A Ai ir rw wa ay y n ni it tr ri ic c o ox xi id de e i in n a as st th hm ma at ti ic c c ch hi il ld dr re en n a an nd d p pa at ti ie en nt ts s w wi it th h c cy ys st ti ic c f fi ib br ro os si is s NO levels in orally exhaled air and nasal gas samples were studied in 90 asthmatic patients (4-14 yrs), 67 patients with cystic fibrosis (CF) (5-32 yrs), and 68 controls (4-34 yrs). NO concentrations measured by chemiluminescence were correlated with the patient's vital capacity, forced expiratory volume in one second (FEV1) and specific airway resistance.In all groups, NO concentrations in orally-exhaled air correlated with the inhaled ambient NO (r=0.85-0.91). At an ambient NO concentration of 0 parts per billion (ppb), asthmatic patients exhaled air with higher NO concentrations than cystic fibrosis patients and controls (8.0±6.1 ppb (n=33); 4.9±2.6 ppb (n=23); and 3.0± 2.5 ppb (n=37); respectively; p<0.001). Similar results were obtained for ventilation-adjusted orally-exhaled NO. Nasal NO concentrations were lower in patients with CF (23±17 ppb) than in controls and asthmatics (96±47 and 103±64 ppb; p<0.001). There was no relationship between nasal or oral NO and pulmonary function tests.Our results suggest that ambient NO levels influence NO concentrations in orallyexhaled air. Like adults, asthmatic children exhale more NO than their controls. Reduced nasal NO concentrations in patients with cystic fibrosis may reflect chronic epithelial cell damage or an increased mucosal barrier impeding NO diffusion into the airway.

Morphologic MRI of the lung in CF patients demonstrates comparable results to MDCT and chest x-ray. Because radiation exposure is an issue in CF patients, MRI might have the ability to be used as an appropriate alternative method for pulmonary imaging.

Due to maturation-related plasticity of the developing nociceptive system, neonatal nociceptive input, as induced by medical procedures in the neonatal intensive care unit (NICU), may cause long-term alterations in pain processing. Using functional magnetic resonance imaging, this study investigated the cerebral pain response in school-aged children and adolescents (11-16 yr) with experience in a NICU after preterm (or=37 weeks gestational age, N=9) as compared to fullterm control children without early hospitalization (N=9). NICU children had been recruited retrospectively among former patients of the Children's University Hospital Mannheim. All children had participated in our previous studies [46,49] entailing psychophysical measurements. In response to tonic (30s) heat stimuli of individually adjusted moderate pain intensity, which were of comparable temperature across groups, the preterm but not the fullterm NICU children exhibited significant activations in a number of brain regions (thalamus, anterior cingulate cortex, cerebellum, basal ganglia, and periaquaeductal gray) that were not significantly activated in controls. The preterms showed significantly higher activations than controls in primary somatosensory cortex, anterior cingulate cortex, and insula. This exaggerated brain response was pain-specific and was not observed during non-painful warmth stimulation. Preterms' continuous pain ratings revealed a tendency for increased sensitization within and a lack of habituation across trials. In highly vulnerable children such as preterms, neonatal nociceptive input may, aside from other neurodevelopmental consequences, persistently increase the gain within pain pathways.

In an optimized clinical setting, flexible bronchoscopy can be regarded as a feasible procedure to remove airway FB through a laryngeal mask. Short-term and long-term outcome is favorable.