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The neurofibromatosis type I (NF I, von Recklinghausen's disease) is an autosomal dominant neurocutaneous disorder with systemic involvement. The respiratory manifestations include: chest wall deformities, upper airway obstruction by neurofibromas, parenchymal neurogenic tumours, pulmonary fibrosis, cystic lung disease, primary pulmonary hypertension, central hypoventilation, diaphragm paralysis. We present 4 cases of NF I associated with chronic respiratory diseases. The common feature is the presence of severe chest deformities. The bullous emphysema was present in 2 of them. All 4 patients suffered from depressive syndrome with neuroleptic use.

The paper reports on three cases of congenital lobular emphysema with warning respiratory manifestations as early as infancy. Starting from the clinical picture of respiratory distress, the diagnosis was established radiologically. The authors discuss the etiopathogenic aspects of the disease and its clinical-radiological manifestations, with the decisive role of the radiological exploration in diagnosis. The extension of respiratory dysfunction and the possible complications determine the opportunity of surgery.

With reference to 156 patients with a post-tuberculous syndrome, admitted to a pneumology unit, the authors discuss the anatomoclinical aspects of the primary disease and morbid entities developing against the background of the sequelae. The circumstances in which chronic bronchitis develops and post-tuberculous bronchopulmonary suppuration, frequently encountered in the pathology secondary to stable tuberculosis are analyzed. The necessity of preventing potential unspecific diseases and insuring an optimal complex treatment is emphasized.

The authors make an analysis of 455 cases of spontaneous pneumothorax hospitalized and treated in the Clinic for Thoracic Surgery from Bucharest between 1952 and 1974. The therapeutic attitude recommended in such cases is the aspiration drainage through minimal pleurotomy (aspiration being carried out in relation with the parenchymal aerial losses). Introduction through the drainage tube of irritating substances will enhance pleural symphisis. The drainage will be maintained for 7--8 days. In the recidivating pneumothorax, or in cases where recovery is not achieved by aspiration drainage, thoracotomy becomes necessary for performing total pleurectomy and atypical resection of emphysema bubbles from the pulmonary cortical, since these are at the origin of the aerorrhagies (the Coman procedure). With the aid of these surgical techniques very good results have been obtained in all cases of spontaneous pneumothorax.

The severity of dyspnoea was confronted to the value of the partial pressure of arterial oxygen at rest in a group of 51 patients with chronic non-specific pneumopathy associated to medium or severe ventilatory obstruction (VEMS under 1,5 I). The patients have been classified as "predominantly bronchitic" or "predominantly emphysematous" on the basis of clinical, radiological and biological criteria. In the group as a whole there was no relation between the partial pressure of arterial oxygen and the severity of the dyspnoea. The analysis of sub-groups evidenced a tendency to decrease of the oxygen pressure with accentuation of dyspnoea in the "bronchitis" group, although the coefficient value of this inverse correlation did not reach the treshold of statistical significance (r = -0,46; p greater than 0,05).