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1.  Differences in aerosol output and airways responsiveness between the DeVilbiss 40 and 45 hand held nebulisers. 
Thorax  1995;50(6):635-638.
BACKGROUND--The DeVilbiss 40 glass hand held nebulisers have been widely used for airways responsiveness testing in epidemiological surveys of asthma. These nebulisers have been superseded in some recent studies by the DeVilbiss 45 plastic hand held nebulisers with the assumption that they are interchangeable. This study compared the aerosol outputs of the DeVilbiss 40 and DeVilbiss 45 nebulisers and investigated whether there was any difference in the in vivo measurements of airways responsiveness when using the two nebuliser types. METHODS--The aerosol output of six DeVilbiss 40 and six DeVilbiss 45 nebulisers was calculated by weight loss per actuation, the usual method of calibrating nebuliser output, and compared with the true amount of aerosol obtained measured by a flouride tracer technique. Airways responsiveness was measured twice in 13 asthmatic patients under identical conditions by the Yan protocol using DeVilbiss 40 and 45 nebulisers in random order. RESULTS--Weight loss overestimated the true aerosol output of both types of nebulisers. Weight loss was similar for the DeVilbiss 40 and 45 nebulisers but the true aerosol output of the DeVilbiss 45 was nearly twice that of the DeVilbiss 40 nebuliser. The geometric mean PD20 values with the DeVilbiss 40 nebuliser was a mean 1.7 doubling doses of histamine higher than that obtained with the DeVilbiss 45 nebuliser. CONCLUSIONS--The DeVilbiss 40 and 45 nebulisers should not be used interchangeably for airways responsiveness testing merely because their outputs based on weight loss are similar. Artefactual differences in the prevalence rates of airways responsiveness could occur in longitudinal studies if a change was inadvertently made from using DeVilbiss 40 to DeVilbiss 45 nebulisers.
PMCID: PMC1021263  PMID: 7638805
2.  Bronchial hyperresponsiveness in lung transplant recipients: lack of correlation with airway inflammation 
Thorax  1997;52(6):551-556.
BACKGROUND: Bronchial hyperresponsiveness (BHR) to methacholine has been reported to occur in most lung transplant recipients. BHR to physical stimuli such as exercise and non-isotonic aerosols has not been as extensively studied in this subject population. This report aims to assess the presence and degree of BHR to methacholine and hypertonic saline in stable lung transplant recipients and to relate it to the presence of airway inflammation. METHODS: Ten patients undergoing bilateral sequential lung transplantation and six heart-lung transplant recipients, all with stable lung function, were recruited 66- 1167 days following transplantation. Subjects underwent a methacholine challenge and bronchoscopy for sampling of bronchoalveolar lavage fluid, transbronchial and endobronchial biopsy tissues. Hypertonic saline challenge was performed six days later. RESULTS: Nine of the 16 transplant recipients had positive methacholine challenges (geometric mean PD20 0.18 mg, interquartile range 0.058-0.509) and three of these subjects also had positive hypertonic saline challenges (PD15 = 2.3, 33.0, and 51.5 ml). No clear relationship was found between BHR to either methacholine or hypertonic saline and levels of mast cells, eosinophils or lymphocytes in samples of biopsy tissue or lavage fluid. CONCLUSIONS: Most of the lung transplant recipients studied were responsive to methacholine and unresponsive to hypertonic saline. BHR was not clearly related to airway inflammation, suggesting an alternative mechanism for BHR following lung transplantation from that usually assumed in asthma. 



PMCID: PMC1758572  PMID: 9227723
3.  Evaluation of six oxygen concentrators. 
Thorax  1985;40(11):806-810.
Examples of six oxygen concentrators (DeVO2, Dom 10, Econo 2, Hudson, Permox, and Roomate) were evaluated over a 9-28 day period to determine (1) the oxygen yield (% O2) over the flow range 1-4 l min-1; (2) 90% oxygen rise time (90% RT) from a cold start when they were operated at 2 l min-1; (3) accuracy and readability of the flow device; (4) static outlet pressure; (5) major components comprising the product gas (Hudson only); and (6) general characteristics. At an outlet flow of 2 l min-1 the mean % O2 generated by all models, except the Permox (which was lower, mean (SD) 90.5% (3.1%), were between 94% and 95% with a range of less than +/- 0.5%. The Dom 10, Econo 2, and Hudson consistently generated higher oxygen concentrations than the other models at flow rates greater than 2 l min-1. The 90% RT was less than 10.5 minutes for all models. Deviations of up to 22% were observed between predicted and measured flow rates in all models except the DeVO2, Hudson, and Permox. It was possible to set the orifice type flow devices fitted to the Permox and Roomate between indicated flow settings, resulting in cessation of flow. Spectral analysis of the output of one device showed that argon and oxygen were concentrated to similar extents, indicating that the maximal attainable oxygen yield for a molecular sieve concentrator is about 96%.
PMCID: PMC1020554  PMID: 4071455

Results 1-3 (3)