Sample records for aerosol inhalation scintigraphy

  1. Alveolar epithelial permeability in bronchial asthma in children; An evaluation by [sup 99m]Tc-DTPA inhalation scintigraphy

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    Oishi, Takuji (Nippon Medical School, Tokyo (Japan))


    To evaluate alveolar epithelial permeability (k[sub ep]) in children with bronchial asthma, [sup 99m]Tc-DTPA (diethylene triamine penta acetate) aerosol lung inhalation scintigraphies were performed. There was no correlation between the k[sub ep] value and the severity of asthma. On the other hand, out of 10 cases which had no aerosol deposition defect in the lung field, 4 showed high k[sub ep] values on the whole lung field and 7 had high k[sub ep] value areas, particularly apparent in the upper lung field. These results suggest that even when the central airway lesions are mild, severe damage exists in the alveolar region of the peripheral airway. (author).

  2. Electrostatics in pharmaceutical aerosols for inhalation. (United States)

    Wong, Jennifer; Chan, Hak-Kim; Kwok, Philip Chi Lip


    Electrostatics continues to play an important role in pharmaceutical aerosols for inhalation. Despite its ubiquitous nature, the charging process is complex and not well understood. Nonetheless, significant advances in the past few years continue to improve understanding and lead to better control of electrostatics. The purpose of this critical review is to present an overview of the literature, with an emphasis on how electrostatic charge can be useful in improving pulmonary drug delivery.

  3. Technetium-99m DTPA inhalation scintigraphy in patients treated with fluoxetine and maprotiline: preliminary results

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    Kaya, G.C.; Durak, H.; Oezdogan, Oe.; Sayit, E.; Degirmenci, B.; Derebek, E. [Dokuz Eyluel Univ., Izmir (Turkey). School of Medicine; Yemez, B.; Turhal, Ue. [Dept. of Psychiatry, Dokuz Eylul Univ. School of Medicine, Izmir (Turkey)


    Drug-metabolising enzymatic activities have been detected in tracheobronchiolar, bronchiolar and alveolar regions in the lungs. Induction of phospholipidosis by amine drugs such as clorphentermine has also been shown. This study aimed to investigate the effect of fluoxetine and maprotiline, which contain amine groups in their structure, on pulmonary epithelial membrane permeability. Twenty-seven patients (mean age 36{+-}12 years) with various psychiatric problems, of whom 17 were treated with fluoxetine and 10 with maprotiline, were included in this study. Technetium-99m diethylene triamine penta-acetic acid (DTPA) aerosol inhalation scintigraphy was performed before and after 4-6 weeks of therapy. Following the inhalation of 1480 MBq {sup 99m}Tc-DTPA for 3 min, lung images in a 64 x 64 matrix were obtained every minute for 30 min. Regions of interest were drawn around the periphery of the lungs and on the major airways. Clearance half-times (T{sub 1/2}) were calculated by placing a mono-exponential fit on the curves. Penetration index (PI) was calculated on the first-minute image. There was no difference between the clearance rates of {sup 99m}Tc-DTPA before and after therapy for either the fluoxetine or the maprotiline group. After therapy, a significant decrease in PI was found in patients treated with fluoxetine (PI values before and after therapy: 0.53{+-}0.03 and 0.49{+-}0.05 respectively, P{<=}0.05). This finding might have been due to the induction of increased synaptic serotonin (5-HT) by fluoxetine, which acts by inhibiting the re-uptake of 5-HT on presynaptic membranes. Bronchoconstriction of small and medium airways may be caused by direct and indirect effects of 5-HT on smooth muscle contraction. (orig.)

  4. Radioaerosol inhalation lung scintigraphy in bronchial asthma; Deposition patterns of radioaerosol and mucocilliary clearance in children and youth

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    Chiba, Takashi (Nippon Medical School, Tokyo (Japan))


    A study on obstructive changes in airways and mucociliary clearance in children and youth with bronchial asthma was performed. Radioaerosol inhalation lung scintigraphies using [sup 99T]c-human serum albumin (HSA) were applied to 50 children and youth with bronchial asthma. The deposition patterns of the radioaerosol and aerosol clearance curves were evaluated. Abnormal deposition patterns, which consisted of non-homogeneous distribution and/or hot spot formation, were likely to be seen in patients with asthmatic attacks at the time of measurements. However, a few asymptomatic patients also revealed abnormal deposition patterns. The deposition patterns were related to FEV[sub 1.0]%, MMF, V[sub 50] and V[sub 25], but especially to FEV[sub 1.0]%. As an index of mucociliary clearance, [beta], the rate constant of the [sup 99m]Tc-HSA aerosol clearance curve, was introduced. [beta] was significantly lower in patients with abnormal aerosol deposition patterns than in normal persons. [beta] was also significantly lower in patients undergoing asthmatic attack at the time of the measurements than in asymptomatic patients. [beta] correlated negatively with FEV[sub 1.0]%, MMF, V[sub 50] and V[sub 25], but especially with FEV[sub 1.0]%. Although patients with long term affection or moderate-to-severe asthma tended to reveal abnormal deposition patterns and had low [beta] values, these differences were not statistically significant. Radioaerosol inhalation lung scintigraphy with [sup 99m]Tc-HSA is useful for evaluating not only obstructive changes in the airways but also for evaluating mucociliary clearance in children with bronchial asthma. (author).

  5. Hospital washbasin water: risk of Legionella-contaminated aerosol inhalation. (United States)

    Cassier, P; Landelle, C; Reyrolle, M; Nicolle, M C; Slimani, S; Etienne, J; Vanhems, P; Jarraud, S


    The contamination of aerosols by washbasin water colonized by Legionella in a hospital was evaluated. Aerosol samples were collected by two impingement technologies. Legionella was never detected by culture in all the (aerosol) samples. However, 45% (18/40) of aerosol samples were positive for Legionella spp. by polymerase chain reaction, with measurable concentrations in 10% of samples (4/40). Moreover, immunoassay detected Legionella pneumophila serogroup 1 and L. anisa, and potentially viable bacteria were seen on viability testing. These data suggest that colonized hospital washbasins could represent risks of exposure to Legionella aerosol inhalation, especially by immunocompromised patients.

  6. Inhalability for aerosols at ultra-low windspeeds

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    Sleeth, Darrah K; Vincent, James H, E-mail: jhv@umich.ed [Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, 48109 (United States)


    Most previous experimental studies of aerosol inhalability were conducted in wind tunnels for windspeeds greater than 0.5 ms-{sup 1}. While that body of work was used to establish a convention for the inhalable fraction, results from studies in calm air chambers (for essentially zero windspeed) are being discussed as the basis of a modified criterion. However, information is lacking for windspeeds in the intermediate range, which - it so happens - pertain to most actual workplaces. With this in mind, we have developed a new experimental system to assess inhalability - and, ultimately, personal sampler performance - for aerosols with particle aerodynamic diameter within the range from about 9 to 90 mum for ultra-low windspeed environments from about 0.1 to 0.5 ms{sup 1}. This new system contains an aerosol test facility, fully described elsewhere, that combines the physical attributes and performance characteristics of moving air wind tunnels and calm air chambers, both of which have featured individually in previous research. It also contains a specially-designed breathing, heated, life-sized mannequin that allows for accurate recovery of test particulate material that has been inhaled. Procedures have been developed that employ test aerosols of well-defined particle size distribution generated mechanically from narrowly-graded powders of fused alumina. Using this new system, we have conducted an extensive set of new experiments to measure the inhalability of a human subject (as represented by the mannequin), aimed at filling the current knowledge gap for conditions that are more realistic than those embodied in most previous research. These data reveal that inhalability throughout the range of interest is significantly different based on windspeed, indicating a rise in aspiration efficiency as windspeed decreases. Breathing flowrate and mode of breathing (i.e. nose versus mouth breathing) did not show significant differences for the inhalability of aerosols. On

  7. Inhalability for aerosols at ultra-low windspeeds (United States)

    Sleeth, Darrah K.; Vincent, James H.


    Most previous experimental studies of aerosol inhalability were conducted in wind tunnels for windspeeds greater than 0.5 ms-1. While that body of work was used to establish a convention for the inhalable fraction, results from studies in calm air chambers (for essentially zero windspeed) are being discussed as the basis of a modified criterion. However, information is lacking for windspeeds in the intermediate range, which - it so happens - pertain to most actual workplaces. With this in mind, we have developed a new experimental system to assess inhalability - and, ultimately, personal sampler performance - for aerosols with particle aerodynamic diameter within the range from about 9 to 90 μm for ultra-low windspeed environments from about 0.1 to 0.5 ms1. This new system contains an aerosol test facility, fully described elsewhere, that combines the physical attributes and performance characteristics of moving air wind tunnels and calm air chambers, both of which have featured individually in previous research. It also contains a specially-designed breathing, heated, life-sized mannequin that allows for accurate recovery of test particulate material that has been inhaled. Procedures have been developed that employ test aerosols of well-defined particle size distribution generated mechanically from narrowly-graded powders of fused alumina. Using this new system, we have conducted an extensive set of new experiments to measure the inhalability of a human subject (as represented by the mannequin), aimed at filling the current knowledge gap for conditions that are more realistic than those embodied in most previous research. These data reveal that inhalability throughout the range of interest is significantly different based on windspeed, indicating a rise in aspiration efficiency as windspeed decreases. Breathing flowrate and mode of breathing (i.e. nose versus mouth breathing) did not show significant differences for the inhalability of aerosols. On the whole

  8. Generation and Characterization of Indoor Fungal Aerosols for Inhalation Studies. (United States)

    Madsen, Anne Mette; Larsen, Søren T; Koponen, Ismo K; Kling, Kirsten I; Barooni, Afnan; Karottki, Dorina Gabriela; Tendal, Kira; Wolkoff, Peder


    In the indoor environment, people are exposed to several fungal species. Evident dampness is associated with increased respiratory symptoms. To examine the immune responses associated with fungal exposure, mice are often exposed to a single species grown on an agar medium. The aim of this study was to develop an inhalation exposure system to be able to examine responses in mice exposed to mixed fungal species aerosolized from fungus-infested building materials. Indoor airborne fungi were sampled and cultivated on gypsum boards. Aerosols were characterized and compared with aerosols in homes. Aerosols containing 10(7)CFU of fungi/m(3)air were generated repeatedly from fungus-infested gypsum boards in a mouse exposure chamber. Aerosols contained Aspergillus nidulans,Aspergillus niger, Aspergillus ustus, Aspergillus versicolor,Chaetomium globosum,Cladosporium herbarum,Penicillium brevicompactum,Penicillium camemberti,Penicillium chrysogenum,Penicillium commune,Penicillium glabrum,Penicillium olsonii,Penicillium rugulosum,Stachybotrys chartarum, and Wallemia sebi They were all among the most abundant airborne species identified in 28 homes. Nine species from gypsum boards and 11 species in the homes are associated with water damage. Most fungi were present as single spores, but chains and clusters of different species and fragments were also present. The variation in exposure level during the 60 min of aerosol generation was similar to the variation measured in homes. Through aerosolization of fungi from the indoor environment, cultured on gypsum boards, it was possible to generate realistic aerosols in terms of species composition, concentration, and particle sizes. The inhalation-exposure system can be used to study responses to indoor fungi associated with water damage and the importance of fungal species composition.

  9. Size aspects of metered-dose inhaler aerosols. (United States)

    Kim, C S; Trujillo, D; Sackner, M A


    The aerodynamic size distribution of several bronchodilator and corticosteroid metered-dose inhaler (MDI) aerosols was estimated in both dry and humid (90% RH) air environments with a six-stage cascade impactor. The distribution of aerosol size that penetrated into a simulated lung model were also measured. The size distributions were approximately log-normal and ranged from 2.4 to 5.5 micron in mass median aerodynamic diameter (MMAD) with geometric standard deviation (GSD) of 1.7 to 2.5 in a dry environment. In humid air, MMAD increased from 1 to 26% above the dry air state, but GSD remained unchanged. The size of aerosol delivered by MDI that penetrated into a simulated lung model fell to 2.4 to 2.8 micron in MMAD (GSD, 1.9 to 2.2). In contrast to aerosols produced by MDI, MMAD of an aerosol of cromolyn sodium powder dispersed by a Spinhaler increased rapidly with increasing humidity, 5.6 +/- 0.3 micron in dry air and 10.1 +/- 0.8 micron in 90% RH air. Finally, the factors influencing size of MDI-delivered aerosols, including formulation, canister pressure, physicochemical properties of propellants, and design of the valve and actuator orifices are discussed. Effective delivery of MDI-generated aerosols into the lung is highly dependent on particle dynamics and jet flow, and no single parameter can produce a unique particle size and jet pattern.

  10. Inhalation toxicity of lithium combustion aerosols in rats

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    Greenspan, B.J.; Allen, M.D.; Rebar, A.H.


    Studies of the acute inhalation toxicity of lithium combustion aerosols were undertaken to aid in evaluating the health hazards associated with the proposed use of lithium metal in fusion reactors. Male and female F344/Lov rats, 9-12 wk of age, were exposed once for 4 h to concentrations of 2600, 2300, 1400, or 620 mg/m/sup 3/ of aerosol (MMAD = 0.69, sigma/sub g/ = 1.45) that was approximately 80% lithium carbonate and 20% lithium hydroxide to determine the acute toxic effects. Fourteen-day LC50 values (with 95% confidence limits) of 1700 (1300-2000) mg/m/sup 3/ for the male rats and 2000 (1700-2400) mg/m/sup 3/ for the female rate were calculated. Clinical signs of anorexia, dehydration, respiratory difficulty, and perioral and perinasal encrustation were observed. Body weights were decreased the first day after exposure in relation to the exposure concentration. In animals observed for an additional 2 wk, body weights, organ weights, and clinical signs began to return to pre-exposure values. Histopathologic examination of the respiratory tracts from the animals revealed ulcerative or necrotic laryngitis, focal to segmental ulcerative rhinitis often accompanied by areas of squamous metaplasia, and, in some cases, a suppurative bronchopneumonia or aspiration pneumonia, probably secondary to the laryngeal lesions. The results of these studies indicate the moderate acute toxicity of lithium carbonate aerosols and will aid in the risk analysis of accidental releases of lithium combustion aerosols.

  11. [Inhalation therapy: inhaled corticosteroids in ENT, development and technical challenges of powder inhalers, nebulisers synchronized with breathing and aerosol size distribution. GAT aerosolstorming, Paris 2012]. (United States)

    Le Guen, P; Peron, N; Durand, M; Pourchez, J; Cavaillon, P; Reychler, G; Vecellio, L; Dubus, J-C


    The working group on aerosol therapy (GAT) of the Société de Pneumologie de Langue Française (SPLF) has organized its third Aerosolstorming in 2012. During one single day, different aspects of inhaled therapies have been treated and are detailed in two articles, this one being the second. This text deals with the indications of inhaled corticosteroids in ENT, the development and technical challenges of powder inhalers, the advantages and disadvantages of each type of technologies to measure the particle sizes of inhaled treatments.

  12. Inhalable PEGylated Phospholipid Nanocarriers and PEGylated Therapeutics for Respiratory Delivery as Aerosolized Colloidal Dispersions and Dry Powder Inhalers

    Directory of Open Access Journals (Sweden)

    Priya Muralidharan


    Full Text Available Nanomedicine is making groundbreaking achievements in drug delivery. The versatility of nanoparticles has given rise to its use in respiratory delivery that includes inhalation aerosol delivery by the nasal route and the pulmonary route. Due to the unique features of the respiratory route, research in exploring the respiratory route for delivery of poorly absorbed and systemically unstable drugs has been increasing. The respiratory route has been successfully used for the delivery of macromolecules like proteins, peptides, and vaccines, and continues to be examined for use with small molecules, DNA, siRNA, and gene therapy. Phospholipid nanocarriers are an attractive drug delivery system for inhalation aerosol delivery in particular. Protecting these phospholipid nanocarriers from pulmonary immune system attack by surface modification by polyethylene glycol (PEGylation, enhancing mucopenetration by PEGylation, and sustaining drug release for controlled drug delivery are some of the advantages of PEGylated liposomal and proliposomal inhalation aerosol delivery. This review discusses the advantages of using PEGylated phospholipid nanocarriers and PEGylated therapeutics for respiratory delivery through the nasal and pulmonary routes as inhalation aerosols.

  13. Production of Inhalable Submicrometer Aerosols from Conventional Mesh Nebulizers for Improved Respiratory Drug Delivery. (United States)

    Longest, P Worth; Spence, Benjamin M; Holbrook, Landon T; Mossi, Karla M; Son, Yoen-Ju; Hindle, Michael


    Submicrometer and nanoparticle aerosols may significantly improve the delivery efficiency, dissolution characteristics, and bioavailability of inhaled pharmaceuticals. The objective of this study was to explore the formation of submicrometer and nanometer aerosols from mesh nebulizers suitable for respiratory drug delivery using experiments and computational fluid dynamics (CFD) modeling. Mesh nebulizers were coupled with add-on devices to promote aerosol drying and the formation of submicrometer particles, as well as to control the inhaled aerosol temperature and relative humidity. Cascade impaction experiments were used to determine the initial mass median aerodynamic diameters of 0.1% albuterol aerosols produced by the AeroNeb commercial (4.69 μm) and lab (3.90 μm) nebulizers and to validate the CFD model in terms of droplet evaporation. Through an appropriate selection of flow rates, nebulizers, and model drug concentrations, submicrometer and nanometer aerosols could be formed with the three devices considered. Based on CFD simulations, a wire heated design was shown to overheat the airstream producing unsafe conditions for inhalation if the aerosol was not uniformly distributed in the tube cross-section or if the nebulizer stopped producing droplets. In comparison, a counter-flow heated design provided sufficient thermal energy to produce submicrometer particles, but also automatically limited the maximum aerosol outlet temperature based on the physics of heat transfer. With the counter-flow design, submicrometer aerosols were produced at flow rates of 5, 15, and 30 LPM, which may be suitable for various forms of oral and nasal aerosol delivery. Thermodynamic conditions of the aerosol stream exiting the counter-flow design were found be in a range of 21-45 °C with relative humidity greater than 40% in some cases, which was considered safe for direct inhalation and advantageous for condensational growth delivery.

  14. Use of pressurised aerosol inhalers among patients attending the Chest Clinic and Primary Care Department of University Hospital, Kuala Lumpur. (United States)

    Liam, C K; Lo, Y L; Yap, B H; Low, S H; Ariwalagam, M


    Eighty consecutive patients who came to collect their prescriptions for pressurised aerosol inhalers at the Pharmacy of the University Hospital, Kuala Lumpur, were interviewed regarding their use of the pressurised inhaler. Their inhaler technique was also assessed. A significant proportion inhaled the steroid aerosol before the bronchodilator and 23.5% used the steroid inhaler for relief of acute dyspnoea. Only 28.8% of the 80 patients performed correctly all 6 steps necessary for the proper use of inhalers. The most common mistake was the failure to inhale slowly and deeply. Patients who had used the device for more than 5 years performed better, while correct inhaler technique was not dependent on the patient's sex, age or level of education.

  15. Temporal effects of inhaled histamine and methacholine aerosols on the pulmonary mechanics of thoroughbred horses. (United States)

    Guthrie, A J; Beadle, R E; Bateman, R D; White, C E


    This paper presents a method for on-line determination of pulmonary mechanics in standing, non-sedated horses during and following inhalation of aerosolized drug solutions. This method was used to evaluate the temporal effects of inhaled histamine and methacholine aerosols on pulmonary mechanics in 18 Thoroughbred horses. The following were concluded from this study. The extremely large between-breath variation, for all variables used to evaluate pulmonary mechanics in the horse, limits the usefulness of these variables for modeling the non-specific pulmonary responses to inhaled stimulants on a breath-by-breath basis. Following the implementation of averaging techniques to control the variation of these response variables, respiratory rate appears to be affected most predictably by inhalation of non-specific bronchoconstrictors. In the 18 subjects studied, the response of respiratory rate to inhaled histamine and methacholine aerosols was well described by a complex function consisting of exponential treatment and post-treatment phases in 10 and six of the subjects, respectively. Large intra-individual variation of the non-specific response to these stimulants in repeated studies of some subjects, suggests that differences in responses on a particular day may be due to inter-day variations in minute ventilation or baseline airway caliber.

  16. Natural versus anthropogenic inhalable aerosol chemistry of transboundary East Asian atmospheric outflows into western Japan

    NARCIS (Netherlands)

    Moreno, T.; Kojima, T.; Querol, X.; Alastuey, A.; Amato, F.; Gibbons, W.


    The eastward transport of aerosols exported from mainland Asia strongly influences air quality in the Japanese archipelago. The bulk of the inhalable particulate matter (PM10) in these intrusions comprises either natural, desert-derived minerals (mostly supermicron silicates) or anthropogenic pollut

  17. Effects of inhaled acid aerosols on lung mechanics: an analysis of human exposure studies. (United States)

    Utell, M J


    There exist significant gaps in our understanding of human health effects from inhalation of pollutants associated with acid precipitation. Controlled clinical studies examine effects of criteria pollutants almost exclusively by assessing changes in lung mechanics. One constituent of acid precipitation, sulfuric acid aerosols, has been shown to induce bronchoconstriction in exercising extrinsic asthmatics at near ambient levels. These asthmatics may be an order of magnitude more sensitive to sulfuric acid aerosols than normal adults. More recently, a second component nitrogen dioxide has been observed to provoke changes in lung mechanics at progressively lower concentrations. To date, virtually no data exist from clinical exposures to acidic aerosols for subjects with chronic obstructive pulmonary disease.

  18. Development and characterization of a resistance spot welding aerosol generator and inhalation exposure system. (United States)

    Afshari, Aliakbar; Zeidler-Erdely, Patti C; McKinney, Walter; Chen, Bean T; Jackson, Mark; Schwegler-Berry, Diane; Friend, Sherri; Cumpston, Amy; Cumpston, Jared L; Leonard, H Donny; Meighan, Terence G; Frazer, David G; Antonini, James M


    Limited information exists regarding the health risks associated with inhaling aerosols that are generated during resistance spot welding of metals treated with adhesives. Toxicology studies evaluating spot welding aerosols are non-existent. A resistance spot welding aerosol generator and inhalation exposure system was developed. The system was designed by directing strips of sheet metal that were treated with an adhesive to two electrodes of a spot welder. Spot welds were made at a specified distance from each other by a computer-controlled welding gun in a fume collection chamber. Different target aerosol concentrations were maintained within the exposure chamber during a 4-h exposure period. In addition, the exposure system was run in two modes, spark and no spark, which resulted in different chemical profiles and particle size distributions. Complex aerosols were produced that contained both metal particulates and volatile organic compounds (VOCs). Size distribution of the particles was multi-modal. The majority of particles were chain-like agglomerates of ultrafine primary particles. The submicron mode of agglomerated particles accounted for the largest portion of particles in terms of particle number. Metal expulsion during spot welding caused the formation of larger, more spherical particles (spatter). These spatter particles appeared in the micron size mode and accounted for the greatest amount of particles in terms of mass. With this system, it is possible to examine potential mechanisms by which spot welding aerosols can affect health, as well as assess which component of the aerosol may be responsible for adverse health outcomes.

  19. Inhalants (United States)

    ... which open the breathing passages. Inhalers are very safe when used as prescribed by doctors. Inhalants, on the other hand, are common household chemicals that contain a volatile component which can be ...

  20. Effects of inhaled acid aerosols on lung mechanics: an analysis of human exposure studies.


    Utell, M J


    There exist significant gaps in our understanding of human health effects from inhalation of pollutants associated with acid precipitation. Controlled clinical studies examine effects of criteria pollutants almost exclusively by assessing changes in lung mechanics. One constituent of acid precipitation, sulfuric acid aerosols, has been shown to induce bronchoconstriction in exercising extrinsic asthmatics at near ambient levels. These asthmatics may be an order of magnitude more sensitive to ...

  1. Differences in physical chemistry and dissolution rate of solid particle aerosols from solution pressurised inhalers. (United States)

    Buttini, Francesca; Miozzi, Michele; Balducci, Anna Giulia; Royall, Paul G; Brambilla, Gaetano; Colombo, Paolo; Bettini, Ruggero; Forbes, Ben


    Solution composition alters the dynamics of beclomethasone diproprionate (BDP) particle formation from droplets emitted by pressurised metered dose inhalers (pMDIs). The hypothesis that differences in inhaler solutions result in different solid particle physical chemistry was tested using a suite of complementary calorimetric techniques. The atomisation of BDP-ethanol solutions from commercial HFA-pMDI produced aerodynamically-equivalent solid particle aerosols. However, differences in particle physico-chemistry (morphology and solvate/clathrate formation) were detected by differential scanning calorimetry (DSC), thermogravimetric analysis (TGA) and supported by hot stage microscopy (HSM). Increasing the ethanol content of the formulation from 8 to 12% (w/w), which retards the evaporation of propellant and slows the increase in droplet surface viscosity, enhanced the likelihood of particles drying with a smooth surface. The dissolution rate of BDP from the 12% (w/w) ethanol formulation-derived particles (63% dissolved over 120 min) was reduced compared to the 8% (w/w) ethanol formulation-derived particles (86% dissolved over 120 min). The addition of 0.01% (w/w) formoterol fumarate or 1.3% (w/w) glycerol to the inhaler solution modified the particles and reduced the BDP dissolution rate further to 34% and 16% dissolved in 120 min, respectively. These data provide evidence that therapeutic aerosols from apparently similar inhaler products, including those with similar aerodynamic performance, may behave non-equivalently after deposition in the lungs.

  2. Near-fatal methemoglobinemia after recreational inhalation of amyl nitrite aerosolized with a compressed gas blower. (United States)

    Lin, Chih-Hao; Fang, Cheng-Chung; Lee, Chien-Chang; Ko, Patrick Chow-In; Chen, Wen-Jone


    Adverse effects associated with recreational inhalation of nitrites are usually mild and rarely life-threatening. We report a rare case of near-fatal methemoglobinemia after inhalation of amyl nitrite after aerosolizing the liquid using a compressed gas blower designed to clean photographic equipment that employed hydrofluoroalkane-134a as a propellant. A 31-year-old previously healthy male became dyspneic and fainted soon after the recreational inhalation of amyl nitrite aerosolized using a compressed gas blower. He was brought to the emergency department with severe cyanotic appearance and profound shock. Oxygen saturation was 82%, unresponsive to oxygen supply. His methemoglobin blood level was 52.2%. After 100 mg of methylene blue (2 mg/kg body weight) was administered intravenously, he recovered consciousness, and dyspnea and cyanosis subsided gradually. This case illustrates the extraordinary hazard of the use of a compressed gas blower in the recreational inhalation of nitrites. Prompt recognition and rapid antidotal treatment may adequately correct near-fatal overdose associated with recreational use of amyl nitrite.

  3. Recent Updates on Electronic Cigarette Aerosol and Inhaled Nicotine Effects on Periodontal and Pulmonary Tissues. (United States)

    Javed, Fawad; Kellesarian, Sergio V; Sundar, Isaac K; Romanos, Georgios E; Rahman, Irfan


    E-cigarette derived inhaled nicotine may contribute to the pathogenesis of periodontal and pulmonary diseases in particular via lung inflammation, injurious and dysregulated repair responses. Nicotine is shown to have anti-proliferative properties and affects fibroblasts in vitro, which may interfere in tissue myofibroblast differentiation in e-cig users. This will affect the ability to heal wounds by decreasing wound contraction. In periodontics, direct exposure to e-vapor has been shown to produce harmful effects in periodontal ligament and gingival fibroblasts in culture. This is due to the generation of reactive oxygen species/aldehydes/carbonyls from e-cig aerosol, leading to protein carbonylation of extracellular matrix and DNA adducts/damage. A limited number of studies regarding the effects of e-cig in oral and lung health are available. However, no reports are available to directly link the deleterious effects on e-cigs, inhaled nicotine, and flavorings aerosol on oral periodontal and pulmonary health in particular to identify the risk of oral diseases by e-cigarettes and nicotine aerosols. This mini-review summarizes the recent perspectives on e-cigarettes including inhaled nicotine effects on several pathophysiological events, such as oxidative stress, DNA damage, innate host response, inflammation, cellular senescence, pro-fibrogenic and dysregulated repair, leading to lung remodeling, oral submucous fibrosis and periodontal diseases. This article is protected by copyright. All rights reserved.

  4. Ultrasensitive detection of inhaled organic aerosol particles by accelerator mass spectrometry. (United States)

    Parkhomchuk, E V; Gulevich, D G; Taratayko, A I; Baklanov, A M; Selivanova, A V; Trubitsyna, T A; Voronova, I V; Kalinkin, P N; Okunev, A G; Rastigeev, S A; Reznikov, V A; Semeykina, V S; Sashkina, K A; Parkhomchuk, V V


    Accelerator mass spectrometry (AMS) was shown to be applicable for studying the penetration of organic aerosols, inhaled by laboratory mice at ultra-low concentration ca. 10(3) cm(-3). We synthesized polystyrene (PS) beads, composed of radiocarbon-labeled styrene, for testing them as model organic aerosols. As a source of radiocarbon we used methyl alcohol with radioactivity. Radiolabeled polystyrene beads were obtained by emulsifier-free emulsion polymerization of synthesized (14)C-styrene initiated by K2S2O8 in aqueous media. Aerosol particles were produced by pneumatic spraying of diluted (14)C-PS latex. Mice inhaled (14)C-PS aerosol consisting of the mix of 10(3) 225-nm particles per 1 cm(3) and 5·10(3) 25-nm particles per 1 cm(3) for 30 min every day during five days. Several millions of 225-nm particles deposited in the lungs and slowly excreted from them during two weeks of postexposure. Penetration of particles matter was also observed for liver, kidneys and brain, but not for a heart.

  5. Evaluation of residual functional lung volume on Tc-99m DTPA aerosol ventilation and Tc-99m MAA perfusion scintigraphy in primary ciliary dyskinesia (Kartagener syndrome). (United States)

    Chen, Yu-Wen; Chang, Chin-Chuan; Lai, Yung-Chuang; Lu, Chia-Ying; Dai, Zen-Kong


    Kartagener syndrome is diagnosed as sinusitis, bronchitis (bronchiectasis), and situs inversus by the clinical features. It is a subclass of primary ciliary dyskinesia (PCD) disease. A 12-year-old girl who had frequent upper and lower airway infections since birth, which was confirmed as Kartagener syndrome by HRCT imaging. We present the residual functional lung volume and mucociliary clearance findings seen on Tc-99m DTPA aerosol ventilation and Tc-99m MAA perfusion scintigraphy.

  6. Novel devices for individualized controlled inhalation can optimize aerosol therapy in efficacy, patient care and power of clinical trials

    Directory of Open Access Journals (Sweden)

    Fischer A


    Full Text Available Abstract In the treatment of pulmonary diseases the inhalation of aerosols plays a key role - it is the preferred route of drug delivery in asthma, chronic obstructive pulmonary disease (COPD and cystic fibrosis. But, in contrast to oral and intravenous administration drug delivery to the lungs is controlled by additional parameters. Beside its pharmacology the active agent is furthermore determined by its aerosol characteristics as particle diameter, particle density, hygroscopicity and electrical charge. The patient related factors like age and stage of pulmonary disease will be additionally affected by the individual breathing pattern and morphometry of the lower airways. A number of these parameters with essential impact on the pulmonary drug deposition can be influenced by the performance of the inhalation system. Therefore, the optimization of nebulisation technology was a major part of aerosol science in the last decade. At this time the control of inspiration volume and air flow as well as the administration of a defined aerosol bolus was in the main focus. Up to date a more efficient and a more targeted pulmonary drug deposition - e.g., in the alveoli - will be provided by novel devices which also allow shorter treatment times and a better reproducibility of the administered lung doses. By such means of precise dosing and drug targeting the efficacy of inhalation therapy can be upgraded, e.g., the continuous inhalation of budesonide in asthma. From a patients' perspective an optimized inhalation manoeuvre means less side effects, e.g., in cystic fibrosis therapy the reduced oropharyngeal tobramycin exposure causes fewer bronchial irritations. Respecting to shorter treatment times also, this result in an improved quality of life and compliance. For clinical trials the scaling down of dose variability in combination with enhanced pulmonary deposition reduces the number of patients to be included and the requirement of pharmaceutical

  7. The efficacy of the inhalation of an aerosolized Group A streptococcal preparation in the treatment of lung cancer

    Institute of Scientific and Technical Information of China (English)

    Jun Liu; Xiang Liu; Fei Cui; Guoqin Chen; Yubao Guan; Jianxing He


    Objective:To observe the efficacy of the inhalation of an aerosolized group A streptococcal (GAS) preparation in treating orthotopic lung cancer in mouse models and assess the feasibility,safety,and effectiveness of this administration mode for lung cancer.Methods:Lewis lung carcinoma (LLC) cell strains were administered via intrathoracic injection to establish orthotopic lung cancer mouse models.After the tumor-bearing models were successfully established,as confirmed by computed tomography,the mice were administered by inhalation with an aerosolized GAS preparation (GAS group) or aerosolized normal saline (control group).The anti-tumor effect of the aerosolized GAS preparation was evaluated histologically; meanwhile,the survival and quality of life were compared between these two groups.Results:The aerosolized GAS preparation showed remarkably anti-tumor effect,causing the necrosis of the orthotopic lung cancer cells in tumor-bearing mice.Furthermore,mice in the GAS group had significantly better quality of life and longer survival than those in control group.conclusions:The inhalation of aerosolized GAS preparation may be a feasible,safe and effective solution for lung cancer.

  8. Comparative irritant potency of inhaled sulfate aerosols--effects on bronchial mucociliary clearance. (United States)

    Schlesinger, R B


    The effect of 1-hr oral inhalation exposures to submicrometer aerosols of ammonium bisulfate (NH4HSO4), ammonium sulfate [NH4)2SO4), and sodium sulfate (Na2SO4) upon mucociliary clearance from the bronchial tree of rabbits was examined. Exposures to NH4HSO4 at concentrations of approximately 600-1700 micrograms/m3 produced a significant depression of clearance rate only at the highest exposure level. No significant effects were observed with the other sulfates at levels up to approximately 2000 micrograms/m3. When results were compared to those from another study in this laboratory using sulfuric acid (H2SO4) aerosol, the ranking of irritant potency was H2SO4 greater than NH4HSO4 greater than (NH4)2SO4, Na2SO4. Alteration in bronchial mucociliary clearance due to sulfate aerosols appears to be related to the deposition of [H+] on the mucus lining of conducting airways.

  9. Cancer mortality and occupational exposure to aromatic amines and inhalable aerosols in rubber tire manufacturing in Poland.

    NARCIS (Netherlands)

    de Vocht, F.; Sobala, W.; Wilczynska, U.; Kromhout, H.; Szeszenia-Dabrowska, N.; Peplonska, B.


    AIM: Most data on carcinogenic risk in the rubber industry are based on data from Western countries. This study assessed cancer risks in a retrospective cohort in a Polish tire manufacturing plant, relying on quantified exposure to inhalable aerosols and aromatic amines instead of job titles or exte

  10. Pilot Study of Inhaled Aerosols Targeted via Magnetic Alignment of High Aspect Ratio Particles in Rabbits

    Directory of Open Access Journals (Sweden)

    Gillian E. S. Redman


    Full Text Available Recently, inhaled pharmaceutical aerosols have seen increased investigation in the treatment of lung cancer, where the inability to deliver adequate therapeutic drug concentrations to tumour sites may be overcome with improved targeted delivery to the site of the tumour. In this study, the feasibility of magnetically targeted delivery of high aspect ratio particles loaded with iron oxide nanoparticles was studied in 19 New Zealand White rabbits. Half of the exposed rabbits had a magnetic field placed externally over their right lung. Iron sensitive magnetic resonance images of the lungs were acquired to determine the iron concentrations in the right and left lung of each animal. The right/left ratio increased in the middle and basal regions of the lung where, due to the morphology of the rabbit lung, this method of targeting is most effective. With further optimization, this technique could be an effective method for increasing the dose of drug delivered to a specific site within the lung.

  11. Changing the dose metric for inhalation toxicity studies: short-term study in rats with engineered aerosolized amorphous silica nanoparticles. (United States)

    Sayes, Christie M; Reed, Kenneth L; Glover, Kyle P; Swain, Keith A; Ostraat, Michele L; Donner, E Maria; Warheit, David B


    Inhalation toxicity and exposure assessment studies for nonfibrous particulates have traditionally been conducted using particle mass measurements as the preferred dose metric (i.e., mg or microg/m(3)). However, currently there is a debate regarding the appropriate dose metric for nanoparticle exposure assessment studies in the workplace. The objectives of this study were to characterize aerosol exposures and toxicity in rats of freshly generated amorphous silica (AS) nanoparticles using particle number dose metrics (3.7 x 10(7) or 1.8 x 10(8) particles/cm(3)) for 1- or 3-day exposures. In addition, the role of particle size (d(50) = 37 or 83 nm) on pulmonary toxicity and genotoxicity endpoints was assessed at several postexposure time points. A nanoparticle reactor capable of producing, de novo synthesized, aerosolized amorphous silica nanoparticles for inhalation toxicity studies was developed for this study. SiO(2) aerosol nanoparticle synthesis occurred via thermal decomposition of tetraethylorthosilicate (TEOS). The reactor was designed to produce aerosolized nanoparticles at two different particle size ranges, namely d(50) = approximately 30 nm and d(50) = approximately 80 nm; at particle concentrations ranging from 10(7) to 10(8) particles/cm(3). AS particle aerosol concentrations were consistently generated by the reactor. One- or 3-day aerosol exposures produced no significant pulmonary inflammatory, genotoxic, or adverse lung histopathological effects in rats exposed to very high particle numbers corresponding to a range of mass concentrations (1.8 or 86 mg/m(3)). Although the present study was a short-term effort, the methodology described herein can be utilized for longer-term inhalation toxicity studies in rats such as 28-day or 90-day studies. The expansion of the concept to subchronic studies is practical, due, in part, to the consistency of the nanoparticle generation method.

  12. Ferrets develop fatal influenza after inhaling small particle aerosols of highly pathogenic avian influenza virus A/Vietnam/1203/2004 (H5N1

    Directory of Open Access Journals (Sweden)

    Sosna William A


    Full Text Available Abstract Background There is limited knowledge about the potential routes for H5N1 influenza virus transmission to and between humans, and it is not clear whether humans can be infected through inhalation of aerosolized H5N1 virus particles. Ferrets are often used as a animal model for humans in influenza pathogenicity and transmissibility studies. In this manuscript, a nose-only bioaerosol inhalation exposure system that was recently developed and validated was used in an inhalation exposure study of aerosolized A/Vietnam/1203/2004 (H5N1 virus in ferrets. The clinical spectrum of influenza resulting from exposure to A/Vietnam/1203/2004 (H5N1 through intranasal verses inhalation routes was analyzed. Results Ferrets were successfully infected through intranasal instillation or through inhalation of small particle aerosols with four different doses of Influenza virus A/Vietnam/1203/2004 (H5N1. The animals developed severe influenza encephalomyelitis following intranasal or inhalation exposure to 101, 102, 103, or 104 infectious virus particles per ferret. Conclusions Aerosolized Influenza virus A/Vietnam/1203/2004 (H5N1 is highly infectious and lethal in ferrets. Clinical signs appeared earlier in animals infected through inhalation of aerosolized virus compared to those infected through intranasal instillation.

  13. Late-occurring pulmonary pathologies following inhalation of mixed oxide (uranium + plutonium oxide) aerosol in the rat. (United States)

    Griffiths, N M; Van der Meeren, A; Fritsch, P; Abram, M-C; Bernaudin, J-F; Poncy, J L


    Accidental exposure by inhalation to alpha-emitting particles from mixed oxide (MOX: uranium and plutonium oxide) fuels is a potential long-term health risk to workers in nuclear fuel fabrication plants. For MOX fuels, the risk of lung cancer development may be different from that assigned to individual components (plutonium, uranium) given different physico-chemical characteristics. The objective of this study was to investigate late effects in rat lungs following inhalation of MOX aerosols of similar particle size containing 2.5 or 7.1% plutonium. Conscious rats were exposed to MOX aerosols and kept for their entire lifespan. Different initial lung burdens (ILBs) were obtained using different amounts of MOX. Lung total alpha activity was determined by external counting and at autopsy for total lung dose calculation. Fixed lung tissue was used for anatomopathological, autoradiographical, and immunohistochemical analyses. Inhalation of MOX at ILBs ranging from 1-20 kBq resulted in lung pathologies (90% of rats) including fibrosis (70%) and malignant lung tumors (45%). High ILBs (4-20 kBq) resulted in reduced survival time (N = 102; p MOX, similar to results for industrial plutonium oxide alone (1.9% Gy). Staining with antibodies against Surfactant Protein-C, Thyroid Transcription Factor-1, or Oct-4 showed differential labeling of tumor types. In conclusion, late effects following MOX inhalation result in similar risk for development of lung tumors as compared with industrial plutonium oxide.

  14. Acute pulmonary toxicity following inhalation exposure to aerosolized VX in anesthetized rats. (United States)

    Peng, Xinqi; Perkins, Michael W; Simons, Jannitt; Witriol, Alicia M; Rodriguez, Ashley M; Benjamin, Brittany M; Devorak, Jennifer; Sciuto, Alfred M


    This study evaluated acute toxicity and pulmonary injury in rats at 3, 6 and 24 h after an inhalation exposure to aerosolized O-ethyl S-[2-(diisopropylamino)ethyl] methylphosphonothioate (VX). Anesthetized male Sprague-Dawley rats (250-300 g) were incubated with a glass endotracheal tube and exposed to saline or VX (171, 343 and 514 mg×min/m³ or 0.2, 0.5 and 0.8 LCt₅₀, respectively) for 10 min. VX was delivered by a small animal ventilator at a volume of 2.5 ml × 70 breaths/minute. All VX-exposed animals experienced a significant loss in percentage body weight at 3, 6, and 24 h post-exposure. In comparison to controls, animals exposed to 514 mg×min/m³ of VX had significant increases in bronchoalveolar lavage (BAL) protein concentrations at 6 and 24 h post-exposure. Blood acetylcholinesterase (AChE) activity was inhibited dose dependently at each of the times points for all VX-exposed groups. AChE activity in lung homogenates was significantly inhibited in all VX-exposed groups at each time point. All VX-exposed animals assessed at 20 min and 3, 6 and 24 h post-exposure showed increases in lung resistance, which was prominent at 20 min and 3 h post-exposure. Histopathologic evaluation of lung tissue of the 514 mg×min/m³ VX-exposed animals at 3, 6 and 24 h indicated morphological changes, including perivascular inflammation, alveolar exudate and histiocytosis, alveolar septal inflammation and edema, alveolar epithelial necrosis, and bronchiolar inflammatory infiltrates, in comparison to controls. These results suggest that aerosolization of the highly toxic, persistent chemical warfare nerve agent VX results in acute pulmonary toxicity and lung injury in rats.

  15. Design, characterization, and aerosolization of organic solution advanced spray-dried moxifloxacin and ofloxacin dipalmitoylphosphatidylcholine (DPPC microparticulate/nanoparticulate powders for pulmonary inhalation aerosol delivery

    Directory of Open Access Journals (Sweden)

    Duan J


    Full Text Available Jinghua Duan,1,2 Frederick G Vogt,3 Xiaojian Li,1 Don Hayes Jr,4,5 Heidi M Mansour6 1University of Kentucky College of Pharmacy, Department of Pharmaceutical Sciences – Drug Development Division, Lexington, KY, USA; 2University of Washington-Seattle, College of Pharmacy, Department of Pharmaceutics, Seattle, WA, USA; 3GlaxoSmithKline, Analytical Sciences, Product Development, King of Prussia, PA, USA; 4The Ohio State University College of Medicine, Departments of Pediatrics and Internal Medicine, Nationwide Children's Hospital Lung and Heart-Lung Transplant Programs, Columbus, OH, USA; 5The Ohio State University, Davis Heart and Lung Research Institute, Columbus, OH, USA; 6The University of Arizona–Tucson, College of Pharmacy, Skaggs Center of Pharmaceutical Sciences, Tucson, AZ, USA Abstract: The aim of this study was to design and develop respirable antibiotics moxifloxacin (MOXI hydrochloride and ofloxacin (OFLX microparticles and nanoparticles, and multifunctional antibiotics particles with or without lung surfactant 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC for targeted dry powder inhalation delivery as a pulmonary nanomedicine. Particles were rationally designed and produced by advanced spray-drying particle engineering from an organic solution in closed mode (no water from dilute solution. Scanning electron microscopy indicated that these particles had both optimal particle morphology and surface morphology, and the particle size distributions were suitable for pulmonary delivery. Comprehensive and systematic physicochemical characterization and in vitro aerosol dispersion performance revealed significant differences between these two fluoroquinolone antibiotics following spray drying as drug aerosols and as cospray-dried antibiotic drug: DPPC aerosols. Fourier transform infrared spectroscopy and confocal Raman microspectroscopy were employed to probe composition and interactions in the solid state. Spray-dried MOXI was

  16. In Vivo Performance Testing of the Novel Medspray (R) Wet Aerosol Inhaler

    NARCIS (Netherlands)

    Munnik, P.; Boer, de A.H.; Wissink, J.; Hagedoorn, P.; Heskamp, I.; Kruijf, de W.; Rijn, van C.J.M.; Frijlink, H.W.; Zanen, P.


    Background: Monodisperse salbutamol inhalers were compared to select the optimal mass median aerodynamic diameter: 4.0, 5.0 or 6.0 mu m. Methods: Fifteen mild asthmatic patients participated. In all a FEV1-response of >12% (vs. baseline) or >200 mL after inhalation of 200 mu g salbutamol was m

  17. Effect of aerosol inhalation of ipratropium bromide combined with budesonide and terbutaline on cytokines in children with bronchopneumonia

    Institute of Scientific and Technical Information of China (English)

    Xiang-Yu Che


    Objective:To explore the clinical efficacy of aerosol inhalation of ipratropium bromide combined with budesonide and terbutaline in the treatment of bronchopneumonia in children and the effect on cytokines.Methods:A total of 70 children with bronchopneumonia who were admitted in our hospital from March, 2015 to March, 2016 were included in the study and randomized into the study group and the control group. The patients in the control group were given anti-infection, oxygen inhalation, cough and asthma relieving, acidosis correcting, mask+oxygen driven aerosol inhalation of budesonide (0.5 mg/time) and terbutaline (1.0 mg/time), with an oxygen flow rate of 5-7 L/min, 5-10 min every time, twice a day. On the above basis, the patients in the study group were given additional ipratropium bromide (1.0 mg/time). After 7-day treatment, the efficacy was evaluated. The levels of IL-6, TNF-α, CRP, and WBC before and after treatment were detected. PEF, FVC, and FEV1 before and after treatment were detected. The improvement of clinical symptoms and signs, and the occurrence of adverse reactions were observed.Results: The levels of IL-6, TNF-α, CRP, and WBC counting after treatment in the two groups were significantly reduced when compared with before treatment (P0.05).Conclusions:Ipratropium bromide combined with budesonide and terbutaline in the treatment of bronchopneumonia in children can rapidly relieve the symptoms, and improve the cytokine level, without obvious adverse reactions; therefore, it deserves to be widely recommended in the clinic.

  18. MR pulmonary ventilation information of canines inhaling aerosolized gadolinium-DTPA%应用雾化Gd DTPA获得犬肺通气信息

    Institute of Scientific and Technical Information of China (English)

    郭佑民; 吴晓明; 杨健; 王建国; 雷晓燕


    AIM:To investigate the effect of inhaling aerosolized gadolinium DTPA (Gd-DTPA) on pulmonary MR imaging in canines. METHODS:Six healthy northern dogs were performed MR scanning by using single shot turbo spin echo sequence.The changes of signal intensity (SI) in pulmonary parenchyma were respectively measured after inhaling air gas,aerosolized sodium chloride and Gd-DTPA as contrast agents.The differences of SI were compared between them. RESULTS:The SI of pulmonary parenchyma increased by 11.5%- 25.8% after inhalation of aerosolized sodium chloride solution, with no statistic difference compared to inhalation of air(t=2.798,P >0.05). Whereas the SI after inhalation of aerosolized Gd DTPA increased much higher by 42.7%- 76.8% than that after inhalation of air and aerosolized sodium chloride solution(t=4.660, P0.05);吸入 Gd-DTPA雾化颗粒后肺实质信号强度明显增加,增强幅度 42.7~ 76.8%,平均 59.2%,与吸入空气时的信号强度相比有统计学差异 (t=4.660,P< 0.05). 结论 :雾化的 Gd-DTPA可以作为一种有效的肺部 MRI增强对比剂,应用雾化 Gd DTPA来获得大型实验动物的有关肺通气信息是可行的.

  19. Diagnostic value of static and dynamic scintigraphy in diagnosis of acute respiratory distress syndrome in the course of sepsis. Part 2. Lung aerosol scintigraphy; Wartosc diagnostyczna scyntygrafii statycznej i dynamicznej pluc w diagnostyce zespolu ostrej niewydolnosci oddechowej doroslych u chorych w przebiegu posocznicy. Czesc 2. Scyntygrafia aerozolowa

    Energy Technology Data Exchange (ETDEWEB)

    Jurgilewicz, D.; Rogowski, F.; Malinowska, L. [Zaklad Medycyny Nuklearnej and Zaklad Anastezjologii i Intensywnej Terapii, Akademia Medyczna, Bialystok (Poland)


    Rapid increase in permeability of functionally and/or structurally damaged alveolar-capillary barrier is the pivotal factor in non-cardiogenic pulmonary edema development. Rate of exudative changes progress in the lungs decides about prognosis in patients with this serious, over 50% death rate, syndrome. The aim of the study was to estimate the usefulness of dynamic lung scintigraphy in diagnosis of gas exchange abnormalities in sepsis and ARDS. Aerosol scintigraphy with pulmonary clearance of DTPA in 6 septic and in 6 ARDS patients were performed. Studies were done using planar gamma camera, type MB9200, in A-P projection. They were analyzed with the modified NMS Warsaw Polytechnic computer program. Aerosol scintiscans demonstrated very irregular borderlines of both lungs, features of marked impairment in ventilation (with foci of increased radioactivity in the view of main bronchi) and about 2.5-fold faster pulmonary clearance of DTPA in ARDS patients comparing to sepsis and control groups. The results showed that dynamic scintigraphy can be safely performed in patients in critical condition. Changes in scintiscans and rapid pulmonary clearance of DTPA might be an early indicator of ARDS development in septic patients. (author) 18 refs, 2 figs, 4 tabs



  1. Pulmonary cellular effects in rats following aerosol exposures to ultrafine Kevlar aramid fibrils: evidence for biodegradability of inhaled fibrils. (United States)

    Warheit, D B; Kellar, K A; Hartsky, M A


    Previous chronic inhalation studies have shown that high concentrations of Kevlar fibrils produced fibrosis and cystic keratinizing tumors in rats following 2-year inhalation exposures. The current studies were undertaken to evaluate mechanisms and to assess the toxicity of inhaled Kevlar fibrils relative to other reference materials. Rats were exposed to ultrafine Kevlar fibers (fibrils) for 3 or 5 days at concentrations ranging from 600-1300 fibers/cc (gravimetric concentrations ranging from 2-13 mg/m3). A complete characterization of the fiber aerosol and dose was carried out. These measurements included gravimetric concentrations, mass median aerodynamic diameter, fiber number, and count median lengths and diameters of the aerosol. Following exposures, cells and fluids from groups of sham- and fiber-exposed animals were recovered by bronchoalveolar lavage (BAL). Alkaline phosphatase, lactate dehydrogenase (LDH), protein, and N-acetyl glucosaminidase (NAG) values were measured in BAL fluids at several time points postexposure. Alveolar macrophages were cultured and studied for morphology, chemotaxis, and phagocytosis by scanning electron microscopy. The lungs of additional exposed animals were processed for deposition, cell labeling, retained dose, and lung clearance studies, as well as fiber dimensions (from digested lung tissue), histopathology, and transmission electron microscopy. Five-day exposures to Kevlar fibrils elicited a transient granulocytic inflammatory response with concomitant increases in BAL fluid levels of alkaline phosphatase, NAG, LDH, and protein. Unlike the data from silica and asbestos exposures where inflammation persisted, biochemical parameters returned to control levels at time intervals between 1 week and 1 month postexposure. Macrophage function in Kevlar-exposed alveolar macrophages was not significantly different from sham controls at any time period. Cell labeling studies were carried out immediately after exposure, as well as 1

  2. Chronic inhalation studies of man-made vitreous fibres: characterization of fibres in the exposure aerosol and lungs. (United States)

    Hesterberg, T W; Miiller, W C; Thevenaz, P; Anderson, R


    Inhalation studies were conducted to determine the chronic biological effects in rodents of respirable fractions of different man-made vitreous fibres (MMVFs), including refractory ceramic fibre (RCF), fibrous glass, rock (stone) wool and slag wool. Animals were exposed nose-only, 6 h per day, 5 days per week, for 18 months (hamsters) or 24 months (rats). Exposure to 10 mg m-3 of crocidolite or chrysotile asbestos induced pulmonary fibrosis, lung tumours and mesothelioma in rats, thus validating the inhalation model with known human carcinogenic fibres. Exposure of rats to 30 mg m-3 of refractory ceramic fibres (RCF) also resulted in pulmonary fibrosis as well as significant increases in lung tumours and mesothelioma. In hamsters, 30 mg m-3 of RCF induced a 41% incidence of mesotheliomas. Exposure of rats to 30 mg m-3 of fibre glasses (MMVF 10 or 11) or of slag wool (MMVF 22) was associated with an inflammatory response, but no mesotheliomas or significant increase in the lung tumours were observed. Rock wool (stone wool: MMVF 21) at the same exposure level resulted in minimal lung fibrosis, but no mesotheliomas or significant increase in the lung tumours were observed. Fibre numbers (WHO fibres) and dimensions in the aerosols and lungs of exposed animals were comparable in this series of inhalation studies. Differences in lung fibre burdens and lung clearance rates could not explain the differences observed in the toxicologic effects of the MMVFs. These findings indicate that dose, dimension and durability may not be the only determinants of fibre toxicity. Chemical composition and the surface physico-chemical properties of the fibres may also play an important role.

  3. Inhaler technique: facts and fantasies. A view from the Aerosol Drug Management Improvement Team (ADMIT). (United States)

    Levy, Mark L; Dekhuijzen, P N R; Barnes, P J; Broeders, M; Corrigan, C J; Chawes, B L; Corbetta, L; Dubus, J C; Hausen, Th; Lavorini, F; Roche, N; Sanchis, J; Usmani, Omar S; Viejo, J; Vincken, W; Voshaar, Th; Crompton, G K; Pedersen, Soren


    Health professionals tasked with advising patients with asthma and chronic obstructive pulmonary disease (COPD) how to use inhaler devices properly and what to do about unwanted effects will be aware of a variety of commonly held precepts. The evidence for many of these is, however, lacking or old and therefore in need of re-examination. Few would disagree that facilitating and encouraging regular and proper use of inhaler devices for the treatment of asthma and COPD is critical for successful outcomes. It seems logical that the abandonment of unnecessary or ill-founded practices forms an integral part of this process: the use of inhalers is bewildering enough, particularly with regular introduction of new drugs, devices and ancillary equipment, without unnecessary and pointless adages. We review the evidence, or lack thereof, underlying ten items of inhaler 'lore' commonly passed on by health professionals to each other and thence to patients. The exercise is intended as a pragmatic, evidence-informed review by a group of clinicians with appropriate experience. It is not intended to be an exhaustive review of the literature; rather, we aim to stimulate debate, and to encourage researchers to challenge some of these ideas and to provide new, updated evidence on which to base relevant, meaningful advice in the future. The discussion on each item is followed by a formal, expert opinion by members of the ADMIT Working Group.

  4. Inhalation of aerosols produced by sodium fires: effects on respiratory tract. Effetto dell'inalazione di aerosols prodotti in fuochi di sodio sull'albero respiratorio con particolare riferimento all'epitelio della laringe e della trachea

    Energy Technology Data Exchange (ETDEWEB)

    Giovanetti, A.; Pagano, P.


    This paper takes stock of the state of knowledge on the effects of inhalation of aerosols produced by a sodium fire on health. The results of the experiments regarding inhalation of sodium combustion products, yielded on laboratory scale, by Sprague-Dawley rats are then reported. This study turns the attention to the toxic effects on the epithelium of the larynx and trachea. This research is carried out in the ambit of the activities that the Laboratory of Physics and Toxicology of Aerosols of the ENEA (Italian Commission for Nuclear and Alternative Energies) Department for the Protection of the Environment and Human Health (Physics and Biology Division) is developing on the atmospheric behavior of aerosols produced in a hypothetical accident in a fast reactor involving the cooling liquid, and also on its environmental and health effects, with particular regard to the experimental fast reactor, PEC, now in construction at Brasimone.

  5. [A disulfiram-alcohol reaction after inhalation of a salbutamol aerosol: a plausible interaction?]. (United States)

    Choi, T; Neven, A; Al Hadithy, A F Y


    An asthmatic patient (male, aged 47) being treated for his alcohol dependence complained of experiencing mild symptoms of disulfiram-alcohol reaction after using of pressurised metered-dose inhaler containing ethanol. It has been reported in the literature that the disulfiram-alcohol reaction may occur after a patient has been exposed to only minimal amounts of ethanol. This is why, in daily practice, physicians are generally reluctant to prescribe preparations containing ethanol and why they usually switch patients to an alternative. However, close evaluation of the biopharmaceutical and pharmacokinetic aspects of ethanol suggests that subjective disulfiram-alcohol reactions following the use of inhalers containing ethanol cannot be explained rationally from a clinical pharmacological perspective.

  6. Influenza A Virus Challenge Models in Cynomolgus Macaques Using the Authentic Inhaled Aerosol and Intra-Nasal Routes of Infection.

    Directory of Open Access Journals (Sweden)

    Anthony C Marriott

    Full Text Available Non-human primates are the animals closest to humans for use in influenza A virus challenge studies, in terms of their phylogenetic relatedness, physiology and immune systems. Previous studies have shown that cynomolgus macaques (Macaca fascicularis are permissive for infection with H1N1pdm influenza virus. These studies have typically used combined challenge routes, with the majority being intra-tracheal delivery, and high doses of virus (> 107 infectious units. This paper describes the outcome of novel challenge routes (inhaled aerosol, intra-nasal instillation and low to moderate doses (103 to 106 plaque forming units of H1N1pdm virus in cynomolgus macaques. Evidence of virus replication and sero-conversion were detected in all four challenge groups, although the disease was sub-clinical. Intra-nasal challenge led to an infection confined to the nasal cavity. A low dose (103 plaque forming units did not lead to detectable infectious virus shedding, but a 1000-fold higher dose led to virus shedding in all intra-nasal challenged animals. In contrast, aerosol and intra-tracheal challenge routes led to infections throughout the respiratory tract, although shedding from the nasal cavity was less reproducible between animals compared to the high-dose intra-nasal challenge group. Intra-tracheal and aerosol challenges induced a transient lymphopaenia, similar to that observed in influenza-infected humans, and greater virus-specific cellular immune responses in the blood were observed in these groups in comparison to the intra-nasal challenge groups. Activation of lung macrophages and innate immune response genes was detected at days 5 to 7 post-challenge. The kinetics of infection, both virological and immunological, were broadly in line with human influenza A virus infections. These more authentic infection models will be valuable in the determination of anti-influenza efficacy of novel entities against less severe (and thus more common influenza

  7. In vitro evaluation of the effect of metered-dose inhaler administration technique on aerosolized drug delivery. (United States)

    Shalansky, K F; Htan, E Y; Lyster, D M; Mouat, B; Tweeddale, M G


    The administration of aerosolized metered-dose inhalers (MDIs) to mechanically ventilated patients is labor intensive due to the large number of activations required and the currently recommended 30- to 60-second "wait and shake" between each puff. No studies have been published that assess the relationship between this delay between puffs and drug delivery. To address this issue, we conducted an in vitro, randomized, single-blind study using fenoterol MDI containing technetium-99m pertechnetate. Four modes of MDI administration were tested in triplicate by random sequence. Eight activations of the MDI were performed for each mode according to the following procedures: rapid succession (5 sec apart); 30-second intervals and shaking MDI between two rapid activations; 30-second intervals and shaking between each activation; and 60-second intervals and shaking between each activation. Two closed in vitro systems were designed to collect and measure the radiolabeled aerosol. In the first system, the MDI was activated into a plastic collection container; with the second system, the MDI was administered through an aerosol holding chamber with attached circuit filter positioned on the inspiratory line of the ventilator circuit. Sixty-second intervals between each activation were not tested with the second system. Radioactivity was measured before and after each mode of testing. No difference was found between the various modes of administration other than a 14% decrease in the amount of radioactivity released with the 60-second waiting period between puffs, compared with their rapid succession when using the plastic collection container system. Our results support the hypothesis that the delay after each activation of a MDI may not be necessary.

  8. [Scintigraphy of pulmonary ventilation with 99mTc-DTPA radio-aerosol. I. Semiotics of the static images]. (United States)

    Maini, C L; Bonetti, M G; Giordano, A; Pistelli, R; Antonelli Incalzi, R; Vecchioli, A; Galli, G


    Papers on deposition pattern analyses of radio-aerosol lung scans are few and not easy to interpret as there is a general lack of technical standardization and the number of patients studied is not large. Moreover these reports have been generally obtained with non-hydrosoluble radioaerosols. In the present study 43 patients underwent conventional pulmonary function testing and lung scanning using small droplet (equal or less than 2 microns) polydisperse 99mTc-DTPA radioaerosol produced with the "Settling Bag System"--Medi 400 (Sorin). The scans were analysed by two methods: a semiquantitative method proposed by Taplin (SQT); an original simpler semiquantitative method (SQM). Correlations of SQT and SQM with FEV1 and MEF75 resulted highly significant (p less than 0,001). SQM proved to be superior to SQT as far as reproducibility is concerned. The following conclusions can be drawn: small particle 99mTc-DTPA aerosol can be easily and cheaply produced by a commercial device; such a radioaerosol is well suited for the evaluation of small and large airways patency, as reflected by MEF75 and FEV1 respectively, with a diagnostic yield comparable to non-hydrosoluble radioaerosols; the original semiquantitative description of the deposition patterns proposed and validated in this study is quite easy to implement and it yields a high correlation with pulmonary function tests; moreover such an approach does not require digital data processing; the sensitivity of 99mTc-DTPA for the diagnosis of bronchial obstruction is very high and superior to routine pulmonary function tests; in addition the ventilation scan allows the topographical localization of the obstructions themselves.

  9. Inhalational anthrax (Ames aerosol) in naive and vaccinated New Zealand rabbits: characterizing the spread of bacteria from lung deposition to bacteremia.


    Bradford eGutting; Tonya L Nichols; Channel, Stephen R.; Gearhart, Jeffery M.; Andrews, George A.; Berger, Alan E.; Mackie, Ryan S.; Brent J Watson; Taft, Sarah C.; Overheim, Katie A.; Robert L Sherwood


    There is a need to better understand inhalational anthrax in relevant animal models. This understanding could aid risk assessment, help define therapeutic windows, and provide a better understanding of disease. The aim here was to characterize and quantify bacterial deposition and dissemination in rabbits following exposure to single high aerosol dose (>100LD50) of Bacillus anthracis (Ames) spores immediately following exposure through 36 hours. The primary goal of collecting the data w...

  10. Characterization and aerosol dispersion performance of advanced spray-dried chemotherapeutic PEGylated phospholipid particles for dry powder inhalation delivery in lung cancer. (United States)

    Meenach, Samantha A; Anderson, Kimberly W; Zach Hilt, J; McGarry, Ronald C; Mansour, Heidi M


    Pulmonary inhalation chemotherapeutic drug delivery offers many advantages for lung cancer patients in comparison to conventional systemic chemotherapy. Inhalable particles are advantageous in their ability to deliver drug deep in the lung by utilizing optimally sized particles and higher local drug dose delivery. In this work, spray-dried and co-spray dried inhalable lung surfactant-mimic PEGylated lipopolymers as microparticulate/nanoparticulate dry powders containing paclitaxel were rationally designed via organic solution advanced spray drying (no water) in closed-mode from dilute concentration feed solution. Dipalmitoylphosphatidylcholine (DPPC) and dipalmitoylphosphatidylethanolamine poly(ethylene glycol) (DPPE-PEG) with varying PEG chain length were mixed with varying amounts of paclitaxel in methanol to produce co-spray dried microparticles and nanoparticles. Scanning electron microscopy showed the spherical particle morphology of the inhalable particles. Thermal analysis and X-ray powder diffraction confirmed the retention of the phospholipid bilayer structure in the solid-state following spray drying, the degree of solid-state molecular order, and solid-state phase transition behavior. The residual water content of the particles was very low as quantified analytically Karl Fisher titration. The amount of paclitaxel loaded into the particles was quantified which indicated high encapsulation efficiencies (43-99%). Dry powder aerosol dispersion performance was measured in vitro using the Next Generation Impactor (NGI) coupled with the Handihaler dry powder inhaler device and showed mass median aerodynamic diameters in the range of 3.4-7 μm. These results demonstrate that this novel microparticulate/nanoparticulate chemotherapeutic PEGylated phospholipid dry powder inhalation aerosol platform has great potential in lung cancer drug delivery.

  11. Pharmaceutical aerosols deposition patterns from a Dry Powder Inhaler: Euler Lagrangian prediction and validation. (United States)

    Ravi Kannan, Ravishekar; Przekwas, A J; Singh, Narender; Delvadia, Renishkumar; Tian, Geng; Walenga, Ross


    This study uses Computational Fluid Dynamics (CFD) to predict, analyze and validate the deposition patterns in a human lung for a Budesonide drug delivered from the Novolizer Dry Powder Inhaler device. We used a test case of known deposition patterns to validate our computational Euler Lagrangian-based deposition predictions. Two different lung models are used: (i) a basic ring-less trachea model and (ii) an advanced Human Zygote5 model. Unlike earlier attempts, the current simulations do not include the device in the computational domain. This greatly reduces the computational effort. To mimic the device, we model the inlet particle jet stream from the device as a spray entering the mouth in a conical fashion. Deposition studies in the various lung regions were performed. We were able to computationally predict and then demonstrate the enhanced deposition in the tracheal and first generation rings/ridges. The enhanced vorticity creation due to the ring structure and the geometrical design contributes to larger deposition in the Zygote5 model. These are in accord with existing data, unlike the ring-less model. Our validated results indicate the need to (i) introduce the ridges in the experimental casts and the CFD surface meshes to be anatomically consistent and obtain physiologically consistent depositions; (ii) introduce a factor to account for the recirculating lighter particles in empirical models.

  12. Design, physicochemical characterization, and optimization of organic solution advanced spray-dried inhalable dipalmitoylphosphatidylcholine (DPPC) and dipalmitoylphosphatidylethanolamine poly(ethylene glycol) (DPPE-PEG) microparticles and nanoparticles for targeted respiratory nanomedicine delivery as dry powder inhalation aerosols. (United States)

    Meenach, Samantha A; Vogt, Frederick G; Anderson, Kimberly W; Hilt, J Zach; McGarry, Ronald C; Mansour, Heidi M


    Novel advanced spray-dried and co-spray-dried inhalable lung surfactant-mimic phospholipid and poly(ethylene glycol) (PEG)ylated lipopolymers as microparticulate/nanoparticulate dry powders of biodegradable biocompatible lipopolymers were rationally formulated via an organic solution advanced spray-drying process in closed mode using various phospholipid formulations and rationally chosen spray-drying pump rates. Ratios of dipalmitoylphosphatidylcholine (DPPC) and dipalmitoylphosphatidylethanolamine PEG (DPPE-PEG) with varying PEG lengths were mixed in a dilute methanol solution. Scanning electron microscopy images showed the smooth, spherical particle morphology of the inhalable particles. The size of the particles was statistically analyzed using the scanning electron micrographs and SigmaScan® software and were determined to be 600 nm to 1.2 μm in diameter, which is optimal for deep-lung alveolar penetration. Differential scanning calorimetry (DSC) and powder X-ray diffraction (PXRD) were performed to analyze solid-state transitions and long-range molecular order, respectively, and allowed for the confirmation of the presence of phospholipid bilayers in the solid state of the particles. The residual water content of the particles was very low, as quantified analytically via Karl Fischer titration. The composition of the particles was confirmed using attenuated total-reflectance Fourier-transform infrared (ATR-FTIR) spectroscopy and confocal Raman microscopy (CRM), and chemical imaging confirmed the chemical homogeneity of the particles. The dry powder aerosol dispersion properties were evaluated using the Next Generation Impactor™ (NGI™) coupled with the HandiHaler® dry powder inhaler device, where the mass median aerodynamic diameter from 2.6 to 4.3 μm with excellent aerosol dispersion performance, as exemplified by high values of emitted dose, fine particle fraction, and respirable fraction. Overall, it was determined that the pump rates defined in the

  13. Sinonasal inhalation of tobramycin vibrating aerosol in cystic fibrosis patients with upper airway Pseudomonas aeruginosa colonization: results of a randomized, double-blind, placebo-controlled pilot study

    Directory of Open Access Journals (Sweden)

    Mainz JG


    Full Text Available Jochen G Mainz,1 Katja Schädlich,1 Claudia Schien,1 Ruth Michl,1 Petra Schelhorn-Neise,2 Assen Koitschev,3 Christiane Koitschev,4 Peter M Keller,5 Joachim Riethmüller,6 Baerbel Wiedemann,7 James F Beck1 1Cystic Fibrosis Centre, Department of Pediatrics, Jena University Hospital, Jena, Germany; 2Otorhinolaryngology Department, Jena University Hospital, Jena, Germany; 3Otorhinolaryngology Department, Klinikum Stuttgart, Germany; 4Otorhinolaryngology Department, University Hospital, Tübingen, Germany; 5Microbiology, Jena University Hospital, Jena, Germany; 6University Hospital, Pediatric CF-Centre, Tübingen, Germany; 7Technical University, Biometrics, Dresden, Germany Rationale: In cystic fibrosis (CF, the paranasal sinuses are sites of first and persistent colonization by pathogens such as Pseudomonas aeruginosa. Pathogens subsequently descend to the lower airways, with P. aeruginosa remaining the primary cause of premature death in patients with the inherited disease. Unlike conventional aerosols, vibrating aerosols applied with the PARI Sinus™ nebulizer deposit drugs into the paranasal sinuses. This trial assessed the effects of vibrating sinonasal inhalation of the antibiotic tobramycin in CF patients positive for P. aeruginosa in nasal lavage. Objectives: To evaluate the effects of sinonasal inhalation of tobramycin on P. aeruginosa quantification in nasal lavage; and on patient quality of life, measured with the Sino-Nasal Outcome Test (SNOT-20, and otologic and renal safety and tolerability. Methods: Patients were randomized to inhalation of tobramycin (80 mg/2 mL or placebo (2 mL isotonic saline once daily (4 minutes/nostril with the PARI Sinus™ nebulizer over 28 days, with all patients eligible for a subsequent course of open-label inhalation of tobramycin for 28 days. Nasal lavage was obtained before starting and 2 days after the end of each treatment period by rinsing each nostril with 10 mL of isotonic saline. Results: Nine

  14. Bronchodilator aerosol administered by metered dose inhaler and spacer in subacute neonatal respiratory distress syndrome. (United States)

    Lee, H; Arnon, S; Silverman, M


    There is increasing evidence that bronchodilators are effective in ventilator dependent preterm infants. The effects of single doses of salbutamol (400 micrograms), ipratropium bromide (72 micrograms), and placebo (four puffs) given by metered dose inhaler and spacer (MDIS) were examined in 10 ventilated preterm infants, with a mean birth weight of 800 g at a postnatal age of 1 week, who were suffering from respiratory distress syndrome. The agents were each given in an open, random design. Blood gases were measured and ventilatory efficiency index (VEI) and arterial/alveolar oxygen tension ratio (PaO2/PAO2) were calculated five minutes before and 30 minutes after administration. Heart rate and mean arterial blood pressure were noted. The mean PaO2 improved by 0.61 kPa and 0.69 kPa after salbutamol and ipratropium bromide, respectively and these changes were significantly greater than the 0.5 kPa fall seen with placebo. The mean arterial carbon dioxide tension fell by 0.98 kPa after salbutamol and 0.59 kPa after ipratropium bromide. After both salbutamol and ipratropium bromide, VEI improved significantly (by 23% and 20% respectively) but there was no significant change in the PaO2/PAO2, suggesting that respiratory mechanics and not ventilation/perfusion balance had improved after a single dose of bronchodilator. We conclude that both salbutamol and ipratropium bromide given by MDIS have useful short term effects in ventilator dependent neonates with respiratory distress syndrome. Precise dose regimens and long term effects remain to be worked out.

  15. Lessons learned from case studies of inhalation exposures of workers to radioactive aerosols

    Energy Technology Data Exchange (ETDEWEB)

    Hoover, M.D.; Fencl, A.F.; Newton, G.J. [and others


    Various Department of Energy requirements, rules, and orders mandate that lessons learned be identified, evaluated, shared, and incorporated into current practices. The recently issued, nonmandatory DOE standard for Development of DOE Lessons Learned Program states that a DOE-wide lessons learned program will {open_quotes}help to prevent recurrences of negative experiences, highlight best practices, and spotlight innovative ways to solve problems or perform work more safely, efficiently, and cost effectively.{close_quotes} Additional information about the lessons learned program is contained in the recently issued DOE handbook on Implementing U.S. Department of Energy Lessons Learned Programs and in October 1995 DOE SAfety Notice on Lessons Learned Programs. This report summarizes work in progress at ITRI to identify lessons learned for worker exposures to radioactive aerosols, and describes how this work will be incorporated into the DOE lessons learned program, including a new technical guide for measuring, modeling, and mitigating airborne radioactive particles. Follow-on work is focusing on preparation of {open_quotes}lessons learned{close_quotes} training materials for facility designers, managers, health protection professionals, line supervisors, and workers.

  16. Measurement of specific parameters for dose calculation after inhalation of aerols containing transuranium elements; Mesure de parametres specifiques pour le calcul de dose apres inhalation d'aerosols renfermant des elements transuraniens

    Energy Technology Data Exchange (ETDEWEB)

    Ramounet-le Gall, B.; Fritsch, P.; Abram, M.C.; Rateau, G.; Grillon, G.; Guillet, K. [Lab. de Radiotoxicologie, CEA/DSV/DRR/SRCA, Bruyeres le Chatel (France); Baude, S. [Lab. de Mesures Specifiques Gaz, CEA/DAM/DASE/SRCE, Bruyeres le Chatel (France); Berard, P. [Cabinet du Conseiller medical du CEA, CEA/DEN/DPS/LABM Saclay, Gif sur Yvette (France); Ansoborlo, E. [CEA/DEN/DRCP/CETAMA, Bagnols sur Ceze (France); Delforge, J. [Lab. de Radiotoxicologie, CEA/DSV/DRR/SRCA, Bruyeres le Chatel (France)


    A review on specific parameter measurements to calculate doses per unit of incorporation according to recommendations of the International Commission of Radiological Protection has been performed for inhaled actinide oxides. Alpha activity distribution of the particles can be obtained by autoradiography analysis using aerosol sampling filters at the work places. This allows us to characterize granulometric parameters of 'pure' actinide oxides, but complementary analysis by scanning electron microscopy is needed for complex aerosols. Dissolution parameters with their standard deviation are obtained after rat inhalation exposure, taking into account both mechanical lung clearance and actinide transfer to the blood estimated from bone retention. In vitro experiments suggest that the slow dissolution rate might decrease as a function of time following exposure. Dose calculation software packages have been developed to take into account granulometry and dissolution parameters as well as specific physiological parameters of exposed individuals. In the case of poorly soluble actinide oxides, granulometry and physiology appear as the main parameters controlling dose value, whereas dissolution only alters dose distribution. Validation of these software packages are in progress. (author)

  17. Granulometric determinations and inhalation dose assessment for atmospheric aerosol contaminated by {sup 137}Cs; Determinazioni granulometriche e valutazioni di dose da inalazione per aerosol atmosferico contaminato da {sup 137}CS

    Energy Technology Data Exchange (ETDEWEB)

    Castellani, C.M.; Luciani, A. [ENEA, Centro Ricerche `E. Clementel`, Bologna (Italy). Dip. Ambiente; Oliviero, L.; Donato, R. [ENEA, Centro Ricerche Saluggia, Vercelli (Italy). Dip. Ambiente


    During the redevelopment of Brescia freight-yard a measurement campaign of atmospheric aerosol was carried out: in fact a {sup 137}Cs ground contamination, caused by the permanence of wagons carrying iron materials contaminated by this radionuclide, had been found out. During the redevelopment phases of excavation and can filling the workers were exposed to the danger of radioactive aerosol inhalation. The aim of the measurement campaign was to test the aerosol sampling and granulometric analysis methodologies with their sensitivity related to the inhalation dose assessments. The results of both aerosuspended mass and activity, evaluated by means of a portable cascade impactor, are presented. The granulometries have been interpolated with a log normal distribution using an iterative routine minimizing the square deviation between the calculated and experimental data. The results related to the dose assessments are also presented. These evaluations have been carried out using both the granulometric information obtained and the more recent models (ICRP 66) both the total concentration data and the dose coefficients referring to the standard conditions of ICRP 68 and of the Italian law (D.Lgs. 230/95). Furthermore the significance and the reliability of the dose assessments referring to the different methodologies are discussed, also in relation to the possibility of using this sampling methodologies for other radionuclides and different exposure conditions.

  18. The effect of excipients on the stability and aerosol performance of salmon calcitonin dry powder inhalers prepared via the spray freeze drying process

    Directory of Open Access Journals (Sweden)

    Poursina Narges


    Full Text Available Spray freeze drying was developed to produce dry powders suitable for applications such as inhalation delivery. In the current study, the spray freeze drying technique was employed to produce inhalable salmon calcitonin microparticles. Effects of the carrier type, concentration of hydroxyl propyl-β-cyclodextrin and the presence of Tween 80 on the chemical and structural stability, as well as on the aerosol performance of the particles were investigated. The results indicated that hydroxyl propyl-β-cyclodextrin had the most important effect on the chemical stability of the powder and strongly increased its stability by increasing its concentration in the formulation. Chemically stable formulations (over 90 % recovery were selected for further examinations. Fluorescence spectroscopy and circular dichroism suggested that the formulations were structurally stable. Aerosol performance showed that the Tween-free powders produced higher fine particle fraction values than the formulations containing Tween (53.7 vs. 41.92 % for trehalose content and 52.85 vs. 43.06 % for maltose content.

  19. The effect of excipients on the stability and aerosol performance of salmon calcitonin dry powder inhalers prepared via the spray freeze drying process. (United States)

    Poursina, Narges; Vatanara, Alireza; Rouini, Mohammad Reza; Gilani, Kambiz; Najafabadi, Abdolhossein Rouholamini


    Spray freeze drying was developed to produce dry powders suitable for applications such as inhalation delivery. In the current study, the spray freeze drying technique was employed to produce inhalable salmon calcitonin microparticles. Effects of the carrier type, concentration of hydroxyl propyl-β-cyclodextrin and the presence of Tween 80 on the chemical and structural stability, as well as on the aerosol performance of the particles were investigated. The results indicated that hydroxyl propyl-β-cyclodextrin had the most important effect on the chemical stability of the powder and strongly increased its stability by increasing its concentration in the formulation. Chemically stable formulations (over 90 % recovery) were selected for further examinations. Fluorescence spectroscopy and circular dichroism suggested that the formulations were structurally stable. Aerosol performance showed that the Tween-free powders produced higher fine particle fraction values than the formulations containing Tween (53.7 vs. 41.92 % for trehalose content and 52.85 vs. 43.06 % for maltose content).

  20. Design, physicochemical characterization, and optimization of organic solution advanced spray-dried inhalable dipalmitoylphosphatidylcholine (DPPC and dipalmitoylphosphatidylethanolamine poly(ethylene glycol (DPPE-PEG microparticles and nanoparticles for targeted respiratory nanomedicine delivery as dry powder inhalation aerosols

    Directory of Open Access Journals (Sweden)

    Meenach SA


    total-reflectance Fourier-transform infrared (ATR-FTIR spectroscopy and confocal Raman microscopy (CRM, and chemical imaging confirmed the chemical homogeneity of the particles. The dry powder aerosol dispersion properties were evaluated using the Next Generation Impactor™ (NGI™ coupled with the HandiHaler® dry powder inhaler device, where the mass median aerodynamic diameter from 2.6 to 4.3 μm with excellent aerosol dispersion performance, as exemplified by high values of emitted dose, fine particle fraction, and respirable fraction. Overall, it was determined that the pump rates defined in the spray-drying process had a significant effect on the solid-state particle properties and that a higher pump rate produced the most optimal system. Advanced dry powder inhalers of inhalable lipopolymers for targeted dry powder inhalation delivery were successfully achieved.Keywords: biocompatible biodegradable lipopolymers, lung surfactant, pulmonary delivery, self-assemblies, solid-state, lipospheres

  1. 大鼠吸入贫铀气溶胶后体内铀的分布%Distribution of uranium in rata inhaled with depleted uranium aerosols

    Institute of Scientific and Technical Information of China (English)

    潘秀颉; 杨陟华; 曹珍山; 李平; 刘刚; 陈忠民; 魏菡; 朱茂祥


    目的 建立贫铀(depleted uranium,Du)气溶胶吸人动物模型,观察气溶胶吸入后Du在重要组织器官的蓄积情况.方法 采用大鼠吸入DU气溶胶的实验模型,分别在吸入后的30、90、180、270、360和540 d,采用激光时间分辨发光分析法测定肺脏、肾脏、股骨、肝脏、心脏、脑、脾脏和胸腺等的铀含量.结果 DU气溶胶吸人后高低剂量组大鼠肺铀含量分别为(499 833.3±14 214.8)ng/g及(25 424.0 ±6193.4)ng/g,明显高于未吸入组(28.8±13.9)ng/g(P<0.05).吸入30 d后,肺、股骨及肾中的铀含量明显升高,随时间逐渐下降;吸入60 d起,肝脏、大脑、心脏、胸腺、脾脏中铀含量高于对照组,铀含量呈先升高后降低的两相分布.铀含量以肺脏、股骨、大脑、胸腺中较高,肾次之,肝、心脏、脾较少.结论 DU气溶胶吸入后,铀可在肺、肾、股骨、肝脏、大脑、心脏、胸腺、脾脏等分布,其中肺、股骨、大脑、胸腺及肾脏中高浓度铀的存在提示上述器官是DU损伤的潜在靶器官.%Objective To investigate the distribution of uranium in rats after inhalation with depleted uranium aerosols. Methods The depleted uranium aerosols were inhaled by Wistar rats. At 30, 90, 180, 270, 360, and 540 d after inhalation, the rata were sacrificed and tissue samples were collected. The contents of uranium in lung, kidney, liver, heart, brain, thighbone, spleen and thymus were measured by laser time-dependent spectroscopy analysis. Resulits The uranium contents of lung increased in the high-dosc and low-dose groups [(499833.3 ± 14214.8) ng/g and (25 424.0 ± 6193.4)ng/g, respectively] after inhalation, and significantly differed from the control (28.8 ± 13.9)ng/g, (P < 0.05).At 30 d after inhalation, the contents of uranium in lung, kidney and thighbone were higher than those of control, and then decreased time-dependently. At 60 d, the contents of uranium in liver, heart, brain, spleen and thymus were higher

  2. Inhalational anthrax (Ames aerosol) in naïve and vaccinated New Zealand rabbits: characterizing the spread of bacteria from lung deposition to bacteremia. (United States)

    Gutting, Bradford W; Nichols, Tonya L; Channel, Stephen R; Gearhart, Jeffery M; Andrews, George A; Berger, Alan E; Mackie, Ryan S; Watson, Brent J; Taft, Sarah C; Overheim, Katie A; Sherwood, Robert L


    There is a need to better understand inhalational anthrax in relevant animal models. This understanding could aid risk assessment, help define therapeutic windows, and provide a better understanding of disease. The aim here was to characterize and quantify bacterial deposition and dissemination in rabbits following exposure to single high aerosol dose (> 100 LD(50)) of Bacillus anthracis (Ames) spores immediately following exposure through 36 h. The primary goal of collecting the data was to support investigators in developing computational models of inhalational anthrax disease. Rabbits were vaccinated prior to exposure with the human vaccine (Anthrax Vaccine Adsorbed, AVA) or were sham-vaccinated, and were then exposed in pairs (one sham and one AVA) so disease kinetics could be characterized in equally-dosed hosts where one group is fully protected and is able to clear the infection (AVA-vaccinated), while the other is susceptible to disease, in which case the bacteria are able to escape containment and replicate uncontrolled (sham-vaccinated rabbits). Between 4-5% of the presented aerosol dose was retained in the lung of sham- and AVA-vaccinated rabbits as measured by dilution plate analysis of homogenized lung tissue or bronchoalveolar lavage (BAL) fluid. After 6 and 36 h, >80% and >96%, respectively, of the deposited spores were no longer detected in BAL, with no detectable difference between sham- or AVA-vaccinated rabbits. Thereafter, differences between the two groups became noticeable. In sham-vaccinated rabbits the bacteria were detected in the tracheobronchial lymph nodes (TBLN) 12 h post-exposure and in the circulation at 24 h, a time point which was also associated with dramatic increases in vegetative CFU in the lung tissue of some animals. In all sham-vaccinated rabbits, bacteria increased in both TBLN and blood through 36 h at which point in time some rabbits succumbed to disease. In contrast, AVA-vaccinated rabbits showed small numbers of CFU in

  3. Higher lung deposition with Respimat® Soft Mist™ Inhaler than HFA-MDI in COPD patients with poor technique

    Directory of Open Access Journals (Sweden)

    Peter Brand


    Full Text Available Peter Brand1, Bettina Hederer2, George Austen3, Helen Dewberry3, Thomas Meyer41RWTH, Aachen, Germany; 2Boehringer Ingelheim, Ingelheim, Germany; 3Boehringer Ingelheim, Bracknell, UK; 4Inamed Research, Gauting, GermanyAbstract: Aerosols delivered by Respimat® Soft Mist™ Inhaler (SMI are slower-moving and longer-lasting than those from pressurized metered-dose inhalers (pMDIs, improving the efficiency of pulmonary drug delivery to patients. In this four-way cross-over study, adults with chronic obstructive pulmonary disease (COPD and with poor pMDI technique received radiolabelled Berodual® (fenoterol hydrobromide 50 µg/ipratropium bromide 20 µg via Respimat® SMI or hydrofluoroalkane (HFA-MDI (randomized order on test days 1 and 2, with no inhaler technique training. The procedure was repeated on test days 3 and 4 after training. Deposition was measured by gamma scintigraphy. All 13 patients entered (9 males, mean age 62 years; FEV1 46% of predicted inhaled too fast at screening (peak inspiratory flow rate [IF]: 69–161 L/min. Whole lung deposition was higher with Respimat® SMI than with pMDI for untrained (37% of delivered dose vs 21% of metered dose and trained patients (53% of delivered vs 21% of metered dose (pSign-Test = 0.15; pANOVA< 0.05. Training also improved inhalation profiles (slower average and peak IF as well as longer breath-hold time. Drug delivery to the lungs with Respimat® SMI is more efficient than with pMDI, even with poor inhaler technique. Teaching patients to hold their breath as well as to inhale slowly and deeply increased further lung deposition using Respimat® SMI.Keywords: chronic obstructive pulmonary disease, drug delivery, inhalation, metered-dose inhaler, poor inhalation technique, training

  4. Preparation and physicochemical characterization of spray-dried and jet-milled microparticles containing bosentan hydrate for dry powder inhalation aerosols (United States)

    Lee, Hyo-Jung; Kang, Ji-Hyun; Lee, Hong-Goo; Kim, Dong-Wook; Rhee, Yun-Seok; Kim, Ju-Young; Park, Eun-Seok; Park, Chun-Woong


    The objectives of this study were to prepare bosentan hydrate (BST) microparticles as dry powder inhalations (DPIs) via spray drying and jet milling under various parameters, to comprehensively characterize the physicochemical properties of the BST hydrate microparticles, and to evaluate the aerosol dispersion performance and dissolution behavior as DPIs. The BST microparticles were successfully prepared for DPIs by spray drying from feeding solution concentrations of 1%, 3%, and 5% (w/v) and by jet milling at grinding pressures of 2, 3, and 4 MPa. The physicochemical properties of the spray-dried (SD) and jet-milled (JM) microparticles were determined via scanning electron microscopy, atomic force microscopy, dynamic light scattering particle size analysis, Karl Fischer titration, surface analysis, pycnometry, differential scanning calorimetry, powder X-ray diffraction, and Fourier transform infrared spectroscopy. The in vitro aerosol dispersion performance and drug dissolution behavior were evaluated using an Anderson cascade impactor and a Franz diffusion cell, respectively. The JM microparticles exhibited an irregular corrugated surface and a crystalline solid state, while the SD microparticles were spherical with a smooth surface and an amorphous solid state. Thus, the in vitro aerosol dispersion performance and dissolution behavior as DPIs were considerably different due to the differences in the physicochemical properties of the SD and JM microparticles. In particular, the highest grinding pressures under jet milling exhibited excellent aerosol dispersion performance with statistically higher values of 56.8%±2.0% of respirable fraction and 33.8%±2.3% of fine particle fraction and lower mass median aerodynamic diameter of 5.0±0.3 μm than the others (P<0.05, analysis of variance/Tukey). The drug dissolution mechanism was also affected by the physicochemical properties that determine the dissolution kinetics of the SD and JM microparticles, which were well

  5. Preparation and physicochemical characterization of spray-dried and jet-milled microparticles containing bosentan hydrate for dry powder inhalation aerosols

    Directory of Open Access Journals (Sweden)

    Lee H


    Full Text Available Hyo-Jung Lee,1 Ji-Hyun Kang,1 Hong-Goo Lee,1 Dong-Wook Kim,2 Yun-Seok Rhee,3 Ju-Young Kim,4 Eun-Seok Park,5 Chun-Woong Park1 1College of Pharmacy, Chungbuk National University, 2Department of Pharmaceutical Engineering, Cheongju University, Cheongju, 3College of Pharmacy and Research Institute of Pharmaceutical Sciences, Gyeongsang National University, Jinju, 4College of Pharmacy, Woosuk University, Wanju-gun, 5School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea Abstract: The objectives of this study were to prepare bosentan hydrate (BST microparticles as dry powder inhalations (DPIs via spray drying and jet milling under various parameters, to comprehensively characterize the physicochemical properties of the BST hydrate microparticles, and to evaluate the aerosol dispersion performance and dissolution behavior as DPIs. The BST microparticles were successfully prepared for DPIs by spray drying from feeding solution concentrations of 1%, 3%, and 5% (w/v and by jet milling at grinding pressures of 2, 3, and 4 MPa. The physicochemical properties of the spray-dried (SD and jet-milled (JM microparticles were determined via scanning electron microscopy, atomic force microscopy, dynamic light scattering particle size analysis, Karl Fischer titration, surface analysis, pycnometry, differential scanning calorimetry, powder X-ray diffraction, and Fourier transform infrared spectroscopy. The in vitro aerosol dispersion performance and drug dissolution behavior were evaluated using an Anderson cascade impactor and a Franz diffusion cell, respectively. The JM microparticles exhibited an irregular corrugated surface and a crystalline solid state, while the SD microparticles were spherical with a smooth surface and an amorphous solid state. Thus, the in vitro aerosol dispersion performance and dissolution behavior as DPIs were considerably different due to the differences in the physicochemical properties of the SD and JM microparticles. In

  6. Effect ofγ-aminobutyric acid combined with conventional aerosol inhalation therapy on serum indicators and induced sputum indicators of patients with asthma

    Institute of Scientific and Technical Information of China (English)

    Jun-Ning Li


    Objective:To analyze the effect ofγ-aminobutyric acid combined with conventional aerosol inhalation therapy on serum indicators and induced sputum indicators of patients with asthma. Methods:A total of 116 asthma patients receiving treatment in our hospital from July 2011 to August 2014 were included for study, and then all patients were divided into observation group (n=60) and control group (n=56). Differences in illness-related factor and protein expression in serum and induced sputum were compared between two groups.Results: Serum PDGF-BB, SP, LTE4 and CGRP levels of observation group after treatment were lower than those of control group, and TGFβ1 level was higher than that of control group (P<0.05); serum OPN, HSP70, Eotaxin and ECP expression levels of observation group after treatment were lower than those of control group, and VDBP and CC16 expression levels were higher than those of control group (P<0.05); SCF, M-CSF, CKLF1 and ICAM-1 levels in induced sputum of observation group after treatment were lower than those of control group (P<0.05); MCP-1, Gal-3, RAGE, HMGB1 and SDF-1 levels in induced sputum of observation group after treatment were lower than those of control group (P<0.05).Conclusions:After patients with asthma receivedγ-aminobutyric acid combined with conventional aerosol inhalation therapy, the levels of disease severity-related indicators in serum and induced sputum are optimized, and it has significant effect on disease treatment.

  7. Inhalational anthrax (Ames aerosol in naive and vaccinated New Zealand rabbits: characterizing the spread of bacteria from lung deposition to bacteremia.

    Directory of Open Access Journals (Sweden)

    Bradford eGutting


    Full Text Available There is a need to better understand inhalational anthrax in relevant animal models. This understanding could aid risk assessment, help define therapeutic windows, and provide a better understanding of disease. The aim here was to characterize and quantify bacterial deposition and dissemination in rabbits following exposure to single high aerosol dose (>100LD50 of Bacillus anthracis (Ames spores immediately following exposure through 36 hours. The primary goal of collecting the data was to support investigators in developing computational models of inhalational anthrax disease. Rabbits were vaccinated prior to exposure with the human vaccine (Anthrax Vaccine Adsorbed, AVA or were sham-vaccinated, and were then exposed in pairs (1 sham and 1 AVA so disease kinetics could be characterized in equally-dosed hosts where one group is fully protected and is able to clear the infection (AVA-vaccinated, while the other is susceptible to disease, in which case the bacteria are able to escape containment and replicate uncontrolled (sham-vaccinated rabbits. Between 4-5% of the presented aerosol dose was retained in the lung of sham- and AVA-vaccinated rabbits as measured by dilution plate analysis of homogenized lung tissue or bronchoalveolar lavage (BAL fluid. After 6 and 36 hours, >80% and >96%, respectively, of the deposited spores were no longer detected in BAL, with no detectable difference between sham- or AVA-vaccinated rabbits. Thereafter, differences between the two groups became noticeable. In sham-vaccinated rabbits the bacteria were detected in the tracheobronchial lymph nodes (TBLN 12 hours post exposure and in the circulation at 24 hours, a time point which was also associated with dramatic increases in vegetative CFU in the lung tissue of some animals. In all sham-vaccinated rabbits, bacteria increased in both TBLN and blood through 36 hours at which point in time some rabbits succumbed to disease. In contrast, AVA-vaccinated rabbits showed

  8. Aerosolized alpha-tocopherol ameliorates acute lung injury following combined burn and smoke inhalation injury in sheep. (United States)

    Morita, Naoki; Traber, Maret G; Enkhbaatar, Perenlei; Westphal, Martin; Murakami, Kazunori; Leonard, Scott W; Cox, Robert A; Hawkins, Hal K; Herndon, David; Traber, Lillian D; Traber, Daniel L


    Victims of fire accidents who sustain both thermal injury to the skin and smoke inhalation have gross evidence of oxidant injury. Therefore, we hypothesized that delivery of vitamin E, an oxygen superoxide scavenger, directly into the airway would attenuate acute lung injury postburn and smoke inhalation. Sheep (N = 17 female, 35 +/- 5 kg) were divided into 3 groups: (1) injured, then nebulized with vitamin E (B&S, Vitamin E, n = 6); (2) injured, nebulized with saline (B&S, Saline, n = 6); and (3) not injured, not treated (Sham, n = 5). While under deep anesthesia with isoflurane, the sheep were subjected to a flame burn (40% total body surface area, 3rd degree) and inhalation injury (48 breaths of cotton smoke, Ringer lactate solution (4 mL/kg/%burn/24 h) and placed on a ventilator [positive end-expiratory pressure (PEEP) = 5 cm H2O, tidal volume = 15 mL/kg] for 48 h. B&S injury halved the lung alpha-tocopherol concentrations (0.9 +/- 0.1 nmol/g) compared with sham-injured animals (1.5 +/- 0.3), whereas vitamin E treatment elevated the lung alpha-tocopherol concentrations (7.40 +/- 2.61) in the injured animals. B&S injury decreased pulmonary gas exchange (PaO2/FiO2 ratios) from 517 +/- 15 at baseline to 329 +/- 49 at 24 h and to 149 +/- 32 at 48 h compared with sham ratios of 477 +/- 14, 536 +/- 48, and 609 +/- 49, respectively. Vitamin E treatment resulted in a significant improvement of pulmonary gas exchange; ratios were 415 +/- 34 and 283 +/- 42 at 24 and 48 h, respectively. Vitamin E nebulization therapy improved the clinical responses to burn and smoke inhalation-induced acute lung injury.

  9. In vitro performance testing of the novel Medspray wet aerosol inhaler based on the principle of Rayleigh break-up

    NARCIS (Netherlands)

    de Boer, Anne H; Wissink, Jeroen; Hagedoorn, Paul; Heskamp, Iwan; de Kruijf, Wilbur; Bünder, Ralf; Zanen, Pieter; Munnik, Paul; van Rijn, Cees; Frijlink, Henderik W


    Purpose: A new inhaler (Medspray(R)) for pulmonary drug delivery based on the principle of Rayleigh break-up has been tested with three different spray nozzles (1.5; 2.0 and 2.5 mu m) using aqueous 0.1% (w/w) salbutamol and 0.9% (w/w) sodium chloride solutions. Materials and methods: Particle size d

  10. 小儿无创正压通气联合雾化喷嘴改接鼻塞吸入的效果观察%The efficacy of noninvasive positive pressure ventilation combined with nasal inhalation aerosol

    Institute of Scientific and Technical Information of China (English)

    林明珠; 陈丽梅; 温碧霞; 谭碧连; 陈绮婷


    目的 寻求小儿无创正压通气联合雾化更有效舒适的雾化方法.方法 选择三种疾病患儿,于同种疾病患儿随机选取相同例数,对照组、观察组按二种雾化方法进行对比.对照组:按传统氧气驱动雾化方法.观察组:按改良氧气驱动雾化方法指安装好的雾化器(同传统方法),但氧表的湿化瓶内放已加温至45℃蒸溜水,喷嘴改直接接无创通气鼻塞喷雾.二组患儿均选择纽邦E360呼吸机辅助通气,喷雾时暂停正压通气,完成雾化再继续接无创正压通气,喷雾20分钟后观察患儿不良反应及排痰效果.结果 两组患儿雾化吸入不良反应发生情况比较、雾化吸入排痰效果比较均有统计学意义(P<0.01).结论 观察组雾化吸入发生不良反应情况明显减少,雾化吸入后排痰效果好,有显著临床意义.%Objective To seek a more comfortable and effective inhalation method in noninvasive positive pressure ventilation combined with nasal aerosol inhalation.Methods The pediatric patients with three different diseases were randomly assigned to a control group or a study group based on two kinds of aerosol inhalation method.The control group received traditional oxygen-driven aerosol inhalation; while the study group received modified oxygen-driven aerosol inhalation method (traditional method),with the humidification bottle of the oxygen meter filled with distilled water of 45 ℃ and a direct connection of nozzle to non-invasive ventilation.The patients in bothgroups were mechanically ventilated via the Pradesh E360.Positive pressure ventilation suspended during aerosol inhalation and then continued after completion of inhalation.The adverse reactions and expectoration effect were observed 20 minutes after aerosol inhalation.Results The rate of adverse reactions and the expectoration effect differed significantly between the two groups (P <0.01).Conclusions Aerosol inhalation has fewer adverse reactions and a better

  11. Device for contaminating laboratory animals by inhalation of radioactive aerosols; Description d'un dispositif permettant la contamination d'animaux de laboratoire par inhalation d'aerosols radioactifs

    Energy Technology Data Exchange (ETDEWEB)

    Lutz, M.; Rouvroy, H. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires


    The contamination enclosure is made up of a sphere to which are attached an aerosol generator, containers adapted to the animals to be used, and the atmospheric sampling system. The sphere is placed in a protective glove-box, the latter being itself protected by an introduction chamber fitted with locking access lids. A detailed description is given of the working principle. As an example, some results are given concerning the contamination of rats by a plutonium oxide aerosol: characteristics of the powder (mean diameter 0.50 {mu} - standard deviation: 1.4), examination and evolution of the atmospheric activity as a function of time, evaluation of the retention by the lungs by means of histological and autoradiographic examinations. (authors) [French] L'enceinte de contamination est constituee par une 'sphere' a laquelle sont associes un generateur d'aerosols, des conteneurs adaptes aux animaux utilises et le systeme d'echantillonnage d'atmosphere; la sphere est contenue dans une boite a gants de protection; elle-meme munie de sas d'introduction a systeme de couvercles verrouillables. Les principes de fonctionnement sont detailles. A titre d'exemple, quelques resultats concernant l'empoussierage de rats par de l'oxyde de plutonium sont donnes: caracteristiques de la poudre (diametre moyen 0,50 {mu} - ecart type: 1,4), etude et evolution de l'activite atmospherique en fonction du temps, mise en evidence de la retention pulmonaire par examens histologique et autoradiographique. (auteurs)

  12. 雾化吸入治疗小儿毛细支气管炎的护理研究进展%A research progress on nursing for aerosol inhalation in the treatment of children with bronchiolitis

    Institute of Scientific and Technical Information of China (English)

    陈领; 陈素娟


    Bronchiolitis is a common disease in children, which usually presents runny nose, cough and shortness of breath.Severe bronchiolitis can cause dyspnea and it seriously impacts the health of children. Supportive care is the basis for the treatment of bronchiolitis.Aerosol inhalation plays an important role in the treatment of bronchiolitis.This paper will review recent inhalation therapy and nursing progress of bronchiolitis from the aspect of aerosolized medication selection and aerosolized mode, nursing intervention on inhalation.%毛细支气管炎是小儿常见病,通常表现为流涕、咳嗽和呼吸急促,严重可引起呼吸困难,严重影响患儿健康. 支持治疗是目前治疗毛细支气管炎的基础,雾化吸入对治疗小儿毛细支气管炎具有重要作用,本文将从雾化药物的选择、雾化方式的选择及雾化吸入的护理干预等方面对近年来雾化吸入治疗小儿毛细支气管炎的研究及护理进展作一综述.

  13. Inhalation delivery of asthma drugs. (United States)

    Matthys, H


    In the immediate future, metered-dose inhalers (MDIs) with spacers remain the aerosol application of choice for topical steroids, mainly to reduce side effects. For beta 2-agonist, anticholinergics and prophylactic drugs, MDI (with or without demand valve), dry powder inhalers (multidose inhalers), ultrasonic or jet aerosol generators (with or without mechanical breathing assistance [IPPB]) are chosen according to the preference or the ability of the patients to perform the necessary breathing maneuvers as well as the availability of different products in different countries.

  14. Broncodilatadores en la crisis asmática: ¿Aerosol o nebulización? Bronchodilators in acute asthma: metered dose inhalers or wet nebulizations?

    Directory of Open Access Journals (Sweden)

    Dora M. Lombardi


    Full Text Available El número de consultas por asma aguda en el Hospital María Ferrer ha aumentado de 3300 consultas anuales en 1980 a 15364 en 2002. Los broncodilatadores de acción corta (salbutamol-ipratropio en nebulizaciones, procedimiento que consume tiempo y recursos humanos, eran el tratamiento inicial en 2002. Para tratar de mejorar el cumplimiento del tratamiento frente al aumento de la demanda, se reemplazaron las nebulizaciones por aerosoles dosificadores. El objetivo de este estudio es evaluar el impacto de este cambio. Comparamos 90 pacientes con crisis asmática tratados con aerosoles en diciembre del 2003 con igual número tratados con nebulizaciones en diciembre del 2002 pareados por sexo, edad, altura, VEF1 teórico y de ingreso. Con aerosoles se observó una reducción significativa del tiempo de permanencia en el Departamento de Emergencia (mediana 3 h (2-4.75 versus 4 h (1-6 p=0.01 y un número mayor de altas en las primeras 2 horas (48% vs. 31% p=0.03. Los pacientes tratados con aerosol recibieron el 87% de las dosis prescriptas, mientras que el otro grupo recibió sólo el 38%. El VEF1 mostró una tendencia a ser mayor al egreso en el grupo que recibió aerosoles, pero la diferencia no fue estadísticamente significativa (78% ± 17% vs. 73% ± 17% p=0.09. El porcentaje de alta final fue similar en los dos grupos (96% vs. 93%. El tratamiento con aerosoles produjo una mejoría más rápida y mejor cumplimiento de las normas de tratamiento indicadas.The number of patients attending our Emergency Department (ED with acute asthma has increased from 3300 patient/year in 1980 to 15364 in 2003. Short acting bronchodilators (albuterol/ipratropium administered in wet nebulizations, a resource consuming procedure, were our main initial treatment in 2002. To improve treatment goals, we switched the method of bronchodilator delivery to metered dose inhalers (MDI in 2003. The purpose of this study is to evaluate the impact of this change in the

  15. Reason Analysis of 1 Case of Dyspnea Induced by Aerosol Inhalation of Ambroxol%注射用氨溴索雾化吸入致呼吸困难1例分析

    Institute of Scientific and Technical Information of China (English)

    王明丽; 谢陶吟; 许建平


    目的:提示临床重视雾化吸入注射用氨溴索所致不良反应.方法:报道我院注射用氨溴索雾化使用致不良反应1例,并检索中国期刊全文数据库(CNKI)中注射用氨溴索致不良反应的相关文献,进行分析.结果:文献检索仅得到1例雾化吸入注射用氨溴索致过敏反应的报道,而我院近年注射用氨溴索雾化使用除1例致呼吸困难外,未见其他严重不良反应.氨溴索本身并不会引起呼吸困难,之所以出现不良反应可能与雾化因素和药物pH值有关.结论:注射用氨溴索的雾化使用需要谨慎,其长期安全性尚有待进一步考察.%OBJECTIVE: To explore the causes of adverse drug reaction of aerosol inhalation of ambroxol and make suggestions for safe drug use in the clinic. METHODS: The use of aerosol inhalation of ambroxol in our hospital was investigated. Relevant literatures of adverse drug reaction (ADR) of ambroxol were retrieved from CNKI and analyzed systematically. RESULTS: Only one allergy case was found in literature and no serious ADR was caused by aerosol inhalation of ambroxol in our hospital recently. Thus, there was little relationship between dyspnea and ambroxol itself. Aerosol inhalation and pH value of ambroxol injection were more important factors of ADR. CONCLUSION: The use of aerosol inhalation of ambroxol should be paid more attention. And there is further work needed to investigate its long-term safety.

  16. Short term inhalation toxicity of a liquid aerosol of glutaraldehyde-coated CdS/Cd(OH)2 core shell quantum dots in rats. (United States)

    Ma-Hock, L; Farias, P M A; Hofmann, T; Andrade, A C D S; Silva, J N; Arnaud, T M S; Wohlleben, W; Strauss, V; Treumann, S; Chaves, C R; Gröters, S; Landsiedel, R; van Ravenzwaay, B


    Quantum dots exhibit extraordinary optical and mechanical properties, and the number of their applications is increasing. In order to investigate a possible effect of coating on the inhalation toxicity of previously tested non-coated CdS/Cd(OH)2 quantum dots and translocation of these very small particles from the lungs, rats were exposed to coated quantum dots or CdCl2 aerosol (since Cd(2+) was present as impurity), 6h/d for 5 consecutive days. Cd content was determined in organs and excreta after the end of exposure and three weeks thereafter. Toxicity was determined by examination of broncho-alveolar lavage fluid and microscopic evaluation of the entire respiratory tract. There was no evidence for translocation of particles from the respiratory tract. Evidence of a minimal inflammatory process was observed by examination of broncho-alveolar lavage fluid. Microscopically, minimal to mild epithelial alteration was seen in the larynx. The effects observed with coated quantum dots, non-coated quantum dots and CdCl2 were comparable, indicating that quantum dots elicited no significant effects beyond the toxicity of the Cd(2+) ion itself. Compared to other compounds with larger particle size tested at similarly low concentrations, quantum dots caused much less pronounced toxicological effects. Therefore, the present data show that small particle sizes with corresponding high surfaces are not the only factor triggering the toxic response or translocation.

  17. An investigation into the effect of fine lactose particles on the fluidization behaviour and aerosolization performance of carrier-based dry powder inhaler formulations. (United States)

    Kinnunen, Hanne; Hebbink, Gerald; Peters, Harry; Shur, Jagdeep; Price, Robert


    The effect of milled and micronized lactose fines on the fluidization and in vitro aerosolization properties of dry powder inhaler (DPI) formulations was investigated, and the suitability of static and dynamic methods for characterizing general powder flow properties of these blends was assessed. Lactose carrier pre-blends were prepared by adding different lactose fines (Lactohale® (LH) 300, 230 and 210) with coarse carrier lactose (Lactohale100) at 2.5, 5, 10 and 20 wt% concentrations. Powder flow properties of lactose pre-blends were characterized using the Freeman Technology FT4 and Schulze RST-XS ring shear tester. A strong correlation was found between the basic flow energy (BFENorm) measured using the Freeman FT4 Rheometer and the flowability number (ffc) measured on Schulze RST-XS. These data indicate that both static and dynamic methods are suitable for characterizing general powder flow properties of lactose carriers. Increasing concentration of fines corresponded with an increase in the normalized fluidization energy (FENorm). The inclusion of fine particles of lactose resulted in a significant (p lactose containing up to 10 wt% LH300. A similar trend was found for the milled lactose grades LH230 and LH210. However, the increase in FENorm upon addition of milled fines only corresponded to a very slight improvement in the performance. These data suggest that whilst the fluidization energy correlated with fine particle delivery, this relationship is specific to lactose grades of similar particle size.

  18. Spatial and temporal variations in inhalable CuZnPb aerosols within the Mexico City pollution plume. (United States)

    Moreno, T; Querol, X; Pey, J; Minguillón, M C; Pérez, N; Alastuey, A; Bernabé, R M; Blanco, S; Cárdenas, B; Eichinger, W; Salcido, A; Gibbons, W


    We report on the CuPbZn content of PM10 and PM2.5 samples collected from three sites (urban T0, suburban T1 and rural T2) during the Mexico City MILAGRO campaign of March 2006. Daytime city centre concentrations of summation operator CuZnPb(PM10) were much higher (T0 > 450 ng m(-3)) than at the suburban site (T1 inversion layer, but decreased at the rural site. Transient spikes in concentrations of different metals, e.g. a "copper event" at T0 (CuPM10 281 ng m(-3)) and "zinc event" at T1 (ZnPM10 1481 ng m(-3)) on the night of March 7-8, demonstrate how industrial pollution sources produce localised chemical inhomogeneities in the city atmosphere. Most metal aerosols are <2.5 microm and SEM study demonstrates the dominance of Fe, Ti, Ba, Cu, Pb and Zn (and lesser Sn, Mo, Sb, W, Ni, V, As, Bi) in metalliferous particles that have shapes including spherical condensates, efflorescent CuZnClS particles, cindery Zn, and Cu wire. Metal aerosol concentrations do not change in concert with PM10 mass, which is more influenced by wind resuspension than industrial emissions. Metalliferous particles can induce cell damage, and PM composition is probably more important than PM mass, with respect to negative health effects, so that better monitoring and control of industrial emissions would likely produce significant improvements in air quality.

  19. Renal scintigraphy in veterinary medicine. (United States)

    Tyson, Reid; Daniel, Gregory B


    Renal scintigraphy is performed commonly in dogs and cats and has been used in a variety of other species. In a 2012 survey of the members of the Society of Veterinary Nuclear Medicine, 95% of the respondents indicated they perform renal scintigraphy in their practice. Renal scintigraphy is primarily used to assess renal function and to evaluate postrenal obstruction. This article reviews how renal scintigraphy is used in veterinary medicine and describes the methods of analysis. Species variation is also discussed.

  20. Testicular scintigraphy; Hodenszintigrafie

    Energy Technology Data Exchange (ETDEWEB)

    Tiling, R. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum der Ludwig-Maximilians Univ. Muenchen (Germany)


    In the clinical situation of an acute scrotum, differentiation between different reasons for scrotal pain may be crucial in certain cases. Beside clinical examination and laboratory tests, Color Doppler sonography is routinely applied. Testicular scintigraphy can only be suggested as a complementary tool if it is available as an emergency procedure. Acute testicular torsion that has already been reliably diagnosed by clinical examination is not an indication for testicular perfusion scintigraphy. This diagnostic procedure is, however, valuable if the clinical findings are equivocal and, especially, if a conservative treatment is planned. The method of and the results obtained with testicular scintigraphy in the differential diagnosis of acute scrotal pain are briefly described in this article. (orig.)

  1. Late effects following inhalation of mixed oxide (U,PuO{sub 2}) mox aerosol in the rat; Effets tardifs de l'inhalation d'aerosols de Mox 2,5% ou 7,1% Pu chez le rat

    Energy Technology Data Exchange (ETDEWEB)

    Griffiths, N.; Van Der Meeren, A.; Fritsch, P.; Maximilien, R


    Exposure to alpha-emitting particles is a potential long-term health risk to workers in nuclear fuel fabrication plants. Mixed Oxide (MOX: U,PuO{sub 2}) fuels containing low percentages of plutonium obtained from spent nuclear fuels are increasingly employed and in the case of accidental contamination by inhalation or wounds may result in the development of late-occurring pathologies such as lung cancer. However the long term risks particularly with regard to lung cancer are to date unclear. In the case of MOX the risk may indeed be different from that assigned to the individual components, plutonium and uranium. Several factors are influential (i) the dissolution of Pu depends on the physico-chemical properties, for example risk of lung cancer is increased 10 fold after Pu(NO{sub 3}){sub 2} as compared with PuO{sub 2}. (ii) The solubility of Pu is variable whether delivered as PuO{sub 2} or contained within MOX. (iii) The risk of cancer appears to increase with spatial homogeneity of the lung alpha dose. The objective of this study was to investigate the long term effects in rat lungs following MOX aerosol inhalation of similar particle size containing 2.5 or 7.1% Pu. Conscious rats were exposed to MOX aerosols using a 'nose-only' system and kept for their entire life (2-3 years). Different Initial Lung Deposits (ILDs) were obtained using different concentrations of the MOX suspension. Lung total alpha activity was determined in vivo at intervals over the study period by external counting as well as at autopsy in order to estimate the total lung dose. Anatomo-pathological and immunohistochemical analyses were performed on fixed lung tissue after euthanasia. The frequencies of lung pathologies and tumours were determined on lung sections at several different levels. In addition, autoradiography of lung sections was performed in order to assess the spatial localisation of a activity. Inhalation of MOX at ILD ranging from 1-20 kBq resulted in lung

  2. Bone scintigraphy in chondroblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Humphry, A.; Gilday, D.L.; Brown, R.G.


    Scintigraphy in 3 patients with chondroblastoma showed that the tumors were hyperemic and avidly accumulated the radionuclide. These changes were also present in adjacent normal bone, but to a lesser degree. This suggests that radionuclide uptake in chondroblastoma is a function of the blood supply to the tumor rather than primary matrix extraction.

  3. Inhaler devices - from theory to practice

    DEFF Research Database (Denmark)

    Sanchis, Joaquin; Corrigan, Chris; Levy, Mark L;


    This brief overview of the factors determining lung deposition of aerosols provides background information required by health care providers when instructing patients to use their prescribed inhalers. We discuss differences in the optimal inhalation manoeuvres for each type of aerosol generator a...... and the difficulties patients face. Provision of short, clear instructions with demonstration of critical steps and checking technique during later clinical visits are necessary if these aerosolised medications are to be fully beneficial....

  4. Bone scintigraphy in psoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, K.; Thiers, G.; Eissner, D.; Holzmann, H.


    Since 1973 bone scintigraphy using sup(99m)Tc-phosphate-complexes was carried out in 382 patients with psoriasis. For comparison with the results of nuclear medicine, roentgenologic and clinical findings a group af 121 patients with psoriasis aged between 11 and 74 years was compared to a group of 42 patients aged between 20 and 49 years without roentgenologic and clinical signs of psoriasis arthritis. We found by means of isotope investigation that an essentially greater part of the bones adjacent to the joints was involved than was expected according to X-ray and clinical findings. In addition, in 205 patients with psoriasis whole-body scintigraphy, using sup(99m)Tc-MDP, was carried out since 1977/78. In 17 patients we found an increased accumulation of activity in the region of extraarticular structures of the skull as well as of the skeletal thorax. According to these results we conclude that in addition to the clinically and roentgenologically defined psoriatic arthritis in patients with psoriasis an osteopathy may exist, which can only be demonstrated by skeletal scintigraphy and which is localized in bones adjacent to the joints but can also be demonstrated in the region of extraarticular bones.

  5. 氧气驱动雾化吸入治疗小儿毛细支气管炎的疗效观察%Oxygen aerosol inhalation to treat infantile capil ary bronchitis curative ef ect observation

    Institute of Scientific and Technical Information of China (English)



    objective:to study the oxygen aerosol inhalation in the treatment of infantile capil ary bronchitis curative ef ect and nursing care.Methods:126 cases of capil ary bronchitis patients were randomly divided into observation group and control group.The control group,62 cases of the conventional comprehensive treatment with traditional way of ultrasonic atomization in-halation.Observation group 64 cases on the basis of routine comprehensive treatment,give driven by oxygen atomization inhalation.Results:in observation group,the blood oxygen saturation, symptoms and signs disappeared time,the cure rate is bet er than that in control group (P <0.01).Conclusion:oxygen aerosol inhalation in the treatment of infantile capil ary bronchitis meth-od is bet er than that of ultrasonic atomization inhalation,can shorten the course of the disease,relieve pain,children promote children recover at an early date,is worth promoting.%目的:探讨氧气驱动雾化吸入治疗小儿毛细支气管炎的疗效和护理。方法:将126例毛细支气管炎患儿随机分为观察组和对照组。对照组62例采用常规综合治疗,运用传统的超声雾化吸入方式。观察组64例在常规综合治疗的基础上,给予由氧气驱动雾化吸入方式。结果:观察组在血氧饱和度、症状及体征消失时间、治愈率等方面优于对照组(P <0.01)。结论:氧气驱动雾化吸入治疗小儿毛细支气管炎的方法优于超声雾化吸入方式,可缩短病程,减轻患儿痛苦,促进患儿早日康复,值得推广。

  6. Awareness of knowledge about aerosol inhalation in the medical nurses%内科护士对COPD患者气雾剂使用方法及知识知晓情况的调查

    Institute of Scientific and Technical Information of China (English)

    马瑞兰; 孙玉梅


    Objective:To investigate the knowledge and application status about aerosol inhalation among the medical nurses from a suburban hospital in Beijing. Methods:A total of 90 nurses were selected by convenient sampling. A self-designed questionnaire was used to investigate the knowledge, application methods and training status about aerosol inhalation. Results:These nurses had a low awareness of knowledge and operation approach about aerosol inhalation. Multiple stepwise regression analysis showed that their knowledge and performance were associated with their medical division, age and whether getting training, but not associated with their educational background, professional title and work experience. Conclusion:Varieties of training about knowledge and operation method were required to enhance the nurses' knowledge and technical level, especially to those who work in non-respiratory department.%目的:调查内科护士对COPD患者气雾剂使用方法及相关知识的知晓情况。方法:采用便利取样对90例内科护士在气雾剂使用方法及药物知识知晓情况、培训与否等方面进行了问卷调查。结果:内科护士对气雾剂相关知识及操作方法知晓率低;多元逐步回归分析显示,气雾剂相关知识及操作得分与其所在科室、是否接受过培训以及年龄有关,而与其学历、职称及护龄等无关。结论:科室应以多种形式有针对性地对内科护士,尤其是非呼吸科护士进行有关气雾剂相关理论知识及正确操作方法的培训,以提高内科护士的气雾剂使用理论水平及技术水平。

  7. Scrotal scintigraphy; Hodenperfusionsszintigraphie

    Energy Technology Data Exchange (ETDEWEB)

    Gruss, A. [Wuerzburg Univ. (Germany). Urologische Klinik und Poliklinik; Scheubeck, M. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Timm, P. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Hofmockel, G. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Reiners, C. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Frohmueller, H.G.W. [Wuerzburg Univ. (Germany). Urologische Klinik und Poliklinik


    Scrotal scintigraphy has two indications in urology; first to prove the vitality of the injured testis after scrotal trauma, second to differentiate the diagnosis of the acute scrotum. The term `acute scrotum` stands for a clinical emergency which needs to be clarified and treated immediately. The most common reason for the acute scrotum is either acute testicular torsion or acute epididymitis. The therapy of both differs totally. Acute testicular torsion requires open surgery within four to six hours in order to prevent loss of the organ, epididymitis will be treated conservatively. It is very difficult to differentiate the diagnosis by the clinical status. In the literature the rate of failure amounts up to 30% because of an unnecessary surgical intervention for the epididymitis or because of a loss of the testicle after a nondiagnosed testicular torsion. Therefore, the use of an additional procedure seems to be necessary to enable a correct assessment of testicular blood supply. Scrotal scintigraphy represents a valuable diagnostic procedure which allows to reduce the rate of clinical failure with an acceptable time expense and a good chance of reproducibility. The sensitivity and specifity of scrotal scintigraphy is 90-96% and 93-100% respectively. Compared to duplex sonography scrotal scintigraphy derives a great advantage form the independance of the investigator and from the painless procedure for the patient. Scrotal scintigraphy is not needed in the clinical definite acute testicular torsion, but it is indicated in each unclear situation especially when a differential diagnosis is not available by palpation. (orig./MG) [Deutsch] Fuer die Hodenperfusionsszintigraphie finden sich in der klinischen Urologie zwei Einsatzbereiche: Zum einen ermoeglicht die Hodenperfusionsszintigraphie eine Vitalitaetspruefung des Hodens nach einem Skrotaltrauma und bietet in Kombination mit der Sonographie eine wesentliche Entscheidungshilfe zur operativen oder konservativen

  8. Clinical effects comparison and research of two aerosol inhalation methods for chronic obstructive pulmonary disease patients%慢性阻塞性肺疾病患者两种雾化吸入疗法的临床效果对比研究

    Institute of Scientific and Technical Information of China (English)

    伍爱芳; 江月娥; 段红萍; 伍海英; 李满莲


    目的 比较两种雾化吸入疗法对慢性阻塞性肺疾病(COPD)患者动脉血气分析及临床症状体征的影响.方法 将90例COPD患者随机分为压缩组和氧驱组各45例,用相同剂量的硫酸沙丁胺醇雾化吸入溶液加生理盐水,分别采用压缩空气雾化吸入和氧驱雾化吸入,雾化吸入前后分别抽取动脉血行血气分析检查,同时监测患者临床症状体征的变化.结果 两组患者雾化吸入前后比较,Pa02值及Sa02值均升高,两组同期比较无显著性差异(P >0.05);PaC02值,压缩空气吸入组降低(P<0.05),而氧驱雾化吸入组无明显变化(P>0.05),两组同期比较有显著性差异(P<0.05);两组雾化吸人后临床症状体征比较,差异无显著性意义(P>0.05).结论 压缩空气雾化吸入及氧驱雾化吸入均适用于COPD患者,但对于COPD合并Ⅱ型呼吸衰竭的患者,压缩空气雾化吸入疗法优于氧驱雾化吸入.%Objective To compare the effects of two ways of aerosol inhalation to arterial blood gas analysis and clinical symptoms and signs of patients with COPD.Methods A total of 90 patients with COPD were randomly divided into two groups,45 per group,using compressed air aerosol inhalation and oxygen aerosol inhalation separately,with the same dose of salbutamol sulfate aerosol inhalation solution and normal saline,before and after that,getting arterial blood samples to analyze blood gas,and monitoring the clinical symptoms and signs of patients at the same time.Results The PaO2 and SaO2 value of both groups of patients were increased after aerosol inhalation.There was no significant difference between the two groups ( P > 0.05 ).The PaCO2 value of the compressed air group was decreased ( P < 0.05 ),and had no significant change in the oxygen group ( P > 0.05 ).There was significant difference between the two groups ( P < 0.05 ).Clinical symptoms and signs had no significant difference between the two groups (P > 0.05 ).Conclusions

  9. [Inhalation therapy: inhaled generics, inhaled antidotes, the future of anti-infectives and the indications of inhaled pentamidine. GAT aerosolstorming, Paris 2012]. (United States)

    Peron, N; Le Guen, P; Andrieu, V; Bardot, S; Ravilly, S; Oudyi, M; Dubus, J-C


    The working group on aerosol therapy (GAT) of the Société de pneumologie de langue française (SPLF) organized its third "Aerosolstorming" in 2012. During the course of one day, different aspects of inhaled therapy were discussed, and these will be treated separately in two articles, this one being the first. Inhaled products represent a large volume of prescriptions both in the community and in hospital settings and they involve various specialties particularly ENT and respiratory care. Technical aspects of the development of these products, their mode of administration and compliance with their indications are key elements for the effective therapeutic use of inhaled treatments. In this first article, we will review issues concerning generic inhaled products, the existence of inhaled antidotes, new anti-infective agents and indications for inhaled pentamidine.

  10. RI scintigraphy in myasthenia gravis

    Energy Technology Data Exchange (ETDEWEB)

    Kuroda, Yoshikazu; Miyamoto, Mariko (Tokyo Metropolitan Fuchu Hospital (Japan)); Maki, Masako; Yamazaki, Toshiro


    35 cases of myasthenia gravis were studied with RI scintigraphy. /sup 67/Ga-citrate was used in 34 patients and /sup 76/Se-selenomethionine in 5 patients for thymus scintigraphy. RI scintigram was negative in non-tumorous thymus, regardless of the severity of illness and it was positive in seven of nine patients with thymomas. RI accumulation in thymus was found both in benign and malignant thymomas. RI seems to accumulated in lymphocytic and mixed thymus more than epithelial type.

  11. Breath-synchronized plume-control inhaler for pulmonary delivery of fluticasone propionate. (United States)

    Shrewsbury, Stephen B; Armer, Thomas A; Newman, Stephen P; Pitcairn, Gary


    A novel breath-synchronized, plume-control inhaler (Tempo inhaler) was developed to overcome limitations of a pressurized metered-dose inhaler. This report compared the Tempo inhaler and a commercial inhaler for fine particle distribution and lung deposition of fluticasone propionate. In vitro fine particle distribution was determined using the Andersen Cascade Impactor at inspiration rates of 28.3 and 45L/min. In vivo lung deposition was assessed in a randomized, two-arm, crossover study of (99m)Tc-radiolabeled fluticasone propionate in 12 healthy adult subjects, analyzed by gamma scintigraphy. In vitro: fine particle fractions at 28.3 and 45L/min were 88.6+/-3.6% and 89.2+/-3.0% (Tempo inhaler) versus 40.4+/-4.7% and 43.1+/-4.4% (commercial inhaler). In vivo: lung deposition was 41.5+/-9.8% (Tempo inhaler) versus 13.8+/-7.4% (commercial inhaler) and oropharyngeal deposition was 18.3+/-7.7% (Tempo inhaler) versus 76.8+/-7.1% (commercial inhaler). Variability of lung deposition was reduced from 55% (commercial inhaler) to 24% (Tempo inhaler) of the delivered dose. The Tempo inhaler produced significantly higher fine particle fraction values, reduced oropharyngeal deposition by 75%, and increased whole, central, intermediate, and peripheral lung delivery by more than 200%. Thus, the Tempo inhaler enhances efficient drug delivery to the lungs.

  12. Liver scintigraphy in veterinary medicine. (United States)

    Morandi, Federica


    The most common veterinary application of liver scintigraphy is for the diagnosis of portosystemic shunts (PSSs). There has been a continual evolution of nuclear medicine techniques for diagnosis of PSS, starting in the early 1980s. Currently, transplenic portal scintigraphy using pertechnetate or (99m)Tc-mebrofenin is the technique of choice. This technique provides both anatomical and functional information about the nature of the PSS, with high sensitivity and specificity. Hepatobiliary scintigraphy has also been used in veterinary medicine for the evaluation of liver function and biliary patency. Hepatobiliary scintigraphy provides information about biliary patency that complements finding in ultrasound, which may not be able to differentiate between biliary ductal dilation from previous obstruction vs current obstruction. Hepatocellular function can also be determined by deconvolutional analysis of hepatic uptake or by measuring the clearance of the radiopharmaceutical from the plasma. Plasma clearance of the radiopharmaceutical can be directly measured from serial plasma samples, as in the horse, or by measuring changes in cardiac blood pool activity by region of interest analysis of images. The objective of this paper is to present a summary of the reported applications of hepatobiliary scintigraphy in veterinary medicine.

  13. Radionuclide scintigraphy of the scrotum

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jun Hyung; Park, Young Hee; Lee, Soon Jin; Lee, Sun Wha; Ko, Young Tae; Kim, Soon Yong [Kyung Hee University College of Medicine, Seoul (Korea, Republic of)


    Radionuclide scrotal scintigraphy with {sup 99m}Tc-pertechnetate is an easy, well established, useful and readily available technique for evaluation of acute scrotum. We studied 41 cases of radionuclide scrotal scintigraphy and the results were as follows: 1. The over all diagnostic accuracy of scrotal scintigraphy was 93% (38/41 cases). 2. Scrotal scintigraphy was very useful and accurate in differential diagnosis of epididymo-orchitis and testticular torsion in patient with acute scrotal pain and swelling, while there was some limitation in differential diagnosis of hematoma from acute epididymo-orchitis or torsion. 3. Scintigraphy of epididymo-orchitis showed increased perfusion and radioactivity in the epididymis and/or testis and its diagnosis accuracy was 90% (19/21 cases). 4. Acute testicular torsion showed normal flow in perfusion and cold defect occupying affected testis in static image, while missed torsion showed slightly increased flow in perfusion image and cold defect surrounded by an uniform rim of hyperactivity (halo sign). Diagnostic accuracy of testicular torsion was 86% (6/7 cases)

  14. Bone scintigraphy; Scintigraphie osseuse de l'appareil locomoteur

    Energy Technology Data Exchange (ETDEWEB)

    Moyen, B.; Chouteau, J. [Centre Hospitalier Universitaire Lyon-Sud, 69 - Pierre-Benite (France)


    Bone scintigraphy permit to detect the active osteoblastic sites. This technic is widely used in orthopaedic surgery either in adult or children. In Traumatology fatigue fractures are early diagnosed. This is also the case for reflex sympathetic dystrophy and bone necrosis. This technic is used for Paget disease, and articular inflammatory process. For bone tumors some specific aspects are recognized like for osteoid osteoma, malignant bone tumors and secondary bone tumors. In case of septic articular prosthesis the couple use of bone scintigraphy and marked polynuclear appear very useful. (author)

  15. Thyroid scintigraphy in veterinary medicine. (United States)

    Daniel, Gregory B; Neelis, Dana A


    Thyroid scintigraphy is performed in cats and dogs and has been used to a limited degree in other species such as the horse. Thyroid scintigraphy is most commonly used to aid in the diagnosis and treatment management of feline hyperthyroidism but is also used in the evaluation of canine hypothyroidism and canine thyroid carcinoma. This article reviews the normal scintigraphic appearance of the thyroid in the cat, the dog, and the horse and the principles of interpretation of abnormal scan results in the cat and the dog. Radioiodine is the treatment of choice for feline hyperthyroidism, and the principles of its use in the cat are reviewed.

  16. Induction of Food Allergy in Mice by Allergen Inhalation (United States)


    14. ABSTRACT The purpose of this project is to test the hypothesis that food allergy may develop in response to antigen inhalation. Studies in a...relative timing of antigen ingestion vs. antigen inhalation to lead to food allergy development. We are also testing whether exposure to aerosolized...antigen will reverse or exacerbate established food allergy to that antigen. Studies in year 1 of this project demonstrate that: 1) initial inhalation

  17. Influence by budesonide suspension aerosol inhalation on breathing mechanics in chronic obstructive pulmonary disease patients with mechanical ventilation%布地奈德混悬液雾化吸入对慢性阻塞性肺疾病机械通气患者呼吸力学的影响

    Institute of Scientific and Technical Information of China (English)

    高婧; 滕海风


    ObjectiveTo research influence by budesonide suspension aerosol inhalation on breathing mechanics in chronic obstructive pulmonary disease (COPD) patients with mechanical ventilation.MethodsA total of 50 COPD patients with complicated respiratory failure (with failed conventional medical treatment and different degree of disturbance of consciousness) were randomly divided into control group (received conventional therapy) with 28 cases and treatment group (received additional budesonide suspension aerosol inhalation) with 22 cases. Observation was made on breathing mechanics and blood gas analysis indexes during mechanical ventilation.ResultsBefore aerosol, there was no statistically significant difference of breathing mechanics and blood gas analysis indexes between the two groups (P>0.05). After aerosol, both groups had improved breathing mechanics and blood gas analysis indexes (P0.05)。雾化后,两组患者呼吸力学指标、血气分析指标均较雾化前改善(P<0.05),且治疗组均优于对照组同期指标(P<0.05)。结论雾化吸入布地奈德混悬液治疗COPD机械通气患者疗效肯定,能明显改善呼吸力学指标,改善预后。

  18. Radiation protect during the ventilation scintigraphy of Tc99m DTPA radioaerosol in pediatric application

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Yu-Wen; Dai, Zen-Kong; Huang, Ying-Fong; Jong, Shiang-Bing [Chou-Hon Memorial Hospital, Kaohsiung Medical Univ., Kaohsiung, Taiwan (China)


    environmental radio-aerosol contamination is detectable. Conclusions: (1) Tc99m DTPA aerosol ventilation scintigraphy is available for pediatric patients with prior breath training. (2) Under protection of mouth mask, the leakage of Tc99mDTPA radioactive aerosol into atmosphere is reduced. (author)

  19. Inhaled Corticosteroids

    Directory of Open Access Journals (Sweden)

    Peter J. Barnes


    Full Text Available Inhaled corticosteroids (ICS are the most effective controllers of asthma. They suppress inflammation mainly by switching off multiple activated inflammatory genes through reversing histone acetylation via the recruitment of histone deacetylase 2 (HDAC2. Through suppression of airway inflammation ICS reduce airway hyperresponsiveness and control asthma symptoms. ICS are now first-line therapy for all patients with persistent asthma, controlling asthma symptoms and preventing exacerbations. Inhaled long-acting β2-agonists added to ICS further improve asthma control and are commonly given as combination inhalers, which improve compliance and control asthma at lower doses of corticosteroids. By contrast, ICS provide much less clinical benefit in COPD and the inflammation is resistant to the action of corticosteroids. This appears to be due to a reduction in HDAC2 activity and expression as a result of oxidative stress. ICS are added to bronchodilators in patients with severe COPD to reduce exacerbations. ICS, which are absorbed from the lungs into the systemic circulation, have negligible systemic side effects at the doses most patients require, although the high doses used in COPD has some systemic side effects and increases the risk of developing pneumonia.

  20. Computational modeling as part of alternative testing strategies in the respiratory and cardiovascular systems: inhaled nanoparticle dose modeling based on representative aerosol measurements and corresponding toxicological analysis. (United States)

    Pilou, Marika; Mavrofrydi, Olga; Housiadas, Christos; Eleftheriadis, Kostas; Papazafiri, Panagiota


    The objectives of modeling in this work were (a) the integration of two existing numerical models in order to connect external exposure to nanoparticles (NPs) with internal dose through inhalation, and (b) to use computational fluid-particle dynamics (CFPD) to analyze the behavior of NPs in the respiratory and the cardiovascular system. Regarding the first objective, a lung transport and deposition model was combined with a lung clearance/retention model to estimate NPs dose in the different regions of the human respiratory tract and some adjacent tissues. On the other hand, CFPD was used to estimate particle transport and deposition of particles in a physiologically based bifurcation created by the third and fourth lung generations (respiratory system), as well as to predict the fate of super-paramagnetic particles suspended in a liquid under the influence of an external magnetic field (cardiovascular system). All the above studies showed that, with proper refinement, the developed computational models and methodologies may serve as an alternative testing strategy, replacing transport/deposition experiments that are expensive both in time and resources and contribute to risk assessment.

  1. Inhalation of antibiotics in cystic fibrosis

    NARCIS (Netherlands)

    Touw, D J; Brimicombe, R W; Hodson, M E; Heijerman, H G; Bakker, W


    Aerosol administration of antipseudomonal antibiotics is commonly used in cystic fibrosis. However, its contribution to the improvement of lung function, infection and quality of life is not well-established. All articles published from 1965 until the present time concerning the inhalation of antibi

  2. Clinical effect comparison of different ways of inhaled Budesonide Aerosol in the treatment of children with combined allergic rhinitis and asthma syndrome%不同途径吸入布地奈德气雾剂治疗儿童过敏性鼻炎哮喘综合征的临床效果对比

    Institute of Scientific and Technical Information of China (English)

    陈俏容; 刘国钧; 刘胜华; 张良静; 吴枥舟


    Objective To discuss the clinical curative effect of different ways of inhaled Budesonide Aerosol in the treatment of combined allergic rhinitis and asthma syndrome (CARAS) in children. Methods A total of 113 children with mild and moderate CARAS in Department of Pediatrics of Shenzhen People's Hospital form June 2011 to January 2015 were selected as the research objects, and according to random number table method they were divided into group A (39 cases) treated through the mouth inhaled budesonide aerosol, 200 μg/time, 2 times/d; group B (36 cases) treated through the nasally inhaled Budesonide Aerosol, 200 μg/time, 2 times/d; and group C (38 cases) treated through the mouth inhaled Budesonide Aerosol (100μg/time, 2 times/d) and the nasally inhaled budesonide nasal spray 200μg/time (each side nasal spray 100 μg each time, 1 time/d); each group were treated for 8 weeks. Correlation parameters of pa-tients in the three groups before and after the treatment were recorded and compared. Results Compared with the group A, the clinical symptom score, pulmonary function, EOS absolute value, and serum total IgE levels of the group B were improved significantly (all P 0.05), but the incidence of adverse re-actions of group C was significantly higher than the group A and B, and the difference between group B and group C was statistically significant (χ2=11.402, P0.05)。 C组不良反应发生率明显高于A组和B组,B组与C组比较,差异有统计学意义(χ2=11.402,P<0.05)。结论采用闭嘴经鼻吸入200μg/次、2次/d(400μg/d)布地奈德气雾剂治疗轻、中度CARAS患儿效果显著,不良反应少,操作更简便,值得临床推广和应用。

  3. [The position of scintigraphy in traumatology]. (United States)

    Kaiser, C; Neck, K; Ritter, R; Glanzmann, C; Schwarz, H


    A report on the findings of skeletal scintigraphy in 80 cases of traumatic bone lesions is discussed. After a short survey on the physiological process in the activity ensilage, the assertion of the scintigraphy is compared to the X-ray. The indication which has been approved in practice is discussed and described. In correct indication scintigraphy is a valuable diagnostic measure and it may influence the procedure.

  4. Scintigraphy of spinal disorders in adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Mandell, G.A. (Dept. of Medical Imaging, Alfred I. duPont Inst., Wilmington, DE (United States)); Harcke, H.T. (Dept. of Medical Imaging, Alfred I. duPont Inst., Wilmington, DE (United States))


    Bone scintigraphy in adolescents is useful in helping to differentiate between developmental (atypical lumbar Scheuermann disease), infectious (discitis, osteomyelitis), neoplastic (osteoid osteoma, osteoblastoma), and traumatic (occult fractures, spondylolysis, pseudoarthrosis) disease of the spine. Double-phase (blood pool, delayed images) scintigraphy can characterize the pattern (i.e., linear in fracture, ovoid in nidus of osteoid osteoma). Single-photon emission computed tomography (SPECT) can be helpful in detecting the subtle presence of stress reaction (spondylolyses) not noted on routine planar scintigraphy and radiography. Bone scintigraphy is most beneficial when correlated with other imaging modalities in refining the diagnosis of spinal diseases. (orig.)

  5. Bone scintigraphy in ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Otsuka, Nobuaki; Fukunaga, Masao; Tomomitsu, Tatsushi (Kawasaki Medical School, Kurashiki, Okayama (Japan)); Morita, Rikushi


    Twelve patients with ankylosing spondylitis (11 males and one female) were examined by both bone scintigraphy and dual energy X-ray absorptiometry (DEXA). Bone scintigraphy revealed increased accumulation in the sacroiliac joint in 6 patients, the spines in 10, and the other joints, including the sternoclavicular joint, in 8 patients. Each one patient had an intense tracer uptake in the finger and toe joints. In 4 patients in whom DEXA was concurrently performed at the level of 2nd to 4th lumbar vertebrae, there was no consistent tendency for mean bone mineral density. In 2 of 3 patients receiving DEXA for the radius, bone marrow density was within the normal range. (N.K.).

  6. Biopersistence and translocation to extrapulmonary organs of titanium dioxide nanoparticles after subacute inhalation exposure to aerosol in adult and elderly rats. (United States)

    Gaté, Laurent; Disdier, Clémence; Cosnier, Frédéric; Gagnaire, François; Devoy, Jérôme; Saba, Wadad; Brun, Emilie; Chalansonnet, Monique; Mabondzo, Aloise


    The increasing industrial use of nanoparticles (NPs) has raised concerns about their impact on human health. Since aging and exposure to environmental factors are linked to the risk for developing pathologies, we address the question of TiO2 NPs toxicokinetics in the context of a realistic occupational exposure. We report the biodistribution of titanium in healthy young adults (12-13-week-old) and in elderly rats (19-month-old) exposed to 10mg/m(3) of a TiO2 nanostructured aerosol 6h/day, 5days/week for 4 weeks. We measured Ti content in major organs using inductively coupled plasma mass spectrometry immediately and up to 180days after the end of exposure. Large amounts of titanium were initially found in lung which were slowly cleared during the post-exposure period. From day 28, a small increase of Ti was found in the spleen and liver of exposed young adult rats. Such an increase was however never found in their blood, kidneys or brain. In the elderly group, translocation to extra-pulmonary organs was significant at day 90. Ti recovered from the spleen and liver of exposed elderly rats was higher than in exposed young adults. These data suggest that TiO2 NPs may translocate from the lung to extra-pulmonary organs where they could possibly promote systemic health effects.

  7. Lung scintigraphy in differential diagnosis of peripheral lung cancer and community-acquired pneumonia (United States)

    Krivonogov, Nikolay G.; Efimova, Nataliya Y.; Zavadovsky, Konstantin W.; Lishmanov, Yuri B.


    Ventilation/perfusion lung scintigraphy was performed in 39 patients with verified diagnosis of community-acquired pneumonia (CAP) and in 14 patients with peripheral lung cancer. Ventilation/perfusion ratio, apical-basal gradients of ventilation (U/L(V)) and lung perfusion (U/L(P)), and alveolar capillary permeability of radionuclide aerosol were determined based on scintigraphy data. The study demonstrated that main signs of CAP were increases in ventilation/perfusion ratio, perfusion and ventilation gradient on a side of the diseased lung, and two-side increase in alveolar capillary permeability rate for radionuclide aerosol. Unlike this, scintigraphic signs of peripheral lung cancer comprise an increase in ventilation/perfusion ratio over 1.0 on a side of the diseased lung with its simultaneous decrease on a contralateral side, normal values of perfusion and ventilation gradients of both lungs, and delayed alveolar capillary clearance in the diseased lung compared with the intact lung.

  8. Generation of aerosolized drugs. (United States)

    Wolff, R K; Niven, R W


    The expanding use of inhalation therapy has placed demands on current aerosol generation systems that are difficult to meet with current inhalers. The desire to deliver novel drug entities such as proteins and peptides, as well as complex formulations including liposomes and microspheres, requires delivery systems of improved efficiency that will target the lung in a reproducible manner. These efforts have also been spurred by the phase out of chlorofluorocarbons (CFCs) and this has included a directed search for alternative propellants. Consequently, a variety of new aerosol devices and methods of generating aerosols are being studied. This includes the use of freon replacement propellants, dry powder generation systems, aqueous unit spray systems and microprocessor controlled technologies. Each approach has advantages and disadvantages depending upon each principle of action and set of design variables. In addition, specific drugs may be better suited for one type of inhaler device vs. another. The extent to which aerosol generation systems achieve their goals is discussed together with a summary of selected papers presented at the recent International Congress of Aerosols in Medicine.

  9. 普米克令舒雾化吸入治疗妊娠期哮喘的临床疗效%Efficacy of Pulmicort Aerosol Inhalation in the Treatment of Asthma during Pregnancy

    Institute of Scientific and Technical Information of China (English)

    代先慧; 冷玲; 李克芬; 江文帅; 刘英勋


    Objective: To investigate the effect of pulmicort inhalation in the treatment of asthma during pregnancy.Methods:With a retrospective analysis, the clinical data of 120 pregnant patients with asthma in our hospital from October 2014 to May 2012 were selected and divided into two groups, control group and observation group, 60 cases in each group. The control group were treated with conventional anti-inflammatory and theophylline drug treatment, observation group on the basis of conventional therapy using Pulmicort Respules atomizing inhalation treatment. After 10 days of treatment, the effect of treatment was observed in the two groups.Results:After a period of treatment,patients with observer treatment the total effective rate was 95.00% (57/60) patients with significantly higher than the control group total effective rate of 66.67% (40/60),through statistical analysis,comparison,P<0.05,there was statistically significant;observation group of patients breathing average disappear time and xiao blare average time was significantly shorter than the control group, by statistical comparison,P<0.05, there was statistical significance.Conclusion:Pulmicort aerosol inhalation application has a better therapeutic effect on asthma in pregnancy, which can not only shorten the course of treatment, but also has better therapeutic efficacy and safety.%目的:探讨普米克令舒雾化吸入治疗妊娠期哮喘的临床疗效。方法:采用回顾性分析法,选取2012年5月至2014年10月我院收治的120妊娠期哮喘患者的临床资料,按照治疗方法的不同将她们分为两组,对照组和观察组,每组各60例。对照组患者采用常规抗炎+茶碱等药物治疗,观察组患者在常规治疗的基础上采用普米克令舒雾化吸入进行治疗。治疗10天后观察两组患者治疗效果。结果:经过一段时间的治疗,观察者患者治疗总有效率为95.00%(57/60)明显高于对照组患者治疗总有效率的66

  10. Pathological changes of major organs after rats inhaled methyl ethyl ketone peroxide aerosol%吸入过氧化甲乙酮气溶胶大鼠主要脏器的病理损伤

    Institute of Scientific and Technical Information of China (English)

    刘玲; 王延让; 王凤山; 刘静


    目的 探讨大鼠吸入过氧化甲乙酮(MEKP)气溶胶后主要器官的病理学改变,为研究过氧化甲乙酮损伤机制提供线索.方法 建立大鼠MEKP亚慢性染毒模型,SD大鼠100只,雌雄各半,随机分为空白对照组、溶剂对照组、50、500和1000 mg/m3MEKP染毒组,每组10只.对照组吸入清洁空气和溶剂气溶胶,6 h/d,5 d/周,共13周,记录染毒期间临床表现,计算肾脏、胸腺、睾丸等脏器的脏器系数,HE染色观察各组大鼠的肺、肝、睾丸等脏器组织病理学改变.结果 1000 mg/m3MEKP染毒组雄性大鼠肾脏、睾丸脏器系数明显低于空白对照组、溶剂对照组及50、500 mg/m3MEKP染毒组,差异有统计学意义(P<0.05); 1000 mg/m3 MEKP染毒组大鼠胸腺脏器系数明显低于空白对照组、溶剂对照组,差异有统计学意义(P<0.05).500和1000 mg/m3 MEKP染毒组中部分大鼠肺脏、肝脏、睾丸出现明显损伤,呈现病变程度随着剂量增加而加重的趋势.肺部损伤主要表现为过度充气,充血,出血,间质性肺炎,甚至肺脓肿症状;肝脏损伤表现为肝脏汇管区细胞核浓缩,细胞内脂肪变性,细胞轻度水肿;睾丸损伤主要表现为局部多级生精细胞变性,坏死,发育不良,生精细胞内的精子数目显著减少.在空白对照组、溶剂对照组及各剂量组雌性大鼠中未发现卵巢异常病变.结论 大鼠吸入MEKP气溶胶可对肝脏、肺脏、肾脏、胸腺、睾丸造成损伤作用,尤其对雄性大鼠睾丸的损害作用较为明显.%Objective To investigate the pathological changes of major organs in rats that have inhaled methyl ethyl ketone peroxide (MEKP) aerosol and to provide clues to the oxidative damage mechanism of MEKP.Methods A total of 100 Sprague-Dawley rats (male-to-female ratio=1∶1) were randomly and equally divided into blank control group,solvent control group,and 50,500,and 1000 mg/m3 MEKP exposure groups to inhale clean air,solvent aerosol,or MEKP

  11. Inhalation devices and patient interface: human factors. (United States)

    Leiner, Stefan; Parkins, David; Lastow, Orest


    The development of any inhalation product that does not consider the patient needs will fail. The needs of the patients must be identified and aligned with engineering options and physical laws to achieve a robust and intuitive-to-use inhaler. A close interaction between development disciplines and real-use evaluations in clinical studies or in human factor studies is suggested. The same holds true when a marketed product needs to be changed. Caution is warranted if an inhaler change leads to a change in the way the patient handles the device. Finally, the article points out potential problems if many inhaler designs are available. Do they confuse the patients? Can patients recall the correct handling of each inhaler they use? How large is the risk that different inhaler designs pose to the public health? The presentations were given at the Orlando Inhalation Conference: Approaches in International Regulation co-organised by the University of Florida and the International Pharmaceutical Aerosol Consortium on Regulation & Science (IPAC-RS) in March 2014.

  12. 雾化吸入小剂量氨溴索对开胸食道手术患者单肺通气时炎性反应的影响%Effects of inhaled aerosolized low dose ambroxol on inflammatory response to one-lung ventilation in patients undergoing open-chest esophagus surgery

    Institute of Scientific and Technical Information of China (English)

    李明川; 李毅海; 丁素春


    Objective To investigate the effects of inhaled aerosolized low dose ambroxol on the inflammatory response to one-lung ventilation (OLV) in patients undergoing open-chest esophagus surgery.Methods Sixty patients (aged 39-64 years,weighing 50-85 kg and with height of 153-181 cm) with normal heart and lung function undergoing open-chest esophagus surgery were randomly divided into three groups:20 patients receiving intravenous infusion of normal saline (control group,group C),20 receiving intravenous infusion of ambroxol 10 mg/kg after induction of anesthesia (group IA) and 20 inhaling aerosolized ambroxol 30 mg after induction of anesthesia (group AIA).Arterial blood samples were taken after induction of anesthesia before ambroxol administration (T0,baseline),after 90 minutes of OLV (T1) and at 30 minutes after OLV (T2) for determination of plasma concentrations of tumor necrosis factor-alpha (TNF-α),interleukin-1 beta (IL-1β),IL-8 and IL-10 by enzyme linked immunosorbent assay (ELISA).Results The levels of TNF-α,IL-1β,and IL-8 in plasma significantly increased while the level of IL-10 in plasma significantly decreased at T1 and T2 as compared with the baseline at T0 in all the three groups.The levels of TNF-α,IL-1β,and IL-8 in plasma were significantly lower and the level of IL-10 in plasma was significantly higher at T1 and T2 in groups IA and AIA than in group C.Conclusion Both intravenous injection of large dose ambroxol and inhaled aerosolized low dose ambroxol can inhibit the inflammatory response to OLV in patients undergoing open-chest esophagus surgery.

  13. Clinical Curative Effect Observation on Treatment of Chronic Obstructive Pulmonary Disease in Exacerbation Stage with Aerosol Inhalation of Budesonide Combined with Chinese Herbal Enema%布地奈德雾化吸入联合中药灌肠治疗COPD加重期的疗效观察

    Institute of Scientific and Technical Information of China (English)

    刘莉; 魏铭


    Objective To observe clinical effect of treating chronic obstructive pulmonary disease(COPD) in exacerbation stage with aerosol inhalation of budesonide combined with Chinese herbal enema. Methods 36 cases with COPD were randomly recurited into a control group and a treatment group. The control group was treated with routine western medicine, and the treatment group was treated with aerosol inhalation of budesonide combined with Chinese herbal enema. The clinical effect was observed in both groups, Results The total effective rate in the treatment group and the control group was 88.9% and 72.2%, respectively, showing significant difference between the two group. (P<0.05) .Conclusion The treatment of aerosol inhalation of budesonide combined with Chinese herbal enema on COPD is better than routine western medicine.%目的 观察布地奈德雾化吸入联合中药灌肠治疗慢性阻塞性肺病(COPD)加重期的临床疗效.方法 36例COPD患者,随机分为两组各18例,对照组采用常规西医治疗,治疗组采用布地奈德雾化吸入联合中药灌肠治疗,比较两组的临床疗效.结果 治疗组总有效率为88.9%,对照组总有效率为72.2%,两组比较差异有统计学意义(X2= 3.841,P<0.05).结论 采用布地奈德雾化吸入联合中药灌肠对COPD加重期的治疗效果优于常规治疗.

  14. Inhalation drug delivery devices: technology update

    Directory of Open Access Journals (Sweden)

    Ibrahim M


    Full Text Available Mariam Ibrahim, Rahul Verma, Lucila Garcia-ContrerasDepartment of Pharmaceutical Sciences, College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USAAbstract: The pulmonary route of administration has proven to be effective in local and systemic delivery of miscellaneous drugs and biopharmaceuticals to treat pulmonary and non-pulmonary diseases. A successful pulmonary administration requires a harmonic interaction between the drug formulation, the inhaler device, and the patient. However, the biggest single problem that accounts for the lack of desired effect or adverse outcomes is the incorrect use of the device due to lack of training in how to use the device or how to coordinate actuation and aerosol inhalation. This review summarizes the structural and mechanical features of aerosol delivery devices with respect to mechanisms of aerosol generation, their use with different formulations, and their advantages and limitations. A technological update of the current state-of-the-art designs proposed to overcome current challenges of existing devices is also provided.Keywords: pulmonary delivery, asthma, nebulizers, metered dose inhaler, dry powder inhaler

  15. Clinical research of hypertonie saline combined with salbutamol aerosol inhalation for capillary bronchitis%雾化吸入3%高渗盐水沙丁胺醇治疗毛细支气管炎的临床研究

    Institute of Scientific and Technical Information of China (English)



    目的:探讨雾化吸入3%高渗盐水沙丁胺醇治疗毛细支气管炎的临床疗效。方法选取我院收治的112例毛细支气管炎患儿,随机分为对照组(雾化吸入生理盐水沙丁胺醇)和观察组(雾化吸入3%高渗盐水沙丁胺醇),比较两组临床症状减轻或消失时间、住院时间、治疗总有效率及不良反应发生率的差异。结果观察组咳嗽减轻、喘息消失、肺部啰音消失等临床症状减轻或消失时间及住院时间均显著低于对照组(P<0.05);观察组治疗总有效率显著高于对照组(P<0.05);两组患儿均无严重不良反应发生(P>0.05)。结论雾化吸入3%高渗盐水沙丁胺醇治疗毛细支气管炎疗效显著,无不良反应发生。%Objective To investigate clinical efficacy of hypertonie saline combined with salbutamol aerosol inhalation for capillary bronchitis.Methods112 cases of capillary bronchitis in our hospital were randomly divided into control group (treated with normal saline combined with salbutamol aerosol inhalation) and observation group (treated with hypertonie saline combined with salbutamol aerosol inhalation).Clinical symptomsextinction time, hospital stays, total effective rate and adverse reaction rate of two groups were compared.Results Clinical symptoms extinction time and hospital stays of observation group were significantly shorter than control group (P0.05).ConclusionHypertonie saline combined with salbutamol aerosol inhalation for capillary bronchitis has exact effect.

  16. 硫酸沙丁胺醇气雾剂吸入与茶碱控释片治疗老年哮喘的疗效%Effect of inhaled salbutamol sulfate aerosol and sustained release theophylline treatment of elderly asthma

    Institute of Scientific and Technical Information of China (English)

    禤肇泉; 谭力雄


    目的:对硫酸沙丁胺醇气雾剂吸入与茶碱控释片急诊治疗老年哮喘患者的临床效果进行分析探讨。方法选取我院急诊科收治的120例老年哮喘患者随机分为研究组与参考组,各60例,参考组患者仅应用硫酸沙丁胺醇气雾剂治疗,研究组患者应用硫酸沙丁胺醇气雾剂吸入与茶碱控释片治疗。结果研究组患者哮喘症状消失时间、肺功能改善、治疗有效率、生存质量以及不良反应等指标均优于参考组(P<0.05)。结论应用硫酸沙丁胺醇气雾剂吸入与茶碱控释片急诊治疗老年哮喘患者,能够明显改善患者肺功能,提高生存质量与治疗有效率,并降低不良反应。%Objective To analyze and study the clinical effect of inhaled salbutamol sulfate aerosol and sustained release theophylline in the emergency treatment of patients with elderly asthma. Methods 120 patients with elderly asthma, who were received and treated in emergency department of our hospital,were selected and were randomly divided into study group and control group,with 60 cases in each group.To treat single with inhaled salbutamol sulfate aerosol on patients in control group,to treat with inhaled salbutamol sulfate aerosol and sustained release theophylline on patients in study group. Results The asthma symptoms disappeared time,the improvement of pulmonary function, the treatment effective rate,the quality of life,and the adverse reactions and etc.of patients in study group were better than which in control group(P < 0.05). Conclusion Inhaled salbutamol sulfate aerosol and sustained release theophylline in the emergency treatment of patients with elderly asthma could obviously improve the pulmonary function of patients,could improve the quality of life and treatment effective rate, could reduce the adverse reactions.

  17. Clinical Observation on Aerosol Inhalation Combined with Oral Corti Cos-teroids in Treatment of Bronchiolitis Obliterans in Children%雾化吸入与口服糖皮质激素联合治疗儿童闭塞性细支气管炎临床分析

    Institute of Scientific and Technical Information of China (English)



    Objective To discuss and observe the clinical effect of aerosol inhalation combined with oral corti costeroids in treatment of bronchiolitis obliterans in children. Methods 116 cases of children with bronchiolitis obliterans diagnosed from December 2010 to June 2015 were collected and randomly divided into two groups with 58 cases in each, the observation group were treated with budesonide inhalation aerosol and oral corti costeroids, the control group were also treated budes-onide inhalation aerosol and oral corti costeroids, but the dose was different, and the treatment effects and asthma control situations were compared. Results The effective rate and asthma control scale were respectively 93.1%and (23.4±1.2) marks in the observation group, which were obviously better than those in the control group, P<0.05. Conclusion The clinical effect of aerosol inhalation combined with oral corti costeroids in treatment of bronchiolitis obliterans in children is satisfactory.%目的:探讨雾化吸入与口服糖皮质激素联合治疗儿童闭塞性细支气管炎临床疗效。方法方便选取2010年12月—2015年6月确诊的116例闭塞性细支气管炎患儿,随机分为观察组(布地奈德雾化吸入和口服泼尼松)和对照组(同观察组,但剂量不同)各58例,比较治疗效果和哮喘控制情况。结果观察组有效率为93.1%,哮喘控制得分为(23.4±1.2)分,均明显优于对照组(P<0.05)。结论雾化吸入与口服糖皮质激素协同治疗儿童闭塞性细支气管炎临床效果满意。

  18. Imaging of pulmonary disease in rheumatoid arthritis using JOO1X scintigraphy: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Goupille, P. [Service de Rhumatologie, Hopital Trousseau, Tours (France); Diot, P. [Service de Pneumologie, Hopital Bretonneau, Tours (France); Valat, J.P. [Service de Rhumatologie, Hopital Trousseau, Tours (France); Lemarie, E. [Service de Pneumologie, Hopital Bretonneau, Tours (France); Valat, C. [Service de Medecine Nucleaire, Hopital Bretonneau, Tours (France); Asquier, E. [Service de Radiologie, Hopital Bretonneau, Tours (France); Delarue, A. [Centre de Developpement Pierre Fabre, Labege (France); Pape, A.L. [Lab. de Biophysique Cellulaire et RMN, INSERM U316, Univ. Tours (France)


    The purpose of this study was to determine the ability of technetium-99m J001X scintigraphy to image active pulmonary involvement in patients suffering from rheumatoid arthritis (RA). J001X is a fully characterized acylated poly(1,3)galactoside, isolated from Klebsiella membranes, which is able to bind recruited macrophages after aerosol administration. J001X scintigraphy was compared with high-resolution computed tomography (HRCT), pulmonary function tests (PFTs) and bronchoalveolar lavage (BAL) in 15 patients suffering from RA. Patients were considered to have pulmonary involvement when they had an interstitial syndrome on HRCT and a decrease of 20% in TCO/VE (transfer coefficient) on PFTs and/or an abnormal BAL (lymphocytosis higher than 20% and/or percentage of neutrophils higher than 10%). Pulmonary involvement was present in eight patients, and absent in seven. Of the eight patients with pulmonary involvement, all had abnormal BAL, two had an interstitial syndrome on HRCT, two had decreased TCO/VE and three had positive J001X scintigraphy. Of the seven patients without pulmonary involvement, six had normal BAL (not available in one), two had an interstitial syndrome on HRCT, one had decreased TCO/VE and two had positive J001X scintigraphy. According to our gold standard of pulmonary involvement, the sensitivity of J001X scintigraphy for the detection of pulmonary involvement in RA was 37.5%, the specificity was 71.4% and the positive predictive value was 60%. The ability of J001X scintigraphy to detect active pulmonary involvement during RA appears unclear in this study but it may detect processes unnoticed by the other modalities. (orig./MG)

  19. Platelet scintigraphy in atherothrombotic disease

    Energy Technology Data Exchange (ETDEWEB)

    Isaka, Yoshinari (Osaka National Hospital (Japan))


    Indium-111 platelet scintigraphy for the measurement of in vivo thrombogenicity is a useful noninvasive technique with a number of applications. From 1982 to 1989, we explored clinical relevance of this method for 576 consecutive patients with atherothrombotic disease. There was a disease-related difference in the percentage of positive platelet accumulation; 85% in patients with Dacron bifurcation graft, 75% in abdominal or thoracic aneurysm, 40% in intra-cardiac thrombi, 33% in arteriosclerosis obliterans and 25% in ischemic cerebrovascular disease. Labelled platelets accumulated frequently in the lesion with severe arteriographic abnormality. Aspirin clearly inhibited platelet accumulation on carotid atheroma but the effect of ticlopidine has been less conclusive. Short-term orally active PGI[sub 2] analogue had inhibitory effects on platelet accumulation in carotid atheroma and platelet aggregability, but did not cause significant reduction in plaque size. The results suggest the usefulness of platelet scintigraphy for monitoring the thrombogenicity in various atherothrombotic diseases. It will be necessary, however, to simplify the labelling procedures and to develop a new [sup 99m]Tc-labelled thrombus imaging agent, if thrombus imaging is to be considered for more generall use for patients with atherosclerosis. (author).

  20. Fine particle mass from the Diskus inhaler and Turbuhaler inhaler in children with asthma

    DEFF Research Database (Denmark)

    Bisgaard, H; Klug, B; Sumby, B S;


    The study aimed to investigate dose consistency and particle distribution from the dry powder inhalers Diskus and Turbuhaler. Full profiles of inhalation pressure versus time were recorded in 18 4 yr old and 18 8 yr old asthmatic children through Diskus and Turbuhaler inhalers. These data were used...... is a determinant of the quality of the aerosol. The mean (SD) amount of drug in large particles (>4.7 microm), fine particles (children and 71 (3), 18 (2) and 2...... (1) from the 8 yr old children, respectively. Similar particle fractions from the Budesonide Turbuhaler were 35 (9), 21 (10) and 7 (5) from 4 yr old children and 30 (7), 32 (9) and 12 (6) from 8 yr old children. In conclusion, the Diskus inhaler provides an improved dose consistency through...

  1. Esophageal scintigraphy: A comparison with esophagoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Kjellen, G.; Andersson, P.; Sandstroem, S.


    Fifty consecutive patients with different esophageal symtoms were investigated with esophageal endoscopy, transit scintigraphy, and gastroesophageal (GE) scintigraphy with extra-abdominal compression. Scintigraphic findings were abnormal in 27 of those 31 patients (87%) who were classified as abnormal at endoscopy. A prolonged transit time was the commonest finding, but hiatal hernia and GE reflux were also found. However, the scintigraphic procedure showed abnormalities in 6 of 19 (31%) patients who were classified as normal at endoscopy. Esophageal scintigraphy is recommended as a screening test before endoscopy is decided on. 20 refs.

  2. Development of an intelligent adapter for metered dose inhalers

    Directory of Open Access Journals (Sweden)

    Zhang Mingrong


    Full Text Available To better coordinate the interaction of inhalation and aerosol release, an intelligent adapter (IA was developed for metered dose inhalers (MDIs. The adapter included three main units: a signal acquisition device, a micro-control-unit (MCU, and an actuation mechanism. To fully study the effectiveness of the intelligent adapter, an inhalation simulation experiment was done, and two bands of MDI were used for the experiment. The results indicated that, when inhalation, the intelligent adapter can press down the MDI automatically; moreover, this intelligent adapter could achieve an aerosol-release time Tr of 0.4 s for MDI A and 0.60 s for MDI B, which compares very well with the existing pure mechanical systems at 0.8 s and 1.0 s.

  3. 硫酸沙丁胺醇气雾剂吸入与茶碱控释片治疗急性老年哮喘的疗效对比分析%Salbutamol Aerosol Inhalation and Efficacy Analysis of Theophylline Con-trolled Release Tablets in the Treatment of Acute Asthma in the Elderly

    Institute of Scientific and Technical Information of China (English)



    Objective To explore the curative effect of inhalation of Salbutamol Aerosol and theophylline controlled release tablets in the treatment of acute asthma in the elderly. Methods Convenient selection from January 2013 to January 2016, 78 patients with acute senile asthma were selected as the research subjects. The patients were randomly divided into the in-halation group and the oral group, 39 cases in each group. Inhalation group received salbutamol sulfate aerosol agent inhala-tion therapy and combination group given salbutamol sulfate aerosol combined with theophylline controlled release tablets in the treatment, pulmonary function, arterial blood gas analysis were observed after the treatment, the patients in the two groups, adverse reactions and therapeutic effect. Results The combined group FEV1/FVC, FEV1%, PaCO2, Pa2O2 were bet-ter than the inhalation group, the total effective rate of the combined group was 94.87%, significantly higher than that in the group of 82.05%, it was proved that the combined group was significantly better than the inhalation group, and the differ-ence between the groups was P < 0.05. Conclusion Salbutamol sulfate aerosol combined with theophylline controlled re-lease tablets can effectively alleviate the asthma in elderly patients with acute arterial blood gas and lung function, reduced in elderly patients with dyspnea felt pain, improve their quality of life, and to enhance the clinical curative effect, worthy of our respiratory physicians actively promote the use of.%目的:探究硫酸沙丁胺醇气雾剂吸入与茶碱控释片治疗急性老年哮喘的疗效对比。方法方便选取该院2013年1月—2016年1月收治患急性老年哮喘患者78例作为研究对象,随机分为吸入组和口服组,每组39例。吸入组给予硫酸沙丁胺醇气雾剂吸入治疗,联合组给予硫酸沙丁胺醇气雾剂联合茶碱控释片治疗,观察两组患者治疗后肺功能水平、动脉血气分析、不良反

  4. Inhalation Toxicology Research Institute annual report, October 1, 1993--September 30, 1994

    Energy Technology Data Exchange (ETDEWEB)

    Belinsky, S. A.; Hoover, M. D.; Bradley, P. L. [eds.


    This document from the Inhalation Toxicology Research Institute includes annual reports in the following general areas: (I) Aerosol Technology and Characterization of Airborne Materials; (II) Deposition, transport, and clearance of inhaled Toxicants; (III) Metabolism and Markers of Inhaled Toxicants; (IV) Carcinogenic Responses to Toxicants; (V) Mechanisms of carcinogenic response to Toxicants; (VI) Non carcinogenic responses to inhaled toxicants; (VII) Mechanisms of noncarcinogenic Responses to Inhaled Toxicants; (VIII) The application of Mathematical Modeling to Risk Estimates. 9 appendices are also included. Selected papers are indexed separately for inclusion in the Energy Science and Technology Database.

  5. Zanamivir Oral Inhalation (United States)

    ... for inhaling powder) and five Rotadisks (circular foil blister packs each containing four blisters of medication). Zanamivir powder ... put a hole in or open any medication blister pack until inhaling a dose with the Diskhaler.Carefully ...

  6. Parathyroid scintigraphy during hypocalcaemia in primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Øgard, Christina G; Thomsen, Jørn Bo; Jakobsen, Henrik


    Minimally invasive parathyroid surgery in patients with primary hyperparathyroidism (PHPT) demands high imaging accuracy. By increasing blood flow to the parathyroid adenoma before injection of a perfusion marker, we intended to improve the parathyroid scintigraphy. We have named the technique...

  7. [Ventricular fibrillation following deodorant spray inhalation]. (United States)

    Girard, F; Le Tacon, S; Maria, M; Pierrard, O; Monin, P


    We report one case of out-of-hospital cardiac arrest with ventricular fibrillation following butane poisoning after inhalation of antiperspiration aerosol. An early management using semi-automatic defibrillator explained the success of the resuscitation. The mechanism of butane toxicity could be an increased sensitivity of cardiac receptors to circulating catecholamines, responsible for cardiac arrest during exercise and for resuscitation difficulties. The indication of epinephrine is discussed.

  8. Pulmonary drug delivery by powder aerosols. (United States)

    Yang, Michael Yifei; Chan, John Gar Yan; Chan, Hak-Kim


    The efficacy of pharmaceutical aerosols relates to its deposition in the clinically relevant regions of the lungs, which can be assessed by in vivo lung deposition studies. Dry powder formulations are popular as devices are portable and aerosolisation does not require a propellant. Over the years, key advancements in dry powder formulation, device design and our understanding on the mechanics of inhaled pharmaceutical aerosol have opened up new opportunities in treatment of diseases through pulmonary drug delivery. This review covers these advancements and future directions for inhaled dry powder aerosols.

  9. Clinical roles in indium-111 octreotide scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Hain, S.F.; Roach, P.J [Royal North Shore Hospital, St Leonards, NSW (Australia). Department of Nuclear Medicine


    Full text: Octreotide is being increasingly used in the assessment of various tumour types, particularly those of neuroendocrine origin. It has even been proposed that octreotide scintigraphy should be used as the first localisation technique in such tumours. We present three cases which show different clinical roles for 111 In- octreotide scintigraphy in both evaluating the extent of disease and assessing likely response to somatostatin therapy. In the first case, a 55-year-old male presented with flushing, diarrhoea, weight loss and elevated urinary 5-HIM levels. Clinical examination showed left supraclavicular Iymphadenopathy and CT revealed only paraaortic Iymphadenopathy. In comparison, octreotide scintigraphy revealed much more extensive disease than noted on CT in both the abdomen and chest. Lesions were histologically confirmed as carcinoid tumour. In the second case, a 52-year-old male underwent scintigraphy for staging of small cell lung carcinoma. Similarly, more extensive disease was noted on octreotide scintigraphy than on CT scanning. In the third case, a 1 6-year-old female underwent debulking surgery for a growth hormone and prolactin producing pituitary tumour. The presence of somatostatin receptors was demonstrated by octreotide scintigraphy. This was performed to determine the potential response to somatostatin therapy which has been reported to reduce tumour size in these patients. These cases show a clinical role for {sup 111}In octreotide scintigraphy in the evaluation of disease extent in neuroendocrine tumours as well as some other tumour sub-types. In the first two cases described, scintigraphy revealed more extensive disease than CT scanning. Indium-111 octreotide can also be used to predict the response of such patients to somatostatin therapy

  10. Design and evaluation of a new dry powder inhaler

    Directory of Open Access Journals (Sweden)

    "Rouholamini Najafabadi AH


    Full Text Available Three versions of a new dry powder inhaler (DPI, RG-haler, were designed using two kinds of grid inserts. Salbutamol sulfate/lactose blend (Ventolin Rotacaps® was selected as a model formulation to analyze the performance of all inhalers and compare their efficiency with three marketed devices (Rotahaler®, Spinhaler® and ISF inhalator® using the twin impinger (TI. Deposition of the drug in device was significantly (P<0.05 lower for ISF inhalator® and all kinds of RG-halers in comparison with those of Rotahaler® and Spinhaler®. The amount of drug deposited in the stage 2 and the respirable dose for RG-halers were similar to those of ISF inhalator® and significantly (P<0.05 higher than those of Rotahaler® and Spinhaler®. The results suggest efficient aerosol generating capability of the RG-haler.

  11. Development of high efficiency ventilation bag actuated dry powder inhalers. (United States)

    Behara, Srinivas R B; Longest, P Worth; Farkas, Dale R; Hindle, Michael


    New active dry powder inhaler systems were developed and tested to efficiently aerosolize a carrier-free formulation. To assess inhaler performance, a challenging case study of aerosol lung delivery during high-flow nasal cannula (HFNC) therapy was selected. The active delivery system consisted of a ventilation bag for actuating the device, the DPI containing a flow control orifice and 3D rod array, and streamlined nasal cannula with separate inlets for the aerosol and HFNC therapy gas. In vitro experiments were conducted to assess deposition in the device, emitted dose (ED) from the nasal cannula, and powder deaggregation. The best performing systems achieved EDs of 70-80% with fine particle fractions ventilation, nose-to-lung aerosol administration, and to assist patients that cannot reproducibly use passive DPIs.

  12. Achieving Consistent Multiple Daily Low-Dose Bacillus anthracis Spore Inhalation Exposures in the Rabbit Model (United States)


    daily low-dose Bacillus anthracis spore inhalation exposures in the rabbit model Roy E. Barnewall 1, Jason E. Comer 1, Brian D. Miller 1, BradfordW...multiple exposure days. Keywords: Bacillus anthracis , inhalation exposures, low-dose, subchronic exposures, spores, anthrax, aerosol system INTRODUCTION... Bacillus Anthracis Spore Inhalation Exposures In The Rabbit Model 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d

  13. Reversibility after inhaling salbutamol in different body postures in asthmatic children: a pilot study

    NARCIS (Netherlands)

    Visser, R.; Palen, van der J.; Jongh, de F.H.C.; Thio, B.J.


    Rationale Pulmonary medication is mostly delivered in the form of medical aerosols to minimize systemic side effects. A major drawback of inhaled medication is that the majority of inhaled particles impacts in the oropharynx at the sharp bend of the airway. Stretching the airway by a forward leaning

  14. Reversibility of pulmonary function after inhaling salbutamol in different doses and body postures in asthmatic children

    NARCIS (Netherlands)

    Visser, R.; Kelderman, S.; Jongh, de F.H.C.; Palen, van der J.; Thio, B.J.


    Rationale Pulmonary medication is often delivered in the form of medical aerosols designed for inhalation. Recently, breath actuated inhalers (BAI's) gained popularity as they can be used without spacers. A major drawback of BAI's is the impaction in the upper airway. Stretching the upper airway by

  15. Clinical observation of mechanical ventilation combined with aerosol inhalation in the treatment of pediatric severe pneumonia%机械通气联合雾化治疗小儿重症肺炎的临床观察

    Institute of Scientific and Technical Information of China (English)

    张欢; 王凯萍; 曾雪飞; 邹伟


    Objective To evaluate the effects of combivent and pulmicort respules for severe pneumonia children under invasive mechanical ventilation.Methods A total of 77 children with severe pneumonia were randomly divided into control group (38 cases) and experimental group (39 cases). The control group received treatment as anti-infection, mechanical ventilation, and sedation. The experimental group received additional combivent and pulmicort respules aerosol inhalation. Ventilator use time, laryngeal edema duration, partial pressure of blood oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) after treatment were compared between the two groups.Results The experimental group had shorter ventilator use time [(102.7±43.0) h VS (124.1±49.7) h], shorter laryngeal edema duration [(31.5±11.7) h VS (37.5±13.0) h], higher PaO2 level after treatment [(86.2±11.1) mm Hg VS (78.6±10.4) mm Hg] (1 mm Hg=0.133 kPa), and lower PaCO2 level [(38.5±12.5) mm Hg VS (46.8±13.1) mm Hg] than the control group, and their differences all had statistical significance (P<0.05).Conclusion Mechanical ventilation combined with combivent and pulmicort respules can effectively improve pediatric severe pneumonia symptoms and reduce adverse reactions of mechanical ventilation. This method is worthy of clinical promotion and application.%目的:评价可必特、普米克令舒在使用有创机械通气的重症肺炎患儿中的作用。方法77例重症肺炎患儿随机分成对照组(38例)和实验组(39例)。对照组给予抗感染、机械通气、镇静等治疗,实验组在对照组治疗的基础上给予可必特、普米克令舒雾化治疗。比较两组呼吸机使用时间、喉头水肿持续时间、治疗后血氧分压(PaO2)、二氧化碳分压(PaCO2)。结果实验组呼吸机使用时间短于对照组[(102.7±43.0)h VS (124.1±49.7)h],喉头水肿持续时间少于对照组[(31.5±11.7)h VS(37.5±13.0)h],治疗后PaO2较对照组升高[(86.2±11.1)mm Hg VS

  16. Occupational Asthma Induced by Inhaling Lumbrokinase Aerosol:A Two-case Report%蚓激酶引起职业性哮喘:附2例病例报道

    Institute of Scientific and Technical Information of China (English)

    顾建青; 文利平; 尹佳


    Objective To investigate the importance of skin prick test ( SPT) , conjunctiva provocation test( CPT) and/or bronchial provocation test ( BPT) in the diagnosis of occupational asthma induced by rare allergen such as lumbrokinase. Methods Medical history was collected carefully in two cases of suspected lumbrokinase induced occupational asthma patients. SPT were performed by using the saline solution of lumbrokinase ( 10 μg/ml) in these two patients and three healthy controls. BPT and CPT in patient A and B was also performed respectively. Results SPT of lumbrokinase was positive in both patients, and negative in three healthy controls. The BPT was positive in patients A with FEV1.0 reduced from 103% to 83% predicted. The CPT was positive in patient B ? S left eye while negative in right eye as control. Conclusions Inhalation of lumbrokinase aerosol could induce occupational allergic rhinitis and asthma, of which culprit is a protein. SPT and CPT and/or BPT might be helpful tools for the diagnosis.%目的 探讨皮肤点刺试验、结膜和(或)支气管激发试验,在蚓激酶这类罕见的职业环境中引起的职业性哮喘的诊断意义.方法 对2例怀疑职业环境中接触蚓激酶粉尘引起的哮喘患者进行临床表现总结,并用蚓激酶粉剂稀释液(10μg/ml)分别对2例患者和3例健康对照进行皮肤点刺试验;对例1进行支气管激发试验;对例2进行结膜激发试验.结果 2例患者蚓激酶皮肤点刺试验均为阳性,3例健康对照者均为阴性.例1支气管激发试验阳性,FEV1.0从103%预计值降到83%预计值.例2左侧眼结膜激发试验阳性,作为对照的右侧眼结膜为阴性.结论 蚓激酶作为一种药用蛋白质,其粉尘可以引起职业性哮喘,特异性皮肤点刺试验、结膜和(或)支气管激发试验有助于诊断.

  17. Radioactive content in aerosols and rainwater; Contenido radiactivo en aerosoles y agua de lluvia

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez Perestelo, N.; Lopez Perez, M.; Rodriguez, S.; Duarte, X.; Catalan, A.; Fernandez de Aldecoa, J. C.; Hernandez, J.


    The environmental radiological characterization of a place requires knowledge of the radioactive contents of its components, such as air (aerosol), rain, soil, etc ... Inhalation of radioactive aerosols in the air remains the main component of the total dose to the world population. This work focuses on its determination. (Author)

  18. 机械通气联合雾化吸入治疗COPD呼吸衰竭疗效观察%Observation of the Efficacy of mechanical ventilation combined with aerosolization inhalation to treat respiratory failure in patients with chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)



    Objective Observation of the efficacy of bi - level positive airway pressure ventilation( BiPAP ) combined with drug aerosolization inhalation to treat respiratory failure in patients with acute exacerbation of chronic obstructive pulmonary disease ( AECO-PD ). Methods 52 patients were randomly divided into group A and group B with based on routine therapies, group A received BiPAP treatment. Group B were received BiPAP combined drug aerosolization inhalation treatment. Changes of clinical situation, time of mechanical ventilation and days of hospitalization in ICU were observed. Results Arterial blood gas( PaO2、PaCO2 )、PaO2/FiO2 and respiratory rate of group B had significant improvement over group A after treatment ( P < 0. 05 ) . Time of mechanical ventilation and days of hospitalization in ICU of group B were also fewer than group A. Conclusion BiPAP combined with drug aerosolization inhalation to treat respiratory failure in AECOPD is more effective.%目的 双水平无创正压通气(BiPAP)联合药物雾化吸入治疗AECOPD Ⅱ型呼吸衰竭疗效观察.方法 52例AECOPD Ⅱ型呼吸衰竭患者在常规治疗基础上随机分为A、B两组,A组BiPAP治疗.B组BiPAP联合药物雾化吸入治疗,观察两组临床情况变化及机械通气时间、住ICU天数.结果 治疗后B组血气指标、氧合指数、呼吸频率较A组改善明显(P<0.05),B组机械通气时间、住ICU天数少于A组.结论 BiPAP联合药物雾化吸入治疗AECOPD Ⅱ型呼吸衰竭疗效好.

  19. Patient preferences for inhaler devices in chronic obstructive pulmonary disease: experience with Respimat® Soft Mist™ Inhaler

    Directory of Open Access Journals (Sweden)

    Richard Hodder


    Full Text Available Richard Hodder,1 David Price21Divisions of Pulmonary and Critical Care, University of Ottawa, Ottawa, Ontario, Canada; 2Department of General Practice and Primary Care, University of Aberdeen, Aberdeen, ScotlandAbstract: Current guidelines for the management of chronic obstructive pulmonary disease (COPD recommend the regular use of inhaled bronchodilator therapy in order to relieve symptoms and prevent exacerbations. A variety of inhaler devices are currently available to COPD patients, and the choice of device is an important consideration because it can influence patients’ adherence to treatment, and thus potentially affect the long-term outcome. The Respimat® Soft Mist™ Inhaler (SMI generates a slow-moving aerosol with a high fine particle fraction, resulting in deposition of a higher proportion of the dose in the lungs than pressurized metered-dose inhalers (pMDIs or some dry powder inhalers (DPIs. We review clinical studies of inhaler satisfaction and preference comparing Respimat® SMI against other inhalers in COPD patients. Using objective and validated patient satisfaction instruments, Respimat® SMI was consistently shown to be well accepted by COPD patients, largely due to its inhalation and handling characteristics. In comparative studies with pMDIs, the patient total satisfaction score with Respimat® SMI was statistically and clinically significantly higher than with the pMDI. In comparative studies with DPIs, the total satisfaction score was statistically significantly higher than for the Turbuhaler® DPI, but only the performance domain of satisfaction was clinically significantly higher for Respimat® SMI. Whether the observed higher levels of patient satisfaction reported with Respimat® SMI might be expected to result in improved adherence to therapy and thus provide benefits consistent with those recently shown to be associated with sustained bronchodilator treatment in patients with COPD remains to be proven

  20. 甲醛预暴露与微生物气溶胶吸入对大鼠呼吸系统的协同损伤效应研究%Synergistic effect of formaldehyde pre-exposure on the damage to the respiratory system in rats after microbial aerosol inhalation

    Institute of Scientific and Technical Information of China (English)

    陈双红; 潘沪湘; 徐雄利; 任小孟; 陈茜; 袁海霞; 陶永华


    织的损伤效应,并降低肺组织对异源性污染物的清除能力.%Objective To investigate the synergistic effect of formaldehyde pre-exposure on the damage to the respiratory system in rats after microbial aerosol inhalation.Methods The intoxication model was established in rats by the dynamic aerosol exposure system.Serum IgM concentration and SOD activity were measured by ELISA and luminescence assay respectively.Morphologic injury of the lung tissue was detected by HE staining.Tunnel chromogenic in-situ detection was used to detect the apoptosis of lung epithelial cells and Gram staining was performed to detect the capacity of lung epithelial cells in bacterial clearance.Results Serum IgM levels in rats increased significantly,after microbial aerosol inhalation,when compared with that of the control group,with the serum IgM levels of the formaldehyde combined with microbial aerosol inhalation group increased more significantly [(0.35 ±0.09) g/L].The serum SOD activity of the experimental groups all increased,with the level of the formaldehyde combined with microbial aerosol inhalation group [(2.22 ± 0.25) × 106 U/L] being significantly higher than that of the 2 other groups [(1.50 ±0.37) × 106 U/L] and [(1.58 ± 0.34) × 106 U/L].Morphological observation showed that widened alveolar septum,interstitial edema and inflammatory cell infiltration could be clearly noted in the lung tissue of the 3 experimental groups,with the pathological changes in the formaldehyde combined with microbial aerosol inhalation group being most significant.Tunnel detection also indicated that the nnmber of apoptotic cells in the lung tissue for the formaldehyde combined with microbial aerosol inhalation group increased significantly.Gram staining showed that the number of residue bacteria in the rat bronchiole for the rats of the formaldehyde combined with microbial aerosol inhalation group after 2-hour air intervention was significantly more than that of the simple

  1. Technical aspects of bone scintigraphy. (United States)

    Brown, M L; O'Connor, M K; Hung, J C; Hayostek, R J


    Optimal bone scintigraphy is obtained by using a current generation gamma camera with a high-resolution collimator, minimizing the patient-to-collimator distance, using scatter reduction techniques where possible, and obtaining a 500,000 to 1 million count image for 40-cm field of view camera. Hard copy images from an analog or digital formatter should be optimized to display all intensities either on the same images or, when necessary, to display the low count information on one image and the high count information on another. Additional images using different collimators, such as converging or pinhole collimators, and oblique and lateral views should be obtained when necessary to demonstrate or define the pathologic area. To optimize SPECT imaging, the following parameters should be used: a high-resolution collimator, a 128 x 128 acquisition matrix, and minimum separation between the patient and the collimator, which may require the use of an elliptic orbit. Between 64 and 128 views should be obtained, and depending on preference, the planar data should be prefiltered with a Butterworth, order 8-12 and a cutoff at 0.5 Nyquist. The data should then be reconstructed using a simple ramp filter. This method provides a good technique when one is first beginning to perform bone SPECT. Attenuation correction is not generally beneficial for SPECT bone studies, although sometimes weighted backprojection may improve image contrast and resolution. Finally, the use of volume rendering may help clarify the location of suspect lesions.

  2. Inhalation of aerosolized perfluorocarbon combined with tetramethylpyrazine ameliorates hemodynamics and pulmonary histopatholgy in a porcine model of acute lung injury%联合雾化吸入氟碳及中药川芎嗪治疗急性肺损伤的血流动力学及组织病理的改变

    Institute of Scientific and Technical Information of China (English)

    彭雪梅; 谢娟华; 帅兵; 李雅兰; 王仲红; 王华东; 王彦平


    目的 探讨联合雾化吸入PFC(perfluorocarbon)与中药川芎嗪治疗急性肺损伤时血流动力学及组织病理的改变.方法 采用肺灌洗诱导急性肺损伤(acute lung injury,ALI)后,动物分3组:①雾化吸人PFC(perfluorocarbon group,P组)组;②联合雾化吸入PFC-川芎嗪(tetramethylpyrazine-perfluorocarbon group,TP组)组;③雾化中药川芎嗪(chinese medicialcontral group,T组)组.分别在ALI前、灌洗后、ALI及ALI后1、2、3、4h7个时段观察MAP、PetCO2、mPAP、CVP以及PAWP等血流动力学指标的变化,实验结束后取肺组织做病理学分析.结果 肺灌洗后3组动物MAP、mPAP、CVP以及PAWP显著升高(P>0.05),TP组治疗干预后各时段MAP、mPAP、CVP以及PAWP变化与P、T组相应时段比较具有统计学意义(P<0.05).组织病理学显示TP组的病理改变最小,T组改变最大.结论 联合雾化吸入PFC与中药川芎嗪能有效的改善氧合,显著的降低肺动脉压,减少肺组织损伤.%Objective To observe the effect of inhalation of aerosolized perfluorocarbon combined with tetramethylpyrazine on the hemodynamics and histopatholgy in a porcine model of acute lung injury. Methods Normal adult pigs were subjected to saline lavage of the bilateral lungs to induce acute lung injury and randomized subsequently into 3 groups for treatment with inhalation of perfluorocarbon, combined inhalation of perfluorocarbon and tetramethylpyrazine, or inhalation of tetramethylpyrazine. The changes of mean arterial pressure (MAP), PetCO2, mPAP, CVP and PAWP were recorded at different time points following the lung injury, and the lung tissues were sampled for histological observations. Results The MAP, mPAP, CVP and PAWP all increased significantly in the 3 groups after acute lung injury. Interventions with combined tetramethylpyrazine and perfluorocarbon inhalation significantly improved these indices as compared with inhalation of tetramethylpyrazine or perfluorocarbon alone (P< 0

  3. 沙丁胺醇与布地奈德联合雾化吸入治疗小儿哮喘临床疗效及安全性研究%Study on the clinical efficacy and safety of aerosol inhalation of salbutamol combined with budesonide for treatment of pediatric asthma

    Institute of Scientific and Technical Information of China (English)



    Objective; To explore the clinical efficacy and safety of aerosol inhalation of salbutamol combined with budesonide for treatment of pediatric asthma. Methods: The clinical data of 82 infants with bronchial asthma who were treated in the hospital from January 2011 to January 2012 were analyzed retrospectively; the clinical efficacies and adverse reactions in observation group (aerosol inhalation of salbutamol combined with budesonide) and control group ( aerosol inhalation of salbutamol) were observed, compared, and analyzed. Results; The total effective rate in observation group was 95. 12% , which was statistically significantly higher than that in control group (78. 05% ) (P <0. 05) ; The disappearance time of symptoms and mean hospitalization time in observation group were statistically significantly lower than those in control group (P<0. 01) ; the improvement of pulmonary function in observation group was better than that in control group ( P < 0. 05) ; the adverse reactions in the two groups were mild. Conclusion: Aerosol inhalation of salbutamol combined with budesonide has the advantages of good curative effect, fast effect, obvious improvement of symptoms, and less adverse reactions, which can be used as a good therapeutic schedule for treatment of pediatric asthma currently.%目的:探讨沙丁胺醇与布地奈德联合雾化吸入治疗小儿支气管哮喘的临床疗效及安全性.方法:回顾性分析2011年1月~2012年1月在该院接受治疗的82例支气管哮喘患儿的临床资料,观察沙丁胺醇与布地奈德 (观察组)联合雾化吸入与单一沙丁胺醇 (对照组)雾化吸入治疗的临床疗效及不良反应情况,并进行对比分析.结果:观察组总有效率为95.12%,明显高于对照组的78.05% (P<0.05);观察组患儿症状消退时间及平均住院时间均明显低于对照组(P<0.01);观察组肺功能改善明显优于对照组(P<0.05);两组不良反应均较轻微.结论:沙丁胺醇与布

  4. Effects of Expelling Phlegm and Relieving Blood Stasis Principle Combined With Tiotropium Bromide Aerosol Inhalation Treatment on Recovery Process and Lung Function of COPD Patients in Remission%祛痰化瘀法联合噻托溴铵雾化吸入治疗对COPD缓解期患者康复进程及肺功能的影响

    Institute of Scientific and Technical Information of China (English)



    目的:研究祛痰化瘀法联合噻托溴铵雾化吸入治疗对慢性阻塞性肺疾病(COPD)缓解期患者康复进程及肺功能的影响。方法选取我院2012年3月~2014年9月COPD缓解期患者84例作为研究对象,将患者随机分为观察组和对照组,每组42例,观察组采用祛痰化瘀法联合噻托溴铵雾化吸入治疗,对照组采用单纯噻托溴铵雾化吸入治疗,比较两组肺功能改善情况。结果观察组治疗后的1 s用力呼气容积(FEV1)为(2.34±0.59)L,高于对照组的(1.82±0.63)L(P<0.05)。结论祛痰化瘀法联合噻托溴铵雾化吸入治疗COPD缓解期患者,具有宣肃肺气、化痰理气、泻热祛淤的功效,可以缓解患者的临床症状,改善肺功能,同时提高患者的免疫力,加快康复进程。%Objective To study effects of expelling phlegm and relieving blood stasis principle combined with tiotropium bromide aerosol inhalation treatment on recovery process and lung function of patients with chronic obstructive pulmoriary disease (COPD) in remission.Methods 84 COPD patients in remission of our hospital from March 2012 to September 2014 were selected as the research objects, they were randomly divided into observation group and control group, 42 cases in each group, observation group was given expelling phlegm and relieving blood stasis principle combined with tiotropium bromide aerosol inhalation treatment, control group was given simple tiotropium bromide aerosol inhalation treatment, clinical efficacy and improvement of lung function of two groups were compared.ResultsThe 1s forced expiratory volume (FEV1) in the observation group was (2.34±0.59) L, higher than that in the control group (1.82±0.63) L (P<0.05) .Conclusion Expelling phlegm and relieving blood stasis principle combined with tiotropium bromide aerosol inhalation treatment for COPD patients in remission has the effects of xuansufeiqi, resolving phlegm, regulating qi

  5. Clinical Observation of Aerosol Inhalation of Salbutamol Combined with Huangqi Injection in the Treatment of Chronic Obstructive Pulmonary Disease%沙丁胺醇雾化吸入联合黄芪注射液治疗COPD的临床观察

    Institute of Scientific and Technical Information of China (English)

    高少琳; 肖虹


    OBJECTIVE: To observe the efficacy of aerosol inhalation of salbutamol combined with Huangqi injection in the treatment of chronic obstructive pulmonary disease (COPD). METHODS: The clinical data of 93 patients with COPD between Oct. 2009 and Jun. 2012 were analyzed retrospectively. Among them, 45 cases of control group were treated with aerosol inhalation of salbutamol on the basis of conventional treatment, and 48 cases of treatment group were treated with aerosol inhalation of salbutamol combined with intravenous drip of Huangqi injection. The dyspnea score, lung function and blood gas analysis were compared between 2 groups before and after treatment, and therapeutic efficacies were evaluated in 2 groups. RESULTS: The clinical symptoms of patients in 2 groups were improved. The improvement of dyspnea, blood gas analysis and lung function in treatment group were significantly higher than in control group (P<0.05). Slight ADR was found in some patients in 2 groups, which didn't affect continuous treatment. CONCLUSION: Aerosol inhalation of salbutamol combined with Huangqi injection is effective for COPD, and its efficacy is better than that of salbutamol alone.%目的:观察沙丁胺醇雾化吸入联合黄芪注射液治疗慢性阻塞性肺疾病(COPD)的疗效.方法:回顾分析我院2009年10月-2012年6月93例COPD患者的临床资料,其中对照组45例,在常规治疗基础上给予沙丁胺醇雾化吸入治疗;治疗组48例,在常规治疗基础上给予沙丁胺醇雾化吸入联合黄芪注射液静脉滴注,比较2组患者治疗前后的呼吸困难评分、肺功能和血气分析情况,以评价2组患者的疗效.结果:治疗后,2组患者临床症状均有所改善,治疗组呼吸困难、肺功能和血气分析改善程度均显著高于对照组(P<0.05).治疗中,2组均有部分患者有轻微不良反应,但不影响继续治疗.结论:沙丁胺醇雾化吸入联合黄芪注射液治疗COPD效果良好,疗效优于单用沙丁胺醇雾化吸入.

  6. Investigation on the application status of aerosol inhalation by suburban patients with chronic obstructive pulmonary disease%北京远郊区县某二级医院慢性阻塞性肺疾病患者气雾剂使用情况调查

    Institute of Scientific and Technical Information of China (English)

    马瑞兰; 李伟; 孙玉梅


    目的:调查北京郊区医院住院的慢性阻塞性肺疾病( COPD )患者气雾剂的使用情况。方法采用方便抽样法选取82例COPD患者,采用自制问卷对入住呼吸科及非呼吸科患者气雾剂的使用情况进行问卷调查。结果共发放调查问卷82份,回收有效问卷82份,有效回收率为100%。入住呼吸科的COPD患者气雾剂使用得分(5.85±1.35)明显高于入住非呼吸科的患者(2.70±1.65)分,两组比较差异有统计学意义(t=9.27,P<0.01)。直线相关分析结果显示,COPD患者气雾剂使用得分与文化程度、是否入住呼吸科、复诊时是否给予检查呈正相关(r值分别为0.350,0.728,0.511;P<0.05);多元回归分析显示,是否入住呼吸科及患者的文化程度进入沙丁胺醇得分的回归方程(R2=0.58),仅是否入住呼吸科进入舒利迭得分的回归方程( R2=0.37)。结论二级医院应进一步加强非呼吸科医护人员气雾剂使用的专业培训,以提高入住非呼吸科的COPD患者气雾剂正确使用率。%Objective To investigate the application status of aerosol inhalation by suburban patients with chronic obstructive pulmonary disease ( COPD) .Methods A total of 82 patients with COPD were chosen by convenience sampling , and self-designed questionnaires were used to investigate their application of aerosol inhalation .Results Eighty-two questionnaires were handed out and 82 were recovered , with the effective rate of 100%.Patients hospitalized in respiratory department had statistically higher score in application of aerosol inhalation than those who were hospitalized in non-respiratory department ( t =9.27, P <0.01 ).Linear correlation analysis showed that the score was in positive correlation with the patients ’ educational background , whether hospitalized in respiratory department , and whether examined upon further interview with doctors ( r=0

  7. Findings of Bone Scintigraphy After Leech Theraphy

    Directory of Open Access Journals (Sweden)

    Sinem Özyurt


    Full Text Available In this case report, we present a 70 year old female patient who had recieved Leech therapy (hirudotherapy on her leg without informing referring physician. In dynamic bone scintigraphy there was increased perfusion and hyperemia in her left ankle and leg, also in late static images moderate increased uptake was seen in soft tissue region and at the fracture site of ankle. We learned that she had Leech therapy applied on her leg, which could explain the increased perfusion and hyperemia in dynamic and blood pool phases of bone scintigraphy because of Leech therapy’s dilatory effects on superficial veins. Leech therapy may lead to an increase in perfusion and hyperemia in blood pool phase of bone scintigraphy, which may cause confusion in differential diagnosis. To our best knowledge this report is the first case that shows the scintigraphic findigs after Leech therapy.

  8. Inhaled budesonide for treatment of recurrent wheezing in early childhood

    DEFF Research Database (Denmark)

    Bisgaard, H; Munck, Susanne; Nielsen, J P;


    be ascribed to the active treatment. The findings indicate that young children below 3 years of age can inhale a pressurised aerosol from a spacer with a facemask. Use of topically active glucocorticosteroids with this simple device may reduce symptoms and distress in young children with moderately severe...

  9. 肾上腺素与布地奈德吸入治疗拔管后喉头水肿疗效比较%Clinical effects of oxygen-driven aerosol inhalation of adrenaline and budesonide on children’ s laryngeal edema after removing endotracheal intubation

    Institute of Scientific and Technical Information of China (English)

    丁寅君; 占雅萍; 方华


    目的:探讨肾上腺素、布地奈德雾化吸入治疗气管插管患儿拔管后喉头水肿的疗效。方法回顾性分析124例重症肺炎行气管插管拔管后出现喉头水肿的患儿,根据拔管后主要治疗方法不同分为A组和B组,A组用氧气雾化吸入肾上腺素治疗喉头水肿,B组用氧气雾化吸入盐酸布地奈德治疗喉头水肿,观察两组喉头水肿症状持续时间、雾化后即刻动脉血气及雾化1h后呼吸频率和心率。结果 A组喉头水肿持续时间为(26.91±12.38) h,B组为(34.86±13.21) h,A组症状持续时间较B组短,两组比较,差异有统计学意义(t=-2.691,P<0.05);A组雾化后即刻动脉血氧分压为(88.57±9.06)mmHg,B组为(76.81±11.03)mmHg,A组动脉血氧分压较B组高,两组比较,差异有统计学意义(t=2.529, P<0.05);A组二氧化碳分压为(41.27±11.50)mmHg,B组为(62.21±11.31)mmHg,A组二氧化碳分压较B组低,两组比较,差异有统计学意义(t=-5.529,P<0.05);雾化1h后A组呼吸频率为(34.32±7.79)次/min,B组为(41.18±7.76)次/min,A组呼吸频率较B组低,两组比较,差异有统计学意义( t=-3.899,P<0.05)。结论氧气雾化吸入肾上腺素可以缩短喉头水肿症状持续时间,提高动脉血氧分压,降低二氧化碳分压,降低呼吸频率。%Objective To evaluate the efficacy of oxygen-driven aerosol inhalation of adrenaline and budesonide on children ’ s laryngeal edema after removing endotracheal intubation .Methods This study was conducted by a retrospective analysis .Totally 124 children with laryngeal edema after removing endotracheal intubation were divided into group A and B according to different treatment methods .Group A was treated by using oxygen-driven aerosol inhalation of adrenaline , while group B was treated by using oxygen-driven aerosol

  10. Inhalant Abuse and Dextromethorphan. (United States)

    Storck, Michael; Black, Laura; Liddell, Morgan


    Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan.

  11. 影响 COPD 患者正确吸入定量气雾剂因素的 Logistic 回归分析%Effects of COPD inhalation in patients with the correct analysis of the related factors of quantitative aerosol and intervention measures

    Institute of Scientific and Technical Information of China (English)

    郭丽华; 胡克


    Objective To investigate the effect of chronic obstructive pulmonary disease( COPD)in patients with right suction related factors and intervention measures of quantitative aerosol. Methods A retrospective analysis was performed in patients with COPD in our hospital from 2011 March to 2014 March 240 cases of outpatients and inpatients,to quantify the aerosol application in clinical practice and use a survey of awareness syndrome as the evaluation points. The indexes included sex,age,course of disease,degree of education,accept the health education situation and condition and the correct relationship between quantitative aerosol inhalation agent for univariate and Logistic multivariate linear re-gression analysis. Results ①The majority of patients cognition of aerosol is relatively low. The scores of the most patients were in the 1 ~ 2 be-tween patients using quantitative aerosol. The error of most patients appearing in the process of the highest frequency of operation is "breath hold 10 s lack of" and "spray and suction synchronization",accounting about the total operation errors 36. 99% and 29. 91% . ②The single factor anal-ysis showed that besides sex,age,culture degree,pathological degree,course of disease,whether or not receiving health education were correlated with quantitative aerosol correct breathing( P < 0. 05),with age( P = 0. 032)and the degree of culture( P = 0. 029)the influence degree of the two factors on the correct inhalation aerosol agent of the maximum. ③Multivariate analysis showed that the three factors of age,culture degree, pathological degree are important factors affecting the correct inhalation aerosol( P < 0. 05). Conclusion Age,culture degree,pathological de-gree are important factor affects COPD of patients with inhalation of quantitative aerosol. All these factors need to be paid attention to by clinicians, patients on specific health intervention.%目的:探讨影响慢性阻塞性肺疾病(COPD)患者正确吸入定量

  12. Guidelines for radioiodinated MIBG scintigraphy in children. (United States)

    Olivier, Pierre; Colarinha, Paula; Fettich, Jure; Fischer, Sibylle; Frökier, Jörgen; Giammarile, Francesco; Gordon, Isky; Hahn, Klaus; Kabasakal, Levent; Mann, Mike; Mitjavila, Mercedes; Piepsz, Amy; Porn, Ute; Sixt, Rune; van Velzen, Jeannette


    These guidelines on the use of radioiodinated (99m)Tc-MIBG scintigraphy in children, which summarise the views of the Paediatric Committee of the European Association of Nuclear Medicine, provide a framework which may prove helpful to nuclear medicine teams in daily practice. They have been influenced by the conclusions of the "Consensus Guidelines for MIBG Scintigraphy" (Paris, November 6, 1997) of the European Neuroblastoma Group and by those of the Oncological Committee of the French Society of Nuclear Medicine. The guidelines should be taken in the context of "good practice" and any local/national rules which apply to nuclear medicine examinations.

  13. Bone-scintigraphy in painful bipartite patella

    Energy Technology Data Exchange (ETDEWEB)

    Iossifidis, A. [Orthopaedic Academic Unit, St. Thomas` Hospital, London (United Kingdom); Brueton, R.N. [Orthopaedic Academic Unit, St. Thomas` Hospital, London (United Kingdom); Nunan, T.O. [Dept. of Nuclear Medicine, St. Thomas` Hospital, London (United Kingdom)


    Although, the use of technetium scintigraphy in the assessment of anterior knee pain has been described, no reference has been made to the scintigraphic appearances of painful bipartite patella. We report the scintigraphic-appearances of painful bipartite patella in 25-year-old man a 2 1/2 years history of unexplained patellar pain. Painful bipartite patella is a rare cause of chronic post-traumatic patellar pain. Bone scintigraphy, by demonstrating increased uptake by the painful accessory bipartite fragment, appears to be an imaging method of choice in the diagnosis of this condition. (orig./MG)

  14. Colovesical fistula demonstrated on renal cortical scintigraphy. (United States)

    Stathaki, Maria; Vamvakas, Lampros; Papadaki, Emmanouela; Papadimitraki, Elisavet; Tsaroucha, Angeliki; Karkavitsas, Nikolaos


    A 70-year-old man with a history of weight loss, changes in bowel habits, and hematochezia had rectal adenocarcinoma. He was palliated with diverting colostomy, followed by radiochemotherapy. Bilateral hydronephrosis was found incidentally on lower abdominal CT scan. He underwent 99mTc dimercaptosuccinic acid scan prior to percutaneous nephrostomy tube placement. Apart from the renal cortex, scintigraphy showed activity in the ascending colon continuous to the activity of the bladder. This indicated urine extravasation on account of a colovesical fistula, complicating postoperative radiation treatment. Here we highlight the contribution of renal cortical scintigraphy in the detection of colovesical fistulas.

  15. Osseous scintigraphy and auxiliary graft. Scintigraphie osseuse et greffe d'appoint

    Energy Technology Data Exchange (ETDEWEB)

    Khelifa, F.; Siles, S. (Hopital de la Timone, 13 - Marseille (France)); Puech, B.


    The scintigraphy could be a good way to survey the osseous graft: three cases are studied in which were recognized the presence of a graft, surinfection, graft lysis, pseudo-arthrosis, algodystrophy. 8 refs., 5 figs.

  16. Automatic actuation of a dry powder inhaler into a nonelectrostatic spacer

    DEFF Research Database (Denmark)

    Bisgaard, H


    This article describes a new "automatic spacer" device, which has been developed to improve the delivery of inhaled medication to young children. In the device, a dry powder inhaler (DPI) is mechanically actuated into a nonelectrostatic spacer, producing an aerosol cloud of fine drug particles...... of the patient to the additives and propellants used in pressurized metered dose inhalers. Studies with the prototype device show a high yield of fine drug particles in the aerosol (mass median aerodynamic diameter, 2.8 microm), a high repeatability of drug delivery owing to the mechanical nature...... of the actuation (relative standard deviation, 12%), and a prolonged residence time of the fine particle aerosol (half-life of the fallout of the fine particles, 82 s). These features should prove advantageous in the treatment of young children with inhaled medication....

  17. Air pollution and asthma: clinical studies with sulfuric acid aerosols

    Energy Technology Data Exchange (ETDEWEB)

    Utell, M.J.; Frampton, M.W.; Morrow, P.E. (University of Rochester School of Medicine and Dentistry, NY (United States))


    Until recently, acid deposition has been widely considered a serious ecological problem but not a threat to human health. The controlled clinical study is an important approach in linking acidic aerosol inhalation with respiratory effects. Asthmatic patients represent a subpopulation most responsive to sulfuric acid aerosols. In a series of studies with asthmatic volunteers, several factors have been identified that may modulate the intensity of the bronchoconstrictor response to inhaled acidic aerosols. We found (1) enhancement of the bronchoconstrictor response during exercise, (2) the more acidic aerosols provoke the greatest changes in lung function, and (3) mitigation of airway responses during sulfuric acid aerosol inhalation caused by high respiratory ammonia concentrations. Additional factors influencing responsiveness await identification.

  18. 黄芪注射液联合超声雾化吸入治疗小儿支气管炎急性发作的临床效果和安全性%Clinical Efficacy and Safety of Astragalus Injection Combined with Ultrasonic Aerosol Inhalation in the Treatment of Children with Acute Episode of Bronchitis

    Institute of Scientific and Technical Information of China (English)



    Objective:To investigate the clinical efficacy and safety of Astragalus Injection combined with ultrasonic aerosol inhalation in the treatment of children with acute episode of bronchitis.Method:In our hospital,100 children with bronchitis acute attack were selected,50 cases were treated by ultrasonic atomizing inhalation therapy(the control group),50 cases were treated by Huangqi Injection combined with ultrasonic atomizing inhalation therapy(the observation group),the clinical efficacy and safety in two groups were compared.Result:The total effective rate of the observation group was significantly higher than that of the control group,the difference was statistically significant(P0.05).Conclusion:The therapeutic effect of Astragalus Injection combined with ultrasonic atomizing inhalation in the treatment of children with acute episode of bronchitis is better,which can be used as a preferred choice.%目的:探讨黄芪注射液联合超声雾化吸入治疗小儿支气管炎急性发作的临床效果和安全性。方法:选择在笔者所在医院就诊的支气管炎急性发作患儿100例,其中50例行超声雾化吸入治疗(对照组),50例行黄芪注射液联合超声雾化吸入治疗(观察组),比较两组的临床疗效和安全性。结果:观察组总有效率明显高于对照组,组间比较差异有统计学意义(P0.05)。结论:黄芪注射液联合超声雾化吸入治疗小儿支气管炎急性发作效果佳,可作为优先选择方式。

  19. Bone scintigraphy in painful os peroneum syndrome

    DEFF Research Database (Denmark)

    Jeppesen, Johanne B; Jensen, Frank K; Falborg, Bettina


    Lateral foot pain may be caused by various entities including the painful os peroneum syndrome. A case of a 68-year-old man is presented, who experienced a trauma with distortion of the right foot. Nine months later, he still had pain in the lateral part of the right foot. Bone scintigraphy showed...

  20. Achieving consistent multiple daily low-dose Bacillus anthracis spore inhalation exposures in the rabbit model

    Directory of Open Access Journals (Sweden)

    Roy E Barnewall


    Full Text Available Repeated low-level exposures to Bacillus anthracis could occur before or after the remediation of an environmental release. This is especially true for persistent agents such as Bacillus anthracis spores, the causative agent of anthrax. Studies were conducted to examine aerosol methods needed for consistent daily low aerosol concentrations to deliver a low-dose (less than 106 colony forming units (CFU of B. anthracis spores and included a pilot feasibility characterization study, acute exposure study, and a multiple fifteen day exposure study. This manuscript focuses on the state-of-the-science aerosol methodologies used to generate and aerosolize consistent daily low aerosol concentrations and resultant low inhalation doses. The pilot feasibility characterization study determined that the aerosol system was consistent and capable of producing very low aerosol concentrations. In the acute, single day exposure experiment, targeted inhaled doses of 1 x 102, 1 x 103, 1 x 104, and 1 x 105 CFU were used. In the multiple daily exposure experiment, rabbits were exposed multiple days to targeted inhaled doses of 1 x 102, 1 x 103, and 1 x 104 CFU. In all studies, targeted inhaled doses remained fairly consistent from rabbit to rabbit and day to day. The aerosol system produced aerosolized spores within the optimal mass median aerodynamic diameter particle size range to reach deep lung alveoli. Consistency of the inhaled dose was aided by monitoring and recording respiratory parameters during the exposure with real-time plethysmography. Overall, the presented results show that the animal aerosol system was stable and highly reproducible between different studies and multiple exposure days.

  1. Application of aerosol inhalation in chronic obstructive pulmonary disease patients%雾化吸入在慢性阻塞性肺疾病患者中的应用

    Institute of Scientific and Technical Information of China (English)



    雾化吸入方法是治疗慢性阻塞性肺疾病(COPD)时常用的一种给药途径,通过雾化吸入可以直接进行抗炎、解痉、稀释痰液及扩张支气管等治疗,因而是临床治疗呼吸系统疾病特别是慢性阻塞性肺疾病(COPD)的一种有效手段.但是不周的雾化药物,不同的雾化装备,对COPD的临床疗效是不同的.本文通过对近年来应用不同药物,不同装置雾化吸入治疗COPD的文献进行综述,比较了不同药物,不同雾化装备对COPD治疗的优缺点.%Atomized inhalation method the common treatment for chronic obstructive pulmonary disease (COPD), and anti-inflammatory, antispasmodic, dilution, sputum and bronchial expansion treatment can be done directly through inhalation. Therefore, inhalation is usually used as a effective clinical treatment for respiratory diseases, especially for COPD. However, atomization of different drugs, different atomization equipment showed difference in the clinical efficacy of COPD. In this paper, we reviewed the application of different devices, different drugs of inhalation in treatment of COPD recently, and compared the the advantages and disadvantages of different drugs and different atomization equipment in treatment of COPD.

  2. Inhalants in Peru. (United States)

    Lerner, R; Ferrando, D


    In Peru, the prevalence and consequences of inhalant abuse appear to be low in the general population and high among marginalized children. Inhalant use ranks third in lifetime prevalence after alcohol and tobacco. Most of the use appears to be infrequent. Among marginalized children, that is, children working in the streets but living at home or children living in the street, the problem of inhalant abuse is a serious problem. Among children working in the streets but living at home, the lifetime prevalence rate for inhalant abuse is high, ranging from 15 to 45 percent depending on the study being cited. For children living in the streets, the use of inhalant is even more severe. As mentioned earlier in this chapter, most of these street children use inhalants on a daily basis. The lack of research on the problem of inhalant abuse is a serious impediment to development of intervention programs and strategies to address this problem in Peru. Epidemiologic and ethnographic research on the nature and extent of inhalant abuse are obvious prerequisites to targeted treatment and preventive intervention programs. The urgent need for current and valid data is underscored by the unique vulnerability of the youthful population at risk and the undisputed harm that results from chronic abuse of inhalants. Nonetheless, it is important to mention several programs that work with street children. Some, such as the Information and Education Center for the Prevention of Drug Abuse, Generation, and Centro Integracion de Menores en Abandono have shelters where street children are offered transition to a less marginal lifestyle. Teams of street educators provide the children with practical solutions and gain their confidence, as well as offer them alternative socialization experiences to help them survive the streets and avoid the often repressive and counterproductive environments typical of many institutions. Most of the children who go through these programs tend to abandon

  3. Electrostatics of Pharmaceutical Aerosols for Pulmonary Delivery. (United States)

    Lip Kwok, Philip Chi


    This paper provides a review on key research findings in the rapidly developing area of pharmaceutical aerosol electrostatics. Solids and liquids can become charged without electric fields, the former by contact or friction and the latter by flowing or spraying. Therefore, charged particles and droplets carrying net charges are produced from pharmaceutical inhalers (e.g. dry powder inhalers, metered dose inhalers, and nebulisers) due to the mechanical processes involved in aerosolisation. The charging depends on many physicochemical factors, such as formulation composition, solid state properties, inhaler material and design, and relative humidity. In silico, in vitro, and limited in vivo studies have shown that electrostatic charges may potentially influence particle deposition in the airways. However, the evidence is not yet conclusive. Furthermore, there are currently no regulatory requirements on the characterisation and control of the electrostatic properties of inhaled formulations. Besides the need for further investigations on the relationship between physicochemical factors and charging characteristics of the aerosols, controlled and detailed in vivo studies are also required to confirm whether charges can affect particle deposition in the airways. Since pharmaceutical aerosol electrostatics is a relatively new research area, much remains to be explored. Thus there is certainly potential for development. New findings in the future may contribute to the advancement of pharmaceutical aerosol formulations and respiratory drug delivery.

  4. Syringe, pen, inhaler - the evolution of insulin therapy. (United States)

    Harsch, I A; Hahn, E G; Konturek, P C


    The therapy with inhalable insulin can be expected to change the present concepts and the market of subcutaneous insulin dramatically within the next years. Several companies are currently developing formulations of inhalable insulin. In the most advanced concept, insulin is delivered as a dry-powder insulin formulation via a special aerosol device system. The phase III studies evaluating the efficiency of the inhaled insulin are already on their way. The recent phase II studies have shown, that the lung is capable of absorbing new insulin formulation in a dose-dependent and reproducible manner. However, a relatively small number of diabetic patients have been included in these studies, yet. The therapeutic efficacy and safety of the inhaled insulin is comparable to that of the usual subcutaneous insulin treatment regimens. The most important advantage of the new therapy is the enhanced therapeutic comfort of the patient who does not need to inject insulin for meal time glucose control. Generally, in terms of glycemic control, inhalable insulin offers no advantages in type 1 diabetics in comparison to an intensified conventional insulin therapy. However, before a large-scale marketing, several open questions have to be carefully investigated, the most important being the possible long-term effects of insulin inhalation for the lung, since insulin is known to have growth-promoting properties. There is still no available clinical data concerning the efficiency of the inhaled insulin in patients with pulmonary diseases which may cause problems in absorption of inhaled insulin due to the smaller cumulative alveolar surface. In smokers without pulmonary disease seems the inhaled insulin to act stronger and faster. Since therapy with inhalable insulin requires larger doses of insulin in comparison to subcutaneous insulin to achieve the same systemic effect, the costs of this therapy need to be clarified, too.

  5. The History of Therapeutic Aerosols: A Chronological Review (United States)

    Thiel, Charles G.


    Abstract In 1956, Riker Laboratories, Inc., (now 3 M Drug Delivery Systems) introduced the first pressurized metered dose inhaler (MDI). In many respects, the introduction of the MDI marked the beginning of the modern pharmaceutical aerosol industry. The MDI was the first truly portable and convenient inhaler that effectively delivered drug to the lung and quickly gained widespread acceptance. Since 1956, the pharmaceutical aerosol industry has experienced dramatic growth. The signing of the Montreal Protocol in 1987 led to a surge in innovation that resulted in the diversification of inhaler technologies with significantly enhanced delivery efficiency, including modern MDIs, dry powder inhalers, and nebulizer systems. The innovative inhalers and drugs discovered by the pharmaceutical aerosol industry, particularly since 1956, have improved the quality of life of literally hundreds of millions of people. Yet, the delivery of therapeutic aerosols has a surprisingly rich history dating back more than 3500 years to ancient Egypt. The delivery of atropine and related compounds has been a crucial inhalation therapy throughout this period and the delivery of associated structural analogs remains an important therapy today. Over the centuries, discoveries from many cultures have advanced the delivery of therapeutic aerosols. For thousands of years, therapeutic aerosols were prepared by the patient or a physician with direct oversight of the patient using custom-made delivery systems. However, starting with the Industrial Revolution, advancements in manufacturing resulted in the bulk production of therapeutic aerosol delivery systems produced by people completely disconnected from contact with the patient. This trend continued and accelerated in the 20th century with the mass commercialization of modern pharmaceutical inhaler products. In this article, we will provide a summary of therapeutic aerosol delivery from ancient times to the present along with a look to the

  6. Accidental Cutaneous Burns Secondary to Salbutamol Metered Dose Inhaler

    Directory of Open Access Journals (Sweden)

    Ashutosh Kale


    Full Text Available We report a case of accidental cutaneous burns caused by salbutamol metered dose inhaler. A 9-year-old boy underwent dental extraction at a children's hospital and was incidentally noted to have burn injuries on dorsum of both hands. On questioning, the boy revealed that a few days ago his 14-year-old brother, who is an asthmatic, playfully sprayed his salbutamol metered dose inhaler on the back of both his hands with the inhaler's mouth piece being in direct contact with the patient's skin. On examination, there was a rectangular area of erythema with superficial peeling on the dorsum of both hands, the dimensions of which exactly matched those of the inhaler's mouthpiece. It is possible that the injury could have been a chemical burn from the pharmaceutical/preservative/propellant aerosol or due to the physical effect of severe cooling of the skin or mechanical abrasive effect of the aerosol blasts or a combination of some or all the above mechanisms. This case highlights the importance of informing children and parents of the potentially hazardous consequences of misusing a metered dose inhaler.

  7. Preclinical safety evaluation of inhaled cyclosporine in propylene glycol. (United States)

    Wang, Tao; Noonberg, Sarah; Steigerwalt, Ronald; Lynch, Maryellen; Kovelesky, Rosemary A; Rodríguez, Carlos A; Sprugel, Katherine; Turner, Nancy


    Cyclosporine inhalation solution has the potential to improve outcomes following lung transplantation by delivering high concentrations of an immunosuppressant directly to the allograft while minimizing systemic drug exposure and associated toxicity. The objective of these studies was to evaluate the potential toxicity of aerosolized cyclosporine formulated in propylene glycol when given by inhalation route to rats and dogs for 28 days. Sprague-Dawley rats received total inhaled doses of 0 (air), 0 (vehicle, propylene glycol), 7.4, 24.3, and 53.9 mg cyclosporine/kg/day. In a separate study, beagle dogs were exposed to 0, 4.4, 7.7, and 9.7 mg cyclosporine/kg/day. Endpoints used to evaluate potential toxicity of inhaled cyclosporine were clinical observations, body weight, food consumption, respiratory functions, toxicokinetics, and clinical/anatomic pathology. Daily administration of aerosolized cyclosporine did not result in observable accumulation of cyclosporine in blood or lung tissue. Toxicokinetic analysis from the rat study showed that the exposure of cyclosporine was approximately 18 times higher in the lung tissue compared to the blood. Systemic effects were consistent with those known for cyclosporine. There was no unexpected systemic toxicity or clinically limiting local respiratory toxicity associated with inhalation exposure to cyclosporine inhalation solution at exposures up to 2.7 times the maximum human exposure in either rats or dogs. There were no respiratory or systemic effects of high doses of propylene glycol relative to air controls. These preclinical studies demonstrate the safety of aerosolized cyclosporine in propylene glycol and support its continued clinical investigation in patients undergoing allogeneic lung transplantation.

  8. Atomization method for verifying size effects of inhalable particles on lung damage of mice. (United States)

    Tao, Chen; Tang, Yue; Zhang, Lan; Tian, Yonggang; Zhang, Yingmei


    To explore the size effects of inhalable particles on lung damage, aqueous aerosol containing cadmium was studied as a model to design a new type of two-stage atomization device that was composed of two adjustable parts with electronic ultrasonic atomization and pneumatic atomization. The working parameters and effectiveness of this device were tested with H2O atomization and CdCl2 inhalation, respectively. By gravimetrically detecting the mass concentrations of PM2.5 and PM10 and analysing the particle size with a laser sensor, we confirmed the particle size distribution of the aqueous aerosol produced by the new device under different working conditions. Then, we conducted experiments in male Kunming mice that inhaled CdCl2 to determine the size effects of inhalable particles on lung damage and to confirm the effectiveness of the device. The new device could effectively control the particle size in the aqueous aerosol. The inhaled CdCl2 entered and injured the lungs of the mice by causing tissue damage, oxidative stress, increasing endoplasmic reticulum stress and triggering an inflammatory response, which might be related to where the particles deposited. The smaller particles in the aqueous aerosol atomized by the new two-stage atomization device deposited deeper into lung causing more damage. This device could provide a new method for animal experiments involving inhalation with water-soluble toxins.

  9. The Influence of Different Periods Aerosol Inhalation Treatment on Acute Oral Mucositis Caused by Radiotherapy%不同雾化吸入时机对放射性急性口腔黏膜炎治疗效果的影响

    Institute of Scientific and Technical Information of China (English)



    Objective To observe the influence of different periods aerosal inhalation treatment on acute o-ral mucositis caused by radiotherapy.Methods Totally 60 patients hospitalized with head and neck cancer and undergoing radiotherapy were randomly divided into observation group and control group,with 30 ca-ses in each group.The observation group received aerosol inhalation while the radiotherapy started,while the control group only received aerosol inhalation while the acute oral mucositis appeared.The incidence rate of acute oral mucositis caused by radiotherapy,inj ury of oral mucosa and pain degree were compared between two groups.Results During the radiotherapy,the incidence rate of acute oral mucositis caused by radiotherapy,inj ury of oral mucosa and pain degree in observation group were less or lower than which in control group (P<0.05 or P<0.01).Conclusion Giving inhalation treatment at the beginning of radio-therapy can reduces the incidence rate of acute oral mucositis caused by radiotherapy,and the inj ury level of oral mucosa,and also ease the pain,which guarantees the success of radiotherapy,and thus to improve pa-tient’s quality of life.%目的:了解不同雾化吸入开始时间对放射性急性口腔黏膜炎治疗效果的影响.方法便利抽样法选择2012年10月至2013年7月,上海交通大学附属第六人民医院肿瘤放疗科收治的头颈部恶性肿瘤行根治性放射治疗的患者60例,按入院先后将其分为观察组和对照组各30例,观察组患者放疗开始即给予雾化吸入,对照组患者放疗过程中出现放射性急性口腔黏膜炎后再给予雾化吸入,评价并比较两组患者放射性急性口腔黏膜炎的发生情况、口腔黏膜损伤及疼痛程度.结果放疗期间,观察组患者放射性急性口腔黏膜炎的发生率、口腔黏膜损伤及疼痛程度均低于或轻于对照组患者,差异均有统计学意义(P<0.05或P<0.01).结论放疗开始即给予雾化

  10. Pentamidine Oral Inhalation (United States)

    Pentamidine is an anti-infective agent that helps to treat or prevent pneumonia caused by the organism ... Pentamidine comes as a solution to be inhaled using a nebulizer. It usually is used once every ...

  11. Formoterol Oral Inhalation (United States)

    ... of lung diseases that includes chronic bronchitis and emphysema) in adults. Formoterol inhalation powder is also used with another medication to treat asthma and to prevent breathing difficulties during exercise in ...

  12. Insulin Human Inhalation (United States)

    Insulin inhalation is used in combination with a long-acting insulin to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar ...

  13. A role for gamma scintigraphy in cancer immunology and immunotherapy. (United States)

    Perkins, A C; Pimm, M V


    Facilities for radiolabelling and gamma scintigraphy are largely restricted to nuclear medicine departments or specialised research institutions and are therefore not widely available to workers in cancer research. Despite this, there is growing interest in gamma scintigraphy, which can provide information relevant to the entire field of cancer immunology. This review discusses the present and future roles of gamma scintigraphy in respect of antibody-targeted, cell-mediated and cytokine therapy. The authors aim to show that gamma scintigraphy is an investigative tool of great potential.

  14. A role for gamma scintigraphy in cancer immunology and immunotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Perkins, A.C. (Nottingham Univ. Hospital (United Kingdom). Dept. of Medical Physics); Pimm, M.V. (Nottingham Univ. (United Kingdom). Cancer Research Campaign Labs.)


    Facilities for radiolabelling and gamma scintigraphy are largely restricted to nuclear medicine departments or specialised research institutions and are therefore not widely available to workers in cancer research. Despite this, there is growing interest in gamma scintigraphy, which can provide information relevant to the entire field of cancer immunology. This review discusses the present and future roles of gamma scintigraphy in respect of antibody-targeted, call-mediated and cytokine therapy. The authors aim to show that gamma scintigraphy is an investigated tool of great potential. (orig.).

  15. Esophageal transit scintigraphy in systemic sclerosis. (United States)

    Chojnowski, Marek; Kobylecka, Małgorzata; Olesińska, Marzena


    Systemic sclerosis is a rare connective tissue disease, distinctive features of which are fibrosis and microangiopathy. The esophagus is one of the most commonly involved internal organs. Most patients experience dysphagia, difficulties in swallowing and gastro-esophageal reflux. However, in up to one third of cases, the initial onset of esophageal disease may be clinically silent. There are several diagnostic modalities available for assessing both morphological and functional abnormalities of the esophagus. If structural abnormalities are suspected, endoscopy is the method of choice. Functional evaluation is best achieved with manometry. Both endoscopy and manometry are invasive techniques, with low patient acceptance. Barium-contrast study is well tolerated, but qualitative assessment of functional abnormalities is imprecise. Esophageal scintigraphy is an easy, non-invasive, sensitive and specific diagnostic modality. It can detect esophageal dysfunction even in asymptomatic patients. In patients already diagnosed with systemic sclerosis, scintigraphy is useful in evaluating severity and progression of the disease.

  16. Cartilage Calcification Mimics Polychondritis in Bone Scintigraphy

    Directory of Open Access Journals (Sweden)

    Hasan Atilgan


    Full Text Available 58 year-old male patient with sternal pain was referred to our Nuclear Medicine Clinic for bone scintigraphy for 2.5 months. Markedly increased activity accumulation in the first bilateral sternocostal junction and increased activity accumulations in 3rd, 4th, 5th sternocostal junctions and lateral portion of inferior part of corpus sterni were seen in late static images without increased perfusion and hyperemia. Soft tissue density and lytic lesions were seen bilaterally in bilateral first costa, sternocostal joints and in right side of xiphoid in his 3D computed tomography (CT. Sternocostal lesions that were seen in bone scintigraphy and CT, was reported as normal in biopsy.

  17. Clinical Analysis of Terbutaline Hemisulfate and Budesonide Aerosol In-halation Treatment for Bronchial Asthma in Children%硫酸特布他林联用布地奈德雾化吸入治疗小儿支气管哮喘的临床分析

    Institute of Scientific and Technical Information of China (English)



    目的:探讨硫酸特布他林联合布地奈德雾化吸入用于小儿支气管哮喘疾病的治疗效果;方法整群该院治疗的支气管哮喘82例患儿,随机分成观察组41例(硫酸特布他林联合布地奈德雾化吸入治疗)和对照组41例(常规治疗),对比两组的疗效;结果观察组的治疗有效率为95.12%(39/41),对照组的治疗有效率为78.05%(32/41),两组患儿在治疗效果方面相比差异具有统计学意义(P<0.05);结论支气管的消炎和舒张是针对小儿急性哮喘治疗的重点,而特布他林联合布地奈德能增强疗效。%Objective To discuss the effect of terbutaline hemisulfate and budesonide aerosol inhalation treatment for bronchial asthma in children. Methods 82 cases of children with bronchial asthma treated in our hospital were randomly di-vided into two groups with 41 cases in each, the observation group were treated with terbutaline hemisulfate and budesonide aerosol inhalation, the control group were treated with conventional method, and the curative effects were compared between the two groups. Results The treatment effective rate was 95.12%(39/41) in the observation group and 78.05%(32/41) in the control group, and the difference in the treatment effect between the two groups had statistical significance, P<0.05. Con-clusion Bronchial inflammation and relaxation is the key to the treatment of acute asthma in children, but terbutaline and budesonide can enhance the curative effect.

  18. New agents for scintigraphy in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Bois, M.H.W. de [Department of Rheumatology, University Hospital, Leiden (Netherlands); Pauwels, E.K.J. [Department of Diagnostic Radiology and Nuclear Medicine, University Hospital, Leiden (Netherlands); Breedveld, F.C. [Department of Rheumatology, University Hospital, Leiden (Netherlands)


    Radiopharmaceuticals have been used as investigative tools for the detection and treatment of arthritis activity in rheumatoid arthritis (RA) since the 1950s. Against the background of the pathophysiology of RA, the current status of joint scintigraphy and possible future developments are reviewed. Both non-specific (radiolabelled leucocytes and technetium-99m labelled human immunoglobulin) and specific targeting radiopharmaceuticals (including radiolabelled antibodies) are considered. The use of radiopharmaceuticals in the detection of arthritis activity has the advantages of allowing direct imaging of joints by means of whole-body scintigraphy and of joints that are difficult to assess clinically or radiographically. Promising results have been obtained with radiolabelled anti-CD4 and anti-E-selectin antibodies and with somatostatin receptor imaging, but more data are available regarding {sup 99m}Tc-IgG scintigraphy, which differentiates between the various degrees of arthritis activity and thus facilitates the choice of antirheumatic drug. Newer promising approaches to the imaging of RA include the use of radiolabelled J001 and cytokines, though studies on these are limited at present. (orig.)

  19. 超声雾化吸入联合抗结核药物治疗26例气管结核的近期效果分析%Ultrasonic aerosol inhalation of unite antitubercular agents treatment 26 patients with bronchial tuberculosis to analyze of the effects

    Institute of Scientific and Technical Information of China (English)

    张兴树; 郭春江; 乔何霞


    Objective EvaJulion of isoniade, amikaxing -I- siqikang ultrasonic atomizing inhalation therapy combined with anti-tuberculosis drug smear bronchial tuberculosis recent effect. Methods 26 patients with bronchial tuberculosis coated smear randomly divided into treatment group and control group, the same anti-tuberculosis treatment programs are 2HRZE/4HRE program, the treatment group given within the first 2 months of isoniazid, amikxing vegas siqikang ultrasonic atomizing inhalation once daily. Result The treatment to 2 at the end,ultrasonic atomizing inhalation group sputum conversion rate was 92. 3% , control group 69. 2% .clinical symptoms improved markedly ultrasonic atomizing inhalation therapy group 84. 6% ; Control group 61. 5% ; markedly effective, bronchoscopy under tracheal. bronchial tuberculosis treatment group improved 84. 6% ,61. 5% of the control, treatment group,compred the two groups,significant difference P <0. 01. Conclusion Smear bronchial tuberculosis combined anti-tuberculosis drugs in treatment, while topical ultrasonic aerosol inhalation of its effective than control group,the method is simple,without any conditions, worthy of further research and.%目的 评价异烟肼、阿米卡星加斯奇康超声雾化吸入联合抗结核药治疗涂阳气管结核的近期效果.方法 26例涂阳气管结核患者随机分为治疗组和对照组,两组抗结核治疗方案相同,均为2HRZE/4HRE方案,治疗组在头2月内给予异烟肼、阿米卡星加斯奇康每日1次超声雾化吸入治疗.结果 治疗至2月来,超声雾化吸入治疗组痰菌阴转率为92.3%,对照组69.2%,临床症状改善显效超声雾化吸入治疗组84.6%;对照组显效61.5%;纤支镜下气管结核病灶好转治疗组显效84.6%;对照组61.5%:两组相比治疗组明显优于对照组,差异显著(P<0.01).结论 涂阳气管结核在联合抗结核药物治疗的同时给予局部超声雾化治疗其疗效优于对照组,方法简单易行,不受任何

  20. The nasal distribution of metered dose inhalers. (United States)

    Newman, S P; Morén, P F; Clarke, S W


    The intranasal distribution of aerosol from a metered dose inhaler has been assessed using a radiotracer technique. Inhalers were prepared by adding 99Tcm-labelled Teflon particles (simulating the drug particles) to chlorofluorocarbon propellants, and scans of the head (and chest) taken with a gamma camera. Ten healthy subjects (age range 19-29 years) each performed two radioaerosol studies with the inhaler held in two different ways: either in a single position (vial pointing upwards) or in two positions (vial pointing upwards and then tilted by 30 degrees in the sagittal plane). The vast majority of the dose (82.5 +/- 2.8 (mean +/- SEM) per cent and 80.7 +/- 3.1 per cent respectively for one-position and two-position studies) was deposited on a single localized area in the anterior one-third of the nose, the initial distribution pattern being identical for each study. No significant radioaerosol was detected in the lungs. Only 18.0 +/- 4.7 per cent and 15.4 +/- 4.1 per cent of the dose had been removed by mucociliary action after 30 minutes, and it is probable that the remainder had not penetrated initially beyond the vestibule. Since the deposition pattern was highly localized and more than half the dose probably failed to reach the turbinates it is possible that the overall effect of nasal MDIs is suboptimal for the treatment of generalized nasal disorders.

  1. Capstone Depleted Uranium Aerosols: Generation and Characterization

    Energy Technology Data Exchange (ETDEWEB)

    Parkhurst, MaryAnn; Szrom, Fran; Guilmette, Ray; Holmes, Tom; Cheng, Yung-Sung; Kenoyer, Judson L.; Collins, John W.; Sanderson, T. Ellory; Fliszar, Richard W.; Gold, Kenneth; Beckman, John C.; Long, Julie


    In a study designed to provide an improved scientific basis for assessing possible health effects from inhaling depleted uranium (DU) aerosols, a series of DU penetrators was fired at an Abrams tank and a Bradley fighting vehicle. A robust sampling system was designed to collect aerosols in this difficult environment and continuously monitor the sampler flow rates. Aerosols collected were analyzed for uranium concentration and particle size distribution as a function of time. They were also analyzed for uranium oxide phases, particle morphology, and dissolution in vitro. The resulting data provide input useful in human health risk assessments.

  2. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... 260 KB] Using a metered dose inhaler (inhaler in mouth) Your browser does not support iframes Using a metered dose inhaler (inhaler in mouth) [PDF - 370 KB] Your browser does not ...

  3. Sodium pertechnetate scintigraphy in detection of Meckel's diverticulum

    DEFF Research Database (Denmark)

    Poulsen, K A; Qvist, N


    OBJECTIVE: To evaluate the results of 99mTc-Na-pertechnetate scintigraphy in children presenting with symptoms suspicious of Meckel's diverticulum (MD). METHOD: Retrospective study. A total of 55 99mTc-Na-pertechnetate scintigraphies in 53 patients were compared with the results from surgery and ...

  4. Inhaled dust and disease

    Energy Technology Data Exchange (ETDEWEB)

    Holt, P.F.


    This book discusses the following: the respiratory system; respirable dust; the fate of inhaled dust; translocation and some general effects of inhaled dust; silicosis; experimental research on silica-related disease; natural fibrous silicates; asbestos dust levels and dust sources; asbestos-related diseases - asbestosis, lung cancer, mesothelioma and other diseases, cancers at sites other than lung and pleura; experimental research relating to asbestos-related diseases; asbestos hazard - mineral types and hazardous occupations, neighbourhood and domestic hazard; silicates other than asbestos-man-made mineral fibres, mineral silicates and cement; metals; coal mine dust, industrial carbon and arsenic; natural and synthetic organic substances; dusts that provoke allergic alveolitis; tobacco smoke.

  5. Inhaled therapeutics for prevention and treatment of pneumonia. (United States)

    Safdar, Amar; Shelburne, Samuel A; Evans, Scott E; Dickey, Burton F


    The lungs are the most common site of serious infection owing to their large surface area exposed to the external environment and minimum barrier defense. However, this architecture makes the lungs readily available for topical therapy. Therapeutic aerosols include those directed towards improving mucociliary clearance of pathogens, stimulation of innate resistance to microbial infection, cytokine stimulation of immune function and delivery of antibiotics. In our opinion inhaled antimicrobials are underused, especially in patients with difficult-to-treat lung infections. The use of inhaled antimicrobial therapy has become an important part of the treatment of airway infection with Pseudomonas aeruginosa in cystic fibrosis and the prevention of invasive fungal infection in patients undergoing heart and lung transplantation. Cytokine inhaled therapy has also been explored in the treatment of neoplastic and infectious disease. The choice of pulmonary drug delivery systems remains critical as air-jet and ultrasonic nebulizer may deliver sub-optimum drug concentration if not used properly. In future development of this field, we recommend an emphasis on the study of the use of aerosolized hypertonic saline solution to reduce pathogen burden in the airways of subjects infected with microbes of low virulence, stimulation of innate resistance to prevent pneumonia in immunocompromised subjects using cytokines or synthetic pathogen-associated molecular pattern analogues and more opportunities for the use of inhaled antimicrobials. These therapeutics are still in their infancy but show great promise.

  6. The effect of carrier particle size on adhesion, content uniformity and inhalation performance of budesonide using dry powder inhalers


    Kaialy, Waseem; Larhrib, El Hassan; Nokhodchi, Ali


    Dry Powder Inhalers (DPIs) are the result of the development of two technologies: powder technology and device technology. Particle deposition in the respiratory tract is affected by many aerosol particle properties such as particle size, shape, density, charge, and hygroscopicity.1 In particular, particle size is of great importance as it is known that particleparticle interactions within DPI formulations are related to van der Waals forces. Therefore, particle size is the mos...

  7. Studies on bone scintigraphy in renal osteodystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Tsuchimochi, Makoto (Nippon Dental Univ., Niigata)


    Bone scintigraphy was superior over roentgenography for detection of abnormal bone findings in chronic dialysis patients. According to the type of scintigraphic findings, an increase in the hot area in the cranium or the mandibule seemed to express fibrous osteitis due to secondary hyperparathyroidism. Multiple coin-shaped hot areas in ribs were thought to indicate advanced osteomalacia or osteomalacia in patients with aluminum poisoning. The 4 hr-B/St ratio of the cranium was thought to serve as a quantitative indicator of the status of fibrous osteitis due to secondary hyperparathyroidism to show the progress and therapeutic course of the disease.

  8. Bone scintigraphy in painful os peroneum syndrome

    DEFF Research Database (Denmark)

    Jeppesen, Johanne B; Jensen, Frank K; Falborg, Bettina;


    Lateral foot pain may be caused by various entities including the painful os peroneum syndrome. A case of a 68-year-old man is presented, who experienced a trauma with distortion of the right foot. Nine months later, he still had pain in the lateral part of the right foot. Bone scintigraphy showe...... uptake in the area where an os peroneum was located and thus confirmed the clinical assumption of painful os peroneum syndrome. Familiarity with the clinical and imaging findings can prevent undiagnosed lateral foot pain....

  9. Radiation exposure and risk estimates for inhaled airborne radioactive pollutants including hot particles. Annual report 1 July 1976--30 June 1977

    Energy Technology Data Exchange (ETDEWEB)

    Mewhinney, J.A.


    Contents: Mixed-oxide fuel fabrication; Generation of aerosols of mixed uranium-plutonium oxides from dry powders for animal inhalation exposures; Analytical radiochemical determination of U, Pu and Am in biological samples; Physical chemical characterization of mixed uranium-plutonium oxide nuclear fuel as samples during animal inhalation exposure; Pilot studies of deposition and retention of industrial mixed-oxide aerosols in the laboratory rat; Extended radiation dose pattern studies of aerosols of mixed uranium-plutonium oxides treated at 750C inhaled by Fishcer-344 rats, beagle dogs and cynomolgus monkeys; Extended radiation dose pattern studies of aerosols of plutonium dioxide, treated at 850C and inhaled by Fischer-344 rats, beagle dogs and cynomolgus monkeys.

  10. An in vitro Method for Predicting Inhalation Toxicity of Impregnation Spray Products

    DEFF Research Database (Denmark)

    Sørli, Jorid B.; Hansen, Jitka S.; Nørgaard, Asger Wisti


    are reported frequently. The toxicity appears to be driven by a disruption of the pulmonary surfactant film, which coats the inside of the lungs. Due to the complex chemistry of impregnation spray products, it is impossible to predict if inhalation of an aerosolized product is toxic in vivo. The aim......-forming compounds, were identified by mass spectrometry. We used a capillary surfactometry method to assess disruption of pulmonary surfactant function in vitro and a mouse model to evaluate acute respiratory toxicity during inhalation. Concentration-response relationships were successfully determined both in vitro...... of the inhalation toxicity of impregnation spray products and thus may reduce the need for animal testing....

  11. [Inhaled corticosteroids for COPD

    NARCIS (Netherlands)

    Dekhuijzen, P.N.R.


    Over 60% of patients with COPD are treated with inhaled corticosteroids (ICS), even though their use is still subject to debate. The inflammatory process in the lungs of patients with COPD is dominated by macrophages, CD8+ T-lymphocytes, neutrophilic granulocytes and mast cells, as well as an increa

  12. Inhalants. Specialized Information Service. (United States)

    Do It Now Foundation, Phoenix, AZ.

    The document presents a collection of articles about inhalant abuse. Article 1 presents findings on the psychophysiological effects related to the use of amyl or butyl nitrate as a "recreational drug." Article 2 suggests a strong association between chronic sniffing of the solvent toulene and irreversible brain damage. Article 3 warns…

  13. Inhalational Lung Disease

    Directory of Open Access Journals (Sweden)

    S Kowsarian


    Full Text Available Inhalational lung diseases are among the most important occupational diseases. Pneumoconiosis refers to a group of lung diseases result from inhalation of usually inorganic dusts such as silicon dioxide, asbestos, coal, etc., and their deposition in the lungs. The resultant pulmonary disorders depend on the susceptibility of lungs; size, concentration, solubility and fibrogenic properties of the inhaled particles; and duration of exposure. Radiographic manifestations of pneumoconiosis become apparent several years after exposure to the particles. However, for certain types of dusts, e.g., silicone dioxide crystal and beryllium, heavy exposure within a short period can cause an acute disease. Pulmonary involvement in asbestosis is usually in the lower lobes. On the contrary, in silicosis and coal worker pneumoconiosis, the upper lobes are involved predominantly. For imaging evaluation of pneumoconiosis, high-resolution computed tomography (CT is superior to conventional chest x-ray. Magnetic resonance imaging (MRI and positron emission tomography (PET scan are helpful in those with suspected tumoral lesions. In this essay, we reviewed the imaging aspects of inhalational lung disease.

  14. Inhaled insulin--does it become reality? (United States)

    Siekmeier, R; Scheuch, G


    After more than 80 years of history the American and European Drug Agencies (FDA and EMEA) approved the first pulmonary delivered version of insulin (Exubera) from Pfizer/Nektar early 2006. However, in October 2007, Pfizer announced it would be taking Exubera off the market, citing that the drug had failed to gain market acceptance. Since 1924 various attempts have been made to get away from injectable insulin. Three alternative delivery methods where always discussed: Delivery to the upper nasal airways or the deep lungs, and through the stomach. From these, the delivery through the deep lungs is the most promising, because the physiological barriers for the uptake are the smallest, the inspired aerosol is deposited on a large area and the absorption into the blood happens through the extremely thin alveolar membrane. However, there is concern about the long-term effects of inhaling a growth protein into the lungs. It was assumed that the large surface area over which the insulin is spread out would minimize negative effects. But recent news indicates that, at least in smokers, the bronchial tumour rate under inhaled insulin seems to be increased. These findings, despite the fact that they are not yet statistical significant and in no case found in a non-smoker, give additional arguments to stop marketing this approach. Several companies worked on providing inhalable insulin and the insulin powder inhalation system Exubera was the most advanced technology. Treatment has been approved for adults only and patients with pulmonary diseases (e.g., asthma, emphysema, COPD) and smokers (current smokers and individuals who recently quitted smoking) were excluded from this therapy. Pharmacokinetics and pharmacodynamics of Exubera are similar to those found with short-acting subcutaneous human insulin or insulin analogs. It is thus possible to use Exubera as a substitute for short-acting human insulin or insulin analogs. Typical side effects of inhaled insulin were coughing

  15. Renal scintigraphy in infants with antenatally diagnosed renal pelvis dilatation

    Directory of Open Access Journals (Sweden)

    Ajdinović Boris


    Full Text Available Background/Aim. Ureteropelvic junction obstruction and vesicoureteral reflux are the most frequent entities identified on the basis of antenatal hydronephrosis. The aim of this study was to determine the incidence and pattern of abnormal renal scintigraphy findings in postnatal investigation of children with antenatal hydronephrosis. Methods. Twenty four infants (19 boys and five girls presented with antenatal hydronephrosis and mild to moderate hydronephrosis on ultrasound in newborn period were referred for renal scintigraphy. Ten patients with vesicoureteral reflux documented on micturating cystoureterography underwent 99mTc-DMSA renal scintigraphy and 14 patients were subjected to 99mTc-DTPA scintigraphy. Results. Anteroposterior pelvic diameter on ultrasound ranged from 11 to 24 mm. Renal DMSA scans identified congenital scars in two boys with bilateral reflux of grade V and unilateral reflux of grade III. Relative kidney uptake (RKU less than 40% was found in three, and poor kidney function (RKU less than 10% in two patients. Significant obstruction was shown on DTPA diuretic renal scintigraphy in 6/14 patients. Some slowing in dranaige (T1/2 greater than 10 minutes with no reduction in differential renal function was identified in three patients. Differential renal function less than 10% was obtained in one case. Conclusion. A high percent of abnormal renal scintigraphy findings was obtained. Renal scintigraphy was useful in determination of underlying cause of antenatally detected hydronephrosis.

  16. Indium-111 platelet scintigraphy in carotid disease

    Energy Technology Data Exchange (ETDEWEB)

    Branchereau, A.; Bernard, P.J.; Ciosi, G.; Bazan, M.; de Laforte, C.; Elias, A.; Bouvier, J.L.


    Forty-five patients (35 men, 10 women) undergoing carotid surgery had Indium-111 platelet scintigraphy as part of their preoperative work-up. Imaging was performed within three hours after injection of the Indium-111. A second series of views was obtained 24 hours later and repeated at 24 hour intervals for two days. Of 54 scintigrams, 22 were positive and 32 negative. Positive results were defined as a twofold or more increase in local activity on a visualized carotid after 24 hours. The sensitivity of the method was 41%, intraoperatively, and the specificity, 100%. The low sensitivity places this method behind sonography and duplex-scanning for screening patients for surgery. We believe that indications for platelet scintigraphy are limited to: 1. Repeated transient ischemic attacks in the same territory with minimal lesions on arteriography and non-homogeneous plaque on duplex scan; 2. Symptomatic patients being treated medically as a possible argument for surgery; 3. Determining therapeutic policy for patients having experienced a transient ischemic attack with a coexisting intracardiac thrombus.

  17. Optimum Energy Window In Liver Scintigraphy

    Directory of Open Access Journals (Sweden)

    Alireza Sadremomtaz


    Full Text Available Abstract In liver scintigraphy radioactive tracers in addition to liver are accumulated in other organs such as spleen. It leads to the presence of secondary source which affects image quality. Therefore knowing the influence of the noise arising from the secondary source and trying to reduce the additional data is necessary. In nuclear medicine imaging using of energy window is a useful way to reduce the noise. In this paper we try to find an optimum energy window to reduce the noise for two different low energy collimators. Liver scintigraphy images with and without activity in spleen were simulated by SIMIND software with different energy window percentages and with Low-Energy High-Resolution LEHR and Low-Energy General-Purpose LEGP collimators. We used with activity of 190 MBq. Spleen was outside of the camera field of view so that just its noise effects on the liver image is examined. Finally the images of liver with activity in spleen were compared with that without activity in spleen by MATLAB code.

  18. Lung deposition of salbutamol in healthy human subjects from the MAGhaler dry powder inhaler. (United States)

    Newman, S; Malik, S; Hirst, R; Pitcairn, G; Heide, A; Pabst, J; Dinkelaker, A; Fleischer, W


    The MAGhaler (Mundipharma GmbH) is a multidose dry powder inhaler (DPI) containing a novel formulation of drug and lactose compacted by an isostatic pressing technique (GGU GmbH). On actuation, a precise dose is metered from a compacted ring-shaped drug tablet. In this study, the lung deposition of salbutamol from this device has been assessed. Ten healthy non-smoking subjects completed a two-way cross-over study assessing the pulmonary deposition of salbutamol (200 microg) from the MAGhaler at high (60 l/min) and low (30 l/min) peak inhaled flow rates (PIFRs), representing maximal and sub-maximal inspiratory efforts. The formulation was radiolabelled with 99mTc, and lung and oropharyngeal depositions were quantified by gamma scintigraphyThe mean (SD)% ofthe delivered dose deposited in the lungs was 26.4 (4.3)% at 60 l/min and 21.1 (5.1)% at 30 l/min (P < 0.05), corresponding to mean lung depositions of 52.8 and 42.2 microg salbutamol, respectively. The distribution of drug within different lung regions did not vary significantly with inhaled flow rate. The data provided proof of concept for the novel inhaler device and the innovative drug formulation. In comparison with previous deposition data obtained with other DPIs, the lung deposition was relatively high, relatively reproducible (coefficient of variation 16% at 60 l/min) and relatively insensitive to the change in peak inhaled flow rate.

  19. Localization of a pheochromocytoma using I-123 MIBG adrenal scintigraphy.

    Directory of Open Access Journals (Sweden)

    Shirkare S


    Full Text Available In a patient with the clinical diagnosis of pheochromocytoma, the localization of the tumor is essential for planning treatment. Recently, we have performed I-123 metaiodobenzylguanidine (MIBG adrenal scintigraphy in a patient presenting with a history of paroxysmal hypertension. Scintigraphy accurately located an ectopic unilateral pheochromocytoma. The scintigraphic diagnosis was confirmed by surgery and a diagnosis of ectopic unilateral pheochromocytoma was made by histopathological examination. This case report illustrates the specific diagnosis of pheochromocytoma by I-123 MIBG scintigraphy which is especially useful when other diagnostic procedures are equivocal.

  20. SiO2 aerosol nanoparticle reactor for occupational health and safety studies. (United States)

    Ostraat, Michele L; Swain, Keith A; Krajewski, James J


    Important questions are emerging about potential occupational safety, toxicological, and ecotoxicological effects and occupational inhalation exposure risks to engineered aerosol nanoparticles. Although multiple avenues are available to synthesize nanoparticles, few tools are accessible to industrial hygienists and inhalation toxicologists to produce well-characterized aerosols of known aerosol size distribution and particle number concentration that are stable, simple, and robust to operate. This article describes a SiO(2) aerosol nanoparticle reactor that has been developed as a tool for the study of the safety, health, and environmental consequences of exposure to nanoparticle synthesis and processing. The SiO(2) aerosol nanoparticle reactor is capable of stable, long-term synthesis of amorphous SiO(2) aerosol nanoparticles from d(50) = 10-70 nm at particle concentrations approximately 10(4)-10(7)particles/cm(3) that does not produce halogen-containing byproducts and does not require daily monitoring of the particle size distribution. This reactor is designed to produce a well-characterized aerosol to enable subsequent testing with a continuous, stable supply of aerosol nanoparticles (i) to facilitate inhalation toxicology studies, (ii) to measure explosion characteristics of aerosol nanoparticles, (iii) to determine the barrier efficacy for respirator filtration, bag house exhaust, and personal protective garment media challenged with diverse aerosol nanoparticles, and (iv) to develop airborne monitoring technologies for verifying workplace safety protocols. This article details reactor design, synthesis parameters, and instruments available to characterize the resulting aerosol nanoparticle size distributions.

  1. Scintigraphy of parathyroids in secondary hyperparathyroidism; Scintigraphie des parathyroides dans l`hyperparathyroidie secondaire

    Energy Technology Data Exchange (ETDEWEB)

    Hublo, D.; Beauchat, V.; Pattou, F.; Lecomte-Houcke, M.; Prangere, T.; Ziegels, P.; Carnaille, B.; Proye, C.; Marchandise, X.; Steiling, M. [Medecine Nucleaire, Chirurgie Endocrinienne et Anatomie et Cytologie Pathologiques - CHU de Lille - 59037 Lille cedex (France)


    Use of pre-surgery imaging of parathyroids is still questioned. The goal of this study is to evaluate the sensitivity of the scintigraphy in the detection of secondary parathyroid anomalies with renal insufficiency. Thirty two patients (20 F, 12 M) of 14 - 74 years old were operated of secondary hyperparathyroidism with renal insufficiency. It was a matter of re-intervention in 9 cases. The acquisitions were achieved 20 min and 2 h after injection of 550 MBq of MIBI-{sup 99m}Tc or of Tetrofosmine - {sup 99m}Tc and 2 h after injection of 5.5 MBq of iodine 123. Eighty seven glands of 28 to 3820 mg were pulled out in 23 first surgeries while the parathyroid tissue was found in thymic prolongations in 5 of these patients. The masses of 41 glands, positive by scintigraphy (from 69 to 3829 mg), were significantly higher (Wilcoxon`s test, p < 10{sup -8}) than the 46 not-seen (from 28 to 1050 mg). The sensitivity of total detection is 47%, of 85% for the 33 glands of 500 mg or more and of 24% for the 54 glands of less than 500 mg. In 9 re-interventions, 12 abnormal glands were pulled out: 11 of 430 to 4500 mg were positive by scintigraphy, while only one gland of 80 mg was not seen. In conclusion, the scintigraphy realised before first surgery for secondary hyperparathyroidism with renal insufficiency presents low sensitivity, related partly, at least, to the low mass of glands and justifies itself only by search for positive ectopic parathyroids. Instead, it appears performing and indispensable in case of re-intervention

  2. [Health significance of inhaled particles]. (United States)

    Gillissen, A; Gessner, C; Hammerschmidt, S; Hoheisel, G; Wirtz, H


    Particulates refer to particles, dust, dirt, soot and aerosol mists that has suspended in the surrounding air. They may consist of solids of various forms including fibres or liquids. Long term exposure to silicon dioxide containing dusts (crystalline silica: quartz, tridymite, cristobalite, coesite, stishovite) may cause pneumoconiosis in the form of acute or/either chronic silicosis. Asbestos refers to a divers family of crystalline hydrated fibrous siliates typically exhibiting a greater tha 3:1 length ot diameter ratio. It is subdivided into serpentine (Chrysotile) and amphibole (crocidolite, amosite, anthophyllite, tremolite, actinolite). Exposure to asbestos fibres may cause lung fibrosis and promote cancer of the lung or the pleura. Besides the induction of malignant diseases dust exposure may result in obstructive as well as restrictive lung diseases which may be compensate in case of the recognition as a occupational diseases. Other occupational exposures leading to pneumoconiosis are caused be talc, or metals including aluminium containing dusts. Also the group of man-made mineral (MMMFs) or vitreous fibres (MMVFs), including glass wool, rock wool, slag wool, glass filaments, microfibres, refractory ceramic fibres are bioactive under certain experimental conditions. Although it has been shown that MMMFs may cause malignancies when injected intraperitoneally in high quantities in rodents, inhalation trials and human studies could not reproduce these results in the same precision. Fine particles (particulate matter = PM) comprise one of the most widespread and harmful air pollutants in the industrialized world. PM may cause worsening of asthma and other respiratory diseases, reduce lung function development in children, potentially increased the risk of premature death in the elderly and enhance mortality from cardiac diseases. Because of the small size PM2.5 is seen to be even more hazardous than PM10.

  3. AB034. Comparative effectiveness of prescribing similarversusdissimilar inhalers for COPD therapy (United States)

    Bosnic-Anticevich, Sinthia; Chrystyn, Henry; Costello, Richard; Dolovich, Myrna; Fletcher, Monica; Lavorini, Federico; Rodríguez-Roisin, Roberto; Ryan, Dermot; Ming, Simon Wan Yau; Skinner, Derek; Price, David


    Background Prescription of different inhaler types for patients with chronic obstructive pulmonary disease (COPD) may lead to poorer outcomes through increased demands on patients to master dissimilar inhalation and dose preparation manoeuvres. To describe the demographic, co-morbidity, and clinical characteristics of patients with COPD prescribed ‘dissimilar’versus‘similar’ inhalers. Methods The study was a historical cohort observational design assessing a 1-year baseline period for patient characterization and categorisation of inhalers, and an index date to signal the last date of data extraction from the UK Optimum Patient Care Research Database (OPCRD). Patients had 1-year of continuous data between February 2008 and February 2015, a Quality and Outcomes Framework (QOF) coded diagnosis for COPD, were aged 40 and over, and had evidence of two or more inhaled respiratory treatments. Descriptive statistics included demographic, co-morbidity and clinical characteristics of patients, and comparison of patients prescribed similarversusdissimilar inhalers by GOLD group, FEV1, and number of exacerbations. Based on inhalation technique and dose preparation data in the OPCRD, two different categorisations were used to describe prescribed inhaler type: ‘similar inhalers’ included those patients prescribed either aerosols or similar dry-powder inhalers (DPIs), while ‘dissimilar inhalers’ included those prescribed both aerosols and DPIs. Results A total of 53,817 patients were selected [mean age of 71 years (SD 10.6); males: 51% in total population]. 13% were non-smokers, 30% current smokers, 52% ex-smokers and 5% with missing smoking status. In the baseline year, 39% received a QOF coded diagnosis for asthma, 36% for diabetes, 26% for ischaemic heart disease, 6% for actively treated rhinitis, and 1.3% for diagnosis for pneumonia. Patients prescribed dissimilar inhalers were of similar age to those prescribed similar inhalers (mean age of 71 in each cohort

  4. History of aerosol therapy: liquid nebulization to MDIs to DPIs. (United States)

    Anderson, Paula J


    Inhaled therapies have been used since ancient times and may have had their origins with the smoking of datura preparations in India 4,000 years ago. In the late 18th and in the 19th century, earthenware inhalers were popular for the inhalation of air drawn through infusions of plants and other ingredients. Atomizers and nebulizers were developed in the mid-1800s in France and were thought to be an outgrowth of the perfume industry as well as a response to the fashion of inhaling thermal waters at spas. Around the turn of the 20th century, combustible powders and cigarettes containing stramonium were popular for asthma and other lung complaints. Following the discovery of the utility of epinephrine for treating asthma, hand-bulb nebulizers were developed, as well as early compressor nebulizers. The marketing of the first pressurized metered-dose inhaler for epinephrine and isoproterenol, by Riker Laboratories in 1956, was a milestone in the development of inhaled drugs. There have been remarkable advances in the technology of devices and formulations for inhaled drugs in the past 50 years. These have been influenced greatly by scientific developments in several areas: theoretical modeling and indirect measures of lung deposition, particle sizing techniques and in vitro deposition studies, scintigraphic deposition studies, pharmacokinetics and pharmacodynamics, and the 1987 Montreal Protocol, which banned chlorofluorocarbon propellants. We are now in an era of rapid technologic progress in inhaled drug delivery and applications of aerosol science, with the use of the aerosolized route for drugs for systemic therapy and for gene replacement therapy, use of aerosolized antimicrobials and immunosuppressants, and interest in specific targeting of inhaled drugs.


    Directory of Open Access Journals (Sweden)

    Shumaila N Muhammad Hanif


    Full Text Available Historically, pharmaceutical aerosols have been employed for the treatment of obstructive airway diseases, such as asthma and chronic obstructive pulmonary disease, but in the past decades their use has been expanded to treat lung infections associated with cystic fibrosis and other respiratory diseases. Tuberculosis (TB is acquired after inhalation of aerosol droplets containing the bacilli from the cough of infected individuals. Even though TB affects other organs, the lungs are the primary site of infection, which makes the pulmonary route an ideal alternative route to administer vaccines or drug treatments. Optimization of formulations and delivery systems for anti-TB vaccines and drugs, as well as the proper selection of the animal model to evaluate those is of paramount importance if novel vaccines or drug treatments are to be successful. Pharmaceutical aerosols for patient use are generated from metered dose inhalers, nebulizers and dry powder inhalers. In addition to the advantages of providing more efficient delivery of the drug, low cost and portability, pharmaceutical dry powder aerosols are more stable than inhalable liquid dosage forms and do not require refrigeration. Methods to manufacture dry powders in respirable sizes include micronization, spray drying and other proprietary technologies. Inhalable dry powders are characterized in terms of their drug content, particle size and dispersibility to ensure deposition in the appropriate lung region and effective aerosolization from the device. These methods will be illustrated as they were applied for the manufacture and characterization of powders containing anti-tubercular agents and vaccines for pulmonary administration. The influence of formulation, selection of animal model, method of aerosol generation and administration on the efficacy demonstrated in a given study will be illustrated by the evaluation of pharmaceutical aerosols of anti-TB drugs and vaccines in guinea pigs by

  6. /sup 131/I-meta-iodobenzylguanidine scintigraphy of neuroblastomas

    Energy Technology Data Exchange (ETDEWEB)

    Munkner, T.


    Sixteen neuroblastoma patients have been studied by /sup 131/I-meta-iodobenzylguanidine (MIBG) scintigraphy. Three patients were possibly cured, and their scintigraphy results were normal. Thirteen patients had tumors and metastases demonstrated by /sup 131/I-MIBG, two of these patients had a normal vanillylmandelic acid (VMA) excretion level. One patient has been treated by /sup 131/I-MIBG, but died. /sup 131/I-MIBG was concentrated in other cells too, eg, in erythrocytes and platelets.

  7. Thyroidal malignancy and scintigraphy; Schilddrsenmalignitaet und Szintigrafie

    Energy Technology Data Exchange (ETDEWEB)

    Brandt-Mainz, K.; Moka, D. [Gemeinschaftspraxis fuer Radiologie und Nuklearmedizin Radionuk, Essen (Germany)


    Thyroid hypofunctional ('scintigraphic cool or cold') nodules are detected frequently. Dependent on the clinical situation, on morbidity and on economic aspects it is necessary to select patients for surgery and to avoid unnecessary surgical treatment. Therefore it is necessary to develop appropriate diagnostic algorithm to manage hypofunctional thyroid nodules. The ultrasound guided fine-needle aspiration cytology (FNA) is on the one hand side a useful diagnostic tool, but on the other hand side there exist certain limitations. It is questionable if the nodule is correctly reached. In case of heterogeneous larger mixed nodules or multiple hypofunctional nodules, it is difficult to choose the correct location of punctation. Furthermore a certain number of FNA's is not diagnostic without any result or due to 'follicular neoplasia'. {sup 99m}Tc-MIBI-sctintigraphy (MIBI) and {sup 18}F-FDG-positron-emission-tomography (FDG-PET) are established methods in the follow-up of differentiated thyroid cancer after thyroidectomy with elevated thyroglobulin-levels without adequate 131-Iodine-uptake. Moreover in case of parafollicular medullary thyroid carcinomas after thyroidectomy with elevated calcitonin-concentrations the FDG-PET is a valuable diagnostic method in localizing tumor. However these tracers gain in importance in differentiating malignant from benign preoperative hypofunctional nodules. In conclusion MIBI-scintigraphy should be used routinely to plan the correct guide of FNA. The application of both methods (MIBI and FNA) improves the differentiation of dignity, whereas a negative MIBI-examination and a negative FNA is able to exclude malignancy nearly. In this way the number of unnecessary numbers of surgical treatments can be reduced. FDG-PET is not definitely superior compared to MIBI-scintigraphy. From the cost perspective MIBI is more attractive than FDG-PET. (orig.)

  8. Gallium 67 scintigraphy in glomerular disease

    Energy Technology Data Exchange (ETDEWEB)

    Bakir, A.A.; Lopez-Majano, V.; Levy, P.S.; Rhee, H.L.; Dunea, G.


    To evaluate the diagnostic usefulness of gallium 67 scintigraphy in glomerular disease, 45 patients with various glomerulopathies, excluding lupus nephritis and renal vasculitis, were studied. Persistent renal visualization 48 hours after the gallium injection, a positive scintigram, was graded as + (less than), ++ (equal to), and +++ (greater than) the hepatic uptake. Positive scintigrams were seen in ten of 16 cases of focal segmental glomerulosclerosis, six of 11 cases of proliferative glomerulonephritis, and one case of minimal change, and one of two cases of membranous nephropathy; also in three of six cases of sickle glomerulopathy, two cases of diabetic neuropathy, one of two cases of amyloidosis, and one case of mild chronic allograft rejection. The 25 patients with positive scans were younger than the 20 with negative scans (31 +/- 12 v 42 +/- 17 years; P less than 0.01), and exhibited greater proteinuria (8.19 +/- 7.96 v 2.9 +/- 2.3 S/d; P less than 0.01) and lower serum creatinine values (2 +/- 2 v 4.1 +/- 2.8 mg/dL; P less than 0.01). The amount of proteinuria correlated directly with the intensity grade of the gallium image (P less than 0.02), but there was no correlation between the biopsy diagnosis and the outcome of the gallium scan. It was concluded that gallium scintigraphy is not useful in the differential diagnosis of the glomerular diseases under discussion. Younger patients with good renal function and heavy proteinuria are likely to have a positive renal scintigram regardless of the underlying glomerulopathy.

  9. Nasal aerodynamics protects brain and lung from inhaled dust in subterranean diggers, Ellobius talpinus

    NARCIS (Netherlands)

    M.P. Moshkin; D.V. Petrovski; A.E. Akulov; A.V. Romashchenko; L.A. Gerlinskaya; V.L. Ganimedov; M.I. Muchnaya; A.S. Sadovsky; I.V. Koptyug; A.A. Savelov; S. Yu Troitsky; Y.M. Moshkn; V.I. Bukhtiyarov; N.A. Kolchanov; R.Z. Sagdeev; V.M. Fomin


    textabstractInhalation of air-dispersed sub-micrometre and nano-sized particles presents a risk factor for animal and human health. Here, we show that nasal aerodynamics plays a pivotal role in the protection of the subterranean mole vole Ellobius talpinus from an increased exposure to nano-aerosols

  10. Detectability of metastatic bone tumor by Ga-67 scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Koizumi, Kiyoshi; Uchiyama, Guio; Araki, Tsutomu; Hihara, Toshihiko; Ogata, Hitoshi; Monzawa, Shuichi; Kachi, Kenji; Matsusako, Masaki


    Ga-67 scintigrams in patients with malignant diseases sometimes reveal uptake of the tracer in the bone metastases. Detectability of Ga-67 scintigraphy for metastatic bone tumors and benign bone lesions was compared with that of Tc-99m bone scintigraphy. Countable bone metastases detected by bone scintigraphy were evaluated whether the lesion showed apparent, faint, or negative Ga-67 uptake. Of 47 lesions 23 (49%) showed apparent uptake and 17 (36%) showed negative uptake, only 7 (10%) mostly fracture/osteotomy, showed apparent uptake of the tracer. Uptake in the other benign lesions such as trauma of the ribs, spondylosis deformans, and arthrosis deformans was rather faint. In patients with multiple bone metastases, 9 patients (82%) out of 11 showed more prominent abnormal findings in Tc-99m MDP bone scintigraphy than in Ga-67 scintigraphy; that is, Ga-67 scintigraphy was not able to reveal all metastatic bone lesions. In patients with untreated or recurrent tumors, relation between Ga-67 uptake in the tumors and that in the bone metastases was evaluated. Of 7 patients with negative Ga-67 uptake in the bone metastases; that is, there seemed to be little relation between Ga-67 affinity to the primary tumors and that to the bone metastases. Mechanisms of the Ga-67 uptake in the bone metastases were discussed. Not only the tumor cells or tissues in the bone metastases but also bone mineral or osteoclasts might be the deposition sites of Ga-67.

  11. Bone- and bone marrow scintigraphy in Gaucher disease type 1

    Energy Technology Data Exchange (ETDEWEB)

    Mikosch, P. [Dept. of Nuclear Medicine and Endocrinology, State Hospital Klagenfurt (Austria); Dept. of Internal Medicine II, State Hospital Klagenfurt (Austria); Zitter, F. [Dept. of Internal Medicine II, State Hospital Klagenfurt (Austria); Gallowitsch, H.J.; Lind, P. [Dept. of Nuclear Medicine and Endocrinology, State Hospital Klagenfurt (Austria); Wuertz, F. [Dept. of Pathology, State Hospital Klagenfurt (Austria); Mehta, A.B.; Hughes, D.A. [Lysosomal Storage Disorder Unit, Dept. of Academic Haematology, Royal Free and Univ. Coll. Medical School, London (United Kingdom)


    Scintigraphy is a method for imaging metabolism and should be viewed as complimentary to morphological imaging. Bone and bone marrow scintigraphy can particularly contribute to the detection of focal disease in Gaucher disease. In bone crises it can discriminate within three days after pain onset between local infection and aseptic necrosis. A further advantage of bone- and bone marrow scintigraphy is the visualization of the whole skeleton within one setting. Whole body imaging for focal lesions might thus be an objective in GD, in particular in patients complaining of several painful sites. Direct imaging of bone marrow deposits in GD by MIBI scintigraphy might be of special interest in children in whom bone marrow undergoes a developmental conversion from red to yellow marrow in the ap-pendicular skeleton. MRI interpretation in young GD patients is thus difficult in order to estimate the exact amount and extent of bone marrow infiltration by Gaucher cells. 99mTc-MIBI scintigraphy with its direct visualization of lipid storage could thus add interesting additional information not shown with other methods including MRI. Although MRI is the most accepted imaging modality in assessing the skeletal status in GD, a selective use of scintigraphy for imaging bone and bone marrow may add information in the evaluation of patients with Gaucher disease.

  12. Minimizing variability of cascade impaction measurements in inhalers and nebulizers. (United States)

    Bonam, Matthew; Christopher, David; Cipolla, David; Donovan, Brent; Goodwin, David; Holmes, Susan; Lyapustina, Svetlana; Mitchell, Jolyon; Nichols, Steve; Pettersson, Gunilla; Quale, Chris; Rao, Nagaraja; Singh, Dilraj; Tougas, Terrence; Van Oort, Mike; Walther, Bernd; Wyka, Bruce


    The purpose of this article is to catalogue in a systematic way the available information about factors that may influence the outcome and variability of cascade impactor (CI) measurements of pharmaceutical aerosols for inhalation, such as those obtained from metered dose inhalers (MDIs), dry powder inhalers (DPIs) or products for nebulization; and to suggest ways to minimize the influence of such factors. To accomplish this task, the authors constructed a cause-and-effect Ishikawa diagram for a CI measurement and considered the influence of each root cause based on industry experience and thorough literature review. The results illustrate the intricate network of underlying causes of CI variability, with the potential for several multi-way statistical interactions. It was also found that significantly more quantitative information exists about impactor-related causes than about operator-derived influences, the contribution of drug assay methodology and product-related causes, suggesting a need for further research in those areas. The understanding and awareness of all these factors should aid in the development of optimized CI methods and appropriate quality control measures for aerodynamic particle size distribution (APSD) of pharmaceutical aerosols, in line with the current regulatory initiatives involving quality-by-design (QbD).

  13. Modeling the Fate of Expiratory Aerosols and the Associated Infection Risk in an Aircraft Cabin Environment

    DEFF Research Database (Denmark)

    Wan, M.P.; To, G.N.S.; Chao, C.Y.H.


    The transport and deposition of polydispersed expiratory aerosols in an aircraft cabin were simulated using a Lagrangian-based model validated by experiments conducted in an aircraft cabin mockup. Infection risk by inhalation was estimated using the aerosol dispersion data and a model was developed...

  14. The Adaptive Aerosol Delivery (AAD) technology: Past, present, and future. (United States)

    Denyer, John; Dyche, Tony


    Conventional aerosol delivery systems and the availability of new technologies have led to the development of "intelligent" nebulizers such as the I-neb Adaptive Aerosol Delivery (AAD) System. Based on the AAD technology, the I-neb AAD System has been designed to continuously adapt to changes in the patient's breathing pattern, and to pulse aerosol only during the inspiratory part of the breathing cycle. This eliminates waste of aerosol during exhalation, and creates a foundation for precise aerosol (dose) delivery. To facilitate the delivery of precise metered doses of aerosol to the patient, a unique metering chamber design has been developed. Through the vibrating mesh technology, the metering chamber design, and the AAD Disc function, the aerosol output rate and metered (delivered) dose can be tailored to the demands of the specific drug to be delivered. In the I-neb AAD System, aerosol delivery is guided through two algorithms, one for the Tidal Breathing Mode (TBM), and one for slow and deep inhalations, the Target Inhalation Mode (TIM). The aim of TIM is to reduce the treatment time by increasing the total inhalation time per minute, and to increase lung deposition by reducing impaction in the upper airways through slow and deep inhalations. A key feature of the AAD technology is the patient feedback mechanisms that are provided to guide the patient on delivery performance. These feedback signals, which include visual, audible, and tactile forms, are configured in a feedback cascade that leads to a high level of compliance with the use of the I-neb AAD System. The I-neb Insight and the Patient Logging System facilitate a further degree of sophistication to the feedback mechanisms, by providing information on long term adherence and compliance data. These can be assessed by patients and clinicians via a Web-based delivery of information in the form of customized graphical analyses.

  15. Characterization of aerosols produced by surgical procedures

    Energy Technology Data Exchange (ETDEWEB)

    Yeh, H.C.; Muggenburg, B.A.; Lundgren, D.L.; Guilmette, R.A.; Snipes, M.B.; Jones, R.K. [Inhalation Toxicology Research Institute, Albuquerque, NM (United States); Turner, R.S. [Lovelace Health Systems, Albuquerque, NM (United States)


    In many surgeries, especially orthopedic procedures, power tools such as saws and drills are used. These tools may produce aerosolized blood and other biological material from bone and soft tissues. Surgical lasers and electrocautery tools can also produce aerosols when tissues are vaporized and condensed. Studies have been reported in the literature concerning production of aerosols during surgery, and some of these aerosols may contain infectious material. Garden et al. (1988) reported the presence of papilloma virus DNA in the fumes produced from laser surgery, but the infectivity of the aerosol was not assessed. Moon and Nininger (1989) measured the size distribution and production rate of emissions from laser surgery and found that particles were generally less than 0.5 {mu}m diameter. More recently there has been concern expressed over the production of aerosolized blood during surgical procedures that require power tools. In an in vitro study, the production of an aerosol containing the human immunodeficiency virus (HIV) was reported when power tools were used to cut tissues with blood infected with HIV. Another study measured the size distribution of blood aerosols produced by surgical power tools and found blood-containing particles in a number of size ranges. Health care workers are anxious and concerned about whether surgically produced aerosols are inspirable and can contain viable pathogens such as HIV. Other pathogens such as hepatitis B virus (HBV) are also of concern. The Occupational Safety and Health funded a project at the National Institute for Inhalation Toxicology Research Institute to assess the extent of aerosolization of blood and other tissues during surgical procedures. This document reports details of the experimental and sampling approach, methods, analyses, and results on potential production of blood-associated aerosols from surgical procedures in the laboratory and in the hospital surgical suite.

  16. Protection of air in premises and environment against beryllium aerosols

    Energy Technology Data Exchange (ETDEWEB)

    Bitkolov, N.Z.; Vishnevsky, E.P.; Krupkin, A.V. [Research Inst. of Industrial and Marine Medicine, St. Petersburg (Russian Federation)


    First and foremost, the danger of beryllium aerosols concerns a possibility of their inhalation. The situation is aggravated with high biological activity of the beryllium in a human lung. The small allowable beryllium aerosols` concentration in air poses a rather complex and expensive problem of the pollution prevention and clearing up of air. The delivery and transportation of beryllium aerosols from sites of their formation are defined by the circuit of ventilation, that forms aerodynamics of air flows in premises, and aerodynamic links between premises. The causes of aerosols release in air of premises from hoods, isolated and hermetically sealed vessels can be vibrations, as well as pulses of temperature and pressure. Furthermore, it is possible the redispersion of aerosols from dirty surfaces. The effective protection of air against beryllium aerosols at industrial plants is provided by a complex of hygienic measures: from individual means of breath protection up to collective means of the prevention of air pollution. (J.P.N.)

  17. 布地奈德雾化吸入疗法在妊娠期慢性咳嗽患者中的应用价值%Analysis on application value of budesonide aerosol inhalation in pregnant patients with chronic cough

    Institute of Scientific and Technical Information of China (English)



    Objective To observe the therapeutic effect of budesonide aerosol inhalation on pregnant patients with chronic cough and its influences on plasma cytokine.Methods Ninety-two pregnant patients with chronic coughs were randomly divided into observation group and control group,46 cases in each group.Patients in the control group were given routine treatment,such as anti-infection,anti-inflammation,relieving cough and eliminating phlegm as well as relieving asthma,while those in the observation group were inhaled with budesonide suspension by air pressure pump based on the treatment of control group.The clinical symptoms,improvement of lung function and levels of plasma cytokine before and after treatment,including interleukin-4 (IL-4),IL-6,IL-10,tumor necrosis factor α (TNF-α) and interferon γ (IFN-γ),were compared in both groups.Results The peak expiratory flow rate (PEFR),forced vital capacity (FVC),forced expiratory volume in 1 second (FEV1) and expiratory volume at the time of forced expiratory 50% vital capacity in the observation group were significantly higher than those in the control group.The levels of IL-4,TNF-α,IL-6,eosnophils (EOS) and immunoglobulin E (IgE) in the observation group were obviously lower than those in the control group,while the levels of IL-10 and IFN-γsignificantly higher than the control group.The symptomatic and visual analog scale scores of cough as well as duration of major clinical symptoms like chest oppression,shortness of breath and coughs in the observation group were all markedly lower than those in the control group,and the effectiveness rate was notably superior to the control group,in which the statistical significance was presented.Conclusion Budesonide aerosol inhalation has explicit therapeutic effects and few adverse reactions in the treatment of chronic cough during pregnancy,is capable of enhancing the symptoms like coughs,chest oppression and shortness of breath rapidly,recovering lung function and correcting

  18. Postdeposition dispersion of aerosol medications using surfactant carriers. (United States)

    Marcinkowski, Amy L; Garoff, Stephen; Tilton, Robert D; Pilewski, Joseph M; Corcoran, Timothy E


    Inhaled aerosol drugs provide a means of directly treating the lungs; however, aerosol deposition and drug distribution can be nonuniform, especially in obstructive lung disease. We hypothesize that surfactant-based aerosol carriers will disperse medications over airway surfaces after deposition through surface tension driven flows, increasing dose uniformity and improving drug distribution into underventilated regions. We considered saline and surfactant aerosol delivery via cannula onto several model airway surfaces including porcine gastric mucus (PGM) and both cystic fibrosis (CF) and non-CF human bronchial epithelial cells (HBEs). Fluorescent dye and microspheres (d = 100 nm, 1 mum) were used to qualitatively and quantitatively assess postdeposition dispersion. Aerosol volume median diameters were in the 1-4 mum range. The tested surfactants included sodium dodecyl sulfate (SDS), cetyl trimethyl ammonium bromide (CTAB), tyloxapol, and calfactant. All surfactants tested on PGM (tyloxapol, calfactant, SDS, and CTAB) significantly increased dispersion area versus saline with all markers (2-20-fold increases; all p surfactants tested on CF HBEs (tyloxapol and calfactant) significantly increased dispersion area versus saline with all markers (1.6-4.1-fold increases; all p Surfactant carriers enhanced dispersion after aerosol deposition onto model airway surfaces, and may improve the efficacy of inhaled preparations such as inhaled antibiotics for cystic fibrosis.

  19. 不同雾化吸入方式对慢性阻塞性肺疾病急性期的临床护理疗效分析%Efficacy analysis of the clinical care of the different aerosol inhalation on chronic obstructive pulmonary disease in acute phase

    Institute of Scientific and Technical Information of China (English)



      目的分析探讨不同雾化吸入方式对 COPD 急性期的临床护理疗效.方法将120例笔者所在医院治疗的 COPD患者随机分为对照组及观察组,对照组给予超声雾化吸入治疗,观察组给予氧驱动雾化吸入治疗.结果两组患者治疗前 PaO2、PaCO2、SO23项指标比较差异均无统计学意义.治疗第3天时两组 PaO2、SO2均出现显著的提升,观察组两项指标显著高于对照组,两组间比较差异有统计学意义(P <0.05);治疗第7、14天时观察组 PaO2、SO2显著高于对照组,两组间比较差异有统计学意义(P <0.05);观察组在第7、14天的 PaCO2显著低于对照组,两组间比较差异有统计学意义(P <0.05).对照组显效33例(55.0%),有效17例(28.3%),总有效率83.3%;观察组显效38例(63.3%),有效20例(33.3%),总有效率为96.7%,观察组显著高于对照组,两组总有效率比较差异有统计学意义(P <0.05).结论氧驱动雾化吸入与超声雾化相比较,能更好的改善 COPD 患者肺通气换气功能,提高 COPD 治疗的总有效率,应在临床推广使用.%  Objective To explore the clinical care efficacy of the different aerosol inhalation on patients with COPD in acute phase. Methods 120 patients with COPD in our hospital were randomly divided into control group and observation group.The control group was treated with ultrasound inhalation therapy, and the observation group were treated with oxygen-driven inhalation therapy. Results PaO2, PaCO2, SO2 of the two groups before treatment had no significant difference in treatment on day 3.PaO2 and SO2 of two groups were significantly improved, but the two indicators of the observation group was significantly higher (P <0.05).The 7th and 14th days of treatment, PaO2 and SO2 of the observation group were significantly higher than that of the control group(P <0.05). PaCO2 of observation group was significantly lower, and there were significant

  20. Diagnostic and Pathophysiological Impact of Myocardial MIBG Scintigraphy in Parkinson's Disease



    Myocardial MIBG scintigraphy is established in the diagnosis and differential diagnosis of Parkinson's disease (PD). Numerous studies address the pathophysiological impact of myocardial MIBG scintigraphy: the myocardial MIBG uptake correlates with the clinical phenotype of PD; the background of this phenomenon is unclear. Furthermore MIBG scintigraphy enables to study the extracranial Lewy body type-degeneration. In combination with cerebral dopamine transporter imaging, MIBG scintigraphy all...

  1. [ECG indices in dogs after inhalation of 239Pu]. (United States)

    Karpova, V N


    Dogs of both sexes aged 2 to 4 were subjected to inhalation inoculation with polymer 239Pu or submicron 239PuO2 aerosols in amounts close to acute, subacute and chronically effective ones. ECG was recorded in standard, amplified and single leads (V3). All calculations were done by lead II. Signs of the right heart overburdening were noted in the presence of the P-pulmonale complex, deep S1 wave or cardiac electrical axis of SI-SII-SIII type. Signs of the right heart overburdening were revealed after inhalation of polimer 239Pu (70%). The absence of similar changes in damage caused by 239Pu could be attributed to its fast resorption from the lungs resulting in more moderate lesion of the respiratory organs.

  2. New liquid aerosol generation devices: systems that force pressurized liquids through nozzles. (United States)

    Geller, David E


    Over the past few decades, aerosol delivery devices have been relatively inefficient, wasteful, and difficult for patients to use. These drawbacks have been tolerated because the drugs available for inhalation have wide therapeutic margins and steep dose-response curves at low doses. Recently several forces have converged to drive innovation in the aerosol device industry: the ban on chlorofluorocarbon propellants in metered-dose inhalers, the need for more user-friendly devices, and the invention of expensive inhalable therapies for topical and systemic lung delivery. Numerous devices are in development to improve the efficiency, ease of use, and reproducibility of aerosol delivery to the lung, including systems that force liquid through a nozzle to form the aerosol cloud. The Respimat is a novel, compact, propellant-free, multi-dose inhaler that employs a spring to push drug solution through a nozzle, which generates a slow-moving aerosol. Deposition studies show that the Respimat can deliver 39-44% of a dose to the lungs. Clinical asthma and chronic obstructive pulmonary disease trials with bronchodilators show that the Respimat is 2-8 times as effective as a metered-dose inhaler. Respimat has been tested with bronchodilators and inhaled corticosteroids. The AERx device uses sophisticated electronics to deliver aerosol from a single-dose blister, using an integral, disposable nozzle array. The electronics control dose expression and titration, timing of aerosol generation with the breath, and provide feedback for proper inhalation technique. Lung deposition ranges from 50 to 80% of the loaded dose, with remarkable reproducibility. AERx has been tested with a variety of drugs, for both topical and systemic delivery, including rhDNase (dornase alfa), insulin, and opioids. These novel devices face competition from other technologies as well as financial and regulatory hurdles, but they both offer a marked improvement in the efficiency of pulmonary drug delivery.

  3. Application of indirect methods of {sup 99m}Tc labelling of drugs used in inhalation devices for children

    Energy Technology Data Exchange (ETDEWEB)

    Roller, C.M.; Devadason, S.G.; Thompson, B.C.; Troedson, R.G.; Wildhaber, J.H. [Prince Margaret Hospital, Perth, WA (Australia)


    Full text: Radionuclide imaging has been widely used to assess pulmonary deposition of inhaled drugs used to treat airway diseases. Drug distribution patterns provide information on the clinical effectiveness of different inhalation devices and therefore provide a guide to dosage regimens. At our institution various indirect labelling procedures have been refined to evaluate lung deposition from different inhalation devices. Assessments of the output of radiolabelled budesonide from Turbuhaler, a dry powder inhaler, and radiolabelled salbutamol from a pressurised metered dose inhaler have been made in vitro by measuring the particle size distribution and total drug delivery using a multistage liquid impinger. The distribution of drug particles from the unlabelled commercial inhalation devices was compared with the distribution of drug particles from labelled devices using a spectrophotometer and the corresponding distribution of radioactivity from the labelled inhalation devices was measured using an ionisation chamber. The drug particle size distributions from commercial and labelled devices compared favorably with the distribution of radioactivity. The radiolabelling method used does not significantly change the particle size distribution of the aerosol generated by the inhalation device and therefore {sup 99m}Tc acts as a suitable marker for the drugs used in these devices. We have identified a number of technical factors which improve labelling efficiency. Indirect radiolabelling of drugs can be used to assess the effectiveness of different inhalation devices in children

  4. Cherry-flavoured electronic cigarettes expose users to the inhalation irritant, benzaldehyde. (United States)

    Kosmider, Leon; Sobczak, Andrzej; Prokopowicz, Adam; Kurek, Jolanta; Zaciera, Marzena; Knysak, Jakub; Smith, Danielle; Goniewicz, Maciej L


    Many non-cigarette tobacco products, including e-cigarettes, contain various flavourings, such as fruit flavours. Although many flavourings used in e-cigarettes are generally recognised as safe when used in food products, concerns have been raised about the potential inhalation toxicity of these chemicals. Benzaldehyde, which is a key ingredient in natural fruit flavours, has been shown to cause irritation of respiratory airways in animal and occupational exposure studies. Given the potential inhalation toxicity of this compound, we measured benzaldehyde in aerosol generated in a laboratory setting from flavoured e-cigarettes purchased online and detected benzaldehyde in 108 out of 145 products. The highest levels of benzaldehyde were detected in cherry-flavoured products. The benzaldehyde doses inhaled with 30 puffs from flavoured e-cigarettes were often higher than doses inhaled from a conventional cigarette. Levels in cherry-flavoured products were >1000 times lower than doses inhaled in the workplace. While e-cigarettes seem to be a promising harm reduction tool for smokers, findings indicate that using these products could result in repeated inhalation of benzaldehyde, with long-term users risking regular exposure to the substance. Given the uncertainty surrounding adverse health effects stemming from long-term inhalation of flavouring ingredients such as benzaldehyde, clinicians need to be aware of this emerging risk and ask their patients about use of flavoured e-cigarettes.

  5. Clinical diagnostic potentials of thyroid ultrasonography and scintigraphy; An evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Torizuka, Tatsuo; Kasagi, Kanji; Hatabu, Hiroto; Misaki, Takashi; Iida, Yasuhiro; Konishi, Junji (Kyoto Univ. (Japan). Hospital); Endo, Keigo


    This prospective study was designed to evaluate the potential contributions of high resolution ultrasonography (US) and Tc-99m scintigraphy in the routine diagnosis of thyroid disease. The diagnostic impacts of US and Tc-99m scintigraphy results in 177 patients visiting our thyroid clinic were assessed and scored according to the following criteria: when the information provided by either test supported, confirmed or changed the initial clinical diagnosis, they received scores of 2, 3 and 4 respectively, while score 1 was given when the test itself was useless for the differential diagnosis. US identified focal lesions that both palpation and scintigraphy had failed to detect in 14 (12.1%) of 116 patients with diffuse thyroid diseases, suggesting the necessity of Hashimoto's thyroiditis, adenoma, adenocarcinoma and adenomatous goiter, and vice versa in the diagnosis of hyperthyroid and euthyroid Graves's diseases. Thus, the advantages of US over scintigraphy for morphological evaluation were confirmed. US was particularly useful for the differential diagnosis of adenomatous goiter from Hashimoto's thyroiditis or a single nodular disease. In contrast, scintigraphy gave functional images, being especially helpful for the differential diagnosis of thyrotoxicosis. (author).

  6. Exubera. Inhale therapeutic systems. (United States)

    Bindra, Sanjit; Cefalu, William T


    Inhale, in colaboration with Pfizer and Aventis Pharma (formerly Hoechst Marion Roussel; HMR), is developing an insulin formulation utilizing its pulmonary delivery technology for macromolecules for the potential treatment of type I and II diabetes. By July 2001, the phase III program had been completed and the companies had begun to assemble data for MAA and NDA filings; however, it was already clear at this time that additional data might be required for filing. By December 2001, it had been decided that the NDA should include an increased level of controlled, long-term pulmonary safety data in diabetic patients and a major study was planned to be completed in 2002, with the NDA filed thereafter (during 2002). US-05997848 was issued to Inhale Therapeutic Systems in December 1999, and corresponds to WO-09524183, filed in February 1995. Equivalent applications have appeared to date in Australia, Brazil, Canada, China, Czech Republic, Europe, Finland, Hungary, Japan, Norway, New Zealand, Poland and South Africa. This family of applications is specific to pulmonary delivery of insulin. In February 1999, Lehman Brothers gave this inhaled insulin a 60% probability of reaching market, with a possible launch date of 2001. The analysts estimated peak sales at $3 billion in 2011. In May 2000, Aventis predicted that estimated peak sales would be in excess of $1 billion. In February 2000, Merrill Lynch expected product launch in 2002 and predicted that it would be a multibillion-dollar product. Analysts Merril Lynch predicted, in September and November 2000, that the product would be launched by 2002, with sales in that year of e75 million, rising to euro 500 million in 2004. In April 2001, Merrill Lynch predicted that filing for this drug would occur in 2001. Following the report of the potential delay in regulatory filing, issued in July 2001, Deutsche Banc Alex Brown predicted a filing would take place in the fourth quarter of 2002 and launch would take place in the first

  7. Radionuclide Esophageal Transit Scintigraphy in Primary Hypothyroidism (United States)

    Khan, Shoukat H; Madhu, Vijay P; Rather, Tanveer A; Laway, Bashir A


    Background/Aims Esophageal dysmotility is associated with gastrointestinal dysmotility in various systemic and neuroregulatory disorders. Hypothyroidism has been reported to be associated with impaired motor function in esophagus due to accumulation of glycosaminoglycan hyaluronic acid in its soft tissues, leading to changes in various contraction and relaxation parameters of esophagus, particularly in the lower esophageal sphincter. In this study we evaluated esophageal transit times in patients of primary hypothyroidism using the technique of radionuclide esophageal transit scintigraphy. Methods Thirty-one patients of primary hypothyroidism and 15 euthyroid healthy controls were evaluated for esophageal transit time using 15–20 MBq of Technetium-99m sulfur colloid diluted in 10–15 mL of drinking water. Time activity curve was generated for each study and esophageal transit time was calculated as time taken for clearance of 90% radioactive bolus from the region of interest encompassing the esophagus. Esophageal transit time of more than 10 seconds was considered as prolonged. Results Patients of primary hypothyroidism had a significantly increased mean esophageal transit time of 19.35 ± 20.02 seconds in comparison to the mean time of 8.25 ± 1.71 seconds in healthy controls (P hypothyroidism may have subclinical esophageal dysmotility with prolonged esophageal transit time which can be reversible by thyroxine treatment. Prolonged esophageal transit time in primary hypothyroidism may correlate with serum thyroid stimulating hormone levels. PMID:27444283

  8. Aerosol challenge of calves with Haemophilus somnus and Mycoplasma dispar

    DEFF Research Database (Denmark)

    Tegtmeier, C.; Angen, Øystein; Grell, S.N.;


    The aim of the study was to examine the ability of Haemophilus somnus and Mycoplasma dispar to induce pneumonia in healthy calves under conditions closely resembling the supposed natural way of infection, viz, by inhalation of aerosol droplets containing the microorganisms. The infections were...... response, probably as a consequence of the natural non-specific local and systemic defence mechanisms acting in healthy calves....

  9. Aerosolized Antibiotics. (United States)

    Restrepo, Marcos I; Keyt, Holly; Reyes, Luis F


    Administration of medications via aerosolization is potentially an ideal strategy to treat airway diseases. This delivery method ensures high concentrations of the medication in the targeted tissues, the airways, with generally lower systemic absorption and systemic adverse effects. Aerosolized antibiotics have been tested as treatment for bacterial infections in patients with cystic fibrosis (CF), non-CF bronchiectasis (NCFB), and ventilator-associated pneumonia (VAP). The most successful application of this to date is treatment of infections in patients with CF. It has been hypothesized that similar success would be seen in NCFB and in difficult-to-treat hospital-acquired infections such as VAP. This review summarizes the available evidence supporting the use of aerosolized antibiotics and addresses the specific considerations that clinicians should recognize when prescribing an aerosolized antibiotic for patients with CF, NCFB, and VAP.

  10. Scintigraphy usefulness in the diagnosis of visceral candidiasis

    Energy Technology Data Exchange (ETDEWEB)

    Ythier, H.; Legghe, R.; Foucher, C.


    From the features of two cases, the authors stress the usefulness of the scintigraphy as regards to the diagnosis of visceral candidial abscesses. Such fungal localisations are not unfrequent, especially in immunodeficient patients (haematologic malignancies undergoing chemotherapy, lupus, serious visceral illness...). The positive diagnosis is uneasy because of non-specific clinical features and frequent negative blood cultures. Splenic localisation is the most likely. Citrate Gallium scintigraphy together with splenic labelled RBC scan enables us to give a precise view of the splenic involvment and even of the abdominal extension of the fungal abscess. From the literature review and these two cases, the excellent adequacy of the scintigraphy to the follow-up of systemic candidiasis is underlined and is compared to other usual morphological studies such as US scan and CT examination. In both cases, the diagnosis is fully confirmed by mycological examination.

  11. Plasma concentrations of disodium cromoglycate after various inhalation methods in healthy subjects (United States)

    Kato, Y; Muraki, K; Fujitaka, M; Sakura, N; Ueda, K


    Aims To compare the plasma concentrations of disodium cromoglycate (DSCG) following various inhalation procedures in healthy volunteers. Methods Nine healthy subjects inhaled 2 mg of aerosol, 20 mg of nebuliser solution only, 20 mg of nebuliser solution mixed with isotonic saline, or 20 mg of nebuliser solution mixed with saline and procaterol, a β2-adenoceptor agonist, on separate occasions 2–3 weeks apart. Plasma concentrations of DSCG were determined by high-performance liquid chromatography (h.p.l.c.). Results The peak plasma concentrations of DSCG were 1.5±0.7 (range 0.4–2.4) ng ml−1 in the aerosol group, 8.8±6.2 (range 5.3–19.9) ng ml−1 in the nebuliser solution only group, 17.2±16.3 (range 5.0–38.6) ng ml−1 in the nebuliser solution plus isotonic saline group, and 24.5±11.9 (range 10.2–44.9) ng ml−1 in the nebuliser solution plus saline and procaterol group. Thus subjects who used the nebuliser had markedly higher plasma concentrations of DSCG than subjects who used the aerosol inhaler. Conclusions These findings may have important implications for the evaluation of inhalation treatment with DSCG for bronchial asthma. PMID:10417491


    The quantification of inhaled aerosols could be improved if a more comprehensive assessment of their spatial distribution patterns among lung airways were obtained. A common technique for quantifying particle deposition in human lungs is with planar gamma scintigraphy. However, t...

  13. Bone scintigraphy for horses; Die Skelettszintigrafie beim Pferd

    Energy Technology Data Exchange (ETDEWEB)

    Jahn, Werner [Pferdeklinik Bargteheide (Germany)


    Scintigraphy (bone scan) is being used approximately since 1980 in the horse under general anaesthesia. With the construction of custom-made overhead gantries for gamma-cameras scintigraphy found widespread entry in big equine referral hospitals for bone-scanning of the standing horse. Indications for the use of a bone scan in the horse are inflammatory alterations in the locomotor apparatus. It is primarily used for diagnosis of lameness of unknown origin, suspect of stress fracture or hairline fracture and for horses with bad riding comfort with suspected painful lesions in the spine. (orig.)

  14. Gallium-67 scintigraphy in patients with hemochromatosis treated by deferoxamine

    Energy Technology Data Exchange (ETDEWEB)

    Nagamachi, Shigeki; Hoshi, Hiroaki; Jinnouchi, Seishi; Ono, Seiji; Watanabe, Katsushi


    Gallium scintigraphy was performed as an aid for determining the presence or absence of malignant neoplasm in two patients with hemochromatosis treated by deferoxamine. However, gallium scan images could not be obtained. So gallium scintigraphy was performed once more to investigate the cause of low activity. Both patients had heavy urinary excretion of gallium in the first 24 hrs after the injection, and activity was very low on the day of examination. This phenomenon may be attributed to the effect of deferoxamine which is highly bound to the gallium.

  15. Testis Scintigraphy in a Patient with Acute Lymphoblastic Leukemia

    Directory of Open Access Journals (Sweden)

    Mine Şencan Eren


    Full Text Available Acute lymphoblastic leukemia (ALL is a pediatric malignancy associated with remissions and relapses. Common relapsing sitesare meninges, testis and ovary. Testicular scintigraphy is a highly specific modality used mainly in the differential diagnosis of testicular torsion and epidydimitis/epidydimo-orchitis. There is only one interesting image on leukemic infiltration with scrotal scintigraphy in the literature. The aim of this case presentation is to report that although the scintigraphic appearance of testicular torsion was observed in a patient with the diagnosis of ALL, testicular ALL infiltration was revealed in pathologic examination.

  16. 亲水作用色谱-串联质谱法测定气雾剂给药后人血浆中的沙丁胺醇%Determination of salbutamol in human plasma after aerosol inhalation using hydrophilic interaction chromatography (HILIC)-tandem mass spectrometry

    Institute of Scientific and Technical Information of China (English)

    马敏康; 陈笑艳; 郭丽霞; 张逸凡; 钟大放


    目的:建立灵敏、快速的亲水作用色谱-串联质谱法(HILIC-MS/MS)测定给予沙丁胺醇气雾剂后人血浆中的沙丁胺醇.方法:以d9-沙丁胺醇为内标,血浆样品经乙腈蛋白沉淀后,采用LunaHILIC(100mm×3.0mm,3μm)色谱柱分离.流动相为乙腈(含0.1%甲酸)-5 mmol·L-1醋酸铵溶液(氨水调节pH为8.5)(93∶7,v/v),等度洗脱,进样体积2.0 μL,样品分析时间为3.5 min.采用电喷雾电离(ESI)源正离子模式、多反应监测(MRM),用于定量分析的离子反应分别为m/z 240→(148+ 166)(沙丁胺醇)和m/z 249→(149+ 167)(d9-沙丁胺醇).结果:沙丁胺醇定量方法的线性范围为11.7~2340pg·mL-1,定量下限达11.7 pg·mL-1,日内、日间精密度(RSD)均小于14.1%,准确度(RE)在-3.8%~0.8%之间.本法成功应用于健康受试者给予硫酸沙丁胺醇气雾剂200 μg后的药动学研究.结论:采用稳定同位素内标的HILIC-MS/MS法快速、灵敏和准确,适用于测定人血浆样品中的沙丁胺醇,可测定给药后24h的血浆浓度.%Objective:To develop and validate a sensitive and rapid hydrophilic interaction chromatography-tandem mass spectrometric (HILIC-MS/MS)method for the determination of salbutamol in human plasma after aerosol inhalation.Methods:Samples were prepared from plasma by protein precipitation using acetonitrile as the precipitation solvent; salbutamol and d9-salbutamol were separated on a Luna HILIC column (100 mm ×3.0 mm,3 μm) using acetonitrile(consisting of 0.1% formic acid)-5 mmol · L-1 ammonium acetate (pH 8.5 adjusted with ammonia water) (93∶7,v/v)as a mobile phase with isocratic elution.The injection volume was 2.0 μL,and a chromatographic total run time was 3.5 min.Mass spectrometry detection was conducted through electrospray ionization in positive ion multiple reaction monitoring modes,using the transitions of m/z 240 → (148 + 166) and m/z 249 →(149 + 167) for salbutamol and d9-salbutamol,respectively.Results:The method

  17. Myocardial scintigraphy - 25 years after start

    Energy Technology Data Exchange (ETDEWEB)

    Hoer, G.


    The development of myocardial scintigraphy (MS) reflects the clinical success of a representative procedure in nuclear medicine. Radiopharmaceuticals for visualizing vital and damaged myocardium and techniques (planar-qualitative, planar-quantitative, SPECT-qualitative-quantitative with comparative sensitivities) are briefly reviewed with the main focus on their clinical application in coronary (CHD) and noncoronary heart disease, where recent literature from the United States and Europe is considered. The limited value of MS for screening of CHD is outlined and its present and future role in detecting asymptomatic (silent) ischemia/infarction and asymptomatic patients at professional risk is stressed. The present state of MS in coronary heart disease is discussed for single and multivessel disease, previous infarction, and risk stratification (myocardial washout, pulmonary uptake, ischemic dilation, absent heart sign), reflecting the importance of the procedure in exercise-induced ischemia as well as in ischemia at rest for prognostication of the natural and therapeutic course, i.e., therapy control (angioplasty, bypass, lysis, cardiac drugs). More marginal but upcoming clinical indications are mentioned, such as progressive systemic sclerosis cardiac transplantation, pediatric cardiology, and problems of nephrology/urology. The ''normal'' values and the impact of digital radiology and of contrast cardiography are touched upon. Preliminary cases with /sup 111/In-antimyosin and /sup 99m/TC-Isonitriles are presented including correlative results between globla ejection fraction determination according to gated /sup 99m/Tc-isonitrile and conventional /sup 99m/Tc-erythrocyte ventriculogram (r=0,75; n=10).

  18. Fluticasone and Vilanterol Oral Inhalation (United States)

    ... the inhaler without using your dose, you will waste the medication. The counter will count down by ... it from the foil overwrap or after every blister has been used (when the dose indicator reads ...

  19. 吸入染毒纳米级炭黑气溶胶致小鼠肺炎性损伤的研究%Study on the pulmonary inflammatory effects induced by inhalation exposure to nanoscale carbon black aerosol in mice

    Institute of Scientific and Technical Information of China (English)

    李园园; 高峰; 解秋艳; 牛勇; 孟涛; 张荣; 陈雯; 郑玉新


    Objective To explore the carbon black induced effects of lung morphology and pro-inflammation in mice, based on the carbon black aerosol dynamic inhalation exposure model.Methods The carbon black aerosol generated by dynamic inhalation device was imported exposure chamber to mice. Scanning electron microscopy ( SEM) and transmission electron microscopy ( TEM) were used to observe the characters of carbon black.Sixty 9-week-old male BALB/c mice were randomly divided into two control groups, 7 d exposure group and 14 d exposure group.The numbers of four groups of animals were 15, respectively.Mice were exposed to carbon black in the inhalation chamber at ( 29.33 ±9.10 ) mg/m3 for 6 h/d for continuous exposure 7 d and 14 d, respectively.After 7 d and 14 d exposure, the mice were sacrificed after the last exposure for 24 h.Control mice were killed at 7 d and 14 d.The trachea, lungs, liver, kidneys, and spleen tissues were separated and weighted.Hematoxylin and eosin (HE) staining was used to observe pathological changes of lung by light microscopy.Pulmonary interleukin-8 ( IL-8) expression was analyzed by immunohistochemistry.Transmission electron microscopy was used to observe the ultra structure of lung tissue.Results After 14 d exposure carbon black, the lung coefficient was increased in exposure group compared with control (0.61 ±0.03 vs 0.79 ±0.06, t =6.26, P <0.01).The spleen coefficient were higher than control ( 0.39 ±0.04 vs 0.51 ±0.06, t =4.23, P <0.01 ) .Other organ coefficients were no significant difference between CB group and control group.Histopathology displayed carbon black particles were deposited in the alveoli and lung bronchial wall in 7 d and 14 d groups.The black carbon particles were deposited within the lung tissue of mice in 14 d group.There were cilia damage, serious damage to the alveolar wall, inflammatory cell infiltration and more hyperemia in 14 d group. Immunohistochemistry showed the level of IL-8 in 7 d(0.272 ±0.011) and 14 d

  20. Potent Inhalational Anesthetics for Dentistry. (United States)

    Satuito, Mary; Tom, James


    Nitrous oxide and the volatile inhalational anesthetics have defined anxiety and pain control in both dentistry and medicine for over a century. From curious experimentation to spectacular public demonstrations, the initial work of 2 dentists, Horace Wells and William T. G. Morton, persists to this day in modern surgery and anesthesia. This article reviews the history, similarities, differences, and clinical applications of the most popular inhalational agents used in contemporary dental surgical settings.

  1. Diagnostic value of MAG3 scintigraphy and DMSA scintigraphy in renal parenchyma damage and acute pyelonephritis of children

    Directory of Open Access Journals (Sweden)

    Buket Kilicaslan


    Results: The fever, elevated leukocytes, C-reactive protein and sedimentation rate were found statistically significant in the detection of pyelonephritis. However, these values were not significant statistically in the demonstration of the severity of parenchyma damage. In the detection of damage in renal parenchyma, MAG3 scintigraphy had a sensitivity of 32.5 % and a specificity of 98.1 %. Conclusion: MAG3 scintigraphy can not replace DMSA scan to determine the renal parenchyma damage in childhood. [Cukurova Med J 2016; 41(3.000: 464-471

  2. A metal aerosol holding chamber devised for young children with asthma

    DEFF Research Database (Denmark)

    Bisgaard, H


    The low tidal volume and flow in preschool children may reduce the efficiency of aerosol delivery from a pressurized metered-dose inhaler (pMDI) through a traditional holding chamber. A prototype small-volume steel holding chamber with two one-way valves was devised to prolong aerosol availability...... children less than 8 yrs of age. In vitro, the half life of aerosol disappearance in the steel prototype and the plastic Nebuhaler was > 30 s and 9 s, respectively. In vivo, the prototype delivered an age-independent mean dose of 38% of the nominal dose, and the Nebuhaler delivered an age-dependent mean...... be achieved by pMDI aerosol inhaled through a small-volume metal holding chamber with separate inlet and outlet valves and minimized dead space. This holding chamber would improve the possibilities of aerosol therapy for young children....

  3. Influence of breathing pattern on pulmonary aerosol deposition in patients with cystic fibrosis (CF): A pharmacokinetic approach

    NARCIS (Netherlands)

    Van Velzen, A.J.; Uges, J.W.F.; Le Brun, P.P.H.; Shahbabai, P.; Touw, D.J.; Heijerman, H.G.M.


    The therapeutic effect of inhaled antibiotics on lung infection in CF patients is dependent on the aerosol deposition achieved in the lungs. Objectives: To evaluate the influence of two breathing patterns on pulmonary aerosol deposition using pharmacokinetic parameters as surrogate for deposition. M

  4. Accuracy of Hepatobiliary Scintigraphy after Liver Transplantation and Liver Resection

    Directory of Open Access Journals (Sweden)

    Manuel Eckenschwiller


    Full Text Available Background and Aims. Biliary complications are the most frequent complications after common liver surgeries. In this study, accuracy of hepatobiliary scintigraphy (HBS and impact of hyperbilirubinemia were evaluated. Methods. Between November 2007 and February 2016, 131 patients underwent hepatobiliary scintigraphy after having liver surgery. 39 patients with 42 scans after LTX (n=13 or hepatic resection (n=26 were evaluated in the study; 27 were male, with mean age 60 years. The subjects underwent hepatobiliary scintigraphy with Tc-99m labeled Mebrofenin. The results were compared to ERCP as gold standard performed within one month after HBS. We calculated sensitivity, specificity, PPV, and NPV. We compared LTX patients to patients with other liver surgeries. Furthermore the influence of hyperbilirubinemia on HBS scans was evaluated. Results. HBS always provided the correct diagnosis in cases of bile leak in the liver-resected group (14/14. Overall diagnostic accuracy was 76% (19/25 in this group and 54% (7/13 in the LTX group. False negative (FN diagnoses occurred more often among LTX patients (p=0.011. Hyperbilirubinemia (>5 mg/dL significantly influenced the excretion function of the liver, prolonging HBS’s time-activity-curve (p=0.001. Conclusions. Hepatobiliary scintigraphy is a reliable tool to detect biliary complications, but reduced accuracy must be considered after LTX.

  5. Bone scintigraphy in costo-iliac impingement syndrome

    DEFF Research Database (Denmark)

    Madsen, Jan L


    fractures of several thoracic and lumbar vertebrae. She presented with progressive lower back pain and weight loss. Bone scintigraphy revealed increased uptake in the lower ribs on both sides compatible with the costo-iliac impingement syndrome. There were no signs of bone metastases....

  6. Hippuran renography and scintigraphy in children with myelomeningocele

    DEFF Research Database (Denmark)

    Thomsen, F; Thorup, Jørgen Mogens; Johnsen, A


    Long-term surveillance of the urinary tract is necessary in children with myelomeningocele and neurogenic bladder dysfunction. The results of Hippuran renography and scintigraphy were analyzed in 52 cases and compared to those of intravenous urography. In addition the radionuclide evaluation...

  7. Myopericarditis in acquired immunodeficiency syndrome diagnosed by gallium scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Cregler, L.L.; Sosa, I.; Ducey, S.; Abbey, L. (Bronx VA Medical Center, NY (USA))


    Myocarditis is among the cardiac complications of acquired immunodeficiency syndrome and, yet, is often not discovered until autopsy. Gallium scintigraphy has been employed in diagnosing this entity, but few data are available about its diagnostic accuracy and value. Here, the authors report two cases of myopericarditis as diagnosed by gallium scan.

  8. Clinical aspects of pulmonary radioactivity observed in radiocolloid liver scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    So, Young; Lee, Kang Wook; Lee, Heon Young; Lee, Won Woo [College of Medicine, Chungnam National Univ., Taejon (Korea, Republic of)


    We studied clinical aspects and courses of patients with pulmonary radioactivity on liver scintigraphy and speculated the mechanism of pulmonary uptake of radiocolloids. Forty-nine patients with pulmonary radioactivity were classified into 5 diseases groups-liver disease, infection, cancer, ischemic necrosis of liver, etc.- and their presence of absence of chronic liver disease (CLD), Child-Pugh class, serum levels of AST and ALT, results of follow-up liver scintigraphy and clinical course were checked. Of total 49 patients 25 had CLD; there were 23 liver disease patients, 16 infection patients, 7 advanced cancer patients, 2 ischemic necrosis of liver patients, and 1 hemolytic anemia patient. Reversible rise of serum levels of AST and ALT was observed in all patients with liver disease and ischemic necrosis of liver; on one-way ANOVA, these rise were statistically significant (p<0.01). Serum level of ALT of liver disease group patients without CLD was significantly higher than that of infection group patients without CLD (p<0.05). Among 17 patients who underwent follow-up liver scintigraphy, 13 showed no pulmonary radioactivity. Total 12 patients died during follow-up and most of them were terminal cancer patients or CLD patients of Child-Pugh class C. Pulmonary radioactivity of radiocolloid liver scintigraphy could be attributed to the mobilization of reticuloendothelial system (RES) cells by the activation of RES cells in severe infection and terminal cancer, and also by the extensive liver desctruction in liver diseases.

  9. Influência da variação dos decúbitos laterais na deposição pulmonar de aerossol Influence of change in lateral decubitus on pulmonary aerosol deposition

    Directory of Open Access Journals (Sweden)

    Luciana Alcoforado


    Full Text Available CONTEXTUALIZAÇÃO: O decúbito lateral apresenta as maiores mudanças em relação à ventilação pulmonar regional e é utilizado na rotina da fisioterapia respiratória. OBJETIVOS: Avaliar a influência do decúbito lateral na deposição pulmonar de radioaerossol durante a inalação em indivíduos jovens e relacionar os efeitos desse decúbito na rotina terapêutica. MÉTODOS: Em estudo randomizado em duas fases, foram incluídos oito homens voluntários saudáveis, com média de idade de 23,6±2,5 anos. Na primeira fase, inalou-se aerossol durante nove minutos no decúbito lateral sorteado e, após intervalo de cinco a sete dias, realizou-se a segunda fase. Para a cintilografia, inalou-se uma dose média de ácido dietilnotriaminopentacético marcado com tecnécio (DTPA - TC99m, com uma atividade radioativa em média de 25 milicuries (mCi. Ao final da inalação, as imagens foram adquiridas em câmaras de cintilação e analisadas por meio da divisão longitudinal e transversal dos pulmões em regiões de interesse (ROI. Para análise estatística, utilizou-se o teste t de Student pareado, considerando significativo pBACKGROUND: The lateral decubitus position leads to the greatest changes in regional pulmonary ventilation and is used in respiratory physical therapy routines. OBJECTIVES: To evaluate the influence of the lateral decubitus position on the pulmonary deposition of inhaled radioaerosol particles in young people and report the effects of the decubitus position on routine therapy. METHODS: Eight healthy male volunteers, mean age 23.6±2.5 years, were included in a randomized study in two phases. In the first phase, aerosol was inhaled for nine minutes in a randomly-selected lateral decubitus position and after an interval of 5 to 7 days, the second phase was conducted. Pulmonary scintigraphy was carried out by inhalation of 25 mCi of 99mTc-DTPA. Following inhalation, images were acquired with scintillation cameras and regions of

  10. Dose assessment for inhalation intakes in complex, energetic environments: experience from the US Capstone study. (United States)

    Guilmette, Raymond A; Parkhurst, Mary Ann


    Because of the lack of existing information needed to evaluate the risks from inhalation exposures to depleted uranium (DU) aerosols of US soldiers during the 1991 Persian Gulf War, the US Department of Defense funded an experimental study to measure the characteristics of DU aerosols created when Abrams tanks and Bradley fighting vehicles are struck with large-caliber DU penetrators, and a dose and risk assessment for individuals present in such vehicles. This paper describes some of the difficulties experienced in dose assessment modelling of the very complex DU aerosols created in the Capstone studies, e.g. high concentrations, heterogeneous aerosol properties, non-lognormal particle size distributions, triphasic in vitro dissolution and rapid time-varying functions of both DU air concentration and particle size. The approaches used to solve these problems along with example results are presented.

  11. Inhaled histamine increases the rate of absorption of sodium cromoglycate from the lung. (United States)

    Richards, R; Fowler, C; Simpson, S; Renwick, A G; Holgate, S T


    Since many factors may alter lung epithelial permeability (LEP) to water soluble molecules, the effect of histamine on the absorption and clearance of inhaled sodium cromoglycate was examined in seven mildly asthmatic patients with hyperresponsive airways and eight normal subjects. The subjects underwent histamine challenge to determine the provocative concentration of histamine required to reduce the forced expiratory volume in one second (FEV1) by 20% (PC20) from baseline. On two further visits they inhaled either saline placebo or histamine and 5 min later inhaled an aerosol containing sodium cromoglycate. Measurements of FEV1 were made and blood samples taken for analysis of plasma sodium cromoglycate concentration at intervals for 3 h. In the asthmatic group histamine inhalation led to a 24 +/- 4% reduction in FEV1 but had no effect on the normal subjects. When compared with inhaled saline, histamine increased the initial pulmonary absorption of SCG without influencing the total amount of drug absorbed in both asthmatics and normals. These observations suggest that the pharmacokinetics of inhaled sodium cromoglycate may be altered significantly by inflammatory mediators present at the site of drug absorption from the airways. PMID:1576060

  12. Does DSM-5 nomenclature for inhalant use disorder improve upon DSM-IV? (United States)

    Ridenour, Ty A; Halliburton, Amanda E; Bray, Bethany C


    Among drug classes, substance use disorder (SUD) consequent to using inhalants (SUD-I) has perhaps the smallest evidence base. This study compared DSM-IV versus DSM-5 nomenclatures, testing whether 4 traditional categories of inhalants (aerosols, gases, nitrites, solvents) are manifestations of a single pathology, obtaining item parameters of SUD-I criteria, and presenting evidence that SUD can result from using nitrites. An urban, Midwestern, community sample of 162 inhalant users was recruited. Participants were 2/3 male, nearly 85% White, and had a mean age of 20.3 years (SD = 2.4 years), spanning the ages of greatest incidence of SUD and slightly older than the primary ages of inhalants use initiation. Analyses consisted of bivariate associations, principle components analysis, and item response theory analysis. Validity was demonstrated for SUD-I consequent to each inhalant type as well as for aggregating all inhalant types into a single drug class. Results supported DSM-5 nomenclature over DSM-IV in multiple ways except that occurrence of diagnostic orphans was not statistically smaller using DSM-5. (PsycINFO Database Record

  13. 煤工尘肺雾化吸入α-糜蛋白酶和可必特的临床疗效观察%Clinical observation of α-chymotrypsin and Combivent by aerosol inhalation in treatment of coal workers' pneumoconiosis

    Institute of Scientific and Technical Information of China (English)

    王建国; 闫香果; 黄晓罡; 多彩虹; 蔡淑琪


    [Objective]To study the therapeutic effect of a-chymotiypsin and Combivent (M-receptor blocker combined with p2 receptor agonist) by aerosol inhalation in treatment of coal workers'pneumoconiosis (CWP) patients who were complicated with pulmonary dysfunction and had stable clinical symptoms. [Methods] Among 123 patients with pulmonary dysfunction, 115 patients had completed the trial, and they were randomly divided into the Combivent group (35 cases) , a-chymotrypsin group (48 cases) and the control group (32 cases). Three groups were treated with aerosol inhalation, Combivent group was given Combivent 2.5 ml with injection water 3.5 ml, a-chymotrypsin group was given a-chymotrypsin 4 000 U with injection water 6 ml, and the control group was given injection water 6 ml, for 5 days, twice daily, 15 min for every time. The pulmonary function (FEV-1, FVC, EVC, FEF25% -75% , MEF75% and MEF 50% ) , clinical symptom scores and six minute walking distance of patients before and after treatment were observed, the adverse reactions were recorded, and the compliance was evaluated. [ Results ] Before treatment, there was no significant difference in clinical symptom scores, six minute walking distance and pulmonary function indexes among three groups. After treatment, the clinical symptom scores in Combivent group were lower than those before treatment, and six minute walking distance was higher than that before treatment ( both P<0. 01). FEV-1, MEF75% and EVC had improved significantly compared with before treatment (all P<0.05). In a-chymotrypsin group, six minute walking distance was higher than that before treatment (P<0. 05) , there was no significant difference in clinical symptom scores, and EVC had improved significantly compared with before treatment (P<0.01). In the control group, there was no significant difference in clinical symptom scores and six minute walking distance between before and after treatment (both P>0. 05). FEF25% -75% (P<0. 01) and MEF

  14. Effects of tumors on inhaled pharmacologic drugs: I. Flow patterns. (United States)

    Martonen, T B; Guan, X


    Lung carcinomas are now the most common form of cancer. Clinical data suggest that tumors are found preferentially in upper airways, perhaps specifically at carina within bifurcations. The disease can be treated by aerosolized pharmacologic drugs. To enhance their efficacies site-specific drugs must be deposited selectively. Since inhaled particles are transported by air, flow patterns will naturally affect their trajectories. Therefore, in Part I of a systematic investigation, we focused on tumor-induced effects on airstreams, in Part II (the following article [p. 245]), particle trajectories were determined. To facilitate the targeted delivery of inhaled drugs, we simulated bifurcations with tumors on carinas using a commercial computational fluid dynamics (CFD) software package (FIDAP) with a Cray T90 supercomputer and studied effects of tumor sizes and ventilatory parameters on localized flow patterns. Critical tumor sizes existed; e.g., tumors had dominant effects when r/R > or = 0.8 for bifurcation 3-4 and r/R > or = 0.6 for bifurcation 7-8 (r = tumor radius and R = airway radius). The findings suggest that computer modeling is a means to integrate alterations to airway structures caused by diseases into aerosol therapy protocols.

  15. Capsaicin inhalation in man and the effects of sodium cromoglycate. (United States)

    Collier, J. G.; Fuller, R. W.


    The inhalation of capsaicin for 1 min, delivered as an aerosol by nebulising solutions of capsaicin at concentrations of 2-65 mumol 1(-1), caused dose-dependent coughing in normal volunteers and subjects with mild asthma. Capsaicin did not cause a feeling of breathlessness, and had no effect on forced expiratory volume in 1 s (FEV1) measured at the 1st, 5th and 9th min after the challenge was completed. Coughing started within seconds of applying the face mask, continued throughout the minute of capsaicin inhalation, and stopped within seconds of the mask being removed. In any one subject the number of coughs was reproducible when repeated on the same day or after an interval of several days. Experiments using local anaesthesia applied to the buccal mucosa or larynx indicated that the cough was caused by the stimulation of capsaicin-sensitive nerve terminals situated in the larynx. Cough response was not altered by the prior inhalation of sodium cromoglycate. PMID:6423016

  16. Zinc toxicology following particulate inhalation

    Directory of Open Access Journals (Sweden)

    Cooper Ross


    Full Text Available The current mini-review describes the toxic effects of zinc inhalation principally in the workplace and associated complications with breathing and respiration. The International Classification of Functioning, Disability and Health Criteria were used to specifically select articles. Most of the commercial production of zinc involves the galvanizing of iron and the manufacture of brass. The recommended daily allowance for adults is 15 mg zinc/day. Metal fume fever associated with inhalation of fumes of ZnO is characterized by fatigue, chills, fever, myalgias, cough, dyspnea, leukocytosis, thirst, metallic taste and salivation. ZnCl 2 inhalation results in edema in the alveolar surface and the protein therein the lavage fluid is elevated. Particular pathological changes associated with zinc intoxication include: pale mucous membranes; jaundice; numerous Heinz bodies; and marked anemia. Adequate ambient air monitors for permissible exposure limits, excellent ventilation and extraction systems, and approved respirators are all important in providing adequate protection.

  17. Clinical effectiveness of the Respimat® inhaler device in managing chronic obstructive pulmonary disease: evidence when compared with other handheld inhaler devices

    Directory of Open Access Journals (Sweden)

    et al


    only outcome for which data were available for meta-analysis was exacerbations, which were not significantly different (RR 1.20: P = 0.12. In addition, five trials with 2136 patients showed that there was no difference in risk of exacerbations or nasopharyngitis when Respimat was compared with all other handheld inhaler devices (RR 1.18: P = 0.13 and RR 1.33: P = 0.19, respectively. None of the clinical outcome measures reported was significantly different when the same, higher, or lower doses of medication were used in the inhaler devices being compared. Unfortunately, none of the included trials reported mortality as an outcome measure.Conclusions: Evidence from high-quality trials published to date suggests that the Respimat inhaler does not provide any additional clinical benefit to that provided by other inhaler devices in the management of COPD. Although in vitro studies have reported differences between the Respimat inhaler device and other handheld devices, we found no difference in any clinical outcome measures, including lung function and adverse events. Although recent reports have highlighted concerns of increased mortality with the Respimat inhaler device, none of the included trials reported mortality as an outcome. Only a small number of trials reported data that could be used in this systematic review, and a limited number of studies have been published that compare Respimat with other inhaler devices using the same drug and strength. Therefore, further trials comparing Respimat with other handheld inhaler devices using the same drug and dose are required before firm conclusions can be drawn. The concern with increased mortality with Respimat use should be investigated urgently.Keywords: Respimat, aerosol cloud, handheld inhaler devices, COPD

  18. Inhalant Abuse: Is Your Child at Risk? (United States)

    ... can be valuable as well. With help, your child can end inhalant abuse and learn how to make healthy choices for a lifetime. References Baydala L. Inhalant abuse. Paediatrics and Child Health. 2010;15:443. Results from the 2013 ...

  19. Cardiac amyloidosis detection with pyrophosphate-99mTc scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Souza, D.S.F.; Ichiki, W.A.; Coura Filho, G.B.; Izaki, M.; Giorgi, M.C.P.; Soares Junior, J; Meneghetti, J.C. [Universidade de Sao Paulo (FM/USP), SP (Brazil). Fac. de Medicina. Instituto do Coracao. Servico de Medicina Nuclear e Imagem Molecular


    Full text: Introduction: Amyloidosis is a rare disease, characterized by extracellular deposition of insoluble amyloid fibrils in organs and tissues. It may affect virtually any system, preferably heart, kidneys and liver. The cardiac involvement produces a spectrum of clinical features, usually with progressive dysfunction. Early diagnosis is important for institution of appropriate therapy. Case report: Male patient, 75 years old, with diagnosed congestive heart failure functional class III and Mobitz II second-degree atrial-ventricular block, was hospitalized for implantation of definitive cardiac pacemaker. Patient mentioned history of worsening effort dyspnoea over a one-month period, progressing to minimum effort, orthopnea, paroxysmal nocturnal dyspnoea and paroxysms of dry cough, and swelling of lower limbs. Echocardiography showed diffuse hypertrophy of left ventricle (LV), with systolic dysfunction due to diffuse hypokinesia and hyperrefringent aspect in the septum. It was questioned a cardiac infiltrating process. Cardiac amyloidosis was considered as a diagnostic hypothesis. The patient underwent a pyrophosphate-{sup 99m}Tc scintigraphy, which showed abnormal tracer uptake in the heart projection, with diffuse pattern on the left ventricle walls, compatible with the clinical suspicion cardiac amyloidosis, which was later confirmed by endomyocardial biopsy. Discussion: In this case report, the patient had clinical and other auxiliary examinations, such as electrocardiography and Doppler echocardiography, compatible with cardiac amyloidosis, which led to implementation with pyrophosphate-{sup 99m}Tc scintigraphy and later endomyocardial biopsy. Cardiac amyloidosis occurs in about half the cases of primary amyloidosis (AL) and is rare in secondary amyloidosis (AA). Its clinical presentation is polymorphic and it can be classified into four distinctive types: restrictive cardiomyopathy, systolic dysfunction, postural hypotension and conduction disorders

  20. Role of thallium-201 total-body scintigraphy in follow-up of thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Hoefnagel, C.A.; Delprat, C.C.; Marcuse, H.R.; de Vijlder, J.J.


    To evaluate the reliability of total-body scintigraphy using (/sup 201/Tl)chloride in postoperative follow-up of thyroid carcinoma, this procedure was performed in 326 patients after total thyroidectomy for thyroid carcinoma. The results were compared with those of 131I scintigraphy and thyroglobulin assays. /sup 201/Tl total-body scintigraphy was found to have the greatest sensitivity (94%), whereas /sup 131/I scintigraphy had the highest specificity (99%). It is shown that /sup 201/Tl total-body scintigraphy is a useful procedure in follow-up of thyroid cancer, however, the combination of parameters provides the greatest reliability. In medullary thyroid carcinoma, which is usually /sup 131/I negative, /sup 201/Tl total-body scintigraphy can be of great value for the localization of metastases which are indicated by elevated serum levels of calcitonin and carcinoembryonic antigen.

  1. The on-line analysis of aerosol-delivered pharmaceuticals via single particle aerosol mass spectrometry. (United States)

    Morrical, Bradley D; Balaxi, Maria; Fergenson, David


    The use of single particle aerosol mass spectrometry (SPAMS) was evaluated for the analysis of inhaled pharmaceuticals to determine the mass distribution of the individual active pharmaceutical ingredients (API) in both single ingredient and combination drug products. SPAMS is an analytical technique where the individual aerodynamic diameters and chemical compositions of many aerosol particles are determined in real-time. The analysis was performed using a Livermore Instruments SPAMS 3.0, which allowed the efficient analysis of aerosol particles with broad size distributions and can acquire data even under a very large particle load. Data similar to what would normally require roughly three days of experimentation and analysis was collected in a five minute period and analyzed automatically. The results were computed to be comparable to those returned by a typical Next Generation Impactor (NGI) particle size distribution experiment.

  2. Effects of inspiratory resistance, inhaled beta-agonists and histamine on canine tracheal blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, W.T.; Baile, E.M.; Brancatisano, A.; Pare, P.D.; Engel, L.A. (Dept. of Respiratory Medicine, Westmead Hospital, Westmead, NSW (Australia))


    Tracheobronchial blood flow is potentially important in asthma as it could either influence the clearance of mediators form the airways, thus affecting the duration and severity of bronchoispasm, or enhance oedema formation with a resultant increase in airflow obstruction. In anaesthetized dogs, spontaneously breathing via a tracheostomy, we investigated the effects of three interventions which are relevant to acute asthma attacks and could potentially influence blood flow and its distribution to the mucosa and remaining tissues of the trachea: (1) increased negative intrathoracic pressure swings (-25[+-]1 cmH[sub 2]O) induced by an inspiratory resistance; (2) variable inhaled doses of a beta-adrenoceptor-agonist (terbutaline); and (3) aerosolized histamine sufficient to produce a threefold increase in pulmonary resistance. Microspheres labelled with different radioisotopes were used to measure blood flow. Resistive breathing did not influence tracheobronchial blood flow. Following a large dose of terbutaline, mucosal blood flow (Qmb) increased by 50%. After inhaled histamine, Qmb reached 265% of the baseline value. We conclude that, whereas increased negative pressure swings do not influence tracheobronchial blood flow or its distribution, inhalation of aerosolized terbutaline, corresponding to a conventionally nebulized dose, increases mucosal blood flow. Our results also confirm that inhaled histamine, in a dose sufficient to produce moderate bronchoconstriction, increases tracheal mucosal blood flow in the area of deposition. (au).

  3. [Effect of mixing of fine carrier particles on dry powder inhalation property of salbutamol sulfate (SS)]. (United States)

    Iida, K; Leuenberger, H; Fueg, L M; Müller-Walz, R; Okamoto, H; Danjo, K


    The most commonly used formulations for dry powder inhalations are binary ordered mixes composed of micronized drugs and coarse carriers. An optimal dry powder aerosol formulation should possess an optimal inhalation property and a good flow property. These characteristics are especially important for a multidose dry powder inheler (DPI). In the present study, model powder blend were prepared consisting of synthesized sugar (different particle sized isomalt; IM-PF, IM-FS, IM-F) as a carrier and micronized salbutamol sulfate (SS). These ordered mixtures were aerosolized by the multidose JAGO DPI (SkyePharma AG) and in vitro deposition properties (fine particle fraction, FPF) were evaluated by a twin impinger (TI) at a flow rate of 60 l/min. The separation property between SS and carrier particles was investigated by the centrifuge method and air jet sieve (AJS) method. It was found that FPF decreased with increasing carrier particle size. However, a large carrier particle possesses a good flow property. Therefore, the effect of mixing of fine carrier particles (IM-PF) into the large carrier particles (IM-FS) on dry powder inhalation property was investigated. When the proportion of IM-PF (fine carrier) increase from 0% to 25% of the total carrier powder blend, the FPF also increases from 16.7% to 38.9%. It is concluded that the effect of mixing of fine carrier particles might be a suitable method for improving the dry powder inhalation properties.

  4. Age dependent systemic exposure to inhaled salbutamol

    DEFF Research Database (Denmark)

    Bønnelykke, Klaus; Jespersen, Jakob Jessing; Bisgaard, Hans


    AIMS: To determine the effect of age on systemic exposure to inhaled salbutamol in children. METHODS: Fifty-eight asthmatic children, aged 3-16 years, inhaled 400 microg of salbutamol from a pressurized metered dose inhaler with spacer. The 20 min serum profile was analyzed. RESULTS: Prescribing...

  5. A novel inhalation challenge set to study animal model of allergic alveolitis. (United States)

    Golec, Marcin; Skórska, Czesława; Lemieszek, Marta; Dutkiewicz, Jacek


    A novel inhalation challenge set for the study of experimental allergic alveolitis (hypersensitivity pneumonitis) in mice was designed. A finely dispersed aerosol of allergenic extract generated by the commercial ultrasonic nebulizer "TAJFUN MU1" (produced by Medbryt, Warsaw, Poland) was transported to the airtight inhalation chamber. In the chamber were placed 15 perforated containers made of transparent plastic, each containing one mouse. They were coupled in 3 units, each consisted of 5 containers. The constant flow of aerosol through the chamber was assured by commercial vacuum pump "PL 2/3" (AGA LABOR S.C., Warsaw, Poland). The applied set enabled the natural exposure of mice via the inhalation route to known quantities of allergen (usually microbial) suspended in saline, and then dispersed in form of fine aerosol by ultrasonic nebulizer. This method assures the penetration of allergen into the deep parts of lungs, alveoli and bronchioli. The detailed study of histopathological and biochemical changes in the lungs of exposed animals will be the subject of further publications. So far, the retention of endotoxin in the lungs of mice exposed to the extract of a Gram-negative bacterium Pantoea agglomerans and appearance of positive serologic reactions to this extract indicate the effectiveness of the method.

  6. TOMS Absorbing Aerosol Index (United States)

    Washington University St Louis — TOMS_AI_G is an aerosol related dataset derived from the Total Ozone Monitoring Satellite (TOMS) Sensor. The TOMS aerosol index arises from absorbing aerosols such...

  7. Iodine-123 scintigraphy in the evaluation of pediatric thyroid disorders: a ten year experience

    Energy Technology Data Exchange (ETDEWEB)

    Paltiel, H.J.; Summerville, D.A.; Treves, S.T. (Children' s Hospital, Boston, MA (United States). Div. of Nuclear Medicine Harvard Medical School, Boston, MA (United States))


    Between 1978 and 1987, we studied 280 children with iodine-123 ([sup 123]I) scintigraphy. Indications for scintigraphy included hypothyroidism, neck masses, hyperthyroidism, and miscellaneous reasons. Scintigraphy was helpful in distinguishing anatomic from functional causes of hyothyroidism. It reliably identified the location of the thyroid gland in patients with neck masses. The functional status of thyroid nodules was readily assessed and was important in directing further treatment. Scintigraphy added little to the management of children with post-irradiation hypothyroidism without a palpable nodule, patients with Hashimoto thyroiditis or Graves disease when the clinical diagnosis was straightforward. (orig./GDG).

  8. Hypertrophic osteoarthropathy manifested with isolated calcaneal periostitis in bone scintigraphy. (United States)

    Moralidis, Efstratios; Gerasimou, Georgios; Theodoridou, Athina; Hilidis, Ilias; Mylonaki, Efrosyni; Gotzamani-Psarrakou, Anna


    Hypertrophic osteoarthropathy (HOA) is an incompletely understood syndrome characterized by digital clubbing and periosteal proliferation of long bones and it is commonly associated with primary lung tumors. Bone scintigraphy is a sensitive method in detecting HOA and characteristic findings have been reported. We present the case of a man with newly diagnosed non-small cell lung cancer, unremarkable clinical examination and blood tests and no digital clubbing. During disease staging, however, bone scintigraphy showed intense calcaneal cortical proliferation bilaterally without involvement of other parts of the skeleton. Cortical reaction of both calcanei resolved significantly after chemotherapy. This case indicates that HOA may manifest with isolated calcaneal periostitis bilaterally, which is a new addition to the literature.

  9. ROC analysis of diagnostic performance in liver scintigraphy. (United States)

    Fritz, S L; Preston, D F; Gallagher, J H


    Studies on the accuracy of liver scintigraphy for the detection of metastases were assembled from 38 sources in the medical literature. An ROC curve was fitted to the observed values of sensitivity and specificity using an algorithm developed by Ogilvie and Creelman. This ROC curve fitted the data better than average sensitivity and specificity values in each of four subsets of the data. For the subset dealing with Tc-99m sulfur colloid scintigraphy, performed for detection of suspected metastases and containing data on 2800 scans from 17 independent series, it was not possible to reject the hypothesis that interobserver variation was entirely due to the use of different decision thresholds by the reporting clinicians. Thus the ROC curve obtained is a reasonable baseline estimate of the performance potentially achievable in today's clinical setting. Comparison of new reports with these data is possible, but is limited by the small sample sizes in most reported series.

  10. Parental Influence on Inhalant Use (United States)

    Baltazar, Alina; Hopkins, Gary; McBride, Duane; Vanderwaal, Curt; Pepper, Sara; Mackey, Sarah


    The purpose of this article is to examine the dynamics of the relationship between parents and their adolescent children and their association with lifetime and past-month inhalant usage. The population studied was seventh- through ninth-grade students in rural Idaho (N = 570). The authors found a small, but consistent, significant inverse…

  11. Toxic effect in the lungs of rats after inhalation exposure to benzalkonium chloride

    Directory of Open Access Journals (Sweden)

    Radosław Świercz


    Full Text Available Background: Benzalkonium chloride (BAC is a quaternary ammonium compound (QAC toxic to microorganisms. Inhalation is one of the major possible routes of human exposure to BAC. Materials and Methods: Experiments were performed on female Wistar rats. The rats were exposed to aerosol of BAC water solution at the target concentration of 0 (control group and 35 mg/m3 for 5 days (6 h/day and, after a 2-week interval, the animals were challenged (day 21 with BAC aerosol at the target concentration of 0 (control group and 35 mg/m3 for 6 h. Results: Compared to the controls, the animals exposed to BAC aerosol were characterized by lower food intake and their body weight was significantly smaller. As regards BAC-exposed group, a significant increase was noted in relative lung mass, total protein concentration, and MIP-2 in BALF both directly after the termination of the exposure and 18 h afterwards. Significantly higher IL-6 and IgE concentrations in BALF and a decrease in the CC16 concentration in BALF were found in the exposed group immediately after the exposure. The leukocyte count in BALF was significantly higher in the animals exposed to BAC aerosol compared to the controls. In the lungs of rats exposed to BAC the following effects were observed: minimal perivascular, interstitial edema, focal aggregates of alveolar macrophages, interstitial mononuclear cell infiltrations, thickened alveolar septa and marginal lipoproteinosis. Conclusion: Inhalation of BAC induced a strong inflammatory response and a damage to the blood-air barrier. Reduced concentrations of CC16, which is an immunosuppressive and anti-inflammatory protein, in combination with increased IgE concentrations in BALF may be indicative of the immuno-inflammatory response in the animals exposed to BAC aerosol by inhalation. Histopathological examinations of tissue samples from the BAC-exposed rats revealed a number of pathological changes found only in the lungs.

  12. Pulmonary scintigraphy in fibrosing mediastinitis due to histoplasmosis

    Energy Technology Data Exchange (ETDEWEB)

    Park, H.M.; Jay, S.J.; Brandt, M.J.; Holden, R.W.


    The pulmonary scintigraphic findings from our patients with fibrosing mediastinitis due to histoplasmosis are reported. The ventilation/perfusion (V/Q) mismatch mimicked pulmonary emboli. However, in these cases the chest radiographs and/or gallium-67 scintigraphy were abnormal, suggesting mediastinal or hilar disease. Awareness of the nonembolic conditions that can result in V/Q mismatches is important in the interpretation of lung scans.

  13. Pectus excavatum defect on liver-spleen scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Moreno, A.J.; Turnbull, G.L.; Parker, A.L.; Fredericks, P.


    A 58-year-old man with a pectus excavatum demonstrated a photon-deficient defect within the left lobe of the liver on liver-spleen scintigraphy using Tc-99m SCOL. Computed tomography of the liver clearly revealed the abnormal defect seen on the liver-spleen scan to be due to the pectus excavatum. This case confirms the impression that these skeletal aberrations may cause false-positive hepatic defects.

  14. Gastrointestinal Bleeding Scintigraphy in the Early 21st Century. (United States)

    Grady, Erin


    Gastrointestinal bleeding scintigraphy performed with (99m)Tc-labeled autologous erythrocytes or historically with (99m)Tc-sulfur colloid has been a clinically useful tool since the 1970s. This article reviews the history of the techniques, the different methods of radiolabeling erythrocytes, the procedure, useful indications, diagnostic accuracy, the use of SPECT/CT and CT angiography to evaluate gastrointestinal bleeding, and Meckel diverticulum imaging. The causes of pediatric bleeding are discussed by age.

  15. Aerosol Observation System (United States)

    Oak Ridge National Laboratory — The aerosol observation system (AOS) is the primary Atmospheric Radiation Measurement (ARM) platform for in situ aerosol measurements at the surface. The principal...

  16. Thallium-201 scintigraphy for bone and soft tissue tumors

    Energy Technology Data Exchange (ETDEWEB)

    Tokuumi, Yuji; Tsuchiya, Hiroyuki; Sunayama, Chiaki; Matsuda, Eizo; Asada, Naohiro; Taki, Junichi; Sumiya, Hisashi; Miyauchi, Tsutomu; Tomita, Katsuro [Kanazawa Univ. (Japan). School of Medicine


    This study was undertaken to assess the usefulness of thallium-201 scintigraphy in bone and soft tissue tumors. Pre-therapy scintigraphy was undertaken in a total of 136 patients with histologically confirmed diagnosis, consisting of 74 with malignant bone and soft tissue tumors, 39 with benign ones, 12 with diseases analogous to tumors, and 11 others. Thallium activity was graded on a scale of 0-4: 0=background activity, 1=equivocal activity, 2=definitive activity, but less than myocardium, 3=definite activity equal to myocardium, and 4=activity greater than myocardium. In the group of malignant tumors, thallium-201 uptake was found in 80%, although it was low for chondrosarcoma (2/8) and malignant Schwannoma (one/3). The group of benign tumors, however, showed it in only 41%, being restricted to those with giant cell tumors, chondroblastoma, fibromatosis, and osteoid osteoma. Thallium-201 uptake was also found in all 8 patients with metastatic tumors. In 23 patients undergoing thallium imaging before and after chemotherapy, scintigraphic findings revealed a high correlation with histopathological findings. Thus, thallium-201 scintigraphy may be potentially used to distinguish malignant from benign bone and soft tissue tumors, except for a few histopathological cases, as well as to determine loco-regional metastases and response to chemotherapy. (N.K.).

  17. Somatostatin receptor scintigraphy in patients with cat-scratch disease

    Energy Technology Data Exchange (ETDEWEB)

    Krause, R.; Schnedl, W.J.; Hoier, S. [Div. of Infectious Diseases, Dept. of Internal Medicine, Univ. Graz (Austria); Piswanger-Soelkner, C.; Lipp, R.W. [Div. of Nuclear Medicine, Dept. of Internal Medicine, Univ. Graz (Austria); Daxboeck, F. [Clinical Inst. for Hygiene and Medical Microbiology, Div. of Hospital Hygiene, Univ. of Vienna (Austria); Reisinger, E.C. [Div. of Infectious Diseases and Tropical Medicine, Dept. of Internal Medicine, Univ. Rostock (Germany)


    Aim: somatostatin receptor scintigraphy images various neoplastic, granulomatous, and auto-immun diseases. Cat-scratch disease in an infectious granulomatous disease usually affecting the lymphnodes. It is not known whether cat-scratch disease provides positive somatostatin receptor scintigrams. Patients, methods: twelve patients with lymphadenitis and suspected cat-scratch disease were investigated by immunofluorescence antibody testing and somatostatin receptor scintigraphy. Suppurated lymphnodes were extracted or drained and Bartonella henselae specific PCR was then performed. Results: eleven of 12 patients showed IgG antibodies against B. henselea. SRS showed positive scintigraphic results in 6 of 11 patients with CSD. B. henselae DNA was detected in tissue of lymphnodes from 4 of 5 patients with lymphnode extraction or lymphnode drainage. SRS demonstrated positive scintigrams in all patients with a positive PCR. In one patient with suspected CSD SRS was negative as well as antibody testing. Conclusion: somatostatin receptor scintigraphy correlated with positive Bartonella henselae specific PCR tests and positive Bartonella henselae specific antibody tests in patients with CSD. (orig.)

  18. Whole-body /sup 67/Ga scintigraphy in dermatomyositis

    Energy Technology Data Exchange (ETDEWEB)

    Hiraki, Yoshio; Okazaki, Yoshio; Murakami, Kiminori; Inoue, Nobuhiro; Noriyasu, Toshiaki; Takeda, Yoshihiro; Morimoto, Setsuo; Aono, Kaname


    The presence or absence of abnormal accumulation of gallium-67 in soft tissues was studied in 11 patients undergoing /sup 67/Ga scintigraphy out of 25 patients with dermatomyositis and polymyositis (DM-PM) who had visited our hospital during the period between July 1981 and March 1987 and met the diagnostic criteria of muscle biopsy, etc. A definite image of abnormal accumulation was obtained by /sup 67/Ga scintigraphy in 3 of the patients. Although the positive site tended to be in agreement with the site of muscular symptoms in the DM-PM active stage, the accumulation was not necessarily correlated with the variations in creatine phosphokinase. From these results, it seems necessary to keep in mind the possibility that gallium-67 may also accumulate abnormally in the soft tissue lesion owing to the pathogenic process specific to DM-PM when /sup 67/Ga scintigraphy is undertaken for the purpose of screening, etc., for complication by a malignant tumor in DM-PM patients

  19. Applicability of a modified MCE filter method with Button Inhalable Sampler for monitoring personal bioaerosol inhalation exposure. (United States)

    Xu, Zhenqiang; Xu, Hong; Yao, Maosheng


    In this study, a "modified" mixed cellulose ester (MCE) filter culturing method (directly placing filter on agar plate for culturing without extraction) was investigated in enumerating airborne culturable bacterial and fungal aerosol concentration and diversity both in different environments. A Button Inhalable Sampler loaded with a MCE filter was operated at a flow rate of 5 L/min to collect indoor and outdoor air samples using different sampling times: 10, 20, and 30 min in three different time periods of the day. As a comparison, a BioStage impactor, regarded as the gold standard, was operated in parallel at a flow rate of 28.3 L/min for all tests. The air samples collected by the Button Inhalable Sampler were directly placed on agar plates for culturing, and those collected by the BioStage impactor were incubated directly at 26 °C. The colony forming units (CFUs) were manually counted and the culturable concentrations were calculated both for bacterial and fungal aerosols. The bacterial CFUs developed were further washed off and subjected to polymerase chain reaction-denaturing gradient gel electrophoresis (DGGE) for diversity analysis. For fungal CFUs, microscopy method was applied to studying the culturable fungal diversity obtained using different methods. Experimental results showed that the performance of two investigated methods varied with sampling environments and microbial types (culturable bacterial and fungal aerosols). For bacterial aerosol sampling, both methods were shown to perform equally well, and in contrast the "modified" MCE filter method was demonstrated to enumerate more culturable fungal aerosols than the BioStage impactor. In general, the microbial species richness (number of gel bands) was observed to increase with increasing collection time. For both methods, the DGGE gel patterns were observed to vary with sampling time and environment despite of similar number of gel bands. In addition, an increase in sampling time from 20 to 30 min

  20. Impact of inhalation therapy on oral health

    Directory of Open Access Journals (Sweden)

    Navneet Godara


    Full Text Available Inhalation therapy has been employed as the mainstay of the treatment in chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD. Beta-2 agonists, anticholinergic bronchodilators, inhaled corticosteroids, and sodium cromoglycate are often used alone or in combination in an inhaled form. Studies have shown that inhaled drugs used in the treatment have some adverse effects on the oral health based on their dosage, frequency, and duration of use. Several oral conditions such as xerostomia, dental caries, candidiasis, ulceration, gingivitis, periodontitis, and taste changes have been associated with inhalation therapy. Since the prevalence of chronic respiratory diseases is rising, it is important to provide optimal oral care to the individuals receiving inhalation therapy. This article will review the influence of inhaled drugs on the oral health of individuals and adequate management and prevention of the same.

  1. Liposome Delivery Systems for Inhalation: A Critical Review Highlighting Formulation Issues and Anticancer Applications. (United States)

    Rudokas, Mindaugas; Najlah, Mohammad; Alhnan, Mohamed Albed; Elhissi, Abdelbary


    This is a critical review on research conducted in the field of pulmonary delivery of liposomes. Issues relating to the mechanism of nebulisation and liposome composition were appraised and correlated with literature reports of liposome formulations used in clinical trials to understand the role of liposome size and composition on therapeutic outcome. A major highlight was liposome inhalation for the treatment of lung cancers. Many in vivo studies that explored the potential of liposomes as anticancer carrier systems were evaluated, including animal studies and clinical trials. Liposomes can entrap anticancer drugs and localise their action in the lung following pulmonary delivery. The safety of inhaled liposomes incorporating anticancer drugs depends on the anticancer agent used and the amount of drug delivered to the target cancer in the lung. The difficulty of efficient targeting of liposomal anticancer aerosols to the cancerous tissues within the lung may result in low doses reaching the target site. Overall, following the success of liposomes as inhalable carriers in the treatment of lung infections, it is expected that more focus from research and development will be given to designing inhalable liposome carriers for the treatment of other lung diseases, including pulmonary cancers. The successful development of anticancer liposomes for inhalation may depend on the future development of effective aerosolisation devices and better targeted liposomes to maximise the benefit of therapy and reduce the potential for local and systemic adverse effects.

  2. Effects of background substraction on differential kidney function measured by static scintigraphy with DMSA and dynamic scintigraphy with MAG 3

    Energy Technology Data Exchange (ETDEWEB)

    Girotto, N.; Smokvina, A.; Grbac Ivankovic, S.; Licul, V. [Dept. of Nuclear Medicine, Clinical Hospital Centre Rijeka (Croatia)


    The aim of this study was to assess the influence of background subtraction (BS) on estimation of differential kidney function (DF) on the static scintigraphy with {sup 99m}Tc dimercaptosuccinic acid (DMSA) and dynamic scintigraphy with {sup 99m}Tc mercaptoacetyltriglicine (MAG3) and to establish possible differences between DF values estimated with these methods. Patients, methods: patients (n = 106) were selected among those scheduled to static and dynamic scintigraphies within 3 months, with no interim clinical and laboratory changes, regardless the kidney pathology. DF was estimated according to the uptake ratio method. Four background regions of interest (ROIs) were applied, identical for both studies, and DF values were recalculated after BS. The corrected values were compared to the values before correction, separately for DMSA and MAG3, and between the studies. The results showed that ROIs used introduce variable results for the same patients, predominantly when noncorrected DF values were < 45%. There were no significant differences between DF values (corrected and noncorrected) obtained from static and dynamic scintigraphy in all groups of patients. Since numerous reasons can bring to the errors in DF estimation when BS is used, the conclusions are that it would probably be more accurate to avoid BS, particularly when DF values are compared in a patient follow-up, and when kidney function is normal. BS should be used, but always in the same way, only when there is a significant difference in kidney size, or when DF is < 25%, since background activity is then considerable. MAG3 and DMSA can be equally used for DF estimation and their results compared in patient follow-up. (orig.)

  3. Decreased uptake with Sulesomab scintigraphy in a case of extra spinal osteitis;Hypofixation de la scintigraphie au sulesomab dans une osteite extrarachidienne

    Energy Technology Data Exchange (ETDEWEB)

    Ungureanu, C.M.; Angoue, O.; Blagosklonov, O.; Boulahdour, H. [CHU Jean-Minjoz, Service de medecine nucleaire, 25 - Besancon (France); Pauchot, J. [CHU Jean-Minjoz, Service de chirurgie orthopedique, traumatologique, plastique et readaptation fonctionnelle, 25 - Besancon (France)


    Decreased uptake of ischion osteitis with Sulesomab scintigraphy. We report the case of a 28-year-old man, who underwent surgery for a left gluteal muscle abscess. During the surgery multiple specimens were taken from the abscess and the left ischion. These specimens revealed a coagulase-negative Staphylococcus abscess and a coagulase-negative Staphylococcus ischion osteitis. Bone scintigraphy showed an increased uptake in the ischion, while Sulesomab scintigraphy demonstrated a decreased uptake in the same area. If a decreased uptake of Sulesomab has already been described in bone spine infection, it has not yet been described in extra spinal infectious osteitis, to our knowledge

  4. Depleted uranium contamination by inhalation exposure and its detection after approximately 20 years: implications for human health assessment. (United States)

    Parrish, Randall R; Horstwood, Matthew; Arnason, John G; Chenery, Simon; Brewer, Tim; Lloyd, Nicholas S; Carpenter, David O


    Inhaled depleted uranium (DU) aerosols are recognised as a distinct human health hazard and DU has been suggested to be responsible in part for illness in both military and civilian populations that may have been exposed. This study aimed to develop and use a testing procedure capable of detecting an individual's historic milligram-quantity aerosol exposure to DU up to 20 years after the event. This method was applied to individuals associated with or living proximal to a DU munitions plant in Colonie New York that were likely to have had a significant DU aerosol inhalation exposure, in order to improve DU-exposure screening reliability and gain insight into the residence time of DU in humans. We show using sensitive mass spectrometric techniques that when exposure to aerosol has been unambiguous and in sufficient quantity, urinary excretion of DU can be detected more than 20 years after primary DU inhalation contamination ceased, even when DU constitutes only approximately 1% of the total excreted uranium. It seems reasonable to conclude that a chronically DU-exposed population exists within the contamination 'footprint' of the munitions plant in Colonie, New York. The method allows even a modest DU exposure to be identified where other less sensitive methods would have failed entirely. This should allow better assessment of historical exposure incidence than currently exists.

  5. Depleted uranium contamination by inhalation exposure and its detection after {approx} 20 years: Implications for human health assessment

    Energy Technology Data Exchange (ETDEWEB)

    Parrish, Randall R. [Department of Geology, University of Leicester, University Road, Leicester LE1 7RH (United Kingdom); NERC Isotope Geosciences Laboratory, British Geological Survey, Keyworth, Notts, NG12 5GG (United Kingdom)], E-mail:; Horstwood, Matthew [NERC Isotope Geosciences Laboratory, British Geological Survey, Keyworth, Notts, NG12 5GG (United Kingdom); Arnason, John G. [Department of Earth and Atmospheric Sciences, University at Albany, 1400 Washington Avenue, Albany NY 12222 (United States); Chenery, Simon [British Geological Survey, Keyworth, Notts, NG12 5GG (United Kingdom); Brewer, Tim [Department of Geology, University of Leicester, University Road, Leicester LE1 7RH (United Kingdom); Lloyd, Nicholas S. [Department of Geology, University of Leicester, University Road, Leicester LE1 7RH (United Kingdom); British Geological Survey, Keyworth, Notts, NG12 5GG (United Kingdom); Carpenter, David O. [Institute for Health and the Environment, University at Albany, Five University Place, Room A217, Rensselaer, NY 12144-3456 (United States)


    Inhaled depleted uranium (DU) aerosols are recognised as a distinct human health hazard and DU has been suggested to be responsible in part for illness in both military and civilian populations that may have been exposed. This study aimed to develop and use a testing procedure capable of detecting an individual's historic milligram-quantity aerosol exposure to DU up to 20 years after the event. This method was applied to individuals associated with or living proximal to a DU munitions plant in Colonie New York that were likely to have had a significant DU aerosol inhalation exposure, in order to improve DU-exposure screening reliability and gain insight into the residence time of DU in humans. We show using sensitive mass spectrometric techniques that when exposure to aerosol has been unambiguous and in sufficient quantity, urinary excretion of DU can be detected more than 20 years after primary DU inhalation contamination ceased, even when DU constitutes only {approx} 1% of the total excreted uranium. It seems reasonable to conclude that a chronically DU-exposed population exists within the contamination 'footprint' of the munitions plant in Colonie, New York. The method allows even a modest DU exposure to be identified where other less sensitive methods would have failed entirely. This should allow better assessment of historical exposure incidence than currently exists.

  6. Protection against inhaled oxidants through scavenging of oxidized lipids by macrophage receptors MARCO and SR-AI/II

    DEFF Research Database (Denmark)

    Dahl, Morten; Bauer, Alison K; Arredouani, Mohamed


    Alveolar macrophages (AMs) express the class A scavenger receptors (SRAs) macrophage receptor with collagenous structure (MARCO) and scavenger receptor AI/II (SRA-I/II), which recognize oxidized lipids and provide innate defense against inhaled pathogens and particles. Increased MARCO expression......, consistent with SRA function in binding oxidized lipids. SR-AI/II-/- mice showed similar enhanced acute lung inflammation after beta-epoxide or another inhaled oxidant (aerosolized leachate of residual oil fly ash). In contrast, subacute ozone exposure did not enhance inflammation in SR-AI/II-/- versus SR-AI...

  7. Inhalation therapy in children with asthma. (United States)

    Brand, P L


    Current consensus guidelines advocate the use of inhalation therapy for all children with asthma. In this paper, the published evidence on technical and practical aspects of inhalation therapy in children with asthma is reviewed. For children under 6 yr of age, nebulizers and metered dose inhaler (MDI)/spacer combinations can be used. Nebulizers are cumbersome, bulky, and difficult to operate. They require technical and hygienic maintenance. A number of studies has shown that nebulizers are no more effective in delivering bronchodilator therapy than MDI/spacer combinations. Thus, for young children with asthma, MDI/spacer combinations are the device of choice for inhalation therapy. Due to static charge, the output from plastic spacers is lower than that from metal spacers. Static charge on plastic spacers can be reduced by washing the spacer in detergent and allow it to drip dry. Most children aged 6 yr or over can use a dry powder inhaler (DPI) reliably. Modern DPIs require relatively low inspiratory flow rates for proper operation. Lung deposition from the Turbuhaler is twice as high as that from the Diskus, but the former device is slightly more difficult to operate than the latter. Many children with asthma have a poor inhalation technique. Because a reliable inhalation technique is the key to successful inhalation therapy, inhalation technique should be instructed carefully and checked repeatedly in every asthmatic child using an inhaler device.

  8. Inhalation therapy in mechanical ventilation (United States)

    Maccari, Juçara Gasparetto; Teixeira, Cassiano; Gazzana, Marcelo Basso; Savi, Augusto; Dexheimer-Neto, Felippe Leopoldo; Knorst, Marli Maria


    Patients with obstructive lung disease often require ventilatory support via invasive or noninvasive mechanical ventilation, depending on the severity of the exacerbation. The use of inhaled bronchodilators can significantly reduce airway resistance, contributing to the improvement of respiratory mechanics and patient-ventilator synchrony. Although various studies have been published on this topic, little is known about the effectiveness of the bronchodilators routinely prescribed for patients on mechanical ventilation or about the deposition of those drugs throughout the lungs. The inhaled bronchodilators most commonly used in ICUs are beta adrenergic agonists and anticholinergics. Various factors might influence the effect of bronchodilators, including ventilation mode, position of the spacer in the circuit, tube size, formulation, drug dose, severity of the disease, and patient-ventilator synchrony. Knowledge of the pharmacological properties of bronchodilators and the appropriate techniques for their administration is fundamental to optimizing the treatment of these patients. PMID:26578139

  9. Passive inhalation of cannabis smoke

    Energy Technology Data Exchange (ETDEWEB)

    Law, B.; Mason, P.A.; Moffat, A.C.; King, L.J.; Marks, V.


    Six volunteers each smoked simultaneously, in a small unventilated room (volume 27 950 liter), a cannabis cigarette containing 17.1 mg delta 9-tetrahydrocannabinol (THC). A further four subjects - passive inhalers - remained in the room during smoking and afterwards for a total of 3 h. Blood and urine samples were taken from all ten subjects and analyzed by radioimmunoassay for THC metabolites. The blood samples from the passive subjects taken up to 3 h after the start of exposure to cannabis smoke showed a complete absence of cannabinoids. In contrast, their urine samples taken up to 6 h after exposure showed significant concentrations of cannabinoid metabolites (less than or equal to 6.8 ng ml-1). These data, taken with the results of other workers, show passive inhalation of cannabis smoke to be possible. These results have important implications for forensic toxicologists who are frequently called upon to interpret cannabinoid levels in body fluids.

  10. Failure of Gallium-67 scintigraphy to identify reliably noninfectious interstitial nephritis: concise communication

    Energy Technology Data Exchange (ETDEWEB)

    Graham, G.D.; Lundy, M.M.; Moreno, A.J.


    Gallium-67 scintigraphy has been reported to be useful in the diagnosis of noninfectious interstitial nephritis. We studied 12 patients with Ga-67 citrate that were diagnosed as having noninfectious interstitial nephritis on renal biopsy. Only seven of the twelve patients with interstitial nephritis on biopsy were scan-positive. Gallium-67 scintigraphy may not reliably identify noninfectious interstitial nephritis.

  11. Incidental detection of a bleeding gastrointestinal stromal tumor on Tc-99m red blood cell scintigraphy. (United States)

    Santhosh, Sampath; Bhattacharya, Anish; Gupta, Vikas; Singh, Rajinder; Radotra, Bishan Dass; Mittal, Bhagwant Rai


    The role of 99m-technetium labeled red blood cell (RBC) scintigraphy in acute gastro-intestinal bleed is well-established. The authors report a case of a bleeding gastrointestinal stromal tumor (GIST) incidentally discovered on Tc-99m RBC scintigraphy.

  12. Liposomal dry powders as aerosols for pulmonary delivery of proteins


    Lu, Dongmei; Hickey, Anthony J.


    The purpose of this research was to develop liposomal dry powder aerosols for protein delivery. The delivery of stable protein formulations is essential for protein subunit vaccine delivery, which requires local delivery to macrophages in the lungs. β-Glucuronidase (GUS) was used as a model protein to evaluate dry powder liposomes as inhaled delivery vehicles. Dimyristoyl phosphatylcholine:cholesterol (7∶3) was selected as the liposome composition. The lyophilization of liposomes, micronizati...

  13. Diffuse Hepatic and Spleen Uptake of Tc-99m MDP on Bone Scintigraphy Resembling Liver-Spleen Scintigraphy in a Patient of Plasma Cell Tumor. (United States)

    Ravanbod, Mohammad Reza; Nemati, Reza; Javadi, Hamid; Nabipour, Iraj; Assadi, Majid


    The present case demonstrates a diffuse intense hepatic and, to a lesser degree, spleen, Tc-99m MDP uptake on a routine bone scintigraphy resembling liver-spleen imaging. A 49-year-old female with a history of anaplastic plasma cell tumor and suffering from bone pain was referred for bone scintigraphy to evaluate possible bone metastases. The bone scintigraphy showed diffuse hepatic and spleen uptake of Tc-99m MDP resembling liver-spleen imaging. Furthermore, bone uptake of Tc-99m MDP was significantly diminished and there were no abnormal foci throughout the skeleton. The bone scintigraphy of the present case of an anaplastic plasma cell tumor suggests the possible presence of amyloidosis.

  14. Performances of scintigraphy in the primitive hyperparathyroidism and the associated thyroid pathologies; Performances de la scintigraphie dans les hyperparathyroidies primitives et les pathologies thyroidiennes associees

    Energy Technology Data Exchange (ETDEWEB)

    Monteil, J. [Service de Medecine Nucleaire, CHRU de Limoges (France); Mathonnet, M. [Service de Chirurgie Endocrinienne, CHRU de Limoges (France); Chianea, T. [Service de Medecine Nucleaire, CHRU de Limoges (France); Cubertafond, P. [Service de Chirurgie Endocrinienne, CHRU de Limoges (France); Piquet, L.; Rince, C.; Bournaud, E.; Verbeke, S.; Perdrisot, R.; Vandroux, J.C. [Service de Medecine Nucleaire, CHRU de Limoges (France)


    The data from scintigraphic and echographic exploration were compared to the surgery results in 32 patients (29 F and 3 M) presenting a primitive hyperparathyroidism, biologically proved, associated to a thyroid pathology. The scintigraphies were achieved with a collimator placed anteriorly and oblique-anteriorly, 4 h after injection by iodine 123 (7 MBq) and 30 min and 2 h after injection of {sup 99m}Tc-MIBI (555 MBq). The cervical echography and scintigraphy are independently interpreted. The results are given in a table containing the sensitivity, specificity, V.P.P. and V.P.N. for scintigraphy and echography, respectively. The association of a primary hyperparathyroidism and of a thyroid pathology (with a prevalence of 70% in our region) appears to affect less the performances of scintigraphy imaging than those of morphologic imaging

  15. Diagnostic value of (111)In-granulocyte scintigraphy in patients with fever of unknown origin

    DEFF Research Database (Denmark)

    Kjaer, Andreas; Lebech, Anne-Mette


    111In-granulocyte scintigraphy is often used as a diagnostic tool in patients with fever of unknown origin (FUO). However, its diagnostic performance has been studied in only a limited number of investigations, with most having been published more than 10 y ago; in addition, a broad range...... to select patients for scintigraphy to raise the diagnostic value. METHODS: For 31 patients with true FUO who underwent granulocyte scintigraphy at a third-line referral hospital between 1995 and 2000, the files and scintigraphy findings were reviewed retrospectively to test the ability of scintigraphy...... to identify infection or chronic inflammatory bowel disease as the cause of FUO. In addition, leukocyte counts and CRP values were recorded. RESULTS: Scintigrams were true-positive in 6 cases, false-positive in 4 cases, true-negative in 19 cases, and false-negative in 2 cases. Sensitivity was 75%, specificity...

  16. Technetium-99m labelled human immunoglobulin scintigraphy predicts rheumatoid arthritis in patients with arthralgia

    Energy Technology Data Exchange (ETDEWEB)

    Bois, M.H.W. de; Arndt, J.W.; Speyer, I.; Pauwels, E.K.J.; Breedveld, F.C.


    The ability of {sup 99m}Tc-IgG scintigraphy to predict the development of rheumatoid arthritis (RA) in 47 patients with arthralgia was investigated. {sup 99m}Tc-IgG scintigraphy and the serum test for rheumatoid factor (RF), measured at the beginning of a year long study, were compared for their ability to predict RA. During the study 8 patients developed RA. The specificity and positive predictive values of RF in predicting RA were 79% and 50% respectively, and for {sup 99m}Tc-IgG scintigraphy 97% and 88%. The sensitivity and negative predictive values of RF were 100% and of {sup 99m}Tc-IgG-scintigraphy 88% and 97%, respectively. In conclusion, {sup 99m}Tc-IgG scintigraphy has additional value to RF with respect to the prediction of the development of RA in patients with arthralgia. 27 refs.

  17. Place of the parathyroid scintigraphy in the preoperative detection of pathological parathyroid glands; Place de la scintigraphie parathyroidienne dans la detection preoperatoire des glandes parathyroides pathologiques

    Energy Technology Data Exchange (ETDEWEB)

    Rejeb, O.; Sellem, A.; Elbez, I.; Elkadri, N.; Hammami, H. [Service de medecine nucleaire, hopital militaire, Tunis, (Tunisia)


    The aim of this work is to evaluate the performances of the scintigraphy in the preoperative localization of pathological parathyroid glands. The parathyroid scintigraphy is a simple, non invasive technique that proved its performances in the preoperative detection of pathological parathyroid glands, mostly in the case of adenoma. It should be indicated in first intention in the topographic diagnosis of a hyperparathyroidism. (N.C.)

  18. Choice of the protocol for the realisation of the parathyroid scintigraphy; Choix du protocole pour la realisation de la scintigraphie parathyroidienne

    Energy Technology Data Exchange (ETDEWEB)

    Nacer-Khodja, M.; Medjaher, M.; Menad, F.; Haffaf, E.M. [Service de medecine nucleaire, hopital central de l' armee, Alger, (Algeria)


    The objective was to have the choice between the different protocols of parathyroid scintigraphy realisation, for a population having a nodule (or multi nodules) goiter with the non availability to iodine 123. The factorial analysis of a dynamic sequence with sestamibi {sup 99m}Tc is the most used protocol in first intention for a population with a nodule goiter in the lack of iodine 123 during the realization of a parathyroid scintigraphy. (N.C.)

  19. Specific diagnosis of neural crest tumours by MIBG scintigraphy; Diagnostic specifique des tumeurs issues de la crete neurale par la scintigraphie a la MIBG

    Energy Technology Data Exchange (ETDEWEB)

    Hoefnagel, C.A. [Het Nederlands Kanker Instituut, Amsterdam (Netherlands)


    MIBG scintigraphy has been used since 1981 as a diagnostic tool in pheochromocytoma and subsequently in a wide variety of neural crest tumors. The authors give the criteria for the choice between {sup 123}I and {sup 123}I-MIBG, remind drug interactions, report sensitivity and specificity values in main indications and discuss the relative merits of MIBG and pentetreotide scintigraphy. (author). 7 refs., 4 figs., 1 tab.

  20. Tailored Antibiotic Combination Powders for Inhaled Rotational Antibiotic Therapy. (United States)

    Lee, Sie Huey; Teo, Jeanette; Heng, Desmond; Ng, Wai Kiong; Zhao, Yanli; Tan, Reginald B H


    Respiratory lung infections due to multidrug-resistant (MDR) superbugs are on a global upsurge and have very grim clinical outcomes. Their MDR profile makes therapeutic options extremely limited. Although a highly toxic antibiotic, colistin, is favored today as a "last-line" therapeutic against these hard-to-treat MDR pathogens, it is fast losing its effectiveness. This work therefore seeks to identify and tailor-make useful combination regimens (that are potentially rotatable and synergistic) as attractive alternative strategies to address the rising rates of drug resistance. Three potentially rotatable ternary dry powder inhaler constructs (each involving colistin and 2 other different-classed antibiotics chosen from rifampicin, meropenem, and tigecycline) were identified (with distinct complementary killing mechanisms), coformulated via spray drying, evaluated on their aerosol performance using a Next-Generation Impactor and tested for their efficacies against a number of MDR pathogens. The powder particles were of respirable size (d50, 3.1 ± 0.3 μm-3.4 ± 0.1 μm) and predominantly crumpled in morphology. When dispersed via a model dry powder inhaler (Aerolizer(®)) at 60 L/min, the powders showed concomitant in vitro deposition with fine particle fractions of ∼53%-70%. All formulations were successfully tested in the laboratory to be highly effective against the MDR pathogens. In addition, a favorable synergistic interaction was detected across all 3 formulations when tested against MDR Pseudomonas aeruginosa.

  1. Gastric Reflux on Routine Tc-99m DISIDA hepatobiliary Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Wook; Lee, Heon Young [Chungnam National University College of Medicine, Daejeon (Korea, Republic of)


    Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid derivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m-DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows: 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenpscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

  2. Pethidine-augmented white cell scintigraphy in inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Davidson, J.; Poon, F.W.; Bessent, R.G.; Neilly, J.B.; Gray, H.W. [Dept. of Nuclear Medicine, Glasgow Royal Infirmary, Alexander Parade, Glasgow (United Kingdom)


    Technetium-99m hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO) white cell scintigraphy is invaluable for assessing the presence and extent of disease activity in patients with inflammatory bowel disease. Interpretation of images can be compromised by physiological excretion of tracer into the bowel via the biliary tree. This study assesses the effect of intravenous pethidine administered with the labelled white cells in an attempt to reduce the enterohepatic circulation of the tracer. Ninety-one subjects with proven or suspected inflammatory bowel disease were included in this study, all of whom underwent {sup 99m}Tc-HMPAO white cell scintigraphy. The control group of 50 subjects underwent the standard protocol for this study performed in our department. The other 41 subjects received an intravenous injection of 0.3 mg/kg of pethidine at the same time as re-injection of the labelled white cells. Images were graded using a five-point scale at both 1 and 2.5 h and categorised as positive, negative or non-diagnostic. Each scan was also assessed for the presence of a visible gall-bladder. The pethidine group had significantly fewer non-diagnostic scans than the control group (P=0.003), and significantly (P=0.001) more studies in which the gall-bladder was visualised. It is concluded that the use of pethidine appears to reduce biliary excretion of tracer during {sup 99m}Tc-HMPAO white cell scintigraphy. This may allow the delayed images, and early images with low-grade tracer uptake in the bowel, to be interpreted with greater confidence and thereby reduce the number of scans classified as non-diagnostic. (orig.)

  3. Deposition of graphene nanomaterial aerosols in human upper airways. (United States)

    Su, Wei-Chung; Ku, Bon Ki; Kulkarni, Pramod; Cheng, Yung Sung


    Graphene nanomaterials have attracted wide attention in recent years on their application to state-of-the-art technology due to their outstanding physical properties. On the other hand, the nanotoxicity of graphene materials also has rapidly become a serious concern especially in occupational health. Graphene naomaterials inevitably could become airborne in the workplace during manufacturing processes. The inhalation and subsequent deposition of graphene nanomaterial aerosols in the human respiratory tract could potentially result in adverse health effects to exposed workers. Therefore, investigating the deposition of graphene nanomaterial aerosols in the human airways is an indispensable component of an integral approach to graphene occupational health. For this reason, this study carried out a series of airway replica deposition experiments to obtain original experimental data for graphene aerosol airway deposition. In this study, graphene aerosols were generated, size classified, and delivered into human airway replicas (nasal and oral-to-lung airways). The deposition fraction and deposition efficiency of graphene aerosol in the airway replicas were obtained by a novel experimental approach. The experimental results acquired showed that the fractional deposition of graphene aerosols in airway sections studied were all less than 4%, and the deposition efficiency in each airway section was generally lower than 0.03. These results indicate that the majority of the graphene nanomaterial aerosols inhaled into the human respiratory tract could easily penetrate through the head airways as well as the upper part of the tracheobronchial airways and then transit down to the lower lung airways, where undesired biological responses might be induced.

  4. Usefulness of 99mTc MIBI scintigraphy in hyperparathyroidism. A retrospective analysis of the surgical patients

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Toshiyuki; Kobayashi, Shinya; Fujimori, Minoru [Shinshu Univ., Matsumoto, Nagano (Japan). School of Medicine] [and others


    In patients who receive surgery for primary or secondary hyperparathyroidism, preoperative diagnosis of the location of the parathyroid glands is important. Ninety-nine-m Technetium methoxyisobutylisonitrile (MIBI) accumulates in the pathological parathyroid. We used MIBI scintigraphy to detect diseased parathyroid glands in 20 patients with hyperparathyroidism, and successfully located the glands in seventeen. The accuracy of MIBI scintigraphy (100%) is significantly (p<0.05) better than that of Thallium-Technetium subtraction scintigraphy (56%). In a patient with hyperparathyroidism due to an ectopic parathyroid gland, MIBI scintigraphy showed accumulation in a mediastinal gland. MIBI scintigraphy is thus useful for gland location in hyperparathyroidism. (author)

  5. Effects of prolonged inhalation of silica and olivine dusts on immune functions in the mouse. [Escherichia coli; Staphylococcus

    Energy Technology Data Exchange (ETDEWEB)

    Scheuchenzuber, W.J.; Eskew, M.L.; Zarkower, A.


    Immunologic responses determined in Balb/c mice following intermittent silica or olivine inhalations for 150, 300, or 570 days. Animals dust-exposed for 570 days were tested immediately postexposure, while those exposed for 150 or 300 days were tested immediately or were rested for 30 or 150 days as a measure of possible recovery from effects of the dust inhalations. Silica inhalation suppressed the number of specific plaque-forming cells (PFC) in the spleen produced in response to aerosolized Escherichia coli bacteria. When tested after 570 days, silica inhalation also reduced the ability of alveolar marcophages to phagocytize Staphylococcus auerus in vitro. Olivine inhalation also suppressed splenic PFCs and alveolar macrophage phagocytosis, but to a lesser degree than silica. In animals tested after 570 days of dust exposure, it was determined that the ability to lyse allogeneic tumor cells in vitro was impaired by olivine slightly more than by silica, while antibody-dependent cell-mediated cytotoxic and mitogenic responses by splenic lymphocytes were unchanged by inhalation of either dust. The effects of increased exposure periods, and of recovery periods after exposure, were confounded by age-related immunologic changes which were present after the longer exposures.

  6. Radiography and scintigraphy in the assessment of early gonarthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Egund, N.; Frost, S.; Brismar, J.; Gustafson, T.

    The radiographic and scintigraphic appearances in early gonarthrosis were compared in 62 knees. Early femorotibial osteoarthrosis was found to be confined to one compartment (medial or lateral) of the joint. However, concomitant patellofemoral osteoarthrosis was common. /sup 99/Tc/sup m/-MDP scintigraphy was consistently positive when the joint space (femorotibial and patellofemoral) was reduced by 75% or more. Joint space narrowing by as much as 50% could be observed in a scintigraphically normal knee. The inconsistency between the radiologic and scintigraphic findings in the earliest stages of gonarthrosis points to the importance of appropriate radiographic technique.

  7. Cold metastases detected by bone scintigraphy in aggressive lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Martinez Carsi, C.; Perales Vila, A. [Servei de Medicina Nuclear de l`Hospital 9 d`Octubre, Valencia (Spain); Ruiz Hernandez, G. [Servei de Medicina Nuclear de l`Hospital Clinic Universitari, Valencia (Spain); Sanchez Marchori, C.; Oro Camps, J. [Servei de Traumatologia de l`Hospital 9 d`Octubre, Valencia (Spain)


    A case of a 55-year-old man was remitted to Traumatology Department to present back pain of two weeks of evolution. The results of bone scintigraphy and the patient`s evolution allowed the diagnosis. This case report and a literature review showed the importance of using a routine bone scan in diagnosis of bone metastases. (orig.) [Deutsch] Ein 55jaehriger Mann mit seit zwei Wochen andauernden lumbalen Schmerzen wurde in der orthopaedischen Klinik untersucht. Die Evolution des klinischen Bildes und eine Knochenszintigraphie ermoeglichten die Diagnose. Dieser klinische Fall und das wissenschaftliche Schrifttum zeigten, wie wichtig eine routinemaessige Knochenszintigraphie in der Diagnostik von Knochenmetastasen ist. (orig.)

  8. Three-phase bone scintigraphy in Pellegrini-Stieda disease. (United States)

    Liu, R S; Chou, C S; Yeh, S H


    In a patient with Pellegrini-Stieda disease, radiographs of the knees were unremarkable at the time the three-phase bone scintigraphy was abnormal. The results of follow-up radiographs three months later remained normal in the left knee, where local steroid injection was given, but revealed typical positive results in the right knee with no treatment. The three-phase bone scintigraphic pattern is rather typical and antedates the radiographic changes. Thus, the radionuclide technique would provide a useful procedure for the early diagnosis and treatment of Pellegrini-Stieda disease.

  9. Gated blood pool scintigraphy in patients with valvular heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Breuel, H.P.; Heusinger, J.H.; Hanisch, K.


    In 58 patients suffering from either stenosis or insufficiency of a single heart valve, gated blood pool scintigraphy was performed to determine the ejection fraction as well as the peak filling and peak ejection rates. It could be demonstrated that in patients with valvular disorders the ejection fraction was only moderately decreased, generally remaining in the lower reference range. The peak filling and ejection rates showed no pathologic changes with the exception of patients with aortic regurgitation where these rates were significantly decreased. Thus, the estimation of left ventricular peak filling and ejection rates may permit diagnosis of myocardial impairment in patients with valvular disease even under resting conditions.

  10. Cerebrospinal fluid scintigraphy in traumas to the nervous system

    Energy Technology Data Exchange (ETDEWEB)

    Nikolov, P. (Meditsinska Akademiya, Sofia (Bulgaria). Nauchen Inst. po Rentgenologiya i Radiobiologiya)


    The results of cerebrospinal fluid scintigraphy in 48 patients who had undergone trauma to the nervous system were studied. This method has gained rather insufficient acceptance in the diagnosis of this disease, in fact, it was helpful in detecting a high percentage of pathologic changes (80 per cent). Their type and localization structure was as follows: Narrowing of the spinal CSF space in 25 patients and 1 suspective; encephalonasal fistula - 3 patients; blockade of the lateral pathway of the CSF to the brain convexity - 4 patients; pathologic CSF circulation; dilatation of the convex brain cysterns with disturbances at the resorption site - 3 patients; combined spino-encephalic lesion - 1 patient.

  11. Hepatobiliary scintigraphy for early diagnosis of biliary atresia

    DEFF Research Database (Denmark)

    Brittain, Jane Maestri; Kvist, Nina; Johansen, Lars Søndergaard;


    INTRODUCTION: The aim of this study was to evaluate the validity of (99m)Technetium-trimethylbromo-iminodiacetic acid hepatobiliary scintigraphy (HS) for the diagnosis of biliary atresia (BA). METHODS: From January 2005 to December 2009, a total of 47 infants with conjugated hyperbilirubinaemia...... sensitivity and NPV prevent un-necessary surgery. Because of the low specificity of HS in diagnosing BA, it should be part of a multimodality imaging strategy when the result supports a clinical suspicion of BA. In cases with non-draining HS and normal GGTP blood levels, supplemental imaging modalities...

  12. Aerosol delivery from spacers in wheezy infants: a daily life study

    NARCIS (Netherlands)

    H.M. Janssens (Hettie); E.M. Heijnen; V.M. de Jong; W.C.J. Hop (Wim); W.P. Holland (Wim); J.C. de Jongste (Johan); H.A.W.M. Tiddens (Harm)


    textabstractThe aims of this study were to assess and compare dose delivery and dose variability of pressurized metered dose inhalers (pMDI)/spacers in wheezy infants in daily life and to investigate factors influencing aerosol delivery. In an open randomized crossover

  13. Airway responses to sulfate and sulfuric acid aerosols in asthmatics. An exposure-response relationship. (United States)

    Utell, M J; Morrow, P E; Speers, D M; Darling, J; Hyde, R W


    Epidemiologic studies support an association between elevated levels of sulfates and increased symptoms in asthmatics. To determine if these pollutants produce airway responses, 17 asthmatics inhaled the following sulfates: sodium bisulfate, ammonium sulfate, ammonium bisulfate (NH4HSO4), or sulfuric acid (H2SO4) aerosols with an aerodynamic diameter of 0.80 micron at concentrations of 100 micrograms/m3, 450 micrograms/m3, and 1,000 micrograms/m3. A sodium chloride (NaCl) aerosol of similar characteristics, administered by double-blind randomization, served as a control. Subjects breathed these aerosols for a 16-minute period via a mouthpiece. Deposition studies showed 54 to 65% retention of the inhaled aerosols. At the 1,000 micrograms/m3 concentration, the Threshold Limit Value for occupational exposure, H2SO4 and NH4HSO4 inhalation produced significant reductions in specific airway conductance (SGaw) (p less than 0.05) and forced expiratory volume in one second (p less than 0.01) compared with NaCl or pre-exposure values. At the 450 micrograms/m3 concentration, only H2SO4 inhalation produced a significant reduction in SGaw (p less than 0.01). At 100 micrograms/m3, a level 3 to 5 times greater than peak urban levels, no significant change in airway function occurred after any sulfate exposure. These data indicate that asthmatics demonstrate bronchoconstriction after brief exposure to common acidic sulfate pollutants.

  14. Use of inhaled corticosteroids in pediatric asthma

    DEFF Research Database (Denmark)

    Bisgaard, H


    Inhaled corticosteroids reduce asthma symptoms and exacerbations, improve lung function, and reduce airway inflammation and bronchial hyperreactivity more effectively than other treatments. However, inhaled corticosteroids may be unable to return lung function and bronchial hyperreactivity...... of the disease. Therefore, a change in treatment strategy toward earlier introduction of corticosteroids may impede airway remodeling, bronchial hyperreactivity, and airway damage. No other treatment has been found to affect the course of the disease. Systemic side-effects, particularly inhibition of growth...... in asthmatic children using inhaled corticosteroids, do not seem to be cause for concern. Growth retardation has not been reported when inhaled corticosteroid doses of

  15. Aerosol typing - key information from aerosol studies (United States)

    Mona, Lucia; Kahn, Ralph; Papagiannopoulos, Nikolaos; Holzer-Popp, Thomas; Pappalardo, Gelsomina


    Aerosol typing is a key source of aerosol information from ground-based and satellite-borne instruments. Depending on the specific measurement technique, aerosol typing can be used as input for retrievals or represents an output for other applications. Typically aerosol retrievals require some a priori or external aerosol type information. The accuracy of the derived aerosol products strongly depends on the reliability of these assumptions. Different sensors can make use of different aerosol type inputs. A critical review and harmonization of these procedures could significantly reduce related uncertainties. On the other hand, satellite measurements in recent years are providing valuable information about the global distribution of aerosol types, showing for example the main source regions and typical transport paths. Climatological studies of aerosol load at global and regional scales often rely on inferred aerosol type. There is still a high degree of inhomogeneity among satellite aerosol typing schemes, which makes the use different sensor datasets in a consistent way difficult. Knowledge of the 4d aerosol type distribution at these scales is essential for understanding the impact of different aerosol sources on climate, precipitation and air quality. All this information is needed for planning upcoming aerosol emissions policies. The exchange of expertise and the communication among satellite and ground-based measurement communities is fundamental for improving long-term dataset consistency, and for reducing aerosol type distribution uncertainties. Aerosol typing has been recognized as one of its high-priority activities of the AEROSAT (International Satellite Aerosol Science Network, initiative. In the AEROSAT framework, a first critical review of aerosol typing procedures has been carried out. The review underlines the high heterogeneity in many aspects: approach, nomenclature, assumed number of components and parameters used for the

  16. The possibility of evaluation on inflammatory change at respiratory tract in chronic bronchial asthma using {sup 67}Ga scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Fukumitsu, Nobuyoshi; Uchiyama, Mayuki; Mori, Yutaka; Kawakami, Kenji [Jikei Univ., Tokyo (Japan). School of Medicine; Kikuchi, Ichiro; Shimada, Takao


    {sup 67}Ga scintigraphy was performed in 17 patients with chronic bronchial asthma to grasp the inflammatory change of respiratory tract. On {sup 67}Ga scintigraphy, abnormal accumulations were detected on lung fields in 6 cases (35.3%) of 17 cases. In 5 cases of these 6 cases, the defect areas which were pointed out on {sup 81m}Kr ventilation scintigraphy were matched to the abnormal accumulation areas which were pointed out on {sup 67}Ga scintigraphy. In dynamics, the abnormal accumulation areas which were pointed out on {sup 67}Ga scintigraphy were matched to the defect areas which had been at all times pointed out on {sup 81m}Kr ventilation scintigraphy. {sup 67}Ga scintigraphy was expected to be one of index to grasp the inflammatory change of respiratory tract in patients with chronic bronchial asthma. (author)

  17. Influence of dose distribution on risk of lung cancer occurrence after actinide oxide inhalation; Influence de la distribution de dose sur le risque d'apparition de cancers pulmonaires apres inhalation d'oxydes d'actinides

    Energy Technology Data Exchange (ETDEWEB)

    Fritsch, P.; Dudoignon, N.; Guillet, K.; Rateau, G.; Delforge, J. [Lab. de Radiotoxicologie, CEA/DSV/DRR/SRCA, Bruyeres le Chatel (France)


    The aim of this work was to estimate risk of lung tumour occurrence after inhalation of actinide oxides from published studies and rat studies in progress. For the same delivered dose, the risk increases when homogeneity of irradiation increases, i.e., the number of particles deposited after inhalation increases (small particles and (or) low specific alpha activity). The dose-effect relationships reported appear linear up to a few gray, depending on the aerosol considered, and then the slope decreases. This slope, which corresponds with the risk, can vary over one order of magnitude de ending on the aerosol used. An effective threshold at about 1 Gy was not observed for the most homogeneous dose distributions. A dosimetric and biological approach is proposed to provide a more realistic risk estimate. (author)

  18. Aerosol administration of phospho-sulindac inhibits lung tumorigenesis. (United States)

    Cheng, Ka Wing; Wong, Chi C; Alston, Ninche; Mackenzie, Gerardo G; Huang, Liqun; Ouyang, Nengtai; Xie, Gang; Wiedmann, Timothy; Rigas, Basil


    Phospho-sulindac is a sulindac derivative with promising anticancer activity in lung cancer, but its limited metabolic stability presents a major challenge for systemic therapy. We reasoned that inhalation delivery of phospho-sulindac might overcome first-pass metabolism and produce high levels of intact drug in lung tumors. Here, we developed a system for aerosolization of phospho-sulindac and evaluated the antitumor efficacy of inhaled phospho-sulindac in an orthotopic model of human non-small cell lung cancer (A549 cells). We found that administration by inhalation delivered high levels of phospho-sulindac to the lungs and minimized its hydrolysis to less active metabolites. Consequently, inhaled phospho-sulindac (6.5 mg/kg) was highly effective in inhibiting lung tumorigenesis (75%; P sulindac suppressed lung tumorigenesis by (i) inhibiting EGF receptor (EGFR) activation, leading to profound inhibition of Raf/MEK/ERK and PI3K/AKT/mTOR survival cascades; (ii) inducing oxidative stress, which provokes the collapse of mitochondrial membrane potential and mitochondria-dependent cell death; and (iii) inducing autophagic cell death. Our data establish that inhalation delivery of phospho-sulindac is an efficacious approach to the control of lung cancer, which merits further evaluation.

  19. Inhaling β2 -agonist with heliox-driven in bronchial asthma

    Institute of Scientific and Technical Information of China (English)

    解立新; 刘又宁; 陈良安; 郝凤英; 金桂清; 赵会泽


    Objective To evaluate the effectiveness of a helium-oxygen mixture (79%He- 21%O2) as an aerosolizing compressed gas for β2-agonist therapy in patients with an asthma exacerbation. Methods Twenty-four patients in the outpatient department with a mild to moderate exacerbation of asthma were enrolled. The patients were randomly divided into an experimental group (13 cases) and a control group (11 cases). The experimental group inhaled Berotec with heliox-driven, and the control group inhaled Berotec with compressed air-driven. Eight hospitalized patients in the respiratory department with severe exacerbation of asthma were enrolled. The patients inhaled Berotec with heliox-driven or compressed air-driven in a random order.Results The results of spirometric parameters and arterial blood-gas analysis were measured. In the mild to moderate asthma patients, no statistical differences between the two groups for forced vital capacity (FVC), forced expired volume in one second (FEV1), and expiratory flow in 50% forced vital capacity (FEF50) were presented. But the severe patients showed significant differences between heliox-driven and compressed air-driven for FVC, FEV1, FEF50 and partial pressure of oxygen (PaO2). Conclusions Compared with the traditional inhalation of β2-agonist therapy using compressed air-driven, the method of inhaling β2-agonist with heliox-driven has more obvious benefits for those suffering from severe asthma. This is likely due to the cooperative effects between inhaling heliox on its physical gas properties and improving delivery of β2-agonist in the treatment of exacerbation of severe asthma.

  20. Inhalation anaesthetics and climate change

    DEFF Research Database (Denmark)

    Andersen, Mads Peter Sulbæk; Sander, S P; Nielsen, O J


    Although the increasing abundance of CO(2) in our atmosphere is the main driver of the observed climate change, it is the cumulative effect of all forcing agents that dictate the direction and magnitude of the change, and many smaller contributors are also at play. Isoflurane, desflurane......, and sevoflurane are widely used inhalation anaesthetics. Emissions of these compounds contribute to radiative forcing of climate change. To quantitatively assess the impact of the anaesthetics on the forcing of climate, detailed information on their properties of heat (infrared, IR) absorption and atmospheric...

  1. Indium-111-labeled platelet scintigraphy in carotid atherosclerosis

    Energy Technology Data Exchange (ETDEWEB)

    Minar, E.; Ehringer, H.; Dudczak, R.; Schoefl, R.J.; Jung, M.; Koppensteiner, R.; Ahmadi, R.; Kretschmer, G.


    We evaluated platelet accumulation in carotid arteries by means of a dual-radiotracer method, using indium-111-labeled platelets and technetium-99m-labeled human serum albumin, in 123 patients (92 men, 31 women; median age 60 years). Sixty patients had symptoms of transient ischemic carotid artery disease, and 63 patients with peripheral arterial occlusive disease served as controls. Antiplatelet treatment with acetylsalicylic acid was taken by 53 of the 123 patients. In 36 of the 60 symptomatic patients, platelet scintigraphy was repeated 3-4 days after carotid endarterectomy. Comparison of different scintigraphic parameters (platelet accumulation index and percent of the injected dose of labeled platelets at the carotid bifurcation) showed no significant differences between symptomatic and asymptomatic patients, and the severity of stenosis and the presence of plaque ulceration also had no influence on the parameters. There was no difference between patients with a short (less than 4 weeks) or long (greater than 4 weeks) interval from the last transient ischemic attack to scintigraphy and no difference between patients with or without antiplatelet treatment. Classifying the patients according to plaque morphology judged by high-resolution real-time ultrasonography also demonstrated no differences. No significant correlation was found between any scintigraphic parameter and other platelet function parameters such as platelet survival time, platelet turnover rate, and concentration of platelet-specific proteins. Quantification of platelet deposition after carotid endarterectomy in 36 patients demonstrated a significant increase of the median platelet accumulation index and the percent injected dose index.

  2. Antimyosin scintigraphy in patients with acquired and hereditary muscular disorders

    Energy Technology Data Exchange (ETDEWEB)

    Loefberg, M. (Dept. of Neurology, Helsinki Univ. Central Hospital (Finland)); Liewendahl, K. (Dept. of Clinical Chemistry, Helsinki Univ. Central Hospital (Finland)); Savolainen, S. (Dept. of Clinical Chemistry, Helsinki Univ. Central Hospital (Finland)); Nikkinen, P. (Dept. of Clinical Chemistry, Helsinki Univ. Central Hospital (Finland)); Lamminen, A. (Dept. of Radiology, Helsinki Univ. Central Hospital (Finland)); Tiula, E. (First Dept. of Internal Medicine, Helsinki Univ. Central Hospital (Finland)); Somer, H. (Dept. of Neurology, Helsinki Univ. Central Hospital (Finland))


    Scintigraphy with indium-111 labelled antimyosin has an established role in the evaluation of cardiac muscle damage. This antibody has been shown to cross-react with myosin in skeletal muscle. We therefore studied the usefulness of this method for the detection of skeletal muscle lesions in rhabdomyolysis, myositis and hereditary muscular dystrophies. All nine patients with rhabdomyolysis had focal uptake of antimyosin antibody which correlated with the clinical findings of soft tissue damage. However, a number of symptomless lesions were also detected by immunoscintigraphy. In rhabdomyolysis the target to non-target uptake ratios varied from 1.3 to 7.6. Diffuse uptake of antibody in skeletal muscle was observed in all three patients with polymyositis-dermatomyositis and in 12 out of 13 patients with muscular dystrophies. In myositis the intensity of antibody accumulation correlated reasonably well with the magnitude of oedema detected by magnetic resonance imaging (MRI). Most patients with Becker type or non-X-chromosomal muscular dystrophies showed slight or moderate uptake of antibody, mainly in the lower extremities. In these patients more antibody accumulated in the calves than in the thighs, whereas the findings on MRI were more prominent in the thighs than in the calves, presumably because of the better preserved muscle bulk in the calves. We conclude that antimyosin scintigraphy can be used for the detection of muscle lesions not only in acquired muscle diseases but also in hereditary muscular disorders, and that immunoscintigraphy provides information on muscle disease activity not obtainable with MRI. (orig.)

  3. Myocardial scintigraphy: methods and indications. Myokardszintigraphie: Methoden und Indikationen

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, W.H. (Herzzentrum Nordrhein-Westfalen, Bad Oeynhausen (Germany). Inst. fuer Nuklearmedizin)


    Myocardial scintigraphy comprises perfusion imaging using TI-201 or - more recently - Tc-99m-labeled compounds with high affinity to myocytes. Imaging with these agents has become an important procedure in the detection of coronary artery disease, particularly in patients with non-diagnostic stress-ECG, in the functional evaluation of coronary stenoses after angiographical documentation in order to meet the adequate therapy decision, in therapy monitoring and follow-up, in the post infarction assessment of myocardial viability and differentiation between severe ischemia and scar and, occasionally, in acute ischemia. The use of positron emitters does not offer significant advantages for mere perfusion imaging, but is indispensable for the scintigraphic investigation of certain aspects of myocardial metabolism, particularly for the differentiation of viable ischemic wall segments from irreversibly damaged tissue. Imaging of myocardial necrosis has been improved by the introduction of labeled antimyosin antibody fragments and offers a considerable clinical potential in the diagnosis of myocarditis and cardiac transplant rejection. Neurohumoral aspects are increasingly involved in our understanding of myocardial failure. Scintigraphy of innervation/neurotransmission contributes to the investigation of pathophysiological alterations in myocardial insufficiency and in heart transplants. (orig.).

  4. The usefulness of bone scintigraphy in SAPHO syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seok Tae; Sohn, Myung Hee [School of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)


    SAPHO syndrome is well known to various disease entities including synovitis, acne, pustulosis, hyperostosis and polyarthritis. The purpose of this study is to evaluate sicntigraphic findings and to compare with radiologic findings in SAPHO syndrome. Five patients (M:F=5:0, Age 22.8{+-}4.78 yrs) with SAPHO syndrome were enrolled in our study. All patients underwent whole-body bone scintigraphy with intravenous administration of 740 MBq of Tc-99m MDP. Among them, two patients were additionally perfomed SPECT of the spine to evaluate the location and extent of spinal lesion. All patients were demonstrated abnormal increased uptakes in sternoclavicular joint (SC), sacroiliac joint (SI), and small joints of both hands. Among them, three patients were bilateral involvement (3/5) and two were unilateral (2/5) in SC. Involvement of SI showed bilateral in four patients (4/5) and unilateral in one (1/5). SPECT images demonstrate that the lesion sites of the lumbar spine are more likely facet joints than vertebral bodies or pedicles. As SAPHO syndrome is the disease entity involved polyarticular joints with various dermatologic manifestations, the bone scintigraphy may be a very useful method to evaluate the location and extent of joint involvement, and to avoid inadequate surgical management or ineffective antibiotic treatment.

  5. Tc-99m HIG Scintigraphy in Detection of Active Inflammation in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Özhan Özdoğan


    Full Text Available Objective: The diagnosis of active inflammation in ankylosing spondylitis (AS is crucial for treatment to delay possible persistent deformities. There are no specific laboratory tests and imaging methods to clarify the active disease. We evaluated the value of Tc-99m human immunoglobulin (HIG scintigraphy in detection of active inflammation. Material and Methods: Twenty-nine patients were included. Tc-99m methylenediphosphonate bone (MDP and HIG scintigraphies were performed within 2-5 day intervals. Two control groups were constituted both for MDP and HIG scintigraphies. Active inflammation was determined clinically and by serologic tests. Both scintigraphies were evaluated visually. Sacroiliac joint index values (SII were calculated. Results: Active inflammation was considered in five (sacroiliitis in 2, sacroiliitis-spinal inflammation in 1, achilles tendinitis in 1, arthritis of coxafemoral joints in 1 patients. HIG scintigraphy demonstrated active disease in all 3 patients with active sacroiliitis. But, it was negative in the rest. The other 2 active cases were HIG negative. Right and left SII obtained from HIG scintigraphy was higher (p<0.05 in clinically active patients than inactive patients. There was not any significant difference between patients with inactive sacroiliitis and normal controls. Right and left SII obtained from bone scintigraphy was higher (p<0.05 in patient group than in control group. Conclusion: Clinically inactive AS patients, behave no differently than normal controls with quantitative sacroiliac joint evaluation on HIG scintigraphy. HIG scintigraphy may be valuable for evaluation of sacroiliac joints in patients with uncertain laboratory and clinical findings. (MIRT 2011;20:52-58

  6. Aerosol mobility size spectrometer (United States)

    Wang, Jian; Kulkarni, Pramod


    A device for measuring aerosol size distribution within a sample containing aerosol particles. The device generally includes a spectrometer housing defining an interior chamber and a camera for recording aerosol size streams exiting the chamber. The housing includes an inlet for introducing a flow medium into the chamber in a flow direction, an aerosol injection port adjacent the inlet for introducing a charged aerosol sample into the chamber, a separation section for applying an electric field to the aerosol sample across the flow direction and an outlet opposite the inlet. In the separation section, the aerosol sample becomes entrained in the flow medium and the aerosol particles within the aerosol sample are separated by size into a plurality of aerosol flow streams under the influence of the electric field. The camera is disposed adjacent the housing outlet for optically detecting a relative position of at least one aerosol flow stream exiting the outlet and for optically detecting the number of aerosol particles within the at least one aerosol flow stream.

  7. Towards the bioequivalence of pressurised metered dose inhalers 1: design and characterisation of aerodynamically equivalent beclomethasone dipropionate inhalers with and without glycerol as a non-volatile excipient. (United States)

    Lewis, D A; Young, P M; Buttini, F; Church, T; Colombo, P; Forbes, B; Haghi, M; Johnson, R; O'Shea, H; Salama, R; Traini, D


    A series of semi-empirical equations were utilised to design two solution based pressurised metered dose inhaler (pMDI) formulations, with equivalent aerosol performance but different physicochemical properties. Both inhaler formulations contained the drug, beclomethasone dipropionate (BDP), a volatile mixture of ethanol co-solvent and propellant (hydrofluoroalkane-HFA). However, one formulation was designed such that the emitted aerosol particles contained BDP and glycerol, a common inhalation particle modifying excipient, in a 1:1 mass ratio. By modifying the formulation parameters, including actuator orifice, HFA and metering volumes, it was possible to produce two formulations (glycerol-free and glycerol-containing) which had identical mass median aerodynamic diameters (2.4μm±0.1 and 2.5μm±0.2), fine particle dose (⩽5μm; 66μg±6 and 68μg±2) and fine particle fractions (28%±2% and 30%±1%), respectively. These observations demonstrate that it is possible to engineer formulations that generate aerosol particles with very different compositions to have similar emitted dose and in vitro deposition profiles, thus making them equivalent in terms of aerosol performance. Analysis of the physicochemical properties of each formulation identified significant differences in terms of morphology, thermal properties and drug dissolution of emitted particles. The particles produced from both formulations were amorphous; however, the formulation containing glycerol generated particles with a porous structure, while the glycerol-free formulation generated particles with a primarily spherical morphology. Furthermore, the glycerol-containing particles had a significantly lower dissolution rate (7.8%±2.1%, over 180min) compared to the glycerol-free particles (58.0%±2.9%, over 60min) when measured using a Franz diffusion cell. It is hypothesised that the presence of glycerol in the emitted aerosol particles altered solubility and drug transport, which may have

  8. Investigation of inhalation anthrax case, United States. (United States)

    Griffith, Jayne; Blaney, David; Shadomy, Sean; Lehman, Mark; Pesik, Nicki; Tostenson, Samantha; Delaney, Lisa; Tiller, Rebekah; DeVries, Aaron; Gomez, Thomas; Sullivan, Maureen; Blackmore, Carina; Stanek, Danielle; Lynfield, Ruth


    Inhalation anthrax occurred in a man who vacationed in 4 US states where anthrax is enzootic. Despite an extensive multi-agency investigation, the specific source was not detected, and no additional related human or animal cases were found. Although rare, inhalation anthrax can occur naturally in the United States.

  9. Pulmonary Biocompatibility Assessment of Inhaled Single-wall and Multiwall Carbon Nanotubes in BALB/c Mice*


    Ravichandran, Prabakaran; Baluchamy, Sudhakar; Gopikrishnan, Ramya; Biradar, Santhoshkumar; Ramesh, Vani; Goornavar, Virupaxi; Thomas, Renard; Wilson, Bobby L.; Jeffers, Robert; Hall, Joseph C.; Ramesh, Govindarajan T.


    With the widespread application of carbon nanotubes (CNTs) in diverse commercial processes, scientists are now concerned about the potential health risk of occupational exposures. In this study, CNT-induced pulmonary toxicity was investigated by exposing BALB/c mice to aerosolized single-wall (SW) CNT and multiwall (MW) CNT (5 μg/g of mice) for 7 consecutive days in a nose-only exposure system. Microscopic studies showed that inhaled CNTs were homogeneously distributed in the mouse lung. The ...

  10. Nanospray Drying as a Novel Technique for the Manufacturing of Inhalable NSAID Powders

    Directory of Open Access Journals (Sweden)

    Aquino Rita Patrizia


    Full Text Available The aim of this research was to evaluate the potential of the nanospray drier as a novel apparatus for the manufacturing of a dry powder for inhalation containing ketoprofen lysinate, a nonsteroidal anti-inflammatory drug able to control the inflammation in cystic fibrosis patients. We produced several ketoprofen lysinate and leucine powder batches by means of nanospray dryer, studying the influence of process parameters on yield, particle properties (size distribution and morphology, and, mainly, aerodynamic properties of powders. Micronized particles were prepared from different hydroalcoholic solutions (alcohol content from 0 to 30% v/v using ketoprofen in its lysine salt form and leucine as dispersibility enhancer in different ratios (from 5 to 15% w/w with a total solid concentration ranging from 1 to 7% w/v. Results indicated that the spray head equipped with a 7 µm nozzle produced powders too big to be inhaled. The reduction of nozzle size from 7 to 4 µm led to smaller particles suitable for inhalation but, at the same time, caused a dramatic increase in process time. The selection of process variables, together with the nozzle pretreatment with a surfactant solution, allowed us to obtain a free flowing powder with satisfying aerosol performance, confirming the usefulness of the nanospray drier in the production of powder for inhalation.

  11. Predicting the Fine Particle Fraction of Dry Powder Inhalers Using Artificial Neural Networks. (United States)

    Muddle, Joanna; Kirton, Stewart B; Parisini, Irene; Muddle, Andrew; Murnane, Darragh; Ali, Jogoth; Brown, Marc; Page, Clive; Forbes, Ben


    Dry powder inhalers are increasingly popular for delivering drugs to the lungs for the treatment of respiratory diseases, but are complex products with multivariate performance determinants. Heuristic product development guided by in vitro aerosol performance testing is a costly and time-consuming process. This study investigated the feasibility of using artificial neural networks (ANNs) to predict fine particle fraction (FPF) based on formulation device variables. Thirty-one ANN architectures were evaluated for their ability to predict experimentally determined FPF for a self-consistent dataset containing salmeterol xinafoate and salbutamol sulfate dry powder inhalers (237 experimental observations). Principal component analysis was used to identify inputs that significantly affected FPF. Orthogonal arrays (OAs) were used to design ANN architectures, optimized using the Taguchi method. The primary OA ANN r(2) values ranged between 0.46 and 0.90 and the secondary OA increased the r(2) values (0.53-0.93). The optimum ANN (9-4-1 architecture, average r(2) 0.92 ± 0.02) included active pharmaceutical ingredient, formulation, and device inputs identified by principal component analysis, which reflected the recognized importance and interdependency of these factors for orally inhaled product performance. The Taguchi method was effective at identifying successful architecture with the potential for development as a useful generic inhaler ANN model, although this would require much larger datasets and more variable inputs.

  12. Toxicokinetics of titanium dioxide (TiO2) nanoparticles after inhalation in rats. (United States)

    Pujalté, Igor; Dieme, Denis; Haddad, Sami; Serventi, Alessandra Maria; Bouchard, Michèle


    This study focused on the generation of aerosols of titanium dioxide (TiO2) nanoparticles (NPs) and their disposition kinetics in rats. Male Sprague-Dawley rats were exposed by inhalation to 15mg/m(3) of anatase TiO2 NPs (∼20nm) during 6h. Rats were sacrificed at different time points over 14days following the onset of inhalation. Ti levels were quantified by ICP-MS in blood, tissues, and excreta. Oxidative damages were also monitored (MDA). Highest tissue levels of Ti were found in lungs; peak values were reached only at 48h followed by a progressive decrease over 14days, suggesting a persistence of NPs at the site-of-entry. Levels reached in blood, lymph nodes and other internal organs (including liver, kidney, spleen) were circa one order of magnitude lower than in lungs, but the profiles were indicative of a certain translocation to the systemic circulation. Large amounts were recovered in feces compared to urine, suggesting that inhaled NPs were eliminated mainly by mucociliary clearance and ingested. TiO2 NPs also appeared to be partly transferred to olfactory bulbs and brain. MDA levels indicative of oxidative damage were significantly increased in lungs and blood at 24h but this was not clearly reflected at later times. Translocation and clearance rates of inhaled NPs under different realistic exposure conditions should be further documented.

  13. I-Metaiodobenzylguanidine Myocardial Scintigraphy in Lewy Body-Related Disorders: A Literature Review

    Directory of Open Access Journals (Sweden)

    Eun Joo Chung


    Full Text Available Lewy body-related disorders are characterized by the presence of Lewy bodies and Lewy neurites, which have abnormal aggregations of α-synuclein in the nigral and extranigral areas, including in the heart. 123I-metaiodobenzylguanidine (MIBG scintigraphy is a well-known tool to evaluate cardiac sympathetic denervation in the Lewy body-related disorders. MIBG scintigraphy showed low uptake of MIBG in the Lewy body-related disorders, including Parkinson’s disease, dementia with Lewy bodies, pure autonomic failure and rapid eye movement sleep behavior disorder. This review summarizes previous results on the diagnostic applications of MIBG scintigraphy in Lewy body-related disorders.

  14. (99m)Tc-methylene diphosphonate bone scintigraphy findings in posttransplant distal limb syndrome. (United States)

    Derlin, Thorsten; Busch, Jasmin D; Bannas, Peter


    We report a case of posttransplant distal limb syndrome (PTDLS) representing a rare complication in kidney transplant recipients characterized by a pain syndrome of the distal extremities. A 68-year-old man with a history of kidney transplantation presented with symmetrical and incapacitating pain in the feet and knees and underwent whole-body Tc-methylene diphosphonate (MDP) scintigraphy for further evaluation. Planar scintigraphy demonstrated marked tracer uptake in the distal femoral and tibial epiphyses, and magnetic resonance imaging showed corresponding osteoedema. Tc-MDP scintigraphy is a valuable tool for evaluation of the etiology of musculoskeletal pain and may demonstrate typical findings in case of PTDLS.

  15. Toxicological Assessment of Noxious Inhalants

    Directory of Open Access Journals (Sweden)

    Kleinsasser, N. H.


    Full Text Available In the past centuries mankind has been exposed to various forms of air pollution not only at his occupational but also in his social environment. He mainly gets exposed with these pollutants through the respiratory organs and partially absorbs them into the body. Many of these airborne substances can be harmful for humans and some of them may account for tumorigenic effects.The following essay describes the main features of toxicological assessment of inhalative environmental and workplace xenobiotics. The essay also explains relevant characteristics and limit values of noxious compounds and gases and depicts modern testing methods. To this end, emphasis is given on methods characterizing the different stages of tumorigenic processes. Various test systems have been developed which can be used in vivo, ex vivo or in vitro. They are to a great part based on the evidence of changes in DNA or particular genes of cells. Among others they have highlighted the impact of interindividual variability on enzymatic activation of xenobiotics and on susceptibility of the host to tumor diseases.Unfortunately, for many inhalative environmental noxious agents no sufficient risk profiles have been developed. The completion of these profiles should be the goal of toxicological assessment in order to allow reasonable socioeconomic or individual-based risk reduction.

  16. Aerosol phage therapy efficacy in Burkholderia cepacia complex respiratory infections. (United States)

    Semler, Diana D; Goudie, Amanda D; Finlay, Warren H; Dennis, Jonathan J


    Phage therapy has been suggested as a potential treatment for highly antibiotic-resistant bacteria, such as the species of the Burkholderia cepacia complex (BCC). To address this hypothesis, experimental B. cenocepacia respiratory infections were established in mice using a nebulizer and a nose-only inhalation device. Following infection, the mice were treated with one of five B. cenocepacia-specific phages delivered as either an aerosol or intraperitoneal injection. The bacterial and phage titers within the lungs were assayed 2 days after treatment, and mice that received the aerosolized phage therapy demonstrated significant decreases in bacterial loads. Differences in phage activity were observed in vivo. Mice that received phage treatment by intraperitoneal injection did not demonstrate significantly reduced bacterial loads, although phage particles were isolated from their lung tissue. Based on these data, aerosol phage therapy appears to be an effective method for treating highly antibiotic-resistant bacterial respiratory infections, including those caused by BCC bacteria.

  17. Inhalant Dependence and its Medical Consequences

    Directory of Open Access Journals (Sweden)

    Mehmet Hamid Boztaş


    Full Text Available The term of inhalants is used for matters easily vapors. Inhalants are preferred for rapid, positive reinforcement and mild high effects. Products including inhalants are cheap, accessible, legal substances and are prevalently used in community. The prevalence of inhalant use in secondary schools in Turkey is about 5.1%. Inhalant substance dependence is generally observed within 14-15 age group. Age at first use could be as low as 5 to 6 years of age. Substance dependence is more probable in adults working in substance existing places. Inhalant usage is common in disadvantaged groups, children living in street, people with history of crimes, prison, depression, suicide, antisocial attitudes and conflict of family, history of abuse, violence and any other drug dependence and isolated populations. Inhalants are absorbed from lungs, after performing their quick and short effect metabolized by cytochrom P450 enzyme system except inhalant nitrites group which has a depressing effect like alcohol. In chronic use general atrophy, ventricular dilatation and wide sulcus were shown in cerebrum, cerebellum and pons by monitoring brain. Defects are mostly in periventricular, subcortical regions and in white matter. Demyelinization, hyperintensity, callosal slimming and wearing off in white and gray matter margins was also found. Ravages of brain shown by brain monitorisation are more and serious in inhalant dependence than in other dependences. It is important to decrease use of inhalants. Different approaches should be used for subcultures and groups in prevention. Prohibiting all the matters including inhalant is not practical as there are too many substances including inhalants. Etiquettes showing harmful materials can be used but this approach can also lead the children and adolescents recognize these substances easily.. Despite determintal effects of inhalant dependence, there are not yet sufficient number of studies conducted on prevention and

  18. Aerosol impacts on climate and environment over East Asia (United States)

    Nakata, M.; Sano, I.; Mukai, S.


    It is well known that the aerosol distribution in East Asia is complex due to both the increasing emissions of the anthropogenic aerosols associated with economic growth and the behavior of natural dusts. Therefore, detailed observations of atmospheric particles in East Asian are important. It is concerned about the change of concentration of aerosols causes various effects on the climate by directly and indirectly modifying the optical properties and lifetimes of cloud. In addition to radiation budget change, aerosol has a significant potential to change cloud and precipitation. These circulation fields change influence on emission of natural aerosols such as dust aerosols and sea salt aerosols. Also, air pollution in megacities in East Asia has become a serious problem. Especially problematic are fine particles called PM2.5, whose diameter is 2.5 mm or less. Particulate matter (PM) pollution as indicated by high PM2.5 readings will cause a spike in the mortality rate of patients suffering from heart and lung diseases. Because fine particles are much smaller than inhalable coarse particles, the can penetrate deeper into the lungs and cause more severe effects on human health. Anthropogenic sources of PM2.5 include automobiles, factories, coal-burning power plants, and heaters in homes. It is well known that the size of dust particles decreases during long-range transport via westerly winds, and the resulting dust storms can contain high concentrations of fine particles. Accordingly, PM2.5 concentrations correspond well to both anthropogenic and dust aerosols. This work intends to investigate impacts of aerosol on regional climate change and environment over East Asia using observations and model simulations.

  19. Inhalants (United States)

    ... area of the brain that gets damaged. The hippocampus, for example, is responsible for memory, so someone ... stimulants like cocaine and narcotics like heroin or morphine can kill you immediately. The old standbys like ...

  20. Inhalants (United States)

    ... and Over-the-Counter Medications Stimulant ADHD Medications: Methylphenidate and Amphetamines Synthetic Cannabinoids Synthetic Cathinones ("Bath Salts") Effects of Drug Abuse Comorbidity: Addiction and Other Mental Disorders Drug Use ...

  1. Inhalants (United States)

    ... Science Adolescent Brain Comorbidity College-Age & Young Adults Criminal Justice Drugged Driving Drug Testing Drugs and the ... Health Effects Statistics and Trends Swipe left or right to scroll. Monitoring the Future Study: Trends in ...

  2. Radiation-dose estimates and hazard evaluations for inhaled airborne radionuclides. Annual progress report, July 1981-June 1982

    Energy Technology Data Exchange (ETDEWEB)

    Mewhinney, J.A.


    The objective was to conduct confirmatory research on aerosol characteristics and the resulting radiation dose distribution in animals following inhalation and to provide prediction of health consequences in humans due to airborne radioactivity which might be released in normal operations or under accident conditions during production of nuclear fuel composed of mixed oxides of U and Pu. Four research reports summarize the results of specific areas of research. The first paper details development of a method for determination of specific surface area of small samples of mixed oxide or pure PuO/sub 2/ particles. The second paper details the extension of the biomathematical model previously used to describe retention, distribution and excretion of Pu from these mixed oxide aerosols to include a description of Am and U components of these aerosols. The third paper summarizes the biological responses observed in radiation dose pattern studies in which dogs, monkeys and rate received inhalation exposures to either 750/sup 0/C heat treated UO/sub 2/ + PuO/sub 2/, 1750/sup 0/C heat-treated (U,Pu)O/sub 2/ or 850/sup 0/C heat-treated pure PuO/sub 2/. The fourth paper described dose-response studies in which rats were exposed to (U,Pu)O/sub 2/ or pure PuO/sub 2/. This paper updates earlier reports and summarizes the status of animals through approximately 650 days after inhalation.

  3. Estimation of the Human Extrathoracic Deposition Fraction of Inhaled Particles Using a Polyurethane Foam Collection Substrate in an IOM Sampler. (United States)

    Sleeth, Darrah K; Balthaser, Susan A; Collingwood, Scott; Larson, Rodney R


    Extrathoracic deposition of inhaled particles (i.e., in the head and throat) is an important exposure route for many hazardous materials. Current best practices for exposure assessment of aerosols in the workplace involve particle size selective sampling methods based on particle penetration into the human respiratory tract (i.e., inhalable or respirable sampling). However, the International Organization for Standardization (ISO) has recently adopted particle deposition sampling conventions (ISO 13138), including conventions for extrathoracic (ET) deposition into the anterior nasal passage (ET₁) and the posterior nasal and oral passages (ET₂). For this study, polyurethane foam was used as a collection substrate inside an inhalable aerosol sampler to provide an estimate of extrathoracic particle deposition. Aerosols of fused aluminum oxide (five sizes, 4.9 µm-44.3 µm) were used as a test dust in a low speed (0.2 m/s) wind tunnel. Samplers were placed on a rotating mannequin inside the wind tunnel to simulate orientation-averaged personal sampling. Collection efficiency data for the foam insert matched well to the extrathoracic deposition convention for the particle sizes tested. The concept of using a foam insert to match a particle deposition sampling convention was explored in this study and shows promise for future use as a sampling device.

  4. Estimation of the Human Extrathoracic Deposition Fraction of Inhaled Particles Using a Polyurethane Foam Collection Substrate in an IOM Sampler

    Directory of Open Access Journals (Sweden)

    Darrah K. Sleeth


    Full Text Available Extrathoracic deposition of inhaled particles (i.e., in the head and throat is an important exposure route for many hazardous materials. Current best practices for exposure assessment of aerosols in the workplace involve particle size selective sampling methods based on particle penetration into the human respiratory tract (i.e., inhalable or respirable sampling. However, the International Organization for Standardization (ISO has recently adopted particle deposition sampling conventions (ISO 13138, including conventions for extrathoracic (ET deposition into the anterior nasal passage (ET1 and the posterior nasal and oral passages (ET2. For this study, polyurethane foam was used as a collection substrate inside an inhalable aerosol sampler to provide an estimate of extrathoracic particle deposition. Aerosols of fused aluminum oxide (five sizes, 4.9 µm–44.3 µm were used as a test dust in a low speed (0.2 m/s wind tunnel. Samplers were placed on a rotating mannequin inside the wind tunnel to simulate orientation-averaged personal sampling. Collection efficiency data for the foam insert matched well to the extrathoracic deposition convention for the particle sizes tested. The concept of using a foam insert to match a particle deposition sampling convention was explored in this study and shows promise for future use as a sampling device.

  5. Improvement in sodium cromoglycate delivery from a spacer device by use of an antistatic lining, immediate inhalation, and avoiding multiple actuations of drug. (United States)

    O'Callaghan, C; Lynch, J; Cant, M; Robertson, C


    BACKGROUND--Aerosols generated from metered dose inhalers may be highly charged. The aim of this study was to determine whether lining the walls of a polycarbonate spacer device with an antistatic agent would result in an increase in drug output. The effects of multiple actuations of drug into the spacer device and increasing residence time of drug within the spacer were also determined. METHODS--The amount of sodium cromoglycate contained in particles of various size available for inhalation (per 5 mg actuation) from a 750 ml polycarbonate spacer was determined by impinger measurement and spectrophotometric assay. RESULTS--Lining the spacer with an antistatic agent increased the mean (SD) amount of sodium cromoglycate in particles < 5 microns available for inhalation (per 5 mg actuation) by 244% from (0.59 (0.03) to 1.44 (0.2) mg). When there was a 20 second interval between actuation into the spacer device and inhalation, sodium cromoglycate available for inhalation in particles < 5 micrograms decreased by 67% (from 0.59 (0.03) mg to 0.2 (0.01) mg). Use of the spacer device increased sodium cromoglycate available for inhalation in respirable particles (< 5 microns) by 18% compared with direct delivery by metered dose inhaler. Multiple actuations into the spacer decreased the amount of sodium cromoglycate available for inhalation in particles < 5 microns by 31% after two actuations and 56% after three acutations. CONCLUSIONS--Multiple actuations of sodium cromoglycate into a spacer device before inhalation should be avoided, and inhalation from spacer devices should take place immediately after actuation to ensure maximum dose. Lining of a standard spacer device with an antistatic agent significantly increased output of sodium cromoglycate. This may have implications for improved therapeutic response and drug cost. Images PMID:8346488

  6. Aerosol distribution apparatus (United States)

    Hanson, W.D.

    An apparatus for uniformly distributing an aerosol to a plurality of filters mounted in a plenum, wherein the aerosol and air are forced through a manifold system by means of a jet pump and released into the plenum through orifices in the manifold. The apparatus allows for the simultaneous aerosol-testing of all the filters in the plenum.

  7. Inhaler device preferences in older adults with chronic lung disease

    Directory of Open Access Journals (Sweden)

    Ghazala L


    Full Text Available Introduction: Patient preferences are important for medication adherence and patient satisfaction, but little is known about older adult preferences for inhaler devices. Methods: We developed a 25-item written self-administered questionnaire assessing experience with inhalers, prior inhaler education, and preferences with respect to inhaler device features and inhaler device teaching. We then conducted a cross-sectional survey of patients at least 65 years of age with chronic lung disease who had experience using inhaler devices for at least six months in the ambulatory setting. Results: Fifty participants completed the questionnaire. The majority of participants (80% reported prior experience with a metered dose inhaler (MDI, but only 26% used an MDI with a spacer. Most patients (76% had received formal instruction regarding proper use of the inhaler, but only 34% had ever been asked to demonstrate their inhaler technique. Physician recommendation for an inhaler, cost of the inhaler device, and inhaler features related to convenience were important with respect to patient preferences. With regard to inhaler education, participants prefer verbal instruction and/or hands-on demonstration at the time a new inhaler is prescribed in the setting of the prescribing provider’s office. Conclusion: Patient preferences for inhaler devices and inhaler education among older adults indicate physician recommendation, cost, and convenience are important. The impact of patient preferences on inhaler adherence and clinical outcomes remains unknown.

  8. Functional imaging of neuroendocrine tumors: a head-to-head comparison of somatostatin receptor scintigraphy, 123I-MIBG scintigraphy, and 18F-FDG PET

    DEFF Research Database (Denmark)

    Binderup, Tina; Knigge, Ulrich; Jakobsen, Annika Loft


    Functional techniques are playing a pivotal role in the imaging of cancer today. Our aim was to compare, on a head-to-head basis, 3 functional imaging techniques in patients with histologically verified neuroendocrine tumors: somatostatin receptor scintigraphy (SRS) with (111)In-diethylenetriamin......Functional techniques are playing a pivotal role in the imaging of cancer today. Our aim was to compare, on a head-to-head basis, 3 functional imaging techniques in patients with histologically verified neuroendocrine tumors: somatostatin receptor scintigraphy (SRS) with (111)In......-diethylenetriaminepentaacetic acid-octreotide, scintigraphy with (123)I-metaiodobenzylguanidine (MIBG), and (18)F-FDG PET. METHODS: Ninety-six prospectively enrolled patients with neuroendocrine tumors underwent SRS, (123)I-MIBG scintigraphy, and (18)F-FDG PET on average within 40 d. The functional images were fused with low......-dose CT scans for anatomic localization, and the imaging results were compared with the proliferation index as determined by Ki67. RESULTS: The overall sensitivity of SRS, (123)I-MIBG scintigraphy, and (18)F-FDG PET was 89%, 52%, and 58%, respectively. Of the 11 SRS-negative patients, 7 were (18)F-FDG PET...

  9. The role of scintigraphy in the lameness evaluation. (United States)

    Steckel, R R


    Bone scanning to help diagnose orthopedic disease has been used in human patients for over two decades. The value of this diagnostic tool has been well established in helping to identify a variety of musculoskeletal conditions. It has only recently been used by veterinarians for more accurate characterization of equine musculoskeletal disease. The technique offers the major advantage of increased sensitivity over standard radiographic imaging. The case material illustrated here shows that except for consistent identification of bone cysts, most of the pathologic changes to the horse's musculoskeletal system that might cause lameness are detected on bone scans. Many acute bone diseases can be diagnosed by scintigraphy that cannot be discerned by radiographs until the condition has become chronic: Because of their body size, these conditions may not be diagnosed at all in horses. Scintigraphy in horses offers the other major advantage of affording accurate imaging of the upper limbs, pelvis, and vertebral column without general anesthesia. Therefore, it has a final advantage of increased safety over conventional radiography because it eliminates the need to perform general anesthesia to study these areas. In the author's experience, if abnormal uptake of isotope in the upper limbs, pelvis or spine is not observed, general anesthesia to radiograph those areas is not warranted. A second major benefit of scintigraphic imaging is to differentiate mixed lameness conditions in which the component of bone disease must be separated from that of soft tissues to arrive at a rational course of treatment or prognosis. Finally, for athletic horses suspected of having lameness due to localized myositis, scintigraphy not only allows confirmation of muscle inflammation but also identifies the muscle bellies injured reasonably accurately so that specific local treatment may be given. Nuclear imaging of equine skeletal disease is an option that should be employed more frequently by

  10. Comparative evaluation of scintigraphy and upper gastrointestinal tract endoscopy for detection of duodenogastric reflux

    Energy Technology Data Exchange (ETDEWEB)

    Mittal, B.R.; Ibrarullah, Mohammad; Agarwal, D.K.; Maini, Atul; Ali, Wasif; Sikora, S.S.; Das, B.K. (Sanjay Gandhi Postgraduate Inst. of Medical Sciences (India))


    Duodenogastric reflux, the reflux of duodenal bile into stomach, when suspected clinically requires an objective evaluation for proper management. In this study hepatobiliary scintigraphy in 91 patients of different clinical conditions was evaluated for presence of duodenogastric reflux. Upper gastrointestinal endoscopy was also performed in 44 of these patients. On scintigraphy duodenogastric reflux was present in 26 (29%) of 91 patients. Upper gastrointestinal endoscopy revealed presence of refluxed bile in the stomach in 12 (27%) of 44 patients. In the same groups of patients scintigraphy detected reflux in 18 (41%) of 44 patients. This shows that hepatobiliary scintigraphy is superior to upper gastrointestinal endoscopy in detection of duodenogastric reflux and also has the advantage of being non-invasive and physiological. (author).

  11. A decision support system for stress only myocardial perfusion scintigraphy may save unnecessary rest studies

    DEFF Research Database (Denmark)

    Tägil, K; Jakobsson, D; Lomsky, M


    The aim of this study was to investigate the influence of a computer-based decision support system (DSS) on performance and inter-observer variability of interpretations regarding ischaemia and infarction in myocardial perfusion scintigraphy (MPS)....

  12. Quantitative kidney scintigraphy in children, using technetium-labelled dimercaptosuccinic acid

    Energy Technology Data Exchange (ETDEWEB)

    Bouissou, F.; Danet, B.; Meguira, B. and others


    Separate measurement of renal function is essential in children with urinary tract disease. This can be done satisfactorily by means of kidney scintigraphy with technetium 99m-labelled dimercaptosuccinic acid. A retrospective study of the records of 415 children, which comprised renal function tests, radiology and scintigraphy, confirmed the value of the radioisotope technique. Graphs of height, kidney uptake and kidney uptake density in relation to age were established, showing highly significant correlations with renal function tests and intravenous urography results, but many dissociations were encountered. Separate renal function evaluation by radioisotope scintigraphy seems to be more reliable than evaluation extrapolated from measurement of the cortical areas at intravenous urography. In vesico-ureteral reflux scintigraphy makes it possible to detect reflux nephropathy at an earlier stage than with other methods.

  13. White blood cell scintigraphy for differentiation of infection and aseptic loosening

    DEFF Research Database (Denmark)

    Simonsen, Lene; Buhl, Anna; Oersnes, Thue;


    Diagnosis of an infected arthroplasty is often difficult. Fever, abnormal physical findings, radiographic changes, findings at bone scintigraphy, an elevated erythrocyte sedimentation rate, CRP, and leucocytosis are not specific enough. We evaluated the diagnostic value of white blood cell...

  14. Clinical experience of [sup 123]I-IMP scintigraphy in detecting vertebral bone metastases of hepatocellular carcinoma. A comparison with bone scintigraphy with [sup 99m]Tc-MDP

    Energy Technology Data Exchange (ETDEWEB)

    Suto, Y. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Iwamiya, T. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Tanigawa, N. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Shabana, M. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan)); Ohta, Y. (Dept. of Radiology, Tottori Univ. Faculty of Medicine, Yonago (Japan) Dept. of Radiology, Matsue City Hospital (Japan))


    [sup 123]I-IMP and bone scintigraphy with [sup 99m]Tc-MDP were consecutively performed in patients with vertebral bone metastases from hepatocellular carcinoma and lumbar spondylosis deformans in a 7-day interval or shorter. The intensity of uptake was compared. Eighteen of the 20 metastatic lesions (90%) were classified as increased uptake areas in [sup 123]I-IMP scintigraphy. MDP-scintigraphy disclosed 16 metastatic lesions (80%), 9 as ''hot'' lesions (56%) and 7 as ''cold'' lesions (44%). [sup 123]I-IMP scintigraphy was negative in all 12 lesions of lumbar spondylosis deformans. Compared to MDP-scintigraphy, [sup 123]I-IMP scintigraphy was more sensitive in detecting vertebral bone metastases of hepatocellular carcinoma with smaller rates of false-positive and false-negative findings. (orig./MG).

  15. Emerging inhaled bronchodilators: an update. (United States)

    Cazzola, M; Matera, M G


    Bronchodilators remain central to the symptomatic management of chronic obstructive pulmonary disease and asthma, and, for this reason and also because the patent protection of many bronchodilators has expired, several companies have reinitiated research into the field. The only limits set for the development of a long-lasting bronchodilator with a new product profile are medical needs and marketing opportunities. The incorporation of once-daily dose administration is an important strategy for improving adherence and is a regimen preferred by most patients. A variety of beta(2)-agonists and antimuscarinic agents with longer half-lives and inhalers containing a combination of several classes of long-acting bronchodilator are currently under development. The present article reviews all of the most important compounds under development, describing what has been done and discussing their genuine advantage.

  16. A Matlab Tool for Tumor Localization in Parathyroid Sestamibi Scintigraphy

    Directory of Open Access Journals (Sweden)

    M. Đurović


    Full Text Available Submarine method for localization of parathyroid tumors (PT has proved to be effective in case of typical pitfalls of conventional scintigraphic methods (combined subtraction and double phase methods. It uses images obtained by standard dynamic parathyroid sestamibi scintigraphy suggested by European Association of Nuclear Medicine. This paper presents: 1 the developed Matlab interface that enables the implementation and evaluation of algorithms for the automatic application of Submarine method; 2 the algorithm for automatic extraction of the entire thyroid region from the background radioactivity using operations from mathematical morphology applied on dynamic scintigrams; 3 the results obtained by algorithm for localization and visualization of PTs based on estimation of exponential decreasing trend of time-activity curves. The algorithm was tested on a group of 20 patients with histopathologically proven PTs using developed Matlab interface.

  17. Esophageal clearance scintigraphy in, diabetic patients; A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Karayalcin, B.; Karayalcin, U.; Aburano, Tamio; Nakajima, Kenichi; Hisada, Kinichi; Morise, Toshio; Okada, Toshihide; Takeda, Ryoyu (Kanazawa Univ. (Japan). School of Medicine)


    The aim of this preliminary study was to evaluate the predictive value of esophageal clearance scintigraphy (ECS) in the diagnosis of esophageal autonomic neuropathy in diabetic patients without any esophageal symptoms. A single swallon ECS was performed in 12 diabetic patients and 15 normal volunteers, and esophageal transit time (ETT) and esophageal (Es) T 1/2 values were calculated. ETT and Es 1/2 were found to be significantly prolonged in the diabetic group (p<0.01 and p<0.05, respectively). In this preliminary study, our results strongly suggest that ECS may be an important noninvasive diagnostic tool in the evaluation of diabetic patients with asymptomatic esophageal autonomic neuropathy. (author).

  18. Nurse exposure doses resulted from bone scintigraphy patient (United States)

    Tunçman, Duygu; Kovan, Bilal; Poyraz, Leyla; ćapali, Veli; Demir, Bayram; Türkmen, Cüneyt


    Bone scintigraphy is used for displaying the radiologic undiagnosed bone lesions in nuclear medicine. It's general indications are researching bone metastases, detection of radiographically occult fractures, staging and follow-up in primary bone tumors, diagnosis of paget's disease, investigation of loosening and infection in orthopedic implants. It is applied with using 99mTc labeled radiopharmaceuticals (e.g 99m Tc MDP,99mTc HEDP and 99mTc HMDP). 20 -25 mCi IV radiotracer was injected into vein and radiotracer emits gamma radiation. Patient waits in isolated room for about 3 hours then a gamma camera scans radiation area and creates an image. When some patient's situation is not good, patients are hospitalized until the scanning because of patients' close contact care need. In this study, measurements were taken from ten patients using Geiger Muller counter. After these measurements, we calculated nurse's exposure radiations from patient's routine treatment, examination and emergency station.

  19. Peritoneal scintigraphy: a simple pre-therapy test. Technical features

    Energy Technology Data Exchange (ETDEWEB)

    De Rossi, G. [Ist. di Medicina Nucleare, Universita Cattolica del Sacro Cuore, Rome (Italy); Valenza, V. [Ist. di Medicina Nucleare, Universita Cattolica del Sacro Cuore, Rome (Italy)


    Peritoneal scintigraphy with 99mTc-MAA was used for monitoring intra-abdominal chemotherapy in refractory metastatic ascites fom various primary tumors. Scintigraphic patterns appeared to be the simplest, most accurate and reliable method to visualize the possible presence of intraperitoneal sacs due to adhesions. In addition, this technique is able to evidentiate the patency of intra-abdominal catheters. (orig.) [Deutsch] Die peritoneale Szintigraphie mit 99mTc-MAA wurde zur Ueberwachung der intraabdominellen Chemotherapie bei therapieresistentem malignen Aszites unterschiedlicher Primaertumorgenese eingesetzt. Die Szintigraphie erwies sich als die einfachste, sensitivste und angemessenste Methode, um moeglicherweise vorliegende intraperitoneale Fluessigkeitsverhalte durch Adhaesionen sichtbar zu machen. Die Methode ist darueber hinaus gut geeignet, um die Durchgaengigkeit intraabdomineller Katheter zu ueberpruefen. (orig.)

  20. Whole body bone scintigraphy in osseous hydatosis: a case report

    Directory of Open Access Journals (Sweden)

    Ebrahimi Abdolali


    Full Text Available Abstract Hydatid disease is common in many parts of the world, and causes considerable health and economic loss. This disease may develop in almost any part of the body. Bone involvement is often asymptomatic, and its diagnosis is primarily based on radiographic findings. A whole body bone scan is able to show the extent and distribution of lesions. We describe an unusual case of multifocal skeletal hydatosis and also explain the clinical and diagnostic points. We hope to stimulate a high index of suspicion among clinicians to facilitate early diagnosis and to consider this disease as a differential diagnosis in cases of multiple abnormal activity in bone scintigraphy especially among people in endemic areas.

  1. /sup 111/In platelet scintigraphy in cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Powers, W.J.; Siegel, B.A.; Davis, H.H.; Mathias, C.J.; Clark, H.B.; Welch, M.J.


    We obtained scintigraphic images of the neck from 100 patients with suspected cerebrovascular disease after injecting /sup 111/In-labeled autologous platelets. One or more focuses of increased activity, implying local platelet accumulation, were seen along the course of the cervical carotid arteries in 52 patients. In 64 patients, there was a highly significant correlation between the results of scintigraphy and carotid arteriography (p . 10(6)). There was no significant correlation between the scintigraphic findings and the previous or subsequent occurrence of transient ischemic attack or cerebral infarction in the carotid circulation. These data suggest that factors other than the simple formation of platlet thrombi in the cervical carotid arteries are of primary importance in the pathogenesis of stroke.

  2. Patterns of salivary gland uptake in I-131 MIBG scintigraphy. (United States)

    Salanci, B Volkan; Ergün, E Lay


    I-131 MIBG scintigraphy is routinely used in the diagnosis of neuroendocrine tumours with high specificity. The radiopharmaceutical is taken up via uptake mechanism and actively transported into storage vesicules. The organs with dense sympathetic innervation such as salivary glands, heart, lachrymal glands, spleen and rarely adrenal medulla are normally visualized with I-131 MIBG. Asymetrical salivary gland uptake is important in a patient with suspected neuroendocrine tumours. Absence of radioactivity may be a result of sympathic denervation or tumor. Bilateral radioactivity absence is observed usually due to drugs or radiopharmaceutical storage conditions. Detailed examination of cervical region is crucial for localisation of neuroendocrine tumours. Therefore, possible false positives should be kept in mind.

  3. In-111 labeled leukocyte scintigraphy in a case of multifocal candidiasis

    Energy Technology Data Exchange (ETDEWEB)

    Palestro, C.J.; Vega, A.; Kim, C.K.; Goldsmith, S.J. (Mount Sinai School of Medicine, New York, NY (USA))


    The value of indium-111 labeled leukocyte scintigraphy for the diagnosis of infection in the general population is well documented; there is less information available on its role in the evaluation of the immunocompromised patient. In this study, leukocyte scintigraphy was performed on a 31-year-old immunocompromised woman who had a possible intra-abdominal abscess. No abscess was detected, but intense oral, esophageal, gastric, and vaginal uptake was observed. Candida infection was histologically confirmed at all four sites.

  4. Multifocal peritoneal splenosis in Tc-99m-labeled heat-denatured red blood cell scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Min Ki; Hwang, Kyung Hoon; Choe, Won Sick [Gachon University Gil Medical Center, Incheon (Korea, Republic of)


    A 44-year-old man with a past medical history of splenectomy came to hospital because of epigastric pain abdominopelvic computed tomography(CT) showed a soft tissue mass and multifocal variable-sized nodules as well as finding suggestive of cholecystitis. Subsequently, he underwent Tc-99m-labeled heat- denatured red blood cell(RBC) scintigraphy to evaluate the mass and nodules. The scintigraphy confirmed multifocal peritoneal splenosis in the abdominopelvic cavity.

  5. Bone Scintigraphy Findings of A Case with Maffucci's Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Mi; Lee, Jong Jin; Kim, Yu Kyeong; Lee, Jeong Won; Chung, Jin Haeng; Kim, Sang Eun [Seoul National University Bundang Hospital, Seoul (Korea, Republic of)


    Maffucci's syndrome is a sporadic rare congenital disease that is characterized by enchondromatosis and soft tissue hemangiomas. A systemic evaluation should be considered because this syndrome is related to generalized meso dermal dysplasia, which has a high likelihood of a malignant transformation. Whole-body bone scintigraphy might be helpful for detecting skeletal involvement. We present a case of Maffucci's syndrome suing bone scintigraphy to evaluate the extent of the disease.

  6. Current Scientific and Regulatory Approaches for Development of Orally Inhaled and Nasal Drug Products: Overview of the IPAC-RS/University of Florida Orlando Inhalation Conference. (United States)

    Hochhaus, Guenther; Davis-Cutting, Craig; Oliver, Martin; Lee, Sau L; Lyapustina, Svetlana


    This article summarizes discussions at the March 2014 conference organized by the University of Florida (UF) and International Pharmaceutical Aerosol Consortium on Regulation and Science (IPAC-RS), entitled "Orlando Inhalation Conference: Approaches in International Regulation." The special focus of the conference was on global scientific and regulatory issues associated with the testing and demonstration of equivalence for the registration of orally inhaled drug products (OIDPs) in the United States, Europe, Brazil, China, and India. The scope included all types of OIDPs throughout their lifecycle, e.g., innovator/brand-name products, generics, modifications due to lifecycle management, device changes, etc. Details were presented for the U.S. "weight of evidence approach" for registration of generic products (which includes demonstration of in vitro and in vivo equivalence, as well as quantitative and qualitative sameness, and device similarity). The European "stepwise" approach was elucidated, and the thinking of regulatory agencies in the major emerging markets was clarified. The conference also highlighted a number of areas that would benefit from further research and discussion, especially around patient/device interface and human factor studies, statistical methods and criteria for demonstrating equivalence, the relative roles of in vivo and in vitro tests, and appropriate designs and metrics for in vivo studies of inhaled drugs.

  7. Improved method to label beta-2 agonists in metered-dose inhalers with technetium-99m

    Energy Technology Data Exchange (ETDEWEB)

    Ballinger, J.R.; Calcutt, L.E.; Hodder, R.V.; Proulx, A.; Gulenchyn, K.Y. (Ottawa Civic Hospital, Ottawa (Canada). Div. of Nuclear Medicine and Respiratory Unit)


    Labelling beta-2 agonists in a metered-dose inhaler (MDI) with technetium-99m allows imaging of the deposition of the aerosol in the respiratory tract. We have developed an improved labeling method in which anhydrous pertechnetate is dissolved in a small volume of ethanol, diluted with a fluorocarbon, and introduced into a commercial MDI. Imaging the MDI demonstrated that the [sup 99m]Tc was associated with the active ingredient, not just the propellant. The method has been used successfully with salbutamol and fenoterol MDIs and should be directly applicable to other MDIs which contain hydrophilic drugs. (Author).

  8. Equivalence considerations for orally inhaled products for local action-ISAM/IPAC-RS European Workshop report. (United States)

    Evans, Carole; Cipolla, David; Chesworth, Tim; Agurell, Eva; Ahrens, Richard; Conner, Dale; Dissanayake, Sanjeeva; Dolovich, Myrna; Doub, William; Fuglsang, Anders; García Arieta, Afredo; Golden, Michael; Hermann, Robert; Hochhaus, Günther; Holmes, Susan; Lafferty, Paul; Lyapustina, Svetlana; Nair, Parameswaran; O'Connor, Dennis; Parkins, David; Peterson, Ilse; Reisner, Colin; Sandell, Dennis; Singh, Gur Jai Pal; Weda, Marjolein; Watson, Patricia


    The purpose of this article is to document the discussions at the 2010 European Workshop on Equivalence Determinations for Orally Inhaled Drugs for Local Action, cohosted by the International Society for Aerosols in Medicine (ISAM) and the International Pharmaceutical Consortium on Regulation and Science (IPAC-RS). The article summarizes current regulatory approaches in Europe, the United States, and Canada, and presents points of consensus as well as ongoing debate in the four major areas: in vitro testing, pharmacokinetic and pharmacodynamic studies, and device similarity. Specific issues in need of further research and discussion are also identified.

  9. Joint scintigraphy using technetium-99m pyrophosphate in experimental hemarthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Salimi, Z.; Vas, W.; Restrepo, G.


    To determine the validity of a method for induction of experimental hemarthrosis in dogs and for the nuclear imaging of hemarthrosis, serial technetium-99m pyrophosphate ((/sup 99m/Tc)PYP) flow and blood-pool scans were performed monthly in eight dogs who received bi-weekly injections of autologous blood into their femoro-tibial joints (also called stifle joint). In four control dogs, one joint was injected with saline while the other joint received only a sham injection. In addition, two dogs received intra-articular injections of autologous blood into their right stifle joint and saline into their left stifle joint. These dogs were studied with /sup 99m/TcO/sub 4/ joint scintigraphy at monthly intervals. The dogs were periodically taken out of the study and explored surgically. Pathologic examination of synovial tissue was performed. Serial radiographs were also obtained and correlated with the scan and surgical findings. There was a striking abnormal increase in blood-pool activity of (/sup 99m/Tc)PYP in the treated stifle joints, commencing at the first examination after 1 mo of blood injections and continuing for the length of the study. All radiographs showed only minimal joint space widening and some soft-tissue swelling. On pathologic examination, both grossly and microscopically, there was profuse pannus formation, with intense inflammatory infiltrate replacing much of the subsynovial fat. The scintigraphic findings correlated well with these pathologic findings. This study not only validates this method for simulating hemophilic hemarthrosis but also suggests that (/sup 99m/Tc)PYP joint scintigraphy is a simple, and noninvasive method for monitoring the early changes in hemophilic arthropathy and is superior to pertechnetate imaging for this disease process.

  10. Variability in the interpretation of DMSA scintigraphy after urine infection

    Energy Technology Data Exchange (ETDEWEB)

    Craig, J.; Howman-Giles, R.; Uren, R.; Irwig, L.; Bernard, E.; Knight, J.; Sureshkumar, P.; Roy, L.P. [New Childrens Hospital, Westmead, NSW, (Australia). Centre for Kidney Research, Department of Nuclear Medicine]|[University of Sydney, Sydney, NSW. (Australia)


    Full text: This study investigated the extent of and potential reasons for interpretation disagreement of {sup 99m}Tc-DMSA scans after urine infection in children. Methods: 441 scans were selected from children with first urine infection (UTI) from 1993-1995. 294 scans were performed at a median time of seven days after UTI and 147 in children free from infection over one year follow-up. Two nuclear medicine physicians independently reported according to whether renal abnormality was present or absent and used the four level grading system described by Goldraich: grade 1-no more than two cortical defects; grade 2 -more than 2 defects; grade 3-diffuse reduction in uptake with or without defects; grade 4 -shrunken kidney <10% function. Indices for variability used were the percentage of agreement and kappa statistic, expressed as a percentage. For the grading scale used, both measures were weighted with integers representing the number of categories from perfect agreement. Disagreement was analysed for children, kidneys and kidney zones. Results: There was agreement in 86 per cent (kappa 69%) for the normal-abnormal DMSA scan dichotomy, the weighted agreement was 94 per cent (kappa 82%) for the grading scale. Disagreement of DMSA scan interpretation {>=} two grades was present in three cases (0.7%). The same level of agreement was present for the patient, kidney and kidney zones comparisons. Agreement was not influenced by age or the timing of scintigraphy after urine infection. Conclusion: Two experienced physicians showed good agreement in the interpretation DMSA scintigraphy in children after urine infection and using the grading system of Goldraich.

  11. Tobramycin Inhalation Powder (TIP): An Efficient Treatment Strategy for the Management of Chronic Pseudomonas Aeruginosa Infection in Cystic Fibrosis. (United States)

    Lam, John; Vaughan, Steven; Parkins, Michael D


    Repeated bouts of acute and chronic lung infections are responsible for progressive pulmonary function decline in individuals with cystic fibrosis (CF), ultimately leading to respiratory failure and death. Pseudomonas aeruginosa is the archetypical CF pathogen, causes chronic infection in 70% of individuals, and is associated with an accelerated clinical decline. The management of P. aeruginosa in CF has been revolutionized with the development and widespread use of inhaled antibiotics. Aerosol delivery of antimicrobial compounds in CF enables extremely high concentrations of antibiotics to be reached directly at the site of infection potentially overcoming adaptive resistance and avoiding the potential for cumulative systemic toxicities. Tobramycin inhalation powder (TIP) represents the first dry powder inhaled (DPI) antibiotic available for use in CF. DPIs are notable for a markedly reduced time for administration, ease of portability, and increased compliance. TIP has been developed as a therapeutic alternative to tobramycin inhalation solution (TIS), the standard of care for the past 20 years within CF. Relative to TIS 300 mg nebulized twice daily in on-and-off cycles of 28 days duration, TIP 112 mg twice daily via the T-326 inhaler administered on the same schedule is associated with marked time savings, increased patient satisfaction, and comparable clinical end points. TIP represents an innovative treatment strategy for those individuals with CF and holds the promise of increased patient compliance and thus the potential for improved clinical outcomes.

  12. Childhood acute pyelonephritis: comparison of power Doppler sonography and Tc-DMSA scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Stogianni, Aggeliki; Oikonomou, Ippoliti; Dimitriadis, Athanasios [Aristotle University of Thessaloniki, Department of Radiology, AHEPA Hospital, Thessaloniki (Greece); Nikolopoulos, Panagiotis [424 Army Hospital, Department of Radiology, Thessaloniki (Greece); Gatzola, Magdalini [Aristotle University of Thessaloniki, 2nd Paediatric Clinic, AHEPA Hospital, Thessaloniki (Greece); Balaris, Vassilios [Aristotle University of Thessaloniki, Department of Nuclear Medicine, AHEPA Hospital, Thessaloniki (Greece); Farmakiotis, Dimitrios [Infectious Diseases Hospital of Thessaloniki, Department of Medicine, Thessaloniki (Greece)


    Tc 99m DMSA scintigraphy is regarded as the gold standard for the detection and localization of acute pyelonephritis (APN) in children. Power Doppler sonography (PD US) is a radiation-free and cost-effective technique that could be useful in the diagnosis of APN in children. To compare the predictive value of PD US with DMSA scintigraphy in the diagnosis of APN in children. A total of 74 neonates and children with clinical findings consistent with possible upper urinary tract infection were evaluated with PD US and DMSA scintigraphy. Children with anatomic (grey-scale) abnormalities were excluded. A total of 147 kidneys were examined within the first 48 h after the onset of symptoms. Each kidney was divided into three zones (upper, middle, and lower third). APN was diagnosed by PD US in 46 kidneys. Sensitivity and specificity for detecting APN using DMSA scintigraphy as the reference standard were 73.8% and 85.7%, respectively. There was good agreement between PD US and DMSA scintigraphy in the localization of lesions. In clinically suspected APN, PD US has acceptable specificity and sensitivity, if performed within the first 48 h and could be helpful in neonates and children under 3 months of age in whom the use of scintigraphy is generally discouraged. (orig.)

  13. Evaluation of DMSA scintigraphy and urography in assessing both acute and permanent renal damage in children

    Energy Technology Data Exchange (ETDEWEB)

    Stokland, E.; Jacobsson, B. [Dept. of Pediatric Radiology, Sahlgrenska Univ. Hospital, Goeteborg Univ. (Sweden).; Hellstroem, M. [Dept. of Radiology, Sahlgrenska Univ. Hospital, Goeteborg Univ. (Sweden); Jodal, U. [Dept. of Pediatrics, Sahlgrenska Univ. Hospital, Goeteborg Univ. (Sweden); Sixt, R. [Dept. of Pediatric Clinical Physiology, Sahlgrenska Univ. Hospital, Goeteborg Univ. (Sweden)


    Purpose: To evaluate dimercaptosuccinic acid (DMSA) scintigraphy and urography in the detection of renal involvement in children with urinary tract infection (UTI) in order to identify patients with a high risk of developing renal damage. Material and Methods: A total of 157 children (median age 0.4 years, range 5 days to 5.8 years) with first-time symptomatic UTI were examined scintigraphy (with an assessment of renal area involvement) and urography at the time of UTI and 1 year later. All evaluations were made blindly. Results: Of the total 314 kidneys, 80 (25%) were abnormal at initial scintigraphy. Of these 80 kidneys, 44 (55%) had normalized at follow-up. Of the 234 initially normal kidneys, 29 (12%) were abnormal at follow-up. One year after UTI, abnormalities were seen in 59 children at scintigraphy and in 18 children at urography. Renal area involvement was larger and split function abnormalities more common in kidneys that were abnormal at both scintigraphy and urography than in kidneys with only scintigraphic abnormalities. Conclusion: Quantitation of renal area involvement and split renal function at early scintigraphy would seem to be useful in identifying patients at risk of developing renal damage. Urography at 1 year after infection identified mainly those with the most severe scintigraphic abnormalities. The clinical importance of scintigraphic abnormalities that are not confirmed by urography is not known. (orig.)

  14. Renal anomalies in patients with turner syndrome: Is scintigraphy superior to ultrasound? (United States)

    Hamza, Rasha T; Shalaby, Mennatallah H; Hamed, Laith S; Abdulla, Dunya B A; Elfekky, Sahar M; Sultan, Omar M


    Renal anomalies are present in up to 30% of patients with Turner syndrome (TS). Renal ultrasound (U/S) detects anatomical renal anomalies only while renal scintigraphy detects anomalies, detects early renal malfunction, and estimates glomerular filtration rate (GFR). Thus, we aimed to assess frequency of renal abnormalities detected by scintigraphy in comparison to renal U/S in TS patients. Ninety TS patients were subjected to auxological assessment, measurement of serum creatinine; and renal U/S and scintigraphy. Renal U/S detected renal anomalies in 22.22% of patients versus 17.78 % detected by scintigraphy (P = 0.035). Scintigraphy detected renal functional abnormalities in 44.44% of patients in the form of subnormal total GFR, abnormal renogram curve pattern, improper tracer handling and perfusion; and difference in split renal function >10% between both kidneys. Patients with a 45,X karyotype had more renal functional abnormalities (56%) than those with mosaic karyotype (33.33%), P = 0.04. In conclusion, renal scintigraphy is not superior to U/S in detection of renal anomalies but is a reliable method for early detection of renal malfunction in TS patients especially those with 45,X to ensure early management to offer a better quality of life.

  15. Inhalation and deposition of nebulized sodium cromoglycate in two different particle size distributions in children with asthma. (United States)

    Nerbrink, O L; Lindström, M; Meurling, L; Svartengren, M


    The relative deposition of two inhaled droplet size distributions of sodium cromoglycate produced by a Hudson Updraft II nebulizer was evaluated, using a setup modified from the proposed Comité Européen Normalisé (CEN) standard prEN 13544-1. The modified setup comprised an Andersen 296 impactor and a Spira Electro 2 dosimeter. The setup was characterized prior to use in children with sodium cromoglycate (SCG) and sodium fluoride as tracer aerosol. The main in vivo study was designed to allow nine children with a mean age of 10 years to inhale SCG aerosol at two different relative humidities (RH), a high RH (> 90%) and a low RH (13%), which in turn resulted in two different droplet size distributions. The nebulizer/dosimeter was set to provide 1-sec nebulization during 50 inhalations. Throughout the exposures, the children were instructed to inhale in a consistent manner with target tidal volumes (0.5 L) and inhalation flows (0.4 L/sec). Blood samples were taken at predefined time intervals, and the area under the curve (AUC) was calculated. A lung deposition program, TGLD2, was used to calculate the expected deposition, using the droplet sizes and inhalation parameters obtained during in vivo exposures. The in vivo monitoring of droplet size distribution during the exposure showed that the low, intermediate (room air), and high RHs gave a mean droplet size distribution with a mass median aerosol diameter (MMAD) of 1.2, 1.7, and 2.0 microm, respectively. The average tidal volume over all exposures was 0.51 +/- 0.12 L. The total deposition fraction was 33.4% of the estimated nebulizer output. A correlation was found between tidal volume and the calculated deposited fraction. The results indicate that there is a difference in total deposition, depending on the size of the droplet size distribution, with the larger droplet size distribution (MMAD, 2.0 microm) having a higher total deposition than the smaller droplet size distribution (MMAD, 1.2 microm). The

  16. The effects of aminophylline infusion in the treatment of children with acute asthma exacerbation. Evaluation with {sup 81m}Kr ventilation scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Matsubara, Yasuko; Shimada, Takao [Jikei Univ., Tokyo (Japan). School of Medicine


    The use of intravenous aminophylline in the treatment of children with acute asthma remains controversial. Most authors suggest that aminophylline be used with caution because of its poor efficacy with adverse reactions and instead recommend other drugs, such as {beta}{sub 2}-adrenergic agonists and glucocorticoids. However other studies have reported the benefits of aminophylline, and current Japanese guidelines for the management of asthma recommend its use. Here, we have evaluated the efficacy of aminophylline infusion in children with acute asthma exacerbations. Twenty children with acute asthma exacerbations were given an infusion of 5 mg/kg of aminophylline over 5 minutes, 30 minutes after the same volume of normal saline had been infused as a control. {sup 81m}Kr ventilation scintigraphy was done sequentially, and lung function was measured with spirometry before and after each infusion. Side effects were also evaluated with a questionnaire. Ventilation images obtained with {sup 81m}Kr scintigraphy, which initially showed widespread ventilatory defects caused by bronchoconstriction, decreased 54.9% after aminophylline infusion (p<0.0001). Ventilatory defects, caused by both central and peripheral airway disturbances and confirmed with the {sup 81m}Kr bolus inhalation procedure, also showed significant improvement (p<0.0001). These improvement were accompanied by improvements in lung function as assessed with forced expiratory volume in 1 second (p<0.01) and maximum expiratory flow rates at 25% (p<0.001) and 50% (p<0.001). No serious adverse reactions were recognized in any subjects. Our results show that aminophylline is a useful bronchodilator which decreased ventilatory imbalance and improves lung function in both central and peripheral airways. (author)

  17. Performance of thyroid scintigraphy in the thyrotoxicosis etiological diagnosis: about 210 cases; Performance de la scintigraphie thyroidienne dans le diagnostic etiologique des thyrotoxicoses: a propos de 210 cas

    Energy Technology Data Exchange (ETDEWEB)

    Chatti, K.; Nouira, M.; Guezguez, M.; Sfar, R.; Essabbah, H. [CHU Sahloul, Service de medecine nucleaire, Sousse (Tunisia); Zantour, B. [CHU Mahdia, service d' endocrinologie (Tunisia)


    Purpose: The thyrotoxicosis is a syndrome linked to thyroid hormones excess grouping any causes leading to a overload in circulating hormones, including these ones linked to an inflammatory process (thyroiditis) or an exogenous contribution. The etiologic diagnosis is based on complementary examinations. The objective of our work is to elucidate the performance of scintigraphy in the etiologic diagnosis and the therapy approach of thyrotoxicosis through the experience of our service. Conclusions: Scintigraphy has a place in the etiologic diagnosis of thyrotoxicosis. it brings functional and morphological information and allows to guide the diagnostic and therapeutic approach. (N.C.)

  18. Contribution of osseous scintigraphy in the fractures of constraint- about five cases; Apport de la scintigraphie osseuse dans les fractures de contrainte- a propos de 5 cas

    Energy Technology Data Exchange (ETDEWEB)

    Berehou, F.; Haddam, A.; Ben Rais, N. [Service de medecine nucleaire, CHU Ibn Sina, Rabat, (Morocco)


    The fracture of constraint lies on an unbalance between the bone resistance and the constraints at which it is submitted. The early diagnosis lies always on four principal elements: anamnesis, the poorness of the clinical examination, an early positive dual phase skeleton scintigraphy, and the delayed emergence of radiological signs. The highlighting of a hyper fixation at the skeleton scintigraphy on a bone prone to a constraint fracture in a context of intense physical activity or osseous insufficiency is highly evocative of the diagnosis. (N.C.)

  19. In vivo-in vitro correlations: predicting pulmonary drug deposition from pharmaceutical aerosols. (United States)

    Byron, Peter R; Hindle, Michael; Lange, Carlos F; Longest, P Worth; McRobbie, Donald; Oldham, Michael J; Olsson, Bo; Thiel, Charles G; Wachtel, Herbert; Finlay, Warren H


    In order to answer the question "what research remains to be done?" we review the current state of the art in pharmaceutical aerosol deposition modeling and explore possible in vivo- in vitro correlations (IVIVC) linking drug deposition in the human lung to predictions made using in vitro physical airway models and in silico computer models. The use of physical replicas of portions of the respiratory tract is considered, alongside the advantages and disadvantages of the different imaging methods used to obtain their dimensions. The use of airway replicas to determine drug deposition in vitro is discussed and compared with the predictions from different empirical curve fits to long-standing in vivo deposition data for monodisperse aerosols. The use of improved computational models and three-dimensional computational fluid dynamics (CFD) to predict aerosol deposition within the respiratory tract is examined. CFD's ability to predict both drug deposition from pharmaceutical aerosol sprays and powder behavior in dry powder inhalers is examined; both were highlighted as important areas for future research. Although the authors note the abilities of current in vitro and in silico methods to predict in vivo data, a number of limitations remain. These include our present inability to either image or replicate all but the most proximal airways in sufficient spatial and temporal detail to allow full capture of the fluid and aerosol mechanics in these regions. In addition, the highly complex microscale behavior of aerosols within inhalers and the respiratory tract places extreme computational demands on in silico methods. When the complexity of variations in respiratory tract geometry is associated with additional factors such as breathing pattern, age, disease state, postural position, and patient-device interaction are all considered, it is clear that further research is required before the prediction of all aspects of inhaled pharmaceutical aerosol deposition is possible.

  20. Open mouth bone scintigraphy is better than closed mouth bone scintigraphy in the diagnosis of temporomandibular osteoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ki Seong; Song, Ho Chun; Cho, Sang Geon [Dept. of Nuclear Medicine, Chonnam National University Hospital, Gwangju (Korea, Republic of); and others


    Closed-mouth bone scintigraphy (CM scan) and closed-mouth single-photon emission computed tomography (CM SPECT) are used for conventional evaluation of osteoarthritis of the temporomandibular joint (TMJ). However, the adequacy of open-mouth bone scintigraphy (OM scan) has not yet been evaluated. Therefore, the purpose of this study was to compare the diagnostic performance of CM scan, CM SPECT, and OM scan. Thirty-six patients with suspicion of an abnormality of the TMJ and who underwent a 99mTc-HDP CM scan, CM SPECT, and an OM scan were enrolled. The scans were assessed visually for the presence of positive focal uptake in the TMJ. Osteoarthritis was defined as arthralgia plus crepitus or radiologic signs of arthrosis. Of 72 TMJs, 21 (29.2 %) were diagnosed with osteoarthritis. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 90.5 %, 49.0 %, 42.2 %, 92.6 % and 61.1 % for the CM scan, 81.0 %, 58.8 %, 44.7 %, 88.2 % and 65.3 % for CM SPECT, and 81.0 %, 82.4 %, 65.4 %, 91.3 % and 81.9 % for the OM scan, respectively. The accuracy of the OM scan was higher than that of CM SPECT and the CM scans (p = 0.004 and p < 0.001, respectively). The OM scan was more accurate than the conventional CM scan and even CM SPECT for diagnosing TMJ osteoarthritis.

  1. Inhalation anthrax in a home craftsman. (United States)

    Suffin, S C; Carnes, W H; Kaufmann, A F


    Inhalation anthrax with complicating subarachnoid hemorrhage due to simultaneous infection with two capsular biotypes of Bacillus anthracis of different virulence for the mouse is reported. The patient, a home craftsman, acquired his infection from imported animal-origin yarn.

  2. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... avoid an attack by taking your medicine exactly as your doctor or other medical professional tells you ... keep them with your Asthma Action Plan. Using a metered dose inhaler with a spacer Your browser ...

  3. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Brochures Facts Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, ... among persons with active asthma Use of long-term control medication among persons with active asthma Uncontrolled ...

  4. Comparison of CT-derived ventilation maps with deposition patterns of inhaled microspheres in rats (United States)

    Jacob, Richard E.; Lamm, Wayne J.; Einstein, Daniel R.; Krueger, Melissa A.; Glenny, Robb W.; Corley, Richard A.


    Purpose Computer models for inhalation toxicology and drug-aerosol delivery studies rely on ventilation pattern inputs for predictions of particle deposition and vapor uptake. However, changes in lung mechanics due to disease can impact airflow dynamics and model results. It has been demonstrated that non-invasive, in vivo, 4DCT imaging (3D imaging at multiple time points in the breathing cycle) can be used to map heterogeneities in ventilation patterns under healthy and disease conditions. The purpose of this study was to validate ventilation patterns measured from CT imaging by exposing the same rats to an aerosol of fluorescent microspheres (FMS) and examining particle deposition patterns using cryomicrotome imaging. Materials and Methods Six male Sprague-Dawley rats were intratracheally instilled with elastase to a single lobe to induce a heterogeneous disease. After four weeks, rats were imaged over the breathing cycle by CT then immediately exposed to an aerosol of ~1μm FMS for ~5 minutes. After the exposure, the lungs were excised and prepared for cryomicrotome imaging, where a 3D image of FMS deposition was acquired using serial sectioning. Cryomicrotome images were spatially registered to match the live CT images to facilitate direct quantitative comparisons of FMS signal intensity with the CT-based ventilation maps. Results Comparisons of fractional ventilation in contiguous, non-overlapping, 3D regions between CT-based ventilation maps and FMS images showed strong correlations in fractional ventilation (r=0.888, p<0.0001). Conclusion We conclude that ventilation maps derived from CT imaging are predictive of the 1μm aerosol deposition used in ventilation-perfusion heterogeneity inhalation studies. PMID:25513951

  5. Comparison of CT-derived Ventilation Maps with Deposition Patterns of Inhaled Microspheres in Rats

    Energy Technology Data Exchange (ETDEWEB)

    Jacob, Rick E.; Lamm, W. J.; Einstein, Daniel R.; Krueger, Melissa; Glenny, Robb W.; Corley, Richard A.


    Purpose: Computer models for inhalation toxicology and drug-aerosol delivery studies rely on ventilation pattern inputs for predictions of particle deposition and vapor uptake. However, changes in lung mechanics due to disease can impact airflow dynamics and model results. It has been demonstrated that non-invasive, in vivo, 4DCT imaging (3D imaging at multiple time points in the breathing cycle) can be used to map heterogeneities in ventilation patterns under healthy and disease conditions. The purpose of this study was to validate ventilation patterns measured from CT imaging by exposing the same rats to an aerosol of fluorescent microspheres (FMS) and examining particle deposition patterns using cryomicrotome imaging. Materials and Methods: Six male Sprague-Dawley rats were intratracheally instilled with elastase to a single lobe to induce a heterogeneous disease. After four weeks, rats were imaged over the breathing cycle by CT then immediately exposed to an aerosol of ~1µm FMS for ~5 minutes. After the exposure, the lungs were excised and prepared for cryomicrotome imaging, where a 3D image of FMS deposition was acquired using serial sectioning. Cryomicrotome images were spatially registered to match the live CT images to facilitate direct quantitative comparisons of FMS signal intensity with the CT-based ventilation maps. Results: Comparisons of fractional ventilation in contiguous, non-overlapping, 3D regions between CT-based ventilation maps and FMS images showed strong correlations in fractional ventilation (r=0.888, p<0.0001). Conclusion: We conclude that ventilation maps derived from CT imaging are predictive of the 1µm aerosol deposition used in ventilation-perfusion heterogeneity inhalation studies.

  6. Quantitative bone and 67Ga scintigraphy in the differentiation of necrotizing external otitis from severe external otitis

    Energy Technology Data Exchange (ETDEWEB)

    Uri, N.; Gips, S.; Front, A.; Meyer, S.W.; Hardoff, R. (Department of Otolaryngology, Lady Davis Carmel Hospital, Haifa (Israel))


    Qualitative technetium Tc 99m bone scintigraphy using phosphate compounds and gallium 67 scintigraphy were described as a helpful means in diagnosing necrotizing external otitis (NEO). They were, however, claimed to be nonspecific. Quantitative Tc 99m methylene diphosphonate bone scintigraphy and gallium 67 scintigraphy were performed in eight patients with NEO and in 20 patients with severe external otitis, in order to prove usefulness of scintigraphy in the diagnosis of NEO. Ratios of lesion to nonlesion for bone scintigraphy were 1.67 {plus minus} 0.16 in patients with NEO and 1.08 {plus minus} 0.09 in patients with severe external otitis, and for gallium 67 scintigraphy they were 1.35 {plus minus} 0.24 in NEO patients and 1.05 {plus minus} 0.03 in patients with severe external otitis. There was no difference in uptake between diabetic patients with severe external otitis and nondiabetic patients. The scintigraphic studies were also evaluated using a qualitative scoring method (scores 0 to +4), according to the intensity of the radiopharmaceutical uptake. This method was found to be inferior in the diagnosis of NEO compared with the quantitative method. We conclude that lesion-to-nonlesion ratios greater than 1.5 and 1.3 on bone and gallium 67 scintigraphy, respectively, are indicative of NEO. Quantitative bone scintigraphy, which is quicker to perform, may be used as a single imaging modality for the diagnosis of NEO.

  7. The usefulness of {sup 99m}Tc-Sn colloid scintigraphy for the evaluation of splenic autotransplantation

    Energy Technology Data Exchange (ETDEWEB)

    Kikuchi, Yoshirou; Oshima, Motoo; Shirai, Tatsuo; Yokokawa, Tokuzou; Kaminaga, Tatsurou; Yasukouchi, Hiroshi; Furui, Shigeru [Teikyo Univ., Tokyo (Japan). Faculty of Medicine


    The purpose of this study is to examine whether splenic scintigraphy is useful for an evaluation of viability of graft after splenic autotransplantation. Nine patients who underwent splenic autotransplantation for the diseases of liver cirrhosis (8 patients) and pancreas cancer (one patient) were examined of abdominal CT scan and splenic scintigraphy with {sup 99m}Tc-Sn colloid. Detection of splenic graft was difficult with CT scan. However, visualization of graft of spleen was obtained with splenic scintigraphy in all cases three months later after the surgery. In conclusion, splenic scintigraphy with {sup 99m}Tc-Sn colloid is useful for the evaluation of viability of splenic graft. (author)

  8. Inhalation anesthesia. What to learn from modelisation? (United States)

    Deriaz, H


    Models describing pharmacokinetics of inhalational anesthetic agents have been developed, usually on Mapleson's description of the body as a collection of tissues characterised by their volume, local blood flow and anesthetic solubility. Such models are very useful to understand the use of inhalation agents and circle circuit, to compare consumption of different agents in different anesthetic practices, and to prepare the anesthetist to administer new products safely.

  9. The role of hepatobiliary scintigraphy and oral cholecystography in predicting the performance of laparoscopic cholecystectomy

    Energy Technology Data Exchange (ETDEWEB)

    Won, Kyoung Sook [Kangnung Hospital, Kangnung (Korea, Republic of); Ryu, Jin Sook; Moon, Dae Hyuk [College of Medicine, Ulsan Univ., Seoul (Korea, Republic of)] [and others


    Laparoscopic cholecystectomy can be performed safely in most patients with symptomatic cholelithiasis. Preoperative evaluation should assess the potential problems that affect the performance of laparoscopic cholecystectomy. Hepatobiliary scintigraphy or oral cholecystography can assess the gallbladder function and nonvisualization of gallbladder usually indicates acute or severe chronic cholecystitis. The purpose of this study was to evaluate the role of preoperative hepatobiliary scintigraphy or oral cholecystography in predicting the performance of laparoscopic cholecystectomy. The study group consists of 176 patients who underwent both hepatobiliary scintigraphy with Tc-99m DISIDA and oral choelcystography within one month before laparoscopic cholecystectomy. Nonvisualization of gallbladder was defined as persistent nonvisualization of gallbladder until 4 hours on hepatobiliary scintigraphy or 12 hours on oral cholecystography. Among 176 patients, gallbladder was not visualized in 38 patients on hepatobiliary scintigraphy and 41 patients on oral cholecystography. Concordance rate between hepatobiliary scintigraphy and oral cholecystography was 89.2%. The conversion rate to open cholocystectomy was significantly higher in patients with nonvisualization of gallbladder than in patients with gallbladder higher in patients with nonvisualization of gallbladder visualization (15.8% vs 2.9% on hepatobiliary scintigraphy, 12.2% vs 3.7% on oral cholecystography: p<0.01 and p<0.05 respectively). The operative complication rate was also significantly higher in patients with nonvisualization of gallbladder (13.2% vs 2.9% on hepatobiliary scintigraphy, 14.6% vs 2.2% on oral cholecystography : p<0.01 and p<0.001, respectively). Similarly, operation time was significantly prolonged in patients with nonvisualization of gallbladder (88.8{+-}41.9 min vs 62.5{+-}23.6 min on hepatobiliary scintigraphy : p<0.001, 89.4{+-}41.3 min vs 61.8{+-}22.8 min on oral cholecystography :p<0

  10. Effect of increases in lung volume on clearance of aerosolized solute from human lungs

    Energy Technology Data Exchange (ETDEWEB)

    Marks, J.D.; Luce, J.M.; Lazar, N.M.; Wu, J.N.; Lipavsky, A.; Murray, J.F.


    To study the effect of increases in lung volume on solute uptake, we measured clearance of /sup 99m/Tc-diethylenetriaminepentaacetic acid (Tc-DTPA) at different lung volumes in 19 healthy humans. Seven subjects inhaled aerosols (1 micron activity median aerodynamic diam) at ambient pressure; clearance and functional residual capacity (FRC) were measured at ambient pressure (control) and at increased lung volume produced by positive pressure (12 cmH2O continuous positive airway pressure (CPAP)) or negative pressure (voluntary breathing). Six different subjects inhaled aerosol at ambient pressure; clearance and FRC were measured at ambient pressure and CPAP of 6, 12, and 18 cmH2O pressure. Six additional subjects inhaled aerosol at ambient pressure or at CPAP of 12 cmH2O; clearance and FRC were determined at CPAP of 12 cmH2O. According to the results, Tc-DTPA clearance from human lungs is accelerated exponentially by increases in lung volume, this effect occurs whether lung volume is increased by positive or negative pressure breathing, and the effect is the same whether lung volume is increased during or after aerosol administration. The effect of lung volume must be recognized when interpreting the results of this method.

  11. The clinical observation of combination chemotherapy of salbutamol and budesonide in aerosol inhalation treatment of acute attack of bronchial asthma%布地奈德联合沙丁胺醇雾化吸入治疗支气管哮喘急性发作的临床观察

    Institute of Scientific and Technical Information of China (English)



    目的:观察布地奈德联合沙丁胺醇雾化吸入治疗支气管哮喘急性发作的临床疗效.方法:将63例急性发作期支气管哮喘患者随机分为2组,其中对照组30例单用沙丁胺醇雾化吸入,治疗组33例在对照组的基础上加用布地奈德.比较2组患者的总体疗效、主要症状、体征持续时间及肺功能变化情况.结果:对照组总有效率为86.67%,治疗组总有效率93.94%,差异无统计学意义(P>0.05).治疗组的胸闷、气短、咳嗽、肺哮鸣音等症状、体征消失时间均较对照组明显缩短;2组患者治疗后第一秒用力呼气容积、用力肺活量、呼气峰流速均显著升高(P<0.01),且治疗组肺功能改善较对照组更明显(P<0.01).结论:布地奈德联合沙丁胺醇雾化吸入治疗支气管哮喘,可明显改善症状,增强肺功能,值得临床推广应用.%Objective:To observe the clinical efficacy of inhalation treatment with salbutamol and budesonide combination for acute attack of bronchial asthma. Methods:Sixty-three cases of acute attack of bronchial asthma were randomly divided into two groups, 30 patients in control group with salbutamol inhalation,33 patients in treatment group treated with salbutamol combined with budesonide.The overall efficacy, main symptoms, sign duration time and the changes of lung function in the two groups were compared. Results:The total effective rate was 86.67% and 93.94% in control group and treatment group, respectively, there was no statistical difference in the two groups( P > 0.05 ). In treatment group, chest tightness, shortness of breath, coughing, wheezing and other lung symptoms, sign disappeared time were significantly shortened compared with control group. The first second forced expiratory volume, forced vital capacity, peak expiratory flow after treatment were significantly higher than before treatment in the two groups( P < 0.01 ), and the lung function in treatment group was improved more

  12. Historical exposure levels of inhalable dust in the Polish rubber industry compared to levels in Western Europe (United States)

    de Vocht, F.; Kromhout, H.; Sobala, W.; Peplonska, B.


    Although studies have been carried out to assess inhalable dust exposure levels in the rubber manufacturing industry, the levels of exposure in factories in Eastern Europe are less well documented. Routine stationary sampling for compliance testing of inhalable aerosols has however been conducted in a large factory producing tires and tubes in Poland between 1981 and 1996 (N=6,152). This study was conducted to assess historical inhalable aerosol levels in different departments in this rubber plant and to compare the results with estimates based on European data from the UK, Sweden, the Netherlands and Germany, and also Poland (EXASRUB project). Geometric mean (GM) concentrations in the factory ranged from 2.41 mg/m3 to 5.82 mg/m3 and were to a large extent associated to the actual production capacity of the plant and flow of the production process. Whereas 3-4 fold differences between departments existed prior to about 1985, stronger reduction of exposure in the raw materials and finishing departments (-12%/year) compared to other departments (range -5%/yr to -3%/yr), resulted in comparable levels in the 1990s. However, in the pre-treating departments, average concentrations were still about a factor 2-3 higher than in other departments, which could presumably be attributed to the use of anti-tacking agents. GM concentrations have been modelled using (1) stationary measurements collected in the Polish factory only, or (2) all European data collected in the EXASRUB project. Comparison of the estimates showed that these were fairly similar for both datasets. This analysis showed that the levels of inhalable aerosols in the Polish rubber industry have been at least a factor three to four higher than in Western European countries in the 1980s and 1990s, depending on the department, but that these differences were getting smaller in the 1990s. Furthermore, the estimates based on all European data from EXASRUB provides valid estimates compared to factory-specific data.

  13. Respiratory care year in review 2010: part 2. Invasive mechanical ventilation, noninvasive ventilation, pediatric mechanical ventilation, aerosol therapy. (United States)

    Macintyre, Neil R; Nava, Stefano; Diblasi, Robert M; Restrepo, Ruben D; Hess, Dean R


    The purpose of this paper is to review the recent literature related to invasive mechanical ventilation, NIV, pediatric mechanical ventilation, and aerosol therapy. Topics covered related to invasive mechanical ventilation topics include the role of PEEP in providing lung protection during mechanical ventilation, unconventional modes for severe hypoxemia, and strategies to improve patient-ventilator interactions. Topics covered related to NIV include real-life NIV use, NIV and extubation failure, and NIV and pandemics. For pediatric mechanical ventilation, the topics addressed are NIV, invasive respiratory support, and inhaled nitric oxide. Topics covered related to aerosol therapy include short-acting β-adrenergic agents, long-acting β-adrenergic agents, long-acting antimuscarinic agents, inhaled corticosteroid therapy, phosphodiesterase type 4 (PDE4) inhibitors, long-acting β-adrenergic plus inhaled corticosteroid, long-acting antimuscarinic plus inhaled corticosteroid, nebulized hypertonic saline, inhaled mannitol, and inhaled antibiotic therapy. These topics were chosen and reviewed in a manner that is most likely to have interest to the readers of Respiratory Care.

  14. Characterization of aerosols containing Legionella generated upon nebulization. (United States)

    Allegra, Séverine; Leclerc, Lara; Massard, Pierre André; Girardot, Françoise; Riffard, Serge; Pourchez, Jérémie


    Legionella pneumophila is, by far, the species most frequently associated with Legionnaires' disease (LD). Human infection occurs almost exclusively by aerosol inhalation which places the bacteria in juxtaposition with alveolar macrophages. LD risk management is based on controlling water quality by applying standardized procedures. However, to gain a better understanding of the real risk of exposure, there is a need (i) to investigate under which conditions Legionella may be aerosolized and (ii) to quantify bacterial deposition into the respiratory tract upon nebulization. In this study, we used an original experimental set-up that enables the generation of aerosol particles containing L. pneumophila under various conditions. Using flow cytometry in combination with qPCR and culture, we determined (i) the size of the aerosols and (ii) the concentration of viable Legionella forms that may reach the thoracic region. We determined that the 0.26-2.5 μm aerosol size range represents 7% of initial bacterial suspension. Among the viable forms, 0.7% of initial viable bacterial suspension may reach the pulmonary alveoli. In conclusion, these deposition profiles can be used to standardize the size of inoculum injected in any type of respiratory tract model to obtain new insights into the dose response for LD.

  15. Characterization of aerosols containing Legionella generated upon nebulization (United States)

    Allegra, Séverine; Leclerc, Lara; Massard, Pierre André; Girardot, Françoise; Riffard, Serge; Pourchez, Jérémie


    Legionella pneumophila is, by far, the species most frequently associated with Legionnaires’ disease (LD). Human infection occurs almost exclusively by aerosol inhalation which places the bacteria in juxtaposition with alveolar macrophages. LD risk management is based on controlling water quality by applying standardized procedures. However, to gain a better understanding of the real risk of exposure, there is a need (i) to investigate under which conditions Legionella may be aerosolized and (ii) to quantify bacterial deposition into the respiratory tract upon nebulization. In this study, we used an original experimental set-up that enables the generation of aerosol particles containing L. pneumophila under various conditions. Using flow cytometry in combination with qPCR and culture, we determined (i) the size of the aerosols and (ii) the concentration of viable Legionella forms that may reach the thoracic region. We determined that the 0.26–2.5 μm aerosol size range represents 7% of initial bacterial suspension. Among the viable forms, 0.7% of initial viable bacterial suspension may reach the pulmonary alveoli. In conclusion, these deposition profiles can be used to standardize the size of inoculum injected in any type of respiratory tract model to obtain new insights into the dose response for LD.


    Institute of Scientific and Technical Information of China (English)

    Chiu-sen Wang; Sheldon K. Friedlander; Lutz M(a)dler


    As a new scientific discipline, nanoparticle aerosol science and technology (NAST) deals with the formation, properties and behavior of nanoparticles in gases. Driven by its practical applications in many different fields, NAST has been undergoing rapid development. A conceptual framework of the discipline, with its own basic principles, experimental methods and computational techniques, is now taking shape. This paper presents an overview of the current status and research needs of the new discipline. The presentation begins with a discourse on the relationship among various particle systems, which occur frequently in nature and industry. The properties and behavior of nanoparticle aerosols are then discussed, with emphasis on the key roles played by particle size and morphology. Similar to fluid dynamics, NAST is an enabling discipline in the sense that it has provided the concepts and methodology needed for the development of many other fields. Applications of nanoparticle aerosol science and technology are highlighted in three important areas: (1) aerosol processes for synthesis of nanoparticles, (2) atmospheric nanoparticles and global climate,and (3) dosimetry of inhaled nanoparticles. These fields have features in common insofar as nanoparticle aerosols follow the same basic laws of physics and chemistry.

  17. Aerosol MTF revisited (United States)

    Kopeika, Norman S.; Zilberman, Arkadi; Yitzhaky, Yitzhak


    Different views of the significance of aerosol MTF have been reported. For example, one recent paper [OE, 52(4)/2013, pp. 046201] claims that the aerosol MTF "contrast reduction is approximately independent of spatial frequency, and image blur is practically negligible". On the other hand, another recent paper [JOSA A, 11/2013, pp. 2244-2252] claims that aerosols "can have a non-negligible effect on the atmospheric point spread function". We present clear experimental evidence of common significant aerosol blur and evidence that aerosol contrast reduction can be extremely significant. In the IR, it is more appropriate to refer to such phenomena as aerosol-absorption MTF. The role of imaging system instrumentation on such MTF is addressed too.

  18. Intestinal circulation during inhalation anesthesia

    Energy Technology Data Exchange (ETDEWEB)

    Tverskoy, M.; Gelman, S.; Fowler, K.C.; Bradley, E.L.


    This study was designed to evaluate the influence of inhalational agents on the intestinal circulation in an isolated loop preparation. Sixty dogs were studied, using three intestinal segments from each dog. Selected intestinal segments were pumped with aortic blood at a constant pressure of 100 mmHg. A mixture of /sub 86/Rb and 9-microns spheres labeled with /sup 141/Ce was injected into the arterial cannula supplying the intestinal loop, while mesenteric venous blood was collected for activity counting. A very strong and significant correlation was found between rubidium clearance and microsphere entrapment (r = 0.97, P less than 0.0001). Nitrous oxide anesthesia was accompanied by a higher vascular resistance (VR), lower flow (F), rubidium clearance (Cl-Rb), and microspheres entrapment (Cl-Sph) than pentobarbital anesthesia, indicating that the vascular bed in the intestinal segment was constricted and flow (total and nutritive) decreased. Halothane, enflurane, and isoflurane anesthesia were accompanied by a much lower arteriovenous oxygen content difference (AVDO/sub 2/) and oxygen uptake than pentobarbital or nitrous oxide. Compared with pentobarbital, enflurane anesthesia was not accompanied by marked differences in VR, F, Cl-Rb, and Cl-Sph; halothane at 2 MAC decreased VR and increased F and Cl-Rb while isoflurane increased VR and decreased F. alpha-Adrenoceptor blockade with phentolamine (1 mg . kg-1) abolished isoflurane-induced vasoconstriction, suggesting that the increase in VR was mediated via circulating catecholamines.

  19. [Evoked potentials and inhalation anesthetics]. (United States)

    Thiel, A; Russ, W; Hempelmann, G


    Intraoperative monitoring of evoked potentials can be affected by various factors including volatile anaesthetics. These effects have to be considered in order to give correct interpretations of the obtained data. Visual evoked potentials (VEP) and auditory evoked potentials (AEP) will show strong alterations under general anaesthesia whereas brainstem auditory evoked potentials (BAEP) are slightly affected. The effects of nitrous oxide, halothane, enflurane, and isoflurane on somatosensory evoked potentials (SEP) after median nerve stimulation were studied in 35 healthy adult patients. pCO2 and tympanic membrane temperature were held constant. Simultaneous cervical and cortical SEP recording was performed using surface electrodes. After induction of anaesthesia SEP were recorded during normoventilation with 100% oxygen and after inhalation of 66.6% nitrous oxide. 10 patients received halothane at inspired concentrations of 0.5, 1.0, 1.5, and 2.0%. After nitrous oxide had been replaced by oxygen, halothane was reduced in steps of 0.5%. SEP were recorded at the end of each period (15 min). Equipotent doses of enflurane or isoflurane were administered to 15 and 10 patients, respectively. Nitrous oxide depressed early cortical SEP amplitude. Halothane, enflurane, and isoflurane caused dose dependent increases of latencies. Reduction of amplitude was most pronounced with isoflurane. Using high doses of enflurane in oxygen cortical SEP showed unusual high amplitudes associated with marked increases of latencies. Even under high concentrations of volatile anaesthetics cervical SEP were minimally affected. The effects of anaesthetic gases have to be considered when SEP are recorded intraoperatively.

  20. Implications of three phase bone scintigraphy for the diagnosis of bisphosphonate related osteonecrosis of the jaw

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Chae Moon; Ahn, Byeong Cheol; Choi, So Young; Kim, Do Hoon; Lee, Sang Woo; Kwon, Tae Geon; Lee, Jaetae [Kyungpook National Univ., Daegu (Korea, Republic of)


    Bisphosphonate (BP) related osteonecrosis of the jaw (BRONJ) is a well known serious complication of BP treatment. This study was undertaken to evaluate the diagnostic usefulness of three phase bone scintigraphy in patients with BRONJ. Forty one patients (48 lesions)with clinically proven BRONJ (2 males, 39 females, age 74.3{+-}6.7 years)under went Tc 99m HDP bone scintigraphy. Visual interpretation and semiquantitative analysis of uptakes using lesion to contralateral uptake ratios during the blood pool phase (BUR)and during the osseous phase (OUR)were performed, and relations were sought between these and various clinical parameters. Three phase bone scintigraphy showed increased perfusion and blood pooling in 21 (63.6%)and 27 (81.8%)of 33 lesions, respectively. The osseous phase was positive for 45 (93.8%)of the 48 lesions. Of the four inflammatory clinical parameters of BRONJ [pus discharge, pain, swelling, and erythrocyte sedimentation rate (ESR)], patients with three or more parameters had more positive findings in vascular and blood pool phase images (p=0.033, p=0.027). By semiquantitative analysis, patients with a positive ESR had statistically higher BUR and OUR (both p<0.001). Higher stage BRONJ lesions had higher OUR than lower stage lesions (p=0.003). In addition, bone scintigraphy revealed three clinically covert BRONJ lesions without bone exposure, and four patients were up staged based on bone scintigraphy. Bone scintigraphy provides a relatively sensitive means of detecting BRONJ, so it was helpful for accurate BRONJ staging. Furthermore, Increased uptakes in vascular and blood pool phases of three phase bone scintigraphy were related to the inflammatory activity of BRONJ.

  1. Aerosols in the study of convective acinar mixing (United States)

    Darquenne, Chantal; Prisk, G. Kim


    Convective mixing (CM) refers to the different transport mechanisms except Brownian diffusion that irreversibly transfer inspired air into resident air and can be studied using aerosol bolus inhalations. This paper provides a review of the present understanding of how each of these mechanisms contributes to CM. Original data of the combined effect of stretch and fold and gravitational sedimentation on CM are also presented. Boli of 0.5 microm-diameter particles were inhaled at penetration volumes (V(p)) of 300 and 1200 ml in eight subjects. Inspiration was followed by a 10-s breath hold, during which small flow reversals (FR) were imposed, and expiration. There was no physiologically significant dependence in dispersion and deposition with increasing FR. The results were qualitatively similar to those obtained in a previous study in microgravity in which it was speculated that the phenomenon of stretch and fold occurred during the first breathing cycle without the need of any subsequent FR.

  2. Inhibition by sodium cromoglycate of bronchoconstriction stimulated by respiratory heat loss: comparison of pressurised aerosol and powder. (United States)

    Latimer, K M; Roberts, R; Morris, M M; Hargreave, F E


    The protective effect was examined of three doses (2, 10, and 20 mg) of sodium cromoglycate inhaled from a pressurised metered dose inhaler on the response to isocapnic hyperventilation of cold dry air in 10 asthmatic subjects. This was compared with the effect of cromoglycate powder (20 mg) inhaled from a Spincap and with placebo given on two occasions. The medications were inhaled on separate days, in random order and with the use of a double blind double dummy technique, 20 minutes before isocapnic hyperventilation of two fold increasing volumes of air (-15 degrees C, 0% humidity) to produce a 20% fall in the post-treatment FEV1. The response was expressed as the provocative dose of respiratory heat loss required to cause a fall in FEV1 of 15% (PD15, kcal/min). The mean baseline spirometric indices exceeded 85% of predicted normal values on each test day; both placebo treatments reduced the baseline FEV1 by comparison with all active treatments (p less than 0.0001). Comparison of the PD15 on the two placebo days confirmed excellent reproducibility. All doses of cromoglycate shifted the respiratory heat loss dose-response curve to the right of the placebo curve; PD15 after all active treatments exceeded PD15 after placebo (p less than 0.0001). There was no cromoglycate dose-response relationship between the three doses of aerosol (p greater than 0.05), or between any dose of aerosol and powder (p greater than 0.05). It is concluded that cromoglycate aerosol inhaled from a pressurised inhaler in a dose of 2 mg gives the same magnitude of protection against bronchoconstriction stimulated by airway cooling as 20 mg of pressurised aerosol or powder from a Spincap. PMID:6426073

  3. Somatostatin analogue scintigraphy and tuberculosis: case report; Scintigraphie des analogues de la somatostatine et tuberculose: a propos d'un cas

    Energy Technology Data Exchange (ETDEWEB)

    Biancheri, I.; Rudenko, B.; Vautrin, P.; Raddoul, J.; Lamfichek, N. [Centre Hospitalier General Andre Boulloche, 25 - Montbeliard (France); Kantelip, B.; Mantion, G. [Centre Hospitalier Universitaire Jean Minjoz, 25 - Besancon (France)


    Scintigraphy using a radiolabelled somatostatin analogue (111 In-pentetreotide) is useful in the detection of neuroendocrine tumors. But this radiopharmaceutical accumulates also in solid tumours or in inflammatory diseases such as granulomatosis. We present a case of 111 In-pentetreotide uptake in a tuberculous adenopathy. (author)

  4. Aerosols Science and Technology

    CERN Document Server

    Agranovski, Igor


    This self-contained handbook and ready reference examines aerosol science and technology in depth, providing a detailed insight into this progressive field. As such, it covers fundamental concepts, experimental methods, and a wide variety of applications, ranging from aerosol filtration to biological aerosols, and from the synthesis of carbon nanotubes to aerosol reactors.Written by a host of internationally renowned experts in the field, this is an essential resource for chemists and engineers in the chemical and materials disciplines across multiple industries, as well as ideal supplementary

  5. Environmental pollution: influence on the operation of a sensor of radioactive aerosols; Contaminacion ambiental: influencia en el funcionamiento de un captador de aerosoles radiactivos

    Energy Technology Data Exchange (ETDEWEB)

    Duarte Rodriguez, X.; Hernandez Armas, J.; Martin Delgado, J.; Rodriguez Perestelo, N.; Perez Lopez, M.; Catalan Acosta, A.; Fernandez de Aldecoa, J. c.


    The content of radioactive aerosols in the air is an important component to estimate the ambient radiation dose. In the laboratories of environmental radioactivity, measurements of radionuclides in air they are performed using sensors. The flow picked up by the equipment can be changed if the degree of air pollution changes for some reason. It handles this study and the population doses are estimated due to inhalation of ambient air. (Author)

  6. Adhesive mixtures for inhalation : the cohesion between formulation variables, inhalation variables and dispersion performance

    NARCIS (Netherlands)

    Grasmeijer, Floris


    Powdery drugs for inhalation to treat asthma and COPD are often mixed with lactose to enable their accurate dosing. However, because the drug particles adhere strongly to the lactose particles, they are difficult to disperse with the aid of a dry powder inhaler. As a result, over half the dose usual

  7. Conference report: 2nd Medicon Valley Inhalation Symposium. (United States)

    Lastow, Orest


    2nd Medicon Valley Inhalation Symposium 16 October 2013, Lund, Sweden The 2nd Medicon Valley Inhalation Symposium was arranged by the Medicon Valley Inhalation Consortium. It was held at the Medicon Village, which is the former AstraZeneca site in Lund, Sweden. It was a 1 day symposium focused on inhaled drug delivery and inhalation product development. 120 delegates listened to 11 speakers. The program was organized to follow the value chain of an inhalation product development. This year there was a focus on inhaled biomolecules. The inhaled delivery of insulin was covered by two presentations and a panel discussion. The future of inhaled drug delivery was discussed together with an overview of the current market situation. Two of the inhalation platforms, capsule inhalers and metered-dose inhalers, were discussed in terms of the present situation and the future opportunities. Much focus was on the regulatory and intellectual aspects of developing inhalation products. The manufacturing of a dry powder inhaler requires precision filling of powder, and the various techniques were presented. The benefits of nebulization and nasal delivery were illustrated with some case studies and examples. The eternal challenge of poor compliance was addressed from an industrial design perspective and some new approaches were introduced.

  8. The generation of diesel exhaust particle aerosols from a bulk source in an aerodynamic size range similar to atmospheric particles

    Directory of Open Access Journals (Sweden)

    Daniel J Cooney


    Full Text Available Daniel J Cooney1, Anthony J Hickey21Department of Biomedical Engineering; 2School of Pharmacy, University of North Carolina, Chapel Hill, NC, USAAbstract: The influence of diesel exhaust particles (DEP on the lungs and heart is currently a topic of great interest in inhalation toxicology. Epidemiological data and animal studies have implicated airborne particulate matter and DEP in increased morbidity and mortality due to a number of cardiopulmonary diseases including asthma, chronic obstructive pulmonary disorder, and lung cancer. The pathogeneses of these diseases are being studied using animal models and cell culture techniques. Real-time exposures to freshly combusted diesel fuel are complex and require significant infrastructure including engine operations, dilution air, and monitoring and control of gases. A method of generating DEP aerosols from a bulk source in an aerodynamic size range similar to atmospheric DEP would be a desirable and useful alternative. Metered dose inhaler technology was adopted to generate aerosols from suspensions of DEP in the propellant hydrofluoroalkane 134a. Inertial impaction data indicated that the particle size distributions of the generated aerosols were trimodal, with count median aerodynamic diameters less than 100 nm. Scanning electron microscopy of deposited particles showed tightly aggregated particles, as would be expected from an evaporative process. Chemical analysis indicated that there were no major changes in the mass proportion of 2 specific aromatic hydrocarbons (benzo[a]pyrene and benzo[k]fluoranthene in the particles resulting from the aerosolization process.Keywords: diesel exhaust particles, aerosol, inhalation toxicology

  9. Assessing inhalation injury in the emergency room

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    Tanizaki S


    Full Text Available Shinsuke Tanizaki Department of Emergency Medicine, Fukui Prefectural Hospital, Fukui, Japan Abstract: Respiratory tract injuries caused by inhalation of smoke or chemical products are related to significant morbidity and mortality. While many strategies have been built up to manage cutaneous burn injuries, few logical diagnostic strategies for patients with inhalation injuries exist and almost all treatment is supportive. The goals of initial management are to ensure that the airway allows adequate oxygenation and ventilation and to avoid ventilator-induced lung injury and substances that may complicate subsequent care. Intubation should be considered if any of the following signs exist: respiratory distress, stridor, hypoventilation, use of accessory respiratory muscles, blistering or edema of the oropharynx, or deep burns to the face or neck. Any patients suspected to have inhalation injuries should receive a high concentration of supplemental oxygen to quickly reverse hypoxia and to displace carbon monoxide from protein binding sites. Management of carbon monoxide and cyanide exposure in smoke inhalation patients remains controversial. Absolute indications for hyperbaric oxygen therapy do not exist because there is a low correlation between carboxyhemoglobin levels and the severity of the clinical state. A cyanide antidote should be administered when cyanide poisoning is clinically suspected. Although an ideal approach for respiratory support of patients with inhalation injuries do not exist, it is important that they are supported using techniques that do not further exacerbate respiratory failure. A well-organized strategy for patients with inhalation injury is critical to reduce morbidity and mortality. Keywords: inhalation injury, burn, carbon monoxide poisoning, cyanide poisoning

  10. Airway irritation, inflammation, and toxicity in mice following inhalation of metal oxide nanoparticles

    DEFF Research Database (Denmark)

    Larsen, Søren T; Jackson, Petra; Poulsen, Steen S


    in the airways following inhalation. In the present study, the acute (24 h) and persistent (13 weeks) effects in the airways after a single exposure to metal oxide nanoparticles were studied using a murine inhalation model. Mice were exposed 60 min to aerosols of either ZnO, TiO2, Al2O3 or CeO2 and the deposited...... particles except TiO2. The ranking of potency regarding induction of acute lung inflammation was Al2O3 = TiO2 CeO2 ≪ ZnO. Exposure to CeO2 gave rise to a more persistent inflammation; both neutrophilic and lymphocytic inflammation was seen 13 weeks after exposure. As the only particles, ZnO caused......Metal oxide nanoparticles are used in a broad range of industrial processes and workers may be exposed to aerosols of the particles both during production and handling. Despite the widespread use of these particles, relatively few studies have been performed to investigate the toxicological effects...

  11. Preparation of inhalable salbutamol sulphate using reactive high gravity controlled precipitation. (United States)

    Hu, Tingting; Chiou, Herbert; Chan, Hak-Kim; Chen, Jian-Feng; Yun, Jimmy


    Reactive high gravity controlled precipitation (HGCP) was carried out to produce salbutamol sulphate (SS) particles suitable for inhalation. Aqueous solutions of free salbutamol base and sulphuric acid were mixed intensely inside a HGCP reactor to form the particles. Spray drying was employed to obtain dry powders. Physical properties of the powders were characterised by scanning electron microscopy, X-ray powder diffraction, thermal gravimetric analysis and dynamic water vapour sorption. Aerosol performance of the powders was measured using an Aeroliser connected to a multiple stage liquid impinger operating at 60 L/min. The results showed that the reactive HGCP powder, comprising primary SS sub-micron particles (approximately 100 nm in width and approximately 500 nm in length) packed into loose spherical agglomerates of about 2 microm in diameter, is of the same polymorphic form as the raw crystalline material, has a high specific surface area (24.7 +/- 0.1 m(2)/g), but a low moisture content (0.2%) and low moisture uptake (1.4% at RH 90%). The aerosol performance of the reactive HGCP powder is excellent, showing FPF(loaded) and FPF(emitted) of 76 +/- 5% and 83 +/- 7%, respectively, with low capsule and device retention. In conclusion, reactive HGCP followed by spray drying is suitable to produce stable crystalline powders of salbutamol with enhanced inhalation properties.

  12. Health Effects Associated with Inhalation of Airborne Arsenic Arising from Mining Operations

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    Rachael Martin


    Full Text Available Arsenic in dust and aerosol generated by mining, mineral processing and metallurgical extraction industries, is a serious threat to human populations throughout the world. Major sources of contamination include smelting operations, coal combustion, hard rock mining, as well as their associated waste products, including fly ash, mine wastes and tailings. The number of uncontained arsenic-rich mine waste sites throughout the world is of growing concern, as is the number of people at risk of exposure. Inhalation exposures to arsenic-bearing dusts and aerosol, in both occupational and environmental settings, have been definitively linked to increased systemic uptake, as well as carcinogenic and non-carcinogenic health outcomes. It is therefore becoming increasingly important to identify human populations and sensitive sub-populations at risk of exposure, and to better understand the modes of action for pulmonary arsenic toxicity and carcinogenesis. In this paper we explore the contribution of smelting, coal combustion, hard rock mining and their associated waste products to atmospheric arsenic. We also report on the current understanding of the health effects of inhaled arsenic, citing results from various toxicological, biomedical and epidemiological studies. This review is particularly aimed at those researchers engaged in the distinct, but complementary areas of arsenic research within the multidisciplinary field of medical geology.

  13. Contribution of the SPECT-T.D.M. in complement of the planar osseous scintigraphy in running practice; Apport de la TEMP-TDM en complement de la scintigraphie osseuse planaire en pratique courante

    Energy Technology Data Exchange (ETDEWEB)

    Netter, F.; Journo, A.; Mayer, J.C.; Daragon, N.; Grandpierre, S.; Scigliano, S.; Olivier, P.; Karcher, G. [Service de medecine nucleaire, CHU de Nancy, (France)


    The aim of our study was to evaluate the contribution of the SPECT-T.D.M. in our daily practice of the osseous scintigraphy. Our study, enlightens a contribution of the SPECT-T.D.M; for 74% (29/39) addressed for an osseous scintigraphy and having got a complementary examination by SPECT-T.D.M. (N.C.)

  14. Diagnostic potential of renal scintigraphy following ACE-inhibition ('captopril scintigraphy') for the detection of renovascular hypertension. Wertigkeit der Nierenszintigraphie unter ACE-Blockade ('Captoprilszintigraphie') in der Diagnostik der renovaskulaeren Hypertonie

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    Baum, R.P.; Maul, F.D.; Hoer, G. (Frankfurt Univ. (Germany). Abt. fuer Nuklearmedizin)


    The purpose of this paper is to: (a) briefly review the pathophysiological basis of renovascular hypertension and the renin-angiotensin-system; (b) to outline the potential of captopril scintigraphy especially using Tc-99m MAG{sub 3}; and (c) to propose a practical protocol for captopril scintigraphy and its role in screening for renovascular hypertension. (orig./MG).

  15. The contribution of bone scintigraphy in occupational health or medical insurance claims: a retrospective study

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    Versijpt, J.; Dierckx, R.A.; Bondt, P. de [Division of Nuclear Medicine, University Hospital Gent (Belgium); Dierckx, I. [Department of Radiology, St. Elisabeth Hospital Antwerpen (Belgium); Lambrecht, L. [Outpatient Internal Medicine Clinic, Gent (Belgium); Sadeleer, C. de [Division of Nuclear Medicine, University Hospital Gent (Belgium)]|[Department of Nuclear Medicine, O.L.V. Hospital Geraardsbergen (Belgium)


    Patients with a suspicion of bone damage following an industrial or traffic accident are often referred for bone scintigraphy as part of an occupational health or medical insurance investigation. The aim of this study was to assess the contribution and the potential role of bone scintigraphy compared with X-ray investigations in the aforementioned situation. To this end we evaluated 70 consecutive patients referred for bone scintigraphy during 1996 and 1997 by occupational health or medical insurance physicians. The most common reasons for referral were the exclusion of occult fractures of hands and feet, whiplash injuries, reflex sympathetic dystrophy or avascular necrosis, or the differentiation between an old and a recent vertebral fracture. X-rays were only available for comparative review of 53 patients, so only those were analysed. The results of bone scintigraphy were compared with X-rays, and their contribution and potential role in occupational health or medical insurance investigations assessed. In 31 out of the 53 patients investigated, bone scintigraphy findings concurred with X-rays as to the number and location of abnormalities. For 19 of the 53 patients, bone scintigraphy showed clinically relevant additional foci when compared with X-rays, predominantly involving lesions to hands/wrists and feet/ankles. Among these 19 patients, scintigraphic diagnoses were subsequently confirmed in ten cases by means of X-ray or computed tomography. In four patients, supplementary radiological investigations revealed no abnormalities, and in five patients no further investigations were undertaken. Finally, in three of the 53 patients, X-rays revealed bone damage (burst fractures) whilst the corresponding bone scintigraphy was negative, thus excluding recent injury. In conclusion, in 22 patients, representing 42% of the cases analysed, bone scintigraphy was conclusive compared with X-ray imaging in the final diagnosis and in this way in detecting occult or excluding

  16. REDIQ: a computer program for estimating health effects from inhalation and ingestion of radionuclides

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    Strenge, D.L.; Watson, E.C.; Kennedy, W.E.


    The computer program REDIQ calculates the risk equivalence of dosage from internally deposited radionuclides to dosage from external whole-body irradiation. The calculation gives an estimate of the microcurie intake per nuclide that would result in a risk equivalent to receiving 1 rem of external whole-body irradiation. The program allows for internal deposition resulting from either inhalation of radioactive aerosols or ingestion of contaminated food. The inhalation portion of REDIQ was taken from the computer program DACRIN, which uses the models of the respiratory tract adopted by the Task Group on Lung Dynamics. REDIQ also uses a simple exponential model for retention by an organ of interest, and the gastrointestinal tract model of the International Commission on Radiological Protection (ICRP). For each nuclide specified, the program first calculates the radiation dose per microcurie intake by inhalation or ingestion to any of 23 organs and tissues. A maximum of 10 organs may be specified for any one case. The values for dose per microcurie intake are then coupled with relative risk values for each organ being considered, to arrive at the estimated intake equivalent to 1 rem of external whole-body irradiation.

  17. Development of an acute model of inhalational melioidosis in the common marmoset (Callithrix jacchus). (United States)

    Nelson, Michelle; Dean, Rachel E; Salguero, Francisco J; Taylor, Christopher; Pearce, Peter C; Simpson, Andrew J H; Lever, Mark S


    Studies of inhalational melioidosis were undertaken in the common marmoset (Callithrix jacchus). Following exposure to an inhaled challenge with aerosolized Burkholderia pseudomallei, lethal infection was observed in marmosets challenged with doses below 10 cfu; a precise LD(50) determination was not possible. The model was further characterized using a target challenge dose of approximately 10(2) cfu. A separate pathogenesis time-course experiment was also conducted. All animals succumbed, between 27 and 78 h postchallenge. The challenge dose received and the time to the humane endpoint (1 °C below normal body temperature postfever) were correlated. The first indicator of disease was an increased core body temperature (T(c) ), at 22 h postchallenge. This coincided with bacteraemia and bacterial dissemination. Overt clinical signs were first observed 3-5 h later. A sharp decrease (typically within 3-6 h) in the T(c) was observed prior to humanely culling the animals in the lethality study. Pathology was noted in the lung, liver and spleen. Disease progression in the common marmoset appears to be consistent with human infection in terms of bacterial spread, pathology and physiology. The common marmoset can therefore be considered a suitable animal model for further studies of inhalational melioidosis.

  18. Whole-body MRI of Langerhans cell histiocytosis: comparison with radiography and bone scintigraphy

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    Goo, Hyun Woo; Yang, Dong Hyun [Asan Medical Center, Department of Radiology, University of Ulsan College of Medicine, Seoul (Korea); Ra, Young Shin [Asan Medical Center, Department of Neurosurgery, University of Ulsan College of Medicine, Seoul (Korea); Song, Joon Sup; Im, Ho Joon; Seo, Jong Jin; Ghim, Thad; Moon, Hyung Nam [Asan Medical Center, Department of Pediatric Oncology, University of Ulsan College of Medicine, Seoul (Korea)


    In Langerhans cell histiocytosis (LCH) evaluation of the extent of disease is one of the major predictors of patient outcome. Historically this is undertaken using plain radiography and bone scintigraphy. Recently, whole-body (WB) MRI has been reported to be useful in detecting skeletal and extraskeletal metastases in both adults and children. To evaluate the usefulness of WB MRI in patients with LCH in comparison with plain radiography and bone scintigraphy. In nine children (1-7 years of age; mean 3.3 years) who had a pathological diagnosis of LCH and had either plain radiography or bone scintigraphy for comparison, 43 WB MR examinations were performed. Skeletal and extraskeletal lesions of the disease on WB MRI were compared with those on plain radiography and bone scintigraphy. LCH showed unifocal single-system involvement in one patient, multifocal single-system involvement in three, and multifocal multisystem disease in five. WB MRI identified additional skeletal lesions in three (38%) of eight patients, compared with plain radiography, and in two (25%) of eight, compared with bone scintigraphy. WB MRI detected extraskeletal lesions of the disease in five (56%) of the nine patients exclusively, except for one patient whose lung lesions were also detected on plain radiography. In two patients, treatment was changed according to WB MRI findings. (orig.)

  19. Comparative diagnostic value of bone scintigraphy and roentgenography in children with Legg-Calve-Perthes disease

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    Cavailloles, F.; Brauner, M.; Dandine, M.; Lonchampt, M.F.; Esteban, C.; Bensahel, H.; Patois, E.; Alperovitch, A.; Bock, B.


    To compare the value of hip roentgenograms and bone scintigraphy in Legg-Calve-Perthes (LCP) disease, a double blind study was done in 153 children, of whom 51 had LCP. Each procedure was read separately by two investigators who had no knowledge of clinical data. Variations across investigators were less significant for roentgenograms than for bone scans. Agreement on diagnosis between the two investigators was 95% for roentgenograms, against only 89% for bone scans. As regards the detailed analysis of each separate finding upon bone scintigraphy and assessment of this procedure's prognostic value, major discrepancies occurred between the two investigators. Diagnostic accuracy was very similar for the two procedures. Both bone scintigraphy and roentgenography showed a 0.86 sensitivity. Specificities were 0.93 and 0.99 respectively. For the subgroup of patients with early-stage LCP disease (33 cases), scintigraphy identified a slightly greater number of cases than roentgenography (0.88 and 0.76 respectively). Some disagreements between our results and those previously published in the literature may stem from biases such as the criteria for entering patients into the study or for establishing the final diagnosis. Roentgenography is obviously the first procedure to perform in a child with a painful hip or a limp. However, the results may be inconclusive in early-stage disease. In such cases, scintigraphy is needed and often avoids unnecessary traction or diagnostic delay.

  20. Vesicoureteral Reflux Detected with 99mTc-DTPA Renal Scintigraphy during Evaluation of Renal Function

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    Nevena Manevska


    Full Text Available BACKGROUND: Radionuclide techniques, as direct radionuclide cystography and 99mTc-DMSA scintigraphy, have been used in evaluation of vesicoureteral reflux (VUR and reflux nephropathy (RN in children. Dynamic 99mTc-DTPA scintigraphy is reserved for evaluation of differential renal function and obstruction in children, where hydronephrosis is detected by ultrasonography (US pre- or postnatally. CASE REPORT: Six year old boy was prenatally diagnosed with bilateral hydronephrosis. Postnatal, severe bilateral VUR was detected by voiding urethrocytography. US and 99mTc-DTPA scintigraphy performed in the first month of life showed small left kidney that participated with 2% in the global renal function. Bilateral cutaneous ureterostomy has been performed in order to obtain good renal drainage and promote optimal renal growth. Twelve months later, classic antireflux procedure was done. Control 99mTc-DTPA scintigraphy, 5 ys after antireflux surgery, revealed persisting radioactivity during the diuretic phase, in the left kidney that indicated antireflux procedure failure with VUR reappearance. CONCLUSION: 99mTc-DTPA scintigraphy is the first method of choice for long-term monitoring of individual kidney function in children with VUR and other congenital urinary tract anomalies. Additionally, it can be used as indirect radionuclide cystography when rising of radioactivity in the kidney region, during the diuretic phase can indicate presence of VUR.

  1. Vesicoureteral Reflux Detected with 99mTc-DTPA Renal Scintigraphy during Evaluation of Renal Function (United States)

    Manevska, Nevena; Stojanoski, Sinisa; Majstorov, Venjamin; Pop-Gjorcheva, Daniela; Zdraveska, Nikolina; Kuzmanovska, Dafina


    BACKGROUND: Radionuclide techniques, as direct radionuclide cystography and 99mTc-DMSA scintigraphy, have been used in evaluation of vesicoureteral reflux (VUR) and reflux nephropathy (RN) in children. Dynamic 99mTc-DTPA scintigraphy is reserved for evaluation of differential renal function and obstruction in children, where hydronephrosis is detected by ultrasonography (US) pre- or postnatally. CASE REPORT: Six year old boy was prenatally diagnosed with bilateral hydronephrosis. Postnatal, severe bilateral VUR was detected by voiding urethrocytography. US and 99mTc-DTPA scintigraphy performed in the first month of life showed small left kidney that participated with 2% in the global renal function. Bilateral cutaneous ureterostomy has been performed in order to obtain good renal drainage and promote optimal renal growth. Twelve months later, classic antireflux procedure was done. Control 99mTc-DTPA scintigraphy, 5 ys after antireflux surgery, revealed persisting radioactivity during the diuretic phase, in the left kidney that indicated antireflux procedure failure with VUR reappearance. CONCLUSION: 99mTc-DTPA scintigraphy is the first method of choice for long-term monitoring of individual kidney function in children with VUR and other congenital urinary tract anomalies. Additionally, it can be used as indirect radionuclide cystography when rising of radioactivity in the kidney region, during the diuretic phase can indicate presence of VUR. PMID:27275347

  2. Bone marrow accumulation in gallium scintigraphy in patients with adult still's disease

    Energy Technology Data Exchange (ETDEWEB)

    Kanegae, Futoshi; Tada, Yoshifumi; Ohta, Akihide; Ushiyama, Osamu; Suzuki; Noriaki; Koarada, Syuichi; Haruta, Yoshio; Yoshikai, Tomonori; Nagasawa, Kohei [Saga Medical School (Japan)


    We investigated the features and the usefulness of gallium scintigraphy in the diagnosis and the assessment of Adult Still's disease (ASD) by retrospective case review. Gallium scintigraphy have been done for 11 cases of ASD (3 males and 8 females) and 4 females were positive. Among these, 67 Ga-citrate was accumulated to the bone marrow in all 4 cases and to the major joints in 2 cases. Positive cases were rather serious and administered more immunosuppressants than negative cases. In order to characterize gallium scintigraphy findings of ASD, i.e. bone marrow accumulation, we analyzed 130 cases of collagen vascular disease. Although 101 cases (77.7%) were positive, only 7 cases (5.4%) showed the accumulation of {sup 67}Ga-citrate to the bone marrow. These include 3 cases with ASD, and 1 case with systemic lupus erythematosus, polyarteritis nodosa, Wegener's granulomatosis and Sjogren's syndrome. We also accumulated 18 patients who exhibited bone marrow accumulation of {sup 69}Ga-citrate, and found that 7 patients had collagen vascular and their related diseases. In conclusion, bone marrow accumulation in gallium scintigraphy is a specific feature of collagen vascular diseases, especially ASD, and it is suggested that cases with positive gallium scintigraphy in ASD can be serious and resistant to treatment. (author)

  3. Chronological study for solitary bone metastasis in the sternum from breast cancer with bone scintigraphy

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    Miyoshi, Hidenao; Otsuka, Nobuaki; Sone, Teruki; Nagai, Kiyohisa; Tamada, Tsutomu; Mimura, Hiroaki; Yanagimoto, Shinichi; Tomomitsu, Tatsushi; Fukunaga, Masao [Kawasaki Medical School, Kurashiki, Okayama (Japan)


    Since breast cancer is frequently associated with bone metastasis, bone scintigraphies have been performed to determine pre-operative staging and to survey postoperative bone metastasis. The sternum, in particular, is a site at which is difficult to differentiate between benign bone disease and bone metastasis, because of varied uptake and wide individual variations. In this study, chronological bone images were scintigraphied in six cases with solitary sternal metastasis and three cases with benign bone disease including two fracture cases and one arthritis case. On bone scintigrams in which solitary sternal metastasis appeared, increased uptake was found in five cases, and photon deficiency was observed in one case. During follow-up scintigraphies, abnormal accumulations, such as hot spots and cold lesions, increased in the bone metastasis while abnormal uptake disappeared or was unchanged in the benign bone disease cases. On CT, four cases showed osteolytic change, and one exhibited osteosclerotic change. These findings indicate that sternal metastasis usually shows osteolytic change, even if a hot lesion is recognized on bone scintigraphy. In solitary sternal metastasis, for which early diagnosis is difficult, both an integrated diagnosis using other imaging techniques and chronological bone scintigraphy are important. (author)

  4. Quantification of left ventricular dilatation in myocardial perfusion scintigraphy

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    Gonzalez, Mauren B. Azambuja, E-mail:, E-mail: [Pontificia Universidade Catolica do Rio Grande do Sul (PUC-RS), Porto Alegre, RS (Brazil). Clinica Medica. Programa de Pos-Graduacao em Medicina e Ciencias da Saude; Azambuja, Roberto Alves [Hospital Sao Vicente de Paulo, Passo Fundo, RS (Brazil); Bodanese, Luiz Carlos [Pontificia Universidade Catolica do Rio Grande do Sul (PUC-RS), Porto Alegre, RS (Brazil). Hospital Sao Lucas. Serv. de Cardiologia


    Background: the rate of transient dilatation can be determined by exercise testing or pharmacological stress test. It is unknown whether the type of stress has an impact on average transient dilatation index values. Objective: to compare average transient dilation index values in 99mTc-sestamibi scintigraphy in patients undergoing treadmill stress test, versus dipyridamole stress test. The secondary purpose was to evaluate the impact on the average index value by demographic characteristics, risk factors for coronary artery disease and severity of ischemia. Methods: the cross-sectional study included 200 patients between 40 and 70 years old, with or without risk factors for ischemic heart disease, with or without a previous diagnosis of ischemic heart disease. The separation between groups was sequential. The software 4D-MSPECT calculated the transient dilatation index and provided a scoring system for perfusion analysis. Results: the average transient dilation index value of the group undergoing exercise stress test was 1.06 ({+-}0.23). For the group undergoing the dipyridamole stress test, it was 1.10 ({+-}0.22); (p = 0.200). There was no association between the type of stress and the average transient dilatation index values. An association was found between the average index values and age only for those patients from the exercise test group (p = 0.009). Conclusion: the results of our study demonstrate that the transient dilation index does not differ when patients undergo exercise stress test on a treadmill or pharmacological stress by dipyridamole. (author)

  5. Incidental Hiatal Hernia Detected with Meckel's Scintigraphy

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    Aksoy, Tamer [Afyon Kocatepe Univ. Medical Faculty, Afyon (Turkmenistan); Kiratli, Pinar Ozgen [Hacettepe Univ. Medical Faculty, Ankara (Turkmenistan)


    Congenital hiatal hernia (CHH) in children is a very rare condition that occurs in about 1 in every 2,000 to 5,000 live births, with a male to female ratio of 2:3. In 97% of cases the anomaly is unilateral with a left side preponderance. The hernia content can include the stomach, bowel loops, spleen or part of the liver. CHH may remain asymptomatic or induce only nonspecific gastro intestinal and/or thoracic symptoms. The symptomatology og these patients is usually non specific, in the form of repeated attacks of chest infection and/or recurrent vomiting, but can be associated with serious complications such as intrathoracic gastric volvulus with incarceration and strangulation. Because of the gastroesophageal reflux, linear ulcerations on the esophageal mucosa might occur and cause intermittent bleeding. Plan chest radiographs, AP and lateral, may raise a suspicion of the condition, while upper gastrointestinal contrast series are diagnostic. The treatment is surgery consisting of excision of the hernial sac after reducing the stomach and repair of the diaphragmatic defect by tightening the crura of the esophageal hiatus. If the defect is large and associated with displacement of the gastroesophageal junction (GEJ) into the thorax, adding an anti reflux procedure to the repair is appropriate. This can be achieved transabdominally either by laparotomy or laparoscopically. To the best of our knowledge, this is the second case diagnosed with Meckel's scintigraphy.

  6. Comparison of Myocardial Perfusion Scintigraphy and Coronary Angiography Results

    Directory of Open Access Journals (Sweden)

    Umut Elboga


    Full Text Available Aim: Coronary artery disease (CAD is one of the most frequent causes of mortality and morbidity worldwide. Coronary angiography is the gold standard for the anatomical diagnosis of coronary artery stenosis. Myocardial Perfusion Scintigraphy (MPS is a non-invasive imaging modality used for the diagnosis of CAD. In this study, we aimed to compare the findings of MPS and coronary angiogram. Material and Method: Eighty-one patients (37 males, 44 females; mean age 55 ± 10.95 years with angina and detected perfusion defects on MPS were included in this study. All of the patients underwent coronary angiogram. A narrowing %u2265 50% was considered pathological on the coronary angiography. Results: Findings of the coronary angiogram and MPS were compared and found consistent in 51 (63% patients. A coronary narrowing < 50% was detected by coronary angiogram in 4 (5% of the remaining patients. Coronary angiogram was found to be normal in the remaining 26 patients (32% and these patients were evaluated as cardiac syndrome X (CSX known as microvascular angina (MA. Discussion: The findings showed that MPS is superior to coronary angiogram in the early diagnosis of myocardial perfusion disorders at the microvascular level. Therefore, we concluded that MPS should be the primary diagnostic tool to begin treatment before an anatomically large narrowing occurs in the coronaries.

  7. Applicability of the Appropriate use Criteria for Myocardial Perfusion Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Anderson de [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Comissão Nacional de Energia Nuclear - CNEN (Brazil); Rezende, Maria Fernanda [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Corrêa, Renato; Mousinho, Rodrigo [Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Azevedo, Jader Cunha [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil); Miranda, Sandra Marina; Oliveira, Aline Ribeiro [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Gutterres, Ricardo Fraga [Comissão Nacional de Energia Nuclear - CNEN (Brazil); Mesquita, Evandro Tinoco; Mesquita, Cláudio Tinoco [Universidade Federal Fluminense - UFF, Niterói, RJ (Brazil); Hospital Pró-Cardíaco, Rio de Janeiro, RJ (Brazil)


    Appropriateness Criteria for nuclear imaging exams were created by American College of Cardiology (ACC) e American Society of Nuclear Cardiology (ASNC) to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS) in a private nuclear medicine service of a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2005 and 2009 and compare the level of indication of both. We included records of 383 patients that underwent MPS, November 2008 up to February 2009. Demographic characteristics, patient's origin, coronary risk factors, time of medical graduation and appropriateness criteria of medical applications were studied. The criteria were evaluated by two independent physicians and, in doubtful cases, defined by a medical expert in MPS. Mean age was 65 ± 12 years. Of the 367 records reviewed, 236 (64.3%) studies were performed in men and 75 (20.4%) were internee. To ACC 2005, 255 (69.5%) were considered appropriate indication and 13 (3.5%) inappropriate. With ACC 2009, 249 (67.8%) were considered appropriate indications and 13 (5.2%) inappropriate. We observed a high rate of adequacy of medical indications for MPS. Compared to the 2005 version, 2009 did not change the results.

  8. Applicability of the Appropriate use Criteria for Myocardial Perfusion Scintigraphy

    Directory of Open Access Journals (Sweden)

    Anderson de Oliveira


    Full Text Available Background: Appropriateness Criteria for nuclear imaging exams were created by American College of Cardiology (ACC e American Society of Nuclear Cardiology (ASNC to allow the rational use of tests. Little is known whether these criteria have been followed in clinical practice. Objective: To evaluate whether the medical applications of myocardial perfusion scintigraphy (MPS in a private nuclear medicine service of a tertiary cardiology hospital were suitable to the criteria of indications proposed by the American medical societies in 2005 and 2009 and compare the level of indication of both. Methods: We included records of 383 patients that underwent MPS, November 2008 up to February 2009. Demographic characteristics, patient's origin, coronary risk factors, time of medical graduation and appropriateness criteria of medical applications were studied. The criteria were evaluated by two independent physicians and, in doubtful cases, defined by a medical expert in MPS. Results: Mean age was 65 ± 12 years. Of the 367 records reviewed, 236 (64.3% studies were performed in men and 75 (20.4% were internee. To ACC 2005, 255 (69.5% were considered appropriate indication and 13 (3.5% inappropriate. With ACC 2009, 249 (67.8% were considered appropriate indications and 13 (5.2% inappropriate. Conclusions: We observed a high rate of adequacy of medical indications for MPS. Compared to the 2005 version, 2009 did not change the results.

  9. Dexamethasone-suppression adrenal scintigraphy in hyperandrogenism: concise communication

    Energy Technology Data Exchange (ETDEWEB)

    Gross, M.D.; Freitas, J.E.; Swanson, D.P.; Woodbury, M.C.; Schteingart, D.E.; Beierwaltes, W.H.


    To assess the contribution of adrenal-derived androgens in women with hirsutism, adrenal scintigrams under dexamethasone suppression (DS) were performed on 35 women with increasing facial or body hair and irregular or absent menses. Based upon the DS regimen chosen (8 mg/d for 2 days or 4 md/d for 7 days before the injection of 6..beta..-(/sup 131/I)iodomethylnorcholesterol), three imaging patterns were identified. The first was the absence of uptake before 3 days (8-mg DS) or before 5 days (4-mg DS) after injection. This imaging pattern was seen in 17 of the 35 patients studied and was considered normal. The second pattern was bilateral uptake earlier than 3 days (8-mg DS regimen) or 5 days (4-mg DS) after injection. This was seen in 13 of the 35 patients and was interpreted as bilateral early visualization. Adrenal-vein catheterization performed on six patients with this pattern showed increased adrenal-vein testosterone. The third pattern, observed in five patients, was unilateral early visualization, which in four cases investigated to date was the result of an adrenocortical adenoma. This study confirms the adrenal cortex as a source of androgens in women with hirsutism and hyperandrogenism and demonstrates that DS adrenal scintigraphy can be utilized to identify those women in whom adrenal-derived androgens contribute to their hyperandrogenism.

  10. Role of radionuclide scintigraphy in the detection of parathyroid adenoma

    Directory of Open Access Journals (Sweden)

    Singh N


    Full Text Available Background: Preoperative detection of parathyroid adenoma is a diagnostic challenge. The sonography and computerized tomography (CT scan demonstrate high sensitivity but low specificity. The advent of radionuclide scanning technique has enhanced the specificity in this context. Aim: We undertook a study to assess the role of radionuclide scanning in suspected cases of parathyroid adenomas. Materials And Methods: Totally 28 cases were incorporated in the study. The suspicion was raised either due to raised PTH levels or recurrent calcinosis. Most of these patients had estimation of calcium done as a routine or specific investigation. The parathyroid scan was performed using either of the two techniques - Dual isotope subtraction or Sestamibi washout technique. We also used the recent approach of fusion imaging (CT + tomographic nuclear images in selected cases. Results: There were 16 true positive, 10 true negative, 1 false negative and 1 equivocal scan findings. The findings were compared with sonography, CT Scan and PTH values. The true positive yield in our study was 57%, true negative 35% and the overall sensitivity and specificity was found to be 94% and 100% respectively. Conclusion: We conclude that parathyroid scintigraphy is a reliable and sensitive technique in the preoperative detection of parathyroid adenomas and should be the first choice of imaging modality in suspicion of parathyroid adenoma.

  11. Diagnosis of neuroblastoma with I-131 meta-iodobenzylguanidine scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Odano, Ikuo; Ohsawa, Yoshihiro; Iwabuchi, Makoto; Sakai, Kunio; Hayashi, Mikio (Niigata Univ. (Japan). School of Medicine); Asami, Keiko; Utsumi, Jiro


    Pre- or post-operative I-131 meta-iodobenzylguanidine (I-131 MIBG) scans were reviewed for its diagnostic significance in neuroblastoma. The subjects were 18 patients with histologically proven neuroblastoma, who ranged in age from 6 months to 9 years. Abnormal uptake of I-131 MIBG was detected in all 10 patients showing positive urinary vanillylmandelic acid (VMA); there was a significant correlation between I-131 MIBG uptake and urinary VMA. For 10 patients undergoing preoperative I-131 MIBG scans, I-131 MIBG was taken up by primary tumors as small as one cm in diameter in 9 patients; the other one had negative urinary VMA. In detecting metastatic foci, the sensitivity of I-131 MIBG scans was 89% for the bone, 50% for the liver, 75% for the lymph nodes, and 38% for the bone marrow. In view of a high specificity, I-131 MIBG scintigraphy may be a useful approach to the localization of primary foci, as well as the diagnosis of metastasis and recurrence in neuroblastoma. (N.K.).

  12. Method and the device for measurement of volume activity of gas and aerosol fractions of radioactive aero disperse systems

    Directory of Open Access Journals (Sweden)

    Tsovianov A.G.


    Full Text Available The given article aims a development of the method and the device for the disperse analysis and simultaneous measurement of volume activity of aerosol and gas fractions of radioactive aero disperse systems. Importance of the article is concerned with the fact that for measuring volume activity of sample including gas and aerosol fractions it's necessary to measure an activity of both fractions. Taking into account the volume activity of only one fraction in other case can result to understatement of internal dose estimation induced by radioactive aerosols inhalation. The method includes separation of aerosol fraction from gas by inertial sedimentation on cascade elements of the impactor, the subsequent chemical transformation of a gas component of aero disperse system to a disperse phase by input of reagent vapors in a gas stream and sedimentation of the formed aerosol particles on the filter. The device can be used in the industry for control of radioactive pollution of the air environment.

  13. Tobramycin Inhalation Powder™: a novel drug delivery system for treating chronic Pseudomonas aeruginosa infection in cystic fibrosis. (United States)

    Parkins, Michael D; Elborn, J Stuart


    Lung disease in cystic fibrosis (CF) is typified by the development of chronic airways infection culminating in bronchiectasis and progression to end-stage respiratory disease. Pseudomonas aeruginosa, a ubiquitous gram-negative bacteria, is the archetypical CF pathogen and is associated with an accelerated clinical decline. The development and widespread use of chronic suppressive aerosolized antibacterial therapies, in particular Tobramycin Inhalation Solution (TIS), in CF has contributed to reduced lung function decline and improved survival. However, the requirement for the aerosolization of these agents through nebulizers has been associated with increased treatment burden, reduced quality of life and remain a barrier to broader uptake. Tobramycin Inhalation Powder (TIP™) has been developed by Novartis with the express purpose of delivering the same benefits as TIS in a time-effective manner. Administered via the T-326™ (Novartis) Inhaler in four individual 28-mg capsules, TIP can be administered in a quarter of the time of traditional nebulizers and is inherently portable. In clinical studies, TIP has been shown to be safe, result in equivalent or superior reductions in P. aeruginosa sputum density and produce similar improvements in pulmonary function. TIP offers significant advantages in time saving, portability and convenience over traditional nebulized TIS with comparable clinical outcomes for individuals with CF.

  14. Dual-energy CT perfusion and angiography in chronic thromboembolic pulmonary hypertension: diagnostic accuracy and concordance with radionuclide scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Dournes, Gael; Verdier, Damien; Montaudon, Michel; Laurent, Francois; Lederlin, Mathieu [Hopital Haut-Leveque, CHU Bordeaux, Department of Medical Imaging, Pessac (France); University Bordeaux Segalen, Bordeaux Cedex (France); Bullier, Eric; Riviere, Annalisa [Hopital Haut-Leveque, CHU Bordeaux, Department of Nuclear Medicine, Pessac (France); Dromer, Claire [Hopital Haut-Leveque, CHU Bordeaux, Department of Respiratory Diseases, Pessac (France); Picard, Francois [Hopital Haut-Leveque, CHU Bordeaux, Department of Cardiology, Pessac (France); Billes, Marc-Alain [Hopital Haut-Leveque, CHU Bordeaux, Department of Cardiac Surgery, Pessac (France); Corneloup, Olivier [Hopital Haut-Leveque, CHU Bordeaux, Department of Medical Imaging, Pessac (France)


    To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) perfusion and angiography versus ventilation/perfusion (V/Q) scintigraphy in chronic thromboembolic pulmonary hypertension (CTEPH), and to assess the per-segment concordance rate of DECT and scintigraphy. Forty consecutive patients with proven pulmonary hypertension underwent V/Q scintigraphy and DECT perfusion and angiography. Each imaging technique was assessed for the location of segmental defects. Diagnosis of CTEPH was established when at least one segmental perfusion defect was detected by scintigraphy. Diagnostic accuracy of DECT perfusion and angiography was assessed and compared with scintigraphy. In CTEPH patients, the per-segment concordance between scintigraphy and DECT perfusion/angiography was calculated. Fourteen patients were diagnosed with CTEPH and 26 with other aetiologies. DECT perfusion and angiography correctly identified all CTEPH patients with sensitivity/specificity values of 1/0.92 and 1/0.93, respectively. At a segmental level, DECT perfusion showed moderate agreement (κ = 0.44) with scintigraphy. Agreement between CT angiography and scintigraphy ranged from fair (κ = 0.31) to slight (κ = 0.09) depending on whether completely or partially occlusive patterns were considered, respectively. Both DECT perfusion and angiography show satisfactory performance for the diagnosis of CTEPH. DECT perfusion is more accurate than angiography at identifying the segmental location of abnormalities. (orig.)

  15. Discovery of unique and ENM- specific pathophysiologic pathways: Comparison of the translocation of inhaled iridium nanoparticles from nasal epithelium versus alveolar epithelium towards the brain of rats. (United States)

    Kreyling, Wolfgang G


    The biokinetics of inhaled nanoparticles (NP) is more complex than that of larger particles since NP may NP deposited on the nasal mucosa of the upper respiratory tract (URT) may translocate to the olfactory bulb of the brain and also via the trigeminus (URT neuronal route); and (b) NP deposited in the lower respiratory tract (LRT) may cross the ABB into blood and enter the brain across the blood-brain-barrier (BBB) or take a neuronal route from enervated tracheo-bronchial epithelia via the vagus nerve. Translocation from both - the URT and the LRT - are quantified during the first 24h after a 1-hour aerosol inhalation of 20nm-sized, (192)Ir radiolabeled iridium NP by healthy adult rats using differential exposures: (I) nose-only exposure of the entire respiratory tract or (II) intratracheal (IT) inhalation of intubated and ventilated rats, thereby bypassing the URT and extrathoracic nasal passages. After nose-only exposure brain accumulation (BrAcc) is significantly nine-fold higher than after IT inhalation since the former results from both pathways (a+b) while the latter exposure comes only from pathway (b). Interestingly, there are significantly more circulating NP in blood 24h after nose-only inhalation than after IT inhalation. Distinguishing translocation from URT versus LRT estimated from the differential inhalation exposures, the former is significantly higher (8-fold) than from the LRT. Although the BrAcc fraction is rather low compared to total NP deposition after this short-term exposure, this study proofs that inhaled insoluble NP can accumulate in the brain from both - URT and LRT which may trigger and/or modulate adverse health effects in the central nervous system (CNS) during chronic exposure.

  16. Clinical Controversies in Aerosol Therapy for Infants and Children. (United States)

    DiBlasi, Robert M


    Pediatric patients are different from adult patients with respect to airway anatomy and breathing patterns. They are also incapable of following commands and often reject breathing treatments. For these reasons, aerosol drug delivery is one of the most technically challenging aspects for clinicians providing respiratory care to young children. Improvements in nebulizer technology have provided better delivery options for pediatric patients. This review highlights research related to pediatric nebulizer and interface devices and how they can be used to provide the safest and most efficient treatments with the array of treatment delivery options. Also addressed are clinical controversies and debates in pediatric aerosol science, including drug delivery in crying versus resting infants, pressurized metered-dose inhalers and small-volume nebulizers for bronchodilator administration, continuous nebulization, noninvasive drug delivery options, and optimization of nebulizer performance during infant and large pediatric conventional and high-frequency ventilation.

  17. Properties of aerosols from sugar-cane burning emissions in Southeastern Brazil (United States)

    Lara, L. L.; Artaxo, P.; Martinelli, L. A.; Camargo, P. B.; Victoria, R. L.; Ferraz, E. S. B.

    The influences of biomass burning emissions in the composition of aerosol have been studied during 1 year around the city of Piracicaba (Southeastern Brazil). Inhalable particles, separated in PM 2.5 and coarse particulate mode (CPM, with size in the range (2.5cane burning is the main source of PM 2.5 representing 60% of PM 2.5, soil dust accounted for 14%, and industries and oil combustion contributed with 12% each one. Resuspended soil is the main source of CPM followed by industrial emissions and sugar-cane burning. The sampling and analytical procedures applied in this study showed that sugar-cane burning and agricultural practices are the main sources of inhalable particles, possibly altering the aerosol composition around the city of Piracicaba.

  18. Use of inhaled corticosteroids in pediatric asthma

    DEFF Research Database (Denmark)

    Bisgaard, H


    Inhaled corticosteroids reduce asthma symptoms and exacerbations, improve lung function, and reduce airway inflammation and bronchial hyperreactivity more effectively than other treatments. However, inhaled corticosteroids may be unable to return lung function and bronchial hyperreactivity...... to normal when introduced for moderately severe asthma. This finding highlights the need to improve treatment strategy in pediatric asthma. The natural progression of persistent asthma may lead to loss of lung function and chronic bronchial hyperreactivity for children and adults. There is evidence...... to suggest that asthma acts via a chronic inflammatory process that causes remodeling of the airways with mucosal thickening and smooth muscle hypertrophy. An optimal treatment strategy would be one aimed at reducing the ongoing airway inflammation. Inhaled steroids ameliorate the inflammation, whereas...

  19. Clinical study of scrotum scintigraphy in 49 patients with acute scrotal pain. A comparison with ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Yuan Zhibin; Luo Quanyong; Chen Libo; Zhu Jifang; Zhu Ruisen [Shanghai 6th People' s Hospital, Shanghai (China)


    The significance of scrotum scintigraphy in differentiating acute testicular torsion from acute orchiepididymitis was evaluated. In this report, 49 patients with acute scrotal pain were examined with radionuclide scrotum scintigraphy and ultrasonography in parallel for comparison. Of 37 patients with decreased radioactivity in the abnormal side scrotum, 35 were diagnosed with testicular torsion surgically and the other 2 were diagnosed with indirect inguinal hernia. Only 17 among the 35 patients were diagnosed by ultrasonography as having testicular torsion. The remaining 12 patients with increased radioactivity in the abnormal side of the scrotum were all diagnosed with orchiepididymitis through conservative treatment and clinical follow-up, but only 8 of the 12 were correctly and exactly diagnosed by ultrasonography. In the process of diagnosing acute scrotal pain, radionuclide scrotum scintigraphy has obvious advantage over ultrasonography. It also has the advantage of being simple, fast and accurate but without any detrimental effect on the human body. (author)

  20. Limitations and pitfalls of 99mTc-EDDA/HYNIC-TOC (Tektrotyd) scintigraphy. (United States)

    Garai, Ildikó; Barna, Sandor; Nagy, Gabor; Forgacs, Attila


    Tektrotyd kit was developed by Polatom company for 99mTc labeling to make an alternative tracer of somatostatin receptor scintigraphy available. Since 2005, 99mTc-EDDA/HYNIC-Tyr3-Octreotide has been used in clinical imaging and achieved high impact in management of patients with neuroendocrine tumors. Knowing the limitations and pitfalls is essential to provide ac-curate diagnosis. Therefore, the potential pitfalls associated with the use of 99mTc-EDDA/HYNIC-TOC are reviewed on the basis of own experience. Data were analyzed of 310 patients who underwent somatostatin receptor scintigraphy with 99mTc-Tektrotyd. Pitfalls during radiolabeling process or acquisition can worsen the sensitivity of SRS (somatostatin receptor scintigraphy). Recognizing physi-ological and clinical pitfalls, the diagnostic accuracy will improve.

  1. The value of RI scintigraphy and angiography in small intestinal bleeding; Report of eight cases

    Energy Technology Data Exchange (ETDEWEB)

    Kurosawa, Susumu; Kuwata, Hajime; Kushibiki, Kyoko; Akimoto, Kimihiko; Hashimoto, Toshiyuki; Kojima, Toshiya (Showa General Hospital, Kodaira, Tokyo (Japan))


    We retrospectively reviewed eight cases of small intestinal bleeding and assessed the value of RI scintigraphy and angiography in diagnosing the bleeding site. The patients' average age was 56.2 years. Chief complaint was melena of variable degree. In most cases neither upper endoscopy nor colonoscopy was diagnostic. RI scientigraphy (Tc-99 labeled human serum albumin) showed 75% of positive rate whereas angiography showed 66.7% (4/6) of positive rate. All four cases of leiomyosarcoma and leiomyoma demonstrated hypervascular stain and/or extra-vasation in angiography whereas RI scintigraphy failed to detect active gastrointestinal bleeding in 2 of the 4 cases. Therefore angiography was considered useful for the detection of bleeding from leiomyoma and leiomyosarcoma which are often hypervascular. Scintigraphy is thought of most value in the demonstration of small amount of bleeding with minimum vascular abnormality. (author).

  2. Particle deposition in a realistic geometry of the human conducting airways: Effects of inlet velocity profile, inhalation flowrate and electrostatic charge

    DEFF Research Database (Denmark)

    Koullapis, P. G.; Kassinos, S. C.; Bivolarova, Mariya Petrova


    Understanding the multitude of factors that control pulmonary deposition is important in assessing the therapeutic or toxic effects of inhaled particles. The use of increasingly sophisticated in silico models has improved our overall understanding, but model realism remains elusive. In this work......, we use Large Eddy Simulations (LES) to investigate the deposition of inhaled aerosol particles with diameters of dp=0.1,0.5,1,2.5,5dp=0.1,0.5,1,2.5,5 and 10μm (particle density of 1200 kg/m3). We use a reconstructed geometry of the human airways obtained via computed tomography and assess the effects....... Nevertheless, flow field differences due to the inlet conditions are largely smoothed out just a short distance downstream of the mouth inlet as a result of the complex geometry. Increasing the inhalation flowrate from sedentary to activity conditions left the mean flowfield structures largely unaffected...

  3. IRIS Toxicological Review of Ammonia - Noncancer Inhalation (Final Report) (United States)

    The U.S. Environmental Protection Agency's (USEPA) has finalized the Integrated Risk Information System (IRIS) Assessment of Ammonia (Noncancer Inhalation). This assessment addresses the potential noncancer human health effects from long-term inhalation exposure to ammon...

  4. Cow Dung Ingestion and Inhalation Dependence: A Case Report (United States)

    Khairkar, Praveen; Tiple, Prashant; Bang, Govind


    Although abuse of several unusual inhalants had been documented, addiction to cow dung fumes or their ashes has not been reported in medical literature as yet. We are reporting a case of cow dung dependence in ingestion and inhalational form.

  5. Comparative study of whole-body MRI and bone scintigraphy for the detection of bone metastases

    Energy Technology Data Exchange (ETDEWEB)

    Balliu, E., E-mail: [Department of Magnetic Resonance, IDI Girona, Hospital Universitari de Girona Dr Josep Trueta, Girona (Spain); Boada, M.; Pelaez, I. [Department of Magnetic Resonance, IDI Girona, Hospital Universitari de Girona Dr Josep Trueta, Girona (Spain); Vilanova, J.C. [Department of Magnetic Resonance, Clinica Girona - Hospital Sta Caterina, Girona (Spain); Barcelo-Vidal, C. [Department of Computer Science and Applied Mathematics, University of Girona (Spain); Rubio, A.; Galofre, P. [Department of Nuclear Medicine, IDI Girona, Hospital Universitari de Girona Dr Josep Trueta, Girona (Spain); Castro, A. [Department of Internal Medicine, Hospital Universitari de Girona Dr Josep Trueta, Girona (Spain); Pedraza, S. [Department of Magnetic Resonance, IDI Girona, Hospital Universitari de Girona Dr Josep Trueta, Girona (Spain)


    Aim: To assess and compare the diagnostic accuracy of whole-body magnetic resonance imaging (MRI) and bone scintigraphy in the detection of metastases to bone. Material and methods: Forty randomly selected patients with known malignant tumours were prospectively studied using bone scintigraphy and whole-body MRI. Two patients were excluded. Symptoms of bone metastasis were present in 29 (76%) patients and absent in nine (24%). Findings were classified into four categories according to the probability of bone metastasis: (1) negative, (2) probably negative, (3) probably positive, and (4) positive. Diagnostic accuracy was determined according to the area under the receiver operating characteristic (ROC) curve. The definitive diagnosis was reached using other imaging techniques, biopsy, or 12 months clinical follow-up. Results: Metastases were present in 18 patients. The sensitivity, specificity, and diagnostic accuracy were 94, 90, and 92%, respectively, for whole-body MRI and 72, 75, and 74%, respectively, for bone scintigraphy. Diagnostic accuracy measured by the area under the ROC curve was significantly higher for whole-body MRI (96%) than for bone scintigraphy (77%; p<0.05). Interobserver agreement measured by the kappa index was significantly higher for whole-body MRI (0.895) than for bone scintigraphy (0.524; p<0.05). Whole-body MRI detected lesions in tissues other than bone in 17 (45%) patients. Conclusions: Whole-body MRI is more accurate and more objective than bone scintigraphy for the detection of bone metastases. Whole-body MRI can also detect lesions in tissues other than bone.

  6. Magnetic resonance imaging and bone scintigraphy in bone metastasis detection: A comparative study

    Directory of Open Access Journals (Sweden)

    Lučić Silvija


    Full Text Available Background/Aim. Bone scintigraphy is well-known method for the detection of neoplastic lesions with a high sensitivity and, at the same time, a lower specificity. On the other hand magnetic resonance imaging (MRI is previously established noninvasive imaging method regarding its diagnostic specificity. The aim of this study was to determine the possibilities and to correlate two different diagnostic methods - bone scintigraphy and MRI in the detection of bone metastasis in the spine and pelvic bones. Methods. A total of 123 patients who underwent both bone scintigraphy and spine and pelvic MRI on 1.5 T MR imager were enrolled in this study. Scans were subsequently analyzed in total and divided in regions of interest (cervical, upper, middle and lower thoracic, upper and lower lumbar and pelvic region, which includes sacral spinal segment; afterwards the total number of 585 matching regions were compared and statistically analyzed. Results. The statistical analysis demonstrated significant correlation between the findings of both methods in total. Divided by regions of interest, significant degrees of correlation were demonstrated in all of them, except in the cervical spine region where the r-value was in the range of low correlation. Conclusion. Having a high mutual correlation, bone scintigraphy and MRI are to be considered as the complementary diagnostic methods in the detection of bone metastases. Still, increased diagnostic potential of MRI may highlights negative bone scintigraphy findings in the patients with solitary metastatic lesions or diffuse vertebral infiltration. Advances in the bone scintigraphy (single photon emission tomography - SPECT, SPECTcomputed tomography - SPECT-CT and MRI (whole body MRI, diffusion MRI, make it possible the diagnostic potential of both methods will result in a further improvement in bone metastasis detection.

  7. Retrospective Analysis of Indication of Bone Scintigraphy Performed in Our Clinic

    Directory of Open Access Journals (Sweden)

    Fusun Aydogan


    Full Text Available Aim: Bone scintigraphy is one of the commonly used radionuclide imaging and it is successfully used in the diagnosis and follow-up of many diseases. The aim of this study is to determine the indications and filming protocols of bone scintigraphy which was performed in our clinic. Material and Method: Two hundred and fifty two patients (132 male, 120 female who was performed bone scintigprapy in our clinic between December 2011 and June 2013 included the study. Mean age was 50.1±20.2 years. Scintigraphic protocols were made in two ways as late static whole body imaging and three-phase bone scintigraphy according to the type of the diseases. Indications of scintigraphies and scintigraphic protocols were detected. Results: Bone scintigraphy was performed for diagnosis and monitoring of metastatic bone disease to 102 patients (40,5 %, for orthopedic applications to 57 patients (22,6 %, for diagnosis and monitoring of primary bone tumors to 29 patients (11,5 %, for diagnosis of osteomyelitis to 17 patients (6,7 %, for differential diagnosis of infection and loosening of the prosthesis to 12 patients (4,8 %, investigate the viability of the graft in 14 patients (4,6 %, for rheumatologic diseases to 9 patients (3,6 %, for investigate the pathological vertebral fractures and osteoporosis to 4 patients (1,6 %, for diagnosis the metabolic bone disease to 2 patients (0,8 %, for diagnosis of otitis externa to 5 patients (1,98 % and for for suspicion of malignancy to 1 patient (0,4 %. Late static whole body imaging protocol was applied to 136 patients (54 % and three-phase imaging protocol was applied to 116 patients (46 %. Discussion: The most common use of bone scintigraphy is the diagnosis and follow-up of metastatic bone disease. It is followed by reasons such as orthopedic applications, monitoring and diagnosis of primary bone tumors and diagnosis of osteomyelitis.

  8. DARE : Dedicated Aerosols Retrieval Experiment

    NARCIS (Netherlands)

    Smorenburg, K.; Courrèges-Lacoste, G.B.; Decae, R.; Court, A.J.; Leeuw, G. de; Visser, H.


    At present there is an increasing interest in remote sensing of aerosols from space because of the large impact of aerosols on climate, earth observation and health. TNO has performed a study aimed at improving aerosol characterisation using a space based instrument and state-of-the-art aerosol retr

  9. Clinical need for both scintigraphy with technetium-99m GSA and per-rectal portal scintigraphy in some patients with chronic liver disease

    Energy Technology Data Exchange (ETDEWEB)

    Shiomi, Susumu; Iwata, Yoshinori; Sasaki, Nobumitsu [Osaka City Univ. (Japan). Medical School] (and others)


    Scintigraphy with {sup 99m}Tc-diethylenetriaminepentaacetate with galactosyl human serum albumin ({sup 99m}Tc-GSA) and per-rectal portal scintigraphy are useful for evaluating hepatic functional reserve and portal circulation, respectively. We did the procedures simultaneously in some patients to examine the relationship between hepatic functional reserve and portal circulation in chronic liver disease. Scintigraphy with {sup 99m}Tc-GSA was done in 10 healthy subjects, 45 patients with chronic hepatitis, and 165 patients with cirrhosis. Fifty-seven patients (13 with hepatitis and 44 with cirrhosis) also underwent per-rectal portal scintigraphy with {sup 99m}Tc-pertechnetate within two weeks. A receptor index was calculated by dividing the radioactivity of the liver region of interest (ROI) by that of the liver-plus-heart ROI at 15 min after the injection of {sup 99m}Tc-GSA. The index of blood clearance was calculated by dividing the radioactivity of the heart ROI at 15 min by that of the heart ROI at 3 min. A solution containing {sup 99m}Tc-pertechnetate was instilled into the rectum, and serial scintigrams were taken while radioactivity curves for the liver and heart were recorded sequentially. A per-rectal portal shunt index was determined by calculating the ratio of counts for the liver to counts for the heart integrated for 24 seconds immediately after the appearance of the liver time-activity curve. The median receptor index was lower for more severe liver disorders, increasing in the order of chronic hepatitis, compensated cirrhosis and decompensated cirrhosis, and the median index of blood clearance was higher. The median receptor index was significantly lower when a complication (varices, ascites, or encephalopathy) was present, and the median index of blood clearance was higher. The shunt index was correlated significantly with the two other indices, but these values for some one-third of the patients disagreed in either indices. Scintigraphy with {sup 99m

  10. Inhaled medication and inhalation devices for lung disease in patients with cystic fibrosis: A European consensus

    DEFF Research Database (Denmark)

    Heijerman, Harry; Westerman, Elsbeth; Conway, Steven;


    , mucolytics/mucous mobilizers, anti-inflammatory drugs, bronchodilators and combinations of solutions. Additionally, we review the current knowledge on devices for inhalation therapy with regard to optimal particle sizes and characteristics of wet nebulisers, dry powder and metered dose inhalers. Finally, we...... review the current status of inhaled medication in CF, including the mechanisms of action of the various drugs, their modes of administration and indications, their effects on lung function, exacerbation rates, survival and quality of life, as well as side effects. Specifically we address antibiotics...

  11. Pulmonary biocompatibility assessment of inhaled single-wall and multiwall carbon nanotubes in BALB/c mice. (United States)

    Ravichandran, Prabakaran; Baluchamy, Sudhakar; Gopikrishnan, Ramya; Biradar, Santhoshkumar; Ramesh, Vani; Goornavar, Virupaxi; Thomas, Renard; Wilson, Bobby L; Jeffers, Robert; Hall, Joseph C; Ramesh, Govindarajan T


    With the widespread application of carbon nanotubes (CNTs) in diverse commercial processes, scientists are now concerned about the potential health risk of occupational exposures. In this study, CNT-induced pulmonary toxicity was investigated by exposing BALB/c mice to aerosolized single-wall (SW) CNT and multiwall (MW) CNT (5 μg/g of mice) for 7 consecutive days in a nose-only exposure system. Microscopic studies showed that inhaled CNTs were homogeneously distributed in the mouse lung. The total number of bronchoalveolar lavage polymorphonuclear leukocytes recovered from the mice exposed to SWCNT and MWCNT (1.2 × 10(6) ± 0.52 and 9.87 × 10(5) ± 1.45; respectively) was significantly greater than control mice (5.46 × 10(5) ± 0.78). Rapid development of pulmonary fibrosis in mice that inhaled CNT was also confirmed by significant increases in the collagen level. The lactate dehydrogenase levels were increased nearly 2- and 2.4-fold in mice that inhaled SWCNT and MWCNT, respectively, as compared with control mice. In addition, exposure of CNTs to mice showed a significant (p CNT than in control mice. Together, this study shows that inhaled CNTs induce inflammation, fibrosis, alteration of oxidant and antioxidant levels, and induction of apoptosis-related proteins in the lung tissues to trigger cell death.

  12. Novel budesonide particles for dry powder inhalation (DPI) prepared using a microfluidic reactor coupled with ultrasonic spray freeze drying. (United States)

    Saboti, Denis; Maver, Uroš; Chan, Hak-Kim; Planinšek, Odon


    Budesonide is a potent active pharmaceutical ingredient, often administered using respiratory devices such as metered dose inhalers (MDI), nebulizers and dry powder inhalers (DPI). Inhalable drug particles are conventionally produced by crystallization followed by milling. This approach tends to generate partially amorphous materials that require post-processing to improve the formulations' stability. Other methods involve homogenization or precipitation and often require the use of stabilizers, mostly surfactants. The purpose of this study was therefore to develop a novel method for preparation of fine budesonide particles using a microfluidic reactor coupled with ultrasonic spray freeze drying, and hence avoiding the need of additional homogenization or stabilizer use. A T-junction microfluidic reactor was employed to produce particle suspension (using an ethanol-water, methanol-water and an acetone-water system), which was directly fed into an ultrasonic atomization probe, followed by direct feeding to liquid nitrogen. Freeze drying was the final preparation step. The result were fine crystalline budesonide powders which, when blended with lactose and dispersed in an Aerolizer at 100 L/min, generated fine particle fraction in the range 47.6±2.8% to 54.9±1.8%, thus exhibiting a good aerosol performance. Subsequent sample analysis confirmed the suitability of the developed method to produce inhalable drug particles without additional homogenization or stabilizers. The developed method provides a viable solution for particle isolation in microfluidics in general.

  13. Analysis of pulmonary surfactant in rat lungs after inhalation of nanomaterials: Fullerenes, nickel oxide and multi-walled carbon nanotubes. (United States)

    Kadoya, Chikara; Lee, Byeong-Woo; Ogami, Akira; Oyabu, Takako; Nishi, Ken-ichiro; Yamamoto, Makoto; Todoroki, Motoi; Morimoto, Yasuo; Tanaka, Isamu; Myojo, Toshihiko


    The health risks of inhalation exposure to engineered nanomaterials in the workplace are a major concern in recent years, and hazard assessments of these materials are being conducted. The pulmonary surfactant of lung alveoli is the first biological entity to have contact with airborne nanomaterials in inhaled air. In this study, we retrospectively evaluated the pulmonary surfactant components of rat lungs after a 4-week inhalation exposure to three different nanomaterials: fullerenes, nickel oxide (NiO) nanoparticles and multi-walled carbon nanotubes (MWCNT), with similar levels of average aerosol concentration (0.13-0.37 mg/m(3)). Bronchoalveolar lavage fluid (BALF) of the rat lungs stored after previous inhalation studies was analyzed, focusing on total protein and the surfactant components, such as phospholipids and surfactant-specific SP-D (surfactant protein D) and the BALF surface tension, which is affected by SP-B and SP-C. Compared with a control group, significant changes in the BALF surface tension and the concentrations of phospholipids, total protein and SP-D were observed in rats exposed to NiO nanoparticles, but not in those exposed to fullerenes. Surface tension and the levels of surfactant phospholipids and proteins were also significantly different in rats exposed to MWCNTs. The concentrations of phospholipids, total protein and SP-D and BALF surface tension were correlated significantly with the polymorphonuclear neutrophil counts in the BALF. These results suggest that pulmonary surfactant components can be used as measures of lung inflammation.

  14. Inhaled tobramycin solution-associated recurrent eosinophilia and severe persistent bronchospasm in a patient with cystic fibrosis: a case report

    Directory of Open Access Journals (Sweden)

    Anbar Ran D


    Full Text Available Abstract Background Delivery of tobramycin by inhalation to the lungs of patients with cystic fibrosis (CF who are infected with Pseudomonas aeruginosa has been proven to be effective and safe. The aerosol administration allows high concentrations of tobramycin to be delivered to the site of infection with limited systemic absorption. In rare patients, systemic absorption of inhaled tobramycin may be significant enough to produce toxic effects, such as renal and vestibular toxicities. Case presentation We report a patient with CF who developed recurrent eosinophilia and severe persistent bronchospasm following repeated administration of preservative-free tobramycin by inhalation, beginning at 16 months of age. Also, he developed similar signs and symptoms when he was administered tobramycin intravenously on one occasion at 5 1/2 years. The patient had a history of environmental allergies. Temporal sequence of his signs and symptoms after each administration of tobramycin (similar to re-challenge testing, and his improvement after discontinuation of the drug strongly suggest an adverse drug reaction. Conclusion Hypersensitivity reaction should be considered in patients who develop recurrent eosinophilia and deterioration of pulmonary function following the use of tobramycin by inhalation or by intravenous administration.

  15. Influence of particle size distribution on inhalation doses to workers in the Florida phosphate industry. (United States)

    Kim, Kwang Pyo; Wu, Chang-Yu; Birky, Brian K; Bolch, Wesley E


    Previous studies have indicated that inhalation exposures to TENORM aerosols are potentially a major contributor to the annual total effective dose to workers in the Florida phosphate industry. Further research was deemed necessary to characterize the particle size distribution of these aerosols containing various radionuclides of the U decay series. In the present study, individualized assessments of worker committed effective doses are reported in which detailed information is used on the particle size distribution, particle density, particle shape, and radioactivity concentrations from sampled aerosols at 6 different phosphate facilities and at various worker areas within these facilities. Inhalation dose assessments are calculated using the ICRP 66 human respiratory tract model as implemented within the LUDEP and IMBA computer codes. Under the least conservative assumptions of radionuclide-specific lung solubility, the annual total effective doses are shown to be 0.31+/-0.12, 0.27+/-0.07, and 0.22+/-0.02 mSv at granulator, storage, and shipping areas, respectively, and thus all annual doses are below the annual limits to the members of the general public (1 mSv y). In contrast, the most conservative assumptions of lung solubility by radionuclide yield annual total effective doses of 2.24+/-2.53 mSv at granulator areas, 1.26+/-1.19 mSv at storage areas, and 0.56+/-0.36 mSv at shipping areas. In this later case, some 44%, 31%, and 15% of individual dose assessments yield worker doses above the annual dose limit. The study thus demonstrates the importance of facility- and area-specific particle solubility data in dose assessments for regulatory compliance and for making decisions regarding worker respiratory protection.

  16. Differential inflammatory response to inhaled lipopolysaccharide targeted either to the airways or the alveoli in man.

    Directory of Open Access Journals (Sweden)

    Winfried Möller

    Full Text Available Endotoxin (Lipopolysaccharide, LPS is a potent inducer of inflammation and there is various LPS contamination in the environment, being a trigger of lung diseases and exacerbation. The objective of this study was to assess the time course of inflammation and the sensitivities of the airways and alveoli to targeted LPS inhalation in order to understand the role of LPS challenge in airway disease.In healthy volunteers without any bronchial hyperresponsiveness we targeted sequentially 1, 5 and 20 µg LPS to the airways and 5 µg LPS to the alveoli using controlled aerosol bolus inhalation. Inflammatory parameters were assessed during a 72 h time period. LPS deposited in the airways induced dose dependent systemic responses with increases of blood neutrophils (peaking at 6 h, Interleukin-6 (peaking at 6 h, body temperature (peaking at 12 h, and CRP (peaking at 24 h. 5 µg LPS targeted to the alveoli caused significantly stronger effects compared to 5 µg airway LPS deposition. Local responses were studied by measuring lung function (FEV(1 and reactive oxygen production, assessed by hydrogen peroxide (H(2O(2 in fractionated exhaled breath condensate (EBC. FEV(1 showed a dose dependent decline, with lowest values at 12 h post LPS challenge. There was a significant 2-fold H(2O(2 induction in airway-EBC at 2 h post LPS inhalation. Alveolar LPS targeting resulted in the induction of very low levels of EBC-H(2O(2.Targeting LPS to the alveoli leads to stronger systemic responses compared to airway LPS targeting. Targeted LPS inhalation may provide a novel model of airway inflammation for studying the role of LPS contamination of air pollution in lung diseases, exacerbation and anti-inflammatory drugs.

  17. Commuter exposure to inhalable, thoracic and alveolic particles in various transportation modes in Delhi. (United States)

    Kumar, Pramod; Gupta, N C


    A public health concern is to understand the linkages between specific pollution sources and adverse health impacts. Commuting can be viewed as one of the significant-exposure activity in high-vehicle density areas. This paper investigates the commuter exposure to inhalable, thoracic and alveolic particles in various transportation modes in Delhi, India. Air pollution levels are significantly contributed by automobile exhaust and also in-vehicle exposure can be higher sometime than ambient levels. Motorcycle, auto rickshaw, car and bus were selected to study particles concentration along two routes in Delhi between Kashmere Gate and Dwarka. The bus and auto rickshaw were running on compressed natural gas (CNG) while the car and motorcycle were operated on gasoline fuel. Aerosol spectrometer was employed to measure inhalable, thoracic and alveolic particles during morning and evening rush hours for five weekdays. From the study, we observed that the concentration levels of these particles were greatly influenced by transportation modes. Concentrations of inhalable particles were found higher during morning in auto rickshaw (332.81 ± 90.97 μg/m(3)) while the commuter of bus exhibited higher exposure of thoracic particles (292.23 ± 110.45 μg/m(3)) and car commuters were exposed to maximum concentrations of alveolic particles (222.37 ± 26.56 μg/m(3)). We observed that in evening car commuters experienced maximum concentrations of all sizes of particles among the four commuting modes. Interestingly, motorcycle commuters were exposed to lower levels of inhalable and thoracic particles during morning and evening hours as compared to other modes of transport. The mean values were found greater than the median values for all the modes of transport suggesting that positive skewed distributions are characteristics of naturally occurring phenomenon.

  18. Dose-response effect of sodium cromoglycate pressurised aerosol in exercise induced asthma.


    Tullett, W M; Tan, K. M.; Wall, R T; Patel, K R


    The effects of 2, 10, and 20 mg of sodium cromoglycate delivered by aerosol were compared with those of placebo in a double blind study in 11 patients with extrinsic and exercise induced asthma. The effect of nebulised sodium cromoglycate delivered through a Wright nebuliser (estimated dose 12 mg) was also studied. Patients exercised on a treadmill for six to eight minutes at submaximal work loads on five days, 30 minutes after inhaling placebo or sodium cromoglycate. The FEV1 was recorded be...

  19. Unusual Case of Occult Brucella Osteomyelitis in the Skull Detected by Bone Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Myung Hee; Lim, Seok Tae; Jeong, Young Jin; Kim, Dong Wook; Jeong, Hwan Jeong; Lee, Chang Seob [Chonbuk National University Medical School, Jeonju (Korea, Republic of)


    Brucellosis is a worldwide infectious disease of animals that can be transmitted to humans. Osteoarticular involvement is the most common complication of brucellosis. A 47-year-old man, who was a stock breeder, complained of myalgia with fever and chills for 2 weeks. The serology titers and blood cultures for brucellosis were positive. Bone scintigraphy demonstrated a focally increased uptake in the left supra orbital area. Plain radiographs showed an osteolytic lesion, and an MRI revealed signal abnormalities in the corresponding site. We present an unusual case of occult Brucella osteomyelitis in the frontal bone of the skull detected by done scintigraphy.

  20. Pelvic and lumbar metastasis detected by bone scintigraphy in malignant pleural mesothelioma

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz Hernandez, G.; Castillo Pallares, F.J.; Llorens Banon, L.; Romero de Avila y Avalos, C. [Hospital Clinic Universitari de Valencia (Spain). Servei de Medicina Nuclear; Garcia Garc`ia, T.; Azagra Ros, P. [Hospital Clinic Universitari de Valencia (Spain). Servei d`Oncologia; Maruenda Paulino, J.I. [Hospital Clinic Universitari de Valencia (Spain). Servei Traumatologia; Ferrer Albiach, C. [Hospital Clinic Universitari de Valencia (Spain). Servei Radioterapia


    A case of a 43-year-old man suffering from pleural mesothelioma with distant bone metastasis is reported. The results of bone scintigraphy and NMR findings allowed the diagnosis. The current case describes a hematogenous metastasis to the pelvis and vertebral column from a malignant pleural mesothelioma that was detected initally by bone scintigraphy. (orig.) [Deutsch] Fallbericht ueber einen 43jaehrigen Mann mit Pleural-Mesotheliom und Knochenmetastasen. Die Diagnose wurde durch Knochenszintigraphie und NMR gestellt. Der vorliegende Fall beschreibt die haematogene Metastasierung ins Becken und in die Wirbelsaeule, ausgehend von einem malignen Pleural-Mesotheliom, das urspruenglich durch Knochenszintigraphie diagnostiziert wurde. (orig.)

  1. Cause of focal uptake in the cervical vertebral column in routine bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Buell, U.; Winkler, U.


    Focal uptake was seen in the cervical vertebral column of 61 patients in the course of routine bone scintigraphy. These focal increases were subjected to close analysis. In 60 of these patients (98.4%) degenerative lesions became manifest as the cause of the scintigraphic finding already by the bone scintigraphy pattern (paravertebral localisation in the posterior and dorsal localisation in the lateral. Two typical examples of metastatic changes are presented to facilitate differentiation. The bone scintigraphic pattern in arthrosis of the intervertebral joint is so typical that X-ray control examinations to confirm the diagnosis can be omitted in many cases.

  2. Functional fecal retention visualized by (111)In-DTPA colon transit scintigraphy. (United States)

    Infante, Jose Rafael; Rayo, Juan I; Serrano, Justo; Dominguez, Maria L; Garcia, Lucia; Moreno, Manuel


    Constipation is an extremely common problem in children, varying from mild and short-lived to severe and chronic. Chronic constipation is a serious childhood condition and requires further investigation, including blood test, colonoscopy, radio-opaque marker study, and/or scintigraphy. We present small bowel and colon transit scintigraphy of a 14-year-old girl with history of chronic constipation, abdominal pain, weight loss, and poor response to medical treatment. After oral administration of In-DTPA in water, planar and SPECT/CT images showed normal small bowel transit time and functional fecal retention in colon transit study.

  3. Radionuclide scintigraphy in the evaluation of gastroesophageal reflux in symptomatic and asymptomatic pre-term infants

    Energy Technology Data Exchange (ETDEWEB)

    Morigeri, C.; Mukhopadhyay, K.; Narang, A. [Postgraduate Institute of Medical Education and Research (PGIMER), Division of Neonatology, Department of Paediatrics, Chandigarh (India); Bhattacharya, A.; Mittal, B.R. [Postgraduate Institute of Medical Education and Research (PGIMER), Department of Nuclear Medicine, Chandigarh (India)


    Gastroesophageal reflux (GER) is very common in pre-term infants. The diagnosis based on symptoms is always questionable. The incidence of GER in symptomatic babies varies from 22% to 85%, but literature regarding the incidence of reflux in asymptomatic pre-term infants is lacking. We used radionuclide scintigraphy to evaluate the incidence of GER in symptomatic as well as asymptomatic pre-term neonates and to assess whether symptoms have any relation with positive scintigraphy. We studied 106 pre-term infants (52 symptomatic, 54 asymptomatic) of less than 34 weeks of gestation, who fulfilled the eligibility criteria. Babies were considered symptomatic in the presence of vomiting, regurgitation, apnea, de-saturations, unexplained bradycardia and recurrent lung collapses. Radionuclide scintigraphy was conducted at post-conceptional age of 32-34 weeks when they were clinically stable for 72 h. Feeding was avoided for 2 h preceding the study. {sup 99m}Tc sulphur colloid was administered in a dose of 1.85 MBq (0.05 mCi) in 1 ml, followed by milk (full feed) through an orogastric tube, prior to imaging under a gamma camera. Reflux was graded as low or high, and reflux episodes during the study were counted. The incidence of GER in the symptomatic group was 71.2% and in asymptomatic babies 61.1% (p=0.275). High-grade reflux was more common (71.4%) than low-grade (28.6%) in both groups (p=0.449). Mean number of reflux episodes in 20 min was 4.4{+-}2.4 in symptomatic babies and 4.9 {+-}2.2 in asymptomatic babies (p=0.321). Babies with positive scintigraphy were similar in birth weight, gestation, time to achieve full feeds, weight and age at discharge to those with negative scintigraphy. GER is common in pre-term infants of less than 34 weeks gestation. The incidence of positive scintigraphy and grade of reflux is not significantly different in symptomatic vs. asymptomatic babies. Though radionuclide scintigraphy is a simple, quick and non-invasive investigation in

  4. Magnetic resonance imaging and bone scintigraphy in the differential diagnosis of unclassified arthritis

    DEFF Research Database (Denmark)

    Duer, Anne; Østergaard, M; Hørslev-Petersen, K;


    OBJECTIVES: To investigate the value in clinical practice of hand magnetic resonance imaging (MRI) and whole body bone scintigraphy in the differential diagnosis of patients with unclassified arthritis. METHODS: 41 patients with arthritis (> or = 2 swollen joints, > 6 months' duration) which...... joints of the most symptomatic hand and whole body bone scintigraphy were performed. Two rheumatologists agreed on the most likely diagnosis and the patients were treated accordingly. A final diagnosis was made by another specialist review 2 years later. RESULTS: Tentative diagnoses after MRI and bone...

  5. sup 99m Tc-sucralfate scintigraphy in inflammatory bowel disease

    Energy Technology Data Exchange (ETDEWEB)

    Mortensen, P.B.; Lech, Y.; Moeller-Petersen, J.; Vilien, M.; Fallingborg, J. (Aalborg Sygehus (Denmark)); Ekelund, S. (Copenhagen County Hospital (Denmark))


    Technetium-99m-labelled albumin-sucralfate was orally administered to 11 patients (Crohn's disease, 8; ulcerative colitis, 3) and 3 healthy volunteers. Serial scintigraphy was performed, and scintigraphic interpretations were compared with radiographic end endoscopic findings in an open study. It was not possible in any patient to relate the scintigraphic findings to the localizations of inflammatory bowel disease, nor was it possible to distinguish the scans in the patients from the scans of the healthy volunteers. It is concluded the {sup 99m}Tc-albumin-sucralfate scintigraphy is of no value in the detection of inflammatory bowel disease. 8 refs.

  6. The role of whole-body bone scintigraphy in a case of osteopetrosis

    Directory of Open Access Journals (Sweden)

    Carlyle Marques Barral


    Full Text Available Male patient, 35 years old, with occasional mild intensity back pain. Lumbosacral spine radiography showed bone structure with increased density, diffusely and symmetrically, conferring to the vertebral bodies “bone-within-bone” aspect, suggesting osteopetrosis (OP. Whole-body bone scintigraphy showed abnormal uptake in proximal epiphysis of both the humeri, tibias and fibulas, distal epiphysis of the femurs and focal in the ribs suggesting old fractures. Conclusions: Nuclear Medicine may provide an important contribution as supporting diagnosis and extensive skeletal evaluation such as fractures and infection. Bone scintigraphy might also be used for baseline assessments, allowing longitudinal monitoring of the disease and patient follow-up.

  7. Unusual appearance for urinary bladder obstruction detected with 99mTc-MDP bone scintigraphy. (United States)

    Wright, Chadwick L; Sharma, Akash


    Unanticipated but clinically significant nonosseous findings can be detected during routine bone scintigraphy. We present a case of an 83-year-old man who presented with a pathologic fracture of the right femur. Whole-body bone scintigraphy for osseous staging revealed intense radiotracer accumulation in the kidneys and ureters but no activity within the urinary bladder. The patient had not voided for 14 hours. A Foley catheter was inserted, and more than 2000 mL of urine was drained, most consistent with urinary bladder obstruction. Subsequent repeat images demonstrated marked reduction of the renal and ureteral activity with trace activity in the urinary bladder.

  8. Myocardial Scintigraphy in the Evaluation of Cardiac Events in Patients without Typical Symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Smanio, Paola Emanuela Poggio, E-mail:; Silva, Juliana Horie; Holtz, João Vitor; Ueda, Leandro; Abreu, Marilia; Marques, Carlindo; Machado, Leonardo [Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil Mailing (Brazil)


    Cardiovascular disease is a leading cause of death in the world and in Brazil. Myocardial scintigraphy is an important noninvasive method for detecting ischemia in symptomatic patients, but its use in asymptomatic ones or those with atypical symptoms is yet to be defined. To verify the presence of major cardiac events in asymptomatic patients or those with atypical symptoms (atypical chest pain or dyspnea) that underwent myocardial scintigraphy (MS), over a period of 8 years. Secondary objectives were to identify cardiac risk factors associated with myocardial scintigraphy abnormalities and possible predictors for major cardiac events in this group. This was a retrospective, observational study using the medical records of 892 patients that underwent myocardial scintigraphy between 2005 and 2011 and who were followed until 2013 for assessment of major cardiac events and risk factors associated with myocardial scintigraphy abnormalities. Statistical analysis was performed by Fisher’s exact test, logistic regression and Kaplan-Meyer survival curves, with statistical significance being set at p ≤ 0.05. Of the total sample, 52.1% were men, 86.9% were hypertensive, 72.4% had hyperlipidemia, 33.6% were diabetic, and 12.2% were smokers; 44.5% had known coronary artery disease; and 70% had high Framingham score, 21.8% had moderate and 8% had low risk. Of the myocardial scintigraphies, 58.6% were normal, 26.1% suggestive of fibrosis and 15.3% suggestive of ischemia. At evolution, 13 patients (1.5%) had non-fatal myocardial infarction and six individuals (0.7%) died. The group with normal myocardial scintigraphy showed longer period of time free of major cardiac events, non-fatal myocardial infarction (p = 0.036) and death. Fibrosis in the myocardial scintigraphy determined a 2.4-fold increased risk of non-fatal myocardial infarction and five-fold higher risk of death (odds ratio: 2.4 and 5.7, respectively; p = 0.043). The occurrence of major cardiac events in 8 years

  9. Detection of acute cerebral ischaemia with Tc-99m apcitide scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Tepmongkol, S. [Nuclear Medicine Division, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Bangkok 10330 (Thailand)


    The established indication for Tc99m apcitide scintigraphy is for detecting deep venous thrombosis. However, due to its mechanism of binding to GP IIb/IIIa receptors on activated platelets, it can be used to image acute cerebral thrombosis. I report a patient with an acute ischaemic stroke, with right leg swelling, referred for Tc99m apcitide scintigraphy to show of deep venous thrombosis. There was no abnormal uptake in the legs but there was in the left parieto-occipital region. This correlated with the clinical and CT data, indicating an acute ischaemic stroke in this area. (orig.)

  10. MSA in Beijing aerosol

    Institute of Scientific and Technical Information of China (English)

    YUAN Hui; WANG Ying; ZHUANG Guoshun


    Methane sulphonate (MSA) and sulfate (SO42-), the main oxidation products of dimethyl sulfide (DMS), are the target of atmospheric chemistry study, as sulfate aerosol would have important impact on the global climate change. It is widely believed that DMS is mainly emitted from phytoplankton production in marine boundary layer (MBL), and MSA is usually used as the tracer of non-sea-salt sulfate (nss- SO42-) in marine and coastal areas (MSA/SO42- = 1/18). Many observations of MSA were in marine and coastal aerosols. To our surprise, MSA was frequently (>60%) detected in Beijing TSP, PM10, and PM2.5 aerosols, even in the samples collected during the dust storm period. The concentrations of MSA were higher than those measured in marine aerosols. Factor analysis, correlation analysis and meteorology analysis indicated that there was no obvious marine influence on Beijing aerosols. DMS from terrestrial emissions and dimethyl sulphoxide (DMSO) from industrial wastes could be the two possible precursors of MSA. Warm and low-pressure air masses and long time radiation were beneficial to the formation of MSA. Anthropogenic pollution from regional and local sources might be the dominant contributor to MSA in Beijing aerosol. This was the first report of MSA in aerosols collected in an inland site in China. This new finding would lead to the further study on the balance of sulfur in inland cities and its global biogeochemical cycle.

  11. Assessment of takotsubo (ampulla) cardiomyopathy using iodine-123 metaiodobenzylguanidine scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Pessoa, Pinheiro M.C.; Xavier, Salles S.; Lima, Souza Leao R.; Mansur, J.; Almeida, Altino S. de; Carvalho, Pires A.C.; Gutfilen, B.; Fonseca, Barbosa L.M. da [Hospital Univ. Clementino Fraga Filho, Univ. Federal do Rio de Janeiro (Brazil). Dept. de Radiologia


    Purpose: To evaluate the role of cardiac sympathetic innervation in patients whose clinical features consisted of chest pain, transient ST-segment elevation, left ventricular apical akinesis, minimal elevation of cardiac enzymes, and onset of symptoms shortly after a severe stress condition. Material and Methods: Five female patients, mean age 67{+-}14 years, underwent thoracic {sup 123}I-MIBG (planar and SPECT) and 67Ga citrate (planar) scans within 5 days after the onset of symptoms. The {sup 123}I-MIBG myocardial washout rate between early (30 min) and delayed (3 hours) planar images was calculated. All patients presented findings consistent with takotsubo-like syndrome. Echocardiograms showed the characteristic wall motion pattern of significant apical dysfunction. Acute-phase coronary angiographies revealed a non-obstructive pattern. A peculiar apical akinesis and basal normokinesis were observed on the ventriculograms. Results: Impairment of cardiac neuronal uptake of {sup 123}I-MIBG based on a reduction of the heart-to-mediastinum uptake ratio was observed in all patients, while the washout rate was raised in four patients. All patients presented an apical uptake defect in the {sup 123}I-MIBG SPECT and planar images and a normal 67Ga scintigraphy. Conclusion: Our data indicate that ampulla cardiomyopathy (AC) is associated with a cardiac sympathetic innervation deficit characterized by a reduced global {sup 123}I-MIBG uptake and an apical uptake defect. The lack of 67Ga uptake in the acute phase of this syndrome indicates that AC is probably not associated with an inflammatory process.

  12. Role of Gallium and labeled leukocyte scintigraphy in AIDS patient

    Energy Technology Data Exchange (ETDEWEB)

    Palestro, C.J. [Division of nuclear medicine, Long Island Jewish Medical Center, New Hyde Park, New York (United States); Goldsmith, S.J. [Division of nuclear medicine, New York Hospital, Cornell Medical Center, New York (United States)


    Because AIDS patients frequently present with minimal symptomatology, radionuclide imaging with its ability to survey the entire body, is especially valuable. Gallium-67 citrate, the most commonly performed radionuclide study for localizing infection in these patients, is most useful for detecting opportunistic infections, especially in the thorax. A negative gallium scan, particularly when the chest X-ray is unremarkable, rules strongly against pulmonary disease. A negative gallium scan in a patient with an abnormal chest X-ray and Kaposi`s sarcoma, suggests that the patient`s respiratory distress is related to the neoplasm. Diffuse pulmonary parenchymal uptake of gallium in the HIV (+) patient is most often associated with PCP. While there are other causes of diffuse pulmonary uptake, the more intense or heterogeneous the uptake, the more likely the patient is to have PCP. Focal pulmonary uptake is usually associated with bacterial pneumonia although PCP may occasionally present in this fashion. Lymph node uptake of gallium is usually associated with Mycob acterium avium complex, tuberculosis, or Iymphoma. When corresponding abnormalities are present on thallium scintigraphy lymphoma is likely. Gallium positive, thallium negative, studies suggest mycobacterial disease. Labeled leukocyte imaging is not useful for detecting opportunistic infections probably because of the inflammatory response incited by these organisms. Leukocyte imaging is, however, more sensitive for detecting bacterial pneumonia. In the abdomen, gallium imaging is most useful for identifying lymphadenopathy, while labeled leukocyte imaging is superior for detecting AlDS-associated colitides. In summary, radionuclide studies are valuable diagnostic modalities in AIDS. Their success can be maximized by tailoring the study to the individual`s needs.

  13. Clinical validation of simultaneous dual-isotope myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Weinmann, Pierre; Moretti, Jean Luc [Department of Nuclear Medicine, Avicenne Hospital, Paris XIII University, 125, Rue de Stalingrad, 93 009 Bobigny Cedex (France); Faraggi, Marc [Department of Nuclear Medicine, Bichat Hospital, Paris VII University (France); Hannequin, Pascal [Centre d' Imagerie Nucleaire, Annecy (France)


    Simultaneous dual-isotope (rest thallium-201/stress technetium-99m sestamibi) myocardial single-photon emission tomography (SPET) would be an ideal procedure; however, {sup 99m}Tc cross-talk on the {sup 201}Tl window hampers its routine use. Photon energy recovery (PER) is a spectral deconvolution technique validated for scatter and cross-talk removal in phantom studies and a limited series of patients. In this study we aimed to validate the technique in 295 patients within a context of clinical routine practice. Conventional separate rest {sup 201}Tl myocardial SPET data sets were visually compared with simultaneous dual-isotope data sets corrected by PER. Conventional separate rest {sup 201}Tl data sets were identical to dual PER-corrected {sup 201}Tl data sets in 173 (58.6%) patients. As dual PER {sup 201}Tl data sets are corrected for {sup 99m}Tc cross-talk but also for {sup 201}Tl scatter, they were compared with separate rest {sup 201}Tl data sets corrected by PER in the 122 discordant patients. No difference was found in 77 (26.1%) patients. In 26 (8.8%) patients, the difference consisted in the presence of a defect on dual PER {sup 201}Tl data sets only, mirroring an ischaemic defect on {sup 99m}Tc-sestamibi data sets. This difference can be attributed to the influence of stress on the kinetics of {sup 201}Tl injected at rest. In the remaining 19 (6.4%) patients, the difference between separate and simultaneous PER-corrected data sets was scored as mild in 11 and moderate in eight patients and seemed to be related to multiple methodological factors. It is concluded that PER correctly removes {sup 99m}Tc cross-talk. With the addition of an appropriate attenuation correction, the PER technique may allow the routine use of simultaneous dual-isotope myocardial scintigraphy in the near future. (orig.)

  14. Coded Aperture Nuclear Scintigraphy: A Novel Small Animal Imaging Technique

    Directory of Open Access Journals (Sweden)

    Dawid Schellingerhout


    Full Text Available We introduce and demonstrate the utility of coded aperture (CA nuclear scintigraphy for imaging small animals. CA imaging uses multiple pinholes in a carefully designed mask pattern, mounted on a conventional gamma camera. System performance was assessed using point sources and phantoms, while several animal experiments were performed to test the usefulness of the imaging system in vivo, with commonly used radiopharmaceuticals. The sensitivity of the CA system for 99mTc was 4.2 × 103 cps/Bq (9400 cpm/μCi, compared to 4.4 × 104 cps/Bq (990 cpm/μCi for a conventional collimator system. The system resolution was 1.7 mm, as compared to 4–6 mm for the conventional imaging system (using a high-sensitivity low-energy collimator. Animal imaging demonstrated artifact-free imaging with superior resolution and image quality compared to conventional collimator images in several mouse and rat models. We conclude that: (a CA imaging is a useful nuclear imaging technique for small animal imaging. The advantage in signal-to-noise can be traded to achieve higher resolution, decreased dose or reduced imaging time. (b CA imaging works best for images where activity is concentrated in small volumes; a low count outline may be better demonstrated using conventional collimator imaging. Thus, CA imaging should be viewed as a technique to complement rather than replace traditional nuclear imaging methods. (c CA hardware and software can be readily adapted to existing gamma cameras, making their implementation a relatively inexpensive retrofit to most systems.

  15. The ADMIT series - Issues in inhalation therapy. 4) How to choose inhaler devices for the treatment of COPD.

    NARCIS (Netherlands)

    Vincken, W.; Dekhuijzen, P.N.R.; Barnes, P.


    For patients with COPD, inhalation is the preferred route of administration of respiratory drugs for both maintenance and acute treatment. Numerous inhaler types and devices have been developed, each with their own particularities, advantages and disadvantages. Nevertheless, published COPD managemen

  16. 49 CFR 172.555 - POISON INHALATION HAZARD placard. (United States)


    ... 49 Transportation 2 2010-10-01 2010-10-01 false POISON INHALATION HAZARD placard. 172.555 Section... REQUIREMENTS, AND SECURITY PLANS Placarding § 172.555 POISON INHALATION HAZARD placard. (a) Except for size and color, the POISON INHALATION HAZARD placard must be as follows: ER22JY97.025 (b) In addition...

  17. 49 CFR 172.429 - POISON INHALATION HAZARD label. (United States)


    ... 49 Transportation 2 2010-10-01 2010-10-01 false POISON INHALATION HAZARD label. 172.429 Section... REQUIREMENTS, AND SECURITY PLANS Labeling § 172.429 POISON INHALATION HAZARD label. (a) Except for size and color, the POISON INHALATION HAZARD label must be as follows: ER22JY97.023 (b) In addition to...

  18. 42 CFR 84.90 - Breathing resistance test; inhalation. (United States)


    ... 42 Public Health 1 2010-10-01 2010-10-01 false Breathing resistance test; inhalation. 84.90...-Contained Breathing Apparatus § 84.90 Breathing resistance test; inhalation. (a) Resistance to inhalation airflow will be measured in the facepiece or mouthpiece while the apparatus is operated by a...

  19. Modal aerosol dynamics modeling

    Energy Technology Data Exchange (ETDEWEB)

    Whitby, E.R.; McMurry, P.H.; Shankar, U.; Binkowski, F.S.


    The report presents the governing equations for representing aerosol dynamics, based on several different representations of the aerosol size distribution. Analytical and numerical solution techniques for these governing equations are also reviewed. Described in detail is a computationally efficient numerical technique for simulating aerosol behavior in systems undergoing simultaneous heat transfer, fluid flow, and mass transfer in and between the gas and condensed phases. The technique belongs to a general class of models known as modal aerosol dynamics (MAD) models. These models solve for the temporal and spatial evolution of the particle size distribution function. Computational efficiency is achieved by representing the complete aerosol population as a sum of additive overlapping populations (modes), and solving for the time rate of change of integral moments of each mode. Applications of MAD models for simulating aerosol dynamics in continuous stirred tank aerosol reactors and flow aerosol reactors are provided. For the application to flow aerosol reactors, the discussion is developed in terms of considerations for merging a MAD model with the SIMPLER routine described by Patankar (1980). Considerations for incorporating a MAD model into the U.S. Environmental Protection Agency's Regional Particulate Model are also described. Numerical and analytical techniques for evaluating the size-space integrals of the modal dynamics equations (MDEs) are described. For multimodal logonormal distributions, an analytical expression for the coagulation integrals of the MDEs, applicable for all size regimes, is derived, and is within 20% of accurate numerical evaluation of the same moment coagulation integrals. A computationally efficient integration technique, based on Gauss-Hermite numerical integration, is also derived.

  20. Experimental Study of Aerosol Deposition in a Realistic Lung Model

    Directory of Open Access Journals (Sweden)

    František LÍZAL


    Full Text Available The inhalation route for administration of medicaments is becoming more and more popular in recent years. The reason is non-invasiveness of the method and instantaneous absorption of drugs to the blood circulation. It is necessary to deliver exact amount of drug to the specific segment because of occurrence of diverse diseases in different segments of lungs. The aim of our work is to contribute to better understanding of transport and deposition of aerosolized drugs in lungs and hence to more effective treatment of respiratory diseases due to the targeted drug delivery. We provided measurements of aerosol deposition in segmented realistic model of lungs without a mouth cavity. Monodisperse particles marked with fluorescein were supplied to the model. The model was then disassembled to segments and each segment was rinsed with isopropanol, whereby fluorescent samples were created. Each sample was analysed by fluorometer and an amount of aerosol deposited in the segment was calculated. Experiences obtained by this study were used for creation of a new model with the mouth cavity. This model will be used for future studies with porous and fiber aerosols.

  1. Regional aerosol deposition in human upper airways. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Swift, D.L.


    During the award period, a number of studies have been carried out related to the overall objective of the project which is to elucidate important factors which influence the upper airway deposition and dose of particles in the size range 0.5 nm - 10 {mu}m, such as particle size, breathing conditions, age, airway geometry, and mode of breathing. These studies are listed below. (1) A high voltage electrospray system was constructed to generate polydispersed 1-10 {mu}m diameter di-ethylhexyl sebacate aerosol for particle deposition studies in nasal casts and in human subjects. (2) The effect of nostril dimensions, nasal passage geometry, and nasal resistance on particle deposition efficiency in forty healthy, nonsmoking adults at a constant flowrate were studied. (3) The effect of nostril dimensions, nasal passage dimensions and nasal resistance on the percentage of particle deposition in the anterior 3 cm of the nasal passage of spontaneously breathing humans were studied. (4) The region of deposition of monodispersed aerosols were studied using replicate casts. (5) Ultrafine aerosol deposition using simulated breath holding path and natural path was compared. (6) An experimental technique was proposed and tested to measure the oral deposition of inhaled ultrafine particles. (7) We have calculated the total deposition fraction of ultrafine aerosols from 5 to 200 n in the extrathoracic airways and in the lung. (8) The deposition fraction of radon progeny in the head airways was studied using several head airway models.

  2. Research of transport and deposition of aerosol in human airway replica

    Directory of Open Access Journals (Sweden)

    Mravec Filip


    Full Text Available Growing concern about knowledge of aerosol transport in human lungs is caused by great potential of use of inhaled pharmaceuticals. Second substantial motive for the research is an effort to minimize adverse effects of particular matter emitted by traffic and industry on human health. We created model geometry of human lungs to 7th generation of branching. This model geometry was used for fabrication of two physical models. The first one is made from thin walled transparent silicone and it allows a measurement of velocity and size of aerosol particles by Phase Doppler Anemometry (PDA. The second one is fabricated by stereolithographic method and it is designed for aerosol deposition measurements. We provided a series of measurements of aerosol transport in the transparent model and we ascertained remarkable phenomena linked with lung flow. The results are presented in brief. To gather how this phenomena affects aerosol deposition in human lungs we used the second model and we developed a technique for deposition fraction and deposition efficiency assessment. The results confirmed that non-symmetric and complicated shape of human airways essentially affects transport and deposition of aerosol. The research will now focus on deeper insight in aerosol deposition.

  3. Particle deposition in a child respiratory tract model: in vivo regional deposition of fine and ultrafine aerosols in baboons. (United States)

    Albuquerque-Silva, Iolanda; Vecellio, Laurent; Durand, Marc; Avet, John; Le Pennec, Déborah; de Monte, Michèle; Montharu, Jérôme; Diot, Patrice; Cottier, Michèle; Dubois, Francis; Pourchez, Jérémie


    To relate exposure to adverse health effects, it is necessary to know where particles in the submicron range deposit in the respiratory tract. The possibly higher vulnerability of children requires specific inhalation studies. However, radio-aerosol deposition experiments involving children are rare because of ethical restrictions related to radiation exposure. Thus, an in vivo study was conducted using three baboons as a child respiratory tract model to assess regional deposition patterns (thoracic region vs. extrathoracic region) of radioactive polydisperse aerosols ([d16-d84], equal to [0.15 µm-0.5 µm], [0.25 µm-1 µm], or [1 µm-9 µm]). Results clearly demonstrated that aerosol deposition within the thoracic region and the extrathoraic region varied substantially according to particle size. High deposition in the extrathoracic region was observed for the [1 µm-9 µm] aerosol (72% ± 17%). The [0.15 µm-0.5 µm] aerosol was associated almost exclusively with thoracic region deposition (84% ± 4%). Airborne particles in the range of [0.25 µm-1 µm] showed an intermediate deposition pattern, with 49% ± 8% in the extrathoracic region and 51% ± 8% in the thoracic region. Finally, comparison of baboon and human inhalation experiments for the [1 µm-9 µm] aerosol showed similar regional deposition, leading to the conclusion that regional deposition is species-independent for this airborne particle sizes.

  4. Particle deposition in a child respiratory tract model: in vivo regional deposition of fine and ultrafine aerosols in baboons.

    Directory of Open Access Journals (Sweden)

    Iolanda Albuquerque-Silva

    Full Text Available To relate exposure to adverse health effects, it is necessary to know where particles in the submicron range deposit in the respiratory tract. The possibly higher vulnerability of children requires specific inhalation studies. However, radio-aerosol deposition experiments involving children are rare because of ethical restrictions related to radiation exposure. Thus, an in vivo study was conducted using three baboons as a child respiratory tract model to assess regional deposition patterns (thoracic region vs. extrathoracic region of radioactive polydisperse aerosols ([d16-d84], equal to [0.15 µm-0.5 µm], [0.25 µm-1 µm], or [1 µm-9 µm]. Results clearly demonstrated that aerosol deposition within the thoracic region and the extrathoraic region varied substantially according to particle size. High deposition in the extrathoracic region was observed for the [1 µm-9 µm] aerosol (72% ± 17%. The [0.15 µm-0.5 µm] aerosol was associated almost exclusively with thoracic region deposition (84% ± 4%. Airborne particles in the range of [0.25 µm-1 µm] showed an intermediate deposition pattern, with 49% ± 8% in the extrathoracic region and 51% ± 8% in the thoracic region. Finally, comparison of baboon and human inhalation experiments for the [1 µm-9 µm] aerosol showed similar regional deposition, leading to the conclusion that regional deposition is species-independent for this airborne particle sizes.

  5. Inhaled medication and inhalation devices for lung disease in patients with cystic fibrosis: A European consensus. (United States)

    Heijerman, Harry; Westerman, Elsbeth; Conway, Steven; Touw, Daan; Döring, Gerd


    In cystic fibrosis inhalation of drugs for the treatment of CF related lung disease has been proven to be highly effective. Consequently, an increasing number of drugs and devices have been developed for CF lung disease or are currently under development. In this European consensus document we review the current status of inhaled medication in CF, including the mechanisms of action of the various drugs, their modes of administration and indications, their effects on lung function, exacerbation rates, survival and quality of life, as well as side effects. Specifically we address antibiotics, mucolytics/mucous mobilizers, anti-inflammatory drugs, bronchodilators and combinations of solutions. Additionally, we review the current knowledge on devices for inhalation therapy with regard to optimal particle sizes and characteristics of wet nebulisers, dry powder and metered dose inhalers. Finally, we address the subject of testing new devices before market introduction.

  6. Simulation study of electric-guided delivery of 0.4µm monodisperse and polydisperse aerosols to the ostiomeatal complex. (United States)

    Xi, Jinxiang; Yuan, Jiayao Eddie; Si, Xiuhua April


    Despite the high prevalence of rhinosinusitis, current inhalation therapy shows limited efficacy due to extremely low drug delivery efficiency to the paranasal sinuses. Novel intranasal delivery systems are needed to enhance targeted delivery to the sinus with therapeutic dosages. An optimization framework for intranasal drug delivery was developed to target polydisperse charged aerosols to the ostiomeatal complex (OMC) with electric guidance. The delivery efficiency of a group of charged aerosols recently reported in the literature was numerically assessed and optimized in an anatomically accurate nose-sinus model. Key design variables included particle charge number, particle size and distribution, electrode strength, and inhalation velocity. Both monodisperse and polydisperse aerosol profiles were considered. Results showed that the OMC delivery efficiency was highly sensitive to the applied electric field and electrostatic charges carried by the particles. Through the synthesis of electric-guidance and point drug release, focused deposition with significantly enhanced dosage in the OMC can be achieved. For 0.4 µm charged aerosols, an OMC delivery efficiency of 51.6% was predicted for monodisperse aerosols and 34.4% for polydisperse aerosols. This difference suggested that the aerosol profile exerted a notable effect on intranasal deliveries. Sensitivity analysis indicated that the OMC deposition fraction was highly sensitive to the charge and size of particles and was less sensitive to the inhalation velocity considered in this study. Experimental studies are needed to validate the numerically optimized designs. Further studies are warranted to investigate the targeted OMC delivery with both electric and acoustics controls, the latter of which has the potential to further deliver the drug particles into the sinus cavity.

  7. Application of AERONET Single Scattering Albedo and Absorption Angstrom Exponent to Classify Dominant Aerosol Types during DRAGON Campaigns (United States)

    Giles, D. M.; Holben, B. N.; Eck, T. F.; Schafer, J.; Crawford, J. H.; Kim, J.; Sano, I.; Liew, S.; Salinas Cortijo, S. V.; Chew, B. N.; Lim, H.; Smirnov, A.; Sorokin, M.; Kenny, P.; Slutsker, I.


    Aerosols can have major implications on human health by inducing respiratory diseases due to inhalation of fine particles from biomass burning smoke or industrial pollution and on radiative forcing whereby the presence of absorbing aerosol particles (e.g., black carbon) increases atmospheric heating. Aerosol classification techniques have utilized aerosol loading and aerosol properties derived from multi-spectral and multi-angle observations by ground-based (e.g., AERONET) and satellite instrumentation (e.g., MISR). Aerosol Robotic Network (AERONET) data have been utilized to determine aerosol types by implementing various combinations of measured aerosol optical depth or retrieved size and absorption aerosol properties (e.g., Gobbi et al., 2007; Russell et al., 2010). Giles et al. [2012] showed single scattering albedo (SSA) relationship with extinction Angstrom exponent (EAE) can provide an estimate of the general classification of dominant aerosol types (i.e., desert dust, urban/industrial pollution, biomass burning smoke, and mixtures) based on data from ~20 AERONET sites located in known aerosol source regions. In addition, the absorption Angstrom exponent relationship with EAE can provide an indication of the dominant absorbing aerosol type such as dust, black carbon, brown carbon, or mixtures of them. These classification techniques are applied to the AERONET Level 2.0 quality assured data sets collected during Distributed Regional Aerosol Gridded Observational Network (DRAGON) campaigns in Maryland (USA), Japan, South Korea, Singapore, Penang (Malaysia), and California (USA). An analysis of aerosol type classification for DRAGON sites is performed as well as an assessment of the spatial variability of the aerosol types for selected DRAGON campaigns. Giles, D. M., B. N. Holben, T. F. Eck, A. Sinyuk, A. Smirnov, I. Slutsker, R. R. Dickerson, A. M. Thompson, and J. S. Schafer (2012), An analysis of AERONET aerosol absorption properties and classifications

  8. Heart failure and 1231-M.I.B.G. scintigraphy: comeback; Scintigraphie cardiaque a la 1231-metaiodobenzylguanidine et cardiomyopathies: le retour

    Energy Technology Data Exchange (ETDEWEB)

    Agostini, D.; Hugentobler, A.; Costo, S.; Bouvard, G. [Centre Hospitalier Universitaire Cote de Nacre, Service de Medecine Nucleaire, 14 - Caen (France); Manrique, A. [Centre de Lutte Contre le Cancer Henri-Becquerel, Service de Medecine Nucleaire, 76 - Rouen (France); Sabatier, R.; Grollier, G. [Centre Hospitalier Universitaire Cote de Nacre, Service de Cardiologie, 14 - Caen (France); Belin, A. [Hopital de Trouville, Service de Readaptation Cardiaque, 14 - Trouville (France)


    Congestive heart failure is a often associated with an impairment of sympathetic nervous system, i.e., global hyperactivity and regional impairment of adrenergic system. Cardiac {sup 123}I-meta-iodo-benzyl-guanidine (M.I.B.G.) scintigraphy is a radionuclide technique which can explore the presynaptic adrenergic function. Cardiac fixation of M.I.B.G. is decreased in congestive heart failure, reflecting a reduction of norepinephrine uptake by the myocardial presynaptic ending nerves. The impairment of presynaptic function is early and actually involved in the pathogenesis of cardiac failure. Cardiac M.I.B.G. scintigraphy is a useful tool to explore the myocardial adrenergic stores in patients with congestive heart failure. (authors)

  9. Comparison of relative renal function measured with either 99m Tc-DTPA or 99m Tc-EC dynamic scintigraphies with that measured with 99m Tc-DMSA static scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Domingues, F.C.; Fujikawa, G.Y.; Decker, H.; Alonso, G.; Pereira, J.C.; Duarte, P.S. [Centro de Diagnostico Fleury, Sao Paulo, SP (Brazil). Secao de Medicina Nu