OBJECTIVES:Nasal nitric oxide (nNO) is a reliable non-invasive screening test for primary ciliary dyskinesia (PCD), but the recommended technique, exhalation against resistance (ER), requires cooperation limiting its use in young children. Our objectives were to determine whether easier non-velum closure techniques have the ability to discriminate PCD and longitudinal reproducibility. STUDY DESIGN:We conducted a case-control study evaluating 5 breathing techniques (ER, breath hold, tidal breathing mouth open, tidal breathing mouth closed, and humming) for measuring nNO in patients with PCD compared with control subjects (cystic fibrosis [CF], non-PCD non-CF bronchiectasis, and healthy). A subgroup repeated measurements 1 month later. Sensitivity, specificity, and intraclass correlation coefficient of each nNO technique were determined. RESULTS:We tested 85 children (20 PCD, 32 CF, 14 broncheoctasis, and 19 healthy), aged 5 to 18 years (mean age, 11.5 years); 52% of children were male. All breathing techniques discriminated patients with PCD from control subjects with high specificity (>90%), 100% sensitivity, and intraclass correlation coefficient >0.8. nNO output cutoff values for diagnosing PCD varied with techniques (ER, 59 nL/min; breath hold, 61 nL/min; tidal breathing mouth open, 37 nL/min; tidal breathing mouth closed, 30 nL/min; humming, 41 nL/min). CONCLUSION:Non-velum closure techniques are reproducible and valid to discriminate PCD; however, they generally yield lower values than ER.

The performance in terms of signal-to-interference ratio (SIR), teletraffic, and spectral efficiency of a combined macrocellular and microcellular network is investigated when either both types of cells share the same channel set, or when the channel set is partitioned between the macrocells and the microcells. The analysis is for time-division multiple access (TDMA) with frequency hopping, power control, and discontinuous transmission, and the radio channel is composed of an inverse fourth-power path loss law with log-normal fading. We commence by introducing a single microcell into a hexagonal cluster of macrocells before considering clustered microcells. Both omnidirectional and sectorized cells are examined. We find that high reuse factors are required when channel sharing is employed. When channel partitioning is used, no co-channel interference occurs between the microcells and the macrocells allowing them to be planned independently. The reuse factors in the microcells and macrocells therefore do not need to be increased beyond conventional values. The outcome is that by opting for channel partitioning, the improvement in spectral efficiency compared to channel sharing is two to three times greater.