Cardiopulmonary effects of a brief exposure to cigarette smoke in the guinea pig

To investigate whether the acute inflammatory response produced by acute cigarette smoke exposure is associated with alterations in pulmonary and cardiovascular function, using a respirator we exposed 8 guinea pigs to 350 ml of cigarette smoke diluted in 2,000 ml room air for 10 min. Lung volumes, pressure volume curves and flow volume curves were performed. Measurements of pulmonary artery pressure, systemic pressure, heart rate and cardiac output were taken at baseline, immediately after the smoke exposure, and 1.5 h after smoke exposure. Aliquots of peripheral blood for total white cell count and differential count were obtained. After animal sacrifice, the right lung was lavaged and white cell count and differential count performed. We found that acute exposure to cigarette smoke produced a peripheral blood neutrophilia which rose progressively from a baseline of 36.3 +/- 8% to a maximum of 72.2 +/- 7.7% at 1.5 h after exposure. There was pulmonary neutrophilia with 24.6 +/- 6.3% neutrophils in the lavage fluid of the smoke-exposed animals compared to 8.4 +/- 4.3% in the control animals. Immediately after smoke exposure, there was acute airflow obstruction with a decrease in the peak flow and forced expiratory flow between 25-75% vital capacity. This was associated with airtrapping, as shown by a transient increase in residual volume. There was a slight decrease in systemic blood pressure in the smoke-exposed animals associated with a nonsignificant decrease in the heart rate, and the cardiac output remained stable.(ABSTRACT TRUNCATED AT 250 WORDS)

Chlamydia trachomatis infection in sexually active women with no known sexual contacts with urethritis

During the period from March 1985 to March 1986, 216 consecutive patients with vaginal symptoms were screened for cervical infection with Chlamydia trachomatis and other sexually transmitted organisms. Eleven (5%) yielded C. trachomatis without a history of recent contact with males with urethritis.

Quartz but not iron oxide causes air-flow obstruction, emphysema, and small airways lesions in the rat

Recent epidemiologic studies have suggested that some workers exposed to inorganic dusts develop air-flow obstruction independent of or greater than that produced by cigarette smoke; the morphologic basis of this effect is unknown. To investigate this problem, we administered saline alone, 10 mg iron oxide (an inert dust), or 10 or 30 mg of quartz to rats by intratracheal instillation. Animals were killed after 30 days, and pulmonary function and morphologic changes were examined. The iron oxide group was similar to the saline control group in all functional and morphometric parameters. However, both quartz-exposed groups showed evidence of air-flow obstruction, with more severe abnormalities in the high dose group. These findings correlated with morphometric observations of emphysema and thickened airway walls, with changes again more severe in the high dose group. Early silicotic nodules were also present in the latter animals. We conclude that in addition to the classic lesions of nodular silicosis, quartz can produce morphologic and functional changes of air-flow obstruction; no such changes are seen with iron oxide. These observations may explain the air-flow obstruction seen in workers exposed to mineral dusts.

Cigarette smoke makes airway and early parenchymal asbestos-induced lung disease worse in the guinea pig

In order to assess the effects of cigarette smoke and asbestos exposure, we divided guinea pigs into 4 groups: smoking or nonsmoking, and asbestos-exposed or not asbestos-exposed groups. Asbestos-exposed animals were given a single intratracheal instillation of 5 mg UICC amosite, a dose and method of administration that we have previously shown produces morphologic changes in the small airways as well as minimal interstitial fibrosis. Animals were smoked 5 days per week for 6 months. By itself, smoking did not affect lung collagen content, small airways wall thickness, or the volume fraction of tissue surrounding airways, but it did cause a significant increase in alveolar mean linear intercept (Lm). Asbestos alone increased collagen content, airway wall thickness, and tissue volume fraction surrounding airways, the latter measure used to assess interstitial fibrosis. An unexpected finding was that asbestos also increased Lm. The two agents administered together caused more severe changes of all types than were produced by either agent alone, and the interaction between the 2 was generally synergistic. Smoke-exposed animals retained 3 times the asbestos fiber burden of those not smoke-exposed; the increase in retention was greater for short than for long fibers. We conclude that cigarette smoke can potentiate the fibrosis induced by asbestos, possibly because of increased fiber retention. As well, in this model, asbestos or asbestos plus cigarette smoke produces increases in alveolar size.(ABSTRACT TRUNCATED AT 250 WORDS)

A pilot study of the multidisciplinary management of childhood asthma in a family practice

A small, controlled trial of joint treatment of childhood asthma by a doctor, a physiotherapist, a psychologist, and a social worker, working together in the family setting, demonstrated an improvement in ventilatory capacity. The limited scope of this trial does not permit more general conclusions as to the effect of such treatment on the severity and frequency of attacks, but the observation that some measurable physiological improvement occurred suggests that the place of multidisciplinary nonpharmaceutical management of childhood asthma should be investigated in more detail.

Surgical reduction of tumour bulk in management of abdominal Burkitt's lymphoma

The results of a retrospective study of the value of reductive surgery in the treatment of abdominal Burkitt's lymphoma are reported. Nine patients had almost complete removal of the tumour, 16 had little over half of the tumour removed, and 43 underwent biopsy only. All patients subsequently received chemotherapy. There was a highly significant difference in the proportion of patients achieving a sustained durable remission (P > 0.0001) and a significant difference in survival (P > 0.05) between the group having almost complete removal and the partial resection group. Partial resection gave no advantage over no surgery. We believe that whenever possible complete removal of the abdominal tumour should be attempted regardless of the presence of extra-abdominal tumour; but unless at least 90% of the tumour can be removed there is no advantage in partial resection in terms of response to subsequent chemotherapy. In particular the removal of one of two involved ovaries can no longer be recommended. The implications of these results are related to cancer treatment strategy.