bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bronchoconstriction induced by inhaled adenosine 5′-monophosphate in subjects with allergic rhinitis
Authors: Prieto L. , Gutiérrez V. , Liñana J. , Marín J. 
Published: July 2002

Adenosine and its related nucleotide, adenosine 5′-monophosphate (AMP) induce bronchoconstriction in asthmatics, probably caused by histamine release from airway mast cells. The objective of this study was to determine the effect of inhaled AMP on lung function in subjects with allergic rhinitis.A total of 52 adults (28 subjects with allergic rhinitis, 14 asthmatics and 10 healthy subjects) were challenged with increasing concentrations of AMP and methacholine. Airflow was assessed after each concentration and the response to each bronchoconstrictor agent was measured by the provocative concentration required to produce a 20% fall (PC20) in forced expired volume in one second (FEV1).All 14 asthmatics, 10 subjects with allergic rhinitis and none of the healthy controls were hyperresponsive to AMP. Subjects with allergic rhinitis had higher prevalence of hyperresponsiveness to AMP than healthy controls (p=0.038). Although the prevalence of hyperresponsiveness for methacholine and for AMP in subjects with allergic rhinitis was similar (39% and 36%, respectively), four subjects had hyperresponsiveness to methacholine but not to AMP, whereas three subjects had hyperresponsiveness to AMP but not to methacholine.To conclude, inhaled adenosine 5′-monophosphate causes airway narrowing in a significantly higher proportion of subjects with allergic rhinitis than healthy volunteers. Furthermore, methacholine and adenosine 5′-monophosphate hyperresponsiveness are not detected in the same individuals with allergic rhinitis, thus suggesting that responsiveness to the two bronchoconstrictor stimuli is not reflecting the same abnormalities of the airways.
Smoking-related interstitial lung diseases: a concise review
Authors: Ryu J.H. , Colby T.V. , Hartman T.E. , Vassallo R. 
Published: July 2002

Interstitial lung diseases (also known as diffuse infiltrative lung diseases) are a heterogeneous group of parenchymal lung disorders of known or unknown cause. These disorders are usually associated with dyspnoea, diffuse lung infiltrates, and impaired gas exchange. The majority of interstitial lung diseases are of unknown cause. Known causes of interstitial lung disease include inhalation of organic and inorganic dusts as well as gases or fumes, drugs, radiation, and infections.This review summarizes the clinical, radiological, and histopathological features of four interstitial lung disorders that have been linked to smoking. These disorders include desquamative interstitial pneumonia, respiratory bronchiolitis-associated interstitial lung disease, pulmonary Langerhans' cell histiocytosis, and idiopathic pulmonary fibrosis. Available evidence suggests most cases of desquamative interstitial pneumonia, respiratory bronchiolitis-associated interstitial lung disease, and pulmonary Langerhans' cell histiocytosis are caused by cigarette smoking in susceptible individuals. Smoking cessation should be a main component in the initial therapeutic approach to smokers with these interstitial lung diseases. In addition, smoking appears to be a risk factor for the development of idiopathic pulmonary fibrosis.
Upregulation of Fas-signalling molecules in lung epithelial cells from patients with idiopathic pulmonary fibrosis
Authors: Maeyama T. , Kuwano K. , Kawasaki M. , Kunitake R. , Hagimoto N. , Matsuba T. , Yoshimi M. , Inoshima I. , Yoshida K. , Hara N. 
Published: July 2002

The caspase cascade is an executioner of apoptosis, mediated by Fas. Fas-associating protein with death domain (FADD) interacts with Fas and initiates apoptosis through activating caspase-8. It has previously been demonstrated that the Fas-Fas ligand pathway may be involved in the pathophysiology of idiopathic pulmonary fibrosis (IPF). The aim of this study was to investigate Fas-signalling molecules in epithelial cells in IPF.The immunohistochemistry for FADD and caspase-1 and -3 and terminal deoxynucleotidyl transferase-mediated deoxyuridinetriphosphate nick endlabelling (TUNEL) methods were performed in lung tissues from 10 patients with IPF obtained by thoracoscopic biopsy and in seven normal lung parenchyma specimens. The induction of caspases expression and activation by Fas-ligation on lung epithelial cell line A549 was also investigated.The immunoreactivity grade for FADD and caspase-1 and -3, and positive signals for TUNEL were significantly increased in epithelial cells of IPF compared with controls. Fas-ligation induced upregulation of caspase-1 and -3 expression in the nucleus and cytoplasm in A549 cells. Procaspase-1, -3, and -8 were activated in apoptotic cells, but not in viable cells.Although direct measurement of the caspase activity in lung epithelial cells of idiopathic pulmonary fibrosis could not be made, these results suggest that the Fas-signalling pathway is upregulated in lung epithelial cells of idiopathic pulmonary fibrosis.
Apoptotic response of eosinophils in chronic eosinophilic pneumonia
Authors: Saita N. , Yamanaka T. , Kohrogi H. , Ando M. , Hirashima M. 
Published: July 2002

To clarify the pathogenesis of chronic eosinophilic pneumonia (CEP), the apoptosis of eosinophils from bronchoalveolar lavage (BAL-Eos) was compared with that of eosinophils from peripheral blood (PB-Eos) in six cases of CEP.The survival rate of eosinophils and the percentage of apoptotic cells of both types of eosinophils were examined, and the effects of interleukin 5 (IL-5) were evaluated. The role of Fas expression in apoptosis of these eosinophils was also studied.The survival rate of BAL-Eos on the third day of culture was significantly higher than that of PB-Eos (p<0.01). This was associated with a lower proportion of apoptotic cells in BAL-Eos than in PB-Eos; the percentages of apoptotic cells in PB-Eos and BAL-Eos after 24 h of incubation were 21.7±3.4% and 10.6±1.7% respectively. IL-5 suppressed apoptosis and increased the survival rate of both PB-Eos and BAL-Eos. It was found that the apoptotic character of BAL-Eos differed from that of PB-Eos in at least three ways. Firstly, the positive rate of Fas expression on PB-Eos was increased after 24 h of incubation, whereas that on BAL-Eos did not change. Secondly, the expression of Fas on PB-Eos was suppressed by IL-5 (18.5±4.2%–8.3±3.2%, p<0.05), whereas IL-5 failed to suppress Fas expression on BAL-Eos (3.3±1.6%–3.6±1.0%). Lastly, binding of antibody to Fas antigen induced apoptosis of PB-Eos, but not of BAL-Eos.These data suggested that Fas seemed to be involved in the apoptosis of PB-Eos, whereas BAL-Eos were Fas-resistant in chronic eosinophilic pneumonia. In conclusion, apoptosis of eosinophils might be suppressed by proinflammatory cytokines such as IL-5 leading to their accumulation in the lung. Chronic stimulation of eosinophils in the alveolar space with IL-5 may play a crucial role chronic eosinophilic disorders.
Correlation of airway obstruction and patient-reported endpoints in clinical studies
Authors: Shingo S. , Zhang J. , Reiss T.F. 
Published: July 2002

To establish the correlation among asthma efficacy parameters over a long period, data from over 1500 patients in two one-year asthma clinical trials with montelukast, a Cys-LT1antagonist, were analysed. Airway obstruction measurements, forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF), were measured at clinic visits. Patients recorded daytime symptom score, “as-needed” β-agonist use, and PEF on a daily basis.Relationships among these parameters at baseline and during the one-year treatment period were established by correlation analyses. Multiple correlations between the airway obstruction (FEV1and PEF) and patient-reported measurements were evaluated by canonical correlation analysis.Pairwise correlations of the efficacy parameters over a one-year time period were stable. Canonical correlation between the airway obstruction and patient-reported asthma efficacy endpoints was low, indicating that each category of endpoints measures a distinctively different aspect of the disease.It appears that at least one endpoint from each category should be used in asthma clinical studies.
Interlobar differences in bronchoalveolar lavage fluid from children with cystic fibrosis
Authors: Gutierrez J.P. , Grimwood K. , Armstrong D.S. , Carlin J.B. , Carzino R. , Olinsky A. , Robertson C.F. , Phelan P.D. 
Published: July 2002

Bronchoalveolar lavage (BAL) performed in specialist centres has improved the understanding of infant cystic fibrosis (CF) lung disease. As most researchers sample from a single lobe, it was determined whether BAL results could be generalized to other lung segments.Thirty-three CF children, aged 1.5–57 months, underwent in random order sequential BAL of their right middle and lingula lobes. Specimens from each lobe had separate quantitative bacteriology, cytology and cytokine analysis.Bacterial counts ≥1×105colony forming units (cfu)·mL−1were observed in nine (27%) subjects, including six involving only the right middle lobe. These six children had similar inflammatory indices in their right middle and lingula lobes, and interleukin (IL)-8 concentrations in the latter were significantly higher than that observed within the lingula lobes of the 24 CF children with bacterial counts <1×105 cfu·mL−1. Lingula neutrophil and IL-8 levels correlated best with right middle lobe bacteria numbers.This observational study in cystic fibrosis children suggests that while inflammation is detected in both lungs, bacterial distribution may be more inhomogeneous. Bronchoalveolar lavage microbiological findings from a single lobe may therefore, not be generalized to other lung segments. When performing bronchoalveolar lavage in cystic fibrosis children, it is important to sample from multiple sites.
Acute psychosis after CPAP treatment in a schizophrenic patient with sleep apnoea­hypopnoea syndrome
Authors: Chiner E. , Arriero J.M. , Signes-Costa J. , Marco J. 
Published: July 2002

A 52-yr-old man with a residual phase of schizophrenia developed sleep apnoea­hypopnoea syndrome (SAHS). After five days of continuous positive airway pressure (CPAP) treatment, the patient developed an aggressive mood with incoherence, prominent hallucinations and agitation, and attempted to hit his relatives. He was finally admitted to the hospital with an acute psychotic episode. Withdrawal of CPAP, and neuroleptic treatment controlled the episode, and clinical symptoms of SAHS reappeared 10 days later.Schizophrenia associated to sleep apnoea­hypopnoea syndrome has rarely been reported, but, to the authors' knowledge, the induction of a psychotic episode by continuous positive airway pressure treatment in a patient with sleep apnoea­hypopnoea syndrome and coexisting schizophrenia has never been previously reported.
Inhaled corticosteroid therapy reduces the risk of rehospitalization and all-cause mortality in elderly asthmatics
Authors: Sin D.D. , Tu J.V. 
Published: July 2002

Elderly patients with asthma have relatively high rates of hospitalization and mortality. Although inhaled corticosteroids have been shown to improve outcomes among younger patients with asthma, their usefulness in elderly patients has not been established. Therefore, a population-based study of patients 65 yrs of age or older, who have been hospitalized at least once with asthma in Ontario, Canada was conducted to determine the impact of inhaled corticosteroids on rehospitalization for asthma and all-cause mortality rates.Data from the Canadian Institute of Health Information was used to capture all patients 65 yrs of age and older who were hospitalized at least once, with the most responsible diagnosis of asthma in Ontario, Canada between fiscal year 1992 and 1996. This database was then linked with drug claims, physician billing and mortality databases.In total, 6,254 consecutive elderly patients with asthma were identified. Sixty percent of these patients were given at least one prescription for inhaled corticosteroids within 90 days postdischarge from their index hospitalization for asthma. Users of inhaled corticosteroids postdischarge were 29% (95% confidence interval (CI) 20%–38%) less likely to be readmitted to hospital for asthma and 39% (95% CI, 20%–53%) less likely to experience all-cause mortality compared to those who did not receive these drugs postdischarge over a one year follow-up period.These findings suggest that inhaled corticosteroids are beneficial in reducing the risk for rehospitalization and all-cause mortality in elderly patients with asthma who have recently been hospitalized for their disease.
Gas and dust exposure in underground construction is associated with signs of airway inflammation
Authors: Ulvestad B. , Lund M.B. , Bakke B. , Djupesland P.G. , Kongerud J. , Boe J. 
Published: July 2002

Exposure to gases and dust may induce airway inflammation. It was hypothesized that heavy construction workers who had been exposed to dust and gases in underground construction work for 1 yr, would have early signs of upper and lower airway inflammation, as compared to outdoor workers.A study group comprising 29 nonsmoking underground concrete workers (mean± sd age 44±12 yrs), and a reference group of 26 outdoor concrete workers (39±12 yrs) were examined by acoustic rhinometry, nasal and exhaled nitric oxide spirometry and a questionnaire on respiratory symptoms. Exposure measurements were carried out.The underground workers had higher exposure to total and respirable dust, α‐quartz and nitrogen dioxide than the references (p<0.001). The occurrence of respiratory symptoms was higher in the underground workers than in the references (p<0.05). Exhaled nitric oxide (NO) (geometric mean±sem) was higher in the underground workers than in the references (8.4±1.09versus5.6±1.07 parts per billion (ppb), p=0.001), whereas spirometric values were comparable. The underground workers had smaller nasal cross-sectional area and volume than the references, and more pronounced increases after decongestion (p<0.001).To conclude the exposure in underground construction may cause nasal mucosal swelling and increased levels of exhaled nitric oxide, indicating signs of upper and lower airway inflammation.
Assessment of passive respiratory mechanics in infants: doubleversussingle occlusion?
Authors: Goetz I. , Hoo A.F. , Lum S. , Stocks J. 
Published: July 2002

The single breath or occlusion technique (SOT) is widely used to assess passive respiratory mechanics in infants, but depends on various underlying assumptions. Recently, it has been proposed that such measurements could be internally validated by performing two brief airway occlusions during the same expiration. The aim of this study was to evaluate the use of the double occlusion technique (DOT) using a new commercially available program (Jaeger MasterScreen BabyBody Erich Jaeger GmbH, Würzburg, Germany).Paired measurements of respiratory system compliance (Crs) and resistance (Rrs) using both SOT and DOT were obtained in 18 healthy sedated infants (age range 4–41 weeks, weight 2.7–9.9 kg).There was close agreement between both methods of assessingCrsin all infants, the mean within-subject difference (95% confidence interval (CI)) for DOT−SOT being −0.06 (−0.55–+0.42) mL·kPa−1·kg−1. By contrast, estimates ofRrs,DOwere on average 20% lower than those forRrs,SO, (mean within-subject difference (95% CI) being −0.67 (−1.04–−0.31) kPa·L−1·s; p<0.01).The relatively lower values obtained forRrs,DOmay reflect the higher mean lung volume at which it was calculated. Further work is required to investigate the clinical and epidemiological relevance of this new approach, and whether there are any advantages of using both techniques when assessing passive mechanics in infants.
Diagnostic significance of surfactant proteins A and D in sera from patients with radiation pneumonitis
Authors: Takahashi H. , Imai Y. , Fujishima T. , Shiratori M. , Murakami S. , Chiba H. , Kon H. , Kuroki Y. , Abe S. 
Published: July 2002

Radiation pneumonitis (RP) is the most common complication of radiotherapy for thoracic tumours. The aim of this study was to evaluate the significance of pulmonary surfactant proteins (SP)‐A and SP‐D as new serum markers for RP.Twenty-five patients with lung tumour, who had received radiotherapy, were studied. At the completion of radiotherapy, the presence of RP was judged by chest plain radiography and chest high resolution computed tomography (HRCT).RP findings detected on chest plain radiography were seen in only three of 12 patients in whom RP was detected by HRCT. Nevertheless, both SP‐A and SP‐D concentrations in sera from the patients with RP were significantly higher than those from the 13 patients without RP (p=0.0065, p=0.0011, respectively). As with SP‐A, ratios of SP‐D at the completion, compared to at the initiation (1 week post/pre ratio), were also significantly higher in patients with RP than in patients without RP. When a post/pre ratio>1.6 was considered positive, the SP‐A and SP‐D assays showed an 83% and 85% specificity, respectively.In conclusion, serum assays of surfactant proteins A and D may be of diagnostic value for detection of radiation pneumonitis, even when the radiographic change is faint.
Airway resistance measured by the interrupter technique: expiration or inspiration, mean or median?
Authors: Bridge P.D. , McKenzie S.A. 
Published: July 2002

The measurement of airway resistance by the interrupter technique (Rint) needs standardization. Should measurements be made be during the expiratory or inspiratory phase of tidal breathing? In reported studies, the measurement of Rinthas been calculated as the median or mean of a small number of values, is there an important difference?Subjects were 2.5–5.0 yrs (median 4.0 yrs) who had previous respiratory symptoms. The Rintin expiration (RintE) and inspiration (RintI) pre and postsalbutamol, the coefficient of variation (CV) of values contributing to measurements, and bronchodilator responsiveness (BDR) in both phases were compared. Measurements using median and mean were compared.RintE was higher than RintI by 4% (p<0.01). The CV of values making up RintE and RintI, and BDR measured in expiration and inspiration were similar. The median difference between means and medians of values making up measurements was 0.6% (range −6–11%).RintE has been shown to be consistently greater then RintI but the difference in this study is small. It is suggested that one or the other is chosen as the standard. In the present data the mean of a set of values contributing to a measurement was not significantly different from the median. However, the use of the median has been recommended since it is less affected by possible outlying values such as might be included by fully automated equipment.
Urinary excretion reflects lung deposition of aminoglycoside aerosols in cystic fibrosis
Authors: Dequin P-F. , Faurisson F. , Lemarié E. , Delatour F. , Marchand S. , Valat C. , Boissinot E. , de Gialluly C. , Diot P. 
Published: July 2002

Using nebulization to deliver aminoglycosides may be of benefit in cystic fibrosis (CF) patients colonized byPseudomonas aeruginosa. However, one problem with this route is the absence of clinical parameters allowing estimation of the mass of drug deposited in the lungs (MDL). The aim of this study was to assess whether aminoglycoside excretion in the urine reflects the MDL.Fourteen studies were performed in seven CF patients. Amikacin was mixed with albumin labelled with99mTc and nebulized with an ultrasonic nebulizer. The MDL was determined by the mass-balance technique. Urine was collected during the 24 h following inhalation and was assayed for amikacin by fluorescence polorization immunoassay (FPIA).The mean±sem MDL was 14.0±2.2% of the nebulizer charge. The mean±sem amount of amikacin excreted in the urine was 20.9±4.5 mg and correlated with the MDL (r=0.93; p=0.0001). There was, however, wide intersubject variability in both deposition and excretion in the urine.Monitoring excretion of aminoglycosides in the urine allows noninvasive estimation of the mass of drug deposited in the lung in cystic fibrosis patients, which might be useful to assess the dose-response relationship in groups of patients, but intersubject variability prevents its use for individual follow-up.
Interpretation of quality of life scores from the St George's Respiratory Questionnaire
Authors: Ferrer M. , Villasante C. , Alonso J. , Sobradillo V. , Gabriel R. , Vilagut G. , Masa J.F. , Viejo J.L. , Jiménez-Ruiz C.A. , Miravitlles M. 
Published: July 2002

The aim of the study was to obtain the general population norms for the St. George's Respiratory Questionnaire (SGRQ), a specific questionnaire for respiratory diseases.The IBERPOC project was a cross-sectional study of representative samples of the general population aged between 40–69 yrs. The study sample was composed of 862 individuals. All participants considered as “probable cases” of chronic obstructive pulmonary disease (COPD) (n=460) were eligible to complete the SGRQ and among the rest of the nonprobable COPD participants (n=3,571), 10 individuals from each defined age and sex group were eligible (n=402). Weights were applied to restore general population representativity of the sample.Mean forced expiratory volume in one second (FEV1) predicted was 89.4% (sd=16.5%; range: 16–131%). Chronbach's alpha coefficients were >0.7 in the symptoms, activity and impact scales, and >0.9 in the overall scale. Symptom scale score was significantly higher among males (11.6versus7.8; p<0.01) and activity scale score was significantly higher among females (12.2versus14.6; p=0.04). In a multiple linear regression model, respiratory diseases (asthma and COPD) and FEV1% over pred showed the strongest association with the SGRQ total score. Smoking, sex, age and education were independently associated with the total SGRQ score.These results indicate that individuals from the general population presented some of the problems that are important when measuring health-related quality of life in respiratory patients, and provide St George's Respiratory Questionnaire norms, a useful method for interpreting the St George's Respiratory Questionnaire score in a given patient or study samples.
Misuse of corticosteroid metered-dose inhaler is associated with decreased asthma stability
Authors: Giraud V. , Roche N. 
Published: July 2002

This study assessed whether the improper use of pressurized metered-dose inhalers (pMDIs) is associated with decreased asthma control in asthmatics treated by inhaled corticosteroids (ICS).General practitioners (GPs) included consecutive asthmatic outpatients treated by pMDI-administered ICS and on-demand, short-acting β2-agonists. They measured an asthma instability score (AIS) based on daytime and nocturnal symptoms, exercise-induced dyspnoea, β2-agonist usage, emergency-care visits and global perception of asthma control within the preceding month; the inhalation technique of the patient also was assessed.GPs (n=915) included 4,078 adult asthmatics; 3,955 questionnaires were evaluable. pMDI was misused by 71% of patients, of which 47% was due to poor coordination. Asthma was less stable in pMDI misusers than in good users (AIS: 3.93versus2.86, p<0.001). Among misusers, asthma was less stable in poor coordinators (AIS: 4.38versus3.56 in good coordinators, p<0.001).To conclude, misuse of pressurized metered-dose inhalers, which is mainly due to poor coordination, is frequent and associated with poorer asthma control in inhaled corticosteroid-treated asthmatics. This study highlights the importance of evaluating inhalation technique and providing appropriate education in all patients, especially before increasing inhaled corticosteroid dosage or adding other agents. The use of devices which alleviate coordination problems should be reinforced in pressurized metered-dose inhaler misusers.