bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inflammatory mediators in nasal lavage, induced sputum and serum of employees with rheumatic and respiratory disorders
Authors: Roponen M. , Kiviranta J. , Seuri M. , Tukiainen H. , Myllykangas-Luosujärvi R. , Hirvonen M-R. 
Published: July 2002

Exposure to microbes present in mould-damaged buildings has been linked to increased frequency of various inflammatory diseases. The current study examined differences in inflammatory mediators in nasal lavage (NAL), induced sputum (IS) and serum of occupants with rheumatic or respiratory disorders and their controls, all working in the same moisture-damaged building.Exhaled nitric oxide (NO) measurements, lung function tests, skin-prick tests and health data collection by questionnaire were performed. Concentrations of NO, interleukin (IL)-1, IL-4, IL-6 and tumour necrosis factor-α in NAL, IS and serum (excluding NO and IL-1) of the subjects were measured during an occupational exposure period and the vacation period without such exposure.The concentrations of IL-4 in NAL fluid were significantly higher among all occupants during the working period (geometric mean 8.5 pg·mL−1, range 0–206.5 pg·mL−1), as compared to that during vacation (0.4 pg·mL−1, range 0–3.7 pg·mL−1) (p=0.008). Absence from the work environment also significantly diminished reporting of symptoms. IL-4 levels in the serum of case subjects were significantly higher than in controls. Moreover, employees with respiratory symptoms had markedly higher exhaled NO values than their controls (p=0.028).In summary, these data suggest that mediators in nasal lavage samples reflect the occupational exposure to moulds, whereas possible indicators of existing disorders are detectable in serum.
Medroxyprogesterone in postmenopausal females with partial upper airway obstruction during sleep
Authors: Saaresranta T. , Polo-Kantola P. , Rauhala E. , Polo O. 
Published: July 2002

The aim of the present study was to evaluate the degree and duration of respiratory stimulation caused by medroxyprogesterone acetate (MPA), and compare the effect of MPA to that of nasal continuous positive airway pressure (nCPAP) in sleep-disordered breathing.Ten postmenopausal females with predominantly partial upper airway obstruction during sleep had an overnight sleep study at baseline, on the fourteenth day of treatment with MPA and after a 3-week washout period. Six subjects on nCPAP were also studied 3 months later.At baseline, the overnight mean±sd end-tidal pressure of carbon dioxide (Pet,CO2) was 5.5±0.4 kPa the arterial oxygen saturation (Sa,O2) 93.0±1.2%,Sa,O2nadir 80.0±6.7%, and frequency of oxygen desaturation ⩾4% (ODI4) per hour 2.2±1.3. MPA decreasedPet,CO2by 0.8 kPa (14.5%, p<0.001). After washout, the meanPet,CO2remained at 0.5 kPa (9.1%, p<0.001) lower than at baseline.Sa,O2did not change.Pet,CO2was lower on MPA than on nCPAP (4.7±0.2 kPaversus5.0±0.3 kPa; p=0.037) butSa,O2was similar. Apnoea/hypopnoea index tended to be lower on CPAP than on MPA.Medroxyprogesterone acetate at a daily dose of 60 mg improves ventilation in postmenopausal females with partial upper airway obstruction during sleep without compromising sleep. The ventilatory improvement is sustained for at least 3 weeks post-treatment. Medroxyprogesterone acetate was more efficient in decreasing the partial pressure of carbon dioxide but continuous positive airway pressure was superior in decreasing respiratory efforts.
Changes in pro-inflammatory cytokines in association with exposure to moisture-damaged building microbes
Authors: Purokivi M.K. , Hirvonen M-R. , Randell J.T. , Roponen M.H. , Meklin T.M. , Nevalainen A.I. , Husman T.M. , Tukiainen H.O. 
Published: July 2002

Several epidemiological studies have described an association between adverse health effects and exposure to mould and microbes present in the indoor air of moisture-damaged buildings. However, the biochemical linkage between microbial exposure and the large variety of reported respiratory symptoms is poorly understood.In the present study, the authors compared the respiratory symptoms, the production of inflammatory mediators interleukin (IL)-1, IL-4, IL-6, tumour necrosis factor-α (TNF-α) and cell count in nasal lavage fluid and induced sputum samples of subjects working in moisture-damaged and control school buildings. The sampling was performed and the questionnaires were completed at the end of the spring term, at the end of the summer vacation (2.5 months), during the winter term and after a 1-week winter holiday.The authors found a significant elevation of IL-1, TNF-α and IL-6 in nasal lavage fluid and IL-6 in induced sputum during the spring term in the subjects from the moisture-damaged school building compared to the subjects from the control building. The exposed workers reported sore throat, phlegm, eye irritation, rhinitis, nasal obstruction and cough in parallel with these findings.The present data suggests an association between microbial exposure, and symptoms as well as changes in pro-inflammatory mediators detected from both the upper and lower airways.
Inflammatory endobronchial polyposis with bronchiectasis in cystic fibrosis
Authors: Roberts C. , Devenny A.M. , Brooker R. , Cockburn J.S. , Kerr K.M. 
Published: July 2002

An unusual case of endobronchial polyposis associated with extensive bronchiectasis in the context of cystic fibrosis (CF) has been described.A 15-yr-old female patient with CF underwent partial pneumonectomy for extensive bronchiectasis and frequent infective pulmonary exacerbations.Cylindrical bronchiectasis with associated purulent bronchitis and bronchiolitis, together with inflammatory polyposis, was noted in the resected lung.To the best of the authors' knowledge, this is the first report of multiple endobronchial polyposis and may represent a rare complication of bronchiectasis in a patient with cystic fibrosis. On-going infection and the cellular composition of the polyps are discussed in relation to their possible aetiological relevance and relationship to upper respiratory tract polyps.
Airway responsiveness and peak flow variability in the diagnosis of asthma for epidemiological studies
Authors: Lewis S.A. , Weiss S.T. , Britton J.R. 
Published: July 2002

Airway responsiveness and variability in peak expiratory flow (PEF) are widely used as objective diagnostic measures of asthma, but it is not clear how these variables should be calculated or adjusted to obtain the highest diagnostic validity for physician-diagnosed asthma in the community.Data from a community-based sample of 1,513 adults has been used. Airway responsiveness to methacholine and 7-day PEF data were obtained in 1991, asthma and respiratory symptoms were diagnosed by questionnaires in 1991 and 1999. Airway responsiveness was expressed as the provocative dose causing a 20% fall in forced expiratory volume in one second (PD20), two-point and least-squares regression slopes. PEF variability was expressed as daily amplitude, weekly standard deviation and mean of the two lowest readings. Continuous measures were adjusted for measures of baseline airway calibre by linear regression.Measures of airway responsiveness had greater sensitivity for specificity for self-reported diagnosed asthma than expressions of PEF variability, before and after adjustment for airway calibre. Diagnostic validity was substantially better in adults aged <50 yrs; PD20provided the best sensitivity for specificity (61% for 95% at 8.3 µmol). In those aged ⩾50 yrs, no measure was closely related to diagnosed asthma.In younger age groups, provocative dose causing a 20% fall in forced expiratory volume in one second provides a valuable objective measure of asthma for epidemiological studies, but is unable to distinguish between asthma and chronic obstructive pulmonary disease in older people.
Virtual tools for imaging of the thorax
Authors: Ferretti G.R. , Bricault I. , Coulomb M. 
Published: July 2002

Helical computed tomography (HCT) allows for volume acquisition of the entire thorax during a single apnoea. Combination of HCT acquisition with synchronous vascular enhancement gives rise to HCT angiography (HCTA).In the last decade, HCT and HCTA have revolutionized the diagnosis of thoracic diseases, modifying many diagnostic algorithms. Because HCT provides for a true volume acquisition free of respiratory misregistration, three-dimensional (3D) rendering techniques can be applied to HCT acquisitions.As these 3D rendering techniques present the HCT information in a different format to the conventional transaxial CT slices, they can be summarized as virtual tools.The purpose of this review is to give the readers the most important technical aspects of virtual tools, to report their application to the thorax, to answer clinical and scientific questions, and to stress their importance for patient management, clinical decision making, and research.
Genetic polymorphisms of CC chemokine receptor 3 in Japanese and British asthmatics
Authors: Fukunaga K. , Asano K. , Mao X‐Q. , Gao P‐S. , Roberts M.H. , Oguma T. , Shiomi T. , Kanazawa M. , Adra C.N. , Shirakawa T. , Hopkin J.M. , Yamaguchi K. 
Published: July 2002

Whole genome scan analyses have revealed that chromosomal region 3p21−24, which contains a gene cluster of CC chemokine receptors such as CCR3, is possibly linked to asthma. Because CCR3 ligands play a pivotal role in the selective recruitment and activation of inflammatory cells in the asthmatic airway, the authors examined whether there is any association between asthma and the CCR3 gene polymorphisms.Three polymorphisms were identified using the single stranded conformational polymorphism method in Japanese (Asian) and British (Caucasian) subjects; one silent mutation T51C and two missense mutations G824A and T971C. These polymorphisms were examined in 391 Japanese subjects (210 asthmatics and 181 nonasthmatic controls) and 234 British subjects (142 asthmatics and 92 nonasthmatic controls). Asthma diagnosis was based on episodic symptoms, documented wheeze, and the presence of reversible airflow limitation.CCR3 T51C demonstrated a significant association with the diagnosis of asthma in the British population (odds ratio 2.35, p<0.01), but not in the Japanese population. Multiple logistic regression analysis also showed that CCR3 T51C was associated with asthma (odds ratio 2.83, p<0.02), independent of atopic phenotypes such as high levels of total or house dust mite-specific immunoglobulin-E in serum.In conclusion, a significant association between asthma and CCR3 T51C polymorphism localized on chromosome 3p21 was found.
In vitroassessment of equipment and software to assess tidal breathing parameters in infants
Authors: Schmalisch G. , Foitzik B. , Wauer R.R. , Stocks J. 
Published: July 2002

The aim of thisin vitrostudy was to compare the measurement accuracy of two currently available devices for measuring tidal breathing in infants.A mechanical model pump was used to generate flow profiles which simulated those observed in infants. A range of flows was applied simultaneously to two different devices, namely the commercially available SensorMedics 2600 (SM 2600) and more recently developed, custom-made equipment based on the flow-through technique (FTT). Automatically derived values from both devices were compared with one another and with manual calculations of printouts of the same breaths.There were no differences in the raw flow signal obtained from the two devices, nor between values calculated automatically or manually from the FTT. Similarly, the deviations between the FTT and SM 2600 were <3% for tidal volume, respiratory frequency and minute ventilation. However, when comparing either with manually calculated values or those derived automatically from the FTT, there was a systematic and highly significant underestimation of shape-dependent parameters, such as the time to peak tidal expiratory flow as a proportion of tidal expiratory time (tPTEF/tE), derived by the SM 2600. The lower the applied flow, the higher the observed deviations, the underestimation being up to 60% when flows simulating those observed in preterm neonates were applied.These errors appear to result from differences in signal processing such as the algorithms used for breath detection and can only be detected if appropriate nonsinusoidal flow profiles representing those seen in infants are used to evaluate equipment.
Effect of apparatus dead space on breathing parameters in newborns: “flow-through”versusconventional techniques
Authors: Schmalisch G. , Foitzik B. , Wauer R.R. , Stocks J. 
Published: July 2002

Commercial devices for tidal breathing measurements in newborns allow only short-term measurements, due to the high apparatus dead space of the face mask and pneumotachometer. The flow-through technique (FTT) minimizes the dead space by a background flow, thereby allowing long-term measurements. The aim of this study was to investigate the comparability of tidal breathing parameters using both techniques.Paired measurements of tidal breathing were performed in 86 sleeping infants (median (range) body weight 2.8 kg (1.9–5.3 kg), age 65 days (3–150 days)), using the FTT and SensorMedics 2600 (SM 2600).There was a significant bias (p<0.001) in all tidal breathing parameters. Compared with the FTT, increases (95% confidence interval (CI)) in tidal volume (VT), respiratory frequency (fR), and minute ventilation (V′E) were 0.74 (0.5–1.0) mL·kg−1, 9.0 (6.9–11.2)·min−1and 92 (74–109) mL·min−1·kg−1when measured with the SM 2600, representing average increases of 13, 17 and 30%, respectively, in response to the added dead space. By contrast, time to peak tidal expiratory flow as a proportion of expiratory time (tPTEF/tE) was changed by −0.09 (−0.11–−0.08). The mean (95% CI) change intPTEF/tEof −54 (−62–−45)%, when measured in infants by the SM 2600, was remarkably similar to that observed duringin vitrovalidation studies (−59 (−73–−44)%), suggesting that the discrepancies in timing parameters may be largely attributable to differences in signal processing.In conclusion, differences in measurement technique and precision of the devices used can result in significant differences in tidal breathing parameters. This may impede the comparison of results within and between infants and the clinical interpretation of tidal breathing measurements in newborns.
Leak compensation in positive pressure ventilators: a lung model study
Authors: Mehta S. , McCool F.D. , Hill N.S. 
Published: July 2002

Leak compensating abilities of six different positive pressure ventilators commonly used to deliver noninvasive positive pressure ventilation, including the bilevel positive airway pressure (BiPAP) S/T-D and Quantum (Respironics Inc, Murrysville, PA, USA), 335 and O'NYX (Mallinckrodt Inc, St Louis, MO, USA), PLV 102 (Respironics), and Siemens Servo 900C (Siemens Inc, Danvers, MA, USA).Using a test lung model, compensatory capabilities of the ventilators were tested for smaller and larger leaks using the assist/control or timed modes. Back-up rate was 20·min−1, inspiratory pressure was 18 cmH2O, and expiratory pressure was 5 cmH2O.It was found that even in the absence of air leaking, delivered tidal volume differed substantially between the ventilators during use of pressure-targeted modes, depending on inspiratory flows, inaccuracies in setversusdelivered pressures, and inspiratory duration. Also during pressure-targeted ventilation, increasing thetI/ttotup to, but not beyond, 0.5 improved compensation by lengthening inspiratory duration, whereas use of a sensitive flow trigger setting tended to cause autocycling during leaking, interfering with compensation. Leaking interfered with cycling of the BiPAP S/T, inverting the I:E ratio, shortening expiratory time, and reducing delivered tidal volume. Volume-targeted modes achieved limited compensation for small air leaks, but compensated poorly for large leaks.To conclude, leak-compensating capabilities differ markedly between ventilators but pressure-targeted ventilators are preferred for noninvasive positive pressure ventilation in patients with substantial air leaking. Adequate inspiratory flows and durations should be used, triggering sensitivity should be adjusted to prevent autocycling, and a mechanism should be available to limit inspiratory time and avoid I:E ratio inversion.
Functional differences in bi-level pressure preset ventilators
Authors: Highcock M.P. , Shneerson J.M. , Smith I.E. 
Published: July 2002

The performance of four bilevel positive pressure preset ventilators was compared.The ventilators tested were; BiPAP ST30 (Respironics); Nippy2 (B+D Electrical); Quantum PSV (Healthdyne); and Sullivan VPAP II ST (Resmed). A patient simulator was used to determine the sensitivity of the triggering mechanisms and the responses to a leak within the patient circuit, and to changes in patient effort.Significant differences (p<0.05) between the devices were seen in the trigger delay time and inspiratory trigger pressure. When a leak was introduced into the patient circuit, the fall in tidal volume (VT) was less than ten per cent for each ventilator. The addition of patient effort produced a number of changes in the ventilation delivered. Patient efforts of 0.25 s induced a variable fall inVT. An increase inVTwas seen with some ventilators with patient efforts of 1 s but the effect was variable. Trigger failures and subsequent falls in minute volume were seen with the BiPAP and the Nippy2 at the highest respiratory frequency.Differences in the responses of the ventilators are demonstrated that may influence the selection of a ventilator, particularly in the treatment of breathless patients with ventilatory failure.
Burkholderia cepacia: current clinical issues, environmental controversies and ethical dilemmas
Authors: Jones A.M. , Dodd M.E. , Webb A.K. 
Published: July 2002

Burkholderia cepaciais a plant phytogen and is known as a hardy and versatile organism.Over the past two decades it has emerged as a pathogen in the cystic fibrosis (CF) community, with devastating effects. Pulmonary colonisation can lead to an accelerated decline in lung function. In some cases, it causes a rapid and progressive pneumonic illness termed “cepaciasyndrome”, which is untreatable and fatal.B. cepaciais inherently resistant to multiple antibiotics and highly transmissible and virulent strains have been identified. CF patients colonised with the organism have to be segregated from their peers to try to prevent cross-infection.However, the pathogenicity ofB. cepaciais not limited to CF. Other groups, such as individuals with chronic granulomatous disease and immunocompromised patients are vulnerable and it has caused disease in healthy individuals. However, the agricultural and petrochemical industries are attempting to exploit properties ofB. cepaciafor use as a biopesticide and biodegradation agent.This article provides an up to date review of clinically based literature on theBurkholderia cepaciacomplex, highlighting clinical management issues for both cystic fibrosis and non-cystic fibrosis patients. The article also addresses the potential conflict between medicine and agriculture on plans to reintroduce strains ofBurkholderia cepaciaback into the environment.
Vascular smooth muscle cell phenotypes in primary pulmonary hypertension
Authors: Mitani Y. , Ueda M. , Komatsu R. , Maruyama K. , Nagai R. , Matsumura M. , Sakurai M. 
Published: July 2002

Primary pulmonary hypertension (PPH) is associated with specific structural alterations, including cellular intimal thickening, intimal fibrosis, and plexiform lesions.To determine the phenotypes of smooth muscle cells (SMCs) in such lesions, the authors conducted an immunohistochemical analysis of lung tissues from two patients with PPH, using two antimuscle actin antibodies, HHF35 and CGA7, and two anti-SMC myosin heavy chain markers, anti-SM1 and anti-SM2 antibodies and related antibodies. Cells that stained positive (+) with HHF35, CGA7, anti-SM1, and anti-SM2 were considered to be SMCs of a mature state. Conversely, those that stained positive with HHF35 and anti-SM1, but weakly positive (+/−) or negative (−) with CGA7 and anti-SM2, were considered to be SMCs exhibiting an immature state.Cellular intimal thickening was composed of SMCs of an immature phenotype (HHF35+, CGA7+/−, SM1+, SM2+/−), accompanied by the expression of fibronectin and the presence of macrophages; intimal fibrosis contained mature SMCs (HHF35+, CGA7+, SM1+, SM2+); and plexiform lesion consisted of proliferative endothelial cells (von Willebrand factor-positive cells, proliferating cell nuclear antigen-positive cells) and underlying immature SMCs (HHF35+, CGA7−, SM1+, SM2−) associated with fibronectin expression and macrophage infiltration.These findings suggest that smooth muscle cells with specific phenotypes may contribute to the development of specific vascular lesions in primary pulmonary hypertension.
Erythromycin attenuates an experimental model of chronic bronchiolitisviaaugmenting monocyte chemoattractant protein‐1
Authors: Takahashi T. , Suga M. , Matsukawa A. , Sato K. , Okamoto T. , Ichiyasu H. , Ohkawara S. , Yoshinaga M. , Ando M. 
Published: July 2002

The mechanisms underlying the therapeutic efficacy of erythromycin (EM) in diffuse panbronchiolitis (DPB) was investigated. For this purpose, an experimental rabbit model of DPB induced byPseudomonas aeruginosainoculation was employed. Daily administration of EM (3 mg·kg·day−1) led to an increase in the number of macrophages in bronchoalveolar lavage fluid (BALF) at an early phase, while reducing the size of granulomatous lesions at the late phase without affecting the number of viable bacteria recovered from the infected lung.Reverse transcriptase polymerase chain reaction (RT-PCR), enzyme-linked immunosorbent assay (ELISA) and immunohistochemical studies showed that monocyte chemoattractant protein (MCP)‐1 was produced in both BALF and infected lung. EM treatment resulted in a significant increase in the level of MCP‐1 in BALF, while reducing that of tumour necrosis factor (TNF)‐α, interleukin (IL)‐1β and IL‐8. EM also increased MCP‐1 messenger ribonucleic acid (mRNA) and protein expression in the infected lung. MCP‐1 blockade abolished the protective effect of EM, as neutralization of MCP‐1 with anti-MCP‐1 antibodies reduced the EM-induced increase in the number of macrophages in BALF, and augmented size of the granulomatous lesions, as compared to control.The results of the present study suggest that erythromycin attenuates the pulmonary granuloma formation, at least in part, by increasing the production of monocyte chemoattractant protein‐1.