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Background -7S collagen, an N-terminal peptide of type IV collagen, is a primary constituent of the basement membrane. To evaluate whether the serum concentration of 7S collagen reflects the severity of inflammatory lung disease, the serum concentration of 7S collagen was measured in patients with adult respiratory distress syndrome (ARDS) and idiopathic pulmonary fibrosis (IPF). Methods -A radioimmunoassay was used for the measurement of 7S collagen. Gas exchange abnormality was expressed as the arterial oxygen tension (PaO2) divided by the fractional concentration of inspired oxygen (FiO2). Results -The mean (SD) concentration of 7S collagen was 2-7 (0 9) ng/ml in 10 healthy subjects, 5 0 (1P5) ng/ml in 11 patients with IPF, and 14-8 (9 7) ng/ml in 13 patients with ARDS. Significant differences were observed between the patients with ARDS and both healthy subjects and the patients with IPF. In the patients with ARDS serum concentrations of 7S collagen were strongly related to PaO2/FiO2 (r= -0-61). Moreover, the mean (SD) serum concentration of 7S collagen in the eight patients with ARDS who died (19-5 (10-2) ng/ml) was considerably higher than that of the five who survived (7-1 (2'1) ng/ml).Conclusion -These results suggest that serum levels of the 7S fragment of type IV collagen may have some prognostic value in ARDS. (Thorax 1994;49:144-146) Type IV collagen is a major constituent of all basement membranes where it forms a network structure, partly because of interactions between the N-terminal domains of adjacent molecules. These domains, known as 7S collagen,' are known to be comparatively resistant to proteases. It has therefore been proposed that serum concentrations of 7S collagen reflect degradation or synthesis of the basement membrane, or both.2'As type IV collagen exists in the basement membrane of pulmonary capillaries and alveoli, we hypothesised that serum concentrations of 7S collagen in patients with inflammatory lung disease may reflect the extent of damage to the pulmonary basement membrane. In this study serum concentrations of 7S collagen were measured in patients with adult respiratory distress syndrome (ARDS) and those with idiopathic pulmonary fibrosis (IPF), and the use of 7S collagen in assessing the severity of these diseases was evaluated.

Early ambulation after open abdominal aortic aneurysm (AAA) surgery is assumed to play a key role in preventing postoperative complications and reducing hospital length of stay. However, the factors predicting early ambulation after open AAA surgery have not yet been sufficiently investigated. Here, we investigated which preoperative and intraoperative variables are associated with start time for ambulation in patients after open AAA surgery. A total of 67 consecutive patients undergoing open AAA surgery were included in the study [male, 62 (92 %); mean age, 68 years (range, 47-82 years), mean AAA diameter, 53 mm (range, 28-80 mm)]. Preoperative physical activity was examined by means of 6-min walk distance (6MWD) and a medical interview. Patients were divided into two groups, according to when independence in walking was attained: early group <3 days (n = 36) and late group ≥3 days (n = 31), and the pre-, intra-, and postoperative recovery data were compared. There were no significant differences in patient baseline characteristics or intraoperative data between the two groups. The number of patients engaging in preoperative regular physical activity and 6MWD were significantly greater (p = 0.042 and p = 0.034, respectively) in the early group than in the late group. In addition, time to hospital discharge was significantly shorter in the early group than in the late group (p = 0.031). Binary logistic regression analysis showed that preoperative regular physical activity was the only independent factor for identifying patients in the early group (odds ratio 2.769, 95 % confidence interval 1.024-7.487, p = 0.045). These results suggest that engaging in regular physical activity is an effective predictor of early ambulation after open AAA surgery.

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