The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology
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Laënnec invented the stethoscope in 1816 and published a treatise on auscultation in 1819. We then had to wait until the 1950s to observe development of modern devices and methods of recording and signal-processing, which allowed objective studies of lung sounds in time and frequency fields. Tracheobronchial sounds generated by ventilation originate in the upper airways, the frequency content of these sounds has led to extensive research. ⋯ Clearly, further studies need to be performed in order to elucidate the true mechanisms involved in generating vesicular lung sounds, the redistribution of intrapulmonary gas or vibrations caused by the stretching of lung tissue. The devices developed are already useful for monitoring the state of patients in intensive care. Sooner or later, real time analysis and automated diagnosis will become available.
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Comparative Study
Aerosol derived airway morphometry in healthy subjects.
Monodisperse aerosol particles can be used to non-invasively probe intrapulmonary airspace dimensions. In this study, the aerosol-derived airway morphometry technique was used to study airspace dimensions in 79 healthy subjects, in order to assess reference data for the future clinical application of aerosol-derived airway morphometry, and to investigate the effect of lung inflation, anthropometric, and lung function parameters on aerosol-derived airway morphometry. Intrapulmonary airspace dimensions were assessed by measuring the deposition of monodisperse, hydrophobic submicron aerosol particles during breathholding. ⋯ Analysis of variance showed an increase of airspace dimensions with age. The results of this study indicate that aerosol-derived airway morphometry is dependent on the level of lung inflation and the age of the subject. These results suggest that in contrast to conventional lung function techniques, aerosol-derived airway morphometry might be a powerful tool for the detection of small changes in peripheral airway geometry.
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Pulmonary lymphangiomatosis is a rare clinical and pathological entity which is distinct from lymphangiomyomatosis and from pulmonary lymphangiectasis. We report a case of a 20 year old man with diffuse lymphangiomatosis involving the mediastinum, lungs and retroperitoneum. ⋯ The patient's clinical course was remarkable for the concomitant development of chronic disseminated intravascular coagulation (DIC). Lymphangiomatosis involving both the mediastinum and pulmonary parenchyma is rare, and DIC is a very unusual complication of lymphangiomatosis.
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Subcutaneous emphysema and pneumomediastinum are well-known complications of barotrauma. There are no fascial barriers between the posterior mediastinum and the retropharyngeal and epidural spaces; thus, air can diffuse freely to the epidural space and produce an epidural pneumatosis. We report a case of epidural pneumatosis caused by a pneumomediastinum following nasotracheal intubation for an attempted suicide. This benign complication of air leakage was easily recognized on computed tomography (CT) scan.
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The conditions of labour appear to favour the development of pleural effusion. The frequency of postpartum pleural effusion was investigated in this study using thoracic ultrasonography. Thirty one postpartum and 22 healthy nonpregnant women of the same age-group were examined, both supine and seated, via an intercostal approach. ⋯ None of the nonpregnant women had pleural effusion. No correlation was found between postpartum pleural effusion and age, weight-gain during pregnancy, duration of labour, use of intravenous fluid, or oxytocin administration. Pleural effusion seems to be a common finding postpartum, but of no clinical significance.