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Contrasting patterns in in vitro fertilization pregnancy rates among fresh autologous, fresh oocyte donor, and cryopreserved cycles with the use of day 5 or day 6 blastocysts may reflect differences in embryo-endometrium synchrony.

OBJECTIVE: To compare the effect of day 5 and day 6 blastocyst transfers on patterns of implantation rates and pregnancy rates (PRs) among fresh autologous, oocyte donor, and frozen ET (FET) cycles. DESIGN: Retrospective study. SETTING: Private fertility center. PATIENT(S): The study included 377 fresh autologous cycles, 106 autologous FET cycles, and 56 fresh oocyte donor cycles. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Implantation rates and clinical PRs. RESULT(S): The clinical PR for day 5 blastocyst transfers was higher than for day 6 blastocyst transfers in fresh autologous cycles (PRs, 51.0% and 33.3%, respectively). However, there was no significant difference between transfers of blastocysts cryopreserved on day 5 and day 6 in FET cycles (PRs, 63.6% and 58.9%, respectively). Furthermore, day 6 blastocyst transfers significantly outperformed day 5 transfers in donor cycles (PRs, 63.0% and 86.2%, respectively), a reversal of the pattern seen in the fresh autologous cycles. Day 6 blastocysts were associated with a significantly greater PR in FET cycles than in fresh autologous cycles (58.9% and 33.3%, respectively). CONCLUSION(S): The superior PRs with day 5 blastocyst transfers in fresh autologous cycles and with day 6 blastocysts in donor cycles may have resulted from better synchrony with endometrial development. This was further supported by the superior performance of day 6 blastocysts in FET cycles relative to their fresh counterparts. Similar PRs with cryopreserved day 5 and day 6 blastocysts in FET cycles may reflect that, in these cycles, day 5 and day 6 blastocysts had equivalent quality and similar synchrony with the endometrium.

Adult↗

Coronary Artery Disease-Based Polygenic Risk Score in Early-Onset Acute Myocardial Infarction Subtypes.

BACKGROUND: The coronary artery disease-based polygenic risk score (PRS-CAD) estimates risk of acute myocardial infarction (AMI), but its performance across AMI subtypes in younger individuals, especially women, remains uncertain. OBJECTIVES: The authors assessed PRS-CAD's performance in AMI subtypes. METHODS: We included 2,079 AMI patients aged 18 to 55 years with a 2:1 female-to-male ratio from the VIRGO (Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction Patients) study and 3,761 controls from the MESA (Multi-Ethnic Study of Atherosclerosis) study. AMI subtypes were classified using the VIRGO taxonomy. We evaluated PRS-CAD's association with AMI subtypes using multinomial logistic regression and with 1-year outcomes in AMI subtypes using Cox regression. RESULTS: PRS-CAD was significantly associated with MI due to coronary artery disease (N = 1,876; OR: 1.82 per 1-SD increase; 95% CI: 1.67-1.97; P < 0.001) but not with MI with nonobstructive coronary artery disease (N = 188; OR: 1.13 per 1-SD increase; 95% CI: 0.96-1.34; P = 0.14). PRS-CAD's performance did not differ by sex. A 1-SD increase in PRS-CAD was associated with higher risk of 1-year hospitalization or death in patients with MI with nonobstructive coronary artery disease (HR: 1.50; 95% CI: 1.08-2.10; P = 0.02) but not in patients with MI due to coronary artery disease (HR: 0.98; 95% CI: 0.91-1.07; P = 0.67). CONCLUSIONS: PRS-CAD's association with AMI varied by subtype but not by sex in young adults, warranting caution in application.

acute myocardial infarction↗

Finite element modeling and intravascular ultrasound elastography of vulnerable plaques: parameter variation.

BACKGROUND AND GOAL: More than 60% of all myocardial infarction is caused by rupture of a vulnerable plaque. A vulnerable plaque can be described as a large, soft lipid pool covered by a thin fibrous cap. Plaque material composition, geometry, and inflammation caused by infiltration of macrophages are considered as major determinants for plaque rupture. For diagnostic purposes, these determinants may be obtained from elastograms (i.e. radial strain images), which are derived from intravascular ultrasound (IVUS) measurements. IVUS elastograms, however, cannot be interpreted directly as tissue component images, because radial strain depends upon plaque geometry, plaque material properties, and used catheter position. To understand and quantify the influence of these parameters upon measured IVUS elastograms, they were varied in a finite element model (FEM) that simulates IVUS elastograms of vulnerable plaques. MATERIALS AND METHODS: IVUS elastography measurements were performed on a vessel mimicking phantom, with a soft plaque embedded in a hard wall, and an atherosclerotic human coronary artery containing a vulnerable plaque. Next, FEMs were created to simulate IVUS elastograms of the same objects. In these FEMs the following parameters were varied: Young's modulus (E), Poisson's ratio (nu) in range 0.49-0.4999, catheter position (translation of 0.8 mm), and cap thickness (t) in range 50-350 microm. Hereby the resulting peak radial strain (PRS) was determined and visualized. RESULTS: Measured static E for phantom was 4.2 kPa for plaque and 16.8 kPa for wall. Variation of E-wall in range 8.4-33.2 kPa and/or E-plaque in range 2.1-8.4 kPa using the phantom FEM, gave a PRS variation of 1.6%, i.e. from 1.7% up to almost 3.3%; for variation in nu this was only 0.07%, i.e. from 2.37% up to 2.44%. Variation of E-lipid in range 6.25-400 kPa and E-cap in range 700-2300 kPa using the artery FEM, gave a PRS variation of 3.1%, i.e. from 0.6% up to 3.7%. The PRS was higher for lower E-lipid and E-cap; it was located at a shoulder of the lipid pool. Variation of nu gave only a variation of 0.17%. Variation of t and E-cap resulted in a PRS variation of 1.4%, i.e. from 0.3% up to 1.7%; thinner and weaker caps gave higher PRS. Catheter position variation changed radial strain value. CONCLUSIONS: Measured IVUS elastograms of vulnerable plaques depend highly upon the Young's modulus of lipid and cap, but not upon the Poisson's ratio. Different catheter positions result in different IVUS elastograms, but the diagnostically important high strain regions at the lipid shoulders are often still detectable. PRS increases when cap weakens or cap thickness decreases.

Arteriosclerosis↗

Diabetes mellitus polygenic risk scores: heterogeneity and clinical translation.

Diabetes mellitus encompasses several disorders, each with differing clinical presentation, prognoses and pathophysiology. Distinct polygenic architectures underlie type 1 diabetes mellitus and type 2 diabetes mellitus, and govern numerous pathophysiological pathways that converge on dysglycaemia. Over the previous decade, polygenic risk scores (PRS) derived from large genome-wide association studies have become broadly recognized for their potential in precision medicine. PRS, and now partitioned polygenic scores generated by clustering of risk variants, can quantify individual genetic predisposition to diabetes mellitus and reveal molecular heterogeneity responsible for variation in clinical presentation and prognoses. In this Review, we examine and contrast progress in the development of type 1 diabetes mellitus PRS and type 2 diabetes mellitus PRS, and discuss paths to further methodological advances. We examine how studies in the past 10&#x2009;years have harnessed PRS and novel partitioned polygenic scores to reveal insights into diabetes mellitus aetiology and characterize changes in cellular and tissue-specific disease-modifying molecular pathways. Additionally, we discuss advances and opportunities in areas of clinical translation, including improved classification of diabetes mellitus type, screening of those at risk and personalized interventions informed by PRS. Finally, we emphasize the urgent need to overcome ancestry-related challenges and highlight current progress and gaps in ensuring the equitable translation of PRS for diabetes mellitus precision medicine.

Humans↗

A progestin antagonist blocks vaginocervical stimulation-induced fos expression in neurones containing progestin receptors in the rostral medial preoptic area.

Vaginocervical stimulation (VCS) has a variety of effects on the brain, physiology and behaviour. Previous work demonstrated that a progestin antagonist blocked neuronal response to VCS (i.e. Fos expression) in the absence of progesterone in some neurones, and suggested that some of the effects of VCS on the brain are mediated by ligand-independent activation of progestin receptors (PRs). Although it had been reported previously that some of the cells in which VCS induces Fos expression also contain PRs, it had not been determined if a progestin antagonist blocked Fos expression in these particular neurones. The purpose of this experiment was to determine if a progestin antagonist decreases Fos expression specifically in cells that also express PRs in the preoptic area and ventromedial hypothalamus. As has been shown previously, VCS increased Fos-immunoreactive (ir) expression in the particular areas studied. In the rostral medial preoptic area, VCS increased Fos expression in cells that coexpressed PRs, as well as in cells that do not. However, in the caudal medial preoptic area, VCS only increased Fos expression in cells that did not coexpress PRs. Injection of the progestin antagonist, RU 486, decreased Fos expression in the rostral, but not caudal medial preoptic area, and it decreased Fos expression only in cells that coexpressed PR-ir. In contrast to a previous report, in the present study, the progestin antagonist did not inhibit VCS-induced Fos expression in the ventromedial hypothalamic area. The results of this experiment suggest that the progestin antagonist inhibits VCS-induced Fos expression in some neurones by blocking PRs, and they provide further support for the idea that VCS influences neuronal response in some cells by ligand-independent activation of PRs in those cells.

Animals↗

Psychiatric Polygenic Risk Scores and Week-by-Week Symptomatic Status in Youth with Bipolar Disorder: An Exploratory Study.

Introduction: Prior studies have demonstrated that, in both adults and youth, bipolar disorder (BD) is a polygenic illness. However, no studies have examined polygenic risk scores (PRSs) in relation to the longitudinal course of mood symptoms in youth with BD. Methods: This study included 246 youth of European ancestry with BD (7-20 years old at intake) from the Course and Outcome of Bipolar Youth study and Centre for Youth Bipolar Disorder. Mood symptom severity was assessed at intake and, for 168 participants, prospectively for a median of 8.7 years. PRSs for BD, schizophrenia (SCZ), major depressive disorder (MDD), and attention-deficit/hyperactivity disorder (ADHD) were constructed using genome-wide summary statistics from independent adult cohorts. Results: Higher BD-PRS was significantly associated with lower most severe lifetime depression score at intake (&#x3b2; = -0.14, p = 0.03). Higher SCZ-PRS and MDD-PRS were associated with significantly less time spent in euthymia (SCZ-PRS: &#x3b2; = -0.21, p = 0.02; MDD-PRS: &#x3b2; = -0.22, p = 0.01) and more time with any subsyndromal mood symptoms (i.e., any mania, mixed, or depression symptoms; SCZ-PRS: &#x3b2; = 0.15, p = 0.04; MDD-PRS: &#x3b2; = 0.17, p = 0.01) during follow-up. PRSs for BD and ADHD were not significantly associated with any longitudinal mood variable. Conclusions: This exploratory analysis was the first to examine psychiatric PRSs in relation to the prospective course of mood symptoms among youth with BD. Results from the current study can serve to guide future youth BD studies with larger sample sizes on this topic.

Humans↗

The expected polygenic risk score (ePRS) framework: an equitable metric for quantifying polygenetic risk via modeling of ancestral makeup.

Polygenic risk scores (PRSs) depend on genetic ancestry due to differences in allele frequencies between ancestral populations. This leads to implementation challenges in diverse populations. We propose a framework to calibrate PRS based on ancestral makeup. We define a metric called "expected PRS" (ePRS), the expected value of a PRS based on one's global or local admixture patterns. We further define the "residual PRS" (rPRS), measuring the deviation of the PRS from the ePRS. Simulation studies confirm that it suffices to adjust for ePRS to obtain nearly unbiased estimates of the PRS-outcome association without further adjusting for PCs. Using the TOPMed dataset, the estimated effect size of the rPRS adjusting for the ePRS is similar to the estimated effect of the PRS adjusting for genetic PCs. Similarly, we applied the ePRS framework to six cardiovascular-related traits in the All of Us dataset, and the results are consistent with those from the TOPMed analysis. The ePRS framework can protect from population stratification in association analysis and provide an equitable strategy to quantify genetic risk across diverse populations.

Journal Article↗

A gene (prsA) of Bacillus subtilis involved in a novel, late stage of protein export.

A gene locus of Bacillus subtilis identified by mutations (prs) conferring a defect in protein secretion was cloned from a lambdaGEM-11 expression library. The sites of three closely linked prs mutations (prs-3, prs-29 and prs-40) were found to reside in a 5.3 kb DNA fragment, which also complemented the secretion defect in prs-3 and prs-29 mutants. Partial sequencing of the fragment showed that these three mutations affect one distinct gene (prsA) encoding a putative protein of 292 amino acids (33 kDa). Sequence analysis indicated the PrsA protein to be a lipoprotein located outside the cytoplasmic membrane. Thirty percent identity was shown to the PrtM protein of Lactococcus lactis, which is involved in the maturation of an exported proteinase. The phenotypes of prsA mutants and the structural similarity of PrsA with PrtM suggest that PrsA may have a novel function at a late phase in protein export.

Amino Acid Sequence↗

Use of polyvalent coagglutination reagents for serotyping of Streptococcus suis.

Polyvalent coagglutination reagents (PRs) have been evaluated for the serotyping of Streptococcus suis. Monovalent antisera produced against 28 S. suis reference strains have been grouped to obtain five different pools. A total of 249 field isolates previously identified and belonging to different serotypes were tested with PRs prepared by two different procedures: (i) monovalent coagglutination reagents were individually prepared and mixed in equal proportions, and (ii) antisera were mixed in equal proportions before the addition of the Staphylococcus aureus suspension. Only antisera tested by a tube agglutination test with 2-mercaptoethanol and presenting titers of 1:32 or higher were used. Results obtained with PRs prepared by both procedures were similar, and there was a very good correlation between the capsular type of the isolate and the reaction obtained with PRs. Thus, from a practical viewpoint, it is suggested that PRs be prepared by the first procedure. To isolates, were tested in parallel with both the PRs and the monovalent coagglutination reagents over a 1-year period. Ninety-nine percent of the typeable and all of the untypeable isolates were correctly identified. Serotyping with PRs is suggested to be a very useful and reliable screening procedure, particularly when a large number of S. suis isolates have to be serotyped. In addition, the choice of antisera to be included in a given pool is facultative and should be oriented to the needs of a region or a country.

Agglutination Tests↗

Hypertrophic cardiomyopathy: a genome-wide association meta-analysis and polygenic risk score.

BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a heritable trait with marked variability in expression and outcomes. Our aims were to discover new genetic loci associated with HCM and to test the effect of a new polygenic risk score (PRS) on incidence, phenotype and outcomes stratified by genotype status. METHODS: A discovery genome-wide association study (GWAS) was performed on 2284 HCM cases and 4525 controls. Two fixed-effects meta-analyses combined our discovery GWAS with single-trait and multi-trait results from a published study. Discovered loci underwent comprehensive bioinformatic analysis including functional and druggability annotations. A PRS using loci from the two meta-analyses was evaluated for association with HCM diagnosis in 411&#x2009;213 individuals from UK Biobank (UKBB); imaging phenotypes in individuals without HCM; a composite endpoint (including all-cause mortality and transplantation); and sudden cardiac death (SCD) in 1756 HCM cases. PRS analyses were stratified by genotype status. RESULTS: Three loci were found in the discovery GWAS (BAG3, FHOD3 and novel locus PPP1R3A). In the meta-analyses, 70 unique loci were identified, four novel (MYPN, YWHAE, NOS1AP and OBSCN). Bioinformatic analyses identified NOS1AP as a candidate HCM gene. A new PRS was significantly associated with HCM diagnosis (HR=3.19, 95%&#x2009;CI 2.46 to 4.14 for top 5% vs lower 95%; HR=1.88, 95%&#x2009;CI 1.72 to 2.06 per SD increase). Significant associations were found between PRS and greater left ventricular (LV) wall thickness and higher LV ejection fraction in UKBB participants without HCM. Genotype-negative HCM cases in the top 20% of the PRS distribution had an increased risk of SCD (HR=2.72, 95%&#x2009;CI 1.03 to 7.17). CONCLUSIONS: We report novel HCM loci. A new PRS predicted the risk of HCM development and associated imaging characteristics in the UKBB and outcomes in an HCM cohort.

Cardiomyopathies↗

Hormonal control of plasma renin substrate; (angiotensinogen).

The effect of ethinyl estradiol (EE2) and dexamethasone (Dex) upon plasma renin substrate (PRS) was studied in rats in relation to sexual maturation and pituitary function. Normal adult rats had large increases in PRS when given either EE2 or Dex. Prepubescent (25-day-old) rats also had a substantial increase in PRS following Dex, but no increase in PRS after EE2. In adult rats, hypophysectomy prevented the rise in PRS due to EE2 but did not prevent the increase in PRS due to Dex. Hepatic estrogen and glucocorticoid receptors were measured in immature and adult rats. Immature rats had markedly reduced concentration of hepatic estrogen receptors (16%), compared with adults. In contrast, glucocorticoid receptor concentration was not significantly different between immature and adult rats. The results indicate that the effect of estrogens and glucocorticoids upon PRS are mediated by pathways that are separable at the hormone receptor level.

Adrenalectomy↗

Influence of adrenal enucleation of plasma renin substrate concentration in saline loaded and unilaterally nephroadrenalectomized rats.

The influence of adrenal enucleation on plasma renin substate (PRS) concentration was investigated by comparison with sham operation (control) or adrenalectomy in unilaterally nephroadrenalectomized rats given 1% saline for drinking. Two days after adrenal enculeation or adrenalectomy, a significant increase in plasma renin activity (PRA), with a concomitant decrease in PRS, was observed. Those changes were less pronounced in adrenal enucleated rats than in adrenalectomized ones. Ten days later PRA markedly decreased to the control level in both groups. PRS rose to the control level at 10 days after adrenal enucleation without increasing further, while that in the adrenalectomized rats remained low as before. These results suggest that the fall in PRS occuring immediately after adrenal enucleation may be due both to enhanced PRS consumption resulting from increased PRA and to diminished PRS production caused by corticosteroid deficiency, and that restoration of corticosterone secretion by the enucleated adrenal gland may account for recovery of PRS.

Adrenal Glands↗

Effect of the catecholestrogen 2-hydroxyestradiol on the renin-angiotensin system in the rat.

The effects of the catecholestrogen 2-hydroxyestradiol (250 and 500 micrograms/day, each for 7 days) on plasma renin substrate (PRS), activity (PRA) and concentration (PRC) were studied in male rats as compared with those of estradiol (250 micrograms/day, for 7 days) and vehicle alone (for 7 days). Pre-treatment levels of PRS, PRA, PRC and the PRA/PRC ratio were similar in four groups. After vehicle treatment, PRS, PRA, PRC and the PRA/PRC ratio remained unchanged. Estradiol treatment, however, produced an increase in PRS, an increase in PRA but no change in PRC. The PRA/PRC ratio after estradiol treatment was high. On the other hand, 2-hydroxyestradiol treatment caused no increase in PRS at a daily dose of 250 micrograms and a slight but significant increase in PRS at a daily dose of 500 micrograms. This treatment also produced increases in PRA as well as PRC at the two daily doses. These increases in PRA and PRC tended to be higher at a daily dose of 500 micrograms than at a daily dose of 250 micrograms. The PRA/PRC ratios after 2-hydroxyestradiol treatment were unaltered at the two daily doses. It is concluded that, while 2-hydroxyestradiol is less active in increasing PRS than estradiol, the compound is capable of increasing PRC.

Angiotensinogen↗

Fractions of Percoll eliminated sperm: increased sperm yield in percoll wash.

Sperm preparation by Percoll is one of the most widely used techniques, but it has the disadvantage of producing a low final yield of motile sperm. This study compared the quality of Percoll-eliminated sperm with that of Percoll recovered sperm to determine if the profile of the Percoll preparation could be improved. Semen specimens were fractionated by discontinuous Percoll gradient column. This resulted in 4 sperm fractions: sperm retained in the semen (SRS), sperm clumped at the interface of 40 and 80% Percoll (SCI), sperm scattered in the column (SSC), and sperm-forming pellet, called Percoll-recovered sperm (PRS). The sperm fractions were evaluated for count, motility, viability, vitality, and morphology. The SRS exhibited the lowest motility, viability, and vitality (40, 68, and 64%, respectively), which were significantly different from those of SCI, SSC, and PRS. The motility, viability, and vitality differences between SSC and PRS did not reach a statistically significant level. Good motility (grades a and b) was found in SSC (73%) when compared with that of PRS (82%). The lower part of SSC and PRS exhibited identical sperm morphology. The Percoll sperm recovery was 18%, but if SSC is combined with PRS, the total recovery becomes 40%. These data suggest that the SSC fraction, particularly the lower part, which maintains the physical contact with the PRS, can be pooled together to increase the final sperm yield without compromising the quality of the sperm to be used for insemination.

Cell Survival↗

On the pathogenesis of cleft palate in the Pierre Robin syndrome.

In a series of Pierre Robin syndrome (PRS) and isolated cleft palate patients (ICP) both U- and V-formed clefts were observed with equal frequency, but the PRS clefts were in average slightly wider. There were totally submucous clefts among the PRS patients. There was no statistical difference between the groups in the prevalence of clefts in the relatives of the patients. The incidence of (genetically influenced) conical elevations in the lower lip was lowest in the noncleft subjects, high in ICP and highest in PRS children. The incidence of hypodontia, which acceptedly is genetically influenced, was also highest in the PRS group. Thus the foetal malposition with the tongue between the palatal shelves does not seem to play any decisive role in the pathogenesis of most PRS clefts. The cause for the PRS is more likely a genetically influenced growth disturbance in the maxilla and the mandible, which due to the organogenetic differences leads to diverging end results, micrognathia and cleft.

Anodontia↗

Stereotactic interstitial radiosurgery for cerebral metastases.

OBJECT: The Photon Radiosurgery System (PRS) is a miniature x-ray generator that can stereotactically irradiate intracranial tumors by using low-energy photons. Treatment with the PRS typically occurs in conjunction with stereotactic biopsy, thereby providing diagnosis and treatment in one procedure. The authors review the treatment of patients with brain metastases with the aid of the PRS and discuss the indications, advantages, and limitations of this technique. METHODS: Clinical characteristics, treatment parameters, neuroimaging-confirmed outcome, and survival were reviewed in all patients with histologically verified brain metastases who were treated with the PRS at the Massachusetts General Hospital between December 1992 and November 2000. Local control of lesions was defined as either stabilization or diminution in the size of the treated tumor as confirmed by Gd-enhanced magnetic resonance imaging. Between December 1992 and November 2000, 72 intracranial metastatic lesions in 60 patients were treated with the PRS. Primary tumors included lung (33 patients), melanoma (15 patients), renal cell (five patients), breast (two patients), esophageal (two patients), colon (one patient), and Merkle cell (one patient) cancers, and malignant fibrous histiocytoma (one patient). Supratentorial metastases were distributed throughout the cerebrum, with only one cerebellar metastasis. The lesions ranged in diameter from 6 to 40 mm and were treated with a minimal peripheral dose of 16 Gy (range 10-20 Gy). At the last follow-up examination (median 6 months), local disease control had been achieved in 48 (81%) of 59 tumors. An actuarial analysis demonstrated that the survival rates at 6 and 12 months were 63 and 34%, respectively. Patients with a single brain metastasis survived a mean of 11 months. Complications included four patients with postoperative seizures, three with symptomatic cerebral edema, two with hemorrhagic events, and three with symptomatic radiation necrosis requiring surgery. CONCLUSIONS: Stereotactic interstitial radiosurgery performed using the PRS can obtain local control of cerebral metastases at rates that are comparable to those achieved through open resection and external stereotactic radiosurgery. The major advantage of using the PRS is that effective treatment can be accomplished at the time of stereotactic biopsy.

Adolescent↗

Validation of a genome-wide polygenic score for body mass index in South Asians.

Obesity is a complex disorder, manifested by the interaction of inherited and environmental factors and modulated by a person's lifestyle habits. India has witnessed more than a two-fold increase in the number of overweight adults in the last 30 years. The polygenic risk score (PRS) quantitatively measures an individual's risk for common diseases. The PRS for obesity have been validated in the Caucasian population but not in the South Asian (SAS) population. In this study, we benchmarked and validated the existing genome-wide PRS model of obesity with 2.1 million variants in the SAS population. We analyzed a total of 14,263 individuals from three different South Asian cohorts. We compared the risk score with the body mass index (BMI) categories (underweight, normal weight, overweight, and obese) in all three cohorts. High PRS was associated with increased BMI in all the three cohorts. This study also compared validation results from another population-specific PRS model for the BMI. We conclude that high PRS is associated with high BMI in South Asians. Our study suggests that the PRS score can perhaps be an early predictor of overweight and obesity in the South Asian population.

South Asian↗

[Measurement and clinical use of recoil pressure of the respiratory system].

Using the principle that the difference of MIP (maximal inspiratory mouth pressure) between RV (residual volume) and FRC (functional residual capacity) equals Prs (recoil pressure of the respiratory system) at RV, we performed the measurement of Prs at RV in 20 normal subjects, 90 patients with COPD (chronic obstructive pulmonary disease) and 15 patients with ILF (interstitial lung fibrosis). We also performed the correlation analysis of Prs at RV and RV/TLC (total lung capacity) %. The results indicated the Prs values at RV (-2.8 +/- 0.5 kPa) in normal subjects measured in this manner was in accord with the values reported by other authors abroad. The Prs in patients with emphysema decreased and it was highly and negatively correlated with RV/TLC% (r = -0.872), but the Prs in patients with ILF was increased. The results suggest that this method for measurement of Prs is simple, reliable, and clinically useful.

Aged↗