A lung diffusion function detection system is designed. Firstly, the controllable collection of air, test gas source and calibration gas source was based on single-breath method measurement principle. Secondly, pulmonary diffusing capacity for carbon monoxide (D_lCO) was calculated by gas concentration measured by the non-dispersive infrared sensor to measure, the gas flow measured by the differential pressure sensor, and the temperature, humidity and atmospheric pressure sensors to test and evaluate the quantitative detection and evaluation of lung diffusion function. Moreover, a preliminary verification of the lung diffusion function detection system was implemented, and the results showed that the error of the lung carbon monoxide diffusion and the alveolar volume did not exceed 5%. Therefore, the system has high accuracy and is of great value for early screening and accurate assessment of COPD.
Carbon Monoxide ; Lung ; Pulmonary Diffusing Capacity/methods*

BACKGROUND: Pulmonary fibrosis is the most common pulmonary complication in patients with end stage renal disease undergoing hemodialysis. The diffusing capacity is sensitive and reliable methods for diagnosis for pulmonary fibrosis. The aim of this study was to investigate the change of diffusing capacity for dialysis duration and membranes (synthetic vs cellulosynthetic) in maintenance hemodialysis patients. METHODS: We evaluated prospectively pulmonary diffusing capacity (DLCO/VA) of the patients who had been receiving regular hemodialysis for a period of at least 3 months at Gyeongsang National University Hospital from April 1, 2002 to June 30, 2003. Seventy one patients were divided into two groups by dialysis duration: less than 24 months; more than 24 months. Also, we divided patients into two groups by dialysis membrane: cellulosynthetic membrane (Hemophan); synthetic membrane (Polysulfone). RESULTS: The diffusing capacity and dialysis durations were presented for negative correlation [r= -0.321 (p=0.01) in DLCO/VA]. According to dialysis membranes, DLCO/VA values were significantly decreased in patients in Hemophan group rather than Polysulfone Group [92.4+/-20.5% vs 107.5+/-19.3%, (p= 0.01)]. According to dialysis durtation and membranes, DLCO/VA values were significantly decreased in patients in Hemophan group rather than Polysulfone group at duration for more than 24 months [84.9+/-20.1% vs 105.2+/-20.8%, (p=0.003)]. CONCLUSION: Patients undergoing long-term maintenance hemodialysis showed a gradual reduction in lung diffusing capacity for dialysis duration. Our results suggested that lung diffusing capacity was more severely reduced in hemodialysis patients using bioincompatible membrane rather than biocompatible membrane.
Diagnosis ; Dialysis* ; Humans ; Kidney Failure, Chronic ; Lung* ; Membranes* ; Prospective Studies ; Pulmonary Diffusing Capacity ; Pulmonary Fibrosis ; Renal Dialysis*

OBJECTIVETo determine the diagnostic value of pulmonary function testing in Chinese patients with known pulmonary arterial hypertension (PAH) without history of lung/heart valve diseases.

METHODSPulmonary function testing was performed in 41 PAH patients diagnosed by right heart catheterization and in 17 healthy controls.

RESULTSNormal pulmonary function testing results were found in 5 PAH patients (12.2%). Total lung capacity, vital capacity and FEV1 were significantly decreased in PAH patients [(80.27 +/- 11.46)% vs. (94.24 +/- 6.82)%; (79.09 +/- 14.89)% vs. (97.35 +/- 9.51)%; (75.40 +/- 16.58)% vs. (95.12 +/- 12.01)%, respectively, all P < 0.001], the ratio of residual volume/total lung capacity was significantly increased [(117.67 +/- 25.73)% vs. (93.39 +/- 10.87)%, P < 0.001]; FEV1/FVC and maximal expiratory flow of 25% to 75% tended to be lower (-6.0% and -19.4%, P = 0.21 and 0.09) while DLCO and DLCO/VA were significantly decreased by 36.6% and 29.8% (P < 0.001) compared with healthy controls.

CONCLUSIONSIncreased peripheral airway obstruction and normal lung resistance were found in these PAH patients. Normal pulmonary function testing results could not rule out the diagnosis of PAH.

Adult ; Case-Control Studies ; Cross-Sectional Studies ; Female ; Forced Expiratory Volume ; Humans ; Hypertension, Pulmonary ; physiopathology ; Lung ; physiopathology ; Male ; Pulmonary Diffusing Capacity ; Respiratory Function Tests ; Vital Capacity

BACKGROUND: The diffusing capacity of the lung is influenced by multiple factors such as age, sex, height, weight, ethnicity and smoking status. Although a prediction equation for the diffusing capacity of Korea was proposed in the mid-1980s, this equation is not used currently. The aim of this study was to develop a new prediction equation for the diffusing capacity for Koreans. METHODS: Using the data of the Korean National Health and Nutrition Examination Survey, a total of 140 nonsmokers with normal chest X-rays were enrolled in this study. RESULTS: Using linear regression analysis, a new predicting equation for diffusing capacity was developed. For men, the following new equations were developed: carbon monoxide diffusing capacity (DLco)=−10.4433−0.1434×age (year)+0.2482×heights (cm); DLco/alveolar volume (VA)=6.01507−0.02374×age (year)−0.00233×heights (cm). For women the prediction equations were described as followed: DLco=−12.8895−0.0532×age (year)+0.2145×heights (cm) and DLco/VA=7.69516−0.02219×age (year)−0.01377×heights (cm). All equations were internally validated by k-fold cross validation method. CONCLUSION: In this study, we developed new prediction equations for the diffusing capacity of the lungs of Koreans. A further study is needed to validate the new predicting equation for diffusing capacity.
Carbon Monoxide ; Diffusion ; Female ; Humans ; Korea ; Linear Models ; Lung ; Male ; Methods ; Nutrition Surveys ; Pulmonary Diffusing Capacity ; Smoke ; Smoking ; Thorax

About a third of the patients with decompensated liver cirrhosis have reduced arterial oxygen saturation and are sometimes cyanosed in the absence of any apparent lung or heart disease; There is a reduction of diffusing capacity without a restrictive ventilatory defect. The aim of this study was to determine diffusing capacities in patients with chronic liver- diseases. The diffusing capacities and arterial oxygen saturations were measured in 25 patients with chronic active hepatitis(CAH), 9 early cirrhotics (early LC), 36 cirrhotics(Child's class A) and 11 cirrhotics(Child's class B). The anterior tibial area was observed for pitting edema, and Thallium-201 test per rectum(shunt index) was done. Hypoxemia was not observed in all subjects. The number of cases with decreased pulmonary diffusing capacity (DLco) is 3/25(12.0%) for CAH, 3/9(33.3%) for CAH with early liver cirrhosis(LC), 17/36(47.2%) for LC(Child's class A) and 6/11(54.5%) for LC(Child's class B). The mean+/-standard deviation of Dlco(% predicred) are 93.1+/-12.1 for CAH, 85.7+/-12.3 for CAH with early LC, 82.2+/-14.7 for LC(Child's class A) and 80.4+/-6.9 for LC(Child's class B), There is a significant difference between DLco in CAH and that in LC(Child's class A)(p<0.01). Patients with higher shunt index(>0.3) had significantly lower DLco than these with lower shunt index(<0.3)(76.4+/-9.7% vs. 89.3+/-13.3%)(p<0.01). The DLco was also lower in patients with pitting edema(77.3+/-10.2%) than in those without pitting edema(85.5+/-13.8%) (p<0.01). These results summarized that the DLco was low in patients with cirrhosis and with higher shunt index(>0.3) or pitting edema. This may be due to an increased systemic blood flow shunt and an increased generalized interstitial edema. Pulmonary function tests including diffusing capacity may be useful as prognostic parameters in patients with chronic liver disease, especially in those with CAH or early LC.
Anoxia ; Edema ; Fibrosis ; Heart Diseases ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Lung ; Oxygen ; Pulmonary Diffusing Capacity* ; Respiratory Function Tests

Social welfare services for respiratory-disabled persons in Korea are offered based on the respiratory impairment grade, which is determined by 3 clinical parameters; dyspnea, forced expiratory volume in 1 second (FEV1), and arterial oxygen tension. This grading system has several limitations in the objective assessment of respiratory impairment. We reviewed several guidelines for the evaluation of respiratory impairment and relevant articles. Then, we discussed a new grading system with respiratory physicians. Both researchers and respiratory physicians agreed that pulmonary function tests are essential in assessing the severity of respiratory impairment, forced vital capacity (FVC), FEV1 and single breath diffusing capacity (DLco) are the primarily recommended tests. In addition, we agreed that arterial blood gas analysis should be reserved for selected patients. In conclusion, we propose a new respiratory impairment grading system utilizing a combination FVC, FEV1 and DLco scores, with more social discussion included.
Blood Gas Analysis ; Disability Evaluation ; Dyspnea ; Forced Expiratory Volume ; Humans ; Korea ; Oxygen ; Pulmonary Diffusing Capacity ; Respiratory Function Tests ; Respiratory System ; Social Welfare ; Spirometry ; Vital Capacity

OBJECTIVEFrom the point of holistic integrative medicine, the D(L)CO depends on not only normal respiratory and circulatory functions, but also an optional matching between them. However, due to the limitation of traditional systemic physiology, the D(L)CO always be classified as lung functional parameter to be analyzed and interpreted. Because ignoring the circulatory system function, so it will certainly have some misunderstandings.

METHODSBased on the Holistic Integrative Medicine, under the control of neurohumoral, respiratory, circulatory and metabolic systems work together, we discussed the diffusion function. We analyzed the change of D(L)CO in the patients with cardiac dysfunction, especially the heart failure.

RESULTSThe D(L)CO, CO gas,diffusion from lung circulating blood, depends on the normality of respiratory and circulatory systems and their matching. We analyzed the reasons of D(L)CO for characteristic pathophysiological changes of patients with heart failure.

CONCLUSIONThe normal D(L)CO depends on a good matching of normal respiratory and circulatory systems. For heart failure, the respiratory and circulatory systems matching is poor. Due to dominant limitation of left ventricle pump function, pulmonary blood volume may slightly increased, but combination of all reduced pulmonary blood flow rate, thicked diffuse member and increased diffusion distance etc. suggest that patients with heart failure should have a decreased, rather than increased, D(L)CO.

Blood Gas Analysis ; Blood Volume ; Heart Failure ; Humans ; Lung ; physiology ; Pulmonary Circulation ; Pulmonary Diffusing Capacity ; Respiratory Function Tests ; Ventricular Function, Left

Alveolitis is believed to be a primary response after dust inhalation. Activated inflammatory cells by dust and their mediators are major participants in the evolution of pneumoconiosis. Therefore evaluation of degree of alveolitis is useful for assessing disease activity and estimating of prognosis in pneumoconiosis. This study focused on the workers with pneumoconiosis who are working and worked in manufacturing industries because the occupying fraction by them among total pneumoconioses patients in our country is increasing recently. In order to identify and validate biomarkers to early diagnosis and better predict for the suceptible workers, the release of tumor necrosis factor (TNF alpha ), interleukine-8 (IL-8), platelet-derived growth factor-AA(PDGF-AA) and transforming growth factor-beta TGF beta ) from alveolar macrophages and blood monocytes, their concentration in BAL (bronchoalveolar lavage) fluid, pulmonary function test and Gallium index of lung were performed on 25 patients with pneumoconiosis who worked in manufactory industries. The results of this study were as follows ; 1. No significant differences were demonstrated between large opacity group and small opacity group, however pulmonary diffusing capacity in large opacity group was significantly lower than that in small opacity group. 2. (67)Gallium index was significantly correlated with increase of category in pnemoconiosis(r=0.83, p<0.05). 3. Numbers of total cells (r=0.583, p<0.05) and alveolar macrophages (r=0.499, p<0.05) in BAL were significantly correlated with the category of pneumoconiosis. 4. Spontaneous (r=0.474, p<0.05) and LPS (r=0.463, p<0.05) stimulated release of TNF alpha from macrophage, IL-8 (r=0.464, p<0.05) and TGF beta r=0.460, p<0.05) in BAL fluid were significantly correlated with category of pneumoconiosis. 5. Significantly positive correlation was demonstrated between spontaneous (r=0.443, p<0.05) and LPS (r=0.573, p<0.05) stimulated release of TNF alpha with the category of pneumoconiosis. 6. Release of TNF alpha from alveolar macrophages(r=0.61, p<0.05) and blood monocytes (r=0.48, p<0.05), IL-8 concentration in BAL fluid (r=0.52, p<0.05) and (67)Gallium index (r=0.53, p<0.05) were consider to sensitive biomarkers for alveolitis by dust.
Biological Markers* ; Dust* ; Early Diagnosis ; Gallium ; Humans ; Inhalation ; Interleukin-8 ; Lung ; Macrophages ; Macrophages, Alveolar ; Monocytes ; Pneumoconiosis* ; Prognosis ; Pulmonary Diffusing Capacity ; Respiratory Function Tests ; Tumor Necrosis Factor-alpha

Adult ; Age Factors ; Air Pollutants, Occupational ; toxicity ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Police ; Pulmonary Diffusing Capacity ; physiology ; Pulmonary Ventilation ; physiology ; Respiratory Function Tests ; Smoking ; adverse effects ; Vehicle Emissions ; toxicity

BACKGROUND/AIMS: Amiodarone is one of the most widely used antiarrhythmic agents; however, amiodarone-induced pulmonary toxicity (APT) can be irreversible and sometimes fatal. The aim of this study was to evaluate the feasibility of chest computed tomography (CT) as a diagnostic tool for APT and to assess the utility of the CT APT score as an index for predicting the severity of APT. METHODS: Patients underwent amiodarone treatment for various reasons, most often atrial fibrillation, for more than 2 years, and those that received a cumulative dose > 100 g were enrolled. A total of 34 patients who underwent chest CT between December 2011 and June 2012 were enrolled, whether or not they had clinical symptoms. The APT CT score was defined as the number of involved regions in the lung, which was divided into 18 regions (right and left, upper, middle, and lower, and central, middle, and peripheral). The CT findings were evaluated according to the total dose and duration of amiodarone treatment and the results of a pulmonary function test. Clinical symptoms and outcomes were also evaluated according to APT CT scores. RESULTS: Seven patients had positive APT CT scores (interstitial fibrosis in five, organizing pneumonia in one, and mixed interstitial fibrosis and organizing pneumonia in one), and these patients exhibited significantly lower diffusion capacity for carbon monoxide in the lungs compared with patients without an increased APT CT score (70.2% +/- 6.9% vs. 89.7% +/- 19.4%; p = 0.011). Three of the seven patients experienced overt APT that required hospital admission. CONCLUSIONS: Chest CT is a useful diagnostic tool for APT, and the APT CT score might be a useful index for assessing the severity of APT.
Aged ; Amiodarone/*adverse effects ; Anti-Arrhythmia Agents/*adverse effects ; Atrial Fibrillation/diagnosis/*drug therapy ; Cross-Sectional Studies ; Cryptogenic Organizing Pneumonia/chemically induced/physiopathology/*radiography/therapy ; Feasibility Studies ; Female ; Forced Expiratory Volume ; Hospitalization ; Humans ; Lung/drug effects/physiopathology/*radiography ; Male ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Pulmonary Diffusing Capacity ; Pulmonary Fibrosis/chemically induced/physiopathology/*radiography/therapy ; Respiratory Function Tests ; Risk Factors ; Time Factors ; *Tomography, X-Ray Computed ; Vital Capacity