Abstract:
:Loss of lung elastic recoil causing hyperinflation with increased TLC and decreased diffusing capacity and expiratory airflow are physiologic hallmarks of emphysema. We studied lung mechanics in 10 patients (seven men and three women) aged 69 +/- 9 yr (mean +/- SD) who had fixed, severe expiratory airflow limitation with a mean FEV1 = 0.73 +/- 0.1 L (mean +/- SD) (32 +/- 7% predicted) and lung computed tomographic picture grade score <= 20, indicating no or trivial emphysema. Three patients died, in whom whole-lung emphysema scores were 15 each and small airways were abnormal. Marked hyperinflation was present in all 10 patients studied, with TLC 7.3 +/- 1.1 L (140 +/- 12% predicted); FRC 5.6 +/- 0.8 L (177 +/- 30% predicted); and RV 5.2 +/- 0.8 L (242 +/- 28% predicted). Diffusing capacity of carbon monoxide (DLCO was reduced, at 12 +/- 6 ml/min/mm Hg (61 +/- 29% predicted). The pressure-volume curves of the lung were markedly abnormal. Pst(L) at TLC was 11.6 +/- 1.4 cm H2O. Transdiaphragmatic pressure (Pdi) in five patients was 66 +/- 13 cm H2O. These results indicate that severe small-airways disease with no or trivial emphysema may cause a spurious reduction in diffusing capacity as well as severe loss of lung elastic recoil resulting in marked hyperinflation, increased TLC, and decreased Pdi and expiratory airflow.
journal_name
Am J Respir Crit Care Medauthors
Gelb AF,Zamel N,Hogg JC,Müller NL,Schein MJdoi
10.1164/ajrccm.158.3.9801045subject
Has Abstractpub_date
1998-09-01 00:00:00pages
815-9issue
3eissn
1073-449Xissn
1535-4970journal_volume
158pub_type
杂志文章abstract::The severity of breathlessness at given degrees of airway obstruction varies between patients with asthma. It has been postulated that the symptoms during bronchoconstriction are determined in part by involvement of airway inflammation. We compared the severity of breathlessness at various degrees of acute airway obst...
journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1164/ajrccm.152.1.7599850
更新日期:1995-07-01 00:00:00
abstract::Relaxation was examined in diaphragm muscle strips of cardiomyopathic Syrian hamsters and control hamsters. Isotonic lengthening velocity and isometric tension decay were analyzed over the load continuum in response to twitch. For each load level (P), we measured the maximum extent of shortening (deltaL), the peak len...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.155.5.9154860
更新日期:1997-05-01 00:00:00
abstract:RATIONALE:The role of NADPH oxidase activation in pneumonia is complex because reactive oxygen species contribute to both microbial killing and regulation of the acute pulmonary infiltrate. The relative importance of each role remains poorly defined in community-acquired pneumonia. OBJECTIVES:We evaluated the contribu...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.200707-990OC
更新日期:2008-04-15 00:00:00
abstract:RATIONALE:Little is known about the incidence of isoniazid-associated hepatitis in HIV-infected Africans who receive both isoniazid preventive therapy (IPT) and antiretroviral therapy (ART). OBJECTIVES:To assess the rate of and risk factors for isoniazid (INH)-associated hepatitis in persons living with HIV (PLWH) dur...
journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1164/rccm.200911-1783OC
更新日期:2010-07-15 00:00:00
abstract::Exposure to fine airborne particulate matter (PM(2.5)) is associated with cardiovascular events and mortality in older and cardiac patients. Potential physiologic effects of in-vehicle, roadside, and ambient PM(2.5) were investigated in young, healthy, nonsmoking, male North Carolina Highway Patrol troopers. Nine troo...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.200310-1463OC
更新日期:2004-04-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.155.6.9196100
更新日期:1997-06-01 00:00:00
abstract:RATIONALE:Asthma treatment might improve when inhaled steroids are titrated on airway inflammation. Fractional exhaled nitric oxide (FeNO0.05), a marker of eosinophilic airway inflammation, can be measured at home. OBJECTIVES:We assessed daily FeNO0.05 telemonitoring in the management of childhood asthma. METHODS:Chi...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1164/rccm.200807-1010OC
更新日期:2009-01-15 00:00:00
abstract::Daily symptom, peak expiratory flow rate (PEFR), and medication diaries are often used in clinical trials of treatments for asthma on the assumption that they provide a better estimate of clinical status than does a questionnaire completed in the clinic. We conducted a study with the aim of comparing the measurement p...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.162.4.9912138
更新日期:2000-10-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,多中心研究
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更新日期:2016-12-15 00:00:00
abstract::Fibrosing alveolitis in systemic sclerosis is histologically identical to lone cryptogenic fibrosing alveolitis (CFA) (idiopathic pulmonary fibrosis). The inflammatory cell content of bronchoalveolar lavage (BAL) samples has been used as a guide to prognosis and treatment in CFA. In this study, the relationship was ex...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.150.2.8049830
更新日期:1994-08-01 00:00:00
abstract:RATIONALE:Severe asthma is a major public health issue throughout the world. Increased bronchial smooth muscle (BSM) mass, a characteristic feature of airway remodeling in severe asthma, is associated with resistance to high-intensity treatment and poor prognosis. In vitro, the Ca(2+)-channel blocker gallopamil decreas...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1164/rccm.201410-1874OC
更新日期:2015-04-15 00:00:00
abstract:RATIONALE:Brief recurrent apneas in preterm infants and adults can precipitate rapid and severe arterial O(2) desaturation for reasons that remain unclear. OBJECTIVES:We tested a mathematically derived hypothesis that when breathing terminates apnea, mixed-venous hypoxemia continues into the subsequent apnea; as a res...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.201003-0477OC
更新日期:2010-10-01 00:00:00
abstract:RATIONALE:FVC has emerged as a standard primary endpoint in clinical trials evaluating novel therapies for patients with idiopathic pulmonary fibrosis (IPF). However, it has recently been proposed that all-cause mortality or a composite comprised of all-cause mortality and all-cause nonelective hospitalization be adopt...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.201311-1951OC
更新日期:2014-04-01 00:00:00
abstract::Vitamin D receptor (VDR) polymorphisms have been associated with several immune-related diseases, and VDR and vitamin D itself modulate T cell differentiation. VDR maps to chromosome 12q, near a region commonly linked to asthma. We evaluated VDR as part of a 12q positional candidate survey, and in response to observat...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.200404-447OC
更新日期:2004-11-15 00:00:00
abstract:RATIONALE:There are no accepted blood-based biomarkers in chronic obstructive pulmonary disease (COPD). Pulmonary and activation-regulated chemokine (PARC/CCL-18) is a lung-predominant inflammatory protein that is found in serum. OBJECTIVES:To determine whether PARC/CCL-18 levels are elevated and modifiable in COPD an...
journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1164/rccm.201008-1220OC
更新日期:2011-05-01 00:00:00
abstract::Ten patients with acute respiratory distress syndrome (ARDS) received in random order nitric oxide (NO) inhalation, aerosolized prostaglandin E1 (PGE1), infusion of PGE1, or no intervention. Inhalation of either aerosolized PGE1 (10 +/- 1 ng/kg/min) or NO (7 +/- 1 ppm) reduced pulmonary vascular resistance (PVR) from ...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.157.6.9609017
更新日期:1998-06-01 00:00:00
abstract::Qualitatively the mechanical, structural, and biochemical properties of airway smooth muscles resemble those of all other smooth muscle. However, one important distinguishing feature of airway smooth muscle is that the major portion of isotonic shortening is completed within the first 3 s in a muscle whose contraction...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1164/ajrccm.158.supplement_2.13tac300
更新日期:1998-11-01 00:00:00
abstract:RATIONALE:Invasive fungal disease (IFD) is a significant cause of morbidity and mortality in immunocompromised patients. OBJECTIVES:We hypothesize that galactomannan (GM), a component of fungal cell wall, as measured in bronchoalveolar lavage (BAL) might be a diagnostic adjunct in hematologic malignancies. METHODS:A ...
journal_title:American journal of respiratory and critical care medicine
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更新日期:2014-08-01 00:00:00
abstract::Although skeletal muscle abnormalities have been described in association with human immunodeficiency virus (HIV), the effects of HIV infection on respiratory muscle function have not been well characterized. We hypothesized that HIV+ individuals may develop respiratory muscle weakness and that respiratory muscle dysf...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.155.3.9116990
更新日期:1997-03-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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更新日期:2006-05-01 00:00:00
abstract:RATIONALE:The inadequacy of effector T-cell response in containment of tubercle bacilli is believed to result in the development of disseminated forms of tuberculosis (TB), such as miliary tuberculosis (MTB). Regulatory T cells (Treg) plausibly play a critical role in the immunopathogenesis of disseminated TB by suppre...
journal_title:American journal of respiratory and critical care medicine
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更新日期:2009-06-01 00:00:00
abstract::The long-acting beta 2-agonist salmeterol has been suggested to have other pharmacologic activities, that is, antiinflammatory capacities, in addition to its bronchodilator properties. We investigated the protective effect of 50 micrograms salmeterol in a placebo-controlled study on house dust mite-induced early- and ...
journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1164/ajrccm.150.5.7952550
更新日期:1994-11-01 00:00:00
abstract::Exaggerated airway narrowing in response to bronchoconstricting stimuli is a characteristic feature of asthmatic subjects. It is unknown whether the site of airway narrowing differs in asthmatic subjects from that observed in normal subjects. Increased airway wall thickness has been suggested as a contributing cause f...
journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章
doi:10.1164/ajrccm.154.5.8912780
更新日期:1996-11-01 00:00:00
abstract:RATIONALE:Tissue injury and repair involve highly conserved processes governed by mechanisms that can be co-opted in tumors. We hypothesized that soluble factors released during the repair response to lung injury would promote orthotopic tumor growth. OBJECTIVES:To determine whether lung injury promoted growth of orth...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
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更新日期:2010-10-15 00:00:00
abstract::Stimulation of the airways of asthmatic individuals causes severe bronchoconstriction, which is in part neurally mediated via the vagus nerve. Local anesthetics are commonly administered to prevent this reflex-induced bronchoconstriction. Therefore, in a double-blind, placebo-controlled prospective study, we tested th...
journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1164/ajrccm.154.4.8887580
更新日期:1996-10-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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更新日期:2002-03-15 00:00:00
abstract::Interpretation of incremental cardiopulmonary exercise tests (CPET) might be enhanced by considering the simultaneous rates of change of certain key variables, e.g., Delta oxygen uptake/Delta work rate (Delta VO(2)/Delta WR), Delta heart rate/Delta VO(2) (Delta HR/Delta VO(2)), Delta ventilation/Delta carbon dioxide p...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.164.8.2103007
更新日期:2001-10-15 00:00:00
abstract::Cilomilast (Ariflo), a new oral phosphodiesterase-4 selective inhibitor, improves lung function in chronic obstructive pulmonary disease (COPD). We have evaluated its antiinflammatory effects in 59 patients with COPD randomized to receive cilomilast, 15 mg two times a day, or placebo for 12 weeks. Induced sputum diffe...
journal_title:American journal of respiratory and critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1164/rccm.200212-1490OC
更新日期:2003-10-15 00:00:00
abstract::Bacterial lipopolysaccharide (LPS) is known to induce the expression of inducible nitric oxide synthase (iNOS) in the lung and to lead to increased pulmonary nitric oxide (NO) production. The contribution of various pulmonary cells to this phenomenon remains unclear. In this study, we used gadolinium chloride, a block...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.157.5.9705040
更新日期:1998-05-01 00:00:00
abstract:RATIONALE:Although the transplantation of induced pluripotent stem cell (iPSC)-derived cells harbors enormous potential for the treatment of pulmonary diseases, in vivo data demonstrating clear therapeutic benefits of human iPSC-derived cells in lung disease models are missing. OBJECTIVES:We have tested the therapeuti...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.201708-1562OC
更新日期:2018-08-01 00:00:00