bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exacerbation of sleep-apnoea related nocturnal blood-pressure fluctuations in hypertensive subjects
Authors: Planès C. , Leroy M. , Fayet G. , Aegerter P. , Foucher A. , Raffestin B. 
Published: October 2002

Obstructive sleep apnoea syndrome (OSAS) induces marked haemodynamic fluctuations during sleep that might be deleterious to the cardiovascular system. The influence of daytime blood pressure (BP) levels and aging on short-term BP variability during sleep in OSAS patients was investigated.Twenty-nine subjects with newly-diagnosed untreated OSAS were categorised into three groups: normotensive subjects aged <50 yrs (n=10); subjects aged <50 yrs with untreated hypertension (n=8); and normotensive subjects aged >50 yrs (n=11). Beat-by-beat BP was recorded with a Finapres device during polysomnography. The average values±sd of apnoea-related BP elevations and the values of the frequency distribution of all BP variations during sleep were assessed to estimate short-term BP variability.Apnoea-related systolic (or diastolic) BP elevations were significantly greater in hypertensives than in normotensives aged <50 yrs (50.3±4.88versus30.7±2.14 mmHg, p<0.001), as was the sd of systolic (or diastolic) BP variations during sleep (I9.6±2.22versus11.1±0.73, p<0.001). Short-term BP variability was not significantly increased in normotensive elderly patients.To conclude, the results suggested that systemic hypertension is associated with a greater exacerbation of short-term variability during sleep in obstructive sleep apnoea syndrome patients.
Acute adrenal crisis in asthmatics treated with high-dose fluticasone propionate: Table 1—
Authors: Todd G.R.G. , Acerini C.L. , Buck J.J. , Murphy N.P. , Ross-Russell R. , Warner J.T. , McCance D.R. 
Published: October 2002

Four cases of asthma (one adult, three children) developing acute adrenal crisis after introduction of high-dose inhaled fluticasone proprionate are presented. The three children, aged 7–9 yrs, had been prescribed inhaled fluticasone, dosage 500–2,000 µg·day−1and duration 5 months–5 yrs. All presented with convulsions due to hypoglycaemia (blood glucose 1.3–1.8 mM). The fourth case was a male of 33 yrs with difficult-to-control asthma and had been taking fluticasone propionate 1,000–2,000 µg·day−1for 3 yrs. He presented with fatigue, lethargy, nausea and postural hypotension.Acute adrenal crisis in each case was confirmed by investigations which included measurement of acute phase cortisol levels, short and long Synacthen stimulation tests and glucagon stimulation tests. Other cases of hypthoalamic-pituitary-adrenal axis suppression were excluded.
Distribution and degranulation of airway mast cells in normal and asthmatic subjects
Authors: Carroll N.G. , Mutavdzic S. , James A.L. 
Published: October 2002

It was hypothesized that the distribution and activation of mast cells across the airway wall may reflect their function in asthma.The density of mast cells (intact and degranulated) within airway compartments in cartilaginous and membranous airways, obtained from autopsies on patients with fatal asthma, nonfatal asthma, and nonasthmatic control cases have been examined.In cartilaginous airways, the mean±se density of mast cells in control cases was 27±9 cells·mm−2. It was similar in nonfatal asthma (24±2 cells·mm−2) but reduced (p<0.05) in fatal asthma cases (16±2 cells·mm−2). In membranous airways, the density of mast cells in control cases was 155±21 cells·mm−2and was higher (p<0.05) in cases of nonfatal (270±51 cells·mm−2) and fatal asthma (219±26 cells·mm−2). Mast-cell density was greatest on the smooth muscle and mucous glands in cartilaginous airways and on the smooth muscle and outer airway wall in membranous airways. The percentage of degranulated mast cells was higher (p<0.05) in cases of asthma, related to disease severity, and was higher in cartilaginous than membranous airways. Degranulation was greatest on the smooth muscle in fatal asthma cases.Mast-cell distribution and degranulation varies between cartilaginous and membranous airways and across the airway wall. Degranulation of mast cells is related to asthma severity. The increased degranulation in proximal airways may reflect stimulationviathe inhaled route.
New imaging techniques in the treatment guidelines for lung cancer
Authors: Schaefer-Prokop C. , Prokop M. 
Published: October 2002

Computed tomography (CT) remains the main imaging technique for the preoperative staging and post-therapeutic evaluation of bronchogenic carcinoma. Spiral CT has already overcome some of the problems encountered with central or more extensive tumours. Multislice CT offers further improvement and allows for scanning of the whole chest within a single breath-hold using a thin-section high-resolution technique. Problem-adapted sections in arbitrary directions become available and provide an excellent spatial resolution. One can expect improved accuracy for the evaluation of transfissural tumour growth, chest wall involvement, mediastinal infiltration and lymph node staging.Despite recent advances in magnetic resonance (MR) techniques for imaging the chest, the role of MR for staging of bronchogenic carcinoma remains limited. It offers advantages such as the assessment of chest-wall involvement or mediastinal involvement in patients in whom CT remains equivocal. Lymph-node-specific MR contrast agents offer new diagnostic potential for the assessment of metastatic disease.New techniques for the display of three-dimensional data sets include volume rendering and virtual bronchoscopy. These techniques represent new tools for the evaluation and demonstration of pathology within the central tracheobronchial tree. Their most important application is the guidance of bronchoscopic biopsies.The assessment of an indeterminate pulmonary nodule is frequently based on positron emission tomography imaging. As an alternative, nodule vascularization (contrast enhancement patterns on CT or magnetic resonance imaging (MRI)), calcifications (absorption characteristics at various X‐ray energies on CT or dual energy radiography), and morphological features (high resolution imaging at CT) can be used as the basis for nodule differentiation. The dynamics of contrast enhancement in CT or MRI can also be used for the assessment of tumour viability after chemotherapy.Lung cancer screening programmes are still controversial. Low-dose computed tomography scanning and computed assisted detection algorithms based on chest radiographs or computed tomography scans form the technical basis for such projects.
The rapamycin analogue SDZ RAD attenuates bleomycin-induced pulmonary fibrosis in rats: Fig. 1.—
Authors: Simler N.R. , Howell D.C.J. , Marshall R.P. , Goldsack N.R. , Hasleton P.S. , Laurent G.J. , Chambers R.C. , Egan J.J. 
Published: October 2002

Pulmonary fibrosis is characterized by excessive deposition of extracellular matrix proteins within the pulmonary interstitium. The new macrolide immunosuppressant SDZ RAD, a rapamycin analogue, inhibits growth-factor dependent proliferation of mesenchymal cells and might therefore be of therapeutic interest for the treatment of fibrotic lung disease.In this study the effect of SDZ RAD on lung-collagen accumulation in the bleomycin model of pulmonary fibrosis in rats was investigated. SDZ RAD (2.5 mg·kg−1·day−1) or drug vehicle were administered orally by daily gavage. Successful dosing was confirmed by measuring splenic weight. Total lung-collagen content was measured by high-performance liquid chromatographic quantitation of hydroxyproline.In animals given bleomycin and drug vehicle, total lung collagen was increased by 182±11% (mean±sem) compared with saline controls at 14 days (p<0.001). The increase in lung-collagen accumulation was reduced by 75±12% (p<0.01) in animals given SDZ RAD and was accompanied by a concomitant 56±6% (p<0.001) reduction in lung weight.SDZ RAD is currently in clinical trials for the prevention of solid organ graft rejection, another condition characterized by excessive extracellular matrix production. The authors propose that SDZ RAD warrants evaluation as a novel therapeutic agent for fibrotic lung disease.
Resistanceversusendurance training in patients with COPD and peripheral muscle weakness
Authors: Spruit M.A. , Gosselink R. , Troosters T. , De Paepe K. , Decramer M. 
Published: October 2002

The effects of endurance training on exercise capacity and health-related quality of life (HRQL) in chronic obstructive pulmonary disease (COPD) patients have been studied thoroughly, while resistance training has been rarely evaluated. This study investigated the effects of resistance training in comparison with endurance training in patients with moderate to severe COPD and peripheral muscle weakness (isometric knee extension peak torque <75% predicted).Forty-eight patients (age 64±8 yrs, forced expiratory volume in one second 38±17% pred) were randomly assigned to resistance training (RT, n=24) or endurance training (ET, n=24). The former consisted of dynamic strengthening exercises. The latter consisted of walking, cycling and arm cranking. Respiratory and peripheral muscle force, exercise capacity, and HRQL were re-evaluated in all patients who completed the 12-week rehabilitation (RT n=14, ET n=16).Statistically significant increases in knee extension peak torque (RT 20±21%, ET 42±21%), maximal knee flexion force (RT 31±39%, ET 28±37%), elbow flexion force (RT 24±19%, ET 33±25%), 6-min walking distance (6MWD) (RT 79±74 m, ET 95±57 m), maximum workload (RT 15±16 Watt, ET 14±13 Watt) and HRQL (RT 16±25 points, ET 16±15 points) were observed. No significant differences in changes in HRQL and 6MWD were seen between the two treatments.Resistance training and endurance training have similar effects on peripheral muscle force, exercise capacity and health-related quality of life in chronic obstructive pulmonary disease patients with peripheral muscle weakness.
Spiral computed tomography of pulmonary embolism
Authors: Herold C.J. 
Published: October 2002

Within the last several years, spiral computed tomography angiography (SCTA) of the pulmonary arteries has emerged as a noninvasive angiographic modality for the evaluation of patients with suspected pulmonary embolism (PE). SCTA is based on continuous computed tomography (CT) data acquisition during patient transport through the rotating X‐ray tube and detector system, where scanning is performed in the time period in which the injected contrast material passes through the pulmonary arteries. Single detector spiral CT has a sensitivity of ∼85–90% and a specificity between 88–95%. Sensitivity and specificity are very likely to increase with the use of multidetector spiral CT scanners that allow scanning of large lung volumes with a scan collimation as narrow as 1 mm.Currently, SCTA is most commonly used as a primary imaging method in patients with suspected PE, and as a second-line method in cases with inconclusive ventilation/perfusion scintigraphy results. SCTA has proven to be cost-effective, especially in combination with ultrasound of the lower extremities.Limitations of the method include a decreased sensitivity for the detection of small isolated clots in the peripheral pulmonary arterial bed, and a potentially reduced image quality in patients with coexistent cardiopulmonary disorders.Despite these limitations, several studies have now documented that, in patients with suspected pulmonary embolism, it is safe to withhold anticoagulation therapy if a spiral computed tomography exam of the pulmonary arteries is negative and no lower extremity venous thrombosis is present. In the future, multislice computed tomography scanning of the pulmonary arteries with multiplanar reformation and one-stop shopping,i.e.scanning of the pulmonary arteries and the lower extremity veins in a single session, will further enhance the role of computed tomography angiography in the examination of patients with suspected pulmonary embolism.
Acute exacerbation of chronic obstructive pulmonary disease and antibiotics: what studies are still needed?
Authors: Sohy C. , Pilette C. , Niederman M.S. , Sibille Y. 
Published: October 2002

The use of antibiotics in acute exacerbations of chronic bronchitis (AECBs) remains the subject of controversy despite considerable medical and socioeconomic implications.First, the contribution of bacterial infection to AECBs is difficult to assess in patients with chronic obstructive pulmonary disease (COPD) who are chronically colonized with respiratory pathogens. In addition, several studies suggest a major role of viral infections in AECBs.Secondly, it is unlikely that all COPD patients will benefit from antibiotics during AECBs. In particular, the benefit in mild COPD remains uncertain. Unfortunately, the number of studies complying with evidence-based medicine requirements is too small for definite recommendations in AECBs to be drawn up.Considering the impact of acute exacerbations of chronic bronchitis on chronic obstructive pulmonary disease patients, as well as the community, and the impact of antibiotic therapy on the development of bacterial resistance, there is an urgent need for the design of appropriate multicentric studies to define the usefulness of this type of treatment in acute exacerbations of chronic bronchitis.
Particulate matter and lung function growth in children: a 3-yr follow-up study in Austrian schoolchildren
Authors: Horak F. , Studnicka M. , Gartner C. , Spengler J.D. , Tauber E. , Urbanek R. , Veiter A. , Frischer T. 
Published: October 2002

The effects of particulate matter <10 µm in diameter (PM10) and other air pollutants on lung function were assessed in 975 schoolchildren, from eight communities in Lower Austria between 1994–1997. In each community, air pollution data were collected. Spirometry was performed twice a year. PM10concentration (mean concentration between two subsequent lung-function measures in spring and autumn (summer interval) or between autumn and spring (winter interval)) showed a mean value of 17.36 µg·m−3in the summer interval and 21.03 µg·m−3in the winter interval. A slower increase in the forced expiratory volume in one second (FEV1) and midexpiratory flow between 25 and 75% of the forced vital capacity (MEF25–75) with age in children exposed to higher summer PM10was observed in the 3-yr study period. After adjusting for potential confounders (sex, atopy, passive smoking, initial height, height difference, site, initial lung function) an increase of summer PM10by 10 µg·m−3was associated with a decrease in FEV1growth of 84 mL·yr−1and 329 mL·s−1·yr−1for MEF25–75. Nitrogen dioxide and ozone also showed a negative effect on lung-function growth, confirming previous work.The authors concluded that long-term exposure to particulate matter <10 µm in diameter had a significant negative effect on lung-function proxy for the development of large (forced expiratory volume in one second) and small (midexpiratory flow between 25 and 75% of the forced vital capacity) airways, respectively, with strong evidence for a further effect of ozone and nitrogen dioxide on the development of forced vital capacity and forced expiratory volume in one second.
Supramaximal flow in asthmatic patients
Authors: Sala H. , Fernández A. , Guardia S. , González A. , Rodenstein D. 
Published: October 2002

In normal subjects supramaximal flows (SF) are known to be correlated with flow limitation. To further understand the mechanisms involved in SF this correlation and the influence of salbutamol and methacholine administration on SF have been investigated in asthmatic subjects.Protocol A involved obtaining basal maximal expiratory flow/volume curves and interrupted curves through a fast valve from 36 asthmatic patients. Maximal flow at 50% of forced vital capacity (V′max50) increase (ΔV′max50) was compared between basal curves and envelope curves passing through SF peaks obtained after each interruption.Protocol B involved the study of 33 asthmatic patients after salbutamol administration and 12 asthmatic patients after methacholine challenge. ΔV′max50between basalversusinterrupted curves were analysed (ΔV′max50B). Similar procedures were performed after salbutamol (ΔV′max50S) and after methacholine administration (ΔV′max50M). A significant negative correlation between forced expiratory volume in one second and ΔV′max50was observed. SF decreased significantly after salbutamol administration and increased significantly after methacholine.The results of this study suggest that in asthmatic patients participation of “pendelluft” in SF increases as airflow limitation increases.
Respiratory impedance response to a deep inhalation in asthmatic children with spontaneous airway obstruction
Authors: Schweitzer C. , Moreau-Colson C. , Marchal F. 
Published: October 2002

The aim of the study was to determine whether the bronchomotor effect of a deep inhalation (DI) may be detected during tidal breathing in asthmatic children with spontaneous airway obstruction (AO).Two groups of children aged 5–15 yrs were studied. AO was mild in group 1 (n=12, forced expiratory volume in one second (FEV1) ≥75% predicted) and moderate-to-severe in group 2 (n=9, FEV1≤70% pred). The forced oscillation technique at 12 Hz using a head generator allowed the determination of respiratory resistance in inspiration (Rrsi) and expiration (Rrse) before and after DI, at baseline and after salbutamol.At baseline,Rrsibut notRrsewas found to decrease significantly after DI in group 1 but not in group 2. The change induced by DI was significantly different in group 1 (−1.5±0.5 hPa·s·L−1) compared to group 2 (0.5±0.5 hPa·s·L−1) and exhibited significant negative correlation to FEV1% pred. After salbutamol, DI had no effect.In conclusion, asthmatic children show a bronchomotor response to deep inhalation that depends on the degree of airway obstruction. The effect is more readily demonstrated in inspiration than in expiration.
Effect of inhaled fluticasone on bronchial responsiveness to neurokinin A in asthma
Authors: Van Schoor J. , Joos G.F. , Pauwels R.A. 
Published: October 2002

Neurokinin (NK) A causes airway narrowing in patients with asthma through direct and indirect mechanisms. The effects of the inhaled glucocorticosteroid fluticasone propionate (FP) on the bronchial responsiveness to NKA and methacholine were studied.Patients (n=11) with mild asthma participated in a randomized, double-blind, placebo-controlled crossover trial. FP (500 µgb.i.d) or matched placebo was administeredviaDiskhalerTMfor 14 days. Bronchial challenges were performed on days 1 and 13 (methacholine) and 0 and 14 (NKA) for each treatment period.At the active treatment period, the mean log2provocative concentration causing a 20% fall in the forced expiratory volume in one second (PC20)±sem for NKA was −12.72±0.63 at the beginning and −9.77±0.49 at the end of the period (p<0.0001), while under placebo, it was −12.16±0.82 and −12.19±0.51 respectively (ns). At the active treatment period, the mean log2PC20for methacholine was −5.25±0.40 at the beginning and −4.22±0.31 at the end of the period (p=0.012), while under placebo, it was −5.47±0.47 and −5.24±0.42 respectively (ns). The reduction in response to NKA was significantly larger than that for methacholine.A 2-week course of an inhaled steroid reduces bronchial responsiveness to neurokinin A, an effect more pronounced than the reduction in bronchial responsiveness to methacholine.
Adaptation to organic dust exposure: a potential role of l-selectin shedding?
Authors: Israël-Assayag E. , Cormier Y. 
Published: October 2002

Swine confinement workers, exposed to high levels of organic dust, present a high prevalence of respiratory symptoms but show only mild lung inflammation. This contrasts with the intense inflammatory response observed when naive subjects are exposed to the same environment. Shedding of l-selectin may regulate the recruitment of inflammatory cells and explain this discrepancy.Soluble l-selectin (sl-selectin) levels were measured in sera of 36 workers, 35 control subjects and eight healthy volunteers briefly and repeatedly exposed to swine confinement buildings. White blood cell counts (WBC) and serum interleukin (IL)-6 levels were measured as markers of systemic inflammation.Higher concentrations of sl-selectin were found in the sera of workers than in controls (1452±62 ng·mL−1and 872±25 ng·mL−1, respectively) whereas no differences were detected before and after acute repeated exposures of exposed volunteers. WBC were increased after exposure in exposed volunteers but not in workers. Both workers and exposed volunteers had increased IL-6 serum levels, although it was more pronounced for the exposed volunteers.These results support the hypothesis that shedding of l-selectin may downregulate the inflammatory response to organic dust-contaminated environments and constitute one mechanism of adaptation to the farm environment.
Alterations in gene expression in hamster diaphragm after emphysema and lung volume reduction surgery
Authors: Reynders V. , Marchand E. , Gayan-Ramirez G. , De Leyn P. , Verhoeven G. , Decramer M. 
Published: October 2002

The authors have demonstrated previously that emphysema and lung volume reduction surgery (LVRS) resulted in a significant shift of type IIx/b to type IIa fibres in the diaphragm of hamsters with elastase-induced emphysema. To explore the mechanisms leading to this fibre switching, the mRNA expression of the myogenic regulatory factors, the inhibitors of DNA binding proteins (Id-proteins) and insulin-like growth factor-I were examined.Ribonucleic acid was extracted from the diaphragm of control, emphysematous, emphysematous and sham operated and LVRS hamsters and subjected to reverse transcriptase polymerase chain reaction.Compared to control, the ratio MyoD to myogenin declined with emphysema, sham and even more after LVRS, due to a decrease in MyoD mRNA and an increase in myogenin mRNA. Similarly, compared to control, Id-1 protein mRNA levels decreased significantly in sham and even more in LVRS. Id-2 protein mRNA levels decreased in all groups, but reached statistical significance in LVRS only, compared to control.In conclusion: 1) the reduced MyoD/myogenin ratio may be the mechanism of the shift to a slower fibre type, 2) the decreased MyoD/myogenin ratio in lung volume reduction surgery animals suggests that lung volume reduction surgery enhances rather than decreases the load placed on the diaphragm and 3) the observed down-regulation of the inhibiting factors may facilitate the diaphragm adaptation to overload.
Severe lung involvement in systemic scleromyxoedema: a highly unusual finding
Authors: Morales P. , Martinez M.Á. , Vera F. , Romero G. 
Published: October 2002

Scleromyxoedema is a rare systemic disorder characterized by a lichenoid papular rash.Although scleromyxoedema can involve any organ, very few cases of pulmonary involvement have been reported. Moreover, there are no reports in the literature on treatment of this condition, especially with lung transplantation.The authors report a case of scleromyxoedema in a young man with neurological, skin and respiratory involvement, the latter being mainly characterized by pulmonary emphysema. Due to the serious respiratory compromise, and to the stability of the systemic lesions, a bilateral lung transplantation was performed with successful results at 4.5 yrs.In conclusion, lung transplantation may be required in patients with severe respiratory failure caused by scleromyxoedema.