[Acoustic analysis of stenotic stridors in respiratory tract diseases in children].
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Antileukoprotease, an inhibitor of granulocyte elastase, was studied in paired sera from 19 patients with pneumonia and from 9 patients with cholecystolithiasis. The circulating level of antileukoprotease was significantly higher in patients with pneumonia compared with patients with cholecystolithiasis. In the latter group, surgery raised the level of general acute phase reactants, but did not affect the level of antileukoprotease. In sera from patients with pneumonia, antileukoprotease was recovered in a free and active form, as shown by gel-filtration of sera before and after the addition of leukocyte elastase. A local protective function of antileukoprotease is suggested by the finding that antileukoprotease was bound to granulocyte elastase in purulent bronchial secretions.
In a retrospective study of hospitalised patients (children aged between 0 and 4 years) covering four years the dependence of the incidence of croup (infectious laryngitis) and obstructive bronchitis on air pollution was investigated. For this reason the incidence of morbidity in residential areas with various levels of SO2 and sedimenting dust were compared. The results show a definitive connection between a high level of SO2 and dust, respectively and a high rate of morbidity. This connection was particularly marked in areas with simultaneous high levels of both SO2 and dust. The effects of confounding factors, such as infection incidence, meteorological influences, distances from hospital, social status, especially the percentage of foreign guest worker families and population density were investigated and separated from air pollution effects.
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Tests were conducted on 90 smokers and a control group of 20 non-smokers using not only simple spirometry but also pneumotachography and the forced oscillation technique, including flow- and resistance-volume graphs. FEV1 was proved to be a sensitive screening test for early recognition of disfunction in the region of the small airways. 39,5% of the younger light smokers already showed signs of impairment to the breathing mechanics indicating exobronchial obstruction. The heavy, mostly older, smokers frequently showed complex disfunction, and in 55,3% the oscillatory resistance revealed quantifiable endobronchial obstruction. The oscillatory flow-resistance-increase-volume (as a percentage of vital capacity) proved the most sensitive small-airways-test during middle age, permitting significant distinction of smokers from non-smokers up to the age of 55.