Exercise changes volatiles in exhaled breath assessed by an electronic nose.

PubMed

Bikov, A; Lazar, Zs; Schandl, K; Antus, B M; Losonczy, G; Horvath, Ildiko

2011-09-01

Exercise-caused metabolic changes can be followed by monitoring exhaled volatiles; however it has not been previously reported if a spectrum of exhaled gases is modified after physical challenge. We have hypothesized that changes in volatile molecules assessed by an electronic nose may be the reason for the alkalization of the exhaled breath condensate (EBC) fluid following physical exercise.Ten healthy young subjects performed a 6-minute running test. Exhaled breath samples pre-exercise and post-exercise (0 min, 15 min, 30 min and 60 min) were collected for volatile pattern ("smellprint") determination and pH measurements (at 5.33 kPa CO2), respectively. Exhaled breath smellprints were analyzed using principal component analysis and were related to EBC pH.Smellprints (p=0.04) and EBC pH (p=0.01) were altered during exercise challenge. Compared to pre-exercise values, smellprints and pH differed at 15 min, 30 min and 60 min following exercise (p<0.05), while no difference was found at 0 min post-exercise. In addition, a significant correlation was found between volatile pattern of exhaled breath and EBC pH (p=0.01, r=-0.34).Physical exercise changes the pattern of exhaled volatiles together with an increase in pH of breath. Changes in volatiles may be responsible for increase in EBC pH.

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.

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.

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...

Impacts of exhalation flow on the microenvironment around the human body under different room temperatures

NASA Astrophysics Data System (ADS)

Jafari, Mohammad Javad; Gharari, Noradin; Azari, Mansour Rezazade; Ashrafi, Khosro

2018-04-01

Exhalation flow and room temperature can have a considerable effect on the microenvironment in the vicinity of human body. In this study, impacts of exhalation flow and room temperature on the microenvironment around a human body were investigated using a numerical simulation. For this purpose, a computational fluid dynamic program was applied to study thermal plume around a sitting human body at different room temperatures of a calm indoor room by considering the exhalation flow. The simulation was supported by some experimental measurements. Six different room temperatures (18 to 28 °C) with two nose exhalation modes (exhalation and non-exhalation) were investigated. Overhead and breathing zone velocities and temperatures were simulated in different scenarios. This study finds out that the exhalation through the nose has a significant impact on both quantitative and qualitative features of the human microenvironment in different room temperatures. At a given temperature, the exhalation through the nose can change the location and size of maximum velocity at the top of the head. In the breathing zone, the effect of exhalation through the nose on velocity and temperature distribution was pronounced for the point close to mouth. Also, the exhalation through the nose strongly influences the thermal boundary layer on the breathing zone while it only minimally influences the convective boundary layer on the breathing zone. Overall results demonstrate that it is important to take the exhalation flow into consideration in all areas, especially at a quiescent flow condition with low temperature.

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

Radon in the Exhaled Air of Patients in Radon Therapy.

PubMed

Lettner, Herbert; Hubmer, Alexander; Hofmann, Werner; Landrichinger, Julia; Gaisberger, Martin; Winkler-Heil, Renate

2017-11-01

In the Gastein valley, numerous facilities use radon for the treatment of various diseases either by exposure to radon in air or in radon rich thermal water. In this study, six test persons were exposed to radon thermal water in a bathtub and the time-dependent radon activity concentration in the exhaled air was recorded. At temperatures between 38°C and 40°C, the radon activity concentration in the water was about 900 kBq/m3 in a total volume of 600 l, where the patients were exposed for 20 min, while continuously sampling the exhaled air during the bathing and 20 min thereafter. After entering the bath, the exhaled radon activity concentration rapidly increased, reaching some kind of saturation after 20 min exposure. The radon activity concentration in the exhaled air was about 8000 Bq/m3 at the maximum, with higher concentrations for male test persons. The total radon transfer from water to the exhaled air was between 480 and 1000 Bq, which is equivalent to 0.08% and 0.2% of the radon in the water. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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.

Off-line exhaled nitric oxide measurements in children.

PubMed

Barreto, M; Villa, M P; Martella, S; Falasca, C; Guglielmi, F; Pagani, J; Darder, M T; Ronchetti, R

2001-08-01

The concentration of exhaled nitric oxide (eNO) is a useful marker of asthmatic bronchial inflammation. eNO can now be measured away from the laboratory (off-line), even in children. Short exhalation maneuvers (8 sec) and small samples (1 L) of exhaled gas are probably sufficient in children, but more information is needed about the effect of different measurement conditions. As a preliminary step before conducting epidemiological studies in schoolchildren, we investigated the effects of expiratory flow, dead space, and expiratory time on eNO concentrations collected in 1-L mylar collection bags. We studied 101 cooperative subjects (62 males) aged 5-18 years (30 healthy volunteers, 51 asthmatics, and 20 children with various other respiratory diseases) in our pulmonary function laboratory. On-line and off-line eNO were compared in a single session, and analyzed with a Sievers NOA 280 nitric oxide analyzer. For both methods of collecting expired gas, subjects did a single exhalation without breath-holding against an expiratory pressure 10 cm H(2)O. We investigated the effects of expiratory flow, dead space, and exhalation time on eNO; we also compared on-line and off-line eNO measurements, and the repeatability of both techniques at a given flow rate. Expiratory flows of 58 mL/sec provided more reproducible data than lower flows (coefficient of repeatability 1.1 ppb for 58 mL/sec vs. 2.8 for 27 mL/sec vs. 5.7 for 18 mL/sec). eNO concentrations were about 25% higher in off-line than in on-line recordings if the initial 250 mL of exhaled gas were not eliminated, and 37% higher if exhalation lasted longer (16 sec vs. 8 sec). Eliminating 250 mL of dead space and shortening the filling time to 8 sec yielded off-line eNO values close to those on-line (geometric mean off-line eNO 14.4 ppb, 95% confidence interval: 12.2-17.0) vs. on-line eNO 13.8 ppb (95% confidence interval: 11.6-16.5). On-line and off-line results were highly correlated (r = 0.996, P = 0.000) and had

Exhaled nitric oxide in paediatric asthma and cystic fibrosis.

PubMed Central

Lundberg, J O; Nordvall, S L; Weitzberg, E; Kollberg, H; Alving, K

1996-01-01

Nitric oxide (NO) is present in exhaled air of humans. This NO is mostly produced in the upper airways, whereas basal NO excretion in the lower airways is low. Children with Kartagener's syndrome have an almost total lack of NO in nasally derived air, whereas adult asthmatics have increased NO in orally exhaled air. NO excretion was measured in the nasal cavity and in orally exhaled air in 19 healthy children, in 36 age matched subjects with asthma, and in eight children with cystic fibrosis. NO levels in orally exhaled air were similar in controls and in children with cystic fibrosis, at 4.8 (SD 1.2) v 5.8 (0.8) parts per billion (ppb), but were increased in asthmatic children who were untreated or were being treated only with low doses of inhaled steroids (13.8 (2.5) ppb). Nasal NO levels were reduced by about 70% in children with cystic fibrosis compared to controls and asthmatics. Measurements of airway NO release in different parts of the airways may be useful in non-invasive diagnosis and monitoring of inflammatory airway diseases. PMID:8984919

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...

[Fractional exhaled nitric oxide in monitoring and therapeutic management of asthma].

PubMed

Melo, Bruno; Costa, Patrício; Afonso, Ariana; Machado, Vânia; Moreira, Carla; Gonçalves, Augusta; Gonçalves, Jean-Pierre

2014-01-01

Asthma is a chronic respiratory disease characterized by hyper-responsiveness and bronchial inflammation. The bronchial inflammation in these patients can be monitored by measuring the fractional exhaled nitric oxide. This study aims to determine fractional exhaled nitric oxide association with peak expiratory flow and with asthma control inferred by the Global Initiative for Asthma. Observational, analytical and cross-sectional study of children with asthma, 6-12 years-old, followed in the Outpatient Respiratory Pathology of Braga Hospital. Sociodemographic and clinical information were collected through a questionnaire. fractional exhaled nitric oxide and peak expiratory flow were determined by portable analyzer Niox Mino® and flow meter, respectively. The sample is constituted by 101 asthmatic children, 63 (62.4%) of males and 38 (37.6%) females. The mean age of participants in the sample is 9.18 (1.99) years. The logistic regression performed with the cutoff value obtained by ROC curve, revealed that fractional exhaled nitric oxide (b(FENO classes) = 0.85; χ(2)Wald (1) = 8.71; OR = 2.33; p = 0.003) has a statistical significant effect on the probability of changing level of asthma control. The odds ratio of going from "controlled" to "partly controlled/uncontrolled" is 2.33 per each level of fractional exhaled nitric oxide. The probability of an asthmatic children change their level of asthma control, from 'controlled' to 'partly controlled/uncontrolled', taking into account a change in their fractional exhaled nitric oxide level, increases 133%.

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.

Increased ethane exhalation, an in vivo index of lipid peroxidation, in alcohol-abusers.

PubMed Central

Lettéron, P; Duchatelle, V; Berson, A; Fromenty, B; Fisch, C; Degott, C; Benhamou, J P; Pessayre, D

1993-01-01

Ethane exhalation was measured in 42 control subjects, 52 patients with various non-alcoholic liver diseases, and 89 alcohol abusers who had been admitted to hospital for alcohol withdrawal and assessment of liver disease (six with normal liver tests, 10 with steatosis with or without fibrosis, six with alcoholic hepatitis, 29 with cirrhosis, 34 with both cirrhosis and alcoholic hepatitis, and four with both cirrhosis and a hepatocellular carcinoma). Ethane exhalation was similar in control subjects and in patients with non-alcoholic liver diseases, but was five times higher in alcohol abusers. Ethane exhalation in alcohol abusers was significantly, but very weakly, correlated with the daily ethanol intake before hospital admission, and the histological score for steatosis, but not with the inflammation or alcoholic hepatitis scores. Ethane exhalation was inversely correlated with the duration of abstinence before the test. In nine alcoholic patients, the exhalation of ethane was measured repeatedly, and showed slow improvement during abstinence. Ethane exhalation was significantly but weakly correlated with the Pugh's score in patients with alcoholic cirrhosis. It is concluded that the mean ethane exhalation is increased in alcohol abusers. One of the possible mechanisms may be the presence of oxidizable fat in the liver. The weak correlation with the Pugh's score is consistent with the contribution of many other factors in the progression to severe liver disease. PMID:8472992

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

Effects of a leukotriene receptor antagonist on exhaled leukotriene E4 and prostanoids in children with asthma.

PubMed

Montuschi, Paolo; Mondino, Chiara; Koch, Pierluigi; Barnes, Peter J; Ciabattoni, Giovanni

2006-08-01

Leukotriene (LT) E(4) and 8-isoprostane concentrations are elevated in exhaled breath condensate in children with asthma. The effects of leukotriene receptor antagonists (LTRAs) on exhaled leukotriene and prostanoids in children with asthma are unknown. (1) To study the effect of montelukast, a LTRA, on exhaled LTE(4), 8-isoprostane, and prostaglandin E(2) in children with asthma and atopic children; (2) to measure exhaled nitric oxide. An open-label study with oral montelukast (5 mg once daily for 4 weeks) was undertaken in 17 atopic children with asthma and 16 atopic children without asthma. Pretreatment exhaled LTE(4) (P < .0001) and 8-isoprostane (P < .0001) values were higher in atopic children with asthma than in atopic children without asthma. In atopic children with asthma, montelukast reduced exhaled LTE(4) by 33% (P < .001), and this reduction was correlated with pretreatment LTE(4) values (r = -0.90; P = .0001). Posttreatment exhaled LTE(4) levels in children with asthma were higher than pretreatment LTE(4) values in atopic children without asthma (P < .004). Montelukast had no effect on exhaled LTE(4) in atopic children without asthma (P = .74), or on exhaled 8-isoprostane (atopic children with asthma, P = .94; atopic children without asthma, P = .55) and PGE(2) (atopic children with asthma, P = .56; atopic children without asthma, P = .93) in both groups. In atopic children with asthma, exhaled nitric oxide concentrations were reduced by 27% (P < .05) after montelukast. Leukotriene receptor antagonists decrease exhaled LTE(4) in atopic children with asthma. This reduction is dependent on baseline exhaled LTE(4) values. Measurement of exhaled LTE(4) might help identify children with asthma most likely to benefit from LTRAs.

The influence of dilution on the offline measurement of exhaled nitric oxide.

PubMed

MacBean, Victoria; Pooranampillai, Dharmika; Howard, Catherine; Lunt, Alan; Greenough, Anne

2018-02-26

Measurement of fractional exhaled nitric oxide (FeNO) is used to determine the presence and severity of eosinophilic airway inflammation in asthma and other wheezing illnesses. The gold standard of online measurement during a single prolonged exhalation is not suitable for use in young children. The international guidelines for offline measurements recommend collection of exhaled gas in an appropriate reservoir for later analysis in young children. The apparatus required for gas collection, however, creates dead space within the system, which may result in sample dilution and hence inaccuracy. Our objective was to investigate the effect such dilution might have on the accuracy of offline FeNO by comparing the results to online results. Thirty-five adult subjects without respiratory disease underwent online measurement of FeNO and, thereafter, undertook offline FeNO measurements via exhalation into a collection reservoir using one, five or ten inhalation-exhalation cycles. Fifteen of the subjects also exhaled using the five-breath technique via apparatus with additional dead space. An equation incorporating dead space volume and the number of breaths was used to predict the degree of dilution; the predicted results were compared to the measured results. The median (IQR) FeNO from a one-breath technique (22 (15-28) ppb was not significantly different to online values (19 (12-27) ppb, p  =  1.00), but the results from the five-breath technique (11 (4-19) ppb, p  <  0.0001), the ten-breath technique (6 (4-15) ppb, p  <  0.0001) and the additional dead space experiment (6 (3-8) ppb, p  =  0.0006) were significantly lower than online FeNO. Measured values were consistently significantly different to those predicted by the dilution equation, even when incorporating the exact exhaled volume of gas. Offline FeNO results may be inaccurate when subjects are unable to fill the collection reservoir with a single exhalation, thus the technique may

Exhaled methyl nitrate as a noninvasive marker of hyperglycemia in type 1 diabetes

PubMed Central

Novak, B. J.; Blake, D. R.; Meinardi, S.; Rowland, F. S.; Pontello, A.; Cooper, D. M.; Galassetti, P. R.

2007-01-01

Recent technical advances allow detection of several hundred volatile organic compounds (VOCs) in human exhaled air, many of which reflect unidentified endogenous pathways. Our group has previously estimated plasma glucose levels in healthy adults during a standard oral glucose tolerance test via exhaled VOC analysis. As a result of the metabolic characteristics of hyperglycemia in the diabetic (low insulin and increased free fatty acids and ketones), we hypothesized that different exhaled VOC profiles may be present in children with type 1 diabetes mellitus (T1DM) during spontaneous hyperglycemia. Exhaled methyl nitrate strongly correlated specifically with the acute, spontaneous hyperglycemia of T1DM children. Eighteen experiments were conducted among 10 T1DM children. Plasma glucose and exhaled gases were monitored during either constant euglycemia (n = 5) or initial hyperglycemia with gradual correction (n = 13); all subjects received i.v. insulin and glucose as needed. Gas analysis was performed on 1.9-liter breath samples via gas chromatography using electron capture, flame ionization, and mass selective detection. Among the ≈100 measured exhaled gases, the kinetic profile of exhaled methyl nitrate, commonly present in room air in the range of 5–10 parts per trillion, was most strongly statistically correlated with that of plasma glucose (P = 0.003–0.001). Indeed, the kinetic profiles of the two variables paralleled each other in 16 of 18 experiments, including repeat subjects who at different times displayed either euglycemia or hyperglycemia. PMID:17895380

Recent analytical approaches to detect exhaled breath ammonia with special reference to renal patients.

PubMed

Krishnan, Sanduru Thamarai; Devadhasan, Jasmine Pramila; Kim, Sanghyo

2017-01-01

The ammonia odor from the exhaled breath of renal patients is associated with high levels of blood urea nitrogen. Typically, in the liver, ammonia and ammonium ions are converted into urea through the urea cycle. In the case of renal dysfunction, urea is unable to be removed and that causes a buildup of excessive ammonia. As small molecules, ammonia and ammonium ions can be forced into the blood-lung barrier and occur in exhaled breath. Therefore, people with renal failure have an ammonia (fishy) odor in their exhaled breath. Thus, exhaled breath ammonia can be a potential biomarker for monitoring renal diseases during hemodialyis. In this review, we have summarized the source of ammonia in the breath of end-stage renal disease patient, cause of renal disorders, exhaled breath condensate, and breath sampling. Further, various biosensor approaches to detect exhaled ammonia from renal patients and other ammonia systems are also discussed. We conclude with future perspectives, namely colorimetric-based real-time breathing diagnosis of renal failure, which might be useful for prospective studies.

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.

Proteomics of exhaled breath: methodological nuances and pitfalls.

PubMed

Kurova, Viktoria S; Anaev, Eldar C; Kononikhin, Alexey S; Fedorchenko, Kristina Yu; Popov, Igor A; Kalupov, Timothey L; Bratanov, Dmitriy O; Nikolaev, Eugenie N; Varfolomeev, Sergey D

2009-01-01

The analysis of exhaled breath condensate (EBC) can be an alternative to traditional endoscopic sampling of lower respiratory tract secretions. This is a simple non-invasive method of diagnosing respiratory diseases, in particular, respiratory inflammatory processes. Samples were collected with a special device-condenser (ECoScreen, VIASYS Healthcare, Germany), then treated with trypsin according to the proteomics protocol for standard protein mixtures and analyzed by nanoflow high-performance liquid chromatography tandem mass spectrometry (HPLC-MS/MS) with a 7-Tesla Finnigan LTQ-FT mass spectrometer (Thermo Electron, Germany). Mascot software (Matrixscience) was used for screening the database NCBInr for proteins corresponding to the peptide maps that were obtained. EBCs from 17 young healthy non-smoking donors were collected. Different methods for concentrating protein were compared in order to optimize EBC preparations for proteomic analysis. The procedure that was chosen allowed identification of proteins exhaled by healthy people. The major proteins in the condensates were cytoskeletal keratins. Another 12 proteins were identified in EBC from healthy non-smokers. Some keratins were found in the ambient air and may be considered exogenous components of exhaled air. Knowledge of the normal proteome of exhaled breath allows one to look for biomarkers of different disease states in EBC. Proteins in ambient air can be identified in the respiratory tract and should be excluded from the analysis of the proteome of EBC. The results obtained allowed us to choose the most effective procedure of sample preparation when working with samples containing very low protein concentrations.

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.

Prognostic Role of Exhaled Breath Condensate pH and Fraction Exhaled Nitric Oxide in Systemic Sclerosis Related Interstitial Lung Disease.

PubMed

Guillen-Del Castillo, Alfredo; Sánchez-Vidaurre, Sara; Simeón-Aznar, Carmen P; Cruz, María J; Fonollosa-Pla, Vicente; Muñoz, Xavier

2017-03-01

Interstitial lung disease (ILD) is one of the major causes of death in systemic sclerosis (SSc). This study investigated exhaled breath (EB) and exhaled breath condensate (EBC) biomarkers in patients with SSc and analyzed their role as a prognostic tool in SSc-related ILD. Fraction exhaled nitric oxide (FeNO) and exhaled carbon monoxide (eCO) measured in EB, together with pH, nitrite, nitrate and interleukin-6 levels measured in EBC were prospectively analyzed in 35 patients with SSc. Twelve patients had established ILD by chest high-resolution computed tomography (HRCT), and 23 patients showed no evidence of ILD. EB and EBC biomarkers were determined at inclusion, and pulmonary function tests were annually performed during 4 years of follow-up. No differences at baseline biomarkers levels were found between groups. In all patients studied, low EBC pH levels were associated with a decreased diffusing capacity for carbon monoxide (DLCO) during follow-up. Low FeNO levels were correlated with lower forced vital capacity (FVC) at baseline, 4years of follow-up and with a decrease in FVC and DLCO during monitoring. Among ILD patients, high eCO levels were correlated with lower baseline FVC. In the global cohort, a worse progression-free survival was identified in patients with EBC pH values lower than 7.88 and FeNO levels lower than 10.75ppb (Log Rank P=.03 and P<.01, respectively). EB and EBC could help to detect patients likely to present a deterioration on lung function during follow up. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

Change of Exhaled Acetone Concentration in a Diabetic Patient with Acute Decompensated Heart Failure.

PubMed

Yokokawa, Tetsuro; Ichijo, Yasuhiro; Houtsuki, Yu; Matsumoto, Yoshiyuki; Oikawa, Masayoshi; Yoshihisa, Akiomi; Sugimoto, Koichi; Nakazato, Kazuhiko; Suzuki, Hitoshi; Saitoh, Shu-Ichi; Shimouchi, Akito; Takeishi, Yasuchika

2017-10-21

In heart failure patients, exhaled acetone concentration, a noninvasive biomarker, is increased according to heart failure severity. Moreover, exhaled acetone concentration is also known to be affected by diabetes mellitus. However, there have been no reports on exhaled acetone concentration in heart failure patients with diabetes mellitus. A 77-year old man was admitted to our hospital with acute decompensated heart failure and atrioventricular block. He had controlled diabetes mellitus under insulin treatment with hemoglobin A1c of 6.5%. He underwent treatment of diuretics and permanent pacemaker implantation. His condition improved and he was discharged at Day 12. Due to the heart failure improvement, his levels of exhaled acetone concentration decreased from 1.623 ppm at admission to 0.664 ppm at discharge. This is the first report to reveal a change of exhaled acetone concentration in a diabetic patient with acute decompensated heart failure.

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...

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

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

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.

Radon exhalation rates from some soil samples of Kharar, Punjab

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mehta, Vimal; Deptt of Physics, Punjabi University, Patiala- 147 001; Singh, Tejinder Pal, E-mail: tejinders03@gmail.com

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 areamore » 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.« less

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.

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.

Electret filter collects more exhaled albumin than glass condenser: A method comparison based on human study.

PubMed

Jia, Ziru; Liu, Hongying; Li, Wang; Xie, Dandan; Cheng, Ke; Pi, Xitian

2018-02-01

In recent years, noninvasive diagnosis based on biomarkers in exhaled breath has been extensively studied. The procedure of biomarker collection is a key step. However, the traditional condenser method has low efficacy in collecting nonvolatile compounds especially the protein biomarkers in breath. To solve this deficiency, here we propose an electret filter method.Exhaled breath of 6 volunteers was collected with a glass condenser and an electret filter. The amount of albumin was analyzed. Furthermore, the difference of exhaled albumin between smokers and nonsmokers was evaluated.The electret filter method collected more albumin than the glass condenser method at the same breath volume level (P < .01). Smokers exhaling more albumin than nonsmokers were also observed (P < .01).The electret filter is capable of collecting proteins more effectively than the condenser method. In addition, smokers tend to exhale more albumin than nonsmokers.

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

PubMed

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

2016-12-01

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. © 2016 Marshfield Clinic.

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...

Exhaled nitric oxide levels in exacerbations of asthma, chronic obstructive pulmonary disease and pneumonia.

PubMed

Al-Ali, M K; Howarth, P H

2001-03-01

Nitric oxide is known to be present in the exhaled air of normal subjects and at higher concentrations in asthmatics. The aim of this study was to measure exhaled nitric oxide levels in patients admitted to hospital with acute exacerbations of asthma, or chronic obstructive pulmonary disease, or with pneumonia. Within 24 hours of admission exhaled nitric oxide levels were measured by a chemiluminescent analyzer in 11 patients with acute sever asthma, 19 patients with acute exacerbation of chronic obstructive pulmonary disease, and in 12 patients with pneumonia. In asthmatics measurements were made on 3 occasions, at day 1, 4, and 28 and were related to changes in peak expiratory flow rate. On admission median exhaled nitric oxide levels (range) were significantly higher in asthmatics 22 (9.3-74) parts per billion in comparison to patients with chronic obstructive pulmonary disease 10.3 (2.7-34) parts per billion; p < 0.01, pneumonia 7 (4-17) parts per billion; p<0.001, and normal subjects 8.7 (5-13.3) parts per billion; p < 0.001. Following treatment the asthmatics had a significant reduction in their exhaled nitric oxide levels from 22 (9.3-74) parts per billion on day 1 to 9.7 (5.7-18.3) parts per billion on day 28; p = 0.005. Peak expiratory flow rate measurements increased from 200 (120-280) l/min on day 1 to 280 (150-475) l/min on day 4; p < 0.05 and to 390 (150-530) l/min on day 28; p < 0.01. A strong negative correlation existed between peak expiratory flow rate measurements and exhaled nitric oxide levels in asthmatics on day 28 (r = -0.70; p = 0.017). Acute exacerbations of asthma are associated with increased levels of exhaled nitric oxide in contrast to exacerbations of chronic obstructive pulmonary disease and acute pneumonia. Exhaled nitric oxide may be a useful indirect marker of asthmatic airway inflammation. The differing time course of response of nitric oxide to peak flow measures suggests that these two measures are reflecting differing airway

Effect of exhaled moisture on breathing resistance of N95 filtering facepiece respirators.

PubMed

Roberge, Raymond J; Bayer, Emily; Powell, Jeffrey B; Coca, Aitor; Roberge, Marc R; Benson, Stacey M

2010-08-01

This study evaluated the effect of exhaled moisture on the breathing resistance of three classes of filtering facepiece respirators (FFR) following 4 h of continuous wear at a breathing volume of 40 l min(-1), utilizing an automated breathing and metabolic simulator as a human surrogate. After 4 h, inhalation and exhalation resistance increased by 0.43 and 0.23 mm of H(2)O pressure, respectively, and average moisture retention in the respirators was 0.26 ml. Under ambient conditions similar to those of the current study, and at similar breathing volumes, it is unlikely that exhaled moisture will add significantly to the breathing resistance of filtering facepiece respirators (FFR) over 4 h of use.

Measurement of 222Rn and 220Rn exhalation rate from soil samples of Kumaun Hills, India

NASA Astrophysics Data System (ADS)

Semwal, Poonam; Singh, Kuldeep; Agarwal, T. K.; Joshi, Manish; Pant, Preeti; Kandari, Tushar; Ramola, R. C.

2018-03-01

The source terms, i.e., exhalation and emanation from soil and building materials are the primary contributors to the radon (222Rn)/thoron (220Rn) concentration levels in the dwellings, while the ecological constraints like ventilation rate, temperature, pressure, humidity, etc., are the influencing factors. The present study is focused on Almora District of Kumaun, located in Himalayan belt of Uttarakhand, India. For the measurement of 222Rn and 220Rn exhalation rates, 24 soil samples were collected from different locations. Gamma radiation level was measured at each of these locations. Chamber technique associated with Smart Rn Duo portable monitor was employed for the estimation of 222Rn and 220Rn exhalation rates. Radionuclides (226Ra, 232Th and 40K) concentrations were also measured in soil samples using NaI(Tl) scintillation based gamma ray spectrometry. The mass exhalation rate for 222Rn was varying between 16 and 54 mBq/kg/h, while the 220Rn surface exhalation rate was in the range of 0.65-6.43 Bq/m2/s. Measured gamma dose rate for the same region varied from 0.10 to 0.31 µSv/h. Inter-correlation of exhalation rates and intra-correlation with background gamma levels were studied.

Exhaled isoprene for monitoring recovery from acute hypoxic stress.

PubMed

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

2017-11-29

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 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, log 2 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% O 2 , p = 0.152). Furthermore, examination of pre-/post-exposure 1 l bag breath samples illustrate an overall increase in exhaled isoprene abundance post-exposure (log 2 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 O 2 concentration when plotted against minimum oxygen saturation (p = 0.0419 100% O 2 , p = 0.7034 21% O 2 ). 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.

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.

Exhaled nitric oxide in a population-based study of asthma and allergy in schoolchildren.

PubMed

Nordvall, S L; Janson, C; Kalm-Stephens, P; Foucard, T; Torén, K; Alving, K

2005-04-01

Exhaled nitric oxide (NO) reflects inflammation in the lower airways and is well adapted for use in children. The aims of this study were to investigate the distribution of the fraction of expired NO (FENO) in school children and to compare FENO and spirometry in relation to the International Study of Asthma and Allergies in Childhood questionnaire. The study was performed in 959 randomly selected 13-14-year-old school children in Uppsala, Sweden. Exhaled NO was measured at an inhalation rate of 0.1 l/s (FENO0.1) and a spirometric test was performed and data from these measurements were related to questionnaire data. Exhaled NO was measured according to American Thoracic Society recommendations, except the use of a mouth wash and an exhalation flow rate of 0.1 l/s. The distribution of the mean FENO0.1 values was skewed, with a preponderance of very low levels and a widespread tail of values ranging up to 102 parts per billion (ppb). Boys exhibited significantly higher mean FENO0.1 values than girls, 5.2 (4.7-5.7) vs 4.4 (4.0-4.8) ppb (geometric mean and 95% CI), P <0.01). Children who reported wheezing in the last year had higher FENO0.1 values than children that had not, 8.5 (7.1-10.2) vs 4.3 (4.0-4.6) ppb, P <0.001). The same association was found to most symptoms indicating hay fever and eczema. In contrast to this, only weak or inconsistent associations were found between asthma and spirometric indices. Exhaled NO levels were found to be independently related to male gender, wheeze and rhinoconjuctivitis but not to current eczema. In conclusion, exhaled NO was closely associated with reported asthma and allergy symptoms whereas spirometric indices such as percent predicted forced expiratory volume in 1 s were not. As most asthma cases in a population are mild, the findings suggest that exhaled NO is a sensitive marker of asthma and allergy.

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.

Relationships of online exhaled, offline exhaled, and ambient nitric oxide in an epidemiologic survey of schoolchildren.

PubMed

Linn, William S; Berhane, Kiros T; Rappaport, Edward B; Bastain, Tracy M; Avol, Edward L; Gilliland, Frank D

2009-11-01

Field measurements of exhaled nitric oxide (FeNO) and ambient nitric oxide (NO) are useful to assess both respiratory health and short-term air pollution exposure. Online real-time measurement maximizes data quality and comparability with clinical studies, but offline delayed measurement may be more practical for large epidemiological studies. To facilitate cross-comparison in larger studies, we measured FeNO and concurrent ambient NO both online and offline in 362 children at 14 schools in 8 Southern California communities. Offline breath samples were collected in bags at 100 ml/s expiratory flow with deadspace discard; online FeNO was measured at 50 ml/s. Scrubbing of ambient NO from inhaled air appeared to be nearly 100% effective online, but 50-75% effective offline. Offline samples were stored at 2-8 degrees C and analyzed 2-26 h later at a central laboratory. Offline and online FeNO showed a nearly (but not completely) linear relationship (R(2)=0.90); unadjusted means (ranges) were 10 (4-94) and 15 (3-181) p.p.b., respectively. Ambient NO concentration range was 0-212 p.p.b. Offline FeNO was positively related to ambient NO (r=0.30, P<0.0001), unlike online FeNO (r=0.09, P=0.08), indicating that ambient NO artifactually influenced offline measurements. Offline FeNO differed between schools (P<0.001); online FeNO did not (P=0.26), suggesting artifacts related to offline bag storage and transport. Artifact effects were small in comparison with between-subject variance of FeNO. An empirical statistical model predicting individual online FeNO from offline FeNO, ambient NO, and lag time before offline analysis gave R(2)=0.94. Analyses of school or age differences yielded similar results from measured or model-predicted online FeNO. Either online or offline measurement of exhaled NO and concurrent ambient NO can be useful in field epidemiology. Influence of ambient NO on exhaled NO should be examined carefully, particularly for offline measurements.

Comparison of exhalation time methods (6 sec vs. 10 sec) of a hand-held exhaled nitric oxide analyzer.

PubMed

Ito, Yasunori; Adachi, Yuichi; Itazawa, Toshiko; Okabe, Yoshie; Adachi, Yoko S; Katsumuma, Toshio; Miyawaki, Toshio

2010-10-01

Standard exhalation time for measuring fractional exhaled nitric oxide (FeNO) is 10 sec, but this is not easy for younger children. We aimed to investigate the agreement between FeNO values during 10-sec (FeNO-10) and 6-sec (FeNO-6) exhalation and the feasibility of measuring FeNO-6, using a hand-held analyzer, NIOX-MINO®. FeNO values measured during 10- and 6-sec (random order) were compared. Success rates of the two different time modes were also evaluated. In 119 asthmatic children (median age 8 years [range 4-15]) who had been already accustomed to NIOX-MINO®, median FeNO-10 (29 ppb [IQR 15.2-42.0]) and FeNO-6 (27 ppb [IQR 16.0-43.5]) did not differ significantly (P = 0.90), and there was a good correlation between both values (r = 0.984, P < 0.001). Mean difference (FeNO-10-FeNO-6) was -0.151 ppb (95% CI: -0.95 to 0.65, limits of agreement: -8.8 to 8.5). In 46 asthmatic children (median age 7 years [range 4-15]) who had never used any FeNO analyzers, all the children aged 8 years and more (n = 21) succeeded in measuring FeNO on both time modes, whereas for children aged younger than 8 years (n = 25) success rates of the 10- and 6-sec mode were 60.0% and 92.0%, respectively. In conclusion, we showed good agreement between FeNO-10 and FeNO-6, and the 6-sec mode of NIOX-MINO® is more feasible than 10-sec mode for measuring FeNO in younger children. © 2010 Wiley-Liss, Inc.

Abnormal exhaled ethane concentrations in scleroderma.

PubMed

Cope, K A; Solga, S F; Hummers, L K; Wigley, F M; Diehl, A M; Risby, T H

2006-01-01

Scleroderma (systemic sclerosis) is a chronic multisystem autoimmune disease in which oxidative stress is suspected to play a role in the pathophysiology. Therefore, it was postulated that patients with scleroderma would have abnormally high breath ethane concentrations, which is a volatile product of free-radical-mediated lipid peroxidation, compared with a group of controls. There was a significant difference (p<0.05) between the mean exhaled ethane concentration of 5.27 pmol ml(-1) CO(2) (SEM=0.76) in the scleroderma patients (n=36) versus the mean exhaled concentration of 2.72 pmol ml(-1) CO(2) (SEM=0.71) in a group of healthy controls (n=21). Within the scleroderma group, those subjects taking a calcium channel blocker had lower ethane concentrations compared with patients who were not taking these drugs (p=0.05). There was a significant inverse association between lung diffusion capacity for carbon monoxide (per cent of predicted) and ethane concentration (b=-2.8, p=0.026, CI=-5.2 to -0.35). These data support the presence of increased oxidative stress among patients with scleroderma that is detected by measuring breath ethane concentrations.

Central Irish geology/metallogeny: A lower Carboniferous rifting-related exhalative catastrophy?

NASA Astrophysics Data System (ADS)

Deeny, D. E.

1987-04-01

The geological background and development of a recently presented Irish Carboniferous metallogenic model is outlined. A new (exhalative-based) interpretation of existing central Irish tectonic, stratigraphic, sedimentological and sulphur isotopic data is shown to be consistent with the model, which suggests that stratiform sulphide metallogeny and the central Irish Waulsortian mudbank complex may be the manifestation of a rifting-related exhalative catastrophy. In this view sulphur isotope age curves of the whole world ocean may indicate that phases of globally synchronous (in the relative sense) rifting may have been a feature of the Phanerozoic record.

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.

Effects of Heat and Moisture Exchangers and Exhaled Humidity on Aerosol Deposition in a Simulated Ventilator-Dependent Adult Lung Model.

PubMed

Ari, Arzu; Alwadeai, Khalid S; Fink, James B

2017-05-01

Many in vitro models report higher inhaled dose with dry versus heated humidity. Heat-and-moisture exchangers (HMEs) provide passive humidity in ventilator-dependent patients but act as a barrier to aerosol. The HMEs designed to allow aerosol delivery (HME-ADs) have not been well described. The purpose of this study is to determine the impact on aerosol deposition of HME-ADs with and without active exhaled humidity in a simulated ventilator-dependent adult model. We used an in vitro lung model consisting of an intubated teaching mannequin with an endotracheal tube of 8.0 mm inner diameter with bronchi directly attached to a collecting filter and passive rubber test lung to provide testing without active exhaled humidity. To simulate exhaled humidity, a Cascade humidifier (37°C and 100% relative humidity) was placed between the collecting filter and test lung, simulating body temperature and pressure saturated exhaled humidity at the bronchi. Albuterol sulfate (2.5 mg/3 mL) was administered with a mesh nebulizer (Aerogen Solo) placed in the inspiratory limb of the ventilator circuit at the Y-piece, with no HME in place (control) and with 3 HME-AD devices, including the CircuVent, Humid-Flo, and AirLife, with and without exhaled humidity. Drug was eluted from the collecting filter and analyzed with spectrophotometry. Student t tests and analysis of variance were used for data analysis ( P < .05). The percentage of drug dose delivered (mean ± SD) distal to the bronchi in the control experiments was greater than all of the HME-ADs without exhaled humidity 18 ± 0.7 and with active exhaled humidity 10.8 ± 0.2% ( P < .005). Without exhaled humidity, aerosol delivery with the CircuVent (12.6 ± 0.8), Humid-Flo (15.3 ± 0.8), and AirLife (12.0 ± 0.5) was less than control ( P < .001, P = .01 and P < .001, respectively). In contrast, with exhaled humidity, no difference was found between control and HME-ADs ( P = .89). Also, a greater variation between control and the 3

Exhaled nitric oxide levels in school children in relation to IgE sensitisation and window pane condensation.

PubMed

Janson, Christer; Kalm-Stephens, Pia; Foucard, Tony; Norbäck, Dan; Alving, Kjell; Nordvall, S Lennart

2005-08-01

A positive relation between exhaled nitric oxide (NO) levels and allergen exposure has been found in some studies whereas there is less information on how non-allergen environmental factors influences exhaled NO. To study the relationship between exhaled NO levels in schoolchildren in relation to IgE sensitisation and allergenic and non-allergenic environmental factors. This study comprised 374 schoolchildren (13-14 years of age) who performed exhaled NO-measurements and skin prick tests. Exposure to allergens, respiratory infections, environmental tobacco smoke and home window pane condensation, the latter an indicator of high humidity and poor ventilation was evaluated through questionnaires. In IgE-sensitised children sensitisation to pets was a more important determinant of exhaled NO than sensitisation to pollen. Higher NO levels were found in cat-sensitised children with a cat or other furred pets at home compared to cat-sensitised children without pets (geometric mean, 24.0 vs. 13.9 ppb, P=0.03). Significantly higher exhaled NO levels were found in non-sensitised children that reported having a cold (5.7 vs. 3.8 ppb, P<0.001) or lived in homes with window pane condensation (7.1 vs. 4.4 ppb, P=0.01) than in non-sensitised children without a cold and window pane condensation, respectively. These associations were not found in children that were sensitised to inhalation allergens. Allergen exposure seems to be the most important determinant for exhaled NO levels in IgE-sensitised children whereas in non-sensitised children NO levels were associated with respiratory infections and home window pane condensation.

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mazur, J.; Kozak, K., E-mail: Krzysztof.Kozak@ifj.edu.pl

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 mademore » 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.« less

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.

[Blocking the spray of contaminants from patients' exhalent using a tracheal detecting bulb during endotracheal intubation].

PubMed

Tong, You-liang; Sun, Ming; Wang, Zhen; Li, Bin; Xie, Jue; Ye, Hui

2011-11-01

To examine the effect of a newly-developed tracheal detecting-bulb (TDB) in preventing the spray of contaminants in patients' exhalent during emergency endotracheal intubation procedure. 62 emergency patients (male or female, age 21-73 years, weight 47-83 kg, with different levels of consciousness and spontaneous breathing) were randomly divided into two groups (n =31 each) to receive endotracheal intubation by an anesthesiologist with more than 17 years of experience, with (TDB group) or without (control group) a TDB connected to the tracheal tubing. Records were taken regarding the patient's coughing, expansion / contraction of the TDB, the operator's feeling of the patient's exhalent on his face / neck and the contamination of these areas by blood / secretions from the patients in the due course. In TDB group, expansion / contraction of TDB occurred in all cases, but the operator felt no exhalent in any of them. In 9 cases the patients coughed but the operator was contaminated only in 2 cases. While in control group, the patients' exhalent was felt in 16 cases. Coughing were recorded in 7 cases, and the operator was contaminated in 11 cases. In comparison with the control group, TDB group had significantly lower(both P < 0.05), incidence in feeling the exhalent (0 vs. 16), and contamination by blood or secretions (2 vs. 11) although the two groups had no significant difference in the incidence of coughing (9 vs. 7, P > 0.05). TDB can play an important role in blocking the spray of contaminants in patients' exhalent during endotracheal intubation.

Evaluation of a new simple collection device for sampling of microparticles in exhaled breath.

PubMed

Seferaj, Sabina; Ullah, Shahid; Tinglev, Åsa; Carlsson, Sten; Winberg, Jesper; Stambeck, Peter; Beck, Olof

2018-03-12

The microparticle fraction of exhaled breath is of interest for developing clinical biomarkers. Exhaled particles may contain non-volatile components from all parts of the airway system, formed during normal breathing. This study aimed to evaluate a new, simple sampling device, based on impaction, for collecting microparticles from exhaled breath. Performance of the new device was compared with that of the existing SensAbues membrane filter device. The analytical work used liquid chromatography-tandem mass spectrometry methods. The new device collected three subsamples and these were separately analysed from eight individuals. No difference was observed between the centre position (0.91 ng/sample) and the side positions (1.01 ng/sample) using major phosphatidylcholine (PC) 16:0/16:0 as the analyte. Exhaled breath was collected from eight patients on methadone maintenance treatment. The intra-individual variability in measured methadone concentration between the three collectors was 8.7%. In another experiment using patients on methadone maintenance treatment, the sampling efficiency was compared with an established filter device. Compared to the existing device, the efficiency of the new device was 121% greater for methadone and 1450% greater for DPPC. The data from lipid analysis also indicated that a larger fraction of the collected material was from the distal parts. Finally, a study using an optical particle counter indicated that the device preferentially collects the larger particle fraction. In conclusion, this study demonstrates the usefulness of the new device for collecting non-volatile components from exhaled breath. The performance of the device was superior to the filter device in several aspects.

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.

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.

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 § 84...

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 § 84...

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 § 84...

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 § 84...

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 § 84...

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.

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.

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.

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

Exhaled breath profiling using broadband quantum cascade laser-based spectroscopy in healthy children and children with asthma and cystic fibrosis.

PubMed

van Mastrigt, E; Reyes-Reyes, A; Brand, K; Bhattacharya, N; Urbach, H P; Stubbs, A P; de Jongste, J C; Pijnenburg, M W

2016-04-08

Exhaled breath analysis is a potential non-invasive tool for diagnosing and monitoring airway diseases. Gas chromatography-mass spectrometry and electrochemical sensor arrays are the main techniques to detect volatile organic compounds (VOC) in exhaled breath. We developed a broadband quantum cascade laser spectroscopy technique for VOC detection and identification. The objective of this study was to assess the repeatability of exhaled breath profiling with broadband quantum cascade laser-based spectroscopy and to explore the clinical applicability by comparing exhaled breath samples from healthy children with those from children with asthma or cystic fibrosis (CF). Healthy children and children with stable asthma or stable CF, aged 6-18 years, were included. Two to four exhaled breath samples were collected in Tedlar bags and analyzed by quantum cascade laser spectroscopy to detect VOCs with an absorption profile in the wavenumber region between 832 and 1262.55 cm(-1). We included 35 healthy children, 39 children with asthma and 15 with CF. Exhaled breath VOC profiles showed poor repeatability (Spearman's rho  =  0.36 to 0.46) and agreement of the complete profiles. However, we were able to discriminate healthy children from children with stable asthma or stable CF and identified VOCs that were responsible for this discrimination. Broadband quantum cascade laser-based spectroscopy detected differences in VOC profiles in exhaled breath samples between healthy children and children with asthma or CF. The combination of a relatively easy and fast method and the possibility of molecule identification makes broadband quantum cascade laser-based spectroscopy attractive to investigate the diagnostic and prognostic potential of volatiles in exhaled breath.

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.

42 CFR 84.91 - Breathing resistance test; exhalation.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 25 mm. (1 inch) water-column height. (c) The exhalation resistance of pressure-demand apparatus shall not exceed the static pressure in the facepiece by more than 51 mm. (2 inches) water-column height. (d) The static pressure (at zero flow) in the facepiece shall not exceed 38 mm. (1.5 inches) water-column...

42 CFR 84.91 - Breathing resistance test; exhalation.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 25 mm. (1 inch) water-column height. (c) The exhalation resistance of pressure-demand apparatus shall not exceed the static pressure in the facepiece by more than 51 mm. (2 inches) water-column height. (d) The static pressure (at zero flow) in the facepiece shall not exceed 38 mm. (1.5 inches) water-column...

42 CFR 84.91 - Breathing resistance test; exhalation.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 25 mm. (1 inch) water-column height. (c) The exhalation resistance of pressure-demand apparatus shall not exceed the static pressure in the facepiece by more than 51 mm. (2 inches) water-column height. (d) The static pressure (at zero flow) in the facepiece shall not exceed 38 mm. (1.5 inches) water-column...

42 CFR 84.91 - Breathing resistance test; exhalation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 25 mm. (1 inch) water-column height. (c) The exhalation resistance of pressure-demand apparatus shall not exceed the static pressure in the facepiece by more than 51 mm. (2 inches) water-column height. (d) The static pressure (at zero flow) in the facepiece shall not exceed 38 mm. (1.5 inches) water-column...

42 CFR 84.91 - Breathing resistance test; exhalation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 25 mm. (1 inch) water-column height. (c) The exhalation resistance of pressure-demand apparatus shall not exceed the static pressure in the facepiece by more than 51 mm. (2 inches) water-column height. (d) The static pressure (at zero flow) in the facepiece shall not exceed 38 mm. (1.5 inches) water-column...

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.

Increased exhaled nitric oxide predicts new-onset rhinitis and persistent rhinitis in adolescents without allergic symptoms.

PubMed

Malinovschi, A; Alving, K; Kalm-Stephens, P; Janson, C; Nordvall, L

2012-03-01

The fraction of nitric oxide in exhaled air (FE(NO)) is increased in rhinitis and asthma. We have previously suggested that elevated FE(NO) levels in the absence of asthma symptoms may be a sign of 'early asthma'. In the present study, we hypothesize that elevated exhaled NO levels may also precede rhinitis symptoms. To investigate in a cohort of adolescents whether or not increased exhaled NO levels at the age of 13-14 years predicted new-onset or persistent rhinitis within a 4-year period. A total of 959 randomly selected adolescents (13-14 years) completed a questionnaire on respiratory symptoms at baseline and follow-up, 4 years later. Exhaled NO was measured at baseline. After exclusion of subjects with asthma diagnosis or asthma symptoms at baseline, 657 participants were eligible for the present study. Higher FE(NO) levels at baseline were associated with increased risk for new-onset (P = 0.009) and persistent rhinitis (P = 0.03) within a 4-year period. The risk of new-onset rhinitis was 2.32 (1.23, 4.37) [OR (95% CI)] times higher if FE(NO) > 90th percentile of the group without rhinitis at baseline. This increased risk for new-onset rhinitis was significant [2.49 (1.24, 5.01)] after excluding subjects with allergic symptoms. The risk of persistent rhinitis was 5.11 (1.34, 19.57) times higher if FE(NO) > 90th percentile of the group without rhinitis at baseline. Elevated exhaled nitric oxide levels predicted incident and persistent rhinitis in this population-based study of adolescents. Moreover, these findings were consistent after excluding subjects with allergic symptoms. Thus, it appears that elevation of exhaled NO precedes airway symptoms and predicts development of rhinitis in subjects without allergic symptoms or family history of allergic disease. © 2011 Blackwell Publishing Ltd.

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...

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 ( F eNO ), volatile organic compounds (VOCs), variables in exhaled breath condensate (EBC) and other measurements. For EBC and for F eNO , 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 F eNO , 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.

Exhaled ethane: an in vivo biomarker of lipid peroxidation in interstitial lung diseases.

PubMed

Kanoh, Soichiro; Kobayashi, Hideo; Motoyoshi, Kazuo

2005-10-01

Oxidative stress plays a role in the pathogenesis and progression of interstitial lung disease (ILD). Exhaled ethane is a product of lipid peroxidation that has been proposed as a biomarker of oxidative stress in vivo. To determine whether the exhaled ethane level is elevated in patients with ILD and to compare it with other clinical parameters. Breath samples were collected from 34 patients with ILD, including 13 with idiopathic pulmonary fibrosis (IPF), 9 patients with cryptogenic organizing pneumonia, 6 patients with collagen vascular disease-associated interstitial pneumonia, and 6 patients with pulmonary sarcoidosis. Gas samples were obtained at hospital admission and after 3 weeks. After each expired sample was concentrated using a trap-and-purge procedure, the ethane level was analyzed by gas chromatography. Exhaled ethane levels were elevated in ILD patients (n = 34, mean +/- SD, 8.5 +/- 8.0 pmol/dL) compared with healthy volunteers (n = 16, 2.9 +/- 1.0 pmol/dL; p < 0.001). Serial measurements revealed that increase and decrease of ethane levels were largely consistent with the clinical course. Four patients with IPF who had persistently high ethane levels died or deteriorated, whereas those with ethane levels < 5.0 pmol/dL remained stable or improved. Exhaled ethane concentrations were positively correlated with levels of lactate dehydrogenase (Spearman rank correlation coefficient [rs], 0.28, p = 0.026) and C-reactive protein (rs, 0.38, p = 0.025) and were inversely correlated with Pa(O2) (rs, - 0.40, p = 0.0026). Patients showing increased uptake on (67)Ga scintigraphy demonstrated higher ethane levels (n = 19, 7.5 +/- 5.7 pmol/dL) compared with those who did not show increased uptake on scintigraphy (n = 10, 3.0 +/- 2.4 pmol/dL; p < 0.01). Exhaled ethane is elevated in patients with ILD and is correlated with the clinical outcome, suggesting that it provides useful information about ongoing oxidative stress, and thereby disease activity and severity in

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...

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

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.

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.

Exhaled molecular profiles in the assessment of cystic fibrosis and primary ciliary dyskinesia.

PubMed

Paff, T; van der Schee, M P; Daniels, J M A; Pals, G; Postmus, P E; Sterk, P J; Haarman, E G

2013-09-01

Early diagnosis and monitoring of disease activity are essential in cystic fibrosis (CF) and primary ciliary dyskinesia (PCD). We aimed to establish exhaled molecular profiles as the first step in assessing the potential of breath analysis. Exhaled breath was analyzed by electronic nose in 25 children with CF, 25 with PCD and 23 controls. Principle component reduction and canonical discriminant analysis were used to construct internally cross-validated ROC curves. CF and PCD patients had significantly different breath profiles when compared to healthy controls (CF: sensitivity 84%, specificity 65%; PCD: sensitivity 88%, specificity 52%) and from each other (sensitivity 84%, specificity 60%). Patients with and without exacerbations had significantly different breath profiles (CF: sensitivity 89%, specificity 56%; PCD: sensitivity 100%, specificity 90%). Exhaled molecular profiles significantly differ between patients with CF, PCD and controls. The eNose may have potential in disease monitoring based on the influence of exacerbations on the VOC-profile. Copyright © 2012 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

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...

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. ...

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. ...

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.

Associations of Exhaled Carbon Monoxide and Fractional Exhaled Nitric Oxide with Metabolic Syndrome: A Cohort Study

PubMed Central

Guo, Yanjun; Ma, Jixuan; Lu, Wei; He, Jintong; Zhang, Runbo; Yuan, Jing; Chen, Weihong

2016-01-01

Exhaled carbon monoxide (eCO) and fractional exhaled nitric oxide (FeNO) could reflect underlying inflammatory and oxidative stresses, which play important roles in pathogenetic pathways of metabolic syndrome (MetS). However, epidemiologic evidence was limited. We conducted a study in Wuhan-Zhuhai (WHZH) cohort of 3649 community participants to investigate the association between eCO, FeNO and MetS in both cross-sectional and prospective ways. The results showed that higher eCO and FeNO were associated cross-sectionally with a higher prevalence of MetS. The multivariable-adjusted odds ratios for MetS at baseline were 1.22 (95% confidence interval [CI]: 1.11 to 1.35) associated with per log eCO and 1.14 (95% CI: 1.00 to 1.30) associated with per log FeNO. During a follow-up of 3 years, 358/2181 new developed MetS cases were identified. Compared with lowest quartile of eCO and FeNO, the multivariable-adjusted risk ratios (95% CI) for MetS were 1.48 (1.06 to 2.06) related to the highest quartile of eCO. These findings remained consistent across sex but not smoking status, eCO was only associated with MetS in non-smokers when stratified by smoking status. In conclusion, our study demonstrated that eCO and FeNO were independently and positively associated with the prevalence of MetS cross-sectionally, while only eCO was positively related with the incidence of MetS prospectively. PMID:27076211

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.

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.

Measurement of Radon Exhalation Rate in Sand Samples from Gopalpur and Rushikulya Beach Orissa, Eastern India

NASA Astrophysics Data System (ADS)

Mahur, Ajay Kumar; Sharma, Anil; Sonkawade, R. G.; Sengupta, D.; Sharma, A. C.; Prasad, Rajendra

Natural radioactivity is wide spread in the earth's environment and exists in various geological formations like soils, rocks, water and sand etc. The measurement of activities of naturally occurring radionuclides 226Ra, 232Th and 40K is important for the estimation of radiation risk and has been the subject of interest of research scientists all over the world. Building construction materials and soil beneath the house are the main sources of radon inside the dwellings. Radon exhalation rate from building materials like, cement, sand and concrete etc. is a major source of radiation to the habitants. In the present studies radon exhalation rates in sand samples collected from Gopalpur and Rushikulya beach placer deposit in Orissa are measured by using "Sealed Can technique" with LR-115 type II nuclear track detectors. In Samples from Rushikulya beach show radon activities varying from 389 ± 24 to 997 ± 38 Bq m-3 with an average value of 549 ±28 Bq m-3. Surface exhalation rates in these samples are found to vary from 140 ± 9 to 359 ± 14 mBq m-2 h-1with an average value of 197 ±10 mBq m-2 h-1, whereas, mass exhalation rates vary from 5 ± 0.3 to 14 ± 0.5 mBq kg-1 h-1 with an average value of 8 ± 0.4 mBq kg-1 h-1. Samples from Gopalpur radon activities are found to vary from 371 ± 23 to 800 ± 34 Bq m-3 with an average value of 549 ± 28 Bq m-3. Surface exhalation rates in these samples are found to vary from 133 ± 8 to 288 ± 12 mBq m-2h-1 with an average value of 197 ± 10 mBq m-2 h-1, whereas, mass exhalation rates vary from 5 ± 0.3 to 11 ± 1 mBq kg-1 h-1 with an average value of 8 ± 0.4 mBq kg-1 h-1.

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

Frequent sampling allows detection of short and rapid surges of exhaled ethane during cardiac surgery.

PubMed

Stenseth, R; Nilsen, T; Haaverstad, R; Vitale, N; Dale, O

2007-11-01

During cardiopulmonary bypass (CPB), hypoperfusion and reperfusion may cause oxidative stress and lipid peroxidation that generates ethane. The aim of this pilot study was to assess the feasibility of frequent sampling of exhaled ethane during cardiac surgery. After approval of the Research Ethics Committee, 10 patients undergoing combined aortic valve and coronary artery bypass surgery were enrolled. Breath samples were drawn in the perioperative period and analyzed by a rapid, sensitive and validated gas-chromatographic method. Increased exhaled ethane was regularly seen following sternotomy, after the start of CPB and after aortic clamp removal, whereas no change was seen after termination of bypass. In one patient, the maximum increase in exhaled ethane was 30-fold. Peak durations lasted only 2-4 min. This study demonstrates that frequent sampling of breath ethane is feasible in a clinical setting, allowing detection of rapid ethane surges of short duration.

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...

42 CFR 84.1137 - 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. 84.1137 Section 84.1137 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE...

42 CFR 84.1137 - 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. 84.1137 Section 84.1137 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE...

42 CFR 84.1137 - 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. 84.1137 Section 84.1137 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE...

42 CFR 84.1137 - 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. 84.1137 Section 84.1137 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE...

42 CFR 84.1137 - 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. 84.1137 Section 84.1137 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE...

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 PROTECTIVE...

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 PROTECTIVE...

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 PROTECTIVE...

42 CFR 84.120 - 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. 84.120 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 PROTECTIVE...

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 PROTECTIVE...

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

Relations between isoprene and nitric oxide in exhaled breath and the potential influence of outdoor ozone: a pilot study.

PubMed

Khan, Alya; Staimer, Norbert; Tjoa, Thomas; Galassetti, Pietro; Blake, Donald R; Delfino, Ralph J

2013-09-01

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.

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.

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

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Exhalation valve leakage test; minimum requirements. 84.1150 Section 84.1150 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Dust...

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 OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Dust...

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

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Exhalation valve leakage test; minimum requirements. 84.1150 Section 84.1150 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Dust...

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

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Exhalation valve leakage test; minimum requirements. 84.1150 Section 84.1150 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Dust...

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

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Exhalation valve leakage test; minimum requirements. 84.1150 Section 84.1150 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES APPROVAL OF RESPIRATORY PROTECTIVE DEVICES Dust...

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 Self...

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 Self...

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 Self...

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 Self...

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 Self...

Detection of Lung Cancer by Sensor Array Analyses of Exhaled Breath

PubMed Central

Machado, Roberto F.; Laskowski, Daniel; Deffenderfer, Olivia; Burch, Timothy; Zheng, Shuo; Mazzone, Peter J.; Mekhail, Tarek; Jennings, Constance; Stoller, James K.; Pyle, Jacqueline; Duncan, Jennifer; Dweik, Raed A.; Erzurum, Serpil C.

2005-01-01

Rationale: Electronic noses are successfully used in commercial applications, including detection and analysis of volatile organic compounds in the food industry. Objectives: We hypothesized that the electronic nose could identify and discriminate between lung diseases, especially bronchogenic carcinoma. Methods: In a discovery and training phase, exhaled breath of 14 individuals with bronchogenic carcinoma and 45 healthy control subjects or control subjects without cancer was analyzed. Principal components and canonic discriminant analysis of the sensor data was used to determine whether exhaled gases could discriminate between cancer and noncancer. Discrimination between classes was performed using Mahalanobis distance. Support vector machine analysis was used to create and apply a cancer prediction model prospectively in a separate group of 76 individuals, 14 with and 62 without cancer. Main Results: Principal components and canonic discriminant analysis demonstrated discrimination between samples from patients with lung cancer and those from other groups. In the validation study, the electronic nose had 71.4% sensitivity and 91.9% specificity for detecting lung cancer; positive and negative predictive values were 66.6 and 93.4%, respectively. In this population with a lung cancer prevalence of 18%, positive and negative predictive values were 66.6 and 94.5%, respectively. Conclusion: The exhaled breath of patients with lung cancer has distinct characteristics that can be identified with an electronic nose. The results provide feasibility to the concept of using the electronic nose for managing and detecting lung cancer. PMID:15750044

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...

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

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

Using the Inflammacheck Device to Measure the Level of Exhaled Breath Condensate Hydrogen Peroxide in Patients With Asthma and Chronic Obstructive Pulmonary Disease (The EXHALE Pilot Study): Protocol for a Cross-Sectional Feasibility Study

PubMed Central

Fogg, Carole; Brown, Thomas P; Jones, Thomas L; Lanning, Eleanor; Bassett, Paul; Chauhan, Anoop J

2018-01-01

Background Asthma and Chronic Obstructive Pulmonary Disease (COPD) are common conditions that affect over 5 million people in the United Kingdom. These groups of patients suffer significantly from breathlessness and recurrent exacerbations that can be difficult to diagnose and go untreated. A common feature of COPD and asthma is airway inflammation that increases before and during exacerbations. Current methods of assessing airway inflammation can be invasive, difficult to perform, and are often inaccurate. In contrast, measurement of exhaled breath condensate (EBC) hydrogen peroxide (H2O2) is performed during normal tidal breathing and is known to reflect the level of global inflammation in the airways. There is a need for novel tools to diagnose asthma and COPD earlier and to detect increased airway inflammation that precedes an exacerbation. Objective The aim of this study was to explore the use of a new handheld device (called Inflammacheck) in measuring H2O2 levels in EBC. We will study whether it can measure EBC H2O2 levels consistently and whether it can be used to differentiate asthma and COPD from healthy controls. Methods We will perform a cross-sectional, feasibility, pilot study of EBC H2O2 levels, as measured by Inflammacheck, and other markers of disease severity and symptom control in patients with asthma and COPD and volunteers with no history of lung disease. Participants will be asked to provide an exhaled breath sample for measurement of their EBC H2O2 using Inflammacheck. The result will be correlated with disease stage, spirometry, fractional exhaled nitric oxide (FeNO), and symptom control scores. Results This study’s recruitment is ongoing; it is anticipated that the results will be available in 2018. Conclusions The EXhaled Hydrogen peroxide As a marker of Lung diseasE (EXHALE) pilot study will provide an evaluation of a new method of measuring EBC H2O2. It will assess the device’s consistency and ability to distinguish airway

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. Copyright © 2014 Elsevier Ltd. All

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

Blood and exhaled air can be used for biomonitoring of hydrofluorocarbon exposure.

PubMed

Ernstgård, Lena; Sjögren, Bengt; Gunnare, Sara; Johanson, Gunnar

2014-02-10

Various hydrofluorocarbons (HFCs) have replaced the ozone-depleting chlorofluorocarbons and hydrochlorofluorocarbons during the last decades. The objective of this study was to examine the usefulness of blood and breath for exposure biomonitoring of HFCs. We compared data on blood and exhaled air from a series of experiments where healthy volunteers were exposed to vapors of four commonly used HFCs; 1,1-difluoroethane, 1,1,1-trifluoroethane, 1,1,1,2-tetrafluoroethane, and 1,1,1,3,3-pentafluoropropane. All four HFCs had similar toxicokinetic profiles in blood with a rapid initial increase and an apparent steady-state reached within a few minutes. For all HFCs, the inhalation uptake during exposure was low (less than 6%), most of which was exhaled post-exposure. No metabolism could be detected and only minor amounts were excreted unchanged in urine. The observed time courses in blood and breath were well described by physiologically-based pharmacokinetic (PBPK) modeling. Simulations of 8-h exposures show that the HFC levels in both blood and breath drop rapidly during the first minutes post-exposure, whereafter the decline is considerably slower and mainly reflects washout from fat tissues. We conclude that blood and exhaled air can be used for biological exposure monitoring. Samples should not be taken immediately at the end of shift but rather 20-30 min later. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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

Oxidative Stress Biomarkers in Exhaled Breath of Workers Exposed to Crystalline Silica Dust by SPME-GC-MS.

PubMed

Jalali, Mahdi; Zare Sakhvidi, Mohammad Javad; Bahrami, Abdulrahman; Berijani, Nima; Mahjub, Hussein

2016-01-01

Silicosis is considered an oxidative stress related disease that can lead to the development of lung cancer. In this study, our purpose was to analysis of volatile organic compounds (VOCs) in the exhaled breath of workers exposed to silica containing dust and compare peak area of these compounds with silicosis patients and healthy volunteers (smokers and nonsmokers) groups. In this cross sectional case-control study, the exhaled breath of 69 subjects including workers exposed to silica (n=20), silicosis patient (n=4), healthy non-smoker (n=20) and healthy smoker (n=25) were analyzed. We collected breath samples using 3-liter Tedlar bags. The VOCs were extracted with solid phase micro-extraction (SPME) and analyzed by gas chromatography-mass spectrometry (GC-MS). Personal exposure intensity was measured according to NIOSH 7601 method. Respiratory parameters were measured using spirometry. Seventy percent and 100% of the exposures to crystalline silica dust exceeded from 8 h TWA ACGIH TLVs in case and positive control groups, respectively. A significant negative correlation was found between dust exposure intensity and FEV1/FVC when exposure and positive control groups were studied in a group (r2=-0.601, P<0.001). Totally, forty VOCs were found in all exhaled breath samples. Among the VOCs, the mean of peak area acetaldehyde, hexanal, nonanal, decane, pentad cane, 2-propanol and 3-hydroxy-2-butanone were higher in exhaled breath of the workers exposed to silica and silicosis patient compared to the healthy smoker and nonsmoker controls. In some cases the difference was significant (P<0.05). The analysis of some VOCs in exhaled breath of subjects is appropriate biomarker to determine of exposure to silica.

Application of laser spectroscopy for measurement of exhaled ethane in patients with lung cancer.

PubMed

Skeldon, K D; McMillan, L C; Wyse, C A; Monk, S D; Gibson, G; Patterson, C; France, T; Longbottom, C; Padgett, M J

2006-02-01

There is increasing interest in ethane (C(2)H(6)) in exhaled breath as a non-invasive marker of oxidative stress (OS) and thereby a potential indicator of disease. However, the lack of real-time measurement techniques has limited progress in the field. Here we report on a novel Tunable Diode Laser Spectrometer (TDLS) applied to the analysis of exhaled ethane in patients with lung cancer. The patient group (n=52) comprised randomly selected patients presenting at a respiratory clinic. Of these, a sub-group (n=12) was subsequently diagnosed with lung cancer. An age-matched group (n=12) corresponding to the lung cancer group was taken from a larger control group of healthy adults (n=58). The concentration of ethane in a single exhaled breath sample collected from all subjects was later measured using the TDLS. This technique is capable of real-time analysis of samples with accuracy 0.1 parts per billion (ppb), over 10 times less than typical ambient levels in the northern hemisphere. After correcting for ambient background, ethane in the control group (26% smokers) ranged from 0 to 10.54 ppb (median of 1.9 ppb) while ethane in the lung cancer patients (42% smokers) ranged from 0 to 7.6 ppb (median of 0.7 ppb). Ethane among the non-lung cancer patients presenting for investigation of respiratory disease ranged from 0 to 25 ppb (median 1.45 ppb). We conclude that, while the TDLS proved effective for accurate and rapid sample analysis, there was no significant difference in exhaled ethane among any of the subject groups. Comments are made on the suitability of the technique for monitoring applications.

Breath condenser coatings affect measurement of biomarkers in exhaled breath condensate.

PubMed

Rosias, P P; Robroeks, C M; Niemarkt, H J; Kester, A D; Vernooy, J H; Suykerbuyk, J; Teunissen, J; Heynens, J; Hendriks, H J; Jöbsis, Q; Dompeling, E

2006-11-01

Exhaled breath condensate collection is not yet standardised and biomarker measurements are often close to lower detection limits. In the current study, it was hypothesised that adhesive properties of different condenser coatings interfere with measurements of eicosanoids and proteins in breath condensate. In vitro, condensate was derived from a collection model using two test solutions (8-isoprostane and albumin) and five condenser coatings (silicone, glass, aluminium, polypropylene and Teflon). In vivo, condensate was collected using these five coatings and the EcoScreen condenser to measure 8-isoprostane, and three coatings (silicone, glass, EcoScreen) to measure albumin. In vitro, silicone and glass coatings had significantly higher albumin recovery compared with the other coatings. A similar trend was observed for 8-isoprostane recovery. In vivo, median (interquartile range) 8-isoprostane concentrations were significantly higher using silicone (9.2 (18.8) pg.mL(-1)) or glass (3.0 (4.5) pg.mL(-1)) coating, compared with aluminium (0.5 (2.4) pg.mL(-1)), polypropylene (0.5 (0.5) pg.mL(-1)), Teflon (0.5 (0.0) pg.mL(-1)), and EcoScreen (0.5 (2.0) pg.mL(-1)). Albumin in vivo was mainly detectable using glass coating. In conclusion, a condenser with silicone or glass coating is more efficient for measurement of 8-isoprostane or albumin in exhaled breath condensate, than EcoScreen, aluminium, polypropylene or Teflon. Guidelines for exhaled breath condensate standardisation should include the most valid condenser coating to measure a specific biomarker.

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.

Feasibility and potential utility of multicomponent exhaled breath analysis for predicting development of radiation pneumonitis after stereotactic ablative radiotherapy.

PubMed

Moré, Jayaji M; Eclov, Neville C W; Chung, Melody P; Wynne, Jacob F; Shorter, Joanne H; Nelson, David D; Hanlon, Alexandra L; Burmeister, Robert; Banos, Peter; Maxim, Peter G; Loo, Billy W; Diehn, Maximilian

2014-07-01

In this prospective pilot study, we evaluated the feasibility and potential utility of measuring multiple exhaled gases as biomarkers of radiation pneumonitis (RP) in patients receiving stereotactic ablative radiotherapy (SABR) for lung tumors. Breath analysis was performed for 26 patients receiving SABR for lung tumors. Concentrations of exhaled nitric oxide (eNO), carbon monoxide (eCO), nitrous oxide (eN2O), and carbon dioxide (eCO2) were measured before and immediately after each fraction using real-time, infrared laser spectroscopy. RP development (CTCAE grade ≥2) was correlated with baseline gas concentrations, acute changes in gas concentrations after each SABR fraction, and dosimetric parameters. Exhaled breath analysis was successfully completed in 77% of patients. Five of 20 evaluable patients developed RP at a mean of 5.4 months after SABR. Acute changes in eNO and eCO concentrations, defined as percent changes between each pre-fraction and post-fraction measurement, were significantly smaller in RP versus non-RP cases (p = 0.022 and 0.015, respectively). In an exploratory analysis, a combined predictor of baseline eNO greater than 24 parts per billion and acute decrease in eCO less than 5.5% strongly correlated with RP incidence (p =0.0099). Neither eN2O nor eCO2 concentrations were significantly associated with RP development. Although generally higher in patients destined to develop RP, dosimetric parameters were not significantly associated with RP development. The majority of SABR patients in this pilot study were able to complete exhaled breath analysis. Baseline concentrations and acute changes in concentrations of exhaled breath components were associated with RP development after SABR. If our findings are validated, exhaled breath analysis may become a useful approach for noninvasive identification of patients at highest risk for developing RP after SABR.

Radium-226 body burden in U miners by measurement of Rn in exhaled breath.

PubMed

Srivastava, G K; Raghavayya, M; Kotrappa, P; Somasundaram, S

1986-02-01

Uranium miners were made to inhale Rn-free medical O2 and exhale through a 5.2-1 A1 chamber before reporting to work. The chamber was sealed and isolated from the sampling circuit. An electrostatic plate collected the freshly formed Rn-decay products. The subsequent programmed alpha counting of the plate yielded a Rn concentration in the exhaled breath. Assuming that the exhaled breath represents a certain fraction of the Rn produced inside the body, the body burden of 226Ra was calculated. Standardisation of this procedure and the data collected on 310 miners are discussed. The procedure is simple and applicable for routine measurements. The miner needs to be in the laboratory for only 10 min. The system is also portable for field application. For routine use, the minimum detectable concentration is 3.87 Bq X m-3 which corresponds to a body burden of 0.26 kBq in a typical miner, if one assumes the Rn release fraction from the body as 84%. The system offers a more convenient and sensitive alternative to whole-body counting of workers for 226Ra.

Diagnosis of acute respiratory distress syndrome by exhaled breath analysis

PubMed Central

2018-01-01

The acute respiratory distress syndrome (ARDS) is a complication of critical illness that is characterized by acute onset, protein rich, pulmonary edema. There is no treatment for ARDS, other than the reduction of additional ventilator induced lung injury. Prediction or earlier recognition of ARDS could result in preventive measurements and might decrease mortality and morbidity. Exhaled breath contains volatile organic compounds (VOCs), a collection of hundreds of small molecules linked to several physiological and pathophysiological processes. Analysis of exhaled breath through gas-chromatography and mass-spectrometry (GC-MS) has resulted in an accurate diagnosis of ARDS in several studies. Most identified markers are linked to lipid peroxidation. Octane is one of the few markers that was validated as a marker of ARDS and is pathophysiologically likely to be increased in ARDS. None of the currently studied breath analysis methods is directly applicable in clinical practice. Two steps have to be taken before any breath test can be allowed into the intensive care unit. External validation in a multi-center study is a prerequisite for any of the candidate breath markers and the breath test should outperform clinical prediction scores. Second, the technology for breath analysis should be adapted so that it is available at a decentralized lab inside the intensive care unit and can be operated by trained nurses, in order to reduce the analysis time. In conclusion, exhaled analysis might be used for the early diagnosis and prediction of ARDS in the near future but several obstacles have to be taken in the coming years. Most of the candidate markers can be linked to lipid peroxidation. Only octane has been validated in a temporal external validation cohort and is, at this moment, the top-ranking breath biomarker for ARDS. PMID:29430450

Detection of creatinine in exhaled breath of humans with chronic kidney disease by extractive electrospray ionization mass spectrometry.

PubMed

Zeng, Qian; Li, Penghui; Cai, Yunfeng; Zhou, Wei; Wang, Haidong; Luo, Jiao; Ding, Jianhua; Chen, Huanwen

2016-02-09

Exhaled breath contains chemicals that have a diagnostic value in human pathologies. Here in vivo breath analysis of creatinine has been demonstrated by constructing a novel platform based on extractive electrospray ionization mass spectrometry (EESI-MS) without sample pretreatment. Under optimized experimental conditions, the limit of creatinine detection in breath was 30.57 ng L(-1), and the linear range of detection was from 0.3 μg L(-1) to 100 μg L(-1). The concentration range of creatinine in the exhaled breath of 50 volunteers with chronic kidney disease was from 42 pptv to 924 pptv, and the range of the relative standard deviations was from 9.3% to 19.2%. The method provides high sensitivity, high specificity and high speed for semi-quantitative analysis of creatinine in exhaled human breath.

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.

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

Using exhaled carbon monoxide and carboxyhemoglobin to evaluate the effectiveness of a chimney stove model in Peru.

PubMed

Eppler, Adam R; Fitzgerald, Christopher; Dorner, Stephen C; Aguilar-Villalobos, Manuel; Rathbun, Stephen L; Adetona, Olorunfemi; Naeher, Luke P

2013-01-01

Measurement of biological indicators of physiological change may be useful in evaluating the effectiveness of stove models, which are intended to reduce indoor smoke exposure and potential health effects. We examined changes in exhaled carbon monoxide (CO), percentage carboxy-hemoglobin, and total hemoglobin in response to the installation of a chimney stove model by the Juntos National Program in Huayatan, Peru in 2008. Biomarkers were measured in a convenience sample comprising 35 women who met requirements for participation, and were measured before and three weeks after installation of a chimney stove. The relationships between exposure to indoor smoke and biomarker measurements were also analyzed using simple linear regression models. Exhaled CO reduced from 6.71 ppm (95% CI 5.84-7.71) to 3.14 ppm (95% CI 2.77-3.66) three weeks after stove installation (P < 0.001) while % COHb reduced from 1.76% (95% CI 1.62-1.91) to 1.18% (95% CI 1.12-1.25; P < 0.001). Changes in exhaled CO and % COHb from pre- to post-chimney stove installation were not correlated with corresponding changes in exposure to CO and PM2.5 even though the exposures also reduced after stove installation. Exhaled CO and % COHb both showed improvement with reduction in concentration after the installation of the chimney cook stoves, indicating a positive physiological response subsequent to the intervention.

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. Copyright © 2012 Elsevier Ltd. All rights reserved.

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.

Evaluation of Bio-VOC Sampler for Analysis of Volatile Organic Compounds in Exhaled Breath

PubMed Central

Kwak, Jae; Fan, Maomian; Harshman, Sean W.; Garrison, Catherine E.; Dershem, Victoria L.; Phillips, Jeffrey B.; Grigsby, Claude C.; Ott, Darrin K.

2014-01-01

Monitoring volatile organic compounds (VOCs) from exhaled breath has been used to determine exposures of humans to chemicals. Prior to analysis of VOCs, breath samples are often collected with canisters or bags and concentrated. The Bio-VOC breath sampler, a commercial sampling device, has been recently introduced to the market with growing use. The main advantage for this sampler is to collect the last portion of exhaled breath, which is more likely to represent the air deep in the lungs. However, information about the Bio-VOC sampler is somewhat limited. Therefore, we have thoroughly evaluated the sampler here. We determined the volume of the breath air collected in the sampler was approximately 88 mL. When sampling was repeated multiple times, with the succeeding exhalations applied to a single sorbent tube, we observed linear relationships between the normalized peak intensity and the number of repeated collections with the sampler in many of the breath VOCs detected. No moisture effect was observed on the Tenax sorbent tubes used. However, due to the limitation in the collection volume, the use of the Bio-VOC sampler is recommended only for detection of VOCs present at high concentrations unless repeated collections of breath samples on the sampler are conducted. PMID:25532709

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

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.

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

PubMed Central

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

2011-01-01

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. PMID:21467303

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

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.

Assessment of radionuclide concentration and exhalation studies in soil of lesser Himalayas of Jammu and Kashmir, India

NASA Astrophysics Data System (ADS)

Kumar, Ajay; Vij, Raman; Sharma, Sumit; Sarin, Amit; Narang, Saurabh

2018-02-01

Because to extensive utilization of soil as a building/construction stuff, the activities of 238U, 40K, 232Th, and exhalation studies in solid samples have been measured using thallium activated sodium iodide (NaI(Tl)) gamma detector and scintillation-based smart RnDuo monitor. The measured activity concentration of radionuclides lies in the range of 2.76-38.96, 12.47-65.70, and 199-450 Bq/kg for uranium (C U), thorium (C Th), and potassium (C K), respectively. The annual effective dose rate due to radionuclides is within the secure limit suggested by ICRP. The radium equivalent activity of all the samples is under 100 Bq/kg. The maximum outward and inside risk indices of all these samples are below the values of 0.37 and 0.43. No direct correlation has been seen between 238U and its mass exhalation rate as well as 232Th and its surface exhalation rate in soil samples.

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...

New method for single-breath fraction of exhaled nitric oxide measurement with improved feasibility in preschool children with asthma.

PubMed

Heijkenskjöld-Rentzhog, Charlotte; Kalm-Stephens, Pia; Nordvall, Lennart; Malinovschi, Andrei; Alving, Kjell

2015-11-01

Respiratory societies recommend use of standardized methodologies for fraction of exhaled nitric oxide (FeNO) measurements in adults and children, but in preschoolers, feasibility remains a problem. The exhalation time needed to obtain steady-state FeNO is unclear. Our primary aim was to study the feasibility of an adapted single-breath FeNO method with age-adjusted exhalation times. We also studied the association between time to steady-state NO level and height, as well as FeNO in relation to asthma and current treatment with inhaled corticosteroids (ICS). Sixty-three children aged 3-10 years performed FeNO measurements with a hand-held electrochemical device with a newly developed flow-control unit. Exhalation times were pre-adapted to age. Exhaled air was simultaneously sampled to a chemiluminescence analyzer to measure time to steady-state NO level. Eighty-one percent of the children achieved at least one approved measurement. From 4 years upwards, success rate was high (96%). Time to steady-state [NO] (median and interquartile range) was 2.5 s (2.4-3.5) at the age of 3-4 years and 3.5 s (2.7-3.8) at the age of 5-6 years. Height was associated with time to steady state (r(2) = 0.13, p = 0.02). FeNO (geometric mean [95% CI]) was higher in ICS-naïve asthmatic children (n = 19): 15.9 p.p.b. (12.2-20.9), than in both healthy controls (n = 8) 9.1 p.p.b. (6.6-12.4) and asthmatic subjects on treatment (n = 24) 11.5 p.p.b. (9.7-13.6). We found this adapted single-breath method with age-adjusted exhalation times highly feasible for children aged 4-10 years. ICS-naïve asthmatic children had FeNO levels under the current guideline cutoff level (20 p.p.b.), highlighting the importance of taking age into account when setting reference values. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Exhaler class: a multidisciplinary program for high quadriplegic patients.

PubMed

DiPasquale, P A

1986-07-01

The Exhaler Class at Craig Hospital was developed to meet the physical, psychosocial, and educational needs of high quadriplegic patients. The class uses a multidisciplinary approach and includes exercise and educational sessions. To date, a total of 56 patients have participated in the 6-week program, and those surveyed rated the sessions as good both in content and presentation. An average increase in vital capacity of 0.5 L was observed in 20 patients surveyed.

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.

COLLECTION OF A SINGLE ALVEOLAR EXHALED BREATH FOR VOLATILE ORGANIC COMPOUNDS ANALYSIS

EPA Science Inventory

Measurement of specific organic compounds in exhaled breath has been used as an indicator of recent exposure to pollutants or as an indicator of the health of an individual. Typical application involves the collection of multiple breaths onto a sorbent cartridge or into an evacua...

Microbiota in Exhaled Breath Condensate and the Lung.

PubMed

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

2017-06-15

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 aerosolized antibiotic treatment would influence the lung microbiota and whether this change could be detected in EBC. EBC was collected from 6 conscious sheep and then from the same anesthetized 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 nebulized colistimethate sodium. Two days after nebulization, EBC and PSB samples were again collected. Bacterial DNA was quantified using 16S rRNA gene quantitative PCR. The V2-V3 region of the 16S rRNA gene was amplified by PCR and sequenced using Illumina MiSeq. Quality control and operational taxonomic unit (OTU) clustering were performed with mothur. The EBC samples contained significantly less bacterial DNA than the PSB samples. The EBC samples from anesthetized animals clustered separately by their bacterial community compositions in comparison to the PSB samples, and 37 bacterial OTUs were identified as 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 before and after 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 that involve a hospital visit for human participants and the use of trained staff. The inconvenience and perceived discomfort of participating in this kind of

Gas analysis of human exhalation by tunable diode laser spectroscopy

NASA Astrophysics Data System (ADS)

Stepanov, Eugene V.; Moskalenko, Konstantin L.

1993-02-01

Results of the application of a tunable diode laser (TDL) to determining the trace gas components of human exhalation are presented. The analyzer is specially developed to measure both carbon oxides (CO and CO2) in expired air. A few results illuminating possible applications of TDLs in high-sensitivity medical diagnostics have been obtained. For nonsmokers, expired concentrations of CO are slightly higher than those in inhaled air. The specific surplus value seems to be independent of the ambient atmospheric CO content. The surplus CO content increases by more than an order of magnitude just after intensive exercises, e.g., jogging. For smokers, the pharmacokinetic of abundant CO removal from the organism could be investigated by this technique, which provides quick and reliable measurements of smoking status. Breath-holding synchronous measurements of CO and CO2 in exhalation demonstrate behavior that is different with breath-holding time. The method seems useful for the investigation of phenomena such as molecular pulmonary diffusion through the alveolar-capillary membrane and an organism's adaptation to oxygen shortage. Prospects for the development and application of diode laser spectroscopy to trace gas analysis in medicine are also discussed.

Wildland smoke exposure values and exhaled breath indicators in firefighters.

PubMed

Miranda, Ana Isabel; Martins, Vera; Cascão, Pedro; Amorim, Jorge Humberto; Valente, Joana; Borrego, Carlos; Ferreira, António Jorge; Cordeiro, Carlos Robalo; Viegas, Domingos Xavier; Ottmar, Roger

2012-01-01

Smoke from forest fires contains significant amounts of gaseous and particulate pollutants. Firefighters exposed to wildland fire smoke can suffer from several acute and chronic adverse health effects. Consequently, exposure data are of vital importance for the establishment of cause/effect relationships between exposure to smoke and firefighter health effects. The aims of this study were to (1) characterize the relationship between wildland smoke exposure and medical parameters and (2) identify health effects pertinent to wildland forest fire smoke exposure. In this study, firefighter exposure levels of carbon monoxide (CO), nitrogen dioxide (NO₂), and volatile organic compounds (VOC) were measured in wildfires during three fire seasons in Portugal. Personal monitoring devices were used to measure exposure. Firefighters were also tested for exhaled nitric oxide (eNO) and CO before and after their firefighting activities. Data indicated that exposure levels during firefighting activities were beyond limits recommended by the Occupational Exposure Standard (OES) values. Medical tests conducted on the firefighters also indicated a considerable effect on measured medical parameters, with a significant increase in CO and decrease in NO in exhaled air of majority of the firefighters.

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.

The fraction of NO in exhaled air and estimates of alveolar NO in adolescents with asthma: methodological aspects.

PubMed

Heijkenskjöld-Rentzhog, Charlotte; Alving, Kjell; Kalm-Stephens, Pia; Lundberg, Jon O; Nordvall, Lennart; Malinovschi, Andrei

2012-10-01

This study investigated the oral contribution to exhaled NO in young people with asthma and its potential effects on estimated alveolar NO (Calv(NO) ), a proposed marker of inflammation in peripheral airways. Secondary aims were to investigate the effects of various exhalation flow-rates and the feasibility of different proposed adjustments of (Calv(NO) ) for trumpet model and axial diffusion (TMAD). Exhaled NO at flow rates of 50-300 ml/sec, and salivary nitrite was measured before and after antibacterial mouthwash in 29 healthy young people (10-20 years) and 29 with asthma (10-19 years). Calv(NO) was calculated using the slope-intercept model with and without TMAD adjustment. Exhaled NO at 50 ml/sec decreased significantly after mouthwash, to a similar degree in asthmatic and healthy subjects (8.8% vs. 9.8%, P = 0.49). The two groups had similar salivary nitrite levels (56.4 vs. 78.4 µM, P = 0.25). Calv(NO) was not significantly decreased by mouthwash. Calv(NO) levels were similar when flow-rates between 50-200 or 100-300 ml/sec were used (P = 0.34 in asthmatics and P = 0.90 in healthy subjects). A positive association was found between bronchial and alveolar NO in asthmatic subjects and this disappeared after the TMAD-adjustment. Negative TMAD-adjusted Calv(NO) values were found in a minority of the subjects. Young people with and without asthma have similar salivary nitrite levels and oral contributions to exhaled NO and therefore no antibacterial mouthwash is necessary in routine use. TMAD corrections of alveolar NO could be successfully applied in young people with asthma and yielded negative results only in a minority of subjects. Copyright © 2012 Wiley Periodicals, Inc.

Effect of a passive exhalation port on tracheostomy ventilation in amyotrophic lateral sclerosis patients: a randomized controlled trial.

PubMed

Vianello, Andrea; Arcaro, Giovanna; Molena, Beatrice; Iovino, Silvia; Gallan, Federico; Turato, Cristian; Marchese-Ragona, Rosario

2018-02-01

Amyotrophic lateral sclerosis (ALS) patients often require long-term tracheostomy ventilation (LT-TV) because of progressive ventilatory failure. Although widely used for non-invasive ventilation (NIV), passive exhalation port systems have not been gaining popularity for TV because of the possibility of carbon dioxide (CO 2 ) rebreathing. The current study set out to investigate the effect of a Whisper Swivel connector in comparison to an active exhalation valve on gas exchange and symptoms in ALS patients requiring LT-TV. A prospective randomized controlled trial was carried out to compare the clinical outcome of ten ALS patients receiving LT-TV by means of a Trilogy 100 ventilator with a Whisper Swivel passive exhalation port (group A) and of 10 ALS patients connected to an Airox Legendair ventilator with an active exhalation valve (group B). The study's main outcome measure was CO 2 retention at the 30-day follow-up assessment. One patient in each of the two cohorts showed significant CO 2 retention. At the 30-day assessment, scores on the following measures were not significantly different in the two groups: the Borg dyspnea scale {2 [1-3] vs. 1 [1-3]; P=0.2891}, the visual analogue scale (VAS) dyspnea {20 [10-85] vs. 20 [0-50]; P=0.8571}, the Epworth sleepiness scale (ESS) {8 [4-10] vs. 5.5 [0-12]; P=0.1443}, the EuroQol-VAS (EQ-VAS) {55 [50-80] vs. 50 [30-80]; P=0.4593} and the relative stress scale (RSS) {49 [30-65] vs. 52 [25-64]; P=0.8650}. At the 3-month follow-up assessment, the numbers of hospitalizations and deaths were likewise similar in the two groups. The efficacy of the Whisper Swivel connector is similar to that of an active exhalation valve in ALS patients undergoing LT-TV.

Exhaled breath condensate nitrates, but not nitrites or FENO, relate to asthma control.

PubMed

Malinovschi, Andrei; Pizzimenti, Stefano; Sciascia, Savino; Heffler, Enrico; Badiu, Iuliana; Rolla, Giovanni

2011-07-01

Asthma is a chronic respiratory disease, characterised by airways inflammation, obstruction and hyperresponsiveness. Asthma control is the goal of asthma treatment, but many patients have sub-optimal control. Exhaled NO and exhaled breath condensate (EBC) NO metabolites (nitrites and nitrates) measurements are non-invasive tools to assess airways inflammation. Our aim was to investigate the relationships between asthma control and the above-named biomarkers of airways inflammation. Thirty-nine non-smoking asthmatic patients (19 women) aged 50 (21-80) years performed measurements of exhaled NO (FENO), EBC nitrates, nitrites and pH, and answered Asthma Control Questionnaire (ACQ) and Asthma Control Test (ACT)-questionnaire. The ACT and ACQ score were strongly interrelated (ρ = -0.84, p < 0.001). No relationships between ACT or ACQ score and FENO were found (p > 0.05). EBC nitrates were negatively related to ACT score (ρ = -0.34, p = 0.03) and positively related to ACQ score (ρ = 0.41, p = 0.001) while no relation of EBC nitrites to either ACQ or ACT score was found (p>0.05). EBC nitrates were the only biomarker that was significantly related to asthma control. This suggests that nitrates, but not nitrites or FENO, reflect an aspect of airways inflammation that is closer related to asthma symptoms. Therefore there is a potential role for EBC nitrates in objective assessment of asthma control. Copyright © 2010 Elsevier Ltd. All rights reserved.

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

Influenza Virus Aerosols in Human Exhaled Breath: Particle Size, Culturability, and Effect of Surgical Masks

PubMed Central

Milton, Donald K.; Cowling, Benjamin J.; Grantham, Michael L.

2013-01-01

The CDC recommends that healthcare settings provide influenza patients with facemasks as a means of reducing transmission to staff and other patients, and a recent report suggested that surgical masks can capture influenza virus in large droplet spray. However, there is minimal data on influenza virus aerosol shedding, the infectiousness of exhaled aerosols, and none on the impact of facemasks on viral aerosol shedding from patients with seasonal influenza. We collected samples of exhaled particles (one with and one without a facemask) in two size fractions (“coarse”>5 µm, “fine”≤5 µm) from 37 volunteers within 5 days of seasonal influenza onset, measured viral copy number using quantitative RT-PCR, and tested the fine-particle fraction for culturable virus. Fine particles contained 8.8 (95% CI 4.1 to 19) fold more viral copies than did coarse particles. Surgical masks reduced viral copy numbers in the fine fraction by 2.8 fold (95% CI 1.5 to 5.2) and in the coarse fraction by 25 fold (95% CI 3.5 to 180). Overall, masks produced a 3.4 fold (95% CI 1.8 to 6.3) reduction in viral aerosol shedding. Correlations between nasopharyngeal swab and the aerosol fraction copy numbers were weak (r = 0.17, coarse; r = 0.29, fine fraction). Copy numbers in exhaled breath declined rapidly with day after onset of illness. Two subjects with the highest copy numbers gave culture positive fine particle samples. Surgical masks worn by patients reduce aerosols shedding of virus. The abundance of viral copies in fine particle aerosols and evidence for their infectiousness suggests an important role in seasonal influenza transmission. Monitoring exhaled virus aerosols will be important for validation of experimental transmission studies in humans. PMID:23505369

Evaluation of a new method for the collection and measurement of 8-isoprostane in exhaled breath for future application in nanoparticle exposure biomonitoring.

PubMed

Marie-Desvergne, Caroline; Dubosson, Muriel; Mossuz, Véronique Chamel

2018-05-14

In the field of nanoparticle exposure biomonitoring, oxidative stress biomarkers measured in exhaled breath condensate appear promising to detect early respiratory effects in workers handling nanomaterials. However, condensation is known for its poor efficiency in collecting non-volatiles in exhaled breath, leading to the low sensitivity of such measurements. Moreover, to be easily used in field studies on large groups of workers, the collection device must be disposable and convenient. In this study, we have tested a totally disposable commercial device that allows for the easy dry collection of exhaled air after filtration on a patented filter. The suitability and efficiency of the SensAbues (SB) device for collecting 8-isoprostane were evaluated and compared to the RTube (RT). Seven healthy volunteers performed two 15 min collections of exhaled breath, one with the SB and one with the RT. Blank devices were used to determine the background levels induced by each device. 8-isoprostane was measured in all samples using an EIA technique. The levels of 8-isoprostane in the exhaled breath of volunteers after collection with the SB were significantly higher than those after collection with the RT. Moreover, the levels obtained in volunteers with the SB were significantly higher than background levels obtained in blank devices, which was not the case for the RT. This is the first study to report the ability of the SB device to collect and measure 8-isoprostane in exhaled breath. The proposed method offers better sensitivity than a classical collection with the RT device and should be further explored before future application in biomonitoring studies.

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...

Oxidative lung injury correlates with one-lung ventilation time during pulmonary lobectomy: a study of exhaled breath condensate and blood.

PubMed

García-de-la-Asunción, José; García-del-Olmo, Eva; Perez-Griera, Jaume; Martí, Francisco; Galan, Genaro; Morcillo, Alfonso; Wins, Richard; Guijarro, Ricardo; Arnau, Antonio; Sarriá, Benjamín; García-Raimundo, Miguel; Belda, Javier

2015-09-01

During lung lobectomy, the operated lung is collapsed and hypoperfused; oxygen deprivation is accompanied by reactive hypoxic pulmonary vasoconstriction. After lung lobectomy, ischaemia present in the collapsed state is followed by expansion-reperfusion and lung injury attributed to the production of reactive oxygen species. The primary objective of this study was to investigate the time course of several markers of oxidative stress simultaneously in exhaled breath condensate and blood and to determine the relationship between oxidative stress and one-lung ventilation time in patients undergoing lung lobectomy. This single-centre, observational, prospective study included 28 patients with non-small-cell lung cancer who underwent lung lobectomy. We measured the levels of hydrogen peroxide, 8-iso-PGF2α, nitrites plus nitrates and pH in exhaled breath condensate (n = 25). The levels of 8-iso-PGF2α and nitrites plus nitrates were also measured in blood (n = 28). Blood samples and exhaled breath condensate samples were collected from all patients at five time points: preoperatively; during one-lung ventilation, immediately before resuming two-lung ventilation; immediately after resuming two-lung ventilation; 60 min after resuming two-lung ventilation and 180 min after resuming two-lung ventilation. Both exhaled breath condensate and blood exhibited significant and simultaneous increases in oxidative-stress markers immediately before two-lung ventilation was resumed. However, all these values underwent larger increases immediately after resuming two-lung ventilation. In both exhaled breath condensate and blood, marker levels significantly and directly correlated with the duration of one-lung ventilation immediately before resuming two-lung ventilation and immediately after resuming two-lung ventilation. Although pH significantly decreased in exhaled breath condensate immediately after resuming two-lung ventilation, these pH values were inversely correlated with the

Performance of a new hand-held device for exhaled nitric oxide measurement in adults and children

PubMed Central

Alving, K; Janson, C; Nordvall, L

2006-01-01

Background Exhaled nitric oxide (NO) measurement has been shown to be a valuable tool in the management of patients with asthma. Up to now, most measurements have been done with stationary, chemiluminescence-based NO analysers, which are not suitable for the primary health care setting. A hand-held NO analyser which simplifies the measurement would be of value both in specialized and primary health care. In this study, the performance of a new electrochemical hand-held device for exhaled NO measurements (NIOX MINO) was compared with a standard stationary chemiluminescence unit (NIOX). Methods A total of 71 subjects (6–60 years; 36 males), both healthy controls and atopic patients with and without asthma were included. The mean of three approved exhalations (50 ml/s) in each device, and the first approved measurement in the hand-held device, were compared with regard to NO readings (Bland-Altman plots), measurement feasibility (success rate with 6 attempts) and repeatability (intrasubject SD). Results Success rate was high (≥ 84%) in both devices for both adults and children. The subjects represented a FENO range of 8–147 parts per billion (ppb). When comparing the mean of three measurements (n = 61), the median of the intrasubject difference in exhaled NO for the two devices was -1.2 ppb; thus generally the hand-held device gave slightly higher readings. The Bland-Altman plot shows that the 95% limits of agreement were -9.8 and 8.0 ppb. The intrasubject median difference between the NIOX and the first approved measurement in the NIOX MINO was -2.0 ppb, and limits of agreement were -13.2 and 10.2 ppb. The median repeatability for NIOX and NIOX MINO were 1.1 and 1.2 ppb, respectively. Conclusion The hand-held device (NIOX MINO) and the stationary system (NIOX) are in clinically acceptable agreement both when the mean of three measurements and the first approved measurement (NIOX MINO) is used. The hand-held device shows good repeatability, and it can be used

Performance of a new hand-held device for exhaled nitric oxide measurement in adults and children.

PubMed

Alving, K; Janson, C; Nordvall, L

2006-04-20

Exhaled nitric oxide (NO) measurement has been shown to be a valuable tool in the management of patients with asthma. Up to now, most measurements have been done with stationary, chemiluminescence-based NO analysers, which are not suitable for the primary health care setting. A hand-held NO analyser which simplifies the measurement would be of value both in specialized and primary health care. In this study, the performance of a new electrochemical hand-held device for exhaled NO measurements (NIOX MINO) was compared with a standard stationary chemiluminescence unit (NIOX). A total of 71 subjects (6-60 years; 36 males), both healthy controls and atopic patients with and without asthma were included. The mean of three approved exhalations (50 ml/s) in each device, and the first approved measurement in the hand-held device, were compared with regard to NO readings (Bland-Altman plots), measurement feasibility (success rate with 6 attempts) and repeatability (intrasubject SD). Success rate was high (> or = 84%) in both devices for both adults and children. The subjects represented a FENO range of 8-147 parts per billion (ppb). When comparing the mean of three measurements (n = 61), the median of the intrasubject difference in exhaled NO for the two devices was -1.2 ppb; thus generally the hand-held device gave slightly higher readings. The Bland-Altman plot shows that the 95% limits of agreement were -9.8 and 8.0 ppb. The intrasubject median difference between the NIOX and the first approved measurement in the NIOX MINO was -2.0 ppb, and limits of agreement were -13.2 and 10.2 ppb. The median repeatability for NIOX and NIOX MINO were 1.1 and 1.2 ppb, respectively. The hand-held device (NIOX MINO) and the stationary system (NIOX) are in clinically acceptable agreement both when the mean of three measurements and the first approved measurement (NIOX MINO) is used. The hand-held device shows good repeatability, and it can be used successfully on adults and most children

Outdoor air pollution, exhaled 8-isoprostane and current asthma in adults: the EGEA study

PubMed Central

Zerimech, Farid; Sanchez, Margaux; Siroux, Valérie; Le Moual, Nicole; Brunekreef, Bert; Stempfelet, Morgane; Künzli, Nino; Jacquemin, Bénédicte; Matran, Régis

2018-01-01

Associations between outdoor air pollution and asthma in adults are still scarce, and the underlying biological mechanisms are poorly understood. Our aim was to study the associations between 1) long-term exposure to outdoor air pollution and current asthma, 2) exhaled 8-isoprostane (8-iso; a biomarker related to oxidative stress) and current asthma, and 3) outdoor air pollution and exhaled 8-iso. Cross-sectional analyses were conducted in 608 adults (39% with current asthma) from the first follow-up of the French case–control and family study on asthma (EGEA; the Epidemiological study of the Genetic and Environmental factors of Asthma). Data on nitrogen dioxide, nitrogen oxides, particulate matter with a diameter ≤10 and ≤2.5 µm (PM10 and PM2.5), road traffic, and ozone (O3) were from ESCAPE (European Study of Cohorts for Air Pollution Effects) and IFEN (French Institute for the Environment) assessments. Models took account of city and familial dependence. The risk of current asthma increased with traffic intensity (adjusted (a)OR 1.09 (95% CI 1.00–1.18) per 5000 vehicles per day), with O3 exposure (aOR 2.04 (95% CI 1.27–3.29) per 10 µg·m−3) and with exhaled 8-iso concentration (aOR 1.50 (95% CI 1.06–2.12) per 1 pg·mL−1). Among participants without asthma, exhaled 8-iso concentration increased with PM2.5 exposure (adjusted (a)β 0.23 (95% CI 0.005–0.46) per 5 µg·m−3), and decreased with O3 and O3-summer exposures (aβ −0.20 (95% CI −0.39– −0.01) and aβ −0.52 (95% CI −0.77– −0.26) per 10 µg·m−3, respectively). Our results add new insights into a potential role of oxidative stress in the associations between outdoor air pollution and asthma in adults. PMID:29618600

Aspergillus spp. colonization in exhaled breath condensate of lung cancer patients from Puglia Region of Italy.

PubMed

Carpagnano, Giovanna E; Lacedonia, Donato; Palladino, Grazia Pia; Logrieco, Giuseppe; Crisetti, Elisabetta; Susca, Antonia; Logrieco, Antonio; Foschino-Barbaro, Maria P

2014-02-18

Airways of lung cancer patients are often colonized by fungi. Some of these colonizing fungi, under particular conditions, produce cancerogenic mycotoxins. Given the recent interest in the infective origin of lung cancer, with this preliminary study we aim to give our small contribution to this field of research by analysing the fungal microbiome of the exhaled breath condensate of lung cancer patients from Puglia, a region of Italy. We enrolled 43 lung cancer patients and 21 healthy subjects that underwent exhaled breath condensate and bronchial brushing collection. The fungal incidence and nature of sample collected were analysed by using a selected media for Aspergillus species. For the first time we were able to analyse the fungal microbioma of the exhaled breath condensate. 27.9% of lung cancer patients showed a presence of Aspergillus niger, or A. ochraceus or Penicillium ssp. while none of the healthy subjects did so. The results confirmed the high percentage of fungal colonization of the airways of lung cancer patients from Puglia, suggesting the need to conduct further analyses in this field in order to evaluate the exact pathogenetic role of these fungi in lung cancer as well as to propose efficient, empirical therapy.

Impact of chorioamnionitis on exhaled nitric oxide and endotracheal aspirate levels of nitrites-nitrates and interleukin-8 in mechanically ventilated preterm neonates.

PubMed

Figueras-Aloy, Josep; Salvia-Roiges, Maria Dolors; Rodriguez-Miguélez, J Manuel; Miracle-Echegoyen, Xavier; Botet-Mussons, Francesc; Marín-Soria, J Luís; Carbonell-Estrany, Xavier

2011-06-01

To assess the influence of maternal chorioamnionitis on early exhaled nitric oxide (NO) and levels of nitrites-nitrates and interleukin (IL)-8 in endotracheal aspirate fluid in mechanically ventilated preterm neonates. Cross-sectional study. PATIENT-SUBJECT SELECTION: Between September 2007 and August 2009, 54 mechanically ventilated preterm neonates were included. Patients were divided into two groups according to the presence or absence of maternal chorioamnionitis, and those without chorioamnionitis (controls) were further stratified into two subgroups by birth weight < or ≥ 2,000 g. The ventilator used was a Babylog 8000. The NO level assessed was the plateau value given by the software of the Sievers NOA apparatus. Collection of endotracheal aspirate fluid samples was performed coinciding with routine aspirations and using the dry technique. The two groups of control neonates showed statistically significant differences in exhaled NO expressed as nl/min and normalized exhaled NO expressed as either nl/min or nl/min/kg, so they are not homogeneous and cannot be used in clinical practice. Serum C-reactive protein and endotracheal aspirate levels of nitrites-nitrates were significantly higher in the chorioamnionitis group than in controls (3.6 vs. 1.07 µmol/L; P = 0.035). Nitrites-nitrates levels were positively correlated with exhaled NO in ppb (ρ = 0.367; P = 0.006). Minute exhaled endogenous NO was significantly higher in the chorioamnionitis group (0.48 vs. 0.27 nl/min/kg; P = 0.021). In mechanically ventilated preterm infants weighing <2,000 g, maternal chorioamnionitis was associated with an increase of early exhaled NO (nl/min/kg) and serum levels of C-reactive protein and levels of nitrites-nitrates in endotracheal aspirate fluid. Copyright © 2011 Wiley-Liss, Inc.

Clinical use of exhaled volatile organic compounds in pulmonary diseases: a systematic review

PubMed Central

2012-01-01

There is an increasing interest in the potential of exhaled biomarkers, such as volatile organic compounds (VOCs), to improve accurate diagnoses and management decisions in pulmonary diseases. The objective of this manuscript is to systematically review the current knowledge on exhaled VOCs with respect to their potential clinical use in asthma, lung cancer, chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), and respiratory tract infections. A systematic literature search was performed in PubMed, EMBASE, Cochrane database, and reference lists of retrieved studies. Controlled, clinical, English-language studies exploring the diagnostic and monitoring value of VOCs in asthma, COPD, CF, lung cancer and respiratory tract infections were included. Data on study design, setting, participant characteristics, VOCs techniques, and outcome measures were extracted. Seventy-three studies were included, counting in total 3,952 patients and 2,973 healthy controls. The collection and analysis of exhaled VOCs is non-invasive and could be easily applied in the broad range of patients, including subjects with severe disease and children. Various research groups demonstrated that VOCs profiles could accurately distinguish patients with a pulmonary disease from healthy controls. Pulmonary diseases seem to be characterized by a disease specific breath-print, as distinct profiles were found in patients with dissimilar diseases. The heterogeneity of studies challenged the inter-laboratory comparability. In conclusion, profiles of VOCs are potentially able to accurately diagnose various pulmonary diseases. Despite these promising findings, multiple challenges such as further standardization and validation of the diverse techniques need to be mastered before VOCs can be applied into clinical practice. PMID:23259710

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.

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.

Lung function and exhaled nitric oxide in healthy unsedated African infants

PubMed Central

Gray, Diane; Willemse, Lauren; Visagie, Ane; Smith, Emilee; Czövek, Dorottya; Sly, Peter D; Hantos, Zoltán; Hall, Graham L; Zar, Heather J

2015-01-01

Background and objective 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. Methods 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. Results 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. Conclusions This study provides reference data for unsedated infant lung function in African infants and highlights the importance of using population-specific data. PMID:26134556

MEASUREMENT OF VOLATILE ORGANIC COMPOUNDS IN EXHALED BREATH AS COLLECTED IN EVACUATED ELECTROPOLISHED CANISTERS

EPA Science Inventory

A set of three complementary analytical methods were developed specifically for exhaled breath as collected in evacuated stainless steel canisters using gas chromatography - mass spectrometry detection. The first is a screening method to quantify the carbon dioxide component (gen...

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

PBTK modeling demonstrates contribution of dermal and inhalation exposure components to end-exhaled breath concentrations of naphthalene.

PubMed

Kim, David; Andersen, Melvin E; Chao, Yi-Chun E; Egeghy, Peter P; Rappaport, Stephen M; Nylander-French, Leena A

2007-06-01

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. 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. 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. The optimized values of parameters for naphthalene were a) permeability coefficient for the stratum corneum 6.8 x 10(-5) cm/hr, b) permeability coefficient for the viable epidermis 3.0 x 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%). 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.

Aspergillus spp. colonization in exhaled breath condensate of lung cancer patients from Puglia Region of Italy

PubMed Central

2014-01-01

Background Airways of lung cancer patients are often colonized by fungi. Some of these colonizing fungi, under particular conditions, produce cancerogenic mycotoxins. Given the recent interest in the infective origin of lung cancer, with this preliminary study we aim to give our small contribution to this field of research by analysing the fungal microbiome of the exhaled breath condensate of lung cancer patients from Puglia, a region of Italy. Methods We enrolled 43 lung cancer patients and 21 healthy subjects that underwent exhaled breath condensate and bronchial brushing collection. The fungal incidence and nature of sample collected were analysed by using a selected media for Aspergillus species. Results For the first time we were able to analyse the fungal microbioma of the exhaled breath condensate. 27.9% of lung cancer patients showed a presence of Aspergillus niger, or A. ochraceus or Penicillium ssp. while none of the healthy subjects did so. Conclusion The results confirmed the high percentage of fungal colonization of the airways of lung cancer patients from Puglia, suggesting the need to conduct further analyses in this field in order to evaluate the exact pathogenetic role of these fungi in lung cancer as well as to propose efficient, empirical therapy. PMID:24548615

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.

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

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.

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

Radiometric surveying for the assessment of radiation dose and radon specific exhalation in underground environment

NASA Astrophysics Data System (ADS)

Bochiolo, M.; Verdoya, M.; Chiozzi, P.; Pasquale, V.

2012-08-01

We performed a radiometric survey for evaluating the natural radioactivity and the related potential hazard level both outdoor and indoor a mine tunnel. The mine is located in a zone of uranium enrichment in the Western Alps (Italy). At first, a γ-ray spectrometry survey of the area surrounding the mine was carried out to define the extent of the ore deposit. Then, spectrometric measurements were performed in the tunnel and rock samples were collected for laboratory analyses. The results point to significant heterogeneity in uranium concentration and consequently in the absorbed dose rate spatial distribution. Spectrometric results in situ and in the laboratory, together with radon air concentration measurements, were used to infer the radon specific exhalation and flow from the mine rocks. The specific exhalation is positively related to the activity concentration of uranium.

Effect of inhaled corticosteroid treatment on exhaled breath condensate leukotriene E(4) in children with mild asthma.

PubMed

Steiss, Jens-Oliver; Rudloff, Silvia; Landmann, Eva; Rückes-Nilges, Claudia; Zimmer, Klaus-Peter; Lindemann, Herrmann

2008-01-01

Chronic airway inflammation in children with asthma might be present even in the absence of pathological lung function tests and is known to increase the risk of permanent pulmonary damage. Thus, we aimed at investigating to what extent inflammatory markers such as leukotrienes (LTs) in exhaled breath condensate (EBC) or fractional exhaled nitric oxide (FE(NO)) reflect therapeutic effects in these patients. Fifty steroid-naive patients (aged 8.8 +/- 2.7 years) were included in the study. EBC was collected before and 6 months after therapy with inhaled corticosteroids. LTs were determined by using commercially available ELISA. In addition, FE(NO) was measured by means of a chemiluminescence analyzer. Conventional lung function testing was performed revealing vital capacity, forced expiratory volume, maximum expiratory flow, and specific resistance. In EBC, LTE(4) but not LTB(4) levels significantly decreased after steroid therapy from 45.3 +/- 36.0 pg/mL to 17.2 +/- 11.4 pg/mL (p < 0.0001) concomitant with a slight, but significant improvement of lung function parameters. Mean FE(NO) also indicated therapeutic success; however, in 20 of 50 patients, exhaled NO concentrations were higher after therapy. These findings suggest that LTE(4) in breath condensate may be helpful in latent inflammatory activity in the bronchial mucosa in children with asthma.

[Photoacoustic spectroscopy evaluation of the impact of smoking on the composition of exhaled air in patients with bronchopulmonary diseases].

PubMed

Bukreeva, E B; Bulanova, A A; Kistenev, Yu V; Nikiforova, O Yu

To investigate the impact of smoking on the air exhaled by patients with chronic obstructive pulmonary disease (COPD) and asthmatics, by applying photoacoustic spectroscopy. The exhaled air absorption spectra (EAAS) were analyzed in healthy volunteers and patients with COPD and asthmatics, by applying an ILPA-1 CO2 laser photoacoustic gas analyzer. The procedure based on the calculation of an integrated estimate (IE) of the state of the object was used to assess the findings. Comparison of the IE of EAAS in COPD patients and non-smoking healthy individuals showed that spectra of the compounds, the formation of which was associated with smoking, were recorded in the range of wavelengths corresponding to the 10R branch of CO2 laser generation. This also provided evidence indicating that the exhaled air of asthmatics differed from that of both smoking and non-smoking healthy individuals. The calculations yielded the threshold values of EAAS IE in the range of wavelengths corresponding to the 10P branche of CO2 laser generation, which made it possible to distinguish non-smoking healthy individuals from asthmatics and COPD patients in 94 and 89% of cases, respectively. The investigation has confirmed that smoking substantially impacts the composition of the air exhaled by healthy individuals. It has been shown that the use of reference groups formed from non-smoking healthy individuals can improve the accuracy of photoacoustic spectroscopy in detecting COPD and asthma. A further development in this direction will open up new prospects for a new method to diagnose COPD and asthma.

A rapid method for the chromatographic analysis of volatile organic compounds in exhaled breath of tobacco cigarette and electronic cigarette smokers.

PubMed

Marco, Esther; Grimalt, Joan O

2015-09-04

A method for the rapid analysis of volatile organic compounds (VOCs) in smoke from tobacco and electronic cigarettes and in exhaled breath of users of these smoking systems has been developed. Both disposable and rechargeable e-cigarettes were considered. Smoke or breath were collected in Bio-VOCs. VOCs were then desorbed in Tenax cartridges which were subsequently analyzed by thermal desorption coupled to gas chromatography-mass spectrometry. The method provides consistent results when comparing the VOC compositions from cigarette smoke and the equivalent exhaled breath of the smokers. The differences in composition of these two sample types are useful to ascertain which compounds are retained in the respiratory system after tobacco cigarette or e-cigarette smoking. Strong differences were observed in the VOC composition of tobacco cigarette smoke and exhaled breath when comparing with those of e-cigarette smoking. The former involved transfers of a much larger burden of organic compounds into smokers, including benzene, toluene, naphthalene and other pollutants of general concern. e-Cigarettes led to strong absorptions of propylene glycol and glycerin in the users of these systems. Tobacco cigarettes were also those showing highest concentration differences between nicotine concentrations in smoke and exhaled breath. The results from disposable e-cigarettes were very similar to those from rechargeable e-cigarettes. Copyright © 2015 Elsevier B.V. All rights reserved.

A selective nanosensor device for exhaled breath analysis.

PubMed

Gouma, P; Prasad, A; Stanacevic, S

2011-09-01

This paper describes a novel concept of a three-nanosensor array microsystem that may potentially serve as a coarse diagnostic tool handheld breath analyzer to provide a first detection device. The specification and performance of a simple metal oxide nanosensor operating between three distinct temperatures are discussed, focusing on the need for a noninvasive blood cholesterol monitor. Interfacing the sensor array to an integrated circuit for electrical readout and temperature control provides a complete microsystem capable of capturing a single exhaled breath and analyzing it with respect to the relative content of isoprene, carbon dioxide and ammonia gas. This inexpensive sensor technology may be used as a personalized medical diagnostics tool in the near future.

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.

Application of support vector machine method for the analysis of absorption spectra of exhaled air of patients with broncho-pulmonary diseases

NASA Astrophysics Data System (ADS)

Bukreeva, Ekaterina B.; Bulanova, Anna A.; Kistenev, Yury V.; Kuzmin, Dmitry A.; Tuzikov, Sergei A.; Yumov, Evgeny L.

2014-11-01

The results of the joint use of laser photoacoustic spectroscopy and chemometrics methods in gas analysis of exhaled air of patients with respiratory diseases (chronic obstructive pulmonary disease, pneumonia and lung cancer) are presented. The absorption spectra of exhaled breath of all volunteers were measured, the classification methods of the scans of the absorption spectra were applied, the sensitivity/specificity of the classification results were determined. It were obtained a result of nosological in pairs classification for all investigated volunteers, indices of sensitivity and specificity.

Leukotriene-B4 concentrations in exhaled breath condensate and lung function after thirty minutes of breathing technically dried compressed air.

PubMed

Neubauer, Birger; Struck, Niclas; Mutzbauer, Till S; Schotte, Ulrich; Langfeldt, Norbert; Tetzlaff, Kay

2002-01-01

In previous studies it had been shown that leukotriene-B4 [LTB4] concentrations in the exhaled breath mirror the inflammatory activity of the airways if the respiratory tract has been exposed to occupational hazards. In diving the respiratory tract is exposed to cold and dry air and the nasopharynx, as the site of breathing-gas warming and humidification, is bypassed. The aim of the present study was to obtain LTB4-concentrations in the exhaled breath and spirometric data of 17 healthy subjects before and after thirty minutes of technically dried air breathing at normobar ambient pressure. The exhaled breath was collected non-invasively, via a permanently cooled expiration tube. The condensate was measured by a standard enzyme immunoassay for LTB4. Lung function values (FVC, FEV1, MEF 25, MEF 50) were simultaneously obtained by spirometry. The measured pre- and post-exposure LTB4- concentrations as well as the lung function values were in the normal range. The present data gave no evidence for any inflammatory activity in the subjects' airways after thirty minutes breathing technically dried air.

Measurements of lactate in exhaled breath condensate at rest and after maximal exercise in young and healthy subjects.

PubMed

Marek, E M; Volke, J; Hawener, I; Platen, P; Mückenhoff, K; Marek, W

2010-03-01

Arterial lactate concentrations, taken as indicators of physical fitness, in athletes as well as in patients with cardio-respiratory or metabolic diseases, are measured invasively from arterialized ear lobe blood. Currently developed micro enzyme detectors permit a non-invasive measurement of hypoxia-related metabolites such as lactate in exhaled breath condensate (EBC). The aim of our study is to prove whether this technology will replace the traditional measurement of lactate in arterialized blood. Therefore, we determined the functional relation between lactate release in EBC and lactate concentration in blood in young and healthy subjects at rest and after exhausting bicycle exercise. During resting conditions as well as after exhausting bicycle exercise, 100 L of exhaled air along with blood samples from the ear lobe was collected after stationary load conditions in 16 healthy subjects. EBC was obtained by cooling the expired air volume with an ECoScreen I (FILT GmbH, Berlin) condenser. The analysis was performed within 90 min using an ECoCheck ampere meter (FILT GmbH, Berlin). Lactate measurements were performed using a bi-enzyme sensor after lactate oxidase-induced oxidation of lactate to pyruvate and H2O2. The rates of lactate release via the exhaled air were calculated from the lactate concentration, the volume and the collection time of the EBC. The functional relation of lactate release in exhaled air and lactate concentration of arterial blood was computed. At rest, the mean lactate concentration in arterialized blood was 0.93 ± 0.30 mmol L(-1). At a resting ventilation of 11.5 ± 3.4 L min(-1), the collection time for 100 L of exhaled air, Ts, was 8.4 ± 2.9 min, and 1.68 ± 0.40 mL EBC was obtained. In EBC, the lactate concentration was 21.4 ± 7.7 µmol L(-1), and the rate of lactate release rate in collected EBC was 4.5 ± 1.7 nmol min(-1). After maximal exercise load (220 ± 20 W), the blood lactate concentration increased to 10.9 ± 1.8 mmol L(-1

A study of indoor radon, thoron and their exhalation rates in the environment of Fazilka district, Punjab, India

NASA Astrophysics Data System (ADS)

Narang, Saurabh; Kumar, Deepak; Sharma, Dinesh Kumar; Kumar, Ajay

2018-02-01

Over the last few decades, the study of radioactive radon gas has gained huge momentum due to its possible role in health related hazards. In the present work, pin-hole twin chamber single entrance dosimeters have been used for track measurements of radon and thoron. The annual average radon concentration varies from 50.3 to 204 Bq/m3 at all locations. Almost all the values are below the safe range provided by ICRP. Radon concentration is found to be higher in winter as compared to other seasons. Variation of radon with quality of dwellings is also discussed. The values of annual effective dose due to radon and thoron are also well within the range provided by ICRP and WHO. Radon and thoron exhalation rates are measured using SMART RnDuo monitor. The radon mass exhalation rates ranged from 11 to 71 mBq/kg/h while the thoron surface values ranged from 36 to 2048 Bq/m2/h. All the values are on the lower side. A weak correlation is found between radon and thoron concentrations and their exhalation rates. When compared with the values of other parts of northern India, the values of present investigation are on higher side.

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...

Prediction of indoor radon/thoron concentration in a model room from exhalation rates of building materials for different ventilation rates

NASA Astrophysics Data System (ADS)

Kumar, Manish; Sharma, Navjeet; Sarin, Amit

2018-05-01

Studies have confirmed that elevated levels of radon/thoron in the human-environments can substantially increase the risk of lung cancer in general population. The building materials are the second largest contributors to indoor radon/thoron after soil and bedrock beneath dwellings. In present investigation, the exhalation rates of radon/thoron from different building materials samples have been analysed using active technique. Radon/thoron concentrations in a model room have been predicted based on the exhalation rates from walls, floor and roof. The indoor concentrations show significant variations depending upon the ventilation rate and type of building materials used.

Detection of gastro-oesophageal reflux disease (GORD) in patients with obstructive lung disease using exhaled breath profiling.

PubMed

Timms, Chris; Thomas, Paul S; Yates, Deborah H

2012-03-01

Gastro-oesophageal reflux disease (GORD) has been implicated in the worsening of several respiratory disorders. Current methods of diagnosis lack accuracy, are invasive and can be costly. Recently, novel methods of analysing lung pathophysiology have been developed including the use of an electronic nose and analysis of components of exhaled breath condensate (EBC). We hypothesised that these methods would distinguish patients with GORD from those without GORD in the common obstructive lung diseases and healthy controls. In a cross-sectional study, exhaled breath was analysed using the Cyranose 320 electronic nose, using principal components and canonical discriminant analyses. EBC pH and pepsin were quantified using a pH meter and an enzyme-linked immunosorbent assay, respectively. A standardized reflux disease questionnaire (RDQ) was used to assess reflux symptoms. The Cyranose 320 distinguished exhaled breath profiles of obstructive lung disease patients without GORD from obstructive lung disease patients with GORD (p = 0.023, accuracy 67.6%), asthmatic patients with reflux from asthmatics without GORD (85%, p = < 0.015, interclass M distance > 2.8), but did not produce as robust a profile for patients with COPD and COPD with GORD (p = 0.047, accuracy 64%). Patients with obstructive lung disease and GORD had significantly higher levels of EBC pepsin (9.81 ± interquartile range (IQR) 4.38 ng ml(-1)) than those without GORD (4.6 ± IQR 6.95 ng ml(-1)), as well as healthy controls (3.44 ± IQR 7.87 ng ml(-1); p = < 0.013). EBC pH was not significantly related to the presence of GORD in any group. The RDQ results correlated significantly with the presence of EBC pepsin. This pilot study has shown that exhaled breath profiling can be used for detecting GORD in obstructive lung diseases. While the electronic nose was useful in asthma, EBC pepsin was more helpful in COPD. In this study, several different confounders could potentially have affected results and larger

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.

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.

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...

Diet-derived changes by sourdough-fermented rye bread in exhaled breath aspiration ion mobility spectrometry profiles in individuals with mild gastrointestinal symptoms.

PubMed

Raninen, Kaisa; Lappi, Jenni; Kolehmainen, Mikko; Kolehmainen, Marjukka; Mykkänen, Hannu; Poutanen, Kaisa; Raatikainen, Olavi

2017-12-01

The potential of utilising exhaled breath volatile organic compound (VOC) profiles in studying diet-derived metabolic changes was examined. After a four-week initial diet period with white wheat bread (WW), seven participants received in randomised order high-fibre diets containing sourdough whole grain rye bread (WGR) or white wheat bread enriched with bioprocessed rye bran (WW + BRB), both for 4 weeks. Alveolar exhaled breath samples were analysed with ChemPro ® 100i analyser (Environics OY, Mikkeli, Finland) at the end of each diet period in fasting state and after a standardised meal. The AIMS signal intensities in fasting state were different after the WGR diet as compared to other diets. The result suggests that WGR has metabolic effects not completely explained by the rye fibre content of the diet. This study encourages to utilise the exhaled breath VOC profile analysis as an early screening tool in studying physiological functionality of foods.

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.

Further Development of an Exhaled microRNA Biomarker of Lung Cancer Risk

DTIC Science & Technology

2017-08-01

devise a non -invasive airway based exhaled microRNA metric for lung cancer risk, initial work to be tested in a case control study. We expanded the...control study. We also expanded the assessment of lung cancer subjects to also include limited (3-month) prospective follow-up of non -cancer controls...follow-up of non -cancer controls in order to minimize control contamination/misclassification, and improved matching on age, smoking status, and

[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.

A widely tunable, near-infrared laser-based trace gas sensor for hydrogen cyanide (HCN) detection in exhaled breath

NASA Astrophysics Data System (ADS)

Azhar, M.; Mandon, J.; Neerincx, A. H.; Liu, Z.; Mink, J.; Merkus, P. J. F. M.; Cristescu, S. M.; Harren, F. J. M.

2017-11-01

A compact, cost-effective sensor is developed for detection of hydrogen cyanide (HCN) in exhaled breath within seconds. For this, an off-axis integrated cavity output spectroscopy setup is combined with a widely tunable compact near-infrared laser (tunability 1527-1564 nm). For HCN a detection sensitivity has been obtained of 8 ppbv in nitrogen (within 1 s), equal to a noise equivalent absorption sensitivity of 1.9 × 10-9 cm-1 Hz-1/2. With this sensor we demonstrated the presence of HCN in exhaled breath; its detection could be a good indicator for bacterial lung infection. Due to its compact, cost-effective and user-friendly design, this laser-based sensor has the potential to be implemented in future clinical applications.

Aspirin provocation increases 8-iso-PGE2 in exhaled breath condensate of aspirin-hypersensitive asthmatics.

PubMed

Mastalerz, Lucyna; Januszek, Rafał; Kaszuba, Marek; Wójcik, Krzysztof; Celejewska-Wójcik, Natalia; Gielicz, Anna; Plutecka, Hanna; Oleś, Krzysztof; Stręk, Paweł; Sanak, Marek

2015-09-01

Isoprostanes are bioactive compounds formed by non-enzymatic oxidation of polyunsaturated fatty acids, mostly arachidonic, and markers of free radical generation during inflammation. In aspirin exacerbated respiratory disease (AERD), asthmatic symptoms are precipitated by ingestion of non-steroid anti-inflammatory drugs capable for pharmacologic inhibition of cyclooxygenase-1 isoenzyme. We investigated whether aspirin-provoked bronchoconstriction is accompanied by changes of isoprostanes in exhaled breath condensate (EBC). EBC was collected from 28 AERD subjects and 25 aspirin-tolerant asthmatics before and after inhalatory aspirin challenge. Concentrations of 8-iso-PGF2α, 8-iso-PGE2, and prostaglandin E2 were measured using gas chromatography/mass spectrometry. Leukotriene E4 was measured by immunoassay in urine samples collected before and after the challenge. Before the challenge, exhaled 8-iso-PGF2α, 8-iso-PGE2, and PGE2 levels did not differ between the study groups. 8-iso-PGE2 level increased in AERD group only (p=0.014) as a result of the aspirin challenge. Urinary LTE4 was elevated in AERD, both in baseline and post-challenge samples. Post-challenge airways 8-iso-PGE2 correlated positively with urinary LTE4 level (p=0.046), whereas it correlated negatively with the provocative dose of aspirin (p=0.027). A significant increase of exhaled 8-iso-PGE2 after inhalatory challenge with aspirin was selective and not present for the other isoprostane measured. This is a novel finding in AERD, suggesting that inhibition of cyclooxygenase may elicit 8-iso-PGE2 production in a specific mechanism, contributing to bronchoconstriction and systemic overproduction of cysteinyl leukotrienes. Copyright © 2015 Elsevier Inc. All rights reserved.

Cavity ring down spectrometry for disease diagnostics using exhaled air

NASA Astrophysics Data System (ADS)

Revalde, G.; Grundšteins, K.; Alnis, J.; Skudra, A.

2017-12-01

In this paper we report the current stage of the development of a cavity ring-down spectrometer (CRDS) system using exhaled human breath analysis for the diagnostics of different diseases like diabetes and later lung cancer. The portable CRDS system is made in ultraviolet spectral region using Nd:Yag laser 266 nm pulsed light. Calibration of the CRDS system was performed using generated samples by KinTek automated permeation tube system and self-prepared mixtures with known concentration of benzene and acetone in air. First experiments showed that the limits of detection for benzene and acetone are several tens of ppb.

Abdominal organ motion during inhalation and exhalation breath-holds: pancreatic motion at different lung volumes compared.

PubMed

Lens, Eelco; Gurney-Champion, Oliver J; Tekelenburg, Daniël R; van Kesteren, Zdenko; Parkes, Michael J; van Tienhoven, Geertjan; Nederveen, Aart J; van der Horst, Astrid; Bel, Arjan

2016-11-01

Contrary to what is commonly assumed, organs continue to move during breath-holding. We investigated the influence of lung volume on motion magnitude during breath-holding and changes in velocity over the duration of breath-holding. Sixteen healthy subjects performed 60-second inhalation breath-holds in room-air, with lung volumes of ∼100% and ∼70% of the inspiratory capacity, and exhalation breath-holds, with lung volumes of ∼30% and ∼0% of the inspiratory capacity. During breath-holding, we obtained dynamic single-slice magnetic-resonance images with a time-resolution of 0.6s. We used 2-dimensional image correlation to obtain the diaphragmatic and pancreatic velocity and displacement during breath-holding. Organ velocity was largest in the inferior-superior direction and was greatest during the first 10s of breath-holding, with diaphragm velocities of 0.41mm/s, 0.29mm/s, 0.16mm/s and 0.15mm/s during BH 100% , BH 70% , BH 30% and BH 0% , respectively. Organ motion magnitudes were larger during inhalation breath-holds (diaphragm moved 9.8 and 9.0mm during BH 100% and BH 70% , respectively) than during exhalation breath-holds (5.6 and 4.3mm during BH 30% and BH 0% , respectively). Using exhalation breath-holds rather than inhalation breath-holds and delaying irradiation until after the first 10s of breath-holding may be advantageous for irradiation of abdominal tumors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Pilot Study: Detection of Gastric Cancer From Exhaled Air Analyzed With an Electronic Nose in Chinese Patients.

PubMed

Schuermans, Valérie N E; Li, Ziyu; Jongen, Audrey C H M; Wu, Zhouqiao; Shi, Jinyao; Ji, Jiafu; Bouvy, Nicole D

2018-06-01

The aim of this pilot study is to investigate the ability of an electronic nose (e-nose) to distinguish malignant gastric histology from healthy controls in exhaled breath. In a period of 3 weeks, all preoperative gastric carcinoma (GC) patients (n = 16) in the Beijing Oncology Hospital were asked to participate in the study. The control group (n = 28) consisted of family members screened by endoscopy and healthy volunteers. The e-nose consists of 3 sensors with which volatile organic compounds in the exhaled air react. Real-time analysis takes place within the e-nose, and binary data are exported and interpreted by an artificial neuronal network. This is a self-learning computational system. The inclusion rate of the study was 100%. Baseline characteristics differed significantly only for age: the average age of the patient group was 57 years and that of the healthy control group 37 years ( P value = .000). Weight loss was the only significant different symptom ( P value = .040). A total of 16 patients and 28 controls were included; 13 proved to be true positive and 20 proved to be true negative. The receiver operating characteristic curve showed a sensitivity of 81% and a specificity of 71%, with an accuracy of 75%. These results give a positive predictive value of 62% and a negative predictive value of 87%. This pilot study shows that the e-nose has the capability of diagnosing GC based on exhaled air, with promising predictive values for a screening purpose.

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...

CFD modeling and image analysis of exhaled aerosols due to a growing bronchial tumor: Towards non-invasive diagnosis and treatment of respiratory obstructive diseases

DOE PAGES

Xi, Jinxiang; Kim, JongWon; Si, Xiuhua A.; ...

2015-01-01

Diagnosis and prognosis of tumorigenesis are generally performed with CT, PET, or biopsy. Such methods are accurate, but have the limitations of high cost and posing additional health risks to patients. In this study, we introduce an alternative computer aided diagnostic tool that can locate malignant sites caused by tumorigenesis in a non-invasive and low-cost way. Our hypothesis is that exhaled aerosol distribution is unique to lung structure and is sensitive to airway structure variations. With appropriate approaches, it is possible to locate the disease site, determine the disease severity, and subsequently formulate a targeted drug delivery plan to treatmore » the disease. This study numerically evaluated the feasibility of the proposed breath test in an image-based lung model with varying pathological stages of a bronchial squamous tumor. Large eddy simulations and a Lagrangian tracking approach were used to model respiratory airflows and aerosol dynamics. Respirations of tracer aerosols of 1 μm at a flow rate of 20 L/min were simulated, with the distributions of exhaled aerosols recorded on a filter at the mouth exit. Aerosol patterns were quantified with multiple analytical techniques such as concentration disparity, spatial scanning and fractal analysis. We demonstrated that a growing bronchial tumor induced notable variations in both the airflow and exhaled aerosol distribution. These variations became more apparent with increasing tumor severity. The exhaled aerosols exhibited distinctive pattern parameters such as spatial probability, fractal dimension, and multifractal spectrum. Results of this study show that morphometric measures of the exhaled aerosol pattern can be used to detect and monitor the pathological states of respiratory diseases in the upper airway. The proposed breath test also has the potential to locate the site of the disease, which is critical in developing a personalized, site-specific drug delivery protocol.« less

CFD modeling and image analysis of exhaled aerosols due to a growing bronchial tumor: Towards non-invasive diagnosis and treatment of respiratory obstructive diseases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xi, Jinxiang; Kim, JongWon; Si, Xiuhua A.

Diagnosis and prognosis of tumorigenesis are generally performed with CT, PET, or biopsy. Such methods are accurate, but have the limitations of high cost and posing additional health risks to patients. In this study, we introduce an alternative computer aided diagnostic tool that can locate malignant sites caused by tumorigenesis in a non-invasive and low-cost way. Our hypothesis is that exhaled aerosol distribution is unique to lung structure and is sensitive to airway structure variations. With appropriate approaches, it is possible to locate the disease site, determine the disease severity, and subsequently formulate a targeted drug delivery plan to treatmore » the disease. This study numerically evaluated the feasibility of the proposed breath test in an image-based lung model with varying pathological stages of a bronchial squamous tumor. Large eddy simulations and a Lagrangian tracking approach were used to model respiratory airflows and aerosol dynamics. Respirations of tracer aerosols of 1 μm at a flow rate of 20 L/min were simulated, with the distributions of exhaled aerosols recorded on a filter at the mouth exit. Aerosol patterns were quantified with multiple analytical techniques such as concentration disparity, spatial scanning and fractal analysis. We demonstrated that a growing bronchial tumor induced notable variations in both the airflow and exhaled aerosol distribution. These variations became more apparent with increasing tumor severity. The exhaled aerosols exhibited distinctive pattern parameters such as spatial probability, fractal dimension, and multifractal spectrum. Results of this study show that morphometric measures of the exhaled aerosol pattern can be used to detect and monitor the pathological states of respiratory diseases in the upper airway. The proposed breath test also has the potential to locate the site of the disease, which is critical in developing a personalized, site-specific drug delivery protocol.« less

CFD Modeling and Image Analysis of Exhaled Aerosols due to a Growing Bronchial Tumor: towards Non-Invasive Diagnosis and Treatment of Respiratory Obstructive Diseases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xi, Jinxiang; Kim, JongWon; Si, Xiuhua A.

Diagnosis and prognosis of tumorigenesis are generally performed with CT, PET, or biopsy. Such methods are accurate, but have the limitations of high cost and posing additional health risks to patients. In this study, we introduce an alternative computer aided diagnostic tool that can locate malignant sites caused by tumorigenesis in a non-invasive and low-cost way. Our hypothesis is that exhaled aerosol distribution is unique to lung structure and is sensitive to airway structure vari-ations. With appropriate approaches, it is possible to locate the disease site, determine the disease severity, and subsequently formulate a targeted drug delivery plan to treatmore » the disease. This study numerically evaluated the feasibility of the proposed breath test in an image-based lung model with varying pathological stages of a bronchial squamous tumor. Large eddy simulations and a Lagran-gian tracking approach were used to model respiratory airflows and aerosol dynamics. Respira-tions of tracer aerosols of 1 µm at a flow rate of 20 L/min were simulated, with the distributions of exhaled aerosols recorded on a filter at the mouth exit. Aerosol patterns were quantified with multiple analytical techniques such as concentration disparity, spatial scanning and fractal analysis. We demonstrated that a growing bronchial tumor induced notable variations in both the airflow and exhaled aerosol distribution. These variations became more apparent with increasing tumor severity. The exhaled aerosols exhibited distinctive pattern parameters such as spatial probability, fractal dimension, and multifractal spectrum. Results of this study show that morphometric measures of the exhaled aerosol pattern can be used to detect and monitor the pathological states of respiratory diseases in the upper airway. The proposed breath test also has the potential to locate the site of the disease, which is critical in developing a personalized, site-specific drug de-livery protocol.« less

CFD Modeling and Image Analysis of Exhaled Aerosols due to a Growing Bronchial Tumor: towards Non-Invasive Diagnosis and Treatment of Respiratory Obstructive Diseases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xi, Jinxiang; Kim, JongWon; Si, Xiuhua A.

Diagnosis and prognosis of tumorigenesis are generally performed with CT, PET, or biopsy. Such methods are accurate, but have the limitations of high cost and posing additional health risks to patients. In this study, we introduce an alternative computer aided diagnostic tool that can locate malignant sites caused by tumorigenesis in a non-invasive and low-cost way. Our hypothesis is that exhaled aerosol distribution is unique to lung structure and is sensitive to airway structure variations. With appropriate approaches, it is possible to locate the disease site, determine the disease severity, and subsequently formulate a targeted drug delivery plan to treatmore » the disease. This study numerically evaluated the feasibility of the proposed breath test in an image-based lung model with varying pathological stages of a bronchial squamous tumor. Large eddy simulations and a Lagrangian tracking approach were used to model respiratory airflows and aerosol dynamics. Respirations of tracer aerosols of 1 µm at a flow rate of 20 L/min were simulated, with the distributions of exhaled aerosols recorded on a filter at the mouth exit. Aerosol patterns were quantified with multiple analytical techniques such as concentration disparity, spatial scanning and fractal analysis. We demonstrated that a growing bronchial tumor induced notable variations in both the airflow and exhaled aerosol distribution. These variations became more apparent with increasing tumor severity. The exhaled aerosols exhibited distinctive pattern parameters such as spatial probability, fractal dimension, and multifractal spectrum. Results of this study show that morphometric measures of the exhaled aerosol pattern can be used to detect and monitor the pathological states of respiratory diseases in the upper airway. The proposed breath test also has the potential to locate the site of the disease, which is critical in developing a personalized, site-specific drug de- livery protocol.« less

Socio-demographic correlates of exhaled breath carbon monoxide in Karachi's adult population.

PubMed

Shafiq, Majid; Khan, Sumera; Khawaja, M Rizwanulhaq; Haque, Suleman; Khan, Javaid A

2008-02-01

To examine the relationship between CO levels and putative factors including smoking status among residents of Karachi, an urban center with very high levels of air pollution. Two hundred and eighteen volunteering subjects were asked to maximally exhale into a Smokerlyzer breath CO analyzer. Each of the volunteers was also asked to reply to a questionnaire-based interview seeking demographic information as well as details of exposure to tobacco, traffic fumes and other air pollutants. Out of the 218 participating subjects, 75% were males and 27% were current or ex-smokers. The mean CO level was 2.92 parts per million (ppm). Cigarette smoking was the only factor found to influence CO levels. Number of cigarettes smoked per day was directly related to CO levels, while time since the last smoke was inversely related. There was no difference in CO levels between ex-smokers and never-been-smokers. Years of residence in Karachi, quantitative exposure to traffic and perception of occupational exposure to air pollutants were not associated with CO levels. Smoking status, number of cigarettes smoked per day and time since last smoke correlated well with exhaled breath CO levels, in spite of high air pollution levels. This tool therefore continues to provide a valid and real-time assessment of a subject's current smoking status.

Pressure optimization of an EC-QCL based cavity ring-down spectroscopy instrument for exhaled NO detection

NASA Astrophysics Data System (ADS)

Zhou, Sheng; Han, Yanling; Li, Bincheng

2018-02-01

Nitric oxide (NO) in exhaled breath has gained increasing interest in recent years mainly driven by the clinical need to monitor inflammatory status in respiratory disorders, such as asthma and other pulmonary conditions. Mid-infrared cavity ring-down spectroscopy (CRDS) using an external cavity, widely tunable continuous-wave quantum cascade laser operating at 5.3 µm was employed for NO detection. The detection pressure was reduced in steps to improve the sensitivity, and the optimal pressure was determined to be 15 kPa based on the fitting residual analysis of measured absorption spectra. A detection limit (1σ, or one time of standard deviation) of 0.41 ppb was experimentally achieved for NO detection in human breath under the optimized condition in a total of 60 s acquisition time (2 s per data point). Diurnal measurement session was conducted for exhaled NO. The experimental results indicated that mid-infrared CRDS technique has great potential for various applications in health diagnosis.

13CO2/12CO2 ratio analysis in exhaled air by lead-salt tunable diode lasers for noninvasive diagnostics in gastroenterology

NASA Astrophysics Data System (ADS)

Stepanov, Eugene V.; Zyrianov, Pavel V.; Miliaev, Valerii A.; Selivanov, Yurii G.; Chizhevskii, Eugene G.; Os'kina, Svetlana; Ivashkin, Vladimir T.; Nikitina, Elena I.

1999-07-01

An analyzer of 13CO2/12CO2 ratio in exhaled air based on lead-salt tunable diode lasers is presented. High accuracy of the carbon isotope ratio detection in exhaled carbon dioxide was achieved with help of very simple optical schematics. It was based on the use of MBE laser diodes operating in pulse mode and on recording the resonance CO2 absorption at 4.2 micrometers . Special fast acquisition electronics and software were applied for spectral data collection and processing. Developed laser system was tested in a clinical train aimed to assessment eradication efficiency in therapy of gastritis associated with Helicobacter pylori infection. Data on the 13C-urea breath test used for P.pylori detection and obtained with tunable diode lasers in the course of the trail was compared with the results of Mass-Spectroscopy analysis and histology observations. The analyzer can be used also for 13CO2/12CO2 ratio detection in exhalation to perform gastroenterology breath test based on using other compounds labeled with stable isotopes.

Exhaled breath condensate MMP-9 levels in children with bronchiectasis.

PubMed

Karakoc, Gulbin Bingol; Inal, Ayfer; Yilmaz, Mustafa; Altintas, Derya Ufuk; Kendirli, Seval Guneser

2009-10-01

Bronchiectasis (BE) is still an important cause of chronic supurative respiratory diseases in developing countries. Neutrophil-derived proteases such as neutrophil elastase and matrix metalloproteases (MMPs) are implicated in causing airway damage in chronic pulmonary disease. In this study, we aimed to evaluate the MMP-9 and its natural tissue inhibitors of metalloproteinases (TIMP-1) levels utilizing the exhaled breath condensate (EBC) method and their relationship with radiological findings and pulmonary functions in children with BE.Thirty-eight children with BE and 12 healthy children were included: Group 1 (cystic fibrosis [CF] BE), Group 2 (non-CF BE), Group 3 (control group). High-resolution computerized tomography (HRCT) scores were calculated according to the anatomic extent of BE. Pulmonary function tests were performed, and MMP-9 and TIMP-1 levels in EBC were analyzed by ELISA.Exhaled breath condensate MMP-9 level was 48.9 +/- 26.8 ng/ml for Group 1, and for Group 2, 42.8 +/- 18.1 ng/ml; and for Group 3, 30 +/- 3.7 ng/ml. Although no statistically significant difference was found between the Groups 1 and 2, a significant difference was detected between these groups and controls. No statistically significant difference was found in TIMP-1 levels regarding all groups. EBC MMP-9 levels were inversely correlated with pulmonary functions test, and positively with HRCT scores and annual number of pulmonary infections.In conclusion, this study showed that EBC of children with both CF BE and non-CF BE contained higher levels of MMP-9 in comparison to controls. We suggest that EBC MMP-9 level may be a useful marker of airway injury in patients with BE however prospective studies are needed.

Daily life negative mood and exhaled nitric oxide in asthma.

PubMed

Ritz, Thomas; Kullowatz, Antje; Bill, Michelle N; Rosenfield, David

2016-07-01

Psychosocial stress and negative affect have been linked to asthma exacerbations, but longitudinal studies demonstrating a daily life association between negative affect and airway nitric oxide are missing. The longitudinal association between negative mood fluctuations, exhaled nitric oxide, and lung function in asthma was examined. Self-assessments of the fraction of exhaled nitric oxide (FeNO), spirometry (forced expiratory volume in the first second, FEV1), negative mood, and daily activities were obtained from 20 patients with asthma for 2 months, resulting in 1108 assessments for the analyses (approximately 55 per patient). Concurrent and prospective associations between FeNO, FEV1, and negative mood were analyzed using mixed effects regression models for longitudinal data. Negative mood was positively associated with changes in FeNO during the same day, and to a stronger extent when prior day negative mood was included in the prediction. FeNO and negative mood were positively associated with same-day FEV1, with the latter relation being partially mediated by changes in FeNO. Associations between FeNO and FEV1 were stronger in younger patients, with earlier onset of asthma, or with lower asthma control. Findings were not changed when controlling for physical activity, medication, cold symptoms, air pollution, and hours spent outside. Daily life changes of negative mood in asthma are positively associated with FeNO changes and FeNO increases are associated with a mild bronchodilation. These findings indicate that psychological influences need to be considered when using FeNO as indicator of airway inflammation and guide for treatment decisions. Copyright © 2016 Elsevier B.V. All rights reserved.

Radon exhalation rates and effective radium contents of the soil samples in Adapazarı, Turkey

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kuş, Adem, E-mail: adem.kus@ogr.sakarya.edu.tr; Yakut, Hakan, E-mail: hyakut@sakarya.edu.tr; Tabar, Emre, E-mail: etabar@sakarya.edu.tr

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 valuemore » 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.« less

Dielectric barrier discharge micro-plasma emission spectrometry for the detection of acetone in exhaled breath.

PubMed

Yang, Ting; Gao, Dong-Xue; Yu, Yong-Liang; Chen, Ming-Li; Wang, Jian-Hua

2016-01-01

Acetone is a predominant volatile organic compound (VOC) in the exhaled breath and a promising biomarker for diabetes and ketoacidosis. A non-thermal micro-plasma generated in a planar dielectric barrier discharge (DBD) is used as a radiation source for the excitation of gaseous acetone followed by its quantification with optical emission spectrometry (OES). Gaseous acetone can be directly sampled, while liquid acetone is evaporated by heated tungsten coil and then introduced into the DBD micro-plasma by a helium carrier flow for performing optical emission and detection at a 519 nm emission line. In the present study, the exhaled breath is collected and transferred into aqueous medium for sampling. With a sampling volume of 7 μL in a micro-drop, a linear range of 40-1600 mg L(-1) is obtained along with a detection limit of 44 ng and a precision of 5.7% RSD. The present system is successfully applied to the determination of breath acetone for both diabetic patients and healthy volunteers. Copyright © 2015 Elsevier B.V. All rights reserved.

Study of the exhaled acetone in type 1 diabetes using quantum cascade laser spectroscopy.

PubMed

Reyes-Reyes, Adonis; Horsten, Roland C; Urbach, H Paul; Bhattacharya, Nandini

2015-01-06

The acetone concentration exhaled in the breath of three type 1 diabetes patients (two minors and one adult) and one healthy volunteer is studied using a quantum cascade laser-based spectroscopic system. Using the acetone signature between 1150 and 1250 cm(-1) and a multiline fitting method, the concentration variations on the order of parts per billion by volume were measured. Blood glucose and ketone concentrations in blood measurements were performed simultaneously to study their relation with acetone in exhaled breath. We focus on personalized studies to better understand the role of acetone in diabetes. For each volunteer, we performed a series of measurements over a period of time, including overnight fastings of 11 ± 1 h and during ketosis-hyperglycemia events for the minors. Our results highlight the importance of performing personalized studies because the response of the minors to the presence of ketosis was consistent but unique for each individual. Also, our results emphasize the need for performing more studies with T1D minors, because the acetone concentration in the breath of the minors differs, with respect to those reported in the literature, which are based on adults.

Radon exhalation of hardening concrete: monitoring cement hydration and prediction of radon concentration in construction site.

PubMed

Kovler, Konstantin

2006-01-01

The unique properties of radon as a noble gas are used for monitoring cement hydration and microstructural transformations in cementitious system. It is found that the radon concentration curve for hydrating cement paste enclosed in the chamber increases from zero (more accurately - background) concentrations, similar to unhydrated cement. However, radon concentrations developed within 3 days in the test chamber containing cement paste were approximately 20 times higher than those of unhydrated cement. This fact proves the importance of microstructural transformations taking place in the process of cement hydration, in comparison with cement grain, which is a time-stable material. It is concluded that monitoring cement hydration by means of radon exhalation method makes it possible to distinguish between three main stages, which are readily seen in the time dependence of radon concentration: stage I (dormant period), stage II (setting and intensive microstructural transformations) and stage III (densification of the structure and drying). The information presented improves our understanding of the main physical mechanisms resulting in the characteristic behavior of radon exhalation in the course of cement hydration. The maximum value of radon exhalation rate observed, when cement sets, can reach 0.6 mBq kg(-1) s(-1) and sometimes exceeds 1.0 mBq kg(-1) s(-1). These values exceed significantly to those known before for cementitious materials. At the same time, the minimum ventilation rate accepted in the design practice (0.5 h(-1)), guarantees that the concentrations in most of the cases will not exceed the action level and that they are not of any radiological concern for construction workers employed in concreting in closed spaces.

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.

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...

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.

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

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.

Evaluation of H2O2 and pH in exhaled breath condensate samples: methodical and physiological aspects.

PubMed

Knobloch, Henri; Becher, Gunther; Decker, Manfred; Reinhold, Petra

2008-05-01

This veterinary study is aimed at further standardization of H(2)O(2) and pH measurements in exhaled breath condensate (EBC). Data obtained in the study provide valuable information for many mammalian species including humans, and may help to avoid general pitfalls in interpretation of EBC data. EBC was sampled via the 'ECoScreen' in healthy calves (body weight 63-98 kg). Serum samples and condensates of ambient (indoor) air were collected in parallel. In the study on H(2)O(2), concentrations of H(2)O(2) in EBC, blood and ambient air were determined with the biosensor system 'ECoCheck'. In EBC, the concentration of H(2)O(2) was found to be dependent on food intake and increased significantly in the course of the day. Physiologically, lowest H(2)O(2) concentrations at 06:00 varied within the range 138-624 nmol l(-1) EBC or 0.10-0.94 nmol per 100 l exhaled breath and individual concentrations were significantly different indicating a remarkable intersubject variability. Highly reproducible results were seen within each subject (three different days within 4 weeks). No correlation existed between H(2)O(2) concentrations in EBC and blood, and EBC-H(2)O(2) was not influenced by variables of spontaneous breathing. Further results confirmed that standardization of H(2)O(2) measurements in EBC requires (1) the re-calculation of the concentration exhaled per 100 l exhaled breath (because the analyzed concentration in the liquid condensate underlies multiple methodological sources of variability given by the collection process), and (2) subtracting the concentration of inspired indoor H(2)O(2). In the study on pH use of the ISFET electrode (Sentron, the Netherlands) and a blood gas analyzer ABL 550 (Radiometer, Denmark) led to comparable results for EBC-pH (r=0.89, R(2)=79.3%, p

Sensitive Spectroscopic Analysis of Biomarkers in Exhaled Breath

NASA Astrophysics Data System (ADS)

Bicer, A.; Bounds, J.; Zhu, F.; Kolomenskii, A. A.; Kaya, N.; Aluauee, E.; Amani, M.; Schuessler, H. A.

2018-06-01

We have developed a novel optical setup which is based on a high finesse cavity and absorption laser spectroscopy in the near-IR spectral region. In pilot experiments, spectrally resolved absorption measurements of biomarkers in exhaled breath, such as methane and acetone, were carried out using cavity ring-down spectroscopy (CRDS). With a 172-cm-long cavity, an efficient optical path of 132 km was achieved. The CRDS technique is well suited for such measurements due to its high sensitivity and good spectral resolution. The detection limits for methane of 8 ppbv and acetone of 2.1 ppbv with spectral sampling of 0.005 cm-1 were achieved, which allowed to analyze multicomponent gas mixtures and to observe absorption peaks of 12CH4 and 13CH4. Further improvements of the technique have the potential to realize diagnostics of health conditions based on a multicomponent analysis of breath samples.

Real-Time Quantitative Analysis of Valproic Acid in Exhaled Breath by Low Temperature Plasma Ionization Mass Spectrometry

NASA Astrophysics Data System (ADS)

Gong, Xiaoxia; Shi, Songyue; Gamez, Gerardo

2017-04-01

Real-time analysis of exhaled human breath is a rapidly growing field in analytical science and has great potential for rapid and noninvasive clinical diagnosis and drug monitoring. In the present study, an LTP-MS method was developed for real-time, in-vivo and quantitative analysis of γ-valprolactone, a metabolite of valproic acid (VPA), in exhaled breath without any sample pretreatment. In particular, the effect of working conditions and geometry of the LTP source on the ions of interest, protonated molecular ion at m/z 143 and ammonium adduct ion at m/z 160, were systematically characterized. Tandem mass spectrometry (MS/MS) with collision-induced dissociation (CID) was carried out in order to identify γ-valprolactone molecular ions ( m/z 143), and the key fragment ion ( m/z 97) was used for quantitation. In addition, the fragmentation of ammonium adduct ions to protonated molecular ions was performed in-source to improve the signal-to-noise ratio. At optimum conditions, signal reproducibility with an RSD of 8% was achieved. The concentration of γ-valprolactone in exhaled breath was determined for the first time to be 4.83 (±0.32) ng/L by using standard addition method. Also, a calibration curve was obtained with a linear range from 0.7 to 22.5 ng/L, and the limit of detection was 0.18 ng/L for γ-valprolactone in standard gas samples. Our results show that LTP-MS is a powerful analytical platform with high sensitivity for quantitative analysis of volatile organic compounds in human breath, and can have potential applications in pharmacokinetics or for patient monitoring and treatment.

L-arginine supplementation enhances exhaled NO, breath condensate VEGF, and headache at 4,342 m.

PubMed

Mansoor, Jim K; Morrissey, Brian M; Walby, William F; Yoneda, Ken Y; Juarez, Maya; Kajekar, Radhika; Severinghaus, John W; Eldridge, Marlowe W; Schelegle, Edward S

2005-01-01

We examined the effect of dietary supplementation with L-arginine on breath condensate VEGF, exhaled nitric oxide (NO), plasma erythropoietin, symptoms of acute mountain sickness, and respiratory related sensations at 4,342 m through the course of 24 h in seven healthy male subjects. Serum L-arginine levels increased in treated subjects at time 0, 8, and 24 h compared with placebo, indicating the effectiveness of our treatment. L-arginine had no significant effect on overall Lake Louise scores compared with placebo. However, there was a significant increase in headache within the L-arginine treatment group at 12 h compared with time 0, a change not seen in the placebo condition between these two time points. There was a trend (p = 0.087) toward greater exhaled NO and significant increases in breath condensate VEGF with L-arginine treatment, but no L-arginine effect on serum EPO. These results suggest that L-arginine supplementation increases HIF-1 stabilization in the lung, possibly through a NO-dependent pathway. In total, our observations indicate that L-arginine supplementation is not beneficial in the prophylactic treatment of AMS.

Effect of maximal dynamic exercise on exhaled ethane and carbon monoxide levels in human, equine, and canine athletes.

PubMed

Wyse, Cathy; Cathcart, Andy; Sutherland, Rona; Ward, Susan; McMillan, Lesley; Gibson, Graham; Padgett, Miles; Skeldon, Kenneth

2005-06-01

Exercise-induced oxidative stress (EIOS) refers to a condition where the balance of free radical production and antioxidant systems is disturbed during exercise in favour of pro-oxidant free radicals. Breath ethane is a product of free radical-mediated oxidation of cell membrane lipids and is considered to be a reliable marker of oxidative stress. The heatshock protein, haem oxygenase, is induced by oxidative stress and degrades haemoglobin to bilirubin, with concurrent production of carbon monoxide (CO). The aim of this study was to investigate the effect of maximal exercise on exhaled ethane and CO in human, canine, and equine athletes. Human athletes (n = 8) performed a maximal exercise test on a treadmill, and canine (n = 12) and equine (n = 11) athletes exercised at gallop on a sand racetrack. Breath samples were taken at regular intervals during exercise in the human athletes, and immediately before and after exercise in the canine and equine athletes. Breath samples were stored in gas-impermeable bags for analysis of ethane by laser spectroscopy, and CO was measured directly using an electrochemical CO monitor. Maximal exercise was associated with significant increases in exhaled ethane in the human, equine, and canine athletes. Decreased concentrations of exhaled CO were detected after maximal exercise in the human athletes, but CO was rarely detectable in the canine and equine athletes. The ethane breath test allows non-invasive and real-time detection of oxidative stress, and this method will facilitate further investigation of the processes mediating EIOS in human and animal athletes.

Determination of ethane, pentane and isoprene in exhaled air--effects of breath-holding, flow rate and purified air.

PubMed

Lärstad, M A E; Torén, K; Bake, B; Olin, A-C

2007-01-01

Exhaled ethane, pentane and isoprene have been proposed as biomarkers of oxidative stress. The objectives were to explore whether ethane, pentane and isoprene are produced within the airways and to explore the effect of different sampling parameters on analyte concentrations. The flow dependency of the analyte concentrations, the concentrations in dead-space and alveolar air after breath-holding and the influence of inhaling purified air on analyte concentrations were investigated. The analytical method involved thermal desorption from sorbent tubes and gas chromatography. The studied group comprised 13 subjects with clinically stable asthma and 14 healthy controls. Ethane concentrations decreased slightly, but significantly, at higher flow rates in subjects with asthma (P = 0.0063) but not in healthy controls. Pentane levels were increased at higher flow rates both in healthy and asthmatic subjects (P = 0.022 and 0.0063 respectively). Isoprene levels were increased at higher flow rates, but only significantly in healthy subjects (P = 0.0034). After breath-holding, no significant changes in ethane levels were observed. Pentane and isoprene levels increased significantly after 20 s of breath-holding. Inhalation of purified air before exhalation resulted in a substantial decrease in ethane levels, a moderate decrease in pentane levels and an increase in isoprene levels. The major fractions of exhaled ethane, pentane and isoprene seem to be of systemic origin. There was, however, a tendency for ethane to be flow rate dependent in asthmatic subjects, although to a very limited extent, suggesting that small amounts of ethane may be formed in the airways.

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 ...

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

Extensive radioactive characterization of a phosphogypsum stack in SW Spain: 226Ra, 238U, 210Po concentrations and 222Rn exhalation rate.

PubMed

Abril, José-María; García-Tenorio, Rafael; Manjón, Guillermo

2009-05-30

Phosphogypsum (PG) is a by-product of the phosphate fertilizer industries that contains relatively high concentrations of uranium series radionuclides. The US-EPA regulates the agriculture use of PG, attending to its (226)Ra content and to the (222)Rn exhalation rate from inactive stacks. Measurements of (222)Rn exhalation rates in PG stacks typically show a large and still poorly understood spatial and temporal variability, and the published data are scarce. This work studies an inactive PG stack in SW Spain of about 0.5 km(2) from where PG can be extracted for agriculture uses, and an agriculture soil 75 km apart, being representative of the farms to be amended with PG. Activity concentrations of (226)Ra, (238)U and (210)Po have been measured in 30 PG samples (0-90 cm horizon) allowing for the construction of maps with spatial distributions in the PG stack and for the characterization of the associated PG inputs to agriculture soils. Averaged (226)Ra concentrations for the stack were 730+/-60 Bq kg(-1) (d.w.), over the US-EPA limit of 370 Bq kg(-1). (222)Rn exhalation rate has been measured by the charcoal canister method in 49 sampling points with 3 canisters per sampling point. Values in PG stack were under the US-EPA limit of 2600 Bq m(-2)h(-1), but they were one order of magnitude higher than those found in the agriculture soil. Variability in radon emissions has been studied at different spatial scales. Radon exhalation rates were correlated with (226)Ra concentrations and daily potential evapotranspiration (ETo). They increased with ETo in agriculture soils, but showed an opposite behaviour in the PG stack.

The biology of exhaled nitric oxide (NO) in ischemia-reperfusion-induced lung injury: a tale of dynamism of NO production and consumption.

PubMed

Marczin, Nándor

2005-12-01

The main objective of this paper is to review the potential diagnostic roles of exhaled nitric oxide (NO) in evaluating ischemia-reperfusion-induced lung injury associated with cardiac surgery. We shall start by elaborating on current clinical practice of cardiac surgery and to arrive at the conclusion that clinically important ischemia-reperfusion injury is a common scenario of many forms of these surgical procedures. We shall conclude this part by establishing the clinical need for biomarkers of inflammation in cardiothoracic surgery and by proposing that exhaled NO could be an important new addition to our anaesthetic monitoring repertoire based on our expertise with exhaled breath monitoring. We shall then take a closer look at mechanisms of ischemia-reperfusion injury and will propose the role of reactive oxygen and nitrogen species as mediators and biomarkers of acute lung injury. This analysis will provide a good opportunity to highlight major potential mechanisms of altered NO production and bioactivity of NO. We shall conclude that multiple relevant mechanisms may either lead to increased production of NO or enhance consumption of NO, leaving us with the paradigm that NO maybe used either as a positive or negative biomarker of inflammation. In order to explore this dilemma further, we will investigate the predominant effect of oxidative stress on NO bioactivity in cell culture models of ischemia-reperfusion injury. We will then turn to animal models of ischemia-reperfusion injury to elucidate the ultimate effects of this condition on lung NO production and concentrations of NO in the lung. Finally, we shall complete this journey by highlighting the human relevance of these observations by reviewing our own experience at Harefield Hospital, UK, and that of others, regarding exhaled NO in ischemia-reperfusion injury associated with cardiac surgery and lung transplantation.

A NON-INVASIVE DIAGNOSIS OF INTESTINAL ISCHEMIA BY EXHALED BREATH ANALYSIS USING GAS CHROMATOGRAPHY AND MASS SPECTROMETRY-PRELIMINARY RESULTS

EPA Science Inventory

To explore the potential of exhaled breath analysis by Column Chromatography-Mass Spectrometry (GC-MS) as a non invasive and sensitive approach to evaluate mesenteric ischemia in pigs.

Domestic pigs (n=3) were anesthetized with Guaifenesin/ Fentanyl/ Ketamine/ Xylazine...

Performance of an exhaled nitric oxide and carbon dioxide sensor using quantum cascade laser-based integrated cavity output spectroscopy.

PubMed

McCurdy, Matthew R; Bakhirkin, Yury; Wysocki, Gerard; Tittel, Frank K

2007-01-01

Exhaled nitric oxide (NO) is an important biomarker in asthma and other respiratory disorders. The optical performance of a NOCO(2) sensor employing integrated cavity output spectroscopy (ICOS) with a quantum cascade laser operating at 5.22 microm capable of real-time NO and CO(2) measurements in a single breath cycle is reported. A NO noise-equivalent concentration of 0.4 ppb within a 1-sec integration time is achieved. The off-axis ICOS sensor performance is compared to a chemiluminescent NO analyzer and a nondispersive infrared (NDIR) CO(2) absorption capnograph. Differences between the gas analyzers are assessed by the Bland-Altman method to estimate the expected variability between the gas sensors. The off-axis ICOS sensor measurements are in good agreement with the data acquired with the two commercial gas analyzers. This work demonstrates the performance characteristics and merits of mid-infrared spectroscopy for exhaled breath analysis.

Natural radioactivity, radon exhalation rates and indoor radon concentration of some granite samples used as construction material in Turkey.

PubMed

Aykamis, Ahmet S; Turhan, Seref; Aysun Ugur, F; Baykan, Umut N; Kiliç, Ahmet M

2013-11-01

It is very important to determine the levels of the natural radioactivity in construction materials and radon exhalation rate from these materials for assessing potential exposure risks for the residents. The present study deals with 22 different granite samples employed as decoration stones in constructions in Turkey. The natural radioactivity in granite samples was measured by gamma-ray spectrometry with an HPGe detector. The activity concentrations of (226)Ra, (232)Th and (40)K were found to be in the range of 10-187, 16-354 and 104-1630 Bq kg(-1), respectively. The radon surface exhalation rate and the radon mass exhalation rate estimated from the measured values of (226)Ra content and material properties varied from 1.3 to 24.8 Bq m(-2) h(-1) with a mean of 10.5±1.5 Bq m(-2) h(-1) and 0.03-0.64 Bq kg(-1) h(-1) with a mean of 0.27±0.04 Bq kg(-1) h(-1), respectively. Radon concentrations in the room caused from granite samples estimated using a mass balance equation varied from 23 to 461 Bq m(-3) with a mean of 196±27 Bq m(-3). Also the gamma index (Iγ), external indoor annual effective dose (Eγ) and annual effective dose due to the indoor radon exposure (ERn) were estimated as the average value of 1.1±0.1, 0.16±0.02 mSv and 5.0±0.7 mSv, respectively, for the granite samples.

[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.

Manganese oxide mineralogy in an exhalative environment from the Solomon Islands

NASA Astrophysics Data System (ADS)

Taylor, G. R.

1983-04-01

The mineralogy and chemistry of oxidate facies sediments associated with a Solomon Island cupriferous pyrite deposit are described. Systematic variations in sediment composition are consistent with the gradual imposition of an oxidising environment on a pool of exhaled solution lying in a topographic depression on the sea floor. Manganese is first precipitated in the Mn2+ oxidation state as pyrochroite, γMn(OH)2. With later seafloor weathering and diagenesis, this oxidises initially to the Mn3+ intermediate minerals manganite (γMnO.OH) or, in the presence of iron hydroxides, to groutite (αMnO.OH). Subsequently, these oxidise further to Mn4+ as the βMnO2 dimorphs pyrolusite or ramsdellite, respectively. Todorokite (δMnO2) is indicative of more oxidising conditions and is found in the upper horizons of the manganiferous sediment. It is invariably non-stoichiometric in composition and its Mn2+/Mn4+ ratio is a direct function of the Eh prevailing during its precipitation. Adsorption of Na+, K+, Ca2+ and Ba2+ions at the time of formation stabilises the todorokite structure and provides an explanation for its persistence (with its Mn2+ions) in association with the completely oxidised Mn4+ mineral, βMnO2, pyrolusite. The enrichment of Cu, Zn and Pb in manganiferous sediments from both pelagic and exhalative environments is associated with the occurrence of goethite. The enrichment of K, Ba and Ca in manganiferous sediments from a similar range in environments is associated with the occurrence of todorokite. Both the mineralogy and trace element characteristics of a manganiferous sediment are thus a function of the environment of deposition rather than the ultimate source of the metals concerned. The trace element contents of manganiferous “floaters” should therefore only be used as an indicator of related sulphide mineralisation in the presence of other favourable factors.

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...

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.

Analytical methodologies for broad metabolite coverage of exhaled breath condensate.

PubMed

Aksenov, Alexander A; Zamuruyev, Konstantin O; Pasamontes, Alberto; Brown, Joshua F; Schivo, Michael; Foutouhi, Soraya; Weimer, Bart C; Kenyon, Nicholas J; Davis, Cristina E

2017-09-01

Breath analysis has been gaining popularity as a non-invasive technique that is amenable to a broad range of medical uses. One of the persistent problems hampering the wide application of the breath analysis method is measurement variability of metabolite abundances stemming from differences in both sampling and analysis methodologies used in various studies. Mass spectrometry has been a method of choice for comprehensive metabolomic analysis. For the first time in the present study, we juxtapose the most commonly employed mass spectrometry-based analysis methodologies and directly compare the resultant coverages of detected compounds in exhaled breath condensate in order to guide methodology choices for exhaled breath condensate analysis studies. Four methods were explored to broaden the range of measured compounds across both the volatile and non-volatile domain. Liquid phase sampling with polyacrylate Solid-Phase MicroExtraction fiber, liquid phase extraction with a polydimethylsiloxane patch, and headspace sampling using Carboxen/Polydimethylsiloxane Solid-Phase MicroExtraction (SPME) followed by gas chromatography mass spectrometry were tested for the analysis of volatile fraction. Hydrophilic interaction liquid chromatography and reversed-phase chromatography high performance liquid chromatography mass spectrometry were used for analysis of non-volatile fraction. We found that liquid phase breath condensate extraction was notably superior compared to headspace extraction and differences in employed sorbents manifested altered metabolite coverages. The most pronounced effect was substantially enhanced metabolite capture for larger, higher-boiling compounds using polyacrylate SPME liquid phase sampling. The analysis of the non-volatile fraction of breath condensate by hydrophilic and reverse phase high performance liquid chromatography mass spectrometry indicated orthogonal metabolite coverage by these chromatography modes. We found that the metabolite coverage

Preliminary assessment, by means of Radon exhalation rate measurements, of the bio-sustainability of microwave treatment to eliminate biodeteriogens infesting stone walls of monumental historical buildings.

NASA Astrophysics Data System (ADS)

Mancini, S.; Caliendo, E.; Guida, M.; Bisceglia, B.

2017-10-01

The main purpose of the work described in this paper has been to establish the protocol for a new non-disruptive technique of intervention, based on microwave treatment, for cleaning operations on monumental historical buildings, to eliminate biodeteriogens infesting stones. Non-destructive methods in the cleaning operations, should not only preserve the physical integrity, the chemical-mineralogical and structural identity of materials, but, when the exhalation of pollutant agents (like for example Radon gas) from building materials is considered, also, make the indoor air quality (IAQ) levels healthy. Therefore, one of the main steps of the protocol proposed in this paper is concerned with the assessment of the Radon exhalation rate in order to verify that microwave treatments do not increase the Radon naturally exhalated by building materials. In this paper, the preliminary results of the Radon measurements performed on two different type of tuff samples (grey tuff and yellow tuff), typical of the Italian traditional construction heritage, with the E-PERM passive technique at the Environmental Radioactivity Laboratory (Amb.Ra.), University of Salerno, Italy, ISO 9001:2008 certified, are summarized.

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.

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

STUDY OF RADON, THORON EXHALATION AND NATURAL RADIOACTIVITY IN COAL AND FLY ASH SAMPLES OF KOTA SUPER THERMAL POWER PLANT, RAJASTHAN, INDIA.

PubMed

Singh, Lalit Mohan; Kumar, Mukesh; Sahoo, B K; Sapra, B K; Kumar, Rajesh

2016-10-01

Electricity generation in India is largely dependent on coal-based thermal power plants, and increasing demand of energy raised the coal consumption in the power plants. In recent years, study of natural radioactivity content and radon/thoron exhalation from combustion of coal and its by-products has given considerable attention as they have been recognised as one of the important technically enhanced naturally occurring radioactive materials. In the present study, radon, thoron exhalation rate and the radioactivity concentration of radionuclides in coal and fly ash samples collected from Kota Super Thermal Power Plant, Rajasthan, India have been measured and compared with data of natural soil samples. The results have been analysed and discussed. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Comparison of exhaled nitric oxide measurements between NIOX MINO electrochemical and Ecomedics chemiluminescence analyzer.

PubMed

Boot, J D; de Ridder, L; de Kam, M L; Calderon, C; Mascelli, M A; Diamant, Z

2008-11-01

Exhaled nitric oxide (eNO) is an established, noninvasive biomarker of active airway inflammation in (atopic) asthma. Treatment with anti-inflammatory therapy, such as inhaled corticosteroids, effectively decreases eNO levels. The NIOX MINO (MINO) is a hand-held, relatively inexpensive, electrochemical device that has been shown to yield comparable eNO measurements to the NIOX stationary unit. To compare measurements of MINO with another widely used and validated stationary chemiluminescence analyzer, the Ecomedics (ECO). We performed subsequent eNO measurements on ECO and MINO in 50 subjects (19 healthy volunteers, 18 healthy smokers and 13 non-smoking, atopic asthmatics, not on controller therapy) on two visits 4-10 days apart. The mean of three acceptable measurements by ECO and the first acceptable measurement with the MINO were used for analysis. Both devices yielded reproducible eNO values for all subjects on both visits, with an overall CV of 22.7% (ECO) and 18.3% (MINO). A significant correlation was found between both devices (r=0.97, p<0.0001). Bland-Altman plots showed a high degree of agreement for the entire study population (mean difference MINO vs ECO=-10%; 95% limit of agreement were -36% and +28%) and in the three individual subgroups. Exhaled NO values measured with the MINO are reproducible and in agreement with the ECO. Our results add further evidence to the reliability of the MINO and warrant its applicability in research and clinical practice.

A collection system for dry solid residues from exhaled breath for analysis via atomic force microscopy.

PubMed

Morozov, Victor N; Mikheev, Andrey Y

2017-01-09

Exhaled air contains sub-micron droplets of lung liquid, which potentially bear biomarkers of lung diseases. After dehydration they form dry residue particles (DRPs). As a first step in developing techniques to characterize individual DRPs, a new electrostatic collector was designed in which DRPs are charged within a unipolar corona charger, concentrated in a cone funnel, and deposited onto a limited area of a highly oriented pyrolytic graphite surface. The collector captures 80%-90% of DRPs at an optimal flow rate of 0.15 l min -1 . Atomic force microscopy (AFM) revealed flattened round particles 20-50 nm high, with notable protrusions at their surface suggestive of an inhomogeneous internal structure. Exposure to humid air resulted in the DRPs spreading over the surface, with a 50%-200% decrease in their heights and an increase in their lateral dimensions so that their volume decreased by only 10% ± 3%. Exposure to saturated chloroform vapor resulted in drainage of 10%-15% of the DRP volume (presumably lipids), forming collar-shaped rings around each particle but leaving the core size and structure unchanged. AFM measurements combined with laser counter measurements of the DRP concentrations were used to estimate that one liter of air exhaled by volunteers contained less than 100 pg of dry residue material.

Effects of immersion in cool water on lung-exhaled nitric oxide at rest and during exercise

NASA Technical Reports Server (NTRS)

Pendergast, D. R.; Krasney, J. A.; DeRoberts, D.; Farhi, L. E. (Principal Investigator)

1999-01-01

Lung nitric oxide (NO) has been postulated to relax airway and vascular smooth muscle at rest and during exercise. As a cold environment is a common cause of respiratory distress, lung exhaled NO was measured during skin and core body cooling at rest and during a progressive cycle exercise. Ten healthy male subjects were immersed in water at a water temperature (Tw) which was thermal neutral (35 degrees C) at 30 degrees C Tw, at which only skin temperature is decreased; and at 20 degrees C Tw, at which the core temperature is decreased (0.05 degrees C). At rest, V(O), and V(E) increased while exhaled NO concentration [NO] and the rate of expiration of NO (V(NO)) decreased with decreased Tw. V(O2) and ventilation (V(E)) increased with workload (W) and the values at all Tw were not different, whereas, [NO] decreased with W and the values during exercise were progressively less at all Ws as Tw declined. These results indicate that lung NO output is reduced in a graded fashion during body cooling at rest and during exercise. This suggests that lower lung NO may contribute to airway obstruction in cold environments and NO may contribute to regulation of lung heat and water exchange.

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.

Storage conditions for stability of offline measurement of fractional exhaled nitric oxide after collection for epidemiologic research

PubMed Central

2012-01-01

Background The measurement of fractional concentration of nitric oxide in exhaled air (FeNO) is valuable for the assessment of airway inflammation. Offline measurement of FeNO has been used in some epidemiologic studies. However, the time course of the changes in FeNO after collection has not been fully clarified. In this study, the effects of storage conditions on the stability of FeNO measurement in exhaled air after collection for epidemiologic research were examined. Methods Exhaled air samples were collected from 48 healthy adults (mean age 43.4 ± 12.1 years) in Mylar bags. FeNO levels in the bags were measured immediately after collection. The bags were then stored at 4°C or room temperature to measure FeNO levels repeatedly for up to 168 hours. Results In the bags stored at room temperature after collection, FeNO levels were stable for 9 hours, but increased starting at 24 hours. FeNO levels remained stable for a long time at 4°C, and they were 99.7% ± 7.7% and 101.3% ± 15.0% relative to the baseline values at 24 and 96 hours, respectively. When the samples were stored at 4°C, FeNO levels gradually decreased with time among the subjects with FeNO ≥ 51 ppb immediately after collection, although there were almost no changes among the other subjects. FeNO levels among current smokers increased even at 4°C, although the values among ex-smokers decreased gradually, and those among nonsmokers remained stable. The rate of increase was significantly higher among current smokers than among nonsmokers and ex-smokers from 9 hours after collection onwards. Conclusions Storage at 4°C could prolong the stability of FeNO levels after collection. This result suggests that valid measurements can be performed within several days if the samples are stored at 4°C. However, the time course of the changes in FeNO levels differed in relation to initial FeNO values and cigarette smoking. PMID:23116255

Exercise in cold air and hydrogen peroxide release in exhaled breath condensate.

PubMed

Marek, E; Volke, J; Mückenhoff, K; Platen, P; Marek, W

2013-01-01

Athletes have changes in the lung epithelial cells caused by inhalation of cold and dry air. The exhaled breath condensate contains a number of mediators from the respiratory system and H(2)O(2) is described as a marker of airways inflammation. The aim of this study was to determine the influence of exercise combined with cold air on the H(2)O(2) release in the exhaled breath. Twelve males (23.1 ± 1.5 years) were randomly assigned at 2 different days (1 day rest) to perform a 50 min run (75-80% of their max. heart rate) under normal (N) laboratory (18.1 ± 1.1°C) or cold (C) field condition (-15.2 ± 3.1°C). Before and immediately after each run, the EBC was collected under laboratory conditions and was analyzed amperometrically. Prior to the two runs, H(2)O(2) concentrations were 145.0 ± 31.0 (N) and 160.0 ± 49.1 nmol/L (C) and theoretical release was 70.3 ± 37.1 (N) and 82.6 ± 27.1 pmol/min (C) (p > 0.05). After each run, H(2)O(2) concentration increased significantly to 388.0 ± 22.8 nmol/L (N) and 622.1 ± 44.2 nmol/L (C) (p < 0.05), along with an increase in the theoretical release: 249.2 ± 35.7 pmol/min (N) and 400.9 ± 35.7 pmol/min (C) (p < 0.05). We conclude that release of H(2)O(2) into the EBC takes place under both resting conditions and after exercise. The concentration and release of H(2)O(2) increased after exercise in cold air compared to resting and laboratory conditions, which points to an increase in inflammatory and oxidative stress.

Electrospun polystyrene/graphene nanofiber film as a novel adsorbent of thin film microextraction for extraction of aldehydes in human exhaled breath condensates.

PubMed

Huang, Jing; Deng, Hongtao; Song, Dandan; Xu, Hui

2015-06-09

In the current study, we introduced a novel polystyrene/graphene (PS/G) composite nanofiber film for thin film microextraction (TFME) for the first time. The PS/G nanofiber film was fabricated on the surface of filter paper by a facile electrospinning method. The morphology and extraction performance of the resultant composite film were investigated systematically. The PS/G nanofiber film exhibited porous fibrous structure, large surface area and strong hydrophobicity. A new thin film microextraction-high performance liquid chromatography (TFME-HPLC) method was developed for the determination of six aldehydes in human exhaled breath condensates. The method showed high enrichment efficiency and fast analysis speed. Under the optimal conditions, the linear ranges of the analytes were in the range of 0.02-30 μmol L(-1) with correlation coefficients above 0.9938, and the recoveries were between 79.8% and 105.6% with the relative standard deviation values lower than 16.3% (n=5). The limits of quantification of six aldehydes ranged from 13.8 to 64.6 nmol L(-1). The established method was successfully applied for the quantification of aldehyde metabolites in exhaled breath condensates of lung cancer patients and healthy people. Taken together, the TFME-HPLC method provides a simple, rapid, sensitive, cost-effective, non-invasion approach for the analysis of linear aliphatic aldehydes in human exhaled breath condensates. Copyright © 2015 Elsevier B.V. All rights reserved.

Fiber-Optic Bio-sniffer (Biochemical Gas Sensor) Using Reverse Reaction of Alcohol Dehydrogenase for Exhaled Acetaldehyde.

PubMed

Iitani, Kenta; Chien, Po-Jen; Suzuki, Takuma; Toma, Koji; Arakawa, Takahiro; Iwasaki, Yasuhiko; Mitsubayashi, Kohji

2018-02-23

Volatile organic compounds (VOCs) exhaled in breath have huge potential as indicators of diseases and metabolisms. Application of breath analysis for disease screening and metabolism assessment is expected since breath samples can be noninvasively collected and measured. In this research, a highly sensitive and selective biochemical gas sensor (bio-sniffer) for gaseous acetaldehyde (AcH) was developed. In the AcH bio-sniffer, a reverse reaction of alcohol dehydrogenase (ADH) was employed for reducing AcH to ethanol and simultaneously consuming a coenzyme, reduced form of nicotinamide adenine dinucleotide (NADH). The concentration of AcH can be quantified by fluorescence detection of NADH that was consumed by reverse reaction of ADH. The AcH bio-sniffer was composed of an ultraviolet light-emitting diode (UV-LED) as an excitation light source, a photomultiplier tube (PMT) as a fluorescence detector, and an optical fiber probe, and these three components were connected with a bifurcated optical fiber. A gas-sensing region of the fiber probe was developed with a flow-cell and an ADH-immobilized membrane. In the experiment, after optimization of the enzyme reaction conditions, the selectivity and dynamic range of the AcH bio-sniffer were investigated. The AcH bio-sniffer showed a short measurement time (within 2 min) and a broad dynamic range for determination of gaseous AcH, 0.02-10 ppm, which encompassed a typical AcH concentration in exhaled breath (1.2-6.0 ppm). Also, the AcH bio-sniffer exhibited a high selectivity to gaseous AcH based on the specificity of ADH. The sensor outputs were observed only from AcH-contained standard gaseous samples. Finally, the AcH bio-sniffer was applied to measure the concentration of AcH in exhaled breath from healthy subjects after ingestion of alcohol. As a result, a significant difference of AcH concentration between subjects with different aldehyde dehydrogenase type 2 (ALDH2) phenotypes was observed. The AcH bio-sniffer can be

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.

Exhaled Nitric Oxide is Not a Biomarker for Pulmonary Tuberculosis.

PubMed

López, José W; Loader, Maria-Cristina I; Smith, Daniel; Pastorius, Daniel; Bravard, Marjory; Caviedes, Luz; Romero, Karina M; Clark, Taryn; Checkley, William; Ticona, Eduardo; Friedland, Jon S; Gilman, Robert H

2018-06-01

To reduce transmission of tuberculosis (TB) in resource-limited countries where TB remains a major cause of mortality, novel diagnostic tools are urgently needed. We evaluated the fractional concentration of exhaled nitric oxide (FeNO) as an easily measured, noninvasive potential biomarker for diagnosis and monitoring of treatment response in participants with pulmonary TB including multidrug resistant-TB in Lima, Peru. In a longitudinal study however, we found no differences in baseline median FeNO levels between 38 TB participants and 93 age-matched controls (13 parts per billion [ppb] [interquartile range (IQR) = 8-26] versus 15 ppb [IQR = 12-24]), and there was no change over 60 days of treatment (15 ppb [IQR = 10-19] at day 60). Taking this and previous evidence together, we conclude FeNO is not of value in either the diagnosis of pulmonary TB or as a marker of treatment response.

Evaluation of oxidative status with exhaled breath 8-isoprostane levels in patients with hyperthyroidism.

PubMed

Bastug, Emrah; Tasliyurt, Turker; Kutluturk, Faruk; Sahin, Safak; Yilmaz, Ayse; Sivgin, Hakan; Yelken, Berna Murat; Ozturk, Banu; Yilmaz, Abdulkerim; Sahin, Semsettin

2013-12-01

Studies conducted so far on the effect of hyperthyroidism on oxidative stress (OS) have employed blood and urine samples. Exhaled Breath Condensate (EBC) is a non-invasive technique used to take sample from lungs to determine many biological indications. The aim of the present study was determine the possibility of using 8- isoprostane levels in EBC as an indicator of OS in hyperthyroid patients. The present study was performed on 42 patients with hyperthyroidism and 42 healthy control subjects. Hyperthyroid patients included patients with newly diagnosed Graves' disease, toxic multinodular goiter and toxic adenoma. Exhaled breath condensates were collected from patients in each group using a condensing device. 8- isoprostane levels as an indicator of OS in EBC were detected via immunoassay method. Hyperthyroid patients and control groups had 8-isoprostane levels of 6.08±6.31 and 1.56±0.88 pg/ml, respectively. The difference between patient and control groups was statistically significant (p<0.001). Of the hyperthyroid patients, eleven had Graves', 21 multinodular goiter, and 10 toxic adenoma diagnosis. There were no significant differences among patients of different diagnoses for 8-isoprostane levels (p=0.541). No significant correlations were found between 8-isoprostane and free thyroxine (fT4) or thyroid stimulating hormone (TSH) levels. In the present study, 8-isoprostane levels in EBC of hyperthyroid patients were found to be significantly higher than that in healthy control group. This study is important in that it is the first to evaluate the effects on respiratory system of elevated OS of hyperthyroidism in EBC.

Analysis of Exhaled Breath Volatile Organic Compounds in Inflammatory Bowel Disease: A Pilot Study.

PubMed

Hicks, Lucy C; Huang, Juzheng; Kumar, Sacheen; Powles, Sam T; Orchard, Timothy R; Hanna, George B; Williams, Horace R T

2015-09-01

Distinguishing between the inflammatory bowel diseases [IBD], Crohn's disease [CD] and ulcerative colitis [UC], is important for determining management and prognosis. Selected ion flow tube mass spectrometry [SIFT-MS] may be used to analyse volatile organic compounds [VOCs] in exhaled breath: these may be altered in disease states, and distinguishing breath VOC profiles can be identified. The aim of this pilot study was to identify, quantify, and analyse VOCs present in the breath of IBD patients and controls, potentially providing insights into disease pathogenesis and complementing current diagnostic algorithms. SIFT-MS breath profiling of 56 individuals [20 UC, 18 CD, and 18 healthy controls] was undertaken. Multivariate analysis included principal components analysis and partial least squares discriminant analysis with orthogonal signal correction [OSC-PLS-DA]. Receiver operating characteristic [ROC] analysis was performed for each comparative analysis using statistically significant VOCs. OSC-PLS-DA modelling was able to distinguish both CD and UC from healthy controls and from one other with good sensitivity and specificity. ROC analysis using combinations of statistically significant VOCs [dimethyl sulphide, hydrogen sulphide, hydrogen cyanide, ammonia, butanal, and nonanal] gave integrated areas under the curve of 0.86 [CD vs healthy controls], 0.74 [UC vs healthy controls], and 0.83 [CD vs UC]. Exhaled breath VOC profiling was able to distinguish IBD patients from controls, as well as to separate UC from CD, using both multivariate and univariate statistical techniques. Copyright © 2015 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Analysis of single-breath profiles of exhaled nitric oxide in children with allergy and asthma: guideline-derived plateau concentrations compared to results of automatic evaluation by two analyzers.

PubMed

Chládková, Jirina; Havlínová, Zuzana; Chyba, Tomás; Krcmová, Irena; Chládek, Jaroslav

2008-11-01

Current guidelines recommend the single-breath measurement of fractional concentration of exhaled nitric oxide (FE(NO)) at the expiratory flow rate of 50 mL/s as a gold standard. The time profile of exhaled FE(NO) consists of a washout phase followed by a plateau phase with a stable concentration. This study performed measurements of FE(NO) using a chemiluminescence analyzer Ecomedics CLD88sp and an electrochemical monitor NIOX MINO in 82 children and adolescents (44 males) from 4.9 to 18.7 years of age with corticosteroid-treated allergic rhinitis (N = 58) and/or asthma (N = 59). Duration of exhalation was 6 seconds for children less than 12 years of age and 10 seconds for older children. The first aim was to compare the evaluation of FE(NO)-time profiles from Ecomedics by its software in fixed intervals of 7 to 10 seconds (older children) and 2 to 4 seconds (younger children) since the start of exhalation (method A) with the guideline-based analysis of plateau concentrations at variable time intervals (method B). The second aim was to assess the between-analyzer agreement. In children over 12 years of age, the median ratio of FE(NO) concentrations of 1.00 (95% CI: 0.99-1.02) indicated an excellent agreement between the methods A and B. Compared with NIOX MINO, the Ecomedics results were higher by 11% (95% CI: 1-22) (method A) and 14% (95% CI: 4-26) (method B), respectively. In children less than 12 years of age, the FE(NO) concentrations obtained by the method B were 34% (95% CI: 21-48) higher and more reproducible (p < 0.02) compared to the method A. The Ecomedics results of the method A were 11% lower (95% CI: 2-20) than NIOX MINO concentrations while the method B gave 21% higher concentrations (95% CI: 9-35). We conclude that in children less than 12 years of age, the guideline-based analysis of FE(NO)-time profiles from Ecomedics at variable times obtains FE(NO) concentrations that are higher and more reproducible than those from the fixed interval of 2 to 4

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.

Exhaled ethane concentration in patients with cancer of the upper gastrointestinal tract - a proof of concept study.

PubMed

Abela, Jo Etienne; Skeldon, Kenneth D; Stuart, Robert C; Padgett, Miles J

2009-06-01

There has been growing interest in the measurement of breath ethane as an optimal non-invasive marker of oxidative stress. High concentrations of various breath alkanes including ethane have been reported in a number of malignancies. Our aim was to investigate the use of novel laser spectroscopy for rapid reporting of exhaled ethane and to determine whether breath ethane concentration is related to a diagnosis of upper gastrointestinal malignancy. Two groups of patients were recruited. Group A (n = 20) had a histo-pathological diagnosis of either esophageal or gastric malignancy. Group B (n = 10) was made up of healthy controls. Breath samples were collected from these subjects and the ethane concentration in these samples was subsequently measured to an accuracy of 0.2 parts per billion, ppb. Group A patients had a corrected exhaled breath ethane concentration of 2.3 +/- 0.8 (mean +/- SEM) ppb. Group B patients registered a mean of 3.1 +/- 0.5 ppb. There was no statistically significant difference between the two groups (p = 0.39). In conclusion, concentrations of ethane in collected breath samples were not significantly elevated in upper gastrointestinal malignancy. The laser spectroscopy system provided a reliable and rapid turnaround for breath sample analysis.

Quantification of Aerosol Hydrofluoroalkane HFA‐134a Elimination in the Exhaled Human Breath Following Inhaled Corticosteroids Administration

PubMed Central

Barletta, Barbara; Yoonessi, Leila; Meinardi, Simone; Leu, Szu‐Yun; Radom‐Aizik, Shlomit; Randhawa, Inderpal; Nussbaum, Eliezer; Blake, Donald R.; Cooper, Dan M.

2015-01-01

Abstract Inhaled corticosteroids (ICS) and β2‐agonists are the primary pharmacotherapies of asthma management. However, suboptimal medication compliance is common in asthmatics and is associated with increased morbidity. We hypothesized that exhaled breath measurements of the aerosol used in the inhaled medications might prove useful as surrogate marker for asthma medication compliance. To explore this, 10 healthy controls were recruited and randomly assigned to ICS (Flovent HFA) or short acting bronchodilators (Proventil HFA). Both inhalers contain HFA‐134a as aerosol propellant. Exhaled breath sampling and pulmonary function tests were performed prior to the inhaler medication dispersion, immediately after inhalation, then at 2, 4, 6, 8, 24, and 48 hours postadministration. At baseline, mean (SD) levels of HFA‐134a in the breath were 252 (156) pptv. Immediately after inhalation, HFA‐134a breath levels increased to 300 × 106 pptv and were still well above ambient levels 24 hours postadministration. The calculated ratio of forced expiratory volume in 1 second over forced vital capacity did not change over time following inhaler administration. This study demonstrates, for the first time, that breath HFA‐134a levels can be used to assess inhaler medication compliance. It may also be used to evaluate how effectively the medicine is delivered. PMID:26155923

Co-liquefaction with acetone and GC analysis of volatile compounds in exhaled breath as lung cancer biomarkers

PubMed Central

Jouyban, Abolghasem; Djozan, Djavanshir; Mohammadandashti, Parastou; Alizadeh-Nabil, Aliakbar; Ghorbanpour, Hooshangh; Khoubnasabjafari, Maryam; Mohammadzadeh, Mohammad

2017-01-01

Introduction: A simple, rapid and low cost method for enrichment of volatile organic compounds (VOCs) from exhaled breath (EB) is presented. Methods: A 1000 mL home-made extraction device was filled with EB. The VOCs were extracted and condensed in 0.5 mL acetone. Recognition of volatiles in the real studied EB samples was performed by a GC-MS. Results: The method displays an extraction efficiency of >86% with the enrichment factor of 1929 for octanal. Limits of detection and quantification, and linear dynamic range were 0.008, 0.026 and 0.026-400 ng/mL respectively. Analysis of real samples showed the existence of more than 100 compounds in EB of healthy volunteers and patients with lung cancer before and after treatment. Exhaled octanal concentration was significantly higher in lung cancer patient than in healthy volunteers and lung cancer patient after treatment. Conclusion: Having used the proposed approach, high extraction recovery (up to 86%) was attained for the lung cancer marker, octanal, as an important biomarker. Our findings on smaples of EB of healthy controls and patients with lung cancer before and after treatment provide complelling evidence upon the effectiveness of the developed method. PMID:28752074

Determination of exhaled nitric oxide distributions in a diverse sample population using tunable diode laser absorption spectroscopy

NASA Astrophysics Data System (ADS)

Namjou, K.; Roller, C. B.; Reich, T. E.; Jeffers, J. D.; McMillen, G. L.; McCann, P. J.; Camp, M. A.

2006-11-01

A liquid-nitrogen free mid-infrared tunable diode laser absorption spectroscopy (TDLAS) system equipped with a folded-optical-path astigmatic Herriott cell was used to measure levels of exhaled nitric oxide (eNO) and exhaled carbon dioxide (eCO2) in breath. Quantification of absolute eNO concentrations was performed using NO/CO2 absorption ratios measured by the TDLAS system coupled with absolute eCO2 concentrations measured with a non-dispersive infrared sensor. This technique eliminated the need for routine calibrations using standard cylinder gases. The TDLAS system was used to measure eNO in children and adults (n=799, ages 5 to 64) over a period of more than one year as part of a field study. Volunteers for the study self-reported data including age, height, weight, and health status. The resulting data were used to assess system performance and to generate eNO and eCO2 distributions, which were found to be log-normal and Gaussian, respectively. There were statistically significant differences in mean eNO levels for males and females as well as for healthy and steroid naïve asthmatic volunteers not taking corticosteroid therapies. Ambient NO levels affected measured eNO concentrations only slightly, but this effect was not statistically significant.

Association of recent exposure to ambient metals on fractional exhaled nitric oxide in 9-11 year old inner-city children.

PubMed

Rosa, Maria José; Perzanowski, Matthew S; Divjan, Adnan; Chillrud, Steven N; Hoepner, Lori; Zhang, Hanjie; Ridder, Robert; Perera, Frederica P; Miller, Rachel L

2014-08-31

Exposure to ambient metals in urban environments has been associated with wheeze, and emergency room visits and hospitalizations due to respiratory illness. However, the effect of ambient metals exposure on airway inflammation, and how these associations may be modified by seroatopy, has not been determined. Fractional exhaled nitric oxide (FENO) is a reliable proxy marker of airway inflammation. We hypothesized that recent ambient concentrations of Ni, V, Zn and Fe would be associated differentially with proximal and distal fractions of exhaled NO, and that these associations would be modified by seroatopy. As part of the Columbia Center for Children's Environmental Health (CCCEH) birth cohort study, 9-11 year old children (n=192) were evaluated. Ambient measures of Ni, V, Zn and Fe were obtained from a local central monitoring site and averaged over 9 days based on three 24h measures every third day. Fractional exhaled nitric oxide (FENO) samples were obtained at constant flows of 50 (FENO50), 83 and 100mL/s, and used to determine surrogate measures for proximal (JNO) and alveolar (Calv) inflammation. Seroatopy was determined by specific IgE at age 7. Data were analyzed using multivariable linear regression. Ambient V and Fe concentrations were associated positively with FENO50 (p=0.018, p=0.027). Ambient Fe was associated positively with JNO (p=0.017). Ambient Ni and V concentrations were associated positively with Calv (p=0.004, p=0.018, respectively). A stronger association of Ni concentrations with Calv was observed among the children with seroatopy. These results suggest that ambient metals are associated differentially with different fractions of FENO production, and this relationship may be modified by seroatopy. Copyright © 2014 Elsevier Inc. All rights reserved.

Using a chemiresistor-based alkane sensor to distinguish exhaled breaths of lung cancer patients from subjects with no lung cancer.

PubMed

Tan, Jiunn-Liang; Yong, Zheng-Xin; Liam, Chong-Kin

2016-10-01

Breath alkanes are reported to be able to discriminate lung cancer patients from healthy people. A simple chemiresistor-based sensor was designed to respond to alkanes by a change in resistance measured by a digital multimeter connected to the sensor. In preclinical experiments, the sensor response was found to have a strong positive linear relationship with alkane compounds and not responsive to water. This study aimed to determine the ability of the alkane sensor to distinguish the exhaled breaths of lung cancer patients from that of chronic obstructive pulmonary disease (COPD) patients and control subjects without lung cancer. In this cross-sectional study, 12 treatment-naive patients with lung cancer, 12 ex- or current smokers with COPD and 13 never-smokers without lung disease were asked to exhale through a drinking straw into a prototype breath-in apparatus made from an empty 125 mL Vitagen ® bottle with the chemiresistor sensor attached at its inside bottom to measure the sensor peak output (percentage change of baseline resistance measured before exhalation to peak resistance) and the time taken for the baseline resistance to reach peak resistance. Analysis of multivariate variance and post-hoc Tukey test revealed that the peak output and the time to peak values for the lung cancer patients were statistically different from that for both the COPD patients and the controls without lung disease, Pillai's Trace =0.393, F=3.909, df = (4, 64), P=0.007. A 2.20% sensor peak output and a 90-s time to peak gave 83.3% sensitivity and 88% specificity in diagnosing lung cancer. Tobacco smoking did not affect the diagnostic accuracy of the sensor. The alkane sensor could discriminate patients with lung cancer from COPD patients and people without lung disease. Its potential utility as a simple, cheap and non-invasive test for early lung cancer detection needs further studies.

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.

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.

Exhaled breath malondialdehyde, spirometric results and dust exposure assessment in ceramics production workers.

PubMed

Sakhvidi, Mohammad Javad Zare; Biabani Ardekani, Javad; Firoozichahak, Ali; Zavarreza, Javad; Hajaghazade, Mohammad; Mostaghaci, Mehrdad; Mehrparvar, Amirhooshang; Barkhordari, Abolfazl

2015-01-01

The study aimed at measuring exhaled breath malondialdehyde (EBC-MDA) in workers exposed to dust containing silica and at its comparison with the non-exposed control group. The cross sectional, case-control study (N = 50) was performed in a tile and ceramics production factory in Yazd, Iran. EBC-MDA was quantified in exhaled breath of the participants by a lab made breath sampler. Exposure intensity was measured according to the NIOSH 0600 method in selected homogeneous exposure groups. Additionally, spirometry test was conducted to investigate a correlation between EBC-MDA and spirometric findings in the exposed workers. There was no difference in the observed exposure intensities of silica containing dust in different units. However, "coating preparation" was the unit with the highest concentration of dust. Although, the level of EBC-MDA in the cases was slightly higher than in the controls, the difference was not statistically significant (U = 252, p = 0.464). A significant and positive correlation was found between dust exposure intensity in working units and the measured EBC-MDA of workers (r = 0.467, N = 25, p = 0.027). There were also no statistically significant differences among job categories in the exposed group for the values of FEV1% (F(3, 44) = 0.656, p = 0.584), FVC% (F(3, 44) = 1.417, p = 0.172), and FEV1/FVC% (F(3, 44) = 1.929, p = 0.139). The results showed a significant correlation between respirable dust exposure intensity and the level of EBC-MDA of the exposed subjects. However, our results did not show a significant correlation between lung function decreases and EBC-MDA. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Diagnostic value of a pattern of exhaled breath condensate biomarkers in asthmatic children.

PubMed

Maloča Vuljanko, I; Turkalj, M; Nogalo, B; Bulat Lokas, S; Plavec, D

Diagnosing asthma in children is a challenge and using a single biomarker from exhaled breath condensate (EBC) showed the lack of improvement in it. The aim of this study was to assess the diagnostic potential of a pattern of simple chemical biomarkers from EBC in diagnosing asthma in children in a real-life setting, its association with lung function and gastroesophageal reflux disease (GERD). In 75 consecutive children aged 5-7 years with asthma-like symptoms the following tests were performed: skin prick tests, spirometry, impulse oscillometry (IOS), exhaled NO (F E NO), 24-hour oesophageal pH monitoring and EBC collection with subsequent analysis of pH, carbon dioxide tension, oxygen tension, and concentrations of magnesium, calcium, iron and urates. No significant differences were found for individual EBC biomarkers between asthmatics and non-asthmatics (p>0.05 for all). A pattern of six EBC biomarkers showed a statistically significant (p=0.046) predictive model for asthma (AUC=0.698, PPV=84.2%, NPV=38.9%). None to moderate association (R 2 up to 0.43) between EBC biomarkers and lung function measures and F E NO was found, with IOS parameters showing the best association with EBC biomarkers. A significantly higher EBC Fe was found in children with asthma and GERD compared to asthmatics without GERD (p=0.049). An approach that involves a pattern of EBC biomarkers had a better diagnostic accuracy for asthma in children in real-life settings compared to a single one. Poor to moderate association of EBC biomarkers with lung function suggests a complementary value of EBC analysis for asthma diagnosis in children. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

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.

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

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.

The lung cancer breath signature: a comparative analysis of exhaled breath and air sampled from inside the lungs

NASA Astrophysics Data System (ADS)

Capuano, Rosamaria; Santonico, Marco; Pennazza, Giorgio; Ghezzi, Silvia; Martinelli, Eugenio; Roscioni, Claudio; Lucantoni, Gabriele; Galluccio, Giovanni; Paolesse, Roberto; di Natale, Corrado; D'Amico, Arnaldo

2015-11-01

Results collected in more than 20 years of studies suggest a relationship between the volatile organic compounds exhaled in breath and lung cancer. However, the origin of these compounds is still not completely elucidated. In spite of the simplistic vision that cancerous tissues in lungs directly emit the volatile metabolites into the airways, some papers point out that metabolites are collected by the blood and then exchanged at the air-blood interface in the lung. To shed light on this subject we performed an experiment collecting both the breath and the air inside both the lungs with a modified bronchoscopic probe. The samples were measured with a gas chromatography-mass spectrometer (GC-MS) and an electronic nose. We found that the diagnostic capability of the electronic nose does not depend on the presence of cancer in the sampled lung, reaching in both cases an above 90% correct classification rate between cancer and non-cancer samples. On the other hand, multivariate analysis of GC-MS achieved a correct classification rate between the two lungs of only 76%. GC-MS analysis of breath and air sampled from the lungs demonstrates a substantial preservation of the VOCs pattern from inside the lung to the exhaled breath.

Oral bacteria--the missing link to ambiguous findings of exhaled nitrogen oxides in cystic fibrosis.

PubMed

Zetterquist, Wilhelm; Marteus, Helena; Kalm-Stephens, Pia; Näs, Elisabeth; Nordvall, Lennart; Johannesson, Marie; Alving, Kjell

2009-02-01

Nitrite in exhaled breath condensate (EBC) has been shown to be elevated in cystic fibrosis (CF), while exhaled nitric oxide (FENO) is paradoxically low. This has been argued to reflect increased metabolism of NO while its diffusion is obstructed by mucus. However, we wanted to study the possible influence of salivary nitrite and bacterial nitrate reduction on these parameters in CF patients by the intervention of an anti-bacterial mouthwash. EBC and saliva were collected from 15 CF patients (10-43 years) and 15 controls (9-44 years) before and 5 min after a 30s chlorhexidine mouthwash, in parallel with measurements of FENO. Nitrite and nitrate concentrations were measured fluorometrically. EBC nitrite, but not nitrate, was significantly higher in the CF patients (median 3.6 vs 1.3 microM in controls, p<0.05) and decreased after mouthwash in both groups (3.6-1.4 microM, p<0.01; 1.3-0.5 microM, p<0.01). Salivary nitrite correlated significantly to EBC nitrite (r=0.60, p<0.001) and decreased correspondingly after chlorhexidine, whereas salivary nitrate increased. FENO was lower in CF and the difference between patients and controls was accentuated after mouthwash (5.4 vs 8.4 ppb in controls, p<0.05). EBC nitrite mainly originates in the pharyngo-oral tract and its increase in CF is possibly explained by a regional change in bacterial activity. The limited lower airway contribution supports the view of a genuinely impaired formation and metabolism of NO in CF, rather than poor diffusion of the molecule.

Phosgene- and chlorine-induced acute lung injury in rats: comparison of cardiopulmonary function and biomarkers in exhaled breath.

PubMed

Luo, Sa; Trübel, Hubert; Wang, Chen; Pauluhn, Jürgen

2014-12-04

This study compares changes in cardiopulmonary function, selected endpoints in exhaled breath, blood, and bronchoalveolar lavage fluid (BAL) following a single, high-level 30-min nose-only exposure of rats to chlorine and phosgene gas. The time-course of lung injury was systematically examined up to 1-day post-exposure with the objective to identify early diagnostic biomarkers suitable to guide countermeasures to accidental exposures. Chlorine, due to its water solubility, penetrates the lung concentration-dependently whereas the poorly water-soluble phosgene reaches the alveolar region without any appreciable extent of airway injury. Cardiopulmonary endpoints were continually recorded by telemetry and barometric plethysmography for 20h. At several time points blood was collected to evaluate evidence of hemoconcentration, changes in hemostasis, and osteopontin. One day post-exposure, protein, osteopontin, and cytodifferentials were determined in BAL. Nitric oxide (eNO) and eCO2 were non-invasively examined in exhaled breath 5 and 24h post-exposure. Chlorine-exposed rats elaborated a reflexively-induced decreased respiratory rate and bradycardia whereas phosgene-exposed rats developed minimal changes in lung function but a similar magnitude of bradycardia. Despite similar initial changes in cardiac function, the phosgene-exposed rats showed different time-course changes of hemoconcentration and lung weights as compared to chlorine-exposed rats. eNO/eCO2 ratios were most affected in chlorine-exposed rats in the absence of any marked time-related changes. This outcome appears to demonstrate that nociceptive reflexes with changes in cardiopulmonary function resemble typical patterns of mixed airway-alveolar irritation in chlorine-exposed rats and alveolar irritation in phosgene-exposed rats. The degree and time-course of pulmonary injury was reflected best by eNO/eCO2 ratios, hemoconcentration, and protein in BAL. Increased fibrin in blood occurred only in chlorine

EXHALED CARBON MONOXIDE LEVELS AMONG TOBACCO SMOKERS BY AGE.

PubMed

Chatrchaiwiwatana, Supaporn; Ratanasiri, Amornrat

2017-03-01

Measurement of exhaled carbon monoxide (ECO) has been used to confirm self-reported tobacco smoking. There is little data regarding ECO levels among Thai tobacco smokers by age. The objectives of this study were to determine ECO cutoff level to confirm tobacco smoking and to assess whether the cutoff level varies by age. During 2009 we evaluated 875 Thai volunteers aged 16-70 years, residing in Pathum Thani (central Thailand) and Khon Kaen (northeastern Thailand). Among the 875 volunteers, there were 584 non-smokers and 291 smokers. Each subject was interviewed and had their ECO level measured. The mean ECO level was 11.24 ppm among smokers and 2.25 ppm among non-smokers. The best ECO cutoff level to distinguish 291smokers from 584 non-smokers was 5 ppm (sensitivity 79.0%, specificity 89.9%).The optimal ECO cutoff level varied by age-group. For subjects aged 16-25 years, the best ECO cutoff level was 4 ppm (sensitivity 85.2%, specificity 77.5%) and for subject aged 26-70 years, the best ECO cutoff level was 5 ppm (sensitivity 79.4%, specificity 91.2%).These levels by age should be used among Thai subjects to determine smoking.

Increased leukotriene E4 in the exhaled breath condensate of children with mild asthma.

PubMed

Shibata, Atsushi; Katsunuma, Toshio; Tomikawa, Morimitsu; Tan, Aiko; Yuki, Keisuke; Akashi, Kenichi; Eto, Yoshikatsu

2006-12-01

Chronic airway inflammation is a feature of asthma. Increased levels of cysteinyl leukotrienes (cys-LTs; leukotriene [LT]C(4), LTD(4), LTE(4)) have been shown in the exhaled breath condensate (EBC) of children with moderate-to-severe asthma. The aim of this study was to examine the relationship between EBC cys-LTs (LTE(4)) levels and bronchial hyperreactivity in children with mild asthma in order to evaluate the clinical utility of measuring EBC cys-LTs levels. We measured LTE(4) levels in the EBC of children aged 8 to 18 years, including healthy nonasthmatic children (n = 6) and children with mild asthma (n = 37). Patients with mild asthma were classified into the following three groups: group 1, participants who had been asymptomatic (no wheezing/symptoms of asthma) for > 6 months prior to examination (n = 12); group 2, participants who were asymptomatic but had had wheezing/symptoms of asthma within 6 months before examination (n = 18); and group 3, patients with current wheeze and/or mild symptoms of asthma exacerbation at the time of examination. Exhaled LTE(4) levels were increased in all children with mild asthma compared with nonasthmatic control subjects (5.69 +/- 9.62 pg/20 min vs 0.74 +/- 0.79 pg/20 min, p < 0.05) [mean +/- SD]. In particular, the EBC LTE(4) levels in group 2 (4.99 +/- 6.70 pg/20 min) and group 3 (14.66 +/- 17.11 pg/20 min) were increased compared with control subjects and group 1 (1.50 +/- 1.69 pg/20 min). The EBC LTE(4) levels negatively correlated with the provocative concentration of methacholine causing a 15% fall in FEV(1) (r = - 0.454, p = 0.012). EBC cys-LTs may be useful as a noninvasive marker assessing airway inflammation and hyperreactivity in children with asthma.

Using a chemiresistor-based alkane sensor to distinguish exhaled breaths of lung cancer patients from subjects with no lung cancer

PubMed Central

Tan, Jiunn-Liang; Yong, Zheng-Xin

2016-01-01

Background Breath alkanes are reported to be able to discriminate lung cancer patients from healthy people. A simple chemiresistor-based sensor was designed to respond to alkanes by a change in resistance measured by a digital multimeter connected to the sensor. In preclinical experiments, the sensor response was found to have a strong positive linear relationship with alkane compounds and not responsive to water. This study aimed to determine the ability of the alkane sensor to distinguish the exhaled breaths of lung cancer patients from that of chronic obstructive pulmonary disease (COPD) patients and control subjects without lung cancer. Methods In this cross-sectional study, 12 treatment-naive patients with lung cancer, 12 ex- or current smokers with COPD and 13 never-smokers without lung disease were asked to exhale through a drinking straw into a prototype breath-in apparatus made from an empty 125 mL Vitagen® bottle with the chemiresistor sensor attached at its inside bottom to measure the sensor peak output (percentage change of baseline resistance measured before exhalation to peak resistance) and the time taken for the baseline resistance to reach peak resistance. Results Analysis of multivariate variance and post-hoc Tukey test revealed that the peak output and the time to peak values for the lung cancer patients were statistically different from that for both the COPD patients and the controls without lung disease, Pillai’s Trace =0.393, F=3.909, df = (4, 64), P=0.007. A 2.20% sensor peak output and a 90-s time to peak gave 83.3% sensitivity and 88% specificity in diagnosing lung cancer. Tobacco smoking did not affect the diagnostic accuracy of the sensor. Conclusions The alkane sensor could discriminate patients with lung cancer from COPD patients and people without lung disease. Its potential utility as a simple, cheap and non-invasive test for early lung cancer detection needs further studies. PMID:27867553

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

Biological effect markers in exhaled breath condensate and biomonitoring in welders: impact of smoking and protection equipment.

PubMed

Gube, Monika; Ebel, Joachim; Brand, Peter; Göen, Thomas; Holzinger, Karl; Reisgen, Uwe; Kraus, Thomas

2010-10-01

The objective of this study was to investigate the effect of welding as well as the impact of smoking and protection measures on biological effect markers in exhaled breath condensate. Additionally, biomonitoring of chromium, aluminium and nickel in urine was performed to quantify internal exposure. Exhaled breath condensate (EBC) and urine samples of 45 male welders and 24 male non-exposed control subjects were collected on Friday pre-shift and after 8 h of work post-shift. In EBC, biological effect markers such as malondialdehyde, nitrite, nitrate, 3-nitrotyrosine, tyrosine, hydroxyproline, proline, H(2)O(2) and pH-value were measured while aluminium, nickel, and chromium were measured in the urine samples. Although internal exposure to aluminium, nickel and chromium in this study was low, welders showed significantly increased concentrations of all these parameters at baseline compared to non-exposed controls. Moreover, welders had higher nitrate concentrations in EBC at baseline and after shift. Nitrate concentration was considerably lower after shift if personal protection equipment was used. H(2)O(2) was increased only when subjects smoked during shift. It has been shown that welding-associated long-term and short-term health effects could be detected in a population of welders. The results also showed that using personal protection equipment is of high importance and H(2)O(2) may be an effect marker associated with smoking rather than with welding fumes, while nitrate in EBC seems to be sensitive to welding fume exposure.

Respiratory symptoms, lung functions, and exhaled nitric oxide (FENO) in two types of fish processing workers: Russian trawler fishermen and Norwegian salmon industry workers.

PubMed

Shiryaeva, Olga; Aasmoe, Lisbeth; Straume, Bjørn; Bang, Berit Elisabeth

2015-01-01

Respiratory outcomes and work-related factors were studied in two seafood worker populations representing different occupational environments. Levels of fractional exhaled nitric oxide (FENO), spirometric values, prevalence of respiratory symptoms, and self-evaluated exposures were compared between 139 Norwegian salmon workers and 127 Russian trawler workers. Increased odds ratios (ORs) of shortness of breath with wheezing and prolonged cough as general respiratory symptoms were found in salmon workers, while increased ORs of work-related dry cough and running nose were found in trawler fishermen. Both worker groups ranked "cold work environment," "use of disinfectants," and "contaminated indoor air" as the first, second, and third most important causes of work-related respiratory symptoms, respectively. Fractional exhaled nitric oxide levels were higher in asthmatic trawler workers compared to asthmatic salmon workers. Respiratory symptoms commonly associated with obstructive airway diseases were more prevalent in salmon workers, while symptoms commonly associated with asthma and short-term effects of cold air exposure were more prevalent in trawler workers.

Optimising hydrogen peroxide measurement in exhaled breath condensate.

PubMed

Brooks, Wendy M; Lash, Heath; Kettle, Anthony J; Epton, Michael J

2006-01-01

Exhaled breath condensate (EBC) analysis has been proposed as a non-invasive method of assessing airway pathology. A number of substances, including hydrogen peroxide (H2O2), have been measured in EBC, without adequate published details of validation and optimisation. To explore factors that affect accurate quantitation of H2O2 in EBC. H2O2 was measured in EBC samples using fluorometry with 4-hydroxyphenylacetic acid. A number of factors that might alter quantitation were studied including pH and buffering conditions, reagent storage, and assay temperature. Standard curve slope was significantly altered by pH, leading to a potential difference in H2O2 quantification of up to 42%. These differences were resolved by increasing the buffering capacity of the reaction mix. H2O2 added to EBC remained stable for 1 h when stored on ice. The assay was unaffected by freezing assay reagents. The limit of detection for H2O2 ranged from 3.4 nM to 8.8 nM depending on the buffer used. The reagents required for this assay can be stored for several months allowing valuable consistency in longitudinal studies. The quantitation of H2O2 in EBC is pH-dependent but increasing assay buffering reduces this effect. Sensitive reproducible quantitation of H2O2 in EBC requires rigorous optimisation.

Association Between Smoking Status, Preoperative Exhaled Carbon Monoxide Levels, and Postoperative Surgical Site Infection in Patients Undergoing Elective Surgery

PubMed Central

Martin, David P.; Thompson, Rodney; Schroeder, Darrell R.; Hanson, Andrew C.; Warner, David O.

2017-01-01

Importance Cigarette smoking is a risk factor for many perioperative complications, including surgical site infection (SSI). The duration of abstinence from smoking required to reduce this risk is unknown. Objectives To evaluate if abstinence from smoking on the day of surgery is associated with a decreased frequency of SSI in patients who smoke cigarettes and to confirm that smoking is significantly independently associated with SSI when adjustment is made for potentially relevant covariates, such as body mass index. Design, Setting, and Participants In this observational, nested, matched case-control study, 2 analyses were performed at an academic referral center in the upper Midwest. Cases included all patients undergoing elective surgical procedures at Mayo Clinic, Rochester, Minnesota, between January 1, 2009, and July 31, 2014 (inclusive) who subsequently developed an SSI. Controls for both analyses were matched on age, sex, and type of surgery. Exposures Smoking status and preoperative exhaled carbon monoxide level, assessed by nurses in the preoperative holding area. Patients were classified as smoking on the day of surgery if they self-reported smoking or if their preoperative exhaled carbon monoxide level was 10 ppm or higher. Main Outcomes and Measures Surgical site infection after a surgical procedure at Mayo Clinic, Rochester, as identified by routine clinical surveillance using National Healthcare Safety Network criteria. Results Of the 6919 patients in the first analysis, 3282 (47%) were men and 3637 (53%) were women; median age (interquartile range) for control and SSI cases was 60 (48-70). Of the 392 patients in the second analysis, 182 (46%) were men and 210 (54%) were women; median age (interquartile range) for controls was 53 (45-49) and for SSI cases was 51 (45-60). During the study period, approximately 2% of surgical patients developed SSI annually. Available for the first analysis (evaluating the influence of current smoking status) were

Short-term effects of electronic and tobacco cigarettes on exhaled nitric oxide

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marini, Sara, E-mail: s.marini@unicas.it; Buonanno, Giorgio; Queensland University of Technology, Brisbane

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 inmore » 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

Breath alcohol concentration determined with a new analyzer using free exhalation predicts almost precisely the arterial blood alcohol concentration.

PubMed

Lindberg, L; Brauer, S; Wollmer, P; Goldberg, L; Jones, A W; Olsson, S G

2007-05-24

A new breath alcohol (ethanol) analyzer has been developed, which allows free exhalation, standardizes measured exhaled alcohol concentration to fully saturated water vapor at a body temperature of 37 degrees C (43.95 mg/L) and includes a built-in self-calibration system. We evaluated the performance of this instrument by comparing standardized alcohol concentration in freely expired breath (BrAC) with arterial (ABAC) and venous (VBAC) blood alcohol concentrations in fifteen healthy volunteers who drank 0.6 g of alcohol per kg body weight. The precision (coefficient of variation, CV) of the analyzer based on in vivo duplicate measurements in all phases of the alcohol metabolism was 1.7%. The ABAC/BrAC ratio was 2251+/-46 (mean+/-S.D.) in the post-absorptive phase and the mean bias between ABAC and BrAC x 2251 was 0.0035 g/L with 95% limits of agreement of 0.033 and -0.026. The ABAC and BrAC x 2251 were highly correlated (r=0.998, p<0.001) and the regression relationship was ABAC = 0.00045 + 1.0069 x (BrAC x 2251) indicating excellent agreement and no fixed or proportional bias. In the absorption phase, ABAC exceeded BrAC x 2251 by at most 0.04+/-0.03 g/L when tests were made at 10 min post-dosing (p<0.05). The VBAC/BrAC ratio never stabilized and varied continuously between 1834 and 3259. There was a proportional bias between VBAC and BrAC x 2251 (ABAC) in the post-absorptive phase (p<0.001). The pharmacokinetic analysis of the elimination rates of alcohol and times to zero BAC confirmed that BrAC x 2251 and ABAC agreed very well with each other, but not with VBAC (p<0.001). We conclude that this new breath analyzer using free exhalation has a high precision for in vivo testing. The BrAC reflects very accurately ABAC in the post-absorption phase and substantially well in the absorption phase and thereby reflects the concentration of alcohol reaching the brain. Our findings highlight the magnitude of arterio-venous differences in alcohol concentration and support

Bio-sniffer (gas-phase biosensor) with secondary alcohol dehydrogenase (S-ADH) for determination of isopropanol in exhaled air as a potential volatile biomarker.

PubMed

Chien, Po-Jen; Suzuki, Takuma; Tsujii, Masato; Ye, Ming; Toma, Koji; Arakawa, Takahiro; Iwasaki, Yasuhiko; Mitsubayashi, Kohji

2017-05-15

Exhaled breath analysis has attracted lots of researchers attention in the past decades due to its advantages such as its non-invasive property and the possibility of continuous monitoring. In addition, several volatile organic compounds in breath have been identified as biomarkers for some diseases. Particularly, studies have pointed out that concentration of isopropanol (IPA) in exhaled air might relate with certain illnesses such as liver disease, chronic obstructive pulmonary (COPD), and lung cancer. In this study, a highly sensitive and selective biochemical gas sensor (bio-sniffer) for the breath IPA concentration determination was constructed and optimized. This bio-sniffer measures the concentration of IPA according to the fluorescence intensity of oxidized nicotinamide adenine dinucleotide (NADH), which was produced by an enzymatic reaction of secondary alcohol dehydrogenase (S-ADH). The NADH detection system employed an UV-LED as the excitation light, and a highly sensitive photomultiplier tube (PMT) as a fluorescence intensity detector. A gas-sensing region was developed using an optical fiber probe equipped with a flow-cell and enzyme immobilized membrane, and connected to the NADH measurement system. The calibration range of the IPA bio-sniffer was confirmed from 1ppb to 9060ppb that was comparable to other IPA analysis methods. The results of the analysis of breath IPA concentration in healthy subjects using the bio-sniffer showed a mean concentration of 16.0ppb, which was similar to other studies. These results have demonstrated that this highly sensitive and selective bio-sniffer could be used to measure the IPA in exhaled air, and it is expected to apply for breath IPA research and investigation of biomarkers for clinical diagnosis. Copyright © 2016 Elsevier B.V. All rights reserved.

Early childhood growth patterns and school-age respiratory resistance, fractional exhaled nitric oxide and asthma.

PubMed

Casas, Maribel; den Dekker, Herman T; Kruithof, Claudia J; Reiss, Irwin K; Vrijheid, Martine; de Jongste, Johan C; Jaddoe, Vincent W V; Duijts, Liesbeth

2016-12-01

Greater infant weight gain is associated with lower lung function and increased risk of childhood asthma. The role of early childhood peak growth patterns is unclear. We assessed the associations of individually derived early childhood peak growth patterns with respiratory resistance, fractional exhaled nitric oxide, wheezing patterns, and asthma until school-age. We performed a population-based prospective cohort study among 5364 children. Repeated growth measurements between 0 and 3 years of age were used to derive standard deviation scores (s.d.s) of peak height and weight velocities (PHV and PWV, respectively), and body mass index (BMI) and age at adiposity peak. Respiratory resistance and fractional exhaled nitric oxide were measured at 6 years of age. Wheezing patterns and asthma were prospectively assessed by annual questionnaires. We also assessed whether any association was explained by childhood weight status. Greater PHV was associated with lower respiratory resistance [Z-score (95% CI): -0.03 (-0.04, -0.01) per s.d.s increase] (n = 3382). Greater PWV and BMI at adiposity peak were associated with increased risks of early wheezing [relative risk ratio (95% CI): 1.11 (1.06, 1.16), 1.26 (1.11, 1.43), respectively] and persistent wheezing [relative risk ratio (95% CI): 1.09 (1.03, 1.16), 1.37 (1.17, 1.60), respectively] (n = 3189 and n = 3005, respectively). Childhood weight status partly explained these associations. No other associations were observed. PWV and BMI at adiposity peak are critical for lung developmental and risk of school-age wheezing. Follow-up studies at older ages are needed to elucidate whether these effects persist at later ages. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Secondary electrospray ionization-mass spectrometry and a novel statistical bioinformatic approach identifies a cancer-related profile in exhaled breath of breast cancer patients: a pilot study.

PubMed

Martinez-Lozano Sinues, Pablo; Landoni, Elena; Miceli, Rosalba; Dibari, Vincenza F; Dugo, Matteo; Agresti, Roberto; Tagliabue, Elda; Cristoni, Simone; Orlandi, Rosaria

2015-09-21

Breath analysis represents a new frontier in medical diagnosis and a powerful tool for cancer biomarker discovery due to the recent development of analytical platforms for the detection and identification of human exhaled volatile compounds. Statistical and bioinformatic tools may represent an effective complement to the technical and instrumental enhancements needed to fully exploit clinical applications of breath analysis. Our exploratory study in a cohort of 14 breast cancer patients and 11 healthy volunteers used secondary electrospray ionization-mass spectrometry (SESI-MS) to detect a cancer-related volatile profile. SESI-MS full-scan spectra were acquired in a range of 40-350 mass-to-charge ratio (m/z), converted to matrix data and analyzed using a procedure integrating data pre-processing for quality control, and a two-step class prediction based on machine-learning techniques, including a robust feature selection, and a classifier development with internal validation. MS spectra from exhaled breath showed an individual-specific breath profile and high reciprocal homogeneity among samples, with strong agreement among technical replicates, suggesting a robust responsiveness of SESI-MS. Supervised analysis of breath data identified a support vector machine (SVM) model including 8 features corresponding to m/z 106, 126, 147, 78, 148, 52, 128, 315 and able to discriminate exhaled breath from breast cancer patients from that of healthy individuals, with sensitivity and specificity above 0.9.Our data highlight the significance of SESI-MS as an analytical technique for clinical studies of breath analysis and provide evidence that our noninvasive strategy detects volatile signatures that may support existing technologies to diagnose breast cancer.

Biomarkers of exposure to metal dust in exhaled breath condensate: methodology optimization.

PubMed

Félix, P M; Franco, C; Barreiros, M A; Batista, B; Bernardes, S; Garcia, S M; Almeida, A B; Almeida, S M; Wolterbeek, H Th; Pinheiro, T

2013-01-01

In occupational assessments where workers are exposed to metal dust, the liquid condensate of exhaled breath (EBC) may provide unique indication of pulmonary exposure. The main goal of this study was to demonstrate the quality of EBC to biological monitoring of human exposure. A pilot study was performed in a group of metal dust-exposed workers and a group of nonexposed individuals working in offices. Only metal dust-exposed workers were followed along the working week to determine the best time of collection. Metal analyses were performed with inductively coupled plasma mass spectrometry (ICP-MS). Analytical methodology was tested using an EBC sample pool for several occupationally exposed metals: potassium, chromium, manganese, copper, zinc, strontium, cadmium, antimony, and lead. Metal contents in EBC of exposed workers were higher than controls at the beginning of the shift and remained augmented throughout the working week. The results obtained support the establishment of EBC as an indicator of pulmonary exposure to metals.

Variability of exhaled breath condensate pH in lung transplant recipients.

PubMed

Czebe, Krisztina; Kullmann, Tamas; Csiszer, Eszter; Barat, Erzsebet; Horvath, Ildiko; Antus, Balazs

2008-01-01

Measurement of pH in exhaled breath condensate (EBC) may represent a novel method for investigating airway pathology. The aim of this longitudinal study was to assess the variability of EBC pH in stable lung transplant recipients (LTR). During routine clinical visits 74 EBC pH measurements were performed in 17 LTR. EBC pH was also measured in 19 healthy volunteers on four separate occasions. EBC pH was determined at standard CO2 partial pressure by a blood gas analyzer. Mean EBC pH in clinically stable LTR and in controls was similar (6.38 +/- 0.09 vs. 6.44 +/- 0.16; p = nonsignificant). Coefficient of variation for pH in LTR and controls was 2.1 and 2.3%, respectively. The limits of agreement for between-visit variability determined by the Bland-Altman test in LTR and healthy volunteers were also comparable (-0.29 and 0.46 vs. -0.53 and 0.44). Our data suggest that the variability of EBC pH in stable LTR is relatively small, and it is similar to that in healthy nontransplant subjects.

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.

A model to predict radon exhalation from walls to indoor air based on the exhalation from building material samples.

PubMed

Sahoo, B K; Sapra, B K; Gaware, J J; Kanse, S D; Mayya, Y S

2011-06-01

In recognition of the fact that building materials are an important source of indoor radon, second only to soil, surface radon exhalation fluxes have been extensively measured from the samples of these materials. Based on this flux data, several researchers have attempted to predict the inhalation dose attributable to radon emitted from walls and ceilings made up of these materials. However, an important aspect not considered in this methodology is the enhancement of the radon flux from the wall or the ceiling constructed using the same building material. This enhancement occurs mainly because of the change in the radon diffusion process from the former to the latter configuration. To predict the true radon flux from the wall based on the flux data of building material samples, we now propose a semi-empirical model involving radon diffusion length and the physical dimensions of the samples as well as wall thickness as other input parameters. This model has been established by statistically fitting the ratio of the solution to radon diffusion equations for the cases of three-dimensional cuboidal shaped building materials (such as brick, concrete block) and one dimensional wall system to a simple mathematical function. The model predictions have been validated against the measurements made at a new construction site. This model provides an alternative tool (substitute to conventional 1-D model) to estimate radon flux from a wall without relying on ²²⁶Ra content, radon emanation factor and bulk density of the samples. Moreover, it may be very useful in the context of developing building codes for radon regulation in new buildings. Copyright © 2011 Elsevier B.V. All rights reserved.

Exhaled gases online measurements for esophageal cancer patients and healthy people by proton transfer reaction mass spectrometry.

PubMed

Zou, Xue; Zhou, Wenzhao; Lu, Yan; Shen, Chengyin; Hu, Zongtao; Wang, Hongzhi; Jiang, Haihe; Chu, Yannan

2016-11-01

Esophageal cancer is a prevalent malignancy. There is a considerable demand for developing a fast and noninvasive method to screen out the suspect esophageal cancer patients who may undergo further clinical diagnosis. The exhaled breathes from 29 esophageal cancer patients and 57 healthy people were directly measured using our home-made proton transfer reaction mass spectrometer (PTR-MS). Mann-Whitney U test and stepwise discriminant analysis were applied to identify the ions in the breath mass spectral data which can distinguish cancer cohort from healthy group. Receiver operating characteristics (ROC) analysis was also performed. Seven kinds of ions in the breath mass spectrum, viz., m/z 136, m/z 34, m/z 63, m/z 27, m/z 95, m/z 107 and m/z 45, have been found to distinguish between the esophageal cancer patients and healthy people with a sensitivity of 86.2% and a specificity of 89.5%, respectively. Compared with that from the healthy people, the breath mass spectra from esophageal cancer patients show that the mediant intensities of five kinds of ions were decrease and the rest two kinds of ions were increase. ROC analysis gave the area under the curve (AUC) of 0.943. This pilot study shows that the ionic characteristics of exhaled VOCs detected by PTR-MS may be used to differentiate between the esophageal cancer patients and the healthy people. Although the breath tests for more patients are needed to confirm such results, the present work indicates that the PTR-MS may be a promising method in the esophageal cancer screening. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Alveolar and exhaled NO in relation to asthma characteristics--effects of correction for axial diffusion.

PubMed

Heijkenskjöld-Rentzhog, C; Nordvall, L; Janson, C; Borres, M P; Alving, K; Malinovschi, A

2014-08-01

Inflammation in the small airways might contribute to incomplete asthma disease control despite intensive treatment in some subgroups of patients. Exhaled NO (FeNO) is a marker of inflammation in asthma and the estimated NO contribution from small airways (CalvNO ) is believed to reflect distal inflammation. Recent studies recommend adjustments of CalvNO for trumpet model and axial diffusion (TMAD-adj). This study aimed to investigate the clinical correlates of CalvNO , both TMAD-adjusted and unadjusted. Asthma symptoms, asthma control, lung function, bronchial responsiveness, blood eosinophils, atopy and treatment level were assessed in 410 subjects, aged 10-35 years. Exhaled NO was measured at different flow-rates and CalvNO calculated, with TMAD-adjustment according to Condorelli. Trumpet model and axial diffusion-adjusted CalvNO was not related to daytime wheeze (P = 0.27), FEF50 (P = 0.23) or bronchial responsiveness (P = 0.52). On the other hand, unadjusted CalvNO was increased in subjects with daytime wheeze (P < 0.001), decreased FEF50 (P = 0.02) and with moderate-to-severe compared to normal bronchial responsiveness (P < 0.001). All these characteristics correlated with increased FeNO (all P < 0.05). Unadjusted CalvNO was positively related to bronchial NO flux (J'awNO ) (r = 0.22, P < 0.001) while TMAD-adjCalvNO was negatively related to J'awNO (r = -0.38, P < 0.001). Adjusted CalvNO was not associated with any asthma characteristics studied in this large asthma cohort. However, both FeNO and unadjusted CalvNO related to asthma symptoms, lung function and bronchial responsiveness. We suggest a potential overadjustment by current TMAD-corrections, validated in healthy or unobstructed asthmatics. Further studies assessing axial diffusion in asthmatics with different degrees of airway obstruction and the validity of proposed TMAD-corrections are warranted. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Assessing the efficacy of immunotherapy with a glutaraldehyde-modified house dust mite extract in children by monitoring changes in clinical parameters and inflammatory markers in exhaled breath.

PubMed

Lozano, Jaime; Cruz, María-Jesús; Piquer, Mónica; Giner, Maria-Teresa; Plaza, Ana María

2014-01-01

The aim of this study was to evaluate the effectiveness of specific immunotherapy (SIT) management with allergoids in children with allergic asthma by monitoring changes in clinical parameters and inflammatory markers in exhaled breath. The study population included 43 patients (24 males) of 6-14 years of age, who had allergic asthma and were sensitized to mites. Twenty-three individuals were treated with subcutaneous SIT (PURETHAL® Mites, HAL Allergy) for 8 months, i.e. the SIT group, and 20 were given medication to treat symptoms only, i.e. the control group. Before treatment and after 4 and 8 months, several clinical parameters, the levels of exhaled nitric oxide and the pH of exhaled breath condensate (EBC) were determined. The SIT group presented with an improvement in asthma classification, a reduction in maintenance drug therapy and improved scores on the quality-of-life questionnaire. These changes were not observed in the control group. Both groups presented significant decreases in EBC pH values at 4 and 8 months after treatment compared to at baseline. However, analysis of the variable 'ratio' showed an increase in the EBC pH values after 8 months of treatment in the SIT group compared with the values at 4 months. SIT with standardized mite extract reduces asthma symptoms in children. A decrease in EBC pH values was observed in both groups, although the SIT group presented a tendency of recovered values after 8 months. Future studies of EBC pH monitoring in the longer term are needed to determine the effectiveness of this marker. © 2014 S. Karger AG, Basel.

Pollen count and exhaled nitric oxide levels in a seasonal allergic rhinitis patient.

PubMed

Shirai, Toshihiro; Mochizuki, Eisuke; Asada, Kazuhiro; Suda, Takafumi

2014-09-01

The subject was a 52-year-old man with Japanese cedar pollinosis, which developed between February and May. He had no history of asthma and was an ex-smoker. He underwent fractional exhaled nitric oxide (FeNO) measurements twice a week from 2010 to 2012. The pollen counts in 2010 were the lowest during the last decade, and the FeNO level was less than 30 ppb for the whole year. In contrast, the mean pollen count in 2011 was very high and the patient's FeNO level rose to more than 100 ppb. The mean pollen count in 2012 was comparable with that of 2010; however, high counts were detected in April and May, and the FeNO level rose to 70 ppb during the latter stages of the pollen season. These results indicate that pollen counts should be taken into consideration during the interpretation of FeNO data in asthma or allergic rhinitis.

Variability in Puff Topography and Exhaled CO in Waterpipe Tobacco Smoking.

PubMed

Kim, Hyoshin; Brinkman, Marielle C; Sharma, Eva; Gordon, Sydney M; Clark, Pamela I

2016-10-01

We examined intra-individual variability in puff topography and CO measures collected during laboratory waterpipe (WP) tobacco smoking using a research-grade waterpipe (RWP). WP smoking topography and exhaled CO measures were obtained from 10 established WP smokers in a single-blind, crossover design. Using a previously validated RWP, each participant smoked "Two Apples" WP tobacco ad libitum with a single quick-light charcoal to satiation in 3 laboratory sessions spaced at least one week apart. To examine the intra-individual variability, the intraclass correlation coefficient ( ρ ) for topography and CO measures were estimated. Results: The majority of the topography and CO measures were stable. Most stable were puff frequency ( ρ = 0.88), number of puffs ( ρ = 0.86), and puff duration (ρ = 0.80). Less stable were peak flow ( ρ = 0.57) and total puff volume ( ρ = 0.52). The results provide the first set of empirical evidence that most topography and CO measurements collected using the RWP from a single laboratory smoking session are stable such that they can be representative of a smoker's puffing behaviors and reproducible among 3 sessions spread equally across 3 weeks.

Investigation of the climatic extremes influence on the humane adaptive capacity by mass spectrometric analysis of exhaled breath condensate

NASA Astrophysics Data System (ADS)

Ryabokon, Anna; Larina, Irina; Kononikhin, Alexey; Starodubtceva, Nataliia; Popov, Igor; Nikolaev, Eugene; Varfolomeev, Sergey

Global climate change, which causes abnormal fluctuations in temperature and rainfall, has adverse effects on human health. Particularly people suffer with cardiovascular and respiratory system disease. Our research was concentrated on the changes in the regulation and adaptation systems of human organism related to hyperthermia and polluted air influence. Healthy individuals with the age from 22 to 45 years were isolated during 30 days in the ground based experimental facility located at Institute of medico-biological problems RAS (Moscow, Russia). In the ground based facility artificially climatic conditions of August, 2010 in Moscow were created. Exhaled breath condensate was collected before and after isolation by R-Tube collector, freeze dried, treated by trypsin and analyzed by nanoflow LC-MS/MS with a 7-Tesla LTQ-FT Ultra mass spectrometer (Thermo Electron, Bremen, Germany). Database search was performed using Mascot Server 2.2 software (Matrix Science, London, UK). Investigation of exhaled breath condensate (EBC) collected from participants of the 30 days isolation with hyper thermic and polluted air climate conditions was performed. After isolation reduction of the protein number was observed. Loss endothelial C receptor precursor - the main physiological anticoagulant - correlate with the clinical data of physicians to increase the propensity to thrombosis. Also COP9 signalosome protein, positive regulator of ubiquitin was identified in all EBC samples before isolation and was not detected for more than a half of donors after isolation. This phenomena may be due to violation of ubiquitin protection system of the cells from harmful proteins. During isolation the air was cleared from microdisperse particles.

Exhaled breath condensate methods adapted from human studies using longitudinal metabolomics for predicting early health alterations in dolphins.

PubMed

Borras, Eva; Aksenov, Alexander A; Baird, Mark; Novick, Brittany; Schivo, Michael; Zamuruyev, Konstantin O; Pasamontes, Alberto; Parry, Celeste; Foutouhi, Soraya; Venn-Watson, Stephanie; Weimer, Bart C; Davis, Cristina E

2017-11-01

Monitoring health conditions is essential to detect early asymptomatic stages of a disease. To achieve this, blood, urine and breath samples are commonly used as a routine clinical diagnostic. These samples offer the opportunity to detect specific metabolites related to diseases and provide a better understanding of their development. Although blood samples are commonly used routinely to monitor health, the implementation of a relatively noninvasive technique, such as exhaled breath condensate (EBC) analysis, may further benefit the well-being of both humans and other animals. EBC analysis can be used to track possible physical or biochemical alterations caused by common diseases of the bottlenose dolphin (Tursiops truncatus), such as infections or inflammatory-mediated processes. We have used an untargeted metabolomic method with liquid chromatography-mass spectrometry analysis of EBC samples to determine biomarkers related to disease development. In this study, five dolphins under human care were followed up for 1 year. We collected paired blood, physical examination information, and EBC samples. We then statistically correlated this information to predict specific health alterations. Three dolphins provided promising case study information about biomarkers related to cutaneous infections, respiratory infections, dental disease, or hormonal changes (pregnancy). The use of complementary liquid chromatography platforms, with hydrophilic interaction chromatography and reverse-phased columns, allowed us to detect a wide spectrum of EBC biomarker compounds that could be related to these health alterations. Moreover, these two analytical techniques not only provided complementary metabolite information but in both cases they also provided promising diagnostic information for these health conditions. Graphical abstract Collection of the exhaled condensed breath from a bottlenose dolphin from U.S. Navy Marine Mammal Program (MMP).

MO-FG-BRA-09: Towards an Optimal Breath-Holding Procedure for Radiotherapy: Differences in Organ Motion During Inhalation and Exhalation Breath-Holds

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lens, E; Gurney-Champion, O; Horst, A van der

Purpose: Breath-holding (BH) is often used to reduce organ motion during radiotherapy. The aim of this study was to determine the differences in pancreatic and diaphragmatic motion during BH between inhalation and exhalation BHs with variable lung volumes and to investigate whether motion increases/decreases during BH. Methods: Sixteen healthy volunteers were asked to perform four different 60-second BHs, from fully inflated to fully deflated lungs (i.e. lung volumes of: 100%, ∼70%, ∼30% and 0% of inspiratory capacity) three times (total of 192 BHs). During each BH, we obtained single-slice (coronal) magnetic-resonance scans with spatial resolution 0.93×0.93×8.0 mm3 and temporal resolutionmore » 0.6 s. We used 2-dimensional image correlation to obtain the motion of pancreatic head and diaphragm during BH. Motion magnitude in inferior-superior direction was obtained by determining the maximum displacement during BH. Results: Pancreatic and diaphragmatic drifts occurred during BH and were mostly in the superior direction. We observed significantly smaller pancreatic and diaphragmatic motion magnitudes in inferior-superior direction during exhalation BHs (BH{sub 30%} and BH{sub 0%}) compared to inhalation BHs (BH{sub 100%} and BH{sub 70%}). The mean motion magnitudes of the pancreatic head were 7.0, 6.5, 4.4 and 4.2 mm during BH{sub 100%}, BH{sub 70%}, BH{sub 30%} and BH{sub 0%}, respectively, and mean BH durations were 59.9, 59.1, 59.0 and 52.7 s. For the diaphragm, mean motion magnitudes were 9.8, 9.0, 5.6 and 4.3 mm, respectively. When considering 30-second BHs, as often used in the clinic, the motion was most pronounced during the first 10 s and excluding these from the analysis (yielding an effective BH period of 20 s) significantly reduced (P≤0.002) organ motion. Conclusion: Organ motion was significantly smaller during exhalation BHs compared to inhalation BHs. Also, motion was largest at the start of BH. Hence, waiting for 10 s may significantly

Exhaled Breath Condensate as a Suitable Matrix to Assess Lung Dose and Effects in Workers Exposed to Cobalt and Tungsten

PubMed Central

Goldoni, Matteo; Catalani, Simona; De Palma, Giuseppe; Manini, Paola; Acampa, Olga; Corradi, Massimo; Bergonzi, Roberto; Apostoli, Pietro; Mutti, Antonio

2004-01-01

The aim of the present study was to investigate whether exhaled breath condensate (EBC), a fluid formed by cooling exhaled air, can be used as a suitable matrix to assess target tissue dose and effects of inhaled cobalt and tungsten, using EBC malondialdehyde (MDA) as a biomarker of pulmonary oxidative stress. Thirty-three workers exposed to Co and W in workshops producing either diamond tools or hard-metal mechanical parts participated in this study. Two EBC and urinary samples were collected: one before and one at the end of the work shift. Controls were selected among nonexposed workers. Co, W, and MDA in EBC were analyzed with analytical methods based on mass spectrometric reference techniques. In the EBC from controls, Co was detectable at ultratrace levels, whereas W was undetectable. In exposed workers, EBC Co ranged from a few to several hundred nanomoles per liter. Corresponding W levels ranged from undetectable to several tens of nanomoles per liter. A parallel trend was observed for much higher urinary levels. Both Co and W in biological media were higher at the end of the work shift in comparison with preexposure values. In EBC, MDA levels were increased depending on Co concentration and were enhanced by coexposure to W. Such a correlation between EBC MDA and both Co and W levels was not observed with urinary concentration of either element. These results suggest the potential usefulness of EBC to complete and integrate biomonitoring and health surveillance procedures among workers exposed to mixtures of transition elements and hard metals. PMID:15345342

Exhaled Breath Condensate Collection in the Mechanically Ventilated Patient

PubMed Central

Carter, Stewart R; Davis, Christopher S; Kovacs, Elizabeth J

2012-01-01

Collection of exhaled breath condensate (EBC) is a non-invasive means of sampling the airway-lining fluid of the lungs. EBC contains numerous measurable mediators, whose analysis could change the management of patients with certain pulmonary diseases. While initially popularized in investigations involving spontaneously breathing patients, an increasing number of studies have been performed using EBC in association with mechanical ventilation. Collection of EBC in mechanically ventilated patients follows basic principles of condensation, but is influenced by multiple factors. Effective collection requires selection of a collection device, adequate minute ventilation, low cooling temperatures, and sampling times of greater than ten minutes. Condensate can be contaminated by saliva, which needs to be filtered. Dilution of samples occurs secondary to distilled water in vapors and humidification in the ventilator circuit. Dilution factors may need to be employed when investigating non-volatile biomarkers. Storage and analysis should occur promptly at −70° C to −80° C to prevent rapid degradation of samples. The purpose of this review is to examine and describe methodologies and problems of EBC collection in mechanically ventilated patients. A straightforward and safe framework has been established to investigate disease processes in this population, yet technical aspects of EBC collection still exist that prevent clinical practicality of this technology. These include a lack of standardization of procedure and analysis of biomarkers, and of normal reference ranges for mediators in healthy individuals. Once these procedural aspects have been addressed, EBC could serve as a non-invasive alternative to invasive evaluation of lungs in mechanically ventilated patients. PMID:22398157

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.

Exhaled nitric oxide levels to guide treatment for adults with asthma.

PubMed

Petsky, Helen L; Kew, Kayleigh M; Turner, Cathy; Chang, Anne B

2016-09-01

Asthma guidelines aim to guide health practitioners to optimise treatment for patients so as to minimise symptoms, improve or maintain good lung function, and prevent acute exacerbations or flare-ups. The principle of asthma guidelines is based on a step-up or step-down regimen of asthma medications to maximise good health outcomes using minimum medications. Asthma maintenance therapies reduce airway inflammation that is usually eosinophilic. Tailoring asthma medications in accordance with airway eosinophilic levels may improve asthma outcomes such as indices of control or reduce exacerbations or both. Fractional exhaled nitric oxide (FeNO) is a marker of eosinophilic inflammation, and as it is easy to measure, has an advantage over other measurements of eosinophilic inflammation (for example sputum eosinophils). To evaluate the efficacy of tailoring asthma interventions based on exhaled nitric oxide (FeNO), in comparison to not using FeNO, that is management based on clinical symptoms (with or without spirometry/peak flow) or asthma guidelines or both, for asthma-related outcomes in adults. We searched the Cochrane Airways Group Specialised Register of Trials, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and reference lists of articles. The last searches were undertaken in June 2016. All randomised controlled trials (RCTs) comparing adjustment of asthma medications based on exhaled nitric oxide levels compared to not using FeNO, that is management based on clinical symptoms (with or without spirometry/peak flow) or asthma guidelines or both. We reviewed results of searches against predetermined criteria for inclusion. We independently selected relevant studies in duplicate. Two review authors independently assessed trial quality and extracted data. We contacted study authors for further information, receiving responses from four. We included seven adult studies; these studies differed in a variety of ways including definition of

Cysteinyl leukotrienes in exhaled breath condensate of smoking asthmatics.

PubMed

Celik, Deniz; Doruk, Sibel; Koseoglu, Handan Inonu; Sahin, Semsettin; Celikel, Serhat; Erkorkmaz, Unal

2013-05-01

Cysteinyl leukotrienes (CysLTs) are among important inflammatory mediators in asthma pathogenesis. In this study, we aimed to determine leukotriene D₄ (LTD₄) and leukotriene E₄ (LTE₄) levels in exhaled breath condensate (EBC) in asthmatics and to evaluate the effect of smoking upon CysLTs levels and to speculate the importance of adding leukotriene receptor antagonists in smoking asthmatics. A total of 88 participants were included in the study. Of them, 59 were asthmatics; 30 of the 59 asthmatics were smokers (Group I) and the others were non-smokers (Group II). As a control group (Group III), 29 healthy non-smokers were enrolled. EBC samples were collected (EcoScreen, Jaeger, Hoechberg, Germany) and pulmonary function tests (PFTs) were performed in each case, and an asthma control questionnaire (ACQ) was completed by the asthmatics. LTD₄ and LTE₄ levels in EBC samples were analyzed by using ELISA. LTD₄ levels were found to be higher in Group I than other groups and similar in Group II and Group III. LTE₄ levels were lower in Group III than other groups and similar in Group I and Group II. PFTs were different between Group I and Group III and there was a significant negative correlation between LTE₄ levels and forced expiratory volume in one second and forced vital capacity ratio in Group I. LTD₄, but not LTE₄, concentrations in EBC were higher in asthmatic smokers than asthmatic nonsmokers. LTE₄ concentrations in EBC were higher in asthmatics than healthy non-smokers. In smoking asthmatics usage of agents that block the effects of LTD₄ can be beneficial; however, new clinical studies are required.

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.

Nitrites and nitrates in exhaled breath condensate in cystic fibrosis: relation to clinical parameters.

PubMed

Fila, L; Chladek, J; Maly, M; Musil, J

2013-01-01

To evaluate correlation of exhaled breath condensate (EBC) nitrite and nitrate concentrations with disease severity in cystic fibrosis (CF) patients. Nitrites and nitrates are products of oxidative metabolism of nitric oxide. Impaired metabolism of nitric oxide plays a role in pathogenesis of CF. EBC was collected from 46 stable CF patients and from 21 healthy controls. EBC concentrations of nitrites and nitrates were correlated with parameters of lung disease and nutritional status and with systemic inflammatory markers. EBC nitrates concentrations in CF patients were lower than in healthy subjects (5.8 vs 14.3 μmol/l, p<0.001). They correlated positively with FEV1 (p=0.025) and serum albumin values (p=0.016) and negatively with chest radiograph Northern score (p=0.015) and serum C-reactive protein values (p=0.005). EBC nitrites concentrations in CF patients did not differ from those in healthy subjects and were not correlated to any studied parameter. EBC nitrates concentrations correlate with disease severity in CF patients and are lower than in healthy subjects (Tab. 4, Fig. 1, Ref. 48).

Evaluation of exhaled breath temperature (EBT) as a marker and predictor of asthma exacerbation in children and adolescents.

PubMed

Wojsyk-Banaszak, Irena; Mikoś, Marcin; Szczepankiewicz, Aleksandra; Wielebska, Alicja; Sobkowiak, Paulina; Kamińska, Aleksandra; Bręborowicz, Anna

2017-09-01

Noninvasive and easy-to-use tools to monitor airway inflammation in asthma are needed to maintain disease control, particularly in pediatric population. The aim of the study was to evaluate exhaled breath temperature (EBT) in pediatric respiratory clinic setting. We evaluated 37 children and adolescents with asthma (5-17 years; median: 11 years). The patients were followed up in stable condition and during exacerbations (paired observations in n = 19 subjects). We evaluated medication use, EBT, fractional exhaled nitric oxide (FeNO), spirometry and atopic status of patients. EBT was significantly higher in children with asthma exacerbation {entire group: median [interquartile range (IQR)]: 32.3 [1.1]°C vs. 33.8 [1.7]°C; p < 0.001 and mean ± SD: 33.1 ± 1.0°C vs. 33.6 ± 1.1°C; p = 0.038 for paired observations}. Significant correlation was observed between EBT and FeNO in the entire group (r = 0.22; p = 0.03). No difference was observed in EBT median values in atopic and non-atopic subjects in the entire group (median [IQR]: 32.6 [1.6] vs. 32.7 [2.0]; p = 0.88) and in subgroups. There was no difference in EBT values in patients receiving systemic or inhaled glucocorticosteroids (p = 0.45 and 0.83). There was no significant correlation between EBT and body or room temperature. The only significant predictor of exacerbation in logistic regression model was EBT {aOR = 2.4; 95% [confidence interval (CI)]: 1.4-4.1}. ROC analysis demonstrated applicability of EBT as a marker of asthma exacerbation in children (AUC = 0.748; p < 0.001; cut-off = 33.3°C; sensitivity: 64.3%; specificity: 82.1%). We suggest that EBT may serve as marker and predictor of asthma exacerbation in children. EBT follow-up may be useful in asthma monitoring in children and adolescents.

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.

Use of pump current modulation of diode laser for increased sensitivity of detection of 13СO2 in human exhaled breath

NASA Astrophysics Data System (ADS)

Kireev, S. V.; Kondrashov, A. A.; Shnyrev, S. L.; Safagaraev, A. P.

2018-03-01

This paper reports that the use of a lock-in detection technique, when the pump current modulation of a diode laser is operating near the wavelength of 2 µm, allows the improvement of the sensitivity of the online detection of 13СO2 in expired air by more than three orders of magnitude. The sensitivity of the 13СO2 detected in the paper is 60 ppb with an error of 13СO2 concentration measured in the exhaled breath at the level of 2.9% for an optical path length of 60 cm.

Towards an easy-to-use tuberculosis diagnosis through exhaled breath analysis: a liquid fluorimeter with an excitation at 265 nm

NASA Astrophysics Data System (ADS)

Hue, J.; Dupoy, M.; Vignoud, S.; Ricaud, J. L.; Tran-Thi, T.; Karpe, S.; Novelli-Rousseau, A.; Mallard, F.

2013-03-01

The struggle against tuberculosis is one of the World Health Organization priorities. Identifying in a short time, patients with active tuberculosis, would bring a tremendous improvement to the current situation. Recovering from this infectious and deadly disease (2 million of death per year) is possible with a correct diagnosis to give an appropriate treatment. Unfortunately, most common tuberculosis diagnoses have few drawbacks: - skin tests: not reliable at 100% and need an incubation of 2 days before the diagnosis, - blood tests: costly and sophisticated technology, - chest X-ray: the first step before the sputum tests used for a bacterial culture with a final diagnosis given within 2 weeks. A tuberculosis test based on exhaled breath analysis is a prospective and noninvasive solution, cheap and easy to use and to transport. This test lies on a fluoregenic detection of niacin, a well-known mycobacterium tuberculosis specific metabolite. In this paper, it is assumed that the selected probe is specific to niacin and that exhaled breath does not contain any interfering species. To address this problem, a fluorimeter is developed with a cheap and cooled CCD ( 2k$) as a sensor, to easily determine the suitable "fluorescent zone". In comparing aqueous solutions with and without niacin, 250 pM of niacin have been detected. With a commercial fluorimeter (Fluorolog from Horiba), only 200 nM of niacin are detected. The present detection remains 10 times above the estimated targeted value for a tuberculosis test. The excitation source is a LED, which typically emits 20 °W at 265 nm through an optical fiber. The emission signal is detected around 545 nm. A typical light exposure lasts 700 seconds. Analysis of biomarkers with a liquid fluorimeter is generic and promising as health diagnosis.

Influences of meteorological parameters on indoor radon concentrations (222Rn) excluding the effects of forced ventilation and radon exhalation from soil and building materials.

PubMed

Schubert, Michael; Musolff, Andreas; Weiss, Holger

2018-06-13

Elevated indoor radon concentrations ( 222 Rn) in dwellings pose generally a potential health risk to the inhabitants. During the last decades a considerable number of studies discussed both the different sources of indoor radon and the drivers for diurnal and multi day variations of its concentration. While the potential sources are undisputed, controversial opinions exist regarding their individual relevance and regarding the driving influences that control varying radon indoor concentrations. These drivers include (i) cyclic forced ventilation of dwellings, (ii) the temporal variance of the radon exhalation from soil and building materials due to e.g. a varying moisture content and (iii) diurnal and multi day temperature and pressure patterns. The presented study discusses the influences of last-mentioned temporal meteorological parameters by effectively excluding the influences of forced ventilation and undefined radon exhalation. The results reveal the continuous variation of the indoor/outdoor pressure gradient as key driver for a constant "breathing" of any interior space, which affects the indoor radon concentration with both diurnal and multi day patterns. The diurnally recurring variation of the pressure gradient is predominantly triggered by the day/night cycle of the indoor temperature that is associated with an expansion/contraction of the indoor air volume. Multi day patterns, on the other hand, are mainly due to periods of negative air pressure indoors that is triggered by periods of elevated wind speeds as a result of Bernoulli's principle. Copyright © 2018 Elsevier Ltd. All rights reserved.

Poly arginine-graphene quantum dots as a biocompatible and non-toxic nanocomposite: Layer-by-layer electrochemical preparation, characterization and non-invasive malondialdehyde sensory application in exhaled breath condensate.

PubMed

Hasanzadeh, Mohammad; Mokhtari, Fozieh; Shadjou, Nasrin; Eftekhari, Aziz; Mokhtarzadeh, Ahad; Jouyban-Gharamaleki, Vahid; Mahboob, Soltanali

2017-06-01

This study reports on the electropolymerization of a low toxic and biocompatible polymer with entitle poly arginine-graphene quantum dots (PARG-GQDs) as a novel strategy for surface modification of glassy carbon (GC) surface and preparation a new interface for biomedical application. The fabrication of PARG-GQDs on GCE was performed using Layer-by-layer regime. Scanning electron microscopy (SEM) was confirmed dispersion of GQDs on the surface of PARG which lead to increase of surface coverage of PARG. The redox behavior of prepared sensor was then characterized by cyclic voltammetry (CV), differential pulse voltammetry (DPV) and chronoamperometry (CHA), square wave voltammetry (SWV), linear sweep voltammetry (LSV). The electroactivity of PARG-GQDs coating towards detection and determination of malondialdehyde (MDA) as one of the most common biomarkers of oxidative stress, was then studied. Then, application of prepared sensor for the detection of MDA in exhaled breath condensate (EBC) is described. Electrochemical based sensor shows the lower limit of quantification (LLOQ) were 0.329nanomolar. This work is the first report on the integration of GQDs to poly amino acids. Further development can lead to monitoring of MDA or other exhaled breath biomarkers by GQDs functionalized poly amino acids in EBC using electrochemical methods. Copyright © 2017. Published by Elsevier B.V.

Manganese in exhaled breath condensate: a new marker of exposure to welding fumes.

PubMed

Hulo, Sébastien; Chérot-Kornobis, Nathalie; Howsam, Mike; Crucq, Sébastien; de Broucker, Virginie; Sobaszek, Annie; Edme, Jean-Louis

2014-04-07

To evaluate manganese in exhaled breath condensate (Mn-EBC) as an indicator of exposure to fumes from metal inert gas welding process. We collected EBC and urine from 17 welders and 16 unexposed control subjects after 5 days exposure. Concentrations of manganese (Mn), nickel (Ni), iron (Fe) and chromium (Cr) were measured in EBC and urine samples and correlated with cumulative exposure indices for the working week (CIW) and for the total welding years (WY), based on duration of welding activity and atmospheric metal measurements. Concentrations of Mn and Ni in EBC were significantly higher among welders than controls whereas this difference was not significant for Mn in urine. Levels of Mn and Ni in EBC were not correlated with their respective levels in urine. The linear regressions found significant positive coefficients between Mn-EBC, Ni-EBC, Ni-U and Cr-U concentrations and the cumulative exposure indices. Taking into account tobacco use, statistical analysis showed the same trends except for the relationship between Mn-U and CIW. This pilot study showed that Mn-EBC, as well as Ni-EBC, can serve as reliable indices of occupational exposure to welding fumes and provide complimentary toxicokinetic information to that provided by urine analyses. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Measurement of natural radioactivity and radon exhalation rate from rock samples of Jaduguda uranium mines and its radiological implications

NASA Astrophysics Data System (ADS)

Mahur, A. K.; Kumar, Rajesh; Sonkawade, R. G.; Sengupta, D.; Prasad, Rajendra

2008-04-01

The Singhbhum shear zone is a 200 km long arcuate belt in Jharkhand state situated in eastern India. The central part between Jaduguda-Bhatin-Nimdih, Narwapahr-Garadih-Turamdih is rich in uranium. Presence of uranium in the host rocks and the prevalence of a confined atmosphere within mines could result in enhanced concentration of radon (222Rn) gas and its progeny. Inhalation of radon daughter products is a major contributor to the radiation dose to exposed subjects. By using high resolution γ-ray spectroscopic system various radionuclides in the rock samples, collected from different places of Jaduguda uranium mines have been identified quantitatively based on the characteristic spectral peaks. The activity concentrations of the natural radionuclides, uranium (238U), thorium (232Th) and potassium (40K) were measured in the rock samples and radiological parameters were calculated. Uranium concentration was found to vary from 123 ± 7 Bq kg-1 to 40,858 ± 174 Bq kg-1. Activity of thorium was not significant in the samples, whereas, few samples have shown potassium activity from 162 ± 11 Bq kg-1 to 9024 ± 189 Bq kg-1. Radon exhalation rates from these samples were also measured using "Sealed Can technique" and found to vary from 4.2 ± 0.05 to 13.7 ± 0.08 Bq m-2 h-1. A positive correlation was found between the radon exhalation rate and the uranium activity. The absorbed dose rates vary from 63.6 to 18876.4 nGy h-1, with an average value of 7054.2 nGy h-1. The annual external effective dose rates vary from 0.7 to 23.2 mSv y-1. Radium equivalent activities (Raeq) varied from 134.3 to 40858.0 Bq kg-1. Value of external hazard index (Hex) varied from 0.4 to 110.4 with an average value of 41.2.

Human breath metabolomics using an optimized noninvasive exhaled breath condensate sampler

PubMed Central

Zamuruyev, Konstantin O.; Aksenov, Alexander A.; Pasamontes, Alberto; Brown, Joshua F.; Pettit, Dayna R.; Foutouhi, Soraya; Weimer, Bart C.; Schivo, Michael; Kenyon, Nicholas J.; Delplanque, Jean-Pierre; Davis, Cristina E.

2017-01-01

Exhaled breath condensate (EBC) analysis is a developing field with tremendous promise to advance personalized, non-invasive health diagnostics as new analytical instrumentation platforms and detection methods are developed. Multiple commercially-available and researcher-built experimental samplers are reported in the literature. However, there is very limited information available to determine an effective breath sampling approach, especially regarding the dependence of breath sample metabolomic content on the collection device design and sampling methodology. This lack of an optimal standard procedure results in a range of reported results that are sometimes contradictory. Here, we present a design of a portable human EBC sampler optimized for collection and preservation of the rich metabolomic content of breath. The performance of the engineered device is compared to two commercially available breath collection devices: the RTube™ and TurboDECCS. A number of design and performance parameters are considered, including: condenser temperature stability during sampling, collection efficiency, condenser material choice, and saliva contamination in the collected breath samples. The significance of the biological content of breath samples, collected with each device, is evaluated with a set of mass spectrometry methods and was the primary factor for evaluating device performance. The design includes an adjustable mass-size threshold for aerodynamic filtering of saliva droplets from the breath flow. Engineering an inexpensive device that allows efficient collection of metalomic-rich breath samples is intended to aid further advancement in the field of breath analysis for non-invasive health diagnostic. EBC sampling from human volunteers was performed under UC Davis IRB protocol 63701-3 (09/30/2014-07/07/2017). PMID:28004639

Exhaled breath condensate adenosine tracks lung function changes in cystic fibrosis

PubMed Central

Olsen, Bonnie M.; Lin, Feng-Chang; Fine, Jason; Boucher, Richard C.

2013-01-01

Measurement of exhaled breath condensate (EBC) biomarkers offers a noninvasive means to assess airway disease, but the ability of EBC biomarkers to track longitudinal changes in disease severity remains unproven. EBC was collected from pediatric patients with cystic fibrosis (CF) during regular clinic visits over 1 yr. EBC biomarkers urea, adenosine (Ado), and phenylalanine (Phe) were measured by mass spectrometry, and biomarker ratios were used to control for variable dilution of airway secretions. EBC biomarker ratios were assessed relative to lung function in longitudinal, multivariate models and compared with sputum inflammatory markers and quality of life assessment (CFQ-R). EBC was successfully analyzed from 51 subjects during 184 visits (3.6 ± 0.9 visits per subject). EBC Ado/urea ratio was reproducible in duplicate samples (r = 0.62, P < 0.01, n = 20) and correlated with sputum neutrophil elastase (β = 2.5, P < 0.05). EBC Ado/urea correlated with the percentage predicted of forced expiratory volume in 1 s in longitudinal, multivariate models (β = −2.9, P < 0.01); EBC Ado/Phe performed similarly (β = −2.1, P < 0.05). In contrast, IL-8 and elastase measured in spontaneously expectorated sputum (n = 57 samples from 25 subjects) and the CFQ-R respiratory scale (n = 90 tests from 47 subjects) were not significantly correlated with lung function. EBC was readily collected in a clinic setting from a wide range of subjects. EBC Ado tracked longitudinal changes in lung function in CF, with results similar to or better than established measures. PMID:23355385

Exhaled nitric oxide monitoring in COPD using a portable analyzer.

PubMed

de Laurentiis, Guglielmo; Maniscalco, Mauro; Cianciulli, Flavia; Stanziola, Anna; Marsico, Serafino; Lundberg, Jon O; Weitzberg, Eddie; Sofia, Matteo

2008-08-01

The exhaled nitric oxide (FeNO) is a non-invasive marker of airway inflammation in asthma. A very recent statement has suggested FeNO as potential outcome in chronic obstructive pulmonary disease (COPD). Recently, a new hand-held FeNO analyzer (NIOX MINO) has been developed. We have evaluated the NIOX MINO in COPD patients and monitored FeNO levels during 1-year assessment in the outpatient setting. Short-term variability in FeNO was compared using a NIOX MINO and a stationary chemiluminescence analyzer (NOA, Sensormedics) in healthy volunteers and COPD patients on two consecutive months. Long-term FeNO variability was assessed on a cohort of 70 COPD outpatients measuring FeNO for 1 year. The intra-individual FeNO coefficient of variation (eNOCoV) was taken as index FeNO long-term variability. In COPD there were no significant differences between NIOX MINO and NOA FeNO values recorded at baseline and 1 month later. Ninety five percent limits of agreement between NIOX MINO and NOA were-2.7 and 1.9ppb with significant reliability (r=0.96, p<0.0001). Mean FeNO at baseline was 15.0+/-9.5ppb. Over the 1-year period the overall mean FeNO was 15.5+/-10.1ppb. The long-term eNOCoV was 33.9+/-16.4% (range 8.1-83.1%), and it was significantly associated with exacerbation rate (r=0.57, p<0.0001). FeNO electrochemical hand-held analyzer is feasible in COPD showing good agreement with stationary chemiluminescence analyzer. COPD patients exhibit a wide range of FeNO levels and a high variability of FeNO over time, which was positively associated with the number of exacerbations.

Methodological implications in pH standardization of exhaled breath condensate.

PubMed

Hoffmeyer, F; Berresheim, H; Beine, A; Sucker, K; Brüning, T; Bünger, J

2015-05-14

The variable amount of dissolved carbon dioxide is one of the main confounding factors of exhaled breath condensate (EBC) pH measurements. There have been many attempts at identifying the optimal approach to displace CO2 as a way to gain reproducible and valid pH values in EBC samples. The aim of the present study was to assess the correlation of pH and pCO2 in untreated, neat EBC samples and, after deaeration, to reevaluate the standardization of CO2 as a means to obtain valid pH values. A further aim was to evaluate the impact of deaeration on the acid-base balance in EBC samples. EBC was collected from seven female and 31 male subjects. The pH and pCO2 values immediately determined in untreated, neat EBC samples were strongly correlated (rp = -0.723, p <  0.0001). This correlation was not observed after deaeration with argon (rs = 0.264, p = 0.109). Based on a regression function for the pH/pCO2 relationship, the calculated pH at a pCO2 of 5.33 kPa was 6.07 (IQR 5.99, 6.20). No significant difference was observed between the pH measured in neat EBC samples and those calculated after deaeration with regression function and measured neat pCO2. Our data suggest that pCO2 is the most important confounder of pH measurement in EBC samples and, when adjusting for pCO2, the acid-base balance of EBC samples is not significantly influenced by the process of deaeration. Furthermore, measurement with a blood-gas analyzer and standardization of pH for pCO2 allows sensitive assaying of EBC samples. Therefore, this method provides a basis for detection of even small changes in airway pH due to inhalative exposure or respiratory disease.

Domestic airborne black carbon and exhaled nitric oxide in children in NYC

PubMed Central

Cornell, Alexandra G.; Chillrud, Steven N.; Mellins, Robert B.; Acosta, Luis M.; Miller, Rachel L.; Quinn, James W.; Yan, Beizhan; Divjan, Adnan; Olmedo, Omar E.; Lopez-Pintado, Sara; Kinney, Patrick L.; Perera, Frederica P.; Jacobson, Judith S.; Goldstein, Inge F.; Rundle, Andrew G.; Perzanowski, Matthew S.

2012-01-01

Differential exposure to combustion by-products and allergens may partially explain the marked disparity in asthma prevalence (3%–18%) among New York City neighborhoods. Subclinical changes in airway inflammation can be measured by fractional exhaled nitric oxide (FeNO). FeNO could be used to test independent effects of these environmental exposures on airway inflammation. Seven and eight year-old children from neighborhoods with lower (range 3–9%, n=119) and higher (range 11–18%, n=121) asthma prevalence participated in an asthma case-control study. During home visits, FeNO was measured, and samples of bed dust (allergens) and air (black carbon) were collected. Neighborhood built-environment characteristics were assessed for the 500m surrounding participants’ homes. Airborne black carbon concentrations in homes correlated with neighborhood asthma prevalence (P<0.001) and neighborhood densities of truck routes (P<0.001) and buildings burning residual oil (P<0.001). FeNO concentrations were higher among asthmatics with compared to asthmatics without frequent wheeze (≥4 times/year) (P=0.002). FeNO concentrations correlated with domestic black carbon among children without seroatopy (P=0.012) and with dust mite allergen among children with seroatopy (P=0.020). The association between airborne black carbon in homes and both neighborhood asthma prevalence and FeNO suggest that further public health interventions on truck emissions standards and residual oil use are warranted. PMID:22377682

Analysis of aldehydes in human exhaled breath condensates by in-tube SPME-HPLC.

PubMed

Wang, ShuLing; Hu, Sheng; Xu, Hui

2015-11-05

In this paper, polypyrrole/graphene (PPy/G) composite coating was prepared by a facile electrochemical polymerization strategy on the inner surface of a stainless steel (SS) tube. Based on the coating tube, a novel online in-tube solid-phase microextraction -high performance liquid chromatography (IT-SPME-HPLC) was developed and applied for the extraction of aldehydes in the human exhaled breath condensates (EBC). The hybrid PPy/G nanocomposite exhibits remarkable chemical and mechanical stability, high selectivity, and satisfactory extraction performance toward aldehyde compounds. Moreover, the proposed online IT-SPME-HPLC method possesses numerous superiorities, such as time and cost saving, process simplicity, high precision and sensitivity. Some parameters related to extraction efficiency were optimized systematically. Under the optimal conditions, the recoveries of the aldehyde compounds at three spiked concentration levels varied in the range of 85%-117%. Good linearity was obtained with excellent correlation coefficients (R(2)) being larger than 0.994. The relative standard deviations (n = 5) of the method ranged from 1.8% to 11.3% and the limits of detection were between 2.3 and 3.3 nmol L(-1). The successful application of the proposed method in human EBC indicated that it is a promising approach for the determination of trace aldehyde metabolites in complex EBC samples. Copyright © 2015 Elsevier B.V. All rights reserved.

Exhaled Breath Markers for Nonimaging and Noninvasive Measures for Detection of Multiple Sclerosis.

PubMed

Broza, Yoav Y; Har-Shai, Lior; Jeries, Raneen; Cancilla, John C; Glass-Marmor, Lea; Lejbkowicz, Izabella; Torrecilla, José S; Yao, Xuelin; Feng, Xinliang; Narita, Akimitsu; Müllen, Klaus; Miller, Ariel; Haick, Hossam

2017-11-15

Multiple sclerosis (MS) is the most common chronic neurological disease affecting young adults. MS diagnosis is based on clinical characteristics and confirmed by examination of the cerebrospinal fluids (CSF) or by magnetic resonance imaging (MRI) of the brain or spinal cord or both. However, neither of the current diagnostic procedures are adequate as a routine tool to determine disease state. Thus, diagnostic biomarkers are needed. In the current study, a novel approach that could meet these expectations is presented. The approach is based on noninvasive analysis of volatile organic compounds (VOCs) in breath. Exhaled breath was collected from 204 participants, 146 MS and 58 healthy control individuals. Analysis was performed by gas-chromatography mass-spectrometry (GC-MS) and nanomaterial-based sensor array. Predictive models were derived from the sensors, using artificial neural networks (ANNs). GC-MS analysis revealed significant differences in VOC abundance between MS patients and controls. Sensor data analysis on training sets was able to discriminate in binary comparisons between MS patients and controls with accuracies up to 90%. Blinded sets showed 95% positive predictive value (PPV) between MS-remission and control, 100% sensitivity with 100% negative predictive value (NPV) between MS not-treated (NT) and control, and 86% NPV between relapse and control. Possible links between VOC biomarkers and the MS pathogenesis were established. Preliminary results suggest the applicability of a new nanotechnology-based method for MS diagnostics.

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.

Outcomes using exhaled nitric oxide measurements as an adjunct to primary care asthma management.

PubMed

Hewitt, Richard S; Modrich, Catherine M; Cowan, Jan O; Herbison, G Peter; Taylor, D Robin

2009-12-01

Exhaled nitric oxide (FENO) measurements may help to highlight when inhaled corticosteroid (ICS) therapy should or should not be adjusted in asthma. This is often difficult to judge. Our aim was to evaluate a decision-support algorithm incorporating FENO measurements in a nurse-led asthma clinic. Asthma management was guided by an algorithm based on high (>45ppb), intermediate (30-45ppb), or low (<30ppb) FENO levels and asthma control status. This provided for one of eight possible treatment options, including diagnosis review and ICS dose adjustment. Well controlled asthma increased from 41% at visit 1 to 68% at visit 5 (p=0.001). The mean fluticasone dose decreased from 312 mcg/day at visit 2 to 211mcg/day at visit 5 (p=0.022). There was a high level of protocol deviations (25%), often related to concerns about reducing the ICS dose. The % fall in FENO associated with a change in asthma status from poor control to good control was 35%. An FENO-based algorithm provided for a reduction in ICS doses without compromising asthma control. However, the results may have been influenced by the education and support which patients received. Reluctance to reduce ICS dose was an issue which may have influenced the overall results. Australian Clinical Trials Registry # 012605000354684.

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.

Adiposity, fractional exhaled nitric oxide, and asthma in U.S. children.

PubMed

Han, Yueh-Ying; Forno, Erick; Celedón, Juan C

2014-07-01

Whether allergic airway inflammation mediates the association between overweight or obesity and childhood asthma is unknown. To examine adiposity, asthma, and fractional exhaled nitric oxide (FeNO) in U.S. children. Cross-sectional study of indicators of adiposity or obesity, FeNO (a biomarker of eosinophilic airway inflammation), and asthma in 2,681 children aged 6-17 years in the 2007-2010 National Health and Nutrition Examination Survey. Adiposity measures included body mass index (BMI), percent body fat (PBF), and waist circumference (WC). BMI, PBF, and WC were associated with asthma among children with low FeNO (odds ratio, 1.54-1.68; P < 0.01), but not among children with increased FeNO. Among children without asthma, BMI, PBF, and WC were associated with higher FEV1 and FVC, and lower FEV1/FVC. Among children with asthma and a high FeNO, all adiposity indicators were associated with decreased FEV1/FVC (β = -1.5% to -1.7% per z score) but not with FEV1 or FVC. Higher BMI or PBF was associated with worse asthma severity or control in children with asthma and increased FeNO, but not in children with asthma and low FeNO. Similar results were obtained in a secondary multivariate analysis of overweight or obesity (defined as BMI ≥85th percentile) and asthma or indicators of asthma severity or control, stratified by FeNO level. Adiposity indicators are associated with asthma in children with low FeNO. Among children with asthma, adiposity indicators are associated with worse asthma severity or control in those with high FeNO.

Human breath metabolomics using an optimized non-invasive exhaled breath condensate sampler.

PubMed

Zamuruyev, Konstantin O; Aksenov, Alexander A; Pasamontes, Alberto; Brown, Joshua F; Pettit, Dayna R; Foutouhi, Soraya; Weimer, Bart C; Schivo, Michael; Kenyon, Nicholas J; Delplanque, Jean-Pierre; Davis, Cristina E

2016-12-22

Exhaled breath condensate (EBC) analysis is a developing field with tremendous promise to advance personalized, non-invasive health diagnostics as new analytical instrumentation platforms and detection methods are developed. Multiple commercially-available and researcher-built experimental samplers are reported in the literature. However, there is very limited information available to determine an effective breath sampling approach, especially regarding the dependence of breath sample metabolomic content on the collection device design and sampling methodology. This lack of an optimal standard procedure results in a range of reported results that are sometimes contradictory. Here, we present a design of a portable human EBC sampler optimized for collection and preservation of the rich metabolomic content of breath. The performance of the engineered device is compared to two commercially available breath collection devices: the RTube ™ and TurboDECCS. A number of design and performance parameters are considered, including: condenser temperature stability during sampling, collection efficiency, condenser material choice, and saliva contamination in the collected breath samples. The significance of the biological content of breath samples, collected with each device, is evaluated with a set of mass spectrometry methods and was the primary factor for evaluating device performance. The design includes an adjustable mass-size threshold for aerodynamic filtering of saliva droplets from the breath flow. Engineering an inexpensive device that allows efficient collection of metalomic-rich breath samples is intended to aid further advancement in the field of breath analysis for non-invasive health diagnostic. EBC sampling from human volunteers was performed under UC Davis IRB protocol 63701-3 (09/30/2014-07/07/2017).

Increase in exhaled nitric oxide is associated with bronchial hyperresponsiveness among apprentices.

PubMed

Tossa, Paul; Paris, Christophe; Zmirou-Navier, Denis; Demange, Valérie; Acouetey, Dovi-Stéphanie; Michaely, Jean-Pierre; Bohadana, Abraham

2010-09-15

Airway inflammation is a hallmark of asthma. Several studies have validated the use of the fractional concentration of exhaled nitric oxide (Fe(NO)) as a surrogate marker of airway inflammation in asthma. We examined how the change in Fe(NO) levels, since the beginning of occupational exposure, could be associated with the incidence of bronchial hyperresponsiveness (BHR) among baker, pastry maker, and hairdresser apprentices during their 2-year training. A standardized questionnaire was administered; skin prick tests for common and specific occupational allergens were done; methacholine challenge and measurement of Fe(NO) were performed 6, 12, and 15 months after the first examination. Of 441 apprentices initially included, 351 completed the study. The increase in Fe(NO), since the beginning of exposure, was associated with the incidence of BHR (odds ratio, 2.00 [95% confidence interval, 1.21-3.32] per unit increase in log parts per billion) both in atopic and nonatopic subjects. The average increase in Fe(NO) was similar in atopic and nonatopic subjects and was unrelated to past or current smoking habits, sex, or training track. Atopy in bakers/pastry makers and sensitization to alkaline persulfates in hairdressers were also independently associated with the incidence of BHR. BHR occurred sooner among bakers/pastry makers than among hairdressers, but its incidence leveled off later. Our results suggest that measurement of Fe(NO), a simple and reproducible test, could be useful in the screening of BHR in workers newly exposed to agents known to cause occupational asthma.

Collecting exhaled breath condensate (EBC) with two condensers in series: a promising technique for studying the mechanisms of EBC formation, and the volatility of selected biomarkers.

PubMed

Corradi, Massimo; Goldoni, Matteo; Caglieri, Andrea; Folesani, Giuseppina; Poli, Diana; Corti, Marina; Mutti, Antonio

2008-03-01

Exhaled breath condensate (EBC) consists mainly of water, but also contains semivolatile and nonvolatile compounds. The aim of this study was to develop a system in which two condensers are simultaneously used in series to clarify the mechanisms of EBC condensation. Two aliquots of EBC (EBC1 and EBC2) were collected from 20 asymptomatic smokers and 20 healthy young nonsmokers using a specifically designed device having two condensers in series in which total volume, hydrogen peroxide (H(2)O(2)), ammonium (NH(4)(+)), and conductivity before and after lyophilization were measured. Water, NH(4)(+) levels and conductivity before lyophilization were significantly lower in the EBC2 than in the EBC1 of smokers and nonsmokers; the contrary was true for H(2)O(2) levels. Almost all nonvolatile salts were collected in the first condenser, because more than 50% of postlyophilization conductivity was below the detection limit in EBC2. The recovery of volatile molecules and their derivatives (water and NH(4)(+)) was partial in the first condenser, but appreciable amounts of both were measured in the second; however, the condenser immediately in contact with exhaled air was more efficient in terms of water, NH(4)(+) and conductivity before lyophilization. On the contrary, nonvolatile ions (conductivity after lyophilization) were mainly collected in the first condenser. Finally, the behavior of H(2)O(2) cannot be explained on the basis of its chemical and physical properties, and the most probable explanation is that some was byproduced by a radical reaction in the gas phase or during the condensation process in water.

Increased exhaled breath condensate 8-isoprostane after a swimming session in competitive swimmers.

PubMed

Morissette, Mathieu C; Murray, Nicolas; Turmel, Julie; Milot, Julie; Boulet, Louis-Philippe; Bougault, Valérie

2016-08-01

This study aimed to evaluate the levels of 8-isoprostane (8-IsoP) in the airways of competitive swimmers at baseline and after a swimming session according to their airway responsiveness. Twenty-three swimmers and six lifeguards had a baseline spirometry and bronchoprovocative challenges. During a second visit, swimmers performed a usual swimming session while lifeguards stayed in the same pool environment for the same time period. Forced expiratory volume in one second (FEV1) was measured before and 5 min after the end of the session. Exhaled breath condensate (EBC) was sampled before and 10 min after the session and EBC 8-IsoP levels were analysed by enzyme immunoassay. Change in EBC 8-IsoP from baseline to post-swimming session was calculated. We observed no relationships between airway hyper-responsiveness and 8-IsoP values before or after swimming in swimmers. The levels of 8-IsoP were significantly higher after the training session (mean value 2.9, s = 0.5 pg mL(-1)) than at baseline (mean value 1.9, s = 0.4 pg mL(-1)) in swimmers only (p = .012). EBC 8-IsoP levels after the swimming session significantly correlated with the percent change in FEV1 after swimming. EBC 8-IsoP levels were increased after training in swimmers but not in lifeguards, suggesting that exercise-induced hyperpnoea in a chlorinated pool environment increases airways oxidative stress.

Adiposity, Fractional Exhaled Nitric Oxide, and Asthma in U.S. Children

PubMed Central

Han, Yueh-Ying; Forno, Erick

2014-01-01

Rationale: Whether allergic airway inflammation mediates the association between overweight or obesity and childhood asthma is unknown. Objectives: To examine adiposity, asthma, and fractional exhaled nitric oxide (FeNO) in U.S. children. Methods: Cross-sectional study of indicators of adiposity or obesity, FeNO (a biomarker of eosinophilic airway inflammation), and asthma in 2,681 children aged 6–17 years in the 2007–2010 National Health and Nutrition Examination Survey. Adiposity measures included body mass index (BMI), percent body fat (PBF), and waist circumference (WC). Measurements and Main Results: BMI, PBF, and WC were associated with asthma among children with low FeNO (odds ratio, 1.54–1.68; P < 0.01), but not among children with increased FeNO. Among children without asthma, BMI, PBF, and WC were associated with higher FEV1 and FVC, and lower FEV1/FVC. Among children with asthma and a high FeNO, all adiposity indicators were associated with decreased FEV1/FVC (β = −1.5% to −1.7% per z score) but not with FEV1 or FVC. Higher BMI or PBF was associated with worse asthma severity or control in children with asthma and increased FeNO, but not in children with asthma and low FeNO. Similar results were obtained in a secondary multivariate analysis of overweight or obesity (defined as BMI ≥85th percentile) and asthma or indicators of asthma severity or control, stratified by FeNO level. Conclusions: Adiposity indicators are associated with asthma in children with low FeNO. Among children with asthma, adiposity indicators are associated with worse asthma severity or control in those with high FeNO. PMID:24922361

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.

Aluminum gallium nitride (GaN)/GaN high electron mobility transistor-based sensors for glucose detection in exhaled breath condensate.

PubMed

Chu, Byung Hwan; Kang, Byoung Sam; Hung, Sheng Chun; Chen, Ke Hung; Ren, Fan; Sciullo, Andrew; Gila, Brent P; Pearton, Stephen J

2010-01-01

Immobilized aluminum gallium nitride (AlGaN)/GaN high electron mobility transistors (HEMTs) have shown great potential in the areas of pH, chloride ion, and glucose detection in exhaled breath condensate (EBC). HEMT sensors can be integrated into a wireless data transmission system that allows for remote monitoring. This technology offers the possibility of using AlGaN/GaN HEMTs for extended investigations of airway pathology of detecting glucose in EBC without the need for clinical visits. HEMT structures, consisting of a 3-microm-thick undoped GaN buffer, 30-A-thick Al(0.3)Ga(0.7)N spacer, and 220-A-thick silicon-doped Al(0.3)Ga(0.7)N cap layer, were used for fabricating the HEMT sensors. The gate area of the pH, chloride ion, and glucose detection was immobilized with scandium oxide (Sc(2)O(3)), silver chloride (AgCl) thin film, and zinc oxide (ZnO) nanorods, respectively. The Sc(2)O(3)-gated sensor could detect the pH of solutions ranging from 3 to 10 with a resolution of approximately 0.1 pH. A chloride ion detection limit of 10(-8) M was achieved with a HEMT sensor immobilized with the AgCl thin film. The drain-source current of the ZnO nanorod-gated AlGaN/GaN HEMT sensor immobilized with glucose oxidase showed a rapid response of less than 5 seconds when the sensor was exposed to the target glucose in a buffer with a pH value of 7.4. The sensor could detect a wide range of concentrations from 0.5 nM to 125 microM. There is great promise for using HEMT-based sensors to enhance the detection sensitivity for glucose detection in EBC. Depending on the immobilized material, HEMT-based sensors can be used for sensing different materials. These electronic detection approaches with rapid response and good repeatability show potential for the investigation of airway pathology. The devices can also be integrated into a wireless data transmission system for remote monitoring applications. This sensor technology could use the exhaled breath condensate to measure the

Aluminum Gallium Nitride (GaN)/GaN High Electron Mobility Transistor-Based Sensors for Glucose Detection in Exhaled Breath Condensate

PubMed Central

Chu, Byung Hwan; Kang, Byoung Sam; Hung, Sheng Chun; Chen, Ke Hung; Ren, Fan; Sciullo, Andrew; Gila, Brent P.; Pearton, Stephen J.

2010-01-01

Background Immobilized aluminum gallium nitride (AlGaN)/GaN high electron mobility transistors (HEMTs) have shown great potential in the areas of pH, chloride ion, and glucose detection in exhaled breath condensate (EBC). HEMT sensors can be integrated into a wireless data transmission system that allows for remote monitoring. This technology offers the possibility of using AlGaN/GaN HEMTs for extended investigations of airway pathology of detecting glucose in EBC without the need for clinical visits. Methods HEMT structures, consisting of a 3-μm-thick undoped GaN buffer, 30-Å-thick Al0.3Ga0.7N spacer, and 220-Å-thick silicon-doped Al0.3Ga0.7N cap layer, were used for fabricating the HEMT sensors. The gate area of the pH, chloride ion, and glucose detection was immobilized with scandium oxide (Sc2O3), silver chloride (AgCl) thin film, and zinc oxide (ZnO) nanorods, respectively. Results The Sc2O3-gated sensor could detect the pH of solutions ranging from 3 to 10 with a resolution of ∼0.1 pH. A chloride ion detection limit of 10-8 M was achievedt with a HEMT sensor immobilized with the AgCl thin film. The drain–source current of the ZnO nanorod-gated AlGaN/GaN HEMT sensor immobilized with glucose oxidase showed a rapid response of less than 5 seconds when the sensor was exposed to the target glucose in a buffer with a pH value of 7.4. The sensor could detect a wide range of concentrations from 0.5 nM to 125 μM. Conclusion There is great promise for using HEMT-based sensors to enhance the detection sensitivity for glucose detection in EBC. Depending on the immobilized material, HEMT-based sensors can be used for sensingt different materials. These electronic detection approaches with rapid response and good repeatability show potential for the investigation of airway pathology. The devices can also be integrated into a wireless data transmission system for remote monitoring applications. This sensor technology could use the exhaled breath condensate to

AIR POLLUTION INFLUENCES ON EXHALED NITRIC OXIDE AMONG PEOPLE WITH TYPE II DIABETES.

PubMed

Peng, Cheng; Luttmann-Gibson, Heike; Zanobetti, Antonella; Cohen, Allison; De Souza, Celine; Coull, Brent A; Horton, Edward S; Schwartz, Joel; Koutrakis, Petros; Gold, Diane R

2016-04-01

In a population with type 2 diabetes mellitus (T2DM), we examined associations of short-term air pollutant exposures with pulmonary inflammation, measured as fraction of exhaled pulmonary nitric oxide (FeNO). Sixty-nine Boston Metropolitan residents with T2DM completed up to 5 bi-weekly visits with 321 offline FeNO measurements. We measured ambient concentrations of particle mass, number and components at our stationary central site. Ambient concentrations of gaseous air pollutants were obtained from state monitors. We used linear models with fixed effects for participants, adjusting for 24-hour mean temperature, 24-hour mean water vapor pressure, season, and scrubbed room NO the day of the visit, to estimate associations between FeNO and interquartile range increases in exposure. Interquartile increases in the 6-hour averages of black carbon (BC) (0.5 μg/m 3 ) and particle number (PN) (1,000 particles/cm 3 ) were associated with increases in FeNO of 3.84% (95% CI 0.60% to 7.18%) and 9.86 % (95% CI 3.59% to 16.52%), respectively. We also found significant associations of increases in FeNO with increases in 24-hour moving averages of BC, PN and nitrogen oxides (NOx). Recent studies have focused on FeNO as a marker for eosinophilic pulmonary inflammation in asthmatic populations. This study adds support to the relevance of FeNO as a marker for pulmonary inflammation in diabetic populations, whose underlying chronic inflammatory status is likely to be related to innate immunity and proinflammatory adipokines.

Assessment of nanoparticles and metal exposure of airport workers using exhaled breath condensate.

PubMed

Marie-Desvergne, Caroline; Dubosson, Muriel; Touri, Léa; Zimmermann, Eric; Gaude-Môme, Marcelline; Leclerc, Lara; Durand, Catherine; Klerlein, Michel; Molinari, Nicolas; Vachier, Isabelle; Chanez, Pascal; Mossuz, Véronique Chamel

2016-07-13

Aircraft engine exhaust increases the number concentration of nanoparticles (NP) in the surrounding environment. Health concerns related to NP raise the question of the exposure and health monitoring of airport workers. No biological monitoring study on this profession has been reported to date. The aim was to evaluate the NP and metal exposure of airport workers using exhaled breath condensate (EBC) as a non-invasive biological matrix representative of the respiratory tract. EBC was collected from 458 French airport workers working either on the apron or in the offices. NP exposure was characterized using particle number concentration (PNC) and size distribution. EBC particles were analyzed using dynamic light scattering (DLS) and scanning electron microscopy coupled to x-ray spectroscopy (SEM-EDS). Multi-elemental analysis was performed for aluminum (Al), cadmium (Cd) and chromium (Cr) EBC contents. Apron workers were exposed to higher PNC than administrative workers (p  <  0.001). Workers were exposed to very low particle sizes, the apron group being exposed to even smaller NP than the administrative group (p  <  0.001). The particulate content of EBC was brought out by DLS and confirmed with SEM-EDS, although no difference was found between the two study groups. Cd concentrations were higher in the apron workers (p  <  0.001), but still remained very low and close to the detection limit. Our study reported the particulate and metal content of airport workers airways. EBC is a potential useful tool for the non-invasive monitoring of workers exposed to NP and metals.

Exhaled breath and oral cavity VOCs as potential biomarkers in oral cancer patients.

PubMed

Bouza, M; Gonzalez-Soto, J; Pereiro, R; de Vicente, J C; Sanz-Medel, A

2017-03-01

Corporal mechanisms attributed to cancer, such as oxidative stress or the action of cytochrome P450 enzymes, seem to be responsible for the generation of a variety of volatile organic compounds (VOCs) that could be used as non-invasive diagnosis biomarkers. The present work presents an attempt to use VOCs from exhaled breath and oral cavity air as biomarkers for oral squamous cell carcinoma (OSCC) patients. A total of 52 breath samples were collected (in 3 L Tedlar bags) from 26 OSCC patients and 26 cancer-free controls. The samples were analyzed using solid-phase microextraction followed by gas chromatography-mass spectrometry detection. Different statistical strategies (e.g., Icoshift, SIMCA, LDA, etc) were used to classify the analytical data. Results revealed that compounds such as undecane, dodecane, decanal, benzaldehyde, 3,7-dimethyl undecane, 4,5-dimethyl nonane, 1-octene, and hexadecane had relevance as possible biomarkers for OSCC. LDA classification with these compounds showed well-defined clusters for patients and controls (non-smokers and smokers). In addition to breath analysis, preliminary studies were carried out to evaluate the possibility of lesion-surrounded air (analyzed OSCC tumors are in the oral cavity) as a source of biomarkers. The oral cavity location of the squamous cell carcinoma tumors constitutes an opportunity to non-invasively collect the air surrounding the lesion. Small quantities (20 ml) of air collected in the oral cavity were analyzed using the above methodology. Results showed that aldehydes present in the oral cavity might constitute potential OSCC biomarkers.

Hydrogen peroxide release and acid-base status in exhaled breath condensate at rest and after maximal exercise in young, healthy subjects.

PubMed

Marek, E; Platen, P; Volke, J; Mückenhoff, K; Marek, W

2009-12-07

Exhaled breath condensate (EBC) contains among a large number of mediators hydrogen peroxide (H2O2) as a marker of airway inflammation and oxidative stress. Similarly EBC pH also changes in respiratory diseases. It was the aim of our investigation to prove if hydrogen peroxide release and changes in pH of EBC changes with exercise. EBC was collected from 100 litres exhaled air along with samples of arterialized blood of 16 healthy subjects (9 males, 7 females, age 23 +/- 1 years). EBC hydrogen peroxide was analyzed with EcoCheck amperometer (FILT, Berlin). The rate of H(2)O(2) release was calculated from the concentration and collection time. pH and PCO(2) in blood and in EBC were measured with the Radiometer blood gas analyzer, EBC was equilibrated with a gas mixture (5% CO(2) in O(2)). The bicarbonate concentration was calculated according to the law of mass action for CO(2) and HCO(3)(-) (pK = 6.1). H(2)O(2) concentration in EBC was 190 +/- 109 nmol/l, and H (2)O(2) release at rest was 31.0 +/- 18.3 pmol/min. At maximal exercise, the H(2)O(2) concentration in EBC increased to 250 +/- 120 nmol/l, and H(2)O(2) release significantly increased at maximal exercise to 84.4 +/- 39.9 pmol/min (P<0.01). At rest pH of the CO(2) equilibrated EBC was at 6.08 +/- 0.23 and the [HCO(3)(-)] was 1.03 +/- 0.40 mmol/l. At maximum exercise, pH 6.18 +/- 0.17 and [HCO(3)(-)] 1.23 +/- 0.30 mmol/l remained almost unaltered. The rate of H(2)O(2) release in EBC increased during exhausting exercise (external load: 300 Watt) by a factor of 2, whereas the pH and the bicarbonate concentration of the EBC, equilibrated with 5% CO(2) at 37 degrees C were not significantly altered. It has to be proven by further experiments whether there is a linear relationship between the rates of H(2)O(2) release in EBC in graded submaximal exercise.

Exhaled nitric oxide measurements: correction equation to compare hand-held device to stationary analyzer.

PubMed

Pizzimenti, Stefano; Bugiani, Massimiliano; Piccioni, Pavilio; Heffler, Enrico; Carosso, Aurelia; Guida, Giuseppe; Rolla, Giovanni

2008-09-01

Exhaled nitric oxide (FE(NO)) is a reliable non-invasive marker of airway inflammation. In 2003 FE(NO) chemiluminescence analyzer (NIOX; Aerocrine AB, Solna, Sweden) was approved by U.S. Food and Drug Administration for monitoring asthma therapy. Recently, the same company developed a portable device using electrochemical sensors (NIOX-MINO; Aerocrine AB). The aim of our study was to compare NIOX-MINO FE(NO) values to those obtained by NIOX and to calculate a correction equation. Two adequate measurements obtained by NIOX and NIOX-MINO were recorded in 32 subjects (16 females, mean age 41 years). FE(NO) values measured by NIOX-MINO were systematically higher than those obtained by NIOX (47.1ppb, IC 95% 35.2-59.1 and 36.9ppb, IC 95% 25.0-49.0, respectively). There was a significant correlation (r=0.998, p<0.001) between FE(NO) measured by the two analyzers and the following conversion equation was calculated as: FE(NO(NIOX))=-1.656(SE=0.61)+0.808(SE=0.009)x FE(NO(NIOX-MINO)) DISCUSSION: FE(NO) values measured by the portable nitric oxide analyzer are reliable and strongly correlated with values obtained by the standard stationary device, with a systematic difference observed between the two instruments' values that can be described by the conversion equation we provided. This equation will help clinicians and researchers to compare data obtainable by the two analyzers.

Effect of exposure to an Asian dust storm on fractional exhaled nitric oxide in adult asthma patients in Western Japan.

PubMed

Watanabe, Masanari; Kurai, Jun; Sano, Hiroyuki; Shimizu, Eiji

2015-01-01

Epidemiological investigations indicate that an Asian dust storm (ADS) can aggravate respiratory disorders. However, the effects of ADS on airway inflammation remain unclear. The aim of this study was to investigate the association of exposure to ADS with airway inflammation. The subjects were 33 adult patients with asthma who measured daily peak flow expiratory (PEF) from March to May 2012. Fractional exhaled nitric oxide (FeNO) was measured before and after ADS. The FeNO values were 13.8±13.7 ppb before the ADS and 20.3±19.0 ppb after the ADS, with no significant difference. There was also no significant association of PEF with ADS exposure. However, the increase of FeNO after ADS exposure was proportional to the decrease of PEF (R=-0.78, P<0.0001). These results suggest that airway inflammation aggravated by ADS exposure may induce a decrease in pulmonary function in some adult patients with asthma.

Screening of exhaled breath by low-resolution multicomponent FT-IR spectrometry in patients attending emergency departments.

PubMed

Laakso, Olli; Haapala, Matti; Kuitunen, Tapio; Himberg, Jaakko-Juhani

2004-03-01

Interest in noninvasive methods for disease diagnosis is increasing. In this study, we tested the utility and potential of a portable Fourier transform infrared (FT-IR) multicomponent analyzer in the emergency rooms (ERs) of two Finnish hospitals. Major detected breath volatiles in this population were ethanol, carbon monoxide, methane, and acetone, in addition to carbon dioxide and water. The analysis of breath revealed an ethanol concentration of over 25 ppm (0.1 g/L in blood) in 56 out of 589 patients (9.5%). During nightshifts the proportion was 30% for all and 63% for trauma patients. Five-hundred eighty-four patients had measurable carbon monoxide in their breath. A breath carbon monoxide of over 4 ppm (4.4 micro g/L) differentiated smokers from nonsmokers. Methane over 2 ppm (1.3 micro g/L) was detected in the breath of 32% of the participants. Methane concentration was higher among aged patients. Two-hundred ninety-eight participants had detectable acetone in their breath. Elevated exhaled acetone [10-76 ppm (23-75 micro g/L)] was detected in 10 patients. The FT-IR method proved functional in the ER setting. A major advantage over blood sampling was fast and easy analysis performed by nonlaboratory personnel.

Viral colonization in exhaled breath condensate of lung cancer patients: Possible role of EBV and CMV.

PubMed

Carpagnano, Giovanna E; Lacedonia, Donato; Natalicchio, Maria Iole; Cotugno, Grazia; Zoppo, Luigi; Martinelli, Domenico; Antonetti, Raffaele; Foschino-Barbaro, Maria Pia

2018-02-01

Today, an increasing interest is being addressed to the viral etiology of lung tumors. As a consequence, research efforts are currently being directed to the identification of the new viruses involved in lung carcinogenesis toward which the screening programs could be directed. The aim of this study was to investigate the airways colonization by the Epstein-Barr virus (EBV) and Citomegalovirus (CMV) in patients affected by lung cancer using, as a respiratory non-invasive sample, the exhaled breath condensate (EBC). About 70 lung-cancer patients and 40 controls were enrolled. All subjects underwent bronchial brushing and EBC collection. EBV-DNA and CMV-DNA were evaluated in both samples by real-time PCR assay. They were able to detect EBV and CMV in the EBC. An increase of the EBV positivity in non-small cell lung cancer (NSCLC) patients compared with controls and of the CMV in advanced stages of lung cancer were observed. The association of the positivity of the cytology and the CMV test (in EBC or brushing) slightly increased the sensitivity of malignant diagnosis. EBV and CMV resulted detectable in the EBC. In consideration of the potential involvement of these viruses in lung cancer, which was confirmed in this study, future studies in this direction were supported. © 2016 John Wiley & Sons Ltd.

Particulate matter in exhaled breath condensate: A promising indicator of environmental conditions

NASA Astrophysics Data System (ADS)

Pinheiro, Teresa; Alexandra Barreiros, M.; Alves, Luis C.; Felix, Pedro M.; Franco, Cristiana; Sousa, Joana; Almeida, S. M.

2011-10-01

Assessing the retention of aerosol particles in the human lung, one of the most important pathways of absorption, is a demanding issue. At present, there is no direct biomarker of exposure for the respiratory system. The collection of exhaled breath condensate (EBC) constitutes a new non-invasive method for sampling from the lung. However, the heterogeneity of the sample due to particulate matter suspended in the condensed phase may influence the quality of analytical results in occupational assessments. The main objective of the study was to confirm the presence of particulate matter in the condensate, to investigate how large the particles in suspension could be and to determine their elemental contents relative to those of EBC matrix. This paper reports on preliminary nuclear microprobe data of particulate matter in EBC. The sizes and the elemental contents of particles suspended in EBC of workers of a lead processing industry and in EBC of non-exposed individuals were inspected. Results demonstrated that EBC of workers contain large aerosol particles, isolated and in agglomerates, contrasting with non-exposed individuals. The particles contained high concentrations of Cl, Ca, Zn and Pb that are elements associated to the production process. These elements were also present in the EBC matrix although in much lower levels, suggesting that a fraction of the inhaled particulate matter was solubilised or their size-ranges were below the nuclear microprobe resolution. Therefore, the morphological characterization of individual particles achieved with nuclear microprobe techniques helped describing EBC constituents in detail, to comprehend their origin and enabled to delineate methodological procedures that can be recommended in occupational assessments. These aspects are critical to the validation of EBC as a biomarker of exposure to metals for the respiratory system.

Short-term effects of electronic and tobacco cigarettes on exhaled nitric oxide.

PubMed

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(9), 5.1±0.1×10(9), and 3.1±0.6×10(9) part. cm(-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(10), 5.2×10(10) and 2.3×10(10) particles. The mean eNO variations measured after each smoking/vaping session were equal to 3.2ppb, 2.7ppb and 2.8ppb 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. Copyright © 2014 Elsevier Inc. All rights reserved.

Obesity disproportionately impacts lung volumes, airflow and exhaled nitric oxide in children.

PubMed

Yao, Tsung-Chieh; Tsai, Hui-Ju; Chang, Su-Wei; Chung, Ren-Hua; Hsu, Jing-Ya; Tsai, Ming-Han; Liao, Sui-Ling; Hua, Man-Chin; Lai, Shen-Hao; Chen, Li-Chen; Yeh, Kuo-Wei; Tseng, Yu-Lun; Lin, Wan-Chen; Chang, Su-Ching; Huang, Jing-Long

2017-01-01

The current literature focusing on the effect of obesity and overweight on lung function and fraction of exhaled nitric oxide (FeNO) in children, particularly among healthy children of non-European descent, remains controversial. Furthermore, whether the relationship of obesity and overweight with lung function and FeNO in children is modified by atopy is unclear. The objective of this study was to examine the effect of excess weight on lung function parameters and FeNO among Asian children, with a particular focus on exploring the potential effect modification by atopy. We investigated the effect of excess weight on lung function and FeNO in a population sample of 1,717 children aged 5 to 18 years and explored the potential modifying effect of atopy. There were positive associations of body mass index (BMI) z-score with forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), and forced expiratory flow at 25-75% (FEF25-75) (all P<0.001), after controlling for confounders. The beta coefficient for FEV1 (0.084) was smaller than that for FVC (0.111). In contrast, a negative association was found between BMI z-score and FEV1/FVC ratio (P<0.001) and FeNO (P = 0.03). A consistent pattern of association for lung function variables was observed when stratifying by atopy. There was a negative association of BMI z-score with FeNO in atopic subjects (P = 0.006), but not in non-atopic subjects (P = 0.46). Excess weight disproportionately impacts lung volumes and airflow in children from the general population, independent of atopic status. Excess weight inversely affects FeNO in atopic but not in non-atopic children.

Evidence from in vivo 31-phosphorus magnetic resonance spectroscopy phosphodiesters that exhaled ethane is a biomarker of cerebral n-3 polyunsaturated fatty acid peroxidation in humans.

PubMed

Puri, Basant K; Counsell, Serena J; Ross, Brian M; Hamilton, Gavin; Bustos, Marcelo G; Treasaden, Ian H

2008-04-17

This study tested the hypothesis that exhaled ethane is a biomarker of cerebral n-3 polyunsaturated fatty acid peroxidation in humans. Ethane is released specifically following peroxidation of n-3 polyunsaturated fatty acids. We reasoned that the cerebral source of ethane would be the docosahexaenoic acid component of membrane phospholipids. Breakdown of the latter also releases phosphorylated polar head groups, giving rise to glycerophosphorylcholine and glycerophosphorylethanolamine, which can be measured from the 31-phosphorus neurospectroscopy phosphodiester peak. Schizophrenia patients were chosen because of evidence of increased free radical-mediated damage and cerebral lipid peroxidation in this disorder. Samples of alveolar air were obtained from eight patients and ethane was analyzed and quantified by gas chromatography and mass spectrometry (m/z = 30). Cerebral 31-phosphorus spectra were obtained from the same patients at a magnetic field strength of 1.5 T using an image-selected in vivo spectroscopy sequence (TR = 10 s; 64 signal averages localized on a 70 x 70 x 70 mm3 voxel). The quantification of the 31-phosphorus signals using prior knowledge was carried out in the temporal domain after truncating the first 1.92 ms of the signal to remove the broad component present in the 31-phosphorus spectra. The ethane and phosphodiester levels, expressed as a percentage of the total 31-phosphorus signal, were positively and significantly correlated (rs = 0.714, p < 0.05). Our results support the hypothesis that the measurement of exhaled ethane levels indexes cerebral n-3 lipid peroxidation. From a practical viewpoint, if human cerebral n-3 polyunsaturated fatty acid catabolism can be measured by ethane in expired breath, this would be more convenient than determining the area of the 31-phosphorus neurospectroscopy phosphodiester peak.

Evidence from in vivo 31-phosphorus magnetic resonance spectroscopy phosphodiesters that exhaled ethane is a biomarker of cerebral n-3 polyunsaturated fatty acid peroxidation in humans

PubMed Central

Puri, Basant K; Counsell, Serena J; Ross, Brian M; Hamilton, Gavin; Bustos, Marcelo G; Treasaden, Ian H

2008-01-01

Background This study tested the hypothesis that exhaled ethane is a biomarker of cerebral n-3 polyunsaturated fatty acid peroxidation in humans. Ethane is released specifically following peroxidation of n-3 polyunsaturated fatty acids. We reasoned that the cerebral source of ethane would be the docosahexaenoic acid component of membrane phospholipids. Breakdown of the latter also releases phosphorylated polar head groups, giving rise to glycerophosphorylcholine and glycerophosphorylethanolamine, which can be measured from the 31-phosphorus neurospectroscopy phosphodiester peak. Schizophrenia patients were chosen because of evidence of increased free radical-mediated damage and cerebral lipid peroxidation in this disorder. Methods Samples of alveolar air were obtained from eight patients and ethane was analyzed and quantified by gas chromatography and mass spectrometry (m/z = 30). Cerebral 31-phosphorus spectra were obtained from the same patients at a magnetic field strength of 1.5 T using an image-selected in vivo spectroscopy sequence (TR = 10 s; 64 signal averages localized on a 70 × 70 × 70 mm3 voxel). The quantification of the 31-phosphorus signals using prior knowledge was carried out in the temporal domain after truncating the first 1.92 ms of the signal to remove the broad component present in the 31-phosphorus spectra. Results The ethane and phosphodiester levels, expressed as a percentage of the total 31-phosphorus signal, were positively and significantly correlated (rs = 0.714, p < 0.05). Conclusion Our results support the hypothesis that the measurement of exhaled ethane levels indexes cerebral n-3 lipid peroxidation. From a practical viewpoint, if human cerebral n-3 polyunsaturated fatty acid catabolism can be measured by ethane in expired breath, this would be more convenient than determining the area of the 31-phosphorus neurospectroscopy phosphodiester peak. PMID:18433512

Use of a least absolute shrinkage and selection operator (LASSO) model to selected ion flow tube mass spectrometry (SIFT-MS) analysis of exhaled breath to predict the efficacy of dialysis: a pilot study.

PubMed

Wang, Maggie Haitian; Chong, Ka Chun; Storer, Malina; Pickering, John W; Endre, Zoltan H; Lau, Steven Yf; Kwok, Chloe; Lai, Maria; Chung, Hau Yin; Ying Zee, Benny Chung

2016-09-28

Selected ion flow tube-mass spectrometry (SIFT-MS) provides rapid, non-invasive measurements of a full-mass scan of volatile compounds in exhaled breath. Although various studies have suggested that breath metabolites may be indicators of human disease status, many of these studies have included few breath samples and large numbers of compounds, limiting their power to detect significant metabolites. This study employed a least absolute shrinkage and selective operator (LASSO) approach to SIFT-MS data of breath samples to preliminarily evaluate the ability of exhaled breath findings to monitor the efficacy of dialysis in hemodialysis patients. A process of model building and validation showed that blood creatinine and urea concentrations could be accurately predicted by LASSO-selected masses. Using various precursors, the LASSO models were able to predict creatinine and urea concentrations with high adjusted R-square (>80%) values. The correlation between actual concentrations and concentrations predicted by the LASSO model (using precursor H 3 O + ) was high (Pearson correlation coefficient  =  0.96). Moreover, use of full mass scan data provided a better prediction than compounds from selected ion mode. These findings warrant further investigations in larger patient cohorts. By employing a more powerful statistical approach to predict disease outcomes, breath analysis using SIFT-MS technology could be applicable in future to daily medical diagnoses.

Can exhaled nitric oxide be a surrogate marker of bronchial hyperresponsiveness to adenosine 5'-monophosphate in steroid-naive asthmatic children?

PubMed

Arga, M; Bakirtas, A; Topal, E; Turktas, I

2015-04-01

The interrelation between airway inflammation, bronchial hyperresponsiveness (BHR) and atopy remains controversial. The aim of this study was to document whether exhaled nitric oxide (eNO) may be used as a surrogate marker that predicts BHR to adenosine 5'-monophosphate (AMP) in steroid-naive school children with asthma. This study was a retrospective analysis of steroid-naive school age children with atopic and non-atopic asthma. All patients whose eNO levels had been measured and who had been challenged with both methacholine (MCH) and AMP were included. Receiver operation characteristic analysis was performed, in both the atopic and the non-atopic groups, to evaluate the ability of eNO to detect the BHR to AMP. One hundred and sixteen patients, sixty-nine (59.5%) of whom had been atopic, were included in the analysis. In the atopic group, eNO values were significantly higher in patients with BHR to AMP compared to those without BHR to AMP (51.9 ± 16.9 p.p.b. vs. 33.7 ± 16.4 p.p.b.; P < 0.001), whereas in the non-atopic group, the differences were not statistically significant (29.7 ± 16.9 p.p.b. vs. 22.6 ± 8.1 p.p.b.; P = 0.152). In the atopic group, eNO levels (R(2) : 0.401; β: 0.092; 95% CI: 1.19-14.42; OR: 7.12; P = 0.008) were found to be the only independent factor for BHR to AMP, whereas none of the parameters predicted BHR to AMP in the non-atopic group. The best cut-off value of eNO that significantly predicts BHR to AMP was 33.3 p.p.b. in the atopic group (P < 0.001), whereas a significant cut-off value for eNO that predicts BHR to AMP was not determined in the non-atopic group (P = 0.142). An eNO ≤ 17.4 p.p.b. has 100% negative predictive values and 100% sensitivity and 60.47% PPV for prediction of BHR to AMP in the atopic group. Exhaled NO may be used to predict BHR to AMP in atopic but not in non-atopic steroid-naïve asthmatic children. © 2014 John Wiley & Sons Ltd.

Genetic influence on the relation between exhaled nitric oxide and pulse wave reflection.

PubMed

Tarnoki, David Laszlo; Tarnoki, Adam Domonkos; Medda, Emanuela; Littvay, Levente; Lazar, Zsofia; Toccaceli, Virgilia; Fagnani, Corrado; Stazi, Maria Antonietta; Nisticó, Lorenza; Brescianini, Sonia; Penna, Luana; Lucatelli, Pierleone; Boatta, Emanuele; Zini, Chiara; Fanelli, Fabrizio; Baracchini, Claudio; Meneghetti, Giorgio; Koller, Akos; Osztovits, Janos; Jermendy, Gyorgy; Preda, Istvan; Kiss, Robert Gabor; Karlinger, Kinga; Lannert, Agnes; Horvath, Tamas; Schillaci, Giuseppe; Molnar, Andrea Agnes; Garami, Zsolt; Berczi, Viktor; Horvath, Ildiko

2013-06-01

Nitric oxide has an important role in the development of the structure and function of the airways and vessel walls. Fractional exhaled nitric oxide (FE(NO)) is inversely related to the markers and risk factors of atherosclerosis. We aimed to estimate the relative contribution of genes and shared and non-shared environmental influences to variations and covariation of FE(NO) levels and the marker of elasticity function of arteries. Adult Caucasian twin pairs (n = 117) were recruited in Hungary, Italy and in the United States (83 monozygotic and 34 dizygotic pairs; age: 48 ± 16 SD years). FE(NO) was measured by an electrochemical sensor-based device. Pulse wave reflection (aortic augmentation index, Aix(ao)) was determined by an oscillometric method (Arteriograph). A bivariate Cholesky decomposition model was applied to investigate whether the heritabilities of FE(NO) and Aix(ao) were linked. Genetic effects accounted for 58% (95% confidence interval (CI): 42%, 71%) of the variation in FE(NO) with the remaining 42% (95%CI: 29%, 58%) due to non-shared environmental influences. A modest negative correlation was observed between FE(NO) and Aix(ao) (r = -0.17; 95%CI:-0.32,-0.02). FE(NO) showed a significant negative genetic correlation with Aix(ao) (r(g) = -0.25; 95%CI:-0.46,-0.02). Thus in humans, variations in FE(NO) are explained both by genetic and non-shared environmental effects. Covariance between FE(NO) and Aix(ao) is explained entirely by shared genetic factors. This is consistent with an overlap among the sets of genes involved in the expression of these phenotypes and provides a basis for further genetic studies on cardiovascular and respiratory diseases.

Exhaled human breath measurement method for assessing exposure to halogenated volatile organic compounds.

PubMed

Pleil, J D; Lindstrom, A B

1997-05-01

The organic constituents of exhaled human breath are representative of blood-borne 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 (VOCs), sampling and analysis of breath is preferred to direct measurement from blood samples because breath collection is noninvasive, potentially infectious waste is avoided, and the measurement of gas-phase analytes is much simpler in a gas matrix rather than in a complex biological tissue such as blood. To exploit these advantages, we have developed the "single breath canister" (SBC) technique, a simple direct collection method for individual alveolar breath samples, and adapted conventional gas chromatography-mass spectrometry analytical methods for trace-concentration VOC analysis. The focus of this paper is to describe briefly the techniques for making VOC measurements in breath, to present some specific applications for which these methods are relevant, and to demonstrate how to estimate exposure to example VOCs on the basis of breath elimination. We present data from three different exposure scenarios: (a) vinyl chloride and cis-1,2-dichloroethene from showering with contaminated water from a private well, (b) chloroform and bromodichloromethane from high-intensity swimming in chlorinated pool water, and (c) trichloroethene from a controlled exposure chamber experiment. In all cases, for all subjects, the experiment is the same: preexposure breath measurement, exposure to halogenated VOC, and a postexposure time-dependent series of breath measurements. Data are presented only to demonstrate the use of the method and how to interpret the analytical results.

Exhaled breath temperature increases during mild exacerbations in children with virus-induced asthma.

PubMed

Xepapadaki, P; Xatziioannou, A; Chatzicharalambous, M; Makrinioti, H; Papadopoulos, N G

2010-01-01

Exhaled breath temperature (EBT) has been suggested as a non-invasive surrogate marker of airway inflammation in asthma. The aim of the study was to evaluate differences in EBT between periods of controlled disease and during exacerbations in children with virus-induced asthma. Twenty-nine children (aged 6-14 years) with a history of intermittent, virus-induced asthma were included in this case-control study. Cases presented with a common cold and/or mild exacerbation of asthma, while controls were free of asthmatic or common cold symptoms during the previous 6 weeks. A baseline questionnaire was obtained. Atopy assessment, central temperature and a spirometric measurement were recorded. EBT was measured with a new device (Delmedica, Singapore). A nasal wash (for identification of common respiratory viruses) was obtained. Twenty-four children (12 from each group) completed the study. Groups were homogeneous with respect to baseline characteristics. PCR revealed the presence of a virus in 3 out of 17 controls and 10 out of 12 cases (17.6 and 83.3%, respectively, p = 0.002). The most commonly identified virus was rhinovirus (3/3 controls and 7/10 cases, p = 0.02). EBT values were significantly higher for cases (34.91 +/- 0.62 degrees C) compared to controls (34.18 +/- 1.1 degrees C, p = 0.032). No important differences were observed in the increase rate of EBT (Deltae degrees T) between groups. Changes in airway inflammation during virus-induced asthma exacerbations are reflected in EBT changes. These preliminary data suggest a possible role of EBT measurements in the assessment of airway inflammation in children with virus-induced asthma. Copyright (c) 2010 S. Karger AG, Basel.

Correlation between concentrations of n-hexane and toluene in exhaled and environmental air in an occupationally exposed population.

PubMed

Periago, J F; Morente, A; Villanueva, M; Luna, A

1994-01-01

We determined the correlations between the concentrations of n-hexane and toluene in exhaled and environmental air in the shoe manufacturing industry. Data were collected in 1988 and in 1992 from a total of 265 subjects. Environmental air samples were collected with personal diffusive samplers by adsorption on activated charcoal during exposure and from end-expired air (alveolar air) on cartridges of activated charcoal after exposure. Both compounds were desorbed with carbon disulphide and analysed by gas chromatography. Linear regression analyses showed a good correlation between environmental and end-expired air concentrations (r = 0.82 for n-hexane and r = 0.81 for toluene). These correlations allowed us to calculate the concentrations in expired air corresponding to current environmental limit values. The calculated concentrations in end-expired air that correspond to current environmental threshold limit values of 176 mg m-3 for n-hexane and 377 mg m-3 for toluene are 28 mg m-3 (95% confidence limit, 27-29 mg m-3) and 40 mg m-3 (95% confidence limit, 39-41 mg m-3), respectively. Similar correlations were found when the data from the two study periods were analysed separately.

Exhaled Breath Condensate Detects Baseline Reductions in Chloride and Increases in Response to Albuterol in Cystic Fibrosis Patients

PubMed Central

Wheatley, Courtney M.; Morgan, Wayne J.; Cassuto, Nicholas A.; Foxx-Lupo, William T.; Daines, Cori L.; Morgan, Mary A.; Phan, Hanna; Snyder, Eric M.

2013-01-01

Impaired ion regulation and dehydration is the primary pathophysiology in cystic fibrosis (CF) lung disease. A potential application of exhaled breath condensate (EBC) collection is to assess airway surface liquid ionic composition at baseline and in response to pharmacological therapy in CF. Our aims were to determine if EBC could detect differences in ion regulation between CF and healthy and measure the effect of the albuterol on EBC ions in these populations. Baseline EBC Cl−, DLCO and SpO2 were lower in CF (n = 16) compared to healthy participants (n = 16). EBC Cl− increased in CF subjects, while there was no change in DLCO or membrane conductance, but a decrease in pulmonary-capillary blood volume in both groups following albuterol. This resulted in an improvement in diffusion at the alveolar-capillary unit, and removal of the baseline difference in SpO2 by 90-minutes in CF subjects. These results demonstrate that EBC detects differences in ion regulation between healthy and CF individuals, and that albuterol mediates increases in Cl− in CF, suggesting that the benefits of albuterol extend beyond simple bronchodilation. PMID:24367235

Particle size concentration distribution and influences on exhaled breath particles in mechanically ventilated patients.

PubMed

Wan, Gwo-Hwa; Wu, Chieh-Liang; Chen, Yi-Fang; Huang, Sheng-Hsiu; Wang, Yu-Ling; Chen, Chun-Wan

2014-01-01

Humans produce exhaled breath particles (EBPs) during various breath activities, such as normal breathing, coughing, talking, and sneezing. Airborne transmission risk exists when EBPs have attached pathogens. Until recently, few investigations had evaluated the size and concentration distributions of EBPs from mechanically ventilated patients with different ventilation mode settings. This study thus broke new ground by not only evaluating the size concentration distributions of EBPs in mechanically ventilated patients, but also investigating the relationship between EBP level and positive expiratory end airway pressure (PEEP), tidal volume, and pneumonia. This investigation recruited mechanically ventilated patients, with and without pneumonia, aged 20 years old and above, from the respiratory intensive care unit of a medical center. Concentration distributions of EBPs from mechanically ventilated patients were analyzed with an optical particle analyzer. This study finds that EBP concentrations from mechanically ventilated patients during normal breathing were in the range 0.47-2,554.04 particles/breath (0.001-4.644 particles/mL). EBP concentrations did not differ significantly between the volume control and pressure control modes of the ventilation settings in the mechanically ventilated patients. The patient EBPs were sized below 5 µm, and 80% of them ranged from 0.3 to 1.0 µm. The EBPs concentrations in patients with high PEEP (> 5 cmH₂O) clearly exceeded those in patients with low PEEP (≤ 5 cmH₂O). Additionally, a significant negative association existed between pneumonia duration and EBPs concentration. However, tidal volume was not related to EBPs concentration.

Determination of hexavalent chromium in exhaled breath condensate and environmental air among chrome plating workers.

PubMed

Goldoni, Matteo; Caglieri, Andrea; Poli, Diana; Vettori, Maria Vittoria; Corradi, Massimo; Apostoli, Pietro; Mutti, Antonio

2006-03-15

Chromium speciation has attracted attention because of the different toxicity of Cr(III), which is considered relatively non-toxic, and Cr(VI), which can cross cell membranes mainly as a chromate anion and has been classified as a class I human carcinogen. The aims of the present study were to measure soluble Cr(VI) levels in environmental samples, to develop a simple method of quantifying Cr(VI) in exhaled breath condensate (EBC), and to follow the kinetics of EBC Cr(VI) in chrome plating workers.Personal air samples were collected from 10 chrome platers; EBC was collected from the same workers immediately after the work shift on Tuesday and before the work shift on the following Wednesday. Environmental and EBC Cr(VI) levels were determined by means of colorimetry and electrothermal absorption atomic spectrometry, respectively.The method of detecting Cr(VI) in environmental air was based on the extraction of the Cr(VI)-diphenylcarbazide (Cr(VI)-DPC) complex in 1-butanol, whereas EBC Cr(VI) was determined using a solvent extraction of Cr(VI) as an ion pair with tetrabutylammonium ion, and subsequent direct determination of the complex (Cr(VI)-DPC) in EBC.Kinetic data showed that airborne Cr(VI) was reduced by 50% in airway lining fluid sampled at the end of exposure and that there was a further 50% reduction after about 15 h. The persistence of Cr(VI) in EBC supports the use of EBC in assessing target tissue levels of Cr(VI).

Apocynin decreases hydrogen peroxide and nitrate concentrations in exhaled breath in healthy subjects.

PubMed

Stefanska, J; Sokolowska, M; Sarniak, A; Wlodarczyk, A; Doniec, Z; Nowak, D; Pawliczak, R

2010-02-01

The imbalance between reactive oxygen species (ROS) synthesis and antioxidants might be involved in the pathogenesis of many inflammatory diseases. NADPH oxidase, an enzyme responsible for ROS production, may represent an attractive therapeutic target to inhibit, for the treatment of these diseases. Apocynin is an inhibitor of activation of NADPH oxidase complex present in the inflammatory cells. In double blind, placebo-controlled, cross-over study, we investigated the effect of nebulized apocynin on ROS synthesis in 10 nonsmoking healthy volunteers. Apocynin (6ml of 0.5mg/ml) was administered by nebulization and its effects on H(2)O(2), NO(2)(-) and NO(3)(-) generation were assessed after 30, 60 and 120min by collecting exhaled breath condensate (EBC) samples using an EcoScreen analyzer. Additionally, respiratory parameters have been evaluated, utilizing spirometry and DLCO. We also analyzed peripheral blood differential counts and NO(2)(-) serum level, cough scale control and blood pressure as safety parameters. Apocynin caused reduction of H(2)O(2) concentration in EBC as compared to placebo, after 60min. of inhalation (0.18microM vs. 0.31microM, p<0.05) as well as after 120min. (0.2microM vs. 0.31microM, p<0.05). Similarly, apocynin significantly decreased concentration of NO(3)(-) as compared to placebo, after 60 and 120min. (6.8microM vs. 14.4microM and 6.5microM vs. 14.9microM respectively, p<0.05). Apocynin was well tolerated and no adverse events have been observed throughout the study. Thus, as apocynin significantly influence ROS concentration, it might have also antiinflammatory properties. As it is safe, it may have a potential to become a drug in airway inflammatory diseases treatment. Copyright 2009 Elsevier Ltd. All rights reserved.

Longitudinal effects of air pollution on exhaled nitric oxide: the Children's Health Study.

PubMed

Berhane, Kiros; Zhang, Yue; Salam, Muhammad T; Eckel, Sandrah P; Linn, William S; Rappaport, Edward B; Bastain, Theresa M; Lurmann, Fred; Gilliland, Frank D

2014-07-01

To assess the effects of long-term variations in ambient air pollutants on longitudinal changes in exhaled nitric oxide (FeNO), a potentially useful biomarker of eosinophilic airway inflammation, based on data from the southern California Children's Health Study. Based on a cohort of 1211 schoolchildren from eight Southern California communities with FeNO measurements in 2006-2007 and 2007-2008, regression models adjusted for short-term effects of air pollution were fitted to assess the association between changes in annual long-term exposures and changes in FeNO. Increases in annual average concentrations of 24-h average NO2 and PM2.5 (scaled to the IQR of 1.8 ppb and 2.4 μg/m(3), respectively) were associated with a 2.29 ppb (CI 0.36 to 4.21; p=0.02) and a 4.94 ppb (CI 1.44 to 8.47; p=0.005) increase in FeNO, respectively, after adjustments for short-term effects of the respective pollutants. In contrast, changes in annual averages of PM10 and O3 were not significantly associated with changes in FeNO. These findings did not differ significantly by asthma status. Changes in annual average exposure to current levels of ambient air pollutants are significantly associated with changes in FeNO levels in children, independent of short-term exposures and asthma status. Use of this biomarker in population-based epidemiological research has great potential for assessing the impact of changing real world mixtures of ambient air pollutants on children's respiratory health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Exhaled breath condensate pH assays are not influenced by oral ammonia

PubMed Central

Wells, K; Vaughan, J; Pajewski, T; Hom, S; Ngamtrakulpanit, L; Smith, A; Nguyen, A; Turner, R; Hunt, J

2005-01-01

Background: Measurement of pH in exhaled breath condensate (EBC) is robust and simple. Acidic source fluid (airway lining fluid) traps bases while volatilising acids, leading to EBC acidification in many lung diseases. Lower airway ammonia is one determinant of airway lining fluid pH, raising the concern that addition of the base ammonia by contamination from the mouth might confound EBC pH assays. Methods: Three discrete methods were used to limit oral ammonia contamination of EBC collections: endotracheal intubation, oral rinsing, and –40°C condenser temperatures. Separately, ammonia was removed from collected EBC samples by lyophilisation and resuspension. Intraweek and intraday variability of ammonia concentration was determined in 76 subjects, and ammonia and pH from a further 235 samples were graphically compared. Ammonia was assayed spectrophotometrically and pH was assessed after deaeration. Results: Data from 1091 samples are presented. Ammonia was reduced in EBC by all methods. Endotracheal intubation decreased EBC ammonia from a mean (SD) of 619 (124) µM to 80 (24) µM (p<0.001, n = 32). Oral rinsing before collection also led to a decline in EBC ammonia from 573 (307) µM to 224 (80) µM (p = 0.016, n = 7). The colder the condensation temperature used, the less ammonia was trapped in the EBC. Lyophilisation removed 99.4 (1.9)% of ammonia. Most importantly, the pH of EBC never decreased after removal of ammonia by any of these methods. Intraweek and intraday coefficients of variation for ammonia were 64 (27)% and 60 (32)%, which is substantially more variable than EBC pH assays. Conclusions: Although ammonia and pH appear to correlate in EBC, the oral ammonia concentration is not an important determinant of EBC pH. No precautions need to be taken to exclude oral ammonia when EBC pH is of interest. The low pH and low ammonia found in EBC from patients with lung diseases appear to be independent effects of volatile compounds arising from the airway

Acute ingestion of beetroot juice increases exhaled nitric oxide in healthy individuals

PubMed Central

Werchan, Chelsey A.; Rosenfield, David; Ritz, Thomas

2018-01-01

Background and objective Nitric oxide (NO) plays an important role in the airways’ innate immune response, and the fraction of exhaled NO at a flow rate of 50mL per second (FENO50) has been utilized to capture NO. Deficits in NO are linked to loss of bronchoprotective effects in airway challenges and predict symptoms of respiratory infection. While beetroot juice supplements have been proposed to enhance exercise performance by increasing dietary nitrate consumption, few studies have examined the impact of beetroot juice or nitrate supplementation on airway NO in contexts beyond an exercise challenge, which we know influences FENO50. Methods We therefore examined the influence of a beetroot juice supplement on FENO50 in healthy males and females (n = 38) during periods of rest and in normoxic conditions. FENO50, heart rate, blood pressure, and state affect were measured at baseline, 45 minutes, and 90 minutes following ingestion of 70ml beetroot juice (6.5 mmol nitrate). Identical procedures were followed with ingestion of 70ml of water on a control day. Results After beetroot consumption, average values of the natural log of FENO50 (lnFENO50) increased by 21.3% (Cohen’s d = 1.54, p < .001) 45 minutes after consumption and by 20.3% (Cohen’s d = 1.45, p < .001) 90 min after consumption. On the other hand, only very small increases in FENO50 were observed after consumption of the control liquid (less than 1% increase). A small subset (n = 4) of participants completed an extended protocol lasting over 3 hours, where elevated levels of FENO50 persisted. No significant changes in cardiovascular measures were observed with this small single dose of beetroot juice. Conclusion As NO serves a key role in innate immunity, future research is needed to explore the potential clinical utility of beetroot and dietary nitrate to elevate FENO50 and prevent respiratory infection. PMID:29370244

Longitudinal Effects of Air Pollution on Exhaled Nitric Oxide: The Children’s Health Study

PubMed Central

Berhane, Kiros; Zhang, Yue; Salam, Muhammad T.; Eckel, Sandrah P.; Linn, William S.; Rappaport, Edward B.; Bastain, Theresa M; Lurmann, Fred; Gilliland, Frank D.

2015-01-01

OBJECTIVES To assess the effects of long-term variations in ambient air pollutants on longitudinal changes in exhaled nitric oxide (FeNO), a potentially useful biomarker of eosinophilic airway inflammation, based on data from the southern California Children’s Health Study. METHODS Based on a cohort of 1,211 schoolchildren from 8 Southern California communities with FeNO measurements in 2006/07 and 2007/08, regression models adjusted for short-term effects of air pollution were fitted to assess the association between changes in annual long-term exposures and changes in FeNO. RESULTS Increases in annual average concentrations of 24-hr average NO2 and PM2.5 (scaled to the interquartile range (IQR) of 1.8 ppb and 2.4 μg/m3, respectively) were associated with a 2.29 ppb (CI=[0.36,4.21]; p =0.02) and a 4.94 ppb (CI=[1.44,8.47]; p = 0.005) increase in FeNO, respectively, after adjustments for short term effects of the respective pollutants. In contrast, changes in annual averages of PM10 and O3 were not significantly associated with changes in FeNO. These findings did not differ significantly by asthma status. CONCLUSIONS Changes in annual average exposure to current levels of ambient air pollutants are significantly associated with changes in FeNO levels in children, independent of short-term exposures and asthma status. Use of this biomarker in population-based epidemiologic research has great potential for assessing the impact of changing real world mixtures of ambient air pollutants on children’s respiratory health. PMID:24696513

Biomarkers of airway acidity and oxidative stress in exhaled breath condensate from grain workers.

PubMed

Do, Ron; Bartlett, Karen H; Dimich-Ward, Helen; Chu, Winnie; Kennedy, Susan M

2008-11-15

Grain workers report adverse respiratory symptoms due to exposures to grain dust and endotoxin. Studies have shown that biomarkers in exhaled breath condensate (EBC) vary with the severity of airway inflammation. The purpose of the study was to evaluate biomarkers of airway acidity (pH and ammonium [NH(4)(+)]) and oxidative stress (8-isoprostane) in the EBC of grain workers. A total of 75 workers from 5 terminal elevators participated. In addition to EBC sampling, exposure monitoring for inhalable grain dust and endotoxin was performed; spirometry, allergy testing, and a respiratory questionnaire derived from that of the American Thoracic Society were administered. Dust and endotoxin levels ranged from 0.010 to 13 mg/m(3) (median, 1.0) and 8.1 to 11,000 endotoxin units/m(3) (median, 610) respectively. EBC pH values varied from 4.3 to 8.2 (median, 7.9); NH(4)(+) values from 22 to 2,400 microM (median, 420); and 8-isoprostane values from 1.3 to 45 pg/ml (median, 11). Univariate and multivariable analyses revealed a consistent effect of cumulative smoking and obesity with decreased pH and NH(4)(+), and intensity of grain dust and endotoxin with increased 8-isoprostane. Duration of work on the test day was associated with decreased pH and NH(4)(+), whereas duration of employment in the industry was associated with decreased 8-isoprostane. Chronic exposures are associated with airway acidity, whereas acute exposures are more closely associated with oxidative stress. These results suggest that the collection of EBC may contribute to predicting the pathological state of the airways of workers exposed to acute and chronic factors.

Impact of different welding techniques on biological effect markers in exhaled breath condensate of 58 mild steel welders.

PubMed

Hoffmeyer, Frank; Raulf-Heimsoth, Monika; Lehnert, Martin; Kendzia, Benjamin; Bernard, Sabine; Berresheim, Hans; Düser, Maria; Henry, Jana; Weiss, Tobias; Koch, Holger M; Pesch, Beate; Brüning, Thomas

2012-01-01

Total mass and composition of welding fumes are predominantly dependent on the welding technique and welding wire applied. The objective of this study was to investigate the impact of welding techniques on biological effect markers in exhaled breath condensate (EBC) of 58 healthy welders. The welding techniques applied were gas metal arc welding with solid wire (GMAW) (n=29) or flux cored wire (FCAW) (n=29). Welding fume particles were collected with personal samplers in the breathing zone inside the helmets. Levels of leukotriene B(4) (LTB(4)), prostaglandin E(2) (PGE(2)), and 8-isoprostane (8-iso-PGF(2α)) were measured with immunoassay kits and the EBC pH was measured after deaeration. Significantly higher 8-iso-PGF(2α) concentrations and a less acid pH were detected in EBC of welders using the FCAW than in EBC of welders using the GMAW technique. The lowest LTB(4) concentrations were measured in nonsmoking welders applying a solid wire. No significant influences were found in EBC concentrations of PGE(2) based upon smoking status or type of welding technique. This study suggests an enhanced irritative effect in the lower airways of mild steel welders due to the application of FCAW compared to GMAW, most likely associated with a higher emission of welding fumes.

Eicosanoids in exhaled breath condensate and bronchoalveolar lavage fluid of patients with primary lung cancer.

PubMed

Ciebiada, Maciej; Górski, Paweł; Antczak, Adam

2012-01-01

Although eicosanoids are involved in lung carcinogenesis they were poorly investigated in exhaled breath condensate (EBC) and bronchoalveolar lavage fluid (BALf) in patients with primary lung cancer. In this study 17 patients with diagnosed non-small cell lung cancer, 10 healthy smokers and 12 healthy nonsmokers were included. The levels of cys-LTs, 8-isoprostane, LTB4 and PGE2 were measured before any treatment in the EBC of all patients and in BALf of patients with lung cancer by enzyme linked immunosorbent assay. 8-isoprostane, LTB4, cys-LTs and PGE2 were detectable in the EBC and BALf. There were no significant differences between healthy smokers and nonsmokers in concentrations of all measured mediators. Compared with both healthy controls, patients with diagnosed lung cancer displayed higher concentrations of cys-LTs (p< 0.05) and LTB4 (p < 0.05) in EBC. In patients with lung cancer, the mean concentrations of all measured mediators were significantly higher in BALf compared with EBC and there was a significant, positive correlation between concentration of cys-LTs, LTB(4) and 8-isoprostane in BALf and their concentrations in the EBC (r=0.64, p < 0.05, r=0.59, p< 0.05, r=0.53, p< 0.05 respectively). Since cys-LT, LTB4 and 8-isoprostane concentrations in EBC from patients with lung cancer reflect their concentrations in BALf, they may serve as a possible non-invasive method to monitor the disease and to assess the effectiveness of therapy.

Determining urea levels in exhaled breath condensate with minimal preparation steps and classic LC-MS.

PubMed

Pitiranggon, Masha; Perzanowski, Matthew S; Kinney, Patrick L; Xu, Dongqun; Chillrud, Steven N; Yan, Beizhan

2014-10-01

Exhaled breath condensate (EBC) provides a relatively easy, non-invasive method for measuring biomarkers of inflammation and oxidative stress in the airways. However, the levels of these biomarkers in EBC are influenced, not only by their levels in lung lining fluid but also by the volume of water vapor that also condenses during EBC collection. For this reason, the use of a biomarker of dilution has been recommended. Urea has been proposed and utilized as a promising dilution biomarker due to its even distribution throughout the body and relatively low volatility. Current EBC urea analytical methods either are not sensitive enough, necessitating large volumes of EBC, or are labor intensive, requiring a derivatization step or other pretreatment. We report here a straightforward and reliable LC-MS approach that we developed that does not require derivatization or large sample volume (∼36 µL). An Acclaim mixed-mode hydrophilic interaction chromatography column was selected because it can produce good peak symmetry and efficiently separate urea from other polar and nonpolar compounds. To achieve a high recovery rate, a slow and incomplete evaporation method was used followed by a solvent-phase exchange. Among EBC samples collected from 28 children, urea levels were found to be highly variable, with a relative standard deviation of 234%, suggesting high variability in dilution of the lung lining fluid component of EBC. The limit of detection was found to be 0.036 µg/mL. Published by Oxford University Press [2013]. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Determination of hexavalent chromium in exhaled breath condensate and environmental air among chrome plating workers

PubMed Central

Goldoni, Matteo; Caglieri, Andrea; Poli, Diana; Vettori, Maria Vittoria; Corradi, Massimo; Apostoli, Pietro; Mutti, Antonio

2006-01-01

Chromium speciation has attracted attention because of the different toxicity of Cr(III), which is considered relatively non-toxic, and Cr(VI), which can cross cell membranes mainly as a chromate anion and has been classified as a class I human carcinogen. The aims of the present study were to measure soluble Cr(VI) levels in environmental samples, to develop a simple method of quantifying Cr(VI) in exhaled breath condensate (EBC), and to follow the kinetics of EBC Cr(VI) in chrome plating workers. Personal air samples were collected from 10 chrome platers; EBC was collected from the same workers immediately after the work shift on Tuesday and before the work shift on the following Wednesday. Environmental and EBC Cr(VI) levels were determined by means of colorimetry and electrothermal absorption atomic spectrometry, respectively. The method of detecting Cr(VI) in environmental air was based on the extraction of the Cr(VI)-diphenylcarbazide (Cr(VI)–DPC) complex in 1-butanol, whereas EBC Cr(VI) was determined using a solvent extraction of Cr(VI) as an ion pair with tetrabutylammonium ion, and subsequent direct determination of the complex (Cr(VI)–DPC) in EBC. Kinetic data showed that airborne Cr(VI) was reduced by 50% in airway lining fluid sampled at the end of exposure and that there was a further 50% reduction after about 15 h. The persistence of Cr(VI) in EBC supports the use of EBC in assessing target tissue levels of Cr(VI). PMID:17047732

A systematic review of fractional exhaled nitric oxide in the routine management of childhood asthma.

PubMed

Gomersal, Tim; Harnan, Sue; Essat, Munira; Tappenden, Paul; Wong, Ruth; Lawson, Rod; Pavord, Ian; Everard, Mark Lloyd

2016-03-01

Fractional exhaled nitric oxide (FeNO) is a non-invasive biomarker of eosinophilic inflammation which may be used to guide the management of asthma in childhood. To synthesise the available evidence on the efficacy of FeNO-guided management of childhood asthma. Databases including MEDLINE and the Cochrane Library were searched, and randomised controlled trials (RCTs) comparing FeNO-guided management with any other monitoring strategy were included. Study quality was assessed using the Cochrane risk of bias tool for RCTs, and a number of outcomes were examined, including: exacerbations, medication use, quality of life, adverse events, and other markers of asthma control. Meta-analyses were planned if multiple studies with suitable heterogeneity were available. However, due to wide variations in study characteristics, meta-analysis was not possible. Seven RCTs were identified. There was some evidence that FeNO-guided monitoring results in improved asthma control during the first year of management, although few results attained statistical significance. The impact on severe exacerbations was unclear. Similarly, the impact on use of anti-asthmatic drugs was unclear, and appears to depend on the step up/down protocols, and the clinical characteristics of patients. The potential benefit of FeNO monitoring is equivocal. Trends toward reduced exacerbation and increased medication use were seen, but typically failed to reach statistical significance. There are a number of issues that complicate data interpretation, including differences in the likely severity of included cohorts and variations in treatment algorithms. Further work is needed to systematically explore the impact of these parameters. © 2016 Wiley Periodicals, Inc.

An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications.

PubMed

Dweik, Raed A; Boggs, Peter B; Erzurum, Serpil C; Irvin, Charles G; Leigh, Margaret W; Lundberg, Jon O; Olin, Anna-Carin; Plummer, Alan L; Taylor, D Robin

2011-09-01

Measurement of fractional nitric oxide (NO) concentration in exhaled breath (Fe(NO)) is a quantitative, noninvasive, simple, and safe method of measuring airway inflammation that provides a complementary tool to other ways of assessing airways disease, including asthma. While Fe(NO) measurement has been standardized, there is currently no reference guideline for practicing health care providers to guide them in the appropriate use and interpretation of Fe(NO) in clinical practice. To develop evidence-based guidelines for the interpretation of Fe(NO) measurements that incorporate evidence that has accumulated over the past decade. We created a multidisciplinary committee with expertise in the clinical care, clinical science, or basic science of airway disease and/or NO. The committee identified important clinical questions, synthesized the evidence, and formulated recommendations. Recommendations were developed using pragmatic systematic reviews of the literature and the GRADE approach. The evidence related to the use of Fe(NO) measurements is reviewed and clinical practice recommendations are provided. In the setting of chronic inflammatory airway disease including asthma, conventional tests such as FEV(1) reversibility or provocation tests are only indirectly associated with airway inflammation. Fe(NO) offers added advantages for patient care including, but not limited to (1) detecting of eosinophilic airway inflammation, (2) determining the likelihood of corticosteroid responsiveness, (3) monitoring of airway inflammation to determine the potential need for corticosteroid, and (4) unmasking of otherwise unsuspected nonadherence to corticosteroid therapy.

Exhaled volatile organic compounds in individuals with a history of high altitude pulmonary edema and varying hypoxia-induced responses.

PubMed

Figueroa, Jennifer A; Mansoor, Jim K; Allen, Roblee P; Davis, Cristina E; Walby, William F; Aksenov, Alexander A; Zhao, Weixiang; Lewis, William R; Schelegle, Edward S

2015-04-20

With ascent to altitude, certain individuals are susceptible to high altitude pulmonary edema (HAPE), which in turn can cause disability and even death. The ability to identify individuals at risk of HAPE prior to ascent is poor. The present study examined the profile of volatile organic compounds (VOC) in exhaled breath condensate (EBC) and pulmonary artery systolic pressures (PASP) before and after exposure to normobaric hypoxia (12% O2) in healthy males with and without a history of HAPE (Hx HAPE, n = 5; Control, n = 11). In addition, hypoxic ventilatory response (HVR), and PASP response to normoxic exercise were also measured. Auto-regression/partial least square regression of whole gas chromatography/mass spectrometry (GC/MS) data and binary logistic regression (BLR) of individual GC peaks and physiologic parameters resulted in models that separate individual subjects into their groups with variable success. The result of BLR analysis highlights HVR, PASP response to hypoxia and the amount of benzyl alcohol and dimethylbenzaldehyde dimethyl in expired breath as markers of HAPE history. These findings indicate the utility of EBC VOC analysis to discriminate between individuals with and without a history of HAPE and identified potential novel biomarkers that correlated with physiological responses to hypoxia.

An acetone bio-sniffer (gas phase biosensor) enabling assessment of lipid metabolism from exhaled breath.

PubMed

Ye, Ming; Chien, Po-Jen; Toma, Koji; Arakawa, Takahiro; Mitsubayashi, Kohji

2015-11-15

Several volatile organic compounds (VOCs) are released from human breath or skin. Like chemical substances in blood or urine, some of these vapors can provide valuable information regarding the state of the human body. A highly sensitive acetone biochemical gas sensor (bio-sniffer) was developed and used to measure exhaled breath acetone concentration, and assess lipid metabolism based on breath acetone analysis. A fiber-optic biochemical gas sensing system was constructed by attaching a flow-cell with nicotinamide adenine dinucleotide (NADH)-dependent secondary alcohol dehydrogenase (S-ADH) immobilized membrane onto a fiber-optic NADH measurement system. The NADH measurement system utilizes an ultraviolet-light emitting diode with peak emission of 335 nm as an excitation light source. NADH is consumed by the enzymatic reaction of S-ADH, and the consumption is proportional to the concentration of acetone vapor. Phosphate buffer which contained NADH was circulated into the flow-cell to rinse products and the excessive substrates from the optode. The change of fluorescent emitted from NADH is analyzed by the PMT. Hence, fluorescence intensity decreased as the acetone concentration increased. The relationship between fluorescence intensity and acetone concentration was identified from 20 ppb to 5300 ppb. This interval included the concentration of acetone vapor in the breath of healthy people and those suffering from disorders of carbohydrate metabolism. Finally, the acetone bio-sniffer was used to measure breath acetone during an exercise stress test on an ergometer after a period of fasting. The concentration of acetone in breath was shown to significantly increase after exercise. This biosensor allows rapid, highly sensitive and selective measurement of lipid metabolism. Copyright © 2015 Elsevier B.V. All rights reserved.

Ambient and microenvironmental particles and exhaled nitric oxide before and after a group bus trip.

PubMed

Adar, Sara Dubowsky; Adamkiewicz, Gary; Gold, Diane R; Schwartz, Joel; Coull, Brent A; Suh, Helen

2007-04-01

Airborne particles have been linked to pulmonary oxidative stress and inflammation. Because these effects may be particularly great for traffic-related particles, we examined associations between particle exposures and exhaled nitric oxide (FE(NO)) in a study of 44 senior citizens, which involved repeated trips aboard a diesel bus. Samples of FE(NO) collected before and after the trips were regressed against microenvironmental and ambient particle concentrations using mixed models controlling for subject, day, trip, vitamins, collection device, mold, pollen, room air nitric oxide, apparent temperature, and time to analysis. Although ambient concentrations were collected at a fixed location, continuous group-level personal samples characterized microenvironmental exposures throughout facility and trip periods. In pre-trip samples, both microenvironmental and ambient exposures to fine particles were positively associated with FE(NO). For example, an interquartile increase of 4 microg/m(3) in the daily microenvironmental PM(2.5) concentration was associated with a 13% [95% confidence interval (CI), 2-24%) increase in FE(NO). After the trips, however, FE(NO) concentrations were associated pre-dominantly with microenvironmental exposures, with significant associations for concentrations measured throughout the whole day. Associations with exposures during the trip also were strong and statistically significant with a 24% (95% CI, 15-34%) increase in FE(NO) predicted per interquartile increase of 9 microg/m(3) in PM(2.5). Although pre-trip findings were generally robust, our post-trip findings were sensitive to several influential days. Fine particle exposures resulted in increased levels of FE(NO) in elderly adults, suggestive of increased airway inflammation. These associations were best assessed by microenvironmental exposure measurements during periods of high personal particle exposures.

Ambient and Microenvironmental Particles and Exhaled Nitric Oxide Before and After a Group Bus Trip

PubMed Central

Adar, Sara Dubowsky; Adamkiewicz, Gary; Gold, Diane R.; Schwartz, Joel; Coull, Brent A.; Suh, Helen

2007-01-01

Objectives Airborne particles have been linked to pulmonary oxidative stress and inflammation. Because these effects may be particularly great for traffic-related particles, we examined associations between particle exposures and exhaled nitric oxide (FENO) in a study of 44 senior citizens, which involved repeated trips aboard a diesel bus. Methods Samples of FENO collected before and after the trips were regressed against microenvironmental and ambient particle concentrations using mixed models controlling for subject, day, trip, vitamins, collection device, mold, pollen, room air nitric oxide, apparent temperature, and time to analysis. Although ambient concentrations were collected at a fixed location, continuous group-level personal samples characterized microenvironmental exposures throughout facility and trip periods. Results In pre-trip samples, both microenvironmental and ambient exposures to fine particles were positively associated with FENO. For example, an interquartile increase of 4 μg/m3 in the daily microenvironmental PM2.5 concentration was associated with a 13% [95% confidence interval (CI), 2–24%) increase in FENO. After the trips, however, FENO concentrations were associated pre-dominantly with microenvironmental exposures, with significant associations for concentrations measured throughout the whole day. Associations with exposures during the trip also were strong and statistically significant with a 24% (95% CI, 15–34%) increase in FENO predicted per interquartile increase of 9 μg/m3 in PM2.5. Although pre-trip findings were generally robust, our post-trip findings were sensitive to several influential days. Conclusions Fine particle exposures resulted in increased levels of FENO in elderly adults, suggestive of increased airway inflammation. These associations were best assessed by microenvironmental exposure measurements during periods of high personal particle exposures. PMID:17450216

The Effect of Inhaled Chromium on Different Exhaled Breath Condensate Biomarkers among Chrome-Plating Workers

PubMed Central

Caglieri, Andrea; Goldoni, Matteo; Acampa, Olga; Andreoli, Roberta; Vettori, Maria Vittoria; Corradi, Massimo; Apostoli, Pietro; Mutti, Antonio

2006-01-01

Chromium is corrosive, cytotoxic, and carcinogenic for humans and can induce acute and chronic lung tissue toxicity. The aim of this study was to investigate Cr levels in exhaled breath condensate (EBC) of workers exposed to Cr(VI) and to assess their relationship with biochemical changes in the airways by analyzing EBC biomarkers of oxidative stress, namely, hydrogen peroxide (H2O2) and malondialdehyde (MDA). EBC samples were collected from 24 chrome-plating workers employed in a chrome-plating plant both before and after the Friday work shift and before the work shift on the following Monday. Cr-EBC levels increased from the beginning (5.3 μg/L) to the end of Friday (6.4 μg/L) but were considerably lower on Monday morning (2.8 μg/L). A similar trend was observed for H2O2-EBC levels (which increased from 0.36 μM to 0.59 μM on Friday and were 0.19 μM on Monday morning) and MDA-EBC levels (which increased from 8.2 nM to 9.7 nM on Friday and were 6.6 nM on Monday). Cr-EBC levels correlated with those of H2O2-EBC (r = 0.54, p < 0.01) and MDA-EBC (r = 0.59, p < 0.01), as well as with urinary Cr levels (r = 0.25, p < 0.05). The results of this study demonstrate that EBC is a suitable matrix that can be used to investigate both Cr levels and biomarkers of free radical production sampling the epithelial-lining fluid of workers exposed to Cr(VI). PMID:16581543

Analysis of volatile compounds in exhaled breath condensate in patients with severe pulmonary arterial hypertension.

PubMed

Mansoor, J K; Schelegle, Edward S; Davis, Cristina E; Walby, William F; Zhao, Weixiang; Aksenov, Alexander A; Pasamontes, Alberto; Figueroa, Jennifer; Allen, Roblee

2014-01-01

An important challenge to pulmonary arterial hypertension (PAH) diagnosis and treatment is early detection of occult pulmonary vascular pathology. Symptoms are frequently confused with other disease entities that lead to inappropriate interventions and allow for progression to advanced states of disease. There is a significant need to develop new markers for early disease detection and management of PAH. Exhaled breath condensate (EBC) samples were compared from 30 age-matched normal healthy individuals and 27 New York Heart Association functional class III and IV idiopathic pulmonary arterial hypertenion (IPAH) patients, a subgroup of PAH. Volatile organic compounds (VOC) in EBC samples were analyzed using gas chromatography/mass spectrometry (GC/MS). Individual peaks in GC profiles were identified in both groups and correlated with pulmonary hemodynamic and clinical endpoints in the IPAH group. Additionally, GC/MS data were analyzed using autoregression followed by partial least squares regression (AR/PLSR) analysis to discriminate between the IPAH and control groups. After correcting for medicaitons, there were 62 unique compounds in the control group, 32 unique compounds in the IPAH group, and 14 in-common compounds between groups. Peak-by-peak analysis of GC profiles of IPAH group EBC samples identified 6 compounds significantly correlated with pulmonary hemodynamic variables important in IPAH diagnosis. AR/PLSR analysis of GC/MS data resulted in a distinct and identifiable metabolic signature for IPAH patients. These findings indicate the utility of EBC VOC analysis to discriminate between severe IPAH and a healthy population; additionally, we identified potential novel biomarkers that correlated with IPAH pulmonary hemodynamic variables that may be important in screening for less severe forms IPAH.

Analysis of Volatile Compounds in Exhaled Breath Condensate in Patients with Severe Pulmonary Arterial Hypertension

PubMed Central

Mansoor, J. K.; Schelegle, Edward S.; Davis, Cristina E.; Walby, William F.; Zhao, Weixiang; Aksenov, Alexander A.; Pasamontes, Alberto; Figueroa, Jennifer; Allen, Roblee

2014-01-01

Background An important challenge to pulmonary arterial hypertension (PAH) diagnosis and treatment is early detection of occult pulmonary vascular pathology. Symptoms are frequently confused with other disease entities that lead to inappropriate interventions and allow for progression to advanced states of disease. There is a significant need to develop new markers for early disease detection and management of PAH. Methodolgy and Findings Exhaled breath condensate (EBC) samples were compared from 30 age-matched normal healthy individuals and 27 New York Heart Association functional class III and IV idiopathic pulmonary arterial hypertenion (IPAH) patients, a subgroup of PAH. Volatile organic compounds (VOC) in EBC samples were analyzed using gas chromatography/mass spectrometry (GC/MS). Individual peaks in GC profiles were identified in both groups and correlated with pulmonary hemodynamic and clinical endpoints in the IPAH group. Additionally, GC/MS data were analyzed using autoregression followed by partial least squares regression (AR/PLSR) analysis to discriminate between the IPAH and control groups. After correcting for medicaitons, there were 62 unique compounds in the control group, 32 unique compounds in the IPAH group, and 14 in-common compounds between groups. Peak-by-peak analysis of GC profiles of IPAH group EBC samples identified 6 compounds significantly correlated with pulmonary hemodynamic variables important in IPAH diagnosis. AR/PLSR analysis of GC/MS data resulted in a distinct and identifiable metabolic signature for IPAH patients. Conclusions These findings indicate the utility of EBC VOC analysis to discriminate between severe IPAH and a healthy population; additionally, we identified potential novel biomarkers that correlated with IPAH pulmonary hemodynamic variables that may be important in screening for less severe forms IPAH. PMID:24748102

Bioanalysis of underivatized amino acids in non-invasive exhaled breath condensate samples using liquid chromatography coupled with tandem mass spectrometry.

PubMed

Konieczna, Lucyna; Pyszka, Magdalena; Okońska, Magdalena; Niedźwiecki, Maciej; Bączek, Tomasz

2018-03-23

Exhaled breath condensate (EBC) is receiving increased attention as a novel, entirely non-invasive technique for collecting biomarker samples. This increased attention is due to the fact that EBC is simple, effort independent, rapid, can be repeated frequently, and can be performed on young children and patients suffering from a variety of diseases. By having a subject breathe tidally through a cooling system for 15-20 min, a sufficient amount of condensate is collected for analysis of biomarkers in clinical studies. However, bioanalysis of EBC involves an unavoidable sample preparation step due to the low concentration of its components. Thus, there is a need for a new and more sensitive analytical method of assessing EBC samples. While researchers have considered analyses of single and small quantities of amino acids - for example, those connected with leukemia - no one has previously attempted to simultaneously analyze a panel of 23 amino acids. Moreover, the present study is well-justified, as prior studies focusing on single amino acids and leukemia at the moment of diagnosis and during chemotherapy (33 days of treatment) are inconsistent. In the present study, amino acids were separated using an XBridge Amide column (3 mm × 100 mm, 3.5 μm). The mobile phase consisted of 10 mM of ammonium buffer in water with a pH of 3 (Phase A) and 10 mM ammonium buffer in acetonitrile (Phase B) under gradient program elution. The analytes were detected in electrospray positive ionization mode. Under optimal conditions, the proposed method exhibited limits of quantification (LOQ) in the range of 0.05-0.5 ng/mL, and good linearity, with the determination coefficient (R 2 ) falling between 0.9904 and 0.9998. The accuracy in human exhaled breath condensate samples ranged between 93.3-113.3% for the 23 studied amino acids, with intra- and inter-day coefficient of variation (CVs) of 0.13-9.92% and 0.17-10.53%, respectively. To demonstrate the liquid

Exhaled breath condensate pH and cysteinyl leukotriens in patients with chronic cough secondary to acid gastroesophageal reflux.

PubMed

Heffler, Enrico; Crimi, Claudia; Brussino, Luisa; Nicola, Stefania; Sichili, Stefania; Dughera, Luca; Rolla, Giovanni; Crimi, Nunzio

2016-12-22

Chronic cough is one of the most common clinical problems and it may be secondary to different stimuli and diseases, including low-level physical and chemical stimulation of the esophageal-bronchial reflex, suggestive of cough-reflex hyperresponsiveness, in patients with gastroesophageal reflux; however, it is still debated whether gastroesophageal reflux could induce airway inflammation and acidification. The aim of this study was to investigate airway pH and cysteynil-leukotrienes (Cys-LTs) concentration (a marker of airway inflammation) in exhaled breath condensate (EBC). Patients with chronic cough and for which all known causes, excluding gastroesophageal reflux, had been investigated and ruled out, were enrolled in the study. All patients underwent 24 h pH monitoring, and EBC was collected to assess pH and Cys-LTs concentration. Forty-five patients were included in the study and those with gastroesophageal reflux had significantly lower EBC-pH and higher concentration of EBC-Cys-LTs. There was a linear inverse correlation between EBC-pH values and EBC-Cys-LTs logarithmically transformed, and a multivariate analysis confirmed that the only significant determinat variable of EBC-Cys-LTs was the presence of gastroesophageal reflux. This study adds knowledge on possible mechanisms related to chronic cough associated with gastroesophageal reflux, which seems to be strictly dependent on airway acidification and the production of Cys-LTs, therefore suggesting an underlying neurogenic inflammation with tachykinins involvement.

Measurement of exhaled breath carbon monoxide in clinical practice: A study of levels in Central Pennsylvania community members.

PubMed

Hrabovsky, Shari; Yingst, Jessica M; Veldheer, Susan; Hammett, Erin; Foulds, Jonathan

2017-06-01

Exhaled breath carbon monoxide (eBCO) reading is a useful tool for nurse practitioners to evaluate smoking status and other exposures to carbon monoxide (CO) to identify risk for cancer and chronic disease. This study aimed to measure one community's eBCO and identify potential environmental factors that may affect eBCO among nonsmokers. Data collected by convenience sampling at community health events included self-reported tobacco use and potential CO exposure. Means and frequency calculations describe the sample, two-sided t-tests determine differences in continuous variables, and chi-square tests determine differences in frequencies of CO levels between nontobacco users exposed to additional CO from their environment and nontobacco users who were not. As expected, smokers have significantly higher mean eBCO than nonsmokers (20.1 ppm vs. 4.4 ppm, p < .001). The self-reported nonsmokers (16.2%) had an elevated eBCO (>6 ppm), although there were no environmental factors that explained a higher eBCO. Measuring eBCO provides an opportunity for the nurse practitioner to engage in a conversation about the impact of smoking and other environmental factors that contribute to eBCO and health. Keeping record of patients' smoking status and eBCO in their medical record is a valuable measure of the nurse practitioner's delivery of this care. ©2017 American Association of Nurse Practitioners.

Study of ethane level in exhaled breath in patients with age-related macular degeneration: preliminary study.

PubMed

Cagini, C; Giordanelli, A; Fiore, T; Giardinieri, R; Malici, B; De Medio, G E; Pelli, M A; De Bellis, F; Capodicasa, E

2011-01-01

A variety of factors have been implicated in the pathogenesis of age-related macular degeneration (ARMD), and oxidative stress plays an important role in the onset and progression of the disease. Breath ethane is now considered a specific and non-invasive test for determining and monitoring the trend of lipid peroxidation and free radical-induced damage in vivo. This test provides an index of the patients' overall oxidative stress level. We evaluated the breath ethane concentration in exhaled air in patients with advanced ARMD. In this study, we enrolled 13 patients with advanced ARMD and a control group, and a breath analysis was carried out by gas chromatography. The mean ethane level in the ARMD patients was 0.82 ± 0.93 nmol/l (range: 0.01-2.7 nmol/l) and the mean ethane value in the control group was 0.12 ± 0.02 nmol/l (range: 0.08-0.16 nmol/l). The difference between the values of the 2 groups was statistically significant (p < 0.005). Receiver operating characteristic analysis showed an elevated area under the curve (0.831; 95% CI: 0.634-0.948), with a significance level of p < 0.0014 (area = 0.5). These preliminary results seem to indicate that breath ethane levels are higher in most patients with ARMD. The breath ethane test could thus be a useful method for evaluating the level of oxidative stress in patients with ARMD. To our knowledge, there are no data on this type of analysis applied to ARMD. Copyright © 2011 S. Karger AG, Basel.

Monitoring asthma control in children with allergies by soft computing of lung function and exhaled nitric oxide.

PubMed

Pifferi, Massimo; Bush, Andrew; Pioggia, Giovanni; Di Cicco, Maria; Chinellato, Iolanda; Bodini, Alessandro; Macchia, Pierantonio; Boner, Attilio L

2011-02-01

Asthma control is emphasized by new guidelines but remains poor in many children. Evaluation of control relies on subjective patient recall and may be overestimated by health-care professionals. This study assessed the value of spirometry and fractional exhaled nitric oxide (FeNO) measurements, used alone or in combination, in models developed by a machine learning approach in the objective classification of asthma control according to Global Initiative for Asthma guidelines and tested the model in a second group of children with asthma. Fifty-three children with persistent atopic asthma underwent two to six evaluations of asthma control, including spirometry and FeNO. Soft computing evaluation was performed by means of artificial neural networks and principal component analysis. The model was then tested in a cross-sectional study in an additional 77 children with allergic asthma. The machine learning method was not able to distinguish different levels of control using either spirometry or FeNO values alone. However, their use in combination modeled by soft computing was able to discriminate levels of asthma control. In particular, the model is able to recognize all children with uncontrolled asthma and correctly identify 99.0% of children with totally controlled asthma. In the cross-sectional study, the model prospectively identified correctly all the uncontrolled children and 79.6% of the controlled children. Soft computing analysis of spirometry and FeNO allows objective categorization of asthma control status.

An Official ATS Clinical Practice Guideline: Interpretation of Exhaled Nitric Oxide Levels (FeNO) for Clinical Applications

PubMed Central

Dweik, Raed A.; Boggs, Peter B.; Erzurum, Serpil C.; Irvin, Charles G.; Leigh, Margaret W.; Lundberg, Jon O.; Olin, Anna-Carin; Plummer, Alan L.; Taylor, D. Robin

2011-01-01

Background: Measurement of fractional nitric oxide (NO) concentration in exhaled breath (FeNO) is a quantitative, noninvasive, simple, and safe method of measuring airway inflammation that provides a complementary tool to other ways of assessing airways disease, including asthma. While FeNO measurement has been standardized, there is currently no reference guideline for practicing health care providers to guide them in the appropriate use and interpretation of FeNO in clinical practice. Purpose: To develop evidence-based guidelines for the interpretation of FeNO measurements that incorporate evidence that has accumulated over the past decade. Methods: We created a multidisciplinary committee with expertise in the clinical care, clinical science, or basic science of airway disease and/or NO. The committee identified important clinical questions, synthesized the evidence, and formulated recommendations. Recommendations were developed using pragmatic systematic reviews of the literature and the GRADE approach. Results: The evidence related to the use of FeNO measurements is reviewed and clinical practice recommendations are provided. Conclusions: In the setting of chronic inflammatory airway disease including asthma, conventional tests such as FEV1 reversibility or provocation tests are only indirectly associated with airway inflammation. FeNO offers added advantages for patient care including, but not limited to (1) detecting of eosinophilic airway inflammation, (2) determining the likelihood of corticosteroid responsiveness, (3) monitoring of airway inflammation to determine the potential need for corticosteroid, and (4) unmasking of otherwise unsuspected nonadherence to corticosteroid therapy. PMID:21885636

Preliminary investigation of human exhaled breath for tuberculosis diagnosis by multidimensional gas chromatography - Time of flight mass spectrometry and machine learning.

PubMed

Beccaria, Marco; Mellors, Theodore R; Petion, Jacky S; Rees, Christiaan A; Nasir, Mavra; Systrom, Hannah K; Sairistil, Jean W; Jean-Juste, Marc-Antoine; Rivera, Vanessa; Lavoile, Kerline; Severe, Patrice; Pape, Jean W; Wright, Peter F; Hill, Jane E

2018-02-01

Tuberculosis (TB) remains a global public health malady that claims almost 1.8 million lives annually. Diagnosis of TB represents perhaps one of the most challenging aspects of tuberculosis control. Gold standards for diagnosis of active TB (culture and nucleic acid amplification) are sputum-dependent, however, in up to a third of TB cases, an adequate biological sputum sample is not readily available. The analysis of exhaled breath, as an alternative to sputum-dependent tests, has the potential to provide a simple, fast, and non-invasive, and ready-available diagnostic service that could positively change TB detection. Human breath has been evaluated in the setting of active tuberculosis using thermal desorption-comprehensive two-dimensional gas chromatography-time of flight mass spectrometry methodology. From the entire spectrum of volatile metabolites in breath, three random forest machine learning models were applied leading to the generation of a panel of 46 breath features. The twenty-two common features within each random forest model used were selected as a set that could distinguish subjects with confirmed pulmonary M. tuberculosis infection and people with other pathologies than TB. Copyright © 2018 Elsevier B.V. All rights reserved.

Fractionation of families of major, minor, and trace metals across the melt-vapor interface in volcanic exhalations

USGS Publications Warehouse

Hinkley, T.K.; Le Cloarec, M.-F.; Lambert, G.

1994-01-01

volcanic plumes, and Cd and Tl are enriched relative to the others. Indium is much more abundant in the plume of the hotspot volcano Kilauea than in the Etna plume (probably non-hotspot in character). It may be a useful indicator of the tapping of deep mantle zones, or could aid in the interpretation of reports of Pt group metals in exhalations from hot spot volcanoes. Indium in old glacial ice strata could help assess magnitude and variability of exhalations from hotspot volcanoes in past time. Strong melt-vapor fractionation of the alkali and alkaline earth metals may only be observed in plumes during quiescent degassing of volcanoes; when large amounts of ash or spatter (undifferentiated lava) enter the plume, its alkali and alkaline earth metal composition may approach that of the melt. Ratios among the chalcophile metals may not be much changed by addition of ash, because their concentrations in melt are so small, and masses of them in any plume may remain dominated by transfer across the melt-vapor interface. Radon daughter nuclides give information about state of volcanic activity at time of sampling. The precisely known origins, ultratrace detectability, decay systematics, and wide variations in volatility of these species provide information about residence times, degassing and travel histories, and identities of melt bodies in volcanic systems. ?? 1994.

Reference values of fractional excretion of exhaled nitric oxide among non-smokers and current smokers.

PubMed

Torén, Kjell; Murgia, Nicola; Schiöler, Linus; Bake, Björn; Olin, Anna-Carin

2017-08-25

Fractional exhaled nitric oxide (FE NO ) is used to assess of airway inflammation; diagnose asthma and monitor adherence to advised therapy. Reliable and accurate reference values for FE NO are needed for both non-smoking and current smoking adults in the clinical setting. The present study was performed to establish reference adult FE NO values among never-smokers, former smokers and current smokers. FE NO was measured in 5265 subjects aged 25-75 years in a general-population study, using a chemiluminescence (Niox ™) analyser according to the guidelines of the American Thoracic Society and the European Respiratory Society. Atopy was based on the presence of immunoglobulin E (IgE) antibodies to common inhalant allergens (measured using Phadiatop® test). Spirometry without bronchodilation was performed and forced vital capacity (FVC), forced expired volume in 1 s (FEV 1 ) and the ratio of FEV 1 to FVC values were obtained. After excluding subjects with asthma, chronic bronchitis, spirometric airway obstruction and current cold, 3378 subjects remained. Equations for predictions of FE NO values were modelled using nonparametric regression models. FE NO levels were similar in never-smokers and former smokers, and these two groups were therefore merged into a group termed "non-smokers". Reference equations, including the 5th and 95th percentiles, were generated for female and male non-smokers, based on age, height and atopy. Regression models for current smokers were unstable. Hence, the proposed reference values for current smokers are based on the univariate distribution of FE NO and fixed cut-off limits. Reference values for FE NO among respiratory healthy non-smokers should be outlined stratified for gender using individual reference values. For current smokers separate cut-off limits are proposed.

Assessment of fractionated exhaled nitric oxide as a biomarker for the treatment of eosinophilic esophagitis

PubMed Central

Nguyen-Traxler, Ann; Lee, Erika M.; Yip, Jason S.; Weinstock, Joel V.; Chan, Walter W.; Ngo, Peter; Weinstein, Barbara J.; Bonis, Peter A.

2012-01-01

Diagnosis of eosinophilic esophagitis (EoE) and determination of response to therapy is based on histological assessment of the esophagus, which requires upper endoscopy. In children, in whom a dietary approach is commonly used, multiple endoscopies are needed, because foods are eliminated and then gradually reintroduced. Ideally, noninvasive methods could supplement or replace upper endoscopy to facilitate management. Fractionated exhaled nitric oxide (FeNO) has been proposed as a useful measure for monitoring disease activity in studies of patients with eosinophil-predominant asthma and in other atopic disorders. Thus, we evaluated whether FeNO levels could be a useful biomarker to assess the response to therapy in EoE patients. This study was designed to determine whether there is a change in FeNO levels during treatment with topical corticosteroids and whether changes correlated with clinical response. This was a prospective, multicenter study that enrolled nonasthmatic patients with established EoE. FeNO levels and symptom scores were measured at baseline, biweekly during 6-week swallowed fluticasone treatment, and 4 weeks posttreatment. Twelve patients completed the trial. We found a statistically significant difference between median pre- and posttreatment FeNO levels [20.3 ppb (16.0–29.0 ppb) vs 17.6 ppb (11.7–27.3 ppb), p=0.009]. However, neither the pretreatment FeNO level, a change of FeNO level after 2 weeks of treatment, nor the FeNO level at the end of treatment confidently predicted a clinical or histological response. Although our findings suggest nitric oxide possibly has a physiological role in EoE, our observations do not support a role of FeNo determination for management of EoE. PMID:23394511

Dynamic measurements of CO diffusing capacity using discrete samples of alveolar gas.

PubMed

Graham, B L; Mink, J T; Cotton, D J

1983-01-01

It has been shown that measurements of the diffusing capacity of the lung for CO made during a slow exhalation [DLCO(exhaled)] yield information about the distribution of the diffusing capacity in the lung that is not available from the commonly measured single-breath diffusing capacity [DLCO(SB)]. Current techniques of measuring DLCO(exhaled) require the use of a rapid-responding (less than 240 ms, 10-90%) CO meter to measure the CO concentration in the exhaled gas continuously during exhalation. DLCO(exhaled) is then calculated using two sample points in the CO signal. Because DLCO(exhaled) calculations are highly affected by small amounts of noise in the CO signal, filtering techniques have been used to reduce noise. However, these techniques reduce the response time of the system and may introduce other errors into the signal. We have developed an alternate technique in which DLCO(exhaled) can be calculated using the concentration of CO in large discrete samples of the exhaled gas, thus eliminating the requirement of a rapid response time in the CO analyzer. We show theoretically that this method is as accurate as other DLCO(exhaled) methods but is less affected by noise. These findings are verified in comparisons of the discrete-sample method of calculating DLCO(exhaled) to point-sample methods in normal subjects, patients with emphysema, and patients with asthma.

Seasonal variations of natural ventilation and radon-222 exhalation in a slightly rising dead-end tunnel.

PubMed

Perrier, Frédéric; Richon, Patrick; Gautam, Umesh; Tiwari, Dilli Ram; Shrestha, Prithvi; Sapkota, Soma Nath

2007-01-01

The concentration activity of radon-222 has been monitored, with some interruptions, from 1997 to 2005 in the end section of a slightly rising, dead-end, 38-m long tunnel located in the Phulchoki hill, near Kathmandu, Nepal. While a high concentration varying from 6 x 10(3) Bq m(-3) to 10 x 10(3) Bq m(-3) is observed from May to September (rainy summer season), the concentration remains at a low level of about 200 Bq m(-3) from October to March (dry winter season). This reduction of radon concentration is associated with natural ventilation of the tunnel, which, contrary to expectations for a rising tunnel, takes place mainly from October to March when the outside air temperature drops below the average tunnel temperature. This interpretation is supported by temperature measurements in the atmosphere of the tunnel, a few meters away from the entrance. The temporal variations of the diurnal amplitude of this temperature indeed follow the ventilation rate deduced from the radon measurements. In the absence of significant ventilation (summer season), the radon exhalation flux at the rock surface into the tunnel atmosphere can be inferred; it exhibits a yearly variation with additional transient reductions associated with heavy rainfall, likely to be due to water infiltration. No effect of atmospheric pressure variations on the radon concentration is observed in this tunnel. This experiment illustrates how small differences in the location and geometry of a tunnel can lead to vastly different behaviours of the radon concentration versus time. This observation has consequences for the estimation of the dose rate and the practicability of radon monitoring for tectonic purposes in underground environments.

Comparison of Ambient and Atmospheric Pressure Ion Sources for Cystic Fibrosis Exhaled Breath Condensate Ion Mobility-Mass Spectrometry Metabolomics

NASA Astrophysics Data System (ADS)

Zang, Xiaoling; Pérez, José J.; Jones, Christina M.; Monge, María Eugenia; McCarty, Nael A.; Stecenko, Arlene A.; Fernández, Facundo M.

2017-08-01

Cystic fibrosis (CF) is an autosomal recessive disorder caused by mutations in the gene that encodes the cystic fibrosis transmembrane conductance regulator (CFTR) protein. The vast majority of the mortality is due to progressive lung disease. Targeted and untargeted CF breath metabolomics investigations via exhaled breath condensate (EBC) analyses have the potential to expose metabolic alterations associated with CF pathology and aid in assessing the effectiveness of CF therapies. Here, transmission-mode direct analysis in real time traveling wave ion mobility spectrometry time-of-flight mass spectrometry (TM-DART-TWIMS-TOF MS) was tested as a high-throughput alternative to conventional direct infusion (DI) electrospray ionization (ESI) and atmospheric pressure chemical ionization (APCI) methods, and a critical comparison of the three ionization methods was conducted. EBC was chosen as the noninvasive surrogate for airway sampling over expectorated sputum as EBC can be collected in all CF subjects regardless of age and lung disease severity. When using pooled EBC collected from a healthy control, ESI detected the most metabolites, APCI a log order less, and TM-DART the least. TM-DART-TWIMS-TOF MS was used to profile metabolites in EBC samples from five healthy controls and four CF patients, finding that a panel of three discriminant EBC metabolites, some of which had been previously detected by other methods, differentiated these two classes with excellent cross-validated accuracy.

Health assessment of natural radioactivity and radon exhalation rate in granites used as building materials in Lebanon.

PubMed

Kobeissi, M A; El-Samad, O; Rachidi, I

2013-03-01

Measurements of specific activities (Bq kg(-1)) of gamma-emissions from radioactive nuclides, (238)U, (226)Ra, (214)Bi, (232)Th, (212)Pb and (40)K, contained in 28 granite types, used as building materials in indoors in Lebanon, were performed on the powdered granites. The concentration of the nuclides, (226)Ra, (232)Th and (40)K, in the granites varied from below detection level (BDL) to 494 Bq kg(-1), BDL to 157.2 Bq kg(-1) and BDL to 1776 Bq kg(-1), respectively. (226)Ra concentration equivalents, C(Raeq), were obtained and ranged between 37 and 591 Bq kg(-1), with certain values above the allowed limit of 370 Bq kg(-1). Calculated annual gamma-absorbed dose in air, D(aR), varied from 17.7 to 274.5 (nGy h(-1)). Annual effective dose, E (mSv y(-1)), of gamma radiations related to the studied granites and absorbed by the inhabitants was evaluated. E (mSv y(-1)) ranged from 0.09 to 1.35 mSv y(-1). Some granite types produced E above the allowed limit of 1 mSv y(-1) set by ICRP. Values of (222)Rn mass exhalation rate, E(M) (mBq kg(-1)h(-1))(,) in granite powder were obtained using the CR-39 detector technique. Diffusion factors, f, in 23 granite types were calculated with f ranging between (0.1 ± 0.02)×10(-2) and (6.6 ± 1.01)×10(-2).

The simultaneous detection of trivalent & hexavalent chromium in exhaled breath condensate: A feasibility study comparing workers and controls.

PubMed

Leese, Elizabeth; Morton, Jackie; Gardiner, Philip H E; Carolan, Vikki A

2017-04-01

The analytical method outlined in this feasibility study has been used to show that trivalent chromium (Cr(III)) and hexavalent chromium (Cr(VI)) can be detected and measured in exhaled breath condensate (EBC) samples. EBC samples and urine samples were collected from a cohort of 58 workers occupationally exposed to hexavalent chromium compounds and 22 unexposed volunteers (control group). Levels of Cr(III) and Cr(VI) were determined in EBC samples and total chromium levels were determined in urine samples. Pre and post working week samples for both EBC and urine were collected in tandem. Total chromium in urine samples was analysed by inductively coupled plasma mass spectrometry (ICP-MS). Analysis of Cr(III) and Cr(VI) in EBC samples used a hyphenated micro liquid chromatography (μLC) system coupled to an ICP-MS. Separation was achieved using an anion exchange micro-sized column. The results showed that the occupationally exposed workers had significantly higher levels of Cr(III) and Cr(VI) in their EBC samples than the control group, as well as higher levels of total chromium in their urine samples. However, for the exposed workers no significant difference was found between pre and post working week EBC samples for either Cr(III) or Cr(VI). This study has established that Cr(III) and Cr(VI) can simultaneously be detected and measured in 'real' EBC samples and will help in understanding inhalation exposure. Crown Copyright © 2016. Published by Elsevier GmbH. All rights reserved.

Urinary leukotriene E4/exhaled nitric oxide ratio and montelukast response in childhood asthma.

PubMed

Rabinovitch, Nathan; Graber, Nora J; Chinchilli, Vernon M; Sorkness, Christine A; Zeiger, Robert S; Strunk, Robert C; Bacharier, Leonard B; Martinez, Fernando D; Szefler, Stanley J

2010-09-01

A subset of children with asthma respond better to leukotriene receptor antagonists than to inhaled corticosteroids. Information is needed to identify children with these preferential responses. We sought to determine whether the ratio of urinary leukotriene E(4) (LTE(4)) to fractional exhaled nitric oxide (FE(NO)) delineates children with preferential responsiveness to montelukast compared with fluticasone propionate (FP) therapy. Data from 318 children with mild-to-moderate asthma enrolled in 2 National Heart, Lung, and Blood Institute Childhood Asthma Research and Education Network studies (Characterizing the Response to a Leukotriene Receptor Antagonist and an Inhaled Corticosteroid [CLIC] and the Pediatric Asthma Controller Trial [PACT]) were analyzed. The association between LTE(4)/FE(NO) ratios at baseline and improved lung function or asthma control days (ACDs) with montelukast and FP therapy was determined, and phenotypic characteristics related to high ratios were assessed. LTE(4)/FE(NO) ratios were associated with a greater response to montelukast than FP therapy for FEV(1) measurements (2.1% increase per doubling of ratio, P = .001) and for ACDs per week (0.3-ACD increase, P = .009) in the CLIC study. In PACT the ratio was associated with greater ACD responsiveness to MT than FP therapy (0.6 ACD increase, P=.03) [corrected]. In a combined study analysis, LTE(4): FE(NO) ratios were associated with greater response to MT than FP therapy for FEV(1) (1.8% increase, P =.0005) and ACDs (0.4 increase, P =.001)[corrected].Children with LTE(4)/FE(NO) ratios at or above the 75th percentile were likely (P < .05) to be younger and female and exhibit lower levels of atopic markers and methacholine reactivity. LTE(4)/FE(NO) ratios predict a better response to montelukast than FP therapy in children with mild-to-moderate asthma. Copyright (C) 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

Changes in exhaled breath condensate pH in healthy and asthmatic pregnant women.

PubMed

Eszes, Noémi; Bikov, András; Lázár, Zsófia; Bohács, Anikó; Müller, Veronika; Stenczer, Balázs; Rigó, János; Losonczy, György; Horváth, Ildikó; Tamási, Lilla

2013-05-01

Asthma is a common chronic disease complicating pregnancy with a risk for perinatal complications. Control of airway inflammation in the asthmatic pregnancy improves pregnancy outcomes. Our aim was to evaluate pH of exhaled breath condensate (EBC), a non-invasive method for the assessment of asthmatic airway inflammation, in healthy and asthmatic pregnancies. Cross-sectional study. Hungarian university clinics. Seventeen healthy pregnant women, 21 asthmatic pregnant women, 23 healthy non-pregnant women and 22 asthmatic non-pregnant women. EBC samples were collected using a portable condenser, EBC pH was measured after argon deaeration. EBC pH. EBC pH (mean ± SD) of healthy non-pregnant and asthmatic non-pregnant women was similar (7.75 ± 0.27 vs. 7.54 ± 0.57; p = 0.118), probably indicating an optimal control of airway inflammation in asthmatic women. On the other hand, EBC pH was higher in healthy pregnant women compared with healthy non-pregnant women (8.02 ± 0.43 vs. 7.75 ± 0.27; p = 0.017). Higher EBC pH accompanying healthy pregnancy was absent in asthmatic pregnant patients whose EBC pH was lower (7.65 ± 0.38) than that of healthy pregnant women (p = 0.006), and it was similar to that in asthmatic and healthy non-pregnant women (p = 0.470 and p = 0.300, respectively). The EBC pH in asthmatic pregnant women correlated positively with birthweight (r = 0.49, p = 0.047) and negatively with forced vital capacity (r = 0.45, p = 0.039). EBC pH was not related to blood pH. EBC pH is higher in healthy pregnant women but not in asthmatic pregnant women compared with data from healthy non-pregnant women, indicating that oxidative inflammatory processes induced by asthma may compromise the regulatory mechanisms causing alkaline pH in the airways during pregnancy. © 2013 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

First report on the pharmacokinetics of tramadol and O-desmethyltramadol in exhaled breath compared to plasma and oral fluid after a single oral dose.

PubMed

Meyer, Markus R; Rosenborg, Staffan; Stenberg, Marta; Beck, Olof

2015-12-01

Exhaled breath (EB) is a promising matrix for bioanalysis of non-volatiles and has been routinely implemented for drugs of abuse analysis. Nothing is known regarding the pharmacokinetics of therapeutics and their metabolites in EB. Therefore, we used tramadol as a model drug. Twelve volunteers received a single oral dose of tramadol and repeated sampling of EB, plasma, and oral fluid (OF) was done for 48 h using a particle filter device for EB and the Quantisal-device for OF. Samples were analyzed with LC-MS/MS and the pharmacokinetic correlations between matrices were investigated. The initial tramadol half-life in EB was shorter than in plasma but it reappeared in EB after 8-24 h. The ratio of O-desmethyltramadol to tramadol was considerably lower in EB and OF compared to plasma. This pilot study compared for the first time the pharmacokinetics of a therapeutic drug and active metabolite in different biomatrices including EB and demonstrated its potential for bioanalysis. Copyright © 2015 Elsevier Inc. All rights reserved.

Noninvasive Recognition and Biomarkers of Early Allergic Asthma in Cats Using Multivariate Statistical Analysis of NMR Spectra of Exhaled Breath Condensate

PubMed Central

Fulcher, Yan G.; Fotso, Martial; Chang, Chee-Hoon; Rindt, Hans; Reinero, Carol R.

2016-01-01

Asthma is prevalent in children and cats, and needs means of noninvasive diagnosis. We sought to distinguish noninvasively the differences in 53 cats before and soon after induction of allergic asthma, using NMR spectra of exhaled breath condensate (EBC). Statistical pattern recognition was improved considerably by preprocessing the spectra with probabilistic quotient normalization and glog transformation. Classification of the 106 preprocessed spectra by principal component analysis and partial least squares with discriminant analysis (PLS-DA) appears to be impaired by variances unrelated to eosinophilic asthma. By filtering out confounding variances, orthogonal signal correction (OSC) PLS-DA greatly improved the separation of the healthy and early asthmatic states, attaining 94% specificity and 94% sensitivity in predictions. OSC enhancement of multi-level PLS-DA boosted the specificity of the prediction to 100%. OSC-PLS-DA of the normalized spectra suggest the most promising biomarkers of allergic asthma in cats to include increased acetone, metabolite(s) with overlapped NMR peaks near 5.8 ppm, and a hydroxyphenyl-containing metabolite, as well as decreased phthalate. Acetone is elevated in the EBC of 74% of the cats with early asthma. The noninvasive detection of early experimental asthma, biomarkers in EBC, and metabolic perturbation invite further investigation of the diagnostic potential in humans. PMID:27764146

Diagnostic utility of fractional exhaled nitric oxide in prolonged and chronic cough according to atopic status.

PubMed

Asano, Takamitsu; Takemura, Masaya; Fukumitsu, Kensuke; Takeda, Norihisa; Ichikawa, Hiroya; Hijikata, Hisatoshi; Kanemitsu, Yoshihiro; Uemura, Takehiro; Takakuwa, Osamu; Ohkubo, Hirotsugu; Maeno, Ken; Ito, Yutaka; Oguri, Tetsuya; Nakamura, Atsushi; Niimi, Akio

2017-04-01

Cough-variant asthma (CVA) and cough-predominant asthma (CPA) are the major causes of persistent cough in Japan. The utility of fractional exhaled nitric oxide (FeNO) measurement in the differential diagnosis of persistent cough has been reported, but the influence of atopic status, which is associated with higher FeNO levels, on the diagnostic utility of FeNO has been unknown. We retrospectively analyzed 105 non-smoking patients with prolonged and chronic cough that were not treated with corticosteroids and anti-leukotrienes. CPA was diagnosed in 37 patients, CVA in 40, and non-asthmatic cough (NAC) in 28. FeNO levels were significantly higher in the CPA [35.8 (7.0-317.9) ppb] and CVA [24.9 (3.1-156.0) ppb] groups than in the NAC group [18.2 (6.9-49.0) ppb] (p < 0.01 by Kruskal-Wallis test). The optimal cut-off for distinguishing asthmatic cough (AC; CPA and CVA) from NAC was 29.2 ppb [area under the curve (AUC) 0.74, p < 0.01]. Ninety-one percent of subjects with FeNO levels ≥29.2 ppb had AC. Meanwhile, 40% of AC patients had FeNO levels <29.2 ppb. Stratified cut-off levels were 31.1 ppb (AUC 0.83) in atopic subjects vs. 19.9 ppb (AUC 0.65) in non-atopic subjects (p = 0.03 for AUC). Although high FeNO levels suggested the existence of AC, lower FeNO levels had limited diagnostic significance. Atopic status affects the utility of FeNO levels in the differential diagnosis of prolonged and chronic cough. Copyright © 2016 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

Exhaled nitric oxide: Not associated with asthma, symptoms, or spirometry in children with sickle cell anemia.

PubMed

Cohen, Robyn T; Rodeghier, Mark; Kirkham, Fenella J; Rosen, Carol L; Kirkby, Jane; DeBaun, Michael R; Strunk, Robert C

2016-11-01

The significance of fractional exhaled nitric oxide (Feno) levels in children with sickle cell anemia (SCA) is unclear, but increased levels can be associated with features of asthma and thus increased morbidity. We sought to determine factors associated with Feno and whether Feno levels are associated with increased rates of acute chest syndrome (ACS) and pain. All participants had SCA, were part of the prospective observational Sleep and Asthma Cohort study, and had the following assessments: Feno levels, spirometry, blood samples analyzed for hemoglobin, white blood cell counts, eosinophil counts and total serum IgE levels, questionnaires about child medical and family history, and review of medical records. The analytic sample included 131 children with SCA (median age, 11.2 years; age range, 6-18 years) followed for a mean of 16.2 years, including a mean of 5.1 years after baseline Feno data measurements. In multivariable analyses higher Feno levels were associated with ln(IgE) levels (P < .001) and the highest quartile of peripheral eosinophil counts (P = .03) but not wheezing symptoms, baseline spirometric indices, or response to bronchodilator. Multivariable analyses identified that the incident rate of ACS was associated with ln(Feno) levels (P = .03), as well as male sex (P = .025), wheezing causing shortness of breath (P = .002), and ACS at less than 4 years of age (P < .001). Feno levels were not associated with future pain episodes. Steady-state Feno levels were not associated with an asthma diagnosis, wheezing symptoms, lung function measures, or prior sickle cell morbidity but were associated with markers of atopy and increased risk of future ACS events. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Normal values of offline exhaled and nasal nitric oxide in healthy children and teens using chemiluminescence.

PubMed

Menou, A; Babeanu, D; Paruit, H N; Ordureau, A; Guillard, S; Chambellan, A

2017-08-21

Nitric oxide (NO) can be used to detect respiratory or ciliary diseases. Fractional exhaled nitric oxide (FeNO) measurement can reflect ongoing eosinophilic airway inflammation and has a diagnostic utility as a test for asthma screening and follow-up while nasal nitric oxide (nNO) is a valuable screening tool for the diagnosis of primary ciliary dyskinesia. The possibility of collecting airway gas samples in an offline manner offers the advantage to extend these measures and improve the screening and management of these diseases, but normal values from healthy children and teens remain sparse. Samples were consecutively collected using the offline method for eNO and nNO chemiluminescence measurement in 88 and 31 healthy children and teens, respectively. Offline eNO measurement was also performed in 30 consecutive children with naïve asthma and/or respiratory allergy. The normal offline eNO value was determined by the following regression equation -8.206 + 0.176 × height. The upper limit of the norm for the offline eNO value was 27.4 parts per billion (ppb). A separate analysis was performed in children, pre-teens and teens, for which offline eNO was 13.6 ± 4.7 ppb, 16.3 ± 13.7 ppb and 20.0 ± 7.2 ppb, respectively. The optimal cut-off value of the offline eNO to predict asthma or respiratory allergies was 23.3 ppb, with a sensitivity and specificity of 77% and 91%, respectively. Mean offline nNO was determined at 660 ppb with the lower limit of the norm at 197 ppb. The use of offline eNO and nNO normal values should favour the widespread screening of respiratory diseases in children of school age in their usual environment.

Establishing IMMULITE® 2000 cut-off values for serum allergen-specific immunoglobulin and exploring their relationship to exhaled nitric oxide

PubMed Central

Evjenth, Bjørg; Hansen, Tonje E; Brekke, Ole-Lars; Holt, Jan

2014-01-01

Aim Paediatric cut-off values for serum allergen-specific IgE (sIgE) using the Siemens IMMULITE® 2000 system to diagnose allergic rhinoconjunctivitis have not been established. We aimed to determine cut-off levels for sIgE for 10 common inhalant allergens and to study the relationship between sIgE, total IgE and fractional exhaled nitric oxide (FENO). Methods We enrolled 243 schoolchildren, including 164 with allergic rhinoconjunctivitis. Parental interviews, skin prick tests, sIgE, total IgE, FENO measurements, spirometry and exercise tests were performed. Results Cut-off values with the best combined sensitivity and specificity were above the detection limit of the assay for seven of the ten allergens (0.23–1.1 kU/L). The overall accuracy of the IMMULITE® in detecting allergic rhinoconjunctivitis was good. sIgE was superior to total IgE and FENO in predicting allergic rhinoconjunctivitis to timothy, birch, mugwort, cat, dog and house dust mite. FENO was elevated in children with allergic rhinoconjunctivitis, irrespective of asthma. Conclusion Cut-off values for sIgE were dependent on the allergic phenotype and were above the IMMULITE® detection limit for seven of ten inhalant allergens. Consequently, using the detection limit for sIgE as the decision point would result in over-diagnosing allergic rhinoconjunctivitis. When measuring elevated FENO in children, allergic rhinoconjunctivitis should be suspected. PMID:24628428

Monitoring the ionic content of exhaled breath condensate in various respiratory diseases by capillary electrophoresis with contactless conductivity detection.

PubMed

Greguš, Michal; Foret, František; Kindlová, Dagmar; Pokojová, Eva; Plutinský, Marek; Doubková, Martina; Merta, Zdeněk; Binková, Ilona; Skřičková, Jana; Kubáň, Petr

2015-05-06

The analysis of an ionic profile of exhaled breath condensate (EBC) by capillary electrophoresis with contactless conductivity detection and double opposite end injection, is demonstrated. A miniature sampler made from a 2 ml syringe and an aluminium cooling cylinder was used for the fast collection of EBC (under one minute). Analysis of the collected EBC was performed in a 60 mM 2-(N-morpholino)ethanesulfonic acid, 60 mM L-histidine background electrolyte with 30 µM cetyltrimethylammonium bromide and 2 mM 18-crown-6 at pH 6, and excellent repeatability of migration times (RSD  <1.3% (n = 7)) and peak areas (RSD  <  7% (n = 7)) of 14 ions (inorganic anions, cations and organic acids) was obtained. It is demonstrated that the analysis of EBC samples obtained from patients with various respiratory diseases (chronic obstructive pulmonary disease, asthma, pulmonary fibrosis, sarcoidosis, cystic fibrosis) is possible in less than five minutes and the ionic profile can be compared with the group of healthy individuals. The analysis of the ionic profile of EBC samples provides a set of data in which statistically significant differences among the groups of patients could be observed for several clinically relevant anions (nitrite, nitrate, acetate, lactate). The developed collection system and method provides a highly reproducible and fast way of collecting and analyzing EBC, with future applicability in point-of-care diagnostics.

Elimination characteristics of post-operative isoflurane levels in alveolar exhaled breath via PTR-MS analysis.

PubMed

Fernández Del Río, R; O'Hara, M E; Pemberton, P; Whitehouse, T; Mayhew, C A

2016-10-12

Isoflurane (1-chloro-2,2,2-trifluoroethyl difluoromethyl ether), C 3 H 2 ClF 5 O, is a commonly used inhalation anaesthetic. Using a proton transfer reaction mass spectrometer (PTR-MS) we have detected isoflurane in the breath of patients several weeks following major surgery. That isoflurane is detected in the breath of patients so long after being anaesthetised raises questions about when cognitive function has fully returned to a patient. Temporal profiles of isoflurane concentrations in breath are presented for five patients (F/M 3/2, mean age 50 years, min-max 36-58 years) who had undergone liver transplant surgery. In addition, results from a headspace analysis of isoflurane are presented so that the product ions resulting from the reactions of H 3 O + with isoflurane in PTR-MS could be easily identified in the absence of the complex chemical environment of breath. Six product ions were identified. In order of increasing m/z (using the 35 Cl isotope where appropriate) these are [Formula: see text] (m/z 51), CHFCl + (m/z 67), CF 3 CHCl + (m/z 117), C 3 F 4 OCl + (m/z 163), C 3 H 2 F 4 OCl + (m/z 165), and C 3 F 4 OCl + H 2 O (m/z 183). No protonated parent was detected. For the headspace study both clean air and CO 2 enriched clean air (4% CO 2 ) were used as buffer gases in the drift tube of the PTR-MS. The CO 2 enriched air was used to determine if exhaled breath would affect the product ion branching ratios. Importantly no significant differences were observed, and therefore for isoflurane the product ion distributions determined in a normal air mixture can be used for breath analysis. Given that PTR-MS can be operated under different reduced electric fields (E/N), the dependence of the product ion branching percentages for isoflurane on E/N (96-138 Td) are reported.

Exhaled carbon monoxide: a non-invasive biomarker of short-term exposure to outdoor air pollution.

PubMed

Lawin, Herve; Ayi Fanou, Lucie; Hinson, Vikkey; Wanjiku, Jacqueline; Ukwaja, N Kingsley; Gordon, Stephen B; Fayomi, Benjamin; Balmes, John R; Houngbegnon, Parfait; Avokpaho, Euripide; Sanni, Ambaliou

2017-04-17

In urban settings of Africa with rapidly increasing population, traffic-related air pollution is a major contributor to outdoor air pollution (OAP). Although OAP has been identified as a leading cause of global morbidity and mortality, there is however, lack of a simple biomarker to assess levels of exposure to OAP in resource-poor settings. This study evaluated the role of exhaled carbon monoxide (exhCO) as a potential biomarker of exposure to ambient carbon monoxide (ambCO) from OAP. This was a descriptive study conducted among male commercial motorcycle riders in Cotonou - the economic capital of Benin. The participants' AmbCO was measured using a portable carbon monoxide (CO) data logger for 8 h during the period of their shift. ExhCO was measured just before and immediately after their shift (8-h) Participants were asked not to cook or to smoke during the day of the measurements. Linear regression analysis was used to assess the association between ambCO and exhCO for the last 2, 4 and 6 h of their shift. Of 170 participants who completed the study, their mean ± SD age was 42.2 ± 8.4 years, and their mean ± SD daily income was 7.3 ± 2.7$. Also, 95% of the participants' used solid fuels for cooking and only 2% had ever smoked. Average exhCO increased by 5.1 ppm at the end of the shift (p = 0.004). Post-shift exhCO was significantly associated to ambCO, this association was strongest for the last 2 h of OAP exposure before exhCO measurement (β = 0.34, p < 0.001). ExhCO level was associated with recent exposure to ambCO from OAP with measurable increase after 8 h of exposure. These findings suggest that ExhCO may be a potential biomarker of short-term exposure to OAP.

Exhaled nitric oxide measurements in the first 2 years of life: methodological issues, clinical and epidemiological applications

PubMed Central

Gabriele, Carmelo; de Benedictis, Fernando M; de Jongste, Johan C

2009-01-01

Fractional exhaled nitric oxide (FeNO) is a useful tool to diagnose and monitor eosinophilic bronchial inflammation in asthmatic children and adults. In children younger than 2 years of age FeNO has been successfully measured both with the tidal breathing and with the single breath techniques. However, there are a number of methodological issues that need to be addressed in order to increase the reproducibility of the FeNO measurements within and between infants. Indeed, a standardized method to measure FeNO in the first 2 years of life would be extremely useful in order to meaningfully interpret FeNO values in this age group. Several factors related to the measurement conditions have been found to influence FeNO, such as expiratory flow, ambient NO and nasal contamination. Furthermore, the exposure to pre- and postnatal risk factors for respiratory morbidity has been shown to influence FeNO values. Therefore, these factors should always be assessed and their association with FeNO values in the specific study population should be evaluated and, eventually, controlled for. There is evidence consistently suggesting that FeNO is increased in infants with family history of atopy/atopic diseases and in infants with recurrent wheezing. These findings could support the hypothesis that eosinophilic bronchial inflammation is present at an early stage in those infants at increased risk of developing persistent respiratory symptoms and asthma. Furthermore, it has been shown that FeNO measurements could represent a useful tool to assess bronchial inflammation in other airways diseases, such as primary ciliary dyskinesia, bronchopulmonary dysplasia and cystic fibrosis. Further studies are needed in order to improve the reproducibility of the measurements, and large prospective studies are warranted in order to evaluate whether FeNO values measured in the first years of life can predict the future development of asthma or other respiratory diseases. PMID:19712438

Influence of condensing equipment and temperature on exhaled breath condensate pH, total protein and leukotriene concentrations.

PubMed

Czebe, Krisztina; Barta, Imre; Antus, Balázs; Valyon, Márta; Horváth, Ildikó; Kullmann, Tamás

2008-05-01

Exhaled breath condensate analysis is an attractive but still not fully standardised method for investigating airway pathology. Adherence of biomarkers to various condensing surfaces and changes in condensing temperature has been considered to be responsible for the variability of the results. Our aims were to compare the efficacy of different types of condensers and to test the influence of condensing temperature on condensate composition. Breath condensates from 12 healthy persons were collected in two settings: (1) by using three condensers of different type (EcoScreen, R-Tube, Anacon) and (2) by using R-Tube condenser either cooled to -20 or -70 degrees C. Condensate pH at standardised CO(2) level was determined; protein content was measured by the Bradford method and leukotrienes by EIA. Breath condensates collected using EcoScreen were more alkaline (6.45+/-0.20 vs. 6.19+/-0.23, p<0.05 and 6.10+/-0.26, p<0.001) and contained more protein (3.89+/-2.03 vs. 2.65+/-1.98, n.s. and 1.88+/-1.99 microg/ml, p<0.004) as compared to the other devices. Only parameters obtained with R-Tube and Anacon correlated. Condensing temperature affected condensate pH (5.99+/-0.20 at -20 degrees C and 5.82+/-0.07 at -70 degrees C, p<0.05) but not protein content. Leukotriene B(4) was not found in any sample and cysteinyl-leukotriene was not found in condensates collected with R-Tube or Anacon. Condenser type influences sample pH, total protein content and cysteinyl-leukotriene concentration. Condensing temperature influences condensate pH but not total protein content. These results suggest that adherence of the biomarkers to condenser surface and condensing temperature may play a role but does not fully explain the variability of EBC biomarker levels.

The Association of Lung Function, Bronchial Hyperresponsiveness, and Exhaled Nitric Oxide Differs Between Atopic and Non-atopic Asthma in Children

PubMed Central

Shim, Eunhee; Lee, Eun; Yang, Song-I; Jung, Young-Ho; Park, Geun Mi; Kim, Hyung Young; Seo, Ju-Hee

2015-01-01

Purpose Although many previous studies have attempted to identify differences between atopic asthma (AA) and non-atopic asthma (NAA), they have mainly focused on the difference of each variable of lung function and airway inflammation. The aim of this study was to evaluate relationships between lung function, bronchial hyperresponsiveness (BHR), and the exhaled nitric oxide (eNO) levels in children with AA and NAA. Methods One hundred and thirty six asthmatic children aged 5-15 years and 40 normal controls were recruited. Asthma cases were classified as AA (n=100) or NAA (n=36) from skin prick test results. Lung function, BHR to methacholine and adenosine-5'-monophosphate (AMP), eNO, blood eosinophils, and serum total IgE were measured. Results The AA and NAA cases shared common features including a reduced small airway function and increased BHR to methacholine. However, children with AA showed higher BHR to AMP and eNO levels than those with NAA. When the relationships among these variables in the AA and NAA cases were evaluated, the AA group showed significant relationships between lung function, BHR to AMP or methacholine and eNO levels. However, the children in the NAA group showed an association between small airway function and BHR to methacholine only. Conclusions These findings suggest that the pathogenesis of NAA may differ from that of AA during childhood in terms of the relationship between lung function, airway inflammation and BHR. PMID:25749776

Domestic airborne black carbon levels and 8-isoprostane in exhaled breath condensate among children in New York City☆

PubMed Central

Rosa, Maria Jose; Yan, Beizhan; Chillrud, Steven N.; Acosta, Luis M.; Divjan, Adnan; Jacobson, Judith S.; Miller, Rachel L.; Goldstein, Inge F.; Perzanowski, Matthew S.

2015-01-01

Background Exposure to airborne black carbon (BC) has been associated with asthma development, respiratory symptoms and decrements in lung function. However, the mechanism through which BC may lead to respiratory symptoms has not been completely elucidated. Oxidative stress has been suggested as a potential mechanism through which BC might lead to adverse health outcomes. Exhaled breath condensate (EBC) allows for the non-invasive collection of airway lining fluid containing biomarkers of oxidative stress like 8-isoprostane, a stable by-product of lipid peroxidation. Therefore, we sought to characterize the association between domestic airborne BC concentrations and 8-isoprostane in EBC. Materials and methods Seven- and eight-year-old children participated in an asthma case–control study in New York City. During home visits, air samples and EBC were collected. Seven day averages of domestic levels of particulate matter <2.5 µm (PM2.5), BC and environmental tobacco smoke (ETS) were measured. Urea and 8-isoprostane were measured by liquid chromatography tandem mass spectrometry (LC/MS/MS) in EBC. Results In univariate models, PM2.5 and BC, but not ETS, were significantly associated with increases in 8-isoprostane in the EBC (β = 0.006 and β = 0.106 respectively, p < 0.05 for both). These associations remained statistically significant for both PM2.5 and BC after adjustment for covariates. In a co-pollutant model including PM2.5, BC and ETS, only BC remained a statistically significant predictor of 8-isoprostane (p < 0.05). Conclusions Our findings suggest the BC fraction of PM might contain exposure relevant to increased oxidative stress in the airways. PMID:25262082

ASSOCIATION BETWEEN FRACTION OF EXHALED NITRIC OXIDE AND SPIROMETRY DATA AND CLINICAL CONTROL OF ASTHMA IN CHILDREN AND ADOLESCENTS

PubMed Central

Salviano, Luanda Dias da Silva; Taglia-Ferre, Karla Delevedove; Lisboa, Sandra; da Costa, Ana Carolina Carioca; Campos, Hisbello da Silva; March, Maria de Fátima Pombo

2018-01-01

ABSTRACT Objective: To evaluate the association between fraction of exhaled nitric oxide (FeNO) values and forced expiratory volume in the first second (FEV1) and the level of asthma control, as proposed by the Global Initiative for Asthma (GINA), in asthmatic children and adolescents attended at the National Institute of Women, Children and Adolescents Health Fernandes Figueira of Fundação Oswaldo Cruz (IFF/FIOCRUZ). Methods: This was a cross-sectional study, with a review of medical records of 90 asthmatics between 7 and 17 years old, who were followed up at the IFF/FIOCRUZ Asthma Outpatient Clinic and were referred to perform respiratory function tests (RFT)between March 2013 and September 2014. After classification according to GINA, patients performed complete spirometry and FeNO measurement. Subsequently, they were separated into two groups: regular and non-regular inhaled corticosteroid (ICS) use, regardless of the ventilatory pattern in spirometry. Results: The association between FEV1 values and the degree of asthma control according to GINA (p=0.001) was observed in all patients, regardless of ICS use, but there was no association between FEV1 and levels of FeNO. Conclusions: The correlation observed between GINA and FEV1 reinforces the importance of spirometry in the clinical follow-up of these patients. Although no association was found between the value of FeNO and the degree of asthma control and FEV1, FeNO may be an early method to detect airway inflammation, even before the symptoms and spirometric changes. PMID:29412429

Fractional exhaled nitric oxide has a good correlation with asthma control and lung function in latino children with asthma.

PubMed

Soto-Ramos, Mario; Castro-Rodríguez, Jose A; Hinojos-Gallardo, Luis Carlos; Hernández-Saldaña, Raul; Cisneros-Castolo, Martin; Carrillo-Rodríguez, Victor

2013-08-01

Although the measurement of fractional exhaled nitric oxide (FE(NO)) has been recommended for observational studies and clinical trials of asthma, FE(NO) has not been examined in studies of childhood asthma in Latin America, To examine the relationship between FE(NO) and indicators of disease control or severity [asthma control test/childhood asthma control test (ACT/C-ACT), lung function, and exercise challenge test (ECT)] in Mexican children with persistent asthma, Children (6-18 years of age) with persistent asthma were consecutively recruited in a tertiary asthma clinic and divided into two groups, e.g. FE(NO) < 20 parts per billion (ppb) and ≥20 ppb.Adequate FE(NO) measurements were obtained in 134 (83.2%) of 161 eligible children, Children with FE(NO)<20 ppb had significantly higher scores on the ACT/C-ACT than those with FE(NO) ≥ 20 ppb (median [interquartile range] :23 [20.8-25] vs. 21 [18-24], p = .002, respectively). Compared to children with FE(NO) ≥20 ppb, those with FE(NO) <20 ppb had a higher baseline predicted forced expiratory volume (FEV(1)) [94% (92.5%-99.4%) vs. 83% (81%-89.9%), p = .001] and a lower probability of having a positive ECT (42.7% vs. 71.2%, p = .001). In addition, FE(NO) was significantly inversely correlated with the participants' ACT/C-ACT score and predicted FEV1, and directly correlated with positive ECT, CONCLUSION: Among Mexican children with persistent asthma, low levels of FE(NO) ( <20 ppb) are associated with better asthma control, and higher lung function.

Relations of exhaled nitric oxide and FEV1 to personal endotoxin exposure in schoolchildren with asthma.

PubMed

Delfino, Ralph J; Staimer, Norbert; Tjoa, Thomas; Gillen, Daniel L

2015-12-01

Asthma prevalence and acute exacerbations have been associated with endotoxin exposure. However, there are limited data on relations between acute asthma outcomes in children and personal exposure to endotoxin or whether this relation is modified by personal air pollution exposures. We made repeated measurements of the fractional concentration of exhaled NO (FeNO), forced expiratory volume in 1 s (FEV1) and personal endotoxin exposures in patients with persistent asthma aged 9-18 years, each of whom was followed for 10 consecutive days in Riverside and Whittier, California. Endotoxin was measured in PM2.5, and simultaneously we measured personal exposure to air pollutants: NO2 and PM2.5 mass, elemental carbon and organic carbon. Endotoxin exposure-response relations and interactions between endotoxin and air pollutants were analysed with mixed models controlling for personal temperature, humidity and the 10-day period. Neither percent-predicted FEV1 nor FeNO was associated with personal endotoxin overall; however, endotoxin was associated with FEV1 among patients with average percent-predicted FEV1<80%. When NO2 was above its median, FeNO increased by 2.2% (95% CI -0.8% to 5.2%) for an interquartile increase in personal endotoxin, whereas FeNO was lower by -1.8% (95% CI -4% to 0.5%) when NO2 was≤its median. However, this is out of 12 interaction tests between personal endotoxin and a binary air pollutant for each outcome (FEV1 and FeNO), and there were no interactions with any continuous-scaled pollutant. Personal endotoxin exposure was not associated with acute daily changes in FeNO or FEV1 in a cohort panel of schoolchildren with asthma, except for decreased FEV1 among patients with more severe asthma (percent-predicted FEV1<80%). There was limited evidence of effect modification of endotoxin by personal exposure to air pollution. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

Detection of ethylene gas in exhaled breath of people living in landfill using CO{sub 2} laser photoacoustic spectroscopy with multicomponent analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Oktafiani, Fitri, E-mail: fitri.oktafiani@mail.ugm.ac.id; Stiyabudi, Rizky; Amin, Mochamad Nurul

The photoacoustic spectrometer (PAS) had been built and the performance had been determined. The research was based on the conversion of the absorbed middle infra red (IR) radiation by gas confined in a closed PAS cell into standing acoustic wave, which could be detected by a suitable electroacoustic transducer such as a microphone. The lowest detection limit for this setup was (57,1 ± 0,3) ppb and quality factor was (14,5 ± 0,6) for ethylene gas in 10P14 CO{sub 2} laser line. Then, this PAS was used to measure of ethylene gas concentration in breath sample of people living in nearmore » the Piyungan Bantul Yogyakarta landfill. The result from multicomponent analysis showed that PAS enable to measure the lowest concentration of volatile organic compound (VOC), such as ethylene, which occured on ambien air in Piyungan landfill. Variaty of distance area applied in this research. In the range of ±0,5 km from landfill, we obtained the concentration of ethylene gas concentration for human breath was (1,520 ± 0,002) ppm, while in the range of ±45 km, the ethylene gas concentration for human breath was (0,424 ± 0,002) ppm. Ethylene gas concentrations in exhaled gas decreased along with increasing distance variation of the landfill.« less

Immunochemistry for high-throughput screening of human exhaled breath condensate (EBC) media: implementation of automated Quanterix SIMOA instrumentation.

PubMed

Pleil, Joachim D; Angrish, Michelle M; Madden, Michael C

2015-12-11

Immunochemistry is an important clinical tool for indicating biological pathways leading towards disease. Standard enzyme-linked immunosorbent assays (ELISA) are labor intensive and lack sensitivity at low-level concentrations. Here we report on emerging technology implementing fully-automated ELISA capable of molecular level detection and describe application to exhaled breath condensate (EBC) samples. The Quanterix SIMOA HD-1 analyzer was evaluated for analytical performance for inflammatory cytokines (IL-6, TNF-α, IL-1β and IL-8). The system was challenged with human EBC representing the most dilute and analytically difficult of the biological media. Calibrations from synthetic samples and spiked EBC showed excellent linearity at trace levels (r(2)  >  0.99). Sensitivities varied by analyte, but were robust from ~0.006 (IL-6) to ~0.01 (TNF-α) pg ml(-1). All analytes demonstrated response suppression when diluted with deionized water and so assay buffer diluent was found to be a better choice. Analytical runs required ~45 min setup time for loading samples, reagents, calibrants, etc., after which the instrument performs without further intervention for up to 288 separate samples. Currently, available kits are limited to single-plex analyses and so sample volumes require adjustments. Sample dilutions should be made with assay diluent to avoid response suppression. Automation performs seamlessly and data are automatically analyzed and reported in spreadsheet format. The internal 5-parameter logistic (pl) calibration model should be supplemented with a linear regression spline at the very lowest analyte levels, (<1.3 pg ml(-1)). The implementation of the automated Quanterix platform was successfully demonstrated using EBC, which poses the greatest challenge to ELISA due to limited sample volumes and low protein levels.

Tailoring asthma treatment on eosinophilic markers (exhaled nitric oxide or sputum eosinophils): a systematic review and meta-analysis.

PubMed

Petsky, Helen L; Cates, Chris J; Kew, Kayleigh M; Chang, Anne B

2018-06-01

Asthma guidelines guide health practitioners to adjust treatments to the minimum level required for asthma control. As many people with asthma have an eosinophilic endotype, tailoring asthma medications based on airway eosinophilic levels (sputum eosinophils or exhaled nitric oxide, FeNO) may improve asthma outcomes. To synthesise the evidence from our updated Cochrane systematic reviews, for tailoring asthma medication based on eosinophilic inflammatory markers (sputum analysis and FeNO) for improving asthma-related outcomes in children and adults. Cochrane reviews with standardised searches up to February 2017. The Cochrane reviews included randomised controlled comparisons of tailoring asthma medications based on sputum analysis or FeNO compared with controls (primarily clinical symptoms and/or spirometry/peak flow). The 16 included studies of FeNO-based management (seven in adults) and 6 of sputum-based management (five in adults) were clinically heterogeneous. On follow-up, participants randomised to the sputum eosinophils strategy (compared with controls) were significantly less likely to have exacerbations (62 vs 82/100 participants with ≥1 exacerbation; OR 0.36, 95% CI 0.21 to 0.62). For the FeNO strategy, the respective numbers were adults OR 0.60 (95% CI 0.43 to 0.84) and children 0.58 (95% CI 0.45 to 0.75). However, there were no significant group differences for either strategy on daily inhaled corticosteroids dose (at end of study), asthma control or lung function. Adjusting treatment based on airway eosinophilic markers reduced the likelihood of asthma exacerbations but had no significant impact on asthma control or lung function. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Recent Marijuana Use and Associations With Exhaled Nitric Oxide and Pulmonary Function in Adults in the United States.

PubMed

Papatheodorou, Stefania I; Buettner, Hannah; Rice, Mary B; Mittleman, Murray A

2016-06-01

The medical and recreational use of marijuana is now legal in some parts of the United States; the health effects are unknown. We aimed to evaluate associations between recent marijuana use and exhaled nitric oxide (eNO) and pulmonary function. We performed a cross-sectional study of 10,327 US adults participating in the National Health and Nutrition Examination Survey in the years 2007 to 2012. We examined associations between marijuana use and eNO, FEV1, FVC, the FEV1/FVC ratio, and forced expiratory flow (midexpiratory phase) (FEF25%-75%) by weighted linear regression. In the study population, there were 4,797 never users, 4,084 past marijuana users, 555 participants who used marijuana 5 to 30 days before the examination, and 891 participants who used marijuana 0 to 4 days before the examination. Current marijuana use in the past 4 days was associated with 13% lower eNO (95% CI, -18% to 8%). FVC was higher in past users (75 mL; 95% CI, 38-112) and current users in the past 5 to 30 days (159 mL; 95% CI, 80-237) and in users within 0 to 4 days of the examination (204 mL; 95% CI, 139-270) compared with never users. All associations remained unchanged and statistically significant in sensitivity analyses excluding current and past tobacco users. Current marijuana use was associated with lower levels of eNO and higher FVC. The lower eNO in marijuana smokers suggests that short-term exposure to marijuana may, like tobacco, acutely affect the pulmonary vascular endothelium and impair airflow through the small airways. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Exhaled Breath Temperature as a Novel Marker of Future Development of COPD: Results of a Follow-Up Study in Smokers.

PubMed

Labor, Marina; Vrbica, Žarko; Gudelj, Ivan; Labor, Slavica; Jurić, Iva; Plavec, Davor

2016-12-01

Although only less than one-third of smokers develop COPD, early marker(s) of COPD development are lacking. The aim of this research was to assess the ability of an average equilibrium exhaled breath temperature (EBT) in identifying susceptibility to cigarette smoke so as to predict COPD development in smokers at risk. The study was a part of a multicenter prospective cohort study in current smokers (N = 140, both sexes, 40-65 years, ≥20 pack-years) with no prior diagnosis of COPD. Diagnostic workup includes history, physical, quality of life, hematology and highly sensitive CRP, EBT before and after smoking a cigarette, lung function with bronchodilator test, and 6-minute walk test. Patients without a diagnosis of COPD and in GOLD 1 stage at initial assessment were reassessed after 2 years. COPD was additionally diagnosed based on lower level of normal (LLN) lung function criteria. Utility of EBT for disease progression was analyzed using receiver operator curve (ROC) and logistic regression analyses. Change in EBT after smoking a cigarette at initial visit (ΔEBT) was significantly predictive for disease progression (newly diagnosed COPD; newly diagnosed COPD + severity progression) after 2 years (p < 0.05 for both). ΔEBT had an AUC of 0.859 (p = 0.011) with sensitivity of 66.7% and specificity of 98.1% for newly diagnosed COPD using LLN criteria. We conclude that EBT shows potential for predicting the future development of COPD in current smokers. This was best seen using LLN to diagnose COPD, adding further evidence to question the use of GOLD criteria for diagnosing COPD.

Comfort and exertion while using filtering facepiece respirators with exhalation valve and an active venting system among male military personnel.

PubMed

Seng, Melvin; Wee, Liang En; Zhao, Xiahong; Cook, Alex R; Chia, Sin Eng; Lee, Vernon J

2017-07-06

This study aimed to determine if disposable filtering facepiece respirators (FFRs), with exhalation valve (EV) and a novel active venting system (AVS), provided greater perceived comfort and exertion when compared to standard N95 FFRs without these features among male military personnel performing prolonged essential outdoor duties. We used a randomised open-label controlled crossover study design to compare three FFR options: (a) standard FFR; (b) FFR with EV; and (c) FFR with EV+AVS. Male military personnel aged between 18 and 20 years completed a questionnaire at the beginning (baseline), after two hours of standardised non-strenuous outdoor duty and after 12 hours of duty divided into two-hour work-rest cycles. Participants rated the degree of discomfort, exertion and symptoms using a five-point Likert scale. The association between outcomes and the types of FFR was assessed using a multivariate ordered probit mixed-effects model. For a majority of the symptoms, study participants rated FFR with EV and FFR with EV+AVS with significantly better scores than standard FFR. Both FFR with EV and FFR with EV+AVS had significantly less discomfort (FFR with EV+AVS: 91.1%; FFR with EV: 57.6%) and exertion (FFR with EV+AVS: 83.5%; FFR with EV: 34.4%) than standard FFR. FFR with EV+AVS also had significantly better scores for exertion (53.4%) and comfort (39.4%) when compared to FFR with EV. Usage of FFR with EV+AVS resulted in significantly reduced symptoms, discomfort and exertion when compared to FFR with EV and standard FFR.

Could Fractional Exhaled Nitric Oxide Test be Useful in Predicting Inhaled Corticosteroid Responsiveness in Chronic Cough? A Systematic Review.

PubMed

Song, Woo-Jung; Won, Ha-Kyeong; Moon, Sung-Do; Chung, Soo-Jie; Kang, Sung-Yoon; Sohn, Kyoung-Hee; Kim, Ju-Young; Kim, Byung-Keun; Lim, Kyung-Hwan; Kim, Mi-Yeong; Yang, Min-Suk; Park, Heung-Woo; Chang, Yoon-Seok; Lee, Byung-Jae; Morice, Alyn H; Cho, Sang-Heon

Fractional exhaled nitric oxide (Feno) is a safe and convenient test for assessing T H 2 airway inflammation, which is potentially useful in the management of patients with chronic cough. To summarize the current evidence on the diagnostic usefulness of Feno for predicting inhaled corticosteroid (ICS) responsiveness in patients with chronic cough. A systematic literature review was conducted to identify articles published in peer-reviewed journals up to February 2015, without language restriction. We included studies that reported the usefulness of Feno (index test) for predicting ICS responsiveness (reference standard) in patients with chronic cough (target condition). The data were extracted to construct a 2 × 2 accuracy table. Study quality was assessed with Quality Assessment of Diagnostic Accuracy Studies 2. We identified 5 original studies (2 prospective and 3 retrospective studies). We identified considerable heterogeneities in study design and outcome definitions, and thus were unable to perform a meta-analysis. The proportion of ICS responders ranged from 44% to 59%. Sensitivity and specificity ranged from 53% to 90%, and from 63% to 97%, respectively. The reported area under the curve ranged from about 0.60 to 0.87; however, studies with a prospective design and a lower prevalence of asthma had lower area under the curve values. None measured placebo effects or objective cough frequency. We did not find strong evidence to support the use of Feno tests for predicting ICS responsiveness in chronic cough. Further studies need to have a randomized, placebo-controlled design, and should use validated measurement tools for cough. Standardization would facilitate the development of clinical evidence. Copyright © 2016. Published by Elsevier Inc.

Cost-effectiveness and Budget Impact of Routine Use of Fractional Exhaled Nitric Oxide Monitoring for the Management of Adult Asthma Patients in Spain.

PubMed

Sabatelli, L; Seppälä, U; Sastre, J; Crater, G

Fractional exhaled nitric oxide (FeNO) is a marker for type 2 airway inflammation. The objective of this study was to evaluate the cost-effectiveness and budget impact of FeNO monitoring for management of adult asthma in Spain. A cost-effectiveness analysis model was used to evaluate the effect on costs of adding FeNO monitoring to asthma management. Over a 1-year period, the model estimated the incremental cost per quality-adjusted life year and incremental number of exacerbations avoided when FeNO monitoring was added to standard guideline-driven asthma care compared with standard care alone. Univariate and multivariate sensitivity analyses were applied to explore uncertainty in the model. A budget impact model was used to examine the impact of FeNO monitoring on primary care costs across the Spanish health system. The results showed that adding FeNO to standard asthma care saved €62.53 per patient-year in the adult population and improved quality-adjusted life years by 0.026 per patient-year. The budget impact analysis revealed a potential net yearly saving of €129 million if FeNO monitoring had been used in primary care settings in Spain. The present economic model shows that adding FeNO to the treatment algorithm can considerably reduce costs and improve quality of life when used to manage asthma in combination with current treatment guidelines.

Clinical trial on the efficacy of exhaled carbon monoxide measurement in smoking cessation in primary health care

PubMed Central

2012-01-01

Background Smoking cessation is beneficial for our health at any point in life, both in healthy people and in people already suffering from a smoking-related disease. Any help to quit smoking can produce considerable benefits for Public Health. The purpose of the present study is to evaluate the efficacy of the CO-oximetry technique together with brief advice in smoking cessation, in terms of reduction of the number of cigarettes or in the variation of the motivation to quit smoking at month 12 compared with brief advice alone. Methods/Design Randomised, parallel, single-blind clinical trial in a primary health care setting in Majorca (Spain). Smokers in contemplation or pre-contemplation phase will be included in the study. Exclusion criteria: Smokers in preparation phase, subjects with a terminal illness or whose health status does not allow them to understand the study or complete the informed consent, and pregnant or breastfeeding women. The subjects will be randomly assigned to the control group (CG) or the intervention group (IG). The CG will receive brief advice, and the IG will receive brief advice together with a measurement of exhaled CO. There will be follow-up evaluations at 6 and 12 months after inclusion. 471 subjects will be needed per group in order to detect a difference between groups ≥ 5%. Primary outcome: sustained smoking cessation (at 6 and 12 months) confirmed by urine cotinine test. Secondary outcomes: point smoking cessation at 6 and 12 months both confirmed by urine cotinine analysis and self-reported, reduction in cigarette consumption, and variation in phase of smoking cessation. Discussion CO-oximetry is an inexpensive, non-invasive, fast technique that requires little technical training; making it a technique for risk assessment in smokers that can be easily applied in primary care and, if proven effective, could serve as a reinforcement aid in smoking cessation intervention activities. Trial Registration Current Controlled

Relation between biomarkers in exhaled breath condensate and internal exposure to metals from gas metal arc welding.

PubMed

Hoffmeyer, Frank; Raulf-Heimsoth, Monika; Weiss, Tobias; Lehnert, Martin; Gawrych, Katarzyna; Kendzia, Benjamin; Harth, Volker; Henry, Jana; Pesch, Beate; Brüning, Thomas

2012-06-01

Concerning possible harmful components of welding fumes, besides gases and quantitative aspects of the respirable welding fumes, particle-inherent metal toxicity has to be considered.The objective of this study was to investigate the effect markers leukotriene B4 (LTB4),prostaglandin E2 (PGE2) and 8-isoprostane (8-Iso PGF2α) as well as the acid–base balance(pH) in exhaled breath condensate (EBC) of 43 full-time gas metal arc welders (20 smokers) in relation to welding fume exposure. We observed different patterns of iron, chromium and nickel in respirable welding fumes and EBC. Welders with undetectable chromium in EBC(group A, n = 24) presented high iron and nickel concentrations. In this group, higher 8-isoPGF2α and LTB4 concentrations could be revealed compared to welders with detectable chromium and low levels of both iron and nickel in EBC (group B): 8-iso PGF2α443.3 pg mL−1 versus 247.2 pg mL−1; p = 0.001 and LTB4 30.5 pg mL−1 versus 17.3 pgmL−1; p = 0.016. EBC-pH was more acid in samples of group B (6.52 versus 6.82; p = 0.011).Overall, effect markers in welders were associated with iron concentrations in EBC according to smoking habits--non-smokers/smokers: LTB4 (rs = 0.48; p = 0.02/rs = 0.21; p = 0.37),PGE2 (rs = 0.15; p = 0.59/rs = 0.47; p = 0.07), 8-iso PGF2α (rs = 0.18; p = 0.54/rs = 0.59;p = 0.06). Sampling of EBC in occupational research provides a matrix for the simultaneous monitoring of metal exposure and effects on target level. Our results suggest irritative effects in the airways of healthy welders. Further studies are necessary to assess whether these individual results might be used to identify welders at elevated risk for developing a respiratory disease.

Exhaled CO2 Parameters as a Tool to Assess Ventilation-Perfusion Mismatching during Neonatal Resuscitation in a Swine Model of Neonatal Asphyxia

PubMed Central

Li, Elliott Shang-shun; Cheung, Po-Yin; O'Reilly, Megan; LaBossiere, Joseph; Lee, Tze-Fun; Cowan, Shaun; Bigam, David L.; Schmölzer, Georg Marcus

2016-01-01

Background End-tidal CO2 (ETCO2), partial pressure of exhaled CO2 (PECO2), and volume of expired CO2 (VCO2) can be continuously monitored non-invasively to reflect pulmonary ventilation and perfusion status. Although ETCO2 ≥14mmHg has been shown to be associated with return of an adequate heart rate in neonatal resuscitation and quantifying the PECO2 has the potential to serve as an indicator of resuscitation quality, there is little information regarding capnometric measurement of PECO2 and ETCO2 in detecting return of spontaneous circulation (ROSC) and survivability in asphyxiated neonates receiving cardiopulmonary resuscitation (CPR). Methods Seventeen newborn piglets were anesthetized, intubated, instrumented, and exposed to 45-minute normocapnic hypoxia followed by apnea to induce asphyxia. Protocolized resuscitation was initiated when heart rate decreased to 25% of baseline. Respiratory and hemodynamic parameters including ETCO2, PECO2, VCO2, heart rate, cardiac output, and carotid artery flow were continuously measured and analyzed. Results There were no differences in respiratory and hemodynamic parameters between surviving and non-surviving piglets prior to CPR. Surviving piglets had significantly higher ETCO2, PECO2, VCO2, cardiac index, and carotid artery flow values during CPR compared to non-surviving piglets. Conclusion Surviving piglets had significantly better respiratory and hemodynamic parameters during resuscitation compared to non-surviving piglets. In addition to optimizing resuscitation efforts, capnometry can assist by predicting outcomes of newborns requiring chest compressions. PMID:26766424

BreathDx - molecular analysis of exhaled breath as a diagnostic test for ventilator-associated pneumonia: protocol for a European multicentre observational study.

PubMed

van Oort, Pouline M P; Nijsen, Tamara; Weda, Hans; Knobel, Hugo; Dark, Paul; Felton, Timothy; Rattray, Nicholas J W; Lawal, Oluwasola; Ahmed, Waqar; Portsmouth, Craig; Sterk, Peter J; Schultz, Marcus J; Zakharkina, Tetyana; Artigas, Antonio; Povoa, Pedro; Martin-Loeches, Ignacio; Fowler, Stephen J; Bos, Lieuwe D J

2017-01-03

The diagnosis of ventilator-associated pneumonia (VAP) remains time-consuming and costly, the clinical tools lack specificity and a bedside test to exclude infection in suspected patients is unavailable. Breath contains hundreds to thousands of volatile organic compounds (VOCs) that result from host and microbial metabolism as well as the environment. The present study aims to use breath VOC analysis to develop a model that can discriminate between patients who have positive cultures and who have negative cultures with a high sensitivity. The Molecular Analysis of Exhaled Breath as Diagnostic Test for Ventilator-Associated Pneumonia (BreathDx) study is a multicentre observational study. Breath and bronchial lavage samples will be collected from 100 and 53 intubated and ventilated patients suspected of VAP. Breath will be analysed using Thermal Desorption - Gas Chromatography - Mass Spectrometry (TD-GC-MS). The primary endpoint is the accuracy of cross-validated prediction for positive respiratory cultures in patients that are suspected of VAP, with a sensitivity of at least 99% (high negative predictive value). To our knowledge, BreathDx is the first study powered to investigate whether molecular analysis of breath can be used to classify suspected VAP patients with and without positive microbiological cultures with 99% sensitivity. UKCRN ID number 19086, registered May 2015; as well as registration at www.trialregister.nl under the acronym 'BreathDx' with trial ID number NTR 6114 (retrospectively registered on 28 October 2016).

Mechanics of lung ventilation in a post-metamorphic salamander, Ambystoma Tigrinum.

PubMed

Simons, R S; Bennett, W O; Brainerd, E L

2000-03-01

The mechanics of lung ventilation in frogs and aquatic salamanders has been well characterized, whereas lung ventilation in terrestrial-phase (post-metamorphic) salamanders has received little attention. We used electromyography (EMG), X-ray videography, standard videography and buccal and body cavity pressure measurements to characterize the ventilation mechanics of adult (post-metamorphic) tiger salamanders (Ambystoma tigrinum). Three results emerged: (i) under terrestrial conditions or when floating at the surface of the water, adult A. tigrinum breathed through their nares using a two-stroke buccal pump; (ii) in addition to this narial two-stroke pump, adult tiger salamanders also gulped air in through their mouths using a modified two-stroke buccal pump when in an aquatic environment; and (iii) exhalation in adult tiger salamanders is active during aquatic gulping breaths, whereas exhalation appears to be passive during terrestrial breathing at rest. Active exhalation in aquatic breaths is indicated by an increase in body cavity pressure during exhalation and associated EMG activity in the lateral hypaxial musculature, particularly the M. transversus abdominis. In terrestrial breathing, no EMG activity in the lateral hypaxial muscles is generally present, and body cavity pressure decreases during exhalation. In aquatic breaths, tidal volume is larger than in terrestrial breaths, and breathing frequency is much lower (approximately 1 breath 10 min(-)(1 )versus 4-6 breaths min(-)(1)). The use of hypaxial muscles to power active exhalation in the aquatic environment may result from the need for more complete exhalation and larger tidal volumes when breathing infrequently. This hypothesis is supported by previous findings that terrestrial frogs ventilate their lungs with small tidal volumes and exhale passively, whereas aquatic frogs and salamanders use large tidal volumes and and exhale actively.

Exercise-Induced Changes in Exhaled NO Differentiates Asthma With or Without Fixed Airway Obstruction From COPD With Dynamic Hyperinflation.

PubMed

Huang, Shu-Yi; Chou, Pai-Chien; Wang, Tsai-Yu; Lo, Yu-Lun; Joa, Wen-Ching; Chen, Li-Fei; Sheng, Te-Fang; Chung, Kian Fan; Wang, Chun-Hua; Kuo, Han-Pin

2016-04-01

Asthmatic patients with fixed airway obstruction (FAO) and patients with chronic obstructive pulmonary disease (COPD) share similarities in terms of irreversible pulmonary function impairment. Exhaled nitric oxide (eNO) has been documented as a marker of airway inflammation in asthma, but not in COPD. To examine whether the basal eNO level and the change after exercise may differentiate asthmatics with FAO from COPD, 27 normal subjects, 60 stable asthmatics, and 62 stable COPD patients were studied. Asthmatics with FAO (n = 29) were defined as showing a postbronchodilator FEV1/forced vital capacity (FVC) ≤70% and FEV1 less than 80% predicted after inhaled salbutamol (400 μg). COPD with dynamic hyperinflation (n = 31) was defined as a decrease in inspiratory capacity (ΔIC%) after a 6 minute walk test (6MWT). Basal levels of eNO were significantly higher in asthmatics and COPD patients compared to normal subjects. The changes in eNO after 6MWT were negatively correlated with the percent change in IC (r = -0.380, n = 29, P = 0.042) in asthmatics with FAO. Their levels of basal eNO correlated with the maximum mid-expiratory flow (MMEF % predicted) before and after 6MWT. In COPD patients with air-trapping, the percent change of eNO was positively correlated to ΔIC% (rs = 0.404, n = 31, P = 0.024). We conclude that asthma with FAO may represent residual inflammation in the airways, while dynamic hyperinflation in COPD may retain NO in the distal airspace. eNO changes after 6MWT may differentiate the subgroups of asthma or COPD patients and will help toward delivery of individualized therapy for airflow obstruction.

Exercise-Induced Changes in Exhaled NO Differentiates Asthma With or Without Fixed Airway Obstruction From COPD With Dynamic Hyperinflation

PubMed Central

Huang, Shu-Yi; Chou, Pai-Chien; Wang, Tsai-Yu; Lo, Yu-Lun; Joa, Wen-Ching; Chen, Li-Fei; Sheng, Te-Fang; Chung, Kian Fan; Wang, Chun-Hua; Kuo, Han-Pin

2016-01-01

Abstract Asthmatic patients with fixed airway obstruction (FAO) and patients with chronic obstructive pulmonary disease (COPD) share similarities in terms of irreversible pulmonary function impairment. Exhaled nitric oxide (eNO) has been documented as a marker of airway inflammation in asthma, but not in COPD. To examine whether the basal eNO level and the change after exercise may differentiate asthmatics with FAO from COPD, 27 normal subjects, 60 stable asthmatics, and 62 stable COPD patients were studied. Asthmatics with FAO (n = 29) were defined as showing a postbronchodilator FEV1/forced vital capacity (FVC) ≤70% and FEV1 less than 80% predicted after inhaled salbutamol (400 μg). COPD with dynamic hyperinflation (n = 31) was defined as a decrease in inspiratory capacity (ΔIC%) after a 6 minute walk test (6MWT). Basal levels of eNO were significantly higher in asthmatics and COPD patients compared to normal subjects. The changes in eNO after 6MWT were negatively correlated with the percent change in IC (r = −0.380, n = 29, P = 0.042) in asthmatics with FAO. Their levels of basal eNO correlated with the maximum mid-expiratory flow (MMEF % predicted) before and after 6MWT. In COPD patients with air-trapping, the percent change of eNO was positively correlated to ΔIC% (rs = 0.404, n = 31, P = 0.024). We conclude that asthma with FAO may represent residual inflammation in the airways, while dynamic hyperinflation in COPD may retain NO in the distal airspace. eNO changes after 6MWT may differentiate the subgroups of asthma or COPD patients and will help toward delivery of individualized therapy for airflow obstruction. PMID:27082615

Technologies for Clinical Diagnosis Using Expired Human Breath Analysis

PubMed Central

Mathew, Thalakkotur Lazar; Pownraj, Prabhahari; Abdulla, Sukhananazerin; Pullithadathil, Biji

2015-01-01

This review elucidates the technologies in the field of exhaled breath analysis. Exhaled breath gas analysis offers an inexpensive, noninvasive and rapid method for detecting a large number of compounds under various conditions for health and disease states. There are various techniques to analyze some exhaled breath gases, including spectrometry, gas chromatography and spectroscopy. This review places emphasis on some of the critical biomarkers present in exhaled human breath, and its related effects. Additionally, various medical monitoring techniques used for breath analysis have been discussed. It also includes the current scenario of breath analysis with nanotechnology-oriented techniques. PMID:26854142

Non-invasive measurements of exhaled NO and CO associated with methacholine responses in mice

PubMed Central

Sethi, Jigme M; Choi, Augustine MK; Calhoun, William J; Ameredes, Bill T

2008-01-01

Background Nitric oxide (NO) and carbon monoxide (CO) in exhaled breath are considered obtainable biomarkers of physiologic mechanisms. Therefore, obtaining their measures simply, non-invasively, and repeatedly, is of interest, and was the purpose of the current study. Methods Expired NO (ENO) and CO (ECO) were measured non-invasively using a gas micro-analyzer on several strains of mice (C57Bl6, IL-10-/-, A/J, MKK3-/-, JNK1-/-, NOS-2-/- and NOS-3-/-) with and without allergic airway inflammation (AI) induced by ovalbumin systemic sensitization and aerosol challenge, compared using independent-sample t-tests between groups, and repeated measures analysis of variance (ANOVA) within groups over time of inflammation induction. ENO and ECO were also measured in C57Bl6 and IL-10-/- mice, ages 8–58 weeks old, the relationship of which was determined by regression analysis. S-methionyl-L-thiocitrulline (SMTC), and tin protoporphyrin (SnPP) were used to inhibit neuronal/constitutive NOS-1 and heme-oxygenase, respectively, and alter NO and CO production, respectively, as assessed by paired t-tests. Methacholine-associated airway responses (AR) were measured by the enhanced pause method, with comparisons by repeated measures ANOVA and post-hoc testing. Results ENO was significantly elevated in naïve IL-10-/- (9–14 ppb) and NOS-2-/- (16 ppb) mice as compared to others (average: 5–8 ppb), whereas ECO was significantly higher in naïve A/J, NOS-3-/- (3–4 ppm), and MKK3-/- (4–5 ppm) mice, as compared to others (average: 2.5 ppm). As compared to C57Bl6 mice, AR of IL-10-/-, JNK1-/-, NOS-2-/-, and NOS-3-/- mice were decreased, whereas they were greater for A/J and MKK3-/- mice. SMTC significantly decreased ENO by ~30%, but did not change AR in NOS-2-/- mice. SnPP reduced ECO in C57Bl6 and IL-10-/- mice, and increased AR in NOS-2-/- mice. ENO decreased as a function of age in IL-10-/- mice, remaining unchanged in C57Bl6 mice. Conclusion These results are consistent with

Collecting Protein Biomarkers in Breath Using Electret Filters: A Preliminary Method on New Technical Model and Human Study.

PubMed

Li, Wang; Pi, Xitian; Qiao, Panpan; Liu, Hongying

2016-01-01

Biomarkers in exhaled breath are useful for respiratory disease diagnosis in human volunteers. Conventional methods that collect non-volatile biomarkers, however, necessitate an extensive dilution and sanitation processes that lowers collection efficiencies and convenience of use. Electret filter emerged in recent decade to collect virus biomarkers in exhaled breath given its simplicity and effectiveness. To investigate the capability of electret filters to collect protein biomarkers, a model that consists of an atomizer that produces protein aerosol and an electret filter that collects albumin and carcinoembryonic antigen-a typical biomarker in lung cancer development- from the atomizer is developed. A device using electret filter as the collecting medium is designed to collect human albumin from exhaled breath of 6 volunteers. Comparison of the collecting ability between the electret filter method and other 2 reported methods is finally performed based on the amounts of albumin collected from human exhaled breath. In conclusion, a decreasing collection efficiency ranging from 17.6% to 2.3% for atomized albumin aerosol and 42% to 12.5% for atomized carcinoembryonic antigen particles is found; moreover, an optimum volume of sampling human exhaled breath ranging from 100 L to 200 L is also observed; finally, the self-designed collecting device shows a significantly better performance in collecting albumin from human exhaled breath than the exhaled breath condensate method (p<0.05) but is not significantly more effective than reported 3-stage impactor method (p>0.05). In summary, electret filters are potential in collecting non-volatile biomarkers in human exhaled breath not only because it was simpler, cheaper and easier to use than traditional methods but also for its better collecting performance.

Hydrodynamics of Low Reynolds Respiratory-type Flows

NASA Astrophysics Data System (ADS)

Connor, Erin; True, Aaron; Crimaldi, John

2017-11-01

Both aquatic and terrestrial animals inhale surrounding fluid for metabolic and sensory purposes. As organisms inhale and exhale, complex fluid interactions occur both internal and external to the physiological orifice. Using both numerical and experimental approaches, we model an idealized respiratory flow consisting of cyclic inhalation and exhalation through a single cylindrical tube. We investigate the effect of varying Reynolds number (Re) as well as the ratio of the inhalation time to the exhalation time (I:E ratio) for a fixed inhalation volume. The numerical model is used for laminar cases at lower Re, whereas the experimental model permits the study to be extended into higher Reynolds numbers that include transitions to turbulence. We map the spatial distribution of both inhaled and exhaled fluid volumes. By comparing these two maps, we can compute the volume of exhaled fluid that is reingested during the subsequent inhalation. The models of interacting inhalation and exhalation exhibit a rich range of flow behaviors across Re number and I:E ratio. This study builds a foundation for more complex studies of animal respiration that will include more realistic morphologies.

Fractional exhaled nitric oxide (FeNO) among office workers in an academic institution, Malaysia--associations with asthma, allergies and office environment.

PubMed

Lim, Fang Lee; Hashim, Zailina; Md Said, Salmiah; Than, Leslie Thian Lung; Hashim, Jamal Hisham; Norbäck, Dan

2016-01-01

There are few studies on fractional exhaled nitric oxide (FeNO) and respiratory symptoms among adults in tropical areas. The aim was to study associations between FeNO and selected personal factors, respiratory symptoms, allergies, office characteristics and indoor office exposures among office workers (n = 460) from a university in Malaysia. Information on health was collected by a questionnaire, skin prick test and FeNO measurement. Temperature, relative air humidity, carbon monoxide and carbon dioxide were measured in the offices. Settled dust was vacuumed in the offices and analyzed for endotoxin, (1,3)-β-glucan and house dust mites allergens, namely Dermatophagoides pteronyssinus (Der p 1) and Dermatophagoides farinae (Der f 1). Two-level linear mixed models and multiple logistic regression were used to analyze the associations. One-fourth (25.9%) of the office workers had elevated FeNO level (≥ 25 ppb) and 61.5% had HDM, cat, seafood or pollen allergy. Male gender (p < 0.001), current smoking (p = 0.037), height (p < 0.001) and atopy (p < 0.001) were associated with FeNO. The amount of vacuumed dust was associated with FeNO among atopic subjects (p = 0.009). Asthma and rhinitis symptoms were associated with FeNO (p < 0.05), especially among atopic subjects. In particular, a combination of atopy and elevated FeNO were associated with doctor-diagnosed asthma (p < 0.001), rhinitis (p < 0.001) and airway symptoms last 12 months (p < 0.001). Gender, smoking, height and atopy are important risk factors for elevated FeNO levels. A combination of allergy testing and FeNO measurement could be useful in respiratory illness epidemiology studies and patient investigations in tropical areas.

The effect of omalizumab on small airway inflammation as measured by exhaled nitric oxide in moderate-to-severe asthmatic patients.

PubMed

Pasha, M Asghar; Jourd'heuil, David; Jourd'heuil, Francis; Mahon, Lori; Romero, Francisco; Feustel, Paul J; Evans, Mary; Smith, Thomas; Mitchell, Jesse; Gendapodi, Pradeep; Demeyere-Coursey, Kelly C; Townley, Robert G

2014-01-01

Measurement of fractional nitric oxide concentration in exhaled breath (FENO) is a simple, noninvasive method to evaluate eosinophilic airway inflammation. Nitric oxide (NO) arising from peripheral small airways/alveoli (alveolar NO concentration [CalvNO]) can be estimated using multiple flow rates and a two-compartment model of the airways and alveoli. Omalizumab, a monoclonal anti-IgE antibody, is approved for the treatment of allergic asthma and also has been shown to decrease FENO levels. This study investigates the effects of omalizumab, when added to an inhaled corticosteroid (ICS) ± long-acting beta-adrenergic agonist (LABA) treatment, on peripheral small airway/alveolar inflammation reflected by FENO measurements at higher flow rates. We hypothesized that compared with placebo, omalizumab would decrease CalvNO levels in asthmatic patients on ICS ± LABA. Forty-two patients with moderate-to-severe asthma were randomly assigned 2:1 to either omalizumab (n = 29) or placebo treatment (n = 13) for 16 weeks. Selection criteria included moderate-to-severe asthmatic patients on an ICS ± LABA, positive skin test to one or more perennial allergen, screening FENO of >13 ppb, and a baseline IgE of 30-700 IU/mL. FENO measured at multiple flow rates was used to calculate CalvNO over the course of 16 weeks. FENO levels decrease with increasing flow rates (p < 0.05 repeated measures ANOVA) but no differences between the placebo and treatment groups in overall CalvNO levels or in the changes of CalvNO with time were found. Omalizumab did not lower the CalvNO, which could have been caused by the initial low CalvNO in this asthmatic population. The model used may not be completely sufficient and/or sensitive enough to detect small changes in CalvNO.

Bronchoscopic lung-volume reduction with Exhale airway stents for emphysema (EASE trial): randomised, sham-controlled, multicentre trial.

PubMed

Shah, P L; Slebos, D-J; Cardoso, P F G; Cetti, E; Voelker, K; Levine, B; Russell, M E; Goldin, J; Brown, M; Cooper, J D; Sybrecht, G W

2011-09-10

Airway bypass is a bronchoscopic lung-volume reduction procedure for emphysema whereby transbronchial passages into the lung are created to release trapped air, supported with paclitaxel-coated stents to ease the mechanics of breathing. The aim of the EASE (Exhale airway stents for emphysema) trial was to evaluate safety and efficacy of airway bypass in people with severe homogeneous emphysema. We undertook a randomised, double-blind, sham-controlled study in 38 specialist respiratory centres worldwide. We recruited 315 patients who had severe hyperinflation (ratio of residual volume [RV] to total lung capacity of ≥0·65). By computer using a random number generator, we randomly allocated participants (in a 2:1 ratio) to either airway bypass (n=208) or sham control (107). We divided investigators into team A (masked), who completed pre-procedure and post-procedure assessments, and team B (unmasked), who only did bronchoscopies without further interaction with patients. Participants were followed up for 12 months. The 6-month co-primary efficacy endpoint required 12% or greater improvement in forced vital capacity (FVC) and 1 point or greater decrease in the modified Medical Research Council dyspnoea score from baseline. The composite primary safety endpoint incorporated five severe adverse events. We did Bayesian analysis to show the posterior probability that airway bypass was superior to sham control (success threshold, 0·965). Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00391612. All recruited patients were included in the analysis. At 6 months, no difference between treatment arms was noted with respect to the co-primary efficacy endpoint (30 of 208 for airway bypass vs 12 of 107 for sham control; posterior probability 0·749, below the Bayesian success threshold of 0·965). The 6-month composite primary safety endpoint was 14·4% (30 of 208) for airway bypass versus 11·2% (12 of 107) for sham control

FEV manoeuvre induced changes in breath VOC compositions: an unconventional view on lung function tests

NASA Astrophysics Data System (ADS)

Sukul, Pritam; Schubert, Jochen K.; Oertel, Peter; Kamysek, Svend; Taunk, Khushman; Trefz, Phillip; Miekisch, Wolfram

2016-06-01

Breath volatile organic compound (VOC) analysis can open a non-invasive window onto pathological and metabolic processes in the body. Decades of clinical breath-gas analysis have revealed that changes in exhaled VOC concentrations are important rather than disease specific biomarkers. As physiological parameters, such as respiratory rate or cardiac output, have profound effects on exhaled VOCs, here we investigated VOC exhalation under respiratory manoeuvres. Breath VOCs were monitored by means of real-time mass-spectrometry during conventional FEV manoeuvres in 50 healthy humans. Simultaneously, we measured respiratory and hemodynamic parameters noninvasively. Tidal volume and minute ventilation increased by 292 and 171% during the manoeuvre. FEV manoeuvre induced substance specific changes in VOC concentrations. pET-CO2 and alveolar isoprene increased by 6 and 21% during maximum exhalation. Then they decreased by 18 and 37% at forced expiration mirroring cardiac output. Acetone concentrations rose by 4.5% despite increasing minute ventilation. Blood-borne furan and dimethyl-sulphide mimicked isoprene profile. Exogenous acetonitrile, sulphides, and most aliphatic and aromatic VOCs changed minimally. Reliable breath tests must avoid forced breathing. As isoprene exhalations mirrored FEV performances, endogenous VOCs might assure quality of lung function tests. Analysis of exhaled VOC concentrations can provide additional information on physiology of respiration and gas exchange.

FEV manoeuvre induced changes in breath VOC compositions: an unconventional view on lung function tests

PubMed Central

Sukul, Pritam; Schubert, Jochen K.; Oertel, Peter; Kamysek, Svend; Taunk, Khushman; Trefz, Phillip; Miekisch, Wolfram

2016-01-01

Breath volatile organic compound (VOC) analysis can open a non-invasive window onto pathological and metabolic processes in the body. Decades of clinical breath-gas analysis have revealed that changes in exhaled VOC concentrations are important rather than disease specific biomarkers. As physiological parameters, such as respiratory rate or cardiac output, have profound effects on exhaled VOCs, here we investigated VOC exhalation under respiratory manoeuvres. Breath VOCs were monitored by means of real-time mass-spectrometry during conventional FEV manoeuvres in 50 healthy humans. Simultaneously, we measured respiratory and hemodynamic parameters noninvasively. Tidal volume and minute ventilation increased by 292 and 171% during the manoeuvre. FEV manoeuvre induced substance specific changes in VOC concentrations. pET-CO2 and alveolar isoprene increased by 6 and 21% during maximum exhalation. Then they decreased by 18 and 37% at forced expiration mirroring cardiac output. Acetone concentrations rose by 4.5% despite increasing minute ventilation. Blood-borne furan and dimethyl-sulphide mimicked isoprene profile. Exogenous acetonitrile, sulphides, and most aliphatic and aromatic VOCs changed minimally. Reliable breath tests must avoid forced breathing. As isoprene exhalations mirrored FEV performances, endogenous VOCs might assure quality of lung function tests. Analysis of exhaled VOC concentrations can provide additional information on physiology of respiration and gas exchange. PMID:27311826

Short-Term Intra-Subject Variation in Exhaled Volatile Organic Compounds (VOCs) in COPD Patients and Healthy Controls and Its Effect on Disease Classification

PubMed Central

Phillips, Christopher; Mac Parthaláin, Neil; Syed, Yasir; Deganello, Davide; Claypole, Timothy; Lewis, Keir

2014-01-01

Exhaled volatile organic compounds (VOCs) are of interest for their potential to diagnose disease non-invasively. However, most breath VOC studies have analyzed single breath samples from an individual and assumed them to be wholly consistent representative of the person. This provided the motivation for an investigation of the variability of breath profiles when three breath samples are taken over a short time period (two minute intervals between samples) for 118 stable patients with Chronic Obstructive Pulmonary Disease (COPD) and 63 healthy controls and analyzed by gas chromatography and mass spectroscopy (GC/MS). The extent of the variation in VOC levels differed between COPD and healthy subjects and the patterns of variation differed for isoprene versus the bulk of other VOCs. In addition, machine learning approaches were applied to the breath data to establish whether these samples differed in their ability to discriminate COPD from healthy states and whether aggregation of multiple samples, into single data sets, could offer improved discrimination. The three breath samples gave similar classification accuracy to one another when evaluated separately (66.5% to 68.3% subjects classified correctly depending on the breath repetition used). Combining multiple breath samples into single data sets gave better discrimination (73.4% subjects classified correctly). Although accuracy is not sufficient for COPD diagnosis in a clinical setting, enhanced sampling and analysis may improve accuracy further. Variability in samples, and short-term effects of practice or exertion, need to be considered in any breath testing program to improve reliability and optimize discrimination. PMID:24957028

Short-Term Intra-Subject Variation in Exhaled Volatile Organic Compounds (VOCs) in COPD Patients and Healthy Controls and Its Effect on Disease Classification.

PubMed

Phillips, Christopher; Mac Parthaláin, Neil; Syed, Yasir; Deganello, Davide; Claypole, Timothy; Lewis, Keir

2014-05-09

Exhaled volatile organic compounds (VOCs) are of interest for their potential to diagnose disease non-invasively. However, most breath VOC studies have analyzed single breath samples from an individual and assumed them to be wholly consistent representative of the person. This provided the motivation for an investigation of the variability of breath profiles when three breath samples are taken over a short time period (two minute intervals between samples) for 118 stable patients with Chronic Obstructive Pulmonary Disease (COPD) and 63 healthy controls and analyzed by gas chromatography and mass spectroscopy (GC/MS). The extent of the variation in VOC levels differed between COPD and healthy subjects and the patterns of variation differed for isoprene versus the bulk of other VOCs. In addition, machine learning approaches were applied to the breath data to establish whether these samples differed in their ability to discriminate COPD from healthy states and whether aggregation of multiple samples, into single data sets, could offer improved discrimination. The three breath samples gave similar classification accuracy to one another when evaluated separately (66.5% to 68.3% subjects classified correctly depending on the breath repetition used). Combining multiple breath samples into single data sets gave better discrimination (73.4% subjects classified correctly). Although accuracy is not sufficient for COPD diagnosis in a clinical setting, enhanced sampling and analysis may improve accuracy further. Variability in samples, and short-term effects of practice or exertion, need to be considered in any breath testing program to improve reliability and optimize discrimination.

Determination of patterns of biologically relevant aldehydes in exhaled breath condensate of healthy subjects by liquid chromatography/atmospheric chemical ionization tandem mass spectrometry

PubMed Central

Andreoli, Roberta; Manini, Paola; Corradi, Massimo; Mutti, Antonio; Niessen, Wilfried M. A.

2006-01-01

A method for the simultaneous determination of several classes of aldehydes in exhaled breath condensate (EBC) was developed using liquid chromatography/atmospheric pressure chemical ionization tandem mass spectrometry (LC/APCI-MS/MS). EBC is a biological matrix obtained by a relatively new, simple and noninvasive technique and provides an indirect assessment of pulmonary status. The measurement of aldehydes in EBC represents a biomarker of the effect of oxidative stress caused by smoke, disease, or strong oxidants like ozone. Malondialdehyde (MDA), acrolein, α,β-unsaturated hydroxylated aldehydes [namely 4-hydroxyhexenal (4-HHE) and 4-hydroxynonenal (4-HNE)], and saturated aldehydes (n-hexanal, n-heptanal and n-nonanal) were measured in EBC after derivatization with 2,4-dinitrophenylhydrazine (DNPH). Atmospheric pressure chemical ionization of the analytes was obtained in positiveion mode for MDA, and in negativeion mode for acrolein, 4-HHE, 4-HNE, and saturated aldehydes. DNPH derivatives were separated on a C18 column using variable proportions of 20 mM aqueous acetic acid and methanol. Linearity was established over 4–5 orders of magnitude and limits of detection were in the 0.3–1.0 nM range. Intra-day and inter-day precision were in the 1.3–9.9% range for all the compounds. MDA, acrolein and n-alkanals were detectable in all EBC samples, whereas the highly reactive 4-HHE and 4-HNE were found in only a few samples. Statistically significant higher concentrations of MDA, acrolein and n-hexanal were found in EBC from smokers. PMID:12661015

'Opt-out' referrals after identifying pregnant smokers using exhaled air carbon monoxide: impact on engagement with smoking cessation support.

PubMed

Campbell, Katarzyna A; Cooper, Sue; Fahy, Samantha J; Bowker, Katharine; Leonardi-Bee, Jo; McEwen, Andy; Whitemore, Rachel; Coleman, Tim

2017-05-01

In the UK, free smoking cessation support is available to pregnant women; only a minority accesses this. 'Opt-out' referrals to stop smoking services (SSS) are recommended by UK guidelines. These involve identifying pregnant smokers using exhaled carbon monoxide (CO) and referring them for support unless they object. To assess the impact of 'opt-out' referrals for pregnant smokers on SSS uptake and effectiveness, we conducted a 'before-after' service development evaluation. In the 6-month 'before' period, there was a routine 'opt-in' referral system for self-reported smokers at antenatal 'booking' appointments. In the 6-month 'after' period, additional 'opt-out' referrals were introduced at the 12-week ultrasound appointments; women with CO≥4 ppm were referred to, and outcome data were collected from, local SSS. Approximately 2300 women attended antenatal care in each period. Before the implementation, 536 (23.4%) women reported smoking at 'booking' and 290 (12.7%) were referred to SSS. After the implementation, 524 (22.9%) women reported smoking at 'booking', an additional 156 smokers (6.8%) were identified via the 'opt-out' referrals and, in total, 421 (18.4%) were referred to SSS. Over twice as many women set a quit date with the SSS after 'opt-out' referrals were implemented (121 (5.3%, 95% CI 4.4% to 6.3%) compared to 57 (2.5%, 95% CI 1.9% to 3.2%) before implementation) and reported being abstinent 4 weeks later (93 (4.1%, 95% CI 3.3% to 4.9%) compared to 46 (2.0%, 1.5% to 2.7%) before implementation). In a hospital with an 'opt-in' referral system, adding CO screening with 'opt-out' referrals as women attended ultrasound examinations doubled the numbers of pregnant smokers setting quit dates and reporting smoking cessation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Decreased expression of indolamine 2,3-dioxygenase in childhood allergic asthma and its inverse correlation with fractional concentration of exhaled nitric oxide.

PubMed

Hu, Ying; Chen, Zhiqiang; Jin, Ling; Wang, Mei; Liao, Wei

2017-11-01

The tryptophan metabolic pathway mediated by indolamine 2,3-dioxygenase (IDO), a tryptophan-degrading enzyme, plays an important role in controlling the development of allergic inflammation. The fractional concentration of exhaled nitric oxide (FeNO) is closely associated with the allergic state and is extensively used for the clinical evaluation of airway allergic inflammation. Clinical trials have rarely assessed the expression of IDO in childhood allergic asthma and its correlation with FeNO. To evaluate the IDO level in children with childhood allergic asthma and the relation between IDO levels and FeNO. Thirty children older than 5 years who were diagnosed the first time with allergic asthma were selected from the pediatric outpatient department. Another 30 healthy children were selected as controls. The subjects were evaluated by complete medical history, pulmonary function test results, skin prick test reaction, FeNO concentration test result, eosinophil count, and a disease severity score. Peripheral venous blood and induced sputum were obtained to measure the concentrations of IDO metabolites (ie, tryptophan and kynurenine). The IDO levels in the peripheral blood and induced sputum were significantly lower in patients with childhood allergic asthma than in children in the control group. The IDO level was negatively correlated with FeNO but was not significantly correlated with age, sex, blood eosinophil count, or disease severity scale. The expression of IDO was significantly lower in childhood allergic asthma, particularly in children with high FeNO levels. There was no significant relation between IDO levels and asthma severity. Chinese Clinical Trial Register (www.chictr.org.cn) Identifier: ChiCTR-COC-15006080. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Environmental and personal determinants of the uptake of disinfection by-products during swimming.

PubMed

Font-Ribera, Laia; Kogevinas, Manolis; Schmalz, Christina; Zwiener, Christian; Marco, Esther; Grimalt, Joan O; Liu, Jiaqi; Zhang, Xiangru; Mitch, William; Critelli, Rossana; Naccarati, Alessio; Heederik, Dick; Spithoven, Jack; Arjona, Lourdes; de Bont, Jeroen; Gracia-Lavedan, Esther; Villanueva, Cristina M

2016-08-01

Trihalomethanes (THMs) in exhaled breath and trichloroacetic acid (TCAA) in urine are internal dose biomarkers of exposure to disinfection by-products (DBPs) in swimming pools. We assessed how these biomarkers reflect the levels of a battery of DBPs in pool water and trichloramine in air, and evaluated personal determinants. A total of 116 adults swam during 40min in a chlorinated indoor pool. We measured chloroform, bromodichloromethane, dibromochloromethane and bromoform in exhaled breath and TCAA in urine before and after swimming, trichloramine in air and several DBPs in water. Personal determinants included sex, age, body mass index (BMI), distance swum, energy expenditure, heart rate and 12 polymorphisms in GSTT1, GSTZ1 and CYP2E1 genes. Median level of exhaled total THMs and creatinine adjusted urine TCAA increased from 0.5 to 14.4µg/m(3) and from 2.5 to 5.8µmol/mol after swimming, respectively. The increase in exhaled brominated THMs was correlated with brominated THMs, haloacetic acids, haloacetonitriles, haloketones, chloramines, total organic carbon and total organic halogen in water and trichloramine in air. Such correlations were not detected for exhaled chloroform, total THMs or urine TCAA. Exhaled THM increased more in men, urine TCAA increased more in women, and both were affected by exercise intensity. Genetic variants were associated with differential increases in exposure biomarkers. Our findings suggest that, although affected by sex, physical activity and polymorphisms in key metabolizing enzymes, brominated THMs in exhaled breath could be used as a non-invasive DBP exposure biomarker in swimming pools with bromide-containing source waters. This warrants confirmation with new studies. Copyright © 2016 Elsevier Inc. All rights reserved.

Effect of oral arginine supplementation on exhaled nitric oxide concentration in sickle cell anemia and acute chest syndrome.

PubMed

Sullivan, Kevin Joseph; Kissoon, Niranjan; Sandler, Eric; Gauger, Cynthia; Froyen, Melanie; Duckworth, Laurie; Brown, Martha; Murphy, Suzanne

2010-10-01

Decreased exhaled nitric oxide levels (FE(NO)) have been described in patients with sickle cell disease (SCD) and a history of acute chest syndrome (ACS) when compared with non-ACS controls. Oral arginine supplementation has been shown to increase FE(NO) in healthy participants, but its effect in SCD patients is not known. To determine the effect of oral arginine intake on FENO in sickle cell patients with and without history of ACS, and in healthy controls. No differences in the FE(NO) increase were seen in SCD patients with a history of ACS (ACS+) compared with healthy controls (HC) and SCD patients without history of ACS (ACS-). ACS+ (n=6), ACS- (n=9), and HC (n=7) patients were studied. At baseline, and after the administration of escalating doses of oral L-arginine (0.1, 0.2, and 0.4 g/kg), serial measurements were made of the following: FE(NO), plasma concentrations of arginine, ornithine, citrulline, aspartate, glutamate, arginine/ornithine ratio, nitrite, nitrate, heart rate (HR), respiratory rate (RR), blood pressure (BP), oxygen saturation (SpO2), forced expiratory volume in 1 second (FEV1), and forced vital capacity (FVC). At baseline, FE(NO) did not differ among the groups. ACS- and ACS+ groups were deficient in arginine, and had decreased FEV1, FVC, and SaO2 when compared with HC patients. After arginine supplementation, FE(NO), arginine, ornithine, citrulline, nitrite, and the arginine/ornithine ratio increased similarly in all groups. Changes from baseline for HR, BP, SpO2, RR, FEV1, and FVC were minimal and similar in all groups. In contrast to our earlier study, ACS+ patients had similar FE(NO) values when compared with ACS- and HC patients. All SCD patients were arginine deficient at baseline and showed impairment in respiratory physiology when compared with HC patients. After arginine supplementation, FE(NO) concentration increased in all groups to a similar degree, and lung function and physiologic parameters were minimally affected. The

Irreversible airway obstruction assessed by high-resolution computed tomography (HRCT), exhaled nitric oxide (FENO), and biological markers in induced sputum in patients with asthma.

PubMed

Zhang, Lanlan; Gang, Jin; Zhigang, Cao; Yali, Cui; Baozhong, Shen; Fangbiao, Zhang; Liu, Chuntao

2014-09-01

The objective of this study was to explore the significance of assessing irreversible airway obstruction (IAO) in asthma patients by high-resolution computed tomography (HRCT), biological markers in induced sputum, and exhaled nitric oxide (FENO). The study was conducted in 34 patients with IAO, 46 patients with reversible airway obstruction (RAO), 40 patients who did not have airway obstruction (NAO), and 40 healthy subjects serving as controls. These patients received a step therapy for at least 3 months based on the guidelines for the prevention and treatment of asthma. After achieving complete or partial control of asthma, HRCT, lung function, FENO, and chemokine levels in induced sputum were measured. The airway wall area (WA; %) correlated with forced expiratory volume-1 (FEV-1(L); r = -0.67, p < 0.0001), and significant differences in bronchial wall thickening (BWT) of the LEVEL E generation airways were observed between the asthma and control groups (p < 0.01). FENO levels correlated with FEV-1 (%) in the IAO group (r = 0.49, p = 0.01). The levels of matrix metalloproteases-9 (MMP-9) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in asthma patients with IAO, RAO, and NAO were significantly higher than those in the controls (p < 0.05). The level of neutrophilia in the sputum from the IAO group was higher than that from the RAO, NAO and control groups. Asthma patients with IAO have an increased BWT. Airway measurements with HRCT scans appear to be valuable in the evaluation of airway remodeling in asthma patients with IAO.

Pulmonary function tests

MedlinePlus

... exhale, and how quickly you exhale, spirometry can evaluate a broad range of lung diseases. In a ... expiratory volume in 1 second (FEV1) Forced expiratory flow 25% to 75% (FEF25-75) Functional residual capacity ( ...

Nanoscale PdO Catalyst Functionalized Co3O4 Hollow Nanocages Using MOF Templates for Selective Detection of Acetone Molecules in Exhaled Breath.

PubMed

Koo, Won-Tae; Yu, Sunmoon; Choi, Seon-Jin; Jang, Ji-Soo; Cheong, Jun Young; Kim, Il-Doo

2017-03-08

The increase of surface area and the functionalization of catalyst are crucial to development of high-performance semiconductor metal oxide (SMO) based chemiresistive gas sensors. Herein, nanoscale catalyst loaded Co 3 O 4 hollow nanocages (HNCs) by using metal-organic framework (MOF) templates have been developed as a new sensing platform. Nanoscale Pd nanoparticles (NPs) were easily loaded on the cavity of Co based zeolite imidazole framework (ZIF-67). The porous structure of ZIF-67 can restrict the size of Pd NPs (2-3 nm) and separate Pd NPs from each other. Subsequently, the calcination of Pd loaded ZIF-67 produced the catalytic PdO NPs functionalized Co 3 O 4 HNCs (PdO-Co 3 O 4 HNCs). The ultrasmall PdO NPs (3-4 nm) are well-distributed in the wall of Co 3 O 4 HNCs, the unique structure of which can provide high surface area and high catalytic activity. As a result, the PdO-Co 3 O 4 HNCs exhibited improved acetone sensing response (R gas /R air = 2.51-5 ppm) compared to PdO-Co 3 O 4 powders (R gas /R air = 1.98), Co 3 O 4 HNCs (R gas /R air = 1.96), and Co 3 O 4 powders (R gas /R air = 1.45). In addition, the PdO-Co 3 O 4 HNCs showed high acetone selectivity against other interfering gases. Moreover, the sensor array clearly distinguished simulated exhaled breath of diabetics from healthy people's breath. These results confirmed the novel synthesis of MOF templated nanoscale catalyst loaded SMO HNCs for high performance gas sensors.

Biomarkers of exposure to stainless steel tungsten inert gas welding fumes and the effect of exposure on exhaled breath condensate.

PubMed

Riccelli, Maria Grazia; Goldoni, Matteo; Andreoli, Roberta; Mozzoni, Paola; Pinelli, Silvana; Alinovi, Rossella; Selis, Luisella; Mutti, Antonio; Corradi, Massimo

2018-08-01

The respiratory tract is the main target organ of the inhaled hexavalent chromium (Cr-VI) and nickel (Ni) contained in stainless steel (SS) welding fumes (WFs). The aim of this study was to investigate the Cr and Ni content of the exhaled breath condensate (EBC) of SS tungsten inert gas (TIG) welders, and relate their concentrations with oxidative stress and inflammatory biomarkers. EBC and urine from 100 SS TIG welders were collected pre-(T 0 ) and post-shift (T 1 ) on a Friday, and pre-shift (T 2 ) on the following Monday morning. Both EBC and urinary Cr concentrations were higher at T 1 (0.08 μg/L and 0.71 μg/g creatinine) and T 0 (0.06 μg/L and 0.74 μg/g creatinine) than at T 2 (below the limit of detection [LOD] and 0.59 μg/g creatinine), and EBC Ni concentrations generally remained

Adequacy of inhale/exhale breathhold CT based ITV margins and image-guided registration for free-breathing pancreas and liver SBRT.

PubMed

Yang, Wensha; Fraass, Benedick A; Reznik, Robert; Nissen, Nicholas; Lo, Simon; Jamil, Laith H; Gupta, Kapil; Sandler, Howard; Tuli, Richard

2014-01-09

To evaluate use of breath-hold CTs and implanted fiducials for definition of the internal target volume (ITV) margin for upper abdominal stereotactic body radiation therapy (SBRT). To study the statistics of inter- and intra-fractional motion information. 11 patients treated with SBRT for locally advanced pancreatic cancer (LAPC) or liver cancer were included in the study. Patients underwent fiducial implantation, free-breathing CT and breath-hold CTs at end inhalation/exhalation. All patients were planned and treated with SBRT using volumetric modulated arc therapy (VMAT). Two margin strategies were studied: Strategy I uses PTV = ITV + 3 mm; Strategy II uses PTV = GTV + 1.5 cm. Both CBCT and kV orthogonal images were taken and analyzed for setup before patient treatments. Tumor motion statistics based on skeletal registration and on fiducial registration were analyzed by fitting to Gaussian functions. All 11 patients met SBRT planning dose constraints using strategy I. Average ITV margins for the 11 patients were 2 mm RL, 6 mm AP, and 6 mm SI. Skeletal registration resulted in high probability (RL = 69%, AP = 4.6%, SI = 39%) that part of the tumor will be outside the ITV. With the 3 mm ITV expansion (Strategy 1), the probability reduced to RL 32%, AP 0.3%, SI 20% for skeletal registration; and RL 1.2%, AP 0%, SI 7% for fiducial registration. All 7 pancreatic patients and 2 liver patients failed to meet SBRT dose constraints using strategy II. The liver dose was increased by 36% for the other 2 liver patients that met the SBRT dose constraints with strategy II. Image guidance matching to skeletal anatomy is inadequate for SBRT positioning in the upper abdomen and usage of fiducials is highly recommended. Even with fiducial implantation and definition of an ITV, a minimal 3 mm planning margin around the ITV is needed to accommodate intra-fractional uncertainties.

Clinical applications of exhaled nitric oxide for the diagnosis and management of asthma: a consensus report.

PubMed

Zitt, Myron

2005-08-01

Patients with asthma routinely exhibit elevated levels of fractionated exhaled nitric oxide (FE(NO)), and this observation has led to studies investigating FE(NO) as a potential marker of airway inflammation. FE(NO) has been shown to enhance the diagnosis of asthma, detect deterioration in control of patients with asthma, and monitor response to anti-inflammatory therapy. The aim of this work was to determine if FE(NO) measurement provides a noninvasive, well-tolerated, and standardized technique to monitor airway inflammation, and if it has the potential to complement standard asthma monitoring tools (eg, symptom diaries, control questionnaires, and pulmonary function testing) and to improve asthma control and patient outcomes. Thirteen experts in the diagnosis and treatment of asthma met to discuss the use of FE(NO) in the diagnosis and management of patients with asthma. Participants were selected by Aerocrine, a medical, technical company with headquarters in Stockholm, Sweden, in consultation with their medical education partner Cadent Medical Communications located in Irving, Texas, to represent a diversity of specialists, including both clinicians and investigators, in the fields of allergy, immunology, and pulmonology. All participants were nominally compensated for their time to attend this closed scientific roundtable discussion. The meeting was supported by an educational grant from Aerocrine. This report represents the overall consensus reached by the participants on the clinical applicability of this technique. Our understanding of asthma has expanded so that investigators are now focusing on inflammation in addition to airway obstruction and hyper-reactivity. Whereas patient history, symptoms, and pulmonary function testing can assist in diagnosing asthma, they are not direct measures of the extent of airway inflammation. Elevated FE(NO) levels have been shown to reflect airway inflammation and to occur together with other conventional markers used to

Comparison of two exhaled nitric oxide analyzers: the NIOX MINO hand-held electrochemical analyzer and the NOA280i stationary chemiluminescence analyzer.

PubMed

Kim, Sang-Heon; Moon, Ji-Yong; Kwak, Hyun Jung; Kim, Sa Il; Park, Dong Won; Kim, Jee Woo; Kim, Tae Hyung; Sohn, Jang Won; Shin, Dong Ho; Park, Sung Soo; Yoon, Ho Joo

2012-07-01

Measurement of the fraction of nitric oxide (FeNO) in exhaled air is useful in the management of asthma. A new hand-held nitric oxide (NO) analyzer, the NIOX MINO, is simple and easy to use in clinical practice. In this study, FeNO values measured using the NIOX MINO were compared with those obtained using a stationary chemiluminescence analyzer, the Sievers NOA280i. FeNO was measured in 100 adults, using both the NIOX MINO and the NOA280i. Nine (9.0%) of these subjects had asthma. The first acceptable measurement with the NIOX MINO and the mean of two acceptable measurements with the NOA280i were compared. There was a significant correlation between FeNO concentrations measured with the two devices (r = 0.876, P < 0.001). A Bland-Altman plot showed a high degree of agreement between the two devices: the mean inter-device difference was 3.3 parts per billion (ppb), and the 95% limits of agreement were -7.0 and 13.6 ppb. In addition, the mean relative difference was 14.5%, with the 95% limits of agreement being -33.7 and 62.7%. The mean value (± standard error of the mean) for FeNO as measured with the NIOX MINO (18.8 ± 0.9 ppb) was significantly lower than that measured with the NOA280i (22.1 ± 1.2 ppb, P < 0.001). There was a significant correlation, but only moderate agreement, between FeNO values measured with the NIOX MINO and those measured with the NOA280i, with the NIOX MINO values being significantly lower than the NOA280i values. Significant differences in FeNO values obtained with these two NO analyzers should be considered when interpreting the results of FeNO measurements. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thrall, Karla D.; Schwartz, Ronald E.; Weitz, Karl K.

Nasal dosimetry models have become increasingly quantitative as insights into tissue deposition/clearance and computational fluid dynamics have become available. Validation of these models requires sufficient experimental data. However, investigations into respiratory deposition, particularly in human volunteers, have been historically limited due to methodological limitations. To overcome this, a method for evaluating the nasal wash-in, wash-out phenomena of a highly water-soluble compound in human volunteers was developed and characterized. This methodology was assessed using controlled human inhalation exposures to uniformly labeled 13C-acetone at approximately 1 ppm concentration for 30 minutes under different breathing maneuvers (inhale nose/exhale nose; inhale nose/exhale mouth; inhalemore » mouth/exhale nose). A small-diameter air-sampling probe inserted in the nasopharyngeal cavity of the volunteer was connected directly to an ion-trap mass spectrometer capable of sampling every 0.8 sec. A second ion-trap mass spectrometer simultaneously sampled from the volunteer?s exhaled breath stream via a breath-inlet device interface. Together, the two mass spectrometers provided real-time appraisal of the 13C-acetone concentrations in the nasopharyngeal region and in the exhaled breath stream before, during, and after the different breathing maneuvers. The breathing cycle (depth and frequency) and heart rate were concurrently monitored throughout the exposure using a heart rate monitor and a human plethysmograph to differentiate inhalation and exhalation. Graphical overlay of the plethysmography results with the mass spectrometer measurements show clear quantifiable differences in 13C-acetone levels at the nasal probe as a function of breathing maneuvers. Breath-by-breath analysis of 13C-acetone concentrations indicate that between 40-75% of the compound is absorbed upon inhalation and nearly all of that absorbed released back into the breath stream during

Ammonia and ethylene biomarkers in the respiration of the people with schizophrenia using photoacoustic spectroscopy

NASA Astrophysics Data System (ADS)

Popa, Cristina; Petrus, Mioara; Bratu, Ana Maria

2015-05-01

Oxidative stress has become an exciting area of schizophrenia (SCZ) research, and provides ample opportunities and hope for a better understanding of its pathophysiology, which may lead to new treatment strategies. The first objective of the present study was to analyze the oxidative stress markers in breath samples of patients with SCZ before and after the treatment with Levomepromazine. The second objective was to analyze the deficiency of amino acids marker in breath samples of patients with SCZ before and after the treatment. Exhaled breath was collected from 15 SCZ patients and 19 healthy controls; subsequently, CO2 laser photoacoustic spectroscopy was used to assess the exhaled breath compounds of the study subjects. One of the main breath biomarkers of the oxidative stress is ethylene, while one of the main breath biomarkers of the amino acids deficiency is ammonia. The breath biomarkers in the exhalation of SCZ patients exhibited significant differences from the breath biomarkers in the exhalation of healthy controls. Analysis of breath ethylene and breath ammonia provides a related model of SCZ exhalation that could represent an effective and convenient screening method for this intellectual disability.

Screening of patients with bronchopulmonary diseases using methods of infrared laser photoacoustic spectroscopy and principal component analysis

NASA Astrophysics Data System (ADS)

Kistenev, Yury V.; Karapuzikov, Alexander I.; Kostyukova, Nadezhda Yu.; Starikova, Marina K.; Boyko, Andrey A.; Bukreeva, Ekaterina B.; Bulanova, Anna A.; Kolker, Dmitry B.; Kuzmin, Dmitry A.; Zenov, Konstantin G.; Karapuzikov, Alexey A.

2015-06-01

A human exhaled air analysis by means of infrared (IR) laser photoacoustic spectroscopy is presented. Eleven healthy nonsmoking volunteers (control group) and seven patients with chronic obstructive pulmonary disease (COPD, target group) were involved in the study. The principal component analysis method was used to select the most informative ranges of the absorption spectra of patients' exhaled air in terms of the separation of the studied groups. It is shown that the data of the profiles of exhaled air absorption spectrum in the informative ranges allow identifying COPD patients in comparison to the control group.

Impact of Exhaled Breath Acetone in the Prognosis of Patients with Heart Failure with Reduced Ejection Fraction (HFrEF). One Year of Clinical Follow-up

PubMed Central

Saldiva, Paulo H. N.; Mangini, Sandrigo; Issa, Victor S.; Ayub-Ferreira, Silvia M.; Bocchi, Edimar A.

2016-01-01

Background The identification of new biomarkers of heart failure (HF) could help in its treatment. Previously, our group studied 89 patients with HF and showed that exhaled breath acetone (EBA) is a new noninvasive biomarker of HF diagnosis. However, there is no data about the relevance of EBA as a biomarker of prognosis. Objectives To evaluate whether EBA could give prognostic information in patients with heart failure with reduced ejection fraction (HFrEF). Methods After breath collection and analysis by gas chromatography-mass spectrometry and by spectrophotometry, the 89 patients referred before were followed by one year. Study physicians, blind to the results of cardiac biomarker testing, ascertained vital status of each study participant at 12 months. Results The composite endpoint death and heart transplantation (HT) were observed in 35 patients (39.3%): 29 patients (32.6%) died and 6 (6.7%) were submitted to HT within 12 months after study enrollment. High levels of EBA (≥3.7μg/L, 50th percentile) were associated with a progressively worse prognosis in 12-month follow-up (log-rank = 11.06, p = 0.001). Concentrations of EBA above 3.7μg/L increased the risk of death or HT in 3.26 times (HR = 3.26, 95%CI = 1.56–6.80, p = 0.002) within 12 months. In a multivariable cox regression model, the independent predictors of all-cause mortality were systolic blood pressure, respiratory rate and EBA levels. Conclusions High EBA levels could be associated to poor prognosis in HFrEF patients. PMID:28030609

Environmental factors associated with baseline and serial changes in fractional exhaled nitric oxide (FeNO) in spice mill workers.

PubMed

Van der Walt, Anita; Baatjies, Roslynn; Singh, Tanusha; Jeebhay, Mohamed F

2016-09-01

This study evaluated the determinants of high fractional exhaled nitric oxide (FeNO; >50 ppb) and serial changes in FeNO over a 24-hour period in spice mill workers at risk of work-related allergic respiratory disease and asthma. A cross-sectional study of 150 workers used European Community Respiratory Health Survey (ECRHS) questionnaires, Phadiatop, serum-specific IgE (garlic, chilli pepper, wheat; Phadia, ImmunoCAP), spirometry and FeNO. A hand-held portable nitric oxide sampling device (NIOX MINO, Aerocrine AB) measured FeNO before and after the 8-hour shift and after 24 hours from baseline. The mean age of workers was 33 years; 71% were male, 46% current smokers and 45% atopic. Among workers with garlic sensitisation, 13% were monosensitised and 6% were co-sensitised to chilli pepper. Baseline preshift FeNO geometric mean (GM=14.9 ppb) was similar to the mean change across shift (GM=15.4 ppb) and across the 24-hour period (GM=15.8 ppb). In multivariate linear models, smoking (β=-0.507) and atopy (β=0.433) were strongly associated with FeNO. High FeNO (>50 ppb) was significantly associated with asthma-like symptoms due to spice dust (OR=5.38, CI 1.01 to 28.95). Sensitisation to chilli pepper was more strongly correlated with FeNO (r=0.32) and FeNO>50 ppb (OR=17.04, p=0.005) than garlic. FeNO increase (>12%) across 24 hours demonstrated a strong association with elevated exposures to spice dust particulate (OR=3.77, CI 1.01 to 14.24). This study suggests that chilli pepper sensitisation is associated with high FeNO (>50 ppb), more strongly compared with garlic, despite the low prevalence of sensitisation to chilli. Elevated inhalant spice dust particulate is associated with a delayed elevation of FeNO across the 24-hour period. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Using fractional exhaled nitric oxide (FeNO) to diagnose steroid-responsive disease and guide asthma management in routine care.

PubMed

Price, David; Ryan, Dermot; Burden, Annie; Von Ziegenweidt, Julie; Gould, Shuna; Freeman, Daryl; Gruffydd-Jones, Kevin; Copland, Anne; Godley, Clifford; Chisholm, Alison; Thomas, Mike

2013-11-07

Fractional exhaled nitric oxide (FeNO) is a surrogate marker of eosinophilic airway inflammation and good predictor of corticosteroid response. To evaluate how FeNO is being used to guide primary care asthma management in the United Kingdom (UK) with a view to devising practical algorithms for the use of FeNO in the diagnosis of steroid-responsive disease and to guide on-going asthma management. Eligible patients (n = 678) were those in the Optimum Patient Care Research Database (OPCRD) aged 4-80 years who, at an index date, had their first FeNO assessment via NIOX MINO® or Flex®. Eligible practices were those using FeNO measurement in at least ten patients during the study period. Patients were characterized over a one-year baseline period immediately before the index date. Outcomes were evaluated in the year immediately following index date for two patient cohorts: (i) those in whom FeNO measurement was being used to identify steroid-responsive disease and (ii) those in whom FeNO monitoring was being used to guide on-going asthma management. Outcomes for cohort (i) were incidence of new ICS initiation at, or within the one-month following, their first FeNO measurement, and ICS dose during the outcome year. Outcomes for cohort (ii) were adherence, change in adherence (from baseline) and ICS dose. In cohort (i) (n = 304) the higher the FeNO category, the higher the percentage of patients that initiated ICS at, or in the one month immediately following, their first FeNO measurement: 82%, 46% and 26% of patients with high, intermediate and low FeNO, respectively. In cohort (ii) (n = 374) high FeNO levels were associated with poorer baseline adherence (p = 0.005) but greater improvement in adherence in the outcome year (p = 0.017). Across both cohorts, patients with high FeNO levels were associated with significantly higher ICS dosing (p < 0.001). In the UK, FeNO is being used in primary practice to guide ICS initiation and dosing decisions

Probing the impact of axial diffusion on nitric oxide exchange dynamics with heliox.

PubMed

Shin, Hye-Won; Condorelli, Peter; Rose-Gottron, Christine M; Cooper, Dan M; George, Steven C

2004-09-01

Exhaled nitric oxide (NO) is a potential noninvasive index of lung inflammation and is thought to arise from the alveolar and airway regions of the lungs. A two-compartment model has been used to describe NO exchange; however, the model neglects axial diffusion of NO in the gas phase, and recent theoretical studies suggest that this may introduce significant error. We used heliox (80% helium, 20% oxygen) as the insufflating gas to probe the impact of axial diffusion (molecular diffusivity of NO is increased 2.3-fold relative to air) in healthy adults (21-38 yr old, n = 9). Heliox decreased the plateau concentration of exhaled NO by 45% (exhalation flow rate of 50 ml/s). In addition, the total mass of NO exhaled in phase I and II after a 20-s breath hold was reduced by 36%. A single-path trumpet model that considers axial diffusion predicts a 50% increase in the maximum airway flux of NO and a near-zero alveolar concentration (Ca(NO)) and source. Furthermore, when NO elimination is plotted vs. constant exhalation flow rate (range 50-500 ml/s), the slope has been previously interpreted as a nonzero Ca(NO) (range 1-5 ppb); however, the trumpet model predicts a positive slope of 0.4-2.1 ppb despite a zero Ca(NO) because of a diminishing impact of axial diffusion as flow rate increases. We conclude that axial diffusion leads to a significant backdiffusion of NO from the airways to the alveolar region that significantly impacts the partitioning of airway and alveolar contributions to exhaled NO.

Detection of halitosis in breath: Between the past, present, and future.

PubMed

Nakhleh, M K; Quatredeniers, M; Haick, H

2017-06-16

To develop a new generation of diagnostics for halitosis, replacing the subjective organoleptic assessment, a series of exhaled breath analyzers has been developed and assessed. All three devices rely on the assessment of exhaled volatile sulfuric compounds (VSCs), which are mainly generated in and emitted from the oral cavity, contributing to the malodor. Portable, on-site and easy to use, these devices have potential for non-invasive diagnosis of halitosis. However, global assessment of exhaled VSCs alone has two main drawbacks: (i) the absence of VSCs does not rule out halitosis; (ii) non-sulfuric volatile compounds that could be biomarkers of systemic diseases, found in up to 15% of halitosis cases, are neglected. In this article, we review and discuss progress to date in the field of oral/exhaled volatile compounds as potential non-invasive diagnostics for halitosis. We will briefly describe the generation of these compounds both from local (oral) and distal (extra-oral) sources. In addition, we debate the different analytical approaches in use and discuss the potential value of bio-inspired artificially intelligent olfaction in diagnosing and classifying oral and systemic diseases by analyzing exhaled breath. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved.

Respiratory Constraints in Verbal and Non-verbal Communication.

PubMed

Włodarczak, Marcin; Heldner, Mattias

2017-01-01

In the present paper we address the old question of respiratory planning in speech production. We recast the problem in terms of speakers' communicative goals and propose that speakers try to minimize respiratory effort in line with the H&H theory. We analyze respiratory cycles coinciding with no speech (i.e., silence), short verbal feedback expressions (SFE's) as well as longer vocalizations in terms of parameters of the respiratory cycle and find little evidence for respiratory planning in feedback production. We also investigate timing of speech and SFEs in the exhalation and contrast it with nods. We find that while speech is strongly tied to the exhalation onset, SFEs are distributed much more uniformly throughout the exhalation and are often produced on residual air. Given that nods, which do not have any respiratory constraints, tend to be more frequent toward the end of an exhalation, we propose a mechanism whereby respiratory patterns are determined by the trade-off between speakers' communicative goals and respiratory constraints.

News from the Breath Analysis Summit 2011.

PubMed

Corradi, Massimo; Mutti, Antonio

2012-06-01

This special section highlights some of the important work presented at the Breath Analysis Summit 2011, which was held in Parma (Italy) from 11 to 14 September 2011. The meeting, which was jointly organized by the International Association for Breath Research and the University of Parma, was attended by more than 250 delegates from 33 countries, and offered 34 invited lectures and 64 unsolicited scientific contributions. The summit was organized to provide a forum to scientists, engineers and clinicians to present their latest findings and to meet industry executives and entrepreneurs to discuss key trends, future directions and technologies available for breath analysis. A major focus was on nitric oxide, exhaled breath condensate, electronic nose, mass spectrometry and newer sensor technologies. Medical applications ranged from asthma and other respiratory diseases to gastrointestinal disease, occupational diseases, critical care and cancer. Most people identify breath tests with breathalysers used by police to estimate ethanol concentration in blood. However, breath testing has far more sophisticated applications. Breath analysis is rapidly evolving as a new frontier in medical testing for disease states in the lung and beyond. Every individual has a breath fingerprint-or 'breathprint'-that can provide useful information about his or her state of health. This breathprint comprises the many thousands of molecules that are expelled with each breath we exhale. Breath research in the past few years has uncovered the scientific and molecular basis for such clinical observations. Relying on mass spectrometry, we have been able to identify many such unique substances in exhaled breath, including gases, such as nitric oxide (NO) and carbon monoxide (CO), and a wide array of volatile organic compounds. Exhaled breath also carries aerosolized droplets that can be collected as an exhaled breath condensate that contains endogenously produced non-volatile compounds. Breath

Metabolic rate meter and method

NASA Technical Reports Server (NTRS)

Taylor, T. I.; Ruderman, I. W. (Inventor)

1968-01-01

A method is described for measuring the dynamic metabolic rate of a human or animal. The ratio of the exhaled carbon dioxide to a known amount of C(13)02 introduced into the exhalation is determined by mass spectrometry. This provides an instantaneous measurement of the carbon dioxide generated.

Breath Tests in Respiratory and Critical Care Medicine: From Research to Practice in Current Perspectives

PubMed Central

Cheepsattayakorn, Attapon; Cheepsattayakorn, Ruangrong

2013-01-01

Today, exhaled nitric oxide has been studied the most, and most researches have now focusd on asthma. More than a thousand different volatile organic compounds have been observed in low concentrations in normal human breath. Alkanes and methylalkanes, the majority of breath volatile organic compounds, have been increasingly used by physicians as a novel method to diagnose many diseases without discomforts of invasive procedures. None of the individual exhaled volatile organic compound alone is specific for disease. Exhaled breath analysis techniques may be available to diagnose and monitor the diseases in home setting when their sensitivity and specificity are improved in the future. PMID:24151617

Chemical analysis of whale breath volatiles: a case study for non-invasive field health diagnostics of marine mammals.

PubMed

Cumeras, Raquel; Cheung, William H K; Gulland, Frances; Goley, Dawn; Davis, Cristina E

2014-09-12

We explored the feasibility of collecting exhaled breath from a moribund gray whale (Eschrichtius robustus) for potential non-invasive health monitoring of marine mammals. Biogenic volatile organic compound (VOC) profiling is a relatively new field of research, in which the chemical composition of breath is used to non-invasively assess the health and physiological processes on-going within an animal or human. In this study, two telescopic sampling poles were designed and tested with the primary aim of collecting whale breath exhalations (WBEs). Once the WBEs were successfully collected, they were immediately transferred onto a stable matrix sorbent through a custom manifold system. A total of two large volume WBEs were successfully captured and pre-concentrated onto two Tenax®-TA traps (one exhalation per trap). The samples were then returned to the laboratory where they were analyzed using solid phase micro extraction (SPME) and gas chromatography/mass spectrometry (GC/MS). A total of 70 chemicals were identified (58 positively identified) in the whale breath samples. These chemicals were also matched against a database of VOCs found in humans, and 44% of chemicals found in the whale breath are also released by healthy humans. The exhaled gray whale breath showed a rich diversity of chemicals, indicating the analysis of whale breath exhalations is a promising new field of research.

Modeling bronchial circulation with application to soluble gas exchange: description and sensitivity analysis.

PubMed

Bui, T D; Dabdub, D; George, S C

1998-06-01

The steady-state exchange of inert gases across an in situ canine trachea has recently been shown to be limited equally by diffusion and perfusion over a wide range (0.01-350) of blood solubilities (betablood; ml . ml-1 . atm-1). Hence, we hypothesize that the exchange of ethanol (betablood = 1,756 at 37 degrees C) in the airways depends on the blood flow rate from the bronchial circulation. To test this hypothesis, the dynamics of the bronchial circulation were incorporated into an existing model that describes the simultaneous exchange of heat, water, and a soluble gas in the airways. A detailed sensitivity analysis of key model parameters was performed by using the method of Latin hypercube sampling. The model accurately predicted a previously reported experimental exhalation profile of ethanol (R2 = 0.991) as well as the end-exhalation airstream temperature (34.6 degrees C). The model predicts that 27, 29, and 44% of exhaled ethanol in a single exhalation are derived from the tissues of the mucosa and submucosa, the bronchial circulation, and the tissue exterior to the submucosa (which would include the pulmonary circulation), respectively. Although the concentration of ethanol in the bronchial capillary decreased during inspiration, the three key model outputs (end-exhaled ethanol concentration, the slope of phase III, and end-exhaled temperature) were all statistically insensitive (P > 0.05) to the parameters describing the bronchial circulation. In contrast, the model outputs were all sensitive (P < 0.05) to the thickness of tissue separating the core body conditions from the bronchial smooth muscle. We conclude that both the bronchial circulation and the pulmonary circulation impact soluble gas exchange when the entire conducting airway tree is considered.

Gene expression changes in blood RNA after swimming in a chlorinated pool.

PubMed

Salas, Lucas A; Font-Ribera, Laia; Bustamante, Mariona; Sumoy, Lauro; Grimalt, Joan O; Bonnin, Sarah; Aguilar, Maria; Mattlin, Heidi; Hummel, Manuela; Ferrer, Anna; Kogevinas, Manolis; Villanueva, Cristina M

2017-08-01

Exposure to disinfection by-products (DBP) such as trihalomethanes (THM) in swimming pools has been linked to adverse health effects in humans, but their biological mechanisms are unclear. We evaluated short-term changes in blood gene expression of adult recreational swimmers after swimming in a chlorinated pool. Volunteers swam 40min in an indoor chlorinated pool. Blood samples were drawn and four THM (chloroform, bromodichloromethane, dibromochloromethane and bromoform) were measured in exhaled breath before and after swimming. Intensity of physical activity was measured as metabolic equivalents (METs). Gene expression in whole blood mRNA was evaluated using IlluminaHumanHT-12v3 Expression-BeadChip. Linear mixed models were used to evaluate the relationship between gene expression changes and THM exposure. Thirty-seven before-after pairs were analyzed. The median increase from baseline to after swimming were: 0.7 to 2.3 for MET, and 1.4 to 7.1μg/m 3 for exhaled total THM (sum of the four THM). Exhaled THM increased on average 0.94μg/m 3 per 1 MET. While 1643 probes were differentially expressed post-exposure. Of them, 189 were also associated with exhaled levels of individual/total THM or MET after False Discovery Rate. The observed associations with the exhaled THM were low to moderate (Log-fold change range: -0.17 to 0.15). In conclusion, we identified short-term gene expression changes associated with swimming in a pool that were minor in magnitude and their biological meaning was unspecific. The high collinearity between exhaled THM levels and intensity of physical activity precluded mutually adjusted models with both covariates. These exploratory results should be validated in future studies. Copyright © 2017. Published by Elsevier B.V.

Gestational Obstructive Sleep Apnea: Biomarker Screening Models and Lack of Postpartum Resolution.

PubMed

Street, Linda M; Aschenbrenner, Carol A; Houle, Timothy T; Pinyan, Clark W; Eisenach, James C

2018-04-15

To measure prevalence and severity of third trimester obstructive sleep apnea and evaluate postpartum resolution. To assess a novel biomarker for screening for obstructive sleep apnea in pregnancy. This prospective observational study was performed at Wake Forest School of Medicine obstetrics clinics between April 2014 and December 2015. Fractional exhaled nitric oxide measurements and sleep studies were obtained and compared at 32 0/7 to 35 6/7 weeks gestation and postpartum. Exhaled nitric oxide and risk factors for the development of gestational sleep apnea were evaluated for predictive ability independently and in screening models. Of 76 women enrolled, 73 performed valid sleep studies in pregnancy and 65 had an additional valid study 6 to 15 weeks postpartum. Twenty-four women (37%) had gestational sleep apnea compared with 23 (35%) with postpartum sleep apnea ( P > .99). Eight of 11 women (73%) retested 6 to 8 months postpartum had persistent sleep apnea. Exhaled nitric oxide had moderate discrimination screening for sleep apnea in pregnancy (area under the receiver operating characteristic curve = 0.64). A model utilizing exhaled nitric oxide, pregnancy-specific screening, and Mallampati score improved ability to identify women at risk for gestational sleep apnea (sensitivity = 46%, specificity = 91% and likelihood ratio = 5.11, area under receiver operating characteristic curve = 0.75). Obstructive sleep apnea is common in the early postpartum period and often persisted at least 6 months. Exhaled nitric oxide as a sole biomarker to screen for sleep apnea in pregnancy has only modest discrimination. Combined with additional parameters sensitivity and specificity improved. Registry: ClinicalTrials.gov, Identifier: NCT02100943, Title: Exhaled Nitric Oxide as a Biomarker of Gestational Obstructive Sleep Apnea and Persistence Postpartum, URL: https://clinicaltrials.gov/ct2/show/NCT02100943. © 2018 American Academy of Sleep Medicine.

Direct Measurement of Lung Motion Using Hyperpolarized Helium-3 MR Tagging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cai Jing; Miller, G. Wilson; Altes, Talissa A.

2007-07-01

Purpose: To measure lung motion between end-inhalation and end-exhalation using a hyperpolarized helium-3 (HP {sup 3}He) magnetic resonance (MR) tagging technique. Methods and Materials: Three healthy volunteers underwent MR tagging studies after inhalation of 1 L HP {sup 3}He gas diluted with nitrogen. Multiple-slice two-dimensional and volumetric three-dimensional MR tagged images of the lungs were obtained at end-inhalation and end-exhalation, and displacement vector maps were computed. Results: The grids of tag lines in the HP {sup 3}He MR images were well defined at end-inhalation and remained evident at end-exhalation. Displacement vector maps clearly demonstrated the regional lung motion and deformationmore » that occurred during exhalation. Discontinuity and differences in motion pattern between two adjacent lung lobes were readily resolved. Conclusions: Hyperpolarized helium-3 MR tagging technique can be used for direct in vivo measurement of respiratory lung motion on a regional basis. This technique may lend new insights into the regional pulmonary biomechanics and thus provide valuable information for the deformable registration of lung.« less

White sand potentially suppresses radon emission from uranium tailings

NASA Astrophysics Data System (ADS)

Abdel Ghany, H. A.; El Aassy, Ibrahim E.; Ibrahim, Eman M.; Gamil, S. H.

2018-03-01

Uranium tailings represent a huge radioactive waste contaminant, where radon emanation is considered a major health hazard. Many trials have been conducted to minimize radon exhalation rate by using different covering materials. In the present work, three covering materials, commonly available in the local environment, (kaolin, white sand and bentonite) have been used with different thickness 10, 15, and 20 mm). 238U, 232Th, 40K and the radon exhalation rate were measured by using gamma spectrometry with a Hyper Pure Germanium (HPGe) detector and solid state nuclear track detectors (CR-39). Radon exhalation rate, calculated before and after covering, ranged from 2.80 ± 0.14 to 4.20 ± 0.21 Bq m-2 h-1, and from 0.30 ± 0.01 to 4.00 ± 0.20 Bq m-2 h-1, respectively. Also, the attenuation coefficients of different covering materials and radon emanation were calculated. The obtained results demonstrate that covering of uranium tailings by kaolin, white sand and bentonite has potentially minimized both the radon exhalation rate and the corresponding internal doses.

Airway exchange of highly soluble gases.

PubMed

Hlastala, Michael P; Powell, Frank L; Anderson, Joseph C

2013-03-01

Highly blood soluble gases exchange with the bronchial circulation in the airways. On inhalation, air absorbs highly soluble gases from the airway mucosa and equilibrates with the blood before reaching the alveoli. Highly soluble gas partial pressure is identical throughout all alveoli. At the end of exhalation the partial pressure of a highly soluble gas decreases from the alveolar level in the terminal bronchioles to the end-exhaled partial pressure at the mouth. A mathematical model simulated the airway exchange of four gases (methyl isobutyl ketone, acetone, ethanol, and propylene glycol monomethyl ether) that have high water and blood solubility. The impact of solubility on the relative distribution of airway exchange was studied. We conclude that an increase in water solubility shifts the distribution of gas exchange toward the mouth. Of the four gases studied, ethanol had the greatest decrease in partial pressure from the alveolus to the mouth at end exhalation. Single exhalation breath tests are inappropriate for estimating alveolar levels of highly soluble gases, particularly for ethanol.

Airway exchange of highly soluble gases

PubMed Central

Powell, Frank L.; Anderson, Joseph C.

2013-01-01

Highly blood soluble gases exchange with the bronchial circulation in the airways. On inhalation, air absorbs highly soluble gases from the airway mucosa and equilibrates with the blood before reaching the alveoli. Highly soluble gas partial pressure is identical throughout all alveoli. At the end of exhalation the partial pressure of a highly soluble gas decreases from the alveolar level in the terminal bronchioles to the end-exhaled partial pressure at the mouth. A mathematical model simulated the airway exchange of four gases (methyl isobutyl ketone, acetone, ethanol, and propylene glycol monomethyl ether) that have high water and blood solubility. The impact of solubility on the relative distribution of airway exchange was studied. We conclude that an increase in water solubility shifts the distribution of gas exchange toward the mouth. Of the four gases studied, ethanol had the greatest decrease in partial pressure from the alveolus to the mouth at end exhalation. Single exhalation breath tests are inappropriate for estimating alveolar levels of highly soluble gases, particularly for ethanol. PMID:23305981

Smelling the Diagnosis: The Electronic Nose as Diagnostic Tool in Inflammatory Arthritis. A Case-Reference Study.

PubMed

Brekelmans, Marjolein P; Fens, Niki; Brinkman, Paul; Bos, Lieuwe D; Sterk, Peter J; Tak, Paul P; Gerlag, Daniëlle M

2016-01-01

To investigate whether exhaled breath analysis using an electronic nose can identify differences between inflammatory joint diseases and healthy controls. In a cross-sectional study, the exhaled breath of 21 rheumatoid arthritis (RA) and 18 psoriatic arthritis (PsA) patients with active disease was compared to 21 healthy controls using an electronic nose (Cyranose 320; Smiths Detection, Pasadena, CA, USA). Breathprints were analyzed with principal component analysis, discriminant analysis, and area under curve (AUC) of receiver operating characteristics (ROC) curves. Volatile organic compounds (VOCs) were identified by gas chromatography and mass spectrometry (GC-MS), and relationships between breathprints and markers of disease activity were explored. Breathprints of RA patients could be distinguished from controls with an accuracy of 71% (AUC 0.75, 95% CI 0.60-0.90, sensitivity 76%, specificity 67%). Breathprints from PsA patients were separated from controls with 69% accuracy (AUC 0.77, 95% CI 0.61-0.92, sensitivity 72%, specificity 71%). Distinction between exhaled breath of RA and PsA patients exhibited an accuracy of 69% (AUC 0.72, 95% CI 0.55-0.89, sensitivity 71%, specificity 72%). There was a positive correlation in RA patients of exhaled breathprints with disease activity score (DAS28) and number of painful joints. GC-MS identified seven key VOCs that significantly differed between the groups. Exhaled breath analysis by an electronic nose may play a role in differential diagnosis of inflammatory joint diseases. Data from this study warrant external validation.

Jet Fuel Exposure and Neurological Health in Military Personnel

DTIC Science & Technology

2011-07-01

and dermal samples E Absorbed Dose measure: Exhaled breath, urine , blood F Lifestyle factors (smoking), use of protective equipment (gloves...toluene, ethylbenzene, xylene, and naphthalene. To assess personal absorbed dose levels to JP8 components, exhaled breath and urine samples were...the following primary analytes of interest were measured: benzene, toluene, ethylbenzene, xylene, and naphthalene. Pre- and post- shift urine samples

Investigating fractional exhaled nitric oxide (FeNO) in chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap (ACO): a scoping review protocol.

PubMed

Mostafavi-Pour-Manshadi, Seyed-Mohammad-Yousof; Naderi, Nafiseh; Barrecheguren, Miriam; Dehghan, Abolfazl; Bourbeau, Jean

2017-12-21

During the last decade, many articles have been published, including reviews on fractional exhaled nitric oxide (FeNO) use and utility in clinical practice and for monitoring and identifying eosinophilic airway inflammation, especially in asthma, and evaluating corticosteroid responsiveness. However, the exact role of FeNO in patients with chronic obstructive pulmonary disease (COPD) and its ability to distinguish patients with COPD and those having concomitant asthma, that is, asthma-COPD overlap (ACO) is still unclear and needs to be defined. Due to the broad topics of FeNO in chronic airway disease, we undertook a scoping review. The present article describes the protocol of a scoping review of peer-reviewed published literature specific to FeNO in COPD/ACO over the last decade. We used Joanna Briggs Institute Reviewers' Manual scoping review methodology as well as Levac et al 's and Arksey et al 's framework as guides. We searched a variety of databases, including Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Web of Science, and BioSciences Information Service (BIOSIS) on 29 June 2016. Additional studies will be recognised by exploring the reference list of identified eligible studies. Screening of eligible studies will be independently performed by two reviewers and any disagreement will be solved by the third reviewer. We will analyse the gathered data from article bibliographies and abstracts. To investigate the body of published studies regarding the role of FeNO in patients with COPD and its usefulness in the clinical setting, a scoping review can be used as a modern and pioneer model, which does not need ethics approval. By this review, new insights for conducting new research specific to FeNO in COPD/ACO population will emerge. The results of this study will be reported in the scientific meetings and conferences, which aim to provide information to the clinicians, primary care providers and basic

Health surveillance for occupational asthma.

PubMed

Fishwick, David; Forman, Steve

2018-04-01

The outcome for workers with occupational asthma is improved for those with an earlier diagnosis. Health surveillance at work is in principle designed to identify such cases, so that the risks to the individual worker, and coworkers, can be reduced. There is recent evidence to suggest that the uptake and quality of such surveillance could be improved. This review has assessed current approaches to health surveillance for occupational asthma. The article covers a review of the utility of questionnaires, lung function testing, immunological investigations, and other tests, including exhaled nitric oxide, sputum eosinophilia, and exhaled breath condensate specifically in the context of workplace-based health surveillance. Questionnaires remain a key component of respiratory health surveillance, although maybe limited by both sensitivity and specificity for early occupational asthma. The role of lung function testing is debated, although is recommended for higher level health surveillance. Various examples of immunological testing in health surveillance are discussed, but more evidence is needed in many specific areas before more general recommendations can be made. Evidence is discussed in relation to the utility of newer approaches such as exhaled nitric oxide, sputum eosinophilia, and exhaled breath condensate.

Sick building syndrome (SBS) among office workers in a Malaysian university--Associations with atopy, fractional exhaled nitric oxide (FeNO) and the office environment.

PubMed

Lim, Fang-Lee; Hashim, Zailina; Md Said, Salmiah; Than, Leslie Thian-Lung; Hashim, Jamal Hisham; Norbäck, Dan

2015-12-01

There are few studies on sick building syndrome (SBS) including clinical measurements for atopy and fractional exhaled nitric oxide (FeNO). Our aim was to study associations between SBS symptoms, selected personal factors, office characteristics and indoor office exposures among office workers from a university in Malaysia. Health data were collected by a questionnaire (n=695), skin prick test (SPT) (n=463) and FeNO test (n=460). Office settled dust was vacuumed and analyzed for endotoxin, (1,3)-β-glucan and house dust mites (HDM) allergens group 1 namely Dermatophagoides pteronyssinus (Der p 1) and Dermatophagoides farinae (Der f 1). Office indoor temperature, relative air humidity (RH), carbon monoxide (CO) and carbon dioxide (CO2) were measured by a direct reading instrument. Associations were studied by two-levels multiple logistic regression with mutual adjustment and stratified analysis. The prevalence of weekly dermal, mucosal and general symptoms was 11.9%, 16.0% and 23.0% respectively. A combination of SPT positivity (allergy to HDM or cat) and high FeNO level (≥25 ppb) was associated with dermal (p=0.002), mucosal (p<0.001) and general symptoms (p=0.05). Der f1 level in dust was associated with dermal (p<0.001), mucosal (p<0.001) and general (p=0.02) symptoms. Among those with allergy to D. farinae, associations were found between Der f 1 levels in dust and dermal (p=0.003), mucosal (p=0.001) and general symptoms (p=0.007). Office-related symptoms were associated with Der f 1 levels in dust (p=0.02), low relative air humidity (p=0.04) and high office temperature (p=0.05). In conclusion, a combination of allergy to cat or HDM and high FeNO is a risk factor for SBS symptoms. Der f 1 allergen in dust can be a risk factor for SBS in the office environment, particularly among those sensitized to Der f 1 allergen. Copyright © 2015 Elsevier B.V. All rights reserved.

Reproducibility of serum IgE, Ara h2 skin prick testing and fraction of exhaled nitric oxide for predicting clinical peanut allergy in children.

PubMed

Percival, Elizabeth; Bhatia, Rani; Preece, Kahn; McElduff, Patrick; McEvoy, Mark; Collison, Adam; Mattes, Joerg

2016-01-01

Ara h2 sIgE serum levels improve the diagnostic accuracy for predicting peanut allergy, but the use of Ara h2 purified protein as a skin prick test (SPT), has not been substantially evaluated. The fraction of exhaled nitric oxide (FeNO) shows promise as a novel biomarker of peanut allergy. Reproducibility of these measures has not been determined. The aim was to assess the accuracy and reproducibility (over a time-period of at least 12 months) of SPT to Ara h2 in comparison with four predictors of clinical peanut allergy (Peanut SPT, Ara h2 specific Immunoglobulin E (sIgE), Peanut sIgE and FeNO). Twenty-seven children were recruited in a follow-up of a prospective cohort of fifty-six children at least 12 months after an open-labelled peanut food challenge. Their repeat assessment involved a questionnaire, SPT to peanut and Ara h2 purified protein, FeNO and sIgE to peanut and Ara h2 measurements. Ara h2 SPT was no worse in accuracy when compared with peanut SPT, FeNO, Ara h2 sIgE and peanut sIgE (AUC 0.908 compared with 0.887, 0.889, 0.935 and 0.804 respectively) for predicting allergic reaction at previous food challenge. SPT for peanut and Ara h2 demonstrated limited reproducibility (ICC = 0.51 and 0.44); while FeNO demonstrated good reproducibility (ICC = 0.73) and sIgE for peanut and Ara h2 were highly reproducible (ICC = 0.81 and 0.85). In this population, Ara h2 SPT was no worse in accuracy when compared with current testing for the evaluation of clinical peanut allergy, but had-like peanut SPT-poor reproducibility. FeNO, peanut sIgE and Ara h2 sIgE were consistently reproducible despite an interval of at least 12 months between the repeated measurements.

Mineralogy and geochemistry of a superhigh-organic-sulfur coal, Yanshan Coalfield, Yunnan, China: Evidence for a volcanic ash component and influence by submarine exhalation

USGS Publications Warehouse

Dai, S.; Ren, D.; Zhou, Y.; Chou, C.-L.; Wang, X.; Zhao, L.; Zhu, Xudong

2008-01-01

The mineralogy and geochemistry of a superhigh-organic-sulfur (SHOS) coal of Late Permian age from the Yanshan Coalfield, Yunnan Province, southwestern China, have been studied using optical microscope, low-temperature ashing plus X-ray diffraction analysis, scanning electron microscope equipped with energy-dispersive X-ray spectrometer, a sequential chemical extraction procedure, and inductively coupled plasma mass spectrometry. The M9 Coal from the Yanshan Coalfield is a SHOS coal that has a total sulfur content of 10.12%-11.30% and an organic sulfur content of 8.77%-10.30%. The minerals in the coal consist mainly of high-temperature quartz, sanidine, albite, muscovite, illite, pyrite, and trace amounts of kaolinite, plagioclase, akermanite, rutile, and dawsonite. As compared with ordinary worldwide (bituminous coals and anthracite) and Chinese coals, the M9 Coal is remarkably enriched in B (268????g/g), F (841????g/g), V (567????g/g), Cr (329????g/g), Ni (73.9????g/g), Mo (204????g/g), and U (153????g/g). In addition, elements including Se (25.2????g/g), Zr (262????g/g), Nb (20.1????g/g), Cd (2.07????g/g), and Tl (2.03????g/g) are also enriched in the coal. Occurrence of high-temperature quartz, sanidine, muscovite, and illite in the M9 Coal is evidence that there is a volcanic ash component in the coal that was derived from acid volcanic ashes fallen into the swamp during peat accumulation. Occurrence of albite and dawsonite in the coal and strong enrichment of some elements, including F, S, V, Cr, Ni, Mo and U, are attributed to the influence by submarine exhalation which invaded along with seawater into the anoxic peat swamp. Abundances of lithophile elements, including rare earth elements, Nb, Y, Zr, and TiO2, indicate that the silicate minerals in the coal were derived from the northern Vietnam Upland to the south of the basin. ?? 2008 Elsevier B.V. All rights reserved.

Mechanics of lung ventilation in a large aquatic salamander, siren lacertina

PubMed

Brainerd; j

1998-06-01

Lung ventilation in Siren lacertina was studied using X-ray video, measurements of body cavity pressure and electromyography of hypaxial muscles. S. lacertina utilizes a two-stroke buccal pump in which mixing of expired and inspired gas is minimized by partial expansion of the buccal cavity during exhalation and then full expansion after exhalation is complete. Mixing is further reduced by the use of one or two accessory inspirations after the first, mixed-gas cycle. Exhalation occurs in two phases: a passive phase in which hydrostatic pressure and possibly lung elasticity force air out of the lungs, and an active phase in which contraction of the transverse abdominis (TA) muscle increases body cavity pressure and forces most of the remaining air out. In electromyograms of the lateral hypaxial musculature, the TA became active 200-400 ms before the rise in body cavity pressure, and activity ceased at peak pressure. The TA was not active during inspiration, and no consistent activity during breathing was noted in the external oblique, internal oblique and rectus abdominis muscles. The finding that the TA is the primary expiratory muscle in S. lacertina agrees with findings in a previous study of another salamander, Necturus maculosus. Together, these results indicate that the use of the TA for exhalation is a primitive character for salamanders and support the hypothesis that the breathing mechanism of salamanders represents an intermediate step in evolution between a buccal pump, in which only head muscles are used for ventilation, and an aspiration pump, in which axial muscles are used for both exhalation and inhalation.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, D; Pollock, S; Keall, P

Purpose: Audiovisual biofeedback breath-hold (AVBH) was employed to reproduce tumor position on inhale and exhale breath-holds for 4D tumor information. We hypothesize that lung tumor position will be more consistent using AVBH compared with conventional breath-hold (CBH). Methods: Lung tumor positions were determined for seven lung cancer patients (age: 25 – 74) during to two separate 3T MRI sessions. A breathhold training session was performed prior to the MRI sessions to allow patients to become comfortable with AVBH and their exhale and inhale target positions. CBH and AVBH 4D image datasets were obtained in the first MRI session (pre-treatment) andmore » the second MRI session (midtreatment) within six weeks of the first session. Audio-instruction (MRI: Siemens Skyra) in CBH and verbal-instruction (radiographer) in AVBH were used. A radiation oncologist contoured the lung tumor using Eclipse (Varian Medical Systems); tumor position was quantified as the centroid of the contoured tumor after rigid registration based on vertebral anatomy across two MRI sessions. CBH and AVBH were compared in terms of the reproducibility assessed via (1) the difference between the two exhale positions for the two sessions and the two inhale positions for the sessions. (2) The difference in amplitude (exhale to inhale) between the two sessions. Results: Compared to CBH, AVBH improved the reproducibility of two exhale (or inhale) lung tumor positions relative to each other by 33%, from 6.4±5.3 mm to 4.3±3.0 mm (p=0.005). Compared to CBH, AVBH improved the reproducibility of exhale and inhale amplitude by 66%, from 5.6±5.9 mm to 1.9±1.4 mm (p=0.005). Conclusions: This study demonstrated that audiovisual biofeedback can be utilized for improving the reproducibility of breath-hold lung tumor position. These results are advantageous towards achieving more accurate emerging radiation treatment planning methods, in addition to imaging and treatment modalities utilizing breath

TU-A-12A-01: Consistency of Lung Expansion and Contraction During Respiration: Implications for Quantitative Imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Patton, T; Du, K; Bayouth, J

Purpose: Four-dimensional computed tomography (4DCT) can be used to evaluate longitudinal changes in pulmonary function. The sensitivity of such measurements to identify function change may be improved with reproducible breathing patterns. The purpose of this study was to determine if inhale was more consistent than exhale, i.e., lung expansion during inhalation compared to lung contraction during exhalation. Methods: Repeat 4DCT image data acquired within a short time interval from 8 patients. Using a tissue volume preserving deformable image registration algorithm, Jacobian ventilation maps in two scanning sessions were computed and compared on the same coordinate for reproducibility analysis. Equivalent lungmore » volumes (ELV) were used for 5 subjects and equivalent title volumes (ETV) for the 3 subjects who experienced a baseline shift between scans. In addition, gamma pass rate was calculated from a modified gamma index evaluation between two ventilation maps, using acceptance criterions of 2mm distance-to-agreement and 5% ventilation difference. The gamma pass rates were then compared using paired t-test to determine if there was a significant difference. Results: Inhalation was more reproducible than exhalation. In the 5 ELV subjects 78.5% of the lung voxels met the gamma criteria for expansion during inhalation when comparing the two scans, while significantly fewer (70.9% of the lung voxels) met the gamma criteria for contraction during exhalation (p = .027). In the 8 total subjects analyzed the average gamma pass rate for expansion during inhalation was 75.2% while for contraction during exhalation it was 70.3%; which trended towards significant (p = .064). Conclusion: This work implies inhalation is more reproducible than exhalation, when equivalent respiratory volumes are considered. The reason for this difference is unknown. Longitudinal investigation of pulmonary function change based on inhalation images appears appropriate for Jacobian

In-vivo measurement of lithium in the brain and other organs

DOEpatents

Vartsky, David; Wielopolski, Lucian; LoMonte, Anthony F.; Ellis, Kenneth J.; Cohn, Stanton H.

1985-01-01

The lithium used clinically and distributed in organs such as the brain or idney of humans and other exhaling animals is determined in-vivo by means of neutron radiation and measuring in the exhaled air elemental tritiated hydrogen released from the tritium reaction by the reaction .sup.6 Li(n,.alpha.)T. The tritium atoms so released are transformed in part in the surrounding aqueous solution to form gaseous tritiated hydrogen which has a small solubility in body tissues and liquids and thus appears quickly in the breath. After a recipient fasts and is irradiated with neutrons, the air exhaled in the breath for a given time after irradiation is captured and processed to remove water, isolate hydrogen and measure the tritiated hydrogen with a gaseous organ-methane counter.

Keeping Fit: Inhale, Exhale

ERIC Educational Resources Information Center

Crupi, Jeffrey

2005-01-01

This article describes yoga and stretching exercises that can quickly restore order and bring a sense of calm to the classroom. All the exercises described can be done sitting cross-legged on the floor or on a small exercise mat or carpet square. Just a few minutes of yoga in the morning, between classes, or in the afternoon can certainly help to…

Permafrost slowly exhales methane

NASA Astrophysics Data System (ADS)

Herndon, Elizabeth M.

2018-04-01

Permafrost soils store vast quantities of organic matter that are vulnerable to decomposition under a warming climate. Recent research finds that methane release from thawing permafrost may outpace carbon dioxide as a major contributor to global warming over the next century.

An electronic nose in the discrimination of patients with non-small cell lung cancer and COPD.

PubMed

Dragonieri, Silvano; Annema, Jouke T; Schot, Robert; van der Schee, Marc P C; Spanevello, Antonio; Carratú, Pierluigi; Resta, Onofrio; Rabe, Klaus F; Sterk, Peter J

2009-05-01

Exhaled breath contains thousands of gaseous volatile organic compounds (VOCs) that may be used as non-invasive markers of lung disease. The electronic nose analyzes VOCs by composite nano-sensor arrays with learning algorithms. It has been shown that an electronic nose can distinguish the VOCs pattern in exhaled breath of lung cancer patients from healthy controls. We hypothesized that an electronic nose can discriminate patients with lung cancer from COPD patients and healthy controls by analyzing the VOC-profile in exhaled breath. 30 subjects participated in a cross-sectional study: 10 patients with non-small cell lung cancer (NSCLC, [age 66.4+/-9.0, FEV(1) 86.3+/-20.7]), 10 patients with COPD (age 61.4+/-5.5, FEV(1) 70.0+/-14.8) and 10 healthy controls (age 58.3+/-8.1, FEV(1) 108.9+/-14.6). After 5 min tidal breathing through a non-rebreathing valve with inspiratory VOC-filter, subjects performed a single vital capacity maneuver to collect dried exhaled air into a Tedlar bag. The bag was connected to the electronic nose (Cyranose 320) within 10 min, with VOC-filtered room air as baseline. The smellprints were analyzed by onboard statistical software. Smellprints from NSCLC patients clustered distinctly from those of COPD subjects (cross validation value [CVV]: 85%; M-distance: 3.73). NSCLC patients could also be discriminated from healthy controls in duplicate measurements (CVV: 90% and 80%, respectively; M-distance: 2.96 and 2.26). VOC-patterns of exhaled breath discriminates patients with lung cancer from COPD patients as well as healthy controls. The electronic nose may qualify as a non-invasive diagnostic tool for lung cancer in the future.

A simple diagnostic test to confirm correct intravascular placement of peripheral catheters in order to avoid extravasation.

PubMed

Keidan, Ilan; Sidi, Avner; Ben-Menachem, Erez; Derazne, Estela; Berkenstadt, Haim

2015-11-01

Intravenous catheters are ubiquitous among modern medical management of patients, yet misplaced or tissued cannulas can result in serious iatrogenic injury due to infiltration or extravasation of injectate. Prevention is difficult, and currently few reliable tests exist to confirm intravascular placement of catheters in awake spontaneously breathing patients. Twenty conscious spontaneously breathing healthy volunteers were injected with 50 mL normal saline and 50 mL 4.2%, or 50 mL 2.1%, or 20 mL 4.2% sodium bicarbonate in a random order. A blinded anesthetist observed continuous sampling of exhaled carbon dioxide and was asked to differentiate between the sodium bicarbonate and saline injections. Peak increase in measured exhaled carbon dioxide was also calculated. Exhaled carbon dioxide increased significantly in participants injected with intravenous sodium bicarbonate. Mean peak increase was 7.4 mm Hg (±2.1 mm Hg) for 50 mL 4.2% sodium bicarbonate, 4.7 mm Hg (±2.5 mm Hg) for 20 mL 4.2% sodium bicarbonate, and 3.5 mm Hg (±1. 8 mm Hg) for 50 mL 2.1% sodium bicarbonate. The blinded observer correctly identified the injection as sodium bicarbonate or normal saline in every instance. Intravenous injection of dilute sodium bicarbonate with exhaled carbon dioxide monitoring reliably confirms correct intravascular placement of a catheter. A transient increase of exhaled carbon dioxide by 10% or more is an objective and reliable confirmation of intravascular location of the catheter. We recommend using 20 mL of 4.2% sodium bicarbonate to minimize the mEq dose of sodium bicarbonate required. Copyright © 2015 Elsevier Inc. All rights reserved.