Thorax
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Four cases of intramural diverticulosis of the oesophagus are described, and the findings are reviewed in 12 previously reported cases. Evidence is presented that this condition is a true pulsion diverticulosis due to deranged motor activity and raised intraluminal pressure. It may occur in cases of diffuse oesophageal spasm, or it may follow inflammation, stricture or surgery. The course is benign, complications being those of the underlying disorder.
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Breath holding was used as the basis of a simple test of respiratory chemosensitivity. Breath holding was begun at selected degrees of hypercapnia produced by CO2 rebreathing. In 16 healthy control subjects there was a linear regression of the log of breath-holding time on the PCO2 at the start of breath holding. ⋯ However, in 17 patients with chronic airways obstruction, breath-holding time was never prolonged and the log BHT/Pco2 relationship was normal, even though 13 had a diminished ventilatory response to CO2 and four had chronic CO2 retention. It is concluded that the BHT/Pco2 relationship provides a useful index of respiratory chemosensitivity which is not influenced by airways obstruction. This may be helpful in the detection of impaired chemosensitivity as a cause of CO2 retention even when the ventilation CO2 response is reduced non-specifically by coexisting airways obstruction.