Symposium on obesity and asthma �CNovember 2, 2006

Asthma and obesity are frequently associated, and obesity has been considered a factor contributing to both an increase in severity of asthma and to its development. The present document summarizes the proceedings of a symposium held in Montreal, Quebec, on November 2, 2006, under the auspices of the Réseau en santé respiratoire du Fonds de la recherche en santé du Québec in collaboration with the McGill University – Strauss Severe Asthma Program, Université Laval (Quebec City) and Université de Montréal. It includes an overview of the various aspects of the relationships between asthma and obesity with regard to animal models; genetic, hormonal and physiological determinants; influence of comorbidities (eg, sleep apnea syndrome); epidemiology; clinical and psychological features; and management of asthma in the obese population.     

Bronchoscopic management of airway obstruction in pediatric endobronchial tuberculosis

The present report describes a case of severe airway obstruction caused by endobronchial tuberculosis in an 11-year-old girl who was successfully treated by bronchoscopic balloon dilation. This case illustrates the insidious presentation and the increasingly important role of bronchoscopic intervention in the management of endobronchial tuberculosis. In addition, a brief literature review of the condition in the pediatric age group is included.     

沙丁胺醇在诱导培养人气管平滑肌细胞凋亡中的作用

目的 研究沙丁胺醇（商品名：舒喘灵）对于诱导培养人气管平滑肌细胞凋亡的作用。 方法 分离人气管平滑肌细胞并且在含有10％胎牛血清的达尔伯克改良伊格尔（DMEM）培养基中培养,4－6代的细胞用于实验。细胞用沙丁胺醇或色满卡林（cromakalim)或8－溴－环磷酸腺苷（Br-Camp)培养24h或48h ,光镜和电镜观察形态学改变。琼脂糖电泳分析DNA碎片。链亲和素－过氧化物酶（SP）免疫组化染色监测p53、Bcl－2和Bax基因表达的改变。通过破碎DNA的原位末端标记技术（TUNEL）检测凋亡细胞的百分数。结果 （1）沙丁胺醇或8－Br-cAMP降低存活细胞的数目。在48h、300μmol/L的浓度,存活的细胞数量最低;（2）人气管平滑肌细胞用沙丁胺醇（100μmol/L、300μmol/L)孵化48h显示出凋亡的形态学特征（细胞皱缩、染色质浓聚）;（3）琼脂糖电泳显示,核酸DNA断裂片呈典型的梯状条带（大约180－200bp);（4）沙丁胺醇或8－Br-cAMP组p53或Bax基因表达显著高于对照组,但Bcl－2组基因表达低于对照组;（5）TUNEL显示,人气管平滑肌细胞的凋亡阳必用100、300μmol沙丁胺醇或100μmol8-Br-cAMP处理组与对照组比较差异有显著性（q分别为24．04、58．47、27．28,P均＜0．001）。但cromakalim组和先用普萘洛尔（商品名：心得安）后与沙丁胺醇组与对照组比较,差异无显著性（q分别为0．12、0．53;P分别为0．932、0．717）,不影响凋亡细胞的基本水平。结论 （1）在体外,沙丁胺醇以时间和浓度依赖的方式诱导人气管平滑肌细胞凋亡。（2）cAMP蛋白激酶A通路对于沙丁胺醇诱导的凋亡是必须的和充分的。     

Pharmacological Study of Oyster Mushroom (<Emphasis Type="Italic">Pleurotus Ostreatus</Emphasis>) Extract on Isolated Guinea Pig Trachea Smooth Muscle

Mushroom farm workers suffer from respiratory symptoms during the farming of mushrooms. The objective of this study was to analyze the effects of oyster mushroom (Pleurotus ostreatus) extract (OME) on isolated guinea pig tracheal smooth muscle in vitro. Isolated guinea pig tracheal tissue from 27 nonsensitized guinea pigs were studied. The OME was obtained from indoor mushroom growing fields and prepared as a 1:10 w/v aqueous solution. Dose-related contractions of nonsensitized guinea pig trachea were demonstrated using these extracts. The OME contained significant quantities of bacterial components (eg., endotoxin: 43,072.92 EU/mg). Parallel, pharmacological studies were performed by pre-treating the tissues with mediator-modifying agents including atropine, indomethacin, pyrilamine, BPB, acivicin, NDGA, captopril, TMB8 and capsaicin. Atropine consistently and strikingly reduced the contractile effects of this extract. These observations suggest an interaction of the OME with parasympathetic nerves or more directly with muscarinic receptors. Pretreatment with TMB8 (inhibitor of intracellular calcium mobilization) also significantly blocked the constrictor effect of OME, indicating a role of calcium mobilization in the constricting effect of OME. Inhibition of contraction by blocking of other mediators was less effective and varied depending on the drug. We conclude that OME causes a dose-related airway smooth muscle constriction by nonimmunological mechanisms involving a variety of airway mediators and possibly cholinergic receptors. This effect is not dependent on pre-sensitization of the guinea pigs.     

Randomized Comparison of Actual and Ideal Body Weight for Size Selection of the Laryngeal Mask Airway Classic in Overweight Patients

Size selection of the laryngeal mask airway (LMA) Classic based on actual body weight remains a common practice. However, ideal body weight might allow for a better size selection in obese patients. The purpose of our study was to compare the utility of ideal body weight and actual body weight when choosing the appropriate size of the LMA Classic by a randomized clinical trial. One hundred patients with age 20 to 70 yr, body mass index ≥25 kg/m², and the difference between LMA sizes based on actual weight and ideal weight were allocated to insert the LMA Classic using either actual body weight or ideal body weight in a weight-based formula for size selection. After insertion of the device, several variables including insertion parameters, sealing function, fiberoptic imaging, and complications were investigated. The insertion success rate at the first attempt was lower in the actual weight group (82%) than in the ideal weight group (96%), even it did not show significant difference. The ideal weight group had significantly shorter insertion time and easier placement. However, fiberoptic views were significantly better in the actual weight group. Intraoperative complications, sore throat in the recovery room, and dysphonia at postoperative 24 hr occurred significantly less often in the ideal weight group than in the actual weight group. It is suggested that the ideal body weight may be beneficial to the size selection of the LMA Classic in overweight patients (Clinical Trial Registry, {"type":"clinical-trial","attrs":{"text":"NCT 01843270","term_id":"NCT01843270"}}NCT 01843270).

Graphical Abstract

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哮喘小鼠气道重塑过程中CD4~+CD25~+调节性T细胞和Th17细胞表达的动态变化

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气管插管救治急性重度有机磷中毒52例临床分析

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Airway ultrasound for the confirmation of endotracheal tube placement in cadavers by military flight medic trainees – A pilot study

Objective

Confirming correct endotracheal tube (ETT) placement is a key component of successful airway management. Ultrasound (US) as a tool for the confirmation of ETT placement has been investigated in the hospital setting but not in the pre-hospital setting. We hypothesized that after a short educational session, military flight medic trainees would be able to accurately identify ETT placement in a cadaver model.

An outbreak of swimming-pool related respiratory symptoms: An elusive source of trichloramine in a municipal indoor swimming pool

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