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Biomedical subjects

W K Morgan

Publications and source records attributed to W K Morgan.

At least 73 records · Page 4Linked to original sources

Differentiation of parenchymal lung disorders with in vitro proton nuclear magnetic resonance.

We investigated in vitro NMR properties of bleomycin-induced alveolitis and pulmonary fibrosis in 18 Lewis rats (6 controls). When alveolitis or fibrosis had developed, animal lungs were excised and examined histologically and gravimetrically and their T1 and T2 were determined by a NMR spectrometer at 10.7 MHz and 37 degrees C. Clinical diagnosis was confirmed histologically in each case. The NMR signal intensities were significantly elevated in both disease states (P less than 0.001). Both T1 and T2 values of alveolitic lungs were about the same as in controls, but were significantly decreased in fibrotic lungs (P less than 0.01). Changes in T1 and T2 correlated well (P less than 0.001) with changes in water content of diseased lungs.

Animals↗

The respiratory effects of particles, vapours, and fumes.

In conclusion it should be possible, when the physical and chemical characteristics of a particular agent are known, to predict its effect on the lungs and its site of action. The same knowledge can be used as a means whereby the effects of that particular hazard can be either limited or controlled completely.

Air Pollution↗

Radioaerosol ventilation imaging in ventilator-dependent patients. Technical considerations.

The differentiation of pulmonary embolism (PE) from regional ventilatory abnormalities accompanied by reduced perfusion requires contemporary perfusion and ventilation studies. Distinguishing these conditions in ventilator-dependent patients is aided by administering a Tc-99m aerosol to characterize regional ventilation, and by performing a conventional Tc-99m MAA perfusion study. The technique uses a simple "in-house" constructed apparatus. Simple photographic techniques suffice, but computer subtraction of perfusion from the combined perfusion-ventilation image renders interpretation easier if aerosol administration follows perfusion imaging. Multiple defects can be examined in a single study. Excluding normal or near-normal perfusion studies, PE was thought to be present in eight of 16 patients after perfusion imaging alone, but in only one of eight after added aerosol imaging. Angiography confirmed the diagnosis in that patient. Of the eight patients who had abnormal perfusion but were thought unlikely to have PE from the perfusion study alone, two had normal ventilation, and subsequently were shown to have PE by angiography. Because angiography was only performed on patients who were thought to have a high probability of PE on sequential perfusion-ventilation imaging, the true incidence of PE may have been higher. Aerosol ventilation imaging is a useful adjunct to perfusion imaging in patients on ventilators. It requires an efficient delivery system, particularly if aerosol administration follows perfusion imaging, as it does in this study. The major disadvantage of aerosol imaging compared to a gas in intubated patients is the significant bronchial deposition due to retained mucus secretions.(ABSTRACT TRUNCATED AT 250 WORDS)

Aerosols↗

Aminophylline and mucociliary clearance in patients with irreversible airflow limitation.

Were aminophylline to improve mucociliary function, it might prove useful in the management of irreversible airflow limitation. Eight subjects with irreversible airflow limitation due to emphysema inhaled an aerosol of 99mTc sulphur-colloid particles on each of 2 days. On day 1 aminophylline was administered intravenously, while on the other nothing was given. Particle clearance was measured by recording posterior gamma-camera images sequentially over a 24 h period. No significant differences were recorded between aminophylline and control studies, but there were marked variations in clearance between study days and between individuals. These differences were compatible with the known effects of airways obstruction and breathing pattern on the sites of particle deposition within the bronchial tree. The latter factors appeared to exert a far greater influence on the observed mucociliary clearance than did aminophylline.

Aminophylline↗

Regional deposition of particles in the lung during cigarette smoking in humans.

Studies were carried out on 11 habitual cigarette smokers to ascertain whether there was a difference in the regional deposition of particles during cigarette smoking compared with tidal breathing and also to investigate whether the ventilatory maneuvers associated with smoking influence the deposition site. A cigarette holder was constructed that permitted cigarette smoke to mix with a radioaerosol. An added resistance simulated the airflow resistance present in a filter-tipped cigarette. Respiratory patterns for the control period of tidal breathing and during smoking were monitored with a respiratory inductance plethysmograph. Smoking resulted in greater apical and central deposition than expected from the distribution of resting ventilation. The changes in the site of deposition during smoking are probably influenced mainly by the properties of the particles concerned, namely, its size, reactivity, and hygroscopicity. Changes in respiratory patterns that occur during inhalation of cigarette smoke may also have an effect but are difficult to quantify and show marked intersubject variation. In selected subjects smoking caused apical deposition to exceed that of the lower zones.

Adult↗

Computerized tomography in the diagnosis of lymphangioleiomyomatosis.

We describe a subject with lymphangioleiomyomatosis who presented with chylothorax but who had an otherwise normal chest radiograph. The diagnosis was established by means of whole-body computerized tomographic scanning, which demonstrated asymptomatic involvement of the lungs, lymphatics, and kidneys. This diagnostic modality offers the potential for noninvasive serial monitoring of this rare condition, and in doing so provides an opportunity to obtain a better understanding of the disease process.

Adult↗

A 10-year follow-up study of a group of workers exposed to isocyanates.

The ventilatory capacity of 68 workers who were exposed to isocyanates was determined. Forty-two of the workers had been studied in 1971. The overall ventilatory capacity of the subjects fell within the predicted range except that two subjects, both of whom were smokers, had minimal obstruction. No significant shift decrement was noted in any of the subjects. There was no evidence to suggest that an excess decrement in ventilatory capacity occurred during the period of observation; however, exposure to isocyanates had been well within the then-extant time-weighted average.

Adult↗

The effect of exercise on the deposition of an inhaled aerosol.

We investigated the regional deposition in the lungs, of an inhaled submicron aerosol at rest and during exercise in 13 normal volunteers of whom 5 were cigarette smokers. The degree of exercise (VO2 approximately 2 L/min) was chosen to simulate moderately heavy physical labour. Tracheobronchial and alveolar components of deposition were measured by comparing images immediately after inhalation of aerosol and 24 h later when mucociliary clearance was complete. At rest almost all deposition was alveolar (97%). The increase in total deposition on exercise was of similar order to the increase in ventilation. On exercise regional alveolar deposition became more even, although basal still exceeded apical deposition. Tracheobronchial deposition on exercise was increased in all zones but particularly in the upper zones, thereby contrasting with the base to apex gradient of parenchymal deposition. These changes were exaggerated in the smokers. The increased upper zone tracheobronchial deposition may have implications in regard to the pathogenesis of diseases caused by the inhalation of dusts and fumes.

Adult↗

Kaolin dust concentrations and pneumoconiosis at a kaolin mine.

Kaolin is removed from underground seams in the mining area to a processing area, where it is sliced, dried, and pulverised to make the finished product. A study was undertaken to determine the dust concentrations in various work areas and to assess the prevalence of radiographic and pulmonary function abnormalities in 65 workers at a Georgia kaolin mine. Respirable dust concentrations were higher in the processing area than in the mine or maintenance areas for all determinations from 1977 to 1981. The mean respirable dust level in the processing area in 1981 was 1.74 mg/m3 and 0.14 mg/m3 in the mine area. Five workers, all of whom had worked at the processing area, had radiographic evidence of kaolin pneumoconiosis. The mean values of forced vital capacity (FVC) and FEV1 of the entire group were within the normal range. When the spirometric values were expressed as a percentage of the predicted values, the FVC and FEV1 were significantly lower in the workers with kaolinosis than in other workers in the processing area. The FVC and FEV1 also declined significantly with increasing years of work in the processing area. The FEV1/FVC%, however, was not significantly altered either by the presence of kaolinosis or by an increasing number of years of work, indicating that the impairment was restrictive and hence likely to be a consequence of dust inhalation rather than smoking. In this study the highest dust concentrations occurred in the processing area, and kaolin pneumoconiosis was limited to those who had worked there. Kaolin exposure appeared to have a small but significant effect on ventilatory capacity in those with kaolin pneumoconiosis and in workers with a longer exposure. There was no association between the radiographic appearances of kaolinosis and cigarette smoking or between the presence of radiographic abnormalities and reduced arterial blood gas tensions.

Adult↗

Factors influencing the regional deposition of inhaled particles in man.

1. Although ventilation in normal human lungs has been shown to decrease from apex to base, comparable observations are lacking in regard to particle deposition. 2. We compared regional ventilation and particle deposition in normal subjects by using radioactive xenon and a radioactive aerosol while sitting, lying, and while breathing at an increased rate. Both smokers and non-smokers were studied. 3. Particle deposition and ventilation were closely related, and the greater the ventilation the greater the deposition of particles, a situation which prevailed irrespective of position and breathing rate. While supine, the apex to base gradient for both ventilation and particle deposition decreased but did not entirely disappear. At higher respiratory rates, central deposition of particles, especially in smokers, increased. 4. We concluded that there are regional differences in the deposition of particles and that such differences are closely related to regional ventilation.

Adult↗