Thorax
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Comparative Study
Retrospective estimation of values for total lung capacity by plethysmography, helium gas dilution, and chest radiography in patients with cystic fibrosis.
In children with cystic fibrosis, total lung capacity was estimated by helium dilution, plethysmography, and radiography. None of these methods should be used interchangeably as the 95% confidence intervals for estimating were large at 58-144% for radiography and 45.3-100.4% for helium dilution.
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A tension pneumomediastinum production features of cardiac tamponade developed in a 6 year old girl as a result of trauma. She improved dramatically when the air was released by cervical mediastinotomy.
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Pneumopericardium is rare in acute asthma and cardiac tamponade has not been reported. The case is reported of a 20 year old asthmatic patient in whom assisted ventilation and high airway pressures resulted in tension pneumopericardium with clinical signs of cardiac tamponade that were relieved by pericardial aspiration.
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An air gun pellet was found in the right superior pulmonary vein after penetrating the left ventricle of a 14 year old boy. This apparent retrograde movement in the left side of the heart has not been reported previously.
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Bronchoalveolar lavage fluid from 43 patients with biopsy proved sarcoidosis and 10 control subjects were assayed for fibronectin and collagenase activity. Fibronectin was significantly increased in the group with sarcoidosis and was found to be positively correlated with angiotensin converting enzyme activity, protein concentration, percentage of T cells and helper:suppressor ratios in the lavage fluid. Increased fibronectin in the bronchoalveolar lavage fluid was not related to functional or radiographic indices of interstitial disease and did not identify patients subsequently requiring treatment. ⋯ Ten of 16 patients with bronchoalveolar lavage fluid collagenase had radiographic class III or IV disease and a disease duration of more than two years. On follow up 62% of patients with bronchoalveolar lavage fluid collagenase required subsequent treatment, compared with only 23% of patients without collagenase. These results indicate an association between bronchoalveolar lavage fluid collagenase and progressive, prolonged disease in sarcoidosis, whereas increased bronchoalveolar lavage fluid fibronectin is associated with indices of disease activity.