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It is the non-specific BHR of asthma, which arises largely through eosinophilic inflammation and the subsequent remodelling of the airway wall, that is responsible for the marked variability in the disease symptomatology. , 1994). , PC20; diurnal PEF variation; bars - symptom score. structural changes within the walls of small airways and alveoli. Therefore, the BHR parallels the slow decline in FEV1 that is characteristic of COPD. Thus, even though the symptoms described by COPD and asthma patients are similar (wheeze, cough, shortness of breath), the pattern of the symptomatology is quite different.

The volume displayed on MEFV curves can be recorded in one of two ways - either as volume expired (the more usual), or as change in thoracic gas volume. The latter is measured with the subject seated within a body plethysmograph, using the plethysmographic signal as the index of change in thoracic volume. In this latter case volume change is due not only to bulk flow of gas out of the lungs, but also to compression of thoracic gas consequent on the high alveolar pressure (Boyle's law). Consequently the shapes of the two curves differ (Fig.

Am Rev Respir Dis, 142,434-57. Dompeling E, van Schayck CP, Molema J, et al. (1992) A comparison of six different ways of expressing the bronchodilating response in asthma and COPD; reproducibility and dependence of prebronchodilator FEV1 EurRespirJ, 5,975-81. Dompeling E, van Schayck CP, van Grunsven PM, et al. /Art/? Intern Med, 118,770-8. Dunnill MS, Massarella GR, Anderson JA. (1969) A comparison of the quantitative anatomy of the bronchi in normal subjects, in status asthmaticus, in chronic bronchitis and in emphysema.

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