The American review of respiratory disease
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Am. Rev. Respir. Dis. · Aug 1984
Case ReportsPulmonary alveolar proteinosis and aluminum dust exposure.
A 44-yr-old male presented with shortness of breath, diffuse X-ray infiltrates, and physiologic evidence of a restrictive lung disease. Biopsy revealed pulmonary alveolar proteinosis. ⋯ Analysis of his lung tissue revealed greater than 300 X 10(6) particles of aluminum/g dry lung; all of the particles appeared as spheres of less than 1 mu diameter. We believe that this case represents an example of pulmonary alveolar proteinosis induced by inhalation of aluminum particles; this finding confirms animal studies which suggest that proteinosis can be produced by very large doses of many types of finely divided mineral dust.
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Am. Rev. Respir. Dis. · Aug 1984
Case ReportsEffect of posture on upper and lower rib cage motion and tidal volume during diaphragm pacing.
We monitored changes in upper and lower rib cage dimensions and tidal volume during bilateral phrenic nerve pacing in a quadraplegic subject with a flaccid chest wall paralysis. Both upper and lower rib cage showed inward (paradoxical) motion during paced breaths in supine (horizontal) and upright positions on a tilt table. ⋯ Abdominal compression in the upright posture caused end-expiratory volume to fall and increased tidal volume 200%. These observations suggest that isolated diaphragm contraction can move the lower ribs independently from the upper ribs and that tidal volume is determined both by the resting length of the diaphragm and by diaphragmatic load.