4 research outputs found
Physiological and morphological determinants of maximal expiratory flow in chronic obstructive lung disease
Maximal expiratory flow in chronic obstructive pulmonary disease (COPD)
could be reduced by three different mechanisms; loss of lung elastic
recoil, decreased airway conductance upstream of flow-limiting segments;
and increased collapsibility of airways. We hypothesized that decreased
upstream conductance would be related to inflammation and thickening of
the airway walls, increased collapsibility would be related to decreased
airway cartilage volume, and decreased collapsibility to inflammation and
thickening of the airway walls. Lung tissue was obtained from 72 patients
with different degrees of COPD, who were operated upon for a solitary
peripheral lung lesion. Maximal flow-static recoil (MFSR) plots to
estimate upstream resistance and airway collapsibility were derived in 59
patients from preoperatively measured maximal expiratory flow-volume and
pressure-volume curves. In 341 transversely cut airway sections, airway
size, airway wall dimensions and inflammatory changes were measured.
Airflow obstruction correlated with lung elastic recoil and the MFSR
estimate of airway conductance but not to airway collapsibility or to the
amount of airway cartilage. The upstream conductance decreased as the
inner wall became thicker. Airway collapsibility did not correlate with
the amount of airway cartilage, inflammation, or airway wall thickness. We
conclude that the maximal flow-static recoil model does not adequately
reflect the collapsibility of the flow-limiting segment
Estimation of lung growth using computed tomography
Anatomical studies suggest that normal lungs grow by rapid alveolar
addition until about 2 yrs of age followed by a gradual increase in
alveolar dimensions. The aim of this study was to examine the hypothesis
that normal lung growth can be monitored by computed tomography (CT).
Therefore, the gas volume per gram of lung tissue was estimated from
measurements of lung density obtained from CT scans performed on children
throughout the growth period. CT scans were performed on 17 males and 18
females, ranging in age from 15 days-17.6 yrs. CT-measured lung weight was
correlated with predicted post mortem values and CT measured gas volume
with predicted values of functional residual capacity. The median value
for lung expansion was 1.86 mL x g(-1) at 15 days, decreased to 0.79 mL x
g(-1) by 2 yrs and then increased steadily to 5.07 mL x g(-1) at 17 yrs.
Computed tomography scans can be used to estimate lung weight, gas volume
and expansion of normal lungs during the growth period. The increase in
the lung expansion after the age of 2 yrs suggests progressive alveolar
expansion with increasing lung volume
Estimation of cancer mortality associated with repetitive computed tomography scanning
Rationale: Low-dose radiation from computed tomography (CT)
may increase the risk of certain cancers, especially in children.
Objective: We sought to estimate the excess all-cause and cancerspecific mort
Multicentre European study for the treatment of advanced emphysema with bronchial valves
This multicentre, blinded, sham-controlled study was performed to assess the safety and effectiveness of bronchial valve therapy using a bilateral upper lobe treatment approach without the goal of lobar atelectasis. Patients with upper lobe predominant severe emphysema were randomised to bronchoscopy with (n=37) or without (n=36) IBV Valves for a 3-month blinded phase. A positive responder was defined as having both a ≥4-point improvement in St George's Respiratory Questionnaire (SGRQ) and a lobar volume shift as measured by quantitative computed tomography. At 3 months, there were eight (24%) positive responders in the treated group versus none (0%) in the control group (p=0.002). Also, there was a significant shift in volume in the treated group from the upper lobes (mean±SD -7.3±9.0%) to the non-treated lobes (6.7±14.5%), with minimal change in the control group (p<0.05). Mean SGRQ total score improved in both groups (treatment: -4.3±16.2; control: -3.6±10.7). The procedure and devices were well tolerated and there were no differences in adverse events reported in the treatment and control groups. Treatment with bronchial valves without complete lobar occlusion in both upper lobes was safe, but not effective in the majority of patients. Copyright©ERS 2012.SCOPUS: ar.jinfo:eu-repo/semantics/publishe