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PubMedDate not supplied

Synergistic effects of air pollution and personal smoking on adult pulmonary function.

There is strong evidence that air pollution and cigarette smoking adversely affect respiratory health, but it remains uncertain whether the joint effects of air pollution and smoking are additive or synergistic. The authors investigated the hypothesized synergistic effects of air pollution and personal smoking on pulmonary function in a random sample of 3287 adults (40-69 y of age) who resided in residential, industrial, and suburban areas in Beijing. The authors used multiple linear regression and adjusted for age, sex, height, education, indoor use of coal stoves, crowding within a house, occupational exposures, and passive smoking. The annual mean total suspended particulates for the period 1981-1985 in residential, industrial, and suburban areas were 389 microg/m3, 449 microg/m3, and 261 microg/m3, respectively, and the annual mean sulfur dioxide levels were 128 microg/m3, 57 microg/m3, and 18 microg/m3, respectively. Compared with individuals in the suburban area, never smokers who resided in the industrial area had a 26-ml (standard error = 39) reduction in forced expiratory volume in 1 s and a 150-ml (standard error = 42) reduction in forced vital capacity; however, smokers in the same area suffered an additional 53-ml (standard error = 38) reduction in forced expiratory volume in 1 s and a 65-ml (standard error = 41) reduction in forced vital capacity. Similarly, never-smokers who resided in the residential area had a 72-ml (standard error = 35) reduction in forced expiratory volume in 1 s and a 274-ml (standard error = 38) reduction in forced vital capacity, and smokers in the same area suffered an additional 75-ml (standard error = 39) reduction in forced expiratory volume in 1 s and a 107-ml (standard error = 42) reduction in forced vital capacity. Long-term exposure to high levels of particulate and sulfur dioxide in Beijing was associated with significantly reduced pulmonary function in both never smokers and smokers. However, the associations were significantly greater among smokers than among never smokers, indicating a synergistic effect of air pollution and personal smoking on adult pulmonary function.

Adult↗

PubMed2005

[C-reactive protein level and the correlation between lung function and CRP levels in patients with chronic obstructive pulmonary diseases].

OBJECTIVE: To investigate the changes of C-reactive protein (CRP) level in patients with chronic obstructive pulmonary diseases (COPD) and to analyze the correlation between the lung function and CRP levels. METHODS: Sputum and serum specimens were obtained from 30 COPD patients diagnosed according to the national criteria. The CRP level was measured by enzyme-linked immunosorbent assays. The lung function indexes such as the forced expiratory volume in one second (FEV1) and the forced expiratory volume in one second/forced vital capacity (FEV1/FVC) were also determined. RESULTS: The sputum CRP level in COPD patients was 30-50 times higher than that of the health controls. The sputum CRP level in COPD patients is significantly higher than that of serum in these patients (P < 0.05). The correlation between changes of serum and sputum CRP levels and sputum CRP levels was positive (r = 0.625, P < 0.05). The correlations between changes of serum CRP levels and FEV1 were negative (r = -0.610, -0.725, respectively, P < 0.001). And the correlations between changes of serum and sputum CRP levels and FEV1/FVC were negative (r = -0.639, -0.600, respectively, P < 0.05). CONCLUSION: The CRP may be secreted from the local respiratory tract. The damage of lung function in COPD patients is associated with the increase of CRP level.

Adult↗

PubMed1987

Nebulized anticholinergic and sympathomimetic treatment of asthma and chronic obstructive airways disease in the emergency room.

The effectiveness of nebulized anticholinergic and sympathomimetic regimens was evaluated in a double-blind study of 199 patients with acute airways obstruction. Patients were assigned to one of three treatment regimens according to a randomized schedule: 0.5 mg of ipratropium bromide, 1.25 mg of fenoterol hydrobromide, and 0.5 mg of ipratropium plus 1.25 mg of fenoterol. In 148 patients with acute exacerbations of asthma (mean one-second forced expiratory volume, 1.18 +/- 0.64 liters), all three regimens produced significant improvement in one-second forced expiratory volume (p less than 0.001). The greatest improvement followed treatment with the ipratropium-fenoterol combination (0.53 +/- 0.40 liters at 45 minutes; 0.57 +/- 0.51 liters at 90 minutes) and was significantly greater than that following either ipratropium alone (p less than 0.001) or fenoterol alone (p less than 0.05). In 51 patients with acute exacerbations of chronic obstructive pulmonary disease (mean one-second forced expiratory volume, 0.67 +/- 0.29 liter), each regimen produced significant improvement in one-second forced expiratory volume at both 45 and 90 minutes (for all, p less than 0.05), but there was no significant difference among the three treatment regimens. It is concluded that, in patients with acute asthma, combination therapy with sympathomimetic and anticholinergic agents is more efficacious than either one alone. In patients with acute exacerbations of chronic obstructive pulmonary disease, although either sympathomimetic or anticholinergic therapy provides bronchodilatation, no further benefit could be demonstrated from combination therapy.

Administration, Intranasal↗

PubMed1996

Morbidity and mortality after thoracoscopic pneumonoplasty.

BACKGROUND: Both video-assisted thoracic surgery and open pneumonoplasty procedures have been used to achieve lung reduction in emphysema patients. METHODS: The surgical and hospital course of 339 patients with a mean forced expiratory volume in 1 second of 750 mL and a mean ratio of forced expiratory volume in 1 second to forced vital capacity of 35% undergoing video-assisted thoracic surgical laser pneumonoplasty was analyzed. RESULTS: The incidence of myocardial infarctions was 0.9% and the hospital mortality rate was 4.1%. CONCLUSIONS: Factors leading to increased morbidity and mortality were advanced age (65 years and greater, especially greater than 75 years), sex (men greater than women), carbon dioxide retention in the resting state (especially an arterial carbon dioxide tension greater than 55 mm Hg), forced expiratory volume in 1 second less than 700 mL for men and 500 mL for women, maximum voluntary ventilation less than 25% predicted, and a ratio of residual volume/total lung capacity greater than 60%.

Age Factors↗

PubMed1980

Abnormalities in maximum flow volume curve and closing volume in patients with hepatic cirrhosis.

Pulmonary functions were measured in 53 patients with hepatic cirrhosis in whom there was no clinical or radiographic evidence of pulmonary involvement. Spirometric tests such as total lung capacity, vital capacity, functional residual capacity, residual volume and forced expiratory volume during one second were within normal ranges, in all subjects. Flow volume curve and closing volume tests, however, were abnormal in the majority. The maximal expiratory flow at 50 per cent of vital capacity was not altered but the maximal expiratory flow at 25 percent of vital capacity was decreased significantly in patients with hepatic cirrhosis. The closing volume in patients with hepatic cirrhosis was also significantly increased. The abnormalities in flow volume curve and closing volume curve were also demonstrated in non-smokers, and at any age, in cases of hepatic cirrhosis. These results suggested that the narrowing or closure in small airways may occur in patients with hepatic cirrhosis. These changes may be due to mechanical compression of small airways but interstitial edema which was induced by presence in the circulating blood of vasoactive substances and endotoxins.

Adult↗

PubMed1985

Duration of increased pulmonary function sensitivity to an initial ozone exposure.

The metabolic and pulmonary function effects were investigated in six non-smoking young adults who were exposed for 2 hours (22 degrees C WBGT) to: filtered air (FA) 0.45 ppm ozone (DAY1); and two days later to a second exposure to 0.45 ppm ozone (DAY2). The subjects alternated 20-minute periods of rest and 20-minute periods of bicycle ergometer exercise at a workload predetermined to elicit a ventilatory minute volume (VE) of 27 L/min (BTPS). Functional residual capacity (FRC) was determined pre- and post-exposure. Forced vital capacity (FVC) was determined before and after exposure, as well as 5 minutes after each exercise period. Heart rate was monitored throughout the exposure, and VE, oxygen uptake (VO2), respiratory rate (fR), and tidal volume (VT) were measured during the last 2 minutes of each exercise period. There were no changes in any variable consequent to FA exposure. Both ozone exposures induced significant (P less than 0.05) decrements in FVC; FEV1.0 (forced expiratory volume in 1 second); FEV3.0 (forced expiratory volume in 3 seconds); FEF25-75% (average flow rate between 25% and 75% of FVC); and total lung capacity (TLC). The decrements following the DAY2 ozone exposure were significantly greater than following DAY1, and averaged 7.2 percentage points greater than those following the DAY1 exposure.

Adolescent↗

PubMed2001

Expiratory and inspiratory forced vital capacity and one-second forced volume in asymptomatic never-smokers in Norway.

The objectives of this study were to examine within and between individual variation detected during forced expiratory (FE) and forced inspiratory (FI) manoeuvers in a general population and to investigate the dependence of these variables on age, body size, and gender. A random sample of asymptomatic never smokers who had never been exposed occupationally to quartz or asbestos and who were living on the south-western coast of Norway were examined by spirometry; 81% of the individuals invited to attend did so. Of the 488 subjects between 18 and 73 years of age, 98% contributed three acceptable recordings for forced expiratory vital capacity (FVC) and one-second forced expiratory volume (FEV1), 94% contributed three acceptable recordings for forced inspiratory vital capacity (FIVC) and 85% contributed three acceptable recordings for one-second forced inspiratory volume (FIV(1)). The within-subject variation increased with body height and was considerably larger for FIV(1) than for FVC, FEV(1) or FIVC. A four-parameter model of pulmonary function measurement divided by height squared, including a gender term and a linear and quadratic term of age, fit the median of the observed values well. The residuals had a close-to-normal distribution, and the fifth-percentile values were estimated as the lower limit of normal. The peak value of dynamic lung volumes was observed into the middle of the fourth decade of life, and the decline thereafter did not differ greatly between the genders or among the different indices. The forced inspiratory volumes are the first reported in any reference population.

Adolescent↗

PubMed2006

Breath-hold single-photon emission tomography and computed tomography for predicting residual pulmonary function in patients with lung cancer.

OBJECTIVE: We sought to evaluate the utility of integrated breath-hold single-photon emission tomography and computed tomography imaging compared with that of simple calculation with the lung segment-counting technique for predicting residual pulmonary function in patients undergoing surgical intervention for lung cancer. METHODS: A prospective series of 22 patients undergoing anatomic lung resection for cancer were enrolled in this study. Postoperative residual forced expiratory volume in 1 second was predicted by measuring the radioactivity counts of the affected lobes or segments to be resected within the entire lungs by placement of regions of interest on single-photon emission tomography and computed tomography images. Residual forced expiratory volume in 1 second was also estimated by using the segment-counting technique. RESULTS: Both predicted values agreed well with postoperative forced expiratory volume in 1 second. Although the residual forced expiratory volume in 1 second predicted by means of single-photon emission tomography and computed tomography correlated well with that predicted by using segment counting, the values were significantly underestimated by the segment-counting technique in 4 outliers with severe emphysema. There were 2 patients with borderline pulmonary functional reserve whose residual forced expiratory volume in 1 second values were predicted more accurately by means of single-photon emission tomography and computed tomography than by using segment counting. CONCLUSION: Integrated breath-hold single-photon emission tomography and computed tomography images allow the accurate prediction of postoperative pulmonary function but without statistical superiority over the simple segment-counting technique. Further study of the usefulness of single-photon emission tomography and computed tomography in patients with severe emphysema and borderline lung function should prove valuable because the segment-counting technique underestimates pulmonary functional reserve in these patients.

Aged↗

PubMed1979

Acute and chronic pulmonary function changes in allergic bronchopulmonary aspergillosis.

Pulmonary functions of patients with allergic bronchopulmonary aspergillosis were studied during an acute episode (n = 6); during a mean follow-up period of 44 months (range four months--14.8 years) (n = 16); and for any correlation between duration of ABPA and asthma with the total lung capacity (helium dilution), 1 second forced expiratory volume (FEV1), vital capacity, 1 second forced expiratory volume-forced vital capacity ratio (FEV1:FVC per cent) and diffusing capacity of carbon monoxide (DL:CO) (single breath) for the entire group (n = 22). All patients were treated with corticosteroids (intermittent or continuous) and bronchodilators. For the 16 patients, slopes using linear regression analysis were determined from the function as per cent predicted versus time in months from diagnosis and then analyzed for significance. Significant functional loss was shown in three of 16 patients for FEV1, two of 16 patients for vital capacity, one of 16 patients for FEV1:FVC per cent, none of 10 patients for DL:CO and one of 10 patients for total lung cital capacity, FEV1:FVC per cent and the duration of asthma or allergic bronchopulmonary aspergillosis was found by multiple regression analysis correcting for age and smoking (mean 4.24 years; range 0.3 to 14.8 years). Roentgenographic criteria and blood eosinophilia were used to define a "flare" of allergic bronchopulmonary aspergillosis. The six patients during a flare showed a significant reduction in total lung capacity (P less than 0.001), vital capacity (P less than 0.05), FEV1 (P less than 0.01) and DL:CO (P less than 0.001) which uniformly returned to baseline values during steroid therapy. The FEV1:FVC per cent remained unaltered. These findings, contrary to suggestions in the literature, indicate that in the majority of our patients there was no significant progressive functional deterioration after diagnosis. However, during acute episodes of allergic bronchopulmonary aspergillosis, transient reduction of volumes and DL:CO were uniformly present.

Adolescent↗

PubMed2005

Long-term pulmonary function after thoracic sympathectomy.

BACKGROUND: The purpose of this study was to evaluate the long-term and midterm effects of thoracic sympathectomy on pulmonary function and to assess the influence of the sympathetic nervous system on bronchomotor tone. METHODS: Thirty-seven consecutive patients were diagnosed with primary hyperhidrosis requiring thoracic sympathectomy and were included in this study. Spirometry and methacholine challenge testing were performed before and 3 months after surgery. To assess the long-term effects of the intervention, another spirometric study was performed 1 year later. RESULTS: Spirometry 3 months after surgery showed a significant decrease in the forced vital capacity (-5.2%), the forced expiratory volume in the first second (-6.1%), and the forced expiratory flow between 25% and 75% of vital capacity (-5.1%). Whereas methacholine challenge testing before surgery was positive in 3 subjects (2 of whom were asthmatic), it was positive in 6 patients after the procedure; differences were not statistically significant. After 12 months, forced vital capacity started recovering, and forced expiratory volume in the first second and forced expiratory flow rate 25% to 75% showed a sustained and significant reduction (-2.8% and -11.2%, respectively); however, patients remained asymptomatic. CONCLUSIONS: We conclude that thoracic sympathectomy generates a mild, although significant, impairment of the bronchomotor tone, with no clinical consequences. These results suggest that the sympathetic nervous system is involved in pulmonary bronchomotor tone.

Adolescent↗

PubMed2005

Comparable efficacy of ciclesonide once daily versus fluticasone propionate twice daily in asthma.

BACKGROUND: Inhaled corticosteroids are the mainstay of therapy in asthma, but local and systemic side effects and adherence remain a concern. Ciclesonide is an inhaled corticosteroid with on-site lung activation that provides potent anti-inflammatory activity and has been shown to have a good safety profile, even at high doses. OBJECTIVE: The aim of this study was to compare the efficacy and safety of once-daily ciclesonide versus twice-daily fluticasone propionate at comparable daily doses in patients with asthma. METHODS: In this multicenter, randomized, double-blind, double-dummy, parallel group study, 529 patients were randomized to ciclesonide 160 microg once daily or fluticasone propionate 88 microg twice daily for 12 weeks. The primary endpoint was change in lung function. RESULTS: Both ciclesonide and fluticasone propionate significantly improved forced expiratory volume in 1s, forced vital capacity, and morning peak expiratory flow compared with baseline (p<0.0001 for all variables). Both medications reduced asthma symptoms and rescue medication use within the first 24 h. At the tested dose, both medications were equally safe and well tolerated. CONCLUSION: Ciclesonide 160 microg once daily was as effective as fluticasone propionate 88 microg twice daily in improving lung function and asthma symptoms, and in reducing rescue medication use in patients with asthma.

Adolescent↗

PubMed1991

Pulmonary health risks among northwest loggers.

Spirometry, respiratory symptom questionnaires, and chest radiographs were obtained from 688 loggers in Oregon and Washington. These were compared against previously published National Institute for Occupational Safety and Health studies of nonexposed blue-collar workers to determine if these predictions fit our population. The loggers forced expiratory volume in 1 second and forced vital capacity values were significantly greater than predicted, and their forced expiratory volume in 1 second/forced vital capacity values were less than predicted. The only consistent difference in symptoms between the sample and reference populations was for recent chest illnesses, which were more prevalent in the loggers than in the reference population. The chest radiographs showed a small excess of pleural thickening that we believe is most likely due to chest trauma. We conclude that the National Institute for Occupational Safety and Health studies spirometry prediction equations may not be generalized to other blue-collar populations.

Aged↗

PubMed1984

A longitudinal study of spirometry in young black and young white children.

Spirometry was performed longitudinally over a period of 8 yr on 72 children (29 black females, 26 black males, 9 white females, and 8 white males) starting as early as 3 yr of age. Weighted straight-line regressions of 6 maximal expiratory flow-volume parameters--forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), forced expiratory flow during the middle half of the FVC (FEF25-75), and maximal expiratory flows after 50 and 75% of the FVC had been exhaled (Vmax50 and Vmax75, respectively) - on height were computed and were found to describe adequately the data over a height range of 100 to 150 cm. Statistical comparisons of regression lines revealed significant differences for FVC and FEV1 when white females were compared with white males, white females with black females, and white males with black males, but not for black females with black males. Regressions of FEF25-75 and Vmax50 for black females were significantly lower than for white females, and those for white males were lower than those for white females, but no differences were detected when black females and white males were compared with black males. Only white females compared with black females revealed significant differences for Vmax75. There were no significant differences for any of the comparisons for PEF. The data presented expand the age range for evaluating lung function in children, indicate the feasibility of testing pre-school-age subjects, and provide new approaches to analysis of longitudinally collected information.

Anthropometry↗

PubMed1991

Comparison of outcomes of double and single lung transplantation for obstructive lung disease. The Toronto Lung Transplant Group.

Single lung transplantation has recently been applied with success in patients with obstructive lung disease. Such patients were previously managed by bilateral pulmonary transplantation. Between November 1986 and January 1990, 18 patients underwent transplantation for obstructive lung disease in our center. Eleven double lung transplants and seven single lung transplants were performed in patients having a mean age of 43.4 and 44.1 years, respectively. Operative death occurred in two of 11 double lung transplantations and one of seven single lung transplantations. Each patient underwent preoperative and 3-month postoperative pulmonary function tests, arterial blood gas analyses, nuclear lung scans, and 6-minute walk tests. There was no difference in the preoperative values for any of these parameters. Double lung recipients had significantly higher forced expiratory volume in 1 second and forced vital capacity than single lung recipients. However, the ratios of forced expiratory volume in 1 second to vital capacity were not different. Arterial oxygen and carbon dioxide tension were not different between the two procedures. Whereas double lung transplantations caused a slight preponderance of perfusion to the right lung, the transplanted lung in single lung recipients received a mean of 79.5% +/- 12.3% of predicted flow and only 61.6% +/- 5.0% of predicted ventilation. Three-month 6-minute walk distances were markedly improved in both groups, with double lung recipients achieving 573.0 +/- 44.7 m in comparison with the 528.0 +/- 43.0 m achieved by the single lung recipients. Single lung transplantation is a satisfactory option in patients with obstructive lung disease and might offer significant advantages to the older patient population, in which risk of double lung transplantation is high.

Adult↗

PubMed1989

Lung function in adolescents after uncomplicated whooping cough in childhood.

Ventilatory function (forced vital capacity, forced expiratory volume in one second, forced expiratory flows), static lung volumes, phase III slope and closing volume (single-breath nitrogen washout test) were measured in 499 children and adolescents aged 10-16 yrs from a general population sample in North-East France. A history of whooping cough was given by 44 children (22 of each sex); their results were compared to those of the 455 children (215 girls) with a negative history. The only difference between the two groups was a minimal increase in the residual volume/total lung capacity ratio in cases (19.2 +/- 3.1 vs 18.0 +/- 2.9%). We conclude that uncomplicated whooping cough in early childhood did not lead to significant pulmonary function abnormality in this population of children born after 1967.

Adolescent↗

PubMed1988

[Dynamic changes in the functional respiratory indices in chronic obstructive lung disease].

The basic functional respiratory indices were followed up in 50 patients suffering from various forms of chronic obstructive pulmonary disease before and after treatment. A decrease of the dynamic indices followed up was found: inspiration indices--FEV 1% (forced expiratory volume), FVC% (forced vital capacity), FEV 1/FVC%, FEV 1/VC%; flow indices--MEF 25% (maximal expiratory flow), MEF 50% MEF 75%, PEF% (peak expiratory flow), MEF/FVC%, MMEF 25-70% (maximal mean expiratory flow). A decrease of vital capacity and of diffusion capacity was also found. The ratio RV/TLC% (residual volume/total lung capacity) was increased and a general hyperventilation was established. Moderate hypoxemia and lowered saturation by normocapnia and normal pH were also established. The control examinations after treatment showed improvement of all indices followed up.

Blood Gas Analysis↗

PubMed2002

Gain and subsequent loss of lung function after lung volume reduction surgery in cases of severe emphysema with different morphologic patterns.

OBJECTIVE: Surgical lung volume reduction improves lung function and dyspnea in advanced emphysema to a variable degree. Because long-term results with this procedure are scant, we prospectively investigated lung function over several years after lung volume reduction surgery with regard to emphysema morphology. METHODS: Bilateral video-assisted thoracoscopic lung volume reduction surgery was performed in severely symptomatic patients with marked hyperinflation caused by advanced nonbullous emphysema. Emphysema heterogeneity was visually graded on chest computed tomography. Symptoms and lung function were assessed before the operation and 3, 6, and then every 6 months after the operation. RESULTS: A total of 115 patients with a median forced expiratory volume in 1 second of 0.73 L (27% of predicted value) underwent lung volume reduction surgery. Follow-up extended over a median of 37 months. Median forced expiratory volume in 1 second significantly increased within 6 months after the operation by 37% in homogeneous (n = 27), by 38% in intermediately heterogeneous (n = 37), and by 63% in markedly heterogeneous emphysema (n = 51, P <.05 vs. other morphologies). Maximal forced expiratory volume in 1 second was reached within 6 months after lung volume reduction surgery and decreased in the first postoperative year by 0.16 L per year in homogeneous, by 0.19 L per year in intermediately heterogenous, and by 0.32 L per year in markedly heterogeneous emphysema (P <.01 vs. other morphologies). The decline in forced expiratory volume in 1 second over subsequent years decelerated according to an exponential decay and was similar for all morphologic types (median annual decrease of 0.09 L [9%]). CONCLUSIONS: Lung volume reduction surgery improves lung function in severe homogeneous and, to an even greater extent, heterogeneous emphysema. Forced expiratory volume in 1 second peaks within 6 months postoperatively. The subsequent decline is most rapid in the first year and slows down in succeeding years according to an exponential decay. Therefore, long-term functional results of lung volume reduction surgery may be more favorable than expected from linear extrapolations of short-term observations.

Adult↗

PubMed1976

Household aggregation of pulmonary function and chronic bronchitis.

Persons from 148 randomly selected households in an urban community were screened in their homes using a modified British Medical Research Council respiratory disease questionnaire and a portable spirometer. Analysis showed a significant tendency for chronic bronchitis to aggregate within households. Significant aggregation was observed for 1-sec forced expiratory volume, when measured as the per cent of the predicted value or as a score calculated from the data. The 1-sec forced expiratory volume was significantly correlated between siblings, but less clearly so between spouses. Correlation of 1-sec forced expiratory volume between mother and child appeared to be confounded by maternal smoking habits, an effect most notable between mothers and male offspring. The 1-sec forced expiratory volume of fathers was significantly correlated with that of their children, especially female children, an effect that appeared to be independent of smoking habits.

Adolescent↗