Thorax · Primarycardiac angiosarcoma causing rupture ofthe heart and spontaneous bilateral...

ThoraxThe Journal of the British Thoracic Society(President: J B L HOWELL)

Executive Editor: ANNE E TAT5ERSFIELD

Contents January 1989 Vol 44 No 1EDITORIALAcute bronchiolitis in infancy: treatment and prognosis AD MILNER, M MURRAY pages 1-5ORIGINAL ARTICLESPrognostic value of bronchoalveolar lavage in sarcoidosis: the critical influence of disease presentationK WARD, C O'CONNOR, C ODLUM, MX FITZGERALD pages 6-12Reversibility and reproducibility of histanmine induced plasma leakage in nasal airways C SVENSSON,CR BAUMGARTEN, U PIPKORN, U ALKNER, CGA PERSSON pages 13-8Effects of ranitidine treatment on patients with asthma and a history of gastro-oesophageal reflux: a doubleblind crossover study T EKSTROM, BR LINDGREN, L TIBBLING pages 19-23Effect of three weeks' treatment with budesonide on in vitro contractile and relaxant airway effects in therat B GUSTAFSSON, CGA PERSSON pages 24-7Beta adrenoceptor binding and induced relaxation in airway smooth muscle from patients with chronicairflow obstruction CJ VAN KOPPEN, JF RODRIGUES DE MIRANDA, AJ BELD, CLA VAN HERWAARDEN,J-WJ LAMMERS, CAM VAN GINNEKEN pages 28-35Effect of changing dietary sodium on the airway response to histamine PGJ BURNEY, JE NEILD, CHC TWORT,S CHINN, TD JONES, WD MITCHELL, C BATEMAN, IR CAMERON pages 36-41Carcinoma of the oesophagus in Transkei: treatment by intubation MH COTTON, AM SAMMON pages 42-7Diathermy resection and radioactive gold grains for palliation of obstruction due to recurrence of bronchialcarcinoma after external irradiation SJM LEDINGHAM, P GOLDSTRAW pages 48-51Influence of lung volume in sleep apnoea F SERIES, Y CORMIER, N LAMPRON, J LA FORGE pages 52-7Atrial natriuretic peptic concentrations in hypoxic secondary pulmonary hypertension: relation tohaemodynamic and blood gas variables and response to supplemental oxygen RJD WINTER, AC DAVIDSON,D TREACHER, RM RUDD, JV ANDERSON, L MELEAGROS, SR BLOOM pages 58-62Anomalous pulmonary venous drainage shown by duplex sonography, computed tomography, and plainradiography P HUEBSCH, A NEUHOLD, H MAYR, D GLOGAR pages 63-5HISTORICAL NOTEAn early report of growth of an Aspergillus species on the wall of a lung cavity L DOYLE pages 66-7

SHORT REPORTSBronchoscopy of symptom free patients infected with human immunodeficiency virus for detection ofpneumocystosis JD LUNDGREN, M ORHOLM, TL NIELSEN, J IVERSEN, J HERTZ, JO NIELSEN pages 68-9Rheumatoid arthritis with extensive lung lesions C FELLBAUM, W DOMEJ, H POPPER pages 70-1Bilateral clicking ribs W PARRY, I BRECKENRIDGE, YF KHALIL pages 72-3Chylopericardium as a complication of mitral valve replacement Y BAR-EL, A SMOLINSKY, A YELLINpages 74-5Successful percutaneous balloon occlusion of a large pulmonary arteriovenous malformationCJ DUGGAN, VS GRINNELL, PC PIGOTT pages 76-7Primary cardiac angiosarcoma causing rupture of the heart and spontaneous bilateralpneumothorax AJ LOBO, RJ BUTLAND, S STEWART, JM SHNEERSON pages 78-9CORRESPONDENCESpontaneous pneumothorax due to metastatic carcinoma of the rectum S SHARMA, M RAJANI page 80Bilateral empyema and purulent pericarditis due to Haemophilus influenzae capsular type b A MIER page80BOOK NOTICE page 80NOTICE page 80

ASTM CODEN: THORA 7 44(1) 1-80 1989 ISSN 0040-6376

Published by British Medical Association, Tavistock Square, London WCCIH 9JRand printed in England by Eyre & Spottiswoode Ltd, London and Margate.

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Contents 1989No. I JANUARY

PAGE

EDITORIAL

Acute bronchiolitis in infancy: treatment and prognosis AD MILNER, M MURRAY ...... ......................... I

ORIGINAL ARTICLES

Prognostic value of bronchoalveolar lavage in sarcoidosis: the critical influence of disease presentation K WARD,C O'CONNOR, C ODLUM, MX FITZGERALD..................................................................... 6

Reversibility and reproducibility of histamine induced plasma leakage in nasal airways C SVENSSON,CR BAUMGARTEN, U PIPKORN, U ALKNER, CGA PERSSON ........ ............................................ 13

Effects of ranitidine treatment on patients with asthma and a history of gastro-oesophageal reflux: a double blindcrossover study T EKSTROM, BR LINDGREN, L TIBBLING ................................................... 19

Effect of three weeks' treatment with budesonide on in vitro contractile and relaxant airway effects in the ratB GUSTAFSSON, CGA PERSSON ............................................................................. 24

Beta adrenoceptor binding and induced relaxation in airway smooth muscle from patients with chronic airflowobstruction CJ VAN KOPPEN, JF RODRIGUES DE MIRANDA, AJ BELD, CLA VAN HERWAARDEN, J-WJ LAMMERS,

CAM VAN GINNEKEN ..................................................................................... 28

Effect ofchanging dietary sodium on the airway response to histamine PGJ BURNEY, JE NEILD, CHC TWORT, S CHINN,TD JONES, WD MITCHELL, C BATEMAN, IR CAMERON ......................................................... 36

Carcinoma of the oesophagus in Transkei: treatment by intubation MH COTTON, AM SAMMON ..... ............. 42Diathermy resection and radioactive gold grains for palliation of obstruction due to recurrence of bronchial

carcinoma after external irradiation SJM LEDINGHAM, P GOLDSTRAW ...................................... 48Influence of lung volume in sleep apnoea F SERIES, Y CORMIER, N LAMPRON, J LA FORGE ..... .................... 52Atrial natriuretic peptic concentrations in hypoxic secondary pulmonary hypertension: relation to haemodynamic

and blood gas variables and response to supplemental oxygen RJID WINTER, AC DAVIDSON, D TREACHER,RM RUDD, JV ANDERSON, L MELEAGROS, SR BLOOM .......................................................... 58

Anomalous pulmonary venous drainage shown by duplex sonography, computed tomography, and plainradiography P HUEBSCH, A NEUHOLD, H MAYR, D GLOGAR ................................................ 63

HISTORICAL NOTE

An early report of growth of an Aspergillus species on the wall of a lung cavity L DOYLE ..... .................. 66

SHORT REPORTS

Bronchoscopy of symptom free patients infected with human immunodeficiency virus for detection ofpneumocystosis JD LUNDGREN, M ORHOLM, TL NIELSEN, J IVERSEN, J HERTZ, JO NIELSEN ..... ................ 68

Rheumatoid arthritis with extensive lung lesions C FELLBAUM, W DOMEJ, H POPPER............................. 70Bilateral clicking ribs W PARRY, I BRECKENRIDGE, YF KHALIL ................................................. 72Chylopericardium as a complication of mitral valve replacement Y BAR-EL, A SMOLINSKY, A YELLIN ..... ........ 74Successful percutaneous balloon occlusion of a large pulmonary arteriovenous malformation CJ DUGGAN,

VS GRINNELL, PC PIGOTT ....... . .......................................................................... 76Primary cardiac angiosarcoma causing rupture of the heart and spontaneous bilateral pneumothorax AJ LOBO,

RJ BUTLAND, S STEWART, JM SHNEERSON................................................................... 78

CORRESPONDENCE

Spontaneous pneumothorax due to metastatic carcinoma of the rectum S SHARMA, M RAJANI................... 80Bilateral empyema and purulent pericarditis due to Haemophilus influen-ae capsular type b A MIER............. 80

BOOK NOTICE ............................................................................................... 80

NOTICE ...................................................................................................... 80

No. 2 FEBRUARYEDITORIAL

Is current treatment increasing asthma mortality and morbidity? EA MITCHELL ................................ 81

ORIGINAL ARTICLES

Combined use of non-invasive techniques to predict pulmonary arterial pressure in chronic respiratory diseaseJM BISHOP, M CSUKAS .....................................................................................5



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Patient self care in acute asthma B SIBBALD .................. ............................................... 97Effects of salbutamol on bronchoconstriction, bronchial hyperresponsiveness, and leucocyte responses induced by

platelet activating factor in man KF CHUNG, G DENT, PJ BARNES .......................................... 102Effects of platelet activating factor on airway calibre, airway responsiveness, and circulating cells in asthmatic

subjects KF CHUNG, PJ BARNES.......................................................................... 108Relation of airway responsiveness to duration of work in a dusty environment P ERNST, RE DALES, F NUNES,

MRBECKLAKE...................................................... ......................................116Increase in ventilation caused by aminophylline in the absence of changes in ventral medullary extracellular fluid

pH and carbon dioxide tension S JAVAHERI, JAM EVERS, LJ TEPPEMA ....................................... 121Hyaluronan and type III procollagen peptide concentrations in bronchoalveolar lavage fluid in idiopathic

pulmonary fibrosis L BJERMER, R LUNDGREN, R HALLGREN................................................ 126Impaired non-specific delayed cutaneous hypersensitivity in bird fancier's lung R ORRIOLS, F MORELL, V CURULL,

A ROMAN, G SAMPOL...................................................................................... 132Cardiovascular and hypokalaemic effects of inhaled salbutamol, fenoterol, and isoprenaline J CRANE, C BURGESS,

R BEASLEY.............................................................................................. 136Oesophagogastrectomy in patients over 70 DD MUEHRCKE, DK KAPLAN, RJ DONNELLY .......................... 141Refractory period following bronchoconstriction provoked by histamine in asthmatic subjects MJ CONNOLLY,

SC STENTON, AJ AVERY, EH WALTERS, DJ HENDRICK ......................................................... 146Increased incidence of pulmonary tuberculosis in chronic interstitial lung disease Y SHACHOR, D SCHINDLER,

A SIEGAL, D LIEBERMAN, Y MIKULSKI, I BRUDERMAN ........................................................ 151

SHORT REPORTS

Malignant primary pulmonary paraganglioma JRW HANGARTNER, TM LOOSEMORE, M BURKE, JR PEPPER.......... 154Occupational asthma in a pharmaceutical worker exposed to penicillamine F LAGIER, A CARTIER, I DOLOVICH,

J-L MALO................................................................................................ 157

CORRESPONDENCEFall in peak expiratory flow during haemodialysis in patients with chronic renal failure RK BEAUCHAMP;

AJ WILLIAMS, A DAVENPORT .............................................................................. 159

BOOK NOTICE................................................................................................ 159

NOTICE...................................................................................................... 160

CORRECTION

British Thoracic Society proceedings (LS HILL) .............. ................................................ 160

No. 3 MARCH

EDITORIAL

Muscarinic receptor subtypes: implications for lung disease PJ BARNES ....................................... 161

ORIGINAL ARTICLES

Ethnic differences in prevalence of asthma symptoms and bronchial hyperresponsiveness in New Zealandschoolchildren PK PATTEMORE, MI ASHER, AC HARRISON, EA MITCHELL, HH REA, AW STEWART ..... ........... 168

Six years' experience with perthoracic core needle biopsy in pulmonary lesions A MORGENROTH, HP PFEUFFER,M AUSTGEN, Hi VIERECK, F TRENDELENBURG .......1......................................................177

Supplemental oxygen and quality of sleep in patients with chronic obstructive lung disease JL MCKEON,K MURREE-ALLEN, NA SAUNDERS ............. . ............................................................. 184

Results of resection for bronchogenic carcinoma in patients over the age of 80 T SHIRAKUSA, M TSUTSUI, N IRIKI,K MATSUBA, T SAITO, S MINODA, T IWASAKI, N HIROTA, J KUONO ............................................. 189

Surgical treatment of hydatid cysts of the lung: report on 1055 patients R DOGAN, M YUKSEL, G SETIN, K SUZER,M ALP, S KAYA, M UNLU, B MOLDIBI ....................................................................... 192

A self management plan in the treatment of adult asthma R BEASLEY, M CUSHLEY, ST HOLGATE.................. 200Uvulopalatopharyngoplasty in severe idiopathic obstructive sleep apnoea syndrome EB WALKER, RW FRITH,

DA HARDING, BR CANT................................................................................. 205Lung function after coronary artery surgery using the internal mammary artery and the saphenous vein

SC JENKINS, SA SOUTAR, A FORSYTH, JRW KEATES, J MOXHAM................................................. 209



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Pulmonary manifestations of tuberous sclerosis in first degree relatives JM SLINGERLAND, RF GROSSMAN,D CHAMBERLAIN, CE TREMBLAY ........................................................................... 212

Etoposide compared with the combination of vincristine, doxorubicin, and cyclophosphamide in the treatment ofsmall cell lung cancer MB MCILLMURRAY, RJ BIBBY, BE TAYLOR, LP ORMEROD, JR EDGE, RJ WOLSTENHOLME,RF WILLEY, JF O REILLY, N HORSFIELD, CE JOHNSON, CP MUSTCHIN, D BRISCOE ................................. 215

Occupational asthma due to soft corrosive soldering fluxes containing zinc chloride and ammonium chlorideDC WEIR, AS ROBERTSON, S JONES, P SHERWOOD BURGE...................................................... 220

SHORT REPORTS

Minitracheotomy: a simple alternative to tracheostomy in obstructive sleep apnoea A HASAN, J MCGUIGAN,MDL MORGAN, HR MATTHEWS ............................................................................ 224

Bronchial casts associated with hilar lymphatic and pulmonary lymphoid abnormalities J WIGGINS, E SHEFFIELD,PK JEFFERY, DM GEDDES, B CORRIN ........................................................................ 226

Q fever pneumonia presenting as an eosinophilic pleural effusion PP MURPHY, SG RICHARDSON ..... ............ 228Bronchioloalveolar carcinoma presenting as a thin walled cavity in a young man PM DE JONG, DLT BUSSCHER,

WIM BAKKER............................................................................................ 230Malignant change in a benign pulmonary hamartoma A BASILE, A GREGORIS, B ANTOCI, M ROMANELLI ..... ...... 232Severe methaemoglobinaemia after flexible fibreoptic bronchoscopy RL KOTLER, J HANSEN-FLASCHEN, MP CASEY. 234Mitral prosthetic valve regurgitation due to stent fracture of a porcine bioprosthesis J AU, C CAMPANELLA ...... 236Prolonged hypoxaemia following inhalation of hydrogen chloride vapour MJ FINNEGAN, ME HODSON ..... ...... 238

CORRESPONDENCE

Predicted values: how should we use them? JE COTES; MR MILLER, AC PINCOCK ................................. 240

No. 4 APRIL

EDITORIALS

Human cytomegalovirus infection JGP SISSONS, LK BORYSIEWICZ.............................................. 241Hypoxia, almitrine, and peripheral neuropathy P HOWARD .................................................. 247

ORIGINAL ARTICLES

Ventilatory and heart rate responses to hypoxia and hypercapnia in patients with diabetes mellitus M NISHIMURA,K MIYAMOTO, A SUZUKI, H YAMAMOTO, M TSUJI, F KISHI, Y KAWAKAMI.........................................251

Ventilation-perfusion mismatching in acute severe asthma: effects of salbutamol-and 100% oxygen E BALLESTER,A REYES, J ROCA, R GUITART, PD WAGNER, R RODRIGUEZ-ROISIN ............................................. 258

Exercise responses in patients treated for pulmonary tuberculosis by thoracoplasty MS PHILLIPS, WJM KINNEAR,D SHAW, JM SHNEERSON .................................................................................. 268

Changes in day and night time oxygenation with protriptyline in patients with chronic obstructive lung diseaseF SERIES, Y CORMIER, J LA FORGE .......................................................................... 275

Randomised controlled trial comparing prednisolone alone with cyclophosphamide and low dose prednisolone incombination in cryptogenic fibrosing alveolitis MA JOHNSON, S KWAN, NJC SNELL, AJ NUNN, JH DARBYSHIRE,M TURNER-WARWICK ............................--............................. 280

Bronchoalveolar lavage cell analysis in patients with human immunodeficiency virus related diseases v PLAZA,P JIMtNEZ, A XAUBET, C PICADO, A TORRES, C AGUSTi, A AGUSTi-VIDAL ....................................... 289

Peripheral nerve function in patients with chronic bronchitis receiving almitrine or placebo MB ALLEN, K PROWSE 292Differential lung function in an infant with the Swyer-James syndrome A AVITAL, DL SHULMAN, E BAR-YISHAY,

N NOVISKI, J SCHACHTER, Y KRAUSZ, S GODFREY............................................................ 298

SHORT REPORTS

Clinical and radiographic study of activated carbon workers CG URAGODA ................................... 303Horner's syndrome caused by an intercostal chest drain P CAMPBELL, T NEIL, PN WAKE ..... ................... 305Sulfadoxine specific lymphocyte transformation in a patient with eosinophilic pneumonia induced by sulfadoxine-

pyrimethamine (Fansidar) PT DANIEL, J HOLZSCHUH, PA BERG ............................................ 307Alveolitis associated with sulphamethoxypyridazine CL STEINFORT, J WIGGINS, EA SHEFFIELD, EE KEAL ..... ...... 310Supraventricular tachycardia caused by nebulised ipratropium bromide BR O'DRISCOLL ..... .................. 312

CORRESPONDENCE

Haemophilus influenzae type b infections in adults A ROUND, I MUSCAT ........................................ 313



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CONTENTS 1989PAGE

BOOK NOTICE................................................................................................ 313

NOTICE...................................................................................................... 313

PROCEEDINGS British Thoracic Society winter meeting 1988 .......... ........................................ 314

No. 5 MAY

EDITORIALS

Significance of antibodies to cytoplasmic components of neutrophils u SPECKS, RA DeREMEE.................... 369Cardiac sarcoidosis CM OAKLEY ............................................................................ 371

ORIGINAL ARTICLES

Antibodies to neutrophil cytoplasmic antigens in Wegener's granulomatosis and other conditions DJ HARRISON,R SIMPSON, R KHARBANDA, VE ABERNETHY, G NIMMO ....................................................... 373

Attitudes to smoking and smoking habit among the staff of a hospital PDO DAVIES, K RAJAN ..... .............. 378Respiratory function in the morbidly obese before and after weight loss PS THOMAS, ERTC OWEN, G HULANDS,

JS MILLEDGE.............................................................................................. 382Effect of low dose nebulised morphine on exercise endurance in patients with chronic lung disease IH YOUNG,

E DAVISKAS, VA KEENA.................................................................................... 387Anginal chest pain in sarcoidosis JL WAIT, A MOVAHED ........... ............................................ 391Detection of pulmonary hypertension by Doppler echocardiography of the inferior vena cava in chronic airflow

obstruction JP LAABAN, B DEEBOLD, M LAFAY, J ROCHEMAURE, P PERONNEAU................................ 396Relation of lung function and exercise capacity to mood and attitudes to health B KING, JE COTES ..... ......... 402Circadian rhythm of peak expiratory flow in asthmatic and normal children AJW HENDERSON, F CARSWELL ..... 410Longitudinal course of extrinsic allergic alveolitis in pigeon breeders SJ BOURKE, SW BANHAM, R CARTER, P LYNCH,

G BOYD................................................................................................. 415How many manoeuvres should be done to measure maximal inspiratory mouth pressure in patients with chronic

airflow obstruction? JA FIZ, JM MONTSERRAT, C PICADO, V PLAZA, A AGUSTI-VIDAL.......................... 419Adrenal function in patients with active tuberculosis DJ BARNES, S NARAQI, P TEMU, JR TURTLE.................. 422

RESEARCH OVERVIEW

Distribution of allergy in a population sample residing in Tucson, Arizona MG CLINE, B BURROWS.............. 425

SHORT REPORTS

Abnormal lung lymphatics and respiratory failure SF MOSS, DC CURRIE, EA SHEFFIELD, M BAXTER, B CORRIN,TW EVANS............................................................................................... 432

Opportunist pulmonary infection with Legionella bozemanii CR SWINBURN, FK GOULD, PA CORRIS, TL HOOPER,NJ ODOM, R FREEMAN, CGA MCGREGOR..................................................................... 434

Discrete pleural masses without effusion in a young man: an unusual presentation of tuberculosis SB BLUNT,MG HARRIES........................................................................................... 436

Primary pulmonary lymphoma in a patient with the acquired immune deficiency syndrome D POELZLEITNER,P HUEBSCH, S MAYERHOFER, A CHOTT, C ZIELINSKI.......................................................... 438

Chronic necrotising pneumonia caused by Aspergillus niger J WIGGINS, TJH CLARK, B CORRIN................... 440Pericardial actinomycosis with cardiac tamponade from a contiguous thoracic lesion AD SLUTZKER, WD CLAYPOOL 442Haemoptysis as the sole presenting symptom of dissection of the aorta AS GUIDETI, A PIK, A PEER, S SHIKIAR,

D BEN-YAAKOV.......................................................................................... 444

CORRESPONDENCE

Transfer factor for carbon monoxide in patients with diabetes mellitus with and without microangiopathy D BELL,DAW COLLIER, D WEIR, AH BARNETT, P SHERWOOD BURGE, PE JENNINGS, MS HENDY............................ 446

Does right ventricular function predict survival in patients with chronic obstructive lung disease? M KARAKUZU;W MacNEE.............................................................................................. 447

Prospective study of asthma in relation to smoking habits KM VENABLES, AJ NEWMAN TAYLOR ..... ............. 447

NOTICE ..................................................................................................... 447

BOOK NOTICES............................................................................................... 448



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CONTENTS 1989

No. 6 JUNE PAGE

EDITORIAL

Treatment of pulmonary disease caused by opportunist mycobacteria J BANKS................................ 449

ORIGINAL ARTICLES

Correlations between histological type, clinical behaviour, and prognosis in thymoma C RICCI, EA RENDINA,EO PESCARMONA, F VENUTA, R DI TOLLA, LP RUCO, CD BARONI............................................... 455

Effects of an external resistance on maximum flow in chronic obstructive lung disease: implications for recognitionof coincident upper airway obstruction DR ROBERTSON, CR SWINBURN, TN STONE, GJ GIBSON ..... ........... 461

The fluctuant nature of precipitating antibodies in dairy farmers Y CORMIER, i BtLANGER ..... ................. 469Repeatability of ventilatory function measurements in a population survey of 7 year old children DP STRACHAN 474Effects of posture on the distribution of pulmonary ventilation and perfusion in children and adults U BHUYAN,

AM PETERS, I GORDON, H DAVIES, P HELMS ................................................................. 480Vertical gradients of lung density in healthy supine men AB MILLAR, DM DENISON ...... ........................ 485Effect of inhaled leukotriene B4 alone and in combination with prostaglandin D2 on bronchial responsiveness to

histamine in normal subjects PN BLACK, RW FULLER, GW TAYLOR, PJ BARNES, CT DOLLERY.................. 491Malignant pleural mesothelioma in western Glasgow 1980-6 G HULKS, JSti THOMAS, E WACLAWSKI ..... ........ 496Relation between immunocytological features of bronchoalveolar lavage fluid and clinical indices in sarcoi-

dosis GM AINSLIE, LW POULTER, RM DU BOIS ............................................................. 501Radiographic measurement of total lung capacity in acute asthma MS ROTHSTEIN, MN ZELEFSKY, PQ EICHACKER,

DJ RUDOLPH, MH WILLIAMS ir .............................................................................. 510Renal and pulmonary effects of angiotensin converting enzyme inhibition in chronic hypoxic lung disease

RM OLIVER, AJ PEACOCK, JS flEMING, DG WALLER ........................................................... 513

SHORT REPORTS

Synchronous pulmonary carcinoid tumour and non-Hodgkin's lymphoma: report of two cases FM JUETTNER,C FELLBAUM, H POPPER, M LEHNERT, M NEUBAUER, W WAGNER, H BECKER ..................................... 516

Long term survival after treatment of disseminated T cell lymphoma presenting with tracheal obstruction in apatient with coeliac disease DJ SEDDON, KF CHUNG, FJ PARADINAS, ES NEWLANDS, PD SNASHALL ..... ........ 519

Non-apnoeic REM sleep induced nocturnal oxygen desaturation treated by nasal continuous positive airwaypressure F StRIS, Y CORMIER, J LA FORGE ................................................................ 521

Management of severe haemoptysis by bronchial artery embolisation in a patient with cystic fibrosis AD KING,DC CUMBERLAND, SR BRENNAN ........................................................................... 523

Pulmonary haemorrhage in Henoch-Schonlein purpura HS MARKUS, JV CLARK ...... .......................... 525

CORRESPONDENCE

Predicted values: how should we use them? DC JOHNSON; MR MILLER, AC PINCOCK.............................. 527Breathing patterns during sleep in patients with nocturnal asthma A GIANOTTI, N FRANCONIERI; AD MORGAN,

NJ DOUGLAS............................................................................................. 527

BOOK NOTICES............................................................................................... 528

NOTICE ..................................................................................................... 528

No. 7 JULY

REPORT

Trends in mortality from chronic obstructive airways disease in the United Kingdom A BACKHOUSE, WW HOLLAND 529

ORIGINAL ARTICLES

Origin and behaviour of emphysematous bullae MDL MORGAN, CW EDWARDS, J MORRIS, HR MATTHEWS .......... 533Laser light scattering spectroscopy: a new method to measure tracheobronchial mucociliary activity

K SVARTENGREN, L-G WIMAN, P THYBERG, R RIGLER ........................................................ 539

Effect of bracing on respiratory mechanics in mild idiopathic scoliosis J DECLAN KENNEDY, CF ROBERTSON,I HUDSON, PD PHELAN .......................,..... . ....................................... 548

Diagnosis of pulmonary disease in human immunodeficiency virus infection: role of transbronchial biopsy andbronchoalveolar lavage MH GRIFFITHS, G KOCJAN, RF MILLER, P GODFREY-FAUSSETT.554



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CONTENTS 1989

Empirical treatment without bronchoscopy for Pneumocystis carinui pneumonia in the acquired immunodeficiency PAGEsyndrome RF MILLER, AB MILLAR, IVD WELLER, SJG SEMPLE................................................ 559

Nebulised pentamidine as treatment for Pneumocystis carinii pneumonia in the acquired immunodeficiencysyndrome RF MILLER, P GODFREY-FAUSSETT, SJG SEMPLE .................................................. 565

Pulmonary cell populations in recipients of bone marrow transplants with interstitial pneumonitis HJ MILBURN,LW POULTER, HG PRENTICE, RM DU BOIS................................................................... 570

Prescription of oxygen concentrators: adherence to published guidelines JP DILWORTH, CMB HIGGS, PA JONES,RJ WITE................................................................................................ 576

Posture and nocturnal asthma KF WHYTE, NJ DOUGLAS ........... ........................................... 579Diurnal variation in serum cortisol concentrations in asthmatic subjects after allergen inhalation SR DURHAM,

J KEENAN, WOCM COOKSON, CF CRADDOCK, MK BENSON..................................................... 582Bronchial asthma at high altitude: a clinical and laboratory study in Addis Ababa B TEKLU.................... 586

PERSONAL VIEW

Studies of domiciliary oxygen in a common cause TL PETTY.................................................. 588

SHORT REPORTS

Relapse of Pneumocystis carinii pneumonia in the upper lobes during aerosol pentamidine prophylaxisRM BRADBURNE, DB ETTENSOHN, SM OPAL, FD MCCOOL ...................................................... 591

Malignant carcinoid tumour of the oesophagus AR READY, JO SOUL, J NEWMAN, HR MATTHEWS.................. 594Metastatic uterine leiomyosarcoma in association with recurrent lung abscess N SHERON, M GRIFFITHS,

NMCI JOHNSON.......................................................................................... 597Tuberculous retropharyngeal abscess producing respiratory obstruction N CARROLL, RJI BAIN, MH TSEUNG,

RHT EDWARDS ............................................................................. 599Obstructive respiratory failure in cicatricial pemphigoid CRR DE CARVALHO, MBP AMATO, LMMF DA SILVA,

CSV BARBAS, RA KAIRALLA, PHN SALDIVA .......... .................... ................................... 601Effect of hyperthyroidism on bronchial reactivity in non-asthmatic patients JA ROBERTS, AR MCLELLAN,

WD ALEXANDER, NC THOMSON............................................. ................................603Changes in serum potassium concentration in asthmatic and normal subjects during exercise M GUGGER ....... 605

CORRESPONDENCE

Bronchoalveolar lavage in talc induced lung disease P DE VUYST, P DUMORTIER, P LEOPHONTE; DB ETTENSOHN,A REDONDO, M KHAN, N KESSIMAN ........................................................................ 607

BOOK NOTICES............................................................................................... 607-8

No. 8 AUGUST

EDITORIAL

Asthma: epidemics and epidemiology DJ HENDRICK ............ ............................................. 609

ORIGINAL ARTICLES

Increase in hospital admissions for childhood asthma: trends in referral, severity, and readmissions from 1970 to1985 in a health region of the United Kingdom HR ANDERSON ........................................... 614

Recurrent accident and emergency department attendance for acute asthma in children SM O'HALLORAN, DP HEAF 620Spontaneous pneumothorax: comparison of simple drainage, talc pleurodesis, and tetracycline pleurodesis

M ALMIND, P LANGE, KAJ VISKUM ......................................................................... 627A phase II study of oral etoposide in elderly patients with small cell lung cancer EF SMIT, DN CARNEY, P HARFORD,

DT SLEIJFER, PE POSTMUS ............................................................................... 631Physiotherapy after coronary artery surgery: are breathing exercises necessary? SC JENKINS, SA SOUTAR,

JM LOUKOTA, LC JOHNSON, J MOXHAM ............ . ............................................................ 634Measurement of lung tissue mass in Pneumocystis carinji pneumonia DJ SEDDON, PD SNASHALL................. 640Lung function and bronchial reactivity in farmers M IVERSEN, R IAHL, EJ JENSEN, J KORSGAARD, T HALLAS ....... 645Role of histamine release in hypertonic saline induced bronchoconstrictioii SP O'HICKEY, NG BELCHER, PJ REES, TH

LEE.......................;.650Nedocromil sodium in adults with asthma dependent on inhaled cortidosteroids: a double blind, placebo controlled

study MF BONE, MM KUBIK, NP KEANEY, GD SUMMERS, CK CONNOLLY, P SHERWOOD BURGE, RG DENT, GW ALLAN 654Disturbance in respiratory mechanics in infants with bronchiolitis J SEIDENBERG, IB MASTERS, I HUDSON, A OLINSKY,

PDPHELAN............t::.; ...... 660



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The immunological component ofthe cellular inflammatory infiltrate in bronchiectasis JR LAPA E SILVA, JAH JONES,PJ COLE, LW POULTER ................................................................................... 668

SHORT REPORTS

Topical nasal anaesthesia for fibreoptic bronchoscopy: patients' preference for lignocaine gel AR WEBB,A WOODHEAD, HR DALTON, JA GRIGG, FJC MILLARD ....................................................... 674

Postirradiation pulmonary fibrosis complicated by aspergilloma and bronchocentric granulomatosis H MAKKER,K McCONNOCHIE, AR GIBBS ......... . ...................................................................... 676

Locally invasive pulmonary aspergillosis occurring in a gardener: an occupational hazard? JA ZUK, D KING,HD ZAKHOUR, JC DELANEY .............................................................................. 678

Use of expandable metal stents in the treatment of bronchial obstruction AK SIMONDS, JD IRVING, SW CLARKE,R DICK................................................................................................. 680

Unilateral pulmonary oedema following the removal of a giant pleural tumour DA WALLER, NR SAUNDERS ...... 682Bacteraemia following orotracheal intubation and oesophageal balloon dilatation CP HANSEN, H WESTH, K-E BROK,

R JENSEN, S BERTELSEN ................................................................................... 684

CORRESPONDENCE

Is current treatment increasing asthma mortality and morbidity? I GREGG; EA MITCHELL ..... .................. 686

BOOK NOTICES............................................................................................... 687

NOTICE ..................................................................................................... 688

No. 9 SEPTEMBER

EDITORIAL

The current state of lung transplantation J DARK, PA CORRIS ................................................. 689

ORIGINAL ARTICLES

Cellular characteristics of sputum from patients with asthma and chronic bronchitis PG GIBSON,A GIRGIS-GABARDO, MM MORRIS, S MATTOLI, JM KAY, J DOLOVICH, J DENBURG, FE HARGREAVE ..... ............. 693

Accident and emergency department attendance by asthmatic children SM O'HALLORAN, DP HEAF............... 700Pressurised aerosol deposition in the human lung with and without an "open" spacer device SP NEWMAN,

AR CLARK, N TALAEE, SW CLARKE......................................................................... 706Bronchiolitis obliterans organising pneumonia in patients taking acebutolol or amiodarone P CAMUS,

J-N LOMBARD, M PERRICHON, F PIARD, J-C GUtRIN, FB THIVOLET, L JEANNIN .................................. 711

Adverse effect of additional weight on exercise against gravity in patients with chronic obstructive airwaysdisease CR SWINBURN, BG COOPER, H MOULD, PA CORRIS, GJ GIBSON........................................ 716

Coronary artery bypass surgery: current practice in the United Kingdom GD ANGELINI, AJ BRYAN, RR WEST,AC NEWBY, IM BRECKENRIDGE ............................................................................ 721

Decreased pulmonary distensibility in fibrosing alveolitis and its relation to decreased lung volume MJ THOMPSON,HJH COLEBATCH ................. ........................................................................ 725

Bronchoalveolar lavage cell counts as a predictor of short term outcome in pulmonary sarcoidosis NM FOLEY,AP CORAL, K TUNG, BN HUDSPITH, DG JAMES, NMCI JOHNSON ................................................ 732

Infective respiratory exacerbations in young adults with cystic fibrosis: role of viruses and atypical micro-organisms ELC ONG, ME ELLIS, AK WEBB, KR NEAL, M DODD, EO CAUL, S BURGESS ............................ 739

Laryngeal resistance immediately after panting in asthmatic subjects M YANAI, T OHRUI, K SEKIZAWA, H SASAKI,T TAKISHIMA............................................................................................. 743

SHORT REPORTS

Small cell carcinoma of the oesophagus: report of three cases and review of published cases DM ECCLES, SG ALLAN,CTM SANG, MA CORNBLEET ............................................................................... 749

Treatment of oesophageal small cell carcinoma by combined chemotherapy and surgical resection: report of twocases and review of published cases SJ WALKER, A STEEL, MH CULLEN, HR MATTHEWS ..... .................. 751

Effect of corticosteroids on post-intubation tracheal stenosis J BRAIDY, G BRETON, L CLtMENT ..... ............. 753Annular lesion of the lung in sarcoidosis H TADA, R YASUMIZU, S YUASA, M SATO, Y MIZUNO ..... ................ 756Heterozygous FZ a, antitrypsin deficiency associated with severe emphysema and hepatic disease: case report and

family study CP KELLY, DNM TYRRELL, GSA MCDONALD, DB WHITEHOUSE, JS PRICHARD ..... ................. 758

Pseudo-occupational asthma KM VENABLES, AG DAVISON, K BROWNE, AJ NEWMAN TAYLOR.760



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CONTENTS 1989PAGE

Colopleural fistula due to strangulated Bochdalek hernia in an adult M SINHA, P GIBBONS, SC KENNEDY,HR MATTHEWS.......................................................................................... 762

BOOK NOTICES............................................................................................... 764

NOTICE ..................................................................................................... 764

CORRESPONDENCE

Attitudes to smoking and smoking habit among the staff of a hospital J COOREMAN, S PRETET; K KNOL; P BURKE;PDO DAVIES............................................................................................. 765

Minitracheotomy: a simple alternative to tracheostomy in obstructive sleep apnoea CD HANNING; MDL MORGAN,HR MATTHEWS.......................................................................................... 766

Alveolitis associated with sulphamethoxypyridazine JC PORTER, JS FRIEDLAND, F WOJNAROWSKA, JGG LEDINGHAM 766Cardiovascular and hypokalaemic effects of inhaled salbutamol, fenoterol, and isoprenaline K LARSSON,

P HJEMDAHL; J CRANE, C BURGESS, R BEASLEY .............................................................. 767Adrenal function in patients with active tuberculosis P MUSTCHIN; DJ BARNES, S NARAQI, P TEMU, JR TURTLE ..... 768

No. 10 OCTOBER

EDITORIAL

Sedation for fibreoptic bronchoscopy MP SHELLEY, P WILSON, J NORMAN ...................................... 769

New series: AIDS AND THE LUNGIntroduction DM MITCHELL, AA WOODCOCK ......................................................... 7761 AIDS, aprons, and elbow grease: preventing the nosocomial spread of human immunodeficiency virus and

associated organisms PJV HANSON, JV COLLINS .......................................................... 778

ORIGINAL ARTICLES

Long term survival after pulmonary resection for small cell carcinoma of the lung US PRASAD, AR NAYLOR,WS WALKER, D LAMB, EWJ CAMERON, PR WALBAUM ........................................................ 784

Second primary lung cancer: importance of long term follow up PC VAN BODEGOM, SjSc WAGENAAR, B CORRIN,JPA BAAK, J BERKEL, RGJRA VANDERSCHUEREN ............................................................. 788

Comparison of the Tru-cut biopsy needle with the Abrams punch for pleural biopsy DT MCLEOD, I TERNOUTH,N NKANZA.............................................................................................. 794

Treatment of adult asthma: is the diagnosis relevant? P LITTLEJOHNS, S EBRAHIM, R ANDERSON ..... ............. 797Circadian change in bronchial responsiveness and airflow obstruction in asthmatic children WMC VAN AALDEREN,

DS POSTMA, GH KOETER, K KNOL ..................................................... ......................803Contractility of papillary muscle from rats exposed to 28 days of hypoxia, hypercapnia, and hypoxia with

hypercapnia SV BAUDOUIN, NT BATEMAN ................................................................ 808Chickenpox pneumonia: an association with pregnancy TF ESMONDE, G HERDMAN, G ANDERSON ..... ........... 812Dose-response study of nebulised nedocromil sodium in exercise induced asthma MK ALBAZZAZ, MG NEALE,

KR PATEL............................................................................................... 816

SHORT REPORTS

Chronic necrotising pulmonary aspergillosis treated with itraconazole JA ELLIOTT, LJR MILNE, D CUMMING ...... 820Bronchoscopy findings in invasive pulmonary aspergillosis H VEREA-HERNANDO, MT MARTIN-EGANA,

C MONTERO-MARTINEZ, J FONTAN-BUESO ....................................................................822Bilateral recurrent haemorrhagic pleural effusion in asymptomatic chronic pancreatitis SC TEWARI, R JAYASWAL,

MS CHAUHAN, SK KAUL, VA NARAYANAN .................................................................. 824Dissemination of tumour cells from fine needle biopsy N REDWOOD, D BEGGS, WE MORGAN ..... ................ 826Palliation of malignant ascites with a Tenckhoff catheter DA LOMAS, PJW WALLIS, RA STOCKLEY ..... ........... 828Sarcoidosis in an adult with cystic fibrosis SD RETTINGER, EP TRULOCK, B MACKAY, HS AUERBACH ..... .......... 829

CORRESPONDENCE

Nebulised pentamidine as treatment for Pneumocystis carinii pneumonia in the acquired immunodeficiencysyndrome Q SUMMERS; RF MILLER ....................................................................... 831

Antibodies to neutrophil cytoplasmic antigens in Wegener's granulomatosis and other conditions GW BRADLEY;DJ HARRISON............................................................................................ 831



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CONTENTS 1989PAGE

BOOK NOTICES............................................................................................... 832

CORRECTION

Ventilation-perfusion mismatching in acute severe asthma: effects of salbutamol and 100% oxygen (BALLESTERet al)..................................................................................... 833

PROCEEDINGS British Thoracic Society meeting, summer 1989................................................. 834

No. II NOVEMBER

EDITORIAL

Botulism: a potentially common problem JM SHNEERSON..................................................... 901

ORIGINAL ARTICLES

Inspiratory and skeletal muscle strength and endurance and diaphragmatic activation in patients with chronicairflow limitation SZ NEWELL, DK MCKENZIE, SC GANDEVIA ............................................... 903

Respiratory muscle weakness in the Lambert-Eaton myasthenic syndrome CM LAROCHE, AK MIER, SG SPIRO,J NEWSOM-DAVIS, J MOXHAM, M GREEN .................................... 913

Pulmonary eosinophilia with and without allergic bronchopulmonary aspergillosis BJ CHAPMAN, S CAPEWELL,R GIBSON, AP GREENING, GK CROMPTON ................................................................... 919

Corticosteroid treatment and prognosis in pulmonary eosinophilia S CAPEWELL, BJ CHAPMAN, F ALEXANDER,AP GREENING, GK CROMPTON............................................................................. 925

Cardiopulmonary response to oxygen therapy in hypoxaemic chronic airflow obstruction JM HUNT, J COPLAND,CF MCDONALD, CE BARTER, PD ROCHFORD, RJ PIERCE ....................................................... 930

Nutritional state and exercise performance in patients with chronic obstructive lung disease AMWJ SCHOLS,R MOSTERT, PB SOETERS, LH GREVE, EFM WOUTERS .......................................................... 937

Effect of nebulised salbutamol on maximal exercise performance in men with mild asthma W FREEMAN, GE PACKE,RM CAYTON............................................................................................. 942

Prevalence ofasthma, atopy, and bronchial hyperreactivity in bronchiectasis: a controlled study J PANG, HS CHAN,JY SUNG ................. .............................................................................. 948

Generalised non-reactive tuberculosis: a clinicopathological study of four patients R SINGH, RC JOSHI, J CHRISTIE 952Transbronchial biopsy without fluoroscopy: a five year experience in outpatients 0 DE FENOYL, F CAPRON,

B LEBEAU, J ROCHEMAURE ................................................................................ 956

REVIEW

Diaphragmatic paresis: pathophysiology, clinical features, and investigation GJ GIBSON ..... .................. 960

AIDS AND THE LUNG

2-Antiretroviral treatment in human immunodeficiency virus disease AJ PINCHING ........................... 971

SHORT REPORTS

Cystic lung in Marfan's syndrome BK SHARMA, B TALUKDAR, R KAPOOR ....................................... 978Tracheal lipoma J RAHAMIN, CA BATES ...................................................................... 980

No. 12 DECEMBER

EDITORIAL

Missing link from Tibet D HEATH........................................................................... 981

REVIEW

Sleep apnoea and systemic hypertension JR STRADLING .......... ............................................ 984

ORIGINAL ARTICLES

Twitch pressures in the assessment of diaphragm weakness A MIER, C BROPHY, J MOXHAM, M GREEN ..... ........ 990Oxygen treatment of sleep hypoxaemia in Duchenne muscular dystrophy PEM SMITH, RHT EDWARDS, PMA

CALVERLEY ............................................................................................. 997



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CONTENTS 1989

Protriptyline treatment of sleep hypoxaemia in Duchenne muscular dystrophy PEM SMITH, RHT EDWARDS, PAGEPMA CALVERLEY .................. . ........................................................................ 1002

Effect of exercise and physiotherapy in aiding sputum expectoration in adults with cystic fibrosis W SALH,D BILTON, M DODD, AK WEBB.......................................................... ....................1006

Characterisation of bronchoconstrictor responses to sodium metabisulphate aerosol in atopic subjects with andwithout asthma GM NICHOL, A NIX, KF CHUNG, PJ BARNES ................................................ 1009

Changes in maximum expiratory flow-volume curve configuration after treatment with inhaled corticosteroidsJ KRAAN, ThW VANDER MARK, GH KOETER ................................................................ 1015

Effect of theophylline and enprofylline on bronchial hyperresponsiveness GH KOETER, J KRAAN, M BOORSMA,JHG JONKMAN, ThW VAN DER MARK....................................................................... 1022

Limited thoracoplasty in the management ofcomplicated pulmonary aspergillomas M AL-ZEERAH, K JEYASINGHAM 1027Prediction of microbial aetiology at admission to hospital for pneumonia from the presenting clinical features

BM FARR, DL KAISER, BDW HARRISON, CK CONNOLLY ....................................................... 1031Accuracy of inpatient oxygen administration AA JEFFREY, S RAY, NJ DOUGLAS ...... ........................... 1036

AIDS AND THE LUNG

Prevention of lung infections associated with human immunodeficiency virus infection PC HOPEWELL .... ...... 1038

SHORT REPORTS

Heterotopic brain tissue in the lung causing acute respiratory distress in an infant C FULLER, AR GIBBS .... ...... 1045Apparent response of small cell lung cancer to an extract of mistletoe and homeopathic treatment GW BRADLEY,

A CLOVER................................................................................................ 1047Total oesophageal duplication associated with dextrocardia and situs inversus HP GREWEL, JN LEVERMENT ...... 1049Treatment of late complications of plumbage by simultaneous removal of plomb and decortication A MORAN,

DE STABLEFORTH, HR MATTHEWS .......................................................................... 1051Squamous cell carcinoma of the pleura following bronchopleural fistula G PRABHAKAR, IM MITCHELL, T GUHA,

R NORTON............................................................................................. 1053Coronary artery-left ventricular fistula and multiple ventricular septal defects due to blunt chest trauma

A RENZULLI, C WREN, CJ HILTON............................. : 1055Evolution of acute chest syndrome in sickle cell trait: an ultrastructural and light microscopic study PS HASLETON,

K ORR, A WEBSTER, RAM LAWSON ......................................................................... 1057

CORRESPONDENCE

Repeatability of ventilatory function measurements in a population survey of 7 year old children N CHAN,M SILVERMAN; D STRACHAN .............................................................................. 1059

Relapse of pneumocystis pneumonia in the upper lobes during aerosol pentamidine prophylaxis MJ O'DOHERTY,SHL THOMAS, NT BATEMAN; RM BRADBURNE, DB ETTENSOHN, SM OPAL, FD MCCOOL............................. 1059

NOTICE...................................................................................................... 1060

BOOK NOTICES............................................................................................... 1005



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