Murray Altose - Academia.edu (original) (raw)

Papers by Murray Altose

Research paper thumbnail of Physician knowledge in the use of canister nebulizers

Chest, May 1, 1983

can be found online on the World Wide Web at:

Research paper thumbnail of Statement on Spirometiy: A Report of the Section on Respiratory Pathophysiology of the American College of Chest Physicians

Research paper thumbnail of Lymphocyte Studies in Asymptomatic Cigarette Smokers

American Review of Respiratory Disease, May 14, 2015

ABSTRACT

Research paper thumbnail of Changes in strength of lung inflation during prolonged inflation

Journal of applied physiology

ABSTRACT

Research paper thumbnail of Changing effect of lung volume on respiratory drive in man

Journal of applied physiology

Experiments were conducted on human subjects to study the effect of lung inflation during breath ... more Experiments were conducted on human subjects to study the effect of lung inflation during breath holding on respiratory drive. Two series of experiments were performed: the first to examine respiratory drive during a single breath hold, the second designed to examine the sustained effect of lung inflation on subsequent breath holds. The experiments involved breath holding begun either at the end of a normal expiration or after a maximum inspiration. When breath holding was repeated at 10-min intervals, the increase in BHT produced by lung inflation was greater in short breath holds (after CO2 rebreathing) than in long breath holds (after hyperventilation). If breath holds were made in rapid succession, the first breath hold was much longer when made at total lung capacity than at functional residual capacity, but this effect of lung inflation diminished in subsequent breath holds. It is concluded that the inhibitory effect of lung inflation decays during breath holding and is regained remarkably slowly during the period of breathing immediately after breath holding.

Research paper thumbnail of Effects of mechanical loading and hypercapnia on inspiratory muscle EMG

Journal of applied physiology

The electromyograms of the diaphragm and an external intercostal muscle were analyzed to see if t... more The electromyograms of the diaphragm and an external intercostal muscle were analyzed to see if the effects of hypercapnia on inspiratory muscle electrical activity could be distinguished from those of mechanical loading and to determine whether changes in inspiratory muscle electrical activity were a sueful measure of CO2 response during mechanical loading. Anesthetized dogs were studied: 1) during progressive hypercapnia without mechanical loading, 2) during flow-resistive and elastic loading at constant PCO2, and 3) during progressive hypercapnia and mechanical loading. Both mechanical loading and hypercapnia increased total inspiratory diaphragmatic and intercostal muscle electrical activity. However, inspiratory duration was increased by mechanical loads but reduced by hypercapnia. Because of these changes in inspiratory duration, the average rate of diaphragmatic electrical activity remained unaffected by mechanical loading before and after vagotomy but was increased by hypercapnia. In contrast, both hypercapnia and mechanical loading increased the average rate of intercostal muscle electrical activity. There was a greater increase in both total and average rate of intercostal muscle electrical activity during hypercapnia in the presence of mechanical loading than during unloaded breathing. However, the change in total and average rate of diaphragmatic electrical activity with PCO2 was unaffected by added mechanical loads. These results suggest that diaphragmatic but not intercostal muscle electrical activity can be used as an index of CO2 response even during mechanical loading.

Research paper thumbnail of Effects of lung volume changes on respiratory drive during hypoxia and hypercapnia

Journal of applied physiology

ABSTRACT

Research paper thumbnail of Electromyographic response of respiratory muscles during elastic loading

The American journal of physiology

The response of respiratory motor neurons to graded elastic loading was assessed in anesthetized ... more The response of respiratory motor neurons to graded elastic loading was assessed in anesthetized dogs by recording the electromyogram (EMG) from the diaphragm (ED) and the intercostal muscle (EIC). Elastic loads were applied for 1-20 breaths. The effects of changes in PCO2 on respiratory motor neuron output was assessed by applying loads during the course of CO2 rebreathing. On the first loaded breath, ED and EIC increased reflexly due chiefly to prolongation of inspiration. Vagotomy or vagal cooling to block the Hering-Breuer reflex eliminated the increase in ED and diminished the increase in EIC. During the second to fifth breath, the level of EMG activity was disproportionately high for the level of PCO2, suggesting an additional reflex component over and above the reflex activity present on the first loaded breath.

Research paper thumbnail of Prolonged alveolar hypoventilation in patients with lung disease

Bulletin européen de physiopathologie respiratoire

Research paper thumbnail of Effects of hypercapnia and flow resistive loading on tracheal pressure during airway occlusion

Journal of applied physiology

Research paper thumbnail of Lymphocyte studies in asymptomatic cigarette smokes, A comparison between lung and peripheral blood

The American review of respiratory disease

ABSTRACT

Research paper thumbnail of Effects of hypercapnia on mouth pressure during airway occlusion in conscious man

Journal of applied physiology

The effects of hypercapnia and inspiratory flow-resistive loading on mouth pressure during period... more The effects of hypercapnia and inspiratory flow-resistive loading on mouth pressure during periods of arrested airflow were studied in conscious human subjects to determine the usefulness of inspiratory muscle force in the assessment of respiratory neural efferent activity. Hypercapnia increased the peak end-inspiratory mouth pressure (Ppeak) during complete airway occlusion and the pressures at 100, 200, and 300 ms after the onset of inspiration (P100, P200, P300). During rebreathing without added mechanical loads, P100 and Ppeak increased linearly with the electrical activity of the diaphragm and changes in P100 and Ppeak during hypercapnia correlated well with ventilatory responses to PCO2 (DELTA V/DELTA PCO2) suggesting that occluded mouth pressures are reliable measures of respiratory activity. In individuals with the greatest reduction in delta V/DELTA PCO2 during inspiratory flow-resistive loading, changes in P100 and Ppeak with PCO2 increased only minimally. In contrast, there was a much greater increase in occluded mouth pressures with hypercapnia in the presence of mechanical loading when inspiratory flow-resistive loading failed to depress delta V/DELTA PCO2. In all subjects, occluded mouth pressures were greater at any given PCO2 during mechanical loading than during free breathing. Mechanical loading resulted in augmented respiratory neural efferent activity unexplained by alterations in chemical stimulation.

Research paper thumbnail of Effect of hypoxia on the pressure developed by inspiratory muscles during airway occlusion

Journal of applied physiology

The effect of progressive isocapnic hypoxia on the pressure generated by the inspiratory muscle d... more The effect of progressive isocapnic hypoxia on the pressure generated by the inspiratory muscle during airway occlusion was studied in 10 awake subjects during normal and obstructed breathing. Isocapnic hypoxia was produced by rebreathing a gas mixture of 6% CO2 in air while the expired gas was passed through a CO2 scrubber so as to maintain PACO2 constant (42.6 mmHg +/- 2.2 SE). Occlusion of the airway was performed randomly for a single breath at FRC. In all 10 subjects maximal pressure (Ppeak) and the pressures measured 100, 200, 300, and 400 ms after the onset of inspiration increased during hypoxia. Furthermore, good correlation was noted between the occlusion pressure response to hypoxia (delta P/DELTA[1/PO2-32]) and simultaneous changes in ventilatory response to hypoxia (delta VI/DELTA[1/PO2-32]). The occlusion pressure response to hypoxia therefore seems to be a reliable measure of respiratory center output. When rebreathing was repeated during inspiratory resistive loading, the occlusion pressure at any given PO2 and delta P/DELTA(1PO2-32) measured in the first 400 ms of inspiration increased in 9 of 10 subjects. Since PACO2 and PAO2 during both control and loaded experiments were the same, the increase in occlusion pressure in the presence of flow-resistive loading appeared to represent a neurally mediated increase in inspiratory motoneuron activity.

Research paper thumbnail of The physiological basis of pulmonary function testing

Clinical symposia (Summit, N.J.: 1957)

Research paper thumbnail of Upper airway and diaphragm muscle response to chemical stimulation and loading

Journal of applied physiology: respiratory, environmental and exercise physiology

ABSTRACT

Research paper thumbnail of Effect of sleep on resting and CO2 stimulated breathing in humans

Journal of applied physiology: respiratory, environmental and exercise physiology

ABSTRACT

Research paper thumbnail of Perception of changes in airflow resistance in obstructive pulmonary disorders

The American review of respiratory disease

Research paper thumbnail of The respiratory neuromuscular response to hypoxia, hypercapnia, and obstruction to airflow in asthma

The American review of respiratory disease

In chronic obstructive pulmonary disease (COPD), the neuromuscular response to an acute increase ... more In chronic obstructive pulmonary disease (COPD), the neuromuscular response to an acute increase in airflow produced by external flow resistive loads (FRL) is impaired. The present study compared the response to FRL of 15 subjects with airway obstruction due to asthma and that of 15 normal subjects. FRL were applied during progressive hypercapnia and isocapnic hypoxia produced by rebreathing techniques to permit the response to be assessed at the same degree of CO2 or O2 drive. The neuromuscular response to FRL was assessed from the airway occlusion pressure developed 100 msec after the onset of inspiration (P100), as well as ventilation. During control rebreathing, ventilatory responses to hypercapnia (ratio of change in minute ventilation to change in PCO2, delta VE/delta PCO2) and hypoxia (ratio of change in VE to the change in percentage of O2 saturation, delta VE/deltaSO2) were the same in asthmatic and normal subjects despite differences in the mechanics of breathing. The P100 response to hypercapnia delta P100/delta PCO2) and hypoxia (delta P100/delta SO2) as well as absolute P100 at any given degree of O2 and CO2 drive was greater during control rebreathing in asthmatics than in normal subjects (P less than 0.05). FRL values of 9 and 18 cm H2O per L per sec applied during either hypercapnia or hypoxia increased the occlusion pressure to a greater extent in asthmatics than in normal subjects. Methacholine-induced bronchoconstriction was used to test the effect of acute airway obstruction on the response to FRL. Bronchoconstriction was associated with an increase in the P100 response to hypercapnia and to FRL, despite increases in lung volume and decreases in inspiratory muscle force. We conclude that: (1) asthmatics with airway dysfunction have an increased nonchemical drive to breathe mediated at least in part by sensory receptors in the airways; (2) asthmatics with airway obstruction respond supernormally to acute changes in resistance to airflow, unlike subjects with COPD. The failure of COPD subjects with prolonged airway obstruction to respond to FRL may be due to adaptation of the sensory mechanisms that respond to changes in airway resistance.

Research paper thumbnail of A prospective classification of the respiratory manifestations of pollen sensitivity

Annals of allergy

Twenty pollen sensitive subjects were classified historically as Groups I-III based upon the elic... more Twenty pollen sensitive subjects were classified historically as Groups I-III based upon the elicitation of lower respiratory symptoms at (I) no time of the year, (II) only during the pollen season or (III) during and apart from the pollen season respectively. Neither antigen skin sensitivity nor antigen or mecholyl inhalational sensitivity was useful in delineating these three groups. However, pulmonary function tests during the season demonstrated changes in MMEFR and airflow at 25% vital capacity in Group II subjects, confirming our classifications.

Research paper thumbnail of Effect of ageing on perception of resistive respiratory loads

The American review of respiratory disease

ABSTRACT

Research paper thumbnail of Physician knowledge in the use of canister nebulizers

Chest, May 1, 1983

can be found online on the World Wide Web at:

Research paper thumbnail of Statement on Spirometiy: A Report of the Section on Respiratory Pathophysiology of the American College of Chest Physicians

Research paper thumbnail of Lymphocyte Studies in Asymptomatic Cigarette Smokers

American Review of Respiratory Disease, May 14, 2015

ABSTRACT

Research paper thumbnail of Changes in strength of lung inflation during prolonged inflation

Journal of applied physiology

ABSTRACT

Research paper thumbnail of Changing effect of lung volume on respiratory drive in man

Journal of applied physiology

Experiments were conducted on human subjects to study the effect of lung inflation during breath ... more Experiments were conducted on human subjects to study the effect of lung inflation during breath holding on respiratory drive. Two series of experiments were performed: the first to examine respiratory drive during a single breath hold, the second designed to examine the sustained effect of lung inflation on subsequent breath holds. The experiments involved breath holding begun either at the end of a normal expiration or after a maximum inspiration. When breath holding was repeated at 10-min intervals, the increase in BHT produced by lung inflation was greater in short breath holds (after CO2 rebreathing) than in long breath holds (after hyperventilation). If breath holds were made in rapid succession, the first breath hold was much longer when made at total lung capacity than at functional residual capacity, but this effect of lung inflation diminished in subsequent breath holds. It is concluded that the inhibitory effect of lung inflation decays during breath holding and is regained remarkably slowly during the period of breathing immediately after breath holding.

Research paper thumbnail of Effects of mechanical loading and hypercapnia on inspiratory muscle EMG

Journal of applied physiology

The electromyograms of the diaphragm and an external intercostal muscle were analyzed to see if t... more The electromyograms of the diaphragm and an external intercostal muscle were analyzed to see if the effects of hypercapnia on inspiratory muscle electrical activity could be distinguished from those of mechanical loading and to determine whether changes in inspiratory muscle electrical activity were a sueful measure of CO2 response during mechanical loading. Anesthetized dogs were studied: 1) during progressive hypercapnia without mechanical loading, 2) during flow-resistive and elastic loading at constant PCO2, and 3) during progressive hypercapnia and mechanical loading. Both mechanical loading and hypercapnia increased total inspiratory diaphragmatic and intercostal muscle electrical activity. However, inspiratory duration was increased by mechanical loads but reduced by hypercapnia. Because of these changes in inspiratory duration, the average rate of diaphragmatic electrical activity remained unaffected by mechanical loading before and after vagotomy but was increased by hypercapnia. In contrast, both hypercapnia and mechanical loading increased the average rate of intercostal muscle electrical activity. There was a greater increase in both total and average rate of intercostal muscle electrical activity during hypercapnia in the presence of mechanical loading than during unloaded breathing. However, the change in total and average rate of diaphragmatic electrical activity with PCO2 was unaffected by added mechanical loads. These results suggest that diaphragmatic but not intercostal muscle electrical activity can be used as an index of CO2 response even during mechanical loading.

Research paper thumbnail of Effects of lung volume changes on respiratory drive during hypoxia and hypercapnia

Journal of applied physiology

ABSTRACT

Research paper thumbnail of Electromyographic response of respiratory muscles during elastic loading

The American journal of physiology

The response of respiratory motor neurons to graded elastic loading was assessed in anesthetized ... more The response of respiratory motor neurons to graded elastic loading was assessed in anesthetized dogs by recording the electromyogram (EMG) from the diaphragm (ED) and the intercostal muscle (EIC). Elastic loads were applied for 1-20 breaths. The effects of changes in PCO2 on respiratory motor neuron output was assessed by applying loads during the course of CO2 rebreathing. On the first loaded breath, ED and EIC increased reflexly due chiefly to prolongation of inspiration. Vagotomy or vagal cooling to block the Hering-Breuer reflex eliminated the increase in ED and diminished the increase in EIC. During the second to fifth breath, the level of EMG activity was disproportionately high for the level of PCO2, suggesting an additional reflex component over and above the reflex activity present on the first loaded breath.

Research paper thumbnail of Prolonged alveolar hypoventilation in patients with lung disease

Bulletin européen de physiopathologie respiratoire

Research paper thumbnail of Effects of hypercapnia and flow resistive loading on tracheal pressure during airway occlusion

Journal of applied physiology

Research paper thumbnail of Lymphocyte studies in asymptomatic cigarette smokes, A comparison between lung and peripheral blood

The American review of respiratory disease

ABSTRACT

Research paper thumbnail of Effects of hypercapnia on mouth pressure during airway occlusion in conscious man

Journal of applied physiology

The effects of hypercapnia and inspiratory flow-resistive loading on mouth pressure during period... more The effects of hypercapnia and inspiratory flow-resistive loading on mouth pressure during periods of arrested airflow were studied in conscious human subjects to determine the usefulness of inspiratory muscle force in the assessment of respiratory neural efferent activity. Hypercapnia increased the peak end-inspiratory mouth pressure (Ppeak) during complete airway occlusion and the pressures at 100, 200, and 300 ms after the onset of inspiration (P100, P200, P300). During rebreathing without added mechanical loads, P100 and Ppeak increased linearly with the electrical activity of the diaphragm and changes in P100 and Ppeak during hypercapnia correlated well with ventilatory responses to PCO2 (DELTA V/DELTA PCO2) suggesting that occluded mouth pressures are reliable measures of respiratory activity. In individuals with the greatest reduction in delta V/DELTA PCO2 during inspiratory flow-resistive loading, changes in P100 and Ppeak with PCO2 increased only minimally. In contrast, there was a much greater increase in occluded mouth pressures with hypercapnia in the presence of mechanical loading when inspiratory flow-resistive loading failed to depress delta V/DELTA PCO2. In all subjects, occluded mouth pressures were greater at any given PCO2 during mechanical loading than during free breathing. Mechanical loading resulted in augmented respiratory neural efferent activity unexplained by alterations in chemical stimulation.

Research paper thumbnail of Effect of hypoxia on the pressure developed by inspiratory muscles during airway occlusion

Journal of applied physiology

The effect of progressive isocapnic hypoxia on the pressure generated by the inspiratory muscle d... more The effect of progressive isocapnic hypoxia on the pressure generated by the inspiratory muscle during airway occlusion was studied in 10 awake subjects during normal and obstructed breathing. Isocapnic hypoxia was produced by rebreathing a gas mixture of 6% CO2 in air while the expired gas was passed through a CO2 scrubber so as to maintain PACO2 constant (42.6 mmHg +/- 2.2 SE). Occlusion of the airway was performed randomly for a single breath at FRC. In all 10 subjects maximal pressure (Ppeak) and the pressures measured 100, 200, 300, and 400 ms after the onset of inspiration increased during hypoxia. Furthermore, good correlation was noted between the occlusion pressure response to hypoxia (delta P/DELTA[1/PO2-32]) and simultaneous changes in ventilatory response to hypoxia (delta VI/DELTA[1/PO2-32]). The occlusion pressure response to hypoxia therefore seems to be a reliable measure of respiratory center output. When rebreathing was repeated during inspiratory resistive loading, the occlusion pressure at any given PO2 and delta P/DELTA(1PO2-32) measured in the first 400 ms of inspiration increased in 9 of 10 subjects. Since PACO2 and PAO2 during both control and loaded experiments were the same, the increase in occlusion pressure in the presence of flow-resistive loading appeared to represent a neurally mediated increase in inspiratory motoneuron activity.

Research paper thumbnail of The physiological basis of pulmonary function testing

Clinical symposia (Summit, N.J.: 1957)

Research paper thumbnail of Upper airway and diaphragm muscle response to chemical stimulation and loading

Journal of applied physiology: respiratory, environmental and exercise physiology

ABSTRACT

Research paper thumbnail of Effect of sleep on resting and CO2 stimulated breathing in humans

Journal of applied physiology: respiratory, environmental and exercise physiology

ABSTRACT

Research paper thumbnail of Perception of changes in airflow resistance in obstructive pulmonary disorders

The American review of respiratory disease

Research paper thumbnail of The respiratory neuromuscular response to hypoxia, hypercapnia, and obstruction to airflow in asthma

The American review of respiratory disease

In chronic obstructive pulmonary disease (COPD), the neuromuscular response to an acute increase ... more In chronic obstructive pulmonary disease (COPD), the neuromuscular response to an acute increase in airflow produced by external flow resistive loads (FRL) is impaired. The present study compared the response to FRL of 15 subjects with airway obstruction due to asthma and that of 15 normal subjects. FRL were applied during progressive hypercapnia and isocapnic hypoxia produced by rebreathing techniques to permit the response to be assessed at the same degree of CO2 or O2 drive. The neuromuscular response to FRL was assessed from the airway occlusion pressure developed 100 msec after the onset of inspiration (P100), as well as ventilation. During control rebreathing, ventilatory responses to hypercapnia (ratio of change in minute ventilation to change in PCO2, delta VE/delta PCO2) and hypoxia (ratio of change in VE to the change in percentage of O2 saturation, delta VE/deltaSO2) were the same in asthmatic and normal subjects despite differences in the mechanics of breathing. The P100 response to hypercapnia delta P100/delta PCO2) and hypoxia (delta P100/delta SO2) as well as absolute P100 at any given degree of O2 and CO2 drive was greater during control rebreathing in asthmatics than in normal subjects (P less than 0.05). FRL values of 9 and 18 cm H2O per L per sec applied during either hypercapnia or hypoxia increased the occlusion pressure to a greater extent in asthmatics than in normal subjects. Methacholine-induced bronchoconstriction was used to test the effect of acute airway obstruction on the response to FRL. Bronchoconstriction was associated with an increase in the P100 response to hypercapnia and to FRL, despite increases in lung volume and decreases in inspiratory muscle force. We conclude that: (1) asthmatics with airway dysfunction have an increased nonchemical drive to breathe mediated at least in part by sensory receptors in the airways; (2) asthmatics with airway obstruction respond supernormally to acute changes in resistance to airflow, unlike subjects with COPD. The failure of COPD subjects with prolonged airway obstruction to respond to FRL may be due to adaptation of the sensory mechanisms that respond to changes in airway resistance.

Research paper thumbnail of A prospective classification of the respiratory manifestations of pollen sensitivity

Annals of allergy

Twenty pollen sensitive subjects were classified historically as Groups I-III based upon the elic... more Twenty pollen sensitive subjects were classified historically as Groups I-III based upon the elicitation of lower respiratory symptoms at (I) no time of the year, (II) only during the pollen season or (III) during and apart from the pollen season respectively. Neither antigen skin sensitivity nor antigen or mecholyl inhalational sensitivity was useful in delineating these three groups. However, pulmonary function tests during the season demonstrated changes in MMEFR and airflow at 25% vital capacity in Group II subjects, confirming our classifications.

Research paper thumbnail of Effect of ageing on perception of resistive respiratory loads

The American review of respiratory disease

ABSTRACT