Ultrasound evaluation of respiratory function of abdominal muscles in normal subjects and chronic obstructive lung disease patients

Ultrasonography has been widely used to evaluate diaphragmatic motion and thickness. Little work has been done to evaluate abdominal muscles thickness and function either in normal or disease state using ultrasonography. This work is conducted to evaluate abdominal muscles function in normal and chronic obstructive lung disease patients using ultrasound. We investigated ten COPD patients and ten healthy male control subjects using 7.5 MHz Bmode ultrasound. Thickness of external oblique [EO], Internal oblique [I0], transversus abdominis [TA] and rectus abdominis [RA] was assessed at functional residual capacity [FRC], at residual volume [RV], at total lung capacity [TLC], during maximal expiratory effort [MEE] and progressive expiratory effort [PEE]. In both healthy subjects and COPD, at RV the thickness of I0. TA, RA were increased in thickness compared to FRC. During MEE, the thickness was increased in I0, TA, RA, while there was no change in E0. During PEE, thickness of TA and RA were increased in COPD and control subjects. In all our data the changes in TA were evident with a lesser extent RA and I0. We conclude that transversus abdominis seems to be the major contributor of abdominal muscle function and the use of ultrasound is a useful tool in investigating abdominal muscles

Interleukin-5 production by peripheral blood monocytes from asthmatic patients: effect of alveolar macrophages

This study aimed to assess the role of ALM in the pathogenesis of bronchial asthma by studying the effect of ALM derived from bronchoalveolar lavage [BAL] on IL-5 production by peripheral blood monocytes PBMC [including T lymphocytes] in cocultures in patients with bronchial asthma as compared to that in non asthmatic individuals. Nineteen patients with bronchial asthma were enrolled in this study. Ten normal non-smoker subjects were considered as controls. Patients were subjected to broncoalveolar lavage [BAL]. The lavage fluid was cultured in 3 wells; one with peripheral blood monocytes [PBMC], another with PBMC with mitogen stimulation and the third with PBMC with BAL cells and stimulation. Cultures were incubated and the supernatants were assayed for IL-5 by EL1SA. The mean [SD] age for the asthmatic patients was 37.67[9.66] years with a mean [SD] body mass index of 28.3[6.12]. Male constituted 53% [11/19] of the studied asthmatic patients. The levels of 1L-5 in the supernatant of resting PBMN cultures were significantly higher in patients with asthma in all three states [basal state, after PHA stimulation, in cocultures with ALM [mean [SD] = 219.45[68.34] ng/ml, range [100-320 ng/ml], 484.85[115048.01], range [170-670 ng/ml], 1118 [336.59], range [530-1800 ng/ml], respectively. The respective levels in the nonatopic normal subjects was [mean [SD]: 21.20[8.97], 26.8[10.10], 29.30[7.87]]. The differences between the three states in the asthmatic patients were highly significant. The changes between the three states in the non-asthmatic patients were insignificant. IL5 production by PBMN is markedly increased in asthmatic patients versus non-asthmatic subjects, furthermore, IL-5 production was markedly amplified by co-culturing PBMN with autologous ALM derived from BAL in the asthmatics patients. This is in contrast to the finidings in non-asthmatic subjects where IL5 production was not augmented by autologous ALM. The fact that ALM from non-asthmatic subjects functioned poorly as APC may represent a local inhibitory protective mechanism in the airways

Cardiopulmonary and polysomnographic changes in patients with snoring and obstructive sleep apnoea undergoing conventional and laser assisted uvulopalatoplasty

To evaluate cardiovascular and polysomnographic changes after conventional and laser assisted uvulopalatoplasty. Prospective study. Chest department, Otolaryngology. department, Faculty of Medicine, Alexandria University. Twenty Snorer patients with or without sleep apnea were included. Pre and post operative study was done after operation and 3 months later of pulmonary functions, echocardiography, and polysomnography. Pulmonary function tests and echocardioaphy did not change Apnea/ hyponea index and desaturation index improved significantly after surgery and after follow up in all groups of patients