It is not uncommon to see unilateral pulmonary emphysema compznsating for lobar collapse, or as a mechanical result of valvular obstruction of a bronchus. The clinical details of a case where neither of these factors was present, with a pathological report on the resected lung, form the subject of this paper.CLINICAL REPORTThe patient was a boy aged 6 years who came under observation after an attack of acute bronchitis in September, 1949. At the ages of 5 weeks, 2 years, and 3 years he had had bronchopneumonia, and since the age of 3 years he had been subject to recurrent attacks of bronchitis, which affected mainly the right lung.The boy was mentally normally developed, but slightly below standard height and weight for his age. Slight clubbing of the fingers was present. Chest expansion was poor on both sides, but more so on the right. Air entry on the right side was diminished with scattered crepitations throughout, and there were a few persistent crepitations at the left base. Other systems were apparently normal. A radiograph of the chest showed relative transradiancy of the right lung field compared with the left, with considerable decrease of vascular markings. The heart was slightly displaced to the right. The right hemithorax and lung were smaller than the left despite the increased transradiancy on the right (Fig. 1). Fluoroscopy showed movement of the heart to the right on inspiration and restricted excursion of the right diaphragm.Bronchography showed on the left side only slight dilatation of the posterior basic segmental bronchus of the lower lobe, and on the right a peculiar appearance because the peripheral bronchi failed to fill, with a sharp line of demarcation between the proximal filled and the peripheral unfilled parts (Figs. 2 and 3). Bronchoscopy showed that the main bronchi were normal with very little secretion present. Angiocardiography showed a normal heart with a right pulmonary artery much diminished in calibre, and confirmed the poor
To compare the growth and accumulation of protein, fat, and carbohydrate in the formula-fed premature infant and in the fetus of a similar postconceptional age, we performed 22 metabolic studies in 13 infants of very low birth weight (1155 +/- 39 g [mean +/- S.E.]). Measurements combining nutritional balance and indirect calorimetry demonstrated the deposition rates of protein and fat. We found that the formula-fed, very-low-birth-weight infant who gained weight comparably to the fetus retained the same amount of protein (1.92 +/- 0.1 g per kilogram of body weight per day) but accumulated fat at a rate of 5.4 +/- 0.3 g per kilogram per day - about three times that in the fetus, as confirmed by increased skin-fold thickness. How this change in body composition affects the future growth of formula-fed premature infants, and how body composition is altered by other dietary regimens such as the provision of human milk, remain to be determined.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.