Maurice S. Segal

Pulmonary function studies in bronchial asthma: I. In the control state

Abstract Pulmonary function studies were performed in forty-two patients with chronic bronchial asthma at a time when they were symptomatic. The results may be summarized as follows: (1) The vital capacity ranged between 51 and 158 per cent of predicted normal value; the inspiratory capacity: vital capacity ratio averaged 68 per cent. (2) The maximum breathing capacity ranged between 11 and 130 per cent of predicted normal value. (3) The resting ventilation was generally increased, and ranged between 3.11 and 7.52 L. per minute per square meter body surface. (4) The index of intrapulmonary mixing ranged between 1.0 and 12.12 per cent nitrogen. (5) The total lung capacity averaged 125.8 per cent of predicted normal value. The residual volume: total lung capacity ratio ranged between 35 and 67 per cent and averaged 47.0 per cent. (6) The maximum expiratory velocity averaged 3.9 L. per second.

GLOMECTOMY IN THE TREATMENT OF CHRONIC BRONCHIAL ASTHMA. A REPORT OF FIFTEEN UNSUCCESSFUL CASES.

THE proper management of the patient with chronic recurring bronchial asthma taxes the patience, ingenuity and integrity of the physician. Too often, as with many chronic diseases, the hope of sur...

Pulmonary function studies in bronchial asthma: II. After treatment

Abstract Pulmonary function studies were performed in forty-two patients with chronic bronchial asthma in the asymptomatic state after treatment which consisted of aminophyllin, 0.5 gm. intravenously, or neosuprel® bronchodilator, six inhalations by aerosol sprays. Pulmonary function studies performed after treatment gave the following results. (1) The average improvement in the vital capacity was 10.6 per cent after aminophyllin and 16.9 per cent after bronchodilator aerosols. (2) The average improvement in the maximum breathing capacity was 30.9 per cent after aminophyllin and 50.0 per cent after bronchodilator aerosols. (3) The average improvement in the index of intrapulmonary mixing was 32.7 per cent after aminophyllin and 28.8 per cent after bronchodilator aerosols. (4) The average residual volume decreased slightly. The average total lung capacity did not change appreciably after treatment. (5) The average improvement in the residual volume to total lung capacity ratio was 7.4 per cent after aminophyllin and 8.1 per cent after bronchodilator aerosols. Clinical and experimental data are discussed in relation to the possible mechanism involved in the pathologic physiology of bronchial asthma and the changes induced by treatment.

THE MECHANICS OF BREATHING IN NORMAL SUBJECTS AND IN PATIENTS WITH CARDIOPULMONARY DISEASE

Excerpt A number of reports have appeared during recent years on the changes of the physical properties of the lung in cardiopulmonary diseases.1-26Valuable new information has been obtained on the...

PANCREATIC DORNASE AEROSOLS IN BRONCHOPULMONARY DISEASE

An increasing number of enzymes of various origins are being used for enzymatic debridement of fibrinopurulent and mucous secretions in the tracheobronchial tree in pulmonary and other suppurative diseases.12’ The harmful potentialities of these secretions in obstructing airways and acting as a culture medium for infectious microorganisms are evident. The rapid and safe evacuation of these secretions in the simplest possible manner is a problem of great importance.

N-allylnormorphine (nalline) action on narcotized and non-narcotized subjects.

Abstract 1.1. Nalline has been found to be a safe and reliable specific antidote for narcotic-induced respiratory depression. 2.2. The action of nalline upon opiate-induced circulatory depression is more gradual but just as marked. 3.3. Nalline did not appear to be effective against barbiturate intoxication. 4.4. In non-narcotized individuals nalline produced a slightly diminished respiratory rate, minute ventilation and maximal breathing capacity. A sedative effect was experienced by all subjects. 5.5. We found 5 to 10 mg. of intravenous nalline effective as the initial dose. However, in order to maintain the stimulating effect a slow intravenous drip of an additional 5 to 10 mg. in 5 per cent glucose in water is advisable. 6.6. The dramatic effect of nalline in opiate intoxication indicates that it should be available for emergency use in all emergency wards, operating rooms and in the bag of the practicing physician.

PHARMACODYNAMICS OF PULMONARY ABSORPTION IN MAN. I. AEROSOL AND INTRATRACHEAL PENICILLIN

Excerpt Direct medication of the pulmonary epithelium is not a new development in therapeutics. It is readily understandable why interest in this accessible direct route of therapy should have deve...

A comparative study of the action of various sympathomimetic amine aerosols in counteracting the dyspnea and bronchospasm induced by histamine and by acetyl-beta-methylcholine

Summary 1.The protecting capacity of aerosols of epinephrine (1:100), Neo-Syneph-rine (1:100), Vaponefrin, and Isuprel (1:200 and 1:100) against the bronchospastic effects of intravenous histamine and acetyl-beta-methylcholine has been described. 2.Isuprel 1:100 was the most effective agent tested for protection against the effects of both histamine and acetyl-beta-methylcholine but was too prone to produce disturbing side reactions for routine clinical use. 3.Isuprel 1:200 demonstrated more prolonged protection against the effects of acetyl-beta-methylcholine than either 1:100 epinephrine or Vaponefrin but less immediate and prolonged protection against the effects of histamine than either 1:100 epinephrine or Vaponefrin. 4.Vaponefrin demonstrated more intense immediate protection against the effects of histamine and acetyl-beta-methylcholine than aerosols of epinephrine epinephrine 1:100. 5.Neo-Synephrine 1:100 demonstrated minimal significant protection against the effects of histamine. No significant protection against the effects of mecholyl could be demonstrated. 6.The bronchospasmolytic properties of aerosols of epinephrine, Isuprel and Vaponefrin, demonstrated clinically, were confirmed in the laboratory and the relative values of these drugs as anticholinergic or antihistaminic agents were evaluated. More definitive usage of one or another of these aerosols should be predicated on the type of asthma presented by the individual patient.

Advances in inhalational therapy in the management of diseases of the chest

Abstract 1. 1. Advances in the use of therapeutic aerosols, oxygen therapy and pressure breathing therapy in the management of patients with chronic bronchial asthma, pulmonary emphysema and suppurative lung disease are discussed. 2. 2. A new air pump apparatus for the production of all types of continuous aerosol therapy and the NebELizer croup tent apparatus for the administration of cold water vapors (humidity therapy) and alevaire (detergent agent) therapy are described. 3. 3. The use of three new therapeutic aerosols—an anticholinergic agent (pamine bromide) of value in certain types of bronchoconstriction, pancreatic dornase, a pus-liquefying enzyme of value in evacuating bronchial secretions, and dusts and emulsions of cortisone and hydrocortone for allergic nasal states—are discussed. 4. 4. The hazards of the carbon dioxide intoxication syndrome and respiratory acidosis in patients with chronic anoxia secondary to chronic pulmonary emphysema and pulmonocardiac disease are presented. Their recognition, prevention and specific management are briefly discussed. The hazard of opiate-induced respiratory acidosis is considerably reduced with the availability of nalline, a remarkable opiate antagonist. 5. 5. The physiologic changes associated with pressure breathing therapy and clinical applications are discussed. Typical recordings of the physiologic effects of IPPB/inspiratory and alternating positive-negative pressures are discussed. 6. 6. A new multipurpose air pressure unit, the Vent EL Aire, combining four of the main therapeutic functions in inhalational therapy is described for the first time.

PHARMACODYNAMICS OF PULMONARY ABSORPTION IN MAN. II. THE INFLUENCE OF VARIOUS DILUENTS ON AEROSOL AND INTRATRACHEAL PENICILLIN

Excerpt The pharmacodynamics of pulmonary absorption has not been generally considered in the clinical reports on the success of aerosol and intratracheal therapy. There is equally meager informati...