Alveolar-arterial gradients and small airways in kyphoscoliosis.

In 14 patients, kyphoscoliotics, at the time without cardiorespiratory diseases, of average age 28 years +/- 17 (range 12-64), the average values for the vital capacity was 79.6 +/- 21.2% (range 49-125), for the Tiffeneau Index was 77.9% +/- 10.3% (range 56-91), for the RV/TLC ratio was 39.6% +/- 10.8% (range 18-56), for the MEF 25 was 2,192.8 +/- 732.1 ml/s (range 1,300-3,800), for the MEF 50 was 3,689.3 +/- 1,310.9 ml/s (range 1,750-5,500). The average value for the PaO2 was 90.3 +/- 8.3 mm Hg (range 75-109), and for the PaCO2 35.3 +/- 4.66 mm Hg (range 27.8-46). The average value for the alveolar-arterial gradient of O2 was 11.96 +/- 7.37 mm Hg (range 0.74-27.94) and for the arterial-alveolar gradient of CO2 2.30 +/- 2.41 mm Hg (range 0.22-9.98). The average value for the CO transfer was 20.06 +/- 6.84 ml/min/mm Hg (range 8-31.4). As the angle of scoliosis and the age of the subject increase, the vital capacity and the Tiffeneau Index decrease, the RV/TLC ratio and the respiratory rate increase, the MEF 25, the MEF 50, the PaO2, and the transfer of CO decrease, while PaCO2 increases. The alveolar-arterial gradient of O2 and the arterial-alveolar gradient of CO2 increase as the angle of scoliosis increases. The data so obtained show, therefore, that in kyphoscoliosis a restrictive type of respiratory dysfunction appears, along with hypoxemia due to alveolar hypoventilation and disturbances in diffusion and in the ventilation-perfusion ratio.

Alveolo-arterial gradients of O2 and CO2 in hyperlipidemic subjects.

In 20 hypertriglyceridemic normocholesterolemic patients, mean age 51 years (range 42-62), +/- 10% ideal body weight, and in 18 normolipidemic controls, mean age 49 years (range 42-63), +/- 10% ideal body weight, the following tests were performed: spirometry, flow-volume curves, arterial blood gases, alveolo-capillary transfer of CO, alveolo-arterial gradients of O2 and arterio-alveolar gradients of CO2. A significant decrease in the arterial partial pressure of O2 and in the transfer of CO, with a significant increase in the alveolo-arterial gradient of O2 were found. Hypertriglyceridemia seems to compromise the alveolo-capillary gas exchange.

[Action of heparin on pulmonary lipids and alveolar surfactant in rabbits]. / Azione dell'eparina sui lipidi polmonari e sul surfactant alveolare di conigli.

The effect of subcutaneous 1000 IU/kg calcic heparin every 12 hr for 7 days on lung lipids and pulmonary surfactant was examined in 10 male rabbits weighing 2.5-3.5 kg. Comparison with an identical control group showed a decrease in phospholipids and lecithins in the lung homogenate extract and in the alveolar liquid bubble stability index. The difference in the means was highly significant (P less than 0.001) for all three parameters.

[The arterio-alveolar CO2 gradient. Physiopathological and clinical significance]. / Il gradiente arterio-alveolare di CO2. Significato fisiopatologico e clinico.

The arterio-alveolar CO(2) gradient was examined in 20 patients with various ventilation diseases. It increased or became negative in obstruction. The tendency to increase was attributable to distribution disturbances, particularly the marked increase in the "dead space" effect. The same picture, though to a lesser degree, owing to a smaller dead space increase, was even more frequent in restriction cases. The appearance of a gradient in healthy subjects is referable to uneven air and blood distribution in the alveoli under physiological conditions. The physiopathological significance of negative gradients is discussed in the light of the results and the findings of other workers.

[Alveolar surfactant and experimental diabetes (protective action of citicoline)]. / Surfactant alveolare e diabete sperimentale (azione portettiva della citicolina).

Above normal or normal S.R. values (0,70-0,90) (S.R. = 0,81 +/- 0,11), were noted in 13 alloxaneinduced diabetic rabbits treated with CDP-choline, and decreased values (S.R. = 0,57 +/- 0,06) in 9 diabetic rabbits not so treated. This difference was statistically significant (P less than 0,001). The results show that CDP-choline can protect surfactant from damage caused by alloxane-induced diabetes. The most likely explanation is increased synthesis of dipalmitoyllecithin, by intervention of CDP-choline, as cofactor, on lipid metabolism in the lung.

[Allergological findings in rhinitis-asthmatic subjects]. / Indagini allergologiche in soggetti rinoasmatici.

A comparison was made between skin-positive and skin-negative subjects in an allergological study of 404 patients with rhinitis and asthma. The two diseases had appeared simultaneously in 52.72% of cases, while rhinitis had appeared first in 35.14%. Respiratory disturbances had occurred more frequently before the age of 30 yr in allergic subjects and between 20 and 50 yr in skin-negative subjects. Familial allergy was noted in 34% and a personal history of skin allergy in 21%. Associations with conjunctivitis, chronic bronchitis and nasal polyposis were noted in about 50%, 13% and 4% respectively. Nearly all skin-negative subjects had disturbances the whole year round, as did 47.67% of the skin-positives, while 36.53% of the latter had disturbances in spring and summer only. A positive reaction to at least one allergen was noted in 79.95%. Pollens were positive in 70.58%, dusts, vegetables fibres and skin derivatives in 66.25%, and moulds in 33.12%. The allergens used and the number of positives obtained with each are listed. It is felt that reaction to pollen should be investigated in such subjects, even when their symptoms are not sea sonal.

[Corticoids and alveolar surfactant. Experimental study]. / Cortisonici e surfactant alveolare. Studio sperimentale

The effect of cortisone on the production of surfactant was studied by measuring the tensioactive property of the alveolar fluid, evaluated with Pattle's method. The stability ratio (R.S.) values obtained in 12 guinea-pigs following cortisone administration were all within normal limits. In rabbits treated with prednisolone during a number of fast days, S.R. values were lower than normal in 9 cases out of 10. The results of this study would seem to exclude any influence of the administration of cortisone on the activity of the alveolar surfactant.