Detection of bronchial breathing caused by pneumonia.

The classic auscultation with stethoscope is the established clinical method for the detection of lung diseases. The interpretation of the sounds depends on the experience of the investigating physician. Therefore, a new computer-based method has been developed to classify breath sounds from digital lung sound recordings. Lung sounds of 11 patients with one-sided pneumonia and bronchial breathing were recorded on both the pneumonia side and on contralateral healthy side simultaneously using two microphones. The spectral power for the 300-600 Hz frequency band was computed for four respiratory cycles and normalized. For each breath, the ratio R between the time-segments (duration = 0.1 s) with the highest inspiratory and highest expiratory flow was calculated and averaged. We found significant differences in R between the pneumonia side (R = 1.4 +/- 1.3) and the healthy side (R = 0.5 +/- 0.5; p = 0.003 Wilcoxon-test) of lung. In 218 healthy volunteers we found R = 0.3 +/- 0.2 as a reference-value. The differences of ratio R (delta R) between the pneumonia side and the healthy side (delta R = 1.0 +/- 0.9) were significantly higher compared to follow-up studies after recovery (delta R = 0.0 +/- 0.1, p = 0.005 Wilcoxon-test). The computer based detection of bronchial breathing can be considered useful as part of a quantitative monitoring of patients at risk to develop pneumonia.     

Transmission to the chest of sound introduced at the mouth

We examined the transmission to the chest wall of white noise and 25-Hz square-wave-generated noise introduced at the mouth of five healthy subjects. The output audio signals were recorded over the left and right upper and lower lung zones, posteriorly. Sound measurements were made during apnea at functional residual capacity, total lung capacity, and residual volume both after breathing air and an 80% He-20% O2 (heliox) gas mixture. We calculated the peak-to-peak amplitude, the peak frequency, and the midpower frequency of the output sound. We found no consistent variations in the values of these indexes due to lung volume or resident gas density. In all cases, the transmitted sound was most intense at the right upper zone. This could not be explained on the basis of technical factors but was probably the result of normal asymmetry of the mediastinal anatomy. These data suggest that sound introduced through the mouth of healthy individuals excites intrathoracic structures but is transmitted through the parenchyma in such a manner that it is not markedly affected by familiar physiological variables. This must be taken into account if objective acoustical tests of lung physiology are to be developed.     

Physics of directional hearing in the cricket Gryllus bimaculatus

In the cricket ear, sound acts on the external surface of the tympanum and also reaches the inner surface after travelling in at least three pathways in the tracheal system. We have determined the transmission gain of the three internal sound pathways; that is, the change of amplitude and phase angle from the entrances of the tracheal system to the inner surface of the tympanum. In addition, we have measured the diffraction and time of arrival of sound at the ear and at the three entrances at various directions of sound incidence. By combining these data we have calculated how the total driving force at the tympanum depends on the direction of sound. The results are in reasonable agreement with the directionality of the tympanal vibrations as determined with laser vibrometry.At the frequency of the calling song (4.7 kHz), the direction of the sound has little effect on the amplitudes of the sounds acting on the tympanum, but large effects on their phase angles, especially of the sound waves entering the tracheal system at the contralateral side of the body. The master parameter for causing the directionality of the ear in the forward direction is the sound wave entering the contralateral thoracic spiracle. The phase of this sound component may change by 130–140° with sound direction. The transmission of sound from the contralateral inputs is dominated by a very selective high-pass filter, and large changes in amplitude and phase are seen in the transmitted sounds when the sound frequency changes from 4 to 5 kHz. The directionality is therefore very dependent on sound frequency.The transmission gains vary considerably in different individuals, and much variation was also found in the directional patterns of the ears, especially in the effects of sounds from contralateral directions. However, the directional pattern in the frontal direction is quite robust (at least 5 dB difference between the 330° and 30° directions), so these variations have only little effect on how well the individual animals can approach singing conspecifics.Abbreviations CS contralateral spiracle - CT contralateral tympanum - IS ipsilateral spiracle - IT ipsilateral tympanum - P the vectorial sum of the sounds acting on the tympanum     

Transmission of sound generated by sternal percussion

We indirectly determined the transmission path of sound generated by sternal percussion in five healthy subjects. We percussed the sternum of each subject while recording the output audio signal at the posterior left and right upper and lower lung zones. Sound measurements were done during apnea at functional residual capacity, total lung capacity, and residual volume both with the lungs filled with air and with an 80% He-20% O2 (heliox) gas mixture. Three acoustic indexes were calculated from the output sound pulse: the peak-to-peak amplitude, the peak frequency, and the mid-power frequency. We found that the average values of all indexes tended to be greater in the upper than in the ipsilateral lower lung zones. In the upper zones, peak-to-peak amplitude was greater at total lung capacity and residual volume than at functional residual capacity. Replacing air with heliox did not change these results. These experiments, together with others performed during Mueller and Valsalva maneuvers, suggest that resonance of the chest cage is the predominant factor determining the transmission of sternal percussion sounds to the posterior chest wall. The transmission seems to be only minimally affected by the acoustic characteristics of the lung parenchyma.     

Plasma volume during heat stress and exercise in women

Five women were studied during exercise and passive heating to determine whether PV dynamics were affected by the menstrual cycle. The exercise bout (80% VO2 peak) on a modified cycle ergometer and the passive heat stress were done in a hot environment (Ta = 50 degrees C, Pw = 1.61 kPa) during the follicular and luteal phase. Esophageal temperature (Tes) was measured continuously. Blood samples were drawn after each 0.2 degree C increase in Tes and VO2 was measured at that time. Initial PV was estimated at rest during the follicular phase. PV changes from rest were calculated at each Tes from Hb and Hct. During passive heating, PV decreased by a mean volume of 156 (+/- 80) ml to 2.83 (+/- 0.09) l in the follicular phase. During the luteal phase, there was a larger volume reduction (300 +/- 100 ml) during passive heating, and the final PV was lower than in the follicular phase and averaged 2.47 +/- 0.18 l. During exercise, PV decreased 463 (+/- 90) ml to 2.50 (+/- 0.11) l in the follicular and 381 (+/- 70) ml to 2.50 (+/- 0.23) l in the luteal phase. These data indicate that there is a menstrual cycle effect on PV dynamics during passive heating such that more fluid is shifted out of the vasculature during the luteal phase. During severe exercise there is a greater fluid loss during the follicular phase, yet the final PV is not different between phases.     

Effects of Acoustic Context on the Perceptual Differences between Spatial Sound Stimuli

We studied the effects of the acoustic context on active and passive discrimination of moving sound signals. Different contexts were created by reversing the role of standard and deviant stimuli in the oddball blocks, while their acoustical features were kept the same. Three types of sounds were used as standard or deviant stimuli in different blocks: stationary midline noises and two (smooth and abrupt) moving sounds moving to the left or right of the midline. Auditory event-related potentials (ERPs) were recorded during passive listening (the sound stimulation ignored), and mismatch negativity potentials (MMNs) were obtained. Active discrimination of sound movements was measured by the hit rate (percent correct responses) and false alarm rate, as well as the reaction time. The influence of the stimulus context on active and passive discrimination of the moving sound stimuli was reflected in the phenomenon known as the effect of deviance direction. The hit rate and MMN amplitude were higher when the deviant moved faster than the standard. The MMN amplitude was more responsive to the velocity of sound stimuli than the hit rate and false alarm rate. The psychophysical measurements in the reversed contexts suggest that smooth and abrupt sound movements may belong to the same perceptual category (moving sounds), while the stationary stimuli form another perceptual category.     

Phonospirometry for noninvasive measurement of ventilation: methodology and preliminary results.

We measured tracheal flow from tracheal sounds to estimate tidal volume, minute ventilation (VI), respiratory frequency, mean inspiratory flow (VT/TI), and duty cycle (TI/Ttot). In 11 normal subjects, 3 patients with unstable airway obstruction, and 3 stable asthmatic patients, we measured tracheal sounds and flow twice: first to derive flow-sound relationships and second to obtain flow-volume relationships from the sound signal. The flow-volume relationship was compared with pneumotach-derived volume. When subjects were seated, facing forward and with neck rotation, flexion, and standing, flow-volume relationship was within 15% of pneumotach-derived volume. Error increased with neck extension and while supine. We then measured ventilation without mouthpiece or nose clip from tracheal sounds during quiet breathing for up to 30 min. Normal results +/- SD revealed tidal volume = 0.37 +/- 0.065 liter, respiratory frequency = 19.3 +/- 3.5 breaths/min, VI = 6.9 +/- 1.2 l/min, VT/TI = 0.31 +/- 0.06 l/s, and TI/Ttot = 0.37 +/- 0.04. Unstable airway obstruction had large VI due to increased VT/TI. With the exception of TI/Ttot, variations in ventilatory parameters were closer to log normal than normal distributions and tended to be greater in patients. We conclude that phonospirometry measures ventilation reasonably accurately without mouthpiece, nose clip, or rigid postural constraints.     

Male Courtship Sounds in a Teleost with Alternative Reproductive Tactics, the Grass Goby, Zosterisessor ophiocephalus

Male grass gobies show two alternative breeding tactics, territorial and sneaker, distinguished by body size and difference in ray elongation on the second dorsal fin. The larger males, with elongated fins, are territorial and emit sounds during courtship. Smaller males, without elongated fins, act as sneakers. Both large and small males produce sounds in the presence of a ripe female. Males produce a grunt, lasting about 300ms, made up of pulses repeated at a low rate (22–68pps). Pulse duration, number, and repetition rate, did not differ between the two male types, but dominant frequency and sound amplitude did. Dominant frequency had a strong, inverse relationship with body size, whereas sound amplitude showed a weak positive relation to body size. Male size, and not the particular reproductive male tactic employed, is the most important correlate of sound properties in this species.     

Acoustic evidence of airway opening during recruitment in excised dog lungs.

The aim of this study was to test the hypothesis that the mechanism of recruitment and the lower knee of the pressure-volume curve in the normal lung are primarily determined by airway reopenings via avalanches rather than simple alveolar recruitments. In isolated dog lung lobes, the pressure-volume loops were measured, and crackle sounds were recorded intrabronchially during both the first inflation from the collapsed state to total lobe capacity and a second inflation without prior degassing. The inflation flow contained transients that were accompanied by a series of crackles. Discrete volume increments were estimated from the flow transients, and the energy levels of the corresponding crackles were calculated from the sound recordings. Crackles were concentrated in the early phase of inflation, with the cumulative energy exceeding 90% of its final value by the lower knee of the pressure-volume curve. The values of volume increments were correlated with crackle energy during the flow transient for both the first and the second inflations (r(2) = 0.29-0.73 and 0.68-0.82, respectively). Because the distribution of volume increments followed a power law, the correlation between crackle energy and discrete volume increments suggests that an avalanche-like airway opening process governs the recruitment of collapsed normal lungs.     

A new method for estimating voice sounds transmitted to the chest wall in children and adolescents

A new method for estimating voice sound transmission to the chest wall is proposed. The spectral characteristics of voice-transmitted sounds have been estimated in children and adolescents. A total of 37 subjects aged 7–17 yers were examined. The frequency of the first spectral peak of the voice-transmitted sounds “tree, tree” (M ± SD) is 263.7 ± 7.82 and 253 ± 4.29 Hz at ages of 7–11 and 12–14 years, respectively. In male adolescents aged 15–17 years, this frequency is decreased to 100–150 Hz. The slope of the descending segment of the spectrum on the high-frequency side of the peak steadily increases on moving from the upper to the lower zones of the lungs, which may be related to the increase in the air content of the lung tissue. The difference between the amplitudes of the first and second spectral peaks of voice-transmitted sounds over symmetric regions of the chest on the right and left sides (Me(Q75-Q25)) is ?0.1(11.0) dB and does not depend on age or sex, which can be interpreted as an average statistical symmetry of sound transmission.     

Age-bodyweight relationships to lung growth in the F344 rat as indexed by lung weight measurements

Measurements of the total lung weights and the individual weights of the lung lobes of male F344 rats ranging in age from about 30 days to 140 days or more were made in order to determine how lung growth and the growths of the individual lung lobes relate to bodyweight over the course of maturation of this species. Additionally, in this study we also compared how each lung lobe grows relative to total lung growth, evaluated the ratios of lung dry weight to wet weight and obtained information on the weights of the trachea and extra-hilar main-stem bronchi as the F344 rat matures. The wet weights WLT of the trachea-lung preparations and the pooled lobe weights WPL as functions of rat bodyweight WB could be readily described by the following logarithmic expressions: WLT = 0.596 ln WB - 1.923, r = 0.95; WPL = 0.464 ln WB - 1.566, r = 0.96. Expressed as percentages of the pooled lobe weights, the individual lobes remained at constant values as the animals grew with the exception of the right caudal lobe which decreased between bodyweights of 72 and 96 g; absolute wet weight measurements of the individual lobes indicated that the right cranial, right middle and right intermediate lobes actually decreased in weight between bodyweights of 300 and 385 g. The dry weights of the lobes consistently represented approximately 22% of the wet weights regardless of animal age or bodyweight, and on average the airways represented about 20% of the weights of the intact airway-lung preparations over the course of animal maturation.     

Transfer function of sound transmission in subglottal human respiratory system at low frequencies

The amplitude of sound transmission from the mouth to a site overlying the extrathoracic trachea and two sites on the posterior chest wall was measured in eight healthy adult male subjects at resting lung volume over the 100- to 600-Hz frequency range. The ratios of the estimated magnitude spectra of transmission of each of the chest wall sites to the tracheal site were determined, with the resulting spectra representing effective transfer functions of transmission in the subglottal system. For the group, the transfer functions exhibited a single peak, which occurred at 143 +/- 13 Hz (mean +/- SD) with a quality factor (Q) of 2.0 +/- 0.2 for the upper chest wall site and at 129 +/- 6 Hz with a Q of 2.2 +/- 0.4 for the lower site. The trend of decreasing spectral energy with increasing frequency was indicated by roll-offs of -10 +/- 4 and -17 +/- 5 dB/octave from 300 to 600 Hz at the two sites, respectively. The fundamental radial mode of a model thoracic cavity, which is a large rigid cylinder filled with lossless lung tissue, provides a good estimate of the observed low-frequency resonance. This agreement suggests that thoracic cavity resonances may have particularly important effects on sound transmission at frequencies below approximately 250 Hz, where the magnitude of parenchymal attenuation appears to be small.     

Self-controlled artificial respiration

We compared respiratory parameters during natural and self-controlled mechanical breathing to investigate mechanisms of respiratory control in alert humans. The self-control of mechanical breathing is realised manually: duration and velocity of air flow are controlled by left and right hands, resp. In this case, the respiratory afferent information is used to control activity of hand muscles but not of breathing muscles. The findings show that lung ventilation during self-controlled mechanical breathing increases by 7.5 l/min. at resting, by 6.3 l/min. during an exercise, as compared with the natural breathing. The increase in the lung ventilation occurs on account of an increase in the tidal volume but the frequency of the self-controlled mechanical breathing tends to be lesser at resting and was statistically significantly lower in exercise that at natural breathing. The exercise increases the lung ventilation by 13.0 l/min. at natural breathing and by 11.8 l/min. during self-controlled mechanical breathing. The findings suggest that the increased lung ventilation during self-controlled mechanical breathing is connected with creation of a new movement skill, and the modified pattern of self-controlled mechanical breathing is caused by a process of cortical transformation of respiratory afferents signals to efferent signals towards the hand muscles.     

Hemodynamics-driven mathematical model of first and second heart sound generation

We propose a novel, two-degree of freedom mathematical model of mechanical vibrations of the heart that generates heart sounds in CircAdapt, a complete real-time model of the cardiovascular system. Heart sounds during rest, exercise, biventricular (BiVHF), left ventricular (LVHF) and right ventricular heart failure (RVHF) were simulated to examine model functionality in various conditions. Simulated and experimental heart sound components showed both qualitative and quantitative agreements in terms of heart sound morphology, frequency, and timing. Rate of left ventricular pressure (LV dp/dt_max) and first heart sound (S1) amplitude were proportional with exercise level. The relation of the second heart sound (S2) amplitude with exercise level was less significant. BiVHF resulted in amplitude reduction of S1. LVHF resulted in reverse splitting of S2 and an amplitude reduction of only the left-sided heart sound components, whereas RVHF resulted in a prolonged splitting of S2 and only a mild amplitude reduction of the right-sided heart sound components. In conclusion, our hemodynamics-driven mathematical model provides fast and realistic simulations of heart sounds under various conditions and may be helpful to find new indicators for diagnosis and prognosis of cardiac diseases.New & noteworthyTo the best of our knowledge, this is the first hemodynamic-based heart sound generation model embedded in a complete real-time computational model of the cardiovascular system. Simulated heart sounds are similar to experimental and clinical measurements, both quantitatively and qualitatively. Our model can be used to investigate the relationships between heart sound acoustic features and hemodynamic factors/anatomical parameters.     

Lack of alveolar O2 during lung reperfusion does not decrease edema formation

We previously reported that pulmonary arterial occlusion for 48 h followed by 4 h of reperfusion in awake dogs results in marked edema and inflammatory infiltrates in both reperfused and contralateral lungs (Am. Rev. Respir. Dis. 134: 752-756, 1986; J. Appl. Physiol. 63: 942-950, 1987). In this experiment we study the effects of alveolar hypoxia on this injury. Anesthetized dogs underwent thoracotomy and occlusion of the left pulmonary artery. Twenty-four hours later the dogs were reanesthetized, and a double-lumen endotracheal tube was placed. The right lung was continuously ventilated with an inspiratory O2 fraction (FIO2) of 0.35. In seven study animals the left lung was ventilated with an FIO2 of 0 for 3 h after the left pulmonary artery occluder was removed. In six control animals the left lung was ventilated with an FIO2 of 0.35 during the same reperfusion period. Postmortem bloodless wet-to-dry weight ratios were 5.87 +/- 0.20 for the left lower lobe and 5.32 +/- 0.12 for the right lower lobe in the dogs with hypoxic ventilation (P less than 0.05 for right vs. left lobes). These values were not significantly different from the control dog lung values of 5.94 +/- 0.22 for the left lower lobe and 5.11 +/- 0.07 for the right lower lobe (P less than 0.05 for right vs. left lobes). All values were significantly higher than our laboratory normal of 4.71 +/- 0.06. We conclude that reperfusion injury is unaffected by alveolar hypoxia during the reperfusion phase.     

Three-dimensional characterization of regional lung deformation

The deformation of the lung during inspiration and expiration involves regional variations in volume change and orientational preferences. Studies have reported techniques for measuring the displacement field in the lung based on imaging or image registration. However, means of interpreting all the information in the displacement field in a physiologically relevant manner is lacking. We propose three indices of lung deformation that are determinable from the displacement field: the Jacobian--a measure of volume change, the anisotropic deformation index--a measure of the magnitude of directional preference in volume change and a slab-rod index--a measure of the nature of directional preference in volume change. To demonstrate the utility of these indices, they were determined for six human subjects using deformable image registration on static CT images, registered from FRC to TLC. Volume change was elevated in the inferior-dorsal region as should be expected for breathing in the supine position. The anisotropic deformation index was elevated in the inferior region owing to proximity to the diaphragm and in the lobar fissures owing to sliding. Vessel regions in the lung had a significantly rod-like deformation compared to the whole lung. Compared to upper lobes, lower lobes exhibited significantly greater volume change (19.4% and 21.3% greater in the right and left lungs on average; p<0.005) and anisotropy in deformation (26.3% and 21.8% greater in the right and left lungs on average; p<0.05) with remarkable consistency across subjects. The developed deformation indices lend themselves to exhaustive and physiologically intuitive interpretations of the displacement fields in the lung determined through image-registration techniques or finite element simulations.     

Postnatal development of the denervated lung in normoxia, hypoxia, or hyperoxia.

We asked whether lung innervation was essential for the normal postnatal development of the lung in conditions of normoxia, hypoxia, or hyperoxia. Litters of newborn rats were assigned to a normoxic [inspired oxygen partial pressure (PIO2) = 150 Torr, eight litters], hypoxic (PIO2 = 100 Torr, nine litters), or hyperoxic (PIO2 = 360 Torr, nine litters) group. Each litter consisted of 12 pups. Two days after birth, one-third of the litter had the vagus and sympathetic trunk cut in the neck on the left side [left denervated (L)], one-third was denervated on the right side (R), and one-third was sham-operated (S). From day 3, all pups were exposed to the designed PIO2, until day 8 or days 21-22. Almost all rats, whether S, R, or L, survived in normoxia and hyperoxia, whereas in hypoxia survival at day 22 of R and L was approximately 60-65%. Body growth was the same in S, R, and L and less in hypoxia than in normoxia or hyperoxia. At days 8 and 22, hematocrit and hemoglobin concentration, heart and lung dry and wet weights, and lung DNA content did not differ among S, R, and L, whether the pups were raised in normoxia, hypoxia, or hyperoxia. At days 21-22, aerobic metabolism and breathing pattern, both measured during air breathing, as well as compliance of isolated lungs, were also similar among S, R, and L for each of the conditions in which the pups were raised.(ABSTRACT TRUNCATED AT 250 WORDS)     

Analysis of diaphragm movement during tidal breathing and during its activation while breath holding using MRI synchronized with spirometry

Using magnetic resonance imaging (MRI) in conjunction with synchronized spirometry we analyzed and compared diaphragm movement during tidal breathing and voluntary movement of the diaphragm while breath holding. Breathing cycles of 16 healthy subjects were examined using a dynamic sequence (77 slices in sagittal plane during 20 s, 1NSA, 240x256, TR4.48, TE2.24, FA90, TSE1, FOV 328). The amplitude of movement of the apex and dorsal costophrenic angle of the diaphragm were measured for two test conditions: tidal breathing and voluntary breath holding. The maximal inferior and superior positions of the diaphragm were subtracted from the corresponding positions during voluntary movements while breath holding. The average amplitude of inferio-superior movement of the diaphragm apex during tidal breathing was 27.3+/-10.2 mm (mean +/- SD), and during voluntary movement while breath holding was 32.5+/-16.2 mm. Movement of the costophrenic angle was 39+/-17.6 mm during tidal breathing and 45.5+/-21.2 mm during voluntary movement while breath holding. The inferior position of the diaphragm was lower in 11 of 16 subjects (68.75 %) and identical in 2 of 16 (12.5 %) subjects during voluntary movement compared to the breath holding. Pearson's correlation coefficient was used to demonstrate that movement of the costophrenic angle and apex of the diaphragm had a linear relationship in both examined situations (r=0.876). A correlation was found between the amplitude of diaphragm movement during tidal breathing and lung volume (r=0.876). The amplitude of movement of the diaphragm with or without breathing showed no correlation to each other (r=0.074). The movement during tidal breathing shows a correlation with the changes in lung volumes. Dynamic MRI demonstrated that individuals are capable of moving their diaphragm voluntarily, but the amplitude of movement differs from person to person. In this study, the movements of the diaphragm apex and the costophrenic angle were synchronous during voluntary movement of the diaphragm while breath holding. Although the sample is small, this study confirms that the function of the diaphragm is not only respiratory but also postural and can be voluntarily controlled.     

Characteristics of the spatio-temporal organization of the P300 component of AEP during the "active" and "passive" stimulus perception in healthy subjects

The concern of the work was in detection and analysis of P300 component of the acoustic evoked potential in healthy subjects in different experimental situations. During counting the rare sounds, P300 was most pronounced in the frontocentral and parietooccipital areas mainly of the left-hemisphere. The response shape was correlated with characteristics of the basic rhythm of the background EEG. Responses of simple and complex shapes were distinguished. The simplest responses were recorded in subjects with hypersynchronous alpha-rhythm. Analysis of three-dimensional dipole source localization showed that structures of the brainstem, limbic system, and frontal lobes participate in generation of the wave. In all the subjects, the decisive role in response generation was played by the brainstem structures. In persons with hypersynchronous alpha-rhythm, the contribution of the frontal lobes was less pronounced. During "passive" listening of sounds, P300 parameters significantly differed from those observed during counting only in 46% of cases (in persons having no hypersynchronous alpha-rhythm). A simplification of the response shape during "passive" listening was observed in these cases, the area of the maximal response expression was shifted to symmetrical areas of the right-hemisphere, the number of dipole sources reduced due to a decrease in the contribution of the frontal and limbic structures into the response generation.     

Measurement and theory of wheezing breath sounds

We measured the time and frequency domain characteristics of breath sounds in seven asthmatic and three nonasthmatic wheezing patients. The power spectra of the wheezes were evaluated for frequency, amplitude, and timing of peaks of power and for the presence of an exponential decay of power with increasing frequency. Such decay is typical of normal vesicular breath sounds. Two patients who had the most severe asthma had no exponential decay pattern in their spectra. Other asthmatic patients had exponential patterns in some of their analyzed sound segments, with a range of slopes of the log power vs. log frequency curves from 5.7 to 17.3 dB/oct (normal range, 9.8-15.7 dB/oct). The nonasthmatic wheezing patients had normal exponential patterns in most of their analyzed sound segments. All patients had sharp peaks of power in many of the spectra of their expiratory and inspiratory lung sounds. The frequency range of the spectral peaks was 80-1,600 Hz, with some presenting constant frequency peaks throughout numerous inspiratory or expiratory sound segments recorded from one or more pickup locations. We compared the spectral shape, mode of appearance, and frequency range of wheezes with specific predictions of five theories of wheeze production: 1) turbulence-induced wall resonator, 2) turbulence-induced Helmholtz resonator, 3) acoustically stimulated vortex sound (whistle), 4) vortex-induced wall resonator, and 5) fluid dynamic flutter. We conclude that the predictions by 4 and 5 match the experimental observations better than the previously suggested mechanisms. Alterations in the exponential pattern are discussed in view of the mechanisms proposed as underlying the generation and transmission of normal lung sounds. The observed changes may reflect modified sound production in the airways or alterations in their attenuation when transmitted to the chest wall through the hyperinflated lung.