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PubMed1976

Lung function among black and white children.

Racial differences in ventilatory lung function were evaluated in a community study of 393 children (158 blacks, 235 whites). Mean forced vital capacity was 18 per cent larger in nonsmoking white males than in nonsmoking black males, and 11 per cent larger in nonsmoking white females than in nonsmoking black females. Similar differences were observed for the 1-sec forced expiratory volume and for the maximal expiratory flow at 50 per cent of the vital capacity. However, when adjusted for lung size (on the basis of forced vital capacity), 1-sec forced expiratory volume and maximal expiratory flow at 50 per cent of the forced vital capacity were larger in the black children compared to the white children. Lung function prediction equations based on race, sex, age, height and weight are presented for healthy nonsmoking children; these allow for an evaluation of normal lung function in both black and white children.

Adolescent↗

PubMed1990

Respiratory failure and sleep in neuromuscular disease.

Sleep hypoxaemia in non-rapid eye movement (non-REM) and rapid eye movement (REM) sleep was examined in 20 patients with various neuromuscular disorders with reference to the relation between oxygen desaturation during sleep and daytime lung and respiratory muscle function. All the patients had all night sleep studies performed and maximum inspiratory and expiratory mouth pressures (PI and Pemax), lung volumes, single breath transfer coefficient for carbon monoxide (KCO), and daytime arterial oxygen (PaO2) and carbon dioxide tensions (PaCO2) determined. Vital capacity in the erect and supine posture was measured in 14 patients. Mean (SD) PI max at RV was low at 33 (19) cm H2O (32% predicted). Mean PE max at TLC was also low at 53 (24) cm H2O (28% predicted). Mean daytime PaO2 was 67 (16) mm Hg and PaCO2 52 (13) mm Hg (8.9 (2.1) and 6.9 (1.7) kPa). The mean lowest arterial oxygen saturation (SaO2) was 83% (12%) during non-REM and 60% (23%) during REM sleep. Detailed electromyographic evidence in one patient with poliomyelitis showed that SaO2% during non-REM sleep was maintained by accessory respiratory muscle activity. There was a direct relation between the lowest SaO2 value during REM sleep and vital capacity, daytime PaO2, PaCO2, and percentage fall in vital capacity from the erect to the supine position (an index of diaphragm weakness). The simple measurement of vital capacity in the erect and supine positions and arterial blood gas tensions when the patient is awake provide a useful initial guide to the degree of respiratory failure occurring during sleep in patients with neuromuscular disorders. A sleep study is required to assess the extent of sleep induced respiratory failure accurately.

Adult↗

PubMed2007

Organizing pneumonia and lymphoplasmacytic inflammation predict treatment response in idiopathic pulmonary fibrosis.

AIMS: To identify individual histopathological features within usual interstitial pneumonia pattern that predict responsiveness to immunosuppressive therapy. METHODS AND RESULTS: Fifty-six retrospectively confirmed usual interstitial pneumonia pattern surgical lung biopsy specimens from subjects with idiopathic pulmonary fibrosis treated with corticosteroid and cytotoxic therapy were included. Eleven prospectively defined histopathological features were evaluated by two expert pulmonary pathologists. Regression analysis identified predictors of response to therapy, as defined by the change in percent predicted forced vital capacity over 6 months. Additional end-points were change in dyspnoea score over 6 months, and survival time. Improvement in percent predicted forced vital capacity was associated with lymphoplasmacytic inflammation, while worsening of percent predicted forced vital capacity was associated with the presence of organizing pneumonia and fibroblast foci. Worsening dyspnoea was associated with fibroblast foci. Survival time was associated with age and baseline percent predicted forced vital capacity, but not with any individual histopathological feature. CONCLUSIONS: In pathological usual interstitial pneumonia pattern, the presence of lymphoplasmacytic inflammation predicts responsiveness to immunomodulatory therapy, while airspace organization predicts lack of response.

Humans↗

PubMed1976

Congenital lobar emphysema: long-term evaluation of surgically and conservatively treated children.

The clinical conditions, roentgenographic findings, and pulmonary function tests of 6 children (mean age, 10.9 years) with surgically treated congenital lobar emphysema (group 1) were compared with those of 5 children (mean age, 10.3 years) with congenital lobar emphysema who had been treated conservatively, i.e., nonsurgically (group 2). At the time of this study, patients in both groups were asymptomatic. Patients in group 1 were surgically treated because of severe respiratory distress in the newborn period, with the exception of one patient, who was eupneic as a newborn and was not operated on until the age of 9 years. Patients in group 2 were eupneic or mildly distressed in the neonatal period and received only conservative treatment. Two patients in group 1 had occasional wheezing and labored breathing, but no patient in group 2 had recurrent respiratory distress. Roentgenographically, at the time of the study, patients in group 1 had generalized overinflation, whereas those in group 2 had only localized overinflation of the involved lobe and minimal compression of remaining lung tissue. Pulmonary function studies in both groups were not significantly different (P greater than 0.05). Both groups had reduced forced vital capacities, large trapped gas volumes, and reduced forced expiratory flows at low lung volumes. Reductions in forced vital capacity were proportional to the unventilated volumes of lung either excised because of congenital lobar emphysema (group 1) or chronically obstructed by congenital lobar emphysema (group 2). These studies suggest that lung growth was not different in these 2 groups and that asymptomatic or midly symptomatic patients do not benefit from surgical treatment.

Adolescent↗

PubMed1981

Lung function after marathon running at warm and cold ambient temperatures.

using maximal expiratory flow-volume curves we studied the effects of endurance exercise on lung function in 46 and 41 runners before and after completion of a marathon race (42.2 km) at different ambient temperatures. There was a significant decrease (-3.9%; -5.9%) in the post-race forced vital capacity in runners at each marathon. The mean values for forced expiratory volume in one second did not change. Post-race peak flow at 50% of forced vital capacity were significantly decreased in runners participating in subfreezing conditions (-2 degrees C to -4 degrees C), but were unchanged when the ambient temperature was above freezing. These data demonstrated that healthy persons may develop bronchoconstriction during endurance exercise in subfreezing temperatures. The decrement in forced vital capacity noted in marathon runners competing at above freezing temperatures may be related to fuel metabolism and running performance.

Adolescent↗

PubMed2000

[Disseminated interstitial lung lesions in Lung Diseases Clinic patients].

The large number of diseases with interstitial lesions in the lungs needs numerous expensive and complicated examinations for differential diagnosis. These difficulties and increasing number of patients made us to look for possibilities to facilitate diagnosis. In 103 patients with diagnosed disease with disseminated lung lesions, the age and gender, vital capacity of the lungs, arterial blood gases pressure, the number of lymphocytes in peripheral blood were assessed. In sarcoidosis patients the subtypes of lymphocytes in peripheral blood and in bronchial washings were examined. It was established, that the number of interstitial lung lesions patients every year was greater. In observed group of patients the interstitial lesions in chronic pulmonary congestion, infections, neoplasms and sarcoidosis were seen. In chronic pulmonary congestion group there were older men with decreased number of lymphocytes, severe decrease of vital capacity, slight hypoxemia and normal pCO2. Disseminated lung lesions in the course of infections, mainly in 36 to 60 year old men with severe lymphopenia were observed. In these men vital capacity, blood gases pressure was normal. Mostly, the interstitial lung lesions in miliary tuberculosis and fungosis were developed. Neoplasmatic interstitial lung lesions existed in the course of lung cancer, rarer in other malignancies occurred. There were found in middle-aged men with severe lymphopenia, mild decrease of vital capacity, severe hypoxia and normal or decreased pCO2. Sarcoidosis in middle-aged persons was seen. There was not dependence on gender. In these patients the severe decrease of vital capacity, hypoxia and increased pCO2 frequently were observed. The number of lymphocytes in peripheral blood and in bronchial washing in most patients was normal. The same was observed according to subtypes of lymphocytes. The results of presented examinations are useful in evaluation of the clinical patient's state but their value in differential diagnosis of disseminated interstitial lung lesions is limited.

Adult↗

PubMed1991

Longitudinal study of lung function development in a cohort of Indian medical students: interaction of respiratory allergy and smoking.

This study was done to identify some factors that affect the growth and development of lung function during adolescence and early adulthood. Forced expiratory spirograms and peak expiratory flow rates were obtained in a cohort of normal young men (n = 63) over a period of 4 years, at intervals of approximately 2 years. Two factors that disturbed the normal pattern of lung function development in this group were smoking and respiratory allergy. Among the smokers and the allergics the decline in the forced expiratory volume expressed as a percentage of the forced vital capacity (FEV1%), the forced expiratory flow in the middle half of the forced vital capacity (FEF25-75%) and the FEF25-75% expressed as a ratio of the forced vital capacity (FEF/FVC) was more than double that among the normal subjects. The number of smokers and of allergics increased during the course of the study from 15 to 19 and from 16 to 23 respectively. There was a significant (P less than .01) interaction between smoking and the manifestation of respiratory allergy. Among nonsmokers, the number of allergic subjects increased from 12 to 13, while among smokers it increased from 4 to 10, during the four years.

Adolescent↗

PubMed1991

Lung function in adult idiopathic scoliosis: a 20 year follow up.

Severe idiopathic scoliosis may lead to respiratory failure, which can be treated by assisted ventilation. Twenty four patients with surgically untreated idiopathic scoliosis who had been examined in 1968 were re-examined in 1988 to assess changes in lung function and risk factors for respiratory failure. The patients were aged 15-67 years in 1968 and had a scoliotic angle of 10-190 degrees and a vital capacity of 1.0-6.0 litres. Spirometric values and scoliotic angles were determined in 1968 and 1988, and arterial blood gas tensions in 1988. The decline in spirometric values over the 20 years was of the same magnitude as the predicted decline due to aging. Arterial blood gas tensions in 1988 were strongly correlated with the scoliotic angles and spirometric indices recorded in 1968. Hypoxaemia and hypercapnia was seen in four patients in 1988 (then aged 43-67 years) and these were the four patients who had a vital capacity below 43% predicted in 1968. The remaining 20 patients had blood gas values within normal limits. Two further patients had died from respiratory failure before 1988, so a total of six patients had developed respiratory failure. In a multiple logistic analysis vital capacity expressed as % predicted in 1968 was the strongest predictor of the development of respiratory failure, followed by the scoliotic angle. Respiratory failure occurred only in patients who had a vital capacity below 45% predicted in 1968 and an angle greater than 110 degrees. Thus respiratory failure develops in adults with scoliosis with a large angle and a low vital capacity when normal aging reduces the ventilatory capacity further. Such individuals merit close follow up.

Adolescent↗

PubMed1976

The response of asthmatic subjects to isoproterenol inhaled at differing lung volumes.

Asthmatics are usually instructed to use pressurized bronchodilator aerosols by delivering a bolus of drug at the beginning of a full inspiration. Because airways are better dilated near total lung capacity, the delivery of the drug near the end of a full breath might allow better penetration of particles into the lung and greater bronchodilatation. To test this hypothesis, 13 asthmatic subjects inhaled 400 mug of isoproterenol at 20 per cent (low) and at 80 per cent (high) vital capacity. The studies were done on 2 separate days when the severity of asthma was the same. Forced vital capacity, 1-sec forced expiratory volume, specific airway conductance and maximal flow at 50 per cent of viral capacity were measured at frequent intervals after drug administration. Ten min after drug delivery, there was a significantly greater (P less than 0.05) improvement in 1-sec forced expiratory volume after the drug was inhaled at the high lung volume compared to the response after delivery at the low lung volume. The differences in forced vital capacity, specific conductance, and maximal flow at 50 per cent of vital capacity were not significant. We concluded that inhaling a bronchodilator drug at the end of a full inspiration causes relatively greater bronchodilatation than inhaling the same dose at the beginning of inspiration.

Adolescent↗

PubMed1990

Relation between chest expansion, pulmonary function, and exercise tolerance in patients with ankylosing spondylitis.

Thirty three patients with definite ankylosing spondylitis (AS) were examined to establish the relation between restriction of chest expansion, limitation of lung function, and working capacity or exercise tolerance. As in previous studies there was a significant association between chest expansion and lung vital capacity. There was also a significant association between vital capacity and exercise tolerance as measured by a subject's maximum oxygen capacity (VO2max). Both vital capacity and VO2max were expressed as a percentage of predicted normal values using patients' height before disease. In this study chest expansion did not have a significant effect on exercise tolerance. The results suggested that patients who took a modest amount of exercise regularly could maintain a satisfactory work capacity despite very restricted spinal and chest wall mobility. It is recommended that greater emphasis should be given to encouraging patients with AS to maintain cardiorespiratory fitness as well as spinal mobility.

Adult↗

PubMed1998

Expiratory CT scans for chronic airway disease: correlation with pulmonary function test results.

OBJECTIVE: The purpose of our study was to correlate findings on expiratory CT scans with results of pulmonary function tests (PFTs) and to determine whether these techniques may be complementary in assessing airway obstruction. MATERIALS AND METHODS: Seventy-four patients with suspected chronic airway disease and 10 healthy nonsmokers underwent inspiratory and expiratory CT scans and PFTs. An air trapping score, corresponding to the ratio of the cross-sectional air trapping area versus the total cross-sectional lung area on expiratory CT, and a reduction score, representing the change in cross-sectional lung area at inspiration and expiration, were calculated using a quantitative grid. The two scores were then correlated with the results of the PFTs. RESULTS: Expiratory air trapping was seen in 18 (51%) of 35 patients with severe airway obstruction (forced expiratory volume in 1 sec [FEV1]:vital capacity < 80%) (group A), in 21 (72%) of 29 patients with predominantly small airways obstruction (abnormal flow-volume curve and FEV1:vital capacity > or = 80%) (group B1), and in four (40%) of 10 patients with normal PFT results (group B2). Expiratory air trapping was never seen in the 10 healthy subjects. Air trapping scores were 27%, 12%, and 8% for groups A, B1, and B2, respectively, with significant negative correlations with FEV1 (r = -.45), FEV1:vital capacity (r = -.31), and forced expiratory flow at 25% of vital capacity (r = -.57). Reduction scores were 18%, 30%, 35%, and 43%, for the groups A, B1, B2, and the healthy group, respectively, with significant correlations with all the PFT indexes (r = .35 to .66) except total lung capacity. CONCLUSION: Air trapping may permit detection of airway obstruction in patients with clinically suspected chronic airway disease even when PFTs are normal. Furthermore, expiratory CT allows one to calculate a reduction score for a cross-sectional lung area that appears to be better correlated with the degree of airway obstruction measured on PFTs.

Adult↗

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↗

PubMed1979

[Examinations of the pulmonary function of untrained and physically trained old men (author's transl)].

In tests there were determined the vital capacity and absolute and relative seconds capacity of 180 physical-trained sportsmen aged 55 to 89 and of 175 untrained, but clinically healthy test persons. The results of the different age-intervals are compared statistically. It was noticed, that vital capacity and absolute seconds-capacity of both groups decrease statistically significant with the age. Vital capacity and seconds capacity are in all age-intervals on a higher level with the trained sportsmen than the control group. The relative seconds-capacity showed no significant difference between the two groups. There is a clear statistic connexion between the vital capacity and the time obtained in a 5 000 meters run. One can suppose that in contrast to juvenile sportsmen a good pulmonary function is a contributory determinant of the performance of old sportsmen.

Age Factors↗

PubMed1994

Effects of deep breaths on subsequent ventilation in man during rest and exercise.

1. We examined the effects of twenty-four to thirty inspiratory capacity (IC), expiratory capacity (EC) and vital capacity (VC) breaths on subsequent breathing pattern in five normal subjects at rest. 2. During IC breaths and following EC and VC breaths at rest, end-tidal CO2 pressure (PET,CO2) fell by 7.5, 8.5 and 9.5 mmHg, respectively. In the group analysis significant inhibition of ventilation of 1.5 l min-1 was seen after the IC breath but not after EC or VC breaths. 3. We repeated the study with five normal subjects under conditions of higher ventilatory drive, namely 50 W exercise (one subject was common to both groups). 4. During exercise, the drop in PET,CO2 was smaller (4.0, 3.5 and 4.0 mmHg, respectively, with IC, EC and VC breaths) but ventilation was inhibited to a greater extent. Ventilatory undershoot was seen after all three types of deep breaths. 5. We propose that the expiration to residual volume in EC and VC breaths abolished the hypocapnic inhibition of ventilation at rest, possibly by a deflation reflex which was not sufficiently powerful to overcome the ventilatory undershoot during exercise. Our results also support the view that the slope of the CO2 response curve is steeper near the control point during exercise.

Adult↗

PubMed1977

Intrasubject variability of maximal expiratory flow volume curve.

Analysis of airflow in the terminal portion of the maximal expiratory flow volume curve has been suggested as a useful test for the early diagnosis of chronic airways obstruction. Whether such an analysis can identify early disease, and whether any subsequent action can prevent the progress of chronic airways obstruction, is unknown and will require prospective studies. As a precursor of such a study we have tried to establish the intrasubject variability of those tests of forced expiration which may be used for screening. We therefore measured expiratory flow volume curves of five healthy males and five healthy females aged 20-30 years as this is an age-group in which early detection of airways obstruction may be of value. Flow volume curves were obtained on the same day of the week for six weeks, and on three separate days during this period we carried out three flow volume curves every hour from 9 am to 6 pm. The data were subjected to analysis of variance to determine the variability of each measurement. Data were collected from forced expired volume in one second (FEV1) forced vital capacity (FVC), maximum expiratory flow rates at 50% and 75% of expired vital capacity, and forced expiratory time (FET). The results showed no consistent pattern of diurnal variation over the working day. The variation in any subject for FEV1 and FVC over the study period was considerably less than variations detected in the maximal expiratory flow rates at 50% and 75% of the expired vital capacity and FET. Our results suggest that the intrasubject variation found in flow rates of the terminal portion of the maximal expiratory flow volume curve and forced expiratory time may limit the usefulness of these tests in detecting early airways obstruction. FEV1 and FVC are more reproducible tests and are therefore particularly suited for cross-sectional screening. The more sensitive maximal expiratory flow volume curve may, however, be more useful for long-term studies in individuals when the onset of disease is sought, or for short-term challenge studies requiring the most sensitive index of change in airway characteristics.

Adult↗

PubMedDate not supplied

Effects of air pollution on children's pulmonary function in urban and suburban areas of Wuhan, People's Republic of China.

In May and June of 1988, the spirometric lung function of 604 children, who were aged 7-13 y and who were free of chronic respiratory conditions, was measured in the urban core and a suburb of Wuhan, China. During 1981-1988, ambient total suspended particulate (TSP) levels averaged 481 micrograms/m3 in the urban core and 167 micrograms/m3 in the suburb. In 1988, TSP levels, measured within 500 m of the children's homes, averaged 251 micrograms/m3 in the urban core and 110 micrograms/m3 in the suburb. Levels of sulfur dioxide and nitrogen oxides were also higher in the urban core. Proportions of families who burned coal and gas domestically were similar in both areas. In linear and logarithmic regression models, height was a stronger determinant of forced vital capacity and forced expiratory volume in 1 s than was age or weight. In linear models, the proportion of variance explained by height (R-squared) ranged from 0.54 for urban females' forced expiratory volume in 1 s to 0.77 for suburban males and females. Both forced vital capacity and forced expiratory volume in 1 s were consistently lower in urban than suburban children. The average forced vital capacity and forced expiratory volume in 1 s in children 132-144 cm tall were 6.7% and 3.8% lower, respectively, in the urban core than the suburb; suburban-urban differences increased with height. Suburban-urban differences in slopes of lung function growth curves were statistically significant for forced vital capacity but not for forced expiratory volume in 1 s. Rates of clinical upper respiratory irritation were also generally elevated in urban children. These results strongly suggest that urban ambient air pollution exposure in China contributes to retardation in the growth of children's lung function. Confirmatory longitudinal studies are in progress in Wuhan and three other Chinese cities.

Adolescent↗

PubMed1985

Preoperative and postoperative pulmonary function tests in patients with atrial septal defect and their relation to pulmonary artery pressure and pulmonary:systemic flow ratio.

Pulmonary diffusing properties and lung volumes were investigated in 44 patients with atrial septal defect, and in 30 of them preoperative and postoperative data were obtained. The patients were divided into three groups according to mean pulmonary artery pressure: less than or equal to 15 mm Hg (group 1), 16-29 mm Hg (group 2), and greater than or equal to 30 mm Hg (group 3). Patients in groups 1 and 2 had a high carbon monoxide transfer test which became normal after surgical correction of their septal defect. In group 3, the carbon monoxide transfer test was normal both before and after operation. As mean pulmonary artery pressure increased there was a progressive reduction in both forced expiratory volume in one second and vital capacity. Patients in group 3 had a low forced expiratory volume in one second, a low vital capacity, and a reduced forced expiratory volume in one second:vital capacity ratio. These abnormalities were not corrected by surgical closure of the septal defect. Formulas were derived from the lung function data, to predict the mean pulmonary artery pressure and the pulmonary:systemic flow ratio. The values predicted when these two formulas were applied to data obtained for patients in this study correlated well with measured values.

Adolescent↗

PubMed1979

An epidemiologic study of a group of talc workers.

Chest roentgenograms, pulmonary function assessment by spirometry, respiratory symptoms, smoking history, and occupational history by questionnaire were obtained from 121 male talc miners and millers exposed to talc containing tremolite and anthophyllite asbestiform fibers. Ninety-three of the employees had worked in talc only at the plant under study. Symptoms were only slightly more prevalent in talc workers when compared to potash miners. Mean pulmonary function (forced expiratory volume in one sec, forced vital capacity, and maximal expiratory flow at 50 and 75 per cent of vital capacity) of talc workers was significantly decreased in comparison to that of potash miners. The prevalence of pleural calcification and pneumoconiosis in talc workers with 15 or more years of employment was higher than in potash miners. The prevalence of pleural thickening was 31 per cent in those who worked more than 15 years and was significantly increased as compared to that in potash miners. Workers with pleural thickening had decreased pulmonary function in comparison to those who did not. Decreased one-sec forced expiratory volume and forced vital capacity were associated with exposure to respirable particulate and asbestiform fibers.

Adult↗