bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of coronavirus on human nasal ciliated respiratory epithelium
Authors: Chilvers M.A. , McKean M. , Rutman A. , Myint B.S. , Silverman M. , O'Callaghan C. 
Published: July 2002

Human coronavirus (HCoV) accounts for 15–30% of common colds, but only one case report has described the effect of a coronavirus infection, that was asymptomatic, on human respiratory epithelium.The authors examined the effects of infection with HCoV on ciliary structure and function in healthy volunteers infected by intranasal inoculation with HCoV 229E. A further four volunteers were sham infected with ultraviolet-inactivated virus. Immediately before inoculation (day 0) and 3 days later (day 3), ciliated epithelium was obtained by brushing the inferior nasal turbinate. Ciliary beat frequency was determined and beat pattern analysed for evidence of dyskinesia (0=normal, 3=severely dyskinetic) using digital high-speed video photography. Ciliary ultrastructure was examined by transmission electron microscopy. Symptom diaries were kept for the duration of the study.All subjects inoculated with HCoV, including the three who did not develop symptoms of an upper respiratory tract infection, had disruption of their respiratory epithelium on day 3. Although there was no difference in the mean ciliary beat frequency between day 0 (11.3 Hz (95% confidence interval (CI): 8.6–14.0) and day 3 (9.4 Hz (95% CI 7.2–11.6)), there was a significant increase (p<0.05) in the ciliary dyskinesia score between day 0 (0.2 (95% CI 0–0.5)) and day 3 (1.1 (95% CI 0.5–1.7). In sham-infected subjects, no differences in epithelial integrity, or ciliary structure and function were found between day 0 and day 3.Inoculation of healthy volunteers with human coronavirus caused disruption of the ciliated epithelium and ciliary dyskinesia. This is likely to impair mucociliary clearance. Damage to the respiratory epithelium, due to human coronavirus infection, may occur without overt clinical symptoms.
Increased detection of interleukin-;5 in sputum by addition of protease inhibitors
Authors: Kelly M.M. , Leigh R. , Carruthers S. , Horsewood P. , Gleich G.J. , Hargreave F.E. , Cox G. 
Published: July 2002

The measurement of interleukin (IL)-;5 in sputum is problematic, with interfering factors affecting immunoassay. The authors investigated whether sputum proteases could be acting as interfering factors by studying the effect of protease inhibitors (PI) on sputum IL-;5 measurement.Induced sputa from 20 subjects with asthma were divided into aliquots, processed with and without protease inhibitors (in low and high concentrations) and the levels of IL-;5 (spiked and endogenous) measured by enzyme immunoassay were compared.The concentration of sputum IL-;5 was significantly increased by PI, with median (interquartile range) levels processed with no, low and high PI concentrations being 0 (0), 41.8 (75.6) and 66.1 (124.4) pg·mL−1, respectively. There was also a significant increase in percentage recovery of spiked IL-;5. Although high concentrations of PI reduced cell viability, there was no effect on total or differential cell counts and low concentrations of PI had no effect on cell counts or viability.Levels of endogenous interleukin-;5 in sputum of asthmatic subjects can be significantly increased by the addition of protease inhibitors, and samples which would be regarded as negative for interleukin-;5 without protease inhibitors may instead have considerable amounts of interleukin-;5 detected.
The humoral immune response to influenza vaccination in lung transplant patients
Authors: Mazzone P.J. , Mossad S.B. , Mawhorter S.D. , Mehta A.C. , Schilz R.J. , Maurer J.R. 
Published: July 2002

The purpose of this study was to evaluate the humoral immune response to influenza vaccination in lung transplant recipients.Antibody levels to the three viral antigens included in the 1999–2000 trivalent influenza vaccine (A/Sydney/5/97-like (H3N2), A/Beijing262/95-like (H1N1), and B/Yamanashi/16/98) were measured before and 4 weeks postvaccination in 43 lung transplant recipients and 21 healthy adult controls. The ability to develop protective antibody levels, a serological response, and the magnitude of change in levels were assessed.The humoral immune response to influenza vaccination was significantly lower in the transplant group for all three viral antigens. To A/Sydney, 95% of the control group and 40% of the transplant group developed protective levels (p=0.0009); to A/Beijing, 71% of the control group and 30% of the transplant group developed protective levels (p=0.004); and to B/Yamanashi, 48% of the control group and 19% of the transplant group developed protective levels (p=0.02). Those receiving cyclosporine had lower antibody responses when compared to those receiving tacrolimus (r=−0.3056, p=0.0463).The humoral immune response to influenza vaccination in lung transplant recipients is poor. Lung transplant recipients receiving cyclosporine may have a lower antibody response than those receiving tacrolimus. Alternative prevention strategies may be needed.
Evaluation of bronchodilator responses in patients with “irreversible” emphysema
Authors: O'Donnell D.E. , Forkert L. , Webb K.A. 
Published: July 2002

Given the emerging physiological and clinical rationale for pharmacological lung-volume reduction, assessment of volume responses to bronchodilators is likely to be highly relevant in chronic obstructive pulmonary disease (COPD). The authors examined the magnitude of lung-volume reduction after acute bronchodilator treatment in patients with advanced emphysema.Eighty-four stable patients with emphysema (mean±sem forced expiratory volume in one second (FEV1): 32±1% predicted) performed spirometry and body plethysmography before and 15–30 min after 200 µg salbutamol. Only irreversible patients with a postbronchodilator change in FEV1<10% pred were considered in this study.Postsalbutamol, the majority of subjects (83%) had significant improvements in one or more lung volumes: on average, residual volume (RV), functional residual capacity (FRC), inspiratory capacity (IC), forced vital capacity and slow vital capacity changed by −18±2, −10±1, 8±1, 9±1 and 7±1% pred (p<0.0005 each). Total lung capacity (TLC) decreased 0.12±0.04 L (p<0.01). Change in IC reflected change in FRC (r=−0.60, p<0.0005), but more strongly in the 57% of patients with no significant change in TLC (r=−0.93, p<0.0005). The magnitude and frequency of volume responses were greatest in patients with the most severe COPD; for example, RV decreased by 0.51±0.09 L (23±4% pred) and 0.27±0.04 L (14±2% pred) in severe and moderate subgroups, respectively.Significant reductions in lung hyperinflation occurred in the absence of a change in forced expiratory volume in one second after low-dose salbutamol in a majority of patients with advanced emphysema; the greatest changes occurred in those with the most severe disease.
The immunology of virus infection in asthma
Authors: Message S.D. , Johnston S.L. 
Published: July 2002

The respiratory tract is commonly infected by a range of viruses with overlapping pathologies. The majority of episodic exacerbations of asthma are associated with viral infection, in particular with rhinovirus infections.Experimental rhinovirus infection in human volunteers provides a useful model of natural virus-induced asthma. The asthmatic airway is characterized by an infiltrate of eosinophils and T-lymphocytes expressing the type 2 cytokines interleukin (IL)-4, IL-5 and IL-13. An effective antiviral immune response requires early viral clearance and appropriate termination of the immune response to minimize associated immunopathology and tissue damage.The antiviral immune response is made up of innate (nonspecific) and specific components, and requires the coordinated actions of many different cell types including neutrophils, macrophages, eosinophils, dendritic cells, epithelial cells, mast cells, natural killer cells and B- and T-lymphocytes. Coordination of this response involves numerous cytokines and chemokines. T-lymphocytes expressing type 1 cytokines including interferon-γ play a key role.Pre-existing asthmatic inflammation in the lower airway may modify the immune response to viral infection by altering the balance of T-cell cytokine expression from type 1 towards a type 2 in what is always a mixed response. The consequence is delayed viral clearance, persistent virus-induced inflammation and amplification of the allergic inflammation.
Magnetic resonance imaging of the pharynx in OSA patients and healthy subjects
Authors: Ciscar M.A. , Juan G. , Martínez V. , Ramón M. , Lloret T. , Mínguez J. , Armengot M. , Marín J. , Basterra J. 
Published: July 2002

Obstructive sleep apnoea (OSA) occurs because of recurrent narrowing and occlusion of the velopharynx (VP) during sleep. The specific cause of OSA is unknown. Cephalometric radiography, fibreoptic nasopharyngoscopy, acoustic reflection techniques, and computerized tomography have limitations (dynamic and tridimensional evaluation) in the mechanism of occlusion investigation. Static and dynamic examination of the soft tissue structures surrounding the upper airway during the respiratory cycle in wakefulness and sleep, can lead to a better understanding of the process.Ultrafast magnetic resonance imaging (one image per 0.8 s) was used to study the upper airway and surrounding soft tissue in 17 patients with OSA during wakefulness and sleep, and in eight healthy subjects whilst awake.The major findings of this investigation in the 25 subjects were as follows: 1) the VP was smaller in apnoeic patients, only during part of the respiratory cycle; 2) the variation in VP area during the respiratory cycle was greater in apnoeic patients than in controls, particularly during sleep, suggesting an increased compliance of the VP in these patients; 3) VP narrowing was similar in the lateral and anterior-posterior dimensions, both in controls and apnoeic patients while awake; apnoeic patients during sleep have a more circular VP upon reaching the minimum area; 4) there was an inverse relationship between dimensions of the lateral pharyngeal walls and airway area, probably indicating that lateral walls are passively compressed or stretched as a result of changes in the airway calibre; and 5) soft palate and parapharyngeal fatpads were larger in apnoeic patients, although their role in the genesis of OSA is uncertain.It was concluded that changes in the velopharynx area and diameter during the respiratory cycle are greater in apnoeic patients than in normal subjects, particularly during sleep. This suggests that apnoeic patients have a more collapsible velopharynx, this being the main mechanism of obstruction.
Plethysmography for the assessment of pneumococcal pneumonia and passive immunotherapy in a mouse model
Authors: de Hennezel L. , Debarre S. , Ramisse F. , Delamanche S. , Harf A. , Alonso J‐M. , Calvet J‐H. 
Published: July 2002

The increasing prevalence of resistance to antibiotics ofStreptococcus pneumoniae, the main causative agent of community-acquired bacterial pneumonia, necessitates the development of both new therapeutic strategies and noninvasive methods in order to evaluate their efficacy.The efficacy of passive immunotherapy with human intravenous immunoglobulin (IVIG) or solvent alone, administered intranasally or intravenously, was evaluated in a mouse model of acute pneumonia. Lung bacterial load was also evaluated, using a classical but invasive method, as was respiratory function (minute ventilation, respiratory frequency and tidal volume) using plethysmography, a simple noninvasive method commonly used in inhalation toxicology, but not previously used to assess respiratory infection.Forty-eight hours after infectious challenge, the lung bacterial load was significantly lower in IVIG-treated mice than in untreated mice. At the same time, minute ventilation was significantly lower than reference values for untreated mice (36±3versus57±8 mL·min−1, p<0.01, and 31±2versus50±5 mL·min−1, p<0.01 for intranasal and intravenous administration of solvent, respectively) but not in mice treated with IVIG by either route of administration.Plethysmography therefore appears to be a simple and reliable test for the follow-up of acute respiratory infection.
Dynamic respiratory system mechanics in infants during pressure and volume controlled ventilation
Authors: Kessler V. , Guttmann J. , Newth C.J.L. 
Published: July 2002

Dynamic respiratory system mechanics can be determined using multiple linear regression (MLR) analysis. There is no need for a particular ventilator setting or for a special ventilatory manoeuvre. The purpose of this study was to investigate whether or not different ventilator modes and the flow-dependent resistance of the endotracheal tube (ETT) influence the determination of resistance and compliance by MLR.Ten paediatric patients who were on controlled mechanical ventilation for various disorders were investigated. The ventilator modes were changed between pressure control (PC) and volume control (VC). Flow and airway pressure were measured and tracheal pressure was continuously calculated. Each mode was applied for 3 min, and 10 consecutive breaths at the end of each period were analysed. Respiratory mechanics were determined by MLR based on either airway pressure, thus including the resistance of the ETT, or tracheal pressure.Resistance was found to be slightly higher in PC than in VC. There was no effect on determination of compliance between the different modes. Elimination of the flow-dependent resistance of the ETT preserved the differences between the modes.The authors conclude that using multiple linear regression compliance is not affected by the actual ventilator mode, whereas resistance is.
Fungal infections in transplant recipients
Authors: Nicod L.P. , Pache J‐C. , Howarth N. 
Published: July 2002

Fungi are ubiquitous and the respiratory tract is exposed to aerosolized spores of both fungi that are “pathogenic” even in the normal host, such asCryptococus neoformans, and those that are “opportunistic”, such asCandidaandAspergillusspecies, among others. Although these latter species may occasionally form fungal balls or induce allergic phenomena in the normal host, they produce more invasive diseases in immunosuppressed patients. Among these diseases, pseudomembranous aspergillosis has recently been described.The diagnostic approach to these entities, and, in particular, the thin dividing line between colonization and infection are addressed, along with the diagnostic value of the various procedures.New prophylactic regimens are reviewed such as the possibility of using amphotericin aerosols in combination with systemic azole administration.The authors would emphasize the importance of restoring lung defences by not only decreasing immunosuppressive regimens but also considering the use of newly available recombinant cytokines such as growth factors, to reduce neutropenia, for instance, in addition to antifungal drugs when infection is diagnosed. However, immunomodulation procedures are far from being well established.
High short-term mortality following lung biopsy for usual interstitial pneumonia
Authors: Utz J.P. , Ryu J.H. , Douglas W.W. , Hartman T.E. , Tazelaar H.D. , Myers J.L. , Allen M.S. , Schroeder D.R. 
Published: July 2002

Usual interstitial pneumonia (UIP) is a specific histological pattern of interstitial pneumonia most often associated with the clinical syndrome of idiopathic pulmonary fibrosis (IPF). There is controversy regarding the use of surgical lung biopsy in the diagnosis of UIP, and the risk of lung biopsy in these patients is largely unknown. This study investigated the 30 day surgical mortality rate in patients undergoing surgical lung biopsy for UIP.Patients undergoing surgical lung biopsy over a 10-yr period from 1986–1995 with the ultimate diagnosis of UIP (with or without underlying connective tissue disease) were identified. Pathology, computed tomography, medical records, and survival were assessed.Ten of sixty patients with usual interstitial pneumonia were found to be dead within 30 days of surgical biopsy. All of these were patients with idiopathic UIP, unassociated with connective tissue disease (clinical condition of IPF).In conclusion, patients with usual interstitial pneumonia of the idiopathic type, who present with atypical features, may be at higher risk for death following surgical biopsy than patients presenting with more typical features or patients with other interstitial illnesses.
Dose dependent increased mortality risk in COPD patients treated with oral glucocorticoids
Authors: Schols A.M.W.J. , Wesseling G. , Kester A.D.M. , de Vries G. , Mostert R. , Slangen J. , Wouters E.F.M. 
Published: July 2002

Systemic corticosteroids are often administered in COPD patients. The relationship between systemic glucocorticoids and mortality in patients with moderate to severe chronic obstructive pulmonary disease (COPD) was retrospectively analysed. Baseline characteristics of the patients, in stable clinical condition, were collected on admission to a pulmonary rehabilitation centre. Overall mortality was asessed at the end of follow-up. The Cox proportional hazards model was used to quantify the relationship between glucocorticoid use, distinguishing administration route (oral/inhalation) and oral dose, and overall mortality, adjusted for the influence of age, sex, smoking, lung function, resting arterial blood gases and body mass index.On multivariate analysis, oral glucocorticoid use at a (prednisone equivalent) dose of 10 mg·day−1without inhaled glucocorticoids, was associated with an increased risk (RR=2.34, 95% confidence interval (CI) 1.24–4.44) while 15 mg·day−1carried a relative risk of 4.03, CI=1.99–8.15). A significant interaction was observed between inhaled and oral glucocorticoid use. Combined with inhaled glucocorticoids, the relative risk of oral glucocorticoid use appeared to be significantly smaller.It is concluded that in severe chronic obstructive pulmonary disease, maintenance treatment with oral glucocorticoids is associated with increased mortality in a dose-dependent manner. Since the present study design cannot exclude the possibility of bias by indication, further prospective studies are indicated using a broader patient characterization.
Utility of echocardiography in assessment of pulmonary hypertension secondary to COPD
Authors: Higham M.A. , Dawson D. , Joshi J. , Nihoyannopoulos P. , Morrell N.W. 
Published: July 2002

Studies have confirmed the close correlation of echocardiographically estimated pulmonary arterial pressure with invasive measurements in patients with chronic obstructive pulmonary disease (COPD), but there are few data on utility of echocardiographic measurement in assessing pulmonary arterial hypertension (PH) in COPD and correlation with pulmonary function tests.Presence or absence of tricuspid regurgitation (TR) was determined by Doppler echocardiography in 73 consecutive COPD patients attending a hospital outpatient clinic. Transtricuspid pressure gradient (TTPG) was calculated. PH was defined as TTPG ≥30 mmHg. Patients also underwent spirometry, forced expiratory volume in one second (FEV1), single breath gas transfer (carbon monoxide transfer coefficient; (KCO) and carbon monoxide diffusing capacity of the lung;DL,CO) and arterial blood gas measurement.Measurable TR was observed in 56/73 patients (77%). There were no differences between the group in which TR was observed compared to that in which it was absent, with regard to age, smoking history nor pulmonary function variables. PH was seen in 31/56 cases (55%), with good reproducibility. There were statistically significant correlations of TTPG with FEV1(r=−0.26, p=0.05),KCO(r=−0.31, p=0.04) andDL,CO(r=−0.42, p=0.006) expressed as % pred. Stepwise regression analysis showed that age andKCOcombined provide a multivariate model for prediction of TTPG.It is concluded the presence and degree of pulmonary arterial hypertension is readily and reliably determined by echocardiography in the majority of chronic obstructive pulmonary disease patients. Pulmonary arterial hypertension is common in severe chronic obstructive pulmonary disease and transtricuspid pressure gradient correlates with spirometry and indices of gas transfer, similar to previous invasive studies. In view of the adverse effects of pulmonary arterial hypertension on morbidity and mortality routine echocardiography in patients with severe chronic obstructive pulmonary disease may be warranted.
Benefit from the inclusion of self-treatment guidelines to a self-management programme for adults with asthma
Authors: Klein J.J. , van der Palen J. , Uil S.M. , Zielhuis G.A. , Seydel E.R. , van Herwaarden C.L.A. 
Published: July 2002

This study assessed the long-term efficacy of adding self-treatment guidelines to a self-management programme for adults with asthma.In this prospective randomized controlled trial, 245 patients with stable, moderate to severe asthma were included. They were randomized into a self-treatment group (group S) and a control group (group C). Both groups received self-management education. Additionally, group S received self-treatment guidelines based on peak expiratory flow (PEF) and symptoms. Outcome parameters included: asthma symptoms, quality of life, pulmonary function, and exacerbation rate. The 2‐yr study was completed by 174 patients.Both groups showed an improvement in the quality of life of 7%. PEF variability decreased by 32% and 29%, and the number of outpatient visits by 25% and 18% in groups S and C, respectively. No significant differences in these parameters were found between the two groups. After 1 yr, patients in both groups perceived better control of asthma and had more self-confidence regarding their asthma. The latter improvements were significantly greater in group S as compared to group C. There were no other differences in outcome parameters between the groups.Individual self-treatment guidelines for exacerbations on top of a general self-management programme does not seem to be of additional benefit in terms of improvements in the clinical outcome of asthma. However, patients in the self-treatment group had better scores in subjective outcome measures such as perceived control of asthma and self-confidence than patients in the control group.