Effect of manufacturing conditions on in vitro starch and protein digestibility of (cellular) lentil-based ingredients.

(Cellular) pulse powders are being proposed as ingredients for different foods. However, the effect of manufacturing conditions on the properties of those powders remained unknown. Therefore, this study investigated the effect of specific manufacturing conditions (cooking time, application of cell isolation, and drying method) on the composition, microstructure, and in vitro starch and protein digestibility of lentil powders. Next to powders consisting of isolated cotyledon cells (ICC), this study proposes the production of precooked whole lentil powders (WL), without a cellular isolation step. In a model food system (heat-treated suspension), starch and protein digestion were significantly attenuated for both WL and ICC compared to raw-milled lentil flour. The applied cooking time determined macronutrient digestibility in the powders by (i) affecting the susceptibility of ICC to in vitro digestion, and (ii) determining the microstructural properties of WL. Freeze-dried ICC powder showed a stronger attenuation of amylolysis compared air-dried ICC. This study showed that WL powders have an important potential as innovative food ingredients higher in fiber but lower in starch compared to ICC.

The endocrinometabolic effects of beclomethasone dipropionate in asthmatic patients.

The endocrinometabolic effects of the aerosol administration of beclomethasone dipropionate (100 microng four times daily) were evaluated in 20 asthmatic patients (11 corticodependent and nine noncorticodependent) during one month. In the noncorticodependent group, aerosol administration of beclomethasone had no statistically significant effect on the results of the glucose tolerance test and the plasma levels of insulin; there was a slight decrease in basal levels of cortisol, but the response of the cortisol level to administration of ACTH remained quite normal. In corticodependent patients, after substitution of aerosol therapy with beclomethasone for the oral therapy with steroids, the depression of adrenal function disappeared, usually quickly (in less than one month), whereas the abnormalities in the results of the glucose tolerance test persisted. Thus, at the dosage used, beclomethasone dipropionate might have minor systemic endocrinometabolic effects.

Double-blind comparison of the respiratory effects of parenteral lorazepam and diazepam in patients with chronic obstructive lung disease.

The effects on the respiratory function of two tranquillising drugs, lorazepam and diazepam, have been compared in 20 patients with chronic obstructive lung disease. Both drugs induce a respiratory depression (decrease in tidal volume and minute ventilation with acceleration of the respiratory frequency) with slight respiratory acidosis, but lorazepam causes no significant hypoxemia and has a shorter duration of action than diazepam. Nevertheless, if tranquillisers are indicated in such patients, they have to be used with care.

Cardiopulmonary adaptation to exercise in coal miners.

Twenty-six coal miners, without associated functional chronic obstructive lung disease (COLD), assessed by normal airway resistance, were divided into three groups: (1) Group C, normal X-ray; (2) Group S1, micronodular silicosis; and (3) Group S2, complicated silicosis. All subjects were evaluated while at rest and during exercise. Significant lung volume reduction was observed in the S2 Group only. Blood gases, pulmonary pressure, and cardiac output were found to be within the normal range for all three groups when at rest. The pulmonary pressure and pulmonary vascular resistance were higher, however, for the S1 and S2 Groups when compared to the C Group. During exercise, pulmonary hypertension was observed in 50% of teh patients with complicated silicosis. When all data (N = 26) were included, the high values for pulmonary pressure and pulmonary vascular resistance correlated well with the loss in vital capacity (VC) and the decrease in forced expiratory volume in 1 sec (FEV 1.0). From the initial 26 patients, 19 were selected on the basis of their normal airway resistance and FEV 1.0/VC ratio. This selection did not alter the differences noted for the pulmonary pressure and total pulmonary vascular resistance, which previously existed between the groups, even though the correlations were not statistically significant. We conclude that silicosis without associated COLD leads to mineral hemodynamic impairment at rest and during exercise, and that airway resistance does not detect impairment of flow as effectively as FEV 1.0 reduction. The increased pulmonary vascular resistance observed, especially in complicated silicosis, may be best explained by the loss of lung parenchyma and possible impairment of small airways.

[Instrumentation support in respiratory kinesiotherapy]. / Le support instrumental en kinésithérapie respiratoire.

The points of impact of instrumental support in respiratory physiotherapy are numerous; they concern primarily the pulmonary expansion, bronchial drainage and function of respiratory muscles. The pulmonary expansion may be helped by incitant spirometry and either intermittent or continuous positive pressure respiration, or indirectly by the utilisation of respiration against resistance (expiratory bottles, masks with uni-directional valves and expiratory resistances etc.). These different techniques may be used in the presence of instability of the respiratory units, secondary to an alteration of surfactant or to closure of the small airways induced by a transitory reduction (in the post-operative period) or permanent reduction (such as parietal wall disease of mechanical or neuro-muscular origin) of the functional residual capacity (CRF). If the continuous positive airway pressure (CPAP) seems particularly helpful for the CRF to recover to the pre-operative level it also appears on the contrary as the least efficacious technique to increase trans-pulmonary pressure. The instrumental support for bronchial drainage may theoretically affect the tension activity of the transport (instrumental help in the pulmonary expansion and in hyperventilation), muco-ciliary transport (external parietal vibration or internal vibrations applied to the upper airways), the biphasic flow (expiratory assistance by negative pressure and humidifiers). The function of the respiratory muscles may in certain cases be improved by the use of abdominal pneumatic cuirasses, by hyperventilation exercises in an isocapnoeic milieu or in breathing exercises against an additional inspiratory or expiratory resistance. If the physiological foundation of mechanical support in respiratory education may be frequently identified, the clinical results reported in the literature are often contradictory.

[Methodology of evaluating results of a rehabilitation technic]. / Méthodologie de l'appréciation des résultats d'une technique de réadaptation.

The author presents a methodology to be used in all readaptation techniques, whatever the importance of the handicap and the technique used. He particularly insists on the necessity not to combine methods (mechanical and medicinal therapeutics...) if the efficiency of the different physical methods of readaptation is to be properly assessed.

Assessment of the anaerobic threshold during exercise in normal man by means of the occlusion pressure as compared to conventional noninvasive techniques.

7 healthy men performed on a bicycle a stepwise increasing maximal exercise. During the work test the classical parameters usually used in the detection of the anaerobic threshold (AT) i.e. minute ventilation (VE), CO2 output (VCO2), O2 intake (VO2), gas exchange ratio (R) were recorded by a computerized system every minute. We also recorded the occlusion pressure (Po.1) in order to introduce it as a new parameter to detect the anaerobic threshold. Po.1 evolution showed a clear 'breaking point' at approximatively the same levels as for some of the other parameters (VE, VCO2). This 'breaking point' which is interpreted as the AT was also situated at the same level where VE/VO2 ratio increases without a change in VE/VCO2 ratio. Moreover the 'breaking point' separated the curves in linear and nonlinear increases as for VE and VCO2. By comparing the slope of the evolution of VCO2, VE, and Po.1 before and after the AT, it appeared that the easier visual detection of the AT was made by the Po.1 profile. We conclude that Po.1 is a valid index to detect the AT, and that this technique is a useful parameter in order to improve the visual detection of the AT.

Functional evaluation of a physical rehabilitation program including breathing exercises and bicycle training in chronic obstructive lung disease.

20 patients suffering from chronic obstructive lung disease (COLD) were submitted to a 6-month rehabilitation program including breathing exercises only (A) or coupled with bicycle training (B). Functional results obtained at rest were the following: for A: nonsignificant changes in FRC, RV, FEV1, Raw, Pa O2, pH, Pp, VO2 max SL but significant changes (p less than 0.05)for TLC (+ 214 cm3), VC (+ 171 cm3), DL CO (+ 1.79 ml), Pa CO2 (-2.9 mm Hg). For B: similar changes as for A with additional significant changes in PaO2 (+ 7.4 mm Hg) VO2 max SL (+ 250 ml) and Pp (-4 mm Hg). These results, although minimal, are attributed to improved respiratory muscle strength and improved alveolar ventilation. Exercise training adds an increased ability to sustain higher loads.

Influence of exercise and CO2 on breathing pattern in patients with chronic obstructive lung disease (COLD).

In ten eucapnic patients with chronic obstructive lung disease (COLD) we evaluated the breathing pattern during induced progressive hypercapnia (CO2 rebreathing) and progressive exercise on an ergometric bicycle (30 W/3 min). The time and volume components of the respiratory cycle were measured breath by breath. When compared to hypercapnia, the increase in ventilation (VE) during exercise was associated with a smaller increase in tidal volume (VT) and a greater increase in respiratory frequency (fR). Plots of tidal volume (VT) against both inspiratory time (TI) and expiratory time (TE) showed a greater decrease in both TI and TE during exercise than with hypercapnia. Analysis of VE in terms of flow (VT/TI) and timing (TI/TT) showed VE to increase by a similar increase to that in VT/TI during both exercise and hypercapnia, while TI/TT did not change significantly. When the patients were matched for a given VE (28 l.min-1), exercise induced a smaller increase in VT (p less than 0.05), a greater increase in fR (p less than 0.025); TI (p less than 0.025) and TE (p less than 0.01) were found to be smaller during exercise than hypercapnia. The change in the off-switch mechanism during exercise and hypercapnia could account for our results.

Site of action of inhaled histamine in asymptomatic asthmatic patients.

Histamine inhalation provocation-tests were performed in twenty-two young asthmatics with normal lung-function tests with progressive, increasing doses of a pressurized aerosol of histamine phosphate. Airway resistances (Raw) and N2 washout-curves were recorded. Two different types of response have been observed: (1) in thirteen cases, there was an increase of both Raw and the N2 phase III slope; and (2) in eight cases, there was only an increase in Raw (in one subject there was an increase in the N2 phase III slope only). Comparing the two groups of patients there was no difference in the inhalation procedure, the dose of histamine delivered or the smoking habits and lung-function data, except a slightly higher residual volume/total lung capacity (RV/TLC) ratio in the first group. The histamine-induced changes could not be related to any of the control lung-function data. We conclude that histamine inhalation may induce either peripheral bronchoconstriction only, or central bronchoconstriction with or without peripheral bronchoconstriction. A local and/or peripheral vagal-mediated bronchoconstrictor effect could account for the different site of airway response.

Hemodynamic characteristics in chronic obstructive lung disease as related to cardiac size.

The hemodynamic adaptation during exercise was evaluated in 19 patients suffering from chronic obstructive lung disease. They were divided into two groups according to cardiac size on the X-ray (group 1, small; group 2, normal). A small cardio-thoracic ratio could be correlated with 'emphysema' assessed on the basis of hyperinflation and a low transfer test for CO. No clear-cut difference could be found between the two groups concerning the hemodynamic data at rest or during exercise. However, for all subjects, the cardiac output was found to be slightly related to the cardiac size (smaller cardiac output for smaller cardiac size). During exercise, a low cardiac output was characterized by a low oxygen transport and a high level of lactate. From this, it is suggested that a small cardiac size, a classical feature of hyperinflation and emphysema, may lead to a low cardiac output. The explanation for these results is speculative, but variable hemodynamic profiles in chronic obstructive lung disease with or without hyperinflation may be related to the morphology of the cardiac chambers and to variable intrathoracic pressure regimes during respiration.

Respiratory drive and ventilatory pattern during exercise in interstitial lung disease.

Ventilation was analysed during a maximal and progressive exercise in 12 patients suffering from interstitial lung disease (ILD) and in 15 healthy subjects. "Rapid shallowing breathing" pattern was observed in patients with ILD. Both normals and patients showed a linear relationship between VE, VT/TI (mean inspiratory flow) and VCO2. The relationship between P0.1, the occlusion pressure at 0.1 S, and VCO2 exponential in both groups and significantly steeper in patients with ILD. P0.1/VE and P0.1/(VT/TI) ratios, indexes of thoracopulmonary impedance, and P0.1/VCO2 ratio, an index of respiratory drive per unit of CO2 output, were all inversely correlated in patients with VC% (vital capacity) and CLstat (static compliance). These results strongly suggest that in patients suffering from ILD the higher respiratory drive observed during exercise could be attributed to increased afferent reflexes originating from the lung and/or chest wall.

Acute pancreatitis in Legionnaires' disease.

Legionnaires' disease may cause severe multisystem damage. We report the case of a patient in whom Legionnaires' disease induced an acute pancreatitis.

Follow-up of pulmonary function after "shock lung".

Long-term follow-up of pulmonary function has been performed in four patients having recovered from "shock lung". In three patients there is a progressive normalization of lung volumes and lung compliance, whereas the pulmonary diffusing capacity improves but without attaining predicted levels. In the fourth patient, a delayed reduction of total lung capacity, lung compliance and diffusion capacity occurred. During the follow-up period (from one month to four years) there was no complaint and physical examination, electrocardiogram, chest roentgenogram, conventional pulmonary perfusion scintigraphy and arterial blood gases at rest were quite normal. These results are compatible with the persistence of some degree of interstitial lung disease after recovery from "shock lung".