Clinical patterns in asthma based on proximal and distal airway nitric oxide categories

<p>Abstract</p> <p>Background</p> <p>The exhaled nitric oxide (eNO) signal is a marker of inflammation, and can be partitioned into proximal [J'aw_NO(nl/s), maximum airway flux] and distal contributions [CA_NO(ppb), distal airway/alveolar NO concentration]. We hypothesized that J'aw_NOand CA_NOare selectively elevated in asthmatics, permitting identification of four inflammatory categories with distinct clinical features.</p> <p>Methods</p> <p>In 200 consecutive children with asthma, and 21 non-asthmatic, non-atopic controls, we measured baseline spirometry, bronchodilator response, asthma control and morbidity, atopic status, use of inhaled corticosteroids, and eNO at multiple flows (50, 100, and 200 ml/s) in a cross-sectional study design. A trumpet-shaped axial diffusion model of NO exchange was used to characterize J'aw_NOand CA_NO.</p> <p>Results</p> <p>J'aw_NOwas not correlated with CA_NO, and thus asthmatic subjects were grouped into four eNO categories based on upper limit thresholds of non-asthmatics for J'aw_NO(≥ 1.5 nl/s) and CA_NO(≥ 2.3 ppb): Type I (normal J'aw_NOand CA_NO), Type II (elevated J'aw_NOand normal CA_NO), Type III (elevated J'aw_NOand CA_NO) and Type IV (normal J'aw_NOand elevated CA_NO). The rate of inhaled corticosteroid use (lowest in Type III) and atopy (highest in Type II) varied significantly amongst the categories influencing J'aw_NO, but was not related to CA_NO, asthma control or morbidity. All categories demonstrated normal to near-normal baseline spirometry; however, only eNO categories with increased CA_NO(III and IV) had significantly worse asthma control and morbidity when compared to categories I and II.</p> <p>Conclusions</p> <p>J'aw_NOand CA_NOreveal inflammatory categories in children with asthma that have distinct clinical features including sensitivity to inhaled corticosteroids and atopy. Only categories with increase CA_NOwere related to poor asthma control and morbidity independent of baseline spirometry, bronchodilator response, atopic status, or use of inhaled corticosteroids.</p

A new method to measure the polymerization shrinkage kinetics of light cured composites

summary This study was undertaken to develop a new measurement method to determine the initial dynamic volumetric shrinkage of composite resins during polymerization, and to investigate the effect of curing light intensity on the polymerization shrinkage kinetics. The instrument was basically an electromagnetic balance that was constructed with a force transducer using a position sensitive photo detector (PSPD) and a negative feedback servo amplifier. The volumetric change of composites during polymerization was detected continuously as a buoyancy change in distilled water by means of the Archimedes' principle. Using this new instrument, the dynamic patterns of the polymerization shrinkage of seven commercial composite resins were measured. The polymerization shrinkage of the composites was 1·92∼4·05 volume %. The shrinkage of a packable composite was the lowest, and that of a flowable composite was the highest. The maximum rate of polymerization shrinkage increased with increasing light intensity but the peak shrinkage rate time decreased with increasing light intensity. A strong positive relationship was observed between the square root of the light intensity and the maximum shrinkage rate. The shrinkage rate per unit time, dVol%/dt, showed that the instrument can be a valuable research method for investigating the polymerization reaction kinetics. This new shrinkage-measuring instrument has some advantages that it was insensitive to temperature changes and could measure the dynamic volumetric shrinkage in real time without complicated processes. Therefore, it can be used to characterize the shrinkage kinetics in a wide range of commercial and experimental visible-light-cure materials in relation to their composition and chemistr