Bronchiectasis and rib fracture. Clinical conference on pulmonary disease from Northwestern University Medical Center.
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Ciliated bronchial or nasal epithelium from 20 Polynesian bronchiectatic patients was examined in an electron microscope. In all patients there was a partial or complete loss of dynein arms. Also, in many patients other ciliary abnormalities were present with a high proportion, often over 25%, of cilia affected. This contrasts with a control group where ciliary abnormalities were infrequent. Mucociliary clearance, measured by imaging 99mTc sulfide dust with a gamma camera, was either absent or markedly reduced in these bronchiectatic patients.
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Mucoid impaction is a complication of asthma and is frequently recurrent in patients with allergic bronchopulmonary aspergillosis (ABPA). This report describes a patient with asthma and recurrent bilateral well-circumscribed densities on chest roentgenogram in the absence of ABPA. Recognition of this clinical presentation may avoid the need for invasive diagnostic procedures or steroid therapy.
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