Total and visceral adipose-tissue (AT) volumes were determined by computed tomography (CT) by a multiscan technique in 17 men and 10 women with a wide range of body weights. In these primary materials, weight, height, and various diameters, circumferences, and subcutaneous AT thicknesses of the trunk were examined for their relationships to CT-determined total and visceral AT volumes. Predictive AT equations from the primary materials were then tested on two cross-validation groups consisting of another 7 men and 9 women. For the prediction of the total AT volume, weight/height was the superior single predictor, with errors less than 11% in primary and cross-validation materials. For the prediction of visceral AT volume, simple equations based entirely on the sagittal diameter of the trunk at the L3-L5 level resulted in errors less than 21% in both sexes.

The adipose tissue volumes of 12 women were determined by computed tomography (CT). Body weight ranged from 46 to 129 kg. Nine or twenty-two transsectional scans were examined with respect to the adipose tissue area. The total adipose tissue volume (ATCT22 or ATCT9) was calculated by assuming linear changes in the adipose tissue area between adjacent scans. Body fat (BF) was also calculated from total body potassium (BF40K), from total body water (BFTHO), and from both these determinations (BF40K + THO). Body mass index (BMI) was calculated by dividing body weight (BW) by height2 (H2). ATCT22, ATCT9, and BFK were more closely related to BW and BMI than were BFTHO and BF40K + THO. When ATCT was used as a standard, the optimal index of adiposity based on BW and H was in the range BW/H0.8 to BW/H1.2. From the CT and 40K measurements it was possible to deduce that the potassium content is 62 mmol/kg fat free mass and 73-75 mmol/kg lean body mass. The error of ATCT9 was 0.6%, while that of BF40K was at least three to four times larger. It is concluded that the CT-based AT determination is the most reproducible method so far available. The technique might turn out to be of great value in human energy balance experiments.

Objective. To estimate predictors and long-term outcome of interstitial lung disease (ILD) in patients with polymyositis (PM) and dermatomyositis (DM).Methods. We conducted a prospective study in which newly diagnosed PM/DM patients, regardless of clinical symptoms of pulmonary disease, were investigated with repeated chest radiography, high-resolution computed tomography (HRCT) of the lungs, and pulmonary function test (PFT). Clinical, radiologic, and lung function outcome was based on the last followup results. Results. Twenty-three patients with a mean followup period of 35 months were included. Findings on radiographic examination and/or PFT compatible with ILD were recorded in 18 patients (78%). Patients with ILD had lower lung function, higher radiologic scores, and higher creatine kinase values than those without ILD. All patients were treated with high-dose glucocorticoids and other immunosuppressive agents. Two patients died due to ILD, both with active myositis. During the followup, total lung capacity (TLC) improved in 33%, remained stable in 39%, and deteriorated in 28%. Changes in TLC correlated only partially with HRCT findings, which persisted even after normalizing for lung function. Conclusion. ILD associated with PM/DM is in most cases mild, chronic, and has a nonprogressive course during immunosuppressive treatment. PFT can be normalized during treatment with immunosuppressive therapy, even if radiologic signs of ILD persist. The course of ILD could not be predicted on the first examination. Therefore, myositis patients with ILD need careful evaluation of clinical features as well as PFT and radiologic features during followup.

Smoking is a risk factor for developing chronic obstructive pulmonary disease (COPD), but there are no good indicators for early identification of subjects who will develop symptomatic COPD. The aim of this study was to investigate inflammatory mechanisms related to changes in lung function and emphysematous changes on high resolution computed tomography (HRCT) in 'healthy' smokers. Subjects were 60-year-old men from a population study. Bronchoscopy was performed in 30 smokers and 18 who had never smoked. Blood tests, lung function measurements and HRCT were carried out in 58 and 34 subjects, respectively. In comparison with never-smokers, smokers had higher levels of myeloperoxidase (MPO), human neutrophil lipocalin (HNL), eosinophil cationic protein (ECP) and lysozyme in blood, higher levels of MPO, interleukin-8 (IL-8) and HNL in bronchial lavage (BL), and of IL-8, HNL and interleukin-lbeta (IL-1beta) in bronchoalveolar lavage (BAL). Smokers also had lower levels of Clara cell protein 16 (CC-16) in blood. HNL in BL and BAL showed strong correlations to other inflammatory markers (MPO, IL-8, IL-1beta). The variations in MPO in BL were explained by variations in HNL (R2 =0.69), while these variations in BAL were explained by variations in HNL and IL-1beta (R2 = 0.76). DL(CO) was the lung function variable most closely related to MPO and IL-8 in BL and BAL and to IL-1beta in BAL. In a multiple regression analysis, MPO, IL-1beta, IL-8 and CC-16 in BL and MPO in BAL contributed to the explanation of variations in DL(CO) to 41% and 22%. respectively, independent of smoking habits. In smokers with emphysematous lesions on HRCT, HNL in BAL correlated to emphysema score (r(s) = 0.71). We conclude that 'healthy' smoking men with a near normal FEV1 show signs of inflammation in the lower airways that are related to a decrease in DL(CO) and to emphysematous lesions on HRCT. This inflammation seems to be the result of both monocyte/macrophage and neutrophil activation.

No abstract