subjects

breathing air or oxygen at low lung volumes. It is reasonable

to conclude that the closure of small airways is the condition
that results in crackles. Explosive airway reopening is probably
normal once the airway has been closed.
Although many investigators have explored the potential
specificity of crackle features and characteristics to certain diseases
(151, 162�166), those with established clinical utility appear
to be: the presence or absence of crackles to distinguish
pulmonary fibrosis (crackles usually prominent) from sarcoidosis
(crackles usually scant or absent) (167); fine, late inspiratory
crackles indicating fibrotic lung disease and early, coarse
crackles indicating obstructive lung disease (162, 168); crackles
as an early (perhaps first) sign of asbestosis (169�171), and
crackles indicating heart failure (163, 166, 172, 173).
Despite the ease with which an experienced examiner can
distinguish fine from coarse crackles by ear, much effort has
been expended on developing and validating devices to do this
chore automatically