Lung biopsy--a review of 3 years' experience.

The results of 140 percutaneous lung biopsies by 3 different methods and 37 transbronchial biopsies through the fibre-optic bronchoscope are presented. The indications for each procedure, their diagnostic accuracy and ensuing complications are discussed. We conclude that each method has its place and that skill with several techniques permits the selection of the most appropriate method in each individual case.

Goodpasture's syndrome: case report of a survivor.

A patient with Goodpasture's syndrome who presented with severe pulmonary haemorrhage and minimal renal involvement is described. The diagnosis was substantiated by immunofluorescence studies on a renal biopsy specimen and by the detection of circulating antiglomerular basement membrane antibody. The patient was treated with corticosteroids and cyclophosphamide.

Pulmonary complications in the immunocompromised patient.

A diagnostic approach to pulmonary complications in the immunocompromised patient is outlined. The importance of early lung biopsy in selected patients is emphasized and the various techniques available are discussed. Successful early diagnosis and management of opportunistic infections ia a challenge for the clinician, bacteriologist and pathologist, and requires these close collaboration.

Sarcoidosis in South Africa. A comparative study in Whites, Blacks and Coloureds.

One hundred and ten cases of sarcoidosis seen in Cape Town over a 7-year period (1969-1975) are reported. Seventy-one patients were Coloured, 25 Black and 14 White. The calculated minimum incidence of sarcoidosis in the Cape Peninsula is 23,2/100 000 population in Blacks, 11,6/100 000 in Coloureds and 3,7/100 000 in Whites.

Aspergillus infection in the Western Cape.

The inhalation of spores of Aspergillus may result in allergic, infective or saprophytic clinical reactions, depending on the immunological status of the host. Five cases of bronchopulmonary aspergillosis in asthmatics, 62 asthmatics with evidence of skin hypersensitivity to Aspergillus, but without bronchopulmonary aspergillosis, 3 patients with Aspergillus pneumonia and 7 with aspergillomas diagnosed in the Western Cape during the last 18 months, are described. The characteristic features of each type of reaction to Aspergillus are reviewed.

Lymphoid interstitial pneumonia with associated chronic active hepatitis and renal tubular acidosis.

Various combinations of diffuse interstitial fibrosis, chronic liver disease, and renal tubular acidosis have been recorded. The patient we report is unique in that the features of chronic liver disease and renal tubular acidosis were discovered while the patient was being treated for lymphoid interstitial pneumonia. This sequence of events has not been previously described.

A case of primary alveolar hypoventilation associated with mild proximal myopathy.

A 34-year-old man presented with clinical features of primary alveolar hypoventilation, but was found additionally to have an adult onset myopathy caused by acid maltase deficiency. This was not severe, as judged clinically, and was initially overlooked. His vital capacity and sprint maximal ventilatory volume were only slightly reduced, and the ventilatory response to CO2 was virtually absent.

Clinical relevance of the flow rate response to low density gas breathing in asthmatics.

The maximal expiratory flow rate response to low density gas breathing was examined at the mid-vital capacity point in 31 asthmatic patients. Clinical features and long-term follow-up date were documented to assess the clinical relevance of the various responses. Many of the patients with chronic asthma had not responded adequately to outpatient therapy, and they had been admitted to hospital for evaluation and management.

Early diagnosis of airways obstruction.

, , 389-393. Three simple tests, maximum expiratory flow volume curve, maximum expiratory volume time curve and `closing volume', were used to detect early airways obstruction in 21 smokers. A high proportion had abnormal values for MEF, MEF, and FET (86%, 71%, and 62% respectively) with a relatively normal FEV.

Correlation between tests of small airway function.

172-178. To compare and correlate tests of small airway function we have measured residual volume, frequency dependence of compliance, `closing volume', maximal expiratory flow rate at 50% and 25% of vital capacity, maximal expiratory flow rate at 50% of total lung capacity, and forced expired time in 10 health non-smoking male subjects and 10 non-smoking asthmatics who on the day of the study had no symptoms of airway obstruction. There was no evidence to suggest that any one particular test was more sensitive than others in detecting the presence of small airways obstruction.