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PubMed2003

Pulmonary compensatory indexes in children and adolescents with idiopathic scoliosis I degree.

Spirometric and plethysmographic examinations were performed in two groups of children. Group I: 23 children with scoliosis I degree by the Cobb (spinal curvature 17.2 degree) which comprised 12 girls and 11 boys at the age of 8-16 years (the mean age was 11.4 +/- 2.4 yr). The Control Group consisted of 20 children--13 girls and 7 boys at the age of 8-16 years (the mean age was 13.77 +/- 1.72 yr). The measurements were performed using Body-plethysmograph with pneumotachograph Jaeger. Total lung capacity (TLC), forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), residual volume (RV), intrathoracic gas volume (ITGV) and at the same time curve indexes, dependence of maximum expiratory flow lung volume, MEF75%VC, MEF50%VC, MEF25%VC were determined. Maximum expiratory flows in relation to vital capacity and total lung capacity were defined as so called compensatory indexes. Slightly decreased values of total lung capacity (TLC) and statistically significantly decreased intrathoracic gas volume (ITGV) as well as residual volume (RV) were found in children with scoliosis in early stage. Forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1) were statistically significantly higher in comparison to the control group. Compensatory index MEF50%VC/FVC in children in the early stage of scoliosis was statistically significantly decreased in comparison to the control group (p < 0.02).

Adolescent↗
PubMed1982

Effect of simple anthracite pneumoconiosis on lung mechanics.

A respiratory questionnaire was administered to 20 miners with simple anthracite coal workers' pneumoconiosis (CWP) and ten normal subjects. Lung function studies which included lung mechanics and small airways disease measurements were also performed. Seventeen of the miners admitted to having symptoms of bronchitis. No significant differences were demonstrated between the two groups for vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and three seconds (FEV3), midmaximal flow rate (FEF25-75%), and peak flow rate (PEFR). A significant decrease in the maximum expiratory flow rate at 50 percent of vital capacity (V max50%) was detected; however, this was not evident when the flow rate was corrected for lung volume. Also, there were no significant differences in lung volumes, diffusing capacity (DCO) and diffusion coefficient (DCO/TLC). The mean static expired compliance (Cstate) was significantly increased in the anthracite miners, but no difference in specific compliance (Cstate/FRC) could be demonstrated. Also, no significant differences were detected in the mean values of any of the tests of small airways disease. There is little evidence of significant alterations in lung mechanics or small airway narrowing in miners with simple anthracite pneumoconiosis.

Aged↗
PubMed1976

[Significance of forced expiratory vital capacity-curves to detect early mechanical alterations in human lungs (author's transl)].

In persons who have been smoking cigarettes for many years, who have normal conventional lung function tests the semilogarithmical plotting of forced expiratory vital capacity curves (FEVC) shows statistically significant differences in volume changes below 25 per cent of vital capacity when compared to FEVC-curves of normal subjects of comparable age. On the basis of the equal pressure point theory it is suggested that the simple semilogarithmical plotting of FEVC-curves may reveal early mechanical alterations rather than can be shown by spirometry and airway resistance measurements.

Adult↗
PubMed2003

Blood coagulation, fibrinolysis, and markers of endothelial dysfunction in systemic sclerosis.

OBJECTIVE: To evaluate the coagulative/fibrinolytic cascade and the circulating markers of the endothelial injury in systemic sclerosis (SSc). METHOD: Plasma was obtained from 29 patients with SSc and tested for thrombin-antithrombin (TAT), fragments 1+2 (F1+2), dermatansulphate (DS), thrombomodulin (TM), lipoprotein (a) [Lp(a)], von Willebrand factor (vWF), tissue type plasminogen activator (tPA), plasminogen activator inhibitor (PAI), D-dimers, intercellular adhesion molecole-1 (ICAM-1), vascular cell adhesion molecule (VCAM), and E-selectin. The data were correlated with lung (forced vital capacity, diffusing lung capacity for carbon monoxide, vital capacity) and skin (skin score) involvement. RESULTS: Coagulation was significantly activated (increase in F1+2, P <.001; TAT, P <.01; and Lp(a), P <.05). TM was not significantly different from controls. vWF was significantly increased (P <.01), and its supranormal multimers increased in more than 50% of patients. DS was significantly increased in diffuse cutaneous SSc (P <.01). Fibrinolysis was impaired as shown by reduced D-dimers (P <.01) and decreased levels of PAI (P < 0.01). The markers of endothelial injury were also significantly elevated. DS correlated significantly with forced vital capacity (P <.01) and forced vital capacity ratio (P <.01). CONCLUSION: Injury to the endothelium reduces endothelial function, as suggested by impairment of fibrinolysis and activation of the coagulative pathway. The loss of the balance between fibrinolysis and coagulation contributes to vessel engulfment with fibrin and breakdown of vessel patency. The increase of circulating DS suggests that this factor may be a new marker of endothelial injury.

Adult↗
PubMed1976

Determination of lung volume by single- and multiple-breath nitrogen washout.

In 10 normal volunteers, total lung capacity determined from a single-breath N2 washout was not significantly different from that determined by body plethysmography. However, in patients who underwent clinical pulmonary function tests, total lung capacity was substantially underestimated by the single-breath N2 washout, compared with that determined by either body plethysmography or the 7-min open-circuit N2 washout method. The single-breath N2 washout underestimated total lung capcity in patients who had a normal slope of Phase III, and the error was even greater in patients who had steeper Phase III slopes or low maximal mid-expiratory flow values. Total lung capacity determined by 5 vital capacity breath N2 washout method was comparable to that determined by the 7-min N2 washout method, provided that expired N2 did not exceed 10 per cent during the fifth vital capcity maneuver. By extending the washout beyond 5 vital capacity maneuvers when necessary to achieve a peak expired N2 of less than 10 per cent, a mean total lung capacity within 1 per cent of that determined by the 7-min washout method was obtained. The multiple vital capacity maneuver was well tolerated by patients and saved considerable time.

Humans↗
PubMed1977

Serial pulmonary function tests in patients with asbestosis.

Serial lung function tests were performed on 17 patients with asbestosis. A marked fall in the transfer factor often preceded any significant decline in the vital capacity. Changes in vital capacity and transfer factor did not appear to give any indication of the prognosis in these patients. Death was more commonly due to carcinoma of the lung than to the effects of the lung fibrosis.

Aged↗
PubMed1986

The effect of transfusion on lung capacity, diffusing capacity, and arterial oxygen saturation in patients with thalassemia major.

Our previous cross-sectional study of patients with thalassemia major suggested progressive lung changes characterized by low total lung capacity, hypoxemia, and elevated transfer factor for carbon monoxide. We reevaluated nine of the patients for three reasons: to determine the relationship of the previous findings to the immediate effects of blood transfusion; to assess the longitudinal progression of the lung changes; and to evaluate the effect of splenectomy on lung volume changes in these patients, all of whom underwent splenectomy in the interval between the two studies. We found that during the 5- to 6-yr period between studies total lung capacity had decreased significantly (p less than 0.05) from a mean 86% predicted to a mean 79% predicted. However, vital capacity increased significantly (p less than 0.05) from a mean 81% predicted to 88% with no significant change in functional residual capacity. There was no significant immediate effect of transfusion on total lung capacity, vital capacity, or functional residual capacity. However, the diffusion constant for carbon monoxide increased significantly (p less than 0.005) immediately following transfusion and there was a positive correlation between the increase and the amount of blood transfused (r = 0.74, p less than 0.05). Arterial oxygen saturation was below 95% in five of eight patients and increased significantly with transfusion (p less than 0.05). We conclude: 1) thalassemia major and/or its treatment is associated with hypoxemia and a progressive reduction in total lung capacity. 2) Despite the progressive reduction in total lung capacity, splenectomy in patients with thalassemia major increases expiratory reserve volume and thereby increases vital capacity.

Adolescent↗
PubMed1994

Pulmonary function after autologous bone marrow transplantation in children.

Forty-two children receiving bone marrow autografts were studied prospectively regarding acute pulmonary complications; there was no procedure-related mortality and only one case of interstitial pneumonitis. An analysis was also made of the pulmonary function tests (PFTs) of the 27 autografted children who were disease-free and had been followed up for at least 1 year (median 4.1 years, range 1.1-7.6 years). PFTs were performed before and 6, 12, 24, 36 and 60 months after autologous BMT. The mean pre-transplant values of total lung capacity (TLC), vital capacity (VC) and forced expiratory volume in one second (FEV1) were close to predicted but 6 months after autologous BMT there was a statistically significant decrease (11, 13 and 15% below baseline, respectively) in patients receiving total body irradiation in their conditioning regimen. There was some but not complete recovery with time. DLCO remained low throughout the study, irrespective of the conditioning regimen. In summary, acute pulmonary complications were few and PFTs showed only modest changes from baseline after ABMT. At the latest follow-up no respiratory symptoms had reportedly occurred in any of the children and the chest radiographs were normal. Although the results are promising so far, long-term follow-up is necessary to evaluate the final outcome in these children.

Adolescent↗
PubMed1985

Characteristics of pulmonary function in patients with diabetes mellitus.

The incidence of pulmonary diseases among diabetics in Japan has been found to be more than 50% at death. This suggests the existence of some pulmonary risk factors. We analyzed pulmonary functions in 50 diabetics (31 males and 19 females) without overt lung disease, compared to 21 healthy male subjects of the same age (around 50 years old). Forced vital capacity and timed vital capacity were lower in diabetics (P less than 0.005). Diffusing capacity was also decreased in male diabetics (P less than 0.05). Among diabetics, a decrease in the diffusing capacity was dominant in patients with diabetic retinopathy, which correlated with an increasing duration of their diabetes. Analysis by the partial correlation method which accounts for the smoking index showed that standardized indices for peripheral airflow in male diabetics decreased significantly as the patient's age increased (P less than 0.005); the rate of decrement was greater than that of the control subjects. Diabetic patients showed abnormal lung function in the peripheral airways which increased with age and gas transfer was also affected by diabetic microangiopathy as well as the duration of diabetes. These changes seemed to deteriorate progressively, possibly combining and contributing to respiratory insufficiency in critical pathological conditions.

Adult↗
PubMed1982

Spirometric studies in non-smoking, healthy adults.

Reference spirometric values for vital capacity (VC), forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced expiratory volume in one second as percentage of vital capacity or of forced vital capacity (FEV%), the highest flow during forced inspiration (Vmax insp), the highest forced expiratory flow at 50% vital capacity (Vmax 50%), the highest forced expiratory flow when 75% of vital capacity has been expired (Vmax 25%), Vmax insp/Vmax 50% and peak expiratory flow (PEF) were determined in a series of 296 males and 257 females, 18-65 years old, who have never smoked. Equations were derived using height and age as predictors. The reproducibility was tested.

Adolescent↗
PubMed1977

Physical capacity in twins.

A comparison of physical capacity, (measured by vital capacity, muscular strength and physical work capacity) in twin boys and controls failed to indicate significant differences. Intrapair correlations showed the MZ twins to be much more similar than the DZ twins in all the capacity measures. The correlations were lower, however, for both MZ and DZ twins for physical work capacity than for the other two capacity variables. When amount of physical exercise during leisure time is kept under control, the DZ twins tend to be more similar for physical work capacity or muscular strength, and the correlations tend to be of the same magnitude for MZ twins. Physical work capacity therefore appears, in this study, to be a more environmentally influenced variable than either vital capacity or muscular strength.

Female↗
PubMed2002

Longitudinal changes of body mass index, spirometry and diffusion in a general population.

The aim of this study was to evaluate the effects of body mass index (BMI) changes over an 8-yr follow-up, on longitudinal changes of vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and carbon monoxide diffusing capacity of the lung (DL,CO) indices in a general population sample of North Italy. To avoid including weight changes possibly related to physical growth, only the 1,426 adults (>24 yrs, 46% males) with complete follow-up were selected. Median linear regression models were applied to estimate the medians of change (computed as follow-up minus baseline values) of VC, FVC, FEV1 and DL,CO indices, as functions of changes of BMI over the follow-up period, separately by sex, after considering several potential confounders and effect modifiers. The extent of lung function loss tended to be higher among those who, at baseline, reported greater BMI values. Males experienced larger losses than females (20 and 16 mL FEV1 median reduction for a BMI unit increase in males and females, respectively). Conversely, longitudinal changes of BMI caused a slight and nonsignificant increase in DL,CO values in both sexes. Over an 8-yr follow-up, the detrimental effect of gaining weight might be reversible for many adults as most of those who reduced their body mass index values also increased their lung function. Overweight patients with ventilatory impairment should be routinely encouraged to lose weight for improving their lung function.

Adult↗
PubMed1981

Laryngomalacia and inspiratory obstruction in later childhood.

Pulmonary function and symptoms were reviewed in 20 children in whom laryngomalacia had been diagnosed by direct laryngoscopy in infancy. Most children developed stridor in the first 2 weeks, but 3 children did not develop it until age 3 months. The mean duration of stridor was 4 years 2 months, with a range of 4 months to 12 years 7 months. Six children had marked posseting as infants. Airway dynamics were assessed by flow volume loops. All except one had normal expiratory flow volume curves. Inspiratory abnormalities were detected in 7 children; 6 were assessed as having variable extrathoracic inspiratory obstructions and 1 had a fixed obstruction consistent with subglottic stenosis. The mean ratios of maximal inspiratory flow at 50% of vital capacity divided by forced vital capacity in the laryngomalacia and control groups differed significantly, as did the mean ratios of maximal expiratory flow to maximal inspiratory flow at 50% of forced vital capacity. Laryngomalacia is not necessarily a benign disorder of limited duration; there may be persisting inspiratory obstruction in later childhood.

Age Factors↗
PubMed1996

Respiratory findings in workers not exposed to air pollutants.

The prevalences of acute and chronic respiratory symptoms and lung function changes were studied in a group of 806 workers working in a "clean environment." Acute symptoms during the work shift were reported by smokers but were essentially absent in nonsmokers. Chronic respiratory-symptom prevalences were similar to those reported in community-based populations, with smokers experiencing more chronic symptoms than nonsmokers. Baseline lung function measurements indicated no significant differences with values obtained from prediction equations based on community populations. There were significant across-shift increases in all ventilatory capacity tests (forced vital capacity, 1-second forced expiratory volume, and maximum expiratory flow rates at 50% and the last 25% of the vital capacity) varying from +1.9% to +9.8% of the preshift values. Workers older than 40 years of age and those employed for more than 10 years had similar across-shift changes compared with younger workers and those with longer durations of employment. Our data indicate that workers in clean work environments (with the exception of smokers) complain of few acute or chronic respiratory symptoms and have normal lung function. These workers experience increases in lung function across the work shift, probably reflecting normal diurnal variation. Smokers, although significantly more affected than nonsmokers, do not appear to have work-related findings, and smoking appears to be the most significant risk factor for the development of lung disease in unexposed workers. In this study, community-based control data was equivalent to worker control data in unexposed workers.

Adolescent↗
PubMed1997

Nasal septum lesions and lung function in workers exposed to chromic acid in electroplating factories.

The objective of this study was to compare workers from chromium, nickel-chromium, and zinc electroplating factories with regards to nasal septum lesions and lung function. Also investigated was the relationship between chromium levels in air and urine. A total of 189 workers from 11 electroplating factories (three chromium, six nickel-chromium, two zinc) were chosen from central Taiwan. All subjects were interviewed by constructed-questionnaire, given a nasal examination by a certified otolaryngologist and a lung function test. In the chromium factories 30.8% of the workers showed evidence of nasal septum perforations and 38.5% showed evidence of nasal septum ulcers. A Mantel extension test for trend showed that workers in the chromium factories were 31.7 times more likely to experience nasal ulcers than nickel-chromium and zinc factory workers. Those who worked in the electroplating tank area were 4.2 times more likely to experience ulcers and those with over 9 years' experience were 30.8 times more likely. A comparison of lung function adjusted for age, gender and smoking habit among workers showed that vital capacity (VC), forced vital capacity (FVC), and forced expiratory volume in 1 s (FEV1) were all significantly decreased among chromium factory workers. Because the results showed that the workers' health is being severely damaged by the harmful environment of chromium electroplating factories, the authors wish to suggest improvements in the workplace are vitally needed to ensure the safety of the workers.

Adult↗
PubMed1993

Airway secretion clearance by mechanical exsufflation for post-poliomyelitis ventilator-assisted individuals.

Pulmonary complications from impaired airway secretion clearance mechanisms are major causes of morbidity and mortality for post-poliomyelitis individuals. The purpose of this study was to review the long-term use of manually assisted coughing and mechanical insufflation-exsufflation (MI-E) by post-poliomyelitis ventilator-assisted individuals (PVAIs) and to compare the peak cough expiratory flows (PCEF) created during unassisted and assisted coughing. Twenty-four PVAIs who have used noninvasive methods of ventilatory support for an average of 27 years, relied on methods of manually assisted coughing and/or MI-E without complications during intercurrent respiratory tract infections (RTIs). Nine of the 24 individuals were studied for PCEF. They had a mean forced vital capacity (FVC) of 0.54 +/- 0.47L and a mean maximum insufflation capacity achieved by air stacking of ventilator insufflations and glossopharyngeal breathing of 1.7L. The PCEF were as follows: unassisted, 1.78 +/- 1.16L/sec; following a maximum assisted insufflation, 3.75 +/- 0.73L/sec; with manual assistance by abdominal compression following a maximum assisted insufflation, 4.64 +/- 1.42L/sec; and with MI-E, 6.97 +/- 0.89L/sec. We conclude that manually assisted coughing and MI-E are effective and safe methods of airway secretion clearance for PVAIs with impaired expiratory muscle function who would otherwise be managed by endotracheal suctioning. Severely decreased maximum insufflation capacity but not vital capacity indicate need for a tracheostomy.

Aged↗
PubMed1993

Pulmonary function in symptom-free asthmatics.

Seventy-five adult asthmatic patients with clinical remission underwent spirometry. Only 8.3% of the subjects demonstrated normal spirometry. The others had reduced vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum mid-expiratory flow rate (MMF) and peak flow rate (PEFR). This study demonstrates that asthma can cause irreversible airflow obstruction and there is a poor relationship between symptoms in asthmatics and their respiratory function test results.

Adolescent↗
PubMed2006

The effect of intrathecal fentanyl added to hyperbaric bupivacaine on maternal respiratory function during Cesarean section.

BACKGROUND: Subarachnoid blockade with local anesthetics induces respiratory depression. Although the addition of fentanyl to bupivacaine has become popular in subarachnoid blockade for Cesarean section, there is no information on the effect of intrathecal fentanyl on maternal spirometric respiratory function in parturients undergoing Cesarean section. METHODS: We tested the effect of the addition of intrathecal fentanyl to hyperbaric bupivacaine on maternal spirometric performance in 40 consenting parturients undergoing Cesarean section. The parturients were randomized into two groups: those receiving 2.0 ml of hyperbaric bupivacaine 0.5% and 0.4 ml of saline intrathecally and those receiving 2.0 ml of hyperbaric bupivacaine and 0.4 ml of fentanyl (20 microg) intrathecally. We performed spirometry on arriving at the operation room and 15 min after subarachnoid blockade. RESULTS: Subarachnoid blockade with bupivacaine significantly decreased the peak expiratory flow rate, but did not induce significant changes in vital capacity and forced vital capacity. The addition of intrathecal fentanyl to bupivacaine improved the quality of subarachnoid blockade, but did not lead to a deterioration in respiratory function compared with intrathecal bupivacaine alone. CONCLUSIONS: The addition of intrathecal fentanyl to hyperbaric bupivacaine did not lead to a deterioration in maternal spirometric respiratory function in parturients undergoing Cesarean section.

Adult↗