Delayed films in bronchography. (73/518)

In bronchography, the oil often does not fill all bronchial branches. Films taken 30 to 60 minutes later frequently complete the opacification of bronchi in lingula, middle lobe and lower lobes. Such delayed films may demonstrate bronchiectasis not shown initially, or may exclude bronchiectasis suspected on the first films.  (+info)

Planned care for patients with bronchiectasis. (74/518)

Bronchiectasis, for which once only the most elementary palliation could be offered, now often can be cured by operation or well controlled by conservative therapy. Since true bronchiectasis implies irreversible anatomic changes, operation offers the only hope of cure, and it should be undertaken whenever it is not contraindicated by extent of involvement, age of the patient or other factors. Surgical results are excellent and mortality is at a minimum. When operation is prohibited, good results can still be anticipated by conservative measures. Such conservative therapy should combine prolonged use of antimicrobial drugs with adequate drainage of the diseased segments and general supportive measures. Any residual infection can be controlled by moderate use of appropriate antimicrobial agents. It is emphasized, however, that the control of bronchiectasis requires very careful diagnostic studies and a detailed analysis of the patient's condition, and that the therapy itself must be carefully adjusted in terms of the individual situation.  (+info)

Sputum sol phase proteins and elastase activity in patients with clinically stable bronchiectasis. (75/518)

BACKGROUND: Inflammatory and proteolytic activity occurs in sputum from patients with stable purulent bronchiectasis and has been proposed as the main pathogenetic mechanism of the disease. This study was designed to define further the role of inflammation and proteolysis in bronchiectasis. METHODS: Neutrophil elastase activity, sputum concentrations of the serum derived inhibitors alpha 1 antiproteinase and alpha 2 macroglobulin, and the sputum to serum ratios of albumin and C reactive protein concentration were measured in 26 patients with bronchiectasis. RESULTS: Free elastase activity was found in 15 sputum samples. A trend to higher proteolytic and inflammatory activity was found between mucoid and purulent sputum samples, suggesting that inflammatory and proteolytic activities are related to the macroscopic degree of purulence. Purulent sputum had a high sputum to serum ratio of C reactive protein, suggesting local production or active transport of this protein into bronchial secretions. C reactive protein was more sensitive than albumin in detecting a higher degree of inflammation in elastase positive samples. CONCLUSION: The finding of greater concentrations of alpha 2 macroglobulin in purulent and elastase positive samples than in mucopurulent, mucoid and elastase negative sputum samples suggests that this inhibitor may have a role in the proteolysis-antiproteolysis balance in bronchial secretions.  (+info)

Post-tuberculous bronchiectasis--indications for surgical treatment. (76/518)

Two hundred twelve of 308 post-tuberculous patients were found to have significant bronchiectasis; and in 105 of them, in whom certain symptoms or combinations of symptoms and conditions were observed, resectional operations were carried out. Good results were obtained in 81 per cent of the group. There were serious complications in 13 per cent. Three of the patients died, two after pneumonectomy, one after lobectomy plus segmental excision.  (+info)

OBSERVATIONS ON THE CLASSIFICATION AND DISTRIBUTION OF PULMONARY EMPHYSEMA IN CANADA. (77/518)

General principles of epidemiology are reviewed, using as an example the chronic non-specific respiratory diseases in Canada. Lack of agreement in definition and classification seriously hampers the use of governmental statistics to study the epidemiology of these diseases. Though Canada is experiencing a mid-century epidemic of deaths from emphysema, evidence is presented which suggests that provincial variation in this death rate is artificial and is likely apparent because physicians do not categorize deaths from this and related diseases in any similar fashion. Three-year-average age-standardized death rates by provincial areas for emphysema with or without bronchitis, asthma, chronic bronchitis and bronchiectasis are presented in evidence that provincial variation is largely obliterated when all chronic non-specific respiratory diseases are considered as a single nosological unit. Advantages and disadvantages of a recent clinical classification of these diseases are reviewed, and it is concluded that such a classification has a great deal to offer epidemiologists or clinicians studying the cause and natural history of these diseases.  (+info)

ENTEROMEGALY AND CARDIOMEGALY IN CHAGAS DISEASE. (78/518)

Chagas disease due to a trypanosome infection may lead to extensive destruction of ganglion cells in the peripheral autonomic system and may result in gross enlargement of the oesophagus, colon, and heart. From studies on nerve cell counts it is concluded that the number of ganglion cells in the oesophagus must be reduced to less than half to produce functional disturbances in the oesophagus and to one tenth to produce a megaoesophagus. Problems of terminology are discussed.  (+info)

BRONCHIOLAR EMPHYSEMA. A REPORT OF A NECROPSIED CASE OF DIFFUSE BRONCHIOLECTASIS AND REVIEW OF THE LITERATURE. (79/518)

Bronchiolar emphysema is a rare, insidious, progressive, bilateral pulmonary fibrosis with diffusion defect. Death follows in five to 10 years after the onset of symptoms because of respiratory failure, cor pulmonale or pneumothorax. In the 20 cases reviewed, the lungs typically showed bosselation of their pleural surfaces, giving the appearance and consistency of a liver involved by Laennec's cirrhosis. Cross sections showed honeycombing chiefly along the lung margins. Microscopically, cystic dilatation of terminal bronchioles was present, with obliteration of the remaining peripheral lung tissue by a dense pulmonary fibrosis. Hyperplasia of smooth muscle and elastica was prominent.Bronchiolar emphysema is a clinicopathologic entity, the etiology of which is unknown and likely multiple. Bronchiolectasis and superimposed recurrent infection are essential in its pathogenesis. Thickening of alveolar walls may play a decisive role in determining the characteristic site of the bronchiolar dilatation.  (+info)

Bronchopulmonary disease in ulcerative colitis. (80/518)

Two cases of ulcerative colitis are described: a 33-year-old woman who developed widespread bronchiectasis 7 months after undergoing colectomy, and a 72-year-old man whose colonic disease began coincidentally with the appearance of diffuse interstitial pulmonary infiltrates. In both cases, clinical correlation and common patterns of response of lung and bowel diseases suggested that the co-existence of these two pathologies might not be merely a casual relation.  (+info)