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PubMed1987

Computerized single-breath nitrogen washout in children: variability and reproducibility.

The variability, short-term (1 hour) and long-term (2 weeks) reproducibility of the variables derived from the single-breath N2 test were evaluated in a group of 56 healthy children aged 10 to 16 years with a computerized system. The variability was low for vital capacity and total lung capacity (coefficient of variation less than 3%), moderate for residual volume and phase III N2 slope (9 and 13%) and very high for closing volume (more than 50%). A closing volume could not be identified by the computer algorithm in 18.3% of the trials. The reproducibility of the variables was satisfactory both at 1 hour and at 2 weeks, with the exception of the closing volume, whose increase at 2 weeks seemed to be due to methodological factors. We conclude that reliable results of static lung volumes and phase III N2 slope, but not of closing volume, may be obtained in children by a computerized system in epidemiological studies.

Adolescent↗
PubMed2004

Nasal administration of albuterol: an alternative route of delivery.

The use of metered-dose inhalers for the delivery of albuterol, a beta2-selective adrenergic agonist, is associated with drawbacks, especially in children and the elderly. This investigation was designed to assess the effectiveness of albuterol delivered intranasally and to compare this delivery route with intratracheal and intravenous delivery. Three parameters of pulmonary function (peak maximal expiratory flow, maximal expiratory flow at 50% vital capacity, and total lung capacity) in anaesthetized, artificially ventilated guinea pigs were used to determine the degree of protection produced by albuterol against bronchoconstrictor responses provoked by acetylcholine. The heart rate was also measured. Although intranasal albuterol induced a slower protective action during the very initial phase of absorption, the drug was shown to be equally effective when administered either intranasally or intratracheally. In contrast, despite a significant effect initially in the case of intravenous albuterol, its ability to influence pulmonary function faded rather rapidly. No statistically significant differences in heart rate could be detected among the different treatment groups. In conclusion, intranasal albuterol may offer an alternative to metered-dose inhalers for the treatment of acute bronchospasm and for prevention of exercise-induced asthma, especially for children and the elderly.

Acetylcholine↗
PubMed2006

Association between markers of emphysema and more severe chronic obstructive pulmonary disease.

BACKGROUND: The predominant emphysema phenotype is associated with more severe airflow limitation in patients with chronic obstructive pulmonary disease (COPD). A study was undertaken to investigate whether COPD patients, with or without emphysema quantitatively confirmed by high resolution computed tomography (HRCT), have different COPD severity as assessed by the BODE index (body mass index, airflow obstruction, dyspnoea, exercise performance) and inspiratory capacity to total lung capacity ratio (IC/TLC), and by different biological markers of lung parenchymal destruction. METHODS: Twenty six outpatients with COPD and eight healthy non-smokers were examined. Each subject underwent HRCT scanning, pulmonary function tests, cell counts, and measurements of neutrophil elastase, matrix metalloproteinase (MMP)-9 and tissue inhibitor of metalloproteinase (TIMP)-1 in induced sputum, as well as measurement of desmosine, a marker of elastin degradation in urine, plasma and sputum. RESULTS: Patients with HRCT confirmed emphysema had a higher BODE index and lower IC/TLC ratio than subjects without HRCT confirmed emphysema and controls. Forced expiratory volume in 1 second (FEV(1)), FEV(1)/forced vital capacity ratio, and carbon monoxide transfer coefficient were lower, whereas the number of eosinophils, MMP-9, and the MMP-9/TIMP-1 ratio in sputum were higher in patients with emphysema. In COPD patients the number of sputum eosinophils was the biological variable that correlated positively with the HRCT score of emphysema (p = 0.04). CONCLUSIONS: These results suggest that COPD associated with HRCT confirmed emphysema is characterised by more severe lung function impairment, more intense airway inflammation and, possibly, more serious systemic dysfunction than COPD not associated with HRCT confirmed emphysema.

Aged↗
PubMed1996

Alterations in pulmonary function after retroperitoneoscopic surgery.

OBJECTIVE: To evaluate and compare changes in pulmonary function after retroperitoneoscopic and open surgery. PATIENTS AND METHODS: From June 1994 to October 1995. 11 patients (five men and six women, mean age 44.7 years, range 29-69) underwent retroperitoneoscopic procedures (Group 1) and 11 patients (eight men and three women, mean age 57.5 years, range 22-73) underwent flank-incision procedures (Group 2). The surgery comprised eight adrenalectomies and one each of nephroureterectomy, nephrectomy and pyelolithotomy in Group 1, and five adrenalectomies, four nephroureterectomies, one ureterolithotomy and one excision of a retroperitoneal tumour in Group 2. Pulmonary function tests (PFTs) were performed before and 3 days after surgery; the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), forced expiratory volume at 25% (FEV25%), FEV1/FVC, vital capacity (VC), total lung capacity (TLC), residual lung volume (RV) and functional residual capacity (FRC) were compared between the groups. The post-operative changes in the PFTs were assessed using a paired t-test and the degree of change in both groups compared using the Mann-Whitney U-test. Other factors possibly influencing PFT were analysed using multiple regression. RESULTS: Pulmonary function was impaired in both groups on the third day after surgery. In Group 2, the FVC, FEV1, FEV25%, VC and TLC had declined significantly (all P < 0.05) from the pre-operative value. In Group 1, only the FVC and VC decreased significantly (P < 0.05). Post-operative pulmonary complications occurred in two patients in Group 2 but in none of those in Group 1, showing that pulmonary function was generally less affected in Group 1 than in Group 2. CONCLUSION: Although pulmonary function was impaired 3 days after surgery in both groups, retroperitoneoscopic surgery, by eliminating a large flank incision, caused less post-operative pulmonary dysfunction than open surgery.

Adult↗
PubMed2006

Respiratory evaluation of patients on continuous ambulatory peritoneal dialysis prior to renal transplantation.

BACKGROUND AND AIM: Pulmonary function tests (PFTs) and cardiopulmonary exercise tests (CPETs) are important in predicting preoperative pulmonary complications and mortality rate in potentially renal transplant recipients. There is no adequate clinical research aimed at learning the effect of empty and full status of the peritoneal cavity on PFTs and CPET for estimating decide PFTs and CPET timing in preoperative evaluation. The aim of this study was to investigate whether PFT and CPET results are altered in patients on continuous ambulatory peritoneal dialysis (CAPD) according to the presence of dialysis solution in the abdomen. SUBJECTS AND METHODS: 22 subjects were included (12 male, 10 female, mean age 29.64 +/- 8.29 years, CAPD duration, 37.35 +/- 7.15 months). Data were collected from each patient when the peritoneal cavity was filled with solution (full status) and again when the cavity had been drained (empty status). Forced expiratory volume in 1 s (FEV1), ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC), total lung capacity (TLC), and residual volume (RV) were calculated. Peak oxygen uptake (peak VO2) and exercise duration were determined by cardiopulmonary exercise testing. RESULTS: When the peritoneal cavity was empty, mean (+/- SD) values for the parameters tested were % predicted FEV1: 85 +/- 17%, %FEV1/FVC: 84 +/- 8%, % predicted TLC: 98 +/- 17%, % predicted RV: 108 +/- 25%, % predicted DLCO: 90 +/- 14%, peak VO2: 43 +/- 11 ml/kg/min, test duration: 6.8 +/- 1.6 min. When the peritoneal cavity was full, mean (+/- SD) values were % predicted FEV1: 86 +/- 17%, %FEV1/FVC: 83 +/- 7%, % predicted TLC: 91 +/- 14%, % predicted RV: 95 +/- 22%, % predicted DLCO: 87 +/- 16%, peak VO2: 42 +/- 8 ml/kg/min, test duration 6.5 +/- 1.7 min. % predicted FEV1, %FEV1/FVC, % predicted DLCO and peak VO2 were not statistically significant between the mean values at empty status versus those at full status (p < 0.05 for all). There were significant decreases between the mean values for % predicted TLC and % predicted RV at full status versus empty status (p < 0.002 for TLC, p < 0.001 for RV). No statistically significant correlation was found between PFTs and % change ratio of dialysate. CONCLUSION: FEV1, %FEV1/FVC, % predicted DLCO and CPET test results do not differ according to abdomen status in CAPD patients suggesting that the timing of PFT maneuver does not affect preoperative transplantation evaluation. Therefore, when evaluating the results of these tests prior to transplantation period, the presence of dialysis solution in the abdomen may be ignored.

Adult↗
PubMed1989

Single breath N2 washout in papain-induced pulmonary emphysema.

Single breath nitrogen washout tests were analyzed in dogs (n = 8) with healthy lungs and after development of emphysema. The animals were in the supine position and studied during anaesthesia and mechanical ventilation (FiO2 = 0.4, FiN2 = 0.6). During controlled expiration with constant flow (VE = 0.15 l/s) onset of phase IV of the alveolar plateau was related to airway closure of dependent lung regions (closing volume CV). In the control state, CV accounted for 6.2 +/- 1.5% VC, and closing capacity (CC) was lower than functional residual capacity (FRC). Likewise, gas exchange was normal in all animals (PaO2 = 24.7 +/- 3.32 kPa, PaCO2 = 5.18 +/- 0.53 kPa, PA-aO2 = 2.6 +/- 0.3 kPa). Panlobular emphysema (PLE) was induced by inhalation of papain (100 mg/kg). After three weeks development of PLE was documented by measurements of lung volumes (functional residual capacity (FRC), expired vital capacity (EVC), total lung capacity (TLC), residual volume (RV], pulmonary mechanics (dynamic and static compliance (Cdyn, Cstat), mean airway resistance (Raw], gas exchange (PaO2, PaCO2, PA-aO2), and by radiomorphological analysis. In the PLE-group, FRC and RV (p less than or equal to 0.05), and Cstat (p less than or equal to 0.01) were significantly elevated. CV increased to 16.2 +/- 2.7% VC (p less than or equal to 0.01) and CC exceeded FRC by 80 ml, indicating that tidal volume breathing took place within the range of closing volume. Oxygenation was significantly impaired (PaO2 = 18.6 +/- 3.72 kPa, PA-aO2 = 6.5 +/- 1.1 kPa, p less than or equal to 0.05), but not CO2-elimination. Pathological analysis by radiomorphological means showed dissiminate parenchymal lesions compatible with emphysema of grade II severity located predominantly in subpleural areas. In dogs with papain-induced PLE, premature closure of dependent airways is enhanced, which is due to structural changes and a loss of elastic recoil in the lungs.

Animals↗
PubMed1981

Long-term follow-up of lung volume measurements in initially healthy young aviators.

Lung volume measurements on a large number of initially healthy young military aviators (the U.S. Navy's "1000 Aviator" cohort) were recorded periodically in follow-up from 1940-69. Vital capacities were measured spirometrically and total lung capacities were measured planimetrically from chest roentgenograms. Residual volumes were calculated by subtracting the vital capacity from the total lung capacity in each subject. Additional variables available for analysis were cigarette smoking histories, family histories, aviation career patterns, pulmonary symptoms, cardiac disease diagnoses, and anthropometric measurements. Multiple linear regression techniques were used on these variables to construct prediction equations for each lung volume in 1969. From these longitudinal analyses, cigarette smoking and pulmonary symptoms were found to be associated with an "obstructive lung volume pattern in 1969, while coronary artery disease and weight gain were found to be associated with a "restrictive" lung volume pattern in 1969. A career in military aviation had no significant association with lung volumes.

Adult↗
PubMed1990

Airflow limitation in morbidly obese, nonsmoking men.

STUDY OBJECTIVE: To determine the effect of obesity on pulmonary function. DESIGN: Case-control study, using nonobese, age- and height-matched [corrected] nonsmokers. SETTING: Metabolic and obesity clinics of two major teaching hospitals. PATIENTS: One hundred and three obese, lifelong nonsmokers without cardiopulmonary disease. CONTROLS: One hundred and ninety healthy, nonobese nonsmokers recruited from among hospital personnel. MEASUREMENTS AND MAIN RESULTS: Complete pulmonary function measurements in all patients and controls. These measurements included maximum expiratory flow-volume curve, lung volumes and airway resistance using body plethysmograph, single-breath diffusing capacity for carbon monoxide, and total lung capacity using the helium dilution technique. Obese persons were found to have lower functional residual capacity, expiratory reserve volume, and total lung capacity by helium dilution than nonobese controls. In addition, residual volume and diffusing capacity were higher in the obese group. Finally, we found that obese men, but not women, had reduced maximum expiratory flow rates at 50% and 75% of exhaled vital capacity. CONCLUSION: Obesity may contribute independently of smoking habits to chronic airflow limitation in men.

Adult↗
PubMed1995

Stability of evoked parasternal intercostal muscle electromyogram at increased end-expiratory lung volume.

The diaphragmatic electromyogram has been measured as an index of the level of diaphragmatic activation. The diaphragmatic electromyogram, however, even when measured by intramuscular electrodes, can be artifactually altered by a change in lung volume (A. Brancatisano, S. M. Kelly, A. Tully, S. H. Loring, and L. A. Engel. J. Appl. Physiol. 66: 1699-1705, 1989) or by a change in body position. The parasternal intercostal muscle may be less subject to the mechanisms that are believed to produce this artifactual change. We asked whether the parasternal intercostal electromyographic activity could be reliable when lung volume changes. Six supine rabbits were anesthetized with ketamine and xylazine. Fine bipolar copper wires, with their tips exposed, were inserted into the left parasternal intercostal muscle in the third interspace. A stimulus that was three times maximal was applied to the corresponding intercostal nerve, and the resulting action potential (AP) was photographed. Parasternal intercostal muscle length was measured by sonomicrometry over the vital capacity range. There were small nonsignificant changes in the AP from functional residual capacity (FRC) to total lung capacity. From FRC to residual volume there was variation in the AP. The AP was also quite stable when regional conductivity was altered but showed variation when the parasternal intercostal muscle length change was accentuated by traction on the rib cage. We conclude that the parasternal intercostal electromyographic activity can be reliably used to measure inspiratory motoneuron output to it over the range of lung volumes from FRC to total lung capacity.

Animals↗
PubMed1994

[Respiratory symptoms and function of coal miners presenting radiological pulmonary abnormalities].

Respiratory symptoms and lung function of 80 coal workers suspected of pneumoconiosis (pulmonary X-rays classified 0/1 or 1/0 according to International Labour Organisation classification) who worked for at least 10 years at face work (Ts) were studied in comparison with two control groups matched by age (+/- 2 years), height (+/- 5 cm), weight (+/- 10 kg) and smoking habits: the Tn group constituted by 80 coal workers who worked for at least 10 years at face work with normal pulmonary X-rays, and the HTn group constituted by 80 underground miners who worked mainly out of face work with normal pulmonary X-rays. The frequencies of cough, expectoration, chronic bronchitis or dyspnoea were significantly higher in Ts group than in the two others. The one-second forced expiratory volume to vital capacity ratio (FEV1/VC) was lower, closing volume to vital capacity (CV/VC) or to total lung capacity ratios (CV/TLC) were higher in Ts group than in the control groups. Unexpectedly, vital capacity (VC), one-second forced expiratory volume (FEV1), total lung capacity (TLC), compliance, diffusing capacity (DLCO) referred to alveolar volume (VA) were higher. In Ts group, the small rounded opacities were noted in the top part of the lung (56.9%), the irregular ones were distributed on the entire lung (65.5%). There were no relation between the category of small opacities and respiratory symptoms or lung function.

Adult↗
PubMed2000

Influence of lung volume on pulmonary microvascular pressure-volume characteristics.

The pressure-volume (P-V) characteristics of the lung microcirculation are important determinants of the pattern of pulmonary perfusion and of red and white cell transit times. Using diffuse light scattering, we measured capillary P-V loops in seven excised perfused dog lobes at four lung volumes, from functional residual capacity (FRC) to total lung capacity (TLC), over a wide range of vascular transmural pressures (Ptm). At Ptm 5 cmH(2)O, specific compliance of the microvasculature was 8.6%/cmH(2)O near FRC, decreasing to 2.7%/cmH(2)O as lung volume increased to TLC. At low lung volumes, the vasculature showed signs of strain stiffening (specific compliance fell as Ptm rose), but stiffening decreased as lung volume increased and was essentially absent at TLC. The P-V loops were smooth without sharp transitions, consistent with vascular distension as the primary mode of changes in vascular volume with changes in Ptm. Hysteresis was small (0.013) at all lung volumes, suggesting that, although surface tension may set basal capillary shape, it does not strongly affect capillary compliance.

Animals↗
PubMed1976

Small airways in fibrosing alveolitis.

Pulmonary function, including lung elastic recoil, was measured in 9 subjects with fibrosing alveolitis. Closing volume and upstream conductance were studied to assess small airway function. Lung volumes, diffusing capacity, and transfer coefficient were decreased. Peak expiratory flow and the ratio of 1-sec forced expiratory volume to forced vital capacity were normal, whereas total lung resistance was low, suggesting that large airways were not narrowed. Lung elastic recoil was increased, but the changes could be accounted for by the loss of lung volume. Closing volume and closing capacity were increased when expressed as a percentage of vital capacity and total lung capacity, respectively; but again, this could be accounted for by the decrease in lung volume, because the absolute lung volume at which airway closure occurred was normal. Upstream conductance was not reduced. We conclude that there is no evidence of narrowing of functional small airways in ventilated parts of the lung. The mechanical findings are compatible with the patchy involvement seen pathologically in fibrosing alveolitis.

Adult↗
PubMed1993

Respiratory dysfunction in congestive heart failure: correction after heart transplantation.

Severe chronic congestive heart failure (CCHF) is known to induce a restrictive ventilatory defect, with a small decrease in lung transfer factor for carbon monoxide (TLCO). The aim of the present work was to assess the reversibility of this dysfunction. We studied a group of 47 patients with CCHF, before and one year after heart transplantation. The measurements included static and dynamic lung volumes, TLCO and cardiac function. On initial evaluation, vital capacity (VC), total lung capacity (TLC) and TLCO were reduced to 76, 79 and 64% of the predicted value (% pred), respectively. Forced expiratory volume in one second (FEV1) was decreased to 69% pred, with a FEV1/VC ratio below 0.70 in 13 out of 47 patients. One year after transplantation, cardiac function had markedly improved, as shown by a normalized left ventricular ejection fraction (from 18% preoperatively to 59% postoperatively), and mean pulmonary wedge pressure (from 26 to 12 mmHg). At this time, VC (94% pred) and TLC (98% pred) were within the normal range, whereas TLCO remained low (67% pred). The FEV1/VC ratio did not change, even in the subgroup with an initial low value. Smoking habits did contribute to the low TLCO and FEV1/VC ratio. In conclusion, respiratory dysfunction induced by CCHF is reversible, with the exception of the reduction in TLCO, which probably reflects permanent changes in the lung vasculature. CCHF does not induce an obstructive ventilatory pattern.

Female↗
PubMed1996

Zone of apposition in the passive diaphragm of the dog.

We determined the regional area of the diaphragmatic zone of apposition (ZAP) as well as the regional craniocaudal extent of the ZAP (ZAPht) of the passive diaphragm in six paralyzed anesthetized beagle dogs (8-12 kg) at residual lung volume (RV), functional residual capacity (FRC), FRC + 0.25 and FRC + 0.5 inspiratory capacity, and total lung capacity (TLC) in prone and supine postures. To identify the caudal boundary of the ZAP, 17 lead markers (1 mm) were sutured to the abdominal side of the costal and crural diaphragms around the diaphragm insertion on the chest wall. Two weeks later, the dogs' caudal thoraces were scanned by the use of the dynamic spatial reconstructor (DSR), a prototype fast volumetric X-ray computer tomographic scanner, developed at the Mayo Clinic. The three-dimensional spatial coordinates of the markers were identified (+/- 1.4 mm), and the cranial boundary of the ZAP was determined from 30-40 1.4-mm-thick sagittal and coronal slices in each DSR image. We interpolated the DSR data to find the position of the cranial and caudal boundaries of the ZAP every 5 degrees around the thorax and computed the distribution of regional variation of area of the ZAP and ZAPht as well as the total area of ZAP. The ZAPht and area of ZAP increased as lung volume decreased and were largest near the lateral extremes of the rib cage. We measured the surface area of the rib cage cephaled to the ZAP (AL) in both postures in another six beagle dogs (12-16 kg) of similar stature, scanned previously in the DSR. We estimated the entire rib cage surface area (Arc = AZAP + AL). The AZAP as a percentage of Arc increased more than threefold as lung volume decreased from TLC to RV, from approximately 9 to 29% of Arc.

Anesthesia, General↗
PubMed1990

Pulmonary function in healthy young adult Indians in Madras.

Forced vital capacity, forced expiratory volume in one second, functional residual capacity, residual volume, total lung capacity, and single breath diffusing capacity measurements (effective alveolar volume, carbon monoxide transfer factor, and transfer coefficient) were measured in 247 young healthy adults (130 male, 117 female) aged 15-40 years living in Madras. Subjects were of Dravidian stock, living at sea level with rice as their staple diet. Regression equations were derived for men and women for predicting normal pulmonary function for young adults in South India. The values were similar to those reported for subjects from Western India and lower than those reported for North Indians and caucasians.

Adolescent↗
PubMedDate not supplied

Lung function in young persons after spinal fusion for scoliosis.

The long-term changes in vital capacity and in total lung capacity after spinal fusion for 43 scoliotic patients are described. The values recorded were seldom lower after surgery but did not show any marked subsequent increases with patient growth. Subsequent increases in volumes are less marked in the group of patients with paralytic scoliosis. These findings suggest that the psychological advantages of improving the patient's appearance by surgery and of preventing any respiratory condition from worsening may be achieved, although the total capacity and vital capacity are not much improved by spinal fusion.

Adolescent↗
PubMed1981

A Kr-81m inhalation method for detection of absence of uniform ventilation in asthma.

In an attempt to compare inhalation methods in detecting abnormal patterns of ventilation, the following four techniques were applied in 12 asthmatic patients: spontaneous respiration with a Kr-81m gas-air mixture (SP technique); serial inhalation of a Kr-81m gas-air mixture from the level of residual volume to total lung capacity (VC technique); bolus inhalation of 10 ml or Kr-81m gas from the level of residual volume, followed by air, to total lung capacity (RV technique); bolus inhalation of 10 ml of Kr-81m gas from the level of functional residual capacity, followed by air, to total lung capacity (FRC technique). Before exercise, abnormalities were detected by the RV and FRC techniques, but no abnormalities were detected by SP and VC techniques. On studies done after exercise, the abnormalities were detected by all the described techniques. However, they were best demonstrated by the RV technique and shown least well by the VC method.

Adolescent↗
PubMed1995

Relation of spinal and thoracic cage deformities and their flexibilities with altered pulmonary functions in adolescent idiopathic scoliosis.

STUDY DESIGN: Seventy patients (average age, 13.8 years) with adolescent idiopathic right thoracic scoliosis had full assessment of pulmonary functions and radiographic evaluation of spinal and thoracic cage deformities and their flexibilities. OBJECTIVES: To determine how measurements of spinal and thoracic cage deformities related to pulmonary function. SUMMARY OF BACKGROUND DATA: Pulmonary functions have been evaluated in relation to lateral curvature of the spine in most of the published studies. Scoliosis is a three-dimensional deformity. There is a need to evaluate these changes in pulmonary functions, reflecting not only spinal curvature but also rotational deformity, thoracic cage deformity, and their flexibilities. METHODS: Radiographic measurements obtained from anteroposterior and lateral standing and anteroposterior supine bending radiographs included lateral curvature, vertebral rotation, kyphosis, maximum sternovertebral distance, and apical rib-vertebral angles. Using previous measurements, the flexibility of the curve, vertebral rotation, and rib-vertebral angle were calculated. A pulmonary function assessment was performed using a computerized pulmonary function system (5000V; Gould, Dayton, Ohio). We analyzed pulmonary functions in relation to deformity. RESULTS: Measurements reflecting spinal deformities obtained from anteroposterior radiographs, such as Cobb angle, vertebral rotation, and vertebral rotation flexibility, were significantly correlated with the percent of predicted values of vital capacity and forced vital capacity, whereas kyphosis measured from lateral radiographs was significantly correlated with absolute values of residual volume, total lung capacity, functional residual capacity, and forced expiratory flow from 25-75% of the forced vital capacity (FEF25-75). Of the measurements reflecting thoracic cage deformity obtained from anteroposterior radiographs, rib-vertebral angle asymmetry (measured from supine bending radiographs) showed significant correlation with the percent of predicted values of vital capacity, forced vital capacity, and functional residual capacity, whereas the sternovertebral distance that was measured from lateral radiographs correlated significantly with absolute values of vital capacity, total lung capacity, forced vital capacity, and FEF25-75. CONCLUSIONS: Deformities in coronal and transverse plane influence changes in pulmonary functions expressed as the percent of predicted values, whereas sagittal plane deformities influence mainly those absolute volumes in which residual volume is a component. It is suggested that rotational flexibility combined with other deformities could be evaluated in future studies on prediction of pulmonary function from the measurements of the deformity.

Adolescent↗