Research Institute for Chest Diseasesand Cancer, Tohoku University,. 4-I Seiryomachi ..... A decrease in ciliary beating frequency, and even stasis ofcilia, on ...
PRELIMINARY
NOTES
Mucociliary Clearance Mechanism in Smoking and Nonsmoking Normal Subjects Toyoharu Isawa, Takeo Teshima, Tomb Hirano, Akio Ebina, and Kiyoshl Konno
TheResearch Institute for Chest Diseases and Cancer, Tohoku University, 4- 1 Seiryomachi, Sendal 980, Japan
Mucoclilaryclearance mechanismswere evaluated In 17 normalsubjectsvls ually and qualitativelyby radloaerosolInhalationclnescintlgraphyof the lung,and quantitatIvelyby calculatingthe followingIndices:(a) overall or regionallungre tentlon ratio; (b) airway depositionratio; (c) airway retentionratio; (d) airway clearance efficiency;and (e) alveolardeposItionratio.The inhaledaerosoldepos ited homogeneouslythroughoutthe lungs,andmucustransportwas alwayscepha lad In directionandconstantin velocity,althougha temporarystasisof mucuswas seen in smokers.Overall lungretentionratio was significantlysmaller and airway depositionratio was signifIcantlylarger In the smokersthan In nonsmokers,but there was no difference between the groupsin airway retentionratio or airway clearance efficiency.There was an inverserelationshipbetween alveolardeposi tion ratio and cigarette consumption.Mucociliary clearance mechanismswere well maintainedin the normalsubjects,but In the smokersinhaledaerosoltended to depositmore proximally. J Nucl Med 25: 352—359,1984 Cinematographic lowing
radioaerosol
inhalation
is useful
for the visual
anisms in the lungs (1—3).Using this method we have learned, initially, that mucus transport in the airways is highly protean in direction and pattern according to
underlying pathology (1—3),but what is within normal limits and what is not in this newly developed modality has not been established. Indices to quantify mucociliary mechanisms
in the lungs have not been de
termined. The purpose of the present study was to see whether there was any visual difference in mucociliary clearance mechanisms in normal subjects, currently smoking and nonsmoking, or in ex- and nonsmokers, and to define indices to quantify the airway clearance mechanisms in
thelungs. Received Feb. 9, 1983; revision accepted Sept. I9, 1983. For reprints contact: Toyoharu Isawa, MD, Dept. of Medicine, The
Research Institute for Chest Diseasesand Cancer, Tohoku University, 4-I Seiryomachi, Sendai 980, Japan.
352
AND
METHODS
and
qualitative assessment of mucociliary clearance mech
clearance
MATERIALS
display of the lung images fol
Seventeen healthy male physician colleagues who were actively engaged in daily patient care and research, volunteered for this study. Their ages ranged from 29 to 5 1 yr. with an average
34.
They had no history of pulmonary disease, and their
chest radiographs were within normal limits. They had no abnormalities
of pulmonary
function, as shown in
Table I . At the time of study they had no acute illness such as sore throat or bronchitis. Three were ex-smokers, five nonsmokers, and nine smokers (Table 1). Ex smokers had a cigarette-smoking history of 2 to 9 pack yr, but they had stopped smoking for more than 10 yr. Smokers abstained from smoking for at least 2 hr before
radioaerosol inhalation, but smoking was permitted from 2 hr after aerosol
inhalation.
Each subject inhaled ultrasonically generated Tc-99m human serum albumin aerosol (mass median diameter 3.73 @m,with geometric s.d. 1.73) (4) for less than 2 mm,
by tidal
breathing
through
a mouthpiece
with
the
nose clipped; he immediately lay supine comfortably on THE JOURNAL OF NUCLEAR MEDICINE
@ @
C@ :@
@
0
.@
0) 0
0
C
C@)
.@
PRELIMINARY NOTES
0 Cs
C@1'-1•-C'J'-C%Jtt)1-•
(I) .@
>%
10
tO
L()
CO
0
CC)
10
0
10
11)
0
0
w
a I— tl) (l)@ (1)@
I—c C.) .@ Ui .@ @
(I)
4L@
C@C@'-'-C@JC@i
-I
@
0
0
0
N. 0
0
0
0
.
0
0
0
(I) 0
0
0
0
C') 00000000
0
0
0
0
0
w I
I-
U-
0 @
>-
@
OJC@0@CDC@'-F'-00C'iC'1U)U)0U) .@
u,c@c'icó
I
@
0 !
@
0
*-@
-c@CD@-U)0Co0)@r-0)Co0
U)U)C@U)@F'-@
(I)
@ @
@
0
z<
