Dieulafoy's disease is a vascular anomaly characterized by the presence of a dysplastic artery that is related to an epithelial ulcer. The French surgeon Georges Dieulafoy first described it in 1898. Most frequently, it is a gastrointestinal condition, but occurrence in the bronchus has been reported in a few cases. The case of a 52-year-old man with massive hemoptysis, for which he underwent successful embolotherapy 10 years previously, is described. Over the next 10 years, he had several hospital admissions due to hemoptysis, and he underwent successful embolotherapy on each occasion. This case report underlines the importance of bronchial arteriography as the investigation of choice for massive hemoptysis.

The transfer coefficient (Kco) was significantly lower in diabetic patients with microangiopathy than in a matched group without this complication. This may reflect microangiopathy in the pulmonary circulation.Diabetic microangiopathy is a generalised abnormality of small blood vessels characterised by thickening of the capillary basal lamina. Postmortem studies have shown similar changes in the lungs of patients with diabetes, and its presence is associated with evidence of microangiopathy in other organs.'Previous studies of lung function in patients with diabetes have found various abnormalities, including reduced gas transfer,23 decreased elasticity,4 and airflow obstruction.5 The cause ofthese abnormalities is not clear. It has been suggested that the changes in elasticity and gas transfer are due in part to microangiopathy in the lungs, but they have not been shown to be associated with diabetic complications elsewhere.2 We have re-examined the relation between gas transfer and microangiopathic complications in patients with diabetes mellitus. MethodsNine subjects (six male) with diabetes with either proliferative retinopathy (eight) or maculopathy (one) were matched for age, sex, height, and smoking history with nine diabetic patients without these features. None of them currently smoked or had clinical evidence of unrelated cardiorespiratory disease, and none was taking drugs known to have effects on the lungs. All patients gave written informed consent after the purpose of the study had been explained.Spirometry was performed with a dry wedge spirometer (Vitalograph), and lung volumes were determined by a closed circuit helium dilution technique. The mean of three technically satisfactory measurements of single breath carbon monoxide gas transfer (TLCO; Morgan Transfertest machine, model C) was used in the analysis. The transfer coefficient (Kco-TLcO corrected for alveolar volume (VA)) was calculated. All patients answered the standard Medical Research Council questionnaire on respiratory symptoms and had blood samples taken for estimation of haemoglobin

No abstract

No abstract

No abstract