[Recent advance in pulmonary function tests--advance in pulmonary function tests for diagnosis and management of...

Development of new machine and small-sized equipment have the advantage on both diagnosis and management of various diseases. In terms of bronchial asthma, the understanding of pathophysiology has been changed from a disease with acute episodes of bronchoconstriction to a disorder with chronic airway inflammation. To verify bronchial responsiveness induced by chronic inflammation, a direct-writing respiratory impedance method(Astograph) is more useful compared with a conventional standard method with measuring FEV1.0. Peak expiratory flow(PEF), an index of pulmonary function test with effort, can be measured with peak flow meter which is small and handy. Repeated measurements of PEF have been recommended by the International Consensus Report on diagnosis and treatment of asthma. The PEF monitoring is effective not only on the understanding of individual pathophysiology but also on the long-term management of patients with asthma. It is needed to develop noninvasive simple technique to evaluate airway inflammation although many investigators have examined hypertonic saline-induced sputum or bronchial mucosal biopsy. Repeated measurements of exhaled nitric oxide may become to a safe and valid method to access inflammatory change in the airway.