Subject(s)
Thoracoscopy/history , History, 19th Century , History, 20th Century , Humans , Sculpture/history , Sweden , ThoracoscopesABSTRACT
This case-control study is based on an investigation of 27 nonsmoking patients with radiologically verified spontaneous pneumothorax (SP) and ten healthy never-smoker control subjects. The posteroanterior and lateral radiographs of patients and control subjects were normal. They were all submitted to the same clinical, laboratory, and radiologic examinations, including computed tomography (CT) of the lungs, with the aim of detecting any parenchymatous lung changes. Emphysema-like changes (ELCs) were detected on CT in 22 (81 percent) of the 27 patients, and if the ELC cases detected during interventional surgery are added, the frequency increases to 24/27 (89 percent). In 20 patients with unilateral SP, at least one ELC was found in 13 of the 20 SP-affected lungs, but only in five of the 20 lungs that were not diagnosed as having SP (p < 0.05). ELCs were found more frequently in the upper than in the lower lung regions (p < 0.05) and more frequently in the radiologically peripheral than in central regions (p < 0.001). No ELC was detected in the control group on CT. No alpha 1-antitrypsin deficiency was found in the 27 nonsmoking patients with radiologically verified SP who had ELCs despite the absence of these known promoters of emphysema.
Subject(s)
Lung/diagnostic imaging , Pneumothorax/diagnostic imaging , Pulmonary Emphysema/diagnostic imaging , Adult , Case-Control Studies , Female , Humans , Male , Pleura/diagnostic imaging , Pneumothorax/complications , Pulmonary Emphysema/complications , Smoking , Tomography, X-Ray Computed , alpha 1-Antitrypsin DeficiencyABSTRACT
Flexible fiberoptic bronchoscopy (FFB) was performed in 26 never-smokers with healed spontaneous pneumothorax (SP) with the aim of detecting and localizing any bronchial obstruction, including congenital anomaly. In a case-control study these patients were compared with a consecutive, randomly sampled, control group of 41 patients who were undergoing FFB for respiratory symptoms but who had not had a SP. In both groups the endobronchial anatomy with respect to such anomalies, which could be classified as disproportionate bronchial anatomy, an accessory bronchus, and/or a missing bronchus, was compared with normal anatomy. All except one of the 26 patients with SP but only four of the 41 control patients without SP had such bronchial anomalies bilaterally. This corresponds to an odds ratio of 231 (95% confidence interval, 24 to 880; p < 0.001). The significantly higher frequency of bilateral bronchial anomalies in never-smokers with SP suggests that a virtual prerequisite for the occurrence of SP has been found. However causal links between the probably congenital bronchial anomalies and SP have not yet been identified.
Subject(s)
Bronchi/abnormalities , Congenital Abnormalities/epidemiology , Pneumothorax/etiology , Adolescent , Adult , Bronchoscopy , Case-Control Studies , Congenital Abnormalities/classification , Congenital Abnormalities/diagnosis , Female , Hospitals, University , Humans , Male , Middle Aged , Observer Variation , Pneumothorax/epidemiology , Risk Factors , Sweden/epidemiology , Videotape RecordingABSTRACT
A model of a freely rotating extended scatterer is proposed to describe light scattering from beating cilia. Gaussian rotation frequency distributions, characterized by a mean angular frequency and a standard deviation, are introduced in order to simulate intensity autocorrelation functions and to fit the model to experimental data. Thus the ciliary beats are characterized by a mean beat frequency and a standard deviation of the beat frequency distribution. The standard deviation influences the damping of the intensity autocorrelation function of light scattered from cilia. The calculated intensity autocorrelation function shows a more prominent oscillating behaviour the smaller the standard deviation of the beat frequency. The validity of the model is supported by experimental data in two ways: 1) The model fits very well to experimental data in computer evaluations, 2) Neither the model nor information obtained from measurements are dependent on the measuring angle.
Subject(s)
Cilia/physiology , Models, Theoretical , Normal Distribution , Animals , Biophysical Phenomena , Biophysics , Cattle , Computer Simulation , Trachea/physiologyABSTRACT
Laser light scattering spectroscopy is based on the evaluation of the frequency shift of coherent light scattered by moving particles. This makes it particularly suitable for use in light guiding systems. In this study laser light scattering spectroscopy was assessed for its ability to provide information on the motility of respiratory cilia. In vitro and in vivo measurements were undertaken with animal tracheal mucosa. The intensity fluctuations of laser light scattered from moving cilia were analysed in terms of their autocorrelation functions to provide information on the frequency and synchrony of beating cilia. In vitro measurements were performed on fresh bovine trachea to estimate a safe laser power level for mucosal exposure and to test the method by defining the temperature dependence of the ciliary beat frequency. Power densities not exceeding 0.3 kW/cm2 were found to be the upper limit for long term exposure of the mucosa in vitro. Ciliary beat frequency showed a pronounced temperature dependence, ranging from 5.8 to 28.3 Hz over the temperature range 20-43.5 degrees C. A maximum frequency was found at 41.5 degrees C. In vivo measurements of ciliary activity were performed in six pigs by means of optical fibres for light transmission combined with fibreoptic bronchoscopy. A ciliary beat frequency of 5 Hz was obtained; heart and breathing frequencies could be separated and identified. These results suggest that laser light scattering spectroscopy might provide a convenient method of studying the mucociliary system of the lower airways.
Subject(s)
Bronchi/physiology , Lasers , Mucociliary Clearance , Trachea/physiology , Animals , Cattle , In Vitro Techniques , Light , Scattering, Radiation , Spectrum Analysis , SwineSubject(s)
Laser Therapy , Lung Neoplasms/radiotherapy , Humans , Lung Neoplasms/drug therapy , PhotochemotherapyABSTRACT
The relation between smoking habits and the occurrence of spontaneous pneumothorax (SP) was studied in a Swedish population, predominantly urban. The study group consisted of a consecutive series of 138 patients admitted to Huddinge University Hospital over ten years for treatment of their first spontaneous pneumothorax. Their smoking habits were routinely analyzed. The sample consisted of 15,204 persons domiciled in the same circumscribed area (County of Stockholm). The annual incidence of first SP in the admission area is 6/100,000 for women and 18/100,000 for men. The study showed that smoking increased the relative risk of contracting a first spontaneous pneumothorax approximately ninefold among women and 22-fold among men and that there is a striking, statistically significant (p less than 0.001) dose-response relationship between smoking and the occurrence of SP. The life span risk of contracting SP among lifelong heavily smoking men is roughly estimated to be 12 percent but only 1/1,000 among never smokers.
Subject(s)
Pneumothorax/etiology , Smoking , Adolescent , Adult , Age Factors , Aged , Female , Humans , Male , Middle Aged , Risk Factors , Sex FactorsABSTRACT
In the County of Stockholm, changes in cigarette consumption were followed within 1-2 years by similar changes in the incidence of spontaneous pneumothorax.
Subject(s)
Pneumothorax/etiology , Smoking/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Pneumothorax/epidemiology , Time FactorsABSTRACT
The degree of physical activity at the onset of spontaneous pneumothorax was evaluated retrospectively in 219 patients, predominantly smokers who had had this disease for the first time. More than 87% had been inactive at the onset of the symptoms. Moderate exertion was recorded in only 2%, and no patients were exerting themselves heavily when the symptoms began. The occurrence of spontaneous pneumothorax was unevenly (p less than 0.001) distributed over the day. In 9% the symptoms had their onset during quick movement--such as fastening a seat belt--without any effort. The inactivity or low activity at the onset of symptoms of spontaneous pneumothorax suggests that this condition is unrelated to muscle effort.
Subject(s)
Physical Exertion , Pneumothorax/etiology , Adult , Female , Humans , Male , Middle Aged , Pneumothorax/epidemiology , Retrospective StudiesABSTRACT
Nuclear DNA content in individual, morphologically identified tumor cells from 33 squamous lung carcinomas, 20 small cell lung carcinomas, and 10 bronchiolo-alveolar carcinomas were analyzed by means of cytophotometry on Feulgen-stained histologic and cytologic specimens. Twenty-eight of the squamous cell carcinomas and 17 of the small cell carcinomas had high and scattered DNA values, indicative of high malignancy potentials. None of the bronchiolo-alveolar carcinomas showed such high DNA values. These results are in line with clinical experience that squamous cell and small cell carcinoma are associated with rapid progression and death in patients, whereas bronchiolo-alveolar carcinomas have a more indolent course.
