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PubMed1991

[Respiratory involvement in AIDS].

This review paper is divided into three parts. The first two parts are devoted to an analytical description of the clinical, diagnostic, prognostic and therapeutic aspects of the various bronchopulmonary and pleural lesions observed in AIDS. The third part presents an overall view of the main diagnostic and therapeutic approaches in the main clinical situations covering all respiratory disorders.

Acquired Immunodeficiency Syndrome↗
PubMed1980

[Relapsing polychondritis with predominant respiratory involvement treated with Dapsone :value of pulmonary function tests (author's transl)].

A 31-year-old patient had developed lesions in the nasal cartilage during infancy, followed by laryngotracheal lesions when 9 years old. The latter lesions recurred when he was 21, followed several years later by an affection of the main left bronchus and the diagnosis of relapsing polychondritis. Initial respiratory function tests showed mainly a reduction in maximum inspiratory flow, due to sequelae in the upper respiratory tract. Repeated tests were able to demonstrate lesions in the main left bronchus, determining severe expiratory slowing. No significant improvement occurred after one year of corticoïd therapy. Treatment with sulfones (Disulone) produced clinical improvement (reappearance of a vesicular murmur in the left lung) and a twofold increase in FEV1. Functional improvement was even better demonstrated by successive flow-volume curves.

Adult↗
PubMed1986

Respiratory involvement in patients with Sjögren's syndrome: is it a problem?

We examined the pulmonary involvement in 40 patients with primary Sjögren's syndrome (1 degree SS), and 26 patients with secondary SS (2 degrees SS) and compared them with 100 healthy matched controls, 40 patients with rheumatoid arthritis (RA) without evidence of SS and 30 patients with scleroderma. The respiratory evaluation included questionnaire, physical examination, chest roentgenogram and pulmonary function studies (spirometry, flow/volume curve, total lung capacity and diffusion: DLCO). The most common symptom in 1 degree SS was dyspnea (25%). Xerotrachea was present only in 1 degree SS (12.5%) while pleurisy only in 2 degrees SS and RA (7.7% and 2.5% respectively). The most common functional defect in 1 degree SS was interstitial lung disease (30%) and in 2 degrees SS and RA airways obstruction (46% and 32.5% respectively). Finally, small airways disease was frequent in all patient groups, as well as the control group. Comparison between patients with glandular and extraglandular SS revealed that xerotrachea was a manifestation of glandular and diffuse interstitial lung disease of extraglandular SS. Finally, comparison of patient groups and controls revealed statistical significant differences in: FVC and DLCO between extraglandular 1 degree SS/controls, FEV1/FVC ratio between 2 degrees SS/controls and the same between RA/controls, FVC, TLC, DLCO between scleroderma/controls, DLCO between scleroderma/SS and separately between scleroderma/1 degree SS and scleroderma/extraglandular 1 degree SS (which were the subgroups of SS with lowest DLCO). Diffusion impairment correlated with the presence of cryoglobulins and low complement levels, suggesting immune complex deposition as a mechanism of the interstitial lung disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Dyspnea↗
PubMed1994

[Respiratory involvement in ankylosing spondylarthritis: relations to alpha-1-antitrypsin phenotypes and tobacco consumption].

The distribution of alpha-1-antitrypsin phenotypes was similar in 555 controls and 98 patients with ankylosing spondylitis: the MM phenotype (including "main" MM subtypes, i.e., M2M2 and M3M3, and "secondary" MM subtypes) was found in 86% of subjects and "rare" phenotypes combining M, F, S, and Z in 14%. Six per cent of the controls and none of the ankylosing spondylitis patients had the M4M4 phenotype (p < 0.01). Respiratory function tests were performed in 49 patients with axial ankylosing spondylitis and 30 controls matched on sex, age, body mass index, smoking status, nonsteroidal antiinflammatory drug use and distribution of "main" and "secondary" phenotypes (no subjects in this study had "rare" phenotypes); the significant reduction in chest expansion seen in the ankylosing spondylitis group (5.6 +/- 2.7 cm versus 8.7 +/- 1.2; p < 0.001) was correlated with total capacity (p < 0.04) and vital capacity (p < 0.001). Restrictive ventilatory dysfunction was seen in four ankylosing spondylitis patients versus no controls (p < 0.02). Proximal airway obstruction, pulmonary distension and decreases in the diffusing capacity for carbon monoxide were seen in similar proportions of ankylosing spondylitis patients and controls. In the ankylosing spondylitis group, evidence of pulmonary distension included increases in mean residual functional capacity and mean residual volume (105.6 +/- 21.2% versus 94.8 +/- 17.4, p < 0.03, and 100.3 +/- 22.8% versus 88.6 +/- 17.9, p < 0.04, respectively) and bullous emphysema in the lung bases in two patients (versus no controls). In the small subgroup of ankylosing spondylitis patients with lung distension or a decreased diffusing capacity for carbon monoxide, smokers and nonsmokers were evenly balanced but subjects with "secondary" phenotypes outnumbered those with "main" phenotypes (p < 0.02); in contrast, our data suggested that smoking may play the central role in the proximal airway obstruction. Our findings suggest that in addition to previously established causes of pulmonary involvement in ankylosing spondylitis a "secondary" MM phenotype (i.e., neither M2M2 nor M3M3) may be a risk factor for lung distension and impaired diffusing capacity for carbon monoxide.

Adult↗
PubMed1995

Spontaneous maturation in Bufo arenarum oocytes: follicle wall involvement, respiratory activity, and seasonal influences.

The various somatic cell layers (surface epithelium, theca, and follicle cells) that envelope the amphibian oocyte were removed one by one. The various follicular preparations thus obtained were tested for their ability to undergo germinal vesicle breakdown (GVBD) in the presence or absence of progesterone during different seasonal periods. Intact follicles, follicles without epithelium, or defolliculated oocytes (without epithelium and theca layers) did not undergo GVBD when cultured in Ringer solution, unless progesterone was added to the culture medium. In contrast, denuded oocytes (lacking all follicular layers) cultured in a medium with no hormones underwent GVBD in percentages similar to those of denuded oocytes incubated with progesterone. This ability of denuded oocytes to undergo spontaneous maturation was found to be related to the respiratory activity of the oocyte, which is in turn a seasonal variable in Bufo arenarum. The different respiratory activity of the full-grown oocyte according to the seasonal period was expressed by the respiratory control quotient (around 1.0 during winter and 4.0 during summer). In fact, only those oocytes with a respiratory control quotient over 2.0 were able to undergo spontaneous nuclear maturation. The maturation obtained without exogenous hormonal stimulus was genuine as indicated by the ability of these oocytes to induce pronuclear formation after sperm injection.

Animals↗