Maximum Breathing Capacity Research Articles

愛知県瀬戸地方における窯業珪肺の研究 : とくにレ線像病型分類と肺機能検査成績との比較研究

Most of ceramics manufacturing plants in Seto district are small in their scale. About 3, 000 workers working in such plants were examined, of which 60.6% were being exposed to dusts. Of these dust workers, 28.2% were found to be silicotic. The smaller the plant, the higher the morbidity of silicosis, e.g. in plants employing workers less than 50 in number, 32.2% of the worker were suffering from silicosis. The length of employment of these silicotic workers were mostly 15 to 25 years, and the size of granular shadows in the X-ray film were less than 3mm in most of them. These may be due to relatively low concentration of silica dusts in their working environment, as revealed by the present investigation. In those employed over 20 years, the density of granular shadows showed an increase in accordance with their length of employment. Values of ventilatory function tests of the lung, i.e. vital capacity, maximum breathing capacity, and timed vital capacity, showed decreases first in the medium degree of silicosis (as diagnosed by the X-ray) and was abnormally low in the high degree of silicosis. Most of both these cases showed disorders of expiratory ventilation, and the mixed type of ventilatory disorders was found in the rest. In the light degree of silicosis, there were a great many cases with almost nil ventilatory disorders. According to the progress of sicicosis, the compressibility of the lung decreased down to 0.100 l/cmH2O and lower, while the viscous resistance increased up to about 4.00 cmH2O/l/sec., thus increasing ventiratory work of the lung accompanied with impaired clinical pulmonary symptoms.

Pulmonary Function Studies in Pulmonary Tuberculosis

Pulmonary function studies were made on 292 patients with pulmonary tuberculosis. All patients were divided into four groups, namely, those with normal ventilation (NV) restrictive ventilatory insufficiency (RVI) obstructive ventilatory insufficiency (OVI) and mixed ventilatory insufficiency(MVI) based upon vital capacity, timed vital capacity and air velocity index , and the functional characteristics of each group were compared.The incidence of NV has progressively decreased and that of MVI has progressively increased as the extent of the disease process progressed, as expected, and this was particularly true in female patients. However, the incidence of OVI was higher among male patients whereas that of RVI was higher among female patients regardless of the extent of the disease process. Vital capacity was within normal range in patients with NV and OVI but it was significantly decreased in those with RVI and MVI. Timed vital capacity in those with NV and RVI showed no deviation from that of normal value but significant decrease was noted in those with OVI and MVI. Air velocity index was within normal range or even higher than normal in patients with NV and RVI but it was lower in those with OVI and MVI. However, even in patients with OVI and MVI the mean values of air velocity index were well above the lower Iimit of the normal, suggesting that this test is not a very sensitive one for the detection of air trapping. Maximal breathing capacity was within normal limits in patients with NV but modcrately decreased in the remaining groups, particularly in those with MV I. Also notcd was a greater decrease in maximal breathing capacity in patients with RVI in comparison to those with OVI. thus suggesting that a decrease in the vcntilating area of the lung rather than airway obstruction playcd a more significant role in the production of ventilatory insufficiency in pulmonary tuberculosis. Changcs in breathing reservc ratio and ventilatory factor according to each type of ventilation were very similar to those of maximal breathing capacity.And the decreases in breathing reserve ratio and ventilatory factor were caused in most of cases by a decrease in maximal breathing capacity. Air trapping index and Leslie’s index not only showed no close correlation to timed vital capacity and air velocity index but even some controversy was present. lt was felt that air trapping index andLeslie's s index were not valuable tests for the diagnosis of air trapping. Changes in capacity ratio according lo each type of ventilation were very similar to those of air velocity index. Minute ventilation, oxygen consumption, ventilation equivalent and oxygen diffusion were approximate of the same range regardless of the type of ventilatory insufficiency.

Pre and post operative pulmonary function test -Part 1 Thoraenp1asty

Twenty of thoracoplasty cases were studied pre and post-operatively with spirometry and bronchos-pirometry. Total vital capacity and maximal breathing capacity have reduced in aþout same proportion.and was about 20% reduction in 5-6 rib resection. However. timed vital capacity showed only slight reduction in both 1 second and 3-second value, and no significant difference was seen according to the number of resected rib. Bronchospirometric study showed relatively small reduction in minute ventilation. oxygen consumption and vital capacity of operated side. Except one case of 7 rib resection in 3 stages who showed 30% reduction, there was 10-15% reduction in average. among which the least reðuction was seen in vital capacity.

Cardiopulmonary Data for Children and Young Adults

The book consists of a series of physiological values in tabular form obtained from laboratory studies performed at the University of Chicago. Nine topics are presented: Heart rate and blood pressure; blood and plasma volume; hemoglobin concentration and oxygenation; carbon dioxide and pH values of arterial and venous blood and plasma; electrolyte concentrations of plasma and the effect of exercise on electrolytes; selected respiratory data; and maximum breathing capacity. Data obtained from patients with congenital heart disease and kyphoscoliosis are also presented. The last 2 chapters include tables of electrocardiographic changes during exercise and studies of peripheral blood flow in children. This cannot be regarded as a complete handbook of cardiopulmonary data, nor do the authors intend it to be so. The fact that all investigation was carried out in one laboratory under the same supervision lends greater significance to the results. Although identical figures may not be obtained by

The Operability of Pulmonary Cancer Seen from the Standpoint of Cardiopulmonary Function Tests

1. As a negative correlation is present between the size of tumors localized in the lung field and the percentage vital capacity, the growth and extension of pulmonary cancer can be estimated by the grade of decrease of percentage vital capacity. The cardiopulmonary function is not so markedly disturbed in the lung-field type of carcinoma, but it is more or less markedly disturbed in the hilar type. 2. In the early stage of pulmonary cancer (80 per cent VC or more), a slight disturbance of ventilatory distribution, and perfusion is observed, but in the advanced stage (80-60 per cent VC) the ventilatory disturbance becomes more pronounced, due to the growth of the tumor accompanied by pneumonitis, atelectasis and pulmonary emphysema. As no compensatory reaction of pulmonary circulation is observed in cases of lung cancer having percentage vital capacity below 60 per cent, hypoxemia seems to be prevented by the increase of heart rate and respiratory rate. 3. Lobectomy is feasible for patients with lung cancer having 60 per cent or more vital capacity. In case of proposed pneumonectomy, it is desirable to have 80 per cent or more maximal breathing capacity and arterial O 2 saturation above 90 per cent.

The respiratory defects in extreme obesity

Severely obese patients, including patients with normal lungs, myxedema and pulmonary emphysema, have been studied. Three of these patients had the hypoventilation syndrome at the time the studies were performed. All the patients exhibited marked reduction in expiratory reserve volume and a low maximal breathing capacity. Many patients had mild desaturation of the arterial blood. Unless concurrent thoracic disease was present, the oxygen cost of breathing and work of breathing were normal or near normal, and did not appear to be important in the pathogenesis of the hypoventilation syndrome. It is concluded that the basic respiratory defect in severe obesity is the low expiratory reserve volume and that the reduction of maximal breathing capacity and arterial oxygen unsaturation are a consequence of this. The hypoventilation syndrome occurring in occasional obese patients is due to a complex combination of factors that vary from case to case.

Simple tests of pulmonary function and the community hospital.

Simple pulmonary function tests such as vital capacity, maximum breathing capacity, and tidal volume can be used in any general hospital to aid in diagnosis and treatment of both medical and surgical conditions. Application of the tests in three different situations is described: differentiation of restrictive and obstructive types of pulmonary disease, preoperative evaluation, and n special bronchoscopic study.

Measurement of the Maximum Breathing Capacity: A Trial of the “Ventube”

The MVV of a group of 20 subjects has been recorded by the ventube and by a low resistance gas meter apparatus under comparable conditions. The repeatability of individual determinations by gas meter method and the ventube are similar. The ventube gives significantly lower results in subjects with high MVV values. It is likely that the explanation of this difference lies in the relatively high resistance to respiration offered by the ventube.

The Size of Cotton Dust Particles Causing Byssinosis: An Environmental and Physiological Study

Fourteen subjects of whom 12 were cotton mill blow- or card-room workers were exposed in a plastic tent for periods of three or four hours to airborne mill dust either of unrestricted size distribution (total dust) or containing only particles of less than 7μ(fine dust). A significant fall in indirect maximum breathing capacity followed exposure to either total or fine dust in most experiments. The response to total dust usually appeared a little larger than to fine but the concentration of fine particles in the unfiltered air was rather higher. The changes in the single-breath nitrogen clearance index and the inspiratory airways resistance were less constant, but the general pattern followed that of the ventilatory capacity. It is concluded that the fine fraction (under 7μ) of cotton mill dust produces changes in respiratory function and may be alone responsible. The findings suggest a direct action by the dust on the smaller air passages and imply that to be completely effective dust suppression measures in cotton mills should remove fine dust.

Ventilatory capacity in miners. A five-year follow-up study.

Abstract A five-year follow-up of ventilatory capacity in over 95% of a random sample of men living in the Rhondda Fach has been carried out. Miners and ex-miners with and without simple pneumoconiosis have been compared with non-mining controls, and the effect of ageing, mining, dust exposure, and tobacco smoking has been assessed. The change in Indirect Maximum Breathing Capacity (I.M.B.C.) between the two surveys appeared to be independent of age, suggesting that a linear decline in this function with age is a tenable hypothesis. An average decline of 1·865 ± 0·274 litres per minute each year in the I.M.B.C. was observed, and this fall was not significantly increased either by mining or by exposure to coal dust as measured by the number of years spent working underground. In the non-miners a greater decline in I.M.B.C. was observed in smokers than in non-smokers, and this decline was greater in the heavy than in the light smokers. The decline in the non-smokers was 0·489 ± 0·714 litres per minute compared with 1·524 ± 0·319 litres per minute in the light and 3·338 ± 0·420 litres per minute in the heavy smokers. In the miners and ex-miners without pneumoconiosis a greater decline in I.M.B.C. was observed in smokers than in non-smokers, but there was no relation between the rate of decline and the amount smoked. The decline in the non-smokers was 0·950 ± 1·071 compared with 2·164 ± 0·485 and 2·080 ± 0·428 litres per minute in the two smoking groups. In the men with simple pneumoconiosis (category 3) there appeared to be no relation between decline in lung function and smoking habits. The decline in non-smokers was 1·492 ± 0·594 compared with 1·956 ± 0·357 and 1·438 ± 0·467 in the two smoking groups. The decline in I.M.B.C. over five years in non-miners smoking 15 g. tobacco per day and over was significantly greater than the fall estimated from the age specific trend. A possible explanation is that there has been a recent change in the effect of heavy smoking on ventilatory function resulting in a more rapid decline. A greater decline in I.M.B.C. was observed in men with respiratory symptoms than in those without.

Studies on Various Pulmonary Functions on Tuberculosis Patients: Part 1: Long Volumes and Ventilatory Capacities in Tuberculosis(TB) Patients, Part 2: Various Pressure-Volume Relationships of the Respiratory Apparatus in Tuberculosis (TB) Patients

A) Studies on Unoperated PatientsThirty TB patients who have been admitted to the Masan Transportation Sanatorium were selected for the study along with ten healthy men acting as the control group. Patients were divided into three equal groups, the minimal(Min), moder-ately-advanced(MA) and far-advanced(FA), dependent upon the severity of disease. Ages of subjects ranged from 20 to 49 years old, with the average of 33. The vital capacity and its subdivisions, the residual volume, the maximal breathing capacity, the minute volume and the resting oxygen consumption were measured and the data obtained from each group was compared with one another. Results may be briefly summarized as follows:1. The vital capacity as well as the inspriatory capacity and the expiratory reserve clume showed a moderate reduction in the FA group, suggesting a reduction in the ventilatory volume of the lung as a result of the extensive lesion in this group. 2. The residual volume increased progressively as the severity of TB increased. 3. The maximal breathing capacity was lowered while the timed vital capacity was delayed in the FA group.4. The calculated values of both the Leshe's index and the index of air trapping were significantly increased.5. Neither the capacity ratio nor the calculated air velocity index showed any significant difference among various groups. suggesting that the air-way resistance is not altered in TB patients.6. The minute cilume as well as the resting oxygen consumption showed no significant difference among various groups.7. These results are considered to be largely due to both the emphysematous and fibrotic changes of the lung, which ar known to occur secondarily in the far-advanced TB patients.B) Studies on Operated PatientsVarious surgical operations such as pnemnonectomy(3 cases), thoracoplasty(4 cases), left upper lobectomy(4 cases) and right upper lobectomy(5 cases) were performed on pulmonary TB patients when they were considered to improve the disease. Ages of patients ranged from 30 to 47 years old. with the average of 35.Measurements of various lung volumes and of ventilatory capacities, as indicated in the previous section, were made before and after(3to 12 months) the operation and results are compared as summarized below:1. The vital capacity as well as the inspiratory capacity and the expiratory reserve volume were reduced most after the pneumonectomy, moderately after the left or right upper lobectomy and least after the thoracoplasty.2. The R.V./T.L.C. ratio was increased by 14.3%, and 5.5% after left upper lobectomy and pneumonectomy, respectively, but it showed little change after either right upper lobectomy or thoracoplasty. The increase in this ratio seems to indicate that the remaining lung tissue overexpands in order to fill the space provided by the resection.3. The maximal breathing capacity was lowered most after both the pneumonectomy(by 28.4%) and the thoracoplasty(by 19.3%), and decreased less after the left or right upper lobectomy.4. The timed vital capacity showed slight improvement(by5%) in all groups after the surgery.5. Calculated values of the air velocity index the capacity ratio, the Leslie's index and the index of air trapping showed no significant change in all groups after the surgery.6. The resting minute volume was significantly increased after the pneumonectomy, while the resing oxygen consumption was no alterd, with the result that the ventilation equivalent was raised in this group. This is probably due to the reduction in the surface area available for the gas exchange after the pneumonecomy, which would invariably lower the overall efficiency of the gas exchange. No significant changes were seen in other groups.

Cardiovascular-respiratory actions of mephentermine in mitral stenosis and its effects on pulmonary function in chronic pulmonary emphysema.

Mephentermine increased maximum breathing capacity in emphysema patients due to partial relief of existing bronehospasm. Small variations occurred in tidal volume, arterial-blood saturation, O 2 uptake and CO 2 removal per liter ventilation, and in respiratory quotient. There was an increase in expiratory minute volume, alveolar ventilation, frequency of respiration, O 2 consumption, CO 2 elimination, and arterial-blood pH; a decrease occurred in physiological dead space, physiological dead space/tidal volume ratio, and CO 2 content and tension in arterial blood. These changes were marked in normal individuals and in mitral stenosis patients, in contrast to the minimal effects obtained in emphysema cases. Bronehodilatation in emphysema, reduction of the physiological dead space and physiological dead space/tidal volume ratio, and changes in both direction in arterial-blood saturation as well as circulatory effects suggest that mephentermine affects the ventilation-perfusion relationships throughout the lung. The disproportionate increase in expiratory minute volume and frequency of respiration, while arterial-blood findings showed a significant decrease in CO 2 tension and a significant increase in pH, suggests an important central effect. In normal and in mitral stenosis patients, mephentermine produced an increase in heart rate, a decrease in mean right-atrial pressure, and an increase in cardiac output as a result of myocardial stimulation. Changes in pulmonary-artery pressure were variable. Pulmonary arteriolar resistance decreased in all three normal controls and in the majority of mitral stenosis cases, while wedge pressure changed very slightly. These changes are interpreted as pulmonary vaso-dilatation. Systemic pressure increased, while total systemic resistance decreased or remained essentially unchanged. Arteriovenous O 2 difference decreased in most eases with increased cardiac output, and vice versa. Increased cardiac output, associated with unchanged or falling systemic resistances and decreased arteriovenous O 2 difference, suggests vasodilatation with, increased peripheral blood flow. The fact that systemic resistance increases slightly in some cases must mean that vasocon-striction with decreased peripheral blood flow occurred in other vascular areas as a probable compensatory reaction. These effects led to an increase in arteriovenous O 2 difference and a reduction in cardiac output.

The Acute Effect of Cigarette Smoking on Pulmonary Function Studies

Pulmonary function studies consisting of vital capacity, timed vital capacity, maximal breathing capacity, functional residual capacity and ventilation equivalent were performed in a group of 23 patients with various pulmonary disorders and 19 normals before and immediately after smoking two cigarettes. A striking increase in the ventilation equivalent was observed in the normal subjects, probably attributable to impaired oxygenation caused by smoking.

Pulmonary Function Tests: Applications, Observations, Interpretations: A Brief Summary of the Physiology of the Lung Together with a Discussion of the More Commonly Used Pulmonary Function Tests

It is well recognized that pulmonary function tests have aided in the early recognition of pulmonary dysfunction in patients considered to be normal on the basis of clinical and radiological examination, and in the differential diagnosis of patients with a known pulmonary disease, but in whom a specific diagnosis could not be made with certainty by other methods. The division of pulmonary function into the arbitrary categories of ventilation, distribution, and diffusion makes for easier discussion, but it should be noted that no single test is available at present which can be used to the exclusion of all others in the testing of these various categories. Different aspects of pulmonary function must be evaluated with different tests. Ventilation Ventilation may be defined as the process whereby air is moved into and out of the lungs. This aspect of pulmonary function, then, involves consideration of both the volumes of air moved, as well as of the factors inherent in moving the volumes of air, i.e., the mechanics of breathing. Ventilation and ventilatory impairment are usually evaluated with measurements of the conventional vital capacity, the timed vital capacity, and the maximal breathing capacity.' However, attention should first be directed to the concept of alveolar ventilation, since this is the volume of air which enters the alveoli with each inspiration and participates in active gas exchange. The amount of air moving into and out of the alveoli is obviously much more important than that moving in and out of the nose and throat. Alveolar ventilation may be evaluated clinically by observation of the uniformity and adequacy of the chest cage expansion, the extent of the diaphragmatic excursions, and by auscultation of the breath sounds.' Such ob~e~ations, however, are by no means quantitative insofar as volumes are concerned and may be misleading. Whenever there is any doubt as to the adequacy of alveolar ventilation, a quantitative determination should be done using the formula: Alveolar Ventilation=(Tidal vol. - Dead Space) x Frequency. The measurement of respiratory dead space is difficult, but in adults this can be considered to be approximately equal to the patient's estimated weight in pound^.^ Measurements of the vital capacity may be exceedingly difficult to evaluate, especially single measurements. A series of measurements, on

The Relation between Smoking Habits and Physique, Respiratory Symptoms, Ventilatory Function, and Radiological Pneumoconiosis amongst Coal Workers at Three Scottish Collieries

Smoking has for some time been strongly sus pected of being a major aetiological factor in chronic bronchitis. Confirmatory evidence has accrued from many epidemiological studies involving widely different populations. Abbott, Hopkins, Van Fleit, and Robinson (1953) found that, in 294 hospital patients with emphysema and cough, tobacco smoking could be incriminated as an aetiological factor in about two-thirds of cases, and Palmer (1954) confirmed these findings, again on a hospital population. The use of hospital populations in epidemiological studies is open to danger of selection, with consequent doubts about general applicability of results, but work of Abbott and Palmer and their collaborators cited above has been confirmed in studies of representative samples of general population. Clifton (1956), in a study of rural dwellers and of workers in heavy industry in Sheffield, found smoking to be an important factor in prevalence of chronic bronchitis in these two populations. Ogilvie and Newell (1957), in their Newcastle survey, confirmed association be tween smoking and chronic bronchitis, but were unable to relate prevalence of disease to amount of tobacco smoked. Brown, McKeown, and Whitfield (1957), in a study of 1,062 men aged 60-69 years, and Higgins, Oldham, Cochrane, and Gilson (1956), in their Leigh survey, agreed with these findings. Less information is available about effects of smoking on ventilatory function. Franklin (1958) found that heavy smokers recorded lower flow rates in maximal forced expirations than did light smokers and non-smokers, this happening frequently in absence of any pulmonary abnormality. Eich, Gilbert, and Auchincloss (1957), investigating experimentally effects of cigarette smoking, found, in emphyse matous patients, that there was an increase in air ways resistance after smoking one cigarette, but Bickerman and Barach (1954) found significant effect after their subjects had smoked three cigarettes. Higgins (1959), in a study of 734 men aged 25 to 64 years randomly selected from urban and rural populations, recorded a higher indirect maximum breathing capacity (M.B.C.) for non-smokers than for smokers, but found no significant downward trend with increasing tobacco consumption among smokers. Fletcher, Elmes, Fairbairn, and Wood (1959) came to same conclusion about a group of London postmen, aged 40 to 59 years. However, Higgins, in a study with other workers of a popula tion of mixed occupations in Staveley, Derbyshire, found that the heavier smokers recorded a lower mean M.B.C. than lighter (Higgins, Cochrane Gilson, and Wood, 1959). As part of National Coal Board's Pneumo coniosis Field Research (Fay, 1957; Fay and Rae, 1959; Rogan, Ashford, Chapman, Duffield, Fay, and Rae, 1961), periodic medical surveys, including measurement of ventilatory function and physique and assessment of radiological pneumoconiosis, respiratory symptoms, and smoking habits, are car ried out on underground and surface workers at a sample of 25 collieries distributed throughout main British coalfields. The data collected on these surveys provide a convenient opportunity to examine relation between smoking habits and these other factors in complete working populations, and this paper is concerned with results obtained at first three collieries in Scotland at which necessary measurements have been made. 106

The diffuse obstructive pulmonary syndrome in a tuberculosis sanatorium. II. Incidence and symptoms.

Article1 June 1961THE DIFFUSE OBSTRUCTIVE PULMONARY SYNDROME IN A TUBERCULOSIS SANATORIUM. II. INCIDENCE AND SYMPTOMSC. J. MARTIN, M.D., F.A.C.P., W. Y. HALLETT, M.D.C. J. MARTIN, M.D., F.A.C.P.Search for more papers by this author, W. Y. HALLETT, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-54-6-1156 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIt is increasingly evident that a diffuse obstructive pulmonary syndrome is often associated with tuberculosis.1, 2 A considerable number of patients in sanatoria require treatment for chronic obstructive pulmonary emphysema as well as for tuberculosis, and deaths in these institutions now occur more often from emphysema than from progressive tuberculosis. This study was initiated to determine the prevalence and severity of obstructive airway disease among patients admitted to Firland Sanatorium.METHODDuring the year ending October 1959, a trained technician questioned the 710 patients who were at least 16 years old and who were admitted for the first time concerning...Bibliography1. AnnoTomashefski HJF: Studies on the impairment of respiratory function in pulmonary tuberculosis. Amer. Rev. Tuberc. 71: 333, 1955. Google Scholar2. GaenslerLindgren EAI: Chronic bronchitis as an etiologic factor in obstructive emphysema; preliminary report. Amer. Rev. Resp. Dis. 80 (No. 1, part 2): 185, 1959. MedlineGoogle Scholar3. Goldsmith JR: A simple test of maximal expiratory flow for detecting ventilatory obstruction. Amer. Rev. Tuberc. 78: 180, 1958. Google Scholar4. Van SlykeNeill DDJM: The determination of gases in blood and other solutions by vacuum extraction and monometric measurement. J. Biol. Chem. 61: 523, 1924. CrossrefGoogle Scholar5. SingersHastings RBAB: Nomogram. An improved clinical method for the estimation of disturbances of the acid-base balance of human blood. Medicine 27: 223, 1948. CrossrefMedlineGoogle Scholar6. Hill AB: Principles of medical statistics, 6th Ed. Oxford University Press, New York, 1955. Google Scholar7. WalkerLev HMJ: Statistical inference. Henry Holt Co., New York, 1953. CrossrefGoogle Scholar8. GoodmanKruskal LDH: Measures of association for cross classifications. J. Amer. Statist. Ass. 49: 732, 1954. Google Scholar9. BaldwinCournandRichards EdADW: Pulmonary insufficency. I. Physiological classification, clinical methods of analysis, standard values in normal subjects. Medicine 27: 243, 1948. CrossrefMedlineGoogle Scholar10. Nomenclature and criteria for diagnosis of diseases of heart and blood vessels. New York Heart Association, New York, 1928. Google Scholar11. Anderson WA: Pathology, 2nd Ed. C. V. Mosby Company, St. Louis, 1953. Google Scholar12. McLean KH: The microscopic anatomy of pulmonary emphysema. Aust. Ann. Med. 5: 73, 1956. MedlineGoogle Scholar13. BrinkmanCoates GLEC: The prevalence of diffuse airway obstruction in men between 40 and 65 years of age. Amer. Rev. Tuberc. 78: 293, 1958. Google Scholar14. HallettMartin WYCJ: The diffuse obstructive pulmonary syndrome in a tuberculosis sanatorium. I. Etiologic factors. Ann. Intern. Med. 54: 1146, 1961. LinkGoogle Scholar15. CohnCochranPinney JETHCT: A comparison of pulmonary physiologic studies with Gough sections of postmortem lungs. Clin. Res. 7: 128, 1959. Google Scholar16. Fletcher CM: Chronic bronchitis. Amer. Rev. Resp. Dis. 80: 483, 1959. MedlineGoogle Scholar17. Motley HL: Clinical pulmonary physiology. I. Evaluation of function impairment and new developments in therapy of chronic pulmonary disease. Arch. Indus. Hyg. Occup. Med. 5: 554, 1952. Google Scholar18. Martin JE: Coal miners' pneumoconiosis. Amer. J. Public Health 44: 581, 1954. CrossrefGoogle Scholar19. Fletcher CM: The clinical diagnosis of pulmonary emphysema—an experimental study. Proc. Roy. Soc. Med. 45: 577, 1952. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Seattle, Washington*Received for publication December 27, 1960.Presented in part before the Medical Session of the American Trudeau Society, May, 1960.†Supported in part by Grant H-1892 from the U. S. Public Health Service and in part by a grant from the National Tuberculosis Association.‡Present address: City of Hope Medical Center, Duarte, Calif.Requests for reprints should be addressed to C. J. Martin, M.D., Firland Sanatorium, 1704 E. 150th St., Seattle 55, Wash.§International Business Machines Corporation. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHistory of pulmonary tuberculosis affects the severity and clinical outcomes of COPDTuberculosis associated chronic obstructive pulmonary diseaseThe Convergence of the Global Smoking, COPD, Tuberculosis, HIV, and Respiratory Infection EpidemicsAirways obstruction in survivors of thoracoplasty: Reversibility is greater in non-smokersPulmonary Function Test and TuberculosisPulmonary Function in Long-term Survivors of ThoracoplastySurvival Following Extensive Pulmonary Resection in Advanced TuberculosisA bronchospirometric method of estimating the effect of pneumonectomy on the maximum breathing capacityThe Prognostic Value of a Reduced Maximum Breathing Capacity in TuberculosisTHE DIFFUSE OBSTRUCTIVE PULMONARY SYNDROME IN A TUBERCULOSIS SANATORIUM. I. ETIOLOGIC FACTORS*†W. Y. HALLETT, M.D., C. J. MARTIN, M.D., F.A.C.P. 1 June 1961Volume 54, Issue 6Page: 1156-1164KeywordsChronic obstructive pulmonary diseaseDyspneaEmphysemaMedical servicesSyncopeTechniciansTuberculosis ePublished: 1 December 2008 Issue Published: 1 June 1961 PDF downloadLoading ...

The Effect of Respiratory Tract Obstruction Upon the Ventilatory Response to Inhaled Carbon Dioxide in Normal Subjects ,

The effect of both inspiratory and expiratory respiratory tract obstruction upon the ventilatory response to 3 and 5 per cent CO2 has been studied in 14 normal subjects. Three grades of obstruction were employed. In nine subjects the effects of two levels of obstruction were noted. Maximum breathing capacities were determined under both control and experimental (respiratory tract obstruction) conditions. The results indicate that mild degrees of obstruction have relatively little effect upon the response to inhaled CO2. A decrease in alveolar ventilation and arterial blood pH and an increase in arterial carbon dioxide tension result from interposition of more severe grades of obstruction. The etiology of the depressed ventilatory response to inhaled CO3 seen in patients with obstructive pulmonary emphysema and hypercarbia is discussed in relation to these experimental observations.

Chronic respiratory disease in a random sample of men and women in the Rhondda Fach in 1958.

Abstract To investigate the high death rates for bronchitis in South Wales miners a survey of respiratory symptoms and ventilatory capacity in 90% of a random sample of 600 men between the ages of 35 and 64 and 200 women between 55 and 64 living in the Rhondda Fach was carried out. The sample of men was stratified by age and occupation, 100 miners and ex-miners, and 100 non-miners being studied in each decade. The higher prevalence of symptoms and lower mean indirect maximum breathing capacity (I.M.B.C.) of the miners and ex-miners, observed previously, was confirmed and within the mining group there was little relation of symptoms to radiological category of pneumoconiosis. Miners and ex-miners with progressive massive fibrosis had a lower mean I.M.B.C. than the rest at all ages. Analysis of symptoms and I.M.B.C. by length of time spent working on the coal-getting shift in both miners and ex-miners did not suggest that the total dust dosage to which a man had been exposed during his working life was closely related to chronic respiratory disease. A lower prevalence of symptoms and a higher mean indirect M.B.C. was found in those who had worked for under one year on the coal-getting shift. Above one year no clear pattern of symptom prevalence was discerned although there was a slight downward trend in the mean indirect M.B.C. with increased time spent working on the coal-getting shift. When working miners alone were considered the reduction in ventilatory function with increasing duration of work was slightly greater. Dust exposure alone seemed unlikely to account for all the excess respiratory disease in miners compared with the rest of the community and other possible explanations are discussed. The women recorded a lower prevalence of symptoms than the men who had never worked in mining. This prevalence was, however, higher than that previously found in rural areas in Wales and Scotland. The mean indirect M.B.C. recorded for the women in this survey was also lower than that observed in Scots women. Analysis of the findings in the women according to the occupation of their husbands showed that miners' wives recorded a higher prevalence of symptoms and lower mean indirect M.B.C. than non-miners' wives, suggesting the importance of social rather than occupational factors in miners. Smoking was associated with an increased prevalence of symptoms and lower indirect M.B.C. in the men but not in the women. Differnces in smoking habits could not, however, account for the differences between miners and non-miners, as these remained after standardization for smoking.

Pulmonary function in asbestosis of the lung: An alveolar-capillary block syndrome

Seventeen workers exposed to asbestos dust were studied clinically and by pulmonary function tests. Vital capacity was well preserved in half of the patients and moderately reduced in the remainder. Residual volume was not significantly altered except for a slight increase in six patients. The RV TG ratio was normal in all but two patients. Maximum breathing capacity was well preserved in all cases. Analysis of ventilation-perfusion relationships revealed normal intrapulmonary mixing of gases in all but three subjects, in whom it was reduced. Hyperventilation was present at rest and exercise in the majority of patients. Arterial oxygen saturation was slightly reduced in six patients at rest, and lower than 92 per cent on exercise in ten patients. While dead space ventilation (expressed as per cent of tidal volume) exceeded the upper limit in twelve patients, alveolar ventilation was increased in absolute terms and in no case was it decreased. The diffusing capacity of the lung for oxygen was measured in five patients at rest. In four of these it was reduced. In addition, in four of these five subjects venous admixture was increased. These abnormalities in pulmonary function correlated poorly with intimacy and duration of exposure. A better correlation was found when compared with roentgenographic abnormalities. The physiologic findings noted are characteristic of the alveolar-capillary block syndrome. The pathologic changes produced in asbestosis of the lung are reviewed in relation to this physiological syndrome.

Pulmonary diffusing capacity in chronic obstructive lung disease: studies at rest and on exercise by the steady state, physiological dead space method.

SummaryStudies of 19 cases of chronic obstructive lung disease are reported. The mean value for the ratio of residual volume to total lung capacity in the series was 0·61, and the mean maximum breathing capacity was 31 L/min.Arterial blood gas findings were confirmatory of those of other workers, arterial oxygen unsaturation at rest, frequently relieved on exercise, being common. Minor degrees of carbon dioxide retention were common.An increase in physiological dead space and in the ratio of dead space to tidal volume was found in nearly all cases at rest and in most cases on exercise.Diffusing capacity for carbon monoxide (DCO) was estimated by the steady state “Filley” method. Resting DCO was reduced in all cases, the reduction being extreme in some. The mean was 7·2 ml./min./mm. Hg. In all patients able to exercise, diffusing capacity rose, but the values on exercise were well below those of normal subjects exercising at the same level of oxygen consumption. DCO reduction did not correlate with arterial oxygen unsaturation or with the degree of airway obstruction.Some of the lowering of DCO is attributed to the presence of non‐uniformity in the lungs, but a true reduction does appear to be present. Possible explanations are discussed of the frequent finding by others that single‐breath DCO is little reduced in this condition.