Pulmonary Disease In Adults Research Articles

General practitioner to a football club.

Whilst alterations in surfactant components of bronchoalveolar lavage fluid (BALF) have been described in a variety of pulmonary diseases in adults, no information is available on the surfactant composition in children beyond the neonatal period. In order to obtain reference values for the paediatric age group, we have studied phospholipid profiles of BALF in children without pulmonary disease. The study population consisted of 38 children aged 3-15 yrs (mean +/- SD 8 +/- 4 yrs) undergoing elective surgery for nonpulmonary illnesses. Surfactant composition was analysed by high pressure liquid chromatography using both an ultraviolet and a light-scattering detector. Total phospholipid concentration was higher in children under 8 yrs of age and decreased with age. In contrast, the total protein concentration remained constant throughout the age range. No age-related changes in the relative composition of phospholipid fractions could be observed. Surfactant protein A concentrations were highly variable in all age groups. This study provides the first data on surfactant components in bronchoalveolar lavage fluid of healthy children and will be the basis for future studies of children with pulmonary diseases.

A Manual of Thoracic Surgery

The title of this book is misleading. Dr von Hippel has put together a collection of essays on the care of patients who have problems that require the services of a thoracic surgeon. These essays, largely anecdotal, represent the summation of his experience. As such, there is much of value, especially concerning the care of chest catheters and drainage systems. He makes the point that simple, relatively foolproof systems are the safest, and that surveillance is required for all available apparatus. In summary, use what you know well and with which you can do a good job. In this manual of thoracic surgery, surgery itself is conspicuously absent. Although specific tips are offered in the pediatric realm, the bulk of the treatment of adult pulmonary and esophageal disease (such as cancer) is mentioned only casually. The surgeon in training will not learn when or how to do mediastinal node dissections

POSTMORTEM ARTERIOGRAPHIC STUDIES OF THE HUMAN LUNG IN PULMONARY EMBOLIZATION.

PULMONARY EMBOLISM is now the most common lethal pulmonary disease in adults seen at necropsy in the general hospital population. It is the third most common nonlethal pulmonary lesion after pneumonia and emphysema. In 1960, it was the third most common cause of death in this hospital; it was the main cause of death in 15% of the patients autopsied, and it was a major contributory cause in an additional 19%. These findings promoted the study of the number, size, and distribution of pulmonary emboli, and of the pulmonary parenchymal and circulatory alterations resulting from them. Previous reports have considered particular aspects of the physiology or pathology of pulmonary embolism, but without detailed correlation of one approach with others. The methods used have not identified smaller emboli, or delineated the extent of anatomic alterations. Moreover, there has been no method for estimating the number of emboli or the reduction in

Pulmonary disease in adults associated with unclassified mycobacteria

Pulmonary disease in adults associated with unclassified mycobacteria

Respiratory Insufficiency and Chronic Cor Pulmonale

This is a review of the current state of our knowledge of pulmonary function in relation to cardiac physiology and the effects of pathologic processes in the lungs on these systems. The pathologic physiology, diagnosis and treatment of respiratory insufficiency and chronic cor pulmonale are thoroughly considered. The article is based on observations of chronic pulmonary disease in adults. The findings and recommendations are directly applicable to conditions which occur in childhood, especially in the pulmonary complication of cystic fibrosis of the pancreas. Pediatricians occupied with the care of the latter condition will find this review particularly enlightening. Efforts to relieve cynosis and hypoxia due to disturbed pulmonary ventilation in children with fibrocystic disease of the pancreas by treatment with oxygen are not without hazard. The respiratory centers are usually unresponsive to carbon dioxide and correction of the hypoxemia may lead to hypoventilation and retention of carbon dioxide with ensuing acidosis and death. Oxygen should be administered in low concentrations, intermittently, and only when it seems absolutely necessary. Digitalis has been shown to be beneficial in the treatment of congestive failure when chronic cor pulmonale develops as a complication of respiratory insufficiency. Detailed discussion of other therapeutic measures is provided. The incidence of cor pulmonale in respiratory insufficiency in diseases of childhood will undoubtedly be found to be greater when the techniques of clinical and pathologic examination described in this review are applied.