Objective The purpose of this study was to clarify the differences in physiological properties of the airways between asthma and COPD using an impulse oscillation system (IOS). Patients and Methods

BackgroundChronic obstructive pulmonary disease (COPD) and asthma may overlap and converge in older people (overlap syndrome). It was hypothesized that patients with overlap syndrome may have different clinical characteristics such as sputum eosinophilia, and better responsiveness to treatment with inhaled corticosteroid (ICS).MethodsSixty-three patients with stable COPD (forced expiratory volume in 1 second [FEV1] ≤80%) underwent pulmonary function tests, including reversibility of airflow limitation, arterial blood gas analysis, analysis of inflammatory cells in induced sputum, and chest high-resolution computed tomography. The inclusion criteria for COPD patients with asthmatic symptoms included having asthmatic symptoms such as episodic breathlessness, wheezing, cough, and chest tightness worsening at night or in the early morning (COPD with asthma group). The clinical features of COPD patients with asthmatic symptoms were compared with those of COPD patients without asthmatic symptoms (COPD without asthma group).ResultsThe increases in FEV1 in response to treatment with ICS were significantly higher in the COPD with asthma group. The peripheral eosinophil counts and sputum eosinophil counts were significantly higher. The prevalence of patients with bronchial wall thickening on chest high-resolution computed tomography was significantly higher. A significant correlation was observed between the increases in FEV1 in response to treatment with ICS and sputum eosinophil counts, and between the increases in FEV1 in response to treatment with ICS and the grade of bronchial wall thickening. Receiver operating characteristic curve analysis revealed 82.4% sensitivity and 84.8% specificity of sputum eosinophil count for detecting COPD with asthma, using 2.5% as the cutoff value.ConclusionCOPD patients with asthmatic symptoms had some clinical features. ICS should be considered earlier as a potential treatment in such patients. High sputum eosinophil counts and bronchial wall thickening on chest high-resolution computed tomography might therefore be a good predictor of response to ICS.

Summary at a GlanceThe purpose of this study was to examine the clinical usefulness of the SD-101, a nonrestrictive, sheet-like portable monitoring device using an array of 162 thin membrane-type pressure sensors developed in Japan for 2 screening sleep apnea-hypopnea syndrome (SAHS). We measured sleep-disordered breathing in 201 subjects attending our hospital with suspected SAHS (suspected SAHS group) and in all 165 male employees of a transport company in Matsumoto city (screening group) using the SD-101 and polysomnography (PSG) simultaneously. Significant correlations were seen between apnea-hypopnea index (AHI) for total recording time on PSG and respiratory disturbance index (RDI) measured with the SD-101 in both the suspected SAHS group (r = 0.88) and the screening group (r = 0.92). Receiver operating characteristic analysis revealed that sensitivity and specificity for differentiating SAHS were 89.5% and 85.8%, respectively, when the cut-off value for RDI was 14.0 events/h. These findings suggest that the SD-101 is useful in screening for SAHS. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 3 ABSTRACT Background and objective: Kentzmedico in Japan has developed the SD-101 as a nonrestrictive, sheet-like

Postintubation tracheal stenosis is usually caused by pressure necrosis at the cuff. Despite the fact that this phenomenon is well known and both large volume and low pressure cuffs have been developed, this lesion nevertheless continues to occur. Although the best results are obtained at a tracheal reconstruction by an experienced surgeon, not all patients are able to undergo this operation for either medical or personal reasons. Argon plasma coagulation (APC) using flexible bronchoscopy has been successfully employed in the treatment of postintubation tracheal stenosis in two of the surgery-refused and inoperable patients. The patients immediately experienced a relief of symptoms after APC. APC was thus performed 3 to 4 times every one to two weeks for each patient. In addition, there were no complications related to this procedure. The number of published clinical reports describing APC in benign airway stenosis are increasing. APC has also been reported to have several advantages over other interventional endobronchial techniques in the management of tracheo-bronchial stenosis. To our knowledge, this is the first description of APC being used in the treatment of endobronchial dilatation against postintubation tracheal stenosis.

In 2005, a 46-year-old