Respiratory Function Test Results Research Articles

A SURGICAL CASE OF GIANT BULLAE WITH SEVERE RESPIRATORY DYSFUNCTION : A CASE REPORT

A 58-year-old man was admitted with dyspnea (Hugh-Jones' grade IV). A chest X-ray film showed left giant bullae. At admission respiratory function test results were VC 2020ml, %VC 58%, FEV1.0 820ml, FEV1.0% 46%. A respiratory nebulizer with steroid agent improved respiratory function just before surgery VC 2490ml, %VC 72%, FEV1.0 1030ml, FEV1.0% 55%. The giant bullae in the S1+2, S6 and S8 were safely excised. Postoperatively, the re-expansion of the residual lung was good. At 3 months after surgery, dyspnea was improved (Hugn-Jones' grade I). It was thought that perioperative management with steroid agents was useful to prevent complications from giant bullectomy with respiratory dysfunction.

Effects of air pollution on the respiratory tract of children.

The effects of air pollution on pulmonary function and respiratory status was evaluated in 1,626 school aged children from a European Alpine region. Based on measurements of SO2, NO2, and O3 as well as infrared imaging and lichen mapping, three zones of exposure were defined. Results of standardized respiratory questionnaires, medical examinations, and lung function tests were compared among the children in the three different exposure zones. After controlling for age, sex, height, socioeconomic status, and exposure to environmental tobacco smoking, areas of increased SO2 and NO2 as well as areas of increased ozone (max. half hourly mean value, 146 ppb) were significantly associated with decrements of forced expiratory volume in 1 s (FEV1) and flow rates at 50 and 75% of vital capacity (FEF50, FEF75). In addition, areas with increased ozone had a higher prevalence of asthma In all regions, maternal smoking was associated with reduced expiratory flow rates and increased prevalence of asthma. The results provide evidence that outdoor pollution and exposure to passive smoking are risk factors for childhood respiratory health.

Cystic fibrosis in Asians.

The clinical course of cystic fibrosis in nine Pakistani Asians was compared with 18 non-Asian age and sex matched controls. The Asian patients grew Pseudomonas aeruginosa at an earlier age (4.0 v 7.5 years), tended to have lower respiratory function test results (forced vital capacity 58.5 v 76.8% predicted; forced expiratory volume in one second 79.8 v 100.3% predicted), and had significantly greater concentrations of immunoglobulin IgG (13.4 v 10.1 g/l). They had a lower weight for age (78.4 v 95.7%) and weight for height (90 v 98.5%) despite similar intakes of dietary energy. Four of the nine Asians carried the delta F508 mutation compared with 17 of 18 controls. All the Asian patients were born in the UK; seven of their mothers were born in Pakistan and had moderate or severe difficulties with the English language. It is concluded that Asian patients may have a more severe clinical course than matched controls and that genetic and environmental factors may be contributory.

Evaluation of some simple methods of expressing the capnographic curve.

The evaluation of the results of respiratory function tests by computer, requires the numerical expression of the data. 150 patients with chronic respiratory disorders and 23 healthy individuals had capnographic examination. Two simple methods of evaluation were compared with each other and with some results obtained by body pletysmography and spirography. It was noted that, both in children and adults, the T2/T1 ratio closely follows the abnormal spirometric values observed in obstructive ventilatory conditions. It often appears to be more sensitive than the Tiffeneau test (FEV1/VC%) or the measurement of airway resistance. The angle between the lines drawn to sectors II and III of the capnogram also shows a positive correlation with these parameters and its measurement is very simple.

Surgical Treatment of Midline Fixation of the Bilateral Vocal Cords and its Functional Results

Midline fixation of the bilateral vocal cords occurs on rare occasions. This condition has been described as bilateral abductor or posticus paralysis. However, the term of midline fixation or immobilization in median position is more adequate. During the past 17 years, 32 cases having this condition were seen in our clinic. Surgery for this condition and its functional results were discussed. To relieve dyspnea, Woodman's operation and the widening of anterior glottis operation were performed. On performing laryngoplastic surgery, we have to succeed on the first attempt, using a meticu lous technique. Important points are not to fracture the thyroid or arytenoid cartilage and not to damage the laryngeal mucosa. Postoperatively, the patients' voice remained rather in intelligible condition. Postoperative respiratory function tests showed that improvement of lung volumes exceeded that of ventilation tests with a time factor. There were some discrepancies between the laryngoscopic findings and the results of postoperative respiratory function tests. Midline fixation of the bilateral vocal cords occurs on rare occasions. This condition has been described as bilateral abductor or posticus paralysis. However, the term of midline fixation or immobilization in median position is more adequate. During the past 17 years, 32 cases having this condition were seen in our clinic. Surgery for this condition and its functional results were discussed. To relieve dyspnea, Woodman's operation and the widening of anterior glottis operation were performed. On performing laryngoplastic surgery, we have to succeed on the first attempt, using a meticu lous technique. Important points are not to fracture the thyroid or arytenoid cartilage and not to damage the laryngeal mucosa. Postoperatively, the patients' voice remained rather in intelligible condition. Postoperative respiratory function tests showed that improvement of lung volumes exceeded that of ventilation tests with a time factor. There were some discrepancies between the laryngoscopic findings and the results of postoperative respiratory function tests.

Hiatal hernia and chronic unremitting asthma.

An incidence of hiatal hernia of 48.1% was found among 54 children suffering from “chronic unremitting asthma” compared to 13.5% among 74 controls, clearly showing that herniae are more common in asthmatics (P<0.001). In asthmatic children herniae were more common in those patients whose height and weight approached the mean for their age and sex (0.01<P<0·02; P<0.001 respectively). Asthmatic patients who had normal oesophagi were generally short and underweight. By contrast, no significant difference could be found in controls with and without hiatal herniae with respect to height and weight. The patients' ages, duration of symptoms, and results of respiratory function tests were similar in asthmatic children with and without herniae. The possible clinical implications of these findings are discussed.

The principles of predicting the risk of post-thoracotomy function-related complications in bronchial carcinoma.

The results of respiratory function tests on 243 patients done as part of theassessmentprior to thoracotomy for carcinoma of the lung are reviewed, with the surgical decision in each case and the post

Dyspnea: psychophysiologic relationships.

In 63 subjects (one-third each: asthmatics, patients with psychogenic respiratory disturbances and normal controls) dyspnea was elicited by a bronchoconstrictive stimulus. Before and after stimulation, the airway resistance (by whole-body plethysmograph), the first-second value and vital capacity (by spirometer) and the breath-holding time were determined. In addition, self-ratings of breathlessness were compared with the results of respiratory function tests for relative deviation. Three hypotheses were confirmed. a) A psychologic prediction (DP) of the capacity of a subject to rate his dyspnea (SDS) proved correct (r= 0.68;P< 0.001). b) The three study groups could be significantly discriminated in respect to respiratory functioning, psychologic evaluation and self-rating of breathlessness. c) A significant relationship between self-evaluation and respiratory functioning proved the measurement of airway resistance to be the most reliable test, followed by first-second value and vital capacity by spirometer and breath-holding time; the two latter were strongly dependent on subjective influence. The results confirmed the importance of psychologic factors in eliciting, self-rating and reaction to dyspnea.

Lung function studies in pulmonary tuberculosis

Summary The results of respiratory function tests in 41 cases of pulmonary tuberculosis are presented. Those obtained after operation showed that the M.V.V. had been reduced by 16·6 per cent. after pneumonectomy, by 9·4 per cent. after lobectomy and by 15 per cent. after segmental resection. Thorocoplasty caused a reduction of 24·9 per cent. Of 10 post-operative deaths in this series, 6 were due to respiratory insufficiency. The relatively small loss of function in these cases is in contrast with the larger loss of function following resection for bronchogenic carcinoma.