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Sample records for preoperative pulmonary function

  1. Clinical value of CT-based preoperative software assisted lung lobe volumetry for predicting postoperative pulmonary function after lung surgery

    NASA Astrophysics Data System (ADS)

    Wormanns, Dag; Beyer, Florian; Hoffknecht, Petra; Dicken, Volker; Kuhnigk, Jan-Martin; Lange, Tobias; Thomas, Michael; Heindel, Walter

    2005-04-01

    This study was aimed to evaluate a morphology-based approach for prediction of postoperative forced expiratory volume in one second (FEV1) after lung resection from preoperative CT scans. Fifteen Patients with surgically treated (lobectomy or pneumonectomy) bronchogenic carcinoma were enrolled in the study. A preoperative chest CT and pulmonary function tests before and after surgery were performed. CT scans were analyzed by prototype software: automated segmentation and volumetry of lung lobes was performed with minimal user interaction. Determined volumes of different lung lobes were used to predict postoperative FEV1 as percentage of the preoperative values. Predicted FEV1 values were compared to the observed postoperative values as standard of reference. Patients underwent lobectomy in twelve cases (6 upper lobes; 1 middle lobe; 5 lower lobes; 6 right side; 6 left side) and pneumonectomy in three cases. Automated calculation of predicted postoperative lung function was successful in all cases. Predicted FEV1 ranged from 54% to 95% (mean 75% +/- 11%) of the preoperative values. Two cases with obviously erroneous LFT were excluded from analysis. Mean error of predicted FEV1 was 20 +/- 160 ml, indicating absence of systematic error; mean absolute error was 7.4 +/- 3.3% respective 137 +/- 77 ml/s. The 200 ml reproducibility criterion for FEV1 was met in 11 of 13 cases (85%). In conclusion, software-assisted prediction of postoperative lung function yielded a clinically acceptable agreement with the observed postoperative values. This method might add useful information for evaluation of functional operability of patients with lung cancer.

  2. Pulmonary function tests in the preoperative evaluation of lung cancer surgery candidates. A review of guidelines

    PubMed Central

    Skoczyński, Szymon; Pierzchała, Władysław

    2014-01-01

    Before planned surgical treatment of lung cancer, the patient's respiratory system function should be evaluated. According to the current guidelines, the assessment should start with measurements of FEV1 (forced expiratory volume in 1 second) and DLco (carbon monoxide lung diffusion capacity). Pneumonectomy is possible when FEV1 and DLco are > 80% of the predicted value (p.v.). If either of these parameters is < 80%, an exercise test with VO2 max (oxygen consumption during maximal exercise) measurement should be performed. When VO2 max is < 35 % p.v. or < 10 ml/kg/min, resection is associated with high risk. If VO2 max is in the range of 35-75% p.v. or 10-20 ml/kg/min, the postoperative values of FEV1 and DLco (ppoFEV1, ppoDLco) should be determined. The exercise test with VO2 max measurement may be replaced with other tests such as the shuttle walk test and the stair climbing test. The distance covered during the shuttle walk test should be > 400 m. Patients considered for lobectomy should be able to climb 3 flights of stairs (12 m) and for pneumonectomy 5 flights of stairs (22 m). PMID:26336435

  3. Pre-operative optimisation of lung function

    PubMed Central

    Azhar, Naheed

    2015-01-01

    The anaesthetic management of patients with pre-existing pulmonary disease is a challenging task. It is associated with increased morbidity in the form of post-operative pulmonary complications. Pre-operative optimisation of lung function helps in reducing these complications. Patients are advised to stop smoking for a period of 4–6 weeks. This reduces airway reactivity, improves mucociliary function and decreases carboxy-haemoglobin. The widely used incentive spirometry may be useful only when combined with other respiratory muscle exercises. Volume-based inspiratory devices have the best results. Pharmacotherapy of asthma and chronic obstructive pulmonary disease must be optimised before considering the patient for elective surgery. Beta 2 agonists, inhaled corticosteroids and systemic corticosteroids, are the main drugs used for this and several drugs play an adjunctive role in medical therapy. A graded approach has been suggested to manage these patients for elective surgery with an aim to achieve optimal pulmonary function. PMID:26556913

  4. Pulmonary Function Tests

    PubMed Central

    Ranu, Harpreet; Wilde, Michael; Madden, Brendan

    2011-01-01

    Pulmonary function tests are valuable investigations in the management of patients with suspected or previously diagnosed respiratory disease. They aid diagnosis, help monitor response to treatment and can guide decisions regarding further treatment and intervention. The interpretation of pulmonary functions tests requires knowledge of respiratory physiology. In this review we describe investigations routinely used and discuss their clinical implications. PMID:22347750

  5. Pulmonary function tests

    MedlinePlus

    ... measured to estimate the lung volume. To measure diffusion capacity , you breathe a harmless gas, called a ... on your report after pulmonary function tests include: Diffusion capacity to carbon monoxide (DLCO) Expiratory reserve volume ( ...

  6. Value of flexible bronchoscopy in the pre-operative work-up of solitary pulmonary nodules.

    PubMed

    Schwarz, Carsten; Schönfeld, Nicolas; Bittner, Roland C; Mairinger, Thomas; Rüssmann, Holger; Bauer, Torsten T; Kaiser, Dirk; Loddenkemper, Robert

    2013-01-01

    The diagnostic value of flexible bronchoscopy in the pre-operative work-up of solitary pulmonary nodules (SPN) is still under debate among pneumologists, radiologists and thoracic surgeons. In a prospective observational manner, flexible bronchoscopy was routinely performed in 225 patients with SPN of unknown origin. Of the 225 patients, 80.5% had lung cancer, 7.6% had metastasis of an extrapulmonary primary tumour and 12% had benign aetiology. Unsuspected endobronchial involvement was found in 4.4% of all 225 patients (or in 5.5% of patients with lung cancer). In addition, flexible bronchoscopy clarified the underlying aetiology in 41% of the cases. The bronchoscopic biopsy results from the SPN were positive in 84 (46.5%) patients with lung cancer. Surgery was cancelled due to the results of flexible bronchoscopy in four cases (involvement of the right main bronchus (impaired pulmonary function did not allow pneumonectomy) n=1, small cell lung cancer n=1, bacterial pneumonia n=2), and the surgical strategy had to be modified to bilobectomy in one patient. Flexible bronchoscopy changed the planned surgical approach in five cases substantially. These results suggest that routine flexible bronchoscopy should be included in the regular pre-operative work-up of patients with SPN. PMID:22496316

  7. Is preoperative physiotherapy/pulmonary rehabilitation beneficial in lung resection patients?

    PubMed

    Nagarajan, Kumaresan; Bennett, Ashley; Agostini, Paula; Naidu, Babu

    2011-09-01

    A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether preoperative physiotherapy/pulmonary rehabilitation is beneficial for patients undergoing lung resection. Ten papers were identified using the reported search, of which five represented the best evidence to answer the clinical question. In 2007 a report showed in 13 subjects receiving a preoperative rehabilitation programme (PRP) an improvement of maximum oxygen uptake consumption (VO(2) max) of an average 2.4 ml/kg/min (95% confidence interval 1-3.8; P=0.002). A report in 2008 showed in 12 patients with chronic obstructive pulmonary disease (COPD) and VO(2) max <15 ml/kg/min that PRP could effect a mean improvement in VO(2) max of 2.8 ml/kg/min (P<0.001). An earlier report in 2005 demonstrated a reduced length of hospital stay (21±7 days vs. 29±9 days; P=0.0003) in 22 subjects who underwent PRP for two weeks compared with a historical control of 60 patients with COPD. It was shown in 2006 that by using a cross-sectional design with historical controls that one day of chest physiotherapy comprising inspiratory and peripheral muscle training compared with routine nursing care was associated with a lower atelectasis rate (2% vs. 7.7%) and a median length of stay that was 5.73 days vs. 8.33 days (P<0.0001). A prospective randomised controlled study in 1997, showed that two weeks of PRP followed by two months of postoperative rehabilitation produced a better predicted postoperative forced expiratory volume in one second in the study group than in the control group at three months (lobectomy + 570 ml vs. -70 ml; pneumonectomy + 680 ml vs. -110 ml). We conclude that preoperative physiotherapy improves exercise capacity and preserves pulmonary function following surgery. Whether these benefits translate into a reduction in postoperative pulmonary complication is uncertain. PMID:21586476

  8. Pulmonary function in space

    NASA Technical Reports Server (NTRS)

    West, J. B.; Elliott, A. R.; Guy, H. J.; Prisk, G. K.

    1997-01-01

    The lung is exquisitely sensitive to gravity, and so it is of interest to know how its function is altered in the weightlessness of space. Studies on National Aeronautics and Space Administration (NASA) Spacelabs during the last 4 years have provided the first comprehensive data on the extensive changes in pulmonary function that occur in sustained microgravity. Measurements of pulmonary function were made on astronauts during space shuttle flights lasting 9 and 14 days and were compared with extensive ground-based measurements before and after the flights. Compared with preflight measurements, cardiac output increased by 18% during space flight, and stroke volume increased by 46%. Paradoxically, the increase in stroke volume occurred in the face of reductions in central venous pressure and circulating blood volume. Diffusing capacity increased by 28%, and the increase in the diffusing capacity of the alveolar membrane was unexpectedly large based on findings in normal gravity. The change in the alveolar membrane may reflect the effects of uniform filling of the pulmonary capillary bed. Distributions of blood flow and ventilation throughout the lung were more uniform in space, but some unevenness remained, indicating the importance of nongravitational factors. A surprising finding was that airway closing volume was approximately the same in microgravity and in normal gravity, emphasizing the importance of mechanical properties of the airways in determining whether they close. Residual volume was unexpectedly reduced by 18% in microgravity, possibly because of uniform alveolar expansion. The findings indicate that pulmonary function is greatly altered in microgravity, but none of the changes observed so far will apparently limit long-term space flight. In addition, the data help to clarify how gravity affects pulmonary function in the normal gravity environment on Earth.

  9. Pulmonary function in microgravity

    NASA Technical Reports Server (NTRS)

    Guy, H. J.; Prisk, G. K.; West, J. B.

    1992-01-01

    We report the successful collection of a large quantity of human resting pulmonary function data on the SLS-1 mission. Preliminary analysis suggests that cardiac stroke volumes are high on orbit, and that an adaptive reduction takes at least several days, and in fact may still be in progress after 9 days on orbit. It also suggests that pulmonary capillary blood volumes are high, and remain high on orbit, but that the pulmonary interstitium is not significantly impacted. The data further suggest that the known large gravitational gradients of lung function have only a modest influence on single breath tests such as the SBN washout. They account for only approximately 25% of the phase III slope of nitrogen, on vital capacity SBN washouts. These gradients are only a moderate source of the cardiogenic oscillations seen in argon (bolus gas) and nitrogen (resident gas), on such tests. They may have a greater role in generating the normal CO2 oscillations, as here the phase relationship to argon and nitrogen reverses in microgravity, at least at mid exhalation in those subjects studied to date. Microgravity may become a useful tool in establishing the nature of the non-gravitational mechanisms that can now be seen to play such a large part in the generation of intra-breath gradients and oscillations of expired gas concentration. Analysis of microgravity multibreath nitrogen washouts, single breath washouts from more physiological pre-inspiratory volumes, both using our existing SLS-1 data, and data from the upcoming D-2 and SLS-2 missions, should be very fruitful in this regard.(ABSTRACT TRUNCATED AT 250 WORDS).

  10. Pulmonary Function Tests Do Not Predict Pulmonary Complications After Thoracoscopic Lobectomy

    PubMed Central

    Berry, Mark F.; Villamizar-Ortiz, Nestor R.; Tong, Betty C.; Burfeind, William R.; Harpole, David H.; D’Amico, Thomas A.; Onaitis, Mark W.

    2011-01-01

    BACKGROUND Pulmonary function tests (PFTs) predict respiratory complications and mortality after lung resection via thoracotomy. We sought to determine the impact of PFTs upon complications after thoracoscopic lobectomy. METHODS A model for morbidity including published preoperative risk factors and surgical approach was developed by multivariable logistic regression. All patients who underwent lobectomy for primary lung cancer between December, 1999 and October, 2007 with preoperative forced expiratory volume in 1 second (FEV1) or diffusion capacity to carbon monoxide (DLCO) ≤ 60% predicted were reviewed. Preoperative, histopathologic, perioperative, and outcome variables were assessed using standard descriptive statistics. Pulmonary complications were defined as atelectasis requiring bronchoscopy, pneumonia, reintubation, and tracheostomy. RESULTS During the study period, 340 patients (median age 67) with DLCO or FEV1 ≤ 60% (mean % predicted FEV1 55±1, mean % predicted DLCO 61±1) underwent lobectomy (173 thoracoscopy, 167 thoracotomy). Operative mortality was 5% (17 patients) and overall morbidity was 48% (164 patients). At least one pulmonary complication occurred in 57 patients (17%). Significant predictors of pulmonary complications by multivariable analysis for all patients included DLCO (odds ratio 1.03, p=0.003), FEV1 (odds ratio 1.04, p=0.003) and thoracotomy as surgical approach (odds ratio 3.46,p=0.0007). When patients were analyzed according to operative approach, DLCO and FEV1 remained significant predictors of pulmonary morbidity for patients undergoing thoracotomy but not thoracoscopy. CONCLUSIONS In patients with impaired pulmonary function, preoperative pulmonary function tests are predictors of pulmonary complications when lobectomy for lung cancer is performed via thoracotomy but not via thoracoscopy. PMID:20338305

  11. PREOPERATIVE PREDICTION OF LUNG FUNCTION IN PNEUMONECTOMY BY SPIROMETRY AND LUNG PERFUSION SCINTIGRAPHY

    PubMed Central

    Cukic, Vesna

    2012-01-01

    Introduction: Nowadays an increasing number of lung resections are being done because of the rising prevalence of lung cancer that occurs mainly in patients with limited lung function, what is caused by common etiologic factor - smoking cigarettes. Loss of lung tissue in such patients can worsen much the postoperative pulmonary function. So it is necessary to asses the postoperative pulmonary function especially after maximal resection, i.e. pneumonectomy. Objective: To check over the accuracy of preoperative prognosis of postoperative lung function after pneumonectomy using spirometry and lung perfusion scinigraphy. Material and methods: The study was done on 17 patients operated at the Clinic for thoracic surgery, who were treated previously at the Clinic for Pulmonary Diseases “Podhrastovi” in the period from 01. 12. 2008. to 01. 06. 2011. Postoperative pulmonary function expressed as ppoFEV1 (predicted postoperative forced expiratory volume in one second) was prognosticated preoperatively using spirometry, i.e.. simple calculation according to the number of the pulmonary segments to be removed and perfusion lung scintigraphy. Results: There is no significant deviation of postoperative achieved values of FEV1 from predicted ones obtained by both methods, and there is no significant differences between predicted values (ppoFEV1) obtained by spirometry and perfusion scintigraphy. Conclusion: It is necessary to asses the postoperative pulmonary function before lung resection to avoid postoperative respiratory failure and other cardiopulmonary complications. It is absolutely necessary for pneumonectomy, i.e.. maximal pulmonary resection. It can be done with great possibility using spirometry or perfusion lung scintigraphy. PMID:23378687

  12. Cardiovascular function in pulmonary emphysema.

    PubMed

    Visca, Dina; Aiello, Marina; Chetta, Alfredo

    2013-01-01

    Chronic obstructive pulmonary disease (COPD) and chronic cardiovascular disease, such as coronary artery disease, congestive heart failure, and cardiac arrhythmias, have a strong influence on each other, and systemic inflammation has been considered as the main linkage between them. On the other hand, airflow limitation may markedly affect lung mechanics in terms of static and dynamic hyperinflation, especially in pulmonary emphysema, and they can in turn influence cardiac performance as well. Skeletal mass depletion, which is a common feature in COPD especially in pulmonary emphysema patients, may have also a role in cardiovascular function of these patients, irrespective of lung damage. We reviewed the emerging evidence that highlights the role of lung mechanics and muscle mass impairment on ventricular volumes, stroke volume, and stroke work at rest and on exercise in the presence of pulmonary emphysema. Patients with emphysema may differ among COPD population even in terms of cardiovascular function.

  13. Pulmonary functions before and after pediatric cardiac surgery.

    PubMed

    Agha, Hala; El Heinady, Fatma; El Falaky, Mona; Sobih, Alae

    2014-03-01

    This study aimed to assess pulmonary functions before and after cardiac surgery in infants with congenital heart diseases and pulmonary overflow and to clarify which echocardiographic parameter correlates best with lung mechanics. Between 2008 and 2009, 30 infants with left-to-right shunt congenital acyanotic heart diseases who had indications for reparative surgery of these lesions were assessed by echocardiography and infant pulmonary function tests before the operation and 6 months afterward. Tests using baby body plethysmography were performed to assess the following infant pulmonary functions: tidal volume, respiratory rate, respiratory system compliance (C(rs)) and respiratory system resistance, functional residual capacity (FRC), and airway resistance. The mean age of the patients was 10.47 ± 3.38 months, and their mean weight was 6.81 ± 1.67 kg. Ventricular septal defect and combined lesions were the predominant cardiac diseases (26.7%). Comparison of the infant pulmonary function tests showed a highly significant improvement in all the parameters between the preoperative and 6-month postoperative visits (p < 0.0001). Systolic pulmonary artery pressure had a statistically significant negative correlation with C(rs) (r = -0.493, p = 0.006) and a positive correlation with FRC (r = 0.450, p = 0.013). The findings showed that C(rs) had a statistically significant negative correlation with the pulmonary artery size (r = -0.398, p = 0.029) and the left atrium size (r = -0.395, p = 0.031), whereas the pulmonary artery size had a statistically positive correlation with effective resistance (r = 0.416, p = 0.022) and specific effective resistance (r = 0.604, p = 0.0001). Surgical correction of left-to-right shunt congenital heart diseases had a positive impact on lung compliance, airway resistance, and FRC. Noninvasive echocardiographic parameters assessing pulmonary vascular engorgement and pulmonary artery pressure were closely related to these infant pulmonary

  14. Massive postoperative pulmonary embolism in a young woman using oral contraceptives: the value of a preoperative anesthetic consult.

    PubMed

    Amar, S; Van Boven, M; Rooijakkers, H; Momeni, M

    2014-01-01

    We describe the case of a woman with a history of active tabagism and on the oral contraceptive Yasmin, presenting in the Post-Anesthesia Care Unit (PACU) with a cardiac arrest due to massive pulmonary embolism following transforaminal lumbar interbody fusion surgery. The patient had preoperatively several risk factors for deep venous thrombosis. This case-report emphasizes the value of a preoperative anesthetic visit and eventual temporary cessation of certain oral contraceptives in specific cases. PMID:25223166

  15. Pulmonary function in Parkinson's disease.

    PubMed

    Hovestadt, A; Bogaard, J M; Meerwaldt, J D; van der Meché, F G; Stigt, J

    1989-03-01

    Pulmonary function was investigated in 31 consecutive patients with relatively severe Parkinson's disease. Clinical disability was assessed by Hoehn and Yahr scale, Northwestern University Disability Scale and Websterscore. All patients were on levodopa substitution therapy and used anticholinergics. Pulmonary function was investigated by spirography, determination of a maximal inspiratory and expiratory flow-volume curve and, when possible, maximal static mouth pressures were determined. Peak inspiratory and expiratory flow, maximal expiratory flow at 50% and maximal static mouth pressures were significantly below normal values. Vital capacity, forced inspiratory volume in 1 s and the ratio of forced expiratory volume in 1 s and vital capacity were relatively normal. Nine patients had upper airway obstruction (UAO) as judged by abnormal values for peak inspiratory flow, the ratio of forced expiratory volume in 1 s and peak expiratory flow and the ratio of maximal expiratory and inspiratory flow at 50%. Flow-volume curves were normal in eight patients; four patients demonstrated flow decelerations and accelerations (type A) and 16 had a rounded off flow-volume curve (type B). Type A can be explained by UAO and type B by a combination of decreased effective muscle strength and possible UAO. Overall results of pulmonary function tests in patients without any clinical signs or symptoms of pulmonary disease point to subclinical upper airway obstruction and decreased effective muscle strength in a significant proportion of patients.

  16. Pulmonary function in Parkinson's disease.

    PubMed Central

    Hovestadt, A; Bogaard, J M; Meerwaldt, J D; van der Meché, F G; Stigt, J

    1989-01-01

    Pulmonary function was investigated in 31 consecutive patients with relatively severe Parkinson's disease. Clinical disability was assessed by Hoehn and Yahr scale, Northwestern University Disability Scale and Websterscore. All patients were on levodopa substitution therapy and used anticholinergics. Pulmonary function was investigated by spirography, determination of a maximal inspiratory and expiratory flow-volume curve and, when possible, maximal static mouth pressures were determined. Peak inspiratory and expiratory flow, maximal expiratory flow at 50% and maximal static mouth pressures were significantly below normal values. Vital capacity, forced inspiratory volume in 1 s and the ratio of forced expiratory volume in 1 s and vital capacity were relatively normal. Nine patients had upper airway obstruction (UAO) as judged by abnormal values for peak inspiratory flow, the ratio of forced expiratory volume in 1 s and peak expiratory flow and the ratio of maximal expiratory and inspiratory flow at 50%. Flow-volume curves were normal in eight patients; four patients demonstrated flow decelerations and accelerations (type A) and 16 had a rounded off flow-volume curve (type B). Type A can be explained by UAO and type B by a combination of decreased effective muscle strength and possible UAO. Overall results of pulmonary function tests in patients without any clinical signs or symptoms of pulmonary disease point to subclinical upper airway obstruction and decreased effective muscle strength in a significant proportion of patients. PMID:2926415

  17. Associations between preoperative functional status and functional outcomes of total joint replacement in the Dominican Republic

    PubMed Central

    Collins, Jamie E.; Ghazinouri, Roya; Alcantara, Luis; Thornhill, Thomas S.; Katz, Jeffrey N.

    2013-01-01

    Objective. In developed countries, the functional status scores of patients with poor preoperative scores undergoing total joint replacement (TJR) improve more following TJR than those for patients with better preoperative scores. However, those with better preoperative scores achieve the best postoperative functional outcomes. We determined whether similar associations exist in a developing country. Methods. Dominican patients undergoing total hip or knee replacement completed WOMAC and SF-36 surveys preoperatively and at 12-month follow-up. Patients were stratified into low-, medium- and high-scoring preoperative groups based on their preoperative WOMAC function scores. We examined the associations between the baseline functional status of these groups and two outcomes—improvement in functional status over 12 months and functional status at 12 months—using analysis of variance with multivariable linear regression. Results. Patients who scored the lowest preoperatively made the greatest gains in function and pain relief following their TJRs. However, there were no significant differences in pain or function at 12-month follow-up between patients who scored low and those who scored high on preoperative WOMAC and SF-36 surveys. Conclusion. Patients with poor preoperative functional status had greater improvement but similar 12-month functional outcomes compared with patients who had a higher level of function before surgery. These results suggest that a policy of focusing scarce resources on patients with worse functional status in developing countries may optimize improvement following TJR without threatening functional outcome. Additional research is needed to confirm these findings in other developing countries and to understand why these associations vary between patients in the Dominican Republic and patients from developed countries. PMID:23748412

  18. The value of preoperative functional cortical mapping using navigated TMS.

    PubMed

    Lefaucheur, Jean-Pascal; Picht, Thomas

    2016-04-01

    The surgical removal of brain tumours in so-called eloquent regions is frequently associated with a high risk of causing disabling postoperative deficits. Among the preoperative techniques proposed to help neurosurgical planning and procedure, navigated transcranial magnetic stimulation (nTMS) is increasingly performed. A high level of evidence is now available in the literature regarding the anatomical and functional accuracy of this mapping technique. This article presents the principles and facts demonstrating the value of using nTMS in clinical practice to preserve motor or language functions from deleterious lesions secondary to brain tumour resection or epilepsy surgery. PMID:27229765

  19. The value of preoperative functional cortical mapping using navigated TMS.

    PubMed

    Lefaucheur, Jean-Pascal; Picht, Thomas

    2016-04-01

    The surgical removal of brain tumours in so-called eloquent regions is frequently associated with a high risk of causing disabling postoperative deficits. Among the preoperative techniques proposed to help neurosurgical planning and procedure, navigated transcranial magnetic stimulation (nTMS) is increasingly performed. A high level of evidence is now available in the literature regarding the anatomical and functional accuracy of this mapping technique. This article presents the principles and facts demonstrating the value of using nTMS in clinical practice to preserve motor or language functions from deleterious lesions secondary to brain tumour resection or epilepsy surgery.

  20. Preoperative computed tomography-guided percutaneous localization of ground glass pulmonary opacity with polylactic acid injection.

    PubMed

    Hu, Mu; Zhi, Xiuyi; Zhang, Jian

    2015-07-01

    Localization of a ground glass nodule is a difficult challenge for thoracic surgeons, especially for ground glass opacities (GGOs) less than 10 mm in diameter. In this study we implement a new method for preoperative localization of pulmonary (GGOs). From October 2013 to December 2014, computed tomography-guided percutaneous polylactic acid injection localizations were performed for five pulmonary nodules in five patients (2 men and 3 women; mean age, 59.8 years; range, 54-65 years). The injection was feasible in all patients and the localization effect was excellent. The total procedure duration was 12.6 minutes (range; 10-15) and the volume of polylactic acid injected was 0.38 mL. The wedge resections were easily and successfully performed in all five cases. The cutting margin was no less than 2 cm from the lesion. This technique is promising for the determination of GGO location in thoracoscopic surgery for wedge resection.

  1. Pre-operative pulmonary evaluation in the patient with suspected respiratory disease

    PubMed Central

    Bevacqua, Brian K

    2015-01-01

    Post-operative pulmonary complications (POPC) occur frequently, especially in patients with pre-existing pulmonary disease and have a significant effect on post-surgical morbidity and mortality. By understanding the patient's existing pulmonary diseases that have a significant effect on post-operative morbidities a combination of information has to be gathered from a thorough history and physical exam as well as selected laboratory and diagnostic tests. Evidence based scores can then be employed to predict the risk of significant POPC. Numbers and testing alone, however, such as diagnosis of chronic obstructive pulmonary disease based on spirometry, may not provide as clear a picture as of the true risk of POPC that is determined by a combination of estimations of the patient's functional status, (b) measured by the patient's estimates of activity and (c) confirmed by the patient's ability to perform simple tasks such as the 6-minute walk test. This information can then be used to rationalize perioperative interventions and improve the safety of the perioperative experience. PMID:26556912

  2. Prediction of postoperative pulmonary function following thoracic operations. Value of ventilation-perfusion scanning

    SciTech Connect

    Bria, W.F.; Kanarek, D.J.; Kazemi, H.

    1983-08-01

    Surgical resection of lung cancer is frequently required in patients with severely impaired lung function resulting from chronic obstructive pulmonary disease. Twenty patients with obstructive lung disease and cancer (mean preoperative forced expiratory volume in 1 second (FEV1) . 1.73 L) were studied preoperatively and postoperatively by spirometry and radionuclide perfusion, single-breath ventilation, and washout techniques to test the ability of these methods to predict preoperatively the partial loss of lung function by the resection. Postoperative FEV1 and forced vital capacity (FVC) were accurately predicted by the formula: postoperative FEV1 (or FVC) . preoperative FEV1 X percent function of regions of lung not to be resected (r . 0.88 and 0.95, respectively). Ventilation and perfusion scans are equally effective in prediction. Washout data add to the sophistication of the method by permitting the qualitative evaluation of ventilation during tidal breathing. Criteria for patients requiring the study are suggested.

  3. Video-Assisted Thoracoscopic Surgery after Preoperative CT-Guided Lipiodol Marking of Small or Impalpable Pulmonary Nodules

    PubMed Central

    Yajima, Toshiki; Tomizawa, Kenji; Onozato, Ryoichi; Tanaka, Shigebumi; Kuwano, Hiroyuki

    2015-01-01

    Purpose: Small pulmonary lesions that include ground-glass attenuation have been increasingly discovered because of progressive imaging diagnostic technologies. Despite the detection of such small lesions, sometimes it is quite difficult to localize them because of their size or considerable depth from the visceral pleura. In the present study, we examined the usefulness of computed tomography-guided lipiodol marking for thoracoscopic resection of impalpable pulmonary nodules. Methods: Fifty-six patients with an undiagnosed peripheral lesion(s) of the lung who had undergone preoperative computed tomography-guided lipiodol marking followed by video-assisted thoracoscopic surgery were studied. Results: All of the nodules were successfully marked by computed tomography-guided lipiodol marking, and all except for one case were localized by means of intraoperative fluoroscopy as clear spots. With regard to complications, pneumothorax occurred in 21 patients (37.5%), and only one patient required transient drainage. Although hemorrhaging in the lung parenchyma and hemosputum occurred in nine patients (16.1%) and one patient (1.8%), respectively, no patients were in serious condition. No intra- or postoperative mortality or morbidity was observed. Conclusion: Preoperative computed tomography-guided lipiodol marking of small or impalpable pulmonary nodules is a safe and useful procedure for thoracoscopic resection of the lung. PMID:26004116

  4. Preoperative FeNO as a screening indicator of pulmonary complications after abdominal surgery in patients over 60 years old.

    PubMed

    Pi, Xin; Wang, Changsong; Li, Yue; Zheng, Juanjuan; Cui, Yinghua; Guo, Lei; Lin, Ziwei; Zhang, Xin; Li, Enyou

    2015-09-01

    The incidence of pulmonary complications after abdominal surgery is higher than that of cardiac complications. The perioperative factors currently used to assess the risk of postoperative pulmonary complications (PPCs) are imperfect. FeNO is a marker of respiratory system disease related to the airway inflammatory response and bronchial hyperresponsiveness; it may be a new indicator to screen PPCs. A total of 162 patients over 60 years old scheduled for major abdominal surgery under general anesthesia were chosen to measure their preoperative FeNO level. Statistical analyses including the receiver operating characteristic (ROC) and general linear regression were used to analyze the relationships of FeNO with PPCs and other parameters. The medians and quartiles of preoperative FeNO were 14.33 (9.67-21.10) ppb; the geometric mean was 14.25 ppb. Preoperative FeNO correlated to age (P <  0.05), and the coefficient of association was 0.267. ROC curve analysis of FeNO and PPCs resulted in a high probability with an area under the curve of 0.747 (p = 0.001, 95% confidence interval =0.602-0.893). The cut-off level was 30.2 ppb, with 47.06% sensitivity and 93.10% specificity. The positive predictive value of the cut-off was 42.11% and negative predictive value was 93.70%. OR value was 10.83. The magnitude of FeNO in the PPCs group was larger than that in the non-PPCs groups 26.20 (11.55 - 39.20) versus 13.50 (9.55-20.00); p = 0.008). Preoperative FeNO levels may be used to screen the patients over 60 years old undergoing abdominal surgery with a lower probability to suffer PPCs whoes FeNO values less than 30.2 ppb. PMID:25992977

  5. Pulmonary function in perlite workers.

    PubMed

    Cooper, W C

    1976-11-01

    Pulmonary function was studied in 117 men employed in three plants engaged in the mining and processing of perlite. Of these, 38 had been employed for ten years or more; 18 for 15 years or more and four men for 20 years or more. Review of chest films confirmed previous studies which showed no changes indicative of pneumoconiosis. Measurement of forced vital capacity (FVC) by Jones Pulmonor and by Collins 9-liter spirometer did not show reductions correlated with length of exposure, after effects of cigarette smoking had been taken into account. There was instead a slight increase in FVC associated with years in the perlite industry. The distribution of individuals with FVC below 80% of predicted also showed no association with duration of perlite exposure. Although there were slight reductions in forced expiratory volume in one second (FEV1) and in FEV1/FVC% which were associated with years in the perlite industry and which could not be explained by cigarette smoking, these reductions were not statistically significant. In summary, the population of men available for study in the major perlite-producing area of the United States, who have worked for periods up to 23 years, showed no evidence of pneumoconiosis by chest radiography or by measurement of forced vital capacity. Nevertheless, continued control of dust to ensure exposures below nuisance dust levels is essential. Medical surveillance should also continue with records being retained for periodic reevaluation. PMID:993865

  6. Pulmonary function in perlite workers.

    PubMed

    Cooper, W C

    1976-11-01

    Pulmonary function was studied in 117 men employed in three plants engaged in the mining and processing of perlite. Of these, 38 had been employed for ten years or more; 18 for 15 years or more and four men for 20 years or more. Review of chest films confirmed previous studies which showed no changes indicative of pneumoconiosis. Measurement of forced vital capacity (FVC) by Jones Pulmonor and by Collins 9-liter spirometer did not show reductions correlated with length of exposure, after effects of cigarette smoking had been taken into account. There was instead a slight increase in FVC associated with years in the perlite industry. The distribution of individuals with FVC below 80% of predicted also showed no association with duration of perlite exposure. Although there were slight reductions in forced expiratory volume in one second (FEV1) and in FEV1/FVC% which were associated with years in the perlite industry and which could not be explained by cigarette smoking, these reductions were not statistically significant. In summary, the population of men available for study in the major perlite-producing area of the United States, who have worked for periods up to 23 years, showed no evidence of pneumoconiosis by chest radiography or by measurement of forced vital capacity. Nevertheless, continued control of dust to ensure exposures below nuisance dust levels is essential. Medical surveillance should also continue with records being retained for periodic reevaluation.

  7. Development, Functioning, and Effectiveness of a Preoperative Risk Assessment Clinic

    PubMed Central

    Tariq, Hassan; Ahmed, Rafeeq; Kulkarni, Salil; Hanif, Sana; Toolsie, Omesh; Abbas, Hafsa; Chilimuri, Sridhar

    2016-01-01

    Lee first described the concept of preoperative assessment testing (PAT) clinic in 1949. An efficiently run clinic is associated with increased cost-effectiveness by lowering preoperative admission time and thus reducing the length of stay and the associated costs. The setup of the PAT clinic should be based on the needs, culture, and resources of the institution. Various models for the setup of PAT clinic have been described, including the concept of a perioperative surgical home, which is a patient-centered model designed to improve health and the delivery of health care and to reduce the cost of care. Although there are several constraints in the development of PAT clinics, with increasing awareness about the usefulness of pre-operative risk assessments, growing bodies of literature, and evidence-based guidelines, these clinics are becoming a medical necessity for the improvement of perioperative care. PMID:27812286

  8. Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis.

    PubMed

    Sebio Garcia, Raquel; Yáñez Brage, Maria Isabel; Giménez Moolhuyzen, Esther; Granger, Catherine L; Denehy, Linda

    2016-09-01

    Lung cancer is the leading cause of cancer-related death worldwide. For early stages of the disease, lung resection surgery remains the best treatment with curative intent, but significant morbidity is associated, especially among patients with poor pulmonary function and cardiorespiratory fitness. In those cases, the implementation of a preoperative exercise-based intervention could optimize patient's functional status before surgery and improve postoperative outcomes and enhance recovery. The aim of this systematic review is to provide the current body of knowledge regarding the effectiveness of a preoperative exercise-based intervention on postoperative and functional outcomes in patients with lung cancer submitted to lung resection surgery. A systematic review of the literature using CINAHL, EMBASE, MEDLINE, Pubmed, PEDro and SCOPUS was undertaken in September 2015 yielding a total of 1656 references. Two independent reviewers performed the assessment of the potentially eligible records against the inclusion criteria and finally, 21 articles were included in the review. Articles were included if they examined the effects of an exercise-based intervention on at least one of the selected outcomes: pulmonary function, (functional) exercise capacity, health-related quality of life (HRQoL) and postoperative outcomes (length of stay and postoperative complications). Fourteen studies were further selected for a meta-analysis to quantify the mean effect of the intervention and generate 95% confidence intervals (CIs) using the Cochrane Review Manager 5.0.25. For two of the outcomes included (exercise capacity and HRQoL), studies showed large heterogeneity and thus, a meta-analysis was considered inappropriate. Pulmonary function (forced vital capacity and forced expiratory volume in 1 s) was significantly enhanced after the intervention [standardized mean difference (SMD) = 0.38; 95% CI 0.14, 0.63 and SMD = 0.27, 95% CI 0.11, 0.42, respectively]. In comparison with the

  9. Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis.

    PubMed

    Sebio Garcia, Raquel; Yáñez Brage, Maria Isabel; Giménez Moolhuyzen, Esther; Granger, Catherine L; Denehy, Linda

    2016-09-01

    Lung cancer is the leading cause of cancer-related death worldwide. For early stages of the disease, lung resection surgery remains the best treatment with curative intent, but significant morbidity is associated, especially among patients with poor pulmonary function and cardiorespiratory fitness. In those cases, the implementation of a preoperative exercise-based intervention could optimize patient's functional status before surgery and improve postoperative outcomes and enhance recovery. The aim of this systematic review is to provide the current body of knowledge regarding the effectiveness of a preoperative exercise-based intervention on postoperative and functional outcomes in patients with lung cancer submitted to lung resection surgery. A systematic review of the literature using CINAHL, EMBASE, MEDLINE, Pubmed, PEDro and SCOPUS was undertaken in September 2015 yielding a total of 1656 references. Two independent reviewers performed the assessment of the potentially eligible records against the inclusion criteria and finally, 21 articles were included in the review. Articles were included if they examined the effects of an exercise-based intervention on at least one of the selected outcomes: pulmonary function, (functional) exercise capacity, health-related quality of life (HRQoL) and postoperative outcomes (length of stay and postoperative complications). Fourteen studies were further selected for a meta-analysis to quantify the mean effect of the intervention and generate 95% confidence intervals (CIs) using the Cochrane Review Manager 5.0.25. For two of the outcomes included (exercise capacity and HRQoL), studies showed large heterogeneity and thus, a meta-analysis was considered inappropriate. Pulmonary function (forced vital capacity and forced expiratory volume in 1 s) was significantly enhanced after the intervention [standardized mean difference (SMD) = 0.38; 95% CI 0.14, 0.63 and SMD = 0.27, 95% CI 0.11, 0.42, respectively]. In comparison with the

  10. Relationship between pulmonary function and degree of spinal deformity, location of apical vertebrae and age among adolescent idiopathic scoliosis patients

    PubMed Central

    Johari, Joehaimey; Sharifudin, Mohd Ariff; Rahman, Azriani Ab; Omar, Ahmad Sabri; Abdullah, Ahmad Tajudin; Nor, Sobri; Lam, Weii Cheak; Yusof, Mohd Imran

    2016-01-01

    INTRODUCTION This retrospective review aimed to examine the relationship between preoperative pulmonary function and the Cobb angle, location of apical vertebrae and age in adolescent idiopathic scoliosis (AIS). To our knowledge, there have been no detailed analyses of preoperative pulmonary function in relation to these three factors in AIS. METHODS A total of 38 patients with thoracic or thoracolumbar scoliosis were included. Curvature of spinal deformity was measured using the Cobb method. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were used to evaluate preoperative pulmonary function. Statistical methods were used to analyse the relationship between preoperative pulmonary function and the factors that may contribute to poor pulmonary function. RESULTS The mean age of the patients was 16.68 ± 6.04 years. An inverse relationship was found between the degree of the Cobb angle and FVC as well as FEV1; however, the relationships were not statistically significant (p = 0.057 and p = 0.072, respectively). There was also a trend towards a significant negative correlation between the thoracic curve and FVC (p = 0.014). Patients with larger thoracic curves had lower pulmonary function. A one-year increase in age significantly decreased FVC by 1.092 units (p = 0.044). No significant relationship between age and preoperative FEV1 was found. The median FVC was significantly higher in patients with affected apical vertebrae located at levels L1–L3 than at T6–T8 or T9–T12 (p = 0.006). CONCLUSION Lung function impairment was seen in more severe spinal deformities, proximally-located curvature and older patients. PMID:26831315

  11. Reduction of Pulmonary Function After Surgical Lung Resections of Different Volume

    PubMed Central

    Cukic, Vesna

    2014-01-01

    Introduction: In recent years an increasing number of lung resections are being done because of the rising prevalence of lung cancer that occurs mainly in patients with limited lung function, what is caused with common etiologic factor - smoking cigarettes. Objective: To determine how big the loss of lung function is after surgical resection of lung of different range. Methods: The study was done on 58 patients operated at the Clinic for thoracic surgery KCU Sarajevo, previously treated at the Clinic for pulmonary diseases “Podhrastovi” in the period from 01.06.2012. to 01.06.2014. The following resections were done: pulmectomy (left, right), lobectomy (upper, lower: left and right). The values of postoperative pulmonary function were compared with preoperative ones. As a parameter of lung function we used FEV1 (forced expiratory volume in one second), and changes in FEV1 are expressed in liters and in percentage of the recorded preoperative and normal values of FEV1. Measurements of lung function were performed seven days before and 2 months after surgery. Results: Postoperative FEV1 was decreased compared to preoperative values. After pulmectomy the maximum reduction of FEV1 was 44%, and after lobectomy it was 22% of the preoperative values. Conclusion: Patients with airway obstruction are limited in their daily life before the surgery, and an additional loss of lung tissue after resection contributes to their inability. Potential benefits of lung resection surgery should be balanced in relation to postoperative morbidity and mortality. PMID:25568542

  12. Cardiac, renal, and neurological benefits of preoperative levosimendan administration in patients with right ventricular dysfunction and pulmonary hypertension undergoing cardiac surgery: evaluation with two biomarkers neutrophil gelatinase-associated lipocalin and neuronal enolase

    PubMed Central

    Guerrero-Orriach, José Luis; Ariza-Villanueva, Daniel; Florez-Vela, Ana; Garrido-Sánchez, Lourdes; Moreno-Cortés, María Isabel; Galán-Ortega, Manuel; Ramírez-Fernández, Alicia; Alcaide Torres, Juan; Fernandez, Concepción Santiago; Navarro Arce, Isabel; Melero-Tejedor, José María; Rubio-Navarro, Manuel; Cruz-Mañas, José

    2016-01-01

    Purpose To evaluate if the preoperative administration of levosimendan in patients with right ventricular (RV) dysfunction, pulmonary hypertension, and high perioperative risk would improve cardiac function and would also have a protective effect on renal and neurological functions, assessed using two biomarkers neutrophil gelatinase-associated lipocalin (N-GAL) and neuronal enolase. Methods This is an observational study. Twenty-seven high-risk cardiac patients with RV dysfunction and pulmonary hypertension, scheduled for cardiac valve surgery, were prospectively followed after preoperative administration of levosimendan. Levosimendan was administered preoperatively on the day before surgery. All patients were considered high risk of cardiac and perioperative renal complications. Cardiac function was assessed by echocardiography, renal function by urinary N-GAL levels, and the acute kidney injury scale. Neuronal damage was assessed by neuron-specific enolase levels. Results After surgery, no significant variations were found in mean and SE levels of N-GAL (14.31 [28.34] ng/mL vs 13.41 [38.24] ng/mL), neuron-specific enolase (5.40 [0.41] ng/mL vs 4.32 [0.61] ng/mL), or mean ± SD creatinine (1.06±0.24 mg/dL vs 1.25±0.37 mg/dL at 48 hours). RV dilatation decreased from 4.23±0.7 mm to 3.45±0.6 mm and pulmonary artery pressure from 58±18 mmHg to 42±19 mmHg at 48 hours. Conclusion Preoperative administration of levosimendan has shown a protective role against cardiac, renal, and neurological damage in patients with a high risk of multiple organ dysfunctions undergoing cardiac surgery. PMID:27143905

  13. Pulmonary function after less invasive anterior instrumentation and fusion for idiopathic thoracic scoliosis

    PubMed Central

    2013-01-01

    Purpose Standard thoracotomy for anterior instrumentation and fusion of the thoracic spine in idiopathic scoliosis may have detrimental effects on pulmonary function. In this study we describe a less invasive anterior surgical technique and show the pre- and postoperative pulmonary function with a minimum follow-up of 2 years. Methods Twenty patients with Lenke type 1 adolescent thoracic idiopathic scoliosis were treated with anterior spinal fusion and instrumentation. The mean preoperative Cobb angle of the thoracic curve was 53° ± 5.8. Pulmonary function tests (PFT) and radiographic evaluation was performed. Results The mean postoperative correction in Cobb angle of the thoracic curve was 27° ± 8.2 (49%). The mean preoperative FEV1 was 2.81 ± 0.43 L, which increased to 3.14 ± 0.50 L at 2 years postoperatively (P = 0.000). The mean FEV1% did not change (89.60 ± 7.49% preoperatively, versus 90.53 ± 5.95% at 2 years follow-up, P = 0.467). The TLC increased from 4.62 ± 0.62 L preoperatively to 5.17 ± 0.63 L at 2 years follow-up (P = 0.000). The FEV1% at two years of follow-up improved to 104% of the FEV1% predicted value. The FEV1 improved to 97% of the FEV1 predicted value. Conclusion Anterior spinal fusion for idiopathic scoliosis by means of a minimal open thoracotomy proved to be a safe surgical technique that resulted in an improvement of pulmonary function. Our results are similar to those of thoracoscopic procedures reported in literature. PMID:23965278

  14. Transfissural Route Used for Preoperative Localization of Small Pulmonary Lesions with a Short Hook Wire and Suture System

    SciTech Connect

    Iguchi, Toshihiro Hiraki, Takao Gobara, Hideo Fujiwara, Hiroyasu Matsui, Yusuke; Sugimoto, Seiichiro Toyooka, Shinichi Oto, Takahiro Miyoshi, Shinichiro; Kanazawa, Susumu

    2015-02-15

    PurposeWe retrospectively evaluated the results of the transfissural route for preoperative localization with a short hook wire and suture system for video-assisted thoracoscopic surgery (VATS).MethodsEleven patients with 11 tumors underwent CT-guided transfissural placement of a hook wire before VATS. This route was selected for all patients, because the distance between the tumor and interlobar fissure was much shorter than the required distance traversed using the conventional approach. Complications were evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0.ResultsThe hook wire was successfully placed using the transfissural route in all but one case. Of these ten successful placements, two tumors needed a second puncture for optimal placement, because the CT scan showed that the first hook wire was not properly placed in the lung. In one patient, we did not attempt replacement after the first placement was incorrect. In ten successful procedures, the mean distance traversed in the parenchyma of the unaffected lung lobe was 27.9 mm. The distance between the pleura and placed hook wire was significantly shorter than the estimated distance between the pleura and hook wire using the conventional route (mean 16.3 vs. 40.9 mm; P = 0.0002). Grade 1 adverse events occurred (11 pneumothoraxes and 4 pulmonary hemorrhages). No grade 2 or higher adverse event was observed.ConclusionsThe transfissural route used for preoperative localization before VATS is useful for selected patients because this route may allow for more limited lung parenchyma resection.

  15. Pulmonary Function Testing in Children

    MedlinePlus

    ... are s pirometry and airway resistance tests . What is spirometry? Spirometry is the most common lung function test done. ... follow very specific instructions. Most children can do spirometry by age 6, though some preschoolers are able ...

  16. The Success of Cataract Surgery and the Preoperative Measurement of Retinal Function by Electrophysiological Techniques

    PubMed Central

    An, Jing; Zhang, Lei; Wang, Yusheng; Zhang, Zuoming

    2015-01-01

    Purpose. To study the effect of different electrophysiological methods to evaluate retinal function prior to cataract surgery. Methods. Cataract patients who had no significant other eye disease were chosen. VA, pattern visual evoked potential (PVEP), electroretinogram (ERG), and multifocal electroretinogram (mfERG) responses were measured from 150 cataract patients and 20 control subjects. Results. When the preoperative VA was more than 0.3 in cataract patients, the amplitude of PVEP was not significantly different between cataract and control subjects. The amplitude of central point mfERG was significantly lower in cataract patients compared with control group from HM to 0.8 of preoperative VA. The 95% confidence intervals (CIs) of the amplitudes of center point mfERG were calculated for a range of preoperative VA values. Most of the patients within 95% CI of the center point mfERG had a postoperative VA more than 0.5. Conclusions. The amplitude of central point mfERG in cataract patients was the most relevant parameter to the preoperative VA compared with PVEP and ERG. The 95% CI of the amplitude of central point mfERG for each level of VA could help to evaluate preoperative macular function which is used to predict the outcome of cataract surgery. PMID:26576292

  17. An automated system for pulmonary function testing

    NASA Technical Reports Server (NTRS)

    Mauldin, D. G.

    1974-01-01

    An experiment to quantitate pulmonary function was accepted for the space shuttle concept verification test. The single breath maneuver and the nitrogen washout are combined to reduce the test time. Parameters are defined from the forced vital capacity maneuvers. A spirometer measures the breath volume and a magnetic section mass spectrometer provides definition of gas composition. Mass spectrometer and spirometer data are analyzed by a PDP-81 digital computer.

  18. Simultaneous Multiple Preoperative Localizations of Small Pulmonary Lesions Using a Short Hook Wire and Suture System

    SciTech Connect

    Iguchi, Toshihiro Hiraki, Takao Gobara, Hideo Fujiwara, Hiroyasu Matsui, Yusuke; Sugimoto, Seiichiro Toyooka, Shinichi Oto, Takahiro Miyoshi, Shinichiro; Kanazawa, Susumu

    2015-08-15

    PurposeThe aim of the study was to retrospectively evaluate simultaneous multiple hook wire placement outcomes before video-assisted thoracoscopic surgery (VATS).Materials and MethodsThirty-eight procedures were performed on 35 patients (13 men and 22 women; mean age, 59.9 years) with 80 lung lesions (mean diameter 7.9 mm) who underwent simultaneous multiple hook wire placements for preoperative localizations. The primary endpoints were technical success, complications, procedure duration, and VATS outcome; secondary endpoints included comparisons between technical success rates, complication rates, and procedure durations of the 238 single-placement procedures performed. Complications were also evaluated.ResultsIn 35 procedures including 74 lesions, multiple hook wire placements were technically successful; in the remaining three procedures, the second target placement was aborted because of massive pneumothorax after the first placement. Although complications occurred in 34 procedures, no grade 3 or above adverse event was observed. The mean procedure duration was 36.4 ± 11.8 min. Three hook wires dislodged during patient transport to the surgical suite. Seventy-four successfully marked lesions were resected. Six lesions without hook wires were successfully resected after detection by palpation with an additional mini-thoracotomy or using subtle pleural changes as a guide. The complication rates and procedure durations of multiple-placement procedures were significantly higher (P = 0.04) and longer (P < 0.001) than those in the single-placement group, respectively, while the technical success rate was not significantly different (P = 0.051).ConclusionsSimultaneous multiple hook wire placements before VATS were clinically feasible, but increased the complication rate and lengthened the procedure time.

  19. The biophysical function of pulmonary surfactant.

    PubMed

    Rugonyi, Sandra; Biswas, Samares C; Hall, Stephen B

    2008-11-30

    Pulmonary surfactant lowers surface tension in the lungs. Physiological studies indicate two key aspects of this function: that the surfactant film forms rapidly; and that when compressed by the shrinking alveolar area during exhalation, the film reduces surface tension to very low values. These observations suggest that surfactant vesicles adsorb quickly, and that during compression, the adsorbed film resists the tendency to collapse from the interface to form a 3D bulk phase. Available evidence suggests that adsorption occurs by way of a rate-limiting structure that bridges the gap between the vesicle and the interface, and that the adsorbed film avoids collapse by undergoing a process of solidification. Current models, although incomplete, suggest mechanisms that would partially explain both rapid adsorption and resistance to collapse as well as how different constituents of pulmonary surfactant might affect its behavior. PMID:18632313

  20. Thoracoscopic sympathicolysis for essential hyperhidrosis: effects on pulmonary function.

    PubMed

    Noppen, M; Vincken, W

    1996-08-01

    Bilateral interruption of the upper dorsal sympathetic chain at the D2 and D3 level represents the only permanent cure for essential hyperhidrosis. Following surgical sympathectomy, significant and symptomatic changes in pulmonary function have been observed. Since functional effects of the surgical intervention cannot be excluded, we wondered whether such alterations also occurred after thoracoscopic sympathicolysis; these should then be attributable to the surgical denervation itself. Pulmonary function tests (PFTs), including spirometry and body plethysmographic measurement of lung volumes and airway resistance and conductance, were compared before and 6 weeks after thoracoscopic sympathicolysis in 47 patients. In order to virtually exclude any effects of thoracoscopy on the test results PFTs were repeated 6 months after thoracoscopic sympathicolysis in 35 patients. Essential hyperhidrosis was completely relieved in all patients, thereby confirming the interruption of the D2-D3 sympathetic chain. None of the patients developed respiratory symptoms after thoracoscopic sympathicolysis. Forced expiratory volume in one second (FEV1) (-3%), forced expiratory flow after exhaling 75% of vital capacity (FEF75) (-8%) and total lung capacity (TLC) (-3%) were slightly but significantly reduced at six weeks after thoracoscopic sympathicolysis; whereas airway resistance (Raw) had increased (+12%). After correction for the small decrease in lung volume (FEV1/forced vital capacity (FVC), specific airway resistance (sRaw), specific airway conductance (sGaw))significant changes in "volume-dependent" PFT parameters were no longer observed. Smoking status had no influence on the reduction in FEF75. At 6 months after thoracoscopic sympathicolysis, TLC had returned to preoperative values, whereas FEF75 remained decreased (-8.6%). The decrease in airway calibre was confirmed by small but significant changes in FEV1/FVC (-2%) and Raw (+29%). We conclude that thoracoscopic

  1. Pulmonary Function Reduction in Diabetes With and Without Chronic Obstructive Pulmonary Disease

    PubMed Central

    Kinney, Gregory L.; Black-Shinn, Jennifer L.; Wan, Emily S.; Make, Barry; Regan, Elizabeth; Lutz, Sharon; Soler, Xavier; Silverman, Edwin K.; Crapo, James; Hokanson, John E.

    2014-01-01

    OBJECTIVE Diabetes damages major organ systems through disrupted glycemic control and increased inflammation. The effects of diabetes on the lung have been of interest for decades, but the modest reduction in pulmonary function and its nonprogressive nature have limited its investigation. A recent systematic review found that diabetes was associated with reductions in forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and diffusing capacity for carbon monoxide of the lung and increased FEV1/FVC. They reported pooled results including few smokers. This study will examine measures of pulmonary function in participants with extensive smoking exposure. RESEARCH DESIGN AND METHODS We examined pulmonary function in participants with a >10–pack-year history of smoking with and without diabetes with and without chronic obstructive pulmonary disease (COPD). We measured pulmonary function, exercise capacity, and pulmonary-related quality of life in 10,129 participants in the Genetic Epidemiology of Chronic Obstructive Pulmonary Disease (COPDGene) Study. RESULTS Participants with diabetes were observed to have reduced pulmonary function after controlling for known risk factors and also significant reductions in exercise capacity and quality of life across functional stages of COPD. CONCLUSIONS Pulmonary function in patients with ≥10 pack-years of smoking and diabetes is reduced, and this decrease is associated with significant reductions in activity-related quality of life and exercise capacity. PMID:24026562

  2. Influence of preemptive analgesia on pulmonary function and complications for laparoscopic cholecystectomy.

    PubMed

    Şen, Meral; Özol, Duygu; Bozer, Mikdat

    2009-12-01

    Pain and diaphragmatic dysfunction are the major reasons for postoperative pulmonary complications after upper abdominal surgery. Preoperative administration of analgesics helps to reduce and prevent pain. The objective of this study was first to research the rate of pulmonary complications for laparoscopic cholecystectomy (LC) and then analyze the influence of preemptive analgesia on pulmonary functions and complications. Seventy patients scheduled for elective LC were included in our double-blind, randomized, placebo-controlled, prospective study. Randomly, 35 patients received 1 g etofenamate (group 1) and 35 patients 0.9% saline (group 2) intramuscularly 1 h before surgery. All patients underwent physical examination, chest radiography, lung function tests, and pulse oxygen saturation measurements 2 h before surgery and postoperatively on day 2. Atelectasis was graded as micro, focal, segmental, or lobar. With preemptive analgesia, the need for postoperative analgesia decreased significantly in group 1. In both groups mean spirometric values were reduced significantly after the operation, but the difference and proportional change according to preoperative recordings were found to be similar [29.5 vs. 31.3% reduction in forced vital capacity (FVC) and 32.9 vs. 33.5% reduction in forced expiratory volume in 1 s (FEV(1)) for groups 1 and 2, respectively]. There was an insignificant drop in oxygen saturation rates for both groups. The overall incidence of atelectasia was similar for group 1 and 2 (30.2 vs. 29.2%). Although the degree of atelectesia was found to be more severe in the placebo group, the difference was not statistically significant. We concluded that although preemptive analgesia decreased the need for postoperative analgesia, this had no effect on pulmonary functions and pulmonary complications. PMID:19117121

  3. Effect of Preoperative Vitamin D Levels on Functional Performance after Total Knee Arthroplasty

    PubMed Central

    Patil, Aniket Machindra; Maniar, Adit Rajesh; Gangaraju, Bharat; Singh, Jaivardhan

    2016-01-01

    Background Low vitamin D levels affects muscle function. Vitamin D and calcium deficiency cause osteomalacic myopathy and poor functional recovery after hip fractures. The relationship of vitamin D and functional performance after total knee arthroplasty (TKA) is not previously reported. Methods Influence of vitamin D on functional performance before and after TKA was reviewed retrospectively in 120 patients. Of these, 64 had vitamin D deficiency (25-hydroxy vitamin D < 30 ng/mL) preoperatively. All 120 patients received vitamin D oral supplementation postoperatively. Functional parameters including Western Ontario and McMaster Osteoarthritis Index (WOMAC), Short-Form Health Survey questionnaire, and Knee Society Score were assessed pre- and postoperatively at 3 months. Results Preoperative function was significantly lower in osteoarthritic patients with vitamin D deficiency (WOMAC score; p = 0.040), but at 3 months all functional scores were similar. Conclusions We concluded that vitamin D deficiency has a negative effect on function in knee osteoarthritic patients. However, postoperative vitamin D supplementation can lead to functional recovery in these patients. Thus, TKA should not be delayed in vitamin D deficient patients; rather supplementation in the postoperative period is preferable to achieve comparable functional outcome at 3 months to patients with vitamin D sufficiency. PMID:27247739

  4. Impact of obesity on recovery and pulmonary functions of obese women undergoing major abdominal gynecological surgeries.

    PubMed

    Moustafa, Ahmed A M; Abdelazim, Ibrahim A

    2016-06-01

    To determine impact of obesity on recovery parameters and pulmonary functions of women undergoing major abdominal gynecological surgeries. Eighty women undergoing major gynecological surgeries were included in this study. Anesthesia was induced by remifentanil bolus, followed by propofol and cisatracurium to facilitate oro-tracheal intubation and was maintained by balanced anesthesia of remifentanil intravenous infusion and sevoflurane in oxygen and air. Time from discontinuation of maintenance anesthesia to fully awake were recorded at 1-min intervals and time from discontinuation of anesthesia until patient was transferred to post-anesthesia care unit (PACU) and discharged from PACU was also recorded. Pulmonary function tests were performed before surgery and repeated 4 h, days 1, 2 and 3 post-operative for evaluation of forced vital capacity, forced expiratory volume in 1 s and peak expiratory flow rate. Occurrence of post-operative complications, re-admission to ICU, hospital stay and morbidities were also recorded. Induction of anesthesia using remifentanil bolus injection resulted in significant decrease of heart rate and arterial pressures compared to pre-operative and pre-induction values. Recovery times were significantly shorter in obese compared to morbidly obese women. Post-operative pulmonary function tests showed significant deterioration compared to pre-operative measures but showed progressive improvement through first 3 post-operative days. Hospital stay was significantly shorter for obese compared to morbid obese women. Obesity delays recovery from general anesthesia, adversely affects pulmonary functions and increases post-operative complications. Remifentanil infusion and sevoflurane could be appropriate combination for obese and morbidly obese women undergoing major surgeries.

  5. Obesity and Pulmonary Function in African Americans

    PubMed Central

    Mehari, Alem; Afreen, Samina; Ngwa, Julius; Setse, Rosanna; Thomas, Alicia N.; Poddar, Vishal; Davis, Wayne; Polk, Octavius D.; Hassan, Sheik; Thomas, Alvin V.

    2015-01-01

    Background Obesity prevalence in United States (US) adults exceeds 30% with highest prevalence being among blacks. Obesity is known to have significant effects on respiratory function and obese patients commonly report respiratory complaints requiring pulmonary function tests (PFTs). However, there is no large study showing the relationship between body mass index (BMI) and PFTs in healthy African Americans (AA). Objective To determine the effect of BMI on PFTs in AA patients who did not have evidence of underlying diseases of the respiratory system. Methods We reviewed PFTs of 339 individuals sent for lung function testing who had normal spirometry and lung diffusion capacity for carbon monoxide (DLCO) with wide range of BMI. Results Functional residual capacity (FRC) and expiratory reserve volume (ERV) decreased exponentially with increasing BMI, such that morbid obesity resulted in patients breathing near their residual volume (RV). However, the effects on the extremes of lung volumes, at total lung capacity (TLC) and residual volume (RV) were modest. There was a significant linear inverse relationship between BMI and DLCO, but the group means values remained within the normal ranges even for morbidly obese patients. Conclusions We showed that BMI has significant effects on lung function in AA adults and the greatest effects were on FRC and ERV, which occurred at BMI values < 30 kg/m2. These physiological effects of weight gain should be considered when interpreting PFTs and their effects on respiratory symptoms even in the absence of disease and may also exaggerate existing lung diseases. PMID:26488406

  6. Utility of preoperative in vitro platelet function tests for predicting bleeding risk in patients undergoing functional endoscopic sinus surgery

    PubMed Central

    Lee, A-Jin; Kim, Sang-Gyung

    2016-01-01

    Background It is necessary to predict the bleeding risk in patients undergoing functional endoscopic sinus surgery (FESS). To evaluate the adequacy of primary hemostasis, preoperative hemostatic screening tests are used. In the present study, we determined whether there is a positive correlation between prolonged closure time (CT) with collagen/epinephrine (CT-epi), prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT) and bleeding during FESS. Patients and methods We reviewed the medical records of 90 patients without bleeding histories who had undergone FESS from March 2013 to June 2014. More than 200 mL of blood loss was defined as moderate bleeding during surgery. With respect to bleeding during surgery, we determined the sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of CT-epi, PT, INR and aPTT. Results Of the 90 patients, 17 (18.9%) patients had preoperative prolonged CT values and three (17.6%) patients had bleeding. In comparison, five (6.8%) of the 73 (81.1%) patients who had undergone FESS with preoperative normal PFA values experienced bleeding (P=0.171). On the other hand, patients with prolonged PT values (2, 2.2%), prolonged INR values (3, 3.3%) or prolonged PTT values (1, 1.1%) had no bleeding episode. Preoperative CT had low sensitivity (44.4%) and PPV (23.5%). Conclusion During preoperative period, the hemostatic screening may not be helpful to detect the bleeding tendency in adult patients undergoing FESS. Routine measurement of CT-epi, PT, INR and aPTT for preoperative screening may not be recommended for FESS patients. PMID:27799837

  7. Pulmonary Function in Children with Development Coordination Disorder

    ERIC Educational Resources Information Center

    Wu, Sheng K.; Cairney, John; Lin, Hsiao-Hui; Li, Yao-Chuen; Song, Tai-Fen

    2011-01-01

    The purpose of this study was to compare pulmonary function in children with developmental coordination disorder (DCD) with children who are typically developing (TD), and also analyze possible gender differences in pulmonary function between these groups. The Movement ABC test was used to identify the movement coordination ability of children.…

  8. 21 CFR 868.1880 - Pulmonary-function data calculator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Pulmonary-function data calculator. 868.1880 Section 868.1880 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1880 Pulmonary-function...

  9. 21 CFR 868.1880 - Pulmonary-function data calculator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pulmonary-function data calculator. 868.1880 Section 868.1880 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1880 Pulmonary-function...

  10. 21 CFR 868.1880 - Pulmonary-function data calculator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Pulmonary-function data calculator. 868.1880 Section 868.1880 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1880 Pulmonary-function...

  11. 21 CFR 868.1880 - Pulmonary-function data calculator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Pulmonary-function data calculator. 868.1880 Section 868.1880 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1880 Pulmonary-function...

  12. 21 CFR 868.1880 - Pulmonary-function data calculator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Pulmonary-function data calculator. 868.1880 Section 868.1880 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1880 Pulmonary-function...

  13. Exposure to formaldehyde: effects of pulmonary function

    SciTech Connect

    Alexandersson, R.; Kolmodin-Hedman, B.; Hedenstierna, G.

    1982-09-01

    Forty-seven subjects exposed to formaldehyde (mean air concentration 0.45 mg/m/sup 3/) and 20 unexposed subjects, all of whom were employed at a carpentry shop, were studied with regard to symptoms and pulmonary function. Symptoms involving eyes and throat as well as chest oppression were significantly more common in the exposed subjects than in the unexposed controls. Spirometry and single breath nitrogen washout were normal Monday morning before exposure to formaldehyde. A reduction in forced expiratory volume in 1 sec by an average of 0.2 L (P = .002), percent forced expiratory volume by 2% (P = .04), maximum midexpiratory flow by 0.3 L/sec (P = .04) and an increase in closing volume in percentage of vital capacity by 3.4% (P = .002) were seen after a day of work and exposure to formaldehyde, suggesting bronchoconstriction. Smokers and nonsmokers displayed similar changes in spirometry and nitrogen washout.

  14. Mechanics and Function of the Pulmonary Vasculature: Implications for Pulmonary Vascular Disease and Right Ventricular Function

    PubMed Central

    Lammers, Steven; Scott, Devon; Hunter, Kendall; Tan, Wei; Shandas, Robin; Stenmark, Kurt R.

    2012-01-01

    The relationship between cardiac function and the afterload against which the heart muscle must work to circulate blood throughout the pulmonary circulation is defined by a complex interaction between many coupled system parameters. These parameters range broadly and incorporate system effects originating primarily from three distinct locations: input power from the heart, hydraulic impedance from the large conduit pulmonary arteries, and hydraulic resistance from the more distal microcirculation. These organ systems are not independent, but rather, form a coupled system in which a change to any individual parameter affects all other system parameters. The result is a highly nonlinear system which requires not only detailed study of each specific component and the effect of disease on their specific function, but also requires study of the interconnected relationship between the microcirculation, the conduit arteries, and the heart in response to age and disease. Here, we investigate systems-level changes associated with pulmonary hypertensive disease progression in an effort to better understand this coupled relationship. PMID:23487595

  15. The Impact of Preoperative and Postoperative Pulmonary Hypertension on Long-Term Surgical Outcome after Mitral Valve Repair for Degenerative Mitral Regurgitation

    PubMed Central

    Okada, Yukikatsu; Kanemitsu, Hideo; Fukunaga, Naoto; Konishi, Yasunobu; Nakamura, Ken; Koyama, Tadaaki

    2014-01-01

    Purpose: The aim of this study is to elucidate the impact of preoperative and postoperative pulmonary hypertension (PH) on long-term clinical outcomes after mitral valve repair for degenerative mitral regurgitation. Methods: A total of 654 patients who underwent mitral valve repair for degenerative mitral regurgitation between 1991 and 2010 were retrospectively reviewed. Patients were divided into PH(+) group (137 patients) and PH(–) group (517 patients). Follow-up was complete in 99.0%. The median follow-up duration was 7.5 years. Results: Patients in PH(+) group were older, more symptomatic and had higher tricuspid regurgitation grade. Thirty-day mortality was not different between 2 groups (p = 0.975). Long-term survival rate was lower in PH(+) group; 10-year survival rate after the operation was 85.2% ± 4.0% in PH(+) group and 89.7% ± 1.8% in PH(–) group (Log-rank, p = 0.019). The incidence of late cardiac events were not different between groups, however, the recurrence of PH was more frequent in PH(+) group. The recurrence of PH had an adverse impact on survival rate, late cardiac events and symptoms. Univariate analysis showed age and preoperative tricuspid regurgitation grade were the predictors of PH recurrence. Conclusion: Early surgical indication should be advocated for degenerative mitral regurgitation before the progression of pulmonary hypertension and tricuspid regurgitation. PMID:24747547

  16. Comparison of Flow and Volume Incentive Spirometry on Pulmonary Function and Exercise Tolerance in Open Abdominal Surgery: A Randomized Clinical Trial

    PubMed Central

    Kumar, Amaravadi Sampath; Augustine, Alfred Joseph; Pazhyaottayil, Zulfeequer Chundaanveetil; Ramakrishna, Anand; Krishnakumar, Shyam Krishnan

    2016-01-01

    Introduction Surgical procedures in abdominal area lead to changes in pulmonary function, respiratory mechanics and impaired physical capacity leading to postoperative pulmonary complications, which can affect up to 80% of upper abdominal surgery. Aim To evaluate the effects of flow and volume incentive spirometry on pulmonary function and exercise tolerance in patients undergoing open abdominal surgery. Materials and Methods A randomized clinical trial was conducted in a hospital of Mangalore city in Southern India. Thirty-seven males and thirteen females who were undergoing abdominal surgeries were included and allocated into flow and volume incentive spirometry groups by block randomization. All subjects underwent evaluations of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow (PEF). Preoperative and postoperative measurements were taken up to day 5 for both groups. Exercise tolerance measured by Six- Minute Walk Test during preoperative period and measured again at the time of discharge for both groups. Pulmonary function was analysed by post-hoc analysis and carried out using Bonferroni’s ‘t’-test. Exercise tolerance was analysed by Paired ‘T’-test. Results Pulmonary function (FVC, FEV1, and PEFR) was found to be significantly decreased in 1st, 2nd and 3rd postoperative day when compared with preoperative day. On 4th and 5th postoperative day the pulmonary function (FVC, FEV1, and PEFR) was found to be better preserved in both flow and volume incentive spirometry groups. The Six-Minute Walk Test showed a statistically significant improvement in pulmonary function on the day of discharge than in the preoperative period. In terms of distance covered, the volume- incentive spirometry group showed a greater statistically significant improvement from the preoperative period to the time of discharge than was exhibited by the flow incentive spirometry group

  17. Reduction in pulmonary function after CABG surgery is related to postoperative inflammation and hypercortisolemia

    PubMed Central

    Roncada, Gert; Dendale, Paul; Linsen, Loes; Hendrikx, Marc; Hansen, Dominique

    2015-01-01

    Pulmonary function is significantly reduced in the acute phase after coronary artery bypass graft (CABG) surgery. Because pulmonary function partly depends on respiratory muscle strength, we studied whether reductions in pulmonary function are related to postoperative alterations in circulatory factors that affect muscle protein synthesis. Methods: Slow vital capacity (SVC) was assessed in 22 subjects before and 9 ± 3 days after CABG surgery. Blood testosterone, cortisol, insulin-like growth factor-1 (IGF-1), growth hormone, sex-hormone binding globulin (SHBG), glucose, insulin, c-peptide, c-reactive protein (CRP) content, and free androgen index, cortisol/testosterone ratio, HOMA-IR index were assessed before surgery and during the first three days after surgery. Intubation, surgery time and cumulative chest tube drainage were measured. Correlations between changes in SVC and blood parameters after surgery or subject characteristics were studied. This was a prospective observational study. Results: After CABG surgery SVC decreased by 37 ± 18% (P < 0.01). Free androgen index, blood SHBG, testosterone and IGF-1 content decreased, while HOMA-IR index, cortisol/testosterone ratio, blood growth hormone, insulin and CRP content increased (P < 0.0025) in the first three days after surgery. Decrease in SVC was independently (P < 0.05) related to higher preoperative SVC (SC β = 0.66), and greater increase in blood cortisol (SC β = 0.54) and CRP (SC β = 0.37) content after surgery. Conclusions: Larger reductions in pulmonary function after CABG surgery are present in patients experiencing greater postoperative increases in blood CRP and cortisol levels. Decrements in pulmonary function after CABG surgery are, at least in part, thus related to alterations in circulatory factors that affect muscle protein synthesis. PMID:26379888

  18. Pre-operative function, motivation and duration of symptoms predict sporting participation after total hip replacement.

    PubMed

    Ollivier, M; Frey, S; Parratte, S; Flecher, X; Argenson, J N

    2014-08-01

    There is little in the literature on the level of participation in sports which patients undertake after total hip replacement (THR). Our aims in this study were to determine first, the level of sporting activity, second, the predictive factors for returning to sporting activity, and third, the correlation between participation in sports and satisfaction after THR. We retrospectively identified 815 patients who had undergone THR between 1995 and 2005. All were asked to complete a self-administered questionnaire regarding their sporting activity. A total of 571 patients (71%) met the inclusion criteria and completed the evaluation. At a mean follow-up of 9.8 years (sd 2.9), 366 patients (64%) returned to sporting activity as defined by a University of California at Los Angeles (UCLA) score of > 5. The main reasons that patients had for refraining from sports were fear of dislocation (65; 31.6%), avoiding wear (52; 25.4%), and the recommendation of the surgeon (34; 16.6%). There was a significant relationship between higher post-operative participation in sport in those patients with a higher pre-operative Harris hip score (HHS) (p = 0.0074), motivation to participate in sporting activities (p = 0.00022) and a shorter duration of symptoms (p = 0.0034). Finally, there was a correlation between age (p = 0.00013), UCLA score (p = 0.012) and pre-operative HHS (p = 0.00091) and satisfaction. In conclusion, we found that most patients participate in sporting activity after THR, regardless of the advice of their surgeon, and that there is a correlation between the level of participation and pre-operative function, motivation, duration of symptoms and post-operative satisfaction.

  19. Coaching patients during pulmonary function testing: A practical guide

    PubMed Central

    Cheung, Heidi J; Cheung, Lawrence

    2015-01-01

    Pulmonary function tests are an important tool to assist in the diagnosis and management of patients with respiratory disease. Ensuring that the tests are of acceptable quality is vital. Acceptable pulmonary function test quality requires, among others, optimal patient performance. Optimal patient performance, in turn, requires adequate coaching from registered respiratory therapists (RRTs) and other pulmonary function laboratory personnel. The present article provides techniques and tips to help RRTs coach patients during testing. The authors briefly review the components of pulmonary function testing, then describe factors that may hinder a patient’s performance, list common mistakes that patients make during testing, and provide tips that RRTs can use to help patients optimize their performance. PMID:26283871

  20. Preoperative evaluation of activity and function in patients with paralytic scoliosis.

    PubMed

    Larsson, E L; Aaro, S; Ahlinder, P; Oberg, B

    1998-01-01

    Preoperative evaluation of patients with paralytic scoliosis should take into account the consequences of surgery on the every day life of the patient. However, the parameters that are customarily used in these operations relate only to very narrow measures such as the angle of scoliosis or kyphosis. The aim of this study was to introduce a set of instruments appropriate for measuring both function and activities in paralytic scoliosis patients. The study took as its starting point the WHO International Classification of Impairments, Disabilities and Handicaps (ICIDH), in which an activity is described at the level of the individual and function at the level of the organ. A consecutive series of 100 paralytic scoliosis patients with 18 different diagnoses were evaluated preoperatively with a set of instruments that had been specially developed at Linköping hospital, in which the variables are classified according to the system used in the ICIDH. The set of instruments included general information and evaluation of activities and function--sitting, balance, weight distribution to sitting surface, angle of scoliosis, reaching, pain estimation, activities of daily living (ADL) Barthel and ADL Klein and Bell, care given, time spent resting, and seating supports). The results showed that patients with paralytic scoliosis constitute a heterogeneous group in activities and function. Even when the patients were grouped into four subgroups according to the Scoliosis Research Society Classification, they remained very heterogeneous. However, reaching, Klein and Bell Activities of Daily Living and pain could only evaluate patients who could understand verbal instructions. In those who could not, assessment relied more heavily on measures of function and level of dependence. It was concluded that the choice of assessment must be guided by the patient's ability to understand verbal instructions irrespective of his/her disorder. It is important to use the three levels

  1. The effect of pollutional haze on pulmonary function.

    PubMed

    Liu, Shao-Kun; Cai, Shan; Chen, Yan; Xiao, Bing; Chen, Ping; Xiang, Xu-Dong

    2016-01-01

    Detrimental health effects of atmospheric exposure to ambient particulate matter (PM) have been investigated in numerous studies. Exposure to pollutional haze, the carrier of air pollutants such as PM and nitrogen dioxide (NO2) has been linked to lung and cardiovascular disease, resulting increases in both hospital admissions and mortality. This review focuses on the constituents of pollutional haze and its effects on pulmonary function. The article presents the available information and seeks to correlate pollutional haze and pulmonary function.

  2. The effect of pollutional haze on pulmonary function

    PubMed Central

    Liu, Shao-Kun; Cai, Shan; Chen, Yan; Xiao, Bing; Chen, Ping

    2016-01-01

    Detrimental health effects of atmospheric exposure to ambient particulate matter (PM) have been investigated in numerous studies. Exposure to pollutional haze, the carrier of air pollutants such as PM and nitrogen dioxide (NO2) has been linked to lung and cardiovascular disease, resulting increases in both hospital admissions and mortality. This review focuses on the constituents of pollutional haze and its effects on pulmonary function. The article presents the available information and seeks to correlate pollutional haze and pulmonary function. PMID:26904252

  3. Pulmonary function in microgravity: KC-135 experience

    NASA Technical Reports Server (NTRS)

    Guy, Harold J.; Prisk, G. K.

    1991-01-01

    We have commenced a KC-135 program that parallels and proceeds our Spacelab (SLS-1) pulmonary function experiment. Our first task was to elucidate the affect of normal gravitation on the shape of the maximum expiratory flow volume (MEFV) curve. Nine normal subjects performed multiple MEFV maneuvers at 0-G, 1-G, and approximately 1.7-G. The MEFV curves for each subject were filtered, aligned at RV, and ensemble-averaged to produce an average MEFV curve for each state, allowing differences to be studied. Most subjects showed a decrease in the FVC at 0-G, which we attribute to an increased intrathoracic blood volume. In most of these subjects, the mean lung volume associated with a given flow was lower at 0-G, over about the upper half of the vital capacity. This is similar to the change previously reported during heat out immersion and is consistent with the known affect of engorgement of the lung with blood, on elastic recoil. There were also consistent but highly individual changes in the position and magnitude of detailed features of the curve, the individual patterns being similar to those previously reported on transition from the erect to the supine position. This supports the idea that the location and motion of choke points which determine the detailed individual configuration of MEFV curves, can be significantly influenced by gravitational forces, presumably via the effects of change in longitudinal tension on local airway pressure-diameter behavior and wave speed. We have developed a flight mass spectrometer and have commenced a study of single breath gradients in gas exchange, inert gas washouts, and rebreathing cardiac outputs and lung volumes at 0-G, 1-G, and 1.7-G. Comparison of our results with those from SLS-1 should identify the opportunities and limitations of the KC-135 as an accessible microgravity resource.

  4. In Lumbar Fusion Patients, How Does Establishing a Comfort Function Goal Preoperatively Impact Postoperative Pain Scores?

    PubMed

    Hennessy, Winnie; Wagner, Elizabeth; Dumas, Bonnie P; Handley, Patricia

    2015-12-01

    The purpose of this feasibility study was to determine the impact of establishing a comfort function goal preoperatively on postoperative pain scores and opiate requirements in lumbar fusion patients. A comfort function goal is defined as the pain score identified by the patient describing the level of pain tolerance to participate in healing activities such as deep breathing, ambulation and participation in activities of daily living. The design was prospective, nonrandomized, intervention group (n = 30) compared with retrospective chart review as control group (n = 30). Sample included patients scheduled for routine lumbar fusion in an urban southeastern hospital. The study intervention established a comfort function goal during a routine preoperative patient education class. No significant difference in pain score or opiate requirement was found for these data. However, a fundamental clinical question arose surrounding opiate requirements and dosing management. In our hospital, the norm for postoperative pain management is to categorize pain scores as mild (1-3), moderate (4-6), and severe (7-10) pain. Physician orders commonly use this differential to order opiate dose ranges. In this sample, the mean pain score for the intervention group at home is 5.8 and the mean comfort function goal is 4.9. Based on normative categories of pain scores, if a patient's baseline of tolerable pain is 4.9, this has potential impact on clinician responses to managing pain, as 4.9-5.8 is, for this patient, perhaps a mild range of pain, not moderate. If a patient reports a pain score of 7, and their norm is 5.8, the delta is only 1.2. Does this imply that the patient is experiencing mild or severe pain? Does the nurse deliver a dose of pain medication that is in the mild or severe dose range? PMID:26293197

  5. Pulmonary functions in plastic factory workers: a preliminary study.

    PubMed

    Khaliq, Farah; Singh, Pawan; Chandra, Prakash; Gupta, Keshav; Vaney, Neelam

    2011-01-01

    Exposure to long term air pollution in the work environment may result in decreased lung functions and various other health problems. A significant occupational hazard to lung functions is experienced by plastic factory workers. The present study is planned to assess the pulmonary functions of workers in the plastic factory where recycling of pastic material was done. These workers were constantly exposed to fumes of various chemicals throughout the day. Thirty one workers of plastic factory were assessed for their pulmonary functions. Parameters were compared with 31 age and sex matched controls not exposed to the same environment. The pulmonary function tests were done using Sibelmed Datospir 120 B portable spirometer. A significant decrease in most of the flow rates (MEF 25%, MEF 50%, MEF 75% and FEF 25-75%) and most of the lung volumes and capacities (FVC, FEV1, VC, TV, ERV, MVV) were observed in the workers. Smoking and duration of exposure were not affecting the lung functions as the non smokers also showed a similar decrement in pulmonary functions. Similarly the workers working for less than 5 years also had decrement in pulmonary functions indicating that their lungs are being affected even if they have worked for one year. Exposure to the organic dust in the work environment should be controlled by adequate engineering measures, complemented by effective personal respiratory protection. PMID:22315811

  6. The Effect of Tonsillectomy and Adenoidectomy on Right Ventricle Function and Pulmonary Artery Pressure by Using Doppler Echocardiography in Children

    PubMed Central

    Acar, Onur Çağlar; Üner, Abdurrahman; Garça, Mehmet Fatih; Ece, İbrahim; Epçaçan, Serdar; Turan, Mahfuz; Kalkan, Ferhat

    2016-01-01

    Objectives The purpose of the present study is to emphasize the efficacy of the myocardial performance index and tricuspid annular plane systolic excursion (TAPSE) in the determination of impaired cardiac functions and recovery period following the treatment in children with adenoid and/or tonsillar hypertrophy. Methods Fifty-three healthy children after routine laboratory, imaging and clinical examinations, with adenoid and/or tonsillar hypertrophy were evaluated before and 3 months after adenotonsillectomy for cardiac functions using M mode and Doppler echocardiography. Results The mean age of cases was 6.4±3.0 years, 34 (65%) were male, and 19 (35%) were female. Pulmonary hypertension was observed to be mild in 3 patients and moderate in 1 patient preoperatively. When the preoperative and postoperative echocardiographic measurements of the patients were compared, the tricuspid valve E wave velocity, the E/A ratio (E, early diastolic flow rate; A, late diastolic flow rate), and the TAPSE values were determined to be significantly higher postoperatively (P<0.05). The tricuspid valve deceleration time, the isovolumetric relaxation time and the systolic pulmonary artery pressure were found to be significantly lower compared to the preoperative values (P<0.05). Conclusion Adenoidectomy and/or tonsillectomy may prevent cardiac dysfunctions that can develop in the later periods due to adenoid and/or tonsil hypertrophy in children, before the appearance of the clinical findings of cardiac failure. PMID:27090272

  7. Improvement of Pulmonary Functions Following Septoplasty: How Are Lower Airways Affected?

    PubMed Central

    Tuzuner, Arzu; Bilgin, Gulden; Demirci, Sule; Yuce, Gulbahar Darilmaz; Acikgoz, Cemile; Samim, Ethem Erdal

    2016-01-01

    Objectives Nasal septal deviation is a frequent cause of increased nasal airway resistance. A narrow nasal airway would result in a decreased airflow into the lungs. The aim of the present study was to evaluate the alterations of the pulmonary functions following septoplasty using spirometry and 6 minutes walking test (6mWT). And reveal the correlation of symptom score improvement with nasal obstruction symptom score (NOSE) and sino-nasal outcome test (SNOT22) questionnaires following surgery. Methods Thirty patients with obvious nasal septal deviations were enrolled in the study. All patients had a detailed otorhinolaryngologic examination, filled NOSE/SNOT22 questionnaires, performed spirometry and 6mWT preoperatively. One month after surgery, NOSE/SNOT22 questionnaires filled by subjects and spirometry with 6mWT were performed again, and the results were compared. Results The mean total walking distance was 702.3±68.2 m preoperatively, and it improved to 753.2±72.6 m postoperatively (P<0.001). Total tour count increased from 11 (range, 10.8 to 12.0) to 12 (range, 11 to 13.3), and the difference was found statistically significant (P<0.001). When the preoperative and postoperative mean 6mWT results were compared, diastolic blood pressure increased from 70 to 80 mmHg (P=0.031), heart rate increased from 83.5±13.2 to 90.1±12.5 bpm (P=0.017), dyspnea rate decreased from 1 to 0 (P=0.002), and fatigue scores reduced from 2 to 1 (P=0.003). Evaluation on spirometry findings revealed that FIF50% (maximum inspiratory flow at 50% of forced vital capacity [FVC]) scores and peak expiratory flow (PEF) values improved significantly after surgery. Septoplasty improves the nasal breathing pattern. While reducing FEF50% (maximum expiratory flow at 50% of FVC)/FIF50%, it increases PEF and FIF50% values. In addition, as shown by 6mWT, exercise capacity improves following surgery. Postoperative NOSE and SNOT22 scores reduced markedly compared to preoperative values (P<0

  8. Effects of anaesthesia techniques and drugs on pulmonary function.

    PubMed

    Saraswat, Vijay

    2015-09-01

    The primary task of the lungs is to maintain oxygenation of the blood and eliminate carbon dioxide through the network of capillaries alongside alveoli. This is maintained by utilising ventilatory reserve capacity and by changes in lung mechanics. Induction of anaesthesia impairs pulmonary functions by the loss of consciousness, depression of reflexes, changes in rib cage and haemodynamics. All drugs used during anaesthesia, including inhalational agents, affect pulmonary functions directly by acting on respiratory system or indirectly through their actions on other systems. Volatile anaesthetic agents have more pronounced effects on pulmonary functions compared to intravenous induction agents, leading to hypercarbia and hypoxia. The posture of the patient also leads to major changes in pulmonary functions. Anticholinergics and neuromuscular blocking agents have little effect. Analgesics and sedatives in combination with volatile anaesthetics and induction agents may exacerbate their effects. Since multiple agents are used during anaesthesia, ultimate effect may be different from when used in isolation. Literature search was done using MeSH key words 'anesthesia', 'pulmonary function', 'respiratory system' and 'anesthesia drugs and lungs' in combination in PubMed, Science Direct and Google Scholar filtered by review and research articles sorted by relevance. PMID:26556914

  9. IDENTIFICATION AND CHARACTERIZATION OF DISEASE USING PULMONARY FUNCTION TESTS

    EPA Science Inventory

    Abstract
    Pulmonary function testing is used routinely in human medicine to objectively define functional deficits in individuals with respiratory disease. Despite the fact that respiratory disease is a common problem in veterinary medicine, evaluation of the small animal pa...

  10. Preoperative cognitive function predicts survival in patients with resectable pancreatic ductal adenocarcinoma

    PubMed Central

    Baekelandt, Bart M.G.; Hjermstad, Marianne J.; Nordby, Tom; Fagerland, Morten W.; Kure, Elin H.; Heiberg, Turid; Buanes, Trond; Labori, Knut J.

    2015-01-01

    Background The purpose of this prospective study was to evaluate whether pre-surgery health-related quality of life (HRQoL) and subjectively rated symptom scores are prognostic factors for survival in patients with resectable pancreatic ductal adenocarcinoma (PDAC). Methods Patients undergoing pancreatic resection for PDAC completed the Edmonton Symptom Assessment System (ESAS) and the EORTC QLQ-C30 and QLQ-PAN26 questionnaires preoperatively. Patient, tumor and treatment characteristics, recurrence and survival were registered. Results Sixty-six consecutive patients underwent R0/R1 resection for PDAC. Baseline ESAS and EORTC questionnaire compliance was 44/66 (67%) with no statistically significant differences between compliers (n = 44) and non-compliers (n = 22) when comparing clinicopathological parameters and survival. Univariable analyses showed that three symptoms (nausea, dry mouth, cognitive function) and two clinicopathological factors (CA 19-9 > 400 U/ml, lymph node ratio > 0.1) were significantly associated with shorter survival (p < 0.05). In multivariable analysis, cognitive function was the only independent predictor for survival: hazard ratio = 0.35 (95%CI 0.13–0.93) for high vs low cognitive function. Median survival times for patients with high and low cognitive function were 21 and 10 months, respectively (p < 0.001). Conclusion Presurgery cognitive function is a significant independent predictor of survival in patients with resectable PDAC. Thus, presurgery patient reported outcomes may provide as strong prognostic information as clinicopathological factors. PMID:27017164

  11. Indoor air pollution and pulmonary function in children

    SciTech Connect

    Shen, S.; Qin, Y.; Cao, Z.; Shang, J.; Liu, Y.; Yang, X.; Deng, Y.; Huang, J.; Fu, Z.; Song, X. )

    1992-06-01

    Pulmonary function in winter time in 1,343 school children aged 10-13 years was measured in four cities located in northern and southern part of China. The results showed that FVC, FEV1, PEF, V75, V50 and V25 in children living in homes with coal stoves were decreased by 1.5-10.7% compared with children living in homes with gas or LPG stoves in Chengde and Shanghai. In contrast to this, no significant difference in pulmonary function was found in Shenyang and Wuhan. It suggested that this phenomenon was related to indoor air pollution, and partly related to passive smoking or outdoor air pollution.

  12. Pulmonary function in young and older athletes and untrained men.

    PubMed

    Hagberg, J M; Yerg, J E; Seals, D R

    1988-07-01

    This study compared the lung volumes and pulmonary functions of older endurance-trained athletes with those of healthy sedentary age-matched controls, young athletes, and young untrained men to determine whether training affects the age-associated changes in these variables. Despite large differences in maximal 02 consumption (VO2max), the older athletes and their sedentary peers had similar values for all pulmonary variables when expressed as absolute values. However, because the older athletes were shorter than the older sedentary men, their vital capacity, total lung capacity (TLC), and forced expiratory volume in 1 s were significantly larger than those of the older sedentary men when normalized for age and height; the average values for maximal voluntary ventilation and residual volume (RV) were also larger in the older athletes when normalized for age and height, but the differences were not significant. The young trained and untrained men did not differ in any of these measures. TLC was the only pulmonary variable that was the same in the young and older men; RV and the RV-to-TLC ratio were larger, whereas all other pulmonary function and volume measures were lower in the older men compared with the younger men. The older athletes were the only group whose lung volumes and pulmonary function measures were all, except for RV, substantially greater than expected based on their age and height. Thus prolonged strenuous endurance training in these older highly trained endurance athletes appears to have altered the decline in pulmonary function and volumes associated with aging.

  13. Influence of Pulmonary Rehabilitation on Lung Function Changes After the Lung Resection for Primary Lung Cancer in Patients with Chronic Obstructive Pulmonary Disease.

    PubMed

    Mujovic, Natasa; Mujovic, Nebojsa; Subotic, Dragan; Ercegovac, Maja; Milovanovic, Andjela; Nikcevic, Ljubica; Zugic, Vladimir; Nikolic, Dejan

    2015-11-01

    Influence of physiotherapy on the outcome of the lung resection is still controversial. Study aim was to assess the influence of physiotherapy program on postoperative lung function and effort tolerance in lung cancer patients with chronic obstructive pulmonary disease (COPD) that are undergoing lobectomy or pneumonectomy. The prospective study included 56 COPD patients who underwent lung resection for primary non small-cell lung cancer after previous physiotherapy (Group A) and 47 COPD patients (Group B) without physiotherapy before lung cancer surgery. In Group A, lung function and effort tolerance on admission were compared with the same parameters after preoperative physiotherapy. Both groups were compared in relation to lung function, effort tolerance and symptoms change after resection. In patients with tumors requiring a lobectomy, after preoperative physiotherapy, a highly significant increase in FEV1, VC, FEF50 and FEF25 of 20%, 17%, 18% and 16% respectively was registered with respect to baseline values. After physiotherapy, a significant improvement in 6-minute walking distance was achieved. After lung resection, the significant loss of FEV1 and VC occurred, together with significant worsening of the small airways function, effort tolerance and symptomatic status. After the surgery, a clear tendency existed towards smaller FEV1 loss in patients with moderate to severe, when compared to patients with mild baseline lung function impairment. A better FEV1 improvement was associated with more significant loss in FEV1. Physiotherapy represents an important part of preoperative and postoperative treatment in COPD patients undergoing a lung resection for primary lung cancer. PMID:26618048

  14. Resting-State Functional Magnetic Resonance Imaging for Language Preoperative Planning.

    PubMed

    Branco, Paulo; Seixas, Daniela; Deprez, Sabine; Kovacs, Silvia; Peeters, Ronald; Castro, São L; Sunaert, Stefan

    2016-01-01

    Functional magnetic resonance imaging (fMRI) is a well-known non-invasive technique for the study of brain function. One of its most common clinical applications is preoperative language mapping, essential for the preservation of function in neurosurgical patients. Typically, fMRI is used to track task-related activity, but poor task performance and movement artifacts can be critical limitations in clinical settings. Recent advances in resting-state protocols open new possibilities for pre-surgical mapping of language potentially overcoming these limitations. To test the feasibility of using resting-state fMRI instead of conventional active task-based protocols, we compared results from fifteen patients with brain lesions while performing a verb-to-noun generation task and while at rest. Task-activity was measured using a general linear model analysis and independent component analysis (ICA). Resting-state networks were extracted using ICA and further classified in two ways: manually by an expert and by using an automated template matching procedure. The results revealed that the automated classification procedure correctly identified language networks as compared to the expert manual classification. We found a good overlay between task-related activity and resting-state language maps, particularly within the language regions of interest. Furthermore, resting-state language maps were as sensitive as task-related maps, and had higher specificity. Our findings suggest that resting-state protocols may be suitable to map language networks in a quick and clinically efficient way. PMID:26869899

  15. Comparison between two thoracotomy closure techniques: postoperative pain and pulmonary function*

    PubMed Central

    Leandro, Juliana Duarte; Rodrigues, Olavo Ribeiro; Slaets, Annie France Frere; Schmidt, Aurelino F.; Yaekashi, Milton L.

    2014-01-01

    OBJECTIVE: To compare two thoracotomy closure techniques (pericostal and transcostal suture) in terms of postoperative pain and pulmonary function. METHODS: This was a prospective, randomized, double-blind study carried out in the Department of Thoracic Surgery of the Luzia de Pinho Melo Hospital das Clínicas and at the University of Mogi das Cruzes, both located in the city of Mogi das Cruzes, Brazil. We included 30 patients (18-75 years of age) undergoing posterolateral or anterolateral thoracotomy. The patients were randomized into two groups by the type of thoracotomy closure: pericostal suture (PS; n = 16) and transcostal suture (TS; n = 14). Pain intensity during the immediate and late postoperative periods was assessed by a visual analogic scale and the McGill Pain Questionnaire. Spirometry variables (FEV1, FVC, FEV1/FVC ratio, and PEF) were determined in the preoperative period and on postoperative days 21 and 60. RESULTS: Pain intensity was significantly greater in the PS group than in the TS group. Between the preoperative and postoperative periods, there were decreases in the spirometry variables studied. Those decreases were significant in the PS group but not in the TS group. CONCLUSIONS: The patients in the TS group experienced less immediate and late post-thoracotomy pain than did those in the PS group, as well as showing smaller reductions in the spirometry parameters. Therefore, transcostal suture is recommended over pericostal suture as the thoracotomy closure technique of choice. PMID:25210961

  16. Impaired Right Ventricular-Pulmonary Vascular Function in Myeloproliferative Neoplasms

    PubMed Central

    Roach, Emir C.; Park, Margaret M.; Tang, W.H. Wilson; Thomas, James D.; Asosingh, Kewal; Kalaycio, Matt; Erzurum, Serpil C.; Farha, Samar

    2014-01-01

    Background Increased bone marrow hemangioblast numbers, alterations in erythroid/myeloid lineages, increased reticulin, and greater circulating bone marrow progenitor cells are present in patients with pulmonary arterial hypertension (PAH). The data suggest that myeloid progenitors contribute to the pathogenesis of PAH, but there is little data on prevalence of pulmonary vascular disease among different forms of myeloid diseases. We hypothesized that there would be a higher prevalence of pulmonary vascular disease in myeloproliferative neoplasms that have high circulating progenitor cells, such as myelofibrosis and chronic myelogenous leukemia (CML), as compared to those with low circulating progenitors, as in aplastic anemia. Methods Patients with myelofibrosis, CML and aplastic anemia who underwent echocardiographic evaluation of cardiac function in preparation for bone marrow transplantation at the Cleveland Clinic between 1997–2012 were identified using electronic medical records for demographic data, blood cell counts, and pulmonary function tests. All echocardiograms were uniformly analyzed in a blinded fashion by an advanced sonographer and cardiologist for measures of right and left ventricular function and estimation of pulmonary vascular disease. Results Gender and race distribution between disease groups were similar. Myelofibrosis [N=19] and aplastic anemia [N=30] had increased right ventricle (RV) wall thickness compared to CML [N=82] [RV Thickness (cm): aplastic anemia 0.7 ± 0.1, CML 0.5 ± 0.1 and myelofibrosis 0.7 ± 0.1; p = 0.02]. Patients with myelofibrosis had higher levels of estimated RV systolic pressure as compared to the other groups [RVSP (mmHg): aplastic anemia 29.9 ± 1.5, CML 26.2 ± 1.1 and myelofibrosis 36.7 ± 3.7; p < 0.01]. Conclusion The findings suggest an important role for myeloid progenitors in maintenance of pulmonary-vascular health, in which abnormal myeloproliferative progenitors are associated with right ventricle

  17. Bronchiolar carcinoma: a case report with pulmonary function studies

    PubMed Central

    Dyer, N. H.; Hughes, D. T. D.; Thompson, J. M. A.

    1967-01-01

    A patient with bilateral multinodular bronchiolar carcinoma is described in whom carbon monoxide transfer factor and arterial oxygen saturation were greatly impaired but lung volumes and ventilation were only minimally reduced. We record this because we have not found previous reports of detailed pulmonary function studies in this condition. Images PMID:4291818

  18. The effect of passive smoking on pulmonary function during childhood

    PubMed Central

    Bek, K.; Tomac, N.; Delibas, A.; Tuna, F.; Tezic, H; Sungur, M.

    1999-01-01

    Passive smoking, especially of maternal origin, is known to influence adversely the development of children's pulmonary function. In this study, the effect of parental smoking on the pulmonary function of 360 primary school children aged 9-13 (mean 10.8±0.7) years was investigated. Information on parental smoking history was collected using a questionnaire, and spirometric measurements were performed on the children.
All spirometric indices were lower in children who had been passively exposed to parental tobacco smoke than those not exposed. The percentage of households in which at least one parent smoked was 81.5%. This figure was significantly lower for mothers (27.5%) than for fathers (79%). Paternal smoking was associated with reduced levels of forced expiratory flow between 25-75% of vital capacity, peak expiratory flow, and flow rates after 50% and 75% of vital capacity expired (p<0.05). Maternal smoking did not have statistically significant adverse effects on children's pulmonary function. This result might be due to the low occurrence of either pre- or post-natal smoking among mothers and confirms that, in our population, the main target group for anti-tobacco campaigns should be fathers.


Keywords: passive smoking; pulmonary function; tobacco smoke PMID:10435167

  19. 20 CFR 718.103 - Pulmonary function tests.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... of the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC). The report shall also provide the FEV1/FVC ratio, expressed as a percentage. If the maximum voluntary ventilation... the results of the FEV1. (b) All pulmonary function test results submitted in connection with a...

  20. 20 CFR 718.103 - Pulmonary function tests.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... of the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC). The report shall also provide the FEV1/FVC ratio, expressed as a percentage. If the maximum voluntary ventilation... the results of the FEV1. (b) All pulmonary function test results submitted in connection with a...

  1. 20 CFR 718.103 - Pulmonary function tests.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... of the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC). The report shall also provide the FEV1/FVC ratio, expressed as a percentage. If the maximum voluntary ventilation... the results of the FEV1. (b) All pulmonary function test results submitted in connection with a...

  2. 20 CFR 718.103 - Pulmonary function tests.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... of the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC). The report shall also provide the FEV1/FVC ratio, expressed as a percentage. If the maximum voluntary ventilation... the results of the FEV1. (b) All pulmonary function test results submitted in connection with a...

  3. 20 CFR 718.103 - Pulmonary function tests.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... of the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC). The report shall also provide the FEV1/FVC ratio, expressed as a percentage. If the maximum voluntary ventilation... the results of the FEV1. (b) All pulmonary function test results submitted in connection with a...

  4. Mechanisms of reduced pulmonary function after a saturation dive.

    PubMed

    Thorsen, E; Segadal, K; Kambestad, B K

    1994-01-01

    Deep saturation diving has been shown to have prolonged effects on pulmonary function. We wanted to assess the relative contribution of various factors that could contribute to these effects. Pulmonary function was, therefore, measured before and after 17 different saturation diving operations to depths of 5-450 m of sea water, corresponding to absolute pressures of 0.15-4.6 MPa. Four to fifteen divers participated in each operation. The measurements included static and dynamic lung volumes and flows, transfer factor of the lungs for carbon monoxide (TLCO), and closing volume. The dives were characterized by the cumulative hyperoxic and hyperbaric exposures, and the load of venous gas microemboli encountered during decompression was measured in 41 divers in three dives to 0.25, 1.2 and 3.7 MPa. TLCO was reduced by 8.3 +/- 7.0% mean +/- SD after the dives, this correlated with cumulative hyperoxic exposure and load of venous gas microembolism, independently of each other. Closing volume was increased and forced mid-expiratory flow rate reduced, in correlation with cumulative hyperoxic exposure. An increase in total lung capacity correlated with cumulative hyperbaric exposure. We conclude that hyperoxia, hyperbaria, and venous gas microembolism all contribute to the changes in pulmonary function after a single saturation dive, and all may explain some of the long-term effects of diving on pulmonary function.

  5. Using Operational Analysis to Improve Access to Pulmonary Function Testing.

    PubMed

    Ip, Ada; Asamoah-Barnieh, Raymond; Bischak, Diane P; Davidson, Warren J; Flemons, W Ward; Pendharkar, Sachin R

    2016-01-01

    Background. Timely pulmonary function testing is crucial to improving diagnosis and treatment of pulmonary diseases. Perceptions of poor access at an academic pulmonary function laboratory prompted analysis of system demand and capacity to identify factors contributing to poor access. Methods. Surveys and interviews identified stakeholder perspectives on operational processes and access challenges. Retrospective data on testing demand and resource capacity was analyzed to understand utilization of testing resources. Results. Qualitative analysis demonstrated that stakeholder groups had discrepant views on access and capacity in the laboratory. Mean daily resource utilization was 0.64 (SD 0.15), with monthly average utilization consistently less than 0.75. Reserved testing slots for subspecialty clinics were poorly utilized, leaving many testing slots unfilled. When subspecialty demand exceeded number of reserved slots, there was sufficient capacity in the pulmonary function schedule to accommodate added demand. Findings were shared with stakeholders and influenced scheduling process improvements. Conclusion. This study highlights the importance of operational data to identify causes of poor access, guide system decision-making, and determine effects of improvement initiatives in a variety of healthcare settings. Importantly, simple operational analysis can help to improve efficiency of health systems with little or no added financial investment. PMID:27445545

  6. Using Operational Analysis to Improve Access to Pulmonary Function Testing.

    PubMed

    Ip, Ada; Asamoah-Barnieh, Raymond; Bischak, Diane P; Davidson, Warren J; Flemons, W Ward; Pendharkar, Sachin R

    2016-01-01

    Background. Timely pulmonary function testing is crucial to improving diagnosis and treatment of pulmonary diseases. Perceptions of poor access at an academic pulmonary function laboratory prompted analysis of system demand and capacity to identify factors contributing to poor access. Methods. Surveys and interviews identified stakeholder perspectives on operational processes and access challenges. Retrospective data on testing demand and resource capacity was analyzed to understand utilization of testing resources. Results. Qualitative analysis demonstrated that stakeholder groups had discrepant views on access and capacity in the laboratory. Mean daily resource utilization was 0.64 (SD 0.15), with monthly average utilization consistently less than 0.75. Reserved testing slots for subspecialty clinics were poorly utilized, leaving many testing slots unfilled. When subspecialty demand exceeded number of reserved slots, there was sufficient capacity in the pulmonary function schedule to accommodate added demand. Findings were shared with stakeholders and influenced scheduling process improvements. Conclusion. This study highlights the importance of operational data to identify causes of poor access, guide system decision-making, and determine effects of improvement initiatives in a variety of healthcare settings. Importantly, simple operational analysis can help to improve efficiency of health systems with little or no added financial investment.

  7. Acute effect upon pulmonary function of low level exposure to phenol-formaldehyde-resin-coated wood.

    PubMed

    Imbus, H R; Tochilin, S J

    1988-09-01

    In order to determine whether phenol-formaldehyde-resin-coated wood particles would cause an acute decline in pulmonary function, 176 workers in 2 oriented strandboard production plants were given respiratory questionnaires and pulmonary function tests before and during their work shifts. Measurements of dust and adsorbed formaldehyde were made on the same day as the pulmonary function tests. Measured formaldehyde levels were low, and measured dust levels were low to moderate. There was no evidence of an acute effect upon pulmonary function.

  8. Assessment of pulmonary functions in obese adolescent boys

    PubMed Central

    Paralikar, Swapnil J.; Kathrotia, Rajesh G.; Pathak, Narendra R.; Jani, Madhusudan B.

    2012-01-01

    Background: Obesity is rapidly escalating in India in all age groups. School-based data indicate a prevalence rate between 5.6% and 24% in children and adolescents. Adolescent obesity is associated with a greater long-term risk of hypertension and type 2 diabetes mellitus in adulthood. However, studies investigating pulmonary functions in obese adolescents are few. The present study assesses pulmonary functions in obese adolescent boys from a school in Baroda city, Gujarat. Aims: (i) To assess the dynamic lung functions in obese adolescent boys. (ii) To determine the predominant lung function impairment associated with obesity in adolescence. Materials and Methods: Dynamic lung functions were measured in 30 obese adolescent boys and an equal number of age-matched controls using MEDI:SPIRO software (Maestros Mediline Systems Ltd., Navi Mumbai, India). Results: Forced expiratory volume in the 1st second (FEV1)/forced vital capacity (FVC) and maximum voluntary ventilation (MVV) were significantly decreased in the obese group (P < 0.001). Pulmonary functions in the study population correlated negatively with various indices of obesity, viz. weight, body mass index (BMI), waist circumference, hip circumference, and waist-to-hip ratio. The strongest negative correlation was between BMI and FEV1/FVC (P < 0.001) and between BMI, MVV, and Forced Expiratory Flow (FEF25–75%) (P < 0.001). Waist-to-hip ratio in the study population correlated negatively with MVV (P < 0.01), but not with FEV1/FVC. Conclusions: Lung function impairment, particularly decreased MVV and reduced FEV1/FVC ratio, is associated with obesity in adolescence. In addition, pulmonary functions deteriorate with increasing obesity in adolescence and correlate negatively with various indices of obesity, viz. weight, BMI, waist circumference, hip circumference, and waist-to-hip ratio. This study reveals another health hazard associated with obesity and highlights the need to aggressively reduce weight at a

  9. Improvement in Pulmonary Function of Chronic Obstructive Pulmonary Disease (COPD) Patients With Osteoporotic Vertebral Compression Fractures (OVCFs) After Kyphoplasty Under Local Anesthesia

    PubMed Central

    Sheng, Song; Zhenzhong, Sun; Weimin, Jiang; Yimeng, Wang; Qudong, Yin; Jinhui, Shi

    2015-01-01

    To investigate the changes in respiratory function of COPD patients with osteoporotic vertebral compression fractures (OVCFs) after kyphoplasty (KP). Pain scores, pulmonary function parameters (PFT), and local kyphotic angle (LKA) were measured in 31 older patients (25 women, 6 men) with OVCFs before, 3 days after and 3 months after kyphoplasty. The preoperative and postoperative (3 days, 3 months) PFT parameters were as follows: % pred FVC, 74.33 ± 12.35, 85.23.8 ± 13.23, and 84.86 ± 14.01; % pred FEV1, 60.23 ± 11.2, 60.02 ± 11.90, and 60.78 ± 12.70; FEV1/FVC ratio (%), 68.22 ± 16.74, 59.56 ± 13.23, and 60.77 ±12.28, % pred MVV 52.46 ± 14.37, 55.23 ± 15.68, and 62.12 ± 14.48, respectively. The preoperative mean VAS score was 8.01 ± 1.41 and significantly decreased to 2.52 ± 0.89 and 2.34 ± 0.78 at 3 days, 3 months after kyphoplasty, respectively. The preoperative local kyphotic angle degree was 21.96 ± 5.75°, significantly decreased to 13.48 ± 6.12° 3 days after KP, and maintained 3 month after KP. The decrease in the VAS scores correlated with the PFT parameters; however, there were no significant correlations between the PFT parameters and the LKA, the VAS scores and the LKA. Kyphoplasty under local anesthesia is a safety treatment for the COPD patients with OVCFS, and is able to improve the lung function impaired by OVCFs. PMID:25785335

  10. Improvement in Pulmonary Function of Chronic Obstructive Pulmonary Disease (COPD) Patients With Osteoporotic Vertebral Compression Fractures (OVCFs) After Kyphoplasty Under Local Anesthesia.

    PubMed

    Sheng, Song; Zhenzhong, Sun; Weimin, Jiang; Yimeng, Wang; Qudong, Yin; Jinhui, Shi

    2015-03-01

    To investigate the changes in respiratory function of COPD patients with osteoporotic vertebral compression fractures (OVCFs) after kyphoplasty (KP). Pain scores, pulmonary function parameters (PFT), and local kyphotic angle (LKA) were measured in 31 older patients (25 women, 6 men) with OVCFs before, 3 days after and 3 months after kyphoplasty. The preoperative and postoperative (3 days, 3 months) PFT parameters were as follows: % pred FVC, 74.33 ± 12.35, 85.23.8 ± 13.23, and 84.86 ± 14.01; % pred FEV1, 60.23 ± 11.2, 60.02 ± 11.90, and 60.78 ± 12.70; FEV1/FVC ratio (%), 68.22 ± 16.74, 59.56 ± 13.23, and 60.77 ± 12.28, % pred MVV 52.46 ± 14.37, 55.23 ± 15.68, and 62.12 ± 14.48, respectively. The preoperative mean VAS score was 8.01 ± 1.41 and significantly decreased to 2.52 ± 0.89 and 2.34 ± 0.78 at 3 days, 3 months after kyphoplasty, respectively. The preoperative local kyphotic angle degree was 21.96 ± 5.75°, significantly decreased to 13.48 ± 6.12° 3 days after KP, and maintained 3 month after KP. The decrease in the VAS scores correlated with the PFT parameters; however, there were no significant correlations between the PFT parameters and the LKA, the VAS scores and the LKA. Kyphoplasty under local anesthesia is a safety treatment for the COPD patients with OVCFS, and is able to improve the lung function impaired by OVCFs.

  11. Preoperative Oral Carbohydrate Loading in Pancreaticoduodenectomy

    PubMed Central

    Son, Kum-Hee; Kim, So-Young; Cho, Yeong-Ah; Han, Sung-Sik; Park, Sang-Jae

    2016-01-01

    Overnight fasting before elective surgery has been the routine to reduce the risk of pulmonary aspiration. Recently, several international guidelines for preoperative fasting recommend to intake carbohydrate-containing fluids up to 2 to 3 hours before the induction of anesthesia to improve postoperative recovery. Based on the recommendations, we developed a "preoperative carbohydrate diet" provided for the preoperative patients. The purpose of this case report is to share our experience of applying preoperative carbohydrate loading prior to surgery. PMID:27482525

  12. Invasive and noninvasive methods for studying pulmonary function in mice

    PubMed Central

    Glaab, Thomas; Taube, Christian; Braun, Armin; Mitzner, Wayne

    2007-01-01

    The widespread use of genetically altered mouse models of experimental asthma has stimulated the development of lung function techniques in vivo to characterize the functional results of genetic manipulations. Here, we describe various classical and recent methods of measuring airway responsiveness in vivo including both invasive methodologies in anesthetized, intubated mice (repetitive/non-repetitive assessment of pulmonary resistance (RL) and dynamic compliance (Cdyn); measurement of low-frequency forced oscillations (LFOT)) and noninvasive technologies in conscious animals (head-out body plethysmography; barometric whole-body plethysmography). Outlined are the technical principles, validation and applications as well as the strengths and weaknesses of each methodology. Reviewed is the current set of invasive and noninvasive methods of measuring murine pulmonary function, with particular emphasis on practical considerations that should be considered when applying them for phenotyping in the laboratory mouse. PMID:17868442

  13. Metal Nanoparticle Pollutants Interfere with Pulmonary Surfactant Function In Vitro☆

    PubMed Central

    Bakshi, Mandeep Singh; Zhao, Lin; Smith, Ronald; Possmayer, Fred; Petersen, Nils O.

    2008-01-01

    Abstract Reported associations between air pollution and pulmonary and cardiovascular diseases prompted studies on the effects of gold nanoparticles (Au NP) on pulmonary surfactant function. Low levels (3.7 mol % Au/lipid, 0.98% wt/wt) markedly inhibited adsorption of a semisynthetic pulmonary surfactant (dipalmitoyl-phosphatidylcholine (DPPC)/palmitoyl-oleoyl-phosphatidylglycerol/surfactant protein B (SP-B); 70:30:1 wt %). Au NP also impeded the surfactant's ability to reduce surface tension (γ) to low levels during film compression and to respread during film expansion. Transmission electron microscopy showed that Au NP generated by a seed-growth method were spherical with diameters of ∼15 nm. Including palmitoyl-oleoyl-phosphatidylglycerol appeared to coat the NP with at least one lipid bilayer but did not affect NP shape or size. Similar overall observations occurred with dimyristoyl phosphatidylglycerol. Dipalmitoyl-phosphatidylglycerol was less effective in NP capping, although similar sized NP were formed. Including SP-B (1% wt/wt) appears to induce the formation of elongated strands of interacting threads with the fluid phosphatidylglycerols (PG). Including DPPC resulted in formation of aggregated, less spherical NP with a larger size distribution. With DPPC, strand formation due to SP-B was not observed. Agarose gel electrophoresis studies demonstrated that the aggregation induced by SP-B blocked migration of PG-coated NP. Migration was also influenced by the fluidity of the PGs. It is concluded that Au NP can interact with and sequester pulmonary surfactant phospholipids and, if inhaled from the atmosphere, could impede pulmonary surfactant function in the lung. PMID:17890383

  14. Pulmonary functional magnetic resonance imaging for paediatric lung disease.

    PubMed

    Kirby, Miranda; Coxson, Harvey O; Parraga, Grace

    2013-09-01

    A better understanding of the anatomic structure and physiological function of the lung is fundamental to understanding the pathogenesis of pulmonary disease and how to design and deliver better treatments and measure response to intervention. Magnetic resonance imaging (MRI) with the hyperpolarised noble gases helium-3 ((3)He) and xenon-129 ((129)Xe) provides both structural and functional pulmonary measurements, and because it does not require the use of x-rays or other ionising radiation, offers the potential for intensive serial and longitudinal studies in paediatric patients. These facts are particularly important in the evaluation of chronic lung diseases such as asthma and cystic fibrosis- both of which can be considered paediatric respiratory diseases with unmet therapy needs. This review discusses MRI-based imaging methods with a focus on hyperpolarised gas MRI. We also discuss the strengths and limitations as well as the future work required for clinical translation towards paediatric respiratory disease. PMID:23522599

  15. Pulmonary functional impairment from years of arc welding

    SciTech Connect

    Kilburn, K.H.; Warshaw, R.H.

    1989-07-01

    The adverse effects of arc welding on pulmonary function have been previously documented. However, in many of these studies, the effects of welding exposure and smoking were not separated. Also, some studies did not adjust for or ignored the effects of asbestosis on pulmonary function. We assessed the long-term effects of welding on pulmonary function in welders who had no evidence of asbestosis on chest radiographs, and adjusted each individual value for height, age, and years of cigarette smoking. The study consisted of 226 male construction welders who had never worked in shipyards. Forced vital capacity (FVC) and flows were measured by spirometry, chest radiographs were obtained and examined for evidence of asbestosis using, and thoracic gas volume (TGV) was determined by planimetry. The subjects were also administered an occupational and respiratory questionnaire. Data on workers with asbestosis (ILO profusion 1/0 or greater) and pleural abnormalities were excluded. The mean age for the 226 subjects without asbestosis was 45 years, mean height was 175.7 cm, and mean duration of welding was 21.3 years. Pulmonary function measurements are presented as mean percentage of predicted (pop) and adjusted for height, age, and years of smoking. In 151 current cigarette smokers, mean midflows and terminal flows were decreased, FEF25-75 to 93.2 pop and FEF75-85 to 91.2 pop, but FVC, forced expiratory volume in one second (FEV1) and TGV were normal. The 43 nonsmokers also had reductions in flows but normal FVC and TGV. Flows in both groups were significantly (p less than 0.05) below those of the referent group. The regression coefficient was -0.0031 for years of welding and FVC pop, -0.0035 for FEV1 pop, and -0.0080 for midflow pop (FEF25-75) (all significant at p less than 0.05), but the coefficient for FEF75-85 pop was not significant.

  16. Influence of Radiofrequency Ablation of Lung Cancer on Pulmonary Function

    SciTech Connect

    Tada, Akihiro Hiraki, Takao; Iguchi, Toshihiro; Gobara, Hideo; Mimura, Hidefumi; Toyooka, Shinichi; Kiura, Katsuyuki; Tsuda, Toshihide; Mitsuhashi, Toshiharu; Kanazawa, Susumu

    2012-08-15

    Purpose: The purpose of this study was to evaluate altered pulmonary function retrospectively after RFA. Methods: This retrospective study comprised 41 ablation sessions for 39 patients (22 men and 17 women; mean age, 64.8 years). Vital capacity (VC) and forced expiratory volume in 1 s (FEV{sub 1}) at 1 and 3 months after RFA were compared with the baseline (i.e., values before RFA). To evaluate the factors that influenced impaired pulmonary function, univariate analysis was performed by using multiple variables. If two or more variables were indicated as statistically significant by univariate analysis, these variables were subjected to multivariate analysis to identify independent factors. Results: The mean VC and FEV{sub 1} before RFA and 1 and 3 months after RFA were 3.04 and 2.24 l, 2.79 and 2.11 l, and 2.85 and 2.13 l, respectively. The values at 1 and 3 months were significantly lower than the baseline. Severe pleuritis after RFA was identified as the independent factor influencing impaired VC at 1 month (P = 0.003). For impaired FEV{sub 1} at 1 month, only severe pleuritis (P = 0.01) was statistically significant by univariate analysis. At 3 months, severe pleuritis (VC, P = 0.019; FEV{sub 1}, P = 0.003) and an ablated parenchymal volume {>=}20 cm{sup 3} (VC, P = 0.047; FEV{sub 1}, P = 0.038) were independent factors for impaired VC and FEV{sub 1}. Conclusions: Pulmonary function decreased after RFA. RFA-induced severe pleuritis and ablation of a large volume of marginal parenchyma were associated with impaired pulmonary function.

  17. Preoperative Determinants of Patient-reported Pain and Physical Function Levels Following Total Knee Arthroplasty: A Systematic Review

    PubMed Central

    Lungu, E.; Vendittoli, P-A.; Desmeules, F.

    2016-01-01

    Background: A sound knowledge of the determinants of total knee arthroplasty (TKA) outcomes could help in patient selection, preparation and education. We aimed to assess the current status of the literature evaluating preoperative determinants of early and medium term patient-reported pain and disability following TKA. Method: A search in Medline, Pubmed, Embase and CINAHL until October 2014 was undertaken. Selection criteria included: 1- participants undergoing primary unilateral TKA with a follow-up from 6 months to 2 years, 2- validated disease-specific patient-reported outcome measures assessing pain and/or function used as outcome measure and 3- identification of preoperative determinants obtained via multivariate analyses. Risk of bias was assessed using a modified version of the Methodology checklist for prognostic studies. Results: Thirty-three prognostic explanatory studies were included. Mean total score of the methodological quality was 80.7±12.2 %. Sociodemographic and psychosocial determinants included greater socioeconomic deprivation (both studies), greater levels of depression and/or anxiety (7 out of 10 studies) and greater preoperative pain catastrophizing (all 3 studies). Significant clinical determinants included worse pre-operative knee related pain or disability (20 out of 22 studies), presence or greater levels of comorbidity (12 out of 23 studies), back pain (4 out of 5 studies) and lower general health (all 11 studies). Conclusion: Several significant determinants of short to medium-term pain and functional outcomes following TKA have been summarized by studies with moderate-to-high methodological quality. No conclusions can be reached regarding the strength of the associations between significant determinants and TKA results because of heterogeneity of study methodologies and results. Further high-quality research is required. PMID:27398109

  18. The evaluation of pulmonary function and blood gas analysis in patients submitted to laparoscopic versus open nephrectomy

    PubMed Central

    Koc, Ayfer; Inan, Gozde; Bozkirli, Fusun; Coskun, Demet; Tunc, Lutfi

    2015-01-01

    ABSTRACT Background: The aim of this study was to assess the early postoperative pulmonary function and arterial blood gases in patients who have undergone open versus laparoscopic nephrectomy. Materials and Methods: Forty patients were randomly assigned to undergo laparoscopic (LN, n=20) or open nephrectomy (ON, n=20). Pulmonary function tests including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), forced expiratory volume at 25% (FEF25), forced expiratory volume at 50% (FEF50), forced expiratory volume at 25% to 75% (FEF25–75), forced expiratory volume in 1 second (FIV1) and peak expiratory flow (PEF) were performed one day before the operation and on the postoperative day 1. The arterial blood gas analysis (pH, pCO2, pO2, SaO2) was made at breathing room preoperatively, in the recovery phase and on postoperative day 1. Results: All spirometric variables decreased after both open and laparoscopic nephrectomy on postoperative day 1. FEV1, FVC, FEF25 and FEF25–75 values decreased on postoperative day 1 (39.7%, 37.4%, 27.7%, 51.8% respectively) in the open surgery group and they were significantly lower in laparoscopic group (29.9%, 32.5%, 23.2%, 44.5% respectively). There were no significant differences in FEF50, PEF and FIV1 between the groups. The SaO2 and pO2 values also decreased in both groups. During early recovery, pH decreased while pCO2 increased significantly but they returned to preoperative values on postoperative day 1 in both groups. Conclusion: Laparoscopic nephrectomy is better than open nephrectomy considering pulmonary functions. PMID:26742981

  19. Tagged MRI and PET in severe CAD: discrepancy between preoperative inotropic reserve and intramyocardial functional outcome after revascularization.

    PubMed

    Mazzadi, Alejandro N; Janier, Marc F; Brossier, Benjamin; André-Fouët, Xavier; Revel, Didier; Croisille, Pierre

    2004-11-01

    In severe coronary artery disease (CAD), it has been shown that intramyocardial inotropic reserve as assessed with tagged magnetic resonance imaging (MRI) is uniformly distributed among positron emission tomography (PET) patterns reflecting normal or concomitant reductions in perfusion and glucose metabolism. This preliminary study aimed to delineate the relationship between preoperative values of intramyocardial inotropic reserve (in different PET patterns of perfusion and glucose uptake) and intramyocardial functional outcome after surgical revascularization in severe CAD. Twelve patients underwent preoperative tagged MRI (baseline, 10 microg.kg(-1).min(-1) of dobutamine), H2 15O/[18F]fluorodeoxyglucose PET imaging, and postoperative resting tagged MRI. Regional midmyocardial circumferential shortening (Ecc, in %) and PET patterns (normal, match viable, mismatch viable, and infarcted) were assessed in three tagged MRI/PET short-axis slices. Ecc at baseline ranged from 12 +/- 6 to 8 +/- 5 and 4 +/- 4% in normal, match-viable, and infarcted regions, respectively (P <0.05) and was 8 +/- 5% in mismatch-viable regions. Of the 429 regions studied, 187 showed preoperative inotropic reserve with dobutamine, but 238 showed postoperative functional improvement. Postoperative functional improvement was less common in infarcted regions (41 vs. approximately 60% in the other PET patterns), but the extent of improvement was similar among PET patterns (approximately 6%). Postoperative functional improvement occurred in 53% of all (normal, match viable, and mismatch viable) regions without inotropic reserve. In severe CAD, revascularization affords greater intramyocardial functional benefit than expected from the evaluation of intramyocardial inotropic reserve with low-dose dobutamine. Postoperative functional improvement in PET-viable regions without inotropic reserve suggests that factors other than regionally enhanced perfusion contribute to such functional improvement. PMID

  20. Pulmonary function in children after open water SCUBA dives.

    PubMed

    Winkler, B E; Tetzlaff, K; Muth, C-M; Hebestreit, H

    2010-10-01

    An increasing number of children and adolescents is diving with Self-Contained Underwater Breathing Apparatus (SCUBA). SCUBA diving is associated with health risks such as pulmonary barotrauma, especially in children and in individuals with airflow limitation. As no data has been published on the effects of open-water diving on pulmonary function in children, the objective of this study was to evaluate the effects of SCUBA dives on airflow in children. 16 healthy children aged 10-13 years underwent spirometry and a cycle-exercise challenge while breathing cold air. They subsequently performed dives to 1-m and 8-m depth in random order. Pulmonary function was measured before and after the exercise challenge and the dives. There were statistically significant decreases in FEV1, FVC, FEV1/FVC, MEF25 and MEF50 after the cold-air exercise challenge and the dives. Changes in lung function following the exercise challenge did not predict the responses to SCUBA diving. In 3 children the post-dive decrements in FEV1 exceeded 10%. These children had a lower body weight and BMI percentile. SCUBA diving in healthy children may be associated with relevant airflow limitation. A low body mass might contribute to diving-associated bronchoconstriction. In the majority of subjects, no clinically relevant airway obstruction could be observed.

  1. Pulmonary function in patients with diabetes mellitus.

    PubMed

    Sreeja, C K; Samuel, Elizabeth; Kesavachandran, C; Shashidhar, Shankar

    2003-01-01

    The present study was carried out to assess the lung functions in oral medicated and insulin administered patients with normal controls. 20 subjects were selected as the study group for oral medication (Group I), 20 subjects were selected as the study group for insulin treatment (Group II) and 40 subjects were selected as normal controls. Age group of Group I and Group II were 51.25 +/- 6.28 and 50.8 +/- 6.56 respectively and controls were age and height matched. Seventeen patients of Group I were undergoing treatment for the last 10-20 years and 20 patients in Group II were undergoing treatment for the last 30 years. Only male subjects were selected for the study. Lung function test were carried out with Spirometer (Vitallograph Compact II). A significant reduction in forced expiratory volume/forced vital capacity (FEV1/FVC%) was observed in oral pills used subjects and insulin administered subjects as compared to controls. Significant decrease in forced expiratory flow rate (FEF25-75%) in group I subjects was also observed as compared to controls. Forced mid flow time (FMFT) showed a significant increase in group II in comparison to controls. These changes clearly show the expiratory flow rates are reduced both in orally medicated and insulin administered patients. Increase in FMFT in group I may be due to the reduced respiratory ability to carry out the FVC test along with the side effects of oral medication for diabetes mellitus. PMID:12708129

  2. Non-invasive pulmonary function test on Morquio Patients

    PubMed Central

    Kubaski, Francyne; Tomatsu, Shunji; Patel, Pravin; Shimada, Tsutomu; Xie, Li; Yasuda, Eriko; Mason, Robert; Mackenzie, William G.; Theroux, Mary; Bober, Michael B.; Oldham, Helen M.; Orii, Tadao; Shaffer, Thomas H.

    2015-01-01

    In clinical practice, respiratory function tests are difficult to perform in Morquio syndrome patients due to their characteristic skeletal dysplasia, small body size and lack of cooperation of young patients, where in some cases, conventional spirometry for pulmonary function is too challenging. To establish feasible clinical pulmonary endpoints and determine whether age impacts lung function in Morquio patients non-invasive pulmonary tests and conventional spirometry were evaluated. The non-invasive pulmonary tests: impulse oscillometry system, pneumotachography, and respiratory inductance plethysmography in conjunction with conventional spirometry were evaluated in twenty-two Morquio patients (18 Morquio A and 4 Morquio B) (7 males), ranging from 3 and 40 years of age. Twenty-two patients were compliant with non-invasive tests (100%) with exception of IOS (81.8%–18 patients). Seventeen patients (77.3%) were compliant with spirometry testing. All subjects had normal vital signs at rest including > 95% oxygen saturation, end tidal CO2 (38–44 mmHg), and age-appropriate heart rate (mean=98.3, standard deviation=19) (two patients were deviated). All patients preserved normal values in impulse oscillometry system, pneumotachography, and respiratory inductance plethysmography, although predicted forced expiratory volume total (72.8 ± 6.9 SE%) decreased with age and was below normal; phase angle (35.5 ± 16.5 Degrees), %Rib Cage (41.6 ± 12.7%), resonant frequency, and forced expiratory volume in one second/forced expiratory volume total (110.0 ± 3.2 SE%) were normal and not significantly impacted by age. The proposed non-invasive pulmonary function tests are able to cover a greater number of patients (young patients and/or wheel-chair bound), thus providing a new diagnostic approach for the assessment of lung function in Morquio syndrome which in many cases may be difficult to evaluate. Morquio patients studied herein demonstrated no clinical or functional signs

  3. Non-invasive pulmonary function test on Morquio patients.

    PubMed

    Kubaski, Francyne; Tomatsu, Shunji; Patel, Pravin; Shimada, Tsutomu; Xie, Li; Yasuda, Eriko; Mason, Robert; Mackenzie, William G; Theroux, Mary; Bober, Michael B; Oldham, Helen M; Orii, Tadao; Shaffer, Thomas H

    2015-08-01

    In clinical practice, respiratory function tests are difficult to perform in Morquio syndrome patients due to their characteristic skeletal dysplasia, small body size and lack of cooperation of young patients, where in some cases, conventional spirometry for pulmonary function is too challenging. To establish feasible clinical pulmonary endpoints and determine whether age impacts lung function in Morquio patients non-invasive pulmonary tests and conventional spirometry were evaluated. The non-invasive pulmonary tests: impulse oscillometry system, pneumotachography, and respiratory inductance plethysmography in conjunction with conventional spirometry were evaluated in twenty-two Morquio patients (18 Morquio A and 4 Morquio B) (7 males), ranging from 3 to 40 years of age. Twenty-two patients were compliant with non-invasive tests (100%) with the exception of IOS (81.8%-18 patients). Seventeen patients (77.3%) were compliant with spirometry testing. All subjects had normal vital signs at rest including >95% oxygen saturation, end tidal CO2 (38-44 mmHg), and age-appropriate heart rate (mean=98.3, standard deviation=19) (two patients were deviated). All patients preserved normal values in the impulse oscillometry system, pneumotachography, and respiratory inductance plethysmography, although predicted forced expiratory total (72.8±6.9 SE%) decreased with age and was below normal; phase angle (35.5±16.5°), %rib cage (41.6±12.7%), resonant frequency, and forced expiratory volume in 1 s/forced expiratory volume total (110.0±3.2 SE%) were normal and not significantly impacted by age. The proposed non-invasive pulmonary function tests are able to cover a greater number of patients (young patients and/or wheel-chair bound), thus providing a new diagnostic approach for the assessment of lung function in Morquio syndrome which in many cases may be difficult to evaluate. Morquio patients studied herein demonstrated no clinical or functional signs of restrictive and

  4. Pulmonary function in Sardinian fire fighters.

    PubMed

    Serra, A; Mocci, F; Randaccio, F S

    1996-07-01

    Our study examined the respiratory function of 92 firemen whose main activity is fire fighting in forests and open country. Such fire fighting activities are to be considered a risk to the respiratory tract, taking into account studies already in the literature that have evaluated the nature and quantity of inhalable toxins present in activities of this kind. The control group was composed of 51 Carabinieri (policemen), who were asked to fill in a questionnaire about their work activities. Forced expiratory volume and flow, total lung capacity, respiratory volume, and the permeability of the alveolar-capillary barrier were measured. Firemen and Carabinieri (policemen) showed FVC rates higher than the European Community for Coal and Steel standards. The firemen showed a significant reduction in forced expiratory volume in 1 second (FEV1)[3.90 (0.50) vs. 4.04 (0.44); p < 0.05] and forced expiratory flow at 75% of forced vital capacity (FVC) (FEF75) [8.37 (4.11) vs. 8.38 (1.67) p < 0.05] and more markedly in the FEV 1/FVC relationship [80.07 (5.89) vs. 83.89 (1.67) p < 0.001] and in FEF50 [4.73 (1.34) vs. 5.54 (1.44) p < 0.01] and FEF25[1.58 (.47) vs. 1.99 (.69) p < 0.001]. There were no marked differences in air-blood exchanges. No correlation was found between respiratory function data and years of service or the number of fires extinguished during work experience.

  5. The immediate effect of individual manipulation techniques on pulmonary function measures in persons with chronic obstructive pulmonary disease

    PubMed Central

    Noll, Donald R; Johnson, Jane C; Baer, Robert W; Snider, Eric J

    2009-01-01

    Background The use of manipulation has long been advocated in the treatment of chronic obstructive pulmonary disease (COPD), but few randomized controlled clinical trials have measured the effect of manipulation on pulmonary function. In addition, the effects of individual manipulative techniques on the pulmonary system are poorly understood. Therefore, the purpose of this study was to determine the immediate effects of four osteopathic techniques on pulmonary function measures in persons with COPD relative to a minimal-touch control protocol. Methods Persons with COPD aged 50 and over were recruited for the study. Subjects received five, single-technique treatment sessions: minimal-touch control, thoracic lymphatic pump (TLP) with activation, TLP without activation, rib raising, and myofascial release. There was a 4-week washout period between sessions. Protocols were given in random order until all five techniques had been administered. Pulmonary function measures were obtained at baseline and 30-minutes posttreatment. For the actual pulmonary function measures and percent predicted values, Wilcoxon signed rank tests were used to test within-technique changes from baseline. For the percent change from baseline, Friedman tests were used to test for between-technique differences. Results Twenty-five subjects were enrolled in the study. All four tested osteopathic techniques were associated with adverse posttreatment changes in pulmonary function measures; however, different techniques changed different measures. TLP with activation increased posttreatment residual volume compared to baseline, while TLP without activation did not. Side effects were mild, mostly posttreatment chest wall soreness. Surprisingly, the majority of subjects believed they could breathe better after receiving osteopathic manipulation. Conclusion In persons with COPD, TLP with activation, TLP without activation, rib raising, and myofascial release mildly worsened pulmonary function measures

  6. Abnormal Pulmonary Function in Adults with Sickle Cell Anemia

    PubMed Central

    Klings, Elizabeth S.; Wyszynski, Diego F.; Nolan, Vikki G.; Steinberg, Martin H.

    2006-01-01

    Rationale: Pulmonary complications of sickle cell anemia (Hb-SS) commonly cause morbidity, yet few large studies of pulmonary function tests (PFTs) in this population have been reported. Objectives: PFTs (spirometry, lung volumes, and diffusion capacity for carbon monoxide [DLCO]) from 310 adults with Hb-SS were analyzed to determine the pattern of pulmonary dysfunction and their association with other systemic complications of sickle cell disease. Methods: Raw PFT data were compared with predicted values. Each subject was subclassified into one of five groups: obstructive physiology, restrictive physiology, mixed obstructive/restrictive physiology, isolated low DLCO, or normal. The association between laboratory data of patients with decreased DLCO or restrictive physiology and those of normal subjects was assessed by multivariate linear regression. Measurements and Main Results: Normal PFTs were present in only 31 of 310 (10%) patients. Overall, adults with Hb-SS were characterized by decreased total lung capacities (70.2 ± 14.7% predicted) and DlCO (64.5 ± 19.9%). The most common PFT patterns were restrictive physiology (74%) and isolated low DlCO (13%). Decreased DLCO was associated with thrombocytosis (p = 0.05), with hepatic dysfunction (elevated alanine aminotransferase; p = 0.07), and a trend toward renal dysfunction (elevated blood urea nitrogen and creatinine; p = 0.05 and 0.07, respectively). Conclusions: Pulmonary function is abnormal in 90% of adult patients with Hb-SS. Common abnormalities include restrictive physiology and decreased DLCO. Decreased DLCO may indicate more severe sickle vasculopathy characterized by impaired hepatic and renal function. PMID:16556694

  7. Cavernostomy x Resection for Pulmonary Aspergilloma: A 32-Year History

    PubMed Central

    2011-01-01

    Background The most adequate surgical technique for the treatment of pulmonary aspergilloma is still controversial. This study compared two groups of patients submitted to cavernostomy and pulmonary parenchyma resection. Methods Cases of pulmonary aspergilloma operated upon between 1979 and 2010 were analyzed retrospectively. Group 1 consisted of patients submitted to cavernostomy and group 2 of patients submitted to pulmonary parenchyma resection. The following variables were compared between groups: gender, age, number of hospitalizations, pre- and postoperative length of hospital stay, time of follow-up, location and type of aspergilloma, preoperative symptoms, underlying disease, type of fungus, preoperative pulmonary function, postoperative complications, patient progression, and associated diseases. Results A total of 208 patients with pulmonary aspergilloma were studied (111 in group 1 and 97 in group 2). Group 1 was older than group 2. The number of hospitalizations, length of hospital stay and time of follow-up were higher in group 1. Hemoptysis was the most frequent preoperative symptom in group 1. Preoperative respiratory malfunction was more severe in group 1. Hemorrhagic complications and recurrence were more frequent in group 1 and infectious complications and residual pleural space were more common in group 2. Postoperative dyspnea was more frequent in group 2. Patient progression was similar in the two groups. No difference in the other factors was observed between groups. Conclusions Older patients with severe preoperative respiratory malfunction and peripheral pulmonary aspergilloma should be submitted to cavernostomy. The remaining patients can be treated by pulmonary resection. PMID:21974978

  8. Pulmonary function parameters changes at different altitudes in healthy athletes.

    PubMed

    Ziaee, Vahid; Alizadeh, Reza; Movafegh, Ali

    2008-06-01

    Hypoxia and hypocapnia can cause broncho-constriction in human subjects, and this could have a bearing on performance at high altitude. The object of this study was to examine how pulmonary ventilatory functions during high-altitude trekking. This study is a cohort study on spirometric parameters at different altitudes. Fifty six healthy male volunteers from a university student population were enrolled in the study (ages 22.9+/-5.3 years). Pulmonary function was assessed with a Spirolab II in all participants before ascending at baseline (1150 meter), after ascending at different altitudes (2850, 4150 meter), and after descending at sea level during a 3-day trek in Sialan Mount. This study indicates that in an actual trek, ascending results in significant decrease in forced vital capacity (FVC). FVC significantly decreased with increasing altitude from baseline level and at the sea level it was significantly less than baseline level. Peak flow increased with increasing altitude from baseline (1150 m) to 2850 m and decreased with decreasing altitude (p<0.01). Maximal midexpiratory flow rate (FEF 25-75%) and forced expiratory volume in 1 second to forced expiratory volume ratio (FEV1.0%) significantly increased with increasing and decreasing altitude from baseline level (p<0.001). There was no significant change in FEV1. It could be concluded that changes in some pulmonary ventilatory parameters were proportional to the magnitude of change in altitude during a high-altitude trek. These changes are significant at the beginning of ascending.

  9. A Novel Data-Driven Approach to Preoperative Mapping of Functional Cortex Using Resting-State Functional Magnetic Resonance Imaging

    PubMed Central

    Mitchell, Timothy J.; Hacker, Carl D.; Breshears, Jonathan D.; Szrama, Nick P.; Sharma, Mohit; Bundy, David T.; Pahwa, Mrinal; Corbetta, Maurizio; Snyder, Abraham Z.; Shimony, Joshua S.

    2013-01-01

    BACKGROUND: Recent findings associated with resting-state cortical networks have provided insight into the brain's organizational structure. In addition to their neuroscientific implications, the networks identified by resting-state functional magnetic resonance imaging (rs-fMRI) may prove useful for clinical brain mapping. OBJECTIVE: To demonstrate that a data-driven approach to analyze resting-state networks (RSNs) is useful in identifying regions classically understood to be eloquent cortex as well as other functional networks. METHODS: This study included 6 patients undergoing surgical treatment for intractable epilepsy and 7 patients undergoing tumor resection. rs-fMRI data were obtained before surgery and 7 canonical RSNs were identified by an artificial neural network algorithm. Of these 7, the motor and language networks were then compared with electrocortical stimulation (ECS) as the gold standard in the epilepsy patients. The sensitivity and specificity for identifying these eloquent sites were calculated at varying thresholds, which yielded receiver-operating characteristic (ROC) curves and their associated area under the curve (AUC). RSNs were plotted in the tumor patients to observe RSN distortions in altered anatomy. RESULTS: The algorithm robustly identified all networks in all patients, including those with distorted anatomy. When all ECS-positive sites were considered for motor and language, rs-fMRI had AUCs of 0.80 and 0.64, respectively. When the ECS-positive sites were analyzed pairwise, rs-fMRI had AUCs of 0.89 and 0.76 for motor and language, respectively. CONCLUSION: A data-driven approach to rs-fMRI may be a new and efficient method for preoperative localization of numerous functional brain regions. ABBREVIATIONS: AUC, area under the curve BA, Brodmann area BOLD, blood oxygen level dependent ECS, electrocortical stimulation fMRI, functional magnetic resonance imaging ICA, independent component analysis MLP, multilayer perceptron MP

  10. Patients with chronic pulmonary disease.

    PubMed

    Hong, Caron M; Galvagno, Samuel M

    2013-11-01

    Chronic pulmonary disease is common among the surgical population and the importance of a thorough and detailed preoperative assessment is monumental for minimizing morbidity and mortality and reducing the risk of perioperative pulmonary complications. These comorbidities contribute to pulmonary postoperative complications, including atelectasis, pneumonia, and respiratory failure, and can predict long-term mortality. The important aspects of the preoperative assessment for patients with chronic pulmonary disease, and the value of preoperative testing and smoking cessation, are discussed. Specifically discussed are preoperative pulmonary assessment and management of patients with chronic obstructive pulmonary disease, asthma, restrictive lung disease, obstructive sleep apnea, and obesity. PMID:24182721

  11. Long-Term Pulmonary Function in Survivors of Childhood Cancer

    PubMed Central

    Armenian, Saro H.; Landier, Wendy; Francisco, Liton; Herrera, Claudia; Mills, George; Siyahian, Aida; Supab, Natt; Wilson, Karla; Wolfson, Julie A.; Horak, David; Bhatia, Smita

    2015-01-01

    Purpose This study was undertaken to determine the magnitude of pulmonary dysfunction in childhood cancer survivors when compared with healthy controls and the extent (and predictors) of decline over time. Patients and Methods Survivors underwent baseline (t1) pulmonary function tests, followed by a second comprehensive evaluation (t2) after a median of 5 years (range, 1.0 to 10.3 years). Survivors were also compared with age- and sex-matched healthy controls at t2. Results Median age at cancer diagnosis was 16.5 years (range, 0.2 to 21.9 years), and time from diagnosis to t2 was 17.1 years (range, 6.3 to 40.1 years). Compared with odds for healthy controls, the odds of restrictive defects were increased 6.5-fold (odds ratio [OR], 6.5; 95% CI, 1.5 to 28.4; P < .01), and the odds of diffusion abnormalities were increased 5.2-fold (OR, 5.2; 95% CI, 1.8 to 15.5; P < .01). Among survivors, age younger than 16 years at diagnosis (OR, 3.0; 95% CI, 1.2 to 7.8; P = .02) and exposure to more than 20 Gy chest radiation (OR, 5.6; 95% CI, 1.5 to 21.0; P = .02, referent, no chest radiation) were associated with restrictive defects. Female sex (OR, 3.9; 95% CI, 1.7 to 9.5; P < .01) and chest radiation dose (referent: no chest radiation; ≤ 20 Gy: OR, 6.4; 95% CI, 1.7 to 24.4; P < .01; > 20 Gy: OR, 11.3; 95% CI, 2.6 to 49.5; P < .01) were associated with diffusion abnormalities. Among survivors with normal pulmonary function tests at t1, females and survivors treated with more than 20 Gy chest radiation demonstrated decline in diffusion function over time. Conclusion Childhood cancer survivors exposed to pulmonary-toxic therapy are significantly more likely to have restrictive and diffusion defects when compared with healthy controls. Diffusion capacity declines with time after exposure to pulmonary-toxic therapy, particularly among females and survivors treated with high-dose chest radiation. These individuals could benefit from subsequent monitoring. PMID:25847925

  12. Pulmonary Hypertension and Indicators of Right Ventricular Function

    PubMed Central

    von Siebenthal, Célia; Aubert, John-David; Mitsakis, Periklis; Yerly, Patrick; Prior, John O.; Nicod, Laurent Pierre

    2016-01-01

    Pulmonary hypertension (PH) is a rare disease, whose underlying mechanisms are not fully understood. It is characterized by pulmonary arterial vasoconstriction and vessels wall thickening, mainly intimal and medial layers. Several molecular pathways have been studied, but their respective roles remain unknown. Cardiac repercussions of PH are hypertrophy, dilation, and progressive right ventricular dysfunction. Multiple echocardiographic parameters are being used, in order to assess anatomy and cardiac function, but there are no guidelines edited about their usefulness. Thus, it is now recommended to associate the best-known parameters, such as atrial and ventricular diameters or tricuspid annular plane systolic excursion. Cardiac catheterization remains necessary to establish the diagnosis of PH and to assess pulmonary hemodynamic state. Concerning energetic metabolism, free fatty acids, normally used to provide energy for myocardial contraction, are replaced by glucose uptake. These abnormalities are illustrated by increased 18F-fluorodeoxyglucose (18F-FDG) uptake on positron emission tomography/computed tomography, which seems to be correlated with echocardiographic and hemodynamic parameters. PMID:27376066

  13. Evaluation of pulmonary function tests by using fuzzy logic theory.

    PubMed

    Uncü, Umit

    2010-06-01

    Pulmonary Function Tests (PFTs) are very important in the medical evaluation of patients suffering from "shortness of breath", and they are effectively used for the diagnosis of pulmonary diseases, such as COPD (i.e. chronic obstructive pulmonary diseases). Measurement of Forced Vital Capacity (FVC) and Forced Expiratory Flow in the 1st second (FEV1) are very important for controlling the treatment of COPD. During PFTs, some difficulties are encountered which complicate the comparison of produced graphs with the standards. These mainly include the reluctance of the patients to co-operate and the physicians' weaknesses to make healthy interpretations. Main tools of the diagnostic process are the symptoms, laboratory tests or measurements and the medical history of the patient. However, quite frequently, most of the medical information obtained from the patient is uncertain, exaggerated or ignored, incomplete or inconsistent. Fuzziness encountered during PFT is very important. In this study, the purpose is to use "fuzzy logic" approach to facilitate reliable and fast interpretation of PFT graphical outputs. A comparison is made between this approach and methodologies adopted in previous studies. Mathematical models and their coefficients for the spirometric plots are introduced as fuzzy numbers. Firstly, a set of rules for categorizing coefficients of mathematical models obtained. Then, a fuzzy rule-base for a medical inference engine is constructed and a diagnostic "expert system COPDes" designed. This program, COPDes helps for diagnosing the degree of COPD for the patient under test.

  14. Body Composition and Pulmonary Function in Cystic Fibrosis

    PubMed Central

    Sheikh, Saba; Zemel, Babette S.; Stallings, Virginia A.; Rubenstein, Ronald C.; Kelly, Andrea

    2014-01-01

    Background: Lower body mass index (BMI) is associated with worse pulmonary function in cystic fibrosis (CF). Hypothesis: lean body mass (LBM) is more strongly associated with pulmonary function than BMI is. Methods: Anthropometrics, body composition by dual x-ray absorptiometry, and pulmonary function were determined in pancreatic insufficient CF (PI-CF) youth. Sex and age-adjusted Z-scores (BMI-Z, LBMI-Z, FMI-Z) were generated for CF and controls. (1) Associations of BMI-Z with LBMI-Z and FMI-Z and (2) age-adjusted associations of BMI-Z, LBMI-Z, and FMI-Z with FEV1%-predicted were tested. Results: Two hundred eight PI-CF subjects had lower BMI-Z, LBMI-Z, and FMI-Z compared to 390 controls. BMI-Z was associated with lower LBMI-Z (p < 0.0001) in PI-CF. In females, LBMI-Z and BMI-Z were positively associated with FEV1%-predicted; this relationship did not persist for FMI-Z after adjustment for LBMI-Z. In males, only LBMI-Z and BMI-Z were associated with FEV1%-predicted. Conclusion: In PI-CF youth, deficits in LBM were apparent. At lower BMI percentiles, BMI may not accurately depict LBM in PI-CF. In under-nourished PI-CF youth, this preservation of FM in preference to LBM is relevant since LBMI-Z, but not FMI-Z, is positively associated with FEV1%-predicted. Lean body mass index is more strongly associated with lung function compared to BMI, especially in the under-nourished child and adolescent with PI-CF. PMID:24783186

  15. About the effect of pulmonary rehabilitation on lung function in patients with chronic obstructive pulmonary disease.

    PubMed

    Incorvaia, Cristoforo; Riario-Sforza, Gian-Galeazzo; Ridolo, Erminia

    2016-01-01

    Detecting an improvement of lung function in a patient with chronic obstructive pulmonary disease (COPD) following pulmonary rehabilitation (PR) may appear unexpected, but actually recent studies showed that is not so rare. In fact, in a prospective study comparing a group of 190 COPD patients undergoing PR to a group of 67 patients treated only with drugs a mean improvement of FEV1 from 1240 mL to 1252.4 mL was found in the former, while the values changed from 1367 mL to 1150 mL in the latter (p < 0.001). Such improvement was detected also in a study in patients with very severe COPD, as assessed by a FEV1 increasing from 970 mL at baseline to 1080 mL after a 3-week PR inpatient program (p < 0.001). These observations suggest that improvement of lung function in COPD patients undergoing PR should be included among the expected outcomes and routinely assessed as an index of clinical success during the treatment. PMID:27489761

  16. Effects of ozone on the pulmonary function of children

    SciTech Connect

    Bock, N.; Lippmann, M.; Lioy, P.; Munoz, A.; Speizer, F.E.

    1985-01-01

    Healthy active children, 7 to 13 years old, in a summer recreational camp were chosen as subjects to investigate the acute effects of exposure to ambient-air pollution. Pulmonary-function tests were administered at the camp on 16 days during a five week period in 1982. Ambient-air-pollution data were collected approximately 6 km from the camp. For each of the 39 children tested on six or more days, a linear regression was calculated between the peak one-hour ozone concentration for a given day and each of three functional parameters determined for the same day from the spirograms: forced vital capacity (FVC), Forced expiratory volume in 1 second (PEV1), and peak expiratory flow rate (PEFR). All mean slopes were negative, except for FVC in boys, indicating a general tendency for decreased function with increasing ozone concentration; however only PEFR mean slopes for girls and for all subjects were statistically significantly different from zero. For each of 49 children seen on four or more days, a summary weighted correlation coefficient between peak ozone level and each of the three pulmonary function parameters was calculated. As in the regression analysis, decrements in PEFR were significantly correlated with the ozone exposure. Overall, the decrements were small, approximately a 10% decrease in PEFR with an ozone exposure level of 120 ppb.

  17. Gender difference in smoking effects on adult pulmonary function.

    PubMed

    Xu, X; Li, B; Wang, L

    1994-03-01

    Data on 1,618 male and 1,669 female adults aged 40-69 yrs, from China in the Beijing Respiratory Health Study, were analysed to investigate the gender differences in effects of smoking on pulmonary function. Smoking was characterized by total smoking-years, smoking status (former, transitional and constant), smoking type (cigarette, cigar and others). The effects of smoking on height-standardized forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were assessed by multiple regressions adjusting for age, education level, use of an indoor coal stove for heating, passive smoking, occupational dust and gas/fume exposure, and residence. Prediction equations were derived from nonsmoking asymptomatic subjects. As compared to women, men had a much higher smoking prevalence (78 vs 35%) but a lower quitting rate (14 vs 23%). Female lifetime nonsmokers had greater mean percentage predicted lung function values than male lifetime nonsmokers, whilst female cigarette smokers had lower values than their male counterparts. In both sexes, the highest mean percentage predicted lung function values were found in lifetime nonsmokers, whilst the lowest values were found among former smokers, the second lowest among transitional smokers, and constant smokers actually had greater values than both former and transitional smokers. These findings were confirmed by sex-specific regression analyses. A global test on the interactions between smoking and sex was highly significant. This study suggests that adverse smoking effects on pulmonary function were greater in women than in men.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Infection control in the pulmonary function test laboratory

    PubMed Central

    Rasam, Shweta Amol; Apte, Komalkirti Keshavkiran; Salvi, Sundeep Santosh

    2015-01-01

    Pulmonary function testing plays a crucial role in the diagnostic evaluation of patients with lung diseases. Cases of cross infection acquired from the pulmonary function laboratory, although rare, have been reported from various countries. It is therefore imperative to identify the risks and potential organisms implicated in cross infections in a pulmonary function test (PFT) laboratory and implement better and more effective infection control procedures, which will help in preventing cross infections. The infrastructure, the daily patient flow, and the prevalent disinfection techniques used in a PFT laboratory, all play a significant role in transmission of infections. Simple measures to tackle the cross infection potential in a PFT laboratory can help reduce this risk to a bare minimum. Use of specialized techniques and equipment can also be of much use in a set up that has a high turnover of patients. This review aims at creating awareness about the possible pathogens and situations commonly encountered in a PFT laboratory. We have attempted to suggest some relevant and useful infection control measures with regard to disinfection, sterilization, and patient planning and segregation to help minimize the risk of cross infections in a PFT laboratory. The review also highlights the lacuna in the current scenario of PFT laboratories in India and the need to develop newer and better methods of infection control, which will be more user-friendly and cost effective. Further studies to study the possible pathogens in a PFT laboratory and evaluate the prevalent infection control strategies will be needed to enable us to draw more precious conclusions, which can lead to more relevant, contextual recommendations for cross infections control in PFT lab in India. PMID:26180386

  19. Pulmonary function changes in children associated with fine particulate matter

    SciTech Connect

    Koenig, J.Q.; Larson, T.V.; Hanley, Q.S.; Rebolledo, V.; Dumler, K.; Checkoway, H.; Wang, S.Z.; Lin, D.; Pierson, W.E. )

    1993-10-01

    During winter months many neighborhoods in the Seattle metropolitan area are heavily affected by particulate matter from residential wood burning. A study was conducted to investigate the relationship between fine particulate matter and pulmonary function in young children. The subjects were 326 elementary school children, including 24 asthmatics, who lived in an area with high particulate concentrations predominantly from residential wood burning. FEV1 and FVC were measured before, during and after the 1988-1989 and 1989-1990 winter heating seasons. Fine particulate matter was assessed using a light-scattering instrument. Analysis of the relationship between light scattering and lung function indicated that an increase in particulate air pollution was associated with a decline in asthmatic children's pulmonary function. FEV1 and FVC in the asthmatic children dropped an average of 34 and 37 ml respectively for each 10(-4) m-1 increase in sigma sp. This sigma sp increase corresponds to an increase in PM2.5 of 20 micrograms/m3. It is concluded that fine particulate matter from wood burning is significantly associated with acute respiratory irritation in young asthmatic children.

  20. Functional Outcomes of Decompressive Craniectomy in Patients with Malignant Middle Cerebral Artery Infarction and Their Association with Preoperative Thalamus Deformation: An Analysis of 12 Patients.

    PubMed

    Fukuoka, Takuya; Hayashi, Takeshi; Ohira, Masayuki; Kato, Yuji; Deguchi, Ichiro; Maruyama, Hajime; Abe, Tetsuya; Sano, Hiroyasu; Mizuno, Satoko; Nagamine, Yuito; Kurita, Hiroki; Takao, Masaki; Tanahashi, Norio

    2016-01-01

    Objective Decompressive craniectomy (DC) in patients with malignant middle cerebral artery (MCA) infarction is known to decrease the mortality rate. However, the functional outcomes (communication and oral intake) of this procedure remain unclear. Most patients with malignant MCA infarction exhibit a loss of consciousness, which may be principally governed by the thalamus. We herein investigated the functional outcomes of DC at 90 days after the onset of malignant MCA infarction and their association with preoperative thalamus deformation, which can occur due to pressure and edema. Methods Twelve of 2,692 patients with acute cerebral infarction were diagnosed with malignant MCA infarction and underwent DC. We evaluated preoperative thalamus damage using brain computed tomography and its association with communication and oral intake abilities and the modified Rankin Scale (mRS) and Barthel index scores at 90 days after stroke onset. Results The mRS score at 90 days was 0-4 in five patients. Seven patients could communicate immediately after surgery, while five could do so by 90 days. Five patients were able to resume the oral intake of food at 90 days. All patients with preoperative thalamus deformation showed a poor recovery, while those with absent or slight preoperative thalamus deformation showed a good recovery. Conclusion Patients with preoperative thalamus deformation caused by pressure and edema show a poor oral intake and communication abilities after DC, suggesting that preoperative thalamus deformation is a predictor of poor functional outcomes after DC in patients with malignant MCA infarction. PMID:27477404

  1. Analysis of functional abnormalities uncovered during preoperative evaluation of donor candidates for living-related liver transplantation.

    PubMed

    Morimoto, T; Awane, M; Tanaka, A; Ikai, I; Nakamura, Y; Yamamoto, Y; Takada, Y; Honda, K; Inamoto, T; Uemoto, S

    1995-02-01

    Functional abnormalities of the liver uncovered during preoperative routine evaluation were analyzed in 109 donor candidates for 100 cases of living-related liver transplantation (LRLT) performed during the period from June, 1990 to May, 1994 at the Second Department of Surgery, Kyoto University Hospital. High serum transaminase (GOT, GPT) levels were noted in 10 (9.2%) cases among 109 candidates, high alkaline phosphatase in 4 (3.7%), hyperbilirubinemia in 3 (2.8%), anemia in 3 and high choline esterase in 3 cases. Positive hepatitis C antibody (HCV) was also noted in 1 case. Fatty liver was detected in 10 (9.2%) cases, cholecystitis in 2 cases, 1 case each of cyst and calcification in the liver by diagnostic imaging (ultra sonograph and/or computed tomography). These abnormalities of the liver necessitated replacing the initial candidate with the other parent in 9 cases, including 1 case without any functional abnormality whose graft liver was too large to fit the recipient abdominal cavity. There were 14 cases of ABO blood type incompatible combination. Switching the initial candidate due to these abnormalities mentioned above resulted in incompatible combinations in 4 of these 14 cases. Although the advantages of the LRLT are the superior viability of the donor graft and the genetic histocompatibility between recipient and donor, to optimize the advantage of LRLT, all donor candidates should be strongly advised to make every effort preoperatively to improve their physical condition in preparation for the LRLT protocol, since many of these abnormalities are typically reversible.

  2. Pulmonary functions in Indian sportsmen playing different sports.

    PubMed

    Mehrotra, P K; Varma, N; Tiwari, S; Kumar, P

    1998-07-01

    Regular exercise has proved to be beneficial for the human body and the lungs are no exception. The present study was undertaken to assess the relation between the quality of exercise performed and the quantitative effect of these exercises on the lungs. Pulmonary function tests of sportsmen engaged in various sports were compared with each other and with that of the controls. Players playing football (n=18), hockey (n=19), volleyball (n=20), swimming (n=20) and basketball (n=18) were chosen for this study. Medical students (n=20) were chosen as controls. The parameters taken into account in this study were forced vital capacity (FVC), forced expiratory volume (FEV-1), and peak expiratory flow rate (PEFR). The results indicate that all the sportspersons had a higher values of lung functions compared to the controls. Among the various groups of players chosen for this study, the swimmers showed the maximum increase in their lung functions.

  3. Effect of pre-operative neuromuscular training on functional outcome after total knee replacement: a randomized-controlled trial

    PubMed Central

    2013-01-01

    Background Total Knee Replacement (TKR) is the standard treatment for patients with severe knee osteoarthritis (OA). Significant improvement in pain and function are seen after TKR and approximately 80% of patients are very satisfied with the outcome. Functional status prior to TKR is a major predictor of outcome after the intervention. Thus, improving functional status prior to surgery through exercise may improve after surgery outcome. However, results from several previous trials testing the concept have been inconclusive after surgery. Methods/design In a randomized controlled trial (RCT) we will test the effect of a pre-operative neuromuscular trainingprogram versus an attention control program on lower extremity function – before and after surgery. We will enroll 80 participants, aged between 55–90 years, who are scheduled for TKR. In this single-blinded RCT, the intervention group will receive a minimum of 8 and a maximum of 24 training sessions plus 3 educational sessions of the knee school. The control group will receive the 3 educational sessions only. Assessments are performed immediately before and after the intervention (before surgery), at 6 weeks, 3 months and 12 months (after surgery). The primary outcome will include the Chair Stand Test as a measure of leg strength and reaction time. Secondary outcomes are knee function and pain assessed with the self-reported Knee Injury and Osteoarthritis Outcome Score (KOOS). All measurements will be carried out by a specially trained physical therapist, blinded to group allocation. Discussion To our knowledge this is the first single-blinded RCT to test the effect of pre-operative neuromuscular training plus knee school against knee school alone – on knee function and pain, assessed immediately after the interventions prior to surgery and repeatedly after surgery. Trial registration Clinical Trials NCT00913575 PMID:23641782

  4. Risk factors for childhood respiratory disease. Analysis of pulmonary function.

    PubMed

    Vedal, S; Schenker, M B; Samet, J M; Speizer, F E

    1984-08-01

    Four thousand elementary-school-age children from a rural area of western Pennsylvania participated in a cross-sectional survey that consisted of a standardized respiratory questionnaire completed by their parents and spirometric testing at school. Spirographic tracings were digitized to obtain the FVC, FEV0.75, FEF25-75, Vmax75, and Vmax90, which were standardized for height, age, and sex for the subsequent analyses. Independent associations of potential risk factors with the standardized pulmonary function measures were evaluated with multiple regression techniques. Asthma, persistent wheeze, and parental smoking habits, especially those of the mothers, were associated with lower flow rates. The effect of parental smoking was primarily due to smoking by the mother and was stronger in girls. In female children of currently smoking mothers, FEF25-75 was 96% of predicted, Vmax75 was 95% of predicted, and Vmax90 was 92% of predicted; each flow measure was 98% of predicted in male children of smoking mothers. Prolonged hospitalization at birth was independently associated with lower FEV0.75 and flow rates. Low socioeconomic status was associated with lower FVC and FEV0.75. Neither current gas stove use nor a history of severe chest illness before 2 yr of age were independently associated with lower levels of pulmonary function.

  5. PULMONARY FUNCTION STUDIES IN FEMALE SINGERS OF KOLKATA, INDIA.

    PubMed

    Roy, Anindita Singha; Bandyopadhyay, Amit

    2015-12-01

    Singing performance is based on the efficiency of the respiratory system. The present study was aimed to evaluate the results of pulmonary function tests (PFTs) in female singers of Kolkata, India and to compare the data with their sedentary counterparts from India and abroad. The study was also aimed to propose prediction norms for PFTs in both the groups. Fifty-six female singers and fifty-two female non-singers (control group) with similar socioeconomic backgrounds were randomly sampled from the Rabindrabharati University, Kolkata. Pulmonary function tests were conducted by an Expirograph and the peak expiratory flow rate (PEFR) was measured by Wright's peak flow meter. PFTs were significantly higher in singers than in their control group. The correlation matrix depicted a significant relationship of physical parameters (age, body height and body weight) with vital capacity (VC), forced vital capacity (FVC), forced expiratoty volume in 1 second (FEV1) and PEFR in both groups. Regression equations were computed to predict PFTs from physical parameters and duration of invovlement in singing training. The results indicated that female singers of Kolkata had higher lung capacity than their non-singer counterparts probably because of their regular practice and training of singing that required imperative effort of the respiratory system. PMID:27501539

  6. Change in pulmonary function in chronic obstructive pulmonary disease stage 0 patients.

    PubMed

    Gong, Su-Gang; Yang, Wen-Lan; Liu, Jin-Ming; Liu, Wen-Zeng; Zheng, Wei

    2015-01-01

    This study aims to elucidate the change in pulmonary function in stage 0 COPD patients. A total of 48 stage 0 COPD patients and 46 healthy adults were included in the study. The status of their pulmonary function was determined by an impulse oscillometry (IOS) system, and the spirometric indexes such as forced vital capacity, maximum expiratory flow-volume (MEFV) curve, total respiratory impedance (Zrs) and respiratory resistance (Rrs) between the two groups were compared. Significant decreases in the values of forced expiratory flow (FEF) at both 75% and 50% of the vital capacity of the predicted value (EF75/pre and FEF50/pre) were detected in stage 0 COPD patients compared with those in the control (P < 0.05). Significant increases were found in the resonant frequency (Fres) (14.37±3.63 VS 11.26±2.61), total respiratory impedance (Z5) compared with the prediction (Z5/pre) (135.65±19.37 VS 104.69±20.64), total airway resistance at 5 Hz (R5) compared with prediction (R5/pre) (128.46±20.14 VS 100.60±20.98) and peripheral airway resistance (R5-R20) compared with prediction (R5-R20/pre) (282.34±192.83 VS 109.31±80.05) in the study group compared with those in the control(all P < 0.05). The reactance at 5 Hz (X5) (-0.14±0.05 VS -0.08±0.05) in the stage 0 COPD group was markedly lower than that in the healthy group (P < 0.05). Disturbance in the small airway may be detected by the MEFV curve and IOS, and these indexes would be valuable in diagnosing stage 0 COPD. PMID:26885083

  7. Pulmonary function and exercise capacity after lung resection.

    PubMed

    Bolliger, C T; Jordan, P; Solèr, M; Stulz, P; Tamm, M; Wyser, C; Gonon, M; Perruchoud, A P

    1996-03-01

    The influence of pulmonary resection on functional capacity can be assessed in different ways. The aim of this study was to compare the effect of lobectomy and pneumonectomy on pulmonary function tests (PFT), exercise capacity and perception of symptoms. Sixty eight patients underwent functional assessment with PFT and exercise testing before (Preop), and 3 and 6 months after lung resection. In 50 (36 males and 14 females; mean age 61 yrs) a lobectomy was performed and in 18 (13 males and 5 females; mean age 59 yrs) a pneumonectomy was performed. Three months after lobectomy, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), total lung capacity (TLC), transfer factor of the lungs for carbon monoxide (TL,CO) and maximal oxygen uptake (V'O2,max) were significantly lower than Preop values, increasing significantly from 3 to 6 months after resection. Three months after pneumonectomy, all parameters were significantly lower than Preop values and significantly lower than postlobectomy values and did not recover from 3 to 6 months after resection. At 6 months after resection significant deficits persisted in comparison with Preop: for FVC 7% and 36%, FEV1 9% and 34%, TLC 10% and 33% for lobectomy and pneumonectomy, respectively; and V'O2,max 20% after pneumonectomy only. Exercise was limited by leg muscle fatigue in 53% of all patients at Preop. This was not altered by lobectomy, but there was a switch to dyspnoea as the limiting factor after pneumonectomy (61% of patients at 3 months and 50% at 6 months after resection). Furthermore, pneumonectomy compared to lobectomy led to a significantly smaller breathing reserve (mean +/- SD) (28 +/- 13 vs 37 +/- 16% at 3 months; and 24 +/- 11% vs 33 +/- 12% at 6 months post resection) and lower arterial oxygen tension at peak exercise 10.1 +/- 1.5 vs 11.5 +/- 1.6 kPa (76 +/- 11 vs 86 +/- 12 mmHg) at 3 months; 10.1 +/- 1.3 vs 11.3 +/- 1.6 kPa (76 +/- 10 vs 85 +/- 12 mmHg) at 6 months postresection. We

  8. Subclinical respiratory dysfunction in chronic cervical cord compression: a pulmonary function test correlation.

    PubMed

    Bhagavatula, Indira Devi; Bhat, Dhananjaya I; Sasidharan, Gopalakrishnan M; Mishra, Rakesh Kumar; Maste, Praful Suresh; Vilanilam, George C; Sathyaprabha, Talakkad N

    2016-06-01

    OBJECTIVE Respiratory abnormalities are well documented in acute spinal cord injury; however, the literature available for respiratory dysfunction in chronic compressive myelopathy (CCM) is limited. Respiratory dysfunction in CCM is often subtle and subclinical. The authors studied the pattern of respiratory dysfunction in patients with chronic cord compression by using spirometry, and the clinical and surgical implications of this dysfunction. In this study they also attempted to address the postoperative respiratory function in these patients. METHODS A prospective study was done in 30 patients in whom cervical CCM due to either cervical spondylosis or ossification of the posterior longitudinal ligament (OPLL) was diagnosed. Thirty age-matched healthy volunteers were recruited as controls. None of the patients included in the study had any symptoms or signs of respiratory dysfunction. After clinical and radiological diagnosis, all patients underwent pulmonary function tests (PFTs) performed using a standardized Spirometry Kit Micro before and after surgery. The data were analyzed using Statistical Software SPSS version 13.0. Comparison between the 2 groups was done using the Student t-test. The Pearson correlation coefficient was used for PFT results and Nurick classification scores. A p value < 0.05 was considered significant. RESULTS Cervical spondylotic myelopathy (prolapsed intervertebral disc) was the predominant cause of compression (n = 21, 70%) followed by OPLL (n = 9, 30%). The average patient age was 45.06 years. Degenerative cervical spine disease has a relatively younger onset in the Indian population. The majority of the patients (n = 28, 93.3%) had compression at or above the C-5 level. Ten patients (33.3%) underwent an anterior approach and discectomy, 11 patients (36.7%) underwent decompressive laminectomy, and the remaining 9 underwent either corpectomy with fusion or laminoplasty. The mean preoperative forced vital capacity (FVC) (65%) of the

  9. Subclinical respiratory dysfunction in chronic cervical cord compression: a pulmonary function test correlation.

    PubMed

    Bhagavatula, Indira Devi; Bhat, Dhananjaya I; Sasidharan, Gopalakrishnan M; Mishra, Rakesh Kumar; Maste, Praful Suresh; Vilanilam, George C; Sathyaprabha, Talakkad N

    2016-06-01

    OBJECTIVE Respiratory abnormalities are well documented in acute spinal cord injury; however, the literature available for respiratory dysfunction in chronic compressive myelopathy (CCM) is limited. Respiratory dysfunction in CCM is often subtle and subclinical. The authors studied the pattern of respiratory dysfunction in patients with chronic cord compression by using spirometry, and the clinical and surgical implications of this dysfunction. In this study they also attempted to address the postoperative respiratory function in these patients. METHODS A prospective study was done in 30 patients in whom cervical CCM due to either cervical spondylosis or ossification of the posterior longitudinal ligament (OPLL) was diagnosed. Thirty age-matched healthy volunteers were recruited as controls. None of the patients included in the study had any symptoms or signs of respiratory dysfunction. After clinical and radiological diagnosis, all patients underwent pulmonary function tests (PFTs) performed using a standardized Spirometry Kit Micro before and after surgery. The data were analyzed using Statistical Software SPSS version 13.0. Comparison between the 2 groups was done using the Student t-test. The Pearson correlation coefficient was used for PFT results and Nurick classification scores. A p value < 0.05 was considered significant. RESULTS Cervical spondylotic myelopathy (prolapsed intervertebral disc) was the predominant cause of compression (n = 21, 70%) followed by OPLL (n = 9, 30%). The average patient age was 45.06 years. Degenerative cervical spine disease has a relatively younger onset in the Indian population. The majority of the patients (n = 28, 93.3%) had compression at or above the C-5 level. Ten patients (33.3%) underwent an anterior approach and discectomy, 11 patients (36.7%) underwent decompressive laminectomy, and the remaining 9 underwent either corpectomy with fusion or laminoplasty. The mean preoperative forced vital capacity (FVC) (65%) of the

  10. Occupational exposure to amorphous silica dust and pulmonary function.

    PubMed Central

    Choudat, D; Frisch, C; Barrat, G; el Kholti, A; Conso, F

    1990-01-01

    Respiratory manifestations among 41 workers exposed to amorphous silica dust were compared with a control group comprising 90 workers of equivalent socioeconomic state in the same plant. Flow volumes were determined, blood gas concentrations were measured at rest and during exercise, chest radiographs were obtained, and data about respiratory symptoms were collected by questionnaire. A dust exposure index was calculated for each exposed worker. It was not possible to differentiate between the two groups from the questionnaire, blood gas analysis, or chest radiographs. On the other hand, the tests of respiratory function showed a significant decrease in forced expiratory flow (FEF25-75, FEF50, and FEF75) in the exposed group compared with the controls, although no correlation was found between the exposure index and pulmonary function. It appears that smoking and exposure to amorphous silica synergise to induce small airway disease. PMID:2173947

  11. Therapeutic Validity and Effectiveness of Preoperative Exercise on Functional Recovery after Joint Replacement: A Systematic Review and Meta-Analysis

    PubMed Central

    Hoogeboom, Thomas J.; Oosting, Ellen; Vriezekolk, Johanna E.; Veenhof, Cindy; Siemonsma, Petra C.; de Bie, Rob A.; van den Ende, Cornelia H. M.; van Meeteren, Nico L. U.

    2012-01-01

    Background Our aim was to develop a rating scale to assess the therapeutic validity of therapeutic exercise programmes. By use of this rating scale we investigated the therapeutic validity of therapeutic exercise in patients awaiting primary total joint replacement (TJR). Finally, we studied the association between therapeutic validity of preoperative therapeutic exercise and its effectiveness in terms of postoperative functional recovery. Methods (Quasi) randomised clinical trials on preoperative therapeutic exercise in adults awaiting TJR on postoperative recovery of functioning within three months after surgery were identified through database and reference screening. Two reviewers extracted data and assessed the risk of bias and therapeutic validity. Therapeutic validity of the interventions was assessed with a nine-itemed, expert-based rating scale (scores range from 0 to 9; score ≥6 reflecting therapeutic validity), developed in a four-round Delphi study. Effects were pooled using a random-effects model and meta-regression was used to study the influence of therapeutic validity. Results Of the 7,492 articles retrieved, 12 studies (737 patients) were included. None of the included studies demonstrated therapeutic validity and two demonstrated low risk of bias. Therapeutic exercise was not associated with 1) observed functional recovery during the hospital stay (Standardised Mean Difference [SMD]: −1.19; 95%-confidence interval [CI], −2.46 to 0.08); 2) observed recovery within three months of surgery (SMD: −0.15; 95%-CI, −0.42 to 0.12); and 3) self-reported recovery within three months of surgery (SMD −0.07; 95%-CI, −0.35 to 0.21) compared with control participants. Meta-regression showed no statistically significant relationship between therapeutic validity and pooled-effects. Conclusion Preoperative therapeutic exercise for TJR did not demonstrate beneficial effects on postoperative functional recovery. However, poor therapeutic validity of the

  12. Pre-operative Assessment Enables Early Diagnosis and Recovery of Shoulder Function in Patients with Breast Cancer

    PubMed Central

    Springer, Barbara A.; Levy, Ellen; McGarvey, Charles; Pfalzer, Lucinda A.; Stout, Nicole L; Gerber, Lynn H.; Soballe, Peter W.; Danoff, Jerome

    2010-01-01

    Purpose To determine the extent and time course of upper limb impairment and dysfunction in women being treated for breast cancer, and followed prospectively, using a novel physical therapy surveillance model post-treatment. Patients and Methods Subjects included adult women with newly diagnosed, untreated, unilateral, Stage I to III BC and normal physiological and biomechanical shoulder function. Subjects were excluded if they had a previous history of BC, or prior injury or surgery of the affected upper limb. Measurements included body weight, shoulder ranges of motion (ROM), manual muscle tests, pain levels, upper limb volume, and an upper limb disability questionnaire (ULDQ). Measurements were taken at baseline (pre surgery), and one, three-six, and 12 months post surgery. All subjects received pre-operative education and exercise instruction and specific physical therapy (PT) protocol after surgery including ROM and strengthening exercises. Results All measures of function were significantly reduced one month post surgery, but most recovered to baseline levels by one year post surgery. Some subjects developed signs of lymphedema 3–12 months post surgery, but this did not compromise function. Shoulder abduction, flexion, and external rotation, but not internal rotation ROM, were associated with the ULDQ. Conclusion Most women in this cohort undergoing surgery for BC who receive PT intervention may expect a return to baseline ROM and strength by three months. Those who do not reach baseline, often continue to improve and reach their pre-operative levels by one year post surgery. Lymphedema develops independently of shoulder function three to 12 months post surgery, necessitating continued monitoring. A prospective physical therapy model of surveillance allows for detection of early and later onset of impairment following surgery for BC in this specific cohort of patients. PMID:20054643

  13. Pulmonary function in advanced uncomplicated singleton and twin pregnancy* **

    PubMed Central

    Siddiqui, Anwar Hasan; Tauheed, Nazia; Ahmad, Aquil; Mohsin, Zehra

    2014-01-01

    Objective: Pregnancy brings about significant changes in respiratory function, as evidenced by alterations in lung volumes and capacities, which are attributable to the mechanical impediment caused by the growing foetus. This study was undertaken in order to identify changes in respiratory function during normal pregnancy and to determine whether such changes are more pronounced in twin pregnancy than in singleton pregnancy. Methods: Respiratory function was assessed in 50 women with twin pregnancies and in 50 women with singleton pregnancies (during the third trimester in both groups), as well as in 50 non-pregnant women. We measured the following pulmonary function test parameters: FVC; FEV1; PEF rate; FEV1/FVC ratio; FEF25-75%; and maximal voluntary ventilation. Results: All respiratory parameters except the FEV1/FVC ratio were found to be lower in the pregnant women than in the non-pregnant women. We found no significant differences between women with twin pregnancies and those with singleton pregnancies, in terms of respiratory function. Conclusions: Despite its higher physiological demands, twin pregnancy does not appear to impair respiratory function to any greater degree than does singleton pregnancy. PMID:25029647

  14. Theophylline and salbutamol improve pulmonary function in patients with irreversible chronic obstructive pulmonary disease.

    PubMed

    Thomas, P; Pugsley, J A; Stewart, J H

    1992-01-01

    To investigate the efficacy of bronchodilators in patients with irreversible chronic obstructive pulmonary disease (COPD), we conducted a double-blind, randomized, four-phase, crossover comparison between placebo, oral theophylline, inhaled salbutamol, and a combination of both drugs in 12 patients with stable COPD (mean age, 63 years) whose increase in forced expiratory volume in 1 s (FEV1) was less than or equal to 15 percent following 200 micrograms of inhaled salbutamol. Patients received two weeks of therapy with each of the test regimens. Both theophylline and salbutamol resulted in statistically significant improvement in FEV1, forced vital capacity (FVC), slow vital capacity (SVC), residual volume (RV), airway resistance (Raw), and maximum expiratory flow rate at 50 percent of vital capacity (V50). In most instances, there were no significant differences between theophylline and salbutamol. Combination therapy produced significantly greater improvement in FEV1, FVC, V50, Raw, and RV than either agent alone. The two drugs interacted in an additive fashion. Neither of the drugs, used singly, significantly reduced the severity or incidence of symptoms. The reduction in dyspnea and wheeze during combination therapy approached statistical significance (p = 0.06) and patient preference was significantly in favor of the combination regimen. None of the active treatments produced significantly more side effects than placebo. We conclude that theophylline and inhaled salbutamol produce significant, and approximately equal, improvement in pulmonary function in patients traditionally classified as suffering from "irreversible" COPD. The combination of theophylline and inhaled salbutamol generally results in additional improvement over that obtained with either drug used alone and this improvement is reflected by reduced symptomatology and treatment preference.

  15. Sarcoidosis: correlation of pulmonary parenchymal pattern at CT with results of pulmonary function tests

    SciTech Connect

    Bergin, C.J.; Bell, D.Y.; Coblentz, C.L.; Chiles, C.; Gamsu, G.; MacIntyre, N.R.; Coleman, R.E.; Putman, C.E.

    1989-06-01

    The appearances of the lungs on radiographs and computed tomographic (CT) scans were correlated with degree of uptake on gallium scans and results of pulmonary function tests (PFTs) in 27 patients with sarcoidosis. CT scans were evaluated both qualitatively and quantitatively. Patients were divided into five categories on the basis of the pattern of abnormality at CT: 1 = normal (n = 4); 2 = segmental air-space disease (n = 4); 3 = spherical (alveolar) masslike opacities (n = 4); 4 = multiple, discrete, small nodules (n = 6); and 5 = distortion of parenchymal structures (fibrotic end-stage sarcoidosis) (n = 9). The percentage of the volume judged to be abnormal (CT grade) was correlated with PFT results for each CT and radiographic category. CT grades were also correlated with gallium scanning results and percentage of lymphocytes recovered from bronchoalveolar lavage (BAL). Patients in CT categories 1 and 2 had normal lung function, those in category 3 had mild functional impairment, and those in categories 4 and 5 showed moderate to severe dysfunction. The overall CT grade correlated well with PFT results expressed as a percentage of the predicted value. In five patients, CT scans showed extensive parenchymal disease not seen on radiographs. CT grades did not correlate with the results of gallium scanning or BAL lymphocytes. The authors conclude that patterns of parenchymal sarcoidosis seen at CT correlate with the PFT results and can be used to indicate respiratory impairment.

  16. Effect of lung transplantation on diaphragmatic function in patients with chronic obstructive pulmonary disease.

    PubMed Central

    Wanke, T.; Merkle, M.; Formanek, D.; Zifko, U.; Wieselthaler, G.; Zwick, H.; Klepetko, W.; Burghuber, O. C.

    1994-01-01

    BACKGROUND--To date there are no data on the effects of lung transplantation on diaphragmatic function in patients with end stage chronic obstructive pulmonary disease (COPD). It is not known whether the relation between the transdiaphragmatic pressure (PDI) and lung volume is altered in recipients after transplantation as a result of changes in diaphragmatic structure caused by chronic hyperinflation. The effect of lung transplantation on diaphragmatic strength was determined in patients with COPD and the relation between postoperative PDI and lung volume analysed. METHODS--Diaphragmatic strength was assessed in eight double lung transplant recipients, six single lung transplant recipients, and in 14 patients with COPD whose lung function was similar to those of the transplant recipients preoperatively. PDI obtained during unilateral and bilateral phrenic nerve stimulation at 1 Hz (twitch PDI) at functional residual capacity (FRC) and during maximal sniff manoeuvres (sniff PDI) at various levels of inspiratory vital capacity (VCin) served as parameters for diaphragmatic strength. Sniff PDI assessed at the various VCin levels were used to analyse the PDI/lung volume relation. RESULTS--Lung transplantation caused a reduction in lung volume, especially in the double lung transplant recipients. As a consequence sniff PDI was higher in the double lung transplant recipients than in the patients with COPD at all levels of VCin analysed. However, sniff PDI values analysed at comparable intrathoracic gas volumes were not reduced in the patients with COPD when compared with those who underwent lung transplantation. Bilateral twitch PDI values were similar in the patients with COPD and in the lung transplant recipients. In the single lung transplant recipients unilateral twitch PDI values were similar on the transplanted and the non-transplanted side. The relation between PDI and lung volume was similar in the patients with COPD and in the lung transplant recipients

  17. Pulmonary Function Testing After Stereotactic Body Radiotherapy to the Lung

    SciTech Connect

    Bishawi, Muath; Kim, Bong; Moore, William H.; Bilfinger, Thomas V.

    2012-01-01

    Purpose: Surgical resection remains the standard of care for operable early-stage non-small-cell lung cancer (NSCLC). However, some patients are not fit for surgery because of comorbidites such as chronic obstructive pulmonary disease (COPD) and other medical conditions. We aimed to evaluate pulmonary function and tumor volume before and after stereotactic body radiotherapy (SBRT) for patients with and without COPD in early-stage lung cancer. Methods and Materials: A review of prospectively collected data of Stage I and II lung cancers, all treated with SBRT, was performed. The total SBRT treatment was 60 Gy administered in three 20 Gy fractions. The patients were analyzed based on their COPD status, using their pretreatment pulmonary function test cutoffs as established by the American Thoracic Society guidelines (forced expiratory volume [FEV]% {<=}50% predicted, FEV%/forced vital capacity [FVC]% {<=}70%). Changes in tumor volume were also assessed by computed tomography. Results: Of a total of 30 patients with Stage I and II lung cancer, there were 7 patients in the COPD group (4 men, 3 women), and 23 in t he No-COPD group (9 men, 14 women). At a mean follow-up time of 4 months, for the COPD and No-COPD patients, pretreatment and posttreatment FEV% was similar: 39 {+-} 5 vs. 40 {+-} 9 (p = 0.4) and 77 {+-} 0.5 vs. 73 {+-} 24 (p = 0.9), respectively. The diffusing capacity of the lungs for carbon monoxide (DL{sub CO}) did significantly increase for the No-COPD group after SBRT treatment: 60 {+-} 24 vs. 69 {+-} 22 (p = 0.022); however, DL{sub CO} was unchanged for the COPD group: 49 {+-} 13 vs. 50 {+-} 14 (p = 0.8). Although pretreatment tumor volume was comparable for both groups, tumor volume significantly shrank in the No-COPD group from 19 {+-} 24 to 9 {+-} 16 (p < 0.001), and there was a trend in the COPD patients from 12 {+-} 9 to 6 {+-} 5 (p = 0.06). Conclusion: SBRT did not seem to have an effect on FEV{sub 1} and FVC, but it shrank tumor volume and

  18. [Preoperative analysis in rhinoplasty].

    PubMed

    Nguyen, P S; Bardot, J; Duron, J B; Levet, Y; Aiach, G

    2014-12-01

    Preoperative analysis in rhinoplasty consists in analyzing individual anatomical and functional characteristics without losing sight of the initial requirements of the patient to which priority should be given. The examination is primarily clinical but it also uses preoperative photographs taken at specific accurate angles. Detecting functional disorders or associated general pathologies, which will reduce the risk of complications. All of these factors taken into account, the surgeon can work out a rhinoplasty plan which he or she will subsequently explain to the patient and obtain his or her approbation.

  19. Assessment of Preoperative Liver Function in Patients with Hepatocellular Carcinoma – The Albumin-Indocyanine Green Evaluation (ALICE) Grade

    PubMed Central

    Kokudo, Takashi; Hasegawa, Kiyoshi; Amikura, Katsumi; Uldry, Emilie; Shirata, Chikara; Yamaguchi, Takamune; Arita, Junichi; Kaneko, Junichi; Akamatsu, Nobuhisa; Sakamoto, Yoshihiro; Takahashi, Amane; Sakamoto, Hirohiko; Makuuchi, Masatoshi; Matsuyama, Yutaka; Demartines, Nicolas; Malagó, Massimo; Kokudo, Norihiro; Halkic, Nermin

    2016-01-01

    Background Most patients with hepatocellular carcinoma (HCC) have underlying liver disease, therefore, precise preoperative evaluation of the patient’s liver function is essential for surgical decision making. Methods We developed a grading system incorporating only two variables, namely, the serum albumin level and the indocyanine green retention rate at 15 minutes (ICG R15), to assess the preoperative liver function, based on the overall survival of 1868 patients with HCC who underwent liver resection. We then tested the model in a European cohort (n = 70) and analyzed the predictive power for the postoperative short-term outcome. Results The Albumin-Indocyanine Green Evaluation (ALICE) grading system was developed in a randomly assigned training cohort: linear predictor = 0.663 × log10ICG R15 (%)−0.0718 × albumin (g/L) (cut-off value: -2.20 and -1.39). This new grading system showed a predictive power for the overall survival similar to the Child-Pugh grading system in the validation cohort. Determination of the ALICE grade in Child-Pugh A patients allowed further stratification of the postoperative prognosis. This result was reproducible in the European cohort. Determination of the ALICE grade allowed better prediction of the risk of postoperative liver failure and mortality (ascites: grade 1, 2.1%; grade 2, 6.5%; grade 3, 16.0%; mortality: grade 1, 0%; grade 2, 1.3%; grade 3, 5.3%) than the previously reported model based on the presence/absence of portal hypertension. Conclusions This new grading system is a simple method for prediction of the postoperative long-term and short-term outcomes. PMID:27434062

  20. Alterations of pulmonary function in patients with inflammatory bowel diseases

    PubMed Central

    Ji, Xiao-Qing; Ji, Yan-Bo; Wang, Shan-Xin; Zhang, Cai-Qing; Lu, De-Gan

    2016-01-01

    AIM: The aim of this study was to investigate the alterations of pulmonary function tests (PFTs) and their relationship with disease activity in inflammatory bowel diseases (IBDs). METHODS: Sixty-four IBD patients (31 Crohn's disease [CD] and 33 ulcerative colitis [UC]) and thirty healthy individuals (controls) were studied with regard to the following parameters of PFTs: Forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), their ratio, mid-forced expiratory flow of 25–75% (FEF 25–75), residual volume, total lung capacity, and diffusing capacity of the lung for carbon monoxide (DLCO). The disease activity was calculated using the Crohn's Disease Activity Index for CD and Mayo Clinic Score for UC. Correlation analysis was performed between disease activity and sputum cytology and PFTs. RESULTS: Nineteen of the 31 CD patients (61.29%) and 17 of the 33 UC patients (51.52%) but none of the controls showed at least one abnormal PFTs (P < 0.05). Compared with controls, both CD and UC patients exhibited a significant reduction in FEV1 (P < 0.05), FVC (P < 0.05), FEF 25–75 (P < 0.05), and DLCO (P < 0.05). The majority with decreased measurements of PFTs were in the active phase of diseases (P < 0.05). IBD activity scores correlated negatively with some parameters of PFTs and positively with lymphocytosis and eosinophilia of sputum (P < 0.05). CONCLUSIONS: Pulmonary function disorders are significantly common in IBD patients. The impairment in active disease is significantly greater than in remission. PMID:27803750

  1. Indoor air pollution and pulmonary function growth in preadolescent children

    SciTech Connect

    Berkey, C.S.; Ware, J.H.; Dockery, D.W.; Ferris, B.G. Jr.; Speizer, F.E.

    1986-02-01

    Results are reported from a study of the association between exposure to sidestream cigarette smoke or gas stove emissions and pulmonary function level and growth rate of 7834 children seen at 2-5 annual visits between the ages of 6-10 years. Children whose mothers smoked one pack of cigarettes per day had levels of forced expiratory volume in one second (FEV1) at age eight that were 0.81% lower than children of nonsmoking mothers (p less than 0.0001), and FEV1 growth rates approximately 0.17% per year lower (p = 0.05). For a child of age eight with an FEV1 of 1.62 liters, this corresponds to a deficit in rate of change of FEV1 of approximately 3 ml/annum and a deficit of 13 ml at age eight. Children whose mothers smoked one pack per day had levels of forced vital capacity (FVC) at age eight that were 0.33% higher than children of nonsmokers (p = 0.12); however, their growth rates of FVC were 0.17% per year lower (p = 0.04). Because few mothers changed their smoking habits during the course of the study, it was not possible to determine whether the difference in rate of growth was due to current exposure or to an effect of prenatal and early childhood exposure on the course of development. The magnitude of the effect on FEV1 is consistent with deficits in FEV1 of up to 3% in early adult life due to childhood exposure to sidestream cigarette smoke. The importance of this relatively small effect will be evaluated further through follow-up of these children as they are exposed to other risk factors such as personal active smoking. The data provide some evidence for an association between gas stove exposure and pulmonary function level, especially at younger ages, but no evidence for an effect of gas stove exposure on growth rate.

  2. Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet.

    PubMed

    Noly, Pierre-Emmanuel; Guihaire, Julien; Coblence, Matthieu; Dorfmüller, Peter; Fadel, Elie; Mercier, Olaf

    2015-11-04

    An original piglet model of Chronic Thromboembolic Pulmonary Hypertension (CTEPH) associated with chronic Right Ventricular (RV) dysfunction is described. Pulmonary Hypertension (PH) was induced in 3-week-old piglets by a progressive obstruction of the pulmonary vascular bed. A ligation of the left Pulmonary Artery (PA) was performed first through a mini-thoracotomy. Second, weekly embolizations of the right lower pulmonary lobe were done under fluoroscopic guidance with n-butyl-2-cyanoacrylate during 5 weeks. Mean Pulmonary Arterial Pressure (mPAP) measured by ritght heart catheterism, increased progressively, as well as Right Atrial pressure and Pulmonary Vascular Resistances (PVR) after 5 weeks compared to sham animals. Right Ventricular (RV) structural and functional remodeling were assessed by transthoracic echocardiography (RV diameters, RV wall thickness, RV systolic function). RV elastance and RV-pulmonary coupling were assessed by Pressure-Volume Loops (PVL) analysis with conductance method. Histologic study of the lung and the right ventricle were also performed. Molecular analyses on RV fresh tissues could be performed through repeated transcutaneous endomyocardial biopsies. Pulmonary microvascular disease in obstructed and unobstructed territories was studied from lung biopsies using molecular analyses and pathology. Furthermore, the reliability and the reproducibility was associated with a range of PH severity in animals. Most aspects of the human CTEPH disease were reproduced in this model, which allows new perspectives for the understanding of the underlying mechanisms (mitochondria, inflammation) and new therapeutic approaches (targeted, cellular or gene therapies) of the overloaded right ventricle but also pulmonary microvascular disease.

  3. Randomized Clinical Trial of Pre-operative Feeding to Evaluate Intestinal Barrier Function in Neonates Requiring Cardiac Surgery

    PubMed Central

    Zyblewski, Sinai C.; Nietert, Paul J.; Graham, Eric M.; Taylor, Sarah N.; Atz, Andrew M.; Wagner, Carol L.

    2015-01-01

    Objective To evaluate intestinal barrier function in neonates undergoing cardiac surgery using lactulose/mannitol (L/M) ratio measurements and to determine correlations with early breast milk feeding. Study design This was a single-center, prospective, randomized pilot study of 27 term neonates (≥37 weeks gestation) requiring cardiac surgery who were randomized to one of two pre-operative feeding groups: 1) nil per os (NPO) vs. 2) trophic (10 cc/kg/day) breast milk feeds. At three time points (pre-op, post-op day 7, and post-op day 14), subjects were administered an oral lactulose/mannitol solution and subsequent L/M ratios were measured using gas chromatography, with higher ratios indicative of increased intestinal permeability. Trends over time in the mean urine L/M ratios for each group were estimated using a general linear mixed model. Results There were no adverse events related to pre-operative trophic feeding. In the NPO group (n=13), the mean urine L/M ratios at pre-op, post-op day 7, and post-op day 14 were 0.06, 0.12, and 0.17, respectively. In the trophic breast milk feeds group (n=14), the mean urine L/M ratios at pre-op, post-op day 7, and post-op day 14 were 0.09, 0.19, and 0.15, respectively. Both groups had significantly higher L/M ratios at post-op day 7 and 14 compared with pre-op (p<0.05). Conclusions Neonates have increased intestinal permeability after cardiac surgery extending to at least post-op day 14. This pilot study was not powered to detect differences in benefit or adverse events comparing NPO with breast milk feeds. Further studies to identify mechanisms of intestinal injury and therapeutic interventions are warranted. Trial registration Registered with ClinicalTrials.gov: NCT01475357. PMID:25962930

  4. Hemodynamic, Functional, and Clinical Responses to Pulmonary Artery Denervation in Patients With Pulmonary Arterial Hypertension of Different Causes

    PubMed Central

    Zhang, Hang; Xie, Du-Jiang; Zhang, Juan; Zhou, Ling; Rothman, Alexander M.K.

    2015-01-01

    Background— The mechanisms underlying pulmonary arterial hypertension (PAH) are multifactorial. The efficacy of pulmonary artery denervation (PADN) for idiopathic PAH treatment has been evaluated. This study aimed to analyze the hemodynamic, functional, and clinical responses to PADN in patients with PAH of different causes. Methods and Results— Between April 2012 and April 2014, 66 consecutive patients with a resting mean pulmonary arterial pressure ≥25 mm Hg treated with PADN were prospectively followed up. Target drugs were discontinued after the PADN procedure. Hemodynamic response and 6-minute walk distance were repeatedly measured within the 1 year post PADN follow-up. The clinical end point was the occurrence of PAH-related events at the 1-year follow-up. There were no PADN-related complications. Hemodynamic success (defined as the reduction in mean pulmonary arterial pressure by a minimal 10% post PADN) was achieved in 94% of all patients, with a mean absolute reduction in systolic pulmonary arterial pressure and mean pulmonary arterial pressure within 24 hours of −10 mm Hg and −7 mm Hg, respectively. The average increment in 6-minute walk distance after PADN was 94 m. Worse PAH-related events occurred in 10 patients (15%), mostly driven by the worsening of PAH (12%). There were 8 (12%) all-cause deaths, with 6 (9%) PAH-related deaths. Conclusions— PADN was safe and feasible for the treatment of PAH. The PADN procedure was associated with significant improvements in hemodynamic function, exercise capacity, and cardiac function and with less frequent PAH-related events and death at 1 year after PADN treatment. Further randomized studies are required to confirm the efficacy of PADN for PAH. Clinical Trial Registration— URL: http://www.chictr.trc.com.cn. Unique identifier: chiCTR-ONC-12002085. PMID:26553699

  5. Respiratory symptoms in rheumatoid arthritis: relation to pulmonary abnormalities detected by high-resolution CT and pulmonary functional testing.

    PubMed

    Youssef, Amir A; Machaly, Shereen A; El-Dosoky, Mohammed E; El-Maghraby, Nermeen M

    2012-07-01

    Pulmonary disease is the most frequent and among the most severe extra-articular manifestation of rheumatoid arthritis (RA). However, this issue has not been sufficiently studied in Egyptian patients. The objectives of the present study are to investigate the prevalence and types of pulmonary involvement using high-resolution computed tomography scan (HRCT) and pulmonary function tests (PFT) and evaluate the association between respiratory symptoms and RA-lung disease in a group of Egyptian RA patients. Thirty-six RA patients were recruited; 34 females (94.4%) and 2 males (5.6%) with median age of 48.5 years, and none of them was smoker. Detailed medical and drug histories were obtained. PFT, plain X-ray of the chest, and HRCT were performed to all subjects involved. Nearly 64% of RA patients demonstrated abnormalities in PFT and 47% in HRCT. Mixed restrictive and obstructive pattern was the commonest. Nearly two-thirds of our patients reported one or more pulmonary symptom whether dyspnea, cough, wheezing, or phlegm. Dyspnea was the most frequent symptom. Respiratory symptoms were statistically more common in patients with lung disease. The advanced age, high radiological score, and severity of rheumatoid disease were found to be predictive of lung involvement. Among respiratory symptoms, dyspnea and cough were associated with any pulmonary abnormalities. When specific pulmonary abnormalities were considered, only dyspnea was identified as predictor for restriction. For obstructive abnormality, both cough and wheezing provided valid prediction. We conclude that pulmonary involvement is a common manifestation in Egyptian RA patients, and the pattern of involvement is generally consistent with other studies that were performed worldwide. Specific respiratory symptoms could be used as practical, easy, and cost-effective method, especially in older and with more severe RA patients, to discriminate patients in need of subsequent PFT and HRCT imaging.

  6. Commuting mode and pulmonary function in Shanghai, China.

    PubMed

    Gaffney, Adam W; Hang, Jing-Qing; Lee, Mi-Sun; Su, Li; Zhang, Feng-Ying; Christiani, David C

    2016-03-01

    Exposure to air pollution can be particularly high during commuting and may depend on the mode of transportation. We investigated the impact of commuting mode on pulmonary function in Shanghai, China.The Shanghai Putuo Study is a cross-sectional, population-based study. Our primary outcomes were forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) % predicted, and the secondary outcome was spirometric airflow obstruction. We tested the association between mode of transportation and these outcomes after adjusting for confounders.The study population consisted of 20 102 subjects. After adjusting for confounders, the change (95% CI) in FEV1 was -2.15% pred (-2.88- -1.42% pred) among pedestrians, -1.32% pred (-2.05- -0.59% pred) among those taking buses without air conditioning, -1.33% pred (-2.05- -0.61% pred) among those taking buses with air conditioning and -2.83% pred (-5.56- -0.10% pred) among those using underground railways, as compared to cyclists (the reference group). The effects of mode on FVC % predicted were in the same direction. Private car use had a significant protective effect on FVC % predicted and the risk of airflow obstruction (defined by Global Initiative for Chronic Obstructive Lung Disease but not by lower limit of normal criteria).Mode of transportation is associated with differences in lung function, which may reflect pollution levels in different transportation microenvironments. PMID:26541519

  7. Does acute exposure to aldehydes impair pulmonary function and structure?

    PubMed

    Abreu, Mariana de; Neto, Alcendino Cândido; Carvalho, Giovanna; Casquillo, Natalia Vasconcelos; Carvalho, Niedja; Okuro, Renata; Ribeiro, Gabriel C Motta; Machado, Mariana; Cardozo, Aléxia; Silva, Aline Santos E; Barboza, Thiago; Vasconcellos, Luiz Ricardo; Rodrigues, Danielle Araujo; Camilo, Luciana; Carneiro, Leticia de A M; Jandre, Frederico; Pino, Alexandre V; Giannella-Neto, Antonio; Zin, Walter A; Corrêa, Leonardo Holanda Travassos; Souza, Marcio Nogueira de; Carvalho, Alysson R

    2016-07-15

    Mixtures of anhydrous ethyl alcohol and gasoline substituted for pure gasoline as a fuel in many Brazilian vehicles. Consequently, the concentrations of volatile organic compounds (VOCs) such as ketones, other organic compounds, and particularly aldehydes increased in many Brazilian cities. The current study aims to investigate whether formaldehyde, acetaldehyde, or mixtures of both impair lung function, morphology, inflammatory and redox responses at environmentally relevant concentrations. For such purpose, C57BL/6 mice were exposed to either medical compressed air or to 4 different mixtures of formaldehyde and acetaldehyde. Eight hours later animals were anesthetized, paralyzed and lung mechanics and morphology, inflammatory cells and IL-1β, KC, TNF-α, IL-6, CCL2, MCP-1 contents, superoxide dismutase and catalalase activities were determined. The extra pulmonary respiratory tract was also analyzed. No differences could be detected between any exposed and control groups. In conclusion, no morpho-functional alterations were detected in exposed mice in relation to the control group. PMID:27102012

  8. Pulmonary function and clearance after prolonged sulfuric acid aerosol exposure

    SciTech Connect

    Ives, P.J. ); Gerrity, T.R.; DeWitt, P.; Folinsbee, L.J. )

    1991-03-15

    The authors studied pulmonary function and clearance responses after a 4 H exposure to 75-100 {mu}g/m{sup 3} sulfuric acid aerosol (SAA). Healthy subjects, who exercised for 30 min/H at ventilation of about 25 L/min, were exposed once to clean air and once to SAA. Oral hygiene and acidic juice gargle were used to minimize oral ammonia. Lung function tests, including spirometry, plethysmography, and partial flow-volume (PEFV) curves were performed before and after exposure. Clearance of 99m-Technetium labeled iron oxide was assessed after each exposure. The first moment of fractional tracheobronchial retention (M1TBR), after correcting for 24 H retention and normalizing to time zero, was used as an index of clearance. There were no significant changes in lung volumes, airways resistance, or maximum expiratory flows after SAA exposure. Flow at 40% of total lung capacity on PEFV curves decreased 17% (NS) after SAA exposure. Tracheobronchial clearance was accelerated after a single exposure to SAA; M1TBR decreased from 73 {plus minus} 5 min (air) to 69 {plus minus} 5 min (SAA). These results suggest that acute prolonged exposure to low levels of SAA has minimal effects on lung mechanics in healthy subjects but does produce a modest acceleration of particle clearance.

  9. Effect of yoga on pulmonary function tests of hypothyroid patients.

    PubMed

    Swami, Gaurav; Singh, Savita; Singh, K P; Gupta, Manish

    2010-01-01

    Aim of this study was to see any effect on respiratory functions in hypothyroid patients after pranayama (yoga). The subjects for the study were 20 hypothyroid females, 39.70 +/- 8.27 years of mean age referred from medicine department of UCMS & G.T.B. Hospital. Spiro metric recordings were taken with hypair (version-1.28). Baseline (first) recordings were taken when patient came for the first time. Patients came to yoga lab in physiology department for 21 days continuously where they were trained by the yoga instructors and then told to do pranayama at home and called at regular intervals after 7 days to see the compliance. The breathing exercises were done for 45 minutes everyday. After 6 months of pranayama second recording was taken and compared with the baseline. There were significant improvement in forced expiratory volume in first second (FEV1), Maximum voluntary ventilation (MVV) and Inspiratory Capacity(IC). Thus Pranayama and meditation has beneficial effect on pulmonary functions of hypothyroid patients along with conventional treatment.

  10. Oxidant-antioxidant status and pulmonary function in welding workers.

    PubMed

    Fidan, Fatma; Unlü, Mehmet; Köken, Tülay; Tetik, Levent; Akgün, Sema; Demirel, Reha; Serteser, Mustafa

    2005-07-01

    Welding is a process during which fumes, gases, electromagnetic radiation and noise are emitted as by-products. Metal oxide particles are particularly hazardous components of welding fumes. Welding has been found to be associated with respiratory symptoms and our objective in the present study was to study the effects of welding on pulmonary function and serum oxidant-antioxidant status. Fifty-one welding workers and 31 control subjects were recruited. Face to face interviews were conducted using the respiratory illness questionnaire adapted from the American Thoracic Society with the addition of demographic characteristics, work history and working conditions. Additionally physical examinations and spirometric measurements were performed at workplaces. Thiobarbituric acid reactive substances (TBARS), protein carbonyls, protein sulfhydryls (SH) and erythrocyte reduced glutathione (GSH) levels were measured to evaluate oxidant-antioxidant status in 34 welding workers and in 20 control subjects. No statistically significant differences were observed in age, height, weight, body mass index (BMI), smoking status and annual working durations between welding workers and controls. Coughing, sputting and wheezing were significantly higher in welding workers (p<0.05). When adjusted for age, BMI and smoking status in logistic regression, welding work showed a significant risk for chronic bronchitis (OR: 4.78, 95%CI: 1.30-17.54). Forced expiratory volume in one second (FEV(1))/forced vital capacity (FVC) and four parameters of forced expiratory flow (FEF: FEF(25), FEF(50), FEF(75), FEF(25-75)) levels measured in the welding workers were significantly lower than those in the control group (p<0.05). Serum TBARS and protein carbonyl levels were higher in welding workers than those in controls (p<0.001, p<0.05, respectively). On the other hand, total protein SH groups and GSH levels were significantly lower in welders than those in controls (p<0.05, p<0.001, respectively

  11. Indoor air pollution and pulmonary function growth in preadolescent children.

    PubMed

    Berkey, C S; Ware, J H; Dockery, D W; Ferris, B G; Speizer, F E

    1986-02-01

    Results are reported from a study of the association between exposure to sidestream cigarette smoke or gas stove emissions and pulmonary function level and growth rate of 7,834 children seen at 2-5 annual visits between the ages of 6-10 years. Children whose mothers smoked one pack of cigarettes per day had levels of forced expiratory volume in one second (FEV1) at age eight that were 0.81% lower than children of nonsmoking mothers (p less than 0.0001), and FEV1 growth rates approximately 0.17% per year lower (p = 0.05). For a child of age eight with an FEV1 of 1.62 liters, this corresponds to a deficit in rate of change of FEV1 of approximately 3 ml/annum and a deficit of 13 ml at age eight. Children whose mothers smoked one pack per day had levels of forced vital capacity (FVC) at age eight that were 0.33% higher than children of nonsmokers (p = 0.12); however, their growth rates of FVC were 0.17% per year lower (p = 0.04). Because few mothers changed their smoking habits during the course of the study, it was not possible to determine whether the difference in rate of growth was due to current exposure or to an effect of prenatal and early childhood exposure on the course of development. The magnitude of the effect on FEV1 is consistent with deficits in FEV1 of up to 3% in early adult life due to childhood exposure to sidestream cigarette smoke. The importance of this relatively small effect will be evaluated further through follow-up of these children as they are exposed to other risk factors such as personal active smoking. The data provide some evidence for an association between gas stove exposure and pulmonary function level, especially at younger ages, but no evidence for an effect of gas stove exposure on growth rate.

  12. Longitudinal pulmonary function losses in Vermont granite workers. A reevaluation.

    PubMed

    Graham, W G; Weaver, S; Ashikaga, T; O'Grady, R V

    1994-07-01

    Previous studies have suggested that excessive losses of FVC and FEV1 were occurring in Vermont granite workers despite the fact that mean quartz levels existing in the industry were below the current OSHA standard of 100 micrograms/m3. We reexamined these losses in granite workers over an 8-year period, testing the workforce biennially from 1979 to 1987. All workers, including stone shed, quarry, and office, were offered forced spirometry using a 10-L water-sealed spirometer (Collins). In the peak year of participation (1983), 887 workers out of a total of approximately 1,400 were tested. Estimates of longitudinal loss were based on 711 workers who participated in at least three of the surveys. The mean age of this group was 42.9 years, and the mean years employed was 19.3 years; 21.4 percent were non-smokers (NS), 34.2 percent were ex-smokers (ES), and 44.4 percent were current smokers (CS). Average annual losses of FVC were 0.018 (SD = 0.056) L (CS, 0.025 L; NS, 0.006 L: and ES, 0.016 L). Average annual losses of FEV1 were 0.030 (SD = 0.041) L (CS, 0.038 L; NS, 0.020 L; and ES, 0.027 L). Analysis of covariance indicated that losses were related to the initial values for FVC or FEV1, height, age, and smoking status. After adjusting for these variables, the losses of both FVC and FEV1 were not correlated with years employed in the granite industry. No significant differences existed in the loss of FVC or FEV1 in categories of workers exposed to different levels of granite dust, eg, office, quarry, and stone shed workers. The annual losses of pulmonary function were significantly smaller than those estimated previously, which were 0.070 to .080 L in FVC, and 0.050-0.070 L in FEV1. We conclude that dust levels in the Vermont granite industry, which have been in conformance with OSHA permissible exposure limits, do not accelerate pulmonary function loss.

  13. Reduction in adverse effect on pulmonary function after exposure to filtered diesel exhaust

    SciTech Connect

    Ulfvarson, U.; Alexandersson, R. )

    1990-01-01

    A statistically significant temporary reduction on pulmonary function was measured with spirometry in stevedores on a roll-on-roll-off ro-ro ship who were exposed to diesel exhausts from trucks during a work shift. When all trucks were equipped with specially designed microfilters mounted on the exhaust pipes, this impairment in pulmonary function was reduced. Removal of the particulate fraction of the exhausts by filtering is an important factor in reducing the adverse effect of diesel exhaust on pulmonary function. The particle fraction should be considered when designing an indicator of the biological effects of diesel exhausts.

  14. The role of diffusion tensor imaging in establishing the proximity of tumor borders to functional brain systems: implications for preoperative risk assessments and postoperative outcomes.

    PubMed

    Ulmer, John L; Salvan, Carmen V; Mueller, Wade M; Krouwer, Hendrikus G; Stroe, Georgetta O; Aralasmak, Ayse; Prost, Robert W

    2004-12-01

    Diffusion Tensor Imaging (DTI) is a new MRI imaging technique sensitive to directional movements of water molecules, induced by tissue barriers. This provides a new form of contrast that allows the identification of functional white matter tracts within the brain, and has been proposed as a technique suitable for presurgical planning in brain tumor patients. Resection of primary brain tumors improves survival, functional performance, and the effectiveness of adjuvant therapies, provided that surgically-induced neurological deficits can be avoided. Diffusion Tensor Imaging (DTI) has the potential to establish spatial relationships between eloquent white matter and tumor borders, provide information essential to preoperative planning, and improve the accuracy of surgical risk assessments preoperatively. We present our experience in a series of 28 brain tumor patients where the integration of functional magnetic resonance imaging (fMRI) and DTI data was used to determine key anatomic spatial relationships preoperatively. Twice as many functional systems were localized to within 5 mm of tumor borders when DTI and fMRI were utilized for preoperative planning, compared to that afforded by fMRI alone. Our results show that the combined use of fMRI and DTI can provide a better estimation of the proximity of tumor borders to eloquent brain systems sub-serving language, speech, vision, motor and premotor functions. Additionally, a low regional complication rate (4%) observed in our series suggests that preoperative planning with these combined techniques may improve surgical outcomes compared to that previously reported in the literature. Larger studies specifically designed to establish the accuracy and predictive value of DTI in brain tumor patients are warranted to substantiate our preliminary observations.

  15. Identifying preoperative language tracts and predicting postoperative functional recovery using HARDI q-ball fiber tractography in patients with gliomas.

    PubMed

    Caverzasi, Eduardo; Hervey-Jumper, Shawn L; Jordan, Kesshi M; Lobach, Iryna V; Li, Jing; Panara, Valentina; Racine, Caroline A; Sankaranarayanan, Vanitha; Amirbekian, Bagrat; Papinutto, Nico; Berger, Mitchel S; Henry, Roland G

    2016-07-01

    OBJECT Diffusion MRI has uniquely enabled in vivo delineation of white matter tracts, which has been applied to the segmentation of eloquent pathways for intraoperative mapping. The last decade has also seen the development from earlier diffusion tensor models to higher-order models, which take advantage of high angular resolution diffusion-weighted imaging (HARDI) techniques. However, these advanced methods have not been widely implemented for routine preoperative and intraoperative mapping. The authors report on the application of residual bootstrap q-ball fiber tracking for routine mapping of potentially functional language pathways, the development of a system for rating tract injury to evaluate the impact on clinically assessed language function, and initial results predicting long-term language deficits following glioma resection. METHODS The authors have developed methods for the segmentation of 8 putative language pathways including dorsal phonological pathways and ventral semantic streams using residual bootstrap q-ball fiber tracking. Furthermore, they have implemented clinically feasible preoperative acquisition and processing of HARDI data to delineate these pathways for neurosurgical application. They have also developed a rating scale based on the altered fiber tract density to estimate the degree of pathway injury, applying these ratings to a subset of 35 patients with pre- and postoperative fiber tracking. The relationships between specific pathways and clinical language deficits were assessed to determine which pathways are predictive of long-term language deficits following surgery. RESULTS This tracking methodology has been routinely implemented for preoperative mapping in patients with brain gliomas who have undergone awake brain tumor resection at the University of California, San Francisco (more than 300 patients to date). In this particular study the authors investigated the white matter structure status and language correlation in a

  16. Characterization of pulmonary function in Duchenne Muscular Dystrophy

    PubMed Central

    Finkel, R.S.; Rummey, C.; Benton, M.J.; Glanzman, A.M.; Flickinger, J.; Lindström, B.‐M.; Meier, T.

    2015-01-01

    Summary Decline in pulmonary function in Duchenne Muscular Dystrophy (DMD) contributes to significant morbidity and reduced longevity. Spirometry is a widely used and fairly easily performed technique to assess lung function, and in particular lung volume; however, the acceptability criteria from the American Thoracic Society (ATS) may be overly restrictive and inappropriate for patients with neuromuscular disease. We examined prospective spirometry data (Forced Vital Capacity [FVC] and peak expiratory flow [PEF]) from 60 DMD patients enrolled in a natural history cohort study (median age 10.3 years, range 5–24 years). Expiratory flow‐volume curves were examined by a pulmonologist and the data were evaluated for acceptability using ATS criteria modified based on the capabilities of patients with neuromuscular disease. Data were then analyzed for change with age, ambulation status, and glucocorticoid use. At least one acceptable study was obtained in 44 subjects (73%), and 81 of the 131 studies (62%) were acceptable. The FVC and PEF showed similar relative changes in absolute values with increasing age, i.e., an increase through 10 years, relative stabilization from 10–18 years, and then a decrease at an older age. The percent predicted, FVC and PEF showed a near linear decline of approximately 5% points/year from ages 5 to 24. Surprisingly, no difference was observed in FVC or PEF by ambulation or steroid treatment. Acceptable spirometry can be performed on DMD patients over a broad range of ages. Using modified ATS criteria, curated spirometry data, excluding technically unacceptable data, may provide a more reliable means of determining change in lung function over time. Pediatr Pulmonol. 2015; 50:487–494. © 2015 Wiley Periodicals, Inc. PMID:25755201

  17. Indoor air pollution and pulmonary function growth in preadolescent children

    SciTech Connect

    Berkey, C.S.; Ware, J.H.; Dockery, D.W.; Ferris, B.G.; Speizer, F.E.

    1986-01-01

    Results are reported from a study of the association between exposure to sidestream cigarette smoke or gas-stove emissions and pulmonary-function level and growth rate of 7,834 children seen at 2-5 annual visits between the ages of 6-10 years. Children whose mothers smoked one pack of cigarettes per day had levels of forced expiratory volume in one second (FEV1) at age eight that were 0.81% lower than children of nonsmoking mothers (p<0.0001), and FEV1 growth rates approximately 0.17% per year lower (p=0.05). For a child of age eight with an FEV1 of 1.62 liters, this corresponds to a deficit in rate of change of FEV1 of approximately 3 ml/annum and a deficit of 13 ml at age eight. Children whose mothers smoked one pack per day had levels of forced vital capacity (FVC) at age eight that were 0.33% higher than children of nonsmokers (p=0.12); however, their growth rates of FVC were 0.17% per year lower (p=0.04). Because few mothers changed their smoking habits during the course of the study, it was not possible to determine whether the difference in rate of growth was due to current exposure or to an effect of prenatal and early childhood exposure on the course of development.

  18. Pulmonary function in children after a single scuba dive.

    PubMed

    Lemaître, F; Tourny-Chollet, C; Hamidouche, V; Lemouton, M C

    2006-11-01

    This study evaluated the respiratory effects of a single dive in children. Eighteen young divers and 18 controls participated in our study (age range: 9 - 13 years). Volumes and expiratory flow rates were measured 20 minutes before and 10 minutes after one air dive (3 meters, 25 minutes). Before the dive, no differences were noted regarding pulmonary parameters. Ten minutes after the dive, decreases were noted in forced expiratory volume in 1 s (FEV1) and maximal voluntary ventilation (- 8 %, - 5.3 %, respectively; p < 0.01), peak expiratory flow, maximal expiratory flow rates at 50 % of FVC (MEF(50 %)) and MEF(25 %), forced mid-expiratory flow rate (FEF(25 - 75 %)), and FEV1/FVC(- 5.9 %, - 14.3 %, - 21.4 %, - 4.2 %, - 3.5 %, respectively; p < 0.05). The respiratory pattern observed 10 minutes after a single dive to three meters indicated airway narrowing. However, no association between diving experience and lung function was obtained.

  19. [Preoperative direct cortical and sub-cortical electric stimulation during cerebral surgery in functional areas].

    PubMed

    Duffau, H; Capelle, L; Sichez, J P; Bitar, A; Faillot, T; Arthuis, F; Van Effenterre, R; Fohanno, D

    1999-09-01

    Indications of surgical treatment for lesions in functional cerebral areas depend on the ratio between the definitive neurological deficit and the beneficial effect of resection. Detection of eloquent cortex is difficult because of important individual variability. Peroperative direct cortical and subcortical electrical stimulations (DCS) provide the most precise and reliable method currently available allowing identification and preservation of neurons essential for motricity, sensitivity++ and language. We report our preliminary experience with DCS in surgery of intracerebral infiltrative tumors with a consecutive series of 15 patients operated from November 96 through September 97 in our institution. Presenting symptoms in the 15 patients (8 males, 7 females, mean age 43 years) were seizures in 11 cases (73%) and neurological deficit in 4 cases (27%). Clinical examination was normal in 11 patients and revealed hemiparesia in 4. Magnetic resonance imaging (MRI) with three-dimensional reconstruction showed a precentral tumor in 10 cases, central lesion in one patient, postcentral lesion in two cases, right insular tumor (non-dominant hemisphere) in one case. All patients underwent surgical resection using DCS with detection in 13 cases of motor cortex and subcortical pathways under genera anesthesia, in one case of somatosensory area under local anesthesia, and in one case of language areas also under local anesthesia. The tumor was recurrent in two patients had been operated earlier but without DCS. Resection, verified by postoperative MRI, was total in 12 cases (80%) and estimated at 80% in 3 patients. Histological examination revealed an infiltrative glioma in 12 cases (8 low grade astrocytomas, 3 low grade oligodendrogliomas, and one anaplastic oligodendroglioma), and metastases in 3 cases. Eight patients had no postoperative deficit, while the other 7 patients were impaired, with, in all cases except one, complete recovery in 15 days to 2 months. Direct

  20. The effect of lumbar stabilization exercise on the pulmonary function of stroke patients

    PubMed Central

    Oh, Dae-Sik; Park, Si-Eun

    2016-01-01

    [Purpose] This study was aimed at assessing the effect of lumbar stabilization exercise on the pulmonary function of stroke patients. [Subjects and Methods] The subjects were randomly allocated into lumbar stabilization exercise group and a general physical therapy group. The program consisted of 30-min sessions conducted 3 days a week for 8 weeks. Pulmonary function was assessed based on lung performance parameters, including forced vital capacity, forced expiratory volume at 1 second, ratio of forced expiratory volume at 1 second to forced vital capacity, and peak expiratory flow. [Results] In the assessment of pulmonary function, the values of all the lung performance parameters were significantly increased in the lumbar stabilization exercise group but were significantly decreased in the general physical therapy group. [Conclusion] These results indicate that lumbar stabilization exercise had a more positive effect on pulmonary function than general physical therapy. PMID:27390442

  1. The effect of lumbar stabilization exercise on the pulmonary function of stroke patients.

    PubMed

    Oh, Dae-Sik; Park, Si-Eun

    2016-06-01

    [Purpose] This study was aimed at assessing the effect of lumbar stabilization exercise on the pulmonary function of stroke patients. [Subjects and Methods] The subjects were randomly allocated into lumbar stabilization exercise group and a general physical therapy group. The program consisted of 30-min sessions conducted 3 days a week for 8 weeks. Pulmonary function was assessed based on lung performance parameters, including forced vital capacity, forced expiratory volume at 1 second, ratio of forced expiratory volume at 1 second to forced vital capacity, and peak expiratory flow. [Results] In the assessment of pulmonary function, the values of all the lung performance parameters were significantly increased in the lumbar stabilization exercise group but were significantly decreased in the general physical therapy group. [Conclusion] These results indicate that lumbar stabilization exercise had a more positive effect on pulmonary function than general physical therapy.

  2. Cross-sectional study of pulmonary function in carbon black workers in the United States

    SciTech Connect

    Robertson, J.M.; Diaz, J.F.; Fyfe, I.M.; Ingalls, T.H.

    1988-04-01

    Since a proportion of airborne carbon black particles is of respirable size, the possibility that it may affect pulmonary function was investigated in 913 employees of 6 carbon black producers in the United States. Exposure was estimated by combining the mean total dust exposures of each job category with the length of time workers had spent in each job, giving a measurement expressed in mg/m3.months. Pulmonary function was measured by spirometry. The major variables affecting pulmonary function were age and cigarette smoking. When the effects of age and smoking were controlled in an age-specific, two-way analysis of variance, no consistent effects of total dust exposure were detectable in these workers. This study provided no evidence that exposure to total dust under the conditions pertaining in the contemporary carbon black industry had detrimental effects on the pulmonary function of men employed in the production and handling of this product.

  3. Antenatal Hypoxia and Pulmonary Vascular Function and Remodeling

    PubMed Central

    Papamatheakis, Demosthenes G.; Blood, Arlin B.; Kim, Joon H.; Wilson, Sean M.

    2015-01-01

    This review provides evidence that antenatal hypoxia, which represents a significant and worldwide problem, causes prenatal programming of the lung. A general overview of lung development is provided along with some background regarding transcriptional and signaling systems of the lung. The review illustrates that antenatal hypoxic stress can induce a continuum of responses depending on the species examined. Fetuses and newborns of certain species and specific human populations are well acclimated to antenatal hypoxia. However, antenatal hypoxia causes pulmonary vascular disease in fetuses and newborns of most mammalian species and humans. Disease can range from mild pulmonary hypertension, to severe vascular remodeling and dangerous elevations in pressure. The timing, length, and magnitude of the intrauterine hypoxic stress are important to disease development, however there is also a genetic-environmental relationship that is not yet completely understood. Determining the origins of pulmonary vascular remodeling and pulmonary hypertension and their associated effects is a challenging task, but is necessary in order to develop targeted therapies for pulmonary hypertension in the newborn due to antenatal hypoxia that can both treat the symptoms and curtail or reverse disease progression. PMID:24063380

  4. Antenatal hypoxia and pulmonary vascular function and remodeling.

    PubMed

    Papamatheakis, Demosthenes G; Blood, Arlin B; Kim, Joon H; Wilson, Sean M

    2013-09-01

    This review provides evidence that antenatal hypoxia, which represents a significant and worldwide problem, causes prenatal programming of the lung. A general overview of lung development is provided along with some background regarding transcriptional and signaling systems of the lung. The review illustrates that antenatal hypoxic stress can induce a continuum of responses depending on the species examined. Fetuses and newborns of certain species and specific human populations are well acclimated to antenatal hypoxia. However, antenatal hypoxia causes pulmonary vascular disease in fetuses and newborns of most mammalian species and humans. Disease can range from mild pulmonary hypertension, to severe vascular remodeling and dangerous elevations in pressure. The timing, length, and magnitude of the intrauterine hypoxic stress are important to disease development, however there is also a genetic-environmental relationship that is not yet completely understood. Determining the origins of pulmonary vascular remodeling and pulmonary hypertension and their associated effects is a challenging task, but is necessary in order to develop targeted therapies for pulmonary hypertension in the newborn due to antenatal hypoxia that can both treat the symptoms and curtail or reverse disease progression.

  5. T Cell Functional Disturbances in Patients with Pulmonary Tuberculosis.

    PubMed

    Ostanin, Alexander A.; Khonina, Nataliya A.; Norkin, Maxim N.; Leplina, Olga Yu.; Nikonov, Sergey D.; Ogirenko, Anatoly P.; Chernykh, Helen R.

    2000-04-01

    The investigations of 38 patients with pulmonary tuberculosis (PT) revealed combined T cell and monocyte functional disturbances. Indeed, the percentages of CD4(+) and CD8(+) T lymphocytes, proliferative response and IL-2 production, as well as the percentages of HLA DR(+) monocytes and IL-1beta production were significantly decreased in PT patients as compared with normal individuals. Herewith the absolute T lymphocyte number did not undergo the pronounced changes. The decrease of T cell proliferative response was not mediated through immunosuppressive action of monocytes or T lymphocytes since removing of "adherent" cells from patient's peripheral blood mononuclear cells (PBMC) or pretreatment of PBMC with indomethacin and cyclophosphan failed to recover mitogenic reactivity in vitro. The patient's sera also did not significantly influence on PBMC proliferation. The decrease of IL-2 production and the stimulation of T cell proliferative response via TcR-CD3 complex, i.e. through the classic pathway of activation, indicated the anergy of T lymphocyte in tuberculosis patients. Furthermore, T lymphocytes were characterized by enhanced apoptosis. It should be noted, that patient's sera (especially in the patients with an initially high apoptosis) promoted significant anti-apoptotic activity. It is likely that this mechanism may be an explanation, why absolute T lymphopenia is absent during tuberculosis infection. Our findings suggest, that T lymphocyte dysfunctions in patients with PT are caused by impairments of T cell activation process, which lead to predominance of "negative" response (induction anergy, apoptosis) and to a lesser degree connected with direct suppressive mechanisms mediated by monocytes, T lymphocytes or serum factors.

  6. [Preoperative Arterial Embolization with N-butyl-2 Cyanoacrylate for Chronic Cavitary Pulmonary Aspergillosis with Trauma Induced Type Ⅰ Diabetes Mellitus].

    PubMed

    Nakanishi, Yusuke; Kojima, Fumitsugu; Kamo, Minobu; Wakejima, Ryo; Okura, Mariko; Jinta, Torahiko; Chonabayashi, Naohiko; Bando, Toru

    2016-03-01

    A 50-year-old man with hemoptysis, given a diagnosis of left upper lobe pulmonary aspergilloma with cavity and fungus ball by computed tomography. He has a history of typeⅠ diabetes mellitus due to traumatic injury of pancreas and underwent diaphragm plasty. Despite of systemic anti-fungal medication, symptom and radiological findings were not progressed and surgical intervention was planned. Before surgery we performed intercostal artery embolization, in order to minimize bleeding on dissecting adhesion between the chest wall and the lobe with aspergilloma. Left upper lobectomy with muscle-flap prombage was done safely with a blood loss of 450 ml. Postoperative course was favorable. Intercostal artery embolization with N-butyl-2cyanoacrylate is an effective way to minimize hemorrhage during surgical resection for pulmonary aspergillosis with sever adhesion. PMID:27075282

  7. Pulmonary Complications due to Esophagectomy

    PubMed Central

    Shirinzadeh, Abulfazl; Talebi, Yashar

    2011-01-01

    Introduction Esophageal carcinoma is the scourge of human beings. Pulmonary complications in patients who have undergone operation are common (20-30% of cases) and there are no suitable tools and ways to predict these complications. Methods During a period of 10 years, from March 1998 to February 2007, 200 patients (150 male and 50 female) underwent Esophagectomy due to esophageal carcinoma in thoracic surgery ward retrospectively. Complications include the length of hospitalization, mechanical ventilation, morbidity and mortality. Patients’ risk factors include age, preoperative chemo-radiotherapy, stage of the disease and preoperative spirometry condition. Results We grouped our patients into three categories: Normal (FEV1 ≥ 80% predicted), mildly impaired (FEV1 65% to 79% predicted), more severely impaired (FEV1 < 65% predicted).Although almost all patients had radiographic pulmonary abnormalities, significant pulmonary complications occurred in 40 patients (20%) which underwent Esophagectomy. Pleural effusion and atelectasia in 160 patients (80%). 24 patients needed chest-tube insertion. 20 patients (10%) developed ARDS. 14 patients (7%) developed chylothorax. 20 patients (10%) of patients died during their postoperative hospital stay. 30 patients (15%) required mechanical ventilation for greater than 48 hours. Conclusion We reviewed a number of preoperative clinical variables to determine whether they contributed to postoperative pulmonary complications as well as other outcomes. In general, age, impaired pulmonary function especially in those patients with FEV1 less than 65% predicted was associated with prolonged hospital length of stay (LOS). In fact pulmonary complications rate after Esophagectomy are high and there was associated mortality and morbidity. PMID:24250962

  8. Sequential Treatments with Tongsai and Bufei Yishen Granules Reduce Inflammation and Improve Pulmonary Function in Acute Exacerbation-Risk Window of Chronic Obstructive Pulmonary Disease in Rats.

    PubMed

    Lu, Xiaofan; Li, Ya; Li, Jiansheng; Wang, Haifeng; Wu, Zhaohuan; Li, Hangjie; Wang, Yang

    2016-01-01

    Background. Sequential treatments of Chinese medicines for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) risk window (RW) have benefits for preventing reoccurrences of AEs; however, the effects on pulmonary function, pulmonary, and systemic inflammatory biomarkers remain unclear. Methods. Cigarette-smoke/bacterial infections induced rats were randomized into Control, COPD, AECOPD, Tongsai Granule/normal saline (TSG/NS), moxifloxacin + salbutamol/NS (MXF+STL/NS), TSG/Bufei Yishen Granule (BYG), MXF+STL/STL, and TSG+MXF+STL/BYG+STL groups and given corresponding medicine(s) in AE- and/or RW phase. Body temperature, pulmonary function, blood cytology, serum amyloid A (SAA) and C-reactive protein (CRP), pulmonary histomorphology and myeloperoxidase (MPO), polymorphonuclear (PMN) elastase, interleukins IL-1β, IL-6, and IL-10, and tumor necrosis factor- (TNF-) α expressions were determined. Results. Body temperature, inflammatory cells and cytokines, SAA, CRP, and pulmonary impairment were higher in AECOPD rats than stable COPD, while pulmonary function declined and recovered to COPD level in 14-18 days. All biomarkers were improved in treated groups with shorter recovery times of 4-10 days, especially in TSG+MXF+STL/BYG+STL group. Conclusion. Sequential treatments with Tongsai and Bufei Yishen Granules, during AECOPD-RW periods, can reduce inflammatory response and improve pulmonary function and shorten the recovery courses of AEs, especially the integrated Chinese and Western medicines. PMID:27563333

  9. Sequential Treatments with Tongsai and Bufei Yishen Granules Reduce Inflammation and Improve Pulmonary Function in Acute Exacerbation-Risk Window of Chronic Obstructive Pulmonary Disease in Rats

    PubMed Central

    Lu, Xiaofan; Li, Ya; Wang, Haifeng; Wu, Zhaohuan; Li, Hangjie; Wang, Yang

    2016-01-01

    Background. Sequential treatments of Chinese medicines for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) risk window (RW) have benefits for preventing reoccurrences of AEs; however, the effects on pulmonary function, pulmonary, and systemic inflammatory biomarkers remain unclear. Methods. Cigarette-smoke/bacterial infections induced rats were randomized into Control, COPD, AECOPD, Tongsai Granule/normal saline (TSG/NS), moxifloxacin + salbutamol/NS (MXF+STL/NS), TSG/Bufei Yishen Granule (BYG), MXF+STL/STL, and TSG+MXF+STL/BYG+STL groups and given corresponding medicine(s) in AE- and/or RW phase. Body temperature, pulmonary function, blood cytology, serum amyloid A (SAA) and C-reactive protein (CRP), pulmonary histomorphology and myeloperoxidase (MPO), polymorphonuclear (PMN) elastase, interleukins IL-1β, IL-6, and IL-10, and tumor necrosis factor- (TNF-) α expressions were determined. Results. Body temperature, inflammatory cells and cytokines, SAA, CRP, and pulmonary impairment were higher in AECOPD rats than stable COPD, while pulmonary function declined and recovered to COPD level in 14–18 days. All biomarkers were improved in treated groups with shorter recovery times of 4–10 days, especially in TSG+MXF+STL/BYG+STL group. Conclusion. Sequential treatments with Tongsai and Bufei Yishen Granules, during AECOPD-RW periods, can reduce inflammatory response and improve pulmonary function and shorten the recovery courses of AEs, especially the integrated Chinese and Western medicines. PMID:27563333

  10. [Preoperative Management of Patients with Bronchial Asthma or Chronic Bronchitis].

    PubMed

    Hagihira, Satoshi

    2015-09-01

    Bronchial asthma is characterized by chronic airway inflammation. The primary goal of treatment of asthma is to maintain the state of control. According to the Japanese guidelines (JGL2012), long-term management consists of 4 therapeutic steps, and use of inhaled corticosteroids (ICS) is recommended at all 4 steps. Besides ICS, inhalation of long-acting β2-agonist (LABA) is also effective. Recently, omalizumab (a humanized antihuman IgE antibody) can be available for patients with severe allergic asthma. Although there is no specific strategy for preoperative treatment of patients with asthma, preoperative systemic steroid administration seemed to be effective to prevent asthma attack during anesthesia. The most common cause of chronic bronchitis is smoking. Even the respiratory function is within normal limits, perioperative management of patients with chronic bronchitis is often troublesome. The most common problem is their sputum. To minimize perioperative pulmonary complication in these patients, smoking cessation and pulmonary rehabilitation are essential. It is known that more than 1 month of smoking cessation is required to reduce perioperative respiratory complication. However, even one or two weeks of smoking cessation can decrease sputum secretion. In summary, preoperative optimization is most important to prevent respiratory complication in patients with bronchial asthma or chronic bronchitis. PMID:26466493

  11. Self-efficacy of knee function as a pre-operative predictor of outcome 1 year after anterior cruciate ligament reconstruction.

    PubMed

    Thomeé, Pia; Währborg, Peter; Börjesson, Mats; Thomeé, Roland; Eriksson, B I; Karlsson, Jon

    2008-02-01

    The knee self-efficacy scale (K-SES) has been shown to have good reliability, validity and responsiveness during rehabilitation for patients' perceived self-efficacy of knee function. Determinants of self-efficacy of knee function 1 year after ACL reconstruction have been found to be the patients' internal locus of control and knee symptoms in sports and recreation. The predictive ability of perceived self-efficacy of knee function measured by the K-SES has not been studied in terms of patient outcome after an ACL reconstruction. The purpose of this study was to explore the potential for pre-operative self-efficacy of knee function measured by the K-SES to predict patient outcome in terms of physical activity, knee symptoms and muscle function 1 year after an ACL reconstruction. Thirty-eight patients were evaluated for outcome in terms of physical activity with the Tegner activity scale and the physical activity scale (PAS), knee symptoms with the Lysholm knee scoring scale and the knee injury and osteoarthritis outcome score (KOOS) and knee function with ability tests for muscle function 1 year after ACL reconstruction. Multiple regression and logistic multiple regression analysis were used to evaluate the K-SES as a possible predictor of outcome. The patients' present perceived self-efficacy of knee function (K-SES(Present)) pre-operatively was a significant predictor (P = 0.016) of the patients returning to their intensity and frequency of physical activity (PAS) 1 year after ACL reconstruction, when adjusted for age, gender and pre-injury physical activity level (Tegner(Pre-injury)) (odds ratio = 2.1). The patients' perceived future self-efficacy of knee function (K-SES(Future)) pre-operatively was a significant predictor (P = 0.045) of their self-rated knee function in sports/recreational activities (KOOS(Sports/recreation)) at the 1-year follow-up, when adjusted for age, gender and Tegner(Pre-injury )(R (2 )=0.25). The pre-operative K-SES(Future) was also a

  12. Physiological functions of transient receptor potential channels in pulmonary arterial smooth muscle cells.

    PubMed

    Yang, Xiao-Ru; Lin, Mo-Jun; Sham, James S K

    2010-01-01

    The transient receptor potential (TRP) gene superfamily, which consists of 7 subfamilies with at least 28 mammalian homologues, is known to encode a wide variety of cation channels with diverse biophysical properties, activation mechanisms, and physiological functions. Recent studies have identified multiple TRP channel subtypes, belonging to the canonical (TRPC), melastatin-related (TRPM), and vanilloid-related (TRPV) subfamilies, in pulmonary arterial smooth muscle cells (PASMCs). They operate as specific Ca(2+) pathways responsive to stimuli, including Ca(2+) store depletion, receptor activation, reactive oxygen species, growth factors, and mechanical stress. Increasing evidence suggests that these channels play crucial roles in agonist-induced pulmonary vasoconstriction, hypoxic pulmonary vasoconstriction, smooth muscle cell proliferation, vascular remodeling, and pulmonary arterial hypertension. This chapter highlighted and discussed these putative physiological functions of TRP channels in pulmonary vasculatures. Since Ca(2+) ions regulate many cellular processes via specific Ca(2+) signals, future investigations of these novel channels will likely uncover more important regulatory mechanisms of pulmonary vascular functions in health and in disease states. PMID:20204726

  13. Preoperative β-cell function in patients with type 2 diabetes is important for the outcome of Roux-en-Y gastric bypass surgery

    PubMed Central

    Lund, Michael Taulo; Hansen, Merethe; Skaaby, Stinna; Dalby, Sina; Støckel, Mikael; Floyd, Andrea Karen; Bech, Karsten; Helge, Jørn Wulff; Holst, Jens Juul; Dela, Flemming

    2015-01-01

    The majority of the patients with type 2 diabetes (T2DM) show remission after Roux-en-Y gastric bypass (RYGB). This is the result of increased postoperative insulin sensitivity and β-cell secretion. The aim of the present study was to elucidate the importance of the preoperative β-cell function in T2DM for the chance of remission after RYGB. Fifteen patients with and 18 without T2DM had 25 g oral (OGTT) and intravenous (IVGTT) glucose tolerance tests performed at inclusion, after a diet-induced weight loss, and 4 and 18 months after RYGB. Postoperative first phase insulin secretion rate (ISR) during the IVGTT and β-cell glucose sensitivity during the OGTT increased in T2DM. Postoperative insulin sensitivity and the disposition index (DI) markedly increased in both groups. By stratifying the T2DM into two groups according to highest (T2DMhigh) and lowest (T2DMlow) baseline DI, a restoration of first phase ISR and β-cell glucose sensitivity were seen only in T2DMhigh. Remission of type 2 diabetes was 71 and 38% in T2DMhigh and T2DMlow, respectively. Postoperative postprandial GLP-1 concentrations increased markedly, but did not differ between the groups. Our findings emphasize the importance of the preoperative of β-cell function for remission of diabetes after RYGB. Key points Roux-en-Y gastric bypass surgery leads to remission of type 2 diabetes in the majority of patients suffering from the disease. The gut hormone glucagon-like peptide-1 is believed to be of major importance for the remission process. The present project demonstrates a marked difference in the chance of remission of type 2 diabetes in patients with low or high preoperative β-cell function in spite of a similar post-surgery increase in postprandial glucagon-like peptide-1 release. Furthermore, post-surgery intravenous glucose administration, which does not stimulate release of glucagon-like peptide-1, leads to increased insulin secretion in the patients with the best preoperative

  14. The effect of manual therapy on pulmonary function in healthy adults.

    PubMed

    Wall, Bradley A; Peiffer, Jeremiah J; Losco, Barrett; Hebert, Jeffrey J

    2016-01-01

    Manual therapy is suggested as a potentially therapeutic intervention that may improve pulmonary function. However, this form of therapy is largely based on clinical observations and hypothetical models rather than mechanistic knowledge. This study examined the influence of a single session of manual therapy applied to the thoracic spine and thorax on dynamic pulmonary function over an extended time frame in healthy adults. 21 healthy individuals (14 males) aged 19-35 (mean [SD] age = 23 [3.9], BMI [SD] = 22.97 [2.41]) completed one experimental testing session consisting of five pulmonary function tests and the delivery of a manual therapy intervention. Pulmonary function was measured at baseline and 1 minute, 10 minutes, 20 minutes and 30 minutes following the intervention. Baseline mean (SD) forced vital capacity (FVC), forced expired volume in 1 second (FEV1) and maximal voluntary ventilation (MVV) were 5.55(1.23 L), 4.64(0.92 L) and 165.7(40.0L min(-1)) respectively. The mean (SD) FEV1/FVC ratio was 0.84(0.07). There were no statistically significant changes in any of the pulmonary function measures following the manual therapy intervention. Our findings do not support the use of manual therapy to provide a short-term benefit in respiratory function to healthy adults. PMID:27616562

  15. The effect of manual therapy on pulmonary function in healthy adults

    PubMed Central

    Wall, Bradley A.; Peiffer, Jeremiah J.; Losco, Barrett; Hebert, Jeffrey J.

    2016-01-01

    Manual therapy is suggested as a potentially therapeutic intervention that may improve pulmonary function. However, this form of therapy is largely based on clinical observations and hypothetical models rather than mechanistic knowledge. This study examined the influence of a single session of manual therapy applied to the thoracic spine and thorax on dynamic pulmonary function over an extended time frame in healthy adults. 21 healthy individuals (14 males) aged 19–35 (mean [SD] age = 23 [3.9], BMI [SD] = 22.97 [2.41]) completed one experimental testing session consisting of five pulmonary function tests and the delivery of a manual therapy intervention. Pulmonary function was measured at baseline and 1 minute, 10 minutes, 20 minutes and 30 minutes following the intervention. Baseline mean (SD) forced vital capacity (FVC), forced expired volume in 1 second (FEV1) and maximal voluntary ventilation (MVV) were 5.55(1.23 L), 4.64(0.92 L) and 165.7(40.0L min−1) respectively. The mean (SD) FEV1/FVC ratio was 0.84(0.07). There were no statistically significant changes in any of the pulmonary function measures following the manual therapy intervention. Our findings do not support the use of manual therapy to provide a short-term benefit in respiratory function to healthy adults. PMID:27616562

  16. Effects of water immersion on pulmonary function in asthmatics.

    PubMed

    Leddy, J J; Roberts, A; Moalem, J; Curry, T; Lundgren, C E

    2001-01-01

    Immersion induces air trapping in the lungs, as does asthma. Consequently, when using diving apparatus, asthmatics may face greater risk than non-asthmatics of pulmonary barotrauma (PBT) during ascent. We studied the pulmonary airflows and closing capacities (CC = closing volume + residual volume) in subjects with exercise-induced asthma (A, n = 12) and in healthy controls (C, n = 11) under four conditions: dry and immersed, both before and after exercise (treadmill running, non-immersed). Immersed, both C and A had significant and equivalent reductions in vital capacity, FEV1, FEV1/FVC, and FEF25%-75%. Post-exercise and immersed, pulmonary airflows deteriorated further in A but were better in C: FEV1 (A, 3.6 +/- 0.8 liter vs. 3.3 +/- 0.8 liter, P = 0.001; C, 3.9 +/- 0.5 liter vs. 4.1 +/- 0.6 liter, P = 0.006), FEF25-75% (A, 3.5 +/- 1.0 liter x s(-1) vs. 3.0 +/- 0.8 liter x s(-1). P < 0.05; C, 4.0 +/- 0.9 liter x s(-1) vs. 4.3 +/- 0.9 liter x s(-1), P < 0.05). Therefore, in contrast to C, A subjects had reduced pulmonary airflows during immersion after exercise. Furthermore, A subjects more often had no closing volume phase IV when immersed after exercise than C (P = 0.005). Interpreting the absence of phase IV as indicative of more air trapping in the asthmatics during immersion after exercise would be consistent with the reductions in airflow.

  17. Coffee intake, smoking, and pulmonary function in the Atherosclerosis Risk in Communities Study.

    PubMed

    Nettleton, Jennifer A; Follis, Jack L; Schabath, Matthew B

    2009-06-15

    Coffee contains polyphenolic antioxidants and caffeine, which may favorably affect pulmonary function. Therefore, the authors studied cross-sectional associations (1987-1989) between coffee intake and pulmonary function in the Atherosclerosis Risk in Communities Study, a population-based cohort study (analytic sample = 10,658). They also conducted analyses stratified by smoking status, since smoking is a strong risk factor for respiratory disease and could influence the effects of caffeine and antioxidants. Self-reported coffee intake was categorized as rare/never, <7 cups/week, 1 cup/day, 2-3 cups/day, and >or=4 cups/day. Pulmonary function was characterized by the spirometric measures forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV(1)). After adjustment for demographic factors, lifestyle characteristics, and dietary factors, pulmonary function values increased across increasing categories of coffee consumption in never and former smokers but not in current smokers. In never or former smokers who consumed >or=4 cups of coffee daily, FVC and FEV(1) were 2%-3% greater than in never or former smokers who rarely/never consumed coffee (P(trend) values: in never smokers, 0.04 for FVC and 0.07 for FEV(1); in former smokers, <0.001 for FVC and <0.001 for FEV(1)). These data show a possible beneficial effect of coffee (or a coffee ingredient) on pulmonary function, but it appears to be limited to nonsmokers.

  18. Cardiorespiratory fitness, pulmonary function and C-reactive protein levels in nonsmoking individuals with diabetes

    PubMed Central

    Francisco, C.O.; Catai, A.M.; Moura-Tonello, S.C.G.; Lopes, S.L.B.; Benze, B.G.; Del Vale, A.M.; Leal, A.M.O.

    2014-01-01

    The objective of this study was to evaluate cardiorespiratory fitness and pulmonary function and the relationship with metabolic variables and C-reactive protein (CRP) plasma levels in individuals with diabetes mellitus (DM). Nineteen men with diabetes and 19 age- and gender-matched control subjects were studied. All individuals were given incremental cardiopulmonary exercise and pulmonary function tests. In the exercise test, maximal workload (158.3±22.3 vs 135.1±25.2, P=0.005), peak heart rate (HRpeak: 149±12 vs 139±10, P=0.009), peak oxygen uptake (VO2peak: 24.2±3.2 vs 18.9±2.8, P<0.001), and anaerobic threshold (VO2VT: 14.1±3.4 vs 12.2±2.2, P=0.04) were significantly lower in individuals with diabetes than in control subjects. Pulmonary function test parameters, blood pressure, lipid profile (triglycerides, HDL, LDL, and total cholesterol), and CRP plasma levels were not different in control subjects and individuals with DM. No correlations were observed between hemoglobin A1C (HbA1c), CRP and pulmonary function test and cardiopulmonary exercise test performance. In conclusion, the results demonstrate that nonsmoking individuals with DM have decreased cardiorespiratory fitness that is not correlated with resting pulmonary function parameters, HbA1c, and CRP plasma levels. PMID:24760118

  19. Pulmonary function of Indian athletes and sportsmen: comparison with American athletes.

    PubMed

    Lakhera, S C; Mathew, L; Rastogi, S K; Sen Gupta, J

    1984-01-01

    Studies were conducted to evaluate pulmonary functions in Indian athletes and sportsmen associated with different athletic events and games. It was found that swimmers were having significantly higher vital capacity (VC) and forced expiratory volume (FEV1) values than all other athletic groups studied. Results have been discussed keeping in view the physiological, functional and structural demands in various events. Pulmonary function values of Indian athletes have also been compared with American athletes of standardized height for a better appraisal of athletic potentiality in our athletes. The importance of athletic training from childhood have been ascribed to be the reason for superior lung volumes and capacities in US athletes.

  20. Pulmonary vascular function and exercise capacity in black sub-Saharan Africans.

    PubMed

    Simaga, Bamodi; Vicenzi, Marco; Faoro, Vitalie; Caravita, Sergio; Di Marco, Giovanni; Forton, Kevin; Deboeck, Gael; Lalande, Sophie; Naeije, Robert

    2015-09-01

    Sex and age affect the pulmonary circulation. Whether there may be racial differences in pulmonary vascular function is unknown. Thirty white European Caucasian subjects (15 women) and age and body-size matched 30 black sub-Saharan African subjects (15 women) underwent a cardiopulmonary exercise test and exercise stress echocardiography with measurements of pulmonary artery pressure (PAP) and cardiac output (CO). A pulmonary vascular distensibility coefficient α was mathematically determined from the natural curvilinearity of multipoint mean PAP (mPAP)-CO plots. Maximum oxygen uptake (V̇o2max) and workload were higher in the whites, while maximum respiratory exchange ratio and ventilatory equivalents for CO2 were the same. Pulmonary hemodynamics were not different at rest. Exercise was associated with a higher maximum total pulmonary vascular resistance, steeper mPAP-CO relationships, and lower α-coefficients in the blacks. These differences were entirely driven by higher slopes of mPAP-CO relationships (2.5 ± 0.7 vs. 1.4 ± 0.7 mmHg·l(-1)·min; P < 0.001) and lower α-coefficients (0.85 ± 0.33 vs. 1.35 ± 0.51%/mmHg; P < 0.01) in black men compared with white men. There were no differences in any of the hemodynamic variables between black and white women. In men only, the slopes of mPAP-CO relationships were inversely correlated to V̇o2max (P < 0.01). Thus the pulmonary circulation is intrinsically less distensible in black sub-Saharan African men compared with white Caucasian Europeans men, and this is associated with a lower exercise capacity. This study did not identify racial differences in pulmonary vascular function in women.

  1. Echocardiographic evaluation of pulmonary venous blood flow and cardiac function changes during one-lung ventilation

    PubMed Central

    Lee, Su Hyun; Kim, Namo; Kim, Hyun IL; Oh, Young Jun

    2015-01-01

    Objectives: The intra-pulmonary shunt induced by one-lung ventilation (OLV), is alleviated by increased pulmonary blood flow by gravitational redistribution and hypoxic pulmonary vasoconstriction. We investigated the changes of pulmonary venous blood flow (PVBF) and biventricular function during OLV with echocardiography. And the correlation between PVBF and intra-pulmonary shunt fraction (Qs/Qt) was evaluated. Methods: PVBF of the left upper pulmonary vein and cardiac function were measured with echocardiography in twenty-five patients who underwent elective thoracic surgery in left lateral decubitus. Qs/Qt and PaO2 were measured with blood gas analysis. Data was obtained at 10 min after two-lung ventilation in supine (TLV-S) and lateral decubitus position (TLV-L), and at 10, 20 and 30 min after OLV in lateral decubitus position (OLV-10, -20 and -30). Results: There were significant changes in PVBF among TLV-S, TLV-L and OLV-10 (959.5±280.8, 1416.9±489.7 and 1999.9±670.5 ml/min; P<0.05, respectively). There were not differences in PVBF, Qs/Qt and PaO2 among OLV-10, -20 and -30. There were an inverse correlation between percent change of PVBF and change of Qs/Qt (r2 = 0.5; P<0.0001) and positive correlations between the percent change of PVBF and change of PaO2 (r2 = 0.4; P<0.0001) during OLV over TLV-L. No significant changes in biventricular systolic and diastolic function were observed during positional change and OLV. Conclusions: A remarkable change of PVBF relevant to gravitational distribution and hypoxic pulmonary vasoconstriction was proved by echocardiography. And PVBF changes could represent the changes of Qs/Qt and PaO2 during OLV. However, biventricular function was not impaired during OLV. PMID:26550232

  2. Assessment of pulmonary function in local healthy Nepalese men of Dharan and it's anthropometric correlation.

    PubMed

    Prajapati, Rajesh; Sinha, Meenakshi; Paudel, Bishnu Hari; Bhattacharya, Soumya

    2007-09-01

    Healthy non smoking male subjects (n = 150) aged 18-40 years were subjected to pulmonary function testing to establish linear multiple regression model. Pulmonary parameters were considered as independent variables and physical parameters (age, height, weight, body mass index (BMI) and body surface area (BSA) and anthropometric parameters (skin fold thickness (SFT), mid arm circumference and abdominal girth) were taken as dependent variables. This study was undertaken to determine correlation coefficients between dependent variables and different pulmonary independent variables and to derive regression equations or prediction formulae in order to find out the expected normal values for the different lung function tests in a given individual. Present study revealed that the upper body fat distribution, as reflected by biceps skin fold thickness and mid arm circumference, is a significant predicator of ventilatory function.

  3. Association of chronic pesticide exposure with serum cholinesterase levels and pulmonary functions.

    PubMed

    Sutoluk, Zeynel; Kekec, Zeynep; Daglioglu, Nebile; Hant, Ismail

    2011-01-01

    The present study focused on the analysis of serum cholinesterase levels and the pulmonary function tests in seasonal farm workers who were chronically exposed to pesticides, mostly organophosphorus, in comparison with non-farm workers in the farming areas of Cukurova region, Turkey. Serum cholinesterase levels and pulmonary function tests using spyrometer in 50 male seasonal farm workers (study group) were compared to 50 male non-farm workers (control group) in this cross-sectional study. The mean serum cholinesterase enzyme level in the farm worker group (7095.5 ± 1699.4 U/L) was significantly lower than those of the control group (9716.4 ± 1484.4 U/L) (p < .001). There was no significant difference between pulmonary function tests of 2 groups (p > .05). These results show that chronic environmental organophosphorus exposure caused a decrease in the serum cholinesterase enzyme levels in farm workers, emphasizing the importance of primary prevention. PMID:24484366

  4. Application of positive airway pressure in restoring pulmonary function and thoracic mobility in the postoperative period of bariatric surgery: a randomized clinical trial

    PubMed Central

    Brigatto, Patrícia; Carbinatto, Jéssica C.; Costa, Carolina M.; Montebelo, Maria I. L.; Rasera-Júnior, Irineu; Pazzianotto-Forti, Eli M.

    2014-01-01

    Objective: To evaluate whether the application of bilevel positive airway pressure in the postoperative period of bariatric surgery might be more effective in restoring lung volume and capacity and thoracic mobility than the separate application of expiratory and inspiratory positive pressure. Method: Sixty morbidly obese adult subjects who were hospitalized for bariatric surgery and met the predefined inclusion criteria were evaluated. The pulmonary function and thoracic mobility were preoperatively assessed by spirometry and cirtometry and reevaluated on the 1st postoperative day. After preoperative evaluation, the subjects were randomized and allocated into groups: EPAP Group (n=20), IPPB Group (n=20) and BIPAP Group (n=20), then received the corresponding intervention: positive expiratory pressure (EPAP), inspiratory positive pressure breathing (IPPB) or bilevel inspiratory positive airway pressure (BIPAP), in 6 sets of 15 breaths or 30 minutes twice a day in the immediate postoperative period and on the 1st postoperative day, in addition to conventional physical therapy. Results: There was a significant postoperative reduction in spirometric variables (p<0.05), regardless of the technique used, with no significant difference among the techniques (p>0.05). Thoracic mobility was preserved only in group BIPAP (p>0.05), but no significant difference was found in the comparison among groups (p>0.05). Conclusion: The application of positive pressure does not seem to be effective in restoring lung function after bariatric surgery, but the use of bilevel positive pressure can preserve thoracic mobility, although this technique was not superior to the other techniques. PMID:25590448

  5. Impact of pulmonary hypertension on tricuspid valve function.

    PubMed

    Casa, Lauren D C; Dolensky, Joseph R; Spinner, Erin M; Veledar, Emir; Lerakis, Stamatios; Yoganathan, Ajit P

    2013-04-01

    Pulmonary arterial hypertension (PAH) results in increased right ventricle (RV) afterload leading to RV remodeling, tricuspid regurgitation (TR), and RV failure. Though characterizing the mechanisms of TR in PAH may suggest new treatment strategies, the mechanisms leading to TR in PAH have not been characterized. In the present study, eleven porcine tricuspid valves were studied in an in vitro right heart simulator. Annular dilatations of 1.2 and 1.4 times normal area, papillary muscle (PM) displacement simulating concentric RV dilatation and eccentric RV dilatation due to concomitant left ventricle dysfunction, and two levels of PAH hemodynamics were simulated independently and in combination. Relative TR, tenting area (TA) along each coaptation line, and coaptation area (CA) of each leaflet were quantified. Results showed a significant increase (p ≤ 0.05) in TR with both increased mean pulmonary artery pressure (mPAP) and annular dilatation of 1.4 times normal. Increased mPAP significantly decreased TA but tended to increase CA, while PM displacement significantly increased TA but did not affect CA, suggesting competing effects of transvalvular pressure and leaflet tethering. Annular dilatation significantly decreased anterior and posterior CA but did not affect TA. These results may inform future TV repairs in PAH to reduce TR and improve RV hemodynamics.

  6. [Gastroesophageal reflux, pulmonary and gastric function in patients with cystic fibrosis. Results of a randomized trial].

    PubMed

    Escobar Castro, H; Perdomo Giraldi, M; Gimeno Benítez, R; Máiz Carro, L; Suárez Cortina, L

    1996-01-01

    We studied ten patients with Cystic fibrosis. The purposes of this study were to investigate the presence of gastroesophageal reflux and establish the probable association between gastroesophageal reflux and pulmonary and gastric involvement. All 10 patients underwent 24-hour esophageal pH recording, spirometry and gastric function. Abnormal reflux index was found in all these patients. Lung function was pathologic in the 3 older children. There were no relationship between the severity of the gastroesophageal reflux and the degree of pulmonary damage. No patient has gastric acid hypersecretion. Eight of 10 patients had steatorrhea. Our findings confirm the high frequence of gastroesophageal reflux in cystic fibrosis. PMID:9180955

  7. Posture and mobility of the upper body quadrant and pulmonary function in COPD: an exploratory study *

    PubMed Central

    Morais, Nuno; Cruz, Joana; Marques, Alda

    2016-01-01

    ABSTRACT Background There is limited evidence regarding interactions between pulmonary (dys)function, posture, and mobility of the upper body quadrant in patients with chronic obstructive pulmonary disease (COPD). Objectives This exploratory study aimed to investigate whether postural alignment and mobility of the upper quadrant are related to changes in pulmonary function and compare such variables between patients with COPD and healthy individuals. Method Fifteen patients with COPD (67.93±9.71yrs) and 15 healthy controls (66.80±7.47yrs) participated. Pulmonary function (FEV1, FVC) was assessed with spirometry. Alignment and mobility of the head, thoracic spine, and shoulder were assessed using digital photographs. Pectoralis minor muscle (PmM) length and thoracic excursion were assessed with a measuring tape. Groups were compared and linear regression analyses were used to assess potential relationships between postural and mobility variables and pulmonary function. Results Patients with COPD were more likely to have a forward head position at maximal protraction (28.81±7.30º vs. 35.91±8.56º, p=0.02) and overall mobility of the head (21.81±10.42º vs. 13.40±7.84º, p=0.02) and a smaller range of shoulder flexion (136.71±11.91º vs. 149.08±11.58º, p=0.01) than controls. Patients’ non-dominant PmM length and maximal head protraction were predictors of FEV1 (r2 adjusted=0.34). These variables, together with the upper thoracic spine at maximal flexion and thoracic kyphosis at maximal extension, were predictors of FVC (r2 adjusted=0.68). Conclusion Our findings suggest that impaired pulmonary function is associated with muscle length and mobility adaptations. Further studies are needed to understand the underlying mechanisms and clinical value of these relationships. PMID:27556391

  8. USE OF POSITIVE PRESSURE IN THE BARIATRIC SURGERY AND EFFECTS ON PULMONARY FUNCTION AND PREVALENCE OF ATELECTASIS: RANDOMIZED AND BLINDED CLINICAL TRIAL

    PubMed Central

    BALTIERI, Letícia; SANTOS, Laisa Antonela; RASERA-JUNIOR, Irineu; MONTEBELO, Maria Imaculada Lima; PAZZIANOTTO-FORTI, Eli Maria

    2014-01-01

    Background In surgical procedures, obesity is a risk factor for the onset of intra and postoperative respiratory complications. Aim Determine what moment of application of positive pressure brings better benefits on lung function, incidence of atelectasis and diaphragmatic excursion, in the preoperative, intraoperative or immediate postoperative period. Method Randomized, controlled, blinded study, conducted in a hospital and included subjects with BMI between 40 and 55 kg/m2, 25 and 55 years, underwent bariatric surgery by laparotomy. They were underwent preoperative and postoperative evaluations. They were allocated into four different groups: 1) Gpre: treated with positive pressure in the BiPAP mode (Bi-Level Positive Airway Pressure) before surgery for one hour; 2) Gpos: BIPAP after surgery for one hour; 3) Gintra: PEEP (Positive End Expiratory Pressure) at 10 cmH2O during the surgery; 4) Gcontrol: only conventional respiratory physiotherapy. The evaluation consisted of anthropometric data, pulmonary function tests and chest radiography. Results Were allocated 40 patients, 10 in each group. There were significant differences for the expiratory reserve volume and percentage of the predicted expiratory reserve volume, in which the groups that received treatment showed a smaller loss in expiratory reserve volume from the preoperative to postoperative stages. The postoperative radiographic analysis showed a 25% prevalence of atelectasis for Gcontrol, 11.1% for Gintra, 10% for Gpre, and 0% for Gpos. There was no significant difference in diaphragmatic mobility amongst the groups. Conclusion The optimal time of application of positive pressure is in the immediate postoperative period, immediately after extubation, because it reduces the incidence of atelectasis and there is reduction of loss of expiratory reserve volume. PMID:25409961

  9. Pulmonary function test: its correlation with pulmonary high-resolution computed tomography in patients with rheumatoid arthritis.

    PubMed

    Leonel, Daza; Lucia, Cervantes; A, Muñiz; Martha-Alicia, Hernández; Blanca, Murillo

    2012-07-01

    Our objective was to try to evaluate lung affection and to correlate an easier and cheaper method with the high-resolution computed tomography (HRCT) findings in patients with RA. Thirty-six RA patients were selected for HRCT lung scan (twelve patients with altered pulmonary function test (PFT) and 24 with normal PFT). The American Thoracic Society criteria were followed for the pulmonary test. Clinical and laboratory variables were recorded. A statistical analysis was done by Kaplan-Meyer survival curve and ROC curve. When HRCT was evaluated in all patients, only sixteen had an HRCT normal and twenty patients showed some radiologic alteration under HRCT such as: pleural thickness, bronchiectasis, interstitial pattern, micro-nodules pattern, ground-glass opacity, and a reticular pattern. A logistic regression showed that methotrexate use, evolution of the disease (beta 0.018), and FEV1 (beta 0.89) were statistically associated with HRCT alterations. A projection of patients, free from event (HRCT lung scan altered), was obtained through a Kaplan-Meyer analysis, using FEV1 as a predictor over time. The curve shows that in the next 240 months (20 years) nearly 40% of the patients with rheumatoid arthritis will have FEV1 values less than 80% of the normal values predicted for the same age and sex. The FEV1 values have demonstrated a good correlation between PFT and HRCT lung scan. Therefore, they provide an accessible tool for tracking early pulmonary alterations. Methotrexate use and time evolution of the disease have been associated with altered FEV1.

  10. Pre-operative anaemia.

    PubMed

    Clevenger, B; Richards, T

    2015-01-01

    Pre-operative anaemia is a relatively common finding, affecting a third of patients undergoing elective surgery. Traditionally associated with chronic disease, management has historically focused on the use of blood transfusion as a solution for anaemia in the peri-operative period. Data from large series now suggest that anaemia is an independent risk associated with poor outcome in both cardiac and non-cardiac surgery. Furthermore, blood transfusion does not appear to ameliorate this risk, and in fact may increase the risk of postoperative complications and hospital length of stay. Consequently, there is a need to identify, diagnose and manage pre-operative anaemia to reduce surgical risk. Discoveries in the pathways of iron metabolism have found that chronic disease can cause a state of functional iron deficiency leading to anaemia. The key iron regulatory protein hepcidin, activated in response to inflammation, inhibits absorption of iron from the gastrointestinal tract and further reduces bioavailability of iron stores for red cell production. Consequently, although iron stores (predominantly ferritin) may be normal, the transport of iron either from the gastrointestinal tract or iron stores to the bone marrow is inhibited, leading to a state of 'functional' iron deficiency and subsequent anaemia. Since absorption from the gastrointestinal tract is blocked, increasing oral iron intake is ineffective, and studies are now looking at the role of intravenous iron to treat anaemia in the surgical setting. In this article, we review the incidence and impact of anaemia on the pre-operative patient. We explain how anaemia may be caused by functional iron deficiency, and how iron deficiency anaemia may be diagnosed and treated.

  11. Maximal respiratory pressures and pulmonary function in male runners.

    PubMed Central

    Cordain, L; Glisan, B J; Latin, R W; Tucker, A; Stager, J M

    1987-01-01

    To determine the effects of long term exercise on respiratory muscle strength, maximal inspiratory (Pl max) and expiratory (PE max) pressures, pulmonary volumes and capacities and anthropometric parameters were measured in a group of 101 male runners aged 16 to 58 years. The runners exhibited significantly (p less than 0.05) lower PE max (202 +/- 41 cm H2O and significantly greater residual lung volumes (RV) (2.08 +/- 0.49 L) than predicted values for normal subjects of similar height and age. Forced vital capacities were not different (p greater than 0.05) from values reported for normal non-smoking populations. These data suggest that running may cause a non-pathological increase in RV, perhaps mediated by reductions in expiratory muscle strength. Additionally, current RV regression equations developed for normal subjects may be inappropriate for use in running populations. PMID:3620798

  12. [Right ventricular function evaluated by thermodilution method in patients with chronic pulmonary diseases].

    PubMed

    Nakashima, T; Imamura, T; Shikuwa, M; Hara, K

    1991-01-01

    The right ventricular ejection fraction (RVEF) is an objective evaluation of the right ventricular systolic function. Recently a rapid-response thermister pulmonary artery catheter which measures RVEF and stroke volume (SV) was introduced. With this new method, RVEF and the right ventricular volumes (RVV) were measured in patients with chronic pulmonary diseases (CPD) and normal subjects. In addition, to evaluate the validity of this method, the data was compared with Kr81m perfusion method. The RVEF and the RVV of CPD patients were also compared with pulmonary hemodynamic data. There was a good correlation between the RVEFs obtained by the Kr81m perfusion method and the TD method. (r = 0.71, p less than 0.001). There was a tendency towards a low RVEF in patient with CPD with pulmonary hypertension (PAm greater than 20 mmHg) or high pulmonary vascular resistance (PAR greater than 160 dyne/sec/cm-5) and the RVV increased in the same group. These results suggested that the right ventricle was unable to respond to the increase of afterload in the CPD group and the evaluation of RVEF and RVV in patients with CPD using the new TD method was valuable for assessing the right ventricular function.

  13. Radiation pneumonitis and pulmonary fibrosis in non-small-cell lung cancer: Pulmonary function, prediction, and prevention

    SciTech Connect

    Mehta, Vivek . E-mail: Vivek.Mehta@swedish.org

    2005-09-01

    Although radiotherapy improves locoregional control and survival in patients with non-small-cell lung cancer, radiation pneumonitis is a common treatment-related toxicity. Many pulmonary function tests are not significantly altered by pulmonary toxicity of irradiation, but reductions in DL{sub CO}, the diffusing capacity of carbon monoxide, are more commonly associated with pneumonitis. Several patient-specific factors (e.g. age, smoking history, tumor location, performance score, gender) and treatment-specific factors (e.g. chemotherapy regimen and dose) have been proposed as potential predictors of the risk of radiation pneumonitis, but these have not been consistently demonstrated across different studies. The risk of radiation pneumonitis also seems to increase as the cumulative dose of radiation to normal lung tissue increases, as measured by dose-volume histograms. However, controversy persists about which dosimetric parameter optimally predicts the risk of radiation pneumonitis, and whether the volume of lung or the dose of radiation is more important. Radiation oncologists ought to consider these dosimetric factors when designing radiation treatment plans for all patients who receive thoracic radiotherapy. Newer radiotherapy techniques and technologies may reduce the exposure of normal lung to irradiation. Several medications have also been evaluated for their ability to reduce radiation pneumonitis in animals and humans, including corticosteroids, amifostine, ACE inhibitors or angiotensin II type 1 receptor blockers, pentoxifylline, melatonin, carvedilol, and manganese superoxide dismutase-plasmid/liposome. Additional research is warranted to determine the efficacy of these medications and identify nonpharmacologic strategies to predict and prevent radiation pneumonitis.

  14. Parametric modeling for quantitative analysis of pulmonary structure to function relationships

    NASA Astrophysics Data System (ADS)

    Haider, Clifton R.; Bartholmai, Brian J.; Holmes, David R., III; Camp, Jon J.; Robb, Richard A.

    2005-04-01

    While lung anatomy is well understood, pulmonary structure-to-function relationships such as the complex elastic deformation of the lung during respiration are less well documented. Current methods for studying lung anatomy include conventional chest radiography, high-resolution computed tomography (CT scan) and magnetic resonance imaging with polarized gases (MRI scan). Pulmonary physiology can be studied using spirometry or V/Q nuclear medicine tests (V/Q scan). V/Q scanning and MRI scans may demonstrate global and regional function. However, each of these individual imaging methods lacks the ability to provide high-resolution anatomic detail, associated pulmonary mechanics and functional variability of the entire respiratory cycle. Specifically, spirometry provides only a one-dimensional gross estimate of pulmonary function, and V/Q scans have poor spatial resolution, reducing its potential for regional assessment of structure-to-function relationships. We have developed a method which utilizes standard clinical CT scanning to provide data for computation of dynamic anatomic parametric models of the lung during respiration which correlates high-resolution anatomy to underlying physiology. The lungs are segmented from both inspiration and expiration three-dimensional (3D) data sets and transformed into a geometric description of the surface of the lung. Parametric mapping of lung surface deformation then provides a visual and quantitative description of the mechanical properties of the lung. Any alteration in lung mechanics is manifest by alterations in normal deformation of the lung wall. The method produces a high-resolution anatomic and functional composite picture from sparse temporal-spatial methods which quantitatively illustrates detailed anatomic structure to pulmonary function relationships impossible for translational methods to provide.

  15. Pulmonary function and respiratory symptoms of school children exposed to ambient air pollution

    SciTech Connect

    Kim, Yoon Shin; Ko, Ung Ring

    1996-12-31

    This study was undertaken to evaluate the health effect of air pollution on pulmonary function and respiratory symptoms of Korean school children between 7 and 10 years of age during November 1995-January 1996. A standard respiratory symptom questionnaire was administered and spirometry was performed to examine pulmonary function of 121 children in an urban polluted area, Seoul, and of 119 children in non-polluted area, Sokcho, respectively. There was significant difference in the level of pulmonary function [forced expiratory volume in second (FEV{sub 1.0}) and forced vital capacity (FVC)] between exposed groups to polluted area and non-polluted area. Parental smoking was significantly related to respiratory symptoms of cough, phlegm, and the level of pulmonary function. The observed changes in FEV{sub 1.0} and FVC seemed to relate to home cooking fuel, not to respiratory symptoms. The additional longitudinal work that carefully monitors ambient and indoor air pollution and health effects data should be conducted to confirm these results.

  16. Association between physical activity in daily life and pulmonary function in adult smokers

    PubMed Central

    Barboza, Miriane Lilian; Barbosa, Alan Carlos Brisola; Spina, Giovanna Domingues; Sperandio, Evandro Fornias; Arantes, Rodolfo Leite; Gagliardi, Antonio Ricardo de Toledo; Romiti, Marcello; Dourado, Victor Zuniga

    2016-01-01

    Objective: To determine whether the level of physical activity in daily life (PADL) is associated with pulmonary function in adult smokers. Methods: We selected 62 adult smokers from among the participants of an epidemiological study conducted in the city of Santos, Brazil. The subjects underwent forced spirometry for pulmonary function assessment. The level of PADL was assessed by the International Physical Activity Questionnaire and triaxial accelerometry, the device being used for seven days. The minimum level of PADL, in terms of quantity and intensity, was defined as 150 min/week of moderate to vigorous physical activity. Correlations between the studied variables were tested with Pearson's or Spearman's correlation coefficient, depending on the distribution of the variables. We used linear multiple regression in order to analyze the influence of PADL on the spirometric variables. The level of significance was set at 5%. Results: Evaluating all predictors, corrected for confounding factors, and using pulmonary function data as outcome variables, we found no significant associations between physical inactivity, as determined by accelerometry, and spirometric indices. The values for FVC were lower among the participants with arterial hypertension, and FEV1/FVC ratios were lower among those with diabetes mellitus. Obese participants and those with dyslipidemia presented with lower values for FVC and FEV1. Conclusions: Our results suggest that there is no consistent association between physical inactivity and pulmonary function in adult smokers. Smoking history should be given special attention in COPD prevention strategies, as should cardiovascular and metabolic comorbidities. PMID:27167434

  17. Athletes and Sedentary Individuals: An Intergroup Comparison Utilizing a Pulmonary Function Ratio Obtained During Submaximal Exercise.

    ERIC Educational Resources Information Center

    Maud, Peter J.

    A pulmonary function ratio describing oxygen extraction from alveolar ventilation was used for an intergroup comparison between three groups of athletes (rugby, basketball, and football players) and one group of sedentary subjects during steady-state submaximal exercise. The ratio and its component parts are determined from only three gas…

  18. Effects of Low-Flow Sevoflurane Anesthesia on Pulmonary Functions in Patients Undergoing Laparoscopic Abdominal Surgery

    PubMed Central

    Doger, Cihan; Kahveci, Kadriye; Ornek, Dilsen; But, Abdulkadir; Aksoy, Mustafa; Gokcinar, Derya; Katar, Didem

    2016-01-01

    Objective. The aim of this prospective, randomized study was to investigate the effects of low-flow sevoflurane anesthesia on the pulmonary functions in patients undergoing laparoscopic cholecystectomy. Methods. Sixty American Society of Anesthesiologists (ASA) physical status classes I and II patients scheduled for elective laparoscopic cholecystectomy were included in the study. Patients were randomly allocated to two study groups: high-flow sevoflurane anesthesia group (Group H, n = 30) and low-flow sevoflurane anesthesia group (Group L, n = 30). The fresh gas flow rate was of 4 L/min in high-flow sevoflurane anesthesia group and 1 L/min in low-flow sevoflurane anesthesia group. Heart rate (HR), mean arterial blood pressure (MABP), peripheral oxygen saturation (SpO2), and end-tidal carbon dioxide concentration (ETCO2) were recorded. Pulmonary function tests were performed before and 2, 8, and 24 hours after surgery. Results. There was no significant difference between the two groups in terms of HR, MABP, SpO2, and ETCO2. Pulmonary function test results were similar in both groups at all measurement times. Conclusions. The effects of low-flow sevoflurane anesthesia on pulmonary functions are comparable to high-flow sevoflurane anesthesia in patients undergoing laparoscopic cholecystectomy. PMID:27413741

  19. 21 CFR 868.1900 - Diagnostic pulmonary-function interpretation calculator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

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  20. 21 CFR 868.1900 - Diagnostic pulmonary-function interpretation calculator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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  1. 21 CFR 868.1890 - Predictive pulmonary-function value calculator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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  2. 21 CFR 868.1900 - Diagnostic pulmonary-function interpretation calculator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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  3. 21 CFR 868.1900 - Diagnostic pulmonary-function interpretation calculator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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  4. 21 CFR 868.1900 - Diagnostic pulmonary-function interpretation calculator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

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  5. 21 CFR 868.1890 - Predictive pulmonary-function value calculator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

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  6. 21 CFR 868.1890 - Predictive pulmonary-function value calculator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

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  7. 21 CFR 868.1890 - Predictive pulmonary-function value calculator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

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  8. 21 CFR 868.1890 - Predictive pulmonary-function value calculator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Predictive pulmonary-function value calculator. 868.1890 Section 868.1890 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Diagnostic Devices § 868.1890...

  9. Effects of air pollution resulting from wire reclamation incineration on pulmonary function in children

    SciTech Connect

    Hsiue, T.R.; Lee, S.S.; Chen, H.I. )

    1991-09-01

    This study evaluated the effect of long-term air pollution resulting from wire reclamation incineration on pulmonary function in children. General physical examination and the determination of spirometric parameters, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and forced mid-expiratory flow (FEF25-75%) were conducted in 400 primary school children between ages 9 and 11 years who reside in one control and three polluted areas. A survey using ATS-DLD-78-C questionnaire indicated that there were no significant differences in their demographic characteristics among children in the four areas under study. Those who had nonrespiratory diseases that might affect pulmonary function and those who failed to perform spirometric measurements were excluded from the study; therefore, 382 children were included in data analysis. The results revealed that (1) the mean values of FVC and FEV1 (expressed as percentage of predicted values calculated from Polgar's equations) in the polluted areas were significantly lower than the nonpolluted area (p less than 0.05), and (2) the incidence of pulmonary function abnormality in the polluted areas was greater than that of the nonpolluted area (p less than 0.05). The results indicated that air pollution produced by wire reclamation incineration can impair children's pulmonary function.

  10. Self-Efficacy, Pulmonary Function, Perceived Health and Global Quality of Life of Cystic Fibrosis Patients

    ERIC Educational Resources Information Center

    Wahl, Astrid K.; Rustoen ,Tone; Hanestad, Berit R.; Gjengedal, Eva; Moum, Torbjorn

    2005-01-01

    This study examined the extent that pulmonary function is related to perceived health status and global quality of life in adults suffering from cystic fibrosis, and the extent that self-efficacy modifies these relationships. Our sample comprised 86 adults (48% female; mean age, 29 years; age range, 18-54 years) with cystic fibrosis, recruited…

  11. Relationship of respiratory symptoms and pulmonary function to tar, nicotine, and carbon monoxide yield of cigarettes

    SciTech Connect

    Krzyzanowski, M.; Sherrill, D.L.; Paoletti, P.; Lebowitz, M.D. )

    1991-02-01

    The data from consecutive surveys of the Tucson Epidemiologic Study (1981-1988) were used to evaluate the relationship in cigarette smokers of respiratory symptoms and pulmonary function to tar, nicotine, and carbon monoxide (CO) yields of the cigarette. There were 690 subjects who reported smoking regularly in at least one survey, over age 15. After adjustment for intensity and duration of smoking and for depth of inhalation, the risk of chronic phlegm, cough, and dyspnea were not related to the tar and nicotine yields. In 414 subjects with pulmonary function tested in at least one of the three surveys the spirometric indices used were significantly related to the daily dose of tar, nicotine, and CO (product of the cigarette yield and daily number of cigarettes smoked). The effects were more pronounced for past than for current doses. However, the differentiation of pulmonary function due to various yields of cigarettes was small in comparison to the difference in pulmonary function between smokers and nonsmokers.

  12. Cardio-Pulmonary Function Testing. Continuing Education Curriculum for Respiratory Therapy.

    ERIC Educational Resources Information Center

    Saint Paul Technical Vocational Inst., MN.

    Compiled from interviews with personnel in pulmonary function testing (PFT) laboratories in the Minneapolis/St. Paul area, this competency-based curriculum guide is intended to provide a knowledge of PFT for persons who provide respiratory care. The guide contains 20 sections covering the following topics: vital capacity, flow measurements,…

  13. PuFT: Computer-Assisted Program for Pulmonary Function Tests.

    ERIC Educational Resources Information Center

    Boyle, Joseph

    1983-01-01

    PuFT computer program (Microsoft Basic) is designed to help in understanding/interpreting pulmonary function tests (PFT). The program provides predicted values for common PFT after entry of patient data, calculates/plots graph simulating force vital capacity (FVC), and allows observations of effects on predicted PFT values and FVC curve when…

  14. COCKROACHES, PESTICIDE USE, AND CHILDREN'S PULMONARY FUNCTION IN AN ARID COMMUNITY

    EPA Science Inventory

    Cockroaches, pesticide use, and children's pulmonary function in an arid community

    Erik Svendsen1, Mary Ross1, Melissa Gonzales2, Debra Walsh1, Scott Rhoney1, Gina Terrill1, Lucas Neas1
    1US EPA, Chapel Hill, NC; 2University of New Mexico

    The El Paso Children's He...

  15. Multi-walled carbon nanotube instillation impairs pulmonary function in C57BL/6 mice

    PubMed Central

    2011-01-01

    Background Multi-walled carbon nanotubes (MWCNTs) are widely used in many disciplines due to their unique physical and chemical properties. Therefore, some concerns about the possible human health and environmental impacts of manufactured MWCNTs are rising. We hypothesized that instillation of MWCNTs impairs pulmonary function in C57BL/6 mice due to development of lung inflammation and fibrosis. Methods MWCNTs were administered to C57BL/6 mice by oropharyngeal aspiration (1, 2, and 4 mg/kg) and we assessed lung inflammation and fibrosis by inflammatory cell infiltration, collagen content, and histological assessment. Pulmonary function was assessed using a FlexiVent system and levels of Ccl3, Ccl11, Mmp13 and IL-33 were measured by RT-PCR and ELISA. Results Mice administered MWCNTs exhibited increased inflammatory cell infiltration, collagen deposition and granuloma formation in lung tissue, which correlated with impaired pulmonary function as assessed by increased resistance, tissue damping, and decreased lung compliance. Pulmonary exposure to MWCNTs induced an inflammatory signature marked by cytokine (IL-33), chemokine (Ccl3 and Ccl11), and protease production (Mmp13) that promoted the inflammatory and fibrotic changes observed within the lung. Conclusions These results further highlight the potential adverse health effects that may occur following MWCNT exposure and therefore we suggest these materials may pose a significant risk leading to impaired lung function following environmental and occupational exposures. PMID:21851604

  16. Effects of diaphragm respiration exercise on pulmonary function of male smokers in their twenties

    PubMed Central

    Seo, KyoChul; Park, Seung Hwan; Park, KwangYong

    2015-01-01

    [Purpose] We investigated how diaphragm respiration exercises can affect pulmonary function in long-term male smokers in their twenties. [Subjects and Methods] Twenty-eight healthy males between 20 and 29 years of age were randomly divided into an experimental and a control group (14 members each). The experiment was conducted during 30 min sessions, 3 times a week for 4 weeks. The experimental group performed diaphragm respiration exercises and the control group performed exercises using MOTOmed. Pulmonary function (tidal volume, breathing capacity, inspiratory reserve volume, inspiratory capacity, and expiratory reserve volume) was evaluated and analyzed before and after the experiment. [Results] Our results revealed significant increases in tidal volume, inspiratory reserve volume, inspiratory capacity, and breathing capacity in the experimental group. These increases were greater in the experimental group than in the control group. [Conclusion] In our study, the experimental group which performed diaphragm respiration exercises showed a greater improvement in pulmonary function compared with the control group. It is hypothesized that greater improvement in pulmonary function is expected if diaphragm respiration exercises are implemented taking into account the age of the smokers. PMID:26311972

  17. Pulmonary functions and respiratory symptoms and diseases among adult Israelis. Variations by country of origin.

    PubMed

    Goren, A I; Bruderman, I

    1986-11-01

    A study group of 1,299 adult Israelis aged 30 to 65 years was chosen from persons referred for evaluation of possible pulmonary diseases in two outpatient chest clinics. They were interviewed using the ATS-NHLI (American Thoracic Society-National Heart and Lung Institute) health questionnaire and underwent the pulmonary function test (PFT), which included the following parameters: forced vital capacity (FVC), forced expiratory volume in 1st sec (FEV1), FEV1/FVC, peak expiratory flow (PEF), FEF50 and FEF25 (forced expiratory flow at 50 and 25% of FVC, respectively). The effect of the country of origin of the subjects on the distribution of respiratory symptoms, pulmonary diseases and PFT was analyzed. The lowest PFT values and an excess of reported respiratory symptoms and chronic obstructive airways diseases--especially asthma--among subjects and their parents were found among immigrants from Iraq-Iran. In immigrants from Morocco, reported respiratory symptoms, pulmonary diseases and impaired PFT were relatively uncommon. The different distribution of reported respiratory symptoms, pulmonary diseases and impaired PFT by country of origin could not be explained by environmental factors, such as smoking habits and socioeconomic background. The high prevalence of reported asthma among immigrants from Iraq-Iran is most probably due to a genetic factor.

  18. Pulmonary function test in formalin exposed and nonexposed subjects: A comparative study

    PubMed Central

    Uthiravelu, P.; Saravanan, A.; Kumar, C. Kishor; Vaithiyanandane, V.

    2015-01-01

    Background: The main function of the lung is gas exchange, which can be assessed in several ways. A spirometer measures the flow and the volumes of the inspired and expired air. The thoracic and abdominal muscle strength plays an important role in pulmonary function and diffusing lung capacity. Aims and Objectives: The aim of this study was to assess the effects of formalin exposure on the pulmonary function to compare with healthy individuals. To assess the chronic effects of formalin exposure on Pulmonary function tests (PFTs) in the faculties, lab technicians and attender of the Department of Anatomy and Pathology of SRM Medical Hospital and Research Centre, Kattankulathur. Materials and Methods: This prospective study was carried out in 50 healthy formalin exposed subjects (at least 5 years exposure) from Department of Anatomy and Pathology of SRM Medical College Hospital and Research Centre, Kattankulathur and 50 healthy controls of same age group of this study were included after obtaining ethical clearance and consent ‘Easy One Pro Spirometer (Ndd Medical Technologies, Cheshire SK 101LT, United Kingdom) was used to find out the PFT. Results: Student's t-test was applied to compare the PFT parameters between formalin exposed and formalin nonexposed group. There was a significant difference in mean and standard deviation of pulmonary parameters with the P < 0.005 in formalin exposed, which shows that they have lesser ventilatory drive. Conclusion: The formalin exposed subjects in our study presented with a mixed disorder of both obstructive and restrictive type. We also found that there was a negative correlation of pulmonary function with that of the degree and duration of exposure to formalin. PMID:26015743

  19. Pulmonary thallium uptake: Correlation with systolic and diastolic left ventricular function at rest and during exercise

    SciTech Connect

    Mannting, F. )

    1990-05-01

    Quantified pulmonary 201-thallium uptake, assessed as pulmonary/myocardial ratios (PM) and body surface area-corrected absolute pulmonary uptake (Pc), was determined from single photon emission computed tomography studies in 22 normal subjects and 46 consecutive patients with coronary artery disease (CAD). By means of equilibrium radionuclide angiography (ERNA), ejection fraction (EF), peak ejection rate (PER) in end-diastolic volume (EDV/sec) and peak filling rate (PFR) in EDV/sec and stroke volume (SV/sec) units, PFR/PER ratio, and time to peak filling rate (TPFR) in milliseconds were computed at rest and during exercise (n = 35). Left ventricular response to exercise was assessed as delta EF, relative delta EF, delta EDV, and delta ESV. In normal subjects the PM ratios showed significant inverse correlation with PER at rest and with EF, PER, and PFRedv during exercise. For the left ventricular response to exercise, delta ESV showed significant correlation with the PM ratios. The body surface area-corrected pulmonary uptake values showed no correlation with any of the variables. In patients with CAD the PM ratios and Pc uptake showed significant inverse correlation with EF, PER, PFRedv and to exercise EF, exercise PER, and exercise PFRedv. For the left ventricular response to exercise, delta EF showed significant inverse correlation with the PM ratios but not with the Pc uptake. Neither in normal subjects nor in patients with CAD did any of the independent diastolic variables show significant correlation with the PM ratios or Pc values. Thus pulmonary thallium uptake is correlated with systolic left ventricular function at rest and during exercise in normal subjects and in patients with CAD but not with diastolic function. In normal subjects delta ESV and in patients with CAD, delta EF showed correlation with pulmonary thallium uptake.

  20. Cardiac function in total anomalous pulmonary venous return before and after surgery.

    PubMed

    Mathew, R; Thilenius, O G; Replogle, R L; Arcilla, R A

    1977-02-01

    Cardiac performance was evaluated in 12 infants with isolated total anomalous pulmonary venous return. Four had significant pulmonary venous obstruction and severe pulmonary hypertension (group A). Eight had no obvious venous obstruction, and the pulmonary pressures were lower (group B). In all subjects, right ventricular end-diastolic volume was increased (197% of predicted normal) and its ejection fraction was normal. Left ventricular volume was, generally speaking, still in the normal range (87% of predicted normal); however, its ejection fraction was reduced (0.57 vs normal of 0.73) and left ventricular output was low (3.08 L/min/m2 vs normal of 3.98). Left atrial volume was consistently small (53% of predicted normal) with an appendage of normal size. The infants in group A had smaller chamber volumes/m2 BSA than those in group B. Left atrial function was abnormal, characterized by reduced reservoir function and a greater role as "conduit" from right atrium to left ventricle. Left atrial size was not found to be critical in the surgical repair of TAPVR. Cardiac function is restored to normal following surgery.

  1. Analysis of the influence of elective nodal irradiation on postirradiation pulmonary function

    SciTech Connect

    Curran, W.J. Jr.; Moldofsky, P.J.; Solin, L.J. )

    1990-06-01

    Irradiation (RT) field selection for bronchogenic carcinoma is based on such factors as extent of disease, pulmonary function, and the perceived need for elective nodal irradiation (ENI). A technique of superimposing a patient's RT treatment film onto his quantitative perfusion lung scan can predict the fractional volume of perfused lung receiving RT and has been shown to reliably estimate the minimum post-RT pulmonary function as measured by the forced expiratory volume in one second (FEV1). This technique has been applied to 20 patients with nonresected clinically staged T1-4N0M0 lesions to quantify the pulmonary impact of varying degrees of ENI. The five treatment volumes selected were as follows: (1) tumor volume plus a 2-cm margin; (2) volume 1 plus ipsilateral hilum; (3) volume 2 plus mediastinum; (4) volume 3 plus supraclavicular fossae; and (5) volume 4 plus contralateral hilum. The median pre-RT FEV1 was 2.0 l, and the median predicted minimal post-RT FEV1 for each proposed field was field 1, 1.7 l; field 2, 1.5 l; field 3, 1.3 l; field 4, 1.1.; and field 5, 1.0 l. The decline in median predicted FEV1 with each increase in field size ranged from 2% to 12%, with a broad range of declines for each field. Such quantification can aid in decisions regarding ENI for patients with impaired pulmonary function.

  2. Pulmonary epithelial barrier function: some new players and mechanisms

    PubMed Central

    Brune, Kieran; Frank, James; Schwingshackl, Andreas; Finigan, James

    2015-01-01

    The pulmonary epithelium serves as a barrier to prevent access of the inspired luminal contents to the subepithelium. In addition, the epithelium dictates the initial responses of the lung to both infectious and noninfectious stimuli. One mechanism by which the epithelium does this is by coordinating transport of diffusible molecules across the epithelial barrier, both through the cell and between cells. In this review, we will discuss a few emerging paradigms of permeability changes through altered ion transport and paracellular regulation by which the epithelium gates its response to potentially detrimental luminal stimuli. This review is a summary of talks presented during a symposium in Experimental Biology geared toward novel and less recognized methods of epithelial barrier regulation. First, we will discuss mechanisms of dynamic regulation of cell-cell contacts in the context of repetitive exposure to inhaled infectious and noninfectious insults. In the second section, we will briefly discuss mechanisms of transcellular ion homeostasis specifically focused on the role of claudins and paracellular ion-channel regulation in chronic barrier dysfunction. In the next section, we will address transcellular ion transport and highlight the role of Trek-1 in epithelial responses to lung injury. In the final section, we will outline the role of epithelial growth receptor in barrier regulation in baseline, acute lung injury, and airway disease. We will then end with a summary of mechanisms of epithelial control as well as discuss emerging paradigms of the epithelium role in shifting between a structural element that maintains tight cell-cell adhesion to a cell that initiates and participates in immune responses. PMID:25637609

  3. [Two cases of lung injury due to inhalation of waterproofing spray--with special reference to pulmonary function disorder].

    PubMed

    Hashimoto, Kazunori; Arita, Kenichi; Kajihara, Toshiki; Nitta, Tomoko; Mito, Akiko; Awaya, Hirokazu; Yamasaki, Masahiro; Ohashi, Nobuyuki

    2009-05-01

    CASE 1: A 57-year-old man experienced severe dyspnea 24 hours after inhalation of waterproofing spray. Computed tomography (CT) revealed diffuse ground glass opacities in bilateral lungs. Pulmonary function tests showed mixed ventilatory disturbance with a low expiratory flow rate near the end of forced expiration and a normal diffusing capacity with normal functional residual capasity. The pulmonary function disorder was quickly improved by steroid therapy. CASE 2: A 59-year-old man smoked after inhaling waterproofing spray and soon developed dyspnea. The findings of CT were similar to those of case 1. His pulmonary function test revealed restrictive ventilatory disturbance and normal pulmonary diffusing capacity with low functional residual capacity. These findings improved without steroid treatment. However, it took more time for the pulmonary function to recover. There was probably specific inflammation around bronchioles, and the inflammation might have spread to the alveolar region in such cases with severe pulmonary function disorder. Steroid treatment seems to be useful to improve both the pulmonary function disorder and the clinical feature due to inhalation of waterproofing spray.

  4. The Relationship between Preoperative Expectations and the Short-Term Postoperative Satisfaction and Functional Outcome in Lumbar Spine Surgery: A Systematic Review

    PubMed Central

    Ellis, Daniel J.; Mallozzi, Scott S.; Mathews, Jacob E.; Moss, Isaac L.; Ouellet, Jean A.; Jarzem, Peter; Weber, Michael H.

    2015-01-01

    Study Design Systematic review. Objective To examine the relationship between the patient's preoperative expectations and short-term postoperative satisfaction and functional outcome in lumbar spine surgery. Methods The Medline, Embase, and Cochrane databases were queried using a predefined search algorithm to identify all lumbar spine studies analyzing the influence of preoperative expectations on postoperative satisfaction and functional outcome. Two independent reviewers and a third independent mediator reviewed the literature and performed study screening, selection, methodological assessment, and data extraction using an objective protocol. Results Of 444 studies identified, 13 met the inclusion criteria. Methodological quality scores ranged from 59 to 100% with the greatest variability in defining patient characteristics and the methods of assessing patient expectations. Patient expectations were assessed in 22 areas, most frequently back and leg pain expectations and general expectations. Functional outcome was assessed by 13 tools; the most common were the visual analog scale, Oswestry Disability Index (ODI), and Short Form Health Survey (SF-36). Positive expectations for symptomatology, activity, general health, and recovery correlated with satisfaction. General expectations correlated with higher SF-36 Physical Subcomponent scores, better global function, and lower ODI outcome. Conclusions on the influence of the expectations for pain were limited due to the study heterogeneity, but the evidence suggests a positive correlation between the expectation and outcome for back and leg pain. Conclusions Positive expectations correlated significantly with short-term postoperative satisfaction and functional outcome, including higher SF-36 scores, earlier return to work, and decreased ODI scores. Future expectation-based investigations will benefit from implementation of the standardized methods of expectation, satisfaction, and outcome analysis

  5. Lung function, transfusion, pulmonary capillary blood volume and sickle cell disease.

    PubMed

    Lunt, Alan; McGhee, Emily; Robinson, Polly; Rees, David; Height, Susan; Greenough, Anne

    2016-02-01

    Lung function abnormalities occur in children with sickle cell disease (SCD) and may be associated with elevated pulmonary blood volume. To investigate that association, we determined whether blood transfusion in SCD children acutely increased pulmonary capillary blood volume (PCBV) and increased respiratory system resistance (Rrs5). Measurements of Rrs5 and spirometry were made before and after blood transfusion in 18 children, median age 14.2 (6.6-18.5) years. Diffusing capacity for carbon monoxide and nitric oxide were assessed to calculate the PCBV. Post transfusion, the median Rrs5 had increased from 127.4 to 141.3% predicted (p<0.0001) and pulmonary capillary blood volume from 39.7 to 64.1 ml/m2 (p<0.0001); forced expiratory volume in one second (p=0.0056) and vital capacity (p=0.0008) decreased. The increase in Rrs5 correlated with the increase in PCBV (r=0.50, p=0.0493). Increased pulmonary capillary blood volume may at least partially explain the lung function abnormalities in SCD children.

  6. Subacute effects of inspiratory resistive loading and head-out water immersion on pulmonary function.

    PubMed

    Thorsen, E; Skogstad, M; Reed, J W

    1999-01-01

    Extrathoracic airways obstruction and scuba diving may induce pulmonary edema, probably because of increased hydrostatic transmural capillary pressure in the lung. This study was designed to examine the subacute pulmonary effects of the combined exposure to inspiratory resistive loading and immersion, as in scuba diving. Two groups each of eight healthy men were exposed to head-out water immersion in thermoneutral water for 40 min with or without an added inspiratory resistive load. At flows of 0.5 and 1.0 liter x s, the measured resistances were 4.4 and 9.0 hPa x s(-1) x liter(-1), respectively. Pulmonary function, including a flow-volume loop and transfer factor of the lung for carbon monoxide (Tlco, was measured before and 60 min after the end of the exposures. Body fluid balance was restored in the first 15 min after exposure, and Tlco was always corrected to a hemoglobin concentration of 146 g x liter(-1). There was a significant reduction in Tlco of 7.3+/-5.5% (P < 0.01) after the combined exposure to head-out water immersion and inspiratory resistive load. No changes in pulmonary function were seen after exposure to head-out water immersion or inspiratory resistive loading alone. The change in Tlco was normalized within 24 h. Submersion and resistance in breathing apparatus may contribute to the changes in pulmonary function seen immediately after dives. The nature of the exposure in these experiments and the time for recovery indicate that these changes are mechanically induced, and may not contribute to the long-term effects of diving on the lung.

  7. Predictive Role of Functional Visceral Fat Activity Assessed by Preoperative F-18 FDG PET/CT for Regional Lymph Node or Distant Metastasis in Patients with Colorectal Cancer

    PubMed Central

    Pahk, Kisoo; Rhee, Seunghong; Kim, Sungeun; Choe, Jae Gol

    2016-01-01

    Objectives To investigate the role of functional visceral fat activity assessed by preoperative F-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in colorectal cancer (CRC) for predicting regional lymph node (LN) or distant metastasis. Method We evaluated 131 patients with newly diagnosed CRC. They all underwent pre-operative 18F-FDG PET/CT and surgery. Functional fat activity was measured by maximum standardized uptake value (SUVmax) using 18F-FDG PET/CT. Functional visceral fat activity was measured by SUVmax of visceral fat/SUVmax of subcutaneous fat (V/S) ratio. Mann-Whitney U test, χ2 test, Fisher’s exact test, receiver-operating characteristic (ROC) analysis, Spearrman’s correlation coefficient, and uni- and multivariate logistic regression statistical analyses were done. Results Patients with higher V/S ratio displayed a significantly higher rate of regional LN (p = 0.004) and distant metastasis (p<0.001). In addition, V/S ratio was the only factor that was significantly associated with distant metastasis. An optimal cut-off V/S ratio of 1.88 was proposed for predicting distant metastasis with a sensitivity of 84.6% and specificity of 78.8% (area under the curve: 0.86; p<0.0001) Conclusion Functional visceral fat activity is significantly associated with distant metastasis in CRC patients. Furthermore, V/S ratio can be useful as a complementary factor in predicting distant metastasis. PMID:26862754

  8. Hypoxic pulmonary vasoconstriction, carotid body function and erythropoietin production in adult rats perinatally exposed to hyperoxia

    PubMed Central

    Prieto-Lloret, Jesus; Ramirez, Maria; Olea, Elena; Moral-Sanz, Javier; Cogolludo, Angel; Castañeda, Javier; Yubero, Sara; Agapito, Teresa; Gomez-Niño, Angela; Rocher, Asuncion; Rigual, Ricardo; Obeso, Ana; Perez-Vizcaino, Francisco; González, Constancio

    2015-01-01

    Adult mammalians possess three cell systems that are activated by acute bodily hypoxia: pulmonary artery smooth muscle cells (PASMC), carotid body chemoreceptor cells (CBCC) and erythropoietin (EPO)-producing cells. In rats, chronic perinatal hyperoxia causes permanent carotid body (CB) atrophy and functional alterations of surviving CBCC. There are no studies on PASMC or EPO-producing cells. Our aim is to define possible long-lasting functional changes in PASMC or EPO-producing cells (measured as EPO plasma levels) and, further, to analyse CBCC functional alterations. We used 3- to 4-month-old rats born and reared in a normal atmosphere or exposed to perinatal hyperoxia (55–60% O2 for the last 5–6 days of pregnancy and 4 weeks after birth). Perinatal hyperoxia causes an almost complete loss of hypoxic pulmonary vasoconstriction (HPV), which was correlated with lung oxidative status in early postnatal life and prevented by antioxidant supplementation in the diet. O2-sensitivity of K+ currents in the PASMC of hyperoxic animals is normal, indicating that their inhibition is not sufficient to trigger HPV. Perinatal hyperoxia also abrogated responses elicited by hypoxia on catecholamine and cAMP metabolism in the CB. An increase in EPO plasma levels elicited by hypoxia was identical in hyperoxic and control animals, implying a normal functioning of EPO-producing cells. The loss of HPV observed in adult rats and caused by perinatal hyperoxia, comparable to oxygen therapy in premature infants, might represent a previously unrecognized complication of such a medical intervention capable of aggravating medical conditions such as regional pneumonias, atelectases or general anaesthesia in adult life. Key points Adult animals that have been perinatally exposed to oxygen-rich atmospheres (hyperoxia), recalling those used for oxygen therapy in infants, exhibit a loss of hypoxic pulmonary vasoconstriction, whereas vasoconstriction elicited by depolarizing agents is

  9. Pulmonary Hypertension

    PubMed Central

    Newman, John H.

    2005-01-01

    The modern era in cardiopulmonary medicine began in the 1940s, when Cournand and Richards pioneered right-heart catheterization. Until that time, no direct measurement of central vascular pressure had been performed in humans. Right-heart catheterization ignited an explosion of insights into function and dysfunction of the pulmonary circulation, cardiac performance, ventilation–perfusion relationships, lung–heart interactions, valvular function, and congenital heart disease. It marked the beginnings of angiocardiography with its diagnostic implications for diseases of the left heart and peripheral circulation. Pulmonary hypertension was discovered to be the consequence of a large variety of diseases that either raised pressure downstream of the pulmonary capillaries, induced vasoconstriction, increased blood flow to the lung, or obstructed the pulmonary vessels, either by embolism or in situ fibrosis. Hypoxic vasoconstriction was found to be a major cause of acute and chronic pulmonary hypertension, and surprising vasoreactivity of the pulmonary vascular bed was discovered to be present in many cases of severe pulmonary hypertension, initially in mitral stenosis. Diseases as disparate as scleroderma, cystic fibrosis, kyphoscoliosis, sleep apnea, and sickle cell disease were found to have shared consequences in the pulmonary circulation. Some of the achievements of Cournand and Richards and their scientific descendents are discussed in this article, including success in the diagnosis and treatment of idiopathic pulmonary arterial hypertension, chronic thromboembolic pulmonary hypertension, and management of hypoxic pulmonary hypertension. PMID:15994464

  10. Right ventricular failure after left ventricular assist device insertion: preoperative risk factors.

    PubMed

    Santambrogio, Luisa; Bianchi, Tiziana; Fuardo, Marinella; Gazzoli, Fabrizio; Veronesi, Roberto; Braschi, Antonio; Maurelli, Marco

    2006-08-01

    Right ventricular failure after left ventricular assist device placement is the major concern on weaning from cardiopulmonary bypass and it is one of the most serious complications in the postoperative period. This complication has a poor prognosis and is generally unpredictable. The identification of pre-operative risk factor for this serious complication is incomplete yet. In order to determine pre-operative risk for severe right ventricular failure after left ventricular assist device support we analyzed preoperative hemodynamics, laboratory data and characteristics of 48 patients who received Novacor (World Heart Corp., Ottawa, ON, Canada). We compared the data from the patients who developed right ventricular failure and the patients who did not. Right ventricular failure occurred in 16% of the patients. There was no significant difference between the groups in demographic characteristics. We identified as preoperative risk factors the pre-operative low mean pulmonary artery and the impairment of hepatic and renal function on laboratory data. Our results confirm in part the findings of the few previous studies. This information may be useful for the patient selection for isolated left ventricular assist device implantation, but other studies are necessary before establishing criteria for patient selection for univentricular support universally accepted.

  11. Monitoring of pulmonary endothelial enzyme function: an animal model for a simplified clinically applicable procedure

    SciTech Connect

    Toivonen, H.J.; Makari, N.; Catravas, J.D.

    1988-01-01

    The authors present a simple and clinically applicable method for the serial monitoring of pulmonary microvascular enzyme function in vivo. This method requires the intravenous injection of trace amounts of a radiolabelled substrate and the collection of a single arterial blood sample. Simultaneous measurement of pulmonary blood flow, (e.g., by dye- or thermo-dilution) and the determination of blood hematocrit are also needed for the calculations. This method was compared to the multiple blood sample indicator dilution method in normal anesthesized rabbits. Both methods gave identical results for the metabolism of the synthetic, hemodynamically inactive tripeptide, /sup 3/H-benzoyl-Phe-Ala-Pro (/sup 3/H-BPAP), by pulmonary microvascular endothelial angiotensin converting enzyme. The parameters measured were: 1) substrate utilization, expressed linearly and logarithmically, and 2) the apparent first order reaction constant. The new method was also used for the simultaneous measurement of single pass, transpulmonary metabolism of /sup 3/H-BPAP by angiotensin converting enzyme and of 5'-adenosine monophosphate by 5'-nucleotidase in rabbits in vivo. The authors propose that similar enzyme kinetic measurements could be used in clinical studies to test their usefulness as an aid in the early diagnosis of incipient pulmonary endothelial dysfunction, e.g., adult respiratory distress syndrome.

  12. In situ enhancement of pulmonary surfactant function using temporary flow reversal

    PubMed Central

    Glindmeyer, Henry W.; Smith, Bradford J.

    2012-01-01

    Acute respiratory distress syndrome is a pulmonary disease with a mortality rate of ∼40% and 75,000 deaths annually in the United States. Mechanical ventilation restores airway patency and gas transport but leads to ventilator-induced lung injury. Furthermore, surfactant replacement therapy is ineffective due to surfactant delivery difficulties and deactivation by vascular proteins leaking into the airspace. Here, we demonstrated that surfactant function can be substantially improved (up to 50%) in situ in an in vitro pulmonary airway model using unconventional flows that incorporate a short-term retraction of the air-liquid interface, leading to a net decrease in cellular damage. Computational fluid dynamic simulations provided insights into this method and demonstrated the physicochemical hydrodynamic foundation for the improved surfactant microscale transport and mobility. This study may provide a starting point for developing novel ventilation waveforms to improve surfactant function in edematous airways. PMID:21998268

  13. Pulmonary function of U. S. coal miners related to dust exposure estimates

    SciTech Connect

    Attfield, M.D.; Hodous, T.K. )

    1992-03-01

    This study of 7,139 U.S. coal miners used linear regression analysis to relate estimates of cumulative dust exposure to several pulmonary function variables measured during medical examinations undertaken between 1969 and 1971. The exposure data included newly derived cumulative dust exposure estimates for the period up to time of examination based on large data bases of underground airborne dust sampling measurements. Negative associations were found between measures of cumulative exposure and FEV1, FVC, and the FEV1/FVC ratio (p less than 0.001). In general, the relationships were similar to those reported for British coal miners. Overall, the results demonstrate an adverse effect of coal mine dust exposure on pulmonary function that occurs even in the absence of radiographically detected pneumoconiosis.

  14. Low level CO2 effects on pulmonary function in humans

    NASA Technical Reports Server (NTRS)

    Sexton, J.; Mueller, K.; Elliott, A.; Gerzer, D.; Strohl, K. P.; West, J. B. (Principal Investigator)

    1998-01-01

    The purpose of the study was to determine whether chamber exposure to low levels of CO2 results in functional alterations in gas mixing and closing volume in humans. Four healthy volunteer subjects were exposed to 0.7% CO2 and to 1.2% CO2. Spirometry, lung volumes, single breath nitrogen washout, diffusing capacity for carbon monoxide (DLCO) by two methods, and cardiac output were measured in triplicate. Values were obtained over two non-consecutive days during the training period (control) and on days 2 or 3, 4, 6, 10, 13, and 23 of exposure to each CO2 level. Measurements were made during the same time of day. There was one day of testing after exposure, while still in the chamber but off carbon dioxide. The order of testing, up until measurements of DLCO and cardiac output, were randomized to avoid presentation effects. The consistent findings were a reduction in diffusing capacity for carbon monoxide and a fall in cardiac output, occurring to a similar degree with both exposures. For the group as a whole, there was no indication of major effects on spirometry, lung volumes, gas mixing or dead space. We conclude that small changes may occur in the function of distal gas exchanging units; however, these effects were not associated with any adverse health effects. The likelihood of pathophysiologic changes in lung function or structure with 0.7 or 1.2% CO2 exposure for this period of time, is therefore, low.

  15. In vitro effects of pulmonary surfactant on macrophage morphology and function.

    PubMed

    Lepekha, L N; Alexandrova, E A; Erokhina, M V

    2012-02-01

    The effects of pulmonary surfactant on the morphology and functioning of young macrophages were studied on the model of monocyte/macrophage differentiation in vitro and on macrophages of the bronchial alveolar lavage fluid. Surfactant is not a differentiation inductor, but it stimulated the maturation and phagocytic activity of young macrophages. The stimulatory effect of surfactant on phagocytic activity of macrophages persisted even after its removal from the culture medium.

  16. Sensitive subgroups and normal variation in pulmonary function response to air pollution episodes.

    PubMed Central

    Brunekreef, B; Kinney, P L; Ware, J H; Dockery, D; Speizer, F E; Spengler, J D; Ferris, B G

    1991-01-01

    The Clean Air Act requires that sensitive subgroups of exposed populations be protected from adverse health effects of air pollution exposure. Hence, data suggesting the existence of sensitive subgroups can have an important impact on regulatory decisions. Some investigators have interpreted differences among individuals in observed pulmonary function response to air pollution episodes as evidence that individuals differ in their sensitivity. An alternative explanation is that the differences are due entirely to normal variation in repeated pulmonary function measurements. This paper investigates this question by reanalyzing data from three studies of children exposed to air pollution episodes to determine whether the observed variability in pulmonary function response indicates differences in sensitivity or natural interoccasion variability. One study investigated exposures to total suspended particulates (TSP), the other two investigated exposure to ozone. In all studies, each child's response to air pollution exposures was summarized by regressing that child's set of pulmonary function measurements on the air pollution concentrations on the day or days before measurement. The within-child and between-child variances of these slopes were used to test the hypothesis of variable sensitivity. Regression slopes did not vary significantly among children exposed to episodes of high TSP concentration, but there was evidence of heterogeneity in both studies of ozone exposures. The finding of heterogeneous response to ozone exposure is consistent with the epidemiologic and chamber studies of ozone exposures, but the lack of evidence for heterogeneous response to TSP exposures implies that observed variation in response can be explained by sampling variability rather than the presence of sensitive subgroup. PMID:2050060

  17. Reliability of an Electronic Inspiratory Loading Device for Assessing Pulmonary Function in Post-Stroke Patients

    PubMed Central

    Lee, Kyeong-Bong; Kim, Min-Kyu; Jeong, Ju-Ri; Lee, Wan-Hee

    2016-01-01

    Background The purpose of this study was to examine the inter- and intra-rater reliability of an electronic inspiratory loading device for the assessment of pulmonary functions: maximum inspiratory pressure, peak inspiratory flow, and vital capacity. Material/Methods Subjects were 50 patient volunteers in a rehabilitation hospital who had experienced their first episode of unilateral stroke with hemiparesis during the previous 6 months (26 men, 24 women; mean age [±SD], 55.96 [±12.81] years), with no use of medications that could induce drowsiness, evidence of restrictive lung disease, history of asthma, use of psychotropic drugs, or alcohol consumption habit. Maximum inspiratory pressure, peak inspiratory flow, and vital capacity for pulmonary functions were assessed using an electronic inspiratory loading device (PowerBreathe, K5, 2010) by 2 examiners, with patients in an unassisted sitting position, and 1 examiner re-assessed with same patients at the same time of a day after 1 week. Intra-class correlation coefficients were used to assess reliability. Results Intra-rater reliability ranged from intra-class correlation coefficients (ICCs)=0.959 to 0.986 in variables. For the inter-rater reliability between 2 examiners, the ICCs ranged from 0.933 to 0.985. Intra-rater and inter-rater reliability were good in variables (maximal inspiratory pressure, peak inspiratory flow, and vital capacity). Conclusions The intra- and inter-examiner reliability of the pulmonary function measurements, maximum inspiratory pressure, peak inspiratory flow, and vital capacity, for the post-stroke patients was very high. The results suggest that the electronic inspiratory loading device would be useful for clinical rehabilitative assessment of pulmonary function. PMID:26782369

  18. Effects of biomass smoke on pulmonary functions: a case control study

    PubMed Central

    Balcan, Baran; Akan, Selcuk; Ugurlu, Aylin Ozsancak; Handemir, Bahar Ozcelik; Ceyhan, Berrin Bagcı; Ozkaya, Sevket

    2016-01-01

    Background Biomass smoke is the leading cause of COPD in developing countries such as Turkey. In rural areas of Turkey, females are more exposed to biomass smoke because of traditional lifestyles. Aim The aim of this study was to determine the adverse effects of biomass smoke on pulmonary functions and define the relationship between duration in years and an index (cumulative exposure index) with altered pulmonary function test results. Participants and methods A total of 115 females who lived in the village of Kağizman (a borough of Kars located in the eastern part of Turkey) and were exposed to biomass smoke were included in the study. The control group was generated with 73 individuals living in the same area who were never exposed to biomass smoke. Results Twenty-seven (23.8%) females in the study group and four (5.5%) in the control group had small airway disease (P=0.038). Twenty-two (19.1%) females in the study group and ten (13.7%) in the control group had obstruction (P=0.223). Twenty (17.3%) females in the study group who were exposed to biomass smoke had restriction compared with ten (13%) in the control group (P=0.189). The duration needed for the existence of small airway disease was 16 years, for obstructive airway disease was 17 years, and for restrictive airway disease was 17 years. The intensity of biomass smoke was defined in terms of cumulative exposure index; it was calculated by multiplying hours per day, weeks per month, and total years of smoke exposure and dividing the result by three. Conclusion Exposure to biomass smoke is a serious public health problem, especially in rural areas of developing countries, because of its negative effects on pulmonary functions. As the duration and the intensity of exposure increase, the probability of having altered pulmonary function test results is higher. PMID:27486318

  19. Assessment of cardiac and pulmonary function in children with juvenile idiopathic arthritis.

    PubMed

    Alkady, Eman A M; Helmy, Hatem A R; Mohamed-Hussein, Aliaë A R

    2012-01-01

    Juvenile idiopathic arthritis (JIA) is the most common rheumatologic disorder of childhood. It is a group of diseases characterized by chronic synovitis and associated with many extra-articular manifestations including cardiac and pulmonary involvement. Cardiac involvement as pericarditis, myocarditis and valvular disease is common in JIA. There are, however, few descriptions concerning systolic and diastolic functions of the left ventricle (LV) and the development of lung disease in children with JIA. The study was carried out to detect the cardiac and pulmonary involvement and to study the systolic and diastolic function of the left ventricle in a group of children with juvenile idiopathic arthritis. Forty-five children with JIA without any cardiac or pulmonary symptoms and 30 age- and sex-matched controls were included in the study. M-mode, two-dimensional and pulsed Doppler echocardiography (ECHO) was performed on 36 patients. Tissue Doppler ECHO examination was performed on 24 patients to assess systolic and diastolic functions of left ventricle. Pulmonary function tests: Forced vital capacity (FVC%), the predicted forced expiratory volume in the first second (FEV(1)%) and FEV(1)/FVC ratio and peak expiratory flow (PEF), total lung capacity (TLC) and residual volume (RV), carbon monoxide diffusing capacity of the lung (DLCO) and DLCO/alveolar volume (VA) were evaluated in 32 patients. Informed consent was obtained from all children's parents. The study protocol was approved by ethical committee of Faculty of Medicine, Assiut University. In this study, children with JIA had higher systolic and diastolic blood pressures, resting heart rate, left ventricle systolic size and volume (4.35 ± 0.68 vs. 3.92 ± 0.28, P value = 0.02). On Doppler and tissue Doppler analysis, the JIA group had lower peak early filling velocity (E, m/s), higher peak atrial filling velocity (A, m/s) and prolonged diastolic E and A waves deceleration times and isovolumic relaxation time

  20. Macular sub-layer thinning and association with pulmonary function tests in Amyotrophic Lateral Sclerosis.

    PubMed

    Simonett, Joseph M; Huang, Russell; Siddique, Nailah; Farsiu, Sina; Siddique, Teepu; Volpe, Nicholas J; Fawzi, Amani A

    2016-01-01

    Amyotrophic Lateral Sclerosis (ALS) is a complex neurodegenerative disorder that may have anterior visual pathway involvement. In this study, we compare the macular structure of patients with ALS to healthy controls, and examine correlations between macular sub-layer thickness measurements and pulmonary function tests and disease duration. ALS patients underwent optical coherence tomography (OCT) imaging to obtain macular cube scans of the right eye. Macular cube OCT data from age-matched healthy subjects were provided by the OCT reading center. Semi-automated retinal segmentation software was used to quantify macular sub-layers. Pulmonary function tests and time since symptom onset were collected retrospectively from the electronic medical records of ALS patients. Macular retinal nerve fiber layer was significantly thinner in ALS patients compared to healthy controls (P < 0.05). Total macular and other sub-layer thicknesses were not reduced in the ALS cohort. Macular retinal nerve fiber layer thickness positively correlated with forced vital capacity % predicted and forced expiratory volume in 1 second % predicted (P < 0.05). In conclusion, analysis of OCT measurements supports the involvement of the anterior visual pathway in ALS. Subtle structural thinning in the macular retinal nerve fiber layer correlates with pulmonary function tests. PMID:27383525

  1. Acute effects of inspiratory muscle warm-up on pulmonary function in healthy subjects.

    PubMed

    Özdal, Mustafa

    2016-06-15

    The acute effects of inspiratory muscle warm-up on pulmonary functions were examined in 26 healthy male subjects using the pulmonary function test (PFT) in three different trials. The control trial (CON) did not involve inspiratory muscle warm-up, while the placebo (IMWp) and experimental (IMW) trials involved inspiratory muscle warm-up. There were no significant changes between the IMWp and CON trials (p>0.05). All the PFT measurements, including slow vital capacity, inspiratory vital capacity, forced vital capacity, forced expiratory volume in one second, maximal voluntary ventilation, and maximal inspiratory pressure were significantly increased by 3.55%, 12.52%, 5.00%, 2.75%, 2.66%, and 7.03% respectively, in the subjects in the IMW trial than those in the CON trial (p<0.05). These results show that inspiratory muscle warm-up improved the pulmonary functions. The mechanisms responsible for these improvements are probably associated with the concomitant increase in the inspiratory muscle strength, and the cooperation of the upper thorax, neck, and respiratory muscles, and increased level of reactive O2 species in muscle tissue, and potentially improvement of muscle O2 delivery-to-utilization. However, further investigation is required to determine the precise mechanisms responsible from among these candidates. PMID:26903486

  2. Pulmonary function evaluation during the Skylab and Apollo-Soyuz missions.

    PubMed

    Sawin, C F; Nicogossian, A E; Rummel, J A; Michel, E L

    1976-02-01

    Previous experience during Apollo postflight exercise testing indicated no major changes in pulmonary function. Pulmonary function has been studied in detail following exposure to hypoxic and hyperoxic normal gravity environments, but no previous study has reported on men exposed to an environment that was both normoxic at 258 torr total pressure and at null gravity as encountered in Skylab. Forced vital capacity (FVC) was measured during the preflight and postflight periods of the Skylab 2 mission. Inflight measurements of vital capacity (VC) were obtained during the last 2 weeks of the second manned mission (Skylab 3). More detailed pulmonary function screening was accomplished during the Skylab 4 mission. The primary measurements made during Skylab 4 testing included residual volume determination (RV), closing volume (CV), VC, FVC and its derivatives. In addition, VC was measured in flight at regular intervals during the Skylab 4 mission. Vital capacity was decreased slightly (-10%) in flight in all Skylab 4 crewmen. No major preflight-to-postflight changes were observed. The Apollo-Soyuz Test Project (ASTP) crewmen were studied using equipment and procedures similar to those employed during Skylab 4. Postflight evaluation of the ASTP crewmen was complicated by their inadvertent exposure to nitrogen tetroxide gas fumes upon reentry.

  3. Acute effects of ambient ozone on pulmonary function of children in The Netherlands

    SciTech Connect

    Hoek, G.; Fischer, P.; Brunekreef, B.; Lebret, E.; Hofschreuder, P.; Mennen, M.G. )

    1993-01-01

    In the spring and summer of 1989 an epidemiologic study was conducted to evaluate the acute effects of photochemical air pollution episodes on pulmonary function of children living in three nonindustrial towns in the Netherlands. Spirometry was performed repeatedly in the schools of the children, mostly during the morning hours. Data from 533 children having more than four valid pulmonary function tests were included in the analyses. The association between previous-day ambient ozone concentration and pulmonary function was evaluated, using individual linear regression analysis and subsequent evaluation of the distribution of individual regression coefficients. One hour maximum ambient ozone concentrations frequently exceeded 160 micrograms/m3 but were all lower than the Dutch Air Quality Guideline of 240 micrograms/m3 for all three populations. Significant negative associations of previous-day ambient ozone with FVC, FEV1, peak expiratory flow (PEF), and maximal midexpiratory flow (MMEF) were observed. There were indications of systematic differences in responses among the children. Children with chronic respiratory symptoms did not have a stronger response than children without these symptoms.

  4. The effects of inhaled sulfuric acid on pulmonary function in adolescent asthmatics

    SciTech Connect

    Koenig, J.Q.; Pierson, W.E.; Horike, M.

    1983-08-01

    Ten adolescent subjects with extrinsic asthma and exercise-induced bronchospasm were studied. The subjects were exposed for 30 min at rest followed by 10 min during moderate exercise on a treadmill to either 100 micrograms/m3 sodium chloride (NaCl) or 100 micrograms/m3 sulfuric acid (H/sub 2/SO/sub 4/) droplet aerosols. All exposures were at approximately 75% relative humidity and 22 degrees C. Pulmonary functional measurements were recorded before, during, and after exposure while the subject was seated in a body plethysmograph. Exposure to the NaCl aerosol during exercise produced a small (12%) but significant drop in maximal expiratory flow (V/sub max/75) (p less than 0.05). However, exposure to the H/sub 2/SO/sub 4/ aerosol produced larger reductions in V/sub max/75 (29%; p less than 0.01) and also significant changes in 3 other parameters of pulmonary function: V/sub max/50, FEV1, and total respiratory resistance (RT). The changes were similar to those reported for exposure to 0.5 ppm of sulfur dioxide in a similar group of adolescents with extrinsic asthma. Our results are the first report of reversible pulmonary functional changes after H/sub 2/SO/sub 4/ exposure in a group of adolescent asthmatic subjects.

  5. Macular sub-layer thinning and association with pulmonary function tests in Amyotrophic Lateral Sclerosis

    PubMed Central

    Simonett, Joseph M.; Huang, Russell; Siddique, Nailah; Farsiu, Sina; Siddique, Teepu; Volpe, Nicholas J.; Fawzi, Amani A.

    2016-01-01

    Amyotrophic Lateral Sclerosis (ALS) is a complex neurodegenerative disorder that may have anterior visual pathway involvement. In this study, we compare the macular structure of patients with ALS to healthy controls, and examine correlations between macular sub-layer thickness measurements and pulmonary function tests and disease duration. ALS patients underwent optical coherence tomography (OCT) imaging to obtain macular cube scans of the right eye. Macular cube OCT data from age-matched healthy subjects were provided by the OCT reading center. Semi-automated retinal segmentation software was used to quantify macular sub-layers. Pulmonary function tests and time since symptom onset were collected retrospectively from the electronic medical records of ALS patients. Macular retinal nerve fiber layer was significantly thinner in ALS patients compared to healthy controls (P < 0.05). Total macular and other sub-layer thicknesses were not reduced in the ALS cohort. Macular retinal nerve fiber layer thickness positively correlated with forced vital capacity % predicted and forced expiratory volume in 1 second % predicted (P < 0.05). In conclusion, analysis of OCT measurements supports the involvement of the anterior visual pathway in ALS. Subtle structural thinning in the macular retinal nerve fiber layer correlates with pulmonary function tests. PMID:27383525

  6. The effects of breathing with mainly inspiration or expiration on pulmonary function and chest expansion

    PubMed Central

    Woo, Seong-Dae; Kim, Tae-Ho; Lim, Jin-Yong

    2016-01-01

    [Purpose] This study aimed to determine the effects of inspiration- and expiration-oriented breathing on pulmonary function and chest expansion. [Subjects and Methods] Twenty healthy male university students were divided randomly into inspiration-oriented and expiration-oriented breathing groups. Their pulmonary function and chest size during inspiration or expiration were evaluated and then re-evaluated after 15 minutes of breathing exercise five times a week for four weeks. [Results] The breathing with mainly inspiration group (BMIG) showed significant differences in chest size during inspiration (CSI), chest expansion values (CEVs), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow (PEF) after four weeks. The breathing with mainly expiration group (BMEG) showed significant differences in all measured variables except CSI. Comparison of the groups after exercise showed that the BMEG demonstrated differences from the BMIG in chest size during expiration (CSE), CEV, and PEF. Comparison of the changes in variables after exercise showed that the BMEG demonstrated significantly different changes in CSE, CEV, FEV1/FVC, and PEF. The BMIG showed a significantly different change in FVC. [Conclusion] Although both groups demonstrated improvements in pulmonary function and chest expansion, inter-group differences were observed. Therefore, inspiration- or expiration-oriented breathing may be recommended differently according to the desired outcome. PMID:27134386

  7. Two year follow up of pulmonary function values among welders in New Zealand

    PubMed Central

    Erkinjuntti-Pekka..., R.; Slater, T.; Cheng, S.; Fishwick, D.; Bradshaw, L.; Kimbell-, D; Dronfield, L.; Pearce, N.

    1999-01-01

    OBJECTIVES: To examine whether welding is a risk factor for an accelerated decline in pulmonary function. METHODS: 2 Year follow up of pulmonary function and respiratory symptoms among 54 welders and 38 non- welders in eight New Zealand welding sites. RESULTS: There were no significant differences in age, height, smoking habits, ethnicity, or total time in industrial work between welders and non-welders. No overall differences were noted in the changes of pulmonary function variables between the two study groups. However, when the comparison was restricted to smokers, welders had a significantly greater (p = 0.02) annual decline (88.8 ml) in FEV1 than non-welders, who had a slight non-significant annual increase (34.2 ml). Also, welders without respiratory protection or local exhaust ventilation while welding had a greater annual decline both in forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) than welders with protection (p = 0.001 and 0.04, respectively). Among welders a significant association was found between the acute across shift change and the annual decline in FEV1. Chronic bronchitis was more common among welders (24%) than non-welders (5%). Only one welder (2%) but eight non- welders (21%) reported having asthma. CONCLUSIONS: Welders who smoked and welders working without local exhaust ventilation or respiratory protection have an increased risk of accelerated decline in FEV1.   PMID:10472307

  8. Pulmonary function in beryllium workers: assessment of exposure.

    PubMed Central

    Kriebel, D; Sprince, N L; Eisen, E A; Greaves, I A

    1988-01-01

    The inhalation of beryllium causes a serious lung disease characterised by pronounced radiographic and functional impairments and occurs in workers engaged in the extraction and manufacture of the metal. This paper describes the beryllium exposure levels and refining processes in a large beryllium factory operating since the 1930s. Lifetime beryllium exposure histories were estimated for the 309 workers present at a health survey conducted in 1977. Beryllium exposure levels in the plant were high for many years, with some estimated exposure levels in excess of 100 micrograms/m3. As late as 1975, there were exposures to beryllium above 10 micrograms/m3 in some jobs. After about 1977, the plant was in compliance with the permissible exposure limit of 2.0 micrograms/m3. The median cumulative exposure in this cohort was 65 micrograms/m3-years and the median duration of exposure was 17 years. From these data a series of exposure parameters, functions of the exposure histories that characterise biologically important dimensions of exposure were calculated for each worker. PMID:3342199

  9. Effects of pneumothorax or pleural effusion on pulmonary function.

    PubMed Central

    Gilmartin, J J; Wright, A J; Gibson, G J

    1985-01-01

    The effects of pneumothorax or pleural effusion on respiratory function as measured by the commonly applied tests were investigated by studying 13 patients (six with pneumothorax, seven with effusion) with and, as far as possible, without air or fluid in the pleural cavity. Measurements included spirometric volumes, carbon monoxide transfer factor (TLCO), and KCO by the single breath method, maximum expiratory flow-volume curves, and subdivisions of lung volume estimated by both inert gas dilution and body plethysmography. In patients with pneumothorax "pleural volume" was estimated as the difference between lung volumes measured by dilution and thoracic gas volume measured by plethysmography. In patients with effusion the change in "pleural volume" was equated with the volume of fluid subsequently aspirated. "Total thoracic capacity" (TTC) was estimated by adding total lung capacity (TLC) measured by dilution and "pleural volume." Both effusion and pneumothorax produced a restrictive ventilatory defect with reductions of vital capacity, functional residual capacity, and TLC. In the patients with effusion TTC fell after aspiration, suggesting that the pleural fluid produced relative expansion of the chest wall as well as compression of the lung. In patients with pneumothorax, however, there was no difference in TTC with and without air in the pleural space. In the presence of pleural air or fluid there was a slight decrease in TLCO and increase in KCO, with a small but significant increase in the rate of lung emptying during forced expiration. PMID:3969656

  10. Investigation of pulmonary function among employees exposed to low levels of monomeric isocyanates and solvents at an automobile finishings plant.

    PubMed

    Schweigert, Michael; Sax, Sol; House, Ron; Henderson, Bruce

    2002-11-01

    There have been reports in the literature of decrements in pulmonary function associated with long-term, low-level monomeric isocyanate exposure combined with solvent exposure. This cross-sectional study examines the relationship between these exposures and pulmonary function in an automobile paint and coating (finishes) plant. A job exposure matrix was developed for isocyanate and solvent exposure; years in a work task were used as a surrogate for exposure. Recent pulmonary function tests were used as the outcome variables; specifically the difference between predicted and actual FEV1 and FVC. The results of the analysis demonstrated no statistically significant relationship between combined isocyanate and solvent exposure and decline in pulmonary function. There was a statistically significant negative correlation between solvent exposure and FEV1 and FVC.

  11. Postoperative Acute Pulmonary Embolism Following Pulmonary Resections

    PubMed Central

    Shonyela, Felix Samuel; Liu, Bo; Jiao, Jia

    2015-01-01

    Postoperative acute pulmonary embolism after pulmonary resections is highly fatal complication. Many literatures have documented cancer to be the highest risk factor for acute pulmonary embolism after pulmonary resections. Early diagnosis of acute pulmonary embolism is highly recommended and computed tomographic pulmonary angiography is the gold standard in diagnosis of acute pulmonary embolism. Anticoagulants and thrombolytic therapy have shown a great success in treatment of acute pulmonary embolism. Surgical therapies (embolectomy and inferior vena cava filter replacement) proved to be lifesaving but many literatures favored medical therapy as the first choice. Prophylaxis pre and post operation is highly recommended, because there were statistical significant results in different studies which supported the use of prophylaxis in prevention of acute pulmonary embolism. Having reviewed satisfactory number of literatures, it is suggested that thoroughly preoperative assessment of patient conditions, determining their risk factors complicating to pulmonary embolism and the use of appropriate prophylaxis measures are the key options to the successful minimization or eradication of acute pulmonary embolism after lung resections. PMID:26354232

  12. Functional and molecular factors associated with TAPSE in hypoxic pulmonary hypertension.

    PubMed

    Crnkovic, Slaven; Schmidt, Albrecht; Egemnazarov, Bakytbek; Wilhelm, Jochen; Marsh, Leigh M; Ghanim, Bahil; Klepetko, Walter; Olschewski, Andrea; Olschewski, Horst; Kwapiszewska, Grazyna

    2016-07-01

    Adaptation of the right ventricle (RV) to increased afterload is crucial for survival in pulmonary hypertension (PH), but it is challenging to assess RV function and identify associated molecular mechanisms. The aim of the current study was to analyze the relationship between invasive and noninvasive parameters of RV morphology and function and associated molecular changes. The response of mice to normobaric hypoxia was assessed by hechocardiography, invasive hemodynamics, and histological and molecular analyses. Plasma levels of possibly novel markers of RV remodeling were measured by ELISA in patients with idiopathic pulmonary arterial hypertension (IPAH) and matched healthy controls. Chronic hypoxia-induced PH was accompanied by significantly decreased tricuspid annular plane systolic excursion (TAPSE) and unchanged RV contractility index and tau. RV hypertrophy was present without an increase in fibrosis. There was no change in α- and β-major histocompatibility class or natriuretic peptides expression. Comparative microarray analysis identified two soluble factors, fibroblast growth factor-5 (FGF5) and interleukin-22 receptor alpha-2 (IL22RA2), as being possibly associated with RV remodeling. We observed significantly higher plasma levels of IL22RA2, but not FGF5, in patients with IPAH. Hypoxic pulmonary hypertension in a stage of RV remodeling with preserved systolic function is associated with decreased pulmonary vascular compliance, mild diastolic RV dysfunction, and significant decrease in TAPSE. Subtle gene expression changes in the RV vs. the left ventricle upon chronic hypoxia suggest that the majority of changes are due to hypoxia and not due to changes in afterload. Increased IL22RA2 levels might represent a novel RV adaptive mechanism.

  13. Functional and molecular factors associated with TAPSE in hypoxic pulmonary hypertension.

    PubMed

    Crnkovic, Slaven; Schmidt, Albrecht; Egemnazarov, Bakytbek; Wilhelm, Jochen; Marsh, Leigh M; Ghanim, Bahil; Klepetko, Walter; Olschewski, Andrea; Olschewski, Horst; Kwapiszewska, Grazyna

    2016-07-01

    Adaptation of the right ventricle (RV) to increased afterload is crucial for survival in pulmonary hypertension (PH), but it is challenging to assess RV function and identify associated molecular mechanisms. The aim of the current study was to analyze the relationship between invasive and noninvasive parameters of RV morphology and function and associated molecular changes. The response of mice to normobaric hypoxia was assessed by hechocardiography, invasive hemodynamics, and histological and molecular analyses. Plasma levels of possibly novel markers of RV remodeling were measured by ELISA in patients with idiopathic pulmonary arterial hypertension (IPAH) and matched healthy controls. Chronic hypoxia-induced PH was accompanied by significantly decreased tricuspid annular plane systolic excursion (TAPSE) and unchanged RV contractility index and tau. RV hypertrophy was present without an increase in fibrosis. There was no change in α- and β-major histocompatibility class or natriuretic peptides expression. Comparative microarray analysis identified two soluble factors, fibroblast growth factor-5 (FGF5) and interleukin-22 receptor alpha-2 (IL22RA2), as being possibly associated with RV remodeling. We observed significantly higher plasma levels of IL22RA2, but not FGF5, in patients with IPAH. Hypoxic pulmonary hypertension in a stage of RV remodeling with preserved systolic function is associated with decreased pulmonary vascular compliance, mild diastolic RV dysfunction, and significant decrease in TAPSE. Subtle gene expression changes in the RV vs. the left ventricle upon chronic hypoxia suggest that the majority of changes are due to hypoxia and not due to changes in afterload. Increased IL22RA2 levels might represent a novel RV adaptive mechanism. PMID:27106290

  14. Improved pulmonary function in working divers breathing nitrox at shallow depths

    NASA Technical Reports Server (NTRS)

    Fitzpatrick, Daniel T.; Conkin, Johnny

    2003-01-01

    INTRODUCTION: There is limited data about the long-term pulmonary effects of nitrox use in divers at shallow depths. This study examined changes in pulmonary function in a cohort of working divers breathing a 46% oxygen enriched mixture while diving at depths less than 12 m. METHODS: A total of 43 working divers from the Neutral Buoyancy Laboratory (NBL), NASA-Johnson Space Center completed a questionnaire providing information on diving history prior to NBL employment, diving history outside the NBL since employment, and smoking history. Cumulative dive hours were obtained from the NBL dive-time database. Medical records were reviewed to obtain the diver's height, weight, and pulmonary function measurements from initial pre-dive, first year and third year annual medical examinations. RESULTS: The initial forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were greater than predicted, 104% and 102%, respectively. After 3 yr of diving at the NBL, both the FVC and FEV1 showed a significant (p < 0.01) increase of 6.3% and 5.5%, respectively. There were no significant changes in peak expiratory flow (PEF), forced mid-expiratory flow rate (FEF(25-75%)), and forced expiratory flow rates at 25%, 50%, and 75% of FVC expired (FEF25%, FEF50%, FEF75%). Cumulative NBL dive hours was the only contributing variable found to be significantly associated with both FVC and FEV1 at 1 and 3 yr. CONCLUSIONS: NBL divers initially belong to a select group with larger than predicted lung volumes. Regular diving with nitrox at shallow depths over a 3-yr period did not impair pulmonary function. Improvements in FVC and FEV1 were primarily due to a training effect.

  15. Surgical management of chronic pulmonary embolism.

    PubMed Central

    Chitwood, W R; Lyerly, H K; Sabiston, D C

    1985-01-01

    Recurrent pulmonary emboli ultimately may produce respiratory insufficiency, severe hypoxemia, and progressive pulmonary hypertension. In many patients this syndrome is silent in its initial phases, and when thrombophlebitis is present it is often unresponsive to anticoagulant therapy. Unless pulmonary embolectomy is undertaken, most of these patients characteristically succumb with severe respiratory insufficiency. Twenty-five patients with this syndrome have been evaluated at the Duke University Medical Center, and 14 were selected for elective pulmonary embolectomy for relief of severe and incapacitating pulmonary insufficiency. In each patient preoperative pulmonary scans and arteriography demonstrated a high degree of vascular occlusion. The obstructing lesions affected both lungs in the majority of patients. Bronchial arteriography was found to be a very valuable method for demonstrating patency of the pulmonary arteries distal to occluding lesions by retrograde filling through collateral vessels joining the bronchial and pulmonary circulations. Preoperatively radionuclide angiocardiography revealed severe right ventricular dysfunction with significantly depressed ejection fractions at rest and during exercise. Retrograde pulmonary arterial flow as shown by selective bronchial arteriography was excellent in ten patients, fair in three, and absent in one. Long term follow-up indicated a clear relationship between the magnitude of arterial backflow at the time of embolectomy and the degree of clinical improvement. There were two perioperative deaths, one from massive reperfusion pulmonary hemorrhage and another from intractable right ventricular failure. Eleven patients with this syndrome were unsuitable candidates for embolectomy and of these, nine had severe distal emboli diffusely spread in the small pulmonary arteries and not amenable to direct removal. One patient had severe right ventricular failure with extreme pulmonary hypertension (145/45 mmHg) and

  16. Diminished pulmonary function in pectus excavatum: from denying the problem to finding the mechanism

    PubMed Central

    Obermeyer, Robert J.; Nuss, Donald

    2016-01-01

    Background Recently, technical improvement in the ability to measure lung function and the severity of chest deformity have enabled progress in understanding the mechanism of limitations of lung function in pectus excavatum. Methods After establishing that most patients with pectus excavatum do have symptoms of exercise intolerance, easy fatigability, and shortness of breath with exertion, lung function has been evaluated by a variety of methods in different centers. Spirometry, plethysmography, exercise testing, oculo electronic plethysmography, and imaging methods have been used to assess lung function in pectus excavatum and its response to surgery. Results Not all patients with pectus excavatum have subnormal static pulmonary function testing; some have above-average values. However, in more than 1500 adult and pediatric surgical patients with anatomically severe pectus excavatum at a single center, the bell curve of FVC, FEV1, and FEF 25-75 is shifted to significantly lower values in pectus excavatum. The curve is shifted to higher values after operation by approximately one standard deviation. Previous work has demonstrated that patients with more anatomically severe pectus excavatum are more likely to have diminished PFT’s. A mechanism for this effect is seen by oculo electronic plethysmography, which demonstrates that the depressed portion of the chest does not move on respiration. After Nuss procedure, the chest wall motion used to create suction to draw air into the lungs is indistinguishable from that of persons with a normal chest, and the intrathoracic volume is markedly increased. Conclusions Pectus excavatum is accompanied in most patients by diminished static pulmonary function. Correction by Nuss procedure results in improvement in chest wall motion; this improvement in the thoracic bellows action is accompanied by improvement in pulmonary function testing. PMID:27747180

  17. Abnormal pulmonary function and associated risk factors in children and adolescents with sickle cell anemia.

    PubMed

    Arteta, Manuel; Campbell, Andrew; Nouraie, Mehdi; Rana, Sohail; Onyekwere, Onyinye C; Ensing, Gregory; Sable, Craig; Dham, Niti; Darbari, Deepika; Luchtman-Jones, Lori; Kato, Gregory J; Gladwin, Mark T; Castro, Oswaldo L; Minniti, Caterina P; Gordeuk, Victor R

    2014-04-01

    Obstructive and restrictive pulmonary changes develop in children with sickle cell disease, but reports conflict as to the type of change that predominates. We prospectively performed spirometry, plethysmography, and lung diffusing capacity in 146 children aged 7 to 20 years with hemoglobin SS or Sβ(0)-thalassemia. Nineteen percent of the patients had obstructive physiology as defined according to guidelines of the American Thoracic Society. In addition, 9% had restrictive physiology and 11% had abnormal but not categorized physiology. Increasing age, patient-reported or family-reported history of asthma or wheezing, and higher lactate dehydrogenase concentration were independent predictors of obstruction as reflected in lower forced expiratory volume in the first second/forced vital capacity. In conclusion, abnormal pulmonary function, most often obstructive, is common in children with hemoglobin SS and Sβ(0)-thalassemia. Full pulmonary function testing should be performed in children with hemoglobin SS or Sβ(0)-thalassemia, especially with history of asthma or wheezing and accentuated elevations in hemolytic markers.

  18. A study on quantifying COPD severity by combining pulmonary function tests and CT image analysis

    NASA Astrophysics Data System (ADS)

    Nimura, Yukitaka; Kitasaka, Takayuki; Honma, Hirotoshi; Takabatake, Hirotsugu; Mori, Masaki; Natori, Hiroshi; Mori, Kensaku

    2011-03-01

    This paper describes a novel method that can evaluate chronic obstructive pulmonary disease (COPD) severity by combining measurements of pulmonary function tests and measurements obtained from CT image analysis. There is no cure for COPD. However, with regular medical care and consistent patient compliance with treatments and lifestyle changes, the symptoms of COPD can be minimized and progression of the disease can be slowed. Therefore, many diagnosis methods based on CT image analysis have been proposed for quantifying COPD. Most of diagnosis methods for COPD extract the lesions as low-attenuation areas (LAA) by thresholding and evaluate the COPD severity by calculating the LAA in the lung (LAA%). However, COPD is usually the result of a combination of two conditions, emphysema and chronic obstructive bronchitis. Therefore, the previous methods based on only LAA% do not work well. The proposed method utilizes both of information including the measurements of pulmonary function tests and the results of the chest CT image analysis to evaluate the COPD severity. In this paper, we utilize a multi-class AdaBoost to combine both of information and classify the COPD severity into five stages automatically. The experimental results revealed that the accuracy rate of the proposed method was 88.9% (resubstitution scheme) and 64.4% (leave-one-out scheme).

  19. Surgical resection of low-grade gliomas in eloquent areas with the guidance of the preoperative functional magnetic resonance imaging and craniometric points

    PubMed Central

    Abdullah, Ahmed; El Shitany, Hisham; Abbass, Waleed; Safwat, Amr; Elsamman, Amr K; El Refaee, Ehab

    2016-01-01

    Objectives: Surgical resection of low-grade gliomas (LGGs) in eloquent areas is one of the challenges in neurosurgery, using assistant tools to facilitate effective excision with minimal postoperative neurological deficits has been previously discussed (awake craniotomy and intraoperative cortical stimulation); however, these tools could have their own limitations thus implementation of a simple and effective technique that can guide to safe excision is needed in many situations. Materials and Methods: The authors conducted a retrospective analysis of a prospectively collected data of 76 consecutive surgical cases of LGGs of these 21 cases were situated in eloquent areas. Preoperative functional magnetic resonance imaging (fMRI), pre- and post-operative MRI with volumetric analysis of the tumor size was conducted, and intraoperative determination of the craniometric points related to the tumor (navigation guided in 10 cases) were studied to evaluate the effectiveness of the aforementioned tools in safe excision of the aforementioned tumors. Results: Total-near total excision in 14 (66.67%) subtotal in 6 (28.57%), and biopsy in 1 case (4.57%). In long-term follow–up, only one case experienced persistent dysphasia. Conclusion: In spite of its simplicity, the identification of the safe anatomical landmarks guided by the preoperative fMRI is a useful technique that serves in safe excision of LGGs in eloquent areas. Such technique can replace intraoperative evoked potentials or the awake craniotomy in most of the cases. However, navigation-guided excision might be crucial in deeply seated and large tumors to allow safe and radical excision. PMID:27695239

  20. Surgical resection of low-grade gliomas in eloquent areas with the guidance of the preoperative functional magnetic resonance imaging and craniometric points

    PubMed Central

    Abdullah, Ahmed; El Shitany, Hisham; Abbass, Waleed; Safwat, Amr; Elsamman, Amr K; El Refaee, Ehab

    2016-01-01

    Objectives: Surgical resection of low-grade gliomas (LGGs) in eloquent areas is one of the challenges in neurosurgery, using assistant tools to facilitate effective excision with minimal postoperative neurological deficits has been previously discussed (awake craniotomy and intraoperative cortical stimulation); however, these tools could have their own limitations thus implementation of a simple and effective technique that can guide to safe excision is needed in many situations. Materials and Methods: The authors conducted a retrospective analysis of a prospectively collected data of 76 consecutive surgical cases of LGGs of these 21 cases were situated in eloquent areas. Preoperative functional magnetic resonance imaging (fMRI), pre- and post-operative MRI with volumetric analysis of the tumor size was conducted, and intraoperative determination of the craniometric points related to the tumor (navigation guided in 10 cases) were studied to evaluate the effectiveness of the aforementioned tools in safe excision of the aforementioned tumors. Results: Total-near total excision in 14 (66.67%) subtotal in 6 (28.57%), and biopsy in 1 case (4.57%). In long-term follow–up, only one case experienced persistent dysphasia. Conclusion: In spite of its simplicity, the identification of the safe anatomical landmarks guided by the preoperative fMRI is a useful technique that serves in safe excision of LGGs in eloquent areas. Such technique can replace intraoperative evoked potentials or the awake craniotomy in most of the cases. However, navigation-guided excision might be crucial in deeply seated and large tumors to allow safe and radical excision.

  1. Pulmonary Ventilation Imaging Based on 4-Dimensional Computed Tomography: Comparison With Pulmonary Function Tests and SPECT Ventilation Images

    SciTech Connect

    Yamamoto, Tokihiro; Kabus, Sven; Lorenz, Cristian; Mittra, Erik; Hong, Julian C.; Chung, Melody; Eclov, Neville; To, Jacqueline; Diehn, Maximilian; Loo, Billy W.; Keall, Paul J.

    2014-10-01

    Purpose: 4-dimensional computed tomography (4D-CT)-based pulmonary ventilation imaging is an emerging functional imaging modality. The purpose of this study was to investigate the physiological significance of 4D-CT ventilation imaging by comparison with pulmonary function test (PFT) measurements and single-photon emission CT (SPECT) ventilation images, which are the clinical references for global and regional lung function, respectively. Methods and Materials: In an institutional review board–approved prospective clinical trial, 4D-CT imaging and PFT and/or SPECT ventilation imaging were performed in thoracic cancer patients. Regional ventilation (V{sub 4DCT}) was calculated by deformable image registration of 4D-CT images and quantitative analysis for regional volume change. V{sub 4DCT} defect parameters were compared with the PFT measurements (forced expiratory volume in 1 second (FEV{sub 1}; % predicted) and FEV{sub 1}/forced vital capacity (FVC; %). V{sub 4DCT} was also compared with SPECT ventilation (V{sub SPECT}) to (1) test whether V{sub 4DCT} in V{sub SPECT} defect regions is significantly lower than in nondefect regions by using the 2-tailed t test; (2) to quantify the spatial overlap between V{sub 4DCT} and V{sub SPECT} defect regions with Dice similarity coefficient (DSC); and (3) to test ventral-to-dorsal gradients by using the 2-tailed t test. Results: Of 21 patients enrolled in the study, 18 patients for whom 4D-CT and either PFT or SPECT were acquired were included in the analysis. V{sub 4DCT} defect parameters were found to have significant, moderate correlations with PFT measurements. For example, V{sub 4DCT}{sup HU} defect volume increased significantly with decreasing FEV{sub 1}/FVC (R=−0.65, P<.01). V{sub 4DCT} in V{sub SPECT} defect regions was significantly lower than in nondefect regions (mean V{sub 4DCT}{sup HU} 0.049 vs 0.076, P<.01). The average DSCs for the spatial overlap with SPECT ventilation defect regions were only moderate (V

  2. Association between Outdoor Fungal Concentrations during Winter and Pulmonary Function in Children with and without Asthma

    PubMed Central

    Watanabe, Masanari; Noma, Hisashi; Kurai, Jun; Hantan, Degejirihu; Burioka, Naoto; Nakamoto, Sachiko; Sano, Hiroyuki; Taniguchi, Jumpei; Shimizu, Eiji

    2016-01-01

    Outdoor fungi are important components of airborne particulate matter (PM). However, the associations between pulmonary function and outdoor fungi are less well known compared to other airborne PM constituents. The objective of this study was to investigate the association between outdoor fungi and pulmonary function in children. Morning peak expiratory flow (PEF) rates were measured daily in 339 schoolchildren (including 36 with asthma), aged 10 to 12, 2 to 27 February 2015. Airborne PM was collected on filters, using a high volume air sampler, each day during the study period. The daily concentration of outdoor fungi-associated PM was calculated using a culture-based method. A linear mixed model was used to estimate the association between PEF values and daily concentrations of outdoor fungi, and the daily levels of suspended PM (SPM) and PM ≤ 2.5 μm (PM2.5). An increase in the interquartile range (46.2 CFU/m3) for outdoor fungal concentration led to PEF changes of −1.18 L/min (95% confidence interval, −2.27 to −0.08) in all children, 1.22 L/min (−2.96 to 5.41) in children without asthma, and −1.44 L/min (−2.57 to −0.32) in children with asthma. Outdoor fungi showed a significant negative correlation with PM2.5 levels (r = −0.4, p = 0.04), but not with SPM (r = ‒0.3, p = 0.10) levels. Outdoor fungi may be associated with pulmonary dysfunction in children. Furthermore, children with asthma may show greater pulmonary dysfunction than those without asthma. PMID:27136569

  3. Effect of Parachlamydia acanthamoebae on pulmonary function parameters in a bovine respiratory model.

    PubMed

    Lohr, M; Prohl, A; Ostermann, C; Diller, R; Greub, G; Reinhold, P

    2016-07-01

    The aim of this study was to evaluate pulmonary dysfunction induced by experimental infection with Parachlamydia acanthamoebae in calves. Intrabronchial inoculation with P. acanthamoebae was performed in 31 calves aged 2-3 months old at two different challenge doses of 10(8) and 10(10) inclusion-forming units (IFU) per animal. Control animals received heat inactivated bacteria. The effects on pulmonary gas exchange were determined by arterial blood gas analysis and haemoximetry during the 7 days post inoculation (DPI). For pulmonary function testing (PFT), impulse oscillometry, capnography, and measurement of O2 uptake were undertaken in spontaneously breathing animals 7 and 3 days before inoculation and were repeated until 10 DPI. In the early phase after challenge (1-3 DPI), mild hypoxaemia occurred, which was accompanied by a significant reduction in both tidal and alveolar volumes (each related to bodyweight, BW). In parallel, expiratory flow rate and specific ventilation (i.e. minute ventilation related to O2 uptake) were significantly increased. Minute and alveolar ventilations (each related to metabolic BW) increased significantly due to higher respiratory rates, lasting until 4 and 5 DPI, respectively. Oxygen uptake was slightly reduced during the first 2 days after challenge, but increased significantly during the recovery phase, from 4 to 8 DPI. No deterioration in respiratory mechanics or acid-base balance was observed. Respiratory infection with 10(10) IFU P. acanthamoebae per calf induced mild respiratory dysfunction, mainly characterised by hypoxaemia. The study's findings do not indicate severe pathophysiological consequences of P. acanthamoebae infection on pulmonary function in the bovine host. PMID:27240907

  4. Changes of Number and Function of Late Endothelial Progenitor Cells in Peripheral Blood of COPD Patients Combined with Pulmonary Hypertension.

    PubMed

    Liu, Pei; Zhang, Hongmei; Liu, Jianxin; Sheng, Chunfeng; Zhang, Linlin; Zeng, Yanjun

    2016-06-01

    Objective The objective of this study was to investigate the changes of number and function of late endothelial progenitor cells (EPCs) in peripheral blood of chronic obstructive pulmonary disease (COPD) patients combined with pulmonary hypertension. Subjects and Methods The study enrolled 120 cases including 40 non-COPD and pulmonary arterial hypertension (PAH) patients (non-COPD group), 40 COPD non-PAH patients (COPD group), and 40 COPD patients combined with PAH (COPD + PAH group). Peripheral blood mononuclear cells were separated by density gradient centrifugation, cultured for 21 days, and then identified as late endothelial progenitor cells. The cell colonies were counted. MTT assay, modified Boyden chamber assay, and human fibronectin plates were used to measure the proliferation, migration, and adhesion functions of the late endothelial progenitor cells, respectively. Results Compared with non-COPD and COPD groups, the number of peripheral blood late EPCs in COPD + PAH group was significantly reduced, and the proliferation, adhesion, and migration capacities were significantly lowered; the differences were statistically significant (p < 0.05). The number and function of late EPCs decreased with the increase of pulmonary artery pressure (p < 0.05). Conclusion The number of late EPCs in COPD patients combined with pulmonary hypertension was reduced, which implies the impaired cell functions. The changes of number and function were negatively correlated with the severity of pulmonary hypertension.

  5. Differences in the effects of Asian dust on pulmonary function between adult patients with asthma and those with asthma–chronic obstructive pulmonary disease overlap syndrome

    PubMed Central

    Watanabe, Masanari; Noma, Hisashi; Kurai, Jun; Sano, Hiroyuki; Ueda, Yasuto; Mikami, Masaaki; Yamamoto, Hiroyuki; Tokuyasu, Hirokazu; Kato, Kazuhiro; Konishi, Tatsuya; Tatsukawa, Toshiyuki; Shimizu, Eiji; Kitano, Hiroya

    2016-01-01

    Background Asian dust (AD) exposure exacerbates pulmonary dysfunction in patients with asthma. Asthma–chronic obstructive pulmonary disease overlap syndrome (ACOS), characterized by coexisting symptoms of asthma and chronic obstructive pulmonary disease, is considered a separate disease entity. Previously, we investigated the effects of AD on pulmonary function in adult patients with asthma. Here, we present the findings of our further research on the differences in the effects of AD exposure on pulmonary function between patients with asthma alone and those with ACOS. Methods Between March and May 2012, we conducted a panel study wherein we monitored daily peak expiratory flow (PEF) values in 231 adult patients with asthma. These patients were divided into 190 patients with asthma alone and 41 patients with ACOS in this study. Daily AD particle levels were measured using light detection and ranging systems. Two heavy AD days (April 23 and 24) were determined according to the Japan Meteorological Agency definition. A linear mixed model was used to estimate the association between PEF and AD exposure. Results Increments in the interquartile range of AD particles (0.018 km−1) led to PEF changes of −0.50 L/min (95% confidence interval, −0.98 to −0.02) in patients with asthma alone and −0.11 L/min (−0.11 to 0.85) in patients with ACOS. The PEF changes after exposure to heavy AD were −2.21 L/min (−4.28 to −0.15) in patients with asthma alone and −2.76 L/min (−6.86 to 1.35) in patients with ACOS. In patients with asthma alone, the highest decrease in PEF values was observed on the heavy AD day, with a subsequent gradual increase over time. Conclusion Our results suggest that the effects of AD exposure on pulmonary function differ between patients with asthma alone and ACOS, with the former exhibiting a greater likelihood of decreased pulmonary function after AD exposure. PMID:26869784

  6. Pulmonary rehabilitation.

    PubMed

    Troosters, Thierry; Demeyer, Heleen; Hornikx, Miek; Camillo, Carlos Augusto; Janssens, Wim

    2014-03-01

    Pulmonary rehabilitation is a therapy that offers benefits to patients with chronic obstructive pulmonary disease that are complementary to those obtained by pharmacotherapy. The main objective of pulmonary rehabilitation is to restore muscle function and exercise tolerance, reverse other nonrespiratory consequences of the disease, and help patients to self-manage chronic obstructive pulmonary disease and its exacerbations and symptoms. To do so, a multidisciplinary program tailored to the patient in terms of program content, exercise prescription, and setting must be offered. Several settings and programs have shown to spin off in significant immediate results. The challenge lies in maintaining the benefits outside the program. PMID:24507849

  7. Environmentally persistent free radicals decrease cardiac function and increase pulmonary artery pressure

    PubMed Central

    Mahne, Sarah; Chuang, Gin C.; Pankey, Edward; Kiruri, Lucy; Kadowitz, Philip J.; Dellinger, Barry

    2012-01-01

    Epidemiological studies have consistently linked inhalation of particulate matter (PM) to increased cardiac morbidity and mortality, especially in at risk populations. However, few studies have examined the effect of PM on baseline cardiac function in otherwise healthy individuals. In addition, airborne PM contain environmentally persistent free radicals (EPFR) capable of redox cycling in biological systems. The purpose of this study was to determine whether nose-only inhalation of EPFRs (20 min/day for 7 days) could decrease baseline left ventricular function in healthy male Sprague-Dawley rats. The model EPFR tested was 1,2-dichlorobenzene chemisorbed to 0.2-μm-diameter silica/CuO particles at 230°C (DCB230). Inhalation of vehicle or silica particles served as controls. Twenty-four hours after the last exposure, rats were anesthetized (isoflurane) and ventilated (3 l/min), and left ventricular function was assessed using pressure-volume catheters. Compared with controls, inhalation of DCB230 significantly decreased baseline stroke volume, cardiac output, and stroke work. End-diastolic volume and end-diastolic pressure were also significantly reduced; however, ventricular contractility and relaxation were not changed. DCB230 also significantly increased pulmonary arterial pressure and produced hyperplasia in small pulmonary arteries. Plasma levels of C-reactive protein were significantly increased by exposure to DCB230, as were levels of heme oxygenase-1 and SOD2 in the left ventricle. Together, these data show that inhalation of EPFRs, but not silica particles, decreases baseline cardiac function in healthy rats by decreasing cardiac filling, secondary to increased pulmonary resistance. These EPFRs also produced systemic inflammation and increased oxidative stress markers in the left ventricle. PMID:22942180

  8. Effects of nitrogen dioxide exposure on pulmonary function and airway reactivity in normal humans.

    PubMed

    Frampton, M W; Morrow, P E; Cox, C; Gibb, F R; Speers, D M; Utell, M J

    1991-03-01

    Nitrogen dioxide (NO2) is a product of combustion that has become recognized as a significant component of indoor air in some homes. Despite extensive study, it remains unresolved whether exposures to low levels of NO2 affect airway function or reactivity. These studies were designed to assess effects of various levels and patterns of NO2 exposure on pulmonary function and airway reactivity in normal humans. Normal volunteers screened for the absence of airway hyperreactivity were exposed for 3 h in an environmental chamber to purified air or NO2, separated by at least 2 wk, according to three protocols: (1) continuous 0.60 ppm NO2, (2) baseline 0.05 ppm NO2 with intermittent peaks of 2.0 ppm, and (3) continuous 1.5 ppm NO2. Subjects exercised for 10 min of each 30 min at a level sufficient to result in a minute ventilation near 40 L/min. Pulmonary function was measured before, during, and after exposure. Airway reactivity to increasing doses of carbachol was assessed 30 min after exposure. NO2 did not directly alter pulmonary function in any of the exposure protocols. In addition, airway reactivity was not altered by continuous exposure to 0.60 ppm or intermittent peaks of 2.0 ppm NO2. In contrast, continuous exposure to 1.5 ppm NO2 resulted in a greater fall in FVC and FEV1 in response to carbachol than after exposure to air (percent decrease in FVC: 1.5% after air, 3.9% after NO2, p less than 0.01). We conclude that for subjects without airway hyperreactivity, exposure to 1.5 ppm NO2 for 3 h increases airway reactivity, whereas repeated 15-min exposures to 2.0 ppm NO2 do not alter airway reactivity. PMID:2001061

  9. Identification of functionally segregated sarcoplasmic reticulum calcium stores in pulmonary arterial smooth muscle.

    PubMed

    Clark, Jill H; Kinnear, Nicholas P; Kalujnaia, Svetlana; Cramb, Gordon; Fleischer, Sidney; Jeyakumar, Loice H; Wuytack, Frank; Evans, A Mark

    2010-04-30

    In pulmonary arterial smooth muscle, Ca(2+) release from the sarcoplasmic reticulum (SR) via ryanodine receptors (RyRs) may induce constriction and dilation in a manner that is not mutually exclusive. We show here that the targeting of different sarcoplasmic/endoplasmic reticulum Ca(2+)-ATPases (SERCA) and RyR subtypes to discrete SR regions explains this paradox. Western blots identified protein bands for SERCA2a and SERCA2b, whereas immunofluorescence labeling of isolated pulmonary arterial smooth muscle cells revealed striking differences in the spatial distribution of SERCA2a and SERCA2b and RyR1, RyR2, and RyR3, respectively. Almost all SERCA2a and RyR3 labeling was restricted to a region within 1.5 microm of the nucleus. In marked contrast, SERCA2b labeling was primarily found within 1.5 microm of the plasma membrane, where labeling for RyR1 was maximal. The majority of labeling for RyR2 lay in between these two regions of the cell. Application of the vasoconstrictor endothelin-1 induced global Ca(2+) waves in pulmonary arterial smooth muscle cells, which were markedly attenuated upon depletion of SR Ca(2+) stores by preincubation of cells with the SERCA inhibitor thapsigargin but remained unaffected after preincubation of cells with a second SERCA antagonist, cyclopiazonic acid. We conclude that functionally segregated SR Ca(2+) stores exist within pulmonary arterial smooth muscle cells. One sits proximal to the plasma membrane, receives Ca(2+) via SERCA2b, and likely releases Ca(2+) via RyR1 to mediate vasodilation. The other is located centrally, receives Ca(2+) via SERCA2a, and likely releases Ca(2+) via RyR3 and RyR2 to initiate vasoconstriction.

  10. Elimination of p19ARF-expressing cells enhances pulmonary function in mice

    PubMed Central

    Hashimoto, Michihiro; Asai, Azusa; Kawagishi, Hiroyuki; Mikawa, Ryuta; Iwashita, Yuji; Kanayama, Kazuki; Sugimoto, Kazushi; Sato, Tadashi; Maruyama, Mitsuo

    2016-01-01

    Senescent cells accumulate in many tissues as animals age and are considered to underlie several aging-associated pathologies. The tumor suppressors p19ARF and p16INK4a, both of which are encoded in the CDKN2A locus, play critical roles in inducing and maintaining permanent cell cycle arrest during cellular senescence. Although the elimination of p16INK4a-expressing cells extends the life span of the mouse, it is unclear whether tissue function is restored by the elimination of senescent cells in aged animals and whether and how p19ARF contributes to tissue aging. The aging-associated decline in lung function is characterized by an increase in compliance as well as pathogenic susceptibility to pulmonary diseases. We herein demonstrated that pulmonary function in 12-month-old mice was reversibly restored by the elimination of p19ARF-expressing cells. The ablation of p19ARF-expressing cells using a toxin receptor-mediated cell knockout system ameliorated aging-associated lung hypofunction. Furthermore, the aging-associated gene expression profile was reversed after the elimination of p19ARF. Our results indicate that the aging-associated decline in lung function was, at least partly, attributed to p19ARF and was recovered by eliminating p19ARF-expressing cells. PMID:27699227

  11. Elimination of p19ARF-expressing cells enhances pulmonary function in mice

    PubMed Central

    Hashimoto, Michihiro; Asai, Azusa; Kawagishi, Hiroyuki; Mikawa, Ryuta; Iwashita, Yuji; Kanayama, Kazuki; Sugimoto, Kazushi; Sato, Tadashi; Maruyama, Mitsuo

    2016-01-01

    Senescent cells accumulate in many tissues as animals age and are considered to underlie several aging-associated pathologies. The tumor suppressors p19ARF and p16INK4a, both of which are encoded in the CDKN2A locus, play critical roles in inducing and maintaining permanent cell cycle arrest during cellular senescence. Although the elimination of p16INK4a-expressing cells extends the life span of the mouse, it is unclear whether tissue function is restored by the elimination of senescent cells in aged animals and whether and how p19ARF contributes to tissue aging. The aging-associated decline in lung function is characterized by an increase in compliance as well as pathogenic susceptibility to pulmonary diseases. We herein demonstrated that pulmonary function in 12-month-old mice was reversibly restored by the elimination of p19ARF-expressing cells. The ablation of p19ARF-expressing cells using a toxin receptor-mediated cell knockout system ameliorated aging-associated lung hypofunction. Furthermore, the aging-associated gene expression profile was reversed after the elimination of p19ARF. Our results indicate that the aging-associated decline in lung function was, at least partly, attributed to p19ARF and was recovered by eliminating p19ARF-expressing cells.

  12. Quantification of heterogeneity in lung disease with image-based pulmonary function testing.

    PubMed

    Stahr, Charlene S; Samarage, Chaminda R; Donnelley, Martin; Farrow, Nigel; Morgan, Kaye S; Zosky, Graeme; Boucher, Richard C; Siu, Karen K W; Mall, Marcus A; Parsons, David W; Dubsky, Stephen; Fouras, Andreas

    2016-01-01

    Computed tomography (CT) and spirometry are the mainstays of clinical pulmonary assessment. Spirometry is effort dependent and only provides a single global measure that is insensitive for regional disease, and as such, poor for capturing the early onset of lung disease, especially patchy disease such as cystic fibrosis lung disease. CT sensitively measures change in structure associated with advanced lung disease. However, obstructions in the peripheral airways and early onset of lung stiffening are often difficult to detect. Furthermore, CT imaging poses a radiation risk, particularly for young children, and dose reduction tends to result in reduced resolution. Here, we apply a series of lung tissue motion analyses, to achieve regional pulmonary function assessment in β-ENaC-overexpressing mice, a well-established model of lung disease. The expiratory time constants of regional airflows in the segmented airway tree were quantified as a measure of regional lung function. Our results showed marked heterogeneous lung function in β-ENaC-Tg mice compared to wild-type littermate controls; identified locations of airway obstruction, and quantified regions of bimodal airway resistance demonstrating lung compensation. These results demonstrate the applicability of regional lung function derived from lung motion as an effective alternative respiratory diagnostic tool. PMID:27461961

  13. Quantification of heterogeneity in lung disease with image-based pulmonary function testing

    PubMed Central

    Stahr, Charlene S.; Samarage, Chaminda R.; Donnelley, Martin; Farrow, Nigel; Morgan, Kaye S.; Zosky, Graeme; Boucher, Richard C.; Siu, Karen K. W.; Mall, Marcus A.; Parsons, David W.; Dubsky, Stephen; Fouras, Andreas

    2016-01-01

    Computed tomography (CT) and spirometry are the mainstays of clinical pulmonary assessment. Spirometry is effort dependent and only provides a single global measure that is insensitive for regional disease, and as such, poor for capturing the early onset of lung disease, especially patchy disease such as cystic fibrosis lung disease. CT sensitively measures change in structure associated with advanced lung disease. However, obstructions in the peripheral airways and early onset of lung stiffening are often difficult to detect. Furthermore, CT imaging poses a radiation risk, particularly for young children, and dose reduction tends to result in reduced resolution. Here, we apply a series of lung tissue motion analyses, to achieve regional pulmonary function assessment in β-ENaC-overexpressing mice, a well-established model of lung disease. The expiratory time constants of regional airflows in the segmented airway tree were quantified as a measure of regional lung function. Our results showed marked heterogeneous lung function in β-ENaC-Tg mice compared to wild-type littermate controls; identified locations of airway obstruction, and quantified regions of bimodal airway resistance demonstrating lung compensation. These results demonstrate the applicability of regional lung function derived from lung motion as an effective alternative respiratory diagnostic tool. PMID:27461961

  14. Respiratory function responses of animals and man to oxidant gases and to pulmonary emphysema

    SciTech Connect

    Mauderly, J.L.

    1984-01-01

    Data on the respiratory functional responses of animals and humans to inhaled oxidant gases and to pulmonary emphysema were reviewed and compared. Comparisons included responses to short-term inhalation of ozone, nitrogen dioxide, and oxygen and the functional manifestations of chronic emphysema. The comparisons illustrated that animals and humans have qualitatively similar functional responses to the irritant, bronchoconstrictive, and sensitizing effects of acutely inhaled ozone and nitrogen dioxide. Animals and humans responded similarly to the inflammatory and edematous effects of inhaled oxygen. Similar changes in maximal expiratory flow-volume curves, pressure-volume curves, lung volumes, and alveolar-capillary gas exchange occurred in animals and humans with emphysema. These results suggest that similar respiratory functional changes occur in both animals and humans when similar morphological changes result from lung injury. This observation lends confidence to the use of laboratory animals in studies to predict the effects of long-term exposure of humans to inhaled oxidant gases. 42 references.

  15. Pulmonary Function in Patients with End-Stage Renal Disease: Effects of Hemodialysis and Fluid Overload.

    PubMed

    Yılmaz, Süreyya; Yildirim, Yasar; Yilmaz, Zülfükar; Kara, Ali Veysel; Taylan, Mahsuk; Demir, Melike; Coskunsel, Mehmet; Kadiroglu, Ali Kemal; Yilmaz, Mehmet Emin

    2016-01-01

    BACKGROUND Respiratory system disorders are one of the most prevalent complications in end-stage renal disease patients on hemodialysis. However, the pathogenesis of impaired pulmonary functions has not been completely elucidated in these patients. We designed a study to investigate acute effects of hemodialysis treatment on spirometry parameters, focusing on the relationship between pulmonary function and fluid status in hemodialysis patients. MATERIAL AND METHODS We enrolled 54 hemodialysis patients in this study. Multifrequency bioimpedance analysis (BIA) was used to assess fluid status before and 30 min after the midweek of hemodialysis (HD). Overhydration (OH)/extracellular water (ECW)% ratio was used as an indicator of fluid status. Fluid overload was defined as OH/ECW ≥7%. Spirometry was performed before and after hemodialysis. RESULTS Forced vital capacity (FVC), FVC%, and forced expiratory volume in the first second (FEV1) levels were significantly increased after hemodialysis. FVC, FVC%, FEV1, FEV1%, mean forced expiratory flow between 25% and 75% of the FVC (FEF25-75), FEF25-75%, peak expiratory flow rate (PEFR), and PEFR% were significantly lower in patients with fluid overload than in those without. OH/ECW ratio was negatively correlated with FVC, FVC%, FEV1, FEV1%, FEF25-75, FEF25-75%, PEFR, and PEFR%. Stepwise multiple regression analysis revealed that male sex and increased ultrafiltration volume were independently associated with higher FVC, whereas increased age and OH/ECW ratio were independently associated with lower FVC. CONCLUSIONS Fluid overload is closely associated with restrictive and obstructive respiratory abnormalities in HD patients. In addition, hemodialysis has a beneficial effect on pulmonary function tests, which may be due to reduction of volume overload. PMID:27497672

  16. Agricultural work exposures and pulmonary function among hired farm workers in California (the MICASA study).

    PubMed

    Rodriquez, Erik J; Stoecklin-Marois, Maria T; Bennett, Deborah H; Tancredi, Daniel J; Schenker, Marc B

    2014-01-01

    Despite California's dependence on hired farm labor, scarce research has been conducted on the respiratory health of hired farm workers. Agricultural exposures to inorganic and organic dusts can adversely affect an individual's respiratory health and differ by farm type and job task. The purpose of the present analysis was to examine associations between agricultural work exposures and pulmonary function among 450 California farm workers. Data were collected as part of the Mexican Immigration to California: Agricultural Safety and Acculturation (MICASA) study, a prospective cohort study examining occupational risk factors and health of hired farm worker families in Mendota, California. Time-weighted self-reported average (TWSRA) dust scores were calculated from assessments of past-12-month agricultural work history. Other dust exposure indicator variables included months worked in agriculture in the past 12 months and years worked in agriculture. Multiple linear regression modeled FEV1 (forced expiratory volume in 1 second), FEF(25-75%) (forced midexpiratory flow rate), FVC (forced vital capacity), FEV6, FEV1/FVC, and FEV1/FEV6 separately. Seventy-six percent of participants had worked in agriculture in the past year. In models conducted for crops and tasks separately, high TWSRA dust score was associated with better FEV6. Crop and task models showed associations between greater months worked in agriculture in the past year and better FEV1, FEF(25-75%), and FEV6. Both models also found greater years worked in agriculture to be associated with worse FEV1/FEV6. Results were generally in the opposite direction as expected given past research but not uncommon. Future research should investigate relationships between pulmonary function and agricultural dust exposure over a lifetime and changes in pulmonary function over time.

  17. Sequential measurement of peripheral blood allogeneic microchimerism levels and association with pulmonary function.

    PubMed

    McSherry, C; Jackson, A; Hertz, M I; Bolman, R M; Savik, K; Reinsmoen, N L

    1996-12-27

    We have shown in lung recipients that high levels of peripheral blood allogeneic microchimerism at 12 to 18 months posttransplant correlated with donor antigen-specific hyporeactivity (i.e., decreased proliferative response to donor antigen in MLC while response to 3rd-party cells remains unchanged); both parameters correlated with an obliterative bronchiolitis (OB)-free state. We have expanded these studies to determine any association of sequential microchimerism levels with concomitant clinical events. In this preliminary study of 7 lung recipients, we used limiting-dilution PCR to quantify peripheral blood microchimerism at serial timepoints ranging from 3 to >48 months posttransplant. These levels were compared with a variety of immunologic and clinical parameters: acute rejection, CMV infection, OB, donor antigen-specific hyporeactivity, and pulmonary function. Pulmonary function was measured per the International Society of Heart and Lung Transplantation: "current FEV1/ baseline FEV1" (FEV1: forced expiratory volume in 1 second). Of the clinical parameters, the association between microchimerism and pulmonary function was the most striking. We observed dynamic patterns of peripheral microchimerism, which reflected the general rise and fall of FEV1. In all 7 recipients, chimerism and FEV1 were high very early posttransplant, then dropped at various rates and to various degrees. After its initial decline, microchimerism increased with FEV1 for the 1 hyporesponsive recipient; for the other 6 recipients, both values declined. These results illustrate, for the first time, that the fluctuation of peripheral blood microchimerism levels is associated with the recipient's clinical condition. PMID:8990369

  18. Pulmonary Function in Patients with End-Stage Renal Disease: Effects of Hemodialysis and Fluid Overload

    PubMed Central

    Yilmaz, Süreyya; Yildirim, Yasar; Yilmaz, Zülfükar; Kara, Ali Veysel; Taylan, Mahsuk; Demir, Melike; Coskunsel, Mehmet; Kadiroglu, Ali Kemal; Yilmaz, Mehmet Emin

    2016-01-01

    Background Respiratory system disorders are one of the most prevalent complications in end-stage renal disease patients on hemodialysis. However, the pathogenesis of impaired pulmonary functions has not been completely elucidated in these patients. We designed a study to investigate acute effects of hemodialysis treatment on spirometry parameters, focusing on the relationship between pulmonary function and fluid status in hemodialysis patients. Material/Methods We enrolled 54 hemodialysis patients in this study. Multifrequency bioimpedance analysis (BIA) was used to assess fluid status before and 30 min after the midweek of hemodialysis (HD). Overhydration (OH)/extracellular water (ECW)% ratio was used as an indicator of fluid status. Fluid overload was defined as OH/ECW ≥7%. Spirometry was performed before and after hemodialysis. Results Forced vital capacity (FVC), FVC%, and forced expiratory volume in the first second (FEV1) levels were significantly increased after hemodialysis. FVC, FVC%, FEV1, FEV1%, mean forced expiratory flow between 25% and 75% of the FVC (FEF25–75), FEF25–75%, peak expiratory flow rate (PEFR), and PEFR% were significantly lower in patients with fluid overload than in those without. OH/ECW ratio was negatively correlated with FVC, FVC%, FEV1, FEV1%, FEF25–75, FEF25–75%, PEFR, and PEFR%. Stepwise multiple regression analysis revealed that male sex and increased ultrafiltration volume were independently associated with higher FVC, whereas increased age and OH/ECW ratio were independently associated with lower FVC. Conclusions Fluid overload is closely associated with restrictive and obstructive respiratory abnormalities in HD patients. In addition, hemodialysis has a beneficial effect on pulmonary function tests, which may be due to reduction of volume overload. PMID:27497672

  19. Effect of triiodothyronine on cyclic AMP and pulmonary function tests in bronchial asthma.

    PubMed

    abdel Khalek, K; el Kholy, M; Rafik, M; Fathalla, M; Heikal, E

    1991-01-01

    This study was undertaken to evaluate the effect of triiodothyronine, determined by pulmonary function tests and c-AMP plasma and sputum levels, in asthmatic children. Twenty-three children clinically euthyroid and complaining of chronic bronchial asthma were given a triiodothyronine (T3) supply for a period of 30 days. Pulmonary function tests, plasma and sputum cyclic AMP and plasma T3 levels were performed prior to and after T3 therapy. Patients were requested to continue on their usual antiasthma medicines and to try reduction of the doses of the drugs they needed as possible. All patients tolerated well the T3 regimen without any adverse effect. They all reported at the end of the 30 days an obvious subjective improvement of their asthmatic conditions with a decrease in the number of exacerbations. Seven patients stopped their usual antiasthmatic medicines, being maintained on T3 only and 3 have decreased the amount of bronchodilators needed. A significant improvement of pulmonary function tests was noted in all patients. Also, significantly increased levels of plasma and sputum c-AMP were observed after T3 administration in comparison to the control and pretest values. No statistical differences were found in plasma T3 between the control and the patients either before or after T3 therapy. The study revealed that T3 administration to clinically euthyroid chronic asthmatic children induced a beneficial effect. This might be through improvement of c-AMP synthesis. T3 in the doses used is devoid of side effects, proves to be a useful adjuvant to classic antiasthma therapy, and may reduce the amount of bronchodilators needed.

  20. Energetic cost of breathing, body composition, and pulmonary function in horses with recurrent airway obstruction.

    PubMed

    Mazan, Melissa R; Deveney, Edward F; DeWitt, Shane; Bedenice, Daniela; Hoffman, Andrew

    2004-07-01

    This study was conducted to determine whether horses with naturally occurring, severe chronic recurrent airway obstruction (RAO) 1). have a greater resting energy expenditure (REE) than control horses, 2). suffer body mass depletion, and 3). have significantly decreased REE after bronchodilation and, therefore, also 4). whether increased work of breathing contributes to the cachexia seen in some horses with RAO. Six RAO horses and six control horses underwent indirect calorimetric measures of REE and pulmonary function testing using the esophageal balloon-pneumotachograph method before and after treatment with ipratropium bromide, a parasympatholytic bronchodilator agent, at 4-h intervals for a 24-h period. Body condition scoring was performed, and an estimate of fat mass was determined via B-mode ultrasonography. O(2) and CO(2) fractions, respiratory airflow, respiratory rate, and pleural pressure changes were recorded, and O(2) consumption, CO(2) production, REE, pulmonary resistance, dynamic elastance, and tidal volume were calculated. In addition, we performed lung function testing and calorimetry both before and after sedation in two control horses. RAO horses had significantly lower body condition scores (2.8 +/- 1.0 vs. 6.4 +/- 1.2) and significantly greater O(2) consumption than controls (4.93 +/- 1.30 vs. 2.93 +/- 0.70 ml.kg(-1).min(-1)). After bronchodilation, there was no significant difference in O(2) consumption between RAO horses and controls, although there remained evidence of residual airway obstruction. There was a strong correlation between O(2) consumption and indexes of airway obstruction. Xylazine sedation was not associated with changes in pulmonary function but did result in markedly decreased REE in controls.

  1. Relationship between clinical signs and pulmonary function estimated by the single breath diagram for CO(2) (SBD-CO(2)) in horses with chronic obstructive pulmonary disease.

    PubMed

    Herholz, C; Straub, R; Gerber, V; Wampfler, B; Lüthi, S; Imhof, A; Moens, Y; Busato, A

    2002-03-01

    The pulmonary health of 66 horses was assessed by a clinical examination and simple supplementary diagnostic methods. Single breath diagrams for CO(2) (SBD-CO(2)) and derived lung function indices were used to determine pulmonary function. The clinical signs in different groups were related to the results of the lung function indices derived from the SBD-CO(2). In horses with moderate to severe chronic obstructive pulmonary disease (COPD), a significant relationship was found between the respiratory frequency and the ratio of Bohr's dead space to the tidal volume (VD(Bohr)/VT), and between the physiological dead space/tidal volume ratio (VD(phys)/VT) and the ratio of the alveolar dead space to the alveolar tidal volume (VD(alv)/VT(alv)), but no significant associations were found between the arterial oxygen tension (P(a)O(2)) and lung function indices derived from the SBD-CO(2). The occurrence of cough, the viscosity of tracheobronchial mucus and the amount of polynuclear neutrophils in tracheobronchial aspirates were significantly related to the expiratory tidal volume (VT), the total expired volume of CO(2) (VCO(2)), VD(Bohr)/VT, VD(phys)/VT and VD(alv)/VT(alv). We conclude that abnormal findings in these clinical parameters indicate a measurable ventilation and perfusion (V(A)/Q) mismatch which is reflected by increases in dead space, VD(Bohr)/VT and VD(phys)/VT as well as VD(alv)/VT(alv).

  2. Effects of acidic mixtures on pulmonary macrophage functions: A pilot study. Final report

    SciTech Connect

    Phalen, R.F.; Kikkawa, Y.; Nadziejko, C.; Kleinman, M.T.

    1992-02-01

    Fischer 344 rats were examined for effects of inhaled nitric acid and ozone on macrophage cell function, to evaluate new endpoints for future acid inhalation studies. Pulmonary macrophage respiratory burst activity, production of arachidonic acid metabolites (leukotriene B4 and leukotriene C4) by macrophages, and lavage fluid elastase inhibitory capacity were found to be affected by in vivo exposure to nitric acid vapor, alone or in combination with ozone. These results have implications with respect to the development of lung infections, asthma, and emphysema.

  3. A comparison of pulmonary function tests for postthoracotomy pain using cryoanalgesia and transcutaneous nerve stimulation.

    PubMed

    Rooney, S M; Jain, S; McCormack, P; Bains, M S; Martini, N; Goldiner, P L

    1986-02-01

    The beneficial effects of transcutaneous nerve stimulation (TNS) and cryoanalgesia for post-thoracotomy pain were compared against each other and against a control group through pulmonary function testing in the immediate and delayed postoperative period. Patients receiving cryoanalgesia did not perform well in the first 24 hours after operation. However, by the fifth postoperative day, they did as well as or even better than the TNS patients. Both cryoanalgesia and TNS were significantly effective in the management of postoperative pain as compared with controls. PMID:3484939

  4. Effects of ozone and other pollutants on the pulmonary function of adult hikers.

    PubMed Central

    Korrick, S A; Neas, L M; Dockery, D W; Gold, D R; Allen, G A; Hill, L B; Kimball, K D; Rosner, B A; Speizer, F E

    1998-01-01

    This study evaluated the acute effects of ambient ozone (O3), fine particulate matter (PM2.5), and strong aerosol acidity on the pulmonary function of exercising adults. During the summers of 1991 and 1992, volunteers (18-64 years of age) were solicited from hikers on Mt. Washington, New Hampshire. Volunteer nonsmokers with complete covariates (n = 530) had pulmonary function measured before and after their hikes. We calculated each hiker's posthike percentage change in forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), the ratio of these two (FEV1/FVC), forced expiratory flow between 25 and 75% of FVC(FEF25-75%), and peak expiratory flow rate (PEFR). Average O3 exposures ranged from 21 to 74 ppb. After adjustment for age,sex, smoking status (former versus never), history of asthma or wheeze, hours hiked, ambient temperature, and other covariates, there was a 2.6% decline in FEV1 [95% confidence interval (CI), 0.4-4.7; p = 0.02] and a 2.2% decline in FVC (CI, 0.8-3.5; p =0.003) for each 50 ppb increment in mean O3. There were consistent associations of decrements in both FVC (0.4% decline; CI,0.2-0.6, p = 0.001) and PEFR (0.8% decline; CI, 0.01-1.6; p = 0.05) with PM2.5 and of decrements in PEFR (0.4% decline; CI, 0.1-0.7; p = 0.02) with strong aerosol acidity across the interquartile range of these exposures. Hikers with asthma or a history of wheeze (n = 40) had fourfold greater responsiveness to ozone than others. With prolonged outdoor exercise, low-level exposures to O3, PM2.5, and strong aerosol acidity were associated with significant effects on pulmonary function among adults. Hikers with a history of asthma or wheeze had significantly greater air pollution-related changes in pulmonary function. Images Figure 1 Figure 2 PMID:9435151

  5. Measuring the profitability of a hospital pulmonary function laboratory: a case study.

    PubMed

    Kocakülâh, Mehmet C; Morris, Jan Taylor; Kessler, Brian

    2011-01-01

    The primary purpose of this article is to evaluate a proposal for a regional hospital to create a second Pulmonary Function Test laboratory (PFT lab) for outpatients. We separated the PFT lab from its departmental budget, thereby allowing a unique determination of the lab's profitability. The lab's separate financial analysis helped us to gain an understanding of the revenues and expenses of the PFT lab, providing information needed to comment on the proposed second lab. Additionally, we recommend a means for maintaining separate control over the PFT lab's revenues and costs and ascertain the efficacy of instituting a separate budget for the PFT lab. PMID:21812353

  6. Pre-operative inspiratory muscle training preserves postoperative inspiratory muscle strength following major abdominal surgery – a randomised pilot study

    PubMed Central

    Kulkarni, SR; Fletcher, E; McConnell, AK; Poskitt, KR; Whyman, MR

    2010-01-01

    INTRODUCTION The aim of this pilot study was to assess the effect of pre-operative inspiratory muscle training (IMT) on respiratory variables in patients undergoing major abdominal surgery. PATIENTS AND METHODS Respiratory muscle strength (maximum inspiratory [MIP] and expiratory [MEP] mouth pressure) and pulmonary functions were measured at least 2 weeks before surgery in 80 patients awaiting major abdominal surgery. Patients were then allocated randomly to one of four groups (Group A, control; Group B, deep breathing exercises; Group C, incentive spirometry; Group D, specific IMT). Patients in groups B, C and D were asked to train twice daily, each session lasting 15 min, for at least 2 weeks up to the day before surgery. Outcome measurements were made immediately pre-operatively and postop-eratively. RESULTS In groups A, B and C, MIP did not increase from baseline to pre-operative assessments. In group D, MIP increased from 51.5 cmH2O (median) pre-training to 68.5 cmH2O (median) post-training pre-operatively (P < 0.01). Postoperatively, groups A, B and C showed a fall in MIP from baseline (P < 0.01, P < 0.01) and P = 0.06, respectively). No such significant reduction in postoperative MIP was seen in group D (P = 0.36). CONCLUSIONS Pre-operative specific IMT improves MIP pre-operatively and preserves it postoperatively. Further studies are required to establish if this is associated with reduced pulmonary complications. PMID:20663275

  7. Preoperative Ambulatory Inspiratory Muscle Training in Patients Undergoing Esophagectomy. A Pilot Study

    PubMed Central

    Agrelli, Taciana Freitas; de Carvalho Ramos, Marisa; Guglielminetti, Rachel; Silva, Alex Augusto; Crema, Eduardo

    2012-01-01

    A major decline in pulmonary function is observed on the first day after upper abdominal surgery. This decline can reduce vital and inspiratory capacity and can culminate in restrictive lung diseases that cause atelectasis, reduced diaphragm movement, and respiratory insufficiency. The objective of this study was to evaluate the efficacy of preoperative ambulatory respiratory muscle training in patients undergoing esophagectomy. The sample consisted of 20 adult patients (14 men [70%] and 6 women [30%]) with a diagnosis of advanced chagasic megaesophagus. A significant increase in maximum inspiratory pressure was observed after inspiratory muscle training when compared with baseline values (from −55.059 ± 18.359 to −76.286 ± 16.786). Preoperative ambulatory inspiratory muscle training was effective in increasing respiratory muscle strength in patients undergoing esophagectomy and contributed to the prevention of postoperative complications. PMID:23113846

  8. Long-chain Acylcarnitines Reduce Lung Function by Inhibiting Pulmonary Surfactant.

    PubMed

    Otsubo, Chikara; Bharathi, Sivakama; Uppala, Radha; Ilkayeva, Olga R; Wang, Dongning; McHugh, Kevin; Zou, Ye; Wang, Jieru; Alcorn, John F; Zuo, Yi Y; Hirschey, Matthew D; Goetzman, Eric S

    2015-09-25

    The role of mitochondrial energy metabolism in maintaining lung function is not understood. We previously observed reduced lung function in mice lacking the fatty acid oxidation enzyme long-chain acyl-CoA dehydrogenase (LCAD). Here, we demonstrate that long-chain acylcarnitines, a class of lipids secreted by mitochondria when metabolism is inhibited, accumulate at the air-fluid interface in LCAD(-/-) lungs. Acylcarnitine accumulation is exacerbated by stress such as influenza infection or by dietary supplementation with l-carnitine. Long-chain acylcarnitines co-localize with pulmonary surfactant, a unique film of phospholipids and proteins that reduces surface tension and prevents alveolar collapse during breathing. In vitro, the long-chain species palmitoylcarnitine directly inhibits the surface adsorption of pulmonary surfactant as well as its ability to reduce surface tension. Treatment of LCAD(-/-) mice with mildronate, a drug that inhibits carnitine synthesis, eliminates acylcarnitines and improves lung function. Finally, acylcarnitines are detectable in normal human lavage fluid. Thus, long-chain acylcarnitines may represent a risk factor for lung injury in humans with dysfunctional fatty acid oxidation.

  9. Effects of ozone on pulmonary function: the relationship of response to dose

    SciTech Connect

    Kleinman, M.T. )

    1991-07-01

    A dose-response relationship for the effects of ozone on pulmonary function in humans has been derived using the concept of internal thoracic dose. This quantity, which represents the dose of inhaled pollutant capable of reaching and affecting target sites in the lower respiratory tract, was estimated using a mathematical model derived in part from theory and in part from data obtained using human and animal subjects. The model was applied to ozone exposures of individuals ranging in age from infants to adults over age 65 and for exercise conditions ranging from rest to heavy exercise (greater than 6 times resting minute ventilation). The dose model was successfully used to compare results from clinical studies in which subjects were exposed under disparate conditions of exercise, exposure concentration and exposure duration. The model can also be applied to estimate doses to populations exposed to ambient pollution. The effects of ozone on pulmonary function in adults and children were evaluated using the model. On the basis of dose of ozone (micrograms O3 per kg body mass), children, aged 8 to 15 years, and adults were equally sensitive. When dose is analyzed as a function of age, the data suggest that children, under the age of 6 years, receive greater doses to respiratory tract tissues than do older children or adults, under equivalent conditions of exposure.

  10. Growth, Nutritional Status, and Pulmonary Function in Children with Chronic Recurrent Bronchitis.

    PubMed

    Umławska, Wioleta; Lipowicz, Anna

    2016-01-01

    Bronchitis is a common health problem in children. Frequent bronchitis in infancy increases the risk of developing chronic respiratory diseases. The aim of the study was to assess the level of growth and the nutritional status in children and youths with special regard to the level of body fatness assessed by measuring skin-fold thickness. Relationships between somatic development, pulmonary function and the course of the disease were also explored. The study was carried out using anthropometric and spirometric measurements and also information on the severity and course of the disease in 141 children with chronic or recurrent bronchitis. All of the subjects were patients of the Pulmonary Medicine and Allergology Center in Karpacz, Poland. The mean body height did not differ significantly between the children examined and their healthy peers. However, the infection-prone children had excessive body fatness and muscle mass deficiency. The increased level of subcutaneous adipose tissue occurred especially in children with short duration of the disease, i.e. a maximum of 1 year. The functional lung parameters were generally normal. The presence of atopic diseases such as allergic rhinitis or atopic dermatitis did not impair the course of the children's somatic development. Also, long-term disease or the presence of additional allergic diseases did not impair lung function in the examined children. Taking appropriate preventive measures is recommended to achieve and maintain normal body weight in children who receive therapy due to bronchitis.

  11. Preoperative functional magnetic resonance imaging (fMRI) of the motor system in patients with tumours in the parietal lobe.

    PubMed

    Nitschke, M F; Melchert, U H; Hahn, C; Otto, V; Arnold, H; Herrmann, H D; Nowak, G; Westphal, M; Wessel, K

    1998-01-01

    Intracranial lesions may compromise structures critical for motor performance, and mapping of the cortex, especially of the motor hand area, is important to reduce postoperative morbidity. We investigated nine patients with parietal lobe tumours and used functional MRI sensitized to changes in blood oxygenation to define the different motor areas, especially the primary sensorimotor cortex, in relation to the localization of the tumour. Activation was determined by pixel-by-pixel correlation of the signal intensity time course with a reference waveform equivalent to the stimulus protocol. All subjects showed significant activation of the primary sensorimotor cortex while performing a finger opposition task with the affected and unaffected side. In five patients the finger opposition task additionally activated the ipsilateral sensorimotor cortex and the supplementary motor area (SMA). Extension and flexion of the foot, additionally performed in two patients, also activated the sensorimotor cortex, in one case within the perifocal oedema of the tumour. Tumour localization near the central sulcus induced displacement of the sensorimotor cortex as compared to the unaffected side in all patients with a relevant mass effect. The results of our study demonstrate that functional MRI at 1.5 T with a clinically used tomograph can reproducibly localize critical brain regions in patients with intracranial lesions.

  12. Reactive oxygen species scavengers improve voltage-gated K+ channel function in pulmonary arteries of newborn pigs with progressive hypoxia-induced pulmonary hypertension

    PubMed Central

    Aschner, Judy L.

    2013-01-01

    Abstract Changes in voltage-gated K+ (Kv) channel function contribute to the pathogenesis of pulmonary hypertension. Yet the mechanisms underlying Kv channel impairments in the pulmonary circulation remain unclear. We tested the hypothesis that reactive oxygen species (ROSs) contribute to the Kv channel dysfunction that develops in resistance-level pulmonary arteries (PRAs) of piglets exposed to chronic in vivo hypoxia. Piglets were raised in either room air (control) or hypoxia for 3 or 10 days. To evaluate Kv channel function, responses to the Kv channel antagonist 4-aminopyridine (4-AP) were measured in cannulated PRAs. To assess the influence of ROSs, PRAs were treated with the ROS-removing agent M40403 (which dismutates superoxide to hydrogen peroxide), plus polyethylene glycol catalase (which converts hydrogen peroxide to water). Responses to 4-AP were diminished in PRAs from both groups of hypoxic piglets. ROS-removing agents had no impact on 4-AP responses in PRAs from piglets exposed to 3 days of hypoxia but significantly increased the response to 4-AP in PRAs from piglets exposed to 10 days of hypoxia. Kv channel function is impaired in PRAs of piglets exposed to 3 or 10 days of in vivo hypoxia. ROSs contribute to Kv channel dysfunction in PRAs from piglets exposed to hypoxia for 10 days but are not involved with the Kv channel dysfunction that develops within 3 days of exposure to hypoxia. Therapies to remove ROSs might improve Kv channel function and thereby ameliorate the progression, but not the onset, of pulmonary hypertension in chronically hypoxic newborn piglets. PMID:24618540

  13. Smoking Status and a Pulmonary Function Test in Patients with Rotator Cuff Tears.

    PubMed

    Yoshii, Chiharu; Uchida, Soushi; Noguchi, Shingo; Torii, Ryo; Shimabukuro, Ikuko; Yatera, Kazuhiro

    2016-09-01

    Although chronic obstructive pulmonary disease (COPD) affects one in several smokers, only a few patients are correctly diagnosed compared to the estimated number of patients. Several recent reports indicate that the development of rotator cuff tears is related to smoking. In this study, we investigated smoking status in patients with rotator cuff tears and evaluated the possibility of undiagnosed COPD by a pulmonary function test. The subjects were 150 consecutive patients over 40 years old, who had been diagnosed with rotator cuff tears and had been examined by a pulmonary function test before surgery in our orthopedic department between April 2011 and June 2015. They consisted of 96 men and 54 women, which included 59 non-smokers (39.3%), 62 ex-smokers (41.3%), and 29 smokers (19.3%). The smoking rate of the subjects was the same as that of the general Japanese population. However, the ever-smokers who smoked more than 21 cigarettes per day were 31.9%, which was high compared to the Japanese ever-smokers population, i.e. 15.2% of men and 5.5% of women. Twenty-five subjects (16.7%) showed airflow limitation, and they consisted of 7 cases of COPD, 3 cases of bronchial asthma, one case of bronchiectasis, and 14 undiagnosed cases. The undiagnosed cases consisted of 7 non-smokers, 5 ex-smokers, and 2 smokers. Their stages of COPD were stage 1 in 11 cases and stage 2 in 3 cases. The prevalence of airflow limitation increased with increasing age: 0% for 40's, 8.3% for 50's, 20.7% for 60's, and 25.6% for over 70's. From these results, we recognized that paying attention to the numbers of cigarettes smoked per day are important in addition to the smoking history, for the patients with rotator cuff tears. Also, sharing the data of a pulmonary function test before surgery can contribute to the early diagnosis of COPD. PMID:27627973

  14. Reduction in pulmonary function and increased frequency of cough associated with passive smoking in teenage athletes.

    PubMed

    Tsimoyianis, G V; Jacobson, M S; Feldman, J G; Antonio-Santiago, M T; Clutario, B C; Nussbaum, M; Shenker, I R

    1987-07-01

    Previous studies have suggested that passive smoking (involuntary inhalation of tobacco smoke by nonsmokers) reduces small airways function. We evaluated the exposure to passive smoking and its effects on pulmonary function and symptoms in a group of 12- to 17-year-old high school athletes (N = 209; 119 boys and 90 girls) at their annual presport participation physical examinations. A structured interview was used to assess pulmonary symptoms, personal smoking habits, and passive cigarette smoke exposure. All athletes performed forced expiratory maneuvers on a portable spirometer. We measured forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow 25% to 75% (FEF25-75). The best of three FEF25-75 measured was used. Less than 70% of predicted FEF25-75 was considered abnormal. Of the 209 athletes, 7.7% were active smokers and were excluded. Of the remaining 193 athletes, 68.4% were currently exposed to passive smoking. We found a fourfold increase in incidence of low FEF25-75 and/or cough in athletes exposed to passive smoking compared with athletes not exposed: 18 of 132 exposed athletes (13.6%) had low FEF25-75 and/or cough compared with two of 61 unexposed athletes (3.3%) who had low FEF25-75 and cough (P = .02). Boys were more frequently exposed to passive smoking than girls (74% of boys [80/108] v 61% of girls [52/85] ), but the effects were more pronounced in girls. These data show a relationship between exposure to passive smoking and early pulmonary dysfunction in young athletes. The frequent exposure to passive smoke and the high prevalence of dysfunction in this population, generally considered to be healthy, is of particular concern.

  15. A meta-analysis of pulmonary function with pulsatile perfusion in cardiac surgery.

    PubMed

    Lim, Choon-Hak; Nam, Myung-Ji; Lee, Ji-Sung; Kim, Hyun-Jung; Kim, Ji-Yeon; Shin, Hye-Won; Lee, Hye-Won; Sun, Kyung

    2015-02-01

    The aim of this study was to determine whether pulsatile or nonpulsatile perfusion had a greater effect on pulmonary dysfunction in randomized controlled trials. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were used to identify available articles published before April 13, 2013. A meta-analysis was conducted on the effects of pulsatile perfusion on postoperative pulmonary function, intubation time, and the lengths of intensive care unit (ICU) and hospital stays. Eight studies involving 474 patients who received pulsatile perfusion and 496 patients who received nonpulsatile perfusion during cardiopulmonary bypass (CPB) were considered in the meta-analysis. Patients receiving pulsatile perfusion had a significantly greater PaO2 /FiO2 ratio 24 h and 48 h post-operation (P < 0.00001, both) and significantly lower chest radiograph scores at 24 h and 48 h post-operation (P < 0.00001 and P = 0.001, respectively) compared with patients receiving nonpulsatile perfusion. The incidence of noninvasive ventilation for acute respiratory insufficiency was significantly lower (P < 0.00001), and intubation time and ICU and hospital stays were shorter (P = 0.004, P < 0.00001, and P < 0.00001, respectively) in patients receiving pulsatile perfusion during CPB compared with patients receiving nonpulsatile perfusion. In conclusion, our meta-analysis suggests that the use of pulsatile flow during CPB results in better postoperative pulmonary function and shorter ICU and hospital stays.

  16. The use of spirometry to evaluate pulmonary function in olive ridley sea turtles (Lepidochelys olivacea) with positive buoyancy disorders.

    PubMed

    Schmitt, Todd L; Munns, Suzanne; Adams, Lance; Hicks, James

    2013-09-01

    This study utilized computed spirometry to compare the pulmonary function of two stranded olive ridley sea turtles (Lepidochelys olivacea) presenting with a positive buoyancy disorder with two healthy captive olive ridley sea turtles held in a large public aquarium. Pulmonary function test (PFT) measurements demonstrated that the metabolic cost of breathing was much greater for animals admitted with positive buoyancy than for the normal sea turtles. Positively buoyant turtles had higher tidal volumes and significantly lower breathing-frequency patterns with significantly higher expiration rates, typical of gasp-type breathing. The resulting higher energetic cost of breathing in the diseased turtles may have a significant impact on their long-term survival. The findings represent a method for clinical respiratory function analysis for an individual animal to assist with diagnosis, therapy, and prognosis. This is the first study, to our knowledge, to evaluate objectively sea turtles presenting with positive buoyancy and respiratory disease using pulmonary function tests. PMID:24063092

  17. Pulmonary function and symptoms of Nigerian workers exposed to carbon black in dry cell battery and tire factories

    SciTech Connect

    Oleru, U.G.; Elegbeleye, O.O.; Enu, C.C.; Olumide, Y.M.

    1983-02-01

    The pulmonary function and symptoms of 125 workers exposed to carbon black in dry cell battery and tire manufacturing plants were investigated. There was no significant difference in the pulmonary function of the subjects in the two plants. There was good agreement in the symptoms reported in the two different factories: cough with phlegm production, tiredness, chest pain, catarrh, headache, and skin irritation. The symptoms also corroborate those reported in the few studies on the pulmonary effects of carbon black. The suspended particulate levels in the dry cell battery plant ranged from 25 to 34 mg/m/sup 3/ and the subjects with the highest probable exposure level had the most impaired pulmonary function. The pulmonary function of the exposed subjects was significantly lower than that of a control, nonindustrially exposed population. The drop in the lung function from the expected value per year of age was relatively constant for all the study subgroups but the drop per year of duration of employment was more severe in the earlier years of employment. This study has underscored the need for occupational health regulations in the industries of developing countries.

  18. Effect of thoracic and cervical joint mobilization on pulmonary function in stroke patients

    PubMed Central

    Jang, Sang-Hun; Bang, Hyun-Soo

    2016-01-01

    [Purpose] This study aimed to conduct thoracic and cervical mobilization in stroke patients and determine its effects on respiratory function. [Subjects and Methods] Twenty-one stroke patients were studied. Subjects were divided into a control group (control group, n=11) who did not undergo thoracic and cervical joint mobilization, and an experimental group (thoracic and cervical mobilization group, n=10) who underwent thoracic and cervical joint mobilization. Forced vital capacity and forced expiratory volume in the first second, well-known indicators of respiratory capabilities, were measured. Peak cough flow was measured as an indicator of cough capability. [Results] After the exercise, respiratory function in the thoracic and cervical mobilization group showed statistically significant improvements demonstrated by increases in forced vital capacity, forced expiratory volume in the first second, and peak cough flow. [Conclusion] The findings indicate that thoracic and cervical mobilization can improve the thoracic movements of stroke patients resulting in improved pulmonary function. PMID:26957769

  19. Long-term effects of welding fumes upon respiratory symptoms and pulmonary function.

    PubMed

    Akbarkhanzadeh, F

    1980-05-01

    To evaluate the long-term influence of welding fumes and of cigarette smoke on the function of the bronchopulmonary system a comparative study of spirometric measurements in 209 welders and 109 non-welder controls was performed in a shipyard. The two groups were matched for age, height, smoking habits, residence and social class. Fifty-one percent of the welders had one or more of the respiratory symptoms, while only 26% of the controls had any of the symptoms. Chronic bronchitis was found to be confined to welders who smoked or had smoked. The welders appeared to show significantly increased impairment of lung function and, with advancing years, a deterioration in lung function greater than that of the controls, but, in general, they did not show serious pulmonary insufficiency.

  20. Association of indoor nitrogen dioxide with respiratory symptoms and pulmonary function in children

    SciTech Connect

    Neas, L.M.; Dockery, D.W.; Ware, J.H.; Spengler, J.D.; Speizer, F.E.; Ferris, B.G. Jr. )

    1991-07-15

    The effect of indoor nitrogen dioxide on the cumulative incidence of respiratory symptoms and pulmonary function level was studied in a cohort of 1,567 white children aged 7-11 years examined in six US cities from 1983 through 1988. Week-long measurements of nitrogen dioxide were obtained at three indoor locations over 2 consecutive weeks in both the winter and the summer months. The household annual average nitrogen dioxide concentration was modeled as a continuous variable and as four ordered categories. Multiple logistic regression analysis of symptom reports from a questionnaire administered after indoor monitoring showed that a 15-ppb increase in the household annual nitrogen dioxide mean was associated with an increased cumulative incidence of lower respiratory symptoms (odds ratio (OR) = 1.4, 95% confidence interval (95% Cl) 1.1-1.7). The response variable indicated the report of one or more of the following symptoms: attacks of shortness of breath with wheeze, chronic wheeze, chronic cough, chronic phlegm, or bronchitis. Girls showed a stronger association (OR = 1.7, 95% Cl 1.3-2.2) than did boys (OR = 1.2, 95% Cl 0.9-1.5). An analysis of pulmonary function measurements showed no consistent effect of nitrogen dioxide. These results are consistent with earlier reports based on categorical indicators of household nitrogen dioxide sources and provide a more specific association with nitrogen dioxide as measured in children's homes.

  1. Acute effects of a winter air pollution episode on pulmonary function and respiratory symptoms of children

    SciTech Connect

    Hoek, G.; Brunekreef, B. )

    1993-09-01

    The acute respiratory effects of a wintertime air pollution episode were studied in a general population sample of 112 children who were 7-12 y of age and who lived in a nonurban community. Spirometry was performed on 6 d, with a fixed interval of 3 wk between successive tests. During an air pollution episode, an additional pulmonary function test was made. Acute respiratory symptoms of the children were noted in a diary. Ambient concentrations of sulfur dioxide, black smoke, particulate matter with an aerodynamic diameter less than 10 microns, and nitrogen dioxide were considered as exposure variables. The association of air pollution with pulmonary function and prevalence of acute respiratory symptoms was assessed by individual linear regression analysis and time series analysis, respectively. In February 1991, an air pollution episode occurred during which daily average sulfur dioxide concentrations were slightly above 100 micrograms/m3, and particulate matter (with an aerodynamic diameter of less than 10 microns) concentrations reached 174 micrograms/m3. During the episode, forced vital capacity, forced expiratory volume in 1 s, and maximal mid-expiratory flow were lower than on baseline tests. Significant negative associations were found between the concentration of sulfur dioxide, black smoke, and particulate matter with an aerodynamic diameter of less than 10 microns. No association between prevalence of acute respiratory symptoms and the concentration of these compounds was found.

  2. Sulfur dioxide and ammonium sulfate effects on pulmonary function and bronchial reactivity in human subjects

    SciTech Connect

    Kulle, T.J.; Sauder, L.R.; Shanty, F.; Kerr, H.D.; Farrell, B.P.; Miller, W.R.; Milman, J.H.

    1984-03-01

    The effect of exposures to 1 ppm sulfur dioxide (SO/sub 2/) and 500 ..mu..g/m/sup 3/ respirable ammonium sulfate ((NH/sub 4/)/sub 2/SO/sub 4/) was studied in 20 nonsmoking subjects to determine if a response can be measured at these atmospheric levels and if the response is additive or synergistic. Four-hour separate and combined exposures were employed. Each subject acted as his or her own control and performed two light-to-moderate exercise stints (612 kg-m/min) for 15 minutes on each day's confinement in the environmental chamber. Pulmonary function tests (body plethysmography and spirometry) and bronchial reactivity to methacholine were performed to assess the response of these exposures. No significant changes in pulmonary function or bronchial reactivity were observed in the individual exposures ((NH/sub 4/)/sub 2/SO/sub 4/ or SO/sub 2/), the combined exposure ((NH/sub 4/)/sub 2/SO/sub 4/ and SO/sub 2/), or 24 hours post-exposure. This study design and the observed results did not demonstrate any readily apparent risk to healthy subjects with these exposures. Since no significant changes were measured, it was not possible to conclude if these two pollutants in combination produce an additive or synergistic response.

  3. Pulmonary function and ambient particulate matter: Epidemiological evidence from NHANES I

    SciTech Connect

    Chestnut, L.G.; Schwartz, J.; Savitz, D.A.; Burchfiel, C.M. )

    1991-05-01

    The relationship between pulmonary function and quarterly average levels of total suspended particulates (TSP) was examined for adults who resided in 49 of the locations where the First National Health and Nutrition Examination Survey (NHANES I) was conducted. Statistically significant relationships were observed between TSP levels and forced vital capacity (FVC) and forced expiratory volume at one second (FEV1.0). These relationships remained strong across several specifications and sample changes, e.g., exclusion of cities with two highest and two lowest TSP levels, restriction of sample to whites only. Anthropometric measurements and socioeconomic characteristics of the subjects were included in the analysis, and we restricted the sample to never smokers. The results indicate a 1 standard deviation increase (about 34 micrograms/m3) in TSP from the sample mean of 87 micrograms/m3 was associated with an average decrease in FVC of 2.25%. The results of this analysis also suggest that there is a threshold level (i.e., {approximately} 60 micrograms/m3 (quarterly average)) of TSP below which a relationship with pulmonary function ceases to exist.

  4. Indomethacin pretreatment reduces ozone-induced pulmonary function decrements in human subjects

    SciTech Connect

    Schelegle, E.S.; Adams, W.C.; Siefkin, A.D.

    1987-12-01

    We studied whether O/sub 3/-induced pulmonary function decrements could be inhibited by the prostaglandin synthetase inhibitor, indomethacin, in healthy human subjects. Fourteen college-age males completed six 1-h exposure protocols consisting of no drug, placebo, and indomethacin (Indocin SR 75 mg every 12 h for 5 days) pretreatments, with filtered air and O/sub 3/ (0.35 ppm) exposures within each pretreatment. Pretreatments were delivered weekly in random order in a double-blind fashion. Ozone and filtered air exposures, separated by 72 h, were delivered in random order in a single-blind fashion. Exposures consisted of 1-h exercise on a bicycle ergometer with work loads set to elicit a mean minute ventilation of 60 L/min. Statistical analysis revealed significant (p less than 0.05) across pretreatment effects for FVC and FEV1, with no drug versus indomethacin and placebo versus indomethacin comparisons being significant. These findings suggest that cyclooxygenase products of arachidonic acid, which are sensitive to indomethacin inhibition, play a prominent role in the development of pulmonary function decrements consequent to acute O/sub 3/ exposure.

  5. Path analysis of familial resemblance of pulmonary function and cigarette smoking.

    PubMed

    Cotch, M F; Beaty, T H; Cohen, B H

    1990-12-01

    The techniques of path analysis were utilized to assess the relative importance of genetic factors, personal smoking behavior, and shared environment in the resemblance of pulmonary function among relatives using both cross-sectional and longitudinal data from nuclear families. Data on 1-s forced expiratory volume, FEV1 (adjusted for age, sex, race, height, and ascertainment group) and the number of cigarettes smoked per day were available on 978 individuals in 384 nuclear families residing in the Baltimore metropolitan area. All these individuals were seen twice between 1971 and 1981, with an average of 5 yr between visits. The direct effect of an individual's own smoking explained 10 and 3% of variation in adjusted FEV1 among parents and offspring, respectively. Shared environmental factors influencing personal smoking behavior accounted for 5% of the parent-offspring correlation in adjusted FEV1 and 3% of the sibling correlation in adjusted FEV1 in this sample. Undefined environmental factors that influenced an individual's smoking habits and could be shared among relatives were found to explain 19% of the familial correlations in smoking. Genetic heritability estimates ranged between 36 and 40%, with no evidence of intergenerational differences in the expression of apparent genetic control of pulmonary function. PMID:2252251

  6. Acute effects of a winter air pollution episode on pulmonary function and respiratory symptoms of children.

    PubMed

    Hoek, G; Brunekreef, B

    1993-01-01

    The acute respiratory effects of a wintertime air pollution episode were studied in a general population sample of 112 children who were 7-12 y of age and who lived in a nonurban community. Spirometry was performed on 6 d, with a fixed interval of 3 wk between successive tests. During an air pollution episode, an additional pulmonary function test was made. Acute respiratory symptoms of the children were noted in a diary. Ambient concentrations of sulfur dioxide, black smoke, particulate matter with an aerodynamic diameter less than 10 microns, and nitrogen dioxide were considered as exposure variables. The association of air pollution with pulmonary function and prevalence of acute respiratory symptoms was assessed by individual linear regression analysis and time series analysis, respectively. In February 1991, an air pollution episode occurred during which daily average sulfur dioxide concentrations were slightly above 100 micrograms/m3, and particulate matter (with an aerodynamic diameter of less than 10 microns) concentrations reached 174 micrograms/m3. During the episode, forced vital capacity, forced expiratory volume in 1 s, and maximal mid-expiratory flow were lower than on baseline tests. Significant negative associations were found between the concentration of sulfur dioxide, black smoke, and particulate matter with an aerodynamic diameter of less than 10 microns. No association between prevalence of acute respiratory symptoms and the concentration of these compounds was found.

  7. The effects of lung volume recruitment on coughing and pulmonary function in patients with ALS.

    PubMed

    Cleary, Stuart; Misiaszek, John E; Kalra, Sanjay; Wheeler, Sonya; Johnston, Wendy

    2013-03-01

    Our objective was to study the intensity and duration of the effects of lung volume recruitment, a manual breath stacking technique, on pulmonary function and coughing in individuals with amyotrophic lateral sclerosis (ALS). Twenty-nine individuals with ALS participated in this study. A cross-over research design was used to compare effects of lung volume recruitment to a control condition. Treatment outcome measures included forced vital capacity (FVC), sniff nasal pressure (SnP) and peak cough flow (PCF). Results demonstrated that LVR had a significantly positive effect on FVC for up to 15 min following treatment but did not have a facilitative effect on SnP at any time-point. LVR had a significantly positive effect on PCF during unassisted coughing at both 15 min and 30 min following treatment, and there was no significant decrease in flow rates from baseline to 30 min later. In conclusion, lung volume recruitment may be an effective treatment for improving coughing and pulmonary function in individuals with ALS. Future research should be focused on determining patient characteristics that contribute to response to treatment, as well as randomized controlled trials of the technique.

  8. Sirtuin 3 deficiency is associated with inhibited mitochondrial function and pulmonary arterial hypertension in rodents and humans.

    PubMed

    Paulin, Roxane; Dromparis, Peter; Sutendra, Gopinath; Gurtu, Vikram; Zervopoulos, Sotirios; Bowers, Lyndsay; Haromy, Alois; Webster, Linda; Provencher, Steeve; Bonnet, Sebastien; Michelakis, Evangelos D

    2014-11-01

    Suppression of mitochondrial function promoting proliferation and apoptosis suppression has been described in the pulmonary arteries and extrapulmonary tissues in pulmonary arterial hypertension (PAH), but the cause of this metabolic remodeling is unknown. Mice lacking sirtuin 3 (SIRT3), a mitochondrial deacetylase, have increased acetylation and inhibition of many mitochondrial enzymes and complexes, suppressing mitochondrial function. Sirt3KO mice develop spontaneous PAH, exhibiting previously described molecular features of PAH pulmonary artery smooth muscle cells (PASMC). In human PAH PASMC and rats with PAH, SIRT3 is downregulated, and its normalization with adenovirus gene therapy reverses the disease phenotype. A loss-of-function SIRT3 polymorphism, linked to metabolic syndrome, is associated with PAH in an unbiased cohort of 162 patients and controls. If confirmed in large patient cohorts, these findings may facilitate biomarker and therapeutic discovery programs in PAH.

  9. The role of nodose ganglia in the regulation of cardiovascular function following pulmonary exposure to ultraffine titanium dioxide

    PubMed Central

    Kan, Hong; Wu, Zhongxin; Lin, Yen-Chang; Chen, Teh-Hsun; Cumpston, Jared L; Kashon, Michael L; Leonard, Steve; Munson, Albert E; Castranova, Vincent

    2015-01-01

    The inhalation of nanosized air pollutant particles is a recognised risk factor for cardiovascular disease; however, the link between occupational exposure to engineered nanoparticles and adverse cardiovascular events remains unclear. In the present study, the authors demonstrated that pulmonary exposure of rats to ultrafine titanium dioxide (UFTiO2) significantly increased heart rate and depressed diastolic function of the heart in response to isoproterenol. Moreover, pulmonary inhalation of UFTiO2 elevated mean and diastolic blood pressure in response to norepinephrine. Pretreatment of the rats ip with the transient receptor potential (TRP) channel blocker ruthenium red inhibited substance P synthesis in nodose ganglia and associated functional and biological changes in the cardiovascular system. In conclusion, the effects of pulmonary inhalation of UFTiO2 on cardiovascular function are most likely triggered by a lung-nodose ganglia-regulated pathway via the activation of TRP channels in the lung. PMID:23593933

  10. A study of respiratory morbidity and pulmonary function among solderers in the electronics industry.

    PubMed

    Gupta, B N; Rastogi, S K; Husain, T; Mathur, N; Pangtey, B S

    1991-02-01

    Pulmonary function assessment of 197 solderers engaged in soldering printed circuit boards and other electronic components using lead-tin alloy impregnated solder in five major electronics workplaces in India was compared with the findings observed in 143 unexposed controls. Spirometry showed a significant impairment in the values of vital capacity (VC) and forced expiratory volume/forced vital capacity (FEV1/FVC) percent ratio in 47.2% of the solderers in comparison to 1.3% in the reference group (p less than 0.001). In the exposed group, female solderers particularly showed significantly higher (55.0%) prevalence of overall respiratory impairment in comparison to the 32.3% observed in their male counterparts (p less than 0.001). Bronchial obstruction was recorded in 7.6% of the solderers compared with 1.3% of the unexposed controls (p less than 0.01). The prevalence of restrictive and mixed ventilatory impairment was found to be 28.9 and 10.6%, respectively, among the exposed workers, while there was none among the control group. The solderers showed a predominantly restrictive pattern of pulmonary impairment that was mild in nature. Smoking caused no significant effect on the pulmonary impairment among the exposed workers. The study also did not show any significant differences in the prevalence of respiratory impairment between solderers exposed either less or more than 10 yr, thereby suggesting that there was no link between the respiratory impairment and duration of exposure. The industrial hygiene study conducted in the assembly section where soldering was done showed the mean concentration of lead to be 0.40 micrograms/m3 (range 0.12-0.43 micrograms/m3).(ABSTRACT TRUNCATED AT 250 WORDS)

  11. Prospective prediction of post-radiation therapy lung function using quantitative lung scans and pulmonary function testing

    SciTech Connect

    Rubenstein, J.H.; Richter, M.P.; Moldofsky, P.J.; Solin, L.J.

    1988-07-01

    Surgeons have made use of quantitative perfusion lung scanning (QS) and forced expiratory volume in one second (FEV1) to predict a patient's ability to tolerate lung resection. In this study QS and FEV1 were used to predict prospectively pulmonary function following lung irradiation (XRT). Twenty-two patients have had QS and FEV1 determined before XRT and at planned intervals post-XRT. Serial determination of lung function post-XRT allows comment on the temporal nature of the XRT effect on lung function. Seventeen patients had QS and FEV1 determined at an interval of 2-6 months post-irradiation with a drop in the groups mean FEV1 from 1.91 to 1.87L. or 2% during that interval. In the interval from 6-12 months post-XRT, 13 patients had studies with the groups mean FEV1 dropping from 1.79 to 1.58L or 12% of the original. In the interval from 12-18 months, 6 patients had a decline in mean FEV1 from 1.73 to 1.56L. or 10% of the original. In 22 patients a predicted final FEV1 was compared with a measured value at an interval from XRT. Fourteen of these determinations were at intervals greater than 6 months from the start of XRT and 6 at intervals of greater than 1 year. FEV1 was seen to drop during the follow-up intervals toward the predicted value. In only 2 patients did the final FEV1 drop below the predicted FEV1 and never by more than 0.12L. (6%). In summary, a method for predicting post-XRT pulmonary function using QS and FEV1 is described. Serial follow-up revealed a latent period followed by a late phase where FEV1 fell toward, but not significantly below, the predicted value. Such a determination can be of value in formulating a treatment plan for patients with significantly diminished pulmonary function.

  12. Structure-function relationships in pulmonary surfactant membranes: from biophysics to therapy.

    PubMed

    Lopez-Rodriguez, Elena; Pérez-Gil, Jesús

    2014-06-01

    Pulmonary surfactant is an essential lipid-protein complex to maintain an operative respiratory surface at the mammalian lungs. It reduces surface tension at the alveolar air-liquid interface to stabilise the lungs against physical forces operating along the compression-expansion breathing cycles. At the same time, surfactant integrates elements establishing a primary barrier against the entry of pathogens. Lack or deficiencies of the surfactant system are associated with respiratory pathologies, which treatment often includes supplementation with exogenous materials. The present review summarises current models on the molecular mechanisms of surfactant function, with particular emphasis in its biophysical properties to stabilise the lungs and the molecular alterations connecting impaired surfactant with diseased organs. It also provides a perspective on the current surfactant-based strategies to treat respiratory pathologies. This article is part of a Special Issue entitled: Membrane Structure and Function: Relevance in the Cell's Physiology, Pathology and Therapy.

  13. Material coefficients of the strain energy function of pulmonary arteries in normal and cigarette smoke-exposed rats.

    PubMed

    Liu, S Q; Fung, Y C

    1993-11-01

    The effect of cigarette smoke on the stress-strain relationship of pulmonary arteries was studied in 2- and 3-month smoke-exposed rats. The animals were exposed to cigarette smoke in a smoke-generating system 10 times daily with one cigarette each time. The smoke density and the puffing duration and frequency of the system were regulated in accordance with reference values measured from human smokers. The mechanical properties of the pulmonary arteries about 450 microns in external diameter (at zero pressure) were determined in vitro by inflation and deflation tests. The average stress and middle-wall strain of the selected pulmonary arteries were determined on the basis of experimental data including inflation and deflation pressures during loading and unloading processes, respectively, and vessel diameter and length at various pressure levels, and vessel circumferential and longitudinal lengths at zero-stress state. A constitutive equation for the pulmonary arteries was derived from an energy function depending on circumferential and longitudinal Green's strains. The coefficients of the strain energy function of the pulmonary arteries were determined in both the smoke-exposed and control rats by fitting the experimental stress-strain data with the constitutive equation. It was found that the wall stress of the pulmonary arteries at a given strain and most of the coefficients of the strain energy function were increased in both the 2- and 3-month smoke-exposed rats in comparison with those in the corresponding controls. These results indicated that cigarette smoke induced an increase in the wall stiffness of the pulmonary arteries in the rats. PMID:8262988

  14. Early effects of intratracheal instillation of elastase on mortality, respiratory function, and pulmonary morphometry of F-344 rats

    SciTech Connect

    Damon, E.G.; Mauderly, J.L.; Jones, R.K.

    1982-01-01

    Rats were intratracheally instilled with purified elastase at doses ranging from 0.3 to 1.6 IU/g of body weight to induce pulmonary emphysema. In 50 rats exposed to elastase at doses ranging from 0.3 to 1.6 IU/g, the LD/sub 50/ was approximately 1.2 IU/g. A mortality of 9% occurred in 94 rats instilled with a dose of 1.0 IU/g. Pulmonary function tests were conducted on nine surviving rats 2 to 4 weeks after instillation of elastase at doses ranging from 0.8 to 1.2 IU/g and on 20 untreated controls. The treated rats exhibited significant differences in pulmonary function similar to those observed in human emphysema. In rats treated at dose of 1.0 or 1.2 IU/g, histopathological studies showed there was an extensive loss of alveolar fine structure resulting in alveolar spaces ranging from 3 to 10 times the size of those in untreated control rats. Morphometric measurements of the mean linear intercepts of the alveolar septa confirmed these findings. Since the changes in pulmonary function and structure in rats treated with elastase at a dose of 1.0 IU/g body weight were consistent with changes observed in human patients with pulmonary emphysema, and since the mortality rate of 9% was considered acceptable, this dose was selected for use in subsequent studies requiring an animal model of emphysema.

  15. Effect of nitrogen dioxide, ozone, and peroxyacetyl nitrate on metabolic and pulmonary function

    SciTech Connect

    Drechsler-Parks, D.M. )

    1987-04-01

    The metabolic and pulmonary function responses were investigated in 32 non-smoking men and women (8 men and 8 women 18-26 years of age, and 8 men and 8 women 51-76 years of age) who were exposed for 2 hours to each of 8 conditions: (1) filtered air (FA), (2) 0.13 ppm peroxyacetyl nitrate (PAN), (3) 0.45 ppm ozone (O3), (4) 0.60 ppm nitrogen dioxide (NO2), (5) 0.13 ppm PAN + 0.45 ppm O3 (PAN/O3), (6) 0.13 ppm PAN + 0.60 ppm NO2 (PAN/NO2), (7) 0.60 ppm NO2 + 0.45 ppm O3 (NO2/O3), and (8) 0.13 ppm PAN + 0.60 ppm NO2 + 0.45 ppm O3 (PAN/NO2/O3). The subjects alternated 20-min periods of rest (n = 3) and cycle ergometer exercise (n = 3) at a work load predetermined to elicit a ventilatory minute volume (VE) of approximately 25 L/min (BTPS). Functional residual capacity (FRC) was determined pre- and post-exposure. Forced vital capacity (FVC) was determined before and after exposure, and 5 min after each exercise period. Heart rate was monitored throughout each exposure, and VE was measured during the last 2 min of each exercise period. Exposure to FA, PAN, NO2, and PAN/NO2 had no effect on any measure of pulmonary or metabolic function. Ozone was primarily responsible for the pulmonary function effects observed. There was no significant difference between the responses to O3 exposure and the responses to the three O3 mixtures, indicating no interactions between the pollutants. The results suggest that women may be somewhat more responsive to O3 exposure than men, and that older people (51-76 years of age) may be less responsive to O3 than younger people (18-26 years of age).

  16. Liquid ventilation improves pulmonary function, gas exchange, and lung injury in a model of respiratory failure.

    PubMed Central

    Hirschl, R B; Parent, A; Tooley, R; McCracken, M; Johnson, K; Shaffer, T H; Wolfson, M R; Bartlett, R H

    1995-01-01

    OBJECTIVE: The authors evaluated gas exchange, pulmonary function, and lung histology during perfluorocarbon liquid ventilation (LV) when compared with gas ventilation (GV) in the setting of severe respiratory failure. BACKGROUND: The efficacy of LV in the setting of respiratory failure has been evaluated in premature animals with surfactant deficiency. However, very little work has been performed in evaluating the efficacy of LV in older animal models of the adult respiratory distress syndrome (ARDS). METHODS: A stable model of lung injury was induced in 12 young sheep weighing 16.4 +/- 3.0 kg using right atrial injection of 0.07 mL/kg of oleic acid followed by saline pulmonary lavage and bijugular venovenous extracorporeal life support (ECLS). For the first 30 minutes on ECLS, all animals were ventilated with gas. Animals were then ventilated with either 15 mL/kg gas (GV, n = 6) or perflubron ([PFC], LV, n = 6) over the ensuing 2.5 hours. Subsequently, ECLS was discontinued in five of the GV animals and five of the LV animals, and GV or LV continued for 1 hour or until death. MAIN FINDINGS: Physiologic shunt (Qps/Qt) was significantly reduced in the LV animals when compared with the GV animals (LV = 31 +/- 10%; GV = 93 +/- 4%; p < 0.001) after 3 hours of ECLS. At the same time point, pulmonary compliance (CT) was significantly increased in the LV group when compared with the GV group (LV = 1.04 +/- 0.19 mL/cm H2O/kg; GV = 0.41 +/- 0.02 mL/cm H2O/kg; p < 0.001). In addition, the ECLS flow rate required to maintain the PaO2 in the 50- to 80-mm Hg range was substantially and significantly lower in the LV group when compared with that of the GV group (LV = 14 +/- 5 mL/kg/min; GV = 87 +/- 15 mL/kg/min; p < 0.001). All of the GV animals died after discontinuation of ECLS, whereas all the LV animals demonstrated effective gas exchange without extracorporeal support for 1 hour (p < 0.01). Lung biopsy light microscopy demonstrated a marked reduction in alveolar hemorrhage

  17. What is the effect of peripheral muscle fatigue, pulmonary function, and body composition on functional exercise capacity in acromegalic patients?

    PubMed Central

    Lopes, Agnaldo José; Guedes da Silva, Débora Pedroza; Ferreira, Arthur de Sá; Kasuki, Leandro; Gadelha, Mônica Roberto; Guimarães, Fernando Silva

    2015-01-01

    [Purpose] The six-minute walk test (6MWT) is increasingly being used as an important tool for analyzing functional capacity in patients with multisystem disorders. The aim of this study was to evaluate the effect of body composition, peripheral muscle function, and pulmonary function on the six-minute walk distance (6MWD) in acromegalic patients. [Subjects and Methods] Thirty-two patients with active acromegaly, with a mean age of 48.6 ± 12.1 years, underwent an evaluation of body composition using electrical bioimpedance, isometric dynamometry with surface electromyography, tests of pulmonary function, and the 6MWT. [Results] The mean ± SD values for the 6MWD, fat-free mass (FFM), and maximal expiratory pressure (MEP) were 65.5 ± 11.7% predicted, 55.1 ± 10.6 kg, and 55.2 ± 16.8% predicted, respectively. There was a significant correlation between the 6MWD and the following parameters: the angle of the linear regression line obtained using the values of the median frequency electromyography signal over time during the fatigability test for the vastus medialis muscle (MDF, r=0.65), FFM (r=0.62), MEP (r=0.60), height(2)/resistance index (r=0.52), resistance (r=−0.50), and forced expiratory volume in 1 second (r=0.50). Multivariate analysis showed that MDF, FFM, and MEP were independent predictors of the 6MWD (R2=0.52). [Conclusion] The fatigability of the peripheral muscles, FFM, and MEP are the primary determinants of the 6MWD in acromegalics. PMID:25931716

  18. Correlation analysis between pulmonary function test parameters and CT image parameters of emphysema

    NASA Astrophysics Data System (ADS)

    Liu, Cheng-Pei; Li, Chia-Chen; Yu, Chong-Jen; Chang, Yeun-Chung; Wang, Cheng-Yi; Yu, Wen-Kuang; Chen, Chung-Ming

    2016-03-01

    Conventionally, diagnosis and severity classification of Chronic Obstructive Pulmonary Disease (COPD) are usually based on the pulmonary function tests (PFTs). To reduce the need of PFT for the diagnosis of COPD, this paper proposes a correlation model between the lung CT images and the crucial index of the PFT, FEV1/FVC, a severity index of COPD distinguishing a normal subject from a COPD patient. A new lung CT image index, Mirage Index (MI), has been developed to describe the severity of COPD primarily with emphysema disease. Unlike conventional Pixel Index (PI) which takes into account all voxels with HU values less than -950, the proposed approach modeled these voxels by different sizes of bullae balls and defines MI as a weighted sum of the percentages of the bullae balls of different size classes and locations in a lung. For evaluation of the efficacy of the proposed model, 45 emphysema subjects of different severity were involved in this study. In comparison with the conventional index, PI, the correlation between MI and FEV1/FVC is -0.75+/-0.08, which substantially outperforms the correlation between PI and FEV1/FVC, i.e., -0.63+/-0.11. Moreover, we have shown that the emphysematous lesion areas constituted by small bullae balls are basically irrelevant to FEV1/FVC. The statistical analysis and special case study results show that MI can offer better assessment in different analyses.

  19. Avoiding Unnecessary Preoperative Testing.

    PubMed

    Rusk, Matthew H

    2016-09-01

    Given the low-risk nature of cataract surgery, no preoperative testing is indicated unless the patient needs it for another reason. Although electrocardiograms may have a role in preoperative testing in patients at high risk of cardiovascular disease, or if the procedure carries with it significant operative risks, they are often unnecessary. Urinalysis and coagulation studies not should be routine because they have not shown any value in predicting complications. Although these tests are not individually expensive, the aggregate cost is substantial. As good stewards of the medical system, physicians need to use these tests more judiciously. PMID:27542420

  20. Clinical Validation of 4-Dimensional Computed Tomography Ventilation With Pulmonary Function Test Data

    SciTech Connect

    Brennan, Douglas; Schubert, Leah; Diot, Quentin; Castillo, Richard; Castillo, Edward; Guerrero, Thomas; Martel, Mary K.; Linderman, Derek; Gaspar, Laurie E.; Miften, Moyed; Kavanagh, Brian D.; Vinogradskiy, Yevgeniy

    2015-06-01

    Purpose: A new form of functional imaging has been proposed in the form of 4-dimensional computed tomography (4DCT) ventilation. Because 4DCTs are acquired as part of routine care for lung cancer patients, calculating ventilation maps from 4DCTs provides spatial lung function information without added dosimetric or monetary cost to the patient. Before 4DCT-ventilation is implemented it needs to be clinically validated. Pulmonary function tests (PFTs) provide a clinically established way of evaluating lung function. The purpose of our work was to perform a clinical validation by comparing 4DCT-ventilation metrics with PFT data. Methods and Materials: Ninety-eight lung cancer patients with pretreatment 4DCT and PFT data were included in the study. Pulmonary function test metrics used to diagnose obstructive lung disease were recorded: forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity. Four-dimensional CT data sets and spatial registration were used to compute 4DCT-ventilation images using a density change–based and a Jacobian-based model. The ventilation maps were reduced to single metrics intended to reflect the degree of ventilation obstruction. Specifically, we computed the coefficient of variation (SD/mean), ventilation V20 (volume of lung ≤20% ventilation), and correlated the ventilation metrics with PFT data. Regression analysis was used to determine whether 4DCT ventilation data could predict for normal versus abnormal lung function using PFT thresholds. Results: Correlation coefficients comparing 4DCT-ventilation with PFT data ranged from 0.63 to 0.72, with the best agreement between FEV1 and coefficient of variation. Four-dimensional CT ventilation metrics were able to significantly delineate between clinically normal versus abnormal PFT results. Conclusions: Validation of 4DCT ventilation with clinically relevant metrics is essential. We demonstrate good global agreement between PFTs and 4DCT-ventilation, indicating that 4DCT

  1. Assessment of multislice CT to quantify pulmonary emphysema function and physiology in a rat model

    NASA Astrophysics Data System (ADS)

    Cao, Minsong; Stantz, Keith M.; Liang, Yun; Krishnamurthi, Ganapathy; Presson, Robert G., Jr.

    2005-04-01

    Purpose: The purpose of this study is to evaluate multi-slice computed tomography technology to quantify functional and physiologic changes in rats with pulmonary emphysema. Method: Seven rats were scanned using a 16-slice CT (Philips MX8000 IDT) before and after artificial inducement of emphysema. Functional parameters i.e. lung volumes were measured by non-contrast spiral scan during forced breath-hold at inspiration and expiration followed by image segmentation based on attenuation threshold. Dynamic CT imaging was performed immediately following the contrast injection to estimate physiology changes. Pulmonary perfusion, fractional blood volume, and mean transit times (MTTs) were estimated by fitting the time-density curves of contrast material using a compartmental model. Results: The preliminary results indicated that the lung volumes of emphysema rats increased by 3.52+/-1.70mL (p<0.002) at expiration and 4.77+/-3.34mL (p<0.03) at inspiration. The mean lung densities of emphysema rats decreased by 91.76+/-68.11HU (p<0.01) at expiration and low attenuation areas increased by 5.21+/-3.88% (p<0.04) at inspiration compared with normal rats. The perfusion for normal and emphysema rats were 0.25+/-0.04ml/s/ml and 0.32+/-0.09ml/s/ml respectively. The fractional blood volumes for normal and emphysema rats were 0.21+/-0.04 and 0.15+/-0.02. There was a trend toward faster MTTs for emphysema rats (0.42+/-0.08s) than normal rats (0.89+/-0.19s) with p<0.006, suggesting that blood flow crossing the capillaries increases as the capillary volume decreases and which may cause the red blood cells to leave the capillaries incompletely saturated with oxygen if the MTTs become too short. Conclusion: Quantitative measurement using CT of structural and functional changes in pulmonary emphysema appears promising for small animals.

  2. Nerves projecting from the intrinsic cardiac ganglia of the pulmonary veins modulate sinoatrial node pacemaker function

    PubMed Central

    Zarzoso, Manuel; Rysevaite, Kristina; Milstein, Michelle L.; Calvo, Conrado J.; Kean, Adam C.; Atienza, Felipe; Pauza, Dainius H.; Jalife, José; Noujaim, Sami F.

    2013-01-01

    Aims Pulmonary vein ganglia (PVG) are targets for atrial fibrillation ablation. However, the functional relevance of PVG to the normal heart rhythm remains unclear. Our aim was to investigate whether PVG can modulate sinoatrial node (SAN) function. Methods and results Forty-nine C57BL and seven Connexin40+/EGFP mice were studied. We used tyrosine-hydroxylase (TH) and choline-acetyltransferase immunofluorescence labelling to characterize adrenergic and cholinergic neural elements. PVG projected postganglionic nerves to the SAN, which entered the SAN as an extensive, mesh-like neural network. PVG neurones were adrenergic, cholinergic, and biphenotypic. Histochemical characterization of two human embryonic hearts showed similarities between mouse and human neuroanatomy: direct neural communications between PVG and SAN. In Langendorff perfused mouse hearts, PVG were stimulated using 200–2000 ms trains of pulses (300 μs, 400 µA, 200 Hz). PVG stimulation caused an initial heart rate (HR) slowing (36 ± 9%) followed by acceleration. PVG stimulation in the presence of propranolol caused HR slowing (43 ± 13%) that was sustained over 20 beats. PVG stimulation with atropine progressively increased HR. Time-course effects were enhanced with 1000 and 2000 ms trains (P < 0.05 vs. 200 ms). In optical mapping, PVG stimulation shifted the origin of SAN discharges. In five paroxysmal AF patients undergoing pulmonary vein ablation, application of radiofrequency energy to the PVG area during sinus rhythm produced a decrease in HR similar to that observed in isolated mouse hearts. Conclusion PVG have functional and anatomical biphenotypic characteristics. They can have significant effects on the electrophysiological control of the SAN. PMID:23559611

  3. Respiratory symptoms and pulmonary function tests in security and safety products plant workers

    PubMed Central

    Balbay, Ege Gulec; Toru, Umran; Arbak, Peri; Balbay, Oner; Suner, Kezban Ozmen; Annakkaya, Ali Nihat

    2014-01-01

    Objective: Lock and key factory workers are under the risk of metal pneumoconiosis and occupational asthma. In this cross-sectional study, it’s aimed to evaluate the relationship between metal dust exposure and respiratory symptoms, pulmonary function tests of workers in different section of lock and key factory. Methods: 54 male workers (mean age, 32.8 ± 5.4) in a security and safety products plant were evaluated for respiratory symptoms, pulmonary function tests and smoking habits. Results have been interpreted by comparison of the painting (28/54) and grinding group workers (26/54). Results: There was no significant difference between painting (32.1 ± 4.8) and grinding (33.6 ± 6.1) groups regarding mean age (P > 0.05). Smokers were in significantly higher in grinding group (18/26). Cough and sputum were reported 14.3% (4/28) in painting and 3.8% (1/26) in grinding workers (P > 0.05). Chest tightness was seen in 7.1% and 7.7% of painting and grinding workers, respectively (P > 0.05). But no chest tightness was reported in both groups when they were away work. Breathlessness was seen in 10.7% and 7.7% of painting and grinding workers, respectively (P > 0.05). Breathlessness was similar in both groups (7.1% vs. 3.8%) when they were away work. When comparing painting and grinding workers respiratory functions no significant difference observed. Chest radiography in painting and grinding workers showed hyperlucency (3.6% vs.11.4%), respectively. Conclusion: Painting groups in lock and key factory workers had more but statistically insignificantrespiratory complaints. Interestingly, chest tightness was only observed when both groups were at work. It was thought that ventilation and using personal protective equipment in factory could provide significant benefits. PMID:25126195

  4. Computed Tomography-Based Centrilobular Emphysema Subtypes Relate with Pulmonary Function

    PubMed Central

    Takahashi, Mamoru; Yamada, Gen; Koba, Hiroyuki; Takahashi, Hiroki

    2013-01-01

    Introduction: Centrilobular emphysema (CLE) is recognized as low attenuation areas (LAA) with centrilobular pattern on high-resolution computed tomography (CT). However, several shapes of LAA are observed. Our preliminary study showed three types of LAA in CLE by CT-pathologic correlations. This study was performed to investigate whether the morphological features of LAA affect pulmonary functions. Materials and Methods: A total of 73 Japanese patients with stable CLE (63 males, 10 females) were evaluated visually by CT and classified into three subtypes based on the morphology of LAA including shape and sharpness of border; patients with CLE who shows round or oval LAA with well-defined border (Subtype A), polygonal or irregular-shaped LAA with ill-defined border (Subtype B), and irregular-shaped LAA with ill-defined border coalesced with each other (Subtype C). CT score, pulmonary function test and smoking index were compared among three subtypes. Results: Twenty (27%), 45 (62%) and 8 cases (11%) of the patients were grouped into Subtype A, Subtype B and Subtype C, respectively. In CT score and smoking index, both Subtype B and Subtype C were significantly higher than Subtype A. In FEV1%, Subtype C was significantly lower than both Subtype A and Subtype B. In diffusing capacity of lung for carbon monoxide, Subtype B was significantly lower than Subtype A. Conclusion: The morphological differences of LAA may relate with an airflow limitation and alveolar diffusing capacity. To assess morphological features of LAA may be helpful for the expectation of respiratory function. PMID:23935765

  5. Pulmonary function in granite dust exposure: a four-year follow-up.

    PubMed

    Musk, A W; Peters, J M; Wegman, D H; Fine, L J

    1977-05-01

    Pulmonary function studies were performed on 974 workers in Vermont granite sheds in 1974. Of these subjects, 668 had been studied 4 years earlier and had remained in jobs in which their exposure to granite dust had not changed based on dust concentrations measured during 1970. The yearly decrement in pulmonary function observed in the 668 granite shed workers was excessive (0.07 to 0.08 liter per year for forced vital capacity and 0.05 to 0.07 liter per year for forced expiratory volume in 1 sec). This exceeded the expected decrement derived from several other occupational and population groups. Studies from this laboratory and published cross-sectional and longitudinal data consistently indicate a decrement of no more than 0.03 to 0.04 liter per year in both forced vital capacity and forced expiratory volume in 1 sec. The observed decrements were independent of exposure groups and not accounted for by cigarette smoking. In 528 additional granite shed workers, decrements in ventilatory capacity had been measured for one, 2, or 3 years and were consistently of the same order of magnitude. Dust concentrations within defined jobs and between granite sheds showed great variability. Despite this, a suggestive relationship between exposure and decrement in ventilatory function was demonstrated at the end of 2 years; however, at the end of 4 years the relationship could no longer be shown with these exposure groupings. The difficulty in characterizing individual dust exposures and projecting dust concentrations for several years is considered to account for the absence of a dose-response relationship at the 4-year follow-up. The results of this study suggest that our previous estimates of annual deterioration in ventilatory capacity attributable to work in granite sheds are underestimates. We conclude that present dust concentrations in Vermont granite sheds cause excessive deterioration of lung capacity. To prevent these effects, dust concentrations must be lowered.

  6. Obesity: systemic and pulmonary complications, biochemical abnormalities, and impairment of lung function.

    PubMed

    Mafort, Thiago Thomaz; Rufino, Rogério; Costa, Cláudia Henrique; Lopes, Agnaldo José

    2016-01-01

    Obesity is currently one of the major epidemics of this millennium and affects individuals throughout the world. It causes multiple systemic complications, some of which result in severe impairment of organs and tissues. These complications involve mechanical changes caused by the accumulation of adipose tissue and the numerous cytokines produced by adipocytes. Obesity also significantly interferes with respiratory function by decreasing lung volume, particularly the expiratory reserve volume and functional residual capacity. Because of the ineffectiveness of the respiratory muscles, strength and resistance may be reduced. All these factors lead to inspiratory overload, which increases respiratory effort, oxygen consumption, and respiratory energy expenditure. It is noteworthy that patterns of body fat distribution significantly influence the function of the respiratory system, likely via the direct mechanical effect of fat accumulation in the chest and abdominal regions. Weight loss caused by various types of treatment, including low-calorie diet, intragastric balloon, and bariatric surgery, significantly improves lung function and metabolic syndrome and reduces body mass index. Despite advances in the knowledge of pulmonary and systemic complications associated with obesity, longitudinal randomized studies are needed to assess the impact of weight loss on metabolic syndrome and lung function. PMID:27408717

  7. Pulmonary function in firefighters: acute changes in ventilatory capacity and their correlates.

    PubMed Central

    Musk, A W; Smith, T J; Peters, J M; McLaughlin, E

    1979-01-01

    A group of 39 firefighters was examined during routine firefighing duty. Following smoke exposure the average decrease in one-second forced expiratory volume (FEV1.0) was 0.05 litre (137 observations). This decline in FEV1.0 was related to the severity of smoke exposure as estimated by the firefighter and to the measured particulate concentration of the smoke to which he was exposed. Decreases in FEV1.0 in excess of 0.10 litre were recorded in 30% of observations. Changes in FEV1.0 resulting from a second exposure to smoke on the same tour of duty were greater when smoke exposure at the previous fire was heavy. The repeated episodes of irritation of the bronchial tree that have been documented in this investigation may explain the origin of the previously observed chronic effect of firefighting on respiratory symptoms and pulmonary function. PMID:444439

  8. The effects of caffeine on ventilation and pulmonary function during exercise: an often-overlooked response.

    PubMed

    Chapman, Robert F; Mickleborough, Timothy D

    2009-12-01

    The effects of caffeine on exercise performance have been well documented, with most reviews focusing on the metabolic, hormonal, and/or central nervous system effects. However, caffeine's effects on ventilation and pulmonary function are often overlooked. Studies have shown that caffeine is a strong ventilatory stimulant, increasing the sensitivity of the peripheral chemoreceptors in untrained subjects and increasing exercise ventilation at all workloads in highly trained endurance athletes. The consequences of increased exercise ventilation could hold either positive or negative effects for exercise performance. Anti-inflammatory and bronchoprotective effects of caffeine are great enough to consider its efficacy as a possible prophylactic antiasthma treatment. Although an upper urinary concentration limit exists for caffeine with international sports doping control agencies, caffeine's universal accessibility in the marketplace has resulted in its daily use being increasingly more socially acceptable as an ergogenic substance for sport and exercise.

  9. Development of a patient-specific model for calculation of pulmonary function

    NASA Astrophysics Data System (ADS)

    Zhong, Hualiang; Ding, Mingyue; Movsas, Benjamin; Chetty, Indrin J.

    2011-06-01

    The purpose of this paper is to develop a patient-specific finite element model (FEM) to calculate the pulmonary function of lung cancer patients for evaluation of radiation treatment. The lung model was created with an in-house developed FEM software with region-specific parameters derived from a four-dimensional CT (4DCT) image. The model was used first to calculate changes in air volume and elastic stress in the lung, and then to calculate regional compliance defined as the change in air volume corrected by its associated stress. The results have shown that the resultant compliance images can reveal the regional elastic property of lung tissue, and could be useful for radiation treatment planning and assessment.

  10. Longitudinal study of pulmonary function in coal miners in Lorraine, France

    SciTech Connect

    Bates, D.V.; Pham, Q.T.; Chau, N.; Pivoteau, C.; Dechoux, J.; Sadoul, P.

    1985-01-01

    A longitudinal study of pulmonary function and radiological change has been conducted on 141 nonsmoking coal miners and 256 smoking coal miners from Lorraine, France. At the time of the first examination occasioned by radiological change or shortness of breath, the men averaged between 46.6 years and 50.9 years of age, and they retired approximately 8 years after entering the study. They have been followed for average periods of about 18 years and a mean of five FEV1 observations per man were made over that period. Changes in radiological category have been documented. Average rates of decline of FVC and FEV1 were similar, and varied between -47 ml/yr in nonsmoking miners still alive, to -78 ml/yr in deceased smoking miners. These accelerated rates were similar before and after retirement from the mine.

  11. Respiratory symptoms and pulmonary function changes among carpet weavers in Iran.

    PubMed

    Boskabady, Mohammad Hossein; Karimiani, Ehsagh Ghayoor; Vostacolaei, Hossein Ahmadzadeh

    2007-01-01

    Respiratory and allergic symptoms were evaluated in 66 Iranian carpet weavers and 66 controls with similar age and gender characteristics using a questionnaire including questions on work-related respiratory symptoms in the past year, allergies, smoking habits, and work exposure duration. A total of 28 carpet weavers (42%) reported work-related respiratory symptoms. Incidences of allrespiratory symptoms and most allergic symptoms were significantly higher in carpet weavers than in controls (p<0.05 - p<0.001). Moreover, most respiratory and allergic symptoms in carpet weavers were significantly more prominent during working hours (p<0.01 - p<0.001). Pulmonary function test results of the carpet weavers showed significant impairment compared with controls (p<0.05 - p<0.001).

  12. Respiratory symptoms and pulmonary function of workers employed in textile dyeing factory in Turkey.

    PubMed

    Sibel, O; Beyza, A; Murat, K; Fatma, E; Göksel, K; Sevin, B

    2012-08-01

    Dyes are known to be a causative agent of occupational asthma exposed to them. We evaluate respiratory symptoms among textile. The study population comprised 106 exposed workers and control (unexposed) group. Data were collected by a questionnaire. Pulmonary Function Tests (PFTs) were performed. Among the exposed workers 36.8% defined phlegm. Respiratory symptoms were not significantly different between two groups. The employment duration of the exposed workers with phlegm was longer than those without phlegm (p = 0.027). The mean % predicted of forced expiratory flow (FEF) 25-75 of the exposed workers was found to be significantly lower than the control (unexposed) group (p = 0.01). Our study suggests that textile dyeing might cause respiratory symptoms at workers.

  13. [Prone position: effect on gas exchange and functional capacity for exercise in patients with pulmonary hypertension].

    PubMed

    Bastidas-L, Andrea Carolina; Colina-Chourio, José A; Guevara, Jesnel M; Nunez, Alexis

    2015-03-01

    The objective of this investigation was to evaluate gas exchange and cardiopulmonary functional behavior in patients with pulmonary hypertension (PH) before, during and after the change to a prone position. Thirty patients with PH and alterations in gas exchange were included in the study. Gas exchange measurements were performed in four stages: at the baseline supine position and after 30, 120 and 240 minutes in prone position. Also, the patients were evaluated by the six minutes walking test (6MWT) after 30 days in prone position during night's sleep. After four hours in prone position, all patients showed an increase of PaO2 and arterial saturation of oxygen (SaO2), with a decrease of intrapulmonary shunts, improving the gas exchange and therefore the physiological demand imposed by exercise in patients with PH. PMID:25920183

  14. Respiratory symptoms and pulmonary functions of workers employed in Turkish textile dyeing factories.

    PubMed

    Ozkurt, Sibel; Kargi, Beyza Akdag; Kavas, Murat; Evyapan, Fatma; Kiter, Göksel; Baser, Sevin

    2012-04-01

    Dyes are known to be a causative agent of occupational asthma in workers exposed to them. We have evaluated respiratory symptoms among textile workers. The study population comprised 106 exposed workers and a control (unexposed) group. Data were collected by a questionnaire. PFTs (Pulmonary Function Test) were performed. Among the exposed workers 36.8% defined phlegm. Respiratory symptoms were not significantly different between two groups. The employment duration of the exposed workers with phlegm was longer than those without phlegm (p = 0.027). The mean % predicted of FEF(25-75) of the exposed workers was found to be significantly lower than the control (unexposed) group (p = 0.01). Our study suggests that textile dyeing might cause respiratory symptoms in workers.

  15. The Changes of Pulmonary Function in COPD During Four-Year Period

    PubMed Central

    Cukic, Vesna; Lovre, Vladimir; Ustamujic, Aida

    2013-01-01

    Conflict of interest: none declared. Introduction COPD (chronic obstructive pulmonary disease) is characterized by airflow limitation that is not fully reversible. OBJECTIVE: to show the changes of pulmonary function in COPD during the 4 -year evolution of illness. Material and Methods The research was done on patients suffering from COPD treated at the Clinic “Podhrastovi” during 2006 and 2007. The tested parameters were examined from the date of receiving patient with COPD to hospital treatment in 2006 and 2007 and then followed prospectively until 2010 or 2011 (the follow-up period was 4 years). There were total 199 treated patients who were chosen at random and regularly attended the control examinations. The study was conducted on adult patients of both sexes, different age group. In each patient the duration of illness was recorded so is sex, age, data of smoking habits, information about the regularity of taking bronchodilator therapy during remissions of disease, about the treatment of disease exacerbations, results of pulmonary functional tests as follows: FVC (forced vital capacity), FEV1 (forced expiratory volume in one second) and bronchodilator reversibility testing. All these parameters were measured at the beginning and at the end of each hospital treatment on the apparatuses of Clinic “Podhrastovi”. We took in elaboration those data obtained in the beginning of the first hospitalization and at the end of the last hospitalization or at the last control in outpatient department when patient was in stable state. Patients were divided into three groups according to the number of exacerbations per year. Results airflow limitation in COPD is progressive; both FVC and FEV1 shows the statistically significant decrease during follow-up period of 4 years (p values / for both parameters/ =0.05) . But in patients regularly treated in phases of remission and exacerbations of illness the course of illness is slower. The fall of FVC and FEV1 is

  16. Pulmonary function changes after radiotherapy in non-small-cell lung cancer patients with long-term disease-free survival

    SciTech Connect

    Borst, Gerben R.; Jaeger, Katrien de; Belderbos, Jose; Burgers, Sjaak A.; Lebesque, Joos V. . E-mail: j.lebesque@nki.nl

    2005-07-01

    Purpose: To evaluate the changes in pulmonary function after high-dose radiotherapy (RT) for non-small-cell lung cancer in patients with a long-term disease-free survival. Methods and Materials: Pulmonary function was measured in 34 patients with inoperable non-small-cell lung cancer before RT and at 3 and 18 months of follow-up. Thirteen of these patients had a pulmonary function test (PFT) 36 months after RT. The pulmonary function parameters (forced expiratory volume in 1 s [FEV{sub 1}], diffusion capacity [T{sub lcoc}], forced vital capacity, and alveolar volume) were expressed as a percentage of normal values. Changes were expressed as relative to the pre-RT value. We evaluated the impact of chronic obstructive pulmonary disease, radiation pneumonitis, mean lung dose, and PFT results before RT on the changes in pulmonary function. Results: At 3, 18, and 36 months, a significant decrease was observed for the T{sub lcoc} (9.5%, 14.6%, and 22.0%, respectively) and the alveolar volume (5.8%, 6.6%, and 15.8%, respectively). The decrease in FEV{sub 1} was significant at 18 and 36 months (8.8% and 13.4%, respectively). No recovery of any of the parameters was observed. Chronic obstructive pulmonary disease was an important risk factor for larger PFT decreases. FEV{sub 1} and T{sub lcoc} decreases were dependent on the mean lung dose. Conclusion: A significant decrease in pulmonary function was observed 3 months after RT. No recovery in pulmonary function was seen at 18 and 36 months after RT. The decrease in pulmonary function was dependent on the mean lung dose, and patients with chronic obstructive pulmonary disease had larger reductions in the PFTs.

  17. [The preoperative anaesthetic visit].

    PubMed

    Harms, Christoph; Kindler, Christoph H

    2009-07-01

    Anaesthetists often visit their patients in exceptional situations characterised by preoperative anxiety or distress. Therefore, even brief contact with the patient can be considered intense and meaningful. The initial preoperative anaesthetic visit is the beginning of the relationship between patient and anaesthetist, and should help to explain the planned anaesthetic technique. Preoperative anaesthetic visits are intense and last for 20 minutes on average. They should assert a professional approach to the patient's emotions, particularly to preoperative anxiety, and a structured and clear collection of information including the past history of the patient. These visits should also provide information about the anaesthesia itself and instructions for the patient with respect to the perioperative period. Communication about the side effects and risks of anaesthetic techniques, and the discussion of potential alternatives are mandatory. Worldwide, courts of law increasingly require a documented discussion between the anaesthetist and patient based on risk-benefit evidence. Today, there is in general a shift away from decisions made solely by physicians, reflecting an increased respect for the autonomy of the patient towards a model of shared decision-making and informed choice. Ideally, the preoperative visit follows the four key habits of highly effective clinicians, i.e., to rapidly establish a rapport with the patient and provide an agenda for the visit, to explore the patient's perspectives and expectations, to demonstrate empathy, and to focus on the end of the visit with providing information and including the patient in the decision-making process. Visits are then concluded upon obtaining informed consent from the patient. PMID:19565444

  18. Decreased proteasomal function accelerates cigarette smoke-induced pulmonary emphysema in mice.

    PubMed

    Yamada, Yosuke; Tomaru, Utano; Ishizu, Akihiro; Ito, Tomoki; Kiuchi, Takayuki; Ono, Ayako; Miyajima, Syota; Nagai, Katsura; Higashi, Tsunehito; Matsuno, Yoshihiro; Dosaka-Akita, Hirotoshi; Nishimura, Masaharu; Miwa, Soichi; Kasahara, Masanori

    2015-06-01

    Chronic obstructive pulmonary disease (COPD) is a disease common in elderly people, characterized by progressive destruction of lung parenchyma and chronic inflammation of the airways. The pathogenesis of COPD remains unclear, but recent studies suggest that oxidative stress-induced apoptosis in alveolar cells contributes to emphysematous lung destruction. The proteasome is a multicatalytic enzyme complex that plays a critical role in proteostasis by rapidly destroying misfolded and modified proteins generated by oxidative and other stresses. Proteasome activity decreases with aging in many organs including lungs, and an age-related decline in proteasomal function has been implicated in various age-related pathologies. However, the role of the proteasome system in the pathogenesis of COPD has not been investigated. Recently, we have established a transgenic (Tg) mouse model with decreased proteasomal chymotrypsin-like activity, showing age-related phenotypes. Using this model, we demonstrate here that decreased proteasomal function accelerates cigarette smoke (CS)-induced pulmonary emphysema. CS-exposed Tg mice showed remarkable airspace enlargement and increased foci of inflammation compared with wild-type controls. Importantly, apoptotic cells were found in the alveolar walls of the affected lungs. Impaired proteasomal activity also enhanced apoptosis in cigarette smoke extract (CSE)-exposed fibroblastic cells derived from mice and humans in vitro. Notably, aggresome formation and prominent nuclear translocation of apoptosis-inducing factor were observed in CSE-exposed fibroblastic cells isolated from Tg mice. Collective evidence suggests that CS exposure and impaired proteasomal activity coordinately enhance apoptotic cell death in the alveolar walls that may be involved in the development and progression of emphysema in susceptible individuals such as the elderly.

  19. Progressive right ventricular functional and structural changes in a mouse model of pulmonary arterial hypertension.

    PubMed

    Wang, Zhijie; Schreier, David A; Hacker, Timothy A; Chesler, Naomi C

    2013-12-01

    Right ventricle (RV) dysfunction occurs with progression of pulmonary arterial hypertension (PAH) due to persistently elevated ventricular afterload. A critical knowledge gap is the molecular mechanisms that govern the transition from RV adaptation to RV maladaptation, which leads to failure. Here, we hypothesize that the recently established mouse model of PAH, via hypoxia and SU5416 treatment (HySu), captures that transition from adaptive to maladaptive RV remodeling including impairments in RV function and decreases in the efficiency of RV interactions with the pulmonary vasculature. To test this hypothesis, we exposed C57BL6 male mice to 0 (control), 14, 21, and 28 days of HySu and then obtained synchronized RV pressure and volume measurements in vivo. With increasing HySu exposure duration, arterial afterload increased monotonically, leading to a continuous increase in RV stroke work, RV fibrosis, and RV wall stiffening (P < 0.05). RV contractility increased at 14 days of HySu exposure and then plateaued (P < 0.05). As a result, ventricular-vascular coupling efficiency tended to increase at 14 days and then decrease. Our results suggest that RV remodeling may begin to shift from adaptive to maladaptive with increasing duration of HySu exposure, which would mimic changes in RV function with PAH progression found clinically. However, for the duration of HySu exposure used here, no drop in cardiac output was found. We conclude that the establishment of a mouse model for overt RV failure due to PAH remains an important task. PMID:24744862

  20. Effects of inhalation of acidic compounds on pulmonary function in allergic adolescent subjects

    SciTech Connect

    Koenig, J.Q.; Covert, D.S.; Pierson, W.E.

    1989-02-01

    There is concern about the human health effects of inhalation of acid compounds found in urban air pollution. It was the purpose of this study to investigate three of these acid compounds, sulfur dioxide (SO/sub 2/), sulfuric acid (H/sub 2/SO/sub 4/), and nitric acid (HNO/sub 3/) in a group of allergic adolescent subjects. Subjects were exposed during rest and moderate exercise to 0.7 mumole/m/sup 3/ (68 micrograms/m/sup 3/) H/sub 2/SO/sub 4/, 4.0 mumole/m/sup 3/ (0.1 ppm) SO/sub 2/, or 2.0 mumole/m/sup 3/ (0.05 ppm) HNO/sub 3/. Pulmonary functions (FEV1, total respiratory resistance, and maximal flow) were measured before and after exposure. Preliminary analysis based on nine subjects indicates that exposure to 0.7 mumole/m/sup 3/ H/sub 2/SO/sub 4/ alone and in combination with SO/sub 2/ caused significant changes in pulmonary function, whereas exposure to air or SO/sub 2/ alone did not. FEV1 decreased an average of 6% after exposure to H/sub 2/SO/sub 4/ alone and 4% when the aerosol was combined with SO/sub 2/. The FEV1 decrease was 2% after both air and SO/sub 2/ exposures. Total respiratory resistance (RT) increased 15% after the combined H/sub 2/SO/sub 4/ exposures, 12% after H/sub 2/SO/sub 4/ alone, and 7% after exposure to air. After exposures to HNO3 alone, FEV1 decreased by 4%, and RT increased by 23%. These results are preliminary; final conclusions must wait for completion of the study.

  1. Effects of inhalation of acidic compounds on pulmonary function in allergic adolescent subjects.

    PubMed

    Koenig, J Q; Covert, D S; Pierson, W E

    1989-02-01

    There is concern about the human health effects of inhalation of acid compounds found in urban air pollution. It was the purpose of this study to investigate three of these acid compounds, sulfur dioxide (SO2), sulfuric acid (H2SO4), and nitric acid (HNO3) in a group of allergic adolescent subjects. Subjects were exposed during rest and moderate exercise to 0.7 mumole/m3 (68 micrograms/m3) H2SO4, 4.0 mumole/m3 (0.1 ppm) SO2, or 2.0 mumole/m3 (0.05 ppm) HNO3. Pulmonary functions (FEV1, total respiratory resistance, and maximal flow) were measured before and after exposure. Preliminary analysis based on nine subjects indicates that exposure to 0.7 mumole/m3 H2SO4 alone and in combination with SO2 caused significant changes in pulmonary function, whereas exposure to air or SO2 alone did not. FEV1 decreased an average of 6% after exposure to H2SO4 alone and 4% when the aerosol was combined with SO2. The FEV1 decrease was 2% after both air and SO2 exposures. Total respiratory resistance (RT) increased 15% after the combined H2SO4 exposures, 12% after H2SO4 alone, and 7% after exposure to air. After exposures to HNO3 alone, FEV1 decreased by 4%, and RT increased by 23%. These results are preliminary; final conclusions must wait for completion of the study.

  2. Communication of Pulmonary Function Test Results: A Survey of Patient’s Preferences

    PubMed Central

    Zagami, Debbie; Hockenhull, Jessica; Bodger, Alanna; Sriram, Krishna Bajee

    2015-01-01

    Introduction Physician-patient communication in patients suffering from common chronic respiratory disease should encompass discussion about pulmonary function test (PFT) results, diagnosis, disease education, smoking cessation and optimising inhaler technique. Previous studies have identified that patients with chronic respiratory disease/s often express dissatisfaction about physician communication. Currently there is a paucity of data regarding patient awareness of their PFT results (among those who have undergone PFTs previously) or patient preferences about PFT result communication. Methods We undertook a three-month prospective study on outpatients referred to two Pulmonary Function Laboratories. If subjects had undergone PFTs previously, the awareness of their previous test results was evaluated. All subjects were asked about their preferences for PFT result communication. Subjects were determined to have chronic respiratory disease based on their past medical history. Results 300 subjects (50% male) with a median age (±SD) of 65 (±14) years participated in the study. 99% of the study participants stated that they were at least moderately interested in knowing their PFT results. 72% (217/300) of the subjects had undergone at least one PFT in the past, 48% of whom stated they had not been made aware of their results. Fewer subjects with chronic respiratory disease preferred that only a doctor discuss their PFT results with them (28% vs. 41%, p = 0.021). Conclusion Our study demonstrates that while almost all subjects want to be informed of their PFT results, this does not occur in a large number of patients. Many subjects are agreeable for their PFT results to be communicated to them by clinicians other than doctors. Further research is required to develop an efficient method of conveying PFT results that will improve patient satisfaction and health outcomes. PMID:25950951

  3. EFFECTS OF INSTILLATION OF RESIDUAL OIL FLY ASH ON INDICES OF CARDIAC, PULMONARY, AND THERMOREGULATORY FUNCTION IN SPONTANEOUSLY HYPERTENSIVE RATS

    EPA Science Inventory


    EFFECTS OF INSTILLED RESIDUAL OIL FLY ASH (ROFA) ON INDICES OF CARDIAC, PULMONARY, AND THERMOREGULATORY FUNCTION IN SPONTANEOUSLY HYPERTENSIVE (SH) RATS. LB Wichers1, JP Nolan2, UP Kodavanti2, MCJ Schladweiler2, R Hauser3, DW Winsett2, DL Costa2, and WP Watkinson2. 1UNC Sch...

  4. Pulmonary function response and effects of antioxidant genetic polymorphisms in healthy young adults exposed to low concentration ozone.

    EPA Science Inventory

    Rational: Ozone is known to induce a variety of pulmonary effects including decrement of spirometric lung function and inflammatory reaction, and antioxidant genes are known to play an important role in modulating the effects. It is unclear, however, if such effects may occur at...

  5. Cross-sectional and longitudinal changes in pulmonary function associated with automobile pollution among bridge and tunnel officers.

    PubMed

    Evans, R G; Webb, K; Homan, S; Ayres, S M

    1988-01-01

    This study investigated the effects of emissions from the internal combustion engine on pulmonary function and respiratory symptoms in men collecting tolls and directing traffic in areas with high levels of air pollution. Bridge and tunnel officers (BTOs) were administered pulmonary function tests and respiratory questionnaires for up to 11 consecutive years (n = 944). Carboxyhemoglobin levels were also measured. Regression coefficients on year tested were calculated on 466 individuals (49% of all BTOs) tested at least 3 years. The tunnel workers had significantly lower FEV1S (forced expiratory volume at one second) and FVCs (forced vital capacity), respiratory symptoms, and higher carboxyhemoglobin levels than the bridge workers. BTOs working over 20 years had the lowest mean pulmonary function values, the steepest slopes, and the most respiratory symptoms. We believe that the data show an association between working as a bridge and tunnel officer and decreased pulmonary function and increased respiratory symptoms, but it was not readily evident whether the effects were of clinical importance.

  6. Predicting respiratory morbidity from pulmonary function tests: A reanalysis of ozone chamber studies

    SciTech Connect

    Ostro, B.D.; Lipsett, M.J.; Jewell, N.P.

    1989-10-01

    Some consequences of acute exposure to ozone are best measured in studies of human respiratory responses in controlled exposure chambers. These studies typically examine relationships between exposures to alternative pollutant concentrations and indicators of lung function as measured by spirometry, such as forced expiratory volume in one second, FEV1. However, the association of respiratory morbidity with these changes in lung function is not well established. To gain a better understanding of the relationship between ozone-related changes in pulmonary function and respiratory symptoms, data from several clinical studies have been reanalyzed. Logistic regression models were used to determine the quantitative relationship between changes in FEV1 and the probability of a mild or moderate lower respiratory symptom. Models were developed that corrected for repeated sampling of individuals and both population-averaged and subject-specific effects were determined. The results indicate the existence of a strong and consistent quantitative relationship between changes in lung function and the probability of a respiratory symptom. Specifically, a 10 percent reduction in FEV1 is associated with a 15 percentage point increase in the probability of a mild, moderate or severe lower respiratory symptom and a 6 percentage point increase in the probability of a moderate or severe lower respiratory symptom.

  7. Efficacy of pirfenidone in patients with idiopathic pulmonary fibrosis with more preserved lung function.

    PubMed

    Albera, Carlo; Costabel, Ulrich; Fagan, Elizabeth A; Glassberg, Marilyn K; Gorina, Eduard; Lancaster, Lisa; Lederer, David J; Nathan, Steven D; Spirig, Dominique; Swigris, Jeff J

    2016-09-01

    This post hoc analysis examined the differences in idiopathic pulmonary fibrosis disease progression and the effects of pirfenidone in patients stratified by more preserved versus less preserved baseline lung function status using forced vital capacity (FVC) or GAP (gender, age and physiology) index stage.Efficacy outcomes, i.e. FVC, 6-min walking distance (6MWD) and dyspnoea (University of California San Diego Shortness of Breath Questionnaire (UCSD SOBQ)), were analysed at 12 months in patients randomised to pirfenidone 2403 mg·day(-1) or placebo in the pooled phase 3 CAPACITY/ASCEND population (n=1247), with subgroups stratified by baseline FVC ≥80% versus <80% or GAP stage I versus II-III. Treatment-by-subgroup interaction was tested based on a rank ANCOVA model; factors in the model included study, region, treatment, subgroup and treatment-by-subgroup interaction term.Patients with both more preserved (FVC ≥80% or GAP stage I) and less preserved (FVC <80% or GAP stage II-III) lung function at baseline demonstrated clinically significant disease progression at 12 months in terms of categorical decline in FVC, 6MWD and UCSD SOBQ. The magnitude of pirfenidone treatment effect was comparable between subgroups, regardless of whether lung function was classified using FVC or GAP index stage.These findings support the initiation of treatment with pirfenidone, irrespective of stage of baseline lung function in this patient population. PMID:27471208

  8. Lung function declines in patients with pulmonary sarcoidosis and increased respiratory epithelial permeability to sup 99m Tc-DTPA

    SciTech Connect

    Chinet, T.; Dusser, D.; Labrune, S.; Collignon, M.A.; Chretien, J.; Huchon, G.J. )

    1990-02-01

    Respiratory epithelial clearance of {sup 99m}Tc-DTPA (RC-Tc-DTPA) and pulmonary function tests (PFT) were determined at intervals of 6 or 12 months in 37 untreated, nonsmoking patients with sarcoidosis over a period of 6 to 36 months. PFT included the measurements of total lung capacity (TLC), vital capacity (VC), FEV1, and diffusing capacity for carbon monoxide. No difference was found between the respiratory clearance of {sup 113m}In-DTPA (2.25 +/- 1.00%/min) and RC-Tc-DTPA (2.29 +/- 1.11%/min) in eight patients with pulmonary sarcoidosis. Pulmonary function decreased 15% or more in at least 2 function tests during 11 follow-up periods, but it remained stable during 47 follow-up periods. In patients whose lung function deteriorated, RC-Tc-DTPA increased to 3.51 +/- 1.55%/min; in contrast, in patients whose lung function remained stable, regardless of the initial values, RC-Tc-DTPA was normal (1.00 +/- 0.50%/min; p less than 0.001). In eight patients who were treated with corticosteroids, RC-Tc-DTPA decreased from 3.48 +/- 1.31%/min to 1.56 +/- 0.64%/min (p less than 0.001), and PFT improved. We conclude that in nonsmokers with pulmonary sarcoidosis, increased RC-Tc-DTPA is not related to dissociation of 99mTc from DTPA, RC-Tc-DTPA is increased when pulmonary function decreases, and, when increased, RC-Tc-DTPA decreases with corticosteroid therapy.

  9. Performance in the 6-minute walk test and postoperative pulmonary complications in pulmonary surgery: an observational study

    PubMed Central

    Santos, Bruna F. A.; Souza, Hugo C. D.; Miranda, Aline P. B.; Cipriano, Federico G.; Gastaldi, Ada C.

    2016-01-01

    OBJECTIVES: To assess functional capacity in the preoperative phase of pulmonary surgery by comparing predicted and obtained values for the six-minute walk test (6MWT) in patients with and without postoperative pulmonary complication (PPC) METHOD: Twenty-one patients in the preoperative phase of open thoracotomy were evaluated using the 6MWT, followed by monitoring of the postoperative evolution of each participant who underwent the routine treatment. Participants were then divided into two groups: the group with PPC and the group without PPC. The results were also compared with the predicted values using reference equations for the 6MWT RESULTS: Over half (57.14%) of patients developed PPC. The 6MWT was associated with the odds for PPC (odds ratio=22, p=0.01); the group without PPC in the postoperative period walked 422.38 (SD=72.18) meters during the 6MWT, while the group with PPC walked an average of 340.89 (SD=100.93) meters (p=0.02). The distance traveled by the group without PPC was 80% of the predicted value, whereas the group with PPC averaged less than 70% (p=0.03), with more appropriate predicted values for the reference equations CONCLUSIONS: The 6MWT is an easy, safe, and feasible test for routine preoperative evaluation in pulmonary surgery and may indicate patients with a higher chance of developing PPC. PMID:26786074

  10. Changes in pulmonary function and airway reactivity due to prolonged exposure to typical ambient ozone (O/sub 3/) levels

    SciTech Connect

    Horstman, D.; McConnell, W.; Folinsbee, L.; Abdul-Salaam, S.; Ives, P.

    1988-05-01

    Daily ambient ozone levels between 0.08 and 0.12 ppm for periods exceeding 6 hours often occur in many urban, suburban, and rural areas of the United States and Europe. Substantial decrements in pulmonary functions, moderate to severe respiratory symptoms, and increased airway reactivity have been observed in young men performing moderate to heavy exercise. This study evaluates pulmonary responses of 22 healthy nonsmoking males, resulting from exposures to 0.08, 0.10, and 0.12 ppm ozone.

  11. The Relationship of Metabolic Syndrome with Stress, Coronary Heart Disease and Pulmonary Function - An Occupational Cohort-Based Study

    PubMed Central

    Nowobilski, Roman; Dropinski, Jerzy; Kotula-Horowitz, Katarzyna; Laskowicz, Bartosz; Stanisz, Andrzej; Lelakowski, Jacek

    2015-01-01

    Background and Aims Higher levels of stress impact the prevalence of metabolic syndrome (MetS) and coronary heart disease. The association between MetS, impaired pulmonary function and low level of physical activity is still pending assessment in the subjects exposed to stress. The study aimed to examine whether higher levels of stress might be related to MetS and the plaque presence, as well as whether MetS might affect pulmonary function. Design and Methods The study embraced 235 police officers (mean age 40.97 years) from the south of Poland. The anthropometrics and biochemical variables were measured; MetS was diagnosed using the International Diabetes Federation criteria. Computed tomography coronary angiography of coronary arteries, exercise ECG, measurements of brachial flow-mediated dilation, and carotid artery intima-media thickness were completed. In order to measure the self-perception of stress, 10-item Perceived Stress Scale (PSS-10) was applied. Pulmonary function and physical activity levels were also addressed. Multivariate logistic regression analyses were applied to determine the relationships between: 1/ incidence of coronary plaque and MetS per se, MetS components and the number of classical cardiovascular risk factors, 2/ perceived stress and MetS, 3/ MetS and pulmonary function parameters. Results Coronary artery atherosclerosis was less associated with MetS (OR = 2.62, 95%CI 1.24–5.52; p = 0.011) than with a co-existence of classical cardiovascular risk factors (OR = 5.67, 95% CI 1.07–29.85, p = 0.03; for 3 risk factors and OR = 9.05; 95% CI 1.24–66.23, p = 0.02; for 6 risk factors, respectively). Perceived stress increased MetS prevalence (OR = 1.07, 95% CI 1.03–1.13; p = 0.03), and impacted coronary plaque prevalence (OR = 1.05, 95% CI 1.001–1.10; p = 0.04). Leisure-time physical activity reduced the chances of developing MetS (OR = 0.98 95% CI 0.96–0.99; p = 0.02). MetS subjects had significantly lower values of certain

  12. Obesity-induced adipokine imbalance impairs mouse pulmonary vascular endothelial function and primes the lung for injury.

    PubMed

    Shah, Dilip; Romero, Freddy; Duong, Michelle; Wang, Nadan; Paudyal, Bishnuhari; Suratt, Benjamin T; Kallen, Caleb B; Sun, Jianxin; Zhu, Ying; Walsh, Kenneth; Summer, Ross

    2015-01-01

    Obesity is a risk factor for the development of acute respiratory distress syndrome (ARDS) but mechanisms mediating this association are unknown. While obesity is known to impair systemic blood vessel function, and predisposes to systemic vascular diseases, its effects on the pulmonary circulation are largely unknown. We hypothesized that the chronic low grade inflammation of obesity impairs pulmonary vascular homeostasis and primes the lung for acute injury. The lung endothelium from obese mice expressed higher levels of leukocyte adhesion markers and lower levels of cell-cell junctional proteins when compared to lean mice. We tested whether systemic factors are responsible for these alterations in the pulmonary endothelium; treatment of primary lung endothelial cells with obese serum enhanced the expression of adhesion proteins and reduced the expression of endothelial junctional proteins when compared to lean serum. Alterations in pulmonary endothelial cells observed in obese mice were associated with enhanced susceptibility to LPS-induced lung injury. Restoring serum adiponectin levels reversed the effects of obesity on the lung endothelium and attenuated susceptibility to acute injury. Our work indicates that obesity impairs pulmonary vascular homeostasis and enhances susceptibility to acute injury and provides mechanistic insight into the increased prevalence of ARDS in obese humans. PMID:26068229

  13. Association between 24-Hour Urinary Cadmium and Pulmonary Function among Community-Exposed Men: The VA Normative Aging Study

    PubMed Central

    Lampe, Brad J.; Park, Sung Kyun; Robins, Thomas; Mukherjee, Bhramar; Litonjua, Augusto A.; Amarasiriwardena, Chitra; Weisskopf, Marc; Sparrow, David; Hu, Howard

    2008-01-01

    Background High levels of cadmium exposure are known to cause emphysema in occupationally exposed workers, but little has been reported to date on the association between chronic environmental cadmium exposure and pulmonary function. Objective In this study we examined the association between pulmonary function and cadmium body burden in a subcohort of the Normative Aging Study, a community-based study of aging. Methods We examined 96 men who had cadmium measured in single 24-hr urinary specimens collected in 1994–1995 and who had one to three tests of pulmonary function between 1994 and 2002 (a total of 222 observations). We used mixed-effect models to predict pulmonary function based on individual 24-hr urinary cadmium output, adjusted for age, height, time elapsed from the baseline, and smoking status. We assessed effect modification by smoking status. Results Among all subjects, a single log-unit increase in baseline urinary cadmium was inversely associated with forced expiratory volume in 1 sec (FEV1) percent predicted [β = −7.56%; 95% confidence interval (CI) −13.59% to −1.53%]; forced vital capacity (FVC) percent predicted (β = −2.70%; 95% CI −7.39% to 1.99%), and FEV1/FVC ratio (β = −4.13%; 95% CI −7.61% to −0.66%). In models including an interaction between urinary cadmium and smoking status, there was a graded, statistically significant reduction in FEV1/FVC ratio across smoking status in association with urinary cadmium. Conclusions This study suggests that chronic cadmium exposure is associated with reduced pulmonary function, and cigarette smoking modifies this association. These results should be interpreted with caution because the sample size is small, and further studies are needed to confirm our findings. PMID:18795167

  14. Mesenchymal stem cells protect cigarette smoke-damaged lung and pulmonary function partly via VEGF-VEGF receptors.

    PubMed

    Guan, Xiao-Jun; Song, Lin; Han, Feng-Feng; Cui, Zhi-Lei; Chen, Xi; Guo, Xue-Jun; Xu, Wei-Guo

    2013-02-01

    Progressive pulmonary inflammation and emphysema have been implicated in the progression of chronic obstructive pulmonary disease (COPD), while current pharmacological treatments are not effective. Transplantation of bone marrow mesenchymal stem cells (MSCs) has been identified as one such possible strategy for treatment of lung diseases including acute lung injury (ALI) and pulmonary fibrosis. However, their role in COPD still requires further investigation. The aim of this study is to test the effect of administration of rat MSCs (rMSCs) on emphysema and pulmonary function. To accomplish this study, the rats were exposed to cigarette smoke (CS) for 11 weeks, followed by administration of rMSCs into the lungs. Here we show that rMSCs infusion mediates a down-regulation of pro-inflammatory mediators (TNF-α, IL-1β, MCP-1, and IL-6) and proteases (MMP9 and MMP12) in lung, an up-regulation of vascular endothelial growth factor (VEGF), VEGF receptor 2, and transforming growth factor (TGFβ-1), while reducing pulmonary cell apoptosis. More importantly, rMSCs administration improves emphysema and destructive pulmonary function induced by CS exposure. In vitro co-culture system study of human umbilical endothelial vein cells (EA.hy926) and human MSCs (hMSCs) provides the evidence that hMSCs mediates an anti-apoptosis effect, which partly depends on an up-regulation of VEGF. These findings suggest that MSCs have a therapeutic potential in emphysematous rats by suppressing the inflammatory response, excessive protease expression, and cell apoptosis, as well as up-regulating VEGF, VEGF receptor 2, and TGFβ-1. PMID:22949406

  15. Effects of the association of diabetes and pulmonary emphysema on cardiac structure and function in rats.

    PubMed

    Di Petta, Antonio; Simas, Rafael; Ferreira, Clebson L; Capelozzi, Vera L; Salemi, Vera M C; Moreira, Luiz F P; Sannomiya, Paulina

    2015-10-01

    Chronic obstructive pulmonary disease is often associated with chronic comorbid conditions of cardiovascular disease, diabetes mellitus and hypertension. This study aimed to investigate the effects of the association of diabetes and pulmonary emphysema on cardiac structure and function in rats. Wistar rats were divided into control non-diabetic instilled with saline (CS) or elastase (CE), diabetic instilled with saline (DS) or elastase (DE), DE treated with insulin (DEI) groups and echocardiographic measurements, morphometric analyses of the heart and lungs, and survival analysis conducted 50 days after instillation. Diabetes mellitus was induced [alloxan, 42 mg/kg, intravenously (iv)] 10 days before the induction of emphysema (elastase, 0.25 IU/100 g). Rats were treated with NPH insulin (4 IU before elastase plus 2 IU/day, 50 days). Both CE and DE exhibited similar increases in mean alveolar diameter, which are positively correlated with increases in right ventricular (RV) wall thickness (P = 0.0022), cavity area (P = 0.0001) and cardiomyocyte thickness (P = 0.0001). Diabetic saline group demonstrated a reduction in left ventricular (LV) wall, interventricular (IV) septum, cardiomyocyte thickness and an increase in cavity area, associated with a reduction in LV fractional shortening (P < 0.05), and an increase in LViv relaxation time (P < 0.05). Survival rate decreased from 80% in DS group to 40% in DE group. In conclusion, alloxan diabetes did not affect RV hypertrophy secondary to chronic emphysema, even in the presence of insulin. Diabetes per se induced left ventricular dysfunction, which was less evident in the presence of RV hypertrophy. Survival rate was substantially reduced as a consequence, at least in part, of the coexistence of RV hypertrophy and diabetic cardiomyopathy.

  16. Variability in pulmonary function following rapid altitude ascent to the Amundsen-Scott South Pole station.

    PubMed

    Lalande, S; Anderson, P J; Miller, A D; Ceridon, M L; Beck, K C; O'Malley, K A; Johnson, J B; Johnson, B D

    2011-09-01

    The impact of acute altitude exposure on pulmonary function is variable. A large inter-individual variability in the changes in forced expiratory flows (FEFs) is reported with acute exposure to altitude, which is suggested to represent an interaction between several factors influencing bronchial tone such as changes in gas density, catecholamine stimulation, and mild interstitial edema. This study examined the association between FEF variability, acute mountain sickness (AMS) and various blood markers affecting bronchial tone (endothelin-1, vascular endothelial growth factor (VEGF), catecholamines, angiotensin II) in 102 individuals rapidly transported to the South Pole (2835 m). The mean FEF between 25 and 75% (FEF(25-75)) and blood markers were recorded at sea level and after the second night at altitude. AMS was assessed using Lake Louise questionnaires. FEF(25-75) increased by an average of 12% with changes ranging from -26 to +59% from sea level to altitude. On the second day, AMS incidence was 36% and was higher in individuals with increases in FEF(25-75) (41 vs. 22%, P = 0.05). Ascent to altitude induced an increase in endothelin-1 levels, with greater levels observed in individuals with decreased FEF(25-75). Epinephrine levels increased with ascent to altitude and the response was six times larger in individuals with decreased FEF(25-75). Greater levels of endothelin-1 in individuals with decreased FEF(25-75) suggest a response consistent with pulmonary hypertension and/or mild interstitial edema, while epinephrine may be upregulated in these individuals to clear lung fluid through stimulation of β(2)-adrenergic receptors. PMID:21327792

  17. Poor Baseline Pulmonary Function May Not Increase the Risk of Radiation-Induced Lung Toxicity

    SciTech Connect

    Wang, Jingbo; Cao, Jianzhong; Yuan, Shuanghu; Arenberg, Douglas; Stanton, Paul; Tatro, Daniel; Ten Haken, Randall K.; Kong, Feng-Ming

    2013-03-01

    Purpose: Poor pulmonary function (PF) is often considered a contraindication to definitive radiation therapy for lung cancer. This study investigated whether baseline PF was associated with radiation-induced lung toxicity (RILT) in patients with non-small cell lung cancer (NSCLC) receiving conformal radiation therapy (CRT). Methods and Materials: NSCLC patients treated with CRT and tested for PF at baseline were eligible. Baseline predicted values of forced expiratory volume in 1 sec (FEV1), forced vital capacity (FVC), and diffusion capacity of lung for carbon monoxide (DLCO) were analyzed. Additional factors included age, gender, smoking status, Karnofsky performance status, coexisting chronic obstructive pulmonary disease (COPD), tumor location, histology, concurrent chemotherapy, radiation dose, and mean lung dose (MLD) were evaluated for RILT. The primary endpoint was symptomatic RILT (SRILT), including grade ≥2 radiation pneumonitis and fibrosis. Results: There was a total of 260 patients, and SRILT occurred in 58 (22.3%) of them. Mean FEV1 values for SRILT and non-SRILT patients were 71.7% and 65.9% (P=.077). Under univariate analysis, risk of SRILT increased with MLD (P=.008), the absence of COPD (P=.047), and FEV1 (P=.077). Age (65 split) and MLD were significantly associated with SRILT in multivariate analysis. The addition of FEV1 and age with the MLD-based model slightly improved the predictability of SRILT (area under curve from 0.63-0.70, P=.088). Conclusions: Poor baseline PF does not increase the risk of SRILT, and combining FEV1, age, and MLD may improve the predictive ability.

  18. Automatic classication of pulmonary function in COPD patients using trachea analysis in chest CT scans

    NASA Astrophysics Data System (ADS)

    van Rikxoort, E. M.; de Jong, P. A.; Mets, O. M.; van Ginneken, B.

    2012-03-01

    Chronic Obstructive Pulmonary Disease (COPD) is a chronic lung disease that is characterized by airflow limitation. COPD is clinically diagnosed and monitored using pulmonary function testing (PFT), which measures global inspiration and expiration capabilities of patients and is time-consuming and labor-intensive. It is becoming standard practice to obtain paired inspiration-expiration CT scans of COPD patients. Predicting the PFT results from the CT scans would alleviate the need for PFT testing. It is hypothesized that the change of the trachea during breathing might be an indicator of tracheomalacia in COPD patients and correlate with COPD severity. In this paper, we propose to automatically measure morphological changes in the trachea from paired inspiration and expiration CT scans and investigate the influence on COPD GOLD stage classification. The trachea is automatically segmented and the trachea shape is encoded using the lengths of rays cast from the center of gravity of the trachea. These features are used in a classifier, combined with emphysema scoring, to attempt to classify subjects into their COPD stage. A database of 187 subjects, well distributed over the COPD GOLD stages 0 through 4 was used for this study. The data was randomly divided into training and test set. Using the training scans, a nearest mean classifier was trained to classify the subjects into their correct GOLD stage using either emphysema score, tracheal shape features, or a combination. Combining the proposed trachea shape features with emphysema score, the classification performance into GOLD stages improved with 11% to 51%. In addition, an 80% accuracy was achieved in distinguishing healthy subjects from COPD patients.

  19. Evaluation of early airway disease in smokers: cost effectiveness of pulmonary function testing.

    PubMed

    Loss, R W; Hall, W J; Speers, D M

    1979-01-01

    We studied 73 young adults who were presently cigarette smokers to evaluate whether the identification of abnormalities in pulmonary function tests had a detectable influence on modification of smoking habits. Utilizing rate schedules for these tests presently applicable in Rochester, New York, we determined the potential cost to these subjects and community relative to the number of subjects who stopped smoking as a result of test findings. Subjects were evaluated by questionnaire and function testing including spirometry, flow-volume curves, body plethysmography and single breath nitrogen washout test (SBN2). Functional abnormalities were present in 75% of subjects screened. The SBN2 test was most sensitive, identifying 97% of subjects with any abnormality. The presence of common respiratory symptoms was found to be highly predictive of test abnormalities. Subjects were informed of results and counseled. At six-month follow-up, 7% of subjects with abnormal test results had stopped smoking. Utilizing even our most cost-effective test, the SBN2, it would cost +1,392 for each "benefit" defined as one subject not smoking for six months. Application of these screening techniques is unlikely to be effective in altering smoking habits in the absence of continued physician support.

  20. Efficacy of Tiotropium Bromide and Rehabilitation Treatment on Pulmonary Function of Patients With Sulfur Mustard Lung Injury

    PubMed Central

    Shohrati, Majid; Jalili, Maryam; Afshar, Homa; Najafian, Bita; Qazvini, Ali; Zaeri, Meysam; Amini Harandi, Ali; Ghanei, Mostafa

    2015-01-01

    Background: Chronic pulmonary complication is the most common delayed toxic effect of sulfur mustard (SM) and it has no treatment so far. Objectives: To evaluate short-term therapeutic effects of inhaled tiotropium bromide and pulmonary rehabilitation on pulmonary function of patients with SM induced lung injury. Patients and Methods: In a randomized clinical trial, using convenient sampling method, 54 patients with chronic lung disease due to SM exposure were recruited in Baqiyatallah General Hospital, Tehran, Iran for a period of 2-month study. They were randomly divided into 3 groups of 18 participants each. Group 1 received routine drugs (Serevent, Flixotide), pulmonary rehabilitation 30 minutes/2 times a week, and tiotropium bromide 18 µg/day. Group 2 was treated with routine drugs and pulmonary rehabilitation and group 3 was only on the routine drugs. cardiopulmonary exercise test (CPET), plethysmographic measurements, and respiratory symptoms evaluation were performed before and after medical intervention. Results: In group 1, compared to group 3, significant differences were found with regard to symptoms of cough ([difference between the first and last visit in group 1: Diff 1] = -1.6, Diff 3 = -0.3, P = 0.01) and nocturnal dyspnea (Diff 1 = -1.9, Diff 3 = 0.0, P = 0.01), likewise, compared to group 2, significant differences were found with regard to lung function parameters of forced vital capacity (Diff 1 = 3.0, Diff 2 = -3.5, P = 0.03), forced expiratory volume in one second (Diff 1 = 3.9, Diff 2 = -5.6, P = 0.009), maximal mid-expiratory flow rate 25% - 75% (Diff 1 = 1.5, Diff 2 = -3.2, P = 0.007) and peak expiratory flow (Diff 1 = -2.06, Diff 2 = -4.3, P = 0.04). Total lung capacity (Diff 2 = 9.28, Diff 3 = -12.07, P = 0.02) and residual volume (Diff2 = 32.1, Diff3 = -27.6, P = 0.04) were increased in group 2 compared to group 3. There were no significant differences with regard to CPET results among all groups (P > 0.05). Conclusions: Inhalation of

  1. Nitric oxide synthase polymorphisms, gene expression and lung function in chronic obstructive pulmonary disease

    PubMed Central

    2013-01-01

    Background Due to the pleiotropic effects of nitric oxide (NO) within the lungs, it is likely that NO is a significant factor in the pathogenesis of chronic obstructive pulmonary disease (COPD). The aim of this study was to test for association between single nucleotide polymorphisms (SNPs) in three NO synthase (NOS) genes and lung function, as well as to examine gene expression and protein levels in relation to the genetic variation. Methods One SNP in each NOS gene (neuronal NOS (NOS1), inducible NOS (NOS2), and endothelial NOS (NOS3)) was genotyped in the Lung Health Study (LHS) and correlated with lung function. One SNP (rs1800779) was also analyzed for association with COPD and lung function in four COPD case–control populations. Lung tissue expression of NOS3 mRNA and protein was tested in individuals of known genotype for rs1800779. Immunohistochemistry of lung tissue was used to localize NOS3 expression. Results For the NOS3 rs1800779 SNP, the baseline forced expiratory volume in one second in the LHS was significantly higher in the combined AG + GG genotypic groups compared with the AA genotypic group. Gene expression and protein levels in lung tissue were significantly lower in subjects with the AG + GG genotypes than in AA subjects. NOS3 protein was expressed in the airway epithelium and subjects with the AA genotype demonstrated higher NOS3 expression compared with AG and GG individuals. However, we were not able to replicate the associations with COPD or lung function in the other COPD study groups. Conclusions Variants in the NOS genes were not associated with lung function or COPD status. However, the G allele of rs1800779 resulted in a decrease of NOS3 gene expression and protein levels and this has implications for the numerous disease states that have been associated with this polymorphism. PMID:24192154

  2. Pulmonary function in workers exposed to diesel exhausts: The effect of control measures

    SciTech Connect

    Ulfvarson, U.; Alexandersson, R.; Dahlqvist, M.; Ekholm, U.; Bergstroem, B. )

    1991-01-01

    To assess the protective effect of exhausts pipe filters or respirators on pulmonary function, 15 workers in a tunnel construction site, truck and loading machine drivers, rock workers, and others were studied. The total and respirable dust, combustible matter in respirable dust, carbon monoxide, nitrogen monoxide and nitrogen dioxide were measured for each subject during entire work shifts. The effect of the exposure on the lung function variables was measured by dynamic spirometry, carbon monoxide single breath technique, and nitrogen single breath wash-out. The exhaust pipe filtering had a protective effect, directly discernible in the drivers on vital capacity and FEV1.0 and for the whole group on FEV% and TLco. The dust respirators had no effect, probably because of the difficulties in correctly using personal protection under the circumstances in the tunnel. In the absence of a true exposure assessment, control measures for diesel exhausts can be tested by medical effect studies. Catalytic particle filters of diesel exhausts are one method of rendering the emissions less irritant, although they will not remove irritant gases. An indicator of diesel exhaust exposure should include the particle fraction of the diesel exhausts, but a discrimination between different sources of organic dust must be possible.

  3. Duration of increased pulmonary function sensitivity to an initial ozone exposure

    SciTech Connect

    Bedi, J.F.; Drechsler-Parks, D.M.; Horvath, S.M.

    1985-12-01

    The metabolic and pulmonary function effects were investigated in six non-smoking young adults who were exposed for 2 hours (22 degrees C WBGT) to: filtered air (FA) 0.45 ppm ozone (DAY1); and two days later to a second exposure to 0.45 ppm ozone (DAY2). The subjects alternated 20-minute periods of rest and 20-minute periods of bicycle ergometer exercise at a workload predetermined to elicit a ventilatory minute volume (VE) of 27 L/min (BTPS). Functional residual capacity (FRC) was determined pre- and post-exposure. Forced vital capacity (FVC) was determined before and after exposure, as well as 5 minutes after each exercise period. Heart rate was monitored throughout the exposure, and VE, oxygen uptake (VO2), respiratory rate (fR), and tidal volume (VT) were measured during the last 2 minutes of each exercise period. There were no changes in any variable consequent to FA exposure. Both ozone exposures induced significant (P less than 0.05) decrements in FVC; FEV1.0 (forced expiratory volume in 1 second); FEV3.0 (forced expiratory volume in 3 seconds); FEF25-75% (average flow rate between 25% and 75% of FVC); and total lung capacity (TLC). The decrements following the DAY2 ozone exposure were significantly greater than following DAY1, and averaged 7.2 percentage points greater than those following the DAY1 exposure.

  4. Evaluation of pulmonary function and respiratory symptoms in pyrochlore mine workers

    PubMed Central

    Borges, Ritta de Cássia Canedo Oliveira; Barros, José Cerqueira; Oliveira, Fabrício Borges; Brunherotti, Marisa Andrade; Quemelo, Paulo Roberto Veiga

    2016-01-01

    ABSTRACT Objective: To identify respiratory symptoms and evaluate lung function in mine workers. Methods: This was a cross-sectional observational study involving production sector workers of a pyrochlore mining company. The subjects completed the British Medical Research Council questionnaire, which is designed to evaluate respiratory symptoms, occupational exposure factors, and smoking status. In addition, they underwent pulmonary function tests with a portable spirometer. Results: The study involved 147 workers (all male). The mean age was 41.37 ± 8.71 years, and the mean duration of occupational exposure was 12.26 ± 7.09 years. We found that 33 (22.44%) of the workers had respiratory symptoms and that 26 (17.69%) showed abnormalities in the spirometry results. However, we found that the spirometry results did not correlate significantly with the presence of respiratory symptoms or with the duration of occupational exposure. Conclusions: The frequencies of respiratory symptoms and spirometric changes were low when compared with those reported in other studies involving occupational exposure to dust. No significant associations were observed between respiratory symptoms and spirometry results.

  5. In utero and postnatal exposure to arsenic alters pulmonary structure and function

    SciTech Connect

    Lantz, R. Clark Chau, Binh; Sarihan, Priyanka; Witten, Mark L.; Pivniouk, Vadim I.; Chen, Guan Jie

    2009-02-15

    In addition to cancer endpoints, arsenic exposures can also lead to non-cancerous chronic lung disease. Exposures during sensitive developmental time points can contribute to the adult disease. Using a mouse model, in utero and early postnatal exposures to arsenic (100 ppb or less in drinking water) were found to alter airway reactivity to methacholine challenge in 28 day old pups. Removal of mice from arsenic exposure 28 days after birth did not reverse the alterations in sensitivity to methacholine. In addition, adult mice exposed to similar levels of arsenic in drinking water did not show alterations. Therefore, alterations in airway reactivity were irreversible and specific to exposures during lung development. These functional changes correlated with protein and gene expression changes as well as morphological structural changes around the airways. Arsenic increased the whole lung levels of smooth muscle actin in a dose dependent manner. The level of smooth muscle mass around airways was increased with arsenic exposure, especially around airways smaller than 100 {mu}m in diameter. This increase in smooth muscle was associated with alterations in extracellular matrix (collagen, elastin) expression. This model system demonstrates that in utero and postnatal exposure to environmentally relevant levels of arsenic can irreversibly alter pulmonary structure and function in the adults.

  6. [Pulmonary function results in healthy subjects breathing through external stenoses compared to patients with airway obstruction].

    PubMed

    Schäfer, Thorsten; Schätt, Dieter; Schläfke, Marianne E; Ulmer, Wolfgang T

    2004-01-01

    We compared body plethysmographic data, flow-volume curves during spontaneous breathing, P0.1 and PETCO2 in healthy subjects breathing through external stenoses (ES) of varying magnitude to the results in patients suffering from chronic obstructive pulmonary disease (COPD). Inspiratory vital capacity (IVC) remained unchanged by experimental airway stenoses. IVC is mainly determined by the end-expiratory closure of the airways, which only weakly correlates with airway resistance in patients. External stenoses had no effect on the physiological end-expiratory closure of the airways. For the other spirometric parameters the available force of the respiratory muscles and the degree of the experimental stenosis played the major role. The mouth occlusion pressure (P0.1) showed considerably lower variation during ES as well as in COPD patients than total resistance (Rt). There was no increase in intrathoracic gas volume (IGV) causing increased tension of the lungs and the thorax during ES. The well-known correlation between Rt and IGV is attributed to the end-expiratory closure of the airways during increased flow resistance and to "trapped air". It remains open, if and how the expiratory muscles act to overcome the increased resistance. With consideration of the underlying factors of the different lung function measures, the combination and the analysis of the correlation between different values may lead to far-reaching results in lung function testing. PMID:15518089

  7. Pulmonary function one and four years after a deep saturation dive.

    PubMed

    Thorsen, E; Segadal, K; Kambestad, B K; Gulsvik, A

    1993-04-01

    The pulmonary function of 24 Norwegian divers who had participated in a deep saturation dive to pressures of 3.1-4.6 MPa was reevaluated one and four years later. Twenty-eight divers performing ordinary saturation diving to pressures of 0.8-1.6 MPa and followed over a three-year period served as referents. A significant reduction in forced expiratory volume in 1 s (FEV1.0) of 210 (SD 84) ml (P < 0.001) occurred the first year after the dive. Thereafter the annual reduction in FEV1.0 was 28 (SD 62) ml.year-1; this value did not differ from the 35 (SD 80) ml.year-1 of the referents. The forced midexpiratory flow rate and forced expiratory flow rates at low lung volumes were also significantly reduced one year after the deep dive, and the closing volume was increased. No significant changes occurred in forced vital capacity. The results agree with those of cross-sectional studies on divers' lung function and indicate the development of airflow limitation in relation to diving exposure.

  8. Pulmonary function, respiratory symptoms, and dust exposures among workers engaged in early manufacturing processes of tea: a cohort study

    PubMed Central

    2012-01-01

    Background To evaluate pulmonary function and respiratory symptoms in workers engaged in the early manufacturing processes of tea and to identify the associated factors, we conducted a study in a tea production area in Taiwan. Methods We recruited tea workers who engaged in the early manufacturing process in the Mountain Ali area in Taiwan and a comparison group of local office workers who were matched for age, gender, and smoking habits. We performed questionnaire interviews, pulmonary function tests, skin prick tests, and measurement of specific IgE for tea on the participants and assessed tea dust exposures in the tea factories. Results The 91 participating tea workers had higher prevalence of respiratory symptoms than the comparison group (32 participants). Among tea workers, ball-rolling workers had the highest prevalence of symptoms and the highest exposures of inhalable dusts. At baseline, tea workers had similar pulmonary functions as the comparison group, but compared to the other tea workers ball-rolling workers had a lower ratio of the 1-second forced expiratory volume to forced vital capacity (FEV1/FVC) and a lower maximal mid-expiratory flow rate expressed as% of the predicted value--MMF (%pred). A total of 58 tea workers participated in the on-site investigation and the cross-shift lung function measurements. We found ball-rolling yielded the highest inhalable dust level, panning yielded the highest respirable dust level, and withering yielded the lowest levels of both dusts. Ball-rolling also yielded the highest coarse fraction (defined as inhalable dusts minus respirable dusts), which represented exposures from nose to tracheobronchial tract. During the shift, we observed significant declines in pulmonary function, especially in ball-rolling workers. Multiple regressions showed that age, height, work tasks, coarse fraction, and number of months working in tea manufacturing each year were independent predictors of certain pulmonary function

  9. Loss- and Gain-of-Function Approaches Indicate a Dual Role Exerted by Regulatory T Cells in Pulmonary Paracoccidioidomycosis

    PubMed Central

    Bazan, Silvia B.; Costa, Tania A.; de Araújo, Eliseu Frank; Feriotti, Claudia; Loures, Flávio V.; Pretel, Fernando D.; Calich, Vera L. G.

    2015-01-01

    Paracoccidioidomycosis (PCM), is a pulmonary fungal disease whose severity depends on the adequate development of T cell immunity. Although regulatory T (Treg) cells were shown to control immunity against PCM, deleterious or protective effects were described in different experimental settings. To clarify the function of Treg cells in pulmonary PCM, loss-and gain-of-function approaches were performed with Foxp3GFP knock-in mice and immunodeficient Rag1-/- mice, respectively, which were intratracheally infected with 106 yeast cells. The activity of Foxp3-expressing Treg cells in pulmonary PCM was determined in Foxp3GFP transgenic mice. First, it was verified that natural Treg cells migrate to the lungs of infected mice, where they become activated. Depletion of Treg cells led to reduced fungal load, diminished pathogen dissemination and increased Th1/Th2/Th17 immunity. Further, adoptive transfer of diverse T cell subsets to Rag1-/- mice subsequently infected by the pulmonary route demonstrated that isolated CD4+Foxp3+ Treg cells were able to confer some degree of immunoprotection and that CD4+Foxp3- T cells alone reduced fungal growth and enhanced T cell immunity, but induced vigorous inflammatory reactions in the lungs. Nevertheless, transfer of Treg cells combined with CD4+Foxp3- T cells generated more efficient and balanced immune Th1/Th2/Th17 responses able to limit pathogen growth and excessive tissue inflammation, leading to regressive disease and increased survival rates. Altogether, these loss- and gain-of-function approaches allow us to clearly demonstrate the dual role of Treg cells in pulmonary PCM, their deleterious effects by impairing T cell immunity and pathogen eradication, and their protective role by suppressing exacerbated tissue inflammation. PMID:26512987

  10. Preoperative saline-filled computed tomography thoracography for awake video-assisted thoracic surgery: report of three cases.

    PubMed

    Watanabe, Tatsuaki; Noda, Masafumi; Okazaki, Toshimasa; Tsukidate, Hisakatsu; Sato, Kota; Notsuda, Hirotsugu; Niikawa, Hiromichi; Okada, Yoshinori; Matsumura, Yuji; Kondo, Takashi

    2015-12-01

    Awake video-assisted thoracic surgery (VATS) is a therapeutic option for patients with intractable secondary spontaneous pneumothorax (SSP) complicated by impaired pulmonary function. The preoperative identification of air leak points is one of the keys to the success of this procedure. We describe how we performed saline-filled computed tomography (CT) thoracography to detect pleural fistulae in three patients with intractable SSP. Saline-filled CT thoracography showed bubble signs in two patients and an air-water level in bulla in one patient. The preoperative identification of air leak points resulted in successful awake VATS for all three patients. Our experience demonstrates that saline-filled CT thoracography is a useful diagnostic tool for SSP, especially when used in preparation for awake VATS when minimally invasive procedures are desirable. PMID:26070908

  11. Should Tricuspid Annuloplasty be Performed With Pulmonary Valve Replacement for Pulmonary Regurgitation in Repaired Tetralogy of Fallot?

    PubMed

    Kurkluoglu, Mustafa; John, Anitha S; Cross, Russell; Chung, David; Yerebakan, Can; Zurakowski, David; Jonas, Richard A; Sinha, Pranava

    2015-01-01

    Indications for prophylactic tricuspid annuloplasty in patients with pulmonary regurgitation (PR) after tetralogy of Fallot (TOF) repair are unclear and often extrapolated from acquired functional tricuspid regurgitation (TR) data in adults, where despite correction of primary left heart pathology, progressive tricuspid annular dilation is noted beyond a threshold diameter >4 cm (21 mm/m(2)). We hypothesized that unlike in adult functional TR, in pure volume-overload conditions such as patients with PR after TOF, the tricuspid valve size is likely to regress after pulmonary valve replacement (PVR). A total of 43 consecutive patients who underwent PVR from 2005 until 2012 at a single institution were retrospectively reviewed. Absolute and indexed tricuspid annulus diameters (TADs), tricuspid annulus Z-scores, grade of TR along with right ventricular size, and function indices were recorded before and after PVR. Preoperative and postoperative echocardiographic data were available in all patients. A higher tricuspid valve Z-score correlated with greater TR both preoperatively (P = 0.005) and postoperatively (P = 0.02). Overall reductions in the absolute and indexed TAD and tricuspid valve Z-scores were seen postoperatively, with greater absolute as well as percentage reduction seen with larger preoperative TAD index (P = 0.007) and higher tricuspid annulus Z-scores (P = 0.06). In pure volume-overload conditions such as patients with PR after TOF, reduction in the tricuspid valve size is seen after PVR. Concomitant tricuspid annuloplasty should not be considered based on tricuspid annular dilation alone. PMID:26686442

  12. Functional improvement in patients with idiopathic pulmonary fibrosis undergoing single lung transplantation *

    PubMed Central

    Rubin, Adalberto Sperb; Nascimento, Douglas Zaione; Sanchez, Letícia; Watte, Guilherme; Holand, Arthur Rodrigo Ronconi; Fassbind, Derrick Alexandre; Camargo, José Jesus

    2015-01-01

    Abstract Objective: To evaluate the changes in lung function in the first year after single lung transplantation in patients with idiopathic pulmonary fibrosis (IPF). Methods: We retrospectively evaluated patients with IPF who underwent single lung transplantation between January of 2006 and December of 2012, reviewing the changes in the lung function occurring during the first year after the procedure. Results: Of the 218 patients undergoing lung transplantation during the study period, 79 (36.2%) had IPF. Of those 79 patients, 24 (30%) died, and 11 (14%) did not undergo spirometry at the end of the first year. Of the 44 patients included in the study, 29 (66%) were men. The mean age of the patients was 57 years. Before transplantation, mean FVC, FEV1, and FEV1/FVC ratio were 1.78 L (50% of predicted), 1.48 L (52% of predicted), and 83%, respectively. In the first month after transplantation, there was a mean increase of 12% in FVC (400 mL) and FEV1 (350 mL). In the third month after transplantation, there were additional increases, of 5% (170 mL) in FVC and 1% (50 mL) in FEV1. At the end of the first year, the functional improvement persisted, with a mean gain of 19% (620 mL) in FVC and 16% (430 mL) in FEV1. Conclusions: Single lung transplantation in IPF patients who survive for at least one year provides significant and progressive benefits in lung function during the first year. This procedure is an important therapeutic alternative in the management of IPF. PMID:26398749

  13. Brazilian studies on pulmonary function in COPD patients: what are the gaps?

    PubMed Central

    Lopes, Agnaldo José; de Melo, Pedro Lopes

    2016-01-01

    Background COPD is a major cause of death and morbidity worldwide, and is characterized by persistent airflow obstruction. The evaluation of obstruction is critically dependent on sensitive methods for lung-function testing. A wide body of knowledge has been accumulated in recent years showing that these methods have been significantly refined and seems promising for detection of early disease. Objectives This review focuses on research on pulmonary function analysis in COPD performed in Brazil during this century. Materials and methods The literature was searched using a systematic search strategy limited to English language studies that were carried out in Brazil from the year 2000 onward, with study objectives that included a focus on lung function. Results After we applied our inclusion and exclusion criteria, 94 articles addressed our stated objectives. Among the new methods reviewed are the forced-oscillation technique and the nitrogen-washout test, which may provide information on small-airway abnormalities. Studies investigating the respiratory muscles and thoracoabdominal motion are also discussed, as well as studies on automatic clinical decision-support systems and complexity measurements. We also examined important gaps in the present knowledge and suggested future directions for the cited research fields. Conclusion There is clear evidence that improvements in lung-function methods allowed us to obtain new pathophysiological information, contributing to improvement in our understanding of COPD. In addition, they may also assist in the diagnosis and prevention of COPD. Further investigations using prospective and longitudinal design may be of interest to elucidate the use of these new methods in the diagnosis and prevention of COPD. PMID:27468230

  14. Longitudinal effects of passive smoking on pulmonary function in New Zealand children.

    PubMed

    Sherrill, D L; Martinez, F D; Lebowitz, M D; Holdaway, M D; Flannery, E M; Herbison, G P; Stanton, W R; Silva, P A; Sears, M R

    1992-05-01

    In this study we examined the longitudinal effects of smoke exposure on lung function in a cohort of New Zealand children observed from 9 to 15 yr of age. Possible exposures included in utero exposure from mothers smoking during pregnancy, passive smoke from parents, and active smoking by the children. Lung function measures of forced expiratory volume in one second (FEV1) and vital capacity (VC) were measured biennially and ratios (FEV1/VC) were computed. The data were analyzed using longitudinal methodology, and all subjects with at least one pulmonary function test and responses to the questions concerning smoke exposures were included (n = 634). Subjects reporting wheeze or asthma were examined as a separate subgroup. In the whole cohort, no significant detrimental effects were detected for absolute FEV1 or VC in either sex, related to active or passive smoke exposures. Parental smoking was, however, associated with persistent but mild and nonprogressive impairment of the FEV1/VC ratio in males, an effect that was present at the time lung function measurements were first made. This effect was not seen in females. In children with reported wheeze or asthma, parental smoking had progressive, more serious, and clinically significant effects on the FEV1/VC ratio among adolescents of both sexes, causing a mean reduction in FEV1/VC ratios by age 15 of 3.9% in males and 2.3% in females, in contrast to the observed increase in FEV1/VC ratios with age seen in nonexposed wheezing children. We conclude that passive smoking is a major contributing factor to the development and persistence of airflow limitation in wheezing children.

  15. Pulmonary Function after Treatment for Embryonal Brain Tumors on SJMB03 that Included Craniospinal Irradiation

    PubMed Central

    Green, Daniel M.; Merchant, Thomas E.; Billups, Catherine A.; Stokes, Dennis C.; Broniscer, Alberto; Bartels, Ute; Chintagumpala, Murali; Hassall, Timothy E.; Gururangan, Sridharan; McCowage, Geoffrey B.; Heath, John A.; Cohn, Richard J.; Fisher, Michael J.; Srinivasan, Ashok; Robinson, Giles W.; Gajjar, Amar

    2015-01-01

    Purpose Treatment of children with embryonal brain tumors (EBT) includes craniospinal irradiation (CSI). There are limited data regarding the effect of CSI on pulmonary function. Methods Protocol XXXXX enrolled patients 3 to 21 years of age with EBT. Pulmonary function tests (PFTs) [forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) by spirometry, total lung capacity (TLC) by nitrogen washout or plethysmography and diffusing capacity of the lung for carbon monoxide corrected for hemoglobin (DLCOcorr)] were obtained. Differences between PFTs obtained immediately after the completion of CSI and 24 or 60 months after completion of treatment (ACT) were compared using exact Wilcoxon signed rank tests and repeated measures models. Results 303 eligible patients (spine dose: ≤ 2345 cGy- 201; > 2345 cGy-102; proton beam, 20) were enrolled between June 24, 2003 and March 1, 2010, 260 of whom had at least one PFT. The median age at diagnosis was 8.9 years (range, 3.1–20.4 years). The median thoracic spinal RT dose was 23.4 Gy (Inter Quartile Range (IQR), 23.4–36.0 Gy). The median cyclophosphamide dose was 16.0 g/m2 (IQR, 15.7–16.0 g/m2). 24 and 60 months ACT, DLCOcorr was <75% predicted in 23% (27/118) and 25% (21/84), FEV1 <80% predicted in 20% (34/170) and 29% (32/109), FVC < 80% predicted in 27% (46/172) and 28% (30/108) and TLC <75% predicted in 9% (13/138) and 11% (10/92) of patients. DLCOcorr was significantly decreased 24 (median difference (MD) in % predicted, − 3.00%; p=0.028) and 60 months ACT (MD in % predicted, − 6.00%; p=0.033) compared to the end of RT. These significant decreases in DLCOcorr were also observed in repeated measures models (p=0.011 and p=0.032 at 24 and 60 months ACT, respectively). Conclusions A significant minority of EBT survivors experience PFT deficits following CSI. Continued monitoring of this cohort is planned. PMID:26279023

  16. Pulmonary Function After Treatment for Embryonal Brain Tumors on SJMB03 That Included Craniospinal Irradiation

    SciTech Connect

    Green, Daniel M.; Merchant, Thomas E.; Billups, Catherine A.; Stokes, Dennis C.; Broniscer, Alberto; Bartels, Ute; Chintagumpala, Murali; Hassall, Timothy E.; Gururangan, Sridharan; McCowage, Geoffrey B.; Heath, John A.; Cohn, Richard J.; Fisher, Michael J.; Srinivasan, Ashok; Robinson, Giles W.; Gajjar, Amar

    2015-09-01

    Purpose: The treatment of children with embryonal brain tumors (EBT) includes craniospinal irradiation (CSI). There are limited data regarding the effect of CSI on pulmonary function. Methods: Protocol SJMB03 enrolled patients 3 to 21 years of age with EBT. Pulmonary function tests (PFTs) (forced expiratory volume in 1 second [FEV{sub 1}] and forced vital capacity [FVC] by spirometry, total lung capacity [TLC] by nitrogen washout or plethysmography, and diffusing capacity of the lung for carbon monoxide corrected for hemoglobin [DLCO{sub corr}]) were obtained. Differences between PFTs obtained immediately after the completion of CSI and 24 or 60 months after the completion of treatment (ACT) were compared using exact Wilcoxon signed-rank tests and repeated-measures models. Results: Between June 24, 2003, and March 1, 2010, 303 eligible patients (spine dose: ≤2345 cGy, 201; >2345 cGy, 102; proton beam, 20) were enrolled, 260 of whom had at least 1 PFT. The median age at diagnosis was 8.9 years (range, 3.1-20.4 years). The median thoracic spinal radiation dose was 23.4 Gy (interquartile range [IQR], 23.4-36.0 Gy). The median cyclophosphamide dose was 16.0 g/m{sup 2} (IQR, 15.7-16.0 g/m{sup 2}). At 24 and 60 months ACT, DLCO{sub corr} was <75% predicted in 23% (27/118) and 25% (21/84) of patients, FEV{sub 1} was <80% predicted in 20% (34/170) and 29% (32/109) of patients, FVC was <80% predicted in 27% (46/172) and 28% (30/108) of patients, and TLC was <75% predicted in 9% (13/138) and 11% (10/92) of patients. DLCO{sub corr} was significantly decreased 24 months ACT (median difference [MD] in % predicted, 3.00%; P=.028) and 60 months ACT (MD in % predicted, 6.00%; P=.033) compared with the end of radiation therapy. These significant decreases in DLCO{sub corr} were also observed in repeated-measures models (P=.011 and P=.032 at 24 and 60 months ACT, respectively). Conclusions: A significant minority of EBT survivors experience PFT deficits after CSI

  17. Age, period, and cohort effects on pulmonary function in a 24-year longitudinal study.

    PubMed

    Xu, X; Laird, N; Dockery, D W; Schouten, J P; Rijcken, B; Weiss, S T

    1995-03-15

    This paper proposes the use of two-factor models (age-period and age-cohort models) to estimate age, period, and cohort effects on pulmonary function by using the data collected in a 24-year longitudinal study in the Netherlands from 1965 to 1990. The analysis included 18,363 pulmonary function measurements on 6,148 subjects aged 20-54 years at the initial visit. The subjects were grouped into four birth cohorts (before 1923, 1923-1934, 1935-1946, and after 1946) and four survey periods (1965-1972, 1973-1978, 1979-1984, and 1985-1990). In the age-cohort model, the decrement in forced expiratory volume in 1 second (FEV1) associated with a yearly increase in age was 28.3 +/- 3.7 ml/year for a man 176 cm tall and 16.0 +/- 1.9 ml/year for a woman 163 cm tall. The estimated acceleration of decline with aging was significant for both men (beta = -0.212; standard error = 0.079 ml) and women (beta = -0.346; standard error = 0.058 ml). Compared with that of the cohort born before 1923, the average level of FEV1 was estimated to increase by 156, 277, and 379 ml, respectively, for the three younger cohorts in men (p = 0.01) and by 133, 213, and 328 ml for the three younger cohorts in women (p < 0.01). In the age-period model, the estimated linear age effect on FEV1 was 36.2 +/- 4.2 ml/year for a man and 30.5 +/- 2.3 ml/year for a woman. The age quadratic term was significant for women, but not for men. Average FEV1 was estimated to be increased by 141, 169, and 250 ml, respectively, for the periods 1973-1978, 1979-1984, and 1985-1990 in men and by 131, 138, and 219 ml in women. These period effects were significant for both men and women. In summary, this study applied the two-factor models to estimate cross-sectional and longitudinal effects of aging on FEV1 and demonstrated significant period and cohort effects, which could be attributed in part to changes in air pollutants, respiratory infections, vaccinations, types of cigarettes, diet, and lifestyles over time.

  18. Changes in pulmonary function after incidental lung irradiation for breast cancer: A prospective study

    SciTech Connect

    Jaen, Javier . E-mail: javier.jaen.sspa@juntadeandalucia.es; Vazquez, Gonzalo; Alonso, Enrique; Leon, Antonio; Guerrero, Rafael; Almansa, Julio F.

    2006-08-01

    Purpose: The aim of this study was to analyze changes in pulmonary function after radiation therapy (RT) for breast cancer. Methods and Materials: A total of 39 consecutive eligible women, who underwent postoperative irradiation for breast cancer, were entered in the study. Spirometry consisting of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV{sub 1}), carbon monoxide diffusing capacity (DLCO), and gammagraphic (ventilation and perfusion) pulmonary function tests (PFT) were performed before RT and 6, 12, and 36 months afterwards. Dose-volume and perfusion-weighted parameters were obtained from 3D dose planning: Percentage of lung volume receiving more than a threshold dose (V{sub i}) and between 2 dose levels (V{sub (i-j)}). The impact of clinical and dosimetric parameters on PFT changes ({delta}PFT) after RT was evaluated by Pearson correlation coefficients and stepwise lineal regression analysis. Results: No significant differences on mean PFT basal values (before RT) with respect to age, smoking, or previous chemotherapy (CT) were found. All the PFT decreased at 6 to 12 months. Furthermore FVC, FEV{sub 1}, and ventilation recovered almost to their previous values, whereas DLCO and perfusion continued to decrease until 36 months (-3.3% and -6.6%, respectively). Perfusion-weighted and interval-scaled dose-volume parameters (pV{sub (i-j)}) showed better correlation with {delta}PFT (only {delta}perfusion reached statistically significance at 36 months). Multivariate analysis showed a significant relation between pV{sub (10-20)} and {delta}perfusion at 3 years, with a multiple correlation coefficient of 0.48. There were no significant differences related to age, previous chemotherapy, concurrent tamoxifen and smoking, although a tendency toward more perfusion reduction in older and nonsmoker patients was seen. Conclusions: Changes in FVC, FEV{sub 1} and ventilation were reversible, but not the perfusion and DLCO. We have not found a conclusive

  19. [Birth weight as a factor determining lung function among healthy persons and its relation with chronic pulmonary disease].

    PubMed

    Ichnowski, Jerzy; Lindner, Karolina; Pawłowicz, Robert; Panaszek, Bernard

    2012-01-01

    Low lung function is associated with increased risk of morbidity and mortality in the population. Lung development seems to be important factor in pathogenesis of respiratory disorders. Airway development is a complex process. Birth weight (BW) is one of perinatal factors which influences development of pulmonary system and multiorgan function of the body. Aforementioned relationships are visible especially at first years of life. However, not very many studies have examined the associations between birth weight and lung function in later age then childhood and adolescence. The aim of this review is to discuss relationships between BW and lung function parameters in healthy individuals and patients with lung disease in childhood and adulthood.

  20. Intralobar pulmonary sequestration and mediastinal bronchogenic cyst.

    PubMed Central

    Grewal, R. G.; Yip, C. K.

    1994-01-01

    A patient with a bronchogenic cyst and intralobar pulmonary sequestration is presented. Chest radiography showed a posterior mediastinal mass and a computed tomographic scan of the chest revealed, in addition, an abnormality suggestive of pulmonary sequestration. This was confirmed by an aortogram. It is important to be aware of the coexistence of these anomalies to make a diagnosis preoperatively. Images PMID:8016803

  1. The Prognostic Importance of Patient Pre-Operative Expectations of Surgery for Lumbar Spinal Stenosis.

    ERIC Educational Resources Information Center

    Iversen, Maura D.; Daltroy, Lawren H.; Fossel, Anne H.; Katz, Jeffrey N.

    1998-01-01

    Examines patients (N=257) with lumbar spinal stenosis preoperatively and at six months to relate patient expectation to baseline function and pain and to determine how patient expectations and preoperative function interact to predict postoperative outcomes. Results show that patients with many preoperative expectations, particularly those with…

  2. Functional connectivity and information flow of the respiratory neural network in chronic obstructive pulmonary disease

    PubMed Central

    Yu, Lianchun; De Mazancourt, Marine; Hess, Agathe; Ashadi, Fakhrul R.; Klein, Isabelle; Mal, Hervé; Courbage, Maurice

    2016-01-01

    Abstract Breathing involves a complex interplay between the brainstem automatic network and cortical voluntary command. How these brain regions communicate at rest or during inspiratory loading is unknown. This issue is crucial for several reasons: (i) increased respiratory loading is a major feature of several respiratory diseases, (ii) failure of the voluntary motor and cortical sensory processing drives is among the mechanisms that precede acute respiratory failure, (iii) several cerebral structures involved in responding to inspiratory loading participate in the perception of dyspnea, a distressing symptom in many disease. We studied functional connectivity and Granger causality of the respiratory network in controls and patients with chronic obstructive pulmonary disease (COPD), at rest and during inspiratory loading. Compared with those of controls, the motor cortex area of patients exhibited decreased connectivity with their contralateral counterparts and no connectivity with the brainstem. In the patients, the information flow was reversed at rest with the source of the network shifted from the medulla towards the motor cortex. During inspiratory loading, the system was overwhelmed and the motor cortex became the sink of the network. This major finding may help to understand why some patients with COPD are prone to acute respiratory failure. Network connectivity and causality were related to lung function and illness severity. We validated our connectivity and causality results with a mathematical model of neural network. Our findings suggest a new therapeutic strategy involving the modulation of brain activity to increase motor cortex functional connectivity and improve respiratory muscles performance in patients. Hum Brain Mapp 37:2736–2754, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. PMID:27059277

  3. [A case of pulmonary tuberculosis with diminished lung function whose paradoxical reaction led to death].

    PubMed

    Omura, Harutaka; Kajiki, Akira; Nagata, Nobuhiko; Kitahara, Yoshinari; Wakamatsu, Kentarou; Minami, Takahiro; Taguchi, Kazuhito; Katahira, Katsuyuki

    2011-05-01

    Paradoxical reaction in tuberculosis treatment is not generally fatal. On rare occasion it can lead a patient with diminished lung function and poor general condition to death. A 60-year-old man with history of left upper lobe resection from tuberculosis was referred to our hospital due to the recurrence of tuberculosis. Sputum examination showed a positive smear with a Gaffky score of 10, and the chest X-ray and CT revealed pulmonary infiltrate with many cavities (bII2) on the whole left lung field. Anti-tuberculosis drugs (isoniazid, rifampicin, ethambutol and pyrazinamide) were administered, but his high fever persisted, and the infiltrate on the chest X-ray deteriorated. While the positive sputum smear persisted, the culture became negative after one month. The tuberculous bacilli were susceptible to all anti-tuberculosis drugs in vitro. Though we performed examinations and trial treatments for non-tuberculous conditions such as pneumonia and drug-induced pneumonia, the patient died after 6 months. A necropsy specimen taken from the worsening lesion (the right upper lobe) as shown on the chest X-ray revealed many epithelioid granulomas. The patient had malnutrition, diabetes, alcoholic hepatic disorder, and insanity. It is supposed that although antituberculosis drugs were effective, a large quantity of killed organisms was continuously excreted from many cavities in the left lung toward the right lung. Lesions in the right lung thus newly produced in this paradoxical reaction seemed to reduce the remaining lung function. In addition, poorly controlled diabetes caused deteriorated heart function. These multiple factors contributed to the poor prognosis of the patient and his ultimate death.

  4. Functional connectivity and information flow of the respiratory neural network in chronic obstructive pulmonary disease.

    PubMed

    Yu, Lianchun; De Mazancourt, Marine; Hess, Agathe; Ashadi, Fakhrul R; Klein, Isabelle; Mal, Hervé; Courbage, Maurice; Mangin, Laurence

    2016-08-01

    Breathing involves a complex interplay between the brainstem automatic network and cortical voluntary command. How these brain regions communicate at rest or during inspiratory loading is unknown. This issue is crucial for several reasons: (i) increased respiratory loading is a major feature of several respiratory diseases, (ii) failure of the voluntary motor and cortical sensory processing drives is among the mechanisms that precede acute respiratory failure, (iii) several cerebral structures involved in responding to inspiratory loading participate in the perception of dyspnea, a distressing symptom in many disease. We studied functional connectivity and Granger causality of the respiratory network in controls and patients with chronic obstructive pulmonary disease (COPD), at rest and during inspiratory loading. Compared with those of controls, the motor cortex area of patients exhibited decreased connectivity with their contralateral counterparts and no connectivity with the brainstem. In the patients, the information flow was reversed at rest with the source of the network shifted from the medulla towards the motor cortex. During inspiratory loading, the system was overwhelmed and the motor cortex became the sink of the network. This major finding may help to understand why some patients with COPD are prone to acute respiratory failure. Network connectivity and causality were related to lung function and illness severity. We validated our connectivity and causality results with a mathematical model of neural network. Our findings suggest a new therapeutic strategy involving the modulation of brain activity to increase motor cortex functional connectivity and improve respiratory muscles performance in patients. Hum Brain Mapp 37:2736-2754, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.

  5. Reduced pulmonary function and its associations in type 2 diabetes: the Fremantle Diabetes Study.

    PubMed

    Davis, T M; Knuiman, M; Kendall, P; Vu, H; Davis, W A

    2000-10-01

    To determine whether diabetes is associated with reduced lung function, we studied 421 Anglo-Celt/European subjects, representing 20.5% of all patients with type 2 diabetes identified in an urban Australian catchment area of 120097 people. In addition to collection of detailed demographic and diabetes-specific data, spirometry was performed and forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), vital capacity (VC) and peak expiratory flow (PEF) measured. When expressed as a percentage of those predicted (%pred) for age, sex and height, the means of all spirometric measures were reduced by > or =9.5%. After controlling for smoking, age and gender in a linear regression model, HbA(1c) was not associated with any measure of lung function (P>0.13) but diabetes duration was significantly associated with FEV1(%pred) and PEF(%pred) (P< or =0.04) and had borderline associations with FVC(%pred) and VC(%pred) (P< or =0.064). In separate analyses controlling for smoking alone, age, body mass index (BMI), coronary heart disease (CHD) and retinopathy were independently and inversely associated with FVC(%pred), FEV1(%pred) and VC(%pred) (P<0.05). In sub-group analyses, these three spirometric measures were associated with BMI, CHD and diabetes duration in males, and age and BMI in females. Pulmonary function is reduced in type 2 diabetes. Diabetes duration seems a more important influence than glycaemic control, but obesity and vascular disease may also contribute.

  6. Health effects of acid aerosols on North American children: Pulmonary function

    SciTech Connect

    Raizenne, M. |; Damokosh, A.I.; Spengler, J.D.

    1996-05-01

    We examined the health effects of exposure to acidic air pollution among children living in 24 communities in the United States and Canada. Parents of children between the ages of 8 and 12 completed a self-administered questionnaire and provided consent for their child to perform a standardized forced expiratory maneuver at school in 22 of these communities. Air quality and meteorology were measured in each community for the year preceding the pulmonary function tests. Forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV{sub 1.0}) measurements of 10,251 white children were examined in a two-stage regression analysis that adjusted for age, sex, height, weight, and sex-height interaction. In this study, a 52 nmol/m{sup 3} difference in annual mean particle strong acidity was associated with a 3.5% (95% CI, 2.0-4.9) decrement in adjusted FVC and a 3.1% (95% CI, 1.6-4.6) decrement in adjusted FEV{sub 1.0}. The FVC decrement was larger, although not significantly different, for children who were lifelong residents of their communities (4.1%, 95% CI, 2.5-5.8). The relative odds for low lung function (that is, measured FVC less than or equal to 85% of predicted), was 2.5 (95% CI, 1.8-3.6) across the range of particle strong acidity exposures. These data suggest that long-term exposure to ambient particle strong acidity may have a deleterious effect on lung growth, development, and function. 45 refs., 5 figs., 6 tabs.

  7. The alveolitis of pulmonary sarcoidosis. Evaluation of natural history and alveolitis-dependent changes in lung function

    SciTech Connect

    Keogh, B.A.; Hunninghake, G.W.; Line, B.R.; Crystal, R.G.

    1983-08-01

    Current concepts of the pathogenesis of pulmonary sarcoidosis suggest that a mononuclear cell alveolitis, comprised of activated T-lymphocytes and activated alveolar macrophages, precedes and modulates the formation of granuloma and fibrosis. To evaluate the natural history of this alveolitis and determine the relationship it has to subsequent changes in lung function, 19 untreated patients with pulmonary sarcoidosis without extrapulmonary manifestations were studied with bronchoalveolar lavage, /sup 67/Ga scanning, and pulmonary function tests to evaluate lung T-cells, lung alveolar macrophages, and lung function, respectively. In patients with sarcoidosis, low intensity alveolitis (lung T-cells less than or equal to 28% of all lung effector cells and/or /sup 67/Ga scan negative) was much more common (80% of all observations) than high intensity alveolitis (lung T-cells greater than 28% and /sup 67/Ga scan positive, 20% of all observations). Conventional clinical, roentgenographic, or physiologic studies could not predict the alveolitis status. Interestingly, of the 51 alveolitis evaluations in the 19 patients, there were 24 occurrences (47%) where the alveolitis was ''split,'' i.e., /sup 67/Ga scans positive and T-cells low (39%) or /sup 67/Ga negative and T-cells high (8%). Most untreated patients with sarcoidosis without extrapulmonary symptoms may have some inflammatory processes ongoing in their alveolar structures. Overall, whenever a high intensity alveolitis episode occurred, it was followed by deterioration over the next 6 months in at least one lung function parameter. A low intensity alveolitis episode was followed by functional deterioration only 8% of the time. The alveolitis parameters (lavage and /sup 67/Ga scanning) clearly predicted prognosis. These observations should prove useful in understanding the natural history of pulmonary sarcoidosis, in staging patients with this disease, and in making rational therapy decisions.

  8. Biophysical inhibition of pulmonary surfactant function by polymeric nanoparticles: role of surfactant protein B and C.

    PubMed

    Beck-Broichsitter, Moritz; Ruppert, Clemens; Schmehl, Thomas; Günther, Andreas; Seeger, Werner

    2014-11-01

    The current study investigated the mechanisms involved in the process of biophysical inhibition of pulmonary surfactant by polymeric nanoparticles (NP). The minimal surface tension of diverse synthetic surfactants was monitored in the presence of bare and surface-decorated (i.e. poloxamer 407) sub-100 nm poly(lactide) NP. Moreover, the influence of NP on surfactant composition (i.e. surfactant protein (SP) content) was studied. Dose-elevations of SP advanced the biophysical activity of the tested surfactant preparation. Surfactant-associated protein C supplemented phospholipid mixtures (PLM-C) were shown to be more susceptible to biophysical inactivation by bare NP than phospholipid mixture supplemented with surfactant protein B (PLM-B) and PLM-B/C. Surfactant function was hindered owing to a drastic depletion of the SP content upon contact with bare NP. By contrast, surface-modified NP were capable of circumventing unwanted surfactant inhibition. Surfactant constitution influences the extent of biophysical inhibition by polymeric NP. Steric shielding of the NP surface minimizes unwanted NP-surfactant interactions, which represents an option for the development of surfactant-compatible nanomedicines.

  9. Effect of Supine Posture on Airway Blood Flow and Pulmonary Function in Stable Heart Failure

    PubMed Central

    Ceridon, Maile L.; Morris, Norman R.; Olson, Thomas P.; Lalande, Sophie; Johnson, Bruce D.

    2014-01-01

    Background The aim of this study was to determine the relationship between body position, pulmonary function (PF) and bronchial blood flow (Qaw) in a group of heart failure (HF) and control subjects. Methods Thirty-six subjects were studied: 24 stable, ambulatory HF patients (HF: LVEF=27±6%, age=65±9yr) and 12 age- and sex-matched controls (CTRL: LVEF=60±7%, age=62±8yr). Measures of Q̇aw (soluble gas method) and PF were collected upright and following 30 min in the supine position. Results Q̇aw was similar between groups and remained unchanged with body position. Declines in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) with the supine position were observed in both groups; declines in forced expiratory flow 25–75% (FEF25–75) and FEF 75% (FEF75) with the supine position were observed in the HF group only. Changes in Q̇aw were related to changes in PF only in the HF patient groups (ΔFVC, %predicted, r=−0.45, p<0.04, ΔFEV1 r=−0.61, p<0.01, ΔFEV1 %predicted, r=−0.45, p<0.04). Conclusion These data demonstrate that relationships between postural changes in Q̇aw and PF exist only in the HF population and that the bronchial circulation may contribute to postural PF decline in HF. PMID:21741500

  10. Longitudinal Lung Function Decrease in Subjects with Spontaneous Healed Pulmonary Tuberculosis

    PubMed Central

    Lee, Seung Heon; Kwon, Amy M.; Yang, Hae-Chung; Lee, Seung Ku; Kim, Young; Choi, Jong Hyun; Kim, Je Hyeong; Shin, Chol

    2016-01-01

    Objective We compared the longitudinal course of post-bronchodilator Forced Expiratory Volume in 1 second (pFEV1) over a 10-year period in subjects with spontaneous healed pulmonary tuberculosis (SHPTB) with that in normal subjects. Methods We prospectively investigated 339 subjects with SHPTB and 3211 normal subjects. pFEV1 values measured biannually over 10 years were analyzed using mixed effects model. Results At baseline, there were no differences in gender, smoking amount, and mean height, except mean age (50.0 ± 8.1 VS. 48.1 ± 7.3, P< 0.001) between the SHPTB and normal group. 52% of the 339 participants with SHPTB and 56% of the 3211 normal participants participated till the end of study. According to the final model, the SHPTB group showed significantly larger decrease in the average pFEV1 over the time than the normal group (P< 0.001) adjusted for gender, age, height, smoking pack years, and time effects. Especially, the interaction effect between time and group was statistically significant (P = 0.036). Conclusion The average lung function in terms of pFEV1 decreases faster in subjects with SHPTB than in normal individuals over time. PMID:27706203

  11. Airborne endotoxin and its relationship to pulmonary function among workers in an Indian jute mill.

    PubMed

    Mukherjee, Ashit K; Chattopadhyay, Bhakar P; Bhattacharya, Sanat K; Saiyed, Habibullah N

    2004-04-01

    Air samples from various processing areas of an Indian jute mill were examined for endotoxin. The authors assessed work-related respiratory symptoms and pulmonary function changes in the dust-exposed workers from the different processing areas using a standard questionnaire and spirometry. Endotoxin was estimated in water extract of jute dust from 3 milling areas, and in outside air, by the Limulus amebocyte lysate gel clot technique. The batching, spinning, and weaving areas of the jute mill showed endotoxin levels of 0.22-4.42 microg/m3, 0.04-1.47 microg/m3, and 0.01-0.07 microg/m3, respectively, values similar to those found in Indian cotton mills. Respiratory morbidities among the workers included typical byssinotic symptoms, along with acute changes in postshift forced expiratory volume in 1 s (FEV1.0) (31.8%). Results of this study demonstrated that increased exposure to bacterial endotoxin in airborne dust is related to byssinotic symptoms among Indian jute mill workers. Findings were similar to those reported previously for workers in the cotton, flax, and hemp industries.

  12. Occupational exposure and pulmonary function of jute mill workers in Sunsari, Nepal.

    PubMed

    Das, P K L; Jha, N

    2009-12-01

    Most workers of building, pottery, timber, food and mine industries suffer from non-specific lung diseases and ventilatory disorders. There are many such industries operative in Sunsari, Nepal and so far no study has been reported on pulmonary function of jute mill workers of this region, who are also exposed to dust as other workers in similar types of industries. A brief clinical sheet regarding age, occupational particulars, smoking habits and presence or absence of respiratory symptoms was recorded for each worker. Spirometric parameters were recorded using an electronic spirometer. The group consisted of 95 male workers with mean age 28.43 +/- 7.58 yrs, weight 53.77 +/- 8.70 kg and height 164.83 +/- 6.82 cm. The study indicated an overall reduction in FVC, FEV1, PEFR, FEF25-75% and MVV. FEV1/FVC was within the normal range. Further division of workers into smokers and non-smokers, showed comparatively more decline in PEFR, FEF 25.0-75.0% and FEV1/ FVC in smokers. From this study, it can be concluded that exposure of jute dust leads to combined types of spirometric deficit revealing restrictive or obstructive diseases.

  13. Effects of ozone and nitrogen dioxide on pulmonary function in healthy and in asthmatic adolescents

    SciTech Connect

    Koenig, J.Q.; Covert, D.S.; Marshall, S.G.; Van Belle, G.; Pierson, W.E.

    1987-11-01

    The aim of this project was to investigate whether well-characterized asthmatic adolescent subjects were more sensitive to the inhaled effects of oxidant pollutants than were well-characterized healthy adolescent subjects. Ten healthy and 10 asthmatic subjects inhaled via a mouth-piece 0.12 or 0.18 ppm of ozone (O/sub 3/) or nitrogen dioxide (NO/sub 2/) or clean air for 30 min at rest followed by 10 min during moderate exercise (32.5 L/min) on a treadmill. The following pulmonary functional values were measured before and after exposure: peak flow, total respiratory resistance (RT), maximal flow at 50 and 75% of expired VC, and FEV1. After exercise exposure to 0.18 ppm O3, statistically significant increases were seen in RT in asthmatic and healthy adolescent subjects. No consistent changes were seen in either group after NO/sub 2/ exposure. Also, no significant differences in response to oxidant pollutants between the 2 groups could be demonstrated. It was concluded that neither group was consistently sensitive to these pollutants.

  14. Respiratory symptoms and pulmonary function of welders in the engineering industry.

    PubMed Central

    Hayden, S P; Pincock, A C; Hayden, J; Tyler, L E; Cross, K W; Bishop, J M

    1984-01-01

    We have studied respiratory symptoms, smoking habits, chest radiographs, sickness absence, and pulmonary function among 258 welders and an equal number of matched control subjects in three engineering factories. Welders who smoked had a higher frequency of chronic phlegm production than control subjects but there was no difference in cough or dyspnoea. The frequency of abnormality on chest radiographs was low and similar in welders and controls. Upper respiratory infections were a more frequent cause of sickness absence in welders than in controls but no difference was found in other respiratory diseases. FEV1 and peak expiratory flow rate were similar in welders and controls. In a subset of 186 subjects the maximum expiratory flow rate at low lung volumes was significantly less in welders who smoked than in control subjects who smoked, but there was no difference in non-smokers. Welders working under these conditions in the engineering industry appear to have no increased risk of chronic obstructive lung disease. PMID:6463913

  15. Pulmonary function of nonsmoking female asbestos workers without radiographic signs of asbestosis

    SciTech Connect

    Wang, X.R.; Yano, E.; Nonaka, Koichi; Wang, M.; Wang, Z.

    1998-07-01

    Researchers disagree about whether exposure to asbestos causes significant respiratory impairments and airway obstruction in the absence of radiographic asbestosis and smoking. To obtain confirmatory information, the authors examined pulmonary function of 208 nonsmoking female asbestos workers who did not have asbestosis and 136 controls. The authors observed an overall lower single-breath carbon monoxide diffusing capacity in the asbestos workers than in controls. In addition, significant decreases in percentage vital capacity, percentage forced vital capacity, and percentage mean forced expiratory flow during the middle half of the forced vital capacity were evident in the older workers. Logistic regression analysis revealed that asbestos exposure was associated with abnormal single-breath carbon monoxide diffusing capacity, vital capacity, and mean forced expiratory flow during the middle half of the forced vital capacity among the older workers. The age-related decline in vital capacity, forced vital capacity, and mean forced expiratory flow during the middle half of the forced vital capacity was significantly greater in the asbestos workers than the controls. The findings imply that asbestos-exposure per se contributes predominantly to restricted lung volume and reduced single-breath carbon monoxide diffusing capacity. Asbestos may also cause slight airway obstruction, especially in workers who are heavily exposed.

  16. The effects of sequential exposure to acidic fog and ozone on pulmonary function in exercising subjects

    SciTech Connect

    Aris, R.; Christian, D.; Sheppard, D.; Balmes, J.R. )

    1991-01-01

    In Southern California coastal regions, morning fog is often acidified by the presence of nitric acid (HNO{sub 3}). Peak exposure to ozone (O{sub 3}) usually occurs in the afternoon and evening, after the fog has dissipated. To determine whether fog containing HNO{sub 3} might enhance pulmonary responses to O{sub 3}, we studied a group of healthy, athletic subjects selected for lung function sensitivity to O{sub 3}. On 3 separate days, the subjects exercised for 2 h in atmospheres containing HNO{sub 3} fog (0.5 mg/ml), H{sub 2}O fog, or clean, filtered air. After a 1-h break, they exercised for an additional 3 h in an atmosphere containing 0.20 ppm O{sub 3}. Surprisingly, the mean O{sub 3}-induced decrements in FEV1 and FVC were smaller after exercise in each fog-containing atmosphere than they were after exercise in clean, filtered air. The mean (+/- SEM) O{sub 3}-induced decrements in FEV1 were 26.4 +/- 5.3% after air, 17.1 +/- 3.7% after H{sub 2}O fog, and 18.0 +/- 4.3% after HNO{sub 3} fog, and in FVC they were 19.9 +/- 4.7% after air, 13.6 +/- 2.8% after H{sub 2}O fog, and 13.6 +/- 4.2% after HNO{sub 3} fog.

  17. Ozone-induced changes in pulmonary function and bronchial responsiveness in asthmatics

    SciTech Connect

    Kreit, J.W.; Gross, K.B.; Moore, T.B.; Lorenzen, T.J.; D'Arcy, J.; Eschenbacher, W.L.

    1989-01-01

    To compare the responses of asthmatic and normal subjects to high effective doses of ozone, nine asthmatic and nine normal subjects underwent two randomly assigned 2-h exposures to filtered, purified air and 0.4 ppm ozone with alternating 15-min periods of rest and exercise on a cycle ergometer (minute ventilation = 30 l.min-1.m-2). Before and after each exposure, pulmonary function and bronchial responsiveness to methacholine were measured and symptoms were recorded. Ozone exposure was associated with a statistically significant decrease in forced vital capacity (FVC), forced expired volume in 1 s (FEV1), percent FEV1 (FEV1%), and forced expired flow at 25-75% FVC (FEF25-75) in both normal and asthmatic subjects. However, comparing the response of asthmatic and normal subjects to ozone revealed a significantly greater percent decrease in FEV1, FEV1%, and FEF25-75 in the asthmatic subjects. The effect of ozone on FVC and symptom scores did not differ between the two groups. In both normal and asthmatic subjects, exposure to ozone was accompanied by a significant increase in bronchial responsiveness. We conclude that exposure to a high effective ozone dose produces 1) increased bronchial responsiveness in both normal and asthmatic subjects, 2) greater airways obstruction in asthmatic than in normal subjects, and 3) similar symptoms and changes in lung volumes in the two groups.

  18. Pulmonary function of children with acute leukemia in maintenance phase of chemotherapy☆

    PubMed Central

    de Macêdo, Thalita Medeiros Fernandes; Campos, Tania Fernandes; Mendes, Raquel Emanuele de França; França, Danielle Corrêa; Chaves, Gabriela Suéllen da Silva; de Mendonça, Karla Morganna Pereira Pinto

    2014-01-01

    OBJECTIVE: The aim of this study was to assess the pulmonary function of children with acute leukemia. METHODS: Cross-sectional observational analytical study that enrolled 34 children divided into groups A (17 with acute leukemia in the maintenance phase of chemotherapy) and B (17 healthy children). The groups were matched for sex, age and height. Spirometry was measured using a spirometer Microloop Viasys(r) in accordance with American Thoracic Society and European Respiratory Society guidelines. Maximal respiratory pressures were measured with an MVD300 digital manometer (Globalmed(r)). Maximal inspiratory pressures and maximal expiratory pressures were measured from residual volume and total lung capacity, respectively. RESULTS: Group A showed a significant decrease in maximal inspiratory pressures when compared to group B. No significant difference was found between the spirometric values of the two groups, nor was there any difference between maximal inspiratory pressure and maximal expiratory pressure values in group A compared to the lower limit values proposed as reference. CONCLUSION: Children with acute leukemia, myeloid or lymphoid, during the maintenance phase of chemotherapy exhibited unchanged spirometric variables and maximal expiratory pressure; However, there was a decrease in inspiratory muscle strength. PMID:25510995

  19. Assessment of diastolic function by tissue Doppler echocardiography: comparison with standard transmitral and pulmonary venous flow

    NASA Technical Reports Server (NTRS)

    Farias, C. A.; Rodriguez, L.; Garcia, M. J.; Sun, J. P.; Klein, A. L.; Thomas, J. D.

    1999-01-01

    The objective of this study was to determine the utility of Doppler tissue echocardiography in the evaluation of diastolic filling and in discriminating between normal subjects and those with various stages of diastolic dysfunction. We measured myocardial velocities in 51 patients with various stages of diastolic dysfunction and in 27 normal volunteers. The discriminating power of each of the standard Doppler indexes of left ventricular filling, pulmonary venous flow, and myocardial velocities was determined with the use of Spearman rank correlation and analysis of variance F statistics. Early diastolic myocardial velocity (E(m)) was higher in normal subjects (16.0 +/- 3.8 cm/s) than in patients with either delayed relaxation (n = 15, 7.5 +/- 2.2 cm/s), pseudonormal filling (n = 26, 7.6 +/- 2.3 cm/s), or restrictive filling (n = 10, 7.4 +/- 2.4 cm/s, P <.0001). E(m ) was the best single discriminator between control subjects and patients with diastolic dysfunction (P =.7, F = 64.5). Myocardial velocities assessed by Doppler tissue echocardiography are useful in differentiating patients with normal from those with abnormal diastolic function. Myocardial velocity remains reduced even in those stages of diastolic dysfunction characterized by increased preload compensation.

  20. Influence of Bronchial Blood Flow and Conductance on Pulmonary Function in Stable Systolic Heart Failure

    PubMed Central

    Ceridon, Maile L.; Morris, Norman R.; Hulsebus, Minelle L.; Olson, Thomas P.; Lalande, Sophie; Johnson, Bruce D.

    2011-01-01

    The aim of this study was to determine the relationship between airway blood flow (Q̇aw), airway conductance (Gf-aw) and pulmonary function in patients with stable HF. 12 controls (CTRL: age=63±9yr, FVC=98±15%pred, LVEF=61±6%) (all data presented as mean±SD), 16 patients with mild HF (HF-A, NYHA I–II: age=64±9yr, FVC=90±17%pred, LVEF=28±6%), and 14 patients with moderate/severe HF (HF-B, NYHA III–IV: age=65±6yr, FVC=84±12%pred, LVEF=26±6%) were studied. Q̇aw was assessed using soluble gas measurements; perfusion pressure across airway bed (ΔPaw) was estimated from systemic and pulmonary pressure measurements; Gf-aw was calculated as Q̇aw/ΔPaw; PF was assessed by spirometry. While Q̇aw was not significantly different between CTRL (61.3±17.9 μL·min−1·ml−1), HF-A (70.1±26.9 μL·min−1·ml−1) and HF-B (56.2±14.9 μL·min−1·ml−1) groups, Gf-aw, was elevated in HF-A (1.1±0.4 μL·min−1·ml−1·mmHg−1, p<0.03) and tended to be elevated in HF-B (1.2±0.6 μL·min−1·ml−1·mmHg−1, p=0.07) when compared to CTRL (0.8±0.3 μL·min−1·ml−1·mmHg−1). Significant positive correlations were found between Gf-aw and RV/TLC for HF-A (r=0.63, p<0.02) and HF-B (r=0.58, p<0.05). These results support the hypothesis that increased bronchial conductance and bronchial congestion may be related to greater small airway obstruction and as such may play a role in the PF abnormalities and symptoms of congestion commonly observed in HF patients. PMID:21545852

  1. Exercise-induced pulmonary artery hypertension in a patient with compensated cardiac disease: hemodynamic and functional response to sildenafil therapy.

    PubMed

    Nikolaidis, Lazaros; Memon, Nabeel; O'Murchu, Brian

    2015-02-01

    We describe the case of a 54-year-old man who presented with exertional dyspnea and fatigue that had worsened over the preceding 2 years, despite a normally functioning bioprosthetic aortic valve and stable, mild left ventricular dysfunction (left ventricular ejection fraction, 0.45). His symptoms could not be explained by physical examination, an extensive biochemical profile, or multiple cardiac and pulmonary investigations. However, abnormal cardiopulmonary exercise test results and a right heart catheterization-combined with the use of a symptom-limited, bedside bicycle ergometer-revealed that the patient's exercise-induced pulmonary artery hypertension was out of proportion to his compensated left heart disease. A trial of sildenafil therapy resulted in objective improvements in hemodynamic values and functional class.

  2. Effects of air stacking on pulmonary function and peak cough flow in patients with cervical spinal cord injury.

    PubMed

    Jeong, Jong-Hwa; Yoo, Won-Gyu

    2015-06-01

    [Purpose] This study evaluated the effects of air stacking on pulmonary function and peak cough flow in patients with cervical spinal cord injury. [Subjects] Twenty-six patients were included in the study and were randomized into experimental (n = 14) and control (n = 12) groups. [Methods] Both groups performed therapeutic exercises: the control group performed incentive spirometry, while the experimental group performed 20 repetitions of air stacking exercise twice a day. The training for both groups continued for 5 days a week for 6 weeks. [Results] Forced vital capacity and peak cough flow increased significantly in the experimental group compared to the controls. All within-group variables in the experimental group differed significantly at 6 weeks compared to baseline, while in the control group only Forced vital capacity differed significantly at 6 weeks compared to baseline. [Conclusion] Air stacking exercise significantly improved pulmonary function and peak cough flow in patients with a cervical spinal cord injury. PMID:26180355

  3. Pneumomediastinum, subcutaneous emphysema, and pneumothorax after a pulmonary function testing in a patient with bleomycin-induced interstitial pneumonitis*

    PubMed Central

    Araujo, Mariana Sponholz; Fernandes, Frederico Leon Arrabal; Kay, Fernando Uliana; Carvalho, Carlos Roberto Ribeiro

    2013-01-01

    Spontaneous pneumomediastinum is an uncommon event, the clinical picture of which includes retrosternal chest pain, subcutaneous emphysema, dyspnea, and dysphonia. The pathophysiological mechanism involved is the emergence of a pressure gradient between the alveoli and surrounding structures, causing alveolar rupture with subsequent dissection of the peribronchovascular sheath and infiltration of the mediastinum and subcutaneous tissue with air. Known triggers include acute exacerbations of asthma and situations that require the Valsalva maneuver. We described and documented with HRCT scans the occurrence of pneumomediastinum after a patient with bleomycin-induced interstitial lung disease underwent pulmonary function testing. Although uncommon, the association between pulmonary function testing and air leak syndromes has been increasingly reported in the literature, and lung diseases, such as interstitial lung diseases, include structural changes that facilitate the occurrence of this complication. PMID:24310635

  4. Chemical constituents of fine particulate air pollution and pulmonary function in healthy adults: the Healthy Volunteer Natural Relocation study.

    PubMed

    Wu, Shaowei; Deng, Furong; Hao, Yu; Shima, Masayuki; Wang, Xin; Zheng, Chanjuan; Wei, Hongying; Lv, Haibo; Lu, Xiuling; Huang, Jing; Qin, Yu; Guo, Xinbiao

    2013-09-15

    The study examined the associations of 32 chemical constituents of particulate matter with an aerodynamic diameter ≤2.5 μm (PM₂.₅) with pulmonary function in a panel of 21 college students. Study subjects relocated from a suburban area to an urban area with changing ambient air pollution levels and contents in Beijing, China, and provided daily morning/evening peak expiratory flow (PEF) and forced expiratory volume in 1s (FEV₂₁) measurements over 6 months in three study periods. There were significant reductions in evening PEF and morning/evening FEV₂₁ associated with various air pollutants and PM₂.₅ constituents. Four PM₂.₅ constituents (copper, cadmium, arsenic and stannum) were found to be most consistently associated with the reductions in these pulmonary function measures. These findings provide clues for the respiratory effects of specific particulate chemical constituents in the context of urban air pollution. PMID:23747477

  5. Effects of air stacking on pulmonary function and peak cough flow in patients with cervical spinal cord injury

    PubMed Central

    Jeong, Jong-hwa; Yoo, Won-gyu

    2015-01-01

    [Purpose] This study evaluated the effects of air stacking on pulmonary function and peak cough flow in patients with cervical spinal cord injury. [Subjects] Twenty-six patients were included in the study and were randomized into experimental (n = 14) and control (n = 12) groups. [Methods] Both groups performed therapeutic exercises: the control group performed incentive spirometry, while the experimental group performed 20 repetitions of air stacking exercise twice a day. The training for both groups continued for 5 days a week for 6 weeks. [Results] Forced vital capacity and peak cough flow increased significantly in the experimental group compared to the controls. All within-group variables in the experimental group differed significantly at 6 weeks compared to baseline, while in the control group only Forced vital capacity differed significantly at 6 weeks compared to baseline. [Conclusion] Air stacking exercise significantly improved pulmonary function and peak cough flow in patients with a cervical spinal cord injury. PMID:26180355

  6. Chemical constituents of fine particulate air pollution and pulmonary function in healthy adults: the Healthy Volunteer Natural Relocation study.

    PubMed

    Wu, Shaowei; Deng, Furong; Hao, Yu; Shima, Masayuki; Wang, Xin; Zheng, Chanjuan; Wei, Hongying; Lv, Haibo; Lu, Xiuling; Huang, Jing; Qin, Yu; Guo, Xinbiao

    2013-09-15

    The study examined the associations of 32 chemical constituents of particulate matter with an aerodynamic diameter ≤2.5 μm (PM₂.₅) with pulmonary function in a panel of 21 college students. Study subjects relocated from a suburban area to an urban area with changing ambient air pollution levels and contents in Beijing, China, and provided daily morning/evening peak expiratory flow (PEF) and forced expiratory volume in 1s (FEV₂₁) measurements over 6 months in three study periods. There were significant reductions in evening PEF and morning/evening FEV₂₁ associated with various air pollutants and PM₂.₅ constituents. Four PM₂.₅ constituents (copper, cadmium, arsenic and stannum) were found to be most consistently associated with the reductions in these pulmonary function measures. These findings provide clues for the respiratory effects of specific particulate chemical constituents in the context of urban air pollution.

  7. ACTH producing pulmonary carcinoid and pituitary macroadenoma: a fortuitous association?

    PubMed

    Wong, M; Isa, S H Md; Kamaruddin, N A; Khalid, B A K

    2007-06-01

    We report a case of a 45 year-old man who presented initially with a non-functioning pituitary macroadenoma. A routine chest radiography done preoperatively revealed a right lung nodule which was confirmed by computed tomography (CT) of the thorax. Transfrontal hypophysectomy was performed while a conservative approach was taken for the lung nodule. Four years later, he presented acutely with adrenocorticotrophic hormone (ACTH) dependent Cushing's syndrome which resolved following a right lobectomy. Histological examination revealed an atypical carcinoid. To our knowledge, this is the first reported case of an ectopic ACTH secreting pulmonary carcinoid found in association with a non-functioning pituitary macroadenoma.

  8. [Combined pulmonary fibrosis and emphysema (CPFE)--limitation of usual lung function test and challenge at practice].

    PubMed

    Takai, Daiya

    2014-12-01

    Spirometry and the flow-volume curve test are commonly performed lung function tests. However, a unique clinical entity occasionally shows almost normal data in these tests, and is therefore missed on screening tests. The clinical entity of combined pulmonary emphysema and pulmdoary fibrosis was recognized and documented in the 90's in Japan, the USA, and Europe. Typical emphysema shows obstructive disorders, and pulmonary fibrosis shows restrictive disorders. Thus, the combination of both should lead to a combined disorder pattern in lung function tests, but this is not the case. In 2005, Cottin reported and redefined this combination of emphysema and fibrosis of the lung as "Combined Pulmonary Fibrosis and Emphysema" (CPFE). The patients are typically heavily smoking males who show an almost normal lung function. The upper lobe of these patients usually shows severe emphysema, which contributes to a static volume and a late phase in the forced volume test. On the other hand their lower lobe shows fibrotic change. The fibrotic portion contributes to early phase flow in the flow-volume curve. These mechanisms are a reason for the normal pattern appearance in lung function tests in CPFE patients. As a matter of course, these patients have damaged upper and lower lobes: their diffusing capacity of the lung shows a low performance, their saturation of blood hemoglobin decreases soon after light exercise, and their KL-6 (a blood marker of pulmonary fibrosis) usually shows a high value. They are considered a high risk group regarding complications of post-surgical treatment. Thus, when medical technologists identify suspicious cases, they should advise doctors to add diffusing capacity and KL-6 tests. (Review).

  9. Pulmonary function loss in Vermont granite workers. A long-term follow-up and critical reappraisal.

    PubMed

    Graham, W G; O'Grady, R V; Dubuc, B

    1981-01-01

    Previous studies of Vermont granite workers averred that pulmonary function loss was occurring at 2 to 3 times the normal rate. The excess loss was attributed to the current, relatively low concentrations of dust prevailing in the stone sheds. Because the Vermont State Health Department had traditionally provided surveillance of granite workers to detect evidence of occupationally related illness, we offered pulmonary function screening to any currently employed worker. Spirometric data from the first 150 workers, compared with data from the previous studies, showed a large increase in the FVC and a smaller increase in the FEV1. We therefore undertook a survey of the entire stone shed work force, as well as of retired workers tested previously. The results in 487 current workers indicated an overall increase in FVC from 1974 to 1979 of 0.540 L, and an increase in FEV1 of 0.030 L: predicted losses based on the previous studies were 0.350 to 0.400 L in FVC and 0.250 to 0.350 L in the FEV1. Analysis of data in various subgroups, such as retired workers or those with more than 20 yr of work experience, also showed increases in FVC, and either slight gains or minimal losses in FEV1. The possible reasons for apparent improvement in pulmonary function are discussed. We concluded that technical deficiencies in the previous studies led to exaggerated and erroneous estimates of loss. At this time, the actual decrement in pulmonary function values for exposed granite workers is not known and requires further investigation. Because the newly proposed, stricter standard, for silica was importantly influenced by the previous studies, we believe that adoption of this standard would be premature.

  10. A study on blood eosinophil level and ventilatory pulmonary function of the workers exposed to storage grain dust.

    PubMed

    Chattopadhyay, B P; Mahata, A; Kundu, S; Alam, J; Das, S; Roychowdhury, A

    2007-01-01

    The workers engaged in storage grain handling are exposed to storage grain dust and suffer from different respiratory symptoms like, cough wheezing, chest tightness, eye and nasal irritations. It has been reported abroad and the present study results noted that the grain handlers have allergic symptoms like redness of eyes, itching, sneezing, skin rash, breathlessness and decrement of pulmonary function test values. According to their nature of job, the workers of storage grain godowns were divided into four categories i.e., load handling worker (LHW), ancillary, quality control and depot administration workers. The pulmonary function tests (PFT) and the differential count of leucocytes were carried out among the workers by standard technique. Decrement of pulmonary function test values was noted with the increment of blood eosinophil level.The PFT results were presented according to the blood eosinophil level. The decrement of mean PFT values were noticed as the blood level of eosinophil gradually increased from, up to -4%, >4-10% and above 10%. The maximum numbers of workers in different job categories are belonged to >4 -10% of eosinophil level. The percentage figure of workers in different departments were LHW 48.38%, (n=45), ancillary 38.88%, (n=7), quality control 54.54% (n=6) and depot administration workers 47.05% (n=16) are belonged to that range. Among the total workers the higher figure was found >4-10% ranges 47.43% (n=74) workers. The allergic manifestations like redness, itchiness and watering of eyes, sneezing, cough, breathless etc. are reported. These workers have blood eosinophil level and low pulmonary function test values. The respiratory impairments among the workers are restrictive, obstructive and combined restrictive and obstructive type.

  11. Development and application of pulmonary structure-function registration methods: towards pulmonary image-guidance tools for improved airway targeted therapies and outcomes

    NASA Astrophysics Data System (ADS)

    Guo, Fumin; Pike, Damien; Svenningsen, Sarah; Coxson, Harvey O.; Drozd, John J.; Yuan, Jing; Fenster, Aaron; Parraga, Grace

    2014-03-01

    Objectives: We aimed to develop a way to rapidly generate multi-modality (MRI-CT) pulmonary imaging structurefunction maps using novel non-rigid image registration methods. This objective is part of our overarching goal to provide an image processing pipeline to generate pulmonary structure-function maps and guide airway-targeted therapies. Methods: Anatomical 1H and functional 3He MRI were acquired in 5 healthy asymptomatic ex-smokers and 7 ex-smokers with chronic obstructive pulmonary disease (COPD) at inspiration breath-hold. Thoracic CT was performed within ten minutes of MRI using the same breath-hold volume. Landmark-based affine registration methods previously validated for imaging of COPD, was based on corresponding fiducial markers located in both CT and 1H MRI coronal slices and compared with shape-based CT-MRI non-rigid registration. Shape-based CT-MRI registration was developed by first identifying the shapes of the lung cavities manually, and then registering the two shapes using affine and thin-plate spline algorithms. We compared registration accuracy using the fiducial localization error (FLE) and target registration error (TRE). Results: For landmark-based registration, the TRE was 8.4±5.3 mm for whole lung and 7.8±4.6 mm for the R and L lungs registered independently (p=0.4). For shape-based registration, the TRE was 8.0±4.6 mm for whole lung as compared to 6.9±4.4 mm for the R and L lung registered independently and this difference was significant (p=0.01). The difference for shape-based (6.9±4.4 mm) and landmark-based R and L lung registration (7.8±4.6 mm) was also significant (p=.04) Conclusion: Shape-based registration TRE was significantly improved compared to landmark-based registration when considering L and R lungs independently.

  12. Functional characterisation of human pulmonary monocyte-like cells in lipopolysaccharide-mediated acute lung inflammation

    PubMed Central

    2014-01-01

    Background We have previously reported the presence of novel subpopulations of pulmonary monocyte-like cells (PMLC) in the human lung; resident PMLC (rPMLC, HLA-DR+CD14++CD16+cells) and inducible PMLC (iPMLC, HLA-DR+CD14++CD16- cells). iPMLC are significantly increased in bronchoalveolar lavage (BAL) fluid following inhalation of lipopolysaccharide (LPS). We have carried out the first functional evaluation of PMLC subpopulations in the inflamed lung, following the isolation of these cells, and other lineages, from BAL fluid using novel and complex protocols. Methods iPMLC, rPMLC, alveolar macrophages (AM), neutrophils, and regulatory T cells were quantified in BAL fluid of healthy subjects at 9 hours post-LPS inhalation (n = 15). Cell surface antigen expression by iPMLC, rPMLC and AM and the ability of each lineage to proliferate and to undergo phagocytosis were investigated using flow cytometry. Basal cytokine production by iPMLC compared to AM following their isolation from BAL fluid and the responsiveness of both cell types following in vitro treatment with the synthetic corticosteroid dexamethasone were assessed. Results rPMLC have a significantly increased expression of mature macrophage markers and of the proliferation antigen Ki67, compared to iPMLC. Our cytokine data revealed a pro-inflammatory, corticosteroid-resistant phenotype of iPMLC in this model. Conclusions These data emphasise the presence of functionally distinct subpopulations of the monocyte/macrophage lineage in the human lung in experimental acute lung inflammation. PMID:24684897

  13. CT densitovolumetry in children with obliterative bronchiolitis: correlation with clinical scores and pulmonary function test results*,**

    PubMed Central

    Mocelin, Helena; Bueno, Gilberto; Irion, Klaus; Marchiori, Edson; Sarria, Edgar; Watte, Guilherme; Hochhegger, Bruno

    2013-01-01

    OBJECTIVE: To determine whether air trapping (expressed as the percentage of air trapping relative to total lung volume [AT%]) correlates with clinical and functional parameters in children with obliterative bronchiolitis (OB). METHODS: CT scans of 19 children with OB were post-processed for AT% quantification with the use of a fixed threshold of −950 HU (AT%950) and of thresholds selected with the aid of density masks (AT%DM). Patients were divided into three groups by AT% severity. We examined AT% correlations with oxygen saturation (SO2) at rest, six-minute walk distance (6MWD), minimum SO2 during the six-minute walk test (6MWT_SO2), FVC, FEV1, FEV1/FVC, and clinical parameters. RESULTS: The 6MWD was longer in the patients with larger normal lung volumes (r = 0.53). We found that AT%950 showed significant correlations (before and after the exclusion of outliers, respectively) with the clinical score (r = 0.72; 0.80), FVC (r = 0.24; 0.59), FEV1 (r = −0.58; −0.67), and FEV1/FVC (r = −0.53; r = −0.62), as did AT%DM with the clinical score (r = 0.58; r = 0.63), SO2 at rest (r = −0.40; r = −0.61), 6MWT_SO2 (r = −0.24; r = −0.55), FVC (r = −0.44; r = −0.80), FEV1 (r = −0.65; r = −0.71), and FEV1/FVC (r = −0.41; r = −0.52). CONCLUSIONS: Our results show that AT% correlates significantly with clinical scores and pulmonary function test results in children with OB. PMID:24473764

  14. Impaired function of regulatory T-cells in patients with chronic obstructive pulmonary disease (COPD).

    PubMed

    Tan, Dino B A; Fernandez, Sonia; Price, Patricia; French, Martyn A; Thompson, Philip J; Moodley, Yuben P

    2014-12-01

    Anti-inflammatory pathways affecting chronic obstructive pulmonary disease (COPD) are poorly understood. Regulatory T-cells (Tregs) are important negative regulators of T-cell activity and hence were investigated in COPD patients in this study. We hypothesised that functional defects in Tregs may promote increased inflammation contributing to the pathogenesis of COPD. Peripheral blood mononuclear cells (PBMC) were isolated from patients with stable COPD and age-matched non-smoking controls. Treg-mediated suppression of memory non-Treg (Foxp3(-)CD45RO(+)) CD4(+) T-cell activation was analysed by comparing PBMC responses to staphylococcal enterotoxin-B (SEB) pre- and post-depletion of Tregs (CD25(+)CD127(low)CD4(+) T-cells) by fluorescence-activated cell sorting (FACS). Activation of T-cells was assessed by HLA-DR expression. Levels of secreted cytokines were measured by ELISA. Depletion of Tregs increased SEB-induced activation of Foxp3(-)CD45RO(+) CD4(+) T-cells in samples from 15/15 healthy controls (demonstrating Treg-mediated suppression) and 9/14 COPD patients (Fisher's test, p=0.017). A screen of clinical data associated a failure of Treg-mediated suppression in the remaining five COPD patients with a higher body mass index (BMI) (33-38 kg/m(2)) compared to patients with unimpaired Treg function (20-32 kg/m(2)). In conclusion, we demonstrate impaired Treg-mediated suppression of CD4(+) T-cell activation in a subset of COPD patients, all of whom had high BMI. Obesity and/or perturbed homeostasis of Treg subsets may explain this defect and therefore contribute to increased inflammation observed in COPD.

  15. ALTERATIONS IN CARDIOMYOCYTE FUNCTION AFTER PULMONARY TREATMENT WITH STAINLESS STEEL WELDING FUME IN RATS

    PubMed Central

    Popstojanov, Risto; Antonini, James M.; Salmen, Rebecca; Ye, Morgan; Zheng, Wen; Castranova, Vincent; Fekedulegn, Desta B.; Kan, Hong

    2015-01-01

    Welding fume is composed of a complex of different metal particulates. Pulmonary exposure to different welding fumes may exert a negative impact on cardiac function, although the underlying mechanisms remain unclear. To explore the effect of welding fumes on cardiac function, Sprague-Dawley rats were exposed by intratracheal instillation to 2 mg/rat of manual metal arc hard surfacing welding fume (MMA-HS) once per week for 7 wk. Control rats received saline. Cardiomyocytes were isolated enzymatically at d 1 and 7 postexposure. Intracellular calcium ([Ca2+]i) transients (fluorescence ratio) were measured on the stage of an inverted phase-contrast microscope using a myocyte calcium imaging/cell length system. Phosphorylation levels of cardiac troponin I (cTnI) were determined by Western blot. The levels of nonspecific inflammatory marker C-reactive protein (CRP) and proinflammatory cytokine interleukin-6 (IL-6) in serum were measured by enzyme-linked immunosorbent assay (ELISA). Contraction of isolated cardiomyocytes was significantly reduced at d 1 and d 7 postexposure. Intracellular calcium levels were decreased in response to extracellular calcium stimulation at d 7 postexposure. Changes of intracellular calcium levels after isoprenaline hydrochloride (ISO) stimulation were not markedly different between groups at either time point. Phosphorylation levels of cTnI in the left ventricle were significantly lower at d 1 post-exposure. The serum levels of CRP were not markedly different between groups at either time point. Serum levels of IL-6 were not detectable in both groups. Cardiomyocyte alterations observed after welding fume treatment were mainly due to alterations in intracellular calcium handling and phosphorylation levels of cTnI. PMID:24786677

  16. Predictive Models for Pulmonary Function Changes After Radiotherapy for Breast Cancer and Lymphoma

    SciTech Connect

    Sanchez-Nieto, Beatriz; Goset, Karen C.; Caviedes, Ivan; Delgado, Iris O.; Cordova, Andres

    2012-02-01

    Purpose: To propose multivariate predictive models for changes in pulmonary function tests ({Delta}PFTs) with respect to preradiotherapy (pre-RT) values in patients undergoing RT for breast cancer and lymphoma. Methods and Materials: A prospective study was designed to measure {Delta}PFTs of patients undergoing RT. Sixty-six patients were included. Spirometry, lung capacity (measured by helium dilution), and diffusing capacity of carbon monoxide tests were used to measure lung function. Two lung definitions were considered: paired lung vs. irradiated lung (IL). Correlation analysis of dosimetric parameters (mean lung dose and the percentage of lung volume receiving more than a threshold dose) and {Delta}PFTs was carried out to find the best dosimetric predictor. Chemotherapy, age, smoking, and the selected dose-volume parameter were considered as single and interaction terms in a multivariate analysis. Stability of results was checked by bootstrapping. Results: Both lung definitions proved to be similar. Modeling was carried out for IL. Acute and late damage showed the highest correlations with volumes irradiated above {approx}20 Gy (maximum R{sup 2} = 0.28) and {approx}40 Gy (maximum R{sup 2} = 0.21), respectively. RT alone induced a minor and transitory restrictive defect (p = 0.013). Doxorubicin-cyclophosphamide-paclitaxel (Taxol), when administered pre-RT, induced a late, large restrictive effect, independent of RT (p = 0.031). Bootstrap values confirmed the results. Conclusions: None of the dose-volume parameters was a perfect predictor of outcome. Thus, different predictor models for {Delta}PFTs were derived for the IL, which incorporated other nondosimetric parameters mainly through interaction terms. Late {Delta}PFTs seem to behave more serially than early ones. Large restrictive defects were demonstrated in patients pretreated with doxorubicin-cyclophosphamide-paclitaxel.

  17. Results of a prospective study evaluating the effects of mantle irradiation on pulmonary function

    SciTech Connect

    Smith, L.M.; Mendenhall, N.P.; Cicale, M.J.; Block, E.R.; Carter, R.L.; Million, R.R.

    1989-01-01

    Thirty patients with Stages I-III Hodgkin's disease receiving mantle irradiation were prospectively evaluated prior to therapy with spirometry, lung volumes, and tests of diffusing capacity (DLCO). Follow-up examinations were performed at 3, 6, and 12 months and then yearly. Sixteen patients had Hodgkin's disease involving the mediastinum at presentation, 10 were smokers, and 16 received either preirradiation or postirradiation chemotherapy. Mantle doses ranged between 2300 cGy and 4000 cGy (mode of 3750 cGy) given at 150 cGy to 170 cGy tumor dose per day with split-course technique. Twenty patients have been tested greater than or equal to 4 years after treatment with a median time from treatment to last pulmonary function test of 8 years. Changes over time in spirometry included an early, mild decrease in both forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1), which returned to baseline by 2 years and then gradually decreased to a 10-15% deficit as compared with predicted values at 6-10 years. Additionally, there was a very slight decrease in FEV1/FVC beginning at 1 year and gradually increasing to an 8% deficit at 6-10 years. Changes over time in lung volumes included a mild nadir of total lung capacity (TLC) and functional residual capacity (FRC) at 6 months to a year, which returned to baseline at 2-4 years and then gradually dropped to a 5-10% deficit at 6-10 years. Mean DLCO for the study group was 20% below predicted values prior to treatment and dropped to a low of 30% below predicted at 6 months following treatment, then gradually returned to baseline by 4 years and showed continued improvement to an overall deficit of approximately 10% at 6-10 years.

  18. Alterations in cardiomyocyte function after pulmonary treatment with stainless steel welding fume in rats.

    PubMed

    Popstojanov, Risto; Antonini, James M; Salmen, Rebecca; Ye, Morgan; Zheng, Wen; Castranova, Vincent; Fekedulegn, Desta B; Kan, Hong

    2014-01-01

    Welding fume is composed of a complex of different metal particulates. Pulmonary exposure to different welding fumes may exert a negative impact on cardiac function, although the underlying mechanisms remain unclear. To explore the effect of welding fumes on cardiac function, Sprague-Dawley rats were exposed by intratracheal instillation to 2 mg/rat of manual metal arc hard surfacing welding fume (MMA-HS) once per week for 7 wk. Control rats received saline. Cardiomyocytes were isolated enzymatically at d 1 and 7 postexposure. Intracellular calcium ([Ca(2+)]i) transients (fluorescence ratio) were measured on the stage of an inverted phase-contrast microscope using a myocyte calcium imaging/cell length system. Phosphorylation levels of cardiac troponin I (cTnI) were determined by Western blot. The levels of nonspecific inflammatory marker C-reactive protein (CRP) and proinflammatory cytokine interleukin-6 (IL-6) in serum were measured by enzyme-linked immunosorbent assay (ELISA). Contraction of isolated cardiomyocytes was significantly reduced at d 1 and d 7 postexposure. Intracellular calcium levels were decreased in response to extracellular calcium stimulation at d 7 postexposure. Changes of intracellular calcium levels after isoprenaline hydrochloride (ISO) stimulation were not markedly different between groups at either time point. Phosphorylation levels of cTnI in the left ventricle were significantly lower at d 1 postexposure. The serum levels of CRP were not markedly different between groups at either time point. Serum levels of IL-6 were not detectable in both groups. Cardiomyocyte alterations observed after welding fume treatment were mainly due to alterations in intracellular calcium handling and phosphorylation levels of cTnI. PMID:24786677

  19. Alterations in cardiomyocyte function after pulmonary treatment with stainless steel welding fume in rats.

    PubMed

    Popstojanov, Risto; Antonini, James M; Salmen, Rebecca; Ye, Morgan; Zheng, Wen; Castranova, Vincent; Fekedulegn, Desta B; Kan, Hong

    2014-01-01

    Welding fume is composed of a complex of different metal particulates. Pulmonary exposure to different welding fumes may exert a negative impact on cardiac function, although the underlying mechanisms remain unclear. To explore the effect of welding fumes on cardiac function, Sprague-Dawley rats were exposed by intratracheal instillation to 2 mg/rat of manual metal arc hard surfacing welding fume (MMA-HS) once per week for 7 wk. Control rats received saline. Cardiomyocytes were isolated enzymatically at d 1 and 7 postexposure. Intracellular calcium ([Ca(2+)]i) transients (fluorescence ratio) were measured on the stage of an inverted phase-contrast microscope using a myocyte calcium imaging/cell length system. Phosphorylation levels of cardiac troponin I (cTnI) were determined by Western blot. The levels of nonspecific inflammatory marker C-reactive protein (CRP) and proinflammatory cytokine interleukin-6 (IL-6) in serum were measured by enzyme-linked immunosorbent assay (ELISA). Contraction of isolated cardiomyocytes was significantly reduced at d 1 and d 7 postexposure. Intracellular calcium levels were decreased in response to extracellular calcium stimulation at d 7 postexposure. Changes of intracellular calcium levels after isoprenaline hydrochloride (ISO) stimulation were not markedly different between groups at either time point. Phosphorylation levels of cTnI in the left ventricle were significantly lower at d 1 postexposure. The serum levels of CRP were not markedly different between groups at either time point. Serum levels of IL-6 were not detectable in both groups. Cardiomyocyte alterations observed after welding fume treatment were mainly due to alterations in intracellular calcium handling and phosphorylation levels of cTnI.

  20. Air stacking: effects on pulmonary function in patients with spinal muscular atrophy and in patients with congenital muscular dystrophy*,**

    PubMed Central

    Marques, Tanyse Bahia Carvalho; Neves, Juliana de Carvalho; Portes, Leslie Andrews; Salge, João Marcos; Zanoteli, Edmar; Reed, Umbertina Conti

    2014-01-01

    OBJECTIVE: Respiratory complications are the main causes of morbidity and mortality in patients with neuromuscular disease (NMD). The objectives of this study were to determine the effects that routine daily home air-stacking maneuvers have on pulmonary function in patients with spinal muscular atrophy (SMA) and in patients with congenital muscular dystrophy (CMD), as well as to identify associations between spinal deformities and the effects of the maneuvers. METHODS: Eighteen NMD patients (ten with CMD and eight with SMA) were submitted to routine daily air-stacking maneuvers at home with manual resuscitators for four to six months, undergoing pulmonary function tests before and after that period. The pulmonary function tests included measurements of FVC; PEF; maximum insufflation capacity (MIC); and assisted and unassisted peak cough flow (APCF and UPCF, respectively) with insufflations. RESULTS: After the use of home air-stacking maneuvers, there were improvements in the APCF and UPCF. In the patients without scoliosis, there was also a significant increase in FVC. When comparing patients with and without scoliosis, the increases in APCF and UPCF were more pronounced in those without scoliosis. CONCLUSIONS: Routine daily air-stacking maneuvers with a manual resuscitator appear to increase UPCF and APCF in patients with NMD, especially in those without scoliosis. PMID:25410841

  1. Right ventricular free wall pacing improves cardiac pump function in severe pulmonary arterial hypertension: a computer simulation analysis.

    PubMed

    Lumens, Joost; Arts, Theo; Broers, Bernard; Boomars, Karin A; van Paassen, Pieter; Prinzen, Frits W; Delhaas, Tammo

    2009-12-01

    In pulmonary arterial hypertension (PAH), duration of myofiber shortening is prolonged in the right ventricular (RV) free wall (RVfw) compared with that in the interventricular septum and left ventricular free wall. This interventricular mechanical asynchrony eventually leads to right heart failure. We investigated by computer simulation whether, in PAH, early RVfw pacing may improve interventricular mechanical synchrony and, hence, cardiac pump function. A mathematical model of the human heart and circulation was used to simulate left ventricular and RV pump mechanics and myofiber mechanics. First, we simulated cardiovascular mechanics of a healthy adult at rest. Size and mass of heart and blood vessels were adapted so that mechanical tissue load was normalized. Second, compensated PAH was simulated by increasing mean pulmonary artery pressure to 32 mmHg while applying load adaptation. Third, decompensated PAH was simulated by increasing mean pulmonary artery pressure further to 79 mmHg without further adaptation. Finally, early RVfw pacing was simulated in severely decompensated PAH. Time courses of circumferential strain in the ventricular walls as simulated were similar to the ones measured in healthy subjects (uniform strain patterns) and in PAH patients (prolonged RVfw shortening). When simulating pacing in decompensated PAH, RV pump function was best upon 40-ms RVfw preexcitation, as evidenced by maximal decrease of RV end-diastolic volume, reduced RVfw myofiber work, and most homogeneous distribution of workload over the ventricular walls. Thus our simulations indicate that, in decompensated PAH, RVfw pacing may improve RV pump function and may homogenize workload over the ventricular walls.

  2. Pulmonary edema

    MedlinePlus

    ... congestion; Lung water; Pulmonary congestion; Heart failure - pulmonary edema ... Pulmonary edema is often caused by congestive heart failure . When the heart is not able to pump efficiently, blood ...

  3. Anesthesia management during aortic surgery: Preoperative patient assessment.

    PubMed

    Mahlmann, Adrian; Weiss, Norbert

    2016-09-01

    Patients with aortic diseases have a high rate of cardiac, cerebrovascular, or pulmonary comorbidities. Open surgery or endovascular interventions of the aorta are associated with high perioperative cardiac risk. Simple scoring systems for preoperative risk stratification can be used to identify high-risk patients. In these patients, further diagnostic and therapeutic interventions are required to reduce perioperative morbidity and mortality. In contrast, low-risk patients can be identified, who may proceed to intervention without additional cardiopulmonary diagnostic testing. According to evidence-based recommendations in patients at risk, statin therapy should be initiated and beta blockers should be uptitrated preoperatively. Smoking cessation preoperatively reduces perioperative complications and should be encouraged in all patients. PMID:27650337

  4. A comparison of the effect of two doses of oral melatonin with oral midazolam and placebo on pre-operative anxiety, cognition and psychomotor function in children: A randomised double-blind study

    PubMed Central

    Kurdi, Madhuri S; Muthukalai, Sindhu Priya

    2016-01-01

    Background and Aims: Melatonin (MT), a naturally occurring pituitary hormone has a sleep promoting effect. There are very few studies on pre-operative oral MT (0.2–0.5 mg/kg) in children. We planned a study to assess the efficacy of oral MT in two doses and compare it with oral midazolam and placebo for pre-operative anxiolysis, sedation, maintenance of cognition and psychomotor skills, parental separation behaviour and venepuncture compliance. Methods: This prospective double-blind randomised study was conducted after ethical committee approval on 100 children aged 5–15 years, American Society of Anaesthesiologists physical status I and II undergoing elective surgery at our hospital from January 1, 2014, to December 31, 2014. Mentally disordered children were excluded from the study. They were randomised into four groups of 25 each (A, B, C, D) to receive either oral MT 0.5 mg/kg or 0.75 mg/kg or oral midazolam 0.5 mg/kg or placebo 45–60 min, respectively, before induction. The child's anxiety, cognition and psychomotor function before and after pre-medication, behaviour during the parental separation and venepuncture were appropriately scored. Kruskal–Wallis analysis of variance for intergroup and Wilcoxon matched pairs tests for intragroup comparisons of data were applied. Results: The four groups were comparable regarding mean age, weight and sex. The anxiety score reductions in the three groups when compared to placebo were statistically significant. Children receiving MT 0.75 mg/kg had maximum anxiolysis and venepuncture compliance (P < 0.05). Cognition was decreased with maximum sedation, successful parental separation and psychomotor impairment in the midazolam group (P < 0.05). Conclusion: Oral MT (0.5 mg/kg and 0.75 mg/kg) in children decreases pre-operative anxiety without impairing cognitive and psychomotor functions, the 0.75 mg/kg dose being most effective. PMID:27761038

  5. A Pre-operative Risk Model for Post-operative Pneumonia following Coronary Artery Bypass Grafting

    PubMed Central

    Strobel, Raymond J.; Liang, Qixing; Zhang, Min; Wu, Xiaoting; Rogers, Mary A. M.; Theurer, Patricia F.; Fishstrom, Astrid B.; Harrington, Steven D.; DeLucia, Alphonse; Paone, Gaetano; Patel, Himanshu J.; Prager, Richard L.; Likosky, Donald S.

    2016-01-01

    Background Post-operative pneumonia is the most prevalent of all hospital-acquired infections following isolated coronary artery bypass grafting (CAB). Accurate prediction of a patient’s risk of this morbid complication is hindered by its low relative incidence. In an effort to support clinical decision-making and quality improvement, we developed a pre-operative prediction model for post-operative pneumonia following CAB. Methods We undertook an observational study of 16,084 patients undergoing CAB between Q3 2011 – Q2 2014 across 33 institutions participating in the Michigan Society of Thoracic and Cardiovascular Surgeons – Quality Collaborative. Variables related to patient demographics, medical history, admission status, comorbid disease, cardiac anatomy and the institution performing the procedure were investigated. Logistic regression via forwards stepwise selection (p < 0.05 threshold) was utilized to develop a risk prediction model for estimating the occurrence of pneumonia. Traditional methods were employed to assess the model’s performance. Results Post-operative pneumonia occurred in 3.30% of patients. Multivariable analysis identified 17 pre-operative factors, including: demographics, laboratory values, comorbid disease, pulmonary and cardiac function, and operative status. The final model significantly predicted the occurrence of pneumonia, and performed well (C-statistic: 0.74). These findings were confirmed via sensitivity analyses by center and clinically important sub-groups. Conclusions We identified 17 readily obtainable pre-operative variables associated with post-operative pneumonia. This model may be used to provide individualized risk estimation and to identify opportunities to reduce a patient’s pre-operative risk of pneumonia through pre-habilitation. PMID:27261082

  6. [A failed improvement in pulmonary function and exercise capacity with carvedilol in congestive heart failure despite an excellent effect on left ventricular function].

    PubMed

    Guazzi, M; Pontone, G; Trevisi, N; Lomanto, M; Matturri, M; Agostoni, P

    1998-02-01

    This study was aimed at investigating in chronic heart failure (CHF) the effects that beta-blockade with carvedilol may have on lung function, and their relationship with left ventricular (LV) performance and peak exercise oxygen uptake (VO2p). CHF causes disturbances in ventilation and pulmonary gas transfer (stress failure of alveolar-capillary membrane) that participate in limiting VO2p. Carvedilol improves LV function and not VO2p. Twenty-one NYHA functional class II-III patients were randomized (2 to 1) to carvedilol (25 mg bid., 14 patients) or placebo (7 patients) for 6 months. Rest forced expiratory volume (FEV1), vital capacity (VC), total lung capacity (TLC), carbon monoxide diffusing capacity (DLCO), its alveolar-capillary membrane component (DM), pulmonary venous and transmitral flows (for monitoring changes in LV end-diastolic pressure, EDP), LV diastolic (EDD) and systolic (ESD) dimensions, stroke volume (SV), ejection fraction (EF), fiber shortening velocity (VCF) were measured at baseline and at 3 and 6 months. VO2p, peak ratio of dead space to tidal volume (VD/VTp), ventilatory equivalent for CO2 production (VE/VCO2), VO2 at anaerobic threshold (VO2at) were also determined. FEV1, VC, TLC, DLCO, DM were impaired in CHF compared to 14 volunteers, and did not vary with treatment. Carvedilol reduced EDP, EDD, ESD, and increased EF, SV, VCF, without affecting VO2p, VO2at, VD/VTp, VE/VCO2, at 3 and 6 months. Placebo was ineffective. In CHF, carvedilol exerts neutral effects on ventilation and pulmonary gas transfer and ameliorates LV function at rest. This proves that antifailure treatment may not be similarly effective on cardiac and pulmonary function; and does not contradict the possibility that persistence of lung impairment may contribute to lack of improvement in exercise performance with carvedilol.

  7. A portable single-sided magnet system for remote NMR measurements of pulmonary function

    PubMed Central

    Mikayel, Dabaghyan; Iga, Muradyan; James, Butler; Eric, Frederick; Feng, Zhou; Angelos, Kyriazis; Charles, Hardin; Samuel, Patz; Mirko, Hrovat

    2014-01-01

    In this work, we report initial results from a light-weight, low field magnetic resonance device designed to make relative pulmonary density measurements at the bedside. The development of this device necessarily involves special considerations for the magnet, RF and data acquisition schemes as well as a careful analysis of what is needed to provide useful information in the ICU. A homogeneous field region is created remotely from the surface of the magnet such that when the magnet is placed against the chest, an NMR signal is measured from a small volume in the lung. In order to achieve portability, one must trade off field strength and therefore spatial resolution. We report initial measurements from a ping-pong ball size region in the lung as a function of lung volume. As expected, we measured decreased signal at larger lung volumes since lung density decreases with increasing lung volume. Using a CPMG sequence with ΔTE=3.5 ms and a 20 echo train, a signal to noise ratio ~1100 was obtained from an 8.8mT planar magnet after signal averaging for 43 s. This is the first demonstration of NMR measurements made on a human lung with a light-weight planar NMR device. We argue that very low spatial resolution measurements of different lobar lung regions will provide useful diagnostic information for clinicians treating Acute Respiratory Distress Syndrome as clinicians want to avoid ventilator pressures that cause either lung over distension (too much pressure) or lung collapse (too little pressure). PMID:24953556

  8. Study of chest radiographs and pulmonary ventilatory function in perlite workers.

    PubMed

    Cooper, W C; Sargent, E N

    1986-03-01

    A review of chest films from 152 workers who had been employed five or more years in perlite mining or processing showed none with small opacities of profusion 1/0 or higher. There were 14 films with doubtful changes (0/1), but these showed no correlation with type or duration of employment. Pulmonary function was measured in 122 current employees from the same plants. Multiple regression analysis showed no significant association between years of employment in perlite and either forced vital capacity (FVC) or forced expiratory volume (FEV1). There was a significant association between pack-years of cigarettes and both measurements. In 66 workers tested in 1975 and again in 1983, there was an average annual decrease in FVC of 32 mL, with 26 mL predicted by the Knudson formula, which is based on nonsmokers. The average annual decrease in FEV1 was 24 mL with 26 mL predicted. Comparison of groups with differing smoking patterns showed that the decreases in both FVC and FEV1 were associated with smoking. The 28 men who had added four or more pack-years in the interval between tests showed decreases in FVC and FEV1 of 44 mL/year and 31 mL/year, respectively, with 26 mL/year predicted for both groups. Those with less than four added pack-years (which included 26 nonsmokers) had decreases in FVC and FEV1 of 23 mL/year and 19 mL/year with 26 mL/year and 27 mL/year predicted. PMID:3009754

  9. Airway size and the rate of pulmonary function decline in grain handlers

    SciTech Connect

    Vedal, S.; Enarson, D.A.; Chan-Yeung, M.

    1988-12-01

    Tracheal diameter and chest dimensions were measured from postero-anterior chest radiographs in grain handlers to prospectively identify airway size and chest size-related predictors of the rate of pulmonary function decline. A total of 634 grain workers were studied at the initial survey, of whom 239 satisfied the following inclusion criteria: (1) had a satisfactory chest radiograph taken at the initial survey in 1975, (2) performed spirometry at the 1975, 1978, and 1981 surveys, and (3) had no change in smoking status from 1975 to 1981. Radiographic measurements consisted of height of the right lung, transverse diameter of the chest at the level of the right diaphragm and at a level two-thirds up the right lung, and tracheal diameter (Tr). Areas of both lungs were measured by planimetry. Tr was only weakly related to height (r = 0.24). Increasing age was strongly associated with faster rates of FEV1 decline. After adjusting for the effects of age and cigarette smoking, Tr was the only radiographic measurement associated with FEV1 decline. Workers with Tr of 16 mm or less lost an average of 0.2% of their FEV1 per year compared to 0.9% per year for those with larger tracheas. This association was not modified by dust exposure estimates based on measurements of total dust. However, the strength of the association did depend upon smoking status, being strongest in current cigarette smokers (Tr less than or equal to 16 mm lost 0.2% annually and Tr greater than or equal to 21 mm lost 1.4% annually).

  10. Changes in Pulmonary Function Up to 10 Years After Locoregional Breast Irradiation

    SciTech Connect

    Erven, Katrien; Weltens, Caroline; Nackaerts, Kristiaan; Fieuws, Steffen; Decramer, Marc; Lievens, Yolande

    2012-02-01

    Purpose: To evaluate the long-term impact of locoregional breast radiotherapy (RT) on pulmonary function tests (PFTs). Methods and Materials: This study included 75 women who underwent postoperative locoregional breast RT. PFTs were performed before RT and 3, 6, and 12 months and 8 to 10 years after RT. By use of univariate and multivariate analyses, the impact of treatment- and patient-related factors on late changes in PFTs was evaluated. Results: During the first year after RT, all PFTs significantly worsened at 3 to 6 months after RT (p < 0.05). At 12 months, forced vital capacity (FVC), vital capacity (VC), and forced expiratory volume in 1 second (FEV{sub 1}) recovered almost to baseline values, whereas total lung capacity (TLC) and diffusion capacity of carbon monoxide (DL{sub CO}) recovered only slightly and were still found to be decreased compared with baseline (p < 0.05). At 8 to 10 years after RT, mean reductions in FEV{sub 1} of 4% (p = 0.03) and in VC, DL{sub CO}, and TLC of 5%, 9%, and 11% (all p < 0.0001), respectively, were observed compared with pre-RT values. On multivariate analysis, tamoxifen use negatively affected TLC at 8 to 10 years after RT (p = 0.033), whereas right-sided irradiation was associated with a late reduction in FEV{sub 1} (p = 0.027). For FEV{sub 1} and DL{sub CO}, an early decrease was predictive for a late decrease (p = 0.003 and p = 0.0009, respectively). Conclusions: The time course of PFT changes after locoregional RT for breast cancer follows a biphasic pattern. An early reduction in PFTs at 3 to 6 months with a partial recovery at 12 months after RT is followed by a late, more important PFT reduction up to 8 to 10 years after RT. Tamoxifen use may have an impact on this late decline in PFTs.

  11. Influence of menstrual cycle phase on pulmonary function in asthmatic athletes.

    PubMed

    Stanford, Kristin I; Mickleborough, Timothy D; Ray, Shahla; Lindley, Martin R; Koceja, David M; Stager, Joel M

    2006-04-01

    The main aim of this study was to investigate whether there is a relationship between menstrual cycle phase and exercise-induced bronchoconstriction (EIB) in female athletes with mild atopic asthma. Seven eumenorrheic subjects with regular 28-day menstrual cycles were exercised to volitional exhaustion on day 5 [mid-follicular (FOL)] and day 21 [mid-luteal (LUT)] of their menstrual cycle. Pulmonary function tests were conducted pre- and post-exercise. The maximal percentage decline in post-exercise forced expiratory volume in 1 s (FEV(1)) and forced expiratory flow from 25 to 75% of forced vital capacity (FEF(25-75%)) was significantly greater (P<0.05) on day 21 (mid-LUT phase) (-17.35+/-2.32 and -26.28+/-6.04%, respectively), when salivary progesterone concentration was highest, compared to day 5 (mid-FOL phase) (-12.81+/-3.35 and -17.23+/-8.20%, respectively), when salivary progesterone concentration was lowest. The deterioration in the severity of EIB during the mid-LUT phase was accompanied by worsening asthma symptoms and increased bronchodilator use. There was a negative correlation between the percent change in pre- to post-exercise FEV(1) and salivary progesterone concentration. However, no such correlation was found between salivary estradiol and the percentage change in pre- to post-exercise FEV(1). This study has shown for the first time that menstrual cycle phase is an important determinant of the severity of EIB in female athletes with mild atopic asthma. Female asthmatic athletes may need to adjust their training and competition schedules to their menstrual cycle and to consider the potential negative effects of the LUT phase of the menstrual cycle on exercise performance.

  12. A HAND2 Loss-of-Function Mutation Causes Familial Ventricular Septal Defect and Pulmonary Stenosis

    PubMed Central

    Sun, Yu-Min; Wang, Jun; Qiu, Xing-Biao; Yuan, Fang; Li, Ruo-Gu; Xu, Ying-Jia; Qu, Xin-Kai; Shi, Hong-Yu; Hou, Xu-Min; Huang, Ri-Tai; Xue, Song; Yang, Yi-Qing

    2016-01-01

    Congenital heart disease (CHD) is the most common developmental abnormality, and is the leading noninfectious cause of mortality in neonates. Increasing evidence demonstrates that genetic defects play an important role in the pathogenesis of CHD. However, CHD exhibits substantial heterogeneity, and the genetic determinants for CHD remain unknown in the overwhelming majority of cases. In the current study, the coding exons and flanking introns of the HAND2 gene, which encodes a basic helix-loop-helix transcription factor essential for normal cardiovascular development, were sequenced in 192 unrelated patients with CHD, and a novel heterozygous mutation, p.S65I, was identified in a patient with congenital ventricular septal defect (VSD). Genetic analysis of the index patient’s pedigree revealed that the mutation was present in all seven affected family members available, but absent in the 13 unaffected family members examined. Besides, in addition to VSD, five of the proband’s close relatives also had pulmonary stenosis (PS), and the proband’s son also had double outlet right ventricle (DORV). The missense mutation, which altered an evolutionarily conserved amino acid, was absent in 300 unrelated, ethnically matched healthy individuals. Biological analyses using a dual-luciferase reporter assay system showed that the mutant HAND2 was associated with significantly diminished transcriptional activity. Furthermore, the mutation abolished the synergistic activation between HAND2 and GATA4, as well as NKX2.5—two other cardiac core transcriptional factors that have been causally linked to CHD. These findings indicate that HAND2 loss-of-function mutation contributes to human CHD, perhaps via its interaction with GATA4 and NKX2.5. PMID:26865696

  13. Effect of thoracic arthrodesis in prepubertal New Zealand white rabbits on cardio-pulmonary function

    PubMed Central

    Canavese, Federico; Dimeglio, Alain; Barbetta, Davide; Pereira, Bruno; Fabbro, Sergio; Bassini, Federica; Canavese, Bartolomeo

    2014-01-01

    Background: This experimental study was aimed at evaluating the type of cardiac and pulmonary involvement, in relation to changes of the thoracic spine and cage in prepubertal rabbits with nondeformed spine following dorsal arthrodesis. The hypothesis was that T1-T12 arthrodesis modified thoracic dimensions, but would not modify cardiopulmonary function once skeletal maturity was reached. Materials and Methods: The study was conducted in 16 female New Zealand White (NZW) rabbits. Nine rabbits were subjected to T1-T12 dorsal arthrodesis while seven were sham-operated. Echocardiographic images were obtained at 12 months after surgery and parameters for 2-dimensional and M-mode echocardiographic variables were assessed. One week before echocardiographic examination, blood samples were withdrawn from the animals’ central artery of the left ear to obtain blood gas values. One week after echocardiographic assessment, a thoracic CT scan was performed under general anesthesia. Chest depth (CD) and width (CW), thoracic kyphosis (ThK) and sternal length (StL) were measured; thoracic index (ThI), expressed as CD/CW ratio. All subjects were euthanized after the CT scan. Heart and lungs were subsequently removed to measure weight and volume. Results: The values for 2-dimensional and M-mode echocardiographic variables were found to be uniformly and significantly higher, compared to those reported in anesthetized rabbits. CD, ThK, and StL were considerably lower in operated rabbits, as compared to the ones that were sham-operated. Similarly, the ThI was lower in operated rabbits than in sham-operated ones. Conclusion: Irregularities in thoracic cage growth resulting from thoracic spine arthrodesis did not alter blood and echocardiographic parameters in NZW rabbits. PMID:24741141

  14. The peroxynitrite catalyst WW-85 improves pulmonary function in ovine septic shock.

    PubMed

    Maybauer, Dirk M; Maybauer, Marc O; Szabó, Csaba; Cox, Robert A; Westphal, Martin; Kiss, Levente; Horvath, Eszter M; Traber, Lillian D; Hawkins, Hal K; Salzman, Andrew L; Southan, Garry J; Herndon, David N; Traber, Daniel L

    2011-02-01

    Systemic inflammatory response syndrome is associated with excessive production of nitric oxide (NO·) and superoxide (O2), forming peroxynitrite, which in turn, acts as a terminal mediator of cellular injury by producing cell necrosis and apoptosis. We examined the effect of the peroxynitrite decomposition catalyst, WW-85, in a sheep model of acute lung injury and septic shock. Eighteen sheep were operatively prepared and randomly allocated to the sham, control, or WW-85 group (n = 6 each). After a tracheotomy, acute lung injury was produced in the control and WW-85 groups by insufflation of four sets of 12 breaths of cotton smoke. Then, a 30-mL suspension of live Pseudomonas aeruginosa bacteria (containing 2 - 5 × 10¹¹ colony-forming units) was instilled into the lungs according to an established protocol. The sham group received only the vehicle (30 mL saline). The sheep were studied in awake state for 24 h and ventilated with 100% oxygen. WW-85 was administered 1 h after injury as bolus infusion (0.1 mg/kg), followed by a continuous infusion of 0.02 mg·kg⁻¹·h⁻¹ until the end of the 24-h experimental period. Compared with injured but untreated controls, WW-85-treated animals had significantly improved gas exchange, reductions in airway obstruction, shunt formation, lung myeloperoxidase concentrations, lung malondialdehyde concentrations, lung 3-nitrotyrosine concentrations, and plasma nitrate-to-nitrite levels. Animals treated with WW-85 exhibited less microvascular leakage and improvements in pulmonary function. These results provide evidence that blockade of the nitric oxide-peroxynitrite pathway improves disturbances from septic shock, as demonstrated in a clinically relevant ovine experimental model.

  15. Individualized prediction of lung-function decline in chronic obstructive pulmonary disease

    PubMed Central

    Zafari, Zafar; Sin, Don D.; Postma, Dirkje S.; Löfdahl, Claes-Göran; Vonk, Judith; Bryan, Stirling; Lam, Stephen; Tammemagi, C. Martin; Khakban, Rahman; Man, S.F. Paul; Tashkin, Donald; Wise, Robert A.; Connett, John E.; McManus, Bruce; Ng, Raymond; Hollander, Zsuszanna; Sadatsafavi, Mohsen

    2016-01-01

    Background: The rate of lung-function decline in chronic obstructive pulmonary disease (COPD) varies substantially among individuals. We sought to develop and validate an individualized prediction model for forced expiratory volume at 1 second (FEV1) in current smokers with mild-to-moderate COPD. Methods: Using data from a large long-term clinical trial (the Lung Health Study), we derived mixed-effects regression models to predict future FEV1 values over 11 years according to clinical traits. We modelled heterogeneity by allowing regression coefficients to vary across individuals. Two independent cohorts with COPD were used for validating the equations. Results: We used data from 5594 patients (mean age 48.4 yr, 63% men, mean baseline FEV1 2.75 L) to create the individualized prediction equations. There was significant between-individual variability in the rate of FEV1 decline, with the interval for the annual rate of decline that contained 95% of individuals being −124 to −15 mL/yr for smokers and −83 to 15 mL/yr for sustained quitters. Clinical variables in the final model explained 88% of variation around follow-up FEV1. The C statistic for predicting severity grades was 0.90. Prediction equations performed robustly in the 2 external data sets. Interpretation: A substantial part of individual variation in FEV1 decline can be explained by easily measured clinical variables. The model developed in this work can be used for prediction of future lung health in patients with mild-to-moderate COPD. Trial registration: Lung Health Study — ClinicalTrials.gov, no. NCT00000568; Pan-Canadian Early Detection of Lung Cancer Study — ClinicalTrials.gov, no. NCT00751660 PMID:27486205

  16. Study of chest radiographs and pulmonary ventilatory function in perlite workers.

    PubMed

    Cooper, W C; Sargent, E N

    1986-03-01

    A review of chest films from 152 workers who had been employed five or more years in perlite mining or processing showed none with small opacities of profusion 1/0 or higher. There were 14 films with doubtful changes (0/1), but these showed no correlation with type or duration of employment. Pulmonary function was measured in 122 current employees from the same plants. Multiple regression analysis showed no significant association between years of employment in perlite and either forced vital capacity (FVC) or forced expiratory volume (FEV1). There was a significant association between pack-years of cigarettes and both measurements. In 66 workers tested in 1975 and again in 1983, there was an average annual decrease in FVC of 32 mL, with 26 mL predicted by the Knudson formula, which is based on nonsmokers. The average annual decrease in FEV1 was 24 mL with 26 mL predicted. Comparison of groups with differing smoking patterns showed that the decreases in both FVC and FEV1 were associated with smoking. The 28 men who had added four or more pack-years in the interval between tests showed decreases in FVC and FEV1 of 44 mL/year and 31 mL/year, respectively, with 26 mL/year predicted for both groups. Those with less than four added pack-years (which included 26 nonsmokers) had decreases in FVC and FEV1 of 23 mL/year and 19 mL/year with 26 mL/year and 27 mL/year predicted.

  17. Pulmonary function responses to ozone in smokers with a limited smoking history

    SciTech Connect

    Bates, Melissa L.; Brenza, Timothy M.; Ben-Jebria, Abdellaziz; Bascom, Rebecca; Eldridge, Marlowe W.; Ultman, James S.

    2014-07-01

    In non-smokers, ozone (O{sub 3}) inhalation causes decreases in forced expiratory volume (FEV{sub 1}) and dead space (V{sub D}) and increases the slope of the alveolar plateau (S{sub N}). We previously described a population of smokers with a limited smoking history that had enhanced responsiveness to brief O{sub 3} boluses and aimed to determine if responsiveness to continuous exposure was also enhanced. Thirty smokers (19 M, 11 F, 24 ± 4 years, 6 ± 4 total years smoking,4 ± 2 packs/week) and 30 non-smokers (17 M, 13 F, 25 ± 6 years) exercised for 1 h on a cycle ergometer while breathing 0.30 ppm O{sub 3}. Smokers and non-smokers were equally responsive in terms of FEV{sub 1} (− 9.5 ± 1.8% vs − 8.7 ± 1.9%). Smokers alone were responsive in terms of V{sub D} (− 6.1 ± 1.2%) and S{sub N} (9.1 ± 3.4%). There was no difference in total delivered dose. Dead space ventilation (V{sub D}/V{sub T}) was not initially different between the two groups, but increased in the non-smokers (16.4 ± 2.8%) during the exposure, suggesting that the inhaled dose may be distributed more peripherally in smokers. We also conclude that these cigarette smokers retain their airway responsiveness to O{sub 3} and, uniquely, experience changes in V{sub D} that lead to heterogeneity in airway morphometry and an increase in S{sub N}. - Highlights: • We previously found lung function responses to O{sub 3} bolus exposure in smokers. • Here, we describe their responsiveness to continuous O{sub 3} exposure with exercise. • Spirometry and capnography were used to assess pulmonary function changes. • Enhanced bronchoconstriction in smokers increases parenchymal delivery of O{sub 3}.

  18. Percutaneous Pulmonary Valve Placement

    PubMed Central

    Prieto, Lourdes R.

    2015-01-01

    Patients with congenital heart disease and pulmonary valve disease need multiple procedures over their lifetimes to replace their pulmonary valves. Chronic pulmonary stenosis, regurgitation, or both have untoward effects on ventricular function and on the clinical status of these patients. To date, all right ventricle–pulmonary artery conduits have had relatively short lifespans. Percutaneous pulmonary valve implantation, although relatively new, will probably reduce the number of operative procedures that these patients will have to undergo over a lifetime. Refinement and further development of this procedure holds promise for the extension of this technology to other patient populations. PMID:26175629

  19. Clinical, functional and pathological correspondence in early stage idiopathic pulmonary fibrosis: evidence for small airway obstruction 1-2.

    PubMed

    Myre, M; Allard, S; Bernard, C; Martin, R R

    1988-01-01

    We describe the clinical, physiological and pathological features of 23 subjects with early stage idiopathic pulmonary fibrosis. Thirteen subjects who had no symptoms had been fortuitously recruited by a routine chest radiograph, whereas the 10 other subjects complained of dyspnea. Twenty-one subjects showed only light to moderate extent of abnormalities on the chest radiograph. Fourteen subjects had a reduced vital capacity whereas 16 and 17 showed a reduced pulmonary compliance and an increase in lung elastic recoil, respectively. Transfer factor was significantly reduced in 18 subjects. Evidence for significant airway obstruction, mainly located at the peripheral level, was demonstrated by a reduced specific lung conductance and upstream conductance in 13 subjects. Airway obstruction was not associated with smoking habits. Bronchial hyperresponsiveness was noted in 50% of the 18 subjects studied. Although fibrosis was mild to moderate in 15 instances, it was only focal, i.e. at least one zone of normal parenchyma in the lung specimen in 17 subjects. Peribronchial fibrosis was established in 8/11 satisfactory biopsy specimens. Significant correlations were observed between rales, the radiological score, some functional indices and the characteristics of fibrosis. We conclude that small airway obstruction documented by physiological and pathological means is frequent in early stage idiopathic pulmonary fibrosis. PMID:3420306

  20. Changes in pulmonary function and airway reactivity due to prolonged exposure to typical ambient ozone (O sub 3 ) levels

    SciTech Connect

    Horstman, D.; McDonnell, W.; Folinsbee, L.; Abdul-Salaam, S.; Ives, P.

    1989-01-01

    Previously observed (JAPCA 38:28-35, 1988) pulmonary responses of delta FEV1 (-13%), moderate to severe pain upon inspiration, and a doubling of PD100 for methacholine following prolonged moderate exercise at 0.12 ppm O3 were of sufficient magnitude to warrant the assessing of responses at a lower range of concentrations, i.e., 0.08, 0.10 and 0.12 ppm O3. Exposures consisted of six 50-min exercises (VE approximately equals 40 L/min), each followed by 10-min rest; a 35-min lunch break was included. When compared with exposures to 0.00 ppm, substantial pulmonary function decrements, respiratory symptoms and increases in nonspecific airway reactivity were observed at all three O3 concentrations. For example, decreases in FEV1 (P < 0.01) of 7%, 7% and 12% were observed at 0.08, 0.10 and 0.12 ppm O3, respectively. The ratios (P < 0.005) of PD100 observed in 0.00 ppm to that in O3 were 1.56 at 0.08 ppm, 1.89 at 0.10 ppm, and 2.21 at 0.12 ppm O3. It is concluded that exercise representative of a day of moderate to heavy work or play performed during exposures to O3 at levels and pattern often found in ambient air induced clinically meaningful pulmonary responses.

  1. Pulmonary endarterectomy after pulmonary infectious embolisms

    PubMed Central

    Heiberg, Johan; Ilkjær, Lars B.

    2013-01-01

    Pulmonary endarterectomy (PEA) is a well-established procedure in the treatment of chronic thromboembolic pulmonary hypertension (CTPH). The procedure is known to increase functional outcome and to raise the 5-year survival rate. We report 2 cases of pulmonary valve endocarditis and secondary embolisms causing sustained pulmonary hypertension. Both were treated with PEA. In none of the cases, a cleavage between the thrombotic masses and the vessel wall was obtainable, and both attempts were therefore inadequate. Based on our reports, we recommend not attempting PEA in cases of CTPH after infectious embolisms. PMID:23248168

  2. Hemodynamics and right-ventricle functional characteristics of a swine carotid artery-jugular vein shunt model of pulmonary arterial hypertension: An 18-month experimental study.

    PubMed

    Wu, Ji; Luo, Xiaoju; Huang, Yuanyuan; He, Yun; Li, Zhixian

    2015-10-01

    The continuous changes in pulmonary hemodynamic properties and right ventricular (RV) function in pulmonary arterial hypertension (PAH) have not been fully characterized in large animal model of PAH induced by a carotid artery-jugular vein shunt. A minipig model of PAH was induced by a surgical anastomosis between the left common carotid artery and the left jugular vein. The model was validated by catheter examination and pathologic analyses, and the hemodynamic features and right-ventricle functional characteristics of the model were continuously observed by Doppler echocardiography. Of the 45 minipigs who received the surgery, 27 survived and were validated as models of PAH, reflected by mean pulmonary artery pressure ≥25 mmHg, and typical pathologic changes of pulmonary arterial remodeling and RV fibrosis. Non-invasive indices of pulmonary hemodynamics (pulmonary artery accelerating time and its ratio to RV ventricular ejection time) were temporarily increased, then reduced later, similar to changes in tricuspid annular displacement. The Tei index of the RV was elevated, indicating a progressive impairment in RV function. Surgical anastomosis between carotid artery and jugular vein in a minipig is effective to establish PAH, and non-invasive hemodynamic and right-ventricle functional indices measured by Doppler echocardiography may be used as early indicators of PAH. PMID:25595189

  3. Hemodynamics and right-ventricle functional characteristics of a swine carotid artery-jugular vein shunt model of pulmonary arterial hypertension: An 18-month experimental study

    PubMed Central

    Luo, Xiaoju; Huang, Yuanyuan; He, Yun; Li, Zhixian

    2015-01-01

    The continuous changes in pulmonary hemodynamic properties and right ventricular (RV) function in pulmonary arterial hypertension (PAH) have not been fully characterized in large animal model of PAH induced by a carotid artery–jugular vein shunt. A minipig model of PAH was induced by a surgical anastomosis between the left common carotid artery and the left jugular vein. The model was validated by catheter examination and pathologic analyses, and the hemodynamic features and right-ventricle functional characteristics of the model were continuously observed by Doppler echocardiography. Of the 45 minipigs who received the surgery, 27 survived and were validated as models of PAH, reflected by mean pulmonary artery pressure ≥25 mmHg, and typical pathologic changes of pulmonary arterial remodeling and RV fibrosis. Non-invasive indices of pulmonary hemodynamics (pulmonary artery accelerating time and its ratio to RV ventricular ejection time) were temporarily increased, then reduced later, similar to changes in tricuspid annular displacement. The Tei index of the RV was elevated, indicating a progressive impairment in RV function. Surgical anastomosis between carotid artery and jugular vein in a minipig is effective to establish PAH, and non-invasive hemodynamic and right-ventricle functional indices measured by Doppler echocardiography may be used as early indicators of PAH. PMID:25595189

  4. Hemodynamics and right-ventricle functional characteristics of a swine carotid artery-jugular vein shunt model of pulmonary arterial hypertension: An 18-month experimental study.

    PubMed

    Wu, Ji; Luo, Xiaoju; Huang, Yuanyuan; He, Yun; Li, Zhixian

    2015-10-01

    The continuous changes in pulmonary hemodynamic properties and right ventricular (RV) function in pulmonary arterial hypertension (PAH) have not been fully characterized in large animal model of PAH induced by a carotid artery-jugular vein shunt. A minipig model of PAH was induced by a surgical anastomosis between the left common carotid artery and the left jugular vein. The model was validated by catheter examination and pathologic analyses, and the hemodynamic features and right-ventricle functional characteristics of the model were continuously observed by Doppler echocardiography. Of the 45 minipigs who received the surgery, 27 survived and were validated as models of PAH, reflected by mean pulmonary artery pressure ≥25 mmHg, and typical pathologic changes of pulmonary arterial remodeling and RV fibrosis. Non-invasive indices of pulmonary hemodynamics (pulmonary artery accelerating time and its ratio to RV ventricular ejection time) were temporarily increased, then reduced later, similar to changes in tricuspid annular displacement. The Tei index of the RV was elevated, indicating a progressive impairment in RV function. Surgical anastomosis between carotid artery and jugular vein in a minipig is effective to establish PAH, and non-invasive hemodynamic and right-ventricle functional indices measured by Doppler echocardiography may be used as early indicators of PAH.

  5. Pulmonary function abnormalities and asthma are prevalent in children with sickle cell disease and are associated with acute chest syndrome.

    PubMed

    Intzes, Stefanos; Kalpatthi, Ram V; Short, Robert; Imran, Hamayun

    2013-11-01

    Pulmonary diseases form major sources of morbidity and mortality in children with sickle cell disease (SCD). The objective of the study was to determine the prevalence of lung function abnormalities and asthma and their association with acute chest syndrome (ACS) in children with SCD. This was a cross-sectional retrospective study of 127 children with SCD; we collected information regarding ACS and asthma and pulmonary function test (PFT) data. Based on PFT results, the patients were assigned to one pattern of lung function [normal, obstructive lung disease (OLD), restrictive lung disease (RLD)]. Statistical analyses included Pearson correlation, prevalence odds ratio (POR), cross-tabulation, and multiple binary logistic regression. OLD was noted in 35% and RLD in 23% of the patients, with the remainder exhibiting a normal PFT pattern. Forty-six percent of patients had asthma, 64% of whom had a history of ACS. OLD (r = .244, P = .008, POR = 2.8) and asthma (r = .395, P < .001, POR = 5.4) were significantly associated with a history of ACS. There was a negative correlation between having normal PFT data and a history of ACS (r = -.289, P = .002, POR = .3). Asthma and pulmonary function abnormalities are prevalent in children with SCD, with OLD being more common than RLD. There is an association between asthma, OLD, and ACS, however causality cannot be proven due to the study design. We stress the importance of actively investigating for a clinical diagnosis of asthma in all patients with SCD and suggest that PFT data may help detect patients at lower risk for ACS.

  6. Effects of milrinone and epinephrine or dopamine on biventricular function and hemodynamics in right heart failure after pulmonary regurgitation.

    PubMed

    Hyldebrandt, Janus Adler; Agger, Peter; Sivén, Eleonora; Wemmelund, Kristian Borup; Heiberg, Johan; Frederiksen, Christian Alcaraz; Ravn, Hanne Berg

    2015-09-01

    Right ventricular failure (RVF) secondary to pulmonary regurgitation (PR) impairs right ventricular (RV) function and interrupts the interventricular relationship. There are few recommendations for the medical management of severe RVF after prolonged PR. PR was induced in 16 Danish landrace pigs by plication of the pulmonary valve leaflets. Twenty-three pigs served as controls. At reexamination the effect of milrinone, epinephrine, and dopamine was evaluated using biventricular conductance and pulmonary catheters. Seventy-nine days after PR was induced, RV end-diastolic volume index (EDVI) had increased by 33% (P = 0.006) and there was a severe decrease in the load-independent measurement of contractility (PRSW) (-58%; P = 0.003). Lower cardiac index (CI) (-28%; P < 0.0001), mean arterial pressure (-15%; P = 0.01) and mixed venous oxygen saturation (SvO2) (36%; P < 0.0001) were observed compared with the control group. The interventricular septum deviated toward the left ventricle (LV). Milrinone improved RV-PRSW and CI and maintained systemic pressure while reducing central venous pressure (CVP). Epinephrine and dopamine further improved biventricular PRSW and CI equally in a dose-dependent manner. Systemic and pulmonary pressures were higher in the dopamine-treated animals compared with epinephrine-treated animals. None of the treatments improved stroke volume index (SVI) despite increases in contractility. Strong correlation was detected between SVI and LV-EDVI, but not SVI and biventricular contractility. In RVF due to PR, milrinone significantly improved CI, SvO2, and CVP and increased contractility in the RV. Epinephrine and dopamine had equal inotropic effect, but a greater vasopressor effect was observed for dopamine. SV was unchanged due to inability of both treatments to increase LV-EDVI.

  7. Preoperative blood transfusions for sickle cell disease

    PubMed Central

    Estcourt, Lise J; Fortin, Patricia M; Trivella, Marialena; Hopewell, Sally

    2016-01-01

    Background Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Surgical interventions are more common in people with sickle cell disease, and occur at much younger ages than in the general population. Blood transfusions are frequently used prior to surgery and several regimens are used but there is no consensus over the best method or the necessity of transfusion in specific surgical cases. This is an update of a Cochrane review first published in 2001. Objectives To determine whether there is evidence that preoperative blood transfusion in people with sickle cell disease undergoing elective or emergency surgery reduces mortality and perioperative or sickle cell-related serious adverse events. To compare the effectiveness of different transfusion regimens (aggressive or conservative) if preoperative transfusions are indicated in people with sickle cell disease. Search methods We searched for relevant trials in The Cochrane Library, MEDLINE (from 1946), Embase (from 1974), the Transfusion Evidence Library (from 1980), and ongoing trial databases; all searches current to 23 March 2016. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register: 18 January 2016. Selection criteria All randomised controlled trials and quasi-randomised controlled trials comparing preoperative blood transfusion regimens to different regimens or no transfusion in people with sickle cell disease undergoing elective or emergency surgery. There was no restriction by outcomes examined, language or publication status. Data collection and analysis Two authors independently assessed trial eligibility and the risk of bias and extracted data. Main results Three trials with 990 participants were eligible for inclusion in the review. There were no

  8. Study of pulmonary functions of the tourist guides in two show caves in Slovenia

    NASA Astrophysics Data System (ADS)

    Debevec Gerjevic, V.; Jovanovič, P.

    2009-04-01

    Park Škocjan Caves is located in South Eastern part of Slovenia. It was established with aim of conserving and protecting exceptional geomorphological, geological and hydrological outstanding features, rare and endangered plant and animal species, paleontological and archaeological sites, ethnological and architectural characteristics and cultural landscape and for the purpose of ensuring opportunities for suitable development, by the National Assembly of the Republic of Slovenia in 1996. Due to their exceptional significance for cultural and natural heritage, the Škocjan Caves were entered on UNESCO's list of natural and cultural world heritage sites in 1986. Caves have always been special places for people all over the world. There has been a lot of research done in the field of speleology and also in medicine in relation to speleotherapy. There is still one field left partial unexplored and its main issue covers the interaction between special ecosystems as caves and human activities and living. Implementing the Slovene legislation in the field of radiation protection, we are obligated to perform special measurements in the caves and also having our guides and workers in the caves regularly examined according to established procedure. The medical exams are performed at Institution of Occupational Safety, Ljubljana in order to monitor the influence of Radon to the workers in the cave. The issue of epidemiologic research encompass several factors that are not necessarily related to the radon. Park Škocjan Caves established research monitoring projects such as caves microclimate parameters, quality of the water, every day's data from our meteorological station useful tool in public awareness related to pollution and climate change. Last year a special study was started in order to evaluate pulmonary functions of persons who work in the caves and those who work mostly in offices. Two groups of tourist guides from Škocjan Caves and Postojna Cave were included in

  9. Functional expression of the transient receptor potential channel TRPA1, a sensor for toxic lung inhalants, in pulmonary epithelial cells.

    PubMed

    Büch, Thomas Robert Heinrich; Schäfer, Eva Anna Maria; Demmel, Maria-Theresia; Boekhoff, Ingrid; Thiermann, Horst; Gudermann, Thomas; Steinritz, Dirk; Schmidt, Annette

    2013-12-01

    The cation channel TRPA1 functions as a chemosensory protein and is directly activated by a number of noxious inhalants. A pulmonary expression of TRPA1 has been described in sensory nerve endings and its stimulation leads to the acceleration of inflammatory responses in the lung. Whereas the function of TRPA1 in neuronal cells is well defined, only few reports exist suggesting a role in epithelial cells. The aim of the present study was therefore (1) to evaluate the expression of TRPA1 in pulmonary epithelial cell lines, (2) to characterize TRPA1-promoted signaling in these cells, and (3) to study the extra-neuronal expression of this channel in lung tissue sections. Our results revealed that the widely used alveolar type II cell line A549 expresses TRPA1 at the mRNA and protein level. Furthermore, stimulating A549 cells with known TRPA1 activators (i.e., allyl isothiocyanate) led to an increase in intracellular calcium levels, which was sensitive to the TRPA1 blocker ruthenium red. Investigating TRPA1 coupled downstream signaling cascades it was found that TRPA1 activation elicited a stimulation of ERK1/2 whereas other MAP kinases were not affected. Finally, using epithelial as well as neuronal markers in immunohistochemical approaches, a non-neuronal TRPA1 protein expression was detected in distal parts of the porcine lung epithelium, which was also found examining human lung sections. TRPA1-positive staining co-localized with both epithelial and neuronal markers underlining the observed epithelial expression pattern. Our findings of a functional expression of TRPA1 in pulmonary epithelial cells provide causal evidence for a non-neuronal TRPA1-mediated control of inflammatory responses elicited upon TRPA1-mediated registration of toxic inhalants in vivo. PMID:23994502

  10. Comparison of pulmonary function and back muscle strength according to the degree of spinal curvature of healthy adults.

    PubMed

    You, Jae Eung; Lee, Hye Young; Kim, Kyoung

    2015-06-01

    [Purpose] Degree of curvature on the spine is known to affect respiratory function and back muscle activation. We compared pulmonary function and back muscle strength according to the degree of curvature of the spine of healthy adults. [Subjects and Methods] Twenty-three healthy volunteers were enrolled. They were divided into two groups according to the degree of curvature of the spine: the below 2° group, and the above 2° group. The degree of curvature was assessed using the Adams forward bending test and a scoliometer. A pulmonary function test (PFT) was conducted, and back muscle strength was measured. [Results] No significant differences in PFT were found between the below 2° group and the above 2° group, in terms of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC), or peak expiratory flow (PEF). However, back muscle strength in the below 2 group was significantly higher than that of the above 2 group. [Conclusion] Our findings indicate that the degree of curvature of the spine is associated with back muscle strength in subjects who have spinal curvature within the normal range. Therefore, evaluation and treatment of back muscle strength might be helpful for preventing the progress of curvature of the spine in adolescents with potential scoliosis. PMID:26180321

  11. The Effects of Game-Based Breathing Exercise on Pulmonary Function in Stroke Patients: A Preliminary Study

    PubMed Central

    Joo, Sunghee; Shin, Doochul; Song, Changho

    2015-01-01

    Background Reduction of respiratory function along with hemiparesis leads to decreased endurance, dyspnea, and increased sedentary behavior, as well as to an increased risk of stroke. The main purpose of this study was to investigate the preliminary effects of game-based breathing exercise (GBE) on pulmonary function in stroke patients. Material/Methods Thirty-eight in-patients with stroke (22 men, 16 women) were recruited for the study. Participants were randomly allocated into 2 groups: patients assigned to the GBE group (n=19), and the control group (n=19). The GBE group participated in a GBE program for 25 minutes a day, 3 days a week, during a 5 week period. For the same period, both groups participated in a conventional stroke rehabilitation program. Forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), FEV1/FVC, and maximum voluntary ventilation (MVV) were measured by a spirometer in pre- and post-testing. Results The GBE group had significantly improved FVC, FEV1, and MVV values compared with the control group (p<0.05), although there was no significant difference in FEV1/FVC value between groups. Significant short-term effects of the GBE program on pulmonary function in stroke patients were recorded in this study. Conclusions These findings gave some indications that it may be feasible to include GBE in rehabilitation interventions with this population. PMID:26098853

  12. Functional mutations in 5'UTR of the BMPR2 gene identified in Chinese families with pulmonary arterial hypertension.

    PubMed

    Wang, Jian; Zhang, Chenting; Liu, Chunli; Wang, Wei; Zhang, Nuofu; Hadadi, Cyrus; Huang, Junyi; Zhong, Nanshan; Lu, Wenju

    2016-03-01

    Pulmonary arterial hypertension (PAH) is a progressive pulmonary vasculopathy with significant morbidity and mortality. Bone morphogenetic protein receptor type 2 (BMPR2) has been well recognized as the principal gene responsible for heritable and sporadic PAH. Four unrelated Chinese patients with PAH and their family members, both symptomatic and asymptomatic, were genetically evaluated by sequencing all exons and the flanking regions of BMPR2. Functionality of the aberrant mutations at the 5' untranslated region (UTR) of BMPR2 in the families with PAH was determined by site mutation, transient transfection, and promoter-reporter assays. Four individual mutations in the BMPR2 gene were identified in the 4 families, respectively: 10-GGC repeats, 13-GGC repeats, 4-AGC repeats in 5'UTR, and a novel missense mutation in exon 7 (c.961C>T; p.Arg321X). Moreover, we demonstrated that (1) these 5'UTR mutations decreased the transcription of BMPR2 and (2) the GGC repeats and AGC repeats in BMPR2 5'UTR bore functional binding sites of EGR-1 and MYF5, respectively. This is the first report demonstrating the presence of functional BMPR2 5'UTR mutations in familial patients with PAH and further indicating that EGR-1 and MYF5 are potential targets for correcting these genetic abnormalities for PAH therapy. PMID:27162618

  13. Pulmonary rehabilitation coupled with negative pressure ventilation decreases decline in lung function, hospitalizations, and medical cost in COPD

    PubMed Central

    Huang, Hung-Yu; Chou, Pai-Chien; Joa, Wen-Ching; Chen, Li-Fei; Sheng, Te-Fang; Lin, Horng-Chyuan; Yang, Lan-Yan; Pan, Yu-Bin; Chung, Fu-Tsai; Wang, Chun-Hua; Kuo, Han-Pin

    2016-01-01

    Abstract Pulmonary rehabilitation (PR) brings benefits to patients with chronic obstructive pulmonary disease (COPD). Negative pressure ventilation (NPV) increases ventilation and decreases hyperinflation as well as breathing work in COPD. We evaluated the long-term effects of a hospital-based PR program coupled with NPV support in patients with COPD on clinical outcomes. One hundred twenty-nine patients with COPD were followed up for more than 5 years, with the NPV group (n = 63) receiving the support of NPV (20–30 cm H2O delivery pressure for 60 min) and unsupervised home exercise program of 20 to 30 min daily walk, while the control group (n = 6) only received unsupervised home exercise program. Pulmonary function tests and 6 min walk tests (6MWT) were performed every 3 to 6 months. Emergency room (ER) visits and hospitalization with medical costs were recorded. A significant time-by-group interaction in the yearly decline of forced expiratory volume in 1 s in the control group analyzed by mixed-model repeated-measure analysis was found (P = 0.048). The 6MWT distance of the NPV group was significantly increased during the first 4 years, with the interaction of time and group (P = 0.003), the time alone (P = 0.014), and the quadratic time (P < 0.001) being significant between the 2 groups. ER exacerbations and hospitalizations decreased by 66% (P < 0.0001) and 54% (P < 0.0001) in the NPV group, respectively. Patients on PR program coupled with NPV had a significant reduction of annual medical costs (P = 0.022). Our hospital-based multidisciplinary PR coupled with NPV reduced yearly decline of lung function, exacerbations, and hospitalization rates, and improved walking distance and medical costs in patients with COPD during a 5-year observation PMID:27741132

  14. Learning distance function for regression-based 4D pulmonary trunk model reconstruction estimated from sparse MRI data

    NASA Astrophysics Data System (ADS)

    Vitanovski, Dime; Tsymbal, Alexey; Ionasec, Razvan; Georgescu, Bogdan; Zhou, Shaohua K.; Hornegger, Joachim; Comaniciu, Dorin

    2011-03-01

    Congenital heart defect (CHD) is the most common birth defect and a frequent cause of death for children. Tetralogy of Fallot (ToF) is the most often occurring CHD which affects in particular the pulmonary valve and trunk. Emerging interventional methods enable percutaneous pulmonary valve implantation, which constitute an alternative to open heart surgery. While minimal invasive methods become common practice, imaging and non-invasive assessment tools become crucial components in the clinical setting. Cardiac computed tomography (CT) and cardiac magnetic resonance imaging (cMRI) are techniques with complementary properties and ability to acquire multiple non-invasive and accurate scans required for advance evaluation and therapy planning. In contrary to CT which covers the full 4D information over the cardiac cycle, cMRI often acquires partial information, for example only one 3D scan of the whole heart in the end-diastolic phase and two 2D planes (long and short axes) over the whole cardiac cycle. The data acquired in this way is called sparse cMRI. In this paper, we propose a regression-based approach for the reconstruction of the full 4D pulmonary trunk model from sparse MRI. The reconstruction approach is based on learning a distance function between the sparse MRI which needs to be completed and the 4D CT data with the full information used as the training set. The distance is based on the intrinsic Random Forest similarity which is learnt for the corresponding regression problem of predicting coordinates of unseen mesh points. Extensive experiments performed on 80 cardiac CT and MR sequences demonstrated the average speed of 10 seconds and accuracy of 0.1053mm mean absolute error for the proposed approach. Using the case retrieval workflow and local nearest neighbour regression with the learnt distance function appears to be competitive with respect to "black box" regression with immediate prediction of coordinates, while providing transparency to the

  15. The dose–response association of urinary metals with altered pulmonary function and risks of restrictive and obstructive lung diseases: a population-based study in China

    PubMed Central

    Feng, Wei; Huang, Xiji; Zhang, Ce; Liu, Chuanyao; Cui, Xiuqing; Zhou, Yun; Sun, Huizhen; Qiu, Gaokun; Guo, Huan; He, Meian; Zhang, Xiaomin; Yuan, Jing; Chen, Weihong; Wu, Tangchun

    2015-01-01

    Objective Reduced pulmonary function is an important predictor of environment-related pulmonary diseases; however, evidence of an association between exposures to various metals from all possible routes and altered pulmonary function is limited. We aimed to investigate the association of various metals in urine with pulmonary function, restrictive lung disease (RLD) and obstructive lung disease (OLD) risks in the general Chinese population. Design A cross-sectional investigation in the Wuhan cohort population. Setting A heavily polluted Chinese city. Participants A total of 2460 community-living Chinese adults from the Wuhan cohort were included in our analysis. Main outcome measures Spirometric parameters (FVC, forced vital capacity; FEV1, forced expiratory volumes in 1 s; FEV1/FVC ratio), RLD and OLD. Results The dose–response associations of pulmonary function, and RLD and OLD, with 23 urinary metals were assessed using regression analysis after adjusting for potential confounders. The false discovery rate (FDR) method was used to correct for multiple hypothesis tests. Our results indicated that there were positive dose–response associations of urinary iron with FEV1 and FEV1/FVC ratio, vanadium with FEV1, and copper and selenium with FEV1/FVC ratio, while a negative dose–response association was observed between urinary lead and FEV1/FVC ratio (all p<0.05). After additional adjusting for multiple comparisons, only iron was dose dependently related to FEV1/FVC ratio (FDR adjusted p<0.05). The dose–response association of iron and lead, with decreased and increased chronic obstructive pulmonary disease risk, respectively, was also observed (both p<0.05). Additionally, we found significant association of urinary zinc with RLD and interaction effects of smoking status with lead on FEV1/FVC, and with cadmium on FVC and FEV1. Conclusions These results suggest that multiple urinary metals are associated with altered pulmonary function, and RLD and OLD

  16. Effects of Autogenic Drainage on Sputum Recovery and Pulmonary Function in People with Cystic Fibrosis: A Systematic Review

    PubMed Central

    Osterling, Kristin; Gilbert, Robert; Dechman, Gail

    2015-01-01

    ABSTRACT Purpose: To determine the effects of short- and long-term use of autogenic drainage (AD) on pulmonary function and sputum recovery in people with cystic fibrosis (CF). Methods: The authors conducted a systematic review of randomized and quasi-randomized clinical trials in which participants were people with CF who use AD as their sole airway clearance technique. Results: Searches in 4 databases and secondary sources using 5 key terms yielded 735 articles, of which 58 contained the terms autogenic drainage and cystic fibrosis. Ultimately, 4 studies, 2 of which were long term, were included. All measured forced expiratory volume in 1 second (FEV1) and found no change. The long-term studies were underpowered to detect change in FEV1; however, the short-term studies found a clinically significant sputum yield (≥4 g). Conclusion: AD has been shown to produce clinically significant sputum yields in a limited number of investigations. The effect of AD on the function of the pulmonary system remains uncertain, and questions have emerged regarding the appropriateness of FEV1 as a valid measure of airway clearance from peripheral lung regions. Further consideration should be given to the use of FEV1 as a primary measure of the effect of AD. PMID:27504031

  17. Effects of 0. 75ppM sulfur dioxide on pulmonary function parameters of normal human subjects

    SciTech Connect

    Stacy, R.W.; House, D.; Friedman, M.; Hazacha, M.; Green, J.; Raggio, L.; Roger, L.J.

    1981-07-01

    Of 31 young, healthy male volunteers who participated in this study, 15 were exposed to air (control) and 16 to 0.75 ppm (2.15 mg/m/sup 3/) SO/sub 2/ for 2 hr at 21/sup o/C and 60% relative humidity. At the end of the first hour, the subjects exercised for 15 min on a treadmill at 6.4 kmph, with a 10% grade. Methods employed in evaluation of pulmonary function included body plethysmography, spirometry, and multigas rebreathing test. From the battery of 15 pulmonary function parameters, only the pattern of airway resistance changes was significantly altered by SO/sub 2/ exposure, although spirometric parameters followed a similar pattern. Eight of the SO/sub 2/-exposed subjects, with one or more positive allergen skin tests, appeared to be significantly more reactive to SO/sub 2/ than skin test-negative subjects. All subjects remained asymptomatic. The small number of changes observed appeared to be reversible and do not suggest a significant health hazard to normal human subjects exposed to SO/sub 2/ under these conditions.

  18. Change in Pulmonary Function after Incentive Spirometer Exercise in Children with Spastic Cerebral Palsy: A Randomized Controlled Study

    PubMed Central

    Choi, Ja Young; Rha, Dong-wook

    2016-01-01

    Purpose The aim of this study was to investigate the effect of incentive spirometer exercise (ISE) on pulmonary function and maximal phonation time (MPT) in children with spastic cerebral palsy (CP). Materials and Methods Fifty children with CP were randomly assigned to two groups: the experimental group and the control group. Both groups underwent comprehensive rehabilitation therapy. The experimental group underwent additional ISE. The forced vital capacity (FVC), forced expiratory volume at one second (FEV1), FEV1/FVC ratio, peak expiratory flow (PEF), and MPT were assessed as outcome measures before and after 4 weeks of training. Results There were significant improvements in FVC, FEV1, PEF, and MPT in the experimental group, but not in the control group. In addition, the improvements in FVC, FEV1, and MPT were significantly greater in the experimental group than in the control group. Conclusion The results of this randomized controlled study support the use of ISE for enhancing pulmonary function and breath control for speech production in children with CP. PMID:26996580

  19. Long-term follow-up of pulmonary function in patients cured from testicular cancer with combination chemotherapy including bleomycin.

    PubMed Central

    Lehne, G.; Johansen, B.; Fosså, S. D.

    1993-01-01

    A follow-up study of pulmonary function in two groups of patients with testicular cancer was performed 6-12 years after treatment. Both groups, 47 patients in each, had undergone retroperitoneal lymph node dissection (RPLND). Patients with pathological stage (ps) II