The objective of this study was to describe high-resolution CT (HRCT) and MR findings of exogenous lipoid pneumonia and to correlate them with pathologic findings. A retrospective review of the medical records of our institution revealed seven patients with a diagnosis of lipoid pneumonia based on clinical data, chest films, bronchoalveolar lavage, and follow-up. Both HRCT and MR imaging were reviewed by two readers. Pathologic examination of the resected specimen or surgical biopsies were also reviewed in the four available cases. The HRCT findings were pulmonary consolidations (n = 6) with fatty (n = 3) or unspecific but low attenuation values (n = 3), areas of ground-glass opacities (n = 5), septal lines, and centrilobular interstitial thickening (n = 5). In five of the seven cases, a crazy-paving pattern of various spread was also present, either isolated (n = 1) or surrounding a pulmonary consolidation. In two cases traction bronchiectasis and cystic changes consistent with fibrosis were seen. At MR imaging (n = 2) a pulmonary consolidation of high signal intensity on T1-weighted image consistent with lipid content was present in one case. Pathologic examination (n = 4) showed the coexistence of lobules with lesions of various ages, sometimes in contiguous lobules, within the same patient. Recent lesions were those with alveolar fill-in by spumous macrophages and almost normal alveolar walls and septae. In more advanced lesions, lobules were filled in with larger vacuoles often surrounded by inflammatory infiltrates of alveolar walls, bronchiolar walls, and septa. The oldest lesions were characterized by fibrosis and parenchymal distortion around large lipid-containing vacuoles. The HRCT findings reflect pathologic findings in exogenous lipoid pneumonia. Although non-specific, consolidation areas of low attenuation values and crazy-paving pattern are frequently associated in exogenous lipoid pneumonia and are indicative of the diagnosis.
The kinetics of platelets labeled with indium-111 were investigated in 13 healthy subjects as well as in 9 patients in the asymptomatic interattack stage of asthma. The survival times of platelets in healthy subjects was 8.9 +/- 1 days; in asthmatic subjects it was 4.7 +/- 1.3 days (p less than 0.001). The survival curve is of a biexponential form in asthmatics, thus suggesting the presence of 2 populations: one with a short life span (23 +/- 7 h), representing a third of the total population (33 +/- 9%), and the other with a normal life span. No single preferred site of platelet sequestration was found. These results suggest the presence of functional or anatomic lesions of platelets in asthmatic patients, which can be explained only hypothetically at the present time.
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Aim-To study the eVect of a warm up schedule on exercise-induced asthma in asthmatic children to enable them to engage in asthmogenic activities. Method-In the first study, peak flows during and after three short, repeated warm up schedules (SRWU 1, 2, and 3), identical in form but diVering in intensity, were compared in 16 asthmatic children. In the second study the eYciency of the best of these SRWU schedules was tested on 30 young asthmatic children. Children performed on diVerent days a 7 minute run alone (EX1) or the same run after an SRWU (EX2). Results-The second study showed that for most children (24/30) the fall in peak flow after EX2 was less than that after EX1. The percentage fall in peak flow after EX2 was significantly correlated with the percentage change in peak flow induced by SRWU2 (r=0.68). The children were divided into three subgroups according to the change in peak flow after SRWU2: (G1: increase in peak flow; G2: < 15% fall in peak flow; G3: > 15% fall in peak flow). Only the children in the G3 subgroup did not show any gain in peak flow after EX2 compared with EX1. Conclusion-The alteration in peak flow at the end of the SRWU period was a good predictor of the occurrence of bronchoconstriction after EX2. An SRWU reduced the decrease in peak flow for most of the children (24/30) in this series, thus reducing subsequent post-exercise deep bronchoconstriction. (Br J Sports Med 1999;33:100-104) Keywords: bronchoconstriction; children; asthma; warm up Physical activity including the practice of many sports tends to be limited in children with post-exercise bronchospasm 1 2 unless they take appropriate medication before exercise. However, physical activity in sports and games contributes to the physical and psychological growth of asthmatic children.3-5 Apart from premedication, various training schedules and warm up periods have been proposed to attenuate the post-exercise bronchospasm seen in these children.6 7 A continuous warm up of three minutes had no beneficial eVect on the bronchospasm induced by treadmill, 8 though short, repeated warm up periods (SRWU) have been shown to reduce the bronchospasm induced by a subsequent long run.9 10 In our study three SRWU schedules were evaluated in 16 children with asthma, and the eYciency of the best of these SRWU was then examined in a further series of 30 asthmatic children. MethodsThe tests were conducted outdoors in a centre for the treatment of asthmatic children in the Pyrenees mountains at an altitude of 1800 m. This centre is dedicated to improving the asthmatic status of the children through physical activity in a non-polluted environment. Ambient mean (SD) temperature was 4 (5)°C with a low humidity (1.5 (0.5) mm Hg). FIRST STUDYThe first study aimed at selecting an optimum SRWU schedule. Sixteen children, aged 11 (2) years, with post-exercise asthma were included. All were tested in the laboratory and showed a fall in FEV 1 of at least 15% after completion of a short 7 minute maximal exercise performed on an ergometric bicycle...
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