Biomedical subjects
Publications and source records attributed to A M van der Elst.
A patient with pulmonary hyalinizing granuloma (PHG) is presented. PHG is a rare disease with very specific histological characteristics. Roentgenograms display multiple bilateral pulmonary nodules which may be cavitated. Evidence exists that the nodules are the result of an exaggerated chronic immune response. The course of the disease is generally favourable. PHG should be considered in patients showing multiple bilateral pulmonary nodules.
A 22-year-old female patient is described who was repeatedly hospitalised on account of severe asthmatic attacks presumably due to the ingestion of cow's milk or milk-containing products. There were no signs of gastrointestinal disturbance, but some urticaria and angioedema occurred. Strongly positive RASTs were observed in the blood serum against the proteins in cow's milk, bovine serum, egg white, cod fish, and house dust. The symptoms were successfully controlled by rigorous dietary measures.
67 patients were studied by pulmonary function and heart catheterization at rest, during exercise and after 20 min 100% oxygen breathing. 14 patients were diagnosed as having COLD without chronic respiratory insufficiency (CRI). 45 patients were considered to be suffering from pulmonary emphysema (COLD + CRI). In this group, 23 patients had normal hemoglobin concentrations (CHb), 14 patients demonstrated decreased values and 8 had secondary polycythemia. All groups of patients had a normal cardiac output (CO), oxygen consumption (VO2) and pulmonary wedge pressure (Pw) at rest and after oxygen breathing. In the group with COLD and CRI high values for pulmonary vascular resistance (Rp) were found, most pronounced in those with polycythemia. All groups of patients except the polycythemia group demonstrated a significant decrease of Rp during oxygen breathing, but only a slight decrease of pulmonary arterial pressure (Ppa). It can be concluded that a normal quantity of oxygen transport to peripheral tissues in patients with arterial hypoxemia can be achieved by maintaining normal values for arterial mixed venous oxygen content without a shift of the oxygen dissociation curve.
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45 patients with chronic obstructive lung disease and chronic respiratory insufficiency were studied. The investigation of these hypoxemic patients concerned the compensating mechanisms in the oxygen transport. The study was performed at rest, during exercise and after 100% oxygen breathing. Normal values for the calculated oxygen consumption (VO2) and cardiac output (Q) were found. Low values of arterial oxygen pressure (PaO2) were compensated by a decrease of the venous oxygen pressure (PvO2) normalizing the arteriovenous oxygen saturation difference (Sa-v). In patients with very low values of PaO2 a further decrease of PvO2 was not established. In these patients, Sa-v became smaller and an increase of the hemoglobin concentration resulted as a compensating mechanism. During exercise, a shift to the right of the oxygen dissociation curve took place as an added compensation.
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