The value of routine spirometry was investigated in 631 unselected out-patients. The spirogram was abnormal in 17%, the ECG in 15% and the chest X-ray in 13% of patients. Pathological spirograms correlated mainly with mild or moderate obstructive ventilatory disturbances (80%) which were associated with clinical findings in only 74%. In the ECG, disturbances of repolarisation were more common (71%) than those of stimulation and conduction (29%) and were associated with clinical findings in 65%. In 91% of patients with pathological chest radiograms other investigations had indicated the necessity for an X-ray. Thus spirometry is, in addition to ECG and chest X-ray, a useful routine method. As disorders of the lung function are not always predictable by smoking habits, spirometry offers the possibility for early detection of symptom-free disease of the lung and respiratory tract.

Electrocardiography↗

PubMed1981

[Significance of measurement of the oscillatory resistance to respiration in children. (author's transl)].

The oscillatory resistance to respiration (Ros) was measured in 218 children and 260 adults using the Siregnost FD5 (Siemens, Erlangen), and compared with whole body plethysmography (Raw) and with spirometry. There was a markedly better correlation between Ros and Raw (r=0.82;n=88) in children than in adults (r=0.53;n=260). Whereas additional recording of the phase angle in children does not yield any substantial additional information, it is of diagnostic importance in adults. Comparison of Ros with the spirometric values yielded the following sequence of decreasing correlation coefficients (linear regression): FEV1.0, PEF, V 75, MMEF, V 50, V 25, whereas in adults these relationships cannot be described by means of a linear correlation. The results enable us to conclude that in paediatric pneumology an alternative use of whole-body plethysmography and of oscillatory method appears justified.

Adolescent↗

PubMed1981

Modulation of histamine-induced bronchoconstriction with inhaled, oral, and intravenous clemastine in normal and asthmatic subjects.

Although histamine plays an important role in the pathophysiology of asthma through stimulation of H1 receptors, H1 antagonists are of only limited use in this disease when given orally. In order to investigate the pharmacological response to a specific H1 antagonist administered by different routes, we measured the effect of inhaled clemastine on airway responsiveness to histamine aerosol and compared the results with those after oral and intravenous administration in normal and asthmatic subjects. Inhalation of 0.6 mg clemastine provided significant protection without side effects and was comparable to intravenous administration of 1.0 mg in both groups. In normal subjects 2.0 mg clemastine orally was significantly less effective than the two other routes of administration whereas in asthmatics an enhanced reaction to histamine was observed.

Administration, Oral↗

PubMed1981

Intrapulmonary gas transport of He and SF6 in healthy subjects and patients with chronic obstructive lung disease.

Intrapulmonary mixing of inert gases of different diffusivity, He and SF6, was studied in 5 healthy subjects before and after bronchoconstriction induced by acetylcholine and in 4 patients with chronic obstructive lung disease by analyzing alveolar plateaus, determined at various breath-holding times, tBH. The following results were obtained: (a) In healthy subjects in patients the slope of the alveolar plateau-e.e. the partial pressure difference between 750 and 1,250 ml of expirate-decreased for both gases with increasing 5BH.(b) In healthy subjects complete mixing within the alveolar space occurred faster for He than for SF6. In the patients the change of the alveolar slope was similar for both gases and no horizontal plateau was attained within the experimental range of tBH.(c) In healthy subjects after bronchoconstriction the behavior of the alveolar plateaus resembled that of the patients. However, the differences between He and SF6 were smaller. From these results we suggest that in healthy subjects efficient mixing of inspired gas with lung gas is brought about by diffusion and convection. After acetylcholine these mechanisms are less effective to overcome the inequalities produced by parallel inhomogeneities. In the patients there is a considerable decrease in overall mixing efficiency, probably due to large diffusional resistance within peripheral lung units, so that convection here is the main mechanism contributing to a flattening of the alveolar plateau.

Acetylcholine↗

PubMed1981

Measurement of respiratory mechanics with forced oscillations. Comparison of two methods (Siregnost FD 5 versus a pseudorandom noise technique).

Two methods for measuring respiratory mechanics by forced oscillations were compared, one using a frequency spectrum of 2-32 Hz produced by a pseudorandom noise generator (PRN), the other (Siregnost FD 5) a constant frequency of 10 Hz. In normals and patients with various lung diseases real part of impedance, Re, and phase angle, psi, determined at 10Hz with the two devices correlated well; however, Re measured by Siregnost FD 5 was always higher when compared to PRN. In patients with airway obstruction frequency dependence of resistance and reactance could be shown to be related to the severity of the disease. This important information cannot be obtained by Siregnost FD 5. As Siregnost FD 5 is a simple and reliable method, it is a valuable completion of standard lung function methods. However, for detailed analysis the respiratory system should be investigated at a variety of frequencies.

Airway Resistance↗

PubMed1980

[Long-term therapy of bronchial asthma with ketotifen. European experiences].

The results of clinical trials in patients with allergic bronchial asthma performed to demonstrate the therapeutic effect of the newly developed substance Ketotifen are reviewed: 1. In 154 patients the efficacy of ketotifen was superior to the antihistaminic clemastine. 2. The therapeutic value of ketotifen was similar to that of cromoglycate. 3. Ketotifen is a beneficial substance for long-term treatment of bronchial asthma. The main advantage of ketotifen is its prophylactic effect when given orally.

Administration, Oral↗

PubMed1980

Lung function studies in a patient with diffuse pulmonary fibroleiomyomas.

Diffuse pulmonary fibroleiomyomas were detected by open-lung biopsy in a 33-year-old male patient. Lung function studies revealed severe airflow obstruction, hyperinflation, grossly impaired single-breath-diffusing capacity and a decrease in PaO2 during exercise, i.e. data which are compatible with pulmonary emphysema. However, static lung compliance was within normal limits excluding the existence of pure emphysema. Additional special lung function tests confirmed the assumption that in diffuse fibroleiomyomas of the lung, functional patterns characteristic of obstructive and restrictive lung disease are present that are in agreement with the histological features of this disease.

Adult↗

PubMed1980

[The effect of aminophylline (Euphyllin) on the mechanics of breathing and the gaseous exchange in persons with bronchial asthma (author's transl)].

The physiological effect of intravenous application of aminophylline on the mechanics of breathing and the gaseous exchange in persons with bronchial asthma was studied in 7 out-patients before, during and up to 90 minutes after intravenous injection of 0,48 g of Euphillin, and the data were related to the respective serum levels of the drug. The patients suffered from long-standing bronchial asthma, generally associated with moderate airways obstruction. The bronchodilating effect of Euphyllin could be substantiated for the whole time of the trial solely in respect of the changes in oscillatory impedence; the other parameters showed only temporary changes which had disappeard by the end of the trial although the serum levels of aminophylline were in the therapeutic range (mean +/- SD: 12,5 +/- 3,0 microgram/ml). The data indicate that in some patients with bronchial asthma the effect of Euphyllin on lung function is unpredictable. The suggestion is made to measure the responsiveness of the patient to aminophylline by means of simple lung function tests in order to decide whether or not other bronchodilatory substances should be aded to the therapy.

Adult↗

PubMed1979

[Comparison of the oscillatory measurement of airway resistance with plethysmography and spirometry in juvenile patients].

In 78 children (age 4 to 17 years, height 102 to 179 cm) with and without clinical signs of airway obstruction, spirometric and plethysmographic measurements were compared with the forced oscillation method for determination of resistance to breathing (Ros). Ros was measured with a recently developed apparatus (Siregnost FD5. Siemens) and showed a close correlation with resistance (r = 0.84; n = 78). The spirometric values did not, however, exhibit a definite relationship to Ros. This study demonstrates that airway obstruction in children can be equally well estimated by oscillatory and plethysmographic techniques. Compared with plethysmography, determination of Ros has the particular advantage of being better tolerated by young subjects.

Adolescent↗