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At least 1,441 records · Page 80Linked to original sources
PubMed1993

The effect of inhaled frusemide on airway sensitivity to inhaled 4.5% sodium chloride aerosol in asthmatic subjects.

BACKGROUND: Frusemide inhaled by asthmatic subjects before a variety of indirect bronchial challenges inhibits the airway response to these challenges. Since inhalation of hyperosmolar saline is an indirect bronchial challenge, the effect of inhaled frusemide and its vehicle on airway sensitivity to a 4.5% sodium chloride (NaCl) aerosol challenge was investigated. METHODS: Eleven asthmatic subjects (five females, six males) who had a 20% fall in forced expiratory volume in one second after 4.5% NaCl challenge were enrolled in this double blind controlled crossover trial. Sensitivity was measured as the dose of aerosol required to provoke a 20% fall in FEV1. Frusemide (33.2 mg) or its vehicle was delivered through a Fisoneb ultrasonic nebuliser and inhaled 10 minutes before challenge with 4.5% NaCl. A Mistogen ultrasonic nebuliser was used to generate the 4.5% NaCl aerosol and FEV1 was measured before and one minute after each challenge period of 0.5, one, two, four, eight, eight and eight minutes. The doubling dose difference for PD20 was calculated. RESULTS: Frusemide or vehicle had no effect on baseline lung function. The geometric mean PD20 after vehicle was 1.3 ml with a 95% confidence interval of 0.7-2.3 and after frusemide was 8.2 ml with a 95% confidence interval of 4.7-14.1. This represented a 2.6 doubling dose increase in PD20 after frusemide inhalation. In five of the 11 subjects an increase from baseline FEV1 occurred after exposure to 4.5% NaCl challenge in the presence of frusemide. This transient bronchodilatation may be caused by the release of prostaglandin E2. CONCLUSION: Inhalation of frusemide is very effective in delaying airway narrowing induced by an aerosol of 4.5% NaCl in asthmatic subjects.

Administration, Inhalation↗
PubMed1995

Effect of a spacer on pulmonary aerosol deposition from a jet nebuliser during mechanical ventilation.

BACKGROUND: Several factors have been identified which improve nebulised aerosol delivery in vitro. One of these is the addition of a spacer to the ventilator circuit which improves aerosol delivery from a jet nebuliser to a model lung by approximately 30%. The current study was designed to demonstrate whether similar improvements could be demonstrated in vivo. METHODS: Ten patients (seven men) were studied during mechanical ventilation (Siemens Servo 900C) after open heart surgery. Aerosol was delivered using a Siemens Servo 945 nebuliser system (high setting) driving a System 22 Acorn jet nebuliser (Medic-Aid) containing 3 ml technetium-99m labelled human serum albumin (99mTc-HSA (50 micrograms); activity in the first nebulisation, 90 MBq; in the second nebulisation, 185 MBq). Central and peripheral lung aerosol deposition and the time to complete deposition were measured using a gamma camera and compared when the nebuliser was connected to the inspiratory limb using a simple T-piece or a 600 ml spacer. RESULTS: The addition of the spacer increased total lung deposition (mean (SD) percentage initial nebuliser activity) from 2.2 (0.7)% to 3 (0.8)%. There was no difference in the time required to complete nebulisation (18.2 min v 18.3 min respectively for T-piece and spacer) or in the retention of activity in the nebuliser (46.2% v 47.1% respectively). CONCLUSIONS: The combination of a spacer with a jet nebuliser increased lung deposition by 36% in mechanically ventilated patients and is a simple way of increasing drug deposition or reducing the amount of an expensive drug required for nebulisation.

Aerosols↗
PubMed1995

Aerosol deposition in the human lung following administration from a microprocessor controlled pressurised metered dose inhaler.

BACKGROUND: Gamma scintigraphy was employed to assess the deposition of aerosols emitted from a pressurised metered dose inhaler (MDI) contained in a microprocessor controlled device (SmartMist), a system which analyses an inspiratory flow profile and automatically actuates the MDI when predefined conditions of flow rate and cumulative inspired volume coincide. METHODS: Micronised salbutamol particles contained in a commercial MDI (Ventolin) were labelled with 99m-technetium using a method validated by the determination of (1) aerosol size characteristics of the drug and radiotracer following actuation into an eight stage cascade impactor and (2) shot potencies of these non-volatile components as a function of actuation number. Using nine healthy volunteers in a randomised factorial interaction design the effect of inspiratory flow rate (slow, 30 l/min; medium, 90 l/min; fast, 270 l/min) combined with cumulative inspired volume (early, 300 ml; late, 3000 ml) was determined on total and regional aerosol lung deposition using the technique of gamma scintigraphy. RESULTS: The SmartMist firing at the medium/early setting (medium flow and early in the cumulative inspired volume) resulted in the highest lung deposition at 18.6 (1.42)%. The slow/early setting gave the second highest deposition at 14.1 (2.06)% with the fast/late setting resulting in the lowest (7.6 (1.15)%). Peripheral lung deposition obtained for the medium/early (9.1 (0.9)%) and slow/early (7.5 (1.06)%) settings were equivalent but higher than those obtained with the other treatments. This reflected the lower total lung deposition at these other settings as no difference in regional deposition, expressed as a volume corrected central zone:peripheral zone ratio, was apparent for all modes of inhalation studied. CONCLUSIONS: The SmartMist device allowed reproducible actuation of an MDI at a preprogrammed point during inspiration. The extent of aerosol deposition in the lung is affected by a change in firing point and is promoted by an inhaled flow rate of up to 90 l/min-that is, the slow and medium setting used in these studies.

Adult↗
PubMed1981

Efficacy of a new oxytetracycline aerosol against foot rot in sheep.

A test was designed to evaluate the efficacy of a new oxytetracycline aerosol in the treatment of foot rot in sheep. Of 186 sheep, 66 were treated with the test preparation, 61 were treated with an existing oxytetracycline aerosol and 50 acted as unmedicated controls. All affected feet in the three groups were first paired and then, for the two treatment groups, a single application of antibiotic aerosol was given. There was little difference in response between the two treated groups, but the improvement in both these groups was significantly greater than in the control group. The test was also applied to 60 cases of scald. One application of either the test product or its comparable antibiotic aerosol was effective in the treatment of scald.

Aerosols↗
PubMed1979

Growth of hygroscopic aerosols in a model of bronchial airways.

Experiments have been performed on the "breathing" of micron-size hygroscopic aerosols in and out of a four-generation model of the bronchial tree. Comparison of the experimental results on aerosol growth in the model with the classical theory for dilute aqueous solutions of nonpolar salts shows a) that the theory is applicable to conditions in the airways, b) that to a high degree of approximation the process represents deposition followed by growth, and c) that there is a significant amount of trapping of particles near their equilibrium size in the deeper model tubes. These experiments are the first to verify that the classical particle growth theory is applicable to the particle sizes and environmental conditions present in the human airways during hygroscopic aerosol therapy. This theory will be useful in designing an optimal hygroscopic aerosol delivery system, but several questions including the method of generation and the effect of drug solutions on particle equilibriums remain to be answered.

Aerosols↗
PubMed1982

Breathing patterns influence aerosol deposition sites in excised dog lungs.

Particles' suspended in inhaled air can deposit on lung surfaces. The amount deposited in different lung regions is determined by distribution of ventilation and local efficiency of particle collection. We examined how the pattern of ventilation influences sites of aerosol deposition in excised dog lungs. The lungs breathed a 99mTc-labeled aerosol according to one of three patterns: slow-deep (f less than 25/min, VT greater than 0.35 TLC); rapid-shallow (f greater than 65/min, VT less than 0.26 TLC); and slow-shallow (f = 8.4/min, VT = 0.1 TLC). After exposure, lungs were inflated, dried, and sliced transversely at 1-cm intervals. Distribution of deposited aerosol in each slice was measured by 1) gamma camera, 2) autoradiography, and 3) dissection of each slice into pieces whose activity, weight, and airway content were recorded. Our results indicate that a) total deposition decreases as f increases, b) slow-deep breathing produces uniform deposition throughout the lung, but with little aerosol collection in large airways, c) rapid-shallow ventilation results in enhanced large-airway deposition and marked heterogeneity in deposition distribution, and d) slow-shallow breathing enhances small-airway deposition. The deposition distributions characteristic of different breathing patterns were apparent on the visual displays from the gamma camera and autoradiographs. These techniques showed particle retention changing across lobar divisions, as a function of distance from the hilum, and across the lungs in both the caudal-to-cranial and dorsal-to-ventral directions.

Aerosols↗
PubMed1983

Production of pharmacologic monodisperse aerosols.

Monodisperse aerosols containing a range of chemical material, including pharmacologically active substances, were produced by using a modified Sinclair-LaMer condensation generator. Instead of the usual hot-wire technique, an ultrasonic nebulizer was used to suspend nuclei in the gas phase as an aqueous polydisperse aerosol. This technique allowed the generation of monodisperse oil (sebacate) aerosols containing nuclei of sodium chloride, histamine, methacholine, antigen, iron oxide, methylene blue, uranine, radioactive technetium pertechnetate, and technetium-labeled human serum albumin. Quantitative agonist activity was demonstrated for each active nucleus. Particle sizes ranged from 0.65 to 3 microns, with a geometric standard deviation of 1.1-1.2. This system can produce a stable, monodisperse, biologically active radiolabeled aerosol for a period of several hours.

Aerosols↗
PubMed1983

Effect of endotoxin on airway responsiveness to aerosol histamine in sheep.

This study tested the hypothesis that in the awake sheep, airway responsiveness to aerosol histamine would be increased acutely by endotoxemia. Eleven sheep were chronically instrumented to allow for measurements of lung lymph flow, vascular pressures, and lung mechanics. Awake sheep were studied in a whole-body plethysmograph designed to measure dynamic compliance (Cdyn), resistance of the lung (RL), and functional residual capacity (FRC). Pulmonary responsiveness to aerosol histamine was assessed by giving five breaths of increasing concentrations of histamine (0.1-50 mg/ml) until Cdyn decreased to 65% (of control) or until 50 mg/ml of histamine had been given. Escherichia coli endotoxin (0.2-0.5 microgram/kg) was then infused, and at 5 h after endotoxemia pulmonary responsiveness to aerosol histamine was remeasured. After endotoxin, 9 of the 11 sheep exhibited decreased Cdyn at a lower concentration of histamine compared with the preendotoxin level (P less than 0.05). The mean of the log dose of histamine necessary to reduce Cdyn to 65% of control was 1.00 +/- 0.16 (SE) before endotoxin and 0.027 +/- 0.29 5 h after endotoxin; i.e., histamine responsiveness was increased. In the last 3 sheep studied, atropine (0.1 mg/kg iv) was given after the second aerosol histamine challenge, and a third dose-response curve was performed. Atropine did not return the endotoxin-induced increase in histamine responsiveness to base line. There was no correlation between the change in histamine responsiveness and the endotoxin-induced changes in Cdyn, FRC, RL, alveolar-arterial O2 difference, pulmonary arterial pressure, or lung lymph flow.

Aerosols↗
PubMed1985

Effect of increases in lung volume on clearance of aerosolized solute from human lungs.

To study the effect of increases in lung volume on solute uptake, we measured clearance of 99mTc-diethylenetriaminepentaacetic acid (Tc-DTPA) at different lung volumes in 19 healthy humans. Seven subjects inhaled aerosol (1 micron activity median aerodynamic diam) at ambient pressure; clearance and functional residual capacity (FRC) were measured at ambient pressure (control) and at increased lung volume produced by positive pressure [12 cmH2O continuous positive airway pressure (CPAP)] or negative pressure (voluntary breathing). Six different subjects inhaled aerosol at ambient pressure; clearance and FRC were measured at ambient pressure and CPAP of 6, 12, and 18 cmH2O pressure. Six additional subjects inhaled aerosol at ambient pressure or at CPAP of 12 cmH2O; clearance and FRC were determined at CPAP of 12 cmH2O. According to the results, Tc-DTPA clearance from human lungs is accelerated exponentially by increases in lung volume, this effect occurs whether lung volume is increased by positive or negative pressure breathing, and the effect is the same whether lung volume is increased during or after aerosol administration. The effect of lung volume must be recognized when interpreting the results of this method.

Aerosols↗
PubMed1986

Aerosol deposition and flow limitation in a compliant tube.

Studies in intact dogs have suggested that aerosol deposition is enhanced in the proximity of a flow-limiting segment (FLS) formed during cough. The mechanism for that observation was investigated using a monodisperse (geometric SD less than or equal to 1.15) fluorescent aerosol produced in a condensation generator. The aerosol was passed through a compliant tube (Penrose) that had been mounted vertically in a two-chamber box. The surrounding pressure (Ps) in the upstream chamber was controlled independent of the surrounding pressure in the downstream chamber, thus allowing development of an FLS near the exit of the upstream chamber. At fixed inlet pressure (P1) and Ps, flow limitation was achieved over a range of 0.1-0.5 l X s-1 by lowering downstream pressure alone (P2). The influence of the FLS cross-sectional geometry on the site of peak deposition was examined because area of an FLS is a function of transmural pressure (Ptm = Px - Ps). For those constriction geometries that did not involve opposing wall contact, the deposition distribution was characterized by a single peak immediately downstream of the constriction. In the most compressed geometries the peak in deposition was diminished and shifted further downstream. Total aerosol deposition was found to be characterized by a dimensionless particle inertia parameter formed as the ratio of particle stopping distance and the minor radius of the elliptical tube cross section. The deposition of small particles with an inertial parameter less than 0.01 was found to be independent of geometry and constriction velocity.(ABSTRACT TRUNCATED AT 250 WORDS)

Aerosols↗
PubMed1987

Maximization of pulmonary hygroscopic aerosol deposition.

A newly developed computer model is used to predict the aqueous salt solution concentration, breathing pattern, and inhaled droplet size distribution parameters that will maximize pulmonary deposition of hygroscopic medicinal aerosols. The parameter values providing maximum pulmonary deposition include 1) a NaCl concentration in the aerosolized solution of 0.035 g/ml or higher if the subject can tolerate it, 2) as nearly a monodispersed inhaled aerosol size distribution as possible, 3) an aerosol mass median diameter of 2-3 micron, and 4) slow (7 breaths/min) uninterrupted breathing of 1.5-2 liters of aerosol/breath. With these values, the model predicts that pulmonary deposition can be increased by greater than 100% relative to the deposition achieved in conventional inhalation therapy with isotonic saline-based medications.

Aerosols↗
PubMed1988

Pulmonary clearance of three aerosolized solutes in oleic acid-induced lung injury.

We studied the effects of oleic acid (OA) on pulmonary clearance of three aerosolized radioactive solutes: 99mTc-diethylenetriamine pentaacetate (99mTc-DTPA), 67Ga-desferoxamine (67Ga-DFOM), and 111In-transferrin (111In-TF). Either 0.09 ml/kg OA or an equivalent volume of 0.9% NaCl (controls) was administered intravenously to 48 anesthetized, paralyzed dogs. Each animal received one aerosolized solute either 60 min after (protocol A) or 30 min before (protocol B) the infusion of OA or NaCl. In protocol A clearances of all three solutes were similar in OA and control animals. In contrast, in protocol B clearances of all three solutes increased significantly during OA infusion; during the next 60 min clearances of 99mTc-DTPA and 67Ga-DFOM returned to control values but 111In-TF remained increased. We conclude that 1) in OA-induced permeability edema pulmonary clearance of aerosolized solutes is increased when the aerosol is delivered 30 min before but not 60 min after injury, and 2) increased clearance persists only for large molecules, presumably because smaller molecules cross injured epithelium quickly and completely. These phenomena are best explained by a nonhomogeneous distribution of OA-induced injury.

Aerosols↗
PubMed1997

Effect of convective stretching and folding on aerosol mixing deep in the lung, assessed by approximate entropy.

There is a surprisingly substantial amount of aerosol mixing and deposition deep in the lung, which cannot be explained by classic transport mechanisms such as streamline crossing, inertial impaction, or gravitational sedimentation with reversible acinar flow. Mixing associated with "stretch and fold" convective flow patterns can, however, be a potent source of transport. We show such patterns in experimental preparations using rat lungs and in the theoretical Baker Transform. In both cases, mixing is associated with the temporal evolution of two length scales. The first is the slowly increasing diffusive length scale. The second is the rapidly decreasing lateral length scale, due to "stretching and folding," over which diffusion must take place. This interaction leads to aerosol mixing in much shorter times than previously appreciated. Finally, we propose a new method by which to quantify the state of mixing, using an approximation to the entropy of the aerosol concentration distribution. The results of the analysis suggest that stretching and folding may be a key feature underlying peripheral aerosol transport.

Aerosols↗
PubMed1999

Aerosolization of P2Y(2)-receptor agonists enhances mucociliary clearance in sheep.

The purpose of this study was to determine whether aerosolized INS316 (UTP) stimulates lung mucociliary clearance (MCC) in sheep and, if so, to compare its effects with INS365, a novel P2Y(2)-receptor agonist. In the first series of studies, we used a previously described roentgenographic technique to measure tracheal mucus velocity (TMV), an index of MCC, before and for 4 h after aerosolization of INS316 (10(-1) M and 10(-2) M) and INS365 (10(-1) M and 10(-2) M), or normal saline in a randomized crossover fashion (n = 6). In a second series of studies, we compared the ability of these agents to enhance total lung clearance. For these tests, the clearance of inhaled technetium-labeled human serum albumin was measured serially over a 2-h period after aerosolization of 10(-1) M concentration of each agent (n = 7). Aerosolization of both P2Y(2)-receptor agonists induced significant dose-related increases in TMV (P < 0.05) compared with saline. The greatest increase in TMV was observed between 15 and 30 min after drug treatment. The highest dose (10(-1) M) of INS316 produced a greater overall stimulation of TMV than did INS365 (10(-1) M). Both compounds, compared with saline, induced a significant increase in MCC (P < 0.05) within 20 min of treatment. This enhancement in MCC began to plateau at 60 min. Although the response to INS316 started earlier, there was no significant difference between the clearance curves for the two compounds. We conclude that inhaled P2Y(2)-receptor agonists can increase lung MCC in sheep and that for P2Y(2)-receptor stimulation TMV accurately reflects changes in whole lung MCC.

Aerosols↗
PubMed2001

Saline aerosol bolus dispersion. I. The effect of acinar airway alteration.

We explored the possibility of using a saline aerosol for bolus dispersion measurements to detect peripheral airway alterations in smokers. Indexes of ventilation inhomogeneity in conductive (S(cond)) and acinar (S(acin)) lung zones, as derived from the multiple-breath N(2) washout (Verbanck S, Schuermans D, Van Muylem A, Noppen M, Paiva M, and Vincken W, J Appl Physiol 83: 1807-1816, 1997), were also measured. The saline bolus test consisted of inhaling 60-ml saline aerosol boluses to different volumetric lung depths (VLD) in the 1.1 liter volume above functional residual capacity. In the never-smoker group (n = 12), saline boluses showed bolus dispersion values consistent with normal values reported in the literature for 0.5- to 1-microm aerosols. In the smoker group (n = 12; 28 +/- 9 pack years, mean +/- SD), significant increases were seen on dispersion and skew of the most peripherally inhaled saline boluses (VLD = 800 ml; P < 0.05) as well as on S(acin) (P = 0.007) with respect to never-smokers. Shallow inhaled boluses (VLD = 200 ml) and S(cond) did not reveal any significant differences between smokers and never-smokers. This study shows the consistent response of two conceptually independent tests, in which both saline aerosol and gas-derived indexes point to a heterogeneous distribution of smoking-induced structural alterations in the lung periphery.

Adult↗
PubMed2004

Aerosol delivery of glucosylated polyethylenimine/phosphatase and tensin homologue deleted on chromosome 10 complex suppresses Akt downstream pathways in the lung of K-ras null mice.

Difficulties in achieving long-term survival of lung cancer patients treated with conventional therapies suggest that novel approaches are required. Although several genes have been investigated for antitumor activities using gene delivery, problems surrounding the methods used such as efficiency, specificity, and toxicity hinder its application as an effective therapy. This has lead to the re-emergence of aerosol gene delivery as a noninvasive approach to lung cancer therapy. In this study, glucosylated conjugated polyethylenimine (glucosylated PEI) was used as carrier. After confirming the efficiency of glucosylated PEI carriers in lungs, the potential effects of the phosphatase and tensin homologue deleted on chromosome 10 (PTEN) tumor suppressor gene on Akt downstream pathways were investigated. Aerosol containing glucosylated PEI and recombinant plasmid pcDNA3.0-PTEN complex was delivered into K-ras null lung cancer model mice through a nose-only inhalation system. Investigation of proteins in the phosphatidylinositol 3'-kinase/Akt signaling pathway in PTEN-delivered mouse lung revealed that the PTEN protein was highly expressed, whereas the protein levels of PDK1, total Akt1, phospho-(Thr-308)-Akt, phospho-(Ser-2448)-mTOR, p70S6K, and 4E-BP1 were decreased to varying degrees. Additionally, the kinase activities of both Akt and mTOR were suppressed. Finally, apoptosis was detected in PTEN-delivered mouse lung by terminal deoxynucleotidyltransferase-mediated nick end labeling assay, suggesting that our aerosol PTEN delivery is capable of functionally altering cell phenotype in vivo. In summary, Western blot analysis, kinase assays, immunohistochemistry, and terminal deoxynucleotidyltransferase-mediated nick end labeling assays suggest that our aerosol gene delivery technique is compatible with in vivo gene delivery and can be applied as a noninvasive gene therapy.

Aerosols↗
PubMed2001

Characterization of 99mTc-DTPA aerosols for lung permeability studies.

BACKGROUND: The interpretation of 99mTc diethylenetriamine pentaacetate (99mTc DTPA) aerosol clearance is based on the hypothesis that the 99mTc-DTPA complex is not altered by the nebulization process. OBJECTIVES: To characterize (1) the radiochemical purity (RCP) of 99mTc-DTPA and the stability of labeling after jet nebulization, and (2) the particle size distribution of the aerosol. METHODS: RCP and stability--the aerosol was driven by oxygen, captured on filters which were eluted and RCP was checked by thin layer chromatography. Particle size distribution--the aerosol was generated using dry air (50 psi) at three different flow rates, i.e. 3 (1 run), 6 (4 runs) and 9 l x min(-1) (4 runs). The mass median aerodynamic diameter (MMAD) and the geometric standard deviation (sigma(g)) were determined using a cascade impactor from the radioactivity counted on each stage. RESULTS: The RCP was more than 95% in all cases. Mean MMAD (+/-SD) was 0.70 microm (+/-0.07) at 9 l x min(-1), 0.93 microm (+/-0.05) at 6 l x min(-1) (p < 0.05) and 1.50 microm at 3 l x min(-1). Mean sigma(g) (+/-SD) was 2.02 (+/-0.08) at 9 l x min(-1), 2.00 (+/-0.16) at 6 l x min(-1) and 1.90 at 3 l x min(-1). CONCLUSION: This study demonstrates (1) that the high RCP of 99mTc-DTPA is not affected by jet nebulization, even when using oxygen at a high flow rate, and (2) that when using a flow rate between 6 and 9 l x min(-1), the MMAD remains optimal for peripheral lung deposition.

Aerosols↗
PubMed2000

Effect of aerosolized docosahexaenoic acid in a mouse model of atopic asthma.

BACKGROUND: Docosahexaenoic acid (DHA) found in fish oil is known to depress inflammation-related mediators. We investigated a novel delivery method of tridocosahexaenoyl-glycerol (DHA-TG). METHODS: BALB/c mice (6-8 weeks old) were primed intraperitoneally with ovalbumin (OVA) and Al(OH)(3) on days 0 and 7, and with aerosolized OVA on day 7. Primed mice were challenged by repeated exposure to aerosolized OVA on days 15-17. Just before each exposure to aerosolized OVA, the mice were also exposed to an aerosol of emulsified DHA-TG or soybean oil, or saline (days 7 and 15-17). Bronchial hyperresponsiveness (BHR) to methacholine was measured, and bronchoalveolar lavage fluid was obtained 24 h after the last challenge (day 18). Lungs were histologically examined. RESULTS: Bronchoalveolar lavage fluid of saline-treated mice showed an increased cellularity with predominant eosinophils. Exposure to DHA-TG significantly reduced the total cell number and the eosinophil percentage in lavage fluid, whereas soybean oil did not. CONCLUSION: DHA but not soybean oil exposure reduced BHR and cell infiltration to bronchovascular bundles. This type of DHA administration could be studied in clinical trials.

Aerosols↗