The lungs in systemic sclerosis (scleroderma): a review and new information.
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Biomedical subjects
Publications and source records attributed to M Sigurdson.
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Lung volumes, maximum expiratory flow rates, and static volume-ressure curves were measured in 16 patients with clinically stable asthma. It was found that flow rates were reduced in such patients because of the combined effects of reduced elastic recoil (transpulmonary pressure) and intrinsic diseases of the airways. In nine patients treated with an aerosol of isoprenaline, flow rates improved as a result of reduction in airways resistance as the static recoil pressure of the lungs fell further in those patients. The possibility is suggested that muscle tone in peripheral airways or alveolar ducts contributed to the elastic recoil measurements.
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The mechanical properties of the lung, forced vital capacity, flow-volume relationships, lung volume, and single-breath N2 curve were determined in 16 nonsmokers and 19 smokers. Pulmonary elastic recoil, Pst (1), was significantly lower at all lung volumes, as were flow parameters, whereas lung volumes were higher in smokers of both sexes. The variables derived from forced vital capacity and single-breath N2 were significantly different from nonsmokers in male smokers but not in female smokers. The inhalation of nebulized bronchodilator was attended by a significant decrease in Pst (1) and in upstream flow resistance in smokers. After cessation of smoking Pst (1) decreased to values similar to those seen after bronchodilator administration, whereas resumption of smoking led to reversal of the pressure-volume curve. The data suggest that the elastic properties of the lungs are altered in cigarette smokers, but the extent of the disturbance is masked by constriction of the alveolar ducts or peripheral airways while smoking, and that these are unmasked by the administration of nebulized bronchodilator or by cessation of smoking.
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This is a replication of a 1956 study that compared three ways to describe the case load of a mental hygiene clinic. The methods used were to follow-up of a cohort group, cases closed, and a survey of all active cases. In 1975, as compared to 1956, it was found that patients are more likely to be psychotic, to be receiving psychotropic drugs, and to stay in treatment much longer. Rate of improvement declined slightly. The number of patients increased by 166% and the annual number of patient visits increased by 84%, with about the same size staff. Some hypotheses for these changes are discussed.