Absolute lymphocytosis associated with nonsurgical trauma.

Absolute lymphocytosis after nonsurgical trauma was investigated in three patient groups at an acute-care tertiary referral hospital. The first group, with mild-to-moderate trauma, consisted of 64 patients who survived knife wounds to the chest and abdomen. Thirteen of the 64 patients had admission lymphocyte counts greater than 5.

Two unusual pathological reactions to nitrofurantoin: case reports.

Idiosyncratic pulmonary reactions to nitrofurantoin are not unusual, often presenting as eosinophilic pneumonia. We report two cases of uncommon pathological reactions, one resembling a hypersensitivity pneumonitis and the other mimicking a giant cell interstitial pneumonia.

Effect of breathing dry air on structure and function of airways.

We compared the effect of breathing dry air (0.70 mg H2O/l) with that of breathing room air (8.62 mg H2O/l) in guinea pigs anesthetized with urethane.

Effects of pulmonary edema on regional blood volume and red blood cell transit time. Comparison of high pressure and oleic acid-induced edema.

The present study was designed to determine the effects of pulmonary vascular pressure, vascular injury, and pulmonary edema on regional blood volume (Vr) and regional red blood cell (RBC) transit time (Tr) in the lung. The experiments were carried out in 15 dogs. Six served as controls, six had oleic acid-induced pulmonary edema (OAPE), and three had high pressure pulmonary edema (HPPE).

Alveolar epithelial damage. A critical difference between high pressure and oleic acid-induced low pressure pulmonary edema.

The present study was designed to compare high pressure pulmonary edema (HPPE) and oleic acid-induced low pressure pulmonary edema (OAPE) in dogs when similar amounts of extra vascular water were present in the lung. The high pressure edema was produced by intravenous fluid overload and by inflating an aortic balloon catheter (n = 6). The low pressure edema was produced by the injecting 0.

Ranking the severity of emphysema on whole lung slices. Concordance of upper lobe, lower lobe, and entire lung ranks.

This study describes a modification of a standard method for grading emphysema that was originally described by Thurlbeck for postmortem lungs. The study was based on pneumonectomy specimens that were fixed in inflation and sliced sagittally. The midsagittal slice was impregnated with barium sulphate and examined under water by 2 observers on 2 separate occasions.

The effects of mechanical stability on the macromolecules of the connective tissue matrices produced during fracture healing. I. The collagens.

The distribution of types I, II, III, V and IX collagens in healing fractures of the rabbit tibia has been demonstrated by immunofluorescent techniques. It has also been shown that the mechanical stability of the healing fracture affects both the distribution and types of the collagens present. The initial fibrous matrix contains types III and V collagens; type I collagen was only located in this matrix if unfixed tissue was used.

Airway structure and function in asthma.

As asthma is a disease characterized by muscle spasm, airways inflammation and mucus plugging of the airways, one can only generalize about their relative importance. For example, when an asthmatic attack is easily and completely reversible by drugs that relax smooth muscle, it is likely that smooth muscle spasm is the major cause of the airways obstruction. It also seems probable that when patients have airways reactivity that waxes and wanes in severity with intermittent severe attacks of asthma, the airways may be thickened by inflammation and the smooth muscle may be unloaded by softening of the cartilage.

Surgical treatment of lung cancer: promise and problems of early diagnosis.

Recent studies have shown that the survival of patients with lung cancer is improved if the tumour is resected before it becomes larger than 3 cm in diameter and before it spreads to lymph nodes. While this suggests a positive benefit from early detection, recent mass-screening studies have claimed that the benefit obtained from this procedure is illusory because it relates to a lead-time bias. This study reports the results of surgical resection of 143 primary lung cancers.

The diagnosis of emphysema. A computed tomographic-pathologic correlation.

To assess the accuracy of computed tomography (CT) in the diagnosis of emphysema, we performed CT on 32 patients prior to surgery for removal of suspected tumors. The CT scans were assessed visually for emphysema by 2 independent radiologists and 1 chest physician. Intraobserver and interobserver variation were assessed.

Relationship between regional pulmonary edema and blood flow.

We studied the effect of edema on the regional distribution of pulmonary blood flow in 12 anesthetized dogs. Two were controls, six had low-pressure pulmonary edema, and four had high-pressure pulmonary edema. All were ventilated with 100% O2.

Lung mechanics in papain-treated rabbits.

To further investigate the effects of airway cartilage softening on static and dynamic lung mechanics, 11 rabbits were treated with 100 mg/kg iv papain, whereas 9 control animals received no pretreatment. Lung mechanics were studied 24 h after papain injection. There was no significant difference in lung volumes, lung pressure-volume curves, or chest wall compliance.

Comparison of the cell content of lung lavage fluid with the presence of emphysema and peripheral airways inflammation in resected lungs.

This study was designed to investigate the relationship between the cellular components of lung lavage fluid and the presence of airways disease and emphysema in resected lung specimens, primarily from current and ex-smokers. Since standard bronchopulmonary lavage cannot be performed on these specimens, an intrapulmonary lavage technique was developed and compared to the results of bronchoalveolar lavage performed prior to surgery on the lung or lobe opposite to the one resected. The specimen lavage produced inflammatory cell differential counts similar to those obtained by bronchopulmonary lavage, and studies on postmortem lungs showed that the fluid washed alveoli, respiratory and membranous bronchioles, and small cartilaginous bronchi.

Nonspecific airway reactivity in cigarette smokers. Relationship to airway pathology and baseline lung function.

To examine the relationship of cigarette smoking, starting airway caliber, and airway pathology to nonspecific airway reactivity, we performed inhalation dose-response curves in 40 patients prior to lung surgery. Airway reactivity was assessed by the provocative concentration of methacholine (n = 30) or histamine (n = 10) resulting in a 20% fall in FEV1 (PC20). All patients had measurements of maximal expiratory flow, diffusing capacity, and lung volumes preoperatively.

Pulmonary function and peripheral airway disease in patients with mineral dust or fume exposure.

Cigarette smoking and mineral dust exposure combined result in small airways function abnormalities difficult to distinguish from smoking effects alone. To determine if mineral dust or fume exposure in smokers results in additional changes in small airways structure and function, we studied small airways disease and pulmonary function in 25 persons (62.4 +/- 8.

Reassessment of inflammation of airways in chronic bronchitis.

The term chronic bronchitis has been criticised because it is associated with hypersecretion of mucus rather than bronchial inflammation. This study was designed to establish the presence or absence of clinical chronic bronchitis and measure pulmonary function in 45 patients about to undergo resection of the lung. The condition in the cartilaginous and small airways and the severity of the emphysema were then measured in the resected specimen.

Regional differences in erythrocyte transit in normal lungs.

We measured regional blood volume and flow in the lungs of nine mongrel dogs. The time taken for the erythrocytes to transit through individual lung regions was calculated from the relationship t = V/Q, where V is blood volume and Q is flow. The data show that the total pulmonary blood volume was 82 +/- 6 ml and that the average time spent in the pulmonary vascular bed was 2.

Macrophage accumulation of inhaled gallium-67 citrate in normal lungs.

Injected 67Ga has been used extensively to monitor inflammatory processes in the peripheral lung. We hypothesized that inhaled 67Ga may be useful in marking early airway inflammation in smokers. Eight nonsmokers and eight smokers breathed a 67Ga aerosol and imaging was performed immediately and 24 and 96 hr later.