FEF Values Research Articles

Effects of Exposure to Incense Smoke Associated with Impaired Lung Function and Respiratory Disease: A Systematic Review

The community uses incense (bakhour) through ceremonies, traditional health practices, and aromatherapy. Nevertheless, evidence from experiments and studies of populations suggests that a habit of burning incense makes the lungs work less well. The study investigated the relationship between exposure to incense smoke and impaired lung function and respiratory diseases. Data tracing was carried out systematically following PRISMA guidelines from January to April 2022 and registered in the PROSPERO database. The articles selected in this review were cross-sectional, cohort, observational, and experimental studies based on the criteria: (1) animals or humans exposed to incense smoke; (2) exposure to incense smoke which was carried out indoors or outdoors; (3) the selected articles which were included in the original type of article; (4) the publication year between 2016-2021 and the selected articles entered into reputable journals (Scopus and Web of Science). JBI guidelines and synthesis guidelines without meta-analysis (SWiM) to determine the level of evidence and minimize bias and interpretation of results. This study describes respiratory symptoms or diseases, home use of incense, and lung function measurement. Six articles were included; 6 (100%) reported using incense indoors, and 5 (83%) reported using incense outside the home. Respiratory symptoms and diseases caused by exposure to incense sticks are 5 (83%) shortness of breath, 6 (100%) wheezing, asthma, and inflammation of the lungs, 2 (33%) chronic obstructive pulmonary disease, and 4 (67%) allergic rhinitis. Incense smoke particles decrease lung function based on FVC, FEV, PEFR, and FEF values of 25-75%. The results indicate that smoking incense adversely affects lung function and leads to respiratory diseases. The community and related parties can minimize and conduct education and prevention related to simultaneous incense exposure in the community to reduce the burden of diseases and disorders due to respiratory incense smoke in areas that use it daily.

Correlation between alveolar-arterial oxygen tension difference gradient baseline with spirometry test in severe coronavirus disease 2019 (COVID-19)

Alveolar-arterial Oxygen Tension Differences are one of the oxygenations that can increase SARS-CoV-2 virus infection. Based on this, the researchers wanted to assess the relationship between the baseline AaDO2 gradient and spirometry tests in severe COVID-19 survivors. This research is an observational analytic study with a cross-sectional design. The analysis was carried out in bivariate and multivariate tests assisted by using SPSS 26. The subjects who participated in the study were 80 people. Subjects with AaDO2 values ​​> 39.4 mmHg 70% (n=56), median AaDO2 gradient was 60.45 (2.75 - 548.2 mmHg). The relationship between baseline AaDO2 analysis and spirometry results showed that it was associated with FVC and FEF25-75% results, respectively (PR) 18.6 (95% CI 3.978-87.401 p = <0.001) and (PR) 7.7 (95% CI 1.606-3.724 p = 0.011) and no significant with FEV1 and FEV1/FVC values. This study concludes a relationship between a high baseline AaDO2 gradient with FVC and FEF values ​​of 25-75% in severe adult COVID-19 survivors. There was no relationship between a high baseline AaDO2 gradient and FEV1 and FEV1/FVC values.

The Role of Spirometry in the Diagnosis of Cough Variant Asthma in Children Aged 5 to 15 Years

Background Cough variant Asthma (CVA) is defined as chronic cough without wheezing, and may be precursor of typical asthma. Thus, the diagnosis of CVA and early intervention can partly inhibit asthma progression.This study aimed to evaluate the role of spirometry in diagniosis of Cough variant Asthma in Iranian Children. Materials and Methods This descriptive observational study included a total of 73 patients, who were referred to the specialized lung clinic of Tabriz Pediatric Center, Tabriz city, Iran. Patients were divided into two groups with classic asthma (n=37) and cough variant asthma (n=36) and basic spirometry parameters such as FEV1, FVC, FEV1/FVC, FEF 25-75% and PEF were measured, and the spirometry findings of each individual were measured based on the European Respiratory Society (ERS) criteria. Results The mean of FEV1 and FVC in the classic asthma group were 83.45 ± 20.49% and 86.45 ± 21.57%, respectively; and in the cough variant asthma group were 87.44 ± 13.99% and 86.8 ± 14.71%, respectively. There was no significant difference between the two groups for the basic spirometry parameters of FEV1 and FVC (p=0.343, P=0.916; respectively). The average FEV1/FVC parameter in the cough variant asthma group was 89.44±13.07, but it was 72.35±8.47 in the classic asthma group, with a significant difference between the two groups (p<0.05). Conclusion There was a significant difference in the FEV1 / FVC value between two groups of cough and classic asthma. Spirometry of patients with cough variant asthma showed the FEF values (25 -75%) were lower than expected; we suggest using spirometry in the diagnosis of cough variant asthma considering small airways changes.

Comparison of different levels of positive expiratory pressure on chest wall volumes in healthy children and patients with fibrosis

ABSTRACT Positive Expiratory Pressure (PEP) improves lung function, however, PEP-induced changes are not fully established. The aim of this study was to assess the acute effects of different PEP levels on chest wall volumes and the breathing pattern in children with Cystic Fibrosis (CF). Anthropometric data, lung function values, and respiratory muscle strength were collected. Chest wall volumes were assessed by Optoelectronic plethysmography at rest and during the use of different PEP levels (10 and 20 cm H2O), randomly chosen. Eight subjects with CF (5M, 11.5±3.2 years, 32±9.5 kilograms) and seven control subjects (4M, 10.7±1.5 years, 38.2±7.8 kilograms) were recruited. The CF group showed significantly lower FEF values 25-75% (CF: 1.8±0.8 vs. CG: 2.3±0.6) and FEV1/FVC ratio (CF: 0.8±0.1 vs. CG: 1±0.1) compared with the control group (p&lt;0.05). Different PEP levels increased the usual volume in chest wall and its compartments in both groups; however, this volume was significantly higher in the control group compared with the CF group during PEP20 (CW: 0.77±0.25 L vs. 0.44±0.16 L; RCp: 0.3±0.13 L vs. 0.18±0.1 L; RCa: 0.21±0.1 L vs. 0.12±0.1 L; AB: 0.25±0.1 L vs. 0.15±0.1 L; p&lt;0.05 for all variables). Minute ventilation was significantly higher during PEP compared with breathing at rest in both groups (p&lt;0.005). End-expiratory volume was also higher during PEP compared with breathing at rest for chest wall and pulmonary rib cage in both groups (p&lt;0.05). Different PEP levels may increase chest wall volumes in CF patients.

Long-term outcome of parapneumonic effusions in children: Lung function and exercise tolerance.

a: To evaluate the long-term outcome of parapneumonic effusions (PPE) in children regarding lung function and exercise tolerance, (b) to investigate the role of bronchial asthma in the outcome of PPE. The design of the study included 51 children with PPE, at least 2 years after the initial infection. They were divided in two groups. Group A (38 children) consisted of children with PPE but without asthma prior initial infection. Group B (13 children) included children with PPE and asthma prior infection. Thirty-six children were taken as healthy controls (group C). All children performed spirometry and a maximal incremental cardiopulmonary exercise test on cycle ergometer. Children of both groups (A and B) showed statistically significant lower values in FVC%, FEV1%, and FEV1 /FVC compared to controls (group C). Children of group B had also significant lower FEF(25-75%) values compared to controls. Children of group B had significant lower FEV1 /FVC values compared to group A. All children of the three groups showed no differences in maximal exercise capacity (VO2max). Children of group A had higher respiratory equivalent to oxygen (VE/VO2) during exercise compared to healthy subjects. There are small effects on lung function and exercise capacity in the long-term, among children with PPE, but of no clinical importance. Pre-existing bronchial asthma doesn't influence the outcome significantly.

Preoperative and Postoperative Spirometry in Patients Undergoing Lobectomy for Sequelae of Pulmonary Tuberculosis

Objective: To assess preoperative and postoperative spirometry values in patients undergoing lobectomy for sequelae of pulmonary tuberculosis. Method: A total of 20 patients (10 males) with history of treatment for tuberculosis and presenting with symptomatic sequelae (repeat infection or hemoptysis) who sought assistance at the chest surgery outpatient clinic between 11.09.07 and 04.02.10, were selected for the study. Only patients that met theeligibility criteria (symptomatic, submitted to tuberculosis treatment) were included in the study. The age of patients ranged from 15 to 56 years (mean: 35.75 years). The average treatment time for tuberculosis was 6 months and onset of symptoms occurred between 01 and 32 years after treatment. To assess the impact of surgery on the variables VC, FVC, FEV1, FEV1/FVC, FEF and PEF preoperative values were compared with postoperative values at 1st, 3rd, 6th and 12th month using the paired t test. The level of significance (α) applied for all tests was 5% where a value of p 0.05 was considered significant. Results: 11 patients were treated because of recurrent infections and 9 because of haemoptysis. The most common lobectomy was right upper lobectomy (7 patients), followed by left upper lobectomy (6 patients), left lower lobectomy (6 patients), and right middle lobectomy (1 patient). There were no postoperative complications. There was no postoperative mortality. Conclusion: Based on the results of the present study, it can be concluded that, at the 12th postoperative month, spirometric parameters of patients with tuberculosis sequelae submitted to lobectomy had returned to preoperative levels.

Effect of Thoracic Lymphatic Pump Technique on Pulmonary Function in COPD Patients

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is characterized by chronic airflow limitation, range of pathological changes in the lung, some significant extra-pulmonary effects, and important co-morbidities and risk factors which may contribute to the severity of the disease in individual patients. Once developed, COPD and its co-morbidities cannot be cured, so must be treated continuously. Treatment options include not only pharmacological & surgical therapies but also use of osteopathic manipulative treatment (OMT). If OMT can reduce pain & immobility associated with pulmonary disease, then it should increase thoracic excursion. Aim: To analyze whether the application of the Thoracic Lymphatic Pump without activation on COPD patients influences their lung function parameters. Methodology: An Experimental Cross Sectional Study with 50 COPD diagnosed patients with COPD grade I - III according to GOLD guidelines were divided in two groups, 25 in Experimental Group(A) & 25 in Control Group(B). Pulmonary function test(Measuring VC, FEV1, FVC, FEV1/FVC RATIO, PEF and FEF) was the outcome measure. Group A was given the TLP manipulation and 10 mins nebulization. Group B was given only nebulization. Results: There were significant improvements in the VC, FVC, FEV1, FEV1/FVC values of both the groups. The FEF values showed significant improvements in experimental group as compared to control group. The means of the difference between the pre and post values of both the groups showed no statistical significance.

A forced expiratory flow at 25‐75% value &lt;65% of predicted should be considered abnormal: A real-world, cross-sectional study

Forced expiratory volume in 1 second (FEV1) is considered an important parameter for asthma diagnosis and follow-up. However, it has been proposed that forced expiratory flow at 25-75% (FEF(25-75)) could be more sensitive than FEV1 to detect slight airways obstruction. In this regard, a cutoff FEF(25-75) value has been recently established in a group of asthmatic children: FEF(25-75) < 65% of predicted has been considered impaired. However, the considered population was specifically selected. Therefore, the aim of the present study was to confirm an FEF(25-75) cutoff value in a large cohort of asthmatic children. Seven hundred allergic children (493 male subjects; median age, 11 years) with controlled and partly controlled asthma were evaluated by performing spirometry and skin-prick tests. Three hundred thirteen (44.7%) patients had FEF(25-75%) values of <65% of predicted. Two predictors were significantly associated with impaired FEF(25-75) values: (i) sensitization to perennial allergens (adjusted odds ratio [OR(Adj)], 3.4) and (ii) FEV(1) ≤ 86% of predicted (OR(Adj), 3.8). This study, conducted in real life, could suggest that FEF(25-75) value of <65% of predicted may be considered abnormal.

Characteristics of Young Atopic Adults with Self-Reported Past Wheeze and Airway Hyperresponsiveness

The present study aimed to illustrate clinical characteristics of spirometric measures and allergy sensitisation among young atopic adults who reported wheezing episodes before adulthood but were not diagnosed with asthma by physicians and have no current wheeze symptoms (self-reported past-wheezers), especially those who exhibited airway hyperresponsiveness (AHR). Fifty self-reported past-wheezers were divided into two groups according to AHR to methacholine. Spirometric functions and blood atopic parameters were compared in these groups with those in 25 age-matched atopic adults with a history of childhood asthma diagnosed by specialists but have no current wheeze symptoms (past-asthmatics) and in 60 counterparts without a previous and current wheezing episode (never-wheezers). Twenty-one of the 50 past-wheezers exhibited AHR (PC(20) < 8 mg/ml). Levels of spirometric function and allergic sensitization in both past-wheezer groups were intermediate between those in never-wheezers and past-asthmatics. Lower FEV(1) and FEF(25-75) values (% predicted) were observed in self-reported past-wheezers with AHR relative to those without AHR. More blood eosinophils and higher serum levels of total IgE and IgE specific to house dust mites were observed in self-reported past-wheezers with AHR relative to those without AHR. Our findings raise the possibility that self-reported past-wheezers with AHR might form a distinct subgroup with features similar to past-asthmatics, which is one of the risk groups for adult asthma.

Passive Smoking, Pulmonary Function and Bronchial Hyper-responsiveness among Indoor Sanitary Workers

Pulmonary function parameters of 21 cleaning/sanitary women workers who have never smoked, exposed to environmental tobacco smoke (ETS) at work were compared with 34 non-exposed women workers of comparable age and other work characteristics. The studied subjects were subjected to an interview questionnaire, pulmonary function measurements, bronchial responsiveness assessment and clinical chest examination. A higher prevalence of dyspnea was found (42.9%) among exposed compared to (14.7%) among the non-exposed workers (p=0.019), also wheezing (52.4% vs. 11.8%; p=0.001). Pulmonary measurements showed a lower FVC, FEV(1)/FVC and FEF(75) values among exposed compared to non-exposed (p<0.05), and a higher prevalence of borderline bronchial hyper-responsiveness (38.1% vs. 11.8%; p=0.021) in the exposed workers. This study provides evidence of adverse respiratory effects in sanitary/cleaning women workers associated with passive smoking in the workplace. The findings support a stricter implementation measures to protect respiratory health of all workers.

Forced expiratory flow between 25 and 75% of vital capacity might be a predictive factor for bronchial hyperreactivity in children with allergic rhinitis, asthma, or both

Allergic rhinitis and asthma are closely associated. Bronchial hyperreactivity (BHR) is a pathophysiological characteristic of asthma. Forced expiratory flow between 25 and 75% of vital capacity (FEF(25-75)) has been previously shown to be able to predict BHR in adult patients with allergic rhinitis. Therefore, the aim of this study was (i) to evaluate the presence of BHR in a large group of children with allergic rhinitis, asthma or both and (ii) to confirm whether FEF(25-75) might be related to BHR and may predict BHR also in a pediatric population. Nine hundred fifty children with allergic rhinitis (350), asthma (300), or both (300) were enrolled. Clinical examination, skin-prick test, spirometry, and methacholine challenge were performed in all patients. Severe BHR was quite frequent in allergic children, mainly in asthmatic patients. FEF(25-75) values were significantly related to BHR grade, mainly in children with rhinitis (r = 0.69). Impaired FEF(25-75) values (such as ≤65% of predicted) constituted a relevant predictive factor for severe BHR, mainly in children with rhinitis (odds ratio, 8.9). In conclusion, this pediatric study confirmed that impaired FEF(25-75) values might predict severe BHR in children, mainly in those with allergic rhinitis. Therefore, low FEF(25-75) values could suggest BHR in children.

Relationship between bronchial hyperreactivity and bronchodilation in patients with allergic rhinitis

Allergic rhinitis (AR) may be considered a risk factor for the onset of asthma. Recently, it has been reported that forced expiratory flow between 25% and 75% of vital capacity (FEF(25%-75%)) may predict a positive response to bronchodilation test in asthmatic children. Moreover, bronchial hyperreactivity (BHR) is frequently detected in AR patients. To evaluate the possible relationship between the response to bronchodilation test and methacholine challenge, also considering the FEF(25%-75%) values in a large group of patients with persistent allergic rhinitis. Three hundred sixty-five consecutive AR patients were evaluated. Clinical examination, spirometry, methacholine bronchial challenge, and bronchodilation test were performed in all patients. Two hundred forty-one patients (66%) had "positive" results for bronchodilation test; FEF(25%-75%) was abnormal in 78 patients (21.4%), and 76 patients (20.8%) had severe BHR. An FEF(25%-75%) cutoff value of less than 58.5% of predicted may optimally (AUC 0.97) discriminate patients with both severe BHR and reversibility. This study confirms previous studies and increases the strength of the role of FEF(25%-75%) as a marker of early bronchial involvement in patients suffering from persistent allergic rhinitis. Moreover, an FEF(25%-75%) value less than 58.5% of predicted may suggest the co-existence of severe BHR and reversibility.

Bronchial hyperreactivity in patients with allergic rhinitis: Forced expiratory flow between 25 and 75% of vital capacity might be a predictive factor

Allergic rhinitis (AR) is considered a strong risk factor for the onset of asthma. Bronchial hyperreactivity (BHR) may be present in patients with AR. Forced expiratory flow between 25 and 75% of vital capacity (FEF(25-75)) may be impaired in AR patients. The aim of this study was to evaluate the presence of BHR in a large group of patients with AR and whether FEF(25-75) might be related to BHR. Four thousand seven hundred eighty-one patients with AR were enrolled. Clinical examination, skin-prick test, spirometry, and methacholine challenge were performed in all patients. Fourteen percent of patients had severe BHR and 25.3% had mild BHR. Patients with low FEF(25-75) values (such as ≤65% of predicted) had severe BHR more frequently than patients with normal FEF(25-75) values (p < 0.001). In addition, low FEF(25-75) values constitute a relevant predictive factor (OR = 12.9) for severe BHR. This study shows that a relevant percentage of AR patients had BHR, and impaired FEF(25-75) values might predict it. Therefore, BHR should be suspected in AR patients with low FEF(25-75) values.

Early Bronchial Involvement in Children with Allergic Rhinitis

Allergic rhinitis (AR) may be frequently associated with asthma or precede it. Bronchial involvement in AR is usually detected by spirometry. Forced expiratory volume in 1 second (FEV(1)) is considered a reliable parameter for asthma diagnosis. However, forced expiratory flow at 25-75% (FEF(25-75)) could be considered a possible marker of early bronchial involvement in AR; indeed, it has been proposed that FEF(25-75) values <70% of predicted may predict this evolution. The aim of this study was to evaluate a large cohort of children with AR to define an FEV(1) value corresponding to impaired FEF(25-75) values. Eight hundred fifty AR children (555 boys; median age, 10 years) were studied. Spirometry and skin-prick test were performed in all of them. Descriptive statistic and multivariate analysis were considered. Three-hundred (35.3%) patients had FEF(25-75) values <70% of predicted. Still, normal FEV(1) values were associated with overt impaired FEF(25-75) values and the cutoff value was 83%. Spirometry should be adequately interpreted in AR patients; indeed, an FEV(1) cutoff value of 83% detects with good efficiency AR children with early bronchial impairment.

Reference values for paediatric pulmonary function testing: The Utrecht dataset

Since populations evolve, measurement protocols and equipment improve and analysis techniques progress, there is an ongoing need to reassess reference data for pulmonary function tests. Furthermore, reference values for total lung capacity and carbon monoxide diffusion capacity are scarcely available in children. We aimed to provide updated reference equations for most commonly used pulmonary function indices in Caucasian children. In the 'Utrecht Pulmonary Function Reference Data Study' we collected data in Caucasian children aged 2-18 years. We analyzed them using the 'Generalized Additive Models for Location Scale and Shape' (GAMLSS) statistical method. Measurements of interrupter resistance (R(int)) (n=877), spirometry (n=1042), body plethysmography (n=723) and carbon monoxide diffusion/helium dilution (n=543) were obtained in healthy children. Height (or the natural logarithm of height) and age (or the natural logarithm of age) were both significantly related to most outcome measures. Also sex was a significant determinant, except for RV, RV/TLC, FRC(pleth), Raw(0,5), Raw(tot), R(int) and FEF values. The application of previously published reference equations on the study population resulted in misinterpretation of pulmonary function. These new paediatric reference equations provide accurate estimates of the range of normality for most commonly used pulmonary function indices, resulting in less underdiagnosis and overdiagnosis of pulmonary diseases.

Auswirkungen der Asbestfaserstaub-Exposition auf die Lungenfunktion – ein systematisches Review

Asbestos-induced lung diseases are in addition to skin diseases and hearing impairment due to noise the most frequent occupational diseases. In this connection, many questions arise. They particularly refer to the fine diagnostics and the compensation in case of early stages. This systematic review questions the prevailing practice of getting medical expert opinions. It was shown that already pleural plaques and low stages of lung fibrosis due to asbestos are significantly associated with symptoms of chronic obstructive bronchitis, lymphocytic alveolitis and significant functional restrictions, i. e. FVC, FEV (1) and TLC restrictions, gas exchange impairments (P ((A-a),O2), P (a,O2)), diffusion disorders (D (L,CO)) and an obstructive ventilation pattern (FEV (1)/FVC, FEF values, D (L,CO)). The asbestos fibre dose shows some relation to reductions of FVC, FEV (1), FEF values, and D (L,CO). Only about half of the asbestos-induced functional impairments are related to radiological (inclusive CT) findings. To a lesser degree, these findings also apply to exposed people without pathological chest X-ray findings. The diffusion capacity reduction, at first still within the reference range, is an early indication of a lung lesion caused by asbestos fibres. The same applies to spiroergometric parameters (P ((A-a),O2), V (E/)V (O2), V (D)/V (T)). Reduced lung compliance can also be determinable at an early asbestosis stage. The results of literature research confirmed by statements of international groups of experts indicate continuous pathophysiological processes due to asbestos fibres deposited in peripheral airways and in the lung. These processes are neither radiologically nor histopathologically detectable and occur with a chronic lymphocytic alveolitis. Therefore, diagnostics of asbestos-induced non-malignant lung and pleural changes require comprehensive lung function tests. The outcome may help to estimate the probable remaining life span.

Identifying problematic severe asthma in the individual child – does lung function matter?*

Measures of lung function (usually FEV(1) <80% predicted) are used to classify asthma severity in both adults and children, despite evidence that lung function impairment is less pronounced in the paediatric asthma population. The present study assesses the relevance of lung function measurements as discriminators of severe childhood asthma. Fifty-one school-aged children with problematic severe asthma, 37 mild-to-moderate asthmatics and 29 healthy controls underwent a comprehensive clinical work-up. Problematic severe asthma was defined in patients exhibiting poor asthma control despite high-dose inhaled corticosteroid treatment and at least one other asthma controller drug. Mild-to-moderate asthmatic children used low-dose inhaled steroids and reported minimal asthma symptoms. Baseline FEV(1) values were significantly reduced in children with problematic severe asthma, yet FEV(1) <80% predicted showed a low sensitivity (41%) for discriminating severe vs. mild-to-moderate asthma. Receiver-operated characteristic analysis estimated the optimal cut-off of FEV(1) to be 90% predicted in this population (sensitivity 61%, specificity 83%). Baseline FEV(1)/FVC and FEF(25-75) values were not superior to FEV(1) in discriminating problematic severe asthma, and neither exhaled nitric oxide levels nor bronchial hyperresponsiveness differentiated between the two asthmatic study populations. Spirometric measurements are insensitive discriminators of problematic severe asthma in childhood.

Pulmonary Function and Airway Hyperresponsiveness in Adults with Sickle Cell Disease

Pulmonary involvement is a major cause of morbidity and mortality in patients with sickle cell disease (SCD). Although a high prevalence of airway hyperresponsiveness (AHR) has been reported, there are no studies demonstrating the relationship between AHR and acute chest syndrome (ACS) in adults with SCD. We investigated AHR prevalence, lung function abnormalities, and the relationships of these variables with ACS in SCD patients. Thirty-one adult patients without asthmatic symptoms were compared with 31 matched controls. Expiratory flow rates, lung volumes, carbon monoxide diffusion capacity (DLCO), and methacholine provocation test (MPT) results were assessed. Forced vital capacity (FVC), forced expiratory volume in one second, forced expiratory flow rate at 25% to 75% of FVC (FEF(25%-75%)), peak expiratory flow rate, total lung capacity, and DLCO values were significantly lower in the patient group than in the controls. No significant difference in pulmonary function test results was found between patients with and without a history of ACS. Fifteen patients with SCD (48%) and only 5 controls (16%) had AHR (p = 0.007). A significant correlation was found between the number of ACS episodes and MPT positivity (r = 0.379, p = 0.035). The FEF(25%-75%) values were significantly lower in patients with positive MPT results than in patients with negative MPT results (p = 0.027). The prevalence of AHR was high in adult patients with SCD. A significant correlation was found between AHR and recurrent ACS episodes. Anti-inflammatory controller agents can be used routinely to decrease pulmonary morbidity associated with SCD, even in the absence of asthmatic symptoms.

Effects of Homogeneous Irradiation of Electron Beam with Low Potential on Microscopic Fracture Resistance of Borosilicate Glass Surface

An effect of homogeneous irradiation of electron beam with low potential (HIEBL) on the micro-fracture resistance of borosilicate glass was studied by using indentation of hardness test. 0.04 MGy-HIEBL increased the critical resistant energy (Ef ) of micro plastic deformation to generate the crack and tremendously decreased their experimental errors. Furthermore, the high values of the midpoints (Ef mid )o fEf values were obtained from 0.04 to 0.22 MGy of irradiation dose. If HIEBL annihilated the spontaneous crack origins, the minimum Ef value (Ef min ) before irradiation was the critical resistant energy of micro-plastic deformation to propagate the crack (Ef p ). Since HIEBL of less than 0.43 MGy didn’t affect the fracture toughness (KIC) estimated by fracture toughness to propagate the crack using standard indentation fracture method, the Ef p value of the borosilicate glass didn’t depend on the irradiation dose. On the other hand, the critical resistant energy of micro-plastic deformation

Natural history of the respiratory involvement in Anderson–Fabry disease

Anderson-Fabry disease (AFD) is an X-linked disorder caused by deficient activity of enzyme alpha-galactosidase A, resulting in the accumulation of glycosphingolipids within lysosomes. Pulmonary involvement in AFD has previously been documented, but until now has been studied only in a few series of patients without any longitudinal follow-up. The aim of this study was to compare spirometric changes in AFD patients with a matched control population and to follow the subsequent progression of the disease. Fifty individuals (27 women, 23 men, mean age 40 +/- 14 years) with AFD from 14 families underwent a static spirometric examination under standard conditions. A set of indices was compared with that of the control population. Out of this cohort, 39 individuals not receiving enzyme replacement therapy were longitudinally evaluated (median follow-up time 24 months). A clinically significant reduction in spirometric parameters, corresponding to mild to severe airway obstruction, was observed in 26% of women and 61% of men. During the serial follow-up, a significant (p < 0.05) age-dependent reduction of predicted %FVC and %FEV1 values was observed in male patients, while the influence of age was not seen in female patients. The %FEF(25-75) values decreased by similar degrees in men and women and in older and younger patients, indicating that progressive bronchial disease affects the small airways first. We have demonstrated a clinically relevant age- and sex-dependent progressive pulmonary involvement in AFD patients. The effects of enzyme replacement therapy on pulmonary involvement remain to be demonstrated.