Significant Changes In Pulmonary Function Research Articles

Human exposure to sulfur dioxide and ozone: absence of a synergistic effect.

Studies of the human health effects of exposure to a combination of ozone and sulfur dioxide have produced somewhat conflicting results; the possibility of a synergistic enhancement of toxicity when the two gases are present simultaneously remains equivocal. We evaluated the effects of 0.40 ppm sulfur dioxide, 0.40 ppm ozone, and the combination of these two under one environmental condition (25 degrees C and 45% relative humidity). Subjects alternately walked and rested during a 2-hr exposure. Subjects exposed to filtered air or to 0.40 ppm sulfur dioxide showed no significant changes in pulmonary function. When exposed to either ozone or ozone plus sulfur dioxide, significant decreases in maximum expiratory flow, forced vital capacity, and inspiratory capacity were observed. There were no significant differences in response between ozone alone and ozone plus sulfur dioxide exposures, thus, in our subjects on synergistic effects were discernible.

Airway responses to exercise in mild asthmatics

Measurements of flow on maximal and partial expiratory flow-volume (MEFV and PEFV) curves offer a simple, sensitive, and safe method for studying the prevalence, clinical characteristics, and airway changes of exercise-induced bronchospasm (EIB). These methods show that asthmatic individuals with even mild disease clearly differ from nonasthmatic persons in terms of their airway response to exercise. Nineteen asthmatic and fourteen nonasthmatic volunteers underwent graded exercise testing to elicit exercise-induced bronchospasm. Pulmonary function was measured using MEFV and PEFV curves before and after exercise. Exercise-induced bronchospasm was demonstrated in 17 of 19 asthmatic subjects without inducing marked degrees of airway constriction. The most sensitive index of EIB was changes in flow rates measured at low lung volumes, particularly those measured on PEFV curves. Analysis of flow-volume curves suggested two patterns of airway response to exercise among asthmatics, involving, respectively, small and larger airways. No significant changes in pulmonary function were demonstrated in the nonasthmatic subjects. The degree of EIB measured by changes in flow rates on the PEFV curve correlated with airway reactivity to nonspecific irritants such as cold weather, tobacco smoke, and respiratory tract infections, but not with a history of specific allergies. We suggest that EIB is a general feature of asthma, reflecting the increased reactivity of asthmatics to a wide variety of airway irritants.

Comparative effects of ephedrine on adrenergic responsiveness in normal and asthmatic subjects

A comparison was made of the metabolic and pulmonary responses to adrenergic stimulation in 6 normal subjects and 10 patients with mild asthma who were treated with equal amounts of ephedrine for 7 to 10 days. During the control and placebo periods, the measurements of cyclic adenosine monophosphate (AMP) in leukocytes of asthmatic subjects were similar to those of normal subjects. After one week of therapy with ephedrine, both groups exhibited suppression of the leukocyte cyclic AMP responses to adrenergic stimulation in vitro; however, the suppression of response was significantly greater in asthmatic subjects (p < 0.01). The plasma glucose responses to administered epinephrine also decreased in both groups after treatment with ephedrine, but the change occurred earlier in asthmatic subjects. Ephedrine did not alter either the baseline pulmonary functions or the pulmonary responses to administered epinephrine; however, significant changes in pulmonary function were not observed after subcutaneous administration of 200 μg of epinephrine during any of the treatment periods. Morning plasma cortisol concentrations were significantly lower in asthmatic patients than in normal controls (p < 0.001) but were not affected by treatment with ephedrine. Administration of 100 mg of Solu-Cortef intravenously improved the glucose responses to epinephrine in ephedrine-treated asthmatic subjects but did not influence the pulmonary responses or the measurements of leukocyte cyclic AMP in either group. The results indicate that the metabolic responses to adrenergic stimulation are markedly altered in both normal and asthmatic subjects by a short period of treatment with ephedrine. However, loss of metabolic response was not associated with corresponding changes in the pulmonary responses to therapy.

Early detection of hypersensitivity pneumonitis in office workers

Symptoms of hypersensitivity pneumonitis in three employees in an office building led to an investigation of their work environment. An open spray water air cooling system was implicated when inhalation challenge with the spray water caused acute illness in one of them. A questionnaire survey of the 4,023 co-workers identified 48 other suspect cases, and laboratory studies confirmed hypersensitivity pneumonitis in three additional workers of this group. A significant change in pulmonary function, occurring only after exposure to the work environment, was the most useful laboratory finding and was found in five workers with no other pulmonary abnormalities, but not in asymptomatic workers or controls. Since five of the six patients with hypersensitivity pneumonitis worked in offices cooled by the spray water system and since three had positive responses to inhalation challenge, use of the spray water system was discontinued. The affected workers improved after they were removed from the office complex.

PROGRESSION AND RESOLUTION OF CHANGES IN PULMONARY FUNCTION AND STRUCTURE DUE TO PULMONARY MICROEMBOLISM AND BLOOD TRANSFUSION

It was the purpose of this research to define the progression over several days of changes in pulmonary function and structure and to document the phases of recovery following transfusions to dogs of sublethal quantities of stored blood containing microaggregates. Ten dogs underwent partial exchange transfusions averaging 60% of blood volume through standard blood transfusion filters. Average screen filtration pressure (SFP) of the blood was 85 mm Hg. Pulmonary hypertension did not develop, but there were striking decreases in O2 consumption, increases in Qs/Qt and decreases in Do2. Changes became progressively more marked over the first 48 to 72 hours after the transfusions. Pulmonary function of surviving animals returned nearly to normal by the sixth day after transfusions. Pathologic examinations of the lungs of animals sequentially sacrificed over 6 days showed intravascular microemboli, alveolar cell hyperplasia and interstitial and alveolar pulmonary edema. Progressive recovery was associated with progressive resolution of all detrimental changes. In 6 animals exchange transfused 100% of their blood volumes through dacron wool (Swank) filters and in three control animals that were not transfused, there were no significant changes in pulmonary function or structure. These experiments define the progression of deterioration and recovery over 6 days of pulmonary function in dogs after sublethal pulmonary microembolism occurring during blood transfusion.

Monovalent influenza A/New Jersey/76 virus vaccines in asthmatic children: pulmonary function and skin tests for allergy.

Eighty-eight asthmatic children aged six to 16 years received monovalent influenza A/New Jersey/76 virus vaccines. Forty-one of these children were given skin tests for allergy to eggs and vaccines, and 57 were given pulmonary function tests before and after immunization. Only four children reacted to the vaccines in the skin tests, with three of these children reacting to only one of four test preparations. Only two of the four children showed a correlation between reactivity to vaccine and allergy to egg antigens. No significant changes in pulmonary function were demonstrated.

Progression and resolution of changes in pulmonary function and structure due to pulmonary microembolism and blood transfusion.

It was the purpose of this research to define the progression over several days of changes in pulmonary function and structure and to document the phases of recovery following transfusions to dogs of sublethal quantities of stored blood containing microaggregates. Ten dogs underwent partial exchange transfusions averaging 60% of blood volume through standard blood transfusion filters. Average screen filtration pressure (SFP) of the blood was 85 mm Hg. Pulmonary hypertension did not develop, but there were striking decreases in O2 consumption, increases in Qs/Qt and decreases in Do2. Changes became progressively more marked over the first 48 to 72 hours after the transfusions. Pulmonary function of surviving animals returned nearly to normal by the sixth day after transfusions. Pathologic examinations of the lungs of animals sequentially sacrificed over 6 days showed intravascular microemboli, alveolar cell hyperplasia and interstitial and alveolar pulmonary edema. Progressive recovery was associated with progressive resolution of all detrimental changes. In 6 animals exchange transfused 100% of their blood volumes through dacron wool (Swank) filters and in three control animals that were not transfused, there were no significant changes in pulmonary function or structure. These experiments define the progression of deterioration and recovery over 6 days of pulmonary function in dogs after sublethal pulmonary microembolism occurring during blood transfusion.

Intranasal immunization with attenuated live influenza vaccine in asthma

Attenuated live intranasal influenza vaccine (“Alice”) was given to 20 asthmatics and 9 control subjects. Pulmonary function tests were performed before and after, with emphasis on tests of small airways function (using flow volume curves with air and a helium-oxygen mixture). In subjects with a low influenza A antibody titer, there was a 4-fold rise in titer to the vaccine, whereas those subjects with a high titer showed no rise. There were no significant changes in pulmonary function in any parameters measured, and no significant symptoms were reported. We have concluded from this study that “Alice” appears safe for use in asthma and was capable of producing an antibody titer rise in persons with low titers.

Dynamic lung function changes following long-term work in polluted environments

Ten young males (mean age 23.1 years) and nine middle-aged males (mean age 47.8 years) forming two groups (smokers and nonsmokers) performed a simple spirometric evaluation test prior to and following 4 hours exposure to four ambient conditions at two temperatures: 25°C dry bulb (DB), 30% rh and 35°C DB, 30% rh). The ambient conditions were filtered air, 50 ppm carbon monoxide in filtered air, 0.24 ppm peroxyacetylnitrate (PAN) in filtered air, and a combination of all three above conditions. During the 4-hour exposure, the subjects performed 3.5 hours of submaximal work (35% VO 2max) resulting in a ventilation of 20–30 liters/min BTPS. The FVC of the younger subjects was reduced (4–7%) following exposure to conditions containing peroxyacetylnitrate ( P < 0.05). The older subjects had no significant change in pulmonary function due to pollutants, suggesting an age-related susceptibility to the oxidant pollutants, such as PAN. Thermal stress reduced the FVC of younger subjects 5.5% ( P < 0.01). There were no interactions between pollutants, temperature, or smoking habits. Exercise alone was effective in changing FEV 1.0 FVC , % of all subjects of both age groups. It was suggested that oxidant-type pollutants act on the dependent regions of the lung, while exercise appeared to stimulate the lung during forceful expiration.

Screening &amp;amp; Obstructive Treatment Program Pulmonary Disease for Mild Chronic

Seven hundred and fifty men were screened for the presence of mild chronic obstructive pulmonary disease, and 134 subjects were enrolled in a therapy program. The findings of follow-up interviews, physical examinations, and laboratory tests were correlated with the screening results. Among those completing six months of therapy, there was a marked improvement of respiratory symptoms, but no significant change in pulmonary function. Cessation of cigarette smoking was most closely associated with the symptomatic improvement.

The effect of viscose rayon ribers on lung function in rats.

Experiments have been performed to determine the effect of viscose rayon fibers upon the pulmonary mechanics of a group of rats. Daily intratracheal injection of synthetic fiber suspension for 20 days produced an increase in index of alveolar pressure and a decrease in tidal volume, respiratory rate, and minute volume. In control animals there was no significant change in pulmonary function after intratracheal injection of normal saline. Comparison of the values after the first exposure of rayon fibers with those after intra tracheal injection of histamine did not show significant difference except in higher respiratory rate after histamine. In both exposed and control groups, infection was present when the animals were killed at the end of the experiment. The significant changes in lung function in control animals with approximately the same histological findings indicated that the changes in dust-exposed animals were mostly related to the rayon fibers.

MIST TENT THERAPY OF THE OBSTRUCTIVE PULMONARY LESION OF CYSTIC FIBROSIS

The physical and physiological principles involved in the effective utilization of nebulization inhalation therapy are discussed. Objective data are presented supporting the use of mist tent therapy in the treatment of the chronic obstructive pulmonary lesion of cystic fibrosis. After three control periods the addition of mist tent therapy to an otherwise comprehensive treatment program resulted over the next 2 months in significant decreases in functional residual capacity, residual volume and ratio of residual volume to total lung capacity, and increase in maximum breathing capacity. These changes in the direction of improvement were maintained with continued use of the mist tent over the next year. A similar study involving elimination of mist tent therapy for 1 month and reinstituting it in the home treatment program revealed significant changes in pulmonary function in increased airway obstruction and overinflation during the period of elimination. These changes were reversed when mist tent therapy was reinstituted.

Environmental Air Pollution, Emphysema and Ionized Air

The present evidence would indicate that both community air pollution and personal air pollution are important factors in some people developing pulmonary emphysema. We feel that cigarette smoking is the more significant factor at the present time in the development of emphysema as compared to community air pollution. However, this does not mean that community air pollution is not important in the development of emphysema. Previous studies by objective tests have demonstrated that Los Angeles smog aggravates the severity of pulmonary emphysema when present in a marked degree. Longer follow-up studies are needed in more groups to assess better the significance of breathing polluted air for many years. The normal large breathing reserve in man and the many variable factors present in the environment render difficult the designing of controlled experiments to demonstrate quickly the significant changes in pulmonary function from community air pollution. It is our feeling at the present time that there is no good evidence to recommend the use of air ions, either negative or positive, in the treatment of chronic pulmonary diseases in man. Although high concentrations of air ions were provided at the level of the nose and mouth, we doubt that there would be many un-neutralized ions that reached the bronchiolar level of the subject.