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[Chemotherapy-induced lung functional changes in patients with destructive pulmonary tuberculosis].

Lung function has been found to be altered in the overwhelming majority of patients with destructive pulmonary tuberculosis treated with drugs, only positive or only negative functional changes being relatively rarely observing. Combined positive and negative functional changes are much frequently revealed. The direction and magnitude of the revealed functional changes depend on the efficiency of tuberculosis treatment and on the specific features of a healing process. A thorough assessment of pulmonary functional changes can be made only on the basis of comprehensive studies of lung volumes, elasticity, and bronchial patency, by recording these parameters.

Antitubercular Agents↗

Pine dust, atopy and lung function: A cross-sectional study in sawmill workers.

An increased risk of asthma symptoms has previously been shown in 772 pine sawmill workers. The aim of the current study was to assess the association between dust exposure, lung function and atopy. Subjects with (n = 59) and without (n = 167) asthma symptoms were randomly selected from the previous survey. Lung function and atopy were determined using spirometry and skin-prick tests, respectively. Inhalable dust levels were measured on the same day. The geometric mean dust concentration was 0.52 mg x m(-3). Exposure to dry but not to green dust was associated with asthma symptoms. Green dust was associated with atopic sensitisation, particularly against outdoor allergens; no association was found for dry dust. Forced vital capacity, forced expiratory volume in one second and peak expiratory flow were significantly lower in workers exposed to high levels of green dust (-350 mL, -260 mL and -860 mL x s(-1), respectively) and dry dust (-230 mL, -190 mL and -850 mL x s(-1), respectively). These associations were observed both in subjects with and without asthma symptoms. No associations with cross-shift changes in lung function were found. Exposure to green pine sawdust may be a risk factor for atopy. Both green and dry dust were associated with obstructive as well as restrictive pulmonary effects.

Adult↗

An 11-year longitudinal study of the occupational dust exposure and lung function of polyvinyl chloride, cement and asbestos cement factory workers.

Standardized questionnaires and lung function tests were administered in 1973, 1980, and 1984 to 126 workers occupationally exposed to polyvinyl chloride (PVC) dust, to cement dust, or to asbestos cement dust until 1974-1978 and to PVC thereafter. The workers in the last group were assigned to two asbestos exposure categories (heavy and slight). The decline in forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1.0) was analyzed with regard to the length of time since the data of first employment. After adjustment for age, height, and smoking status at the date of first employment, the decline in FVC and FEV1.0 among the nonsmokers-light smokers was slightly accelerated with length of employment in the PVC and slight asbestos exposure groups and markedly accelerated with time since first employment in the heavy asbestos exposure group. The heavy smokers in all the exposure groups had FVC and FEV1.0 predicted values that were lower than those of the nonsmokers-light smokers; these differences remained constant with length of employment. Cessation of asbestos exposure for about 10 years did not seem to change lung function decline.

Adult↗

Combined effects of fetal beta agonist stimulation and glucocorticoids on lung function of preterm lambs.

We asked whether a single-dose fetal treatment strategy using betamethasone plus either a long-acting beta 2 agonist (formoterol) or betamethasone plus agents that elevate intracellular cyclic adenosine monophosphate (isobutyl methylxanthine and dibutyryl-cyclic adenosine monophosphate) would augment the effects of prenatal betamethasone on postnatal lung function. Preterm lambs were treated with 0.5 mg/kg beta-methasone or betamethasone plus the other agents and delivered 48 h after treatment. The postnatal lung function as assessed by compliance, ventilatory efficiency, and lung volumes at 40 min of age was improved by prenatal betamethasone and improved further by combination treatment, although the augmented responses were not significantly greater than with betamethasone alone. Fatty acid synthase protein and enzymatic activity were not increased by betamethasone or combined treatments, in contrast to responses reported for other animal models. There were no effects of glucocorticoids or the combined treatments on surfactant. Stimulation of the beta 2 agonist system did not augment postnatal lung function significantly above that noted for betamethasone alone with the agents, doses, and duration of exposures tested.

1-Methyl-3-isobutylxanthine↗

Effects of long term exposure to occupational noise on textile industry workers' lung function.

UNLABELLED: Vibroacoustic disease is a pathology caused by long occupational exposure to large pressure amplitude and low frequency noise. It is a systemic disease, with evolvement of respiratory structures. The exposure workers to this noise of textile industry may favour alterations in lung function. We studied 28 women working more than ten years in cotton-mill rooms to evaluate their lung function, including Spirometry, forced oscillation technique (I.O.S.) and Diffusion capacity. These results were compared with those of 30 women of similar ages not exposed to similar noise and not presenting respiratory disease. Statistical significance (P<0.05) was found with FEV25, R5 and Delta Rs5-Rs20. There was a resistance frequency dependence in 36% of the population exposed to noise, not statistically confirmed. Neither restriction nor changes in diffusing capacity where detected. CONCLUSION: The analysis of global alterations of lung function parameters suggests small airways aggression by noise. However we cannot definitively exclude the influence of cotton dust inhalation in itself which effects could be increased by the loss of ciliated cells and impairment of airways clearance caused by noise.

Female↗

Regional lung function in pleural effusion.

In 6 seated subjects with small unilateral pleural effusion without other radiographic abnormality, we measured regional lung function using xenon-133, comparing the function of the lung on the side with the effusion to the function on the contralateral side. When both lungs were equilibrated with Xe, count rates were lower at the base with the effusion, indicating either collapse or displacement of lung in these regions. Regional lung expansion was measured as fractions of regional total lung capacity: regional functional residual capacity/regional total lung capacity and regional residual volume/regional total lung capacity. The distribution of boluses inhaled slowly from residual volume was also measured, In all subjects the results were the same on the side with the effusion as on the other side. These findings were compatible with effective static pleural pressure being the same on both sides and suggest that the reduction in count rate at the base with effusion was due to displacement rather than compression of lung. We also measured regional washout half-times during dynamic breathing and found them prolonged in regions underlying effusion, indicating that dynamic ventilation of these areas was reduced. We postulated that the dynamic pressure swings applied to these regions were decreased by the effusions.

Adult↗

Partial relaxation of diaphragm and lung function parameters.

The present study investigates the effect of partial relaxation of diaphragm on the lung functions in the absence of active lung and neuromuscular disorders. Comprehensive functional tests of the breathing was performed on 22 subjects with partial relaxation of the diaphragm (elevated hemidiaphragm) found during an X-ray study on the occasion of gastrointestinal disorder. On the basis of the results of two group of patients, one with ventilatory disorders (n = 9-4 men and 5 women) and another with normal lung ventilation (n = 13-7 men and 6 women) the conclusion was drawn that in the absence of additional pathology the partial relaxation of the diaphragm does not causes any changes in the lung function parameters with the exception of the tendency towards low values of the parameters for the respiratory muscle strength (PImax and PEmax).

Blood Gas Analysis↗

Respiratory symptoms, lung function, and mortality in a screening center cohort.

Numerous studies have documented the effects of smoking and reduced pulmonary function on all-cause mortality. The effects of respiratory symptoms are less well studied. This paper examines the joint effects of respiratory symptoms, lung function, and smoking using 11-year mortality data on 698 subjects aged 25 years and older. Copies of death certificates were obtained for all 120 confirmed deaths, and cause of death was coded by a nosologist using the rules of the International Classification of Diseases, Ninth Revision. Symptoms of cough/phlegm, wheeze, and dyspnea were significantly associated with all-cause mortality in separate univariate analyses. On a cause-specific basis, these associations appeared to hold for chronic obstructive pulmonary disease, lung cancer, and vascular disease. Further analysis indicated that, for both smokers and nonsmokers, the presence of chronic cough and/or sputum production was related to mortality only in the presence of wheezing. In addition, among smokers, the presence of both cough/phlegm and wheeze. In addition, among smokers, the presence of both cough/phlegm and wheeze was significantly associated with mortality only among subjects with low initial lung function. Although the limited number of deaths and the nonrandom nature of the cohort limit the generalizability of our findings, it seems clear, based on these results and other published studies, that symptoms of cough, phlegm, and/or wheeze have important adverse health implications even in the absence of smoking and reduced lung function. More studies using common methodological approaches are needed.

Adult↗

Lung function in Malay children.

We conducted a study to measure the peak expiratory flow rate (PEFR), forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) in a group of normal Malay primary school children aged 7 to 12 years. PEFR was measured in 920 children (482 boys and 438 girls) while FVC and FEV1 were measured in 292 of them (168 boys and 124 girls). In agreement with previous studies, we found that PEFR was correlated with age and height of the subjects but FVC and FEV1 were correlated with height only. Prediction equations for all 3 lung function indices for Malay boys and girls were formulated. In comparison with the lung function values from Western and Chinese subjects, the lung function values in our subjects are lower.

Age Factors↗

Relationships between respiratory symptoms and FEV1 in men and women with normal lung function: The Korean Health and Genome Study.

Although the prevalence of chronic obstructive pulmonary disease (COPD) and its relationship with respiratory symptoms are well documented, few studies have focused on individuals with normal lung function, particularly in developed regions of Asia. The purpose of this report is to examine the relationship between respiratory symptoms and FEV1 in a population-based sample of Korean men and women with normal lung function. Subjects comprised 7518 individuals aged 40-69 years without airflow obstruction based on spirometric testing and in the absence of a medical history of pulmonary disease. Respiratory symptoms included chronic cough, chronic phlegm, wheezing, and shortness of breath. In men, the age-adjusted mean FEV1 was lower by 165 ml in smokers and 133 ml in nonsmokers in the presence versus the absence of wheezing (p < 0.05). While walking at a usual pace, FEV1 in smoking men was 210 ml lower in the presence versus the absence of shortness of breath (p < 0.05). Among nonsmoking men, overall shortness of breath and shortness of breath while walking uphill were associated with a lower FEV1 by 56 and 80 ml, respectively) versus those who reported having no shortness of breath (p < 0.05). Respiratory symptoms were unrelated to FEV1 in women smokers, although only 3.5% smoked cigarettes. In nonsmoking women, FEV1 was lower by an average of 89 ml in the presence versus the absence of wheezing (p < 0.001). Nonsmoking women also had a lower FEV1 in the presence of shortness of breath (overall, while at rest, and while walking uphill or at a usual pace, p < 0.001). Our findings suggest that respiratory symptoms are associated with a lower FEV1 in men and nonsmoking women with normal lung function. Whether respiratory symptoms can be used to identify individuals at risk for developing COPD needs further study.

Adult↗

Lung function in 6-20 month old infants born very preterm but without respiratory troubles.

Lung function results of 21 healthy infants born very prematurely are reported. The median gestational age was 29 weeks, but none had developed respiratory distress or required any form of respiratory support in the neonatal period. Lung function was assessed by measurements of thoracic gas volume (TGV) and airway resistance (Raw) plethysmographically, and of functional residual capacity (FRC) using a helium gas dilution technique. Two separate measurements were made between 6 and 20 months of age; all infants were measured once in the first and once in the second year of life. Regression equations were calculated for TGV, Raw, and FRC related to weight, height, and postnatal age. These data provide a new set of values for very preterm infants, in part small for gestational age, without neonatal respiratory trouble.

Age Factors↗

Are race and sex differences in lung function explained by frame size? The CARDIA Study.

Using the CARDIA cohort of 20- to 32-yr-old black and white men and women, FVC and FEV1 were standardized for standing height, sitting height, leg height, elbow breadth, and biacromial diameter in such a way that the standardized lung function showed minimal statistical dependence on these measures of frame size. Race and sex differences in lung function have been reported even after adjustment for height; however, these differences might depend on aspects of frame size other than height. We found that within this age group height2 provided robust standardization for FVC and FEV1 for all race and sex strata of the population. Height explained approximately 40% of the variance of FVC and FEV1 in whites, 30% in black women, and 20% in black men. In black men only, standardization for the combination of sitting height, leg height, elbow breadth, and biacromial diameter improved explained variance to nearly 40% for FVC and nearly 30% for FEV1. After standardization for height, FVC and FEV1 were found to be 14 to 19% higher in whites than in blacks, and in men than in women. Standardization of FVC and FEV1 for sitting height, leg height, elbow breadth, and biacromial diameter combined reduced these differences to 13-16%. Thus, race and sex differences in lung function exist even after detailed adjustment for frame size.

Adult↗

[Lung function and exercise tolerance after treatment with salmeterol or ipratropium bromide in chronic obstructive pulmonary disease].

The aim of this study was to compare the effects of 6 months therapy with salmeterol or ipratropium bromide on lung function (resting and dynamic parameters), exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). In open, randomised study patients at visit 1 were included into trial, at visit 2 and, after 6 months therapy, at visit 3 lung function measured by a pressure body plethysmography, exercise tolerance was investigated by 6 minute walking test and dyspnoea was analysed by the means of Borg scale. We studied 24 patients (18 males, 6 females, range age 45-76 yrs, mean: 60.2+/-10.46) with stable COPD. 13 subjects (mean FEV1 = 63.61% predicted, SD = 15.66%) received salmeterol (2 x 50 microg/day) and 11 subjects (mean FEV1 = 62.52% predicted, SD = 12.39%) received ipratropium bromide (4 x 40 microg/day). There were no significant changes in lung function parameters (FEV1, VC, Rtot, TLC, RV and RV%TLC) after 6 months therapy with both drugs, but the treatment with salmeterol significantly improves exercise tolerance in 6 minute walking test (p=0.048) and Borg dyspnea ratings (p=0.008).

Aged↗

Presence of cystic fibrosis-related diabetes mellitus is tightly linked to poor lung function in patients with cystic fibrosis: data from the European Epidemiologic Registry of Cystic Fibrosis.

Data derived from a cross-sectional analysis of 7,566 patients stratified into six age groups were used to compare lung function, body mass index (BMI), and weight for age in patients with and without cystic fibrosis-related diabetes mellitus (CFDM). The presence of CFDM was tightly linked to poor lung function, regardless of age. The mean value of FEV(1) % predicted in the age groups < 10, 10-< 15, 15-< 20, 20-< 25, 25-< 30, and 30 years or older were 87%, 77%, 69%, 58%, 55%, and 53% in the nondiabetic cystic fibrosis (CF) patients as compared to 79%, 66%, 55%, 49%, 46%, and 44% in the diabetic CF patients. BMI and weight for age were also lower in diabetic than nondiabetic CF patients in all age groups, except for BMI in the youngest patients. The difference in lung function and in nutritional parameters between diabetic and nondiabetic CF patients was not linked to presence or absence of any specific pathogen in the lower respiratory tract. These results confirm and extend those of earlier studies in smaller numbers of patients, and they clearly identify CFDM as a powerful determinant of severe lung disease and reduced survival in patients with CF and diabetes mellitus.

Adolescent↗

Plasminogen did not affect lung function in surfactant-treated preterm lambs.

Preterm infants with respiratory distress syndrome develop fibrin-rich hyaline membranes within the alveoli and have depressed fibrinolytic activity, which is thought to be due to a relative deficiency of plasminogen. Local fibrin deposition inhibits surfactant function and amplifies inflammation. We hypothesized that plasminogen administration to surfactant-treated preterm lambs would prevent fibrin-rich hyaline membrane formation, resulting in the amelioration of lung pathology and improved lung function. We randomly treated preterm lambs (gestational age 127-129 days) with either 16 mg of lysine-plasminogen (n = 10) or saline (n = 10), and ventilated them for 5 h. There were no significant differences in physiologic measurements of lung function (ventilation efficiency index, oxygenation index, dynamic compliance, quasi-static pressure volume curve), measures of lung injury (alveolar wash protein content and (125)I-albumin recovery) or surfactant pool size. The degree and extent of bronchiolar erosion and hyaline membrane formation were similar in the two groups. Plasminogen administration did not improve lung function or prevent hyaline membrane formation in surfactant-treated lambs.

Animals↗

Postnatal lung function in lambs after fetal hormone treatment. Effects of gestational age.

We previously found that a single dose of betamethasone in combination with thyroxine given by intramuscular injection to fetal sheep 48 h before preterm delivery at 128 d gestation improved postnatal lung function. We have now asked how the combination of 0.5 mg/kg betamethasone and 15 micrograms/kg T4 given by a single fetal intramuscular injection changes lung response 48 h after treatment at 121 and 135 d gestation. At 121 d gestation the fetal hormone treatment significantly improved postnatal lung function. Compliance increased by 55%, arterial PO2 increased from 39 to 215 mm Hg, PCO2 decreased from 109 to 79 mm Hg, and maximal lung volumes increased by 112%. The hormone treatment decreased the severity of the respiratory failure, although these very preterm lambs still had severe respiratory failure. At 135 d gestation, the fetal hormone treatment decreased the ventilatory pressure requirements that were needed to normalize PCO2 values from 30 to 21 cm H2O. Compliance increased by 40%, and maximal lung volumes increased by 33%. Alveolar or lung tissue, saturated phosphatidylcholine, or alveolar SP-A pool sizes did not change with hormone treatment at 135 d gestation. We conclude that fetal hormone treatment significantly improved postnatal lung function at both gestational ages, although the characteristics of the responses were different.

Animals↗

[Duration of preoxygenation in patients with normal and impaired lung function (author's transl)].

We determined the time required for the O2-filling of the lung, which is important for reasons of preoxygenation prior to intubation during apnoea and apnoeic oxygenation. 97 patients were examined. A multiple breath nitrogen washout method, the Hewlett-Packard lung function analyser HP 47402 A, was used. Complete O2-saturation of the lung in three different groups of patients took a mean time of 2 min 55 s, 4 min 20 s and 7 min 17 s. The differences were attributed to varying qualities of ventilatory gas distribution. Total O2-filling of the lung is necessary for apnoeic oxygenation. After breathing air, there is a mean decrease of PaO2 from 97 to 54 mm of mercury in 2 min of apnoea. For purposes of intubation, a 90% O2-filling of the lung takes not more than 1 and a half minutes even in patients with seriously impaired lung function. The gain of apnoeic tolerance time is approximately 4 min.

Adolescent↗

[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↗