateau represented 89 +/- 11% of the maximum response which developed within one minute of the final challenge. For ISH, the plateau was only 56 +/- 26% of the maximum response, which developed within 5.2 +/- 2.9 min after challenge. The similarities in the response to these challenges are consistent with the hypothesis that ISH induces asthma via hyperosmolarity. The delayed response to ISH suggests that cooling may delay the response to hyperosmolarity.
Airway responses to hypertonic saline, exercise and histamine challenges in bronchial asthma
Authors: Belcher NG , Lee TH , Rees PJ
Published: November 2022

The airway responses to histamine, exercise and ultrasonically nebulized hypertonic saline have been compared in ten asthmatic patients. The responses to hypertonic saline were not significantly different when the same volume of aerosol was given in a single dose or in 10 l aliquots, suggesting that the challenge is cumulative. The variability of the response to hypertonic saline challenge was not significantly different from that of exercise challenge. Response to hypertonic saline correlated significantly with exercise (r = 0.68, p less than 0.05) and with histamine response (r = 0.74, p less than 0.02), but the correlation between exercise and histamine was not statistically significant (r = 0.15, p greater than 0.1). These findings suggest that exercise-induced asthma has a closer relationship to bronchial responsiveness to hypertonic saline aerosol than it does to non-specific reactivity demonstrated by histamine challenge.
Dose-response and pharmacokinetic study with almitrine bismesylate after single oral administrations in COPD patients
Authors: Bury T , Jeannot JP , Ansquer JC , Radermecker M
Published: November 2022

To better define the dose-effect relationship and the pharmacokinetics of almitrine, sixteen stable hypoxaemic COPD patients received random single oral administrations of almitrine bismesylate 50, 100 and 150 mg or placebo at two-week intervals in a double-blind manner. Resting ventilation, arterial blood gases and plasma almitrine levels were measured. No significant changes were seen after placebo administration. Almitrine 50 and 100 mg caused a significant dose-related improvement in arterial oxygen tension (PaO2) in thirteen of the sixteen patients. Almitrine 150 mg caused little if any additional PaO2 increment. PaO2 returned to near basal values after 24 h. Two patients responded to almitrine 100 and 150 mg only, whereas one patient did not respond at all. Mean PaO2 increases in the sixteen patients were 0.9 kPa (7 mmHg), 1.5 kPa (11 mmHg) and 1.6 kPa (12 mmHg) 3 h after 50, 100 and 150 mg, respectively. A significant mean 0.9 kPa (7 mmHg) decrease in arterial carbon dioxide tension (PaCO2) and a l.min-1 increase in ventilation were observed after almitrine 150 mg. Mean maximum almitrine plasma concentration and area under the curve correlated linearly with dose. The relationship between mean PaO2 improvement and mean almitrine plasma level was curvilinear with a flattening of the curve over plasma levels of 150 ng.ml-1. Almitrine plasma half-life was found to be 116-140 h.
Pulmonary permeability in primary ciliary dyskinesia
Authors: Groth S , Pedersen M
Published: November 2022

Pulmonary clearance (Pcl) of aerosolized 99mTc-DTPA was studied in fourteen patients with primary ciliary dyskinesia (PCD), (median age 23.5 yrs, range 12-44 yrs) and nine normal individuals (median age 23 yrs, range 18-27 yrs). All had never smoked. Regional Pcl was studied for arbitrarily defined central and peripheral regions of the lung using a gamma camera method, whilst total Pcl was studied by a plasma sample method. The patients with PCD had significantly reduced total Pcl compared to the normal individuals (p less than 0.05) and also significantly lower total lung capacity (TLC), vital capacity (VC), forced expiratory volume in one second (FEV1), and FEV1/VC values (p less than 0.05). There was no correlation between Pcl and FEV1/VC. It is concluded that the reduced Pcl in the PCD patients may be associated with their small lung volumes. In addition, reduced bronchial clearance of surfactant in PCD may be associated with an increased alveolar lining fluid volume and/or an impaired movement of 99mTc-DTPA along the alveolar septa to the bronchoalveolar junction, where the epithelium may be more specialized for absorption.
Airway mucus
Authors: Widdicombe JG
Published: November 2022

Airway surface liquid (ASL), a mixture of periciliary fluid and submucosal gland secretions, was collected from the ferret isolated trachea in vitro. The trachea was closed, without possibility of evaporation. The collected ASL was hyperosmolar (310-350 mosmol.kg-1) compared with Krebs-Henseleit solution (280 mosmol.kg-1). Compared with surrounding Krebs-Henseleit solution, the ASL had higher sodium and chloride contents, and considerably higher potassium and calcium contents. The ASL was acid (pH about 7.00) compared with Krebs-Henseleit solution (pH 7.40). Applying methacholine and salbutamol to the preparation significantly changed most of the electrolyte concentrations, and reduced pH. The pH was not significantly changed by bubbling the surrounding buffer with 0-20% CO2, with corresponding buffer changes in pH of 6.95-8.05. Adding labelled albumin to the external buffer resulted in lumenal concentrations that, in the presence of salbutamol, were higher than outside. This and other evidence suggested that albumin could be actively secreted into the lumen, a process enhanced by salbutamol. Thus ASL is hyperosmolar, of different electrolyte composition from interstitial fluid, and of low pH which is homeostatically regulated. The epithelium can actively secrete albumin into the lumen.
Aspirin-intolerance as a precipitating factor of life-threatening attacks of asthma requiring mechanical ventilation
Authors: Picado C , Castillo JA , Montserrat JM , Agusti-Vidal A
Published: November 2022

The records of 92 asthmatics who underwent mechanical ventilation were reviewed. In seven patients (8%) the severe attack was precipitated by a non-steroidal anti-inflammatory drug (NSAID); one of these patients died. Five of the cases had a history of asthmatic attacks provoked by NSAIDs; whilst in two the severe attack requiring mechanical ventilation was the first manifestation of NSAID-intolerance. In two patients the NSAID had been prescribed by their physicians. Another aspirin-intolerant patient, a general practitioner, self-administered a NSAID. The sudden attack in another patient was precipitated by a preparation which contains aspirin and is usually recommended for indigestion. In the fatal case the attack was provoked by a capsule containing aspirin, which had been given by a herbalist. Unlike other reports, we found that NSAID-intolerance is a frequent provoking factor in severe acute asthma requiring mechanical ventilation. Inadequate investigation of precipitating factors in asthmatics with severe sudden attacks is a possible reason why this phenomenon is underreported.
Pulmonary fat embolism presenting as chronic respiratory failure
Authors: Galdermans D , Coolen D , Neetens I , Bultinck J , Parizel G
Published: November 2022

A patient is presented with progressive respiratory failure, caused by pulmonary fat embolism as proved by an open lung biopsy. Four and a half yrs earlier, she underwent a right hip operation. We surmise that a loosening hip prosthesis caused the marrow embolisation.
Insufficient oxygen concentration obtained at domiciliary controls of eighteen concentrators
Authors: Bongard JP , Pahud C , De Haller R
Published: November 2022

The oxygen concentration (O2%) produced by 12 type A concentrators, with a working time of 28-18,099 h, and 6 type B concentrators, with a working time of 0-3,033 h, was measured over a 12 month period in the user's home, at a flow rate of 2 l.min-1. One hundred and two measurements of O2% (mean 82.9), made at least once monthly by a visiting nurse, showed that type A concentrators were usually delivering less than 92% expected O2. Four concentrators were delivering less than 40% O2 after a working time of only 4,000 h. Sixty two measurements made by the manufacturer confirmed these findings (mean 86.8). The 18 measurements performed by the nurse on the type B concentrators showed expected O2% values (mean 93.1). Our study demonstrates the necessity of regular clinical and technical surveillance, at the user's home, during long-term domiciliary oxygen therapy and the need for the manufacturer to incorporate an alarm system monitoring the O2% into oxygen concentrators.
Formoterol, a new long-acting bronchodilator for inhalation
Authors: Arvidsson P , Larsson S , Lofdahl CG , Melander B , Wahlander L , Svedmyr N
Published: November 2022

The aim of this study was to evaluate if treatment with inhaled formoterol is appreciated by asthmatics and whether it causes tachyphylaxis. Twenty stable asthmatics were included in a randomized, double-blind, crossover study. They were treated for two weeks either with formoterol or salbutamol, with one week washout inbetween. They were given 12 micrograms formoterol or 200 micrograms salbutamol twice daily and instructed to use additional spray doses on demand. On a diary card they recorded the number of doses, asthma symptoms and peak expiratory flow rate (PEFR) before every dose. Forced expiratory volume in one second (FEV1) dose-response curves for salbutamol (total dose 1.3 mg) were performed before and after each treatment period to evaluate development of tachyphylaxis. There was a significant difference in favour of formoterol concerning symptoms, PEFR recordings, spray consumption, and preference. Fifteen patients preferred formoterol and two salbutamol. The dose-response curves before formoterol and before, as well as after salbutamol were almost identical. After formoterol the curve had changed; both basal and maximum values were higher than before. Thus, no evidence of tachyphylaxis was found, compared to the ordinary beta-stimulant treatment.
Reversibility of induced bronchoconstriction by deep inspiration in asthmatic and normal subjects
Authors: Wheatley  , Pare PD , Engel LA
Published: November 2022

Five normal and five asthmatic subjects underwent a progressive methacholine provocation study. At each concentration inspiratory pulmonary resistance (RL) was measured, as well as isovolumic maximal flow and residual volume from both partial and complete forced expirations. Results were compared over the RL range of 6-11 cmH2O.1-1.S-1. The reversibility of bronchoconstriction by deep inspiration was quantified as the ratio of the flow increase to potential maximal increase; the reversibility of gas trapping was the ratio of decrease in residual volume to potential maximal decrease. The reversibility of bronchoconstriction did not differ between the groups. In contrast, the reversibility of gas trapping was smaller in asthmatic subjects (21 +/- 17%) than in normals (84 +/- 6%). As gas trapping reflects airway closure, our findings suggest that during induced bronchoconstriction airway closure is more resistant to the effects of deep inspiration in asthmatic than in normal subjects but the reversibility of bronchoconstriction by deep inspiration is not different.
Pleural metastatic tumours and effusions. Frequency and pathogenic mechanisms in a post-mortem series
Authors: Rodriguez-Panadero F , Borderas Naranjo F , Lopez Mejias J
Published: November 2022

We examined the post-mortem records of 191 patients who had one or more malignant tumours (196 neoplasms in total). We found 55 cases with pleural metastases (28%) and 30 of these presented pleural effusions (15% of the total number of neoplasms). The visceral pleural was involved in all 24 cases of lung cancer with pleural metastasis and in 27 out of 31 of those of other origins. The parietal pleura was affected in 16 out of 24 cases of the lung tumours and in 15 out of 31 of those of other origins. There were no cases in which only the parietal layer of the pleura was involved, with the only exception of neighbouring tumours. We found neoplastic vascular invasion in 43 out of 55 cases, retrograde lymphatic spread from the mediastinum in two cases, and direct pleural involvement from a neighbouring tumour in the remaining. We conclude that malignant pleural implantation fundamentally arises from the spread of tumour emboli to the lungs and the visceral pleura, with secondary seedings to the parietal pleura. Therefore, this phenomenon leads to the usual finding of lower involvement of parietal pleura as compared to the visceral pleura in our series.
Effects of theophylline and S 9795 on hyperoxic and hypoxic pulmonary vascular tone in intact dogs
Authors: Lejeune P , Leeman M , Melot C , Naeije R
Published: November 2022

In the literature, it remains uncertain whether methylxanthines inhibit hypoxic pulmonary vasoconstriction. We examined the effects of theophylline and of S 9795, a new methylxanthine derivative, on multipoint mean pulmonary arterial pressure (Ppa)/cardiac index (Q) relationships in 31 intact dogs, ventilated alternately in hyperoxia (fraction of inspired oxygen, FIO2 0.4) and in hypoxia (FIO2 0.1). A sequence of two 5-point Ppa/Q plots at FIO2 0.4 and at FIO2 0.1, consecutively, was performed before and after i.v. administrations of theophylline 10 mg.kg-1 (n = 8) and 25 mg.kg-1 (n = 7), of S 9795 10 mg.kg-1 (n = 8) and of placebo (n = 8). The Ppa/Q plots were rectilinear in all experimental conditions. Over the entire range of Q studied, 2-5 l.min-1.m-2, hypoxia increased Ppa in all animals. Placebo had no effect on these Ppa/Q plots. Theophylline at the lowest dose (plasma levels from 8.4-13.6 micrograms.ml-1) and S 9795 (plasma levels from 3.0-11.2 micrograms.ml-1) did not affect Ppa/Q in hyperoxia or in hypoxia. Theophylline at the highest dose (plasma levels from 17.8-40.4 micrograms.ml-1) reduced hypoxic Ppa at all levels of Q and hyperoxic Ppa at the highest Q, from 3-5 l.min-1.m-2, and inhibited hypoxia-induced increases in Ppa. We conclude that pulmonary vasoconstriction may be preserved after the lowest doses of methylxanthines recommended for the treatment of increased bronchial tone.
The combined effect of nifedipine and sodium cromoglycate on the airway response to inhaled hypertonic saline in patients with bronchial asthma
Authors: Kivity S , Ganem R , Greif J , Topilsky M
Published: November 2022

The combined effect of oral nifedipine and aerosolized sodium cromoglycate on the airway response to inhaled sodium chloride at increasing concentrations was randomly studied in 10 patients with bronchial asthma. Nifedipine (20 mg) protected the airways in 6 of the 10 patients, and sodium cromoglycate (20 mg) in all the 10 patients. Following both drugs, the airway response to hypertonic saline was further reduced when compared to each drug on its own. It is concluded that the combination of nifedipine with sodium cromoglycate might be of benefit in the treatment of difficult asthmatic patients.
Effects of atropine, acetylsalicylic acid, FPL 55712, and phentolamine on increased histamine responsiveness of cat lung strips under conditions of airway inflammation
Authors: Banovcin P , Visnovsky P , Hanacek J , Plank L , Korpas J
Published: November 2022

Our recent in vitro studies on airway smooth muscles of cats with turpentine oil inflammation showed an increase of isometric tension of the lung strips to histamine application. This communication describes the effect of atropine, acetylsalicylic acid, FPL 55712, and phentolamine on the histamine contractions of the lung strips derived from control and experimental groups of cats. Pretreatment of the lung strips with atropine and acetylsalicylic acid had no significant effect on histamine induced contraction. FPL 55712 significantly decreased the mean values of isometric contractions after the low doses of histamine in experimental groups of strips. The isometric contractions after higher doses of histamine were not affected by FPL 55712 in both groups of strips. The significant increase of histamine contractions of the lung strips induced by experimental inflammation was reduced by phentolamine. The role of alpha adrenergic receptors in the increased responsiveness of the inflamed lung tissues to histamine is discussed.
The effect of aminophylline on respiratory and limb muscle contractility in man
Authors: Brophy C , Mier A , Moxham J , Green M
Published: November 2022

The effect of oral aminophylline on respiratory muscle and quadriceps femoris strength was compared with placebo in five normal subjects. A double-blind randomized cross-over protocol, spanning 2-3 wks, was followed. Aminophylline was taken before both placebo and active drug periods to establish correct dosage, to allow tolerance to side-effects to develop, and to keep the two limbs of the study identical and double-blind. Maximal static inspiratory and expiratory mouth pressures at residual volume and total lung capacity, respectively, maximal sniff transdiaphragmatic pressure, maximal voluntary quadriceps femoris contraction force and theophylline levels were measured during placebo and active drug periods. For the group, there were no significant differences between respiratory or quadriceps muscle strength on aminophylline and on placebo although there was a tendency for greater values on aminophylline. Mean theophylline level was 14.6 mg.l-1 (range 8.4-25.0 mg.l-1). We conclude that aminophylline produces no enhancement of skeletal muscle strength, at therapeutic dosage in normal subjects.
Special neutrophil elastase inhibitory activity in BAL fluid from patients with silicosis and asbestosis
Authors: Scharfman A , Hayem A , Davril M , Marko D , Hannothiaux MH , Lafitte JJ
Published: November 2022

Pneumoconiosis is defined as the disease resulting from a chronic exposure to different inorganic dusts. In order to assess the lung defence against the effects of dust exposure, we studied the bronchoalveolar lavage (BAL) fluids from 30 silicotic patients (9 of them having a diagnosis of progressive massive fibrosis (PMF)) and 8 subjects with a diagnosis of asbestosis. Total protein content, N-acetyl-beta-D-glucosaminidase activity, free elastase-like activity, immunoreactive alpha 1-proteinase inhibitor (alpha 1PI) and neutrophil elastase inhibitory capacity (NEIC) were determined, and the values obtained were compared to those of 14 control BAL fluids. In all of the patients, our data showed a significant increase of total protein content and free elastase-like activity. In contrast, N-acetyl-beta-D-glucosaminidase activities did not reach statistical significance. Values concerning immunoreactive alpha 1PI and NEIC were significantly raised only in patients with PMF and with asbestosis. When the ratio NEIC/immunoreactive alpha 1PI was calculated, a significant difference was noticed in the asbestosis group; on the other hand, this ratio was significantly reduced in the group of PMF patients. After neutrophil elastase addition, an electrophoretic study by SDS-PAGE and immunoblotting was carried out; it showed more proteolysed alpha 1PI in the BAL fluids having a lowered NEIC/alpha 1PI ratio. These facts could be explained by the presence of inhibitors of neutrophil elastase different from alpha 1PI.
Effect of theophylline on airway responses to inhaled platelet-activating factor in man
Authors: Chung KF , Lammers JW , McCusker M , Roberts NM , Nichol GM , Barnes PJ
Published: November 2022

It has been suggested that theophylline may possess anti-inflammatory actions which underlie its antiasthma properties. We examined whether theophylline could inhibit the bronchoconstriction and the bronchial hyperresponsiveness induced by inhaled platelet-activating factor (PAF) in eight nonasthmatic subjects in a double-blind, cross-over study. After oral theophylline (6 mg.kg-1), plasma theophylline at 1 h was 10.4 +/- 1.8 mg.ml-1 (mean +/- SEM) compared to 0.39 +/- 0.19 mg.ml-1 on the placebo day (p less than 0.005). PAF, inhaled in five successive doses every 15 min, caused a 56 +/- 11% fall in Vp30 (flow at 30% of vital capacity from a partial expiratory manoeuvre) after the first dose at 5 min, and diminishing responses with successive doses. Theophylline had no significant effect on PAF-induced bronchoconstriction. PAF caused a significant decrease in PC40 (the concentration of methacholine needed to cause 40% fall in baseline Vp30) from a baseline of 12.8 mg.ml-1 (geometric standard error of mean (GSEM) 1.98) to 7.9 (1.79) mg.ml-1 on day 3 and 6.9 (1.74) on day 7 (p less than 0.02). There was no significant difference when mean PC40 values on corresponding days after PAF were compared between placebo and theophylline treatment periods. Our results suggest that theophylline has negligible influence on the airway effects of PAF.
Effects of smoking and changes in smoking habits on the decline of FEV1
Authors: Lange P , Groth S , Nyboe GJ , Mortensen J , Appleyard M , Jensen G , Schnohr P
Published: November 2022

The aim of this study was to examine the effects of cigarette smoking and changes in smoking habits on the decline of forced expiratory volume in the first second of expiration (FEV1). We studied 7,764 men and women for 5 yrs. The subjects were grouped according to self-reported smoking habits during the observation period. We found that persistent cigarette smoking, in particular heavy smoking, accelerated the decline in FEV1. In 310 subjects who quitted smoking during the observation period, the decline of FEV1 was less pronounced than the decline observed in persistent smokers. In subjects younger than 55 yrs of age, smoking reduction was associated with a less pronounced FEV1 decline, while in the elderly subjects smoking reduction had no effect on the FEV1 decline. An increase in the number of cigarettes smoked was generally associated with a more rapid decline of FEV1, while the beginning of smoking during the 5 yrs of observation did not seem to influence the decline of FEV1. We conclude that smoking cessation or reduction may lead to a demonstrable beneficial effect on the FEV1 decline within a few years.
Asthma and chronic airflow limitation in the highlands of Papua New Guinea: low prevalence of asthma in the Asaro Valley
Authors: Woolcock AJ , Peat JK , Keena V , Smith D , Molloy C , Simpson A , Middleton P , Vallance P , Alpers M , Green W
Published: November 2022

The prevalence of asthma in the South Fore region of Papua New Guinea was found to be 7.3%, which is thought exceptionally high for highland areas in this country. To investigate the prevalence of asthma and of chronic airflow limitation in a different highland region with similar living conditions, adults and children from 7 villages in the Asaro Valley were interviewed. Questions were asked about smoking history and about past and present symptoms of cough, of shortness of breath, of chest tightness and of asthma. Of 743 adults interviewed, 206 underwent a clinical study with measurements of lung function, bronchial responsiveness and skin prick tests. Dust was collected from the floors and blankets of 36 houses for counts of house dust mites. We did not find any children with symptoms of asthma. Only 2 adults (0.3%) had symptoms consistent with asthma, and a further 6.2% had symptoms and/or lung function consistent with chronic airflow limitation. Most bronchial hyperresponsiveness was associated with asthma or with chronic airflow limitation. The prevalence of atopy was similar in the Asaro and South Fore populations, but the South Fore had higher house dust mite counts in blanket dust. The low prevalence of asthma in the Asaro Valley is unexplained in terms of factors normally associated with asthma. Because asthma in this area does not appear in childhood and only develops in a small proportion of adults, it may be of different aetiology to asthma in Caucasian populations.
Anatomy and physiology of collateral respiratory pathways
Authors: Delaunois L
Published: November 2022

When complete obstruction of an airway occurs, ventilation and gas exchange distal to the obstruction can be preserved if "collateral ventilation" exists. Three collateral pathways have been described: the interalveolar, the bronchioloalveolar and the interbronchiolar communications. The various techniques used to measure collateral flow, resistance, compliance and time constant are described, with particular attention to those trying to separate the resistances of intrasegmental and collateral pathways. The various techniques used to measure collateral flow, resistance, compliance and time constant are described, with particular attention to those trying to separate the resistances of intrasegmental and collateral pathways. The relative importance of collateral ventilation in humans and animals is shown; factors affecting this ventilation are described: type of flow, lung volume, surface tension, alveolar CO2, pulmonary circulation and oedema, cholinergic and adrenergic receptors, histamine, interdependence. Parenchymal diseases disturb collateral flow; on the other hand, collateral channels can provide alternative pathways in various human pathologies.
Education of adult patients at an "asthma school": effects on quality of life, knowledge and need for nursing
Authors: Ringsberg KC , Wiklund I , Wilhelmsen L
Published: November 2022

The effect of education of adult asthma patients at a special "asthma school" was studied with regard to knowledge of the disease and its treatment and quality of life measured by leisure activities, social interaction and psychological well being. We also studied if there were any differences in number of days in hospital and emergency visits before and one year after the asthma-school. Patients were randomised to an intervention group (7 men and 13 women) and a control group (7 men and 11 women). The age-range was 22-66 yrs. Both groups answered the same standardized and quantified questionnaires on three occasions, before the start of the asthma school, after five months and after twelve months. Both groups increased their knowledge of the disease and how to treat it, with slightly better results in the intervention group. The self-assessments all showed that patients in the intervention group felt better than those in the control group. The number of days in hospital as well as acute visits to out patients clinics were reduced significantly after the asthma school. The intervention did not influence spirometric variables.
The effect of inhaled 15-(s)-hydroxyeicosatetraenoic acid (15-HETE) on airway calibre and non-specific responsiveness in normal and asthmatic human subjects
Authors: Lai CK , Phillips GD , Jenkins  , Holgate ST
Published: November 2022

15-hydroxyeicosatetraenoic acid (15-HETE) is the predominant oxidative metabolite of arachidonic acid in human lung. We have studied its effects on airway calibre and non-specific bronchial responsiveness (NSBR) in eight normal and eight asthmatic subjects. 15-HETE, at doses up to 70 nmol, had no effect on airway calibre in either group of subjects. However, 3 h after its administration, 15-HETE reduced NSBR in the normal subjects (geometric mean methacholine PD40 Vp30 increased by 2.29-fold from baseline compared with a corresponding 1.14-fold increase after diluent, p less than 0.05). Similarly, 4 h after inhaled 15-HETE, the spontaneous increase in NSBR in the asthmatics was completely inhibited (geometric mean histamine PD40 Vp30 decreased significantly to 0.41-fold of baseline after diluent (p less than 0.01) compared with a 1.1-fold increase after 15-HETE, p less than 0.01). These data suggest 15-HETE may play an autacoid role in airway function.
Phagocytic properties and organelle motility of pulmonary macrophages from smokers and nonsmokers estimated in vitro by magnetometric means
Authors: Im Hof V , Klauser M , Gehr P
Published: November 2022

Monolayer cultures of pulmonary macrophages (PM) from 11 smokers (S) and 9 nonsmokers (NS) were incubated with submicrometric ferromagnetic Fe3O4 particles for one hour. After magnetization by an externally applied pulse magnetic field, the aligned Fe3O4 particles, located in the phagosomes and secondary lysosomes of the PM, emanated a remanent magnetic field which decayed with time. The initial field strength, B0, which is proportional to the amount of phagocytosed Fe3O4 particles, was 13.24 nT (SE 0.79 nT) in S and 11.74 nT (SE 1.39 nT) in NS. Ten nT correspond to roughly 4 micrograms Fe3O4. The initial rate of decay of the remanent field (during the first 60 s after magnetization), lambda 0, is proportional to the rate of particle misalignment. Therefore, lambda 0, is hypothesized to be an estimate of organelle motility. It was found to be the same in S and in NS, being 3.14 x 10(-3).s-1 (SE 0.18 x 10(-3).s-1) in S and 3.17 x 10(-3).s-1) (SE 0.22 x 10(-3).s-1) in NS. These results suggest that, in vitro, there is no difference in phagocytic activity and organelle motility in PM from S and NS.
Influence of hypercapnia on rabbit intrapulmonary neuroepithelial bodies: microfluorimetric and morphometric study
Authors: Lauweryns JM , Tierens A , Decramer M
Published: November 2022

The present investigation was undertaken to investigate the influence of hypercapnia on intrapulmonary neuroepithelial bodies (NEB). Rabbits were mechanically ventilated with a hypercapnic gas mixture (7% carbon dioxide, 20% oxygen, 73% nitrogen). Lung samples were examined by a microspectrographical analysis of the NEB formaldehyde-induced fluorescence to quantify the cytoplasmic 5-hydroxy-tryptamine (5HT) content and by electron microscopy to determine morphometrically the extent of the secretory exocytosis at the basal poles of the NEB epithelial cells. In contrast to our earlier studies on the effects of hypoxia and/or vagal stimulation, hypercapnia did not alter significantly the NEB cytoplasmic fluorescence nor did it affect the corpuscular epithelial exocytosis. NEB appear not to be influenced by hypercapnia to discharge their contents of 5HT and peptides. This investigation appears to support a high selectivity of the intrapulmonary NEB to local hypoxia and changes in vagal efferent output.
Metal toxicity and the respiratory tract
Authors: Nemery B
Published: November 2022

The type of lung disease caused by metal compounds depends on the nature of the offending agent, its physicochemical form, the dose, exposure conditions and host factors. The fumes or gaseous forms of several metals, e.g. cadmium (Cd), manganese (Mn), mercury (Hg), nickel carbonyl (Nl(CO)4, zinc chloride (ZnCl2), vanadium pentoxide (V2O5), may lead to acute chemical pneumonitis and pulmonary oedema or to acute tracheobronchitis. Metal fume fever, which may follow the inhalation of metal fumes e.g. zinc (Zn), copper (Cu) and many others, is a poorly understood influenza-like reaction, accompanied by an acute self-limiting neutrophil alveolitis. Chronic obstructive lung disease may result from occupational exposure to mineral dusts, including probably some metallic dusts, or from jobs involving the working of metal compounds, such as welding. Exposure to cadmium may lead to emphysema. Bronchial asthma may be caused by complex platinum salts, nickel, chromium or cobalt, presumably on the basis of allergic sensitization. The cause of asthma in aluminium workers is unknown. It is remarkable that asthma induced by nickel (Ni) or chromium (Cr) is apparently infrequent, considering their potency and frequent involvement as dermal sensitizers. Metallic dusts deposited in the lung may give rise to pulmonary fibrosis and functional impairment, depending on the fibrogenic potential of the agent and on poorly understood host factors. Inhalation of iron compounds causes siderosis, a pneumoconiosis with little or no fibrosis. Hard metal lung disease is a fibrosis characterized by desquamative and giant cell interstitial pneumonitis and is probably caused by cobalt, since a similar disease has been observed in workers exposed to cobalt in the absence of tungsten carbide. Chronic beryllium disease is a fibrosis with sarcoid-like epitheloid granulomas and is presumably due to a cell-mediated immune response to beryllium. Such a mechanism may be responsible for the pulmonary fibrosis occasionally found in subjects exposed to other metals e.g. aluminium (Al), titanium (Ti), rare earths. The proportion of lung cancer attributable to occupation is around 15%, with exposure to metals being frequently incriminated. Underground mining of e.g. uranium or iron is associated with a high incidence of lung cancer, as a result of exposure to radon. At least some forms of arsenic, chromium and nickel are well established lung carcinogens in humans. There is also evidence for increased lung cancer mortality in cadmium workers and in iron or steel workers.