Sample records for rat nasal airway

  1. Numerical simulation of airway dimension effects on airflow patterns and odorant deposition patterns in the rat nasal cavity.

    Zehong Wei

    Full Text Available The sense of smell is largely dependent on the airflow and odorant transport in the nasal cavity, which in turn depends on the anatomical structure of the nose. In order to evaluate the effect of airway dimension on rat nasal airflow patterns and odorant deposition patterns, we constructed two 3-dimensional, anatomically accurate models of the left nasal cavity of a Sprague-Dawley rat: one was based on high-resolution MRI images with relatively narrow airways and the other was based on artificially-widening airways of the MRI images by referencing the section images with relatively wide airways. Airflow and odorant transport, in the two models, were determined using the method of computational fluid dynamics with finite volume method. The results demonstrated that an increase of 34 µm in nasal airway dimension significantly decreased the average velocity in the whole nasal cavity by about 10% and in the olfactory region by about 12% and increased the volumetric flow into the olfactory region by about 3%. Odorant deposition was affected to a larger extent, especially in the olfactory region, where the maximum odorant deposition difference reached one order of magnitude. The results suggest that a more accurate nasal cavity model is necessary in order to more precisely study the olfactory function of the nose when using the rat.

  2. Role of neutrophilic inflammation in ozone-induced epithelial alterations in the nasal airways of rats

    Cho, Hye Youn

    Ozone is a principal oxidant air pollutant in photochemical smog. Epithelial cells lining the centriacinar region of lung and the proximal aspects of nasal passage are primary target sites for ozone-induced injury in laboratory animals. Acute exposure of rats to high ambient concentrations of ozone (e.g., 0.5 ppm) results in neutrophilic inflammation, epithelial hyperplasia and mucous cell metaplasia (MCM) in the nasal transitional epithelium (NTE) lining the proximal nasal airways. The principal purpose of the present study was to investigate the role of pre-metaplastic cellular responses, especially neutrophilic inflammation, in the pathogenesis of ozone-induced MCM in rat NTE. For this purpose, three specific hypotheses-based whole-animal inhalation studies were conducted. Male F344/N rats were exposed in whole-body inhalation chambers to 0 (filtered air) or 0.5 ppm ozone for 1-3 days (8 h/day). Histochemical, immunochemical, molecular and morphometric techniques were used to investigate the ozone-induced cellular and molecular events in the NTE. Two in vitro studies were also conducted to examine the effects of ozone-inducible cytokines (i.e., tumor necrosis factor-alpha; TNF- a, and interleukin-6; IL-6) on mucin gene (rMuc-5AC) expression. Ozone induced a rapid increase of rMuc-5AC mRNA in nasal tissues within hours after the start of exposure. It preceded the appearance of MCM, and persisted with MCM. Ozone-induced neutrophilic inflammation accompanied the mucin gene upregulation, but was resolved when MCM first appeared in the NTE. Antibody-mediated depletion of circulating neutrophils attenuated ozone-induced MCM, although it did not affect the ozone-induced epithelial hyperplasia and mucin mRNA upregulation. In another study, it was found that preexisting neutrophilic rhinitis induced by endotoxin augmented the ozone-induced MCM. However, pre-existing rhinitis did not alter the severity of ozone-induced epithelial hyperplasia and mucin gene upregulation

  3. Nasal continuous positive airway pressure

    Scholze, Alexandra; Lamwers, Stephanie; Tepel, Martin


    Obstructive sleep apnoea (OSA) is linked to increased cardiovascular risk. This risk can be reduced by nasal continuous positive airway pressure (nCPAP) treatment. As OSA is associated with an increase of several vasoconstrictive factors, we investigated whether nCPAP influences the digital volume...

  4. Nasal Airway Resistance: Its Measurement and Regulation.

    Hamilton, Lyle H.


    Reviews studies of regulation of nasal airway resistance (Rn). Describes methods of calculating Rn by measuring pressure-flow relationship. Data are presented on improved methods for measuring Rn and effects for expiratory and inspiratory Rn after topical application of phenylephrine nasal decongestant spray. (Author/SA)

  5. Mechanics of airflow in the human nasal airways.

    Doorly, D J; Taylor, D J; Schroter, R C


    The mechanics of airflow in the human nasal airways is reviewed, drawing on the findings of experimental and computational model studies. Modelling inevitably requires simplifications and assumptions, particularly given the complexity of the nasal airways. The processes entailed in modelling the nasal airways (from defining the model, to its production and, finally, validating the results) is critically examined, both for physical models and for computational simulations. Uncertainty still surrounds the appropriateness of the various assumptions made in modelling, particularly with regard to the nature of flow. New results are presented in which high-speed particle image velocimetry (PIV) and direct numerical simulation are applied to investigate the development of flow instability in the nasal cavity. These illustrate some of the improved capabilities afforded by technological developments for future model studies. The need for further improvements in characterising airway geometry and flow together with promising new methods are briefly discussed.

  6. Mucociliary clearance, airway inflammation and nasal symptoms in urban motorcyclists

    Tereza C.S. Brant


    Full Text Available OBJECTIVES: There is evidence that outdoor workers exposed to high levels of air pollution exhibit airway inflammation and increased airway symptoms. We hypothesized that these workers would experience increased airway symptoms and decreased nasal mucociliary clearance associated with their exposure to air pollution. METHODS: In total, 25 non-smoking commercial motorcyclists, aged 18-44 years, were included in this study. These drivers work 8-12 hours per day, 5 days per week, driving on urban streets. Nasal mucociliary clearance was measured by the saccharine transit test; airway acidification was measured by assessing the pH of exhaled breath condensate; and airway symptoms were measured by the Sino-nasal Outcome Test-20 questionnaire. To assess personal air pollution exposure, the subjects used a passive-diffusion nitrogen dioxide (NO2 concentration-monitoring system during the 14 days before each assessment. The associations between NO2 and the airway outcomes were analyzed using the Mann-Whitney test and the Chi-Square test. NCT01976039. RESULTS: Compared with clearance in healthy adult males, mucociliary clearance was decreased in 32% of the motorcyclists. Additionally, 64% of the motorcyclists had airway acidification and 92% experienced airway symptoms. The median personal NO2 exposure level was 75 mg/m3 for these subjects and a significant association was observed between NO2 and impaired mucociliary clearance (p = 0.036. CONCLUSION: Non-smoking commercial motorcyclists exhibit increased airway symptoms and airway acidification as well as decreased nasal mucociliary clearance, all of which are significantly associated with the amount of exposure to air pollution.

  7. The effect of rapid maxillary expansion on nasal airway resistance.

    White, B C; Woodside, D G; Cole, P


    The purpose of this investigation was to provide quantitative data describing the effects of rapid palatal expansion on nasal airway resistance. Rapid palatal expansion is an orthodontic procedure which is commonly used to widen the maxilla to correct maxillary narrowing resulting in the orthodontic abnormality of crossbite and to provide more space for alignment of crowded teeth. Recordings of nasal airway resistance were taken prior to expansion, immediately after expansion (approximately one month), after a retention period of approximately 4 months and approximately one year after initiation of treatment. Findings indicate an average reduction in nasal airway resistance of 48.7 per cent which was statistically significant at the 0.005 level. The reduction also appeared stable throughout the post treatment observation period (maximum one year) as each series of readings was statistically significantly lower than the initial reading, but not significantly different from each other. Reduction of nasal airway resistance was highly correlated to the initial nasal resistance level prior to rapid maxillary expansion. Those individuals with the greater initial resistance tended to have greater reductions in airway resistance following the expansion.

  8. Airway Inflammation in Chronic Rhinosinusitis with Nasal Polyps and Asthma: The United Airways Concept Further Supported

    Håkansson, Kåre; Bachert, Claus; Konge, Lars;


    Background It has been established that patients with chronic rhinosinusitis with nasal polyps (CRSwNP) often have co-existing asthma. Objective We aimed to test two hypotheses: (i) upper and lower airway inflammation in CRSwNP is uniform in agreement with the united airways concept; and (ii...

  9. Randomized trial of prongs or mask for nasal continuous positive airway pressure in preterm infants.

    Kieran, Emily A


    To determine whether nasal continuous positive airway pressure (NCPAP) given with nasal prongs compared with nasal mask reduces the rate of intubation and mechanical ventilation in preterm infants within 72 hours of starting therapy.

  10. The NOFLO trial: low-flow nasal prongs therapy in weaning nasal continuous positive airway pressure in preterm infants.

    O'Donnell, Sinéad M


    To determine if low-flow nasal prongs therapy with room air, compared with no treatment, facilitates weaning from nasal continuous positive airway pressure (NCPAP) in very low birth weight (VLBW, birth weight <1500 g) infants.

  11. Modeling of inertial deposition in scaled models of rat and human nasal airways: Towards in vitro regional dosimetry in small animals

    Xi, Jinxiang; Kim, JongWon; Si, Xiuhua A.; Corley, Richard A.; Zhou, Yue


    Rodents are routinely used in inhalation toxicology tests as human surrogates. However, in vitro dosimetry tests in rodent casts are still scarce due to small rodent airways and in vitro tests to quantify sub-regional dosimetry are still impractical. We hypothesized that for inertial particles whose deposition is dominated by airflow convection (Reynolds number) and particle inertia (Stokes number), the deposition should be similar among airway replicas of different scales if their Reynolds and Stokes numbers are kept the same. In this study, we aimed to (1) numerically test the hypothesis in three airway geometries: a USP induction port, a human nose model, and a Sprague-Dawley rat nose model, and (2) find the range of applicability of this hypothesis. Five variants of the USP and human nose models and three variants of the rat nose model were tested. Inhalation rates and particle sizes were scaled to match the Reynolds number and Stokes numbers. A low-Reynolds-number k–ω model was used to resolve the airflow and a Lagrangian tracking algorithm was used to simulate the particle transport and deposition. Statistical analysis of predicted doses was conducted using ANOVA. For normal inhalation rates and particle dia- meters ranging from 0.5 to 24 mm, the deposition differences between the life-size and scaled models are insignificant for all airway geometries considered (i.e., human nose, USP, and rat nose). Furthermore, the deposition patterns and exit particle profiles also look similar among scaled models. However, deposition rates and patterns start to deviate if inhalation rates are too low, or particle sizes are too large. For the rat nose, the threshold velocity was found to be 0.71 m/s and the threshold Froude number to be 50. Results of this study provide a theoretical foundation for sub-regional in vitro dosimetry tests in small animals and for interpretation of data from inter-species or intra-species with varying body sizes.

  12. Congenital nasal pyriform aperture stenosis: a rare cause of neonatal nasal airway obstruction

    A Rao


    Full Text Available Congenital nasal pyriform aperture stenosis (CNPAS is a rare cause of nasal airway obstruction that clinically mimics choanal atresia in a neonate. The differentiation between the two is very important as the management of the two conditions is different. Timely recognition is important to prevent fatal outcome. CNPAS may present as an isolated condition or with associated craniofacial anomalies. Despite typical findings of CNPAS being present on cross-sectional imaging, this condition is commonly overlooked, probably because of a lack of familiarity with the normal morphological features of the nasal cavity in infants and also owing to a lack of awareness of this rare entity. Here we report a case of CNPAS with pre- and post-surgical CT images and the complication that occurred owing to nasal stenting.

  13. Airway Inflammation in Chronic Rhinosinusitis with Nasal Polyps and Asthma: The United Airways Concept Further Supported

    Håkansson, Kåre; Bachert, Claus; Konge, Lars


    Background It has been established that patients with chronic rhinosinusitis with nasal polyps (CRSwNP) often have co-existing asthma. Objective We aimed to test two hypotheses: (i) upper and lower airway inflammation in CRSwNP is uniform in agreement with the united airways concept; and (ii....... Inflammatory cytokines were investigated using a Th1/Th2 assay including 14 chemokines and cytokines; tissue concentrations were normalized according to tissue weight and total protein concentration. Individual cytokines and multivariate inflammatory profiles were compared between biopsy sites and between...... patients and controls. Results We found significantly higher concentrations of Th2 cytokines in nasal polyps compared to inferior turbinate and bronchial biopsies. In addition, we showed that the inflammatory profile of nasal polyps and bronchial biopsies correlated significantly (p

  14. Hydrocolloid dressing in preventing nasal trauma secondary to nasal continuous positive airway pressure in preterm infants.

    Xie, Li-Hua


    Continuous positive airway pressure (CPAP) with nasal devices (nCPAP) is widely used in the respiratory management of newborns. The present study aimed to compare the incidence of nasal trauma secondary to nasal continuous positive airway pressure (nCPAP) protected with or without hydrocolloid dressing in preterm infants. This prospective controlled study was performed in the neonatal intensive care unit (NICU) of the Children's Hospital of Hunan Province from March 1, 2010 to June 31, 2010. A total of 65 infants, 46 males and 19 females, were recruited in this study. Their average gestational age was 32.6 weeks (range 28-37 weeks). The infants were randomly divided into clinical trial group (group A, n=33) and control group (group B, n=32). Paraffin oil was smeared around the nostrils before inserting prongs in group B; the infants in group A were covered on the infant's nostrils surface with hydrocolloid dressing (hydrocolloid dressing, 1.8 mm thick, 90029T, 3M Company, Minnesota, USA) with a size of 2-3 cm cutting two holes adapted to the nose and nostrils. The nostrils of those infants were inspected daily during nCPAP support until they were weaned off nCPAP. Nine infants (2 in group A and 7 in group B) developed nasal injury during nCPAP support. The Chi-square test revealed that there was a statistically significant difference (P=0.01) in the incidence of nasal injury between groups A and B. The study demonstrated that hydrocolloid dressing significantly decreased the incidence and the severity of nasal injury.

  15. Early nasal continuous positive airway pressure in a cohort of the smallest infants in Denmark

    Hansen, Bo M; Esbjørn, Barbara Hoff; Greisen, G


    To evaluate neurodevelopmental outcome at age 5 y of age in a cohort of preterm children treated mainly with nasal continuous positive airway pressure (CPAP) in the neonatal period.......To evaluate neurodevelopmental outcome at age 5 y of age in a cohort of preterm children treated mainly with nasal continuous positive airway pressure (CPAP) in the neonatal period....

  16. In vivo deposition of ultrafine aerosols in human nasal and oral airways

    Yeh, Hsu-Chi; Swift, D.L. [John Hopkins Univ., Baltimore, MD (United States); Simpson, S.Q. [Univ. of New Mexico, Albuquerque, NM (United States)] [and others


    The extrathoracic airways, including the nasal passage, oral passage, pharynx, and larynx, are the first targets for inhaled particles and provide an important defense for the lung. Understanding the deposition efficiency of the nasal and oral passages is therefore crucial for assessing doses of inhaled particles to the extrathoracic airways and the lung. Significant inter-subject variability in nasal deposition has been shown in recent studies by Rasmussen, T.R. et al, using 2.6 {mu}m particles in 10 human subjects and in our preliminary studies using 0.004-0.15 {mu}m particles in four adult volunteers. No oral deposition was reported in either of these studies. Reasons for the intersubject variations have been frequently attributed to the geometry of the nasal passages. The aims of the present study were to measure in vivo the nasal airway dimensions and the deposition of ultrafine aerosols in both the nasal and oral passages, and to determine the relationship between nasal airway dimensions and aerosol deposition. A statistical procedure incorporated with the diffusion theory was used to model the dimensional features of the nasal airways which may be responsible for the biological variability in particle deposition. In summary, we have correlated deposition of particles in the size range of 0.004 to 0.15 {mu}m with the nasal dimensions of each subject.

  17. The Efficacy of a Protocolized Nursing Care on Nasal Skin Breakdown in Preterm Neonates Receiving Nasal Continuous Positive Airway Pressure

    Mahnaz Jabraeili


    Full Text Available Background: Nasal continuous positive airway pressure (NCPAP is an effective method of ventilation in newborns with respiratory distress syndrome (RDS. Using an appropriate nasal skin care protocol is identical to prevention or reduction of nasal skin breakdown in those who receive NCPAP. This study aimed to investigate the effectiveness of an evidence-based clinical care protocol on nasal skin integrity in preterm newborns who receive NCPAP.Materials and Methods: A Randomized Controlled Trial was used to conduct the study. A cohort of 110 preterm newborns with a gestational age (GA of 25 to 36 weeks, receiving nasal continuous positive airway pressure (NCPAP for RDS in the neonatal intensive care unit of a university teaching hospital were selected to perform the study. They were randomly assigned to a protocolized nasal skin care (group A or to a group receiving the routine care (group B. Nasal skin integrity of the preterm neonates, were measured on a daily basis for 10 days using the Neonatal Skin Condition Scale (NSCS 24 hours after placement of NCPAPs in both groups.Results: Each intervention and control group included 55 neonates. 65.50% of neonates in the control group and 47.30% of neonates in the intervention group were male. Repeated measures analysis showed thatNSCS scores were significantly lower in intervention group receiving nasal skin care in accordance with the protocol than the control group receiving the routine nasal skin care (P=0.000. Conclusion: In this study, the protocolized care reduced nasal skin breakdown in the preterm newborns receiving NCPAP. Therefore, it can be used as an effective method in nasal skin care in neonates who are treated by NCPAP.

  18. The Usefulness of Nasal Packing with Vaseline Gauze and Airway Silicone Splint after Closed Reduction of Nasal Bone Fracture

    Hyo Young Kim


    Full Text Available BackgroundPacking after closed reduction of a nasal bone fracture causes inconvenient nasal obstruction in patients. We packed the superior meatus with Vaseline gauze to support the nasal bone, and packed the middle nasal meatus with a Doyle Combo Splint consisting of an airway tube, a silastic sheet, and an expandable sponge to reduce the inconvenience. In addition, we aimed to objectively identify whether this method not only enables nasal respiration but also sufficiently supports the reduced nasal bone.MethodsNasal ventilation was measured via spirometry 1 day before surgery and compared to 1 day after surgery. To compare support of the reduced nasal bone by the 2 methods, 2 plastic surgeons assessed the displacementon X-rays taken after the surgery and after removing the packing. The extent of nasal obstruction, dry mouth, sleep disturbance, headache, and swallowing difficulty were compared with visual analog scales (VAS on a pre-discharge survey.ResultsIn the experimental group, the nasal respiration volume 1 day after surgery remained at 71.3%±6.84% on average compared to 1 day prior to surgery. Support of the reduced bone in the experimental group (2.80±0.4 was not significantly different from the control group (2.88±0.33. The VAS scores for all survey items were lower in the experimental group than in the control group, where a lower score indicated a lower level of inconvenience.ConclusionsThe nasal cavity packing described here maintained objective measures of nasal respiration and supported the reduced bone similar to conventional methods. Maintaining nasal respiration reduced the inconvenience to patients, which demonstrates that this packing method is useful.

  19. Continuous Positive Airway Pressure Strategies with Bubble Nasal Continuous Positive Airway Pressure: Not All Bubbling Is the Same: The Seattle Positive Airway Pressure System.

    Welty, Stephen E


    Premature neonates are predisposed to complications, including bronchopulmonary dysplasia (BPD). BPD is associated with long-term pulmonary and neurodevelopmental consequences. Noninvasive respiratory support with nasal continuous positive airway pressure (CPAP) has been recommended strongly by the American Academy of Pediatrics. However, CPAP implementation has shown at least a 50% failure rate. Enhancing nasal CPAP effectiveness may decrease the need for mechanical ventilation and reduce the incidence of BPD. Bubble nasal CPAP is better than nasal CPAP using mechanical devices and the bubbling provides air exchange in distal respiratory units. The Seattle PAP system reduces parameters that assess work of breathing. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Nasal Functional Evaluation Using Nasal Endoscopy, Acoustic Rhinometry, and Rhinomanometry on Nasal Airway-Obstructed Patients after Endoscopic Septoplasty, Corrective Rhinoplasty, and Internal Nasal Valve Surgery

    Yiğit Özer Tiftikcioğlu


    Full Text Available Objective: Rhinoplasty is a very common surgical procedure that is performed throughout the world as well as in our country for aesthetic concerns, nasal obstruction, or both. However, functional results still remain subjective, and compared to the vast number of operations, studies about functional results in the literature are very limited. The aim of this study is to evaluate respiratory functions after corrective rhinoplasty and to find the benefits both numerically and statistically. Material and Methods: Thirty patients who were admitted to our department with nasal obstruction based on the statements of the patients were included in the study. Patients who were admitted only for aesthetic considerations were excluded from the study. These patients were preoperatively evaluated with radiographic and endoscopic imaging; preoperative nasal resistance and nasal airway cross-sectional area values were measured and recorded with acoustic rhinometry and rhinomanometry devices. Then, patients were operated by open rhinoplasty technique, and measurements were repeated at three months and one year postoperative follow-ups. Results: As a result of measurements made with rhinomanometry one year after the surgery, a decrease in resistance value was observed in 20 patients, and an increase in minimal cross-sectional area measured with acoustic rhinometry was observed in 24 patients. The values measured by both methods were found to be statistically significant. Conclusion: As a result of our study, we advocate performing both functional and aesthetic rhinoplasty operations instead of functional or aesthetic purposes alone.

  1. Nasal airway and septal variation in unilateral and bilateral cleft lip and palate.

    Starbuck, John M; Friel, Michael T; Ghoneima, Ahmed; Flores, Roberto L; Tholpady, Sunil; Kula, Katherine


    Cleft lip and palate (CLP) affects the dentoalveolar and nasolabial facial regions. Internal and external nasal dysmorphology may persist in individuals born with CLP despite surgical interventions. 7-18 year old individuals born with unilateral and bilateral CLP (n = 50) were retrospectively assessed using cone beam computed tomography. Anterior, middle, and posterior nasal airway volumes were measured on each facial side. Septal deviation was measured at the anterior and posterior nasal spine, and the midpoint between these two locations. Data were evaluated using principal components analysis (PCA), multivariate analysis of variance (MANOVA), and post-hoc ANOVA tests. PCA results show partial separation in high dimensional space along PC1 (48.5% variance) based on age groups and partial separation along PC2 (29.8% variance) based on CLP type and septal deviation patterns. MANOVA results indicate that age (P = 0.007) and CLP type (P ≤ 0.001) significantly affect nasal airway volume and septal deviation. ANOVA results indicate that anterior nasal volume is significantly affected by age (P ≤ 0.001), whereas septal deviation patterns are significantly affected by CLP type (P ≤ 0.001). Age and CLP type affect nasal airway volume and septal deviation patterns. Nasal airway volumes tend to be reduced on the clefted sides of the face relative to non-clefted sides of the face. Nasal airway volumes tend to strongly increase with age, whereas septal deviation values tend to increase only slightly with age. These results suggest that functional nasal breathing may be impaired in individuals born with the unilateral and bilateral CLP deformity.

  2. The Usefulness of Nasal Packing with Vaseline Gauze and Airway Silicone Splint after Closed Reduction of Nasal Bone Fracture

    Hyo Young Kim


    Full Text Available Background Packing after closed reduction of a nasal bone fracture causes inconvenientnasal obstruction in patients. We packed the superior meatus with Vaseline gauze to supportthe nasal bone, and packed the middle nasal meatus with a Doyle Combo Splint consistingof an airway tube, a silastic sheet, and an expandable sponge to reduce the inconvenience.In addition, we aimed to objectively identify whether this method not only enables nasalrespiration but also sufficiently supports the reduced nasal bone.Methods Nasal ventilation was measured via spirometry 1 day before surgery and comparedto 1 day after surgery. To compare support of the reduced nasal bone by the 2 methods, 2plastic surgeons assessed the displacementon X-rays taken after the surgery and after removingthe packing. The extent of nasal obstruction, dry mouth, sleep disturbance, headache, andswallowing difficulty were compared with visual analog scales (VAS on a pre-discharge survey.Results In the experimental group, the nasal respiration volume 1 day after surgery remainedat 71.3%±6.84% on average compared to 1 day prior to surgery. Support of the reducedbone in the experimental group (2.80±0.4 was not significantly different from the controlgroup (2.88±0.33. The VAS scores for all survey items were lower in the experimental groupthan in the control group, where a lower score indicated a lower level of inconvenience.Conclusions The nasal cavity packing described here maintained objective measures of nasalrespiration and supported the reduced bone similar to conventional methods. Maintainingnasal respiration reduced the inconvenience to patients, which demonstrates that thispacking method is useful.

  3. Dysgenesis of the Middle Turbinate: A Unique Cause of Nasal airway obstruction


    disclosed for this article . We present a unique case of nasal airway obstructionresulting from dysgenesis of the middle turbinate that has not been...Understanding the embryologic development of the lateral nasal wall provides insight into its complex anatomy and anatomic variants. The ethmoid turbinates...from the lateral wall of the middle meatus.2 Few articles reference the secondary MTs, which are quite rare and are most frequently bilateral.2-5 The

  4. The use of nasal dilator strips as a placebo for trials evaluating continuous positive airway pressure

    Aline C.S. Amaro


    Full Text Available OBJECTIVES: The aim of the current study was to compare the objective and subjective effects of continuous positive airway pressure to the use of nasal dilator strips in patients with acromegaly and moderate to severe obstructive sleep apnea. METHODS: We studied 12 patients with acromegaly and moderate to severe obstructive sleep apnea (male/ females = 8/4, age = 52±8 ys, body mass index = 33.5±4.6 Kg/m², apnea-hypopnea index = 38±14 events/h who had been included in a randomized, crossover study to receive three months of treatment with continuous positive airway pressure and nasal dilator strips. All patients were evaluated at study entry and at the end of each treatment by polysomnography, and Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index and treatment satisfaction questionnaires. NCT01265121 RESULTS: The apnea-hypopnea index values decreased significantly with continuous positive airway pressure treatment but did not change with the use of nasal dilator strips. All of the subjective symptoms improved with both treatments, but these improvements were significantly greater with continuous positive airway pressure than with the nasal dilator strips CONCLUSION: The use of nasal dilator strips had a much smaller effect on the severity of obstructive sleep apnea in patients with acromegaly and moderate to severe obstructive sleep apnea in comparison to the use of continuous positive airway pressure. Moreover, the improvement in several subjective parameters without any significant objective improvement in obstructive sleep apnea resulting from the use of nasal dilator strips is compatible with a placebo effect.

  5. Influence of Chronic Sinusitis and Nasal Polyp on the Lower Airway of Subjects Without Lower Airway Diseases

    Lee, Suh-Young; Yoon, Soon Ho; Song, Woo-Jung; Lee, So-Hee; Kang, Hye-Ryun; Kim, Sun-Sin


    Purpose Upper and lower respiratory tract pathologies are believed to be interrelated; however, the impact of upper airway inflammation on lung function in subjects without lung disease has not been evaluated. This study investigated the association of CT finding suggesting chronic sinusitis and lung function in healthy subjects without lung disease. Methods This was a retrospective study of prospectively collected data from 284 subjects who underwent a pulmonary function test, bronchial provocation test, rhinoscopy, and osteomeatal unit computed tomography offered as a private health check-up option. Results CT findings showed that the sinusitis group had a significantly lower FEV1/FVC ratio than subjects without sinusitis finding (78.62% vs 84.19%, P=0.019). Among the sinusitis group, subjects classified by CT findings as the extensive disease group had a slightly lower FEV1/FVC than those of the limited disease group (76.6% vs 79.5%, P=0.014) and the associations were independent of the presence of airway hyperresponsiveness. The subjects with nasal polyp had also lower FEV1 and FEV1/FVC than subjects without nasal polyp (FEV1: 100.0% vs 103.6%, P=0.045, FEV1/FVC: 77.4% vs 80.0%, P=0.005). Conclusions CT findings suggesting chronic sinusitis and nasal polyp were associated with subclinical lower airway flow limitation even in the absence of underlying lung disease. PMID:24991454

  6. Nasal high flow clears anatomical dead space in upper airway models

    Celik, Gülnaz; Feng, Sheng; Bartenstein, Peter; Meyer, Gabriele; Eickelberg, Oliver; Schmid, Otmar; Tatkov, Stanislav


    Recent studies showed that nasal high flow (NHF) with or without supplemental oxygen can assist ventilation of patients with chronic respiratory and sleep disorders. The hypothesis of this study was to test whether NHF can clear dead space in two different models of the upper nasal airways. The first was a simple tube model consisting of a nozzle to simulate the nasal valve area, connected to a cylindrical tube to simulate the nasal cavity. The second was a more complex anatomically representative upper airway model, constructed from segmented CT-scan images of a healthy volunteer. After filling the models with tracer gases, NHF was delivered at rates of 15, 30, and 45 l/min. The tracer gas clearance was determined using dynamic infrared CO2 spectroscopy and 81mKr-gas radioactive gamma camera imaging. There was a similar tracer-gas clearance characteristic in the tube model and the upper airway model: clearance half-times were below 1.0 s and decreased with increasing NHF rates. For both models, the anterior compartments demonstrated faster clearance levels (half-times clearance (half-times clearance in the models. For the anatomically based model, there was complete tracer-gas removal from the nasal cavities within 1.0 s. The level of clearance in the nasal cavities increased by 1.8 ml/s for every 1.0 l/min increase in the rate of NHF. The study has demonstrated the fast-occurring clearance of nasal cavities by NHF therapy, which is capable of reducing of dead space rebreathing. PMID:25882385

  7. Comparison of the upper airway dynamics of oronasal and nasal masks with positive airway pressure treatment using cine magnetic resonance imaging.

    Ebben, Matthew R; Milrad, Sara; Dyke, Jonathan P; Phillips, C Douglas; Krieger, Ana C


    It is known that oronasal masks are not as effective at opening the upper airway compared to nasal only continuous positive airway pressure (CPAP) masks in patients with sleep-disordered breathing. However, the physiological mechanism for this difference in efficacy is not known; although, it has been hypothesized to involve the retroglossal and/or retropalatal region of the upper airway. The objective of this study was to investigate differences in retroglossal and retropalatal anterior-posterior space with the use of oronasal vs. nasal CPAP masks using real-time cine magnetic resonance imaging (cMRI). Ten subjects (eight men, two women) with obstructive sleep apnea (OSA) were given cMRI with both nasal and oronasal CPAP masks. Each subject was imaged with each interface at pressures of 5, 10, and 15 cm of H2O, while in the supine position along the sagittal plane. The oronasal mask produced significantly less airway opening in the retropalatal region of the upper airway compared to the nasal mask interface. During exhalation, mask style had a significant effect on anterior-posterior distance p = 0.016. No differences were found in the retroglossal region between mask styles. Our study confirmed previous findings showing differences in treatment efficacy between oronasal and nasal mask styles. We have shown anatomic evidence that the nasal mask is more effective in opening the upper airway compared to the oronasal mask in the retropalatal region.

  8. Upper airway obstruction during midazolam sedation: modification by nasal CPAP.

    Nozaki-Taguchi, N; Isono, S; Nishino, T; Numai, T; Taguchi, N


    We examined the depressant effect of midazolam on respiration in 21 healthy women undergoing lower abdominal surgery with spinal anaesthesia. Airway gas flow, airway pressure, and the sound of snoring were recorded together with arterial oxygen saturation (SpO2). After spinal anaesthesia was established, subjects were deeply sedated with pentazocine 15 mg followed by incremental doses of midazolam 1 mg i.v. up to 0.1 When SpO2 decreased to midazolam sedation for spinal anaesthesia.

  9. Ozone-Induced Type 2 Immunity in Nasal Airways. Development and Lymphoid Cell Dependence in Mice.

    Ong, Chee Bing; Kumagai, Kazuyoshi; Brooks, Phillip T; Brandenberger, Christina; Lewandowski, Ryan P; Jackson-Humbles, Daven N; Nault, Rance; Zacharewski, Timothy R; Wagner, James G; Harkema, Jack R


    Inhalation exposures to ozone commonly encountered in photochemical smog cause airway injury and inflammation. Elevated ambient ozone concentrations have been epidemiologically associated with nasal airway activation of neutrophils and eosinophils. In the present study, we elucidated the temporal onset and lymphoid cell dependency of eosinophilic rhinitis and associated epithelial changes in mice repeatedly exposed to ozone. Lymphoid cell-sufficient C57BL/6 mice were exposed to 0 or 0.5 parts per million (ppm) ozone for 1, 2, 4, or 9 consecutive weekdays (4 h/d). Lymphoid cell-deficient, Rag2(-/-)Il2rg(-/-) mice were similarly exposed for 9 weekdays. Nasal tissues were taken at 2 or 24 hours after exposure for morphometric and gene expression analyses. C57BL/6 mice exposed to ozone for 1 day had acute neutrophilic rhinitis, with airway epithelial necrosis and overexpression of mucosal Ccl2 (MCP-1), Ccl11 (eotaxin), Cxcl1 (KC), Cxcl2 (MIP-2), Hmox1, Il1b, Il5, Il6, Il13, and Tnf mRNA. In contrast, 9-day ozone exposure elicited type 2 immune responses in C57BL/6 mice, with mucosal mRNA overexpression of Arg1, Ccl8 (MCP-2), Ccl11, Chil4 (Ym2), Clca1 (Gob5), Il5, Il10, and Il13; increased density of mucosal eosinophils; and nasal epithelial remodeling (e.g., hyperplasia/hypertrophy, mucous cell metaplasia, hyalinosis, and increased YM1/YM2 proteins). Rag2(-/-)Il2rg(-/-) mice exposed to ozone for 9 days, however, had no nasal pathology or overexpression of transcripts related to type 2 immunity. These results provide a plausible paradigm for the activation of eosinophilic inflammation and type 2 immunity found in the nasal airways of nonatopic individuals subjected to episodic exposures to high ambient ozone.

  10. Airway symptoms and biological markers in nasal lavage fluid in subjects exposed to metalworking fluids.

    Louise Fornander

    Full Text Available BACKGROUNDS: Occurrence of airway irritation among industrial metal workers was investigated. The aims were to study the association between exposures from water-based metal working fluids (MWF and the health outcome among the personnel, to assess potential effects on the proteome in nasal mucous membranes, and evaluate preventive actions. METHODS: The prevalence of airway symptoms related to work were examined among 271 metalworkers exposed to MWF and 24 metal workers not exposed to MWF at the same factory. At the same time, air levels of potentially harmful substances (oil mist, morpholine, monoethanolamine, formaldehyde generated from MWF was measured. Nasal lavage fluid was collected from 13 workers and 15 controls and protein profiles were determined by a proteomic approach. RESULTS: Airway symptoms were reported in 39% of the workers exposed to MWF although the measured levels of MWF substances in the work place air were low. Highest prevalence was found among workers handling the MWF machines but also those working in the same hall were affected. Improvement of the ventilation to reduce MWF exposure lowered the prevalence of airway problems. Protein profiling showed significantly higher levels of S100-A9 and lower levels of SPLUNC1, cystatin SN, Ig J and β2-microglobulin among workers with airway symptoms. CONCLUSIONS: This study confirms that upper airway symptoms among metal workers are a common problem and despite low levels of MWF-generated substances, effects on airway immune proteins are found. Further studies to clarify the role of specific MWF components in connection to airway inflammation and the identified biological markers are warranted.

  11. Acoustic rhinometry (AR): An Alternative Method to Image Nasal Airway Geometry

    Straszek, Sune; Pedersen, O.F.

      ACOUSTIC RHINOMETRY (AR): AN ALTERNATIVE METHOD TO IMAGE NASAL AIRWAY GEOMETRY.  INTRODUCTION AND BACKGROUND:  In human studies the acoustic reflection technique was first applied to describe the area-distance relationship of the lower airways, but later the acoustic reflection technique appeared...... studies in laboratory animals more reliable. To accomplish this we hope to receive new input from adjacent fields of research.  [OFP1] Det er ikke nogen piezoelektrisk mikrofon. Det er en ganske billig kondensator mikrofon. [OFP2] Jeg tror du kan nøjes med små figurer1) Indfaldende og reflekteret kurve...

  12. Voice low tone to high tone ratio--a new index for nasal airway assessment.

    Lee, Guoshe; Yang, Cheryl C H; Kuo, Terry B J


    There are several methodology based on voice analysis to evaluate nasal airway. Here we introduce a new quantitative index based on voice spectrum analysis to evaluate nasal obstruction. Ten subjects of nasal blockage were instructed to produced the sustained consonant-vowel syllable /m partial partial differential/ at comfortable levels of speech for at least 5 seconds. After nasal decongestant treatment, the second voice sample was collected. Sound spectrum was obtained by the algorithm of fast Fourier transform and the fundamental frequency (F0) was calculated by the method of autocorrelation. Voice low tone to high tone ratio (VLHR) was defined as the division of low frequency power (LFP) into high frequency power (HFP) of the sound power spectrum and was finally expressed in decibels. The cut-off frequency was the product of F0 and square root of (4 x 5). The VLHR after nasal decongestant treatment increased significantly as compared with that before treatment (P < 0.01). VLHR is a new index derived from sound spectral analysis and that may detect the changes in frequency characteristics of voice during treatment for nasal obstruction. The index is quantitative, non-invasive, and potentially useful for basic researches and clinical applications.

  13. Effects of nasal continuous positive airway pressure therapy on partners' sexual lives.

    Acar, Mustafa; Kaya, Coskun; Catli, Tolgahan; Hancı, Deniz; Bolluk, Ozge; Aydin, Yunus


    To assess sexual functioning in male and female partners before and after nasal continuous positive airway pressure (CPAP) therapy in men with obstructive sleep apnea (OSA). Twenty-one male patients with moderate to severe OSA and erectile dysfunction, and their female partner, were recruited into this prospective study. Males diagnosed with OSA were treated with nasal CPAP therapy for 12 weeks. Women were assessed for sexual functioning using the Female Sexual Function Index (FSFI), and for mood status using the Beck Depression Inventory (BDI), before and after their male partner underwent nasal CPAP therapy. Sexual functioning was assessed in men using the International Index of Erectile Function (IIEF), before and after nasal CPAP therapy. After nasal CPAP therapy for OSA in men, IIEF scores were significantly higher than pre-treatment scores. Total pre- and post-treatment IIEF scores (mean ± standard deviation) were 50.28 ± 15.88 and 65.42 ± 7.47, respectively, P sexual functioning in both the male and female partners. Moreover, our findings indicate that improved sexual function in women after their male partner underwent nasal CPAP also had psychological benefits.

  14. A Randomized Trial of Low-Flow Oxygen versus Nasal Continuous Positive Airway Pressure in Preterm Infants

    Heiring, Christian; Steensberg, Jesper; Bjerager, Mia


    BACKGROUND: Nasal continuous positive airway pressure (nCPAP) stabilizes the residual volume and may decrease the risk of 'atelectotrauma', potentially promoting lung development in neonates. OBJECTIVES: To assess whether replacing nCPAP by low-flow O2 by nasal cannula affects lung function expre...

  15. Patient-specific three-dimensional explant spheroids derived from human nasal airway epithelium

    Marthin, June Kehlet; Stevens, Elizabeth Munkebjerg; Larsen, Lars Allan


    BACKGROUND: Three-dimensional explant spheroid formation is an ex vivo technique previously used in studies of airway epithelial ion and water transport. Explanted cells and sheets of nasal epithelium form fully differentiated spheroids enclosing a partly fluid-filled lumen with the ciliated apical....... Nasal ciliary cells and sheets were removed on day 1 by nasal brush biopsy and analyzed with regard to ciliary beat pattern-and frequency using high-speed video imaging for standard reference values. Three-dimensional explant spheroid formation was initiated in the same individual on the same day...... was successful in 15 out of 18 (82%) sampled individuals. Thus, formation was successful in seven healthy controls and eight PCD patients, while unsuccessful in 3 with PCD due to infection. Median (range) number of days in culture before harvesting of spheroids was 4 (1-5) in healthy versus 2 (1-5) in PCD...

  16. Nasal Airway Evaluation After Le Fort I Osteotomy Combined With Septoplasty in Patients With Cleft Lip and Palate.

    Wang, Zhongying; Wang, Peihua; Zhang, Yixin; Shen, Guofang


    Septal deviation constitutes an important component of both esthetic deformity and airway compromise in patients with cleft lip and palate (CLP). The posterior parts of the nasal septum presented greater deviation than the anterior parts in patients with complete unilateral CLP. Le Fort I down-fracture provides better access to the nasal septum than intranasal incision during rhinoplasty, especially to the posterior part. This study objectively and subjectively evaluated the nasal function after Le Fort I osteotomy combined with septoplasty in patients with complete unilateral CLP. Twenty-three patients with complete unilateral CLP presenting with nasal obstruction and septum deviation were included (12-combined surgery group; 11-control group). Types of septum deviation in the patients were analyzed. Presurgical and 6-month-postsurgical acoustic rhinometry (AR) was performed for objective assessment; and the nasal obstruction symptom evaluation (NOSE) scale was used for subjective assessment. The authors used SPSS to compare the baseline and follow-up results. Acoustic rhinometry assessment showed improvements in the nasal minimal cross-sectional area (MCA), nasal resistance, and nasal volumes in 12 patients who received combined surgery. For the 2 groups, significant improvements in nasal breathing were documented (by NOSE scores) at 6 months after surgery. Simultaneous management of the maxillary dysplasia (Le Fort I osteotomy) and intranasal pathology (septoplasty) were effective for relief of nasal airway obstruction in patients with complete unilateral CLP. The combination of objective (AR) and subjective (NOSE scale) assessments allowed better evaluation of the nasal function.

  17. Effects of flow amplitudes on intraprong pressures during bubble versus ventilator-generated nasal continuous positive airway pressure in premature infants.

    Kahn, Doron J; Habib, Robert H; Courtney, Sherry E


    The goal were to characterize the flow dependence of bubble nasal continuous positive airway pressure delivery in a cohort of preterm infants and to compare the actual (delivered) intraprong continuous positive airway pressure with the intended (set) nasal continuous positive airway pressure for both ventilator-generated nasal continuous positive airway pressure and bubble nasal continuous positive airway pressure delivery. A range of set values and constant flow rates were studied in the same preterm infants. For 12 premature infants of pressures were measured at 3 increasing flow settings, repeated for set nasal continuous positive airway pressures (or desired immersion depths) of 4 and 6 cm H(2)O. Next, intraprong pressures were measured at bubble nasal continuous positive airway pressure expiratory tubing submersion depths and ventilator-generated nasal continuous positive airway pressure set expiratory pressures of 2, 3, 4, 5, and 7 cm H(2)O while the flow rate was held constant. Actual (delivered) intraprong pressure during bubble nasal continuous positive airway pressure delivery was highly flow dependent and increased as the flow rate increased. During ventilator-generated nasal continuous positive airway pressure delivery, actual pressure at the nasal prongs closely approximated the pressure set at the ventilator. During bubble nasal continuous positive airway pressure delivery at constant flow rate, the average delivered prong pressure was 1.3 cm H(2)O (range: 0.5-2.2 cm H(2)O) higher than that set through submersion of the expiratory tubing, and the relative difference between the set and actual pressures increased at lesser immersion depths. Prong pressure during bubble nasal continuous positive airway pressure delivery is highly variable and depends on the interaction of submersion depth and flow amplitudes.

  18. Effect of Nasal Obstruction on Continuous Positive Airway Pressure Treatment: Computational Fluid Dynamics Analyses.

    Tadashi Wakayama

    Full Text Available Nasal obstruction is a common problem in continuous positive airway pressure (CPAP therapy for obstructive sleep apnea and limits treatment compliance. The purpose of this study is to model the effects of nasal obstruction on airflow parameters under CPAP using computational fluid dynamics (CFD, and to clarify quantitatively the relation between airflow velocity and pressure loss coefficient in subjects with and without nasal obstruction.We conducted an observational cross-sectional study of 16 Japanese adult subjects, of whom 9 had nasal obstruction and 7 did not (control group. Three-dimensional reconstructed models of the nasal cavity and nasopharynx with a CPAP mask fitted to the nostrils were created from each subject's CT scans. The digital models were meshed with tetrahedral cells and stereolithography formats were created. CPAP airflow simulations were conducted using CFD software. Airflow streamlines and velocity contours in the nasal cavities and nasopharynx were compared between groups. Simulation models were confirmed to agree with actual measurements of nasal flow rate and with pressure and flow rate in the CPAP machine.Under 10 cmH2O CPAP, average maximum airflow velocity during inspiration was 17.6 ± 5.6 m/s in the nasal obstruction group but only 11.8 ± 1.4 m/s in the control group. The average pressure drop in the nasopharynx relative to inlet static pressure was 2.44 ± 1.41 cmH2O in the nasal obstruction group but only 1.17 ± 0.29 cmH2O in the control group. The nasal obstruction and control groups were clearly separated by a velocity threshold of 13.5 m/s, and pressure loss coefficient threshold of approximately 10.0. In contrast, there was no significant difference in expiratory pressure in the nasopharynx between the groups.This is the first CFD analysis of the effect of nasal obstruction on CPAP treatment. A strong correlation between the inspiratory pressure loss coefficient and maximum airflow velocity was found.

  19. Upper airway finding on CT scan with and without nasal CPAP in obstructive sleep apnea patients

    Akashiba, Tsuneto; Sasaki, Iwao; Kurashina, Keiji; Yoshizawa, Takayuki; Otsuka, Kenzo; Horie, Takashi (Nihon Univ., Tokyo (Japan). School of Medicine)


    The area of upper airway (from the nasopharynx to the hypopharynx) was measured by means of computed tomography (CT) scan in 15 confirmed cases of obstructive sleep apnea (OSA) and in 4 normal controls while they were awake. The minimum cross-sectional area (MA) of the upper airway was 14.7+-20.0 mm{sup 2} in OSA patients and 80.0+-33.1 mm{sup 2} in normal controls and the difference was statistically significant (p<0.01). In OSA patients, MA did not correlate with age, body weight, apnea index, desaturation index, mean nadir-SO{sub 2} and lowest SO{sub 2}. MA was also measured with OSA patients while nasal continuous positive airway pressure (NCPAP) of 10 cmH{sub 2}O was applied and it was found that MA was significantly widened when NCPAP therapy was performed. We conclude that upper airway narrowing is consistent finding in OSA patients but the degree of narrowing does not correlate with parameters of apnea and gas exchange during sleep, and NCPAP is effective to widen the area of upper airway in OSA patients. (author).

  20. Effects of concentrated ambient particles on normal and hypersecretory airways in rats.

    Harkema, Jack R; Keeler, Gerald; Wagner, James; Morishita, Masako; Timm, Edward; Hotchkiss, Jon; Marsik, Frank; Dvonch, Timothy; Kaminski, Norbert; Barr, Edward


    Detroit during the summer months when particulate air pollution is usually high (July and September 2000). We monitored the outdoor air pollution in this community daily, and exposed normal and compromised rats to concentrated PM2.5 from this local urban atmosphere. Rats in the inhalation studies were exposed for 1 day or for 4 or 5 consecutive days (10 hours/day) to either filtered air (controls) or concentrated ambient particles (CAPs) delivered by a Harvard ambient fine particle concentrator. Rats were killed 24 hours after the end of the exposure. Biochemical, morphometric, and molecular techniques were used to identify airway epithelial and inflammatory responses to CAPs. Lung lobes were also either intratracheally lavaged with saline to determine cellular composition and protein in bronchoalveolar lavage fluid (BALF) or removed for analysis by inductively coupled plasma-mass spectrometry (ICPMS) to detect retention of ambient PM2.5--derived trace elements. The Harvard concentrator effectively concentrated the fine ambient particles from this urban atmosphere (10-30 times) without significantly changing the major physicochemical features of the atmospheric particles. Daily CAPs mass concentrations during the 10-hour exposure period (0800-1800) in July ranged from 16 to 895 microg/m3 and in September ranged from 81 to 755 microg/m3. In general, chemical characteristics of ambient particles were conserved through the concentrator into the exposure chamber. Single or repeated exposures to CAPs did not cause adverse effects in the nasal or pulmonary airways of healthy F344 or BN rats. In addition, CAPs-related toxicity was not observed in F344 rats pretreated with bacterial endotoxin. Variable airway responses to CAPs exposure were observed in BN rats with preexisting allergic airway disease induced by OVA sensitization and challenge. Only OVA-challenged BN rats exposed to CAPs for 5 consecutive days in September 2000 had significant increases in airway mucosubstances

  1. Nasal Expiratory Positive Airway Pressure Devices (Provent for OSA: A Systematic Review and Meta-Analysis

    Muhammad Riaz


    Full Text Available Objective. To quantify the effectiveness of nasal expiratory positive airway pressure (nasal EPAP devices or Provent as treatment for obstructive sleep apnea (OSA. Methods. PubMed and six other databases were searched through November 15, 2015, without language limitations. Results. Eighteen studies (920 patients were included. Pre- and post-nasal EPAP means ± standard deviations (M ± SD for apnea-hypopnea index (AHI in 345 patients decreased from 27.32±22.24 to 12.78±16.89 events/hr (relative reduction = 53.2%. Random effects modeling mean difference (MD was −14.78 events/hr [95% CI −19.12, −10.45], p value < 0.00001. Oxygen desaturation index (ODI in 247 patients decreased from 21.2±19.3 to 12.4±14.1 events/hr (relative reduction = 41.5%, p value < 0.00001. Lowest oxygen saturation (LSAT M ± SD improved in 146 patients from 83.2±6.8% to 86.2±11.1%, MD 3 oxygen saturation points [95% CI 0.57, 5.63]. Epworth Sleepiness Scale (ESS M ± SD improved (359 patients from 9.9±5.3 to 7.4±5.0, MD −2.5 [95% CI −3.2, −1.8], p value < 0.0001. Conclusion. Nasal EPAP (Provent reduced AHI by 53.2%, ODI by 41.5% and improved LSAT by 3 oxygen saturation points. Generally, there were no clear characteristics (demographic factors, medical history, and/or physical exam finding that predicted favorable response to these devices. However, limited evidence suggests that high nasal resistance could be associated with treatment failure. Additional studies are needed to identify demographic and polysomnographic characteristics that would predict therapeutic success with nasal EPAP (Provent.

  2. Nasal Expiratory Positive Airway Pressure Devices (Provent) for OSA: A Systematic Review and Meta-Analysis

    Riaz, Muhammad; Certal, Victor; Nigam, Gaurav; Abdullatif, Jose; Zaghi, Soroush; Kushida, Clete A.; Camacho, Macario


    Objective. To quantify the effectiveness of nasal expiratory positive airway pressure (nasal EPAP) devices or Provent as treatment for obstructive sleep apnea (OSA). Methods. PubMed and six other databases were searched through November 15, 2015, without language limitations. Results. Eighteen studies (920 patients) were included. Pre- and post-nasal EPAP means ± standard deviations (M ± SD) for apnea-hypopnea index (AHI) in 345 patients decreased from 27.32 ± 22.24 to 12.78 ± 16.89 events/hr (relative reduction = 53.2%). Random effects modeling mean difference (MD) was −14.78 events/hr [95% CI −19.12, −10.45], p value < 0.00001. Oxygen desaturation index (ODI) in 247 patients decreased from 21.2 ± 19.3 to 12.4 ± 14.1 events/hr (relative reduction = 41.5%, p value < 0.00001). Lowest oxygen saturation (LSAT) M ± SD improved in 146 patients from 83.2 ± 6.8% to 86.2 ± 11.1%, MD 3 oxygen saturation points [95% CI 0.57, 5.63]. Epworth Sleepiness Scale (ESS) M ± SD improved (359 patients) from 9.9 ± 5.3 to 7.4 ± 5.0, MD −2.5 [95% CI −3.2, −1.8], p value < 0.0001. Conclusion. Nasal EPAP (Provent) reduced AHI by 53.2%, ODI by 41.5% and improved LSAT by 3 oxygen saturation points. Generally, there were no clear characteristics (demographic factors, medical history, and/or physical exam finding) that predicted favorable response to these devices. However, limited evidence suggests that high nasal resistance could be associated with treatment failure. Additional studies are needed to identify demographic and polysomnographic characteristics that would predict therapeutic success with nasal EPAP (Provent). PMID:26798519

  3. Effects of heated humidification and topical steroids on compliance, nasal symptoms, and quality of life in patients with obstructive sleep apnea syndrome using nasal continuous positive airway pressure.

    Ryan, Silke


    BACKGROUND: Nasal side effects are common in patients with obstructive sleep apnea syndrome (OSAS) starting on nasal continuous positive airway pressure (CPAP) therapy. We tested the hypothesis that heated humidification or nasal topical steroids improve compliance, nasal side effects and quality of life in this patient group. METHODS: 125 patients with the established diagnosis of OSAS (apnea\\/hypopnea index > or = 10\\/h), who tolerated CPAP via a nasal mask, and who had a successful CPAP titration were randomized to 4 weeks of dry CPAP, humidified CPAP or CPAP with additional topical nasal steroid application (fluticasone, GlaxoWellcome). Groups were similar in all demographic variables and in frequency of nasal symptoms at baseline. Outcome measures were objective compliance, quality of life (short form 36), subjective sleepiness (Epworth Sleepiness Scale score) and nasal symptoms such as runny, dry or blocked nose, sneezing and headaches; all variables assessed using a validated questionnaire and by direct interview. RESULTS: There was no difference in compliance between groups after 4 weeks (dry: 5.21 +\\/- 1.66 h\\/night, fluticasone: 5.66 +\\/- 1.68, humidifier: 5.21 +\\/- 1.84; p = 0.444). Quality of life and subjective sleepiness improved in all groups, but there were no differences in the extent of improvement. Nasal Symptoms were less frequently reported in the humidifier group (28%) than in the remaining groups (dry: 70%, fluticasone: 53%, p = 0.002). However, the addition of fluticasone resulted in increased frequency of sneezing. CONCLUSION: The addition of a humidifier, but not nasal steroids decreases the frequency of nasal symptoms in unselected OSAS patients initiating CPAP therapy; however compliance and quality of life remain unaltered.

  4. Kinetics of naphthalene metabolism in target and non-target tissues of rodents and in nasal and airway microsomes from the Rhesus monkey

    Buckpitt, Alan, E-mail: [Department of Molecular Biosciences, School of Veterinary Medicine, UC Davis, Davis, CA 95616 (United States); Morin, Dexter [Department of Molecular Biosciences, School of Veterinary Medicine, UC Davis, Davis, CA 95616 (United States); Murphy, Shannon; Edwards, Patricia; Van Winkle, Laura [Department of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, UC Davis, Davis, CA 95616 (United States); Center for Health and the Environment, UC Davis, Davis, CA 95616 United States (United States)


    Naphthalene produces species and cell selective injury to respiratory tract epithelial cells of rodents. In these studies we determined the apparent K{sub m}, V{sub max}, and catalytic efficiency (V{sub max}/K{sub m}) for naphthalene metabolism in microsomal preparations from subcompartments of the respiratory tract of rodents and non-human primates. In tissues with high substrate turnover, major metabolites were derived directly from naphthalene oxide with smaller amounts from conjugates of diol epoxide, diepoxide, and 1,2- and 1,4-naphthoquinones. In some tissues, different enzymes with dissimilar K{sub m} and V{sub max} appeared to metabolize naphthalene. The rank order of V{sub max} (rat olfactory epithelium > mouse olfactory epithelium > murine airwaysrat airways) correlated well with tissue susceptibility to naphthalene. The V{sub max} in monkey alveolar subcompartment was 2% that in rat nasal olfactory epithelium. Rates of metabolism in nasal compartments of the monkey were low. The catalytic efficiencies of microsomes from known susceptible tissues/subcompartments are 10 and 250 fold higher than in rat airway and monkey alveolar subcompartments, respectively. Although the strong correlations between catalytic efficiencies and tissue susceptibility suggest that non-human primate tissues are unlikely to generate metabolites at a rate sufficient to produce cellular injury, other studies showing high levels of formation of protein adducts support the need for additional studies. - Highlights: • Naphthalene is metabolized with high catalytic efficiency in susceptible tissue. • Naphthalene is metabolized at low catalytic efficiency in non-susceptible tissue. • Respiratory tissues of the non human primate metabolize naphthalene slowly.

  5. A multicenter randomized controlled trial comparing effectiveness of two nasal continuous positive airway pressure devices in very-low-birth-weight infants.

    Bober, Klaudiusz; Świetliński, Janusz; Zejda, Jan; Kornacka, Katarzyna; Pawlik, Dorota; Behrendt, Jakub; Gajewska, Elżbieta; Czyżewska, Małgorzata; Korbal, Piotr; Witalis, Janusz; Walas, Wojciech; Wilińska, Maria; Turzańska, Agnieszka; Zieliński, Grzegorz; Czeszyńska, Beata; Bachman, Thomas


    Many studies suggest nasal continuous positive airway pressure is an effective and relatively complication-free means of respiratory support in premature infants. However, only limited data exist regarding the practical aspects of nasal continuous positive airway pressure delivery, including the best way to provide the positive airway pressure. Our aim was to compare the results of treatment using two different nasal continuous positive airway pressure devices: variable flow Infant Flow and constant flow nasal continuous positive airway pressure in two different groups of very-low-birth-weight infants in a multicenter randomized controlled trial. The indication groups were elective to avoid intubation and weaning from mechanical ventilation. Twelve leading tertiary care neonatal centers in Poland. Among 276 infants (weighing between 750-1500g, with a gestational age ≤32 wks) enrolled, 51% were randomized to receive Infant Flow and 49% to receive constant flow nasal continuous positive airway pressure. Treatment success (i.e., no need for intubation/reintubation) occurred in 75% of our patients with a nonstatistically significant advantage seen with Infant Flow. The incidence of severe nasal complications and necrotizing enterocolitis were statistically significantly lower in the infants treated with Infant Flow. In our study, factors associated with elective nasal continuous positive airway pressure failure were birth weight ≤1000 g, gestational age ≤28 wks, clinical risk index for babies score >1, and PaO(2)/FIO(2) ratio of <150. Only birth weight ≤1000 g was associated with weaning failure. We found fewer severe nasal complications but no statistically significant advantage in treatment success in infants assigned to Infant Flow nasal continuous positive airway pressure compared with those assigned to constant flow nasal continuous positive airway pressure treatment. Significant risk factors of treatment failure include small size, maturity, and severity

  6. Numerical simulation of pharyngeal airflow applied to obstructive sleep apnea: effect of the nasal cavity in anatomically accurate airway models.

    Cisonni, Julien; Lucey, Anthony D; King, Andrew J C; Islam, Syed Mohammed Shamsul; Lewis, Richard; Goonewardene, Mithran S


    Repetitive brief episodes of soft-tissue collapse within the upper airway during sleep characterize obstructive sleep apnea (OSA), an extremely common and disabling disorder. Failure to maintain the patency of the upper airway is caused by the combination of sleep-related loss of compensatory dilator muscle activity and aerodynamic forces promoting closure. The prediction of soft-tissue movement in patient-specific airway 3D mechanical models is emerging as a useful contribution to clinical understanding and decision making. Such modeling requires reliable estimations of the pharyngeal wall pressure forces. While nasal obstruction has been recognized as a risk factor for OSA, the need to include the nasal cavity in upper-airway models for OSA studies requires consideration, as it is most often omitted because of its complex shape. A quantitative analysis of the flow conditions generated by the nasal cavity and the sinuses during inspiration upstream of the pharynx is presented. Results show that adequate velocity boundary conditions and simple artificial extensions of the flow domain can reproduce the essential effects of the nasal cavity on the pharyngeal flow field. Therefore, the overall complexity and computational cost of accurate flow predictions can be reduced.

  7. Infants with severe respiratory syncytial virus needed less ventilator time with nasal continuous airways pressure then invasive mechanical ventilation

    Borckink, Ilse; Essouri, Sandrine; Laurent, Marie; Albers, Marcel J. I. J.; Burgerhof, Johannes G. M.; Tissieres, Pierre; Kneyber, Martin C. J.


    AIM: Nasal continuous positive airway pressure (NCPAP) has been proposed as an early first-line support for infants with severe respiratory syncytial virus (RSV) infection. We hypothesised that infants <6 months with severe RSV would require shorter ventilator support on NCPAP than invasive mechanic

  8. Infants with severe respiratory syncytial virus needed less ventilator time with nasal continuous airways pressure then invasive mechanical ventilation

    Borckink, Ilse; Essouri, Sandrine; Laurent, Marie; Albers, Marcel J. I. J.; Burgerhof, Johannes G. M.; Tissieres, Pierre; Kneyber, Martin C. J.

    AIM: Nasal continuous positive airway pressure (NCPAP) has been proposed as an early first-line support for infants with severe respiratory syncytial virus (RSV) infection. We hypothesised that infants <6 months with severe RSV would require shorter ventilator support on NCPAP than invasive

  9. Nasal continuous positive airway pressure (CPAP) for the respiratory care of the newborn infant.

    Diblasi, Robert M


    Nasal continuous positive airway pressure (CPAP) is a noninvasive form of respiratory assistance that has been used to support spontaneously breathing infants with lung disease for nearly 40 years. Following reports that mechanical ventilation contributes to pulmonary growth arrest and the development of chronic lung disease, there is a renewed interest in using CPAP as the prevailing method for supporting newborn infants. Animal and human research has shown that CPAP is less injurious to the lungs than is mechanical ventilation. The major concepts that embrace lung protection during CPAP are the application of spontaneous breathing at a constant distending pressure and avoidance of intubation and positive-pressure inflations. A major topic for current research focuses on whether premature infants should be supported initially with CPAP following delivery, or after the infant has been extubated following prophylactic surfactant administration. Clinical trials have shown that CPAP reduces the need for intubation/mechanical ventilation and surfactant administration, but it is still unclear whether CPAP reduces chronic lung disease and mortality, compared to modern lung-protective ventilation techniques. Despite the successes, little is known about how best to manage patients using CPAP. It is also unclear whether different strategies or devices used to maintain CPAP play a role in improving outcomes in infants. Nasal CPAP technology has evolved over the last 10 years, and bench and clinical research has evaluated differences in physiologic effects related to these new devices. Ultimately, clinicians' abilities to perceive changes in the pathophysiologic conditions of infants receiving CPAP and the quality of airway care provided are likely to be the most influential factors in determining patient outcomes.

  10. Transport and Deposition of Welding Fume Agglomerates in a Realistic Human Nasal Airway.

    Tian, Lin; Inthavong, Kiao; Lidén, Göran; Shang, Yidan; Tu, Jiyuan


    Welding fume is a complex mixture containing ultra-fine particles in the nanometer range. Rather than being in the form of a singular sphere, due to the high particle concentration, welding fume particles agglomerate into long straight chains, branches, or other forms of compact shapes. Understanding the transport and deposition of these nano-agglomerates in human respiratory systems is of great interest as welding fumes are a known health hazard. The neurotoxin manganese (Mn) is a common element in welding fumes. Particulate Mn, either as soluble salts or oxides, that has deposited on the olfactory mucosa in human nasal airway is transported along the olfactory nerve to the olfactory bulb within the brain. If this Mn is further transported to the basal ganglia of the brain, it could accumulate at the part of the brain that is the focal point of its neurotoxicity. Accounting for various dynamic shape factors due to particle agglomeration, the current computational study is focused on the exposure route, the deposition pattern, and the deposition efficiency of the inhaled welding fume particles in a realistic human nasal cavity. Particular attention is given to the deposition pattern and deposition efficiency of inhaled welding fume agglomerates in the nasal olfactory region. For particles in the nanoscale, molecular diffusion is the dominant transport mechanism. Therefore, Brownian diffusion, hydrodynamic drag, Saffman lift force, and gravitational force are included in the model study. The deposition efficiencies for single spherical particles, two kinds of agglomerates of primary particles, two-dimensional planar and straight chains, are investigated for a range of primary particle sizes and a range of number of primary particles per agglomerate. A small fraction of the inhaled welding fume agglomerates is deposited on the olfactory mucosa, approximately in the range 0.1-1%, and depends on particle size and morphology. The strong size dependence of the deposition

  11. Time-course changes in nasal airway resistance after house dust antigen challenge: With special reference to late phase response

    Kimihiro Okubo


    Full Text Available The definition of late-phase response (LPR associated with nasal allergy is not as clear as that associated with asthma. Furthermore, LPR and immediate-phase response often act in concert to produce confounding symptoms due to repeated attacks over a short period of time. We examined the nasal airway resistance (NAR, allergic symptoms, eosinophil cationic protein and histamine concentration in nasal surface tissue 30 min before, and 10 min, 1, 3, 5, 7 and 9 h after a house dust (HD nasal challenge test was performed twice on 10 patients with HD perennial nasal allergy. Nasal airway resistance readings after the HD nasal challenge test were classified into three types based on changes in NAR: type I (short-lasting, five cases; type II (prolonged, eight cases; and type III (biphasic, six cases. Delayed increases in NAR were not observed in type I patients with weak responses to nasal challenge. In type II patients, baseline NAR was elevated and numerous basophilic metachromatic cells (BC were present in the epithelial layer. In type III patients, baseline NAR was not as elevated as it was in type II patients, but marked responses to challenge were noted. In all three types of changes in NAR, eosinophil leukocyte increased at late phase. Moreover, there was no correlation of change in NAR with an increase in the number of eosinophil leukocyte and BC at the epithelial layer in all three types, which suggests that further study is required to confirm the exact role of eosinophils and basophilic cells in LPR.

  12. Effects of nasal continuous positive-airway pressure on nutritive swallowing in lambs.

    Bernier, Anne; Catelin, Céline; Ahmed, Mohamed Amine Hadj; Samson, Nathalie; Bonneau, Pauline; Praud, Jean-Paul


    Current knowledge suggests that, to be successful, oral feeding in preterm infants should be initiated as soon as possible, often at an age where immature respiration still requires ventilatory support in the form of nasal continuous positive airway pressure (nCPAP). While some neonatologist teams claim great success with initiation of oral feeding in immature infants with nCPAP, others strictly wait for this ventilatory support to be no longer necessary before any attempt at oral feeding, fearing laryngeal penetration and tracheal aspiration. Therefore, the aim of the present study was to provide a first assessment of the effect of various levels of nCPAP on bottle-feeding in a neonatal ovine model, including feeding safety, feeding efficiency, and nutritive swallowing-breathing coordination. Eight lambs born at term were surgically instrumented 48 h after birth to collect recordings of electrical activity of laryngeal constrictor muscle, electrocardiography, and arterial blood gases. Two days after surgery, lambs were bottle-fed under five randomized nCPAP conditions, including without any nCPAP or nasal mask and nCPAP of 0, 4, 7, and 10 cmH(2)O. Results revealed that application of nCPAP in the full-term lamb had no deleterious effect on feeding safety and efficiency or on nutritive swallowing-breathing coordination. The present study provides a first and unique insight on the effect of nCPAP on oral feeding, demonstrating its safety in newborn lambs born at term. These results open the way for further research in preterm lambs to better mimic the problems encountered in neonatology.

  13. Effect of adjuvant nasal continuous positive airway pressure therapy on immune response and organ injury in children with severe pneumonia

    Ni-Na Huang; Yu-Dan Zhang


    Objective:To analyze the effect of adjuvant nasal continuous positive airway pressure therapy on immune response and organ injury in children with severe pneumonia.Methods:A total of 90 children with severe pneumonia were randomly divided into observation group and control group (n=45), control group received conventional therapy, observation group accepted regular + adjuvant nasal continuous positive airway pressure therapy, and then differences in immune globulin, Th1/Th2 indexes, blood coagulation indexes, echocardiography parameters and so on were compared between two groups of children.Results:IgG2, IgG3, IgA and IgM content in peripheral blood of observation group were higher than those of control group; Th1/Th2 indexes IL-4 and IFN-γ content in serum as well as IL-4/IFN-γ level were lower than those of control group; blood coagulation indexes PT, TT, APTT and D-D levels were lower than those of control group while FIB and PLT levels were higher than those of control group; echocardiography parameters PVAT and AVAT levels were higher than those of control group while PFVMA level was lower than that of control group.Conclusions: Adjuvant nasal continuous positive airway pressure therapy helps to enhance the immune response and optimize blood coagulation function and cardiac function in children with severe pneumonia.

  14. Anesthesia for pediatric day-case dental surgery: a study comparing the classic laryngeal mask airway with nasal trachea intubation.

    Zhao, Nan; Deng, Feng; Yu, Cong


    To study sevoflurane inhalation general anesthesia using the laryngeal mask airway (LMA) and nasal endotracheal (ET) intubation to maintain the airway in pediatric day-case dental surgery. A total of 171 children aged 2 to 7 years received elective day-case dental surgical procedure under general anesthesia. Children were randomly grouped into LMA groups (L) and nasal ET intubation group (N). In L groups, LMA was inserted after induction of anesthesia using 8% sevoflurane and were allowed to breathe spontaneously. Rocuronium and remifentanil were given intravenously during 8% sevoflurane induction by nasal ET intubation in the N group . The time of anesthetic induction, maintenance, recovery, surgical access, and bispectral index score were recorded. Postoperative nausea and vomiting and the incidence of adverse events during induction and recovery period were also recorded. The insertion time of LMA was significantly shorter than nasal ET (P index were not different between the 2 groups. However, recovery time was significantly shorter in group L (P < 0.05). The incidence of sore throat and postoperative nausea and vomiting (P < 0.01) were much less in group L as well. Sevoflurane inhalation anesthesia through LMA is a safe and reliable method for pediatric day-case dental surgery.

  15. Nasal pillows as an alternative interface in patients with obstructive sleep apnoea syndrome initiating continuous positive airway pressure therapy.

    Ryan, Silke


    Side-effects directly due to the nasal mask are common in patients with obstructive sleep apnoea syndrome (OSAS) commencing continuous positive airway pressure (CPAP). Recently, nasal pillows have been designed to overcome these issues. Limited evidence exists of the benefits and effectiveness of these devices. Twenty-one patients (19 male, 49+\\/-10years) with the established diagnosis of OSAS [apnoea\\/hypopnoea index (AHI): 52+\\/-22] and who had a successful CPAP titration were commenced on CPAP therapy (10+\\/-2cmH2O), and randomized to 4weeks of a nasal pillow (P) and a standard nasal mask (M) in a crossover design. Outcome measures were objective compliance, AHI, quality of life, Epworth Sleepiness Score (ESS) and CPAP side-effects. There was no difference in compliance (M versus P: 5.1+\\/-1.9h versus 5.0+\\/-1.7h; P=0.701) and AHI (2.6+\\/-2.7 versus 3.0+\\/-2.9; P=0.509). Quality of life and ESS improved with CPAP, but there was no difference in the extent of improvement between both devices. Usage of nasal pillows resulted in less reported pressure on the face and more subjects found the nasal pillow the more comfortable device. However, there was no clear overall preference for either device at the end of the study (mask=57%, pillow=43%; P=0.513). The applied CPAP pressure did not correlate with compliance, AHI and ESS. Furthermore, no differences in outcome parameters were noted comparing groups with CPAP pressure <10 and >\\/=10cm H(2) O. Nasal pillows are equally effective in CPAP therapy, but do not generally lead to improved compliance.

  16. Regulation of nasal airway homeostasis and inflammation in mice by SHP-1 and Th2/Th1 signaling pathways.

    Seok Hyun Cho

    Full Text Available Allergic rhinitis is a chronic inflammatory disease orchestrated by Th2 lymphocytes. Src homology 2 domain-containing protein tyrosine phosphatase (SHP-1 is known to be a negative regulator in the IL-4α/STAT-6 signaling pathway of the lung. However, the role of SHP-1 enzyme and its functional relationship with Th2 and Th1 cytokines are not known in the nasal airway. In this study, we aimed to study the nasal inflammation as a result of SHP-1 deficiency in viable motheaten (mev mice and to investigate the molecular mechanisms involved. Cytology, histology, and expression of cytokines and chemokines were analyzed to define the nature of the nasal inflammation. Targeted gene depletion of Th1 (IFN-γ and Th2 (IL-4 and IL-13 cytokines was used to identify the critical pathways involved. Matrix metalloproteinases (MMPs were studied to demonstrate the clearance mechanism of recruited inflammatory cells into the nasal airway. We showed here that mev mice had a spontaneous allergic rhinitis-like inflammation with eosinophilia, mucus metaplasia, up-regulation of Th2 cytokines (IL-4 and IL-13, chemokines (eotaxin, and MMPs. All of these inflammatory mediators were clearly counter-regulated by Th2 and Th1 cytokines. Deletion of IFN-γ gene induced a strong Th2-skewed inflammation with transepithelial migration of the inflammatory cells. These findings suggest that SHP-1 enzyme and Th2/Th1 paradigm may play a critical role in the maintenance of nasal immune homeostasis and in the regulation of allergic rhinitis.

  17. Integrity of airway epithelium is essential against obliterative airway disease in transplanted rat tracheas

    Qu, N; de Vos, P; Schelfhorst, M; de Haan, A; Timens, W; Prop, J


    Background: The pathogenesis of obliterative bronchiolitis after lung transplantation requires further elucidation. In this study we used rat trachea transplantation to examine the role of epithelium in the progression of obliterative airway disease. Methods: Normal and denuded (i.e., epithelium rem

  18. Improved growth and development in premature infants managed with nasal continuous positive airway pressure.

    Flesher, Susan Lee; Domanico, Renee S


    Our goal was to assess the association between the use of nasal continuous positive airway pressure (NCPAP) vs. conventional ventilation (CV) in premature infants and its effects on: 1) growth in the NICU and at follow up visits 2) neurodevelopmental outcomes measured by Bayley Infant Neurodevelopmental Screener (BINS) 3) the incidence of retinopathy of prematurity (ROP) and chronic lung disease (CLD). A retrospective chart review of two groups of NICU patients was conducted. The first group was from 1/1999-12/2000 (n = 140) and was managed by CV. The second group (n = 168) was from 1/2003-12/2004 and was managed primarily by NCPAP. Categorical variables were analyzed using Pearson Chi Square. Mean numerical values were analyzed with the student t-test. There was no statistical difference between the groups in regard to 15 demographic and interventional variables. There were significant differences between the two groups in CLD (p < 0.05) and ROP (p < 0.01), mean weight at one month (p < 0.05), 9-12 months (p < 0.01) and 15-18 months (p < 0.01), length at 4-6 months (p < 0.05), 9-12 months (p < 0.05), 15-18 months (p < 0.01), and 2 years (p = .05), and in BINS scores at 9-12 months (p < 0.01) and 15-18 months (p < 0.01). Managing babies with NCPAP therapy when compared with CV, significantly increased the weight at one month which was sustained at the 9-12 month and 15-18 month visits, increased length at all follow up visits, increased BINS scores at the 9-12 month and 15-18 month visits, and decreased the incidence of ROP and CLD.

  19. Effect of uncertainty in nasal airway deposition of radioactive particles on effective dose

    Guilmette, R.A.; Birchall, A.; Jarvis, N.S


    In the current ICRP human respiratory tract (RT) model (ICRP Publication 66), the deposition of particles in various regions of the RT during natural breathing is modelled by considering the RT as a series of filters, resulting in deposition probabilities for distal portions of the RT being dependent on those of the proximal segments. Thus, uncertainties in regional deposition in proximal segments of the RT are reflected or propagated in uncertainties in deposition in the distal segments of the lung. Experimental data on aerosol particle deposition have demonstrated significant variability in nasal airway (NA) deposition for different individuals studied. This report summarises the impact of introducing variability in NA deposition efficiency on the calculation of effective doses using the ICRP 66 model for selected radionuclides. The computer software LUDEP, modified for this purpose, was used to customise deposition patterns, and effective doses were calculated for several radionuclides ({sup 111}In, {sup 106}Ru, {sup 60}Co, {sup 210}Po, {sup 238}U and {sup 239}Pu) chosen to represent isotopes with various decay schemes and half-lives. The results indicated significant but particle-size-specific effects of assumed NA deposition efficiencies on the calculated effective doses, which varied typically by factors of five to six. The majority of the variability was associated with direct effects on deposition patterns, but in some cases, alterations of radiation dose distribution within the various target organs also contributed to the variability. These results provide a basis for evaluating uncertainties due to inter-individual differences in deposition patterns for radiation protection and risk analysis. (author)

  20. Initial size of cleft does not correlate with size and function of nasal airway in adults with unilateral cleft lip and palate.

    Reiser, Erika; Andlin-Sobocki, Anna; Mani, Maria; Holmström, Mats


    The noses of patients with clefts are often functionally inadequate. The aim of the present study was to evaluate the correlation between size of the maxillary cleft in infancy and size and function of the nasal airway in adults with unilateral cleft lip and palate (UCLP). This is a long-term follow up study including 53 patients with UCLP born between 1960 and 1987 and treated at the Cleft Lip and Palate Centre, Uppsala University Hospital, Sweden. Lip repair was performed at 3-4 months of age followed by either a one-stage or a two-stage palatal closure. The size of the cleft was measured on infant maxillary dental casts. Nasal minimum cross-sectional area (cm(2)) and volume (cm(3)) (acoustic rhinometry), air flow resistance (Pa s/cm(3)) (rhinomanometry), peak inspiratory flow (l/min) (peak nasal inspiratory flow) and number of identified odours (Scandinavian odor-identification test) were assessed in adulthood. The size of the maxillary cleft varied considerably at infancy. The size of the nasal airway and its function on the cleft side in adulthood were reduced compared with the non-cleft side, but no correlations were found between size of the initial cleft in infancy and size and function of the nasal airway in adulthood. In adults born with UCLP, therefore, size of the maxillary cleft in infancy does not seem to affect size and function of the nasal airway in adulthood.

  1. Influence of body position on the displacement of nasal prongs in preterm newborns receiving continuous positive airway pressure

    Brunherotti, Marisa Afonso Andrade; Martinez, Francisco Eulógio


    Abstract Objective: To evaluate the influence of body position on the displacement of nasal prongs in preterm infants. Methods: This prospective, randomized, crossover study enrolled infants born at a mean gestational age of 29.7±2 weeks, birth weight of 1353±280g and 2.9±2.2 days of life, submitted to continuous positive airway pressure by nasal prongs. The main outcome was the number of times that the nasal prongs were displaced following infant positioning in the following body positions: prone, right lateral, left lateral, and supine, according to a pre-established random order. Moreover, cardiorespiratory variables (respiratory rate, heart rate, and oxygen saturation) were evaluated for each body position. Data for each position were collected every 10 min, over a period of 60 min. An occurrence was defined when the nasal prongs were displaced from the nostrils after 3 min in the desired position, requiring intervention of the examiner. Results: Among the 16 studied infants, the occurrence of nasal prong displacement was only observed in the prone position (9 infants - 56.2%) and in the left lateral position (2 infants - 12.5%). The number of times that the prongs were displaced was 11 in the prone position (7 within the first 10min) and 2 in the left lateral position (1 within the first 10min). No clinically significant changes were observed in the cardiorespiratory variables. Conclusions: Maintenance of the nasal prongs to provide adequate noninvasive respiratory support was harder in the prone position. PMID:26116326

  2. [Influence of body position on the displacement of nasal prongs in preterm newborns receiving continuous positive airway pressure].

    Brunherotti, Marisa Afonso Andrade; Martinez, Francisco Eulógio


    To evaluate the influence of body position on the displacement of nasal prongs in preterm infants. This prospective, randomized, crossover study enrolled infants born at a mean gestational age of 29.7±2 weeks, birth weight of 1.353±280g and 2.9±2.2 days of life, submitted to continuous positive airway pressure by nasal prongs. The main outcome was the number of times that the nasal prongs were displaced following infant positioning in the following body positions: prone, right lateral, left lateral, and supine, according to a pre-established random order. Moreover, cardiorespiratory variables (respiratory rate, heart rate, and oxygen saturation) were evaluated for each body position. Data for each position were collected every 10 minutes, over a period of 60minutes. An occurrence was defined when the nasal prongs were displaced from the nostrils after 3 minutes in the desired position, requiring intervention of the examiner. Among the 16 studied infants, the occurrence of nasal prong displacement was only observed in the prone position (9 infants-56.2%) and in the left lateral position (2 infants-12.5%). The number of times that the prongs were displaced was 11 in the prone position (seven within the first 10minutes) and two in the left lateral position (one within the first 10minutes). No clinically significant changes were observed in the cardiorespiratory variables. Maintenance of the nasal prongs to provide adequate noninvasive respiratory support was harder in the prone position. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  3. Simulation modeling of the tissue disposition of formaldehyde to predict nasal DNA-protein cross-links in Fischer 344 rats, rhesus monkeys, and humans.

    Conolly, R B; Lilly, P D; Kimbell, J S


    Formaldehyde inhalation causes formation of DNA-protein cross-links (DPX) in the nasal mucosa of Fischer 344 (F344) rats and rhesus monkeys. DPX are considered to be part of the mechanism by which cytotoxic and carcinogenic effects of formaldehyde in laboratory animals are exerted, and DPX data have been used as a measure of tissue dose in cancer risk assessments for formaldehyde. Accurate prediction of DPX concentrations in humans is therefore desirable. The goal of this work was to increase confidence in the prediction of human DPX by refining earlier models of formaldehyde disposition and DPX kinetics in the nasal mucosa. Anatomically accurate, computational fluid dynamics models of the nasal airways of F344 rats, rhesus monkeys, and humans were used to predict the regional flux of formaldehyde to the respiratory and olfactory mucosa. A previously developed model of the tissue disposition of formaldehyde and of DPX kinetics was implemented in the graphical simulation tool SIMULINK and linked to the regional flux predictions. Statistical optimization was used to identify parameter values, and good simulations of the data were obtained. The parameter estimates for rats and monkeys were used to guide allometric scale-up to the human case. The relative levels of nasal mucosal DPX in rats, rhesus monkeys, and humans for a given inhaled concentration of formaldehyde were predicted by the model to vary with concentration. This modeling approach reduces uncertainty in the prediction of human nasal mucosal DPX resulting from formaldehyde inhalation.

  4. An Experimental and Numerical Investigation of CO2 Distribution in the Upper Airways During Nasal High Flow Therapy.

    Van Hove, S C; Storey, J; Adams, C; Dey, K; Geoghegan, P H; Kabaliuk, N; Oldfield, S D; Spence, C J T; Jermy, M C; Suresh, V; Cater, J E


    Nasal high flow (NHF) therapy is used to treat a variety of respiratory disorders to improve patient oxygenation. A CO2 washout mechanism is believed to be responsible for the observed increase in oxygenation. In this study, experimentally validated Computational Fluid Dynamics simulations of the CO2 concentration within the upper airway during unassisted and NHF assisted breathing were undertaken with the aim of exploring the existence of this washout mechanism. An anatomically accurate nasal cavity model was generated from a CT scan and breathing was reproduced using a Fourier decomposition of a physiologically measured breath waveform. Time dependent CO2 profiles were obtained at the entrance of the trachea in the experimental model, and were used as simulation boundary conditions. Flow recirculation features were observed in the anterior portion of the nasal cavity upon application of the therapy. This causes the CO2 rich gas to vent from the nostrils reducing the CO2 concentration in the dead space and lowering the inspired CO2 volume. Increasing therapy flow rate increases the penetration depth within the nasal cavity of the low CO2 concentration gas. A 65% decrease in inspired CO2 was observed for therapy flow rates ranging from 0 to 60 L min(-1) supporting the washout mechanism theory.

  5. Aging increases upper airway collapsibility in Fischer 344 rats.

    Ray, Andrew D; Ogasa, Toshiyuki; Magalang, Ulysses J; Krasney, John A; Farkas, Gaspar A


    The upper airway muscles play an important role in maintaining upper airway collapsibility, and the incidence of sleep-disordered breathing increases with age. We hypothesize that the increase in airway collapsibility with increasing age can be linked to changes in upper airway muscle mechanics and structure. Eight young (Y: 6 mo) and eight old (O: 30 mo) Fischer 344 rats were anesthetized and mechanically ventilated, and the pharyngeal pressure associated with flow limitation (Pcrit) was measured 1) with the hypoglossal (cnXII) nerve intact, 2) following bilateral cnXII denervation, and 3) during cnXII stimulation. With the cnXII intact, the upper airways of older rats were more collapsible compared with their younger counterparts [Pcrit = -7.1 +/- 0.6 (SE) vs. -9.5 +/- 0.7 cmH2O, respectively; P = 0.033]. CnXII denervation resulted in an increase in Pcrit such that Pcrit became similar in both groups (O: -4.2 +/- 0.5 cmH2O; Y: -5.4 +/- 0.5 cmH2O). In all rats, cnXII stimulation decreased Pcrit (less collapsible) in both groups (O: -11.3 +/- 1.0 cmH2O; Y: -10.2 +/- 1.0 cmH2O). The myosin heavy chain composition of the genioglossus muscle demonstrated a decrease in the percentage of the IIb isoform (38.3 +/- 2.5 vs. 21.7 +/- 1.7%; P collapsible with age and that the increase in upper airway collapsibility with age is likely related to altered neural control rather than to primary alterations in upper airway muscle structure and function.

  6. Short palate, lung, and nasal epithelial clone-1 is a tightly regulated airway sensor in innate and adaptive immunity.

    Britto, Clemente J; Liu, Qing; Curran, David R; Patham, Bhargavi; Dela Cruz, Charles S; Cohn, Lauren


    Short palate, lung, and nasal epithelial clone-1 (SPLUNC1) is a protein abundantly expressed by the respiratory epithelium of the proximal lower respiratory tract, a site of great environmental exposure. Previous studies showed that SPLUNC1 exerts antimicrobial effects, regulates airway surface liquid and mucociliary clearance, and suppresses allergic airway inflammation. We studied SPLUNC1 to gain insights into its role in host defense. In the lower respiratory tract, concentrations of SPLUNC1 are high under basal conditions. In models of pneumonia caused by common respiratory pathogens, and in Th1-induced and Th2-induced airway inflammation, SPLUNC1 secretion is markedly reduced. Pathogen-associated molecular patterns and IFN-γ act directly on airway epithelial cells to inhibit SPLUNC1 mRNA expression. Thus, SPLUNC1 is quickly suppressed during infection, in response to an insult on the epithelial surface. These experiments highlight the finely tuned fluctuations of SPLUNC1 in response to exposures in the respiratory tract, and suggest that the loss of SPLUNC1 is a crucial feature of host defense across air-breathing animal species.

  7. Airway management using a supraglottic airway device without endotracheal intubation for positive ventilation of anaesthetized rats.

    Cheong, S H; Lee, J H; Kim, M H; Cho, K R; Lim, S H; Lee, K M; Park, M Y; Yang, Y I; Kim, D K; Choi, C S


    Endotracheal intubation is often necessary for positive pressure ventilation of rats during open thoracic surgery. Since endotracheal intubation in rats is technically difficult and is associated with numerous complications, many techniques using various devices have been described in the scientific literature. In this study, we compared the effectiveness of airway management of a home-made supraglottic airway device (SAD), which is cheap to fabricate and easy to place with that of an endotracheal intubation tube in enflurane-anaesthetized rats. Twenty male Sprague-Dawley rats (200-300 g) were randomly assigned to two equal groups for positive pressure mechanical ventilation using either the SAD or an endotracheal intubation tube. The carotid artery of each rat was cannulated for continuous blood pressure measurements and obtaining blood samples for determination of oxygen tension, carbon dioxide tension, and blood acidity before, during and after SAD placement or endotracheal intubation. Proper placement of the SAD was confirmed by observing chest wall movements that coincided with the operation of the mechanical ventilator. No complications and adverse events were encountered in the rats in which the SAD was placed, during SAD placement and immediate removal, during their mechanical ventilation through the SAD, and one week after SAD removal. From the results of blood gas analyses, we conclude that anaesthetized rats can be successfully ventilated using an SAD for open thoracic surgery.

  8. Acoustic Rhinometry (AR): An alternative method to image nasal airway geometry

    Straszek, Sune


    In acoustic rhinometry (AR) a soud pulse enters the nasal cavity, where it is reflected due to changes in the local impedances. From the incident and reflected sound signal we use the Ware-Aki algorithm to calculate an area-distance relationship. The method has been validated in nasal cavity models...

  9. Satratoxin-G from the black mold Stachybotrys chartarum induces rhinitis and apoptosis of olfactory sensory neurons in the nasal airways of rhesus monkeys.

    Carey, Stephan A; Plopper, Charles G; Hyde, Dallas M; Islam, Zahidul; Pestka, James J; Harkema, Jack R


    Satratoxin-G (SG) is a trichothecene mycotoxin of Stachybotrys chartarum, the black mold suggested to contribute etiologically to illnesses associated with water-damaged buildings. We have reported that intranasal exposure to SG evokes apoptosis of olfactory sensory neurons (OSNs) and acute inflammation in the nose and brain of laboratory mice. To further assess the potential human risk of nasal airway injury and neurotoxicity, we developed a model of SG exposure in monkeys, whose nasal airways more closely resemble those of humans. Adult, male rhesus macaques received a single intranasal instillation of 20 µg SG (high dose, n = 3), or 5 µg SG daily for four days (repeated low dose, n = 3) in one nasal passage, and saline vehicle in the contralateral nasal passage. Nasal tissues were examined using light and electron microscopy and morphometric analysis. SG induced acute rhinitis, atrophy of the olfactory epithelium (OE), and apoptosis of OSNs in both groups. High-dose and repeated low-dose SG elicited a 13% and 66% reduction in OSN volume density, and a 14-fold and 24-fold increase in apoptotic cells of the OE, respectively. This model provides new insight into the potential risk of nasal airway injury and neurotoxicity caused by exposure to water-damaged buildings.

  10. Modeling the Nonlinear Motion of the Rat Central Airways.

    Ibrahim, G; Rona, A; Hainsworth, S V


    Advances in volumetric medical imaging techniques allowed the subject-specific modeling of the bronchial flow through the first few generations of the central airways using computational fluid dynamics (CFD). However, a reliable CFD prediction of the bronchial flow requires modeling of the inhomogeneous deformation of the central airways during breathing. This paper addresses this issue by introducing two models of the central airways motion. The first model utilizes a node-to-node mapping between the discretized geometries of the central airways generated from a number of successive computed tomography (CT) images acquired dynamically (without breath hold) over the breathing cycle of two Sprague-Dawley rats. The second model uses a node-to-node mapping between only two discretized airway geometries generated from the CT images acquired at end-exhale and at end-inhale along with the ventilator measurement of the lung volume change. The advantage of this second model is that it uses just one pair of CT images, which more readily complies with the radiation dosage restrictions for humans. Three-dimensional computer aided design geometries of the central airways generated from the dynamic-CT images were used as benchmarks to validate the output from the two models at sampled time-points over the breathing cycle. The central airway geometries deformed by the first model showed good agreement to the benchmark geometries within a tolerance of 4%. The central airway geometry deformed by the second model better approximated the benchmark geometries than previous approaches that used a linear or harmonic motion model.

  11. Effect of ethanol on the efficacy of nasal continuous positive airway pressure as a treatment for obstructive sleep apnea.

    Berry, R B; Desa, M M; Light, R W


    The effect of ethanol ingestion on the efficacy of nasal continuous positive airway pressure (nasal CPAP) as a treatment for the obstructive sleep apnea (OSA) syndrome was studied in ten obese male subjects undergoing this therapy. On the first night of polysomnography, the lowest level of CPAP that maintained airway patency was determined (critical level). On the second (control) night (C), subjects slept the entire night on this level of CPAP. On the third night (E), subjects ingested either 1.5 ml/kg (part A, N = 6) or 2.0 ml/kg (part B, N = 4) of 50 percent ethanol (100 proof vodka) over one half-hour starting 1 h before bedtime. A serum ethanol level was obtained at bedtime (part A: 63.7 +/- 17.3 mg/dl; part B: 108.6 +/- 20.6 mg/dl), and subjects were monitored on the critical level of CPAP. Comparison of nights C and E for parts A + B showed no difference in total sleep time (TST) or the amount of different sleep stages as an absolute time or a percentage of TST except that there was more stage 2 (as a percent of TST) on E nights. The apnea + hypopnea index and C and E nights did not differ and was quite low (3.6 +/- 3.7/h vs 1.9 +/- 2.7/h). Similarly, ethanol ingestion did not increase the number of desaturations to at or below 90 and 85 percent, or lower the mean arterial oxygen saturation in NREM or REM sleep. Analysis of parts A and B separately also showed no differences with respect to the apnea + hypopnea index or the number of desaturations on control and ethanol nights. We conclude that acute moderate ethanol ingestion does not decrease the efficacy of an optimum level of nasal CPAP.

  12. Metaplastic changes of nasal respiratory epithelium in rats exposed to hexamethylphosphoramide (HMPA) by inhalation.

    Lee, K. P.; Trochimowicz, H. J.


    Rats exposed by inhalation to hexamethylphosphoramide (HMPA) at concentrations of 50, 100, 400, and 4000 parts per billion (ppb) for 6-24 months revealed nasal tumors and squamous metaplasia with inflammation in the nasal epithelium, but no changes were observed at 10 ppb. The ciliated cells were most susceptible to HMPA, showing degenerative changes, with abnormal cilia and extensive deciliation. The desquamated nasal epithelium was repaired initially by undifferentiated mucus or microvillou...

  13. EXTUBATE: A randomised controlled trial of nasal biphasic positive airway pressure vs. nasal continuous positive airway pressure following extubation in infants less than 30 weeks' gestation: study protocol for a randomised controlled trial

    Victor Suresh


    Full Text Available Abstract Background Respiratory distress syndrome remains a significant problem among premature infants. Mechanical ventilation through an endotracheal tube remains the mainstay of respiratory support but may be associated with lung injury and the development of chronic lung disease of prematurity. Efforts are needed to reduce the duration of mechanical ventilation in favour of less invasive forms of respiratory support and to improve rates of successful extubation. Non-invasive respiratory support has been demonstrated to be less injurious to the premature lung. Standard practice is to use nasal continuous positive airway pressure (n-CPAP following extubation to support the baby's breathing. Many clinicians also use nasal biphasic positive airway pressure (n-BiPAP in efforts to improve rates of successful extubation. However, there is currently no evidence that this confers any advantage over conventional nasal continuous positive airway pressure. Methods We propose an unblinded multi-centre randomised trial comparing n-CPAP with n-BiPAP in babies born before 30 weeks' gestation and less than two weeks old. Babies with congenital abnormalities and severe intra-ventricular haemorrhage will be excluded. 540 babies admitted to neonatal centres in England will be randomised at the time of first extubation attempt. The primary aim of this study is to compare the rate of extubation failure within 48 hours following the first attempt at extubation. The secondary aims are to compare the effect of n-BiPAP and n-CPAP on the following outcomes: 1. Maintenance of successful extubation for 7 days post extubation 2. Oxygen requirement at 28 days of age and at 36 weeks' corrected gestational age 3. Total days on ventilator, n-CPAP/n-BiPAP 4. Number of ventilator days following first extubation attempt 5. pH and partial pressure of carbon dioxide in the first post extubation blood gas 6. Duration of hospital stay 7. Rate of abdominal distension requiring

  14. Nasal polyps

    ... BS, Burks AW, et al, eds. Middleton's Allergy: Principles and Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 43. Becker SS. Surgical management of polyps in the treatment of nasal airway ...


    陈亚红; 赵鸣武; 刘秀华; 姚婉贞; 杨军; 张肇康; 唐朝枢


    Objective. To investigate the characteristics of urotensin II (U-II) receptor in the rat airway smooth muscleand the effect and signal transduction pathway of U-II on the proliferation of airway smooth muscle cells.Methods. Using 125-UII binding assay to measure the Bmax and Kd of U-II receptor. Using the 3H-TdRincorporation to deter mine the effect of U-II on the proliferation of airway smooth muscle cells and its signal transduc-tion pathway. Using Fura-2/AM to measure the effect of U-II on the cytosolic free calcium concentration.Results. 1. 125I-UⅡ binding increased with the time and reached saturation at 45min. The Bmax was(ll. 36 +0.37)fmol/mg pr and Kd was (4.46 +0.61)nmol/L. 2. U-II increased 3H-TdR incorporation of theairway smooth muscle cells in a dose-dependent manner. 3. H7, PDg8059 and nicardipine, inhibitors of PKC,MAPK, calcium cha.nnel, respectively, significantly inhibited U-II-stimulated 3H-TdR incorporation of airwaysmooth muscle cells. W7, inhibitor of CaM-PK, had no effect. 4. Cyclosporin A, inhibitor of CaN, inhibited3H-TdRincorporation ofthe airway smooth muscle cells induced by U-Ⅱl in a dose-dependent manner. 5. U-Ⅱlpromot-ed cy-tosolic free calcium concentration increase by 18%.Conclusions. 1. There was U-II receptor in the rat airway smooth muscle. 2. The effect of U-II-stimulated-3H-TdR incorporation of airway smooth muscle cells was mediated by such signal transduction pathway as Ca2 +.PKC, MAPK and Ca.N, etc.``

  16. CR3 (CD11b/CD18) activation of nasal neutrophils: a measure of upper airway endotoxin exposure.

    Seth, Romy; Romaschin, Alexander D; Ribeiro, Marcos; Tarlo, Susan M


    Inhaled endotoxin (lipopolysaccharide, LPS) initiates an inflammatory response and leads to the expression of CR3 (CD11b/CD18) receptors on polymorphonuclear leukocytes (PMNs). We determined if PMN activation in nasal lavage fluid (NLF) is a possible biomarker of occupational endotoxin exposure. Seven subjects exposed to endotoxin provided NLF samples that were split into three aliquots (negative control--1 M nicotinamide; sham; positive control--11 etag of exogenous LPS) and PMN activation was measured using a chemiluminometer. Differences in mean PMN activation were apparent, negative control: 548 +/- 15.65 RLU 100 microl(-1); sham: 11469 +/- 2582 RLU 100 microl(-1); positive control: 42026 +/- 16659 RLU 100 microl (n = 7; p <0.05). This technique shows promise as a diagnostic method for measuring upper airway LPS exposure.

  17. Morphogenesis of nasal tumors in rats exposed to hexamethylphosphoramide by inhalation

    Lee, K.P.; Trochimowicz, H.J.


    Hexamethylphosphoramide (HMPA) is used as a solvent, polymerization catalyst and, to some extent, as a deicing additive for jet fuels. Nasal tumors have been induced in rats by inhalation exposure to the compound for 6 to 24 months at concentrations of 50, 100, 400, and 4000 parts per billion (ppb), but not in rats exposed at 10 ppb for 24 months. Most nasal tumors were epidermoid carcinomas and developed from the respiratory epithelium or subepithelial nasal gland, both of which revealed squamous metaplasia or dysplasia in the anterior nasal cavity. The glandular cells appear to play an important role in developing epidermoid carcinomas in the nasal cavity. The ultrastructure of epidermoid carcinomas revealed abundant features of glandular differentiation in the neoplastic squamous cells. The morphological expression of glandular cell metamorphosis in the epidermoid carcinoma included intermediate cells showing both glandular and squamous differentiation, inter- or intracellular lumina, secretory vesicles, and mucus droplets in squamous cells and keratin plates.

  18. Simvastatin attenuates lipopolysaccharide-induced airway mucus hypersecretion in rats

    OU Xue-mei; WANG Bai-ding; WEN Fu-qiang; FENG Yu-lin; HUANG Xiang-yang; XIAO Jun


    Background Mucus hypersecretion in the respiratory tract and goblet cell metaplasia in the airway epithelium contribute to the morbidity and mortality associated with airway inflammatory diseases.This study aimed to examine the effect and mechanisms of simvastatin on airway mucus hypersecretion in rats treated with lipopolysaccharide (LPS).Methods Mucus hypersecretion in rat airways was induced by intra-tracheal instillation of LPS.Rats treated with or without LPS were administered intra-peritoneally simvastatin (5 and 20 mg/kg) for 4 days.Expression of Muc5ac,RhoA and mitogen-activated protein kinases (MAPK) p38 in lung were detected by real-time polymerase chain reaction (PCR),immunohistochemistry or Western blotting.Tumor necrosis factor (TNF)-a and IL-8 in bronchoalveolar lavage fluid (BALF)were assayed by an enzyme-linked lectin assay and enzyme linked immunosorbent assay (ELISA).Results Simvastatin attenuated LPS-induced goblet cell hyperplasia in bronchial epithelium and Muc5ac hypersecretion at both the gene and protein levels in lung (P<0.05).Moreover,simvastatin inhibited neutrophil accumulation and the increased concentration of TNF-α and IL-8 in BALF follows LPS stimulation (P<0.05).The higher dose of simvastatin was associated with a more significant reduction in Muc5ac mRNA expression,neutrophil accumulation and inflammatory cytokine release.Simultaneously,the increased expression of RhoA and p38 MAPK were observed in LPS-treated lung (P<0.05).Simvastatin inhibited the expression of RhoA and p38 phosphorylation in lung following LPS stimulation (P<0.05).However,the increased expression of p38 protein in LPS-traated lung was not affected by simvastatin administration.Conclusions Simvastatin attenuates airway mucus hypersecretion and pulmonary inflammatory damage induced by LPS.The inhibitory effect of simvastatin on airway mucus hypersecretion may be through,at least in part,the suppression of neutrophil accumulation and inflammatory cytokine


    UYAMA, T; Winter, Jobst B.; GROEN, Greetje; WILDEVUUR, Charles R.H.; MONDEN, Y; PROP, J


    Airway disease after lung or heart-lung transplantation is one of late major complications, affecting the prognosis of the transplants. Little is known about the causes of airway changes. We performed rat lung transplantation and investigated the late airway changes of the long-term surviving lung g

  20. Efficacy of Home Single-Channel Nasal Pressure for Recommending Continuous Positive Airway Pressure Treatment in Sleep Apnea

    Masa, Juan F.; Duran-Cantolla, Joaquin; Capote, Francisco; Cabello, Marta; Abad, Jorge; Garcia-Rio, Francisco; Ferrer, Antoni; Fortuna, Ana M.; Gonzalez-Mangado, Nicolas; de la Peña, Monica; Aizpuru, Felipe; Barbe, Ferran; Montserrat, Jose M.; Larrateguy, Luis D.; de Castro, Jorge Rey; Garcia-Ledesma, Estefania; Corral, Jaime; Martin-Vicente, Maria J.; Martinez-Null, Cristina; Egea, Carlos; Cancelo, Laura; García-Díaz, Emilio; Carmona-Bernal, Carmen; Sánchez-Armengol, Ángeles; Mayos, Merche; Miralda, Rosa M; Troncoso, Maria F.; Gonzalez, Monica; Martinez-Martinez, Marian; Cantalejo, Olga; Piérola, Javier; Vigil, Laura; Embid, Cristina; del Mar Centelles, Mireia; Prieto, Teresa Ramírez; Rojo, Blas; Lores, Vanesa


    Introduction: Unlike other prevalent diseases, obstructive sleep apnea (OSA) has no simple tool for diagnosis and therapeutic decision-making in primary healthcare. Home single-channel nasal pressure (HNP) may be an alternative to polysomnography for diagnosis but its use in therapeutic decisions has yet to be explored. Objectives: To ascertain whether an automatically scored HNP apnea-hypopnea index (AHI), used alone to recommend continuous positive airway pressure (CPAP) treatment, agrees with decisions made by a specialist using polysomnography and several clinical variables. Methods: Patients referred by primary care physicians for OSA suspicion underwent randomized polysomnography and HNP. We analyzed the total sample and both more and less symptomatic subgroups for Bland and Altman plots to explore AHI agreement; receiver operating characteristic curves to establish area under the curve (AUC) measurements for CPAP recommendation; and therapeutic decision efficacy for several HNP AHI cutoff points. Results: Of the 787 randomized patients, 35 (4%) were lost, 378 (48%) formed the more symptomatic and 374 (48%) the less symptomatic subgroups. AHI bias and agreement limits were 5.8 ± 39.6 for the total sample, 5.3 ± 38.7 for the more symptomatic, and 6 ± 40.2 for the less symptomatic subgroups. The AUC were 0.826 for the total sample, 0.903 for the more symptomatic, and 0.772 for the less symptomatic subgroups. In the more symptomatic subgroup, 70% of patients could be correctly treated with CPAP. Conclusion: Automatic home single-channel nasal pressure scoring can correctly recommend CPAP treatment in most of more symptomatic patients with OSA suspicion. Our results suggest that this device may be an interesting tool in initial OSA management for primary care physicians, although future studies in a primary care setting are necessary. Clinical Trials Information: identifier: NCT01347398. Citation: Masa JF, Duran-Cantolla J, Capote F, Cabello

  1. Allergic airway inflammation by nasal inoculation of particulate matter (PM2.5 in NC/Nga mice.

    Keiki Ogino

    Full Text Available To evaluate the effect of airborne particulate matter 2.5 (PM2.5 in winter on airway inflammation, water-soluble supernatant (Sup and water-insoluble precipitate (Pre in PM2.5 were inoculated in NC/Nga mice with high sensitivity to mite allergens. Sup with aluminum oxide was injected intraperitoneally for sensitization. Five days later, Sup, Pre or both Sup and Pre were inoculated via the nasal route five times for more sensitization and a challenge inoculation on the 11th day in NC/Nga mice. On the 12th day, mice were examined for airway hyperresponsiveness (AHR, BALF cell count and IL-1β concentration, mRNA expression of Th1 and Th2 cytokines, chemokines such as eotaxin 1 and eotaxin 2, inflammasomal complex molecules such as IL-1β, caspase 1 and the nucleotide-binding domain and leucine-rich repeat protein 3 (NLRP3 in lung tissue as well as histopathology. The synergistic effect of Sup and Pre was observed in terms of increases in AHR, BALF cells, the mRNA expression of IL-13, eotaxin1 and IL-1β, and the IL-1β concentration in BALF. Intracellular deposits of insoluble particulates were observed in macrophages around inflammatory granulation of the mouse group treated with Sup and Pre. These results suggest that PM2.5 can induce airway hyperresponsiveness in mice with genetically high sensitivity to mite allergens by an inflammasome-associated mechanism and synergistic action of insoluble particulates and soluble components.

  2. Neurotoxic, inflammatory, and mucosecretory responses in the nasal airways of mice repeatedly exposed to the macrocyclic trichothecene mycotoxin roridin A: dose-response and persistence of injury.

    Corps, Kara N; Islam, Zahidul; Pestka, James J; Harkema, Jack R


    Macrocyclic trichothecene mycotoxins encountered in water-damaged buildings have been suggested to contribute to illnesses of the upper respiratory tract. Here, the authors characterized the adverse effects of repeated exposures to roridin A (RA), a representative macrocyclic trichothecene, on the nasal airways of mice and assessed the persistence of these effects. Young, adult, female C57BL/6 mice were exposed to single daily, intranasal, instillations of RA (0.4, 2, 10, or 50 microg/kg body weight [bw]) in saline (50 microl) or saline alone (controls) over 3 weeks or 250 microg/kg RA over 2 weeks. Histopathologic, immunohistochemical, and morphometric analyses of nasal airways conducted 24 hr after the last instillation revealed that the lowest-effect level was 10 microg/kg bw. RA exposure induced a dose-dependent, neutrophilic rhinitis with mucus hypersecretion, atrophy and exfoliation of nasal transitional and respiratory epithelium, olfactory epithelial atrophy and loss of olfactory sensory neurons (OSNs). In a second study, the persistence of lesions in mice instilled with 250 microg/kg bw RA was assessed. Nasal inflammation and excess luminal mucus were resolved after 3 weeks, but OSN loss was still evident in olfactory epithelium (OE). These results suggest that nasal inflammation, mucus hypersecretion, and olfactory neurotoxicity could be important adverse health effects associated with short-term, repeated, airborne exposures to macrocyclic trichothecenes.

  3. Effects of awake tidal breathing, swallowing, nasal breathing, oral breathing and the Müller and Valsalva maneuvers on the dimensions of the upper airway. Evaluation by ultrafast computerized tomography

    W Stanford; J Galvin; M Rooholamini


    .... This report defines the size of the upper airway during normal tidal breathing and describes the changes that occur with swallowing, isolated nasal breathing, and isolated oral breathing and with the...

  4. Effects of awake tidal breathing, swallowing, nasal breathing, oral breathing and the Müller and Valsalva maneuvers on the dimensions of the upper airway. Evaluation by ultrafast computerized tomography

    Stanford, W; Galvin, J; Rooholamini, M


    .... This report defines the size of the upper airway during normal tidal breathing and describes the changes that occur with swallowing, isolated nasal breathing, and isolated oral breathing and with the...

  5. Initial Treatment of Respiratory Distress Syndrome with Nasal Intermittent Mandatory Ventilation versus Nasal Continuous Positive Airway Pressure: A Randomized Controlled Trial

    Armanian, Amir-Mohammad; Badiee, Zohreh; Heidari, Ghobad; Feizi, Awat; Salehimehr, Nima


    Background: Neonatal respiratory distress syndrome (RDS) in premature infants who survived and its complications are a common problem. Due to high morbidity and mechanical ventilation (MV) nowadays researchers in interested minimizing MV. To determine, in very low birth weight (BW) preterm neonates with RDS, if initial treatment with nasal intermittent mandatory ventilation (early NIMV) compared with early nasal continuous positive airway pressure (early NCPAP) obtains more favorable outcomes in terms of the duration of treatment, and the need for endotracheal tube ventilation. Methods: In this single-center randomized control trial study, infants (BW ≤ 1500 g and/or gestational age ≤ 34 weeks) with respiratory distress were considered eligible. Forty-four infants were randomly assigned to receive early-NIMV and 54 comparable infants to early-NCPAP. Surfactants were given, when FIO2 requirement was of >30%. Primary outcomes were failure of noninvasive respiratory support, that is, the need for MV in the first 48 h of life and for the duration of noninvasive respiratory support in each group. Results: 98 infants were enrolled (44 in the NIMV and 54 in the NCPAP group). The Preventive power of MV of NIMV usage (95.5%) was not lower than the NCPAP (98.1%) strength (hazard ratio: 0.21 (95% confidence interval: 0.02-2.66); P: 0.23). The duration of noninvasive respiratory support in the NIMV group was significantly shorter than NCPAP (the median (range) was 24 (18.00-48.00) h versus 48.00 (22.00-120.00) h in NIMV versus NCPAP groups; P < 0.001). Similarly, the duration of dependency on oxygen was less, for NIMV (the median (range) was 96.00 (41.00-504.00) h versus144.00 (70.00-1130.00) h in NIMV versus NCPAP groups; P: 0.009). Interestingly, time to full enteral feeds and length of hospital stay were more favorable in the NIMV versus the NCPAP group. Conclusions: Initial treatment of RDS with NIMV was safe, and well tolerated. Furthermore, NIMV had excellent

  6. Initial treatment of respiratory distress syndrome with nasal intermittent mandatory ventilation versus nasal continuous positive airway pressure: A randomized controlled trial

    Amir-Mohammad Armanian


    Full Text Available Background: Neonatal respiratory distress syndrome (RDS in premature infants who survived and its complications are a common problem. Due to high morbidity and mechanical ventilation (MV nowadays researchers in interested minimizing MV. To determine, in very low birth weight (BW preterm neonates with RDS, if initial treatment with nasal intermittent mandatory ventilation (early NIMV compared with early nasal continuous positive airway pressure (early NCPAP obtains more favorable outcomes in terms of the duration of treatment, and the need for endotracheal tube ventilation. Methods: In this single-center randomized control trial study, infants (BW ≤ 1500 g and/or gestational age ≤ 34 weeks with respiratory distress were considered eligible. Forty-four infants were randomly assigned to receive early-NIMV and 54 comparable infants to early-NCPAP. Surfactants were given, when FIO 2 requirement was of >30%. Primary outcomes were failure of noninvasive respiratory support, that is, the need for MV in the first 48 h of life and for the duration of noninvasive respiratory support in each group. Results: 98 infants were enrolled (44 in the NIMV and 54 in the NCPAP group. The Preventive power of MV of NIMV usage (95.5% was not lower than the NCPAP (98.1% strength (hazard ratio: 0.21 (95% confidence interval: 0.02-2.66; P: 0.23. The duration of noninvasive respiratory support in the NIMV group was significantly shorter than NCPAP (the median (range was 24 (18.00-48.00 h versus 48.00 (22.00-120.00 h in NIMV versus NCPAP groups; P < 0.001. Similarly, the duration of dependency on oxygen was less, for NIMV (the median (range was 96.00 (41.00-504.00 h versus144.00 (70.00-1130.00 h in NIMV versus NCPAP groups; P: 0.009. Interestingly, time to full enteral feeds and length of hospital stay were more favorable in the NIMV versus the NCPAP group. Conclusions: Initial treatment of RDS with NIMV was safe, and well tolerated. Furthermore, NIMV had excellent

  7. Nasal cytochrome P4502A: Identification in rats and humans

    Thornton-Manning, J.R.; Hotchkiss, J.A. [Michigan State Univ., East Lansing, MI (United States); Ding, Xinxin [Wadsworth Center for Laboratories and Research, Albany, NY (United States)] [and others


    The nasal mucosa, the first tissue of contact for inhaled xenobiotics, possesses substantial enobiotic-metabolizing capacti. Enzymes of the nasal cavity may metabolize xenobiotics to innocuous, more water-soluble compounds that are eliminated from the body, or they may bioactivate them to toxic metabolites. These toxic metabolites may find to cellular macromolecules in the nasal cavity or be transported to other parts of the body where they may react. Nasal carcinogenesis in rodents often results from bioactivation of xenobiotics. The increased incidences of nasal tumors associated with certain occupations suggest that xenobiotic bioactivation may be important in human nasal cancer etiology, as well. The increasing popularity of the nose as a route of drug administration makes information concerning nasal drug metabolism and disposition vital to accomplish therapeutic goals. For these reasons, the study of xenobiotic-met abolizing capacity of the nasal cavity is an important area of health-related research. In the present study, we have confirmed the presence of CYP2A6 mRNA in human respiratory mucosa.

  8. Randomized controlled trial comparing nasal intermittent positive pressure ventilation and nasal continuous positive airway pressure in premature infants after tracheal extubation

    Daniela Franco Rizzo Komatsu

    Full Text Available Summary Objective: To analyze the frequency of extubation failure in premature infants using conventional mechanical ventilation (MV after extubation in groups subjected to nasal intermittent positive pressure ventilation (nIPPV and continuous positive airway pressure (nCPAP. Method: Seventy-two premature infants with respiratory failure were studied, with a gestational age (GA ≤ 36 weeks and birth weight (BW > 750 g, who required tracheal intubation and mechanical ventilation. The study was controlled and randomized in order to ensure that the members of the groups used in the research were chosen at random. Randomization was performed at the time of extubation using sealed envelopes. Extubation failure was defined as the need for re-intubation and mechanical ventilation during the first 72 hours after extubation. Results: Among the 36 premature infants randomized to nIPPV, six (16.6% presented extubation failure in comparison to 11 (30.5% of the 36 premature infants randomized to nCPAP. There was no statistical difference between the two study groups regarding BW, GA, classification of the premature infant, and MV time. The main cause of extubation failure was the occurrence of apnea. Gastrointestinal and neurological complications did not occur in the premature infants participating in the study. Conclusion: We found that, despite the extubation failure of the group of premature infants submitted to nIPPV being numerically smaller than in premature infants submitted to nCPAP, there was no statistically significant difference between the two modes of ventilatory support after extubation.

  9. Nasal Airway Dysfunction in Children with Cleft Lip and Cleft Palate: Results of a Cross-Sectional Population-Based Study, with Anatomical and Surgical Considerations.

    Sobol, Danielle L; Allori, Alexander C; Carlson, Anna R; Pien, Irene J; Watkins, Stephanie E; Aylsworth, Arthur S; Meyer, Robert E; Pimenta, Luiz A; Strauss, Ronald P; Ramsey, Barry L; Raynor, Eileen; Marcus, Jeffrey R


    The aesthetic aspects of the cleft lip nasal deformity have been appreciated for over a century, but the functional implications have remained largely underappreciated or misunderstood. This study describes the frequency and severity of nasal obstructive symptoms among children with cleft lip and/or cleft palate, addressing the hypotheses that age, cleft type, and severity are associated with the development of nasal obstructive symptoms. Children with nonsyndromic cleft lip and/or cleft palate and a comparison group of unaffected children born from 1997 to 2003 were identified through the North Carolina Birth Defects Monitoring Program and birth certificates. Nasal airway obstruction was measured using the validated Nasal Obstruction Symptom Evaluation scale. The survey was completed by parental proxy for 176 children with cleft lip and/or cleft palate and 333 unaffected children. Nasal obstructive symptoms were more frequently reported in cleft lip with cleft palate compared with unaffected children (p teams to consider using this or similar screening methods to identify which children may benefit from functional rhinoplasty. Risk, I.

  10. A simple method to use the preformed nasotracheal tube during the lightwand-guided awake nasal intubation in the patients with difficult airways

    XUE Fu-shan; YANG Quan-yong; XU Ya-chao; LIAO Xu


    @@ To the Editor: Management of a difficult airway remains one of the major challenges to the anesthetists in clinical practice.1 Lightwand-guided nasal intubation has been shown to be a useful technique in the patients with known difficult airways.2-4 Also the preformed nasotracheal tubes (PNTs) are commonly selected for nasal intubation in the patients undergoing head and neck surgery because they are easy to secure,provide convenient surgical access and help to reduce nasal damage.5 However, the anesthetists must be faced with a problem that the PNT is significantly longer than the wand of the Trachlight TM (Laerdal Medical Corporation, New York, USA). For example, the lengths of the sizes 6.0-7.5 Portex Polar cuffed nasal tubes (Portex Lmited Hythe, England) range from 43 to 46 cm,whereas the wand of the Trachlight TM is only 33 cm long.After the wand of the TrachlightTM is inserted into the PNT, therefore, its distal light bulb is not able to protrude beyond the distal end of the PNT. We have adapted a simple method to solve this problem.

  11. Sleep-related breathing disorders. 5. Nasal continuous positive airway pressure treatment for obstructive sleep apnoea.

    Grunstein, R R


    CPAP should be considered the first line of treatment in patients with moderate to severe obstructive sleep apnoea. In our centre in Sydney this generally means patients with more than 20 apnoea/hypopnoeas per hour with repeated dips in oxyhaemoglobin saturation and usually some symptomatology. Despite this first line role of nasal CPAP, recent objective studies question whether earlier enthusiastic reports on adherence to CPAP are correct. The role of technical innovations in new CPAP machines in improving usage remains to be tested. The "drop out" rate from physician selection for a CPAP trial to highly compliant user is certainly more than 50% of patients. What happens to these patients? Data from some studies suggest that surgical treatments are used, at least in the USA, but in all probability many of these patients remain untreated. The challenge in the next decade is either to improve CPAP devices to increase usage in this group or to develop other treatment options. The role of intensive inhospital "acclimatisation" to CPAP also has yet to be objectively tested. It is unclear whether "intelligent" CPAP will make huge inroads in increasing the number of patients who accept CPAP trials, prescriptions, or compliance. It will have minimal impact on patients with mask problems or claustrophobia or those who feel that CPAP is inconvenient. There is a high likelihood that it will reduce technologist workload during CPAP titration studies. "Intelligent" CPAP may help to reduce total overnight mouth leakage and therefore reduce nasal side effects. The current expense of developing such devices will mean that they are unlikely to supersede much cheaper standard "one pressure" CPAP machines in the next few years.

  12. The Effect of Nasal Surgery on Continuous Positive Airway Pressure Device Use and Therapeutic Treatment Pressures: A Systematic Review and Meta-Analysis

    Camacho, Macario; Riaz, Muhammad; Capasso, Robson; Ruoff, Chad M.; Guilleminault, Christian; Kushida, Clete A.; Certal, Victor


    Background: The relationship between nasal surgery and its effect on continuous positive airway pressure (CPAP) device therapeutic treatment pressures and CPAP device use has not been previously systematically examined. Study Objectives: To conduct a systematic review and meta-analysis evaluating the effect of isolated nasal surgery on therapeutic CPAP device pressures and use in adults with obstructive sleep apnea. Methods: MEDLINE, Scopus, Web of Science, and The Cochrane Library were searched through July 15, 2014. The MOOSE consensus statement and PRISMA statement were followed. Results: Eighteen studies (279 patients) reported CPAP data after isolated nasal surgery. Seven studies (82 patients) reported preoperative and postoperative mean therapeutic CPAP device pressures and standard deviations, which reduced from 11.6 ± 2.2 to 9.5 ± 2.0 centimeters of water pressure (cwp) after nasal surgery. Pooled random effects analysis demonstrated a statistically significant pressure reduction, with a mean difference of −2.66 cwp (95% confidence intervals, −3.65 to −1.67); P < 0.00001. Eleven studies (153 patients) described subjective, self-reported data for CPAP use; and a subgroup analysis demonstrated that 89.1% (57 of 64 patients) who were not using CPAP prior to nasal surgery subsequently accepted, adhered to, or tolerated it after nasal surgery. Objective, device meter-based hours of use increased in 33 patients from 3.0 ± 3.1 to 5.5 ± 2.0 h in the short term (< 6 mo of follow-up). Conclusion: Isolated nasal surgery in patients with obstructive sleep apnea and nasal obstruction reduces therapeutic CPAP device pressures and the currently published literature's objective and subjective data consistently suggest that it also increases CPAP use in select patients. Citation: Camacho M, Riaz M, Capasso R, Ruoff CM, Guilleminault C, Kushida CA, Certal V. The effect of nasal surgery on continuous positive airway pressure device use and therapeutic treatment

  13. Tissue sensitivity of the rat upper and lower extrapulmonary airways to the inhaled electrophilic air pollutants diacetyl and acrolein.

    Cichocki, Joseph A; Smith, Gregory J; Morris, John B


    The target site for inhaled vapor-induced injury often differs in mouth-breathing humans compared with nose-breathing rats, thus complicating the use of rat inhalation toxicity data for assessment of human risk. We sought to examine sensitivity of respiratory/transitional nasal (RTM) and tracheobronchial (TBM) mucosa to two electrophilic irritant vapors: diacetyl and acrolein. Computational fluid dynamic physiologically based pharmacokinetic modeling was coupled with biomarker assessment to establish delivered dose-response relationships in RTM and TBM in male F344 rats following 6 h exposure to diacetyl or acrolein. Biomarkers included glutathione status, proinflammatory and antioxidant gene mRNA levels, and nuclear translocation of nuclear factor (erythroid-derived 2)-like 2 (Nrf2). Modeling revealed that 0.0094-0.1653 μg acrolein/min-cm(2) and 3.9-21.6 μg diacetyl/min-cm(2) were deposited into RTM/TBM. Results indicate RTM and TBM were generally of similar sensitivity to diacetyl and acrolein. For instance, both tissues displayed induction of antioxidant and proinflammatory genes, and nuclear accumulation of Nrf2 after electrophile exposure. Hierarchical cellular response patterns were similar in RTM and TBM but differed between vapors. Specifically, diacetyl exposure induced proinflammatory and antioxidant genes concomitantly at low exposure levels, whereas acrolein induced antioxidant genes at much lower exposure levels than that required to induce proinflammatory genes. Generally, diacetyl was less potent than acrolein, as measured by maximal induction of transcripts. In conclusion, the upper and lower extrapulmonary airways are of similar sensitivity to inhaled electrophilic vapors. Dosimetrically based extrapolation of nasal responses in nose-breathing rodents may provide an approach to predict risk to the lower airways of humans during mouth-breathing.

  14. Viral bronchiolitis in young rats causes small airway lesions that correlate with reduced lung function.

    Sorkness, Ronald L; Szakaly, Renee J; Rosenthal, Louis A; Sullivan, Ruth; Gern, James E; Lemanske, Robert F; Sun, Xin


    Viral illness with wheezing during infancy is associated with the inception of childhood asthma. Small airway dysfunction is a component of childhood asthma, but little is known about how viral illness at an early age may affect the structure and function of small airways. We used a well-characterized rat model of postbronchiolitis chronic airway dysfunction to address how postinfectious small airway lesions affect airway physiological function and if the structure/function correlates persist into maturity. Brown Norway rats were sham- or virus inoculated at 3 to 4 weeks of age and allowed to recover from the acute illness. At 3 to 14 months of age, physiology (respiratory system resistance, Newtonian resistance, tissue damping, and static lung volumes) was assessed in anesthetized, intubated rats. Serial lung sections revealed lesions in the terminal bronchioles that reduced luminal area and interrupted further branching, affecting 26% (range, 13-39%) of the small airways at 3 months of age and 22% (range, 6-40%) at 12 to 14 months of age. At 3 months of age (n = 29 virus; n = 7 sham), small airway lesions correlated with tissue damping (rs = 0.69) but not with Newtonian resistance (rs = 0.23), and Newtonian resistance was not elevated compared with control rats, indicating that distal airways were primarily responsible for the airflow obstruction. Older rats (n = 7 virus; n = 6 sham) had persistent small airway dysfunction and significantly increased Newtonian resistance in the postbronchiolitis group. We conclude that viral airway injury at an early age may induce small airway lesions that are associated quantitatively with small airway physiological dysfunction early on and that these defects persist into maturity.

  15. Unilateral Nasal Obstruction during Later Growth Periods Affects Craniofacial Muscles in Rats

    Uchima Koecklin, Karin H.; Hiranuma, Maya; Kato, Chiho; Funaki, Yukiha; Kataguchi, Taku; Yabushita, Tadachika; Kokai, Satoshi; Ono, Takashi


    Nasal obstruction can occur at different life stages. In early stages of life the respiratory system is still under development, maturing during the growth period. Previous studies have shown that nasal obstruction in neonatal rats alters craniofacial function. However, little is known about the effects of nasal obstruction that develops during later growth periods. The aim of this study was to investigate the effects of nasal obstruction during later periods of growth on the functional characteristics of the jaw-opening reflex (JOR) and tongue-protruding muscles. In total, 102 6-day-old male Wistar rats were randomized into either a control or experimental group (both n = 51). In order to determine the appropriate timing of nasal obstruction, the saturation of arterial oxygen (SpO2) was monitored at 8 days, and at 3, 5, 7, 9, and 11 weeks in the control group. Rats in the experimental group underwent unilateral nasal obstruction at the age of 5 weeks. The SpO2 was monitored at 7, 9, and 11 weeks in the experimental group. The electromyographic responses of JOR and the contractile properties of the tongue-protruding muscles were recorded at 7, 9, and 11 weeks. In the control group, SpO2 decreased until 5 weeks of age, and remained relatively stable until 11 weeks of age. The SpO2 was significantly lower in the experimental group than in the control. In the experimental group, JOR changes included a longer latency and smaller peak-to-peak amplitude, while changes in the contractile properties of the tongue-protruding muscles included larger twitch and tetanic forces, and a longer half-decay time. These results suggest that nasal obstruction during later growth periods may affect craniofacial function.

  16. EDU pretreatment decreases polymorphonuclear leukocyte migration into rat lung airways.

    Bassett, D J; Elbon, C L; Ishii, Y; Yang, H; Otterbein, L; Boswell, G A; Kerr, J S


    Pretreatment with the heterocyclic compound EDU (N-[2-(2-oxo-1-imidazolindinyl)ethyl]-N'-phenylurea) has previously been shown to reduce polymorphonuclear leukocyte (PMN) infiltration into the airways of ozone-exposed rats. The present study further examined the effects of 1 and 2 days EDU pretreatment on rat lung inflammatory responses by determining PMN infiltration in response to intratracheal instillation with the chemoattractant formyl-norleucine-leucine-phenylalanine (fNLP). Maximal recovery of PMNs by bronchoalveolar lavage was observed 4 hr after fNLP instillation with no alteration in the numbers of recoverable macrophages and lymphocytes. Although 1-day pretreatment with EDU did not affect PMN recovery from fNLP-instilled rat lungs, 2 days of EDU pretreatment prevented PMN infiltration as indicated by PMN recoveries that were similar to those obtained from saline-instilled lungs. Measurements of lung-marginated and interstitial pools of inflammatory cells using collagenase tissue digestion demonstrated no effect of 2 days EDU pretreatment. Although 2 days EDU pretreatment alone did not alter blood PMN content, lung permeability, and the lavage recoveries of inflammatory cells, blood PMN responses to chemotactic stimuli in vitro were impaired. In addition, EDU was shown to directly inhibit PMN chemotaxis and superoxide anion generation in vitro. These data demonstrated that EDU acts by interfering with PMN activation and migration rather than by decreasing PMN availability. EDU, by modulating the inflammatory response, represents a useful compound for preventing PMN-associated amplification of acute lung injuries.

  17. Absence of effect of nasal continuous positive airway pressure on the esophageal phase of nutritive swallowing in newborn lambs.

    Djeddi, Djamal; Cantin, Danny; Samson, Nathalie; Tian, Hao; Praud, Jean-Paul


    It is presently recommended that oral feeding be started in premature infants as soon as possible, often at an age at which nasal continuous positive airway pressure (nCPAP) is still required for ventilatory support. Our previous data showed that application of nCPAP up to 10 cmH2O in full-term lambs had no deleterious effect on cardiorespiratory safety, feeding efficiency, or on nutritive swallowing-breathing coordination. Besides fear of swallowing-breathing coordination disturbances, esophageal motility disruption by nCPAP could be a reason to delay oral feeding. To our knowledge, no study has focused on the effects of nCPAP on esophageal motility in the neonatal period. The aim of the present study was therefore to further assess the effects of nCPAP on oral feeding by assessing its effects on the esophageal phase of nutritive swallowing (nutritive esophagodeglutition). Six full-term lambs, ages 2 to 3 days, underwent esophageal multichannel intraluminal impedance-pH monitoring. Lambs were bottle-fed under 2 randomized conditions, namely spontaneous breathing and nCPAP 6 cmH(2)O. Beyond confirmation of unaltered feeding efficiency, analysis of multiple variables measured by impedance monitoring revealed that nCPAP 6 does not alter nutritive esophagodeglutition in any way (nCPAP vs spontaneous breathing, P > 0.1 for all variables). offering further support to neonatologists pleading for initiation of oral feeding in infants still on nCPAP, the present results set the foundations for similar clinical studies in preterm human infants to confirm the absence of effects of nCPAP on nutritive swallowing.

  18. Elective nasal continuous positive airway pressure to support respiration after prolonged ventilation in infants after congenital cardiac surgery

    Gandhi, Hemang; Mishra, Amit; Thosani, Rajesh; Acharya, Himanshu; Shah, Ritesh; Surti, Jigar; Sarvaia, Alpesh


    Background: We sought to compare the effectiveness of oxygen (O2) treatment administered by an O2 mask and nasal continuous positive airway pressure (NCPAP) in infants after congenital cardiac surgery. Methods: In this retrospective observational study, 54 infants undergoing corrective cardiac surgery were enrolled. According to the anesthesiologist's preference, the patients ventilated for more than 48 h were either put on NCPAP or O2 mask immediately after extubation. From pre-extubation to 24 h after treatment, arterial blood gas and hemodynamic data were measured. Results: After 24 h of NCPAP institution, the patients showed a significant improvement in oxygenation compared to O2 mask group. Respiratory rate (per minute) decreased from 31.67 ± 4.55 to 24.31 ± 3.69 (P < 0.0001), PO2 (mmHg) increased from 112.12 ± 22.83 to 185.74 ± 14.81 (P < 0.0001), and PCO2 (mmHg) decreased from 42.88 ± 5.01 to 37.00 ± 7.22 (P < 0.0076) in patients on NCPAP. In this group, mean pediatric cardiac surgical Intensive Care Unit (PCSICU) stay was 4.72 ± 1.60 days, with only 2 (11.11%) patients requiring re-intubation. Conclusion: NCPAP can be used safely and effectively in infants undergoing congenital cardiac surgery to improve oxygenation/ventilation. It also reduces the work of breathing, PCSICU stay, and may reduce the likelihood of re-intubation. PMID:28163425

  19. PM2.5-Induced Oxidative Stress and Mitochondrial Damage in the Nasal Mucosa of Rats

    Guo, Zhiqiang; Hong, Zhicong; Dong, Weiyang; Deng, Congrui; Zhao, Renwu; Xu, Jian; Zhuang, Guoshun; Zhang, Ruxin


    Exposure to PM2.5 (particulate matter ≤2.5 μm) increases the risk of nasal lesions, but the underlying mechanisms, especially the mechanisms leading to mitochondrial damage, are still unclear. Thus, we investigated the in vivo effects of PM2.5 exposure on the inflammatory response, oxidative stress, the enzyme activities of Na+K+-ATPase and Ca2+-ATPase, and the morphology and function of mitochondria in the nasal mucosa of rats. Exposure to PM2.5 occurred through inhalation of a PM2.5 solution aerosol. The results show that the PM2.5 exposure induced increased levels of malondialdehyde (MDA) and levels of proinflammatory mediators, including interleukin 6 (IL-6), IL-8, and tumor necrosis factor-α (TNF-α). These changes were accompanied by decreases in the activities of total superoxide dismutase (T-SOD), Na+K+-ATPase, and Ca2+-ATPase in rat nasal mucosa. PM2.5 significantly affected the expression of specific mitochondrial fission/fusion genes (OPA1, Mfn1, Fis1, and Drp1) in nasal mucosa. These changes were accompanied by abnormal alterations of mitochondrial structures, including mitochondrial swelling, cristae disorder, and even fission resulting from higher doses of PM2.5. Our data shows that oxidative damage, inflammatory response, and mitochondrial dysfunction may be the toxic mechanisms that cause nasal lesions after exposure to PM2.5. PMID:28146064

  20. Comparison of airway measurements during influenza-induced tachypnea in infant and adult cotton rats

    Prince Gregory A


    Full Text Available Abstract Background Increased respiratory rate (tachypnea is frequently observed as a clinical sign of influenza pneumonia in pediatric patients admitted to the hospital. We previously demonstrated that influenza infection of adult cotton rats (Sigmodon hispidus also results in tachypnea and wanted to establish whether this clinical sign was observed in infected infant cotton rats. We hypothesized that age-dependent differences in lung mechanics result in differences in ventilatory characteristics following influenza infection. Methods Lung tidal volume, dynamic elastance, resistance, and pleural pressure were measured in a resistance and compliance system on mechanically-ventilated anesthestized young (14–28 day old and adult (6–12 week old cotton rats. Animals at the same age were infected with influenza virus, and breathing rates and other respiratory measurements were recorded using a whole body flow plethysmograph. Results Adult cotton rats had significantly greater tidal volume (TV, and lower resistance and elastance than young animals. To evaluate the impact of this increased lung capacity and stiffening on respiratory disease, young and adult animals were infected intra-nasally with influenza A/Wuhan/359/95. Both age groups had increased respiratory rate and enhanced pause (Penh during infection, suggesting lower airway obstruction. However, in spite of significant tachypnea, the infant (unlike the adult cotton rats maintained the same tidal volume, resulting in an increased minute volume. In addition, the parameters that contribute to Penh were different: while relaxation time between breaths and time of expiration was decreased in both age groups, a disproportionate increase in peak inspiratory and expiratory flow contributed to the increase in Penh in infant animals. Conclusion While respiratory rate is increased in both adult and infant influenza-infected cotton rats, the volume of air exchanged per minute (minute volume is

  1. Correction of Symptomatic Chronic Nasal Airway Obstruction in Conjunction With Bimaxillary Orthognathic Surgery: Does It Complicate Recovery and Is It Effective?

    Posnick, Jeffrey C; Choi, Elbert; Adachie, Anayo; Troost, Thomas


    The purpose of this study was to assess the safety and efficacy of intranasal procedures carried out simultaneously with bimaxillary orthognathic surgery. The authors executed a retrospective cohort study derived from patients treated by a single surgeon at 1 institution from 2004 through 2013 with a minimum follow-up of 1 year (range, 1 to 10 yr). An index study group consisting of a consecutive series of patients with symptomatic chronic obstructive nasal breathing (CONB) and a bimaxillary developmental dentofacial deformity (DFD) also involving the chin were identified. They underwent a minimum of: Le Fort I osteotomy, bilateral sagittal ramus osteotomies, septoplasty, inferior turbinate reduction (ITR), and osseous genioplasty. Study variables included age at operation, gender, pattern of presenting DFD, presence of obstructive sleep apnea, segmentation of the maxilla, and airway management. The primary outcome variable studied was residual CONB. During the study period, 262 patients met the inclusion criteria. Their age at operation averaged 25 years (range, 13 to 63 yr) and 134 were female (51%). The major patterns of presenting DFD included long face (29%) and maxillary deficiency (25%). No patients required nasal packing, reintubation, tracheostomy, or blood transfusion. In 6 of the 262 patients (2%), the intranasal procedures did not resolve nasal breathing difficulties. In these patients, procedures recommended included synechiae release (n = 3), revision septoplasty (n = 3), and further ITR (n = 4). An association between age at time of surgery and non-segmental Le Fort I osteotomy with the occurrence of residual nasal obstruction was confirmed. When completing septoplasty and ITR through a Le Fort I, airway management need not be altered from standard protocol. The management of CONB in conjunction with orthognathic surgery is highly effective, with few complications. Non-segmental Le Fort I in patients at least 40 years of age is more likely to be

  2. Specific allergen immunotherapy attenuates allergic airway inflammation in a rat model of Alstonia scholaris pollen induced airway allergy.

    Datta, Ankur; Moitra, Saibal; Hazra, Iman; Mondal, Somnath; Das, Prasanta Kumar; Singh, Manoj Kumar; Chaudhuri, Suhnrita; Bhattacharya, Debanjan; Tripathi, Santanu Kumar; Chaudhuri, Swapna


    Pollen grains are well established to be an important cause of respiratory allergy. Current pharmacologic therapies for allergic asthma do not cure the disease. Allergen specific immunotherapy is the only treatment method which re-directs the immune system away from allergic response leading to a long lasting effect. The mechanism by which immunotherapy achieves this goal is an area of active research world-wide. The present experimental study was designed to develop an experimental model of allergic lung inflammation based on a relevant human allergen, Alstonia scholaris pollen, and to establish the immunological and cellular features of specific allergen immunotherapy using this same pollen extract. Our results revealed that Alstonia scholaris pollen sensitization and challenge causes eosinophilic airway inflammation with mucin hypersecretion. This is associated with increased total IgE, increased expression of FcɛRI on lung mast cells and increased levels of IL-4, IL-5 & IL-13 as confirmed by ELISA, in-situ immunofluorescence and FACS assay. Allergen specific immunotherapy reduced airway inflammation and also decreased total IgE level, FcɛRI expression, IL-4, IL-5 & IL-13 levels. It was further noted that the reduction of these levels was more by intra-nasal route than by intra-peritoneal route. Thus we present a novel animal model of Alstonia scholaris pollen allergic disease and specific allergen immunotherapy which will pave the way towards the development of better treatment modalities.

  3. Cytochrome P-450 dependent monooxygenase activity in rat nasal epithelial membranes

    Hadley, W.M.; Dahl, A.R.


    Cytochrome P-450 was found in nasal epithelial membranes (NEM) of the rat. The quantity was 12% that of liver on a per mg of microsomal protein basis and 1.6 times that of the lung on the same basis. Metabolism of p-nitroanisole was faster by microsomes from NEM than by microsomes from liver or lungs while the metabolism rate of aniline by microsomes from NEM was between that of microsomes from liver and lung.

  4. In Situ Casting and Imaging of the Rat Airway Tree for Accurate 3D Reconstruction

    Jacob, Richard E.; Colby, Sean M.; Kabilan, Senthil; Einstein, Daniel R.; Carson, James P.


    The use of anatomically accurate, animal-specific airway geometries is important for understanding and modeling the physiology of the respiratory system. One approach for acquiring detailed airway architecture is to create a bronchial cast of the conducting airways. However, typical casting procedures either do not faithfully preserve the in vivo branching angles or produce rigid casts that when removed for imaging are fragile and thus easily damaged. We address these problems by creating an in situ bronchial cast of the conducting airways in rats that can be subsequently imaged in situ using 3D micro-CT imaging. We also demonstrate that deformations in airway branch angles resulting from the casting procedure are small, and that these angle deformations can be reversed through an interactive adjustment of the segmented cast geometry. Animal work was approved by the Institutional Animal Care and Use Committee of Pacific Northwest National Laboratory. PMID:23786464

  5. Attenuation of cigarette smoke-induced airway mucus production by hydrogen-rich saline in rats.

    Yunye Ning

    Full Text Available BACKGROUND: Over-production of mucus is an important pathophysiological feature in chronic airway disease such as chronic obstructive pulmonary disease (COPD and asthma. Cigarette smoking (CS is the leading cause of COPD. Oxidative stress plays a key role in CS-induced airway abnormal mucus production. Hydrogen protected cells and tissues against oxidative damage by scavenging hydroxyl radicals. In the present study we investigated the effect of hydrogen on CS-induced mucus production in rats. METHODS: Male Sprague-Dawley rats were divided into four groups: sham control, CS group, hydrogen-rich saline pretreatment group and hydrogen-rich saline control group. Lung morphology and tissue biochemical changes were determined by immunohistochemistry, Alcian Blue/periodic acid-Schiff staining, TUNEL, western blot and realtime RT-PCR. RESULTS: Hydrogen-rich saline pretreatment attenuated CS-induced mucus accumulation in the bronchiolar lumen, goblet cell hyperplasia, muc5ac over-expression and abnormal cell apoptosis in the airway epithelium as well as malondialdehyde increase in the BALF. The phosphorylation of EGFR at Tyr1068 and Nrf2 up-regulation expression in the rat lungs challenged by CS exposure were also abrogated by hydrogen-rich saline. CONCLUSION: Hydrogen-rich saline pretreatment ameliorated CS-induced airway mucus production and airway epithelium damage in rats. The protective role of hydrogen on CS-exposed rat lungs was achieved at least partly by its free radical scavenging ability. This is the first report to demonstrate that intraperitoneal administration of hydrogen-rich saline protected rat airways against CS damage and it could be promising in treating abnormal airway mucus production in COPD.

  6. Analysis of acute impact of oleoresin capsicum on rat nasal mucosa using scanning electron microscopy.

    Catli, Tolgahan; Acar, Mustafa; Olgun, Yüksel; Dağ, İlknur; Cengiz, Betül Peker; Cingi, Cemal


    Analysis of acute cellular changes seen in nasal mucosa of Wistar-Albino rats exposed to different doses of oleoresin capsicum for various time periods by means of scanning electron microscopy. Thirty-five Wistar-Albino rats were divided into five groups of seven rats each. 6-gram oleoresin capsicum per second was sprayed into cages of the groups except group 1. Spray times and duration of exposure to pepper gasses were different for each group. Thirty minutes after the exposure, the animals were killed and specimens from their nasal mucosas were harvested and examined under scanning electron microscope. Mucosal damage was scored from 0-4 points. Mean values of nasal mucosa damage scores of the groups were calculated and compared statistically. Average damage scores of the groups exposed to identical doses of oleoresin capsicum for various exposure times were compared and a statistically significant difference was seen between Groups 2 and 3 (p 0.05). Average damage scores of the groups exposed to various doses for identical exposure times were compared, and statistically significant differences were observed between Groups 2 and 4 and also Groups 3 and 5 (p mucosa. The extent of these destructive changes increases with the prolonged exposure to higher doses. Besides, exposure time also stands out as an influential factor on the extent of the destructive changes.

  7. The ΔF508-CFTR mutation inhibits wild-type CFTR processing and function when co-expressed in human airway epithelia and in mouse nasal mucosa

    Tucker Torry A


    Full Text Available Abstract Background Rescue or correction of CFTR function in native epithelia is the ultimate goal of CF therapeutics development. Wild-type (WT CFTR introduction and replacement is also of particular interest. Such therapies may be complicated by possible CFTR self-assembly into an oligomer or multimer. Results Surprisingly, functional CFTR assays in native airway epithelia showed that the most common CFTR mutant, ΔF508-CFTR (ΔF-CFTR, inhibits WT-CFTR when both forms are co-expressed. To examine more mechanistically, both forms of CFTR were transfected transiently in varying amounts into IB3-1 CF human airway epithelial cells and HEK-293 human embryonic kidney cells null for endogenous CFTR protein expression. Increasing amounts of ΔF-CFTR inhibited WT-CFTR protein processing and function in CF human airway epithelial cells but not in heterologous HEK-293 cells. Stably expressed ΔF-CFTR in clones of the non-CF human airway epithelial cell line, CALU-3, also showed reduction in cAMP-stimulated anion secretion and in WT-CFTR processing. An ultimate test of this dominant negative-like effect of ΔF-CFTR on WT-CFTR was the parallel study of two different CF mouse models: the ΔF-CFTR mouse and the bitransgenic CFTR mouse corrected in the gut but null in the lung and airways. WT/ΔF heterozygotes had an intermediate phenotype with regard to CFTR agonist responses in in vivo nasal potential difference (NPD recordings and in Ussing chamber recordings of short-circuit current (ISC in vitro on primary tracheal epithelial cells isolated from the same mice. In contrast, CFTR bitransgenic +/− heterozygotes had no difference in their responses versus +/+ wild-type mice. Conclusions Taken altogether, these data suggest that ΔF-CFTR and WT-CFTR co-assemble into an oligomeric macromolecular complex in native epithelia and share protein processing machinery and regulation at the level of the endoplasmic reticulum (ER. As a consequence, ΔF-CFTR slows WT

  8. Development of T Lymphocytes in the Nasal-associated Lymphoid Tissue (NALT from Growing Wistar Rats

    Gustavo A. Sosa


    Full Text Available The aim of the present report was to study the development of several T-lymphocyte subsets in the nasal-associated lymphoid tissue (NALT of growing Wistar rats. CD5+ and CD4+ lymphocytes gradually increased with age. A predominance of CD8α+ over CD4+ T cells was found from 7 to 45 days but from 45 to 60 days of age T helper cells outnumbered the cytotoxic subpopulation. The majority of CD8+ T lymphocytes expressed the heterodimeric isoform. The most relevant findings by immunohistochemistry are: (1 the predominance of TCRγδ+ and CD8α+ cells at 7 days postpartum over all the other T-cell subpopulations; and (2 that TCRγβ+ outnumbered TCRαβ+ T cells from 7 to 45 days postpartum whereas αβ T cells predominated in 45- and 60-day-old rats. Besides, cytometric studies have shown that the percentages of TCRγ+, CD8+, as well as the population coexpressing both phenotypes (TCRγδ+CD8α+, were significantly higher in rats at 7 days postpartum when compared to 60 day-old rats. In the present study, the finding of a high number of γδ+ and CD8+ T cells early in NALT development may indicate the importance of these subpopulations in the protection of the nasal mucosa in suckling and weaning Wistar rats.

  9. In Situ and in Vivo Study of Nasal Absorption of Paeonol in Rats

    Pengyue Li


    Full Text Available The objective of this work was to study the in situ and in vivo nasal absorption of paeonol. A novel single pass in situ nasal perfusion technique was applied to examine the rate and extent of nasal absorption of paeonol by rats. Various experimental conditions, such as perfusion rate, pH, osmotic pressure and drug concentration, were investigated. The in situ experiments showed that the nasal absorption of paeonol was not dependent on drug concentration, and fitted a first order process. The absorption rate constant, Ka, increased with an increase in perfusion speed. Paeonol was better absorbed in acidic solutions than in neutral or alkaline solutions. The value of Ka was higher in a hypertonic environment than under isotonic or hypotonic conditions. In vivo studies of paeonol absorption were carried out in rats and the pharmacokinetics parameters of intranasal (i.n. and intragastric (i.g. administration were compared with intravenous (i.v. administration. The bioavailabilities of paeonol were 52.37% and 15.81% for i.n. and i.g, respectively, while Tmax values were 3.05 ± 1.46 min and 6.30 ± 0.70 min. MRT (Mean Residence Time were 23.19 ± 6.46 min, 41.49 ± 2.96 min and 23.09 ± 5.88 min for i.n., i.g. and i.v. methods, respectively. The results demonstrate that paeonol could be absorbed promptly and thoroughly by i.n. administration in rats.

  10. A unique method for the isolation of nasal olfactory stem cells in living rats.

    Stamegna, Jean-Claude; Girard, Stéphane D; Veron, Antoine; Sicard, Gilles; Khrestchatisky, Michel; Feron, François; Roman, François S


    Stem cells are attractive tools to develop new therapeutic strategies for a variety of disorders. While ethical and technical issues, associated with embryonic, fetal and neural stem cells, limit the translation to clinical applications, the nasal stem cells identified in the human olfactory mucosa stand as a promising candidate for stem cell-based therapies. Located in the back of the nose, this multipotent stem cell type is readily accessible in humans, a feature that makes these cells highly suitable for the development of autologous cell-based therapies. However, preclinical studies based on autologous transplantation of rodent olfactory stem cells are impeded because of the narrow opening of the nasal cavity. In this study, we report the development of a unique method permitting to quickly and safely biopsy olfactory mucosa in rats. Using this newly developed technique, rat stem cells expressing the stem cell marker Nestin were successfully isolated without requiring the sacrifice of the donor animal. As an evidence of the self-renewal capacity of the isolated cells, several millions of rat cells were amplified from a single biopsy within four weeks. Using an olfactory discrimination test, we additionally showed that this novel biopsy method does not affect the sense of smell and the learning and memory abilities of the operated animals. This study describes for the first time a methodology allowing the derivation of rat nasal cells in a way that is suitable for studying the effects of autologous transplantation of any cell type present in the olfactory mucosa in a wide variety of rat models.

  11. An exposure system for measuring nasal and lung uptake of vapors in rats

    Dahl, A.R.; Brookins, L.K.; Gerde, P. [National Inst. for Working Life, Solna (Sweden)


    Inhaled gases and vapors often produce biological damage in the nasal cavity and lower respiratory tract. The specific site within the respirator tract at which a gas or vapor is absorbed strongly influences the tissues at risk to potential toxic effects; to predict or to explain tissue or cell specific toxicity of inhaled gases or vapors, the sites at which they are absorbed must be known. The purpose of the work reported here was to develop a system for determining nose and lung absorption of vapors in rats, an animal commonly used in inhalation toxicity studies. In summary, the exposure system described allows us to measure in the rate: (1) nasal absorption and desorption of vapors; (2) net lung uptake of vapors; and (3) the effects of changed breathing parameters on vapor uptake.

  12. Nasal Physiology

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  13. Nasal Anatomy

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  14. Lingual muscle activity across sleep-wake states in rats with surgically altered upper airway

    Irma eRukhadze


    Full Text Available Obstructive sleep apnea (OSA patients have increased upper airway muscle activity, including such lingual muscles as the genioglossus (GG, geniohyoid (GH and hyoglossus (HG. This adaptation partially protects their upper airway against obstructions. Rodents are used to study the central neural control of sleep and breathing but they do not naturally exhibit OSA. We investigated whether, in chronically instrumented, behaving rats, disconnecting the GH and HG muscles from the hyoid (H apparatus would result in a compensatory increase of other upper airway muscle activity (EMG and/or other signs of upper airway instability. We first determined that, in intact rats, lingual (GG and intrinsic muscles maintained stable activity levels when quantified based on 2 h-long recordings conducted on days 6 through 22 after instrumentation. We then studied 5 rats in which the tendons connecting the GH and HG muscles to the H apparatus were experimentally severed. When quantified across all recording days, lingual EMG during SWS was modestly but significantly increased in rats with surgically altered upper airway (8.6% ±0.7(SE vs. 6.2% ±0.7 of the mean during wakefulness; p=0.012. Respiratory modulation of lingual EMG occurred mainly during SWS and was similarly infrequent in both groups, and the incidence of sighs and central apneas also was similar. Thus, a weakened action of selected lingual muscles did not produce sleep-disordered breathing but resulted in a relatively elevated activity in other lingual muscles during SWS. These results encourage more extensive surgical manipulations with the aim to obtain a rodent model with collapsible upper airway.

  15. Alteration of airway responsiveness mediated by receptors in ovalbumin-induced asthmatic E3 rats

    Jing-wen LONG; Xu-dong YANG; Lei CAO; She-min LU; Yong-xiao CAO


    Aim:Airway hyperresponsiveness is a constant feature of asthma.The aim of the present study was to investigate airway hyperreactivity mediated by contractile and dilative receptors in an ovalbumin (OVA)-induced model of rat asthma.Methods:Asthmatic E3 rats were prepared by intraperitoneal injection with OVA/aluminum hydroxide and then challenged with intranasal instillation of OVA-PBS two weeks later.The myograph method was used to measure the responses of constriction and dilatation in the trachea,main bronchi and lobar bronchi.Results:In asthmatic E3 rata,β2 adrenoceptor-mediated relaxation of airway smooth muscle pre-contracted with 5-HT was inhibited,and there were no obvious difference in relaxation compared with normal E3 rats.Contraction of lobar bronchi mediated by 5-HT and sarafotoxin 6c was more potent than in the trachea or main bronchi.Airway contractions mediated by the endothelin (ET)A receptor,ETB receptor and M3 muscarinic receptor were augmented,and the augmented contraction was most obvious in lobar bronchi.The order of efficacy of contraction for lobar bronchi induced by agonists was ET-1,sarafotoxin 6c>ACh>5-HT.OX8 (an antibody against CD8+ T cells) strongly shifted and 0X35 (an antibody against CD4+ T cells) modestly shifted isoprenaline-induced concentration-relaxation curves in a nonparallel fashion to the left with an increased Rmax in asthmatic rats and sarafotoxin 6c-induced concentration-contractile curves to the right with a decreased Emax.Conclusion:The inhibition of airway relaxation and the augmentation of contraction mediated by receptors contribute to airway hyperresponsiveness and involve CD8+ and CD4+ T cells.

  16. Establishment of Allergic Airway Inflammation Model in Late- phase Response of Sprague- Dawley Rats

    朱敏敏; 傅诚章; 周钦海


    Objective To establish allergic airway inflammation model in late-phase airwayreaction of Sprague-Dawley (SD) rats. Methods Thirty-six SD rats were randomly divided intothree groups: control group (Group Ⅰ),single challenge group (Group Ⅱ),consecutive challenge group(Group Ⅲ). The rats in Group Ⅱ and Group Ⅲ were sensitized twice by injection of ovalbumin (OA) to-gether with aluminum hydroxide and Bordetella pertussis as adjuvants, followed by challenge withaerosolized OA for 20 min once in Group Ⅱ or one time on each day for one week in Group Ⅲ . Therats in Group Ⅰ received 0.9 % saline by injection and inhalation. Results Conpared uith groupⅠ , there were positive symptoms observed in the group Ⅱ and group Ⅲ; the amount of total leucocytesand eosinophil percentage in brochoalveolar lauage fluid (BALF) significantly increased (P<0.05 orP <0.01 respectively) in Group Ⅱ or Ⅲ; histopathologic changes of lung showed acute allergic inflam-mation changes in Group Ⅱ : Disrupted epithelium damaged subepithelial structure and eosinophil infiltra-tion the in the airway wall. As for the Group Ⅲ , there were allergen-induced characteristic features ofchronic allergic airways inflammation: hypertrophy and hyperplasia of bronchial smooth muscle, gobletcell hyperplasia , basement membrane thickening, eosinophil infiltration, edema. Conclusion The mod-el of allergic airway inflammation in late-phase response of SD rats was successfully established by OAsensitization (twice) and consecutive challenge.

  17. Oral and nasal administration of chicken type Ⅱ collagen suppresses adjuvant arthritis in rats with intestinal lesions induced by meloxicam

    Yong-Qiu Zheng; Wei Wei; Yu-Xian Shen; Min Dai; Li-Hua Liu


    AIM: To investigate the curative effects of oral and nasal administration of chicken type Ⅱ collagen (CⅡ) on adjuvant arthritis (AA) in rats with meloxicam-induced intestinal lesions.METHODS: AA model in Sprague-Dawley (SD) rats with or without intestinal lesions induced by meloxicam was established and those rats were divided randomly into six groups which included AA model, AA model+meloxicam,AA model+oral CⅡ, AA model+nasal CⅡ, AA model+meloxicam+oral CⅡ and AA model+meloxicam+nasal CⅡ (n = 12). Rats was treated with meloxicam intragastrically for 7 d from d 14 after immunization with complete Freund's adjuvant (CFA), and then treated with chicken CⅡ intragastrically or nasally for 7 d. Histological changes of right hind knees were examined. Hind paw secondary swelling and intestinal lesions were evaluated. Synoviocyte proliferation was measured by 3-(4,5-dimethylthiazol-2-thiazolyl)-2,5-diphenyl-2H tetrazolium bromide (MTT)method. Activities of myeloperoxidase (MPO) and diamine oxidase (DAO) from supernatants of intestinal homogenates were assayed by spectrophotometric analysis.RESULTS: Intragastrical administration of meloxicam (1.5 mg/kg) induced multiple intestinal lesions in AA rats.There was a significant decrease of intestinal DAO activities in AA+meloxicam group (P<0.01) and AA model group (P<0.01) compared with normal group. DAO activities of intestinal homogenates in AA+meloxicam group were significantly less than those in AA rats (P<0.01). There was a significant increase of intestinal MPO activities in AA+meloxicam group compared with normal control (P<0.01). Oral or nasal administration of CⅡ (20 μg/kg)could suppress the secondary hind paw swelling(P<0.05for oral CⅡ; P<0.01 for nasal CⅡ), synoviocyte proliferation (P<0.01) and histopathological degradation in AA rats, but they had no significant effects on DAO and MPO changes.However, oral administration of CⅡ (20 μg/kg) showed the limited efficacy on arthritis

  18. Humidified High Flow Nasal Cannula versus Nasal Continuous Positive Airway Pressure as an Initial Respiratory Support in Preterm Infants with Respiratory Distress: a Randomized, Controlled Non-Inferiority Trial.

    Shin, Jeonghee; Park, Kyuhee; Lee, Eun Hee; Choi, Byung Min


    Heated, humidified, high-flow nasal cannula (HHFNC) is frequently used as a noninvasive respiratory support for preterm infants with respiratory distress. But there are limited studies that compares HHFNC with nasal continuous positive airway pressure (nCPAP) only as the initial treatment of respiratory distress in preterm infants immediately after birth. The aim of this study is to assess the effectiveness and safety of HHFNC compared to nCPAP for the initial treatment of preterm infants with respiratory distress. Preterm infants at between 30 and 35 weeks of gestational age were randomized to HHFNC or nCPAP when they showed respiratory distress in less than 24 hours of age postnatally. Preterm infants who needed invasive respiratory supports were excluded. Primary outcome was the incidence of treatment failure (defined as need for the intubation or mechanical ventilation). Eighty-five infants were analyzed. Sixteen of 42 infants randomized to HHFNC showed treatment failure compared to 9 of 43 infants using nCPAP (Risk difference 17.17 [-1.90-36.23]; P = 0.099). In terms of the reason for treatment failure, the frequency of hypoxia was significantly higher in the HHFNC group than in the nCPAP group (P = 0.020). There was no difference between the 2 groups in terms of respiratory and clinical outcomes and complications. Although HHFNC is safe compared to nCPAP, it is not certain that HHFNC is effective compared to nCPAP non-inferiorly as an initial respiratory support in preterm infants with respiratory distress.

  19. Effect of Nuclear Factor-κB on Airway Remodeling in Asthmatic Rats

    许淑云; 徐永健; 张珍祥; 倪望; 陈士新


    Summary: In order to investigate the effect of nuclear factor-κB (NF-κB) on airway remodeling in asthmatic rats, 18 Wistar rats were divided into three groups: asthmatic group; pyrrolidine dithiocarbamate (PDTC) group, in which rats were injected intraperitoneally with NF-κB specific inhibitor PDTC (100 mg/kg) before ovalbumin (OVA) challenge; control group. The NF-κB activity and the expression of inhibitory protein κBa (I-κBα) in airway were detected by electrophoretic mobility shift assay (EMSA), Western blot and immunohistochemistry respectively. The infiltration of inflammatory cells, the number of Goblet cells, the area of collagen and smooth muscle in airway were measured by means of image analysis system. The results showed that with the up-regulation of airway NF-κB activity in asthmatic group, the number of goblet cells (3.08 ±0.86/100μm basement membrane (BM)), the area of collagen (24.71 ± 4. 24 μm2/μm BM) and smooth muscle (13.81 ± 2.11 μm2/μm BM) in airway were significantly increased (P<0.05) as compared with control group (0.14±0. 05/100μm BM, 14.31 ±3.16 μm2/μm BM and 7.67±2.35 μm2/μm BM respectively) and PDTC group (0. 33±0. 14/100 μm BM, 18. 16±2.85 μm2/μm BM and 8.95±2.16 μm2/μm BM respectively). However, there was no significant difference between PDTC group and control group (P>0.05). It was concluded that the activity of NF-κB is increased in airway of asthmatic rats. Inhibition of NF-κB activation can attenuate constructional changes in asthma airway, suggesting NF-κB may contribute to asthmatic airway remodeling.

  20. Expression of Leukemia Inhibitory Factor in Airway Epithelial Tissue of Asthmatic Rats

    XIONG Weining; ZENG Daxiong; XU Yongjian; XIONG Shengdao; FANG Huijuan; CAO Yong; SONG Qingfeng; CAO Chao


    In order to investigate the expression of leukemia inhibitory factor (LIF) in airway epithelial tissues of normal and asthmatic rats, the influence of dexamethasone and the role of LIF in pathogenesis of asthma, 30 Sprague-Dawley (SD) rats were randomly divided into 3 groups (10 for each group): normal group, asthma model group, and dexamethasone-interfered group. In asthmamodel group and dexamethasone-interfered group, asthma rat models were established by intraperitoneal (i.p.) injection of 10% ovalbumin (OVA) and challenge with 1% OVA via inhalation. Rats in dexamethasone-interfered group were pretreated with dexamethasone (2 mg/kg, i.p) 30 min before each challenge. The expression of LIF protein in lung was detected by immunohistochemistry. The results showed that LIF protein was mainly expressed in cytoplasm of bronchial epithelial cells. The expression of LIF protein in the airway epithelial tissue of asthma model group was significantly higher than that in normal group and dexamethasone-interfered group (P<0.01), but there was no significant difference between normal group and dexamethasone-interfered group (P>0.05). It was concluded that the expression of LIF was increased significantly in the airway epithelial tissue of the asthma rats, and dexamethasone could down-regulate the expression of LIF. It was suggested that LIF might play an important role in the pathogenesis of asthma as an inflammation regulator.

  1. Chronic Mild Prenatal Stress Exacerbates the Allergen-Induced Airway Inflammation in Rats

    Paulo J. Nogueira


    Full Text Available The effects of chronic mild prenatal stress on leukocyte infiltration into the airways was investigated in rat offspring. The chronic prenatal stress consisted of transitory and variable changes in the rat's living conditions. Offspring at adult age were actively sensitized (day 0 and intratracheally challenged (day 14 with ovalbumin. Bronchoalveolar lavage was performed in the offspring at 48 h after intratracheal challenge with ovalbumin. A significant increase in total leukocyte infiltration was observed in the nonstressed offspring group and this was associated with a marked recruitment of eosinophils without a significant effect on the influx of neutrophils and mononuclear cells. In the prenatal stressed offspring, the counts of both total leukocyte and eosinophils, as well as mononuclear cells, was increased by 50% compared to the non-stressed offspring. We provide here the first experimental evidence that chronic mild unpredictable prenatal stress produces a marked increase in the allergen-induced airway inflammation in the rat offspring.

  2. Effects of Endogenous Formaldehyde in Nasal Tissues on Inhaled Formmaldehyde Dosimetry Predictions in the Rat, Monkey, and Human Nasal Passages

    ABSTRACT Formaldehyde, a nasal carcinogen, is also an endogenous compound that is present in all living cells. Due to its high solubility and reactivity, quantitative risk estimates for inhaled formaldehyde rely on internal dose calculations in the upper respiratory tract which ...

  3. Nasal cavity dimensions in guinea pig and rat measured by acoustic rhinometry and fluid-displacement method

    Straszek, Sune; Pedersen, O.F.


    the potential of AR in pharmacological research with these animals. We measured the area-distance relationships by AR of nasal cavities postmortem in five guinea pigs (Duncan Hartley, 400 g) and five rats (Wistar, 250 g) by using custom-made equipment scaled for the purpose. Nosepieces were made from plastic...

  4. [Effects of carbocisteine on airway inflammation and related events in SO2-exposed rats].

    Ishibashi, Y; Okamura, T; Masumoto, Y; Tachiiri, T; Momo, K


    Airway inflammation leads to secretion of abnormal mucous glycoprotein and ciliary injury. To investigate the possible usefulness of carbocisteine against airway inflammation and events related to it, we conducted a study in SO2-exposed rats of the effects of carbocisteine and ambroxol, as an active control drug, on components of mucous glycoprotein (fucose, sialic acid and protein) in bronchoalveolar lavage fluid (BALF); on infiltration and activation of inflammatory cells in BALF; on tracheal and bronchial-ciliary lesions; and on cAMP levels in tracheal and alveolar tissues. Carbocisteine inhibited or improved all SO2-induced changes tested, and dosages of 125 and 250 mg/kg b.i.d. reduced fucose, sialic acid and protein contents, inflammatory cells (as markers of inflammation), free radicals, and elastase activity in BALF, and suppressed the development of ciliary lesions of the tracheal and bronchial mucosa, while ambroxol (10 mg/kg b.i.d.) showed no such effects. In addition, carbocisteine improved cAMP levels in the tracheal and alveolar tissues. These results indicate that carbocisteine is able to prevent the development of inflammation-related respiratory disease in this rat model, and that this remission of airway inflammation may be associated with carbocisteine-induced normalization of cAMP levels in tracheal and alveolar tissues as well as with its mucoregulant and anti-inflammatory effects. In conclusion, carbocisteine has a unique mucoregulant action and inhibits SO2-induced airway inflammation in a manner different from that of ambroxol.

  5. Airway management in trauma

    Rashid M Khan


    Full Text Available Trauma has assumed epidemic proportion. 10% of global road accident deaths occur in India. Hypoxia and airway mismanagement are known to contribute up to 34% of pre-hospital deaths in these patients. A high degree of suspicion for actual or impending airway obstruction should be assumed in all trauma patients. Objective signs of airway compromise include agitation, obtundation, cyanosis, abnormal breath sound and deviated trachea. If time permits, one should carry out a brief airway assessment prior to undertaking definitive airway management in these patients. Simple techniques for establishing and maintaining airway patency include jaw thrust maneuver and/or use of oro- and nas-opharyngeal airways. All attempts must be made to perform definitive airway management whenever airway is compromised that is not amenable to simple strategies. The selection of airway device and route- oral or -nasal, for tracheal intubation should be based on nature of patient injury, experience and skill level.

  6. Effect of aminated gelatin on the nasal absorption of insulin in rats.

    Seki, Toshinobu; Kanbayashi, Hiroshi; Nagao, Tomonobu; Chono, Sumio; Tomita, Mikio; Hayashi, Masahiro; Tabata, Yasuhiko; Morimoto, Kazuhiro


    Absorption enhancers, which increase the permeability of drugs through epithelial membranes without damaging them, are especially useful for intranasal administration of peptide drugs. In this study, aminated gelatins, candidate enhancers, having different numbers of amino groups were prepared from gelatin (H-gelatin, isoelectric point = 9.0, MW 100 kDa) and a partial gelatin hydrolysate (L-gelatin, isoelectric point = 8.0, MW 5 kDa), and the enhancing effects on the nasal absorption of insulin, used as a model peptide drug, and 5(6)-carboxyfluorescein (CF), a paracellular marker, were examined in rats. The enhancing effect on insulin and CF depends on the MW and number of amino groups. A high correlation between the enhancing effects on insulin and CF was observed and this suggests that an increase in the paracellular permeability is the mechanism governing the nasal absorption-enhancement of aminated gelatins, at least as far as insulin and CF are concerned. The enhancing mechanism might be shared with other cationic polymers having absorption-enhancing effects.

  7. (--Epigallocatechin-3-gallate Reduces Cigarette Smoke-Induced Airway Neutrophilic Inflammation and Mucin Hypersecretion in Rats

    Yingmin Liang


    Full Text Available Background: Cigarette smoking is the leading cause of chronic obstructive pulmonary disease. (--Epigallocatechin-3-gallate (EGCG, the major catechins in Chinese green tea, has been studied for its anti-oxidative and anti-inflammatory properties in cell and animal models. In this study, we aimed to analyze the effects of EGCG on cigarette smoke (CS-induced airway inflammation and mucus secretion in the CS-exposed rat model.Methods: Male Sprague-Dawley rats were randomly divided into either sham air (SA or CS exposure. EGCG (50 mg/kg b.wt. was given by oral gavage every other day in both SA and CS-exposed animals. Oxidative stress and inflammatory markers were determined in serum and/or bronchoalveolar lavage fluid by biochemical assays or ELISA. Lung morphological changes were examined by Periodic Acid-Schiff, Masson’s Trichrome staining and immunohistochemical analysis. Western blot analysis was performed to explore the effects of EGCG on epidermal growth factor receptor (EGFR-mediated signaling pathway.Results: (--Epigallocatechin-3-gallate treatment attenuated CS-induced oxidative stress, lung cytokine-induced neutrophil chemoattractant-1 release and neutrophil recruitment. CS exposure caused an increase in the number of goblet cells in line with MUC5AC upregulation, and increased lung collagen deposition, which were alleviated in the presence of EGCG. In addition, CS-induced phosphorylation of EGFR in rat lung was abrogated by EGCG treatment.Conclusion: (--Epigallocatechin-3-gallate treatment ameliorated CS-induced oxidative stress and neutrophilic inflammation, as well as airway mucus production and collagen deposition in rats. The present findings suggest that EGCG has a therapeutic effect on chronic airway inflammation and abnormal airway mucus production probably via inhibition of EGFR signaling pathway.


    EFFECTS OF ALLERGIC AIRWAYS DISEASE ON INFLUENZA VIRUS INFECTION IN BROWN NORWAY RATS (P. Singhl, D.W. Winsett2, M.J. Daniels2,C.A.J. Dick', K.B. Adlerl and M.I. Gilmour2, INCSU, Raleigh, N.C., 2NHEERL/ORD/ USEPA, RTP, N.C. and 3UNC, Chapel Hill, N.C.)The interaction between ...

  9. Nasal administration of interleukin-33 induces airways angiogenesis and expression of multiple angiogenic factors in a murine asthma surrogate.

    Shan, Shan; Li, Yan; Wang, Jingjing; Lv, Zhe; Yi, Dawei; Huang, Qiong; Corrigan, Chris J; Wang, Wei; Quangeng, Zhang; Ying, Sun


    The T-helper cell type 2-promoting cytokine interleukin-33 (IL-33) has been implicated in asthma pathogenesis. Angiogenesis is a feature of airways remodelling in asthma. We hypothesized that IL-33 induces airways angiogenesis and expression of angiogenic factors in an established murine surrogate of asthma. In the present study, BALB/c mice were subjected to serial intranasal challenge with IL-33 alone for up to 70 days. In parallel, ovalbumin (OVA) -sensitized mice were subjected to serial intranasal challenge with OVA or normal saline to serve as positive and negative controls, respectively. Immunohistochemical analysis of expression of von Willebrand factor and erythroblast transformation-specific-related gene, both blood vessel markers, and angiogenic factors angiogenin, insulin-like growth factor-1, endothelin-1, epidermal growth factor and amphiregulin was performed in lung sections ex vivo. An established in-house assay was used to test whether IL-33 was able to induce microvessel formation by human vascular endothelial cells. Results showed that serial intranasal challenge of mice with IL-33 or OVA resulted in proliferation of peribronchial von Willebrand factor-positive blood vessels to a degree closely related to the total expression of the angiogenic factors amphiregulin, angiogenin, endothelin-1, epidermal growth factor and insulin-like growth factor-1. IL-33 also induced microvessel formation by human endothelial cells in a concentration-dependent fashion in vitro. Our data are consistent with the hypothesis that IL-33 has the capacity to induce angiogenesis at least partly by increasing local expression of multiple angiogenic factors in an allergen-independent murine asthma surrogate, and consequently that IL-33 or its receptor is a potential novel molecular target for asthma therapy.

  10. Inflammatory airway features and hypothalamic-pituitary adrenal axis function in asthmatic rats combined with chronic obstructive pulmonary disease

    CAI Cui; CAO Yu-xue; ZHANG Hong-ying; LE Jing-jing; DONG Jing-cheng; CUI Yan; XU Chang-qing; LIU Bao-jun; WU Jin-feng; DUAN Xiao-hong


    Background Bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) are both inflammatory airway diseases with different characteristics. However, there are many patients who suffer from both BA and COPD. This study was to evaluate changes of inflammatory airway features and hypothalamic-pituitary-adrenal (HPA) axis function in asthmatic rats combined with COPD.Methods Brown Norway (BN) rats were used to model the inflammatory airway diseases of BA, COPD and COPD+BA.These three models were compared and evaluated with respect to clinical symptoms, pulmonary histopathology, airway hyperresponsiveness (AHR), inflammatory cytokines and HPA axis function.Results The inflammatory airway features and HPA axis function in rats in the COPD+BA model group were greatly influenced. Rats in this model group showed features of the inflammatory diseases BA and COPD. The expression of inflammatory cytokines in this model group might be up or downregulated when both disease processes are present. The levels of corticotrophin releasing hormone mRNA and corticosterone in this model group were both significantly decreased than those in the control group (P <0.05).Conclusions BN rat can be used as an animal model of COPD+BA. By evaluating this animal model we found that the features of inflammation in rats in this model group seem to be exaggerated. The HPA axis functions in rats in this model group have been disturbed or impaired, which is prominent at the hypothalamic level.

  11. Metabolic activation of phenacetin in rat nasal mucosa: dose-dependent binding to the glands of Bowman

    Brittebo, E.B.


    The metabolism and binding of the analgetic drug (ring-/sup 3/H)phenacetin in the nasal mucosa were studied in vitro and in vivo in male Sprague-Dawley rats. As shown by whole-body and light microscopic autoradiography there was an irreversible binding of metabolites to the glands of Bowman in the olfactory mucosa after high but not after low doses of (/sup 3/H)phenacetin. In the other tissues, the distribution of radioactivity was not changed when the dose was increased. Autoradiography of (/sup 3/H)-acetaminophen showed no preferential uptake of radioactivity in the olfactory mucosa. At incubation of nasal septa with (/sup 3/H)phenacetin in vitro, a binding of metabolites to the glands of Bowman was observed indicating that the metabolism occurred in situ. In rats, glutathione (GSH) depleted by pretreatment with phorone, there was a binding to the glands of Bowman in the olfactory mucosa also after a trace dose of (/sup 3/H)phenacetin. Addition of GSH decreased the irreversible binding of (/sup 3/H)phenacetin metabolites that occurred in 9000 X g nasal mucosa supernatants incubated with (/sup 3/H)phenacetin. There was a moderate decrease in the level of nonprotein sulfhydryl groups, mainly GSH, in the olfactory mucosa after administration of 100-300 mg/kg phenacetin. Collectively, these data suggest that phenacetin is metabolized and subsequent to GSH depletion, bound preferentially in the glands of Bowman. The data also suggest that in situ metabolic activation and binding of phenacetin in the rat nasal mucosa at high doses may play a role in the pathogenesis of the nasal tumors induced by high doses of phenacetin in the rat.

  12. Low-intensity aerobic exercise training attenuates airway inflammation and remodeling in a rat model of steroid-resistant asthma

    Qin Qingwu; Chen Xi; Feng Juntao; Qin Ling; Hu Chengping


    Background Aerobic exercise can improve symptoms,reduce airway inflammation,and even ameliorate airway remodeling in asthmatic animals and patients.However,previous studies have focused mainly on the effect of aerobic exercise on steroid-sensitive asthma (SSA).The goals of this study were to determine the effect of low-intensity aerobic exercise training on airway hyperresponsiveness,inflammation,and remodeling in a rat model of steroid-resistant asthma (SRA) and to identify the potential mechanisms underlying these effects.Methods Endotoxin-free ovalbumin with or without lipopolysaccharide were applied to establish rat models of SRA and SSA,respectively.Airway hyperresponsiveness,inflammation,remodeling,expression of interleukin (IL)-25,IL-33,thymic stromal lymphopoietin (TSLP),high mobility group box-1 (HMGB1),and IL-17 in bronchoalveolar lavage fluid (BALF),and the role of dexamethasone (DXM) were compared between these two asthmatic rat models.The effect of low-intensity aerobic exercise training and anti-HMGB1 treatment on airway hyperresponsiveness,inflammation,and remodeling in SRA rats also was evaluated.Results SRA rats developed neutrophil-dominated airway inflammation ((29.5±4.1)% of the total cell numbers in BALF),whereas SSA rats developed eosinophil-dominated airway inflammation ((24.0±6.1)% of the total cell numbers in BALF).Compared with SSA rats,SRA rats had more severe airway hyperresponsiveness,lower levels of IL-25 ((33.6±10.3) vs.(104.8±24.9) pg/ml),IL-33 ((87.5±25.0) vs.(226.6±40.7) pg/ml),and TSLP ((1 933.2±899.5) vs.(7 224.0±992.1) pg/ml),and higher levels of HMGB1 ((21.2±4.5) vs.(5.4±1.6) ng/ml) and IL-17 ((780.5±261.7) vs.(291.4±76.4) pg/ml) in BALF (all P <0.05).However,there was no significant difference in goblet cell hyperplasia,subepithelial collagen thickness,and airway smooth muscle remodeling between the two groups.Compared with control SSA rats,airway hyperresponsiveness,inflammation,and remodeling in SRA rats

  13. Effect of smoking cessation on airway inflammation of rats with chronic bronchitis

    LI Qing-yun; HUANG Shao-guang; WAN Huan-ying; WU Hua-cheng; ZHOU Tong; LI Min; DENG Wei-wu


    Background Smoking is the major cause of airway inflammation in chronic obstructive pulmonary disease (COPD),and smoking cessation is regarded as one of the important strategies for prevention and treatment of the inflammation.The inflammation of the chronic airway may be present and deteriorated even if the COPD patients stop smoking.Whether and how early smoking cessation affects the progress of inflammation is still obscure. This study was conducted to find the appropriate time for smoking cessation to terminate the airway inflammation in rats with smoke-induced chronic bronchitis.Methods A rat model of COPD was established by passively inhaling smoke mixture. Fifty-four young male Sprague-Dawley rats were randomly divided into 9 groups with different periods of smoke exposure and different time points of cessation. The inflammation markers to be detected included inflammatory cells in the bronchoalveolar lavage fluid (BALF), the myeloperoxidose (MPO) activity, the morphologic changes and the expression of ICAM-1 on the airway epithelium.Results When smoking was terminated at early stage, the inflammatory markers and related indexes were different from those of the typical chronic bronchitis group (group M7) (P<0.01). The pathologic score of group SC7 (2 weeks of smoking cessation after occurrence of typical chronic bronchitis ) was not different from that of group M7, and the level of ICAM-1 was still up-regulated (compared to group M7, P>0.05). Meanwhile, most of inflammatory cells in BALF were neutrophils compared to other groups (P<0.01).When smoking was terminated, the MPO activity was significantly lower than that of group M7 (P<0.01).Conclusions Smoking cessation at early stage can effectively inhibit the inflammatory reaction of COPD. Once chronic bronchitis occurs, little could be improved by smoking cessation.

  14. [Comparison of the brain pharmacokinetics of nasal tetramethylpyrazine phosphate pH-sensitive in situ gel in normal rats and model rats].

    Liu, Hong-Wei; Yan, Yi-Lin; Zhou, Li-Ling


    The study is to investigate the brain pharmacokinetics change of nasal tetramethylpyrazine phosphate (TMPP) pH-sensitive in situ gel in normal and model rats. Acute cerebral ischemia rat model was successfully established by middle cerebral artery occlusion (MCAO) method. Both normal and model rats were given nasal TMPP pH-sensitive in situ gel (10 mg x kg(-1)). Perfusates of brain striatum area were collected at each time point by microdialysis. The content of TMPP was determined by HPLC. The pharmacokinetics parameters were calculated by Kinetica 4.4 software at each time point of the brain drug concentration. The main pharmacokinetics parameters of TMPP were fitted with compartments 2. After nasal TMPP pH-sensitive in situ gel the values of C(max) and AUC of both components in brain showed as follows: the value of model group > that of normal group. Significant difference can be observed in the process of brain pharmacokinetics in normal and model rats after giving nasal TMPP pH-sensitive in situ gel.

  15. Transcriptional responses in the rat nasal epithelium following subchronic inhalation of naphthalene vapor

    Clewell, H.J., E-mail:; Efremenko, A.; Campbell, J.L.; Dodd, D.E.; Thomas, R.S.


    Male and female Fischer 344 rats were exposed to naphthalene vapors at 0 (controls), 0.1, 1, 10, and 30 ppm for 6 h/d, 5 d/wk, over a 90-day period. Following exposure, the respiratory epithelium and olfactory epithelium from the nasal cavity were dissected separately, RNA was isolated, and gene expression microarray analysis was conducted. Only a few significant gene expression changes were observed in the olfactory or respiratory epithelium of either gender at the lowest concentration (0.1 ppm). At the 1.0 ppm concentration there was limited evidence of an oxidative stress response in the respiratory epithelium, but not in the olfactory epithelium. In contrast, a large number of significantly enriched cellular pathway responses were observed in both tissues at the two highest concentrations (10 and 30 ppm, which correspond to tumorigenic concentrations in the NTP bioassay). The nature of these responses supports a mode of action involving oxidative stress, inflammation and proliferation. These results are consistent with a dose-dependent transition in the mode of action for naphthalene toxicity/carcinogenicity between 1.0 and 10 ppm in the rat. In the female olfactory epithelium (the gender/site with the highest incidences of neuroblastomas in the NTP bioassay), the lowest concentration at which any signaling pathway was significantly affected, as characterized by the median pathway benchmark dose (BMD) or its 95% lower bound (BMDL) was 6.0 or 3.7 ppm, respectively, while the lowest female olfactory BMD values for pathways related to glutathione homeostasis, inflammation, and proliferation were 16.1, 11.1, and 8.4 ppm, respectively. In the male respiratory epithelium (the gender/site with the highest incidences of adenomas in the NTP bioassay), the lowest pathway BMD and BMDL were 0.4 and 0.3 ppm, respectively, and the lowest male respiratory BMD values for pathways related to glutathione homeostasis, inflammation, and proliferation were 0.5, 0.7, and 0.9 ppm

  16. Characterization of primary rat nasal epithelial cultures in CFTR knockout rats as a model for CF sinus disease.

    Tipirneni, Kiranya E; Cho, Do-Yeon; Skinner, Daniel F; Zhang, Shaoyan; Mackey, Calvin; Lim, Dong-Jin; Woodworth, Bradford A


    The objectives of the current experiments were to develop and characterize primary rat nasal epithelial cultures and evaluate their usefulness as a model of cystic fibrosis (CF) sinonasal transepithelial transport and CF transmembrane conductance regulator (CFTR) function. Laboratory in vitro and animal studies. CFTR(+/+) and CFTR(-/-) rat nasal septal epithelia (RNSE) were cultured on semipermeable supports at an air-liquid interface to confluence and full differentiation. Monolayers were mounted in Ussing chambers for pharmacologic manipulation of ion transport and compared to similar filters containing murine (MNSE) and human (HSNE) epithelia. Histology and scanning electron microscopy (SEM) were completed. Real-time polymerase chain reaction of CFTR(+/+) RNSE, MNSE, and HSNE was performed to evaluate relative CFTR gene expression. Forskolin-stimulated anion transport (ΔIsc in μA/cm(2) ) was significantly greater in epithelia derived from CFTR(+/+) when compared to CFTR(-/-) animals (100.9 ± 3.7 vs. 10.5 ± 0.9; P < 0.0001). Amiloride-sensitive ISC was equivalent (-42.3 ± 2.8 vs. -46.1 ± 2.3; P = 0.524). No inhibition of CFTR-mediated chloride (Cl(-) ) secretion was exhibited in CFTR(-/-) epithelia with the addition of the specific CFTR inhibitor, CFTRInh -172. However, calcium-activated Cl(-) secretion (UTP) was significantly increased in CFTR(-/-) RNSE (CFTR(-/-) -106.8 ± 1.6 vs. CFTR(+/+) -32.2 ± 3.1; P < 0.0001). All responses were larger in RNSE when compared to CFTR(+/+) and CFTR(-/-) (or F508del/F508del) murine and human cells (P < 0.0001). Scanning electron microscopy demonstrated 80% to 90% ciliation in all RNSE cultures. There was no evidence of infection in CFTR(-/-) rats at 4 months. CFTR expression was similar among species. The successful development of the CFTR(-/-) rat enables improved evaluation of CF sinus disease based on characteristic abnormalities of ion transport. NA. Laryngoscope, 2017. © 2017 The American Laryngological

  17. Coordinated Respiratory Motor Activity in Nerves Innervating the Upper Airway Muscles in Rats.

    Tachikawa, Satoshi; Nakayama, Kiyomi; Nakamura, Shiro; Mochizuki, Ayako; Iijima, Takehiko; Inoue, Tomio


    Maintaining the patency of the upper airway during breathing is of vital importance. The activity of various muscles is related to the patency of the upper airway. In the present study, we examined the respiratory motor activity in the efferent nerves innervating the upper airway muscles to determine the movements of the upper airway during respiration under normocapnic conditions (pH = 7.4) and in hypercapnic acidosis (pH = 7.2). Experiments were performed on arterially perfused decerebrate rats aged between postnatal days 21-35. We recorded the efferent nerve activity in a branch of the cervical spinal nerve innervating the infrahyoid muscles (CN), the hypoglossal nerve (HGN), the external branch of the superior laryngeal nerve (SLN), and the recurrent laryngeal nerve (RLN) with the phrenic nerve (PN). Inspiratory nerve discharges were observed in all these nerves under normocapnic conditions. The onset of inspiratory discharges in the CN and HGN was slightly prior to those in the SLN and RLN. When the CO2 concentration in the perfusate was increased from 5% to 8% to prepare for hypercapnic acidosis, the peak amplitudes of the inspiratory discharges in all the recorded nerves were increased. Moreover, hypercapnic acidosis induced pre-inspiratory discharges in the CN, HGN, SLN, and RLN. The onset of pre-inspiratory discharges in the CN, HGN, and SLN was prior to that of discharges in the RLN. These results suggest that the securing of the airway that occurs a certain time before dilation of the glottis may facilitate ventilation and improve hypercapnic acidosis.

  18. Effects of chronic intermittent hypoxia on allergen-induced airway inflammation in rats.

    Broytman, Oleg; Braun, Rudolf K; Morgan, Barbara J; Pegelow, David F; Hsu, Pei-Ning; Mei, Linda S; Koya, Ajay K; Eldridge, Marlowe; Teodorescu, Mihaela


    Obstructive sleep apnea aggravates asthma, but its mechanisms are unknown. Chronic intermittent hypoxia is one hallmark feature of sleep apnea. In this study, we tested the effects of chronic intermittent hypoxia on allergen-induced inflammation in rats. Four groups (n = 9-11/group) of ovalbumin (OVA)-sensitized Brown-Norway rats underwent intermittent hypoxia (10% oxygen, 30 cycles/h, 10 h/d) or normoxia for 30 days concurrent with weekly OVA or vehicle challenges. Lung physiology, differential leukocyte counts from bronchoalveolar lavage, and histology (Picro Sirius Red staining for collagen content) were compared between groups 2 days after the last challenge. Gene expression in bronchoalveolar lavage cells was quantified by quantitative PCR. Compared with normoxia, chronic intermittent hypoxia reduced the FEV0.1/FVC ratio (P = 0.005), peak expiratory flow (P = 0.002), and mean midexpiratory flow (P = 0.004), predominantly in medium and large airways; decreased the baseline eosinophil number (P = 0.01) and amplified the effect of OVA on monocyte number (P = 0.02 for the interaction); in proximal airways, increased (P = 0.008), whereas in distal airways it decreased (P = 0.004), collagen density; induced qualitative emphysematous changes in lung periphery; and increased expression of the M2 macrophage marker YM-1 and augmented OVA-induced expression of plasminogen activator inhibitor-1. Chronic intermittent hypoxia alters immune response to allergen toward a more TH-1-predominant cellular phenotype with collagen deposition and matrix degradation, leading to airflow limitation. These findings highlight the potential of sleep apnea to aggravate airway dysfunction in patients with preexistent asthma.

  19. The Effects of Massage with Coconut and Sunflower Oils on Oxygen Saturation of Premature Infants with Respiratory Distress Syndrome Treated With Nasal Continuous Positive Airway Pressure

    Sousan Valizadeh


    Full Text Available Introduction: Nowadays particular emphasis is placed on the developmental aspects of premature infants care. Massage therapy is one of the best-known methods of caring. Due to the minimal touch policy in neonatal intensive care units (NICUs, massaging is not usually performed on premature infants. However, there is not sufficient evidence to support the claim that newborn infants with complex medical conditions should not be massaged. This study aimed to determine the effects of massage with coconut and sunflower oils on oxygen saturation of infants with respiratory distress syndrome (RDS treated with nasal continuous positive airway pressure (NCPAP. Methods: This was a randomized controlled trial on 90 newborns who were admitted to Alzahra Hospital (Tabriz, Iran. The infants were divided into control and massage therapy groups (massage with coconut and sunflower oils. Data was collected using a hospital documentation form. A 15-minute daily massage was performed for 3 days. Respiratory rate (RR, fraction of inspired oxygen (FiO2 and oxygen saturation were measured 5 minutes before the massage, 3 times during the massage, and 5 minutes after the massage. The collected data was analyzed using a mixed model. Results: In comparison to coconut oil and control groups, mean oxygen saturation of sunflower oil group was improved. In addition, the coconut massage group showed lower oxygen saturation than the control group but was all values were within the normal range. Although massage decreased oxygen saturation, there was no need to increase FiO2. Conclusion: Massage therapy can provide developmental care for infants treated with NCPAP.

  20. Mandibular advancement devices vs nasal-continuous positive airway pressure in the treatment of obstructive sleep apnoea. Systematic review and meta-analysis

    Galletti, Cosimo; Galletti, Francesco; Galletti, Bruno; Galletti, Claudio; Gay-Escoda, Cosme


    Background Obstructive sleep apnoea (OSA) is a common disorder that may affect at least 2 to 4% of the adult population. Nasal-Continuous Positive Airway Pressure (N-CPAP) is today considered the gold standard for the treatment of OSA. The development of oral appliances (OAs) represents a new approach for the management of this pathology. The aim of this systematic review is to compare the efficacy of OAs and N-CPAP in the treatment of patients with mild to severe OSA. Material and Methods A PubMed-MEDLINE and Cochrane databases search of articles published between 1982 and 2016 comparing the effect of N-CPAP and OAs in OSA patients was conducted during July 2016. The studies were selected and stratified according to PRISMA and SORT criteria. The main outcome measure was post-treatment Apnoea-Hypopnoea Index (AHI) while secondary outcomes included post-treatment Epworth Score Scale (ESS) score and lowest Oxygen Saturation level. Results N-CPAP was significantly more effective in suppressing AHI than OA. Moreover, N- CPAP was significantly more effective in increasing post-treatment lowest Oxygen Saturation level than OA. However, no significant different in decreasing ESS values was found between the two treatments. Conclusions On the basis of evidence in this review it would appear appropriate to offer OA therapy to those who are unwilling or unable to persist with CPAP therapy. N-CPAP still must be considered the gold standard treatment for OSA and, therefore, OAs may be included in the list of alternative options. Key words:CPAP, obstructive sleep apnoea, oral appliances. PMID:28578372

  1. Effects of the Traditional Chinese Medicine Dilong on Airway Remodeling in Rats with OVA-induced-Asthma

    Chen Yujuan


    Full Text Available The present study focuses on the effects and suggests possible mechanisms of the traditional Chinese medicine Dilong as compared to dexamethasone on lower respiratory tract remodeling in rats with asthma. The number of leukocytes and eosinophils in blood from the inferior vena cava and bronchoalveolar lavage fluid (BALF were counted. Lung tissues underwent hematoxylin and eosin staining. The thickness of the basement membrane and smooth muscle or the airways, and the ratio of inner to outer diameter of the airway wall were measured. Levels of transforming growth factor β1 (TGF-β1, matrix metallopeptidase 9/tissue inhibitor of metalloproteinase 1 (MMP-9/TIMP-1, urokinase plasminogen activator (uPA, plasminogen activator inhibitor 1 (PAI-1, and c-Myc(mRNA were evaluated. Results indicate that treatment with Dilong decreased the number of eosinophils in blood and BALF, decreased levels of TGF-β1, MMP-9/TIMP-1, uPA, PAI-1 and c-Myc, and ameliorated the thickening of airway walls, airway basement membrane and airway smooth muscle. Co-treatment with dexamethasone was found to intensity these effects. The cellularity of eosinophils and thickness of the airway basement membrane and smooth muscle were positively correlated with levels of TGF- 1, uPA, and c-Myc. Treatment with Dilong, either alone or in combination with dexamethasone, could inhibit and partly reverse airway remodeling in rats with asthma at an early stage.

  2. Effects of nebulized ketamine on allergen-induced airway hyperresponsiveness and inflammation in actively sensitized Brown-Norway rats

    Qian Yan


    Full Text Available Abstract Since airway hyperresponsiveness (AHR and allergic inflammatory changes are regarded as the primary manifestations of asthma, the main goals of asthma treatment are to decrease inflammation and maximize bronchodilation. These goals can be achieved with aerosol therapy. Intravenous administration of the anesthetic, ketamine, has been shown to trigger bronchial smooth muscle relaxation. Furthermore, increasing evidence suggests that the anti-inflammatory properties of ketamine may protect against lung injury. However, ketamine inhalation might yield the same or better results at higher airway and lower ketamine plasma concentrations for the treatment of asthma. Here, we studied the effect of ketamine inhalation on bronchial hyperresponsiveness and airway inflammation in a Brown-Norway rat model of ovalbumin(OVA-induced allergic asthma. Animals were actively sensitized by subcutaneous injection of OVA and challenged by repeated intermittent (thrice weekly exposure to aerosolized OVA for two weeks. Before challenge, the sensitizened rats received inhalation of aerosol of phosphate-buffered saline (PBS or aerosol of ketamine or injection of ketamine respectivity. Airway reactivity to acetylcholine (Ach was measured in vivo, and various inflammatory markers, including Th2 cytokines in bronchoalveolar lavage fluid (BALF, as well as induciable nitric oxide synthase (iNOS and nitric oxide (NO in lungs were examined. Our results revealed that delivery of aerosolized ketamine using an ultrasonic nebulizer markedly suppressed allergen-mediated airway hyperreactivity, airway inflammation and airway inflammatory cell infiltration into the BALF, and significantly decreased the levels of interleukin-4 (IL-4 in the BALF and expression of iNOS and the concentration of NO in the inflamed airways from OVA-treated rats. These findings collectively indicate that nebulized ketamine attenuated many of the central components of inflammatory changes and AHR in

  3. Histological changes in the nasal mucosa in rats after long-term exposure to formaldehyde and wood dust.

    Holmström, M; Wilhelmsson, B; Hellquist, H


    Wood dust is a well known nasal carcinogen in man, as formaldehyde is in rats. In certain occupational environments, combined exposure to wood dust and formaldehyde is common. Little is known about the effects of this combination. A pilot study was performed on four groups of Sprague-Dawley rats: one exposed to wood dust (25 mg/m3), another to formaldehyde (12.4 ppm) and a third to both wood dust and formaldehyde; the fourth group served a control group. After 104 weeks of exposure the nose and lungs were examined histologically. One well differentiated squamous cell carcinoma was found in the formaldehyde group. Squamous cell metaplasia was found significantly more often among the formaldehyde-exposed rats. Squamous cell metaplasia with dysplasia was most frequently observed, however, in the group exposed to both formaldehyde and wood dust. There were also significantly more rats with pulmonary emphysema in the groups exposed to wood dust than in the other groups.

  4. Triptolide inhibits TGF-β1-induced cell proliferation in rat airway smooth muscle cells by suppressing Smad signaling

    Chen, Ming; Lv, Zhiqiang; Huang, Linjie [Department of Respiratory Medicine, Sun Yat-Sen Memorial Hospital, Institute for Respiratory disease of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, Guangdong Province 510120 (China); Zhang, Wei [Department of Geratology, the Second People' s Hospital of Shenzhen, Shenzhen 518000 (China); Lin, Xiaoling; Shi, Jianting; Zhang, Wei; Liang, Ruiyun [Department of Respiratory Medicine, Sun Yat-Sen Memorial Hospital, Institute for Respiratory disease of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, Guangdong Province 510120 (China); Jiang, Shanping, E-mail: [Department of Respiratory Medicine, Sun Yat-Sen Memorial Hospital, Institute for Respiratory disease of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, Guangdong Province 510120 (China)


    Background: We have reported that triptolide can inhibit airway remodeling in a murine model of asthma via TGF-β1/Smad signaling. In the present study, we aimed to investigate the effect of triptolide on airway smooth muscle cells (ASMCs) proliferation and the possible mechanism. Methods: Rat airway smooth muscle cells were cultured and made synchronized, then pretreated with different concentration of triptolide before stimulated by TGF-β1. Cell proliferation was evaluated by MTT assay. Flow cytometry was used to study the influence of triptolide on cell cycle and apoptosis. Signal proteins (Smad2, Smad3 and Smad7) were detected by western blotting analysis. Results: Triptolide significantly inhibited TGF-β1-induced ASMC proliferation (P<0.05). The cell cycle was blocked at G1/S-interphase by triptolide dose dependently. No pro-apoptotic effects were detected under the concentration of triptolide we used. Western blotting analysis showed TGF-β1 induced Smad2 and Smad3 phosphorylation was inhibited by triptolide pretreatment, and the level of Smad7 was increased by triptolide pretreatment. Conclusions: Triptolide may function as an inhibitor of asthma airway remodeling by suppressing ASMCs proliferation via negative regulation of Smad signaling pathway. - Highlights: • In this study, rat airway smooth muscle cells were cultured and made synchronized. • Triptolide inhibited TGF-β1-induced airway smooth muscle cells proliferation. • Triptolide inhibited ASMCs proliferation via negative regulation of Smad signaling pathway.

  5. Inhibitory effect of acetamide-45 on airway inflammation and phosphodiesterase 4 in allergic rats

    Kai WANG; Hua-hao SHEN; Jun-chun CHEN; Zhong CHEN


    Aim: To determine the effects of acetamide-45 on respiratory function, airway inflammation, and the activity of phosphodiesterase 4 (PDE4) in allergic rats.Methods: Rats were sensitized by a single intramuscular injection with ovalbumin (OVA) and were challenged with ovalbumin applied by using an aerosol repeatedly for 7 d after 2 weeks. Acetamide-45 at concentrations of 5, 10, or 30 mg/kg was then administered by intraperitoneal injection. Changes in dynamic lung compliance and lung resistance, the accumulation of inflammatory cells in bronchoalveolar lavage, PDE4 activity, and the concentration of interleukin-4 in rat lung tissue were determined. Results: Seven days of treatment with acetamide-45 prevented eosinophil accumulation in allergic rats. At doses of 5, 10, and 30 mg/kg, acetamide-45 decreased lung resistance to 0.20±0.04, 0.25±0.07, and 0.22±0.05compliance to 0.41±0.07, 0.39±0.06, and 0.42±0.09 mL/cmH2O (P<0.05 vs OVA).After being treated with different doses of acetamide-45, the PDE4 activities in the concentrations of interleukin-4 in lung tissue were 6.22± 1.13, 5.95± 1.20,and 5.68±2.20 μg/g protein (P<0.05 vs OVA). Conclusions: Acetamide-45 was found to improve respiratory function and inhibit airway inflammation in this animal model, and the PDE4 activity of lung tissue was obviously inhibited.Acetamide-45 was an effective anti-inflammatory agent in respiratory inflammation,and the mechanism of its action might depend on inhibition of PDE4.

  6. The effect and mechanism of action of carbocysteine on airway bacterial load in rats chronically exposed to cigarette smoke.

    Sun, Li; Tang, Lifeng; Xu, Yan; Wang, Shouqin; Li, Yaming; Kang, Jian


    Carbocysteine (S-carboxymethylcysteine) is a mucoactive drug with in vitro free radical scavenging and anti-inflammatory properties. Several clinical trials have indicated that carbocysteine reduces exacerbation rates in COPD. In the present study, the effect of carbocysteine on the airway load of Haemophilus influenzae was assessed in rats chronically exposed to cigarette smoke (CS). In addition, the effects of carbocysteine on airway mucus hypersecretion and mucociliary clearance (MCC) associated with the adherence and clearance of H. influenzae were investigated. Wistar rats were randomly divided into control, carbocysteine vehicle, CS exposure and carbocysteine treatment groups. After 12 weeks, rats were selected for quantitative inoculation of H. influenzae. BAL fluid and lungs were collected aseptically after 3 h for quantitative culture of H. influenzae. MCC was measured by quantifying the clearance of (99m)Tc-Sc. Goblet cell metaplasia and the presence of mucoid matter were evaluated by Alcian blue/periodic acid-Schiff staining. Mucin 5AC (Muc5AC) expression was detected by western blotting and real-time reverse transcription-PCR. Exposure to CS increased airway H. influenzae load, aggravated mucus hypersecretion and delayed MCC. Treatment with carbocysteine decreased airway H. influenzae load, and attenuated airway mucus hypersecretion, with improved MCC associated with adherence and clearance of H. influenzae. These results suggest that carbocysteine may be beneficial in patients with COPD by increasing the clearance of bacteria and decreasing bacterial load. © 2010 The Authors. Respirology © 2010 Asian Pacific Society of Respirology.

  7. Nasal application of neuropeptide S reduces anxiety and prolongs memory in rats: social versus non-social effects.

    Lukas, Michael; Neumann, Inga D


    Recent studies demonstrated potent behavioral effects of centrally applied neuropeptide S (NPS) in mice and rats. These include increased arousal and wakefulness, facilitation of fear extinction and object memory consolidation and anxiolysis. Here, we compared the effects of NPS on both social and non-social memory, in male rats, and on social preference/social anxiety versus non-social anxiety after either intracerebroventricular (icv) or nasal application. Intranasal application of neuropeptides has been successfully employed to alter behavioral parameters in humans and rodents, but studies concerning nasal application of NPS are lacking so far. First, we confirmed the facilitatory effect of icv NPS (1 nmol) on object discrimination after an inter-exposure interval (IEI) of 240 min. These effects were context-dependent, as icv NPS (1 nmol) did not prolong social memory in a social discrimination paradigm. Second, we confirmed the anxiolytic effect of icv NPS (1 nmol) on the elevated plus-maze, whereas neither icv NPS (1 nmol) nor NPS receptor antagonist (10 nmol) altered social preference/social avoidance behavior. Third, nasal NPS (4-40 nmol applied topically on the rhinarium) facilitated object discrimination in a dose-dependent manner. Also, the anxiolytic effect of NPS on the elevated plus-maze could be confirmed after nasal administration (40 nmol). In contrast, identical doses of subcutaneously injected NPS failed to produce corresponding behavioral effects in both tests. Our findings provide evidence for memory-enhancing and anxiolytic effects of icv NPS in a non-social context. We could further show that these effects are context-specific, as social memory and social preference behavior remained unchanged after icv NPS. The effects of icv NPS were replicated by nasal application of the neuropeptide. Thus, nasal application of NPS seems to be a useful method in rodents for screening for behavioral or physiological effects before more specific and time

  8. Effect of All-trans Retinoic Acid on Airway Inflammation in Asthmatic Rats and Its Mechanism

    方红; 金红芳; 王宏伟


    Summary: The inhibitive effects of all-trans retinoic acid (ARTA) on airway inflammation in asthmatic rats and its mechanism on the basis of the regulation of nuclear factor kappaB (NF-κB) were explored. Thirty-two SD rats were randomly divided into 4 groups: control group, asthma group,dexamethasone treatment group and retinotic acid treatment group. The total and differential cell counts in the collected bronchoalveolar lavage fluid (BALF) were measured. The pathological changes in lung tissues were estimated by scoring. The expression of NF-κB inhibitor (IκBa), NF-κB,intercellular adhering molecule-1 (ICAM-1) in lung tissue was detected by immunohistochemical method. The results showed that in the two treatment groups, the total cell counts and proportion of inflammatory cells in BALF were significantly reduced, but there was no significant difference in differential cell counts in BALF between, them. The pathological changes in lung tissues in the treatment groups were significantly attenuated as compared with asthma group. Except the epithelial injury in retinotic acid treatment group was milder than in dexamethasone treatment group, the remaining lesions showed no significant difference between them. In the two treatment groups, the expression of IκBa was increased, while the expression of NF-κB and ICAM-1 decreased with the difference between the two groups being not significant. It was concluded that the similar anti-inflammatory effects and mechanism of ATRA on airway in asthmatic rats to those of dexamethasone were contributed to the increase of cytoplasmic IκBa content and suppression of NF-cB activation and expression.

  9. Pituitary Adenylate Cyclase-Activating Polypeptide Reverses Ammonium Metavanadate-Induced Airway Hyperresponsiveness in Rats

    Mounira Tlili


    Full Text Available The rate of atmospheric vanadium is constantly increasing due to fossil fuel combustion. This environmental pollution favours vanadium exposure in particular to its vanadate form, causing occupational bronchial asthma and bronchitis. Based on the well admitted bronchodilator properties of the pituitary adenylate cyclase-activating polypeptide (PACAP, we investigated the ability of this neuropeptide to reverse the vanadate-induced airway hyperresponsiveness in rats. Exposure to ammonium metavanadate aerosols (5 mg/m3/h for 15 minutes induced 4 hours later an array of pathophysiological events, including increase of bronchial resistance and histological alterations, activation of proinflammatory alveolar macrophages, and increased oxidative stress status. Powerfully, PACAP inhalation (0.1 mM for 10 minutes alleviated many of these deleterious effects as demonstrated by a decrease of bronchial resistance and histological restoration. PACAP reduced the level of expression of mRNA encoding inflammatory chemokines (MIP-1α, MIP-2, and KC and cytokines (IL-1α and TNF-α in alveolar macrophages and improved the antioxidant status. PACAP reverses the vanadate-induced airway hyperresponsiveness not only through its bronchodilator activity but also by counteracting the proinflammatory and prooxidative effects of the metal. Then, the development of stable analogs of PACAP could represent a promising therapeutic alternative for the treatment of inflammatory respiratory disorders.

  10. Steroids and antihistamines synergize to inhibit rat's airway smooth muscle contractility.

    Liu, Shao-Cheng; Chu, Yueng-Hsiang; Kao, Chuan-Hsiang; Wu, Chi-Chung; Wang, Hsing-Won


    Both glucocorticoids and H1-antihistamines were widely used on patients with allergic rhinitis (AR) and obstructive airway diseases. However, their direct effects on airway smooth muscle were not fully explored. In this study, we tested the effectiveness of prednisolone (Kidsolone) and levocetirizine (Xyzal) on isolated rat trachea submersed in Kreb's solution in a muscle bath. Changes in tracheal contractility in response to the application of parasympathetic mimetic agents were measured. The following assessments of the drug were performed: (1) effect on tracheal smooth muscle resting tension; (2) effect on contraction caused by 10(-6) M methacholine; (3) effect of the drug on electrical field stimulation (EFS) induced tracheal smooth muscle contractions. The result revealed sole use of Kidsolone or Xyzal elicited no significant effect or only a little relaxation response on tracheal tension after methacholine treatment. The tension was 90.5 ± 7.5 and 99.5 ± 0.8 % at 10(-4) M for Xyzal and 10(-5) M for Kidsolone, respectively. However, a dramatically spasmolytic effect was observed after co-administration of Kidsolone and Xyzal and the tension dropped to 67.5 ± 13.6 %, with statistical significance (p antihistamines to dramatically relax the trachea smooth muscle within minutes. Therefore, for AR patients with acute asthma attack, combined use of those two drugs is recommended.

  11. Environmentally persistent free radicals induce airway hyperresponsiveness in neonatal rat lungs

    Lominiki Slawo


    Full Text Available Abstract Background Increased asthma risk/exacerbation in children and infants is associated with exposure to elevated levels of ultrafine particulate matter (PM. The presence of a newly realized class of pollutants, environmentally persistent free radicals (EPFRs, in PM from combustion sources suggests a potentially unrecognized risk factor for the development and/or exacerbation of asthma. Methods Neonatal rats (7-days of age were exposed to EPFR-containing combustion generated ultrafine particles (CGUFP, non-EPFR containing CGUFP, or air for 20 minutes per day for one week. Pulmonary function was assessed in exposed rats and age matched controls. Lavage fluid was isolated and assayed for cellularity and cytokines and in vivo indicators of oxidative stress. Pulmonary histopathology and characterization of differential protein expression in lung homogenates was also performed. Results Neonates exposed to EPFR-containing CGUFP developed significant pulmonary inflammation, and airway hyperreactivity. This correlated with increased levels of oxidative stress in the lungs. Using differential two-dimensional electrophoresis, we identified 16 differentially expressed proteins between control and CGUFP exposed groups. In the rats exposed to EPFR-containing CGUFP; peroxiredoxin-6, cofilin1, and annexin A8 were upregulated. Conclusions Exposure of neonates to EPFR-containing CGUFP induced pulmonary oxidative stress and lung dysfunction. This correlated with alterations in the expression of various proteins associated with the response to oxidative stress and the regulation of glucocorticoid receptor translocation in T lymphocytes.

  12. L-citrulline supplementation reverses the impaired airway relaxation in neonatal rats exposed to hyperoxia

    Sopi Ramadan B


    Full Text Available Abstract Background Hyperoxia is shown to impair airway relaxation via limiting L-arginine bioavailability to nitric oxide synthase (NOS and reducing NO production as a consequence. L-arginine can also be synthesized by L-citrulline recycling. The role of L-citrulline supplementation was investigated in the reversing of hyperoxia-induced impaired relaxation of rat tracheal smooth muscle (TSM. Methods Electrical field stimulation (EFS, 2–20 V-induced relaxation was measured under in vitro conditions in preconstricted tracheal preparations obtained from 12 day old rat pups exposed to room air or hyperoxia (>95% oxygen for 7 days supplemented with L-citrulline or saline (in vitro or in vivo. The role of the L-citrulline/L-arginine cycle under basal conditions was studied by incubation of preparations in the presence of argininosuccinate synthase (ASS inhibitor [α-methyl-D, L-aspartate, 1 mM] or argininosuccinate lyase inhibitor (ASL succinate (1 mM and/or NOS inhibitor [Nω-nitro-L-arginine methyl ester; 100 μM] with respect to the presence or absence of L-citrulline (2 mM. Results Hyperoxia impaired the EFS-induced relaxation of TSM as compared to room air control (p ; 0.5 ± 0.1% at 2 V to 50.6 ± 5.7% at 20 V in hyperoxic group: 0.7 ± 0.2 at 2 V to 80.0 ± 5.6% at 20 V in room air group. Inhibition of ASS or ASL, and L-citrulline supplementation did not affect relaxation responses under basal conditions. However, inhibition of NOS significantly reduced relaxation responses (p in vivo and in vitro also reversed the hyperoxia-impaired relaxation. The differences were significant (p ; 0.8 ± 0.3% at 2 V to 47.1 ± 4.1% at 20 V without L-citrulline; 0.9 ± 0.3% at 2 V to 68.2 ± 4.8% at 20 V with L-citrulline. Inhibition of ASS or ASL prevented this effect of L-citrulline. Conclusion The results indicate the presence of an L-citrulline/L-arginine cycle in the airways of rat pups

  13. Post septorhinoplasty custom-made unilateral nasal stent for nasal cleft deformity

    Manu Rathee; Mohaneesh Bhoria; Priyanka Boora


    Context: Nasal cleft deformity is a complicated problem. Utilization of nasal stent in post septorhinoplastyaims at establishing and maintaining airway patency, tissue position, and reduces tissue contracture after surgery. Case Report: A 16-year-old female patient presented with history of surgical reconstruction of congenital cleft lip and cleft palate with secondary septorhinoplasty of nasal cleft deformity. Patient was referred for nasal stent 1 week after septorhinoplasty. This case repo...

  14. Non-chemosensitive parafacial neurons simultaneously regulate active expiration and airway patency under hypercapnia in rats.

    de Britto, Alan A; Moraes, Davi J A


    Hypercapnia or parafacial respiratory group (pFRG) disinhibition at normocapnia evokes active expiration in rats by recruitment of pFRG late-expiratory (late-E) neurons. We show that hypercapnia simultaneously evoked active expiration and exaggerated glottal dilatation by late-E synaptic excitation of abdominal, hypoglossal and laryngeal motoneurons. Simultaneous rhythmic expiratory activity in previously silent pFRG late-E neurons, which did not express the marker of ventral medullary CO2 -sensitive neurons (transcription factor Phox2b), was also evoked by hypercapnia. Hypercapnia-evoked active expiration, neural and neuronal late-E activities were eliminated by pFRG inhibition, but not after blockade of synaptic excitation. Hypercapnia produces disinhibition of non-chemosensitive pFRG late-E neurons to evoke active expiration and concomitant cranial motor respiratory responses controlling the oropharyngeal and upper airway patency. Hypercapnia produces active expiration in rats and the recruitment of late-expiratory (late-E) neurons located in the parafacial respiratory group (pFRG) of the ventral medullary brainstem. We tested the hypothesis that hypercapnia produces active expiration and concomitant cranial respiratory motor responses controlling the oropharyngeal and upper airway patency by disinhibition of pFRG late-E neurons, but not via synaptic excitation. Phrenic nerve, abdominal nerve (AbN), cranial respiratory motor nerves, subglottal pressure, and medullary and spinal neurons/motoneurons were recorded in in situ preparations of juvenile rats. Hypercapnia evoked AbN active expiration, exaggerated late-E discharges in cranial respiratory motor outflows, and glottal dilatation via late-E synaptic excitation of abdominal, hypoglossal and laryngeal motoneurons. Simultaneous rhythmic late-E activity in previously silent pFRG neurons, which did not express the marker of ventral medullary CO2 -sensitive neurons (transcription factor Phox2b), was also evoked by

  15. Vertical transmission of respiratory syncytial virus modulates pre- and postnatal innervation and reactivity of rat airways.

    Giovanni Piedimonte

    Full Text Available BACKGROUND: Environmental exposure to respiratory syncytial virus (RSV is a leading cause of respiratory infections in infants, but it remains unknown whether this infection is transmitted transplacentally from the lungs of infected mothers to the offspring. We sought to test the hypothesis that RSV travels from the respiratory tract during pregnancy, crosses the placenta to the fetus, persists in the lung tissues of the offspring, and modulates pre- and postnatal expression of growth factors, thereby predisposing to airway hyperreactivity. METHODOLOGY: Pregnant rats were inoculated intratracheally at midterm using recombinant RSV expressing red fluorescent protein (RFP. Viral RNA was amplified by RT-PCR and confirmed by sequencing. RFP expression was analyzed by flow cytometry and viral culture. Developmental and pathophysiologic implications of prenatal infection were determined by analyzing the expression of genes encoding critical growth factors, particularly neurotrophic factors and receptors. We also measured the expression of key neurotransmitters and postnatal bronchial reactivity in vertically infected lungs, and assessed their dependence on neurotrophic signaling using selective biological or chemical inhibition. PRINCIPAL FINDINGS: RSV genome was found in 30% of fetuses, as well as in the lungs of 40% of newborns and 25% of adults. RFP expression was also shown by flow cytometry and replicating virus was cultured from exposed fetuses. Nerve growth factor and its TrkA receptor were upregulated in RSV- infected fetal lungs and co-localized with increased cholinergic innervation. Acetylcholine expression and smooth muscle response to cholinergic stimulation increased in lungs exposed to RSV in utero and reinfected after birth, and blocking TrkA signaling inhibited both effects. CONCLUSIONS/SIGNIFICANCE: Our data show transplacental transmission of RSV from mother to offspring and persistence of vertically transmitted virus in lungs after

  16. Nasal CPAP

    Continuous positive airway pressure; CPAP; Bilevel positive airway pressure; BiPAP; Autotitrating positive airway pressure; APAP; nCPAP; Non-invasive positive pressure ventilation; NIPPV; Non-invasive ventilation; ...

  17. Maternal Disononyl Phthalate Exposure Activates Allergic Airway Inflammation via Stimulatingthe Phosphoinositide 3-kinase/Akt Pathway in Rat Pups

    CHEN Li; CHEN Jiao; XIE ChangMing; ZHAO Yan; WANG Xiu; andZHANG YunHui


    ObjectiveTo evaluate the effectof diisononyl phthalate (DINP) exposure during gestation and lacta-tion on allergic response in pups and to explore the role of phosphoinositide 3-kinase/Akt pathway on it. MethodsFemale Wistar rats were treated with DINP at different dosages (0, 5, 50,and 500 mg/kg of body weight per day). The pups were sensitized and challenged by ovalbumin (OVA). The airway response was assessed; the airway histological studies were performed by hematoxylin and eosin (HE) staining; and the relative cytokines in phosphoinositide 3-kinase (PI3K)/Akt pathway were measured by enzyme-linked immunosorbent assay (ELISA) and western blot analysis. ResultsThere was no significant difference in DINP’s effect on airway hyperresponsiveness (AHR) between male pups and female pups. In the 50 mg/(kg·d) DINP-treated group, airway response to OVA significantly increased and pups showed dramatically enhanced pulmonary resistance (RI) compared with those from controls (P<0.05). Enhanced Akt phosphorylation and NF-κB translocation, and Th2 cytokines expression were observed in pups of 50 mg/(kg·d) DINP-treated group. However, in the 5 and 500 mg/(kg·d) DINP-treated pups, no significant effects were observed. ConclusionTherewas an adjuvant effect of DINP on allergic airway inflammation in pups. Maternal DINP exposure could promote OVA-induced allergic airway response in pups in part by upregulation of PI3K/Akt pathway.

  18. Cuffed oropharyngeal airway for difficult airway management.

    Takaishi, Kazumi; Kawahito, Shinji; Tomioka, Shigemasa; Eguchi, Satoru; Kitahata, Hiroshi


    Difficulties with airway management are often caused by anatomic abnormalities due to previous oral surgery. We performed general anesthesia for a patient who had undergone several operations such as hemisection of the mandible and reconstructive surgery with a deltopectoralis flap, resulting in severe maxillofacial deformation. This made it impossible to ventilate with a face mask and to intubate in the normal way. An attempt at oral awake intubation using fiberoptic bronchoscopy was unsuccessful because of severe anatomical abnormality of the neck. We therefore decided to perform retrograde intubation and selected the cuffed oropharyngeal airway (COPA) for airway management. We inserted the COPA, not through the patient's mouth but through the abnormal oropharyngeal space. Retrograde nasal intubation was accomplished with controlled ventilation through the COPA, which proved to be very useful for this difficult airway management during tracheal intubation even though the method was unusual.

  19. The influence of gellan gum on the transfer of fluorescein dextran across rat nasal epithelium in vivo.

    Jansson, Björn; Hägerström, Helene; Fransén, Nelly; Edsman, Katarina; Björk, Erik


    The nasal uptake of a 3000 Da fluorescein dextran (FD3) was investigated in rats, using fluorescence microscopy. The uptake from a formulation containing deacetylated gellan gum, an in situ gelling agent, was compared to that from a mannitol solution. Additionally, the rheological behavior of the gellan gum in water and saline was studied. It was shown that the gellan gum solution was easily administered owing to its low viscosity, and upon contact with the mucosa, a gel was formed. The epithelial uptake and transfer of FD3 appeared to be increased and prolonged using the gellan gum formulation. This increase was not accompanied by qualitative changes of the epithelial FD3 distribution or any visible harmful effects.

  20. The environmental pollutant hexachlorobenzene causes eosinophilic and granulomatous inflammation and in vitro airways hyperreactivity in the Brown Norway rat

    Michielsen, C.; Zeamari, S.; Vos, J. [Department of Pathology, Faculty of Veterinary Medicine, Utrecht University (Netherlands); Leusink-Muis, A.; Bloksma, N. [Department of Pharmacology and Pathophysiology, Utrecht Institute for Pharmaceutical Sciences and Faculty of Biology, Utrecht University, Utrecht (Netherlands)


    Based on observations that the persistent environmental pollutant hexachlorobenzene (HCB) induces inflammatory skin lesions and eosinophilic and granulomatous lung pathology as well as in vivo airways hyperresponsiveness to methacholine in the BN/SsNOlaHsd rat (Michielsen et al., Toxicol Appl Pharmacol 172:11-20, 2001), which are features of human Churg-Strauss syndrome (CSS), we have investigated whether HCB induced other features of CSS such as asthma and systemic vasculitis involving the heart and kidneys in this strain of rat. To this end, BN/SsNOlaHsd rats received control feed or feed supplemented with 450 mg/kg HCB. On days 6, 14 or 21, tracheas were isolated to assess non-specific in vitro airways hyperresponsiveness (AHR) to cumulative concentrations of arecoline and serotonin. In addition, lungs were lavaged to count and differentiate lavage cells, and skin, lungs, heart, kidneys, and lymph nodes were processed for histopathological investigation. HCB induced eosinophilic and granulomatous lung pathology in the BN/SsNOlaHsd rat, which became more severe with time and was associated with significant in vitro AHR to arecoline. Moreover, as in CSS-patients, systemic effects on spleen and lymph nodes were observed in HCB-fed BN/SsNOlaHsd rats, as well as development of skin lesions with vascular changes and eosinophilic infiltrates. In contrast, cardiac or renal involvement, frequently seen in CSS-patients, was not seen in HCB-fed rats. More importantly, there were no indications of necrotizing vasculitis, a hallmark feature of CSS, in the lungs and skin of BN/SsNOlaHsd rats. Thus, it is concluded that the persistent environmental pollutant HCB possibly induces a mild or early stage of CSS in the BN/SsNOlaHsd rat that may evolve into fully developed CSS after prolonged exposure to HCB. (orig.)

  1. Airway management in trauma

    Rao B


    Full Text Available Airway Management for the victims of major trauma is the first priority in the care of the trauma victim and is a core skill in emergency medicine and critical care. Endotracheal intubation remains the gold standard for trauma airway management. Airway management in trauma patients is not just the capability to insert an oral/nasal airway or endotracheal tube beyond the vocal cords. The five components integral to modern, sophisticated airway management in trauma patients include equipment, pharmacologic adjuncts, manual techniques, physical circumstances, and patient profile. A trauma patient may require airway management in a variety of physical circumstances. Whereas, the commonly used airway management algorithms may not suffice in all these situations, the construction of a truly complete decision tree is also virtually impossible. There is consensus that it is not the intervention per se but rather the conditions, skills, and performance that might be the possible variables that affect outcome. Paramedics have only limited experience and on-the-job skills for invasive airway management. Difficult airway management is best left for the experienced physicians to handle.

  2. Nasal Cancer

    ... the way to your throat as you breathe. Cancer of the nasal cavity and paranasal sinuses is ... be like those of infections. Doctors diagnose nasal cancer with imaging tests, lighted tube-like instruments that ...




    Airway damage resulting in bronchiolitis obliterans occurs frequently in patients after heart-lung and lung transplantation. Generally, chronic rejection is assumed to be the most important cause of bronchiolitis obliterans. However, viral infections might also be potential causes of airway damage a

  4. Efeitos da pressão positiva contínua em vias aéreas sobre os sintomas nasofaríngeos em pacientes com a síndrome da apnéia obstrutiva do sono Effects of continuos positive airway pressure on nasal and pharyngeal symptoms in patients with obstructive sleep apnea

    Adelaide Cristina de Figueiredo


    Full Text Available INTRODUÇÃO: Sintomas nasofaríngeos são comuns em pacientes com a síndrome da apnéia obstrutiva do sono (SAOS em tratamento com pressão positiva contínua em vias aéreas (CPAP. No entanto, sintomas nasofaríngeos são também comuns em pacientes com SAOS antes do início do tratamento. OBJETIVO: Determinar o impacto do tratamento com CPAP nasal sobre os sintomas nasofaríngeos em pacientes com SAOS. MÉTODO: Foram avaliados 35 pacientes (28 homens, com idade de 54 ±10 anos portadores de SAOS moderada a grave diagnosticada através de polissonografia. Os sintomas nasofaríngeos (espirros, coriza, prurido, obstrução, sangramento e ressecamento nasal e de garganta foram quantificados através de questionário aplicado antes e depois de pelo menos 3 meses de tratamento com CPAP nasal. RESULTADOS: O índice de apnéia + hipopnéia foi de 50±25 eventos por hora. Ao menos um sintoma nasofaríngeo estava presente em 26 pacientes (74% antes do tratamento. A obstrução nasal foi o sintoma mais comum, presente em 18 pacientes (51%. Dentre os pacientes inicialmente assintomáticos (n = 9, 78% apresentaram alguma reação nasofaríngea adversa com o tratamento. Em contraste, nos pacientes inicialmente sintomáticos, houve redução significativa da intensidade da obstrução, do ressecamento nasal e de garganta e do sangramento nasal após o tratamento. CONCLUSÃO: Sintomas nasofaríngeos são freqüentes em pacientes com SAOS. O uso de CPAP pode tanto desencadear sintomas nasofaríngeos em pacientes assintomáticos, como reduzir sua intensidade nos pacientes com sintomas prévios.BACKGROUND: Nasal and pharyngeal symptoms are common in patients with obstructive sleep apnoea (OSA treated with nasal continuous positive airway pressure (CPAP. However, these symptoms are common in OSA patients even before the treatment. OBJECTIVE: Determine the impact of nasal CPAP on nasal and pharyngeal symptoms in OSA patients. METHOD: Thirty-five adult patients

  5. Post septorhinoplasty custom-made unilateral nasal stent for nasal cleft deformity

    Manu Rathee


    Full Text Available Context: Nasal cleft deformity is a complicated problem. Utilization of nasal stent in post septorhinoplastyaims at establishing and maintaining airway patency, tissue position, and reduces tissue contracture after surgery. Case Report: A 16-year-old female patient presented with history of surgical reconstruction of congenital cleft lip and cleft palate with secondary septorhinoplasty of nasal cleft deformity. Patient was referred for nasal stent 1 week after septorhinoplasty. This case report provides a novel technique for fabrication of esthetic nasal stent after postseptorhinoplasty for secondary cleft nose deformity correction. Conclusion: This case report presents a simple, convenient technique for nasal stent fabrication for prevention of restenosis for cleft nose deformity post secondary septorhinoplasty. Provision of nasal stent allows breathing, maintains esthetics, comfort, nasal patency, and contour with minimal discomfort.

  6. Nasal PMN response to repeated challenge with endotoxin in healthy volunteers**

    Abstract Rationale: We have employed nasal challenge with Iipopolysaccharid (lPS) followed by nasal lavage (NU to experimentally induce and examine upper airway inflammation in human volunteers.It is unclear however whether adaptation within individuals occurs following repeated ...

  7. Evaluation of short-term use of nocturnal nasal continuous positive airway pressure for a clinical profile and exercise capacity in adult patients with obstructive sleep apnea-hypopnea syndrome

    Amrit K Goel


    Full Text Available Background and Aim: The obstructive sleep apnea-hypopnea syndrome (OSAHS is a common chronic respiratory disease, characterized by repetitive complete or partial collapse of the upper airway during sleep. The clinical spectrum extends between stoppage of breathing, snoring, daytime somnolence, and fatigue, to serious cardiovascular disease, stroke, metabolic syndrome, increased morbidity, and mortality. We aim to evaluate the short-term use of nasal continuous positive airway pressure (nCPAP therapy for the clinical profile and exercise capacity of patients with OSAHS. Patient Selection: Twenty patients diagnosed with moderate-to-severe OSAHS were enrolled in the study (study group - 15; clinically and PSG-matched control group - 5. Materials and Methods: Each patient was clinically evaluated for sleep-related symptoms, and also assessed with spirometry, the six-minute walk test (6MWT, and a symptom-limited incremental cardiopulmonary exercise test (CPET. The study group patients were administered nCPAP therapy for eight hours each night for four weeks, while the control group patients were just observed. They were re-assessed after four weeks and the data were statistically analyzed between the two groups. Results: The study group patients showed a significant (P- < 0.05 improvement in the OSAHS symptoms-the Epworth sleepiness score, six-minute walk distance; duration of exercise, power output, peak oxygen uptake, anaerobic threshold, diastolic blood pressure, dyspnea, and fatigue-in comparison with the control group patients. The improvement in exercise capacity following nCPAP therapy was attributed to the relief of disabling the OSAHS symptoms and improved cardiovascular, ventilator, and musculoskeletal functions. Conclusion: All OSAHS patients must be treated with nCPAP.

  8. Functional evidence of persistent airway obstruction in rats following a two-hour inhalation exposure to methyl isocyanate

    Stevens, M.A.; Fitzgerald, S.; Menache, M.G.; Costa, D.L.; Bucher, J.R.


    Pulmonary function was assessed in male, F344 rats 1,2,4,7 and 13 weeks after a single 2-hr exposure to 0, 3, 10, or 30 ppm methyl isocyanate. No significant changes were observed in the rats exposed to 3 ppm through 13 weeks. Diffusing capacity (DL/sub co/), quasistatic lung compliance, and homogeneity of ventilation, as determined by multibreath nitrogen washout, were depressed in the rats exposed to 10 and 30 ppm by 1 week after exposure. None of the rats exposed to 30 ppm survived beyond 1 week. By 13 weeks, dramatic increases in lung volumes were observed in the rats exposed to 10 ppm, while DL/sub co/ and lung compliance were only mildly affected. However, volume-specific DL/sub co/ and compliance were depressed in the rats exposed to 10 ppm, suggesting that lung hyperinflation or other compensatory means of increasing lung size occurred in response to the methyl isocyanate-induced lung lesion. This group also exhibited increased expiratory times during tidal breathing and severely impaired distribution of ventilated air. Collectively, these results suggest the development and likely progression of a severe, obstructive airway lesion with associated gas trapping, and the existence of a pronounced concentration-response relationship between 3 and 10 ppm methyl isocyanate exposures.

  9. Effects of nasal continuous positive airway pressure treatment on insulin resistance and ghrelin levels in non-diabetic apnoeic patients with coronary heart disease

    YANG Dan; LIU Zhi-hong; ZHAO Qing; LUO Qin


    Background Obesity is a common risk factor for several diseases.Obesity related hormone and increased insulin resistance (IR) may contribute to the effects of obstructive sleep apnoea on cardiovascular consequences.We investigated ghrelin and IR in non-diabetic apnoeic patients with stable coronary heart disease and assessed the effects of continuous positive airway pressure (CPAP).Methods Plasma ghrelin,glucose and insulin were measured in 22 patients with CPAP and 22 matched controls without CPAP at baseline and three months.Indexes including homeostasis model assessment IR (HOMA IR),HOMA S and HOMA β were calculated for the assessment of IR,insulin sensitivity and pancreatic β cell function.Results At three months follow-up,plasma ghrelin levels and HOMA IR in CPAP group were significantly decreased (,P=0.002 and 0.046,respectively) while those in control group increased significantly (P=0.012 and 0.009,respectively).Significant moderate correlations were found between ghrelin vs.HOMA IR and ghrelin vs.HOMA S after CPAP,however,for those without CPAP,no significant associations were observed.Conclusions Short-term effective continuous positive airway pressure had a significant effect on lowering plasma ghrelin levels and IR,but not body fat.Further large scale and longer term studies are warranted to corroborate these findings.

  10. A Review of the Comparative Anatomy, Histology, Physiology and Pathology of the Nasal Cavity of Rats, Mice, Dogs and Non-human Primates. Relevance to Inhalation Toxicology and Human Health Risk Assessment.

    Chamanza, R; Wright, J A


    There are many significant differences in the structural and functional anatomy of the nasal cavity of man and laboratory animals. Some of the differences may be responsible for the species-specific nasal lesions that are often observed in response to inhaled toxicants. This paper reviews the comparative anatomy, physiology and pathology of the nasal cavity of the rat, mouse, dog, monkey and man, highlighting factors that may influence the distribution of nasal lesions. Gross anatomical variations such as turbinate structure, folds or grooves on nasal walls, or presence or absence of accessory structures, may influence nasal airflow and species-specific uptake and deposition of inhaled material. In addition, interspecies variations in the morphological and biochemical composition and distribution of the nasal epithelium may affect the local tissue susceptibility and play a role in the development of species-specific nasal lesions. It is concluded that, while the nasal cavity of the monkey might be more similar to that of man, each laboratory animal species provides a model that responds in a characteristic and species-specific manner. Therefore for human risk assessment, careful consideration must be given to the anatomical differences between a given animal model and man.

  11. Efficiency of different decalcification protocols for nasal osseous structures in a rat experimental model of allergic rhinitis, and their effects on epithelial histology: an attempt at standardization.

    Guibas, George V; Lakis, Sotiris; Gkimpas, Christoforos; Manda, Marianthi; Kapoukranidou, Dorothea; Spandou, Evangelia


    Decalcification of osseous specimens is required for histological analysis; this however may cause tissue damage. In rodent models of allergic rhinitis (AR), epithelial histologic assessment necessitates prior decalcification of the nasal osseous structures. However, respiratory epithelium is highly susceptible to damage, and rat nasal architecture is elaborate and its sectioning is challenging. Nevertheless, decalcification is not standardized in experimental AR. We therefore undertook this task, in order to reduce experimental bias. Six-to-eight week-old Wistar rats underwent an AR protocol. Subsequently, nasal structures were decalcified in the following mediums: (i) formic acid 10% for 5 and 20 days; (ii) formic acid 15% for 5 and 15 days; (iii) Morse Solution for 5 and 20 days and (iv) EDTA for 20 and 40 days. Decalcification efficiency/speed was evaluated via radiographic analysis. Furthermore, specimens were stained with hematoxylin and eosin and assessed for preservation of epithelial features. Specimens were appropriately decalcified in 5 days in the formic acid-based mediums and in 20 days in EDTA with minimal epithelial damage. EDTA for 40 days had no unacceptable adverse effects; conversely, 15 and/or 20 days in acid-based agents provided no extra benefit for decalcification and were detrimental to the epithelium. EDTA treatment for 20 days is appropriate for decalcification of nasal structures in rat models of allergic rhinitis; further incubation preserves epithelial integrity but is not required. When urgency is a factor, formic-acid-based decalcification for 5 days yields acceptable results. Copyright © 2014 Elsevier GmbH. All rights reserved.

  12. Nasal lifting.

    Pontes, Ronaldo; Pontes, Gisela Hobson; Serpa, Narayana Pauline; Lopez, Carlos


    Patients with gland hyperplasia as well as thickening and redundancy of nasal skin who receive treatment that addresses only the support structures generally suffer from lack of definition of the nasal tip. We report on a case in which this problem was treated by redefinition of the nasal dorsum and tip through resection of the redundant skin. The surgical approach involved open rhinoplasty with a columella-alar incision, wide dissection of the dorsum filling, caudal traction, and resection of excess tissue. This method enabled reshaping of the nasal dorsum and tip by readjustment of the cutaneous covering of the osteocartilaginous structures.

  13. Expression of taste receptors in Solitary Chemosensory Cells of rodent airways

    Sbarbati Andrea


    Full Text Available Abstract Background Chemical irritation of airway mucosa elicits a variety of reflex responses such as coughing, apnea, and laryngeal closure. Inhaled irritants can activate either chemosensitive free nerve endings, laryngeal taste buds or solitary chemosensory cells (SCCs. The SCC population lies in the nasal respiratory epithelium, vomeronasal organ, and larynx, as well as deeper in the airway. The objective of this study is to map the distribution of SCCs within the airways and to determine the elements of the chemosensory transduction cascade expressed in these SCCs. Methods We utilized a combination of immunohistochemistry and molecular techniques (rtPCR and in situ hybridization on rats and transgenic mice where the Tas1R3 or TRPM5 promoter drives expression of green fluorescent protein (GFP. Results Epithelial SCCs specialized for chemoreception are distributed throughout much of the respiratory tree of rodents. These cells express elements of the taste transduction cascade, including Tas1R and Tas2R receptor molecules, α-gustducin, PLCβ2 and TrpM5. The Tas2R bitter taste receptors are present throughout the entire respiratory tract. In contrast, the Tas1R sweet/umami taste receptors are expressed by numerous SCCs in the nasal cavity, but decrease in prevalence in the trachea, and are absent in the lower airways. Conclusions Elements of the taste transduction cascade including taste receptors are expressed by SCCs distributed throughout the airways. In the nasal cavity, SCCs, expressing Tas1R and Tas2R taste receptors, mediate detection of irritants and foreign substances which trigger trigeminally-mediated protective airway reflexes. Lower in the respiratory tract, similar chemosensory cells are not related to the trigeminal nerve but may still trigger local epithelial responses to irritants. In total, SCCs should be considered chemoreceptor cells that help in preventing damage to the respiratory tract caused by inhaled irritants and

  14. Inhibitory effects of a standardized extract of Justicia pectoralis in an experimental rat model of airway hyper-responsiveness.

    Moura, Carlos T M; Batista-Lima, Francisco J; Brito, Teresinha S; Silva, Alfredo A V; Ferreira, Luan C; Roque, Cássia R; Aragão, Karoline S; Havt, Alexandre; Fonseca, Francisco N; Leal, Luzia K A M; Magalhães, Pedro J C


    Justicia pectoralis is a plant useful for the treatment of respiratory diseases. Here, we studied the antiasthmatic properties of a standardized extract of J. pectoralis (Jp). Ovalbumin (OVA)-sensitized rats were actively challenged with saline or OVA to study airway hyper-responsiveness after oral treatment with saline or Jp. The ability of Jp to inhibit hyper-reactivity was evaluated in isolated trachea mounted in isolated organ bath chamber. Using KCl or carbachol as contractile agents, tracheal rings of OVA-challenged rats contracted with higher magnitude than trachea of rats challenged with saline. Such hyper-responsive phenotype of OVA-challenged tissues decreased with Jp administration. In Ca(+) -free medium, Jp or its major constituent coumarin inhibited preferentially the contractions induced by Ca(2+) addition in tissues of OVA-challenged rats stimulated with KCl or acetylcholine. In tissues depleted of their internal Ca(+) stores in the presence of thapsigargin, Jp inhibited the contraction induced by capacitative Ca(2+) entry. By gavage, Jp abolished the increase caused by challenge with OVA on the levels of IL-1β and TNF-α in the bronchoalveolar fluid and also impaired the changes in gene expression of canonical transient receptor proteins. Jp has antiasthmatic properties in an experimental model that reproduces tracheal hyper-reactivity. © 2017 Royal Pharmaceutical Society.



  16. Apical Localization of Zinc Transporter ZnT4 in Human Airway Epithelial Cells and Its Loss in a Murine Model of Allergic Airway Inflammation

    Chiara Murgia


    Full Text Available The apical cytoplasm of airway epithelium (AE contains abundant labile zinc (Zn ions that are involved in the protection of AE from oxidants and inhaled noxious substances. A major question is how dietary Zn traffics to this compartment. In rat airways, in vivo selenite autometallographic (Se-AMG-electron microscopy revealed labile Zn-selenium nanocrystals in structures resembling secretory vesicles in the apical cytoplasm. This observation was consistent with the starry-sky Zinquin fluorescence staining of labile Zn ions confined to the same region. The vesicular Zn transporter ZnT4 was likewise prominent in both the apical and basal parts of the epithelium both in rodent and human AE, although the apical pools were more obvious. Expression of ZnT4 mRNA was unaffected by changes in the extracellular Zn concentration. However, levels increased 3-fold during growth of cells in air liquid interface cultures and decreased sharply in the presence of retinoic acid. When comparing nasal versus bronchial human AE cells, there were significant positive correlations between levels of ZnT4 from the same subject, suggesting that nasal brushings may allow monitoring of airway Zn transporter expression. Finally, there were marked losses of both basally-located ZnT4 protein and labile Zn in the bronchial epithelium of mice with allergic airway inflammation. This study is the first to describe co-localization of zinc vesicles with the specific zinc transporter ZnT4 in airway epithelium and loss of ZnT4 protein in inflamed airways. Direct evidence that ZnT4 regulates Zn levels in the epithelium still needs to be provided. We speculate that ZnT4 is an important regulator of zinc ion accumulation in secretory apical vesicles and that the loss of labile Zn and ZnT4 in airway inflammation contributes to AE vulnerability in diseases such as asthma.

  17. Perception of Better Nasal Patency Correlates with Increased Mucosal Cooling after Surgery for Nasal Obstruction

    Garcia, Guilherme; Sullivan, Corbin; Frank-Ito, Dennis; Kimbell, Julia; Rhee, John


    Nasal airway obstruction (NAO) is a common health problem with 340,000 patients undergoing surgery annually in the United States. Traditionally, otolaryngologists have focused on airspace cross-sectional areas and nasal resistance to airflow as objective measures of nasal patency, but neither of these variables correlated consistently with patients' symptoms. Given that the sensation of nasal airflow is also associated with mucosal cooling (i.e., heat loss) during inspiration, we investigated the correlation between the sensation of nasal obstruction and mucosal cooling in 10 patients before and after NAO surgery. Three-dimensional models of the nasal anatomy were created based on pre- and post-surgery computed tomography scans. Computational fluid dynamics (CFD) simulations were conducted to quantify nasal resistance and mucosal cooling. Patient-reported symptoms were measured by a visual analog scale and the Nasal Obstruction Symptom Evaluation (NOSE), a disease-specific quality of life questionnaire. Our results revealed that the subjective sensation of nasal obstruction correlated with both nasal resistance and heat loss, but the strongest correlation was between the NOSE score and the nasal surface area where heat flux exceeds 50 W /m2 . In conclusion, a significant post-operative increase in mucosal cooling correlates well with patients' perception of better nasal patency after NAO surgery.

  18. Sodium cromoglycate on plasma protein exudation to topically-applied substance P in the tracheal airways of rats or guinea-pigs in vivo.

    O'Donnell, S R; Coulson, F R; Bigg, C S


    Sodium cromoglycate (SCG) was examined against substance P(SP)-induced plasma protein exudation in the trachea of anaesthetized rats and guinea-pigs in vivo to determine whether SCG is a tachykinin receptor antagonist in the airways. A segment of trachea was prepared in situ for continuous perfusion with normal saline. Plasma-derived protein in the perfusion fluid (airway lumen) was increased after topical application of SP (1 microM, 5 min contact). In rats, the SP response was not attenuated by iv SCG but was inhibited (29%) by topical SCG under certain experimental conditions and using a high concentration of SCG (500 microM, 5 min contact, 30 min before SP and with SP). The NK(1)receptor antagonist, RP 67 580 (67 microM) abolished the SP response in rats. Sodium cromoglycate did not inhibit the SP response in guinea-pigs (same protocol as in rats). Thus, SCG attenuates plasma protein exudation (and presumably microvascular leak) induced by SP in rat tracheal airways but, if SCG is a tachykinin receptor (NK(1)) antagonist, it not only lacks potency but is species-selective, i.e. more effective in rats than in guinea-pigs.

  19. Picornavirus-Induced Airway Mucosa Immune Profile in Asymptomatic Neonates

    Wolsk, Helene M.; Følsgaard, Nilofar V.; Birch, Sune;


    Bacterial airway colonization is known to alter the airway mucosa immune response in neonates whereas the impact of viruses is unknown. The objective was therefore to examine the effect of respiratory viruses on the immune signature in the airways of asymptomatic neonates. Nasal aspirates from 571...

  20. RPR 106541, a novel, airways-selective glucocorticoid: effects against antigen-induced CD4+ T lymphocyte accumulation and cytokine gene expression in the Brown Norway rat lung.

    Underwood, S L; Raeburn, D; Lawrence, C; Foster, M; Webber, S; Karlsson, J A


    1. The effects of a novel 17-thiosteroid, RPR 106541, were investigated in a rat model of allergic airway inflammation. 2. In sensitized Brown Norway rats, challenge with inhaled antigen (ovalbumin) caused an influx of eosinophils and neutrophils into the lung tissue and airway lumen. In the lung tissue there was also an accumulation of CD4+ T lymphocytes and increased expression of mRNA for interleukin-4 (IL-4) and IL-5, but not interferon-gamma (IFN-gamma). These findings are consistent with an eosinophilia orchestrated by activated Th2-type cells. 3. RPR 106541 (10-300 microg kg[-1]), administered by intratracheal instillation into the airways 24 h and 1 h before antigen challenge, dose-dependently inhibited cell influx into the airway lumen. RPR 106541 (100 microg kg[-1]) caused a significant (PRPR 106541 was approximately 7 times and 4 times more potent than budesonide and fluticasone propionate, respectively. 4. When tested at a single dose (300 microg kg[-1]), RPR 106541 and fluticasone each caused a significant (PRPR 106541 and fluticasone (300 microg kg[-1]), but not budesonide (300 microg kg[-1]), significantly (PRPR 106541 (300 microg kg[-1]) also significantly (PRPR 106541 in this model, which mimics important aspects of airway inflammation in human allergic asthmatics, suggests that this glucocorticoid may be useful in the treatment of bronchial asthma.

  1. Oral appliance therapy versus nasal continuous positive airway pressure in obstructive sleep apnea syndrome: a randomized, placebo-controlled trial on self-reported symptoms of common sleep disorders and sleep-related problems.

    Nikolopoulou, Maria; Byraki, Anna; Ahlberg, Jari; Heymans, Martijn W; Hamburger, H L; De Lange, Jan; Lobbezoo, Frank; Aarab, Ghizlane


    Obstructive sleep apnea syndrome (OSAS) is associated with several sleep disorders and sleep-related problems. Therefore, the aim of this study was to compare the effects of a mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. In this randomized placebo-controlled trial sixty-four OSAS patients (52.0± 9.6 years) were randomly assigned to an MAD, nCPAP or an intra-oral placebo appliance in a parallel design. All participants filled out the validated Dutch Sleep Disorders Questionnaire (SDQ) twice: one before treatment and one after six months of treatment. With 88 questions, thirteen scales were constructed, representing common sleep disorders and sleep-related problems. Linear mixed model analyses were performed to study differences between the groups for the different SDQ scales over time. The MAD group showed significant improvements over time in symptoms corresponding with "insomnia", "excessive daytime sleepiness", "psychiatric sleep disorder", "periodic limb movements", "sleep apnea", "sleep paralysis", "daytime dysfunction", "hypnagogic hallucinations/dreaming", "restless sleep", "negative conditioning", and "automatic behaviour" (range of P values: 0.000-0.014). These improvements in symptoms were, however, not significantly different from the improvements in symptoms observed in the nCPAP and placebo groups (range of P values: 0.090-0.897). It can be concluded that there is no significant difference between MAD and nCPAP in their positive effects on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. These beneficial effects may be a result of placebo effects. This article is protected by copyright. All rights reserved.


    Corley, Richard A.; Kabilan, Senthil; Kuprat, Andrew P.; Carson, James P.; Minard, Kevin R.; Jacob, Rick E.; Timchalk, Charles; Glenny, Robb W.; Pipavath, Sudhaker; Cox, Timothy C.; Wallis, Chris; Larson, Richard; Fanucchi, M.; Postlewait, Ed; Einstein, Daniel R.


    Coupling computational fluid dynamics (CFD) with physiologically based pharmacokinetic (PBPK) models is useful for predicting site-specific dosimetry of airborne materials in the respiratory tract and elucidating the importance of species differences in anatomy, physiology, and breathing patterns. Historically, these models were limited to discrete regions of the respiratory system. CFD/PBPK models have now been developed for the rat, monkey, and human that encompass airways from the nose or mouth to the lung. A PBPK model previously developed to describe acrolein uptake in nasal tissues was adapted to the extended airway models as an example application. Model parameters for each anatomic region were obtained from the literature, measured directly, or estimated from published data. Airflow and site-specific acrolein uptake patterns were determined under steadystate inhalation conditions to provide direct comparisons with prior data and nasalonly simulations. Results confirmed that regional uptake was dependent upon airflow rates and acrolein concentrations with nasal extraction efficiencies predicted to be greatest in the rat, followed by the monkey, then the human. For human oral-breathing simulations, acrolein uptake rates in oropharyngeal and laryngeal tissues were comparable to nasal tissues following nasal breathing under the same exposure conditions. For both breathing modes, higher uptake rates were predicted for lower tracheo-bronchial tissues of humans than either the rat or monkey. These extended airway models provide a unique foundation for comparing dosimetry across a significantly more extensive range of conducting airways in the rat, monkey, and human than prior CFD models.

  3. Phase-contrast MRI and CFD modeling of apparent 3He gas flow in rat pulmonary airways

    Minard, Kevin R.; Kuprat, Andrew P.; Kabilan, Senthil; Jacob, Richard E.; Einstein, Daniel R.; Carson, James P.; Corley, Richard A.


    Phase-contrast (PC) magnetic resonance imaging (MRI) with hyperpolarized 3He is potentially useful for developing and testing patient-specific models of pulmonary airflow. One challenge, however, is that PC-MRI provides apparent values of local 3He velocity that not only depend on actual airflow but also on gas diffusion. This not only blurs laminar flow patterns in narrow airways but also introduces anomalous airflow structure that reflects gas-wall interactions. Here, both effects are predicted in a live rat using computational fluid dynamics (CFD), and for the first time, simulated patterns of apparent 3He gas velocity are compared with in vivo PC-MRI. Results show (1) that correlations (R2) between measured and simulated airflow patterns increase from 0.23 to 0.79 simply by accounting for apparent 3He transport, and (2) that remaining differences are mainly due to uncertain airway segmentation and partial volume effects stemming from relatively coarse MRI resolution. Higher-fidelity testing of pulmonary airflow predictions should therefore be possible with future imaging improvements.

  4. Airways Hyperresponsiveness Following a Single Inhalation Exposure to Doxorubicin-Induced Heart Failure Prevents Airways Transition Metal-Rich Particulate Matter in Hypertensive Rats

    Exposure to particulate matter (PM) air pollution results in airways hyperresponsiveness (AHR), however it also results in adverse cardiovascular effects, particularly in individuals with underlying cardiovascular disease. The impact of pre-existing cardiac deficit on PM-induced ...

  5. Evaluation of layers of the rat airway epithelial cell line RL-65 for permeability screening of inhaled drug candidates.

    Hutter, V; Hilgendorf, C; Cooper, A; Zann, V; Pritchard, D I; Bosquillon, C


    A rat respiratory epithelial cell culture system for in vitro prediction of drug pulmonary absorption is currently lacking. Such a model may however enhance the understanding of interspecies differences in inhaled drug pharmacokinetics by filling the gap between human in vitro and rat in/ex vivo drug permeability screens. The rat airway epithelial cell line RL-65 was cultured on Transwell inserts for up to 21 days at an air-liquid (AL) interface and cell layers were evaluated for their suitability as a drug permeability measurement tool. These layers were found to be morphologically representative of the bronchial/bronchiolar epithelium when cultured for 8 days in a defined serum-free medium. In addition, RL-65 layers developed epithelial barrier properties with a transepithelial electrical resistance (TEER) >300 Ω cm(2) and apparent (14)C-mannitol permeability (P(app)) values between 0.5-3.0 × 10(-6)cm/s; i.e., in the same range as established in vitro human bronchial epithelial absorption models. Expression of P-glycoprotein was confirmed by gene analysis and immunohistochemistry. Nevertheless, no vectorial transport of the established substrates (3)H-digoxin and Rhodamine123 was observed across the layers. Although preliminary, this study shows RL-65 cell layers have the potential to become a useful in vitro screening tool in the pre-clinical development of inhaled drug candidates.

  6. Balloon dilatation for congenital nasal piriform aperture stenosis (CNPAS): a novel conservative technique.

    Gungor, Anil A; Reiersen, David A


    Congenital nasal piriform aperture stenosis (CNPAS) is an uncommon but important cause of nasal obstruction in infants. When it is severe, nasal decongestants or temporary nasal airway devices cannot address the problem adequately. The most common surgical technique used to treat the bony piriform aperture stenosis is the sublabial approach and drill-out of the nasal aperture followed by nasal stenting. This paper describes an infant with bilateral CNPAS who underwent a single successful balloon dilatation and short-term stenting of the nasal piriform apertures without the need for additional procedures.

  7. Anti-angiogenic Nanotherapy Inhibits Airway Remodeling and Hyper-responsiveness of Dust Mite Triggered Asthma in the Brown Norway Rat

    Lanza, Gregory M.; Jenkins, John; Schmieder, Anne H.; Moldobaeva, Aigul; Cui, Grace; Zhang, Huiying; Yang, Xiaoxia; Zhong, Qiong; Keupp, Jochen; Sergin, Ismail; Paranandi, Krishna S.; Eldridge, Lindsey; Allen, John S.; Williams, Todd; Scott, Michael J.; Razani, Babak; Wagner, Elizabeth M.


    Although angiogenesis is a hallmark feature of asthmatic inflammatory responses, therapeutic anti-angiogenesis interventions have received little attention. Objective: Assess the effectiveness of anti-angiogenic Sn2 lipase-labile prodrugs delivered via αvβ3-micellar nanotherapy to suppress microvascular expansion, bronchial remodeling, and airway hyper-responsiveness in Brown Norway rats exposed to serial house dust mite (HDM) inhalation challenges. Results: Anti-neovascular effectiveness of αvβ3-mixed micelles incorporating docetaxel-prodrug (Dxtl-PD) or fumagillin-prodrug (Fum-PD) were shown to robustly suppress neovascular expansion (p<0.01) in the upper airways/bronchi of HDM rats using simultaneous 19F/1H MR neovascular imaging, which was corroborated by adjunctive fluorescent microscopy. Micelles without a drug payload (αvβ3-No-Drug) served as a carrier-only control. Morphometric measurements of HDM rat airway size (perimeter) and vessel number at 21d revealed classic vascular expansion in control rats but less vascularity (p<0.001) after the anti-angiogenic nanotherapies. CD31 RNA expression independently corroborated the decrease in airway microvasculature. Methacholine (MCh) induced respiratory system resistance (Rrs) was high in the HDM rats receiving αvβ3-No-Drug micelles while αvβ3-Dxtl-PD or αvβ3-Fum-PD micelles markedly and equivalently attenuated airway hyper-responsiveness and improved airway compliance. Total inflammatory BAL cells among HDM challenged rats did not differ with treatment, but αvβ3+ macrophages/monocytes were significantly reduced by both nanotherapies (p<0.001), most notably by the αvβ3-Dxtl-PD micelles. Additionally, αvβ3-Dxtl-PD decreased BAL eosinophil and αvβ3+ CD45+ leukocytes relative to αvβ3-No-Drug micelles, whereas αvβ3-Fum-PD micelles did not. Conclusion: These results demonstrate the potential of targeted anti-angiogenesis nanotherapy to ameliorate the inflammatory hallmarks of asthma in a

  8. Nasal flaring

    ... be caused by any of the following: Asthma flare-up Blocked airway (any cause) Swelling and mucus ... Tests that may be done include: Arterial blood gas analysis Complete blood count (CBC) ECG to check ...

  9. Objective measurements differ for perception of left and right nasal obstruction.

    Ng, Teik-Ying; Chen, Yung-Fu; Tsai, Ming-Hsui; Huang, Kuang-Hua; Tai, Chih-Jaan


    Nasal obstruction is one of the most common sensation complaints of nasal disease in clinical practice. It is a subjective sensation of nasal airflow. Objective assessment of nasal patency and nasal physiology includes the use of rhinomanometry and acoustic rhinometry. The perception of nasal obstruction changes as the alternating of nasal airway resistance and nasal airflow. However, there were limited studies reported whether the perceptions of the left and right nostrils are similar. We examined the relationship between subjective and objective parameters of the nasal airway in the left and right nostrils. A prospective study of 101 patients with a deviated nasal septum and chronic hypertrophic rhinitis was conducted for subjective and objective nasal airway evaluation. Patients were then divided into three groups based on the visual analog scale. Associations between measures were evaluated with analysis of variance, f tests and simple regression. Among three patient groups with different subjective sensations of nasal obstruction, there were significant differences among three patient groups according to the objective measurements of airflow resistance on the right side (p=0.0002 for inspiration right mean resistance; p=0.0049 for expiration right mean resistance), and for the minimal cross-sectional area (p=0.030) and nasal cavity volume (p=0.028 for 0-3.3cm left nostril; p=0.047 for 2-4cm left nostril) on the left side. This indicates that nasal flow resistance is an important determinant for right side nasal obstruction. Nasal minimal cross-sectional area and nasal cavity volume are an important determinant for left side nasal obstruction. Our study indicates the important role of rhinomanometry in objective measurement of right side nasal obstruction and acoustic rhinometry in objective measurement of left side nasal obstruction. Thus, human perception of right and left nostrils may be different and requires further study. Copyright © 2012 Elsevier

  10. Role of growth hormone-releasing hormone in sleep and growth impairments induced by upper airway obstruction in rats.

    Tarasiuk, A; Berdugo-Boura, N; Troib, A; Segev, Y


    Upper airway obstruction (UAO) can lead to abnormal growth hormone (GH) homeostasis and growth retardation but the mechanisms are unclear. We explored the effect of UAO on hypothalamic GH-releasing hormone (GHRH), which has a role in both sleep and GH regulation. The tracheae of 22-day-old rats were narrowed; UAO and sham-operated animals were sacrificed 16 days post-surgery. To stimulate slow-wave sleep (SWS) and GH secretion, rats were treated with ritanserin (5-HT(2) receptor antagonist). Sleep was measured with a telemetric system. Hypothalamic GHRH, hypothalamic GHRH receptor (GHRHR) and GH receptor, and orexin were analysed using ELISA, real-time PCR and Western blot. UAO decreased hypothalamic GHRH, GHRHR and GH receptor levels, while orexin mRNA increased (psleep and slow-wave activity was reduced (pgrowth impairment (pgrowth retardation in UAO is associated with a reduction in hypothalamic GHRH content. Our findings show that abnormalities in the GHRH/GH axis underlie both growth retardation and SWS-disorder UAO.

  11. Study of the variability in upper and lower airway morphology in Sprague-Dawley rats using modern micro-CT scan-based segmentation techniques.

    De Backer, Jan W; Vos, Wim G; Burnell, Patricia; Verhulst, Stijn L; Salmon, Phil; De Clerck, Nora; De Backer, Wilfried


    Animal models are being used extensively in pre-clinical and safety assessment studies to assess the effectiveness and safety of new chemical entities and delivery systems. Although never entirely replacing the need for animal testing, the use of computer simulations could eventually reduce the amount of animals needed for research purposes and refine the data acquired from the animal studies. Computational fluid dynamics is a powerful tool that makes it possible to simulate flow and particle behavior in animal or patient-specific respiratory models, for purposes of inhaled delivery. This tool requires an accurate representation of the respiratory system, respiration and dose delivery attributes. The aim of this study is to develop a representative airway model of the Sprague-Dawley rat using static and dynamic micro-CT scans. The entire respiratory tract was modeled, from the snout and nares down to the central airways at the point where no distinction could be made between intraluminal air and the surrounding tissue. For the selection of the representative model, variables such as upper airway movement, segmentation length, airway volume and size are taken into account. Dynamic scans of the nostril region were used to illustrate the characteristic morphology of this region in anaesthetized animals. It could be concluded from this study that it was possible to construct a highly detailed representative model of a Sprague-Dawley rat based on imaging modalities such as micro-CT scans.

  12. 经鼻持续气道正压给氧多中心临床试验研究%A multi-center clinical trial of oxygen administration with nasal continuous positive airway pressure



    目的 评价经鼻持续气道正压(CPAP)给氧的效果.方法 2003年1月至2007年12月首都儿科研究所(牵头)和北京市9家郊区县医院对107例因肺部疾患导致低氧血症新生儿和婴幼儿进行多中心临床试验,通过脉搏血氧仪并结合临床观察对国产的CPAP氧疗仪和普通给氧方法 (面罩、头罩)在改善血氧饱和度的效果方面进行评价.结果 CPAP治疗组46例,普通给氧组61例.应用CPAP后新生儿组在给氧后0.5 h及2 h血氧饱和度为(88.6±7.9)%及(94.4±5.0)%,普通给氧组为(82.4±5.7)%及(90.3±4.5)%,两组间差异有显著性(P<0.05).婴幼儿组在CPAP给氧后1 h血氧饱和度为(95.7±2.6)%,普通给氧组为(87.3±15.8)%,两组间差异有显著性(P<0.05).给氧后紫绀和呼吸困难程度的改善,CPAP组优于普通给氧组.结论 经鼻CPAP氧疗仪是适用于基层、安全、有效、效果优于普通给氧方法 的给氧工具.%Objective To evaluate the effect of nasal continuous positive airway pressure (CPAP).Methods A randomized controlled multi-center clinical trial was conducted during January 2003 to December 2007 in 107 newborns and infants with hypoxemia due to pulmonary diseases.These patients were hospitalized in Capital Institute of Pediatrics and 9 local hospitals.The changes of arterial oxygen saturation and clinical signs were studied after CPAP treatment and conventional oxygen therapy.Results CPAP group recruited 46 cases,conventional oxygen therapy group included 61 cases.After CPAP treatment,oxygen saturation values in newborns at 0.5 and 2 hour were (88.6±7.9)% and (94.4±5.0)%,and there was significant difference as compared with those in conventional oxygen therapy group [(82.4±5.7)% and (90.3±4.5)%].Oxygen saturation value of infants with CPAP at 1 hour was (95.7±2.6)%,and there was significant difference as compared with that in conventional oxygen therapy group[(87.3±15.8)%].Oxygen therapy alleviated the severity of cyanosis and dyspnea

  13. Numerical simulation and nasal air-conditioning

    Keck, Tilman


    Full Text Available Heating and humidification of the respiratory air are the main functions of the nasal airways in addition to cleansing and olfaction. Optimal nasal air conditioning is mandatory for an ideal pulmonary gas exchange in order to avoid desiccation and adhesion of the alveolar capillary bed. The complex three-dimensional anatomical structure of the nose makes it impossible to perform detailed in vivo studies on intranasal heating and humidification within the entire nasal airways applying various technical set-ups. The main problem of in vivo temperature and humidity measurements is a poor spatial and time resolution. Therefore, in vivo measurements are feasible only to a restricted extent, solely providing single temperature values as the complete nose is not entirely accessible. Therefore, data on the overall performance of the nose are only based on one single measurement within each nasal segment. In vivo measurements within the entire nose are not feasible. These serious technical issues concerning in vivo measurements led to a large number of numerical simulation projects in the last few years providing novel information about the complex functions of the nasal airways. In general, numerical simulations merely calculate predictions in a computational model, e.g. a realistic nose model, depending on the setting of the boundary conditions. Therefore, numerical simulations achieve only approximations of a possible real situation. The aim of this review is the synopsis of the technical expertise on the field of in vivo nasal air conditioning, the novel information of numerical simulations and the current state of knowledge on the influence of nasal and sinus surgery on nasal air conditioning.

  14. 早期联合应用NCPAP和PS治疗新生儿呼吸窘迫综合征%Early Nasal Continuous Positive Airway Pressure And Pulmonary Surfactant Therapy For Neonatal Respiratory Distress Syndrome

    周媛; 杨静; 王岩岩; 王李敏


    目的 讨论经鼻持续气道正压通气(NCPAP)联合肺表面活性物质(PS)治疗新生儿呼吸窘迫综合征(NRDS)的治疗效果.方法 应用NCPAP联合PS治疗25例呼吸窘迫综合征的新生儿,并对其临床特点、动脉血气分析进行分析.结果 23例发绀和呼吸困难症状均有所减轻或消失.X线表现肺透亮度明显改善,或病变未进展,血气分析参数明显改善.2例因病情加重放弃治疗.结论 NCPAP联合PS能迅速有效地治疗新生儿呼吸窘迫综合征.用这种方法通过阻止呼吸窘迫综合征的进展,降低了以后应用呼吸机的需要.细致观察和正确的护理也是治疗成功的关键.%Objective To investigate the effects of nasal continuous positive airway pressure ( NCPAP ) early combined with pul-monary surfactant ( PS ) on newborn with respiratory distress syndrome ( RDS ). Methods 25 cases of newborn with respiratory distress syndrome were treated by Curosurf ( 100 ~ 200 mg/kg, every times ) and then they were given breath support by NCPAP. The clinical characteristics and results of blood gas analysis were evaluated. Results The symptoms of cyanosis and breathing difficulties disappeared or were reduced in 23 cases. The lung permeability showed by X-ray was obviously improved. Because the condition became more serious, two cases gave up. Conclusions Early NCPAP combined with PS have a good effect for newborn with respiratory distress syndrome, and improving the survival rate. It can decrease the requirement for respiratory machine by preventing respiratory distress syndrome. The cor-rect nursing is the key of successful treatment.

  15. Infant flow biphasic nasal continuous positive airway pressure (BP- NCPAP vs. infant flow NCPAP for the facilitation of extubation in infants' ≤ 1,250 grams: a randomized controlled trial

    O'Brien Karel


    Full Text Available Abstract Background The use of mechanical ventilation is associated with lung injury in preterm infants and therefore the goal is to avoid or minimize its use. To date there is very little consensus on what is considered the "best non-invasive ventilation mode" to be used post-extubation. The objective of this study was to compare the effectiveness of biphasic nasal continuous positive airway pressure (BP-NCPAP vs. NCPAP in facilitating sustained extubation in infants ≤ 1,250 grams. Methods We performed a randomized controlled trial of BP-NCPAP vs. NCPAP in infants ≤ 1,250 grams extubated for the first time following mechanical ventilation since birth. Infants were extubated using preset criteria or at the discretion of the attending neonatologist. The primary outcome was the incidence of sustained extubation for 7 days. Secondary outcomes included incidence of adverse events and short-term neonatal outcomes. Results Sixty-seven infants received BP-NCPAP and 69 NCPAP. Baseline characteristics were similar between groups. The trial was stopped early due to increased use of non-invasive ventilation from birth, falling short of our calculated sample size of 141 infants per group. The incidence of sustained extubation was not statistically different between the BP-NCPAP vs. NCPAP group (67% vs. 58%, P = 0.27. The incidence of adverse events and short-term neonatal outcomes were similar between the two groups (P > 0.05 except for retinopathy of prematurity which was noted to be higher (P = 0.02 in the BP-NCPAP group. Conclusions Biphasic NCPAP may be used to assist in weaning from mechanical ventilation. The effectiveness and safety of BP-NCPAP compared to NCPAP needs to be confirmed in a large multi-center trial as our study conclusions are limited by inadequate sample size. Clinical Trials Registration # NCT00308789 Source of support Grant # 06-06, Physicians Services Incorporated Foundation, Toronto, Canada. Summit technologies Inc. provided

  16. Sarcoidosis of the upper and lower airways.

    Morgenthau, Adam S; Teirstein, Alvin S


    Sarcoidosis is a systemic granulomatous disease of undetermined etiology characterized by a variable clinical presentation and disease course. Although clinical granulomatous inflammation may occur within any organ system, more than 90% of sarcoidosis patients have lung disease. Sarcoidosis is considered an interstitial lung disease that is frequently characterized by restrictive physiologic dysfunction on pulmonary function tests. However, sarcoidosis also involves the airways (large and small), causing obstructive airways disease. It is one of a few interstitial lung diseases that affects the entire length of the respiratory tract - from the nose to the terminal bronchioles - and causes a broad spectrum of airways dysfunction. This article examines airway dysfunction in sarcoidosis. The anatomical structure of the airways is the organizational framework for our discussion. We discuss sarcoidosis involving the nose, sinuses, nasal passages, larynx, trachea, bronchi and small airways. Common complications of airways disease, such as, atelectasis, fibrosis, bullous leions, bronchiectasis, cavitary lesions and mycetomas, are also reviewed.

  17. Azithromycin Inhibits Mucus Hypersecretion from Airway Epithelial Cells

    Takeshi Shimizu


    Full Text Available To examine the in vivo effects of the 15-member macrolide, azithromycin (AZM, on mucus hypersecretion, we induced hypertrophic and metaplastic changes of goblet cells in rat nasal epithelium by intranasal instillation of ovalbumin (OVA in OVA-sensitized rats, or by intranasal lipopolysaccharides (LPS instillation. Oral administration of AZM (5–10 mg/kg or clarithromycin (CAM, 5–10 mg/kg significantly inhibited OVA- and LPS-induced mucus production, whereas josamycin (JM or ampicillin (ABPC showed no effect. In vitro effects of AZM on airway epithelial cells were examined using NCI-H292 cells and human nasal epithelial cells cultured in air-liquid interface. Mucus secretion was evaluated by enzyme-linked immunosorbent assay using an anti-MUC5AC monoclonal antibody. AZM or CAM significantly inhibited tumor necrosis factor-α (TNF-α (20 ng/mL-induced MUC5AC secretion from NCI-H292 cells at 10−6–10−7 M, whereas JM or ABPC showed no effect. AZM significantly inhibited TNF- (20 ng/mL-induced MUC5AC secretion from human nasal epithelial cells at 10−4 M. MUC5AC mRNA expression was also significantly inhibited. These results indicate that the 15-member macrolide, AZM, exerts direct inhibitory effects on mucus secretion from airway epithelial cells and that it may be useful for the treatment of mucus hypersecretion caused by allergic inflammation and LPS stimulation.

  18. Effects of angiotensin Ⅱ receptor antagonist on expression of collagen Ⅲ, collagen Ⅴ, and transforming growth factor β1 in the airway walls of sensitized rats

    杜永成; 许建英; 张韶君


    Background Repeated attacks of bronchial asthma lead to different degrees of airway remodeling, the mechanism of which is not yet clear. Some evidences indicate that it is related to the excessive expression of some growth promotion factors. Angiotensin Ⅱ is a polypeptide that may be involved in airway remodeling. To evaluate its role in airway remodeling in asthma, we observed the effects of an angiotensin Ⅱ type 1 receptor antagonist (valsartan) on the expression of collagen Ⅲ, collagen Ⅴ, and transforming growth factor β1 (TGF-β1) mRNA and protein in the airway walls of sensitized rats.Methods Forty Wistar rats were randomly divided into 5 groups: control group, sensitized group, and valsartan groups 1, 2, and 3. The rats in the sensitized group and in valsartan groups 1, 2, and 3 were sensitized and challenged with ovalbumin. Rats in control group were sensitized and challenged with 0.9% NaCl. Rats from valsartan groups 1, 2, and 3 were drenched with valsartan (10 μg, 20 μg, or 30 μg, respectively) at the time of the ovalbumin challenges. The expression of collagen Ⅲ, collagen Ⅴ, and TGF-β1 protein were detected using immunohistochemical method in combination with image analysis methods. The expression of TGF-β1 mRNA was detected by in situ hybridization. Results The expression in the airways of collagen Ⅲ and collagen Ⅴ was significantly higher in rats from the sensitized group (7.73±0.81, 1.34±0.28) and from valsartan groups 1, 2, and 3 (5.73±0.64, 1.13±0.15; 4.96±0.51, 0.98±0.08; 4.43±0.35, 0.93±0.06, respectively) than those in the control group (2.65±0.38, 0.67±0.08, P<0.05). In addition, collagen levels were significantly lower in valsartan groups 1, 2, and 3 than those from the sensitized group (P<0.05). The expression of TGF-β1 mRNA and protein in the airways was significantly higher in rats from the sensitized group (20.49%±3.46%, 29.73%±3.25%) and from valsartan groups 1, 2, and 3 (16.47%±1.94%, 19.41%±1.87%; 14

  19. A model of airflow in the nasal cavities: Implications for nasal air conditioning and epistaxis.

    Bailie, Neil; Hanna, Brendan; Watterson, John; Gallagher, Geraldine


    A friction force is generated when moving air contacts the nasal walls, referred to as wall shear stress. This interaction facilitates heat and mass transfer between the mucosa and air, i.e., air-conditioning. The objective of this research was to study the distribution of wall shear stress within the nasal cavity to identify areas that contribute significantly to air-conditioning within the nasal cavity. Three-dimensional computational models of the nasal airways of five healthy subjects (three male and two female subjects) were constructed from nasal CT scans. Numerical simulations of nasal airflow were conducted using the commercial computational fluid dynamics code Fluent 6 (Ansys, Inc., Canonsburg, PA). Wall shear stress was derived from the numerical simulation. Air-conditioning was simulated to confirm the relationship with wall shear stress. Nasal airflow simulations predicted high wall shear stress along the anterior aspect of the inferior turbinate, the anteroinferior aspect of the middle turbinate, and within Little's area. The airflow simulations indicate that the inferior and middle turbinates and Little's area on the anterior nasal septum contribute significantly to nasal air-conditioning. The concentration of wall shear stress within Little's area indicates a desiccating and potentially traumatic effect of inhaled air that may explain the predilection for spontaneous epistaxis at this site.

  20. Perceiving nasal patency through mucosal cooling rather than air temperature or nasal resistance.

    Kai Zhao

    Full Text Available Adequate perception of nasal airflow (i.e., nasal patency is an important consideration for patients with nasal sinus diseases. The perception of a lack of nasal patency becomes the primary symptom that drives these patients to seek medical treatment. However, clinical assessment of nasal patency remains a challenge because we lack objective measurements that correlate well with what patients perceive. The current study examined factors that may influence perceived patency, including air temperature, humidity, mucosal cooling, nasal resistance, and trigeminal sensitivity. Forty-four healthy subjects rated nasal patency while sampling air from three facial exposure boxes that were ventilated with untreated room air, cold air, and dry air, respectively. In all conditions, air temperature and relative humidity inside each box were recorded with sensors connected to a computer. Nasal resistance and minimum airway cross-sectional area (MCA were measured using rhinomanometry and acoustic rhinometry, respectively. General trigeminal sensitivity was assessed through lateralization thresholds to butanol. No significant correlation was found between perceived patency and nasal resistance or MCA. In contrast, air temperature, humidity, and butanol threshold combined significantly contributed to the ratings of patency, with mucosal cooling (heat loss being the most heavily weighted predictor. Air humidity significantly influences perceived patency, suggesting that mucosal cooling rather than air temperature alone provides the trigeminal sensation that results in perception of patency. The dynamic cooling between the airstream and the mucosal wall may be quantified experimentally or computationally and could potentially lead to a new clinical evaluation tool.

  1. Evaluation of Histological Findings of Airways of Rats Exposed to Highly Polluted Indoor Air in Offices

    Martinsone Žanna


    Full Text Available Humans are exposed to chemicals and PM (particulate matter, including ultrafine particles (nanoparticles, mainly through inhalation. This creates a risk to their health. Another effect to exposure is expression of cytokines and their role in lung inflammation and morphpathogenesis. We conducted a pilot project based on testing of realistic exposure scenarios by describing morphological changes of the respiratory tract in Wistar rats (male during a 30-day exposure in office where there was high intensity of printing activities. Tracheal tissue of experimental animals had increasing concentrations of inflammatory interleukin IL-1 and decreasing concentrations of IL-6 and TNF-α. The lungs of the experimental animals tended to show focal infiltration of inflammatory cells, vascular plethora, focal and/or diffuse localisation of lymphatic nodules, and also vascular sclerosis and focal emphysema. The results suggested potential dangerous and adverse effect of poor indoor air quality (particles, including nanoparticles, and chemical compounds on respiratory tract tissue of rats.

  2. Discovery of unique and ENM- specific pathophysiologic pathways: Comparison of the translocation of inhaled iridium nanoparticles from nasal epithelium versus alveolar epithelium towards the brain of rats.

    Kreyling, Wolfgang G


    The biokinetics of inhaled nanoparticles (NP) is more complex than that of larger particles since NP may NP deposited on the nasal mucosa of the upper respiratory tract (URT) may translocate to the olfactory bulb of the brain and also via the trigeminus (URT neuronal route); and (b) NP deposited in the lower respiratory tract (LRT) may cross the ABB into blood and enter the brain across the blood-brain-barrier (BBB) or take a neuronal route from enervated tracheo-bronchial epithelia via the vagus nerve. Translocation from both - the URT and the LRT - are quantified during the first 24h after a 1-hour aerosol inhalation of 20nm-sized, (192)Ir radiolabeled iridium NP by healthy adult rats using differential exposures: (I) nose-only exposure of the entire respiratory tract or (II) intratracheal (IT) inhalation of intubated and ventilated rats, thereby bypassing the URT and extrathoracic nasal passages. After nose-only exposure brain accumulation (BrAcc) is significantly nine-fold higher than after IT inhalation since the former results from both pathways (a+b) while the latter exposure comes only from pathway (b). Interestingly, there are significantly more circulating NP in blood 24h after nose-only inhalation than after IT inhalation. Distinguishing translocation from URT versus LRT estimated from the differential inhalation exposures, the former is significantly higher (8-fold) than from the LRT. Although the BrAcc fraction is rather low compared to total NP deposition after this short-term exposure, this study proofs that inhaled insoluble NP can accumulate in the brain from both - URT and LRT which may trigger and/or modulate adverse health effects in the central nervous system (CNS) during chronic exposure.

  3. Airway morphology and function of rats following dermal sensitization and respiratory challenge with low molecular weight chemicals

    Arts, J.H.E.; Kuper, C.F.; Spoor, S.M.; Bloksma, N.


    Local lymph node activation and increased total serum IgE levels are suggested to be predictive parameters of airway hypersensitivity caused by low molecular weight (LMW) chemicals. Whether increases of total serum IgE are indicative of actual induction of specific airway reactions (morphological an

  4. Baculovirus-mediated expression and characterization of rat CYP2A3 and human CYP2a6: role in metabolic activation of nasal toxicants.

    Liu, C; Zhuo, X; Gonzalez, F J; Ding, X


    Cytochrome P450 2A3 (CYP2A3) was previously identified in rat lung by cDNA cloning and recently found to be expressed at a high level in the olfactory mucosa. In the current study, CYP2A3 was expressed in insect cells lacking endogenous cytochrome P450 (P450) activity, and the substrate specificity of the recombinant cytochrome was characterized and compared with that of CYP2A6, a human ortholog of rat CYP2A3, which has been detected in human olfactory mucosa as well as in liver. The CYP2A3 and CYP2A6 cDNAs were cloned into baculovirus, and recombinant viruses were used to produce active enzymes in Spodoptera frugiperta (SF9) cells. The metabolic activities of S. frugiperta cell microsomal fractions containing CYP2A3 or CYP2A6 were studied in a reconstituted system with purified rabbit NADPH-P450 reductase. CYP2A3 was found to be active toward testosterone, producing 15 alpha-hydroxytestosterone and several other metabolites, but it had only low activity toward coumarin. On the other hand, CYP2A6 was active toward coumarin but not toward testosterone. However, both enzymes were active in the metabolic activation of hexamethylphosphoramide, a nasal procarcinogen, and 2,6-dichlorobenzonitrile (DCBN), a herbicide known to cause tissue-specific toxicity in the olfactory mucosa of rodents at very low doses. In addition, both enzymes were active toward 4-nitrophenol, a preferred substrate for CYP2E1. Consistent with CYP2A3 being a major catalyst in microsomal metabolism of DCBN, the activities of both CYP2A3 and rat olfactory microsomes in DCBN metabolism were inhibited strongly by metyrapone and methoxsalen (ID50 50 microM). Thus, rat CYP2A3 and human CYP2A6 have differences in substrate specificity as well as tissue distributor. These findings should be taken into account when assessing the risk of exposure to potential nasal toxicants in humans.

  5. Croton sonderianus essential oil samples distinctly affect rat airway smooth muscle.

    Pinho-da-Silva, L; Mendes-Maia, P V; do Nascimento Garcia, T M; Cruz, J S; de Morais, S M; Coelho-de-Souza, A N; Lahlou, S; Leal-Cardoso, J H


    Plants of the genus Croton have been used extensively in the northeast of Brazil for treating various clinical conditions. Previous studies have demonstrated that the essential oil of some specimens of Croton sp. have a relaxing effect on tracheal smooth muscle. Our study aimed to characterize the effects of Croton sonderianus essential oil samples, collected at 1:00 pm (EO-13) and 9:00 pm (EO-21), on rat tracheal smooth muscle. The two samples were submitted to gas chromatography (GC) and mass spectrometry (MS) analysis to identify their components. Rat tracheal smooth muscle strips were used to assess the biological activity. The major constituents of EO-21 were: spathulenol (18.32%), beta-caryophyllene (14.58%) and caryophyllene oxide (8.54%) and the major constituents of EO-13 were bicyclogermacrene (16.29%), beta-phellandrene (15.42%) and beta-caryophyllene (13.82%). These samples showed an antispasmodic effect on tracheal smooth muscle strips pre-contracted with high K+ concentration (80 mM) or with acetylcholine. EO-21 increased baseline tonus while EO-13 provoked a decrease. These results demonstrated that EO-13 and EO-21 have different chemical composition and showed myorelaxant activity. In conclusion, EO-13 and EO-21 may have potential therapeutic use in the treatment of bronchospasm.

  6. Numerical analysis of respiratory flow patterns within human upper airway

    Wang, Ying; Liu, Yingxi; Sun, Xiuzhen; Yu, Shen; Gao, Fei


    A computational fluid dynamics (CFD) approach is used to study the respiratory airflow dynamics within a human upper airway. The airway model which consists of the airway from nasal cavity, pharynx, larynx and trachea to triple bifurcation is built based on the CT images of a healthy volunteer and the Weibel model. The flow characteristics of the whole upper airway are quantitatively described at any time level of respiratory cycle. Simulation results of respiratory flow show good agreement with the clinical measures, experimental and computational results in the literature. The air mainly passes through the floor of the nasal cavity in the common, middle and inferior nasal meatus. The higher airway resistance and wall shear stresses are distributed on the posterior nasal valve. Although the airways of pharynx, larynx and bronchi experience low shear stresses, it is notable that relatively high shear stresses are distributed on the wall of epiglottis and bronchial bifurcations. Besides, two-dimensional fluid-structure interaction models of normal and abnormal airways are built to discuss the flow-induced deformation in various anatomy models. The result shows that the wall deformation in normal airway is relatively small.

  7. Cellular mechanism underlying formaldehyde-stimulated Cl- secretion in rat airway epithelium.

    Yu-Li Luo

    Full Text Available BACKGROUND: Recent studies suggest that formaldehyde (FA could be synthesized endogeneously and transient receptor potential (TRP channel might be the sensor of FA. However, the physiological significance is still unclear. METHODOLOGY/PRINCIPAL FINDINGS: The present study investigated the FA induced epithelial Cl(- secretion by activation of TRPV-1 channel located in the nerve ending fiber. Exogenously applied FA induced an increase of I(SC in intact rat trachea tissue but not in the primary cultured epithelial cells. Western blot and immunofluorescence analysis identified TRPV-1 expression in rat tracheal nerve ending. Capsazepine (CAZ, a TRPV-1 specific antagonist significantly blocked the I(SC induced by FA. The TRPV-1 agonist capsaicin (Cap induced an increase of I(SC, which was similar to the I(SC induced by FA. L-703606, an NK-1 specific inhibitor and propranolol, an adrenalin β receptor inhibitor significantly abolished the I(SC induced by FA or Cap. In the ion substitute analysis, FA could not induce I(SC in the absence of extracelluar Cl(-. The I(SC induced by FA could be blocked by the non-specific Cl(- channel inhibitor DPC and the CFTR specific inhibitor CFTR(i-172, but not by the Ca(2+-activated Cl(- channel inhibitor DIDS. Furthermore, both forskolin, an agonist of adenylate cyclase (AC and MDL-12330A, an antagonist of AC could block FA-induced I(SC. CONCLUSION: Our results suggest that FA-induced epithelial I(SC response is mediated by nerve, involving the activation of TRPV-1 and release of adrenalin as well as substance P.

  8. Time- and concentration-dependent genomic responses of the rat airway to inhaled nickel subsulfide

    Efremenko, A.Y., E-mail: [The Hamner Institutes for Health Sciences, 6 Davis Drive, Research Triangle Park, NC 27709 (United States); Campbell, J.L.; Dodd, D.E. [The Hamner Institutes for Health Sciences, 6 Davis Drive, Research Triangle Park, NC 27709 (United States); Oller, A.R. [NiPERA, Inc., 2525 Meridian Parkway, Suite 240, Durham, NC 27713 (United States); Clewell, H.J. [The Hamner Institutes for Health Sciences, 6 Davis Drive, Research Triangle Park, NC 27709 (United States)


    Objective: To provide insights into the mode of action for Ni{sub 3}S{sub 2} lung carcinogenicity by examining gene expression changes in target cells after inhalation exposure. Methods: Gene expression changes were determined in micro-dissected lung broncho-alveolar cells from Fischer 344 rats following inhalation of Ni{sub 3}S{sub 2} at 0.0, 0.04, 0.08, 0.15, and 0.60 mg/m{sup 3} (0.03, 0.06, 0.11, and 0.44 mg Ni/m{sup 3}) for one and four weeks (6 h/day, 5 days/week). Results: Broncho-alveolar lavage fluid evaluation and lung histopathology provided evidence of inflammation only at the two highest concentrations, which were similar to those tested in the 2-year bioassay. The number of statistically significant up- and down-regulated genes decreased markedly from one to four weeks of exposure, suggesting adaptation. Cell signal pathway enrichment at both time-points primarily reflected responses to toxicity, including inflammatory and proliferative signaling. While proliferative signaling was up-regulated at both time points, some inflammatory signaling reversed from down-regulation at 1 week to up-regulation at 4 weeks. Conclusions: These results support a mode of action for Ni{sub 3}S{sub 2} carcinogenicity driven by chronic toxicity, inflammation and proliferation, leading to mis-replication, rather than by direct genotoxicity. Benchmark dose (BMD) analysis identified the lowest pathway transcriptional BMD exposure concentration as 0.026 mg Ni/m{sup 3}, for apoptosis/survival signaling. When conducted on the basis of lung Ni concentration the lowest pathway BMD was 0.64 μg Ni/g lung, for immune/inflammatory signaling. Implications: These highly conservative BMDs could be used to derive a point of departure in a nonlinear risk assessment for Ni{sub 3}S{sub 2} toxicity and carcinogenicity. - Highlights: • The mode of action for lung carcinogenicity of inhaled Ni{sub 3}S{sub 2} was investigated in rats. • Gene expression changes were determined in micro

  9. Regional aerosol deposition in human upper airways. Final report

    Swift, D.L.


    During the award period, a number of studies have been carried out related to the overall objective of the project which is to elucidate important factors which influence the upper airway deposition and dose of particles in the size range 0.5 nm - 10 {mu}m, such as particle size, breathing conditions, age, airway geometry, and mode of breathing. These studies are listed below. (1) A high voltage electrospray system was constructed to generate polydispersed 1-10 {mu}m diameter di-ethylhexyl sebacate aerosol for particle deposition studies in nasal casts and in human subjects. (2) The effect of nostril dimensions, nasal passage geometry, and nasal resistance on particle deposition efficiency in forty healthy, nonsmoking adults at a constant flowrate were studied. (3) The effect of nostril dimensions, nasal passage dimensions and nasal resistance on the percentage of particle deposition in the anterior 3 cm of the nasal passage of spontaneously breathing humans were studied. (4) The region of deposition of monodispersed aerosols were studied using replicate casts. (5) Ultrafine aerosol deposition using simulated breath holding path and natural path was compared. (6) An experimental technique was proposed and tested to measure the oral deposition of inhaled ultrafine particles. (7) We have calculated the total deposition fraction of ultrafine aerosols from 5 to 200 n in the extrathoracic airways and in the lung. (8) The deposition fraction of radon progeny in the head airways was studied using several head airway models.

  10. Nicotine Elevated Intracellular Ca2+ in Rat Airway Smooth Muscle Cells via Activating and Up-Regulating α7-Nicotinic Acetylcholine Receptor

    Yongliang Jiang


    Full Text Available Background: Chronic obstructive pulmonary disease (COPD is characterized by airway remodeling with airway smooth muscle (ASM hypertrophy and hyperplasia. Since tobacco use is the key risk factor for the development of COPD and intracellular Ca2+ concentration ([Ca2+]i plays a major role in both cell proliferation and differentiation, we hypothesized that nicotinic acetylcholine receptor (nAChR activation plays a role in the elevation of [Ca2+]i in airway smooth muscle cells (ASMCs. Methods: We examined the expression of nAChR and characterized the functions of α7-nAChR in ASMCs. Results: RT-PCR analysis showed that α2-7, β2, and β3-nAChR subunits are expressed in rat ASMCs, with α7 being one of the most abundantly expressed subtypes. Chronic nicotine exposure increased α7-nAChR mRNA and protein expression, and elevated resting [Ca2+]i in cultured rat ASMCs. Acute application of nicotine evoked a rapid increase in [Ca2+]i in a concentration-dependent manner, and the response was significantly enhanced in ASMCs cultured with 1 µM nicotine for 48 hours. Nicotine-induced Ca2+ response was reversibly blocked by the α7-nAChR nicotinic antagonists, methyllycaconitine and α-bungarotoxin. Small interfering RNA suppression of α7-nAChR also substantially blunted the Ca2+ responses induced by nicotine. Conclusion: These observations suggest that nicotine elevates [Ca2+]i in ASMCs through α7-nAChR-mediated signals pathways, and highlight the possibility that α7-nAChR can be considered as a potential target for the treatment of airway remodeling.that nicotine elevates [Ca2+]i in ASMCs through α7-nAChR-mediated signals pathways, and highlight the possibility that α7-nAChR can be considered as a potential target for the treatment of airway remodeling.

  11. Water permeability in human airway epithelium

    Pedersen, Peter Steen; Procida, Kristina; Larsen, Per Leganger;


    Osmotic water permeability (P(f)) was studied in spheroid-shaped human airway epithelia explants derived from nasal polyps by the use of a new improved tissue collection and isolation procedure. The fluid-filled spheroids were lined with a single cell layer with the ciliated apical cell membrane...

  12. Comparison of the detection rate and load of rhinovirus in nasal versus lower airway samples from patients with chronic obstructive pulmonary disease%慢性阻塞性肺疾病患者鼻部及下气道的鼻病毒检出率及载量比较

    廖华; 陈荣昌; 关文达; 杨子峰; 刘文宽; 周荣; 钟南山


    Objective To compare the rhinovirus detection rate and the viral load in nasal samples versus lower airway samples from patients with COPD,and therefore to provide evidence for sampling selection for detection of rhinovirus.Methods Nasal swab and induced sputum were collected from patients with COPD during acute exacerbation and the stable period.Rhinovirus was detected by real-time fluorescent quantitative polymerase chain reaction.The difference in detection rates of rhinovirus between acute exacerbation and stable COPD was compared.The detection rates and the viral load from nasal samples versus induced sputum were also compared.Results A total of 639 paired nasal swab and induced sputum specimens were collected between September 2009 and January 2013,including 114 paired specimens from COPD patients with acute exacerbations 114 paired specimens from stable COPD (matching with the stable one),and 411 paired specimens from stable COPD patients.For the 114 paired samples from stable and acute COPD patients,there was a higher detection rate in samples [nasal swab 13.2% (15/114),induced sputum 21.9% (25/114)] from patients with acute exacerbation,compared those with stable disease [nasal swab 3.5% (4/114),P < 0.05 ; and induced sputum 5.3% (6/114) P < 0.01,respectively].Forty-two (6.6%) of the 639 nasal swab specimens were positive for rhinovirus,while 58 (9.1%) of the 639 induced sputum specimens were positive for rhinovirus (P < 0.05).For the 27 paired rhinovirus positive specimens,the mean viral load of rhinovirus in induced sputum was (62.1 ± 9.5) × 108 copies/L,significantly higher than that of the nasal swab (3.4 ± 0.5) × 108 copies/L,P < 0.05.Conclusion For patients with COPD,induced sputum specimens may be more suitable for rhinovirus detection compared to nasal swabs,and the load of rhinovirus was higher in the lower airways than in the upper airways.%目的 比较慢性阻塞性肺疾病(简称慢阻肺)患者鼻部及下气道标

  13. Influence of Nasal Continues Positive Airway Pressure on Retention of Carbon Dioxide in Newborn%新生儿经鼻持续气管正压通气对二氧化碳潴留的影响

    吴玫; 陈大鹏; 熊英; 陈超


    Objective To investigate the influence of nasal continues positive airway pressure (nCPAP) on retention of carbon dioxide(CO2) in newborns.Methods From June to December 2009,a total of 46 newborns who had nCPAP treatment for 72 hours in West China Second University Hospital,Sichuan University were included in nCPAP group.Meanwhile,another 20 cases of neonates with jaundice were selected as control group.The artery blood gas was detected by STEPHAN CPCP-B just before nCPAP treatment and at 30 min,6 h,12 h,24 h,36 h after nCPAP treatment in nCPAP group.The same method determined the artery blood gas in control group.The blood gas analysis results between nCPAP group before nCPAP treatment and control group,and between nCPAP group at different time slots and control group were analyzed by statistical methods.The procedure of this study was consistent with ethical standard which was established by the committee of investigation in human beings of West China Second University Hospital,Sichuan University.And it was approved by this committee.Guardians were informed of grouping and their written informed consent was obtained before clinical studies.There had no significance differences between two groups among gestational age at delivery,day age,and gender (P>0.05).Results There had significant difference between nCPAP group before nCPAP treatment and control group in pH value and partial pressure of oxygen in artery (Pao2) (P<0.01),but partial pressure of CO2 in artery (PaCO2 ),levels of ( HCO3ˉ ),standard bicarbonate (SB) and base excess (BE) had no significant difference (P>0.05).The blood gas results of nCPAP group at different treatment time slots and control group showed that even using nCPAP in newborns with normal Paco2 for 72 h,there were no signs of retention of CO2 (P>0.05).Conclusions Using nCPAP in newborn with normal PaCO2 for 72 h may not cause serous retention of CO2.%目的 探讨新生儿使用经鼻持续气管正压通气(nCPAP)前

  14. Full Airway Drainage by Fiber Bronchoscopy Through Artificial Airway in the Treatment of Occult Traumatic Atelectasis.

    Zhao, Xue Hong; Zhang, Yun; Liang, Zhong Yan; Zhang, Shao Yang; Yu, Wen Qiao; Huang, Fang-Fang


    The objective of this study is to investigate the effects of full airway drainage by fiber bronchoscopy through artificial airway in the treatment of traumatic atelectasis with occult manifestations. From May 2006 to May 2011, 40 cases of occult traumatic atelectasis were enrolled into our prospective study. Group A (n = 18) received drainage by nasal bronchoscope; group B underwent airway drainage by fiber bronchoscopy through artificial airway (n = 22). The effects of treatment were evaluated by the incidence of adult respiratory distress syndrome (ARDS), lung abscess, and the average length of hospital stay. Compared with nasal fiber-optic treatment, airway drainage by fiber bronchoscopy through artificial airway reduced the incidence of ARDS (p = 0.013) and lung abscess (p = 0.062) and shortened the mean length of stay (p = 0.018). Making the decision to create an artificial airway timely and carry out lung lavage by fiber bronchoscopy through artificial airway played a significant role in the treatment of occult traumatic atelectasis.




    Full Text Available Restricted mouth opening presents one of the greatest challenges to the anesthetist for endotracheal intubation and ventilation. Awake blind nasal intubation has been one of the finest and favored techniques for intubation in previous decades for restricted mouth opening patients. A coordinated team approach, monitoring and adequate counseling of the patient is mandatory for the airway management to carry out a safe surgical procedure

  16. 哮喘气道重塑与氧化应激的实验研究%Airway Remodeling and Oxidative Stress in Rat Asthmatic Model

    王尧; 杨青; 郭锋; 况九龙; 李里香


    目的 探讨大鼠支气管哮喘模型的慢性气道炎症、气道重塑特征以及与氧化应激的关系.方法 以卵蛋白为过敏原致敏,反复多次激发以模拟临床反复发作过程,建立大鼠慢性哮喘模型.64只SD大鼠随机分为正常对照组和哮喘组,每组再进一步划分4、8、12、16 周4个时间段.观察指标:①肺泡灌洗液(bronchoalveolar lavage fluid,BALF)细胞计数与分类;②肺组织病理观察:进行支气管周围炎性细胞浸润及杯状细胞增殖评分,测定支气管壁的平滑肌面积、胶原沉积面积,及肺组织TGF-β1的积分光密度值(IOD值);③测定12周大鼠肺组织匀浆MDA含量、SOD活性及肺组织TGF-β1蛋白含量.结果 ①各时间段哮喘组的BALF细胞计数与正常对照组相比,差异均有统计学意义(均P<0.01).其中中性粒细胞百分比、黏液指数随时间推移呈增加趋势.②4周哮喘组即有气道管壁增厚、平滑肌增生、胶原沉积增多、管腔变小、TGF-β1的表达增多等气道重塑的特征,与对照组比较差异均有统计学意义(均P<0.01),并随时间推移呈增加趋势,以16周哮喘组最明显.③与对照组比较,哮喘组的MDA含量、TGF-β1含量均明显升高(均P<0.01),SOD活性明显降低(P<0.01).结论 通过延长卵蛋白激发时间可以成功制备SD大鼠慢性哮喘气道重塑模型;哮喘气道重塑在早期即出现,中性粒细胞及氧化应激可能参与哮喘的气道重塑.%Objective To approach the effect of prolonged allergen on airway remodeling and to understand the correlation between the chronic airway inflammation, airway remodeling and oxidative stress in rat asthmatic model. Methods Sixty-four female SD rats were randomly divided into 2 groups : control group and asthmatic group. The rats were sensitized with ovalbumin,and repeatedly exposed to aerosolized ovalbumin for 4 , 8 , 12,16 weeks. Inflammation cell count and classification in bronchoalveolar lavage

  17. Rat Nasal Respiratory Mucosa-Derived Ectomesenchymal Stem Cells Differentiate into Schwann-Like Cells Promoting the Differentiation of PC12 Cells and Forming Myelin In Vitro

    Jian Zhang


    Full Text Available Schwann cell (SC transplantation as a cell-based therapy can enhance peripheral and central nerve repair experimentally, but it is limited by the donor site morbidity for clinical application. We investigated weather respiratory mucosa stem cells (REMSCs, a kind of ectomesenchymal stem cells (EMSCs, isolated from rat nasal septum can differentiate into functional Schwann-like cells (SC-like cells. REMSCs proliferated quickly in vitro and expressed the neural crest markers (nestin, vimentin, SOX10, and CD44. Treated with a mixture of glial growth factors for 7 days, REMSCs differentiated into SC-like cells. The differentiated REMSCs (dREMSCs exhibited a spindle-like morphology similar to SC cells. Immunocytochemical staining and Western blotting indicated that SC-like cells expressed the glial markers (GFAP, S100β, Galc, and P75 and CNPase. When cocultured with dREMSCs for 5 days, PC12 cells differentiated into mature neuron-like cells with long neurites. More importantly, dREMSCs could form myelin structures with the neurites of PC12 cells at 21 days in vitro. Our data indicated that REMSCs, a kind of EMSCs, could differentiate into SC-like cells and have the ability to promote the differentiation of PC12 cells and form myelin in vitro.

  18. 磷酸川芎嗪鼻用pH敏感型原位凝胶在正常大鼠和模型大鼠的脑部药动学比较研究%Comparison of the brain pharmacokinetics of nasal tetramethylpyrazine phosphate pH-sensitive in situ gel in normal rats and model rats

    刘宏伟; 晏亦林; 周莉玲


    The study is to investigate the brain pharmacokinetics change of nasal tetramethylpyrazine phosphate (TMPP) pH-sensitive in situ gel in normal and model rats. Acute cerebral ischemia rat model was successfully established by middle cerebral artery occlusion (MCAO) method. Both normal and model rats were given nasal TMPP pH-sensitive in situ gel (10 mg·kg-1). Perfusates of brain striatum area were collected at each time point by microdialysis. The content of TMPP was determined by HPLC. The pharmacokinetics parameters were calculated by Kinetica 4.4 software at each time point of the brain drug concentration. The main pharmacokinetics parameters of TMPP were fitted with compartments 2. After nasal TMPP pH-sensitive in situ gel the values of Cmax and AUC of both components in brain showed as follows: the value of model group > that of normal group. Significant difference can be observed in the process of brain pharmacokinetics in normal and model rats after giving nasal TMPP pH-sensitive in situ gel.

  19. [The effectiveness of measurement of nasal resistance in patients with sleep disordered breathing].

    Shimoyama, Kumiko; Yasuda, Kyo; Kawano, Masako; Satoh, Makoto


    Nasal breathing disorder has been associated with the condition and treatment of sleep disordered breathing (SDB). In the current study, we investigated the utility of measurement of nasal resistance in patients with SDB. We examined the relationship between nasal symptoms and nasal resistance in 219 patients, and how the results affected the administration of nasal continuous positive airway pressure (nCPAP) in 34 SDB patients. Total nasal resistance was not significantly different between patients who were divided into two groups: those with nasal symptoms, and those without. The left-right ratio of nasal flow in the group with nasal symptoms was higher than in the group without nasal symptoms (p resistance. The mean percentage of nCPAP use > or = 4 hours was lower in the group in which total nasal resistance was more than 0.25Pa/cm3/sec (p measurement of nasal resistance for confirming nasal breathing disorder is effective in patients with SDB, whether a patient complains of nasal symptoms or not.

  20. 茶多酚对哮喘大鼠气道炎症和气道重塑的干预研究%The Effects of Tea Polyphenols on Airway Inflammation and Airway Remodeling in Asthmatic Rats

    杨青; 王尧; 李里香; 况九龙


    目的:研究茶多酚(TP)对支气管哮喘大鼠早期和晚期气道氧化应激水平及气道炎症、气道重塑的影响.方法:48只大鼠随机分对照组、哮喘组、早布地奈德(BUD)组、晚BUD组、早TP组和晚TP组,每组8只.早BUD组、早TP组在造模前2周药物干预,晚BUD组、晚TP组在造模5周后药物干预.造模12周时观察各项指标.测定支气管壁的平滑肌面积、胶原沉积面积,以及肺组织转化生长因子-β1 (TGF-β1)的表达.测定肺组织TGF-β1含量、丙二醛(MDA)含量及超氧化物歧化酶(SOD)活力.结果:早TP组、晚TP组、早BUD组干预后支气管壁平滑肌面积、胶原沉积面积和TGF-β1含量较哮喘组均有改善(P<0.05或P<0.01).晚BUD组较哮喘组无明显改善(P>0.05).哮喘组肺组织中MDA含量明显上升,SOD活性显著下降,与对照组比较差异有统计学意义(P<0.01);各药物干预后SOD活性均上升,MDA含量均下降,以早TP组最明显(P<0.01).SOD活性与MDA含量呈负相关,TGF-β1含量与MDA含量呈正相关.结论:茶多酚可能通过清除氧自由基,减少气道炎症及氧化应激,从而改善或延缓气道重塑的发生.%Objective: To observe the effects of tea polyphenols (TP) on oxidative stress level, airway inflammation and airway remodeling of early stage and late stage in asthmatic rats. Methods: Forty-eight rats were randomly divided into 6 groups, normal saline group, asthma group, early budesonide (early BUD) group, late BUD group, early TP group and late TP group. Drugs were administrated 2 weeks before sensitizing in early BUD group and early TP group, and administrated 5 weeks after sensitizing in late BUD group and late TP group. The lung tissues were harvested from rats 12 weeks after sensitizing. The smooth muscle area, collagen deposition area and the expression of transforming growth factor-β1 (TGF-βl) were assessed in bronchi and lung tissues. The contents of TGF-β1, malondialdehyde (MDA) and

  1. Nasal chondromesenchymal hamartoma with no nasal symptoms.

    Uzomefuna, Vincent


    The authors present a case of nasal chondromesenchymal hamartoma (NCMH) in an 8-year-old boy with a 4-month history of frontal headache and no symptoms of nasal obstruction, rhinorrhoea or postnasal drip. An ENT examination as well as ophthalmology assessment presented normal results. CT scan showed a lesion involving the sphenoid and ethmoid sinuses. The patient had an endoscopic resection of the lesion that was confirmed histologically to be a NCMH. Though NCMH is known to present usually in infants with obstructing nasal mass, an unusual presentation of a patient with throbbing headache without any nasal symptoms is reported here.

  2. Suplatast tosilate alleviates nasal symptoms through the suppression of nuclear factor of activated T-cells-mediated IL-9 gene expression in toluene-2,4-diisocyanate-sensitized rats.

    Mizuguchi, Hiroyuki; Orimoto, Naoki; Kadota, Takuya; Kominami, Takahiro; Das, Asish K; Sawada, Akiho; Tamada, Misaki; Miyagi, Kohei; Adachi, Tsubasa; Matsumoto, Mayumi; Kosaka, Tomoya; Kitamura, Yoshiaki; Takeda, Noriaki; Fukui, Hiroyuki


    Histamine H1 receptor (H1R) gene is upregulated in patients with pollinosis; its expression level is highly correlated with the nasal symptom severity. Antihistamines are widely used as allergy treatments because they inhibit histamine signaling by blocking H1R or suppressing H1R signaling as inverse agonists. However, long-term treatment with antihistamines does not completely resolve toluene-2,4-diisocyanate (TDI)-induced nasal symptoms, although it can decrease H1R gene expression to the basal level, suggesting additional signaling is responsible for the pathogenesis of the allergic symptoms. Here, we show that treatment with suplatast tosilate in combination with antihistamines markedly alleviates nasal symptoms in TDI-sensitized rats. Suplatast suppressed TDI-induced upregulation of IL-9 gene expression. Suplatast also suppressed ionomycin/phorbol-12-myristate-13-acetate-induced upregulation of IL-2 gene expression in Jurkat cells, in which calcineurin (CN)/nuclear factor of activated T-cells (NFAT) signaling is known to be involved. Immunoblot analysis demonstrated that suplatast inhibited binding of NFAT to DNA. Furthermore, suplatast suppressed ionomycin-induced IL-9 mRNA upregulation in RBL-2H3 cells, in which CN/NFAT signaling is also involved. These data suggest that suplatast suppressed NFAT-mediated IL-9 gene expression in TDI-sensitized rats and this might be the underlying mechanism of the therapeutic effects of combined therapy of suplatast with antihistamine.

  3. Curative effect of mometasone furoate nasal spray on upper airway cough syndrome in children with chronic rhinosinusitis%糠酸莫米松鼻喷剂对表现为上气道咳嗽综合征的儿童慢性鼻-鼻窦炎的治疗作用

    朱学伟; 孙宇新


    Objective:To observe the curative effect of mometasone furoate nasal spray on upper airway cough syndrome in children with chronic rhinosinusitis.Methods:Mometasone furoate nasal spray was used to treat upper airway cough syndrome in 48 children with chronic rhinosinusitis ; the symptoms before and after treatment and the change of total score of signs were observed,and the related adverse reactions were analyzed.Results:The scores of cough symptom and endoscopy before treatment were (3.02 ± 1.61) and (5.80 ±2.00),respectively; the scores of cough symptom and endoscopy at three weeks after treatment were (1.20 ±0.83) and (2.01 ± 1.19),respectively; the total scores of symptoms and signs at two months after treatment were (0.61 ±0.45) and (1.38 ±0.89) on average.There were statistically significant differences in the total scores of symptoms and signs between before and after treatment (P < 0.01).Conclusion:Mometasone furoate nasal spray has a certain curative effect on upper airway cough syndrome in children with chronic rhinosinusitis,the safety and long-term curative effect need further studies.%目的:观察糠酸莫米松鼻喷雾剂治疗表现为上气道咳嗽综合征的儿童慢性鼻-鼻窦炎的效果.方法:对48例表现为上气道咳嗽综合征的慢性鼻-鼻窦炎的患儿,用糠酸莫米松鼻喷雾剂进行治疗,观察治疗前后症状和体征总评分的改变,并对相关不良反应进行分析.结果:采用糠酸莫米松鼻喷雾剂治疗表现为上气道咳嗽综合征的慢性鼻-鼻窦炎患儿,治疗前咳嗽症状和鼻内镜检查评分平均为(3.02±1.61)分及(5.80±2.00)分;治疗3周后咳嗽症状和鼻内镜检查评分为(1.20±0.83)分及(2.01±1.19)分;治疗2个月后症状和体征总评分平均为(0.61±0.45)分及(1.38±0.89)分.治疗前与治疗后症状和体征总评分比较,差异有统计学意义(P<0.01).结论:糠酸莫米松鼻喷剂对表现为上气道咳嗽综合征的儿童慢性鼻-鼻

  4. Alcohol hyper-responsiveness in chronic rhinosinusitis with nasal polyps.

    De Schryver, Els; Derycke, Lara; Campo, Paloma; Gabriels, Eline; Joos, Guy F; Van Zele, Thibaut; Bachert, Claus; Hellings, Peter W; Gevaert, Philippe


    An important percentage of subjects diagnosed with chronic upper airway disease report alcohol-induced worsening of their symptoms. The prevalence and characteristics of respiratory reactions provoked by alcohol-containing drinks have not been fully investigated yet. The aim of this study was to estimate the prevalence and characteristics of alcohol hyper-responsiveness in patients with chronic airway disease and healthy controls. Furthermore, nasal inflammation was evaluated in nasal polyp patients with and without hyper-responsiveness. We evaluated the prevalence and characteristics of alcohol-induced respiratory complaints in 1281 subjects. Chronic rhinosinusitis with nasal polyps (CRSwNP) patients with and without NSAID exacerbated respiratory disease (NERD), chronic rhinosinusitis patients without nasal polyps (CRSsNP), allergic rhinitis (AR) patients and healthy controls were approached by means of a questionnaire. Inflammatory markers (eosinophilic cationic protein (ECP), IL-5, IgE, SAE-specific IgE, IL-17, TNFα and IFNγ) in tissue were then compared between alcohol hyper-responsive and non-hyper-responsive CRSwNP patients. The highest prevalence of nasal and bronchial alcohol hyper-responsiveness was observed in patients with NERD, followed by CRSwNP, and less frequent in CRSsNP, AR and healthy controls. Alcohol hyper-responsiveness is significantly more prevalent in CRSwNP patients suffering from recurrent disease and in patients with severe symptomatology. In nasal tissue of the hyper-responsive CRSwNP group, we observed significantly higher nasal levels of the eosinophilic biomarker ECP. Nasal hyper-responsiveness to alcohol is significantly more prevalent in severe eosinophilic upper airway disease. © 2016 John Wiley & Sons Ltd.

  5. Impact of nasal symptoms on the evaluation of asthma control.

    Huang, Chien-Chia; Chang, Po-Hung; Wu, Pei-Wen; Wang, Chun-Hua; Fu, Chia-Hsiang; Huang, Chi-Che; Tseng, Hsiao-Jung; Lee, Ta-Jen


    The united airways concept suggests that patients with asthma typically exhibit parallel inflammation in the upper airway. The resulting nasal symptoms should reduce quality of life and substantially affect the evaluation of asthma control among these patients. This study aimed to assess the association of nasal symptoms with the evaluation of asthma control.Fifty-eight patients with asthma and persistent nasal symptoms were prospectively recruited for evaluations of their sinonasal symptoms and asthma control in a cross-sectional study from August 2013 to June 2016. Participants underwent thorough nasal endoscopy, sinus computed tomography, pulmonary function testing, the asthma control test (ACT), and the Sino-Nasal Outcome Test-22 (SNOT-22) questionnaires to evaluate their asthma control and sinonasal symptoms.There was a significant association between ACT and SNOT-22 scores. Among patients with asthma and chronic rhinosinusitis, ACT scores were closely related to the symptoms of cough, post-nasal discharge, dizziness, waking up at night, absence of a good night's sleep, and waking up tired. Among patients with asthma and chronic rhinitis, the forced expiratory volume in 1 second was closely related to the symptoms of needing to blow nose, runny nose, and cough. Patients with emergency clinic visits during the previous 3 months had relatively high SNOT-22 scores, especially for the symptoms of sneezing, runny nose, nasal blockage, cough, and dizziness.Sinonasal symptom severity was closely associated with measured asthma control status among patients with asthma and persistent nasal symptoms. Therefore, upper and lower airway inflammations should be considered and treated simultaneously.

  6. Nasal mucosal biopsy

    Biopsy - nasal mucosa; Nose biopsy ... to fast for a few hours before the biopsy. ... Nasal mucosal biopsy is usually done when abnormal tissue is seen during examination of the nose. It may also be done ...

  7. Testosterone Nasal Gel

    Testosterone nasal gel is used to treat symptoms of low testosterone in men who have hypogonadism (a condition in which the ... does not produce enough natural testosterone). Testosterone nasal gel is used only for men with low testosterone ...

  8. Sexual Dimorphism in the Regulation of Estrogen, Progesterone, and Androgen Receptors by Sex Steroids in the Rat Airway Smooth Muscle Cells

    Abraham Zarazúa


    Full Text Available The role of sex hormones in lung is known. The three main sex steroid receptors, estrogen, progesterone, and androgen, have not been sufficiently studied in airway smooth muscle cells (ASMC, and the sex hormone regulation on these receptors is unknown. We examined the presence and regulation of sex hormone receptors in female and male rat ASMC by Western blotting and flow cytometry. Gonadectomized rats were treated with 17β-estradiol, progesterone, 17β-estradiol + progesterone, or testosterone. ASMC were enzymatically isolated from tracheas and bronchi. The experiments were performed with double staining flow cytometry (anti-α-actin smooth muscle and antibodies to each hormone receptor. ERα, ERβ, tPR, and AR were detected in females or males. ERα was upregulated by E2 and T and downregulated by P4 in females; in males, ERα was downregulated by P4, E + P, and T. ERβ was downregulated by each treatment in females, and only by E + P and T in males. tPR was downregulated by P4, E + P, and T in females. No hormonal regulation was observed in male receptors. AR was downregulated in males treated with E + P and T. We have shown the occurrence of sex hormone receptors in ASMC and their regulation by the sex hormones in female and male rats.

  9. Sexual Dimorphism in the Regulation of Estrogen, Progesterone, and Androgen Receptors by Sex Steroids in the Rat Airway Smooth Muscle Cells

    Zarazúa, Abraham; González-Arenas, Aliesha; Ramírez-Vélez, Gabriela; Bazán-Perkins, Blanca; Guerra-Araiza, Christian; Campos-Lara, María G.


    The role of sex hormones in lung is known. The three main sex steroid receptors, estrogen, progesterone, and androgen, have not been sufficiently studied in airway smooth muscle cells (ASMC), and the sex hormone regulation on these receptors is unknown. We examined the presence and regulation of sex hormone receptors in female and male rat ASMC by Western blotting and flow cytometry. Gonadectomized rats were treated with 17β-estradiol, progesterone, 17β-estradiol + progesterone, or testosterone. ASMC were enzymatically isolated from tracheas and bronchi. The experiments were performed with double staining flow cytometry (anti-α-actin smooth muscle and antibodies to each hormone receptor). ERα, ERβ, tPR, and AR were detected in females or males. ERα was upregulated by E2 and T and downregulated by P4 in females; in males, ERα was downregulated by P4, E + P, and T. ERβ was downregulated by each treatment in females, and only by E + P and T in males. tPR was downregulated by P4, E + P, and T in females. No hormonal regulation was observed in male receptors. AR was downregulated in males treated with E + P and T. We have shown the occurrence of sex hormone receptors in ASMC and their regulation by the sex hormones in female and male rats. PMID:27110242

  10. Irrigação intranasal: avaliação dos efeitos do uso de soluções hidroeletrolíticas na mucosa de ratos Nasal irrigation: effects of hydroelectrolytic solutions on rats mucosa

    Erika Y. C. Viertler


    Full Text Available A irrrigação intranasal tem grande importância como terapia adjuvante de doenças nasossinusais. Entretanto, faltam estudos que avaliem as alterações histológicas que as diferentes soluções utilizadas podem causar na mucosa do nariz. OBJETIVO: Analisar os aspectos histológicos da mucosa nasal de ratos após irrigação local com diferentes soluções hidroeletrolíticas. FORMA DE ESTUDO: Experimental. MATERIAL E MÉTODO: 120 ratos Wistar foram divididos igualmente em 4 grupos. O grupo número 1 recebeu solução salina a 0,9%. Os grupos 2 e 3 receberam soluções contendo Cloreto de Sódio associado a Cloreto de Potássio e Glicose, em diferentes concentrações. O grupo 4 foi o grupo controle. Duas vezes ao dia, 0,1ml (2 gotas das soluções foram aplicados na narina esquerda dos ratos, através de uma seringa. Metade dos animais de cada grupo foi sacrificado após a primeira semana e a metade restante após a quarta semana de tratamento. Os fragmentos de mucosa obtidos foram processados e estudados em microscopia óptica, utilizando a hematoxilina e eosina. RESULTADOS: Pôde-se observar que a infiltração de células inflamatórias foi estatisticamente mais intensa no grupo 2, em 1 e 4 semanas de administração das soluções (pNasal irrigation is an important adjuvant therapy for nasosinusis diseases. Many hydroelectrolytic solutions have been used for it, but studies are lacking to analyze the histological reactions they may cause to the nasal mucosa. PURPOSE: to examine the histological patterns in nasal mucosa after application of three different hydroelectrolytic solutions. STUDY DESIGN: Experimental. MATERIAL AND METHOD: 120 Wistar rats were equally divided into four groups. Group number 1 received a 0.9% saline solution. Group's number 2 and 3 received solutions composed by Sodium Chloride, associated to Potassium Chloride and Glucose in different concentrations. Group 4 was the control group. Twice a day, 0.1ml (2 drops of

  11. Analysis of toxicity produced by inhalation of trichloroethylene within rat and mice`s respiratory epithelium; Comparazione del danno indotto dall`inalazione di tricloroetilene nell`epitelio nasale e tracheobronchiale del ratto e del topo

    Mancuso, M.T.; Fravolini, M.E.; Parasacchi, P.; Lombardi, C.C.; Giovanetti, A. [ENEA, Casaccia (Italy). Area Energia Ambiente e Salute


    The aim of this study was to define the sites of cytotoxicity within the respiratory tract (nasal cavity and tracheobronchial tree) after acute inhalation of trichloroethylene (TCE), an organic solvent requiring metabolic activation by cytochrome P-450 enzymatic system to exert its toxic effects. Two animals species, rats and mice, were exposed to 3500 and 7000 ppm of TCE for 30 minutes. The morphological analysis of the respiratory epithelium has underlined a species-specific difference in the cellular sensitivity after treatment with TCE. This work is a part of ENEA (Italian Agency for New Technologies, Energy and the Environment) INTO program, environmental department, sector of effects on man and ecosystem.

  12. Finite Element Model and Validation of Nasal Tip Deformation.

    Manuel, Cyrus T; Harb, Rani; Badran, Alan; Ho, David; Wong, Brian J F


    Nasal tip mechanical stability is important for functional and cosmetic nasal airway surgery. Palpation of the nasal tip provides information on tip strength to the surgeon, though it is a purely subjective assessment. Providing a means to simulate nasal tip deformation with a validated model can offer a more objective approach in understanding the mechanics and nuances of the nasal tip support and eventual nasal mechanics as a whole. Herein we present validation of a finite element (FE) model of the nose using physical measurements recorded using an ABS plastic-silicone nasal phantom. Three-dimensional photogrammetry was used to capture the geometry of the phantom at rest and while under steady state load. The silicone used to make the phantom was mechanically tested and characterized using a linear elastic constitutive model. Surface point clouds of the silicone and FE model were compared for both the loaded and unloaded state. The average Hausdorff distance between actual measurements and FE simulations across the nose were 0.39 ± 1.04 mm and deviated up to 2 mm at the outermost boundaries of the model. FE simulation and measurements were in near complete agreement in the immediate vicinity of the nasal tip with millimeter accuracy. We have demonstrated validation of a two-component nasal FE model, which could be used to model more complex modes of deformation where direct measurement may be challenging. This is the first step in developing a nasal model to simulate nasal mechanics and ultimately the interaction between geometry and airflow.

  13. High Flow Nasal Cannulae in preterm infants

    F. Ciuffini


    Full Text Available Despite of improved survival of premature infants, the incidence of long term pulmonary complications, mostly associated with ventilation-induced lung injury, remains high. Non invasive ventilation (NIV is able to reduce the adverse effects of mechanical ventilation. Although nasal continuous positive airway pressure (NCPAP is an effective mode of NIV, traumatic nasal complications and intolerance of the nasal interface are common. Recently high flow nasal cannula (HFNC is emerging as an efficient, better tolerated form of NIV, allowing better access to the baby’s face, which may improve nursing, feeding and bonding. The aim of this review is to discuss the available evidence of effectiveness and safety of HFNC in preterm newborns with respiratory distress syndrome (RDS. It is known that distending pressure generated by HFNC increases with increasing flow rate and decreasing infant size and varies according to the amount of leaks by nose and mouth. The effects of HFNC on lung mechanics, its clinical efficacy and safety are still insufficiently investigated. In conclusion, there is a growing evidence of the feasibility of HFNC as an alternative mode of NIV. However, further larger randomized trials are required, before being able to recommend HFNC in the treatment of moderate respiratory distress of preterm infants.

  14. Nasal reconstruction with articulated irradiated rib cartilage

    Murakami, C.S.; Cook, T.A.; Guida, R.A. (Univ. of Washington School of Medicine, Seattle (USA))


    Nasal structural reconstruction is a formidable task in cases where there is loss of support to both the nasal dorsum and tip. A multitude of surgical approaches and materials have been used for the correction of the saddle-nose deformity with varying degrees of success. Articulated irradiated rib cartilage inserted through an external rhinoplasty approach was used to reconstruct nasal deformities in 18 patients over a 6-year period. Simultaneous use of a midline forehead flap to reconstruct the overlying soft tissue was required in four cases. Follow-up ranged from 1 to 6 years (mean, 2.8 years). Results were rewarding in most cases with marked improvement in nasal support and airway. Revision and/or replacement secondary to trauma or warping of the graft was required in four cases. None of the patients exhibited infection, extrusion, or noticeable resorption. A description of the surgical technique, review of all the cases, and recommendation for continued use of this graft material are discussed.

  15. Triclosan promotes Staphylococcus aureus nasal colonization.

    Syed, Adnan K; Ghosh, Sudeshna; Love, Nancy G; Boles, Blaise R


    The biocide triclosan is used in many personal care products, including toothpastes, soaps, clothing, and medical equipment. Consequently, it is present as a contaminant in the environment and has been detected in some human fluids, including serum, urine, and milk. Staphylococcus aureus is an opportunistic pathogen that colonizes the noses and throats of approximately 30% of the population. Colonization with S. aureus is known to be a risk factor for several types of infection. Here we demonstrate that triclosan is commonly found in the nasal secretions of healthy adults and the presence of triclosan trends positively with nasal colonization by S. aureus. We demonstrate that triclosan can promote the binding of S. aureus to host proteins such as collagen, fibronectin, and keratin, as well as inanimate surfaces such as plastic and glass. Lastly, triclosan-exposed rats are more susceptible to nasal colonization with S. aureus. These data reveal a novel factor that influences the ability of S. aureus to bind surfaces and alters S. aureus nasal colonization. IMPORTANCE Triclosan has been used as a biocide for over 40 years, but the broader effects that it has on the human microbiome have not been investigated. We demonstrate that triclosan is present in nasal secretions of a large portion of a test population and its presence correlates with Staphylococcus aureus nasal colonization. Triclosan also promotes the binding of S. aureus to human proteins and increases the susceptibility of rats to nasal colonization by S. aureus. These findings are significant because S. aureus colonization is a known risk factor for the development of several types of infections. Our data demonstrate the unintended consequences of unregulated triclosan use and contribute to the growing body of research demonstrating inadvertent effects of triclosan on the environment and human health.

  16. The relationship between nasal resistance to airflow and the airspace minimal cross-sectional area.

    Garcia, Guilherme J M; Hariri, Benjamin M; Patel, Ruchin G; Rhee, John S


    The relationship between nasal resistance (R) and airspace minimal cross-sectional area (mCSA) remains unclear. After the introduction of acoustic rhinometry, many otolaryngologists believed that mCSA measurements would correlate with subjective perception of nasal airway obstruction (NAO), and thus could provide an objective measure of nasal patency to guide therapy. However, multiple studies reported a low correlation between mCSA and subjective nasal patency, and between mCSA and R. This apparent lack of correlation between nasal form and function has been a long-standing enigma in the field of rhinology. Here we propose that nasal resistance is described by the Bernoulli Obstruction Theory. This theory predicts two flow regimes. For mCSA>Acrit, the constriction is not too severe and there is not a tight coupling between R and mCSA. In contrast, when mCSAfluid dynamics (CFD) simulations were run in 3-dimensional models based on computed tomography scans of 15 NAO patients pre- and post-surgery (i.e., 60 unilateral nasal cavities). Airspace cross-sectional areas were quantified perpendicular to airflow streamlines. Our computational results are consistent with the theory. Given that in most people mCSA>Acrit (estimated to be 0.37cm(2)), this theory suggests that airway constrictions are rarely an exclusive contributor to nasal resistance, which may explain the weak correlation between mCSA and subjective nasal patency.

  17. Numerical analysis for the efficacy of nasal surgery in obstructive sleep apnea hypopnea syndrome

    Yu, Shen; Liu, Ying-Xi; Sun, Xiu-Zhen; Su, Ying-Feng; Wang, Ying; Gai, Yin-Zhe


    In the present study, we reconstructed upper airway and soft palate models of 3 obstructive sleep apnea—hypopnea syndrome (OSAHS) patients with nasal obstruction. The airflow distribution and movement of the soft palate before and after surgery were described by a numerical simulation method. The curative effect of nasal surgery was evaluated for the three patients with OSAHS. The degree of nasal obstruction in the 3 patients was improved after surgery. For 2 patients with mild OSAHS, the upper airway resistance and soft palate displacement were reduced after surgery. These changes contributed to the mitigation of respiratory airflow limitation. For the patient with severe OSAHS, the upper airway resistance and soft palate displacement increased after surgery, which aggravated the airway obstruction. The efficacy of nasal surgery for patients with OSAHS is determined by the degree of improvement in nasal obstruction and whether the effects on the pharynx are beneficial. Numerical simulation results are consistent with the polysomnogram (PSG) test results, chief complaints, and clinical findings, and can indirectly reflect the degree of nasal patency and improvement of snoring symptoms, and further, provide a theoretical basis to solve relevant clinical problems. [Figure not available: see fulltext.

  18. Non-invasive airway health measurement using synchrotron x-ray microscopy of high refractive index glass microbeads

    Donnelley, Martin, E-mail:; Farrow, Nigel; Parsons, David [Respiratory & Sleep Medicine, Women’s and Children’s Hospital, North Adelaide, South Australia (Australia); Robinson Research Institute, University of Adelaide, South Australia (Australia); School of Paediatrics and Reproductive Health, University of Adelaide, South Australia (Australia); Morgan, Kaye; Siu, Karen [School of Physics, Monash University, Victoria (Australia)


    Cystic fibrosis (CF) is caused by a gene defect that compromises the ability of the mucociliary transit (MCT) system to clear the airways of debris and pathogens. To directly characterise airway health and the effects of treatments we have developed a synchrotron X-ray microscopy method that non-invasively measures the local rate and patterns of MCT behaviour. Although the nasal airways of CF mice exhibit the CF pathophysiology, there is evidence that nasal MCT is not altered in CF mice1. The aim of this experiment was to determine if our non-invasive local airway health assessment method could identify differences in nasal MCT rate between normal and CF mice, information that is potentially lost in bulk MCT measurements. Experiments were performed on the BL20XU beamline at the SPring-8 Synchrotron in Japan. Mice were anaesthetized, a small quantity of micron-sized marker particles were delivered to the nose, and images of the nasal airways were acquired for 15 minutes. The nasal airways were treated with hypertonic saline or mannitol to increase surface hydration and MCT. Custom software was used to locate and track particles and calculate individual and bulk MCT rates. No statistically significant differences in MCT rate were found between normal and CF mouse nasal airways or between treatments. However, we hope that the improved sensitivity provided by this technique will accelerate the ability to identify useful CF lung disease-modifying interventions in small animal models, and enhance the development and efficacy of proposed new therapies.

  19. Actual therapeutic management of allergic and hyperreactive nasal disorders

    Rudack, Claudia


    Full Text Available Allergic rhinitis (AR and hyperractive disorders of the upper airways, depending upon the type of releasing stimuli, are defined as nasal hyperreactivity, for example in the case of AR, or as non-specific nasal hyperreactivity and as idiopathic rhinitis (IR (synonyms frequently used in the past: non-specific nasal hyperreactivity; vasomotor rhinitis in the case of non-characterised stimuli.An early and professional therapy of allergic disorders of the upper airways is of immense importance as allergic rhinitis is detected in comorbidities such as asthma and rhino sinusitis. The therapeutic concept is influenced by new and further developments in pharmacological substance classes such as antihistamines and glucocorticosteroids. Specific immune therapy, the only causal therapy for AR, has been reviewed over the past few years in respect of the type and pattern of application. However, to date no firm recommendations on oral, sublingual and /or nasal immune therapy have yet been drawn up based on investigations of these modifications.Therapeutic management of IR is aimed at a symptom-oriented therapy of nasal hyperactivity as etiological factors relating to this form of rhinitis are not yet sufficiently known. Drug groups such as mast cell stabilizers, systemic and topic antihistamines, topic and systemic glucocorticosteroids, ipatroium bromide and alpha symphatomimetics belong to the spectrum of the therapeutics employed.

  20. Advanced airway management strategies for severe OSAS and craniofacial anomalies.

    Gungor, Anil

    Pediatric OSAS and craniofacial malformations present challenges that require innovative approaches and comprehensive treatment strategies. Synchronous airway lesions, craniofacial malformations, obstructive anomalies of the tongue base, nasal vault and choanae are commonly addressed by subspecialists from various clinical and surgical academic traditions who practice variable levels of required communication. This is not a mere social requirement but an important requisite for intelligent and effective airway management. Membership of dedicated airway, aero digestive or craniofacial teams are desirable but not required. I expect this clinical brief to help many brilliant clinicians in their pursuit of perfection. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Warm SPA-induced hyperthermia confers protection to rats against airway inflammation evoked by capsaicin and substance P.

    Fu, Yaw-Syan; Wang, Peng-Han; Liu, Shang-Pin; Huang, Wen-Hung; Huang, Hung-Tu


    Solus par aqua (SPA) is a traditional health care therapy. Warm SPA may enhance immunity and cellular defense to protect body against diseases. The present study investigated whether the warm SPA could confer protection to neurogenic inflammation in rats. The rats were immersed in water where the body core temperatures were maintained at hyperthermia (41.5 degrees C) or normothermia (37 degrees C) for a period of 15min. After SPA for 1 or 6 days, neurogenic inflammation was induced by intravenous injection of capsaicin (90microg/kg) or substance P (SP; 3microg/kg). The plasma leakage and arterial pressures in rats after neurogenic inflammation were monitored. The extent of capsaicin- or SP-induced plasma leakage and hypotension was significantly attenuated in rats on day 1 after SPA hyperthermia. However, such resistance to neurogenic inflammation was not found on day 6 after hyperthermia. Western blotting analysis showed that the expression of heat shock protein 72 (HSP 72) in the trachea on days 1 and 2 after hyperthermia was 9.61-fold and 6.66-fold, respectively, of that in normothermia. Afterwards, the hyperthermia-induced HSP 72 upregulation gradually declined in a time-dependent manner. Thus, SPA hyperthermia may protect rats against neurogenic inflammation through modulation of HSP expression.

  2. Nasal Mucociliary Clearance in Adenoid Hypertrophy and Otitis Media with Effusion.

    Yazıcı, Hasmet


    Mucociliary clearance (MCC), which exists in many systems, is the first defensive mechanism of the human body. Nasal MCC has an important role in transporting the secretions of the nasal cavity and paranasal sinuses along with the trapped inhaled pathogens to the nasopharynx. Physiologic or pathologic situations that effect nasal MCC, such as temperature, humidity, nasal obstruction, allergic rhinitis, chronic infections, etc., lead to impaired MCC and related local or circumjacent system disorders. With this perspective, when a unified airway with a multiple disease principle is considered, investigating the relationship between adenoid hypertrophy (AH), otitis media with effusion (OME) and nasal MCC is logical. In this review, histological and physiologic properties of nasal MCC and its possible role involving pathologic situations such as AH and OME is discussed together with recent literature findings.

  3. Airway management in cervical spine ankylosing spondylitis: Between a rock and a hard place

    Naveen Eipe


    Full Text Available We report the perioperative course of a patient with long standing ankylosing spondylitis with severe dysphagia due to large anterior cervical syndesmophytes at the level of the epiglottis. He was scheduled to undergo anterior cervical decompression and the surgical approach possibly precluded an elective pre-operative tracheostomy. We performed a modified awake fibreoptic nasal intubation through a split nasopharyngeal airway while adequate oxygenation was ensured through a modified nasal trumpet inserted in the other nares. We discuss the role of nasal intubations and the use of both the modified nasopharyngeal airways we used to facilitate tracheal intubation. This modified nasal fibreoptic intubation technique could find the application in other patients with cervical spine abnormalities and in other anticipated difficult airways.

  4. Stimulation of aquaporin-5 and transepithelial water permeability in human airway epithelium by hyperosmotic stress

    Pedersen, Peter Steen; Braunstein, Thomas Hartig; Jørgensen, Anders;


    Osmotic water permeability (P(f )) was measured in spheroid-shaped human nasal airway epithelial explants pre-exposed to increasing levels of hyperosmotic stress. The fluid-filled spheroids, derived from nasal polyps, were lined by a single cell layer with the ciliated apical cell membrane facing......-CF spheroids and were not significantly influenced by hyperosmotic stress. The results suggest that hyperosmotic stress is an important activator of AQP-5 in human airway epithelium, leading to significantly increased transepithelial water permeability.......Osmotic water permeability (P(f )) was measured in spheroid-shaped human nasal airway epithelial explants pre-exposed to increasing levels of hyperosmotic stress. The fluid-filled spheroids, derived from nasal polyps, were lined by a single cell layer with the ciliated apical cell membrane facing...

  5. Seasonal variations of nasal resistance in allergic rhinitis and environmental pollen counts. II: Efficacy of preseasonal therapy.

    Naito, K; Ishihara, M; Senoh, Y; Takeda, N; Yokoyama, N; Iwata, S


    We gave Mao-bushi-saishin-to, a Chinese blended medicine, and azelastine to an adult patient with hay fever due to Japanese cedar pollen and measured nasal resistance and ambient floating pollen counts throughout the time of Japanese cedar pollination in separated years. In the patient Mao-bushi-saishin-to was effective against preseasonal increases in nasal airway resistance but could not control severe episodes of allergic rhinitis caused by high dose exposure to Japanese cedar pollen and also perhaps caused by a priming effect. Azelastine inhibited both pre- and post-seasonal increases in nasal airway resistance but not only on high pollen counts days.

  6. Measurement of nasal resistance by rhinomanometry in 892 Japanese elementary school children.

    Kobayashi, Ryuichi; Miyazaki, Soichiro; Karaki, Masayuki; Kobayashi, Eiji; Karaki, Rie; Akiyama, Kosuke; Matsubara, Ai; Mori, Nozomu


    The normal value of nasal resistance in adults has been reported (0.25 Pa/cm³/s), but that in children has not. In this study, we measured nasal resistance in Japanese school children by employing rhinomanometry. An otolaryngologist examined 939 Japanese school children with regard to the presence or absence of nasal diseases and tonsil size. Nasal resistance was measured by rhinomanometry employing the active anterior method in 892 children. A questionnaire concerning the condition during sleep, such as the presence or absence of snoring and sleep apnea syndrome, was performed. The mean nasal resistance was 0.43 ± 0.50 Pa/cm³/s: 0.46 ± 0.65 and 0.39 ± 0.22 Pa/cm³/s in boys and girls, respectively. Of the 892 children, Grade 3 and 4 tonsil hypertrophy was noted in 84 (9%), but the presence of tonsil hypertrophy did not influence nasal resistance. Nasal diseases were noted in 335 children (38%) and the nasal condition was normal (the normal group) in 557 (62%). Nasal resistance was 0.56 ± 0.75 Pa/cm³/s in the nasal disease group and 0.36 ± 0.21 Pa/cm³/s in the normal group, showing that the resistance was significantly higher in the nasal disease group. The resistance tended to decrease as the school grade increased. In the normal group, 290 children (33%) experienced no problem regarding the upper airway, such as snoring and sleep apnea syndrome, based on a questionnaire, and nasal resistance was 0.35 ± 0.17 Pa/cm³/s. This normal nasal resistance value may be adopted for the objective evaluation of nasal obstruction and effects of treatment in pediatric nasal diseases. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  7. Nasal dermoid sinus cyst.

    Cauchois, R; Laccourreye, O; Bremond, D; Testud, R; Küffer, R; Monteil, J P


    Nasal dermoid sinus cyst is one of the diagnoses of midline nasal masses in children. This retrospective study analyzes the various theories regarding the origin of this congenital abnormality, the differential diagnosis, and the value of magnetic resonance imaging, as well as the various surgical options available.


    Verma, Sidharth; Mehta, Nitika; Mehta, Nandita; Mehta, Satish; Verma, Jayeeta


    We present a case of confusing white foreign body in the nasal cavity detected during Endoscopic Sinus Surgery (ESS) in a 35-yr-old male which turned out to be a malposition of classic laryngeal mask airway (LMA). Although malposition of LMA is a known entity to the anesthesiologist, if ventilation is adequate, back folded LMA in nasal cavity might not be recognized by the surgeon and lead to catastrophic consequences during endoscopic sinus surgery. In principle, misfolding and malpositioning can be reduced by pre usage testing, using appropriate sizes, minimizing cuff volume, and early identification and correction of malposition.

  9. Clinical Observation of Creatine Phosphate Sodium Combined with Nasal Continuous Positive Airway Pressure for the Treatment of Chronic Heart Failure with OSA%磷酸肌酸钠配合经鼻持续气道正压通气治疗慢性心衰伴OSA的临床观察



    Objective:To observe the clinical efficacy of Creatine Phosphate Sodium combined with nasal continuous positive airway pressure(n-CPAP) for the treatment of chronic heart failure with obstructive sleep apnea(OSA).Method:Eighty-six chronic heart failure patients with obstructive sleep apnea admitted to our hospital from May 2012 to May 2015 were selected as research objects,they were divided into the observation group and the control group according to the random number table method,43 cases in each group.The control group was given conventional drugs and nasal continuous positive airway pressure for treatment,the observation group was treated with Creatine Phosphate Sodium on the basis of the control group.The clinical effect,the cardiac function indexes and respiratory sleep parameters before and after treatment between the two groups were observed and compared.Result:After treatment,the total effective rate of the observation group was 88.4%,which was significantly higher than 48.8% of the control group,the difference was statistically significant(χ²=15.6020, P=0.0001).There were no statistically significant differences in the B type natriuretic peptide(BNP),left ventricular ejection fraction(LVEF) and polysomnogram parameters between the two groups before treatment (P>0.05).After treatment,the BNP level of the two groups were significantly lower than before treatment,the LVEF were significantly higher than before treatment,the respiratory sleep parameters were significantly better than before treatment,and the BNP level of the observation group was significantly lower than the control group, the LVEF was significantly higher than the control group,the longest apnea duration,average apnea duration, apnea hypopnea index(AHI) and lowest SaO2 were significantly better than the control group,the differences were statistically significant(P0.05)。两组治疗后BNP水平均明显低于治疗前,LVEF均明显高于治疗前,多导睡眠图参数均明显优

  10. [Recombination and identification of sense and antisence CyclinD1 eukaryotic expression vectors and the effects of the vectors on the proliferation of airway smooth muscle cell in asthmatic rats].

    Qiao, Li-Fen; Xu, Yong-Jian; Liu, Xian-Sheng; Xie, Jun-Gang; Du, Chun-Ling; Zhang, Jian; Ni, Wang; Chen, Shi-Xin


    This study is to investigate the expression of CyclinD1 in asthmatic rats and construct expression plasmids of sense and antisense CyclinD1 gene and transfect them to asthmatic airway smooth muscle cell to study the effects of CyclinD1 on the proliferation of airway smooth muscle cells in asthmatic rats. CyclinD1 cDNA was obtained by RT-PCR of total RNA extracted from the airway smooth muscle in asthmatic rats. The sequence was inserted into eukaryotic expression vector pcDNA3.1 (+) to recombinate the sense and antisense pcDNA3.1-CyclinD1 eukaryotic expression vector. The two recombinations and vector were then separately transfected into airway smooth muscle cell in asthmatic rats by using liposome. The expression level of CyclinD1 was certificated by Western blotting analysis. The proliferations of ASMCs isolated from asthmatic rats were examined with cell cycle analysis, MTT colorimetric assay and proliferating cell nuclear antigen (PCNA) immunocytochemical staining. Results showed (1) Compared with control group, the content of CyclinD1 was significantly increased; (2) It was comformed by restriction endonucleasa digestion and DNA sequence analysis that the expression plasmid of sense and antisense CyclinD1 were successfully recombinated. There was significant change of CyclinD1 expression between vector and sense CyclinD1 transfected cells, and the expression level of CyclinD1 in ASMC transfected with antisense CyclinD1 was lower than that in vector transfected cells (P <0.01); (3) In the asthmatic groups, compared with the vecter group, the percentage of S + G2M phase, absorbance A value of MTT and the expression rate of PCNA protein in ASMC transfected with pcDNA3. 1-CyclinD1 vector significantly increased. The values decreased remarkably in the pcDNA3,1-as CyclinD1 group. Statistical analysis revealed that there were significant differences in these indicators of cell proliferation in three groups (P <0.01). In the normal groups, statistical analysis


    Miesje Karmiati Purwanegara


    Full Text Available The influenced of respiration to dentocraniofacial growth and development is still controversial. The accurate radiologic examination is important factor for proper diagnosis. Deviation of upper airway (i.e. nasopharynx, oropharymx and nasal cavity could be evaluated by lateral and anteroposterior cephalometric projection technique. This paper explains several methods to evaluate upper respiratory tract by lateral radiograph.

  12. Comparison of surgical procedures for vascular and airway anastomoses that utilize a modified non-suture external cuff technique for experimental lung transplantation in rats.

    Mizobuchi, Teruaki; Sekine, Yasuo; Yasufuku, Kazuhiro; Fujisawa, Takehiko; Wilkes, David S


    Lung transplantation in rats is technically difficult and results may vary. The non-suture cuff technique (non-suture [NS]), which involves using a cuff for anastomoses of vessels and airways, is commonly utilized to perform transplant procedures. However, the standard bronchial cuff may occlude the lumen, resulting in diminished graft survival. In contrast, the non-suture cuff technique for vascular anastomoses with bronchial suturing (bronchial suture [BS]), although more technically difficult, is known to have prolonged bronchial patency. We developed a "modified" NS technique that uses a larger and longer cuff for anastomoses and compared the efficacy of this procedure to the BS technique for lung transplantation. The BS procedure was performed in 146 transplant procedures. The modified NS procedure, which uses a larger cuff than the standard NS procedure, was performed in 113 procedures. Although total ischemic times were comparable, the total operation time in the NS group was significantly shorter than in the BS group (p technique is widely acknowledged to provide prolonged patency of bronchial anastomosis, graft survival in the NS group was observed up 17 months post-transplant. These data show that the NS technique, which is less technically difficult, results in shorter operative times compared with the BS procedure, and results in durable anastomoses of lung grafts.

  13. Insulin self-association: effects on lung disposition kinetics in the airways of the isolated perfused rat lung (IPRL).

    Pang, Yinuo; Sakagami, Masahiro; Byron, Peter R


    To characterize the kinetic dependence of pulmonary absorption and metabolism of insulin and lispro on the magnitude of their hexameric association. Hexamer content by weight percent (%Hex) in various insulin-zinc and lispro-zinc solutions were determined by quantitative centrifugal ultrafiltration and zinc titration with terpyridine (QCUF-ZTT). Each of the solutions (0.1 ml) was then administered into the airways of the IPRL of normal and experimental diabetic animals. Rate constants were determined for lung absorption (k (a)) and non-absorptive loss (k (nal); comprising mucociliary clearance and metabolism). %Hex in administered solutions ranged from 3.3 to 94.4%. Data analysis showed excellent correlations between the values for k (a) or k (nal) and %Hex, irrespective of insulin type, concentration, solution pH or ionic strength. The values for k (a) decreased (0.22 --> 0.05 h(-1)) with increasing %Hex, as did values for k (nal). At %Hex in administered solutions >/=50%, values for k (nal) approached estimates for the rate constant for mucociliary clearance, implying that lung metabolism occurred primarily with monomeric insulin. There were no differences in insulin disposition kinetics between lungs taken from experimental diabetic and sham-control animals. The kinetics of pulmonary insulin disposition depended on the magnitude of molecular self-association. Dissociated forms of insulin (dimers or monomers) in the dosing solution showed higher rates than hexamers for both lung absorption and metabolism.

  14. Upper airway resistance syndrome.

    Montserrat, J M; Badia, J R


    This article reviews the clinical picture, diagnosis and management of the upper airway resistance syndrome (UARS). Presently, there is not enough data on key points like the frequency of UARS and the morbidity associated with this condition. Furthermore, the existence of LIARS as an independent sleep disorder and its relation with snoring and obstructive events is in debate. The diagnosis of UARS is still a controversial issue. The technical limitations of the classic approach to monitor airflow with thermistors and inductance plethysmography, as well as the lack of a precise definition of hypopnea, may have led to a misinterpretation of UARS as an independent diagnosis from the sleep apnea/hypopnea syndrome. The diagnosis of this syndrome can be missed using a conventional polysomnographic setting unless appropriate techniques are applied. The use of an esophageal balloon to monitor inspiratory effort is currently the gold standard. However, other sensitive methods such as the use of a pneumotachograph and, more recently, nasal cannula/pressure transducer systems or on-line monitoring of respiratory impedance with the forced oscillation technique may provide other interesting possibilities. Recognition and characterization of this subgroup of patients within sleep breathing disorders is important because they are symptomatic and may benefit from treatment. Management options to treat UARS comprise all those currently available for sleep apnea/hypopnea syndrome (SAHS). However, the subset of patients classically identified as LIARS that exhibit skeletal craneo-facial abnormalities might possibly obtain further benefit from maxillofacial surgery.

  15. Demonstration of carboxylesterase in cytology samples of human nasal respiratory epithelium

    Rodgers, D.A.; Nikula, K.J.; Avila, K. [and others


    The epithelial lining of the nasal airways is a target for responses induced by a variety of toxicant exposures. The high metabolic capacity of this tissue has been suggested to play a role in both protection of the airways through detoxication of certain toxicants, as well as in activation of other compounds to more toxic metabolites. Specifically, nasal carboxylesterase (CE) has been shown to mediate the toxicity of inhaled esters and acrylates by converting them to more toxic acid and alcohol metabolites which can be cytotoxic and/or carcinogenic to the nasal mucosa. Due to difficulties in extrapolating rodent models to human, new paradigms using human cells and tissues are essential to understanding and evaluating the metabolic processes in human nasal epithelium.

  16. A Rare Nasal Bone Fracture: Anterior Nasal Spine Fracture

    Egemen Kucuk


    Full Text Available Anterior nasal spine fractures are a quite rare type of nasal bone fractures. Associated cervical spine injuries are more dangerous than the nasal bone fracture. A case of the anterior nasal spine fracture, in a 18-year-old male was presented. Fracture of the anterior nasal spine, should be considered in the differential diagnosis of the midface injuries and also accompanying cervical spine injury should not be ignored.




    Full Text Available Rhinosleroma is a chronic destructive bacterial infection of the nose and upper respiratory airways, caused by klebsiella rhinoscleromatis. We report a case of 22 years old male, who presented with symptoms of nasal obstruction, both sides due to bilateral nasal masse s of 1 year duration. Patient underwent all the necessary investigation, including biopsy. Biopsy revealed the histological diagnosis of rhinoscleroma. Medical management was given to the patient, which is adequate to effectively cure the patient, unless r ecurrence occurs.

  18. The potential effect of the angiotensin II receptor blocker telmisartan in regulating OVA-induced airway remodeling in experimental rats.

    Abdel-Fattah, Maha M; Salama, Abeer A A; Shehata, Basim A; Ismaiel, Ismaiel E


    Bronchial asthma is a true ascending clinical problem. Angiotensin II is now accused to be potentially implicated in its pathogenesis, being a potent pro-inflammatory mediator with remodeling effects. This study aims to evaluate the possible protective effect of telmisartan, an angiotensin II receptor blocker, on experimentally-induced bronchial asthma. Animals were divided into 5 groups; a normal control group, an asthma control group, a reference treatment group, receiving dexamethasone, and two treatment groups, receiving telmisartan in two dose levels. Bronchial asthma was induced by intraperitoneal sensitization followed by intranasal challenge with ovalbumin (OVA). Test agents were administered prior to each intranasal OVA challenge. Lung function tests, namely tidal volume (TV) and peak expiratory flow rate (PEF) were assessed 1h after the last challenge. One day after the last challenge, absolute eosinophil counts (AEC) in blood and bronchoalveolar lavage fluids (BALF) were assessed. Serum immunoglobulin E (IgE) as well as BALF total nitrate/nitrite (NOx) were assessed. Oxidative and inflammatory biomarkers, namely lung tissue superoxide dismutase (SOD), glutathione reduced (GSH), tumor necrosis factor-alpha (TNF-α) and interleukin-5 (IL-5), were also assessed, in addition to histopathological study. Telmisartan administration in both doses significantly improved TV, PEF, AEC, IgE, NOx, GSH, SOD, TNF-α and IL-5 values compared to asthma control values. Histopathological study strongly supported the results of biochemical estimations, particularly regarding airway remodeling. These results suggest that telmisartan may have potential protecting effects against experimental bronchial asthma, probably due to its bronchodilator, antioxidant and anti-inflammatory effects. Copyright © 2015 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  19. Treatment of rhinitis sicca anterior with ectoine containing nasal spray.

    Sonnemann, Uwe; Scherner, Olaf; Werkhäuser, Nina


    Objectives. The safety and efficacy of ectoine nasal spray and ectoine nasal spray with dexpanthenol in the treatment of rhinitis sicca were evaluated in two studies. Design and Methods. Two noninterventional observational studies were performed to evaluate the efficacy and safety of a nasal spray containing ectoine (study 1) and ectoine/dexpanthenol (study 2) over a period of two weeks including comparable numbers of patients suffering from rhinitis sicca anterior. Patients and physicians were asked to rate the efficacy in reducing symptoms and the tolerability over the treatment phase. Results. The treatment in both studies resulted in a clinical and statistical significant reduction of the main diagnosis parameters, nasal airway obstruction, and crust formation. There was also a significant reduction in the secondary diagnosis parameters in both studies. Importantly, the tolerability was very good. During the whole observational study, neither patients nor doctors stopped the medication due to unwanted effects. Conclusion. Rhinitis sicca could be successfully treated with a nasal spray containing ectoine and a nasal spray combining ectoine with dexpanthenol. The combination of both substances led to slight advantages.

  20. Treatment of Rhinitis Sicca Anterior with Ectoine Containing Nasal Spray

    Uwe Sonnemann


    Full Text Available Objectives. The safety and efficacy of ectoine nasal spray and ectoine nasal spray with dexpanthenol in the treatment of rhinitis sicca were evaluated in two studies. Design and Methods. Two noninterventional observational studies were performed to evaluate the efficacy and safety of a nasal spray containing ectoine (study 1 and ectoine/dexpanthenol (study 2 over a period of two weeks including comparable numbers of patients suffering from rhinitis sicca anterior. Patients and physicians were asked to rate the efficacy in reducing symptoms and the tolerability over the treatment phase. Results. The treatment in both studies resulted in a clinical and statistical significant reduction of the main diagnosis parameters, nasal airway obstruction, and crust formation. There was also a significant reduction in the secondary diagnosis parameters in both studies. Importantly, the tolerability was very good. During the whole observational study, neither patients nor doctors stopped the medication due to unwanted effects. Conclusion. Rhinitis sicca could be successfully treated with a nasal spray containing ectoine and a nasal spray combining ectoine with dexpanthenol. The combination of both substances led to slight advantages.


    Ramachandra Prabhu


    Full Text Available INTRODUCTION: Asthma is an inflammatory, reversible and progressive disease with episodes of exacerbations. Asthma is now considered as single airway disease and hence comprehensive diagnosis, treatment and follow-up of upper and lower respiratory tract is essential. Both the Nasal and Bronchial mucosa are the elements of united airway disease and Eosinophils measured from this mucosa can be an indirect marker of Airway inflammation in asthma. Eosinophil infiltration is hallmark feature of pathogenesis of asthma which is the trigger for the chronic airway inflammation and these are raised in acute exacerbations. Hence assessing Eosinophil is evidence of serological marker for Airway inflammation (AI. Nasal Smear Eosinophils (NSE is used in asthma with Allergic Rhinitis (AR. This study Using Definition of GINA explores the utility of NSE as marker for management of Asthma. METHODS: In this study 100 patients diagnosed with bronchial asthma attending the outpatient department in KIMS were studied. The severity of asthma was assessed as per FEV1 classification- Adapted from 2007 NHLBI Guidelines for the diagnosis and treatment of Asthma Expert panel Report 3. The Statistical analysis was done with SAS 9.2, SPSS 15.0, Stata 10.1, Med Calc 9.0.1, Systat 12.0 and R environment RESULTS: Asthma was more common in Females in this study with M: F ratio of 1.04 and Allergic Rhinitis was found in 55% of Asthmatics. Nasal Eosinophilia was seen in 44% in asthmatic group and 49% in Asthma with Allergic Rhinitis. Absolute Eosinophil count (AEC and Differential count (DC for Eosinophils was almost same in both groups. The Sensitivity of NSE with respect to DC is 70% and in AR group with Asthma and in Asthma group with/without AR it was 38%. Similarly the NSE with respect to AEC was 47% in AR group with Asthma whereas in Asthma group with/without AR it was 38%. CONCLUSIONS: The finding confirms that symptoms, Variable airflow Obstruction and

  2. [Nasal obstruction and mouth breathing: the ENT's point of view].

    Leboulanger, Nicolas


    Obstructive diseases of children's upper airways are frequent, mostly caused by tonsils and adenoids hypertrophy. A nasal septum deviation or a lower turbinate hypertrophy may also cause a significant obstruction. Tonsillectomy and adenoidectomy must be performed in case of clinical obstruction, sometimes documented by a sleep study. A tonsils' hypertrophy without significant obstruction and clinical symptoms is not an indication of adenotonsillectomy, even in case of snoring or if an orthodontic treatment is planned.

  3. Phase contrast X-ray imaging for the non-invasive detection of airway surfaces and lumen characteristics in mouse models of airway disease

    Siu, K.K.W. [School of Physics, Monash University, Victoria 3800 (Australia); Monash Centre for Synchrotron Science, Monash University, Victoria 3800 (Australia)], E-mail:; Morgan, K.S.; Paganin, D.M. [School of Physics, Monash University, Victoria 3800 (Australia); Boucher, R. [CF Research and Treatment Center, University of North Carolina at Chapel Hill (United States); Uesugi, K.; Yagi, N. [SPring-8/JASRI, Hyogo 679-5198 (Japan); Parsons, D.W. [Department of Pulmonary Medicine, Women' s and Children' s Hospital, South Australia 5006 (Australia); Department of Paediatrics, University of Adelaide, South Australia, 5006 (Australia); Women' s and Children' s Health Research Institute, South Australia, 5006 (Australia)


    We seek to establish non-invasive imaging able to detect and measure aspects of the biology and physiology of surface fluids present on airways, in order to develop novel outcome measures able to validate the success of proposed genetic or pharmaceutical therapies for cystic fibrosis (CF) airway disease. Reduction of the thin airway surface liquid (ASL) is thought to be a central pathophysiological process in CF, causing reduced mucociliary clearance that supports ongoing infection and destruction of lung and airways. Current outcome measures in animal models, or humans, are insensitive to the small changes in ASL depth that ought to accompany successful airway therapies. Using phase contrast X-ray imaging (PCXI), we have directly examined the airway surfaces in the nasal airways and tracheas of anaesthetised mice, currently to a resolution of {approx}2 {mu}m. We have also achieved high resolution three-dimensional (3D) imaging of the small airways in mice using phase-contrast enhanced computed tomography (PC-CT) to elucidate the structure-function relationships produced by airway disease. As the resolution of these techniques improves they may permit non-invasive monitoring of changes in ASL depth with therapeutic intervention, and the use of 3D airway and imaging in monitoring of lung health and disease. Phase contrast imaging of airway surfaces has promise for diagnostic and monitoring options in animal models of CF, and the potential for future human airway imaging methodologies is also apparent.

  4. Association of Nasal Nostril Stenosis with Bilateral Choanal Atresia: A Case Report

    Shahin Abdollahifakhim


    Full Text Available Introduction: Neonatal nasal airway obstruction induces various degrees of respiratory distress. The management of this disease, including surgical repair, will depend on the severity and location of the obstruction. We describe here a case of congenital nasal nostril stenosis that required surgical repair for stenting of both nares after coanal atresia repair.   Case Report: A 2 days old female newborn referred to neonatal department of Tabriz Children’s Hospital affiliated to the University of Medical Sciences of Tabriz, Iran on the 3rd of December, 2011 immediately after birth with respiratory distress due to bilateral coanal atresia and nasal hypoplasia with very small nostrils. CT scan showed normal brain and bilateral choanal atresia with normal size Pyriform apertures.   Conclusion: Nasal obstruction can lead to airway compromise and respiratory distress. Congenital bony nasal deformities are being recognized as an important cause of newborn airway obstruction. Nasal hypoplasia is seen in many craniofacial syndromes. Although our patient had hypoplastic nostrils with respiratory distress due to bilateral coanal atresia, correction of hypoplastic nostrils was necessary for completing the operation of choanal atresia.

  5. Bacterial Nasal Infections

    ... vestibule. Nasal furuncles may develop into a spreading infection under the skin (cellulitis) at the tip of the nose. A doctor becomes concerned about infections in this part of the face because veins ...

  6. Zolmitriptan Nasal Spray

    ... a copy of the manufacturer's information for the patient.To use the nasal spray, follow these steps: ... used to treat certain types of migraine headaches (hemiplegic or basilar) or other types of headaches (such ...

  7. Nasal packing and stenting

    Weber, Rainer K.


    Full Text Available Nasal packs are indispensable in ENT practice. This study reviews current indications, effectiveness and risks of nasal packs and stents. In endoscopic surgery, nasal packs should always have smooth surfaces to minimize mucosal damage, improve wound healing and increase patient comfort. Functional endoscopic endonasal sinus surgery allows the use of modern nasal packs, since pressure is no longer required. So called hemostatic/resorbable materials are a first step in this direction. However, they may lead to adhesions and foreign body reactions in mucosal membranes. Simple occlusion is an effective method for creating a moist milieu for improved wound healing and avoiding dryness. Stenting of the frontal sinus is recommended if surgery fails to produce a wide, physiologically shaped drainage path that is sufficiently covered by intact tissue.

  8. Budesonide Nasal Spray

    ... ingredients in budesonide nasal spray. Check the package label for a list of the ingredients.tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or ...

  9. Fluticasone Nasal Spray

    ... ingredients in fluticasone nasal spray. Check the package label for a list of the ingredients.tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking, or ...

  10. 不同剂量脑醒喷鼻剂对再灌注损伤脑组织自由基及一氧化氮合酶变化的干预%Changes of free radicals and nitric oxide synthase in rat brain following ischemia-reperfusion injury due to different dosage brain-awakening nasal sprayer intervention

    李荣; 吴伟; 陈宏珪; 黄衍寿; 刘煜德; 杨开清


    BACKGROUND: Brain-awakening nasal sprayer is composed of many herbs,such as Chuanxiong and Shichangpu, which were regarded by "Shennong Bencaojing" as having the function of "preventing stroke in the brain".OBJECTIVE: To observe the changes of free radicals and nitric oxide synthase in rat brain following focal ischemic-reperfusional injury due to brain-awakening nasal sprayer intervention and compare with that due to classical nimodipine.DESIGN: A randomized controlled study.SETTING: Department of internal medicine of a hospital affiliated to a traditional Chinese medical university.MATERIALS: Seventy adult male Wistar rats of clean grade, were randomly divided into seven groups: brain-awakening nasal sprayer of higher dosage group, moderate dosage group, lower dosage group, nimodipine intraperitoneal injection group, physical saline nasal sprayer group, menstruum nasal sprayer group, and sham operation group with 10 rats in each.METHODS: Focal brain ischemia-reperfusion model was established by blocking the left cerebral middle artery in rats of all the groups except sham operation group. Three days before model establishment and during reperfusion, rats were given different dosages of brain-awakening nasal sprayer composed of Chuanxiongqin and Shichangpu of 5.4, 2.7, 1.08 mg/(kg · d) and 1.35, 0. 54, 0.27 g/(kg· d), respectively, three times a day; which was replaced by physical saline and menstruum nasal sprayer of 0. 18 mL/ (kg · d),three times a day in physical saline nasal sprayer group and menstruum nasal sprayer group; rats in nimodipine intraperitoneal injection group received intraperitoneal injection of nimodipine by 0. 8 mg/(kg · d) twice a day. Rats in sham operation group were routinely raised. The content of prodialdehyde, superoxide dismutase and nitric oxide synthase were measured with colorimetric method.MAIN OUTCOME MEASURES: ① The changes of prodialdehyde content, superoxide dismutase and nitric oxide synthase activity in rat brain

  11. The Healthy Infant Nasal Transcriptome: A Benchmark Study

    Chu, Chin-Yi; Qiu, Xing; Wang, Lu; Bhattacharya, Soumyaroop; Lofthus, Gerry; Corbett, Anthony; Holden-Wiltse, Jeanne; Grier, Alex; Tesini, Brenda; Gill, Steven R.; Falsey, Ann R.; Caserta, Mary T.; Walsh, Edward E.; Mariani, Thomas J.


    Responses by resident cells are likely to play a key role in determining the severity of respiratory disease. However, sampling of the airways poses a significant challenge, particularly in infants and children. Here, we report a reliable method for obtaining nasal epithelial cell RNA from infants for genome-wide transcriptomic analysis, and describe baseline expression characteristics in an asymptomatic cohort. Nasal epithelial cells were collected by brushing of the inferior turbinates, and gene expression was interrogated by RNA-seq analysis. Reliable recovery of RNA occurred in the absence of adverse events. We observed high expression of epithelial cell markers and similarity to the transcriptome for intrapulmonary airway epithelial cells. We identified genes displaying low and high expression variability, both inherently, and in response to environmental exposures. The greatest gene expression differences in this asymptomatic cohort were associated with the presence of known pathogenic viruses and/or bacteria. Robust bacteria-associated gene expression patterns were significantly associated with the presence of Moraxella. In summary, we have developed a reliable method for interrogating the infant airway transcriptome by sampling the nasal epithelium. Our data demonstrates both the fidelity and feasibility of our methodology, and describes normal gene expression and variation within a healthy infant cohort. PMID:27658638

  12. Nasal gouty tophus: Report a rare case presenting as a nasal hump with nasal obstruction

    John Chung-Han Wu


    Full Text Available Dorsal nasal gouty tophus are rare occurrences with limited documentation. Here we report a male patient who has a history of poorly controlled gouty arthritis. He had nasal obstruction with an enlarging mass over his left nasal ridge for the past three years. Image studies revealed a nasal bone defect underneath the nasal lesion. The firm mass was excised and confirmed to be of gouty origin. The nasal bone defect was repaired with a titanium mesh plate to prevent nasal depression. He has fully recovered with no more nasal obstruction or recurrence of nasal tophus. The case report illustrates a common illness, gout, with a rare clinical manifestation leading to a common symptom, nasal obstruction. It demonstrates the importance of a detailed history, a thorough physical examination and most important of all, an extensive differential diagnosis in our clinical practice.

  13. Pathophysiology of nasal congestion

    Robert M Naclerio


    Full Text Available Robert M Naclerio1, Claus Bachert2, James N Baraniuk31University of Chicago, Department of Surgery, Section of Otolaryngology – Head and Neck Surgery, Chicago, Illinois, USA; 2University of Ghent, Ghent, Belgium; 3Georgetown University, Washington, DC, USAAbstract: Nasal congestion is a common symptom in rhinitis (both allergic and nonallergic, rhinosinusitis and nasal polyposis. Congestion can also be caused by physical obstruction of nasal passages and/or modulation of sensory perception. Mucosal inflammation underlies many of the specific and interrelated factors that contribute to nasal congestion, as well as other symptoms of both allergic rhinitis and rhinosinusitis. A wide range of biologically active agents (eg, histamine, tumor necrosis factor-α, interleukins, cell adhesion molecules and cell types contribute to inflammation, which can manifest as venous engorgement, increased nasal secretions and tissue swelling/edema, ultimately leading to impaired airflow and the sensation of nasal congestion. Inflammation-induced changes in the properties of sensory afferents (eg, expression of peptides and receptors that innervate the nose can also contribute to altered sensory perception, which may result in a subjective feeling of congestion. Increased understanding of the mechanisms underlying inflammation can facilitate improved treatment selection and the development of new therapies for congestion.Keywords: allergic rhinitis, congestion, obstruction, pathophysiology, rhinosinusitis

  14. 鼻塞持续气道正压通气治疗新生儿呼吸窘迫综合征的临床应用%Clinical application of nasal continuous positive airway pressure in the treatment of neonatal respiratory distress syndrome

    卓平辉; 杨钊; 熊英


    目的 观察鼻塞持续气道正压通气( NCPAP)治疗新生儿呼吸窘迫综合征(NRDS)的疗效.方法 对2008年8月~2011年6月本院新生儿重症监护病房收治的60例NRDS进行回顾性分析.观察患儿的临床症状及血气指标在治疗前后的变化.结果 60例患儿中,54例患儿CPAP治疗呼吸困难及低氧血症明显改善,与治疗前比较,差异有统计学意义(P<0.05);血气分析pH、PaCO2、PaO2值治疗前后比较,差异有统计学意义(P<0.05).6例CPAP治疗无效转为肺表面物质活性+机械通气.结论 早期运用NCPAP可有效的治疗新生儿NRDS,并可减少患儿对机械通气的需要.%Objective To explore the curative effects of nasal continuous positive airway pressure (NCPAP) ventilation on newborn respiratory distress syndrome (NRDS). Methods Medical records of 60 hospitalized newborns were reviewed. The clinical effects and the blood gas were detected. The results were compared with before and after the treatment with NCPAP. Results The dyspnea and hypoxemia in 54 cases of them has been much improved, the difference was statistically significant (P<0. 05); The blood samples PaO2 and pH was increasing while the PaCO2 was decreasing. The difference was statistically significant(P<0. 05) t 6 cases of them were treated with NCPAP had no improvement, but needed the pulmonary surfactant and mechanical ventilation. Conclusion Early NCPAP is significantly effective in treatment with neonatal respiratory distress syndrome and reduce the rate of using traumatic mechanical ventilation.

  15. Effects of nasal-continuous positive airway pressure on patients with obstructive sleep apnea apnea-hypopnea syndrome combined with depression and anxiety emotions%经鼻持续正压通气治疗对合并抑郁焦虑情绪的阻塞性呼吸睡眠暂停综合征患者的影响

    牛丹丹; 王亮


    Objective:To explore effects of nasal-continuous positive airway pressure ( CPAP ) on patients with obstructive sleep apnea apnea-hypopnea syndrome ( OSAHS) combined with depression and anxiety emotions. Methods:56 patients with moder-ate and severe OSAHS with mood disorders were randomly divided into CPAP treatment group and conventional treatment group. The patients were evaluated with HAD test three and six months after the treatment, and the two groups were compared. Results:For CPAP treatment group, the mood disorders were not improved three months after the treatment for the patients with OSAHS (P>0. 05);how-ever, they were significantly improved six months after the treatment (P0. 05). Conclusions:The state of mood could be improved by effective long-term CPAP therapy for OSAS patients with mood disorders.%目的::探讨经鼻持续正压通气( CPAP)治疗对合并情绪障碍的阻塞性呼吸睡眠暂停综合征( OSAHS)患者的影响。方法:选取中重度OSAHS合并情绪障碍患者56例,随机分为CPAP治疗组及常规治疗组,在治疗3月及6月后进行医院焦虑抑郁情绪测量表( HAD量表)评测,比较两组患者之间HAD评分情况。结果:使用CPAP治疗3月后OSAHS患者情绪障碍无明显改善(P>0.05),6月后有明显改善(P0.05)。结论:对临床上OSAHS合并情绪障碍的患者,经过较长时间CAPA治疗后,其情绪障碍可以得到有效改善。

  16. Nasal continuous positive airway pressure in the treatment of obstructive sleep apnea/hypopnea syndrome with coronary heart disease%经鼻持续气道正压通气治疗睡眠呼吸暂停低通气综合征合并冠心病临床研究

    赵军; 郝芙蓉; 汪贺媛; 魏小刚


    目的 探讨经鼻持续气道正压通气(nCPAP)治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并冠心病的疗效和机制.方法 选择OSAHS合并冠心病患者126例,随机分为2组,观察组在原药物治疗基础上加用nCPAP治疗,对照组继续原药物治疗3个月,观察动态心电图变化,单纯药物及药物联合nCPAP治疗效果.结果 2组比较,夜间心肌缺血发生率明显下降(55.6%和6.35%,P<0.05).结论 nCPAP治疗可以消除呼吸暂停,纠正低氧血症,降低夜间平均心率和平均收缩压,降低心肌缺血发生率,从而降低心血管终点事件发生率.%Objective To observe the effect and mechanism of nasal continuous positive airway pressure(nCPAP)in the treatment of obstructive sleep apnea/hypopnea syndrome(OSAHS)with coronary heart disease.Methods 126 OSAHS patients with coronary heart disease were randomly divided into two groups.The treatment group was treated by nCPAP on the basis of former medicine but the control group was treated by former methods.Three months later,polysomnography(PSG)and the holter ECG examination were conducted.Results After three months,the nocturnal myocardial ischemia episodes decreased significantly in both groups(55.6%and 6.35%,P<0.01).Conclusion nCPAP may abolish sleep apnea and hypopnea,correct hypoxemia,reduce the nocturnal mean heart rate and systolic blood pressure,and improve myocardial ischemia episodes,so to reduce the incidence of cardiac end-point events.

  17. Gender, Weight, and Age Effects on Prevalence of Caudal Aberrant Nasal Turbinates in Clinically Healthy English Bulldogs : A Computed Tomographic Study and Classification

    Vilaplana Grosso, Federico; Haar, Gert Ter; Boroffka, Susanne A E B


    English Bulldogs have been reported to demonstrate abnormal growth and development of the nasal turbinates, which contribute to an increase in airway resistance and hence clinical signs of brachycephalic airway syndrome. The purpose of this prospective, cross-sectional study was to assess the preval

  18. Nasal septum extramedullary plasmacytoma

    Belić Branislav


    Full Text Available Introduction. Plasmacytomas are malignant tumors characterized by abnormal monoclonal proliferation of plasma cells. They originate in either bone - solitary osseous plasmacytoma, or in soft tissue - extramedullary plasmacytoma (EMP. EMP represents less than 1% of all head and neck malignancies. Case report. We presented a case of EMP of the nasal septum in a 44-year-old male who had progressive difficulty in breathing through the nose and frequent heavy epistaxis on the right side. Nasal endoscopy showed dark red, soft, polypoid tumor in the last third of the right nasal cavity arising from the nasal septum. The biopsy showed that it was plasmacytoma. Bence Jones protein in the urine, serum electrophoresis, bone marrow biopsy, skeletal survey and other screening tests failed to detect multiple myeloma. This confirmed the diagnosis of EMP. The mass was completely removed via an endoscopic approach, and then, 4 week later, radiotherapy was conducted with a radiation dose of 50 Gray. No recurrence was noted in a 3-year follow- up period. Conclusion. EMP of the nasal cavity, being rare and having long natural history, represents a diagnostic and therapeutic challenge for any ear, nose and throat surgeon. Depending on the resectability of the lesion, a combined therapy is the accepted treatment.

  19. Association between cigarette smoking and interleukin-17A expression in nasal tissues of patients with chronic rhinosinusitis and asthma

    Huang, Chien-Chia; Wang, Chun-Hua; Fu, Chia-Hsiang; Huang, Chi-Che; Chang, Po-Hung; Chen, Yi-Wei; Wu, Chia-Chen; Wu, Pei-Wen; Lee, Ta-Jen


    Abstract Cigarette smoke plays a substantial role in the development of airway inflammatory diseases, including asthma and chronic rhinosinusitis (CRS). Interleukin (IL)-17A might contribute to cigarette smoke-related inflammation of the airway. This study aimed to investigate the association between cigarette smoking and IL-17A expression in the nasal tissues of patients with CRS and asthma. We prospectively recruited 24 patients (13 smokers, 11 nonsmokers) with CRS and asthma and 6 patients with asthma but without CRS (control group) in a tertiary medical center. Nasal mucosa was obtained as part of the nasal surgery. Protein and mRNA levels of IL-17A in the nasal tissues were determined by immunostaining and real-time polymerase chain reaction. The number of unexpected emergency clinic visits for acute asthma attacks were higher among smokers than among nonsmokers. Interleukin-17A protein and mRNA levels in the nasal tissues of smokers were greater compared to those in the nasal tissues of nonsmokers (P = 0.02 both) and control patients (P = 0.05 and 0.04, respectively). Cigarette smoking was associated with an increase in the number of unexpected emergency clinic visits due to acute asthma attack and in the expression of IL-17A in the nasal tissues of patients with airway inflammatory diseases. PMID:27893686

  20. Selective response of human airway epithelia to luminal but not serosal solution hypertonicity. Possible role for proximal airway epithelia as an osmolality transducer

    Willumsen, Niels J.; Davis, C.W.; Boucher, R.C.


    exposure (10 min) to 430 mosM luminal solution elicited no regulation of any parameter. Optical measurements revealed a reduction in the thickness of preparations only in response to luminal hypertonic solutions. We conclude that (a) airway epithelial cells exhibit asymmetric water transport properties......- secretion; and (d) cell volume loss increases the resistance of the paracellular path. We speculate that these properties configure human nasal epithelium to behave as an osmotic sensor, transducing information about luminal solutions to the airway wall....

  1. Airway distensibility in Chronic Obstructive Airway Disease

    Winkler Wille, Mathilde Marie; Pedersen, Jesper Holst; Dirksen, Asger


    Rationale – Chronic Obstructive Pulmonary Disease (COPD) is a combination of chronic bronchitis and emphysema, which both may lead to airway obstruction. Under normal circumstances, airway dimensions vary as a function of inspiration level. We aim to study the influence of COPD and emphysema...... and emphysema, respectively. Conclusions – Airway distensibility decreases significantly with increasing severity of both GOLD status and emphysema, indicating that in COPD the dynamic change in airway calibre during respiration is compromised. Chronic bronchitis and emphysema appear to be interacting...

  2. Deposition of graphene nanomaterial aerosols in human upper airways.

    Su, Wei-Chung; Ku, Bon Ki; Kulkarni, Pramod; Cheng, Yung Sung


    Graphene nanomaterials have attracted wide attention in recent years on their application to state-of-the-art technology due to their outstanding physical properties. On the other hand, the nanotoxicity of graphene materials also has rapidly become a serious concern especially in occupational health. Graphene naomaterials inevitably could become airborne in the workplace during manufacturing processes. The inhalation and subsequent deposition of graphene nanomaterial aerosols in the human respiratory tract could potentially result in adverse health effects to exposed workers. Therefore, investigating the deposition of graphene nanomaterial aerosols in the human airways is an indispensable component of an integral approach to graphene occupational health. For this reason, this study carried out a series of airway replica deposition experiments to obtain original experimental data for graphene aerosol airway deposition. In this study, graphene aerosols were generated, size classified, and delivered into human airway replicas (nasal and oral-to-lung airways). The deposition fraction and deposition efficiency of graphene aerosol in the airway replicas were obtained by a novel experimental approach. The experimental results acquired showed that the fractional deposition of graphene aerosols in airway sections studied were all less than 4%, and the deposition efficiency in each airway section was generally lower than 0.03. These results indicate that the majority of the graphene nanomaterial aerosols inhaled into the human respiratory tract could easily penetrate through the head airways as well as the upper part of the tracheobronchial airways and then transit down to the lower lung airways, where undesired biological responses might be induced.

  3. Nasal valve surgery.

    Apaydin, Fazil


    Nasal obstruction can be due to internal and external valve problems that can be seen before and after rhinoplasty. The main scope of this article is to concentrate on surgical solutions to these problems. To overcome nasal obstruction at the internal valve, spreader grafts, spreader flaps, upper lateral splay graft, butterfly graft, flaring suture, M-plasty, Z-plasty, and suspension sutures have been described. The management of the external valve problems is possible by using lateral crural dissection and repositioning, lateral crural strut grafts, alar battens, lateral crural turn-in flap, alar rim grafts, and various other methods. It is not easy to decide which techniques would work best in every case. After a thorough examination and analysis, the underlying cause of the nasal obstruction can be understood, and one or multiple procedures can be chosen according to each individual problem.

  4. Nasal spray flu vaccine (image)

    The flu vaccine can also be administered as a nasal spray instead of the usual injection method. It can be ... the recombinant influenza vaccine (RIV). The nasal spray flu vaccine (live attenuated influenza vaccine or LAIV) should not ...

  5. Obstructive sleep apnea with pulmonary hypertension and cor-pulmonale in an 11-year-old Nigerian boy with sino-nasal non-hodgkin lymphoma

    Ibrahim Aliyu


    Full Text Available Children are predominantly nasal breathers, therefore obstruction of the nasal passage presents early with difficulty in breathing; however, with advance in age they soon adapt to mouth breathing. Chronic upper airway obstruction may result in cardiovascular complications such as pulmonary hypertension, right ventricular heart failure, and also renal disease. Therefore, we report the case of an 11-year-old Nigerian boy who had upper airway obstruction complicated with sleep apnea, pulmonary hypertension and cor-pulmonale resulting from sino-nasal (nasopharyngeal non-Hodgkin lymphoma which is rare in African children

  6. [Difficult airway management for general anesthesia in two patients with Kartagener syndrome].

    Andoh, Taiki; Momota, Yoshihiro; Murata, Kenji; Kotani, Junichiro


    Two patients with Kartagener syndrome were managed under general anesthesia by nasal intubation for sagital split ramus osteotomy. Many episodes of expectoration were encountered in the former patient's perioperative period and the expectoration discharge was inadequate by postoperative nausea, leading to trouble in airway management. In the second patient, tube collapse was caused after intubation by serious nasal cavity strangulation, and re-intubation was necessary. Expectoration is seen resulting from decreased ciliary function with bronchiectasis during anesthetic management of patients with Kartagener syndrome. It is important to prevent lung complications by nausea prevention and pain killing in the postoperative period, in addition to proper suctioning in the perioperative period. Furthermore, there is nasal cavity narrowing by chronic sinusitis. When performing nasal intubation, the difficult airway management is required.

  7. Intranasal epidermoid cyst causing upper airway obstruction in three brachycephalic dogs.

    Murgia, D; Pivetta, M; Bowlt, K; Volmer, C; Holloway, A; Dennis, R


    This case report describes three brachycephalic dogs with intranasal epidermoid cysts that were causing additional upper airway obstruction. Although epidermoid cysts have been described in several locations in dogs, to the authors' knowledge intranasal epidermoid cysts have not been previously reported. All dogs had mucopurulent to haemorrhagic nasal discharge. Magnetic resonance imaging of the head revealed the presence of unilateral or bilateral intranasal cystic lesions obstructing the nasal cavities partially or completely, with atrophy of the ipsilateral nasal turbinates. The cystic lesions were surgically excised in all dogs using a modified lateral alveolar mucosal approach to the affected nasal cavity. Aerobic, anaerobic and fungal culture of the cystic contents were negative and histology of the excised tissue was consistent with a benign intranasal epidermoid cyst in each dog. Upper airway obstruction was clinically improved in two dogs.

  8. A comparative and descriptive study of asthma in chronic rhinosinusitis with nasal polyps

    Håkansson, Kåre; Thomsen, Simon Francis; Konge, Lars;


    BACKGROUND: Chronic rhinosinusitis (CRS) is a common health problem that is subclassified as CRS with nasal polyps (CRSwNPs) or CRS without NPs (CRSsNP). In accordance with the united airways concept, CRSwNPs frequently coexists with asthma but to date, this association remains unexplained and its...

  9. Correction of internal nasal valve stenosis: a single surgeon comparison of butterfly versus traditional spreader grafts.

    Stacey, D Heath; Cook, Ted A; Marcus, Benjamin C


    Nasal obstruction due to internal nasal valve (INV) collapse is relatively common. This article evaluates 2 different methods repairing the INV.Our subject population is a single-surgeon group of 82 patients who underwent a septorhinoplasty for nasal airway obstruction. Patients received either a spreader graft or butterfly graft. There are 30 patients who received spreader grafts and 52 patients who received a butterfly graft. All patients had a minimum of 3 months follow-up. All patients were evaluated with standardized questionnaire. Participants were asked to evaluate improvement in their nasal airway on an analog scale of 1 to 5. Participants were also asked to comment on changes in pre and postoperative snoring and sleep habits. Lastly, participants were queried regarding the ear cartilage harvest and if this bothered them.Patients undergoing both procedures demonstrated an overall improvement in their nasal breathing. Significant differences in improvement were observed for patients in the categories of postoperative snoring, sleep, and continuous positive airway pressure use. Patients were not bothered by the ear cartilage harvest.In select patients, the butterfly graft is a useful solution for INV collapse correction.

  10. Lysosomal exoglycosidases in nasal polyps.

    Chojnowska, Sylwia; Minarowska, Alina; Knaś, Małgorzata; Niemcunowicz-Janica, Anna; Kołodziejczyk, Paweł; Zalewska-Szajda, Beata; Kępka, Alina; Minarowski, Łukasz; Waszkiewicz, Napoleon; Zwierz, Krzysztof; Szajda, Sławomir Dariusz


    Nasal polyps are smooth outgrowths assuming a shape of grapes, formed from the nasal mucosa, limiting air flow by projecting into a lumen of a nasal cavity. Up to now the surgical resection is the best method of their treatment, but etiology and pathogenesis of the nasal polyps is not yet fully established. The aim of the study was the assessment of the selected lysosomal exoglycosidases activity in the nasal polyps. In this study the activity of β-galactosidase, α-mannosidase and α-fucosidase was determined in the tissue of the nasal polyps obtained from 40 patients (10F, 30M) and control tissues derived from mucosa of lower nasal conchas obtained during mucotomy from 20 patients (10F, 10M). We observed significant lower values of GAL, FUC and tendency to decrease of MAN and GLU concentration in nasal polyps (P) in comparison to control healthy nasal mucosa (C). In nasal polyp tissue (P) no differences of GAL, MAN and FUC specific activity in comparison to control mucosa (C) were found. Our research supports bioelectrical theory of the nasal polyps pathogenesis and directs attention at research on glycoconjugates and glycosidases of the nasal mucosa extracellular matrix. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  11. Nasalance Norms in Greek Adults

    Okalidou, Areti; Karathanasi, Asimina; Grigoraki, Eleni


    The purposes of this study were to derive nasalance norms for monolingual Greek speakers, to examine nasalance scores as a function of gender and to draw cross-linguistic comparisons based on normative data. Participants read aloud a corpus of linguistic material, consisting of (1) a nasal text, an oral text and a balanced text; (2) a set of nasal…

  12. Nasalance Norms in Greek Adults

    Okalidou, Areti; Karathanasi, Asimina; Grigoraki, Eleni


    The purposes of this study were to derive nasalance norms for monolingual Greek speakers, to examine nasalance scores as a function of gender and to draw cross-linguistic comparisons based on normative data. Participants read aloud a corpus of linguistic material, consisting of (1) a nasal text, an oral text and a balanced text; (2) a set of nasal…

  13. Nasal obstruction and human communication.

    Malinoff, R; Moreno, C


    Nasal obstruction may cause a variety of communication disorders, particularly in children. The effects of nasal obstruction on hearing, speech, language, and voice are examined. Methods for assessing the effects of nasal obstruction are delineated, and recommendations for therapeutic interventions are described.

  14. Cosmetic and Functional Nasal Deformities

    ... nasal complaints. Nasal deformity can be categorized as “cosmetic” or “functional.” Cosmetic deformity of the nose results in a less ... taste , nose bleeds and/or recurrent sinusitis . A cosmetic or functional nasal deformity may occur secondary to ...

  15. 间歇性双侧完全鼻阻塞的幼年大鼠模型的建立%Animal model of bilateral intermittent nasal obstruction in young rats

    朱敏; 陈金东; 聂萍; 刘炯; 盛潇; 赵彦惠; 徐晓珑; 陶丽


    目的 建立生长发育期大鼠的间歇性双侧完全鼻阻塞的动物模型.方法 30只3周龄SD大鼠,分为3组,A组:对照组,B组:单侧鼻阻塞组,C组:双侧鼻阻塞组(张口呼吸组),每组各10只.用特制的阻塞器阻塞大鼠鼻腔,阻塞的时间为8:00am至4:00pm,4周后处死30只大鼠.结果 A组、B组大鼠以鼻呼吸为主;C组表现为张口呼吸.A、B、C三组的呼吸频率分别为(96.8±5.91)次/min、(92.8±2.98)次/min和(48.6±4.38)次/min,C组的呼吸频率较A组与B组明显减慢(P<0.001).建模4周时,A、B、C三组的体重分别为(276.60±20.17)g、(236.80±19.46)g和(127.33±24.8)g,C组的体重较A组和B组明显的降低(P<0.001).结论 本研究通过间歇性的双侧完全阻塞大鼠的外鼻初步建立了一个存活率高、重复性较好与人类张口呼吸较相似的大鼠的间歇性张口呼吸模型.%Objective To build up a steady and credible animal model of bilateral intermittent nasal obstruction in young rats.Methods Thirty 3-week-old SD rats were employed and divided into group A(control),group B(left nostril occluded),and group C(both nostrils occluded by nose plugs).The occlusion period was between 8 a.m.and 4 p.m.every day.Four weeks later all rats were sacrificed.Results Rats in group A and B remained nose breathing,but group C developed mouth breathing.The mean respiratory rate of rats in group A,B and C were (96.8±5.91),(92.8±2.98) and (48.6 ± 4.38) respectively.Group C was significantly slower compared with group A and B (P<0.001).The meanweight for group A,B and C were(276.60±20.17) g、(236.80±19.46) g and (127.33±24.8) g four weeks later,respectively.Group C reduced significantly compared with group A and B(P<0.001).Conclusions The animal model of bilateral intermittent nasal obstruction in young rats established by occlusion with nose plugs was steady,credible and similar to oral breathing of human being.

  16. Early surfactant therapy and nasal continuous positive airways ...

    Neonatal Medicine, School of Child and Adolescent Health, University of Cape Town. S Holgate, MB ... birth weight ≥900 g) with a diagnosis of RDS, requiring. NCPAP ≥5 ..... pathogenesis, classification, and spectrum of illness. Curr Probl ...

  17. Submental Intubation Including Extubation: Airway Complications of Maxillomandibular Fixation

    Santosh Kumar Yadav


    Full Text Available Hernandez first described the submental route for endotracheal intubation in 1986 as an alternative airway maneuver for maxillofacial procedures. Since that time, several case studies have been performed demonstrating the efficacy of the submental approach. This method was recently implemented in the case of a patient with altered nasal anatomy who sustained a mandibular fracture necessitating maxillomandibular fixation. Unlike most of the cases described in the literature, this patient’s operative course was confounded by the need to extubate through the submental tunnel. The patient tolerated the procedure well and was able to avoid other forms of surgical airway.

  18. Calcitonin Salmon Nasal Spray

    ... is important that you get enough calcium and vitamin D while you are using calcitonin salmon. Your doctor may prescribe supplements if your dietary ... examinations of the nose to make sure calcitonin salmon nasal spray is not ... such as vitamins, minerals, or other dietary supplements. You should bring ...

  19. Nasalization in Polish

    Rubach, Jerzy


    This paper gives a complete account of vowel nasalization in Standard Polish. A distinction is made between obligatory and phonostylistic processes. Phonostylistic evidence may serve as a basis for making unambiguous decisions about the structure of underlying representations, intermediate phonological forms, and assimilation of borrowings to the…

  20. Nasal tooth: case report

    Park, Si Hyun; Kim, Ji Hye; Hwang, Hee Young; Yang, Dal Mo; Kim, Hyung Sik; Park, Chol Heui [Gachon Medical School, Inchon (Korea, Republic of)


    Ectopic tooth is not uncommon and usually occurs in the palate and maxillary sinus. We report a case of ectopic tooth located in the nasal cavity, a rare site. The mass depicted by CT was highly attenuated, and central lucency was observed.

  1. Premature infants have impaired airway antiviral IFNγ responses to human metapneumovirus compared to respiratory syncytial virus

    Pancham, Krishna; Perez, Geovanny F.; Huseni, Shehlanoor; Jain, Amisha; Kurdi, Bassem; Rodriguez-Martinez, Carlos E.; Preciado, Diego; Rose, Mary C.; Nino, Gustavo


    BACKGROUND It is unknown why human metapneumovirus (HMPV) and respiratory syncytial virus (RSV) cause severe respiratory infection in children, particularly in premature infants. Our aim was to investigate if there are defective airway antiviral responses to these viruses in young children with history of prematurity. METHODS Nasal airway secretions were collected from 140 children ≤3 y old without detectable virus (n = 80) or with PCR-confirmed HMPV or RSV infection (n = 60). Nasal protein levels of IFNγ, CCL5/RANTES, IL-10, IL-4, and IL-17 were determined using a multiplex magnetic bead immunoassay. RESULTS Full-term children with HMPV and RSV infection had increased levels of nasal airway IFNγ, CCL5, and IL-10 along with an elevation in Th1 (IFNγ)/Th2 (IL-4) ratios, which is expected during antiviral responses. In contrast, HMPV-infected premature children (< 32 wk gestation) did not exhibit increased Th1/Th2 ratios or elevated nasal airway secretion of IFNγ, CCL5, and IL-10 relative to uninfected controls. CONCLUSION Our study is the first to demonstrate that premature infants have defective IFNγ, CCL5/RANTES, and IL-10 airway responses during HMPV infection and provides novel insights about the potential reason why HMPV causes severe respiratory disease in children with history of prematurity. PMID:26086642

  2. Small particles disrupt postnatal airway development


    Increasing numbers of epidemiologic studies associate air pollution exposure in children with decreased lung function development. The objective of this study was to examine the effects of exposure to combustion-generated fine [230 and 212 nm number mean aerodynamic particle diameter (NMAD)] to ultrafine (73 nm NMAD) particles differing in elemental (EC) and organic (OC) carbon content on postnatal airway development in rats. Neonatal Sprague-Dawley rats were exposed from postnatal day 7 thro...

  3. Nasal versus oronasal raised volume forced expirations in infants--a real physiologic challenge.

    Morris, Mohy G


    Raised volume rapid thoracoabdominal compression (RTC) generates forced expiration (FE) in infants typically from an airway opening pressure of 30 cm H(2)O (V(30)). We hypothesized that the higher nasal than pulmonary airway resistance limits forced expiratory flows (FEF(%)) during (nasal) FE(n), which an opened mouth, (oronasal) FE(o), would resolve. Measurements were performed during a brief post-hyperventilation apnea on 12 healthy infants aged 6.9-104 weeks. In two infants, forced expiratory (FEFV) flow volume (FV) curves were generated using a facemask that covered the nose and a closed mouth, then again with a larger mask with the mouth opened. In other infants (n = 10), the mouth closed spontaneously during FE. Oronasal passive expiration from V(30) generated either the inspiratory capacity (IC) or by activating RTC before end-expiration, the slow vital capacity ((j) SVC). Peak flow (PF), FEF(25), FEF(50), FEF(25-75), FEV(0.4), and FEV(0.5) were lower via FE(n) than FE(o) (P vital capacity (FVC) as percent was higher (P 0.05). FEFV curves generated via FE(o) exhibited higher PF than FV curves of IC (P 0.05) but lower than those of (j) SVC (P < 0.05). In conclusion, the higher nasal than pulmonary airways resistance unequivocally affects the FEFV curves by consistently reducing PF and decreases mid-expiratory flows. A monitored slightly opened mouth and a gentle anterior jaw thrust are physiologically integral for raised volume RTC in order to maximize the oral and minimize nasal airways contribution to FE so that flow limitation would be in the pulmonary not nasal airways.

  4. Downregulation of peroxisome proliferator-activated receptors (PPARs in nasal polyposis

    Adner Mikael


    Full Text Available Abstract Background Peroxisome proliferator-activated receptor (PPAR α, βδ and γ are nuclear receptors activated by fatty acid metabolites. An anti-inflammatory role for these receptors in airway inflammation has been suggested. Methods Nasal biopsies were obtained from 10 healthy volunteers and 10 patients with symptomatic allergic rhinitis. Nasal polyps were obtained from 22 patients, before and after 4 weeks of local steroid treatment (fluticasone. Real-time RT-PCR was used for mRNA quantification and immunohistochemistry for protein localization and quantification. Results mRNA expression of PPARα, PPARβδ, PPARγ was found in all specimens. No differences in the expression of PPARs were obtained in nasal biopsies from patients with allergic rhinitis and healthy volunteers. Nasal polyps exhibited lower levels of PPARα and PPARγ than normal nasal mucosa and these levels were, for PPARγ, further reduced following steroid treatment. PPARγ immunoreactivity was detected in the epithelium, but also found in smooth muscle of blood vessels, glandular acini and inflammatory cells. Quantitative evaluation of the epithelial immunostaining revealed no differences between nasal biopsies from patients with allergic rhinitis and healthy volunteers. In polyps, the PPARγ immunoreactivity was lower than in nasal mucosa and further decreased after steroid treatment. Conclusion The down-regulation of PPARγ, in nasal polyposis but not in turbinates during symptomatic seasonal rhinitis, suggests that PPARγ might be of importance in long standing inflammations.

  5. Nasal highflow improves ventilation in patients with COPD

    Bräunlich J


    Full Text Available Jens Bräunlich,* Marcus Köhler,* Hubert WirtzDepartment of Respiratory Medicine, University of Leipzig, Leipzig, Germany *These authors contributed equally to this workBackground: Nasal highflow (NHF provides a warmed and humidified air stream up to 60 L/min. Recent data demonstrated a positive effect in patients with acute hypoxemic respiratory failure, especially when caused by pneumonia. Preliminary data show a decrease in hypercapnia in patients with COPD. Therefore, NHF should be evaluated as a new ventilatory support device. This study was conducted to assess the impact of different flow rates on ventilatory parameters in patients with COPD.Materials and methods: This interventional clinical study was performed with patients suffering from severe COPD. The aim was to characterize flow-dependent changes in mean airway pressure, breathing volumes, breathing frequency, and decrease in partial pressure of CO2 (pCO2. Mean airway pressure was measured in the nasopharyngeal space (19 patients. To evaluate breathing volumes, we used a polysomnographic device (18 patients. All patients received 20 L/min, 30 L/min, 40 L/min, and 50 L/min and – to illustrate the effects – nasal continuous positive airway pressure and nasal bilevel positive airway pressure. Capillary blood gas analyses were performed in 54 patients with hypercapnic COPD before and two hours after the use of NHF. We compared the extent of decrease in pCO2 when using 20 L/min and 30 L/min. Additionally, comfort and dyspnea during the use of NHF were surveyed.Results: NHF resulted in a minor flow dependent increase in mean airway pressure. Tidal volume increased, and breathing rate decreased. The calculated minute volume decreased under NHF breathing. In spite of this fact, hypercapnia decreased with increasing flow (20 L/min vs 30 L/min. Additionally, an improvement in dyspnea was observed. The rapid shallow breathing index shows a decrease when using NHF.Conclusion: NHF

  6. Exhaled and nasal nitric oxide in laryngectomized patients

    Jörres Rudolf A


    Full Text Available Abstract Background Nitric oxide (NO shows differing concentrations in lower and upper airways. Patients after total laryngectomy are the only individuals, in whom a complete separation of upper and lower airways is guaranteed. Thus the objective of our study was to assess exhaled and nasal NO in these patients. Methods Exhaled bronchial NO (FENO and nasal nitric oxide (nNO were measured in patients after total laryngectomy (n = 14 and healthy controls (n = 24. To assess lung function we additionally performed spirometry. Co-factors possibly influencing NO, such as smoking, infections, and atopy were excluded. Results There was a markedly (p NO in patients after total laryngectomy (median (range: 4 (1-22 ppb compared to healthy controls 21 (9-41 ppb. In contrast, nNO was comparable between groups (1368 versus 1380 in controls but showed higher variability in subjects after laryngectomy. Conclusions Our data suggest that either bronchial NO production in patients who underwent laryngectomy is very low, possibly due to alterations of the mucosa or oxidant production/inflammation, or that substantial contributions to FENO arise from the larynx, pharynx and mouth, raising FENO despite velum closure. The data fit to those indicating a substantial contribution to FENO by the mouth in healthy subjects. The broader range of nNO values found in subjects after laryngectomy may indicate chronic alteration or oligo-symptomatic inflammation of nasal mucosa, as frequently found after total laryngectomy.

  7. Volumetric nasal cavity analysis in children with unilateral and bilateral cleft lip and palate.

    Farzal, Zainab; Walsh, Jonathan; Lopes de Rezende Barbosa, Gabriella; Zdanski, Carlton J; Davis, Stephanie D; Superfine, Richard; Pimenta, Luiz A; Kimbell, Julia S; Drake, Amelia Fischer


    Children with cleft lip and palate (CLP) often suffer from nasal obstruction that may be related to effects on nasal volume. The objective of this study was to compare side:side volume ratios and nasal volume in patients with unilateral (UCLP) and bilateral (BCLP) clefts with age-matched controls. Retrospective case-control study using three-dimensional (3D) nasal airway reconstructions. We analyzed 20 subjects (age range = 7-12 years) with UCLP and BCLP from a regional craniofacial center who underwent cone beam computed tomography (CT) prior to alveolar grafting. Ten multislice CT images from age-matched controls were also analyzed. Mimics software (Materialise, Plymouth, MI) was used to create 3D reconstructions of the main nasal cavity and compute total and side-specific nasal volumes. Subjects imaged during active nasal cycling phases were excluded. There was no statistically significant difference in affected:unaffected side volume ratios in UCLP (P = .48) or left:right ratios in BCLP (P = .25) when compared to left:right ratios in controls. Mean overall nasal volumes were 9,932 ± 1,807, 7,097 ± 2,596, and 6,715 ± 2,115 mm(3) for control, UCLP, and BCLP patients, respectively, with statistically significant volume decreases for both UCLP and BCLP subjects from controls (P < .05). This is the first study to analyze total nasal volumes in BCLP patients. Overall nasal volume is compromised in UCLP and BCLP by approximately 30%. Additionally, our finding of no major difference in side:side ratios in UCLP and BCLP compared to controls conflicts with pre-existing literature, likely due to exclusion of actively cycling scans and our measurement of the functional nasal cavity. 3b. Laryngoscope, 126:1475-1480, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  8. Effect of Nasal Continuous Positive Pressure on the Nostrils of Patients with Sleep Apnea Syndrome and no Previous Nasal Pathology. Predictive Factors for Compliance.

    Aguilar, Francina; Cisternas, Ariel; Montserrat, Josep Maria; Àvila, Manuel; Torres-López, Marta; Iranzo, Alex; Berenguer, Joan; Vilaseca, Isabel


    To evaluate the effect of continuous positive airway pressure (CPAP) on the nostrils of patients with sleep apnea-hypopnea syndrome and its impact on quality of life, and to identify predictive factors for compliance. Longitudinal prospective study. Thirty-six consecutive patients evaluated before and 2 months after CPAP using the following variables: clinical (eye, nose and throat [ENT] symptoms, Epworth test, anxiety/depression scales, general and rhinoconjunctivitis-specific quality of life); anatomical (ENT examination, computed tomography); functional (auditive and Eustachian tube function, nasal flow, mucociliary transport); biological (nasal cytology); and polisomnographics. The sample was divided into compliers (≥4h/d) and non-compliers (<4h/d). A significant improvement was observed in daytime sleepiness (p=0.000), anxiety (P=.006), and depression (P=.023). Nasal dryness (P=.000), increased neutrophils in nasal cytology (P=.000), and deteriorating ciliary function were evidenced, particularly in compliers. No significant differences were observed in the other variables. Baseline sleepiness was the only factor predictive of compliance. CPAP in patients without previous nasal pathology leads to an improvement in a series of clinical parameters and causes rhinitis and airway dryness. Some ENT variables worsened in compliers. Sleepiness was the only prognostic factor for poor tolerance. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Clinical comparison of early prophylactic application of nasal continuous positive airway pressure and pulmonary surfactant in the premature very low birth weight infants%早产极低出生体重儿早期预防性应用鼻塞式持续气道正压与肺表面活性物质的临床比较

    高薇薇; 谭三智; 杨杰; 张永; 叶秀桢; 聂川; 王越; 王俊平


    目的:探讨在早产极低出生体重儿中生后早期使用鼻塞式持续气道正压(nCPAP)或应用肺表面活性剂(PS)以预防新生儿呼吸窘迫综合征(NRDS)的临床疗效比较.方法:采用前瞻性对照研究,对出生后早期使用nCPAP辅助通气或早期使用PS替代治疗的早产极低出生体重儿进行对照研究,观察其死亡率、支气管肺发育不良发生率、辅助通气时间及临床并发症.结果:共106例患儿人选,死亡率和支气管肺发育不良(BPD)发生率组间比较差异无统计学意义.机械辅助通气、总用氧时间组间比较差异无统计学意义;nCPAP组PS使用数少于对照组(Odds Ratio:0.37,90% CI 0.209~0.655);气漏发生率低(Odds Ratio:0.476,90% CI0.233~0.971),IVH发生率低(Odds Ratio:o.778,90%CI 0.319~1.898).其他临床并发症组间比较差异无统计学意义.结论:早期应用nCPAP是预防早产极低出生体重儿呼吸窘迫综合征另一良好选择.%Objective; To explore the clinical effects of early prophylactic application of nasal continuous positive airway pressure (nCPAP) and pulmonary surfactant (PS) in prevention of neonatal respiratory distress syndrome ( NROS) among the premature very low birth weight infants. Methods: The clinical effects of early prophylactic application of nCPAP and PS in the premature very low birth weight infants were compared, the death rates, the incidences of bronchopulmonary dysplasia, the duration times of assisted ventilation, and clinical complications in the two groups were observed. Results; A total of 106 infants were enrolled in the study. There was no significant difference in the death rate and the incidence of bronchopulmonary dysplasia between the two groups. There was no significant difference in the duration time of mechanical ventilation and total using oxygen time between the two groups; the number of infants using PS in nCPAP group was fewer than that in control group (Odds ratio; 0. 37, 90

  10. Comparative study on nasal continuous positive airway pressure combined with pulmonary surfactant in treatment of premature infants' Hyaline membrane disease%鼻塞式持续气道正压通气联合肺表面活性物质治疗早产儿肺透明膜病对照研究

    刘勇; 程国平


    Objective To study the difference in curative effects of nasal continuous positive airway pressure (NCPAP) combined with pulmonary surfactant (PS) and NCPAP combined with Mucosolvan ( MU) on premature infants' Hyaline membrane disease ( HMD). Methods 90 premature infants with HMD were randomly divided into NCPAP combined with PS ( NC + PS treatment) group and MU ( NC + MU treatment) group. Curative effects, arterial blood gas, short and long term complications were compared after treatment. Results ( NC + PS) group' s total effective rate was higher than ( NC + MU) group, while the time of dyspnea remission , respirator treatment and mean hospitalization were lower than ( NC + MU) group with statistical significance (P 0.05 ) . They all increased after treatment except PaCO2, the differences in both group had statistical significance ( P < 0. 05 ). The main short term complications were pneumonia, intracranial hemorrhage and pulmonary hemorrhage; the main long term complications were cerebral palsy, hearing disorder and retinopathy of prematurity. Comprehensive situation in short and long term complications were significantly better in (NC + PS) group than (NC +MU) group (P<0.05). Conclusion NCPAP combined with PS could significantly promote curative effect on hyaline membrane disease with few short and long term complications. It is significantly better than NCPAP combined withMU.%目的 探讨鼻塞式持续气道正压通气(NCPAP)联合肺表面活性物质(PS)和NCPAP联合沐舒坦(MU)两种方法治疗早产儿肺透明膜病的疗效差异.方法 将90例肺透明膜病(HMD)早产儿随机分为NCPAP联合PS(NC+PS治疗组)和NCPAP联合MU(NC+ MU治疗组),分别进行治疗,并比较两组的疗效、动脉血气分析和近远期并发症的差异.结果 (NC+PS)组的总有效率显著高于( NC+ MU)组,而在呼吸困难缓解时间、上呼吸机时间和平均住院时间方面均小于(NC+MU)组,两组间的差异具有统计学意义(P<0.05).治

  11. Application of nasal continuous positive airway pressure preferential ventilation strategy in the treatment of infant severe pneumonia%经鼻持续气道正压通气优先支持策略在婴儿重症肺炎中的实践

    董九伟; 祝彬; 姜晓华; 田明达; 孙玉晶; 张伟强


    目的:探讨经鼻持续气道正压通气(NCPAP)优先支持策略在婴儿重症肺炎中的治疗价值。方法对59例婴儿重症肺炎使用NCPAP优先支持策略,评价治疗效果。结果 NCPAP治疗有效50例,无效9例。有效组和无效组治疗前月龄、呼吸频率(RR)、心率(HR)比较差异无统计学意义(P>0.05);但无效组动脉血二氧化碳分压(PaCO2)、氧合指数(PaO2/FiO2)显著高于有效组,动脉血氧分压(PaO2)显著低于有效组,差异均有统计学意义(P<0.05)。50例对NCPAP治疗有效患儿治疗后1、12、24 h PaO2、PaO2/FiO2显著上升(P<0.05),PaCO2、RR、HR显著下降(P<0.01)。结论 NCPAP优先支持策略能够减少有创呼吸机的使用,改善氧合,缓解呼吸困难,稳定生命体征。%Objective To investigate the value of nasal continuous positive airway pressure (NCPAP) in the treatment of severe pneumonia. Methods The clinical data of 59 severe pneumonia infants who received NCPAP preferential ventilation strategy were retrospectively analyzed. Results After treatment, 50 infants were effective and 9 infants were ineffective. Before treatment, the age, RR, HR between effective group and ineffective group had no significant differences (P>0.05). But the levels of PaCO2, PaO2/FiO2 in ineffective group were significantly higher than those in effective group and the level of PaO2 in ineffective group was significantly lower than that in effective group (P<0.05). In effective group, the levels of PaO2 and PaO2/FiO2 were significantly increased after treatment for 1, 12 and 24 h, and the levels of PaCO2, RR and HR were significantly decreased (P<0.01). Conclusions NCPAP preferential ventilation strategy can reduce the use of invasive mechanical ventilation, improve oxygenation, ease dyspnea and make vital signs stable.

  12. Investigation of Ischemic Stroke Patients with Mild or Moderate Obstructive Sleep Apnea-hypopnea Syndrome Treated by Nasal Continuous Positive Airway Pressure%nCPAP治疗伴轻中度OSAHS缺血性卒中患者的随访研究

    唐晓梅; 于逢春; 孟晓梅; 陈新平; 刘伟; 冯浩; 朱健


    目的比较合并轻中度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)非急性缺血性卒中患者接受经鼻持续气道正压通气(nasal continuous positive airway pressure,nCPAP)治疗与未接受nCPAP治疗患者2年内缺血性卒中复发事件及相关指标变化。  方法前瞻性连续选取2008年3月~2010年3月北京市海淀医院神经内科住院及门诊的非急性缺血性卒中患者30例,发病90 d后进行多导睡眠图(polysomnography,PSG)监测,符合轻中度OSAHS诊断标准,纳入研究,根据是否应用nCPAP治疗,将患者分为nCPAP治疗组(14例)和非nCPAP治疗组(16例),分别于入组后第6、12、18、24个月随访观察缺血性卒中复发、呼吸暂停低通气指数(apnea hypopnea index,AHI)、血压、体重指数(body mass index,BMI)、Epworth嗜睡量表评分(Epworth Sleepiness Scale, ESS)、焦虑和抑郁状态发生率等。  结果 nCPAP治疗组和非nCPAP治疗组,入组时年龄、性别、糖尿病、高血压病史、AHI、收缩压、舒张压、BMI、改良Rankin量表评分、ESS评分、焦虑和抑郁状态发生率评分差异无显著性(P值均>0.05)。随访2年中两组均无缺血性卒中复发事件。第6、12、18、24个月nCPAP治疗组AHI(3.9±0.6、3.8±0.5、3.9±0.5、3.8±0.5)较非nCPAP治疗组(20.8±4.1、21.7±4.5、22.6±4.2、26.8±6.1)改善,差异具有显著性(t值分别为16.2、15.9、17.8、15.0,P值均<0.001)。治疗组ESS评分在第6、12、18、24个月(3.5±1.7、2.6±1.5、2.2±1.4、2.1±1.1)较对照组(6.8±1.2、7.0±1.3、7.1±1.2、7.2±1.6)改善,差异具有显著性(t值分别为6.1、8.8、9.9、10.0,P值均<0.001)。在第24个月焦虑发生率改善(nCPAP组7.1%、非nCPAP组43.8%),差异具有显著性(P=0.039),抑郁发生率在第6、12、18、24

  13. Mycotic bovine nasal granuloma.

    Conti Díaz, Ismael Alejandro; Vargas, Roberto; Apolo, Ada; Moraña, José Antonio; Pedrana, Graciela; Cardozo, Elena; Almeida, Edgardo


    A case of mycotic bovine nasal granuloma in a 10 year-old Jersey cow, produced by Drechslera halodes is presented. Histopathological sections showed abundant hyaline and pigmented extra and intracellular fungal structures together with a polymorphic cellular granuloma formed by neutrophils, lymphocytes, plasmocytes, histiocytes and giant cells of the Langhans type. It is the first case of mycotic bovine nasal granuloma recognized in Uruguay although this disease seems to be frequent according to the opinion of veterinarian specialists. Another similar clinical case also in a Jersey cow from the same dairy house with an intense cellular infiltrate rich in eosinophils without granulomatous image, together with extracellular hyaline and fuliginous fungal forms, is also referred for comparative purposes. Geotrichum sp. was isolated. The need of an early diagnosis and treatment of the disease is stressed.

  14. Effects of azithromycin on expression of leptin and airway inflammation in rats with asthma%阿奇霉素对哮喘大鼠瘦素表达及气道炎症的影响

    朱述阳; 嵇桂娟; 卢立国; 闫明华; 段存玲; 张文辉; 卞宏


    Objective To investigate the role of azithromycin on the expression change of leptin in airway inflammatory lung tis sues and airway smooth muscle cells(ASMC) in obese rats with asthma and its anti inflammatory effects. Methods Rats were ran domly divided into 6 groups(n = 8) :3 groups with normal weight including the control group(group A) ,asthmatic group(group B) , and azithromycin intervention group(group C) and 3 groups with obesity including the control group(group D) , asthmatic group (group E) and azithromycin intervention group(group F). The obese and asthma models were constructed. The rat ASMC was cul tured in vitro. The concentrations of leptin in serum,BALF and the supernatant of cultured ASMC were determined by ELISA,and the expression of leptin in lung tissue and ASMC was measured by Western blot. Results The total number of WBC and the num ber of neutrophils of bronchoalveolar lavage fluid(BALF) ,the protein expression of leptin in lung tissues and the leptin concentra tions in serum,BALF and supernatant in the group D,E and F all showed statistical difference compared with the corresponding groups with normal weight(P-<0. 05). Conclusion The expression of leptin in the airway inflammatory lung tissues in obese rats with asthma is increased. Azithromycin can inhibit airway inflammation and partially reduce the expression of leptin in asthmatic rats.%目的 探讨阿奇霉素对肥胖哮喘大鼠气道炎症肺组织内及气道平滑肌细胞(ASMC)内瘦素表达的变化及抗炎作用.方法 将大鼠随机分为正常对照组、正常哮喘组、正常干预组和肥胖对照组、肥胖哮喘组、肥胖干预组,建立肥胖、哮喘模型以及体外培养大鼠ASMC,采用酶联免疫吸附试验(ELISA)法测定血清、支气管肺泡灌洗液(BALF)及细胞上清液中瘦素浓度,Western blot法检测肺组织和ASMC内瘦素蛋白的表达.结果 肥胖对照组、肥胖哮喘组和肥胖干预组BALF白细胞总数及中性粒细胞数,

  15. Three-dimensional Evaluation of Nasal Surgery in Patients with Obstructive Sleep Apnea

    Dan-Mo Cui; De-Min Han; Busaba Nicolas; Chang-Long Hu; Jun Wu; Min-Min Su


    Background:Obstructive sleep apnea (OSA) is a common sleep disorder and is characterized by airway collapse at multiple levels of upper airway.The effectiveness of nasal surgery has been discussed in several studies and shows a promising growing interest.In this study,we intended to evaluate the effects of nasal surgery on the upper airway dimensions in patients with OSA using three-dimensional (3D)reconstruction of cone-beam computed tomography (CT).Methods:Twelve patients with moderate to severe OSA who underwent nasal surgery were included in this study.All patients were diagnosed with OSA using polysomnography (PSG) in multi sleep health centers associated with Massachusetts General Hospital,Massachusetts Eye and Ear Infirmary and the Partners Health Care from May 31,2011 to December 14,2013.The effect of nasal surgery was evaluated by the examination of PSG,subjective complains,and 3D reconstructed CT scan.Cross-sectional area was measured in eleven coronal levels,and nasal cavity volume was evaluated from anterior nasal spine to posterior nasal spine.The thickness of soft tissue in oral pharynx region was also measured.Results:Five out of the 12 patients were successfully treated by nasal surgery,with more than 50% drop of apnea-hypopnea index.All the 12 patients showed significant increase of cross-sectional area and volume postoperatively.The thickness of soft tissue in oral pharynx region revealed significant decrease postoperatively,which decreased from 19.14 ± 2.40 cm2 and 6.11 ± 1.76 cm2 to 17.13 ± 1.91 cm2 and 5.22 ± 1.20 cm2.Conclusions:Nasal surgery improved OSA severity as measured by PSG,subjective complaints,and 3D reconstructed CT scan.3D assessment of upper airway can play an important role in the evaluation of treatment outcome.

  16. Health risks associated with inhaled nasal toxicants

    Feron, V.J.; Arts, J.H.E.; Kuper, C.F.; Slootweg, P.J.; Woutersen, R.A.


    Health risks of inhaled nasal toxicants were reviewed with emphasis on chemically induced nasal lesions in humans, sensory irritation, olfactory and trigeminal nerve toxicity, nasal immunopathology and carcinogenesis, nasal responses to chemical mixtures, in vitro models, and nasal dosimetry- and me

  17. European Position Paper on Rhinosinusitis and Nasal Polyps 2012.

    Fokkens, Wytske J; Lund, Valerie J; Mullol, Joachim; Bachert, Claus; Alobid, Isam; Baroody, Fuad; Cohen, Noam; Cervin, Anders; Douglas, Richard; Gevaert, Philippe; Georgalas, Christos; Goossens, Herman; Harvey, Richard; Hellings, Peter; Hopkins, Claire; Jones, Nick; Joos, Guy; Kalogjera, Livije; Kern, Bob; Kowalski, Marek; Price, David; Riechelmann, Herbert; Schlosser, Rodney; Senior, Brent; Thomas, Mike; Toskala, Elina; Voegels, Richard; Wang, De Yun; Wormald, Peter John


    The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007.The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps and chronic rhinosinusitis with nasal polyps are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed.

  18. Usage of four-phase high-resolution rhinomanometry and measurement of nasal resistance in sleep-disordered breathing.

    Toh, Song-Tar; Lin, Cheng-Hui; Guilleminault, Christian


    To investigate the ease of use of four-phase high-resolution rhinomanometry (HRR), a new way of measuring nasal resistance, in measuring change in nasal resistance from supine to inclined position in a clinical sleep laboratory setting, and to correlate findings with continuous positive airway pressure (CPAP) tolerance. Retrospective review of clinical charts. Forty successively seen Caucasian subjects diagnosed with sleep-disordered breathing (SDB) with complete charts were analyzed. Using four-phase HRR and acoustic rhinometry, nasal resistance and minimal cross-sectional area of the nasal cavity were objectively measured with the patient in the supine position and repeated in the inclined position (30° from the horizontal plane), respectively. From the supine to inclined position, reduction in total nasal resistance was observed in 87.5% (35 out of 40). There was a mean reduction of nasal resistance by 37.1 ± 21.6%. Five (12.5%) out of 40 subjects showed no change or mild increase in nasal resistance. Subjects with nasal resistance unresponsive to the inclined position change tended to have difficulty using nasal CPAP based on downloaded compliance card data. Four-phase HRR and acoustic rhinometry are tests that can be easily performed by sleep specialists to characterize nasal resistance in SDB patients and determine changes in resistance with positional changes. In this study, we found that patients who did not demonstrate a decrease in nasal resistance with inclined position were more likely to be noncompliant with nasal CPAP. These measurements may help us objectively identify patients who might have trouble tolerating nasal CPAP. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  19. Engineering Airway Epithelium

    John P. Soleas


    Full Text Available Airway epithelium is constantly presented with injurious signals, yet under healthy circumstances, the epithelium maintains its innate immune barrier and mucociliary elevator function. This suggests that airway epithelium has regenerative potential (I. R. Telford and C. F. Bridgman, 1990. In practice, however, airway regeneration is problematic because of slow turnover and dedifferentiation of epithelium thereby hindering regeneration and increasing time necessary for full maturation and function. Based on the anatomy and biology of the airway epithelium, a variety of tissue engineering tools available could be utilized to overcome the barriers currently seen in airway epithelial generation. This paper describes the structure, function, and repair mechanisms in native epithelium and highlights specific and manipulatable tissue engineering signals that could be of great use in the creation of artificial airway epithelium.

  20. Particle Image Velocimetry Measurements Inside the Human Nasal Passage

    Kelly, James; Hopkins, Lisa; Sreenivas, K. R.; Wexler, Anthony; Prasad, Ajay


    In some applications (such as biological flows) the flow passage exhibits a highly complex geometry. A method is described by which such a flow passage is rendered as a three-dimensional model. A computer model of an adult human nasal cavity was generated from digitized computed tomography (CT) scan images, using the I-DEAS modeling package, and was converted to a stereolithographic file for rapid prototyping. Rapid prototyping yielded a water soluble negative of the airway. Silicone elastomer was poured over the negative, which was washed out after the silicone hardened. This technique can be used to obtain an accurate, transparent, silicone, replicate model of any arbitrary geometry. If the working fluid is refractive-index matched to the silicone, it is possible to obtain PIV measurements in any cross-section. We demonstrate the technique by creating a double-scale model of the human nasal passage, and obtaining PIV measurements.

  1. [Regeneration of airway epithelium].

    Adam, D; Perotin, J-M; Lebargy, F; Birembaut, P; Deslée, G; Coraux, C


    Epithelial regeneration is a complex process. It can lead to the remodeling of the airway epithelium as in asthma, COPD or cystic fibrosis. The development of in vivo and in vitro models has allowed the analysis of remodeling mechanisms and showed the role of components of extracellular matrix, proteases, cytokines and growth factors. Airway epithelial progenitors and stems cells have been studied in these models. However, their identification remains difficult. Identification and characterization of airway epithelial progenitor/stem-cells, and a better knowledge of the regeneration process may allow the development of new therapeutic strategies for airway epithelial reconstitution. Copyright © 2013 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  2. Impact of nasal obstruction on sleep quality: a community-based study of women.

    Bengtsson, Caroline; Jonsson, Lars; Holmström, Mats; Svensson, Malin; Theorell-Haglöw, Jenny; Lindberg, Eva


    The aim of the study was to analyse the impact of self-reported nasal obstruction on sleep quality in women. A community-based sample of 400 women underwent a full night of polysomnography. Airway diseases, allergies and sleep-related symptoms were assessed by questionnaires. Women with subjective nasal obstruction were subdivided into three groups: persistent nasal obstruction (PNO, n = 46), hay fever (n = 88) and nasal obstruction at night (NON, n = 30). Sleep problems and related daytime symptoms were most prevalent among women with NON. After adjusting for age, BMI, smoking and asthma, NON was an independent predictor of 'Difficulties inducing sleep due to nasal obstruction' [adjusted odds ratio (95 % CI): 89.5 (27.0-296.7)], 'Snoring' [4.2 (1.7-10.2)], 'Sweating at night' [2.6 (1.1-6.1)], 'Difficulties maintaining sleep' [2.7 (1.2-6.2)], and 'Waking up hastily gasping for breath' [32.2 (8.7-119.1)]. 'Dry mouth on awakening' [7.7 (3.2-18.4)], 'Waking up unrefreshed' [2.7 (1.2-6.0)], 'Excessive daytime sleepiness' [2.6 (1.1-6.0)], and 'Daytime nasal obstruction' [12.2 (4.8-31.2)] were also associated with NON. Persistent nasal obstruction and hay fever were both associated with some reported sleep problems due to an overlap with NON. When women with NON were excluded, only 'Daytime nasal obstruction' was still significantly associated with PNO, while hay fever was associated with 'Daytime nasal obstruction' and 'Waking up hastily gasping for breath'. There were no significant differences in objectively measured sleep variables between any of the three subgroups and the study cohort. Self-reported nasal obstruction at night in women has a significant effect on several subjective day- and nighttime symptoms, but it does not appear to affect objectively measured sleep quality.

  3. Mode-of-Action Uncertainty for Dual-Mode Carcinogens: A Bounding Approach for Naphthalene-Induced Nasal Tumors in Rats Based on PBPK and 2-Stage Stochastic Cancer Risk Models

    Bogen, K T


    A relatively simple, quantitative approach is proposed to address a specific, important gap in the appr approach recommended by the USEPA Guidelines for Cancer Risk Assessment to oach address uncertainty in carcinogenic mode of action of certain chemicals when risk is extrapolated from bioassay data. These Guidelines recognize that some chemical carcinogens may have a site-specific mode of action (MOA) that is dual, involving mutation in addition to cell-killing induced hyperplasia. Although genotoxicity may contribute to increased risk at all doses, the Guidelines imply that for dual MOA (DMOA) carcinogens, judgment be used to compare and assess results obtained using separate 'linear' (genotoxic) vs. 'nonlinear' (nongenotoxic) approaches to low low-level risk extrapolation. However, the Guidelines allow the latter approach to be used only when evidence is sufficient t to parameterize a biologically based model that reliably o extrapolates risk to low levels of concern. The Guidelines thus effectively prevent MOA uncertainty from being characterized and addressed when data are insufficient to parameterize such a model, but otherwise clearly support a DMOA. A bounding factor approach - similar to that used in reference dose procedures for classic toxicity endpoints - can address MOA uncertainty in a way that avoids explicit modeling of low low-dose risk as a function of administere administered or internal dose. Even when a 'nonlinear' toxicokinetic model cannot be fully validated, implications of DMOA uncertainty on low low-dose risk may be bounded with reasonable confidence when target tumor types happen to be extremely rare. This concept was i illustrated llustrated for a likely DMOA rodent carcinogen naphthalene, specifically to the issue of risk extrapolation from bioassay data on naphthalene naphthalene-induced nasal tumors in rats. Bioassay data, supplemental toxicokinetic data, and related physiologically based p

  4. Compound odontoma causing airway obstruction of the newborn: a case report.

    Tam, D; Francis, L; Perry, C; Thirwall, A


    A newborn presented with acute airway obstruction secondary to a compound odontoma of the hard palate/nasal floor. This is the first case recorded in the literature. We review the pathology of compound odontomas and discuss the management of this rare and interesting case.

  5. Interaction between otorhinolaryngology and orthodontics: correlation between the nasopharyngeal airway and the craniofacial complex

    Stellzig-Eisenhauer, Angelika; Meyer-Marcotty, Philipp


    In terms of pathophysiology, an anatomically narrow airway is a predisposing factor for obstruction of the upper respiratory tract. The correlation between the nasopharyngeal airway and the craniofacial structures is discussed in this context. Thus a mutual interaction between the pharynx and the mandibular position was demonstrated, whereby the transverse dimension of the nasopharynx was significantly larger in patients with prognathism than in patients with retrognathism. The influence of chronic obstruction of the nasal airway on craniofacial development was also discussed. The form-and-function interaction, which ought to explain the causal relationship between nasal obstruction and craniofacial growth, appears to be of a multifactorial rather than a one-dimensional, linear nature. It is not disputed, however, that expanding the maxilla improves not only nasal volume and nasal flow, but also the subjective sensation of patients, although it is not possible to make a prognostic statement about the extent of this improvement because of the differing reactions of individuals. Orthodontic appliances for advancing the mandible can also be successfully used in the treatment of mild obstructive sleep apnea syndrome. This treatment method should be considered particularly for patients who are unwilling to undergo or cannot tolerate CPAP (continuous positive airway pressure) treatment. PMID:22073108


    M. Gharebaghian


    Full Text Available Treacher Collin’s syndrome (TCS is a rare inherited condition characterized by bilateral and symmetric abnormalities of structures within the first and second bronchial arches. Patients with TCS present a serious problem to anesthetists maintaining their airway as upper airway obstruction and difficult tracheal intubation due to severe facial deformity. Because of retrognathia, airway management of these patients is often challenging. We report the case of a 25-yr-old patient with TCS undergoing microtia repair under general anesthesia twice. In the first time he could not be intubated via direct laryngoscopy and was intubated via blind nasal intubation. In the second time, he was intubated through an ILMA using endotracheal tube.

  7. [Upper airway's 3D analysis of patients with obstructive sleep apnea using tomographic cone beam].

    Bruwier, A; Poirrier, A L; Limme, M; Poirrier, R


    The progress of medical imaging over the last decades has led to a better understanding of the upper airway structure in sleep-disordered patients. The Obstructive Sleep Apnea Syndrome (OSA) is attributed to a functional narrowing of the upper airway, particularly of the oropharynx, during sleep. This narrowing is multifactorial. We have shown that in 60% cases, the maxilla (nasal pyramid) seems too narrow. A mandible retroposition may also play a dominant role in 30% of the cases. Both scenarios can be combined. Cone Beam Computed Tomography (CBCT) is a new medical imaging technique that permits to visualize the upper airway with less ionizing radiation than the conventional scanner. To date, only five authors have performed an upper airway's 3D analysis of sleep apnea patients with cone beam. A better understanding of the affected segment of the upper airway should help refine treatment options.

  8. Essentials of airway management, oxygenation, and ventilation: part 2: advanced airway devices: supraglottic airways

    Rosenberg, M B; Phero, J C; Becker, D E


    .... This article will review the evolution and use of advanced airway devices, specifically supraglottic airways, with the emphasis on the laryngeal mask airway, as the next intervention in difficult...

  9. Nasal delivery of P-gp substrates to the brain through the nose-brain pathway.

    Shingaki, Tomotaka; Hidalgo, Ismael J; Furubayashi, Tomoyuki; Sakane, Toshiyasu; Katsumi, Hidemasa; Yamamoto, Akira; Yamashita, Shinji


    The objective of this study was to evaluate in rats the potential utility of the nasal route to enhance central nervous system (CNS) delivery of drugs recognized by P-glycoprotein (P-gp). Well-known P-gp substrates verapamil and talinolol were perfused nasally or infused intravenously, and when plasma concentrations following intravenous infusion and nasal perfusion showed similar profiles. The concentration of verapamil in the brain after nasal perfusion was twice that after intravenous infusion. Although talinolol in the brain and the cerebrospinal fluid after i.v. infusion were below the detection limit, it was detected after nasal perfusion. When rats were treated with cyclosporin A, brain concentrations of verapamil after both administration modes were increased significantly, while those of talinolol were not significantly changed. Since the permeability of talinolol is low, talinolol in the brain which was transported directly from the nasal cavity has little chance of transport by P-gp localized in the apical membrane of cerebral microvessel endothelial cells. The potential for drug delivery utilizing the nose-CNS route was confirmed for P-gp substrates. The advantage of nasal delivery over i.v. delivery of talinolol to the brain was more significant than that of verapamil, suggesting that nasal administration is more useful strategy for the brain delivery of low-permeability P-gp substrates than the use of P-gp inhibitors.

  10. Indirect airway challenges

    Joos, GF; O'Connor, B; Anderson, SD; Chung, F; Cockcroft, DW; Dahlen, B; DiMaria, G; Foresi, A; Hargreave, FE; Holgate, ST; Inman, M; Lotvall, J; Magnussen, H; Polosa, R; Postma, DS; Riedler, J


    Indirect challenges act by causing the release of endogenous mediators that cause the airway smooth muscle to contract. This is in contrast to the direct challenges where agonists such as methacholine or histamine cause airflow limitation predominantly via a direct effect on airway smooth muscle. Di

  11. Postoperative upper airway problems



    Jun 9, 2003 ... REVIEW ARTICLE. Southern African Journal of Anaesthesia & Analgesia - May 2003. 12. Postoperative upper airway problems way. A number of factors, some avoidable, influence the incidence ... debilitating pain, inability to swallow and temporary voice changes, and are a ..... decrease airway resistance.

  12. Pediatric airway nightmares.

    D'Agostino, James


    Pediatric disorders that involve actual or potential airway compromise are among the most challenging cases that emergency department providers face. This article discusses the diagnosis and management of common and uncommon conditions in infants and children who may present with airway obstruction.

  13. Effects of bilateral intermittent nasal obstruction on the mandibular growth and development in young rats%间歇性双侧完全鼻阻塞对幼年大鼠下颌骨生长发育的影响

    陈金东; 王晓玲; 孙惠珺; 薛晓晨; 朱妍菲; 朱敏


    Objective To investigate the effects of bilateral intermittent nasal obstruction on the mandibular growth and development of young rats. Methods Thirty 3-week⁃old SD rats were randomly distributed into three groups ( n=10 each) . The experimental sub⁃jects were treated with single / both nostrils occluded with nose plugs, while the internal control group was left with blank treatment. The experimental subjects were sacrificed after 4 weeks and their mandibles were detached. Ten variables of mandibles were acquired based on X⁃rays. Results The subjects with bilateral nasal obstruction showed significant reduced mandible and femur in size com⁃pared to unilateral nasal obstruction group and control group. However, only length of mandibular body、height of first molar in mandi⁃ble and length of femur in unilateral nasal obstruction group showed significant difference compared to control group. Conclusion The bilateral intermittent nasal obstruction may retard the development of mandibles in rats.%目的:探讨间歇性双侧完全鼻阻塞对幼年大鼠下颌骨生长发育的影响。方法30只3周龄SD大鼠,分为3组,A组:对照组,B组:单侧鼻阻塞组,C组:双侧鼻阻塞组(张口呼吸组),每组各10只。4周后处死30只大鼠,分离大鼠的下颌骨,在X线片上测量10项下颌骨的指标。结果双侧鼻阻塞组与对照组及单侧鼻阻塞组相比,下颌骨及股骨明显小,差异有统计学意义。单侧鼻阻塞组与对照组相比仅下颌体长度、下颌磨牙高度、股骨长度有统计学差异。结论间歇性双侧完全鼻阻塞可以引起大鼠下颌骨的发育不足。

  14. Human respiratory epithelial cells from nasal turbinate expressed stem cell genes even after serial passaging.

    Ruszymah, B H I; Izham, B A Azrul; Heikal, M Y Mohd; Khor, S F; Fauzi, M B; Aminuddin, B S


    Current development in the field of tissue engineering led to the idea of repairing and regenerating the respiratory airway through in vitro reconstruction using autologous respiratory epithelial (RE). To ensure the capability of proliferation, the stem cell property of RE cells from the nasal turbinate should be evaluated. Respiratory epithelial cells from six human nasal turbinates were harvested and cultured in vitro. The gene expression of FZD-9 and BST-1 were expressed in passage 2 (P2) and passage 4 (P4). The levels of expression were not significant between both passages. The RE cells exhibit the stem cell properties, which remains even after serial passaging.

  15. Same Noses, Different Nasalance Scores: Data from Normal Subjects and Cleft Palate Speakers for Three Systems for Nasalance Analysis

    Bressmann, Tim; Klaiman, Paula; Fischbach, Simone


    Nasalance scores from the Nasometer, the NasalView and the OroNasal System were compared. The data was collected from 50 normal participants and 19 hypernasal patients with cleft palate. The Nasometer had the lowest nasalance scores for the non-nasal Zoo Passage and that the OroNasal System had the lowest nasalance scores for the Nasal Sentences.…

  16. Controversies in Pediatric Perioperative Airways

    Jozef Klučka


    Full Text Available Pediatric airway management is a challenge in routine anesthesia practice. Any airway-related complication due to improper procedure can have catastrophic consequences in pediatric patients. The authors reviewed the current relevant literature using the following data bases: Google Scholar, PubMed, Medline (OVID SP, and Dynamed, and the following keywords: Airway/s, Children, Pediatric, Difficult Airways, and Controversies. From a summary of the data, we identified several controversies: difficult airway prediction, difficult airway management, cuffed versus uncuffed endotracheal tubes for securing pediatric airways, rapid sequence induction (RSI, laryngeal mask versus endotracheal tube, and extubation timing. The data show that pediatric anesthesia practice in perioperative airway management is currently lacking the strong evidence-based medicine (EBM data that is available for adult subpopulations. A number of procedural steps in airway management are derived only from adult populations. However, the objective is the same irrespective of patient age: proper securing of the airway and oxygenation of the patient.

  17. [Effect of dental arch length decrease during orthodontic treatment in the upper airway development. A review].

    Haddad, Stéphanie; Kerbrat, Jean-Baptiste; Schouman, Thomas; Goudot, Patrick


    A possible relation between an upper airway space decrease and the development of obstructive sleep apnea syndrom explains the importance to know the effect of the modification of dental arch length on the upper airway during orthodontic treatment. The aim of this article is to expose recent knowledge about upper airway development and dental arch length decrease factors, to determine the influence of this decrease on upper airway development. A review was done to determine the upper airway normal development, to define dental arch to specify if an ideal position of dental arch on apical base exists. All of the length dental arch decrease factors during orthodontic treatment (dental extraction, dental agenesis and dental malpositions) and their upper airway resounding were searched. Some authors found a diminution of upper airway space after premolars extractions while others didn't found this diminution after extractions premolars when incisor retraction is finished. A decrease of transversal maxillary diameter and nasal cavity may be due to absence of permanent teeth. The effect of dental arch length decrease during orthodontic treatment in the upper airway development was not scientifically proved. However we had to be vigilant and adapt our orthodontic treatment case by case to avoid an upper airway modification. © EDP Sciences, SFODF, 2017.

  18. A Typical Path Model of Tracheobronchial Clearance of Inhaled Particles in Rats


    A mathematical description of particle clearance from the ciliated conducting airways (tracheobronchial region) of the lungs in rats was developed...particle transport velocities for given generations of airways were estimated from reported tracheal transport velocities. Using typical rat airway geometry...and estimated particle transport velocities solutions of sets of rate equations for transport from each generation of airways were summed to estimate

  19. Influences of nasal continuous positive airway pressure on sleep architecture of obstructive sleep apnea-hypopnea syndrome patients%经鼻持续气道正压通气对阻塞性睡眠呼吸暂停低通气综合征患者睡眠结构的影响

    温励志; 朱银花


    Objective To investigate the instant influences of nasal continuous positive airway pressure(nCPAP) on sleep architecture of obstructive sleep apnea-hypopnea syndrome(OSAHS) patients. Methods Eighty-seven OSAHS patients were diagnosed by polysomnography (PSG). The CPAP pressure was titrated during the first night. The patients accepted the whole night nCPAP treatment while PSG was monitored. The sleep architectures, apnea-hypopnea index(AHI) and arterial O2 saturation (SaO2) of OSAHS patients were analyzed before and during nCPAP therapy. Results Sleep architecture, AHI and SaO2 were significantly improved during therapy. AHI reduced from (54, 45±28. 85) times/h to (8.11± 13.41) times/h(F = 184. 528, P<0. 001). Minimum SaO2 increased from (64.33±14.73) % to (75.08 ± 15.52)% (F =21. 948, P <0. 001). Average SaO2 increased from (88.19±6.80)% to (91.99±3.87)% (F = 20. 469, P < 0.001). Stage I time vs total sleep time (TST) reduced from (22.63 ± 20.95) % to (18. 56±16.92) %,total REM sleep time vs TST increased from (13.28± 10.25)% to (16.07±9.87)%, but neither differences were significant (F = 1. 984, P = 0. 161 ; F = 3. 347, P = 0.069). Stage Ⅱ time vs TST reduced greatly from (58.84±22.87)% to (48.67±19.57)%(F =9. 947, P =0. 002). Total slow wave sleep times vs TST increased from (6.29±7.16) % to (17.01±9.84) %(F =67. 511, P <0. 001). Conclusions While AHI and SaO2 are significantly improved during therapy, nCPAP can improve the sleep architecture on OSAHS patients significantly.%目的 评价经鼻持续气道正压通气(nCPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者睡眠结构的影响.方法 87例经多导睡眠图(PSG)诊断的OSAHS患者接受nCPAP和PSG监测,分析患者nCPAP治疗前、治疗中睡眠结构和病情严重度指标的改变.结果 患者在nCPAP治疗过程中睡眠结构和病情严重度指标发生明显改善,呼吸暂停低通气指数(AHI)由(54.45±28.85)次/h减至(8.11±13.41)次/h(F=184.528,P<0

  20. Definitive magnetic nasal prosthesis for partial nasal defect

    E Nagaraj


    Full Text Available Maxillofacial trauma refers to any injury to the face or jaw caused by physical force, trauma, the presence of foreign objects, animal or human bites, and burns. Facial defects can be devastating in their impact on physical structure and function of the affected individual, leading to potential compromises in quality of life. Restoration of facial defects, especially nasal defects, is a difficult challenge for both the surgeon and the prosthodontist. Here is a case report of partial nasal defect caused by trauma, rehabilitated with a magnetic nasal prosthesis made with silicone elastomers using mechanical and anatomical retentive aids.

  1. Estenose congênita da abertura piriforme Congenital nasal pyriform aperture stenosis

    José V. Tagliarini


    Full Text Available A estenose congênita da abertura piriforme é uma rara causa de obstrução nasal que pode ocorrer no recém-nascido. É provocada pelo crescimento excessivo do processo nasal medial da maxila causando um estreitamento do terço anterior da fossa nasal. Inicialmente foi relatada uma deformidade isolada, posteriormente a estenose congênita da abertura piriforme foi considerada como apresentação de forma menor da holoprosencefalia. Neste artigo relatamos um caso de recém-nascido do sexo masculino que apresentava desde o parto dispnéia, cianose e episódios de apnéia. O paciente foi submetido a cirurgia com alargamento da abertura piriforme por acesso sublabial. No seguimento apresentou boa evolução durante o acompanhamento. O relato desta deformidade mostra sua importância como causa de obstrução nasal congênita e diagnóstico diferencial de atresia coanal. A estenose congênita da abertura piriforme pode ser reparada adequadamente, quando necessário, através de procedimento cirúrgico.The congenital stenosis of pyriform aperture is an unusual cause of neonatal nasal obstruction. It is due to bony overgrowth of the nasal lateral process of the maxilla. Initially this narrowest part of nasal airway was considered an isolated deformity; subsequently the congenital Stenosis of pyriform aperture was thought to represent a microform of holoprosencephaly. In this report a male neonate had respiratory distress, cyclic cyanosis and apnea after delivery. The patient underwent surgical correction of pyriform stenosis by sublabial access. In the follow up, the patient had good evolution. The report of this deformity shows an important cause of neonatal nasal obstruction and its differential diagnosis with bilateral choanal atresia. Congenital stenosis of nasal pyriform aperture can be surgically corrected when necessary.

  2. Airway distensibility in Chronic Obstructive Airway Disease

    Winkler Wille, Mathilde Marie; Pedersen, Jesper Holst; Dirksen, Asger


    on the airway distensibility, defined as the ratio of relative change in lumen diameter to the relative change in total lung volume (TLV) divided by predicted total lung capacity (pTLC) . Methods – We included 1900 participants from the Danish Lung Cancer Screening Trial (DLCST); all randomized to annual low...

  3. Effects of Quercetin Encapsulated Liposomes via Nasal Administration: A Novel Cognitive Enhancer

    Terdthai Tong-un


    Full Text Available Problem statement: Demand for cognitive-enhancing drugs is growing. Numerous medicinal plants possessing antioxidant activity have received much attention as food supplement to improve cognitive function. Quercetin is a potent free radical scavenger and antioxidant. However, the limitations of quercetin: Rapidly metabolized is an obstacle to its use for a cognitive enhancer. In addition, the burden of blood brain barrier can be overcome by nasal administration and liposomes. In the present study, we investigated whether nasal administration of quercetin liposomes could improve spatial memory in healthy adult rats. Approach: Male Wistar rats were pretreated with quercetin liposomes, containing 0.5 mg of quercetin in 20 µL (dose = 20 µg, via right nasal cavity once daily continually for 4 weeks. Evaluation of rodent learning and memory was assessed by Morris water maze test and then all rats were sacrificed for determining the survival and cholinergic neurons densities in hippocampus. Results: Quercetin liposomes via nasal route treated rats exhibited a significant improvement in cognitive performance. In addition, nasal administration of quercetin liposomes also resulted in induced the densities of survival and cholinergic neurons in hippocampus. However, further researches about the precise underlying mechanism are still required. Conclusion: Our studies demonstrate that quercetin liposomes via nasal administration may have a candidate for cognitive enhancer in the future.

  4. Pharmacological evaluation of selective α2c-adrenergic agonists in experimental animal models of nasal congestion.

    Jia, Yanlin; Mingo, Garfield G; Hunter, John C; Lieber, Gissela B; Palamanda, Jairam R; Mei, Hong; Boyce, Christopher W; Koss, Michael C; Yu, Yongxin; Cicmil, Milenko; Hey, John A; McLeod, Robbie L


    Nasal congestion is one of the most troublesome symptoms of many upper airways diseases. We characterized the effect of selective α2c-adrenergic agonists in animal models of nasal congestion. In porcine mucosa tissue, compound A and compound B contracted nasal veins with only modest effects on arteries. In in vivo experiments, we examined the nasal decongestant dose-response characteristics, pharmacokinetic/pharmacodynamic relationship, duration of action, potential development of tolerance, and topical efficacy of α2c-adrenergic agonists. Acoustic rhinometry was used to determine nasal cavity dimensions following intranasal compound 48/80 (1%, 75 µl). In feline experiments, compound 48/80 decreased nasal cavity volume and minimum cross-sectional areas by 77% and 40%, respectively. Oral administration of compound A (0.1-3.0 mg/kg), compound B (0.3-5.0 mg/kg), and d-pseudoephedrine (0.3 and 1.0 mg/kg) produced dose-dependent decongestion. Unlike d-pseudoephedrine, compounds A and B did not alter systolic blood pressure. The plasma exposure of compound A to produce a robust decongestion (EC(80)) was 500 nM, which related well to the duration of action of approximately 4.0 hours. No tolerance to the decongestant effect of compound A (1.0 mg/kg p.o.) was observed. To study the topical efficacies of compounds A and B, the drugs were given topically 30 minutes after compound 48/80 (a therapeutic paradigm) where both agents reversed nasal congestion. Finally, nasal-decongestive activity was confirmed in the dog. We demonstrate that α2c-adrenergic agonists behave as nasal decongestants without cardiovascular actions in animal models of upper airway congestion.

  5. Effect of TGF-β1 on proliferation of airway smooth muscle cells in asthma rats%TGF-β1对哮喘大鼠气道平滑肌细胞增殖的影响研究

    吴立琴; 戴元荣; 李凤琴; 王瑞丽; 曾潍贤


    Objective To investigate the effect of TGF- β1 on the proliferation of airway smooth muscle cells (ASMCs) in asthma rats. Methods Chronic asthma model was induced in rats and airway smooth muscle cells were isolated and cultured in vitro. The cultured ASMCs were divided into normal group, asthma group, TGF- β1 group and TGF- β1+PD- 98059 group. The cellproliferation was determined with CCK- 8 method and the expression of caveolin- 1 and p- ERK1/2 protein was detected with Western blot. Results The expression of p- ERK1/2 increased significantly in TGF- β1 group compared with other 3 groups (P<0.05), while the expression in TGF- β1+PD- 98059 group was higher than that in asthma group (P<0.05). The expression of caveolin- 1 in TGF- β1 group was lower than that in the normal group and asthma group as wel as in TGF- β1+PD- 98059 group (P<0.05). Conclusion TGF- β1 can down- regulate the expression of protein caveolin- 1 to activate the ERK pathway, thereby to promote the proliferation of airway smooth muscle cells, which final y causes airway remodeling.%目的:探究TGF-β1对哮喘大鼠气道平滑肌细胞(ASMC)增殖的影响,进一步揭示哮喘的发病机制。方法建立大鼠慢性哮喘模型,原代分离培养大鼠ASMC,将细胞分为正常组、哮喘组、TGF-β1组和TGF-β1+PD-98059组,以CCK-8法检测细胞增殖,Western blot法检测caveolin-1和p- ERK1/2蛋白表达。结果 TGF-β1组细胞增殖较正常组和哮喘组明显(均P<0.01);TGF-β1+PD-98059组细胞增殖较TGF-β1组减低,但较哮喘组仍明显(均P<0.05)。TGF-β1组p- ERK1/2表达量较正常组和哮喘组增加;TGF-β1+PD-98059组p- ERK1/2表达量较TGF-β1组减少,但较哮喘组表达量仍有所增加(均P<0.05)。TGF-β1组caveolin-1表达量较正常组和哮喘组减少(均P<0.05);TGF-β1+PD-98059组caveolin-1表达量较TGF-β1组增加(P<0.05)。结论 TGF-β1可以下调caveolin-1蛋白的表达量,

  6. Study Of The Effect Of Nasal- Septal Deviation On The Middle Ear Pressure

    Motesaddi Zarandi M


    Full Text Available Eustachian tube connects middle ear space to the nasopharyngeal space. Upper airway obstruction, with any cause, can derange Eustachian tube function. Nasal septal deviation is one of the prevalent causes of upper airway obstruction which can affects the ventilation function of Eustachian tube."nMaterials and Methods: This study was conducted on the patients who underwent septoplasty due to severe septal deviation leading to unilateral nasal obstruction in Amiraalam hospital from summer of 1378 till the spring of 1379."nResults: There was 140 patients whose data were as: female patients 34 (24.3% male patients 106 (75.7%, mean age (22.7. Median age (20 years and mode of age (18 years of age. they were from 12 to 40 years of age."nConclusion: Comparison between preoperative and postoperative middle ear pressures shows no any significant statistical difference (p=0.798.

  7. Assessment of nasopharyngeal airway and adenoid by MRI

    Jung, Myung Suk; Hur, Gham; Kim, Yong Hoon; Joe, Eun Ok; Lee, Seong Sook [Sanggae Paik Hospital, College of Medicine, Inje University, Seoul (Korea, Republic of)


    Adenoid is a kind of tonsil located in the posterior wall of nasopharynx. Enlargement of the adenoid can produce obstruction of the nasopharynx and Eustachian tube. Disturbance in discharge of nasal and paranasal secretions can be a cause of chronic rhinitis, sinusitis, and otitis media. Diagnosis of enlarged adenoid simply by inspection is different due to its location. Measurement of nasopharyngeal airway and adenoid using lateral radiographs of nasopharynx may be inaccurate for magnification and rotation. It was some limitations in demonstrating the actual state of nasopharyngeal airway and adenoid because it gives only two dimensional information. The authors measured the size and areas of nasopharyngeal airway and adenoid using MRI with sagittal and oblique coronal pilot views of T1 weighted spin echo. We categorized the patients into 4 groups according to the scoring system by symptoms such as apnea, mouth breathing, and snoring. The results of several measurment and their ratios were evaluated in these 4 categorized patients. The ratios of area of adenoid and nasopharyngeal airway (AA/Na) in each patient group were 6.52, 7.76, 10.53, 15.93, respectively. And the ratios of adenoid and nasopharyngeal airway (A/N) by Fujioka's method were 0.6, 0.65, 0.69, 0.71, respectively. We found that AA/Na might be the most effective index as an objective indicator in the evaluation of nasopharyngeal obstruction by the enlarged adenoid.

  8. Nasalization in Galician and Portuguese

    Regueira Fernández, Xosé Luís


    Gallego y portugués compartieron una parte de su historia, y en su evolución el comportamiento de las nasales ha jugado un importante papel. El gallego contemporáneo no presenta nasalidad contrastiva (vocales orales vs nasales), mientras que si las tiene el portugués. En este trabajo muestro que la descripción de la coarticulación velar (o nasalización) de las vocales en contacto con sonorantes nasales es relevante para la descripción de las lenguas tanto gallega como portuguesa y, adem...

  9. Cytotoxic Effects of Intranasal Midazolam on Nasal Mucosal Tissue.

    Ozbay, I; Kucur, C; Değer, A; Ital, I; Kasim, Cayci M; Oghan, F


    The aim of this experimental study was to investigate the cytotoxic effects of intranasal midazolam on nasal mucosal tissue in rats. Forty healthy rats were randomly divided into 5 groups. Group 1 (n = 8) was the control group, group 2 (n = 8) received intranasal saline, group 3 (n = 8) received intranasal midazolam, group 4 (n = 8) received intraperitoneal saline, and group 5 received intraperitoneal midazolam (n = 8). Midazolam and saline were administered via intraperitoneal and intranasal routes at doses of 200 μg/kg. Nasal septal mucosal stripe tissues were removed at the 6th hour. All materials were evaluated according to Ki67 and p53 staining to evaluate proliferation and apoptosis, respectively, and hemotoxylin and eosin staining was performed for histopathology evaluation. Ki67 values and inflammation in group 3 were statistically higher compared to group 1, group 2, and group 4. P53 values in group 3 were statistically higher compared to group 1. Assessment of subepithelial edema between group 3 and the other groups revealed no statistically significant differences. Assessment of cilia loss between group 3 and group 1, group 2, and group 4 revealed no statistically significant difference. The evaluation of goblet cell loss between group 3 and group 1 revealed a statistically significant difference. Intranasal midazolam had adverse effects on nasal mucosa. However, intranasal midazolam is as safe as systemic midazolam administration with respect to nasal mucosa.

  10. Regulation of Tight Junctions in Upper Airway Epithelium

    Takashi Kojima


    Full Text Available The mucosal barrier of the upper respiratory tract including the nasal cavity, which is the first site of exposure to inhaled antigens, plays an important role in host defense in terms of innate immunity and is regulated in large part by tight junctions of epithelial cells. Tight junction molecules are expressed in both M cells and dendritic cells as well as epithelial cells of upper airway. Various antigens are sampled, transported, and released to lymphocytes through the cells in nasal mucosa while they maintain the integrity of the barrier. Expression of tight junction molecules and the barrier function in normal human nasal epithelial cells (HNECs are affected by various stimuli including growth factor, TLR ligand, and cytokine. In addition, epithelial-derived thymic stromal lymphopoietin (TSLP, which is a master switch for allergic inflammatory diseases including allergic rhinitis, enhances the barrier function together with an increase of tight junction molecules in HNECs. Furthermore, respiratory syncytial virus infection in HNECs in vitro induces expression of tight junction molecules and the barrier function together with proinflammatory cytokine release. This paper summarizes the recent progress in our understanding of the regulation of tight junctions in the upper airway epithelium under normal, allergic, and RSV-infected conditions.

  11. Upper and lower airway pathology in young children with allergic- and non-allergic rhinitis

    Chawes, Bo Lk


    Allergic- and non-allergic rhinitis are very common diseases in childhood in industrialized countries. Although these conditions are widely trivialized by both parents and physicians they induce a major impact on quality of life for the affected children and a substantial drainage of health care...... symptom in both allergic- and non-allergic rhinitis, and eosinophilic inflammation is a hallmark of the allergic diseases. In paper I, we studied nasal eosinophilia and nasal airway patency assessed by acoustic rhinometry in children with allergic rhinitis, non-allergic rhinitis and healthy controls...... nasal eosinophilia albeit less than children with allergic rhinitis. These findings suggest different pathology in allergic- and non-allergic rhinitis which may have important clinical implications for early pharmacological treatment of rhinitis in young children. In paper II, we utilized the nasal...

  12. Nasal CPAP and surfactant for treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasia

    Verder, Henrik; Bohlin, Kajsa; Kamper, Jens


    The Scandinavian approach is an effective combined treatment for respiratory distress syndrome (RDS) and prevention of bronchopulmonary dysplasia (BPD). It is composed of many individual parts. Of significant importance is the early treatment with nasal continuous positive airway pressure (nCPAP)......-postnatal treatment with nCPAP and surfactant decreases the severity and mortality of RDS and BPD. This is mainly due to a diminished use of MV in the first days of life....

  13. Emergency airway puncture - slideshow

    ... presentations/100113.htm Emergency airway puncture - series—Normal anatomy To ... larynx is a tubular structure in the neck, through which air passes to the lungs. The thryoid and cricoid cartilage form the narrowest ...

  14. Emergency airway puncture

    ... inserted into the throat, just below the Adam's apple (cricoid cartilage), into the airway. In a hospital, ... Choking Browse the Encyclopedia A.D.A.M., Inc. is accredited by URAC, also known as the ...

  15. Nasal Delivery of High Molecular Weight Drugs

    Erdal Cevher; Yıldız Ozsoy; Sevgi Gungor


    Nasal drug delivery may be used for either local or systemic effects. Low molecular weight drugs with are rapidly absorbed through nasal mucosa. The main reasons for this are the high permeability, fairly wide absorption area, porous and thin endothelial basement membrane of the nasal epithelium. Despite the many advantages of the nasal route, limitations such as the high molecular weight (HMW) of drugs may impede drug absorption through the nasal mucosa. Recent studies have focused particula...

  16. CPAP and High-Flow Nasal Cannula Oxygen in Bronchiolitis.

    Sinha, Ian P; McBride, Antonia K S; Smith, Rachel; Fernandes, Ricardo M


    Severe respiratory failure develops in some infants with bronchiolitis because of a complex pathophysiologic process involving increased airways resistance, alveolar atelectasis, muscle fatigue, and hypoxemia due to mismatch between ventilation and perfusion. Nasal CPAP and high-flow nasal cannula (HFNC) oxygen may improve the work of breathing and oxygenation. Although the mechanisms behind these noninvasive modalities of respiratory support are not well understood, they may help infants by way of distending pressure and delivery of high concentrations of warmed and humidified oxygen. Observational studies of varying quality have suggested that CPAP and HFNC may confer direct physiologic benefits to infants with bronchiolitis and that their use has reduced the need for intubation. No trials to our knowledge, however, have compared CPAP with HFNC in bronchiolitis. Two randomized trials compared CPAP with oxygen delivered by low-flow nasal cannula or face mask and found some improvements in blood gas results and some physiologic parameters, but these trials were unable to demonstrate a reduction in the need for intubation. Two trials evaluated HFNC in bronchiolitis (one comparing it with headbox oxygen, the other with nebulized hypertonic saline), with the results not seeming to suggest important clinical or physiologic benefits. In this article, we review the pathophysiology of respiratory failure in bronchiolitis, discuss these trials in detail, and consider how future research studies may be designed to best evaluate CPAP and HFNC in bronchiolitis.

  17. Airway management in trauma.

    Langeron, O; Birenbaum, A; Amour, J


    Maintenance of a patent and prevention of aspiration are essential for the management of the trauma patient, that requires experienced physicians in airway control techniques. Difficulties of the airway control in the trauma setting are increased by the vital failures, the risk of aspiration, the potential cervical spine injury, the combative patient, and the obvious risk of difficult tracheal intubation related to specific injury related to the trauma. Endotracheal intubation remains the gold standard in trauma patient airway management and should be performed via the oral route with a rapid sequence induction and a manual in-line stabilization maneuver, to decrease the risks previously mentioned. Different techniques to control the airway in trauma patients are presented: improvement of the laryngoscopic vision, lighted stylet tracheal intubation, retrograde technique for orotracheal intubation, the laryngeal mask and the intubating laryngeal mask airways, the combitube and cricothyroidotomy. Management of the airway in trauma patients requires regular training in these techniques and the knowledge of complementary techniques allowing tracheal intubation or oxygenation to overcome difficult intubation and to prevent major complications as hypoxemia and aspiration.

  18. Bilateral cleft lip nasal deformity

    Singh Arun; Nandini R.


    Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the li...

  19. Coarticulation effects on the nasalization of vowels using nasal/voice amplitude ratio instrumentation.

    Larson, P L; Hamlet, S L


    Nasal coarticulation in phonetically controlled nonsense syllables was investigated in four normal adult speakers. Nasalization was determined using the ratio of a nasal accelerometer signal amplitude to airborn microphone signal amplitude. Measurements of nasalization were made at the midpoint of vowels and at a constant time from the nasal consonant. Nasal acoustical coupling was greater for high vowels than for low vowels in all consonant contexts. Nasalization was also greater for vowels between two nasal consonants than for vowels between a nasal consonant and a fricative or stop. Results for progressive versus regressive assimilation depended on the measurement strategy. For within-vowel measurements made a constant time from the nasal consonant, prenasal vowels showed greater nasalization than postnasal vowels. This nasal accelerometric technique shows promise for clinical assessment of articulatory details of velar function.

  20. Acquisition and adaptation of the airway microbiota in the early life of cystic fibrosis patients.

    Boutin, Sébastien; Dalpke, Alexander H


    Cystic fibrosis (CF) is a genetic disease in which bacterial infections of the airways play a major role in the long-term clinical outcome. In recent years, a number of next-generation sequencing (NGS)-based studies aimed at deciphering the structure and composition of the airways' microbiota. It was shown that the nasal cavity of CF patients displays dysbiosis early in life indicating a failure in the first establishment of a healthy microbiota. In contrast, within the conducting and lower airways, the establishment occurs normally first, but is sensitive to future dysbiosis including chronic infections with classical pathogens in later life. The objective of this mini-review is to give an update on the current knowledge about the development of the microbiota in the early life of CF patients. Microbial acquisition in the human airways can be described by the island model: Microbes found in the lower airways of CF patients represent "islands" that are at first populated from the upper airways reflecting the "mainland." Colonization can be modeled following the neutral theory in which the most abundant bacteria in the mainland are also frequently found in the lower airways initially. At later times, however, the colonization process of the lower airways segregates by active selection of specific microbes. Future research should focus on those processes of microbial and host interactions to understand how microbial communities are shaped on short- and long-term scales. We point out what therapeutic consequences arise from the microbiome data obtained within ecological framework models.

  1. Angioleiomyoma of the Nasal Cavity

    Arruda, Milena Moreira


    Full Text Available Introduction Vascular leiomyoma of the nasal cavity is an extremely rare tumor that represents less than 1% of all vascular leiomyomas. It is more prevalent in women between the fourth and sixth decades, reaching primarily the inferior nasal turbinates. Objectives Reporting and assisting the systematization of more accurate diagnostic methods in clinical and complementary investigation of vascular leiomyoma in the nasal cavity. Resumed Report We present the case of a 49-year-old woman diagnosed with vascular leiomyoma in the nasal cavity, which manifested mainly with nasal obstruction. During investigation, computer tomography was not diagnostic, the cytologic study was not conclusive, and according to the biopsy, it was a squamous papilloma. Conclusion We suggest that the technical difficulty in obtaining an adequate amount of material for preoperative biopsy, associated with the topography of the lesion in the vestibular nasal region, may have contributed to changing the postoperative diagnosis. Thus, pathologic study of the surgical fragment is the more accurate method for diagnosis.

  2. Angioleiomyoma of the Nasal Cavity

    Arruda, Milena Moreira; Monteiro, Daniela Yasbek; Fernandes, Atilio Maximino; Menegatti, Vanessa; Thomazzi, Emerson; Hubner, Ricardo Arthur; Lima, Luiz Guilherme Cernaglia Aureliano de


    Introduction Vascular leiomyoma of the nasal cavity is an extremely rare tumor that represents less than 1% of all vascular leiomyomas. It is more prevalent in women between the fourth and sixth decades, reaching primarily the inferior nasal turbinates. Objectives Reporting and assisting the systematization of more accurate diagnostic methods in clinical and complementary investigation of vascular leiomyoma in the nasal cavity. Resumed Report We present the case of a 49-year-old woman diagnosed with vascular leiomyoma in the nasal cavity, which manifested mainly with nasal obstruction. During investigation, computer tomography was not diagnostic, the cytologic study was not conclusive, and according to the biopsy, it was a squamous papilloma. Conclusion We suggest that the technical difficulty in obtaining an adequate amount of material for preoperative biopsy, associated with the topography of the lesion in the vestibular nasal region, may have contributed to changing the postoperative diagnosis. Thus, pathologic study of the surgical fragment is the more accurate method for diagnosis. PMID:25992133

  3. Interleukin-13 Inhibits Lipopolysaccharide-Induced BPIFA1 Expression in Nasal Epithelial Cells.

    Tsou, Yung-An; Lin, Chia-Der; Chen, Hui-Chen; Hsu, Hui-Ying; Wu, Lii-Tzu; Chiang-Ni, Chuan; Chen, Chih-Jung; Wu, Tsu-Fang; Kao, Min-Chuan; Chen, Yu-An; Peng, Ming-Te; Tsai, Ming-Hsui; Chen, Chuan-Mu; Lai, Chih-Ho


    Short palate, lung, and nasal epithelium clone 1 (SPLUNC1) protein is expressed in human nasopharyngeal and respiratory epithelium and has demonstrated antimicrobial activity. SPLUNC1 is now referred to as bactericidal/permeability-increasing fold containing family A, member 1 (BPIFA1). Reduced BPIFA1 expression is associated with bacterial colonization in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Interleukin 13 (IL-13), predominately secreted by T helper 2 (TH2) cells, has been found to contribute to airway allergies and suppress BPIFA1 expression in nasal epithelial cells. However, the molecular mechanism of IL-13 perturbation of bacterial infection and BPIFA1 expression in host airways remains unclear. In this study, we found that lipopolysaccharide (LPS)-induced BPIFA1 expression in nasal epithelial cells was mediated through the JNK/c-Jun signaling pathway and AP-1 activation. We further demonstrated that IL-13 downregulated the LPS-induced activation of phosphorylated JNK and c-Jun, followed by attenuation of BPIFA1 expression. Moreover, the immunohistochemical analysis showed that IL-13 prominently suppressed BPIFA1 expression in eosinophilic CRSwNP patients with bacterial infection. Taken together, these results suggest that IL-13 plays a critical role in attenuation of bacteria-induced BPIFA1 expression that may result in eosinophilic CRSwNP.

  4. A entomoftorose nasal

    Zilton A. Andrade


    Full Text Available São apresentados os dados clínico-patológicos de dois casos de entomoftorose nasal, nova doença humana causada por um ficomiceto - Entomophthora coronata. Os pacientes, uma menina e um homem, com 8 e 44 anos de idade respectivamente, apresentaram doença localizada, com nódulos no nariz e região paranasal, edema e deformação da face. O parasito foi isolado do primeiro caso, mas todas as tentativas para isolá-lo no segundo caso resultaram negativas. Histologicamente, havia reação granulomatosa, fibrose e edema, em torno de hifas não septadas, as quais exibiam envólucro eosinófilo amorfo em torno. Foram demonstrados anticorpos circulantes contra, as hifas do E. coronata no soro de um dos pacientes. O material eosinófilo em torno das hifas continha fibrina e material auto-fluorescente sob luz ultra-violeta, provavelmente lipofuscina, mas não foram demonstrados anticorpos ou antígenos nesta área. A apresentação destes casos, os primeiros a serem descritos no Brasil, é acompanhado, de uma revisão geral do assunto, pois tal poderá vir a ser de interesse para aqueles que estudam os problemas da patologia tropical em nosso meio.

  5. Image diagnosis of nasal bone fracture

    Hirota, Yoshiharu; Shimizu, Yayoi; Iinuma, Toshitaka.


    Twenty cases of nasal bone fractures were evaluated as to the types of fractures based upon HRCT findings. Conventional X-Ray films for nasal bones were analyzed and compared with HRCT findings. Nasal bone fractures were classified into lateral and frontal fractures. HRCT images were evaluated in three planes including upper, middle and lower portions of the nasal bone. Fractures favored males of teens. Lateral fracture gave rise to the fractures of the nasal bone opposite to the external force, loosening of the ipsilateral nasomaxillary sutures and fractures of the frontal process of the maxilla. Conventional X-Ray films were reevaluated after HRCT evaluation and indications of nasal bone fractures were determined. In addition to the discontinuity of the nasal dorsum, fracture lines parallel to and beneath the nasal dorsum and indistinct fracture lines along the nasomaxillary sutures are the indication of nasal bone fractures by conventional X-Ray films.

  6. Essentials of airway management, oxygenation, and ventilation: part 2: advanced airway devices: supraglottic airways.

    Rosenberg, M B; Phero, J C; Becker, D E


    Offices and outpatient dental facilities must be properly equipped with devices for airway management, oxygenation, and ventilation. Part 1 in this series on emergency airway management focused on basic and fundamental considerations for supplying supplemental oxygen to the spontaneously breathing patient and utilizing a bag-valve-mask system including nasopharyngeal and oropharyngeal airways to deliver oxygen under positive pressure to the apneic patient. This article will review the evolution and use of advanced airway devices, specifically supraglottic airways, with the emphasis on the laryngeal mask airway, as the next intervention in difficult airway and ventilation management. The final part of the series (part 3) will address airway evaluation, equipment and devices for tracheal intubation, and invasive airway procedures.

  7. Regional deposition of radon decay products in human airways

    Falk, R.; Moere, H.; Nyblom, L.; Oestergren, I. (Swedish Radiation Protection Inst., Stockholm (Sweden))


    Experimental studies of the uptake and deposition pattern in the human airways of inhaled radon decay products have been carried out using two different techniques. The deposition in the nasal, bronchial and lung regions was assessed by external gamma measurements on the subject. The exposure of the subject was performed in a 'walk-in' radon chamber with controlled conditions. Results from exposure with high and low aerosol concentrations show that no rapid clearance occurred for the deposited decay products. About 20% of the attached inhaled decay products are retained and deposited in the lungs when mouth breathing during resting conditions, while nasal breathing gave about 26% retention, of which 5% was deposited in the nasal region and about 21% in the lungs. Exposure at low aerosol concentration with unattached fraction of about 80% shows a total retention of about 90% indicating a 100% retention of the unattached fraction. Only about 20% of the unattached fraction is found to penetrate the nasal cavity and it seems to be deposited in the bronchial region. (author).

  8. Bilateral cleft lip nasal deformity

    Singh Arun


    Full Text Available Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the literature for correction of this deformity alludes to the fact that no single procedure is entirely effective. The timing for surgical intervention and its extent varies considerably. Early surgery on cartilage may adversely affect growth and development; at the same time, allowing the cartilage to grow in an abnormal position and contributing to aggravation of deformity. Some surgeons advocate correction of deformity at an early age. However, others like the cartilages to grow and mature before going in for surgery. With peer pressure also becoming an important consideration during the teens, the current trend is towards early intervention. There is no unanimity in the extent of nasal dissection to be done at the time of primary lip repair. While many perform limited nasal dissection for the fear of growth retardation, others opt for full cartilage correction at the time of primary surgery itself. The value of naso-alveolar moulding (NAM too is not universally accepted and has now more opponents than proponents. Also most centres in the developing world have neither the personnel nor the facilities for the same. The secondary cleft nasal deformity is variable and is affected by the extent of the original abnormality, any prior surgeries performed and alteration due to nasal growth. This article reviews the currently popular methods for correction of nasal deformity associated with bilateral cleft lip, it′s management both at the time of cleft lip repair

  9. Airway exploration in children

    Fernando GÓMEZ-SÁEZ


    Full Text Available Introduction and objective: The management of the airways represents a constant challenge in pediatric practice. In the last years, bronchoscopy has become an essential technique in the diagnosis and treatment of various abnormalities of the child's respiratory system. The special characteristics of the pediatric airway and the differentiated pathology it presents give pediatric bronchoscopy its own entity. Pediatric bronchoscopy is a safe technique with many applications, both diagnostic and therapeutic. The use of both types of bronchoscopes (flexible and rigid allows to take advantage of each one of them. Flexible bronchoscopy in pediatrics is a relatively simple and low-risk procedure that provides anatomical and dynamic information on the airways, as well as cytological and microbiological studies. The simplicity and low risk of this technique, in addition to not requiring general anesthesia, allows it to be performed even at the head of the patient, which has led to an increasingly extensive field of indications. The purpose of this article is to provide a review on the timeliness of the pediatric bronchoscopy procedure, especially about its indications. Method: Narrative review. Conclusion: The endoscopic examination of the airway is a cost-effective technique in pediatrics, with little complications and can offer very valuable diagnostic information, as well as perform certain therapeutic procedures. It is recommended that all professionals involved in the management of patients with airway pathology should know their indications, contraindications, complications, as well as their therapeutic applications.

  10. Epithelial cell-derived micro RNA-146a generates interleukin-10-producing monocytes to inhibit nasal allergy.

    Luo, Xi; Han, Miaomiao; Liu, Jianqi; Wang, Yu; Luo, Xiangqian; Zheng, Jing; Wang, Shuai; Liu, Zhigang; Liu, Dabo; Yang, Ping-Chang; Li, Huabin


    The aberrant immunity plays an important role in the pathogenesis of allergic diseases. Micro RNAs (miR) are involved in regulating the immunity in the body. This study aims to test a hypothesis that miR-146a induces the expression of interleukin (IL)-10 in monocytes (Mos). In this study, the levels of miR-146a were determined by real time RT-PCR. The IL-10(+) Mos were evaluated by flow cytometry. The miR-146a-laden exosomes were generated with RPMI2650 cells (an airway epithelial cell line). An allergic rhinitis mouse model was developed. The results showed that nasal epithelial cells expressed miR-146a, which was markedly lower in the nasal epithelial cells of patients with nasal allergy than that in healthy controls. Exposure to T helper (Th)2 cytokines suppressed the levels of miR-146a in the nasal epithelial cells. The nasal epithelial cell-derived miR-146a up regulated the expression of IL-10 in Mos. The inducible IL-10(+) Mos showed an immune suppressor effect on the activities of CD4(+) effector T cells and the Th2 polarization in a mouse model of allergic rhinitis. In summary, nasal epithelial cells express miR-146a, the latter is capable of inducing IL-10 expression in Mos, which suppress allergic reactions in the mouse nasal mucosa.

  11. Integrated care pathways for airway diseases (AIRWAYS-ICPs)

    Bousquet, J.; Addis, A.; Adcock, I.; Agache, I.; Agusti, A.; Alonso, A.; Annesi-Maesano, I.; Anto, J. M.; Bachert, C.; Baena-Cagnani, C. E.; Bai, C.; Baigenzhin, A.; Barbara, C.; Barnes, P. J.; Bateman, E. D.; Beck, L.; Bedbrook, A.; Bel, E. H.; Benezet, O.; Bennoor, K. S.; Benson, M.; Bernabeu-Wittel, M.; Bewick, M.; Bindslev-Jensen, C.; Blain, H.; Blasi, F.; Bonini, M.; Bonini, S.; Boulet, L. P.; Bourdin, A.; Bourret, R.; Bousquet, P. J.; Brightling, C. E.; Briggs, A.; Brozek, J.; Buh, R.; Bush, A.; Caimmi, D.; Calderon, M.; Calverley, P.; Camargos, P. A.; Camuzat, T.; Canonica, G. W.; Carlsen, K. H.; Casale, T. B.; Cazzola, M.; Sarabia, A. M. Cepeda; Cesario, A.; Chen, Y. Z.; Chkhartishvili, E.; Chavannes, N. H.; Chiron, R.; Chuchalin, A.; Chung, K. F.; Cox, L.; Crooks, G.; Crooks, M. G.; Cruz, A. A.; Custovic, A.; Dahl, R.; Dahlen, S. E.; De Blay, F.; Dedeu, T.; Deleanu, D.; Demoly, P.; Devillier, P.; Didier, A.; Dinh-Xuan, A. T.; Djukanovic, R.; Dokic, D.; Douagui, H.; Dubakiene, R.; Eglin, S.; Elliot, F.; Emuzyte, R.; Fabbri, L.; Wagner, A. Fink; Fletcher, M.; Fokkens, W. J.; Fonseca, J.; Franco, A.; Frith, P.; Furber, A.; Gaga, M.; Garces, J.; Garcia-Aymerich, J.; Gamkrelidze, A.; Gonzales-Diaz, S.; Gouzi, F.; Guzman, M. A.; Haahtela, T.; Harrison, D.; Hayot, M.; Heaney, L. G.; Heinrich, J.; Hellings, P. W.; Hooper, J.; Humbert, M.; Hyland, M.; Iaccarino, G.; Jakovenko, D.; Jardim, J. R.; Jeandel, C.; Jenkins, C.; Johnston, S. L.; Jonquet, O.; Joos, G.; Jung, K. S.; Kalayci, O.; Karunanithi, S.; Keil, T.; Khaltaev, N.; Kolek, V.; Kowalski, M. L.; Kull, I.; Kuna, P.; Kvedariene, V.; Le, L. T.; Carlsen, K. C. Lodrup; Louis, R.; MacNee, W.; Mair, A.; Majer, I.; Manning, P.; Keenoy, E. de Manuel; Masjedi, M. R.; Meten, E.; Melo-Gomes, E.; Menzies-Gow, A.; Mercier, G.; Mercier, J.; Michel, J. P.; Miculinic, N.; Mihaltan, F.; Milenkovic, B.; Molimard, M.; Mamas, I.; Montilla-Santana, A.; Morais-Almeida, M.; Morgan, M.; N'Diaye, M.; Nafti, S.; Nekam, K.; Neou, A.; Nicod, L.; O'Hehir, R.; Ohta, K.; Paggiaro, P.; Palkonen, S.; Palmer, S.; Papadopoulos, N. G.; Papi, A.; Passalacqua, G.; Pavord, I.; Pigearias, B.; Plavec, D.; Postma, D. S.; Price, D.; Rabe, K. F.; Pontal, F. Radier; Redon, J.; Rennard, S.; Roberts, J.; Robine, J. M.; Roca, J.; Roche, N.; Rodenas, F.; Roggeri, A.; Rolland, C.; Rosado-Pinto, J.; Ryan, D.; Samolinski, B.; Sanchez-Borges, M.; Schunemann, H. J.; Sheikh, A.; Shields, M.; Siafakas, N.; Sibille, Y.; Similowski, T.; Small, I.; Sola-Morales, O.; Sooronbaev, T.; Stelmach, R.; Sterk, P. J.; Stiris, T.; Sud, P.; Tellier, V.; To, T.; Todo-Bom, A.; Triggiani, M.; Valenta, R.; Valero, A. L.; Valiulis, A.; Valovirta, E.; Van Ganse, E.; Vandenplas, O.; Vasankari, T.; Vestbo, J.; Vezzani, G.; Viegi, G.; Visier, L.; Vogelmeier, C.; Vontetsianos, T.; Wagstaff, R.; Wahn, U.; Wallaert, B.; Whalley, B.; Wickman, M.; Williams, D. M.; Wilson, N.; Yawn, B. P.; Yiallouros, P. K.; Yorgancioglu, A.; Yusuf, O. M.; Zar, H. J.; Zhong, N.; Zidarn, M.; Zuberbier, T.


    The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will ad

  12. Integrated care pathways for airway diseases (AIRWAYS-ICPs)

    Bousquet, J.; Addis, A.; Adcock, I.; Agache, I.; Agusti, A.; Alonso, A.; Annesi-Maesano, I.; Anto, J. M.; Bachert, C.; Baena-Cagnani, C. E.; Bai, C.; Baigenzhin, A.; Barbara, C.; Barnes, P. J.; Bateman, E. D.; Beck, L.; Bedbrook, A.; Bel, E. H.; Benezet, O.; Bennoor, K. S.; Benson, M.; Bernabeu-Wittel, M.; Bewick, M.; Bindslev-Jensen, C.; Blain, H.; Blasi, F.; Bonini, M.; Bonini, S.; Boulet, L. P.; Bourdin, A.; Bourret, R.; Bousquet, P. J.; Brightling, C. E.; Briggs, A.; Brozek, J.; Buh, R.; Bush, A.; Caimmi, D.; Calderon, M.; Calverley, P.; Camargos, P. A.; Camuzat, T.; Canonica, G. W.; Carlsen, K. H.; Casale, T. B.; Cazzola, M.; Sarabia, A. M. Cepeda; Cesario, A.; Chen, Y. Z.; Chkhartishvili, E.; Chavannes, N. H.; Chiron, R.; Chuchalin, A.; Chung, K. F.; Cox, L.; Crooks, G.; Crooks, M. G.; Cruz, A. A.; Custovic, A.; Dahl, R.; Dahlen, S. E.; De Blay, F.; Dedeu, T.; Deleanu, D.; Demoly, P.; Devillier, P.; Didier, A.; Dinh-Xuan, A. T.; Djukanovic, R.; Dokic, D.; Douagui, H.; Dubakiene, R.; Eglin, S.; Elliot, F.; Emuzyte, R.; Fabbri, L.; Wagner, A. Fink; Fletcher, M.; Fokkens, W. J.; Fonseca, J.; Franco, A.; Frith, P.; Furber, A.; Gaga, M.; Garces, J.; Garcia-Aymerich, J.; Gamkrelidze, A.; Gonzales-Diaz, S.; Gouzi, F.; Guzman, M. A.; Haahtela, T.; Harrison, D.; Hayot, M.; Heaney, L. G.; Heinrich, J.; Hellings, P. W.; Hooper, J.; Humbert, M.; Hyland, M.; Iaccarino, G.; Jakovenko, D.; Jardim, J. R.; Jeandel, C.; Jenkins, C.; Johnston, S. L.; Jonquet, O.; Joos, G.; Jung, K. S.; Kalayci, O.; Karunanithi, S.; Keil, T.; Khaltaev, N.; Kolek, V.; Kowalski, M. L.; Kull, I.; Kuna, P.; Kvedariene, V.; Le, L. T.; Carlsen, K. C. Lodrup; Louis, R.; MacNee, W.; Mair, A.; Majer, I.; Manning, P.; Keenoy, E. de Manuel; Masjedi, M. R.; Meten, E.; Melo-Gomes, E.; Menzies-Gow, A.; Mercier, G.; Mercier, J.; Michel, J. P.; Miculinic, N.; Mihaltan, F.; Milenkovic, B.; Molimard, M.; Mamas, I.; Montilla-Santana, A.; Morais-Almeida, M.; Morgan, M.; N'Diaye, M.; Nafti, S.; Nekam, K.; Neou, A.; Nicod, L.; O'Hehir, R.; Ohta, K.; Paggiaro, P.; Palkonen, S.; Palmer, S.; Papadopoulos, N. G.; Papi, A.; Passalacqua, G.; Pavord, I.; Pigearias, B.; Plavec, D.; Postma, D. S.; Price, D.; Rabe, K. F.; Pontal, F. Radier; Redon, J.; Rennard, S.; Roberts, J.; Robine, J. M.; Roca, J.; Roche, N.; Rodenas, F.; Roggeri, A.; Rolland, C.; Rosado-Pinto, J.; Ryan, D.; Samolinski, B.; Sanchez-Borges, M.; Schunemann, H. J.; Sheikh, A.; Shields, M.; Siafakas, N.; Sibille, Y.; Similowski, T.; Small, I.; Sola-Morales, O.; Sooronbaev, T.; Stelmach, R.; Sterk, P. J.; Stiris, T.; Sud, P.; Tellier, V.; To, T.; Todo-Bom, A.; Triggiani, M.; Valenta, R.; Valero, A. L.; Valiulis, A.; Valovirta, E.; Van Ganse, E.; Vandenplas, O.; Vasankari, T.; Vestbo, J.; Vezzani, G.; Viegi, G.; Visier, L.; Vogelmeier, C.; Vontetsianos, T.; Wagstaff, R.; Wahn, U.; Wallaert, B.; Whalley, B.; Wickman, M.; Williams, D. M.; Wilson, N.; Yawn, B. P.; Yiallouros, P. K.; Yorgancioglu, A.; Yusuf, O. M.; Zar, H. J.; Zhong, N.; Zidarn, M.; Zuberbier, T.

    The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will

  13. Craniofacial and pharyngeal airway morphology in patients with acromegaly.

    Balos Tuncer, Burcu; Canigur Bavbek, Nehir; Ozkan, Cigdem; Tuncer, Cumhur; Eroglu Altinova, Alev; Gungor, Kahraman; Akturk, Mujde; Balos Toruner, Fusun


    The aim of this study was to assess differences in craniofacial characteristics, upper spine and pharyngeal airway morphology in patients with acromegaly compared with healthy individuals. Twenty-one patients with acromegaly were compared with 22 controls by linear and angular measurements on cephalograms. The differences between the mean values of cephalometric parameters were analyzed with Mann-Whitney U-test. With respect to controls, anterior (pacromegaly. Craniofacial changes were predominantly found in the frontal bone (pacromegaly exhibited diminished dimensions at nasal (pacromegaly. Current results point to the importance of the reduced airway dimensions and that dentists and/or orthodontists should be aware of the cranial or dental abnormalities in patients with acromegaly.

  14. Airway reconstruction in children

    Rao Sanjay


    Full Text Available Aim/Background : Airway anomalies are infrequent but potentially life threatening in children. A program to care for these difficult children was set up at our institution, and this paper summarizes our experience. Methods: A total of 34 children were enrolled in the program over a period of three years. These children were evaluated as per the standard protocols. Treatment was individualized. Results: Of these 34 children, 28 had their airways restored and are doing well. Four children continue to remain on tracheostomy and two will require long term tracheostomy. There were two deaths. All children are under surveillance as there is a risk of recurrence. Conclusions: Airway anomalies are complex problems with significant morbidity and mortality. Current therapeutic modalities allow for good results. Most children were successfully decannulated and did well.

  15. Different regulation of cigarette smoke induced inflammation in upper versus lower airways

    Bracke Ken R


    Full Text Available Abstract Background Cigarette smoke (CS is known to initiate a cascade of mediator release and accumulation of immune and inflammatory cells in the lower airways. We investigated and compared the effects of CS on upper and lower airways, in a mouse model of subacute and chronic CS exposure. Methods C57BL/6 mice were whole-body exposed to mainstream CS or air, for 2, 4 and 24 weeks. Bronchoalveolar lavage fluid (BAL was obtained and tissue cryosections from nasal turbinates were stained for neutrophils and T cells. Furthermore, we evaluated GCP-2, KC, MCP-1, MIP-3α, RORc, IL-17, FoxP3, and TGF-β1 in nasal turbinates and lungs by RT-PCR. Results In both upper and lower airways, subacute CS-exposure induced the expression of GCP-2, MCP-1, MIP-3α and resulted in a neutrophilic influx. However, after chronic CS-exposure, there was a significant downregulation of inflammation in the upper airways, while on the contrary, lower airway inflammation remained present. Whereas nasal FoxP3 mRNA levels already increased after 2 weeks, lung FoxP3 mRNA increased only after 4 weeks, suggesting that mechanisms to suppress inflammation occur earlier and are more efficient in nose than in lungs. Conclusions Altogether, these data demonstrate that CS induced inflammation may be differently regulated in the upper versus lower airways in mice. Furthermore, these data may help to identify new therapeutic targets in this disease model.

  16. Airway management in patients with maxillofacial trauma - A retrospective study of 177 cases

    Chetan B Raval


    Full Text Available Background: Airway management in maxillofacial injuries presents with a unique set of problems. Compromised airway is still a challenge to the anesthesiologist in spite of all modalities available. Maxillofacial injuries are the result of high-velocity trauma arising from road traffic accidents, sport injuries, falls and gunshot wounds. Any flaw in airway management may lead to grave morbidity and mortality in prehospital or hospital settings and as well as for reconstruction of fractures subsequently. Methods: One hundred and seventy-seven patients of maxillofacial injuries, operated over a period of one and half years during July 2008 to December 2009 in Al-Nahdha hospital were reviewed. All patients were reviewed in depth with age related type of injury, etiology and techniques of difficult airway management. Results: The major etiology of injuries were road traffic accidents (67% followed by sport (15% and fall (15%. Majority of patients were young in the age group of 11-30 years (71 %. Fracture mandible (53% was the most common injury, followed by fracture maxilla (21%, fracture zygoma (19% and pan-facial fractures (6%. Maxillofacial injuries compromise mask ventilation and difficult airway due to facial fractures, tissue edema and deranged anatomy. Shared airway with the surgeon needs special attention due to restrictions imposed during surgery. Several methods available for securing the airway, both decision-making and performance, are important in such circumstances. Airway secured by nasal intubation with direct visualization of vocal cords was the most common (57%, followed by oral intubation (17%. Other methods like tracheostomy and blind nasal intubation was avoided by fiberoptic bronchoscopic nasal intubation in 26% of patients. Conclusion: The results of this study indicated that surgically securing the airway by tracheostomy should be revised compared to other available methods. In the era of rigid fixation of fractures and the

  17. Paediatric airway management: basic aspects

    Holm-Knudsen, R J; Rasmussen, L S


    . Airway obstruction can be avoided by paying close attention to the positioning of the head of the child and by keeping the mouth of the child open during mask ventilation. The use of oral and nasopharyngeal airways, laryngeal mask airways, and cuffed endotracheal tubes is discussed with special reference...... to the circumstances in infants. A slightly different technique during laryngoscopy is suggested. The treatment of airway oedema and laryngospasm is described....

  18. TRPA1 is a major oxidant sensor in murine airway sensory neurons.

    Bessac, Bret F; Sivula, Michael; von Hehn, Christian A; Escalera, Jasmine; Cohn, Lauren; Jordt, Sven-Eric


    Sensory neurons in the airways are finely tuned to respond to reactive chemicals threatening airway function and integrity. Nasal trigeminal nerve endings are particularly sensitive to oxidants formed in polluted air and during oxidative stress as well as to chlorine, which is frequently released in industrial and domestic accidents. Oxidant activation of airway neurons induces respiratory depression, nasal obstruction, sneezing, cough, and pain. While normally protective, chemosensory airway reflexes can provoke severe complications in patients affected by inflammatory airway conditions like rhinitis and asthma. Here, we showed that both hypochlorite, the oxidizing mediator of chlorine, and hydrogen peroxide, a reactive oxygen species, activated Ca(2+) influx and membrane currents in an oxidant-sensitive subpopulation of chemosensory neurons. These responses were absent in neurons from mice lacking TRPA1, an ion channel of the transient receptor potential (TRP) gene family. TRPA1 channels were strongly activated by hypochlorite and hydrogen peroxide in primary sensory neurons and heterologous cells. In tests of respiratory function, Trpa1(-/-) mice displayed profound deficiencies in hypochlorite- and hydrogen peroxide-induced respiratory depression as well as decreased oxidant-induced pain behavior. Our results indicate that TRPA1 is an oxidant sensor in sensory neurons, initiating neuronal excitation and subsequent physiological responses in vitro and in vivo.

  19. Effect of Class III bone anchor treatment on airway.

    Nguyen, Tung; De Clerck, Hugo; Wilson, Michael; Golden, Brent


    To compare airway volumes and minimum cross-section area changes of Class III patients treated with bone-anchored maxillary protraction (BAMP) versus untreated Class III controls. Twenty-eight consecutive skeletal Class III patients between the ages of 10 and 14 years (mean age, 11.9 years) were treated using Class III intermaxillary elastics and bilateral miniplates (two in the infra-zygomatic crests of the maxilla and two in the anterior mandible). The subjects had cone beam computed tomographs (CBCTs) taken before initial loading (T1) and 1 year out (T2). Twenty-eight untreated Class III patients (mean age, 12.4 years) had CBCTs taken and cephalograms generated. The airway volumes and minimum cross-sectional area measurements were performed using Dolphin Imaging 11.7 3D software. The superior border of the airway was defined by a plane that passes through the posterior nasal spine and basion, while the inferior border included the base of the epiglottis to the lower border of C3. From T1 to T2, airway volume from BAMP-treated subjects showed a statistically significant increase (1499.64 mm(3)). The area in the most constricted section of the airway (choke point) increased slightly (15.44 mm(2)). The airway volume of BAMP patients at T2 was 14136.61 mm(3), compared with 14432.98 mm(3) in untreated Class III subjects. Intraexaminer correlation coefficients values and 95% confidence interval values were all greater than .90, showing a high degree of reliability of the measurements. BAMP treatment did not hinder the development of the oropharynx.

  20. Reduced nasal nitric oxide production in cystic fibrosis patients with elevated systemic inflammation markers.

    Ruth K Michl

    Full Text Available BACKGROUND: Nitric oxide (NO is produced within the respiratory tract and can be detected in exhaled bronchial and nasal air. The concentration varies in specific diseases, being elevated in patients with asthma and bronchiectasis, but decreased in primary ciliary dyskinesia. In cystic fibrosis (CF, conflicting data exist on NO levels, which are reported unexplained as either decreased or normal. Functionally, NO production in the paranasal sinuses is considered as a location-specific first-line defence mechanism. The aim of this study was to investigate the correlation between upper and lower airway NO levels and blood inflammatory parameters, CF-pathogen colonisation, and clinical data. METHODS AND FINDINGS: Nasal and bronchial NO concentrations from 57 CF patients were determined using an electrochemical analyser and correlated to pathogen colonisation of the upper and lower airways which were microbiologically assessed from nasal lavage and sputum samples. Statistical analyses were performed with respect to clinical parameters (lung function, BMI, laboratory findings (CRP, leucocytes, total-IgG, fibrinogen, and anti-inflammatory and antibiotic therapy. There were significant correlations between nasal and bronchial NO levels (rho = 0.48, p<0.001, but no correlation between NO levels and specific pathogen colonisation. In patients receiving azithromycin, significantly reduced bronchial NO and a tendency to reduced nasal NO could be found. Interestingly, a significant inverse correlation of nasal NO to CRP (rho = -0.28, p = 0.04 and to leucocytes (rho = -0.41, p = 0.003 was observed. In contrast, bronchial NO levels showed no correlation to clinical or inflammatory parameters. CONCLUSION: Given that NO in the paranasal sinuses is part of the first-line defence mechanism against pathogens, our finding of reduced nasal NO in CF patients with elevated systemic inflammatory markers indicates impaired upper airway defence. This

  1. Numeric simulation of the upper airway structure and airflow dynamic characteristics after unilateral complete maxillary resection.

    Qian, Yumei; Qian, Haixin; Wu, Yadong; Jiao, Ting


    This study investigated upper airway aerodynamic characteristics of patients who underwent maxillectomy using three-dimensional reconstruction and computational fluid dynamics. The results revealed the generation of low-velocity vortices throughout the entire maxillary defect during respiration. The nasal structure on the nonsurgical side changed postsurgically, possibly due to the pressure gradient between the defective and healthy side. The bilateral disturbed airflow patterns are believed to be the cause of common symptoms. The numeric simulation technique could be used as a potential method to understand upper airway morphology changes and respiratory functions, thus guiding the fabrication of prostheses.

  2. The management of endotracheal tubes and nasal cannulae: the role of nurses.

    Trevisanuto, Daniele; Doglioni, Nicoletta; Zanardo, Vincenzo


    The management of endotracheal tubes and nasal cannulae covers a large part of work time of nurses involved in the care of very preterm infants. These procedures, although continuously performed, have not yet been scientifically demonstrated. In fact, there is limited evidence regarding several points such as the frequency of endotracheal suctioning, the level of suction pressure, the duration of suctioning, the depth of catheter insertion, the sterility, and the use of normal saline during endotracheal suction. With regard to the nasal cannulae, there is a more recent use of this device consisting in delivering end-expiratory pressure or gas flow to reduce the frequency of apneas and desaturations in preterm infants or for the management of RDS. This approach is defined high-flow nasal cannulae (HFNC). In this article, we review the literature on the airway management of intubated patients as well as of infants managed with nasal-CPAP or nasal cannulae. Potential fields of research on this topic are suggested.

  3. Nasal lavage fluid examination in diagnostics of occupational allergy to chloramine.

    Pałczyński, Cezary; Walusiak, Jolanta; Krakowiak, Anna; Szymczak, Wiesław; Wittczak, Tomasz; Ruta, Urszula; Górski, Paweł; Szymczak, Wojciech


    Chloramine T is a known sensitising agent in the occupational environment of health care workers. In cases of occupational hazards induced by this agent, a clinical history may be far from conclusive, hence appropriate provocation tests are absolutely essential. The aim of the study was to evaluate the usefulness of the nasal challenge test in diagnostics of respiratory allergy to chloramine T. A single-blind, placebo-controlled study was conducted in 6 subjects with chloramine T asthma and rhinitis. Two control groups comprised 7 atopic subjects with asthma and rhinitis and 6 healthy persons. All the controls had negative results of skin prick tests with chloramine T and none displayed any respiratory symptoms under exposure to the agent. A "nasal pool" technique was used to evaluate morphological and biochemical parameters (mast cell tryptase, eosinophil cationic protein, permeability index) in nasal washings before and 30 min, 4 h and 24 h after the provocation with chloramine T and placebo. A significant increase was found in the total count and percentage of eosinophils and basophils, albumin, tryptase and eosinophil cationic protein levels in the nasal lavage fluid from patients with chloramine T respiratory allergy when compared to both control groups. Also a dual asthmatic reaction in 4 patients and an isolated late reaction in 2 cases were observed in chloramine-sensitive subjects. The results indicate the applicability of the "nasal pool" technique as a diagnostic procedure in chloramine T-induced airway allergy.

  4. Distinct PKA and Epac compartmentalization in airway function and plasticity

    Dekkers, Bart G. J.; Racke, Kurt; Schmidt, Martina


    Asthma and chronic obstructive pulmonary disease (COPD) are obstructive lung diseases characterized by airway obstruction, airway inflammation and airway remodelling. Next to inflammatory cells and airway epithelial cells, airway mesenchymal cells, including airway smooth muscle cells and (myo)fibro

  5. Schwannoma of the nasal septum

    Abdullah Karatas


    Full Text Available Schwannomas are benign and slow growing tumors originating from the Schwann cells of peripheral nerve sheath. Schwannomas of sinonasal origin are rare (4% however septal schwannomas are much more rarer. We presented a 31 year old female patient. At physical examination a pale gray, smooth polypoid lesion obstructing the right nasal cavity was detected. Midfacial degloving and endoscopic approach were combined for surgical treatment. The tumor was originating from posteromedial area of the septal nasal cartilage, close to the bony cartilaginous junction. Postoperative histological examination of the specimen showed a benign tumoral growth consisting of spindle shaped cells and immunohistochemical staining of the tumor proved septal schwannoma.

  6. Aspiration of Nasopore nasal packing.

    Smith, Jonathan; Reddy, Ekambar


    We present a case of postoperative Nasopore aspiration in an otherwise fit and well 11-year-old. An endoscopic adenoidectomy had been performed without incident and Nasopore packing placed into each nasal cavity. Immediately after extubation, there was marked hypoxia, tachypnoea and high clinical suspicion of pack aspiration. The patient returned to theatre for emergency rigid bronchoscopy and retrieval of nasal packing. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Acanthamoeba protease activity promotes allergic airway inflammation via protease-activated receptor 2.

    Park, Mi Kyung; Cho, Min Kyoung; Kang, Shin Ae; Park, Hye-Kyung; Kim, Dong-Hee; Yu, Hak Sun


    Acanthamoeba is a free-living amoeba commonly present in the environment and often found in human airway cavities. Acanthamoeba possesses strong proteases that can elicit allergic airway inflammation. To our knowledge, the aeroallergenicity of Acanthamoeba has not been reported. We repeatedly inoculated mice with Acanthamoeba trophozoites or excretory-secretory (ES) proteins intra-nasally and evaluated symptoms and airway immune responses. Acanthamoeba trophozoites or ES proteins elicited immune responses in mice that resembled allergic airway inflammation. ES proteins had strong protease activity and activated the expression of several chemokine genes (CCL11, CCL17, CCL22, TSLP, and IL-25) in mouse lung epithelial cells. The serine protease inhibitor phenyl-methane-sulfonyl fluoride (PMSF) inhibited ES protein activity. ES proteins also stimulated dendritic cells and enhanced the differentiation of naive T cells into IL-4-secreting T cells. After repeated inoculation of the protease-activated receptor 2 knockout mouse with ES proteins, airway inflammation and Th2 immune responses were markedly reduced, but not to basal levels. Furthermore, asthma patients had higher Acanthamoeba-specific IgE titers than healthy controls and we found Acanthamoeba specific antigen from house dust in typical living room. Our findings suggest that Acanthamoeba elicits allergic airway symptoms in mice via a protease allergen. In addition, it is possible that Acanthamoeba may be one of the triggers human airway allergic disease.

  8. Acanthamoeba protease activity promotes allergic airway inflammation via protease-activated receptor 2.

    Mi Kyung Park

    Full Text Available Acanthamoeba is a free-living amoeba commonly present in the environment and often found in human airway cavities. Acanthamoeba possesses strong proteases that can elicit allergic airway inflammation. To our knowledge, the aeroallergenicity of Acanthamoeba has not been reported. We repeatedly inoculated mice with Acanthamoeba trophozoites or excretory-secretory (ES proteins intra-nasally and evaluated symptoms and airway immune responses. Acanthamoeba trophozoites or ES proteins elicited immune responses in mice that resembled allergic airway inflammation. ES proteins had strong protease activity and activated the expression of several chemokine genes (CCL11, CCL17, CCL22, TSLP, and IL-25 in mouse lung epithelial cells. The serine protease inhibitor phenyl-methane-sulfonyl fluoride (PMSF inhibited ES protein activity. ES proteins also stimulated dendritic cells and enhanced the differentiation of naive T cells into IL-4-secreting T cells. After repeated inoculation of the protease-activated receptor 2 knockout mouse with ES proteins, airway inflammation and Th2 immune responses were markedly reduced, but not to basal levels. Furthermore, asthma patients had higher Acanthamoeba-specific IgE titers than healthy controls and we found Acanthamoeba specific antigen from house dust in typical living room. Our findings suggest that Acanthamoeba elicits allergic airway symptoms in mice via a protease allergen. In addition, it is possible that Acanthamoeba may be one of the triggers human airway allergic disease.

  9. Assessment of pulmonary antibodies with induced sputum and bronchoalveolar lavage induced by nasal vaccination against Pseudomonas aeruginosa: a clinical phase I/II study

    Freihorst Joachim


    Full Text Available Abstract Background Vaccination against Pseudomonas aeruginosa is a desirable albeit challenging strategy for prevention of airway infection in patients with cystic fibrosis. We assessed the immunogenicity of a nasal vaccine based on the outer membrane proteins F and I from Pseudomonas aeruginosa in the lower airways in a phase I/II clinical trial. Methods N = 12 healthy volunteers received 2 nasal vaccinations with an OprF-OprI gel as a primary and a systemic (n = 6 or a nasal booster vaccination (n = 6. Antibodies were assessed in induced sputum (IS, bronchoalveolar lavage (BAL, and in serum. Results OprF-OprI-specific IgG and IgA antibodies were found in both BAL and IS at comparable rates, but differed in the predominant isotype. IgA antibodies in IS did not correlate to the respective serum levels. Pulmonary antibodies were detectable in all vaccinees even 1 year after the vaccination. The systemic booster group had higher IgG levels in serum. However, the nasal booster group had the better long-term response with bronchial antibodies of both isotypes. Conclusion The nasal OprF-OprI-vaccine induces a lasting antibody response at both, systemic and airway mucosal site. IS is a feasible method to non-invasively assess bronchial antibodies. A further optimization of the vaccination schedule is warranted.

  10. Tissue factor pathway inhibitor prevents airway obstruction, respiratory failure and death due to sulfur mustard analog inhalation

    Rancourt, Raymond C., E-mail:; Veress, Livia A., E-mail:; Ahmad, Aftab, E-mail:; Hendry-Hofer, Tara B., E-mail:; Rioux, Jacqueline S., E-mail:; Garlick, Rhonda B., E-mail:; White, Carl W., E-mail:


    Sulfur mustard (SM) inhalation causes airway injury, with enhanced vascular permeability, coagulation, and airway obstruction. The objective of this study was to determine whether recombinant tissue factor pathway inhibitor (TFPI) could inhibit this pathogenic sequence. Methods: Rats were exposed to the SM analog 2-chloroethyl ethyl sulfide (CEES) via nose-only aerosol inhalation. One hour later, TFPI (1.5 mg/kg) in vehicle, or vehicle alone, was instilled into the trachea. Arterial O{sub 2} saturation was monitored using pulse oximetry. Twelve hours after exposure, animals were euthanized and bronchoalveolar lavage fluid (BALF) and plasma were analyzed for prothrombin, thrombin–antithrombin complex (TAT), active plasminogen activator inhibitor-1 (PAI-1) levels, and fluid fibrinolytic capacity. Lung steady-state PAI-1 mRNA was measured by RT-PCR analysis. Airway-capillary leak was estimated by BALF protein and IgM, and by pleural fluid measurement. In additional animals, airway cast formation was assessed by microdissection and immunohistochemical detection of airway fibrin. Results: Airway obstruction in the form of fibrin-containing casts was evident in central conducting airways of rats receiving CEES. TFPI decreased cast formation, and limited severe hypoxemia. Findings of reduced prothrombin consumption, and lower TAT complexes in BALF, demonstrated that TFPI acted to limit thrombin activation in airways. TFPI, however, did not appreciably affect CEES-induced airway protein leak, PAI-1 mRNA induction, or inhibition of the fibrinolytic activity present in airway surface liquid. Conclusions: Intratracheal administration of TFPI limits airway obstruction, improves gas exchange, and prevents mortality in rats with sulfur mustard-analog-induced acute lung injury. - Highlights: • TFPI administration to rats after mustard inhalation reduces airway cast formation. • Inhibition of thrombin activation is the likely mechanism for limiting casts. • Rats given TFPI

  11. Does Post Septoplasty Nasal Packing Reduce Complications?

    Bijan Naghibzadeh


    Full Text Available The main issues in nasal surgery are to stabilize the nose in the good position after surgery and preserve the cartilages and bones in the favorable situation and reduce the risk of deviation recurrence. Also it is necessary to avoid the synechia formation, nasal valve narrowing, hematoma and bleeding. Due to the above mentioned problems and in order to solve and minimize them nasal packing, nasal splint and nasal mold have been advised. Patients for whom the nasal packing used may faced to some problems like naso-pulmonary reflex, intractable pain, sleep disorder, post operation infection and very dangerous complication like toxic shock syndrome. We have two groups of patients and three surgeons (one of the surgeons used post operative nasal packing in his patients and the two others surgeons did not.Complications and morbidities were compared in these two groups. Comparing the two groups showed that the rate of complication and morbidities between these two groups were same and the differences were not valuable, except the pain and discomfort post operatively and at the time of its removal. Nasal packing has several risks for the patients while its effects are not studied. Septoplasty can be safely performed without postoperative nasal packing. Nasal packing had no main findings that compensated its usage. Septal suture is one of the procedures that can be used as alternative method to nasal packing. Therefore the nasal packing after septoplasty should be reserved for the patients with increased risk of bleeding.

  12. Nasal pulse oximetry overestimates oxygen saturation

    Rosenberg, J; Pedersen, M H


    Ten surgical patients were monitored with nasal and finger pulse oximetry (Nellcor N-200) for five study periods with alternating mouth and nasal breathing and switching of cables and sensors. Nasal pulse oximetry was found to overestimate arterial oxygen saturation by 4.7 (SD 1.4%) (bias...

  13. COPD 大鼠气道上皮 CC16 mRNA的表达及意义%CC16 expression in airway epithelium of rats with chronic obstructive pulmonary disease

    方苏榕; 谷伟; 谭焰; 孙丽华


    Objective:To explore the significance of CC 16 in the pathogenesis of chronic obstructive pulmonary disease( COPD ) by examining the CC16 expression in the airway epithelium of COPD rats before and after Tiotropium intervention.Methods: The male Sprague-Dawley(SD)rats were randomly assigned into the healthy control group , COPD model group ( smoke+endotoxin ) , and Tiotropium intervention group , with 10 in each .RT-PCR was used to detect the gene expression of CC 16 mRNA and immunohistochemistery was applied to test the protein expression of CC16 in the lung tissue in each group of rats .Enzyme-linked immunosorbent assay (ELISA) was adopted to investigate the levels of CC 16, PLA2, IL8 and TNFαin the serum as well as PLA2, IL8, and TNFαin the lung tissue .Results: CC16 mRNA gene expression was significantly reduced in the lung tissue of COPD model group compared with the healthy control group , but remarkably increased in Tiotropium intervention group as opposed to COPD model group .CC16 was found to be higher in the serum and lung tissue of COPD model group and PLA2, IL8 and TNFαwere lower than those in the healthy control group , while CC16 level was shown to be markedly elevated in the serum and lung tissue of Tiotropium intervention group and PLA 2, IL8, and TNFαlevels were significantly lower when compared with COPD model group .The differences were statistically significant (P<0.05).Conclusion:Gene expression of CC16 mRNA and CC16 protein expression in the airway epithelium decreased in the development of COPD rats , which may be a histological marker of mild airway injury in pathogenesis of COPD and involved in the development and progression of COPD .%目的:探讨CC16在慢性阻塞性肺病( COPD)发病机制中的作用。方法:将雄性SD大鼠随机分为健康对照组、COPD模型组(烟熏+内毒素)和噻托溴铵药物干预组,每组10只。 RT-PCR检测各组大鼠气道上皮中CC16 mRNA的表达;免疫组化检

  14. Changes in nasal resistance and nasal geometry using pressure and acoustic rhinometry in a feline model of nasal congestion

    McLeod, R.L.; Mingo, G.G.; Herczku, C.


    This is the first report describing the use and pharmacological characterization of nasal patency by both pressure rhinometry and acoustic rhinometry (AcR) in an experimental cat model of nasal congestion. In pressure rhinometry studies, aerosolized compound 48/80 (0.1-3.0%), a mast cell liberator...... histamine (0.1-1.0%) on nasal geometry were similar to compound 48/80. We conclude that the cat is a useful model for evaluating the pharmacological actions of potential nasal decongestants. Furthermore, we also conclude that AcR is a useful method for noninvasive assessment of nasal patency...

  15. Upper and lower airway pathology in young children with allergic- and non-allergic rhinitis

    Chawes, Bo Lk


    Allergic- and non-allergic rhinitis are very common diseases in childhood in industrialized countries. Although these conditions are widely trivialized by both parents and physicians they induce a major impact on quality of life for the affected children and a substantial drainage of health care...... symptom in both allergic- and non-allergic rhinitis, and eosinophilic inflammation is a hallmark of the allergic diseases. In paper I, we studied nasal eosinophilia and nasal airway patency assessed by acoustic rhinometry in children with allergic rhinitis, non-allergic rhinitis and healthy controls......, and filaggrin mutations; levels of total IgE, FeNO, and blood-eosinophils; lung function and bronchial responsiveness to cold dry air. We found that asthma was similarly associated with allergic- and non-allergic rhinitis suggesting a link between upper and lower airway diseases beyond an allergy associated...

  16. Advances in prehospital airway management.

    Jacobs, Pe; Grabinsky, A


    Prehospital airway management is a key component of emergency responders and remains an important task of Emergency Medical Service (EMS) systems worldwide. The most advanced airway management techniques involving placement of oropharyngeal airways such as the Laryngeal Mask Airway or endotracheal tube. Endotracheal tube placement success is a common measure of out-of-hospital airway management quality. Regional variation in regard to training, education, and procedural exposure may be the major contributor to the findings in success and patient outcome. In studies demonstrating poor outcomes related to prehospital-attempted endotracheal intubation (ETI), both training and skill level of the provider are usually often low. Research supports a relationship between the number of intubation experiences and ETI success. National standards for certification of emergency medicine provider are in general too low to guarantee good success rate in emergency airway management by paramedics and physicians. Some paramedic training programs require more intense airway training above the national standard and some EMS systems in Europe staff their system with anesthesia providers instead. ETI remains the cornerstone of definitive prehospital airway management, However, ETI is not without risk and outcomes data remains controversial. Many systems may benefit from more input and guidance by the anesthesia department, which have higher volumes of airway management procedures and extensive training and experience not just with training of airway management but also with different airway management techniques and adjuncts.

  17. Extraglottic airway devices: technology update

    Sharma B


    Full Text Available Bimla Sharma, Chand Sahai, Jayashree Sood Department of Anaesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital, New Delhi, India Abstract: Extraglottic airway devices (EADs have revolutionized the field of airway management. The invention of the laryngeal mask airway was a game changer, and since then, there have been several innovations to improve the EADs in design, functionality, safety and construction material. These have ranged from changes in the shape of the mask, number of cuffs and material used, like rubber, polyvinylchloride and latex. Phthalates, which were added to the construction material in order to increase device flexibility, were later omitted when this chemical was found to have serious adverse reproductive outcomes. The various designs brought out by numerous companies manufacturing EADs resulted in the addition of several devices to the airway market. These airway devices were put to use, many of them with inadequate or no evidence base regarding their efficacy and safety. To reduce the possibility of compromising the safety of the patient, the Difficult Airway Society (DAS formed the Airway Device Evaluation Project Team (ADEPT to strengthen the evidence base for airway equipment and vet the new extraglottic devices. A preuse careful analysis of the design and structure may help in better understanding of the functionality of a particular device. In the meantime, the search for the ideal EAD continues. Keywords: extraglottic airway devices, laryngeal mask airway, other extraglottic airway devices, safety, technology update

  18. Supraglottic airway devices in children

    S Ramesh


    Full Text Available Modern anaesthesia practice in children was made possible by the invention of the endotracheal tube (ET, which made lengthy and complex surgical procedures feasible without the disastrous complications of airway obstruction, aspiration of gastric contents or asphyxia. For decades, endotracheal intubation or bag-and-mask ventilation were the mainstays of airway management. In 1983, this changed with the invention of the laryngeal mask airway (LMA, the first supraglottic airway device that blended features of the facemask with those of the ET, providing ease of placement and hands-free maintenance along with a relatively secure airway. The invention and development of the LMA by Dr. Archie Brain has had a significant impact on the practice of anaesthesia, management of the difficult airway and cardiopulmonary resuscitation in children and neonates. This review article will be a brief about the clinical applications of supraglottic airways in children.

  19. Effect of doxycycline on airway inflammation and remodeling in asthmatic rats%多西环素对哮喘大鼠气道炎症及气道重塑的影响

    李静; 王亮; 杨红申; 李亚妹; 侯宏伟; 李香兰; 张聪瑶; 李玉静


    目的:探讨多西环素对哮喘大鼠气道炎症及重塑的预防作用及可能机制。方法将实验 SD 大鼠分为正常对照组、哮喘组、多西环素干预组。计数大鼠肺泡灌洗液中的细胞数并进行分类;检测血清中的白细胞介素5(IL-5)、白细胞介素13(IL-13)、肿瘤坏死因子α(TNF-α)的水平;检测肺组织中基质金属蛋白酶9(MMP-9)、肌动蛋白α(α-SMA)的表达;测定支气管基底膜周径(Pbm)、总管壁面积(WAt)、平滑肌面积(WAm)等反映气道壁厚度的指标,分析多西环素的影响。结果哮喘组与多西环素干预组的肺泡灌洗液细胞总数、嗜酸性粒细胞计数、支气管壁厚度、平滑肌厚度、血清 IL-5、IL-13及 TNF-α水平、肺组织 MMP-9、α-SMA 平均光度值均明显高于正常对照组,其中多西环素干预组均明显低于哮喘组(P <0.05)。结论多西环素可以影响炎症介质的生成及通过抑制 MMP-9的活性从而减轻哮喘的气道炎症及气道重塑。%ABSTRACT:Objective To investigate the effect of doxycycline on airway inflammation and remodeling in asthmatic rats.Methods Thirty-three male Sprague Dawley rats were randomly divided into three groups:control group,asthma group and doxycycline intervention group.Total cell number and different cell number in BALF were counted.The concentrations of serum IL-5,IL-13 were assayed by ELISA,and the concentration of serum TNF-αwas determined by radioimmunoassay.The expression of MMP-9 and α-SMA in lung tissues were observed by immunohistochemistry.Lung tissues were sliced and stained with HE.These parameters such as bronchial basement membrane perimeter (Pbm),total bronchial wall area (WAt)and smooth muscle area (WAm),which reflected the thickness of airway wall,were measured by image analysis system.Results The count of total cells and eosinophils significantly increased in asthma group and doxycycline intervention group than in control group(P <0.05),and the

  20. Irsogladine maleate regulates gap junctional intercellular communication-dependent epithelial barrier in human nasal epithelial cells.

    Miyata, Ryo; Nomura, Kazuaki; Kakuki, Takuya; Takano, Ken-Ichi; Kohno, Takayuki; Konno, Takumi; Sawada, Norimasa; Himi, Tetsuo; Kojima, Takashi


    The airway epithelium of the human nasal mucosa acts as the first physical barrier that protects against inhaled substances and pathogens. Irsogladine maleate (IM) is an enhancer of gastric mucosal protective factors via upregulation of gap junctional intercellular communication (GJIC). GJIC is thought to participate in the formation of functional tight junctions. However, the effects of IM on GJIC and the epithelial barrier in human nasal epithelial cells (HNECs) remain unknown. To investigate the effects of IM on GJIC and the tight junctional barrier in HNECs, primary cultures of HNECs transfected with human telomerase reverse transcriptase (hTERT-HNECs) were treated with IM and the GJIC inhibitors oleamide and 18β-GA. Some cells were pretreated with IM before treatment with TLR3 ligand poly(I:C) to examine whether IM prevented the changes via TLR3-mediated signal pathways. In hTERT-HNECs, GJIC blockers reduced the expression of tight junction molecules claudin-1, -4, -7, occludin, tricellulin, and JAM-A. IM induced GJIC activity and enhanced the expression of claudin-1, -4, and JAM-A at the protein and mRNA levels with an increase of barrier function. GJIC blockers prevented the increase of the tight junction proteins induced by IM. Furthermore, IM prevented the reduction of JAM-A but not induction of IL-8 and TNF-α induced by poly(I:C). In conclusion, IM can maintain the GJIC-dependent tight junctional barrier via regulation of GJIC in upper airway nasal epithelium. Therefore, it is possible that IM may be useful as a nasal spray to prevent the disruption of the epithelial barrier by viral infections and exposure to allergens in human nasal mucosa.

  1. 清金化痰汤对 COPD 模型大鼠肺组织中性粒细胞弹性蛋白酶及黏蛋白5AC 表达的影响%Qingjinhuatan decoction adjusting chronic obstructive pulmonary model rat in airway mucus hypersecretion by neutrophil elastase and mucin 5AC

    陈英; 冯淬灵; 李根茂; 葛东宇; 王骏; 李春盈; 姚小芹


    目的:探讨清金化痰汤调节慢性阻塞性肺疾病模型大鼠气道黏液高分泌的作用机制。方法40只清洁级 Wistar 大鼠随机分为空白对照组(A)、模型组(B)、清金化痰汤组(C)与克拉霉素组(D)。B、C、D 组大鼠均给与气道内滴注脂多糖(LPS)联合烟熏的方法建立慢性阻塞性肺疾病气道黏液高分泌模型。B、C、D 组连续30 d 分别给予生理盐水、清金化痰汤、克拉霉素灌胃,正常组正常喂养。实验第31天,处死大鼠,提取肺组织。每组随机选取6只,采用实时荧光定量 PCR 检测肺组织中性粒细胞弹性蛋白酶(HE)、黏蛋白5AC(MUC 5AC)基因表达,阿尔新兰-过碘酸雪夫法观察气道上皮杯状细胞增生,免疫组化法检测肺组织及气道上皮 HE、MUC 5AC 蛋白表达。结果模型组 HEmRHA、MUC 5AC mRHA 表达、杯状细胞数目、肺组织中 HE 及 MUC 5AC 表达均较空白对照组显著升高;清金化痰汤组、克拉霉素组 MUC 5ACmRHA、杯状细胞数目、肺组织中MUC 5AC 均较模型组显著降低;清金化痰汤组 HEmRHA、MUC 5ACmRHA、肺组织气道上皮 HE 表达较克拉霉素组降低;清金化痰汤组在杯状细胞增生、肺组织气道上皮 MUC 5AC 表达与克拉霉素组无差异。结论清金化痰汤可能通过调节 HE / MUC 5AC 途径,抑制慢性阻塞性肺疾病气道黏液高分泌。%Objective To explore Qingjinhuatan decoction’s mechanism on airway mucus hypersecretion of chro-nic obstructive pulmonary disease rat model. Methods Clean level Wistar rats(n = 40)are randomly divided into blank control group(A),model group(B),Qingjinhuatan decoction group(C)and Clarithromycin group(D). Using dripping LPS in bronchus and smoking to intervene on B,C and D group rat in order to build COPD airway mucus hy-persecretion model. B,C and D group rats are separately raised by normal saline,Qingjinhuatan decoction and Clar-ithromycin for 30 days

  2. Swelling of Erectile Nasal Tissue Induced by Human Sexual Pheromone.

    Mazzatenta, Andrea; De Luca, C; Di Tano, A; Cacchio, M; Di Giulio, C; Pokorski, Mieczyslaw


    Most chemically mediated sexual communication in humans remains uncharacterized. Yet the study of sexual communication is decisive for understanding sexual behavior and evolutive mechanisms in our species. Here we provide the evidence to consider 4,16-androstadien-3-one (AND) as a man's sexual pheromone. Our experiment provides support for the physiological effect of AND on nasal airway resistance (Rna) in women, as assessed by anterior rhinomanometry. We found that AND administration increased the area of turbinate during the ovulatory phase, resulting in an increase of Rna. Thus, we discovered that minute amounts of AND, acting through neuroendocrine brain control, regulate Rna and consequently affect the sexual physiology and behavior. Fascinatingly, this finding provides the evidence of the preservation of chemosexual communication in humans, which it has been largely neglected due to its unconscious perception and concealed nature. Therefore, chemical communication is a plesiomorphic evolutive phenomenon in humans.

  3. Nasal intubation: A comprehensive review

    Varun Chauhan


    Full Text Available Nasal intubation technique was first described in 1902 by Kuhn. The others pioneering the nasal intubation techniques were Macewen, Rosenberg, Meltzer and Auer, and Elsberg. It is the most common method used for giving anesthesia in oral surgeries as it provides a good field for surgeons to operate. The anatomy behind nasal intubation is necessary to know as it gives an idea about the pathway of the endotracheal tube and complications encountered during nasotracheal intubation. Various techniques can be used to intubate the patient by nasal route and all of them have their own associated complications which are discussed in this article. Various complications may arise while doing nasotracheal intubation but a thorough knowledge of the anatomy and physics behind the procedure can help reduce such complications and manage appropriately. It is important for an anesthesiologist to be well versed with the basics of nasotracheal intubation and advances in the techniques. A thorough knowledge of the anatomy and the advent of newer devices have abolished the negative effect of blindness of the procedure.

  4. Diagnostic strategies in nasal congestion

    John Krouse


    Full Text Available John Krouse1, Valerie Lund2, Wytske Fokkens3, Eli O Meltzer41Temple University School of Medicine, Philadelphia, PA, USA; 2Ear Institute, University College London, UK; 3Department of Otorhinolaryngology, Amsterdam Medical Centre, Netherlands; 4Allergy and Asthma Medical Group and Research Center, San Diego, CA and Department of Pediatrics, University of California, San Diego, USAAbstract: Nasal congestion is a major symptom of upper respiratory tract disorders, and its characterization an important part of the diagnosis of these illnesses. Patient history and assessment of nasal symptoms are essential components of diagnosis, providing an initial evaluation that may be adequate to rule out serious conditions. However, current congestion medications are not always fully effective. Thus, if symptoms do not respond adequately to therapy, or symptoms suggestive of more serious conditions are present, specialized assessments may be needed. Various techniques are available for diagnosing patients, including those used chiefly by primary care clinicians and those requiring the expertise of otolaryngologists, allergists, and other specialists. Endoscopy remains a mainstay for evaluating nasal blockage and its causes, while modalities such as peak nasal inspiratory flow and acoustic rhinometry are evolving to provide easy-to-use, noninvasive procedures that are sensitive enough to measure small but clinically important abnormalities and therapeutic changes. Several imaging modalities are available to the specialist for severe or unusual cases, as are specialized diagnostic procedures that measure adjunctive features of congestion, such as impaired mucociliary function.Keywords: allergic rhinitis, congestion, diagnosis, obstruction, rhinosinusitis

  5. Nasal Schwannoma: a case report

    Siu-Navarro YJ, Pérez-Carbajal AJ


    Full Text Available Introduction: Schwannomas are benign tumors that arise from Schwann cells peripheral nerves sheath. About 25-45% occur in the head and neck and only 4% of these tumors involve the sinunasal tract.Objective: To provide, through a clinic case and lecture review, the clinical and radiopatology findings of a bening and unusual tumors, as are the Nasal schwannomas. Case Report: We report a case of a young woman with nasal schwannoma, who complain of left nasal obstruction and rhinorrhea, which after subsequent imaging studies, surgical and pathology analisis, diagnosis was found. Sustained a favorable clinical evolution.Results and Discussion: The clinic and radiologic findings are nonspecific, depend upon the location or size of the tumor and subsequent involvement of surrounding structures, but generally present as a mass with less agressive behavior. The elective treatment is surgery, confirming this disease by microscopic and immunohistochemistry studies.Conclusion: Given these aspects must be considered nasal schwannomas within the differential diagnosis of a tumor with less aggressive behavior, clinical-radiological, because implies good results for the patient and unusual recurrence after surgery.

  6. Immunophenotype Heterogeneity in Nasal Glomangiopericytoma

    Adriana Handra-Luca


    Full Text Available Nasal glomangiopericytoma is rare. The immunophenotype is heterogeneous, more frequently smooth-muscle-actin and CD34-positive. We report expression patterns for several vascular-related proteins such as CD99, CD146, Bcl2, and WT1 as well as for treatment-related proteins such as mTOR and EGFR in a nasal glomangiopericytoma. The patient (woman, 86 years presented with a left nasal tumefaction. The resected specimen (1.5-cm showed a glomangiopericytoma. Tumor cells expressed smooth-muscle-actin, CD31, CD34, and progesterone receptor. They also expressed the vascular-cell-related proteins Bcl2, CD99, CD146, and WT1, as well as mTOR and EGFR. Nasal glomangiopericytomas show immunohistochemical heterogeneity for vascular-related markers, suggesting a possible extensive pericytic differentiation. The expression of potential targets for drug treatments such as mTOR and EGFR may impact on the clinical follow-up of these tumors occurring at advanced ages, which may require complex surgery.

  7. Available techniques for objective assessment of upper airway narrowing in snoring and sleep apnea

    Faber, Christian; Grymer, Luisa


    A number of techniques are available to determine the level of obstructive predominance in snoring and in the obstructive sleep apnea hypopnea syndrome (OSAHS): lateral cephalography, awake endoscopy, awake endoscopy with the Müller maneuver, endoscopy during sleep, endoscopy with nasal continuous...... positive airway pressure during sleep, fluoroscopy, CT scanning, MR scanning, manometry, and acoustic reflections. Data from different studies using various methods suggest that different patients have different patterns of narrowing or collapse of the pharynx. No reference standard exists...

  8. Development of a Transnasal Delivery System for Recombinant Human Growth Hormone (rhGH): Effects of the Concentration and Molecular Weight of Poly-L-arginine on the Nasal Absorption of rhGH in Rats.

    Kawashima, Ryo; Uchida, Masaki; Yamaki, Tsutomu; Ohtake, Kazuo; Hatanaka, Tomomi; Uchida, Hiroyuki; Ueda, Hideo; Kobayashi, Jun; Morimoto, Yasunori; Natsume, Hideshi


    A novel system for delivering recombinant human growth hormone (rhGH) that is noninvasive and has a simple method of administration is strongly desired to improve the compliance of children. The aim of this study was to investigate the potential for the intranasal (i.n.) co-administration of rhGH with poly-L-arginine (PLA) as a novel delivery system by evaluating the effects of the concentration and molecular weight of PLA on the nasal absorption of rhGH. The influence of the formation of insoluble aggregates and a soluble complex in the dosage formulation on nasal rhGH absorption was also evaluated by size-exclusion chromatography and ultrafiltration. PLA enhanced the nasal absorption of rhGH at each concentration and molecular weight examined. Nasal rhGH absorption increased dramatically when the PLA concentration was 1.0 % (w/v) due to the improved solubility of rhGH in the formulation. A delay in rhGH absorption was observed when the molecular weight of PLA was increased. This appeared to be because the increase in molecular weight caused the formation of a soluble complex. It seems that the PLA concentration affects the absorption-enhancing effect on rhGH, while the molecular weight of PLA affects the time when the maximum plasma rhGH concentration was reached (Tmax) of rhGH after i.n. administration, mainly because of the interactions among rhGH, PLA, and additives. Therefore, the transnasal rhGH delivery system using PLA is considered to be a promising alternative to subcutaneous (s.c.) injection if these interactions are sufficiently controlled.

  9. Nasal Septum Perforation due to Methamphetamine abuse

    Mehdi Bakhshaee


    Full Text Available Introduction: Spontaneous Perforation of the nasal septum is an uncommon condition. Nasal inhalation of substances such as cocaine has long been linked to this Perforation. Case Report: This report describes the case of a 46-year-old woman who was addicted to methamphetamine and who presented with perforation of the nasal septum.This is the first reported case of nasal septal necrosis linked to nasal inhalation of methamphetamine. Conclusions: Patient history and assurance regardingillegal drug consumption and abuse is a key point for fast and accurate diagnosis. The pathophysiology of drug-induced sinunasal disease and a review of the literature are also presented.

  10. Idiopathic calcinosis cutis of nasal dorsum

    Shrinath D.P Kamath


    Full Text Available A 23-year-old lady presented with a slowly progressing firm mass on the nasal dorsum since 8 months. Her biochemical, haematological and collagen vascular disease screening tests were normal. Radiographs of the nasal bones showed a subcutaneous calcifying lesion with no evidence of nasal bone erosion. A diagnosis of idiopathic calcinosis cutis (ICC was made. The mass was excised and soft tissue defect was augmented with silicone prosthesis. The histopathology with the haematoxylin and eosin staining and von Kossa stain confirmed the diagnosis of calcinosis cutis. This is an unusual presentation of ICC involving the nasal dorsum requiring surgery and nasal dorsal augmentation with silicone prosthesis.

  11. Effects of simvastatin on airway inflammation and airway mucus hypersecretion in rats with chronic obstructive pulmonary disease%辛伐他汀对慢性阻塞性肺疾病模型大鼠气道炎症和气道黏液高分泌的防治作用及其机制

    王胜; 熊玲玲; 邓雪; 任薇; 朱春冬; 李春颖; 周群


    ,减轻气道炎症和气道黏液高分泌.%Objective To explore the preventive and therapeutic effects of simvastatin on rats with chronic obstructive pulmonary disease (COPD) and examine the mechanism of airway inflammation and airway mucus hypersecretion.Methods The rat model of COPD was established by cigarette smoking and an intratracheal injection of lipopolysaccharide (LPS).A total of 18 male Sprague-Dawley rats were randomly divided into control,COPD and simvastatin groups (n =6 each).The control and COPD groups received normal saline once daily via intragastric administration (i.g.) while the simvastatin group had simvastatin (0.5 g/L) 1 ml/100 g once daily via i.g.Pulmonary function was tested and pathological changes in bronchus and lung were observed.The bronchoalveolar lavage fluid (BALF) levels of interleukin-8 (IL-8),interleukin-17 (IL-17) and tumor necrosis factor (TNF)-α were measured by enzyme-linked immunosorbent assay (ELISA).The protein expressions of intercellular adhesion molecule 1 (ICAM-1),nuclear factor κB (NF-κB),mucin 5AC (MUC5AC) and Toll-like receptor 4 (TLR4) in rat airway were detected by immunohistochemical staining.The mRNA and protein expressions of TLR4 and MUC5AC in bronchi and lung tissue were detected by fluorescent real time quantitative polymerase chain reaction (RT-PCR) and Western blot.Results The changes of bronchi and lung tissues in COPD group were consistent with typical pathological manifestations of COPD.As compared with the COPD group,the degree of pulmonary pathological damage and the decline of pulmonary function in the simvastatin group were significantly lessened,but still remarkable as compared with the control group.The BALF levels of IL-8,IL-17 and TNF-α in the smvastatin group [(484.4 ± 11.1),(78.9 ± 2.0),(192.7 ± 2.0) ng/L] were significantly lower than those in the COPD group [(605 ±48.7),(89.9 ±6.9),(212.6 ± 10.7) ng/L],but still higher than those in the control group [(341.2 ± 21.4),(56.0 ± 2

  12. Effects of Shenmai and Aminophylline on Apoptosis of Small Airway Smooth Muscle Cells and the Expression of Relevant Genes in Rats with Emphysema

    牛汝楫; 刘辉国; 傅娟


    Summary: The effects of Shenmai injection (SMI) and aminophylline on apoptosis of small airwaysmooth muscle cells (SASMC) and the Fas/FasL expression in rats with papain-induced emphyse-ma were investigated. Rat emphysema model was established by a single intratracheal instillationof papain. Apoptosis and Fas/FasL expression of SASMC were detected by immunohistochemistrySABC and TUNEL assay at day 1, 3, 5, 7, 15, 30 after modeling, and the effect of SMI andaminophylline on them were observed. The results indicated that the Fas/FasL expression positiverate in SASMC was 2.31±0. 55/1. 28±0. 47 respectively. After a single intratracheal instillationof papain, the expression of Fas/FasL positive rate in the placebo group was increased in a time-dependent manner. SMI could inhibit the expression of Fas/FasL, but aminophylline couldn't.The positive rate of apoptosis in the control group was 0. 87±0. 32. After a single intratracheal in-stillation of papain, the SASMC apoptosis positive rate in the placebo group was increased in atime-dependent manner. The SASMC apoptosis rate in all groups was declined after treatmentwith SMI, but the effect of aminophylline was not obvious. It was demonstrated that in the patho-genesis of emphysema Fas/FasL played an important role in the regulation of SASMC apoptosis.SMI influenced the expression of Fas/FasL and declined SASMC apoptosis by inhibiting the releas-ing of inflammatory media and played an important role in the therapy of emphysema.

  13. The role of trigeminal nasal TRPM8-expressing afferent neurons in the antitussive effects of menthol.

    Plevkova, J; Kollarik, M; Poliacek, I; Brozmanova, M; Surdenikova, L; Tatar, M; Mori, N; Canning, B J


    The cold-sensitive cation channel TRPM8 is a target for menthol, which is used routinely as a cough suppressant and as an additive to tobacco and food products. Given that cold temperatures and menthol activate neurons through gating of TRPM8, it is unclear how menthol actively suppresses cough. In this study we describe the antitussive effects of (-)-menthol in conscious and anesthetized guinea pigs. In anesthetized guinea pigs, cough evoked by citric acid applied topically to the tracheal mucosa was suppressed by menthol only when it was selectively administered as vapors to the upper airways. Menthol applied topically to the tracheal mucosa prior to and during citric acid application or administered continuously as vapors or as an aerosol to the lower airways was without effect on cough. These actions of upper airway menthol treatment were mimicked by cold air delivered to the upper airways but not by (+)-menthol, the inactive isomer of menthol, or by the TRPM8/TRPA1 agonist icilin administered directly to the trachea. Subsequent molecular analyses confirmed the expression of TRPM8 in a subset of nasal trigeminal afferent neurons that do not coincidently express TRPA1 or TRPV1. We conclude that menthol suppresses cough evoked in the lower airways primarily through a reflex initiated from the nose.

  14. Three dimensional assessment of the pharyngeal airway in individuals with non-syndromic cleft lip and palate.

    Tracy Cheung

    Full Text Available INTRODUCTION: Children with cleft lip and palate (CLP are known to have airway problems. Previous studies have shown that individuals with CLP have a 30% reduction in nasal airway size compared to non-cleft controls. No reports have been found on cross-sectional area and volume of the pharyngeal airway in clefts. Introduction of Cone-Beam CT (CBCT and imaging software has facilitated generation of 3D images for assessment of the cross-sectional area and volume of the airway. OBJECTIVE: To assess the pharyngeal airway in individuals with CLP using CBCT by measuring volume and smallest cross-sectional areas and compare with 19 age- and sex-matched non-cleft controls. METHODS: Retrospective study of CBCT data of pre-adolescent individuals (N = 19, Mean age = 10.6, 7 females, 12 males, UCLP = 6, BCLP = 3 from the Center for Craniofacial Anomalies. Volumetric analysis was performed using image segmentation features in CB Works 3.0. Volume and smallest cross-sectional were studied in both groups. Seven measurements were repeated to verify reliability using Pearson correlation coefficient. Volume and cross-sectional area differences were analyzed using paired t-tests. RESULTS: The method was found to be reliable. Individuals with CLP did not exhibit smaller total airway volume and cross sectional area than non-CLP controls. CONCLUSION: 3D imaging using CBCT and CB Works is reliable for assessing airway volume. Previous studies have shown that the nasal airway is restricted in individuals with CLP. In our study, we found that the pharyngeal airway is not compromised in these individuals.

  15. Appraisal of transverse nasal groove: A study

    Belagola D Sathyanarayana


    Full Text Available Background: Transverse nasal groove is a condition of cosmetic concern which awaits due recognition and has been widely described as a shallow groove that extends transversely over the dorsum of nose. However, we observed variations in the clinical presentations of this entity, hitherto undescribed in literature. Aims: We conducted a clinicoepidemiological study of transverse nasal lesions in patients attending our outpatient department. Methods: We conducted a prospective observational study. We screened all patients attending our out-patient department for presence of transverse nasal lesions, signs of any dermatosis and associated other skin conditions. Results: One hundred patients were recruited in the study. Females (80% predominated over males. Most patients were of 15-45 years age group (70%. Majority of the transverse nasal lesions were classical transverse nasal groove (39% and others included transverse nasal line (28%, strip (28%, ridge (4% and loop (1%. Seborrhoeic diathesis was the most common condition associated with transverse nasal lesion. Conclusions: Occurrence of transverse nasal line, strip, ridge and loop, in addition to classical transverse nasal groove implies that latter is actually a subset of transverse nasal lesions. Common association of this entity with seborrheic dermatitis, seborrhea and dandruff raises a possibility of whether transverse nasal lesion is a manifestation of seborrheic diathesis.

  16. A simple nasal anemometer for clinical purposes.

    Hutters, B; Brøndsted, K


    There is a need for clinical methods which give more direct information about the behaviour of the velopharyngeal mechanism in natural speech than do the examination methods normally applied to patients suffering from velopharyngeal insufficiency. One possibility is the recording of nasal airflow in order to detect nasal emission of air. The purpose of the present study is to examine the qualities and the characteristics of a simple and cheap nasal anemometer. As this type of flowmeter is considered less reliable than most other flowmeters, its limitations must be clearly understood and accounted for in drawing conclusions. Therefore, nasal airflow in speech obtained with this flowmeter is discussed in relation to nasal airflow obtained by the more reliable pneumotachograph and in relation to nasal airflow data found in the literature. The tests made here suggest that, at least for the type of speech material and measurements used in the present study, reliable nasal airflow data can be obtained by the anemometer.

  17. Relationship between airway pathophysiology and airway inflammation in older asthmatics

    Porsbjerg, Celeste M; Gibson, Peter G; Pretto, Jeffrey J;


    BACKGROUND AND OBJECTIVE: Asthma-related morbidity is greater in older compared with younger asthmatics. Airway closure is also greater in older asthmatics, an observation that may be explained by differences in airway inflammation. We hypothesized that in older adult patients with asthma......: Mean patient age was 67 years (confidence interval: 63-71) with a mean FEV1 of 78 % predicted (confidence interval: 70-85%). AHR correlated with sputum eosinophils (r = 0.68, P = 0.005) and eNO (r = 0.71, P ... or eNO. CONCLUSIONS: In older patients with asthma, airway inflammatory cells are linked to abnormal airway physiology. Eosinophilic airway inflammation is associated with AHR while neutrophilic inflammation may be an important determinant of airflow limitation at rest and airway closure during...

  18. Upper airway imaging and its role in preoperative airway evaluation

    Jagadish G Sutagatti


    Full Text Available Ultrasonography (USG is well-known as a fast, safe, and noninvasive technique. Its application for imaging of the airway is now gaining momentum. The upper airway has a complex anatomy, and its assessment forms a vital part of every preanesthetic evaluation. Ultrasound (US imaging can help in upper airway assessment in the preoperative period. There are various approaches to upper airway USG. The technique has its own advantages, disadvantages, and limitations. This simple yet challenging imaging technique is all set to become an important part of routine preoperative airway evaluation. This article reviews the various approaches to upper airway US imaging, interpretation of the images, limitations, and disadvantages of the technique and its varied clinical applications in the preoperative period. The scientific material presented here was hand searched from textbooks and journals, electronically from PubMed, and Google scholar using text words.

  19. Particle Image Velocimetry Measurements in Anatomically-Accurate Models of the Mammalian Nasal Cavity

    Rumple, C.; Richter, J.; Craven, B. A.; Krane, M.


    A summary of the research being carried out by our multidisciplinary team to better understand the form and function of the nose in different mammalian species that include humans, carnivores, ungulates, rodents, and marine animals will be presented. The mammalian nose houses a convoluted airway labyrinth, where two hallmark features of mammals occur, endothermy and olfaction. Because of the complexity of the nasal cavity, the anatomy and function of these upper airways remain poorly understood in most mammals. However, recent advances in high-resolution medical imaging, computational modeling, and experimental flow measurement techniques are now permitting the study of airflow and respiratory and olfactory transport phenomena in anatomically-accurate reconstructions of the nasal cavity. Here, we focus on efforts to manufacture transparent, anatomically-accurate models for stereo particle image velocimetry (SPIV) measurements of nasal airflow. Challenges in the design and manufacture of index-matched anatomical models are addressed and preliminary SPIV measurements are presented. Such measurements will constitute a validation database for concurrent computational fluid dynamics (CFD) simulations of mammalian respiration and olfaction. Supported by the National Science Foundation.

  20. Cyanide levels found in infected cystic fibrosis sputum inhibit airway ciliary function.

    Nair, Chandrika; Shoemark, Amelia; Chan, Mario; Ollosson, Sarah; Dixon, Mellissa; Hogg, Claire; Alton, Eric W F W; Davies, Jane C; Williams, Huw D


    We have previously reported cyanide at concentrations of up to 150 μM in the sputum of cystic fibrosis patients infected with Pseudomonas aeruginosa and a negative correlation with lung function. Our aim was to investigate possible mechanisms for this association, focusing on the effect of pathophysiologically relevant cyanide levels on human respiratory cell function. Ciliary beat frequency measurements were performed on nasal brushings and nasal air-liquid interface (ALI) cultures obtained from healthy volunteers and cystic fibrosis patients. Potassium cyanide decreased ciliary beat frequency in healthy nasal brushings (n = 6) after 60 min (150 μM: 47% fall, pcyanide as a key component inhibiting the ciliary beat frequency. If cyanide production similarly impairs mucocilliary clearance in vivo, it could explain the link with increased disease severity observed in cystic fibrosis patients with detectable cyanide in their airway. ©ERS 2014.

  1. Unrecognized failed airway management using a supraglottic airway device.

    Vithalani, Veer D; Vlk, Sabrina; Davis, Steven Q; Richmond, Neal J


    911 Emergency Medical Services (EMS) systems utilize supraglottic devices for either primary advanced airway management, or for airway rescue following failed attempts at direct laryngoscopy endotracheal intubation. There is, however, limited data on objective confirmation of supraglottic airway placement in the prehospital environment. Furthermore, the ability of EMS field providers to recognize a misplaced airway is unknown. Retrospective review of patients who underwent airway management using the King LTS-D supraglottic airway in a large urban EMS system, between 3/1/15-9/30/2015. Subjective success was defined as documentation of successful airway placement by the EMS provider. Objective success was confirmed by review of waveform capnography, with the presence of a 4-phase waveform greater than 5mmHg. Sensitivity and specificity of the field provider's assessment of success were then calculated. A total of 344 supraglottic airway attempts were reviewed. No patients met obvious death criteria. 269 attempts (85.1%) met criteria for both subjective and objective success. 19 attempts (5.6%) were recognized failures by the EMS provider. 47 (13.8%) airways were misplaced but unrecognized by the EMS provider. 4 attempts (1.2%) were correctly placed but misidentified as failures, leading to the unnecessary removal and replacement of the airway. Sensitivity of the provider's assessment was 98.5%; specificity was 28.7%. The use of supraglottic airway devices results in unrecognized failed placement. Appropriate utilization and review of waveform capnography may remedy a potential blind-spot in patient safety, and systemic monitoring/feedback processes may therefore be used to prevent unrecognized misplaced airways. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Integrated care pathways for airway diseases (AIRWAYS-ICPs)

    Bousquet, J; Addis, A; Adcock, I


    The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy....... AIRWAYSICPs was initiated by Area 5 of the Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing. All stakeholders are involved (health and social care, patients, and policy makers)....

  3. Biomarkers in Airway Diseases

    Janice M Leung


    Full Text Available The inherent limitations of spirometry and clinical history have prompted clinicians and scientists to search for surrogate markers of airway diseases. Although few biomarkers have been widely accepted into the clinical armamentarium, the authors explore three sources of biomarkers that have shown promise as indicators of disease severity and treatment response. In asthma, exhaled nitric oxide measurements can predict steroid responsiveness and sputum eosinophil counts have been used to titrate anti-inflammatory therapies. In chronic obstructive pulmonary disease, inflammatory plasma biomarkers, such as fibrinogen, club cell secretory protein-16 and surfactant protein D, can denote greater severity and predict the risk of exacerbations. While the multitude of disease phenotypes in respiratory medicine make biomarker development especially challenging, these three may soon play key roles in the diagnosis and management of airway diseases.

  4. Feasibility of coblation versus laser resection in recurrent nasal polyps

    Ilgner, Justus; Schramm, Karsten; Duwel, Philip; Donner, Andreas; Westhofen, Martin


    Introduction: Chronic sinusitis with nasal polyps is one of the commonest diseases of the upper airways, with a recurrence rate of about 15%. Minimally-invasive endoscopic laser procedures have been established to reduce the need for conventional revision surgery whenever medical follow-up fails. However, laser surgery requires special considerations for surgical, safety and economic aspects. This study evaluates the feasibility of coblation versus laser resection for recurrent nasal polyps. Material and methods: 6 nasal polyps were harvested each from the ostiomeatal complex of patients undergoing microscopic endonasal surgery for chronic sinusitis. 3 were dissected using a Neodymium:YAG laser system (Dornier MediLas 5060N) set at 10, 20 and 30w in cw mode with a 600μm bare fiber in contact mode with negative feedback power control, while further 3 polyps were dissected using a Coblation system (ArthroCare® Coblator® I) with a 30° angled and a 0° straight probe with 2.4 mm outer diameter. The specimens were examined histologically for carbonization and coagulation as well as unaltered tissue. Results: Laser resection resulted in a carbonization zone of 30μm in depth plus a coagulation zone of about 100μm, depending on the water content and type of tissue. While the carbonization zone was smaller with coblation, coagulation zones were comparable, leaving ample amount of unaltered tissue available for further diagnosis. Conclusion: Both resection techniques are generally feasible to be used in day case surgery for recurrent polyps. While the coblation system required no special safety requirements, accessibility of the sinuses was limited by the rigidity of applicators that are available.

  5. Fungi, β-Glucan, and Bacteria in Nasal Lavage of Greenhouse Workers and Their Relation to Occupational Exposure


    The nose and mouth are the first regions of the respiratory tract in contact with airborne microorganisms. Occupational exposures to airborne microorganisms are associated with inflammation and different symptoms of the airways. The purpose of this study is to investigate the relation between occupational exposure to fungi, β-glucan, and bacteria and contents of fungi, β-glucan, and bacteria in nasal lavage (NAL) of greenhouse workers. We also studied whether contents of microorganisms in NAL...

  6. A model of human nasal epithelial cells adapted for direct and repeated exposure to airborne pollutants.

    Bardet, Gaëlle; Achard, Sophie; Loret, Thomas; Desauziers, Valérie; Momas, Isabelle; Seta, Nathalie


    Airway epithelium lining the nasal cavity plays a pivotal role in respiratory tract defense and protection mechanisms. Air pollution induces alterations linked to airway diseases such as asthma. Only very few in vitro studies to date have succeeded in reproducing physiological conditions relevant to cellular type and chronic atmospheric pollution exposure. We therefore, set up an in vitro model of human Airway Epithelial Cells of Nasal origin (hAECN) close to real human cell functionality, specifically adapted to study the biological effects of exposure to indoor gaseous pollution at the environmental level. hAECN were exposed under air-liquid interface, one, two, or three-times at 24 h intervals for 1 h, to air or formaldehyde (200 μg/m(3)), an indoor air gaseous pollutant. All experiments were ended at day 4, when both cellular viability and cytokine production were assessed. Optimal adherence and confluence of cells were obtained 96 h after cell seeding onto collagen IV-precoated insert. Direct and repeated exposure to formaldehyde did not produce any cellular damage or IL-6 production change, although weak lower IL-8 production was observed only after the third exposure. Our model is significantly better than previous ones due to cell type and the repeated exposure protocol.

  7. Ultrasound of the airway

    Pankaj Kundra


    Full Text Available Currently, the role of ultrasound (US in anaesthesia-related airway assessment and procedural interventions is encouraging, though it is still ill defined. US can visualise anatomical structures in the supraglottic, glottic and subglottic regions. The floor of the mouth can be visualised by both transcutaneous view of the neck and also by transoral or sublinguial views. However, imaging the epiglottis can be challenging as it is suspended in air. US may detect signs suggestive of difficult intubation, but the data are limited. Other possible applications in airway management include confirmation of correct endotracheal tube placement, prediction of post-extubation stridor, evaluation of soft tissue masses in the neck prior to intubation, assessment of subglottic diameter for determination of paediatric endotracheal tube size and percutaneous dilatational tracheostomy. With development of better probes, high-resolution imaging, real-time picture and clinical experience, US has become the potential first-line noninvasive airway assessment tool in anaesthesia and intensive care practice.

  8. Airway epithelial NF-κB activation promotes Mycoplasma pneumoniae clearance in mice.

    Di Jiang

    Full Text Available Respiratory infections including atypical bacteria Mycoplasma pneumoniae (Mp contribute to the pathobiology of asthma and chronic obstructive pulmonary disease (COPD. Mp infection mainly targets airway epithelium and activates various signaling pathways such as nuclear factor κB (NF-κB. We have shown that short palate, lung, and nasal epithelium clone 1 (SPLUNC1 serves as a novel host defense protein and is up-regulated upon Mp infection through NF-κB activation in cultured human and mouse primary airway epithelial cells. However, the in vivo role of airway epithelial NF-κB activation in host defense against Mp infection has not been investigated. In the current study, we investigated the effects of in vivo airway epithelial NF-κB activation on lung Mp clearance and its association with airway epithelial SPLUNC1 expression.Non-antimicrobial tetracycline analog 9-t-butyl doxycycline (9-TB was initially optimized in mouse primary tracheal epithelial cell culture, and then utilized to induce in vivo airway epithelial specific NF-κB activation in conditional NF-κB transgenic mice (CC10-(CAIKKβ with or without Mp infection. Lung Mp load and inflammation were evaluated, and airway epithelial SPLUNC1 protein was examined by immunohistochemistry. We found that 9-TB treatment in NF-κB transgene positive (Tg+, but not transgene negative (Tg- mice significantly reduced lung Mp load. Moreover, 9-TB increased airway epithelial SPLUNC1 protein expression in NF-κB Tg+ mice.By using the non-antimicrobial 9-TB, our study demonstrates that in vivo airway epithelial NF-κB activation promotes lung bacterial clearance, which is accompanied by increased epithelial SPLUNC1 expression.

  9. Anticholinergic treatment in airways diseases.

    Flynn, Robert A


    The prevalence of chronic airways diseases such as chronic obstructive pulmonary disease and asthma is increasing. They lead to symptoms such as a cough and shortness of breath, partially through bronchoconstriction. Inhaled anticholinergics are one of a number of treatments designed to treat bronchoconstriction in airways disease. Both short-acting and long-acting agents are now available and this review highlights their efficacy and adverse event profile in chronic airways diseases.

  10. Smart polymers in nasal drug delivery

    Ankita Chonkar


    Full Text Available Nasal drug delivery has now been recognized as a promising route for drug delivery due to its capability of transporting a drug to systemic circulation and central nervous system. Though nasal mucosa offers improved bioavailability and quick onset of action of the drug, main disadvantage associated with nasal drug delivery is mucocilliary clearance due to which drug particles get cleared from the nose before complete absorption through nasal mucosa. Therefore, mucoadhesive polymeric approach can be successfully used to enhance the retention of the drug on nasal mucosal surface. Here, some of the aspects of the stimuli responsive polymers have been discussed which possess liquid state at the room temperature and in response to nasal temperature, pH and ions present in mucous, can undergo in situ gelation in nasal cavity. In this review, several temperature responsive, pH responsive and ion responsive polymers used in nasal delivery, their gelling mechanisms have been discussed. Smart polymers not only able to enhance the retention of the drug in nasal cavity but also provide controlled release, ease of administration, enhanced permeation of the drug and protection of the drug from mucosal enzymes. Thus smart polymeric approach can be effectively used for nasal delivery of peptide drugs, central nervous system dugs and hormones.

  11. Toxicity of formaldehyde and acrolein mixtures : in vitro studies using nasal epithelial cells

    Cassee, F.R.; Stenhuis, W.S.; Groten, J.P.; Feron, V.J.


    In vitro studies with human and rat nasal epithelial cells were carried out to investigate the combined toxicity of formaldehyde and acrolein and the role of aldehyde dehydrogenases in this process. These studies showed that the toxic effect of mixtures of aldehydes was additive. In addition, aldehy

  12. Airway epithelium is a predominant source of endogenous airway GABA and contributes to relaxation of airway smooth muscle tone

    Gallos, George; Townsend, Elizabeth; Yim, Peter; Virag, Laszlo; Zhang, Yi; Xu, Dingbang; Bacchetta, Matthew; Emala, Charles W.


    Chronic obstructive pulmonary disease and asthma are characterized by hyperreactive airway responses that predispose patients to episodes of acute airway constriction. Recent studies suggest a complex paradigm of GABAergic signaling in airways that involves GABA-mediated relaxation of airway smooth muscle. However, the cellular source of airway GABA and mechanisms regulating its release remain unknown. We questioned whether epithelium is a major source of GABA in the airway and whether the ab...

  13. Is Health-Related Quality of Life Associated with Upper and Lower Airway Inflammation in Asthmatics?

    Nicola Scichilone


    Full Text Available Background. Allergic diseases impair health-related quality of life (HR-QoL. However, the relationship between airway inflammation and HR-QoL in patients with asthma and rhinitis has not been fully investigated. We explored whether the inflammation of upper and lower airways is associated with HR-QoL. Methods. Twenty-two mild allergic asthmatics with concomitant rhinitis (10 males, 38 ± 17 years were recruited. The Rhinasthma was used to identify HR-QoL, and the Asthma Control Test (ACT was used to assess asthma control. Subjects underwent lung function and exhaled nitric oxide (eNO test, collection of exhaled breath condensate (EBC, and nasal wash. Results. The Rhinasthma Global Summary score (GS was 25 ± 11. No relationships were found between GS and markers of nasal allergic inflammation (% eosinophils: , ; ECP: , or bronchial inflammation (pH of the EBC: , ; bronchial NO: , ; alveolar NO: , . The mean ACT score was 18. When subjects were divided into controlled (ACT ≥ 20 and uncontrolled (ACT < 20, the alveolar NO significantly correlated with GS in uncontrolled asthmatics (, . Conclusions. Upper and lower airways inflammation appears unrelated to HR-QoL associated with respiratory symptoms. These preliminary findings suggest that, in uncontrolled asthma, peripheral airway inflammation could be responsible for impaired HR-QoL.

  14. Mouth-opening increases upper-airway collapsibility without changing resistance during midazolam sedation.

    Ayuse, T; Inazawa, T; Kurata, S; Okayasu, I; Sakamoto, E; Oi, K; Schneider, H; Schwartz, A R


    Sedative doses of anesthetic agents affect upper-airway function. Oral-maxillofacial surgery is frequently performed on sedated patients whose mouths must be as open as possible if the procedures are to be accomplished successfully. We examined upper-airway pressure-flow relationships in closed mouths, mouths opened moderately, and mouths opened maximally to test the hypothesis that mouth-opening compromises upper-airway patency during midazolam sedation. From these relationships, upper-airway critical pressure (Pcrit) and upstream resistance (Rua) were derived. Maximal mouth-opening increased Pcrit to -3.6 +/- 2.9 cm H2O compared with -8.7 +/- 2.8 (p = 0.002) for closed mouths and -7.2 +/- 4.1 (p = 0.038) for mouths opened moderately. In contrast, Rua was similar in all three conditions (18.4 +/- 6.6 vs. 17.7 +/- 7.6 vs. 21.5 +/- 11.6 cm H2O/L/sec). Moreover, maximum mouth-opening produced an inspiratory airflow limitation at atmosphere that was eliminated when nasal pressure was adjusted to 4.3 +/- 2.7 cm H2O. We conclude that maximal mouth-opening increases upper-airway collapsibility, which contributes to upper-airway obstruction at atmosphere during midazolam sedation.

  15. Airway Management of Respiratory Failure.

    Overbeck, Michael C


    Patients in respiratory distress often require airway management, including endotracheal intubation. It takes a methodical approach to transition from an unstable patient in distress with an unsecured airway, to a stable, sedated patient with a definitive airway. Through a deliberate course of advanced preparation, the emergency physician can tailor the approach to the individual clinical situation and optimize the chance of first-pass success. Sedation of the intubated patient confers physiologic benefits and should be included in the plan for airway control. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Nasal Outcomes of Presurgical Nasal Molding in Complete Unilateral Cleft Lip and Palate

    Emily M. Williams


    Full Text Available Objective. Short-term nasal forms following primary lip repair were compared between presurgical nasal molding and control groups. Aim. To compare nasal symmetry between patients that had nasal molding and lip repair with those that had only lip repair. Design. Retrospective case-control study Patients. Complete unilateral CL+P patients had basilar and frontal photographs at two time points: (1 initial (2 postsurgical. 28 nasal molding patients and 14 control patients were included. Intervention. Presurgical nasal molding was performed prior to primary lip repair in intervention group. No nasal molding was performed in control group. Hypothesis. Nasal molding combined with lip surgery repair according to the Millard procedure provides superior nasal symmetry than surgery alone for nostril height-width ratios and alar groove ratios. Statistics. Shapiro-Wilk test of normality and Student’s -tests. Results. A statistically significant difference was found for postsurgical nostril height-width ratio (<.05. No other statistically significant differences were found. Conclusions. Nasal molding and surgery resulted in more symmetrical nostril height-width ratios than surgery alone. Alar groove ratios were not statistically significantly different between groups perhaps because application of nasal molding was not early enough; postsurgical nasal splints were not utilized; overcorrection was not performed for nasal molding.

  17. Treatment of upper airway resistance syndrome in adults: Where do we stand?☆

    de Godoy, Luciana B.M.; Palombini, Luciana O.; Guilleminault, Christian; Poyares, Dalva; Tufik, Sergio; Togeiro, Sonia M.


    Objective: To evaluate the available literature regarding Upper Airway Resistance Syndrome (UARS) treatment. Methods: Keywords “Upper Airway Resistance Syndrome,” “Sleep-related Breathing Disorder treatment,” “Obstructive Sleep Apnea treatment” and “flow limitation and sleep” were used in main databases. Results: We found 27 articles describing UARS treatment. Nasal continuous positive airway pressure (CPAP) has been the mainstay therapy prescribed but with limited effectiveness. Studies about surgical treatments had methodological limitations. Oral appliances seem to be effective but their efficacy is not yet established. Conclusion: Randomized controlled trials with larger numbers of patients and long-term follow-up are important to establish UARS treatment options. PMID:26483942

  18. Treatment of upper airway resistance syndrome in adults: Where do we stand?

    Luciana B.M. de Godoy


    Full Text Available Objective: To evaluate the available literature regarding Upper Airway Resistance Syndrome (UARS treatment. Methods: Keywords “Upper Airway Resistance Syndrome,” “Sleep-related Breathing Disorder treatment,” “Obstructive Sleep Apnea treatment” and “flow limitation and sleep” were used in main databases. Results: We found 27 articles describing UARS treatment. Nasal continuous positive airway pressure (CPAP has been the mainstay therapy prescribed but with limited effectiveness. Studies about surgical treatments had methodological limitations. Oral appliances seem to be effective but their efficacy is not yet established. Conclusion: Randomized controlled trials with larger numbers of patients and long-term follow-up are important to establish UARS treatment options.

  19. Ozone-Induced Nasal Type 2 Immunity in Mice Is Dependent on Innate Lymphoid Cells.

    Kumagai, Kazuyoshi; Lewandowski, Ryan; Jackson-Humbles, Daven N; Li, Ning; Van Dyken, Steven J; Wagner, James G; Harkema, Jack R


    Epidemiological studies suggest that elevated ambient concentrations of ozone are associated with activation of eosinophils in the nasal airways of atopic and nonatopic children. Mice repeatedly exposed to ozone develop eosinophilic rhinitis and type 2 immune responses. In this study, we determined the role of innate lymphoid cells (ILCs) in the pathogenesis of ozone-induced eosinophilic rhinitis by using lymphoid-sufficient C57BL/6 mice, Rag2(-/-) mice that are devoid of T cells and B cells, and Rag2(-/-)Il2rg(-/-) mice that are depleted of all lymphoid cells including ILCs. The animals were exposed to 0 or 0.8 ppm ozone for 9 consecutive weekdays (4 h/d). Mice were killed 24 hours after exposure, and nasal tissues were selected for histopathology and gene expression analysis. ILC-sufficient C57BL/6 and Rag2(-/-) mice exposed to ozone developed marked eosinophilic rhinitis and epithelial remodeling (e.g., epithelial hyperplasia and mucous cell metaplasia). Chitinase-like proteins and alarmins (IL-33, IL-25, and thymic stromal lymphopoietin) were also increased morphometrically in the nasal epithelium of ozone-exposed C57BL/6 and Rag2(-/-) mice. Ozone exposure elicited increased expression of Il4, Il5, Il13, St2, eotaxin, MCP-2, Gob5, Arg1, Fizz1, and Ym2 mRNA in C57BL/6 and Rag2(-/-) mice. In contrast, ozone-exposed ILC-deficient Rag2(-/-)Il2rg(-/-) mice had no nasal lesions or overexpression of Th2- or ILC2-related transcripts. These results indicate that ozone-induced eosinophilic rhinitis, nasal epithelial remodeling, and type 2 immune activation are dependent on ILCs. To the best of our knowledge, this is the first study to demonstrate that ILCs play an important role in the nasal pathology induced by repeated ozone exposure.

  20. Transnasal tracheobronchial stenting for malignant airway narrowing under local anesthesia: Our experience of treating three cases using this technique

    Jayanta Medhi


    Full Text Available Purpose: To study the technical feasibility of tracheobronchial stenting via transnasal route under bronchoscopy and fluoroscopic guidance in severe malignant airway strictures using self-expandable nitinol stents. Materials and Methods: We describe three patients with malignant airway strictures, treated entirely via transnasal route under local anesthesia using bronchoscopic and fluoroscopic guidance. Nasal route allowed convenient access to the airway for the bronchoscope across the stricture and a guidewire was introduced through its working channel. The 18F tracheal stent and the 6F bronchial stent assembly could be easily introduced and deployed under bronchoscopic (reintroduced through the other nostril and fluoroscopic guidance. Results: We achieved technical success in all the three patients with immediate relief of dyspnea. Conclusion: Transnasal airway stenting with self-expandable nitinol stent using bronchoscopic and fluoroscopic guidance under local anesthesia is a safe and effective method with minimal patient discomfort.

  1. Pharmacology of airway smooth muscle proliferation

    Gosens, Reinoud; Roscioni, Sara S.; Dekkers, Bart G. J.; Pera, Tonio; Schmidt, Martina; Schaafsma, Dedmer; Zaagsma, Johan; Meurs, Herman


    Airway smooth muscle thickening is a pathological feature that contributes significantly to airflow limitation and airway hyperresponsiveness in asthma. Ongoing research efforts aimed at identifying the mechanisms responsible for the increased airway smooth muscle mass have indicated that hyperplasi

  2. Cholinergic regulation of airway inflammation and remodelling

    Kolahian, Saeed; Gosens, Reinoud


    Acetylcholine is the predominant parasympathetic neurotransmitter in the airways that regulates bronchoconstriction and mucus secretion. Recent findings suggest that acetylcholine regulates additional functions in the airways, including inflammation and remodelling during inflammatory airway disease

  3. Inflammatory mediators in nasal lavage among school-age children from urban and rural areas in São Paulo, Brazil

    Clóvis Eduardo Santos Galvão

    Full Text Available CONTEXT: Some studies have shown that inflammatory processes in the nasal air passages may reflect or affect those in the lower airways. We decided to indirectly assess the inflammatory status of the nasal airways in two groups of children with different sensitization rates to aeroallergens. OBJECTIVE: To compare the inflammatory activity in the nasal airways, through the determination of mediators in nasal lavage fluid in two distinct populations. TYPE OF STUDY: Cross-sectional study. SETTING: Two public elementary schools, one in an urban setting and the other in a rural setting of the State of São Paulo, Brazil. METHODS: Two groups of 40 elementary school children with different sensitization rates to aeroallergens were formed. Samples of nasal lavage fluid were assessed for eosinophil cationic protein (ECP and tryptase. Non-parametric tests were used for statistical analysis. RESULTS: Significantly higher levels of ECP were observed among students living in the urban area than those in the rural area (p < 0.05. No significant difference in the tryptase levels was observed. Also, the urban children who were sensitized to aeroallergens presented higher levels of ECP in nasal mucosa than the non-sensitized children, while this difference was not observed among the rural children. DISCUSSION: The lack of mast cell activity and increased eosinophil degranulation revealed a chronic inflammatory state in the nasal air passages. The higher eosinophil activity in the urban area, coinciding with higher sensitization to aeroallergens, suggests that there must be some factors in the urban area that can modulate airway inflammation by influencing the activation of inflammatory cells. CONCLUSION: Our findings showed that there was no difference in the concentrations of tryptase in nasal lavage fluids between the two studied groups. However, the children from the urban area presented with higher concentrations of eosinophil cationic protein than did those

  4. Compensatory hypertrophy of the contralateral inferior turbinate in patients with unilateral nasal septal deviation. A computed tomography study.

    Chiesa Estomba, Carlos; Rivera Schmitz, Teresa; Ossa Echeverri, Carla C; Betances Reinoso, Frank A; Osorio Velasquez, Alejandra; Santidrian Hidalgo, Carmelo


    The compensatory hypertrophy of the inferior turbinate in patients with septal deviation to one of the nostrils is considered to protect the airways from the excess of air that could enter through the nostril and its potential negative effects such as dryness, alteration of air filtration, mucociliary flow, or lung involvement. A prospective, longitudinal, non-randomized study. Patients were divided in two groups: 10 consecutive patients, with nasal septal deviation and compensatory hypertrophy of the inferior turbinate in the contralateral nasal cavity (10 non-hypertrophied turbinates as control and 10 contralateral hypertrophied turbinates as study cases), and the second group with 5 patients without any nasal pathology (10 turbinates without any obvious pathology). In both groups CT scans of the nasal region were performed. A comparison of patients with nasal septal deviation with compensatory hypertrophy of the inferior turbinate in the contralateral nasal cavity and with non-pathological inferior turbinate was carried out. When analyzing the groups of patients with septal deviation, the contralateral hypertrophied turbinate and the non-hypertrophied turbinate side, we found a significant hypertrophy in the anterior portion of the inferior turbinate, at the level of the medial mucosa (P = 0.002) and bone (P = 0.001) in the group of patients with contralateral hypertrophied turbinate. However, when we compared the contralateral hypertrophic turbinate with the turbinate of patients without septal deviation, we found a significant difference in all volumes of the medial and lateral mucosa and the bone portion (P = 0.001, P = 0.005). Surgical correction of the nasal septum and lateralization or reduction of the volume of the inferior turbinate (which may include the medial mucosa, head or part of the bone) is necessary in order to improve air passage into the nasal valve.

  5. Unusual Postrhinoplasty Complication: Nasal Dorsum Cyst

    Pier Giorgio Giacomini


    Full Text Available Among all the possible complications of aesthetic rhinoplasty, a rare one is the development of cystic masses on the nasal dorsum: several theories suggest that cysts develop commonly by entrapment of nasal mucosa in the subcutaneous space, but they can also originate from foreign body reactions. This report deals with two cases of nasal dorsum cysts with different pathogenesis: both patients had undergone aesthetic rhinoplasty in the past (26 years ago and 14 years ago, resp.. Both cystic masses were removed via a direct open approach and nasal reconstruction was performed successfully with autologous vomer bone. The pathologic investigations showed a foreign body inclusion cyst associated with latex rubber in the first case and a sequestration of a mucosal-lined nasal bone was not removed at the time of primary rhinoplasty in the second case. A brief review of the literature focuses on the pathophysiology and treatment options for nasal dorsal cysts following aesthetic rhinoplasty.

  6. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists.

    Fokkens, Wytske J; Lund, Valerie J; Mullol, Joachim; Bachert, Claus; Alobid, Isam; Baroody, Fuad; Cohen, Noam; Cervin, Anders; Douglas, Richard; Gevaert, Philippe; Georgalas, Christos; Goossens, Herman; Harvey, Richard; Hellings, Peter; Hopkins, Claire; Jones, Nick; Joos, Guy; Kalogjera, Livije; Kern, Bob; Kowalski, Marek; Price, David; Riechelmann, Herbert; Schlosser, Rodney; Senior, Brent; Thomas, Mike; Toskala, Elina; Voegels, Richard; Wang, De Yun; Wormald, Peter John


    The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007. The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP) are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed. This executive summary for otorhinolaryngologists focuses on the most important changes and issues for otorhinolaryngologists. The full document can be downloaded for free on the website of this journal:

  7. Airflow in the Human Nasal Passage and Sinuses of Chronic Rhinosinusitis Subjects.

    Haribalan Kumar

    Full Text Available Endoscopic surgery is performed on patients with chronic inflammatory disease of the paranasal sinuses to improve sinus ventilation. Little is known about how sinus surgery affects sinonasal airflow. In this study nasal passage geometry was reconstructed from computed tomographic imaging from healthy normal, pre-operative, and post-operative subjects. Transient air flow through the nasal passage during calm breathing was simulated. Subject-specific differences in ventilation of the nasal passage were observed. Velocity magnitude at ostium was different between left and right airway. In FESS, airflow in post-surgical subjects, airflow at the maxillary sinus ostium was upto ten times higher during inspiration. In a Lothrop procedure, airflow at the frontal sinus ostium can be upto four times higher during inspiration. In both post-operative subjects, airflow at ostium was not quasi-steady. The subject-specific effect (of surgery on sinonasal interaction evaluated through airflow simulations may have important consequences for pre- and post-surgical assessment and surgical planning, and design for improvement of the delivery efficiency of nasal therapeutics.

  8. Respiratory support with heated humidified high flow nasal cannula in preterm infants.

    Jeon, Ga Won


    The incidence of bronchopulmonary dysplasia (BPD) has not decreased over the last decade. The most important way to decrease BPD is by weaning the patient from the ventilator as soon as possible in order to reduce ventilator-induced lung injury that underlies BPD, and by using a noninvasive ventilator (NIV). Use of a heated, humidified, high flow nasal cannula (HHHFNC), which is the most recently introduced NIV mode for respiratory support in preterm infants, is rapidly increasing in many neonatal intensive care units due to the technical ease of use without sealing, and the attending physician's preference compared to other NIV modes. A number of studies have shown that nasal breakdown and neonatal complications were lower when using a HHHFNC than when using nasal continuous positive airway pressure (nCPAP), or nasal intermittent positive pressure ventilation. The rates of extubation failure during respiratory support were not different between patients who used HHHFNC and nCPAP. However, data from the use of HHHFNC as the initial respiratory support "after birth", particularly in extremely preterm infants, are lacking. Although the HHHFNC is efficacious and safe, large randomized controlled trials are needed before the HHHFNC can be considered an NIV standard, particularly for extremely preterm infants.

  9. Nasal inhalation of budesonide from a spacer in children with perennial rhinitis and asthma

    Pedersen, W; Hjuler, Inga Merete; Bisgaard, H;


    compliance with the treatment. In the present study, we evaluated a nasal inhalation system used for the simultaneous treatment of rhinitis and asthma. In principle, it results in an airway deposition of the corticosteroid similar to that of inhaled allergens. Twenty-four children with perennial rhinitis...... and effective treatment for both rhinitis and asthma in children, but it is an open question whether the nasal inhalation system can improve the ratio of antirhinitis/antiasthma effects to side-effects.......The standard treatment of allergic rhinitis and asthma consists of topical corticosteroids administered intranasally and inhaled through the mouth. Although this therapy is highly effective, and side-effects are few and mild, it may be possible further to improve the therapeutic index and patient...

  10. Use of in vivo desensitization to treat a patient's claustrophobic response to nasal CPAP.

    Edinger, J D; Radtke, R A


    Continuous positive airway pressure (CPAP) has proven to be a safe, effective treatment for sleep apnea patients. However, many patients display claustrophobic reactions to the CPAP nasal mask and cannot tolerate this treatment. The current report describes the successful application of in vivo desensitization with a male apnea patient who initially failed CPAP therapy due to his claustrophobia. Over the course of treatment, the patient became able to tolerate using his CPAP device throughout his nocturnal sleep periods. Moreover, follow-up visits scheduled 6 months and again at 6 1/2 years after behavioral treatment showed that the patient continued to use CPAP on a regular basis. It is concluded that in vivo desensitization therapy may be useful in assisting claustrophobic patients to tolerate nasal CPAP. Results are discussed in view of the specific features of the case presented, and future applications of this behavioral procedure are encouraged.

  11. [Airway management in obstetrics].

    Boutonnet, M; Faitot, V; Keïta, H


    Reviewing problems related to the airway management in obstetrics, taking into account the recent evolutions of the anaesthetic practices in obstetrics. A review of the literature in English and French was performed in the Pumed database in April 2010. The first research used the following MeshTerms: "Anesthesia, Obstetrical" [Mesh] AND "Intubation, Intratracheal" [Mesh]. Complementary research used alone or in combination the following keywords: difficult tracheal intubation; failed tracheal intubation; airway; prediction of difficult tracheal intubation; maternal mortality; maternal morbidity; liability; aspiration pneumonia and obstetrical anesthesia. All the publications were retained excluding the correspondence. Data analysis for the airway management in obstetrics, the prediction of difficult intubation, the prevention of pulmonary inhalation of gastric fluid, but also on maternal morbi-mortality in link with general anesthesia in obstetrics. Airway management in obstetrics remains a true challenge for various reasons. The physiological and anatomical modifications related to pregnancy are responsible for a faster hypoxemia, a reduction of the diameter of the pharyngolaryngal tract, as well as an increase of the risk of inhalation of gastric contents after 16 weeks of amenorrhea. The emergency or extreme emergency context and the presence of diseases like obesity or preeclampsia raise the risks of difficulties with airway management. The logical evolution of the practices, with the considerable rise of the regional anesthesia/analgesia limits the training and the maintenance of competences for intratracheal intubation in obstetrics. The training per simulation appears particularly interesting on the subject and this approach needs to be developed. The literature indicates that the incidence of difficult intubation is of one per 30. The impossible intubation is one per 280 in obstetrics, eight times greater than in the general population. No criterion of

  12. Anatomical Details of the Rabbit Nasal Passages and Their Implications in Breathing, Air Conditioning, and Olfaction.

    Xi, Jinxiang; Si, Xiuhua A; Kim, Jongwon; Zhang, Yu; Jacob, Richard E; Kabilan, Senthil; Corley, Richard A


    The rabbit is commonly used as a laboratory animal for inhalation toxicology tests and detail knowledge of the rabbit airway morphometry is needed for outcome analysis or theoretical modeling. The objective of this study is to quantify the morphometric dimension of the nasal airway of a New Zealand white rabbit and to relate the morphology and functions through analytical and computational methods. Images of high-resolution MRI scans of the rabbit were processed to measure the axial distribution of the cross-sectional areas, perimeter, and complexity level. The lateral recess, which has functions other than respiration or olfaction, was isolated from the nasal airway and its dimension was quantified separately. A low Reynolds number turbulence model was implemented to simulate the airflow, heat transfer, vapor transport, and wall shear stress. Results of this study provide detailed morphological information of the rabbit that can be used in the studies of olfaction, inhalation toxicology, drug delivery, and physiology-based pharmacokinetics modeling. For the first time, we reported a spiral nasal vestibule that splits into three paths leading to the dorsal meatus, maxilloturbinate, and ventral meatus, respectively. Both non-dimensional functional analysis and CFD simulations suggested that the airflow in the rabbit nose is laminar and the unsteady effect is only significantly during sniffing. Due to the large surface-to-volume ratio, the maxilloturbinate is highly effective in warming and moistening the inhaled air to body conditions. The unique anatomical structure and respiratory airflow pattern may have important implications for designing new odorant detectors or electronic noses. Anat Rec, 299:853-868, 2016. © 2016 Wiley Periodicals, Inc.

  13. Persistent gene expression in mouse nasal epithelia following feline immunodeficiency virus-based vector gene transfer.

    Sinn, Patrick L; Burnight, Erin R; Hickey, Melissa A; Blissard, Gary W; McCray, Paul B


    Gene transfer development for treatment or prevention of cystic fibrosis lung disease has been limited by the inability of vectors to efficiently and persistently transduce airway epithelia. Influenza A is an enveloped virus with natural lung tropism; however, pseudotyping feline immunodeficiency virus (FIV)-based lentiviral vector with the hemagglutinin envelope protein proved unsuccessful. Conversely, pseudotyping FIV with the envelope protein from influenza D (Thogoto virus GP75) resulted in titers of 10(6) transducing units (TU)/ml and conferred apical entry into well-differentiated human airway epithelial cells. Baculovirus GP64 envelope glycoproteins share sequence identity with influenza D GP75 envelope glycoproteins. Pseudotyping FIV with GP64 from three species of baculovirus resulted in titers of 10(7) to 10(9) TU/ml. Of note, GP64 from Autographa californica multicapsid nucleopolyhedrovirus resulted in high-titer FIV preparations (approximately 10(9) TU/ml) and conferred apical entry into polarized primary cultures of human airway epithelia. Using a luciferase reporter gene and bioluminescence imaging, we observed persistent gene expression from in vivo gene transfer in the mouse nose with A. californica GP64-pseudotyped FIV (AcGP64-FIV). Longitudinal bioluminescence analysis documented persistent expression in nasal epithelia for approximately 1 year without significant decline. According to histological analysis using a LacZ reporter gene, olfactory and respiratory epithelial cells were transduced. In addition, methylcellulose-formulated AcGP64-FIV transduced mouse nasal epithelia with much greater efficiency than similarly formulated vesicular stomatitis virus glycoprotein-pseudotyped FIV. These data suggest that AcGP64-FIV efficiently transduces and persistently expresses a transgene in nasal epithelia in the absence of agents that disrupt the cellular tight junction integrity.

  14. Carbon dioxide washout during high flow nasal cannula versus nasal CPAP support: An in vitro study.

    Sivieri, Emidio M; Foglia, Elizabeth E; Abbasi, Soraya


    To compare CO2 washout time at different levels of HFNC versus NCPAP in a premature infant lung model with simulated mouth-closed and mouth-open conditions using two sizes of nasal cannula and full- and half-prong HFNC insertion depths. A piston-cylinder lung simulator, having a fixed volume of 30 ml and a 4.8 ml dead space, simulated spontaneous breathing (6.5 ml tidal volume, 50 br/min, Ti = 0.5 sec). Two Fisher & Paykel™ cannulas (Fisher & Paykel Healthcare Ltd., Auckland, New Zealand) (2.8 and 3.2 mm O.D.) and two Infant-Flow™ (CareFusion, Yorba Linda, CA) NCPAP cannulas (3.4 and 4.1 mm O.D.) were applied to simulated airways having either 3.5 or 4.5 mm I.D. nares. Simulated mouth opening was a 5 mm I.D. side tap below the nasal interface. The lung was primed with 5% CO2 . Washout times were determined at HFNC settings of 3, 4, 5, 6, and 8 L/min and NCPAP at 3, 4, 5, 6, and 8 cm H2 O with simulated open and closed-mouth conditions and full- and half-inserted HFNC prongs. Overall combined mean washout times for NCPAP with mouth-closed were significantly longer than HFNC over all five pressure and flow device settings by 16.2% (P times decreased as flow or pressure device settings were increased. There were negligible differences in washout times between NCPAP and HFNC with mouth-open. Mouth-open washout times were significantly less than mouth-closed for all conditions. Overall closed-mouth washout times for HFNC half-prong insertion were longer than for full-prong insertion by 5.3% (P < 0.022). Significantly improved CO2 elimination using HFNC versus NCPAP should be a particularly important consideration in premature infants having very high dead space-to-tidal volume ratio compared to larger infants. Pediatr Pulmonol. 2017;52:792-798. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  15. IgG4-Related Nasal Pseudotumor

    L. K. Døsen


    Full Text Available IgG4-related disease is recognized as one form of autoimmune pancreatitis. During the last ten years, it has also been described in several other organs. We present two patients with lesions showing a histological picture of fibrosis and lymphoplasmacytic infiltrations with abundant IgG4 positive plasma cells at hitherto unreported symmetrical nasal locations. The symmetrical complex consisted of one central lesion in the anterior nasal septum and the two others in each of the lateral nasal walls. The lesions extended from the anterior part of the inferior concha into the vestibulum and caused severe nasal obstruction.

  16. Nasal Myiasis in Hinduism and Contemporary Otorhinolaryngology.

    Bosmia, Anand N; Zimmermann, Terence M; Griessenauer, Christoph J; Shane Tubbs, R; Rosenthal, Eben L


    Various case reports on nasal myiasis written during the 1990s and 2000s state that nasal myiasis, which is known as peenash among South Asian natives, is a form of divine punishment in Hindu mythology, but do not provide citations from Hindu scriptures that would suggest this interpretation. This paper aims to discuss the phenomenon of peenash in a historical context by examining medical literature written during the nineteenth and early twentieth centuries, to identify Hindu texts contributing to the belief of some Hindus that nasal myiasis is a form of divine punishment, and to provide an overview of contemporary treatment for and management of nasal myiasis.

  17. High-Flow Nasal Interface Improves Oxygenation in Patients Undergoing Bronchoscopy

    Umberto Lucangelo


    Full Text Available During bronchoscopy hypoxemia is commonly found and oxygen supply can be delivered by interfaces fed with high gas flows. Recently, the high-flow nasal cannula (HFNC has been introduced for oxygen therapy in adults, but they have not been used so far during bronchoscopy in adults. Forty-five patients were randomly assigned to 3 groups receiving oxygen: 40 L/min through a Venturi mask (V40, N=15, nasal cannula (N40, N=15, and 60 L/min through a nasal cannula (N60, N=15 during bronchoscopy. Gas exchange and circulatory variables were sampled before (FiO2 = 0.21, at the end of bronchoscopy (FiO2 = 0.5, and thereafter (V40, FiO2 = 0.35. In 8 healthy volunteers oxygen was randomly delivered according to V40, N40, and N60 settings, and airway pressure was measured. At the end of bronchoscopy, N60 presented higher PaO2, PaO2/FiO2, and SpO2 than V40 and N40 that did not differ between them. In the volunteers (N60 median airway pressure amounted to 3.6 cmH2O. Under a flow rate of 40 L/min both the Venturi mask and HFNC behaved similarly, but nasal cannula associated with a 60 L/min flow produced the better results, thus indicating its use in mild respiratory dysfunctions.

  18. Intra-operative airway management in patients with maxillofacial trauma having reduction and immobilization of facial fractures

    Babatunde Babasola Osinaike


    Full Text Available Background: Despite advancements in airway management, treatment of fractures in the maxillofacial region under general anesthesia remains a unique anesthetic challenge. We reviewed the pattern of airway management in patients with maxillofacial fractures and assessed those challenges associated with the different airway management techniques employed. Materials and Methods: The anesthetic chart, theatre and maxillofacial operations records of patients who had reduction and immobilization of various maxillofacial fractures over a 2-year period were reviewed. Information obtained included the patient demographics, mechanisms of injury, types of fractures and details about airway management. Statistical Package for Social Sciences, SPSS version 17.0 was utilized for all data analysis. Results: Fifty-one patients were recruited during the 2-year study period. Mask ventilation was easy in 80-90% of the patients, 80% had Mallampati three or four, while 4 (7.8% had laryngoscopy grading of 4. There was no statistically significant difference between the fracture groups in terms of the laryngoscopy grading (P = 0.153 but there was statistical significant difference in the technique of airway management (P = 0.0001. Nasal intubation following direct laryngoscopy was employed in 64.7% of the patients, fiber-optic guided nasal intubation was utilized in only 7.8%. None of the patients had tracheostomy either before or during operative management. Conclusion: Laryngoscopic grading and not adequacy of mouth opening predicted difficult intubation in this group of patients in the immediate preoperative period. Despite the distortions in the anatomy of the upper airway that may result from maxillofacial fractures, nasal intubation following direct laryngoscopy may be possible in many patients with maxillofacial fractures.

  19. Nasal and Oral Consonant Similarity in Speech Errors: Exploring Parallels with Nasal Consonant Harmony

    Walker, Rachel


    Previous research has found that "similar" sounds interact in phonological nasal consonant harmony, wherein certain consonants become nasals when the word contains a nasal (e.g., Kikongo: /-kun-idi/ [right arrow] [-kun-ini] "planted"). Across languages, stops and approximants are chiefly affected, especially voiced consonants and ones that match…

  20. The extract of Cordyceps sinensis inhibited airway inflammation by blocking NF-κB activity.

    Chiou, Ya-Ling; Lin, Ching-Yuang


    Aiming the extract of Cordyceps sinensis significantly inhibits airway inflammation, airway hyperresponsiveness, and the infiltration of eosinophils in the airway of rats and may be related to the modulation of T helper (Th)1 and Th2 cells functions. The mechanisms of C. sinensis involved in modulation of suppression inflammation are not yet determined. In this study, the mechanism involved in the extract of C. sinensis-C.S.3-modulated suppression of inflammation was investigated in vivo and in vitro systems. The results showed that C.S.3 reduced airway inflammation in ovalbumin-induced allergic mice. Furthermore, we found C.S.3 could decrease extracellular signal-regulated kinase 1/2 signaling pathway to suppress activity of nuclear factor-κB in lung cells and cultured airway smooth muscle cells. Conclusion C.S.3 may provide clinical applications for asthma in the future.

  1. Localization and function of histamine H3 receptor in the nasal mucosa

    Suzuki, Shinya; Takeuchi, Kazuhiko; Majima, Yuichi


    BACKGROUND: Histamine is an important chemical mediator of allergic rhinitis (AR). Histamine H3 receptors H3R are located on cholinergic and NANC neurons of the myenteric plexus, and activation of H3R regulates gastric acid secretion. However, little is known about the localization and function of H3R in the upper airway. OBJECTIVE: The objective of this study was to examine the localization and possible function of H3R in the nasal mucosa. METHODS: We extracted total RNA from the inferior tu...

  2. Negative pressure pulmonary edema after nasal fracture reduction in an obese female patient: a case report

    Choi, Eunkyung; Yi, Junggu; Jeon, Younghoon


    Postoperative negative pressure pulmonary edema (NPPE) is a rare, but well-known life-threatening complication of acute upper airway obstruction (UAO) which develops after general anesthesia. The pronounced inspiratory efforts following UAO lead to excessive negative inspiratory pressure, which may cause acute pulmonary edema. Early recognition and prompt treatment of NPPE is necessary to prevent patient morbidity and mortality. In addition, the physician should carefully manage the patient who has risk factors of UAO to prevent this situation. We experienced a case of NPPE following laryngospasm after tracheal extubation in an obese patient who underwent open reduction of orbital wall and nasal bone surgery. PMID:26316826

  3. Study on influence of bilateral intermittent nasal obstruction on condylar cartilage cell apoptosis in young rats%间歇性完全鼻阻塞对幼年大鼠髁突软骨细胞凋亡影响的研究

    刘炯; 陈金东; 朱敏; 聂萍; 盛潇; 赵彦惠; 徐晓珑; 陶丽


    Objective To investigate the condylar cartilage cell apoptosis in young rats with bilateral intermittent nasal obstruction to try exploring the influence of intermittent nasal obstruction on the development of condylar cartilage of children who have to breathe through mouth.Methods Twenty 4-week-old SD rats were employed and divided into two groups.Group A:10 of them had both nos-trils occluded by nose plugs on normal oxygen conditions up to 8 hours for 35 d and group B served as the control group:10 of them were raised under normal oxygen conditions.The same food and water were offered to the two groups and then the bilateral condylar was extracted to make parafin section for the immumohistochemical staining,including Caspase-3,Bcl-2,Bax protein.Cartilage cell prolifera-tion and apoptosis,the regulatory mechanism of Bcl-2 gene family and its correlation with maxillary growth were observed and analyzed. Results Under the circumstance of bilateral intermittent nasal obstruction,the apoptosis of condylar chondrocytes in Group A increased significantly compared with the control group.The expression of caspase-3,bcl-2,bax protein was significantly higher than the control group.Conclusions Oral breathing caused by nasal obstruction results in the apoptosis in the condyle process cells.%目的:研究幼年大鼠在双侧间歇性鼻阻塞情况下双侧髁突软骨细胞的凋亡情况,尝试探讨间歇性鼻阻塞对张口呼吸儿童髁突软骨发育的影响。方法将20只4周龄大鼠(Sprague-Dawley rat,SD rat)分为2组,A组:双侧鼻阻塞组,常氧条件下鼻孔双侧阻塞8 h(早晨8点至下午4点),持续35 d;B组:对照组,常氧条件下饲养。2组给予同样的饮食以及饮水,然后分别取出双侧髁突,用甲醛保存做成石蜡切片,同时进行 caspase-3以及 Bcl-2,Bax蛋白免疫组化染色。以观察在双侧鼻阻塞对髁突前斜面中上部软骨细胞增殖以及凋亡的影响,以及双

  4. Immunohistochemical demonstration of airway epithelial cell markers of guinea pig.

    Li, Yong; Wang, Jing; He, Hai Yan; Ma, Ling Jie; Zeng, Jin; Deng, Guang Cun; Liu, Xiaoming; Engelhardt, John F; Wang, Yujiong


    The guinea pig (Cavea porcellus) is a mammalian non-rodent species in the Caviidae family. The sensitivity of the respiratory system and the susceptibility to infectious diseases allows the guinea pig to be a useful model for both infectious and non-infectious lung diseases such as asthma and tuberculosis. In this report, we demonstrated for the first time, the major cell types and composition in the guinea pig airway epithelium, using cell type-specific markers by immunohistochemical staining using the commercial available immunological reagents that cross-react with guinea pig. Our results revealed the availability of antibodies cross-reacting with airway epithelial cell types of basal, non-ciliated columnar, ciliated, Clara, goblet and alveolar type II cells, as well as those cells expressing Mucin 5AC, Mucin 2, Aquaporin 4 and Calcitonin Gene Related Peptide. The distribution of these various cell types were quantified in the guinea pig airway by immunohistochemical staining and were comparable with morphometric studies using an electron microscopy assay. Moreover, this study also demonstrated that goblet cells are the main secretory cell type in the guinea pig's airway, distinguishing this species from rats and mice. These results provide useful information for the understanding of airway epithelial cell biology and mechanisms of epithelial-immune integration in guinea pig models.

  5. Postsurgical volumetric airway changes in 2-jaw orthognathic surgery patients.

    Hart, P Sheamus; McIntyre, Brian P; Kadioglu, Onur; Currier, G Fräns; Sullivan, Steven M; Li, Ji; Shay, Christina


    Findings from early cephalometric studies on airway changes after 2-jaw orthognathic surgery have been challenged because the previous anteroposterior interpretation of airway changes can now be evaluated in 3 dimensions. The aims of this study were to use cone-beam computed tomography to quantify the nasopharynx, oropharynx, and total airway volume changes associated with skeletal movements of the maxilla and mandible in a sample of patients undergoing 2-jaw orthognathic surgery for correction of skeletal malocclusion. Skeletal movements and airway volumes of 71 postpubertal patients (31 male, 40 female; mean age, 18.8 years) were measured. They were divided into 2 groups based on ANB angle, overjet, and occlusion (Class II: ANB, >2°; overjet, >1 mm; total, 35 subjects; and Class III: ANB, overjet, <1 mm; total, 36 subjects). Presurgical and postsurgical measurements were collected for horizontal, vertical, and transverse movements of the maxilla and the mandible, along with changes in the nasopharynx, oropharynx, and total airways. Associations between the directional movements of skeletal structures and the regional changes in airway volume were quantified. Changes in the most constricted area were also noted. Horizontal movements of D-point were significantly associated with increases in both total airway (403.6 ± 138.6 mm(3); P <0.01) and oropharynx (383.9 ± 127.9 mm(3); P <0.01) volumes. Vertical movements of the posterior nasal spine were significantly associated with decreases in total airway volume (-459.2 ± 219.9 mm(3); P = 0.04) and oropharynx volume (-639.7 ± 195.3 mm(3); P <0.01), increases in nasopharynx (187.2 ± 47.1 mm(3); P <0.01) volume, and decreases in the most constricted area (-10.63 ± 3.69 mm(2); P <0.01). In the Class III patients only, the vertical movement of D-point was significantly associated with decreases in both total airway (-724.0 ± 284.4 mm(3); P = 0.02) and oropharynx (-648.2 ± 270.4 mm(3); P = 0.02) volumes. A similar

  6. Airway management during cardiopulmonary resuscitation.

    Bernhard, Michael; Benger, Jonathan R


    This article evaluates the latest scientific evidence regarding airway management during in-hospital and out-of-hospital cardiopulmonary resuscitation (CPR). In the in-hospital setting, observational research suggested that the quality of CPR using 'no flow ratio' as a surrogate marker was improved when advanced airway techniques were used. A registry study demonstrated that an initial failed intubation attempt was associated with an average delay of 3 min in time to return of spontaneous circulation. A prospective observational study showed that the Glide Scope videolaryngoscope was associated with a first-pass success rate of 93%, with no differences between less and more experienced physicians. In the out-of-hospital setting, a registry study suggested that intubation leads to a better outcome compared with supraglottic airway devices. However, no advanced airway devices showed a better outcome than basic airway techniques. An observational study reported that the i-gel supraglottic airway device offers a first-pass insertion success rate of 90%, and was easier to establish than the Portex Soft Seal laryngeal mask airway. Other out-of-hospital observational studies showed that the laryngeal tube offers a lower first-pass insertion success rate than expected, and complications of this device may influence later definitive airway management and the outcome as a whole. Recent studies of airway management during CPR rely mostly on registry and observational designs. Prospective randomized trials are needed to determine the optimal approach to airway management during cardiac arrest, but have not yet been completed.

  7. Nasal high-frequency oscillatory ventilation impairs heated humidification: A neonatal bench study.

    Ullrich, Tim L; Czernik, Christoph; Bührer, Christoph; Schmalisch, Gerd; Fischer, Hendrik S


    Nasal high-frequency oscillatory ventilation (nHFOV) is a novel mode of non-invasive ventilation used in neonates. However, upper airway obstructions due to viscous secretions have been described as specific adverse effects. We hypothesized that high-frequency oscillations reduce air humidity in the oropharynx, resulting in upper airway desiccation. Therefore, we aimed to investigate the effects of nHFOV ventilatory settings on oropharyngeal gas conditions. NHFOV or nasal continuous positive airway pressure (nCPAP) was applied, along with heated humidification, to a previously established neonatal bench model that simulates oropharyngeal gas conditions during spontaneous breathing through an open mouth. A digital thermo-hygro sensor measured oropharyngeal temperature (T) and humidity at various nHFOV frequencies (7, 10, 13 Hz), amplitudes (10, 20, 30 cmH2 O), and inspiratory-to-expiratory (I:E) ratios (25:75, 33:66, 50:50), and also during nCPAP. Relative humidity was always >99%, but nHFOV resulted in lower mean T and absolute humidity (AH) in comparison to nCPAP (P frequency and increasing nHFOV amplitude caused a decline in T and AH (P frequency of 7 Hz and an amplitude of 30 cmH2 O (T 32.4 ± 0.3°C, AH 34.7 ± 0.5 g · m(-3) ). Increasing the I:E ratio also reduced T and AH (P = 0.03). Intensified nHFOV settings with low frequencies, high amplitudes, and high I:E ratios may place infants at an increased risk of upper airway desiccation. Future studies should investigate strategies to optimize heated humidification during nHFOV. © 2017 Wiley Periodicals, Inc.

  8. The impact of allergic rhinitis and asthma on human nasal and bronchial epithelial gene expression.

    Ariane H Wagener

    Full Text Available BACKGROUND: The link between upper and lower airways in patients with both asthma and allergic rhinitis is still poorly understood. As the biological complexity of these disorders can be captured by gene expression profiling we hypothesized that the clinical expression of rhinitis and/or asthma is related to differential gene expression between upper and lower airways epithelium. OBJECTIVE: Defining gene expression profiles of primary nasal and bronchial epithelial cells from the same individuals and examining the impact of allergic rhinitis with and without concomitant allergic asthma on expression profiles. METHODS: This cross-sectional study included 18 subjects (6 allergic asthma and allergic rhinitis; 6 allergic rhinitis; 6 healthy controls. The estimated false discovery rate comparing 6 subjects per group was approximately 5%. RNA was extracted from isolated and cultured epithelial cells from bronchial brushings and nasal biopsies, and analyzed by microarray (Affymetrix U133+ PM Genechip Array. Data were analysed using R and Bioconductor Limma package. For gene ontology GeneSpring GX12 was used. RESULTS: The study was successfully completed by 17 subjects (6 allergic asthma and allergic rhinitis; 5 allergic rhinitis; 6 healthy controls. Using correction for multiple testing, 1988 genes were differentially expressed between healthy lower and upper airway epithelium, whereas in allergic rhinitis with or without asthma this was only 40 and 301 genes, respectively. Genes influenced by allergic rhinitis with or without asthma were linked to lung development, remodeling, regulation of peptidases and normal epithelial barrier functions. CONCLUSIONS: Differences in epithelial gene expression between the upper and lower airway epithelium, as observed in healthy subjects, largely disappear in patients with allergic rhinitis with or without asthma, whilst new differences emerge. The present data identify several pathways and genes that might be

  9. 葛根总黄酮经鼻给药对硝酸甘油致偏头痛模型大鼠的保护作用%Protective effects of pueraria total flavone by nasal drug delivery on experimental migraine rats

    张素慧; 宁炼; 石劲敏; 唐黎明; 金若敏; 张彤


    目的 研究葛根总黄酮经鼻给药对硝酸甘油致偏头痛模型大鼠的主要预防作用及其机制.方法 皮下注射硝酸甘油建立大鼠偏头痛模型,实验设正常对照组(滴鼻给予生理盐水)、模型组(滴鼻给予生理盐水)、麦角胺咖啡因口服灌胃组(灌胃给予麦角胺咖啡因2 mg· kg-1)、葛根总黄酮口服灌胃组(给予葛根总黄酮800 mg· kg-1)、葛根总黄酮滴鼻给药两剂量组(分别给予葛根总黄酮94 mg· kg-1和141 mg·kg-1).除麦角胺咖啡因组为7只大鼠外,其余各组均为12只.造模前给药,造模后连续观察4h,记录大鼠前肢挠头次数,4h后取大鼠血与脑组织,观察药物对血清及脑组织中一氧化氮合酶(NOS)与一氧化氮(NO)含量的影响.结果 造模后30 min大鼠出现倦卧、双耳发红,前肢挠头等症状,模型组血清与脑组织中的NOS与NO含量明显升高.滴鼻给予葛根总黄酮后,能明显减少硝酸甘油致偏头痛模型大鼠的前肢挠头次数,降低血清和脑组织中NOS与NO含量.结论 葛根总黄酮滴鼻给药能明显改善硝酸甘油致偏头痛的症状.%AIM To observe the preventive effect and mechanism of pueraria total flavone (PTF) by nasal delivery on nitroglycerin experimental migraine rats.METHODS The nitroglycerin experimental migraine rat model was used to observe the effect of pueraria total flavone on nitric oxide synthase (NOS) and nitric oxide (NO) in brain and serum.Rats were divided into common control group (n =12),model group (n =12),positive control group (ergotamine caffeine,EC,2 mg·kg-1,n =7),oral group (PTF,800 mg·kg-1,n =12) and nasal group (PTF,94 mg·kg-1 and 141 mg·kg-1,both n =12).Rats were treated with EC or PTF before model was made.The symptoms of scratching head with forepaws were observed for four hours after model was made.Serum and brains of rats were collected after observation was finished.The effect of PTF on NOS and NO in brain and serum were assayed.RESULTS Some

  10. Airway Progenitor Clone Formation Is Enhanced by Y-27632-Dependent Changes in the Transcriptome.

    Reynolds, Susan D; Rios, Cydney; Wesolowska-Andersen, Agata; Zhuang, Yongbin; Pinter, Mary; Happoldt, Carrie; Hill, Cynthia L; Lallier, Scott W; Cosgrove, Gregory P; Solomon, George M; Nichols, David P; Seibold, Max A


    The application of conditional reprogramming culture (CRC) methods to nasal airway epithelial cells would allow more wide-spread incorporation of primary airway epithelial culture models into complex lung disease research. In this study, we adapted the CRC method to nasal airway epithelial cells, investigated the growth advantages afforded by this technique over standard culture methods, and determined the cellular and molecular basis of CRC cell culture effects. We found that the CRC method allowed the production of 7.1 × 10(10) cells after 4 passages, approximately 379 times more cells than were generated by the standard bronchial epithelial growth media (BEGM) method. These nasal airway epithelial cells expressed normal basal cell markers and could be induced to form a mucociliary epithelium. Progenitor cell frequency was significantly higher using the CRC method in comparison to the standard culture method, and progenitor cell maintenance was dependent on addition of the Rho-kinase inhibitor Y-27632. Whole-transcriptome sequencing analysis demonstrated widespread gene expression changes in Y-27632-treated basal cells. We found that Y-27632 treatment altered expression of genes fundamental to the formation of the basal cell cytoskeleton, cell-cell junctions, and cell-extracellular matrix (ECM) interactions. Importantly, we found that Y-27632 treatment up-regulated expression of unique basal cell intermediate filament and desmosomal genes. Conversely, Y-27632 down-regulated multiple families of protease/antiprotease genes involved in ECM remodeling. We conclude that Y-27632 fundamentally alters cell-cell and cell-ECM interactions, which preserves basal progenitor cells and allows greater cell amplification.

  11. Numbered nasal discs for waterfowl

    Bartonek, J.C.; Dane, C.W.


    Numbered nasal discs were successfully used in studies requiring large numbers of individually marked waterfowl. The procedure for constructing these discs is outlined. Blue-winged teal (Anas discors) with 5/8-inch discs, and canvasback (Aythya valisineria) and redhead (A. americana) with 3/4-inch discs can be individually identified up to 50 and 80 yards, respectively, with a gunstock-mounted, 20-power spotting scope. The particular value of these markers is their durability, the number of combinations possible, and the apparent absence of behavioral or mortality influence among such species as the blue-winged teal.

  12. Obstrução nasal e alto escore de Mallampati como fatores de risco associados para Apneia Obstrutiva do Sono Nasal obstruction and high Mallampati score as risk factors for Obstructive Sleep Apnea

    Marcos Marques Rodrigues


    Full Text Available Os distúrbios respiratórios do sono estão associados à perviedade das vias aéreas superiores. Obstrução nasal é associada com o aumento de eventos de apneia do sono, principalmente pelo aumento da pressão negativa imposta às vias aéreas durante a inspiração. OBJETIVO: Avaliar a influência da obstrução nasal associada à classificação modificada de Mallampati na gravidade da SAOS. MATERIAIS E MÉTODOS: Foram avaliados e classificados 206 pacientes com queixa de roncos e história sugestiva de SAOS através do Escore Modificado de Mallampati, Friedman, obstrução nasal e quanto à gravidade da SAOS pelo IAH. RESULTADOS: Foram incluídos 168 pacientes que se submeteram ao estudo de polissonografia no laboratório de sono. Uma crostabulação foi feita entre o escore modificado de Mallampati, obstrução nasal e o IAH. O Oddis Ratio entre alto escore de Mallampati e IAH foi OR=5,053, IC 95%=1,458 - 7,517(p = 0,0071. Alto Mallampati associado com obstrução nasal se correlacionam com SAOS (p=0,0227. Entretanto, a influência da obstrução nasal sobre a relação do alto escore de Mallampati e SAOS não foi significativa OR = 2,850, IC 95%=0,992 - 8,189. CONCLUSÃO: A associação de alto escore de Mallampati e obstrução nasal é fator de risco para agravamento da SAOS.Respiratory sleep disorders are strongly associated with upper airway patency. Nasal obstruction is associated with higher incidences of sleep apnea, primarily by increasing the negative pressure on the airway during inspiration. AIMS: To evaluate the influence of nasal obstruction in the worsening of sleep apnea in patients with OSA and a high score on the modified classification of Mallampati. MATERIALS AND METHODS: We evaluated and classified 206 patients complaining of snoring, and with a past suggestive of OSA through the Modified Mallampati score, Friedman, nasal obstruction and the severity of OSA by AHI. RESULTS: 168 patients who underwent polysomnography

  13. Effectiveness of carbocysteine lysine salt monohydrate on models of airway inflammation and hyperresponsiveness.

    Asti, C; Melillo, G; Caselli, G F; Daffonchio, L; Hernandez, A; Clavenna, G; Omini, C


    We investigated the possible effects of the mucoactive drug Carbocysteine lysine salt monohydrate (CLS.H2O) on experimentally-induced airway inflammation and hyperresponsiveness. CLS.H2O given by the oral route (300 mg kg(-1)) significantly reduced neutrophil infiltration into the airway lumen induced by intratracheal injection of IL-1 beta in rats. In addition, CLS.H2O inhibited dose-dependently (100-300 mg kg(-1) p.o.) the formation of pleural exudate and leukocyte recruitment induced by intrapleural injection of carrageenan in rats. Because of the close interaction between the inflammatory process and the development of airway hyperresponsiveness we also tested CLS.H2O on cigarette-smoke-induced inflammation and hyperreactivity in anaesthetized guinea-pigs. The drug, given either by oral (300 mg kg(-1)) or aerosol route (30-100 mg ml(-1)), was able to reduce the increase in airway responsiveness induced by smoke and the associated cell recruitment detected in the bronchoalveolar lavage (BAL) fluids. These results suggest that CLS.H2O can exert an anti-inflammatory action in addition to its mucoregulatory activity. The anti-inflammatory and anti-hyperreactivity effect of the drug within the airways may be of advantage in the treatment of inflammatory lung diseases where mucus secretion together with airway inflammation and hyperreactivity contribute to airway obstruction.

  14. Adherencia al tratamiento con presión positiva continua nasal en pacientes con síndrome de apnea/hipoapnea del sueño Compliance with continuous positive airway pressure therapy in patients with sleep apnea/hypopnea syndrome

    Claudio W. Gallego


    Full Text Available Se evalúan prospectivamente los factores predictores y nivel de cumplimiento del tratamiento con presión positiva continua nasal (CPAP en un grupo de pacientes con síndrome de apnea del sueño. Valora efectos adversos y estado del equipamiento: interfase siliconada (IS, máscara-conectores (M-C, tubuladura (TU y arnés (A. Se incluyeron pacientes con >3meses de tratamiento, se registraron las horas de encendido mediante el contador horario al inicio, 2 y 4 meses. Definimos paciente cumplidor (C+ al que usara el CPAP >4h/d y >5d/semana. De los 46 pacientes estudiados (hombres 34; edad 62±9 años; IMC 33±7kg/m²; IAH 38±18/h; inicio 2.1±1.7años; CPAP 9±1.4cmH2O, 34 tenían contador horario y 24 (71% eran C+. El motivo de consulta fue: hipersomnolencia (65%, ronquido (39%, apneas vistas por cónyuge (28%. Entre C+ y C- no hallamos diferencias significativas en edad, IMC, presión de CPAP, tiempo de tratamiento, IAH, y clasificación de Epworth pre-tratamiento. Las horas de uso referidas vs. medidas para C+ y C- fueron 6.6±1 vs. 6.1±1 (p=0.02 y 5.6±1 vs 2.4±1 (p1año de uso, observamos un menor porcentaje de elementos categorizados como óptimos (87 a 44%, 74 a 44%, 83 a 44%, 91 a 78%, respectivamente. Los defectos más frecuentes fueron: endurecimiento de IS, rajaduras en IS, M-C y TU, conexiones flojas. El estudio confirma la importancia del monitoreo objetivo en pacientes con CPAP. Especial atención merece la presencia de efectos adversos y el control del estado del equipo que podrían afectar el tratamiento eficaz.Predictive factors and compliance level were evaluated in a group of patients with sleep apnea syndrome under CPAP treatment, assessing side effects and equipment condition: silicone interface (SI, mask-conectors (M-C, air tube (AT and head strap (HS. Patients with >3mo treatment were included, clock counter reading was registered at the beginning, 2 and 4 mo. Patients were considered compliant (C+ when usage was >4h


    kasim s. kasim


    Full Text Available Two cases of Schneiderian papilloma of the nasal septum are presented. The condition is rare, as indicated by a review of previously published cases. The clinical course of the lesion suggests that it behaves like Schneiderian papillomas elsewhere in the nasal cavity and paranasal sinuses. The need for aggressive surgical management and careful follow-up is emphasized.


    Abdelmonem Awad Hegazy


    Full Text Available Background: The nasal index determination is one of the most commonly used anthropometric parameters in classifying human races. There are few reports in medical literature concerning nasal index that specifically address particular Egyptian populations. The objective of this study was to determine the normal parameters of external nose (width, height and nasal index in Egyptians. Methods: The study was conducted randomly on healthy Egyptian subjects of both sexes. Nasal height and width were measured using vernier caliper. Then, nasal index was determined for each subject. The obtained data were subjected to statistical analysis. Results: A total of 290 subjects, 144 males and 146 females, aged 1 month– 65 years, were enrolled in the study. The study showed the existence of sexual dimorphism in nasal morphology, appearing after the age 20 years. The mean nasal index in the investigated adults was 68.01; in males and females was 71.46 and 64.56, respectively. Conclusions: The dominant nasal type in Egyptians was in-between mesorrhine "medium" and leptorrhine "narrow" nose. Forensic and anthropological research, as well as cosmetic and reconstructive surgery may benefit from age- and sex- based data of the study.

  17. Rhinoscleroma and nasal non-Hodgkin lymphoma

    Oliveira, Henrique Fernandes de


    Full Text Available Introduction: Rhinoscleroma, a rare nasal granulomatous disease, is caused by Klebsiella rhinoscleromatis. The nose is the primary occurrence region. Nasal non-Hodgkin lymphoma is a rare cancer, and could be of T or B type. The rhinoscleroma and the nasal non-Hodgkin lymphoma present with nasal obstruction as the main symptom, and are part of the nasal granulomatosis differential diagnosis. Objective: To report the association of rhinoscleroma and non-Hodgkin lymphoma in the same patient, by remarking the importance of the nasal granulomatosis' differential diagnosis. Case Report: A forty-nine year old female patient that appeared with a one-month progressive nasal obstruction. Rhinoscopy showed papillomatous feature lesion in left middle meatus. The immunohistochemical analysis confirmed rhinoscleroma. The patient was duly treated with total remission of the lesion. Ten months after, she returned with the same symptoms, but the histologic study confirmed non-Hodgkin lymphoma. Final Comments: Both pathologies may cause more severe nasal symptoms and complications. The early diagnostic enables the choice for the right treatment and contributes for the prognosis. The immunohistochemical study was essential for the diagnostic differentiation.

  18. A novel model of invasive fungal rhinosinusitis in rats.

    Zhang, Fang; An, Yunfang; Li, Zeqing; Zhao, Changqing


    Invasive fungal rhinosinusitis (IFRS) is a life-threatening inflammatory disease that affects immunocompromised patients, but animal models of the disease are scarce. This study aimed to develop an IFRS model in neutropenic rats. The model was established in three consecutive steps: unilateral nasal obstruction with Merocel sponges, followed by administration of cyclophosphamide (CPA), and, finally, nasal inoculation with Aspergillus fumigatus. Fifty healthy Wistar rats were randomly divided into five groups, with group I as the controls, group II undergoing unilateral nasal obstruction alone, group III undergoing nasal obstruction with fungal inoculation, group IV undergoing nasal obstruction with administration of CPA, and group V undergoing nasal obstruction with administration of CPA and fungal inoculation. Hematology, histology, and mycology investigations were performed. The changes in the rat absolute neutrophil counts (ANCs) were statistically different across the groups. The administration of CPA decreased the ANCs, whereas nasal obstruction with fungal inoculation increased the ANCs, and nasal obstruction did not change them. Histological examination of the rats in group V revealed the hyphal invasion of sinus mucosa and bone, thrombosis, and tissue infarction. No pathology indicative of IFRS was observed in the remaining groups. Positive rates of fungal culture in tissue homogenates from the maxillary sinus (62.5%) and lung (25%) were found in group V, whereas groups I, II, III, and IV showed no fungal culture in the homogenates. A rat IFRS model was successfully developed through nasal obstruction, CPA-induced neutropenia, and fungal inoculation. The disease model closely mimics the pathophysiology of anthropic IFRS.

  19. 戒烟对吸烟致敏大鼠气道5-脂氧合酶及其mRNA表达的影响%Effects of smoke cessation on expressions of 5-lipoxygenase protein and mRNA in smoking sensitized rats airway



    Objective To study the effect of smoking and smoke cessation on airway inflammation of asthma and put forward experimental basis for the treatment of asthma of smoking through researching the effect of smoking on the expressional levels of 5-lipoxygenase protein and mRNA in sensitized rats airway.Methods Forty male Wistar rats were divided randomly into control group,sensitized group,smoking group and smoke cessation group.The rats of latter three groups were sensitized and challenged by ovalbumin to establish the asthmatic model.From the challenged third weeks,the smoking group and smoke cessation group rats were put in the self-made fumigating box to smoke passively.The expressions of 5-lipoxygenase protein and mRNA in airway were defected using immunohistochemistry and hybridization in situ in all rats of three groups.Results ① The expressions of airway 5-lipoxygenase protein of the smoking group (32.58 ± 2.78) and the smoke cessation group (26.36 ± 2.34) were significantly higher than those of the sensitized group (21.65 ± 2.12) and the control group (15.38 ± 1.68,all P <0.01),so did the sensitized group and the control group (P <0.01).②The expression of airway 5-lipoxygenase mRNA of the smoking group (34.68 ± 2.90) and the smoke cessation group (27.16 ± 2.38) were significantly higher than those of the sensitized group (23.55 ± 2.28) and the control group (15.78±1.72,all P <0.01),so did the sensitized group and the control group (P <0.01).Conclusions Smoking can increase the expession level of 5-lipoxygenase protein and mRNA in sensitized rats airway and aggravation airway inflammation.Smoke cessation can relieve airway inflammation and is an effective measure for preventing asthma.%目的 通过研究戒烟对吸烟致敏大鼠气道5-脂氧合酶(5-LO)及其mRNA表达的影响,探讨吸烟及戒烟对支气管哮喘(简称哮喘)气道炎症的影响,为吸烟哮喘患者戒烟及治疗提供依据.方法 雄性Wistar大鼠40只,随机

  20. Effects of rapamycin on airway remodeling, IL-8 and IL-10 in asthmatic rats%雷帕霉素对哮喘大鼠气道重塑和白细胞介素-8白细胞介素-10的影响

    余可斐; 熊紫君; 穆敬平; 周立志; 陈雄


    Objective To investigate the effects of rapamycin on airway remodeling and lung tissue IL-8 and IL-10 in asthmatic rats, and to explore the mechanism by which rapamycin intervene in airway inflammation and re-modeling in bronchial asthma, so as to provide experimental basis for clinical research. Methods The asthmatic rat model of airway remodeling was established. Then, 30 SD rats were randomly divided i