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PubMed1977

Pulmonary function in former alcoholics.

Pulmonary function was evaluated in 44 former alcoholics (abstinence, 0.5 to 32 years) without cardiac or specific pulmonary disease. All were members of Alcoholics Anonymous. Fourteen subjects (32 percent) were non-smokers, ex-smokers, and cigar or pipe smokers, yet 28 subjects (64 percent) had abnormal expiratory flow rates, and 17 (39 percent) had an elevated value for the ratio of the residual volume to the total lung capacity. Single-breath diffusing capacity was abnormal in seven subjects (16 percent). Of interest was the high incidence (77 percent) of obstructive phenomena among the women. This high incidence of abnormalities among both the men and women could not be attributed to previous pulmonary infection or smoking. Comparison of these patients with chronic alcoholics suggests that the obstructive component in these patients is, in part, a result of their past alcoholic intake and that it is not reversed by abstinence. On the other hand, the impairment in diffusion, which was so common in alcoholics, appears to be reversible with sobriety.

Adult↗
PubMed1994

Maximal inspiratory pressure following endurance training at altitude.

Effects of endurance training on maximal inspiratory pressure and fatigue were evaluated after 5 weeks. Twelve male and 9 female untrained subjects were matched in the three groups for sex and maximal oxygen uptake (VO2 max). Training was performed at 70% VO2max; 45 min day-1; 5 days week-1 (n = 7); and at the same relative (n = 7) and absolute (n = 7) work loads in a pressure chamber corresponding to 2500 m (560 mmHg). Work load was increased every week to maintain the training heart rate. Maximal respiratory pressure was measured at the mouth before and 30, 60 and 120 s after maximal exercise. With no significant difference between the three groups of subjects, VO2max increased from 2.96 (1.98-4.47) (median and range for 21 subjects) to 3.33 (2.50-4.72) 1 min-1 (p < 0.001) and ventilation (VE max) from 109 (57-147) to 123 (73-148) 1 min-1 (p < 0.001), while maximal heart rate decreased from 193 (180-211) to 192 (169-207) beats min-1 (p < 0.01). Maximal inspiratory pressure (87 (56-115) mmHg), inspiratory muscle fatigue (18 (-2-43)%, p < 0.001), and arterial oxygen tension during exercise (12.4 (9.9-15.6)kPa) were similar before and after training. The results demonstrate that training at simulated altitude at 2500 m does not increase VE max or VO2 max above the increases obtained from training at sea level. Furthermore, VEmax and VO2 max increased approximately 13% despite unchanged maximal inspiratory pressure and inspiratory muscle fatigue.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1999

Does the cellular bronchoalveolar lavage fluid profile reflect the severity of sarcoidosis?

The aim of this study was to assess whether the cellular bronchoalveolar lavage fluid (BALF) profile, particularly the number of polymorphonuclear neutrophils (PMNs), is associated with disease severity of sarcoidosis and its usefulness in determining remission. Twenty-six nonsmoking outpatients with sarcoidosis were included in this study. The patients were divided into two subgroups according to the absolute number of PMNs in BALF: < or =0.2x10(4) cells x mL(-1) (group 1; n = 15) and >0.2x10(4) cells x mL(-1) (group 2; n = 11). The radiographic stage, high-resolution computed tomography (HRCT) findings, 67Ga lung uptake as well as lung function tests differed significantly between group 1 and 2. Follow-up revealed that 14 (93.3%) patients of group 1 compared to four (36.4%) of group 2 recovered spontaneously without the help of corticosteroids. In contrast, no differences were found in the number of lymphocytes in BALF nor in the serum angiotensin converting enzyme (sACE) level between both groups. The number of PMNs, the transfer factor of the lungs for carbon monoxide (TL,CO), the forced expiratory volume in one second (FEV1) and one of the HRCT subscores discriminated between patients with different disease progression. Of these parameters the PMNs appeared to be the only one which differentiated patients who demonstrated remission and those who deteriorated. In conclusion, these results indicate that the number of polymorphonuclear neutrophils in bronchoalveolar lavage fluid distinguish between sarcoidosis patients who demonstrated remission and those having a more severe course of the disease. Whether polymorphonuclear neutrophils may be considered as markers of disease activity and/or prognosis in sarcoidosis needs further investigation.

Adult↗
PubMed1990

Relation of amiodarone hepatic and pulmonary toxicity to serum drug concentrations and superoxide dismutase activity.

Hepatic enzymes, pulmonary function, serum amiodarone and desethylamiodarone (DEA) concentrations and erythrocyte superoxide dismutase (SOD) activity were monitored at regular intervals for 1 year in 30 patients receiving amiodarone. Subclinical hepatotoxicity developed in 5 patients. These patients had higher baseline alanine transaminase values (42.6 +/- 6.8 vs 22.9 +/- 1.8 U/liter) and had an increase in serum aspartate transaminase from 27 +/- 4.1 at baseline to 147 +/- 77.3 U/liter at 12 months. The other patients had little variation in aspartate transaminase. Six patients with normal baseline carbon monoxide diffusing capacity had subclinical pulmonary toxicity develop with a mean decrease in diffusing capacity to 0.7 +/- 0.05 of the baseline value, which correlated with decreasing erythrocyte SOD activity. Mean carbon monoxide diffusing capacity and SOD activity remained unchanged in the other patients. The mechanisms of hepatic and pulmonary injury remain unknown, but appear to be associated with exposure to higher total serum concentrations of amiodarone plus DEA. Patients who had hepatic and/or pulmonary abnormalities develop received higher doses of amiodarone (440 +/- 27 vs 340 +/- 18 mg/day), but also had a higher amiodarone:DEA ratio suggesting that dose-dependent kinetics contributed to the higher concentrations. Elevated baseline alanine transaminase may indicate increased risk for hepatotoxicity while a progressive decrease in erythrocyte SOD may be an early indication of pulmonary toxicity. The latter finding indicates a need to investigate the role of free radicals in the pathogenesis of amiodarone pulmonary toxicity.

Alanine Transaminase↗
PubMed1977

[Sports and breathing (author's transl)].

The effect of physical training on pulmonary function and the changes in pulmonary parameters during physical exertion is described. Respiratory mechanics, vital capacity, forced expiratory volume and related variables are of less importance in judging the state of physical fitness and training condition. On the other hand, ventilation, respiratory gas exchange and regulation of breathing are important. Continuous analysis of alveolar and arterial partial pressures of gas and measurement of diffusion capacity may improve the assessment of the exercise test and physical fitness. Regular physical training may be of increasing significance for the rehabilitation of patients with chronic lung diseases.

Humans↗
PubMed1977

Comparison of different kinds of tests in the evaluation of lung function among healthy smokers and nonsmokers.

The following groups of lung function tests were performed on 25 healthy male smokers and 25 healthy male nonsmokers. 1) Dynamic function tests: PEF, MMEF, and FEV1/FVC %. 2) Static lung volumes: VC, TLC, FRC, FRC/TLC, and RV/TLC. 3) deltaPco2 was used as a measure of ventilation-perfusion inequalities 4) diffusing capacity was measured with the steady state method described by Filley and coworkers. 5) The blood THb and Tbv were measured. One-way analysis of variance showed that PEF, FEV1/FVC %, and MMEF% were lower (p less than 0.05) in the smoking group. Smokers did not differ from nonsmokers with respect to lung volumes. deltaPco2, THb, and TBV were higher and diffusing capacity lower in the smoking group (p less than 0.001).

Adult↗
PubMed1978

Impairment of pulmonary function in acute pancreatitis.

Arterial blood gas levels, lung volumes, and diffusing properties for carbon monoxide were measured in 22 patients with uncomplicated acute pancreatitis who had no clinical or radiographic evidence of pulmonary involvement. Mild arterial hypoxemia (less than 75 mm Hg) was present in four patients. The mean values of inspiratory lung volumes were clearly reduced, and the diffusing properties were sharply altered; the mean value for the diffusing capacity of carbon monoxide per unit of lung volume (Krogh's constant [KCO]) was 78 percent of predicted. Four patients with a low KCO in the first four days after an acute episode had normal values when reevaluated one week later. These findings suggest the occurrence, even in mild acute pancreatitis, of transient pulmonary injury mainly localized at the level of the capillaries, leading to decreased gas transfer.

Acute Disease↗
PubMed1992

Impairment of lung diffusion capacity in Schönlein-Henoch purpura.

Twenty-nine children with typical Schönlein-Henoch purpura (SHP) were tested at the initial phase of the disease for respiratory function. Of the 29 patients, 28 had a decrease of lung transfer for carbon monoxide (TLCO) as measured by a steady-state method. Lung volumes and blood gas values were normal; slight radiologic signs of interstitial lung involvement were observed in 18 of 26 patients. There was a decrease in TLCO to 56.8% of normal values for height and gender and to 58.5% when normal values were volume-adjusted to functional residual capacity. In 19 of 25 patients, TLCO measurements were performed at 3-month intervals during follow-up. In all cases, normalization of TLCO values was observed only after complete clinical recovery from SHP. All children with persisting symptoms, even limited to microscopic hematuria or slight proteinuria, had low TLCO values. In one patient low TLCO during follow-up preceded a late relapse of SHP in the form of acute nephritic disease with characteristic IgA deposits on renal biopsy. We conclude that low TLCO in SHP is probably related to alteration of the alveolar-capillary membrane by circulating immune complexes. This noninvasive technique may be useful in diagnosis, and during the follow-up of the disease as an early indicator of reactivation.

Carbon Monoxide↗
PubMed1984

Factors affecting expired waveform for carbon monoxide.

We previously presented a method based on a computer lung model for determining the distribution of both specific ventilation and specific diffusing capacity. These argon and carbon monoxide (CO) washin and washout studies were obtained in 12 normal subjects and 24 patients with varying degrees of obstructive lung disease. In addition to end-tidal and mixed expired gas concentrations, the expired waveform for both gases was sampled. In patients we found that this method failed to adequately describe CO dynamics during the early part of expiration; predicted concentrations were higher than actual data. Modifications of the original model that satisfy all data are presented. This new model suggests that CO uptake occurs in spaces with ventilatory properties of dead space. The accuracy and reliability of these observations were established by computer simulation studies as well as by repeated testing in one subject. These proved to be highly reproducible over a period of 5 mo. Standard parameter sensitivity tests showed parameters to vary by less than 10% and to be stable even when realistic levels of noise were added to the data. We conclude that studies involving ventilation of insoluble gases are insufficient to describe gas exchange in the lung. The addition of an exchangeable gas adds significant understanding of lung function, particularly in disease.

Adult↗
PubMed1979

Pulmonary function testing in horses.

Pulmonary function tests in horses are in the early stages of development and there will be a limit in the range of tests available since those requiring patient cooperation cannot be conducted in animals. Some tests such as blood gas analysis, A-aDo2 and delta Ppl measurements could presently be used to a greater extent under field conditions. Others that require expensive equipment and considerable technical assistance will be limited to the larger referral type veterinary clinics until the time is reached when there is adequate information to select those procedures that give a reasonable cost to benefit ratio to make their use more widespread.

Animals↗
PubMed1976

Effect of inspired volume on closing volume.

Closing volume (CV) was ?EASURED WITH THE RESIDENT GAS TECHNIQUE IN 12 HEALTHY SEATED SUBJECTS AGE 22-70 YR, AND IN 8 SUBJECTS WITH THE BOLUS TECHNIQUE. Various volumes were inspired (Vi range: 20-100% vital capacity) from residual volume and CV was assessed on the subsequent recording of expired volume versus gas concentration. The results indicate that the resident gas technique may erroneously underestimate CV at reduced Vi in conformity with calculations which predict that during expiration, after a certain reduced VI, the nitrogen concentration is identical in the most basal lung region and at the mouth. CV obtained with the bolus technique decreased linearly with reduced Vi and the effect appeared to be age dependent according to the equation CV50/CV100=0.0078 X age +1.18, where CV50 and CV100 denote the bolus CV corresponding to Vi=50% and 100% of vital capacity. Therefore, in older subjects, during tidal breathing, airways appear to close at substantially lower lung volume than previously considered.

Adult↗