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PubMed1985

Effects of mitral valve surgery on static lung function and exercise performance.

Lung function at rest was assessed in 50 patients before and six months after mitral valve surgery. There were small increases in spirometric volumes (FEV1 and vital capacity) with decreases in total lung capacity and residual volume, but no change in carbon monoxide transfer factor or transfer coefficient (KCO). Progressive exercise tests performed before and after operation in 19 of the patients confirmed an improved exercise capacity after surgery. The patients with the greatest symptomatic improvement in breathlessness were also those who achieved the greatest increase in maximum work load and the greatest decrease in ventilation for a given oxygen consumption. Depression of the ST segment of the electrocardiogram and frequent ventricular ectopic beats on exercise remained common after surgery and may have been due to digoxin treatment.

Adult↗

PubMedDate not supplied

A guide to lung function tests.

In patients with respiratory disease, measurement of lung function should be part of the assessment if possible. In the ward, clinic and lung function laboratory there are tests available to examine airflow, lung volume, gas transfer and exercise capacity. These provide information on lung function which may be vital for adequate diagnosis and assessment of the patient.

Blood Gas Analysis↗

PubMed1985

[Correlation of roentgen picture and lung function testing within the scope of silicosis evaluation].

The chest roentgenograms codified according to the 1980 ILO classification and the lung function tests of 100 persons with silicosis have been compared with each other. The results show that, with a higher degree of dissemination and a growing size of nodes, there is a statistically significant tendency to increasing gravity of pathological results of resistance and the arterial blood gas analysis. A correlation between the degree of dissemination and the size of nodes to other lung function parameters (vital capacity, intrathoracic gas volume) cannot be finally established. Furthermore, neither coding as category B nor the employment of the symbols em (emphysema) and tb (tuberculosis) allow conclusions to be drawn about the results of lung function tests. The poor correlation is caused on one hand by the insufficient description of the morphological parameters important for function, due to the restricted classification. On the other hand there is little correlation between chest roentgenogram and lung function, as lung function in anthracosis is essentially influenced by obstructive bronchitis, which has only a loose connection with silicosis.--Lung function must be the central point in the process of forming an opinion. Chest roentgenograms are important for clarifying the causes of pathological changes and allow a simple observation of progress.

Airway Resistance↗

PubMed1985

Impaired lung function in patients with IgA deficiency and low levels of IgG2 or IgG3.

We examined the relation between serum levels of IgG subclasses and lung function, as determined by spirometry, lung volumes, the single-breath nitrogen test, and static recoil pressures, in 29 patients with IgA deficiency and repeated upper or lower respiratory tract infections. Four of the patients had decreased levels of IgG2, and two had decreased levels of IgG3. Two or more lung-function values were abnormal in each of these six patients and also in three others with normal levels of IgG subclasses. Low levels of IgG2 and IgG3 were significantly related to abnormal lung function (P less than 0.01). The 20 patients with normal lung function all had IgG-subclass levels above the lower range. There may be a causal relation between low levels of IgG subclasses and deterioration in lung function, suggesting that patients with combined IgA and IgG-subclass deficiencies may benefit from immunoglobulin prophylaxis.

Adolescent↗

PubMed1992

Alterations in bronchoalveolar lavage fluid but not in lung function and bronchial responsiveness in swine confinement workers.

Testing of lung function and bronchial reactivity, bronchoalveolar lavage (BAL), and a skin prick test with a standard panel and six "swine" extracts obtained from swine and swine environment were performed in 20 randomly selected nonsmoking swine confinement workers. In addition, blood samples for detection of antibodies by the diffusion in gel-enzyme-linked immunosorbent assay (DIG-ELISA) technique and precipitating antibodies were drawn. Air samples for measurement of dust and endotoxin levels were collected. All the farmers regarded themselves as healthy. The results were compared with reference groups consisting of urban nonsmoking subjects who had not been exposed to pig farming environment. The pig farmers had normal lung function and the bronchial reactivity was not different from the reference group. In the BAL fluid of the farmers, the concentration of total cells and granulocytes was increased while the concentrations of lymphocytes and macrophages were normal. The BAL fluid concentrations of albumin, fibronectin, and hyaluronan were elevated in the farmers. Skin prick tests with swine extracts were negative in all farmers. Antibodies (assessed by DIG-ELISA) against swine dander, swine dust, and pig feed were increased and precipitating antibodies against swine dander were found in 14, against pig food in five, and against swine confinement dust in three of the 20 pig farmers. The concentration of airborne total dust was 7.4 mg/cu mm and the endotoxin concentration was 37 (22 to 60) ng/cu mm during tending the pigs and increased, during feeding, to 13.8 mg/cu mm and 315 (194 to 716) ng/cu mm, respectively. There was no correlation between exposure and lung function or lavage findings. In conclusion, randomly selected pig farmers had signs of airway inflammatory reaction and activation of the immune system without alteration in lung function and bronchial reactivity.

Adult↗

PubMed1975

Regional and total lung function studies in patients with hemidiaphragmatic paralysis.

Global and regional lung function were studied in 17 subjects with hemidiaphragmatic paralysis. Global lung function (VC, MVV, and FEV1) in the sitting postion was reduced by an average of about 25%. Regional lung function data in the same position showed a considerable decrease in perfusion (19%), ventilation (20%), and lung volume (7%) of the diseased side as compared to reference values obtained in healthy volunteers. Compared to the partition of function in the supine, the perfusion of the affected lung increased when it was lowermost in the lateral decubitus postion, while regional FRC decreased and ventilation changed little. When uppermost, perfusion and ventilation of the affected lung decreased while FRCr increased somewhat. The arterial oxygen tension was significantly below normal in the supine position but in the normal range in the sitting position. It increased further during exercise. Bronchography showed compression of the basal lung segments on the affected side in the erect, and kinking and obliteration of lower lobe bronchi in the supine position and still more when the lung was lowermost in the lateral decubitus position.

Activities of Daily Living↗

PubMed1986

Lung function in workers using cadmium containing solders.

The lung function of 57 male workers previously exposed to cadmium in connection with the use of cadmium containing solders was examined by spirometry (FVC, FEV1, FEV%, and MMF) and single breath nitrogen washout (CV, CV%, and phase III). A reference group (n = 31) from a nearby industry was examined at the same time. Despite the fact that the exposure in previous years had been relatively high, in the order of 0.05-0.5 mg Cd/m3, and that 24 (42%) of the workers had cadmium induced renal damage in the form of beta 2-microglobulinuria there was no evidence of pulmonary damage. There were no significant differences in lung function data from the exposed and reference group and there was no dose-response relation within the exposed group. It thus appears that signs of kidney toxicity in the form of low molecular weight proteinuria precede those that may be identified in the lung with commonly used lung function tests.

Cadmium↗

PubMed1989

Lung function and bronchial reactivity in aluminum potroom workers.

Lung function and bronchial reactivity were measured in 38 aluminum potroom workers with no airway symptoms and in 20 healthy referents (office workers). All of the participants were non-smokers. The magnitude of exposure to airborne dust (alumina) and fluorides was determined. The aluminum potroom workers had obstructive lung function impairment with a significant decrease in expiratory flow and an increase in residual volume. Diffusing capacity was found to be lower than in the referents. No bronchial hyperreactivity was found in the aluminum potroom workers. The exposure to inhaled alumina and particulate and gaseous fluorides in the plant was low, 15-20% of the Swedish exposure limits. The finding of only modest lung function alterations with no bronchial hyperreactivity in the aluminum potroom workers is not consistent with the results of other authors. This discrepancy can probably be explained by the fact that the exposure to inhaled contaminants in the investigated aluminum plant was low.

Adult↗

PubMed1991

Smoking and symptom effects on the curves of lung function growth and decline.

Numerous studies have examined the natural time course of human lung function growth and decline throughout life. In most of these studies the investigators used statistical models that required a priori assumptions concerning the underlying form or structure of the lung function data, thus introducing possible biases. In this study we used recently developed nonparametric regression (spline) techniques to describe the evolution of lung function measures with age. This procedure yields an optimally fitted smooth curve through the data and estimates of the process velocity and does not require assumptions concerning the underlying shape of the data curves. The lung function growth-velocity curves are used to estimate the age of growth cessation. This technique was applied to the FVC, FEV1, and the FEV1/FVC ratios of 1,295 females and 1,230 males who were tested in at least one of the first nine surveys of the Tucson epidemiologic study of airway obstructive diseases. Data were analyzed stratified according to gender, smoking status, and respiratory symptoms or diseases. The results indicate large differences between the fitted FEV1 and FEV1/FVC smoothed curves of the various subgroups compared with asymptomatic nonsmokers. These differences were most pronounced in the adult symptomatic smokers, who had higher rates of lung function loss that also began at earlier ages, for both sexes. No significant differences were observed between asymptomatic and symptomatic nonsmokers, most likely because of the reduced number of symptomatic nonsmokers, particularly among the males.

Body Height↗

PubMed1987

Algorithmic errors of lung function test analysis.

Nowadays lung function parameters will be determined by digital data processing algorithms. Minimal sampling frequency characterizing analogue-digital convertion is given by Shannon's law. Integration is a typical operation in data processing. The dynamical errors of generally used integration algorithms are much influenced by the sampling frequency. Theoretical examinations show unambiguously that using Simpson's rule the condition 6fsignal less than or equal to fsample has to be fulfilled to keep the amplitude error of integration lower than 1%. This means that sampling frequency will be determined by both the signal's spectrum and the structure of the data processing system.

Algorithms↗

PubMed1983

Factors affecting ventilatory lung function in young Navy selectees.

Ventilatory lung function was studied in 528 Navy selectees 16 to 23 yr of age. Analysis of the pulmonary function data indicated that height and chest circumference were the best "predictors" of forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). Other factors, such as amount of sports activity, ethnicity, weight, or Quetelet index, were of minimal predictive value. Linear prediction formulas of ventilatory lung function for young male adults of this age range were derived. Analysis of variance showed that the apparently greater FVC found in smokers than that found in nonsmokers was related to the smokers being older and consequently taller than the nonsmokers. After adjusting for age (even in this narrow age range) and height, no difference in pulmonary function between the 2 groups could be demonstrated.

Adolescent↗

PubMed1983

Comparison of lung function in young nonsmokers and smokers before and after initiation of the smoking habit. A prospective study.

It has been suggested that young persons who smoke have better lung function initially than those who remain nonsmokers. To examine this possibility prospectively, we analyzed respiratory questionnaire responses and lung function results in residents of Burbank and Lancaster, California, who had completed field screening studies of respiratory status at 2 times 5 yr apart. At Time 1 and Time 2, we calculated the age- and height-adjusted values for forced vital capacity (FVC) and forced expiratory volume in one second (FEV) of all white residents who at Time 1 were 13 to 23 yr of age and did not smoke tobacco. Dividing these into 2 groups, "starters" and "nonsmokers," we used analysis of covariance for males and females with height and age as covariates and compared lung function values at Times 1 and 2 and changes in lung function between these times. Among males at Time 1, FVC, FEV, peak expiratory flow, and maximal flow after exhalation of 25% of FVC were significantly larger for starters than for nonsmokers. At Time 2, values for these same indexes (except for FVC) were no longer significantly different between starters and nonsmokers. Our findings suggest that (1) relatively poor lung function may discourage young males (but not young females) from becoming regular tobacco smokers; (2) prediction equations based on so-called normal populations of nonsmokers might underestimate normal lung function, and (3) the adverse effect of smoking on lung function may be even greater than that estimated from cross-sectional studies.

Adolescent↗

PubMed1992

Lung function abnormalities in repaired oesophageal atresia and tracheo-oesophageal fistula.

BACKGROUND: Respiratory complications are common after neonatal repair of oesophageal atresia and tracheo-oesophageal fistula. The prevalence of lung function abnormalities and the relation between gastrointestinal complications and lung function has not been studied in a large number of patients. METHODS: Lung volumes and flow-volume loops were measured in 155 patients without spinal curvature aged 6-37 years who had undergone surgery for oesophageal atresia and tracheo-oesophageal fistula. RESULTS: Sixty four of the 155 patients had evidence of mild lower airways disease, with values for FEV1 more than two standardised scores below the predicted value in 39 (25%) and above 2 standardised scores for the residual volume (RV)/total lung capacity (TLC) ratio in 64 (41%). Restrictive lung disease (TLC more than 2 standardised scores below predicted) was present in 28 (18%). Severe lung function abnormalities were present in under 10% of the 155. Half the subjects had some evidence of extra-thoracic tracheal obstruction, with a high ratio of expiratory to inspiratory flow for peak flow in 76 (50%) and at 50% of vital capacity in 59 (38%). Patients with radiological gastro-oesophageal reflux in early childhood had more airways obstruction and smaller lung volumes. Patients with current gastrointestinal symptoms were similar in their lung function to symptom free patients. CONCLUSIONS: Minor lung function abnormalities are common in patients after repair of oesophageal atresia. Early diagnosis and management of gastro-oesophageal reflux may help to minimise these lung function abnormalities.

Adolescent↗

PubMed1988

Lung function in infants with cystic fibrosis.

Lung function was measured in 28 infants with cystic fibrosis and repeated in 17 of the infants during the first year of life. Thoracic gas volume (TGV) and specific airway conductance (sGaw) were measured plethysmographically and maximum forced expiratory flow at functional residual capacity (VmaxFRC) was derived from the partial expiratory flow-volume curve. At the time of the initial evaluation respiratory function was correlated with the clinical condition of the infants but not with age. There was a good correlation between sGaw and VmaxFRC when both were expressed as percentages of the predicted normal values. On the basis of the normal range for sGaw the infants were divided into two groups. Group A (n = 9), who had normal sGaw, were younger and had a lower clinical score and normal VmaxFRC and TGV values. Group B (n = 19), who had low sGaw, had increased TGV and decreased VmaxFRC. There was no correlation with age for any measure of lung function for the population as a whole. Repeat testing was undertaken at intervals in 17 representative infants. In most of these infants the relation between sGaw and VmaxFRC was maintained; there was no evidence that VmaxFRC was affected before sGaw. There was no functional evidence that the earliest changes in cystic fibrosis occur in small airways, as reflected by changes in VmaxFRC in infancy.

Airway Resistance↗

PubMed1976

Effect of modification of the smoking habit on lung function.

The effect of smoking cessation or modification on lung function was determined during a 48-week period. In a large number of the cigarette smokers, a disturbance of lung function was not revealed by conventional tests, such as the 1-sec forced expiratory volume; however, an abnormality was often demonstrable in tests that may reflect alterations in small airways, such as closing volume and Phase III of the single-breath expired N2 curve. There was no relation between the degree of abnormality of lung function and the presence of respiratory symptoms, but there appeared to be a relationship to lifetime smoking history, the heaviest smokers having the poorest function. Cessation, or more than 25 per cent decrease in the number of cigarettes smoked, was attened by improvement in the slope of Phase III of the N2 washout curve, closing volume, and closing capacity, as well as forced vital capacity, 1-sec forced expiratory volume, and peak flow. Resumption of smoking after cessation was attended by a deterioration in the slope of Phase III and closing capacity. The data suggest that the functional abnormalities in smokers are related to smoking and are at least partially reversible by cessation or significant modification of the smoking habit.

Adolescent↗

PubMed1991

Relationship of airborne endotoxin and bacteria levels in pig farms with the lung function and respiratory symptoms of farmers.

Previous studies have demonstrated a high prevalence of respiratory and other symptoms and a decrement in lung function among pig farm workers, although the relationships with specific agents present in the work environment remain obscure. This study was therefore undertaken to investigate the relationship between symptoms, lung function and airborne endotoxin, ammonia and dust levels in piggeries. Information on symptoms, lung function, endotoxin, ammonia and dust levels was available for 183 pig farmers who worked in 136 farms. For 62 farms information was present on the levels of bacteria and gram-negative bacteria. For these 62 farms, endotoxin exposure measurements were taken in more than one stable. In general, no significant correlations were found between lung function and chronic respiratory symptoms, or dust and ammonia levels. The endotoxin concentration in stables was negatively related to most lung function variables, but only for the subgroup of 62 farmers was a statistically significant relationship found between endoxtoxin exposure and FEV1. A borderline statistically significant and negative relationship was found between the endotoxin concentration and the FVC. Symptoms experienced during or shortly after work showed odds ratios larger than one with the levels of bacteria, gram-negative bacteria and endotoxin, indicating a positive relationship. No consistency in the relationship between symptoms and dust levels was found. The results suggest that endotoxins and (gram-negative) bacteria probably play an important role in the development of symptoms and lung function changes among pig farmers.

Adolescent↗

PubMed1995

Effect of a microaerosol barrier filter on the measurement of lung function.

STUDY OBJECTIVE: A disposable barrier filter (Pall Biomedical, United Kingdom) was developed to prevent the contamination of lung function equipment in clinical use. The aims of this study were to examine its resistance characteristics and to determine the effect of the filter on clinical measurements of lung function. MEASUREMENTS: Twenty-one randomly selected patients and four normal subjects had lung function measured with and without the filter between the mouth and measuring equipment. Measurements of ventilatory function were made with a pneumotachograph (Lilly; Hoechberg, Germany), total lung capacity and airway resistance by constant volume plethysmography, and diffusing capacity for carbon monoxide by the single breath method. Resistance was determined in five unused filters over the flow range 1 to 12 L/s and at a single flow rate (12 L/s) just after a normal subject expired 20 forced vital capacity (FVC) breaths through each of them. RESULTS: The resistance (mean +/- SD) of unused filters was 0.19 +/- 0.02 cm H2O/L/s at 1 L/s and increased linearly to 0.56 +/- 0.02 cm H2O/L/s at 12 L/s. There was no significant increase in resistance after use. The addition of the filter to the breathing circuit caused statistically significant decreases in forced expiratory volume in 1 s (FEV1) (0.044 +/- 0.08 L, p = 0.014) and peak expiratory flow rate (PEFR) (0.47 +/- 0.073 L/s, p = 0.004). The filter did not affect other indices of lung function. CONCLUSION: The filter caused a statistically significant reduction in FEV1 and PEFR; however, this difference was believed not to affect the clinical utility of routine lung function testing.

Adult↗

PubMed1982

Lung function in adults with mycoplasmal pneumonia.

We prospectively studied on lung function of 17 patients (7 men and 10 women) of acute Mycoplasma pneumoniae pneumonia. Lung function tests including %VC, FEV1.0%, Peak flow, V75/HT, V25/HT, V50/V25 and MMF were measured during the acute and convalescent stage. The results showed dysfunction of peripheral airway because of reduction in V50/HT, V25/HT and MMF. It was suggested that lung function in patients with Mycoplasma pneumoniae pneumonia was impaired at the high lung volume as well as low lung volume.

Adolescent↗