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Introduction: International recommendations state that reference values for lung function should derive from cross-sectional studies of healthy nonsmokers and be renewed from time to time because of cohort effect and newer, more accurate, technical equipment. In 1986, the Danish Lung Society published reference values for spirometry based on 570 individuals aged 30-70 years. Objectives: To produce new reference values for lung function and to extend the existing values by including individuals between 20 and 30 years of age and older than 70 years of age. Methods: Two similar but independent studies was used: The 2001-2003 examination of the Copenhagen City Heart Study and the 2003-2010 examination of the Copenhagen General Population Study. Of a total of 69 822 individuals, we included 11 288 healthy never-smoking white individuals to produce the reference values: 6307 women and 4981 men, 20 years of age or older with adequate lung function. Results: We used sex-stratified multiple linear regression analysis to find prediction formulas for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC adjusted for age and height. The cutoff value of normal lung function was defined as the fifth percentile (also named the 5% quantile) according to gender, age and height. The robustness of the data was tested and validated in several ways. Conclusion: Compared with the 1986 data, our 2001-2010 material contributes with a substantial number of individuals in the more extreme groups of age and height, and in general, our dataset shows that in most subgroups, the lung function level has improved during the last two decades. Please cite this paper as: Løkke A, Marott JL, Mortensen J, Nordestgaard BG, Dahl M and Lange P. New Danish reference values for spirometry. Clin Respir J 2013; 7: 153-167. [ABSTRACT FROM AUTHOR]

Background: Tumour necrosis factor-alpha (TNF-α) plays a crucial role in sarcoidosis. In severe disease, treatment with TNF-α inhibitors may be effective. Objectives: Changes in sarcoid disease activity were assessed by fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) in patients with recalcitrant sarcoidosis treated with adalimumab. Methods: Prospective 24-week observational study. Patients continued medication with steroids and antimetabolites and received adalimumab 40 mg subcutaneously every other week. Ten patients with biopsy-proven sarcoidosis (two men) were included with a median age of 47 years (range 35-73). An FDG-PET showing uptake indicating sarcoid activity was required at inclusion and repeated at the end of the study. FDG-PET uptake was assessed by calculated standardised uptake value (SUV). Blood samples and lung function tests were performed regularly. Quality of life was assessed by the short-form health survey (SF-36) questionnaire. Results: Following treatment with adalimumab, FDG-PET uptake decreased in nine patients ( P = 0.011) and increased in one patient. Maximum SUV fell from median 14.1 to 7.0 ( P < 0.03), and mean SUV fell from median 6.5 to 2.9 ( P < 0.02). Six patients had uptake in the lungs, which decreased after treatment ( P = 0.035). Six patients had uptake in the lymph nodes, which decreased after treatment in five patients ( P = 0.035). Four patients had non-lymphatic extrathoracic uptake, which decreased after treatment ( P = 0.05). There was no effect of adalimumab on pulmonary function tests, serum angiotensin I converting enzyme and blood lymphocyte (CD3+, CD4+, CD8+) concentrations. Physical component summary score (SF-36) increased during treatment, mental component summary score was unchanged. Conclusion: In sarcoidosis, treatment with adalimumab can reduce disease activity, as assessed by FDG-PET. Please cite this paper as: Milman N, Graudal N, Loft A, Mortensen J, Larsen J and Baslund B. Effect of the TNF-α inhibitor adalimumab in patients with recalcitrant sarcoidosis: a prospective observational study using FDG-PET. Clin Respir J 2012; DOI:10.1111/j.1752-699X.2011.00276.x. [ABSTRACT FROM AUTHOR]

Bronchial carcinoid tumours seldom occur in children, and represent a rare cause of pulmonary obstruction. Because of low clinical suspicion and the variable ways of presentation, diagnosis may be delayed. We report on a patient with this tumour. It is hoped that increased awareness of the tumour can lead to earlier diagnosis. Report of a case. This case describes a 14-year-old previously healthy girl, presenting with asthma-like symptoms throughout 2 years, decreased lung function and emphysema in left lower lobe on chest x-ray. Computerized tomography (CT) showed an intraluminal process in the left main bronchus and emphysema in both the upper and lower left lobe and showed no signs of metastasis or spread to lung tissue. Bronchoscopy showed an inflammatory polyp. Surgical resection demonstrated a typical carcinoid tumour. Later control biopsy revealed no persisting malignant tissue. The asthma symptoms returned and a new bronchoscopy showed scarring and narrowing of the left bronchus. Treatment comprised of dilatation by bronchoscopy plus daily combination corticosteroids and beta-2-agonist inhalation and the symptoms improved. No signs of relapse 16 months postdiagnosis. The case clearly shows the delay, which is common in the diagnosis of children with bronchial carcinoid tumours. Symptoms of the obstructive nature of the tumour are variable and might present as emphysema seen on x-ray and CT. Carcinoid tumour should be considered in children with longstanding pulmonary symptoms with no response to conventional treatment. Prognosis is good but long-term follow up is needed. Please cite this paper as: Andersen JB, Mortensen J, Damgaard K, Skov M, Sparup J, Petersen BL, Rechnitzer C and Borgwardt L. Fourteen-year-old girl with endobronchial carcinoid tumour presenting with asthma and lobar emphysema. The Clinical Respiratory Journal 2010; 4: 120-124. [ABSTRACT FROM AUTHOR]

The article presents two case studies of two males aged 55 and 57 with acute pulmonary embolism. The two patients have been examined with the use of combined lung ventilation perfusion (V/Q) SPECT/MSCT angiography. Results from the examination found no hints of pulmonary embolism and illustrate the potential for the fused 3-D imaging's additional value.

The article presents a case study of a 33-year-old woman presented herself with sarcoidosis. The magnetic resonance scanning confirmed the involvement of the pituitary stalk, which is a condition normally resistant to ordinary treatment with prednisolone. The article discusses the treatment in sarcoidosis with the use of 18F-fluoro-deoxyglucose positron emission tomography (PET).