ABSTRACT
We have assessed the uniformity of regional ventilation during tidal breathing using continuous inhalation of krypton-81m in 43 male, lifelong nonsmokers and 46 male, current cigarette smokers (mean daily consumption 24.1 cigarettes/day) between 44 and 61 yr of age and with mild or no respiratory symptoms. All subjects had normal chest radiographs. The results of the ventilation scans were compared with tests of overall lung function (spirometry, maximal expiratory flow-volume curves, and single-breath N2 test). Diffuse abnormalities of the ventilation scan were found in 19 (41%) of the 46 smokers but in none of the nonsmokers. Focal abnormalities were found in 7 smokers and 3 nonsmokers. Smokers showed the expected abnormalities in overall lung function (reduced FEV1 and VC, increased single-breath N2 slope, and closing volume), but in individual smokers there was only a weak relation between the severity of abnormality of overall lung function and an abnormal ventilation scan. Abnormal scans could be found when overall lung function was normal and were not invariably found when significant abnormalities in FEV1/VC or N2 slope were present. There was no relation between the presence of chronic expectoration and an abnormal scan. The prognostic significance of an abnormal ventilation scan in such smokers remains to be established.
Subject(s)
Lung/physiopathology , Respiratory Function Tests , Smoking , Adult , Humans , Krypton , Lung/diagnostic imaging , Middle Aged , Radioisotopes , Radionuclide ImagingABSTRACT
Volume-motion coefficients were determined for the rib cage and abdomen in normal human subjects in upright, supine, and semirecumbent postures by the isovolume calibration technique of Konno and Mead (J Appl Physiol 1967; 22:407-422, using the respiratory inductive plethysmograph (RIP) to measure displacements of rib cage and abdominal walls. Volume motion coefficients changed systematically with posture; those for the rib cage were smallest in the upright posture, and for the abdomen, greatest in the upright posture. These volume motion coefficients were then used to estimate tidal volume during resting breathing in the different postures, and compared with estimates of tidal volume derived from calibration by the change in posture technique reported by Sackner and coworkers (American Review of Respiratory Disease 1980; 122:867-871). Estimates of tidal volume derived from RIP signals using both calibration techniques were compared with independently measured spirometric volume changes. Errors in tidal volume averaged 6% with the isovolume technique and 9 to 23% with the change in posture technique (depending upon whether the calibrating postures were upright, supine or semirecumbent supine). The larger errors with the change in posture calibration method are attributable to both the change in volume motion coefficients with posture and the change in distribution of tidal volume between rib cage and abdomen compartments with change in posture.
Subject(s)
Abdomen/physiology , Plethysmography/instrumentation , Posture , Respiratory Physiological Phenomena , Ribs/physiology , Adult , Calibration , Humans , Male , Tidal VolumeABSTRACT
The effects of 10 mg of nebulized salbutamol on lung mechanics and exercise tolerance in 10 patients with severe airflow obstruction are described. All patients were previously considered to have irreversible airflow obstruction as demonstrated by little or no improvement in expiratory flow rates either during a corticosteroid trial or after inhalation of 100 micrograms of isoprenaline. There was a small improvement in expiratory flow rate after nebulized salbutamol but the greatest increases were seen in slow vital capacity, inspiratory capacity, inspiratory flow rates, dynamic compliance during tidal breathing, mid-inspiratory and expiratory pulmonary resistance and exercise tolerance. The mechanism of these effects and their therapeutic significance is discussed.
Subject(s)
Albuterol/therapeutic use , Lung Diseases, Obstructive/physiopathology , Lung/drug effects , Physical Exertion , Aged , Female , Humans , Lung/physiopathology , Lung Diseases, Obstructive/drug therapy , Male , Middle Aged , Respiratory Function TestsSubject(s)
Infant Food , Lactation , Milk, Human , Developing Countries , Female , Food, Fortified , Humans , PregnancyABSTRACT
Nine patients with severe chronic airway obstruction secondary to chronic bronchitis and emphysema all preferred nebulised salbutamol solution to placebo in a double-blind controlled trial. Four of the patients who had previously received domiciliary nebulised salbutamol failed to complete the placebo period, though all completed the active period. Five others improved subjectively on active therapy, and showed a significant improvement in morning and evening peak flows. Symptom scores for breathlessness, wheezing, and sputum production were lower in the active treatment period and standard aerosol usage fell, although these changes might have been due to chance. Patients with severe chronic airway obstruction who do not respond to conventional bronchodilator therapy should be considered for this form of treatment.
Subject(s)
Albuterol/therapeutic use , Aerosols , Aged , Clinical Trials as Topic , Double-Blind Method , Female , Humans , Lung Diseases, Obstructive , Male , Middle Aged , Respiratory Function Tests , Self AdministrationABSTRACT
A 54-year-old patient with long-standing rheumatoid arthritis developed chronic eosinophilic pneumonia in association with a relapse of his arthritic condition. There was a rapid and complete response to oral steroid therapy.
Subject(s)
Arthritis, Rheumatoid/complications , Pulmonary Eosinophilia/etiology , Humans , Male , Prednisolone/therapeutic use , Pulmonary Eosinophilia/diagnostic imaging , Pulmonary Eosinophilia/drug therapy , RadiographyABSTRACT
The case of stockfarmer with hydatid disease which presented as a left tension pneumothorax is described. The diagnosis was not made until the patient underwent a thoracotomy for a complicating empyema.
