bluuebunny/crossref_metadata_2025 huggingface dataset:
Tachykinins and airway microvascular leakage induced by HCl intra-oesophageal instillation
Authors: Daoui S. , D'Agostino B. , Gallelli L. , Emonds Alt X. , Rossi F. , Advenier C.
Published: October 2002

Gastro-oesophageal reflux is a common clinical disorder associated with a variety of respiratory symptoms, including chronic cough and exacerbation of asthma. In this study, the potential role of acid-induced tachykinin release was examined in guinea pigs and rabbits, by examining the effects of the tachykinin NK1and NK3receptors antagonists (SR 140333 and SR 142801, respectively) (1–10 mg·kg−1) on plasma protein extravasation induced in airways by hydrochloric acid (HCl) infusion in the oesophagus.

Guinea pigs were anaesthetised with urethane, while rabbits were subject to neuroleptoanalgesia with hypnorm. Airway vascular leakage was evaluated by measuring extravasation of Evans blue dye. All animals were pretreated with atropine (1 mg·kg−1i.p.), propranolol (1 mg·kg−1i.p.), phosphoramidon (2.5 mg·kg−1i.v.) and saline or tachykinin receptor antagonists (1–10 mg·kg−1i.p.).

Infusion of 1 N HCl into the oesophagus led to a three- and five-fold increase in plasma extravasation in the main bronchi and trachea, respectively. This increase was largely prevented by the tachykinin NK1and NK3receptor antagonists SR 140333 and SR 142801 (1–10 mg·kg−1).

These results suggest that protein extravasation in the airways, as induced by intra-oesophageal HCl infusion, is mainly dependent on the release of tachykinins, and that both NK1and NK3tachykinin receptors are involved. The results suggest that HCl-induced sensory nerve stimulation may act in the periphery on intermediate neurons and/or ganglia where NK3receptors have been shown to play an important role.
The association between diet and chronic obstructive pulmonary disease in subjects selected from general practice
Authors: Watson L. , Margetts B. , Howarth P. , Dorward M. , Thompson R. , Little P.
Published: October 2002

It is unclear why some smokers develop chronic obstructive pulmonary disease (COPD) whilst the majority do not. Antioxidants found in food may protect against lung tissue injury, but previous epidemiological studies are inconsistent and do not focus on those most at risk of COPD, namely smokers. This case-controlled study measured the difference in dietary intake between smokers and exsmokers with and without COPD.

Cases were patients >45 yrs of age with >10 pack-yrs of smoking, a forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) of ≤70% and a FEV1of ≤80% of predicted. Controls were patients >45 yrs of age with >10 pack-yrs of smoking, a FEV1/FVC of >70% and a FEV1>80% pred. Data were collected using validated questionnaires. Logistic regression analysis for an unmatched case-controlled study was performed.

After controlling for other independent predictors of COPD, those with vegetable intake of ≥1 portion·day−1(93 g) were less likely to have COPD, as were those consuming ≥1.5 portions·day−1of fruit. This was not due to an overall reduction in food/calorie intake caused by the disease because: 1) adjusting for body mass index did not alter the estimates; 2) the effect was specific to fruit and vegetables,i.e.not other food groups; and 3) the estimates from incident cases were similar.

In conclusion, fruit and vegetable consumption is inversely associated with chronic obstructive pulmonary disease and may explain why some smokers do not develop chronic obstructive pulmonary disease.
Omalizumab provides long-term control in patients with moderate-to-severe allergic asthma
Authors: Buhl R. , Solèr M. , Matz J. , Townley R. , O'Brien J. , Noga O. , Champain K. , Fox H. , Thirlwell J. , Della Cioppa G.
Published: October 2002

The ability of omalizumab, an anti-immnoglobulin‐E agent, to maintain long‐term disease control in patients with moderate-to-severe allergic asthma was investigated in a 24‐week double-blind extension to a 28‐week core trial.

During the extension, 483 of the initial 546 patients were maintained on randomised treatment and the lowest sustainable dose of beclomethasone dipropionate (BDP) as established during the steroid-reduction phase of the core trial. The use of concomitant asthma medication was permitted and investigators were allowed to adjust the BDP dose or switch patients from BDP to other asthma medications if deemed necessary.

More omalizumab-treated patients (33.5%) than placebo-treated patients (13.5%) were able to complete the extension period without requiring inhaled corticosteroid treatment. The mean BDP equivalent dose throughout the extension was lower in the omalizumab group (25 µg·day−1) than in the placebo group (43 µg·day−1). Disease control was sustained in 76% of omalizumab patients compared with 59.4% of placebo patients free from an asthma exacerbation during the extension period. Compared with placebo, fewer patients in the omalizumab group used other concomitant asthma medication during the extension. Treatment with omalizumab was well tolerated and the incidence of adverse events was similar between groups.

In conclusion, these results suggest that omalizumab is a promising new agent for the long-term control of allergic asthma.
Improved quality of life after lung volume reduction surgery
Authors: Hamacher J. , Büchi S. , Georgescu C.L. , Stammberger U. , Thurnheer R. , Bloch K.E. , Weder W. , Russi E.W.
Published: October 2002

Lung volume reduction surgery (LVRS) improves dyspnoea, pulmonary function, and physical performance in patients with severe pulmonary emphysema. This study investigated the impact of LVRS on health-related quality of life (HRQL) over a 2-yr period following surgery.

Thirty-nine consecutive patients were prospectively assessed before LVRS, and followed over 24 months postoperatively. The assessments included pulmonary function, dyspnoea (Medical Research Council (MRC) dyspnoea score), 6-min walking distance (6MWD) and HRQL using the Short Form 36-item questionnaire (SF-36) .

Several domains of SF-36 improved considerably over 2 yrs after surgery: Physical Functioning: 39±4 (mean±sem)versus16±2 (p<0.01); Vitality: 51±3versus32±3 (p<0.01); Social Functioning: 72±4versus51±5 (p<0.01). Also, improvements in pulmonary function (forced expiratory volume in one second (FEV1): 27±1% predicted, residual volume (RV)/total lung capacity (TLC): 0.65±0.01), 6 MWD (274±16 m) and dyspnoea (MRC: 3.9±01) were sustained for up to 2 yrs after LVRS (FEV136±2% pred, RV/TLC: 0.58±0.02; 6 MWD: 342±19 m; MRC: 2.0±0.2; p<0.05).

In patients with severe emphysema, lung volume reduction surgery had positive effects on health-related quality of life and pulmonary function over 2 yrs.
Detection ofChlamydia pneumoniaein unexplained pulmonary hypertension
Authors: Theegarten D. , Anhenn O. , Aretz S. , Maass M. , Mogilevski G.
Published: October 2002

The pathogenesis of primary pulmonary hypertension is still unclear. The case of a 68-yr-old female patient who complained of recurrent dizzy spells and collapses over a period of 6 weeks and died of global cardiac failure is presented.

Autopsy revealed severe pulmonary hypertension, slight chronic bronchitis, and bronchiolitis as well as intra-alveolar accumulation of macrophages. Chlamydiae were detected within the pulmonary arteries and in intramural and intra-alveolar macrophages by immunofluorescence, confocal laser scanning microscopy, scanning and transmission electron microscopy. Nested-polymerase chain reaction (PCR) and nonradioactive deoxyribonucleic acid (DNA) hybridization of PCR products from pulmonary arteries revealedChlamydia pneumoniaeDNA.

Chlamydia pneumoniaehas already been detected in atherosclerosis and in pulmonary emphysema. It can induce proliferation of smooth muscle cells.Chlamydia pneumoniaemight be relevant in aggravation of primary pulmonary hypertension and might perhaps be a trigger factor in some cases.
Prednisone-dependent asthma: inflammatory indices in induced sputum
Authors: Pizzichini MM , Pizzichini E , Clelland L , Efthimiadis A , Pavord I , Dolovich J , Hargreave FE
Published: October 2002

The kinetics of changes in inflammatory indices in induced sputum from eight prednisone dependent asthmatics whose minimum clinical maintenance and exacerbation doses were known were investigated. The study began on the last day of a course of 30 mg prednisone daily for one week. Thereafter, the daily prednisone was reduced in a structured way to below the maintenance dose. This treatment was continued until a clinical exacerbation occurred. Prednisone 30 mg daily was then given again for one week. The mean duration of prednisone reduction was 7.4 weeks and the median dose was 7.5 mg x day(-1). Increases in sputum eosinophils preceded increases in blood eosinophils by 4 weeks and worsening of symptoms and forced expiratory volume in one second by 6 weeks. The clinical exacerbation was also accompanied by sputum neutrophilia and increases in sputum eosinophil cationic protein (ECP), fibrinogen and interleukin (IL)-5. Treatment with prednisone suppressed median sputum eosinophilia (from 16.3 to 0%, p<0.001), decreased sputum ECP (from 7,480 to 700 microg x L(-1), p = 0.01), but did not improve neutrophil numbers, fibrinogen or IL-5. The results show that the reduction of prednisone treatment in prednisone-dependent asthmatics evokes a severe airway eosinophilic inflammatory response. Clinical and blood indices deteriorate later than those in sputum suggesting that sputum examination may be useful to identify the minimum regular dose of prednisone required in these patients.
Allergen challenge-induced acute exudation of IL-8, ECP and alpha2-macroglobulin in human rhinovirus-induced common colds
Authors: Greiff L , Andersson M , Svensson C , Linden M , Myint S , Persson CG
Published: October 2002

Rhinovirus infections cause exacerbations of eosinophilic airway disease. The acute effects of allergen-challenge on nasal interleukin-8 (IL-8), eosinophil cationic protein (ECP), and alpha2-macroglobulin were examined in atopic subjects with common cold symptoms. Twenty-three patients with seasonal allergic rhinitis were inoculated with human rhinovirus 16 outside the pollen season. Diluent and allergen challenges, followed by nasal lavages, were carried out about 3 months before and 4 days after virus inoculation. Seventeen patients developed significant common cold symptoms with increased nasal lavage fluid levels of alpha2-macroglobulin, IL-8, and ECP at baseline (p<0.001-0.05 versus before inoculation), and were further increased by allergen challenge (p< 0.001-0.05); IL-8 and ECP levels were correlated (r = 0.63, p<0.001). Before inoculation, the six patients who later did not develop common cold symptoms had high levels of IL-8 and myeloperoxidase (MPO), and exhibited strong allergen-induced plasma exudation responses (alpha2-macroglobulin). After inoculation, IL-8 and ECP did not increase in these symptomless subjects. In conclusion, high nasal interleukin-8 and myeloperoxidase levels and exudative hyperresponsiveness may protect against infection. The association between nasal interleukin-8 and eosinophil cationic protein in common cold, particularly that observed in nasal lavage fluids after allergen-induced acute exudation of plasma, suggests the involvement of interleukin-8 in exacerbation of airway mucosal eosinophil activity.
Changes in exhaled carbon monoxide and nitric oxide levels following allergen challenge in patients with asthma
Authors: Paredi P , Leckie MJ , Horvath I , Allegra L , Kharitonov SA , Barnes PJ
Published: October 2002

Carbon monoxide is a product of haem degradation by haem oxygenase (HO), activated by inflammatory cytokines and oxidants. This study examined whether allergen challenge can increase exhaled CO levels, as a reflection of HO activation. Exhaled CO and nitric oxide, an expired gas also thought to reflect cytokine-induced airway inflammation, were measured in 15 atopic steroid-naive nonsmoking patients with asthma (13 males, aged 30+/-2 yrs) before and for up to 20 h after allergen challenge. Baseline CO (4.4+/-0.3 parts per million (ppm)) and NO (20.6+/-1.2 parts per billion (ppb)) levels were elevated in asthmatic as compared with nonsmoking normal volunteers (n = 37, 2.1+/-0.2 ppm and 7.0+/-0.1 ppb, respectively, p<0.05). In 10 patients with a dual response in the forced expiratory volume in one second (FEV1) there was a maximal increase in exhaled CO at 1 h (343+/-7.1%) and at 6 h (69+/-12%, p<0.01), followed by a maximal fall in FEV1 (28+/-9%, p<0.05) at 9 h, whereas the maximal NO increase was observed at 10 h (50.2+/-11.8%). The maximal increase in exhaled CO in single response patients (n = 5) was 30+/-2% during the early asthmatic reaction and 46.3+/-9.2% between 4 and 10 h, followed by a fall in FEV1 (9+/-3%, p>0.05) at 9 h, whereas exhaled NO was not significantly changed. In five patients exhaled CO was not attenuated by inhalation of increasing concentrations of histamine causing a 20% fall in FEV1 (PC20) or its subsequent relief by beta2-agonists. In conclusion, exhaled carbon monoxide is increased during the early and late asthmatic reactions independently of the change in airway calibre, while exhaled nitric oxide is increased only during the late reaction and follows the increase in carbon monoxide and fall in the forced expiratory volume in one second in time.
Bronchoalveolar lavage findings in patients with chronic nonproductive cough
Authors: McGarvey LP , Forsythe P , Heaney LG , MacMahon J , Ennis M
Published: October 2002

Mast cells and eosinophils may play a role in the pathophysiology of chronic cough in nonasthmatics. It is unknown, however, whether degranulation of these cells occurs in the airways of such patients. Thirty-five nonsmoking patients referred with a chronic nonproductive cough (mean cough duration 76.2 months) were evaluated using a comprehensive diagnostic protocol. Bronchoalveolar lavage (BAL) cell differentials and BAL histamine, tryptase and eosinophilic cationic protein (ECP) concentrations were determined. Ten nonsmoking healthy volunteers served as controls. Diagnostic subgroups were identified: eight postnasal drip syndrome (PNDS), seven cough variant asthma (CVA), seven gastro-esophageal reflux (GOR), seven dual aetiology and six idiopathic. Nonasthmatic coughers (NAC) were characterized as those patients without bronchial hyperresponsiveness on histamine challenge and whose cough had either responded to therapy for PNDS or GOR or failed to improve with antiasthma therapy. There was a significant increase in both eosinophil and mast cell numbers (p<0.05) and in histamine levels (p = 0.027) when NAC patients were compared with controls. Tryptase and ECP levels were elevated in 7 of 23 and 6 of 23 NAC patients, respectively. In conclusion, airway inflammatory cell numbers are not only increased but also activated, suggesting an important role for airways inflammation in the pathophysiology of chronic nonproductive cough.
Expired hydrogen peroxide in breath condensate of cystic fibrosis patients
Authors: Ho LP , Faccenda J , Innes JA , Greening AP
Published: October 2002

Stimulated inflammatory cells release large amounts of hydrogen peroxide (H2O2). Breath condensate H2O2 has been shown to be elevated in stable asthmatic children, chronic obstructive pulmonary disease and intubated adult respiratory distress syndrome. In cystic fibrosis airways, where neutrophilic inflammation dominates, it is postulated that H2O2 in breath condensate would be elevated and may be used as a marker of airways inflammation. Expired breath condensate was collected from 16 clinically stable cystic fibrosis (CF) patients (mean age 25.3 yrs, mean forced expiratory volume in one second (FEV1) 50.2%) and 14 normal subjects (mean age 29.9 yrs). Total plasma leukocyte, neutrophil, monocyte and eosinophil counts and lung function were also measured on the day of collection. A method of breath condensate collection excluding the confounding factors of nasal air and saliva contamination was validated and used and H2O2 measured fluorometrically using an optimized assay. The median level of H2O2 concentration in breath condensate of CF patients was lower than that in normal subjects (0.064 versus 0.089 microM), but this did not reach statistical significance (p = 0.20, Mann-Whitney rank sum test). Within the CF group, there was no correlation between H2O2 concentration and lung function. Expired breath condensate H2O2 is not elevated in patients with cystic fibrosis, and is thus not a suitable marker of airways inflammation in these patients. Possible explanations include physical barriers to its detection caused by viscous airways secretions, reaction with other reactive species or increased antioxidant activity caused by trapping of positively charged antioxidants in negatively charged airways secretions.
Clearance of inhaled technetium-99m-DTPA as a clinical index of pulmonary vascular disease in systemic sclerosis
Authors: Kon OM , Daniil Z , Black CM , du Bois RM
Published: October 2002

This study evaluated the utility of the clearance time of inhaled diethylenetriamine pentaacetate (DTPA) to distinguish pulmonary vascular disease from early fibrosing alveolitis (FA) in patients with systemic sclerosis (SSc). It was hypothesized that this would be preserved in patients with vascular disease compared with FA, despite similar gas-transfer deficits and matching lung volumes, because of the preservation of alveolar epithelial integrity. All patients had SSc and were categorized into a control group (C; n=9), pulmonary vascular group (VAS; n=14) or FA group (n=14) dependent on the appearance on a computed tomography (CT) scan and the transfer factor of the lung for carbon monoxide (T(L,CO)) (VAS and FA < or =70%, C > or =80%). All patients had a forced vital capacity (FVC) of >80%. The T(L,CO) (median) was similar in the VAS (57.5%) and FA (60%) groups. There was a significant difference in median DTPA clearance half-times between FA (21.25 min) and VAS (46.5 min) (p=0.014) and between FA and C (84.5 min) (p=0.0004). No difference was found between VAS and C (p=0.0778). Follow-up data from the VAS group showed no subsequent development of FA on the CT scan and no decrease in FVC (n=13, mean 42 months). These results suggest that clearance of diethylenetriamine pentaacetate is preserved in patients likely to have pulmonary vascular disease and may be useful in distinguishing fibrosing alveolitis from vascular disease in systemic sclerosis.
Effects of endothelin-1 on airway and parenchymal mechanics in guinea-pigs
Authors: Adamicza A , Petak F , Asztalos T , Hantos Z
Published: October 2002

The contributions of the airways and the parenchyma to the overall lung mechanical response to endothelin-1 (ET-1) have not been systematically studied. In this investigation, the ET-1 induced changes on lung mechanics in guinea-pigs were separated into airway and parenchymal components. Pulmonary impedance (ZL) data were collected between 0.5 and 21 Hz in six anaesthetized, paralysed, open-chest animals by introducing small-amplitude pseudorandom oscillations into the trachea through a wave tube. ZL was calculated before and following intravenous boluses of ET-1, with doses doubled from 0.125-2 microg x kg of body weight(-1). A model containing an airway resistance (Raw) and inertance (Iaw) and tissue damping (G) and elastance (H) was fitted to the ZL spectra in each condition. Parenchymal hysteresis (eta) was calculated as G/H. After each dose, ET-1 induced significant increases in Raw (at peak response mean+/-SEM: 424+/-129%), G (400+/-80%), H (95+/-22%) and eta (156+/-33%), whereas Iaw decreased following the two highest doses (-291+/-77%). These data suggest that the parenchymal constriction was accompanied by inhomogeneous constriction of the peripheral airways.
Secretory leukocyte proteinase inhibitor is preferentially increased in patients with acute respiratory distress syndrome
Authors: Sallenave JM , Donnelly SC , Grant IS , Robertson C , Gauldie J , Haslett C
Published: October 2002

Inappropriate release of proteases from inflammatory and stromal cells can lead to destruction of the lung parenchyma. Antiproteinases such as alpha-1-proteinase inhibitor (alpha1-Pi), secretory leukocyte proteinase inhibitor (SLPI) and elastase-specific inhibitor (elafin) control excess production of human neutrophil elastase. In the present study, the concentrations of alpha1-Pi, SLPI and elafin found in bronchoalveolar lavage (BAL) fluid from control subjects, patients at risk of developing acute respiratory distress syndrome (ARDS) and patients with established ARDS were determined. Levels of all three inhibitors were raised in patients compared with normal subjects. SLPI was increased in the group of patients who were at risk of ARDS and went on to develop the condition, compared with the "at-risk" group who did not progress to ARDS (p=0.0083). Alpha1-Pi and elafin levels were similar in these two populations. In patients with established ARDS, both alpha1-Pi and SLPI levels were significantly increased, compared to patients at risk of ARDS who did (p=0.0089) or did not (p=0.0003) progress to ARDS. The finding of increased antiproteinases shortly before the development of acute respiratory distress syndrome provide further evidence for enhanced inflammation prior to clinical disease.
Skin bruising, adrenal function and markers of bone metabolism in asthmatics using inhaled beclomethasone and fluticasone
Authors: Malo JL , Cartier A , Ghezzo H , Mark S , Brown J , Laviolette M , Boulet LP
Published: October 2002

Fluticasone propionate (FP) is generally considered to have twice the efficacy of beclomethasone dipropionate (BDP) on a weight-to-weight basis for the control of asthma, and may have lesser effects on adrenal function. However, the effects of FP and BDP on skin integrity and bone metabolism markers require further examination. Sixty-nine asthmatic subjects were enrolled in a double-blind crossover study in which, after a baseline period, they received BDP or FP (at half the dose of BDP) for two 4-month periods each. A questionnaire on skin bruising, a skin examination, tests of adrenal function and of markers of bone metabolism were performed after 2 months of each period. The number of asthma exacerbations was not significantly different for the two treatment periods (eight for BDP and nine for FP), nor were various indices of asthma control. Whereas the frequency of bruising reported by the questionnaire was not different, there were more bruises on examination for BDP (1.6+/-2.5) than for FP (1.2+/-2.3) (p=0.04). Although baseline serum cortisol was not significantly different for the two drugs, the increase in cortisol after cortrosyn was lower for BDP (357+/-158 micromol x dL(-1)) than for FP (422+/-144 micromol x dL(-1)) (p<0.01). Serum osteocalcin levels were significantly lower in subject on BDP (2.8+/-1.7 microg x mL(-1)) than on FP (3.5+/-1.9 ng x mL(-1)) (p=0.003). Other markers of bone metabolism were not significantly altered. The three major side-effects were loosely, but significantly correlated with the periods on BDP and FP. However, skin bruises, increase in cortisol after Cortrosyn and osteocalcin were not significantly correlated for the period on either BDP or FP. In conclusion, whereas fluticasone propionate used at half the dose of beclomethasone dipropionate has a comparable effect on the control of asthma, fluticasone propionate demonstrated fewer side-effects in terms of skin bruising, adrenal suppression and bone metabolism.
Severe pulmonary hypertensive diseases: a perspective
Authors: Voelkel NF , Tuder RM
Published: October 2002

Clinically "severe pulmonary hypertension" is a group of diseases. The nomenclature of pulmonary hypertensive disorders is confusing since terms like "primary", "idiopathic", "unexplained" and "plexogenic" are often used interchangeably. In this Point of view or perspective the authors challenge the validity of the traditional pathohistological classification as it had been provided by HEATH and EDWARDS [1]. A classification that is focused on histological and clinical association is proposed and a recommendation to reorder "Severe pulmonary hypertension" in an association-morphology-function context is provided. The purpose of this "perspective" is to stimulate a discussion which hopefully will lead to a change in the presently used nomenclature and classification of pulmonary hypertensive disorders.
Effect of mouth leak on effectiveness of nasal bilevel ventilatory assistance and sleep architecture
Authors: Teschler H , Stampa J , Ragette R , Konietzko N , Berthon-Jones M
Published: October 2002

Mouth leak is common during nasal ventilatory assistance, but its effects on ventilatory support and on sleep architecture are unknown. The acute effect of sealing the mouth on sleep architecture and transcutaneous carbon dioxide tension (Ptc,CO2) was tested in 9 patients (7 hypercapnic) on longterm nasal bilevel ventilation with symptomatic mouth leak. Patients slept with nasal bilevel ventilation at their usual settings on two nights in random order. On one night, the mouth was taped closed. Leak was measured with a pneumotachograph. Median leak fell from 0.35+/-0.07 (mean +/- SEM) L x s(-1) untaped to 0.06+/-0.03 L x s(-1) taped. Ptc,CO2 fell in 8/9, including all hypercapnic patients. Across all patients, the mean Ptc,CO2 fell by 1.02+/-0.28 kPa (7.7+/-2.1 mm Hg) with taping (p = 0.007). Arousal index fell in every patient. Mean arousal index fell from 35.0+/-3.0 to 13.9+/-1.2 h(-1) (p<0.0001), and rapid eye movement (REM) sleep increased from 12.9+/-1.5% to 21.1+/-1.8% sleep time (p = 0.0016). Slow wave sleep changed inconsistently, from a mean of 13.1+/-1.6% to 19.5+/-2.2% of sleep (p = 0.09). Sleep latency and efficiency were unchanged. In four healthy volunteers ventilator-induced awake hypopharyngeal pressure swing during timed bilevel ventilation fell by 35+/-5% L(-1) x s(-1) of voluntary mouth leak (p<0.0001). Mouth leak reduces effective nasal bilevel ventilatory support, increases transcutaneous carbon dioxide tension, and disrupts sleep architecture.
Bronchiolitis in Kartagener's syndrome
Authors: Homma S , Kawabata M , Kishi K , Tsuboi E , Narui K , Nakatani T , Saiki S , Nakata K
Published: October 2002

The association of diffuse bronchiolitis in patients with Kartagener's syndrome (KS) has not been reported previously. The aim of this study was to present the morphological characteristics of bronchiolitis in patients with KS. Eight patients (four males, four females; mean age 37.9+/-18.7 yrs), clinically diagnosed as KS with the classical triad of chronic pansinusitis, bronchiectasis and situs in versus with dextrocardia, were evaluated. Routine chest radiography showed bronchiectasis and dextrocardia in all patients. Chest computed tomography (CT) showed diffuse centrilobular small nodules up to 2 mm in diameter throughout both lungs in six out of eight patients. Pulmonary function tests revealed marked obstructive impairment in all patients (forced expiratory volume in one second 57.0+/-11.3%, residual volume/total lung capacity 45.+/-12.7%, maximum midexpiratory flow 0.92+/-0.72 L x s(-1), forced vital capacity 74.1+/-12.2% (all mean +/- SD)). The examination of cilial movement of the bronchus revealed immotility in all of the five patients examined. The ultrastructure showed ciliary dynein arm defects in all patients. Histopathological examination of lung specimens obtained at autopsy or by video-assisted thoracoscopic surgery showed obliterative thickening of the walls of the membranous bronchioli with infiltration of lymphocytes, plasma cells and neutrophils, but most of the distal respiratory bronchioli were spared and alveolar spaces were overinflated. Pathologically, the diffuse centrilobular small nodules on the chest CT mainly corresponded to membranous bronchiolitis. This is the first report demonstrating that the association of diffuse bronchiolitis might be one of the characteristic features of the lung in Kartagener's syndrome.
Helicobacter pylori and upper gastrointestinal symptoms in bronchiectasis
Authors: Tsang KW , Lam WK , Kwok E , Chan KN , Hu WH , Ooi GC , Zheng L , Wong BC , Lam SK
Published: October 2002

The recently reported increase in seroprevalence of Helicobacter pylori, the causative pathogen in peptic ulceration, in bronchiectasis is unexplained. Therefore, the association of antibodies directed against cytotoxin-associated gene A(CagA), whose expression indicates virulence of H. pylori, and upper gastrointestinal symptoms in patients with stable bronchiectasis and healthy volunteers evaluated. One hundred patients (mean +/- SD age 55.1+/-16.7 yrs) and 94 healthy asymptomatic subjects (54.6+/-7.6 yrs) underwent clinical and physiological assessment and serum levels of anti-H. pylori CagA were determined using standard clinical and enzyme-linked immunosorbent assay techniques. Samples were positive for anti-H. pylori CagA in 11.7% of controls and 24% of bronchiectatic subjects (p = 0.03). There was, however, no association between serum H. pylori CagA immunoglobulin G level and forced expiratory volume in one second (FEV1), forced vital capacity (FVC), sputum volume, respiratory symptoms or upper respiratory gastrointestinal symptoms (p>0.05). Patients who suffered from acid regurgitation or upper abdominal distension had significantly lower FEV1 and FVC (as a percentage of the predicted value) compared to their counterparts. The results of anticytotoxin-associated gene A measurements in this study contrasted with the previous finding that anti-Helicobacter pylori immunoglobulin G correlated with sputum volume. These findings, therefore, suggest that Helicobacter pylori, should it have a pathogenic role in bronchiectasis, could act via noncytotoxin-associated gene A-mediated mechanisms, and, in this context, gastro-oesophageal reflux might be of importance in bronchiectasis.
The relationship between moisture or mould observations in houses and the state of health of their occupants
Authors: Koskinen OM , Husman TM , Meklin TM , Nevalainen AI
Published: October 2002

This work was conducted in order to study how the health of adults is affected by the presence of moisture or mould in the home. A random sample of 310 houses in Finland was studied during the years 1993-1994. The houses were investigated for visual signs of moisture by a surveyor, and observations of mould were reported by the occupants. A moisture problem was observed in 52% and a mould problem in 27% of the houses. Health data was collected by means of a postal questionnaire from 699 adults. Exposure to moisture was significantly associated with sinusitis, acute bronchitis, nocturnal cough, nocturnal dyspnoea and sore throat, and the exposed inhabitants had significantly more episodes of common cold and tonsillitis. Exposure to mould was significantly associated with common cold, cough without phlegm, nocturnal cough, sore throat, rhinitis, fatigue and difficulties in concentration. Building-related moisture or mould increased the risk of upper and lower respiratory infections and symptoms as well as of nonrespiratory symptoms.
Value of FDG-PET in detecting residual or recurrent nonsmall cell lung cancer
Authors: Bury T , Corhay JL , Duysinx B , Daenen F , Ghaye B , Barthelemy N , Rigo P , Bartsch P
Published: October 2002

In order to evaluate the usefulness of 18-fluorodeoxyglucose (FDG) positron emission tomography (PET) in the assessment of therapeutic effects, a study was performed before and after therapy in 126 patients with non-small cell lung cancer (NSCLC) codified stage I to stage IIIB. Treatment with an early curative result was given in 58 patients, whereas in 68 cases it was limited to palliation. During the treatment follow-up period (8-40 months), each patient was evaluated every 3 months by clinical examination and < or =6 months by imaging techniques (PET and computed tomography (CT)). A diagnosis of persistent or recurrent tumour was established by means of pathological analysis in 31 patients and by clinical evolution and subsequent imaging progression in 29 other patients. PET showed increased FDG uptake in all cases (n = 60) of persistent or recurrent tumour, whereas CT was nonspecific in 17 cases. Conversely, there were five false positive cases via PET imaging and three via CT. In detecting residual or recurrent NSCLC, PET had a sensitivity of 100% and specificity of 92%, whereas CT had a sensitivity and specificity of 71% and 95% respectively. In conclusion, 18-fluorodeoxyglucose positron emission tomography correctly identified response to therapy in 96% (121 of 126) of patients. Positron emission tomography appears to be more accurate (p = 0.05) than conventional imaging in distinguishing persistent or recurrent tumour from fibrotic scar in patients undergoing treatment for non-small cell lung cancer.
Groundwater electromagnetic imaging in complex geological and topographical regions: A case study of a tectonic boundary in the French Alps
Authors: Hautot Sophie , Tarits Pascal , Perrier Frédéric , Tarits Corinne , Trique Michael
Published: October 2002

Very‐low‐frequency (VLF), audiomagnetotelluric (AMT), and water geochemistry surveys were performed on the Sur‐Frêtes Ridge in the French Alps to evaluate the groundwater circulation system within the ridge. At this site, temporal variations of the electric field have been observed in association with water‐level variations of neighboring artificial lakes. The Sur‐Frêtes Ridge is 1 km wide and trends east–west. Water samples were collected at 52 points distributed throughout the area. VLF soundings were carried out along three parallel east–west profiles, and 7 AMT soundings were carried out along an east–west profile on the top of the ridge. This site is characterized by a rugged topography of the ridge where geological and topographic trends are almost perpendicular, making the structure fully three dimensional. We constructed a 2‐D resistivity model of the ridge from 2‐D and 3‐D analyses of the VLF and AMT data, associating geology and topography models. When combined with the water chemistry data, a model is proposed for groundwater percolation below the ridge across the geological contacts. This study demonstrates that electromagnetic imaging in a highly heterogeneous context can be combined with water chemistry to map groundwater circulation at the kilometer scale. The approach is relevant for hydrogeological and environmental applications.
Gravimagnetic similarity in anomaly formulas for uniform polyhedra
Authors: Holstein Horst
Published: October 2002

Gravitational and magnetic anomalies of an arbitrary target body are linked through Poisson's differential relation. For a uniform polyhedral target, Poisson's relation reduces to an algebraic link between gravity and magnetic anomaly formulas.

The derivation is given in tensor form. It identifies for each target facet edge a vector function, in terms of which the gravitational and magnetic potential and field anomaly formulas are similarly expressed as appropriately weighted linear combinations. This similarity unifies the theory of uniform polyhedral anomalies. It benefits analysis and construction of software that naturally embraces all anomalies in a single code.

The analysis is exemplified by a discussion of singularities and by the adaptation of three gravity‐field algorithms to the remaining gravitational and magnetic cases, while retaining the respective computational advantages of the former gravity‐field algorithms.
Prediction ahead of the bit by using drill‐bit pilot signals and reverse vertical seismic profiling (RVSP)
Authors: Malusa Massimo , Poletto Flavio , Miranda Francesco
Published: October 2002

Surface drillstring axial pilot signals are used to predict reflections ahead of the drill bit. We show that part of the drill‐bit signal propagates downward in the formation, reflects upward by a seismic interface, and is then transmitted to the drillstring and the surface pilot sensors. These reflections are interpreted in drill‐bit pilot signals by means of a numerical model of the drillstring coupled to the formation at the bit–rock contact. The result is an additional, low‐cost, reverse VSP (RVSP) in the zero‐offset approximation. These while‐drilling results are integrated with conventional drill‐bit RVSP measurements and compared with other geophysical and well results.
Cross‐borehole geological interpretation model based on a fuzzy neural network and geotomography
Authors: Janakiraman Kalyan Kumar , Konno Masao
Published: October 2002

This paper demonstrates a method of predicting subsurface geological characteristics in the region between boreholes using a fuzzy neural network (FNN), inverted geophysical data (geotomogram), and fuzzy geological knowledge. Traditionally, geological interpretations are often of inadequate reliability in cross‐borehole regions because of the scarcity of quantitative data. Hence, geological interpretation has been a subjective process. Although there is a paucity of data, a fair amount of information exists in the form of human perception, summarized as either “rough maps” or “vague descriptions.” Here, a method based on fuzzy set theory that can extract rough information from conventional geological interpretations is described. The extracted data can be used with geophysical tomography data in a FNN to improve geological interpretation.

The proposed method was applied to the geological evaluation of a site where construction of an underground hydroelectric power‐generation facility was being considered. The site was roughly 500 m below the surface and is generally composed of Mesozoic sedimentary rock. The results indicate that a significantly superior geologic interpretation is obtained by incorporating rough information and by using the proposed FNN model.
Automatic velocity analysis by differential semblance optimization
Authors: Mulder W. A. , ten Kroode A. P. E.
Published: October 2002

We present a method for automatic velocity analysis of seismic data based on differential semblance optimization (DSO). The data are mapped for each offset from the time domain to the depth domain by a Born migration scheme using ray tracing with the efficient wavefront construction method. The DSO cost functional is evaluated by taking differences of the migration images for neighboring offsets. The gradient of this functional with respect to the underlying velocity model is obtained by a first‐order approximation of the adjoint‐state method, leading to an optimal complexity: the cost of evaluating the gradient is about the same as that of evaluating the functional.

The method has been applied to a marine line. Multiples turned out to be a problem, but were handled effectively by incorporating a multiple filter inside the DSO cost functional.
Multiresolution modeling and seismic wavefield reconstruction in attenuating media
Authors: Song Shougen , Innanen Kristopher
Published: October 2002

The propagation of the seismic wavefield through a viscoelastic medium is a multiresolution process, in which depth of propagation and scale are closely associated with one another. We propose the multiresolution wavefield reconstruction (MRWR) as a means to directly integrate such concepts of scale into the backpropagation component of an imaging method. MRWR produces a reconstruction of the wavefield (at some fixed depth d), in which each scale term reconstitutes the resolution that was lost as the wavefield propagated some step‐length towards the measurement surface, away from d. Concurrently, MRWR provides a stable platform for this removal of the effects of absorption in propagation. In a multiresolution model of propagation, the viscoelastic propagation kernel is seen, mathematically, to fill the role of the scale function in multiresolution theory, as it operates on a wavefield to propagate it through some distance. The suppression of high‐resolution components of the wavefield via this scaling/propagation kernel function is readily illustrated with a simple numerical example. We use this scale‐based view of propagation and the differential inversion method to provide a physical and mathematical rationale for MRWR. Two cases of the MRWR formula are derived, and applications in one dimension and two dimensions, for synthetic data, and one field data example, are presented to demonstrate its use.
Removal of scattered guided waves from seismic data
Authors: Ernst Fabian E. , Herman Gérard C. , Ditzel Auke
Published: October 2002

Near‐surface scattered waves form a major source of coherent noise in seismic land data. Most current methods for removing these waves do not attenuate them adequately if they come from other than the inline direction. We present a wave‐theory‐based method for removing (scattered) guided waves by a prediction‐and‐removal algorithm. We assume that the near surface consists of a laterally varying medium, in which heterogeneities are embedded that act as scatterers. We first estimate the dispersive and laterally varying phase slowness field by applying a phase‐based tomography algorithm on the direct groundroll wave. Subsequently, the near‐surface heterogeneities are imaged using a least‐squares criterium. Finally, the scattered guided waves are modeled and subtracted adaptively from the seismic data. We have applied this method to seismic land data and found that near‐surface scattering effects are attenuated.
An optimization of the inverse scattering multiple attenuation method for OBS and VC data
Authors: Ikelle Luc T. , Amundsen Lasse , Yoo Seung
Published: October 2002

The inverse scattering multiple attenuation (ISMA) algorithm for ocean‐bottom seismic (OBS) data can be formulated in the form of a series expansion for each of the four components of OBS data. Besides the actual data, which constitute the first term of the series, each of the other terms is computed as a multidimensional convolution of OBS data with streamer data, and aims at removing one specific order of multiples. If the streamer data do not contain free‐surface multiples, we found that the computation of only the second term of the series is needed to predict and remove all orders of multiples, whatever the water depth. As the computation of the various terms of the series is the most expensive part of ISMA, this result can produce significant savings in computation time, even in data storage, as we no longer need to store the various terms of the series. For example, if the streamer data contained free‐surface multiples, OBS seismic data of 6‐s duration, corresponding to a geological model of the subsurface with 250‐m water depth, require the computation of five terms of the series for each of the four components of OBS data. With the new implementation, in which the streamer data do not contain free‐surface multiples, we need the computation of only one term of the series for each component of the OBS data. The saving in CPU time for this particular case is at least fourfold.

The estimation of the inverse source signature, which is an essential part of ISMA, also benefits from the reduction of the number of terms needed for the demultiple to two because it becomes a linear inverse problem instead of a nonlinear one. Assuming that the removal of multiple events produces a significant reduction in the energy of the data, the optimization of this problem leads to a stable, noniterative analytic solution.

We have also adapted these results to the implementation of ISMA for vertical‐cable (VC) data. This implementation is similar to that for OBS data. The key difference is that the basic model in VC imaging assumes that data consist of receiver ghosts of primaries instead of the primaries themselves. We have used the following property to achieve this goal. The combination of VC data with surface seismic data, which do not contain free‐surface multiples, allows us to predict free‐surface multiples and receiver ghosts as well as the receiver ghosts of primary reflections. However, if the direct wave arrivals are removed from the VC data, this combination will not predict the receiver ghosts of primary reflections. The difference between these two predictions produces data containing only receiver ghosts of primaries.
Robust control for a class of modified Duffing equations
Authors: Yan Xing-Gang , Chen I-Ming , Li Hsi-Shang
Published: October 2002

In this paper, a new class of modified Duffing equations with coupled periodic forcing and damping terms is developed, and the robust control problem for the system with structural uncertainty is studied systematically. This type of modified Duffing equations originates from swimming dynamics of a shape-changing underwater vehicle. The set-point control problem is studied for the system with constant disturbance and general structural uncertainty separately. Then, the trajectory tracking problem is investigated based on the discontinuous Lyapunov control and the sliding mode control. These presented approaches do not require any statistical information of the uncertainties; only their bounds are used in the design. Simulation results are given to demonstrate the effectiveness of the control algorithms.
The evolution of cardiopulmonary bypass: lessons to be learned
Authors: Edmunds L Henry
Published: October 2002

John Gibbon conceived cardiopulmonary bypass (CPB) and performed the first intracardiac repair using extracorporeal perfusion in 1953. This achievement stimulated rapid development of the knowledge base and equipment necessary for accurate diagnoses and successful intracardiac operations. In the early 60s increasing evidence indicated that exposure of blood to nonendothelial cell surfaces produced bleeding and thrombotic complications and a massive inflammatory response. Early efforts to discover a synthetic, nonthrombogenic surface gave way to efforts to control the ‘whole-body inflammatory response’ by pharmacological means. These efforts are ongoing; progress is slow; and heparin is still required for most applications of extracorporeal perfusion technology. Nevertheless, CPB now enables over one million cardiac surgical operations each year. Future progress and the development of artificial internal organs that process blood depend upon control of the blood -surface interface without anticoagulants.
Artificial lungs: a new inspiration
Authors: Zwischenberger Joseph B , Alpard Scott K
Published: October 2002

An estimated 16 million Americans are afflicted with some degree of chronic obstructive pulmonary disease (COPD), accounting for 100,000 deaths per year. The only current treatment for chronic irreversible pulmonary failure is lung transplantation. Since the widespread success of single and double lung transplantation in the early 1990s, demand for donor lungs has steadily outgrown the supply. Unlike dialysis, which functions as a bridge to renal transplantation, or a ventricular assist device (VAD), which serves as a bridge to cardiac transplantation, no suitable bridge to lung transplantation exists. The current methods for supporting patients with lung disease, however, are not adequate or efficient enough to act as a bridge to transplantation. Although occasionally successful as a bridge to transplant, ECMO requires multiple transfusions and is complex, labor-intensive, time-limited, costly, non-ambulatory and prone to infection. Intravenacaval devices, such as the intravascular oxygenator (IVOX) and the intravenous membrane oxygenator (IMO), are surface area limited and currently provide inadequate gas exchange to function as a bridge-to-recovery or transplant. A successful artificial lung could realize a substantial clinical impact as a bridge to lung transplantation, a support device immediately post-lung transplant, and as rescue and//or supplement to mechanical ventilation during the treatment of severe respiratory failure.