Reference spirometric values for healthy lifetime nonsmokers in Thailand.

The normal spirometric reference values for Thai people are still not yet available. The aim of this study was to establish standard spirometric equations for Thai people. Subjects 10 years of age and over were selected and their demographic distributions represented that of the population of the whole country. Inclusion criteria were strictly lifetime nonsmokers, no history of chronic cardiopulmonary disease (using a modified ATS--DLD 78 respiratory adult questionnaire), normal standard chest radiograph and unremarkable physical examination. They had to be without respiratory symptoms at the time of the study. Spirometric values were obtained by 5 turbine system 'Pony graphic' (Cosmed, Italy) spirometers which met ATS recommendations. A normal group of 2299 women and 1655 men were selected. Regression analyses using sex, height and age as independent variables were used to provide equations for predicted values. The results were: [table: see text] FVC and FEV1 from this study are close to the Chinese but are 8-20 per cent lower than the Caucasians. These predicted equations are recommended to be used for future reference values in the Thai population.

Pulmonary dirofilariasis in a patient with multisystem Langerhans cell histiocytosis--the first reported case in Thailand.

Despite a high prevalence of canine dirofilariasis, there is no case of pulmonary dirofilariasis reported from Thailand. We herein report a case of multisystem Langerhans cell histiocytosis who had an incidental pulmonary dirofilariasis found at the time of autopsy as a solitary nodule at the periphery of the right lower lobe. This is the first reported case in Thailand. Association between pulmonary dirofilariasis and Langerhans cell histiocytosis has not been described before in the literature.

Is driving oxygen flow rate clinically important for nebulizer therapy in patients with COPD?

Our study suggests that the administration of bronchodilator drug via nebulizer powered by flow rate 6 L/min is more suitable in COPD patients. The oxygen flow rates should not be given more than 6 L/min. In this study, we recruited COPD patients in a stable stage, in whom the risk of hyperoxic induced hypercarbia is less than in the acute exacerbation stage. Thus, in acute exacerbation stage of the COPD patients, the rise of carbondioxide should be higher. We recommend that the COPD patients should receive bronchodilator drug via the nebulizer, especially in acute exacerbation stage, with oxygen flow rate not more than 6 L/min. The medical personnel must closely observe the clinical signs of the patients to prevent the hazard of carbondioxide retention.