Daniel E. Jenkins

Ventilatory functions of normal children and young adults—Mexican-American, white, and black. I. Spirometry

This is a study of the ventilatory functions of 1,805 normal Mexican-American, white, and black students of six public schools in Houston, Texas, with ages ranging from 7 to 20. A roll-seal piston type spirometer was used. The best performed forced vital capacity curve of each student was selected by the computer program from which the following measurements were extracted: FVC, FEV1, FEV1/FVC ratio, PEFR, and MMEF. Each student also had the peak expiratory flow rate measured by the Wright peak flowmeter to establish normal values with this instrument. Significant differences of lung volume and flow rate exist among the three races, and between male and female subjects. Prediction equations and prediction curves for each race and sex are presented. The results of the present study are compared with those of previously published works.

Regional Ventilation and Perfusion after Lung Transplantation in Patients with Emphysema

Abstract Serial 133Xe ventilation and perfusion scans were done on two patients who underwent left-lung transplantation because of severe emphysema associated with alpha1 antitrypsin deficiency. In...

Ventilatory functions of normal children and young adults: Mexican-American, white, and black. III. Sitting height as a predictor

We studied the ventilatory functions of 1800 normal children ranging in age 7 to 20 years. Boys and girls of black, white, and Mexican-American ethnic groups were represented adequately. The FVC and FEV1 of normal black children were fully 1 SD lower than those of white children with the same standing height. Such racial differences could not be corrected by a scaling factor, because the differences vary with sex and also with height as the children grow. Using sitting height as a predictor greatly reduced the racial differences of ventilatory functions and permitted the application of one set of prediction equations for children of all three groups.

Alveolar Epithelial Cells Following Exposure to Nitric Acid

This study has demonstrated the fine structure of the type 1 and 2 alveolar epithelial cells at different time periods after intrabronchial instillation of dilute (1%) nitric acid. The damaged type 2 cells were partially or largely covered by cytoplasmic extensions of adjacent type 1 cells. This covering is considered to be a mechanism by which the alveolar epithelium maintains an intact surface. Alveolar epithelial cells having the morphologic characteristics suggesting transition from type 1 membranous pneumonocytes to type 2 granular pneumonocytes were seen. These intermediate type alveolar epithelial cells have large nuclei and microvilli but lacked lamellar bodies. This demonstrates a possible source of origin for the physiologically important type 2 cells. Occasional phagocytosis of carbon particles by type 2 cells was observed.

Human lung allotransplantation. Report of two cases.

Abstract Although canine lung allografts have survived with function for periods up to five years, to date human lung allotransplantation has been unsuccessful with the exception of one patient now surviving more than six months after operation. This report reviews two cases of left lung transplantation for terminal pulmonary emphysema associated with serum alpha-1 globulin or antitrypsin deficiency. These patients died twenty-six and ten days after operation, respectively, and the causes of death were herpes simplex viral pneumonia in the first and bacterial pneumonia with lung abscess formation in the second. The second case was particularly disappointing in that mechanical lymphocyte depletion rather than conventional immunosuppressive therapy was employed in an attempt to prevent infectious complications. Problems encountered in the management of these patients are numerous. Many of the findings of previous experimental studies may not be applicable to the clinical situation, and much remains to be learned about human lung allotransplantation.

Left ventricular function during respiratory failure.

Indirect measures of left ventricular function were studied in seven patients with respiratory failure secondary to chronic obstructive pulmonary disease to determine if there were a relationship between left ventricular function and treatment of the pulmonary disease. All patients were studied during acute episodes while in respiratory failure having arterial Pco2, (Paco2) values greater than 49 torr with no clinical evidence of left ventricular failure. Indirect methods to evaluate left ventricular function included the use of the Swan-Ganz catheter for pulmonary capillary wedge pressure measurement, systolic time intervals, and cardiac output. There was improvement in left ventricular function with treatment of the respiratory failure manifested by decreases in the wedge pressure and pre-ejection period/left ventricular ejection time ratio, and an increase in the dp/dt/pulmonary capillary wedge pressure with treatment of the chronic obstructive pulmonary disease. The improvement in left ventricular function suggests that there is a depression of left ventricular function in respiratory failure. The depressed function improved with therapy of the lung disease without additional medication directed at cardiac function.