Rapid onset of severe and irreversbile airflow obstruction developed in two women. One had eosinophilic fasciitis and the other had rheumatoid arthritis. Both were treated with penicillamine. In the first patient, aged 42 years, dyspnea developed after six months of therapy. Her roentgenogram showed hyperinflation. Forced vital capacity expired in one second (FEV1/FVC%) decreased from 75% to 40%, and the residual volume increased by 1 L. In the second patient, aged 54 years, cough and dyspnea developed after ten months of therapy. The FEV1/FVC% was 56%, the FEV1 was 0.9 L, and the roentgenogram was normal. Lung biopsy specimens demonstrated severe and widespread bronchiolitis. An association between obliterative bronchiolitis and rheumatoid arthritis has been reported. Penicillamine may impair healing of bronchiolitis in such patients.

Adult↗

PubMed1979

Anatomically localised re-expansion pulmonary oedema following pneumothorax drainage. Case report and literature review.

We describe the 15th recorded case of ipsilateral pulmonary oedema following re-expansion of a pneumothorax. In contrast to previously described cases, the oedema was exclusively confined to the right middle and lower lobes, with complete sparing of the right upper lobe. This strict anatomical localisation can best be explained by the presence of a discrete temporary obstruction of the bronchus intermedius during the critical period of rapid pneumothorax re-expansion. We believe that this case lends strong support to previous contentions that bronchial occlusion plays a crucial role in the genesis of re-expansion oedema.

Adult↗

PubMed1979

Bronchial artery embolization in the control of massive haemoptysis.

Bronchial artery embolization is a useful palliative treatment for life-threatening haemoptyses where surgery is contra-indicated. Patients presenting with haemoptyses complicating cystic fibrosis and aspergilloma have been embolized. Control of haemoptysis was achieved in the former, but late recurrence of haemoptysis in the latter led to asphyxiation.

Adolescent↗

PubMed1979

The pharmacology of bronchodilator drugs: introduction.

Explore the source record for details and available documents.

Asthma↗

PubMed1978

Natural history and treated course of usual and desquamative interstitial pneumonia.

Patients with confirmed interstitial pneumonia were initially classified histologically into "desquamative" (n = 40) and "usual" (n = 53) types, and followed for one to 22 years. Both the diagnosis and the extent of fibrosis affected the course and response to therapy. Mortality in desquamative interstitial pneumonia was 27.5 per cent, and mean survival 12.2 years, as compared with 66.0 per cent and 5.6 years in usual interstitial pneumonia (P less than 0.01). Without treatment, 21.9 per cent with the desquamative but none with the usual type improved. With corticosteroid therapy, 61.5 per cent with desquamative and only 11.5 per cent with usual interstitial pneumonia improved, whereas 27.0 per cent and 69.2 per cent worsened. We conclude that the histologic classification of chronic interstitial pneumonia used here permits forecasts of prognosis and response to treatment that cannot be deduced from other data.

Adolescent↗

PubMed1978

Giant intralobar sequestration.

A case of intralobar sequestration is reported in a 20-year-old male who had recurrent localized infections since age 5. The prolonged course without diagnosis, the very large size of the lesion, and the demonstration of an anomalous artery from the abdomen on the plain chest film represented unusual features. Classification, clinical presentation, and diagnostic and therapeutic approaches are emphasized.

Adult↗

PubMed1974