Chronic Effect of Smoking upon Pulmonary Distribution of Ventilation in Healthy Males

Stănescu, Dan; Teculescu, D; Păcuraru, R; Gavrilescu, N.

doi:10.1159/000192583

Cited by 8 publications

(7 citation statements)

References 9 publications

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“…Physiologically, a decrease in small airway calibre ("small airway disease") corresponds with a functional syndrome of discrete perturbations of airway mechanisms in the presence of normal values of "classical" tests of airway obstruction (e.g., FEV1, PEP, Raw). FEF75 is often decreased in smokers [31] and a decrease in FEF75 is one of the earliest indices of the commencement of obstructive airways disease. In our patients, we were able to show that smoking status was not responsible for the observed decrease in FEF75 after TS.…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic sympathicolysis for essential hyperhidrosis: effects on pulmonary function

Noppen¹,

Vincken²

1996

Eur Respir J

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Bilateral interruption of the upper dorsal sympathetic chain at the D2 and D3 level represents the only permanent cure for essential hyperhidrosis. Following surgical sympathectomy, significant and symptomatic changes in pulmonary function have been observed. Since functional effects of the surgical intervention cannot be excluded, we wondered whether such alterations also occurred after thoracoscopic sympathicolysis; these should then be attributable to the surgical denervation itself.Pulmonary function tests (PFTs), including spirometry and body plethysmographic measurement of lung volumes and airway resistance and conductance, were compared before and 6 weeks after thoracoscopic sympathicolysis in 47 patients. In order to virtually exclude any effects of thoracoscopy on the test results, PFTs were repeated 6 months after thoracoscopic sympathicolysis in 35 patients.Essential hyperhidrosis was completely relieved in all patients, thereby confirming the interruption of the D2-D3 sympathetic chain. None of the patients developed respiratory symptoms after thoracoscopic sympathicolysis. Forced expiratory volume in one second (FEV1) (-3%), forced expiratory flow after exhaling 75% of vital capacity (FEF75) (-8%) and total lung capacity (TLC) (-3%) were slightly but significantly reduced at six weeks after thoracoscopic sympathicolysis; whereas airway resistance (Raw) had increased (+12%). After correction for the small decrease in lung volume (FEV1/forced vital capacity (FVC), specific airway resistance (sRaw), specific airway conductance (sGaw))significant changes in "volume-dependent" PFT parameters were no longer observed. Smoking status had no influence on the reduction in FEF75. At 6 months after thoracoscopic sympathicolysis, TLC had returned to preoperative values, whereas FEF75 remained decreased (-8.6%). The decrease in airway calibre was confirmed by small but significant changes in FEV1/FVC (-2%) and Raw (+29%).We conclude that thoracoscopic sympathicolysis in patients with essential hyperhidrosis causes only minimal and subclinical changes in pulmonary function secondary to a temporary small decrease in lung volume, which in turn is probably inherent to the thoracoscopic procedure. D2-D3 sympathicolysis, in itself, is responsible only for a small and permanent decrease in forced expiratory flow, which suggests that, at least in essential hyperhidrosis patients, airway bronchomotor tone is influenced by sympathetic innervation. Eur Respir J., 1996Respir J., , 9, 1660Respir J., -1664 Essential hyperhidrosis (EH) is a disorder characterized by excessive sweating of the palms of the hands and often the armpits and soles of the feet [1]. It is caused by a poorly understood overactivity of the sympathetic nervous system at the level of the D2 and D3 dorsal sympathetic ganglia [2]. Anatomical interruption of the sympathetic innervation at this level, preferably by minimally invasive techniques, such as percutaneous ablation or thoracoscopy, provides a permanent cure in patients with severe EH refr...

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Section: Discussionmentioning

confidence: 99%

Thoracoscopic sympathicolysis for essential hyperhidrosis: effects on pulmonary function

Noppen¹,

Vincken²

1996

Eur Respir J

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“…This may be explained by the reduced number of patients in each group and the intragroup inhomogeneity. In a previous paper we found that healthy long term smokers had a significantly higher zfNo than non-smokers of similar age [28], Despite the lack of statistical significance between smokers and non-smokers, it seems reasonable to assume that smoking exerts an adverse effect on the lung function in silicosis.…”

Section: Discussionmentioning

confidence: 83%

“…Five consecutive tests were carried out in each patient and the result is expressed as their arithmetical mean. Details of the method were published elsewhere [28,29].…”

mentioning

confidence: 99%

Increased N<sub>2</sub> Alveolar Slope in Silicosis

Stanescu¹,

Téculescu²,

Păcuraru³

1970

Respiration

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1. In 96 miners in various stages of silicosis, smokers and non-smokers, without clinical signs of chronic bronchitis or obstructive ventilatory impairment, the distribution of ventilation was assessed using the single breath O₂ test.The N₂ gradient was greater in smokers as compared with non-smokers in each radiological group although these differences were statistically non-significant. There was a steady increase of the N₂ gradient from the radiological group L to the group BC. The N₂ gradient was significantly higher in all groups as compared with group L. The unevenness of ventilation in silicosis, in the absence of an obstructive syndrome, was attributed to regional differences in distensibility. The implications of these results are discussed.

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“…The factors associated with SBN 2 test failure in the present study were older age and the presence of a BHR. The measurement of phase III slope and of closing volume became of interest for epidemiologists when it was reported that abnormal results were present in asymptomatic smokers with normal spirometry [5,37]. The first studies were performed in the hospital or smoking cessation laboratories, and these results are not strongly related to those obtained in field surveys [10].…”

Section: Discussionmentioning

confidence: 99%

“…smokers with normal 1-s forced expiratory volume (FEV 1 ) [5,28,37]. Becklake and Permutt classified the SBN 2 test among the "sensitive tests" for screening [1] but expressed the caveat that acceptability might be reduced "because the manoeuvres [for the SBN 2 test] are somewhat complicated."…”

Section: Introductionmentioning

confidence: 99%

Age and Bronchial Hyperresponsiveness Are Associated with Failure to Perform the Single Breath N2 Test in a Rural Female Population

Téculescu

Bohadana

Megherbi

et al. 1999

Lung

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Because some authors have reported high rates of failure in performing the single breath N2 (SBN2) test in rural areas, the present study aimed at evaluating its acceptability in a female population, unfamiliar with lung function testing, in a rural area of northeastern France. Two hundred ninety-eight women from a rural area volunteered for a preventive medicine examination (91.6% of those invited); four of them were excluded for clinical reasons, and six (2%) were unable to perform spirometry. The protocol included completion of a questionnaire, spirometry with a bronchial reactivity test, skin prick test, and the SBN2 test utilizing a computerized assembly. Although failures caused by the apparatus were few (n = 7, 2.4%) 96 of 281 women (34.1%) were unable to produce two valid SBN2 tests in a series of six attempts. Compared with the group who succeeded in the test (n = 185), women who failed were older and had a higher prevalence of bronchial hyperresponsiveness. Logistic regression confirmed the independent association of these two variables with an inability to perform. We conclude that in a female population completely unfamiliar with lung function testing the SBN2 test has a high rate of failure associated with higher age and the presence of bronchial hyperresponsiveness.

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Chronic Effect of Smoking upon Pulmonary Distribution of Ventilation in Healthy Males

Cited by 8 publications

References 9 publications

Thoracoscopic sympathicolysis for essential hyperhidrosis: effects on pulmonary function

Thoracoscopic sympathicolysis for essential hyperhidrosis: effects on pulmonary function

Increased N<sub>2</sub> Alveolar Slope in Silicosis

Age and Bronchial Hyperresponsiveness Are Associated with Failure to Perform the Single Breath N2 Test in a Rural Female Population

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