OBJECTIVETo investigate the expression of vitamin D3 upregulated protein-1 (VDUP1) in peripheral eosinophils at different stages of asthma and its correlation with clinical manifestations of asthma.

METHODSFourteen normal volunteers and 51 mild to moderate asthma patients, including 16 untreated patients with asthma attack and 35 with asthma remission by continuously corticosterone inhalation. The symptom severity and pulmonary function indices were evaluated and induced sputum eosinophil counts and blood eosinophil count measured. VDUP1 and beta-actin gene fragments were amplified simultaneously by RT-PCR from the total RNA of peripheral eosinophils, and 10 microl of the RT-PCR product underwent agarose gel electrophoresis and the VDUP1/beta-actin ratio was obtained by Gel-Pro software.

RESULTSVDUP1/beta-actin ratio significantly decreased in untreated patients with asthma attacks in comparison with normal volunteers (0.314+/-0.242 vs 0.532 +/-0.279) but not in patients with asthma remission (0.612+/-0.381). In the former patients, a positive correlation of VDUP1/beta-actin ratio was found with FEV1.0% (r=0.587, P=0.046) and %PEF (r=0.563, P=0.033), whereas an inverse one observed with sputum eosinophil count (r=-0.436, P=0.049).

CONCLUSIONVDUP1 expression in the eosinophils correlates to eosinophil activation and may influence the disease severity of asthma patients.

Actins ; biosynthesis ; genetics ; Asthma ; blood ; metabolism ; Carrier Proteins ; biosynthesis ; genetics ; Eosinophils ; metabolism ; Humans ; Maximal Expiratory Flow-Volume Curves ; Peak Expiratory Flow Rate ; Respiratory Function Tests ; Thioredoxins ; biosynthesis ; genetics

OBJECTIVETo investigate the lung function of the normal subjects living in Hebei province and its correlative factors such as living circumstance, age, height, and body weight.

METHODSThe lung volumes and breath capacities of 1,587 normal subjects were tested by portable spirometers (Scope Rotry) from August to October in 2002. The influences of living circumstance, age, gender, height, and body weight on lung functions were observed and analyzed.

RESULTSNo significant difference was found between urban and rural areas in all indexes (P > 0.05); however, significant difference existed between male and female subjects (P = 0.000). The change trends of lung function in male and female subjects were similar. Growth spurt appeared at the age of 12-16 years in male subjects and 12-14 years in female subjects. Vital capacity (VC), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) reached their peaks at the age of 26-34 years and then decreased with age. Peak expiratory flow (PEF), 25% forced expiratory flow (FEF50%), and 75% forced expiratory flow (FEF75%) appeared at the age of 18 and then went down with age. Both height and weight had a correlation with all the indexes of lung functions, although the influence of height is stronger than weight.

CONCLUSIONSAll the indexes of lung function have correlations with age, height, and weight. Lung function changes with aging, therefore different expected values shall be available for the adolescence, young adults, and middle-aged and old people. This study provides reference values of lung function for normal population.

Adolescent ; Adult ; Aged ; Child ; Female ; Forced Expiratory Flow Rates ; Forced Expiratory Volume ; Humans ; Lung ; physiology ; Male ; Middle Aged ; Peak Expiratory Flow Rate ; Reference Values ; Respiratory Function Tests ; Rural Health ; Sampling Studies ; Urban Health ; Vital Capacity

In the present study, the signs of airflow obstruction on inspiratory and expiratory CT scans in 45 patients with rheumatoid arthritis were investigated. Radiologic findings were evaluated and correlated with the clinical data, which included rheumatoid factors and pulmonary function tests results. A lung biopsy was performed in five patients. The pattern of CT findings was as follows: infiltrative (n=15), obstructive (n=12), mixed (infiltrative and obstructive; n=10), other complicating diseases (n=7), and normal (n=1). The rheumatologic factor between patients with bronchial wall thickenings and patients without thickenings was significantly different (p=0.009). The forced expiratory flow rate between 25% and 75% of the vital capacity (FEF25-75%) was significantly more reduced in patients with interlobular septal thickenings than in patients without these thickenings. The patients with mosaic attenuation had significantly lower mean values of FEF25-75% (p=0.001) and a lower peak expiratory flow (p=0.003) than patients without mosaic attenuation. On expiratory scans, the mean air-trapping score was 21%. These air-trapping scores were found to be well correlated with FEV1/FVC (r=0.230, p=0.0452), and FEF25-75% (r=-0.63, p= 0.05). It is widely known that a relatively higher percentage of mosaic attenuation with air-trapping and a good correlation between these and functional values contribute to the detection of early airway obstruction in patients with rheumatoid arthritis, and even in patients with infiltrative lung disease only.
Adolescent ; Adult ; Aged ; Airway Obstruction/*epidemiology/physiopathology/*radiography ; Arthritis, Rheumatoid/*epidemiology ; Female ; Forced Expiratory Flow Rates ; Human ; Incidence ; Male ; Middle Aged ; Peak Expiratory Flow Rate ; *Respiratory Function Tests ; *Tomography, X-Ray Computed ; Vital Capacity

OBJECTIVETo investigate the changes of pulmonary functions in children with segmental Mycoplasma pneumoniae pneumonia (SMPP).

METHODSA total of 55 children with SMPP were recruited into this study. Pulmonary functions were measured at both acute and recovery phases, including FVC, FEV1, FEV1/FVC, PEF, FEF25%, FEF50%, FEF75% and FEF25%-75%.

RESULTSFVC, FEV1, FEV1 /FVC, PEF, FEF25%, FEF50%, FEF75%, and FEF25%-75% were reduced in all of the 55 cases at the acute phase. FEF25%, FEF50%, FEF75% and FEF25%-75% decreased more significantly. The indexes above mentioned were improved significantly at the recovery phase compared with the acute phase (P<0.05). During the acute phase FVC and FEV1 decreased more significantly in the group with multiple area lesions than in the group with single area lesions (P<0.05).

CONCLUSIONSBoth large and small airway functions are damaged in different degrees in children with SMPP during the acute phase. More cases show restrictive ventilatory disorders and the injury of small airway function is more severe. The pulmonary function is markedly improved at the recovery phase, suggesting that the pulmonary function impairments are reversible. The pulmonary function impairments are more severe in children with multiple area lesions.

Adolescent ; Child ; Child, Preschool ; Female ; Forced Expiratory Flow Rates ; Forced Expiratory Volume ; Humans ; Lung ; physiopathology ; Male ; Pneumonia, Mycoplasma ; physiopathology

OBJECTIVETo assess the risk factors correlating to the likelihood for airflow obstruction among first-degree children of chronic obstructive pulmonary disease (COPD) patients and whether familial aggregation of pulmonary function abnormality exists.

METHODSFifty-nine smokers with COPD and 28 smokers without COPD as control and all their children available were recruited into the study. Their history was recorded and a binary logistic regression analysis was carried out to ascertain the effects of their relationship to a proband with COPD, when other potential risk factors were controlled.

RESULTSChildren with COPD probands showed increased risk of FEV1 below the 70% predicted (OR = 1.987) after accounting for the effects of smoking, sex and clinical symptoms. The lower the pulmonary function of the COPD proband, the higher the risk to their children for FEV1 below the 70% predicted.

CONCLUSIONSOur finding demonstrates the presence of a household aggregation inclination of COPD and pulmonary function impairment. Genetic factors might act as the basis of the familial aggregation.

Aged ; Female ; Forced Expiratory Flow Rates ; Humans ; Lung ; physiopathology ; Male ; Pulmonary Disease, Chronic Obstructive ; genetics ; physiopathology ; Regression Analysis ; Smoking

PURPOSE: For patients with neuromuscular disease, air stacking, which inflates the lungs to deep volumes, is important for many reasons. However, neuromuscular patients with severe glottic dysfunction or indwelling tracheostomy tubes cannot air stack effectively. For these patients, we developed a device that permits deep lung insufflations substituting for glottic function. MATERIALS AND METHODS: Thirty-seven patients with bulbar-innervated muscle weakness and/or tracheostomies were recruited. Twenty-three had amyotrophic lateral sclerosis, and 14 were tetraplegic patients due to cervical spinal cord injury. An artificial external glottic device (AEGD) was used to permit passive deep lung insufflation. In order to confirm the utility of AEGD, vital capacity, maximum insufflation capacity (MIC), and lung insufflation capacity (LIC) with AEGD (LICA) were measured. RESULTS: For 30 patients, MICs were initially zero. However, with the use of the AEGD, LICA was measurable for all patients. The mean LICA was 1,622.7+/-526.8 mL. Although MIC was measurable for the remaining 7 patients without utilizing the AEGD, it was significantly less than LICA, which was 1,084.3+/-259.9 mL and 1,862.9+/-248 mL, respectively (p<0.05). CONCLUSION: The AEGD permits lung insufflation by providing deeper lung volumes than possible by air stacking.
Adult ; Aged ; Female ; Forced Expiratory Flow Rates/physiology ; Humans ; Insufflation/*instrumentation/methods ; Male ; Middle Aged ; Neuromuscular Diseases/*physiopathology/therapy ; *Ventilators, Mechanical ; Vital Capacity/physiology ; Young Adult

PURPOSE: To evaluate the HRCT findings of hypersensitive pneumonitis and to correlate the findings with the results of the pulmonary function test (PFT). MATERIALS AND METHODS: Seven patients in whom hypersensitive pneumonitis was histologically confirmed (by transbronchial lung biopsy in two, thoracoscopic lung biopsy in one, open lung biopsy in two, and typical clinical and laboratory findings in two) were involved in this study. Their radiological patterns were assessed by HRCT and the extent of each finding was evaluated semi-quantitatively and correlated with the results of the pulmonary function test. RESULTS: The HRCT findings were as follows: lobular overinflation (n = 7), ground glass attenuation (n = 7), centrilobular nodule (n = 6), reticular opacity (n = 5), interlobular septal thickening (n = 3), consolidation (n = 2), and irregular subpleural line (n = 1). Five patients showed lower lung predominance and two, middle lung predominance. In all, a restrictive pattern and diminished diffusion capacity was noted. The grade score of reticular opacity showed significant correlation with forced vital capacity and forced expiratory volume. There was, however, no significant correlation between other HRCT findings and PFT results. Two patientsin whom lobular overinflation associated with parenchymal fibrosis was noted showed a decreased maximal midexpiratory flow rate of 25 -75. CONCLUSION: Lobular overinflation, ground-glass attenuation and centrilobular nodules are commonly observed in hypersensitive pneumonitis. The only significant correlation between each HRCT finding and the pulmonary function test was that between reticular opacity and both forced expiratory volume and forced vital capacity. In cases of chronic hypersensitive pneumonitis presenting as pulmonary fibrosis, associated lobular overinflation could be helpful for differential diagnosis.
Alveolitis, Extrinsic Allergic* ; Biopsy ; Diagnosis, Differential ; Diffusion ; Fibrosis ; Forced Expiratory Volume ; Glass ; Humans ; Hypersensitivity* ; Lung ; Maximal Midexpiratory Flow Rate ; Pneumonia ; Pulmonary Fibrosis ; Respiratory Function Tests* ; Vital Capacity

OBJECTIVEImpulse oscillation system (IOS) as an approach to lung function determination is suitable for children, especially for preschool children in that it only requires the individual to be examined to breathing stably with tidal volume. However, until now there have been no uniformly agreed criteria for positive bronchial reversibility test in clinical practice. A screening method was applied to seek for answer when this question in the hope of providing objective evidence for clinical diagnosis of respiratory diseases, esp. asthma.

METHODSOne hundred and fifty-six children patients during asthma attack were recruited randomly for this study from January to December, 2004. These patients included 103 boys and 53 girls aged from 5 to 18 years with mean age of 8.84 +/- 2.58 years, who visited the doctors in the Clinical and Educational Centre for Asthma, Capital Institute of Pediatrics and were diagnosed as asthma. Maximal expiratory flow volume and IOS lung function were determined followed by bronchodilator reversibility test in all patients. The sensitivity and specificity of IOS parameters, total respiratory impedance (Zrs), respiratory resistance at 5 Hz (R5) and reactance at 5 Hz (X5) for diagnosing asthma at different improvement levels after inhalation of bronchodilator were calculated respectively using forced expiratory volume in first second (FEV(1)) and maximal mid-expiratory flow (MMEF) as gold standard. And the regression equation between parameters of lung function which were determined with the two different methods was analyzed.

RESULTSAfter inhalation of bronchodilator, the lung function of the children was improved significantly (P < 0.01), with the FEV(1), MMEF increase and Zrs, R5, and X5 decrease. There were significantly positive correlations (P < 0.01) between the improvement rate of parameters of lung functions determined with the two methods, and the highest correlation coefficients existed between X5 and FEV(1) and MMEF (respectively 0.676, 0.571), correlation coefficients between X5 and Zrs ranked second (0.519 and 0.505, respectively). When an increase of FEV(1) equal to or greater than 15%, or increase of MMEF equal to or greater than 30% was used as reference for positive bronchial reversibility, the sensitivity and specificity were relatively high for considering positive bronchial reversibility test with at least 20% decrease of Zrs, R5, and 30% decrease of X5 with IOS lung function. The sensitivity and specificity of Zrs, R5 and X5 calculated from FEV(1) were 0.62, 0.51; 0.49, 0.54; 0.70, and 0.54, respectively. The sensitivity and specificity of Zrs, R5 and X5 calculated from MMEF were 0.63, 0.54; 0.53, 0.60; 0.60, and 0.58, respectively. The regression equation showed that the decrease of Zrs, R5 and X5 corresponding to 15% increase of FEV(1) and 30% increase of MMEF were 21.7%, 21.3%; 19.9%, 19.5%; 30.1%, and 29.6%, respectively.

CONCLUSIONWhen lung function is determined with IOS in children, only when decrease of Zrs and R5 is equal to or more than 20% and decrease of X5 is 30% or more after inhalation of bronchodilator, can the bronchial reversibility test be considered as positive.

Adolescent ; Asthma ; diagnosis ; Bronchodilator Agents ; administration & dosage ; Child ; Child, Preschool ; Female ; Forced Expiratory Volume ; Humans ; Male ; Maximal Midexpiratory Flow Rate ; Regression Analysis ; Respiratory Function Tests ; methods ; Sensitivity and Specificity

OBJECTIVETo investigate the changes of pulmonary function and fractional exhaled nitric oxide (FeNO) in the standardized treatment of bronchial asthma in children.

METHODSA total of 254 children who were newly diagnosed with acute exacerbation of bronchial asthma were selected as asthma group, and they were divided into two subgroups: asthma with concurrent rhinitis and asthma without concurrent rhinitis. All patients received the standardized management and treatment for one year. The pulmonary function parameters included forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), maximal mid-expiratory flow (MMEF), and mid-expiratory flow at 25%, 50%, and 75% of vital capacity (MEF25, MEF50, and MEF75). The FeNO levels were measured before treatment and at 3, 6, 9, and 12 months after treatment. Another 62 healthy children were selected as the control group, and the pulmonary function and FeNO levels were measured only once.

RESULTSDuring one year of standardized treatment, FEV1, PEF, MMEF, MEF25, MEF50, and MEF75 gradually increased, and FeNO levels gradually decreased (P<0.05). Indicators of large airway function, such as FEV1 and PEF, almost returned to normal after 6 months of treatment; indicators of small airway function, such as MMEF, MEF25, MEF50, and MEF75 almost returned to normal after 9 months of treatment; there were no significant differences in the above indices between the asthma group and the control group after one year of treatment (P>0.05). However, the asthma group had a significantly higher FeNO levels than the control group after one year of treatment (P<0.05). The asthmatic patients with concurrent rhinitis had significantly higher FeNO levels than those without concurrent rhinitis before treatment and 3 months after treatment (P<0.05). Before treatment, there was a significant negative correlation between FeNO levels and pulmonary function parameters (P<0.05).

CONCLUSIONSWith the standardized treatment of bronchial asthma in children, pulmonary function parameters gradually increase and FeNO levels gradually decrease. The recovery of large airway function occurs earlier than the recovery of small airway function. Furthermore, the effect of rhinitis on airway responsiveness should be noted.

Asthma ; physiopathology ; therapy ; Breath Tests ; Child ; Female ; Forced Expiratory Volume ; Humans ; Lung ; physiopathology ; Male ; Maximal Midexpiratory Flow Rate ; Nitric Oxide ; analysis ; Rhinitis ; physiopathology

PURPOSE: To evaluate on the basis of the pulmonary function test the correlation between the extent of air trapping on HRCT with the severity of airway obstruction and also to identify the prognostic effect of the extent of air trapping after treatment of asthma. MATERIALS AND METHODS: Thirty five patients with clinically diagnosed bronchial asthma and air trapping, as seen on HRCT, were included in this study. We quantitatively analysed on HRCT the extent of air trapping and then statistically compared this with the clinical parameters of the pulmonary function test. We classified the patients into two groups on the basis of the pulmonary function test and clinical status : Group 1(N=35), the total number of asthmatic patients ; Group 2(N=18), relatively stable asthmatics without acute asthmatic attack who showed FEV1 of more than 80% of the predicted value. Using the functional parameters of PEFR, one of the objective indications of improvement in airway obstruction, we also classified the patients into three groups on the basis of interval between treatment and clinical improvement. The result of this was as follows ; group 1, asymptomatic group(initial PEFR within normal limit, N=7) ; group 2, early responder(improvement of PEFR within three hospital days, N=18) ; group 3, late responder(improvement of PEFRwithin fourteen hospital days should there be a number here). Using HRCT, we then statistically analysed the differences between the three groups in the extent of air trapping. RESULTS: Among the total of 35 asthmatics, the extent of air trapping on HRCT showed significant correlation with the FEV1(r=-0.6161, p<0.001) and MEFR(r=-0.6012, p<0.001). Among the relatively stable asthmatics who showed FEV1 of more than 80% of the predicted value, MEFR(r=-0.7553, p<0.001) and FEF75(r=-0.7529, p=0.012) showed statistically significant correlation with the extent of air trapping on HRCT, but there was no significant corrlation between air trapping on HRCT and FEV1. In the three groups of asthmatics classified on the basis of interval between treatment and clinical improvement, the extents of air trapping on HRCT in the asymptomatic, early responder and late responder groups was as follows: (mean valuse) 9.31%, 21.50% and 27.89%, respectively ; these differences were statistically significant. CONCLUSION: The extent of air trapping on HRCT in asthmatics showed positive correlation with FEV1 and MEFR. Quantitative analysis of air trapping on HRCT also provides prognostic information about a patient's response to treatment.
Airway Obstruction ; Asthma ; Humans ; Maximal Expiratory Flow Rate ; Peak Expiratory Flow Rate ; Respiratory Function Tests*