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PubMed1987

Lung function in relation to thoracic spinal mobility and kyphosis.

Mobility and kyphosis of the thoracic spine were correlated with lung function in 185 men and 87 women not suffering from respiratory disease. Curvatures of the spine were measured goniometrically with inclinometers and a compass, and lung function by spirometry. Vital capacity and forced expiratory volume in 1 sec had significant positive correlations only with forward and lateral flexion. The strongest correlations were with forward flexion (r = 0.16 to 0.24, p less than 0.05). The results and possible advantages of mobilizing the thoracic spine in pathological conditions of the lungs and the spine are discussed.

Adult↗

PubMed1993

[Early detection of chronic obstructive pulmonary disease by following individual annual changes in lung function].

The possibility of early detection of chronic obstructive pulmonary disease (COPD) was investigated among subjects whose lung function could be followed for more than ten years. Ten subjects aged 60 or more were selected from among about 1500 cases using the following diagnostic criteria; (1) subjects had complained of exertional dyspnea (2) chest X-ray abnormalities were suggestive of COPD (3) FEV1.0% was under 55%. Data on FVC/height, FEV1.0/height and FEV1.0% of these subjects were available for the previous ten years. Individual linear regression equations were estimated. Average annual changes of cases of obstruction were compared with those of normal cases, and individual deviations from the normal standard range were observed. Declines of the regression lines were as follows; FEV1.0/height: normal case--0.016 +/- 0.017, obstruction cases--0.038 +/- 0.018 (L/m/yr), FEV1.0%: normal cases 0.164 +/- 0.627, obstruction cases--1.522 +/- 0.638 (%/yr). Significant differences were observed between the normal and the obstruction cases (p < 0.01). FEV1.0% of all obstruction cases was under--2 SD of that of normal subjects. All individual FEV1.0% regression lines of the obstruction cases were outside +/- 2 RSD of the normal standard range more than 5 years before the onset of symptoms. Following individual annual changes in lung function was considered to be useful for the early detection of COPD.

Adult↗

PubMedDate not supplied

Association of ambient air quality with children's lung function in urban and rural Iran.

During the summer of 1994, a cross-sectional epidemiological study, in which the pulmonary function of children in Tehran was compared with pulmonary function in children in a rural town in Iran, was conducted. Four hundred children aged 5-11 y were studied. Daytime ambient nitrogen dioxide, sulfur dioxide, and particulate matter were measured with portable devices, which were placed in the children's neighborhoods on the days of study. Levels of these ambient substances were markedly higher in urban Tehran than in rural areas. Children's parents were questioned about home environmental exposures (including heating source and environmental tobacco smoke) and the children's respiratory symptoms. Pulmonary function was assessed, both by spirometry and peak expiratory flow meter. Forced expiratory volume in 1 s and forced vital capacity-as a percentage of predicted for age, sex and height-were significantly lower in urban children than in rural children. Both measurements evidenced significant reverse correlations with levels of sulfur dioxide, nitrogen dioxide, and particulate matter. Differences in spirometric lung function were not explained by nutritional status, as assessed by height and weight for age, or by home environmental exposures. Reported airway symptoms (i.e., cough, phlegm, and wheeze) were higher among rural children, whereas reported physician diagnosis of bronchitis and asthma were higher among urban children. The association between higher pollutant concentrations and reduced pulmonary function in this urban-rural comparison suggests that there is an effect of urban air pollution on short-term lung function and/or lung growth and development during the preadolescent years.

Air Pollutants↗

PubMed1991

Alterations in lung function due to mixtures of organic solvents used in floor laying.

To determine the short-term and long-term effects of organic solvents on the respiratory tract, 26 male floorlayers exposed to organic solvents were compared with 36 persons unexposed to such substances. The investigation primarily included a detailed history, determination of solvent concentration in the air inhaled by the workers, long-term ECG during the entire shift and lung-function test (vital capacity, forced expiratory volume in one second, flow volume curve) as well as non-specific bronchial inhalation challenge using a 3% acetylcholine aerosol before and after the shift. The floorlayers were primarily subjected to inhalative exposure to adhesives containing mixtures of toluene, petroleum hydrocarbons, ethyl acetate, methanol and acetone or one of these substances alone. This frequently resulted in short-term value limit excesses, especially in the MAK value (standardised threshold concentration in Germany) for toluene, which is a prime component of neoprene glue. Of the 26 floorlayers, 6 complained of breathlessness and coughing, whereas 13 suffered from nasal discharge and blockage--symptoms closely related to work. The smokers in this group showed a decline in lung function during the shift--especially in the forced expiratory volume in 1 s (FEV1)--as compared with the non-smokers in this group and the persons in the control group. This probably due to the combination of noxious substances. A strong correlation between occupational age and changes in lung function was observed: the occupationally youngest workers demonstrated the highest decrease in values during the course of the shift. There was no evidence of either obstructive or restrictive respiratory disorders or of marked deviation from the European Community for Coal and Steel (ECCS) references.(ABSTRACT TRUNCATED AT 250 WORDS)

Adhesives↗

PubMed1987

[Acute effect of prostigmin on lung function and breathing of patients with myasthenia gravis at rest and following ergometric exercise].

The acute effects of a single intravenous Prostigmin injection (0.5 mg) on lung function and gas exchange during rest and bicycle ergometry were measured in 26 patients with myasthenia gravis. The mean age of the patients was 44.6 +/- 17.6 years and the mean duration of myasthenia gravis 5.4 +/- 6.3 years. Lung function parameters obtained from 15 patients showed a normal total lung capacity with an increase in functional residual capacity and residual volume, while vital capacity was diminished. While the application of Prostigmin showed no acute effects on these lung volumes, there was a significant increase in airway resistance, even into the pathologic range. Data obtained during spiro-ergometry concerning gas exchange, circulation and muscle metabolism correspond to those expected from healthy individuals; application of Prostigmin did only influence the heart rate, which can be explained by parasympathomimetic activity. We conclude that dyspnoea in patients with myasthenia gravis need not necessarily be a symptom of the illness itself but can also be caused by therapy; in the latter case bronchodilatators are required.

Adult↗

PubMed1997

Weight gain and longitudinal changes in lung function in steel workers.

Associations among dust exposure, smoking habits, and demographic factors and longitudinal changes of lung function were assessed among male steel workers. Cohort descriptive data analysis was conducted in 541 steel workers who had performed spirometry at least twice between 1982 and 1991 (mean follow-up, 6.1 years). The annual change (slope) in FVC, FEV1, FEV1/FVC%, and in body weight was determined by simple linear regression. The Pearson correlation coefficient between weight change and spirometry changes was calculated. Comparisons were also done in 75 pairs of steel workers matched by age, height, initial FEV1, and smoking status, but whose FEV1 declines differed by > or = 60 mL/yr. The FEV1 and FVC declined an average of 44 and 50 mL/yr, respectively, for the cohort as a whole. The FEV1 and FVC declined 52 and 54 mL/yr for current smokers, 43 and 53 mL/yr for ex-smokers, and 36 and 43 mL/yr for nonsmokers, respectively. Increasing weight was highly correlated with accelerated decline in lung function (p<0.0001). In the matched pairs, mean slopes for FVC, FEV1, and FEV1/FVC ratio were -96 mL/yr, -95 mL/yr, and -0.40%/yr for the rapid decliners; and +5 mL/yr, +10 mL/yr, and +0.10%/yr for their partners (p<0.0001). Matched pair comparisons showed that the rapid decliners averaged a 4.313 kg weight gain, while their partners gained 1.044 kg during the follow-up period. The slope of weight gain was 0.708 kg/yr for rapid decliners and 0.191 kg/yr for comparison workers (p<0.0036). Weight gain, in addition to aging and cigarette smoking, was found to be associated with the longitudinal rate of decline in FVC, FEV1, and FEV1/FVC ratio.

Adult↗

PubMed1989

Lung function during anesthesia and respiratory insufficiency in the postoperative period: physiological and clinical implications.

This review covers the physiological and clinical implications of lung function during anesthesia and respiratory insufficiency in the postoperative period. We have divided it into 3 main sections: 1) lung function changes induced by anesthesia and surgery, in which the impact on pulmonary mechanics, ventilation/perfusion changes and gas exchange are examined; 2) physiological implications of postoperative respiratory function secondary to decreased alveolar ventilation, development of atelectasis, and interstitial lung edema; and 3) clinical implications of postoperative respiratory failure. In this last section we analyze the current therapeutic modalities available to reduce the incidence of postoperative respiratory failure, as well as related morbidity and mortality.

Anesthesia, General↗

PubMed2001

Occupation, chronic bronchitis, and lung function in young adults. An international study.

We studied the relationship between occupational exposures, chronic bronchitis, and lung function in a general population survey in 14 industrialized countries, including 13,253 men and women aged 20 to 44 yr. We studied associations between occupational group, occupational exposures, bronchitis symptoms (cough and phlegm production for at least 3 mo each year), FEV(1), and nonspecific bronchial responsiveness (NSBR) separately in lifetime nonsmokers, cigarette smokers, and ex-smokers. Occupational exposure to vapors, gas, dust, or fumes, estimated with a job exposure matrix (JEM), was associated with chronic bronchitis among current smokers only (prevalence ratio (PR): 1.2 to 1.7). The interaction of occupational exposure with smoking, however, was not statistically significant (p > 0.1). Self-reported exposure was related to chronic bronchitis in all smoking groups. An increased risk for chronic bronchitis was found in agricultural, textile, paper, wood, chemical, and food processing workers, being more pronounced in smokers. Lung function and NSBR were not clearly related to occupational exposures. Findings were similar for asthmatic and nonasthmatic subjects. In conclusion, occupational exposures contributed to the occurrence of chronic (industrial) bronchitis in young adults. Fixed airflow limitation was not evident, probably due to the relatively young age of this population.

Adult↗

PubMed1991

Acute effect of passive smoking on lung function and airway responsiveness in asthmatic children.

The effect of a 1-hour exposure at rest during passive cigarette smoking (20 ppm CO) or Sham was investigated in 11 children with bronchial asthma (age range, 8-13 yr; ten boys, one girl). Nine of the subjects were on regular therapy with inhaled beta 2-agonists and disodium cromoglycate. Both drugs were withheld at least 6 hours prior to each study session. Exposure was performed in an environmental chamber. Before and immediately after exposure, lung function and symptom scores were determined. After exposure, a histamine inhalation challenge was performed to determine the concentrations that caused a 100% increase in SRaw (PC100SRaw) and a 20% fall in FEV1, (PC20FEV1). Mean (SD) SRaw before and after Sham was 8.7 (3.6) and 9.0 (3.2) cmH2O.s, and mean FEV1 (SD) was 1.97 (0.32) and 1.98 (0.40) L, respectively. Before and after cigarette smoking, mean SRaw (SD) was 10.4 (5.3) and 9.4 (3.3) cmH2O.s, and mean FEV1 (SD) was 1.95 (0.37) and 1.94 (0.35 L, respectively. Geometric mean (SD) PC100 SRaw and PC20FEV1 after Sham was 1.39 (3.0) and 0.70 (2.7) mg/mL, and after passive smoking 1.65 (2.5) and 0.96 (2.3) mg/mL, respectively. There were no statistical differences in lung function and PC values between Sham and passive cigarette smoking. The main symptoms during passive smoking were irritation of the eye and the nasopharynx. Our observations suggest that in children with mild bronchial asthma 1 hour of passive cigarette smoking does not cause consistent changes of lung function and bronchial responsiveness.

Adolescent↗

PubMed2000

Atopy, lung function, and obstructive airways disease after prenatal exposure to famine.

BACKGROUND: Associations have been found between a large head size at birth and atopy, and between low birth weight and obstructive airways disease. A study was undertaken of people born around the time of the Dutch famine in 1944-5 to determine the effects of maternal malnutrition during specific periods of gestation on the prevalence of obstructive airways disease and atopy. METHODS: Nine hundred and twelve people aged about 50, born at term between November 1943 and February 1947 in Amsterdam, were asked about their medical history. Lung function was measured in 733 and serum concentrations of total IgE and specific IgE against mite, pollen and cat were measured in 726. Those exposed in late, mid, and early gestation (exposed participants) were compared with those born before or conceived after the famine (non-exposed participants). RESULTS: Exposure to famine during gestation affected neither the concentrations of total or specific IgE nor lung function values. The prevalence of obstructive airways disease was increased in people exposed to famine in mid gestation (odds ratio adjusted for sex 1.7, 95% confidence interval (CI) 1.1 to 2.6) and tended to be higher in those exposed in early gestation (odds ratio 1.5, 95% CI 0. 9 to 2.6). CONCLUSIONS: The observed increase in the prevalence of obstructive airways disease in people exposed to famine in mid and early gestation was not parallelled by effects on IgE concentrations or lung function. The link between exposure to famine in mid and early gestation and obstructive airways disease in adulthood suggests that fetal lungs can be permanently affected by nutritional challenges during periods of rapid growth.

Birth Weight↗

PubMed1993

Bronchoalveolar lavage cell analysis and lung function impairment in patients with systemic lupus erythematosus (SLE).

We examined the relationship between peripheral blood and bronchoalveolar lavage (BAL) lymphocyte phenotypes and lung function in 19 patients with SLE, and evaluated their association with disease activity. Lung function assessment showed a mildly restrictive pattern with frequent impairment of transfer factor for carbon monoxide (T1,co) and diffusing capacity of the alveolocapillary membrane (Dm), of late-expiratory airflow rates and with a high prevalence of increased airway resistance. T1,co, Kco and Dm correlated inversely with the numbers of CD8+ cells and CD56+/CD16+/CD3- (NK) cells in BAL. Oxygen radical production, both by stimulated and unstimulated BAL cells and blood polymorphonuclear leucocytes (PMN) was significantly increased in SLE. In comparison with healthy controls, patients with SLE had a lower percentage of CD19+ B cells in the BAL versus an increased percentage of these cells in peripheral blood. HLA-DR expression on CD4+ and CD8+ lung lymphocytes was markedly increased in SLE. Current SLE disease activity was not associated with changes in BAL or peripheral blood lymphocyte phenotypes. Our data suggest that an ongoing cell-mediated immune response is present in the lungs in SLE, particularly involving activated CD8+ T cells and CD56+/CD16+/CD3- NK cells. It is associated with up-regulated local production of oxygen radicals and with impaired pulmonary diffusing capacity. This inflammatory process seems to be independent of general SLE disease activity.

Adult↗

PubMed2002

Predictors of deterioration of lung function in cystic fibrosis.

The severity of lung disease in cystic fibrosis (CF) may be related to the type of mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, and to environmental and immunological factors. Since pulmonary disease is the main determinant of morbidity and mortality in CF, it is important to identify factors that can explain and predict this variation. The aim of this longitudinal study of the whole Swedish CF population over age 7 years was to correlate genetic and clinical data with the rate of decline in pulmonary function. The statistical analysis was performed using the mixed model regression method, supplemented with calculation of relative risks for severe lung disease in age cohorts.The severity of pulmonary disease was to some extent predicted by CFTR genotype. Furthermore, the present investigation is the first long-term study showing a significantly more rapid deterioration of lung function in patients with concomitant diabetes mellitus. Besides diabetes mellitus, pancreatic insufficiency and chronic Pseudomonas colonization were found to be negative predictors of pulmonary function. In contrast to several other reports, we found no significant differences in lung function between genders. Patients with pancreatic sufficiency have no or only a slight decline of lung function with age once treatment is started, but an early diagnosis in this group is desirable.

Adolescent↗

PubMed1986

The validity of different methods of analysis of 133Xe washout curves for the determination of lung function.

The influence of different mathematical methods on the analysis of 133Xe washout data, used in the assessment of lung function in the pig, were investigated. When the data were fitted using a bi-exponential or a bi-exponential plus a constant type equation, neither the two clearance rate constants nor the overall 50% clearance time were found totally appropriate for the study of lung function. A new two compartmental model for the in vivo clearance of 133Xe is proposed. The model assumes the whole blood as one compartment and the lung, including the pulmonary blood, as the second compartment. This suggests that the curvature of the xenon clearance curve is the result of recording the summation of the activities from the alveoli and the pulmonary blood and not, as previously described, due to the existence of two different sub-populations of alveoli.

Animals↗

PubMed1975

Xenon-133, 127Xe, and 125Xe for lung function investigations: a dosimetric comparison.

Of the possible radionuclides of xenon, 127Xe and 125 Xe have better physical properties for lung function measurement than 133Xe. A comparison of the radiation doses for these three radionuclides has been made for a typical scintillation camera investigation. Using an exponential model for washin and washout of gas, it is shown that the specific activity-time relationship is always equal to the product of the spirometer concentration and the rebreathing period. It is concluded that of the three radionuclides 127Xe gives the lowest radiation dose during a typical lung function study.

Adipose Tissue↗

PubMed1985

Airway reactivity and lung function in triiodothyronine-induced thyrotoxicosis.

To evaluate the possible relationship between asthma and hyperthyroidism, airway reactivity and lung function were prospectively compared in healthy volunteers before, during, and after liothyronine (triiodothyronine, T3)-induced hyperthyroidism. Base-line evaluation of the 10 subjects included clinical evaluation, thyroid and pulmonary function tests, and airway reactivity assessed by methacholine inhalational challenge (MIC). All studies were normal. During T3-induced hyperthyroidism, no subject developed respiratory symptoms or changes in pulmonary function or airway reactivity. The mean percent change in forced expiratory volume at 1 s from base line (delta FEV1) of -2.4 +/- 3.0 after MIC was not significantly different from that obtained before T3 administration (-1.4 +/- 1.5, P greater than 0.2). When all serum T3 concentrations and delta FEV1 values before, during and after T3-induced hyperthyroidism were compared, there was no significant correlation. We conclude that T3-induced hyperthyroidism of 3-wk duration has no effect on airway reactivity or lung function in normal volunteers.

Adult↗

PubMed1991

Bronchial provocation determined by breath sounds compared with lung function.

Bronchial provocation testing with methacholine was undertaken in 15 children aged 5 to 8 years with obstructive lung disease, mostly asthma (13/15). The methacholine was inhaled during two minutes of tidal breathing in increasing concentrations. After each inhalation, lung function was measured and clinical signs recorded independently by two observers unaware of each other's results. The logarithm of the concentration of methacholine which caused wheezing over the trachea correlated closely with the logarithm of the concentration of methacholine causing a 20% fall in the forced expiratory volume in one second (FEV1) but was 52% greater on average. At the end of the test there was a mean (SD) fall in FEV1 of 33.3 (7.4)% and a fall in oxygen saturation of 5.2 (3.1)%. Bronchial provocation testing by listening for wheeze over the trachea is a safe technique, which correlates with objective measures of lung function in young children.

Bronchi↗

PubMed1997

Serum angiotensin converting enzyme activity in pulmonary diseases: correlation with lung function parameters.

Serum angiotensin converting enzyme activity (ACE), plasma renin activity (PRA), blood pressure (BP), blood pH, blood gases and lung function parameters were measured in patients with emphysema, extrinsic and intrinsic asthma, malignant pulmonary neoplasms, active sarcoidosis and healthy adults. Serum ACE activity was significantly higher in sarcoidosis (250.22+/-34.18 U/L); in small cell carcinoma of lung (155.10+/-38.25 U/L); emphysema (149.82+/-18.31 U/L); extrinsic asthma (141.22+/-25.30 U/L) and lower in intrinsic asthma (98.12+/-15.11 U/L) and squamous cell carcinoma of lung (97.294+/-18.85 U/L) when compared with that of control subjects (108.20+/-13.15 U/L). PRA and BP values of the patients with sarcoidosis, emphysema and small cell carcinoma were markedly elevated and sACE activity was found to be correlated with PRA and mean BP in the same diagnostic groups. sACE activity, PRA and BP of smokers were higher than those of non-smokers in control subjects and in patients with emphysema, extrinsic asthma and small cell carcinoma of lung. Oxygen tensions of the patients with emphysema , extrinsic asthma and small cell carcinoma of lung were found to be significantly decreased. Negative correlations between the sACE activity and oxygen tension (r= -0.68) and between the sACE activity and lung function parameters (r= -0.69 ) were found in these diagnostic groups suggesting that increased sACE level might appeared as a response to chronic hypoxia in the patients with emphysema, extrinsic asthma and small cell carcinoma of lung.

Adult↗

PubMed1990

Carbon monoxide diffusing capacity, other indices of lung function, and respiratory symptoms in a general population sample.

To assess the relationships among single-breath diffusing capacity for CO (DLCOsb) (13), respiratory symptoms, and cigarette smoking in a general population sample, the data of 718 men and 894 women 20 yr of age or older were analyzed, and comparisons were performed with flow-volume curve (MEFV) variables and the slope of the alveolar plateau (DN2%/L) as well. Percent predicted DLCOsb and its correction for alveolar volume (DL/VA) were significantly lower in smokers than in nonsmokers. The relationship of presence/absence of respiratory symptoms and cigarette smoking with DLCOsb and DL/VA was significant. DLCO indices were almost always selected as discriminant variables in multivariate analysis between asymptomatic and symptomatic subjects. Poor concordance among lung function tests was evident: in men, 30% with abnormal (i.e., lower than 97.5% percentile) and 21% with normal DLCO indices also had abnormal MEFV parameters and/or DN2%/L. In women, the corresponding figures were 24 and 10%, respectively. In men, when considering only DLCO indices, the percentage of symptomatic subjects with abnormal lung function tests ranged from 33% in those with at least one symptom to 45% in those complaining of dyspnea. When the proportion of symptomatic subjects with DN2%/L and MEFV abnormalities were added, it increased to 56 and 66%, respectively. However, in women the proportion of symptomatic subjects with abnormal lung function indices was very small. These results indicate the usefulness of including CO diffusing capacity in epidemiologic surveys in the detection of abnormalities.

Adolescent↗