{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:14:03Z","timestamp":1774620843122,"version":"3.50.1"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[1998,9,1]],"date-time":"1998-09-01T00:00:00Z","timestamp":904608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Loss of lung elastic recoil causing hyperinflation with increased TLC and decreased diffusing capacity and expiratory airflow are physiologic hallmarks of emphysema. We studied lung mechanics in 10 patients (seven men and three women) aged 69 \u00b1 9 yr (mean \u00b1 SD) who had fixed, severe expiratory airflow limitation with a mean FEV1 = 0.73 \u00b1 0.1 L (mean \u00b1 SD) (32 \u00b1 7% predicted) and lung computed tomographic picture grade score \u2264 20, indicating no or trivial emphysema. Three patients died, in whom whole-lung emphysema scores were 15 each and small airways were abnormal. Marked hyperinflation was present in all 10 patients studied, with TLC 7.3 \u00b1 1.1 L (140 \u00b1 12% predicted); FRC 5.6 \u00b1 0.8 L (177 \u00b1 30% predicted); and RV 5.2 \u00b1 0.8 L (242 \u00b1 28% predicted). Diffusing capacity of carbon monoxide (DlCO was reduced, at 12 \u00b1 6 ml\/min\/mm Hg (61 \u00b1 29% predicted). The pressure\u2013volume curves of the lung were markedly abnormal. Pst(L) at TLC was 11.6 \u00b1 1.4 cm H2O. Transdiaphragmatic pressure (Pdi) in five patients was 66 \u00b1 13 cm H2O. These results indicate that severe small-airways disease with no or trivial emphysema may cause a spurious reduction in diffusing capacity as well as severe loss of lung elastic recoil resulting in marked hyperinflation, increased TLC, and decreased Pdi and expiratory airflow.<\/jats:p>","DOI":"10.1164\/ajrccm.158.3.9801045","type":"journal-article","created":{"date-parts":[[2013,4,4]],"date-time":"2013-04-04T13:45:28Z","timestamp":1365083128000},"page":"815-819","source":"Crossref","is-referenced-by-count":75,"title":["Pseudophysiologic Emphysema Resulting from Severe Small-Airways Disease"],"prefix":"10.1093","volume":"158","author":[{"given":"ARTHUR F.","family":"GELB","sequence":"first","affiliation":[{"name":"Departments of Medicine and Radiology, Lakewood Regional Medical Center, University of California Los Angeles, School of Medicine, Los Angeles, California; Faculty of Medicine, University of Toronto, Toronto, Ontario; Pulmonary Research Laboratory and St. Paul's Hospital, Vancouver, British Columbia; and Department of Radiology, University of British Columbia and Department of Radiology, Vancouver Hospital, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"NOE","family":"ZAMEL","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Radiology, Lakewood Regional Medical Center, University of California Los Angeles, School of Medicine, Los Angeles, California; Faculty of Medicine, University of Toronto, Toronto, Ontario; Pulmonary Research Laboratory and St. Paul's Hospital, Vancouver, British Columbia; and Department of Radiology, University of British Columbia and Department of Radiology, Vancouver Hospital, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JAMES C.","family":"HOGG","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Radiology, Lakewood Regional Medical Center, University of California Los Angeles, School of Medicine, Los Angeles, California; Faculty of Medicine, University of Toronto, Toronto, Ontario; Pulmonary Research Laboratory and St. Paul's Hospital, Vancouver, British Columbia; and Department of Radiology, University of British Columbia and Department of Radiology, Vancouver Hospital, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"NESTER L.","family":"M\u00dcLLER","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Radiology, Lakewood Regional Medical Center, University of California Los Angeles, School of Medicine, Los Angeles, California; Faculty of Medicine, University of Toronto, Toronto, Ontario; Pulmonary Research Laboratory and St. Paul's Hospital, Vancouver, British Columbia; and Department of Radiology, University of British Columbia and Department of Radiology, Vancouver Hospital, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MARK J.","family":"SCHEIN","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Radiology, Lakewood Regional Medical Center, University of California Los Angeles, School of Medicine, Los Angeles, California; Faculty of Medicine, University of Toronto, Toronto, Ontario; Pulmonary Research Laboratory and St. Paul's Hospital, Vancouver, British Columbia; and Department of Radiology, University of British Columbia and Department of Radiology, Vancouver Hospital, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1998,9,1]]},"reference":[{"key":"2026032709085124900_B1","first-page":"762","article-title":"Definitions and classification of chronic bronchitis, asthma, and pulmonary emphysema.","volume":"85","author":"American Thoracic Society","year":"1962","journal-title":"Am. 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