Cicatricial pemphigoid presenting as upper airways obstruction.

A 53-year-old woman presented with a history of increased shortness of breath, stridor and dryness of the eyes. Flow volume loops demonstrated evidence of upper airways obstruction. Conjunctival and laryngeal biopsies suggested a diagnosis of cicatricial pemphigoid.

Metabolic responses to graded exercise in chronic heart failure.

To determine if exercise intolerance and fatigue in chronic heart failure could be exacerbated by an abnormal metabolic response to exercise, we studied 12 patients with stable chronic heart failure and 12 normal volunteers during symptom-limited maximal treadmill exercise. Peak VO2 was 17.2 (15.

Respiratory gas exchange and metabolic responses during exercise in McArdle's disease.

During normal progressive exercise, the gas exchange anaerobic threshold occurs when CO2 production (VCO2) and ventilation (VE) increase so as to depart from a linear relationship to O2 consumption (VO2). This is thought to represent a gas exchange response to metabolic acidosis due to lactate accumulation. Patients with McArdle's disease have previously been reported to exhibit a steepened ventilatory response relative to VCO2, despite an inability to produce lactate.

The effect of methacholine on nasal transmucosal potential difference in normal human subjects.

This study was proposed to test the hypothesis that the parasympathetic system might attribute to the transmucosal potential difference. In a double-blind, placebo-controlled study six volunteers had nasal transmucosal potential difference (NTPD) recorded at 4-min intervals during 12-min periods of rest, before and after treatment, as well as during exercise and recovery. Application of placebo did not significantly alter NTPD at rest.

The prevalence of preferential nasal breathing in adults.

The prevalence of preferential nasal breathing was studied in an awake adult population. One hundred and ninety-four people consented to gentle manual compression of the nostrils. They were advised to 'breathe in and out', but no further information regarding breathing was given to avoid influencing the patient.

Effect of beta-adrenoceptor blockade on atrial natriuretic peptide levels during exercise in angina pectoris.

The effects of epanolol (200 mg once daily) and diltiazem (60 mg three times daily) on the response of atrial natriuretic peptide (ANP) to exercise were investigated in a double-blind placebo-controlled crossover study in 16 patients with angina pectoris. Exercise tolerance as assessed by peak oxygen consumption was similar with all treatments. Peak heart rate (mean and 95% confidence intervals) was lower (P < 0.

Regulatory peptides in the plasma of patients with chronic cardiac failure at rest and during exercise.

The levels of several regulatory peptides were measured in peripheral plasma samples from individuals with chronic cardiac failure (CCF) and matched controls in both the resting state and during a short period of maximal exercise. Basal levels of noradrenaline (NA; 705 +/- 114 vs 195 +/- 54 ng.l-1; mean +/- SEM; P < 0.

The use of an exponential protocol for bicycle and treadmill exercise testing in patients with chronic cardiac failure.

We have studied a standardized exercise protocol suitable for use with a treadmill or bicycle (STEEP protocol) and compared it with a modified Bruce treadmill protocol in a group of patients with chronic cardiac failure. The STEEP protocol has been previously validated in normal subjects. Exercise time (6.

Lung function testing in adults with preferential nasal breathing.

Three adult patients with asthma with preferential nasal breathing were found to have a typical pattern of lung function test results with substantial between test variation. This condition can be identified as a cause of unsatisfactory performance in respiratory tests by observing the patient's reaction after the nostrils have been occluded.

The effects of diuretics on nasal transmucosal potential difference.

The effects of application of frusemide, amiloride and bumetanide on nasal transmucosal potential difference (NTPD), at rest and during exercise, were studied in 8 normal subjects. In a double-blind placebo controlled study, 8 volunteers had NTPD recorded at 4-min intervals during 12-min periods of rest, before and after treatment, during 12 min of exercise, and recovery. Application of placebo, frusemide and bumetanide did not significantly alter NTPD at rest.

Comparative effects of epanolol and diltiazem on exercise performance and respiratory gas exchange in angina pectoris.

The effects of epanolol (a new selective beta-adrenoceptor antagonist), diltiazem and placebo were compared in a group of 16 patients with chronic stable angina pectoris. Each patient received each treatment in random order. Diltiazem reduced weekly angina attack rate from 7.

Comparison of immunodiffusion and enzyme linked immunosorbent assay in the detection of abnormal antibodies in pigeon breeder's disease.

Aims: To compare the sensitivity of two methods for the detection of serum antibodies to pigeon faecal antigens in patients with pigeon breeder's disease.

Methods: Serum samples stored at -20 degrees C from 50 patients with pigeon breeder's disease, 50 control samples from patients with other respiratory diseases, and 50 healthy blood donors were examined for the precipitating antibodies and IgG antibodies to antigens present in extract of pigeon droppings by immunodiffusion and enzyme linked immunosorbent assay (ELISA), respectively.

Results: Both antigen preparations of pigeon dropping extract were equally effective.

Oxygen consumption during corridor walk testing in chronic cardiac failure.

We have examined the use of a 6-min corridor walk test in the assessment of functional capacity in 16 patients with chronic cardiac failure. VO2 was determined concurrently by a portable 'Oxylog'. Three tests were performed sequentially, and although there was a significant increase in distance walked and highest VO2 achieved between the first and second tests, good reproducibility was attained between the second and third tests.

A pharmacokinetic and pharmacodynamic comparison of plain and enteric-coated prednisolone tablets.

1. Eight healthy volunteers and eight patients suffering from chronic obstructive pulmonary disease (COPD) received 30 mg prednisolone as plain (P) and enteric-coated tablets (EP) in a randomised, cross-over manner. Plasma prednisolone and cortisol and blood glucose were measured over 24 h.

The parasympathetic system in exercise-induced rhinorrhoea.

The present study demonstrates that ipratropium bromide significantly reduces normal resting nasal secretion (p less than 0.05) and also significantly reduces exercise induced rhinorrhoea compared with a placebo (p less than 0.01).

Short-term plasma-cleaning treatments enhance in vitro osteoblast attachment to titanium.

The purpose of this research was to characterize the in vitro cellular behavior of osteoblast-like cells on titanium surfaces prepared with argon plasma-cleaning (PC) treatments for various lengths of time. The highest levels of cell attachment were observed for surfaces which had been plasma-treated for one min. Surface analyses indicated that although PC treatments dramatically improved surface wettability, the presence of inorganic contaminants was observed with longer treatment times and may have interfered with cell attachment.

Magnesium status and digoxin toxicity.

1. Eighty-one hospital patients receiving digoxin were separated into groups with and without digoxin toxicity using clinical criteria. Serum digoxin, sodium, potassium, calcium, creatinine, magnesium and monocyte magnesium concentrations were compared.

Non-arterial assessment of blood gas status in patients with chronic pulmonary disease.

Assessment of blood gas status is important in the management of patients with chronic pulmonary disease. Arterial puncture is often painful and may damage the arterial wall. Measurement of oxygen saturation by transcutaneous oximetry offers a non-invasive alternative to arterial methods but does not allow assessment of partial pressure of carbon dioxide.

Resting energy expenditure in chronic cardiac failure.

1. Resting energy expenditure has previously been shown to be elevated in the acute phase of heart failure, but the situation in the compensated state of chronic cardiac failure is unclear. Resting energy expenditure was assessed in 14 patients with stable chronic cardiac failure and 14 matched control subjects by using indirect calorimetry.

Social dynamics of intergroup encounters in the capped langur (Presbytis pileata).

Data from a 15-month field study of the capped langur (Presbytis pileata) in moist deciduous forest in Bangladesh show that during intergroup encounters males respond more aggressively to extra-group males and to the resident males of unfamiliar one-male groups than they do toward familiar males. Lone males followed established one-male groups and attempted to interact with group females. During intergroup encounters males responded to the approach of unfamiliar males with significantly more displays than were given to familiar (frequently encountered) males.

The concept of osseointegration and bone matrix expression.

Osseointegration has been defined as the direct structural and functional connection between ordered, living bone and the surface of a load-carrying implant. To date, this concept has been described by descriptive histological and ultrastructural criteria but not by biochemical means. This review evaluates the basic science work performed on this concept and then applies the concept to the principle of osseous healing.