Lung injury related to consuming Sauropus androgynus vegetable.

BACKGROUND: Taking Sauropus androgynus, a Malaysian food, to reduce weight began as a fad in Taiwan in 1994. Some advocates of this fad developed pulmonary dysfunction. The aim of this study is to report the lung injury in patients taking Sauropus androgynus. METHODS: From July 1995 to November 1995, we investigated 104 nonsmoking patients (one male and 103 females) with chest roentgenography, pulmonary function, test, and Technetium 99m-labeled diethylene triamine penta-acetate (Tc-99m DTPA) radioaerosol inhalation lung scintigraphy. RESULTS: Among the 90 patients receiving Tc-99m DTPA inhalation lung scan, 46 (51.1%) patients had increased clearance of Tc-99m DTPA from lung and 20 (22.2%) patients had inhomogeneous deposition of the submicronic radioaerosol. Eighteen (18/100) patients had obstructive ventilatory impairment in pulmonary function test. Analyzing the results, we found that the patients with respiratory symptoms (n = 42) took more vegetables (p = 0.016), had increased clearance of Tc-99m DTPA (p = 0.010) and had lower FEV1 (p = 0.001), FEV1/FVC (p < 0.001), FEF25-75 (p = 0.001), VC (p = 0.002) and DLCO (p = 0.009) than the patients without respiratory symptoms (n = 62). FEV1 and FEV1/FVC were significantly reduced in patients with severe impairment of alveolar permeability. The cumulative dosage and duration of exposure were significantly associated with the reduction of FEV1 and FEV1/FVC. CONCLUSION: The lung injury after taking Sauropus androgynus involves alveoli and/or small airways and is manifest as obstructive ventilatory impairment with inhomogeneous aerosol distribution and increased lung epithelial permeability.

A new device of incentive spirometry.

Incentive spirometry is a feedback system to encourage patients to take a deep breath and produce a sustained maximal inspiration (SMI) for the primary purpose of opening and stabilizing atelectatic areas of the lung. However, currently available incentive devices are not reusable, expensive, and emphasize inspiratory effort only. We have designed a new device of incentive spirometer based on pursed-lip breathing technique. The device consists of a piece of paper hanging on a frame. The patient is instructed to take a deep and slow inspiration followed by holding the breath for 5 seconds. Then, using pursed-lip technique, the patient generates a flow to keep the paper attached to a bar as long as possible. The duration of paper blowing is recorded and is compared with vital capacity. In the present study 96 cases were recorded. Vital capacity was correlated well with paper blowing time (multiple regression test r = 0.87, p less than 0.0001). The advantages of our device include (1) reusibility and less cost, (2) equal emphasis of both inspiration and expiration, and (3) being especially helpful for patients with chronic obstructive lung disease (COPD). This is a preliminary result and further clinical study is needed.