Relationship of ventilation inhomogeneity to morphologic variables in excised human lungs.

Ventilation inhomogeneity, as assessed by the regional distribution of 133Xe and the single breath washout (SBW) curve, is compared with the morphologic aspects in excised human lungs. Morphologic measurements include central airway diameter, bronchial gland area, peripheral airway diameter, and the alveolar surface-to-volume ratio. Lung inflation with a constant concentration of 133Xe results in relatively more 133Xe distributed to the lung base than to the apex. Neither the vertical gradient in ventilation nor other interregional inhomogeneities in 133Xe distribution are correlated with morphologic variations in the lung. Also, interregional inhomogeneities of 133Xe distribution do not correlate with phase III slope of the SBW curve. This suggests that the phase III slope is determined primarily by intraregional ventilation inhomogeneities. Within the phase IV region of the SBW curve two distinct inflections are identified: an inflection at volume V1 and another sharper inflection at volume V2. Both the phase III slope and V2 correlate significantly (p less than 0.05) with peripheral airway diameter, indicating that parameters of the SBW curve do assess peripheral airway properties.

Abnormal lung elasticity in juvenile diabetes mellitus.

Static lung pressure-volume curves, lung volumes, spirometry, diffusing capacity for CO, and airway and total pulmonary resistance were determined in 11 young men with juvenile-onset diabetes mellitus who were not cigarette smokers. Twelve nonsmoking men of similar age without diabetes served as control subjects. Elastic recoil at low lung volumes was significantly less in the diabetics than in the control group. Total lung capacity was also decreased in the diabetics. There were no significant differences between the 2 groups in the other parameters of pulmonary function measured. It is postulated that the abnormalities in lung elastic behavior are manifestations of the widespread elastin and collagen abnormalities that have been demonstrated in diabetes and are, in some respects, similar to those that occur during normal aging. Loss of elastic recoil at low lung volumes may cause more significant decreases in flows and gas transport as the juvenile diabetics age.