Scandinavian journal of respiratory diseases
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We studied reinflation of collapsed parts in excised normal human lungs through both the ordinary bronchial route and through collateral channels. A model of atelectasis was made either by simple collapse or by applying a positive pressure to the pleura and a negative to the airway. Five different ventilatory patterns were used for reinflation: simulated normal breathing with and without continuous positive airway pressure (CPAP), simulated deep breathing and mechanical ventilation with and without positive end-expiratory pressure (PEEP). ⋯ A comparison between CPAP and PEEP showed CPAP to be preferable. Collateral reinflation occurred just as readily as normal reinflation and the results suggest that collateral reinflation is the primary choice. This route of reexpansion also has a potential secretion clearing effect in that pressure is built up distal to an obstruction.
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Serum angiotensin-converting enzyme (ACE) was studied in 51 patients with early or newly diagnosed sarcoidosis. Only 45% of these patients had increased ACE activity when their diagnosis was established, which diminishes the diagnostic value of this enzyme measurement. ⋯ Patients with acute sarcoidosis associated with erythema nodosum (EN) had low ACE activity compared with the other patients with active, but less acute disease. Serum ACE was not significantly correlated with blood lymphocytes or the immunoglobulins, but there was a positive correlation between the enzyme and serum lysozyme, which strengthens the hypothesis of both enzymes being produced by the epithelioid cells of sarcoid granulomas.
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Cardiac output, using dye-dilution technique, and intra-arterial blood pressure at rest and during exercise on a bicycle ergometer were determined in six boys with bronchial asthma, mean age 11.9 years. Intra-arterial blood pressure was also measured in another group of eight boys with bronchial asthma. ⋯ At maximal exercise, cardiac output averaged 12.4 l/min, stroke volume 66 ml, systolic, diastolic and mean blood pressures 128, 81 and 107 mmHg, respectively, and total peripheral vascular resistance 10.9 mmHg/l/min. The maximal arteriovenous oxygen difference amounted to 14.1 ml/100 ml blood which is similar to that in healthy adults.
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An intravenous injection of 100 microgram salbutamol sulphate was administered to a group of atopic asthmatics and a group of atopic control subjects without asthma. There was no difference in the metabolic and cardiovascular reponses of the two groups.
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Transbronchial lung biopsy (TBB) was performed during fiberoptic bronchoscopy under fluoroscopic guidance in 133 patients with diffuse or peripherally localized lung diseases without endobronchial lesions. Histological diagnosis consistent with the clinical course and roentgenographic appearance was obtained in 96 patients (72%). ⋯ In 33 cases a diagnosis was not possible even though the specimens were adequate for histological examination. The low complication rate in this series seems due to the selection of patients and the technique used.