Sex differences in growth patterns of the airways and lung parenchyma in children

1984 ◽  
Vol 56 (5) ◽  
pp. 1204-1210 ◽  
Author(s):  
R. D. Pagtakhan ◽  
J. C. Bjelland ◽  
L. I. Landau ◽  
G. Loughlin ◽  
W. Kaltenborn ◽  
...  

Seventeen boys and 19 girls, 8–15 yr in age, were studied to ascertain, in the two sex groups, the predictors of airway size [assessed by measurement of tracheal cross-sectional area (CSA) and maximal expiratory flows (Vmax)] and the relative rates of growth of the major divisions of the airways and lung parenchyma. In boys, total lung capacity (TLC) accounted for 77% of the variance of CSA and for 66% of the variability of Vmax. In contrast, somatic growth and maturation in girls accounted for only 45% of the variance of CSA and for 64% of the variability of Vmax; TLC was relatively unimportant. In boys, but not in girls, TLC-corrected CSA was significantly and inversely related to height and to TLC. In girls, TLC-corrected Vmax at 50 and 75% of forced vital capacity were directly related to height. These observations suggest different patterns of airway-parenchymal-somatic growth relationships in the two sexes. Furthermore, parenchymal growth appears to be the best determinant of airway growth in boys. In girls, other factors, perhaps genetic in nature, besides growth of parenchyma, may help determine airway size.

1988 ◽  
Vol 64 (3) ◽  
pp. 1050-1054 ◽  
Author(s):  
L. J. Brooks ◽  
P. J. Byard ◽  
R. C. Helms ◽  
J. M. Fouke ◽  
K. P. Strohl

To determine whether airway size correlates with measures of lung or body size, we used the acoustic reflection technique to calculate tracheal cross-sectional area in 103 healthy young adults. Men have significantly larger tracheas than women [2.48 ± 0.08 vs. 1.91 ± 0.05 (SE) cm2, P less than 0.001]. Within each sex, there is no correlation between tracheal size and body size or maximal expiratory flows. There is a significant positive correlation between tracheal area and vital capacity in males only (r = 0.36, P less than 0.01). These results support the concept of dysanapsis, relatively independent growth of the airways and lung parenchyma, as well as sex-related differences in airway size and growth. Inherent airway size may be a factor in the development and/or progression of lung disease.


1987 ◽  
Vol 62 (3) ◽  
pp. 1179-1185 ◽  
Author(s):  
R. B. Filuk ◽  
N. R. Anthonisen

Twelve stable adult asthmatics slowly inhaled boluses of He at 20, 40, or 60% vital capacity (VC); these volumes were achieved either by expiring from total lung capacity (TLC) or by inspiring from residual volume (RV). Inspirations were continued to TLC and then were followed by slow expirations to RV while expired He was measured as a function of expired volume. At 20% VC slopes of alveolar plateaus (phase III) were positive, at 40% VC they were flat, and at 60% VC they were negative; at 20 and 60% VC the slopes were steeper than those in normals. When boluses were administered at 40 and 60% VC, He washout curves were independent of lung volume history. However at 20% VC the slope of phase III was significantly less positive when boluses were given after inspiration from RV than after expiration from TLC. In eight subjects, who were given inhaled beta-agonists, slopes of all He washouts decreased and became independent of volume history at 20% VC. We conclude that in asthmatics at low lung volumes the airways that determine ventilation distribution behave as though they have less hysteresis than the lung parenchyma probably due to increased airway tone.


1991 ◽  
Vol 70 (4) ◽  
pp. 1781-1786 ◽  
Author(s):  
Y. Kawakami ◽  
M. Nishimura ◽  
H. Kusaka

Tracheal dimensions at total lung capacity (TLC) and residual volume (RV) were analyzed roentgenographically in 17 pairs of male adolescent twins (mean age 16.3 yr; 12 monozygotic pairs and 5 dizygotic pairs). Genetic factors dominated environmental traits in intra- as well as extrathoracic tracheal width at RV. Extrathoracic tracheal width at TLC was also governed by genetic components. Intrathoracic tracheal depth (anteroposterior diameter), length, and cross-sectional area did not seem to be genetically controlled at TLC and RV. Intrathoracic tracheal cross-sectional area increased by 14.4% and became more elliptical from RV to TLC, owing mainly to an increase in tracheal depth (16.7%). Increments from RV to TLC in tracheal depth but not width correlated with increases in lung width, depth, and height. Intrathoracic trachea was elongated 14% in association with increase in lung height from RV to TLC. At TLC, extrathoracic tracheal width was larger than intrathoracic tracheal width, but this dimension did not differ at RV. These results indicate that genetic factors influence, at least at RV, the tracheal rings more strongly than membranous parts. Intrathoracic tracheal depth but not width increases during inspiration in accordance with increase in lung volume. Extrathoracic tracheal width widens more than intrathoracic trachea from RV to TLC.


2001 ◽  
Vol 91 (5) ◽  
pp. 1913-1923 ◽  
Author(s):  
Bhajan Singh ◽  
Peter R. Eastwood ◽  
Kevin E. Finucane

To examine the effect of hyperinflation on the volume displaced by diaphragm motion (ΔVdi), we compared nine subjects with emphysema and severe hyperinflation [residual volume (RV)/total lung capacity (TLC) 0.65 ± 0.08; mean ± SD] with 10 healthy controls. Posteroanterior and lateral chest X rays at RV, functional residual capacity, one-half inspiratory capacity, and TLC were used to measure the length of diaphragm apposed to ribcage (Lap), cross-sectional area of the pulmonary ribcage, ΔVdi, and volume beneath the lung-apposed dome of the diaphragm. Emphysema subjects, relative to controls, had increased Lap at comparable lung volumes (4.3 vs. 1.0 cm near predicted TLC, 95% confidence interval 3.4–5.2 vs. 0–2.1), pulmonary rib cage cross-sectional area (emphysema/controls 1.22 ± 0.03, P < 0.001 at functional residual capacity), and ΔVdi/ΔLap (0.25 vs. 0.14 liters/cm, P < 0.05). During a vital capacity inspiration, relative to controls, ΔVdi was normal in five (1.94 ± 0.51 liters) and decreased in four (0.51 ± 0.40 liters) emphysema subjects, and volume beneath the dome did not increase in emphysema (0 ± 0.36 vs. 0.82 ± 0.80 liters, P < 0.05). We conclude that ΔVdi can be normal in emphysema because 1) hyperinflation is shared between ribcage and diaphragm, preserving Lap, and 2) the diaphragm remains flat during inspiration.


1987 ◽  
Vol 63 (4) ◽  
pp. 1493-1498 ◽  
Author(s):  
M. Decramer ◽  
T. X. Jiang ◽  
M. Demedts

We studied chest wall mechanics at functional residual capacity (FRC) and near total lung capacity (TLC) in 14 supine anesthetized and vagotomized dogs. During breathing near TLC compared with FRC, tidal volume decreased (674 +/- 542 vs. 68 +/- 83 ml; P less than 0.025). Both inspiratory changes in gastric pressure (4.5 +/- 2.5 vs. -0.2 +/- 2.0 cmH2O; P less than 0.005) and changes in abdominal cross-sectional area (25 +/- 17 vs. -1.0 +/- 4.2%; P less than 0.001) markedly decreased; they were both often negative during inspiration near TLC. Parasternal intercostal shortening decreased (-3.0 +/- 3.7 vs. -2.0 +/- 2.7%), whereas diaphragmatic shortening decreased slightly more in both costal and crural parts (costal -8.4 +/- 2.9 vs. -4.3 +/- 4.1%, crural -22.8 +/- 13.2 vs. -10.0 +/- 7.5%; P less than 0.05). As a result, the ratio of parasternal to diaphragm shortening increased near TLC (0.176 +/- 0.135 vs. 0.396 +/- 0.340; P less than 0.05). Electromyographic (EMG) activity in the parasternals slightly decreased near TLC, whereas the EMG activity in the costal and crural parts of the diaphragm slightly increased. We conclude that 1) the mechanical outcome of diaphragmatic contraction near TLC is markedly reduced, and 2) the mechanical outcome of parasternal intercostal contraction near TLC is clearly less affected.


1992 ◽  
Vol 73 (6) ◽  
pp. 2328-2332 ◽  
Author(s):  
G. Julia-Serda ◽  
N. A. Molfino ◽  
K. R. Chapman ◽  
P. A. McClean ◽  
N. Zamel ◽  
...  

We examined the effect of volume history on the dynamic relationship between airways and lung parenchyma (relative hysteresis) in 20 asthmatic subjects. The acoustic reflection technique was employed to evaluate changes in airway cross-sectional areas during a slow continuous expiration from total lung capacity to residual volume and inspiration back to total lung capacity. Lung volume was measured continuously during this quasi-static maneuver. We studied three anatomic airway segments: extra- and intrathoracic tracheal and main bronchial segments. Plots of airway area vs. lung volume were obtained for each segment to assess the relative magnitude and direction of the airway and parenchymal hysteresis. We also performed maximal expiratory flow-volume and partial expiratory flow-volume curves and calculated the ratio of maximal to partial flow rates (M/P) at 30% of the vital capacity. We found that 10 subjects (group I) showed a significant predominance of airway over parenchymal hysteresis (P < 0.005) at the extra- and intrathoracic tracheal and main bronchial segments; these subjects had high M/P ratios [1.53 +/- 0.27 (SD)]. The other 10 subjects (group II) showed similar airway and parenchymal hysteresis for all three segments and significantly lower M/P ratios (1.16 +/- 0.20, P < 0.01). We conclude that the effect of volume history on the relative hysteresis of airway and lung parenchyma and M/P ratio at 30% of vital capacity in nonprovoked asthmatic subjects is variable. We suggest that our findings may result from heterogeneous airway tone in asthmatic subjects.


1989 ◽  
Vol 67 (2) ◽  
pp. 694-698 ◽  
Author(s):  
J. A. Verschakelen ◽  
K. Deschepper ◽  
T. X. Jiang ◽  
M. Demedts

In eight healthy volunteers we simultaneously measured the axial diaphragmatic motion by fluoroscopy and the cross-sectional area changes of the rib cage (RC) and abdomen (ABD) by Respitrace (RIP) during semistatic vital capacities (VC). We found that, if the fluoroscopic axial displacement of the posterior part of the diaphragm between residual volume (RV) and total lung capacity (TLC) is considered equal to 100%, the movement of the middle part is 90%, whereas that of the anterior part is only approximately 60%; the ratio of the axial displacements to mouth volume, furthermore, decreases at high lung volumes, especially for the anterior part. The RIP signal is nearly linearly related to mouth volume, but the contribution of the RC (delta RC) progressively increases (and is approximately 80% RIP at TLC), whereas the volume contribution of the ABD (delta ABD) levels off (to 20% RIP at TLC). The diaphragmatic volume displacement calculated from the theoretical analysis described by Mead and Loring also levels off at high volumes similarly as the ABD but is approximately 50% RIP at TLC. Finally, the axial movements of the three parts of the diaphragm are linearly related to the RC and ABD cross-sectional-area changes (r 0.91–0.97) and are even significantly better correlated with the “calculated” diaphragmatic volume displacement.


2012 ◽  
Vol 112 (1) ◽  
pp. 237-245 ◽  
Author(s):  
C. Wongviriyawong ◽  
R. S. Harris ◽  
H. Zheng ◽  
M. Kone ◽  
T. Winkler ◽  
...  

Heterogeneity in narrowing among individual airways is an important contributor to airway hyperresponsiveness. This paper investigates the contribution of longitudinal heterogeneity (the variability along the airway in cross-sectional area and shape) to airway resistance ( Raw). We analyzed chest high-resolution computed tomography scans of 8 asthmatic (AS) and 9 nonasthmatic (NA) subjects before and after methacholine (MCh) challenge, and after lung expansion to total lung capacity. In each subject, Raw was calculated for 35 defined central airways with >2 mm diameter. Ignoring the area variability and noncircular shape results in an underestimation of Raw (%Utotal) that was substantial in some airways (∼50%) but generally small (median <6%). The average contribution of the underestimation of Raw caused by longitudinal heterogeneity in the area (%Uarea) to %Utotal was 36%, while the rest was due to the noncircularity of the shape (%Ushape). After MCh challenge, %Uarea increased in AS and NA ( P < 0.05). A lung volume increase to TLC reduced %Utotal and %Uarea in both AS and NA ( P < 0.0001, except for %Utotal in AS with P < 0.01). Only in NA, %Ushape had a significant reduction after increasing lung volume to TLC ( P < 0.005). %Uarea was highly correlated, but not identical to the mean-normalized longitudinal heterogeneity in the cross-sectional area [CV2( A)] and %Ushape to the average eccentricity of the elliptical shape. This study demonstrates that Raw calculated assuming a cylindrical shape and derived from an average area along its length may, in some airways, substantially underestimate Raw. The observed changes in underestimations of Raw with the increase in lung volume to total lung capacity may be consistent with, and contribute in part to, the differences in effects of deep inhalations in airway function between AS and NA subjects.


PEDIATRICS ◽  
1959 ◽  
Vol 24 (2) ◽  
pp. 181-193
Author(s):  
C. D. Cook ◽  
P. J. Helliesen ◽  
L. Kulczycki ◽  
H. Barrie ◽  
L. Friedlander ◽  
...  

Tidal volume, respiratory rate and lung volumes have been measured in 64 patients with cystic fibrosis of the pancreas while lung compliance and resistance were measured in 42 of these. Serial studies of lung volumes were done in 43. Tidal volume was reduced and the respiratory rate increased only in the most severely ill patients. Excluding the three patients with lobectomies, residual volume and functional residual capacity were found to be significantly increased in 46 and 21%, respectively. These changes correlated well with the roentgenographic evaluation of emphysema. Vital capacity was significantly reduced in 34% while total lung capacity was, on the average, relatively unchanged. Seventy per cent of the 61 patients had a signficantly elevated RV/TLC ratio. Lung compliance was significantly reduced in only the most severely ill patients but resistance was significantly increased in 35% of the patients studied. The serial studies of lung volumes showed no consistent trends among the groups of patients in the period between studies. However, 10% of the surviving patients showed evidence of significant improvement while 15% deteriorated. [See Fig. 8. in Source Pdf.] Although there were individual discrepancies, there was a definite correlation between the clinical evaluation and tests of respiratory function, especially the changes in residual volume, the vital capacity, RV/ TLC ratio and the lung compliance and resistance.


1977 ◽  
Vol 42 (4) ◽  
pp. 508-513 ◽  
Author(s):  
N. E. Brown ◽  
E. R. McFadden ◽  
R. H. Ingram

Bronchia reactivity to inhaled histamine was assessed in asymptomatic cigarette smokers and in nonsmoking atopic and nonatopic subjects. The only prechallenge between-group difference was the ratio of maximal flow on 80% helium-20% oxygen (Vmax HeO2) to maximal flow on air (Vmax air) from partial expiratory flow volume curves at 25% vital capacity (25% VC PEFV): Mean +/- SEM for smokers 1.18 /+- 0.06, atopics 1.45 +/- 0.08, nonatopics 1.51 +/- 0.03. This suggests that prior to inhalation to total lung capacity, the predominant site of resistance at flow limitation was in smaller airways of the smokers and in larger airways of both groups of nonsmokers. Following inhalation of histamine, smokers and nonatopics had similar changes in lung volumes and Vmax air which were less than in atopics. The Vmax HeO2/Vmax air ratios at 25% VC PEFV increased in smokers and decreased in nonsmokers: smokers 1.48 +/- 0.08, atopics 1.22 +/- 0.10, nontopics 1.16 +/- 0.06. This suggests a predominant large airway response in smokers and a prominent small airway response in nonsmokers. These responses may reflect differences in the predominant site of aerosol deposition rather than in airway reactivity.


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