The extralobar type of sequestration often remains asymptomatic, and is usually an incidental finding during infancy. The intralobar type mostly presents with recurrent infections in adulthood resulting in more lobectomies. We believe these findings support our current policy to remove any pulmonary malformation whenever diagnosed in order to: (1), prevent infection and other potentially serious late complications which may compromise the surgical outcome; and (2), enhance the chance of a parenchymal-sparing resection.

Background: Skeletal muscle weakness is assumed to be present in patients with sarcoidosis but has never been reported in a consecutive group of patients. Moreover, its relationship with previously observed exercise intolerance and reduced health status has never been studied in these patients. Methods: Pulmonary function, skeletal and respiratory muscle forces, peak and functional exercise capacity, health status, and the circulating levels of inflammatory and anabolic markers were determined in 25 patients with sarcoidosis who complained of fatigue (15 men) and in 21 healthy subjects (13 men). Results: Patients with sarcoidosis had lower respiratory and skeletal muscle forces, reduced exercise capacity and health status, higher anxiety and depression scores, and higher circulating levels of tumour necrosis factor-a than healthy subjects (all p(0.01). Its soluble receptor p75 tended to be higher (p = 0.04). Circulating levels of interleukin (IL)-6, IL-8, insulin-like growth factor I and its binding protein 3 were not significantly different between the two groups. Skeletal muscle weakness was related to exercise intolerance, depression, and reduced health status in patients with sarcoidosis, irrespective of age, sex, body weight and height (p(0.05). Quadriceps peak torque was inversely related to fatigue but not to the circulating levels of inflammatory or anabolic markers. The mean daily dose of corticosteroids received in the 6 month period before testing was related to quadriceps peak torque only in patients who received oral corticosteroids. Conclusion: Skeletal muscle weakness occurs in patients with sarcoidosis who complain of fatigue and is associated with reduced health status and exercise intolerance.

We report the results of a prospective registration of the prevalence of interstitial lung diseases by 20 centres of respiratory medicine in Flanders from January 1992 till July 1996. The 20 centres registered a total of 362 cases. Sarcoidosis (31% with inclusion of stage I, or 22% without stage I), idiopathic pulmonary fibrosis (20%), hypersensitivity pneumonitis (13%) and unclassified forms of interstitial lung diseases (9%) were the most often diagnosed diseases. The mean age of the patients was 52 +/- 17 (SD) years, but ranged from 32 +/- 10 years in histiocytosis X to 70 +/- 13 years in drug induced interstitial lung diseases. The male to female ratio was 1.3 but ranged from 2.3 in interstitial lung diseases due to inhalation of inorganic materials to 0.8 in interstitial lung diseases due to connective tissue disease. The diagnosis was considered certain in 60%, probable in 30% and possible in 10%. In 50% of the cases the diagnosis was proven by biopsy and the most often used biopsy technique was transbronchiolo-alveolar biopsy (40% of biopsies) followed by open lung biopsy (32%). At diagnosis vital capacity was 82 +/- 22% pred. (ranging from 92 +/- 19% in sarcoidosis to 71 +/- 24% in idiopathic pulmonary fibrosis) and CO-diffusing capacity was 77 +/- 19% pred. (ranging from 77 +/- 19% in sarcoidosis to 41 +/- 13% in drug induced pneumonitis). The regional frequency of interstitial lung diseases in Flanders varied widely and was not proportional to the regional distribution of the 20 contributing centres. In conclusion this registration provides interesting information on the occurrence and presentation of the different forms of interstitial lung diseases, although it may still underestimate the real prevalence and incidence of interstitial lung diseases.

A technique is described allowing one to determine simultaneously the resistance and reactance of the total respiratory system for various frequencies. During spontaneous breathing, regularly recurring impulses are produced at the mouth by means of a loud speaker. A Fourier analysis of the mouth pressure and flow signals yields mean resistance and reactance values, over 16 s, for all harmonics of 2 Hz up to 30 Hz. The values are in good agreement with those obtained in the absence of breathing and those determined by means of the forced oscillation technique and by body plethysmography. The reproducibility of the measurements is satisfactory (coefficient of variation: 11.6%).

The purpose of this study was to assess normal values of thoracoabdominal motions (TAM) during spontaneous breathing and vital capacity (VC) maneuvers in relation to sex, age, and body position. For this, 120 healthy subjects from 10 to > 60 yr old were studied using the respiratory inductive plethysmograph (Respitrace). The volume-motion coefficients obtained during quiet breathing for the rib cage (RC) were almost twice those for the abdomen (ABD) and were not influenced by sex or age and also not by posture, except for the increased ABD coefficients in the supine posture (p < 0.05). Under most conditions RC motion predominated over ABD motion, except quiet breathing in the supine position. Sex-related differences in TAM were not found during quiet breathing, yet during VC maneuvers the women were slightly more RC breathing (p < 0.01). Age-related differences were also only significant during VC maneuvers: men of more than 50 yr old especially became less RC breathing. Posture had a very significant effect (p < 0.001) during quiet breathing as well as during VC maneuvers: the RC predominance was greatest in the standing posture and least in the supine posture. During VC maneuvers the subjects became more RC breathers than during quiet breathing (p < 0.001). The X-Y coordinates of RC motion (on the Y axis) versus ABD motion (on the X axis) showed under all conditions a counterclockwise looping during the breathing cycle: the looping was elliptic during quiet breathing but was more irregular and variable during VC maneuvers, and this also depended on body position.(ABSTRACT TRUNCATED AT 250 WORDS)