Cyclophosphamide
Ventilation: perfusion mismatch during sleep
These authors review the literature accumulated on the nitroblue tetrazolium reduction test (NBT) during the past 5 or 6 years and give an objective appraisal on its usefulness in screening patients or carriers with chronic granulomatous disease, in studying neutrophil dysfunction and in differentiating bacterial from nonbacterial infections and other illnesses. They caution that the resuits of this test should be interpreted in the context of other laboratory test results and the clinical picture of the patient. Preliminary data indicate that in certain diseases, in patients in whom the initial test is positive, it may be useful as one of the followup tests to ascertain the activity of the disease process.
Chronic granulomatous disease
Complications of prolonged endotracheal intubation are thought to be directly related to lateraI tracheal wall pressure. To elucidate the pathogenesis, relevance and duration of these complications, these authors undertook scanning electron microscope studies of tracheal mucosa exposed to a cuff system known to produce the lowest lateral wall pressure of any of the presently available cuff systems. They studied the morphology in anesthetized “norrnal” dogs, dogs sacrificed 2 hours after intubation and in dogs intubated for 2 hours and then examined at 2 and 7 days after extubation. Results of similar studies in human tracheas obtained at autopsy from patients subjected to prolonged intubation with the same cuff systern correlated well with those in dogs.
Neutrophll dysfunction
Nltroblue tetrarollum reduction test
Lace JK, Tan JS. Watanakunakorn C: An appraisal of the nitroblue tetrazolium reduction test. Am J Med 58: 685-694, 1975.
Tracheostomy
Klainer AS, Turndorf hi, Wu W-H, Maewal H, Allender P: Surface alterations due to endotracheal intubation. Am J Med 58: 874-683, 1975.
Scanning electron microscopy
Endotracheai intubation
Thirteen patients with Wegener’s granulomatosis were treated with cytotoxic agents. Only one died from the disease whereas two died of infectious complications of therapy and one of heart disease. Of the nine survivors, seven are well without medication, one is alive with renal insufficiency, and one is in the 5th year of treatment. Differentiation of Wegener’s granulomatosis from lymphomatoid granulomatosis, which it resembles clinically, roentgenologically and pathologically, is important since the latter responds differently to cytotoxic drug therapy.
Arterial blood gases were measured during 7 hours of sleep in 15 patients with severe stable chronic obstructive pulmonary disease (COPD): 6 awake patients with COPD studied in recumbency for an average of 5 hours served as controls. The objective was to further evaluate the magnitude of change in arterial blood gases during sleep in such patients, to clarify the mechanism of hypoxemia during sleep and to establish criteria for nocturnal oxygen therapy in patients with severe stable COPD. It was found that all patients with COPD whose waking Pa02 was below 60 mm Hg had Pa02 below 50 mm Hg during sleep: nocturnal oxygen therapy should be considered in such patients, particularly in the presence of polycythemia or troublesome right-sided heart failure.
Surface alteratlons
Israel HL, Patchefsky AS: Treatment of Wegener’s granulomatosis of lung. Am J Med 58: 671-673. 1975.
Chlorambucil
Cytotoxic therapy
Koo KW, Sax DS, Snider GL: Arterial blood gases and pH during sleep in chronic obstructive pulmonary disease. Am J Med 58: 663-670, 1975.
Azathioprine
Wegener’s granuiomatosis of lung
Alveolar hypoventllation Arterial blood gases during sleep Chronic obstructive pulmonary disease Hypoxemla