Science.gov

Sample records for exhalation

  1. Monitoring Exhaled Carbon Dioxide.

    PubMed

    Siobal, Mark S

    2016-10-01

    In the past few decades, assessment of exhaled CO2 in both intubated and non-intubated patients has evolved into an essential component in many aspects of patient monitoring. Besides the basic assessment of ventilation, exhaled CO2 monitoring can provide valuable patient safety information and critical physiologic data in regard to the ventilation and perfusion matching in the lungs, cardiac output, and metabolic rate. Despite these important clinical monitoring benefits and widespread availability, exhaled CO2 monitoring is often underutilized. The purpose of this paper is to review the importance and present the extensive body of knowledge to support the use of exhaled CO2 monitoring in various areas of clinical practice. Advanced application concepts and the future development of exhaled CO2 monitoring will also be discussed.

  2. Exhaled breath analysis and sleep.

    PubMed

    Carpagnano, Giovanna E

    2011-10-15

    It is currently estimated that the economic burden for obstructive sleep apnea syndrome (OSAS) cases not coming to medical attention is steadily increasing, thus making OSAS a major public health concern. For its increasing incidence among the common population, the interest of researchers and clinicians has been recently directed to the study of pathological mechanisms underlying sleep disorders. Current opinion is that airway inflammation and oxidative stress play a crucial role in the pathophysiology of OSAS. Recently there has been increasing interest in the investigation of lungs by non-invasive means measuring the exhaled breath volatile mediators, such as nitric oxide (NO), carbon monoxide (CO), ethane and pentane and finally the non-volatile substances in the liquid phase of exhalate, termed breath condensate. The non-invasiveness of these techniques for the study of airways affected by different respiratory disorders and among those, the OSAS, makes these ideally suited for the evaluation and serial monitoring of patients. Notwithstanding the increasing number of scientific contributions on the use of the exhaled markers in sleep disorders, at the moment, their use is not completely suitable for clinical application. An important contribution to the increase of our knowledge on exhaled markers and for their possible concrete application in clinical practice may come from future studies using proteomics, genomics and metabolomics. In this review, we focus on exhaled breath analysis giving an update on its general aspects, its application in OSAS, and finally its actual clinical applicability and areas for future direction.

  3. Inhaling to mitigate exhaled bioaerosols

    PubMed Central

    Edwards, David A.; Man, Jonathan C.; Brand, Peter; Katstra, Jeffrey P.; Sommerer, K.; Stone, Howard A.; Nardell, Edward; Scheuch, Gerhard

    2004-01-01

    Humans commonly exhale aerosols comprised of small droplets of airway-lining fluid during normal breathing. These “exhaled bioaerosols” may carry airborne pathogens and thereby magnify the spread of certain infectious diseases, such as influenza, tuberculosis, and severe acute respiratory syndrome. We hypothesize that, by altering lung airway surface properties through an inhaled nontoxic aerosol, we might substantially diminish the number of exhaled bioaerosol droplets and thereby provide a simple means to potentially mitigate the spread of airborne infectious disease independently of the identity of the airborne pathogen or the nature of any specific therapy. We find that some normal human subjects expire many more bioaerosol particles than other individuals during quiet breathing and therefore bear the burden of production of exhaled bioaerosols. Administering nebulized isotonic saline to these “high-producer” individuals diminishes the number of exhaled bioaerosol particles expired by 72.10 ± 8.19% for up to 6 h. In vitro and in vivo experiments with saline and surfactants suggest that the mechanism of action of the nebulized saline relates to modification of the physical properties of the airway-lining fluid, notably surface tension. PMID:15583121

  4. Inhaling to mitigate exhaled bioaerosols.

    PubMed

    Edwards, David A; Man, Jonathan C; Brand, Peter; Katstra, Jeffrey P; Sommerer, K; Stone, Howard A; Nardell, Edward; Scheuch, Gerhard

    2004-12-14

    Humans commonly exhale aerosols comprised of small droplets of airway-lining fluid during normal breathing. These "exhaled bioaerosols" may carry airborne pathogens and thereby magnify the spread of certain infectious diseases, such as influenza, tuberculosis, and severe acute respiratory syndrome. We hypothesize that, by altering lung airway surface properties through an inhaled nontoxic aerosol, we might substantially diminish the number of exhaled bioaerosol droplets and thereby provide a simple means to potentially mitigate the spread of airborne infectious disease independently of the identity of the airborne pathogen or the nature of any specific therapy. We find that some normal human subjects expire many more bioaerosol particles than other individuals during quiet breathing and therefore bear the burden of production of exhaled bioaerosols. Administering nebulized isotonic saline to these "high-producer" individuals diminishes the number of exhaled bioaerosol particles expired by 72.10 +/- 8.19% for up to 6 h. In vitro and in vivo experiments with saline and surfactants suggest that the mechanism of action of the nebulized saline relates to modification of the physical properties of the airway-lining fluid, notably surface tension.

  5. Exhaled Breath Analysis and Sleep

    PubMed Central

    Carpagnano, Giovanna E.

    2011-01-01

    It is currently estimated that the economic burden for obstructive sleep apnea syndrome (OSAS) cases not coming to medical attention is steadily increasing, thus making OSAS a major public health concern. For its increasing incidence among the common population, the interest of researchers and clinicians has been recently directed to the study of pathological mechanisms underlying sleep disorders. Current opinion is that airway inflammation and oxidative stress play a crucial role in the pathophysiology of OSAS. Recently there has been increasing interest in the investigation of lungs by non-invasive means measuring the exhaled breath volatile mediators, such as nitric oxide (NO), carbon monoxide (CO), ethane and pentane and finally the non-volatile substances in the liquid phase of exhalate, termed breath condensate. The non-invasiveness of these techniques for the study of airways affected by different respiratory disorders and among those, the OSAS, makes these ideally suited for the evaluation and serial monitoring of patients. Notwithstanding the increasing number of scientific contributions on the use of the exhaled markers in sleep disorders, at the moment, their use is not completely suitable for clinical application. An important contribution to the increase of our knowledge on exhaled markers and for their possible concrete application in clinical practice may come from future studies using proteomics, genomics and metabolomics. In this review, we focus on exhaled breath analysis giving an update on its general aspects, its application in OSAS, and finally its actual clinical applicability and areas for future direction. Citation: Carpagnano GE. Exhaled breath analysis and sleep. J Clin Sleep Med 2011;7(5):Supplement S34-S37. PMID:22003329

  6. Submarines, Spacecraft, and Exhaled Breath

    EPA Science Inventory

    The International Association of Breath Research (IABR) meetings are an eclectic gathering of researchers in the medical, environmental and instrumentation fields; our focus is on human health as assessed by the measurement and interpretation of trace chemicals in human exhaled b...

  7. Submarines, Spacecraft, and Exhaled Breath

    EPA Science Inventory

    The International Association of Breath Research (IABR) meetings are an eclectic gathering of researchers in the medical, environmental and instrumentation fields; our focus is on human health as assessed by the measurement and interpretation of trace chemicals in human exhaled b...

  8. Elective haemodialysis increases exhaled isoprene.

    PubMed

    Lirk, Philipp; Bodrogi, Florian; Raifer, Hartmann; Greiner, Karin; Ulmer, Hanno; Rieder, Josef

    2003-05-01

    Uraemic odour is a characteristic feature of patients with end-stage renal disease (ESRD). However, few investigations have been carried out into the composition of exhaled air in ESRD patients undergoing haemodialysis (HD). Increases of exhaled isoprene levels by a factor of up to 2.7 following HD have been reported. We attempted to confirm these findings in 50 patients undergoing HD using haemophan (n=23) or polysulphone (n=27) dialysis membranes. Parallel evaluation of ambient air, calorie intake, medication and haemodynamic variables was performed. Samples were analysed using proton transfer reaction-mass spectrometry (PTR-MS). Significant changes in breath isoprene concentration were observed when comparing patients before [39.14+/-14.96 parts per billion (ppbv)] and after (63.54+/-27.59 ppbv) dialysis (P<0.001). The quotient of values before and after dialysis was 1.84 (SD 1.41). No significant differences in isoprene kinetics were found between the use of haemophan and polysulphone membranes. No significant correlations were observed between isoprene quotients and variations in blood pressure during HD, calorie intake, ingestion of lipid-lowering drugs or serum lipid levels. Isoprene concentration was higher in the exhaled air of patients after HD as compared with values before HD. Large interindividual variability existed in isoprene kinetics. Oxidative stress appears to be an unlikely cause for this rise. An alternative hypothesis is an influence of respiratory variables on isoprene exhalation based upon Henry's law constant. We therefore propose to perform online monitoring of isoprene exhalation by PTR-MS during the HD session to investigate the possible influence of respiratory variables.

  9. Comparison of select analytes in exhaled aerosol from e-cigarettes with exhaled smoke from a conventional cigarette and exhaled breaths.

    PubMed

    Long, Gerald A

    2014-10-27

    Exhaled aerosols were collected following the use of two leading U.S. commercial electronic cigarettes (e-cigarettes) and a conventional cigarette by human subjects and analyzed for phenolics, carbonyls, water, glycerin and nicotine using a vacuum-assisted filter pad capture system. Exhaled breath blanks were determined for each subject prior to each product use and aerosol collection session. Distribution and mass balance of exhaled e-cigarette aerosol composition was greater than 99.9% water and glycerin, and a small amount (<0.06%) of nicotine. Total phenolic content in exhaled e-cigarette aerosol was not distinguishable from exhaled breath blanks, while total phenolics in exhaled cigarette smoke were significantly greater than in exhaled e-cigarette aerosol and exhaled breaths, averaging 66 µg/session (range 36 to 117 µg/session). The total carbonyls in exhaled e-cigarette aerosols were also not distinguishable from exhaled breaths or room air blanks. Total carbonyls in exhaled cigarette smoke was significantly greater than in exhaled e-cigarette aerosols, exhaled breath and room air blanks, averaging 242 µg/session (range 136 to 352 µg/session). These results indicate that exhaled e-cigarette aerosol does not increase bystander exposure for phenolics and carbonyls above the levels observed in exhaled breaths of air.

  10. Comparison of Select Analytes in Exhaled Aerosol from E-Cigarettes with Exhaled Smoke from a Conventional Cigarette and Exhaled Breaths

    PubMed Central

    Long, Gerald A.

    2014-01-01

    Exhaled aerosols were collected following the use of two leading U.S. commercial electronic cigarettes (e-cigarettes) and a conventional cigarette by human subjects and analyzed for phenolics, carbonyls, water, glycerin and nicotine using a vacuum-assisted filter pad capture system. Exhaled breath blanks were determined for each subject prior to each product use and aerosol collection session. Distribution and mass balance of exhaled e-cigarette aerosol composition was greater than 99.9% water and glycerin, and a small amount (<0.06%) of nicotine. Total phenolic content in exhaled e-cigarette aerosol was not distinguishable from exhaled breath blanks, while total phenolics in exhaled cigarette smoke were significantly greater than in exhaled e-cigarette aerosol and exhaled breaths, averaging 66 µg/session (range 36 to 117 µg/session). The total carbonyls in exhaled e-cigarette aerosols were also not distinguishable from exhaled breaths or room air blanks. Total carbonyls in exhaled cigarette smoke was significantly greater than in exhaled e-cigarette aerosols, exhaled breath and room air blanks, averaging 242 µg/session (range 136 to 352 µg/session). These results indicate that exhaled e-cigarette aerosol does not increase bystander exposure for phenolics and carbonyls above the levels observed in exhaled breaths of air. PMID:25350011

  11. 42 CFR 84.91 - Breathing resistance test; exhalation.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Breathing resistance test; exhalation. 84.91...-Contained Breathing Apparatus § 84.91 Breathing resistance test; exhalation. (a) Resistance to exhalation...-circuit apparatus with a breathing machine as described in § 84.88, and the exhalation resistance...

  12. 42 CFR 84.91 - Breathing resistance test; exhalation.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Breathing resistance test; exhalation. 84.91...-Contained Breathing Apparatus § 84.91 Breathing resistance test; exhalation. (a) Resistance to exhalation...-circuit apparatus with a breathing machine as described in § 84.88, and the exhalation resistance...

  13. 42 CFR 84.91 - Breathing resistance test; exhalation.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Breathing resistance test; exhalation. 84.91...-Contained Breathing Apparatus § 84.91 Breathing resistance test; exhalation. (a) Resistance to exhalation...-circuit apparatus with a breathing machine as described in § 84.88, and the exhalation resistance...

  14. 42 CFR 84.91 - Breathing resistance test; exhalation.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing resistance test; exhalation. 84.91...-Contained Breathing Apparatus § 84.91 Breathing resistance test; exhalation. (a) Resistance to exhalation... continuous rate of 85 liters per minute. (b) The exhalation resistance of demand apparatus shall not...

  15. 42 CFR 84.91 - Breathing resistance test; exhalation.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Breathing resistance test; exhalation. 84.91...-Contained Breathing Apparatus § 84.91 Breathing resistance test; exhalation. (a) Resistance to exhalation... continuous rate of 85 liters per minute. (b) The exhalation resistance of demand apparatus shall not...

  16. Characterizing exhaled airflow from breathing and talking.

    PubMed

    Gupta, Jitendra K; Lin, Chao-Hsin; Chen, Qingyan

    2010-02-01

    The exhaled air of infected humans is one of the prime sources of contagious viruses. The exhaled air comes from respiratory events such as the coughing, sneezing, breathing and talking. Accurate information on the thermo-fluid characteristics of the exhaled airflow can be important for prediction of infectious disease transmission. The present study developed a source model to provide the thermo-fluid conditions of the exhaled air from the breathing and talking processes. The source model is a set of equations obtained from the measurements of the flow rate, flow direction, and area of mouth/nose opening with human subjects. It was found that the exhaled flow rate over time can be represented as a sinusoidal function for breathing and a constant for talking. The flow rates can be calculated by physiological parameters of a subject. The direction of the exhalation jet did not vary much between subjects and the area of mouth/nose opening could be regarded as a constant. Though the mouth/nose opening size varied among subjects, they were not correlated with the physiological parameters of the subjects. If combined with appropriate virus and droplet distribution information, the model can be used to describe the disease source due to breathing and talking. Accurate prediction of airborne disease transmission, and the infection prone zones, can aid in identifying and implementing the control strategies. With the recent advancements, Computational Fluid Dynamics (CFD) has become a powerful tool in predicting the disease transmission. Accurate prediction of the transmission by these CFD simulations requires information on sources and sinks of infectious viruses and models for dispersion of these viruses. The exhaled air of an infected human is one of the prime sources of disease viruses. In the present study, measurements of the flow were conducted on human subjects to develop models for the flow boundary conditions for the exhalation and inhalation during breathing and

  17. Submarines, spacecraft and exhaled breath.

    PubMed

    Pleil, Joachim D; Hansel, Armin

    2012-03-01

    Foreword The International Association of Breath Research (IABR) meetings are an eclectic gathering of researchers in the medical, environmental and instrumentation fields; our focus is on human health as assessed by the measurement and interpretation of trace chemicals in human exhaled breath. What may have escaped our notice is a complementary field of research that explores the creation and maintenance of artificial atmospheres practised by the submarine air monitoring and air purification (SAMAP) community. SAMAP is comprised of manufacturers, researchers and medical professionals dealing with the engineering and instrumentation to support human life in submarines and spacecraft (including shuttlecraft and manned rockets, high-altitude aircraft, and the International Space Station (ISS)). Here, the immediate concerns are short-term survival and long-term health in fairly confined environments where one cannot simply 'open the window' for fresh air. As such, one of the main concerns is air monitoring and the main sources of contamination are CO(2) and other constituents of human exhaled breath. Since the inaugural meeting in 1994 in Adelaide, Australia, SAMAP meetings have been held every two or three years alternating between the North American and European continents. The meetings are organized by Dr Wally Mazurek (a member of IABR) of the Defense Systems Technology Organization (DSTO) of Australia, and individual meetings are co-hosted by the navies of the countries in which they are held. An overriding focus at SAMAP is life support (oxygen availability and carbon dioxide removal). Certainly, other air constituents are also important; for example, the closed environment of a submarine or the ISS can build up contaminants from consumer products, cooking, refrigeration, accidental fires, propulsion and atmosphere maintenance. However, the most immediate concern is sustaining human metabolism: removing exhaled CO(2) and replacing metabolized O(2). Another

  18. Exhaled breath analysis for lung cancer.

    PubMed

    Dent, Annette G; Sutedja, Tom G; Zimmerman, Paul V

    2013-10-01

    Early diagnosis of lung cancer results in improved survival compared to diagnosis with more advanced disease. Early disease is not reliably indicated by symptoms. Because investigations such as bronchoscopy and needle biopsy have associated risks and substantial costs, they are not suitable for population screening. Hence new easily applicable tests, which can be used to screen individuals at risk, are required. Biomarker testing in exhaled breath samples is a simple, relatively inexpensive, non-invasive approach. Exhaled breath contains volatile and non-volatile organic compounds produced as end-products of metabolic processes and the composition of such compounds varies between healthy subjects and subjects with lung cancer. Many studies have analysed the patterns of these compounds in exhaled breath. In addition studies have also reported that the exhaled breath condensate (EBC) can reveal gene mutations or DNA abnormalities in patients with lung cancer. This review has summarised the scientific evidence demonstrating that lung cancer has distinct chemical profiles in exhaled breath and characteristic genetic changes in EBC. It is not yet possible to accurately identify individuals with lung cancer in at risk populations by any of these techniques. However, analysis of both volatile organic compounds in exhaled breath and of EBC have great potential to become clinically useful diagnostic and screening tools for early stage lung cancer detection.

  19. Exhaled breath analysis for lung cancer

    PubMed Central

    Sutedja, Tom G.; Zimmerman, Paul V.

    2013-01-01

    Early diagnosis of lung cancer results in improved survival compared to diagnosis with more advanced disease. Early disease is not reliably indicated by symptoms. Because investigations such as bronchoscopy and needle biopsy have associated risks and substantial costs, they are not suitable for population screening. Hence new easily applicable tests, which can be used to screen individuals at risk, are required. Biomarker testing in exhaled breath samples is a simple, relatively inexpensive, non-invasive approach. Exhaled breath contains volatile and non-volatile organic compounds produced as end-products of metabolic processes and the composition of such compounds varies between healthy subjects and subjects with lung cancer. Many studies have analysed the patterns of these compounds in exhaled breath. In addition studies have also reported that the exhaled breath condensate (EBC) can reveal gene mutations or DNA abnormalities in patients with lung cancer. This review has summarised the scientific evidence demonstrating that lung cancer has distinct chemical profiles in exhaled breath and characteristic genetic changes in EBC. It is not yet possible to accurately identify individuals with lung cancer in at risk populations by any of these techniques. However, analysis of both volatile organic compounds in exhaled breath and of EBC have great potential to become clinically useful diagnostic and screening tools for early stage lung cancer detection. PMID:24163746

  20. Measurement of transfer factor during constant exhalation.

    PubMed Central

    Wilson, A. F.; Hearne, J.; Brenner, M.; Alfonso, R.

    1994-01-01

    BACKGROUND--Transfer factor of the lung for carbon monoxide (TLCO) was measured by a new method based on analysis of the ratio of the concentrations of carbon monoxide to an inert gas (methane) relative to lung volume during a constant exhalation. Since this new technique is based solely upon exhalation, anomalies associated with inspiration and breath holding do not affect results. Additionally, because prolonged breath holding is not required, measurements can readily be made in dyspnoeic patients. METHODS--Exhalation TLCO (TLCO,ex) was compared with the standard (Jones and Meade) 10 second breath holding TLCO (TLCO,bh) in 100 consecutive patients. Patients did not practise the exhalation manoeuvre prior to testing. RESULTS--The comparative results were very close; mean difference (bias) +/- standard deviation (precision) was 0.05 (0.84) mmol/min/kPa. The relation was equally strong in patients with severe pulmonary disease; for patients with FEV1 < 1.51 the mean difference was 0.21 (0.80) mmol/min/kPa. CONCLUSIONS--Since the results were essentially identical between the techniques, it seems that comparable pathophysiological factors affect TLCO during breath holding and constant exhalation. Constant exhalation may therefore be a useful alternative to the breath holding technique for clinical measurement of TLCO. PMID:7831628

  1. Radon and Thoron exhalation rate map in Japan

    SciTech Connect

    Masahiro, Hosoda; Michikuni, Shimo; Kazuyuki, Minami; Kazutaka, Ejiri; Masato, Sugino; Masahide, Furukawa; Masahiro, Fukushi

    2008-08-07

    Measurements of radon and thoron exhalation rates have been done using the radon and thoron exhalation rate measuring instrument adopting the accumulation method. We obtained the 111 data in the 40 sites of the 14 prefectures in Japan. The arithmetic average value of the radon and thoron exhalation rates by all 111 data were obtained to be 8.6 mBq{center_dot}m{sup -2}{center_dot}s{sup -1} and 0.80 Bq{center_dot}m{sup -2}{center_dot}s{sup -1}, respectively, and we have reported the radon and thoron exhalation rates in relation to the geological features. The relation between the exhalation rate and geology was shown that the exhalation rate had an increasing tendency in order of basic rock, neutral rock and acidic rock. We made the nationwide exhalation-rate map using the survey data of exhalation-rate of radon and thoron and the geological distribution map.

  2. The origin of mouth-exhaled ammonia.

    PubMed

    Chen, W; Metsälä, M; Vaittinen, O; Halonen, L

    2014-09-01

    It is known that the oral cavity is a production site for mouth-exhaled NH3. However, the mechanism of NH3 production in the oral cavity has been unclear. Since bacterial urease in the oral cavity has been found to produce ammonia from oral fluid urea, we hypothesize that oral fluid urea is the origin of mouth-exhaled NH3. Our results show that under certain conditions a strong correlation exists between oral fluid urea and oral fluid ammonia (NH4(+)+NH3) (rs = 0.77, p < 0.001). We also observe a strong correlation between oral fluid NH3 and mouth-exhaled NH3 (rs = 0.81, p < 0.001). We conclude that three main factors affect the mouth-exhaled NH3 concentration: urea concentration, urease activity and oral fluid pH. Bacterial urease catalyses the hydrolysis of oral fluid urea to ammonia (NH4(+)+NH3). Oral fluid ammonia (NH4(+)+NH3) and pH determine the concentration of oral fluid NH3, which evaporates from oral fluid into gas phase and turns to mouth-exhaled NH3.

  3. Nasal contribution to exhaled nitric oxide during exhalation against resistance or during breath holding

    PubMed Central

    Kharitonov, S. A.; Barnes, P. J.

    1997-01-01

    BACKGROUND: The concentration of nitric oxide (NO) is increased in the exhaled air of patients with inflammation of the airways, suggesting that this may be a useful measurement to monitor inflammation in diseases such as asthma. However, there have been concerns that exhaled NO may be contaminated by the high concentrations of NO derived from the upper airways, and that this may account for differences in reported values of exhaled NO using different techniques. A study was performed, with argon as a tracer, to determine the extent of nasal contamination of exhaled NO using different expiratory manoeuvres. METHODS: Exhaled and nasal NO were measured by a chemiluminescence analyser. Argon (4.8%) was delivered continuously to the nose. Gas was sampled from the posterior oropharynx and argon and carbon dioxide were measured by mass spectrometry at the same time as NO. RESULTS: During a single expiration against a low resistance and during breath holding there was no evidence for nasal contamination, whereas during exhalation without resistance argon concentration in the oropharynx was increased from 0.91% (95% CI 0.84% to 0.98%) in ambient air to 1.28% (0.9% to 2.24%, p < 0.0001) during a single breath or 2.37% (2.29% to 2.51%, p < 0.0001) during tidal breathing. CONCLUSIONS: Collection of exhaled NO in a reservoir during tidal breathing is likely to be contaminated by NO derived from the nose and this may underestimate any increases in NO derived from the lower respiratory tract in inflammatory diseases. However, with slow expiration against a resistance and created back pressure to close the soft palate, there is no contamination of exhaled air which then reflects concentrations of NO in the lower airways. 


 PMID:9227721

  4. Nasal contribution to exhaled nitric oxide during exhalation against resistance or during breath holding.

    PubMed

    Kharitonov, S A; Barnes, P J

    1997-06-01

    The concentration of nitric oxide (NO) is increased in the exhaled air of patients with inflammation of the airways, suggesting that this may be a useful measurement to monitor inflammation in diseases such as asthma. However, there have been concerns that exhaled NO may be contaminated by the high concentrations of NO derived from the upper airways, and that this may account for differences in reported values of exhaled NO using different techniques. A study was performed, with argon as a tracer, to determine the extent of nasal contamination of exhaled NO using different expiratory manoeuvres. Exhaled and nasal NO were measured by a chemiluminescence analyser. Argon (4.8%) was delivered continuously to the nose. Gas was sampled from the posterior oropharynx and argon and carbon dioxide were measured by mass spectrometry at the same time as NO. During a single expiration against a low resistance and during breath holding there was no evidence for nasal contamination, whereas during exhalation without resistance argon concentration in the oropharynx was increased from 0.91% (95% CI 0.84% to 0.98%) in ambient air to 1.28% (0.9% to 2.24%, p < 0.0001) during a single breath or 2.37% (2.29% to 2.51%, p < 0.0001) during tidal breathing. Collection of exhaled NO in a reservoir during tidal breathing is likely to be contaminated by NO derived from the nose and this may underestimate any increases in NO derived from the lower respiratory tract in inflammatory diseases. However, with slow expiration against a resistance and created back pressure to close the soft palate, there is no contamination of exhaled air which then reflects concentrations of NO in the lower airways.

  5. Novel method of measurement of radon exhalation from building materials.

    PubMed

    Awhida, A; Ujić, P; Vukanac, I; Đurašević, M; Kandić, A; Čeliković, I; Lončar, B; Kolarž, P

    2016-11-01

    In the era of the energy saving policy (i.e. more air tight doors and windows), the radon exhaled from building materials tends to increase its concentration in indoor air, which increases the importance of the measurement of radon exhalation from building materials. This manuscript presents a novel method of the radon exhalation measurement using only a HPGe detector or any other gamma spectrometer. Comparing it with the already used methods of radon exhalation measurements, this method provides the measurement of the emanation coefficient, the radon diffusion length and the radon exhalation rate, all within the same measurement, which additionally defines material's radon protective properties. Furthermore it does not necessitate additional equipment for radon or radon exhalation measurement, which simplifies measurement technique, and thus potentially facilitates introduction of legal obligation for radon exhalation determination in building materials. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. EXHALED BREATH ANALYSIS FOR HUMAN EXPOSURE RESEARCH

    EPA Science Inventory

    Exhaled breath collection and analysis has historically been used in environmental research studies to characterize exposures to volatile organic compounds. The use of this approach is based on the fact that many compounds present in blood are reflected in the breath, and that...

  7. Drinking influences exhaled breath condensate acidity.

    PubMed

    Kullmann, Tamás; Barta, Imre; Antus, Balázs; Horváth, Ildikó

    2008-01-01

    Exhaled breath condensate analysis is a developing method for investigating airway pathology. Impact of food and drink on breath condensate composition has not been systematically addressed. The aim of the study was to follow exhaled breath condensate pH after drinking an acidic and a neutral beverage. Breath condensate, capillary blood, and urine of 12 healthy volunteers were collected before and after drinking either 1 l of coke or 1 l of mineral water. The pH of each sample was determined with a blood gas analyzer. The mean difference between the pH of two breath condensate samples collected within 15 min before drinking was 0.13+/-0.03. Condensate pH decreased significantly from 6.29+/-0.02 to 6.24+/-0.02 (p<0.03) after drinking coke and from 6.37+/-0.03 to 6.22+/-0.04 (p<0.003) after drinking water. Drinking coke induced significant changes in blood and urine pH as well. Drinking influences exhaled breath condensate composition and may contribute to the variability of exhaled breath condensate pH.

  8. EXHALED BREATH ANALYSIS FOR HUMAN EXPOSURE RESEARCH

    EPA Science Inventory

    Exhaled breath collection and analysis has historically been used in environmental research studies to characterize exposures to volatile organic compounds. The use of this approach is based on the fact that many compounds present in blood are reflected in the breath, and that...

  9. Role of exhaled nitric oxide in asthma.

    PubMed

    Yates, D H

    2001-04-01

    Nitric oxide (NO), an evanescent atmospheric gas, has recently been discovered to be an important biological mediator in animals and humans. Nitric oxide plays a key role within the lung in the modulation of a wide variety of functions including pulmonary vascular tone, nonadrenergic non-cholinergic (NANC) transmission and modification of the inflammatory response. Asthma is characterized by chronic airway inflammation and increased synthesis of NO and other highly reactive and toxic substances (reactive oxygen species). Pro- inflammatory cytokines such as TNFalpha and IL-1beta are secreted in asthma and result in inflammatory cell recruitment, but also induce calcium- and calmodulin-independent nitric oxide synthases (iNOS) and perpetuate the inflammatory response within the airways. Nitric oxide is released by several pulmonary cells including epithelial cells, eosinophils and macrophages, and NO has been shown to be increased in conditions associated with airway inflammation, such as asthma and viral infections. Nitric oxide can be measured in the expired air of several species, and exhaled NO can now be rapidly and easily measured by the use of chemiluminescence analysers in humans. Exhaled NO is increased in steroid-naive asthmatic subjects and during an asthma exacerbation, although it returns to baseline levels with appropriate anti-inflammatory treatment, and such measurements have been proposed as a simple non-invasive method of measuring airway inflammation in asthma. Here the chemical and biological properties of NO are briefly discussed, followed by a summary of the methodological considerations relevant to the measurement of exhaled NO and its role in lung diseases including asthma. The origin of exhaled NO is considered, and brief mention made of other potential markers of airway inflammation or oxidant stress in exhaled breath.

  10. Analysis of Exhaled Breath for Disease Detection

    NASA Astrophysics Data System (ADS)

    Amann, Anton; Miekisch, Wolfram; Schubert, Jochen; Buszewski, Bogusław; Ligor, Tomasz; Jezierski, Tadeusz; Pleil, Joachim; Risby, Terence

    2014-06-01

    Breath analysis is a young field of research with great clinical potential. As a result of this interest, researchers have developed new analytical techniques that permit real-time analysis of exhaled breath with breath-to-breath resolution in addition to the conventional central laboratory methods using gas chromatography-mass spectrometry. Breath tests are based on endogenously produced volatiles, metabolites of ingested precursors, metabolites produced by bacteria in the gut or the airways, or volatiles appearing after environmental exposure. The composition of exhaled breath may contain valuable information for patients presenting with asthma, renal and liver diseases, lung cancer, chronic obstructive pulmonary disease, inflammatory lung disease, or metabolic disorders. In addition, oxidative stress status may be monitored via volatile products of lipid peroxidation. Measurement of enzyme activity provides phenotypic information important in personalized medicine, whereas breath measurements provide insight into perturbations of the human exposome and can be interpreted as preclinical signals of adverse outcome pathways.

  11. Analysis of exhaled breath for disease detection.

    PubMed

    Amann, Anton; Miekisch, Wolfram; Schubert, Jochen; Buszewski, Bogusław; Ligor, Tomasz; Jezierski, Tadeusz; Pleil, Joachim; Risby, Terence

    2014-01-01

    Breath analysis is a young field of research with great clinical potential. As a result of this interest, researchers have developed new analytical techniques that permit real-time analysis of exhaled breath with breath-to-breath resolution in addition to the conventional central laboratory methods using gas chromatography-mass spectrometry. Breath tests are based on endogenously produced volatiles, metabolites of ingested precursors, metabolites produced by bacteria in the gut or the airways, or volatiles appearing after environmental exposure. The composition of exhaled breath may contain valuable information for patients presenting with asthma, renal and liver diseases, lung cancer, chronic obstructive pulmonary disease, inflammatory lung disease, or metabolic disorders. In addition, oxidative stress status may be monitored via volatile products of lipid peroxidation. Measurement of enzyme activity provides phenotypic information important in personalized medicine, whereas breath measurements provide insight into perturbations of the human exposome and can be interpreted as preclinical signals of adverse outcome pathways.

  12. Methodological Issues of Sample Collection and Analysis of Exhaled Breath

    EPA Science Inventory

    Recommended standardized procedures have been developed for measurement of exhaled lower respiratory nitric oxide (NO) and nasal NO. It would be desirable to develop similar guidelines for the sampling of exhaled breath related to other compounds. For such systemic volatile o...

  13. Influenza virus in human exhaled breath: an observational study.

    PubMed

    Fabian, Patricia; McDevitt, James J; DeHaan, Wesley H; Fung, Rita O P; Cowling, Benjamin J; Chan, Kwok Hung; Leung, Gabriel M; Milton, Donald K

    2008-07-16

    Recent studies suggest that humans exhale fine particles during tidal breathing but little is known of their composition, particularly during infection. We conducted a study of influenza infected patients to characterize influenza virus and particle concentrations in their exhaled breath. Patients presenting with influenza-like-illness, confirmed influenza A or B virus by rapid test, and onset within 3 days were recruited at three clinics in Hong Kong, China. We collected exhaled breath from each subject onto Teflon filters and measured exhaled particle concentrations using an optical particle counter. Filters were analyzed for influenza A and B viruses by quantitative polymerase chain reaction (qPCR). Twelve out of thirteen rapid test positive patients provided exhaled breath filter samples (7 subjects infected with influenza B virus and 5 subjects infected with influenza A virus). We detected influenza virus RNA in the exhaled breath of 4 (33%) subjects--three (60%) of the five patients infected with influenza A virus and one (14%) of the seven infected with influenza B virus. Exhaled influenza virus RNA generation rates ranged from <3.2 to 20 influenza virus RNA particles per minute. Over 87% of particles exhaled were under 1 microm in diameter. These findings regarding influenza virus RNA suggest that influenza virus may be contained in fine particles generated during tidal breathing, and add to the body of literature suggesting that fine particle aerosols may play a role in influenza transmission.

  14. Methodological Issues of Sample Collection and Analysis of Exhaled Breath

    EPA Science Inventory

    Recommended standardized procedures have been developed for measurement of exhaled lower respiratory nitric oxide (NO) and nasal NO. It would be desirable to develop similar guidelines for the sampling of exhaled breath related to other compounds. For such systemic volatile o...

  15. Exhaled breath condensate pH assays.

    PubMed

    Davis, Michael D; Hunt, John

    2012-08-01

    Airway pH is central to the physiologic function and cellular biology of the airway. The causes of airway acidification include (1) hypopharyngeal gastric acid reflux with or without aspiration through the vocal cords, (2) inhalation of acid fog or gas (such as chlorine), and (3) intrinsic airway acidification caused by altered airway pH homeostasis in infectious and inflammatory disease processes. The recognition that relevant airway pH deviations occur in lung diseases is opening doors to new simple and inexpensive therapies. This recognition has resulted partly from the ability to use exhaled breath condensate as a window on airway acid-base balance.

  16. Fast and accurate exhaled breath ammonia measurement.

    PubMed

    Solga, Steven F; Mudalel, Matthew L; Spacek, Lisa A; Risby, Terence H

    2014-06-11

    This exhaled breath ammonia method uses a fast and highly sensitive spectroscopic method known as quartz enhanced photoacoustic spectroscopy (QEPAS) that uses a quantum cascade based laser. The monitor is coupled to a sampler that measures mouth pressure and carbon dioxide. The system is temperature controlled and specifically designed to address the reactivity of this compound. The sampler provides immediate feedback to the subject and the technician on the quality of the breath effort. Together with the quick response time of the monitor, this system is capable of accurately measuring exhaled breath ammonia representative of deep lung systemic levels. Because the system is easy to use and produces real time results, it has enabled experiments to identify factors that influence measurements. For example, mouth rinse and oral pH reproducibly and significantly affect results and therefore must be controlled. Temperature and mode of breathing are other examples. As our understanding of these factors evolves, error is reduced, and clinical studies become more meaningful. This system is very reliable and individual measurements are inexpensive. The sampler is relatively inexpensive and quite portable, but the monitor is neither. This limits options for some clinical studies and provides rational for future innovations.

  17. Fast and Accurate Exhaled Breath Ammonia Measurement

    PubMed Central

    Solga, Steven F.; Mudalel, Matthew L.; Spacek, Lisa A.; Risby, Terence H.

    2014-01-01

    This exhaled breath ammonia method uses a fast and highly sensitive spectroscopic method known as quartz enhanced photoacoustic spectroscopy (QEPAS) that uses a quantum cascade based laser. The monitor is coupled to a sampler that measures mouth pressure and carbon dioxide. The system is temperature controlled and specifically designed to address the reactivity of this compound. The sampler provides immediate feedback to the subject and the technician on the quality of the breath effort. Together with the quick response time of the monitor, this system is capable of accurately measuring exhaled breath ammonia representative of deep lung systemic levels. Because the system is easy to use and produces real time results, it has enabled experiments to identify factors that influence measurements. For example, mouth rinse and oral pH reproducibly and significantly affect results and therefore must be controlled. Temperature and mode of breathing are other examples. As our understanding of these factors evolves, error is reduced, and clinical studies become more meaningful. This system is very reliable and individual measurements are inexpensive. The sampler is relatively inexpensive and quite portable, but the monitor is neither. This limits options for some clinical studies and provides rational for future innovations. PMID:24962141

  18. Exhaled Breath Condensate: Technical and Diagnostic Aspects

    PubMed Central

    Konstantinidi, Efstathia M.; Lappas, Andreas S.; Tzortzi, Anna S.; Behrakis, Panagiotis K.

    2015-01-01

    Purpose. The aim of this study was to evaluate the 30-year progress of research on exhaled breath condensate in a disease-based approach. Methods. We searched PubMed/Medline, ScienceDirect, and Google Scholar using the following keywords: exhaled breath condensate (EBC), biomarkers, pH, asthma, gastroesophageal reflux (GERD), smoking, COPD, lung cancer, NSCLC, mechanical ventilation, cystic fibrosis, pulmonary arterial hypertension (PAH), idiopathic pulmonary fibrosis, interstitial lung diseases, obstructive sleep apnea (OSA), and drugs. Results. We found 12600 related articles in total in Google Scholar, 1807 in ScienceDirect, and 1081 in PubMed/Medline, published from 1980 to October 2014. 228 original investigation and review articles were eligible. Conclusions. There is rapidly increasing number of innovative articles, covering all the areas of modern respiratory medicine and expanding EBC potential clinical applications to other fields of internal medicine. However, the majority of published papers represent the results of small-scale studies and thus current knowledge must be further evaluated in large cohorts. In regard to the potential clinical use of EBC-analysis, several limitations must be pointed out, including poor reproducibility of biomarkers and absence of large surveys towards determination of reference-normal values. In conclusion, contemporary EBC-analysis is an intriguing achievement, but still in early stage when it comes to its application in clinical practice. PMID:26106641

  19. Exhaled Breath Condensate: Technical and Diagnostic Aspects.

    PubMed

    Konstantinidi, Efstathia M; Lappas, Andreas S; Tzortzi, Anna S; Behrakis, Panagiotis K

    2015-01-01

    The aim of this study was to evaluate the 30-year progress of research on exhaled breath condensate in a disease-based approach. We searched PubMed/Medline, ScienceDirect, and Google Scholar using the following keywords: exhaled breath condensate (EBC), biomarkers, pH, asthma, gastroesophageal reflux (GERD), smoking, COPD, lung cancer, NSCLC, mechanical ventilation, cystic fibrosis, pulmonary arterial hypertension (PAH), idiopathic pulmonary fibrosis, interstitial lung diseases, obstructive sleep apnea (OSA), and drugs. We found 12600 related articles in total in Google Scholar, 1807 in ScienceDirect, and 1081 in PubMed/Medline, published from 1980 to October 2014. 228 original investigation and review articles were eligible. There is rapidly increasing number of innovative articles, covering all the areas of modern respiratory medicine and expanding EBC potential clinical applications to other fields of internal medicine. However, the majority of published papers represent the results of small-scale studies and thus current knowledge must be further evaluated in large cohorts. In regard to the potential clinical use of EBC-analysis, several limitations must be pointed out, including poor reproducibility of biomarkers and absence of large surveys towards determination of reference-normal values. In conclusion, contemporary EBC-analysis is an intriguing achievement, but still in early stage when it comes to its application in clinical practice.

  20. [Measurement of exhaled nitric oxide in healthy Chinese].

    PubMed

    Zhang, Luo; Luo, Xue-rui; Liu, Cheng-yao; Zhao, Yan; Han, De-min

    2009-04-01

    To obtain the normal values of nitric oxide (NO) exhaled through nose and mouth in healthy Chinese adults by measuring exhaled NO and analyzing the influencing factors. Eighty healthy Chinese adults were recruited, including 20 males and 60 females. The age ranged from 18 to 44 years old. Chemiluminescence analyzer (NIOX) was used to obtain the values of exhaled NO through nose and mouth. The relativity between NO and gender, age, height, body mass index, time, ambient NO were analyzed with Multiple linear regression and correlation. Exhaled NO values were (17+/-8)x10(-9) and correlated significantly with height. Regression equation: Y (exhaled nitric oxide)=-58.524+0.457X (height, cm), t=-2.985, P<0.01. Transnasal NO values were (819+/-211)x10(-9) and correlated significantly with age and gender. Regression equation: Y (nasal nitric oxide)=760.245+9.417X1(age)-111.222X2(gender), t=5.188, P<0.01. Exhaled NO normal values were 17x10(-9) and Transnasal NO normal values were 819x10(-9). Exhaled NO correlated positively with height. Transnasal NO correlated positively with age and negatively with gender.

  1. Fractional exhaled nitric oxide-measuring devices: technology update

    PubMed Central

    Maniscalco, Mauro; Vitale, Carolina; Vatrella, Alessandro; Molino, Antonio; Bianco, Andrea; Mazzarella, Gennaro

    2016-01-01

    The measurement of exhaled nitric oxide (NO) has been employed in the diagnosis of specific types of airway inflammation, guiding treatment monitoring by predicting and assessing response to anti-inflammatory therapy and monitoring for compliance and detecting relapse. Various techniques are currently used to analyze exhaled NO concentrations under a range of conditions for both health and disease. These include chemiluminescence and electrochemical sensor devices. The cost effectiveness and ability to achieve adequate flexibility in sensitivity and selectivity of NO measurement for these methods are evaluated alongside the potential for use of laser-based technology. This review explores the technologies involved in the measurement of exhaled NO. PMID:27382340

  2. Radon exhalation from building materials used in Libya

    NASA Astrophysics Data System (ADS)

    Saad, A. F.; Al-Awami, Hend H.; Hussein, N. A.

    2014-08-01

    Radon exhalation rates have been determined for various different samples of domestic and imported building materials available in the Libyan market for home construction and interior decoration. Radon exhalation rates were measured by the sealed-can technique based on CR-39 nuclear track detectors (NTDs). The results show that radon exhalation rates from some imported building materials used as foundations and for decoration are extremely high, and these samples are the main sources of indoor radon emanation. Radium contents and annual effective doses have also been estimated.

  3. USE OF EXHALED BREATH CONDENSATE IN A HUMAN EXPOSURE STUDY

    EPA Science Inventory

    Exhaled breath condensate (EBC) is a noninvasive, repeatable collection technique to sample biomarkers of lung inflammation, oxidative stress, and environmental exposure. It is unclear whether EBC is an effective tool in human environmental exposure studies with multi-day samplin...

  4. On the exhalation rate of radon by man

    SciTech Connect

    Rundo, J.; Markun, F.; Plondke, N.J.

    1990-01-01

    This paper describes some aspects of the exhalation rate of radon by man which may be relevant to its internal dosimetry and, therefore, to possible radiobiological consequences. Prolonged exposure of a person to radon results in a reservoir or radon dissolved in body fat and fluids. If the person then moves to an environment with a lower radon concentration, there is a net exhalation of radon and the initial exhalation rate depends on the radon concentration in the first environment. This is demonstrated for seven persons whose houses contained radon at concentrations varying from 10 Bq m{sup {minus}3} to almost 1000 Bq m{sup {minus}3}. About one hour after leaving the house, the subjects' average exhalation rate of radon, expressed as the equivalent volume of house air per unit time, was 236 mL min{sup {minus}1}. 4 refs., 4 figs., 2 tabs.

  5. MEASUREMENT METHOD FOR VOLATILE METABOLIC BIOMARKERS IN EXHALED BREATH CONDENSATE

    EPA Science Inventory

    EPA is developing biomarker methodology to interpret spot biological measurements and their linkage to previous environmental pollutants exposures for individuals. This work explores the use of a promising biological media, exhaled breath condensate (EBC), which contains trapped...

  6. USE OF EXHALED BREATH CONDENSATE IN A HUMAN EXPOSURE STUDY

    EPA Science Inventory

    Exhaled breath condensate (EBC) is a noninvasive, repeatable collection technique to sample biomarkers of lung inflammation, oxidative stress, and environmental exposure. It is unclear whether EBC is an effective tool in human environmental exposure studies with multi-day samplin...

  7. Elevation in Exhaled Nitric Oxide Predicts for Radiation Pneumonitis

    SciTech Connect

    Guerrero, Thomas; Martinez, Josue; McCurdy, Matthew R.; Wolski, Michael; McAleer, Mary Francis

    2012-02-01

    Purpose: Radiation pneumonitis is a major toxicity after thoracic radiotherapy (RT), with no method available to accurately predict the individual risk. This was a prospective study to evaluate exhaled nitric oxide as a predictive biomarker for radiation pneumonitis in esophageal cancer patients. Patients and Methods: A total of 34 patients prescribed neoadjuvant chemoradiotherapy for esophageal cancer were enrolled in the present trial. Each patient underwent respiratory surveys and exhaled nitric oxide (NO) measurements before, at the end of, and 1 to 2 months after completing RT. Pneumonitis toxicity was scored using the Common Terminology Criteria for Adverse Events, version 4.0. The demographics, dosimetric factors, and exhaled NO levels were evaluated for correlation with symptomatic patients (scores {>=}2). Results: Of the 34 patients, 28 were evaluable. All had received 50.4 Gy RT with concurrent chemotherapy. The pneumonitis toxicity score was Grade 3 for 1, Grade 2 for 3, Grade 1 for 7, and Grade 0 for 17. The dosimetric factors were not predictive of symptoms. The mean exhaled NO level measured before, at completion, and at restaging was 17.3 {+-} 8.5 (range, 5.5-36.7), 16.0 {+-} 14.2 (range, 5.8-67.7), and 14.7 {+-} 6.2 (range, 5.5-28.0) parts per billion, respectively. The ratio of exhaled NO at the end of RT vs. before treatment was 3.4 (range, 1.7-6.7) for the symptomatic and 0.8 (range, 0.3-1.3) for the asymptomatic (p = .0017) patients. The elevation in exhaled NO preceded the peak symptoms by 33 days (range, 21-50). The interval to peak symptoms was inversely related to the exhaled NO elevation. Conclusions: Elevations in exhaled NO at the end of RT was found to predict for radiation pneumonitis symptoms.

  8. Radon exhalation from building materials for decorative use.

    PubMed

    Chen, Jing; Rahman, Naureen M; Abu Atiya, Ibrahim

    2010-04-01

    Long-term exposure to radon increases the risk of developing lung cancer. There is considerable public concern about radon exhalation from building materials and the contribution to indoor radon levels. To address this concern, radon exhalation rates were determined for 53 different samples of drywall, tile and granite available on the Canadian market for interior home decoration. The radon exhalation rates ranged from non-detectable to 312 Bq m(-2) d(-1). Slate tiles and granite slabs had relatively higher radon exhalation rates than other decorative materials, such as ceramic or porcelain tiles. The average radon exhalation rates were 30 Bq m(-2) d(-1) for slate tiles and 42 Bq m(-2) d(-1) for granite slabs of various types and origins. Analysis showed that even if an entire floor was covered with a material having a radon exhalation rate of 300 Bq m(-2) d(-1), it would contribute only 18 Bq m(-3) to a tightly sealed house with an air exchange rate of 0.3 per hour. Generally speaking, building materials used in home decoration make no significant contribution to indoor radon for a house with adequate air exchange.

  9. Oxygenation using tidal volume breathing after maximal exhalation.

    PubMed

    Baraka, Anis S; Taha, Samar K; El-Khatib, Mohamad F; Massouh, Faraj M; Jabbour, Dima G; Alameddine, Mahmoud M

    2003-11-01

    We compared, in volunteers, the oxygenation achieved by tidal volume breathing (TVB) over a 3-min period after maximal exhalation with that achieved by TVB alone. Twenty-three healthy volunteers underwent the two breathing techniques in a randomized order. A circle absorber system with an oxygen flow of 10 L/min was used. The end-expiratory oxygen concentration (EEO(2)) was monitored at 15-s intervals up to 3 min. TVB after maximal exhalation produced EEO(2) values of 68% +/- 5%, 75% +/- 5%, and 79% +/- 4% at 30, 45, and 60 s, respectively, which were significantly larger (P < 0.05) than the corresponding values obtained with TVB alone (58% +/- 5%, 66% +/- 6%, and 71% +/- 5%, respectively). In both techniques, the EEO(2) increased exponentially, with time constants of 35 s during TVB after maximal exhalation versus 58 s during TVB without prior maximal exhalation. In conclusion, maximal exhalation before TVB can hasten preoxygenation by decreasing the nitrogen content of the functional residual capacity, with a consequent increase of EEO(2) to approximately 70% in 30 s and 80% in 60 s. Oxygenation by using maximal exhalation before tidal volume breathing produced a significantly faster increase in end-expiratory oxygen concentration than oxygenation with tidal volume breathing alone.

  10. Exhaled pH, exhaled nitric oxide, and induced sputum cellularity in obese patients with obstructive sleep apnea syndrome.

    PubMed

    Carpagnano, Giovanna E; Spanevello, Antonio; Sabato, Roberto; Depalo, Annarita; Turchiarelli, Viviana; Foschino Barbaro, Maria Pia

    2008-01-01

    Airway inflammation plays an important role in obstructive sleep apnea syndrome as well as in obesity. Increasingly, researchers are studying airway inflammation noninvasively and are studying the new markers of airways inflammation. The aim of this study was to measure pH in the exhaled breath condensate (EBC), the exhaled nitric oxide (NO), and the inflammatory cell profile in the induced sputum of obese patients with and without obstructive sleep apnea syndrome (OSAS). The pH in EBC, the exhaled NO, and the induced sputum cells were measured in 30 obese patients with OSAS (OOs), in 20 obese patients without OSAS (ONOs), and in 10 healthy patients (HPs). Levels of pH in EBC were lower in OOs and in ONOs than in HPs. Furthermore, the concentrations of exhaled NO and the percentages of neutrophils in the induced sputum were greater in OOs and in ONOs than in HPs. No significant differences were found between OO and ONO for other measurements of airway inflammation. This study shows the presence of airway's inflammation in obese patients with and without OSAS and indicates that the "exhaled acidopnea" as well as exhaled NO and sputum neutrophils are good tools to measure airway inflammation in these subjects.

  11. Origin of Exhaled Breath Particles from Healthy and Human Rhinovirus-Infected Subjects

    PubMed Central

    Brain, Joseph; Houseman, E. Andres; Gern, James; Milton, Donald K.

    2011-01-01

    Abstract Background Exhaled breath studies suggest that humans exhale fine particles during tidal breathing, but little is known of their physical origin in the respiratory system during health or disease. Methods Particles generated by 3 healthy and 16 human rhinovirus (HRV)-infected subjects were counted using an optical particle counter with nominal diameter-size bins ranging between 0.3 and 10 μm. Data were collected from HRV-infected subjects during tidal breathing. In addition, data from healthy subjects were collected during coughs, swallows, tidal breathing, and breathing to total lung capacity (TLC) and residual volume (RV). Using general additive models, we graphed exhaled particle concentration versus airflow during exhalation. Exhaled particles were collected from expired air on gelatin filters and analyzed for HRV via quantitative PCR. Results HRV-infected subjects exhaled from 0.1 to 7200 particles per liter of exhaled air during tidal breathing (geometric mean = 32 part/L). A small fraction (24%) of subjects exhaled most (81%) of the particles measured and 82% of particles detected were 0.300–0.499 μm. Minute ventilation, maximum airflow during exhalation, and forced expiratory volume 1 second (FEV1 % predicted) were positively correlated with particle production. No human rhinovirus was detected in exhaled breath samples. Three healthy subjects exhaled less than 100 particles per liter of exhaled air during tidal breathing and increased particle concentrations more with exhalation to RV than with coughing, swallowing, or rapid exhalation. Conclusions Submicron particles were detected in the exhaled breath of healthy and HRV-infected subjects. Particle concentrations were correlated with airflow during the first half of exhalation, and peaked at the end of exhalation, indicating both lower and upper airways as particle sources. The effect of breathing maneuver suggested a major contribution from lower airways, probably the result of

  12. Analysis of exhaled breath by laser detection

    NASA Astrophysics Data System (ADS)

    Thrall, Karla D.; Toth, James J.; Sharpe, Steven W.

    1996-04-01

    The goal of our work is two fold: (1) to develop a portable rapid laser based breath analyzer for monitoring metabolic processes, and (2) predict these metabolic processes through physiologically based pharmacokinetic (PBPK) modeling. Small infrared active molecules such as ammonia, carbon monoxide, carbon dioxide, methane and ethane are present in exhaled breath and can be readily detected by laser absorption spectroscopy. In addition, many of the stable isotopomers of these molecules can be accurately detected, making it possible to follow specific metabolic processes. Potential areas of applications for this technology include the diagnosis of certain pathologies (e.g. Helicobacter Pylori infection), detection of trauma due to either physical or chemical causes and monitoring nutrient uptake (i.e., malnutrition). In order to understand the origin and elucidate the metabolic processes associated with these small molecules, we are employing physiologically based pharmacokinetic (PBPK) models. A PBPK model is founded on known physiological processes (i.e., blood flow rates, tissue volumes, breathing rate, etc.), chemical-specific processes (i.e., tissue solubility coefficients, molecular weight, chemical density, etc.), and on metabolic processes (tissue site and rate of metabolic biotransformation). Since many of these processes are well understood, a PBPK model can be developed and validated against the more readily available experimental animal data, and then by extrapolating the parameters to apply to man, the model can predict chemical behavior in humans.

  13. 42 CFR 84.120 - Inhalation and exhalation valves; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) Inhalation valves shall be designed and constructed to prevent excessive exhaled air from adversely affecting cartridges, canisters, and filters. (c) Exhalation valves shall be protected against external influence, and designed and constructed to prevent inward leakage of contaminated air. ...

  14. 42 CFR 84.182 - Exhalation valve leakage test; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...-Powered Air-Purifying Particulate Respirators § 84.182 Exhalation valve leakage test; minimum requirements. (a) Dry exhalation valves and valve seats will be subjected to a suction of 25 mm. water-column...

  15. 42 CFR 84.182 - Exhalation valve leakage test; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...-Powered Air-Purifying Particulate Respirators § 84.182 Exhalation valve leakage test; minimum requirements. (a) Dry exhalation valves and valve seats will be subjected to a suction of 25 mm. water-column...

  16. [Exogenic proteins in the human exhaled breath condensate].

    PubMed

    Kurova, V S; Kononikhin, A S; Sakharov, D A; Popov, I A; Larina, I M; Tonevitskiĭ, A G; Varfolomeev, S D; Nikolaev, E N

    2011-01-01

    The analysis of the protein composition of exhaled breath to diagnose diseases of the respiratory system raises a problem of differentiation proteins of expressed in the tissues of the lungs and respiratory tract (endogenous) and got in the respiratory system from the ambient air in the process of respiration (exogenous). In this work an attempt was made to estimate a set of exhaled exogenic proteins by mass spectrometry coupled with nanoflow HPLC. Six-month isolation of healthy donors indoors with air cleaned of dust leads to removal from the spectrum of exhaled proteins of some keratins that are considered therefore to be exogenic. Non-keratin proteins may also circulate between the ambient air and human respiratory ways, but their concentration appears to be significantly lower the keratin concentrations (especially epidermis keratin). Among non-keratins dermcidin seems to be the most significant exogenic protein of exhaled air. The conclusion of the diagnostic value of exhaled proteins can be done only after careful comparison of the results of quantitative and qualitative analysis of their composition in norm and pathology for a statistically significant sample of donors.

  17. Exhaled breath condensate: a new method for lung disease diagnosis.

    PubMed

    Cepelak, Ivana; Dodig, Slavica

    2007-01-01

    Analysis of exhaled breath composition in lung disease patients can indirectly point to biochemical changes that occur in the fluid lining airway surfaces. The parameters of redox and acid-base changes, and of inflammatory changes relevant in the pathogenesis of most pulmonary diseases are currently most widely determined in exhaled breath condensate. The collection of exhaled breath condensate is a safe, non-invasive, easy and simple diagnostic procedure that is suitable for longitudinal studies and applicable in patients of all age groups, irrespective of the disease severity. In spite of many scientific studies involving lung disease patients, methodology for exhaled breath condensate collection and analysis has not yet been realized for daily utilization. Additional studies of the exact origin of condensate constituents and standardization of the overall analytical process, including collection, storage, analysis and result interpretation, are needed. Irrespective of these limitations, further investigation of this sample type is fully justified by the fact that classical specimens used in the management of pulmonary disease are either obtained by invasive procedures (e.g., induced sputum, biopsy, bronchoalveolar lavage) or cannot provide appropriate information (e.g., urine, serum). Analysis of exhaled breath condensate in the future might contribute significantly to our understanding of the physiological and pathophysiological processes in lungs, to early detection, diagnosis and follow up of disease progression, and to evaluation of therapeutic response.

  18. The Clinical Potential of Exhaled Breath Analysis For Diabetes Mellitus

    PubMed Central

    Minh, Timothy Do Chau; Blake, Donald Ray; Galassetti, Pietro Renato

    2012-01-01

    Summary Various compounds in present human breath have long been loosely associated with pathological states (including acetone smell in uncontrolled diabetes). Only recently, however, the precise measurement of exhaled volatile organic compounds (VOCs) and aerosolized particles was made possible at extremely low concentrations by advances in several analytical methodologies, described in detail in the international literature and each suitable for specific subsets of exhaled compounds. Exhaled gases may be generated endogenously (in the pulmonary tract, blood, or peripheral tissues), as metabolic byproducts of human cells or colonizing micro-organisms, or may be inhaled as atmospheric pollutants; growing evidence indicates that several of these molecules have distinct cell-to-cell signaling functions. Independent of origin and physiological role, exhaled VOCs are attractive candidates as biomarkers of cellular activity/metabolism, and could be incorporated in future non-invasive clinical testing devices. Indeed, several recent studies reported altered exhaled gas profiles in dysmetabolic conditions and relatively accurate predictions of glucose concentrations, at least in controlled experimental conditions, for healthy and diabetic subjects over a broad range of glycemic values. Optimization of this methodology and validation in large-scale trials under a wider range of conditions is needed to determine its true potential to transition into practical clinical use. PMID:22410396

  19. Modelling the risk of airborne infectious disease using exhaled air.

    PubMed

    Issarow, Chacha M; Mulder, Nicola; Wood, Robin

    2015-05-07

    In this paper we develop and demonstrate a flexible mathematical model that predicts the risk of airborne infectious diseases, such as tuberculosis under steady state and non-steady state conditions by monitoring exhaled air by infectors in a confined space. In the development of this model, we used the rebreathed air accumulation rate concept to directly determine the average volume fraction of exhaled air in a given space. From a biological point of view, exhaled air by infectors contains airborne infectious particles that cause airborne infectious diseases such as tuberculosis in confined spaces. Since not all infectious particles can reach the target infection site, we took into account that the infectious particles that commence the infection are determined by respiratory deposition fraction, which is the probability of each infectious particle reaching the target infection site of the respiratory tracts and causing infection. Furthermore, we compute the quantity of carbon dioxide as a marker of exhaled air, which can be inhaled in the room with high likelihood of causing airborne infectious disease given the presence of infectors. We demonstrated mathematically and schematically the correlation between TB transmission probability and airborne infectious particle generation rate, ventilation rate, average volume fraction of exhaled air, TB prevalence and duration of exposure to infectors in a confined space.

  20. Regional diffusing capacity in normal lungs during a slow exhalation.

    PubMed

    MacIntyre, N R; Nadel, J A

    1982-06-01

    From an analysis of carbon monoxide uptake and xenon-133 distribution after two bolus inhalations of these gases, we calculated regional diffusing capacity in the upper and lower volume halves of the lungs during the middle 60% of an exhaled vital capacity in five seated normal subjects. We found that the regional diffusing capacity of the upper half of the lungs was 11.6 +/- 4.2 (mean +/- SD) ml.min-1.Torr-1 and that the regional diffusing capacity of the lower half of the lungs was 24.4 +/- 2.4 ml.min-1.Torr-1 after 25% of the vital capacity had been exhaled. These values remained relatively constant as lung volume decreased from 25 to 75% of the exhaled vital capacity. Diffusing capacity in the upper half of the lungs ranged from 9.4 to 12.4 ml.min-1.Torr-1 during exhalation, and in the lower half of the lungs from 21.0 to 28.6 ml.min-1.Torr-1 during exhalation. These results suggest that total lung diffusing capacity remains relatively constant over this midrange of lung volumes and that this occurs because the regional diffusing capacities in both the upper and lower halves of the lungs remain relatively constant.

  1. Metabolite Content Profiling of Bottlenose Dolphin Exhaled Breath

    PubMed Central

    2014-01-01

    Changing ocean health and the potential impact on marine mammal health are gaining global attention. Direct health assessments of wild marine mammals, however, is inherently difficult. Breath analysis metabolomics is a very attractive assessment tool due to its noninvasive nature, but it is analytically challenging. It has never been attempted in cetaceans for comprehensive metabolite profiling. We have developed a method to reproducibly sample breath from small cetaceans, specifically Atlantic bottlenose dolphins (Tursiops truncatus). We describe the analysis workflow to profile exhaled breath metabolites and provide here a first library of volatile and nonvolatile compounds in cetacean exhaled breath. The described analytical methodology enabled us to document baseline compounds in exhaled breath of healthy animals and to study changes in metabolic content of dolphin breath with regard to a variety of factors. The method of breath analysis may provide a very valuable tool in future wildlife conservation efforts as well as deepen our understanding of marine mammals biology and physiology. PMID:25254551

  2. Slower rise of exhaled breath temperature in cystic fibrosis.

    PubMed

    Bade, Geetanjali; Gupta, Sumita; Kabra, Sushil Kumar; Talwar, Anjana

    2015-02-01

    To measure exhaled breath temperature in patients with cystic fibrosis. 17 patients (6-18 years) with cystic fibrosis and 15 age- and gender-matched healthy controls were recruited in this cross sectional study. Exhaled breath temperature was measured in subjects recruited in both the groups with a device X-halo and analyzed as plateau temperature achieved and rate of temperature rise. Patients with cystic fibrosis showed no significant difference in plateau temperature [34.4(32.3-34.6) versus 33.9 (33.0-34.4)oC; P=0.35] while mean (SEM.) rate of temperature rise was significantly less in patients [0.09 (0.01) versus 0.14 (0.02) ƼC/s ; P=0.04] as compared to controls. There was a slower rise of exhaled breath temperature in patients with cystic fibrosis whereas plateau temperature was not significantly different from controls.

  3. RECENT DEVELOPMENTS IN EXHALED BREATH ANALYSIS AND HUMAN EXPOSURE RESEARCH

    EPA Science Inventory

    Exhaled breath collection and analysis has historically been used in environmental research studies to characterize exposures to volatile organic compounds. The use of this approach is based on the fact that many compounds present in blood are reflected in the breath, and that u...

  4. 42 CFR 84.123 - Exhalation valve leakage test.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Exhalation valve leakage test. 84.123 Section 84.123 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Gas Masks §...

  5. 42 CFR 84.123 - Exhalation valve leakage test.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Exhalation valve leakage test. 84.123 Section 84.123 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Gas Masks §...

  6. 42 CFR 84.123 - Exhalation valve leakage test.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Exhalation valve leakage test. 84.123 Section 84.123 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Gas Masks §...

  7. 42 CFR 84.123 - Exhalation valve leakage test.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Exhalation valve leakage test. 84.123 Section 84.123 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Gas Masks §...

  8. MEASUREMENTS OF AIR POLLUTANT BIOMARKERS WITH EXHALED BREATH TECHNIQUES

    EPA Science Inventory

    Use of exhaled breath condensate (EBC) has appeal as a noninvasive surrogate sample for lung-derived fluid. Additionally, EBC can be collected multiple times over the course of a study, unlike many other lung sampling techniques which can be performed fewer times. However validat...

  9. 42 CFR 84.123 - Exhalation valve leakage test.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Exhalation valve leakage test. 84.123 Section 84.123 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Gas Masks §...

  10. Radon exhalation rate of some building materials used in Egypt.

    PubMed

    Maged, A F; Ashraf, F A

    2005-09-01

    Indoor radon has been recognized as one of the health hazards for mankind. Common building materials used for construction of houses, which are considered as one of the major sources of this gas in indoor environment, have been studied for exhalation rate of radon. Non-nuclear industries, such as coal fired power plants or fertilizer production facilities, generate large amounts of waste gypsum as by-products. Compared to other building materials waste gypsum from fertilizer production facilities (phosphogypsum) shows increased rates of radon exhalation. In the present, investigation solid state alpha track detectors, CR-39 plastic detectors, were used to measure the indoor radon concentration and the radon exhalation rates from some building materials used in Egypt. The indoor radon concentration and the radon exhalation rate ranges were found to be 24-55 Bq m(-3 )and 11-223 mBq m(-2) h(-1), respectively. The effective dose equivalent range for the indoor was found 0.6-1.4 mSv y(-1). The equilibrium factor between radon and its daughters increased with the increase of relative humidity.

  11. MEASUREMENTS OF AIR POLLUTANT BIOMARKERS WITH EXHALED BREATH TECHNIQUES

    EPA Science Inventory

    Use of exhaled breath condensate (EBC) has appeal as a noninvasive surrogate sample for lung-derived fluid. Additionally, EBC can be collected multiple times over the course of a study, unlike many other lung sampling techniques which can be performed fewer times. However validat...

  12. Radon exhalation rates from some soil samples of Kharar, Punjab

    SciTech Connect

    Mehta, Vimal; Singh, Tejinder Pal; Chauhan, R. P.; Mudahar, G. S.

    2015-08-28

    Radon and its progeny are major contributors in the radiation dose received by general population of the world. Because radon is a noble gas, a large portion of it is free to migrate away from radium. The primary sources of radon in the houses are soils and rocks source emanations, emanation from building materials, and entry of radon into a structure from outdoor air. Keeping this in mind the study of radon exhalation rate from some soil samples of the Kharar, Punjab has been carried out using Can Technique. The equilibrium radon concentration in various soil samples of Kharar area of district Mohali varied from 12.7 Bqm{sup −3} to 82.9 Bqm{sup −3} with an average of 37.5 ± 27.0 Bqm{sup −3}. The radon mass exhalation rates from the soil samples varied from 0.45 to 2.9 mBq/kg/h with an average of 1.4 ± 0.9 mBq/kg/h and radon surface exhalation rates varied from 10.4 to 67.2 mBq/m{sup 2}/h with an average of 30.6 ± 21.8 mBq/m{sup 2}/h. The radon mass and surface exhalation rates of the soil samples of Kharar, Punjab were lower than that of the world wide average.

  13. RECENT DEVELOPMENTS IN EXHALED BREATH ANALYSIS AND HUMAN EXPOSURE RESEARCH

    EPA Science Inventory

    Exhaled breath collection and analysis has historically been used in environmental research studies to characterize exposures to volatile organic compounds. The use of this approach is based on the fact that many compounds present in blood are reflected in the breath, and that u...

  14. Noninvasive detection of lung cancer by analysis of exhaled breath

    PubMed Central

    2009-01-01

    Background Lung cancer is one of the leading causes of death in Europe and the western world. At present, diagnosis of lung cancer very often happens late in the course of the disease since inexpensive, non-invasive and sufficiently sensitive and specific screening methods are not available. Even though the CT diagnostic methods are good, it must be assured that "screening benefit outweighs risk, across all individuals screened, not only those with lung cancer". An early non-invasive diagnosis of lung cancer would improve prognosis and enlarge treatment options. Analysis of exhaled breath would be an ideal diagnostic method, since it is non-invasive and totally painless. Methods Exhaled breath and inhaled room air samples were analyzed using proton transfer reaction mass spectrometry (PTR-MS) and solid phase microextraction with subsequent gas chromatography mass spectrometry (SPME-GCMS). For the PTR-MS measurements, 220 lung cancer patients and 441 healthy volunteers were recruited. For the GCMS measurements, we collected samples from 65 lung cancer patients and 31 healthy volunteers. Lung cancer patients were in different disease stages and under treatment with different regimes. Mixed expiratory and indoor air samples were collected in Tedlar bags, and either analyzed directly by PTR-MS or transferred to glass vials and analyzed by gas chromatography mass spectrometry (GCMS). Only those measurements of compounds were considered, which showed at least a 15% higher concentration in exhaled breath than in indoor air. Compounds related to smoking behavior such as acetonitrile and benzene were not used to differentiate between lung cancer patients and healthy volunteers. Results Isoprene, acetone and methanol are compounds appearing in everybody's exhaled breath. These three main compounds of exhaled breath show slightly lower concentrations in lung cancer patients as compared to healthy volunteers (p < 0.01 for isoprene and acetone, p = 0.011 for methanol; PTR

  15. Noninvasive detection of lung cancer by analysis of exhaled breath.

    PubMed

    Bajtarevic, Amel; Ager, Clemens; Pienz, Martin; Klieber, Martin; Schwarz, Konrad; Ligor, Magdalena; Ligor, Tomasz; Filipiak, Wojciech; Denz, Hubert; Fiegl, Michael; Hilbe, Wolfgang; Weiss, Wolfgang; Lukas, Peter; Jamnig, Herbert; Hackl, Martin; Haidenberger, Alfred; Buszewski, Bogusław; Miekisch, Wolfram; Schubert, Jochen; Amann, Anton

    2009-09-29

    Lung cancer is one of the leading causes of death in Europe and the western world. At present, diagnosis of lung cancer very often happens late in the course of the disease since inexpensive, non-invasive and sufficiently sensitive and specific screening methods are not available. Even though the CT diagnostic methods are good, it must be assured that "screening benefit outweighs risk, across all individuals screened, not only those with lung cancer". An early non-invasive diagnosis of lung cancer would improve prognosis and enlarge treatment options. Analysis of exhaled breath would be an ideal diagnostic method, since it is non-invasive and totally painless. Exhaled breath and inhaled room air samples were analyzed using proton transfer reaction mass spectrometry (PTR-MS) and solid phase microextraction with subsequent gas chromatography mass spectrometry (SPME-GCMS). For the PTR-MS measurements, 220 lung cancer patients and 441 healthy volunteers were recruited. For the GCMS measurements, we collected samples from 65 lung cancer patients and 31 healthy volunteers. Lung cancer patients were in different disease stages and under treatment with different regimes. Mixed expiratory and indoor air samples were collected in Tedlar bags, and either analyzed directly by PTR-MS or transferred to glass vials and analyzed by gas chromatography mass spectrometry (GCMS). Only those measurements of compounds were considered, which showed at least a 15% higher concentration in exhaled breath than in indoor air. Compounds related to smoking behavior such as acetonitrile and benzene were not used to differentiate between lung cancer patients and healthy volunteers. Isoprene, acetone and methanol are compounds appearing in everybody's exhaled breath. These three main compounds of exhaled breath show slightly lower concentrations in lung cancer patients as compared to healthy volunteers (p < 0.01 for isoprene and acetone, p = 0.011 for methanol; PTR-MS measurements). A comparison

  16. Relationship between exhaled nitric oxide and childhood asthma.

    PubMed

    Frank, T L; Adisesh, A; Pickering, A C; Morrison, J F; Wright, T; Francis, H; Fletcher, A; Frank, P I; Hannaford, P

    1998-10-01

    The purpose of the study was to determine if exhaled nitric oxide levels in children varied according to their asthmatic and atopic status. Exhaled nitric oxide was measured in a sample of 93 children attending the North West Lung Centre, Manchester, United Kingdom, for the clinical evaluation of a respiratory questionnaire being developed as a screening tool in general practice. The clinical assessment included full lung function, skin prick testing, and exercise challenge. Children were said to be asthmatic either by consensus decision of three independent consultant pediatricians, who reviewed all the clinical results except the nitric oxide measurements, or by positive exercise test. Atopic asthmatic children had higher geometric mean exhaled nitric oxide levels (consensus decision, 12.5 ppb [parts per billion] 95% CI, 8.3 to 18. 8; positive exercise test, 12.2 ppb 95% CI, 7.6 to 19.7) than did nonatopic asthmatic children (3.2 ppb 95% CI, 2.3 to 4.6; 3.2 ppb 95% CI, 2.0 to 5.0), atopic nonasthmatic children (3.8 ppb 95% CI, 2. 7 to 5.5; 5.7 ppb 95% CI, 4.1 to 8.0), or nonatopic nonasthmatic children (3.4 ppb 95% CI, 2.8 to 4.1; 3.5 ppb 95% CI, 3.0 to 4.1). Thus, exhaled nitric oxide was raised in atopic asthmatics but not in nonatopic asthmatics, and these nonatopic asthmatics had levels of exhaled nitric oxide similar to those of the nonasthmatics whether atopic or not.

  17. Standardised exhaled breath collection for the measurement of exhaled volatile organic compounds by proton transfer reaction mass spectrometry

    PubMed Central

    2013-01-01

    Background Exhaled breath volatile organic compound (VOC) analysis for airway disease monitoring is promising. However, contrary to nitric oxide the method for exhaled breath collection has not yet been standardized and the effects of expiratory flow and breath-hold have not been sufficiently studied. These manoeuvres may also reveal the origin of exhaled compounds. Methods 15 healthy volunteers (34 ± 7 years) participated in the study. Subjects inhaled through their nose and exhaled immediately at two different flows (5 L/min and 10 L/min) into methylated polyethylene bags. In addition, the effect of a 20 s breath-hold following inhalation to total lung capacity was studied. The samples were analyzed for ethanol and acetone levels immediately using proton-transfer-reaction mass-spectrometer (PTR-MS, Logan Research, UK). Results Ethanol levels were negatively affected by expiratory flow rate (232.70 ± 33.50 ppb vs. 202.30 ± 27.28 ppb at 5 L/min and 10 L/min, respectively, p < 0.05), but remained unchanged following the breath hold (242.50 ± 34.53 vs. 237.90 ± 35.86 ppb, without and with breath hold, respectively, p = 0.11). On the contrary, acetone levels were increased following breath hold (1.50 ± 0.18 ppm) compared to the baseline levels (1.38 ± 0.15 ppm), but were not affected by expiratory flow (1.40 ± 0.14 ppm vs. 1.49 ± 0.14 ppm, 5 L/min vs. 10 L/min, respectively, p = 0.14). The diet had no significant effects on the gasses levels which showed good inter and intra session reproducibility. Conclusions Exhalation parameters such as expiratory flow and breath-hold may affect VOC levels significantly; therefore standardisation of exhaled VOC measurements is mandatory. Our preliminary results suggest a different origin in the respiratory tract for these two gasses. PMID:23837867

  18. Assessment of airway inflammation with exhaled NO measurement

    PubMed Central

    Hatziagorou, E; Tsanakas, J

    2007-01-01

    Assessing airway inflammation is important for investigating the underlying mechanisms of many lung diseases, including asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis, primary ciliary dyskinesia (PCD) and cystic fibrosis. A growing interest has recently directed toward non-invasive methods for the assessment of airway inflammation. Measurement of exhaled nitric oxide in exhaled air is an exciting innovative technique that gives new insights into the pathophysiology of lung disease and asthma in particular, with many potential clinical applications. Careful standardisation of measurement techniques has facilitated the use of this new measurement in paediatric respiratory medicine. Non-invasiveness and instantaneous results potentially make it a suitable instrument for use in children starting from the age of 4, with useful applications both in asthma diagnosis and monitoring. PMID:19582178

  19. Exhaled nitric oxide in children after accidental exposure to chlorine gas.

    PubMed

    Grasemann, Hartmut; Tschiedel, Eva; Groch, Manuela; Klepper, Jörg; Ratjen, Felix

    2007-08-01

    Chronic exposure to chlorine gas has been shown to cause occupational asthma. Acute inhalation of chlorine is known to cause airway inflammation and induce airway nitric oxide formation. Exhaled nitric oxide may therefore be a marker of airway damage after chlorine gas exposure. After accidental chlorine gas exposure in a swimming pool, exhaled nitric oxide and pulmonary function were repeatedly measured in 18 children over a 1-mo period. Symptomatic children with impaired pulmonary function had higher nitric oxide levels on the day after the exposure compared to day 8 and day 28. Differences in exhaled nitric oxide were more pronounced at a higher exhalation flow compared to lower flow, suggesting peripheral rather than central airway damage. This was in accordance with the observed changes in pulmonary function. No changes in exhaled nitric oxide were seen in asymptomatic children. These data suggest that acute chlorine gas exposure results in a mild increase of exhaled nitric oxide in symptomatic children.

  20. Hydrogen cyanide in the headspace of oral fluid and in mouth-exhaled breath.

    PubMed

    Chen, W; Metsälä, M; Vaittinen, O; Halonen, L

    2014-06-01

    Mouth-exhaled hydrogen cyanide (HCN) concentrations have previously been reported to originate from the oral cavity. However, a direct correlation between the HCN concentration in oral fluid and in mouth-exhaled breath has not been explicitly shown. In this study, we set up a new methodology to simultaneously measure HCN in the headspace of oral fluid and in mouth-exhaled breath. Our results show that there is a statistically significant correlation between stimulated oral fluid HCN and mouth-exhaled HCN (rs = 0.76, p < 0.001). This confirms that oral fluid is the main contributor to mouth-exhaled HCN. Furthermore, we observe that after the application of an oral disinfectant, both the stimulated oral fluid and mouth-exhaled HCN concentrations decrease. This implies that HCN production in the oral cavity is related to the bacterial and/or enzymatic activity.

  1. Exhaled isoprene for monitoring recovery from acute hypoxic stress.

    PubMed

    Harshman, Sean William; Geier, Brian A; Qualley, Anthony; Drummond, Leslie A; Flory, Laura; Fan, Maomian; Pitsch, Rhonda; Grigsby, Claude C; Phillips, Jeffrey B; Martin, Jennifer

    2017-10-11

    Hypoxia-like incidents in-flight have increased over the past decade causing severe safety concerns across the aviation community. As a result, the need to monitor flight crews in real-time for the onset of hypoxic conditions is paramount for continued aeronautical safety. Here, hypoxic events were simulated in the laboratory via a reduced oxygen-breathing device to determine the effect of recovery gas oxygen concentration (21% and 100%) on exhaled breath volatile organic compound (VOC) composition. Data from samples collected both serially (throughout the exposure), prior to, and following exposures yielded 326 statistically significant features, 203 of which were unique. Of those, 72 features were tentatively identified while 51 were verified with authentic standards. A comparison of samples collected serially between recovery and hypoxia time points shows a statistically significant reduction in exhaled breath isoprene (2-methyl-1,3-butadiene, log2 FC -0.399, p=0.005, FDR=0.034, q=0.033), however no significant difference in isoprene abundance was observed when comparing recovery gases (21% or 100% O2, p=0.152). Furthermore, examination of pre/post exposure 1L bag breath samples illustrate an overall increase in exhaled isoprene abundance post exposure (log2 FC 0.393, p=0.005, FDR=0.094, q=0.033) but again no significant difference between recovery gas (21% and 100%, p=0.798) was observed. A statistically significant difference in trend was observed between isoprene abundance and recovery gases O2 concentration when plotted against minimum oxygen saturation (p=0.0419 100% O2, p=0.7034 21% O2). Collectively, these results suggest exhaled isoprene is dynamic in the laboratory ROBD setup and additional experimentation will be required to fully understand the dynamics of isoprene in response to acute hypoxic stress. Creative Commons Attribution license.

  2. Exhaled breath analysis: physical methods, instruments, and medical diagnostics

    NASA Astrophysics Data System (ADS)

    Vaks, V. L.; Domracheva, E. G.; Sobakinskaya, E. A.; Chernyaeva, M. B.

    2014-07-01

    This paper reviews the analysis of exhaled breath, a rapidly growing field in noninvasive medical diagnostics that lies at the intersection of physics, chemistry, and medicine. Current data are presented on gas markers in human breath and their relation to human diseases. Various physical methods for breath analysis are described. It is shown how measurement precision and data volume requirements have stimulated technological developments and identified the problems that have to be solved to put this method into clinical practice.

  3. Optimization of sampling parameters for standardized exhaled breath sampling.

    PubMed

    Doran, Sophie; Romano, Andrea; Hanna, George B

    2017-09-05

    The lack of standardization of breath sampling is a major contributing factor to the poor repeatability of results and hence represents a barrier to the adoption of breath tests in clinical practice. On-line and bag breath sampling have advantages but do not suit multicentre clinical studies whereas storage and robust transport are essential for the conduct of wide-scale studies. Several devices have been developed to control sampling parameters and to concentrate volatile organic compounds (VOCs) onto thermal desorption (TD) tubes and subsequently transport those tubes for laboratory analysis. We conducted three experiments to investigate (i) the fraction of breath sampled (whole vs. lower expiratory exhaled breath); (ii) breath sample volume (125, 250, 500 and 1000ml) and (iii) breath sample flow rate (400, 200, 100 and 50 ml/min). The target VOCs were acetone and potential volatile biomarkers for oesophago-gastric cancer belonging to the aldehyde, fatty acids and phenol chemical classes. We also examined the collection execution time and the impact of environmental contamination. The experiments showed that the use of exhaled breath-sampling devices requires the selection of optimum sampling parameters. The increase in sample volume has improved the levels of VOCs detected. However, the influence of the fraction of exhaled breath and the flow rate depends on the target VOCs measured. The concentration of potential volatile biomarkers for oesophago-gastric cancer was not significantly different between the whole and lower airway exhaled breath. While the recovery of phenols and acetone from TD tubes was lower when breath sampling was performed at a higher flow rate, other VOCs were not affected. A dedicated 'clean air supply' overcomes the contamination from ambient air, but the breath collection device itself can be a source of contaminants. In clinical studies using VOCs to diagnose gastro-oesophageal cancer, the optimum parameters are 500mls sample

  4. Characterization of exhaled nitric oxide: introducing a new reproducible method for nasal nitric oxide measurements.

    PubMed

    Palm, J P; Graf, P; Lundberg, J O; Alving, K

    2000-08-01

    Nitric oxide (NO) is present in the human nasal airways and has been suggested to originate primarily from the paranasal sinuses. The aim of this study was to establish a new and reproducible method for measurement of nasal NO. Through repeated single-breath measurements the intra- and inter-individual variations of NO levels in nasally (into a tightly fitting mask covering the nose) and orally exhaled air were determined in healthy humans. Variations due to the methods used were investigated. The contribution of oral NO to the nasal exhalations by introducing a mouthwash procedure was also studied. This study shows distinct individual values of NO in nasally and orally exhaled air of healthy humans. Some diurnal variability was also found with a rise in NO in nasally and orally exhaled air over the day, but no, or little, day-to-day variability when comparing the results from separate mornings. There was no correlation between NO levels in nasally and orally exhaled air, whereas there was a strong correlation between NO levels in air exhaled through the left and right nostril. The levels of NO in air exhaled at 0.17 L x s(-1) through either nostril separately were higher than in air exhaled at the same flow rate through both nostrils simultaneously. After the introduction of a mouthwash procedure the level of NO in orally, but not nasally exhaled air was reduced. To conclude the method using nasal exhalation into a nose mask is highly reproducible. It is also suggested that subtracting the level of NO in orally exhaled air, after mouthwash, from that in nasally exhaled air, would adequately reflect nasal NO levels.

  5. Influences of mixed expiratory sampling parameters on exhaled volatile organic compound concentrations.

    PubMed

    Thekedar, B; Oeh, U; Szymczak, W; Hoeschen, C; Paretzke, H G

    2011-03-01

    Breath gas analysis is a promising technology for medical applications. By identifying disease-specific biomarkers in the breath of patients, a non-invasive and easy method for early diagnosis or therapy monitoring can be developed. In order to achieve this goal, one essential prerequisite is the reproducibility of the method applied, i.e. the quantification of exhaled volatile organic compounds (VOCs). The variability of breath gas VOC measurements can be affected by many factors. In this respect, sampling-specific parameters like flow rate and volume of exhalation, exhalation with or without breath holding, exhalation in single or multiple breathing and volume of air inhaled before breath gas exhalation can play a vital role. These factors affecting the measurements must be controlled by optimizing the sampling procedure. For such an optimization, it is important to know how exactly the different parameters affect the exhaled VOC concentrations. Therefore, a study has been undertaken in order to identify some effects of different breath sampling-specific parameters on the exhaled VOC profile using the mixed expired breath sampling technique. It was found that parameters such as filling the sampling bag with high or low flow rate of exhalation, with multiple or single exhalations, in different volumes of exhalation, with breath holding and under different surrounding air conditions significantly affect the concentrations of the exhaled VOCs. Therefore, the specific results of this work should be taken into account before planning new breath gas studies or developing new breath gas collection systems in order to minimize the number of artefacts affecting the concentration of exhaled VOCs.

  6. Exhaled nitric oxide concentration upon acute exposure to moderate altitude.

    PubMed

    Caspersen, C; Stang, J; Thorsen, E; Stensrud, T

    2013-03-01

    The purpose of this study was to assess immediate changes in the partial pressure of nitric oxide (NO) in exhaled gas (PE NO ) in healthy trained subjects who were acutely exposed to moderate altitude. One group of nine and another group of 20 healthy subjects were exposed to an ambient pressure of 728 hPa (546 mmHg) corresponding to an altitude of 2800 m for 5 and 90 min, respectively, in an altitude chamber. PE NO was measured offline by sampling exhaled gas in tight metal foil bags at 5, 30, 60, and 90 min. A correction for increased expiratory flow rate due to gas density effects at altitude was performed (PE NO corr). PE NO was significantly decreased by 13-16%, while the fraction of NO in exhaled gas (FE NO) was increased by 16-19% compared to sea level. There was no significant change in PE NO corr after exposure to altitude for 5, 30, 60, and 90 min. We conclude that there was no change in PENO upon arrival at altitude after correcting for gas density effects on expiratory flow rate. Corrections for altitude effects must be done before comparing measurements performed at different altitudes when using measurements of FENO to monitor athletes who have asthma during training at altitude.

  7. Measuring the exhaled breath of a manikin and human subjects.

    PubMed

    Xu, C; Nielsen, P V; Gong, G; Liu, L; Jensen, R L

    2015-04-01

    Due to scarcity of accurate information and available data of actual human breathing, this investigation focuses on characterizing the breathing dynamic process based on the measurement of healthy human subjects. The similarities and differences between one breathing thermal manikin and the human subjects, including geometry and breathing functions, were thoroughly studied. As expected, actual human breathing is more complicated than that of the manikin in terms of airflow fluctuations, individual differences, and exhaled flow directions. The simplification of manikin mouth structure could result in overestimated exhaled velocity and contaminant concentration. Furthermore, actual human breathing appears to be relatively stable and reproducible for an individual person in several conditions and is also accompanied by some uncertainties simultaneously. The averaged values are used to analyze the overall characteristics of actual human breathing. There are different characteristics of the exhaled breath between male and female subjects with or without wearing a nose clip. The experimental results obtained from the measurement of human subjects may be helpful for manikin specification or validation and accuracy assessment of CFD simulations.

  8. Exhaled methane concentration profiles during exercise on an ergometer

    PubMed Central

    Szabó, A; Ruzsanyi, V; Unterkofler, K; Mohácsi, Á; Tuboly, E; Boros, M; Szabó, G; Hinterhuber, H; Amann, A

    2016-01-01

    Exhaled methane concentration measurements are extensively used in medical investigation of certain gastrointestinal conditions. However, the dynamics of endogenous methane release is largely unknown. Breath methane profiles during ergometer tests were measured by means of a photoacoustic spectroscopy based sensor. Five methane-producing volunteers (with exhaled methane level being at least 1 ppm higher than room air) were measured. The experimental protocol consisted of 5 min rest—15 min pedalling (at a workload of 75 W)—5 min rest. In addition, hemodynamic and respiratory parameters were determined and compared to the estimated alveolar methane concentration. The alveolar breath methane level decreased considerably, by a factor of 3–4 within 1.5 min, while the estimated ventilation-perfusion ratio increased by a factor of 2–3. Mean pre-exercise and exercise methane concentrations were 11.4 ppm (SD:7.3) and 2.8 ppm (SD:1.9), respectively. The changes can be described by the high sensitivity of exhaled methane to ventilationperfusion ratio and are in line with the Farhi equation. PMID:25749807

  9. Radon exhalation from granites used in Saudi Arabia.

    PubMed

    al-Jarallah, M

    2001-01-01

    Measurements of radon exhalation for a total of 50 selected samples of construction materials used in Saudi Arabia were taken using a radon gas analyzer. These materials included sand, aggregate, cement, gypsum, hydrated lime, ceramics and granite. It was found that the granite samples were the main source of radon emanations. A total of 32 local and imported granite samples were tested. It was found that the radon exhalation rates per unit area from these granite samples varied from not detectable to 10.6 Bq m-2 h-1 with an average of 1.3 Bq m-2 h-1. The linear correlation coefficient between emanated radon and radium content was 0.92. The normalized radon exhalation rates from 2.0 cm thick granite samples varied from not detectable to 0.068 (Bq m-2 h-1)/(Bq kg-1) with an average of 0.030 (Bq m-2 h-1)/(Bq kg-1). The average radon emanation of the granite samples was found to be 21% of the total radium concentration. Therefore, granite can be a source of indoor radon as well as external gamma-radiation from the uranium decay series.

  10. Radon exhalation rates and gamma doses from ceramic tiles.

    PubMed

    O'Brien, R S; Aral, H; Peggie, J R

    1998-12-01

    This study was carried out to assess the possible radiological hazard resulting from the use of zircon in glaze applied to tiles used in buildings. The 226Ra content of various stains and glazing compounds was measured using gamma spectroscopy and the 222Rn exhalation rates for these materials were measured using adsorption on activated charcoal. The radon exhalation rates were found to be close to or less than the minimum detectable values for the equipment used. This limit was much lower than the estimated exhalation rates, which were calculated assuming that the parameters controlling the emanation and diffusion of 222Rn in the materials studied were similar to those of soil. This implied that the 222Rn emanation coefficients and/or diffusion coefficients for most of the materials studied were very much lower than expected. Measurements on zircon powders showed that the 222Rn emanation coefficient for zircon was much lower than that for soil, indicating that only a small fraction of the 222Rn produced by the decay of 226Ra was able to escape from the zircon grains. The estimated increase in radon concentration in room air and the estimated external gamma radiation dose resulting from the use of zircon glaze are both much lower than the relevant action level and dose limit.

  11. Uranium distribution and radon exhalation from Brazilian dimension stones.

    PubMed

    Amaral, P G Q; Galembeck, T M B; Bonotto, D M; Artur, A C

    2012-04-01

    This paper provides evaluations of the radiometric behavior and exhalation patterns of radon gas in decorative and dimension stones explored in the Brazilian states of Minas Gerais and Espírito Santo, given the importance of determining radon gas concentrations in human-inhabited environments. A total of 10 silicate rock types were studied, featuring different petrographic/petrophysical characteristics given by seven magmatic rocks (three of which are granitic pegmatites) and three metamorphic rocks. The study, comprising radiometric data of U and monitoring of (222)Rn gas exhalation, shows a strong correlation between petrographic parameters and the physical properties of rocks. U levels ranged between 2.9 and 37 ppm, revealing a good coherence between the presence and the absence of radioactive element-bearing accessory minerals for each rock type. The rate of radon exhalation from the stones is related to the petrographic/petrophysical features of each material. By comparing the (222)Rn level generated by a rock to the amount effectively emanated by it, the rate of emanated gas proves to be insignificant; also, a rock that produces more Rn will not always emanate more. Simulations performed to estimate the radon levels inside residences or any given indoor environment showed that nine samples attained values below the 4 pCi/L EPA limit, whereas one was above that limit.

  12. Fractional exhaled nitric oxide measurement with a handheld device.

    PubMed

    Magori, Erhard; Hiltawsky, Karsten; Fleischer, Maximilian; Simon, Elfriede; Pohle, Roland; von Sicard, Oliver; Tawil, Angelika

    2011-06-01

    A sensing system for fractional exhaled nitric oxide (FeNO) measurement is presented, which is characterized by a compact setup and a cost potential to be made available for the patient at home. The sensing is based on the work function measurement of a phthalocyanine-type sensing material, which is shown to be sufficiently sensitive for NO(2) in the ppb range. The transducer used to measure the work function is a field effect transistor with a suspended gate electrode. Selectivity is given with respect to other breath components including typically metabolic by-products. The measurement system includes breath treatments in a simple setup, which essentially are dehumidification and a quantitative conversion of NO to NO(2) with a conversion rate of approx. 95%, using a disposable oxidation catalyst. The accomplishment of the correct exhalation maneuver and feeding of the suited portion of exhaled air to the sensor is provided by breath sampling means. The sensor is not gas consuming. This allows us to fill the measurement chamber once, instead of establishing a gas flow for the measurement. This feature simplifies the device architecture. In this paper, we report on sensor characteristics, system architecture and measurement with artificial breath-gas as well as with human breath with the device.

  13. Medical diagnostics by laser-based analysis of exhaled breath

    NASA Astrophysics Data System (ADS)

    Giubileo, Gianfranco

    2002-08-01

    IMany trace gases can be found in the exhaled breath, some of them giving the possibility of a non invasive diagnosis of related diseases or allowing the monitoring of the disease in the course of its therapy. In the present lecture the principle of medical diagnosis based on the breath analysis will be introduced and the detection of trace gases in exhaled breath by high- resolution molecular spectroscopy in the IR spectral region will be discussed. A number of substrates and the optical systems for their laser detection will be reported. The following laser based experimental systems has been realised in the Molecular Spectroscopy Laboratory in ENEA in Frascati for the analysis of specific substances in the exhaled breath. A tuneable diode laser absorption spectroscopy (TDLAS) appartus for the measurement of 13C/12C isotopic ratio in carbon dioxide, a TDLAS apparatus for the detection of CH4 and a CO2 laser based photoacoustic system to detect trace ethylene at atmospheric pressure. The experimental set-up for each one of the a.m. optical systems will be shown and the related medical applications will be illustrated. The concluding remarks will be focuses on chemical species that are of major interest for medical people today and their diagnostic ability.

  14. Dispersal of exhaled air and personal exposure in displacement ventilated rooms.

    PubMed

    Bjørn, E; Nielsen, P V

    2002-09-01

    The influence of the human exhalation on flow fields, contaminant distributions, and personal exposure in displacement ventilated rooms is studied together with the effects of physical movement. Experiments are conducted in full-scale test rooms with life-sized breathing thermal manikins. Numerical simulations support the experiments. Air exhaled through the mouth can lock in a thermally stratified layer, if the vertical temperature gradient in breathing zone height is sufficiently large. With exhalation through the nose, exhaled air flows to the upper part of the room. The exhalation flow from both nose and mouth is able to penetrate the breathing zone of another person standing nearby. The stratification of exhaled air breaks down if there is physical movement in the room. As movement increases, the concentration distribution in the room will move towards a fully mixed situation. The protective effect of the boundary layer flow around the body of a moving person disappears at low speed, and is reduced for a seated person placed nearby due to horizontal air movements, which can also cause rebreathing of exhaled air for the seated person. The results indicate that the effect of the exhalation flow is no acute problem in most normal ventilation applications. However, exhalation and local effects caused by movement may be worth considering if one wishes to contain contaminants in certain areas, as in the case of tobacco smoking, in hospitals and clinics, or in certain industries.

  15. Measurements of radon exhalation rate in NORM used as consumer products in Japan.

    PubMed

    Iwaoka, Kazuki; Hosoda, Masahiro; Yajima, Kazuaki; Tokonami, Shinji

    2017-01-25

    Twenty-five beauty products known to contain natural radionuclides were collected, and their (222)Rn mass exhalation rates were measured. The effective doses to workers due to (222)Rn exhaled from these products were estimated. The (222)Rn mass exhalation rates of these products were below 177 μBq kg(-1) s(-1) and were almost identical to those of natural rocks in Japan. The maximum effective dose of (222)Rn exhaled from these products was 71 μSv y(-1).

  16. Elevated levels of exhaled nitric oxide in patients with anorexia nervosa.

    PubMed

    Oświęcimska, Joanna; Ziora, Katarzyna; Ziora, Dariusz; Machura, Edyta; Smerdziński, Sebastian; Pyś-Spychała, Magdalena; Kasperski, Jacek; Zamłyński, Jacek; Kasperska-Zajac, Alicja

    2014-09-01

    Nitric oxide (NO) is involved in eating behavior and inflammatory response. Moreover, there is evidence that NO production is altered in patients with anorexia nervosa (AN). To assess whether the overproduction of NO in AN can affect NO level in exhaled air. Exhaled NO level was studied in 23 girls with AN and compared with that of healthy age- and gender-matched nonatopic controls. Exhaled NO levels were significantly higher in girls with AN compared with healthy age-matched controls. It appears that anorexia nervosa was accompanied by a higher level of exhaled NO, likely resulting from a systemic increase in NO production because of the severe catabolic state.

  17. Investigation of Exhaled Breath Samples from Patients with Alzheimer's Disease Using Gas Chromatography-Mass Spectrometry and an Exhaled Breath Sensor System.

    PubMed

    Lau, Hui-Chong; Yu, Joon-Boo; Lee, Ho-Won; Huh, Jeung-Soo; Lim, Jeong-Ok

    2017-08-03

    Exhaled breath is a body secretion, and the sampling process of this is simple and cost effective. It can be non-invasively collected for diagnostic procedures. Variations in the chemical composition of exhaled breath resulting from gaseous exchange in the extensive capillary network of the body are proposed to be associated with pathophysiological changes. In light of the foreseeable potential of exhaled breath as a diagnostic specimen, we used gas chromatography and mass spectrometry (GC-MS) to study the chemical compounds present in exhaled breath samples from patients with Alzheimer's disease (AD), Parkinson's disease (PD), and from healthy individuals as a control group. In addition, we also designed and developed a chemical-based exhaled breath sensor system to examine the distribution pattern in the patient and control groups. The results of our study showed that several chemical compounds, such as 1-phenantherol and ethyl 3-cyano-2,3-bis (2,5,-dimethyl-3-thienyl)-acrylate, had a higher percentage area in the AD group than in the PD and control groups. These results may indicate an association of these chemical components in exhaled breath with the progression of disease. In addition, in-house fabricated exhaled breath sensor systems, containing several types of gas sensors, showed significant differences in terms of the normalized response of the sensitivity characteristics between the patient and control groups. A subsequent clustering analysis was able to distinguish between the AD patients, PD patients, and healthy individuals using principal component analysis, Sammon's mapping, and a combination of both methods, in particular when using the exhaled breath sensor array system A consisting of eight sensors. With this in mind, the exhaled breath sensor system could provide alternative option for diagnosis and be applied as a useful, effective tool for the screening and diagnosis of AD in the near future.

  18. Investigation of Exhaled Breath Samples from Patients with Alzheimer’s Disease Using Gas Chromatography-Mass Spectrometry and an Exhaled Breath Sensor System

    PubMed Central

    Lau, Hui-Chong; Yu, Joon-Boo; Lee, Ho-Won; Huh, Jeung-Soo; Lim, Jeong-Ok

    2017-01-01

    Exhaled breath is a body secretion, and the sampling process of this is simple and cost effective. It can be non-invasively collected for diagnostic procedures. Variations in the chemical composition of exhaled breath resulting from gaseous exchange in the extensive capillary network of the body are proposed to be associated with pathophysiological changes. In light of the foreseeable potential of exhaled breath as a diagnostic specimen, we used gas chromatography and mass spectrometry (GC-MS) to study the chemical compounds present in exhaled breath samples from patients with Alzheimer’s disease (AD), Parkinson’s disease (PD), and from healthy individuals as a control group. In addition, we also designed and developed a chemical-based exhaled breath sensor system to examine the distribution pattern in the patient and control groups. The results of our study showed that several chemical compounds, such as 1-phenantherol and ethyl 3-cyano-2,3-bis (2,5,-dimethyl-3-thienyl)-acrylate, had a higher percentage area in the AD group than in the PD and control groups. These results may indicate an association of these chemical components in exhaled breath with the progression of disease. In addition, in-house fabricated exhaled breath sensor systems, containing several types of gas sensors, showed significant differences in terms of the normalized response of the sensitivity characteristics between the patient and control groups. A subsequent clustering analysis was able to distinguish between the AD patients, PD patients, and healthy individuals using principal component analysis, Sammon’s mapping, and a combination of both methods, in particular when using the exhaled breath sensor array system A consisting of eight sensors. With this in mind, the exhaled breath sensor system could provide alternative option for diagnosis and be applied as a useful, effective tool for the screening and diagnosis of AD in the near future. PMID:28771180

  19. Increased levels of exhaled nitric oxide during nasal and oral breathing in subjects with seasonal rhinitis.

    PubMed

    Martin, U; Bryden, K; Devoy, M; Howarth, P

    1996-03-01

    Allergic rhinitis is associated with nasal mucosal inflammation. Exhaled nitric oxide may be a useful marker of inflammation and has recently been shown to be increased in patients with asthma. The purpose of this study was to determine whether exhaled levels of nitric oxide are increased with nasal breathing in patients with seasonal allergic rhinitis compared with nonatopic individuals and whether there is an increase with oral breathing consistent with lower respiratory inflammation in the absence of clinical asthma. Nitric oxide levels in exhaled air were measured by chemiluminescence in 18 nonatopic volunteers and 32 patients with seasonal rhinitis. Measurements were made with both nasal and oral exhalation and orally after 10 seconds and 60 seconds of breath-holding. The detection limit was 1 part per billion (ppb). In control subjects nasal levels of nitric oxide in exhaled air (mean +/- SD, 24.7 +/- 9.2 ppb) were higher than those after oral exhalation (11.1 +/- 2.5 ppb, p less than 0.0001). Breath-holding significantly increased levels of nitric oxide in exhaled air in a time-dependent manner. Levels of exhaled nitric oxide were significantly higher for all measurements in patients with seasonal rhinitis, with levels without breath-holding of 35.4 +/- 11.3 ppb (p less than 0.001) in nasally exhaled air and 16.3 +/- 5.9 ppb (p less than 0.001) in orally exhaled air. Nasal levels were significantly higher than oral levels in subjects with rhinitis (p less than 0.0001). The results indicate that exhaled nitric oxide may be a useful marker for nasal inflammation in patients with seasonal rhinitis and suggest that generalized airway inflammation may be present, even without clinical asthma, in such patients.

  20. Exhaled particles as markers of small airway inflammation in subjects with asthma.

    PubMed

    Larsson, Per; Lärstad, Mona; Bake, Björn; Hammar, Oscar; Bredberg, Anna; Almstrand, Ann-Charlotte; Mirgorodskaya, Ekaterina; Olin, Anna-Carin

    2017-09-01

    Exhaled breath contains suspended particles of respiratory tract lining fluid from the small airways. The particles are formed when closed airways open during inhalation. We have developed a method called Particles in Exhaled air (PExA(®) ) to measure and sample these particles in the exhaled aerosol. Here, we use the PExA(®) method to study the effects of birch pollen exposure on the small airways of individuals with asthma and birch pollen allergy. We hypothesized that birch pollen-induced inflammation could change the concentrations of surfactant protein A and albumin in the respiratory tract lining fluid of the small airways and influence the amount of exhaled particles. The amount of exhaled particles was reduced after birch pollen exposure in subjects with asthma and birch pollen allergy, but no significant effect on the concentrations of surfactant protein A and albumin in exhaled particles was found. The reduction in the number of exhaled particles may be due to inflammation in the small airways, which would reduce their diameter and potentially reduce the number of small airways that open and close during inhalation and exhalation. © 2015 The Authors. Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd.

  1. Fractal and Chaos Analysis for Dynamics of Radon Exhalation from Uranium Mill Tailings

    NASA Astrophysics Data System (ADS)

    Li, Yongmei; Tan, Wanyu; Tan, Kaixuan; Liu, Zehua; Xie, Yanshi

    2016-08-01

    Tailings from mining and milling of uranium ores potentially are large volumes of low-level radioactive materials. A typical environmental problem associated with uranium tailings is radon exhalation, which can significantly pose risks to environment and human health. In order to reduce these risks, it is essential to study the dynamical nature and underlying mechanism of radon exhalation from uranium mill tailings. This motivates the conduction of this study, which is based on the fractal and chaotic methods (e.g. calculating the Hurst exponent, Lyapunov exponent and correlation dimension) and laboratory experiments of the radon exhalation rates. The experimental results show that the radon exhalation rate from uranium mill tailings is highly oscillated. In addition, the nonlinear analyses of the time series of radon exhalation rate demonstrate the following points: (1) the value of Hurst exponent much larger than 0.5 indicates non-random behavior of the radon time series; (2) the positive Lyapunov exponent and non-integer correlation dimension of the time series imply that the radon exhalation from uranium tailings is a chaotic dynamical process; (3) the required minimum number of variables should be five to describe the time evolution of radon exhalation. Therefore, it can be concluded that the internal factors, including heterogeneous distribution of radium, and randomness of radium decay, as well as the fractal characteristics of the tailings, can result in the chaotic evolution of radon exhalation from the tailings.

  2. Optoacoustic Determination of Carbon Dioxide Concentration in Exhaled Breath in Various Human Diseases*

    NASA Astrophysics Data System (ADS)

    Ageev, V. G.; Nikiforova, O. Yu.

    2016-11-01

    We determined the carbon dioxide concentrations in exhaled breath from healthy donors and patients with various diseases from the absorption spectra of test samples, recorded on a laser optoacoustic gas analyzer based on a CO2 laser. We observed that the carbon dioxide concentrations in exhaled breath from healthy donors is higher than in patients with various diseases.

  3. Mathematical and statistical approaches for interpreting biomarker compounds in exhaled human breath

    EPA Science Inventory

    The various instrumental techniques, human studies, and diagnostic tests that produce data from samples of exhaled breath have one thing in common: they all need to be put into a context wherein a posed question can actually be answered. Exhaled breath contains numerous compoun...

  4. Mathematical and statistical approaches for interpreting biomarker compounds in exhaled human breath

    EPA Science Inventory

    The various instrumental techniques, human studies, and diagnostic tests that produce data from samples of exhaled breath have one thing in common: they all need to be put into a context wherein a posed question can actually be answered. Exhaled breath contains numerous compoun...

  5. Daily exhaled nitric oxide measurements and asthma exacerbations in children.

    PubMed

    van der Valk, R J P; Baraldi, E; Stern, G; Frey, U; de Jongste, J C

    2012-02-01

    Fractional exhaled Nitric Oxide (FeNO) is a biomarker for eosinophilic airway inflammation and can be measured at home on a daily basis. A short-term increase in FeNO may indicate a higher risk of future asthma exacerbations. To assess changes in FeNO before and after asthma exacerbations compared to a stable control period. A post hoc analysis was performed on daily FeNO measurements over 30 weeks in children with asthma (n = 77). Moderate exacerbations were defined by an increase in symptom scores and severe exacerbations by prescription of prednisone. Individual mean and maximum FeNO, the variability of FeNO assessed by the coefficient of variation (CV), and slopes of FeNO in time were all quantified in 3-week blocks. Cross-correlation of FeNO with symptoms and autocorrelation of FeNO were assessed in relation to exacerbations and examined as predictors for exacerbations compared to reference periods using logistic regression. Fractional exhaled nitric oxide could be assessed in relation to 25 moderate and 12 severe exacerbations. The CV, slope, cross-correlation, and autocorrelation of daily FeNO increased before moderate exacerbations. Increases in slope were also randomly seen in 19% of 2-week blocks of children without exacerbations. At least 3-5 FeNO measurements in the 3 weeks before an exacerbation were needed to calculate a slope that could predict moderate exacerbations. No specific pattern of FeNO was seen before severe exacerbations. Fractional exhaled nitric oxide monitoring revealed changes in FeNO prior to moderate exacerbations. Whether this can be used to prevent loss of asthma control should be further explored. © 2011 John Wiley & Sons A/S.

  6. Ethane and n-pentane in exhaled breath are biomarkers of exposure not effect

    PubMed Central

    Gorham, Katrine A.; Sulbaek Andersen, Mads P.; Meinardi, Simone; Delfino, Ralph J.; Staimer, Norbert; Tjoa, Thomas; Rowland, F. Sherwood; Blake, Donald R.

    2013-01-01

    The relationship of exhaled ethane and n-pentane to exhaled NO, carbonylated proteins, and indoor/outdoor atmospheric pollutants were examined in order to evaluate ethane and n-pentane as potential markers of airway inflammation and/or oxidative stress. Exhaled NO and carbonylated proteins were found to have no significant associations with either ethane (p = 0.96 and p = 0.81, respectively) or n-pentane (p = 0.44 and 0.28, respectively) when outliers were included. In the case where outliers were removed n-pentane was found to be inversely associated with carbonylated proteins. Exhaled hydrocarbons adjusted for indoor hydrocarbon concentrations were instead found to be positively associated with air pollutants (NO, NO2 and CO), suggesting pollutant exposure is driving exhaled hydrocarbon concentrations. Given these find-ings, ethane and n-pentane do not appear to be markers of airway inflammation or oxidative stress. PMID:19283520

  7. Ethane and n-pentane in exhaled breath are biomarkers of exposure not effect.

    PubMed

    Gorham, Katrine A; Sulbaek Andersen, Mads P; Meinardi, Simone; Delfino, Ralph J; Staimer, Norbert; Tjoa, Thomas; Rowland, F Sherwood; Blake, Donald R

    2009-02-01

    The relationship of exhaled ethane and n-pentane to exhaled NO, carbonylated proteins, and indoor/outdoor atmospheric pollutants were examined in order to evaluate ethane and n-pentane as potential markers of airway inflammation and/or oxidative stress. Exhaled NO and carbonylated proteins were found to have no significant associations with either ethane (p = 0.96 and p = 0.81, respectively) or n-pentane (p = 0.44 and 0.28, respectively) when outliers were included. In the case where outliers were removed n-pentane was found to be inversely associated with carbonylated proteins. Exhaled hydrocarbons adjusted for indoor hydrocarbon concentrations were instead found to be positively associated with air pollutants (NO, NO(2) and CO), suggesting pollutant exposure is driving exhaled hydrocarbon concentrations. Given these findings, ethane and n-pentane do not appear to be markers of airway inflammation or oxidative stress.

  8. Combined sensing platform for advanced diagnostics in exhaled mouse breath

    NASA Astrophysics Data System (ADS)

    Fortes, Paula R.; Wilk, Andreas; Seichter, Felicia; Cajlakovic, Merima; Koestler, Stefan; Ribitsch, Volker; Wachter, Ulrich; Vogt, Josef; Radermacher, Peter; Carter, Chance; Raimundo, Ivo M.; Mizaikoff, Boris

    2013-03-01

    Breath analysis is an attractive non-invasive strategy for early disease recognition or diagnosis, and for therapeutic progression monitoring, as quantitative compositional analysis of breath can be related to biomarker panels provided by a specific physiological condition invoked by e.g., pulmonary diseases, lung cancer, breast cancer, and others. As exhaled breath contains comprehensive information on e.g., the metabolic state, and since in particular volatile organic constituents (VOCs) in exhaled breath may be indicative of certain disease states, analytical techniques for advanced breath diagnostics should be capable of sufficient molecular discrimination and quantification of constituents at ppm-ppb - or even lower - concentration levels. While individual analytical techniques such as e.g., mid-infrared spectroscopy may provide access to a range of relevant molecules, some IR-inactive constituents require the combination of IR sensing schemes with orthogonal analytical tools for extended molecular coverage. Combining mid-infrared hollow waveguides (HWGs) with luminescence sensors (LS) appears particularly attractive, as these complementary analytical techniques allow to simultaneously analyze total CO2 (via luminescence), the 12CO2/13CO2 tracer-to-tracee (TTR) ratio (via IR), selected VOCs (via IR) and O2 (via luminescence) in exhaled breath, yet, establishing a single diagnostic platform as both sensors simultaneously interact with the same breath sample volume. In the present study, we take advantage of a particularly compact (shoebox-size) FTIR spectrometer combined with novel substrate-integrated hollow waveguide (iHWG) recently developed by our research team, and miniaturized fiberoptic luminescence sensors for establishing a multi-constituent breath analysis tool that is ideally compatible with mouse intensive care stations (MICU). Given the low tidal volume and flow of exhaled mouse breath, the TTR is usually determined after sample collection via gas

  9. Measuring airway exchange of endogenous acetone using a single-exhalation breathing maneuver.

    PubMed

    Anderson, Joseph C; Lamm, Wayne J E; Hlastala, Michael P

    2006-03-01

    Exhaled acetone is measured to estimate exposure or monitor diabetes and congestive heart failure. Interpreting this measurement depends critically on where acetone exchanges in the lung. Health professionals assume exhaled acetone originates from alveolar gas exchange, but experimental data and theoretical predictions suggest that acetone comes predominantly from airway gas exchange. We measured endogenous acetone in the exhaled breath to evaluate acetone exchange in the lung. The acetone concentration in the exhalate of healthy human subjects was measured dynamically with a quadrupole mass spectrometer and was plotted against exhaled volume. Each subject performed a series of breathing maneuvers in which the steady exhaled flow rate was the only variable. Acetone phase III had a positive slope (0.054+/-0.016 liter-1) that was statistically independent of flow rate. Exhaled acetone concentration was normalized by acetone concentration in the alveolar air, as estimated by isothermal rebreathing. Acetone concentration in the rebreathed breath ranged from 0.8 to 2.0 parts per million. Normalized end-exhaled acetone concentration was dependent on flow and was 0.79+/-0.04 and 0.85+/-0.04 for the slow and fast exhalation rates, respectively. A mathematical model of airway and alveolar gas exchange was used to evaluate acetone transport in the lung. By doubling the connective tissue (epithelium+mucosal tissue) thickness, this model predicted accurately (R2=0.94+/-0.05) the experimentally measured expirograms and demonstrated that most acetone exchange occurred in the airways of the lung. Therefore, assays using exhaled acetone measurements need to be reevaluated because they may underestimate blood levels.

  10. Exhaled nitric oxide in systemic sclerosis: relationships with lung involvement and pulmonary hypertension.

    PubMed

    Rolla, G; Colagrande, P; Scappaticci, E; Chiavassa, G; Dutto, L; Cannizzo, S; Bucca, C; Morello, M; Bergerone, S; Bardini, D; Zaccagna, A; Puiatti, P; Fava, C; Cortese, G

    2000-07-01

    To measure nitric oxide (NO) concentration in exhaled air of patients with systemic sclerosis (SSc) and to investigate its relationships with lung involvement, complicated or not by pulmonary hypertension (PH). Exhaled NO was measured by chemiluminescence in 47 patients with SSc (16 with PH) and in 30 controls. All the patients underwent Doppler echocardiography to assess pulmonary artery pressure (PAP), lung function tests, and thin section computed tomographic scans of the lung to quantify the extent of fibrosing alveolitis. Exhaled NO levels were higher in patients with SSc (16.6 +/- 9.1 ppb), particularly those with interstitial lung disease (ILD) (18.3 +/- 10.4 ppb), compared to controls (9.9 +/- 2.9 ppb; p < 0.0001). In patients with PH, exhaled NO was less than in patients without PH (10.7 +/- 5.9 vs 19.6 +/- 9 ppb, respectively; p < 0.001), and patients with PH without ILD had even lower exhaled NO than patients with PH and ILD (6.6 +/- 1.1 vs 12.6 +/- 6.3 ppb; p = 0.004). There was an inverse correlation between PAP and exhaled NO (r = 04).53, p = 0.004). Exhaled NO was not correlated to age, disease duration, current therapy, or form of disease (limited or diffuse). The increased concentration of exhaled NO in patients with SSc may reflect respiratory tract inflammation. The relatively low value of exhaled NO in patients with PH and the negative correlation between PAP and exhaled NO suggest the important role of NO in regulating pulmonary vascular resistance in patients with SSc.

  11. Influence of atmospheric nitric oxide concentration on the measurement of nitric oxide in exhaled air

    PubMed Central

    Corradi, M.; Pelizzoni, A.; Majori, M.; Cuomo, A.; Munari, E. d.; Pesci, A.

    1998-01-01

    BACKGROUND—Measurement of nitric oxide (NO) in exhaled air shows promise as a non-invasive method of detecting lung inflammation. However, variable concentrations of NO are measured in environmental air. The aim of this study was to verify a possible relationship between exhaled NO and atmospheric NO values during high atmospheric NO days.
METHOD—Exhaled air from 78 healthy non-smokers of mean age 35.3 years was examined for the presence of NO using a chemiluminescence NO analyser and NO levels were expressed as part per billion (ppb). The exhaled air from all the subjects was collected into a single bag and into two sequential bags. Before each test atmospheric NO was measured.
RESULTS—The mean (SE) concentration of exhaled NO collected into the single bag was 17.1 (0.6) ppb while the mean values of exhaled NO in bags 1 and 2 were 16.7 (1.3) ppb and 13.8 (1.2) ppb, respectively. The atmospheric NO concentrations registered before each test varied from 0.4 to 71 ppb. There was a significant correlation between exhaled NO in the single bag and atmospheric NO (r = 0.38,p = 0.001). The atmospheric NO concentration also correlated with exhaled NO both in bag 1 (r = 0.44, p = 0.0001) and in bag 2 (r= 0.42, p = 0.0001). These correlations disappeared with atmospheric NO concentrations lower than 35ppb.
CONCLUSIONS—These results indicate a relationship between atmospheric NO and NO levels measured in exhaled air, therefore exhaled NO should not be measured on very high atmospheric NO days.

 PMID:9828854

  12. Carbon Monoxide in Exhaled Breath Testing and Therapeutics

    PubMed Central

    Ryter, Stefan W.; Choi, Augustine M.K.

    2013-01-01

    Carbon monoxide (CO), a low molecular weight gas, is a ubiquitous environmental product of organic combustion, which is also produced endogenously in the body, as the byproduct of heme metabolism. CO binds to hemoglobin, resulting in decreased oxygen delivery to bodily tissues at toxicological concentrations. At physiological concentrations, CO may have endogenous roles as a potential signaling mediator in vascular function and cellular homeostasis. Exhaled CO (eCO), similar to exhaled nitric oxide (eNO), has been evaluated as a candidate breath biomarker of pathophysiological states, including smoking status, and inflammatory diseases of the lung and other organs. eCO values have been evaluated as potential indicators of inflammation in asthma, stable COPD and exacerbations, cystic fibrosis, lung cancer, or during surgery or critical care. The utility of eCO as a marker of inflammation, and potential diagnostic value remains incompletely characterized. Among other candidate “medicinal gases” with therapeutic potential, (e.g., NO and H2S), CO has been shown to act as an effective anti-inflammatory agent in preclinical animal models of inflammatory disease, acute lung injury, sepsis, ischemia/reperfusion injury and organ graft rejection. Current and future clinical trials will evaluate the clinical applicability of this gas as a biomarker and/or therapeutic in human disease. PMID:23446063

  13. Chemiresistive Electronic Nose toward Detection of Biomarkers in Exhaled Breath.

    PubMed

    Moon, Hi Gyu; Jung, Youngmo; Han, Soo Deok; Shim, Young-Seok; Shin, Beomju; Lee, Taikjin; Kim, Jin-Sang; Lee, Seok; Jun, Seong Chan; Park, Hyung-Ho; Kim, Chulki; Kang, Chong-Yun

    2016-08-17

    Detection of gas-phase chemicals finds a wide variety of applications, including food and beverages, fragrances, environmental monitoring, chemical and biochemical processing, medical diagnostics, and transportation. One approach for these tasks is to use arrays of highly sensitive and selective sensors as an electronic nose. Here, we present a high performance chemiresistive electronic nose (CEN) based on an array of metal oxide thin films, metal-catalyzed thin films, and nanostructured thin films. The gas sensing properties of the CEN show enhanced sensitive detection of H2S, NH3, and NO in an 80% relative humidity (RH) atmosphere similar to the composition of exhaled breath. The detection limits of the sensor elements we fabricated are in the following ranges: 534 ppt to 2.87 ppb for H2S, 4.45 to 42.29 ppb for NH3, and 206 ppt to 2.06 ppb for NO. The enhanced sensitivity is attributed to the spillover effect by Au nanoparticles and the high porosity of villi-like nanostructures, providing a large surface-to-volume ratio. The remarkable selectivity based on the collection of sensor responses manifests itself in the principal component analysis (PCA). The excellent sensing performance indicates that the CEN can detect the biomarkers of H2S, NH3, and NO in exhaled breath and even distinguish them clearly in the PCA. Our results show high potential of the CEN as an inexpensive and noninvasive diagnostic tool for halitosis, kidney disorder, and asthma.

  14. Exhaled nitric oxide measurement in patients affected by nasal polyposis.

    PubMed

    Galli, Jacopo; Montuschi, Paolo; Passàli, Giulio Cesare; Laruffa, Marianna; Parrilla, Claudio; Paludetti, Gaetano

    2012-08-01

    Nitric oxide (NO) is produced in the respiratory tract with a major contribution coming from paranasal sinuses and the nose. The pathophysiological role of NO in the airways has been debated. The aims of this study were to measure fraction of exhaled NO (FENO), a validated marker of airway inflammation, in patients affected by nasal polyposis with and without asthma; to assess the importance of FENO measurement in detecting subclinical involvement of lower airways in patients with clinical rhinosinusal symptoms; and to clarify the impact of endoscopic surgical removal of polyps on airway inflammation. The study was conducted at the O.R.L. Clinic and Clinical Pharmacology Unit, University Hospital Agostino Gemelli, Rome, Italy. Prospective study. Concentrations of FENO were measured with the NIOX system (Aerocrine, Stockholm, Sweden) by using a single-breath online method, according to the American Thoracic Society guidelines. Compared with those in healthy subjects (15 [11-19] ppb, n = 15; P < .0001), FENO values were elevated in patients with nasal polyposis (41 [21-77] ppb, n = 43). There was no significant difference in FENO concentrations between asthmatic and nonasthmatic patients with nasal polyposis (P = .73). Concentrations of FENO in patients with nasal polyposis were decreased after surgery (64.2 [30.0-132.7] ppb vs 56.0 [26.4-73.8] ppb, respectively; P = .03). The fraction of exhaled NO is elevated in the inflammatory process involving both the rhinosinusal district and lower airways, supporting the one-airway disease hypothesis.

  15. Screening for emphysema via exhaled volatile organic compounds.

    PubMed

    Cristescu, S M; Gietema, H A; Blanchet, L; Kruitwagen, C L J J; Munnik, P; van Klaveren, R J; Lammers, J W J; Buydens, L; Harren, F J M; Zanen, P

    2011-12-01

    Chronic obstructive pulmonary disease (COPD)/emphysema risk groups are well defined and screening allows for early identification of disease. The capability of exhaled volatile organic compounds (VOCs) to detect emphysema, as found by computed tomography (CT) in current and former heavy smokers participating in a lung cancer screening trial, was investigated. CT scans, pulmonary function tests and breath sample collections were obtained from 204 subjects. Breath samples were analyzed with a proton-transfer reaction mass spectrometer (PTR-MS) to obtain VOC profiles listed as ions at various mass-to-charge ratios (m/z). Using bootstrapped stepwise forward logistic regression, we identified specific breath profiles as a potential tool for the diagnosis of emphysema, of airflow limitation or gas-exchange impairment. A marker for emphysema was found at m/z 87 (tentatively attributed to 2-methylbutanal). The area under the receiver operating characteristic curve (ROC) of this marker to diagnose emphysema was 0.588 (95% CI 0.453-0.662). Mass-to-charge ratios m/z 52 (most likely chloramine) and m/z 135 (alkyl benzene) were linked to obstructive disease and m/z 122 (most probably alkyl homologs) to an impaired diffusion capacity. ROC areas were 0.646 (95% CI 0.562-0.730) and 0.671 (95% CI 0.524-0.710), respectively. In the screening setting, exhaled VOCs measured by PTR-MS constitute weak markers for emphysema, pulmonary obstruction and impaired diffusion capacity.

  16. Exhaled nitric oxide is age-dependent in asthma.

    PubMed

    Avital, Avraham; Uwyyed, Kamal; Berkman, Neville; Bar-Yishay, Ephraim; Godfrey, Simon; Springer, Chaim

    2003-11-01

    We determined whether the exhaled nitric oxide (eNO) level in asthmatics is age-dependent. Eighty-seven asthmatic patients aged 2-41 years were studied. Hyperreactivity to adenosine 5'-monophosphate (AMP) was used to confirm asthma (Exhaled NO was measured in the younger group by the tidal breathing method (TBm) and in the older subjects by the slow vital capacity method (SVCm). TBm and SVCm were compared in 21 other subjects, and there was a significant correlation between the two values (r = 0.96, P < 0.0001). The equation of correlation between the two methods was eNOTBm = 0.78eNOSVCm - 0.51. Within asthmatic patients, we found a significant increase in eNO with age (P < 0.0001), while there was no significant difference in AMP reactivity (P = 0.35). We conclude that eNO in asthmatic patients is age-dependent, with lower values in young children.

  17. Exhaled breath and fecal volatile organic biomarkers of chronic kidney disease.

    PubMed

    Meinardi, Simone; Jin, Kyu-Bok; Barletta, Barbara; Blake, Donald R; Vaziri, Nosratola D

    2013-03-01

    While much is known about the effect of chronic kidney disease (CKD) on composition of body fluids little is known regarding its impact on the gases found in exhaled breath or produced by intestinal microbiome. We have recently shown significant changes in the composition of intestinal microbiome in humans and animals with CKD. This study tested the hypothesis that uremia-induced changes in cellular metabolism and intestinal microbiome may modify the volatile organic metabolites found in the exhaled breath or generated by intestinal flora. SD rats were randomized to CKD (5/6 nephrectomy) or control (sham operation) groups. Exhaled breath was collected by enclosing each animal in a glass chamber flushed with clean air, then sealed for 45 min and the trapped air collected. Feces were collected, dissolved in pure water, incubated at 37 degrees C in glass reactors for 24 h and the trapped air collected. Collected gases were analyzed by gas chromatography. Over 50 gases were detected in the exhaled breath and 36 in cultured feces. Four gases in exhaled breath and 4 generated by cultured feces were significantly different in the two groups. The exhaled breath in CKD rats showed an early rise in isoprene and a late fall in linear aldehydes. The CKD animals' cultured feces released larger amounts of dimethyldisulfide, dimethyltrisulfide, and two thioesters. CKD significantly changes the composition of exhaled breath and gaseous products of intestinal flora. Analysis of breath and bowel gases may provide useful biomarkers for detection and progression of CKD and its complications.

  18. Application of the can technique and radon gas analyzer for radon exhalation measurements.

    PubMed

    Fazal-ur-Rehman; Al-Jarallah, M I; Musazay, M S; Abu-Jarad, F

    2003-01-01

    A passive "can technique" and an active radon gas analyzer with an emanation container were applied for radon exhalation rate measurements from different construction materials, viz. five marble seven ceramic and 100 granite tiles used in Saudi Arabia. The marble and ceramic tiles did not show detectable radon exhalation using the active radon gas analyzer system. However the granite tiles showed relatively high radon exhalations, indicating a relatively high uranium content. A comparison of the radon exhalation rates measured by the two techniques showed a linear correlation coefficient of 0.57. The radon exhalation rates from the granites varied from 0.02 to 6.58 Bqm(-2)h(-1) with an average of 1.35+/-1.40 Bqm(-2)h(-1). The geometric mean and the geometric standard deviation of the frequency distribution were found to be 0.80 and 3.1, respectively. The track density found on the nuclear track detectors in the can technique exposed to the granites, having high exhalation rates, varied linearly with exposure time with a linear correlation coefficient of 0.99. This experimental finding agrees with the theoretical prediction. The can technique showed sensitivity to low radon exhalation rates from ceramic, marble and some granite over a period of 2 months, which were not detectable by the active radon gas analyzer system. The reproducibility of data with both measuring techniques was found to be within a 7% deviation.

  19. Unsuitability of exhaled breath condensate for the detection of herpesviruses DNA in the respiratory tract.

    PubMed

    Costa, Cristina; Bucca, Caterina; Bergallo, Massimiliano; Solidoro, Paolo; Rolla, Giovanni; Cavallo, Rossana

    2011-05-01

    Exhaled breath condensate is a non-invasive method for detecting a wide number of molecules as well as genomic DNA in the airways. No study investigated the detection of viral DNA in exhaled breath condensate, while only one study excluded its usefulness for detection of influenza virus RNA. In this study, the suitability of exhaled breath condensate for detecting herpesviruses infection or reactivation in the respiratory tract of lung transplant recipients was evaluated. Twenty-four matched samples (exhaled breath condensate, bronchoalveolar lavage, whole blood, transbronchial biopsy) were evaluated for the detection of human cytomegalovirus (HCMV), human herpesvirus (HHV-6 and -7), Epstein-Barr virus (EBV) DNA by real-time PCR. Eighteen bronchoalveolar lavages (75%), six whole blood samples (25%), and two transbronchial biopsies (8.3%) were positive for at least one herpesvirus. Only one exhaled breath condensate specimen was positive for HCMV DNA (and positive also in the bronchoalveolar lavage, with low viral load in both specimens); while no other patient, irrespective of the viral load in any specimen or the presence of clinical symptoms and signs, had a positive exhaled breath condensate. These findings seem to exclude the suitability of exhaled breath condensate for non-invasive detection of viral DNA in the respiratory tract of lung transplant recipients.

  20. Exhalation behavior of four organic substrates and water absorbed by human skin.

    PubMed

    Naitoh, Ken; Inai, Yoshihito; Hirabayashi, Tadamichi; Tsuda, Takao

    2002-07-01

    The simultaneous measurement of several volatile organic compounds and water released from the human skin can be achieved successfully by using a modified gas chromatographic system. After the thumb of each subject was dipped in aqueous solution containing acetone, diethyl ether, ethanol, and toluene, it was dried in the air. Then the thumb attached to the sampling probe for measuring the released gases. It is found that 90% of all these chemical substrates were desorbed after 20 min. The initial exhalation rate factor for each chemical substrate was determined in every subject. Correlation factors of the linear relationships between the initial exhalation rate for hydrophilic substrates (acetone and ethanol) and the total amount of water (TAW) released from the skin were 0.94 and 0.92, respectively. However, the rate of hydrophobic toluene was not dependent on the TAW. Therefore, the exhalation rate of substrates is greatly influenced by both their hydrophilicity and TAW. Additionally, an interesting personal specific character among the 6 subjects was observed on plotting the exhalation rate of organic substrates and water during the elapsed time. With the released water mostly due to insensible perspiration, the exhalation rate of all simultaneous organic substrates decreased monotonically over the elapsed time. On the contrary, when subjects sweated emotionally, the exhalation rate of organic substrates showed some variation, namely a higher of exhalation rate compared to the case of mostly due to insensible perspiration. Therefore, emotionally-induced sweating can enhance the release of organic substrates.

  1. Exhaled Aerosol Pattern Discloses Lung Structural Abnormality: A Sensitivity Study Using Computational Modeling and Fractal Analysis

    PubMed Central

    Xi, Jinxiang; Si, Xiuhua A.; Kim, JongWon; Mckee, Edward; Lin, En-Bing

    2014-01-01

    Background Exhaled aerosol patterns, also called aerosol fingerprints, provide clues to the health of the lung and can be used to detect disease-modified airway structures. The key is how to decode the exhaled aerosol fingerprints and retrieve the lung structural information for a non-invasive identification of respiratory diseases. Objective and Methods In this study, a CFD-fractal analysis method was developed to quantify exhaled aerosol fingerprints and applied it to one benign and three malign conditions: a tracheal carina tumor, a bronchial tumor, and asthma. Respirations of tracer aerosols of 1 µm at a flow rate of 30 L/min were simulated, with exhaled distributions recorded at the mouth. Large eddy simulations and a Lagrangian tracking approach were used to simulate respiratory airflows and aerosol dynamics. Aerosol morphometric measures such as concentration disparity, spatial distributions, and fractal analysis were applied to distinguish various exhaled aerosol patterns. Findings Utilizing physiology-based modeling, we demonstrated substantial differences in exhaled aerosol distributions among normal and pathological airways, which were suggestive of the disease location and extent. With fractal analysis, we also demonstrated that exhaled aerosol patterns exhibited fractal behavior in both the entire image and selected regions of interest. Each exhaled aerosol fingerprint exhibited distinct pattern parameters such as spatial probability, fractal dimension, lacunarity, and multifractal spectrum. Furthermore, a correlation of the diseased location and exhaled aerosol spatial distribution was established for asthma. Conclusion Aerosol-fingerprint-based breath tests disclose clues about the site and severity of lung diseases and appear to be sensitive enough to be a practical tool for diagnosis and prognosis of respiratory diseases with structural abnormalities. PMID:25105680

  2. Production of carbon dioxide in a fattening pig house under field conditions. I. Exhalation by pigs

    NASA Astrophysics Data System (ADS)

    Ni, Ji-Qin; Hendriks, Jos; Coenegrachts, Jan; Vinckier, Christiaan

    Exhalation of carbon dioxide (CO 2) by pigs was investigated under field conditions in a mechanically ventilated commercial fattening house. The tranquil CO 2 exhalation rate (TCER) by pigs was defined and methodology was developed to study it. The experiments were conducted by moving groups of pigs in and out of one of the compartments in the house and comparing differences of measured CO 2 production rates. The measured TCERs ranged from 41.5 to 73.9 g CO 2 h -1 per pig for pigs from 32 to 105 kg. When pigs were very active, the CO 2 exhalation rate could be about 200% of the TCER but did not last for long time. A TCER mathematical model was developed based on 4 sets of experiments. It calculated the CO 2 exhalation by a pig at tranquil time as a function of its weight. Daily mean CO 2 exhalation rate (CER) by a pig was about 110% of the TCER. The TCER/CER model related the CO 2 exhalation to some aspects of pigs' behaviours and was the first reported model developed with direct measurement of CO 2 production rates. Five models of CO 2 exhalation in available literature were reviewed and the CER model was compared with them. There was a clear disparity among these models. The average CO 2 exhalation rate calculated with the "Ouwerkerk Model" was about three times as that obtained by the "Anderson Model" for pigs from 35 to 120 kg. The CER model produced the same CO 2 exhalation rate as the "Ouwerkerk Model" for a pig of 35 kg and a close rate to the "Klooster Model" for a pig of 85 kg.

  3. Dietary Nitrate Acutely and Markedly Increased Exhaled Nitric Oxide in a Cystic Fibrosis Case

    PubMed Central

    Kerley, Conor P.; Kilbride, Emma; Greally, Peter; Elnazir, Basil

    2016-01-01

    Airway nitric oxide (NO) is a ubiquitous signaling molecule with bronchoprotective, anti-inflammatory and anti-infective roles. Cystic fibrosis (CF) is a chronic lung condition associated with deceased exhaled NO. Strategies to increase exhaled NO in CF have yielded inconsistent results. A potential new method of increasing systemic NO involves ingestion of dietary, inorganic nitrate which is reduced to nitrite and NO. We present the case of a 12-year-old, athletic boy with CF who demonstrated acute but marked increases in exhaled NO following dietary nitrate consumption compared to placebo PMID:27630187

  4. Radium concentration and radon exhalation measurements using LR-115 type II plastic track detectors

    NASA Astrophysics Data System (ADS)

    Azam, A.; Naqvi, A. H.; Srivastava, D. S.

    1995-12-01

    The “Track-Etch” technique using LR-115 type II plastic track detectors has been employed for measuring the radium content and radon exhalation rates of different types of building materials. Among the eight materials studied it was found that fine aggregates (Badarpur) show the greatest radon exhalation, whereas portland cement produces minimum values of radon exhalation. Experimentally-measured values of the “effective radium content” (in Bq kg-1) their “mass exhalation” rates (in Bq kg-1d-1) and “surface exhalation” rates (in Bq m-2d-1 ) are reported.

  5. Microbiota in Exhaled Breath Condensate and the Lung.

    PubMed

    Glendinning, Laura; Wright, Steven; Tennant, Peter; Gill, Andrew C; Collie, David; McLachlan, Gerry

    2017-04-07

    The lung microbiota is commonly sampled using relatively invasive bronchoscopic procedures. Exhaled breath condensate (EBC) collection potentially offers a less invasive alternative for lung microbiota sampling. We compared lung microbiota samples retrieved by protected specimen brushings (PSB) and exhaled breath condensate collection. We also sought to assess whether aerosolised antibiotic treatment would influence the lung microbiota and whether EBC was sensitive enough to detect such changes.EBC was collected from 6 conscious sheep, and then from the same anaesthetised sheep during mechanical ventilation. Following the latter EBC collection, PSB samples were collected from separate sites within each sheep lung. On the subsequent day each sheep was then treated with nebulised colistimethate sodium. Two days after nebulisation, EBC and PSB samples were again collected. Bacterial DNA was quantified using 16S rRNA gene qPCR. The V2-V3 region of the 16S rRNA gene was amplified by PCR and sequenced using an Illumina Miseq. Quality control and operational taxonomic unit (OTU) clustering were performed within mothur.EBC contained significantly less bacterial DNA than PSB samples. EBC samples from anaesthetised animals clustered separately by their bacterial community compositions in comparison to PSB samples and 37 bacterial OTUs were identified which were differentially abundant between the two sample types. Despite only low concentrations of colistin being detected in bronchoalveolar lavage fluid, PSB samples were found to differ by their bacterial compositions pre and post colistimethate sodium treatment. Our findings indicate that microbiota in EBC samples and PSB samples are not equivalent.Importance Sampling of the lung microbiota usually necessitates performing bronchoscopic procedures which involve a hospital visit for human participants and the use of trained staff. The inconvenience and perceived discomfort of participating in this kind of research may deter

  6. Exhaled breath analysis: The new interface between medicine and engineering

    PubMed Central

    Mashir, Alquam; Dweik, Raed A.

    2010-01-01

    Exhaled breath testing is becoming an increasingly important non-invasive diagnostic method that can be used in the evaluation of health and disease states in the lung and beyond. Potential advantages of breath tests over other conventional medical tests include their non-invasive nature, low cost, and safety. To advance in this area further, however, there has to be a close collaboration between technical experts and engineers who have devices looking for clinical application(s), the medical experts who have the clinical problems looking for a test/biomarker that can be helpful in diagnosis or monitoring, and industry/commercial experts who can build and commercialize the final product. PMID:20948990

  7. Method for measuring the exhalation of radon from building materials

    SciTech Connect

    Ingersoll, J.G.; Stitt, B.D.; Zapalac, G.H.

    1982-02-01

    The health hazards associated with radon, a naturally occurring radioactive gas, may be significantly greater in buildings where ventilation is restricted. Since building materials such as concrete, gypsum, brick, and wood are potential sources of radon, it is important that their radon emanation rate be determined. A rapid and accurate method is presented for determining the radon emanation rate per mass from building materials by determining simply the radon exhalation rate per unit mass. A small sample of the material is sealed in a container from one to three days. The emanated radon is then collected on glass wool cooled to liquid-nitrogen temperature and subsequently transferred to a scintillation flask where the ..cap alpha..-activity is counted. The reproducibility errors of the measurements are on the order of 5%.

  8. Why inhaling salt water changes what we exhale.

    PubMed

    Watanabe, Wiwik; Thomas, Matthew; Clarke, Robert; Klibanov, Alexander M; Langer, Robert; Katstra, Jeffrey; Fuller, Gerald G; Griel, Lester C; Fiegel, Jennifer; Edwards, David

    2007-03-01

    We find that inhaling salt water diminishes subsequently exhaled biomaterial in man and animals due to reversible stabilization of the airway lining fluid (ALF)/air interface as a novel potential means for control of the spread of airborne infectious disease. The mechanism of this phenomenon relates to charge shielding of mucin or mucin-like macromolecules that consequently undergo gelation; this gelation alters the physical properties of the ALF surface and reduces its breakup. Cations in the nebulized solution and apparent surface viscoelasticity of the ALF (more than any other ALF intrinsic physical property) appear to be responsible for the reduced tendency of the ALF to disintegrate into very small droplets. We confirm these effects in vivo and show their reversibility through nebulization of saline solutions to anesthetized bull calves.

  9. Electronic Nose To Detect Patients with COPD From Exhaled Breath

    NASA Astrophysics Data System (ADS)

    Velásquez, Adriana; Durán, Cristhian M.; Gualdron, Oscar; Rodríguez, Juan C.; Manjarres, Leonardo

    2009-05-01

    To date, there is no effective tool analysis and detection of COPD syndrome, (Chronic Obstructive Pulmonary Disease) which is linked to smoking and, less frequently to toxic substances such as, the wood smoke or other particles produced by noxious gases. According to the World Health Organization (WHO) estimates of this disease show it affects more than 52 million people and kills more than 2.7 million human beings each year. In order to solve the problem, a low-cost Electronic Nose (EN) was developed at the University of Pamplona (N. S) Colombia, for this specific purpose and was applied to a sample group of patients with COPD as well as to others who were healthy. From the exhalation breath samples of these patients, the results were as expected; an appropriate classification of the patients with the disease, as well as from the healthy group was obtained.

  10. Detection of cancer through exhaled breath: a systematic review

    PubMed Central

    Krilaviciute, Agne; Heiss, Jonathan Alexander; Leja, Marcis; Kupcinskas, Juozas; Haick, Hossam; Brenner, Hermann

    2015-01-01

    Background Timely diagnosis of cancer represents a challenging task; in particular, there is a need for reliable non-invasive screening tools that could achieve high levels of adherence at virtually no risk in population-based screening. In this review, we summarize the current evidence of exhaled breath analysis for cancer detection using standard analysis techniques and electronic nose. Methods Relevant studies were identified searching Pubmed and Web of Science databases until April 30, 2015. Information on breath test performance, such as sensitivity and specificity, was extracted together with volatile compounds that were used to discriminate cancer patients from controls. Performance of different breath analysis techniques is provided for various cancers together with information on methodological issues, such as breath sampling protocol and validation of the results. Results Overall, 73 studies were included, where two-thirds of the studies were conducted on lung cancer. Good discrimination usually required a combination of multiple biomarkers, and area under the receiver operating characteristic curve or accuracy reached levels of 0.9 or higher in multiple studies. In 25% of the reported studies, classification models were built and validated on the same datasets. Huge variability was seen in different aspects among the studies. Conclusions Analyses of exhaled breath yielded promising results, although standardization of breath collection, sample storage and data handling remain critical issues. In order to foster breath analysis implementation into practice, larger studies should be implemented in true screening settings, paying particular attention to standardization in breath collection, consideration of covariates, and validation in independent population samples. PMID:26440312

  11. Geographical variation in the exhaled volatile organic compounds.

    PubMed

    Amal, Haitham; Leja, Marcis; Broza, Yoav Y; Tisch, Ulrike; Funka, Konrads; Liepniece-Karele, Inta; Skapars, Roberts; Xu, Zhen-Qin; Liu, Hu; Haick, Hossam

    2013-12-01

    Breath-gas analysis has demonstrated that concentration profiles of volatile organic compounds (VOCs) could be used for detecting a variety of diseases, among them gastric cancer (GC) and peptic ulcer disease (PUD). Here, we explore how geographical variation affects the disease-specific changes in the chemical composition of breath samples, as compared to control states (less severe gastric conditions). Alveolar exhaled breath samples from 260 patients were collected at two remotely different geographic locations (China and Latvia), following similar breath-collection protocols. Each cohort included 130 patients that were matched in terms of diagnosis (37 GC/32 PUD/61 controls), average age, gender ratio and smoking habits. Helicobacter Pylori infection, which is a major cause for GC and PUD, was found in part of the patients, as well as in part of the controls, at both locations. The breath samples were analyzed by gas chromatography/mass spectrometry, using the same equipment and protocol-of-experiment. We observed similar characteristic differences in the chemical composition of the breath samples between the study groups at the two locations, even though the exact composition of the breath samples differed. Both in China and Latvia, the GC patients and controls could be distinguished by differences in the average levels of 6-methyl-5-hepten-2-one; PUD patients were distinguished from controls by the levels of aromatic compounds and alcohols; GC and PUD patients could not be distinguished at either site. This pilot study indicates the limitations of chemical breath-gas analysis alone for identifying gastric diseases based on the concentration profiles of separate VOCs in international patient cohorts. We assume that these limitations would apply to other diseases as well. The presented data could potentially be useful for developing an alternative, universally applicable diagnostic method that relies on the detection of changes in the collective patterns of

  12. Exhaled Nitric Oxide in Systemic Sclerosis Lung Disease

    PubMed Central

    Kozij, Natalie K.; Silkoff, Philip E.; Thenganatt, John; Chakravorty, Shobha

    2017-01-01

    Background. Exhaled nitric oxide (eNO) is a potential biomarker to distinguish systemic sclerosis (SSc) associated pulmonary arterial hypertension (PAH) and interstitial lung disease (ILD). We evaluated the discriminative validity, feasibility, methods of eNO measurement, and magnitude of differences across lung diseases, disease-subsets (SSc, systemic lupus erythematosus), and healthy-controls. Methods. Consecutive subjects in the UHN Pulmonary Hypertension Programme were recruited. Exhaled nitric oxide was measured at 50 mL/s intervals using chemiluminescent detection. Alveolar and conducting airway NO were partitioned using a two-compartment model of axial diffusion (CMAD) and the trumpet model of axial diffusion (TMAD). Results. Sixty subjects were evaluated. Using the CMAD model, control subjects had lower median (IQR) alveolar NO than all PAH subjects (2.0 (1.5, 2.5) versus 3.14 ppb (2.3, 4.0), p = 0.008). SSc-ILD had significantly lower median conducting airway NO compared to controls (1009.5 versus 1342.1 ml⁎ppb/s, p = 0.04). SSc-PAH had increased median (IQR) alveolar NO compared to controls (3.3 (3.0, 5.7) versus 2.0 ppb (1.5, 2.5), p = 0.01). SSc-PAH conducting airway NO inversely correlated with DLCO (r −0.88 (95% CI −0.99, −0.26)). Conclusion. We have demonstrated feasibility, identified that CMAD modeling is preferred in SSc, and reported the magnitude of differences across cases and controls. Our data supports discriminative validity of eNO in SSc lung disease. PMID:28293128

  13. RECENT DEVELOPMENTS IN EXHALED BREATH ANALYSIS AND HUMAN EXPOSURE ASSESSMENT RESEARCH

    EPA Science Inventory

    This presentation will explore historical and newly emerging methods for the collection and analysis of exhaled breath for use in environmental exposure assessment studies. We will discuss their applicability and limitations with respect to environmental research. Particular em...

  14. Standardization of exhaled breath condensate (EBC) collection using a feedback regulated breathing pattern

    EPA Science Inventory

    Collection of exhaled breath condensate (EBC) fluid by cooling of expired breath is a potentially valuable approach for the detection of biomarkers associated with disease or exposure to xenobiotics. EBC is generally collected using unregulated breathing patterns, perceived to el...

  15. Standardization of exhaled breath condensate (EBC) collection using a feedback regulated breathing pattern

    EPA Science Inventory

    Collection of exhaled breath condensate (EBC) fluid by cooling of expired breath is a potentially valuable approach for the detection of biomarkers associated with disease or exposure to xenobiotics. EBC is generally collected using unregulated breathing patterns, perceived to el...

  16. RECENT DEVELOPMENTS IN EXHALED BREATH ANALYSIS AND HUMAN EXPOSURE ASSESSMENT RESEARCH

    EPA Science Inventory

    This presentation will explore historical and newly emerging methods for the collection and analysis of exhaled breath for use in environmental exposure assessment studies. We will discuss their applicability and limitations with respect to environmental research. Particular em...

  17. Shaping exhale durations for breath CO detection for men with mild mental retardation.

    PubMed

    Rea, Jerry; Williams, Dean

    2002-01-01

    Roll, Higgins, and Badger (1996) used a carbon monoxide (CO) detector to determine whether participants smoked in a smoking-cessation study. We sought to replicate their work with adults with mild mental retardation. However, verbal instructions were inadequate to establish stable exhalations of sufficient durations for reliable and accurate CO evaluation. This report describes a shaping procedure that enabled 3 of 4 participants to achieve 20-s exhalation durations.

  18. Biological monitoring of occupational exposure to isoflurane by measurement of isoflurane exhaled breath.

    PubMed

    Prado, C; Tortosa, J A; Ibarra, I; Luna, A; Periago, J F

    1997-01-01

    The relationship between isoflurane environmental concentrations in operating rooms and the corresponding isoflurane concentration in the exhaled air of the operating personnel at the end of the exposure has been investigated. Isoflurane was retained in an adsorbent cartridge and after thermal desorption the concentration was estimated by gas chromatography. Significant correlation between environmental and exhaled air isoflurane concentrations allowed the establishment of a biological exposure index and biological exposure limits corresponding to proposed atmospheric threshold values.

  19. Detection of exhaled hydrogen sulphide gas in rats exposed to intravenous sodium sulphide

    PubMed Central

    Insko, Michael A; Deckwerth, Thomas L; Hill, Paul; Toombs, Christopher F; Szabo, Csaba

    2009-01-01

    Background and purpose: Sodium sulphide (Na2S) disassociates to sodium (Na+) hydrosulphide, anion (HS−) and hydrogen sulphide (H2S) in aqueous solutions. Here we have established and characterized a method to detect H2S gas in the exhaled breath of rats. Experimental approach: Male rats were anaesthetized with ketamine and xylazine, instrumented with intravenous (i.v.) jugular vein catheters, and a tube inserted into the trachea was connected to a pneumotach connected to a H2S gas detector. Sodium sulphide, cysteine or the natural polysulphide compound diallyl disulphide were infused intravenously while the airway was monitored for exhaled H2S real time. Key results: Exhaled sulphide concentration was calculated to be in the range of 0.4–11 ppm in response to i.v. infusion rates ranging between 0.3 and 1.1 mg·kg−1·min−1. When nitric oxide synthesis was inhibited with Nω-nitro-L-arginine methyl ester the amount of H2S exhaled during i.v. infusions of sodium sulphide was significantly increased compared with that obtained with the vehicle control. An increase in circulating nitric oxide using DETA NONOate [3,3-bis(aminoethyl)-1-hydroxy-2-oxo-1-triazene] did not alter the levels of exhaled H2S during an i.v. infusion of sodium sulphide. An i.v. bolus of L-cysteine, 1 g·kg−1, and an i.v. infusion of the garlic derived natural compound diallyl disulphide, 1.8 mg·kg−1·min−1, also caused exhalation of H2S gas. Conclusions and implications: This method has shown that significant amounts of H2S are exhaled in rats during sodium sulphide infusions, and the amount exhaled can be modulated by various pharmacological interventions. PMID:19422378

  20. Determination of methadone in exhaled breath condensate by liquid chromatography-tandem mass spectrometry.

    PubMed

    Beck, Olof; Sandqvist, Sören; Eriksen, Paul; Franck, Johan; Palmskog, Göran

    2011-04-01

    Within the field of toxicology exhaled breath is used as specimen only for determination of alcohol. However, it was recently discovered that when using sensitive liquid chromatography-mass spectrometry (LC-MS) technique, amphetamine, methamphetamine, and methadone are detectable in exhaled breath following intake by drug addicts. We therefore undertook to develop a method for determination of methadone in exhaled breath condensate from patients undergoing methadonemaintenance treatment. Exhaled breath condensate was collected from 14 patients after intake of the daily methadone dose. The exhaled breath condensate was collected for 10 min using an Ecoscreen instrument. After extraction of any trapped methadone from the condensate by solid-phase extraction, the final extract was analyzed by a combined LC-MS-MS method. Recovery of methadone from breath condensate in the solid-phase extraction was 104%, no significant matrix effects were observed, and the quantification using methadone-d(3) as internal standard was accurate (10% bias) and precise (coefficient of variation 6.2%). Methadone was indisputably identified by means of the MS technique in exhaled breath condensate from all 14 patients. Identification was based on monitoring two product ions in selected reaction monitoring mode with correct relative ratio (± 20%) and correct retention time. Excretion rates ranged from 23.6 to 275 pg/min. No methadone was detected in five control subjects (< 2 pg/min). This finding confirms that methadone is present in exhaled breath from patients in methadone treatment. Collection of exhaled breath specimen is likely to be complementary to other matrices presently in use in testing for drugs-of-abuse.

  1. Clinical Effects, Exhaled Breath Condensate pH and Exhaled Nitric Oxide in Humans After Ethyl Acrylate Exposure.

    PubMed

    Hoffmeyer, F; Bünger, J; Monsé, C; Berresheim, H; Jettkant, B; Beine, A; Brüning, T; Sucker, K

    Ethyl acrylate is an irritant known to affect the upper airways and eyes. An increase of the eye blink frequency in humans was observed during exposure to 5 ppm. Studies on the lower airways are scant and our study objective was the evaluation of pH in exhaled breath condensate (EBC-pH) and nitric oxide in exhaled breath (FeNO) as markers of inflammation. Sixteen healthy volunteers were exposed for 4 h to ethyl acrylate at a concentration of 5 ppm and to sham (0.05 ppm) in an exposure laboratory. Clinical irritation symptoms, EBC-pH (at a pCO2 of 5.33 kPa) and FeNO were assessed before and after exposure. Differences after ethyl acrylate exposure were adjusted for those after sham exposure. 5 ppm ethyl acrylate induced clinical signs of local irritation in the nose and eyes, but not in lower airways. Exposure produced a subtle, but statistically significant, decrease in breathing frequency (1 breath/min; p = 0.017) and a lower EBC-pH (by 0.045 units; p = 0.037). Concerning FeNO, we did not observe significant changes compared to sham exposure. We conclude that local effects induced by 5 ppm ethyl acrylate consist of sensory irritation of eyes and nose. In addition, acute ethyl acrylate exposure to 5 ppm resulted in a net decrease of EBC-pH. Whether that can be interpreted in terms of additional lower airway irritation or already inflammatory alterations set in needs further investigations.

  2. Experimental analysis of the air velocity and contaminant dispersion of human exhalation flows.

    PubMed

    Berlanga, F A; Olmedo, I; Ruiz de Adana, M

    2017-07-01

    Human exhalation flow is a potential source of pathogens that can constitute a cross-infection risk to people in indoor environments. Thus, it is important to investigate the characteristics of this flow, its development, area of influence, and the diffusion of the exhaled contaminants. This paper uses phase-averaged particle image velocimetry together with a tracer gas (CO2 ) to study two different exhalation flows over time: the exhalation of an average male (test M) and an average female (test F), using a life-sized thermal manikin in a supine position. The exhalation jets generated for both tests are similar in terms of symmetrical geometry, vorticity values, jet opening angles, and velocity and concentration decays. However, there is a difference in the penetration length of the two flows throughout the whole exhalation process. There is also a time difference in reaching maximum velocity between the two tests. It is also possible to see that the tracer gas dispersion depends on the momentum of the jet so the test with the highest velocity decay shows the lowest concentration decay. All these results are of interest to better understand cross-infection risk. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Quantum cascade laser-based integrated cavity output spectroscopy of exhaled nitric oxide

    NASA Astrophysics Data System (ADS)

    McCurdy, M. R.; Bakhirkin, Y. A.; Tittel, F. K.

    2006-11-01

    A nitric oxide (NO) sensor employing a thermoelectrically cooled, continuous-wave, distributed feedback quantum cascade laser operating at 5.47 μm (1828 cm-1) and off-axis integrated cavity output spectroscopy was used to measure NO concentrations in exhaled breath. A minimum measurable concentration (3σ) of 3.6 parts-per-billion by volume (ppbv) of NO with a data-acquisition time of 4 s was demonstrated. Five prepared gas mixtures and 15 exhaled breath samples were measured with both the NO sensor and for intercomparison with a chemiluminescence-based NO analyzer and were found to be in agreement within 0.6 ppbv. Exhaled NO flow-independent parameters, which may provide diagnostic and therapeutic information in respiratory diseases where single-breath measurements are equivocal, were estimated from end-tidal NO concentration measurements collected at various flow rates. The results of this work indicate that a laser-based exhaled NO sensor can be used to measure exhaled nitric oxide at a range of exhalation flow rates to determine flow-independent parameters in human clinical trials.

  4. RADIUM AND RADON EXHALATION RATE IN SOIL SAMPLES OF HASSAN DISTRICT OF SOUTH KARNATAKA, INDIA.

    PubMed

    Jagadeesha, B G; Narayana, Y

    2016-10-01

    The radon exhalation rate was measured in 32 soil samples collected from Hassan district of South Karnataka. Radon exhalation rate of soil samples was measured using can technique. The results show variation of radon exhalation rate with radium content of the soil samples. A strong correlation was observed between effective radium content and radon exhalation rate. In the present work, an attempt was made to assess the levels of radon in the environment of Hassan. Radon activities were found to vary from 2.25±0.55 to 270.85±19.16 Bq m(-3) and effective radium contents vary from 12.06±2.98 to 1449.56±102.58 mBq kg(-1) Surface exhalation rates of radon vary from 1.55±0.47 to 186.43±18.57 mBq m(-2) h(-1), and mass exhalation rates of radon vary from 0.312±0.07 to 37.46±2.65 mBq kg(-1) h(-1). © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Exhalation of (222)Rn from phosphogypsum piles located at the Southwest of Spain.

    PubMed

    Dueñas, C; Liger, E; Cañete, S; Pérez, M; Bolívar, J P

    2007-01-01

    Phosphogypsum (PG) is a waste product of the phosphoric acid production process and contains, generally, high activity concentrations of uranium series radionuclides. It is stored in piles formed over the last 40 years close to the town of Huelva (Southwest of Spain). The very broad expanse of the PG piles (about 1200 ha) produces a local, but unambiguous, radioactive impact to their surroundings. In 1992, the regional government of Andalusia restored an area of 400 ha by covering it with a 25-cm thick layer of natural soil and, currently, there is an additional zone of 400 ha in course of restoration (unrestored) and the same area of active PG stacks. Due to the high activity concentration of (226)Ra in active PG stacks (average 647 Bq kg(-1)), a significant exhalation of (222)Rn could be produced from the surface of the piles. Measurements have been made of (222)Rn exhalation from active PG stacks and from restored and unrestored zones. The (222)Rn exhalation from unrestored zones is half of that of the active PG stacks. Following restoration, the (222)Rn exhalation is approximately eight times lower than the active PG stacks. The activity concentrations of natural radionuclides ((226)Ra, (40)K, (232)Th) in the mentioned zones have been determined. This study was also conducted to determine the effect of (226)Ra activity concentration on the (222)Rn exhalation, and a good correlation was obtained between the (222)Rn exhalation and (226)Ra activity, porosity and density of soil.

  6. Studying radon exhalation rates variability from phosphogypsum piles in the SW of Spain.

    PubMed

    López-Coto, I; Mas, J L; Vargas, A; Bolívar, J P

    2014-09-15

    Nearly 1.0 × 10(8) tonnes of phosphogypsum were accumulated during last 50 years on a 1,200 ha disposal site near Huelva town (SW of Spain). Previous measurements of exhalation rates offered very variable values, in such a way that a worst case scenario could not be established. Here, new experimental data coupled to numerical simulations show that increasing the moisture contents or the temperature reduces the exhalation rate whilst increasing the radon potential or porosity has the contrary effect. Once the relative effects are compared, it can be drawn that the most relevant parameters controlling the exhalation rate are radon potential (product of emanation factor by (226)Ra concentration) and moisture saturation of PG. From wastes management point of view, it can be concluded that piling up the waste increasing the height instead of the surface allows the reduction of the exhalation rate. Furthermore, a proposed cover here is expected to allow exhalation rates reductions up to 95%. We established that the worst case scenario corresponds to a situation of extremely dry winter. Under these conditions, the radon exhalation rate (0.508 Bqm(-2)s(-1)) would be below though close to the upper limit established by U.S.E.P.A. for inactive phopsphogypsum piles (0.722 Bqm(-2)s(-1)).

  7. Detection of Δ9-tetrahydrocannabinol in exhaled breath collected from cannabis users.

    PubMed

    Beck, Olof; Sandqvist, Sören; Dubbelboer, Ilse; Franck, Johan

    2011-10-01

    Exhaled breath has recently been proposed as a new possible matrix for drugs of abuse testing. A key drug is cannabis, and the present study was aimed at investigating the possibility of detecting tetrahydrocannabinol and tetrahydrocannabinol carboxylic acid in exhaled breath after cannabis smoking. Exhaled breath was sampled from 10 regular cannabis users and 8 controls by directing the exhaled breath by suction through an Empore C(18) disk. The disk was extracted with hexane/ethyl acetate, and the resulting extract was evaporated to dryness and redissolved in 100 μL hexane/ethyl acetate. A 3-μL aliquot was injected onto the LC-MS-MS system and analyzed using positive electrospray ionization and selected reaction monitoring. In samples collected 1-12 h after cannabis smoking, tetrahydrocannabinol was detected in all 10 subjects. The rate of excretion was between 9.0 and 77.3 pg/min. Identification of tetrahydrocannabinol was based on correct retention time relative to tetrahydrocannabinol-d(3) and correct product ion ratio. In three samples, peaks were observed for tetrahydrocannabinol carboxylic acid, but these did not fulfill identification criteria. Neither tetrahydrocannabinol or tetrahydrocannabinol carboxylic acid was detected in the controls. These results confirm older reports that tetrahydrocannabinol is present in exhaled breath following cannabis smoking and extend the detection time from minutes to hours. The results further support the idea that exhaled breath is a promising matrix for drugs-of-abuse testing.

  8. Nasal and oral contribution to inhaled and exhaled nitric oxide: a study in tracheotomized patients.

    PubMed

    Törnberg, D C F; Marteus, H; Schedin, U; Alving, K; Lundberg, J O N; Weitzberg, E

    2002-05-01

    Nitric oxide (NO) is produced at different sites in the human airways and may have several physiological effects. Orally-produced NO seems to contribute to the levels found in exhaled air. Autoinhalation of nasal NO increases oxygenation and reduces pulmonary artery pressure in humans. The aim of this study was to measure the concentration and output of NO during nasal, oral and tracheal controlled exhalation and inhalation. Ten tracheotomized patients and seven healthy subjects were studied. The mean+/-SEM fraction of exhaled NO from the nose, mouth and trachea was 56+/-8, 14+/-4 and 6+/-1 parts per billion (ppb), respectively. During single-breath nasal, oral and tracheal inhalation the fraction of inhaled NO was 64+/-14, 11+/-3 and 4+/-1, respectively. There was a marked flow dependency on nasal NO output in the healthy subjects, which was four-fold greater at the higher flow rates, during inhalation when compared to exhalation. There is a substantial contribution of nasal and oral nitric oxide during both inhalation and exhalation. Nasal nitric oxide output is markedly higher during inhalation, reaching levels similar to those that are found to have clinical effects in the trachea. These findings have implications for the measurement of nitric oxide in exhaled air and the physiological effects of autoinhaled endogenous nitric oxide.

  9. Dopant titrating ion mobility spectrometry for trace exhaled nitric oxide detection.

    PubMed

    Peng, Liying; Hua, Lei; Li, Enyou; Wang, Weiguo; Zhou, Qinghua; Wang, Xin; Wang, Changsong; Li, Jinghua; Li, Haiyang

    2015-01-05

    Ion mobility spectrometry (IMS) is a promising non-invasive tool for the analysis of exhaled gas and exhaled nitric oxide (NO), a biomarker for diagnosis of respiratory diseases. However, the high moisture in exhaled gas always brings about extra overlapping ion peaks and results in poor identification ability. In this paper, p-benzoquinone (PBQ) was introduced into IMS to eliminate the interference of overlapping ion peaks and realize the selective identification of NO. The overlapping ions caused by moisture were titrated by PBQ and then converted to hydrated PBQ anions (C6H4[Formula: see text](H2O)n). The NO concentration could be determined by quantifying gas phase hydrated nitrite anions (N[Formula: see text](H2O)n), product ions of NO. Under optimized conditions, a limit of detection (LOD) of about 1.4 ppbv and a linear range of 10-200 ppbv were obtained for NO even in 100% relative humidity (RH) purified air. Furthermore, this established method was applied to measure hourly the exhaled NO of eight healthy volunteers, and real-time monitoring the exhaled NO of an esophageal carcinoma patient during radical surgery. These results revealed the potential of the current dopant titrating IMS method in the measurement of exhaled NO for medical disease diagnosis.

  10. Could exhaled ferritin and SOD be used as markers for lung cancer and prognosis prediction purposes?

    PubMed

    Carpagnano, Giovanna E; Lacedonia, Donato; Palladino, Grazia P; Koutelou, Anna; Martinelli, Domenico; Orlando, Silvio; Foschino-Barbaro, Maria P

    2012-05-01

    Today an increasing interest is being generated by the study of lung cancer markers in the exhaled breath condensate (EBC), precisely because this sample seems to lend itself to lung cancer early screening and follow-up. Indeed, ferritin and superoxide dismutase (SOD) have recently been recognized to play a role in lung cancerogenesis and patients' survival. The aim of this study was to evaluate the clinical value and the prognostic power of exhaled ferritin and exhaled SOD in patients with lung cancer. Forty patients with nonsmall cell lung cancer (NSCLC) and 15 controls were enrolled in the study. All subjects under study underwent EBC collection and analysis of ferritin and SOD. A total of 36 patients were either given a follow-up of at least 25.5 months or followed up until death. Exhaled ferritin and SOD resulted as being higher in NSCLC than in controls and as being influenced by the stage of cancer. A pronounced survival difference was found in the presence of exhaled ferritin 300 ng/mL and exhaled SOD > 13.5 U/μL. In conclusion, although the results need to be confirmed on a larger and homogeneous population, we hypothesized that the notion of using the measurement of ferritin and SOD in the EBC could, if deemed feasible, have clinical implications in the monitoring of lung cancer and as an outcome predictor. © 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation.

  11. New method for determination of trihalomethanes in exhaled breath: applications to swimming pool and bath environments.

    PubMed

    Lourencetti, Carolina; Ballester, Clara; Fernández, Pilar; Marco, Esther; Prado, Celia; Periago, Juan F; Grimalt, Joan O

    2010-03-03

    A method for the estimation of the human intake of trihalomethanes (THMs), namely chloroform, bromodichloromethane, dibromochloromethane and bromoform, during showering and bathing is reported. The method is based on the determination of these compounds in exhaled breath that is collected by solid adsorption on Tenax using a device specifically designed for this purpose. Instrumental measurements were performed by automatic thermal desorption coupled to gas chromatography with electron capture detection. THMs in exhaled breath samples were determined during showering and swimming pool attendance. The levels of these compounds in indoor air and water were also determined as reference for interpretation of the exhaled breath results. The THM concentrations in exhaled breath of the volunteers measured before the exposure experiments showed a close correspondence with the THMs levels in indoor air where the sampler was located. Limits of detection in exhaled breath were dependent on THM analytes and experimental sites. They ranged between 170 and 710 ng m(-3) in the swimming pool studies and between 97 and 460 ng m(-3) in the showering studies. Application of this method to THMs determination during showering and swimming pool activities revealed statistically significant increases in THMs concentrations when comparing exhaled breath before and after exposure.

  12. Low Levels of Exhaled Surfactant Protein A Associated With BOS After Lung Transplantation

    PubMed Central

    Ericson, Petrea A.; Mirgorodskaya, Ekaterina; Hammar, Oscar S.; Viklund, Emilia A.; Almstrand, Ann-Charlotte R.; Larsson, Per J-W.; Riise, Gerdt C.; Olin, Anna-Carin

    2016-01-01

    Background There is no clinically available marker for early detection or monitoring of chronic rejection in the form of bronchiolitis obliterans syndrome (BOS), the main long-term complication after lung transplantation. Sampling and analysis of particles in exhaled air is a valid, noninvasive method for monitoring surfactant protein A (SP-A) and albumin in the distal airways. Methods We asked whether differences in composition of exhaled particles can be detected when comparing stable lung transplant recipients (LTRs) (n = 26) with LTRs who develop BOS (n = 7). A comparison between LTRs and a matching group of healthy controls (n = 33) was also conducted. Using a system developed in-house, particles were collected from exhaled air by the principal of inertial impaction before chemical analysis by immunoassays. Results Surfactant protein A in exhaled particles and the SP-A/albumin ratio were lower (P = 0.002 and P = 0.0001 respectively) in the BOS group compared to the BOS-free group. LTRs exhaled higher amount of particles (P < 0.0001) and had lower albumin content (P < 0.0001) than healthy controls. Conclusions We conclude that low levels of SP-A in exhaled particles are associated with increased risk of BOS in LTRs. The possibility that this noninvasive method can be used to predict BOS onset deserves further study with prospective and longitudinal approaches. PMID:27795995

  13. LASER BIOLOGY AND MEDICINE: Application of tunable diode lasers for a highly sensitive analysis of gaseous biomarkers in exhaled air

    NASA Astrophysics Data System (ADS)

    Stepanov, E. V.; Milyaev, Varerii A.

    2002-11-01

    The application of tunable diode lasers for a highly sensitive analysis of gaseous biomarkers in exhaled air in biomedical diagnostics is discussed. The principle of operation and the design of a laser analyser for studying the composition of exhaled air are described. The results of detection of gaseous biomarkers in exhaled air, including clinical studies, which demonstrate the diagnostic possibilities of the method, are presented.

  14. An Acoustic-Based Method to Detect and Quantify the Effect of Exhalation into a Dry Powder Inhaler.

    PubMed

    Holmes, Martin S; Seheult, Jansen N; O'Connell, Peter; D'Arcy, Shona; Ehrhardt, Carsten; Healy, Anne Marie; Costello, Richard W; Reilly, Richard B

    2015-08-01

    Dry powder inhaler (DPI) users frequently exhale into their inhaler mouthpiece before the inhalation step. This error in technique compromises the integrity of the drug and results in poor bronchodilation. This study investigated the effect of four exhalation factors (exhalation flow rate, distance from mouth to inhaler, exhalation duration, and relative air humidity) on dry powder dose delivery. Given that acoustic energy can be related to the factors associated with exhalation sounds, we then aimed to develop a method of identifying and quantifying this critical inhaler technique error using acoustic based methods. An in vitro test rig was developed to simulate this critical error. The effect of the four factors on subsequent drug delivery were investigated using multivariate regression models. In a further study we then used an acoustic monitoring device to unobtrusively record the sounds 22 asthmatic patients made whilst using a Diskus(™) DPI. Acoustic energy was employed to automatically detect and analyze exhalation events in the audio files. All exhalation factors had a statistically significant effect on drug delivery (p<0.05); distance from the inhaler mouthpiece had the largest effect size. Humid air exhalations were found to reduce the fine particle fraction (FPF) compared to dry air. In a dataset of 110 audio files from 22 asthmatic patients, the acoustic method detected exhalations with an accuracy of 89.1%. We were able to classify exhalations occurring 5 cm or less in the direction of the inhaler mouthpiece or recording device with a sensitivity of 72.2% and specificity of 85.7%. Exhaling into a DPI has a significant detrimental effect. Acoustic based methods can be employed to objectively detect and analyze exhalations during inhaler use, thus providing a method of remotely monitoring inhaler technique and providing personalized inhaler technique feedback.

  15. [Exhaled and nasal nitric oxide in patients with Japanese cedar pollinosis and effects of nasal steroids].

    PubMed

    Miyazaki, Y

    1999-12-01

    Nitric oxide (NO) is produced by the action of NO synthase (NOS) using L-arginine as a substrate in various cells and found in air exhaled by humans. Previous studies suggest that almost all exhaled NO is derived from the upper airways and increases in patients with untreated asthma and allergic rhinitis. Exhaled NO is inhibited by treatment with inhalation of steroids that may be caused by inhibition of inducible nitric oxide synthase (iNOS). The purpose of this study is to determine whether exhaled and nasal NO increases in patients with Japanese cedar pollinosis compared with nonallergic healthy subjects, and whether it is affected by treatment with nasal steroids. Furthermore, we investigated its relation to nasal function and allergic rhinitis. 10 patients with Japanese cedar pollinosis and 5 healthy normal subjects were tested. All subjects had no history of respiratory infection for at least 2 weeks and did not smoke. Exhaled NO was collected in a sampling bag from oral and nasal breathing, and nasal NO was sampled directly from the nasal cavity. Both were measured by a chemiluminescence NO analyzer, ML9841, at a detection limit of 1 part per billion (ppb). Subjects used nasal steroids for 2 weeks and were measured similarly afterwards. NO concentrations in nasal air and air exhaled from the nose in patients with Japanese cedar pollinosis (277.9 +/- 59.5 ppb, 34.4 +/- 3.9 ppb, n = 10) were higher than the normal subjects (153.3 +/- 30.6 ppb, 19.9 +/- 3.4 ppb, n = 5) (p < 0.05). NO exhaled from the mouth was not significantly different between patients (20.5 +/- 4.9 ppb) and normal subjects (23.7 +/- 2.6 ppb). In patients with Japanese cedar pollinosis, the concentration of nasal NO and nasal exhaled NO were significantly decreased after treatment with nasal steroids (144.0 +/- 21.0 ppb, 26.1 +/- 3.0 ppb) (p < 0.01, p < 0.05), but there was no change in oral exhaled NO (17.2 +/- 3.3 ppb). In normal subjects, oral (22.5 +/- 5.3 ppb), nasal exhaled NO (19

  16. Exhaled nitric oxide in acute respiratory syncytial virus bronchiolitis.

    PubMed

    Gadish, Tal; Soferman, Ruth; Merimovitch, Tamar; Fireman, Elizabeth; Sivan, Yakov

    2010-08-01

    To investigate fractional exhaled nitric oxide (FeNO) levels in infants during acute respiratory syncytial virus (RSV) bronchiolitis and during convalescence. Prospective cohort study. Comparison of FeNO levels between infants with laboratory-confirmed acute RSV bronchiolitis and 2 control groups: healthy infants and infants with recurrent wheezing. The Department of Pediatric Emergency Medicine and the Pediatric Pulmonary Clinic of the Tel Aviv Medical Center from November 2008 to July 2009. The FeNO levels were measured at referral and at 2 visits over 4 months after convalescence. The FeNO level was measured using the multiple-breath exhalation technique. Forty-four infants with acute RSV bronchiolitis (mean [SD] age, 6.8 [7.3] months), 21 infants with recurrent wheezing (mean [SD] age, 10.8 [7.59] months), and 32 age-matched healthy controls (mean [SD] age, 6.8 [9.1] months). Follow-up data were available for 22 children (55%) for the first follow-up visit and for 11 children (25%) for the second follow-up visit. Acute RSV bronchiolitis. The FeNO levels during acute RSV bronchiolitis vs controls and FeNO levels during follow-up vs acute-stage disease. Mean FeNO levels for RSV-positive infants were significantly lower compared with healthy controls and infants with recurrent wheezing: mean (SD), 1.89 (1.76) parts per billion (ppb), 7.28 (4.96) ppb, and 4.86 (7.49) ppb, respectively (P<.001). The FeNO levels at the 2- and 4-month follow-up visits increased to 7.74 (5.13) ppb and 11.37 (6.29) ppb, respectively (P=.001). The FeNO levels are temporarily reduced during acute RSV bronchiolitis and increase during convalescence to normal levels and higher. The mechanisms for this suppression and its relation to future wheezing and asthma need to be studied.

  17. Sponge exhalent seawater contains a unique chemical profile of dissolved organic matter

    PubMed Central

    Freeman, Christopher J.; Kujawinski, Elizabeth B.

    2017-01-01

    Sponges are efficient filter feeders, removing significant portions of particulate and dissolved organic matter (POM, DOM) from the water column. While the assimilation and respiration of POM and DOM by sponges and their abundant microbial symbiont communities have received much attention, there is virtually no information on the impact of sponge holobiont metabolism on the composition of DOM at a molecular-level. We applied untargeted and targeted metabolomics techniques to characterize DOM in seawater samples prior to entering the sponge (inhalant reef water), in samples exiting the sponge (exhalent seawater), and in samples collected just outside the reef area (off reef seawater). Samples were collected from two sponge species, Ircinia campana and Spheciospongia vesparium, on a near-shore hard bottom reef in the Florida Keys. Metabolic profiles generated from untargeted metabolomics analysis indicated that many more compounds were enhanced in the exhalent samples than in the inhalant samples. Targeted metabolomics analysis revealed differences in diversity and concentration of metabolites between exhalent and off reef seawater. For example, most of the nucleosides were enriched in the exhalent seawater, while the aromatic amino acids, caffeine and the nucleoside xanthosine were elevated in the off reef water samples. Although the metabolic profile of the exhalent seawater was unique, the impact of sponge metabolism on the overall reef DOM profile was spatially limited in our study. There were also no significant differences in the metabolic profiles of exhalent water between the two sponge species, potentially indicating that there is a characteristic DOM profile in the exhalent seawater of Caribbean sponges. Additional work is needed to determine whether the impact of sponge DOM is greater in habitats with higher sponge cover and diversity. This work provides the first insight into the molecular-level impact of sponge holobiont metabolism on reef DOM and

  18. Increased exhaled nitric oxide in patients with stable chronic obstructive pulmonary disease

    PubMed Central

    Corradi, M.; Majori, M.; Cacciani, G. C.; Consigli, G. F.; de'Munari, E.; Pesci, A.

    1999-01-01

    BACKGROUND—Nitric oxide (NO) plays an important role as an inflammatory mediator in the airways. Since chronic obstructive pulmonary disease (COPD) is characterised by airway inflammation, a study was undertaken to determine NO levels in the exhaled air of patients with COPD.
METHODS—Two groups of patients with clinically stable COPD were studied, 10 current smokers and 10 ex-smokers. Two control groups of healthy subjects consisting of 10 current smokers and 20 non-smokers were also studied. Exhaled NO levels were measured by the collection bag technique and NO chemiluminescence analyser.
RESULTS—Mean (SE) levels of exhaled NO in ex-smokers and current smokers with COPD (25.7 (3.0) ppb and 10.2 (1.4) ppb, respectively) were significantly higher than in non-smoker and current smoker control subjects (9.4 (0.8) ppb and 4.6 (0.4) ppb, respectively). In current smokers with COPD exhaled levels of NO were significantly lower than in ex-smokers. In this latter group of patients there was a significant negative correlation between smoking history (pack years) and levels of exhaled NO (r = -0.8, p = 0.002). A positive correlation was seen between forced expiratory volume in one second (FEV1) and levels of exhaled NO (r = 0.65, p = 0.001) in patients with COPD.
CONCLUSIONS—These data show that exhaled NO is increased in patients with stable COPD, both current and ex-smokers, compared with healthy control subjects.

 PMID:10377199

  19. Exhaled Aerosol Transmission of Pandemic and Seasonal H1N1 Influenza Viruses in the Ferret

    PubMed Central

    Koster, Frederick; Gouveia, Kristine; Zhou, Yue; Lowery, Kristin; Russell, Robert; MacInnes, Heather; Pollock, Zemmie; Layton, R. Colby; Cromwell, Jennifer; Toleno, Denise; Pyle, John; Zubelewicz, Michael; Harrod, Kevin; Sampath, Rangarajan; Hofstadler, Steven; Gao, Peng; Liu, Yushi; Cheng, Yung-Sung

    2012-01-01

    Person-to-person transmission of influenza viruses occurs by contact (direct and fomites) and non-contact (droplet and small particle aerosol) routes, but the quantitative dynamics and relative contributions of these routes are incompletely understood. The transmissibility of influenza strains estimated from secondary attack rates in closed human populations is confounded by large variations in population susceptibilities. An experimental method to phenotype strains for transmissibility in an animal model could provide relative efficiencies of transmission. We developed an experimental method to detect exhaled viral aerosol transmission between unanesthetized infected and susceptible ferrets, measured aerosol particle size and number, and quantified the viral genomic RNA in the exhaled aerosol. During brief 3-hour exposures to exhaled viral aerosols in airflow-controlled chambers, three strains of pandemic 2009 H1N1 strains were frequently transmitted to susceptible ferrets. In contrast one seasonal H1N1 strain was not transmitted in spite of higher levels of viral RNA in the exhaled aerosol. Among three pandemic strains, the two strains causing weight loss and illness in the intranasally infected ‘donor’ ferrets were transmitted less efficiently from the donor than the strain causing no detectable illness, suggesting that the mucosal inflammatory response may attenuate viable exhaled virus. Although exhaled viral RNA remained constant, transmission efficiency diminished from day 1 to day 5 after donor infection. Thus, aerosol transmission between ferrets may be dependent on at least four characteristics of virus-host relationships including the level of exhaled virus, infectious particle size, mucosal inflammation, and viral replication efficiency in susceptible mucosa. PMID:22509254

  20. Exhaled breath condensate – from an analytical point of view

    PubMed Central

    Dodig, Slavica; Čepelak, Ivana

    2013-01-01

    Over the past three decades, the goal of many researchers is analysis of exhaled breath condensate (EBC) as noninvasively obtained sample. A total quality in laboratory diagnostic processes in EBC analysis was investigated: pre-analytical (formation, collection, storage of EBC), analytical (sensitivity of applied methods, standardization) and post-analytical (interpretation of results) phases. EBC analysis is still used as a research tool. Limitations referred to pre-analytical, analytical, and post-analytical phases of EBC analysis are numerous, e.g. low concentrations of EBC constituents, single-analyte methods lack in sensitivity, and multi-analyte has not been fully explored, and reference values are not established. When all, pre-analytical, analytical and post-analytical requirements are met, EBC biomarkers as well as biomarker patterns can be selected and EBC analysis can hopefully be used in clinical practice, in both, the diagnosis and in the longitudinal follow-up of patients, resulting in better outcome of disease. PMID:24266297

  1. Exhaled nitric oxide levels in children with chronic adenotonsillar disease.

    PubMed

    Torretta, S; Marchisio, P; Esposito, S; Garavello, W; Cappadona, M; Clemente, I A; Pignataro, L

    2011-01-01

    Exhaled nitric oxide (eNO) is a highly reactive biological mediator that has recently been associated with chronic tonsillar disease in adults, but there are no published data concerning eNO levels in their pediatric counterparts. The aim of this study is to measure mean eNO levels in children with chronic adenotonsillitis or adenotonsillar hypertrophy, and assess the effects of potential confounding factors. Children aged 3-17 years were divided into three groups (chronic adenotonsillitis, adenotonsillar hypertrophy and controls). Their eNO levels were measured in accordance with the international guidelines, and their other clinical and anamnestic characteristics were recorded. The mean eNO level in the children with chronic adenotonsillitis was slightly higher than that in the other groups, but there was no statistically significant between-group difference. Age (p=0.009), allergy (p=0.05) and body mass index (p=0.03), but not the mean grade of adenoidal or tonsil hypertrophy, were all statistically related to mean eNO levels. These preliminary results indicate the lack of an increase in mean eNO levels in children with chronic adenotonsillar disease, with no substantial difference between children with chronic adenotonsillitis and those with adenotonsillar hypertrophy.

  2. Sedimentary exhalative (sedex) zinc-lead-silver deposit model

    USGS Publications Warehouse

    Emsbo, Poul; Seal, Robert R.; Breit, George N.; Diehl, Sharon F.; Shah, Anjana K.

    2016-10-28

    This report draws on previous syntheses and basic research studies of sedimentary exhalative (sedex) deposits to arrive at the defining criteria, both descriptive and genetic, for sedex-type deposits. Studies of the tectonic, sedimentary, and fluid evolution of modern and ancient sedimentary basins have also been used to select defining criteria. The focus here is on the geologic characteristics of sedex deposit-hosting basins that contain greater than 10 million metric tons of zinc and lead. The enormous size of sedex deposits strongly suggests that basin-scale geologic processes are involved in their formation. It follows that mass balance constraints of basinal processes can provide a conceptual underpinning for the evaluation of potential ore-forming mechanisms and the identification of geologic indicators for ore potential in specific sedimentary basins. Empirical data and a genetic understanding of the physicochemical, geologic, and mass balance conditions required for each of these elements are used to establish a hierarchy of quantifiable geologic criteria that can be used in U.S. Geological Survey national assessments.  In addition, this report also provides a comprehensive evaluation of environmental considerations associated with the mining of sedex deposits.

  3. Exhaled nitric oxide in childhood asthma: a review.

    PubMed

    Pijnenburg, M W H; De Jongste, J C

    2008-02-01

    As an 'inflammometer', the fraction of nitric oxide in exhaled air (Fe(NO)) is increasingly used in the management of paediatric asthma. Fe(NO) provides us with valuable, additional information regarding the nature of underlying airway inflammation, and complements lung function testing and measurement of airway hyper-reactivity. This review focuses on clinical applications of Fe(NO) in paediatric asthma. First, Fe(NO) provides us with a practical tool to aid in the diagnosis of asthma and distinguish patients who will benefit from inhaled corticosteroids from those who will not. Second, Fe(NO) is helpful in predicting exacerbations, and predicting successful steroid reduction or withdrawal. In atopic asthmatic children Fe(NO) is beneficial in adjusting steroid doses, discerning those patients who require additional therapy from those whose medication dose could feasibly be reduced. In pre-school children Fe(NO) may be of help in the differential diagnosis of respiratory symptoms, and may potentially allow for better targeting and monitoring of anti-inflammatory treatment.

  4. Increased metal concentrations in exhaled breath condensate of industrial welders.

    PubMed

    Hoffmeyer, Frank; Weiss, Tobias; Lehnert, Martin; Pesch, Beate; Berresheim, Hans; Henry, Jana; Raulf-Heimsoth, Monika; Broding, Horst Christoph; Bünger, Jürgen; Harth, Volker; Brüning, Thomas

    2011-01-01

    It was the aim of this study to evaluate the effect of different devices on the metal concentration in exhaled breath condensate (EBC) and to prove whether working conditions in different welding companies result in diverse composition of metallic elements. The influence of two collection devices (ECoScreen, ECoScreen2) on detection of metallic elements in EBC was evaluated in 24 control subjects. Properties of ECoScreen and a frequent use can alter EBC metal content due to contamination from metallic components. ECoScreen2 turned out to be favourable for metal assessment. Concentrations of iron, nickel and chromium in EBC sampled with ECoScreen2 were compared between non-exposed controls and industrial welders. Metal concentrations in EBC were higher in 36 welders recruited from three companies. Exposure to welding fumes could be demonstrated predominantly for increased iron concentrations. Concentrations of iron and nickel differed by working conditions, but chromium could not be detected in EBC.

  5. Detection of pulmonary amylase activity in exhaled breath condensate.

    PubMed

    Zweifel, M; Rechsteiner, T; Hofer, M; Boehler, A

    2013-12-01

    Amylase activity in exhaled breath condensate (EBC) is usually interpreted as an indication of oropharyngeal contamination despite the fact that amylase can be found in pulmonary excretions. The aim of this study was to recruit and refine an amylase assay in order to detect amylase activity in any EBC sample and to develop a method to identify EBC samples containing amylase of pulmonary origin. EBC was collected from 40 volunteers with an EcoScreen condenser. Amylase assays and methods to discriminate between oropharyngeal and pulmonary proteins were tested and developed using matched EBC and saliva samples. Our refined 2-chloro-4-nitrophenyl-α-D-maltotriosid (CNP-G3) assay was 40-fold more sensitive than the most sensitive commercial assay and allowed detection of amylase activity in 30 µl of EBC. We developed a dot-blot assay which allowed detection of salivary protein in saliva diluted up to 150 000-fold. By plotting amylase activity against staining intensity we identified a few EBC samples with high amylase activity which were aligned with diluted saliva. We believe that EBC samples aligned with diluted saliva contain amylase activity introduced during EBC collection and that all other EBC samples contain amylase activity of pulmonary origin and are basically free of oropharyngeal protein contamination.

  6. Exhaled nitric oxide in patients with sleep apnea.

    PubMed

    Agustí, A G; Barbé, F; Togores, B

    1999-03-15

    Cardiovascular diseases are frequent in patients with obstructive sleep apnea syndrome (OSAS), but the mechanisms underlying this association are largely unknown. Nitric oxide (NO) is a key regulatory element of vascular physiology. The concentration of NO in the exhaled air ([NOexh]) appears to be reduced in patients with systemic and pulmonary hypertension. This study sought to investigate whether [NOexh] is abnormal in patients with OSAS, and to explore potential relationships between [NOexh] and the severity of OSAS. We measured [NOexh] in 24 patients with OSAS (apnea-hypopnea index (AHI), 55 +/- 4 hour-1) (x +/- SEM), and in 7 healthy volunteers in whom OSAS was excluded clinically. [NOexh] was measured on line by a chemiluminescence analyzer (Dasibi Environmental Corporation, Glendale, Calif). Seven patients with OSAS (29%) had a positive history of cardiovascular disease. Mean [NOexh] was 19.7 +/- 3.2 ppb in healthy subjects, and 22.2 +/- 3.0 ppb in patients with OSAS (p = ns). [Noexh] was not significantly different in those patients with or without cardiovascular disease. [NOexh] was not significantly related to the AHI, the body mass index, or the arterial O2 saturation at night. These results show that [NOexh] is not abnormal in patients with OSAS, and that it does not relate to the presence of cardiovascular disease or to any of various common indices of disease severity.

  7. Leukotrienes in exhaled breath condensate and fractional exhaled nitric oxide in workers exposed to TiO2 nanoparticles.

    PubMed

    Pelclova, Daniela; Zdimal, Vladimir; Kacer, Petr; Fenclova, Zdenka; Vlckova, Stepanka; Komarc, Martin; Navratil, Tomas; Schwarz, Jaroslav; Zikova, Nadezda; Makes, Otakar; Syslova, Kamila; Belacek, Jaroslav; Zakharov, Sergey

    2016-06-30

    Human health data regarding exposure to nanoparticles are extremely scarce and biomonitoring of exposure is lacking in spite of rodent pathological experimental data. Potential markers of the health-effects of engineered nanoparticles were examined in 30 workers exposed to TiO2 aerosol, 22 office employees of the same plant, and 45 unexposed controls. Leukotrienes (LT) B4, C4, E4, and D4 were analysed in the exhaled breath condensate (EBC) and urine via liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS). Fractional exhaled nitric oxide (FeNO) and spirometry was also measured. The median particle number concentration of the aerosol in the production ranged from 1.98  ×  10(4) to 2.32  ×  10(4) particles cm(-3); about 80% of the particles were  <100 nm in diameter. Median total mass concentration varied between 0.4 and 0.65 mg m(-3). All LT levels in workers' EBC were elevated relative to the controls (p  <  0.01). LTs in the EBC sample were correlated with titanium levels. Urinary LTs were not elevated in the workers and office employees. Office workers had higher LTB4 in EBC (p  <  0.05), and higher levels of FeNO (p  <  0.01). FeNO was higher in office employees with allergic diseases and was negatively correlated with smoking (p  <  0.01). In spirometry significant impairment in the workers was seen only for %VCIN and %PEF (both p  <  0.01). Multiple regression analysis confirmed a significant association between production of TiO2 and all cysteinyl LTs in EBC (p  <  0.01) and impaired %VCIN and %PEF (both p  <  0.01). LTB4 was also associated with smoking (p  <  0.01). LT levels complemented our earlier findings of DNA, protein, and lipid damage in the EBC of workers with nanoTiO2 exposures. Cysteinyl LTs in EBC analysis suggest inflammation and potential fibrotic changes in the lungs; they may be helpful for monitoring the biological

  8. Improvement of CT-based treatment-planning models of abdominal targets using static exhale imaging.

    PubMed

    Balter, J M; Lam, K L; McGinn, C J; Lawrence, T S; Ten Haken, R K

    1998-07-01

    CT-based models of the patient that do not account for the motion of ventilation may not accurately predict the shape and position of critical abdominal structures. Respiratory gating technology for imaging and treatment is not yet widely available. The purpose of the current study is to explore an intermediate step to improve the veracity of the patient model and reduce the treated volume by acquiring the CT data with the patients holding their breath at normal exhale. The ventilatory time courses of diaphragm movement for 15 patients (with no special breathing instructions) were measured using digitized movies from the fluoroscope during simulation. A subsequent clinical protocol was developed for treatment based on exhale CT models. CT scans (typically 3.5-mm slice thickness) were acquired at normal exhale using a spiral scanner. The scan volume was divided into two to three segments, to allow the patient to breathe in between. Margins were placed about intrahepatic target volumes based on the ventilatory excursion inferior to the target, and on only the reproducibility of exhale position superior to the target. The average patient's diaphragm remained within 25% of the range of ventilatory excursion from the average exhale position for 42% of the typical breathing cycle, and within 25% of the range from the average inhale position for 15% of the cycle. The reproducibility of exhale position over multiple breathing cycles was 0.9 mm (2sigma), as opposed to 2.6 mm for inhale. Combining the variation of exhale position and the uncertainty in diaphragm position from CT slices led to typical margins of 10 mm superior to the target, and 19 mm inferior to the target, compared to margins of 19 mm in both directions under our prior protocol of margins based on free-breathing CT studies. For a typical intrahepatic target, these smaller volumes resulted in a 3.6% reduction in Veff for the liver. Analysis of portal films shows proper target coverage for patients treated

  9. 8-isoprostane in exhaled breath condensate after experimental exposure to wood smoke in humans.

    PubMed

    Murgia, N; Barregard, L; Sallsten, G; Almstrand, A C; Montuschi, P; Ciabattoni, G; Olin, A C

    2016-01-01

    Wood smoke, a well-known indoor and outdoor air pollutant, may cause adverse health effects through oxidative stress. In this study 8-isoprostane, a biomarker of oxidative stress, was measured in exhaled breath condensate (EBC) and urine before and after experimental exposure to wood smoke. The results were compared with measurements of other biomarkers of oxidative stress and inflammation. Thirteen subjects were exposed first to clean air and then, after 1 week, to wood smoke in an exposure chamber during 4-hour sessions. Exhaled breath condensate, exhaled nitric oxide, blood and urine were sampled before and at various intervals after exposure to wood smoke and clean air. Exhaled breath condensate was examined for 8-isoprostane and malondialdehyde (MDA), while exhaled air was examined for nitric oxide, serum for Clara cell protein (CC16) and urine for 8-isoprostane. 8-isoprostane in EBC did not increase after wood smoke exposure and its net change immediately after exposure was inversely correlated with net changes in MDA (r(s)= -0.57, p= 0.041) and serum CC16 (S-CC16) (r(p)= -0.64, p= 0.020) immediately after the exposure. No correlation was found between 8-isoprostane in urine and 8-isoprostane in EBC. In this study controlled wood smoke exposure in healthy subjects did not increase 8-isoprostane in EBC.

  10. Hydrogen peroxide in exhaled air: a source of error, a paradox and its resolution.

    PubMed

    Peters, Stefan; Kronseder, Angelika; Karrasch, Stefan; Neff, Petra A; Haaks, Matz; Koczulla, Andreas R; Reinhold, Petra; Nowak, Dennis; Jörres, Rudolf A

    2016-04-01

    The concentration of hydrogen peroxide (H2O2) in exhaled air has been reported to be elevated in asthma and chronic obstructive pulmonary disease (COPD), but results are inconsistent and difficult to reproduce. As H2O2 occurs in ambient air, we examined its association with exhaled H2O2 in human subjects. Exhaled breath condensate (EBC) of 12 COPD patients and nine healthy control subjects was collected either with an inhalation filter (efficiency 81%) or without. Ambient air condensate (AAC) was collected in parallel and samples were analysed for H2O2. Additionally, ambient H2O2 was recorded by an atmospheric measuring device (online fluorometric measurement). H2O2 concentration in AAC was significantly higher (p<0.001) than in EBC. AAC variations were concordant with the data from the atmospheric measuring instrument. In both subjects' groups, the inhalation filter reduced H2O2 values (p<0.01). Despite generally low levels in exhaled air, analysis by a mathematical model revealed a contribution from endogenous H2O2 production. The low H2O2 levels in exhaled air are explained by the reconditioning of H2O2-containing inhaled air in the airways. Inhaled H2O2 may be one factor in the heterogeneity and limited reproducibility of study results. A valid determination of endogenous H2O2 production requires inhalation filters.

  11. Diagnostic Chemical Analysis of Exhaled Human Breath Using a Novel Sub-Millimeter Spectroscopic Approach

    NASA Astrophysics Data System (ADS)

    Fosnight, Alyssa M.; Moran, Benjamin L.; Branco, Daniela R.; Thomas, Jessica R.; Medvedev, Ivan R.

    2013-06-01

    As many as 3000 chemicals are reported to be found in exhaled human breath. Many of these chemicals are linked to certain health conditions and environmental exposures. Present state of the art techniques used for analysis of exhaled human breath include mass spectrometry based methods, infrared spectroscopic sensors, electro chemical sensors and semiconductor oxide based testers. Some of these techniques are commercially available but are somewhat limited in their specificity and exhibit fairly high probability of false alarm. Here, we present the results of our most recent study which demonstrated a novel application of a terahertz high resolutions spectroscopic technique to the analysis of exhaled human breath, focused on detection of ethanol in the exhaled breath of a person which consumed an alcoholic drink. This technique possesses nearly ``absolute'' specificity and we demonstrated its ability to uniquely identify ethanol, methanol, and acetone in human breath. This project is now complete and we are looking to extend this method of chemical analysis of exhaled human breath to a broader range of chemicals in an attempt to demonstrate its potential for biomedical diagnostic purposes.

  12. Detection of Lung Cancer with Volatile Organic Biomarkers in Exhaled Breath and Lung Cancer Cells

    NASA Astrophysics Data System (ADS)

    Yu, Jin; Wang, Di; Wang, Le; Wang, Ping; Hu, Yanjie; Ying, Kejing

    2009-05-01

    In patients with lung cancer, volatile organic compounds (VOCs) are excreted in exhaled breath. In this article, exhaled breath of 30 lung cancer paitients and 30 healthy people were collected, preconcentrated by solid-microextraction(SPME) and analyzed with gas chrom-atography and mass spectrometry (GC/MS). A predictive model composed of 5 VOCs out of 16 candidate VOCs detected in the lung cancer patients is constructed by discriminant analysis, with a sensitivity of 76.7% and specificity of 96.7%. We detected exhaled VOCs of 3 different lung cancer cell lines and human bronchial epithelial cell lines. 2-Tridicanone is considered the distinctive marker of lung cancer cells, which is found in lung cancer patients' exhaled breath as well. Compared to healthy people, patients with lung cancer had distinctive VOCs in their exhaled breath. The predictive model can work as diagnosis reference for lung cancer. VOCs found in lung cancer cell line help the cognition of the mechasim VOCs generating in lung cancer patients.

  13. Exhaled nasal nitric oxide output is reduced in humans at night during the sleep period.

    PubMed

    O'Hearn, Daniel J; Giraud, George D; Sippel, Jeffrey M; Edwards, Chad; Chan, Benjamin; Holden, William E

    2007-04-16

    The physiologic function of nasal nitric oxide (NO) release is unknown. In prior experiments, topical NG-nitro-L-arginine methyl ester (L-NAME) on nasal mucosa reduced exhaled nasal NO output and caused daytime sleepiness. We hypothesized that nasal NO output is reduced at night during the sleep period. We measured exhaled nasal NO concentration and minute ventilation and calculated nasal NO output in humans over 24 h. Daytime awake NO output was greater than NO output at night during sleep or transient wakefulness. Exhaled NO concentration decreased during sleep along with minute ventilation. A daytime voluntary reduction in minute ventilation also decreased nasal NO output but exhaled NO concentration increased. Nasal NO output was not changed by body position. We conclude that exhaled nasal NO output is decreased at night due to decreased mass flow of NO into nasal air in addition to decreased minute ventilation. Our findings suggest a role of nasal NO in sleep or in the physiologic processes accompanying sleep.

  14. Use of exhaled air as an improved biomonitoring method to assess perchloroethylene short-term exposure.

    PubMed

    Dias, Cláudia M; Menezes, Helvécio C; Cardeal, Zenilda L

    2017-03-22

    This paper shows the use of exhaled air as a biomonitoring method to assess perchloroethylene (PERC) environmental and occupational exposure. A sensitive, fast, and solvent free analytical method was developed to determine PERC in ambient and exhaled air of individuals occupationally exposed. The developed method used cold fiber solid phase microextraction (CF-SPME) as the sampling technique, and a standard permeation method to simulation of air matrix. The analysis were conducted by gas chromatography coupled to mass spectrometry (GC/MS). The methods were validated and were found to be precise, linear and sensitive for environmental and biological monitoring. The developed methods were applied to twenty-seven sampling points spread across Belo Horizonte city, Brazil, twenty four dry cleaners, an electroplating industry, a research laboratory, and an automotive paint preparation shop. The results of ambient air analyses ranging from 14.0 to 3205.0µgm(-3) with median concentration of 599.0µgm(-3). Furthermore, sampling of exhaled air of individuals occupationally exposed presented results ranging from 6.0 to 2635.0µgm(-3) with median concentration of 325.0µgm(-3). The strong correlation observed between ambient and exhaled air (r =0.930) demonstrates that exhaled air is a suitable biomarker for evaluating occupational exposure to PERC.

  15. Hydrogen peroxide in exhaled air: a source of error, a paradox and its resolution

    PubMed Central

    Peters, Stefan; Kronseder, Angelika; Karrasch, Stefan; Neff, Petra A.; Haaks, Matz; Koczulla, Andreas R.; Reinhold, Petra; Nowak, Dennis

    2016-01-01

    The concentration of hydrogen peroxide (H2O2) in exhaled air has been reported to be elevated in asthma and chronic obstructive pulmonary disease (COPD), but results are inconsistent and difficult to reproduce. As H2O2 occurs in ambient air, we examined its association with exhaled H2O2 in human subjects. Exhaled breath condensate (EBC) of 12 COPD patients and nine healthy control subjects was collected either with an inhalation filter (efficiency 81%) or without. Ambient air condensate (AAC) was collected in parallel and samples were analysed for H2O2. Additionally, ambient H2O2 was recorded by an atmospheric measuring device (online fluorometric measurement). H2O2 concentration in AAC was significantly higher (p<0.001) than in EBC. AAC variations were concordant with the data from the atmospheric measuring instrument. In both subjects' groups, the inhalation filter reduced H2O2 values (p<0.01). Despite generally low levels in exhaled air, analysis by a mathematical model revealed a contribution from endogenous H2O2 production. The low H2O2 levels in exhaled air are explained by the reconditioning of H2O2-containing inhaled air in the airways. Inhaled H2O2 may be one factor in the heterogeneity and limited reproducibility of study results. A valid determination of endogenous H2O2 production requires inhalation filters. PMID:27730191

  16. Comparison of active and passive methods for radon exhalation from a high-exposure building material.

    PubMed

    Abbasi, A; Mirekhtiary, F

    2013-12-01

    The radon exhalation rates and radon concentrations in granite stones used in Iran were measured by means of a high-resolution high purity Germanium gamma-spectroscopy system (passive method) and an AlphaGUARD model PQ 2000 (active method). For standard rooms (4.0 × 5.0 m area × 2.8 height) where ground and walls have been covered by granite stones, the radon concentration and the radon exhalation rate by two methods were calculated. The activity concentrations of (226)Ra in the selected granite samples ranged from 3.8 to 94.2 Bq kg(-1). The radon exhalation rate from the calculation of the (226)Ra activity concentration was obtained. The radon exhalation rates were 1.31-7.86 Bq m(-2)h(-1). The direction measurements using an AlphaGUARD were from 218 to 1306 Bq m(-3) with a mean of 625 Bq m(-3). Also, the exhalation rates measured by the passive and active methods were compared and the results of this study were the same, with the active method being 22 % higher than the passive method.

  17. Influence of environmental concentrations of NO on the exhaled NO test.

    PubMed

    Piacentini, G L; Bodini, A; Vino, L; Zanolla, L; Costella, S; Vicentini, L; Boner, A L

    1998-10-01

    Measurement of levels of exhaled nitric oxide (NO) has been proposed as a noninvasive method for evaluating the degree of airway inflammation in asthmatic patients. Some concern in the interpretation of results of such measurement may arise from possible interference by high environmental concentrations of NO inhaled by these patients. The aim of this study was to verify whether environmental concentrations of NO in the range from 0 to 150 ppb can influence levels of exhaled NO. We tested two groups of subjects. The first group, consisting of 16 subjects, was tested when environmental levels of NO were from 0 to 3 ppb and from 20 to 60 ppb, and exhaled NO mean ppb (+/- SEM) levels were 9.81 +/- 1.43 and 9.78 +/- 1.47 (p = ns) (mean +/- SEM), respectively. The second group, consisting of 30 subjects, was tested at ambient NO concentrations of 0 to 3 ppm, 80 to 100 ppm, and 120 to 150 ppb, and for 18 of these subjects who underwent testing under all three conditions investigated, the mean levels of exhaled NO were 9.23 +/- 1.51, 7.78 +/- 1.19, and 9.33 +/- 1.55 ppb (p = ns), respectively. The results of this study suggest that significantly different ambient levels of NO have no effect on levels of exhaled NO.

  18. A Meta-Analysis of Exhaled Nitric Oxide in Acute Normobaric Hypoxia.

    PubMed

    MacInnis, Martin J; Carter, Eric A; Donnelly, Joseph; Koehle, Michael S

    2015-08-01

    The effect of hypoxia on the exhaled nitric oxide (NO) of humans is unresolved. Many studies have measured the fraction of exhaled NO (FENO) or the partial pressure of exhaled NO (PENO) in normobaric and hypobaric hypoxia, with differing results. To better understand NO physiology and altitude acclimatization, we employed a random effects meta-analysis to determine the effect of acute normobaric hypoxia on the PENO of humans. A total of 93 subjects from 7 published studies (with 9 groups) were included. The median duration of exposure was 30 min and the mean hypoxic PIo2 was 95 (SD=10) mmHg. The weighted standardized mean difference (SMD) in PENO measured at baseline and during an acute exposure to normobaric hypoxia was not significantly different from zero (SMD=0.09; 95% CI=-0.17, 0.34; z=0.65). Based on this meta-analysis, acute normobaric hypoxia does not affect the PENO measured from the mouths of humans. This result should be considered for interpretations of high-altitude (and hypobaric) measurements of exhaled NO. As the PENO is a potential biomarker for altitude-illness susceptibility, recognizing that normobaric hypoxia does not affect the PENO will be important for understanding previous associations between low exhaled NO and poor acclimatization to hypoxia.

  19. Effects of Ginkgo biloba on exhaled nasal nitric oxide during normobaric hypoxia in humans.

    PubMed

    Jowers, Casey; Shih, Richard; James, Jim; Deloughery, Thomas G; Holden, William E

    2004-01-01

    Ginkgo biloba, an extract of the ginkgo tree, may prevent or lessen symptoms of acute mountain sickness in humans. The mechanism of this effect is poorly understood. One hypothesis is that ginkgo alters nitric oxide (NO) metabolism, possibly by scavenging NO or altering nitric oxide synthase expression and thereby lessening the vasodilatory effects of NO. To date, an effect of Ginkgo biloba on NO metabolism has not been demonstrated in humans. We measured exhaled nasal NO output in humans (n = 9) during normoxia and then during acute normobaric hypoxia (goal oxyhemoglobin saturation 75% to 85%) before and after administration of a standardized extract of Ginkgo biloba (120 mg twice daily for 5 days). Oxygen saturation, heart rate, and minute ventilation were similar before and after Ginkgo biloba administration. Exhaled nasal NO output was increased during normoxia following ginkgo (p < 0.02) and reduced during normobaric hypoxia both before (p < 0.02) and following (p < 0.003) ginkgo. Exhaled nasal NO output during normobaric hypoxia was lowest following ginkgo (p < 0.003). We conclude that Ginkgo biloba increases exhaled nasal NO output during normoxia and enhances reduced exhaled nasal NO output during normobaric hypoxia. Our results suggest that Ginkgo biloba may act to reduce AMS through an effect on NO metabolism.

  20. The Effect of Grain Size on Radon Exhalation Rate in Natural-dust and Stone-dust Samples

    NASA Astrophysics Data System (ADS)

    Kumari, Raj; Kant, Krishan; Garg, Maneesha

    Radiation dose to human population due to inhalation of radon and its progeny contributes more than 50% of the total dose from the natural sources which is the second leading cause of lung cancer after smoking. In the present work the dependence of radon exhalation rate on the physical sample parameters of stone dust and natural dust were studied. The samples under study were first crushed, grinded, dried and then passed through sieves with different pore sizes to get samples of various grain sizes (μm). The average value of radon mass exhalation rate is 5.95±2.7 mBqkg-1hr-1 and average value of radon surface exhalation rate is 286±36 mBqm-2 hr-1 for stone dust, and the average value of radon mass exhalation rate is 9.02±5.37 mBqkg-1hr-1 and average value of radon surface exhalation rate is 360±67 mBqm-2 hr-1 for natural dust. The exhalation rate was found to increase with the increase in grain size of the sample. The obtained values of radon exhalation rate for all the samples are found to be under the radon exhalation rate limit reported worldwide.

  1. Airway drug pharmacokinetics via analysis of exhaled breath condensate.

    PubMed

    Esther, Charles R; Boucher, Richard C; Johnson, M Ross; Ansede, John H; Donn, Karl H; O'Riordan, Thomas G; Ghio, Andrew J; Hirsh, Andrew J

    2014-02-01

    Although the airway surface is the anatomic target for many lung disease therapies, measuring drug concentrations and activities on these surfaces poses considerable challenges. We tested whether mass spectrometric analysis of exhaled breath condensate (EBC) could be utilized to non-invasively measure airway drug pharmacokinetics and predicted pharmacological activities. Mass spectrometric methods were developed to detect a novel epithelial sodium channel blocker (GS-9411/P-680), two metabolites, a chemically related internal standard, plus naturally occurring solutes including urea as a dilution marker. These methods were then applied to EBC and serum collected from four (Floridian) sheep before, during and after inhalation of nebulized GS-9411/P-680. Electrolyte content of EBC and serum was also assessed as a potential pharmacodynamic marker of drug activity. Airway surface concentrations of drug, metabolites, and electrolytes were calculated from EBC measures using EBC:serum urea based dilution factors. GS-9411/P-680 and its metabolites were quantifiable in the sheep EBC, with peak airway concentrations between 1.9 and 3.4 μM measured 1 h after inhalation. In serum, only Metabolite #1 was quantifiable, with peak concentrations ∼60-fold lower than those in the airway (45 nM at 1 h). EBC electrolyte concentrations suggested a pharmacological effect; but this effect was not statistical significant. Analysis of EBC collected during an inhalation drug study provided a method for quantification of airway drug and metabolites via mass spectrometry. Application of this methodology could provide an important tool in development and testing of drugs for airways diseases. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. [Exhaled nitric oxide levels in school children of Beijing].

    PubMed

    Li, Shuo; Lou, Xiao-shang; Ma, Yu; Han, Sheng-li; Liu, Chuan-he; Chen, Yu-zhi

    2010-02-01

    To learn the normal values of exhaled nitric oxide (eNO) in children. School children in Beijing from 11 to 18 years of age were included in the study. All the students were assigned into two groups: normal group and abnormal group (with allergic disease) according to the International Study of Asthma and Allergy in Childhood questionnaires. eNO, peak expiratory flow rate and sensitization were measured. Totally 395 students were screened out as normal subject (male: 177, female: 218). The eNO level was not significantly different between genders (P > 0.05), but was associated positively with age in both male and female group (P = 0.008 and P = 0.05 respectively) and associated with height in male students (P = 0.02). The geometric mean value of eNO was 11.22 ppb (parts per billion, ppb = 10(9)) in children aged from 11 to 14 years and 14.13 ppb in children aged from 14 to 18 years, with 95% confidence interval 4.17 - 30.20, 5.50 - 36.31 ppb. The eNO level was significantly increased in children who "ever had asthma or wheezing" (n = 68), and children who "ever had rhinitis" (n = 96) compared with normal subjects (P = 0.001 and P = 0.008). The geometric mean value of eNO was 16.98 ppb in children with positive skin prick test and was significantly increased as compared with children with negative skin prick test with eNO level at 11.75 ppb (P = 0.001). eNO level varied between 10.72 ppb and 13.80 ppb in normal children 11 - 18 years of age, and was positively associated with age and height, but not with gender. eNO level increased significantly in children with wheezing and atopy.

  3. Natural radioactivity and radon exhalation rate in Brazilian igneous rocks.

    PubMed

    Moura, C L; Artur, A C; Bonotto, D M; Guedes, S; Martinelli, C D

    2011-07-01

    This paper reports the natural radioactivity of Brazilian igneous rocks that are used as dimension stones, following the trend of other studies on the evaluation of the risks to the human health caused by the rocks radioactivity as a consequence of their use as cover indoors. Gamma-ray spectrometry has been utilized to determine the (40)K, (226)Ra and (232)Th activity concentrations in 14 rock types collected at different quarries. The following activity concentration range was found: 12.18-251.90 Bq/kg for (226)Ra, 9.55-347.47 Bq/kg for (232)Th and 407.5-1615.0 Bq/kg for (40)K. Such data were used to estimate Ra(eq), H(ex) and I(γ), which were compared with the threshold limit values recommended in literature. They have been exceeded for Ra(eq) and H(ex) in five samples, where the highest indices corresponded to a rock that suffered a process of ductile-brittle deformation that caused it a microbrecciated shape. The exhalation rate of Rn and daughters has also been determined in slabs consisting of rock pieces ~10 cm-long, 5 cm-wide and 3 cm-thick. It ranged from 0.24 to 3.93 Bq/m(2)/h and exhibited significant correlation with eU (=(226)Ra), as expected. The results indicated that most of the studied rocks did not present risk to human health and may be used indoors, even with low ventilation. On the other hand, igneous rocks that yielded indices above the threshold limit values recommended in literature may be used outdoors without any restriction or indoors with ample ventilation.

  4. Exhaled carbon monoxide in asthmatics: a meta-analysis

    PubMed Central

    2010-01-01

    Background The non-invasive assessment of airway inflammation is potentially advantageous in asthma management. Exhaled carbon monoxide (eCO) measurement is cheap and has been proposed to reflect airway inflammation and oxidative stress but current data are conflicting. The purpose of this meta-analysis is to determine whether eCO is elevated in asthmatics, is regulated by steroid treatment and reflects disease severity and control. Methods A systematic search for English language articles published between 1997 and 2009 was performed using Medline, Embase and Cochrane databases. Observational studies comparing eCO in non-smoking asthmatics and healthy subjects or asthmatics before and after steroid treatment were included. Data were independently extracted by two investigators and analyzed to generate weighted mean differences using either a fixed or random effects meta-analysis depending upon the degree of heterogeneity. Results 18 studies were included in the meta-analysis. The eCO level was significantly higher in asthmatics as compared to healthy subjects and in intermittent asthma as compared to persistent asthma. However, eCO could not distinguish between steroid-treated asthmatics and steroid-free patients nor separate controlled and partly-controlled asthma from uncontrolled asthma in cross-sectional studies. In contrast, eCO was significantly reduced following a course of corticosteroid treatment. Conclusions eCO is elevated in asthmatics but levels only partially reflect disease severity and control. eCO might be a potentially useful non-invasive biomarker of airway inflammation and oxidative stress in nonsmoking asthmatics. PMID:20433745

  5. Elevated exhaled nitric oxide in anaphylaxis with respiratory symptoms.

    PubMed

    Nakamura, Yoichi; Hashiba, Yoko; Endo, Jyunji; Furuie, Masashi; Isozaki, Atsushi; Yagi, Kei-ichi

    2015-10-01

    Anaphylaxis is a serious type I allergic reaction that occurs suddenly and can result in death, but it is sometimes difficult to differentiate from other diseases, and physicians must rely on symptoms alone for its diagnosis. Meanwhile, fractional exhaled nitric oxide (FeNO) concentration, used in assessing airway inflammation in bronchial asthma, is known to be affected by atopic disposition. The possible role of FeNO measurements was evaluated in patients with anaphylaxis. FeNO was measured in 52 adult patients (17-78 years old, median age 41.5 years) in whom anaphylaxis occurred. These measurements were made within 24 h after onset and after about one month when the patients were symptom-free. In some of these patients, FeNO was measured a third time, two months or more after onset. The FeNO level in the 52 patients was not significantly different in measurement made within 24 h of onset of anaphylaxis and after one month. However, excluding 9 patients who also had asthma history, the FeNO level in the remaining 43 patients decreased significantly from within 24 h of onset (36.7 ± 27.5 ppb) to one month later (28.8 ± 19.5 ppb). Of these 43 patients, this phenomenon was evident in a group that had respiratory symptoms (31 patients), but it was not seen in a group that did not have respiratory symptoms (12 patients). Elevation of FeNO was related to respiratory symptoms observed in anaphylactic patients without asthma. Although the mechanism of increased FeNO level is unclear, its usefulness for diagnosis of anaphylaxis must be examined in prospective studies. Copyright © 2015 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  6. Methodological aspects of exhaled nitric oxide measurements in infants.

    PubMed

    Gabriele, Carmelo; van der Wiel, Els C; Nieuwhof, Eveline M; Moll, Henriette A; Merkus, Peter J F M; de Jongste, Johan C

    2007-02-01

    Guidelines for the measurement of fractional exhaled nitric oxide (FE(NO)) recommend refraining from lung function tests (LFT) and certain foods and beverages before performing FE(NO) measurements, as they may lead to transiently altered FE(NO) levels. Little is known of such factors in infants. The aim of the present study was to evaluate whether forced expiratory maneuvers, sedation, nasal contamination, and breastfeeding affect FE(NO) values in infants. FE(NO) was measured off-line during tidal breathing by means of a facemask covering nose and mouth. FE(NO) measurements were performed in 45 sedated infants (mean age 12.1 months) who underwent LFT because of airway diseases and in 83 unsedated healthy infants (mean age 4.3 months). In infants with airway diseases, no difference was found in FE(NO) values before and 5 min after LFT (n = 19 infants, p = 0.7) and FE(NO) values before sedation did not differ from FE(NO) values during sedation (n = 10 infants, p = 0.2). Oral FE(NO) values were significantly lower than mixed (nasal + oral) FE(NO) (n = 42 infants, p < 0.001). FE(NO) values before and 5 min after breastfeeding were not different (n = 11 healthy infants, p = 0.57). The short-term reproducibility in healthy infants (n = 54) was satisfactory (intraclass correlation coefficient = 0.94). We conclude that, in infants with airway diseases, LFT prior to FE(NO) measurement did not influence FE(NO) values and FE(NO) values did not change after sedation. Oral FE(NO) values were significantly lower than mixed (oral + nasal) FE(NO), and breastfeeding did not influence FE(NO). Short-term reproducibility in awake healthy infants was good.

  7. Nasal and exhaled nitric oxide in chronic rhinosinusitis with polyps.

    PubMed

    Jeong, Jin Hyeok; Yoo, Han Seok; Lee, Seung Hwan; Kim, Kyung Rae; Yoon, Ho Joo; Kim, Sang Heon

    2014-01-01

    The ciliary epithelial cells in the paranasal sinuses produce nasal nitric oxide (NO) continuously and plays a variety of roles in the paranasal sinuses. The purpose of this study was to assess whether we can use the levels of nasal NO (nNO) and exhaled NO (eNO) as a tool for evaluation in chronic rhinosinusitis (CRS) with nasal polyp patients. We used chemiluminescent NO analyzer to measure nNO and eNO among normal controls (32) and CRS with polyp (30) and CRS with polyp and allergic rhinitis patients (27) and compared it with various clinical symptoms, laboratory data, and computed tomography (CT) scores. Levels of nNO were significantly lower in patients with CRS with polyps (88.5 ± 54.7 ppb) compared with controls (241.0 ± 89.5 ppb). Levels of nNO in CRS with polyps and allergic rhinitis (167.0 ± 47.6 ppb) were significantly higher than CRS with polyps and lower than controls. A significant inverse relationship was observed between nNO and sinus CT scores, severity of nasal obstruction, and purulent rhinorrhea in CRS with polyps. Low values of nNO separated well patients with CRS with polyps, and the cutoff value of <163 ppb was associated with the best combination of specificity (93%) and sensitivity (81%). A significant positive relationship was observed between eNO and CT scores. The nNO could be used for another screening of CRS with polyps for the more severe phenotypes, which may eventually have to be treated with surgery.

  8. Spirometry filters can be used to detect exhaled respiratory viruses.

    PubMed

    Mitchell, Alicia B; Mourad, Bassel; Tovey, Euan; Buddle, Lachlan; Peters, Matthew; Morgan, Lucy; Oliver, Brian G

    2016-09-26

    Respiratory viruses are very common in the community and contribute to the burden of illness for patients with chronic respiratory diseases, including acute exacerbations. Traditional sampling methods are invasive and problematic to repeat. Accordingly, we explored whether respiratory viruses could be isolated from disposable spirometry filters and whether detection of viruses in this context represented presence in the upper or lower respiratory tract. Discovery (n  =  53) and validation (n  =  49) cohorts were recruited from a hospital outpatient department during two different time periods. Spirometry mouthpiece filters were collected from all participants. Respiratory secretions were sampled from the upper and lower respiratory tract by nasal washing (NW), sputum, and bronchoalveolar lavage (BAL). All samples were examined using RT-PCR to identify a panel of respiratory viruses (rhinovirus, respiratory syncytial virus, influenza A, influenza B, parainfluenza virus 1, 2 & 3, and human metapneumovirus). Rhinovirus was quantified using qPCR. Paired filter-NW samples (n  =  29), filter-sputum samples (n  =  24), filter-BAL samples (n  =  39) and filter-NW-BAL samples (n  =  10) provided a range of comparisons. At least one virus was detected in any sample in 85% of participants in the discovery cohort versus 45% in the validation cohort. Overall, 72% of viruses identified in the paired comparator method matched those detected in spirometry filters. There was a high correlation between viruses identified in spirometry filters compared with viruses identified in both the upper and lower respiratory tract using traditional sampling methods. Our results suggest that examination of spirometry filters may be a novel and inexpensive sampling method for the presence of respiratory viruses in exhaled breath.

  9. Determinants of exhaled nitric oxide in chronic rhinosinusitis.

    PubMed

    Guida, Giuseppe; Rolla, Giovanni; Badiu, Iuliana; Marsico, Pietro; Pizzimenti, Stefano; Bommarito, Luisa; De Stefani, Antonella; Usai, Antonio; Bugiani, Massimiliano; Malinovschi, Andrei; Bucca, Caterina; Heffler, Enrico

    2010-03-01

    Chronic rhinosinusitis (CRS) has been reported to be associated with increased values of exhaled nitric oxide (ENO), which could not be entirely explained by the association between CRS and asthma. The aim of this study was to investigate the variables associated with increased ENO in patients with CRS. This was a prospective cross-sectional descriptive study of 93 consecutive patients with CRS. The effect on ENO of age, gender, atopy, asthma, respiratory symptoms without bronchial hyperresponsiveness (BHR), and nasal polyps was evaluated by multiple regression analysis. Nasal polyps (P = .01), asthma (P < .001), and respiratory symptoms without BHR (P = .01) were the only independent variables associated with increased ENO. The prevalence of asthma was significantly higher in subjects with nasal polyps (61% vs 29.4%), P = .005, whereas the prevalence of respiratory symptoms without BHR was higher in those without nasal polyps (44.1% vs 15.3%, P = .003). Respiratory symptoms without BHR were associated with significantly higher ENO and prevalence of sputum eosinophilia (eosinophils > 3%) in patients with nasal polyps compared with those without nasal polyps (68.2 vs 24.0 ppb, P = .001; 60% vs 8.3%, P = .03, respectively). The presence of nasal polyps in patients with CRS was associated with increased asthma prevalence as well as increased ENO levels. Respiratory symptoms without BHR were associated with eosinophilic airway inflammation and increased ENO only in patients with nasal polyps. These findings suggest important clinical and biologic differences between the two types of CRS, with and without nasal polyps.

  10. Exhaled breath condensate pH in mechanically ventilated patients.

    PubMed

    Nannini, L J; Quintana, R; Bagilet, D H; Druetta, M; Ramírez, M; Nieto, R; Guelman Greta, G

    2013-12-01

    In this prospective clinical trial we aimed to answer if spontaneous exhaled breath condensate (EBC) in the trap of the expiratory arm of the ventilator could replace EBC collected by coolant chamber standardized with Argon as an inert gas. Second, if EBC pH could predict ventilator associated pneumonia (VAP) and mortality. We included 34 critically ill patients (males = 26), aged = 54.85 ± 19.86 (mean ± SD) yrs, that required mechanical ventilation due to non-pulmonary direct cause (APACHE II score = 23.58 ± 14.7; PaO(2)/FiO(2) = 240.00 ± 98.29). ICU with 9 beds from a regional teaching hospital. The patients were followed up until development of VAP, successful weaning or death. There were significant differences between mean EBC pH from the 4 procedures with the exception of spontaneous EBC de-aerated with Argon (n = 79; 6.74 ± 0.28) and coolant chamber deaerated with Argon (n = 79; 6.70 ± 0.36; p = NS by Tukey's Multiple Comparison Test). However, none of the procedures were extrapolated between each other according to Bland & Altman method. The mean EBC pH from the trap without Argon was 6.50 ± 0.28. From the total of 34 patients, 22 survived and were discharged and 12 patients died in the ICU. Spontaneous EBC pH could not be extrapolated to EBC pH from coolant chamber and it did not change in subjects who dead, neither subject with VAP in comparison with baseline data. The lack of other biomarker in EBC and the lack of a control group determinate the need for further studies in this setting. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  11. Complementary system for long term measurements of radon exhalation rate from soil

    SciTech Connect

    Mazur, J.; Kozak, K.

    2014-02-15

    A special set-up for continuous measurements of radon exhalation rate from soil is presented. It was constructed at Laboratory of Radiometric Expertise, Institute of Nuclear Physics Polish Academy of Sciences (IFJ PAN), Krakow, Poland. Radon exhalation rate was determined using the AlphaGUARD PQ2000 PRO (Genitron) radon monitor together with a special accumulation container which was put on the soil surface during the measurement. A special automatic device was built and used to raise and lower back onto the ground the accumulation container. The time of raising and putting down the container was controlled by an electronic timer. This set-up made it possible to perform 4–6 automatic measurements a day. Besides, some additional soil and meteorological parameters were continuously monitored. In this way, the diurnal and seasonal variability of radon exhalation rate from soil can be studied as well as its dependence on soil properties and meteorological conditions.

  12. A breath sampling system assessing the influence of respiratory rate on exhaled breath composition.

    PubMed

    Lomonaco, T; Salvo, P; Ghimenti, S; Biagini, D; Bellagambi, F; Fuoco, R; Di Francesco, F

    2015-01-01

    This work presents a computerized system to monitor mouth pressure, tidal volume, exhaled airflow, respiration rate and end-tidal partial pressure of CO2 during breath collection. The system was used to investigate the effect of different respiratory rates on the volatile organic compounds (VOCs) concentrations in exhaled breath. For this purpose, VOCs with well-defined biochemical pathways and different chemical and physical properties were selected as biomarkers related to metabolism (acetone and isopropyl alcohol), cholesterol synthesis (isoprene) and intestinal microflora activity (ethanol). Mixed breath was collected from a nominally healthy volunteer in resting conditions by filling a Nalophan bag. The subject followed a regimented breathing pattern at different respiratory rates (10, 30 and 50 breaths per minute). Results highlight that ventilation pattern strongly influences the concentration of the selected compounds. The proposed system allows exhaled breath to be collected also in patients showing dyspnea such as in case of chronic heart failure, asthma and pulmonary diseases.

  13. Application of thermal desorption to the biological monitoring of organic compounds in exhaled breath.

    PubMed

    Periago, J F; Prado, C; Ibarra, I; Tortosa, J

    1993-12-24

    We have developed a thermal desorption-gas chromatographic method for the analysis of organic compounds in exhaled breath air, to be used in the biological monitoring of environmental exposure. The exhaled breath sampler is based on the concentration of compounds present in alveolar air in a solid sorbent material. Isoflurane (1-chloro-2,2,2-trifluoroethyl-difluoromethyl-ether), an inhaled anaesthetic used widely in surgery, and styrene, used in boat construction and the manufacture of fibreglass-reinforced plastics, are partially eliminated from the body in exhaled breath, samples of which can therefore be used to monitor biological exposure to these two organic compounds. Recoveries were tested in controlled atmospheres of isoflurane or styrene, with Chromosorb 106 or Tenax, respectively, as the adsorbent. We also investigated the influence of relative humidity, an important factor in breath sampling, on adsorption.

  14. Radon exhalation from sub-slab aggregate used in home construction in Canada.

    PubMed

    Bergman, Lauren; Lee, Jaeyoung; Sadi, Baki; Chen, Jing

    2015-06-01

    Exposure to elevated levels of radon in homes has been shown to result in an increased risk of developing lung cancer. The two largest contributors to indoor radon are radon in soil gas, formed from the rocks and soil surrounding the home, and building materials such as aggregate. This study measured the surface radon exhalation rates for 35 aggregate samples collected from producers across Canada. The radon exhalation rates ranged from 2.3 to 479.9 Bq m(-2) d(-1), with a mean of 80.7±112 Bq m(-2) d(-1). Using a simple, conservative analysis, the aggregate contribution to radon concentrations in an unfinished basement was determined. The maximum estimated radon concentration was 32.5±2.7 Bq m(-3), or ~16 % of the Canadian Radon Guideline. It can be concluded that under normal conditions radon exhalation from aggregate contributes very little to the total radon concentration in indoor air.

  15. Natural radioactivity and radon exhalation rate of soil in southern Egypt.

    PubMed

    Sroor, A; El-Bahi, S M; Ahmed, F; Abdel-Haleem, A S

    2001-12-01

    The level of natural radioactivity in soil of 30 mining samples collected from six locations in southern Egypt was measured. Concentrations of radionuclides in samples were determined by gamma-ray spectrometer using HPGe detector with a specially designed shield. The obtained results of uranium and thorium series as well as potassium (K-40) are discussed. The present data were compared with data obtained from different areas in Egypt. Also, a solid state nuclear track detector SSNTD (Cr-39) was used to measure the radon concentration as well as exhalation rate for these samples. The radon concentrations were found to vary from 1.54 to 5.37 Bq/kg. The exhalation rates were found to vary from 338.81 to 1426.47 Bq/m2d. The values of the radon exhalation rate are found to correspond with the uranium concentration values measured by the germanium detector in the corresponding soil samples.

  16. Gas chromatography/mass spectrometry analysis of exhaled leukotrienes in asthmatic patients

    PubMed Central

    Cap, P; Chladek, J; Pehal, F; Maly, M; Petru, V; Barnes, P; Montuschi, P

    2004-01-01

    Background: Leukotriene-like immunoreactivity has been detected in exhaled breath condensate (EBC), but definitive evidence for the presence of leukotrienes (LTs) in this biological fluid is not available. A study was undertaken to determine whether LTC4, LTD4, LTE4, and LTB4 are measurable in EBC by gas chromatography/mass spectrometry and to quantify exhaled LTs in adults and children with asthma and in control subjects. Methods: Twenty eight adults and 33 children with mild to moderate persistent asthma treated with inhaled corticosteroids and age matched healthy controls (50 adults and 50 children) were studied. LTB4, LTC4, LTD4, and LTE4 in EBC were measured by gas chromatography/mass spectrometry. Results: LTD4, LTE4, and LTB4 were detectable in all samples. Concentrations of LTC4 in EBC were either close to or below the detection limit of 1 pg/ml. Median exhaled LTD4, LTE4, and LTB4 concentrations in asthmatic adults were increased 4.1-fold (p<0.001), 1.8-fold (p<0.01), and 2.6-fold (p<0.001), respectively, compared with values in healthy adults. Median exhaled LTD4, LTE4, and LTB4 concentrations in asthmatic children were increased 2.8-fold (p<0.001), 1.3-fold (p<0.001), and 1.6-fold (p<0.001), respectively, compared with those in healthy children. In patients with asthma there was a correlation between exhaled LTD4 and LTE4 in both adults (r = 0.87, p<0.0001) and children (r = 0.78, p<0.0001). Conclusions: Gas chromatography/mass spectrometry can be used to accurately quantify exhaled LTs which are increased in asthmatic adults and children compared with controls. PMID:15170025

  17. [Exhale nitric oxide (NO) and respiratory function measured with body plethysmography in children].

    PubMed

    Storme, L; Riou, Y; Leclerc, F; Dubois, A; Deschildre, A; Pierre, M H; Logier, R; Robin, H; Lequien, P

    1998-04-01

    Exhaled nitric oxide (NO) may be a marker of airway inflammation. Previous studies in adults have shown that the level of NO in exhaled air is influenced by several factors (breath holding, exercise, etc), or by several disease (asthma, congestive heart failure, diseases of the upper respiratory tract, cystic fibrosis, etc). However, few studies have been performed in children less than 3 years of age. The aim of this study was to determine endogenous NO levels in children with various diseases during lung volume measurements. Fifty-two children aged 18.3 +/- 9.5 months were studied. The population was divided in two groups, according to the underlying disease: a group of 39 children with cystic fibrosis (n = 7), bronchopulmonary dysplasia (n = 17), asthma (n = 7) or recurrent respiratory tract infections (n = 8) and a second group of 13 children without respiratory disease. Lung function was measured by whole body plethysmography and several respiratory parameters were calculated (functional residual capacity [FRC], compliance and resistances of the respiratory system, trapped volume). NO production was measured on a chemiluminescence analyzer from mixed exhaled air collected into a bag, over a period of 5 minutes. NO production was related to disease: exhaled NO levels were three times higher in bronchopulmonary dysplasia and cystic fibrosis, compared to NO levels in children without respiratory disease. They were higher in asthma. They were not altered in recurrent respiratory tract infections. No correlation was found between respiratory parameters and NO production. However, exhaled NO levels were correlated to trapped volume, which defined dynamic part of pulmonary hyperinflation. Levels of endogenous NO in infants were similar to those measured in adults with and without inflammatory respiratory disease. Lung distention influenced exhaled NO production.

  18. Diagnostic significance of nitric oxide concentrations in exhaled air from the airways in allergic rhinitis patients

    PubMed Central

    Krzych-Fałta, Edyta; Samoliński, Bolesław K; Zalewska, Marta

    2016-01-01

    Introduction The effect of nitric oxide (NO) on the human body is very important due its physiological regulation of the following functions of airways: modulation of ciliary movement and maintenance of sterility in sinuses. Aim To evaluate the diagnostic significance of NO concentrations in exhaled air from the upper and lower airways in patients diagnosed with allergic rhinitis (AR). Material and methods The subjects included in the study were a group of 30 people diagnosed with sensitivity to environmental allergens and a control group consisting of 30 healthy subjects. The measurement of NO in the air exhaled from the lower and upper airways was performed using an on-line method by means of Restricted Exhaled Breath (REB), as well as using the measurement procedure (chemiluminescence) set out in the guidelines prepared in 2005 by the American Thoracic Society and the European Respiratory Society. Results In the late phase of the allergic reaction, higher values of the level of exhaled NO concentration from the lower airways were observed in the groups of subjects up to the threshold values of 25.17 ppb in the group of subjects with year-round allergic rhinitis and 21.78 ppb in the group with diagnosed seasonal allergic rhinitis. The difference in the concentration of NO exhaled from the lungs between the test group and the control group in the 4th h of the test was statistically significant (p = 0.045). Conclusions Exhaled NO should be considered as a marker of airway inflammation. It plays an important role in the differential diagnosis of allergy. PMID:27279816

  19. Effects of condensate in the exhalation limb of neonatal circuits on airway pressure during bubble CPAP.

    PubMed

    Youngquist, Tiffany M; Richardson, C Peter; Diblasi, Robert M

    2013-11-01

    Bubble CPAP is frequently used in spontaneously breathing infants with lung disease. Often bubble CPAP systems lack pressure alarms and pressure-release valves. We observed a large volume of condensate in the exhalation limb of a patient circuit and conducted a series of experiments to test the hypothesis that accumulated condensate could affect delivered pressures. An anatomically accurate nasal airway model of a preterm infant was attached to a spontaneously breathing lung model. A bubble CPAP system was attached to the nasal airway with bi-nasal short prongs, and the rate of fluid condensation was measured. Next, tracheal pressures were monitored digitally to detect changes in airway pressure related to condensate accumulation. Measurements were obtained with volumes of 0, 5, 10, 15, and 20 mL of water in the exhalation limb, at flows of 4, 6, 8, and 10 L/min. Measurements with 20 mL in the exhalation limb were recorded with and without a pressure-relief valve in the circuit. The rate of condensate accumulation was 3.8 mL/h. At volumes of ≥ 10 mL, noticeable alterations in the airway pressure waveforms and significant increases in mean tracheal pressure were observed. The pressure-relief valve effectively attenuated peak tracheal pressure, but only decreased mean pressure by 0.5-1.5 cm H2O. Condensate in the exhalation limb of the patient circuit during bubble CPAP can significantly increase pressure delivered to the patient. The back and forth movement of this fluid causes oscillations in airway pressure that are much greater than the oscillations created by gas bubbling out the exhalation tube into the water bath. We recommend continuously monitoring pressure at the nasal airway interface, placing an adjustable pressure-relief valve in the circuit, set to 5 cm H2O above the desired mean pressure, and emptying fluid from the exhalation limb every 2-3 hours.

  20. Exhaled breath condensate pH decreases during exercise-induced bronchoconstriction.

    PubMed

    Bikov, Andras; Galffy, Gabriella; Tamasi, Lilla; Bartusek, Dora; Antus, Balazs; Losonczy, Gyorgy; Horvath, Ildiko

    2014-05-01

    Exercise-induced bronchoconstriction (EIB) is the temporary narrowing of the airways caused by physical exercise. Its exact pathophysiology is unclear; however, acute changes in airways pH may play a role. Exhaled breath condensate (EBC) pH was suggested as a surrogate indicator for airway acid-base status, but its value is also affected by volatile molecules and respiratory droplet dilution. The aim of the study was to assess changes in EBC pH during EIB. Twenty-two asthmatics who reported breathlessness following exercise and 16 healthy individuals participated in the study. Lung function test was performed and exhaled breath samples were collected for pH, dilution factor and volatile compound pattern measurements (Cyranose 320) pre-exercise and at 0, 10, 20 and 30 min after physical exercise challenge. Fractional exhaled nitric oxide was measured before exercise. EIB developed in 13 asthmatic subjects. In these participants, but not in the EIB-negative asthmatics (P = 0.51), EBC pH reduced significantly during exercise (P = 0.01). In addition, changes in EBC pH were related to the degree of bronchospasm in the EIB-positive group (P = 0.01, r = 0.68). Exhaled volatile pattern became altered (P < 0.05) during exercise in all subjects (asthmatics and controls). EBC pH changes were not related to EBC dilution or volatile compound pattern alterations (P > 0.05). The development of EIB was related to acute changes of EBC pH, which suggest the role of airway pH decrease in the pathophysiology of EIB. Exercise-induced changes in exhaled biomarkers suggest methodological precautions to avoid physical exercise before performing exhaled breath tests. © 2014 The Authors. Respirology © 2014 Asian Pacific Society of Respirology.

  1. Chemical analysis of exhaled human breath using a terahertz spectroscopic approach

    NASA Astrophysics Data System (ADS)

    Fosnight, Alyssa M.; Moran, Benjamin L.; Medvedev, Ivan R.

    2013-09-01

    As many as 3500 chemicals are reported in exhaled human breath. Many of these chemicals are linked to certain health conditions and environmental exposures. This experiment demonstrated a method of breath analysis utilizing a high resolution spectroscopic technique for the detection of ethanol, methanol, and acetone in the exhaled breath of a person who consumed alcohol. This technique is applicable to a wide range of polar molecules. For select species, unambiguous detection in a part per trillion dilution range with a total sample size in a femtomol range is feasible. It compares favorably with other methods of breath analysis.

  2. Detection of ammonia in exhaled breath for clinical diagnosis- A review

    NASA Astrophysics Data System (ADS)

    Gafare, Mawahib; Dennis, J. O.; Md Khir, M. H.

    2014-10-01

    This paper presents ammonia gas as a biomarker for different clinical conditions when it exceeds the normal concentration in the exhaled breath. In peculiar, detection of ammonia in human breath has the effort to investigate various practicabilities inclusive those comprising the kidneys, liver and bacterial infection of either the stomach or mouth. Laser spectroscopy, gas chromatography, photo-acoustic spectroscopy, chemical ionization, and chemical sensing are used to measure and detect ammonia gas from exhaled breath. These methods and techniques are discussed in terms of their response time and the minimum concentration detectable. Furthermore, the benefits and importance of these methods and their limitation and drawback are highlighted.

  3. The relationships among Dermatophagoides pteronyssinus exposure, exhaled nitric oxide, and exhaled breath condensate pH levels in atopic asthmatic children.

    PubMed

    Yan, Dah-Chin; Chung, Fen-Fang; Lin, Syh-Jae; Wan, Gwo-Hwa

    2016-09-01

    This study examined seasonal changes in indoor Dermatophagoides pteronyssinus 1 (Der p 1)/Blattella germanica 1 (Bla g 1) antigen concentrations in the homes of atopic asthmatic and atopic nonasthmatic children. Possible associations between environmental allergen exposure and levels of exhaled breath indices were also evaluated.A total of 38 atopic children were recruited for this cross-sectional study: 22 were asthmatic and 16 were nonasthmatic. Home visits were conducted for indoor air and dust sampling each season. Exhaled nitric oxide (eNO)/spirometric measurements were taken and exhaled breath condensate (EBC) was collected after sampling of the domestic environment.The highest Der p 1 concentrations were on the top of mattresses in the homes of recruited children. The floors of kitchens and living rooms had the highest Bla g 1 concentrations in the homes of atopic asthmatic children. A positive correlation was found between Der p 1 exposure of mattress, bedroom floor, and living room floor and eNO levels in the atopic asthmatic children. The Der p 1 concentrations on the surfaces of mattress and bedroom floor were positively related to high eNO levels in the atopic asthmatic children after adjusting for season. No association was found between Der p 1 exposure and EBC pH values in the recruited children.A positive correlation was found between Der p 1 exposure and high eNO levels in atopic asthmatic children, especially in Der p 1 exposure of mattress and bedroom floor.

  4. The relationships among Dermatophagoides pteronyssinus exposure, exhaled nitric oxide, and exhaled breath condensate pH levels in atopic asthmatic children

    PubMed Central

    Yan, Dah-Chin; Chung, Fen-Fang; Lin, Syh-Jae; Wan, Gwo-Hwa

    2016-01-01

    Abstract This study examined seasonal changes in indoor Dermatophagoides pteronyssinus 1 (Der p 1)/Blattella germanica 1 (Bla g 1) antigen concentrations in the homes of atopic asthmatic and atopic nonasthmatic children. Possible associations between environmental allergen exposure and levels of exhaled breath indices were also evaluated. A total of 38 atopic children were recruited for this cross-sectional study: 22 were asthmatic and 16 were nonasthmatic. Home visits were conducted for indoor air and dust sampling each season. Exhaled nitric oxide (eNO)/spirometric measurements were taken and exhaled breath condensate (EBC) was collected after sampling of the domestic environment. The highest Der p 1 concentrations were on the top of mattresses in the homes of recruited children. The floors of kitchens and living rooms had the highest Bla g 1 concentrations in the homes of atopic asthmatic children. A positive correlation was found between Der p 1 exposure of mattress, bedroom floor, and living room floor and eNO levels in the atopic asthmatic children. The Der p 1 concentrations on the surfaces of mattress and bedroom floor were positively related to high eNO levels in the atopic asthmatic children after adjusting for season. No association was found between Der p 1 exposure and EBC pH values in the recruited children. A positive correlation was found between Der p 1 exposure and high eNO levels in atopic asthmatic children, especially in Der p 1 exposure of mattress and bedroom floor. PMID:27684812

  5. Fraction of exhaled nitric oxide in healthy elderly Tunisian subjects.

    PubMed

    Sfaxi, Ines; Ben Saad, Helmi; Rouatbi, Sonia

    2015-09-05

    Exhaled-fraction-of-nitric-oxide (FeNO) norms are absent in healthy elderly North-African subjects. i) to identify FeNO influencing factors of elderly Tunisians older 50 years and more; ii) to assess the applicability of some published FeNO norms for elderly in local population; iii) to set-up FeNO norms and to prospectively evaluate their validity in two elderly validation-groups (healthy and asthmatic subjects). A convenience sample of healthy and asthmatic elderly Tunisians was recruited. Subjects responded to a medical questionnaire and then FeNO levels were measured by an online method (Medisoft, Sorinnes (Dinant), Belgium). Clinical, anthropometric and spirometric data were collected. Three groups of subjects were identified: group I (healthy-elderly; n = 100, 57 females); group II (healthy-validation; n = 17, 4 females) and group III (asthmatic-validation; n = 10, 9 females). ANOVA was performed to compare the three groups' data. No significant factor, among those evaluated, influenced Tunisian elderly FeNO values. The available published FeNO norms did not reliably predict FeNO in Tunisian elderly population. The mean ± SD (minimum-maximum) of FeNO (ppb) for group I was 14 ± 6 (3-34). For Tunisian people, each elderly FeNO value higher than 34 ppb will be considered as abnormal. There was no statistical significant difference between FeNO (ppb) mean values of group I and groups II (15 ± 8) or III (18 ± 13). No subject of group II had a FeNO value higher than 34 ppb. Thirty percent of group III subjects had a FeNO value higher than 34 ppb. In practice, FeNO value of more than 34 ppb is considered abnormal in elderly Tunisian population. Copyright © 2015. Published by Elsevier Inc.

  6. [Diagnostic value of exhaled nitric oxide measurement in mild asthma].

    PubMed

    Pérez Tarazona, S; Martínez Camacho, R M; Alfonso Diego, J; Escolano Serrano, S; Talens Gandía, J

    2011-11-01

    To assess the diagnostic value of fractional exhaled nitric oxide (FE(NO)) in mild asthma. Cross-sectional descriptive study in a group of patients with no history of respiratory or allergic illness (control group) and a group of patients with a history of mild asthma with no baseline treatment (asthma group), both aged 6 to 14 years. The following examinations were performed: measurement of FE(NO) using the portable NIOX MINO(®) device, allergy tests and spirometry. Repeatability of paired FE(NO) measurements was estimated with the intraclass correlation coefficient, the repeatability coefficient and the variation coefficient. The diagnostic value was assessed with the sensitivity, specificity, area under the ROC curve and positive likelihood ratio (LR+) for each cut-off point. Eighty-seven patients were included in the control group and 57 in the asthma group. The mean FE(NO) value was 12.1 ppb (SD 13.5) in the control group and 42.9 ppb (SD 24.5) in asthmatics (P<.001). The intraclass correlation coefficient was 0.98 (95% CI: 0.96-0.99) and of 0.97 (95% CI: 0.92-0.99) in controls and asthmatics, respectively. The repeatability coefficient was 5.5 in controls and 9.2 in asthmatic children, and the median variation coefficient was 8.3% and 6.1%. The optimal cut-off value for FE(NO) was 19 ppb (sensitivity and specificity were 91.4% and 87.2%, respectively). The area under the ROC curve was 0.93 (95% CI: 0.88-0.97) (P<.001) and the LR+ was 7.1. Subclinical sensitisation to pneumoallergens accounted for most false positive cases. The determination of FE(NO) with NIOX MINO(®) has an adequate repeatability, especially for healthy patients. For asthmatic patients we recommend determining the average of two measurements. The test has a high diagnostic value in mild asthma. Subclinical sensitisation to pneumoallergens can cause the FE(NO) value to rise to pathologic levels. Copyright © 2011 Asociación Española de Pediatría. Published by Elsevier Espana. All rights

  7. Analysis of volatile organic compounds in exhaled breath to diagnose ventilator-associated pneumonia.

    PubMed

    Schnabel, Ronny; Fijten, Rianne; Smolinska, Agnieszka; Dallinga, Jan; Boumans, Marie-Louise; Stobberingh, Ellen; Boots, Agnes; Roekaerts, Paul; Bergmans, Dennis; van Schooten, Frederik Jan

    2015-11-26

    Ventilator-associated pneumonia (VAP) is a nosocomial infection occurring in the intensive care unit (ICU). The diagnostic standard is based on clinical criteria and bronchoalveolar lavage (BAL). Exhaled breath analysis is a promising non-invasive method for rapid diagnosis of diseases and contains volatile organic compounds (VOCs) that can differentiate diseased from healthy individuals. The aim of this study was to determine whether analysis of VOCs in exhaled breath can be used as a non-invasive monitoring tool for VAP. One hundred critically ill patients with clinical suspicion of VAP underwent BAL. Before BAL, exhaled air samples were collected and analysed by gas chromatography time-of-flight mass spectrometry (GC-tof-MS). The clinical suspicion of VAP was confirmed by BAL diagnostic criteria in 32 patients [VAP(+)] and rejected in 68 patients [VAP(-)]. Multivariate statistical comparison of VOC profiles between VAP(+) and VAP(-) revealed a subset of 12 VOCs that correctly discriminated between those two patient groups with a sensitivity and specificity of 75.8% ± 13.5% and 73.0% ± 11.8%, respectively. These results suggest that detection of VAP in ICU patients is possible by examining exhaled breath, enabling a simple, safe and non-invasive approach that could diminish diagnostic burden of VAP.

  8. Exhaled nitric oxide decreases upon acute exposure to high-altitude hypoxia.

    PubMed

    Brown, Daniel E; Beall, Cynthia M; Strohl, Kingman P; Mills, Phoebe S

    2006-01-01

    Nitric oxide (NO) is a vasodilator that plays a role in blood flow and oxygen delivery. Acute hypoxia down regulates NO synthesis, a response that may exacerbate hypoxic stress by decreasing blood flow. This study was designed to test the hypotheses that pulmonary NO decreases upon acute exposure to high-altitude hypoxia and that relatively low levels of NO at altitude are associated with greater stress as reflected in more symptoms of acute mountain sickness (AMS). A sample of 47 healthy, adult, nonsmoking, sea-level residents provided measurements at sea level, at 2,800 m, and at 0-, 2-, and 3-h exposure times at 4,200 m altitude on Mauna Kea, Hawaii. Measurements were made of exhaled NO, oxygen saturation of hemoglobin, heart rate, and reported symptoms of AMS. The partial pressure of NO concentration in exhaled breath decreased significantly from a sea level mean of 4.2 nmHg to 3.8 nmHg at 2,800 m and 3.4 nmHg at 4,200 m. NO concentration in exhaled breath did not change significantly over a 3-h exposure at 4,200 m and recovered to pre-exposure baseline upon return to sea level. There was no significant association between the level of NO exhaled and the number of self-reported symptoms of AMS during this brief exposure. Am. J. Hum. Biol. 18:196-202, 2006. (c) 2006 Wiley-Liss, Inc.

  9. Exhaled breath malondialdehyde as a matter of effect of exposure to airpollution in children with asthma

    EPA Science Inventory

    BACKGROUND: Assessment of the adverse effects of oxidative stress related to air pollution is limited by the lack of biological markers of dose to the lungs. OBJECTIVE: We evaluated the use of exhaled breath condensate (EBC) malondialdehyde as a biomarker of exposure to traffic-r...

  10. A REVIEW OF THE US EPA'S SINGLE BREATH CANISTER (SBC) METHOD FOR EXHALED VOLATILE ORGANIC BIOMARKERS

    EPA Science Inventory

    Exhaled alveolar breath can provide a great deal of information about an individual?s health and previous exposure to potentially harmful xenobiotic materials. Because breath can be obtained noninvasively and its constituents directly reflect concentrations in the blood, its us...

  11. 42 CFR 84.77 - Inhalation and exhalation valves; minimum requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Inhalation and exhalation valves; minimum requirements. 84.77 Section 84.77 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  12. 42 CFR 84.77 - Inhalation and exhalation valves; minimum requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Inhalation and exhalation valves; minimum requirements. 84.77 Section 84.77 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  13. 42 CFR 84.120 - Inhalation and exhalation valves; minimum requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Inhalation and exhalation valves; minimum requirements. 84.120 Section 84.120 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY...

  14. 42 CFR 84.77 - Inhalation and exhalation valves; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Inhalation and exhalation valves; minimum requirements. 84.77 Section 84.77 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  15. 42 CFR 84.120 - Inhalation and exhalation valves; minimum requirements.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Inhalation and exhalation valves; minimum requirements. 84.120 Section 84.120 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY...

  16. 42 CFR 84.120 - Inhalation and exhalation valves; minimum requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Inhalation and exhalation valves; minimum requirements. 84.120 Section 84.120 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY...

  17. 42 CFR 84.77 - Inhalation and exhalation valves; minimum requirements.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Inhalation and exhalation valves; minimum requirements. 84.77 Section 84.77 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  18. 42 CFR 84.120 - Inhalation and exhalation valves; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Inhalation and exhalation valves; minimum requirements. 84.120 Section 84.120 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY...

  19. Quantum cascade laser-based sensors for the detection of exhaled carbon monoxide

    NASA Astrophysics Data System (ADS)

    Pakmanesh, Nahid; Cristescu, Simona M.; Ghorbanzadeh, Atamalek; Harren, Frans J. M.; Mandon, Julien

    2016-01-01

    Carbon monoxide (CO) is an important biomarker as it originates in the human body from the heme (component of hemoglobin) degradation. Tunable laser absorption spectroscopy in the mid-infrared wavelength region is used for sensitive trace gas sensing of exhaled carbon monoxide (CO). Based on a quantum cascade laser emitting at 4.61 µm, two different spectroscopic methods are investigated: off-axis integrated cavity output spectroscopy (OA-ICOS) and wavelength modulation 2f/1f spectroscopy (WMS). The optical sensors integrate a slow feedback system to correct for wavelength drifts improving their stability over days. Both approaches demonstrate a high reproducibility and sensitivity during online measurements of exhaled human breath. Considering the detection limit to be the equal to the standard deviation of the background fluctuations, the noise-equivalent detection limit for both OA-ICOS and WMS is 7 ppbv (1-s averaging time), leading to a noise-equivalent absorption sensitivity of 3.1 × 10-7 cm-1 Hz-1/2, which is sufficient for measurements of exhaled CO (eCO). Collection and measurements of eCO samples were investigated, and different exhalation flow rates and breath-holding time were explored, to provide a reliable sampling method for future medical investigations.

  20. Environmental variables and levels of exhaled carbon monoxide and carboxyhemoglobin in elderly people taking exercise.

    PubMed

    Salicio, Marcos Adriano; Mana, Viviane Aparecida Martins; Fett, Waléria Christiane Rezende; Gomes, Luciano Teixeira; Botelho, Clovis

    2016-04-01

    This article aims to analyze levels of exhaled carbon monoxide, carboxyhemoglobinand cardiopulmonary variables in old people practicing exercise in external environments, and correlate them with climate and pollution factors. Temporal ecological study with118 active elderly people in the city of Cuiabá, in the state of Mato Grosso, Brazil. Data were obtained on use of medication, smoking, anthropometric measurements, spirometry, peak flow, oxygen saturation, heart rate, exhaled carbon monoxide, carboxyhemoglobin, climate, number of farm fires and pollution. Correlations were found between on the one hand environmental temperature, relative humidity of the air and number of farmers' fires, and on the other hand levels of carbon monoxide exhaled and carboxyhemoglobin (p < 0.05).There was a correlation between heart rate and changes in environmental temperature, time of exposure to the sun and relative humidity (p < 0.05). In elderly people, environmental factors influence levels of exhaled carbon monoxide, carboxyhemoglobin and heart rate. There is thus a need for these to be monitored during exercise. The use of a carbon monoxide monitor to evaluate exposure to pollutants is suggested.

  1. Characteristics of radon and thoron exhalation rates in Okinawa, subtropical region of Japan.

    PubMed

    Shiroma, Y; Kina, S; Fujitani, T; Hosoda, M; Sorimachi, A; Ishikawa, T; Sahoo, S K; Tokonami, S; Furukawa, M

    2012-11-01

    Radon and thoron exhalation rates from the ground surface were estimated in three islands of Okinawa Prefecture, a subtropical region of Japan. In situ measurements of the exhalation rates were conducted at a total of 88 points using an accumulation technique with a ZnS(Ag) scintillation detector. The radon and thoron exhalation rates were calculated to be 1-137 (arithmetic mean: 21) mBq m(-2) s(-1) and 32-6244 (1801) mBq m(-2) s(-1), respectively. In the surface soil samples collected at 53 measurement points, (238)U and (232)Th series concentrations were estimated to be 17.9-254.0 (64.0) Bq kg(-1) dry and 17.8-136.1 (58.8) Bq kg(-1) dry, respectively. The maximum rates and concentrations were observed in the dark red soil area. Recent studies strongly suggest that the base material of the soils may be the eolian dust derived from the southeastern part of China, a high background radiation area. The eolian dust is, therefore, considered to be an enhancer for the radon and thoron exhalations in Okinawa.

  2. Exhaled breath metabolomics as a noninvasive diagnostic tool for acute respiratory distress syndrome.

    PubMed

    Bos, Lieuwe D J; Weda, Hans; Wang, Yuanyue; Knobel, Hugo H; Nijsen, Tamara M E; Vink, Teunis J; Zwinderman, Aeilko H; Sterk, Peter J; Schultz, Marcus J

    2014-07-01

    There is a need for biological markers of the acute respiratory distress syndrome (ARDS). Exhaled breath contains hundreds of metabolites in the gas phase, some of which reflect (patho)physiological processes. We aimed to determine the diagnostic accuracy of metabolites in exhaled breath as biomarkers of ARDS. Breath from ventilated intensive care unit patients (n=101) was analysed using gas chromatography and mass spectrometry during the first day of admission. ARDS was defined by the Berlin definition. Training and temporal validation cohorts were used. 23 patients in the training cohort (n=53) had ARDS. Three breath metabolites, octane, acetaldehyde and 3-methylheptane, could discriminate between ARDS and controls with an area under the receiver operating characteristic curve (AUC) of 0.80. Temporal external validation (19 ARDS cases in a cohort of 48) resulted in an AUC of 0.78. Discrimination was insensitive to adjustment for severity of disease, a direct or indirect cause of ARDS, comorbidities, or ventilator settings. Combination with the lung injury prediction score increased the AUC to 0.91 and improved net reclassification by 1.17. Exhaled breath analysis showed good diagnostic accuracy for ARDS, which was externally validated. These data suggest that exhaled breath analysis could be used for the diagnostic assessment of ARDS.

  3. 42 CFR 84.77 - Inhalation and exhalation valves; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Inhalation and exhalation valves; minimum requirements. 84.77 Section 84.77 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES...

  4. Target volume definition for upper abdominal irradiation using CT scans obtained during inhale and exhale phases.

    PubMed

    Aruga, T; Itami, J; Aruga, M; Nakajima, K; Shibata, K; Nojo, T; Yasuda, S; Uno, T; Hara, R; Isobe, K; Machida, N; Ito, H

    2000-09-01

    To evaluate the clinical utility of a treatment-planning technique involving the use of CT images obtained during both the static exhalation phase and static inhalation phase (two-phase planning). Ten patients with pancreatic or liver tumors underwent CT scanning under static exhale and inhale conditions, after a period of mild ventilation. By setting image positions differently, we were able to treat the two-phase images as one dataset. Each gross tumor volume (GTV) was contoured separately and the mixed GTV was used for the two-phase treatment planning. Treatment plans were constructed to compare the two-phase plans with the plans constructed using static exhalation images. The shift of the center of the GTV and kidneys and the minimum dose of GTV were then calculated. The shift of the GTV ranged from 2.6 to 27. 3 mm and that of the kidneys from 2.2 to 24 mm. In some patients whose treatment was planned using exhalation planning, the minimum dose of GTV at inhalation was less than 90% of the isocenter dose. Two-phase planning is a simple technique that can visualize tumor and organ movement simultaneously using CT. It further defines adequate field margins around the tumor and prevents unexpected radiation exposure to critical organs. Routine use of this technique for upper abdominal irradiation is recommended.

  5. Does it really matter what volume to exhale before using asthma inhalation devices?

    PubMed

    Self, Timothy H; Pinner, Nathan A; Sowell, Rebecca S; Headley, A Stacey

    2009-04-01

    Correct use of inhalation devices is one essential component of optimal management of asthma. Several longstanding controversies regarding specific steps to correct use of metered dose inhalers (MDI) include the lung volume when the MDI should be actuated. As a primary objective, literature was reviewed examining this one step in MDI use. Results from six of nine investigations support the need to gently exhale either to functional residual capacity (FRC) or residual volume (RV) before MDI actuation. Literature is also summarized regarding the need to exhale to FRC or RV before inhaling from MDI plus valved holding chambers or other extension devices and from dry powder inhalers. Numerous studies indicate that many patients as well as health care professionals either do not know or forget to exhale to RV or FRC before inhaling asthma medications. Both patients and health care professionals need education to help ensure correct use of MDI and other asthma inhalation devices, including instruction to first exhale gently to RV or FRC before inhaling the medication.

  6. A REVIEW OF THE US EPA'S SINGLE BREATH CANISTER (SBC) METHOD FOR EXHALED VOLATILE ORGANIC BIOMARKERS

    EPA Science Inventory

    Exhaled alveolar breath can provide a great deal of information about an individual?s health and previous exposure to potentially harmful xenobiotic materials. Because breath can be obtained noninvasively and its constituents directly reflect concentrations in the blood, its us...

  7. Analysis of volatile organic compounds in exhaled breath to diagnose ventilator-associated pneumonia

    PubMed Central

    Schnabel, Ronny; Fijten, Rianne; Smolinska, Agnieszka; Dallinga, Jan; Boumans, Marie-Louise; Stobberingh, Ellen; Boots, Agnes; Roekaerts, Paul; Bergmans, Dennis; van Schooten, Frederik Jan

    2015-01-01

    Ventilator-associated pneumonia (VAP) is a nosocomial infection occurring in the intensive care unit (ICU). The diagnostic standard is based on clinical criteria and bronchoalveolar lavage (BAL). Exhaled breath analysis is a promising non-invasive method for rapid diagnosis of diseases and contains volatile organic compounds (VOCs) that can differentiate diseased from healthy individuals. The aim of this study was to determine whether analysis of VOCs in exhaled breath can be used as a non-invasive monitoring tool for VAP. One hundred critically ill patients with clinical suspicion of VAP underwent BAL. Before BAL, exhaled air samples were collected and analysed by gas chromatography time-of-flight mass spectrometry (GC-tof-MS). The clinical suspicion of VAP was confirmed by BAL diagnostic criteria in 32 patients [VAP(+)] and rejected in 68 patients [VAP(−)]. Multivariate statistical comparison of VOC profiles between VAP(+) and VAP(−) revealed a subset of 12 VOCs that correctly discriminated between those two patient groups with a sensitivity and specificity of 75.8% ± 13.5% and 73.0% ± 11.8%, respectively. These results suggest that detection of VAP in ICU patients is possible by examining exhaled breath, enabling a simple, safe and non-invasive approach that could diminish diagnostic burden of VAP. PMID:26608483

  8. Modeling of lung cancer risk due to radon exhalation of granite stone in dwelling houses.

    PubMed

    Abbasi, Akbar

    2017-01-01

    Due to increasing occurrences of lung cancer, radon exhalation rates, radon concentrations, and lung cancer risks in several types of commonly used granite stone, samples used for flooring in buildings, have been investigated. We measured the radon exhalation rates due to granite stones by means of an AlphaGUARD Model PQ2000 in a cube container with changeable floor by various granite stones. The lung cancer risk and percentage of lung cancer deaths (LCRn) due to those conditions were calculated using Darby's model. The radon exhalation rates ranged from 1.59 ± 0.41 to 9.43 ± 0.74 Bq/m 2/h. The radon concentrations in the standard room with poor and normal ventilation were calculated 20.10-71.09 Bq/m 3 and 16.12-47.01 Bq/m 3, respectively. The estimated numbers of lung cancer deaths attributable to indoor radon due to granite stones in 2013 were 145 (3.33%) and 103 (2.37%) for poor and normal ventilation systems, respectively. According to our estimations, the values of 3.33% and 2.37% of lung cancer deaths in 2013 are attributed to radon exhalation of granite stones with poor and normal ventilation systems, respectively.

  9. Exhaled volatile organic compounds as lung cancer biomarkers during one-lung ventilation

    PubMed Central

    Wang, Changsong; Dong, Ran; Wang, Xiaoyang; Lian, Ailing; Chi, Chunjie; Ke, Chaofu; Guo, Lei; Liu, Shanshan; Zhao, Wei; Xu, Guowang; Li, Enyou

    2014-01-01

    In this study, single-lung ventilation was used to detect differences in the volatile organic compound (VOCs) profiles between lung tissues in healthy and affected lungs. In addition, changes that occurred after lung cancer resection in both the VOCs profiles of exhaled breath from ipsilateral and contralateral lungs and the VOCs profiles of exhaled breath and blood sample headspaces were also determined. Eighteen patients with non-small cell carcinoma were enrolled. Alveolar breath samples were taken separately from healthy and diseased lungs before and after the tumor resection. Solid phase microextraction–gas chromatography/mass spectrometry was used to assess the exhaled VOCs of the study participants. The VOCs exhibited significant differences between the contralateral and ipsilateral lungs before surgery, the contralateral and ipsilateral lungs after surgery, the ipsilateral lungs before and after surgery, and the blood samples from before and after surgery; 12, 19, 12 and 5 characteristic metabolites played decisive roles in sample classification, respectively. 2,2-Dimethyldecane, tetradecane, 2,2,4,6,6-pentamethylheptane, 2,3,4-trimethyldecane, nonane, 3,4,5,6-tetramethyloctane, and hexadecane may be generated from lipid peroxidation during surgery. Caprolactam and propanoic acid may be more promising exhaled breath biomarkers for lung cancer. PMID:25482491

  10. Microbial content of household dust associated with exhaled NO in asthmatic children.

    EPA Science Inventory

    Exhaled nitric oxide (eNO) is increasingly used as a non-invasive measure of airway inflammation. Despite this, little information exists regarding the potential effects of indoor microbial components on eNO. We determined the influence of microbial contaminants in house dust and...

  11. 42 CFR 84.177 - Inhalation and exhalation valves; minimum requirements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... air from adversely affecting filters, except where filters are specifically designed to resist... DEVICES Non-Powered Air-Purifying Particulate Respirators § 84.177 Inhalation and exhalation valves... external influence; and (3) Designed and constructed to prevent inward leakage of contaminated air. ...

  12. 42 CFR 84.177 - Inhalation and exhalation valves; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... air from adversely affecting filters, except where filters are specifically designed to resist... DEVICES Non-Powered Air-Purifying Particulate Respirators § 84.177 Inhalation and exhalation valves... external influence; and (3) Designed and constructed to prevent inward leakage of contaminated air. ...

  13. Microbial content of household dust associated with exhaled NO in asthmatic children.

    EPA Science Inventory

    Exhaled nitric oxide (eNO) is increasingly used as a non-invasive measure of airway inflammation. Despite this, little information exists regarding the potential effects of indoor microbial components on eNO. We determined the influence of microbial contaminants in house dust and...

  14. Influencing effect of heat-treatment on radon emanation and exhalation characteristic of red mud.

    PubMed

    Sas, Zoltán; Szántó, János; Kovács, János; Somlai, János; Kovács, Tibor

    2015-10-01

    The reuse of industrial by-products is important for members of numerous industrial sectors. However, though the benefits of reuse are evident from an economical point of view, some compounds in these materials can have a negative effect on users' health. In this study, the radon emanation and exhalation features of red mud were surveyed using heat-treatment (100-1200 °C). As a result of the 1200°C-treated samples, massic radon exhalation capacity reduced from 75 ± 10 mBq kg(-1) h(-1) to 7 ± 4 mBq kg(-1) h(-1), approximately 10% of the initial exhalation rate. To find an explanation for internal structural changes, the porosity features of the heat-treated samples were also investigated. It was found that the cumulative pore volume reduced significantly in less than 100 nm, which can explain the reduced massic exhalation capacity in the high temperature treated range mentioned above. SEM snapshots were taken of the surfaces of the samples as visual evidence for superficial morphological changes. It was found that the surface of the high temperature treated samples had changed, proving the decrement of open pores on the surface. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Simplified models for exhaled airflow from a cough with the mouth covered.

    PubMed

    Chen, C; Lin, C-H; Jiang, Z; Chen, Q

    2014-12-01

    Covering a cough can be useful in reducing the transmission of airborne infectious diseases. However, no simple method is available in the literature for predicting the exhaled airflow from a cough with the mouth covered. This investigation used smoke to visualize the airflow exhaled by 16 human subjects. Their mouths were covered by a tissue, a cupped hand, a fist, and an elbow with and without a sleeve. This study then developed simplified models for predicting the airflow on the basis of the smoke visualization data. In addition, this investigation performed numerical simulations to assess the influence of mouth coverings on the receptor's exposure to exhaled particles. It was found that covering a cough with a tissue, a cupped hand, or an elbow can significantly reduce the horizontal velocity and cause the particles to move upward with the thermal plumes generated by a human body. In contrast with an uncovered cough, a covered cough or a cough with the head turned away may prevent direct exposure. This study developed simplified models for predicting the exhaled airflow from a cough with the mouth covered. The proposed models can easily be used to investigate the risk of transmission of airborne infectious diseases in enclosed environments. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Increased Exhaled 8-Isoprostane and Interleukin-6 in Patients with Helicobacter pylori Infection.

    PubMed

    Yildirim, Zeki; Bozkurt, Bulent; Ozol, Duygu; Armutcu, Ferah; Akgedik, Recep; Karamanli, Harun; Kizilirmak, Deniz; İkizek, Mustafa

    2016-10-01

    Helicobacter pylori (H. pylori) infection triggers both local inflammation, usually in gastric mucosa, and chronic systemic inflammation. It is assumed that this local and systemic inflammation is caused by extracellular products excreted by H. pylori. The aim of this study was to investigate the possible association between H. pylori infection and a local inflammatory response in the airway by using exhaled breath condensate technique. This study includes 41 H. pylori seropositive patients who have gastric symptoms and 27 healthy control subjects. Pulmonary function tests (PFT), chest X ray, and physical examination were performed in all patients and interleukin-6 (IL-6), 8-isoprostane and nitrotyrosine levels were measured in exhaled breath condensate. Levels of IL-6 and 8-isoprostane in exhaled breath condensate (EBC) were significantly higher in H. pylori positive patients than control subjects (p < 0.05). Nitrotyrosine levels were also higher in H. pylori positive patients but the difference was not statistically significant. Both groups had similar leukocyte counts, C-reactive protein (CRP) levels and PFT parameters. H. pylori infection causes an asymptomatic airway inflammation which can be detected by exhaled breath condensate. The clinical importance of this inflammation remains unclear. © 2016 John Wiley & Sons Ltd.

  17. Capillary electrophoresis--a new tool for ionic analysis of exhaled breath condensate.

    PubMed

    Kubáň, Petr; Kobrin, Eeva-Gerda; Kaljurand, Mihkel

    2012-12-07

    Exhaled breath condensate has been analyzed for its ionic content by capillary electrophoresis with capacitively coupled contactless conductometric detection. A simple device for collection of small volumes (100-200 μL) of exhaled breath condensate in less than 2 min was developed. A method for simultaneous determination of inorganic cations, inorganic anions and organic anions from the samples using dual-opposite end injection principle with a short fused silica capillary (35 cm, 50 μm I.D.) was developed. A background electrolyte composed of 20mM 2-(N-morpholino)ethanesulfonic acid, 20 mM l-histidine, 30 μM cetyltrimethylammonium bromide and 2mM 18-crown-6 was used. The analysis time was less than 3 min with limits of detection reaching low μM levels for most of the anions and cations. It has been shown that changes of nitrite could be observed in acute inflammation of upper airways and in a person with diagnosed mild chronic obstructive pulmonary disease, while changes of other ions could also be observed. Lactate concentrations could also be monitored and about 4-fold increase of lactate concentration in exhaled breath condensate was determined following an exhaustive cycling exercise. The developed non-invasive sampling of exhaled breath condensate, followed by rapid capillary electrophoretic analysis, could be very useful in lung inflammatory disease screening as well as in monitoring fast metabolic processes such as lactate build-up and removal.

  18. Exhaled air dispersion during noninvasive ventilation via helmets and a total facemask.

    PubMed

    Hui, David S; Chow, Benny K; Lo, Thomas; Ng, Susanna S; Ko, Fanny W; Gin, Tony; Chan, Matthew T V

    2015-05-01

    Noninvasive ventilation (NIV) via helmet or total facemask is an option for managing patients with respiratory infections in respiratory failure. However, the risk of nosocomial infection is unknown. We examined exhaled air dispersion during NIV using a human patient simulator reclined at 45° in a negative pressure room with 12 air changes/h by two different helmets via a ventilator and a total facemask via a bilevel positive airway pressure device. Exhaled air was marked by intrapulmonary smoke particles, illuminated by laser light sheet, and captured by a video camera for data analysis. Significant exposure was defined as where there was ≥ 20% of normalized smoke concentration. During NIV via a helmet with the simulator programmed in mild lung injury, exhaled air leaked through the neck-helmet interface with a radial distance of 150 to 230 mm when inspiratory positive airway pressure was increased from 12 to 20 cm H2O, respectively, while keeping the expiratory pressure at 10 cm H2O. During NIV via a helmet with air cushion around the neck, there was negligible air leakage. During NIV via a total facemask for mild lung injury, air leaked through the exhalation port to 618 and 812 mm when inspiratory pressure was increased from 10 to 18 cm H2O, respectively, with the expiratory pressure at 5 cm H2O. A helmet with a good seal around the neck is needed to prevent nosocomial infection during NIV for patients with respiratory infections.

  19. Exhaled breath malondialdehyde as a matter of effect of exposure to airpollution in children with asthma

    EPA Science Inventory

    BACKGROUND: Assessment of the adverse effects of oxidative stress related to air pollution is limited by the lack of biological markers of dose to the lungs. OBJECTIVE: We evaluated the use of exhaled breath condensate (EBC) malondialdehyde as a biomarker of exposure to traffic-r...

  20. 42 CFR 84.1150 - Exhalation valve leakage test; minimum requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Exhalation valve leakage test; minimum requirements. 84.1150 Section 84.1150 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES..., Fume, and Mist; Pesticide; Paint Spray; Powered Air-Purifying High Efficiency Respirators and...

  1. [Exhaled nitric oxide in children: a noninvasive marker of airway inflammation].

    PubMed

    Cobos Barroso, Nicolás; Pérez-Yarza, Eduardo G; Sardón Prado, Olaia; Reverté Bover, Conrado; Gartner, Silvia; Korta Murua, Javier

    2008-01-01

    This article is an academic review of the application in children of the measurement of fractional exhaled nitric oxide (FENO). We outline the joint American Thoracic Society/European Respiratory Society recommendations for online measurement of FENO in both cooperating children and children unable to cooperate, offline measurement with uncontrolled exhalation flow rate, offline measurement with controlled exhalation flow rate using a dynamic flow restrictor, and offline measurement during tidal breathing in children unable to cooperate. This is followed by a review of the normal range of values for single-breath online measurements obtained with a chemiluminescence FENO analyzer (geometric mean, 9.7 parts per billion [ppb]; upper limit of the 95% confidence interval, 25.2 ppb). FENO values above 17 ppb have a sensitivity of 81% and a specificity of 80% for predicting asthma of an eosinophilic phenotype. We discuss the response of FENO values to anti-inflammatory treatment and the use of this marker in the management of asthma. Results obtained with chemiluminescence and portable electrochemical analyzers are compared. The portable devices offer the possibility--in children over 5 years of age--of accurate and universal monitoring of exhaled nitric oxide concentrations, an emerging marker of eosinophilic inflammation in asthma that facilitates diagnosis, monitoring of disease progression, and assessment of response to therapy.

  2. Surfactant Protein A in Exhaled Endogenous Particles Is Decreased in Chronic Obstructive Pulmonary Disease (COPD) Patients: A Pilot Study.

    PubMed

    Lärstad, Mona; Almstrand, Ann-Charlotte; Larsson, Per; Bake, Björn; Larsson, Sven; Ljungström, Evert; Mirgorodskaya, Ekaterina; Olin, Anna-Carin

    2015-01-01

    Exhaled, endogenous particles are formed from the epithelial lining fluid in small airways, where surfactant protein A (SP-A) plays an important role in pulmonary host defense. Based on the knowledge that chronic obstructive pulmonary disease (COPD) starts in the small airway epithelium, we hypothesized that chronic inflammation modulates peripheral exhaled particle SP-A and albumin levels. The main objective of this explorative study was to compare the SP-A and albumin contents in exhaled particles from patients with COPD and healthy subjects and to determine exhaled particle number concentrations. Patients with stable COPD ranging from moderate to very severe (n = 13), and healthy non-smoking subjects (n = 12) were studied. Subjects performed repeated breath maneuvers allowing for airway closure and re-opening, and exhaled particles were optically counted and collected on a membrane using the novel PExA® instrument setup. Immunoassays were used to quantify SP-A and albumin. COPD patients exhibited significantly lower SP-A mass content of the exhaled particles (2.7 vs. 3.9 weight percent, p = 0.036) and lower particle number concentration (p<0.0001) than healthy subjects. Albumin mass contents were similar for both groups. Decreased levels of SP-A may lead to impaired host defense functions of surfactant in the airways, contributing to increased susceptibility to COPD exacerbations. SP-A in exhaled particles from small airways may represent a promising non-invasive biomarker of disease in COPD patients.

  3. Asthma, atopy and exhaled nitric oxide in a cohort of 6-yr-old New Zealand children.

    PubMed

    Crane, Julian; Lampshire, Philippa; Wickens, Kristin; Epton, Michael; Siebers, Robert; Ingham, Tristram; Pattemore, Philip; Town, Ian

    2012-02-01

    Exhaled nitric oxide has been promoted as a non-invasive measure of airway inflammation, with clinical utility for the diagnosis and management of asthma. We studied associations between exhaled nitric oxide, asthma and atopy in a variety of clinically relevant phenotypes in a cohort of 6-yr-old children. Asthma was defined using standard questionnaire criteria, atopy was measured using skin prick tests (SPT) and specific IgE to common allergens, and exhaled nitric oxide was measured using a chemiluminescence analyser according to American and European Thoracic Society criteria. Exhaled nitric oxide was strongly related to atopy and in particular to sensitization to house dust mites. Children with non-allergic asthma had no increase in exhaled nitric oxide compared with non-asthmatic children. Compared with children who never wheezed both late onset and persistent, wheezing was associated with increased FE(NO), while early transient wheezing was not. Elevated levels of exhaled nitric oxide amongst children with allergic asthma were almost entirely explained by their levels of specific IgE to aeroallergens, predominantly D pteronyssinus. Airway inflammation as measured by exhaled nitric oxide in young New Zealand children is related to their level of specific IgE to aeroallergens. This has implications for the utility of nitric oxide as a diagnostic and management tool in childhood asthma and for the importance of specific IgE as a marker of asthma severity. © 2011 John Wiley & Sons A/S.

  4. Exhaled breath for drugs of abuse testing - evaluation in criminal justice settings.

    PubMed

    Beck, Olof

    2014-01-01

    Exhaled breath is being developed as a possible specimen for drug testing based on the collection of aerosol particles originating from the lung fluid. The present study was aimed to evaluate the applicability of exhaled breath for drugs of abuse testing in criminal justice settings. Particles in exhaled breath were collected with a new device in parallel with routine urine testing in two Swedish prisons, comprising both genders. Urine screening was performed according to established routines either by dipstick or by immunochemical methods at the Forensic Chemistry Laboratory and confirmations were with mass spectrometry methods. A total of 247 parallel samples were studied. Analysis of exhaled breath samples was done with a sensitive mass spectrometric method and identifications were made according to forensic standards. In addition tested subjects and personnel were asked to fill in a questionnaire concerning their views about drug testing. In 212 cases both the urine and breath testing were negative, and in 22 cases both urine and breath were positive. Out of 6 cases where breath was negative and urine positive 4 concerned THC. Out of 7 cases where, breath was positive and urine negative 6 concerned amphetamine. Detected substances in breath comprised: amphetamine, methamphetamine, THC, methylphenidate, buprenorphine, 6-acetylmorphine, cocaine, benzoylecgonine, diazepam and tramadol. Both the prison inmates and staff members reported breath testing to be preferable due to practical considerations. The results of this study documented that drug testing using exhaled breath provided as many positives as urine testing despite an expected shorter detection window, and that the breath sampling procedure was well accepted and provided practical benefits reported both by the prison inmates and testing personnel.

  5. Moderate exercise decreases nitric oxide exhalation in patients with stable coronary artery disease.

    PubMed

    Nadziakiewicz, P; Knapik, P; Ziora, D; Nowak, D

    2006-09-01

    Nitric oxide (NO) is present in exhaled air in humans and its level may decrease in heart diseases. Nitrates are metabolised to NO. In the present study we prospectively investigated how coronary disease treated with oral nitrates and physical exercise influence the exhaled NO concentration (exNO). The study was performed in 44 patients with stable coronary artery disease (CAD) treated with oral nitrates (31 nonsmokers and 13 smokers). End-tidal concentration of exhaled NO was measured by the use of a chemiluminescence method. The Bruce protocol of an exercise test was performed in 21 coronary patients and 11 volunteers. NO was measured before and 2-5 min after the test. We found no significant differences in the exNO level between healthy controls and CAD patients as analyzed either for the whole groups or non-smoker and smoker subgroups (6.01 parts per billion (ppb) vs. 4.91 ppb; 7.02 ppb vs. 5,89 ppb; 3.62 ppb vs. 3.33 ppb, respectively). However, the coronary patients group, as a whole, had lower exNO after exercise (4.22 ppb vs. 3,84 ppb, P<0.01). The difference persisted after division of this group into non-smokers and smokers; 5.19 ppb vs. 4,79 ppb, P<0.05 and 3.63 ppb vs. 3.27 ppb, P<0.05, respectively). The level of exNO changed inappreciably after exercise in control subjects. We conclude that coronary disease and oral nitrates, in themselves, do not influence the exhaled NO concentration. Physical exercise, on the other side, lowers the exhaled NO level in coronary patients.

  6. Measuring Compounds in Exhaled Air to Detect Alzheimer's Disease and Parkinson’s Disease

    PubMed Central

    Hattesohl, Akira; Lubbe, Dirk; Schmid, Severin; Tackenberg, Björn; Rieke, Jürgen; Maddula, Sasidhar; Baumbach, Jörg Ingo; Nell, Christoph; Boeselt, Tobias; Michelis, Joan; Alferink, Judith; Heneka, Michael; Oertel, Wolfgang; Jessen, Frank; Janciauskiene, Sabina; Vogelmeier, Claus; Dodel, Richard; Koczulla, Andreas Rembert

    2015-01-01

    Background Alzheimer’s disease (AD) is diagnosed based upon medical history, neuropsychiatric examination, cerebrospinal fluid analysis, extensive laboratory analyses and cerebral imaging. Diagnosis is time consuming and labour intensive. Parkinson’s disease (PD) is mainly diagnosed on clinical grounds. Objective The primary aim of this study was to differentiate patients suffering from AD, PD and healthy controls by investigating exhaled air with the electronic nose technique. After demonstrating a difference between the three groups the secondary aim was the identification of specific substances responsible for the difference(s) using ion mobility spectroscopy. Thirdly we analysed whether amyloid beta (Aβ) in exhaled breath was causative for the observed differences between patients suffering from AD and healthy controls. Methods We employed novel pulmonary diagnostic tools (electronic nose device/ion-mobility spectrometry) for the identification of patients with neurodegenerative diseases. Specifically, we analysed breath pattern differences in exhaled air of patients with AD, those with PD and healthy controls using the electronic nose device (eNose). Using ion mobility spectrometry (IMS), we identified the compounds responsible for the observed differences in breath patterns. We applied ELISA technique to measure Aβ in exhaled breath condensates. Results The eNose was able to differentiate between AD, PD and HC correctly. Using IMS, we identified markers that could be used to differentiate healthy controls from patients with AD and PD with an accuracy of 94%. In addition, patients suffering from PD were identified with sensitivity and specificity of 100%. Altogether, 3 AD patients out of 53 participants were misclassified. Although we found Aβ in exhaled breath condensate from both AD and healthy controls, no significant differences between groups were detected. Conclusion These data may open a new field in the diagnosis of neurodegenerative disease

  7. Immediate effects of breath holding maneuvers onto composition of exhaled breath.

    PubMed

    Sukul, Pritam; Trefz, Phillip; Schubert, Jochen K; Miekisch, Wolfram

    2014-09-01

    Rapid concentration changes due to physiological or pathophysiological effects rather than appearance of unique disease biomarkers are important for clinical application of breath research. Simple maneuvers such as breath holding may significantly affect breath biomarker concentrations. In this study, exhaled volatile organic compound (VOC) concentrations were assessed in real time before and after different breath holding maneuvers. Continuous breath-resolved measurements (PTR-ToF-MS-8000) were performed in 31 healthy human subjects in a side-stream sampling mode. After 1 min of tidal breathing participants held their breath for 10, 20, 40, 60 s and as long as possible. Afterwards they continued to breathe normally for another minute. VOC profiles could be monitored in real time by assigning online PTR-ToF-MS data to alveolar or inspired phases of breath. Sudden and profound changes of exhaled VOC concentrations were recorded after different breath holding maneuvers. VOC concentrations returned to base line levels 10-20 s after breath holding. Breath holding induced concentration changes depended on physico-chemical properties of the substances. When substance concentrations were normalized onto end-tidal CO2 content, variation of acetone concentrations decreased, whereas variations of isoprene concentrations were not affected. As the effects of breathing patterns on exhaled substance concentrations depend on individual substance properties, sampling procedures have to be validated for each compound by means of appropriate real-time analysis. Normalization of exhaled concentrations onto exhaled CO2 is only valid for substances having similar physico-chemical properties as CO2.

  8. Nasal nitric oxide assessment in primary ciliary dyskinesia using aspiration, exhalation, and humming.

    PubMed

    Santamaria, Francesca; De Stefano, Sara; Montella, Silvia; Barbarano, Federico; Iacotucci, Paola; Ciccarelli, Roberto; Sofia, Matteo; Maniscalco, Mauro

    2008-02-01

    Several studies reported low nasal nitric oxide (nNO) levels in subjects with primary ciliary dyskinesia (PCD) and proposed nNO measurement as a diagnostic tool to screen for the disease. All these reports used the aspiration nNO method. The goal of this study was to evaluate nNO in patients with PCD using different methods of NO measurement, including continuous aspiration, silent exhalation, and single-breath humming exhalation, which increases NO wash-out from the paranasal sinuses to the nose. Fourteen patients with established diagnosis of PCD and 14 healthy controls (HC) were examined. Oral and nasal NO levels were measured by chemiluminescence. Each subject performed NO measurement in triplicate during oral exhalation, nasal aspiration (nNOasp), nasal exhalation (nNOexh), and single-breath humming (nNOhum). The median nNOasp value (95% confidence interval) was 11.6 (7.2-19.1) ppb in PCD and 321.8 (270.6-510.6) ppb in HC (p<0.001). The nNOexh value was 2.2 (1.3-3.1) in PCD and 31.8 (26.6-47.2) ppb in HC (p<0.001). Patients with PCD had lower nNO than HC during the last 80% of the exhalation throughout humming, i.e. 2.8 (2.2-4.3) ppb vs. 212.4 (158.7-244.8) ppb (p<0.001), and did not show a clear nNO peak. All nasal NO measurements had excellent specificity and sensitivity in detecting PCD compared with the healthy controls. nNO is consistently low in PCD with good specificity and sensitivity whatever the method used for NO measurement. The extremely low levels of nNO during humming support the notion that NO is defective in the paranasal sinuses in PCD.

  9. Extended analysis of exhaled and nasal nitric oxide for the evaluation of chronic cough.

    PubMed

    Maniscalco, Mauro; Faraone, Stanislao; Sofia, Matteo; Molino, Antonio; Vatrella, Alessandro; Zedda, Anna

    2015-08-01

    Chronic cough is usually defined as a cough that lasts for eight weeks or longer. Its etiological diagnosis is not always straightforward, and the measurement of exhaled nitric oxide (FeNO) has been proposed in patients' evaluation. No studies have assessed the usefulness of extended exhaled NO measurement for the evaluation of chronic cough. Therefore, we aimed at evaluating the usefulness of an extended exhaled NO measurement and nasal NO for an initial evaluation of chronic cough. We studied 52 non-smoker patients with prolonged cough lasting more than eight weeks. Etiologies of cough were identified. Nasal NO and FeNO were assessed using multiple single-breath NO analysis at different constant expiratory flow-rates. From the fractional NO concentration measured at each flow-rate, the total NO flux between tissue and gas phase in the bronchial lumen (J'awNO), and the alveolar NO concentration (Cano) were extrapolated. The patients were classified in four categories: cough variant asthma (CVA), nonasthmatic eosinophilic bronchitis (NAEB), upper airway cough syndrome (UACS) and gastro-esophageal reflux disease (GERD). Compared with UACS and GERD, both exhaled NO and J'awNO were higher in CVA and NAEB, and no differences were found in Cano and nasal NO level among the four groups. Our study suggests a potentially useful role for FeNO measurement in the etiological diagnosis of chronic cough. We did not find any additive value of performing exhaled NO at multiple flow-rates and nasal NO measurements. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Phosphogypsum recycling in the building materials industry: assessment of the radon exhalation rate.

    PubMed

    Campos, M P; Costa, L J P; Nisti, M B; Mazzilli, B P

    2017-06-01

    Phosphogypsum can be classified as a Naturally Occurring Radioactive Material (NORM) residue of the phosphate fertilizer industry. One of the main environmental concerns of its use as building material is the radon exhalation. The aim of this study is to measure the radon exhalation rate from plates and bricks manufactured with phosphogypsum from three installations of the main Brazilian producer, Vale Fertilizantes, in order to evaluate the additional health risk to dwellers. A simple and reliable accumulator method involving a PVC pipe sealed with a PVC pipe cover commercially available with CR-39 radon detector into a diffusion chamber was used for measuring radon exhalation rate from phosphogypsum made plates and bricks. The radon exhalation rate from plates varied from 0.19 ± 0.06 Bq m(-2) h(-1), for phosphogypsum from Bunge Fertilizers, from 1.3 ± 0.3 Bq m(-2) h(-1), for phosphogypsum from Ultrafertil. As for the bricks, the results ranged from 0.11 ± 0.01 Bq m(-2) h(-1), for phosphogypsum from Bunge Fertilizers, to 1.2 ± 0.3 Bq m(-2) h(-1), for phosphogypsum from Ultrafertil. The results obtained in this study for the radon exhalation rate from phosphogypsum plates and bricks are of the same order of magnitude than those from ordinary building materials. So, it can be concluded that the recycling of phosphogypsum as building material is a safe practice, since no additional health risk is expected from the radiological point of view. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Exhaled air dispersion distances during noninvasive ventilation via different Respironics face masks.

    PubMed

    Hui, David S; Chow, Benny K; Ng, Susanna S; Chu, Leo C Y; Hall, Stephen D; Gin, Tony; Sung, Joseph J Y; Chan, Matthew T V

    2009-10-01

    As part of our influenza pandemic preparedness, we studied the exhaled air dispersion distances and directions through two different face masks (Respironics; Murrysville, PA) attached to a human-patient simulator (HPS) during noninvasive positive-pressure ventilation (NPPV) in an isolation room with pressure of -5 Pa. The HPS was positioned at 45 degrees on the bed and programmed to mimic mild lung injury (oxygen consumption, 300 mL/min; lung compliance, 35 mL/cm H(2)O). Airflow was marked with intrapulmonary smoke for visualization. Inspiratory positive airway pressure (IPAP) started at 10 cm H(2)O and gradually increased to 18 cm H(2)O, whereas expiratory pressure was maintained at 4 cm H(2)O. A leakage jet plume was revealed by a laser light sheet, and images were captured by high definition video. Normalized exhaled air concentration in the plume was estimated from the light scattered by the smoke particles. As IPAP increased from 10 to 18 cm H(2)O, the exhaled air of a low normalized concentration through the ComfortFull 2 mask (Respironics) increased from 0.65 to 0.85 m at a direction perpendicular to the head of the HPS along the median sagittal plane. When the IPAP of 10 cm H(2)O was applied via the Image 3 mask (Respironics) connected to the whisper swivel, the exhaled air dispersed to 0.95 m toward the end of the bed along the median sagittal plane, whereas higher IPAP resulted in wider spread of a higher concentration of smoke. Substantial exposure to exhaled air occurs within a 1-m region, from patients receiving NPPV via the ComfortFull 2 mask and the Image 3 mask, with more diffuse leakage from the latter, especially at higher IPAP.

  12. Post-operative elimination of sevoflurane anesthetic and hexafluoroisopropanol metabolite in exhaled breath: Pharmacokinetic models for assessing liver function

    EPA Science Inventory

    Sevoflurane (SEV), a commonly used anesthetic agent for invasive surgery, is directly eliminated via exhaled breath and indirectly by metabolic conversion to inorganic fluoride and hexafluoroisopropanol (HFIP), which is also eliminated in the breath. We studied the post-operativ...

  13. Development of an Exhaled Breath Monitoring System with Semiconductive Gas Sensors, a Gas Condenser Unit, and Gas Chromatograph Columns.

    PubMed

    Itoh, Toshio; Miwa, Toshio; Tsuruta, Akihiro; Akamatsu, Takafumi; Izu, Noriya; Shin, Woosuck; Park, Jangchul; Hida, Toyoaki; Eda, Takeshi; Setoguchi, Yasuhiro

    2016-11-10

    Various volatile organic compounds (VOCs) in breath exhaled by patients with lung cancer, healthy controls, and patients with lung cancer who underwent surgery for resection of cancer were analyzed by gas condenser-equipped gas chromatography-mass spectrometry (GC/MS) for development of an exhaled breath monitoring prototype system involving metal oxide gas sensors, a gas condenser, and gas chromatography columns. The gas condenser-GC/MS analysis identified concentrations of 56 VOCs in the breath exhaled by the test population of 136 volunteers (107 patients with lung cancer and 29 controls), and selected four target VOCs, nonanal, acetoin, acetic acid, and propanoic acid, for use with the condenser, GC, and sensor-type prototype system. The prototype system analyzed exhaled breath samples from 101 volunteers (74 patients with lung cancer and 27 controls). The prototype system exhibited a level of performance similar to that of the gas condenser-GC/MS system for breath analysis.

  14. Post-operative elimination of sevoflurane anesthetic and hexafluoroisopropanol metabolite in exhaled breath: Pharmacokinetic models for assessing liver function

    EPA Science Inventory

    Sevoflurane (SEV), a commonly used anesthetic agent for invasive surgery, is directly eliminated via exhaled breath and indirectly by metabolic conversion to inorganic fluoride and hexafluoroisopropanol (HFIP), which is also eliminated in the breath. We studied the post-operativ...

  15. Variability of exhaled breath condensate (EBC) volume and pH using a feedback regulated breathing pattern

    EPA Science Inventory

    Exhaled breath condensate (EBC) is a valuable biological medium for non-invasively measuring biomarkers with the potential to reflect organ systems responses to environmental and dietary exposures and disease processes. Collection of EBC has typically been with spontaneous breat...

  16. Development of an Exhaled Breath Monitoring System with Semiconductive Gas Sensors, a Gas Condenser Unit, and Gas Chromatograph Columns

    PubMed Central

    Itoh, Toshio; Miwa, Toshio; Tsuruta, Akihiro; Akamatsu, Takafumi; Izu, Noriya; Shin, Woosuck; Park, Jangchul; Hida, Toyoaki; Eda, Takeshi; Setoguchi, Yasuhiro

    2016-01-01

    Various volatile organic compounds (VOCs) in breath exhaled by patients with lung cancer, healthy controls, and patients with lung cancer who underwent surgery for resection of cancer were analyzed by gas condenser-equipped gas chromatography-mass spectrometry (GC/MS) for development of an exhaled breath monitoring prototype system involving metal oxide gas sensors, a gas condenser, and gas chromatography columns. The gas condenser-GC/MS analysis identified concentrations of 56 VOCs in the breath exhaled by the test population of 136 volunteers (107 patients with lung cancer and 29 controls), and selected four target VOCs, nonanal, acetoin, acetic acid, and propanoic acid, for use with the condenser, GC, and sensor-type prototype system. The prototype system analyzed exhaled breath samples from 101 volunteers (74 patients with lung cancer and 27 controls). The prototype system exhibited a level of performance similar to that of the gas condenser-GC/MS system for breath analysis. PMID:27834896

  17. Application of Novel Method to Measure Endogenous VOCs in Exhaled Breath Condensate Before and After Exposure to Diesel Exhaust

    EPA Science Inventory

    Polar volatile organic compounds (PVOCs) such as aldehydes, ketones, and alcohols are byproducts of normal human metabolism and are present in exhaled breath and blood. Environmental exposures, individual activities, and disease states can perturb normal metabolic processes and ...

  18. Application of Novel Method to Measure Endogenous VOCs in Exhaled Breath Condensate Before and After Exposure to Diesel Exhaust

    EPA Science Inventory

    Polar volatile organic compounds (PVOCs) such as aldehydes, ketones, and alcohols are byproducts of normal human metabolism and are present in exhaled breath and blood. Environmental exposures, individual activities, and disease states can perturb normal metabolic processes and ...

  19. Measuring radon exhalation rate in two cycles avoiding the effects of back-diffusion and chamber leakage.

    PubMed

    Tan, Yanliang; Xiao, Detao

    2013-10-01

    This paper will present a simple method for measuring the radon exhalation rate from the medium surface in two cycles and also avoiding the effects of back-diffusion and chamber leakage. The method is based on a combination of the "accumulation chamber" technique and a radon monitor. The radon monitor performs the measurement of the radon concentration inside the accumulation chamber, and then the radon exhalation rate can be obtained by simple calculation. For reducing the systematic error and the statistical uncertainty, too short of total measurement time is not appropriate, and the first cycle time should be about 70 % of the total measurement. The radon exhalation rate from the medium surface obtained through this method is in good agreement with the reference value. This simple method can be applied to develop and improve the instruments for measuring radon exhalation rate.

  20. Variability of exhaled breath condensate (EBC) volume and pH using a feedback regulated breathing pattern

    EPA Science Inventory

    Exhaled breath condensate (EBC) is a valuable biological medium for non-invasively measuring biomarkers with the potential to reflect organ systems responses to environmental and dietary exposures and disease processes. Collection of EBC has typically been with spontaneous breat...

  1. Viral kinetics and exhaled droplet size affect indoor transmission dynamics of influenza infection.

    PubMed

    Chen, S C; Chio, C P; Jou, L J; Liao, C M

    2009-10-01

    The purpose of this paper was to investigate the effects of viral kinetics and exhaled droplet size on indoor transmission dynamics of influenza infection. The target cell-limited model with delayed virus production was adopted to strengthen the inner mechanisms of virus infection on human epithelial cell. The particle number and volume involved in the viral kinetics were linked with Wells-Riley mathematical equation to quantify the infection risk. We investigated population dynamics in a specific elementary school by using the seasonal susceptible - exposed - infected - recovery (SEIR) model. We found that exhaled pulmonary bioaerosol of sneeze (particle diameter <10 microm) have 10(2)-fold estimate higher than that of cough. Sneeze and cough caused risk probabilities range from 0.075 to 0.30 and 0.076, respectively; whereas basic reproduction numbers (R(0)) estimates range from 4 to 17 for sneeze and nearly 4 for cough, indicating sneeze-posed higher infection risk. The viral kinetics and exhaled droplet size for sneeze affect indoor transmission dynamics of influenza infection since date post-infection 1-7. This study provides direct mechanistic support that indoor influenza virus transmission can be characterized by viral kinetics in human upper respiratory tracts that are modulated by exhaled droplet size. Practical Implications This paper provides a predictive model that can integrate the influenza viral kinetics (target cell-limited model), indoor aerosol transmission potential (Wells-Riley mathematical equation), and population dynamic model [susceptible - exposed - infected - recovery (SEIR) model] in a proposed susceptible population. Viral kinetics expresses the competed results of human immunity ability with influenza virus generation. By linking the viral kinetics and different exposure parameters and environmental factors in a proposed school setting with five age groups, the influenza infection risk can be estimated. On the other hand, we implicated

  2. Determining the radon exhalation rate from a gold mine tailings dump by measuring the gamma radiation.

    PubMed

    Ongori, Joash N; Lindsay, Robert; Newman, Richard T; Maleka, Peane P

    2015-02-01

    The mining activities taking place in Gauteng province, South Africa have caused millions of tons of rocks to be taken from underground to be milled and processed to extract gold. The uranium bearing tailings are placed in an estimated 250 dumps covering a total area of about 7000 ha. These tailings dumps contain considerable amounts of radium and have therefore been identified as large sources of radon. The size of these dumps make traditional radon exhalation measurements time consuming and it is difficult to get representative measurements for the whole dump. In this work radon exhalation measurements from the non-operational Kloof mine dump have been performed by measuring the gamma radiation from the dump fairly accurately over an area of more than 1 km(2). Radon exhalation from the mine dump have been inferred from this by laboratory-based and in-situ gamma measurements. Thirty four soil samples were collected at depths of 30 cm and 50 cm. The weighted average activity concentrations in the soil samples were 308 ± 7 Bq kg(-1), 255 ± 5 Bq kg(-1) and 18 ± 1 Bq kg(-1) for (238)U, (40)K and (232)Th, respectively. The MEDUSA (Multi-Element Detector for Underwater Sediment Activity) γ-ray detection system was used for field measurements. The radium concentrations were then used with soil parameters to obtain the radon flux using different approaches such as the IAEA (International Atomic Energy Agency) formula. Another technique the MEDUSA Laboratory Technique (MELT) was developed to map radon exhalation based on (1) recognising that radon exhalation does not affect (40)K and (232)Th activity concentrations and (2) that the ratio of the activity concentration of the field (MEDUSA) to the laboratory (HPGe) for (238)U and (40)K or (238)U and (232)Th will give a measure of the radon exhalation at a particular location in the dump. The average, normalised radon flux was found to be 0.12 ± 0.02 Bq m(-2) s(-1) for the mine dump.

  3. The analysis of volatile organic compounds in exhaled breath and biomarkers in exhaled breath condensate in children - clinical tools or scientific toys?

    PubMed

    van Mastrigt, E; de Jongste, J C; Pijnenburg, M W

    2015-07-01

    Current monitoring strategies for respiratory diseases are mainly based on clinical features, lung function and imaging. As airway inflammation is the hallmark of many respiratory diseases in childhood, noninvasive methods to assess the presence and severity of airway inflammation might be helpful in both diagnosing and monitoring paediatric respiratory diseases. At present, the measurement of fractional exhaled nitric oxide is the only noninvasive method available to assess eosinophilic airway inflammation in clinical practice. We aimed to evaluate whether the analysis of volatile organic compounds (VOCs) in exhaled breath (EB) and biomarkers in exhaled breath condensate (EBC) is helpful in diagnosing and monitoring respiratory diseases in children. An extensive literature search was conducted in Medline, Embase and PubMed on the analysis and applications of VOCs in EB and EBC in children. We retrieved 1165 papers, of which nine contained original data on VOCs in EB and 84 on biomarkers in EBC. These were included in this review. We give an overview of the clinical applications in childhood and summarize the methodological issues. Several VOCs in EB and biomarkers in EBC have the potential to distinguish patients from healthy controls and to monitor treatment responses. Lack of standardization of collection methods and analysis techniques hampers the introduction in clinical practice. The measurement of metabolomic profiles may have important advantages over detecting single markers. There is a lack of longitudinal studies and external validation to reveal whether EB and EBC analysis have added value in the diagnostic process and follow-up of children with respiratory diseases. In conclusion, the use of VOCs in EB and biomarkers in EBC as markers of inflammatory airway diseases in children is still a research tool and not validated for clinical use. © 2014 John Wiley & Sons Ltd.

  4. Online Measurement of Exhaled NO Concentration and Its Production Sites by Fast Non-equilibrium Dilution Ion Mobility Spectrometry

    NASA Astrophysics Data System (ADS)

    Peng, Liying; Jiang, Dandan; Wang, Zhenxin; Liu, Jiwei; Li, Haiyang

    2016-03-01

    Exhaled nitric oxide (NO) is one of the most promising breath markers for respiratory diseases. Its profile for exhalation and the respiratory NO production sites can provide useful information for medical disease diagnosis and therapeutic procedures. However, the high-level moisture in exhaled gas always leads to the poor selectivity and sensitivity for ion spectrometric techniques. Herein, a method based on fast non-equilibrium dilution ion mobility spectrometry (NED-IMS) was firstly proposed to directly monitor the exhaled NO profile on line. The moisture interference was eliminated by turbulently diluting the original moisture to 21% of the original with the drift gas and dilution gas. Weak enhancement was observed for humid NO response and its limit of detection at 100% relative humidity was down to 0.58 ppb. The NO concentrations at multiple exhalation flow rates were measured, while its respiratory production sites were determined by using two-compartment model (2CM) and Högman and Meriläinen algorithm (HMA). Last but not the least, the NO production sites were analyzed hourly to tentatively investigate the daily physiological process of NO. The results demonstrated the capacity of NED-IMS in the real-time analysis of exhaled NO and its production sites for clinical diagnosis and assessment.

  5. Exhaled pentane as a possible marker for survival and lipid peroxidation during radiotherapy for lung cancer--a pilot study.

    PubMed

    Crohns, Marika; Saarelainen, Seppo; Laitinen, Jukka; Peltonen, Kimmo; Alho, Hannu; Kellokumpu-Lehtinen, Pirkko

    2009-10-01

    To examine lipid peroxidation during radiotherapy (RT), exhaled pentane samples were collected from 11 lung cancer patients before RT and 30 and 120 min after the start of RT on days 1, 4 and 5 and at 30 and 40 Grays, if possible. Exhaled pentane samples were collected once from 30 healthy controls. Serum thiobarbituric-acid-reactive substances (TBARS) and conjugated dienes (CD) were obtained from patients on each exhaled air collection day. Lung cancer patients had higher exhaled pentane levels than controls (1.73 ng/L vs 0.83 ng/L, p=0.017). Exhaled pentane levels tended to decrease during the first RT day (p=0.075) and levels of CD decreased during the first week of RT (p=0.014). Higher pre-treatment pentane levels predicted better survival (p=0.003). Elevated exhaled pentane levels before RT may be due to the lipid peroxidation burden associated with cancer. The decrease of lipid peroxidation markers during RT may be attributable to enhanced antioxidant defense mechanisms.

  6. Measurement of radon/thoron exhalation rates and gamma-ray dose rate in granite areas in Japan.

    PubMed

    Prasad, G; Ishikawa, T; Hosoda, M; Sahoo, S K; Kavasi, N; Sorimachi, A; Tokonami, S; Uchida, S

    2012-11-01

    Radon and thoron exhalation rates and gamma-ray dose rate in different places in Hiroshima Prefecture were measured. Exhalation rates were measured using an accumulation chamber method. The radon exhalation rate was found to vary from 3 to 37 mBq m(-2) s(-1), while the thoron exhalation rate ranged from 40 to 3330 mBq m(-2) s(-1). The highest radon exhalation rate (37 mBq m(-2) s(-1)) and gamma-ray dose rate (92 nGy h(-1)) were found in the same city (Kure City). In Kure City, indoor radon and thoron concentrations were previously measured at nine selected houses using a radon-thoron discriminative detector (Raduet). The indoor radon concentrations varied from 16 to 78 Bq m(-3), which was higher than the average value in Japan (15.5 Bq m(-3)). The indoor thoron concentration ranged from ND (not detected: below a detection limit of approximately 10 Bq m(-3)) to 314 Bq m(-3). The results suggest that radon exhalation rate from the ground is an influential factor for indoor radon concentration.

  7. Online Measurement of Exhaled NO Concentration and Its Production Sites by Fast Non-equilibrium Dilution Ion Mobility Spectrometry

    PubMed Central

    Peng, Liying; Jiang, Dandan; Wang, Zhenxin; Liu, Jiwei; Li, Haiyang

    2016-01-01

    Exhaled nitric oxide (NO) is one of the most promising breath markers for respiratory diseases. Its profile for exhalation and the respiratory NO production sites can provide useful information for medical disease diagnosis and therapeutic procedures. However, the high-level moisture in exhaled gas always leads to the poor selectivity and sensitivity for ion spectrometric techniques. Herein, a method based on fast non-equilibrium dilution ion mobility spectrometry (NED-IMS) was firstly proposed to directly monitor the exhaled NO profile on line. The moisture interference was eliminated by turbulently diluting the original moisture to 21% of the original with the drift gas and dilution gas. Weak enhancement was observed for humid NO response and its limit of detection at 100% relative humidity was down to 0.58 ppb. The NO concentrations at multiple exhalation flow rates were measured, while its respiratory production sites were determined by using two-compartment model (2CM) and Högman and Meriläinen algorithm (HMA). Last but not the least, the NO production sites were analyzed hourly to tentatively investigate the daily physiological process of NO. The results demonstrated the capacity of NED-IMS in the real-time analysis of exhaled NO and its production sites for clinical diagnosis and assessment. PMID:26975333

  8. Modeling and experimental examination of water level effects on radon exhalation from fragmented uranium ore.

    PubMed

    Ye, Yong-Jun; Dai, Xin-Tao; Ding, De-Xin; Zhao, Ya-Li

    2016-12-01

    In this study, a one-dimensional steady-state mathematical model of radon transport in fragmented uranium ore was established according to Fick's law and radon transfer theory in an air-water interface. The model was utilized to obtain an analytical solution for radon concentration in the air-water, two-phase system under steady state conditions, as well as a corresponding radon exhalation rate calculation formula. We also designed a one-dimensional experimental apparatus for simulating radon diffusion migration in the uranium ore with various water levels to verify the mathematical model. The predicted results were in close agreement with the measured results, suggesting that the proposed model can be readily used to determine radon concentrations and exhalation rates in fragmented uranium ore with varying water levels. Copyright © 2016. Published by Elsevier Ltd.

  9. Quantum cascade laser-based sensor for detection of exhaled and biogenic nitric oxide

    NASA Astrophysics Data System (ADS)

    Marchenko, D.; Mandon, J.; Cristescu, S. M.; Merkus, P. J. F. M.; Harren, F. J. M.

    2013-05-01

    A sensor based on a continuous wave quantum cascade laser, operating near 5.2 μm, in combination with integrated cavity output spectroscopy has been developed for simultaneous measurement of nitric oxide (NO) and carbon dioxide (CO2) traces in exhaled air. A detection limit of 0.7 parts-per-billion by volume of NO (acquisition time: 1 s) is achieved. Comparison is made with the standard chemiluminescence NO analyzer and commercial CO2 breath sampler. The QCL-based sensor is tested on healthy subjects at various exhalation flow rates (15, 50, 100 and 300 ml/s) for both online and offline sampling procedures as well as on asthmatic children (offline sampling). Possibilities for measurements of biogenic NO in vivo, i.e., NO coming from human skin tissue, are also demonstrated.

  10. Assessment of airway inflammation by exhaled breath condensate and impedance due to gastroesophageal reflux disease (GERD).

    PubMed

    Shimizu, Yasuo; Dobashi, Kunio; Nagoshi, Atsuto; Kawamura, Osamu; Mori, Masatomo

    2009-09-01

    Avoiding oxidative stress in the airways is important for the treatment of respiratory disease associated with gastroesophageal reflux disease (GERD). It is often difficult to decide whether GERD is causing airway inflammation or whether an airway disease is complicated by GERD. Measurement of exhaled breath condensate (EBC) is performed by cooling and collecting the airway lining fluid contained in exhaled air. A decrease of pH and an increase of the 8-isoprostane concentration in EBC have been observed in patients with mild to moderate asthma accompanied by GERD. There are still problems to be overcome before EBC can be used clinically, but pH and 8-isoprostane may be promising objective markers of airway inflammation due to GERD. The disease concept and diagnosis of GERD are constantly advancing, including the development of impedance methods. It is expected that treatment will be based on the latest diagnostic knowledge of GERD associated with respiratory disease and on monitoring of airway inflammation.

  11. [Determination of proteomic and metabolic composition of exhaled breath condensate of newborns].

    PubMed

    Kononikhin, A S; Chagovets, V V; Starodubtseva, N L; Ryndin, A Y; Bugrova, A E; Kostyukevich, Y I; Popov, I A; Frankevich, V E; Ionov, O V; Sukhikh, G T; Nikolaev, E N

    2016-01-01

    Here, the possibility of proteomic and metabolomic analysis of the composition of exhaled breath condensate of neonates with respiratory support. The developed method allows non-invasive collecting sufficient amount of the material for identification of disease-specific biomarkers. Samples were collected by using a condensing device that was incorporated into the ventilation system. The collected condensate was analyzed by liquid chromatography coupled with high resolution mass spectrometry and tandem mass spectrometry. The isolated substances were identified with a use of databases for proteins and metabolites. As a result, a number of compounds that compose the exhaled breath condensate was determined and can be considered as possible biomarkers of newborn diseases or stage of development.

  12. Exhaled nitric oxide in mylar balloons: influence of storage time, humidity and temperature.

    PubMed Central

    Bodini, Alessandro; Pijnenburg, Mariëlle W H; Boner, Atillio L; de Jongste, Johan C

    2003-01-01

    BACKGROUND: Mylar balloons are used to collect exhaled air for analysis of fractional nitric oxide concentration (FENO). AIM: We studied the effect of storage conditions on the stability of nitric oxide (NO) in mylar balloons. METHODS: Exhaled air samples and calibration gases were stored in mylar balloons at 4, 21 and 37 degrees C, with or without silica gel. NO was measured after 0, 6, 9, 24 and 48 h. Scheffe F-tests were used to compare NO values. RESULTS: NO remained stable in balloons for 9 h at all temperatures, without silica gel. NO increased between 9 and 48 h, but only with low initial FENO. Silica gel increased variability. CONCLUSIONS: FENO in mylar balloons is stable for at least 9 h. The storage temperature is not critical, but silica gel increases variability. PMID:12745548

  13. Influence of the oropharyngeal microflora on the measurement of exhaled breath hydrogen.

    PubMed

    Thompson, D G; O'Brien, J D; Hardie, J M

    1986-10-01

    We investigated the possible contribution made by oropharyngeal microfloral fermentation of ingested carbohydrate to the generation of the early, transient exhaled breath hydrogen rise seen after carbohydrate ingestion. Ten subjects ate or were sham fed carbohydrate-containing meals with and without prior chlorhexidine mouthwash during serial collection of exhaled breath and mouth hydrogen samples. Meal ingestion and sham feeding both induced significant (p less than 0.01) elevations of breath and mouth hydrogen that were virtually abolished by prior chlorhexidine mouthwash. In 7 subjects, delivery of the meal directly into the stomach via an orogastric tube did not cause a breath or mouth hydrogen rise. Oral contents incubated anaerobically in vitro with carbohydrate generated hydrogen that was again inhibited by chlorhexidine. These studies indicate that fermentation of ingested carbohydrate by oropharyngeal bacteria can contribute significantly to measured breath hydrogen values soon after meal ingestion, and may introduce avoidable error into the interpretation of serial breath hydrogen data.

  14. Measurement of exhaled nitric oxide in beef cattle using tunable diode laser absorption spectroscopy

    NASA Astrophysics Data System (ADS)

    Roller, C. B.; Holland, B. P.; McMillen, G.; Step, D. L.; Krehbiel, C. R.; Namjou, K.; McCann, P. J.

    2007-03-01

    Measurement of nitric oxide (NO) in the expired breath of crossbred calves received at a research facility was performed using tunable diode laser absorption spectroscopy. Exhaled NO (eNO) concentrations were measured using NO absorption lines at 1912.07 cm-1 and employing background subtraction. The lower detection limit and measurement precision were determined to be ˜330 parts in 1012 per unit volume. A custom breath collection system was designed to collect lower airway breath of spontaneously breathing calves while in a restraint chute. Breath was collected and analyzed from calves upon arrival and periodically during a 42 day receiving period. There was a statistically significant relationship between eNO, severity of bovine respiratory disease (BRD) in terms of number of times treated, and average daily weight gain over the first 15 days postarrival. In addition, breathing patterns and exhaled CO2 showed a statistically significant relationship with BRD morbidity.

  15. Multifrequency high precise subTHz-THz-IR spectroscopy for exhaled breath research

    NASA Astrophysics Data System (ADS)

    Vaks, Vladimir L.; Domracheva, Elena G.; Pripolzin, Sergey I.; Chernyaeva, Mariya B.

    2016-09-01

    Nowadays the development of analytical spectroscopy with high performance, sensitivity and spectral resolution for exhaled breath research is attended. The method of two-frequency high precise THz spectroscopy and the method of high precise subTHz-THz-IR spectroscopy are presented. Development of a subTHz-THz-IR gas analyzer increases the number of gases that can be identified and the reliability of the detection by confirming the signature in both THz and MIR ranges. The testing measurements have testified this new direction of analytical spectroscopy to open widespread trends of its using for various problems of medicine and biology. First of all, there are laboratory investigations of the processes in exhaled breath and studying of their dynamics. Besides, the methods presented can be applied for detecting intermediate and short time living products of reactions in exhaled breath. The spectrometers have been employed for investigations of acetone, methanol and ethanol in the breath samples of healthy volunteers and diabetes patients. The results have demonstrated an increased concentration of acetone in breath of diabetes patients. The dynamic of changing the acetone concentration before and after taking the medicines is discovered. The potential markers of pre-cancer states and oncological diseases of gastrointestinal tract organs have been detected. The changes in the NO concentration in exhaled breath of cancer patients during radiotherapy as well as increase of the NH3 concentration at gastrointestinal diseases have been revealed. The preliminary investigations of biomarkers in three frequency ranges have demonstrated the advantages of the multifrequency high precise spectroscopy for noninvasive medical diagnostics.

  16. Prediction of Asthma Exacerbations in Children by Innovative Exhaled Inflammatory Markers: Results of a Longitudinal Study

    PubMed Central

    van Vliet, Dillys; Alonso, Ariel; Rijkers, Ger; Heynens, Jan; Rosias, Philippe; Muris, Jean; Jöbsis, Quirijn; Dompeling, Edward

    2015-01-01

    Background In asthma management guidelines the primary goal of treatment is asthma control. To date, asthma control, guided by symptoms and lung function, is not optimal in many children and adults. Direct monitoring of airway inflammation in exhaled breath may improve asthma control and reduce the number of exacerbations. Aim 1) To study the use of fractional exhaled nitric oxide (FeNO) and inflammatory markers in exhaled breath condensate (EBC), in the prediction of asthma exacerbations in a pediatric population. 2) To study the predictive power of these exhaled inflammatory markers combined with clinical parameters. Methods 96 asthmatic children were included in this one-year prospective observational study, with clinical visits every 2 months. Between visits, daily symptom scores and lung function were recorded using a home monitor. During clinical visits, asthma control and FeNO were assessed. Furthermore, lung function measurements were performed and EBC was collected. Statistical analysis was performed using a test dataset and validation dataset for 1) conditionally specified models, receiver operating characteristic-curves (ROC-curves); 2) k-nearest neighbors algorithm. Results Three conditionally specified predictive models were constructed. Model 1 included inflammatory markers in EBC alone, model 2 included FeNO plus clinical characteristics and the ACQ score, and model 3 included all the predictors used in model 1 and 2. The area under the ROC-curves was estimated as 47%, 54% and 59% for models 1, 2 and 3 respectively. The k-nearest neighbors predictive algorithm, using the information of all the variables in model 3, produced correct predictions for 52% of the exacerbations in the validation dataset. Conclusion The predictive power of FeNO and inflammatory markers in EBC for prediction of an asthma exacerbation was low, even when combined with clinical characteristics and symptoms. Qualitative improvement of the chemical analysis of EBC may lead to a

  17. Learning to EXHALE: don't catch the flu this season!

    PubMed

    Sherman, Fredrick T

    2008-10-01

    Decrease your chances of getting the flu by first, getting your flu shot, and second, by adopting this three-step technique to help prevent the spread of influenza as well as other viral respiratory illnesses. Like cough etiquette (ie, covering your nose and mouth when coughing or sneezing) and hand washing, this easily implemented, noninvasive technique should be an additional component of respiratory hygiene. The three steps are exhale, look away, and walk away.

  18. Electronic Nose and Exhaled Breath NMR-based Metabolomics Applications in Airways Disease.

    PubMed

    Santini, Giuseppe; Mores, Nadia; Penas, Andreu; Capuano, Rosamaria; Mondino, Chiara; Trové, Andrea; Macagno, Francesco; Zini, Gina; Cattani, Paola; Martinelli, Eugenio; Motta, Andrea; Macis, Giuseppe; Ciabattoni, Giovanni; Montuschi, Paolo

    2016-01-01

    Breathomics, the multidimensional molecular analysis of exhaled breath, includes analysis of exhaled breath with gas-chromatography/mass spectrometry (GC/MS) and electronic noses (e-noses), and metabolomics of exhaled breath condensate (EBC), a non-invasive technique which provides information on the composition of airway lining fluid, generally by high-resolution nuclear magnetic resonance (NMR) spectroscopy or MS methods. Metabolomics is the identification and quantification of small molecular weight metabolites in a biofluid. Specific profiles of volatile compounds in exhaled breath and metabolites in EBC (breathprints) are potentially useful surrogate markers of inflammatory respiratory diseases. Electronic noses (e-noses) are artificial sensor systems, usually consisting of chemical cross-reactive sensor arrays for characterization of patterns of breath volatile compounds, and algorithms for breathprints classification. E-noses are handheld, portable, and provide real-time data. E-nose breathprints can reflect respiratory inflammation. E-noses and NMR-based metabolomics of EBC can distinguish patients with respiratory diseases such as asthma, COPD, and lung cancer, or diseases with a clinically relevant respiratory component including cystic fibrosis and primary ciliary dyskinesia, and healthy individuals. Breathomics has also been reported to identify patients affected by different types of respiratory diseases. Patterns of breath volatile compounds detected by e-nose and EBC metabolic profiles have been associated with asthma phenotypes. In combination with other -omics platforms, breathomics might provide a molecular approach to respiratory disease phenotyping and a molecular basis to tailored pharmacotherapeutic strategies. Breathomics might also contribute to identify new surrogate markers of respiratory inflammation, thus, facilitating drug discovery. Validation in newly recruited, prospective independent cohorts is essential for development of e

  19. Exhaled volatile substances mirror clinical conditions in pediatric chronic kidney disease

    PubMed Central

    Obermeier, Juliane; Trefz, Phillip; Happ, Josephine; Schubert, Jochen K.; Staude, Hagen

    2017-01-01

    Monitoring metabolic adaptation to chronic kidney disease (CKD) early in the time course of the disease is challenging. As a non-invasive technique, analysis of exhaled breath profiles is especially attractive in children. Up to now, no reports on breath profiles in this patient cohort are available. 116 pediatric subjects suffering from mild-to-moderate CKD (n = 48) or having a functional renal transplant KTx (n = 8) and healthy controls (n = 60) matched for age and sex were investigated. Non-invasive quantitative analysis of exhaled breath profiles by means of a highly sensitive online mass spectrometric technique (PTR-ToF) was used. CKD stage, the underlying renal disease (HUS; glomerular diseases; abnormalities of kidney and urinary tract or polycystic kidney disease) and the presence of a functional renal transplant were considered as classifiers. Exhaled volatile organic compound (VOC) patterns differed between CKD/ KTx patients and healthy children. Amounts of ammonia, ethanol, isoprene, pentanal and heptanal were higher in patients compared to healthy controls (556, 146, 70.5, 9.3, and 5.4 ppbV vs. 284, 82.4, 49.6, 5.30, and 2.78 ppbV). Methylamine concentrations were lower in the patient group (6.5 vs 10.1 ppbV). These concentration differences were most pronounced in HUS and kidney transplanted patients. When patients were grouped with respect to degree of renal failure these differences could still be detected. Ammonia accumulated already in CKD stage 1, whereas alterations of isoprene (linked to cholesterol metabolism), pentanal and heptanal (linked to oxidative stress) concentrations were detectable in the breath of patients with CKD stage 2 to 4. Only weak associations between serum creatinine and exhaled VOCs were noted. Non-invasive breath testing may help to understand basic mechanisms and metabolic adaptation accompanying progression of CKD. Our results support the current notion that metabolic adaptation occurs early during the time course of CKD

  20. Noninvasive measurement of plasma glucose from exhaled breath in healthy and type 1 diabetic subjects.

    PubMed

    Minh, Timothy D C; Oliver, Stacy R; Ngo, Jerry; Flores, Rebecca; Midyett, Jason; Meinardi, Simone; Carlson, Matthew K; Rowland, F Sherwood; Blake, Donald R; Galassetti, Pietro R

    2011-06-01

    Effective management of diabetes mellitus, affecting tens of millions of patients, requires frequent assessment of plasma glucose. Patient compliance for sufficient testing is often reduced by the unpleasantness of current methodologies, which require blood samples and often cause pain and skin callusing. We propose that the analysis of volatile organic compounds (VOCs) in exhaled breath can be used as a novel, alternative, noninvasive means to monitor glycemia in these patients. Seventeen healthy (9 females and 8 males, 28.0 ± 1.0 yr) and eight type 1 diabetic (T1DM) volunteers (5 females and 3 males, 25.8 ± 1.7 yr) were enrolled in a 240-min triphasic intravenous dextrose infusion protocol (baseline, hyperglycemia, euglycemia-hyperinsulinemia). In T1DM patients, insulin was also administered (using differing protocols on 2 repeated visits to separate the effects of insulinemia on breath composition). Exhaled breath and room air samples were collected at 12 time points, and concentrations of ~100 VOCs were determined by gas chromatography and matched with direct plasma glucose measurements. Standard least squares regression was used on several subsets of exhaled gases to generate multilinear models to predict plasma glucose for each subject. Plasma glucose estimates based on two groups of four gases each (cluster A: acetone, methyl nitrate, ethanol, and ethyl benzene; cluster B: 2-pentyl nitrate, propane, methanol, and acetone) displayed very strong correlations with glucose concentrations (0.883 and 0.869 for clusters A and B, respectively) across nearly 300 measurements. Our study demonstrates the feasibility to accurately predict glycemia through exhaled breath analysis over a broad range of clinically relevant concentrations in both healthy and T1DM subjects.

  1. Altered exhaled biomarker profiles in children during and after rhinovirus-induced wheeze.

    PubMed

    van der Schee, Marc P; Hashimoto, Simone; Schuurman, Annemarie C; van Driel, Janine S Repelaer; Adriaens, Nora; van Amelsfoort, Romy M; Snoeren, Tessa; Regenboog, Martine; Sprikkelman, Aline B; Haarman, Eric G; van Aalderen, Wim M C; Sterk, Peter J

    2015-02-01

    Preschool rhinovirus-induced wheeze is associated with an increased risk of asthma. In adult asthma, exhaled volatile organic compounds (VOC) are associated with inflammatory activity. We therefore hypothesised that acute preschool wheeze is accompanied by a differential profile of exhaled VOC, which is maintained after resolution of symptoms in those children with rhinovirus-induced wheeze. We included 178 children (mean±sd age 22±9 months) from the EUROPA cohort comparing asymptomatic and wheezing children during respiratory symptoms and after recovery. Naso- and oropharyngeal swabs were tested for rhinovirus by quantitative PCR. Breath was collected via a spacer and analysed using an electronic nose. Between-group discrimination was assessed by constructing a 1000-fold cross-validated receiver operating characteristic curve. Analyses were stratified by rhinovirus presence/absence. Wheezing children demonstrated a different VOC profile when compared with asymptomatic children (p<0.001), regardless of the presence (area under the curve (AUC) 0.77, 95% CI 0.07) or absence (AUC 0.81, 95% CI 0.05) of rhinovirus. After symptomatic recovery, discriminative accuracy was maintained in children with rhinovirus-induced wheeze (AUC 0.84, 95% CI 0.06), whereas it dropped significantly in infants with non-rhinovirus-induced wheeze (AUC 0.67, 95% CI 0.06). Exhaled molecular profiles differ between preschool children with and without acute respiratory wheeze. This appears to be sustained in children with rhinovirus-induced wheeze after resolution of symptoms. Therefore, exhaled VOC may qualify as candidate biomarkers for early signs of asthma.

  2. Inflammatory Markers in Blood and Exhaled Air after Short-Term Exposure to Cooking Fumes

    PubMed Central

    Svedahl, Sindre Rabben

    2013-01-01

    Objectives: Cooking fumes contain aldehydes, alkanoic acids, polycyclic aromatic hydrocarbons, and heterocyclic compounds. The inhalation of cooking fumes entails a risk of deleterious health effects. The aim of this study was to see if the inhalation of cooking fumes alters the expression of inflammatory reactions in the bronchial mucosa and its subsequent systemic inflammatory response in blood biomarkers. Methods: Twenty-four healthy volunteers stayed in a model kitchen on two different occasions for 2 or 4h. On the first occasion, there was only exposure to normal air, and on the second, there was exposure to controlled levels of cooking fumes. On each occasion, samples of blood, exhaled air, and exhaled breath condensate (EBC) were taken three times in 24h and inflammatory markers were measured from all samples. Results: There was an increase in the concentration of the d-dimer in blood from 0.27 to 0.28mg ml–1 on the morning after exposure to cooking fumes compared with the levels the morning before (P-value = 0.004). There was also a trend of an increase in interleukin (IL)-6 in blood, ethane in exhaled air, and IL-1β in EBC after exposure to cooking fumes. In a sub-analysis of 12 subjects, there was also an increase in the levels of ethane—from 2.83 parts per billion (ppb) on the morning before exposure to cooking fumes to 3.53 ppb on the morning after exposure (P = 0.013)—and IL-1β—from 1.04 on the morning before exposure to cooking fumes to 1.39 pg ml–1 immediately after (P = 0.024). Conclusion: In our experimental setting, we were able to unveil only small changes in the levels of inflammatory markers in exhaled air and in blood after short-term exposure to moderate concentrations of cooking fumes. PMID:23179989

  3. Assessment of the exhalation kinetics of volatile cancer biomarkers based on their physicochemical properties

    PubMed Central

    Amann, Anton; Mochalski, Pawel; Ruzsanyi, Vera; Broza, Yoav Y; Haick, Hossam

    2016-01-01

    The current review provides an assessment of the exhalation kinetics of volatile organic compounds (VOCs) that have been linked with cancer. Towards this end, we evaluate various physicochemical properties, such as ‘breath:air’ and ‘blood:fat’ partition coefficients, of 112 VOCs that have been suggested over the past decade as potential markers of cancer. With these data, we show that the cancer VOC concentrations in the blood and in the fat span over 12 and 8 orders of magnitude, respectively, in order to provide a specific counterpart concentration in the exhaled breath (e.g., 1 ppb). This finding suggests that these 112 different compounds have different storage compartments in the body and that their exhalation kinetics depends on one or a combination of the following factors: (i) the VOC concentrations in different parts of the body; (ii) the VOC synthesis and metabolism rates; (iii) the partition coefficients between tissue(s), blood and air; and (iv) the VOCs’ diffusion constants. Based on this analysis, we discuss how this knowledge allows modeling and simulating the behavior of a specific VOC under different sampling protocols (with and without exertion of effort). We end this review by a brief discussion on the potential role of these scenarios in screening and therapeutic monitoring of cancer. PMID:24566039

  4. Radon exhalation study of manganese clay residue and usability in brick production.

    PubMed

    Kovács, Tibor; Shahrokhi, Amin; Sas, Zoltán; Vigh, Tamás; Somlai, János

    2017-03-01

    The reuse of by-products and residue streams is an important topic due to environmental and financial aspects. Manganese clay is a residue of manganese ore processing and is generated in huge amounts. This residue may contain some radionuclides with elevated concentrations. In this study, the radon emanation features and the massic exhalation rate of the heat-treated manganese clay were determined with regard to brick production. From the manganese mud depository, 20 samples were collected and after homogenization radon exhalation characteristics were determined as a function of firing temperatures from 100 to 750 °C. The major naturally occurring radionuclides (40)K, (226)Ra and (232)Th concentrations were 607 ± 34, 52 ± 6 and 40 ± 5 Bq kg(-1), respectively, comparable with normal clay samples. Similar to our previous studies a strong correlation was found between the internal structure and the radon emanation. The radon emanation coefficient decreased by ∼96% from 0.23 at 100 °C to 0.01 at 750 °C. The massic radon exhalation rate of samples fired at 750 °C reduced by 3% compared to samples fired at 100 °C. In light of the results, reusing of manganese clay as a brick additive is possible without any constraints. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Open charcoal chamber method for mass measurements of radon exhalation rate from soil surface.

    PubMed

    Tsapalov, Andrey; Kovler, Konstantin; Miklyaev, Peter

    2016-08-01

    Radon exhalation rate from the soil surface can serve as an important criterion in the evaluation of radon hazard of the land. Recently published international standard ISO 11665-7 (2012) is based on the accumulation of radon gas in a closed container. At the same time since 1998 in Russia, as a part of engineering and environmental studies for the construction, radon flux measurements are made using an open charcoal chamber for a sampling duration of 3-5 h. This method has a well-defined metrological justification and was tested in both favorable and unfavorable conditions. The article describes the characteristics of the method, as well as the means of sampling and measurement of the activity of radon absorbed. The results of the metrological study suggest that regardless of the sampling conditions (weather, the mechanism and rate of radon transport in the soil, soil properties and conditions), uncertainty of method does not exceed 20%, while the combined standard uncertainty of radon exhalation rate measured from the soil surface does not exceed 30%. The results of the daily measurements of radon exhalation rate from the soil surface at the experimental site during one year are reported. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Ascent exhalations of Antarctic fur seals: a behavioural adaptation for breath-hold diving?

    PubMed Central

    Hooker, Sascha K.; Miller, Patrick J. O.; Johnson, Mark P.; Cox, Oliver P.; Boyd, Ian L.

    2005-01-01

    Novel observations collected from video, acoustic and conductivity sensors showed that Antarctic fur seals consistently exhale during the last 50–85% of ascent from all dives (10–160 m, n>8000 dives from 50 seals). The depth of initial bubble emission was best predicted by maximum dive depth, suggesting an underlying physical mechanism. Bubble sound intensity recorded from one seal followed predictions of a simple model based on venting expanding lung air with decreasing pressure. Comparison of air release between dives, together with lack of variation in intensity of thrusting movement during initial descent regardless of ultimate dive depth, suggested that inhaled diving lung volume was constant for all dives. The thrusting intensity in the final phase of ascent was greater for dives in which ascent exhalation began at a greater depth, suggesting an energetic cost to this behaviour, probably as a result of loss of buoyancy from reduced lung volume. These results suggest that fur seals descend with full lung air stores, and thus face the physiological consequences of pressure at depth. We suggest that these regular and predictable ascent exhalations could function to reduce the potential for a precipitous drop in blood oxygen that would result in shallow-water blackout. PMID:15734689

  7. Social support as a predictor exhaled nitric oxide in healthy individuals across time.

    PubMed

    Trueba, Ana F; Rosenfield, David; Smith, Noelle Bassi; Gorena, Tabitha L; Ritz, Thomas

    2014-09-01

    Psychosocial factors such as social support and depression have long been associated with health outcomes. Elevated depressive symptoms are usually associated with worse health outcomes, whereas social support has been related to improvements in health. Nitric oxide levels are an important marker of both cardiovascular health and immune function. Research suggests that exhaled nitric oxide is affected by stress, negative affect, and depression; however, the effect of social support has not been previously explored. Thus, we sought to examine the association of social support, negative affect, and depression with exhaled nitric oxide in a group of 35 healthy individuals (10 males and 25 females) with a mean age of 20.5years across five weekly assessments. Results showed that changes in social support within individuals were positively associated with levels of exhaled nitric oxide independent of other psychosocial factors. Further exploration of the health implications of this positive relationship between airway nitric oxide and social support is necessary. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Air contamination with nitric oxide: effect on exhaled nitric oxide response.

    PubMed

    Therminarias, A; Flore, P; Favre-Juvin, A; Oddou, M F; Delaire, M; Grimbert, F

    1998-03-01

    This study examines the response of exhaled nitric oxide (NO) concentration (ECNO) and quantity of exhaled NO over time (EVNO) in 10 healthy subjects breathing into five polyethylene bags, one in which synthetic air was free of NO and four in which NO was diluted to concentrations of 20 +/- 0.6, 49 +/- 0.8, 98 +/- 2, and 148 +/- 2 ppb, respectively. Each subject was connected to each bag for 10 min at random. Minute ventilation and ECNO were measured continuously, and EVNO was calculated continuously. ECNO and EVNO values were significantly higher for an inhaled NO concentration of 20 ppb than for NO-free air. Above 20 ppb, ECNO and EVNO increased linearly with inhaled NO concentration. It is reasonable to assume that a share of the quantity of inspired NO over time (InspVNO) because of air contamination by pollution is rejected by the ventilatory pathway. Insofar as InspVNO does not affect endogenous production or the metabolic fate of NO in the airway, this share may be estimated as being approximately one third of InspVNO, the remainder being taken by the endogenous pathway. Thus, air contamination by the NO resulting from pollution greatly increases the NO response in exhaled air.

  9. Application of drug testing using exhaled breath for compliance monitoring of drug addicts in treatment.

    PubMed

    Carlsson, Sten; Olsson, Robert; Lindkvist, Irene; Beck, Olof

    2015-04-01

    Exhaled breath has recently been identified as a possible matrix for drug testing. This study explored the potential of this new method for compliance monitoring of patients being treated for dependence disorders. Outpatients in treatment programs were recruited for this study. Urine was collected as part of clinical routine and a breath sample was collected in parallel together with a questionnaire about their views of the testing procedure. Urine was analyzed for amphetamines, benzodiazepines, cannabis, cocaine, buprenorphine, methadone and opiates using CEDIA immunochemical screening and mass spectrometry confirmation. The exhaled breath was collected using the SensAbues device and analyzed by mass spectrometry for amphetamine, methamphetamine, diazepam, oxazepam, tetrahydrocannabinol, cocaine, benzoylecgonine, buprenorphine, methadone, morphine, codeine and 6-acetylmorphine. A total of 122 cases with parallel urine and breath samples were collected; 34 of these were negative both in urine and breath. Out of 88 cases with positive urine samples 51 (58%) were also positive in breath. Among the patients on methadone treatment, all were positive for methadone in urine and 83% were positive in breath. Among patients in treatment with buprenorphine, 92% were positive in urine and among those 80% were also positive in breath. The questionnaire response documented that in general, patients accepted drug testing well and that the breath sampling procedure was preferred. Compliance testing for the intake of prescribed and unprescribed drugs among patients in treatment for dependence disorders using the exhaled breath sampling technique is a viable method and deserves future attention.

  10. Analytical study of radionuclide concentration and radon exhalation rate in market available building materials of Ramsar

    NASA Astrophysics Data System (ADS)

    Bavarnegin, Elham; Vahabi-moghaddam, Masoud; Babakhani, Asad; Fathabadi, Nasrin

    2012-07-01

    Samples of structural and covering market available building materials from Ramsar, a northern city of Iran, were analyzed for their radon exhalation rate using an active radon gas analyzer with an emanation container. The radon exhalation rate varied from below the minimum detection limit of 0.01 to 0.31 Bq·m-2·h-1 with an average of 0.08 Bq·m-2·h-1. The 226Ra, 232Th, and 40K contents were also measured using a high resolution HPGe gamma-ray spectrometer system. The radionuclides contents varied from below the minimum detectable activity up to 73.5, 169, and 1,350 Bq.kg-1, with the average value of 16 ± 6, 25 ± 11, and 280 ± 101 Bq.kg-1, respectively. It was concluded from the results that some granite samples along with the block sample were the main source of radon exhalation rate, and the mean values of 226Ra, 232Th, and 40K in building material samples are below the world average values. Therefore, the use of these market available building materials in construction of Ramsar dwellings is considered to be safe for human habitation.

  11. Effects of bronchoconstriction, minute ventilation, and deep inspiration on the composition of exhaled breath condensate.

    PubMed

    Debley, Jason S; Ohanian, Arpy S; Spiekerman, Charles F; Aitken, Moira L; Hallstrand, Teal S

    2011-01-01

    Exhaled breath condensate (EBC) is composed of droplets of airway surface liquid (ASL) diluted by water vapor. The goal of this study was to determine if the composition of EBC is affected by changes in airway caliber, minute ventilation, or forceful exhalation, factors that may differ among subjects with asthma in cross-sectional studies. In a group of subjects with asthma, we measured the effects of the following: (1) a series of three deep-inspiration and forceful-exhalation maneuvers; (2) a doubling of minute ventilation; and (3) acute bronchoconstriction induced by methacholine on EBC volume, dilution of ASL, and concentration of cysteinyl leukotrienes (CysLTs). With the exception of an increase in EBC volume with increased minute ventilation, there were no significant changes in the volume, dilution, or levels of CysLTs in EBC introduced by each of these factors. The CIs surrounding the differences introduced by each factor showed that the maximum systematic errors due to these factors were modest. These results indicate that changes in airway caliber, minute ventilation, or breathing pattern among subjects with asthma do not significantly alter the measurements of mediator concentrations in EBC.

  12. Predicting co-morbidities in chemically sensitive individuals from exhaled breath analysis.

    PubMed

    Zeliger, Harold I; Pan, Yaqin; Rea, William J

    2012-09-01

    The exhaled breath of more than four hundred patients who presented at the Environmental Health Center - Dallas with chemical sensitivity conditions were analyzed for the relative abundance of their breath chemical composition by gas chromatography and mass spectrometry for volatile and semi-volatile organic compounds. All presenting patients had no fewer than four and as many as eight co-morbid conditions. Surprisingly, almost all the exhaled breath analyses showed the presence of a preponderance of lipophilic aliphatic and aromatic hydrocarbons. The hydrophilic compounds present were almost entirely of natural origin, i.e. expected metabolites of foods. The lipophile, primarily C3 to C16 hydrocarbons and believed to have come from inhalation of polluted air, were, in all cases, present at concentrations far below those known to be toxic to humans, but caused sensitivity and signs of chemical overload. The co-morbid health effects observed are believed to be caused by the sequential absorption of lipophilic and hydrophilic chemicals; an initial absorption and retention of lipophile followed by a subsequent absorption of hydrophilic species facilitated by the retained lipophile to produce chemical mixtures that are toxic at very low levels. It is hypothesized that co-morbid conditions in chemically sensitive individuals can be predicted from analysis of their exhaled breath.

  13. Optimizing an Internal Airway Percussion Device for Facilitating Exhalate Diagnostics of the Human Respiratory System.

    PubMed

    Afshar-Mohajer, Nima; Wu, Chang-Yu; Tsai, Hsiu-Wen; Silverman, Erin; Davenport, Paul; Hegde, Satyanarayan

    2015-03-31

    There is an urgent need for simple, inexpensive, noninvasive, and repeatable technique for the diagnosis of pulmonary diseases. Bronchoalveolar lavage, which is the gold standard diagnostic method for pulmonary diseases, does not meet any of these criteria. This study seeks to develop and optimize a novel technique of Internal Airway Percussion (IAP) to facilitate the collection and characterization of human respiratory system exhalates. The IAP device transmits sound waves into the respiratory tract, thereby increasing the release of aerosolized particles within exhaled breath by vibrating both lungs. Nine combinations of sound wave frequencies and amplitudes were studied to determine optimal frequency and amplitude combination for maximum aerosol particle gain in healthy human subjects. Square-shaped sound waves generated at 15 Hz and 3 cm H2O resulted in 15 times greater total mass of collected particles in the first 2 min of sampling, and 1.2 to 1.5 times increase in count median diameter of the particles. IAP, optimized at the frequency of 15 Hz and the pressure amplitude of 3 cm H2O, increased the total mass of particles exhaled from the human respiratory system. IAP has a broad range of potential clinical applications for noninvasive diagnosis of lung diseases including asthma, cystic fibrosis, pneumonia, and lung cancer, along with improvement of mucus clearance.

  14. The effects of Aspergillus fumigatus challenge on exhaled and nasal NO levels.

    PubMed

    Stark, H J; Randell, J T; Hirvonen, M-R; Purokivi, M K; Roponen, M H; Tukiainen, H O

    2005-11-01

    Several studies have previously shown that exposure to indoor air microbes from moisture-damaged buildings can cause adverse health effects. Aspergillus fumigatus is one of the best-documented moulds causing health problems to those exposed. In this study, inhalation of a commercial A. fumigatus solution was assessed, to establish if it would have effects on fractional exhaled (FeNO) and nasal (FnNO) nitric oxide levels and on lung function. The results were compared with placebo challenge. A total of 28 subjects were divided into three study groups: group 1 had been exposed to occupational mould; group 2 consisted of atopic subjects; and group 3 was a control group. Some 3 h after A. fumigatus challenge, there was a considerable increase in FeNO, and a significant difference was observed between the A. fumigatus and placebo inhalations. The difference was seen in all study groups. No such differences were found in the levels of FnNO or nitrite in nasal lavage fluid. Subjects reported significantly more frequent respiratory tract symptoms after the A. fumigatus inhalation compared with placebo challenge. In conclusion, it was shown here that inhalation challenge of Aspergillus fumigatus elevated fractional exhaled nitric oxide levels. An increase in fractional exhaled nitric oxide may serve as an indicator of respiratory inflammation of acute mould exposure.

  15. Stable isotope and high precision concentration measurements confirm that all humans produce and exhale methane.

    PubMed

    Keppler, Frank; Schiller, Amanda; Ehehalt, Robert; Greule, Markus; Hartmann, Jan; Polag, Daniela

    2016-01-29

    Mammalian formation of methane (methanogenesis) is widely considered to occur exclusively by anaerobic microbial activity in the gastrointestinal tract. Approximately one third of humans, depending on colonization of the gut by methanogenic archaea, are considered methane producers based on the classification terminology of high and low emitters. In this study laser absorption spectroscopy was used to precisely measure concentrations and stable carbon isotope signatures of exhaled methane in breath samples from 112 volunteers with an age range from 1 to 80 years. Here we provide analytical evidence that volunteers exhaled methane levels were significantly above background (inhaled) air. Furthermore, stable carbon isotope values of the exhaled methane unambiguously confirmed that this gas was produced by all of the human subjects studied. Based on the emission and stable carbon isotope patterns of various age groups we hypothesize that next to microbial sources in the gastrointestinal tracts there might be other, as yet unidentified, processes involved in methane formation supporting the idea that humans might also produce methane endogenously in cells. Finally we suggest that stable isotope measurements of volatile organic compounds such as methane might become a useful tool in future medical research diagnostic programs.

  16. Assessment of nasal and sinus nitric oxide output using single-breath humming exhalations.

    PubMed

    Maniscalco, M; Weitzberg, E; Sundberg, J; Sofia, M; Lundberg, J O

    2003-08-01

    Nasal nitric oxide (NO) levels increase greatly during humming compared to silent exhalation. In this study, the physiological and anatomical factors that regulate NO release during humming have been characterised in 10 healthy subjects and in a model of the sinus and the nose. Single-breath humming caused a large initial peak in nasal NO output, followed by a progressive decline. The NO peak decreased in a step-wise manner during repeated consecutive humming manoeuvres but recovered completely after a silent period of 3 min. Topical nasal application of an NO synthase inhibitor reduced nasal NO by >50% but had no effect on the increase evoked by humming. Silently exhaled nasal NO measured immediately after repeated humming manoeuvres was between 5-50% lower than basal silent NO exhalation, suggesting variable continuous contribution from the sinuses to nasal NO. Among the factors known to influence normal sinus ventilation, ostium size was the most critical during humming, but humming frequency was also of importance. In conclusion, humming results in a large increase in nasal nitric oxide, which is caused by a rapid gas exchange in the paranasal sinuses. Combined nasal nitric oxide measurement with and without humming could be of use to estimate sinus ventilation and to better separate nasal mucosal nitric oxide output from sinus nitric oxide in health and disease.

  17. Design and evaluation of an exhaled breath sampler for biological monitoring of organic solvents.

    PubMed

    Periago, J F; Luna, A; Morente, A; Zambudio, A

    1992-04-01

    We designed a breath sampler based on a tube which collects the final portion of exhaled air. The passage of successive fractions through a layer of activated charcoal is controlled by a three-way valve. This system was validated in a controlled atmosphere of n-hexane and toluene at four concentrations between 12 and 110 mg m-3 and 12 and 115 mg m-3, respectively. Uptake volumes of 0.1, 0.2 and 0.31 were tested at relative humidities of 46% and 98%. There were no significant differences in the recoveries obtained under any of the conditions tested. We confirmed the reproducibility between successive samples in volunteers and exposed workers, and found no significant differences between the different sampling conditions studied. Our system enriches the sample in an adsorbent cartridge by collecting successive fractions of end-exhaled breath from one or more exhalations until the amount required by the analytical method has been accumulated. It is portable, economical and highly operative in the field.

  18. Effect of gravity on lung exhaled nitric oxide at rest and during exercise

    NASA Technical Reports Server (NTRS)

    Pogliaghi, S.; Krasney, J. A.; Pendergast, D. R.

    1997-01-01

    Exhaled nitric oxide (NO) from the lungs (VNO) in nose-clipped subjects increases during exercise. This may be due to endothelial shear stress secondary to changes in pulmonary blood flow. We measured VNO after modifying pulmonary blood flow with head-out water immersion (WI) or increased gravity (2 Gz) at rest and during exercise. Ten sedentary males were studied during exercise performed in air and WI. Nine subjects were studied at 1 and 2 Gz. Resting NO concentrations in exhaled air ([NO]) were 16.3 +/- 8.2 ppb (air). 15 +/- 8.2 ppb (WI) and 17.4 +/- 5 ppb (2 Gz). VNO (ppb/min) was calculated as [NO]VE and was unchanged at rest by either WI or 2 Gz. VNO increased linearly with Vo2, VE and fii during exercise in air, WI and at 2 Gz. These relationships did not differ among the experimental conditions. Therefore, changes in pulmonary blood flow failed to alter the output of NO exhaled from the lungs at rest or during exercise.

  19. A European Respiratory Society technical standard: exhaled biomarkers in lung disease.

    PubMed

    Horváth, Ildiko; Barnes, Peter J; Loukides, Stelios; Sterk, Peter J; Högman, Marieann; Olin, Anna-Carin; Amann, Anton; Antus, Balazs; Baraldi, Eugenio; Bikov, Andras; Boots, Agnes W; Bos, Lieuwe D; Brinkman, Paul; Bucca, Caterina; Carpagnano, Giovanna E; Corradi, Massimo; Cristescu, Simona; de Jongste, Johan C; Dinh-Xuan, Anh-Tuan; Dompeling, Edward; Fens, Niki; Fowler, Stephen; Hohlfeld, Jens M; Holz, Olaf; Jöbsis, Quirijn; Van De Kant, Kim; Knobel, Hugo H; Kostikas, Konstantinos; Lehtimäki, Lauri; Lundberg, Jon; Montuschi, Paolo; Van Muylem, Alain; Pennazza, Giorgio; Reinhold, Petra; Ricciardolo, Fabio L M; Rosias, Philippe; Santonico, Marco; van der Schee, Marc P; van Schooten, Frederik-Jan; Spanevello, Antonio; Tonia, Thomy; Vink, Teunis J

    2017-04-01

    Breath tests cover the fraction of nitric oxide in expired gas (FeNO), volatile organic compounds (VOCs), variables in exhaled breath condensate (EBC) and other measurements. For EBC and for FeNO, official recommendations for standardised procedures are more than 10 years old and there is none for exhaled VOCs and particles. The aim of this document is to provide technical standards and recommendations for sample collection and analytic approaches and to highlight future research priorities in the field. For EBC and FeNO, new developments and advances in technology have been evaluated in the current document. This report is not intended to provide clinical guidance on disease diagnosis and management.Clinicians and researchers with expertise in exhaled biomarkers were invited to participate. Published studies regarding methodology of breath tests were selected, discussed and evaluated in a consensus-based manner by the Task Force members.Recommendations for standardisation of sampling, analysing and reporting of data and suggestions for research to cover gaps in the evidence have been created and summarised.Application of breath biomarker measurement in a standardised manner will provide comparable results, thereby facilitating the potential use of these biomarkers in clinical practice. Copyright ©ERS 2017.

  20. Neutrophilic airways inflammation in lung cancer: the role of exhaled LTB-4 and IL-8.

    PubMed

    Carpagnano, Giovanna E; Palladino, Grazia P; Lacedonia, Donato; Koutelou, Anna; Orlando, Silvio; Foschino-Barbaro, Maria P

    2011-06-07

    Recent advances in lung cancer biology presuppose its inflammatory origin. In this regard, LTB-4 and IL-8 are recognized to play a crucial role in neutrophil recruitment into airways during lung cancer.Notwithstanding the intriguing hypothesis, the exact role of neutrophilic inflammation in tumour biology remains complex and not completely known.The aim of this study was to give our contribution in this field by investigating LTB-4 and IL-8 in the breath condensate of NSCLC patients and verifying their role in cancer development and progression. We enrolled 50 NSCLC patients and 35 controls. LTB-4 and IL-8 concentrations were measured in the breath condensate and the blood of all the subjects under study using EIA kits. Thirty NSCLC patients and ten controls underwent induced sputum collection and analysis. LTB-4 and IL-8 resulted higher in breath condensate and the blood of NSCLC patients compared to controls. Significantly higher concentrations were found as the cancer stages progressed. A positive correlation was observed between exhaled IL-8 and LTB-4 and the percentage of neutrophils in the induced sputum. The high concentrations of exhaled LTB-4 and IL-8 showed the presence of a neutrophilic inflammation in the airways of NSCLC patients and gave a further support to the inflammatory signalling in lung cancer. These exhaled proteins could represent a suitable non-invasive marker in the diagnosis and monitoring of lung cancer.

  1. Volatile organic compounds in exhaled breath in a healthy population: effect of tobacco smoking.

    PubMed

    Jareño-Esteban, José Javier; Muñoz-Lucas, M Ángeles; Carrillo-Aranda, Belén; Maldonado-Sanz, José Ángel; de Granda-Orive, Ignacio; Aguilar-Ros, Antonio; Civera-Tejuca, Concepción; Gutiérrez-Ortega, Carlos; Callol-Sánchez, Luis Miguel

    2013-11-01

    Tobacco smoke is a source of free radicals and reactive oxygen and nitrogen species, which are the main causes of oxidative stress. The analysis of volatile organic compounds (VOC) in exhaled breath is an indirect method of measuring the level of oxidative stress that occurs in the airways caused by tobacco consumption. The aim of this study was to determine whether smoking influences the production of VOC, in a clinically healthy population. Exhaled breath from 89 healthy volunteers, divided into three groups (non-smokers, ex-smokers and smokers) was analysed. Samples were collected using Bio-VOC® devices and transferred to universal desorption tubes. Chemical compounds were analysed by thermal desorption, gas chromatography and mass spectrometry. We analysed hexanal, heptanal, octanal, nonanal, nonanoic acid and propanoic acid, all identified by retention time and mass spectra referenced in the NIST 08 mass spectral library; confirmation was carried out using reference standards of the pure chemical compound. These VOC were found in very low concentrations. Only nonanal showed significant quantitative and qualitative statistical differences among the study groups. Nonanal concentration is dependent on smoking, but is independent of the amount of tobacco consumed, age and gender. Nonanal in exhaled breath is associated with tobacco consumption, current or previous. Nonanal is a sub-product of the destruction of the cell membrane, and its finding may be indicative of cell damage in smokers. This result appears in many farmers who smoke. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  2. Effect of gravity on lung exhaled nitric oxide at rest and during exercise

    NASA Technical Reports Server (NTRS)

    Pogliaghi, S.; Krasney, J. A.; Pendergast, D. R.

    1997-01-01

    Exhaled nitric oxide (NO) from the lungs (VNO) in nose-clipped subjects increases during exercise. This may be due to endothelial shear stress secondary to changes in pulmonary blood flow. We measured VNO after modifying pulmonary blood flow with head-out water immersion (WI) or increased gravity (2 Gz) at rest and during exercise. Ten sedentary males were studied during exercise performed in air and WI. Nine subjects were studied at 1 and 2 Gz. Resting NO concentrations in exhaled air ([NO]) were 16.3 +/- 8.2 ppb (air). 15 +/- 8.2 ppb (WI) and 17.4 +/- 5 ppb (2 Gz). VNO (ppb/min) was calculated as [NO]VE and was unchanged at rest by either WI or 2 Gz. VNO increased linearly with Vo2, VE and fii during exercise in air, WI and at 2 Gz. These relationships did not differ among the experimental conditions. Therefore, changes in pulmonary blood flow failed to alter the output of NO exhaled from the lungs at rest or during exercise.

  3. Ascent exhalations of Antarctic fur seals: a behavioural adaptation for breath-hold diving?

    PubMed

    Hooker, Sascha K; Miller, Patrick J O; Johnson, Mark P; Cox, Oliver P; Boyd, Ian L

    2005-02-22

    Novel observations collected from video, acoustic and conductivity sensors showed that Antarctic fur seals consistently exhale during the last 50-85% of ascent from all dives (10-160 m, n > 8000 dives from 50 seals). The depth of initial bubble emission was best predicted by maximum dive depth, suggesting an underlying physical mechanism. Bubble sound intensity recorded from one seal followed predictions of a simple model based on venting expanding lung air with decreasing pressure. Comparison of air release between dives, together with lack of variation in intensity of thrusting movement during initial descent regardless of ultimate dive depth, suggested that inhaled diving lung volume was constant for all dives. The thrusting intensity in the final phase of ascent was greater for dives in which ascent exhalation began at a greater depth, suggesting an energetic cost to this behaviour, probably as a result of loss of buoyancy from reduced lung volume. These results suggest that fur seals descend with full lung air stores, and thus face the physiological consequences of pressure at depth. We suggest that these regular and predictable ascent exhalations could function to reduce the potential for a precipitous drop in blood oxygen that would result in shallow-water blackout.

  4. Measurement of radon exhalation rate in various building materials and soil samples

    NASA Astrophysics Data System (ADS)

    Bala, Pankaj; Kumar, Vinod; Mehra, Rohit

    2017-03-01

    Indoor radon is considered as one of the potential dangerous radioactive elements. Common building materials and soil are the major source of this radon gas in the indoor environment. In the present study, the measurement of radon exhalation rate in the soil and building material samples of Una and Hamirpur districts of Himachal Pradesh has been done with solid state alpha track detectors, LR-115 type-II plastic track detectors. The radon exhalation rate for the soil samples varies from 39.1 to 91.2 mBq kg-1 h-1 with a mean value 59.7 mBq kg-1 h-1. Also the radium concentration of the studied area is found and it varies from 30.6 to 51.9 Bq kg-1 with a mean value 41.6 Bq kg-1. The exhalation rate for the building material samples varies from 40.72 (sandstone) to 81.40 mBq kg-1 h-1 (granite) with a mean value of 59.94 mBq kg-1 h-1.

  5. Study of 5 Volatile Organic Compounds in Exhaled Breath in Chronic Obstructive Pulmonary Disease.

    PubMed

    Jareño-Esteban, José Javier; Muñoz-Lucas, M Ángeles; Gómez-Martín, Óscar; Utrilla-Trigo, Sergio; Gutiérrez-Ortega, Carlos; Aguilar-Ros, Antonio; Collado-Yurrita, Luis; Callol-Sánchez, Luis Miguel

    2017-05-01

    A major risk factor for chronic obstructive pulmonary disease (COPD) is tobacco smoke, which generates oxidative stress in airways, resulting in the production of volatile organic compounds (VOC). The purpose of this study was to identify VOCs in exhaled breath and to determine their possible use as disease biomarkers. Exhaled breath from 100 healthy volunteers, divided into 3groups (never smokers, former smokers and active smokers) and exhaled breath from 57 COPD patients were analyzed. Samples were collected using BioVOC(®) devices and transferred to universal desorption tubes. Compounds were analyzed by thermal desorption, gas chromatography and mass spectrometry. VOCs analyzed were linear aldehydesand carboxylic acids. The COPD group and healthy controls (never smokers and former smokers) showed statistically significant differences in hexanal concentrations, and never smokers and the COPD group showed statistically significant differences in nonanal concentrations. Hexanal discriminates between COPD patients and healthy non-smoking controls. Nonanal discriminates between smokers and former smokers (with and without COPD) and never smokers. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Seasonal Changes in Endotoxin Exposure and Its Relationship to Exhaled Nitric Oxide and Exhaled Breath Condensate pH Levels in Atopic and Healthy Children

    PubMed Central

    Tung, Tao-Hsin; Tang, Chin-Sheng; Liu, Chiu-Hsin

    2013-01-01

    Endotoxin, a component of the cell walls of gram-negative bacteria, is a contaminant in organic dusts (house dust) and aerosols. In humans, small amounts of endotoxin may cause a local inflammatory response. Exhaled nitric oxide (eNO) levels, an inflammation indicator, are associated with the pH values of exhaled breath condensate (EBC). This study evaluated seasonal changes on indoor endotoxin concentrations in homes and the relationships between endotoxin exposure and eNO/EBC pH levels for healthy children and children with allergy-related respiratory diseases. In total, 34 children with allergy-related respiratory diseases and 24 healthy children were enrolled. Indoor air quality measurements and dust sample analysis for endotoxin were conducted once each season inside 58 surveyed homes. The eNO, EBC pH levels, and pulmonary function of the children were also determined. The highest endotoxin concentrations were on kitchen floors of homes of children with allergy-related respiratory diseases and healthy children, and on bedroom floors of homes of asthmatic children and healthy children. Seasonal changes existed in endotoxin concentrations in dust samples from homes of children with allergic rhinitis, with or without asthma, and in EBC pH values among healthy children and those with allergy-related respiratory diseases. Strong relationships existed between endotoxin exposure and EBC pH values in children with allergic rhinitis. PMID:23840530

  7. Seasonal Changes in Endotoxin Exposure and Its Relationship to Exhaled Nitric Oxide and Exhaled Breath Condensate pH Levels in Atopic and Healthy Children.

    PubMed

    Wan, Gwo-Hwa; Yan, Dah-Chin; Tung, Tao-Hsin; Tang, Chin-Sheng; Liu, Chiu-Hsin

    2013-01-01

    Endotoxin, a component of the cell walls of gram-negative bacteria, is a contaminant in organic dusts (house dust) and aerosols. In humans, small amounts of endotoxin may cause a local inflammatory response. Exhaled nitric oxide (eNO) levels, an inflammation indicator, are associated with the pH values of exhaled breath condensate (EBC). This study evaluated seasonal changes on indoor endotoxin concentrations in homes and the relationships between endotoxin exposure and eNO/EBC pH levels for healthy children and children with allergy-related respiratory diseases. In total, 34 children with allergy-related respiratory diseases and 24 healthy children were enrolled. Indoor air quality measurements and dust sample analysis for endotoxin were conducted once each season inside 58 surveyed homes. The eNO, EBC pH levels, and pulmonary function of the children were also determined. The highest endotoxin concentrations were on kitchen floors of homes of children with allergy-related respiratory diseases and healthy children, and on bedroom floors of homes of asthmatic children and healthy children. Seasonal changes existed in endotoxin concentrations in dust samples from homes of children with allergic rhinitis, with or without asthma, and in EBC pH values among healthy children and those with allergy-related respiratory diseases. Strong relationships existed between endotoxin exposure and EBC pH values in children with allergic rhinitis.

  8. Dependence of exhaled breath composition on exogenous factors, smoking habits and exposure to air pollutants*

    PubMed Central

    Mochalski, P; Filipiak, A; Bajtarevic, A; Ager, C; Denz, H; Hilbe, W; Jamnig, H; Hackl, M; Dzien, A; Amann, A

    2013-01-01

    Non-invasive disease monitoring on the basis of volatile breath markers is a very attractive but challenging task. Several hundreds of compounds have been detected in exhaled air using modern analytical techniques (e.g. proton-transfer reaction mass spectrometry, gas chromatography-mass spectrometry) and have even been linked to various diseases. However, the biochemical background for most of compounds detected in breath samples has not been elucidated; therefore, the obtained results should be interpreted with care to avoid false correlations. The major aim of this study was to assess the effects of smoking on the composition of exhaled breath. Additionally, the potential origin of breath volatile organic compounds (VOCs) is discussed focusing on diet, environmental exposure and biological pathways based on other’s studies. Profiles of VOCs detected in exhaled breath and inspired air samples of 115 subjects with addition of urine headspace derived from 50 volunteers are presented. Samples were analyzed with GC-MS after preconcentration on multibed sorption tubes in case of breath samples and solid phase micro-extraction (SPME) in the case of urine samples. Altogether 266 compounds were found in exhaled breath of at least 10% of the volunteers. From these, 162 compounds were identified by spectral library match and retention time (based on reference standards). It is shown that the composition of exhaled breath is considerably influenced by exposure to pollution and indoor-air contaminants and particularly by smoking. More than 80 organic compounds were found to be significantly related to smoking, the largest group comprising unsaturated hydrocarbons (29 dienes, 27 alkenes and 3 alkynes). On the basis of the presented results, we suggest that for the future understanding of breath data it will be necessary to carefully investigate the potential biological origin of volatiles, e.g., by means of analysis of tissues, isolated cell lines or other body fluids. In

  9. Dependence of exhaled breath composition on exogenous factors, smoking habits and exposure to air pollutants.

    PubMed

    Filipiak, W; Ruzsanyi, V; Mochalski, P; Filipiak, A; Bajtarevic, A; Ager, C; Denz, H; Hilbe, W; Jamnig, H; Hackl, M; Dzien, A; Amann, A

    2012-09-01

    Non-invasive disease monitoring on the basis of volatile breath markers is a very attractive but challenging task. Several hundreds of compounds have been detected in exhaled air using modern analytical techniques (e.g. proton-transfer reaction mass spectrometry, gas chromatography-mass spectrometry) and have even been linked to various diseases. However,the biochemical background for most of compounds detected in breath samples has not been elucidated; therefore, the obtained results should be interpreted with care to avoid false correlations. The major aim of this study was to assess the effects of smoking on the composition of exhaled breath. Additionally, the potential origin of breath volatile organic compounds (VOCs) is discussed focusing on diet, environmental exposure and biological pathways based on other's studies. Profiles of VOCs detected in exhaled breath and inspired air samples of 115 subjects with addition of urine headspace derived from 50 volunteers are presented. Samples were analyzed with GC-MS after preconcentration on multibed sorption tubes in case of breath samples and solid phase micro-extraction (SPME) in the case of urine samples. Altogether 266 compounds were found in exhaled breath of at least 10% of the volunteers. From these, 162 compounds were identified by spectral library match and retention time (based on reference standards). It is shown that the composition of exhaled breath is considerably influenced by exposure to pollution and indoor-air contaminants and particularly by smoking. More than 80 organic compounds were found to be significantly related to smoking, the largest group comprising unsaturated hydrocarbons (29 dienes, 27 alkenes and 3 alkynes). On the basis of the presented results, we suggest that for the future understanding of breath data it will be necessary to carefully investigate the potential biological origin of volatiles, e.g., by means of analysis of tissues, isolated cell lines or other body fluids. In

  10. Surfactant Protein A in Exhaled Endogenous Particles Is Decreased in Chronic Obstructive Pulmonary Disease (COPD) Patients: A Pilot Study

    PubMed Central

    Lärstad, Mona; Almstrand, Ann-Charlotte; Larsson, Per; Bake, Björn; Larsson, Sven; Ljungström, Evert; Mirgorodskaya, Ekaterina; Olin, Anna-Carin

    2015-01-01

    Background Exhaled, endogenous particles are formed from the epithelial lining fluid in small airways, where surfactant protein A (SP-A) plays an important role in pulmonary host defense. Based on the knowledge that chronic obstructive pulmonary disease (COPD) starts in the small airway epithelium, we hypothesized that chronic inflammation modulates peripheral exhaled particle SP-A and albumin levels. The main objective of this explorative study was to compare the SP-A and albumin contents in exhaled particles from patients with COPD and healthy subjects and to determine exhaled particle number concentrations. Methods Patients with stable COPD ranging from moderate to very severe (n = 13), and healthy non-smoking subjects (n = 12) were studied. Subjects performed repeated breath maneuvers allowing for airway closure and re-opening, and exhaled particles were optically counted and collected on a membrane using the novel PExA® instrument setup. Immunoassays were used to quantify SP-A and albumin. Results COPD patients exhibited significantly lower SP-A mass content of the exhaled particles (2.7 vs. 3.9 weight percent, p = 0.036) and lower particle number concentration (p<0.0001) than healthy subjects. Albumin mass contents were similar for both groups. Conclusions Decreased levels of SP-A may lead to impaired host defense functions of surfactant in the airways, contributing to increased susceptibility to COPD exacerbations. SP-A in exhaled particles from small airways may represent a promising non-invasive biomarker of disease in COPD patients. PMID:26656890

  11. Non-invasive spatial visualization system of exhaled ethanol for real-time analysis of ALDH2 related alcohol metabolism.

    PubMed

    Wang, Xin; Ando, Eri; Takahashi, Daishi; Arakawa, Takahiro; Kudo, Hiroyuki; Saito, Hirokazu; Mitsubayashi, Kohji

    2011-09-21

    A novel imaging system of ethanol in exhaled breath induced by acetaldehyde dehydrogenase (ALDH2)-related alcohol metabolism has been developed. The system provides an image of ethanol distribution as chemiluminescence (CL) on an enzyme-immobilized support. The spatiotemporal change of CL generated by ethanol in exhaled breath after oral administration of ethanol was detected by employing an electron multiplier CCD (EM-CCD) camera, illustrated and analyzed. Prior to measurement of standard gaseous ethanol and ethanol in exhaled breath, the system was optimized by investigating the enzyme-immobilized supports, concentration of substrate and pH condition of Tris-HCl buffer solution. The ethanol skin patch test, a simple method as an indicator of ALDH2, was performed on healthy volunteers. Breath samples of 5 volunteers with ALDH2 (+) and 5 volunteers with ALDH2 (-) were used for exhaled ethanol analysis. Concentration-time profiles of exhaled ethanol obtained from all volunteers were analyzed over a period of 120 min after oral administration of ethanol (0.4 g per kg body weight) in the form of beer which contains 5% of alcohol. The results obtained from the system showed that the peaks of exhaled ethanol concentrations appeared at 30 min, which was considered as a rapid ethanol absorption phase following first-order kinetics. Exhaled ethanol concentrations of volunteers with ALDH2 (+) were lower than volunteers with ALDH2 (-) and the digestion of ethanol in volunteers with ALDH2 (+) was faster than in volunteers with ALDH2 (-). The eliminations were analyzed to follow zero-order kinetics with a rate constant for each group.

  12. Sampling of exhaled nitric oxide in children: end-expiratory plateau, balloon and tidal breathing methods compared.

    PubMed

    Jöbsis, Q; Schellekens, S L; Kroesbergen, A; Hop, W C; de Jongste, J C

    1999-06-01

    The aim of this study was to compare exhaled nitric oxide concentrations obtained during controlled slow exhalation, presently considered as the method of choice, with two sampling methods that are easily performed by children: blowing air into a balloon and tidal breathing through a mouthpiece. One hundred and one well controlled, stable allergic asthmatic children (median age 11.7 yrs) performed the following tasks in duplicate: 1) exhalation from total lung capacity through a mouthpiece against a resistor with a standardized flow rate of 20% of the subject's vital capacity per second, using a biofeedback system; 2) a single deep exhalation into an NO-impermeable mylar balloon; and 3) tidal breathing through a low resistance mouthpiece over 2 min. NO was measured using a chemiluminescence analyser. Twenty-nine children (29%) were not able to perform a constant-flow exhalation of at least 3 s. All children performed the balloon and tidal breathing methods without difficulty. NO concentrations (means +/-SEM) were 5.3+/-0.2 parts per billion (ppb) at the end-expiratory plateau, 5.2+/-0.3 ppb in balloons (intraclass correlation coefficient (r(i)) = 0.73) and 8.0+/-0.4 ppb during tidal breathing (p<0.001, r(i) = 0.53 compared to plateau values). Mean values of NO during tidal breathing increased significantly with time, suggesting increasing contamination with nasal air. It was concluded that, in asthmatic children, the end-expiratory plateau concentration of nitric oxide during exhalation at 20% of the vital capacity per second is similar to the values obtained with the balloon method, with satisfactory agreement, but differs from values obtained during tidal breathing. The balloon method is cheap, simple and offers the interesting possibility to study exhaled nitric oxide in young children independently of the presence of a nitric oxide analyser.

  13. Radon-222 exhalation from open ground on and around a uranium mine in the wet-dry tropics.

    PubMed

    Lawrence, Cameron E; Akber, Riaz A; Bollhöfer, Andreas; Martin, Paul

    2009-01-01

    Radon-222 exhalation from the ground surface depends upon a number of variables such as the 226Ra activity concentration and its distribution in soil grains; soil grain size; soil porosity, temperature and moisture; atmospheric pressure, rainfall and temperature. In this study, 222Rn exhalation flux density measurements within and around the Ranger uranium mine in northern Australia were performed to investigate the effect of these variables within a tropical region. Measurements were taken at the waste rock dumps, ore stockpiles, mine pits, and at sites where effluent water with elevated 226Ra concentration has been spray irrigated over land, as well as at sites outside the mine. The sites selected represented a variety of geomorphic regions ranging from uranium-bearing rocks to ambient soils. Generally, wet season rains reduced 222Rn exhalation but at a few sites the onset of rains caused a step rise in exhalation flux densities. The results show that parameters such as 226Ra activity concentration, soil grain size and soil porosity have a marked effect on 222Rn flux densities. For similar geomorphic sites, 226Ra activity concentration is a dominant factor, but soil grain size and porosity also influence 222Rn exhalation. Surfaces with vegetation showed higher exhalation flux densities than their barren counterparts, perhaps because the associated root structure increases soil porosity and moisture retention. Repeated measurements over one year at eight sites enabled an analysis of precipitation and soil moisture effects on 222Rn exhalation. Soil moisture depth profiles varied both between seasons and at different times during the wet season, indicating that factors such as duration, intensity and time between precipitation events can influence 222Rn flux densities considerably.

  14. Increased nitric oxide in exhaled air: an early marker of asthma in non-smoking aluminium potroom workers?

    PubMed Central

    Lund, M; Oksne, P; Hamre, R; Kongerud, J

    2000-01-01

    OBJECTIVES—To study exhaled nitric oxide (NO) as a marker of airway inflammation caused by potroom exposure, hypothesising that (a) workers exposed to potroom pollutants would have higher concentrations of NO in expired air than control subjects employed at the same plant but working outside of the potroom atmosphere, and (b) that concentrations of exhaled NO in potroom employees might be positively associated with concentrations of fluoride and exposure to dust.
METHODS—A study group comprising 186 male subjects (aged 24-63 years), employed in the potrooms of one Norwegian aluminium smelter, and 40 comparable control subjects (aged 25-60 years) recruited from the same plant, were examined by measurements of exhaled and nasal concentrations of NO, spirometry, and a questionnaire on respiratory symptoms as a part of an annual health surveillance programme. Estimates of exposure to fluorides and dust for selected job categories were obtained by means of personal samplers carried by the workers.
RESULTS—In the non-smokers, the concentrations of exhaled NO were higher in the potroom workers than in the controls (median (interquartile range) 9.3 (6.2-15.6) v 5.7 (4.6-8.3) ppb, p=0.001). The two groups did not differ in spirometry and asthma-like symptoms. Non-smoking potroom workers with asthma-like symptoms had higher concentrations of exhaled NO than those with no symptoms (median (interquartile range) 21.0 (19.3-41.4) v 8.5 (5.9-12.8) ppb, p=0.001), but had comparable spirometric values. In subjects who smoked, the concentrations of exhaled NO did not differ significantly between potroom workers and controls (median (interquartile range) 4.6 (3.3-8.0) v 4.0 (3.4-5.1) ppb. Exhaled NO was not significantly associated with either duration of employment or routine measurements of dust and fluorides.
CONCLUSIONS—Exposure to potroom pollutants is associated with increased concentrations of exhaled NO in non-smoking subjects. Nitric oxide in exhaled

  15. Detecting Lung Diseases from Exhaled Aerosols: Non-Invasive Lung Diagnosis Using Fractal Analysis and SVM Classification

    PubMed Central

    Xi, Jinxiang; Zhao, Weizhong; Yuan, Jiayao Eddie; Kim, JongWon; Si, Xiuhua; Xu, Xiaowei

    2015-01-01

    Background Each lung structure exhales a unique pattern of aerosols, which can be used to detect and monitor lung diseases non-invasively. The challenges are accurately interpreting the exhaled aerosol fingerprints and quantitatively correlating them to the lung diseases. Objective and Methods In this study, we presented a paradigm of an exhaled aerosol test that addresses the above two challenges and is promising to detect the site and severity of lung diseases. This paradigm consists of two steps: image feature extraction using sub-regional fractal analysis and data classification using a support vector machine (SVM). Numerical experiments were conducted to evaluate the feasibility of the breath test in four asthmatic lung models. A high-fidelity image-CFD approach was employed to compute the exhaled aerosol patterns under different disease conditions. Findings By employing the 10-fold cross-validation method, we achieved 100% classification accuracy among four asthmatic models using an ideal 108-sample dataset and 99.1% accuracy using a more realistic 324-sample dataset. The fractal-SVM classifier has been shown to be robust, highly sensitive to structural variations, and inherently suitable for investigating aerosol-disease correlations. Conclusion For the first time, this study quantitatively linked the exhaled aerosol patterns with their underlying diseases and set the stage for the development of a computer-aided diagnostic system for non-invasive detection of obstructive respiratory diseases. PMID:26422016

  16. Development/verification of methods for measurement of exhaled breath and environmental e-vapor product aerosol.

    PubMed

    Oldham, Michael J; Wagner, Karl A; Gene Gilman, I; Beach, James B; Liu, Jianmin; Rostami, Ali A; Sarkar, Mohamadi A

    2017-04-01

    Concerns have been raised about the potential health effects of potential bystander exposure to exhaled aerosols from e-vapor products (EVPs). An exhaled breath collection system (EBS) was developed and analytical methods were verified for collection and analysis of exhaled breath from users of EVPs. Analytical methods were adapted and verified for collection of environmental air samples during EVP use in an exposure chamber. Analysis of constituents in exhaled breath focused on nicotine, propylene glycol, and glycerin (because these are reported as the major constituents in EVPs) and selected carbonyl compounds (acetaldehyde, acrolein, and formaldehyde). Analysis of environmental samples included nicotine, propylene glycol, glycerin, 12 volatile organic compounds (VOCs), 15 carbonyl compounds and 4 metals. The EBS and analytical methods used were found to be suitable for collection and analysis of the target constituents in exhaled breath. Environmental sampling for background levels of VOCs and carbonyl compounds found only acetone, acetaldehyde, benzene, ethylbenzene, formaldehyde, isoprene, methyl ethyl ketone, hexaldehyde, propionaldehyde, and toluene above the limit of quantification in some samples. None of the targeted metals were detected. Background levels of VOCs and carbonyl compounds were consistent with levels previously reported for ambient air.

  17. Diagnosis by Volatile Organic Compounds in Exhaled Breath from Lung Cancer Patients Using Support Vector Machine Algorithm

    PubMed Central

    Sakumura, Yuichi; Koyama, Yutaro; Tokutake, Hiroaki; Hida, Toyoaki; Sato, Kazuo; Itoh, Toshio; Akamatsu, Takafumi; Shin, Woosuck

    2017-01-01

    Monitoring exhaled breath is a very attractive, noninvasive screening technique for early diagnosis of diseases, especially lung cancer. However, the technique provides insufficient accuracy because the exhaled air has many crucial volatile organic compounds (VOCs) at very low concentrations (ppb level). We analyzed the breath exhaled by lung cancer patients and healthy subjects (controls) using gas chromatography/mass spectrometry (GC/MS), and performed a subsequent statistical analysis to diagnose lung cancer based on the combination of multiple lung cancer-related VOCs. We detected 68 VOCs as marker species using GC/MS analysis. We reduced the number of VOCs and used support vector machine (SVM) algorithm to classify the samples. We observed that a combination of five VOCs (CHN, methanol, CH3CN, isoprene, 1-propanol) is sufficient for 89.0% screening accuracy, and hence, it can be used for the design and development of a desktop GC-sensor analysis system for lung cancer. PMID:28165388

  18. Influence of age and gender on the profile of exhaled volatile organic compounds analyzed by an electronic nose

    PubMed Central

    Dragonieri, Silvano; Quaranta, Vitaliano Nicola; Carratu, Pierluigi; Ranieri, Teresa; Resta, Onofrio

    2016-01-01

    We aimed to investigate the effects of age and gender on the profile of exhaled volatile organic compounds. We evaluated 68 healthy adult never-smokers, comparing them by age and by gender. Exhaled breath samples were analyzed by an electronic nose (e-nose), resulting in "breathprints". Principal component analysis and canonical discriminant analysis showed that older subjects (≥ 50 years of age) could not be distinguished from younger subjects on the basis of their breathprints, as well as that the breathprints of males could not distinguished from those of females (cross-validated accuracy, 60.3% and 57.4%, respectively).Therefore, age and gender do not seem to affect the overall profile of exhaled volatile organic compounds measured by an e-nose. PMID:27167436

  19. Diagnosis by Volatile Organic Compounds in Exhaled Breath from Lung Cancer Patients Using Support Vector Machine Algorithm.

    PubMed

    Sakumura, Yuichi; Koyama, Yutaro; Tokutake, Hiroaki; Hida, Toyoaki; Sato, Kazuo; Itoh, Toshio; Akamatsu, Takafumi; Shin, Woosuck

    2017-02-04

    Monitoring exhaled breath is a very attractive, noninvasive screening technique for early diagnosis of diseases, especially lung cancer. However, the technique provides insufficient accuracy because the exhaled air has many crucial volatile organic compounds (VOCs) at very low concentrations (ppb level). We analyzed the breath exhaled by lung cancer patients and healthy subjects (controls) using gas chromatography/mass spectrometry (GC/MS), and performed a subsequent statistical analysis to diagnose lung cancer based on the combination of multiple lung cancer-related VOCs. We detected 68 VOCs as marker species using GC/MS analysis. We reduced the number of VOCs and used support vector machine (SVM) algorithm to classify the samples. We observed that a combination of five VOCs (CHN, methanol, CH₃CN, isoprene, 1-propanol) is sufficient for 89.0% screening accuracy, and hence, it can be used for the design and development of a desktop GC-sensor analysis system for lung cancer.

  20. Application of end-exhaled breath monitoring to assess carbon monoxide exposures of wildland firefighters at prescribed burns.

    PubMed

    Dunn, Kevin H; Devaux, Isabelle; Stock, Allison; Naeher, Luke P

    2009-01-01

    Exposure to the range of combustion products from wildland fires has been demonstrated to cause respiratory irritation and decreased lung function among firefighters. The measurement of carbon monoxide (CO) has been previously shown to be highly correlated with the range of contaminants found in wildland fires. In this article, we assess the feasibility of using a simple, noninvasive biological test to assess exposure to CO for a group of wildland firefighters. Measurements of CO exposure were collected using personal monitors as well as in exhaled breath for wildland firefighters who conducted prescribed burns in February-March 2004. Overall, the CO concentrations measured in this study group were low with a shift mean of 1.87 ppm. Correspondingly, the cross-shift difference in carboxyhemoglobin as estimated from exhaled breath CO levels was also low (median increase =+0.2% carboxyhemoglobin). The use of exhaled breath measurements for CO has limitations in characterizing exposures within this worker population.

  1. Application of End-Exhaled Breath Monitoring to Assess Carbon Monoxide Exposures of Wildland Firefighters at Prescribed Burns.

    SciTech Connect

    Dunn, K.H.; Devaux, I; Stock, A.; Naeher, L.P.

    2009-04-01

    Exposure to the range of combustion products from wildland fires has been demonstrated to cause respiratory irritation and decreased lung function among firefighters. The measurement of carbon monoxide (CO) has been previously shown to be highly correlated with the range of contaminants found in wildland fires. In this article, we assess the feasibility of using a simple, noninvasive biological test to assess exposure to CO for a group of wildland firefighters. Measurements of CO exposure were collected using personal monitors as well as in exhaled breath for wildland firefighters who conducted prescribed burns in February–March 2004. Overall, the CO concentrations measured in this study group were low with a shift mean of 1.87 ppm. Correspondingly, the cross-shift difference in carboxyhemoglobin as estimated from exhaled breath CO levels was also low (median increase =+0.2% carboxyhemoglobin). The use of exhaled breath measurements for CO has limitations in characterizing exposures within this worker population.

  2. Application of End-Exhaled Breath Monitoring to Assess Carbon Monoxide Exposures of Wildland Firefighters at Prescribed Burns.

    SciTech Connect

    Dunn, K.H.; Devaux, I; Stock, A.; Naeher, L.P.

    2009-04-01

    Exposure to the range of combustion products from wildland fires has been demonstrated to cause respiratory irritation and decreased lung function among firefighters. The measurement of carbon monoxide (CO) has been previously shown to be highly correlated with the range of contaminants found in wildland fires. In this article, we assess the feasibility of using a simple, noninvasive biological test to assess exposure to CO for a group of wildland firefighters. Measurements of CO exposure were collected using personal monitors as well as in exhaled breath for wildland firefighters who conducted prescribed burns in February–March 2004. Overall, the CO concentrations measured in this study group were low with a shift mean of 1.87 ppm. Correspondingly, the cross-shift difference in carboxyhemoglobin as estimated from exhaled breath CO levels was also low (median increase =+0.2% carboxyhemoglobin). The use of exhaled breath measurements for CO has limitations in characterizing exposures within this worker population.

  3. Design of the exhale airway stents for emphysema (EASE) trial: an endoscopic procedure for reducing hyperinflation.

    PubMed

    Shah, Pallav L; Slebos, Dirk-Jan; Cardoso, Paulo F G; Cetti, Edward J; Sybrecht, Gerhard W; Cooper, Joel D

    2011-01-07

    Airway Bypass is a catheter-based, bronchoscopic procedure in which new passageways are created that bypass the collapsed airways, enabling trapped air to exit the lungs. The Exhale Airway Stents for Emphysema (EASE) Trial was designed to investigate whether Exhale® Drug-Eluting Stents, placed in new passageways in the lungs, can improve pulmonary function and reduce breathlessness in severely hyperinflated, homogeneous emphysema patients (NCT00391612). The multi-center, randomized, double-blind, sham-controlled trial design was posted on http://www.clinicaltrials.gov in October 2006. Because Bayesian statistics are used for the analysis, the proposed enrollment ranged from 225 up to 450 subjects at up to 45 institutions. Inclusion criteria are: high resolution CT scan with evidence of homogeneous emphysema, post-bronchodilator pulmonary function tests showing: a ratio of FEV1/FVC < 70%, FEV1 ≤ 50% of predicted or FEV1 < 1 liter, RV/TLC ≥ 0.65 at screening, marked dyspnea score ≥ 2 on the modified Medical Research Council scale of 0-4, a smoking history of at least 20 pack years and stopped smoking for at least 8 weeks prior to enrollment. Following 16 to 20 supervised pulmonary rehabilitation sessions, subjects were randomized 2:1 to receive either a treatment (Exhale® Drug-Eluting Stent) or a sham bronchoscopy. A responder analysis will evaluate the co-primary endpoints of an FVC improvement ≥ 12% of the patient baseline value and modified Medical Research Council dyspnea scale improvement (reduction) ≥ 1 point at the 6-month follow-up visit. If through the EASE Trial, Airway Bypass is shown to improve pulmonary function and reduce dyspnea while demonstrating an acceptable safety profile, then homogeneous patients will have a minimally invasive treatment option with meaningful clinical benefit. ClinicalTrials.gov: NCT00391612.

  4. Design of the exhale airway stents for emphysema (EASE) trial: an endoscopic procedure for reducing hyperinflation

    PubMed Central

    2011-01-01

    Background Airway Bypass is a catheter-based, bronchoscopic procedure in which new passageways are created that bypass the collapsed airways, enabling trapped air to exit the lungs. The Exhale Airway Stents for Emphysema (EASE) Trial was designed to investigate whether Exhale® Drug-Eluting Stents, placed in new passageways in the lungs, can improve pulmonary function and reduce breathlessness in severely hyperinflated, homogeneous emphysema patients (NCT00391612). Methods/Design The multi-center, randomized, double-blind, sham-controlled trial design was posted on http://www.clinicaltrials.gov in October 2006. Because Bayesian statistics are used for the analysis, the proposed enrollment ranged from 225 up to 450 subjects at up to 45 institutions. Inclusion criteria are: high resolution CT scan with evidence of homogeneous emphysema, post-bronchodilator pulmonary function tests showing: a ratio of FEV1/FVC < 70%, FEV1≤50% of predicted or FEV1 < 1 liter, RV/TLC≥0.65 at screening, marked dyspnea score ≥2 on the modified Medical Research Council scale of 0-4, a smoking history of at least 20 pack years and stopped smoking for at least 8 weeks prior to enrollment. Following 16 to 20 supervised pulmonary rehabilitation sessions, subjects were randomized 2:1 to receive either a treatment (Exhale® Drug-Eluting Stent) or a sham bronchoscopy. A responder analysis will evaluate the co-primary endpoints of an FVC improvement ≥12% of the patient baseline value and modified Medical Research Council dyspnea scale improvement (reduction) ≥1 point at the 6-month follow-up visit. Discussion If through the EASE Trial, Airway Bypass is shown to improve pulmonary function and reduce dyspnea while demonstrating an acceptable safety profile, then homogeneous patients will have a minimally invasive treatment option with meaningful clinical benefit. Trial Registration ClinicalTrials.gov: NCT00391612 PMID:21214899

  5. Allergic asthma exhaled breath metabolome: a challenge for comprehensive two-dimensional gas chromatography.

    PubMed

    Caldeira, M; Perestrelo, R; Barros, A S; Bilelo, M J; Morête, A; Câmara, J S; Rocha, S M

    2012-09-07

    Allergic asthma represents an important public health issue, most common in the paediatric population, characterized by airway inflammation that may lead to changes in volatiles secreted via the lungs. Thus, exhaled breath has potential to be a matrix with relevant metabolomic information to characterize this disease. Progress in biochemistry, health sciences and related areas depends on instrumental advances, and a high throughput and sensitive equipment such as comprehensive two-dimensional gas chromatography-time of flight mass spectrometry (GC×GC-ToFMS) was considered. GC×GC-ToFMS application in the analysis of the exhaled breath of 32 children with allergic asthma, from which 10 had also allergic rhinitis, and 27 control children allowed the identification of several hundreds of compounds belonging to different chemical families. Multivariate analysis, using Partial Least Squares-Discriminant Analysis in tandem with Monte Carlo Cross Validation was performed to assess the predictive power and to help the interpretation of recovered compounds possibly linked to oxidative stress, inflammation processes or other cellular processes that may characterize asthma. The results suggest that the model is robust, considering the high classification rate, sensitivity, and specificity. A pattern of six compounds belonging to the alkanes characterized the asthmatic population: nonane, 2,2,4,6,6-pentamethylheptane, decane, 3,6-dimethyldecane, dodecane, and tetradecane. To explore future clinical applications, and considering the future role of molecular-based methodologies, a compound set was established to rapid access of information from exhaled breath, reducing the time of data processing, and thus, becoming more expedite method for the clinical purposes.

  6. Diagnostic performance of an electronic nose, fractional exhaled nitric oxide, and lung function testing in asthma.

    PubMed

    Montuschi, Paolo; Santonico, Marco; Mondino, Chiara; Pennazza, Giorgio; Mantini, Giulia; Martinelli, Eugenio; Capuano, Rosamaria; Ciabattoni, Giovanni; Paolesse, Roberto; Di Natale, Corrado; Barnes, Peter J; D'Amico, Arnaldo

    2010-04-01

    Analysis of exhaled breath by biosensors discriminates between patients with asthma and healthy subjects. An electronic nose consists of a chemical sensor array for the detection of volatile organic compounds (VOCs) and an algorithm for pattern recognition. We compared the diagnostic performance of a prototype of an electronic nose with lung function tests and fractional exhaled nitric oxide (FENO) in patients with atopic asthma. A cross-sectional study was undertaken in 27 patients with intermittent and persistent mild asthma and in 24 healthy subjects. Two procedures for collecting exhaled breath were followed to study the differences between total and alveolar air. Seven patients with asthma and seven healthy subjects participated in a study with mass spectrometry (MS) fingerprinting as an independent technique for assessing between group discrimination. Classification was based on principal component analysis and a feed-forward neural network. The best results were obtained when the electronic nose analysis was performed on alveolar air. Diagnostic performance for electronic nose, FENO, and lung function testing was 87.5%, 79.2%, and 70.8%, respectively. The combination of electronic nose and FENO had the highest diagnostic performance for asthma (95.8%). MS fingerprints of VOCs could discriminate between patients with asthma and healthy subjects. The electronic nose has a high diagnostic performance that can be increased when combined with FENO. Large studies are now required to definitively establish the diagnostic performance of the electronic nose. Whether this integrated noninvasive approach will translate into an early diagnosis of asthma has to be clarified. EUDRACT https://eudralink.emea.europa.eu; Identifier: 2007-000890-51; and clinicaltrials.gov; Identifier: NCT00819676.

  7. Influence of ventilatory settings on exhaled nitric oxide during high frequency oscillatory ventilation.

    PubMed

    Yuh, Yeong-Seng; Hua, Yi-Ming

    2009-08-01

    Nitric oxide (NO), which is produced in the lower airways, diffuses from cells into the air space and can be measured in exhaled air. The influence of high frequency oscillatory ventilation on the production of exhaled NO (eNO) has not been thoroughly studied. The objectives of this study are to establish an animal model for evaluation of lower airway NO and to evaluate settings in terms of frequency, mean airway pressure (MAP), amplitude pressure (amplitude), and inspiratory time ratio (t(I)/t(E)) during high frequency oscillatory ventilation on the production of eNO. An observational animal study was performed on 12 female New Zealand White rabbits, which were anesthetized, tracheotomized and ventilated using a SensorMedics 3100A HFOV ventilator (SM3100A). The concentration of NO in exhaled gas was measured by chemiluminescence continuously from the nose and the side hole of the adaptor of endotracheal tube. The individual effects of the respiratory settings were evaluated. The results were analyzed by paired t-test or by the generalized estimating equation method. We found that the lower airway was the main source of the eNO, that amplitude, MAP, and t(I)/t(E) were positively correlated with the level of eNO and that frequency was negatively correlated with the level of eNO. These findings fit the stretch theory for the production of endogenous NO. Monitoring of eNO during HFOV may provide insights into lung mechanics and ventilation efficiency and be used in the future as a guide during clinical practice.

  8. Comparison between exhaled and sputum oxidative stress biomarkers in chronic airway inflammation

    PubMed Central

    Corradi, M.; Pignatti, P.; Manini, P.; Andreoli, R.; Goldoni, M.; Poppa, M.; Moscato, G.; Balbi, B.; Mutti, A.

    2006-01-01

    The aim of the present study was to compare aldehyde levels resulting from lipid peroxidation in exhaled breath condensate (EBC) and induced sputum (IS) supernatant of subjects with asthma and chronic obstructive pulmonary disease (COPD). Aldehydes (malondialdehyde (MDA), acrolein, n-hexanal (C6), n-heptanal (C7), n-nonanal (C9), 4-hydroxynonenal (HNE) and 4-hydroxyhexenal (HHE)) in both biological fluids were measured by liquid chromatography-tandem mass spectrometry. MDA concentrations in sputum were 132.5 nM (82.5–268.8) and 23.7 nM (9–53.7) in EBC. Similarly, C6, C7 and C9 concentrations in IS were 1.5–4.7-fold higher than in EBC. Acrolein levels were 131.1 nM (55.6–264.6) in IS and 45.3 nM (14.4–127.1) in EBC. The concentrations of HNE and HHE in IS were not significantly different from the levels in EBC. Aldehyde levels in EBC did not show any correlation with aldehyde levels in IS or with differential sputum cellular count. In COPD, MDA in EBC, but not its IS counterpart, was negatively correlated with the severity of disease. In conclusion, the data presented here show that aldehydes can be detected in both exhaled breath condensate and supernatant of induced sputum, but that their relative concentrations are different and not correlated with each other. Therefore, with regard to lipid peroxidation products, exhaled breath condensate and induced sputum must be considered as independent techniques. PMID:15572547

  9. [Exhaled nitric oxide in children under 4 years of age with recurrent bronchitis].

    PubMed

    de Mir Messa, Inés; Moreno Galdó, Antonio; Cobos Barroso, Nicolás; Gartner, Silvia; Martín De Vicente, Carlos; Liñán Cortés, Santos

    2009-09-01

    The objective of the study was to assess bronchial inflammation in preschool children with recurrent bronchitis by measuring exhaled nitric oxide. The study included patients under 4 years of age with at least 3 episodes of wheezing in the past year (n=63) and a control group (n=30). Exhaled nitric oxide was measured in samples collected offline during spontaneous tidal breathing with a face mask and stored in Mylar balloons. The fractional exhaled nitric oxide concentration (FE(NO)) was higher in the group with bronchitis (mean [SD], 5.3 [1.3] parts per billion [ppb]) than in the control group (4.6 [1.1]ppb) (P=.02). There was a significant difference between the control group and children in the bronchitis group not treated with inhaled corticosteroids (P<.05), but not between controls and corticosteroid-treated patients. A relationship with eosinophil count was observed in that those with higher counts (>400 microL) had higher FE(NO) levels (P<.01). No relationship was observed between FE(NO) and a positive methacholine challenge test. Follow-up lasted at least 20 months. The initial FE(NO) level did not differ significantly according to whether patients were subsequently transient, infrequent, or frequent wheezers (5.2 [0.98]ppb, 5.6 [1.5]ppb, and 4.8 [1.34]ppb, respectively; P=.36). In children under 4 years of age with recurrent wheezing bronchitis who were asymptomatic at study entry, a small increase in FE(NO) was observed although there was a good deal of overlap with the control group.

  10. Influence of the porosity on the ²²²Rn exhalation rate of concrete.

    PubMed

    de Jong, Peter; van Dijk, Willem; de Rooij, Mario

    2011-02-01

    The composition of 23 concrete mixtures was varied in five separate series to evaluate the influence of porosity on the ²²²Rn exhalation rate. In each series, a range in porosities is obtained by varying (1) the amount of cement, (2) type of cement (Portland or blast furnace slag cement), (3) the amount of water at a fixed cement level, (4) addition of an air entraining agent, or (5) the amount of recycled aggregates. The porosities ranged from 1% to 16%. The ²²²Rn exhalation rate is normalized to the ²²⁶Ra activity concentration and expressed as the ²²²Rn release factor to eliminate the effect of differences in ²²⁶Ra activity concentrations among the various concrete mixtures. Since most ²²²Rn originates from the cement, a ²²²Rn release factor based on the amount of ²²⁶Ra introduced by the cements appeared to be more adequate. Although the methods to attain the porosities in the concrete mixtures differ widely, this cement-related factor corresponds well with the capillary porosity of the mixtures. Since the water-to-cement ratio of the fresh paste is a good indicator of the capillary porosity, this is the guiding factor in the fabrication of concretes low in ²²²Rn exhalation. The lower the water-to-cement ratio, the less capillary pore area will be available from which ²²²Rn can emanate from the mineral matrix into the pore system. The good correlation between the cement-based ²²²Rn release factor and literature data on the internal capillary pore area support the results of this study.

  11. Exhaled flow monitoring can detect bronchial flap-valve obstruction in a mechanical lung model.

    PubMed

    Breen, P H; Serina, E R; Barker, S J

    1995-08-01

    Flap-valve obstruction to expiratory flow (V) in a major bronchus can result from inspissated secretions, blood, or foreign body. During inhalation, increasing airway caliber preserves inspired V past the obstruction; during exhalation, decreasing airway diameter causes airflow obstruction and even frank gas trapping. We reasoned that the resultant sequential, biphasic exhalation of the lungs would be best detected by measuring exhaled V versus time. Accordingly, we designed an airway obstruction element in a mechanical lung model to examine flap-valve bronchial obstruction. A mechanical lung simulator was ventilated with a pressure-limited flow generator, where f = 10/min, tidal volume = 850 mL, and respiratory compliance = 40 mL/cm H2O. Airway V (pneumotachometer) and pressure (P) were digitally sampled for 1 min. Then, the circumference of the diaphragm in a respiratory one-way valve was trimmed to generate unidirectional resistance to expiratory V. Measurement sequences were repeated after this flap-valve was interposed in the right "main-stem bronchus." Integration of airway V versus time generated changes in lung volume. During flap-valve obstruction of the right bronchus, the V-time plot revealed preservation of peak expired flow from the normal lung, followed by retarded and decreased flow from the obstructed right lung. Gas trapping of the obstructed lung occurred during conditions of decreased expiratory time and increased expiratory resistance. Airway P could not differentiate between bronchial and tracheal flap-valve obstruction because P decreased abruptly in both conditions. The flow-volume loop displayed less distinctive changes than the flow-time plot, in part because the flow-volume loop was data (flow) plotted against its time integral (volume), with loss of temporal data. In this mechanical lung model, we conclude that bronchial flap-valve obstruction was best detected by the flow-time plot, which could measure the sequential emptying of the

  12. Effects of acute hypoventilation and hyperventilation on exhaled carbon monoxide measurement in healthy volunteers

    PubMed Central

    2009-01-01

    Background High levels of exhaled carbon monoxide (eCO) are a marker of airway or lung inflammation. We investigated whether hypo- or hyperventilation can affect measured values. Methods Ten healthy volunteers were trained to achieve sustained end-tidal CO2 (etCO2) concentrations of 30 (hyperventilation), 40 (normoventilation), and 50 mmHg (hypoventilation). As soon as target etCO2 values were achieved for 120 sec, exhaled breath was analyzed for eCO with a photoacoustic spectrometer. At etCO2 values of 30 and 40 mmHg exhaled breath was sampled both after a deep inspiration and after a normal one. All measurements were performed in two different environmental conditions: A) ambient CO concentration = 0.8 ppm and B) ambient CO concentration = 1.7 ppm. Results During normoventilation, eCO mean (standard deviation) was 11.5 (0.8) ppm; it decreased to 10.3 (0.8) ppm during hyperventilation (p < 0.01) and increased to 11.9 (0.8) ppm during hypoventilation (p < 0.01). eCO changes were less pronounced than the correspondent etCO2 changes (hyperventilation: 10% Vs 25% decrease; hypoventilation 3% Vs 25% increase). Taking a deep inspiration before breath sampling was associated with lower eCO values (p < 0.01), while environmental CO levels did not affect eCO measurement. Conclusions eCO measurements should not be performed during marked acute hyperventilation, like that induced in this study, but the influence of less pronounced hyperventilation or of hypoventilation is probably negligible in clinical practice PMID:20030802

  13. Anodic alumina coating for extraction of volatile organic compounds in human exhaled breath vapor.

    PubMed

    Zhang, GuoJuan; Zou, LiangYuan; Xu, Hui

    2015-01-01

    The objective of the study is to develop a facile and highly sensitive solid phase microextraction-gas chromatography/mass spectrometry method for the analysis of volatile organic compounds in human exhaled breath vapor. For the purpose, a highly ordered nanoporous anodic alumina coating was prepared by a two-step anodic oxidization method based on aluminum substrate. To have a good knowledge of the fiber, some features were characterized and the results indicate that the coating has several advantages, including excellent chemical and thermal stability, high mechanical strength, large surface area and good extraction performance. In addition, some parameters related to extraction efficiency were also studied. Under the optimal conditions, the coating was used to quantitatively extract volatile organic compounds. Good linearity and wide linear range were obtained with correlation coefficients (R(2)) ranging from 0.9933 to 0.9999. The detection limits of benzene homologues, aldehydes and ketones were between 0.7 and 3.4 ng L(-1). Relative standard deviations (n=5) ranged from 1.8 to 15.0%. Satisfied recovery (89-115%) was obtained at two spiked concentration levels. Finally, the developed method was successfully applied for the analysis of volatile organic compounds in human exhaled vapor samples of lung cancer patients and the controls, and the results were statistically analyzed with Independent-Sample T Test. The proposed method exhibits some outstanding merits, including convenience, non-invasion, low cost and sensitivity. It provides a potential tool for rapid detection of volatile organic compounds in human exhaled breath.

  14. The human volatilome: volatile organic compounds (VOCs) in exhaled breath, skin emanations, urine, feces and saliva.

    PubMed

    Amann, Anton; Costello, Ben de Lacy; Miekisch, Wolfram; Schubert, Jochen; Buszewski, Bogusław; Pleil, Joachim; Ratcliffe, Norman; Risby, Terence

    2014-09-01

    Breath analysis is a young field of research with its roots in antiquity. Antoine Lavoisier discovered carbon dioxide in exhaled breath during the period 1777-1783, Wilhelm (Vilém) Petters discovered acetone in breath in 1857 and Johannes Müller reported the first quantitative measurements of acetone in 1898. A recent review reported 1765 volatile compounds appearing in exhaled breath, skin emanations, urine, saliva, human breast milk, blood and feces. For a large number of compounds, real-time analysis of exhaled breath or skin emanations has been performed, e.g., during exertion of effort on a stationary bicycle or during sleep. Volatile compounds in exhaled breath, which record historical exposure, are called the 'exposome'. Changes in biogenic volatile organic compound concentrations can be used to mirror metabolic or (patho)physiological processes in the whole body or blood concentrations of drugs (e.g. propofol) in clinical settings-even during artificial ventilation or during surgery. Also compounds released by bacterial strains like Pseudomonas aeruginosa or Streptococcus pneumonia could be very interesting. Methyl methacrylate (CAS 80-62-6), for example, was observed in the headspace of Streptococcus pneumonia in concentrations up to 1420 ppb. Fecal volatiles have been implicated in differentiating certain infectious bowel diseases such as Clostridium difficile, Campylobacter, Salmonella and Cholera. They have also been used to differentiate other non-infectious conditions such as irritable bowel syndrome and inflammatory bowel disease. In addition, alterations in urine volatiles have been used to detect urinary tract infections, bladder, prostate and other cancers. Peroxidation of lipids and other biomolecules by reactive oxygen species produce volatile compounds like ethane and 1-pentane. Noninvasive detection and therapeutic monitoring of oxidative stress would be highly desirable in autoimmunological, neurological, inflammatory diseases and cancer

  15. Gene promoter methylation assayed in exhaled breath, with differences in smokers and lung cancer patients

    PubMed Central

    2009-01-01

    Background There is a need for new, noninvasive risk assessment tools for use in lung cancer population screening and prevention programs. Methods To investigate the technical feasibility of determining DNA methylation in exhaled breath condensate, we applied our previously-developed method for tag-adapted bisulfite genomic DNA sequencing (tBGS) for mapping of DNA methylation, and adapted it to exhaled breath condensate (EBC) from lung cancer cases and non-cancer controls. Promoter methylation patterns were analyzed in DAPK, RASSF1A and PAX5β promoters in EBC samples from 54 individuals, comprised of 37 controls [current- (n = 19), former- (n = 10), and never-smokers (n = 8)] and 17 lung cancer cases [current- (n = 5), former- (n = 11), and never-smokers (n = 1)]. Results We found: (1) Wide inter-individual variability in methylation density and spatial distribution for DAPK, PAX5β and RASSF1A. (2) Methylation patterns from paired exhaled breath condensate and mouth rinse specimens were completely divergent. (3) For smoking status, the methylation density of RASSF1A was statistically different (p = 0.0285); pair-wise comparisons showed that the former smokers had higher methylation density versus never smokers and current smokers (p = 0.019 and p = 0.031). For DAPK and PAX5β, there was no such significant smoking-related difference. Underlying lung disease did not impact on methylation density for this geneset. (4) In case-control comparisons, CpG at -63 of DAPK promoter and +52 of PAX5β promoter were significantly associated with lung cancer status (p = 0.0042 and 0.0093, respectively). After adjusting for multiple testing, both loci were of borderline significance (padj = 0.054 and 0.031). (5) The DAPK gene had a regional methylation pattern with two blocks (1)~-215~-113 and (2) -84 ~+26); while similar in block 1, there was a significant case-control difference in methylation density in block 2 (p = 0.045); (6)Tumor stage and histology did not impact on the

  16. Oral or nasal breathing? Real-time effects of switching sampling route onto exhaled VOC concentrations.

    PubMed

    Sukul, Pritam; Oertel, Peter; Kamysek, Svend; Trefz, Phillip

    2017-03-21

    There is a need for standardisation in sampling and analysis of breath volatile organic compounds (VOCs) in order to minimise ubiquitous confounding effects. Physiological factors may mask concentration changes induced by pathophysiological effects. In humans, unconscious switching of oral and nasal breathing can occur during breath sampling, which may affect VOC patterns. Here, we investigated exhaled VOC concentrations in real-time while switching breathing routes. Breath from 15 healthy volunteers was analysed continuously by proton transfer reaction time-of-flight mass spectrometry during paced breathing (12 breaths min(-1)). Every two minutes breathing routes were switched (Setup-1: Oral → Nasal → Oral → Nasal; Setup-2: OralinNasalout → NasalinOralout → OralinNasalout → NasalinOralout). VOCs in inspiratory and alveolar air and respiratory and hemodynamic parameters were monitored quantitatively in parallel. Changing of the breathing routes and patterns immediately affected exhaled VOC concentrations. These changes were reproducible in both setups. In setup-1 cardiac output and acetone concentrations remained constant, while partial pressure of end-tidal CO2 (pET-CO2), isoprene and furan concentrations inversely mirrored tidal-volume and minute-ventilation. H2S (hydrogen-sulphide), C4H8S (allyl-methyl-sulphide), C3H8O (isopropanol) and C3H6O2 increased during oral exhalation. C4H10S increased during nasal exhalations. CH2O2 steadily decreased during the whole measurement. In setup-2 pET-CO2, C2H6S (dimethyl-sulphide), isopropanol, limonene and benzene concentrations decreased whereas, minute-ventilation, H2S and acetonitrile increased. Isoprene and furan remained unchanged. Breathing route and patterns induced VOC concentration changes depended on respiratory parameters, oral and nasal cavity exposure and physico-chemical characters of the compounds. Before using breath VOC concentrations as biomarkers it is essential that the breathing

  17. Quantification of methane in humid air and exhaled breath using selected ion flow tube mass spectrometry.

    PubMed

    Dryahina, Kseniya; Smith, D; Spanel, P

    2010-05-15

    In selected ion flow tube mass spectrometry, SIFT-MS, analyses of humid air and breath, it is essential to consider and account for the influence of water vapour in the media, which can be profound for the analysis of some compounds, including H(2)CO, H(2)S and notably CO(2). To date, the analysis of methane has not been considered, since it is known to be unreactive with H(3)O(+) and NO(+), the most important precursor ions for SIFT-MS analyses, and it reacts only slowly with the other available precursor ion, O(2) (+). However, we have now experimentally investigated methane analysis and report that it can be quantified in both air and exhaled breath by exploiting the slow O(2) (+)/CH(4) reaction that produces CH(3)O(2) (+) ions. We show that the ion chemistry is significantly influenced by the presence of water vapour in the sample, which must be quantified if accurate analyses are to be performed. Thus, we have carried out a study of the loss rate of the CH(3)O(2) (+) analytical ion as a function of sample humidity and deduced an appropriate kinetics library entry that provides an accurate analysis of methane in air and breath by SIFT-MS. However, the associated limit of detection is rather high, at 0.2 parts-per-million, ppm. We then measured the methane levels, together with acetone levels, in the exhaled breath of 75 volunteers, all within a period of 3 h, which shows the remarkable sample throughput rate possible with SIFT-MS. The mean methane level in ambient air is seen to be 2 ppm with little spread and that in exhaled breath is 6 ppm, ranging from near-ambient levels to 30 ppm, with no significant variation with age and gender. Methane can now be included in the wide ranging analyses of exhaled breath that are currently being carried out using SIFT-MS. Copyright (c) 2010 John Wiley & Sons, Ltd.

  18. Quantifying Aerosol Delivery in Simulated Spontaneously Breathing Patients With Tracheostomy Using Different Humidification Systems With or Without Exhaled Humidity.

    PubMed

    Ari, Arzu; Harwood, Robert; Sheard, Meryl; Alquaimi, Maher Mubarak; Alhamad, Bshayer; Fink, James B

    2016-05-01

    Aerosol and humidification therapy are used in long-term airway management of critically ill patients with a tracheostomy. The purpose of this study was to determine delivery efficiency of jet and mesh nebulizers combined with different humidification systems in a model of a spontaneously breathing tracheotomized adult with or without exhaled heated humidity. An in vitro model was constructed to simulate a spontaneously breathing adult (tidal volume, 400 mL; breathing frequency, 20 breaths/min; inspiratory-expiratory ratio, 1:2) with a tracheostomy using a teaching manikin attached to a test lung through a collecting filter (Vital Signs Respirgard II). Exhaled heat and humidity were simulated using a cascade humidifier set to deliver 37°C and >95% relative humidity. Albuterol sulfate (2.5 mg/3 mL) was administered with a jet nebulizer (AirLife Misty Max) operated at 10 L/min and a mesh nebulizer (Aeroneb Solo) using a heated pass-over humidifier, unheated large volume humidifier both at 40 L/min output and heat-and-moisture exchanger. Inhaled drug eluted from the filter was analyzed via spectrophotometry (276 nm). Delivery efficiency of the jet nebulizer was less than that of the mesh nebulizer under all conditions (P < .05). Aerosol delivery with each nebulizer was greatest on room air and lowest when heated humidifiers with higher flows were used. Exhaled humidity decreased drug delivery up to 44%. The jet nebulizer was less efficient than the mesh nebulizer in all conditions tested in this study. Aerosol deposition with each nebulizer was lowest with the heated humidifier with high flow. Exhaled humidity reduced inhaled dose of drug compared with a standard model with nonheated/nonhumidified exhalation. Further clinical research is warranted to understand the impact of exhaled humidity on aerosol drug delivery in spontaneously breathing patients with tracheostomy using different types of humidifiers. Copyright © 2016 by Daedalus Enterprises.

  19. The role of obstructive sleep apnea syndrome and obesity in determining leptin in the exhaled breath condensate.

    PubMed

    Carpagnano, G E; Resta, O; Pergola, G De; Sabato, Roberto; Foschino Barbaro, M P

    2010-09-01

    Leptin plays a key role in obstructive sleep apnea syndrome (OSAS). Leptin production in human airways has been previously evaluated by measuring leptin concentration in the exhaled breath condensate and in the induced sputum. The aim was to study leptin expression in the cells of induced sputum and in exhaled breath condensate of subjects with OSAS. Moreover, leptin concentrations in the blood were measured in the same groups of subjects. We enrolled four groups of patients: (1) obese patients with OSAS (OO); (2) non-obese patients with OSAS (NOO); (3) obese patients without OSAS (ONO); and (4) non-obese subjects without OSAS (C). Leptin expression was evaluated by immunocytochemistry in the sputum cells of the enrolled subjects. The concentrations of leptin in the exhaled breath condensate and plasma were measured by using a specific enzyme immunoassay. Leptin protein expression and the percentage of macrophages and neutrophils expressing leptin were higher in the induced sputum of OO, NOO and ONO patients than in C. Leptin concentrations in the exhaled breath condensate were significantly higher in OO patients (5.12 (3.8-6.6) ng ml(-1)) than in NOO (4.1 (3.9-5.2) ng ml(-1)) and ONO (4.2 (3.6-5.0) ng ml(-1)) patients. The concentration of leptin in plasma was significantly more elevated in OO (36 (24-65.9) ng ml(-1)) than in NOO (30.2 (12.4-51.4) ng ml(-1)), whereas it was not significantly different in ONO patients. This study showed that leptin in sputum and in the exhaled breath condensate is higher in obese patients with OSAS than in obese subjects without OSAS. Moreover, different mechanisms for determining leptin concentrations in the exhaled breath condensate and the blood are suggested.

  20. Relations between isoprene and nitric oxide in exhaled breath and the potential influence of outdoor ozone: a pilot study

    PubMed Central

    Khan, Alya; Staimer, Norbert; Tjoa, Thomas; Galassetti, Pietro; Blake, Donald R.; Delfino, Ralph J.

    2013-01-01

    The role of endogenous isoprene in the human body, if any, is unclear because previous research is inconsistent and mechanistic evidence for the biologic function of isoprene is lacking. Given previous evidence that exhaled isoprene is elevated in systemic inflammatory states, we hypothesized that exhaled isoprene would be positively associated with a breath biomarker of airway inflammation, the fractional concentration of exhaled nitric oxide (FENO). We examined relationships of exhaled breath isoprene with FENO and with outdoor ozone given that ozone chemically reacts with isoprene and has been positively associated with FENO in past studies. Sixteen elderly subjects were followed with ≤12 weekly exhaled hydrocarbon and FENO collections at the subjects’ retirement community. Outdoor ozone concentrations were measured continuously on site. Mixed-effects regression analyses tested relations of FENO with isoprene, and FENO and isoprene with ozone, adjusted for temperature. We found FENO was inversely associated with isoprene, and this was not confounded by ozone. Isoprene was inversely related to ozone. FENO was positively related to ozone and this relation was not confounded by isoprene. In contrast to hypothesized relations, we conclude that exhaled isoprene is inversely associated with FENO as well as outdoor ozone, which suggests possible protective ozone-scavenging functions of endogenous isoprene. Findings may indicate chemical reactions of isoprene oxidation by ozone and by hydroxyl radicals in the presence of O2 that is dependent on NO concentration. These preliminary results need to be confirmed in additional studies of human subjects, particularly as they apply to FENO monitoring in asthma. PMID:23999846

  1. Calibration and validation of a MCC/IMS prototype for exhaled propofol online measurement.

    PubMed

    Maurer, Felix; Walter, Larissa; Geiger, Martin; Baumbach, Jörg Ingo; Sessler, Daniel I; Volk, Thomas; Kreuer, Sascha

    2017-10-25

    Propofol is a commonly used intravenous general anesthetic. Multi-capillary column (MCC) coupled Ion-mobility spectrometry (IMS) can be used to quantify exhaled propofol, and thus estimate plasma drug concentration. Here, we present results of the calibration and analytical validation of a MCC/IMS pre-market prototype for propofol quantification in exhaled air. Calibration with a reference gas generator yielded an R(2)≥0.99 with a linear array for the calibration curve from 0 to 20 ppbv. The limit of quantification was 0.3 ppbv and the limit of detection was 0.1 ppbv. The device is able to distinguish concentration differences >0.5 ppbv for the concentration range between 2 and 4 ppbv and >0.9 ppbv for the range between 28 and 30 ppbv. The imprecision at 20 ppbv is 11.3% whereas it is 3.5% at a concentration of 40 ppbv. The carry-over duration is 3min. The MCC/IMS we tested provided online quantification of gaseous propofol over the clinically relevant range at measurement frequencies of one measurement each minute. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Characterizations of particle size distribution of the droplets exhaled by sneeze

    PubMed Central

    Han, Z. Y.; Weng, W. G.; Huang, Q. Y.

    2013-01-01

    This work focuses on the size distribution of sneeze droplets exhaled immediately at mouth. Twenty healthy subjects participated in the experiment and 44 sneezes were measured by using a laser particle size analyser. Two types of distributions are observed: unimodal and bimodal. For each sneeze, the droplets exhaled at different time in the sneeze duration have the same distribution characteristics with good time stability. The volume-based size distributions of sneeze droplets can be represented by a lognormal distribution function, and the relationship between the distribution parameters and the physiological characteristics of the subjects are studied by using linear regression analysis. The geometric mean of the droplet size of all the subjects is 360.1 µm for unimodal distribution and 74.4 µm for bimodal distribution with geometric standard deviations of 1.5 and 1.7, respectively. For the two peaks of the bimodal distribution, the geometric mean (the geometric standard deviation) is 386.2 µm (1.8) for peak 1 and 72.0 µm (1.5) for peak 2. The influences of the measurement method, the limitations of the instrument, the evaporation effects of the droplets, the differences of biological dynamic mechanism and characteristics between sneeze and other respiratory activities are also discussed. PMID:24026469

  3. Quantitative detection of nitric oxide in exhaled human breath by extractive electrospray ionization mass spectrometry

    NASA Astrophysics Data System (ADS)

    Pan, Susu; Tian, Yong; Li, Ming; Zhao, Jiuyan; Zhu, Lanlan; Zhang, Wei; Gu, Haiwei; Wang, Haidong; Shi, Jianbo; Fang, Xiang; Li, Penghui; Chen, Huanwen

    2015-03-01

    Exhaled nitric oxide (eNO) is a useful biomarker of various physiological conditions, including asthma and other pulmonary diseases. Herein a fast and sensitive analytical method has been developed for the quantitative detection of eNO based on extractive electrospray ionization mass spectrometry (EESI-MS). Exhaled NO molecules selectively reacted with 2-phenyl-4, 4, 5, 5-tetramethylimidazoline-1-oxyl-3-oxide (PTIO) reagent, and eNO concentration was derived based on the EESI-MS response of 1-oxyl-2-phenyl-4, 4, 5, 5-tetramethylimidazoline (PTI) product. The method allowed quantification of eNO below ppb level (~0.02 ppbv) with a relative standard deviation (RSD) of 11.6%. In addition, eNO levels of 20 volunteers were monitored by EESI-MS over the time period of 10 hrs. Long-term eNO response to smoking a cigarette was recorded, and the observed time-dependent profile was discussed. This work extends the application of EESI-MS to small molecules (<30 Da) with low proton affinity and collision-induced dissociation efficiency, which are usually poorly visible by conventional ion trap mass spectrometers. Long-term quantitative profiling of eNO by EESI-MS opens new possibilities for the research of human metabolism and clinical diagnosis.

  4. Reference values of exhaled nitric oxide in healthy Asian children aged 5 to 18 years.

    PubMed

    Yao, T-C; Lee, W-I; Ou, L-S; Chen, L-C; Yeh, K-W; Huang, J-L

    2012-02-01

    This study was undertaken to establish reference values of exhaled nitric oxide fraction (F(eNO)) and its determinants in healthy Asian children. 693 healthy Asian children aged 5-18 yrs were assessed using a single-breath online F(eNO) measurement (exhaled flow 50 mL·s(-1)), questionnaires, anthropometric measurements, spirometry and total and specific immunoglobulin (Ig) E. Geometric mean F(eNO) and the upper 95% CI were 13.7 ppb and 49.7 ppb, respectively, for healthy children, and 11.2 ppb and 30.2 ppb, respectively, for those without allergic sensitisation. F(eNO) was positively associated with age, allergic sensitisation, total IgE, ambient nitric oxide, measurement in the afternoon, and drinking water within 1 h before testing, and was negatively associated with weight. In healthy children without allergic sensitisation, age was the single best explanatory variable. The F(eNO) predicted values were 1-2 ppb higher in Asian than in Caucasian children in earlier studies, while the upper 95% CI were 9-10 ppb higher. In conclusion, the upper limits of normal F(eNO) in Asian children depend on age, from 21 ppb in young children to 39 ppb in adolescents. Ethnicity, age, allergic sensitisation, total IgE, ambient nitric oxide, time of testing, drinking water and weight are important determinants.

  5. Radon exhalation rates and effective radium contents of the soil samples in Adapazarı, Turkey

    SciTech Connect

    Kuş, Adem; Yakut, Hakan Tabar, Emre

    2016-03-25

    In this study effective radium content and radon exhalation rates in soil samples collected from Adapazarı district of Sakarya, Turkey have been measured using LR-115 type-II plastic track detectors by closed-can technique for the first time. The obtained effective radium contents are found to vary from 6.66 to 34.32 Bqkg{sup −1} with a mean value of 18.01 Bqkg{sup −1}. The radon exhalation rates measured in terms of mass and area of soil samples are found to vary from 50.35-259.41 mBqkg{sup −1}h{sup −1} with a mean value of 136.12 mBqkg{sup −1}h{sup −1} and 1035.18-5333.39 mBqm{sup −2}h{sup −1} with a mean value of mBqm{sup −2}h{sup −1}. All the measurements show that the values of radium content are under the safe limit recommended by Organization for Cooperation and Development.

  6. Exhaled nitric oxide and breath condensate ph in asthmatic reactions induced by isocyanates.

    PubMed

    Ferrazzoni, Silvia; Scarpa, Maria Cristina; Guarnieri, Gabriella; Corradi, Massimo; Mutti, Antonio; Maestrelli, Piero

    2009-07-01

    We investigated the usefulness of measurements of fractional exhaled nitric oxide (FeNO) and pH of exhaled breath condensate (EBC) for monitoring airway response after specific inhalation challenges with isocyanates in sensitized subjects. Lung function (FEV(1)), FeNO, and pH in argon-deaerated EBC were measured before and at intervals up to 30 days after a specific inhalation challenge in 15 subjects with isocyanate asthma, in 24 not sensitized control subjects exposed to isocyanates, and in 3 nonasthmatic subjects with rhinitis induced by isocyanate. Induced sputum was collected before and 24 h after isocyanate exposure. Isocyanate-induced asthmatic reactions were associated with a rise in sputum eosinophil levels at 24 h (p < 0.01), and an increase in FeNO at 24 h (p < 0.05) and 48 h (p < 0.005), whereas FeNO level did not vary with isocyanate exposure in subjects with rhinitis and in control subjects. FeNO changes at 24 h positively correlated with corresponding sputum eosinophil changes (rho = 0.66, p < 0.001). A rise in pH was observed in the afternoon samples of EBC, irrespective of the occurrence of isocyanate-induced asthmatic reactions. We demonstrated that isocyanate-induced asthmatic reactions are associated with a consistent delayed increase in FeNO but not with the acidification of EBC.

  7. Terahertz Chemical Analysis of Exhaled Human Breath - Broad Essay of Chemicals

    NASA Astrophysics Data System (ADS)

    Branco, Daniela R.; Fosnight, Alyssa M.; Thomas, Jessica R.; Medvedev, Ivan R.

    2013-06-01

    Approximately 3000 chemicals are thought to be present in human breath. Of these chemicals, many are considered typical of exhaled air. Yet, others can allude to different disease pathologies. The detection of chemicals in breath could have many practical purposes in medicine and provide a noninvasive means of diagnostics. We have previously reported on detection of ethanol, methanol, and acetone in exhaled human breath using a novel sub-millimeter/THz spectroscopic approach. This paper reports on our most recent study. A tentative list has been made of approximately 20 chemicals previously found in breath using other methods. Though many of these chemicals are only expressed in samples from donors with certain pathologies, at the time of this submission we are able to detect and quantitatively measure acetaldehyde and dimethyl sulfide in the breath of several healthy donors. Additional tentatively identified chemicals have been seen using this approach. This presentation will explain our experimental procedures and present our most recent results in THz breath analysis. Prospects, challenges and future plans will be outlined and discussed.

  8. Measurement of acetaldehyde in exhaled breath using a laser absorption spectrometer

    NASA Astrophysics Data System (ADS)

    Kamat, Pratyuma C.; Roller, Chad B.; Namjou, Khosrow; Jeffers, James D.; Faramarzalian, Ali; Salas, Rodolfo; McCann, Patrick J.

    2007-07-01

    A high-resolution liquid-nitrogen-free mid-infrared tunable diode laser absorption spectroscopy (TDLAS) system was used to perform real-time measurement of acetaldehyde concentrations in human exhaled breath following ingestion of an alcoholic beverage. Acetaldehyde absorption features were measured near 5.79 μm (1727 cm-1) using a IV-VI semiconductor laser, a 100 m long path optical gas cell, and second- harmonic detection coupled with wavelength modulation. Acetaldehyde levels were measured with a minimum detection limit of 80 ppb for 5 s integration time. The variations in exhaled acetaldehyde levels over time were analyzed prior to and following ingestion of two different amounts of white wine. A method to calibrate acetaldehyde measurements internally using water vapor absorption lines was investigated to eliminate the need for system calibration with gas standards. The potential of a TDLAS system to be used as a noninvasive clinical tool for measurements of large volatile compounds with possible applications in cancer detection is demonstrated.

  9. A review of the USEPA's single breath canister (SBC) method for exhaled volatile organic biomarkers.

    PubMed

    Lindstrom, Andrew B; Pleil, Joachim D

    2002-01-01

    Exhaled alveolar breath can provide a great deal of information about an individual's health and previous exposure to potentially harmful xenobiotic materials. Because breath can be obtained non-invasively and its constituents directly reflect concentrations in the blood, its use has many potential applications in the field of biomarker research. This paper reviews the utility and application of the single breath canister (SBC) method of alveolar breath collection and analysis first developed by the US Environmental Protection Agency (USEPA) in the 1990s. This review covers the development of the SBC technique in the laboratory and its application in a range of field studies. Together these studies specifically show how the SBC method (and exhaled breath analysis in general) can be used to clearly demonstrate recent exposure to volatile organic compounds, to link particular activities to specific exposures, to determine compound-specific uptake and elimination kinetics, and to assess the relative importance of various routes of exposure (i.e. dermal, ingestion, inhalation) in multi-pathway scenarios. Specific investigations covered in this overview include an assessment of exposures related to the residential use of contaminated groundwater, exposures to gasoline and fuel additives at self-service gas stations, swimmers' exposures to trihalomethanes, and occupational exposures to jet fuel.

  10. Comparison of single-breath and tidal breathing exhaled nitric oxide levels in infants.

    PubMed

    Franklin, P J; Turner, S W; Mutch, R C; Stick, S M

    2004-03-01

    The aim of this study was to compare two different methods, tidal breathing (TB) and single-breath (SB), for measuring fractional exhaled nitric oxide (FENO) in infants. FENO was measured in 71 infants with either recurrent wheeze (n=32), recurrent cough (n=16) or no symptoms (healthy, n=23) using both methods. For TB measurements five breaths were collected into a gas sampling bag (off-line reservoir sampling). The SB method was modified from the raised volume rapid thoraco-abdominal technique. Agreement between the two methods was investigated and both methods were used to compare FENO in infants with and without symptoms. Flow dependence of SB FENO was demonstrated using two expiratory flows (11 and 40 mL x s(-1)). There was a moderate correlation (r=0.60) but poor agreement between levels using the TB and SB methods. A significant difference in FENO between healthy children and children with wheeze was found using the SB but not the TB method. Due to lower expiratory flow and reduced nasal nitric oxide contamination the single-breath technique may be more sensitive than the tidal breathing method for detecting differences in exhaled nitric oxide between infants with and without respiratory symptoms.

  11. Lung function and exhaled nitric oxide in healthy unsedated African infants.

    PubMed

    Gray, Diane; Willemse, Lauren; Visagie, Ane; Smith, Emilee; Czövek, Dorottya; Sly, Peter D; Hantos, Zoltán; Hall, Graham L; Zar, Heather J

    2015-10-01

    Population-appropriate lung function reference data are essential to accurately identify respiratory disease and measure response to interventions. There are currently no reference data in African infants. The aim was to describe normal lung function in healthy African infants. Lung function was performed on healthy South African infants enrolled in a birth cohort study, the Drakenstein child health study. Infants were excluded if they were born preterm or had a history of neonatal respiratory distress or prior respiratory tract infection. Measurements, made during natural sleep, included the forced oscillation technique, tidal breathing, exhaled nitric oxide and multiple breath washout measures. Three hundred sixty-three infants were tested. Acceptable and repeatable measurements were obtained in 356 (98%) and 352 (97%) infants for tidal breathing analysis and exhaled nitric oxide outcomes, 345 (95%) infants for multiple breath washout and 293 of the 333 (88%) infants for the forced oscillation technique. Age, sex and weight-for-age z score were significantly associated with lung function measures. This study provides reference data for unsedated infant lung function in African infants and highlights the importance of using population-specific data. © 2015 The Authors. Respirology published by Wiley Publishing Asia Pty Ltd on behalf of Asian Pacific Society of Respirology.

  12. [Confrontation of knowledge on alcohol concentration in blood and in exhaled air].

    PubMed

    Bauer, Miroslav; Bauerová, Jiřina; Šikuta, Ján; Šidlo, Jozef

    2015-01-01

    The authors of the paper give a brief historical overview of the development of experimental alcohology in the former Czechoslovakia. Enhanced attention is paid to tests of work quality control of toxicological laboratories. Information on results of control tests of blood samples using the method of gas chromatography in Slovakia and within a world-wide study "Eurotox 1990" is presented. There are pointed out the pitfalls related to objective evaluation of the analysis results interpreting alcohol concentration in biological materials and the associated need to eliminate a negative influence of the human factor. The authors recommend performing analyses of alcohol in biological materials only at accredited workplaces and in the case of samples storage to secure a mandatory inhibition of phosphorylation process. There are analysed the reasons of numerical differences of analyses while taking evidence of alcohol in blood and in exhaled air. The authors confirm analysis accuracy using the method of gas chromatography along with breath analysers of exhaled air. They highlight the need for making the analysis results more objective also through confrontation with the results of clinical examination and with examined circumstances. The authors suggest a method of elimination of the human factor, the most frequently responsible for inaccuracy, to a tolerable level (safety factor) and the need of sample analysis by two methods independent of each other or the need of analysis of two biological materials.

  13. Exhaled Metallic Elements and Serum Pneumoproteins in Asymptomatic Smokers and Patients With COPD or Asthma*

    PubMed Central

    Mutti, Antonio; Corradi, Massimo; Goldoni, Matteo; Vettori, Maria Vittoria; Bernard, Alfred; Apostoli, Pietro

    2006-01-01

    Study objectives The aim of this study was to characterize the elemental composition of exhaled breath condensate (EBC) in order to identify new biomarkers of exposure and susceptibility in COPD patients. Serum pneumoproteins were used as lung-specific biomarkers of effect. Design EBC was obtained from 50 healthy subjects, 30 healthy smokers, 30 asthmatics, and 50 patients with stable COPD, and was collected by cooling exhaled air. Trace elements and toxic metals in the samples were measured by means of inductively coupled plasma-mass spectrometry and electrothermal atomic absorption spectroscopy. The serum pneumoproteins were immunoassayed. Results The EBC of COPD subjects had higher levels of such toxic elements as lead, cadmium, and aluminum, and lower levels of iron and copper, than that of the nonsmoking control subjects. There were no between-group differences in surfactant protein (SP)-A and SP-B levels. Clara-cell protein and SP-D levels were negatively and positively influenced, respectively, by tobacco smoke. Conclusions Our results show that toxic metals and transition elements are detectable in the EBC of studied subjects. We propose new biomarkers of exposure as a means of assessing the target tissue dose of carcinogenic and pneumotoxic substances from tobacco smoke or polluted workplaces, and the use of the transition elements involved in redox systems of oxidative stress as disease biomarkers associated with effect or susceptibility. Together with biomarkers of effect, such as serum pneumoproteins, the elemental composition of EBC may be clinically useful in distinguishing similar diseases. PMID:16685021

  14. Modeling of indoor radon concentration from radon exhalation rates of building materials and validation through measurements.

    PubMed

    Kumar, Amit; Chauhan, R P; Joshi, Manish; Sahoo, B K

    2014-01-01

    Building materials are the second major source of indoor radon after soil. The contribution of building materials towards indoor radon depends upon the radium content and exhalation rates and can be used as a primary index for radon levels in the dwellings. The radon flux data from the building materials was used for calculation of the indoor radon concentrations and doses by many researchers using one and two dimensional model suggested by various researchers. In addition to radium content, the radon wall flux from a surface strongly depends upon the radon diffusion length (L) and thickness of the wall (2d). In the present work the indoor radon concentrations from the measured radon exhalation rate of building materials calculated using different models available in literature and validation of models was made through measurement. The variation in the predicted radon flux from different models was compared with d/L value for wall and roofs of different dwellings. The results showed that the radon concentrations predicted by models agree with experimental value. The applicability of different model with d/L ratio was discussed. The work aims to select a more appropriate and general model among available models in literature for the prediction of indoor radon. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Endogenous CO monitoring in exhalation with tunable diode lasers: applications to clinical and biomedical diagnostics

    NASA Astrophysics Data System (ADS)

    Stepanov, Eugene V.; Zyrianov, Pavel V.; Miliaev, Valerii A.; Shulagin, Yurii A.; D'yachenko, Alexander I.

    1999-07-01

    Middle IR tunable diode lasers were applied to studies of pulmonary excretion of endogenous carbon monoxide (CO). Variations of the CO content level in exhaled air of healthy nonsmokers were investigated for different environmental conditions with the applied laser technique. Correlation of the obtained data with atmospheric CO contamination and elevated oxygen content were studied as well as diurnal variations of the endogenous CO in exhalation was observed. Criteria for correct conditions of the endogenous CO detection in breath could be derive don this basis. Developed laser approach and methods were applied for the analysis of the excreted CO level in different diseases like bronchial asthma, cystic fibrosis, idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease, anemia and hepatitis. Laser based close-to-real-time monitoring of the endogenous CO elimination with breath in the course of different dynamic tests was demonstrated to be informative in studies of blood oxygen transport and pH variations in tissues for different challenges tests in human physiology.

  16. Iron and ferritin concentrations in exhaled breath condensate of children with asthma.

    PubMed

    Vlasić, Z; Dodig, S; Cepelak, I; Topić, R Zrinski; Zivcić, J; Nogalo, B; Turkalj, M

    2009-02-01

    Maintenance of iron homeostasis is of utmost importance for the respiratory system physiology and pathophysiology. Local iron deficiency or accumulation may result in particular respiratory function impairment. The aim of the present study was to find out whether iron and ferritin could be determined in exhaled breath condensate (EBC) of healthy children and children with asthma. Oxidative stress was verified by determination of EBC superoxide dismutase (SOD) activity, and the airway inflammatory process by determination of exhaled nitric oxide (F(E)NO). EBC was collected from 39 children (22 healthy children as a control group and 17 asthmatics) using an EcoScreen condenser. Iron, ferritin, and SOD were determined on optimization and validation for low concentrations. In comparison with a control group, asthma patients had a statistically significantly lower iron concentration (p = 0.0001) and higher SOD catalytic activity (p = 0.0160), with no significant difference in ferritin levels (p = 0.5252), although percentile values indicated elevated ferritin concentration in about half of asthma patients. F(E)NO values were significantly higher in the asthma group (p = 0.0047). This preliminary study demonstrated the possibility of determining iron and ferritin concentrations and SOD activity in EBC, and a significant difference in EBC iron and SOD between asthma patients and healthy children.

  17. The measurement of exhaled carbon monoxide is influenced by airflow obstruction.

    PubMed

    Togores, B; Bosch, M; Agustí, A G

    2000-01-01

    The concentration of carboxyhaemoglobin (COHb) is often estimated from measurements of carbon monoxide in the exhaled air (COexh). This study investigates whether the presence of airflow obstruction significantly alters the relationship between COexh and COHb. Eighty-one regular smokers were prospectively studied and divided in four groups according to the presence and severity of airflow obstruction (none, mild, moderate, severe). In each subject, the authors measured in this order: 1) arterial blood gases; 2) haemoglobin concentration and COHb (by co-oxymetry); 3) COexh; 4) lung volumes; and 5) forced spirometry. The size of the measurement error (deltaCO) was calculated from the difference between COHb and COexh. Neither the smoking history nor COexh were different in the four groups of subjects studied. In contrast, deltaCO increased in parallel to the degree of airflow obstruction. DeltaCO was >2% (a threshold value normally used in the clinic to separate smokers from nonsmokers) only in patients with severe airflow obstruction. A stepwise multivariate analysis showed that both forced expiratory volume in one second (FEV1) (percentage reference) and COHb contributed significantly (p<0.0001) to predict deltaCO. This study shows that the estimation of carboxyhaemoglobin from exhaled carbon monoxide measurements can be inaccurate in patients with severe airflow obstruction. In these patients, the direct measurement of carboxyhaemoglobin seems advisable in clinical practice.

  18. Exhaled air analysis using wideband wave number tuning range infrared laser photoacoustic spectroscopy

    NASA Astrophysics Data System (ADS)

    Kistenev, Yury V.; Borisov, Alexey V.; Kuzmin, Dmitry A.; Penkova, Olga V.; Kostyukova, Nadezhda Y.; Karapuzikov, Alexey A.

    2017-01-01

    The infrared laser photoacoustic spectroscopy (LPAS) and the pattern-recognition-based approach for noninvasive express diagnostics of pulmonary diseases on the basis of absorption spectra analysis of the patient's exhaled air are presented. The study involved lung cancer patients (N=9), patients with chronic obstructive pulmonary disease (N=12), and a control group of healthy, nonsmoking volunteers (N=11). The analysis of the measured absorption spectra was based at first on reduction of the dimension of the feature space using principal component analysis; thereafter, the dichotomous classification was carried out using the support vector machine. The gas chromatography-mass spectrometry method (GC-MS) was used as the reference. The estimated mean value of the sensitivity of exhaled air sample analysis by the LPAS in dichotomous classification was not less than 90% and specificity was not less than 69%; the analogous results of analysis by GC-MS were 68% and 60%, respectively. Also, the approach to differential diagnostics based on the set of SVM classifiers usage is presented.

  19. Characterizations of particle size distribution of the droplets exhaled by sneeze.

    PubMed

    Han, Z Y; Weng, W G; Huang, Q Y

    2013-11-06

    This work focuses on the size distribution of sneeze droplets exhaled immediately at mouth. Twenty healthy subjects participated in the experiment and 44 sneezes were measured by using a laser particle size analyser. Two types of distributions are observed: unimodal and bimodal. For each sneeze, the droplets exhaled at different time in the sneeze duration have the same distribution characteristics with good time stability. The volume-based size distributions of sneeze droplets can be represented by a lognormal distribution function, and the relationship between the distribution parameters and the physiological characteristics of the subjects are studied by using linear regression analysis. The geometric mean of the droplet size of all the subjects is 360.1 µm for unimodal distribution and 74.4 µm for bimodal distribution with geometric standard deviations of 1.5 and 1.7, respectively. For the two peaks of the bimodal distribution, the geometric mean (the geometric standard deviation) is 386.2 µm (1.8) for peak 1 and 72.0 µm (1.5) for peak 2. The influences of the measurement method, the limitations of the instrument, the evaporation effects of the droplets, the differences of biological dynamic mechanism and characteristics between sneeze and other respiratory activities are also discussed.

  20. [Verification of exhaled air temperature and heat flux in respiratory diseases as useful biomarker].

    PubMed

    Ito, Wataru; Chihara, Junichi

    2008-12-01

    Asthma, chronic obstructive pulmonary disease, and diffuse panbronchiolitis are syndromes associated with chronic airway inflammation. In the conventional definition of inflammation, local pyrexia at the site of inflammation should be observed. However, there are very few reports that have evaluated the "heat" in inflammatory respiratory diseases. We considered that the evaluation of allergic airway inflammation such as asthma might be possible by measuring the exhaled air temperature, and devised an original device that stabilizes the flow rate, which is a very important factor for the direct measurement of heat. Moreover, an expiratory heat flux meter, which can detect a change in air temperature more precisely and immediately, was also incorporated into our original device. As a result, we succeeded in the measurement and evaluation of the heat flux and air temperature in healthy subjects and asthmatic patients, and, further, the air temperature was straightforwardly evaluated by a portable spirometer including a temperature sensor. These findings suggest that the heat flux and temperature of exhaled air can be used to objectively monitor airway inflammation noninvasively, and assist in the diagnosis/monitoring of inflammatory respiratory diseases, including asthma.

  1. Feasibility of a new method to collect exhaled breath condensate in pre-school children.

    PubMed

    Rosias, Philippe P R; Robroeks, Charlotte M; van de Kant, Kim D; Rijkers, Ger T; Zimmermann, Luc J; van Schayck, Constant P; Heynens, Jan W; Jöbsis, Quirijn; Dompeling, Edward

    2010-02-01

    Exhaled breath condensate (EBC) is a promising non-invasive method to assess respiratory inflammation in adults and children with lung disease. Especially in pre-school children, condensate collection is hampered by long sampling times because of open-ended collection systems. We aimed to assess the feasibility of condensate collection in pre-school children using a closed glass condenser with breath recirculation system, which also collects the residual non-condensed exhaled breath, and subsequently recirculates it back into the condenser. Condensate was collected before and after breath recirculation in 70 non-sedated pre-school children with and without recurrent wheeze. Cytokines (IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, TNF-α) were measured in 50 μl samples using ultrasensitive multiplexed liquid bead array. The success rate of condensate collection increased from 64% (without recirculation) to 83% (after breath recirculation), and mean condensate volume from 214 to 465 μl respectively. Detection of cytokines was successful in 95-100% of samples. Cytokine concentrations before and after breath recirculation were not different (p > 0.232). In asthmatic children, only TNF-α concentrations were significantly decreased, compared to non-asthmatics. In pre-school children, the collection of EBC is feasible using a new closed glass condenser with breath recirculation system. This new method may help to assess - non-invasively - cytokine profiles in asthmatic and non-asthmatic pre-school children.

  2. Real-time monitoring of endogenous lipid peroxidation by exhaled ethylene in patients undergoing cardiac surgery

    PubMed Central

    Cristescu, Simona M.; Kiss, Rudolf; te Lintel Hekkert, Sacco; Dalby, Miles; Harren, Frans J. M.; Risby, Terence H.

    2014-01-01

    Pulmonary and systemic organ injury produced by oxidative stress including lipid peroxidation is a fundamental tenet of ischemia-reperfusion injury, inflammatory response to cardiac surgery, and cardiopulmonary bypass (CPB) but is not routinely measured in a surgically relevant time frame. To initiate a paradigm shift toward noninvasive and real-time monitoring of endogenous lipid peroxidation, we have explored pulmonary excretion and dynamism of exhaled breath ethylene during cardiac surgery to test the hypothesis that surgical technique and ischemia-reperfusion triggers lipid peroxidation. We have employed laser photoacoustic spectroscopy to measure real-time trace concentrations of ethylene from the patient breath and from the CPB machine. Patients undergoing aortic or mitral valve surgery-requiring CPB (n = 15) or off-pump coronary artery bypass surgery (OPCAB) (n = 7) were studied. Skin and tissue incision by diathermy caused striking (>30-fold) increases in exhaled ethylene resulting in elevated levels until CPB. Gaseous ethylene in the CPB circuit was raised upon the establishment of CPB (>10-fold) and decreased over time. Reperfusion of myocardium and lungs did not appear to enhance ethylene levels significantly. During OPCAB surgery, we have observed increased ethylene in 16 of 30 documented reperfusion events associated with coronary and aortic anastomoses. Therefore, novel real-time monitoring of endogenous lipid peroxidation in the intraoperative setting provides unparalleled detail of endogenous and surgery-triggered production of ethylene. Diathermy and unprotected regional myocardial ischemia and reperfusion are the most significant contributors to increased ethylene. PMID:25128523

  3. Measurement of acetaldehyde in exhaled breath using a laser absorption spectrometer.

    PubMed

    Kamat, Pratyuma C; Roller, Chad B; Namjou, Khosrow; Jeffers, James D; Faramarzalian, Ali; Salas, Rodolfo; McCann, Patrick J

    2007-07-01

    A high-resolution liquid-nitrogen-free mid-infrared tunable diode laser absorption spectroscopy (TDLAS) system was used to perform real-time measurement of acetaldehyde concentrations in human exhaled breath following ingestion of an alcoholic beverage. Acetaldehyde absorption features were measured near 5.79 mum (1727 cm(-1)) using a IV-VI semiconductor laser, a 100 m long path optical gas cell, and second- harmonic detection coupled with wavelength modulation. Acetaldehyde levels were measured with a minimum detection limit of 80 ppb for 5 s integration time. The variations in exhaled acetaldehyde levels over time were analyzed prior to and following ingestion of two different amounts of white wine. A method to calibrate acetaldehyde measurements internally using water vapor absorption lines was investigated to eliminate the need for system calibration with gas standards. The potential of a TDLAS system to be used as a noninvasive clinical tool for measurements of large volatile compounds with possible applications in cancer detection is demonstrated.

  4. Real-time monitoring of endogenous lipid peroxidation by exhaled ethylene in patients undergoing cardiac surgery.

    PubMed

    Cristescu, Simona M; Kiss, Rudolf; Hekkert, Sacco te Lintel; Dalby, Miles; Harren, Frans J M; Risby, Terence H; Marczin, Nandor

    2014-10-01

    Pulmonary and systemic organ injury produced by oxidative stress including lipid peroxidation is a fundamental tenet of ischemia-reperfusion injury, inflammatory response to cardiac surgery, and cardiopulmonary bypass (CPB) but is not routinely measured in a surgically relevant time frame. To initiate a paradigm shift toward noninvasive and real-time monitoring of endogenous lipid peroxidation, we have explored pulmonary excretion and dynamism of exhaled breath ethylene during cardiac surgery to test the hypothesis that surgical technique and ischemia-reperfusion triggers lipid peroxidation. We have employed laser photoacoustic spectroscopy to measure real-time trace concentrations of ethylene from the patient breath and from the CPB machine. Patients undergoing aortic or mitral valve surgery-requiring CPB (n = 15) or off-pump coronary artery bypass surgery (OPCAB) (n = 7) were studied. Skin and tissue incision by diathermy caused striking (> 30-fold) increases in exhaled ethylene resulting in elevated levels until CPB. Gaseous ethylene in the CPB circuit was raised upon the establishment of CPB (> 10-fold) and decreased over time. Reperfusion of myocardium and lungs did not appear to enhance ethylene levels significantly. During OPCAB surgery, we have observed increased ethylene in 16 of 30 documented reperfusion events associated with coronary and aortic anastomoses. Therefore, novel real-time monitoring of endogenous lipid peroxidation in the intraoperative setting provides unparalleled detail of endogenous and surgery-triggered production of ethylene. Diathermy and unprotected regional myocardial ischemia and reperfusion are the most significant contributors to increased ethylene.

  5. Venous gas emboli and exhaled nitric oxide with simulated and actual extravehicular activity.

    PubMed

    Karlsson, Lars L; Blogg, S Lesley; Lindholm, Peter; Gennser, Mikael; Hemmingsson, Tryggve; Linnarsson, Dag

    2009-10-01

    The decompression experienced due to the change in pressure from a space vehicle (1013hPa) to that in a suit for extravehicular activity (EVA) (386hPa) was simulated using a hypobaric chamber. Previous ground-based research has indicated around a 50% occurrence of both venous gas emboli (VGE) and symptoms of decompression illness (DCI) after similar decompressions. In contrast, no DCI symptoms have been reported from past or current space activities. Twenty subjects were studied using Doppler ultrasound to detect any VGE during decompression to 386hPa, where they remained for up to 6h. Subjects were supine to simulate weightlessness. A large number of VGE were found in one subject at rest, who had a recent arm fracture; a small number of VGE were found in another subject during provocation with calf contractions. No changes in exhaled nitric oxide were found that can be related to either simulated EVA or actual EVA (studied in a parallel study on four cosmonauts). We conclude that weightlessness appears to be protective against DCI and that exhaled NO is not likely to be useful to monitor VGE.

  6. Study of the correlations between fractional exhaled nitric oxide in exhaled breath and atopic status, blood eosinophils, FCER2 mutation, and asthma control in Vietnamese children

    PubMed Central

    Nguyen-Thi-Bich, Hanh; Duong-Thi-Ly, Huong; Thom, Vu Thi; Pham-Thi-Hong, Nhung; Dinh, Long Doan; Le-Thi-Minh, Huong; Craig, Timothy John; Duong-Quy, Sy

    2016-01-01

    Introduction Fractional exhaled nitric oxide (FENO) is a biomarker of airway inflammation in asthma. The measurement of FENO is utilized to assist in the diagnosis and treatment of children with asthma, especially for those treated with inhaled corticosteroids. Objectives The aims of this study were to evaluate the correlations between FENO and atopic status, blood eosinophil levels, FCER2 mutation, and asthma control in Vietnamese children. Subjects and methods This was a prospective and descriptive study approved by the local Ethical Board. All children with uncontrolled asthma, seen in the National Hospital of Pediatrics (Hanoi, Vietnam), were included. Exhaled breath FENO, blood eosinophils, skin prick test, total IgE, asthma control test (ACT), and FCER2 gene polymorphism were performed at inclusion. They were followed up at 3 months to evaluate clinical status, FENO levels, and ACT. Results Forty-two children with uncontrolled asthma with a mean age of 10±3 years (6–16 years) were included. The male/female ratio was 2.5/1. The mean FENO levels were 26±25 ppb. FENO was significantly higher in patients with a positive skin prick test for respiratory allergens (P<0.05). FENO was significantly correlated with blood eosinophil levels (r=0.5217; P=0.0004). Five of the 32 subjects (15.6%) had a mutation of FCER2 gene (rs28364072 SNP). In this group, the levels of FENO were highest (37±10 ppb; P<0.05). The levels of FENO were significantly decreased after 3 months of treatment (17±8 ppb vs 26±25 ppb; P<0.05). Significant correlations between inhaled corticosteroid doses and FENO levels occurred at 1 and 3 months (r=0.415, P=0.007; r=0.396, P=0.010; respectively). There were no correlations between FENO levels, ACT, and daily use of salbutamol. After 3 months, asthma remained uncontrolled in 22.2% of children. Conclusion The measurement of FENO levels is a useful and feasible tool to predict clinical, biological, and asthma control in Vietnamese children. PMID

  7. Comparison of exhaled and nasal nitric oxide and exhaled carbon monoxide levels in bronchiectatic patients with and without primary ciliary dyskinesia.

    PubMed

    Horváth, I; Loukides, S; Wodehouse, T; Csiszér, E; Cole, P J; Kharitonov, S A; Barnes, P J

    2003-01-01

    Primary ciliary dyskinesia (PCD) is associated with chronic airway inflammation resulting in bronchiectasis. The levels of exhaled nitric oxide (eNO), carbon monoxide (eCO) and nasal NO (nNO) from bronchiectatic patients with PCD (n=14) were compared with those from patients with non-PCD bronchiectasis without (n=31) and with cystic fibrosis (CF) (n=20) and from normal subjects (n=37) to assess the clinical usefulness of these measurements in discriminating between PCD and other causes of bronchiectasis. Exhaled NO levels were lower in patients with PCD than in patients with non-PCD non-CF bronchiectasis or healthy subjects (median (range) 2.1 (1.3-3.5) ppb v 8.7 (4.5-26.0) ppb, p<0.001; 6.7 (2.6-11.9) ppb, p<0.001, respectively) but not lower than bronchiectatic patients with CF (3.0 (1.5-7.5) ppb, p>0.05). Nasal levels of nNO were significantly lower in PCD patients than in any other subjects (PCD: 54.5 (5.0-269) ppb, non-PCD bronchiectasis without CF: 680 (310-1000) ppb, non-PCD bronchiectasis with CF: 343 (30-997) ppb, control: 663 (322-1343) ppb). In contrast, eCO levels were higher in all patient groups than in control subjects (PCD: 4.5 (3.0-24.0) ppm, p<0.01, other bronchiectasis without CF: 5.0 (3.0-15.0) ppm, p<0.001; CF: 5.3 (2.0-23.0) ppm, p<0.001 v 3.0 (0.5-5.0) ppm). Low values in both eNO and nNO readings (<2.4 ppb and <187 ppb, respectively) identified PCD patients from other bronchiectatic patients with a specificity of 98% and a positive predictive value of 92%. The simultaneous measurement of eNO and nNO is a useful screening tool for PCD.

  8. Activity concentration of natural radionuclides and radon and thoron exhalation rates in rocks used as decorative wall coverings in Japan.

    PubMed

    Iwaoka, Kazuki; Hosoda, Masahiro; Tabe, Hiroyuki; Ishikawa, Tetsuo; Tokonami, Shinji; Yonehara, Hidenori

    2013-01-01

    In Japan, many dwellings have decorative wall coverings made from granite, andesite, tuff, gabbro, and marble. However, information regarding activity concentrations and radon (Rn) and thoron (Rn) exhalation rates for such rocks is very scarce. Therefore, samples of the granite, andesite, tuff, and marble that are used as wall coverings in Japan were collected from mining companies, and their activity concentrations and Rn and Rn exhalation rates were measured. Dose estimations for inhabitants living in houses built with these materials were also carried out. The activity concentration of natural radionuclides in all the materials was lower than the critical values described by the International Atomic Energy Agency (IAEA) (10,000 Bq kg for K and 1,000 Bq kg for all other radionuclides of natural origin). The maximum values of Rn and Rn mass exhalation rates for the granite samples were 0.12 and 430 mBq kg s, and those for the area exhalation rates were 1.8 and 6300 mBq m s, respectively; these values are higher than those for other samples. The maximum value of effective doses to inhabitants was 0.68 mSv y, which is lower than the intervention exemption level (1 mSv y) given in the International Commission on Radiological Protection (ICRP) Publication 82.

  9. Metallic elements in exhaled breath condensate and serum of patients with exacerbation of chronic obstructive pulmonary disease.

    PubMed

    Corradi, Massimo; Acampa, Olga; Goldoni, Matteo; Andreoli, Roberta; Milton, Donald; Sama, Susan R; Rosiello, Richard; de Palma, Giuseppe; Apostoli, Pietro; Mutti, Antonio

    2009-01-01

    Biomarkers in exacerbated chronic obstructive pulmonary disease may be useful in aiding diagnosis, defining specific phenotypes of disease, monitoring the disease and evaluating the effects of drugs. The aim of this study was the characterization of metallic elements in exhaled breath condensate and serum as novel biomarkers of exposure and susceptibility in exacerbated chronic obstructive pulmonary disease using reference analytical techniques. C-Reactive protein and procalcitonin were assessed as previously validated diagnostic and prognostic biomarkers which have been associated with disease exacerbation, thus useful as a basis of comparison with metal levels. Exhaled breath condensate and serum were obtained in 28 patients at the beginning of an episode of disease exacerbation and when they recovered. Trace elements and toxic metals were measured by inductively coupled plasma-mass spectrometry. Serum biomarkers were measured by immunoassay. Exhaled manganese and magnesium levels were influenced by exacerbation of chronic obstructive pulmonary disease, an increase in their concentrations--respectively by 20 and 50%--being observed at exacerbation in comparison with values obtained at recovery; serum elemental composition was not modified by exacerbation; serum levels of C-reactive protein and procalcitonin at exacerbation were higher than values at recovery. In outpatients who experienced a mild-moderate chronic obstructive pulmonary disease exacerbation, manganese and magnesium levels in exhaled breath condensate are elevated at admission in comparison with values at recovery, whereas no other changes were observed in metallic elements at both the pulmonary and systemic level.

  10. Radon exhalation rate and natural radionuclide content in building materials of high background areas of Ramsar, Iran.

    PubMed

    Bavarnegin, E; Fathabadi, N; Vahabi Moghaddam, M; Vasheghani Farahani, M; Moradi, M; Babakhni, A

    2013-03-01

    Radon exhalation rates from building materials used in high background radiation areas (HBRA) of Ramsar were measured using an active radon gas analyzer with an emanation container. Radon exhalation rates from these samples varied from below the lower detection limit up to 384 Bq.m(-2) h(-1). The (226)Ra, (232)Th and (40)K contents were also measured using a high resolution HPGe gamma- ray spectrometer system. The activity concentration of (226)Ra, (232)Th and (40)K content varied from below the minimum detection limit up to 86,400 Bq kg(-1), 187 Bq kg(-1) and 1350 Bq kg(-1), respectively. The linear correlation coefficient between radon exhalation rate and radium concentration was 0.90. The result of this survey shows that radon exhalation rate and radium content in some local stones used as basements are extremely high and these samples are main sources of indoor radon emanation as well as external gamma radiation from uranium series. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Exhaled breath hydrogen cyanide as a marker of early Pseudomonas aeruginosa infection in children with cystic fibrosis.

    PubMed

    Gilchrist, Francis J; Belcher, John; Jones, Andrew M; Smith, David; Smyth, Alan R; Southern, Kevin W; Španěl, Patrik; Webb, A Kevin; Lenney, Warren

    2015-10-01

    Hydrogen cyanide is readily detected in the headspace above Pseudomonas aeruginosa cultures and in the breath of cystic fibrosis (CF) patients with chronic (P. aeruginosa) infection. We investigated if exhaled breath HCN is an early marker of P. aeruginosa infection. 233 children with CF who were free from P. aeruginosa infection were followed for 2 years. Their median (interquartile range) age was 8.0 (5.0-12.2) years. At each study visit, an exhaled breath sample was collected for hydrogen cyanide analysis. In total, 2055 breath samples were analysed. At the end of the study, the hydrogen cyanide concentrations were compared to the results of routine microbiology surveillance. P. aeruginosa was isolated from 71 children during the study with an incidence (95% CI) of 0.19 (0.15-0.23) cases per patient-year. Using a random-effects logistic model, the estimated odds ratio (95% CI) was 3.1 (2.6-3.6), which showed that for a 1- ppbv increase in exhaled breath hydrogen cyanide, we expected a 212% increase in the odds of P. aeruginosa infection. The sensitivity and specificity were estimated at 33% and 99%, respectively. Exhaled breath hydrogen cyanide is a specific biomarker of new P. aeruginosa infection in children with CF. Its low sensitivity means that at present, hydrogen cyanide cannot be used as a screening test for this infection.

  12. Nitric oxide in exhaled and aspirated nasal air as an objective measure of human response to indoor air pollution.

    PubMed

    Kolarik, B; Lagercrantz, L; Sundell, J

    2009-04-01

    The concentration of nitric oxide (NO) in exhaled and aspirated nasal air was used to objectively assess human response to indoor air pollutants in a climate chamber exposure experiment. The concentration of NO was measured before exposure, after 2, and 4.5 h of exposure, using a chemiluminescence NO analyzer. Sixteen healthy female subjects were exposed to two indoor air pollutants and to a clean reference condition for 4.5 h. Subjective assessments of the environment were obtained by questionnaires. After exposure (4.5 h) to the two polluted conditions a small increase in NO concentration in exhaled air was observed. After exposure to the reference condition the mean NO concentration was significantly reduced compared to pre-exposure. Together these changes resulted in significant differences in exhaled NO between exposure to reference and polluted conditions. NO in nasal air was not affected by the exposures. The results may indicate an association between polluted indoor air and subclinical inflammation. Measurement of nitric oxide in exhaled air is a possible objective marker of subclinical inflammation in healthy adults.

  13. Comparison of exhaled nitric oxide and cardiorespiratory indices between nasal and oral breathing during submaximal exercise in humans.

    PubMed

    Yasuda, Y; Itoh, T; Miyamura, M; Nishino, H

    1997-10-01

    In order to examine the origin and role of nitric oxide (NO) in exhaled air during exercise, exhaled NO outputs of 8 healthy human subjects were compared using different breathing methods, through the mouth or nose, at two intensities of bicycle exercise. The concentration of NO in the exhaled air and ventilatory gas exchange variables were measured by a chemiluminescence analyzer and a mixing chamber method, respectively. The concentration and total output of NO in the expired air was significantly higher under nasal breathing than under oral breathing for both exercise intensities, whereas no significant difference was observed in cardiorespiratory variables between them. NO output increased significantly when exercise intensity was increased from unloaded (0 W) to 60 W under nasal breathing, but not under oral breathing. A negative correlation among subjects was found between NO output and minute ventilation in both breathing methods only for unloaded exercise. Data indicate that nasal airways have a large contribution, at least 50% of total NO output in the exhaled air during nasal breathing, but this nasal NO may have no further modulation on respiratory function during submaximal exercise by healthy humans.

  14. Study of Natural Radioactivity, Radon Exhalation Rate and Radiation Doses in Coal and Flyash Samples from Thermal Power Plants, India

    NASA Astrophysics Data System (ADS)

    Singh, Lalit Mohan; Kumar, Mukesh; Sahoo, B. K.; Sapra, B. K.; Kumar, Rajesh

    Coal is one of the most important source used for electrical power generation. Its combustion part known as fly ash is used in the manufacturing of bricks, sheets, cement, land filling etc. Coal and its by-products have significant amounts of radionuclide's including uranium, thorium which is the ultimate source of the radioactive gas radon and thoron respectively. Radiation hazard from airborne emissions of coal-fired power plants have been cited as possible causes of health in environmental. Assessment of the radiation exposure from coal burning is critically dependent on the concentration of radioactive elements in coal and in the fly ash. In the present study, samples of coal and flyash were collected from Rajghat Power Plant and Badarpur Thermal Power Plant, New Delhi, India. Radon exhalation is important parameter for the estimation of radiation risk from various materials. Solis State Nuclear Track Detector based sealed Can Technique (using LR-115 type II) has been used for measurement radon exhalation rate. Also accumulation chamber based Continuous Radon Monitor and Continuous Thoron Monitor have been used for radon masss exhalation and thoron surface exhalation rate respectively. Natural radioactivity has been measured using a low level NaI(Tl) detector based on gamma ray spectrometry.

  15. Exhaled breath hydrogen cyanide as a marker of early Pseudomonas aeruginosa infection in children with cystic fibrosis

    PubMed Central

    Belcher, John; Jones, Andrew M.; Smith, David; Smyth, Alan R.; Southern, Kevin W.; Španěl, Patrik; Webb, A. Kevin; Lenney, Warren

    2015-01-01

    Hydrogen cyanide is readily detected in the headspace above Pseudomonas aeruginosa cultures and in the breath of cystic fibrosis (CF) patients with chronic (P. aeruginosa) infection. We investigated if exhaled breath HCN is an early marker of P. aeruginosa infection. 233 children with CF who were free from P. aeruginosa infection were followed for 2 years. Their median (interquartile range) age was 8.0 (5.0–12.2) years. At each study visit, an exhaled breath sample was collected for hydrogen cyanide analysis. In total, 2055 breath samples were analysed. At the end of the study, the hydrogen cyanide concentrations were compared to the results of routine microbiology surveillance. P. aeruginosa was isolated from 71 children during the study with an incidence (95% CI) of 0.19 (0.15–0.23) cases per patient-year. Using a random-effects logistic model, the estimated odds ratio (95% CI) was 3.1 (2.6–3.6), which showed that for a 1- ppbv increase in exhaled breath hydrogen cyanide, we expected a 212% increase in the odds of P. aeruginosa infection. The sensitivity and specificity were estimated at 33% and 99%, respectively. Exhaled breath hydrogen cyanide is a specific biomarker of new P. aeruginosa infection in children with CF. Its low sensitivity means that at present, hydrogen cyanide cannot be used as a screening test for this infection. PMID:27730156

  16. Use of exhaled breath condensate endpoints for examination of Body Mass Index as a susceptibility factor to diesel exhaust.

    EPA Science Inventory

    High and low Body Mass Index (BMI) is a risk factor for effects (e.g., premature mortality) induced by exposure to common air pollutants such as ozone and particulate matter. Diesel exhaust contributes to particulate matter levels. We examined lung responses using the exhaled bre...

  17. Use of exhaled breath condensate endpoints for examination of Body Mass Index as a susceptibility factor to diesel exhaust.

    EPA Science Inventory

    High and low Body Mass Index (BMI) is a risk factor for effects (e.g., premature mortality) induced by exposure to common air pollutants such as ozone and particulate matter. Diesel exhaust contributes to particulate matter levels. We examined lung responses using the exhaled bre...

  18. Long-term temporal variability of the radon-222 exhalation flux from a landform covered by low uranium grade waste rock.

    PubMed

    Bollhöfer, Andreas; Doering, Che

    2016-01-01

    Radon-222 exhalation flux densities from two different substrates of several metres thickness, waste rock and waste rock mixed with approximately 30% lateritic material, were measured over a period of five years in the wet-dry tropics of Northern Australia. Fourteen measurement campaigns using activated charcoal canisters (n > 1000) covered both dry and wet seasons and showed differences in seasonal and long term trends of the (222)Rn exhalation flux densities normalised to the (226)Ra activity concentrations of the substrate. Dry season (222)Rn exhalation was generally higher for the mixed substrate, due to the larger fraction of fines. Seasonality established within the first year of landform construction on the mixed substrate, due to the higher water holding capacity of the lateritic material. In contrast, waste rock only shows no seasonality until years four and five after construction, when average normalised dry season (222)Rn exhalation flux densities from waste rock increase to values (0.47 ± 0.06 mBq m(-2) s(-1) per Bq kg(-1)) similar to the mixed substrate (0.64 ± 0.08 mBq m(-2) s(-1) per Bq kg(-1)), likely due to an increase in fines from rapid weathering of the schistose waste rock. Volumetric water content has been used to parametrize relative (222)Rn exhalation and we determined that wet season (222)Rn exhalation is about 40% of the dry season exhalation.

  19. A comparative study of the indoor radon level with the radon exhalation rate from soil in Alexandria city.

    PubMed

    Abd El-Zaher, Mohamed

    2013-05-01

    The assessment of the radiological risk related to the inhalation of radon and radon its progeny is based mainly on the integrated measurement of radon in both indoor and outdoor environments. The exhalation of radon from the earth's crust and building materials forms the main source of radon in the indoor environment. This study has been undertaken for the purpose of health risk assessment. In this comparative study, the indoor radon level, radium content, radon exhalation rate and concentration of soil radon are measured using the Can Technique. Soil samples were collected simultaneously from different geological formations of the same area for laboratory measurement of the radon exhalation rate. The radon exhalation rate was measured in the laboratory using LR-115 type II plastic track detectors. The indoor radon concentrations in this study area were found to vary from 44±9 to 132±31 Bq m(-3) with an average of 72±29 Bq m(-3). The seasonal variations of the indoor radon reveal the maximum values in the winter and in summer in different dwellings of Alexandria city. The annual effective dose varies from 0.75 to 2.2 mSv with an average value of 1.34 mSv. The radon exhalation rate was found to vary in the ranges 8.31-233.70×10(-3) Bq kg(-1) h(-1), 0.48-15.37 Bq m(-2) h(-1) with an average 47.97×10(-3) Bq kg(-1) h(-1), (3.14 Bq m(-2) h(-1)). The radium content in soil varies from 3.14 to 39.60 Bq kg(-1) with an average of 11.55 Bq kg(-1). The significance of this study is discussed in details from the point of view of radiation protection.

  20. Molecular and Microscopic Analysis of Bacteria and Viruses in Exhaled Breath Collected Using a Simple Impaction and Condensing Method

    PubMed Central

    Xu, Zhenqiang; Shen, Fangxia; Li, Xiaoguang; Wu, Yan; Chen, Qi; Jie, Xu; Yao, Maosheng

    2012-01-01

    Exhaled breath condensate (EBC) is increasingly being used as a non-invasive method for disease diagnosis and environmental exposure assessment. By using hydrophobic surface, ice, and droplet scavenging, a simple impaction and condensing based collection method is reported here. Human subjects were recruited to exhale toward the device for 1, 2, 3, and 4 min. The exhaled breath quickly formed into tiny droplets on the hydrophobic surface, which were subsequently scavenged into a 10 µL rolling deionized water droplet. The collected EBC was further analyzed using culturing, DNA stain, Scanning Electron Microscope (SEM), polymerase chain reaction (PCR) and colorimetry (VITEK 2) for bacteria and viruses. Experimental data revealed that bacteria and viruses in EBC can be rapidly collected using the method developed here, with an observed efficiency of 100 µL EBC within 1 min. Culturing, DNA stain, SEM, and qPCR methods all detected high bacterial concentrations up to 7000 CFU/m3 in exhaled breath, including both viable and dead cells of various types. Sphingomonas paucimobilis and Kocuria variants were found dominant in EBC samples using VITEK 2 system. SEM images revealed that most bacteria in exhaled breath are detected in the size range of 0.5–1.0 µm, which is able to enable them to remain airborne for a longer time, thus presenting a risk for airborne transmission of potential diseases. Using qPCR, influenza A H3N2 viruses were also detected in one EBC sample. Different from other devices restricted solely to condensation, the developed method can be easily achieved both by impaction and condensation in a laboratory and could impact current practice of EBC collection. Nonetheless, the reported work is a proof-of-concept demonstration, and its performance in non-invasive disease diagnosis such as bacterimia and virus infections needs to be further validated including effects of its influencing matrix. PMID:22848436

  1. A COMPARATIVE STUDY OF RADIUM CONTENT AND RADON EXHALATION RATE FROM SOIL SAMPLES USING ACTIVE AND PASSIVE TECHNIQUES.

    PubMed

    Yadav, Manjulata; Prasad, Mukesh; Joshi, Veena; Gusain, G S; Ramola, R C

    2016-10-01

    Soil is the most important factor affecting the radon level in the human living environments. It depends not only on uranium and thorium contents but also on the physical and chemical properties of the soil. In this paper, the measurements of radium content and mass exhalation rate of radon from the soil samples collected from Uttarkashi area of Garhwal Himalaya are presented. The correlation between radium content and radon mass exhalation rate from soil has also been obtained. The radium was measured by gamma ray spectrometry, while the mass exhalation rate of radon has been determined by both active and passive methods. The radium activity in the soil of study area was found to vary from 45±7 to 285±29 Bq kg(-1) with an average of 99 Bq kg(-1) The radon mass exhalation rate was found to vary from 0.59 × 10(-5) to 2.2 × 10(-5) Bq kg(-1) h(-1) with an average of 1.4 × 10(-5) Bq kg(-1) h(-1) by passive technique and from 0.8 × 10(-5) to 3.2 × 10(-5) Bq kg(-1) h(-1) with an average of 1.5 × 10(-5) Bq kg(-1) h(-1) by active technique. The results suggest that the measured radium value is positively correlated with the radon mass exhalation rate measured with both the active and passive techniques. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Δ(9)-Tetrahydrocannabinol concentrations in exhaled breath and physiological effects following cannabis intake - A pilot study using illicit cannabis.

    PubMed

    Coucke, Line; Massarini, Enrico; Ostijn, Zachery; Beck, Olof; Verstraete, Alain G

    2016-09-01

    Δ(9)-Tetrahydrocannabinol (THC) can be measured in exhaled breath by using an aerosol particle collection device. The sampling procedure is simple, non-invasive and takes only 2-3min. In the present study we measured the amount of THC in exhaled breath of cannabis users at specific time intervals up to 3h after smoking one cannabis cigarette. The breath concentration-effect relationship was studied by measuring the pulse rate and the pupil diameter to assess physiological changes. THC and the main metabolite 11-nor-9-carboxy-Δ(9)-tetrahydrocannabinol were analyzed in exhaled breath by a liquid chromatography-tandem mass spectrometry method. Thirteen subjects (9 males and 4 females, aged 23-24years) participated. Five of those were using cannabis more frequently than monthly. THC was detected in most subjects already at baseline, concentrations increased following smoking and remained detectable for over 3h (mean THC concentration in breath at 3h: 1479pg/sample). Pulse rate (p=0.015) and pupil diameter (p=0.044) were significantly altered up to 30min after smoking. The detection window of cannabis in breath after smoking one cannabis cigarette in occasional and chronic smokers was at least 3h. Only THC was detected, and not the metabolite. The THC concentration in exhaled breath was related to the physiological changes that occur over time. Exhaled breath can be used to detect recent cannabis exposure. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  3. MEASUREMENT OF INDOOR RADON-THORON IN AIR AND EXHALATION FROM SOIL IN THE ENVIRONMENT OF WESTERN HARYANA, INDIA.

    PubMed

    Mann, Nisha; Kumar, Amit; Kumar, Sushil; Chauhan, R P

    2016-10-01

    Measurement of indoor radon and thoron is important because the inhalation of radon-thoron and their daughters contributes more than 50 % of the total dose from natural sources. One of the important parameters to find out the contribution of soil and building materials towards indoor radon is radon exhalation rates, which can be used for estimation of indoor radon levels. The indoor radon and thoron levels from the air and radon exhalation rates from soil samples collected from two districts (Hisar and Fatehabad) of Western Haryana are measured using pin-hole-based radon-thoron dosimeter and LR-115 solid-state nuclear track detector by canister technique. The results show that the indoor radon and thoron levels from Hisar district varied from 11 to 112 and 11 to 80 Bq m(-3), while for Fatehabad district from 5 to 24 and 59 to 105 Bq m(-3), respectively, in summer season. In winter season, indoor radon and thoron levels from Hisar district varied from 15 to 43 and 32 to 102 Bq m(-3), while for Fatehabad district from 18 to 31 and 11 to 80 Bq m(-3), respectively. The indoor radon levels of 95 % locations lie well below the limit recommended by International Commission of Radiation Protection, 2011. The radon mass exhalation rate varied from 6 to 56 mBq kg(-1) h(-1) The radon mass exhalation rates from the soil samples were lower than the worldwide average, i.e. 56 mBq kg(-1) h(-1) There exists a poor correlation between indoor radon and exhalation rates. More investigations of measurement of radionuclide contents from rock and stone of study area can improve the understanding. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Relating changes in radon exhalation to increasing loading in rocks. New insights from rock deformation laboratory experiments.

    NASA Astrophysics Data System (ADS)

    Tuccimei, P.; Vinciguerra, S.; Moretti, S.; Mollo, S.; Castelluccio, M.; Soligo, M.

    2009-04-01

    Radon emissions increase is regarded as a valuable geophysical precursor of earthquakes. Radon concentrations are observed in the soil or groundwater and have been related to increasing fracturing of the medium, which increases the exhaling surface area and originates pathways for radon release. In order to investigate the relation between increasing load and changes of radon exhalation rates, a volcanic tuff ("Tufo Rosso a Scorie Nere") from Vico volcano (central Italy) has been investigated in the laboratory. Four samples of 120 (length) x 60 (diameter) mm, have been loaded at constant strain rate, to guarantee a homogeneous deformation of the microstructure, with a strain rate of 0.5 micron / s. Two samples have been loaded up to the failure, while the remaining two have been downloaded, before the onset of dilatancy, when the highest compaction of existing voids space was reached. Radon exhalation rates of rock samples before deformation (step 1), at the end of the compaction phase (step 2) and after rupture, with a partial creep along the failure plain (step 3) have been measured in laboratory by using a solid-state alpha detector, connected to a small accumulation chamber kept at the constant temperature of 60 °C, with the aim to enhance radon exhalation. Measurements have been always performed on groups of two samples to achieve strong signals and being able to discriminate better changes in radon emissions. Analyses were repeated several times in order to verify their reproducibility. A decrease of radon emissions, induced by a stress of about 2 MPa has been measured after step 2, when samples porosity (about 47 %) was reduced from the compaction and formation of new cracks did not start yet. On the contrary, radon release increased after rupture, when the total exhaling surface of test samples was evidently enlarged.

  5. Internal exposure from building materials exhaling (222)Rn and (220)Rn as compared to external exposure due to their natural radioactivity content.

    PubMed

    Ujić, Predrag; Celiković, Igor; Kandić, Aleksandar; Vukanac, Ivana; Durasević, Mirjana; Dragosavac, Dusan; Zunić, Zora S

    2010-01-01

    The main scope of this paper is to point out the importance of introducing radon and thoron exhalation measurements from building materials in the regulating frame. Currently (2009), such a regulation of this kind of exposure is not explicitly included in the Serbian regulating network. To this end, this work reports concentration measurements of (226)Ra, (232)Th and (40)K and radon and thoron exhalation rates from building materials used in Serbia. Following detailed analysis, it was noticed that both internal exposures to radon and/or thoron exhaling from building materials may exceed external exposures to their precursors contained therein.

  6. Upper mantle-derived free gas exhalations in central Europe - an isotope study

    NASA Astrophysics Data System (ADS)

    Braeuer, K.; Kaempf, H.; Niedermann, S.; Strauch, G.; Weise, S. M.

    2003-04-01

    The results of geochemical mapping (about 100 locations) of free gas exhalations in the western Eger Rift (Czech-German border region) are compared with data of free gas exhalations from the surroundings of the Laacher See (East Eifel, Germany) and Le Mont Dore (Massif Central, France). In the western Eger Rift, three gas exhalation centres characterized by high gas flux (> 85 m^3 h-1), CO_2 concentrations > 99 vol. -%, δ13C between -2 and -4 per mil, and ^3He/^4He ratios up to 6 R_a could be distinguished. CO_2-rich gases consist of mantle-derived components with only small admixtures of dissolved air due to sampling after passing a water phase. The scatter in δ13C values of CO_2-rich gases is due to isotope fractionation between gaseous CO_2, dissolved CO_2 and HCO_3, respectively. As a result of long-term monitoring studies at four locations in the western Eger Rift, the natural variation range of the gas and isotope composition could be evaluated and as a consequence of numerous data sets reliable δ15N mean values could be specified. At the Bublak mofette (NW Bohemia), the transport velocity in the upper crust is estimated at about 400 m/d. The Bublak CO_2 is enriched in 13C (δ13C ≈ -2 per mil) relative to MORB values and its CO_2/^3He is ˜6.5x10^9. In addition to the ^3He/^4He ratio of ≈ 5.9 R_a, which is in the range of values for European sub-continental mantle xeno-liths, also the uncorrected δ15N values (-3.2±0.7, n=16) show an upper mantle signature. Corrected for air via O_2 contents and/or 40Ar/36Ar ratios, the 15N/14N ratios yield δ15N <= -5 per mil, corresponding to mantle-derived nitrogen contributions of about 50 %. The channel-like fluid supply at the Bublak mofette related with the high transport velocity indicates that its isotope ratios are not significantly altered during transport through the crust and represent probably the signature of the magmatic source in the European sub-continental mantle. Comparable distribution patterns of

  7. Urates in exhaled breath condensate as a biomarker of control in childhood asthma.

    PubMed

    Navratil, Marta; Plavec, Davor; Erceg, Damir; Bulat Lokas, Sandra; Živković, Jelena; Turkalj, Mirjana

    2015-06-01

    The aim of this study was to (1) investigate the possibility to use urates in exhaled breath condensate (EBC) as a biomarker of airway inflammation and control in childhood asthma and (2) explore their association with other biomarkers of airway inflammation and clinical indices of asthma control (Asthma Control Test [ACT], quality of life [PAQLQ], lung function, prn beta-agonist use, time from last exacerbation [TLE]. This cross-sectional study comprised 103 consecutive patients (age 6-18 years) divided in groups of uncontrolled ([NC], n = 53) and controlled asthma ([C], n = 50). Measured lung function and biomarkers included: spirometry, eosinophilic cationic protein (ECP), high-sensitivity C-reactive protein (hs-CRP), exhaled NO (FENO), pH and urates in EBC and exhaled breath temperature (EBT). Statistically significant differences were found between groups for EBC urates, EBC pH and EBT (NC versus C: EBC urates, median [IQR], µmol/L; 10 [6] versus 45 [29], p < 0.001; EBC pH, mean [SD], 7.2 [0.17] versus 7.33 [0.16], p = 0.002; EBT mean [SD], °C; 34.26 [0.83], versus 33.90 [0.60], p = 0.014). EBC urates showed significant association with TLE and FENO (r = 0.518, p < 0.001; r = 0.369, p = 0.007, respectively) in NC, and EBC pH (r = 0.351, p < 0.001), FEV1 (r = 0.222, p = 0.024), ACT (r = 0.654, p < 0.001), PAQLQ (r = 0.686, p < 0.001) and prn salbutamol use (r = -0.527, p < 0.001) in all asthmatics. In our study, EBC urates were found to be the best single predictor of asthma control and underlying airway inflammation. Our results provide evidence supporting the potential utility to use EBC urates as an additional non-invasive biomarker of control in childhood asthma.

  8. Evaluation of carbon dioxide rebreathing during exercise assisted by noninvasive ventilation with plateau exhalation valve

    PubMed Central

    Ou, Yong-er; Lin, Zhi-min; Hua, Dong-ming; Jiang, Ying; Huo, Ya-ting; Luo, Qun; Chen, Rong-Chang

    2017-01-01

    Noninvasive ventilation with a plateau exhalation valve (PEV) is often used as an adjunct to exercise to achieve a physiologic training effect in severe chronic obstructive pulmonary disease (COPD) patients. However, during exercise, with the increase of exhalation flow and respiratory rate and limited capability of PEV to exhale gases out of the circuit, it is still unknown whether CO2 rebreathing occurs in COPD patients ventilated during exercise assisted by single-limb circuit with a PEV. A maximal symptom-limited cycle exercise test was performed while ventilated on pressure support (inspiratory:expiratory pressure 14:4 cmH2O) in 18 male patients with stable severe COPD (mean ± standard deviation, forced expiratory volume in 1 s: 29.5%±6.9% predicted). At rest and during exercise, breathing pattern, mean expiratory flow, mean expiratory flow of PEV, and the mean inspiratory fraction of CO2 (tidal fractional concentration of inspired CO2 [FiCO2]) reinsufflated from the circuit was measured for each breath. In comparison with rest, with the significant increase of mean expiratory flow (0.39±0.15 vs 0.82±0.27 L/s), fractional concentration of end-tidal CO2 (2.6%±0.7% vs 5.5%±0.6%), and the significant decrease of mean expiratory flow of PEV (0.41±0.02 vs 0.39±0.03 L/s), tidal FiCO2 significantly increased at peak exercise (0.48%±0.19% vs 1.8%±0.6%) in patients with stable severe COPD. The inflection point of obvious CO2 rebreathing was 0.67±0.09 L/s (95% confidence interval 0.60–0.73 L/s). Ventilated by a single-limb tubing with PEV caused CO2 rebreathing to COPD patients during exercise. Patients with mean expiratory flow >0.60–0.73 L/s may be predisposed to a higher risk of CO2 rebreathing. PMID:28144134

  9. Evaluation of carbon dioxide rebreathing during exercise assisted by noninvasive ventilation with plateau exhalation valve.

    PubMed

    Ou, Yong-Er; Lin, Zhi-Min; Hua, Dong-Ming; Jiang, Ying; Huo, Ya-Ting; Luo, Qun; Chen, Rong-Chang

    2017-01-01

    Noninvasive ventilation with a plateau exhalation valve (PEV) is often used as an adjunct to exercise to achieve a physiologic training effect in severe chronic obstructive pulmonary disease (COPD) patients. However, during exercise, with the increase of exhalation flow and respiratory rate and limited capability of PEV to exhale gases out of the circuit, it is still unknown whether CO2 rebreathing occurs in COPD patients ventilated during exercise assisted by single-limb circuit with a PEV. A maximal symptom-limited cycle exercise test was performed while ventilated on pressure support (inspiratory:expiratory pressure 14:4 cmH2O) in 18 male patients with stable severe COPD (mean ± standard deviation, forced expiratory volume in 1 s: 29.5%±6.9% predicted). At rest and during exercise, breathing pattern, mean expiratory flow, mean expiratory flow of PEV, and the mean inspiratory fraction of CO2 (tidal fractional concentration of inspired CO2 [FiCO2]) reinsufflated from the circuit was measured for each breath. In comparison with rest, with the significant increase of mean expiratory flow (0.39±0.15 vs 0.82±0.27 L/s), fractional concentration of end-tidal CO2 (2.6%±0.7% vs 5.5%±0.6%), and the significant decrease of mean expiratory flow of PEV (0.41±0.02 vs 0.39±0.03 L/s), tidal FiCO2 significantly increased at peak exercise (0.48%±0.19% vs 1.8%±0.6%) in patients with stable severe COPD. The inflection point of obvious CO2 rebreathing was 0.67±0.09 L/s (95% confidence interval 0.60-0.73 L/s). Ventilated by a single-limb tubing with PEV caused CO2 rebreathing to COPD patients during exercise. Patients with mean expiratory flow >0.60-0.73 L/s may be predisposed to a higher risk of CO2 rebreathing.

  10. Controlled low flow off line sampling of exhaled nitric oxide in children

    PubMed Central

    Jobsis, Q; Raatgeep, H; Hop, W; de Jongste, J C

    2001-01-01

    BACKGROUND—The aim of this study was to validate exhaled nitric oxide (eNO) values obtained with an alternative off line, single breath, low flow balloon sampling method against on line sampling according to ERS and ATS guidelines in children who could perform both methods.
METHODS—One hundred and twenty seven white children of median age 14.1 years, all pupils of a secondary school, participated in the study. They performed the two different sampling techniques at three different flows of 50, 100, 150 ml/s. Additional measurements were done in random subgroups to determine the influence of the dead space air on eNO values obtained off line by excluding the first 220 ml of exhaled air. All children completed a questionnaire on respiratory and allergic disorders and underwent spirometric tests.
RESULTS—The off line eNO values were significantly higher than the on line values at all flows. At 50 ml/s the geometric mean (SE) off line eNO was 18.7 (1.1) ppb and the on line eNO was 15.1 (1.1) ppb (p<0.0001). However, when dead space air was discarded, off line and on line values were similar: at 50 ml/s off line eNO was 17.7 (1.0) ppb and on line eNO 16.0 (1.2) ppb. There was a good agreement between off line eNO values without dead space air and on line eNO: for 50 ml/s the mean on/off line ratio was 0.95 (95% agreement limits 0.63 to 1.27). The off line eNO level at 50 ml/s in 80 children with negative questionnaires for asthma, rhinitis, and eczema was 13.6 (1.0) ppb compared with 33.3 (1.1) ppb in the remaining children with positive questionnaires on asthma and allergy and/or recent symptoms of cold (p<0.0001).
CONCLUSIONS—In children, off line assessment of eNO using constant low flow sampling and excluding dead space air is feasible and produces similar results as on line assessment with the same exhalation flow rate. Both sampling methods are sufficiently sensitive to differentiate between groups of otherwise healthy school children with and

  11. Biomarkers of oxidative-stress and inflammation in exhaled breath condensate from hospital cleaners.

    PubMed

    Casimirri, Enrico; Stendardo, Mariarita; Bonci, Melissa; Andreoli, Roberta; Bottazzi, Barbara; Leone, Roberto; Schito, Michela; Vaccari, Alice; Papi, Alberto; Contoli, Marco; Corradi, Massimo; Boschetto, Piera

    2016-01-01

    We studied the impact of chlorinated agents exposure on exhaled breath condensate (EBC) biomarkers in cleaners. Malondialdehyde (MDA), 4-hydroxynonenal (4-HNE), nitrites (NO2(-)), nitrates (NO3(-)), pH, hydrogen peroxide (H2O2) and ammonium (NH3(+)) were tested in EBC of 40 cleaners and 40 non-exposed controls. Pentraxin-3 (PTX3) and soluble type II receptor of IL-1 (sIL-1RII) were analyzed also in plasma. Levels of MDA-EBC, 4-HNE-EBC and NO3(-)-EBC were higher, while pH-EBC values were lower, in cleaners. MDA-EBC was associated with 4-HNE-EBC, NO3(-)-EBC and pH. 4-HNE-EBC correlated with PTX3. Professional exposure to chlorinated agents increases EBC biomarkers of oxidative stress and inflammation.

  12. Real-time measurement of inhaled and exhaled cigarette smoke: Implications for dose

    NASA Astrophysics Data System (ADS)

    McGrath, Conor; Warren, Nigel; Biggs, Philip; McAughey, John

    2009-02-01

    Inhalation of tobacco smoke aerosol is a two-step process involving puffing followed by inhalation. Measured smoke deposition efficiencies in the lung (20-70%) are greater than expected for smoke particles of 150 -- 250 nm count median diameter (CMD). Various mechanisms have been put forward to explain this enhanced deposition pattern, including coagulation, hygroscopic growth, condensation and evaporation, changes in composition, or changes in inhalation behaviour. This paper represents one of a series of studies seeking to better quantify smoke chemistry, inhalation behaviour and cumulative particle growth. The studies have been conducted to better understand smoke dosimetry and links to disease as part of a wider programme defining risk and potential harm reduction. In this study, the average CMD of inhaled smoke was 160 nm while the average CMD of exhaled smoke was 239 nm with an average growth factor of 1.5.

  13. An Overview of Fractional Exhaled Nitric Oxide and Children with Asthma

    PubMed Central

    Rao, Devika R.; Phipatanakul, Wanda

    2016-01-01

    SUMMARY Asthma is the most common pediatric chronic disease and is characterized by lung inflammation. Fractional exhaled nitric oxide (FeNO) is thought to reflect the presence of eosinophilic airway inflammation, and is an easy, non-invasive test that has held promise in providing additional objective data. However, not all studies have shown a clinical benefit in the use of FeNO to guide management of asthma in children. This review will describe the results of the most recent studies examining the use of FeNO in the diagnosis and treatment of asthma in infants, pre-school-aged children and in school-aged children. It will aid the clinician in providing a clinical context in which FeNO may be most useful in treating pediatric asthma. PMID:26757849

  14. Clinical application of exhaled nitric oxide measurement in pediatric lung diseases

    PubMed Central

    2012-01-01

    Summary Fractional exhaled nitric oxide (FeNO) is a non invasive method for assessing the inflammatory status of children with airway disease. Different ways to measure FeNO levels are currently available. The possibility of measuring FeNO levels in an office setting even in young children, and the commercial availability of portable devices, support the routine use of FeNO determination in the daily pediatric practice. Although many confounding factors may affect its measurement, FeNO is now widely used in the management of children with asthma, and seems to provide significantly higher diagnostic accuracy than lung function or bronchial challenge tests. The role of FeNO in airway infection (e.g. viral bronchiolitis and common acquired pneumonia), in bronchiectasis, or in cases with diffuse lung disease is less clear. This review focuses on the most recent advances and the current clinical applications of FeNO measurement in pediatric lung disease. PMID:23273317

  15. Relationship between Methacholine Challenge Testing and exhaled nitric oxide in adult patients with suspected bronchial asthma.

    PubMed

    Giovannini, M; Valli, M; Ribuffo, V; Melara, R; Cappiello, G; Businarolo, E; Andreani, A

    2014-05-01

    Usually, hyperresponsiveness to inhaled methacholine is considered closely associated with a diagnosis of bronchial asthma. Recently, it has been clearly pointed out that bronchial hyperreactivity (BHR) is not a constant feature of asthma and that this condition is not always related to airways inflammation. In the present study we evaluated 42 Patients (21 positive and 21 negative for bronchial hyperreactivity, BHR) with the aim to determine the effect of Methacholine Challenge Testing (MCT) on the levels of exhaled nitric oxide (NO). Higher FeNO levels were found before methacholine provocation in the group that eventually resulted positive to the challenge, while after the challenge in both groups FeNO decreased in similar way, with no statistical difference. These data confirm that MCT is a relevant test for asthma diagnosis, but it is not always related to the severity of bronchial inflammation, while FeNO levels in our study have limited clinical significance when evaluated out of asthma exacerbation.

  16. The use of fraction of exhaled nitric oxide in pulmonary practice.

    PubMed

    Lim, Kaiser G; Mottram, Carl

    2008-05-01

    The measurement of the fractional concentration of exhaled nitric oxide (FeNO) is a convenient, noninvasive, point-of-service office test for airway inflammation. The first half of this practice management review presents the methodological, interpretative, and clinical applications of FeNO. The second half discusses practical management issues, including current and future technology, equipment specifications, US Food and Drug Administration regulations, cost, current procedural terminology coding, and reimbursement. The measurement of FeNO is helpful in the diagnosis of asthma. It is predictive of a response to inhaled corticosteroids (ICSs). Monitoring FeNO is useful in maintaining asthma control by allowing the assessment of adherence to medication and dose titration of ICSs. An elevated level of FeNO is predictive of asthma relapse following corticosteroid withdrawal especially in children. The advances in technology, ease of use, and clinical utility will lead to greater availability, acceptance, and routine application in the care of asthma.

  17. Exhaled nitric oxide in pediatrics: what is new for practice purposes and clinical research in children?

    PubMed

    Piacentini, G L; Cattazzo, E; Tezza, G; Peroni, D G

    2012-06-01

    Fractional exhaled NO (FeNO) is universally considered an indirect marker of eosinophilic airways inflammation, playing an important role in the physiopathology of childhood asthma. Advances in technology and standardization have allowed a wider use of FeNO in clinical practice in children from the age of four years. FeNO measurements add a new dimension to the traditional clinical tools (symptoms scores, lung function tests) in the assessment of asthma. To date a number of studies have suggested a possible use of FeNO in early identification of exacerbation risk and in inhaled corticosteroids titration. The aim of this paper is to address practical issues of interest to paediatric clinicians who are attempting to use FeNO measurements as an adjunctive tool in the diagnosis and management of childhood airway diseases.

  18. Chemical Analysis of Exhaled Human Breath Using High Resolution Mm-Wave Rotational Spectra

    NASA Astrophysics Data System (ADS)

    Guo, Tianle; Branco, Daniela; Thomas, Jessica; Medvedev, Ivan; Dolson, David; Nam, Hyun-Joo; O, Kenneth

    2014-06-01

    High resolution rotational spectroscopy enables chemical sensors that are both sensitive and highly specific, which is well suited for analysis of expired human breath. We have previously reported on detection of breath ethanol, methanol, acetone, and acetaldehyde using THz sensors. This paper will outline our present efforts in this area, with specific focus on our ongoing quest to correlate levels of blood glucose with concentrations of a few breath chemicals known to be affected by elevated blood sugar levels. Prospects, challenges and future plans will be outlined and discussed. Fosnight, A.M., B.L. Moran, and I.R. Medvedev, Chemical analysis of exhaled human breath using a terahertz spectroscopic approach. Applied Physics Letters, 2013. 103(13): p. 133703-5.

  19. [Proteomic analysis of exhaled breath condensate for diagnosis of pathologies of the respiratory system].

    PubMed

    Kononikhin, A S; Fedorchenko, K Yu; Ryabokon, A M; Starodubtseva, N L; Popov, I A; Zavialova, M G; Anaev, E C; Chuchalin, A G; Varfolomeev, S D; Nikolaev, E N

    2015-01-01

    Study of the proteomic composition of exhaled breath condensate (EBC), is a promising non-invasive method for the diagnosis of the respiratory tract diseases in patients. In this study the EBC proteomic composition of the 79 donors, including patients with different pathologies of the respiratory system has been investigated. Cytoskeletal keratins type II (1, 2, 3, 4, 5, 6) and cytoskeletal keratins the type I (9, 10, 14, 15, 16) were invariant for all samples. Analyzing the frequency of occurrence of proteins in different groups of examined patients, several categories of protein have been recognized: found in all pathologies (Dermcidin, Alpha-1-microglobulin, SHROOM3), found in several pathologies (CSTA, LCN1, JUP, PIP, TXN), and specific for a single pathology (PRDX1, Annexin A1/A2). The EBC analysis by HPLC-MS/MS can be used to identify potential protein markers characteristic for pathologies such as chronic obstructive pulmonary disease (PRDX1) and pneumonia (Annexin A1/A2).

  20. Exhaled breath analysis for the early detection of lung cancer: recent developments and future prospects

    PubMed Central

    Nardi-Agmon, Inbar; Peled, Nir

    2017-01-01

    In lung cancer, the prognosis and treatment options depend directly on tumor size and its spread at the time of diagnosis. There is therefore a constant search for methods that will allow early detection of cancerous lung nodules. With advancing imaging technology and implantation of screening routines in high-risk populations by low-dose computerized tomography, a significant increase in the number of diagnosed small peripheral lesions can be expected. While early detection of small cancerous lesions carries the benefit of wider treatment options and better prognosis, the process of obtaining a biopsy to confirm a cancerous tissue is not free of complications and bears inconveniences and stress to the patient. This review discusses the potential use of exhaled breath analysis as a simple, noninvasive tool for early detection of lung cancer and characterization of suspicious lung nodules. PMID:28553152

  1. Exhaled air temperature as a function of ambient temperature in flying and resting ducks.

    PubMed

    Engel, Sophia; Klaassen, Raymond H G; Klaassen, Marcel; Biebach, Herbert

    2006-08-01

    Exhaled air temperature (T (exh)) has a paramount effect on respiratory water loss during flight. For migratory birds, low T (exh) potentially reduces water loss and increases flight range. However, only three studies provide empirical data on T (exh) during flight. The aim of this study was to record T (exh) of birds during rest and flight at a range of controlled ambient temperatures (T (amb)). One wigeon and two teal flew a total of 20 times in a wind tunnel at T (amb) ranging from 1 degrees to 24 degrees C. T (exh) during flight did not differ between the two species and was strongly correlated with T (amb) (T (exh)=1.036 T (amb) + 13.426; R2=0.58). In addition, body temperature had a weak positive effect on T (exh). At a given T (amb), T (exh )was about 5 degrees C. higher during flight than at rest.

  2. Detection of acetone in exhaled breath with the use of micropreconcentrator and a commercial gas sensor

    NASA Astrophysics Data System (ADS)

    Michoń, Dagmara; Rydosz, Artur; Domański, Krzysztof; Maziarz, Wojciech; Pisarkiewicz, Tadeusz

    2016-12-01

    This paper presents investigation results obtained with the measuring system enabling detection of acetone with concentrations lower than 1 ppm. In the experiment we used both conventional preconcentrators made from materials such as stainless steel and quartz tubes and a micropreconcentrator manufactured in MEMS technology. The active volume of all preconcentrators was equal to enable comparisons of their performance. As a gas detector at the output of the measurement system we used both commercial semiconductor gas sensor and a mass spectrometer for comparison purposes. The obtained results show that the measurement system with micropreconcentrator and a commercial gas sensor can be used for detection of low level acetone present in the air exhaled by diabetics.

  3. Respiratory symptoms, exhaled nitric oxide, and lung function among workers in Tanzanian coffee factories.

    PubMed

    Sakwari, Gloria; Mamuya, Simon H D; Bråtveit, Magne; Moen, Bente E

    2013-05-01

    To compare chronic respiratory symptoms, fractional exhaled nitric oxide (FENO), and lung function between Robusta and Arabica coffee workers and a control group. Chronic respiratory symptoms were assessed by a questionnaire (n = 138 coffee workers and n = 120 controls). The FENO was measured by NIOX MINO device (Aerocrine AB, Solna, Sweden). Lung function was examined by a portable spirometer. Coffee workers had higher prevalence of chronic respiratory and asthma symptoms than controls. Robusta coffee workers were exposed to higher levels of endotoxin and had more asthma symptoms than Arabica coffee workers (38% vs. 18%). Coffee workers had reduced lung function associated with cumulative exposure to total dust and endotoxin. Work in coffee factories is associated with small but significant lung function impairment. These changes were not associated with the level of FENO.

  4. Exhaled breath condensate analysis from intubated newborns by nano-HPLC coupled to high resolution MS.

    PubMed

    Kononikhin, A S; Starodubtseva, N L; Chagovets, V V; Ryndin, A Y; Burov, A A; Popov, I A; Bugrova, A E; Dautov, R A; Tokareva, A O; Podurovskaya, Y L; Ionov, O V; Frankevich, V E; Nikolaev, E N; Sukhikh, G T

    2017-03-15

    Invasiveness of examination and therapy methods is a serious problem for intensive care and nursing of premature infants. Exhaled breath condensate (EBC) is the most attractive biofluid for non-invasive methods development in neonatology for monitoring the status of intubated infants. The aim of the study was to propose an approach for EBC sampling and analysis from mechanically ventilated neonates. EBC collection system with good reproducibility of sampling was demonstrated. Discovery-based proteomic and metabolomic studies were performed using nano-HPLC coupled to high resolution MS. Label-free semi-quantitative data were compared for intubated neonates with congenital pneumonia (12 infants) and left-sided congenital diaphragmatic hernia (12 infants) in order to define disease-specific features. Totally 119 proteins and 164 metabolites were found. A number of proteins and metabolites that can act as potential biomarkers of respiratory diseases were proposed and require further validation.

  5. Exhaled NO: Determinants and Clinical Application in Children With Allergic Airway Disease

    PubMed Central

    Kim, Hyo-Bin; Eckel, Sandrah P.

    2016-01-01

    Nitric oxide (NO) is endogenously released in the airways, and the fractional concentration of NO in exhaled breath (FeNO) is now recognized as a surrogate marker of eosinophilic airway inflammation that can be measured using a noninvasive technique suitable for young children. Although FeNO levels are affected by several factors, the most important clinical determinants of increased FeNO levels are atopy, asthma, and allergic rhinitis. In addition, air pollution is an environmental determinant of FeNO that may contribute to the high prevalence of allergic disease. In this review, we discuss the mechanism for airway NO production, methods for measuring FeNO, and determinants of FeNO in children, including host and environmental factors such as air pollution. We also discuss the clinical utility of FeNO in children with asthma and allergic rhinitis and further useful directions using FeNO measurement. PMID:26540497

  6. Investigation of human biomarkers in exhaled breath by laser photoacoustic spectroscopy

    NASA Astrophysics Data System (ADS)

    Dumitras, D. C.; Giubileo, G.; Puiu, A.

    2005-06-01

    The paper underlines the importance of breath tests in medicine and the potential of laser techniques to measure in-vivo and in real time human biomarkers. The presence of trace amounts of gases or the metabolites of a precursor in exhaled air could be linked to kidney or liver malfunction, asthma, diabetes, cancer, ulcers or neurological disorders. The measurement of some human biomarkers (ethylene, ammonia), based on laser photoacoustic spectroscopy methods, insure very high sensitivity and selectivity. The technical characteristics of this instrument were measured to determine the detection limits (sub-ppb for ethylene). The results of ethylene release following lipid peroxidation initiated by X-ray irradiation or ingestion of radioactive compounds are presented. The possibility to extend this technique for measurement of breath ammonia levels in patients with end-stage renal disease while they are undergoing hemodialysis is discussed.

  7. Determination of radon exhalation from construction materials using VOC emission test chambers.

    PubMed

    Richter, M; Jann, O; Kemski, J; Schneider, U; Krocker, C; Hoffmann, B

    2013-10-01

    The inhalation of (222) Rn (radon) decay products is one of the most important reasons for lung cancer after smoking. Stony building materials are an important source of indoor radon. This article describes the determination of the exhalation rate of stony construction materials by the use of commercially available measuring devices in combination with VOC emission test chambers. Five materials - two types of clay brick, clinker brick, light-weight concrete brick, and honeycomb brick - generally used for wall constructions were used for the experiments. Their contribution to real room concentrations was estimated by applying room model parameters given in ISO 16000-9, RP 112, and AgBB. This knowledge can be relevant, if for instance indoor radon concentration is limited by law. The test set-up used here is well suited for application in test laboratories dealing with VOC emission testing.

  8. [Determining asthma treatment in children by monitoring fractional exhaled nitric oxide, sputum eosinophils and leukotriene B₄].

    PubMed

    Vizmanos-Lamotte, G; Cruz, M J; Gómez-Ollés, S; Muñoz, X; de Mir Messa, I; Moreno-Galdó, A

    2015-01-01

    Sputum eosinophils and exhaled fractional nitric oxide (FENO) are markers of airway inflammation in asthma. Cytokines, cysteinyl-leukotrienes and leukotriene B4 (LTB4) are responsible for this inflammation. The aim of this study is to determine the usefulness of these markers in monitoring asthma treatment in children. FENO, sputum eosinophils, and LTB4 in induced sputum were performed in 10 children (9-15 years old). These determinations were repeated four months later, after the beginning or an increase in the treatment. FENO values tended to decrease (P=.15), pulmonary function tended to improve (P=.10), and sputum eosinophils decreased (P=.003) compared to the first determination. There were no differences in LTB4 concentrations (P=.88). Sputum eosinophils seem to be more precise than FENO in the monitoring of inflammation in asthmatic children.

  9. Non-alcoholic steatohepatitis: a non-invasive diagnosis by analysis of exhaled breath.

    PubMed

    Verdam, Froukje J; Dallinga, Jan W; Driessen, Ann; de Jonge, Charlotte; Moonen, Edwin J C; van Berkel, Joep B N; Luijk, Jakobus; Bouvy, Nicole D; Buurman, Wim A; Rensen, Sander S; Greve, Jan Willem M; van Schooten, Frederik Jan

    2013-03-01

    Histological evaluation of a liver biopsy is the current gold standard to diagnose non-alcoholic steatohepatitis (NASH), but the procedure to obtain biopsies is associated with morbidity and high costs. Hence, only subjects at high risk are biopsied, leading to underestimation of NASH prevalence, and undertreatment. Since analysis of volatile organic compounds in breath has been shown to accurately identify subjects with other chronic inflammatory diseases, we investigated its potential as a non-invasive tool to diagnose NASH. Wedge-shaped liver biopsies from 65 subjects (BMI 24.8-64.3 kg/m(2)) were obtained during surgery and histologically evaluated. The profile of volatile organic compounds in pre-operative breath samples was analyzed by gas chromatography-mass spectrometry and related to liver histology scores and plasma parameters of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Three exhaled compounds were sufficient to distinguish subjects with (n=39) and without NASH (n=26), with an area under the ROC curve of 0.77. The negative and positive predictive values were 82% and 81%. In contrast, elevated ALT levels or increased AST/ALT ratios both showed negative predictive values of 43%, and positive predictive values of 88% and 70%, respectively. The breath test reduced the hypothetical percentage of undiagnosed NASH patients from 67-79% to 10%, and of misdiagnosed subjects from 49-51% to 18%. Analysis of volatile organic compounds in exhaled air is a promising method to indicate NASH presence and absence. In comparison to plasma transaminase levels, the breath test significantly reduced the percentage of missed NASH patients and the number of unnecessarily biopsied subjects. Copyright © 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  10. Determinants of Exhaled Breath Condensate pH in a Large Population With Asthma

    PubMed Central

    Teague, W. Gerald; Erzurum, Serpil; Fitzpatrick, Anne; Mantri, Sneha; Dweik, Raed A.; Bleecker, Eugene R.; Meyers, Deborah; Busse, William W.; Calhoun, William J.; Castro, Mario; Chung, Kian Fan; Curran-Everett, Douglas; Israel, Elliot; Jarjour, W. Nizar; Moore, Wendy; Peters, Stephen P.; Wenzel, Sally; Hunt, John F.

    2011-01-01

    Background: Exhaled breath condensate (EBC) pH is 2 log orders below normal during acute asthma exacerbations and returns to normal with antiinflammatory therapy. However, the determinants of EBC pH, particularly in stable asthma, are poorly understood. We hypothesized that patients with severe asthma would have low EBC pH and that there would be an asthma subpopulation of patients with characteristically low values. Methods: We studied the association of EBC pH with clinical characteristics in 572 stable subjects enrolled in the Severe Asthma Research Program. These included 250 subjects with severe asthma, 291 with nonsevere asthma, and 31 healthy control subjects. Results: Overall, EBC in this population of stable, treated study subjects was not lower in severe asthma (8.02; interquartile range [IQR], 7.61-8.41) or nonsevere asthma (7.90; IQR, 7.52-8.20) than in control subjects (7.9; IQR, 7.40-8.20). However, in subjects with asthma the data clustered below and above pH 6.5. Subjects in the subpopulation with pH < 6.5 had lower fraction of exhaled NO (FeNO) values (FeNO = 22.6 ± 18.1 parts per billion) than those with pH ≥ 6.5 (39.9 ± 40.2 parts per billion; P < .0001). By multiple linear regression, low EBC pH was associated with high BMI, high BAL neutrophil counts, low prebronchodilator FEV1 ratio, high allergy symptoms, race other than white, and gastroesophageal reflux symptoms. Conclusion: Asthma is a complex syndrome. Subjects who are not experiencing an exacerbation but have low EBC pH appear to be a unique subpopulation. PMID:20966042

  11. Exhaled breath temperature measurement and asthma control in children prescribed inhaled corticosteroids: A cross sectional study.

    PubMed

    Hamill, Laura; Ferris, Kathryn; Kapande, Kirsty; McConaghy, Laura; Douglas, Isobel; McGovern, Vincent; Shields, Michael D

    2016-01-01

    Exhaled breath temperature (EBT) reflects airways (both eosinophilic and neutrophilic) inflammation in asthma and thus may aid the management of children with asthma that are treated with anti-inflammatory drugs. A new EBT monitor has become available that is cheap and easy to use and may be a suitable monitoring device for airways inflammation. Little is known about how EBT relates to asthma treatment decisions, disease control, lung function, or other non-invasive measures of airways inflammation, such as exhaled nitric oxide (ENO). To determine the relationships between EBT and asthma treatment decision, current control, pulmonary function, and ENO. Cross-sectional prospective study on 159 children aged 5-16 years attending a pediatric respiratory clinic. EBT was compared with the clinician's decision regarding treatment (decrease, no change, increase), asthma control assessment (controlled, partial, uncontrolled), level of current treatment (according to British Thoracic Society guideline, BTS step), ENO, and spirometry. EBT measurement was feasible in the majority of children (25 of 159 could not perform the test) and correlated weakly with age (R = 0.33, P = <0.01). EBT did not differ significantly between the three clinician decision groups (P = 0.42), the three asthma control assessment groups (P = 0.9), or the current asthma treatment BTS step (P = 0.57). EBT measurement was not related to measures of asthma control determined at the clinic. The routine intermittent monitoring of EBT in children prescribed inhaled corticosteroids who attend asthma clinics cannot be recommended for adjusting anti-inflammatory asthma therapy. © 2015 Wiley Periodicals, Inc.

  12. Expanding analytical options in sports drug testing: Mass spectrometric detection of prohibited substances in exhaled breath.

    PubMed

    Thevis, Mario; Krug, Oliver; Geyer, Hans; Schänzer, Wilhelm

    2017-08-15

    Continuously refining and advancing the strategies and methods employed in sports drug testing is critical for efficient doping controls. Besides improving and expanding the spectrum of target analytes, alternative test matrices have warranted in-depth evaluation as they commonly allow for minimal-/non-invasive and non-intrusive sample collection. In this study, the potential of exhaled breath (EB) as doping control specimen was assessed. EB collection devices employing a non-woven electret-based air filter unit were used to generate test specimens, simulating a potential future application in doping controls. A multi-analyte sports drug testing approach configured for a subset of 12 model compounds that represent specific classes of substances prohibited in sports (anabolic agents, hormone and metabolic modulators, stimulants, and beta-blockers) was established using unispray liquid chromatography/tandem mass spectrometry (LC/MS/MS) and applied to spiked and elimination study EB samples. The test method was characterized concerning specificity, assay imprecision, and limits of detection. The EB collection device allowed for retaining and extracting all selected model compounds from the EB aerosol. Following elution and concentration, LC/MS/MS analysis enabled detection limits between 5 and 100 pg/filter and imprecisions ranging from 3% to 20% for the 12 selected model compounds. By means of EB samples from patients and participants of administration studies, the elimination of relevant compounds and, thus, their traceability in EB for doping control purposes, was investigated. Besides stimulants such as methylhexaneamine and pseudoephedrine, also the anabolic-androgenic steroid dehydrochloromethyltestosterone, the metabolic modulator meldonium, and the beta-blocker bisoprolol was detected in exhaled breath. The EB aerosol has provided a promising proof-of-concept suggesting the expansion of this testing strategy as a complement to currently utilized sports drug

  13. NMR metabolomic analysis of exhaled breath condensate of asthmatic patients at two different temperatures.

    PubMed

    Motta, Andrea; Paris, Debora; D'Amato, Maria; Melck, Dominique; Calabrese, Cecilia; Vitale, Carolina; Stanziola, Anna A; Corso, Gaetano; Sofia, Matteo; Maniscalco, Mauro

    2014-12-05

    Exhaled breath condensate (EBC) collection is a noninvasive method to investigate lung diseases. EBC is usually collected with commercial/custom-made condensers, but the optimal condensing temperature is often unknown. As such, the physical and chemical properties of exhaled metabolites should be considered when setting the temperature, therefore requiring validation and standardization of the collecting procedure. EBC is frequently used in nuclear magnetic resonance (NMR)-based metabolomics, which unambiguously recognizes different pulmonary pathological states. Here we applied NMR-based metabolomics to asthmatic and healthy EBC samples collected with two commercial condensers operating at -27.3 and -4.8 °C. Thirty-five mild asthmatic patients and 35 healthy subjects were included in the study, while blind validation was obtained from 20 asthmatic and 20 healthy different subjects not included in the primary analysis. We initially analyzed the samples separately and assessed the within-day, between-day, and technical repeatabilities. Next, samples were interchanged, and, finally, all samples were analyzed together, disregarding the condensing temperature. Partial least-squares discriminant analysis of NMR spectra correctly classified samples, without any influence from the temperature. Input variables were either integral bucket areas (spectral bucketing) or metabolite concentrations (targeted profiling). We always obtained strong regression models (95%), with high average-quality parameters for spectral profiling (R(2) = 0.84 and Q(2) = 0.78) and targeted profiling (R(2) = 0.91 and Q(2) = 0.87). In particular, although targeted profiling clustering is better than spectral profiling, all models reproduced the relative metabolite variations responsible for class differentiation. This warrants that cross comparisons are reliable and that NMR-based metabolomics could attenuate some specific problems linked to standardization of EBC collection.

  14. Real time detection of exhaled human breath using quantum cascade laser based sensor technology

    NASA Astrophysics Data System (ADS)

    Tittel, Frank K.; Lewicki, Rafal; Dong, Lei; Liu, Kun; Risby, Terence H.; Solga, Steven; Schwartz, Tim

    2012-02-01

    The development and performance of a cw, TE-cooled DFB quantum cascade laser based sensor for quantitative measurements of ammonia (NH3) and nitric oxide (NO) concentrations present in exhaled breath will be reported. Human breath contains ~ 500 different chemical species, usually at ultra low concentration levels, which can serve as biomarkers for the identification and monitoring of human diseases or wellness states. By monitoring NH3 concentration levels in exhaled breath a fast, non-invasive diagnostic method for treatment of patients with liver and kidney disorders, is feasible. The NH3 concentration measurements were performed with a 2f wavelength modulation quartz enhanced photoacoustic spectroscopy (QEPAS) technique, which is suitable for real time breath measurements, due to the fast gas exchange inside a compact QEPAS gas cell. A Hamamatsu air-cooled high heat load (HHL) packaged CW DFB-QCL is operated at 17.5°C, targeting the optimum interference free NH3 absorption line at 967.35 cm-1 (λ~10.34 μm), with ~ 20 mW of optical power. The sensor architecture includes a reference cell, filled with a 2000 ppmv NH3 :N2 mixture at 130 Torr, which is used for absorption line-locking. A minimum detection limit (1σ) for the line locked NH3 sensor is ~ 6 ppbv (with a 1σ 1 sec time resolution of the control electronics). This NH3 sensor was installed in late 2010 and is being clinically tested at St. Luke's Hospital in Bethlehem, PA.

  15. Markers of oxidative stress are increased in exhaled breath condensates of children with atopic dermatitis.

    PubMed

    Peroni, D G; Bodini, A; Corradi, M; Coghi, A; Boner, A L; Piacentini, G L

    2012-04-01

    Airway inflammation may be present in subjects affected by atopic dermatitis (AD) but still without asthma symptoms. Exhaled breath condensate (EBC) reflects the composition of bronchoalveolar extracellular lining fluid that contains a large number of mediators of airway inflammation and oxidative damage.   We assessed inflammatory markers in the EBC of patients with AD. Fifty-six children (34 girls and 22 boys) were enrolled: 33 affected by AD and 23 healthy controls.   EBC was collected using a condenser device. We measured EBC pH and concentrations of leukotriene B4 (LTB4), 8-isoprostane, H(2) O(2) , malondialdehyde and 4-hydroxynoneal. Respiratory resistance was also evaluated.   EBC pH in patients with AD was significantly lower than in healthy children, median (range) being 8·02 (7·94-8·12) in AD vs. 8·11 (8·05-8·16) (P = 0·02). The values of exhaled 8-isoprostane and LTB4 were significantly increased in subjects with AD compared with normal controls (P < 0·01 and P < 0·001, respectively). There was increased 4-hydroxynoneal in patients with AD but this did not reach statistical significance. Evaluating respiratory resistance, no bronchoreversibility was demonstrated in the children with AD. pH, LTB4 and 8-isoprostane in EBC could be sensitive markers of airway inflammation in children with AD. Prospective studies would be of interest to evaluate if airway inflammation, not yet clinically evident, could predict the development of asthma later in life in children with AD. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.

  16. Effect of hemodialysis and diet on the exhaled breath methanol concentration in patients with ESRD.

    PubMed

    Lee, Hyun Ji Julie; Pahl, Madeleine V; Vaziri, Nosratola D; Blake, Donald R

    2012-05-01

    End-stage renal disease (ESRD) causes accumulation of nitrogenous waste products and acid-base, mineral, fluid, and electrolyte disorders, which are partially corrected by hemodialysis (HD). While the effects of ESRD and dialysis on body fluid composition are well known, the effects on composition of expired breath are uncertain. Methanol is produced from unabsorbable complex carbohydrates by the colonic microbiome. Dietary restrictions of fruits and vegetables aimed at limiting potassium intake lower the intake of dietary fibers; the reduced fiber intake can in turn reduce production of methanol and its appearance in the exhaled breath. In this study, we investigated the inter- and intradialytic changes in the breath methanol levels. Ten ESRD patients were studied during HD procedures at 3- and 2-day interdialytic intervals. On each occasion, 20 exhaled breath and room air samples were collected using evacuated canisters. Ten age-matched normal subjects served as controls. The samples were analyzed on a unique 6-column/detector gas chromatography system. Seven ESRD patients consuming renal diet had lower methanol concentration (90 ± 29 ppbv) than the 3 patients consuming high-fiber diet (340 ± 48 ppbv, P ≤ .0006) and the 10 controls consuming unrestricted diets (202 ± 80 ppbv, P ≤ .001). HD significantly lowered breath methanol (60% ± 12%), paralleling the fall in serum urea concentration (70% ± 6%). The predialysis methanol concentration was slightly higher at 3-day than the 2-day interdialytic intervals. Dietary restriction of fruits and vegetables lowers methanol production by the gut microbial flora in ESRD patients. Perhaps, methanol is a reliable breath biomarker to monitor individuals' daily fiber intake. Breath methanol is dramatically reduced by HD, reflecting its efficient removal. Copyright © 2012 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  17. Diagnosis and Classification of 17 Diseases from 1404 Subjects via Pattern Analysis of Exhaled Molecules.

    PubMed

    Nakhleh, Morad K; Amal, Haitham; Jeries, Raneen; Broza, Yoav Y; Aboud, Manal; Gharra, Alaa; Ivgi, Hodaya; Khatib, Salam; Badarneh, Shifaa; Har-Shai, Lior; Glass-Marmor, Lea; Lejbkowicz, Izabella; Miller, Ariel; Badarny, Samih; Winer, Raz; Finberg, John; Cohen-Kaminsky, Sylvia; Perros, Frédéric; Montani, David; Girerd, Barbara; Garcia, Gilles; Simonneau, Gérald; Nakhoul, Farid; Baram, Shira; Salim, Raed; Hakim, Marwan; Gruber, Maayan; Ronen, Ohad; Marshak, Tal; Doweck, Ilana; Nativ, Ofer; Bahouth, Zaher; Shi, Da-You; Zhang, Wei; Hua, Qing-Ling; Pan, Yue-Yin; Tao, Li; Liu, Hu; Karban, Amir; Koifman, Eduard; Rainis, Tova; Skapars, Roberts; Sivins, Armands; Ancans, Guntis; Liepniece-Karele, Inta; Kikuste, Ilze; Lasina, Ieva; Tolmanis, Ivars; Johnson, Douglas; Millstone, Stuart Z; Fulton, Jennifer; Wells, John W; Wilf, Larry H; Humbert, Marc; Leja, Marcis; Peled, Nir; Haick, Hossam

    2017-01-24

    We report on an artificially intelligent nanoarray based on molecularly modified gold nanoparticles and a random network of single-walled carbon nanotubes for noninvasive diagnosis and classification of a number of diseases from exhaled breath. The performance of this artificially intelligent nanoarray was clinically assessed on breath samples collected from 1404 subjects having one of 17 different disease conditions included in the study or having no evidence of any disease (healthy controls). Blind experiments showed that 86% accuracy could be achieved with the artificially intelligent nanoarray, allowing both detection and discrimination between the different disease conditions examined. Analysis of the artificially intelligent nanoarray also showed that each disease has its own unique breathprint, and that the presence of one disease would not screen out others. Cluster analysis showed a reasonable classification power of diseases from the same categories. The effect of confounding clinical and environmental factors on the performance of the nanoarray did not significantly alter the obtained results. The diagnosis and classification power of the nanoarray was also validated by an independent analytical technique, i.e., gas chromatography linked with mass spectrometry. This analysis found that 13 exhaled chemical species, called volatile organic compounds, are associated with certain diseases, and the composition of this assembly of volatile organic compounds differs from one disease to another. Overall, these findings could contribute to one of the most important criteria for successful health intervention in the modern era, viz. easy-to-use, inexpensive (affordable), and miniaturized tools that could also be used for personalized screening, diagnosis, and follow-up of a number of diseases, which can clearly be extended by further development.

  18. Exhaled Nitric Oxide, Lung Function, and Exacerbations in Wheezy Infants and Toddlers

    PubMed Central

    Debley, Jason S.; Stamey, David C.; Cochrane, Elizabeth S.; Gama, Kim L.; Redding, Gregory J.

    2010-01-01

    Background There are limited data assessing the relationship between fractional concentration of exhaled nitric oxide (FENO) and lung function or exacerbations in infants with recurrent wheezing. Objectives In a longitudinal pilot study of children < 2 years old we assessed whether baseline FENO was associated with lung function, bronchodilator responsiveness, changes in lung function, or subsequent exacerbations of wheezing. Methods Forced expiratory flows and volumes using the raised-volume rapid thoracic compression method were measured in 44 infants and toddlers (mean age 15.7 mos.) with recurrent wheezing. Single-breath exhaled nitric oxide (SB-eNO) was measured at 50 mL/sec. Lung function was again measured 6 months after enrollment. Results At enrollment FEV0.5, FEF25-75, and FEF75 z-scores for the cohort were significantly less than zero. There was no correlation between enrollment SB-eNO and enrollment lung function measures. SB-eNO was higher in infants with bronchodilator responsiveness (46.1 vs. 23.6 ppb, p<0.001), and was associated with a decline in FEV0.5 (r = -.54, P = 0.001), FEF25-75 (r = -0.6, P < 0.001), and FEF75 (r = -0.55, P = 0.001) over 6 months. A 10ppb increase in SB-eNO was associated with a 0.4 z-score decline in FEV0.5, a 0.4 z-score decline in FEF25-75, and a 0.42 z-score decline in FEF75. SB-eNO was superior to lung function and bronchodilator responsivenss in predicting subsequent wheezing treated with systemic steroids. Conclusions SB-eNO may predict changes in lung function and risk of future wheezing, and holds promise as a biomarker to predict asthma in wheezy infants and toddlers. PMID:20462633

  19. Effect of Inhaled β2-Agonist on Exhaled Nitric Oxide in Chronic Obstructive Pulmonary Disease

    PubMed Central

    Amer, Mostafa; Cowan, Jan; Gray, Andrew; Brockway, Ben

    2016-01-01

    The fractional exhaled nitric oxide measured at an expiratory flow of 50mL/s (FENO50) is a marker of airway inflammation, and high levels are associated with greater response to steroid treatment. In asthma, FENO50 increases with bronchodilation and decreases with bronchoconstriction, the latter potentially causing an underestimate of the degree of airway inflammation when asthma worsens. It is unknown whether the same effect occurs in chronic obstructive lung disease (COPD). Likewise, it is not known whether changes in airway calibre in COPD patients alter flow-independent parameters describing pulmonary nitric oxide exchange, such as the maximal flux of nitric oxide (NO) from the proximal airway compartment (J’awNO) and the distal airway/alveolar concentration of NO (CANO). We recruited 24 patients with COPD and performed FENO analysis at multiple expiratory flows before and after treatment with inhaled β2-agonist bronchodilator therapy. For the 21 patients analysed, FENO50 rose from 17.1 (1.4) ppb (geometric mean (geometric SD)) at baseline, to 19.3 (1.3) ppb after bronchodilator therapy, an increase of 2.2 ppb (95% CI, 0.7–3.6; P = 0.005). There were non-significant changes in flow-independent NO parameters. The change in FENO50 correlated positively with the change in J’awNO (rs = 0.67, P < 0.001; rs = 0.62, P = 0.002 before and after correction for axial back-diffusion respectively) following bronchodilation. Inhaled bronchodilator therapy can increase exhaled nitric oxide measurements in COPD. The standardisation of inhaled bronchodilator therapy before FENO analysis in COPD patients should therefore be considered in both research and clinical settings. PMID:27258087

  20. Traffic-related air pollution affects peak expiratory flow, exhaled nitric oxide, and inflammatory nasal markers.

    PubMed

    Steerenberg, P A; Nierkens, S; Fischer, P H; van Loveren, H; Opperhuizen, A; Vos, J G; van Amsterdam, J G

    2001-01-01

    The authors used a longitudinal observational design, with repeated measures, to study the association between traffic-related air pollutants (i.e., nitric oxide, nitrogen dioxide, carbon monoxide, and Black Smoke) and respiratory symptoms. Subjects (N = 82) attended an elementary school in either Utrecht (i.e., urban children) or Bilthoven (i.e., suburban children). These two geographic areas differed with respect to levels of Black Smoke (means = 53 microg/m3 and 18 microg/m3, respectively). Levels of nitric oxide, nitrogen dioxide, carbon monoxide, and Black Smoke were consistently higher in Utrecht than in Bilthoven (mean daily ratios were 8, 1.5, 1.8, and 2.7, respectively). The authors compared mean levels of short-term effects of the aforementioned air pollutants on suburban and urban children. Urban children had higher mean levels (p = .05) of interleukin-8 (32%), urea (39%), uric acid (26%), albumin (15%), and nitric oxide metabolites (21%) in nasal lavage than did suburban children. Peak expiratory flow, exhaled nitric oxide levels, and nasal markers were associated with levels of particulate matter with diameters less than or equal to 10 microm, Black Smoke, nitrogen dioxide, and nitric oxide. With respect to per-unit increases in air pollution, urban children had more increased peak expiratory flow, higher levels of exhaled nitric oxide, and more increased release of uric acid, urea, and nitric oxide metabolites than suburban children. In summary, urban children had increased levels of inflammatory nasal markers, and their responses were more pronounced than were the suburban children's responses to the same increments of air pollution.

  1. Measurement of exhaled nitric oxide in young children during tidal breathing through a facemask.

    PubMed

    Daniel, Peter Fleng; Klug, Bent; Valerius, Niels Henrik

    2005-05-01

    Measurement of exhaled nitric oxide (eNO) offers a non-invasive means for assessment of airway inflammation. The currently available methods are difficult to apply in preschool children. We evaluated four methods potentially applicable for eNO measurement during tidal breathing in young children. eNO was assessed during tidal breathing in 24 children, 2-7 yr old, using a facemask which separated nasal and oral airflow. Facemasks with and without a one-way valve allowing exhalation through the nose were used. Expiratory flow control was not attempted. Measurements of eNO were performed both on-line and off-line. In 11 children, 8-12 yr old, measurements were compared with the standard single breath on-line method. eNO was significantly lower applying the one-way valve in on-line and off-line measurements in comparison with measurements without the valve [4.6 and 3.9 parts per billion (ppb) vs. 6.9 ppb and 6.5 ppb]. The mean within subject coefficient of variation (CV) was significantly lower in on-line measurements with the one-way valve (9.6%) compared with the other three methods (18.8, 27.7 and 29.3% respectively). Measurements with a facemask fitted with a one-way valve yielded similar eNO levels as the standard single breath method (7.0 ppb vs. 6.9 ppb) and reproducibility (9.8% vs. 7.1%). In conclusion, reproducible measurements of eNO can be obtained without control of expiration flow using a facemask fitted with a one-way valve on the nasal compartment. The likely explanation to this is that the one-way valve reduces the admixture of nasal NO, thereby improving the reliability of eNO measurements. Copyright 2005 Blackwell Munksgaard

  2. Exhaled nitric oxide levels and airway responsiveness to adenosine 5'-monophosphate in subjects with nasal polyposis.

    PubMed

    Prieto, L; Seijas, T; Gutiérrez, V; Uixera, S; Bruno, L; López, R

    2004-08-01

    It is widely appreciated that asthma is an inflammatory disease of the airways associated with airway hyperresponsiveness, and that nasal polyposis and asthma are related diseases. The objective of this study was to determine differences in exhaled nitric oxide (ENO) levels and airway responsiveness to adenosine 5'-monophosphate (AMP) between nonasthmatic patients with nasal polyposis and healthy controls. Twenty patients without asthma with nasal polyposis and 16 healthy control subjects were enrolled in the study. Participants were challenged with increasing concentrations of AMP and methacholine. ENO was measured with the single-exhalation method. Bronchoconstriction in response to AMP was detected in 7 (35%) subjects with nasal polyposis. The geometric mean (95% CI) of ENO for subjects with nasal polyposis was 33.1 parts per billion (ppb) (24.0-45.7 ppb) compared with 12.3 ppb (8.5-18.2 ppb) for the healthy controls (p = 0.0002). ENO values were significantly higher in atopic than in nonatopic subjects with nasal polyposis [51.3 ppb (32.3-83.2 ppb) vs. 24.5 ppb (16.2-37.1 ppb), p = 0.02]. Nonatopic subjects with nasal polyposis also had higher concentrations of ENO than healthy control subjects (p = 0.016). Inhaled AMP causes airway narrowing in a significantly higher proportion of nonasthmatic subjects with nasal polyposis than in healthy controls. Furthermore, increased concentrations of ENO are detected in atopic and nonatopic subjects with nasal polyposis. These results suggest that bronchial inflammation is present in nonasthmatic subjects with nasal polyposis. Copyright 2004 S. Karger AG, Basel

  3. Exhaled nitric oxide as a tool in managing and monitoring difficult-to-treat asthma.

    PubMed

    Bukstein, Don; Luskin, Allan T; Brooks, Elizabeth A

    2011-01-01

    Most patients diagnosed with asthma maintain control reasonably well and do not experience asthma exacerbations; however, on average, 30% of patients achieve suboptimal control, have severe or difficult-to-treat asthma, and are relatively nonresponsive to the same medications that achieve and maintain asthma control for most patients. This small patient population of difficult-to-treat or severe asthma accounts for 80% of asthma medical costs. This study was designed to determine the potential U.S. payer cost savings resulting from an asthma specialist incorporating fractionated exhaled nitric oxide (FE(NO)) as an asthma management or monitoring tool to guide treatment of difficult-to-treat asthma patients. We present an annual medical resource use scenario typical of a difficult-to-treat asthma patient as well as five hypothetical scenarios of annual medical resource use for a difficult-to-treat asthma patient being managed with regular FE(NO) measurements in addition to current standard asthma management guidelines. We used the most conservative estimate of the potential asthma cost savings when FE(NO) measurement is used for difficult-to-treat asthma. The most likely clinical scenario assumes a 5% reduction in hospitalization and emergency department costs only. The inclusion of FE(NO) measurements to the asthma management strategy would essentially reach parity with the current standard of care, despite the additional cost of FE(NO) MEASUREMENTS: Additional scenarios were examined, all showed cost and use reduction across all medical resource usage categories. Use of exhaled NO measurement to guide asthma management, maintenance, and control in difficult-to-treat asthma would almost certainly result in cost savings to the payer.

  4. Exhaled air and aerosolized droplet dispersion during application of a jet nebulizer.

    PubMed

    Hui, David S; Chow, Benny K; Chu, Leo C Y; Ng, Susanna S; Hall, Stephen D; Gin, Tony; Chan, Matthew T V

    2009-03-01

    As part of our influenza pandemic preparedness, we studied the dispersion distances of exhaled air and aerosolized droplets during application of a jet nebulizer to a human patient simulator (HPS) programmed at normal lung condition and different severities of lung injury. The experiments were conducted in a hospital isolation room with a pressure of - 5 Pa. Airflow was marked with intrapulmonary smoke. The jet nebulizer was driven by air at a constant flow rate of 6 L/min, with the mask reservoir filled with sterile water and attached to the HPS via a nebulizer mask. The exhaled leakage jet plume was revealed by a laser light sheet and images captured by high-definition video. Smoke concentration in the plume was estimated from the light scattered by smoke and droplet particles. The maximum dispersion distance of smoke particles through the nebulizer side vent was 0.45 m lateral to the HPS at normal lung condition (oxygen consumption, 200 mL/min; lung compliance, 70 mL/cm H(2)O), but it increased to 0.54 m in mild lung injury (oxygen consumption, 300 mL/min; lung compliance, 35 mL/cm H(2)O), and beyond 0.8 m in severe lung injury (oxygen consumption, 500 mL/min; lung compliance, 10 mL/cm H(2)O). More extensive leakage through the side vents of the nebulizer mask was noted with more severe lung injury. Health-care workers should take extra protective precaution within at least 0.8 m from patients with febrile respiratory illness of unknown etiology receiving treatment via a jet nebulizer even in an isolation room with negative pressure.

  5. Diagnosis and Classification of 17 Diseases from 1404 Subjects via Pattern Analysis of Exhaled Molecules

    PubMed Central

    2016-01-01

    We report on an artificially intelligent nanoarray based on molecularly modified gold nanoparticles and a random network of single-walled carbon nanotubes for noninvasive diagnosis and classification of a number of diseases from exhaled breath. The performance of this artificially intelligent nanoarray was clinically assessed on breath samples collected from 1404 subjects having one of 17 different disease conditions included in the study or having no evidence of any disease (healthy controls). Blind experiments showed that 86% accuracy could be achieved with the artificially intelligent nanoarray, allowing both detection and discrimination between the different disease conditions examined. Analysis of the artificially intelligent nanoarray also showed that each disease has its own unique breathprint, and that the presence of one disease would not screen out others. Cluster analysis showed a reasonable classification power of diseases from the same categories. The effect of confounding clinical and environmental factors on the performance of the nanoarray did not significantly alter the obtained results. The diagnosis and classification power of the nanoarray was also validated by an independent analytical technique, i.e., gas chromatography linked with mass spectrometry. This analysis found that 13 exhaled chemical species, called volatile organic compounds, are associated with certain diseases, and the composition of this assembly of volatile organic compounds differs from one disease to another. Overall, these findings could contribute to one of the most important criteria for successful health intervention in the modern era, viz. easy-to-use, inexpensive (affordable), and miniaturized tools that could also be used for personalized screening, diagnosis, and follow-up of a number of diseases, which can clearly be extended by further development. PMID:28000444

  6. The necessity of external validation in exhaled breath research: a case study of sarcoidosis.

    PubMed

    Fijten, Rianne; Smolinska, Agnieszka; Drent, Marjolein; Dallinga, Jan; Mostard, Remy; Pachen, Daniëlle; van Schooten, Frederik Jan; Boots, Agnes

    2017-08-04

    As in other disciplines of 'omics' research, reproducibility is a major problem in exhaled breath research. Many studies report discriminatory volatiles in the same disease, yet the similarity between lists of identified compounds is low. This can occur due to many factors including the lack of internal and in particular external validation. In an ideal situation, an external validation - sampled at for example a different location - is always included to ensure generalization of the observed findings to a general population. In this study, we hypothesized that sarcoidosis patients and healthy controls could be discriminated based on a group of volatile organic compounds (VOCs) in exhaled breath and that these discriminating VOCs could be validated in an external population. The first dataset consisted of 87 sarcoidosis patients and 27 healthy controls, whereas the validation dataset consisted of 25 patients and 29 controls. Using the first dataset, 9 VOCs were found that could predict sarcoidosis with 79.4% accuracy. Different types of internal and external validation were tested to assess the validity of the 9 VOCs. Of the internal validations, randomly setting aside part of the data achieved the most accurate predictions while external validation was only possible by building a new prediction model that yielded a promising yet not entirely convincing accuracy of 74% due to the indirect approach. In conclusion, the initial results of this study are very promising but, as the results of our validation set already indicated, may not be reproducible in other studies. In order to achieve a reliable diagnostic breath fingerprint for sarcoidosis we encourage other scientists to validate the presented findings. ClinicalTrials Identifiers: NCT00741572 & NCT02361281 . © 2017 IOP Publishing Ltd.

  7. Increase of methanol in exhaled breath quantified by SIFT-MS following aspartame ingestion.

    PubMed

    Španěl, Patrik; Dryahina, Kseniya; Vicherková, Petra; Smith, David

    2015-11-19

    Aspartame, methyl-L-α-aspartyl-L-phenylalaninate, is used worldwide as a sweetener in foods and drinks and is considered to be safe at an acceptable daily intake (ADI) of 40 mg per kg of body weight. This compound is completely hydrolyzed in the gastrointestinal tract to aspartic acid, phenylalanine and methanol, each being toxic at high levels. The objective of the present study was to quantify the volatile methanol component in the exhaled breath of ten healthy volunteers following the ingestion of a single ADI dose of aspartame. Direct on-line measurements of methanol concentration were made in the mouth and nose breath exhalations using selected ion flow tube mass spectrometry, SIFT-MS, several times before aspartame ingestion in order to establish individual pre-dose (baseline) levels and then during two hours post-ingestion to track their initial increase and subsequent decrease. The results show that breath methanol concentrations increased in all volunteers by 1082   ±   205 parts-per-billion by volume (ppbv) from their pre-ingestion values, which ranged from 193 to 436 ppbv to peak values ranging from 981-1622 ppbv, from which they slowly decreased. These observations agree quantitatively with a predicted increase of 1030 ppbv estimated using a one-compartment model of uniform dilution of the methanol generated from a known amount of aspartame throughout the total body water (including blood). In summary, an ADI dose of aspartame leads to a 3-6 fold increase of blood methanol concentration above the individual baseline values.

  8. Exhaled breath condensate pH decreases following oral glucose tolerance test.

    PubMed

    Bikov, Andras; Pako, Judit; Montvai, David; Kovacs, Dorottya; Koller, Zsofia; Losonczy, Gyorgy; Horvath, Ildiko

    2015-12-15

    Exhaled breath condensate (EBC) pH is a widely measured non-invasive marker of airway acidity. However, some methodological aspects have not been thoroughly investigated. The aim of the study was to determine the effect of oral glucose tolerance test (OGTT) on EBC pH in attempt to better standardize its measurement. Seventeen healthy subjects (24  ±  2 years, 6 men, 11 women) participated in the study. EBC collection and capillary blood glucose measurements were performed before as well as 0, 30, 60 and 120 min after a standardized OGTT test. The rate of respiratory droplet dilution and pH were evaluated in EBC. Blood glucose significantly increased at 30 min and maintained elevation after 60 and 120 min following OGTT. Compared to baseline (7.99  ±  0.25) EBC pH significantly decreased immediately after OGTT (7.41  ±  0.47); this drop sustained over 30 (7.44  ±  0.72) and 60 min (7.62  ±  0.44) without a significant difference at 120 min (7.78  ±  0.26). No change was observed in the rate of respiratory droplet dilution. There was no relationship between blood glucose and EBC pH values. Sugar intake may significantly decrease EBC pH. This effect needs to be considered when performing EBC pH studies. Further experiments are also warranted to investigate the effect of diet on other exhaled biomarkers.

  9. Development and Performance Evaluation of an Exhaled-Breath Bioaerosol Collector for Influenza Virus

    PubMed Central

    McDevitt, James J.; Koutrakis, Petros; Ferguson, Stephen T.; Wolfson, Jack M.; Fabian, M. Patricia; Martins, Marco; Pantelic, Jovan; Milton, Donald K.

    2013-01-01

    The importance of the aerosol mode for transmission of influenza is unknown. Understanding the role of aerosols is essential to developing public health interventions such as the use of surgical masks as a source control to prevent the release of infectious aerosols. Little information is available on the number and size of particles generated by infected persons, which is partly due to the limitations of conventional air samplers, which do not efficiently capture fine particles or maintain microorganism viability. We designed and built a new sampler, called the G-II, that collects exhaled breath particles that can be used in infectivity analyses. The G-II allows test subjects to perform various respiratory maneuvers (i.e. tidal breathing, coughing, and talking) and allows subjects to wear a mask or respirator during testing. A conventional slit impactor collects particles > 5.0 μm. Condensation of water vapor is used to grow remaining particles, including fine particles, to a size large enough to be efficiently collected by a 1.0 μm slit impactor and be deposited into a buffer-containing collector. We evaluated the G-II for fine particle collection efficiency with inert particle aerosols and evaluated infective virus collection using influenza A virus aerosols. Testing results showed greater than 85% collection efficiency for particles greater than 50nm and influenza virus collection comparable with a reference SKC BioSampler®. The new design will enable determination of exhaled infectious virus generation rate and evaluate control strategies such as wearing a surgical type mask to prevent the release of viruses from infected persons. PMID:23418400

  10. A method to simultaneously and continuously measure the 222Rn and 220Rn exhalation rates of soil in an open loop.

    PubMed

    Tan, Yanliang; Xiao, Detao; Yuan, Hongzhi; Shan, Jian

    2014-01-01

    This paper presents a process in which a radon monitor based on the electrostatic collection method is used to measure the (222)Rn and (220)Rn exhalation rates simultaneously and continuously employing a ventilation-type accumulation chamber. Generally, the radon exhalation rate can be measured by accumulation technique, but cannot be measured continuously. The advantage of this method using a ventilation-type accumulation chamber is that the radon exhalation rates can be measured continuously. Even though the environmental air is drawn into the chamber, the low atmospheric values of radon and thoron do not influence the measurement accuracy. The (222)Rn and (220)Rn exhalation rates error from the environmental air is less than 5% in this experiment.

  11. Assessment of the correlations between nicotine dependence, exhaled carbon monoxide levels and oral hygiene status: an observational study

    PubMed Central

    MOGA, MINODORA; BOSCA, ADINA BIANCA; BONDOR, COSMINA IOANA; ILEA, ARANKA; LUCACIU, ONDINE PATRICIA; IONEL, ANCA; MAN, MILENA ADINA; RAJNOVEANU, RUXANDRA MIOARA; CÂMPIAN, RADU SEPTIMIU

    2017-01-01

    Background and aim Cigarette smoking has negative effects on general health, including oral health. The aim of our study was to assess the correlations between nicotine dependence, exhaled carbon monoxide levels and oral hygiene status. Methods Smoker and non-smoker participants were enrolled in this observational study. The Fagerström test was used to classify nicotine dependences: low (score: 0–3), medium (score: 4–6) or high (score: 7–10). The oral hygiene status was classified according to the oral hygiene indices of plaque, calculus and gingival inflammation. Lastly, the exhaled carbon monoxide levels were measured with a MicroSmokelyzer (Bedfont Scientific Ltd., Kent, United Kingdom). Results Sixty five participants (50 smokers in the study group and 15 non-smokers in the control group) were enrolled between 11th and 29th of January 2016. No statistical differences were observed between the study group and the control group in terms of age (mean age±SD 23.5±1.9 and 24.0±1.5, respectively) or gender (50% and 26.6%, respectively). A statistically significant difference was observed between the 2 groups in terms of plaque, (p=0.036), calculus (p=0.001) and gingival indices (p<0.001). A positive correlation was found between the exhaled levels of carbon monoxide and the general Fagerström score (r=0.97, p<0.001) or the Fagerström score in smokers (r=0.93, p<0.001); a negative correlation was observed between the exhaled carbon monoxide levels and the number of tooth brushings daily (r=−0.41, p=0.001). The plaque index was statistically significantly associated with the exhaled carbon monoxide levels (p=0.008), general Fagerström score (p=0.016) and number of tooth brushings daily (p<0.001). The calculus and gingival indices were statistically significantly associated with the exhaled carbon monoxide levels (p<0.001), general Fagerström score (p<0.001) and score in smoker participants (p=0.029 and p=0.001, respectively) as well as the number of

  12. Volatile organic compounds in exhaled breath are independent of systemic inflammatory syndrome caused by intravenous lipopolysaccharide infusion in humans: results from an experiment in healthy volunteers.

    PubMed

    Peters, Anna L; Gerritsen, Marije G; Brinkman, Paul; Zwinderman, Koos A H; Vlaar, Alexander P J; Bos, Lieuwe D

    2017-04-11

    Systemic inflammatory response syndrome (SIRS) is observed during critical illness in most patients. It is defined by a clinical definition. The composition of volatile organic compounds (VOCs) in exhaled breath may change during SIRS and may thus serve as a diagnostic tool. We investigated whether exhaled breath VOCs can serve as biomarker for SIRS in a human model of endotoxemia. Eighteen healthy volunteers received 2 ng Eschericia coli lipopolysaccharide (LPS) kg(-1) body weight intravenously. Venous blood and exhaled breath were collected before infusion of LPS and every 2 h thereafter, up to 8 h after infusion. The interleukin (IL)-6 concentration was measured in plasma. VOCs in the exhaled breath were measured by gas chromatography and mass spectrometry. A mixed effects model was fitted to examine the relation between the measured compounds in exhaled breath and time after LPS infusion or IL-6 levels in plasma. Partially-least squares discriminant analysis (PLS-DA) was used to investigate whether we could discriminate between samples collected before and after LPS infusion. The exhaled concentrations of 3-methyl-pentane, 4-methyl-pentanol, 1-hexanol, 2,4-dimethyl-heptane, decane and one unknown compound changed after LPS infusion. However, the false-discovery rate was 43% for the total set of 52 compounds that were present in all samples. Of these VOCs only the unknown compound was associated with systemic levels of IL-6. The PLS-DA algorithm resulted in a moderate discriminatory accuracy. SIRS induced by endotoxemia in human volunteers resulted in minor changes in exhaled VOCs. We therefore conclude that LPS infusion in healthy volunteers does not induce metabolic effects that can be detected through VOC analysis of the exhaled breath. This trial is registered at the Dutch Trial Register: NTR4455.

  13. Influence of air pollution on exhaled carbon monoxide levels in smokers and non-smokers. A prospective cross-sectional study.

    PubMed

    Maga, Mikołaj; Janik, Maciej K; Wachsmann, Agnieszka; Chrząstek-Janik, Olga; Koziej, Mateusz; Bajkowski, Mateusz; Maga, Paweł; Tyrak, Katarzyna; Wójcik, Krzysztof; Gregorczyk-Maga, Iwona; Niżankowski, Rafał

    2017-01-01

    The poor air quality and cigarette smoking are the most important reasons for increased carbon monoxide (CO) level in exhaled air. However, the influence of high air pollution concentration in big cities on the exhaled CO level has not been well studied yet. To evaluate the impact of smoking habit and air pollution in the place of living on the level of CO in exhaled air. Citizens from two large cities and one small town in Poland were asked to complete a survey disclosing their place of residence, education level, work status and smoking habits. Subsequently, the CO level in their exhaled air was measured. Air quality data, obtained from the Regional Inspectorates of Environmental Protection, revealed the differences in atmospheric CO concentration between locations. 1226 subjects were divided into 4 groups based on their declared smoking status and place of living. The average CO level in exhaled air was significantly higher in smokers than in non-smokers (p<0.0001) as well as in non-smokers from big cities than non-smokers from small ones (p<0.0001). Created model showed that non-smokers from big cities have odds ratio of 125.3 for exceeding CO cutoff level of 4ppm compared to non-smokers from small towns. The average CO level in exhaled air is significantly higher in smokers than non-smokers. Among non-smokers, the average exhaled CO level is significantly higher in big city than small town citizens. These results suggest that permanent exposure to an increased concentration of air pollution and cigarette smoking affect the level of exhaled CO. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Using of laser spectroscopy and chemometrics methods for identification of patients with lung cancer, patients with COPD and healthy people from absorption spectra of exhaled air

    NASA Astrophysics Data System (ADS)

    Bukreeva, Ekaterina B.; Bulanova, Anna A.; Kistenev, Yury V.; Kuzmin, Dmitry A.; Nikiforova, Olga Yu.; Ponomarev, Yurii N.; Tuzikov, Sergei A.; Yumov, Evgeny L.

    2014-11-01

    The results of application of the joint use of laser photoacoustic spectroscopy and chemometrics methods in gas analysis of exhaled air of patients with chronic respiratory diseases (chronic obstructive pulmonary disease and lung cancer) are presented. The absorption spectra of exhaled breath of representatives of the target groups and healthy volunteers were measured; the selection by chemometrics methods of the most informative absorption coefficients in scan spectra in terms of the separation investigated nosology was implemented.

  15. The presence of biofilm-producing bacteria on tonsils is associated with increased exhaled nitric oxide levels: preliminary data in children who experience recurrent exacerbations of chronic tonsillitis.

    PubMed

    Torretta, S; Marchisio, P; Drago, L; Capaccio, P; Baggi, E; Pignataro, L

    2015-03-01

    It has been suggested that bacterial biofilms may be a causative factor in the aetiopathogenesis of chronic tonsillitis. Involvement of exhaled nitric oxide has been previously considered, with conflicting findings. A pilot study was performed to investigate the relationship between exhaled nitric oxide levels and the presence of tonsillar biofilm-producing bacteria in children with chronic tonsillitis. Tonsillar biofilm-producing bacteria on bioptic specimens taken during tonsillectomy were assessed by means of spectrophotometry. Analysis was based on 24 children aged 5-10 years (median, 7.5 years). Biofilm-producing bacteria were found in 40.9 per cent of specimens. The median exhaled nitric oxide level was 11.6 ppb (range, 3.2-22.3 ppb). There was a significant relationship between the presence of biofilm-producing bacteria and increased exhaled nitric oxide levels (p = 0.03). Children with exhaled nitric oxide levels of more than 8 ppb were at three times greater risk of developing tonsillar biofilm-producing bacteria than those with lower levels. Our findings suggest the possibility of discriminating children with chronic biofilm-sustained tonsillar infections on the basis of exhaled nitric oxide levels.

  16. Exhaled breath condensate appears to be an unsuitable specimen type for the detection of influenza viruses with nucleic acid-based methods

    PubMed Central

    St. George, Kirsten; Fuschino, Meghan E.; Mokhiber, Katharine; Triner, Wayne; Spivack, Simon D.

    2013-01-01

    Exhaled breath condensate is an airway-derived specimen type that has shown significant promise in the diagnosis of asthma, cancer, and other disorders. The presence of human genomic DNA in this sample type has been proven, but there have been no reports on its utility for the detection of respiratory pathogens. The suitability of exhaled breath condensate for the detection of influenza virus was investigated, as an indication of its potential as a specimen type for respiratory pathogen discovery work. Matched exhaled condensates and nasopharyngeal swabs were collected from 18 adult volunteers. Eleven cases were positive for influenza A virus, and one was positive for influenza B virus. All swab samples tested positive in real-time amplification assays, but only one exhaled condensate, an influenza A positive sample with a very high viral load, tested positive in the real-time RT-PCR assay. Most of the positive nasopharyngeal swab samples inoculated for virus culture also tested positive, whereas influenza virus was not grown from any of the exhaled condensate specimens. It was concluded that influenza viruses are not readily detectable with culture or nucleic acid-based techniques in this sample type, and that exhaled breath condensate may not be suitable for respiratory pathogen investigations with molecular methods. PMID:19733195

  17. Exhaled breath condensate appears to be an unsuitable specimen type for the detection of influenza viruses with nucleic acid-based methods.

    PubMed

    St George, Kirsten; Fuschino, Meghan E; Mokhiber, Katharine; Triner, Wayne; Spivack, Simon D

    2010-01-01

    Exhaled breath condensate is an airway-derived specimen type that has shown significant promise in the diagnosis of asthma, cancer, and other disorders. The presence of human genomic DNA in this sample type has been proven, but there have been no reports on its utility for the detection of respiratory pathogens. The suitability of exhaled breath condensate for the detection of influenza virus was investigated, as an indication of its potential as a specimen type for respiratory pathogen discovery work. Matched exhaled condensates and nasopharyngeal swabs were collected from 18 adult volunteers. Eleven cases were positive for influenza A virus, and one was positive for influenza B virus. All swab samples tested positive in real-time amplification assays, but only one exhaled condensate, an influenza A positive sample with a very high viral load, tested positive in the real-time RT-PCR assay. Most of the positive nasopharyngeal swab samples inoculated for virus culture also tested positive, whereas influenza virus was not grown from any of the exhaled condensate specimens. It was concluded that influenza viruses are not readily detectable with culture or nucleic acid-based techniques in this sample type, and that exhaled breath condensate may not be suitable for respiratory pathogen investigations with molecular methods.

  18. The application of exhaled breath analysis in racing Thoroughbreds and the influence of high intensity exercise and ambient temperature on the concentration of carbon monoxide and pH in exhaled breath.

    PubMed

    Cathcart, Michael P; Love, Sandy; Sutton, David G M; Reardon, Richard J M; Hughes, Kristopher J

    2013-08-01

    Analyses of exhaled breath (EB) and exhaled breath condensate (EBC) are non-invasive modalities for assessing the lower airways but these methods have not been applied to Thoroughbred racehorses in training. The aims of this study were to determine whether EB and EBC could be obtained from Thoroughbred racehorses in the field and to investigate the effects of exercise per se and during different ambient temperatures and humidity on exhaled concentrations of nitric oxide (eNO), carbon monoxide (eCO) and EBC pH. EB and EBC samples were obtained from 28 Thoroughbred racehorses pre- and post-exercise during warm (n=23) and/or cold (n=19) ambient temperatures. eNO was detected in 19/84 EB samples. eCO was measured in 39/42 EB samples pre-exercise (median 1.3 ppm) and concentrations decreased significantly post-exercise (median 0.8 ppm, P<0.005) and were associated with ambient temperature. EBC pH was 4.51 ± 0.23 pre-exercise and increased significantly post-exercise (4.79 ± 0.59, P=0.003). The study documented the collection of EB and EBC from Thoroughbred racehorses in a field setting. Alterations in concentrations of volatile gases and EBC pH occurred in response to exercise, and were likely to have been influenced by environmental factors.

  19. LASER BIOLOGY AND MEDICINE: Laser analysis of the 13C/12C isotope ratio in CO2 in exhaled air

    NASA Astrophysics Data System (ADS)

    Stepanov, E. V.

    2002-11-01

    Tunable diode lasers (TDLs) are applied to the diagnostics of gastroenterological diseases using respiratory tests and preparations enriched with the stable 13C isotope. This method of the analysis of the 13C/12C isotope ratio in CO2 in exhaled air is based on the selective measurement of the resonance absorption at the vibrational — rotational structure of 12CO2 and 13CO2. The CO2 transmission spectra in the region of 4.35 μm were measured with a PbEuSe double-heterostructure TDL. The accuracy of carbon isotope ratio measurements in CO2 of exhaled air performed with the TDL was ~0.5%. The data of clinical tests of the developed laser-based analyser are presented.

  20. Validation of a method for collection and assay of pentane in the exhaled breath of the horse.

    PubMed

    Wyse, C A; Love, S; Christley, R M; Yam, P S; Cooper, J M; Cumming, D R S; Preston, T

    2004-04-01

    Oxidative stress refers to an imbalance between the production of oxidising free radicals and the antioxidant defenses of the cell, and is associated with many pathogenic processes. Oxidative damage to cellular lipids results in the evolution of pentane and ethane gas, and detection of these hydrocarbons in the exhaled breath can be used to monitor in vivo oxidative stress. The aim of this study was to validate a gas chromatography (GC) method for measurement of breath pentane in the horse. The GC-system developed showed good specificity for discrimination of pentane from other breath hydrocarbons, and was sensitive to 0.5 ppb pentane. Pentane was detected in the exhaled breath of five horses investigated on two occasions. The results of this preliminary study demonstrate that breath pentane can be measured in the horse, and further work is now justified to investigate the feasibility of applying this method for monitoring in vivo oxidative stress in the horse.

  1. Normal values for single exhalation diffusing capacity and pulmonary capillary blood flow in sitting, supine positions, and during mild exercise.

    PubMed

    Huang, Y C; Helms, M J; MacIntyre, N R

    1994-02-01

    Previous approaches to the measurements of pulmonary diffusing capacity (DL) and pulmonary capillary blood flow (QC) utilized either the rebreathing or the single inhalation technique in conjunction with radioisotope gas and mass spectrometry. In the present study, we utilized a newly developed rapid infrared analyzer in conjunction with the slow single exhalation technique on 100 healthy volunteers to establish normal values for DL and QC under sitting, supine, and exercise conditions. The exercise level was determined by a target heart rate: HRex = ([HRmax - HRrest]/3) + HRrest. Prediction equations based on regressions on age, sex, height, or weight were then computed for sitting, supine, and exercise values. We found that mean DL and QC increased by approximately 12 percent and 8 percent, respectively, from sitting to supine posture, and by approximately 30 percent and 100 percent, respectively, from sitting (rest) to mild exercise. These results provided a database for further studies in the single exhalation method in various clinical settings.

  2. Exhaled nitric oxide and nasal tryptase are associated with wheeze, rhinitis and nasal allergy in primary school children.

    PubMed

    De Prins, Sofie; Marcucci, Francesco; Sensi, Laura; Van de Mieroop, Els; Nelen, Vera; Nawrot, Tim S; Schoeters, Greet; Koppen, Gudrun

    2014-09-01

    Rhinitis and asthma are the most common respiratory diseases in children. We assessed whether airway inflammation markers were associated with nasal allergies and self-reported symptoms of wheeze and rhinitis in 130 children 6-12 year old in an epidemiological context. Independent of sex and age, the fraction of exhaled nitric oxide (FeNO) and nasal mast cell (MC) activation (tryptase ≥ 5 ng/mL) were positively associated with wheeze, rhinitis and with nasal allergy. Nasal eosinophil cationic protein (ECP) and exhaled breath condensate (EBC) markers (pH, 8-isoprostane, interleukin-1β) were not associated with symptoms or with nasal allergy. In conclusion, FeNO and nasal tryptase reflect allergic inflammation in the respiratory system.

  3. On the calibration of a radon exhalation monitor based on the electrostatic collection method and accumulation chamber.

    PubMed

    Tan, Yanliang; Tokonami, Shinji; Hosoda, Masahiro

    2015-06-01

    The radon exhalation rate can be obtained quickly and easily from the evolution of radon concentration over time in the accumulation chamber. Radon monitoring based on the electrostatic collection method is not interfered with by (220)Rn. In this paper, we propose that the difference between radon and (218)Po concentrations in the measurement cell of this kind of radon exhalation monitor is the main system error, and it changes with time and different effective decay constants. Based on the results of simulation experiments, we propose that the calibration factor obtained from the suitable experiment cannot completely correct the system error, even if it is useful to reduce the measurement error. The better way for reducing measurement error is to use the new measurement model which we have proposed in recent years.

  4. [The determination of the ethanol elimination rate in the blood based on its concentration in the exhaled air].

    PubMed

    Obukhova, L M; Erlykina, E I; Andriianova, N A

    2014-01-01

    The objective of the present study was to calculate the blood ethanol level from its content in the exhaled air. The plot of the blood ethanol level versus its content in the exhaled air was constructed and used to determine the rate of ethanol elimination from the blood. The result proved to lie within the range corresponding to the normal-for-age values. These data put in question the opinion of the independent specialist about disturbances in the alcohol dehydrogenase activity in blood manifested as a considerable increase of the rate of acetaldehyde reduction to ethanol with the decreasing ethanol dehydration rate. It is concluded that the prfoposed algorithm can be recommended for the application in the practical work of various expert services.

  5. Analysis of ketone bodies in exhaled breath and blood of ten healthy Japanese at OGTT using a portable gas chromatograph.

    PubMed

    Tanda, Naoko; Hinokio, Yoshinori; Washio, Jumpei; Takahashi, Nobuhiro; Koseki, Takeyoshi

    2014-11-24

    Ketone bodies including acetone are disease biomarkers for diabetes that sometimes causes severe ketoacidosis. The present study was undertaken to clarify the significance of exhaled acetone and plasma ketone bodies at bedside in a clinical setting. The oral glucose tolerance test (OGTT) was performed in 10 healthy Japanese volunteers (five females and five males). Exhaled breath acetone and volatile sulfide compounds (VSCs) in mouth air were measured simultaneously with blood sampling during the OGTT using a portable gas chromatograph equipped with an In2O3 thick-film type gas sensor and a VSC monitor. Acetone, β-hydroxybutyrate (β-OHB) and acetoacetate (AcAc) in blood plasma as well as glucose and insulin were examined. Oral conditions were examined based on the Community Periodontal Index (CPI) by one dentist. In addition, the same type of analysis was applied to two uncontrolled type 2 diabetes mellitus patients hospitalized at Tohoku University Hospital. Exhaled acetone was measured at the same time as blood withdrawal in the morning before breakfast and at night before bed at the beginning, the middle, and the end of hospitalization. All volunteers showed normal OGTT patterns with no ketonuria and periodontitis; however, there were significant correlations between breath acetone and plasma β-ΟΗΒ and between breath acetone and plasma AcAc under fasting conditions. Breath acetone of the type 2 diabetes mellitus patients showed positive correlations with plasma glucose when the level of plasma glucose tended to decrease during hospitalization. In spite of a very limited number of cases, our results support the idea that exhaled breath acetone may be related to plasma β-OHB and AcAc, which reflect glucose metabolism in the body.

  6. National survey on the natural radioactivity and 222Rn exhalation rate of building materials in The Netherlands.

    PubMed

    de Jong, P; van Dijk, W; van der Graaf, E R; de Groot, T J H

    2006-09-01

    The present study reports on results of a nation-wide survey on the natural radioactivity concentrations and Rn exhalation rates of the prevailing building materials in the Netherlands. In total 100 samples were taken and analyzed for the activity concentrations of Ra, Ra, Th, and K and for their Rn exhalation rate. The sampled materials consisted of gypsum products, aerated concrete, sand-lime and clay bricks, mortars and concrete, representing about 95% of the stony building materials used in the construction of Dutch homes. The laboratory analyses were performed according to two well-documented standard procedures, the interlaboratory reproducibility of which is found to be within 5% on average. The highest radionuclide concentrations were found in a porous inner wall brick to which fly ash was added. The second highest were clay bricks with average Ra and Ra levels around 40 Bq kg. Concrete and mortar show the highest exhalation rates with a fairly broad range of 1 to 13 microBq (kg s). Low natural radioactivity levels are associated with either natural gypsum (products) or gypsum from flue gas desulphurization units, and low exhalation rates with clay bricks. To evaluate the radiological impact the radioactivity concentrations in each sample were combined into a so-called dose factor, representing the absorbed dose rate in a room with a floor, walls and ceiling of 20 cm of the material in question. For that purpose, calculations with the computer codes MCNP, Marmer and MicroShield on the specific absorbed dose rates were incorporated in the paper. The results of these codes corresponded within 6% and average values were calculated at 0.90, 1.10, and 0.080 nGy h per Bq kg for the U series, the Th series, and K, respectively. Model calculations on the external dose rate, based on the incidence of the various building materials in 1,336 living rooms, are in accordance with measured data.

  7. PBTK Modeling Demonstrates Contribution of Dermal and Inhalation Exposure Components to End-Exhaled Breath Concentrations of Naphthalene

    PubMed Central

    Kim, David; Andersen, Melvin E.; Chao, Yi-Chun E.; Egeghy, Peter P.; Rappaport, Stephen M.; Nylander-French, Leena A.

    2007-01-01

    Background Dermal and inhalation exposure to jet propulsion fuel 8 (JP-8) have been measured in a few occupational exposure studies. However, a quantitative understanding of the relationship between external exposures and end-exhaled air concentrations has not been described for occupational and environmental exposure scenarios. Objective Our goal was to construct a physiologically based toxicokinetic (PBTK) model that quantitatively describes the relative contribution of dermal and inhalation exposures to the end-exhaled air concentrations of naphthalene among U.S. Air Force personnel. Methods The PBTK model comprised five compartments representing the stratum corneum, viable epidermis, blood, fat, and other tissues. The parameters were optimized using exclusively human exposure and biological monitoring data. Results The optimized values of parameters for naphthalene were a) permeability coefficient for the stratum corneum 6.8 × 10−5 cm/hr, b) permeability coefficient for the viable epidermis 3.0 × 10−3 cm/hr, c) fat:blood partition coefficient 25.6, and d) other tissue:blood partition coefficient 5.2. The skin permeability coefficient was comparable to the values estimated from in vitro studies. Based on simulations of workers’ exposures to JP-8 during aircraft fuel-cell maintenance operations, the median relative contribution of dermal exposure to the end-exhaled breath concentration of naphthalene was 4% (10th percentile 1% and 90th percentile 11%). Conclusions PBTK modeling allowed contributions of the end-exhaled air concentration of naphthalene to be partitioned between dermal and inhalation routes of exposure. Further study of inter- and intraindividual variations in exposure assessment is required to better characterize the toxicokinetic behavior of JP-8 components after occupational and/or environmental exposures. PMID:17589597

  8. Determination of amphetamine and methylphenidate in exhaled breath of patients undergoing attention-deficit/hyperactivity disorder treatment.

    PubMed

    Beck, Olof; Stephanson, Niclas; Sandqvist, Sören; Franck, Johan

    2014-08-01

    It has been discovered recently that exogenous substances are detectable in exhaled breath after intake. Exhaled breath therefore constitutes a new possible matrix in clinical pharmacology and toxicology. The present work was aimed at exploring this possibility further by a study on patients treated for attention-deficit/hyperactivity disorder with D-amphetamine and methylphenidate. Thirteen patients (age range: 32-61 years; 5 women) were included in the study, and breath and urine samples were collected at different times in the dose interval. Analyses of breath and urine samples were done with liquid chromatography-mass spectrometry methods. Urine was examined for amphetamine, methylphenidate, and its metabolite ritalinic acid. Among the 9 patients who received D-amphetamine medication in daily doses of 20-100 mg, amphetamine was detected in all subjects in amounts ranging from 1200 to 30,800 picogram per filter. Among 8 patients receiving methylphenidate medication in daily doses of 80-400 mg, it was detected and quantified in 7 of the cases in amounts ranging from 150 to 10,400 picogram per filter and ritalinic acid was detected and quantified in 3 of the cases ranging from 35 to 360 picogram per filter. In 1 case, methylphenidate was only detectable in breath and urine, whereas ritalinic acid was quantifiable in urine, which could indicate noncompliance, with the 4 hours of dose regimen prescribed. In a number of cases, the sampling was performed 24 hours after the last dose intake. Identification of amphetamine and methylphenidate was based on correct chromatographic retention time and correct product ion ratio with detection performed in selected reaction monitoring mode. The results confirm that amphetamine is present in exhaled breath after intake and demonstrate for the first time the presence of methylphenidate and ritalinic acid after its intake. This gives further support to the potential use of exhaled breath for detecting drug intake.

  9. A profile of volatile organic compounds in exhaled air as a potential non-invasive biomarker for liver cirrhosis.

    PubMed

    Pijls, Kirsten E; Smolinska, Agnieszka; Jonkers, Daisy M A E; Dallinga, Jan W; Masclee, Ad A M; Koek, Ger H; van Schooten, Frederik-Jan

    2016-01-29

    Early diagnosis of liver cirrhosis may prevent progression and development of complications. Liver biopsy is the current standard, but is invasive and associated with morbidity. We aimed to identify exhaled volatiles within a heterogeneous group of chronic liver disease (CLD) patients that discriminates those with compensated cirrhosis (CIR) from those without cirrhosis, and compare this with serological markers. Breath samples were collected from 87 CLD and 34 CIR patients. Volatiles in exhaled air were measured by gas chromatography mass spectrometry. Discriminant Analysis was performed to identify the optimal panel of serological markers and VOCs for classifying our patients using a random training set of 27 CIR and 27 CLD patients. Two randomly selected independent internal validation sets and permutation test were used to validate the model. 5 serological markers were found to distinguish CIR and CLD patients with a sensitivity of 0.71 and specificity of 0.84. A set of 11 volatiles discriminated CIR from CLD patients with sensitivity of 0.83 and specificity of 0.87. Combining both did not further improve accuracy. A specific exhaled volatile profile can predict the presence of compensated cirrhosis among CLD patients with a higher accuracy than serological markers and can aid in reducing liver biopsies.

  10. Development of a couple of methods for measuring radon exhalation from building materials commonly used in the Iberian Peninsula.

    PubMed

    Miró, C; Andrade, E; Reis, M; Madruga, M J

    2014-07-01

    Radon is considered to be the main contributor to the worldwide population exposure to natural sources of radiation and so a lot of efforts have been made in most countries to assess indoor radon concentrations. Radon exhales from the earth's surface and is part of the radioactive decay series of uranium, which is also present in building materials. In this work, measurements of radon exhalation rates in building materials commonly used in the Iberian Peninsula have been carried out by using two different methods: active and passive techniques. In the first technique, the radon exhalation rate was measured following the radon activity growth as a function of time, by using a continuous radon monitor. The second technique is based on integrated measurements by using solid-state nuclear track detectors and a Spark Counter reading equipment. The results obtained by both measuring methods were found to be consistent. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. A profile of volatile organic compounds in exhaled air as a potential non-invasive biomarker for liver cirrhosis

    PubMed Central

    Pijls, Kirsten E.; Smolinska, Agnieszka; Jonkers, Daisy M. A. E.; Dallinga, Jan W.; Masclee, Ad A. M.; Koek, Ger H.; van Schooten, Frederik-Jan

    2016-01-01

    Early diagnosis of liver cirrhosis may prevent progression and development of complications. Liver biopsy is the current standard, but is invasive and associated with morbidity. We aimed to identify exhaled volatiles within a heterogeneous group of chronic liver disease (CLD) patients that discriminates those with compensated cirrhosis (CIR) from those without cirrhosis, and compare this with serological markers. Breath samples were collected from 87 CLD and 34 CIR patients. Volatiles in exhaled air were measured by gas chromatography mass spectrometry. Discriminant Analysis was performed to identify the optimal panel of serological markers and VOCs for classifying our patients using a random training set of 27 CIR and 27 CLD patients. Two randomly selected independent internal validation sets and permutation test were used to validate the model. 5 serological markers were found to distinguish CIR and CLD patients with a sensitivity of 0.71 and specificity of 0.84. A set of 11 volatiles discriminated CIR from CLD patients with sensitivity of 0.83 and specificity of 0.87. Combining both did not further improve accuracy. A specific exhaled volatile profile can predict the presence of compensated cirrhosis among CLD patients with a higher accuracy than serological markers and can aid in reducing liver biopsies. PMID:26822454

  12. A cross-sectional study of exhaled carbon monoxide as a biomarker of recent household air pollution exposure

    PubMed Central

    Lee, Alison; Sanchez, Tiffany R.; Shahriar, Muhammad Hasan; Eunus, Mahbubul; Perzanowski, Matthew; Graziano, Joseph

    2016-01-01

    RATIONALE Household air pollution causes 3.5 million deaths annually. Personal exposure assessments required for examining health associations are expensive and require technical expertise, limiting the quality of research in resource-poor settings. OBJECTIVES To assess the feasibility of exhaled carbon monoxide and its relationship to continuous personal carbon monoxide monitoring and markers of respiratory health in female cooks primarily cooking with biomass fuels in Araihazar, Bangladesh. METHODS & MEASURES For a 24-hour period, exhaled carboxyhemoglobin (eCOHb) % saturation was measured before and after each cooking episode while simultaneous 24-hour personal carbon monoxide monitoring was conducted. The Coburn-Forester-Kane (CFK) equation was used to convert continuous personal CO exposures to predicted COHb % saturation. Respiratory symptoms were assessed by St. George's Respiratory Questionnaire, airway inflammation measured by exhaled breath condensate pH, and lung function determined by spirometry. Spearman's correlation was used to examine the relationship between eCOHb and CKF-derived COHb, EBC pH, and lung function variables. eCOHb % saturation was dichotomized around the median and odds ratios calculated for each respiratory symptom. MAIN RESULTS Measurement of eCOHb % saturation is feasible in a resource-poor setting. eCOHb % saturation responds to cooking episodes and demonstrates consistency when measured at the same time point 24-hours later, suggesting that eCOHb may be a sensitive biomarker of recent HAP exposures. PMID:26457622

  13. A cross-sectional study of exhaled carbon monoxide as a biomarker of recent household air pollution exposure.

    PubMed

    Lee, Alison; Sanchez, Tiffany R; Shahriar, Muhammad Hasan; Eunus, Mahbubul; Perzanowski, Matthew; Graziano, Joseph

    2015-11-01

    Household air pollution causes 3.5 million deaths annually. Personal exposure assessments required for examining health associations are expensive and require technical expertize, limiting the quality of research in resource-poor settings To assess the feasibility of exhaled carbon monoxide and its relationship to continuous personal carbon monoxide monitoring and markers of respiratory health in female cooks primarily cooking with biomass fuels in Araihazar, Bangladesh METHODS AND MEASURE: For a 24-h period, exhaled carboxyhemoglobin (eCOHb) % saturation was measured before and after each cooking episode while simultaneous 24-h personal carbon monoxide monitoring was conducted. The Coburn-Forester-Kane (CFK) equation was used to convert continuous personal CO exposures to predicted COHb % saturation. Respiratory symptoms were assessed by St. George's Respiratory Questionnaire, airway inflammation measured by exhaled breath condensate pH, and lung function determined by spirometry. Spearman's correlation was used to examine the relationship between eCOHb and CKF-derived COHb, EBC pH, and lung function variables. eCOHb % saturation was dichotomized around the median and odds ratios calculated for each respiratory symptom Measurement of eCOHb % saturation is feasible in a resource-poor setting. eCOHb % saturation responds to cooking episodes and demonstrates consistency when measured at the same time point 24-h later, suggesting that eCOHb may be a sensitive biomarker of recent HAP exposures. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Caffeine, quercetin and alizarin stimulate the exhalation of metabolic products of [14C]-N-nitrosodiethylamine in mice.

    PubMed

    Khanduja, K L; Sangari, R K; Bhardwaj, A

    2002-06-01

    Naturally occurring plant products belonging to different chemical classes namely alizarin, an anthraquinone, caffeine, a methylxanthine derivative and quercetin, a flavonol were studied for their effect on elimination of metabolites of [14C]-N-nitrosodiethylamine (14C-NDEA) through respiration in mice. Treatment with caffeine, quercetin and alizarin at doses of 200, 9 and 9 microg/ml respectively, in drinking water enhanced the exhalation of 14CO2, one of the major end products of NDEA metabolism. Radioactive CO2 exhaled in 60 min increased by 2, 1.61 and 1.4-folds in animals treated with caffeine, quercetin and alizarin for 8 weeks respectively. This increase in exhalation in caffeine-treated animals was achieved even in 2 weeks. These compounds had no adverse effects on the absorption of radioactive NDEA from the gut of the animals as shape and time of 14CO2 peak was similar in i.p. and orally administered [14C-NDEA]. Increased detoxification/elimination of the carcinogen could be one of the mechanisms for the anticarcinogenic properties of these phytochemicals in lung tumorigenesis induced by orally administered NDEA.

  15. Exhaled breath condensate: determination of non-volatile compounds and their potential for clinical diagnosis and monitoring. A review.

    PubMed

    Kubáň, Petr; Foret, František

    2013-12-17

    Exhaled breath condensate is a promising, non-invasive, diagnostic sample obtained by condensation of exhaled breath. Starting from a historical perspective of early attempts of breath testing towards the contemporary state-of-the-art breath analysis, this review article focuses mainly on the progress in determination of non-volatile compounds in exhaled breath condensate. The mechanisms by which the aerosols/droplets of non-volatile compounds are formed in the airways are discussed with methodological consequences for sampling. Dilution of respiratory droplets is a major problem for correct clinical interpretation of the measured data and there is an urgent need for standardization of EBC. This applies also for collection instrumentation and therefore various commercial and in-house built devices are described and compared with regard to their design, function and collection parameters. The analytical techniques and methods for determination of non-volatile compounds as potential markers of oxidative stress and lung inflammation are scrutinized with an emphasis on method suitability, sensitivity and appropriateness. The relevance of clinical findings for each group of possible non-volatile markers of selected pulmonary diseases and methodological recommendations with emphasis on interdisciplinary collaboration that is essential for future development into a fully validated clinical diagnostic tool are given.

  16. Natural radioactivity and radon exhalation rates in man-made tiles used as building materials in Japan.

    PubMed

    Iwaoka, K; Hosoda, M; Suwankot, N; Omori, Y; Ishikawa, T; Yonehara, H; Tokonami, S

    2015-11-01

    Man-made tiles frequently used in Japan were collected, and activity concentrations and radon ((222)Rn) exhalation rates in these tiles were measured. Dose estimations for inhabitants living in houses built using these tiles were also carried out. The activity concentrations of (226)Ra, (228)Ra and (40)K in the man-made tiles were 31-170, 35-110 and 260-980 Bq kg(-1), respectively. The (222)Rn exhalation rates in the tiles were 8.8-21 μBq m(-2) s(-1). The ranges of experimental activity concentrations and (222)Rn exhalation rates were almost identical to those of natural rocks used as typical building materials in Japan. The maximum value of effective dose to inhabitants living in houses built with the man-made tiles was 0.14 mSv y(-1), which is lower than the reference level range (1-20 mSv y(-1)) for abnormally high levels of natural background radiation published in the ICRP Publication 103.

  17. Effect of allergen-specific immunotherapy with purified Alt a1 on AMP responsiveness, exhaled nitric oxide and exhaled breath condensate pH: a randomized double blind study

    PubMed Central

    2010-01-01

    Background Little information is available on the effect of allergen-specific immunotherapy on airway responsiveness and markers in exhaled air. The aims of this study were to assess the safety of immunotherapy with purified natural Alt a1 and its effect on airway responsiveness to direct and indirect bronchoconstrictor agents and markers in exhaled air. Methods This was a randomized double-blind trial. Subjects with allergic rhinitis with or without mild/moderate asthma sensitized to A alternata and who also had a positive skin prick test to Alt a1 were randomized to treatment with placebo (n = 18) or purified natural Alt a1 (n = 22) subcutaneously for 12 months. Bronchial responsiveness to adenosine 5'-monophosphate (AMP) and methacholine, exhaled nitric oxide (ENO), exhaled breath condensate (EBC) pH, and serum Alt a1-specific IgG4 antibodies were measured at baseline and after 6 and 12 months of treatment. Local and systemic adverse events were also registered. Results The mean (95% CI) allergen-specific IgG4 value for the active treatment group increased from 0.07 μg/mL (0.03-0.11) at baseline to 1.21 μg/mL (0.69-1.73, P < 0.001) at 6 months and to 1.62 μg/mL (1.02-2.22, P < 0.001) at 12 months of treatment. In the placebo group, IgG4 value increased nonsignificantly from 0.09 μg/mL (0.06-0.12) at baseline to 0.13 μg/mL (0.07-0.18) at 6 months and to 0.11 μg/mL (0.07-0.15) at 12 months of treatment. Changes in the active treatment group were significantly higher than in the placebo group both at 6 months (P < 0.001) and at 12 months of treatment (P < 0.0001). However, changes in AMP and methacholine responsiveness, ENO and EBC pH levels were not significantly different between treatment groups. The overall incidence of adverse events was comparable between the treatment groups. Conclusion Although allergen-specific immunotherapy with purified natural Alt a1 is well tolerated and induces an allergen-specific IgG4 response, treatment is not associated with

  18. Trichloroethene levels in human blood and exhaled breath from controlled inhalation exposure.

    PubMed Central

    Pleil, J D; Fisher, J W; Lindstrom, A B

    1998-01-01

    The organic constituents of exhaled human breath are representative of bloodborne concentrations through gas exchange in the blood/breath interface in the lungs. The presence of specific compounds can be an indicator of recent exposure or represent a biological response of the subject. For volatile organic compounds, sampling and analysis of breath is preferred to direct measurement from blood samples because breath collection is noninvasive, potentially infectious waste is avoided, the sample supply is essentially limitless, and the measurement of gas-phase analytes is much simpler in a gas matrix rather than in a complex biological tissue such as blood. However, to assess the distribution of a contaminant in the body requires a reasonable estimate of the blood level. We have investigated the use of noninvasive breath measurements as a surrogate for blood measurements for (high) occupational levels of trichloroethene in a controlled exposure experiment. Subjects were placed in an exposure chamber for 24 hr; they were exposed to 100 parts per million by volume trichloroethene for the initial 4 hr and to purified air for the remaining 20 hr. Matched breath and blood samples were collected periodically during the experiment. We modeled the resulting concentration data with respect to their time course and assessed the blood/breath relationship during the exposure (uptake) period and during the postexposure (elimination) period. Estimates for peak blood levels, compartmental distribution, and time constants were calculated from breath data and compared to direct blood measurements to assess the validity of the breath measurement methodology. Blood/breath partition coefficients were studied during both uptake and elimination. At equilibrium conditions at the end of the exposure, we could predict actual blood levels using breath elimination curve calculations and a literature value partition coefficient with a mean ratio of calculated:measured of 0.98 and standard error

  19. Short-term effects of electronic and tobacco cigarettes on exhaled nitric oxide

    SciTech Connect

    Marini, Sara; Buonanno, Giorgio; Stabile, Luca; Ficco, Giorgio

    2014-07-01

    The objective of this study was to compare the short-term respiratory effects due to the inhalation of electronic and conventional tobacco cigarette-generated mainstream aerosols through the measurement of the exhaled nitric oxide (eNO). To this purpose, twenty-five smokers were asked to smoke a conventional cigarette and to vape an electronic cigarette (with and without nicotine), and an electronic cigarette without liquid (control session). Electronic and tobacco cigarette mainstream aerosols were characterized in terms of total particle number concentrations and size distributions. On the basis of the measured total particle number concentrations and size distributions, the average particle doses deposited in alveolar and tracheobronchial regions of the lungs for a single 2-s puff were also estimated considering a subject performing resting (sitting) activity. Total particle number concentrations in the mainstream resulted equal to 3.5 ± 0.4 × 10{sup 9}, 5.1 ± 0.1 × 10{sup 9}, and 3.1 ± 0.6 × 10{sup 9} part. cm{sup −3} for electronic cigarettes without nicotine, with nicotine, and for conventional cigarettes, respectively. The corresponding alveolar doses for a resting subject were estimated equal to 3.8 × 10{sup 10}, 5.2 × 10{sup 10} and 2.3 × 10{sup 10} particles. The mean eNO variations measured after each smoking/vaping session were equal to 3.2 ppb, 2.7 ppb and 2.8 ppb for electronic cigarettes without nicotine, with nicotine, and for conventional cigarettes, respectively; whereas, negligible eNO changes were measured in the control session. Statistical tests performed on eNO data showed statistically significant differences between smoking/vaping sessions and the control session, thus confirming a similar effect on human airways whatever the cigarette smoked/vaped, the nicotine content, and the particle dose received. - Highlights: • Electronic cigarettes (with and without nicotine) mainstream aerosols were analyzed; • Particle number

  20. Nutrient routing in omnivorous animals tracked by stable carbon isotopes in tissue and exhaled breath.

    PubMed

    Voigt, Christian C; Rex, Katja; Michener, Robert H; Speakman, John R

    2008-08-01

    Omnivorous animals feed on several food items that often differ in macronutrient and isotopic composition. Macronutrients can be used for either metabolism or body tissue synthesis and, therefore, stable C isotope ratios of exhaled breath (delta(13)C(breath)) and tissue may differ. To study nutrient routing in omnivorous animals, we measured delta(13)C(breath) in 20-g Carollia perspicillata that either ate an isotopically homogeneous carbohydrate diet or an isotopically heterogeneous protein-carbohydrate mixture. The delta(13)C(breath) converged to the delta(13)C of the ingested carbohydrates irrespective of whether proteins had been added or not. On average, delta(13)C(breath) was depleted in (13)C by only ca. -2 per thousand in relation to the delta(13)C of the dietary carbohydrates and was enriched by +8.2 per thousand in relation to the dietary proteins, suggesting that C. perspicillata may have routed most ingested proteins to body synthesis and not to metabolism. We next compared the delta(13)C(breath) with that of wing tissue (delta(13)C(tissue)) in 12 free-ranging, mostly omnivorous phyllostomid bat species. We predicted that species with a more insect biased diet--as indicated by the N isotope ratio in wing membrane tissue (delta(15)N(tissue))--should have higher delta(13)C(tissue) than delta(13)C(breath) values, since we expected body tissue to stem mostly from insect proteins and exhaled CO(2) to stem from the combustion of fruit carbohydrates. Accordingly, delta(13)C(tissue) and delta(13)C(breath) should be more similar in species that feed predominantly on plant products. The species-specific differences between delta(13)C(tissue) and delta(13)C(breath) increased with increasing delta(15)N(tissue), i.e. species with a plant-dominated diet had similar delta(13)C(tissue) and delta(13)C(breath) values, whereas species feeding at a higher trophic level had higher delta(13)C(tissue) than delta(13)C(breath) values. Our study shows that delta(13)C

  1. Nasal nitric oxide is associated with exhaled NO, bronchial responsiveness and poor asthma control.

    PubMed

    Krantz, C; Janson, C; Borres, M P; Nordvall, L; Alving, K; Malinovschi, A

    2014-06-01

    The fraction of exhaled nitric oxide (FeNO) is an established marker of airway inflammation in asthma. Nasal nitric oxide (nNO) has initially been regarded as a promising marker of inflammation of nasal mucosa. However, due to its dual origins, paranasal sinuses and nasal mucosa, the clinical use of nNO is controversial. There is an inflammatory link between inflammation in the upper and lower airways within the united airways' paradigm, but the study of the clinical value of nNO in asthma has been limited. The objective of this study is to analyse nNO in asthmatics and its relationship to FeNO, bronchial hyperresponsiveness, allergic sensitization and asthma control. A total of 371 children and young adults from an asthma cohort were included in this study, which performed measurements of nNO (through aspiration at 5 mL s(-1)), FeNO, bronchial responsiveness to methacholine, blood eosinophil count (B-Eos) and IgE sensitization. The asthma control test (ACT) and a questionnaire regarding medical treatment, symptoms of asthma, rhinitis and chronic rhinosinusitis were completed by all subjects. An association was found between higher nNO levels and increased bronchial responsiveness (p < 0.001), FeNO (p < 0.001) and B-Eos (p = 0.002). Sensitization to furry animals related to higher levels of nNO (p < 0.001). Subjects with poorly controlled asthma (ACT < 15) had lower levels of nNO than subjects with a higher ACT score (619 ± 278 ppb, versus 807 ± 274 ppb, p = 0.002). Loss of smell showed the strongest association with lower nNO levels among the upper airway symptoms recorded. In patients with asthma, nNO was positively correlated with exhaled NO, bronchial responsiveness and asthma control. This study suggests clinical utility of nNO in subjects with asthma, but in order to get better understanding of the nNO determinants, simultaneous mapping of upper airway comorbidities by clinical examination is appropriate.

  2. Measurement of exhaled nitric oxide concentration in patients with obstructive sleep apnea

    PubMed Central

    Zhang, Dongmei; Luo, Jinmei; Qiao, Yixian; Xiao, Yi; Huang, Rong; Zhong, Xu

    2017-01-01

    Abstract Background: Exhaled nitric oxide (eNO) has been proposed as a noninvasive measure of airway inflammation. However, its value in patients with obstructive sleep apnea (OSA) is still controversial. The authors aim to assess the difference in eNO levels between patients with OSA and controls by a meta-analysis. Methods: A systematic search was performed in the PubMed, EMBASE, the Cochrane Library, and MEDLINE databases to collect relevant studies published from 1996 to 2016. Eligible studies that reported eNO levels in patients with OSA were included. STATA (version 12.0) was used for data analysis. Results: Two hundred eighty-four studies were reviewed for inclusion, with 16 studies pooled for analysis (16 studies for fractional exhaled nitric oxide [FENO], 5 for alveolar nitric oxide [CANO], and 4 for the maximum airway wall flux of nitric oxide [J′awNO]). The FENO levels were significantly higher in patients with OSA compared with that in the control groups (6.32 ppb, 95% confidence interval [CI] 4.46–8.33, P < 0.001). Furthermore, FENO was significantly increased (4.00 ppb, 95% CI 1.74–6.27, P = 0.001) after overnight sleep in patients with OSA, but not in healthy controls. Additionally, long-term continuous positive airway pressure (CPAP) therapy reduced FENO levels (−5.82 ppb, 95% CI −9.6 to −2.01, P < 0.001). However, the CANO (−0.01 ppb, 95% CI −1.66 to 1.64, P = 0.989) and J’awNO levels (220.32 pl/s, 95% CI −49.31 to 489.94, P = 0.109) were not significantly different between the OSA groups and non-OSA groups. Conclusion: The results of the meta-analysis suggest that OSA is significantly associated with airway inflammation and elevated FENO levels can be modified by long-term CPAP therapy. J’awNO and CANO levels were not significantly different between the OSA groups and control groups. PMID:28328850

  3. Exhaled breath temperature in healthy children is influenced by room temperature and lung volume.

    PubMed

    Logie, Karla M; Kusel, Merci M H; Sly, Peter D; Hall, Graham L

    2011-11-01

    Exhaled breath temperature (EBT) has been proposed for the non-invasive assessment of airway inflammation. Previous studies have not examined the influence of room temperature or lung size on the EBT. This study aimed to address these issues in healthy children. We assessed the effects of room temperature and lung volume in 60 healthy children aged 9-11 years (mean age 10.3 years, 33 male). Static lung volumes were assessed using multiple breath nitrogen washout. Questionnaire and skin prick tests were also used to establish respiratory health in the children. We obtained the EBT parameters of slope, end plateau temperature (PLET) and normalized plateau temperature (nPLET; plateau temperature minus inspired air temperature), and ascertained physiological factors influencing EBT. End plateau temperature was shown to be proportionally affected by room temperature (r = 0.532, P < 0.001) whereas slope and nPLET decreased with increasing room temperature (r = -0.392 P < 0.02 and r = -0.507 P = 0.002). After adjusting for room temperature, height and age, the total lung capacity (r(2)  = 0.435, P = 0.006) and slow vital capacity (SVC; r(2)  = 0.44, P = 0.005) were found to be the strongest predictors of end PLET in healthy children. When all factors were included in a multiple regression model, SVC and room temperature were the only predictors of plateau and nPLET. Slope was only influenced by room temperature. Exhaled breath temperature measurements are highly feasible in children with a 95% success rate in this healthy population. Room temperature and SVC significantly influence EBT variables in healthy children. Further studies are required to investigate the ability of EBT to assess airway inflammation in children with respiratory disease. Pediatr. Pulmonol. 2011; 46:1062-1068. © 2011 Wiley Periodicals, Inc. Copyright © 2011 Wiley Periodicals, Inc.

  4. Particulate Oxidative Burden as a Predictor of Exhaled Nitric Oxide in Children with Asthma

    PubMed Central

    Maikawa, Caitlin L.; Weichenthal, Scott; Wheeler, Amanda J.; Dobbin, Nina A.; Smargiassi, Audrey; Evans, Greg; Liu, Ling; Goldberg, Mark S.; Pollitt, Krystal J. Godri

    2016-01-01

    Background: Epidemiological studies have provided strong evidence that fine particulate matter (PM2.5; aerodynamic diameter ≤ 2.5 μm) can exacerbate asthmatic symptoms in children. Pro-oxidant components of PM2.5 are capable of directly generating reactive oxygen species. Oxidative burden is used to describe the capacity of PM2.5 to generate reactive oxygen species in the lung. Objective: In this study we investigated the association between airway inflammation in asthmatic children and oxidative burden of PM2.5 personal exposure. Methods: Daily PM2.5 personal exposure samples (n = 249) of 62 asthmatic school-aged children in Montreal were collected over 10 consecutive days. The oxidative burden of PM2.5 samples was determined in vitro as the depletion of low-molecular-weight antioxidants (ascorbate and glutathione) from a synthetic model of the fluid lining the respiratory tract. Airway inflammation was measured daily as fractional exhaled nitric oxide (FeNO). Results: A positive association was identified between FeNO and glutathione-related oxidative burden exposure in the previous 24 hr (6.0% increase per interquartile range change in glutathione). Glutathione-related oxidative burden was further found to be positively associated with FeNO over 1-day lag and 2-day lag periods. Results further demonstrate that corticosteroid use may reduce the FeNO response to elevated glutathione-related oxidative burden exposure (no use, 15.8%; irregular use, 3.8%), whereas mold (22.1%), dust (10.6%), or fur (13.1%) allergies may increase FeNO in children with versus children without these allergies (11.5%). No association was found between PM2.5 mass or ascorbate-related oxidative burden and FeNO levels. Conclusions: Exposure to PM2.5 with elevated glutathione-related oxidative burden was associated with increased FeNO. Citation: Maikawa CL, Weichenthal S, Wheeler AJ, Dobbin NA, Smargiassi A, Evans G, Liu L, Goldberg MS, Godri Pollitt KJ. 2016. Particulate oxidative burden

  5. Gas chromatograph-surface acoustic wave for quick real-time assessment of blood/exhaled gas ratio of propofol in humans.

    PubMed

    Chen, X; Zhang, X L; Liu, L; Chen, Y; Piao, M Y; Zhang, F J; Wu, W D; Zhong, Y B; Sun, K; Zou, Y C; Zhang, X; Wang, D; Wang, P; Yan, M

    2014-11-01

    Although pilot studies have reported that exhaled propofol concentrations can reflect intraoperative plasma propofol concentrations in an individual, the blood/exhaled partial pressure ratio RBE varies between patients, and the relevant factors have not yet been clearly addressed. No efficient method has been reported for the quick evaluation of RBE and its association with inter-individual variables. We proposed a novel method that uses a surface acoustic wave (SAW) sensor combined with a fast gas chromatograph (GC) to simultaneously detect propofol concentrations in blood and exhaled gas in 28 patients who were receiving propofol i.v. A two-compartment pharmacokinetic (PK) model was established to simulate propofol concentrations in exhaled gas and blood after a bolus injection. Simulated propofol concentrations for exhaled gas and blood were used in a linear regression model to evaluate RBE. The fast GC-SAW system showed reliability and efficiency for simultaneous quantitative determination of propofol in blood (correlation coefficient R(2)=0.994, P<0.01) and exhaled gas (R(2)=0.991, P<0.01). The evaluation of RBE takes <50 min for a patient. The distribution of RBE in 28 patients showed inter-individual differences in RBE (median 1.27; inter-quartile range 1.07-1.59). Fast GC-SAW, which analyses samples in seconds, can perform both rapid monitoring of exhaled propofol concentrations and fast analysis of blood propofol concentrations. The proposed method allows early determination of the coefficient RBE in individuals. Further studies are required to quantify the distribution of RBE in a larger cohort and assess the effect of other potential factors. ChiCTR-ONC-13003291. © The Author 2014. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Comparative analysis of selected exhaled breath biomarkers obtained with two different temperature-controlled devices

    PubMed Central

    2009-01-01

    Background The collection of exhaled breath condensate (EBC) is a suitable and non-invasive method for evaluation of airway inflammation. Several studies indicate that the composition of the condensate and the recovery of biomarkers are affected by physical characteristics of the condensing device and collecting circumstances. Additionally, there is an apparent influence of the condensing temperature, and often the level of detection of the assay is a limiting factor. The ECoScreen2 device is a new, partly single-use disposable system designed for studying different lung compartments. Methods EBC samples were collected from 16 healthy non-smokers by using the two commercially available devices ECoScreen2 and ECoScreen at a controlled temperature of -20°C. EBC volume, pH, NOx, LTB4, PGE2, 8-isoprostane and cys-LTs were determined. Results EBC collected with ECoScreen2 was less acidic compared to ECoScreen. ECoScreen2 was superior concerning condensate volume and detection of biomarkers, as more samples were above the detection limit (LTB4 and PGE2) or showed higher concentrations (8-isoprostane). However, NOx was detected only in EBC sampled by ECoScreen. Conclusion ECoScreen2 in combination with mediator specific enzyme immunoassays may be suitable for measurement of different biomarkers. Using this equipment, patterns of markers can be assessed that are likely to reflect the complex pathophysiological processes in inflammatory respiratory disease. PMID:19948050

  7. Predictive value of exhaled nitric oxide and aerobic capacity for sepsis complications after liver transplantation.

    PubMed

    Neviere, Remi; Trinh-Duc, Pierre; Hulo, Sébastien; Edme, Jean Louis; Dehon, Aurélie; Boleslawski, Emmanuel; Dharancy, Sébastien; Lebuffe, Gilles

    2016-12-01

    Our objective was to investigate the predictive value of fractional nitric oxide (NO) concentration in exhaled breath (FeNO) and aerobic capacity (peak VO2 ) for postoperative sepsis in liver transplantation candidates. Patients were identified and charts of all consecutive patients were prospectively reviewed. Bacterial sepsis represented the commonest postoperative complications (30%), which was attributed to peritonitis, pneumonia, and catheter-related infections. Preoperative FeNO and peak VO2 values were lower in patients with postoperative sepsis. Patients with sepsis required higher needs for mechanical ventilation and ICU length of stay. Inverse correlation was found between logarithmically FeNO-transformed data and systolic pulmonary artery pressure (r = -0.348; P = 0.018). Multivariate analyses using bootstrap sampling method indicated that odds of sepsis were associated with lower values of peak exercise VO2 [OR = 0.790 (0.592; 0.925)] and reduced log(FeNo) [OR = 0.027 (0.001; 0.451)], but not with higher MELD scores [OR = 1.141 (0.970; 1.486)]. By evaluating the cutoff for the ROC curves in each bootstrap resampling, median and 95% confidence interval were calculated for peak VO2 : 17 [16.2; 22] ml/kg/min and FeNO: 17.2 [13.0; 33.9] ppb. We conclude that low peak exercise VO2 and reduced FeNO may help identify patients who are at risk to develop perioperative sepsis. © 2016 Steunstichting ESOT.

  8. Exhaled nitric oxide monitoring by quantum cascade laser: comparison with chemiluminescent and electrochemical sensors.

    PubMed

    Mandon, Julien; Högman, Marieann; Merkus, Peter J F M; van Amsterdam, Jan; Harren, Frans J M; Cristescu, Simona M

    2012-01-01

    Fractional exhaled nitric oxide (F(E)NO) is considered an indicator in the diagnostics and management of asthma. In this study we present a laser-based sensor for measuring F(E)NO. It consists of a quantum cascade laser (QCL) combined with a multi-pass cell and wavelength modulation spectroscopy for the detection of NO at the sub-part-per-billion by volume (ppbv, 110(-9)) level. The characteristics and diagnostic performance of the sensor were assessed. A detection limit of 0.5 ppbv was demonstrated with a relatively simple design. The QCL-based sensor was compared with two market sensors, a chemiluminescent analyzer (NOA 280, Sievers) and a portable hand-held electrochemical analyzer (MINO, Aerocrine AB, Sweden). F(E)NO from 20 children diagnosed with asthma and treated with inhaled corticosteroids were measured. Data were found to be clinically acceptable within 1.1 ppbv between the QCL-based sensor and chemiluminescent sensor and within 1.7 ppbv when compared to the electrochemical sensor. The QCL-based sensor was tested on healthy subjects at various expiratory flow rates for both online and offline sampling procedures. The extended NO parameters, i.e. the alveolar region, airway wall, diffusing capacity, and flux were calculated and showed a good agreement with the previously reported values.

  9. Interaction of Ambient Air Pollution With Asthma Medication on Exhaled Nitric Oxide Among Asthmatics

    PubMed Central

    Qian, Zhengmin; Lin, Hung-Mo; Chinchilli, Vernon M.; Lehman, Erik B.; Duan, Yinkang; Craig, Timothy J.; Wilson, William E.; Liao, Duanping; Lazarus, Stephen C.; Bascom, Rebecca

    2013-01-01

    The interaction between ambient air pollution and asthma medication remains unclear. The authors compared airway inflammation response to air pollution among asthmatics. Increases of 10 ppb of nitrogen dioxide (NO2) and of 10 μg/m3 of particulate matter < 10 micron in diameter (PM10) daily concentrations were associated with an increase in exhaled nitric oxide (eNO) of 0.13 ppb (95% confidence interval = 0.06, 0.19) and of 0.07 ppb (95% confidence interval = 0.02, 0.12), respectively, in models adjusted for important covariates. The results show that the medication could not counteract airway inflammation effects of air pollution. Specifically, the patients on triamcinolone decreased the sensitivity to PM10 but increased the sensitivity to NO2. The patients on salmeterol were more vulnerable to both NO2 and PM10. This study indicates that the current pollution levels may still enhance airway inflammation among patients with persistent asthma even when they are on asthma medications. PMID:19864219

  10. Helmet Exhalation Capture System (HECS) Sizing Evaluation for an Advanced Space Suit Portable Life Support System

    NASA Technical Reports Server (NTRS)

    Paul, Heather L.; Waguespack, Glenn M.; Paul, Thomas H.; Conger, Bruce C.

    2008-01-01

    As part of NASA s initiative to develop an advanced portable life support system (PLSS), a baseline schematic has been chosen that includes gaseous oxygen in a closed circuit ventilation configuration. Supply oxygen enters the suit at the back of the helmet and return gases pass over the astronaut s body to be extracted at the astronaut s wrists and ankles through the liquid cooling and ventilation garment (LCVG). The extracted gases are then treated using a rapid cycling amine (RCA) system for carbon dioxide and water removal and activated carbon for trace gas removal before being mixed with makeup oxygen and reintroduced into the helmet. Thermal control is provided by a suit water membrane evaporator (SWME). As an extension of the original schematic development, NASA evaluated several Helmet Exhalation Capture System (HECS) configurations as alternatives to the baseline. The HECS configurations incorporate the use of full contact masks or non-contact masks to reduce flow requirements within the PLSS ventilation subsystem. The primary scope of this study was to compare the alternatives based on mass and volume considerations; however other design issues were also briefly investigated. This paper summarizes the results of this sizing analysis task.

  11. Measurement of levels of fractional exhaled nitric oxide in patients with pulmonary tuberculosis.

    PubMed

    Yhi, J Y; Park, D W; Min, J-H; Park, Y K; Kim, S-H; Kim, T-H; Sohn, J W; Yoon, H J; Shin, D H; Moon, J-Y

    2016-09-01

    The role of fractional exhaled nitric oxide (FeNO) in the diagnosis and treatment of pulmonary tuberculosis (PTB) is uncertain. To examine the value of FeNO as a biomarker for PTB. Baseline FeNO levels were compared in 69 PTB patients and 118 healthy controls. The correlation between baseline FeNO levels and clinical variables of tuberculosis were studied. FeNO levels were checked twice in the PTB group, at diagnosis and after 2 months of anti-tuberculosis medication, and factors affecting changes in FeNO levels after treatment were analysed. FeNO levels were not significantly different in the PTB group and controls (mean ± standard deviation 27.7 ± 17.6 parts per billion [ppb] vs. 27.0 ± 10.8 ppb, P = 0.531). In a multivariate regression analysis, no variable was shown to affect FeNO levels at diagnosis. FeNO levels did not significantly change after 2 months of treatment (26.8 ± 18.3 ppb vs. 24.0 ± 10.7 ppb, P = 0.257). Only PTB with a high FeNO level (>25 ppb) was related to a decline in FeNO levels after 2 months of treatment. FeNO levels do not appear to be affected in PTB patients.

  12. Exhaled nitric oxide monitoring by quantum cascade laser: comparison with chemiluminescent and electrochemical sensors

    NASA Astrophysics Data System (ADS)

    Mandon, Julien; Högman, Marieann; Merkus, Peter J. F. M.; van Amsterdam, Jan; Harren, Frans J. M.; Cristescu, Simona M.

    2012-01-01

    Fractional exhaled nitric oxide (FENO) is considered an indicator in the diagnostics and management of asthma. In this study we present a laser-based sensor for measuring FENO. It consists of a quantum cascade laser (QCL) combined with a multi-pass cell and wavelength modulation spectroscopy for the detection of NO at the sub-part-per-billion by volume (ppbv, 1∶10-9) level. The characteristics and diagnostic performance of the sensor were assessed. A detection limit of 0.5 ppbv was demonstrated with a relatively simple design. The QCL-based sensor was compared with two market sensors, a chemiluminescent analyzer (NOA 280, Sievers) and a portable hand-held electrochemical analyzer (MINO®, Aerocrine AB, Sweden). FENO from 20 children diagnosed with asthma and treated with inhaled corticosteroids were measured. Data were found to be clinically acceptable within 1.1 ppbv between the QCL-based sensor and chemiluminescent sensor and within 1.7 ppbv when compared to the electrochemical sensor. The QCL-based sensor was tested on healthy subjects at various expiratory flow rates for both online and offline sampling procedures. The extended NO parameters, i.e. the alveolar region, airway wall, diffusing capacity, and flux were calculated and showed a good agreement with the previously reported values.

  13. Temperature changes in exhaled breath condensate collection devices affect observed acetone concentrations.

    PubMed

    Loyola, Bryan R; Bhushan, Abhinav; Schivo, Michael; Kenyon, Nicholas J; Davis, Cristina E

    2008-09-01

    Chemical analysis of exhaled breath condensate (EBC) is an emerging method to non-invasively identify and measure potential biomarkers of disease. Various EBC collection methods have been proposed, each with strengths and weaknesses. Recent evidence in the literature suggests that sample collection methodologies could introduce potential artifacts in biomarker measurements. In this study, we tested the effect of thermal changes during condensate collection on measured EBC chemical concentrations. Using both actively-cooled and passively-cooled devices, we measured distinct differences in the amount of condensate that can be collected over discrete time periods. We also found that concentrations of acetone varied with the thermal profile changes in the collection devices, in apparently identical EBC samples. Together, this evidence suggests that great care should be taken to standardize EBC collection methods, and that small deviations in the thermal properties of the collection devices could contribute to confounding EBC measurement artifacts. This has implications for the design and development of future portable breath analysis systems, especially miniature hand-held devices.

  14. Integrating exhaled breath diagnostics by disease-sniffing dogs with instrumental laboratory analysis.

    PubMed

    Pleil, Joachim; Giese, Roger

    2017-09-07

    Dogs have been studied for many years as a medical diagnostic tool to detect a pre-clinical disease state by sniffing emissions directly from a human or an in vitro biological sample. Some of the studies report high sensitivity and specificity in blinded case-control studies. However, in these studies it is completely unknown as to which suites of chemicals the dogs detect and how they ultimately interpret this information amidst confounding background odors. Herein, we consider the advantages and challenges of canine olfaction for early (meaningful) detection of cancer, and propose an experimental concept to narrow the molecular signals used by the dog for sample classification to laboratory-based instrumental analysis. This serves two purposes; first, in contrast to dogs, analytical methods could be quickly up-scaled for high throughput sampling. Second, the knowledge gained from identifying probative chemicals could be helpful in learning more about biochemical pathways and disease progression. We focus on exhaled breath aerosol, arguing that the semi-volatile fraction should be given more attention. Ultimately, we conclude that the interaction between dog-based and instrument-based research will be mutually beneficial and accelerate progress towards early detection of cancer by breath analysis.

  15. Combined atmospheric oxidant capacity and increased levels of exhaled nitric oxide

    NASA Astrophysics Data System (ADS)

    Yang, Changyuan; Li, Huichu; Chen, Renjie; Xu, Wenxi; Wang, Cuicui; Tse, Lap Ah; Zhao, Zhuohui; Kan, Haidong

    2016-07-01

    Nitrogen dioxide and ozone are two interrelated oxidative pollutants in the atmosphere. Few studies have evaluated the health effects of combined oxidant capacity (O x ). We investigated the short-term effects of O x on fractional exhaled nitric oxide (FeNO), a well-established biomarker for airway inflammation, in a group of chronic obstructive pulmonary disease patients. Real-time concentrations of O x were obtained by calculating directly the sum of nitrogen dioxide and ozone. Linear mixed-effect models were applied to explore the acute effects of O x on FeNO levels. Short-term exposure to Ox was significantly associated with elevated FeNO. This effect was strongest in the first 24 h after exposure, and was robust to the adjustment of PM2.5. A 10 μg m-3 increase in 24 h average concentrations of O x was associated with 4.28% (95% confidence interval: 1.19%, 7.37%) increase in FeNO. The effect estimates were statistically significant only among males, elders, and those with body mass index ≥24 kg m-2, a comorbidity, higher educational attainment, or moderate airflow limitation. This analysis demonstrated an independent effect of O x on respiratory inflammation, and suggested that a single metric O x might serve as a preferable indicator of atmospheric oxidative capacity in further air pollution epidemiological studies.

  16. Exhaled Nitric Oxide is Decreased by Exposure to the Hyperbaric Oxygen Therapy Environment

    PubMed Central

    Puthucheary, Zudin A.; Liu, Jia; Bennett, Michael; Trytko, Barbara; Chow, Sharron; Thomas, Paul S.

    2006-01-01

    Exhaled nitric oxide (eNO) detects airway inflammation. Hyperbaric oxygen therapy (HBOT) is used for tissue hypoxia, but can cause lung damage. We measured eNO following inhalation of oxygen at different tensions and pressures. Methods. Part 1, eNO was measured before and after HBOT. Part 2, normal subjects breathed 40% oxygen. Results. Baseline eNO levels in patients prior to HBOT exposure were significantly higher than in normal subjects (P < .05). After HBOT, eNO significantly decreased in patients (15.4 ± 2.0 versus 4.4 ± 0.5 ppb, P < .001), but not in normal subjects, after either 100% O2 at increased pressure or 40% oxygen, 1 ATA. In an in vitro study, nitrate/nitrite release decreased after 90 minutes HBOT in airway epithelial (A549) cells. Conclusion. HBO exposure causes a fall in eNO. Inducible nitric oxide synthase (iNOS) may cause elevated eNO in patients secondary to inflammation, and inhibition of iNOS may be the mechanism of the reduction of eNO seen with HBOT. PMID:17392577

  17. A Mini Review of Dolphin Carbohydrate Metabolism and Suggestions for Future Research Using Exhaled Air

    PubMed Central

    Ridgway, Sam H.

    2013-01-01

    In the 1960s, I explored some aspects of carbohydrate metabolism in healthy bottlenose dolphins (Tursiops truncatus). Their physiological picture resembled what had been described for hyperthyroid diabetics. Dolphins have elevated thyroid hormone turnover, and fasting dolphins maintain a relatively high level of plasma glucose. After dolphins ingest glucose, plasma levels remain high for many hours. Interestingly, plasma glucose must exceed 300 mg/dL (about twice as high as the human threshold) before glucose appears in urine. Due to their diabetes-like states, trainability, and unique natural respiratory anatomy and physiology, dolphins may offer useful clues to metabolites in the breath that may be used to non-invasively monitor diabetes in humans. Dolphins take very rapid and deep breaths that are four or five times as deep as humans and other terrestrial mammals, making them ideal for physiological assessment using non-invasive exhaled air. Avenues for successfully identifying breath-based markers for metabolic disease and physiology in dolphins can be done with both modern technology and the evolutionarily advantageous canine nose. This review summarizes aspects of dolphin metabolism previously learned and offers new directions for diabetes research that may benefit both dolphin and human health. PMID:24379802

  18. Online monitoring of ethane traces in exhaled breath with a difference frequency generation spectrometer

    NASA Astrophysics Data System (ADS)

    Halmer, D.; Thelen, S.; Hering, P.; Mürtz, M.

    2006-11-01

    We report a transportable mid-infrared laser cavity leak-out spectrometer for online detection of trace gases. The laser spectrometer is based on continuous-wave difference-frequency generation in the wavelength region around 3 μm. Sensitive spectroscopic trace gas monitoring was achieved using a high-finesse ring-down cavity. For difference-frequency generation, we use a periodically poled lithium niobate (PPLN) crystal, pumped by a Nd:YAG laser (signal wave) and a diode laser (pump wave) with a tapered amplifier. A maximum power of 280 μW near λ=3.3 μm is achieved using a pump power of 180 mW at 807 nm, a signal power of 890 mW at 1064.46 nm, and a 50-mm-long PPLN crystal. The resulting system proved to be a unique tool with high sensitivity and specificity for rapid and precise breath testing. We demonstrate spectroscopic online monitoring of ethane traces in exhaled human breath with a precision of 270 parts per trillion (1σ) and a time resolution of 1 s.

  19. Developing an amperometric hydrogen peroxide sensor for an exhaled breath analysis system.

    PubMed

    Wiedemair, Justyna; van Dorp, Henriëtte D S; Olthuis, Wouter; van den Berg, Albert

    2012-11-01

    In this work, we present a chip-integrated amperometric sensor targeted at the detection of hydrogen peroxide (H₂O₂) in the gaseous phase. Electrode chips are manufactured in a series of microfabrication steps and characterized electrochemically. Using such devices detection of H₂O₂ in an aqueous phase is shown by means of cyclic voltammetry and amperometry. Furthermore, it is discussed that variation of conditions such as the composition of the supporting electrolyte largely influences the obtained electrochemical signal. Additionally, electrochemical pretreatment of platinum working electrodes aiming at surface oxidation improves the limit of detection of the sensor and the linearity of the calibration curve at low H₂O₂ concentrations (<10 μM). Agarose-coated el