With more elderly people in the population there are more people surviving with lung diseases that need assessing so that the best treatment options can be chosen and delivered. Lung function is known to deteriorate with age and this is largely due to a reduction in muscle strength, an increased alveolar size leading to reduced elastic recoil, and a reduction in chest wall compliance. The processes involved are outlined together with the effects this has on normal lung function. Tests of lung function are commonly used to determine whether an individual patient's lungs are working abnormally, and using a lower limit of normal is the best method to use. The problems and solutions for defining the lower limit of normal for older subjects are discussed. If a subject's lung function is deemed abnormal from comparing their tests against a predicted value, then assessing how severe this abnormality is can be determined by using the results as per cent of predicted, or better still by relating the value to a minimum survivable limit.

We describe two patients, aged seven and 21 years, with unilateral atresia of a solitary pulmonary vein. Until now, to the best or our knowledge, this condition has been reported only twice. Although symptoms, diagnostic measures and treatment have been described in detail, clinical diagnosis is still difficult.