[Evaluation of ventilatory function of the small airways]. / Prilog evaluaciji funkcije ventilacije malih disnih putova.

The results of functional tests and the values of flow-volume and spirometric parameters were reevaluated in 1174 randomly selected patients with no evidence of heart disease. There were 533 patients with normal ventilation and 327 patients with no restrictive disorders. In the latter group 11% of the patients had normal FEV1 and lowered FEF50 and FEF75 values. In those patients obstructive changes would not have been found if expiratory flow rates had not been taken into account as one of the criteria for evaluating airway obstruction. In further 13% of the patients a mild airway obstruction would have been found had only FEV1 been evaluated without taking account of expiratory flow rates. It is concluded that expiratory flow rates along with anamnestic data and clinical status are important indicators of obstructive changes of ventilation, especially as they serve to identify functional disorders while these are still reversible and therapy can be useful.

[The effect of cigarette smoking on pulmonary diffusing capacity in asymptomatic smokers]. / Utjecaj pusenja cigareta na difuzijski kapacitet pluca u asimptomatskih pusaca.

Ninety-seven subjects of which 72 smokers and 25 nonsmokers attending the Laboratory for Respiratory Functional Diagnostics of the University Hospital for Lung Diseases, Jordanovac, Zagreb were examined. The selection criteria were normal standard spirometric test values (FEV1, FVC, FEV1/FVC) in asymptomatic healthy, young smokers/nonsmokers who showed no signs of hematological, cardiovascular and chronic or acute pulmonary symptoms or diseases (according to a standardized questionnaire), and were not exposed to harmful environmental factors. The single-breath carbon monoxide diffusing capacity was measured in all patients. The results of our study confirm the findings of those authors who report reduced values of DLCO and DL/VA in smokers in comparison with the nonsmokers. A linear value diminution has been noticed in smokers and nonsmokers with increasing age, with the values being much lower in smokers. Our results also demonstrate a significant correlation between DLCO and DL/VA in young healthy smokers vs the duration of smoking and the number of cigarettes smoked per day (p < 0.01). The possibility to detect early reversible damages of lung function in young healthy smokers is an important contribution to the prevention of all diseases in which causal consecutive relation with cigarette smoking is confirmed.

[How should pharmacodynamic tests for respiratory tract obstruction be evaluated?]. / Kako procijeniti farmakodinamski test pri opstrukciji disnih putova?

The factors that could influence the results of pharmacodynamic testing with beta 2 agonists in lung function diagnostics are discussed. These are: hypersecretion of the mucus, acute respiratory infection, tachyphylaxis of the adrenoceptors, therapy in the past 48 hours, patient's cooperation, and ambient or environmental pollution. The correct application, by inhalation, of selective sympathomimetics is described and differences between the basic values of lung function parameters and those following the salbutamol test are discussed.

[A computer program for the interpretation of the acid-base status and respiratory gases]. / Kompjutorski program za interpretaciju acido-baznog statusa i respiratornih plinova.

A computer program for analysing the parameters of the acid-base status and respiratory gases has been designed. The program separates cases which are included into classical picture of certain respiratory, metabolic and mixed disorders. Out of a test series of 200 findings, 93% findings have been accurately interpreted. The program is written in BASIC, translated into machine code and occupies about 25 Kbyte computer memory. The main parts of the program use commands which do not favorize any version of BASIC increasing the program portability to other systems. The classification of respiratory gases and acid-base status was based on the already known facts.

[Functional diagnosis of pulmonary sarcoidosis]. / Funkcionalna dijagnostika plucne sarkoidoze.

Restrictive disturbances of ventilation of various degree and disorders in diffusing capacity of the lung have been reported as the most frequent disorders in pulmonary sarcoidosis. Recently, however, several authors have found the obstructive disorders of ventilation being present as well, especially in the second stage of disease, and pointed out a possibility of the airways being affected very early at the onset of disease. Present study shows the results of functional tests carried out in 70 patients with histologically verified pulmonary sarcoidosis at all three stages of the disease (classification by Würm). All of them were nonsmokers, aged 20 to 55 years, and had no symptoms of chronic bronchitis, asthma or emphysema, either in case history or clinical findings. They included spirometry, flow-volume loop, body-plethysmography, blood gas analyses at rest and after exercise and pulmonary diffusing capacity for carbon monoxide obtained by single-breath method. Results from the study show the obstructive disorders of ventilation to be dominant in the early stage, while restrictive disturbances dominate in the third stage in pulmonary sarcoidosis. Diffusing capacity of the lung should be measured in the early stage of the disease as well as in those more advanced because of a possibility that interstitial space is being affected, although there is no visible damage on a radiograph. Measurement of pulmonary diffusing capacity together with radiological findings provide a highly valuable data which is of great importance in monitoring the dynamics of this disease.

[Correlation of the size of the residual volume measured by whole body plethysmography and the single breath helium dilution method]. / Korelacija velicina rezidualnih volumena mjerenih pletizmografijom cijelog tijela i dilucijom helija metodom jednog udaha.

The value of residual volume, intrathoracic gas volume, functional residual capacity and total lung capacity obtained by the method of body plethysmography and helium dilution method was correlated by single-breath diffusing capacity. These parameters were correlated in 22 patients who had had complete functional diagnostics of the lung: spirometry, flow volume curve, body plethysmography and single-breath diffusing capacity. All findings were within normal limits, which was a condition for selection of patients for our group. Statistically significant differences (p = 0.01) of t-test were established between residual volumes by the plethysmographic and helium dilution method of single-breath diffusing capacity. The residual volume obtained by body plethysmography showed higher values for 526 ml, or 30%. The intrathoracic gas volume showed higher values for 682 ml, or 17%. Inspite of the fact that values of RV obtained by two methods had statistically significant differences, they were still within normal limits, if presented as percent of the predicted value.