BACKGROUND: The most frequently used parameters for assessing bronchoconstriction and bronchodilation are forced expiratory volume in 1 s (FEV(1)) and peak expiratory flow (PEF). OBJECTIVES: To assess the sensitivity of other parameters after induced bronchoconstriction and bronchodilation. METHODS: From maximum expiratory flow-volume (MEFV) curves, forced vital capacity, FEV(1), PEF, maximum expiratory flows (MEF) at 25, 50 and 75% of vital capacity and the area under the MEFV curve (A(ex)) were measured in two groups of asthmatic children after induced bronchoconstriction and bronchodilation, and in children with cystic fibrosis (CF) after bronchodilation. RESULTS: In 142 asthmatics without airway obstruction, bronchoconstriction was induced by inhalation of 1% histamine aerosol. The 20% fall in A(ex) compared to baseline was found in all asthmatics, while the 20 and 15% falls in FEV(1) were noted in 36 and 65% of the patients, respectively. Other parameters were less sensitive or interpretation was problematic. Another 110 asthmatics with mild-moderate airway obstruction were treated with various bronchodilators. The 20% increase in A(ex) was observed in all asthmatics, while the 20% increase in FEV(1) was found in only 33% of the patients and the 15% increase in FEV(1) in 51%. In 9 CF children, the pattern of changes in A(ex) and FEV(1) after bronchodilation was similar to that in asthmatics. CONCLUSIONS: A(ex) was a sensitive and less problematic parameter in the evaluation of airway patency in comparison with FEV(1) and other parameters measured from the MEFV curve in our study patients. (c) 2007 S. Karger AG, Basel.
- MeSH
- aplikace inhalační MeSH
- bronchiální astma diagnóza farmakoterapie MeSH
- bronchiální hyperreaktivita diagnóza farmakoterapie MeSH
- bronchodilatancia aplikace a dávkování MeSH
- bronchokonstrikce účinky léků MeSH
- bronchoprovokační testy MeSH
- cystická fibróza diagnóza farmakoterapie MeSH
- dítě MeSH
- dospělí MeSH
- histamin diagnostické užití MeSH
- kohortové studie MeSH
- lidé MeSH
- maximální exspirační objemové křivky MeSH
- mladiství MeSH
- plocha pod křivkou MeSH
- předškolní dítě MeSH
- rezistence dýchacích cest fyziologie MeSH
- senzitivita a specificita MeSH
- usilovný výdechový objem MeSH
- vrcholová exspirační průtoková rychlost MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- srovnávací studie MeSH
BACKGROUND: Chronic hypoxia induces lung vascular remodeling, which results in pulmonary hypertension. Vascular remodeling is associated with collagenolysis and activation of matrix metalloproteinases (MMPs). One of the possible sources of MMPs in hypoxic lung are mast cells. OBJECTIVE: The role of lung mast cell collagenolytic activity in hypoxic pulmonary hypertension was tested by the inhibitor of mast cell degranulation disodium cromoglycate (DSCG). METHODS: Rats were treated with DSCG in an early or later phase of isobaric hypoxia. Control groups were exposed to hypoxia only or to normoxia. Lung hemodynamics, muscularization and collagen metabolism in the walls of peripheral pulmonary vessels in the lungs were measured. RESULTS: DSCG applied at an early phase of exposure to hypoxia reduced the development of pulmonary hypertension, inhibited muscularization in peripheral pulmonary arteries and decreased the amount of collagen cleavage fragments in prealveolar vessels. CONCLUSIONS: Mast cell degranulation plays a role in the initiation of hypoxic pulmonary vascular remodeling. 2008 S. Karger AG, Basel.
- MeSH
- arteria pulmonalis metabolismus MeSH
- degranulace buněk účinky léků MeSH
- financování organizované MeSH
- hypoxie komplikace MeSH
- kolagen metabolismus MeSH
- kromoglykát dvojsodný farmakologie MeSH
- krysa rodu rattus MeSH
- mastocyty fyziologie účinky léků MeSH
- plicní hypertenze etiologie metabolismus patofyziologie prevence a kontrola MeSH
- potkani Wistar MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
BACKGROUND: Inflammatory markers in exhaled breath condensate (EBC) are investigated as a non-invasive approach to monitoring of inflammation in the respiratory tract. EBC concentrations of nitrite and nitrate, the stable end products of oxidative metabolism of nitric oxide, are increased in patients with asthma, especially during acute exacerbations. OBJECTIVES: To examine methodological aspects of nitrite and nitrate measurements in EBC such as sample collection, storage and analysis. METHODS: In a randomized study, EBC was collected twice within 1 h (with and without a nose clip) in 20 healthy adults and 20 patients with well-controlled asthma and no symptoms of allergic rhinitis. Nitrite and nitrate were assayed by ionex chromatography and fluorimetrically after derivatization with diaminonaphthalene. RESULTS: The geometric mean [exp (mean +/- SD)] EBC levels of nitrite and nitrate in healthy subjects [4.3 (3.0-6.1) and 11.0 (5.3-22.7) micromol/l] and patients [4.6 (2.6-7.3) and 8.7 (3.2-23.8) micromol/l] did not differ (p = 0.13). Wearing a nose clip (p = 0.3) did not influence nitrite and nitrate concentrations. The mean intra-subject %CVs of EBC concentrations of nitrite were 26 and 21% in healthy subjects and patients, while those of nitrate achieved 49 and 88%, respectively. CONCLUSIONS: Ionex chromatography of nitrite and nitrate requires no sample pretreatment and provides comparable results as a more laborious diaminonaphthalene method. EBC samples should be kept cold (8 degrees C) and analyzed for nitrite and nitrate within 24 h of collection or stored in the freezer and thawed preferably only once. Wearing a nose clip during EBC collection has no influence on nitrite and nitrate concentrations. Short-term repeatability of nitrite and nitrate measurements was worse compared to published data on exhaled nitric oxide.
- MeSH
- bronchiální astma metabolismus MeSH
- chromatografie MeSH
- dechové testy metody přístrojové vybavení MeSH
- dospělí MeSH
- dusičnany metabolismus MeSH
- dusitany metabolismus MeSH
- financování organizované MeSH
- fluorometrie MeSH
- klinické křížové studie MeSH
- lidé MeSH
- odběr biologického vzorku MeSH
- plíce metabolismus MeSH
- vydechnutí MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- validační studie MeSH
BACKGROUND: Clinically significant benign stenoses of the large airways develop in about 1% of patients after intubation. The management of benign stenoses is not unified around the world, nor are there any accepted methods for their screening. OBJECTIVES: The purpose of this study is to describe and compare results of interventional bronchoscopy and surgical therapy of benign stenoses as well as to propose an algorithm for the management of this airways disorder. METHODS: Prospective study on 80 consecutive patients with benign stenoses of the large airways admitted to the Pulmonary Department of the University Hospital of Prague-Motol. RESULTS: Sixty-two patients developed stenoses after endotracheal intubation or tracheostomy, in 18 patients the stenosis was caused by other diseases or pathological situations. Thirty-eight patients were sent for surgical resection of the stenotic part of the airways. 2 surgically treated patients developed recurrence of the stenosis and had to be reoperated on. Narrowing of the trachea at the site of end-to-end anastomosis developed in 6 other patients and was cured by interventional bronchoscopy. The remaining 42 patients were treated by interventional bronchoscopy (Nd-YAG laser, electrocautery, stent) which was curative in 35 patients. Sixty-five patients were alive at the time of evaluation, 15 patients died. Five of them died between 3 and 14 (median 4) months after surgery from a disease other than airway stenosis. Ten nonresected patients also died, with 1 exception, due to a disease other than airway stenosis; the median survival was 9 months. CONCLUSIONS: We recommend to assess the patient for surgery after the initial diagnosis and therapeutic bronchoscopy with dilatation of the stenosis. If the patient is not a suitable candidate for resection, interventional bronchoscopy is an appropriate alternative for the management of benign stenoses of the large airways. Copyright (c) 2005 S. Karger AG, Basel.
- MeSH
- bronchiální nemoci epidemiologie etiologie terapie MeSH
- bronchoskopie metody MeSH
- intratracheální intubace škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- nemocnice univerzitní MeSH
- prospektivní studie MeSH
- senioři MeSH
- stenóza průdušnice epidemiologie etiologie terapie MeSH
- stenóza epidemiologie etiologie terapie MeSH
- tracheostomie škodlivé účinky MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- amyloidóza komplikace MeSH
- lidé MeSH
- plicní nemoci komplikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- bronchogenní cysta diagnóza MeSH
- dospělí MeSH
- lidé MeSH
- počítačová rentgenová tomografie MeSH
- retroperitoneální prostor ultrasonografie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- atropin aplikace a dávkování farmakologie MeSH
- časové faktory MeSH
- elektronová mikroskopie MeSH
- epitel účinky léků ultrastruktura MeSH
- epitelové buňky MeSH
- králíci MeSH
- trachea cytologie účinky léků ultrastruktura MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- zvířata MeSH
- Check Tag
- králíci MeSH
- zvířata MeSH
- Publikační typ
- srovnávací studie MeSH
