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Purpose: To investigate delays in the diagnosis of deep vein thrombosis (DVT) and pulmonary embolism (PE). Subjects and methods: We prospectively identified 1,152 patients in whom DVT or PE had [...]

Objectives: (1) To compare the performance of three spirometric algorithms developed to predict whether the total lung capacity (TLC) is reduced vs normal or increased, (2) to determine if forced [...]

Background: Essential hypertension and symptoms of depression such as unexplained fatigue and tiredness are frequently encountered in primary, medical care clinics. Although, exhaustive evaluation rarely detects unsuspected underlying disorders, obstructive [...]

Study objectives: The guidelines of the National Lung Health Education Program for COPD screening proposed a shorter FVC maneuver (forced expiratory volume at 6 s of exhalation [FE[V.sub.6]). Although reference [...]

Research presented concerns the prevalence of dyspnea or airflow limitation in otherwise healthy older people. Findings suggest that airflow limitation or shortness of breath is often present and underrecognized in the aged population.

Objective: To quantify the effect of altitude on the operational characteristics of hand-held peak flowmeters. Design: Altitude simulation within a hypobaric chamber combined with five constant simulated peak flows delivered [...]

Objectives: To quantify intraindividual variability in peak expiratory flow (PEF) measured with peak flowmeters and to define factors affecting PEF variability. Methods: Three hundred one healthy subjects (aged 4 to [...]

Peak flow meters provide physicians and patients with objective measures about changes in pulmonary obstruction. We evaluated eight models of peak flowmeters and measured their accuracy and reproducibility with methods recently recommended by the National Asthma Education Program (NAEP). Waveforms from the American Thoracic Society's spirometer testing set were used to drive a computer-controlled syringe. Testing was done at Salt Lake City at an altitude 1,400 m. It appears that the original Wright peak flowmeter has been used as the 'de facto' standard. We found that the original Wright peak flowmeter overestimated flows in its midrange; and, as a consequence, most of the other peak flowmeters also overestimated peak flows. The overestimation of peak flows may have been understated because of the 1,400-m altitude testing site. To the credit of the instrument manufacturers, we were pleasantly surprised with the quality, accuracy, and reproducibility of presently available peak flowmeters; however, as a result of our testing, we suspect that with little effort, manufacturers of peak flowmeters could improve the accuracy of their devices. Standardized testing methods and equipment should make the task of peak flowmeter design, manufacture, and testing even easier. We trust that manufacturers of peak flowmeters will respond appropriately and improve their instruments., Recently, the National Asthma Education Program (NAEP) sponsored by the National Heart, Lung, and Blood Institute released a report entitled 'Diagnosis and Management of Asthma.' In this document the importance [...]

Since ethnic differences in pulmonary function are known to occur, failure to account for them when they exist could lead to errors in diagnosis and in classification of impairment. [1,2] [...]

Study objectives: Nasal continuous positive airway pressure (CPAP) is standard therapy for obstructive sleep apnea syndrome. The effective nasal mask pressure may be adversely affected by factors that increase system [...]

To test the hypothesis that there is genetic control of pulmonary function parameters independent of that influencing height, we evaluated 74 pairs of asymptomatic, nonsmoking twins. FVC, [FEV.sub.1], FEF25-75%, TLCsb, [...]

Background and Objectives: An experimental model consisting of gonococcal infection of human fallopian tube mucosa in organ culture has proven useful in studying the molecular pathogenesis of acute gonococcal salpingitis and postsalpingitis sequelae. Gonococcal infection of human fallopian tube mucosa in organ culture results in the sloughing of ciliated epithelial cells from the mucosa. This damage to the mucosa can be quantified on fallopian tube pieces by an assay of the percent of the periphery that has ciliary activity (PPCA) remaining at specific time points after infection. Although assay of the PPCA has been quite valuable, it is labor-intensive, somewhat subjective, and requires that the observers have training and experience. A more practical assay for genital mucosal damage is desirable for further investigations that employ the fallopian tube experimental model. Gonococcal infection of fallopian tube mucosa in organ culture also results in the production of easily quantified tumor necrosis factor-alpha (TNF-[Alpha]) by the mucosa. Furthermore, treatment of the organ cultures with recombinant human TNF-[Alpha] (rHuTNF[Alpha]) alone also causes sloughing of ciliated cells from the mucosa. These findings strongly suggest that TNF-[Alpha] is a mediator of the mucosal damage that attends gonococcal infection. Goals of the Study: To determine: (1) whether the PPCA values and the TNF-[Alpha] concentrations in fallopian tube mucosal tissues correlate closely enough to allow prediction of the PPCA from a measurement of the mucosal tissue TNF-[Alpha] concentration; and (2) whether the correlation of the TNF-[Alpha] mucosal tissue concentration with the sloughing of ciliated cells (measured by the PPCA) supports the hypothesis that induction of TNF-[Alpha] by gonococcal infection, with resultant sloughing of ciliated cells, is likely to be a major pathogenic mechanism of gonococcal salpingitis and might mediate postsalpingitis infertility and ectopic pregnancy. Study Design: A metaanalysis was performed on studies from three research groups (two laboratories in the United States and one in the United Kingdom, using identical techniques for quantifying the PPCA, TNF-[Alpha], or both. Results: There was a close and statistically significant correlation between the TNF-[Alpha] mucosal tissue concentration and the proportion of ciliated cells lost from the mucosa as measured by the PPCA (r = 0.95, p [is less than] 0.001). Therefore, as the mucosal tissue concentration of endogenous TNF-[Alpha] increased, the loss of ciliated cells from the epithelium increased proportionately. Conclusions: During gonococcal infection of human fallopian tube mucosa in organ culture, the mucosal tissue concentration of TNF-[Alpha] can be used to predict the PPCA, and therefore, the extent of mucosal damage. This finding should facilitate studies of the molecular pathogenesis of infectious diseases involving human genital mucosa. Further, the close correlation of mucosal TNF-[Alpha] concentration with genital mucosal damage, evaluated by the PPCA, supports the hypothesis that induction of the proinflammatory cytokine, TNF-[Alpha], by gonococcal infection, with resultant inflammation and sloughing of ciliated cells, is an important pathogenic mechanism of gonococcal salpingitis and may mediate postsalpingitis infertility and ectopic pregnancy as well., Gonococcal infection of the fallopian tubes may be characterized by an increase in the concentration of tumor necrosis factor in the mucous membranes, causing sloughing of cells from the fallopian tubes. Researchers studied fallopian tube cells in tissue culture to determine the physiological changes associated with the infection. Tumor necrosis factor, an inflammatory substance, increases in concentration and in relation to mucous membrane damage. The influence of tumor necrosis factor on the fallopian tubes may be the cause of inflammation and infertility following gonococcal infection.