The alveolar macrophage (AM) has been cited as a potential source for clearing tantalum from the lungs following bronchography. We studied the short term effects of tantalum oxide on rabbit AM viability and metabolism in vitro. AM phagocytosed tantalum oxide particles without cytotoxicity and with a significant rise in glucoxe oxidation. These results suggest that the AM represents an important vehicle for clearance of tantalum particles from airways in vivo.

Animals↗

PubMedDate not supplied

Tantalum oxide, silica and latex: effects on alveolar macrophage viability and lysozyme release.

Tantalum an experimental bronchographic material, may be retained in the lungs for a prolonged period following bronchography. The alveolar macrophage (AM) is a cell with potential for clearing tantalum particles from the airways. We studied the in vitro effects of tantalum oxide and two other particles, silca and latex, on rabbit AM viability and lysozyme release over 30 hours. Results indicate: 1) tantalum oxide, silica, and latex particles are ingested by rabbit AM in culture; 2) tantalum oxide and silica are both toxic to AM in vitro; and 3) tantalum oxide exerts its toxic effects less rapidly on AM than does silica. On the basis of these in vitro culture results we conclude that tantalum oxide may be toxic to alveolar macrophages in vivo. Delayed lung clearance of tantalum oxide particles may be due in part to their toxic effects on alveolar macrophages.

Animals↗

PubMedDate not supplied

1979 Memorial Award Paper. Comparison of exercise right ventricular performance in chronic obstructive pulmonary disease and coronary artery disease: noninvasive assessment by quantitative radionuclide angiocardiography.

The right ventricular (RV) response to upright bicycle exercise was assessed in 16 patients with chronic obstructive pulmonary disease (COPD), in 23 patients with coronary artery disease (CAD), and in 19 normal control subjects. Right ventricular (RV) and left ventricular (LV) ejection fractions were determined noninvasively using first-pass quantitative radionuclide angiocardiography, a technique well suited for simultaneous assessment of RV and LV systolic performance. The factors limiting exercise in COPD and CAD are distinctly different, and therefore patients with COPD were studied by means of a single-stage submaximal exercise test, while patients with CAD were studied by means of a graded maximal test. The normal response to exercise, irrespective of exercise protocol, was at least a 5% increase in RV and LV ejection fractions. In 12 of 16 patients with COPD, RV ejection fraction either decreased or remained the same with exercise (abnormal exercise RV reserve). Left ventricular exercise reserve was abnormal only in five patients, probably due to occult CAD. Isolated abnormal exercise RV reserve was present in nine patients. The severity of ventilatory impairment and resting arterial hypoxemia were major determinants of abnormal exercise RV reserve in patients with COPD. In 12 or 23 patients with CAD, RV ejection fraction either decreased or remained the same with exercise (abnormal exercise RV reserve). Left ventricular reserve was abnormal in 18 of 23 patients; RV exercise reserve was abnormal only in CAD patients with concomitant abnormal LV reserve. The presence of proximal right coronary artery stenosis (the major blood supply to the RV) was not a significant determinant of the RV response to exercise in patients with CAD. These data suggest that abnormal exercise RV reserve occurs frequently both in COPD and CAD patients. In COPD the predominant hemodynamic abnormality involves performance of the RV, while in CAD the predominant abnormality involves the LV. The common factor modulating RV exercise performance in both diseases appears to be altered RV afterload.

Angiocardiography↗

PubMedDate not supplied

Thoracic metastases from cervical carcinoma: current status.

Thoracic metastases from squamous carcinoma and adenocarcinoma of the cervix were studied by reviewing 245 consecutive cases to describe comparative incidence, natural history, and radiographic patterns. The incidence of chest metastases was higher for adenocarcinoma (20%) than for squamous carcinoma (4%). Few patients diagnosed in the early stages of squamous carcinoma developed metastases; for adenocarcinoma, chest metastases occurred regardless of the stage at diagnosis. For both histologies, parenchymal (often cavitary) nodules only were seen; lymphangitic pattern was not observed. Both adenopathy and malignant effusion are common (44% of metastases) in thoracic metastasis from squamous carcinoma. Adenopathy but not effusion was common in adenocarcinoma.

Adenocarcinoma↗

PubMedDate not supplied

Pulmonary artery hypertension in chronic obstructive pulmonary disease: determination by chest radiography.

Pulmonary artery hypertension is a frequent complication of severe chronic obstructive pulmonary disease (COPD). A study was undertaken to determine whether analysis of the chest radiograph can reveal the presence of pulmonary artery hypertension in COPD. Sixty-one men with COPD (forced expiratory volume in 1 second 0.97 +/- 0.35 liters, mean +/- SD) underwent right heart catheterization, and in 46 the mean pulmonary artery pressure was elevated (greater than 20 mmHg). Plain chest radiographs of the 61 patients and 42 normal control subjects were evaluated. The right descending pulmonary artery (RDPA) was enlarged (greater than 16 mm) in 43 of 46 patients (93%) with an elevated mean pulmonary artery pressure, and the left descending pulmonary artery (LDPA) diameter also was enlarged (greater than 18 mm) in 43 of 46. Combined increased RDPA and increased LDPA diameter measurements permitted correct diagnosis in 45 of 46 patients (98%) with pulmonary artery hypertension, including all 26 a mild elevation of mean pulmonary artery pressure (21-30 mmHg). There was a significant correlation between pulmonary artery pressure and both RDPA and LDPA measurements. Analysis of RDPA and LDPA diameters on the plain chest radiograph is a sensitive and accurate method of detecting the presence and severity of pulmonary artery hypertension in COPD.

Aged↗

PubMedDate not supplied

The adult respiratory distress syndrome.

The adult respiratory distress syndrome (ARDS) represents a common denominator of acute lung injury leading to alveolar flooding, decreased lung compliance, and altered gas transport. In the absence of specific etiology and therapy, the management of ARDS remains largely supportive. Ubiquitous use of intermittent positive-pressure ventilation with positive end-expiratory pressure (PEEP) improves arterial oxygenation but with some risk of pulmonary barotrauma and decreased cardiac output. The recent understanding of lung inflation as a modulator of right heart afterload and the effect of the right ventricle on global cardiac performance continues to redefine optimal patterns of ventilatory and hemodynamic intervention in ARDS.

Capillary Permeability↗

PubMedDate not supplied

Pulmonary renal syndromes. II. Etiology and pathogenesis.

Numerous systemic diseases share immunopathogenic mechanisms. This article reviews the proposed etiologies and immunopathogenic mechanisms of a group of diseases which share pulmonary and renal abnormalities. Specifically, we discuss the following diseases: Good-pasture's syndrome, systemic lupus erythematosus, progressive systemic sclerosis, Wegener's granulomatosis, lymphomatoid granulomatosis, and Churg-Strauss syndrome.

Animals↗

PubMedDate not supplied

Systemic and discoid lupus erythematosus: analysis of pulmonary function.

To determine the prevalence of pulmonary dysfunction in lupus erythematosus, 24 patients with systemic lupus erythematosus (SLE) and 5 patients with discoid lupus erythematosus (DLE) were studied. Diffusing capacity for carbon monoxide was abnormal in 17 (71 percent) SLE patients. A restrictive ventilatory defect was present in 6 (25 percent) and arterial hypoxemia in 4 of 23 (17 percent). The mean ratio of forced expiratory volume in one second to forced vital capacity (FVC) was 83 percent. To test for the presence of small airways disease, maximum expiratory flow rate at 50 percent of FVC was measured on air and on an 80 percent helium-20 percent oxygen mixture. Ten patients (5 smokers and 5 nonsmokers) with SLE were nonresponders to helium suggesting small airways disease. Pulmonary dysfunction was present in 90 percent (9/10) of SLE patients with a previous history of pleuritis and/or pneumonitis, and in 71 percent (10/14) without respiratory symptoms or history of lung disease and with a normal chest radiograph. Pulmonary function tests were normal in DLE patients except for an abnormal response to helium and/or mild arterial hypoxemia in two patients, all of whom were smokers. These data indicate that there is a high prevalence of pulmonary function abnormalities in SLE including patients without clinically evident pleuropulmonary disease.

Female↗

PubMedDate not supplied

Pulmonary renal syndromes--a review.

Several systemic diseases share clinical, pathologic and radiologic characteristics. This article emphasizes similarities and differences in the clinical and chest radiographic manifestations of six diseases with both pulmonary and renal abnormalities-Goodpasture's syndrome, Wegener's granulomatosis, lymphomatoid granulomatosis, Churg-Strauss syndrome, systemic lupus erythematosus, and scleroderma.

Anti-Glomerular Basement Membrane Disease↗