WorldWideScience

Sample records for bronchi

  1. Quick Dissection of the Segmental Bronchi

    Science.gov (United States)

    Nakajima, Yuji

    2010-01-01

    Knowledge of the three-dimensional anatomy of the bronchopulmonary segments is essential for respiratory medicine. This report describes a quick guide for dissecting the segmental bronchi in formaldehyde-fixed human material. All segmental bronchi are easy to dissect, and thus, this exercise will help medical students to better understand the…

  2. Hixozide in therapy of tuberculosis of bronchi

    Directory of Open Access Journals (Sweden)

    Morozova T.l.

    2014-06-01

    Full Text Available The purpose of the article is to evaluate the efficacy and tolerability of the combined inhaled anti-TB preparation Hixozide for improving the effectiveness of medical treatment of patients suffering from tuberculosis of bronchus. Material and Methods. Hixozide (made in Russia, the active substance Hydroxymethylchinoxylindioxydum 100mg + Isoniazidum 250 mg, was delivered via inhalations using a compressor nebulizer within 21 days in the course of the complex chemotherapy. Inclusion criteria: newly diagnosed patients and patients with relapsed tuberculosis with the presence of tuberculousendobronchitis, drug sensitivity saved to isoniazid. Exclusion criteria: the state of preventing the appointment of adequate treatment, HIV-infection (group 1, n=30. The comparison group was consisted of patients receiving standard treatment in combination with inhaled administration of Isoniazid (group 2, n=21. Rezults. The clinical study has figured out: after a course of inhalations of Hixozide the clinical cure of bronchial tuberculosis occurs after the period of 2 months of treatment (according to the results of endoscopy of bronchi; more patients — 69.2% versus 38.1% in the comparison group, p=0,039 showed a positive trend during the nonspecific endobronchitis — 85,7% vs. 52,9%, p=0,017; the treatment and bacteriological conversion were achieved: 143±27 days in the first group vs. 164±32 days in the control group, p=0,019. Adverse reactions to Hixozide demanding its abolition occurred in 13,3%, they were stopped and did not affect the health of patients in the future. Conclusion. Inhaled Hixozide in the complex treatment of patients with tuberculosis accelerates clinical cure of tuberculosis of the bronchi, healing the lesions in the lung tissue and abacillation.

  3. The correlation between increased reactivity of the bronchi and of mediator releasing cells in asthma

    OpenAIRE

    Neijenst, H.; Degenhart, Herman; Raatgeep, Rolien; Kerrebijn, K.F.

    1980-01-01

    textabstractThe hypothesis that increased reactivity in asthma is not always limited to the bronchi but also exists in the mediator releasing system was investigated in forty‐five asthmatic children, approximately half of whom had exercise‐induced bronchoconstriction (EIB). The bronchial threshold to histamine was measured as an indicator of the reactivity of the bronchi and the histamine release from leucocytes without adding allergen (spontaneous histamine release) was considered as an indi...

  4. Imaging features of nontumorous conditions involving the trachea and main-stem bronchi

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Kyung Nyeo; Kang, Duk Sik; Bae, Kyung Soo [Kyungpook National University Hospital, Taegu (Korea, Republic of)

    2002-09-01

    A number of nontumorous diseases may affect the trachea and main-stem bronchi, and their nonspecific symptoms may include coughing, dyspnea, wheezing and stridor. The clinical course is often long-term and a misdiagnosis of bronchial asthma is common. The imaging findings of these nontumorous conditions are, however, relatively characteristic, and diagnosis either without or in conjunction with clinical information is often possible. For specific diagnosis, recognition of their imaging features is therefore of prime importance. In this pictorial essay, we illustrate the imaging features of various nontumorous conditions involving the trachea and main-stem bronchi.

  5. The correlation between increased reactivity of the bronchi and of mediator releasing cells in asthma

    NARCIS (Netherlands)

    H.J. Neijenst (H.); H.J. Degenhart (Herman); R.H. Raatgeep (Rolien); K.F. Kerrebijn

    1980-01-01

    textabstractThe hypothesis that increased reactivity in asthma is not always limited to the bronchi but also exists in the mediator releasing system was investigated in forty‐five asthmatic children, approximately half of whom had exercise‐induced bronchoconstriction (EIB). The bronchial threshold

  6. Images of the Respiratory System in Ancient Egypt: Trachea, Bronchi and Pulmonary Lobes

    Directory of Open Access Journals (Sweden)

    Jakub Kwiecinski

    2012-01-01

    Full Text Available Examination of ancient Egyptians’ depictions of the respiratory tract, dating back to the 30th century BC, reveals their awareness of the pulmonary anatomy: reinforced with cartilaginous rings, the trachea is split into two main bronchi, which then enter the lungs (lungs being divided into pulmonary lobes.

  7. First images of respiratory system in ancient Egypt: Trachea, bronchi and pulmonary lobes.

    Science.gov (United States)

    Kwiecinski, Jakub

    2012-01-01

    Examination of ancient Egyptians' depictions of the respiratory tract, dating back to the 30th century BC, reveals their awareness of the pulmonary anatomy: reinforced with cartilaginous rings, the trachea is split into two main bronchi, which then enter the lungs (lungs being divided into pulmonary lobes).

  8. Metabolism of acyclic and cyclic N-nitrosamines in cultured human bronchi

    DEFF Research Database (Denmark)

    Harris, Curtis C.; Autrup, Herman; Stoner, Gary D.

    1977-01-01

    The metabolism of carcinogenic N-nitrosamines was studied in normal-appearing bronchial specimens obtained from 4 patients. Explants of bronchi were cultured in a chemically defined medium for 7 days. N-Nitrosamines [N-nitrosodimethylamine (DMN), N-nitrosodiethylamine (DEN), N,N'-dinitrosopiperaz......The metabolism of carcinogenic N-nitrosamines was studied in normal-appearing bronchial specimens obtained from 4 patients. Explants of bronchi were cultured in a chemically defined medium for 7 days. N-Nitrosamines [N-nitrosodimethylamine (DMN), N-nitrosodiethylamine (DEN), N...... bronchial specimens, these N-nitrosamines and/or their metabolites bound to bronchial mucosal DNA and protein. Binding levels were higher to protein than to DNA. Binding levels of DNP were as high as those with the two acyclic N-nitrosamines DMN and DEN, but binding levels of NPy and NPd were lower. Human...

  9. Antagonist profile of ibodutant at the tachykinin NK(2) receptor in guinea pig isolated bronchi.

    Science.gov (United States)

    Santicioli, Paolo; Meini, Stefania; Giuliani, Sandro; Lecci, Alessandro; Maggi, Carlo Alberto

    2013-11-15

    In this study we have characterized the pharmacological profile of the non-peptide tachykinin NK(2) receptor antagonist ibodutant (MEN15596) in guinea pig isolated main bronchi contractility. The antagonist potency of ibodutant was evaluated using the selective NK(2) receptor agonist [βAla8]NKA(4-10)-mediated contractions of guinea pig isolated main bronchi. In this assay ibodutant (30, 100 and 300 nM) induced a concentration-dependent rightward shift of the [βAla8]NKA(4-10) concentration-response curves without affecting the maximal contractile effect. The analysis of the results yielded a Schild-plot linear regression with a slope not different from unity (0.95, 95% c.l. 0.65-1.25), thus, indicating a surmountable behavior. The calculated apparent antagonist potency as pK(B) value was 8.31 ± 0.05. Ibodutant (0.3-100 nM) produced a concentration-dependent inhibition of the nonadrenergic-noncholinergic (NANC) contractile response induced by electrical field stimulation (EFS) of intrinsic airway nerves in guinea pig isolated main bronchi. At the highest concentration tested (100 nM) ibodutant almost abolished the EFS-induced bronchoconstriction (95 ± 4% inhibition), the calculated IC(50) value was 2.98 nM (95% c.l. 1.73-5.16 nM). In bronchi from ovalbumin (OVA) sensitized guinea pigs ibodutant (100 nM) did not affect the maximal contractile response to OVA, but completely prevented the slowing in the fading of the motor response induced by phosphoramidon pretreatment linked to the endogenous neurokinin A release. Altogether, the present study demonstrates that ibodutant is a potent NK(2) receptor antagonist in guinea pig airways.

  10. Effectiveness of a Load-Imposing Device for Cyclic Stretching of Isolated Human Bronchi: A Validation Study

    Science.gov (United States)

    Le Guen, Morgan; Naline, Emmanuel; Grassin-Delyle, Stanislas; Devillier, Philippe; Faisy, Christophe

    2015-01-01

    Background Mechanical ventilation may induce harmful effects in the airways of critically ill patients. Nevertheless, the effects of cyclic stretching caused by repetitive inflation-deflation of the bronchial compartment have not been well characterized in humans. The objective of the present study was to assess the effectiveness of a load-imposing device for the cyclic stretching of human bronchi. Methods Intact bronchial segments were removed from 128 thoracic surgery patients. After preparation and equilibration in an organ bath, bronchi were stretched repetitively and cyclically with a motorized transducer. The peak force imposed on the bronchi was set to 80% of each individual maximum contraction in response to acetylcholine and the minimal force corresponded to the initial basal tone before stretching. A 1-min cycle (stretching for 15 sec, relaxing for 15 sec and resting for 30 sec) was applied over a time period ranging from 5 to 60 min. The device's performance level was assessed and the properties of the stretched bronchi were compared with those of paired, non-stretched bronchi. Results Despite the intrinsic capacities of the device, the targets of the tension adjustments remained variable for minimal tension (156–178%) while the peak force set point was unchanged (87–115%). In the stretched bronchi, a time-dependent rise in basal tone (P stretched) was apparent after as little as 5 min of cyclic stretching. The stretch-induced rise in basal tone continued to increase (P stretching had ended. Only 60 min of cyclic stretching was associated with a significant (P stretched bronchi. Conclusions Low-frequency, low-force, cyclic loading of human bronchi is associated with elevated basal tone and acetylcholine responsiveness. The present experimental model is likely to be a useful tool for future investigations of the bronchial response to repetitive stress during mechanical ventilation. PMID:26011598

  11. Effect of high laser output on the central bronchi and pulmonary artery.

    Science.gov (United States)

    Kirschbaum, A; Rexin, P; Bartsch, D K; Quint, K

    2017-05-01

    A diode-pump Nd:YAG high-power laser (wavelength 1320 nm, power 100 W) is routinely used to surgically remove lung metastases. Even pulmonary lesions in central locations are resectable via this method, yet it also carries a potential risk of damaging the larger bronchi and vessels in the vicinity. Studies investigating the safety of using high-power lasers are lacking. We therefore aimed to examine the direct effects of a 100-watt laser on the bronchi and pulmonary artery at a standard working velocity. From freshly slaughtered pigs, we isolated cylindrical specimens of the trachea, the main and lobar bronchi, and the central pulmonary artery from the both lungs. These specimens were fixed consecutively in rows behind each other on a Styrofoam surface in the laboratory. The laser's handle was clamped into a hydraulic feed unit so that the laser was focused at constant distance perpendicular to the tissue and would move at 10 mm/s over the specimens. The Nd:YAG Laser LIMAX® 120 functioned at a consistent power of 100 W during all the experiments. The lasered specimens were examined macroscopically and histologically for tissue damage. None of the trachea or bronchial walls were perforated. Compared to the pulmonary parenchyma, we observed no vaporization effects-only minor superficial coagulation (with a mean depth of 2.1 ± 0.8 mm). This finding was histologically confirmed in each specimen, which revealed mild superficial coagulation and no damage to the cartilage. In the presence of a residual peribronchial fatty tissue, the laser effect was even attenuated. The pulmonary arteries presented no lumen openings whatsoever, merely a discrete trace of coagulation. The vessel wall revealed increased vacuolization without alteration of the remaining vessel wall. In conclusion, laser resection at 100 W of the central lung areas is safe with respect to airways and blood vessels and the laser output does not need to be reduced when treating these areas.

  12. Lung cancer and bronchi-pulmonary diseases of iron uranium miners

    Energy Technology Data Exchange (ETDEWEB)

    Gneusheva, G. I.; Uspenskaya, K. M.

    2004-07-01

    The lung cancer mortality has been analyzed for 2.582 miners employed from 1943 to 1961. All persons observed had three years occupation at least. Basing upon the lung cancer risk value per unit of the exposure, the assessment of the effective standard of pulmonary organ irradiation to radon progeny was elaborated and mortality excess was calcuated. Medical demography studies of morbidity and mortality were elaborated for silicosis, silicotuberculosis, lung cancer and occupational bronchitis versus the magnitude of dust and radiation exposure. Annual and cumulative exposures have been assessed for seven cohorts of miners employed and vast primary material has been accumulated for the period of 40 years (1943-1984). Intensive indice of mortality were determined for observation periods. The mortality excess was compared to cumulated radiation exposure. The lung cancer mortality excess in iron-uranium miners was 3.3 cases per 106 man-years per 1 WLM; 4.8 cases per 106 man-years per 1 WLM was assessed if first years of occupation are negected. The latent period from radiation exposure to death from lung cancer is generally ten year or more. Changes of miners labor conditions (the magnitude of dust exposure) have been reflected by the bronchi pulmonary disease structure. The input of these dieseases into the occupational lung pathology has been significantly changed with the time course. Within first 18-20 years, pneumoconiosis was the only form of occupational lung pathology in the mine, whereas occupational bronchis and lung cancers were recorded within next then years thereafter. In cohorts of longest observation period, the average age of patients was increasingly ranked versus diseases as follows: silicosis, silicotuberculosis, chronic bronchitis, and lung cancer. (Author)

  13. Novel patterns for the growing main bronchi in the human fetus: an anatomical, digital and statistical study.

    Science.gov (United States)

    Szpinda, Michał; Daroszewski, Marcin; Woźniak, Alina; Szpinda, Anna; Flisiński, Piotr; Dombek, Małgorzata; Mila-Kierzenkowska, Celestyna; Siedlaczek, Waldemar

    2014-01-01

    Intensive progress in prenatal medicine results in performing airway management in the fetus affected by life-threatening congenital malformations. This study aimed to examine age-specific reference intervals and growth dynamics for length, proximal and distal external transverse diameters, and projection surface areas of the two main bronchi at varying gestational ages, including their relative growth in length and projection surface area. Using anatomical dissection, digital image analysis and statistics, length, proximal and distal external transverse diameters, and projection surface areas of the right and left main bronchi were examined in 73 human fetuses (39 males, 34 females) aged 14-25 weeks, derived from spontaneous abortions and stillbirths. Statistical analysis showed no sex differences. Between the 14 and 25th week of gestation, the lengths of the right and left main bronchi increased from 1.43 ± 0.18 to 3.18 ± 0.39 mm, and from 2.97 ± 0.16 to 7.58 ± 1.95 mm, in accordance with the functions: [Formula: see text], respectively. The proximal external transverse diameters of the right and left main bronchi varied from 2.13 ± 0.41 to 4.24 ± 0.20 mm, and from 1.84 ± 0.06 to 3.67 ± 0.66 mm, following the logarithmic models: [Formula: see text], respectively. The distal external transverse diameter rose from 2.09 ± 0.47 to 4.24 ± 0.20 mm, as [Formula: see text] for the right main bronchus, and from 1.85 ± 0.04 to 3.67 ± 0.66 mm, like [Formula: see text] for the left one. On either side, there were no statistically significant differences between values of the proximal and distal transverse diameters of the main bronchus. The projection surface areas of the right and left main bronchi ranged from 2.95 ± 0.19 to 13.34 ± 2.12 mm(2), and from 5.57 ± 0.21 to 28.52 ± 5.24 mm(2), as [Formula: see text] and [Formula: see text]. The two main bronchi revealed a proportionate increase in both length and projection

  14. Transient Dynamics Simulation of Airflow in a CT-Scanned Human Airway Tree: More or Fewer Terminal Bronchi?

    Directory of Open Access Journals (Sweden)

    Shouliang Qi

    2017-01-01

    Full Text Available Using computational fluid dynamics (CFD method, the feasibility of simulating transient airflow in a CT-based airway tree with more than 100 outlets for a whole respiratory period is studied, and the influence of truncations of terminal bronchi on CFD characteristics is investigated. After an airway model with 122 outlets is extracted from CT images, the transient airflow is simulated. Spatial and temporal variations of flow velocity, wall pressure, and wall shear stress are presented; the flow pattern and lobar distribution of air are gotten as well. All results are compared with those of a truncated model with 22 outlets. It is found that the flow pattern shows lobar heterogeneity that the near-wall air in the trachea is inhaled into the upper lobe while the center flow enters the other lobes, and the lobar distribution of air is significantly correlated with the outlet area ratio. The truncation decreases airflow to right and left upper lobes and increases the deviation of airflow distributions between inspiration and expiration. Simulating the transient airflow in an airway tree model with 122 bronchi using CFD is feasible. The model with more terminal bronchi decreases the difference between the lobar distributions at inspiration and at expiration.

  15. Computed tomography and upper gastrointestinal series findings of esophageal bronchi in infants

    Energy Technology Data Exchange (ETDEWEB)

    Colleran, Gabrielle C. [Boston Children' s Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Our Lady' s Children' s Hospital Crumlin, Department of Radiology, Dublin (Ireland); Ryan, Ciara E. [Our Lady' s Children' s Hospital Crumlin, Department of Pathology, Dublin (Ireland); Lee, Edward Y. [Boston Children' s Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Sweeney, Brian [Our Lady' s Children' s Hospital Crumlin, Department of Surgery, Dublin (Ireland); Rea, David; Brenner, Clare [Our Lady' s Children' s Hospital Crumlin, Department of Radiology, Dublin (Ireland)

    2017-02-15

    Esophageal bronchus is a rare form of communicating bronchopulmonary foregut malformation and a rare but important cause of an opaque hemithorax on chest radiography. A higher incidence of esophageal bronchus is associated with esophageal atresia, tracheo-esophageal fistula (TEF) and VACTERL (vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities) association. In the presence of these conditions, the pediatric radiologist may be the first to consider the diagnosis of esophageal bronchus or esophageal lung. To describe the imaging features in five children with esophageal bronchus. We reviewed hospital records and teaching files at two large pediatric tertiary referral centers over the 24-year period from January 1992 to January 2016. We reviewed all imaging studies and tabulated findings on radiography, fluoroscopic upper gastrointestinal (GI) series and CT. We then described the imaging features of esophageal bronchi with emphasis on CT and upper GI findings in four infants and one toddler. Three cases were identified from one institution (cases 2, 3, 4) and two from another (cases 1, 5). All five cases occurred in association with other midline malformations: four of the five had VACTERL association and three of the five had esophageal atresia and TEF. Lung opacification, ipsilateral mediastinal shift, and an abnormal carina and anomalous vascular anatomy suggest an esophageal bronchus or an esophageal lung on CT. While esophageal bronchus is a rare cause of an opaque hemithorax, CT and upper GI imaging play key roles in its diagnosis. Associations with esophageal atresia with tracheo-esophageal fistula and VACTERL association are particularly pertinent. Early diagnosis of esophageal bronchus might prevent complications such as aspiration and infection, which can allow for parenchymal sparing surgery as opposed to pneumonectomy. (orig.)

  16. Pharmacological characterization of the interaction between umeclidinium and vilanterol in human bronchi.

    Science.gov (United States)

    Calzetta, Luigino; Rogliani, Paola; Facciolo, Francesco; Rendina, Erino; Cazzola, Mario; Matera, Maria Gabriella

    2017-10-05

    The long-acting β 2 -agonist (LABA) / long-acting muscarinic antagonist (LAMA) fixed dose combination (FDC) therapy represents the cornerstone for the treatment of chronic obstructive pulmonary disease (COPD). Nevertheless, conflicting clinical findings still exist on the real benefit of the LABA/LAMA FDCs. Therefore, we investigated whether combining the LABA vilanterol with the LAMA umeclidinium may induce synergistic bronchorelaxant effect in isolated airways. The effect of umeclidinium and vilanterol, administered alone, in combination at the ratio of concentrations reproducing the doses delivered by Anoro ® Ellipta ® (55:22), or at isoeffective low concentrations, was investigated on the cholinergic contractile tone induced by the parasympathetic activation of human isolated airways. The interaction was analyzed by using the Bliss Independence and Unified Theory models. Umeclidinium and vilanterol induced a concentration-dependent relaxation of isolated bronchi, with umeclidinium significantly (P < 0.05) more potent than vilanterol (E max at 10Hz: umeclidium 102.6 ± 6.8%, vilanterol 75.1 ± 13.8%; pEC 50 at 10Hz: umeclidinium 8.6 ± 0.4, vilanterol 6.9 ± 0.6). When administered at 55:22 concentration-ratio, umeclidinium plus vilanterol completely relaxed the isolated airways (E max at 10Hz: 99.6 ± 8.0%; pEC 50 at 10Hz: 8.2 ± 0.4). No synergistic interaction was detected for umeclidinium/vilanterol combined at 55:22 ratio, whereas strong synergism was elicited when the drugs were administered at low isoeffective concentrations (+ 41.4 ± 5.8% vs. monocomponents), leading to submaximal relaxant effect (81.4 ± 5.8%). Umeclidinium and vilanterol are imbalanced when combined at 55:22 ratio, with umeclidinium over-dosed, or vice versa vilanterol under-dosed. Specific studies are needed to identify the dose ratio of umeclidinium/vilanterol combination to guarantee equipotency concentrations of each component into the lung, and induce synergistic

  17. Pro-Resolving Effects of Resolvin D2 in LTD4 and TNF-α Pre-Treated Human Bronchi.

    Directory of Open Access Journals (Sweden)

    Rayan Khaddaj-Mallat

    Full Text Available Inflammation is a major burden in respiratory diseases, resulting in airway hyperresponsiveness. Our hypothesis is that resolution of inflammation may represent a long-term solution in preventing human bronchial dysfunctions. The aim of the present study was to assess the anti-inflammatory effects of RvD2, a member of the D-series resolving family, with concomitant effects on ASM mechanical reactivity. The role and mode of action of RvD2 were assessed in an in vitro model of human bronchi under pro-inflammatory conditions, induced either by 1 μM LTD4 or 10 ng/ml TNF-α pre-treatment for 48h. TNF-α and LTD4 both induced hyperreactivity in response to pharmacological stimuli. Enhanced 5-Lipoxygenase (5-LOX and cysteinyl leukotriene receptor 1 (CysLTR1 detection was documented in LTD4 or TNF-α pre-treated human bronchi when compared to control (untreated human bronchi. In contrast, RvD2 treatments reversed 5-LOX/β-actin and CysLTR1/β-actin ratios and decreased the phosphorylation levels of AP-1 subunits (c-Fos, c-Jun and p38-MAP kinase, while increasing the detection of the ALX/FPR2 receptor. Moreover, various pharmacological agents revealed the blunting effects of RvD2 on LTD4 or TNF-α induced hyper-responsiveness. Combined treatment with 300 nM RvD2 and 1 μM WRW4 (an ALX/FPR2 receptor inhibitor blunted the pro-resolving and broncho-modulatory effects of RvD2. The present data provide new evidence regarding the role of RvD2 in a human model of airway inflammation and hyperrresponsiveness.

  18. The impact of low-frequency, low-force cyclic stretching of human bronchi on airway responsiveness.

    Science.gov (United States)

    Le Guen, Morgan; Grassin-Delyle, Stanislas; Naline, Emmanuel; Buenestado, Amparo; Brollo, Marion; Longchampt, Elisabeth; Kleinmann, Philippe; Devillier, Philippe; Faisy, Christophe

    2016-11-14

    In vivo, the airways are constantly subjected to oscillatory strain (due to tidal breathing during spontaneous respiration) and (in the event of mechanical ventilation) positive pressure. This exposure is especially problematic for the cartilage-free bronchial tree. The effects of cyclic stretching (other than high-force stretching) have not been extensively characterized. Hence, the objective of the present study was to investigate the functional and transcriptional response of human bronchi to repetitive mechanical stress caused by low-frequency, low-force cyclic stretching. After preparation and equilibration in an organ bath, human bronchial rings from 66 thoracic surgery patients were stretched in 1-min cycles of elongation and relaxation over a 60-min period. For each segment, the maximal tension corresponded to 80% of the reference contraction (the response to 3 mM acetylcholine). The impact of cyclic stretching (relative to non-stretched controls) was examined by performing functional assessments (epithelium removal and incubation with sodium channel agonists/antagonists or inhibitors of intracellular pathways), biochemical assays of the organ bath fluid (for detecting the release of pro-inflammatory cytokines), and RT-PCR assays of RNA isolated from tissue samples. The application of low-force cyclic stretching to human bronchial rings for 60 min resulted in an immediate, significant increase in bronchial basal tone, relative to non-cyclic stretching (4.24 ± 0.16 g vs. 3.28 ± 0.12 g, respectively; p stretching up-regulated the early mRNA expression of MMP9 only, and was not associated with changes in organ bath levels of pro-inflammatory mediators. Low-frequency, low-force cyclic stretching of whole human bronchi induced a myogenic response rather than activation of the pro-inflammatory signaling pathways mediated by mechanotransduction.

  19. Smoking particles enhance endothelin A and endothelin B receptor-mediated contractions by enhancing translation in rat bronchi

    Directory of Open Access Journals (Sweden)

    Vikman Petter

    2006-03-01

    Full Text Available Abstract Background Smoking is known to cause chronic inflammatory changes in the bronchi and to contribute to airway hyper-reactivity, such as in bronchial asthma. To study the effect of smoking on the endothelin system in rat airways, bronchial segments were exposed to DMSO-soluble smoking particles (DSP from cigarette smoke, to nicotine and to DMSO, respectively. Methods Isolated rat bronchial segments were cultured for 24 hours in the presence or absence of DSP, nicotine or DMSO alone. Contractile responses to sarafotoxin 6c (a selective agonist for ETB receptors and endothelin-1 (an ETA and ETB receptor agonist were studied by use of a sensitive myograph. Before ET-1 was introduced, the ETB receptors were desensitized by use of S6c. The remaining contractility observed was considered to be the result of selective activation of the ETA receptors. ETA and ETB receptor mRNA expression was analyzed using real-time quantitative PCR. The location and concentration of ETA and ETB receptors were studied by means of immunohistochemistry together with confocal microscopy after overnight incubation with selective antibodies. Results After being cultured together with DSP for 24 hours the bronchial segments showed an increased contractility mediated by ETA and ETB receptors, whereas culturing them together with nicotine did not affect their contractility. The up-regulation of their contractility was blunted by cycloheximide treatment, a translational inhibitor. No significant change in the expression of ETA and ETB receptor mRNA through exposure to DMSO or to nicotine exposure alone occurred, although immunohistochemistry revealed a clear increase in ETA and ETB receptors in the smooth muscle after incubation in the presence of DSP. Taken as a whole, this is seen as the presence of a translation mechanism. Conclusion The increased contractility of rat bronchi when exposed to DSP appears to be due to a translation mechanism.

  20. Cellular morphometry and cycling cell populations of human and dog bronchi. Annual progress report, April 1, 1994--March 31, 1995

    Energy Technology Data Exchange (ETDEWEB)

    Robbins, E.S.

    1994-12-01

    Quantitative data of the human bronchial epithelial cells at possible risk for malignant transformation in lung cancer is crucial for accurate radon dosimetry and risk analysis. The nuclei of these cells may be targets for damage by {alpha} particles. Then it is important to determine the locations and other parameters of these nuclei in different airway generations, among smokers, non-smokers and ex-smokers, between men and women and in people of different ages. This proposal includes extended morphometric studies on electron micrographs of human bronchial epithelium of defined airway generations. The second part of this proposal describes the continuation of studies to quantitate the cycling tracheo-bronchial epithelial population(s) using proliferation markers and immunocytochemistry on paraffin sections. The proliferative potential of the airway mucosa of smokers, non-smokers, and ex-smokers, men and women, as well as individuals of different ages are being compared. Normal human bronchial linings are also being compared with normal adult dog bronchi and metaplastic and repairing human airways. Since cycling cells can be more sensitive to damage from carcinogens and radioactivity, the quantitative data from this project will allow the development of more accurate radon risk analysis.

  1. Segmental bronchi collapsibility: computed tomography-based quantification in patients with chronic obstructive pulmonary disease and correlation with emphysema phenotype, corresponding lung volume changes and clinical parameters.

    Science.gov (United States)

    Kloth, Christopher; Thaiss, Wolfgang Maximilian; Ditt, Hendrik; Hetzel, Jürgen; Schülen, Eva; Nikolaou, Konstantin; Horger, Marius

    2016-12-01

    Global pulmonary function tests lack region specific differentiation that might influence therapy in severe chronic obstructive pulmonary disease (COPD) patients. Therefore, the aim of this work was to assess the degree of expiratory 3 rd generation bronchial lumen collapsibility in patients with severe COPD using chest-computed tomography (CT), to evaluate emphysema-phenotype, lobar volumes and correlate results with pulmonary function tests. Thin-slice chest-CTs acquired at end-inspiration & end-expiration in 42 COPD GOLD IV patients (19 females, median-age: 65.9 y) from November 2011 to July 2014 were re-evaluated. The cross-sectional area of all segmental bronchi was measured 5 mm below the bronchial origin in both examinations. Lung lobes were semi-automatically segmented, volumes calculated at end-inspiratory and end-expiratory phase and visually defined emphysema-phenotypes defined. Results of CT densitometry were compared with lung functional tests including forced expiratory volume at 1 s (FEV 1 ), total lung capacity (TLC), vital capacity (VC), residual volume (RV), diffusion capacity parameters and the maximal expiratory flow rates (MEFs). Mean expiratory bronchial collapse was 31%, stronger in lobes with homogenous (38.5%) vs . heterogeneous emphysema-phenotype (27.8%, P=0.014). The mean lobar expiratory volume reduction was comparable in both emphysema-phenotypes (volume reduction 18.6%±8.3% in homogenous vs . 17.6%±16.5% in heterogeneous phenotype). The degree of bronchial lumen collapsibility, did not correlate with expiratory volume reduction. MEF 25 correlated weakly with 3 rd generation airway collapsibility (r=0.339, P=0.03). All patients showed a concentric expiratory reduction of bronchial cross-sectional area. Changes in collapsibility of 3 rd generation bronchi in COPD grade IV patients is significantly lower than that in the trachea and the main bronchi. Collapsibility did not correlate with the reduction in lung volume but was

  2. The state of bronchi remodeling in school-age children with bronchial asthma at the Glutathione-S-Transferase gene polymorphism

    Directory of Open Access Journals (Sweden)

    Олена Костянтинівна Колоскова

    2016-01-01

    Full Text Available The aim of research was to establish connection between the bronchi remodeling processes and allelic polymorphism of GSTT1 and GSTM1 genes in school-age children with bronchial asthma (BA for optimization of results of the basic treatment.Methods: 66 school children with bronchial asthma in the period without attacks underwent the complex examination. All patients underwent general clinic and spirographic examination, point assessment of the bronchial asthma controllability with the help of clinically-instrumental evaluation scale, the analysis of the sample of capillary blood by the method of multiplex polymerase chain reaction (PCR for detecting the deletions in glutathione-s-transferase genes that is GSTT1 and GSTM1.Results: As the result of molecular and genetic analysis of studying of GSTT1 and GSTM1 genes polymorphism there were demonstrated that the (GSTT1+М1+ genotype homozygous on the normal copies was more often and took place in 40,9% of children, «null genotype» -in 9 patients (13,64 %, GSTT1-М1+ genotype was equally often, whereas the heterozygous GSTT1+М1- genotype was detected in every third patient (31,82 %.Conclusions: The deletion polymorphism of GSТT1 and GSТM1 in homozygous state (so called “null genotype” is three times less often in school children with bronchial asthma comparing with patients with GSTT1+М1+ genotype, it raises more than twice the risk of the heavy clinical course of disease, associates with the low indices of bronchi lability. In patients with bronchial asthma even at preserved structure of glutathione-s-transferase genes (GSTT1+М1+ genotype the continuous contact with the tobacco smoke in family raises the content of endothelial factor of vessel growth (EFVG in sputum in 1,25 times that underlines the more aggressive remodeling of respiratory tracts

  3. Photodetection of early cancer in the upper aerodigestive tract and the bronchi using photofrin II and colorectal adenocarcinoma with fluoresceinated monoclonal antibodies

    Science.gov (United States)

    Wagnieres, Georges A.; Braichotte, Daniel; Chatelain, Andre; Depeursinge, Christian D.; Monnier, Philippe; Savary, Jean-Francois; Fontolliet, Charlotte; Calmes, J.-M.; Givel, Jean-Claude; Chapuis, G.; Folli, S.; Pelegrin, A.; Buchegger, F.; Mach, J.-P.; van den Bergh, Hubert

    1991-11-01

    The performance of a fluorescence endoscope for the detection of early cancer is clinically evaluated. the apparatus is based on the imaging of the laser-induced fluorescence (LIF) of a dye which localizes in the tumor after IV injection with a higher concentration than in the surrounding normal tissue. The tests are carried out in several of the hollow organs, such as the upper aerodigestive tract, the bronchi, and the colon. In the two former cases the dye used is photofrin II, whereas in the latter case conjugates between monoclonal antibodies (Mab) directed against carcinoembrionic antigen (CEA) and fluorescein molecules are injected. The fluorescence contrast between tumor and surrounding tissue is enhanced by real-time image processing which eliminates most of the tissue autofluorescence as well as the fluorescence due to the relatively small amount of dye localized in the normal tissue. This is done by recording the fluorescence image in two spectral domains, after which these two images are digitized and manipulated with a mathematical operator (lookup-table). The sources of false positives and false negatives are evaluated in terms of the fluorescent dye and tissue optical properties.

  4. Very early evaluation by PET-F.D.G. of the therapeutic response to erlotinib (Tarceva) of non at small cells bronchi cancer (NSCBC);Evaluation tres precoce par TEP-FDG de la reponse therapeutique a l erlotinib (Tarceva1) des cancers bronchiques non a petites cellules (CBNPC)

    Energy Technology Data Exchange (ETDEWEB)

    Vervueren, L.; Berthelot, C.; Fosse, P.; Le Jeune, J.J.; Couturier, O. [CHU dAngers, Service de medecine nucleaire, 49 - Angers (France); Hureaux, J.; Baize, N.; Urban, T. [CHU dAngers, Service de pneumologie, 49 - Angers (France)

    2010-05-15

    Erlotinib is a inhibitor of tyrosine kinase targeting the receptor to E.G.F. This targeted therapy can be proposed to patients suffering of non at small cells bronchi cancer (N.S.C.B.C.) in stage 4. The survival median without any progression of these patients does not go over three months so it is essential for the clinician to have available very early evaluation tools allowing in case of inefficiency to change the therapy before a rapid deterioration of the patient general condition. As conclusion, the PET-F.D.G realised 7 days after the beginning of the treatment by erlotinib seems to be a sensitive and reliable tool in the early evaluation of the therapy response for these patients with a gloomy prognosis. (N.C.)

  5. Cellular morphometry of the bronchi of human and dog lungs

    Energy Technology Data Exchange (ETDEWEB)

    Robbins, E.S.

    1992-09-01

    Quantitative data of the human bronchial epithelial cells at possible risk for malignant transformation in lung cancer is crucial for accurate radon dosimetry and risk analysis. The locations and other parameters of the nuclei which may be damaged by [alpha] particles must be determined and compared in different airway generations, among smokers, non-smokers and ex-smokers, between men and women and in people of different ages. This proposal includes extended morphometric studies on electron micrographs of human epithelium of defined airway generations and in parallel on electron micrographs of the dog bronchial lining. The second part of this proposal describes studies to quantitate the cycling bronchial epithelial population(s) using proliferation markers and immunocytochemistry on frozen and paraffin sections and similar labeling of isolated bronchial epithelial cells sorted flow cytometry.

  6. Účinek osmitýdenního plicního rehabilitačního programu na hrudní mobilitu a maximální vdechový a výdechový ústní tlak u pacientů s bronchiálním astmatem The effect of 8 week pulmonary rehabilitation programme on chest mobility and maximal inspiratory and expiratory mouth pressure in patients with bronchial asthma

    Directory of Open Access Journals (Sweden)

    Ivan Vařeka

    2008-04-01

    Full Text Available U nemocných s bronchiálním astmatem se mohou vyskytovat nejen poruchy dýchání, ale také muskuloskeletální poruchy. Poruchy dýchání a muskuloskeletální poruchy mohou vést k dalším zdravotním problémům a mohou tak snižovat kvalitu života. Tyto poruchy mohou být také spojeny s psychosociálními problémy a mohou mít vliv na omezení různých aktivit nemocných (pohybové aktivity, sportování, běžné denní aktivity – nakupování, uklízení atd.. Mezi nejvíce omezující symptomy u nemocných s bronchiálním astmatem patří ztížené dýchání a kašel. Komprehensivní léčba je založena nejen na farmakoterapii, ale také na nemedikamentózní léčbě, jejíž důležitou součástí je respirační fyzioterapie. Pro účinek rehabilitační léčby je ale nutné správné nastavení farmakoterapie. Cílem této studie bylo zjistit, zda program plicní rehabilitace ovlivní hodnoty maximálních nádechových a výdechových ústních tlaků a rozvíjení hrudníku u nemocných s bronchiálním astmatem. Výzkumný soubor byl tvořen 23 nemocnými s bronchiálním astmatem, kteří absolvovali osmitýdenní program plicní rehabilitace (30minutová terapie dvakrát týdně. Jednalo se o pacienty s intermitentním lehkým stádiem bronchiálního astmatu beze změn ve farmakoterapii. Program plicní rehabilitace byl zaměřen na dechová cvičení (aktivace bráničního dýchání, aktivace výdechu, nácvik efektivní expektorace atd. a techniky měkkých tkání s cílem uvolnění svalů a fascií v oblasti hrudního koše a pletence ramenního. Na začátku a konci osmitýdenního programu plicní rehabilitace byly vyšetřeny maximální nádechové a výdechové ústní tlaky a rozvíjení hrudníku. Rozvíjení hrudníku bylo hodnoceno ve dvou úrovních – mezosternální a xiphosternální. Po absolvování osmitýdenního programu plicní rehabilitace bylo zaznamenáno zlepšení rozv

  7. Common Cold - an Umbrella Term for Acute Infections of Nose, Throat, Larynx and Bronchi.

    Science.gov (United States)

    Kardos, P; Malek, F A

    2017-04-01

    Acute respiratory tract infections, i. e. rhinitis, sinusitis, pharyngitis, laryngitis, bronchitis, belong to the most common medical conditions with a high economic burden. Nonetheless, there is little agreement concerning their differential diagnosis.This paper will discuss to what extent different anatomical sites of acute respiratory tract infections can be uniquely identified or whether the overlap and consecutive development in signs and symptoms renders these distinctions meaningless.Acute respiratory tract infections are variable but definition of diagnostic categories based on the anatomical sites of the dominant complaints shows that signs and symptoms both overlap to a great extent and/or emerge successively. Thus, in common cold distinguishing between acute symptom-based diagnoses arising from different anatomical sites of the aerodigestive system remains elusive. Therefore, preferred symptomatic treatments should foster a resolution of all possible symptoms as opposed to an isolated treatment of a single symptom (e. g. mucus hypersecretion) according to the presumed anatomical site (i. e. acute bronchitis). © Georg Thieme Verlag KG Stuttgart · New York.

  8. March 2015 pulmonary case of the month: sticks and stones may break my bronchi

    Directory of Open Access Journals (Sweden)

    Amer S

    2015-03-01

    Full Text Available No abstract available. Article truncated after 150 words. History of Present Illness: A 67-year-old woman presented to the emergency department with a chief complaint of persistent cough of 2 months duration, productive of yellow sputum. Her symptoms progressed to include dyspnea despite an outpatient course of antibiotics, bronchodilators, and corticosteroids. She denied fevers, chills, hemoptysis, or chest pain. PMH, FH, SH: She was on chronic immunosuppression secondary to a history of liver transplant due to non-alcoholic steatohepatitis and kidney transplant due to calcineurin toxicity. She denied any history of smoking, alcoholism or recreational drug use. Medications: Tacrolimus 3.5 mg bid, Mycophenolate mofetil 720 mg bid, Fluconazole 100 mg daily. Physical Examination: Vitals: Temperature 37.1°C, respiratory rate 18 breaths/min, heart rate 88 beats/min, blood pressure 130/76 mm Hg, SpO2 95% on room air. General: Elderly female in no apparent distress. Lungs: Scattered inspiratory and expiratory squeaks and pops bilaterally, louder in the left lower lobe. The rest of her ...

  9. Automatic segmentation of the pulmonary lobes from chest CT scans based on fissures, vessels, and bronchi

    NARCIS (Netherlands)

    Lassen, B.C.; Rikxoort, E.M. van; Schmidt, M.; Kerkstra, S.; Ginneken, B. van; Kuhnigk, J.

    2013-01-01

    Segmentation of the pulmonary lobes is relevant in clinical practice and particularly challenging for cases with severe diseases or incomplete fissures. In this work an automated segmentation approach is presented that performs a markerbased watershed transformation on {CT} scans to subdivide the

  10. Network analysis of quantitative proteomics on asthmatic bronchi: effects of inhaled glucocorticoid treatment

    Directory of Open Access Journals (Sweden)

    Sihlbom Carina

    2011-09-01

    Full Text Available Abstract Background Proteomic studies of respiratory disorders have the potential to identify protein biomarkers for diagnosis and disease monitoring. Utilisation of sensitive quantitative proteomic methods creates opportunities to determine individual patient proteomes. The aim of the current study was to determine if quantitative proteomics of bronchial biopsies from asthmatics can distinguish relevant biological functions and whether inhaled glucocorticoid treatment affects these functions. Methods Endobronchial biopsies were taken from untreated asthmatic patients (n = 12 and healthy controls (n = 3. Asthmatic patients were randomised to double blind treatment with either placebo or budesonide (800 μg daily for 3 months and new biopsies were obtained. Proteins extracted from the biopsies were digested and analysed using isobaric tags for relative and absolute quantitation combined with a nanoLC-LTQ Orbitrap mass spectrometer. Spectra obtained were used to identify and quantify proteins. Pathways analysis was performed using Ingenuity Pathway Analysis to identify significant biological pathways in asthma and determine how the expression of these pathways was changed by treatment. Results More than 1800 proteins were identified and quantified in the bronchial biopsies of subjects. The pathway analysis revealed acute phase response signalling, cell-to-cell signalling and tissue development associations with proteins expressed in asthmatics compared to controls. The functions and pathways associated with placebo and budesonide treatment showed distinct differences, including the decreased association with acute phase proteins as a result of budesonide treatment compared to placebo. Conclusions Proteomic analysis of bronchial biopsy material can be used to identify and quantify proteins using highly sensitive technologies, without the need for pooling of samples from several patients. Distinct pathophysiological features of asthma can be identified using this approach and the expression of these features is changed by inhaled glucocorticoid treatment. Quantitative proteomics may be applied to identify mechanisms of disease that may assist in the accurate and timely diagnosis of asthma. Trial registration ClinicalTrials.gov registration NCT01378039

  11. Reactions of eosinophilic granulocytes in the sputum and peripheral blood of children suffering from bronchial asthma with signs of eosinophilic and non-eosinophilic inflammation of the bronchi

    Directory of Open Access Journals (Sweden)

    O. K. Koloskova

    2017-02-01

    Full Text Available The aim of research was to improve the management of bronchial asthma in children by examining the peculiarities and diagnostic value of reaction markers of eosinophil granulocytes in the sputum and peripheral blood of patients with signs of eosinophil and non-eosinophil phenotypes of this disease. A cohort of 118 school-age children suffering from BA was examined during a period free from attacks. Group I (the main group included 61 schoolchildren with signs of eosinophil phenotype (EP of asthma detected by the character of bronchial inflammation with eosinophil granulocytes present in the sputum at a level of >3%, group II (the comparison group included 57 patients with a lower number of eosinophils in the sputum (non-eosinophil phenotype (NP of BA. The average index of the relative content of eosinophils in the peripheral blood among the representatives of group I was 5.82 ± 0.63%, and in children with the signs of NPBA – 6.02 ± 0.74% (P > 0.05, and average indices in the groups of absolute eosinophil number in the blood were 0.37 ± 0.04 and 0.41 ± 0.05 respectively (P > 0.05. The negative reserve of NBT eosinophils in the sputum as a test to verify EPBA showed the following diagnostic values: specificity – 83.3%, predicted value of a positive result – 95.6%. IL-5 content in the blood serum of children with EPBA was 5.99 ± 1.74 ng/ml, in patients of group ІІ – only 1.99 ± 0.49 ng/ml (P 1.0 ng/ml the risk of EPBA showed a statistically significant increase: OR = 4.13, RR = 2.02, and AR – 0.34. The efficacy of the standardized basic anti-inflammatory therapy in patients of clinical group I was higher as compared to the children with the signs of NPBA, which was illustrated by the reduced risk of inadequate control of the disease: the index of absolute risk decrease was 31.7%, relative risk – 57.1% with necessary minimal number of patients – 1.75.

  12. Tumoral metabolism variation during radiotherapy (R.T.E.) evaluated by PET-F.D.G. among patients bearers of primitive bronchi tumors; Variation du metabolisme tumoral en cours de radiotherapie (RTE) evaluee par TEP-FDG chez des patients porteurs de tumeur primitive bronchique

    Energy Technology Data Exchange (ETDEWEB)

    Edet-Sanson, A.; Hapdey, S.; Hitzel, A.; Guernou, M.; Gardin, I.; Vera, P. [Departement de medecine nucleaire, centre Henri-Becquerel, Rouen, (France); Doyeux, K. [EA4108, laboratoire Quantif-Litis, (France); Dubray, B. [departement de radiotherapie, centre Henri-Becquerel, Rouen, (France)

    2009-05-15

    The objective of this study is to describe the variation of the tumor metabolism during a radiotherapy for patients treated by exclusive radiotherapy or concomitant radio chemotherapy for a non at small cells pulmonary tumor. Conclusions: the PET-T.D.M. during an external radiotherapy is interpretable. As regard of the variability of the tumor metabolism during a radiotherapy, the predictive value on the upgradability of the tumor pathology of a PET-F.D.G. realised between 28 and 42 Gy would be worthy of being evaluated. (N.C.)

  13. [The respiratory system in Arctocephalus australis (Pinnipedia, Otariidae). I--Macroanatomy and microanatomy of the trachea and extrapulmonary airways].

    Science.gov (United States)

    De Cidre, L L; Crespo, F

    1991-02-01

    This paper presents the results of histological and histochemical organization of trachea and primary bronchi. The presence of a subepithelial lamina and a smooth muscle layer in the superficial corion, probably related with a functional respiratory mechanism are defined. The structure of tracheal and primary bronchi glands, the way they secretes and the type of secretion are also described.

  14. Is bronchial wall imaging affected by temporal resolution? Comparative evaluation at 140 and 75 ms in 90 patients

    Energy Technology Data Exchange (ETDEWEB)

    Hutt, Antoine; Tacelli, Nunzia; Faivre, Jean-Baptiste; Remy, Jacques; Remy-Jardin, Martine [CHRU et Universite de Lille, Department of Thoracic Imaging, Hospital Calmette (EA 2694), Lille (France); Flohr, Thomas [Computed Tomography, Siemens Healthcare, Forchheim (Germany); Duhamel, Alain [CHRU et Universite de Lille, Department of Biostatistics (EA 2694), Lille (France)

    2016-02-15

    To evaluate the influence of temporal resolution (TR) on cardiogenic artefacts at the level of bronchial walls. Ninety patients underwent a dual-source, single-energy chest CT examination enabling reconstruction of images with a TR of 75 ms (i.e., optimized TR) (Group 1) and 140 ms (i.e., standard TR) (Group 2). Cardiogenic artefacts were analyzed at the level of eight target bronchi, i.e., right (R) and left (L) B1, B5, B7, and B10 (total number of bronchi examined: n = 720). Cardiogenic artefacts were significantly less frequent and less severe in Group 1 than in Group 2 (p < 0.0001) with the highest scores of discordant ratings for bronchi in close contact with cardiac cavities: RB5 (61/90; 68 %); LB5 (66/90; 73 %); LB7 (63/90; 70 %). In Group 1, 78 % (560/720) of bronchi showed no cardiac motion artefacts, whereas 22 % of bronchi (160/720) showed artefacts rated as mild (152/160; 95 %), moderate (7/160; 4 %), and severe (1/160; 1 %). In Group 2, 70 % of bronchi (503/720) showed artefacts rated as mild (410/503; 82 %), moderate (82/503; 16 %), and severe (11/503; 2 %). At 75 ms, most bronchi can be depicted without cardiogenic artefacts. (orig.)

  15. Bronchial Disorders

    Science.gov (United States)

    ... when your airways shrink while you are exercising Bronchiolitis - an inflammation of the small airways that branch off from the bronchi Bronchopulmonary dysplasia - a chronic lung condition in infants, most often premature infants

  16. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... such as inflammation of the bronchi (breathing passages) birth defects trauma to blood vessels or lung CT is well-suited for visualizing diseases or injury of important organs in the abdomen including the ...

  17. Breathing Problems

    Science.gov (United States)

    ... enough air. Sometimes you can have mild breathing problems because of a stuffy nose or intense exercise. ... Lung conditions such as asthma, emphysema, or pneumonia Problems with your trachea or bronchi, which are part ...

  18. Human airway smooth muscle

    NARCIS (Netherlands)

    J.C. de Jongste (Johan)

    1987-01-01

    textabstractThe function of airway smooth muscle in normal subjects is not evident. Possible physiological roles include maintenance of optimal regional ventilation/perfusion ratios, reduction of anatomic dead space, stabilisation of cartilaginous bronchi, defense against impurities and, less

  19. Intrabronchial Microdialysis: Effects of Probe Localization on Tissue Trauma and Drug Penetration into the Pulmonary Epithelial Lining Fluid

    DEFF Research Database (Denmark)

    Rottbøll, Lisa Amanda Holm; Skovgaard, Kerstin; Barington, Kristiane

    2015-01-01

    (PELF). The objective of this study was to investigate the effect of intrabronchial microdialysis on the integrity of the bronchial epithelium. Microdialysis sampling in PELF in proximal (n=4) and distal bronchi (n=4) was performed after intravenous inulin and florfenicol administration in anaesthetized...... pigs. Inulin was used as a marker molecule of permeability of the epithelium, and florfenicol was used as test drug. Bronchial tissue was examined by histopathology (distal and proximal bronchi) and gene expression analysis (RT-qPCR, proximal bronchi) at the termination of the experiment (6.5hr...... probes suggesting initiation of an inflammatory response. The observed up-regulation is considered to have limited impact on drug penetration during short-term studies. Inulin penetrated the respiratory epithelium in both proximal and distal bronchi without any correlation to histopathological lesions...

  20. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... has spread there from a distant site airway disease such as inflammation of the bronchi (breathing passages) birth defects trauma to blood vessels or lung CT is well-suited for visualizing ...

  1. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available ... injury after trauma, diagnose and stage cancer, monitor response to treatment for cancer, and diagnose and monitor ... lung or has spread there from a distant site airway disease such as inflammation of the bronchi ( ...

  2. Minutes of the 51. meeting of the American Society for Therapeutic Radiology and Oncology (Astro); Compte rendu de la 51. reunion de l'American Society for Therapeutic Radiology and Oncology (ASTRO)

    Energy Technology Data Exchange (ETDEWEB)

    Mazeron, J.J. [Groupe hospitalier de la Pitie-Salpetriere, AP-HP, Service de radiotherapie oncologique, 75 - Paris (France)

    2010-04-15

    The 51. meeting of the American society for therapeutic radiology and oncology occurred in chicago from the 1. to 5 november 2009. More than 1600 works were presented. Among these works, the most striking are presented in this article. The different studies treat prostate cancer, breast cancer, cerebral metastases after bronchi cancer, malignant melanoma, bronchi cancers, bladder cancer, rectum cancer cancer of the head and neck. (N.C.)

  3. Modified method for bronchial suture by Ramirez Gama compared to separate stitches suture: experimental study

    Directory of Open Access Journals (Sweden)

    Vitor Mayer de Moura

    Full Text Available OBJECTIVE: To experimentally compare two classic techniques described for manual suture of the bronchial stump. METHODS: We used organs of pigs, with isolated trachea and lungs, preserved by refrigeration. We dissected 30 bronchi, which were divided into three groups of ten bronchi each, of 3mm, 5mm, and 7mm, respectively. In each, we performed the suture with simple, separated, extramucosal stitches in five other bronchi, and the technique proposed by Ramirez and modified by Santos et al in the other five. Once the sutures were finished, the anastomoses were tested using compressed air ventilation, applying an endotracheal pressure of 20mmHg. RESULTS: the Ramirez Gama suture was more effective in the bronchi of 3, 5 and 7 mm, and there was no air leak even after subjecting them to a tracheal pressure of 20mmHg. The simple interrupted sutures were less effective, with extravasation in six of the 15 tested bronchi, especially in the angles of the sutures. These figures were not significant (p = 0.08. CONCLUSION: manual sutures of the bronchial stumps were more effective when the modified Ramirez Gama suture was used in the caliber bronchi arms when tested with increased endotracheal pressure.

  4. Do the lung segments exist continuously from the early stage of the embryonic period as units?

    Science.gov (United States)

    Onuki, Takamasa; Kanzaki, Masato; Wachi, Naoko; Isaka, Tamami; Sakamoto, Kei; Maeda, Hideyuki; Oyama, Kunihiro; Murasugi, Masahide

    2016-07-01

    Although various types of segmentectomy are frequently performed for resecting lung tumours at present, there is no clear answer to the question what kind of segmentectomy would be more efficient for performing lymphadenectomy. Learning the embryological mechanism of the segment formation could be one of the methods for selecting the surgical procedure. To investigate the developmental mechanism of the lung, this study focused on 'sharing structure', a unique 3D structure consisting of the bronchi and pulmonary arteries. In the structure, two arteries from different directions, after straddling the bronchus in the central part, share one bronchial tree at the peripheral part. Using computed tomography data obtained before segmentectomy, this study observed the 'sharing structure' in 193 left and right upper lobe cases. This study investigated the relationship between the segmental arterial types and the straddled bronchi, which were straddled by the pulmonary arteries found in the centre of the sharing structure. In the right upper lobes, the straddled bronchi were anterior segmental bronchi. In the left upper lobes, however, the straddled bronchi of the lingular interlobar pulmonary artery type contained no anterior segmental bronchi. But, the straddled bronchi of lingular mediastinal pulmonary artery type contained anterior segmental bronchi in all cases. Although pulmonary arteries in almost all sharing structures in the right upper lobes straddled anterior bronchi, those in mediastinal type and interlobar type in the left upper lobe were found to straddle the anterior and apicoposterior bronchi, respectively. These findings indicated that the interlobar type was speculated to be rotating mediastinal type backward in the embryonic period. This study strongly suggested a new concept that 'the lung segments never continuously exist from the early stage of the embryonic period as units, but they are only simple units artificially named by their prevailing bronchial

  5. The role of target 3D-reconstructions when analysyng qualitative characteristics of the surface of circular-shaped growth in the lungs

    Directory of Open Access Journals (Sweden)

    V. G. Kolmogorov

    2016-01-01

    Full Text Available The purpose of this paper is to improve the accuracy of X-ray diagnostics of circular-shaped growth (CSG by developing computed tomographic semiotics of qualitative characteristics of its surface and the state of the surrounding bronchi using target 3D-reconstruction.Material and methods. 560 patients at the age of 3–89 years were examined. Target 3D reconstruction was carried out with the use of 3D Fly Through program (Toshiba Medical Systems, Japan which removed the tissue surrounding CSG at a distance of 5–10 mm from the outer boundaries.CSG was inscribed into a cube. In case of the primary central and peripheral lung cancer a number of patients with severe rough surface of CSG prevailed over a number of patients with slightly rough surface was detected. In case of infiltrative tuberculosis, pneumonia, echinococcus, retention cysts the prevalence of a number of patients with slightly rough surface of CSG over a number of patients with rough surface was identified. In case of single cancer metastases, single and multiple tuberculomas the prevalence of a number of patients with non-uniform smooth surface of CSG over a number of patients with uniform smooth surface was identified. In case of multiple cancer metastasis, focal tuberculosis, cysticercosis the prevalence of a number of patients with a uniform smooth surface of CSG over a number of patients with uneven smooth surface was identified. In case of benign tumors, eosinophilic infiltrate, gamartohondroma, aspergilloma, chronic abscess, intrapulmonary hematoma there was not difference between the number of patients with a uniform smooth surface of CSG and a number of patients with uneven smooth surface. In case of primary lung cancer metastasis, single and multiple tuberkulomas, echinococcus, cysticercosis there was a prevalence of the number of patients with expressed deformed bronchi surrounding CSL over a number of patients with moderately deformed bronchi. In case of infiltrative

  6. Therapeutic bronchoscopy for malignant airway stenoses: Choice of modality and survival

    Directory of Open Access Journals (Sweden)

    Chhajed Prashant

    2010-01-01

    Full Text Available Background: There are no data regarding the factors influencing the choice of therapeutic bronchoscopic modality in the management of malignant airway stenoses. Objectives: To assess the choice of therapeutic bronchoscopy modality and analyze factors influencing survival in patients with malignant central airway obstruction. Materials and Methods: We performed 167 procedures in 130 consecutive patients, for malignant central airway obstruction, over six years. Results: Laser was used either alone or in combination with stent insertion in 76% procedures. Laser only was used in 53% procedures for lesions below the main bronchi. Stents alone were used for extrinsic compression or stump insufficiency. Combined laser and stent insertion was most frequently used for lesions involving the trachea plus both main bronchi or only the main bronchi. The Dumon stent was preferred in lesions of the trachea and the right bronchial tree, the Ultraflex stent for lesions on the left side and stenoses below the main bronchi. Survival was better in patients with lung cancer, lesions restricted to one lung and when laser alone was used compared to esophageal cancer, metastases and tracheal involvement. Conclusion: The choice of different airway stents can be made based on the nature and site of the lesion. Dumon stents are suited for lesions in trachea and right main bronchus and the Ultraflex stents on the left side and stenoses beyond the main bronchi. Survival can be estimated based on the diagnosis, site of the lesion and treatment modality used.

  7. Visualization of the airway in infants with MRI using pointwise encoding time reduction with radial acquisition (PETRA).

    Science.gov (United States)

    Niwa, Tetsu; Nozawa, Kumiko; Aida, Noriko

    2017-03-01

    To assess airway visibility in infants using pointwise encoding time reduction with radial acquisition (PETRA). PETRA was obtained in 37 infants (gestational age: 23-43 weeks; postconceptional age: 34-46 weeks) using 3T magnetic resonance imaging (MRI) without respiratory gating. The visibility of the branching point and the airway structures, including the trachea and bronchi, on PETRA was scored by two experienced pediatric radiologists using a four-point scale (0-3). The rates of good visibility (score 3 or 2) were calculated for each airway structure. Interrater agreement was evaluated by intraclass correlation coefficient (ICC). For readers 1 and 2, good visibility was achieved for the branching point of the main bronchi (76% and 95%, respectively), trachea (97% and 95%, respectively), right main bronchus (92% and 92%, respectively), and left main bronchus (97% and 84%, respectively). Lower rates of visibility were achieved for the lobar bronchi. There was substantial agreement (ICC: 0.61-0.79) between the two readers for all the airway structures, except for the branching point at the right upper/middle lobe bronchi, for which there was moderate agreement (ICC: 0.56). PETRA has the potential for good airway visibility in infants, particularly for the trachea and main bronchi. 3 J. Magn. Reson. Imaging 2017;45:839-844. © 2016 International Society for Magnetic Resonance in Medicine.

  8. Tracheobronchopathia osteochondroplastica presenting as a respiratory insufficiency: diagnosis by bronchoscopy and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Hantous-Zannad, S. E-mail: saoussen.hantous@rns.tn; Sebaie, L.; Zidi, A.; Ben Khelil, J.; Mestiri, I.; Besbes, M.; Hamzaoui, A.; Ben Miled-M' rad, K

    2003-02-01

    Tracheobronchopathia osteochondroplastica (TO) is a rare benign disorder affecting the trachea and occasionally the bronchi. We report a case of TO presenting as a respiratory insufficiency. Chest radiograh revealed an irregular narrowing of the intra thoracic trachea and a parenchymal consolidation of the left lower lobe. Magnetic resonance examination of the chest showed a diffuse irregular thickening of the trachea and central bronchi, which had an intermediate signal intensity with punctiform low signal intensity suggesting calcifications and no contrast enhancement. The diagnosis was confirmed by bronchoscopy and biopsies.

  9. Metabolic activation and DNA binding of benzo(a)pyrene in cultured human bronchus

    DEFF Research Database (Denmark)

    Yang, Shen K.; Gelboin, Harry V.; Trump, Benjamin F.

    1977-01-01

    Human bronchus is one target site for the carcinogenic action of tobacco smoke, which contains chemical carcinogens, including benzo(a)pyrene. Human bronchi were obtained from surgery or “immediate” autopsy and then cultured in a chemically defined medium. The cultured bronchi were exposed....... The predominant metabolite formed by human bronchus from the (-)-trans-7,8-diol is found by high-pressure liquid chromatographic analysis to be the diol-epoxide r-7,t-8-dihydroxy-t-9,10-oxy-7,8,9,10-tetrahy-drobenzo(a)pyrene. The results suggest that this diol-epoxide is the major benzo(a)pyrene metabolite bound...

  10. A 64-slice multidetector CT of tracheobronchopathia osteochondroplastica with virtual bronchoscopy view

    OpenAIRE

    Cardinale, L; Busso, M.; A. Cataldi; Volpicelli, G

    2010-01-01

    A 65-year-old female presented in our Emergency Department complaining of cough and progressive dyspnea. Plain chest radiography showed long-segment narrowing of the trachea. Multislice computed tomography confirmed the tracheal narrowing and demonstrated multiple nodular calcifications protruding into the visceral lumen, involving also the main and segmental bronchi but sparing the pars membranacea trachealis (Fig. A).

  11. Bronchial Epithelial Cells and Peptidases: Modulation by cytokincs and glucocorticoids ill vitro and in asthma

    NARCIS (Netherlands)

    V.H.J. van der Velden (Vincent)

    1998-01-01

    textabstractThe airways can be divided in the upper respiratory tract, including the nose, the pharynx, and the larynx. and the lower respiratory tract. consisting of the trachea, bronchi, bronchioles, and alveoli. This structure provides an enormous surface area where the exchange of oxygen and

  12. Anaesthetic management of tracheobronchial disruption during ...

    African Journals Online (AJOL)

    A second surgical procedure using a single-lumen endotracheal tube was undertaken. During the procedure the ... Subsequently, oxygenation and ventilation of both lungs was achieved by intubating both the main bronchi with microlaryngeal tubes, with the patient in the left lateral position. Keywords: oesophagectomy ...

  13. Dip patterns in asthmatic and non-asthmatic children in Benin-city ...

    African Journals Online (AJOL)

    Objective: Although the calibre of the airway is kept patent by multifactorial control system, there is evidence that the calibre of the bronchi varies with time of the day in normal subjects. Asthma is now known to be a chronic inflammatory disease and this chronic inflammation causes hyperreactivity and lability in the airway.

  14. Children's (Pediatric) CT (Computed Tomography)

    Medline Plus

    Full Text Available Toggle navigation Test/Treatment Patient Type Screening/Wellness Disease/Condition Safety En Español More Info Images/Videos ... has spread there from a distant site airway disease such as inflammation of the bronchi (breathing passages) ...

  15. Tracheobronchomegaly (Mounier-Kuhn syndrome) - case report and review of the literature; Traqueobroncomegalia (sindrome de Mounier-Kuhn) - relato de caso e revisao da literatura

    Energy Technology Data Exchange (ETDEWEB)

    Nobrega, Bruno Barcelos da; Figueiredo, Sizenildo da Silva; Ribeiro, Ronei Edmar; Teixeira, Kim-Ir-Sem Santos [Goias Univ., Goiania, GO (Brazil). Hospital das Clinicas. Dept. de Diagnostico por Imagem e Anatomia Patologica]. E-mail: brunoradiol@hotmail.com; Cavalcante, Luciana Porto [Goias Univ., Goiania, GO (Brazil). Faculdade de Medicina

    2002-06-01

    Tracheobronchomegaly is a rare condition of uncertain etiology characterized by marked dilatation of the trachea and main bronchi, bronchiectasis and recurrent respiratory tract infections. Clinical presentation is nonspecific and the diagnosis is usually made by imaging methods. We report a case of a patient with tracheobronchomegaly. Diagnosis was confirmed by plain X-ray films and computed tomography of the chest. (author)

  16. Anaesthetic management of tracheobronchial disruption during ...

    African Journals Online (AJOL)

    ... into the left main bronchus. Subsequently, oxygenation and ventilation of both lungs was achieved by intubating both the main bronchi with microlaryngeal tubes, with the patient in the left lateral position. Keywords: oesophagectomy, tracheobronchial disruption, thoracotomy, emphysema, iatrogenic, microlaryngeal tube ...

  17. Bronchial fracture following blunt chest trauma | Hitchcock | South ...

    African Journals Online (AJOL)

    Between 1848 and 1948 only 61 cases were reported and another 94 cases were reported in the following 10 years.' Hoed and Sloan' in 1959, in a comprehensive review of the world literature. found only 18 reports of traumatic tracheal rupture. Nevertheless, fractures of bronchi following blunt chest trauma are still rare ...

  18. BRONCHIAL FRACTURE FOLLOWING BLUNT CHEST TRAUMA*

    African Journals Online (AJOL)

    1971-01-02

    Jan 2, 1971 ... BRONCHIAL FRACTURE FOLLOWING BLUNT CHEST TRAUMA*. J. F. HITCHCOCK, M.B., CH.B., M.MED. (SURG.), Department of Cardiolhoracic SlIrger.\\", Croote Schllllr Hospilal,. Cape Town. Fractures of the trachea or major bronchi are becoming increasingly common. in particu:ar fractures of one or.

  19. Ascaris Lumbricoides (Round Worm) in the Upper Airway of an ...

    African Journals Online (AJOL)

    Serious airway obstruction occurs when the adult worm obstructs the bronchi or the vocal cords with attending sequaele. We hereby present a case of a 67 year old man with cerebrovascular accident (stroke) admitted and mechanically ventilated in the Intensive Care Unit. However, four days later, a 15cm long adult ascaris ...

  20. Quantitative modelling of the biomechanics of the avian syrinx

    DEFF Research Database (Denmark)

    Elemans, Coen P. H.; Larsen, Ole Næsbye; Hoffmann, Marc R.

    2003-01-01

    We review current quantitative models of the biomechanics of bird sound production. A quantitative model of the vocal apparatus was proposed by Fletcher (1988). He represented the syrinx (i.e. the portions of the trachea and bronchi with labia and membranes) as a single membrane. This membrane acts...

  1. Chronic persistent asthma: A review of medicines in the step-up ...

    African Journals Online (AJOL)

    Introduction. Allergic sensitisation in atopic individuals sets the stage for the initiation and perpetuation of a series of events at cellular level in the bronchi and lungs that manifest as asthma. Over the last 20 years a bewildering number of genetic factors and a veritable arsenal of inflammatory pathways and mediators have ...

  2. WEST AFRICAN JOURNAL OF MEDICINE Exercise-Induced

    African Journals Online (AJOL)

    2017-04-02

    Apr 2, 2017 ... of the bronchi of asthmatic children to various challenge tests differentiate them from ... determine the current prevalence of asthma in childhood in a ... Abbreviations: EIB, Exercise-Induced Bronchospasm; ISAAC, International Study on Asthma and Allergy in Childhood; PEFR, Peak Expiratory. Flow Rate.

  3. A Belief Rule-Based Expert System to Diagnose Influenza

    DEFF Research Database (Denmark)

    Hossain, Mohammad Shahadat; Khalid, Md. Saifuddin; Akter, Shamima

    2014-01-01

    Influenza is a viral disease that usually affects the nose, throat, bronchi, and seldom lungs. This disease spreads as seasonal epidemics around the world, with an annual attack rate of estimated at 5%–10% in adults and 20%–30% in children. Thus, influenza is regarded as one of the critical health...

  4. The late allergic reaction in bronchial asthma. De allergeen-geïnduceerde laat obstructive reactie bij allergische CARA patienten

    NARCIS (Netherlands)

    Dieges, Paul Hendrik; Monchy, Jan Gunnar Rene de

    1987-01-01

    In this thesis a number of studies are described concerning the mechanism of the late allergic reactions in the bronchi (LAR). In Chapter 1 a general introduction is given. Since the late allergic reaction was studied in patients with chronic non-specific lung disease (CNSLD, Dutch: CARA :

  5. In situ light dosimetry during photodynamic therapy of Barrett's esophagus with 5-aminolevulinic acid

    NARCIS (Netherlands)

    R. van Veen (Robert); M.J.A.M. Aalders; K.L. Pasma (Kasper); P.D. Siersema (Peter); J. Haringsma (Jelle); W.V. de Vrie (Wim Van); E.E.E. Gabeler; D.J. Robinson (Dominic); H.J.C.M. Sterenborg (Dick)

    2002-01-01

    textabstractBackground and Objectives: Previous studies with PhotoDynamic Therapy (PDT) in bladder and bronchi have shown that due to scattering and reflection, the actually delivered fluence rate on the surface in a hollow organ can be significantly higher than expected. In this pilot study, we

  6. Tracheobronchopathia osteochondroplastica: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Junping Sun

    2015-01-01

    Full Text Available Tracheobronchopathia osteochondroplastica (TPO is a rare disorder characterized as multiple osseous or cartilaginous nodules in the submucosa of trachea and main bronchi. TPO remains an under recognized entity due to lack of awareness. Four cases of TPO are reported in this review as well as various facets of TPO description.

  7. Sex and gender differences in lung development and their clinical significance

    NARCIS (Netherlands)

    Boezen, HA; Jansen, DF; Postma, DS

    Because little is known about the development of lung parenchyma, this article focuses on developmental airway changes. The lung continues to develop throughout most of a person's life. Alterations to bronchi and bronchioli during the distinct phases of early life (ie, human intrauterine

  8. Tracheobronchomegaly following intrauterine tracheal occlusion for congenital diaphragmatic hernia.

    Science.gov (United States)

    Enriquez, Goya; Cadavid, Lina; Garcés-Iñigo, Enrique; Castellote, Amparo; Piqueras, Joaquim; Peiró, Jose Luis; Carreras, Elena

    2012-08-01

    Fetuses with severe congenital diaphragmatic hernia (CDH) and pulmonary hypoplasia may benefit from fetal endoluminal tracheal occlusion (FETO). Enlargement of the main bronchi and trachea appears to be a common complication of FETO. To retrospectively evaluate the trachea and main bronchi of infants who underwent FETO for CDH and compare diameters with age-matched references. Postnatal and follow-up chest radiographs were performed in seven children with unilateral CDH treated by FETO. Additional CT was performed in six of these (one neonate died before CT could be performed). Images were acquired from 3 days to 23 months of age. For each child, radiographs and CT images with optimal visualisation of the airways were selected for retrospective analysis. Tracheal and bronchial morphology was assessed by two experienced paediatric radiologists, and the diameters of these structures measured and compared with age-matched references. Mean diameters of the trachea and main bronchi were above the age-matched normal range in all patients, regardless of the side of the hernia or the degree of lung hypoplasia. Enlargement of the trachea and main bronchi appears following FETO and persists at least to the age of 5 years.

  9. AcEST: DK957815 [AcEST

    Lifescience Database Archive (English)

    Full Text Available PTMAA_DANRE Prothymosin alpha-A OS=Danio rerio GN=ptma... 32 0.98 sp|P12650|SPIKE_IBVK Spike glycoprotein OS=Avian infectious...VDEEDD-DVAEEDEEDDGEGDDDDEDEEAEGGTGKR 84 >sp|P12650|SPIKE_IBVK Spike glycoprotein OS=Avian infectious bronchi

  10. The Use of Paramecium to Observe the Toxic Effect of Cigarette Smoke.

    Science.gov (United States)

    Bardell, David

    1986-01-01

    Describes a laboratory experiment in which Paramecium caudatum was used to demonstrate the toxic effect of cigarette smoke on the cilia of epithelium cells lining the trachea and bronchi of smokers. Provides background information and explains the procedure, including how to make a simple mechanical smoking device. (TW)

  11. Proteomic analysis of human epithelial lining fluid by microfluidics-based nanoLC-MS/MS : A feasibility study

    NARCIS (Netherlands)

    Franciosi, Lorenza; Govorukhina, Natalia; Fusetti, Fabrizia; Poolman, Bert; Lodewijk, Monique E.; Timens, Wim; Postma, Dirkje; ten Hacken, Nick; Bischoff, Rainer

    Microfluidics-based nanoLC-MS/MS (chipLC-MS/MS) was used to identify and quantify proteins in epithelial lining fluid (ELF), collected during bronchoscopy from the main bronchi of chronic obstructive pulmonary disease (COPD) patients and healthy controls using microprobes. ELF is a biofluid that is

  12. CHOLINERGIC CONTRACTION OF THE GUINEA-PIG LUNG STRIP IS MEDIATED BY 9USCARINIC M(2)-LIKE RECEPTORS

    NARCIS (Netherlands)

    ROFFEL, AF; ELZINGA, CRS; ZAAGSMA, J

    1993-01-01

    The muscarinic receptor subtype mediating contraction of the guinea pig lung strip preparation was investigated and compared with that in guinea pig tracheal and human peripheral airway (small bronchi) smooth muscle preparations, using a number of subtype selective muscarinic receptor antagonists.

  13. Effect of inspiration on airway dimensions measured in maximal inspiration CT images of subjects without airflow limitation

    DEFF Research Database (Denmark)

    Petersen, Jens; Wille, Mathilde M.W.; Raket, Lars Lau

    2014-01-01

    . Automated software was utilized to segment lungs and airways, identify segmental bronchi, and match airway branches in all images of the same subject. Inspiration level was defined as segmented total lung volume (TLV) divided by predicted total lung capacity (pTLC). Mixed-effects models were used to predict...... relative change in lumen diameter (ALD) and wall thickness (AWT) in airways of generation 0 (trachea) to 7 and segmental bronchi (R1-R10 and L1-L10) from relative changes in inspiration level. RESULTS: Relative changes in ALD were related to relative changes in TLV/pTLC, and this distensibility increased...... with generation (p TLC in generation 3--7 (p 

  14. Multiple bronchoceles in a non-asthmatic patient with allergic bronchopulmonary aspergillosis.

    Science.gov (United States)

    Amin, Muhammad Umar; Mahmood, Rabia

    2008-09-01

    Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction due to a fungus, Aspergillus fumigatus. It is typically seen in patients with long-standing asthma. Our patient was a non-asthmatic 18 years old male who presented with chronic cough for 2 years. Peripheral blood eosinophilia and elevated scrum IgE were observed. His x-ray chest revealed v-shaped opacity in the left upper lobe close to the hilum. High resolution computed tomographic scan of the chest revealed multiple dilated bronchi filled with mucous (bronchoceles) and central bronchiectasis (CB) involving main segmental bronchi. Central bronchiectasis (CB) was typical of ABPA but bronchocele formation was a rare manifestation of the disease. The patient was managed with oral prednisolone and was relieved of his symptoms. Occurrence of ABPA in non-asthmatics is very rare and deserves reporting.

  15. Polymorphonuclear leucocytes consume oxygen in sputum from chronic Pseudomonas aeruginosa pneumonia in cystic fibrosis

    DEFF Research Database (Denmark)

    Kolpen, Mette; Hansen, C. R.; Bjarnsholt, Thomas

    2010-01-01

    BACKGROUND: Chronic lung infection with Pseudomonas aeruginosa is the most severe complication for patients with cystic fibrosis (CF). This infection is characterised by endobronchial mucoid biofilms surrounded by numerous polymorphonuclear leucocytes (PMNs). The mucoid phenotype offers protection...... against the PMNs, which are in general assumed to mount an active respiratory burst leading to lung tissue deterioration. An ongoing respiratory burst by the PMNs has, however, not been demonstrated previously in endobronchial secretions from chronically infected patients with CF. OBJECTIVE: Based...... on the accumulating evidence for depletion of molecular oxygen (O(2)) in the mucus in infected CF bronchi, it was hypothesised that the O(2) depletion in the mucus in infected CF bronchi may be accelerated by the respiratory burst of the PMNs due to the reduction of O(2) to the superoxide anion (O(-)(2...

  16. Evaluation of internal characteristic in small adenocarcinomas by MR images

    Energy Technology Data Exchange (ETDEWEB)

    Awaya, Hitomi; Matsumoto, Tsuneo; Miura, Goji; Tanaka, Nobuyuki; Emoto, Takuya; Matsunaga, Naofumi [Yamaguchi Univ., Ube (Japan). School of Medicine

    2000-01-01

    We reviewed MR images in 24 patients with small adenocarcinomas measuring 2 cm or less in size. Histological types of them were classified into three types based on a Noguchi's report: i.e. group 1 (Noguchi type A and B), group 2 (type C) and group 3 (type D, E and F). We evaluated the relationship between the nodule and vessels or bronchi, enhancement pattern, and internal signal patterns on MR images in three groups. Homogeneous signal intensity, vessels and bronchi branching within the nodule, and an early enhancement without a delayed enhancement on MR images were characteristic for group 1 with the most favorable disease-free-survival. (author)

  17. Tracheobronchomegaly with multiple diverticula: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan Sup; Kim, Joung Sook [College of Medicine, Inha University, Incheon (Korea, Republic of)

    1993-01-15

    Chest radiograhs revealed evidences of dilatation of the trachea and both main bronchi, multiple air bubbles around the trachea and focal bronchopneumonia in right lower lobe. Tracheobronchomegaly is a rare condition characterized by marked dilatation of the trachea and main bronchi and frequently associated with tracheal diverticulosis, bronchiectasis, and recurrent lower respiratory tract infection. Mounier-Kuhn, in 1932, was the first to associate the presence of tracheobronchomegaly with the clinical syndrome of chronic, recurrent respiratory tract infection. Tracheobronchomegaly is believed to be extremely rare. To date, only 92 cases have been reported in the literatures. We recently encountered a case of tracheobronchomegaly associated with multiple diverticula formation. The diagnosis was made by chest radiography, computed tomography (CT), bronchography, and CT taken immediately after the bronchography.

  18. The role of imaging in the diagnosis of bronchiectasis: the key is in the distribution.

    Science.gov (United States)

    Bueno, J; Flors, L

    2017-08-03

    Diseases that involve the medium caliber airways (segmental and subsegmental bronchi) are common and present clinically with nonspecific respiratory symptoms such as cough, recurrent respiratory infections and occasionally, hemoptysis. The abnormal and irreversible dilation of bronchi is known as "bronchiectasis". The diagnosis can be challenging and the analysis of the regional distribution of the bronchiectasis is the most useful diagnostic guide. The objective of this manuscript is to describe the main imaging findings of bronchiectasis and their classification, review the diseases that most commonly present with this abnormality, and provide an approach to the diagnosis based on their imaging appearance and anatomic distribution. Bronchiectasis is a frequent finding that may result from a broad range of disorders. Imaging plays a paramount role in diagnosis, both in the detection and classification, and in the diagnosis of the underlying pathology. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Sarcoidosis with Major Airway, Vascular and Nerve Compromise

    Directory of Open Access Journals (Sweden)

    Hiroshi Sekiguchi

    2013-01-01

    Full Text Available The present report describes a 60-year-old Caucasian woman who presented with progressive dyspnea, cough and wheeze. A computed tomography scan of the chest showed innumerable bilateral inflammatory pulmonary nodules with bronchovascular distribution and a mediastinal and hilar infiltrative process with calcified lymphadenopathy leading to narrowing of lobar bronchi and pulmonary arteries. An echocardiogram revealed pulmonary hypertension. Bronchoscopy showed left vocal cord paralysis and significant narrowing of the bilateral bronchi with mucosal thickening and multiple nodules. Transbronchial biopsy was compatible with sarcoidosis. Despite balloon angioplasty of the left lower lobe and pulmonary artery, and medical therapy with oral corticosteroids, her symptoms did not significantly improve. To the authors’ knowledge, the present report describes the first case of pulmonary sarcoidosis resulting in major airway, vascular and nerve compromise due to compressive lymphadenopathy and suspected concurrent granulomatous infiltration. Its presentation mimicked idiopathic mediastinal fibrosis.

  20. Injury Prevention in Aircraft Crashes: Investigative Techniques and Applications (la Prevention des lesions lors des accidents d’ avions: les techniques d’investigation et leurs applications)

    Science.gov (United States)

    1998-02-01

    respiratory excursion. Soot in the distal trachea (below the vocal cords) and bronchi is good evidence of inhalation of combustion products. The...no thermal bums below the level of the vocal cords and very low levels of carboxyhemoglobin. Burns seen in the airways of those not exposed to a...prepared by INTA (Institute» Nacional de Tecnica Aeroespacial) at the request of, and with the help of, the Lecture Series Director, Major Francisco Rios

  1. Superficial‑type endobronchial metastases from colon cancer : A case report

    OpenAIRE

    Kurishima, Koichi; SATOH, HIROAKI; KAGOHASHI, KATSUNORI; MIYAZAKI, KUNIHIKO; Tamura, Tomohiro; Shiozawa, Toshihiro; Ohara,Gen; KAWAGUCHI, MIO; TAKAYASHIKI, NORIO; Hizawa, Nobuyuki

    2014-01-01

    Certain internal malignancies, including colon cancer, can develop endobronchial metastasis. The present study reports a case of colon cancer with superficial-type endobronchial metastases in a 76-year-old male. Chest computed tomography revealed small masses and infiltrates in each lung, with bilateral hilar lymph node swelling. Superficial endobronchial tumors in each of the bronchi were unexpectedly found by bronchoscopic examination. A biopsy specimen obtained from the endobronchial tumor...

  2. Human airway smooth muscle

    OpenAIRE

    Jongste, Johan

    1987-01-01

    textabstractThe function of airway smooth muscle in normal subjects is not evident. Possible physiological roles include maintenance of optimal regional ventilation/perfusion ratios, reduction of anatomic dead space, stabilisation of cartilaginous bronchi, defense against impurities and, less likely, squeezing mucus out of mucous glands and pulling open the alveoli next to the airways1 . Any role of airway smooth muscle is necessarily limited, because an important degree of contraction will l...

  3. Recent Developments in United Airways Disease

    OpenAIRE

    Ciprandi, Giorgio; Caimmi, Davide; Miraglia del Giudice, Michele; La Rosa, Mario; Salpietro, Carmelo; Marseglia, Gian Luigi

    2012-01-01

    The nose and lung are both part of the respiratory tract. Often the diseases affecting the nose and/or the bronchi are treated separately. However, in recent years, numerous studies have highlighted the fact that the respiratory system is a single entity and the concept of "united airway disease" has become more and more important. The unity of the respiratory tract is confirmed both from a morphological and from a functional point of view. Nevertheless, this concept is also confirmed for the...

  4. Sulfur dioxide poisoning as a cause of asthma

    Energy Technology Data Exchange (ETDEWEB)

    Romanoff, A.

    1939-01-01

    This report discusses 3 cases of asthmatic attack following exposure to SO/sub 2/ from leaking refrigerators. This report speculates that primary effects are inflammatory destructive lesions in upper tract which predispose bronchi to bacterial attack followed by hypersensitivity to bacterial products (complex of bronchial asthma) in certain susceptible individuals. SO/sub 2/, like cold, exercise, or overeating, may be included in the same category of nonspecific precipitating causes. No immunologic case for specificity of SO/sub 2/ was observed.

  5. OMALIZUMAB: EXPANDED OPPORTUNITIES FOR THE ATOPIC DISEASES TREATMENT

    OpenAIRE

    T.V. Kulichenko

    2009-01-01

    The review highlights experience and administration perspectives of the immunobiological medication Omalizumab in allergy. Omalizumab is the anti'IgE monoclonal antibody. Growing successful experience of anti'IgE application confirms the assumption that treatment by Omalizumab may modify the course of bronchial asthma, by preventing the remodeling processes in the respiratory tracts and reducing hyperactivity of bronchi. Today, it is widely discussed what other possible areas of anti'IgE ther...

  6. Clinical Practice Guideline Selection, Development, Implementation, and Evaluation

    Science.gov (United States)

    2000-02-01

    Wymes DoD Gerd COL Sodhi NARMC NSAID Use LTC Nishimura NARMC Allergic Rhinitis / MAJ Deguzman NARMC Allergy Disease Obstetric Topic MAJ Harrison ORYX...bronchi (lung passageways) making breathing difficult. Treatment includes bronchodilators which are given orally or delivered as an aerosol (inhaled...Corticosteroids are reserved for more difficult cases. Symptoms include wheezing, difficulty breathing (particularly exhaling air) and tightness in the

  7. Bronchitis (acute)

    OpenAIRE

    Wark, Peter

    2008-01-01

    Acute bronchitis, with transient inflammation of the trachea and major bronchi, affects over 40/1000 adults a year in the UK. The causes are usually considered to be infective, but only around half of people have identifiable pathogens.The role of smoking or environmental tobacco smoke inhalation in predisposing to acute bronchitis is unclear.A third of people may have longer-term symptoms or recurrence.

  8. THE EFFECTIVENESS OF ANTIMICROBIAL PRESERVATIVES TESTING OF THE MEDICINE "EFIAL"

    OpenAIRE

    Borshchevskiy GI; Railko ZО; Reida VP

    2015-01-01

    Dosage form - spray is one of the most advanced and modern methods of medicines administration in the human body. The advantage of airborne mode of medicines delivery (inhalation) than injection and enterable methods is the ability to direct and rapid impact on the area of inflammation of the mucous membranes or when fine evaporation - on the bronchi and lungs. When finished medicinal product itself has not a sufficient antimicrobial activity, in its composition can be...

  9. RHINOSCLEROMA OF LARYNX : A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Kusuma Jeevan

    2015-06-01

    Full Text Available Rhinoscleroma is a chronic granulomatous disease of the respiratory mucosa caused by klebsiella rhinoscleromatis. It commonly involves the nose followed by nasopharynx, oropharynx, larynx, trachea and bronchi. Middle aged females are most prone for this disease. Isolated lar yngeal involvement is a rare condition. It should be differentiated from other chronic granulomatous conditions and should be managed early to decrease the morbidity caused by the disease.

  10. Linear opacities on HRCT in bronchiolitis obliterans organising pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, J.M.; Flower, C.D.R. [Dept. of Radiology, Addenbrookes Hospital, Univ. of Cambridge (United Kingdom); Schnyder, P.; Leuenberger, P. [Depts. of Radiology and Medicine, University Hospital, CHUV, Lausanne (Switzerland); Verschakelen, J. [Dept. of Radiology, University Hospital, Leuven (Belgium)

    1999-07-01

    The aim of this study was to report the high-resolution computed tomography (HRCT) appearances of linear opacities that may occur in isolation or in combination with other changes in bronchiolitis obliterans organising pneumonia (BOOP). Eleven patients with BOOP and linear opacities on HRCT were identified at three independent teaching hospitals. The HRCT images and clinical course of each patient were reviewed. Two distinct types of linear opacity were identified. The type-1 opacity extended in a radial manner along the line of the bronchi towards the pleura and was usually intimately related to bronchi. The type-2 opacity occurred in a sub-pleural location and bore no relationship to the bronchi. Both types occurred most commonly in the lower lobes, frequently were associated with multi-focal areas of consolidation and usually completely resolved with treatment. There was no associated bronchiectasis, irreversible volume loss or a reticular or honeycomb pattern. In 2 patients linear opacities were the sole abnormality on HRCT. Bronchiolitis obliterans organising pneumonia may occur in a pure ''linear form'' or HRCT may demonstrate linear opacities in addition to multi-focal consolidation. (orig.)

  11. Structure, material characteristics and function of the upper respiratory tract of the pygmy sperm whale.

    Science.gov (United States)

    Davenport, John; Cotter, Liz; Rogan, Emer; Kelliher, Denis; Murphy, Colm

    2013-12-15

    Cetaceans are neckless, so the trachea is very short. The upper respiratory tract is separate from the mouth and pharynx, and the dorsal blowhole connects, via the vestibular and nasopalatine cavities, directly to the larynx. Toothed cetaceans (Odontoceti) are capable of producing sounds at depth, either for locating prey or for communication. It has been suggested that during dives, air from the lungs and upper respiratory tract can be moved to the vestibular and nasal cavities to permit sound generation to continue when air volume within these cavities decreases as ambient pressure rises. The pygmy sperm whale, Kogia breviceps, is a deep diver (500-1000 m) that is known to produce hunting clicks. Our study of an immature female shows that the upper respiratory tract is highly asymmetrical: the trachea and bronchi are extremely compressible, whereas the larynx is much more rigid. Laryngeal and tracheal volumes were established. Calculations based on Boyle's Law imply that all air from the lungs and bronchi would be transferred to the larynx and trachea by a depth of 270 m and that the larynx itself could not accommodate all respiratory air mass at a depth of 1000 m. This suggests that no respiratory air would be available for vocalisation. However, the bronchi, trachea and part of the larynx have a thick vascular lining featuring large, thin-walled vessels. We propose that these vessels may become dilated during dives to reduce the volume of the upper respiratory tract, permitting forward transfer of air through the larynx.

  12. Effect of inspiration on airway dimensions measured in maximal inspiration CT images of subjects without airflow limitation

    Energy Technology Data Exchange (ETDEWEB)

    Petersen, Jens; Raket, Lars Lau; Nielsen, Mads [University of Copenhagen, Department of Computer Science, Copenhagen (Denmark); Wille, Mathilde M.W.; Dirksen, Asger [University of Copenhagen, Department of Respiratory Medicine, Gentofte Hospital, Hellerup (Denmark); Feragen, Aasa [University of Copenhagen, Department of Computer Science, Copenhagen (Denmark); Max Planck Institute for Intelligent Systems and Max Planck Institute for Developmental Biology, Tuebingen (Germany); Pedersen, Jesper H. [Rigshospitalet, University Hospital of Copenhagen, Department of Cardio-Thoracic Surgery RT, Copenhagen (Denmark); Bruijne, Marleen de [University of Copenhagen, Department of Computer Science, Copenhagen (Denmark); Erasmus MC Rotterdam, Departments of Medical Informatics and Radiology, Rotterdam (Netherlands)

    2014-09-15

    To study the effect of inspiration on airway dimensions measured in voluntary inspiration breath-hold examinations. 961 subjects with normal spirometry were selected from the Danish Lung Cancer Screening Trial. Subjects were examined annually for five years with low-dose CT. Automated software was utilized to segment lungs and airways, identify segmental bronchi, and match airway branches in all images of the same subject. Inspiration level was defined as segmented total lung volume (TLV) divided by predicted total lung capacity (pTLC). Mixed-effects models were used to predict relative change in lumen diameter (ALD) and wall thickness (AWT) in airways of generation 0 (trachea) to 7 and segmental bronchi (R1-R10 and L1-L10) from relative changes in inspiration level. Relative changes in ALD were related to relative changes in TLV/pTLC, and this distensibility increased with generation (p < 0.001). Relative changes in AWT were inversely related to relative changes in TLV/pTLC in generation 3-7 (p < 0.001). Segmental bronchi were widely dispersed in terms of ALD (5.7 ± 0.7 mm), AWT (0.86 ± 0.07 mm), and distensibility (23.5 ± 7.7 %). Subjects who inspire more deeply prior to imaging have larger ALD and smaller AWT. This effect is more pronounced in higher-generation airways. Therefore, adjustment of inspiration level is necessary to accurately assess airway dimensions. (orig.)

  13. Diagnostic value of using multiplanar reformation images: Case report for rare endotracheal hamartomas.

    Science.gov (United States)

    Xiang, Zhiming; Ai, Zhu; Zhong, Guimian; Deng, Yu; Malhi, Harshawn; Palmer, Suzanne; Zee, Chishing

    2017-10-01

    Pulmonary hamartomas are the most common benign tumor of the lung. Two types of pathologically similar hamartomas exist based on their location. These tumors have a low incidence, are rarely reported and frequently misdiagnosed because of lack of familiarity and/or understanding concerning their imaging features. Seventeen patients received treatment between June 2007 and May 2013 and had complete medical records. All of them had different degrees of cough and expectoration. Other symptoms include fever (5 cases), hemoptysis (4 cases), chest pain (3 cases), shortness of breath (2 cases), and dyspnea (1 case). These patients all have pathologically confirmed, and informed the diagnosis of endobronchial hamartoma. Unenhanced and enhanced CT scans were performed using Toshiba Aquilion 64-slice and GE Lightspeed 64-slice CT scanners. The scan was performed from the superior thoracic aperture to the lateral costophrenic angle. The transaxial CT data was inserted into a Volume Wizard workstation to reconstruct images using MPR technique. The relationship between the location of the tumor and bronchi was clearly displayed on the axial images in only 2 patients. In all 17 patients, reconstructed MPR images were able to display the tumor parallel to the long axis of bronchi, thus facilitating in tumor identification and positioning along the bronchial tree. MPR images are valuable tools in the diagnosis of endobronchial hamartomas. Chiefly, these reconstructions aid in the detection of intratumoral fat/calcification and clearly demonstrate the tumors relationship and effect with the adjacent bronchi.

  14. Quantitative computed tomography analysis of the airways in patients with cystic fibrosis using automated software: correlation with spirometry in the evaluation of severity

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Marcel Koenigkam; Cruvinel, Danilo Lemos; Menezes, Marcelo Bezerra de; Teixeira, Sara Reis; Vianna, Elcio de Oliveira; Elias Junior, Jorge; Martinez, Jose Antonio Baddini, E-mail: marcelk46@yahoo.com.br [Universidade de Sao Paulo (HC/FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina

    2016-11-15

    Objective: To perform a quantitative analysis of the airways using automated software, in computed tomography images of patients with cystic fibrosis, correlating the results with spirometric findings. Materials and methods: Thirty-four patients with cystic fibrosis were studied-20 males and 14 females; mean age 18 ± 9 years - divided into two groups according to the spirometry findings: group I (n = 21), without severe airflow obstruction (forced expiratory volume in first second [FEV1] > 50% predicted), and group II (n = 13), with severe obstruction (FEV1 ≤ 50% predicted). The following tracheobronchial tree parameters were obtained automatically: bronchial diameter, area, thickness, and wall attenuation. Results: On average, 52 bronchi per patient were studied. The number of bronchi analyzed was higher in group II. The correlation with spirometry findings, especially between the relative wall thickness of third to eighth bronchial generation and predicted FEV1, was better in group I. Conclusion: Quantitative analysis of the airways by computed tomography can be useful for assessing disease severity in cystic fibrosis patients. In patients with severe airflow obstruction, the number of bronchi studied by the method is higher, indicating more bronchiectasis. In patients without severe obstruction, the relative bronchial wall thickness showed a good correlation with the predicted FEV1. (author)

  15. Development of an in vitro model assay system for the evaluation of the effects of toxic chemicals on human airways. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Ellis, J.L.; Filbert, M.G.

    1994-03-01

    The ability of the anticholinesterase agent soman to contract human bronchi was examined. Soman (1-2 uM) had variable effects on human bronchi that had not been stimulated with an electric field stimulator (EFS). In bronchi continuously stimulated by EFS (0.5 Hz, 1 ms, 12 V), soman produced contractions in all tissues examined (12 preparations from 9 humans). In tissues stimulated by EFS, the beta-adrenoreceptor agonist isoproterenol produced relaxations that were greater in magnitude than the contractions produced by soman. The duration of the isoproterenol induced relaxations was variable. Of 12 preparations studied, 3 showed no reversal of the relaxation within 120 min, 6 showed a slow reversal with a reversal time of 106 + or - 6 min and 3 showed rapid reversal with a 50% reversal time of 14 min. In the latter group the duration of the relaxation produced by isoproterenol was doubled (28 + or - 2 min) by the M2 muscarinic receptor antagonist AFDX 116 (10 uM). These results show that the isolated human bronchus is a useful model for studying the effects of toxic chemical agents such as soman on the airways. The data obtained with isoproterenol suggest that beta-2 agonists may be useful adjuncts for treating the effects of anticholinesterase agents.

  16. Bronchial abnormalities found in a consecutive series of 40 brachycephalic dogs.

    Science.gov (United States)

    De Lorenzi, Davide; Bertoncello, Diana; Drigo, Michele

    2009-10-01

    To detect abnormalities of the lower respiratory tract (trachea, principal bronchi, and lobar bronchi) in brachycephalic dogs by use of endoscopy, evaluate the correlation between laryngeal collapse and bronchial abnormalities, and determine whether dogs with bronchial abnormalities have a less favorable postsurgical long-term outcome following correction of brachycephalic syndrome. Prospective case series study. 40 client-owned brachycephalic dogs with stertorous breathing and clinical signs of respiratory distress. Brachycephalic dogs anesthetized for pharyngoscopy and laryngoscopy between January 2007 and June 2008 underwent flexible bronchoscopy for systematic evaluation of the principal and lobar bronchi. For dogs that underwent surgical correction of any component of brachycephalic syndrome, owners rated surgical outcome during a follow-up telephone survey. Correlation between laryngeal collapse and bronchial abnormalities and association between bronchial abnormalities and long-term outcome were assessed. Pugs (n = 20), English Bulldogs (13), and French Bulldogs (7) were affected. A fixed bronchial collapse was recognized in 35 of 40 dogs with a total of 94 bronchial stenoses. Abnormalities were irregularly distributed between hemithoraces; 15 of 94 bronchial abnormalities were detected in the right bronchial system, and 79 of 94 were detected in the left. The left cranial bronchus was the most commonly affected structure, and Pugs were the most severely affected breed. Laryngeal collapse was significantly correlated with severe bronchial collapse; no significant correlation was found between severity of bronchial abnormalities and postsurgical outcome. Bronchial collapse was a common finding in brachycephalic dogs, and long-term postsurgical outcome was not affected by bronchial stenosis.

  17. Computed tomography assessment of airways throughout bronchial tree demonstrates airway narrowing in severe asthma.

    Science.gov (United States)

    Brillet, Pierre-Yves; Debray, Marie-Pierre; Golmard, Jean-Louis; Ould Hmeidi, Yahya; Fetita, Catalin; Taillé, Camille; Aubier, Michel; Grenier, Philippe A

    2015-06-01

    To analyze airway dimensions throughout the bronchial tree in severe asthmatic patients using multidetector row computed tomography (MDCT) focusing on airway narrowing. Thirty-two patients with severe asthma underwent automated (BronCare software) analysis of their right lung bronchi, with counts of airways >3 mm long arising from the main bronchi (airway count) and bronchial dimension quantification at segmental and subsegmental levels (lumen area [LA], wall area [WA], and WA%). Focal bronchial stenosis was defined as >50% narrowing of maximal LA on contiguous cross-sectional slices. Severe asthmatics were compared to 13 nonsevere asthmatic patients and nonasthmatic (pooled) subjects (Wilcoxon rank tests, then stepwise logistic regression). Finally, cluster analysis of severe asthmatic patients and stepwise logistic regression identified specific imaging subgroups. The most significant differences between severe asthmatic patients and the pooled subjects were bronchial stenosis (subsegmental and all bronchi: P bronchial stenosis: P = .009). Airway count was as discriminant as forced expiratory volume in 1 second/forced vital capacity (P = .01) to identify patients in each cluster, with both variables being correlated (r = 0.59, P = .005). Severe asthma-associated morphologic changes were characterized by focal bronchial stenoses and diffuse airway narrowing; the latter was associated with airflow obstruction. WA%, dependent on airway caliber, is the best parameter to identify severe asthmatic patients from pooled subjects. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  18. Effect of subchronic in vivo exposure to nitrogen dioxide on lung tissue inflammation, airway microvascular leakage, and in vitro bronchial muscle responsiveness in rats.

    Science.gov (United States)

    Chitano, P; Rado, V; Di Stefano, A; Papi, A; Boniotti, A; Zancuoghi, G; Boschetto, P; Romano, M; Salmona, M; Ciaccia, A; Fabbri, L M; Mapp, C E

    1996-06-01

    In a previous study on bronchoalveolar lavage fluid from rats exposed in vivo for seven days to 10 ppm nitrogen dioxide (NO2), it has been shown that there is an influx of macrophages into the airways. The present study investigated the effect of seven day exposure to 10 ppm NO2, on: (a) lung tissue inflammation and morphology; (b) airway microvascular leakage; (c) in vitro contractile response of main bronchi. Lung tissue was studied by light microscopy, after fixing the lungs by inflation with 4% formalin at a pressure of 20 cm H2O. Microvascular leakage was measured by extravasation of Evans blue dye in the larynx, trachea, main bronchi, and intrapulmonary airways. Smooth muscle responsiveness was evaluated by concentration-responses curves to acetylcholine (10(-9)-10(-3) M), serotonin (10(-9)-10(-4) M), and voltage-response curves (12-28 V) to electrical field stimulation. Histology showed an increased total inflammation at the level of respiratory bronchioles and alveoli. No influx of inflammatory cells was found in the main bronchi. A loss of cilia in the epithelium of small airways and ectasia of alveolar capillaries was also found. By contrast, no alterations to microvascular permeability or modification of bronchial smooth muscle responsiveness was found. Subchronic exposure to 10 ppm NO2 causes airway inflammation and structural damage, but does not cause any persistent alteration to microvascular permeability or bronchial smooth muscle responsiveness in rats.

  19. Airway smooth muscle dysfunction in Pompe (Gaa-/- ) mice.

    Science.gov (United States)

    Keeler, Allison M; Liu, Donghai; Zieger, Marina; Xiong, Lang; Salemi, Jeffrey; Bellvé, Karl; Byrne, Barry J; Fuller, David D; ZhuGe, Ronghua; ElMallah, Mai K

    2017-06-01

    Pompe disease is an autosomal recessive disorder caused by a deficiency of acid α-glucosidase (GAA), an enzyme responsible for hydrolyzing lysosomal glycogen. Deficiency of GAA leads to systemic glycogen accumulation in the lysosomes of skeletal muscle, motor neurons, and smooth muscle. Skeletal muscle and motor neuron pathology are known to contribute to respiratory insufficiency in Pompe disease, but the role of airway pathology has not been evaluated. Here we propose that GAA enzyme deficiency disrupts the function of the trachea and bronchi and this lower airway pathology contributes to respiratory insufficiency in Pompe disease. Using an established mouse model of Pompe disease, the Gaa-/- mouse, we compared histology, pulmonary mechanics, airway smooth muscle (ASM) function, and calcium signaling between Gaa-/- and age-matched wild-type (WT) mice. Lysosomal glycogen accumulation was observed in the smooth muscle of both the bronchi and the trachea in Gaa-/- but not WT mice. Furthermore, Gaa-/- mice had hyporesponsive airway resistance and bronchial ring contraction to the bronchoconstrictive agents methacholine (MCh) and potassium chloride (KCl) and to a bronchodilator (albuterol). Finally, calcium signaling during bronchiolar smooth muscle contraction was impaired in Gaa-/- mice indicating impaired extracellular calcium influx. We conclude that GAA enzyme deficiency leads to glycogen accumulation in the trachea and bronchi and impairs the ability of lower ASM to regulate calcium and respond appropriately to bronchodilator or constrictors. Accordingly, ASM dysfunction may contribute to respiratory impairments in Pompe disease. Copyright © 2017 the American Physiological Society.

  20. Bronchus associated lymphoid tissue (BALT) in human lung: its distribution in smokers and non-smokers.

    Science.gov (United States)

    Richmond, I; Pritchard, G E; Ashcroft, T; Avery, A; Corris, P A; Walters, E H

    1993-11-01

    Bronchus associated lymphoid tissue (BALT) is a normal component of the lung's immune system in many animals and may be analogous to gut associated lymphoid tissue (GALT). This study aimed at assessing the nature and extent of BALT in human lung and determining whether its expression is induced within the human airway in response to smoking. Paraffin embedded, formalin fixed full thickness bronchial wall sections were examined from 31 whole lung specimens derived from both smokers and non-smokers. Samples were taken from throughout the bronchial tree to include main stem bronchi, lobar bronchi and segmental bronchi, as well as first to third generation carinae. Standard 4 microns step sections were stained by haematoxylin and eosin and immunocytochemical methods to show foci of BALT. Examination of 256 airway sites detected 46 foci of BALT. These differed from those described in other mammals in being distributed throughout the bronchial tree, in being found in relation to bronchial glandular epithelium as well as luminal bronchial epithelium, and in lacking any accompanying M cells. Analysis by smoking status showed that the expression of BALT was significantly more common in smokers than non-smokers (82% (14/17) v 14% (2/14) respectively). The findings support the view that BALT in humans is an integral feature in a comparatively small proportion of lungs from non-smokers while being significantly more prominent in lungs from smokers. The tissue shows several important differences from that described in other mammals.

  1. Expression of Heat Stress Protein 70 mRNA in Patients with Chronic Ob-structive Pulmonary Disease and Its Significance

    Institute of Scientific and Technical Information of China (English)

    ZHAO Jianping; XIE Jungang; XU Yongjian; ZHANG Zhenxiang; ZHANG Ning

    2005-01-01

    The effects of cigarette smoke extract (CSE) on the expression of heat stress protein 70(Hsp70) in human bronchi smooth muscle cells were investigated in vitro, and the changes in Hsp70 mRNA in the patients with chronic obstructive pulmonary disease and their significance were explored. Human bronchi smooth muscle cells were cultured with CSE at the different concentrations. The expression of Hsp70 mRNA and Hsp70 was detected by reverse translation-polymerase chain reaction (RT-PCR) and Western blotting respectively. Levels of Hsp70 mRNA and Hsp70 in lymphocytes from 20 patients with COPD and 20 healthy smoking control subjects were measured by RT-PCR and Western blotting. The results showed the expression of both Hsp70 mRNA and Hsp70 was decreased conformably in human bronchi smooth muscle cells treated with CSE at certain concentration in vitro. The A values of the Hsp70 mRNA expression were 0. 24±0.11 and 0.42±0.13 respectively in COPD patients and healthy smoking controls with the difference being significant (P<0.01). There was also significant difference in the A values of the Hsp70 expression between COPD patients and healthy smoking controls (20.9±9.9 vs 44.8±15.3, P<0.01). The levels of Hsp70 mRNA had strongly positive correlation with Hsp70 protein (r = 0. 85, P<0.01). It was suggested that the expression of Hsp70 mRNA was in concordance with the expression of Hsp70, which could provide a basis on the study of Hsp70 gene regulation and Hsp70 gene in the development of COPD.

  2. Radiological spectrum of anthracofibrosis: A series of 40 patients with computed tomography, bronchoscopy, and biopsy

    Directory of Open Access Journals (Sweden)

    Anandamoyee Dhar

    2017-01-01

    Full Text Available Introduction: Anthracofibrosis is a lesser known clinical entity. Patients present with chronic symptoms of cough and breathlessness with a history of biofuel/wood fire smoke exposure. There are distinct computed tomography (CT imaging features of anthracofibrosis that can differentiate it from more common conditions such as tuberculosis (TB and bronchogenic carcinoma. Findings include multifocal noncontiguous stenosis of bronchial tree, calcified enlarged mediastinal or hilar nodes, and secondary lung parenchymal changes. However, in TB, bronchostenosis usually involves a single lobar bronchus in a contiguous manner with trachea and/or major bronchi also being affected. In this study, we highlight the imaging characteristics of anthracofibrosis. Context: The CT findings of anthracofibrosis closely mimic TB and bronchogenic carcinoma, hence we highlight the key imaging features of anthracofibrosis. Aims and Objectives: To identify and describe the CT imaging features of anthracofibrosis and correlate it with bronchoscopic findings. Setting and Design: Retrospective study. Materials and Methods: Retrospectively, 40 patients were selected who were diagnosed with anthracofibrosis on bronchoscopy and biopsy. However, CT scan records of only 14 patients were available for review. Two radiologists reviewed the scans independently. Results: Most common CT finding was multisegmental noncontiguous bronchostenosis seen in 93% patients mostly involving the right middle lobe. 85% of the cases showed lymph node enlargement involving hilar, peribronchial, and mediastinal nodes. The nodes were calcified in 91.7% of the cases, with 58% showing pressure effect on adjacent bronchi due to nodal enlargement. The next common findings were peribronchial cuffing and bronchial obstruction seen in 57 and 28% of the cases, respectively. Conclusion: The key imaging features of anthracofibrosis on CT are multifocal involvement of bronchi with smooth peribronchial

  3. Brief mechanical ventilation causes differential epithelial repair along the airways of fetal, preterm lambs.

    Science.gov (United States)

    Deptula, Nicole; Royse, Emily; Kemp, Matthew W; Miura, Yuichiro; Kallapur, Suhas G; Jobe, Alan H; Hillman, Noah H

    2016-08-01

    Mechanical ventilation of preterm lambs causes lung inflammation and injury to the airway epithelium, which is repaired by 15 days after ventilation. In mice, activated basal cells (p63+, KRT14+, KRT8+) initiate injury repair to the trachea, whereas club cells coordinate distal airway repair. In both human and sheep, basal cells line the pseudostratified airways to the distal bronchioles with club cells only present in terminal bronchioles. Mechanical ventilation causes airway epithelial injury that is repaired through basal cell activation in the fetal lung. Ewes at 123 ± 1 day gestational age had the head and chest of the fetus exteriorized and tracheostomy placed. With placental circulation intact, fetal lambs were mechanically ventilated with up to 15 ml/kg for 15 min with 95% N2/5% CO2 Fetal lambs were returned to the uterus for up to 24 h. The trachea, left mainstem bronchi, and peripheral lung were evaluated for epithelial injury and cellular response consistent with repair. Peripheral lung tissue had inflammation, pro-inflammatory cytokine production, epithelial growth factor receptor ligand upregulation, increased p63 expression, and proliferation of pro-SPB, TTF-1 positive club cells. In bronchi, KRT14 and KRT8 mRNA increased without increases in Notch pathway mRNA or proliferation. In trachea, mRNA increased for Notch ligands, SAM pointed domain-containing Ets transcription factor and mucin 5B, but not for basal cell markers. A brief period of mechanical ventilation causes differential epithelial activation between trachea, bronchi, and peripheral lung. The repair mechanisms identified in adult mice occur at different levels of airway branching in fetal sheep with basal and club cell activation. Copyright © 2016 the American Physiological Society.

  4. DEGRO 2006: 12. annual congress of the German Radiation Oncology Society, 10. annual meeting of SASRO and 22. annual meeting of OeGRO. Abstracts; DEGRO 2006 - 12. Jahreskongress der Deutschen Gesellschaft fuer Radioonkologie, 10. Jahrestagung der SASRO und 22. Jahrestagung der OeGRO. Abstracts

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-05-15

    The volume displays the abstracts of the meetings of the German, Swiss, and Austrian societies for radiooncology. Issues of the lectures, posters, and symposia were: new technological developments, head-neck tumors, radiobiology, prostate carcinomas, radiotherapy in palliative treatment, hematological malignomas, tumors of gastrointestinal tract, bladder, brain, breast, or bronchi, carrier planning, women in the field of radiooncology, image-guided radiotherapy, sexuality, fertility and pregnancy with gynecological tumors, psychooncology, pediatric oncology and radiotherapy, sex-dependent radiosensitivity, dosimetry, irradiation planning, quality of life in radiooncology, radiooncological information systems. (uke)

  5. Inflammatory Pattern of the Bronchial Mucosa in Patients with Asthma with Airway Hyperresponsiveness to Hypoosmotic Stimulus.

    Science.gov (United States)

    Pirogov, A B; Prikhod'ko, A G; Perelman, Yu M; Zinovyev, S V; Afanasyeva, E Yu; Kolosov, V P

    2016-08-01

    Positive reaction of the bronchi to distilled water inhalation in asthmatics is associated with significant stimulation of the respiratory epithelium desquamation against the background of increased content of eosinophilic and neutrophilic leukocytes in induced sputum, predomination of eosinophil and neutrophil cytolysis, and lower activity of myeloperoxidase in leukocyte granules (in comparison with the parameter in patients with a negative response to bronchostimulation). Enhanced cytolysis and destruction of leukocytes and high myeloperoxidase concentration in the extracellular space are essential for the development of bronchial hyperresponsiveness to hypoosmotic stimulus in asthma.

  6. Follow-up of patients treated by erlotinib (Tarceval) for a non at small cells lung cancer by PET-F.D.G.: preliminary results; Suivi de patients traites par erlotinib (Tarceval) pour cancer bronchique non a petites cellules par TEP-FDG: resultats preliminaires

    Energy Technology Data Exchange (ETDEWEB)

    Vervueren, L.; Berthelot, C.; Rakotonirina, H.; Lacoeuille, F.; Cahouet Vannier, A.; Le Jeune, J.J.; Couturier, O. [Service de medecine nucleaire et biophysique, CHU d' Angers, (France)

    2009-05-15

    This study is in the frame of the evaluation of targeted therapies. Its principal objective is to provide information on the tumor metabolism evolution by PET-F.D.G. for patients treated for non at small cells bronchi carcinomas by erlotinib (Tarceval), an inhibitor of tyrosine kinase targeting the receptor to epidermal growth factor (E.G.F.). The secondary objectives are to evaluate at term, the interest of the PET-F.D.G. in the identification of responder patients and the early evaluation of the therapy response. (N.C.)

  7. A case report of Mounier-Kuhn syndrome

    Directory of Open Access Journals (Sweden)

    Keerthivasan Sivanmani

    2017-01-01

    Full Text Available Mounier-Kuhn syndrome is a congenital abnormality characterized by tracheobronchomegaly as a result of atrophy or absence of elastic fibers and thinning of smooth muscle layer in trachea and main bronchi. The usual presentation is one of recurrent respiratory tract infections with a broad spectrum of functional impairment ranging from minimal disease with preservation of lung function to severe disease in the form of bronchiectasis. We describe a case of an elderly man who presented with a recurrent respiratory infection who was subsequently diagnosed as Mounier-Kuhn syndrome.

  8. Huge Tracheal Diverticulum in a Patient with Mounier-Kuhn Syndrome

    Directory of Open Access Journals (Sweden)

    Michele Mondoni

    2016-07-01

    Full Text Available Tracheal diverticulum is a rare benign entity. Tracheobronchomegaly (TBM, also known as Mounier-Kuhn syndrome, is a rare disorder characterized by marked dilation of the trachea and main bronchi, associated with thinning or atrophy of the elastic tissue. Because of the weakened trachea and increased intraluminal pressure related to chronic cough, some patients may develop mucosal herniation leading to tracheal diverticulosis. We report the case of a patient with TBM with a huge tracheal diverticulum, diagnosed by bronchoscopy and computed tomography with three-dimensional reconstruction. To our knowledge this is the largest tracheal diameter described in a patient affected by this syndrome.

  9. An unusual long standing tracheal foreign body – A rare incidence

    Directory of Open Access Journals (Sweden)

    Santosh Kumar Swain

    2015-03-01

    Full Text Available Foreign body (FB inhalation is often encountered by emergent otolaryngology services. A long standing undiagnosed FB in trachea is very rare and lethal. Inhalation of betel nut and presenting at the proximal trachea is rarer. As often in the airway FB gravitate to bronchi, long standing tracheal FB is a rare presentation and also rare in the literature. Children who are not given proper individual attention at an early age are more liable to inhale FB. FB aspiration is associated with significant morbidity.

  10. Delayed recurrence of ulcerative colitis manifested by tracheobronchitis, bronchiolitis, and bronchiolectasis

    Directory of Open Access Journals (Sweden)

    Iclal Ocak MD,

    2017-12-01

    Full Text Available Ulcerative colitis can cause inflammation of small and large airways, characterized by mucosal inflammation, tracheobronchial stenosis, bronchiestasis, and bronchiolitis. We present a case of tracheobronchitis and bronchiolitis associated with ulcerative colitis in a 58-year-old nonsmoking man, 17 years after the total colectomy and complete resolution of intestinal findings. Computed tomography demonstrated wall thickening of trachea and left main stem bronchus, and multiple bronchi around the both hilum with mild to moderate stenosis. Fiberoptic bronchial biopsy showed inflammation of the airways, similar to histologic findings of ulcerative colitis within colon. Keywords: Ulcerative colitis, Trachea, Lung

  11. CT findings of respiratory bronchiolitis caused by cigarette smoking

    Energy Technology Data Exchange (ETDEWEB)

    Katagiri, Siro; Osima, K.; Kim, S. [Chiba Tokusyukai Hospital, Funabashi (Japan)

    1998-07-01

    CT scans were performed in 11 cases of respiratory bronchiolitis caused by cigarette smoking. Characteristics of CT findings were as follows: Remarkable visualization of the branching in peripheral bronchi within secondary lobules, multiple ground-glass opacities of centrilobular or lobular size adjacent to the above mentioned bronchial branching, thickening of the bronchial wall without dilatation, and no or minimal centrilobular emphysema. These characteristic CT findings were observed in all of 11 cases, who are current smokers, and never observed in non-smokers, ex-smokers and patients with apparent centrilobular emphysema. (author)

  12. Sinonasal inflammation in COPD

    DEFF Research Database (Denmark)

    Håkansson, Kåre; Konge, Lars; Thomsen, Sf

    2013-01-01

    In this review we demonstrate that patients with chronic obstructive pulmonary disease (COPD) frequently report sinonasal symptoms. Furthermore, we present evidence that smoking on its own can cause nasal disease, and that in COPD patients, nasal inflammation mimics that of the bronchi. All...... this evidence suggests that COPD related sinonasal disease does exist and that smoking on its own rather than systemic inflammation triggers the condition. However, COPD related sinonasal disease remains to be characterized in terms of symptoms and endoscopic findings. In addition, more studies are needed...... to quantify the negative impact of sinonasal symptoms on the quality of life in COPD patients....

  13. A 46-year-old man with tracheomegaly, tracheal diverticulosis, and bronchiectasis: Mounier-Kuhn syndrome

    Directory of Open Access Journals (Sweden)

    Ashish K Jaiswal

    2012-01-01

    Full Text Available Lower respiratory tract infection is one of the common causes of morbidity in India which is occasionally undiagnosed. In this regard tracheobronchomegaly is one of those conditions which masquerade as chronic bronchitis and bronchiectasis and are usually undiagnosed. It is a well-defined clinical and radiologic entity characterized by marked dilatation of the trachea and the central bronchi and is frequently associated with recurrent lower respiratory tract infection. Tracheobronchomegaly has been described by a variety of names, including Mounier-Kuhn syndrome, tracheal diverticulosis, tracheobronchiectasis, tracheocele, tracheomalacia, and tracheobronchopathia malacia.

  14. Airway Inflammation in Chronic Rhinosinusitis with Nasal Polyps and Asthma: The United Airways Concept Further Supported

    DEFF Research Database (Denmark)

    Håkansson, Kåre; Bachert, Claus; Konge, Lars

    2015-01-01

    ) bronchial inflammation exists in all CRSwNP patients irrespective of clinical asthma status. Methods We collected biopsies from nasal polyps, inferior turbinates and bronchi of 27 CRSwNP patients and 6 controls. All participants were evaluated for lower airway disease according to international guidelines......Background It has been established that patients with chronic rhinosinusitis with nasal polyps (CRSwNP) often have co-existing asthma. Objective We aimed to test two hypotheses: (i) upper and lower airway inflammation in CRSwNP is uniform in agreement with the united airways concept; and (ii...

  15. Metabolism of benzo(a)pyrene and 7,12-dimethylbenz(a)anthracene in cultured human bronchus and pancreatic duct

    DEFF Research Database (Denmark)

    Harris, Curtis C.; Autrup, Herman; Stoner, Gary

    1977-01-01

    cochromatographed with both the 9,10-diol and a triol of BP. 7,12-Dimethylbenz[a]anthracene was bound to the DMA of cultured human bronchial cells at higher levels than was BP. Binding of 7,12-dimethylbenz[a]anthracene to DMA in human pancreatic duct was consistently less than that in cultured bronchi in the 5......The metabolism of two carcinogenic polynuclear aro matic hydrocarbons, benzo[a]pyrene (BP) and 7,12-dimethylbenz[a]anthracene, was studied in expiants of human pancreatic duct and bronchus cultured in a chemically defined medium. In cultured human bronchial mucosa, activity of aryl hydrocarbon...

  16. Interaction between Lung Mechanics and Gas Exchange by Low Volume High Frequency Pulmonary Ventilation in Patients with Respiratory Failure.

    Science.gov (United States)

    1985-11-30

    is taken as the sum of maximal dynamic effort (Hyatt and Flath , 1966) and elastic recoil pressure. However, since the maximal dynamic effort depends on...flow limitation. J. Appl. Physiol. 55:1-8, 1983. 14. Hyatt, R.E., and R.E. Flath . Influence of lung parenchyma on pressure-diameter behavior of dog...bronchi. J. Appl. Physiol. % 21:1448-1452, 1966. % % % 34 . 15. Hyatt, R.E., and R.E. Flath . Relationship of air flow to pressure during maximal

  17. Mammalian Toxicological Evaluation of p-Chlorophenyl Methyl Sulfide, p-Chlorophenyl Methyl Sulfoxide, and p-Chlorophenyl Methyl Sulfone.

    Science.gov (United States)

    1979-07-01

    closed 4 ± . . .i Conjunctival score (C.D)12 Total Total Rye Score , I 23 layer. The fluoroscein was flushed out of-the eyes with physiological saline ...in mice. This change was confined to the respiratory epithelium of the bronchi and bronchioles and consisted of denudation and/or flattening of the...a KY Jelly- lubricated infant feeding tube (B-D Infant Feeding Tube 8 fr.) through the nasal cavity and into the monkey’s stomach. Each compound was

  18. COUGH PHYTOTHERAPY IN EARLY CHILDHOOD

    Directory of Open Access Journals (Sweden)

    I. V. Davydova

    2012-01-01

    Full Text Available Treatment of acute respiratory infections remains one of the most pressing problems in children. Mucolytic and expectorant therapy aimed at facilitating the expectoration of sputum and improvement of the drainage function of bronchi, is an integral part of this treatment. Expectorant herbal medicine occupies a special niche in the treatment of acute respiratory viral infections. This paper presents literature data on the efficacy and safety of herbal expectorants in children, as well as the results of a comparative analysis of single- and multicomponent herbal medications.  

  19. Development of Therapeutic Modality of Esophageal Cancer Using Ho-166 Stent

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Doo; Park, Kwang Kyun; Lee, Min Geol [Yonsei University Medical College, Seoul (Korea, Republic of); Park, Kyung Bae [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1997-09-01

    The prognosis of esophageal cancer is poor due absence of serosa which prevent local invasion to the surrounding organs such as aorta, mediastinum, trachea, and bronchi. We developed a Ho-166 Coated Radioactive Self-Expandable Metallic Stent which is a new herapeutic device in the treatment of esophageal cancer and underwent an animal experiment in mongrel dogs. We observed mucosal destruction by 4-6 mCi of Ho-166 without serious complications such as perforation of esophageal wall. Therefore, Ho-166 coated self-expandable stent appears to be an effective therapeutic device in the palliative treatment of esophageal cancer. 17 refs., 4 figs. (author)

  20. Epidermal growth factor in the rat lung

    DEFF Research Database (Denmark)

    Raaberg, Lasse; Poulsen, Steen Seier; Nexø, Ebba

    1991-01-01

    of the rat from a couple of days prior to birth and throughout life. Further, we report EGF immunoreactivity to be present in cells in the bronchi and the bronchioles from day 20-21 of gestation and throughout life. G-200 gelchromatography of lung extracts indicates that the EGF-reactive material is a high...... molecular weight form of EGF. Since previous studies have shown that EGF in pharmacological doses is able to promote lung maturation, our results may imply a physiological role for EGF in the lungs....

  1. Endosonography in bronchopulmonary disease

    DEFF Research Database (Denmark)

    Vilmann, Peter; Annema, Jouke; Clementsen, Paul

    2009-01-01

    FNA and EBUS-TBNA of mediastinal nodes and tumors can provide a specimen adequate for interpretation in over 95% of cases with a specificity of close to 100% and a sensitivity ranging between 88% and 96%. A growing number of studies including randomized trails and meta-analyses have demonstrated...... via the esophagus, trachea and main bronchi. The concept of complete echo-endoscopic staging of lung cancer is postulated as virtually all mediastinal nodes as well as regions relevant to pulmonal medicine (liver and adrenal glands) can be reached by these two methods in combination....

  2. Isolation of M. pneumoniae from monkeys (Presbitus cristata).

    Science.gov (United States)

    Stipkovits, L; Marantidi, A N; Dzikidze, E K; Krylova, R I; Vulvovich, J V

    1989-03-01

    Monkeys of the species Presbitus cristata died of severe interstitial pneumonia 20-60 days after their transportation. The carcases were examined for the presence of mycoplasmas. Thirty-six out of 65 samples obtained from the liver, spleen, kidney, lung, lymph nodes, pharynx, bronchi and blood of 13 monkeys contained mycoplasmas biochemically and serologically identical with M. pneumoniae. The isolated strains were able to elicit a rise in body temperature and an elevation in the number of leucocytes in blood as well as development of interstitial pneumonia, colonization of the inner organs by the mycoplasmas and a serological response in the experimentally infected guinea-pigs.

  3. Mounier-Kuhn Syndrome in an Elderly Female with Pulmonary Fibrosis

    Directory of Open Access Journals (Sweden)

    Panagiotis Boglou

    2016-01-01

    Full Text Available Mounier-Kuhn syndrome (MKS, or tracheobronchomegaly, is a rare clinical and radiologic condition characterized by pronounced tracheobronchial dilation and recurrent lower respiratory tract infections. Tracheobronchomegaly presents when the defect extends to the central bronchi. MKS can be diagnosed in adult women when the transverse and sagittal diameters of the trachea, right mainstem bronchus, and left mainstem bronchus exceed 21, 23, 19.8, and 17.4 mm, respectively. Its diagnosis is based on chest radiograph and chest computed tomography (CT. Patients, usually middle-aged men, may be asymptomatic or present with clinical manifestations ranging from minimal symptoms with preserved lung function to severe respiratory failure. Pulmonary function tests (PFTs typically reveal a restrictive pattern. This report presents an elderly woman with previously diagnosed pulmonary fibrosis with symptoms of increased sputum production and haemoptysis. High-resolution chest CT showed tracheal and main stem bronchi dilatation along with bronchial diverticulosis. PFTs indicated a restrictive pattern characteristic of the underlying pulmonary fibrosis. The patient is the oldest, referred to the female gender, at presentation of MKS hitherto reported. This case highlights the need to include MKS in the differential diagnosis of recurrent lower respiratory tract infections, even in older subjects.

  4. The effects of cannabidiol on the antigen-induced contraction of airways smooth muscle in the guinea-pig.

    Science.gov (United States)

    Dudášová, A; Keir, S D; Parsons, M E; Molleman, A; Page, C P

    2013-06-01

    (-)-Δ(9)-Tetrahydrocannabinol has been demonstrated to have beneficial effects in the airways, but its psychoactive effects preclude its therapeutic use for the treatment of airways diseases. In the present study we have investigated the effects of (-)-cannabidiol, a non-psychoactive component of cannabis for its actions on bronchial smooth muscle in vitro and in vivo. Guinea-pig bronchial smooth muscle contractions induced by exogenously applied spasmogens were measured isometrically. In addition, contractile responses of bronchial smooth muscle from ovalbumin-sensitized guinea-pigs were investigated in the absence or presence of (-)-cannabidiol. Furthermore, the effect of (-)-cannabidiol against ovalbumin-induced airway obstruction was investigated in vivo in ovalbumin-sensitized guinea-pigs. (-)-Cannabidiol did not influence the bronchial smooth muscle contraction induced by carbachol, histamine or neurokinin A. In contrast, (-)-cannabidiol inhibited anandamide- and virodhamine-induced responses of isolated bronchi. A fatty acid amide hydrolase inhibitor, phenylmethanesulfonyl fluoride reversed the inhibitory effect of (-)-cannabidiol on anandamide-induced contractions. In addition, (-)-cannabidiol inhibited the contractile response of bronchi obtained from allergic guinea-pigs induced by ovalbumin. In vivo, (-)-cannabidiol reduced ovalbumin-induced airway obstruction. In conclusion, our results suggest that cannabidiol can influence antigen-induced airway smooth muscle tone suggesting that this molecule may have beneficial effects in the treatment of obstructive airway disorders. Copyright © 2013. Published by Elsevier Ltd.

  5. Hydatid disease of the liver with thoracic involvement.

    Science.gov (United States)

    Kilani, T; El Hammami, S; Horchani, H; Ben Miled-Mrad, K; Hantous, S; Mestiri, I; Sellami, M

    2001-01-01

    Hydatidosis, caused by Echinococcus granulosus, is an endemic parasitic disease in Mediterranean countries. The most frequent anatomic locations are liver and lung. Intrathoracic rupture of hydatid cysts situated in the hepatic dome is a serious complication resulting in damage to the pleura, pulmonary parenchyma, and bronchi. From January 1984 to December 1997 we operated on 40 patients with intrathoracic rupture of a hepatic hydatid cyst. Chest roentgenograms showed a shadow of varying size at the base of the hemithorax. Hepatic and thoracic ultrasonography was performed in all cases. The diagnosis of intrathoracic rupture of a liver cyst was confirmed preoperatively in 30 of the 40 cases. Posterolateral thoracotomy was performed in all patients. This transthoracic approach allowed adhesiolysis and treatment of the pleural lesions, pulmonary lesions, and hepatic cyst. Treatment of the diaphragmatic gap is easily done. We performed 15 lobectomies, 10 wedge resections, 16 decortications, and in one patient simple drainage of a voluminous pleuropulmonary and hepatic purulent hydatic collection. The postoperative course was uneventful in 26 cases, but 14 patients had complications, from which 3 patients died. The therapeutic approach depends on ultrasonographic findings. We believe ultrasonography to be the best examination for assessing biliary, hepatic, diaphragmatic, and pleuropulmonary lesions. When an intrathoracic collection is present, thoracotomy must be performed and is sufficient if the biliary tract is safe. An abdominal approach is necessary when biliary duct drainage is required, and it may be sufficient in cases of direct rupture into the bronchi.

  6. High-resolution computed tomography evaluation of the bronchial lumen to vertebral body diameter and pulmonary artery to vertebral body diameter ratios in anesthetized ventilated normal cats.

    Science.gov (United States)

    Lee-Fowler, Tekla M; Cole, Robert C; Dillon, A Ray; Tillson, D Michael; Garbarino, Rachel; Barney, Sharron

    2017-10-01

    Objectives Bronchial lumen to pulmonary artery diameter (BA) ratio has been utilized to investigate pulmonary pathology on high-resolution CT images. Diseases affecting both the bronchi and pulmonary arteries render the BA ratio less useful. The purpose of the study was to establish bronchial lumen diameter to vertebral body diameter (BV) and pulmonary artery diameter to vertebral body diameter (AV) ratios in normal cats. Methods Using high-resolution CT images, 16 sets of measurements (sixth thoracic vertebral body [mid-body], each lobar bronchi and companion pulmonary artery diameter) were acquired from young adult female cats and 41 sets from pubertal female cats. Results Young adult and pubertal cat BV ratios were not statistically different from each other in any lung lobe. Significant differences between individual lung lobe BV ratios were noted on combined age group analysis. Caudal lung lobe AV ratios were significantly different between young adult and pubertal cats. All other lung lobe AV ratios were not significantly different. Caudal lung lobe AV ratios were significantly different from all other lung lobes but not from each other in both the young adult and pubertal cats. Conclusions and relevance BV ratio reference intervals determined for individual lung lobes could be applied to both young adult and pubertal cats. Separate AV ratios for individual lung lobes would be required for young adult and pubertal cats. These ratios should allow more accurate evaluation of cats with concurrent bronchial and pulmonary arterial disease.

  7. Morphometric evaluation of murine pulmonary mast cells in experimental hemorrhagic shock

    Directory of Open Access Journals (Sweden)

    I Kasacka

    2009-06-01

    Full Text Available Respiratory failure resulting frequently in death is one of the complications in the course of post-hemorrhagic changes. A systemic inflammatory reaction plays a significant role in the pathogenesis of this syndrome. Mast cells also contribute to this effect. To broaden our knowledge of the pathogenesis of respiratory insufficiency, we evaluated morphometrically lung mast cells in hemorrhagically shocked rats. Lung sections were stained with alcian blue and safranin, and four separate locations were distinguished: under the lung pleura, around the bronchi and the large vessels, and in the interalveolar septa. A decrease in the area and volume of mast cells and an increase in their circularity index in interalveolar septa and around the bronchi was observed. An enlargement of mast cells around lung vessels was also found. There were no changes in the morphometric parameters of mast cells under pleura. The results suggest an activation and degranulation of mast cells and a role in the inflammatory process causing acute lung injury in hemorrhagic shock.

  8. Characteristics of Consolidation, Centrilobular Nodule and Bronchus as CT Findings for the Differentiation between Tuberculosis and Pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Se Young; Chung, Myung Hee; Lim, Yeon Soo; Lim, Hyun Wook; Kahng, Ji Min [Bucheon St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Bucheon (Korea, Republic of); Sung, Mi Sook [Dept. of Radiology, St. Paul' s Hospital, The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of)

    2013-06-15

    To differentiate tuberculosis from pneumonia by computed tomography (CT) in cases difficult to diagnose clinically and radiologically. CT scans of 300 patients with tuberculosis and 234 patients with pneumonia were retrospectively analyzed. Parenchymal abnormalities, lymph nodes, pleural effusions and central bronchial narrowing were evaluated. The density of consolidation was measured by pre- and post-enhanced CT. Centrilobular nodules, granulomas, cavitations in both nodules as well as consolidation, conglomerated nodules, and enlarged lymph nodes occurred with significantly greater frequency in patients with tuberculosis than in those with pneumonia. Centrilobular nodules were larger and denser in tuberculosis patients. In consolidation, decreases in lung lobe volume and a bronchial beaded appearance (irregular narrowing and dilatation) were more frequent in patients with tuberculosis. The tuberculous consolidation had significantly lower mean enhancement and net enhancement than that from pneumonia. When the diagnostic criteria for tuberculosis were set as well-demarcated larger centrilobular nodules and/or a lowerly enhancing consolidation with internal beaded bronchi, the diagnostic accuracy was found to be 82.0%. Consolidation with a low level of enhancement, decreased lung lobe volume, and bronchi with irregular, beaded shape and denser and larger centrilobular nodules are helpful CT findings for the diagnosis of tuberculosis.

  9. Thoracic manifestation of Wegener's granulomatosis: CT findings in 30 patients

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Soo; Kim, Tae Sung; Kim, Eun A. [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea); Fujimoto, Kiminori [Department of Radiology, Kurume University School of Medicine, Kurume 830-0011 (Japan); Moriya, Hiroshi [Department of Radiology, Fukushima Medical University School of Medicine, Fukushima 960-1295 (Japan); Watanabe, Hideyuki [Department of Radiology, University of Occupational and Environmental Health, Japan School of Medicine, Kitakyushu 807-8555 (Japan); Tateishi, Ukihide [Department of Radiology, Hokkaido University Graduate School of Medicine, Sapporo 060-8638 (Japan); Ashizawa, Kazuoto [Department of Radiology, Nagasaki University School of Medicine, Nagasaki 852-8501 (Japan); Johkoh, Takeshi [Department of Radiology, Osaka University Graduate School of Medicine, Suita 565-0871 (Japan); Kwon, O. Jung [Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710 (Korea)

    2003-01-01

    Our objective was to describe the CT findings of thoracic Wegener's granulomatosis. At presentation, both conventional and thin-section CT scans were available in 30 patients with Wegener's granulomatosis. Serial CT scans (range of intervals: 1-25 months, mean 4.5 months) were available in 20 patients. The initial and follow-up CT scans were analyzed retrospectively by two observers in terms of pattern and extent of parenchymal and airway lesions. Positive CT findings were seen in 29 of 30 (97%) patients at initial presentation. The most common pattern was nodules or masses seen in 27 of 30 (90%) patients. They were multiple in 23 of 27 (85%) patients, bilateral in 18 (67%), subpleural in 24 (89%), and peribronchovascular in 11 (41%) in distribution. Bronchial wall thickening in the segmental or subsegmental bronchi was seen in 22 (73%) patients. Large airways were also abnormal in 9 (30%) patients. Patchy areas of consolidation and ground-glass opacity were seen in 7 (23%) patients, respectively. In 17 of 20 (85%) patients in whom follow-up CT scans were available, the parenchymal or airway lesion showed complete or partial improvement with treatment. The CT findings of Wegener's granulomatosis, although multiple and variable, consist mainly of bilateral subpleural or peribronchovascular nodules or masses and bronchial wall thickening in the segmental or subsegmental bronchi. Parenchymal and airway lesions improve with treatment in most patients. (orig.)

  10. [Diagnosis of primary tracheobronchial amyloidosis by multiplanar reconstruction of the computed tomography combined with bronchoscope].

    Science.gov (United States)

    Li, Dan; Wang, Lei; Asmit, Thakur; Wang, Chunbao; Wang, Yuan

    2015-10-01

    To summarize the specific CT characteristics and the endoscopic findings of primary tracheobronchial amyloidosis (PTBA) for improvement of the diagnostic accuracy.
 The imaging features of 6 patients with PTBA were analyzed by multiplanar reconstructed CT and the fiberoptic bronchoscope, and the pathology were summarized retrospectively.
 All PTBA patients received bronchoscopic examination and the definite diagnosis were confirmed by positive staining with Congo red. PTBA presented diffuse thickening of major airway and lumen stenosis in various degrees with scattered hemorrhage of the mucous membrane under CT and bronchoscope, which was more obvious in low part of trachea, main bronchus and lobar bronchus. The mucosa of trachea and bilateral main bronchi were irregular and bumpy with jutting nodes in 5 patients, which was called "wavy path" pattern. Widely nodular or stripy calcifications of airway were found in 4 patients, which was considered as specific imaging features in PTBA and was involved bilateral main bronchi largely. There were obstructive atelectasis in 2 patients, and calcifications of hilus of lung with longitudinal diaphragm lymph nodes in 3 patients, but they were not specific. Ignoring the extensive circumferential thickening of large airway, "wavy path sign" and rail-like calcification was mainly responsible for misdiagnosis of PTBA as endobronchial tuberculosis or other diseases.
 Attentions to the specific imaging features on multiplanar CT and the endoscopic findings are the fundamentals to avoid the misdiagnosis of PTBA.

  11. Postmortem CT versus forensic autopsy: frequent discrepancies of tracheobronchial content findings.

    Science.gov (United States)

    Zech, Wolf-Dieter; Jackowski, Christian; Schwendener, Nicole; Brencicova, Eva; Schuster, Frederick; Lombardo, Paolo

    2016-01-01

    In their daily forensic casework, the authors experienced discrepancies of tracheobronchial content findings between postmortem computed tomography (PMCT) and autopsy to an extent previously unnoticed in the literature. The goal of this study was to evaluate such discrepancies in routine forensic cases. A total of 327 cases that underwent PMCT prior to routine forensic autopsy were retrospectively evaluated for tracheal and bronchial contents according to PMCT and autopsy findings. Hounsfield unit (HU) values of tracheobronchial contents, causes of death, and presence of pulmonary edema were assessed in mismatching and matching cases. Comparing contents in PMCT and autopsy in each of the separately evaluated compartments of the respiratory tract low positive predictive values were assessed (trachea, 38.2%; main bronchi, 40%; peripheral bronchi, 69.1%) indicating high discrepancy rates. The majority of tracheobronchial contents were viscous stomach contents in matching cases and low radiodensity materials (i.e., HU cases. The majority of causes of death were cardiac related in the matching cases and skull/brain trauma in the mismatching cases. In mismatching cases, frequency of pulmonary edema was significantly higher than in matching cases. It can be concluded that discrepancies in tracheobronchial contents observed between PMCT and routine forensic autopsy occur in a considerable number of cases. Discrepancies may be explained by the runoff of contents via nose and mouth during external examination and the flow back of tracheal and main bronchial contents into the lungs caused by upright movement of the respiratory tract at autopsy.

  12. Tendons, Concentric Tubes, and a Bevel Tip: Three Steerable Robots in One Transoral Lung Access System.

    Science.gov (United States)

    Swaney, Philip J; Mahoney, Arthur W; Remirez, Andria A; Lamers, Erik; Hartley, Bryan I; Feins, Richard H; Alterovitz, Ron; Webster, Robert J

    2015-05-01

    Lung cancer is the most deadly form of cancer, and survival depends on early-stage diagnosis and treatment. Transoral access is preferable to traditional between-the-ribs needle insertion because it is less invasive and reduces risk of lung collapse. Yet many sites in the peripheral zones of the lung or distant from the bronchi cannot currently be accessed transorally, due to the relatively large diameter and lack of sufficient steerablity of current instrumentation. To remedy this, we propose a new robotic system that uses a tendon-actuated device (bronchoscope) as a first stage for deploying a concentric tube robot, which itself is a vehicle through which a bevel steered needle can be introduced into the soft tissue of the lung outside the bronchi. In this paper we present the various components of the system and the workflow we envision for deploying the robot to a target using image guidance. We describe initial validation experiments in which we puncture ex vivo bronchial wall tissue and also target a nodule in a phantom with an average final tip error of 0.72 mm.

  13. Computed tomography of the thorax in calves from birth to 105 days of age.

    Science.gov (United States)

    Ohlerth, S; Augsburger, H; Abé, M; Ringer, S; Hatz, L; Braun, U

    2014-10-01

    The present study was undertaken to provide computed tomographic (CT) reference values for structures in the thorax of the calf. Six clinically healthy Holstein-Friesian calves were anaesthetized. Transverse pre- and postcontrast images with a reconstructed 1.5-mm slice thickness were obtained using a multislice-CT scanner at 6 different time points from birth to 105 days of age. Absolute and relative measurements of the trachea, heart, cranial and caudal vena cava, thoracic aorta, right and left principal bronchi, right and left caudal lobar bronchi and the accompanying branches of the right and left pulmonary artery and vein, thoracic lymph nodes and lung density were taken for every time point. All animals were euthanized after the last CT scan, and 4 calves were frozen to generate an atlas comparing gross anatomy with CT. During the study, 4 animals temporarily showed coughing and mucopurulent nasal discharge, and mild to moderate bronchopneumonia and pleuritis were diagnosed using CT. Animals recovered with treatment; however, mild to moderate CT changes remained throughout the study. Even in the 2 clinically normal animals, mild bronchopneumonia was diagnosed on CT.

  14. [Actual respiratory technologies in thoracic surgery: traditional problems and innovative solutions].

    Science.gov (United States)

    Vyzhigina, M A; Parshin, V D; Titov, V A; Alekseev, A V

    2015-01-01

    The problem of efficient gas exchange maintenance is always actual in anesthetic management of thoracic surgery and determines the selection of appropriate method of anesthesia. The article presents an experience of anesthesia during operations on lungs, trachea, bronchi and mediastinal structures performed from 1963 to 2015. Current concept of safety and efficacy of anesthetic management in thoracic surgery is presented. The role of actual current respiratory technologies and methods of anesthesia per se to maximize the efficiency of gas exchange in all stages of thoracicsurgery is emphasized. Absolute coherence of anesthesiologist and surgeon based on correct interaction is the most important condition of successful surgery. Effectiveness of special respiratory technologies for thoracic surgery associated with one-lung ventilation and prolonged wide dissection of airways is described. The research results and pathophysiological rationale for the use of special respiratory technologies including different variants of differentiated independent lung ventilation especially important for patients with concomitant cardiorespiratory pathology are presented. We reported experience of effective gas exchange maintenance in reconstructive surgery of trachea and main bronchi including traditional mechanical ventilation with "shunt-breath" system, use of jet high-frequency ventilation and relatively new respiratory technology such as flow apnoeic oxygenation.

  15. Imaging Findings of Isolated Bronchial Anthracofibrosis: A Computed Tomography Analysis of Patients With Bronchoscopic and Histologic Confirmation.

    Science.gov (United States)

    Kahkouee, Shahram; Pourghorban, Ramin; Bitarafan, Mahdi; Najafizadeh, Katayoun; Makki, Seyed Shahabeddin Mohammad

    2015-07-01

    To evaluate the chest computed tomography (CT) findings of patients with isolated bronchial anthracofibrosis confirmed by bronchoscopy and histopathology. Fifty-eight patients with isolated bronchial anthracofibrosis (29 females; mean age, 70 years) were enrolled in this study. The diagnosis of bronchial anthracofibrosis was made based on both bronchoscopy and pathology findings in all patients. The various chest CT images were retrospectively reviewed by two chest radiologists who reached decisions in consensus. Central peribronchial soft tissue thickening (n=37, 63.8%) causing bronchial narrowing (n=37, 63.8%) or obstruction (n=11, 19%) was identified as an important finding on imaging. Multiple bronchial stenoses with concurrent involvement of 2, 3, and 5 bronchi were seen in 12 (21%), 9 (15%), and 2 (3.4%) patients, respectively. Segmental atelectasis and lobar or multilobar collapse were detected. These findings mostly occurred in the right lung, predominantly in the right middle lobe. Mosaic attenuation patterns, scattered parenchymal nodules, nodular patterns, and calcified or non-calcified lymph nodes were also observed. On chest CT, isolated bronchial anthracofibrosis appeared as peribronchial soft tissue thickening, bronchial narrowing or obstruction, segmental atelectasis, and lobar or multilobar collapse. The findings were more common in the right side, with simultaneous involvement of multiple bronchi in some patients. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  16. Towards the modeling of mucus draining from human lung: role of airways deformation on air-mucus interaction

    CERN Document Server

    Mauroy, Benjamin; Pelca, Dominique; Fausser, Christian; Merckx, Jacques; Mitchell, Barrett R

    2015-01-01

    Chest physiotherapy is an empirical technique used to help secretions to get out of the lung whenever stagnation occurs. Although commonly used, little is known about the inner mechanisms of chest physiotherapy and controversies about its use are coming out regularly. Thus, a scientific validation of chest physiotherapy is needed to evaluate its effects on secretions. We setup a quasi-static numerical model of chest physiotherapy based on thorax and lung physiology and on their respective biophysics. We modeled the lung with an idealized deformable symmetric bifurcating tree. Bronchi and their inner fluids mechanics are assumed axisymmetric. Static data from the literature is used to build a model for the lung's mechanics. Secretions motion is the consequence of the shear constraints apply by the air flow. The input of the model is the pressure on the chest wall at each time, and the output is the bronchi geometry and air and secretions properties. In the limit of our model, we mimicked manual and mechanical ...

  17. Quantitative normal thoracic anatomy at CT.

    Science.gov (United States)

    Matsumoto, Monica M S; Udupa, Jayaram K; Tong, Yubing; Saboury, Babak; Torigian, Drew A

    2016-07-01

    Automatic anatomy recognition (AAR) methodologies for a body region require detailed understanding of the morphology, architecture, and geographical layout of the organs within the body region. The aim of this paper was to quantitatively characterize the normal anatomy of the thoracic region for AAR. Contrast-enhanced chest CT images from 41 normal male subjects, each with 11 segmented objects, were considered in this study. The individual objects were quantitatively characterized in terms of their linear size, surface area, volume, shape, CT attenuation properties, inter-object distances, size and shape correlations, size-to-distance correlations, and distance-to-distance correlations. A heat map visualization approach was used for intuitively portraying the associations between parameters. Numerous new observations about object geography and relationships were made. Some objects, such as the pericardial region, vary far less than others in size across subjects. Distance relationships are more consistent when involving an object such as trachea and bronchi than other objects. Considering the inter-object distance, some objects have a more prominent correlation, such as trachea and bronchi, right and left lungs, arterial system, and esophagus. The proposed method provides new, objective, and usable knowledge about anatomy whose utility in building body-wide models toward AAR has been demonstrated in other studies. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. The pathophysiology of bronchiectasis

    Directory of Open Access Journals (Sweden)

    Paul T King

    2009-10-01

    Full Text Available Paul T KingDepartment of Medicine, Department of Respiratory and Sleep Medicine, Monash University, Monash Medical Centre, Melbourne, Victoria, AustraliaAbstract: Bronchiectasis is defined by permanent and abnormal widening of the bronchi. This process occurs in the context of chronic airway infection and inflammation. It is usually diagnosed using computed tomography scanning to visualize the larger bronchi. Bronchiectasis is also characterized by mild to moderate airflow obstruction. This review will describe the pathophysiology of noncystic fibrosis bronchiectasis. Studies have demonstrated that the small airways in bronchiectasis are obstructed from an inflammatory infiltrate in the wall. As most of the bronchial tree is composed of small airways, the net effect is obstruction. The bronchial wall is typically thickened by an inflammatory infiltrate of lymphocytes and macrophages which may form lymphoid follicles. It has recently been demonstrated that patients with bronchiectasis have a progressive decline in lung function. There are a large number of etiologic risk factors associated with bronchiectasis. As there is generally a long-term retrospective history, it may be difficult to determine the exact role of such factors in the pathogenesis. Extremes of age and smoking/chronic obstructive pulmonary disease may be important considerations. There are a variety of different pathogens involved in bronchiectasis, but a common finding despite the presence of purulent sputum is failure to identify any pathogenic microorganisms. The bacterial flora appears to change with progression of disease. Keywords: bronchiectasis, inflammation, obstructive lung disease, pathophysiology, pathology

  19. Computed tomographic imaging of dogs with primary laryngeal or tracheal airway obstruction.

    Science.gov (United States)

    Stadler, Krystina; Hartman, Susan; Matheson, Jodi; O'Brien, Robert

    2011-01-01

    Seventeen dogs with clinical signs attributable to nonneoplastic obstruction of the larynx, trachea, or large bronchi underwent computed tomography (CT) imaging. In 16 of the 17 dogs, CT was performed without general anesthesia using a positioning device. Fifteen of these 16 dogs were imaged without sedation or general anesthesia. Three-dimensional (3D) internal rendering was performed on each image set based on lesion localization determined by routine image planes. Visual laryngeal examination, endoscopy, video fluoroscopy, and necropsy were used for achieving the cause of the upper airway obstruction. The CT and 3D internal rendering accurately indicated the presence and cause of upper airway obstruction in all dogs. CT findings indicative of laryngeal paralysis included failure to abduct the arytenoid cartilages, narrowed rima glottis, and air-filled laryngeal ventricles. Laryngeal collapse findings depended on the grade of collapse and included everted laryngeal saccules, collapse of the cuneiform processes and corniculate processes, and narrowed rima glottis. Trachea abnormalities included hypoplasia, stenosis, or collapse syndrome. The CT findings in tracheal hypoplasia consisted of a severely narrowed lumen throughout the entire length. Tracheal stenosis was represented by a circumferential decrease in tracheal lumen size limited to one region. Tracheal collapse syndrome was diagnosed by severe asymmetric narrowing. Lobar bronchi collapse appeared in CT images as a narrowed asymmetric lumen diameter. CT imaging of unanesthetized dogs with upper airway obstruction compares favorably with traditional definitive diagnostic methods. © 2011 Veterinary Radiology & Ultrasound.

  20. Effects of microbial stimulation on the number, size and activity of bronchus-associated lymphoid tissue (BALT) structures in the pig.

    Science.gov (United States)

    Delventhal, S; Hensel, A; Petzoldt, K; Pabst, R

    1992-06-01

    The development of bronchus-associated lymphoid tissue (BALT) was investigated in the pig, which is a species in which BALT is not found constantly. Different routes of contact with a specifically lung-pathogen bacterium Actinobacillus (Haemophilus) pleuropneumoniae were tested. Pigs, selected by bacteriological screening methods and the number of granulocytes in the bronchoalveolar lavage (BAL), were infected by aerosol. They were compared to previously enterally immunized pigs using active and inactivated bacteria. The development of BALT after the infection was compared to that in pigs with a single enteral, or no, contact with the bacterium. BALT was less frequent in these groups than in the infected pigs. Previously immunized pigs developed the highest number and the largest BALT with the most prominent morphological signs of activation. Immunization with living or inactivated bacteria did not cause histological differences. BALT was preferentially located around bronchioli and small bronchi. Additional BALT predominantly occurred in the walls of larger bronchi. Definite compartments of T and B lymphocytes were not found in immunohistological studies of BALT. It was concluded that the development of BALT can be induced by different modes of microbial stimulation.

  1. Superficial-type endobronchial metastases from colon cancer: A case report.

    Science.gov (United States)

    Kurishima, Koichi; Satoh, Hiroaki; Kagohashi, Katsunori; Miyazaki, Kunihiko; Tamura, Tomohiro; Shiozawa, Toshihiro; Ohara, Gen; Kawaguchi, Mio; Takayashiki, Norio; Hizawa, Nobuyuki

    2014-11-01

    Certain internal malignancies, including colon cancer, can develop endobronchial metastasis. The present study reports a case of colon cancer with superficial-type endobronchial metastases in a 76-year-old male. Chest computed tomography revealed small masses and infiltrates in each lung, with bilateral hilar lymph node swelling. Superficial endobronchial tumors in each of the bronchi were unexpectedly found by bronchoscopic examination. A biopsy specimen obtained from the endobronchial tumor was diagnosed as colon cancer. Superficial-type endobronchial metastasis from colon cancer is extremely rare, however, such metastasis should be considered for patients who have a history of colon cancer. There should be no hesitation in performing a bronchoscopic biopsy as an additional examination.

  2. Vocal Hoarseness and a Subglottic Mass

    Directory of Open Access Journals (Sweden)

    Sassan Rafizadeh PhD

    2015-05-01

    Full Text Available We report a patient with tracheopathia osteoplastica (TPO, a rare or perhaps underrecognized disorder, detected in approximately 1 in every 2000 to 5000 patients who undergo bronchoscopy. TPO is marked by proliferation of bony and cartilaginous spurs leading to airway stenosis. Multiple submucosal cartilaginous and osseous nodules can develop in the respiratory tract and may involve the entire trachea and mainstem bronchi. Symptoms may range from a completely silent condition to life-threatening respiratory failure and diagnosis is made based on radiological and bronchoscopic findings. Although the etiology has not been established, TPO can be familial and is sometimes associated with chronic inflammation, such as seen with rheumatic diseases. This case highlights the need for understanding TPO so that it can be differentiated from potentially serious conditions such as necrotizing granulomatous diseases, invasive infections, and cancer.

  3. Metabolomic studies in pulmonology

    Directory of Open Access Journals (Sweden)

    R. R. Furina

    2015-01-01

    Full Text Available The review shows the results of metabolomic studies in pulmonology. The key idea of metabolomics is to detect specific biomarkers in a biological sample for the diagnosis of diseases of the bronchi and lung. Main methods for the separation and identification of volatile organic substances as biomarkers (gas chromatography, mass spectrometry, and nuclear magnetic resonance spectrometry used in metabolomics are given. A solid-phase microextraction method used to pre-prepare a sample is also covered. The results of laboratory tests for biomarkers for lung cancer, acute respiratory distress syndrome, chronic obstructive pulmonary disease, cystic fibrosis, chronic infections, and pulmonary tuberculosis are presented. In addition, emphasis is placed on the possibilities of metabolomics used in experimental medicine, including to the study of asthma. The information is of interest to both theorists and practitioners.

  4. Tracheobronchomalacia post-pneumonectomy: A late complication

    Directory of Open Access Journals (Sweden)

    Ashima Datey

    2013-01-01

    Full Text Available An 83-year-old male presented with dyspnoea and stridor. He had undergone pneumonectomy 40 years ago. CT scan revealed gross shift of mediastinum (post-pneumonectomy syndrome with tortuous trachea kinked at the thoracic inlet. Fibre optic bronchoscopy showed a near total expiratory closure of trachea, right main bronchus, and segmental bronchi confirming tracheobronchomalacia. He was managed with long length, low tracheostomy in view of his poor general condition of permitting more invasive procedures. He showed adequate clinical improvement and was discharged home. Tracheobronchomalacia in post-pneumonectomy syndrome requires emergent management. Its occurrence after 40 years is very rare and may be easily missed. It can be diagnosed with dynamic CT and FOB. Although invasive management with stenting or surgical methods is routinely advised, conservative care can be effective in selected cases.

  5. Tracheal and bronchial involvement in colitis ulcerosa – a colo-bronchitic syndrome? A case report and some additional considerations

    Directory of Open Access Journals (Sweden)

    von Wichert, Peter

    2015-03-01

    Full Text Available Systemic involvement is well known in patients with inflammatory bowel diseases (IBD, but there are only few data looking to Crohn’s disease (CD and ulcerative colitis (UC separately instead of lumping together both entities to IBD. The frequency of bronchial involvement in UC is not yet exactly analysed but reported to be rare. We asked 100 patients with UC for bronchial complaints, and found in 13 patients a bronchial affection. From reports in the literature it is known that sometimes a bronchial involvement in patients with UC can affect the whole bronchial tree including small bronchi. The involvement of bronchial system in UC is obviously more prominent than previously thought and may fulfil the criteria for a separate syndrome. These relations may have consequences for pathogenetic understanding of UC as well as bronchitis and also consequences for treatment regimes.

  6. Tracheal and bronchial involvement in colitis ulcerosa – a colo-bronchitic syndrome? A case report and some additional considerations

    Science.gov (United States)

    von Wichert, Peter; Barth, Peter; von Wichert, Goetz

    2015-01-01

    Systemic involvement is well known in patients with inflammatory bowel diseases (IBD), but there are only few data looking to Crohn’s disease (CD) and ulcerative colitis (UC) separately instead of lumping together both entities to IBD. The frequency of bronchial involvement in UC is not yet exactly analysed but reported to be rare. We asked 100 patients with UC for bronchial complaints, and found in 13 patients a bronchial affection. From reports in the literature it is known that sometimes a bronchial involvement in patients with UC can affect the whole bronchial tree including small bronchi. The involvement of bronchial system in UC is obviously more prominent than previously thought and may fulfil the criteria for a separate syndrome. These relations may have consequences for pathogenetic understanding of UC as well as bronchitis and also consequences for treatment regimes. PMID:25834480

  7. Variations in the morphology of Rhizomucor pusillus in granulomatous lesions of a Magellanic penguin (Spheniscus magellanicus).

    Science.gov (United States)

    Suzuta, Fumiko; Kimura, Kumiko; Urakawa, Ryo; Kusuda, Yukio; Tanaka, Shogo; Hanafusa, Yasuko; Haritani, Makoto

    2015-08-01

    This report presents a new case of mucormycosis encountered in penguin characterized by morphological variation of hyphae and presence of sporangia with numerous sporangiospores. A 4.5-year-old Magellanic penguin (Spheniscus magellanicus) died after exhibiting anorexia, poor nutritional condition and dyspnea. Multiple nodular lesions were observed in the thoracic and abdominal regions. Histopathologically, hyphae of various sizes were seen in the lungs, air sac and nodular lesions. Myriad sporangiospores and several sporangia were observed in/around the bronchi or parabronchi. The very narrow and short hyphae in the nodules were not consistent with the characteristics of Mucorales. However, for most hyphae, including those in the nodules, sporangiospores and sporangia, immunohistochemistry revealed Mucorales-positive reactions. In addition, these fungi were identified as Rhizomucor pusillus by gene analysis.

  8. Ex vivo exposure to gaseous pollutants of air passages and human and animal pulmonary vessels: effect on the reactivity and cell signalling; Exposition ex vivo aux polluants gazeux des voies aeriennes et de vaisseaux pulmonaires humains et animaux: effet sur la reactivite et la signalisation cellulaire

    Energy Technology Data Exchange (ETDEWEB)

    Hyvelin, J.M.

    2000-07-01

    The objectives of this work have been to characterize effects of exposure to several pollutants on the reactivity of air passages, to study the action mechanisms of pollutants on the smooth muscle cell of air passages, to characterize the calcic signalling of the human bronchi smooth muscle in order to identify the pollutants cell targets, to look for others pollutants cell targets. This work contributes to a better knowledge of air pollution effects, by underlining the additive character of pollutants. It allows a better knowledge of cell mechanisms implied in the pollutants effects. Then, it notices the existence of other cell types, the pulmonary arterial myocyte, sensitive to pollutants exposure and that can be implied in the respiratory health degradation. (N.C.)

  9. Recurrent respiratory papillomatosis with pulmonary involvement; Papilomatose respiratoria recorrente com envolvimento pulmonar

    Energy Technology Data Exchange (ETDEWEB)

    Ikawa, Marcos Hiroyuki [Universidade Federal de Sao Paulo, SP (Brazil). Escola Paulista de Medicina. Dept. de Diagnostico por Imagem; Meirelles, Gustavo Souza Portes [Centro de Medicina Diagnostica Fleury, Sao Paulo, SP (Brazil)]. E-mail: gmeirelles@gmail.com

    2008-01-15

    A five-year-old girl developed hoarseness with gradual worsening at the age of eight months. Three months later, she underwent bronchoscopy in which papillomas in the vocal cords, larynx and trachea were observed. Because of serious bronchospasm crises and respiratory failure, she needed several hospitalizations, definitive tracheostomy and multiple endoscopic procedures for papilloma excision. The most recent chest radiography (Figure A) and computed tomography (CT) scans (Figures B and C) showed a nodule inside the trachea and multiple pulmonary nodules, cysts and consolidations. The anatomopathological findings from curettage of the lesions revealed benign squamous-cell papillomas. Recurrent respiratory papillomatosis (RRP) is directly related to the human papillomavirus (HPV). Its spread to the lower airways is uncommon, with involvement of trachea and/or proximal bronchi in 5% of the patients, and extension to the lungs in only 1% of the cases. (author)

  10. An unusual cause for recurrent chest infections.

    LENUS (Irish Health Repository)

    Lobo, Ronstan

    2012-10-01

    We present a case of an elderly non-smoking gentleman who, since 2005, had been admitted multiple times for recurrent episodes of shortness of breath, wheeze, cough and sputum. The patient was treated as exacerbations of chronic obstructive pulmonary disease (COPD) and\\/or lower respiratory tract infections. Bronchoscopy was done which revealed multiple hard nodules in the trachea and bronchi with posterior tracheal wall sparing. Biopsies confirmed this as tracheopathia osteochondroplastica (TO). He had increasing frequency of admission due to methicillin-resistant Staphylococcus aureus and pseudomonas infections, which failed to clear despite intravenous, prolonged oral and nebulised antibiotics. The patient developed increasing respiratory distress and respiratory failure. The patient died peacefully in 2012. This case report highlights the typical pathological and radiological findings of TO and the pitfalls of misdiagnosing patients with recurrent chest infections as COPD.

  11. Clinicoroentgenological diagnosis of mediastinal lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Vinner, M.G.; Khudyakov, L.M. (Sverdlovskij Meditsinskij Inst. (USSR))

    There was described a typical pulmonary picture (28 cases) and present differential diagnostic features permitting one to differentiate these patients from those with Hodgkin disease, sarcoidosis and tuberculous bronchadenitis. The main clinical signs that make it possible to establish a correct diagnosis are old age, chest pains and dry cough, accelerated ESR; the roentgenological signs are the unilateral enlargement of the peribronchial lymph nodes. Enlarged lymph nodes merge into a conglomerate with tuberous, ill defined contours. These lymph nodes are located or projected in the central mediastinum leaving the retroperitoneal space free. This outside compression often causes the narrowing of the main bronchi. Clinicoroentgenological diagnosis of mediastinal cancer is usually confirmed at biopsy. A small atypical group (9 cases) where the leading role in diagnosis is played by biopsy, is singled out.

  12. A Case of Paraneoplastic Cushing Syndrome Presenting as Hyperglycemic Hyperosmolar Nonketotic Syndrome

    Directory of Open Access Journals (Sweden)

    Christina E. Brzezniak

    2017-04-01

    Full Text Available Carcinoid tumors are neuroendocrine tumors that mainly arise in the gastrointestinal tract, lungs, and bronchi. Bronchopulmonary carcinoids have been associated with Cushing syndrome, which results from ectopic adrenocorticotrophic hormone (ACTH secretion. We report the case of a 65-year-old man, a colonel in the US Air Force, with metastatic bronchopulmonary carcinoid tumors treated on a clinical trial who was hospitalized for complaints of increasing thirst, polydipsia, polyuria, weakness, and visual changes. Decompensated hyperglycemia suggested a diagnosis of hyperglycemic hyperosmolar nonketotic syndrome (HHNS. Additional findings, which included hypokalemia, hypernatremia, hypertension, metabolic alkalosis, moon facies, and striae, raised a red flag for an ectopic ACTH syndrome. Elevated ACTH levels confirmed Cushing syndrome. Treatment with a fluid replacement and insulin drip resulted in immediate symptomatic improvement. Cushing syndrome should be considered in carcinoid patients with physical stigmata such as moon facies and striae. HHNS may be the presenting clinical feature in patients with impaired glucose metabolism.

  13. Imaging of community-acquired pneumonia: Roles of imaging examinations, imaging diagnosis of specific pathogens and discrimination from noninfectious diseases

    Science.gov (United States)

    Nambu, Atsushi; Ozawa, Katsura; Kobayashi, Noriko; Tago, Masao

    2014-01-01

    This article reviews roles of imaging examinations in the management of community-acquired pneumonia (CAP), imaging diagnosis of specific CAP and discrimination between CAP and noninfectious diseases. Chest radiography is usually enough to confirm the diagnosis of CAP, whereas computed tomography is required to suggest specific pathogens and to discriminate from noninfectious diseases. Mycoplasma pneumoniae pneumonia, tuberculosis, Pneumocystis jirovecii pneumonia and some cases of viral pneumonia sometimes show specific imaging findings. Peribronchial nodules, especially tree-in-bud appearance, are fairly specific for infection. Evidences of organization, such as concavity of the opacities, traction bronchiectasis, visualization of air bronchograms over the entire length of the bronchi, or mild parenchymal distortion are suggestive of organizing pneumonia. We will introduce tips to effectively make use of imaging examinations in the management of CAP. PMID:25349662

  14. Palliative therapy in adults with cancer: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Angelita Visentin

    Full Text Available ABSTRACT Objective: To characterize the socioeconomic and clinical profile of adult cancer patients in palliative therapy. Method: Cross-sectional study in an oncology hospital in Paraná, with 124 adult patients who started palliative therapy in the period from Jan. 2 to June 30, 2015. Results: Of the participating population, 60.5% were women, 68.5% white, 48.4% married, 72.6% catholic and with income of one to two minimum wages. Non-smokers, 45.2%, non-alcoholics 75%, and 92% had Performance Status 1 and 2. The predominant primary diagnosis was breast cancer, with previous chemotherapy and radiotherapy. The sites of metastasis were lung/mediastinum/bronchi and lymph nodes. Conclusion: The socioeconomic and clinical context characterized the profile of adult patients in palliative therapy. The demand arising from the increase in cases of advanced cancer requires nursing care at all stages of treatment.

  15. VALVE BRONCHIAL BLOCK IN THE INTEGRATED TREATMENT OF BRONCHIAL PLEURAL FISTULAS AFTER SURGICAL REDUCTION OF PULMONARY VOLUME

    Directory of Open Access Journals (Sweden)

    E. A. Tseymakh

    2015-01-01

    Full Text Available Formation of bronchopleural fistulas after surgical reduction of pulmonary volume is one of the most frequent complications of surgical treatment of pulmonary emphysema. In order to control bronchopleural fistulas in the patients after surgical reduction of pulmonary volume the technique of valve bronchial block has been o}ered. This technique has been applied in 7 patients, and the favorable outcomes have been achieved in 6 (85.7% patients. The use of endobronchial valve for occlusion of fistulous bronchi allowed stopping air leaking through drainages, reducing time for pleural cavity drain and decreasing duration of patients' hospital stay.

  16. [Good clinical practice in nebulization].

    Science.gov (United States)

    Dautzenberg, B; Fauroux, B; Bonfils, P; Diot, P; Faurisson, F

    1998-01-01

    A meeting on nebulization held in April 1997 defined good clinical practices. Guidelines that were proposed pertained to the following: pneumatic and ultrasonic nebulizers; delivering circuit, occluded or not, the choice of the tip being done according to the disease to treat and to the drugs to be delivered; various functions, depending on the type of nebulizer; the particle size, as it will indicate which disease may be treated: between 2 and 6 microns for bronchi, between 0.5 et 3 microns for lung, > 5 microns for ear, nose and throat diseases; compatibility between the type of nebulizer and drugs. Ten drugs are currently registered in France. Nebulization has multiple clinical indications, such as asthma, cystic fibrosis, chronic obstructive pulmonary disease, Pneumocystis carinii pneumonia, acute laryngitis, and in infants, acute bronchiolitis. The prescription must be detailed, and the physician should make sure that the medical staff put it into application.

  17. Congenital Giant Melanocytic Nevus with Malignant Melanoma of the Pleura: Do Primary Pleural Melanomas Exist?

    Directory of Open Access Journals (Sweden)

    Brijesh Sharma

    2017-09-01

    Full Text Available Cases of primary pleural and bronchial melanoma have been described in the literature in the absence of melanocytic cells in the pleura and bronchi. We described a case of congenital giant melanocytic nevus that had a presentation suggestive of primary pleural melanoma. However, biopsy of a chest wall lesion confirmed the presence of another melanoma deposit in a subcutaneous swelling concealed within the congenital giant melanocytic nevus. Histopathology with immunohistochemistry results showed that the pleural and chest wall swelling were similar. The difficult clinical detection of the primary tumor contributes to the fact that 24% of cases of congenital giant melanocytic nevus receive a diagnosis of metastatic melanoma without identification of the primary site. We propose that it is probable that the entity “primary pleural melanoma” may, in fact, not exist. Instead, all such reported tumors in the pleura may actually be metastatic from an unknown, regressed, or missed primary site.

  18. Monitoring the state of the human airways by analysis of respiratory sound

    Science.gov (United States)

    Hardin, J. C.; Patterson, J. L. Jr

    1979-01-01

    A mechanism whereby sound is generated by the motion of vortices in the human lung is described. This mechanism is believed to be responsible for most of the sound which is generated both on inspiration and expiration in normal lungs. Mathematical expressions for the frequencies of sound generated, which depend only upon the axial flow velocity and diameters of the bronchi, are derived. This theory allows the location within the bronchial tree from which particular sounds emanate to be determined. Redistribution of pulmonary blood volume following transition from Earth gravity to the weightless state probably alters the caliber of certain airways and doubtless alters sound transmission properties of the lung. We believe that these changes can be monitored effectively and non-invasively by spectral analysis of pulmonary sound.

  19. [Mucoepidermoid tracheo-bronchial tumors in adulthood. A series of 22 cases].

    Science.gov (United States)

    Abdennadher, M; Rivera, C; Gibault, L; Fabre, E; Pricopi, C; Arame, A; Foucault, C; Dujon, A; Le Pimpec Barthes, F; Riquet, M

    2015-02-01

    Mucoepidermoid tumours (TME) are rare tumours arising from the submucosal glands of the tracheobronchial tree. The majority of these tumours develop in a benign fashion but some of them are malignant. The latter can be easily mistaken for adenosquamous carcinomas. We have reviewed 22 patients suffering from TME observed over a period of 25 years. Two arose from the trachea and 20 from the cartilaginous bronchi; 12 of these tumours had macroscopic and histological criteria of low-grade malignancy, 4 had macroscopic and 6 macroscopic and microscopic criteria of high grade malignancy. Prognosis of the latter was very poor and no survival observed after 6 years follow-up, a behavior similar to that observed in non-small cell lung carcinomas and adenosquamous carcinomas. The best treatment of these orphan tumours remains surgery. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. MONTELUKAST IN TREATING ALLERGIC DISEASES

    Directory of Open Access Journals (Sweden)

    T.V. Kulichenko

    2006-01-01

    Full Text Available Anti inflammatory medications are the basis for pathogenetic treatment of allergic diseases. The review covers description of the most studied and efficient medication of leukotriene receptors' antagonist category montelukast. Specific and reversible antagonism to leukotriene receptors sets two most important effects of this medication: treatment of inflammatory process and influence tu muscular cells of bronchi. The article reviews in detail the possibility of applying montelukast in allergology as a basis therapy, peculiarities of its pharmacokinetics, pharmacodynamics and safety. Its advantages and disadvantages for monotherapy of bronchial asthma and allergic rhinitis are discussed, as well as the role of this category of medications in combined therapy of bronchial asthma and allergic rhinitis, and its influence to exercise induced bronchoconstriction.Key words: antagonists of leukotriene receptors, montelukast, bronchial asthma, allergic rhinitis, treatment, children.

  1. Estimated radiation doses to different organs among patients treated for ankylosing spondylitis with a single course of X rays

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, C.A.; Smith, P.G.; Stratton, I.M.; Darby, S.C.; Doll, R.

    1988-03-01

    A follow-up study of over 14000 patients treated with a single course of X rays for ankylosing spondylitis demonstrated substantial excess risk of developing cancer. Previously the excess risk of leukaemia has been related to the estimated mean radiation dose to active bone marrow but detailed estimates were not made of the radiation doses to other organs. Data extracted from the original treatment records of a random sample of one in 15 patients have been used to make dose estimates, using Monte Carlo methods, for 30 specific organs or body regions and 12 bone marrow sites. Estimates of mean and median organ doses, standard deviations and ranges have been tabulated. Detailed distributions are presented for six organs (lung, bronchi, stomach, oesophagus, active bone marrow and total body). Comparison with the earlier bone marrow estimates and more recent theoretical estimates shows good agreement.

  2. Progressing subglottic and tracheobronchial stenosis in a patient with CHARGE syndrome diagnosed in adulthood

    Directory of Open Access Journals (Sweden)

    Keiko Mitaka Komatsuzaki

    2014-01-01

    Full Text Available A 33-year-old woman was admitted for a pseudocroup-like cough and wheezing after general anesthesia. Several months ago, she had undergone cardiac re-operation and turbinectomy, both of which had involved difficult intubations. Bronchoscopy indicated a pin-hall-like subglottic stenosis; therefore, emergency tracheotomy was performed. Six years later, a computed tomography scan demonstrated progressive stenosis of the entire circumference of the trachea and main bronchi. She died at 40 years. Her autopsy revealed marked tracheobronchial stenosis. She had many medical histories that had gone undiagnosed and had been clinically ill with only heart defects. She did not have coloboma but had microphthalmos, atresia choanae, retarded growth development, and deafness; thus, we diagnosed CHARGE syndrome that refers to multiple congenital anomalies, including airway abnormalities, which can lead to secondary complications such as traumatic stenosis after intubation. Physicians should have knowledge of this rare disease and should pay special attention to potential airway problems.

  3. Treatment of Adult Primary Alveolar Proteinosis.

    Science.gov (United States)

    Rodríguez Portal, José Antonio

    2015-07-01

    Pulmonary alveolar proteinosis (PAP) is a rare disease characterized by the accumulation of surfactant-like lipoproteinaceous material in the distal air spaces and terminal bronchi, which may lead to impaired gas exchange. This accumulation of surfactant is due to decreased clearance by the alveolar macrophages. Its primary, most common form, is currently considered an autoimmune disease. Better knowledge of the causes of PAP have led to the emergence of alternatives to whole lung lavage, although this is still considered the treatment of choice. Most studies are case series, often with limited patient numbers, so the level of evidence is low. Since the severity of presentation and clinical course are variable, not all patients will require treatment. Due to the low level of evidence, some objective criteria based on expert opinion have been arbitrarily proposed in an attempt to define in which patients it is best to initiate treatment. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  4. Imaging findings of bronchial atresia in fetuses, neonates and infants

    Energy Technology Data Exchange (ETDEWEB)

    Alamo, Leonor; Meuli, Reto [University Hospital of Lausanne (CHUV) and University of Lausanne (UNIL), Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Vial, Yvan [University Hospital of Lausanne (CHUV) and University of Lausanne (UNIL), Department of Obstetrics and Gynecology, Lausanne (Switzerland); Gengler, Carole [University Hospital of Lausanne (CHUV) and University of Lausanne (UNIL), Department of Pathology, Lausanne (Switzerland)

    2016-03-15

    Congenital lung malformations are increasingly detected before birth. However, bronchial atresia is rarely identified in utero and not always recognized in neonates. There are two types of atresia: (1) proximal, located at the level of the mainstem or the proximal lobar bronchi, which is extremely rare and usually lethal during pregnancy, causing a tremendous volume increase of the distal involved lung with secondary hypoplasia of the normal lung, and (2) peripheral, located at the segmental/subsegmental bronchial level, which may present as an isolated lesion or as part of a complex congenital malformation. Prenatal findings are mostly nonspecific. Postnatal exams show overinflated lung areas and focal bronchial dilations. The typical fluid-filled bronchoceles are not always observed in neonates but develop progressively in the first months of life. This pictorial essay describes the spectrum of imaging findings of bronchial atresia in fetuses, neonates and infants. (orig.)

  5. Video-assisted thoracoscopic left lower lobectomy in a patient with lung cancer and a right aortic arch

    Directory of Open Access Journals (Sweden)

    Wada Hideyuki

    2012-11-01

    Full Text Available Abstract A right aortic arch is a rare congenital anomaly, with a reported incidence of around 0.1%. A patient with a right aortic arch underwent video-assisted thoracic surgery left lower lobectomy and mediastinal lymph node dissection for squamous cell carcinoma. There was no aortic arch or descending aorta in the left thoracic cavity, but the esophagus. There was no anomaly in the location or branching of the pulmonary vessels, the bronchi, and the lobulation of the lungs. The vagus nerve was found at the level of the left pulmonary artery. The arterial ligament was found between the left subclavian artery and the left pulmonary artery. The recurrent laryngeal nerve was recurrent around the left subclavian artery. A Kommerell diverticulum was found at the origin of the left subclavian artery. The patient experienced no complications. We conclude that video-assisted thoracoscopic lobectomy with mediastinal dissection is feasible for treating lung cancer with a right aortic arch.

  6. Anatomy of the lower respiratory tract in domestic birds, with emphasis on respiration.

    Science.gov (United States)

    Casteleyn, C; Cornillie, P; Van Cruchten, S; Van den Broeck, W; Van Ginneken, C; Simoens, P

    2017-12-17

    This manuscript describes the anatomy of the lower respiratory tract in domestic bird species including the chicken and pigeon. The here described anatomical structures play a major role avian respiration, which is fundamentally different from respiration in mammals. During inspiration and expiration, a continuous caudocranial airflow is present within the tertiary bronchi of the Paleopulmo, while the Neopulmo, which is only present in phylogenetically recent species, is characterized by tidal respiration. Various anatomical structures and aerodynamic mechanisms have been described in an attempt to explain the proposed mechanism of respiration. The air sac system that is essential for avian respiration usually comprises an unpaired clavicular air sac and paired cervical, cranial and caudal thoracic, and abdominal air sacs. The latter are by far the larger and are interwoven with the abdominal organs. © 2017 Blackwell Verlag GmbH.

  7. The pulmonary anatomy of Alligator mississippiensis and its similarity to the avian respiratory system.

    Science.gov (United States)

    Sanders, R Kent; Farmer, C G

    2012-04-01

    Using gross dissections and computed tomography we studied the lungs of juvenile American alligators (Alligator mississippiensis). Our findings indicate that both the external and internal morphology of the lungs is strikingly similar to the embryonic avian respiratory system (lungs + air sacs). We identified bronchi that we propose are homologous to the avian ventrobronchi (entobronchi), laterobronchi, dorsobronchi (ectobronchi), as well as regions of the lung hypothesized to be homologous to the cervical, interclavicular, anterior thoracic, posterior thoracic, and abdominal air sacs. Furthermore, we suggest that many of the features that alligators and birds share are homologous and that some of these features are important to the aerodynamic valve mechanism and are likely plesiomorphic for Archosauria. Copyright © 2012 Wiley Periodicals, Inc.

  8. Phylogenetic relationships of Spiruromorpha from birds of prey based on 18S rDNA.

    Science.gov (United States)

    Honisch, M; Krone, O

    2008-06-01

    A total of 153 free-ranging birds from Germany belonging to 15 species were examined for nematodes in their digestive and respiratory tracts. In 51.7% of the birds 14 different nematode species were found: the intestinal ascarids Porrocaecum depressum and P. angusticolle, the strongylid Hovorkonema variegatum, which inhabits the trachea and bronchi, the hairworms Eucoleus dispar and Capillaria tenuissima isolated from the digestive system, the spirurid nematodes Cyrnea leptoptera, C. mansioni, C. seurati, Microtetrameres cloacitectus, Physaloptera alata, P. apivori, Synhimantus hamatus and S. laticeps, which inhabit the proventriculus and gizzard of the raptors, and the spirurid nematode Serratospiculum tendo, which lives in the air sacs. To revise their systematic positions the ribosomal 18S gene regions of the nematode species were analysed and a phylogenetic tree was constructed. The molecular data confirmed the morphological systematics, except the spirurid family Physalopteridae, which grouped together with the Acuariidae.

  9. VALVULAR BRONCHIAL BLOCKING IN TREATMENT OF RELAPSING SPONTANEOUS PHEUMOTHORAX IN THE PATIENT WITH PARASEPTAL PULMONARY EMPHYSEMA

    Directory of Open Access Journals (Sweden)

    O. V. Lovacheva

    2014-01-01

    Full Text Available Spontaneous pneumothorax was treated by placing two endobronchial valves during rigid bronchoscopy under anesthesia in a patient with severe end-stage chronic obstructive pulmonary disease (an emphysematous phenotype and overall paraseptal emphysema in the presence of grade III respiratory failure, with complicated spontaneous pneumothorax recurring manifold even after surgical treatment for spontaneous pneumothorax. This gave rise to the expansion of the lung that had collapsed within 18 months, to healing of bronchopleural fistula, and to return to normal life.The duration of a follow-up was 1 year with the valves being present in the bronchi and another year after their removal; there was no recurrence of spontaneous pneumothorax. Examination of respiratory function established significant positive changes (forced expiratory volume, vital capacity, and forced vital capacity after one year, then after removal of endobronchial valves. There were more significant positive changes in blood gas composition: normalization of blood oxygen saturation was achieved. 

  10. AcEST: BP919061 [AcEST

    Lifescience Database Archive (English)

    Full Text Available ike B1 OS=Arabidopsis thaliana G... 31 3.1 sp|P05136|VME1_IBV6 Membrane protein OS=Avian infectious bronchi....ous bronch... 30 6.8 sp|P69601|VME1_IBVB Membrane protein OS=Avian infectious bronc...VKTC 595 >sp|P69602|VME1_IBVBC Membrane protein OS=Avian infectious bronchitis virus (strain Beaudette CK) G...5.2 sp|P00533|EGFR_HUMAN Epidermal growth factor receptor OS=Homo sa... 30 5.2 sp|P69602|VME1_IBVBC Membrane protein OS=Avian infecti...ctious bronchitis virus (strain 6/82) GN=M PE=3 SV=1 Len

  11. AcEST: DK957378 [AcEST

    Lifescience Database Archive (English)

    Full Text Available mbrane protein OS=Avian infectious bronchi... 31 6.0 sp|P69607|VME1_IBVH5 Membrane protein OS=Avian infectious... bronch... 31 6.0 sp|P69604|VME1_IBVH1 Membrane protein OS=Avian infectious bronch... 31 6.0 sp|Q9J3N8|VME...1_IBVDE Membrane protein OS=Avian infectious bronch... 31 6.0 sp|P69603|VME1_IBVD1 Membrane protein OS=Avian infectious... bronch... 31 6.0 sp|Q91QS9|VME1_IBVBU Membrane protein OS=Avian infectious... bronch... 31 6.0 sp|P69602|VME1_IBVBC Membrane protein OS=Avian infectious bronch... 31 6.0 sp|P11222|

  12. Should antihistamines be re-considered as antiasthmatic drugs as adjuvants to anti-leukotrienes?

    Science.gov (United States)

    Bartho, Lorand; Benko, Rita

    2013-02-15

    In spite of histamine mimicking the symptoms of allergic bronchoconstriction and severe anaphylaxis, histamine antagonists most probably represent no effective treatment for these conditions. Anti-leukotrienes proved effective for preventing attacks of allergic asthma. In vitro evidence supports a supra-additive effect of histamine H1 receptor antagonists and anti-leukotrienes in vitro, in asthma models utilizing human bronchi. The same seems to hold true for human allergen provocation tests in vivo. We conclude that combinations of second-generation antihistamines and anti-leukotrienes deserve a large-scale clinical trial for preventing and/or treating attacks of allergic asthma. If useful, these drugs could provide a cost-effective alternative to some recent antiasthmatics. Given that redundant mechanisms may be included in asthma pathophysiology, other combinations (including thromboxane or platelet activating factor antagonists) could also be considered. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Aerosol deposition in the human respiratory tract. I. Experimental procedure and total deposition

    Energy Technology Data Exchange (ETDEWEB)

    Altshuler, B.; Yarmus, L.; Palmes, E.D.; Nelson, N.

    1957-01-01

    Three volunteers were exposed via mouth inhalation to triphenyl phosphate (non-hygroscopic). Particle sizes tested ranged from 0.14 to 3.2 ..mu..m (6 homogenous steps). Deposition curves show minimum retention of 0.4 ..mu..m particle size. Brownian motion (random impact with gas) varies by d/sup -//sup 1/2; settling effect and impact effect vary by d/sup 2/ so minimum deposition is where these three processes counteract each other. Slower, deeper breathing resulted in greater deposition; differences were greater with larger particles, because settling and impaction vary with first power of time and Brownian varies with square root of time. Pneumoconiosis-producing dusts act on deep pulmonary tissues whereas major cancer producers act on the bronchi.

  14. Pistachio nutshell foreign body of the oral cavity in two children.

    Science.gov (United States)

    Sobol, Steven E; Jacobs, Ian N; Levin, Lawrence; Wetmore, Ralph F

    2004-08-01

    Pistachio nutshell foreign bodies have been documented in the literature, occurring most commonly in the bronchi. The objective of this study is to report on two cases of oral cavity lesions, which were subsequently found to be pistachio nutshell foreign bodies. The first patient is a 9-month-old male who presented with a hard palate mass measuring 1.5 cm. The patient was evaluated in the operating room, and found to have a submucosal pistachio nutshell foreign body. The second patient is a 17-month-old female who presented with a firm, fixed midline hard palate mass. The lesion was subsequently noted to dislodge from the palate, and was identified as a pistachio nutshell.

  15. Idiopathic bronchocentric granulomatosis in an asthmatic adolescent

    Directory of Open Access Journals (Sweden)

    Hiroki Umezawa

    2015-01-01

    Full Text Available Bronchocentric granulomatosis in asthmatic patients has been generally considered to be associated with allergic bronchopulmonary aspergillosis and represent a histopathologic manifestation of fungal hypersensitivity. Here we report a case of an idiopathic bronchocentric granulomatosis in a 17-year-old man with a history of asthma. He was admitted to the hospital with a fever and cough, and a chest CT scan showed peribronchial consolidation in the pulmonary parenchyma, which was unresponsive to antibiotic therapy. The pathological findings obtained by video-assisted thoracoscopic lung biopsy revealed necrotizing granulomatous inflammation centered on bronchi and bronchioles and there was no evidence of fungal colonization, resulting in a diagnosis of idiopathic bronchocentric granulomatosis. Systemic corticosteroid therapy led to clinical and radiological recovery. Physicians should take into account the possibility of the idiopathic process in bronchocentric granulomatosis of asthmatic patients.

  16. Cellular senescence in normal and premature lung aging.

    Science.gov (United States)

    Bartling, B

    2013-10-01

    The incidence of chronic respiratory diseases (e.g., chronic obstructive pulmonary disease, COPD) and interstitial lung diseases (e.g., pneumonia and lung fibrosis) increases with age. In addition to immune senescence, the accumulation of senescent cells directly in lung tissue might play a critical role in the increased prevalence of these pulmonary diseases. In the last couple of years, detailed studies have identified the presence of senescent cells in the aging lung and in diseased lungs of patients with COPD and lung fibrosis. Cellular senescence has been shown for epithelial cells of bronchi and alveoli as well as mesenchymal and vascular cells. Known risk factors for pulmonary diseases (cigarette smoke, air pollutions, bacterial infections, etc.) were identified in experimental studies as being possible mediators in the development of cellular senescence. The present findings indicate the importance of cellular senescence in normal lung aging and in premature aging of the lung in patients with COPD, lung fibrosis, and probably other respiratory diseases.

  17. Evaluation of health factors in high-rise buildings. 2. Bioclimatological consequences resulting from comparative measurements of the air ionisation in a high-rise building located in a heavily contaminated suburban area and at certain altitudes

    Energy Technology Data Exchange (ETDEWEB)

    M' ose, J.R.; Fischer, G.

    1981-01-01

    According to accepted scientific theories inhaled small ions deliver their charges in the pulmonary alveoli and this leads to local recharges. This process stimulates structures of the central nervous system and the activity of the endocrine is excited, resulting in an enhancement of the general well-being. In urban settings, it appears that large ions may be more prevalent and, therefore, are inhaled an increasing extent. They stick to the epithelia in the trachea and in the bronchi as well as the endothelia in the lung vesicles. The number of the ciliary movements in reduced. This results in a decreased ability of expectoration and a lower intake of oxygen by the alveoli. These facts could furnish an explanation for the increased vulnerability of city dwellers to infections diseases. The study also examines the effects of living in a high-rise building with respect to the different microclimates that may exist at different altitudes.

  18. Sites of replication of bovine respiratory syncytial virus in naturally infected calves as determined by in situ hybridization

    DEFF Research Database (Denmark)

    Viuff, B.; Uttenthal, Åse; Tegtmeier, C.

    1996-01-01

    Replication of bovine respiratory syncytial virus (BRSV) was studied in three naturally infected calves by in situ hybridization using strand-specific RNA probes. One of the calves was a 5-month-old Friesian, the other two calves were a 3-month-old and a 2-week-old Jersey. Two Jersey calves, 3...... months and 3 weeks of age, served as controls. Replication of BRSV took place in the luminal lining of the respiratory tract. In one of the BRSV infected animals (calf No. 1), replication was especially seen in the bronchi, whereas in the two other animals (calf Nos. 2 and 3) replication of BRSV...... was detected. In tissue outside the respiratory tract neither BRSV antigen nor replication of BRSV could be demonstrated....

  19. Different Cell Types In the Lower Respiratory Tract of the Reindeer (Rangifer tarandus tarandus L. - A Transmission Electron Microscopical Study

    Directory of Open Access Journals (Sweden)

    Seppo A.m. Saari

    1997-02-01

    Full Text Available The epithelium of the trachea and distal airways of 12 healthy adult reindeer were studied with transmission electron microscopy. The ultrastructure of the reindeer respiratory tract corresponded to the findings of previous investigators studying other mammalian species. The epithelium of the trachea and bronchi, down to the level of the distal bronchioli, was composed of three main types of cell: ciliated, goblet, and basal. In the distal brochioli, non-ciliated cells similar to those known as Clara cells were predominant. Numerous electron-dense granules and the cell organelle pattern resembled the Clara cell type observed in laboratory rodents, rabbit, sheep, pig, horse, and llama. Pneumocyte 1 and pneumocyte 2 cells were readily identified in the alveoli. The pneumocyte 2 cells possessed short microvilli and granules with lamellar content. Micropinocytotic vesicles were very numerous in the alveolar wall, and a small number of alveolar macrophages occasionally seen in the alveolar lumen.

  20. Mechanisms of avian songs and calls

    DEFF Research Database (Denmark)

    Larsen, Ole Næsbye

    2008-01-01

    -filming during sound production has revealed that sound pulses coincide with short duration formation of slots between the soft tissue masses forming a pneumatic valve, which suggests that the avian sound generating mechanism is a similar to that in the human larynx. Lately studies have revealed surprising......The avian vocal organ, the syrinx, is a specialized structure located rather inaccessibly in an air sac close to the heart where the trachea bifurcates into the two primary bronchi. The syrinx of different avian taxa varies so much in position and morphology that it has been used for taxonomy....... It consists of a skeletal framework, flexible membranes or soft tissue masses, labia, stretched between elements of this framework, and the syringeal muscles. Until a decade ago most of our knowledge about syringeal mechanics was based on such indirect evidence as electromyography, emitted sound, and anatomy...

  1. Bronchus-associated lymphoid tissue (BALT) and larynx-associated lymphoid tissue (LALT) are found at different frequencies in children, adolescents and adults.

    Science.gov (United States)

    Hiller, A S; Tschernig, T; Kleemann, W J; Pabst, R

    1998-02-01

    The lung in 98 and the larynx in 51 consecutive autopsies (age: 17th gestational week to 99 years) were studied for the presence of organized lymphoid tissue in the epiglottis and in the wall of larger bronchi. Bronchus-associated lymphoid tissue (BALT) was seen in about 40% of patients younger than 20 years of age but in older patients only in exceptional cases. In the wall of the epiglottis, however, larynx-associated lymphoid tissue (LALT) was found at a frequency of approximately 80% in patients younger than 20 years and in 56% of the patients older than 20 years. The clinical relevance of LALT as a physiological entry site for antigens or for vaccination protocols using aerosols needs to be studied in further experiments.

  2. Chronic Pulmonary Aspergillosis Complicating Bronchial Atresia

    Directory of Open Access Journals (Sweden)

    Mazen O. Al-Qadi

    2014-01-01

    Full Text Available Bronchial atresia is a rare pulmonary developmental anomaly characterized by the presence of a focal obliteration of a segmental or lobar bronchial lumen. The lung distal to the atretic bronchus is typically emphysematous along with the presence of mucus filled ectatic bronchi (mucoceles. BA is usually asymptomatic but pulmonary infections can rarely develop in the emphysematous lung distal to the atretic bronchus. We present a unique case of chronic pulmonary aspergillosis (CPA in a patient with BA with no evidence of immune dysfunction. The patient was treated initially with voriconazole and subsequently underwent surgical excision of the involved area. On follow-up, she has done extremely well with no evidence for recurrence. In summary, we describe the first case of chronic pulmonary aspergillosis in an immunocompetent patient with bronchial atresia.

  3. Local Delivery of Antiproliferative Agents via Stents

    Directory of Open Access Journals (Sweden)

    Hyuck Joon Kwon

    2014-03-01

    Full Text Available A stent is a medical device for serving as an internal scaffold to maintain or increase the lumen of a body conduit. Stent placement has become a primary treatment option in coronary artery disease for more than the last two decades. The stenting is also currently used for relieving the symptoms of narrowed lumen of nonvascular organs, such as esophagus, trachea and bronchi, small and large intestines, biliary, and urinary tract. Local delivery of active pharmaceutical agents via the stents can not only enhance healing of certain diseases, but it can also help decrease the potential risk of the stenting procedure to the surrounding tissue. In this review, we focus on reviewing a variety of drug-impregnated stents and local drug delivery systems using the stents.

  4. Lungworm infection in three loggerhead sea turtles, Caretta caretta.

    Science.gov (United States)

    Manire, Charles A; Kinsel, Michael J; Anderson, Eric T; Clauss, Tonya M; Byrd, Lynne

    2008-03-01

    Although lungworms are known to infect many mammalian species and a few are known to infect snakes, lizards, and birds, previously none were known to infect chelonians. This study documents the first three known cases of lungworms in loggerhead sea turtles, Caretta caretta. It is unlikely that the lungworms were the primary cause of illness in any of the cases, and they may be only contributory or even incidental. Changes observed in the two cases that died included tracheal and bronchial epithelial hyperplasia and goblet cell hyperplasia. Lesions caused directly by the parasites seem to be restricted to the upper respiratory tree (trachea and main bronchi), but changes in the lungs themselves may be caused by the debris produced by the worms. Although neither case was successfully treated for the lungworms prior to death, it would appear that oxfendazole may be an effective treatment and has been used in the third case that is still undergoing rehabilitation.

  5. Quantitative functional lung imaging with synchrotron radiation using inhaled xenon as contrast agent

    Energy Technology Data Exchange (ETDEWEB)

    Bayat, S. [TIMC-PRETA, UMR CNRS 5525, Laboratoire de Physiologie, Universite Joseph Fourier, Faculte de Medecine, Domaine de la Merci, Grenoble (France)]. E-mail: sam.bayat@imag.fr; Le Duc, G.; Berruyer, G.; Nemoz, C.; Monfraix, S.; Fiedler, S.; Thomlinson, W. [European Synchrotron Radiation Facility, BP 220, Grenoble (France); Porra, L.; Suortti, P. [Department of Physics, University of Helsinki, Helsinki (Finland); Standertskjoeld-Nordenstam, C.G. [Department of Radiology, University of Helsinki Central Hospital, Helsinki (Finland); Sovijaervi, A.R.A. [Department of Clinical Physiology and Nuclear Medicine, Helsinki University Central Hospital, Helsinki (Finland)

    2001-12-01

    Small airways play a key role in the distribution of ventilation and in the matching of ventilation to perfusion. The purpose of this study was to introduce an imaging method that allows measurement of regional lung ventilation and evaluation of the function of airways with a small diameter. The experiments were performed at the Medical Beamline of the European Synchrotron Radiation Facility. Monochromatic synchrotron radiation beams were used to obtain quantitative respiration-gated images of lungs and airways in two anaesthetized and mechanically ventilated rabbits using inhaled stable xenon (Xe) gas as a contrast agent. Two simultaneous images were acquired at two different energies, above and below the K-edge of Xe. Logarithmic subtraction of the two images yields absolute Xe concentrations. This technique is known as K-edge subtraction (KES) radiography. Two-dimensional planar and CT images were obtained showing spatial distribution of Xe concentrations within the airspaces, as well as the dynamics of filling with Xe. Bronchi down to 1 mm in diameter were visible both in the subtraction radiographs and in tomographic images. Absolute concentrations of Xe gas were calculated within the tube carrying the inhaled gas mixture, small and large bronchi, and lung tissue. Local time constants of ventilation with Xe were obtained by following the evolution of gas concentration in sequential computed tomography images. The results of this first animal study indicate that KES imaging of lungs with Xe gas as a contrast agent has great potential in studies of the distribution of ventilation within the lungs and of airway function, including airways with a small diameter. (author)

  6. Image quality of mixed convolution kernel in thoracic computed tomography

    Science.gov (United States)

    Neubauer, Jakob; Spira, Eva Maria; Strube, Juliane; Langer, Mathias; Voss, Christian; Kotter, Elmar

    2016-01-01

    Abstract The mixed convolution kernel alters his properties geographically according to the depicted organ structure, especially for the lung. Therefore, we compared the image quality of the mixed convolution kernel to standard soft and hard kernel reconstructions for different organ structures in thoracic computed tomography (CT) images. Our Ethics Committee approved this prospective study. In total, 31 patients who underwent contrast-enhanced thoracic CT studies were included after informed consent. Axial reconstructions were performed with hard, soft, and mixed convolution kernel. Three independent and blinded observers rated the image quality according to the European Guidelines for Quality Criteria of Thoracic CT for 13 organ structures. The observers rated the depiction of the structures in all reconstructions on a 5-point Likert scale. Statistical analysis was performed with the Friedman Test and post hoc analysis with the Wilcoxon rank-sum test. Compared to the soft convolution kernel, the mixed convolution kernel was rated with a higher image quality for lung parenchyma, segmental bronchi, and the border between the pleura and the thoracic wall (P < 0.03). Compared to the hard convolution kernel, the mixed convolution kernel was rated with a higher image quality for aorta, anterior mediastinal structures, paratracheal soft tissue, hilar lymph nodes, esophagus, pleuromediastinal border, large and medium sized pulmonary vessels and abdomen (P < 0.004) but a lower image quality for trachea, segmental bronchi, lung parenchyma, and skeleton (P < 0.001). The mixed convolution kernel cannot fully substitute the standard CT reconstructions. Hard and soft convolution kernel reconstructions still seem to be mandatory for thoracic CT. PMID:27858910

  7. Iterative reconstruction technique vs filter back projection: utility for quantitative bronchial assessment on low-dose thin-section MDCT in patients with/without chronic obstructive pulmonary disease

    Energy Technology Data Exchange (ETDEWEB)

    Koyama, Hisanobu; Seki, Shinichiro; Sugimura, Kazuro [Kobe University Graduate School of Medicine, Division of Radiology, Department of Radiology, Kobe, Hyogo (Japan); Ohno, Yoshiharu; Nishio, Mizuho; Matsumoto, Sumiaki; Yoshikawa, Takeshi [Kobe University Graduate School of Medicine, Advanced Biomedical Imaging Research Centre, Kobe (Japan); Kobe University Graduate School of Medicine, Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe (Japan); Sugihara, Naoki [Toshiba Medical Systems Corporation, Ohtawara, Tochigi (Japan)

    2014-08-15

    The aim of this study was to evaluate the utility of the iterative reconstruction (IR) technique for quantitative bronchial assessment during low-dose computed tomography (CT) as a substitute for standard-dose CT in patients with/without chronic obstructive pulmonary disease. Fifty patients (mean age, 69.2; mean % predicted FEV1, 79.4) underwent standard-dose CT (150mAs) and low-dose CT (25mAs). Except for tube current, the imaging parameters were identical for both protocols. Standard-dose CT was reconstructed using filtered back-projection (FBP), and low-dose CT was reconstructed using IR and FBP. For quantitative bronchial assessment, the wall area percentage (WA%) of the sub-segmental bronchi and the airway luminal volume percentage (LV%) from the main bronchus to the peripheral bronchi were acquired in each dataset. The correlation and agreement of WA% and LV% between standard-dose CT and both low-dose CTs were statistically evaluated. WA% and LV% between standard-dose CT and both low-dose CTs were significant correlated (r > 0.77, p < 0.00001); however, only the LV% agreement between SD-CT and low-dose CT reconstructed with IR was moderate (concordance correlation coefficient = 0.93); the other agreement was poor (concordance correlation coefficient <0.90). Quantitative bronchial assessment via low-dose CT has potential as a substitute for standard-dose CT by using IR and airway luminal volumetry techniques. circle Quantitative bronchial assessment of COPD using low-dose CT is possible. (orig.)

  8. Multi-slice computed tomography assessment of bronchial compression with absent pulmonary valve

    Energy Technology Data Exchange (ETDEWEB)

    Zhong, Yu-Min; Sun, Ai-Min; Wang, Qian; Zhu, Ming; Qiu, Hai-Sheng [Shanghai Children' s Medical Center and Shanghai Jiao Tong University Medical School, Department of Radiology, Shanghai (China); Jaffe, Richard B. [Primary Children' s Medical Center, Department of Medical Imaging, Salt Lake City, UT (United States); Liu, Jin-Fen [Shanghai Children' s Medical Center, Department of Cardiothoracic Surgery, Shanghai (China); Gao, Wei [Shanghai Children' s Medical Center and Shanghai Jiao Tong University Medical School, Department of Cardiology, Shanghai (China); Berdon, Walter E. [Children' s Hospital of New York, Department of Radiology, New York, NY (United States)

    2014-07-15

    Absent pulmonary valve is a rare cardiovascular anomaly that can result in profound tracheobronchial compression. To demonstrate the advantage of multi-slice CT in diagnosing tracheobronchial compression, its severity as related to the adjacent dilated pulmonary arteries, and associated lung and cardiac lesions. We included children with absent pulmonary valve who were reviewed by multi-slice CT during a 17-year period. The number and locations of stenoses and lung lesions were noted and the severity of stenosis was categorized. The diameter of the pulmonary artery was measured and associated cardiac defects were demonstrated. Thirty-one children (14 girls and 17 boys) were included. Of these, 29 had ventricular septal defect and 2 had an intact ventricular septum. Twenty-nine children (94%) had tracheobronchial compression, judged to be mild in nine children (31%), moderate in 10 (34%) and severe in 10 (34%). The different locations of the stenosis (carina, main bronchi, lobar and segmental bronchi) were observed. And the number and location of lung lesions demonstrated that the right middle and left upper and lower lobes were often affected. The diameter of the pulmonary artery in these children was well above normal published values, and Spearman rank correlation analysis showed a correlation between the size of the pulmonary artery and the severity of the tracheobronchial stenosis. Nineteen children (61%) underwent surgery and 4 of these children had a multi-slice CT post-operative follow-up study. Absent pulmonary valve can cause significant morbidity and mortality in children. Multi-slice CT can accurately depict areas of tracheobronchial compression, associated lung lesions and cardiac defects, helping to direct the surgeon. (orig.)

  9. A confocal microscopic study of solitary pulmonary neuroendocrine cells in human airway epithelium

    Directory of Open Access Journals (Sweden)

    Sparrow Malcolm P

    2005-10-01

    Full Text Available Abstract Background Pulmonary neuroendocrine cells (PNEC are specialized epithelial cells that are thought to play important roles in lung development and airway function. PNEC occur either singly or in clusters called neuroepithelial bodies. Our aim was to characterize the three dimensional morphology of PNEC, their distribution, and their relationship to the epithelial nerves in whole mounts of adult human bronchi using confocal microscopy. Methods Bronchi were resected from non-diseased portions of a lobe of human lung obtained from 8 thoracotomy patients (Table 1 undergoing surgery for the removal of lung tumors. Whole mounts were stained with antibodies to reveal all nerves (PGP 9.5, sensory nerves (calcitonin gene related peptide, CGRP, and PNEC (PGP 9.5, CGRP and gastrin releasing peptide, GRP. The analysis and rendition of the resulting three-dimensional data sets, including side-projections, was performed using NIH-Image software. Images were colorized and super-imposed using Adobe Photoshop. Results PNEC were abundant but not homogenously distributed within the epithelium, with densities ranging from 65/mm2 to denser patches of 250/mm2, depending on the individual wholemount. Rotation of 3-D images revealed a complex morphology; flask-like with the cell body near the basement membrane and a thick stem extending to the lumen. Long processes issued laterally from its base, some lumenal and others with feet-like processes. Calcitonin gene-related peptide (CGRP was present in about 20% of PNEC, mainly in the processes. CGRP-positive nerves were sparse, with some associated with the apical part of the PNEC. Conclusion Our 3D-data demonstrates that PNEC are numerous and exhibit a heterogeneous peptide content suggesting an active and diverse PNEC population.

  10. Divergent expression of claudin -1, -3, -4, -5 and -7 in developing human lung

    Directory of Open Access Journals (Sweden)

    Lehtonen Siri

    2010-05-01

    Full Text Available Abstract Background Claudins are the main components of tight junctions, structures which are associated with cell polarity and permeability. The aim of this study was to analyze the expression of claudins 1, 3, 4, 5, and 7 in developing human lung tissues from 12 to 40 weeks of gestation. Methods 47 cases were analyzed by immunohistochemisty for claudins 1, 3, 4, 5 and 7. 23 cases were also investigated by quantitative RT-PCR for claudin-1, -3 and -4. Results Claudin-1 was expressed in epithelium of bronchi and large bronchioles from week 12 onwards but it was not detected in epithelium of developing alveoli. Claudin-3, -4 and -7 were strongly expressed in bronchial epithelium from week 12 to week 40, and they were also expressed in alveoli from week 16 to week 40. Claudin-5 was expressed strongly during all periods in endothelial cells. It was expressed also in epithelium of bronchi from week 12 to week 40, and in alveoli during the canalicular period. RT-PCR analyses revealed detectable amounts of RNAs for claudins 1, 3 and 4 in all cases studied. Conclusion Claudin-1, -3, -4, -5, and -7 are expressed in developing human lung from week 12 to week 40 with distinct locations and in divergent quantities. The expression of claudin-1 was restricted to the bronchial epithelium, whereas claudin-3, -4 and -7 were positive also in alveolar epithelium as well as in the bronchial epithelium. All claudins studied are linked to the development of airways, whereas claudin-3, -4, -5 and -7, but not claudin-1, are involved in the development of acinus and the differentiation of alveolar epithelial cells.

  11. Towards the modeling of mucus draining from human lung: role of airways deformation on air-mucus interaction.

    Directory of Open Access Journals (Sweden)

    Benjamin eMauroy

    2015-08-01

    Full Text Available Chest physiotherapy is an empirical technique used to help secretions to get out of the lung whenever stagnation occurs. Although commonly used, little is known about the inner mechanisms of chest physiotherapy and controversies about its use are coming out regularly. Thus, a scientific validation of chest physiotherapy is needed to evaluate its effects on secretions.We setup a quasi-static numerical model of chest physiotherapy based on thorax and lung physiology and on their respective biophysics. We modeled the lung with an idealized deformable symmetric bifurcating tree. Bronchi and their inner fluids mechanics are assumed axisymmetric. Static data from the literature is used to build a model for the lung's mechanics. Secretions motion is the consequence of the shear constraints apply by the air flow. The input of the model is the pressure on the chest wall at each time, and the output is the bronchi geometry and air and secretions properties. In the limit of our model, we mimicked manual and mechanical chest physiotherapy techniques. We show that for secretions to move, air flow has to be high enough to overcome secretion resistance to motion. Moreover, the higher the pressure or the quicker it is applied, the higher is the air flow and thus the mobilization of secretions. However, pressures too high are efficient up to a point where airways compressions prevents air flow to increase any further. Generally, the first effects of manipulations is a decrease of the airway tree hydrodynamic resistance, thus improving ventilation even if secretions do not get out of the lungs. Also, some secretions might be pushed deeper into the lungs; this effect is stronger for high pressures and for mechanical chest physiotherapy. Finally, we propose and tested two adimensional numbers that depend on lung properties and that allow to measure the efficiency and comfort of a manipulation.

  12. Response of the adrenergic system after provoked bronchoconstriction in patients with bronchial asthma.

    Science.gov (United States)

    Islami, Hilmi; Ilazi, Ali; Gashi, Nijazi; Mustafa, Lirim; Maloku, Halit; Jashanica, Adelina

    2014-04-01

    In this paper, effect of the Tolazoline as antagonist of the alpha-2 adrenergic receptors in patients with bronchial asthma and chronic obstructive bronchitis was studied, and also the effect of stimulation with Hexoprenaline of beta-2 adrenergic receptor after bronchi-constriction caused with Propranolol, and Acetylcholine. Lung function parameters are determined with Body plethysmography. In patients with bronchial asthma and chronic obstructive bronchitis was registered resistance (Raw), was determined the amount of intrathoracic gas volume (ITGV), and specific resistance was calculated as well (SRaw). Aerosolization was done with standard aerosolizing machine-Asema. The study included a total of 21 patients. Two hours after the inhalation of Propranolol, in experimental group, it was applied the blocker of alpha-2 adrenergic receptors (Tolazoline 20 mg / ml with inhalator ways), which did not cause changes in bronchomotor tonus of tracheobronchial system (p > 1.0). Meanwhile, at the same patient, stimulation of beta-2 adrenergic receptor with Hexoprenaline (2 inh x 0.2 mg) is associated with a significant decrease of the specific resistance of airways (SRaw, p < 0.01). Control group results show that after bronchi-constriction caused by Propranolol-aerosol (20 mg / ml) in patients with bronchial asthma and chronic obstructive bronchitis, an increase of specific resistance in airways was caused (SRaw, p < 0.01), which confirms the presence of hyper-reactive bronco-constrictor effects intermediated by vagal ways. Two hours after Propranolol, inhaled Hexorenaline has blocked the action of Propranolol, but not entirely. Furthermore, two hours after acetylcholine-aerosol (1 mg /ml) was applied, inhaled Ipratropium (2 inh x 1 mg) has fully blocked the action of chemical bronchoconstrictor mediators, causing a decline of specific resistance in the airways (SRaw; p < 0.01). This suggests that primary mechanism, which would cause reaction in patients with increased

  13. Relationship of airway dimensions with airflow limitation or lung volumes in chronic obstructive pulmonary disease (COPD

    Directory of Open Access Journals (Sweden)

    Masaru Hasegawa

    2006-12-01

    Full Text Available We have recently developed new software to obtain longitudinal images and accurate short axis images of airways with an inner diameter > 2 mm located anywhere in the lung, using curved multiplanar reconstruction. Using this software, we demonstrated in patients with COPD that FEV1 (%predicted was highly correlated with airway dimensions and the correlation coefficients improved as the airway became smaller in size (3. In this study, our aims are to further confirm the significant relationship between airway dimensions and airflow limitation in larger number of subjects, and to examine the relationship of airway dimensions with lung volumes in 95 patients with COPD (stage 0, 10; stage I, 23; stage II, 35; stage III, 24; stage IV, 3. We analyzed the airway dimensions from the 3rd to the 6th generations of the apical bronchus (B1 of the right upper lobe and the anterior basal bronchus (B8 of the right lower lobe. Lung volumes were measured by the helium closed circuit method. Both airway luminal area (Ai and wall area percent (WA% of all the generations, except a few, from the two bronchi were significantly correlated with RV and RV/TLC, but not with TLC or FRC. More importantly, the correlation coefficients (r between airway dimensions and RV/TLC improved as the airways became smaller in size from the 3rd to 6th generations in both bronchi (r = –0.483, –0482, –0.553, –0.624 for Ai of B8; r = 0.316, 0.380, 0.499, 0.551 for WA% of B8. These findings provide further evidence that distal (small airways rather than proximal (large airways are the determinants for airflow limitation in COPD.

  14. Long-term effects of mustard gas on respiratory system of Iranian veterans after Iraq-Iran war: a review

    Directory of Open Access Journals (Sweden)

    Razavi Seyed Mansour

    2013-06-01

    Full Text Available 【Abstract】To review long-term respiratory effects of mustard gas on Iranian veterans having undergone Iraq-Iran war. Electronic databases of Scopus, Medline, ISI, IranMedex, and Irandoc sites were searched. We accepted articles published in scientific journals as a quality criterion. The main pathogenic factors are free radical mediators. Preva-lence of pulmonary involvement is approximately 42.5%. The most common complaints are cough and dyspnea. Major respiratory complications are chronic obstructive pulmo-nary disease, bronchiectasis, and asthma. Spirometry re-sults can reveal restrictive and obstructive pulmonary disease. Plain chest X-ray does not help in about 50% of lung diseases. High-resolution CT of the lung is the best modality for diagnostic assessment of parenchymal lung and bronchi. There is no definite curative treatment for mus-tard lung. The effective treatment regimens consist of oxy-gen administration, use of vaporized moist air, respiratory physiotherapy, administration of mucolytic agents, bronchodilators, corticosteroids, and long-acting beta-2 agonists, antioxidants, surfactant, magnesium ions, thera-peutic bronchoscopy, laser therapy, placement of respira-tory stents, early tracheostomy in laryngospasm, and ulti-mately lung transplantation. High-resolution CT of the lung is the most accurate modality for the evaluation of the lung parenchyma and bronchi. The treatment efficacy of patients exposed to mustard gas depends on patient conditions (acute or chronic, upper or lower respiratory tract involvement. There are various treatment protocols, but unfortunately none of them is definitely curable. Key words: Lung injury; Chemical warfare; Mustard gas

  15. Influenza A (H10N7 Virus Causes Respiratory Tract Disease in Harbor Seals and Ferrets.

    Directory of Open Access Journals (Sweden)

    Judith M A van den Brand

    Full Text Available Avian influenza viruses sporadically cross the species barrier to mammals, including humans, in which they may cause epidemic disease. Recently such an epidemic occurred due to the emergence of avian influenza virus of the subtype H10N7 (Seal/H10N7 in harbor seals (Phoca vitulina. This epidemic caused high mortality in seals along the north-west coast of Europe and represented a potential risk for human health. To characterize the spectrum of lesions and to identify the target cells and viral distribution, findings in 16 harbor seals spontaneously infected with Seal/H10N7 are described. The seals had respiratory tract inflammation extending from the nasal cavity to bronchi associated with intralesional virus antigen in respiratory epithelial cells. Virus infection was restricted to the respiratory tract. The fatal outcome of the viral infection in seals was most likely caused by secondary bacterial infections. To investigate the pathogenic potential of H10N7 infection for humans, we inoculated the seal virus intratracheally into six ferrets and performed pathological and virological analyses at 3 and 7 days post inoculation. These experimentally inoculated ferrets displayed mild clinical signs, virus excretion from the pharynx and respiratory tract inflammation extending from bronchi to alveoli that was associated with virus antigen expression exclusively in the respiratory epithelium. Virus was isolated only from the respiratory tract. In conclusion, Seal/H10N7 infection in naturally infected harbor seals and experimentally infected ferrets shows that respiratory epithelial cells are the permissive cells for viral replication. Fatal outcome in seals was caused by secondary bacterial pneumonia similar to that in fatal human cases during influenza pandemics. Productive infection of ferrets indicates that seal/H10N7 may possess a zoonotic potential. This outbreak of LPAI from wild birds to seals demonstrates the risk of such occasions for mammals

  16. Morphogenesis and morphometric scaling of lung airway development follows phylogeny in chicken, quail, and duck embryos

    Directory of Open Access Journals (Sweden)

    Daniel Tzou

    2016-05-01

    Full Text Available Abstract Background New branches within the embryonic chicken lung form via apical constriction, in which epithelial cells in the primary bronchus become trapezoidal in shape. These branches form at precise locations along the primary bronchus that scale relative to the size of the organ. Here, we examined the extent to which this scaling relationship and branching mechanism are conserved within lungs of three species of birds. Findings Analyzing the development of embryonic lungs from chicken, quail, and duck, as well as lungs explanted and cultured ex vivo, revealed that the patterns of branching are remarkably conserved. In particular, secondary bronchi form at identical positions in chicken and quail, the patterns of which are indistinguishable, consistent with the close evolutionary relationship of these two species. In contrast, secondary bronchi form at slightly different positions in duck, the lungs of which are significantly larger than those of chicken and quail at the same stage of development. Confocal analysis of fixed specimens revealed that each secondary bronchus forms by apical constriction of the dorsal epithelium of the primary bronchus, a morphogenetic mechanism distinct from that used to create branches in mammalian lungs. Conclusions Our findings suggest that monopodial branching off the primary bronchus is driven by apical constriction in lungs of chicken, quail, and duck. The relative positions at which these branches form are also conserved relative to the evolutionary relationship of these species. It will be interesting to determine whether these mechanisms hold in more distant species of birds, and why they differ so significantly in mammals.

  17. Impact of endobronchial coiling on segmental bronchial lumen in treated and untreated lung lobes: Correlation with changes in lung volume, clinical and pulmonary function tests.

    Science.gov (United States)

    Kloth, C; Thaiss, W M; Hetzel, J; Ditt, H; Grosse, U; Nikolaou, K; Horger, M

    2016-07-01

    To assess the impact of endobronchial coiling on the segment bronchus cross-sectional area and volumes in patients with lung emphysema using quantitative chest-CT measurements. Thirty patients (female = 15; median age = 65.36 years) received chest-CT before and after endobronchial coiling for lung volume reduction (LVR) between January 2010 and December 2014. Thin-slice (0.6 mm) non-enhanced image data sets were acquired both at end-inspiration and end-expiration using helical technique and 120 kV/100-150 mAs. Clinical response was defined as an increase in the walking distance (Six-minute walk test; 6MWT) after LVR-therapy. Additionally, pulmonary function test (PFT) measurements were used for clinical correlation. In the treated segmental bronchia, the cross-sectional lumen area showed significant reduction (p  0.05). In the ipsilateral lobes, the lumina showed no significant changes. In the contralateral lung, we found tendency towards increased cross-sectional area in inspiration (p = 0.06). Volumes of the treated segments correlated with the treated segmental bronchial lumina in expiration (r = 0.80, p volume of the treated lobe in responders only. Endobronchial coiling causes significant decrease in the cross-sectional area of treated segment bronchi in inspiration and a slight increase in expiration accompanied by a volume reduction. • Endobronchial coiling has indirect impact on cross-sectional area of treated segment bronchi • Volume changes of treated lobes correlate with changes in bronchial cross-sectional area • Coil-induced effects reflect their stabilizing and stiffening impact on lung parenchyma • Endobronchial coiling reduces bronchial collapsing compensating the loss of elasticity.

  18. Image quality of mixed convolution kernel in thoracic computed tomography.

    Science.gov (United States)

    Neubauer, Jakob; Spira, Eva Maria; Strube, Juliane; Langer, Mathias; Voss, Christian; Kotter, Elmar

    2016-11-01

    The mixed convolution kernel alters his properties geographically according to the depicted organ structure, especially for the lung. Therefore, we compared the image quality of the mixed convolution kernel to standard soft and hard kernel reconstructions for different organ structures in thoracic computed tomography (CT) images.Our Ethics Committee approved this prospective study. In total, 31 patients who underwent contrast-enhanced thoracic CT studies were included after informed consent. Axial reconstructions were performed with hard, soft, and mixed convolution kernel. Three independent and blinded observers rated the image quality according to the European Guidelines for Quality Criteria of Thoracic CT for 13 organ structures. The observers rated the depiction of the structures in all reconstructions on a 5-point Likert scale. Statistical analysis was performed with the Friedman Test and post hoc analysis with the Wilcoxon rank-sum test.Compared to the soft convolution kernel, the mixed convolution kernel was rated with a higher image quality for lung parenchyma, segmental bronchi, and the border between the pleura and the thoracic wall (P < 0.03). Compared to the hard convolution kernel, the mixed convolution kernel was rated with a higher image quality for aorta, anterior mediastinal structures, paratracheal soft tissue, hilar lymph nodes, esophagus, pleuromediastinal border, large and medium sized pulmonary vessels and abdomen (P < 0.004) but a lower image quality for trachea, segmental bronchi, lung parenchyma, and skeleton (P < 0.001).The mixed convolution kernel cannot fully substitute the standard CT reconstructions. Hard and soft convolution kernel reconstructions still seem to be mandatory for thoracic CT.

  19. Surgical management of bronchiectasis

    Directory of Open Access Journals (Sweden)

    Shanker Bhandari

    2016-07-01

    Full Text Available Background: Bronchiectasis is the permanent dilatation of the bronchi due to destruction of bronchial wall. Bronchi­ectasis still remains a serious problem in developing countries despite of modern medical facilities.Objectives: This study aims to demonstrate our surgical experience for bronchiectasis and analyze the risk factors related with the surgery outcome.Methods: Hospital based analyses of 39 patients were done who were underwent surgery for bronchiectasis and were on follow up in National Institute of Diseases of Chest hospital (NIDCH in September 2014 to February 2015 were included in this study. All 39 patients had surgery for the bronchiectasis in the period of January 2014 to December 2014.Results: The mean age of the patients were 22.2 years. Twenty four patients were females and 15 were male. Symptoms were recurrent infection with cough, copious sputum in all patients and hemoptysis in 31 patients. The etiology was recur­rent childhood infection in 17 patients, pneumonia in 11 patients, PTB in 6 patients, Aspiration in 2 patients, foreign body obstruction in 1 patient, and unknown etiology in 2 patients. Chest x-ray, CT scan and rigid bronchoscope were done for all patients. Bronchiectasis was left-sided in 17 patients. It was mainly confined to the lower lobes either alone in 9 patients and in conjunction with middle lobe or lingual in 8 patients. Indications for resection were failure of conservative therapy in 22 patients, hemoptysis in 8 patients, destroyed lung in 9 patients. Surgery was lobectomy in 24 patients, Bilobectomy in 5 patients, and pneumonectomy in 10 patients. Complications occurred in 10 patients with no operative mortality. Thirty four patients had relief of their preoperative symptoms after surgery in follow up periods.Conclusions: Surgical resection for bronchiectasis should be reserved for patients with localised disease who have failed medical management and have persistent symptoms that negatively affect

  20. Effects of Heat and Moisture Exchangers and Exhaled Humidity on Aerosol Deposition in a Simulated Ventilator-Dependent Adult Lung Model.

    Science.gov (United States)

    Ari, Arzu; Alwadeai, Khalid S; Fink, James B

    2017-05-01

    Many in vitro models report higher inhaled dose with dry versus heated humidity. Heat-and-moisture exchangers (HMEs) provide passive humidity in ventilator-dependent patients but act as a barrier to aerosol. The HMEs designed to allow aerosol delivery (HME-ADs) have not been well described. The purpose of this study is to determine the impact on aerosol deposition of HME-ADs with and without active exhaled humidity in a simulated ventilator-dependent adult model. We used an in vitro lung model consisting of an intubated teaching mannequin with an endotracheal tube of 8.0 mm inner diameter with bronchi directly attached to a collecting filter and passive rubber test lung to provide testing without active exhaled humidity. To simulate exhaled humidity, a Cascade humidifier (37°C and 100% relative humidity) was placed between the collecting filter and test lung, simulating body temperature and pressure saturated exhaled humidity at the bronchi. Albuterol sulfate (2.5 mg/3 mL) was administered with a mesh nebulizer (Aerogen Solo) placed in the inspiratory limb of the ventilator circuit at the Y-piece, with no HME in place (control) and with 3 HME-AD devices, including the CircuVent, Humid-Flo, and AirLife, with and without exhaled humidity. Drug was eluted from the collecting filter and analyzed with spectrophotometry. Student t tests and analysis of variance were used for data analysis ( P < .05). The percentage of drug dose delivered (mean ± SD) distal to the bronchi in the control experiments was greater than all of the HME-ADs without exhaled humidity 18 ± 0.7 and with active exhaled humidity 10.8 ± 0.2% ( P < .005). Without exhaled humidity, aerosol delivery with the CircuVent (12.6 ± 0.8), Humid-Flo (15.3 ± 0.8), and AirLife (12.0 ± 0.5) was less than control ( P < .001, P = .01 and P < .001, respectively). In contrast, with exhaled humidity, no difference was found between control and HME-ADs ( P = .89). Also, a greater variation between control and the 3

  1. Nasal mucosa secretion exudation response to cold air in bronchial asthma patients

    Directory of Open Access Journals (Sweden)

    Eduard V. Nekrasov

    2017-01-01

    responsiveness to the cold and osmotic stimuli (n = 6; 2 combined airway responsiveness to both stimuli (drop in FEV1 by 10% or more after CAHV and DWI (n = 11; 3 isolated airway responsiveness to only one of the stimuli (n = 6. In the total group of asthma patients, the mean content of TP, TC, α2-MG, and TBARS increased by 63%, 109, 47, and 68%, respectively, after the cold air nasal challenge, whereas MUC5AC and MUC5B decreased by 15 and 20%, respectively. Secretion and exudation in the nasal mucosa were more pronounced in asthma patients of group 2 in comparison with other groups. Oxidative stress was lower in group 1. There were two interesting correlations between bronchi responsiveness to CAHV and DWI and changes in the content of the biomarkers after the cold air nasal challenge in group 2: 1 ∆FEV1 after CAHV and TC level at 15 min (r = –0,65; р = 0,0401 and at 30 min (r = –0,82; р = 0,0034; 2 ∆FEV1 after DWI and the change of α2-MG at 1 min after the cold air nasal challenge (r = –0,67; р = 0,0242.Conclusion. In accordance with the unified airway model, the found correlations may indicate that prolonged mucin secretion after cold air breathing is a negative factor for the bronchi response to cold air, whereas enhanced plasma exudation determines the bronchi responsiveness to a hypoosmotic stimulus. Nasal mucosa is a promising model for the simultaneous investigation of molecular processes of airway secretion, exudation and oxidative response in asthma patients. 

  2. Validação técnica da drenagem pulmonar como tratamento do enfisema pulmonar avançado: estudo anatômico em cadáveres Technical validation of pulmonary drainage for the treatment of severe pulmonary emphysema: a cadaver-based study

    Directory of Open Access Journals (Sweden)

    Júlio Mott Ancona Lopez

    2013-02-01

    , Brazil. A 7.5-cm, 24 F steel chest tube was inserted into the second intercostal space along the midclavicular line bilaterally, and we measured the distances from the tube to the main bronchi, upper lobe bronchi, subclavian vessels, pulmonary arteries, pulmonary arteries in the upper lobe, superior pulmonary vein, azygos vein, and aorta. Weight, height, and chest wall thickness, as well as laterolateral and posteroanterior diameters of the chest, were measured for each cadaver. RESULTS: Of the 30 cadavers dissected, 20 and 10 were male and female, respectively. The mean distance between the distal end of the tube and the main bronchi (right and left was 7.2 cm (for both. CONCLUSIONS: The placement of a fixed-size chest tube in the specified position is feasible and safe, regardless of the anthropometric characteristics of the patients.

  3. Obesity induced by neonatal overfeeding worsens airway hyperresponsiveness and inflammation.

    Directory of Open Access Journals (Sweden)

    Zehui Ye

    Full Text Available BACKGROUND: Obesity is a risk factor for the development of certain respiratory diseases, and neonatal overfeeding results in an early onset of obesity in adulthood. However, the influence of neonatal overfeeding on respiratory diseases has rarely been studied. Therefore, this paper is aimed at investigating the effect of neonatal overfeeding on airway responsiveness and inflammation. METHODOLOGY/PRINCIPAL FINDINGS: The neonatal overfeeding was induced by reducing litter size to three pups per litter (small litter, SL in contrast to the normal litter size with ten pups per litter (NL on postnatal day 3 (P3 in male ICR mice. On P21, mice were weaned to standard chow diet. Airway responsiveness to methacholine was measured either on P21 or P150. Total and classified inflammatory cells in bronchoalveolar lavage fluid (BALF were counted, lung inflammatory cells were evaluated through staining with hematoxylin & eosin and F4/80 immunohistochemistry; lung fibrosis was evaluated through staining with Masson and α-SAM immunohistochemistry. Leptin levels in serum were measured by RIA; TNF-α levels in serum and BALF were quantified by ELISA; mRNA levels of TNF-α, CTGF and TGF-β1 in lung tissues were measured using real-time PCR. Mice from SL exhibited accelerated body weight gain, impaired glucose tolerance and hyperleptinemia. Enhanced airway responsiveness to methacholine was observed in SL mice on P150, but not on P21. Pulmonary inflammation was evident in SL mice on P150, as reflected by inflammatory cells especially macrophages around bronchi and interstitium. BALF and serum TNF-α levels and lung TNF-α mRNA expression were significantly increased in SL mice on P150. More collagen accumulated surrounding the bronchi on P150; lung mRNA levels of TGF-β1 and CTGF were also increased on P150. CONCLUSION: In addition to inducing a variety of metabolic defects, neonatal overfeeding enhanced lung inflammation, which may lead to airway remodeling and

  4. Image analysis in multiplanar spiral CT of the lung with MPR and MIP reconstructions; Bildanalyse bei der Mehrschicht-Spiral-CT der Lunge mit MPR- und MIP-Rekonstruktionen

    Energy Technology Data Exchange (ETDEWEB)

    Eibel, R.; Bruening, R.; Schoepf, U.J.; Leimeister, P.; Stadie, A.; Reiser, M.F. [Klinikum Grosshadern, Muenchen (Germany). Inst. fuer Klinische Radiologie

    1999-11-01

    Purpose: To test, whether axial, coronal and sagittal MIP and MPR reconstructions of diagnostic quality can be obtained from 1-mm collimation MSCT data of the chest for the evaluation of thoracic anatomy and pathology. Materials and methods: 1-mm collimation MSCT scans were obtained with a pitch of 6 in an acrylic phantom and in 20 patients. Axial images were reconstructed with 0.6-mm increment. Multiplanar Reformations (MPRs) and Sliding Thin-Slab Maximum Intensity Projections (STS-MIPs) were reconstructed in axial, coronal and sagittal planes. Images were printed in lung windows and evaluated by three readers by using a standardized evaluation scheme. Results: Overall, both methods allowed good visualization of anatomic structures. MIP was superior for visualization of the pulmonary arteries (p<0.05) while central and peripheral bronchi and the lung parenchyma were better depicted on multiplanar reconstructions. A confident diagnosis of thoracic pathology was feasible using both modalities, however MIPs appeared less usefull for evaluation of gross parenchymal abnormalities, such as pneumonic infiltrates or fibrotic changes. No significant difference in the degree of motion artifacts were detected between both modalities. Conclusion: MSCT data sets are ideally suited for generating MPR and MIP reconstructions. While MIPs are superior for the evaluation of thoracic vessels, MPR is advantageous for visualizing central and peripheral bronchi and the pulmonary parenchyma. (orig.) [German] Untersucht wurde die Darstellung der normalen und pathologischen Strukturen des Thorax mit der MPR- und MIP-Technik in drei Raumrichtungen berechnet aus einem 1 mm Spiraldatensatz des Mehrzeilen-Spiral-CT. Ein Plexiglasphantom und 20 Patienten wurden im Mehrzeilen-Spiral-CT mit 1 mm Schichtdicke und einem Pitch 6 untersucht. Die mit 0,6 mm Inkrement errechneten Bilddaten wurden mit der Multiplanaren Reformation (MPR) und der Sliding Thin-Slab Maximum Intensity Projection (STS

  5. Role of acetylcholine and polyspecific cation transporters in serotonin-induced bronchoconstriction in the mouse

    Directory of Open Access Journals (Sweden)

    Koepsell Hermann

    2006-04-01

    Full Text Available Abstract Background It has been proposed that serotonin (5-HT-mediated constriction of the murine trachea is largely dependent on acetylcholine (ACh released from the epithelium. We recently demonstrated that ACh can be released from non-neuronal cells by corticosteroid-sensitive polyspecific organic cation transporters (OCTs, which are also expressed by airway epithelial cells. Hence, the hypothesis emerged that 5-HT evokes bronchoconstriction by inducing release of ACh from epithelial cells via OCTs. Methods We tested this hypothesis by analysing bronchoconstriction in precision-cut murine lung slices using OCT and muscarinic ACh receptor knockout mouse strains. Epithelial ACh content was measured by HPLC, and the tissue distribution of OCT isoforms was determined by immunohistochemistry. Results Epithelial ACh content was significantly higher in OCT1/2 double-knockout mice (42 ± 10 % of the content of the epithelium-denuded trachea, n = 9 than in wild-type mice (16.8 ± 3.6 %, n = 11. In wild-type mice, 5-HT (1 μM caused a bronchoconstriction that slightly exceeded that evoked by muscarine (1 μM in intact bronchi but amounted to only 66% of the response to muscarine after epithelium removal. 5-HT-induced bronchoconstriction was undiminished in M2/M3 muscarinic ACh receptor double-knockout mice which were entirely unresponsive to muscarine. Corticosterone (1 μM significantly reduced 5-HT-induced bronchoconstriction in wild-type and OCT1/2 double-knockout mice, but not in OCT3 knockout mice. This effect persisted after removal of the bronchial epithelium. Immunohistochemistry localized OCT3 to the bronchial smooth muscle. Conclusion The doubling of airway epithelial ACh content in OCT1/2-/- mice is consistent with the concept that OCT1 and/or 2 mediate ACh release from the respiratory epithelium. This effect, however, does not contribute to 5-HT-induced constriction of murine intrapulmonary bronchi. Instead, this activity involves 1 a non

  6. Aspirasi Benda Asing Paku dengan Komplikasi Atelektasis Paru dan Aspirasi Benda Asing Jarum Pentul Tanpa Komplikasi

    Directory of Open Access Journals (Sweden)

    Novialdi .

    2015-05-01

    Full Text Available Abstrak Aspirasi benda asing bronkus adalah masalah yang sering  pada anak-anak dan merupakan masalah seriusserta bisa berakibat fatal. Sebagian besar aspirasi benda asing di bronkus pada anak-anak karena kecenderunganmemasukkan sesuatu ke mulut, pertumbuhan gigi molar yang belum lengkap, kurangnya pengawasan dari orang tuadan lain-lain. Aspirasi jarum pentul di bronkus biasanya terjadi pada wanita remaja muslim yang menggunakan jilbab.Benda asing tajam di bronkus harus segera dikeluarkan dalam kondisi dan peralatan optimal untuk mencegahkomplikasi yang timbul. Komplikasi akibat aspirasi benda asing tajam yang paling sering berupa perforasi jalan nafas,trakeitis, bronkitis, jaringan granulasi, efusi pleura dan atelektasis. Tindakan bronkoskopi merupakan pilihan untukekstraksi benda asing tajam yang teraspirasi. Dilaporkan dua kasus aspirasi benda asing tajam di bronkus yaitu padaseorang anak laki-laki, berusia 6 tahun dengan aspirasi paku dengan komplikasi atelektasis paru dan seorang anakperempuan, berusia 14 tahun dengan aspirasi jarum pentul tanpa komplikasi yang telah berhasil diekstraksimenggunakan bronkoskopi kaku.Kata kunci: benda asing tajam di bronkus, aspirasi paku, aspirasi jarum pentul, atelektasis, bronkoskopi kaku  Abstract Bronchial foreign body aspiration is a common problem in children and it is a serious problem that can befatal. Most of bronchial foreign body aspiration occur in children because of the tendency to put something into themouth, the molar growth is not yet complete, the lack of supervision from parents and others situation . Aspiration of apin in the bronchi usually occurs in adolescent Muslim women who wear headscarf. Sharp foreign bodies in thebronchi must be removed immediately and the optimal equipment to prevent complications. Complications due tosharp foreign bodies aspiration most often in the form of perforation, tracheitis, bronchitis, granulation tissue, pleuraleffusion and atelectasis. Bronchoscopy

  7. Distribution of sialic acid receptors and influenza A virus of avian and swine origin in experimentally infected pigs

    Directory of Open Access Journals (Sweden)

    Viuff Birgitte M

    2011-09-01

    Full Text Available Abstract Background Pigs are considered susceptible to influenza A virus infections from different host origins because earlier studies have shown that they have receptors for both avian (sialic acid-alpha-2,3-terminal saccharides (SA-alpha-2,3 and swine/human (SA-alpha-2,6 influenza viruses in the upper respiratory tract. Furthermore, experimental and natural infections in pigs have been reported with influenza A virus from avian and human sources. Methods This study investigated the receptor distribution in the entire respiratory tract of pigs using specific lectins Maackia Amurensis (MAA I, and II, and Sambucus Nigra (SNA. Furthermore, the predilection sites of swine influenza virus (SIV subtypes H1N1 and H1N2 as well as avian influenza virus (AIV subtype H4N6 were investigated in the respiratory tract of experimentally infected pigs using immunohistochemical methods. Results SIV antigen was widely distributed in bronchi, but was also present in epithelial cells of the nose, trachea, bronchioles, and alveolar type I and II epithelial cells in severely affected animals. AIV was found in the lower respiratory tract, especially in alveolar type II epithelial cells and occasionally in bronchiolar epithelial cells. SA-alpha-2,6 was the predominant receptor in all areas of the respiratory tract with an average of 80-100% lining at the epithelial cells. On the contrary, the SA-alpha-2,3 was not present (0% at epithelial cells of nose, trachea, and most bronchi, but was found in small amounts in bronchioles, and in alveoli reaching an average of 20-40% at the epithelial cells. Interestingly, the receptor expression of both SA-alpha-2,3 and 2,6 was markedly diminished in influenza infected areas compared to non-infected areas. Conclusions A difference in predilection sites between SIV and AIV virus was found, and this difference was in accordance with the distribution of the SA-alpha-2,6 and SA-alpha-2,3 receptor, respectively. The results indicated

  8. An unusual presentation of gastric mucosa-associated lymphoid tissue (MALT-type lymphoma

    Directory of Open Access Journals (Sweden)

    Bikram Shrestha

    2016-09-01

    Full Text Available Mucosa-associated lymphoid tissue (MALT-type lymphoma is a relatively rare disease; nevertheless, it is the third most common lymphoma type, accounting for 5–7% of all non-Hodgkin lymphomas. Case series and retrospective analysis published in the literature have suggested that extra gastrointestinal (GI MALT-type lymphoma can occur simultaneously with MALT-type lymphoma involving the GI tract. We report the case of a healthy, 64-year-old Caucasian male who presented with progressive fatigue, non-productive cough, and worsening exertional shortness of breath for 3 months who was subsequently diagnosed with gastric extra-nodal marginal zone B-cell lymphoma or MALToma with simultaneous metastasis to the lung (bronchi based on biopsy reports. Case presentation: A 64-year-old Caucasian male presented to the emergency room complaining of progressive fatigue for 3 months which had progressed to the point of hindering his usual activities of daily living (ADL. He had recently visited his primary care provider for evaluation of a non-productive cough and exertional shortness of breath. A chest radiography obtained at the time showed bilateral infiltrates. He was then treated for atypical pneumonia but his symptoms unfortunately did not improve. Initial investigations in the emergency room revealed severe anemia and a positive stool guaiac test. Imaging showed bilateral pulmonary infiltrates and an irregular gastric mass. Gastric and transbronchial biopsies were suggestive of extra-nodal marginal zone B-cell lymphoma with simultaneous metastasis to the bronchi. He was treated symptomatically with transfusion of packed red blood cells (PRBC and intravenous iron followed by radiotherapy. Helicobacter pylori infection was ruled out eliminating the possibility of treating him with eradication therapy. Conclusion: Although the stomach is the most common and most extensively studied site of involvement of MALT lymphomas, they can also emerge in many other

  9. Wnt/β-catenin signaling modulates human airway sensitization induced by β2-adrenoceptor stimulation.

    Directory of Open Access Journals (Sweden)

    Christophe Faisy

    Full Text Available BACKGROUND: Regular use of β2-agonists may enhance non-specific airway responsiveness. The wingless/integrated (Wnt signaling pathways are responsible for several cellular processes, including airway inflammation and remodeling while cAMP-PKA cascade can activate the Wnt signaling. We aimed to investigate whether the Wnt signaling pathways are involved in the bronchial hyperresponsiveness induced by prolonged exposure to β2-adrenoceptor agonists in human isolated airways. METHODS: Bronchi were surgically removed from 44 thoracic surgery patients. After preparation, bronchial rings and primary cultures of bronchial epithelial cells were incubated with fenoterol (0.1 µM, 15 hours, 37 °C, a β2-agonist with high intrinsic efficacy. The effects of inhibitors/blockers of Wnt signaling on the fenoterol-induced airway sensitization were examined and the impact of fenoterol exposure on the mRNA expression of genes interacting with Wnt signaling or cAMP-PKA cascade was assessed in complete bronchi and in cultured epithelial cells. RESULTS: Compared to paired controls, fenoterol-sensitization was abolished by inhibition/blockage of the Wnt/β-catenin signaling, especially the cell-surface LRP5/6 co-receptors or Fzd receptors (1 µM SFRP1 or 1 µM DKK1 and the nuclear recruitment of TCF/LEF transcriptions factors (0.3 µM FH535. Wnt proteins secretion did not seem to be involved in the fenoterol-induced sensitization since the mRNA expression of Wnt remained low after fenoterol exposure and the inactivator of Wnt secretion (1 µM IWP2 had no effect on the fenoterol-sensitization. Fenoterol exposure did not change the mRNA expression of genes regulating Wnt signaling or cAMP-PKA cascade. CONCLUSIONS: Collectively, our pharmacological investigations indicate that fenoterol-sensitization is modulated by the inhibition/blockage of canonical Wnt/β-catenin pathway, suggesting a phenomenon of biased agonism in connection with the β2-adrenoceptor stimulation

  10. Bronchial reactivity in hyperresponsive patients and healthy individuals: demonstration with high resolution computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Schueller, G. E-mail: gerd.schueller@univie.ac.at; Neumann, K.; Helbich, T.; Riemer, H.; Backfrieder, W.; Sertl, K.; Herold, C.J

    2004-11-01

    Objective: High resolution computed tomography (HRCT) was used to assess the extent of bronchial reactivity after inhalative bronchoprovocation and dilation in hyperresponsive patients and healthy subjects. Patients and methods: Patients with mild intermittent asthma, 15 with a >20% decrease in FEV{sub 1} and a >10 mmHg (PC{sub 20}+) in PaO{sub 2}, 12 with a <20% decrease in FEV{sub 1} and a >10 mmHg (PC{sub 20}-) in PaO{sub 2} after provocation, and eight healthy humans were included in the study. Changes in cross-sectional area in a total of 1256 bronchi and in bronchial wall area (792 bronchi) were evaluated after histamine-triggered bronchoprovocation and salbutamol-induced bronchodilation at high lung volumes (FVC 80%). Data were compared with the results of pulmonary function tests (FEV{sub 1}, PaO{sub 2}, PaCO{sub 2}). Results: In all groups, a significant decrease in bronchial cross-sectional area (P<0.001) and a significant increase in bronchial wall area (P<0.001) were observed subsequent to bronchoprovocation. After bronchodilation, the increase in cross-sectional area (P<0.001) and the further increase in airway wall area (P<0.01) were significant in all groups. In PC{sub 20}+ and PC{sub 20}- asthmatics, significant differences (P<0.05) in PaO{sub 2}, >10 mmHg between baseline and provocation were observed. In healthy persons, the PaO{sub 2} decrease was <10 mmHg (P>0.05). After histamine provocation, the decrease in FEV{sub 1} was measured in the PC{sub 20}+ group, whereas a <20% FEV{sub 1} decrease was found in the PC{sub 20}- and the control groups, respectively. No significant correlations were observed between radiological data and the results of pulmonary function tests. Conclusions: HRCT demonstrated bronchial reactivity in hyperresponsive patients and, unexpectedly, in healthy subjects. The applied pulmonary function tests failed to characterize bronchial reactions in the healthy subjects. Based on these results, HRCT is a useful tool by which

  11. Liposome as nanocarrier: Site targeted delivery in lung cancer

    Directory of Open Access Journals (Sweden)

    Najeeb Ullah

    2017-08-01

    Full Text Available Lung cancer is fatal and spreading rapidly worldwide. Different clinical strategies are applied to stop this cancer. As the lung is a delicate organ, special clinical applications must be used and nanodrugs delivery systems are the most important applications of all. This review discusses the lung problems such as lung cancer, lung inflammation and bronchi constrictions followed by repetitive intake of some drugs. The objective of this review is to study how nanodrug delivery systems were synthesized and used in lung disorder treatment especially in lung cancer. The authors studied some articles from 1989 to 2015. Liposome encapsulation was done in various ways for the delivery of different drugs such as metaproterenol into liposomes caused bronchodilation, immunoliposomes bearing antibodies for doxorubicin reduced 50% inhibitory effects, radioliposomes with high penetrating ability to peripheral airways, aerosol delivery systems with deep pulmonary deposition, polymeric drug delivery having potential to improve beneficial index of drug, solid lipid liposomes, liposomal gentamicin with altered different clinical susceptibilities of resistance, transferrin conjugated liposomes to deliver cytostatic drugs to site of lungs, anti-inflammatory drugs with mannosylated liposomes, liposomal suspensions with single stranded RNAs and peptide encapsulation of liposomes. This review indicates that many animals perished with intravenous administration of drugs but survived in liposomal targeting groups.

  12. Age-related changes in the cellular composition and epithelial organization of the mouse trachea.

    Directory of Open Access Journals (Sweden)

    Carolien Wansleeben

    Full Text Available We report here senescent changes in the structure and organization of the mucociliary pseudostratified epithelium of the mouse trachea and main stem bronchi. We confirm previous reports of the gradual appearance of age-related, gland-like structures (ARGLS in the submucosa, especially in the intercartilage regions and carina. Immunohistochemistry shows these structures contain ciliated and secretory cells and Krt5+ basal cells, but not the myoepithelial cells or ciliated ducts typical of normal submucosal glands. Data suggest they arise de novo by budding from the surface epithelium rather than by delayed growth of rudimentary or cryptic submucosal glands. In old mice the surface epithelium contains fewer cells per unit length than in young mice and the proportion of Krt5+, p63+ basal cells is reduced in both males and females. However, there appears to be no significant difference in the ability of basal stem cells isolated from individual young and old mice to form clonal tracheospheres in culture or in the ability of the epithelium to repair after damage by inhaled sulfur dioxide. Gene expression analysis by Affymetrix microarray and quantitative PCR, as well as immunohistochemistry and flow sorting studies, are consistent with low-grade chronic inflammation in the tracheas of old versus young mice and an increase in the number of immune cells. The significance of these changes for ARGL formation are not clear since several treatments that induce acute inflammation in young mice did not result in budding of the surface epithelium.

  13. Tracheobronchial Manifestations of Aspergillus Infections

    Directory of Open Access Journals (Sweden)

    Rafal Krenke

    2011-01-01

    Full Text Available Human lungs are constantly exposed to a large number of Aspergillus spores which are present in ambient air. These spores are usually harmless to immunocompetent subjects but can produce a symptomatic disease in patients with impaired antifungal defense. In a small percentage of patients, the trachea and bronchi may be the main or even the sole site of Aspergillus infection. The clinical entities that may develop in tracheobronchial location include saprophytic, allergic and invasive diseases. Although this review is focused on invasive Aspergillus tracheobronchial infections, some aspects of allergic and saprophytic tracheobronchial diseases are also discussed in order to present the whole spectrum of tracheobronchial aspergillosis. To be consistent with clinical practice, an approach basing on specific conditions predisposing to invasive Aspergillus tracheobronchial infections is used to present the differences in the clinical course and prognosis of these infections. Thus, invasive or potentially invasive Aspergillus airway diseases are discussed separately in three groups of patients: (1 lung transplant recipients, (2 highly immunocompromised patients with hematologic malignancies and/or patients undergoing hematopoietic stem cell transplantation, and (3 the remaining, less severely immunocompromised patients or even immunocompetent subjects.

  14. Radiological description about the globally first case of human infected avian influenza virus (H10N8 induced pneumonia

    Directory of Open Access Journals (Sweden)

    Jian He

    2016-03-01

    Full Text Available Human infected avian influenza (H10N8 is an acute infectious respiratory tract infection caused by JX346-H10N8. The reported case in this paper is the globally first case report about radiological description of human infected avian influenza (H10N8 virus related pneumonia. The patient showed an epidemiological history of contacts to living poultries and the incubation period lasted for 4 days. The condition was clinically characterized by fever, cough, chest distress and obvious hypoxia. CT scan demonstrated the lungs with large flake of hyper-intense consolidation, confined patch of ground glass opacity, dilated bronchi, predominantly dorsal thickening of the interlobular septum, and other types of lesions related to interstitial pulmonary edema. Meanwhile, accompanying interlobar effusion, infrapulmonary effusion and pleural effusion were demonstrated in a small quantity by CT scan. Human infected avian influenza (H10N8 related pneumonia should be differentiated from pneumonia induced by human infected avian influenza viruses H5N1 and H7N9. No characteristic key points for radiological differentiation have been found. And its definitive diagnosis should be based on the etiological examination.

  15. An autopsy case of suicide by acetylene explosion: a case report.

    Science.gov (United States)

    Kashiwagi, Masayuki; Hara, Kenji; Takamoto, Mutsuo; Kageura, Mitsuyoshi; Matsusue, Aya; Sugimura, Tomoko; Kubo, Shin-ichi

    2009-04-01

    We report an autopsy case of a male welder in his thirties who was found dead in an exploded truck cabin. The roof, windows and doors of the cabin had been blown up to 50 metres away. An oxygen cylinder and an acetylene cylinder, both unexploded, were found in the back of the truck. The deceased was lying on the driver's seat. His entire body was burnt, carbonised and partially skeletonised. There was a small amount of soot in his oesophagus and stomach and a large volume of bloody fluid in the trachea and bronchi. There was an extensive haemorrhage in the posterior thoracic wall. No drugs were detected in the blood. Hardly any carbon monoxide and combustion-related gases were detected in the blood, therefore he was not considered to have died from the fire. Acetylene was detected in his blood (21.5 microg/ml in the femoral vein blood) and urine (7.49 microg/ml), with marked haemorrhaging in his back. We therefore concluded that the victim died because of an acetylene explosion in the cabin and also that this was a suicide.

  16. Unusual pathology of canary poxvirus infection associated with high mortality in young and adult breeder canaries (Serinus canaria).

    Science.gov (United States)

    Shivaprasad, H L; Kim, T; Tripathy, D; Woolcock, P R; Uzal, F

    2009-08-01

    Mortality in excess of 65% occurred in a flock of 450 canaries (Serinus canaria). Clinical signs in the canaries included severe respiratory distress, loss of feathers and/or scaly skin on the head, neck and back, anorexia, loss of weight and fluffed-up appearance of several days duration before death. Gross pathology in most of the canaries included thickened eye lids and small scab-like nodules on the skin of the head and neck, enlarged thymus, mild to severe consolidation of lungs and exudate in the sinuses and trachea. A few birds also had thickened air sacs and enlarged and pale spleens. Microscopically unusual lesions included severe epithelial proliferation and hypertrophy and mononuclear inflammatory cells containing eosinophilic intracytoplasmic inclusion bodies of poxvirus in the thymus, bursa of Fabricius, spleen, bone marrow, air sac, peritoneum, external and middle ears, and lachrymal gland. Similar inclusion bodies associated with inflammation were also seen in the epidermis, dermis, feather follicles, conjunctivae, sinuses, turbinates, choana, oral mucosa including tongue, oesophagus, larynx, trachea, syrinx and bronchi and parabronchi of lungs. Some of the birds also had concurrent bacterial, mycotic and polyomavirus infections. Poxvirus was isolated from lungs and skin in chicken embryo liver cells and confirmed as avian poxvirus by polymerase chain reaction.

  17. The Mounier-Kuhn syndrome

    Directory of Open Access Journals (Sweden)

    Milić Rade

    2010-01-01

    Full Text Available Background. The Mounier-Kuhn syndrome (MKS or tracheobronchomegaly (TBM is a rare condition of unknown frequency, up to now about 100 cases have been reported. It presents by marked dilatation of the trachea and major bronchi, recurrent respiratory infections and consecutive bronchiectasis and scars in lung parenchyme. Sometimes enlargement of transversal colon may be present. Diagnosis is usually made radiologically. Cases report. We reviewed two patients 77 and 72 years old with typical clinical presentation and enlarged upper airways, in whom diagnosis of MKS was established by chest multislice computed tomography (MSCT. Transversal diameter of trachea was 30 mm in the first patient and 33 mm in the other one. Complications of syndrome (tracheal diverticulosis in the first patient, and pulmonary fibrosis, bulous emphysema and bronchiectasis in both patients also were seen. Lung function tests showed mixed ventilation disorder, and disturbance of respiratory gases values in arterial blood samples. Conclusion. The Mounier-Kuhn syndrome is rare disorder, although diagnosis is often missed. Clinical presentation is similar to chronic obstructive pulmonary disease or bronchiectasis. Computed tomography is gold standard for diagnosis. Therapy is presumely supportive.

  18. The Virtual Hydrostatic Test.

    Science.gov (United States)

    Mazuchowski, Edward L; Franco, Dori M; Berran, Philip J; Harcke, H Theodore

    2017-03-01

    The hydrostatic test is used to help determine if there has been a live birth. Computed tomography (CT), with its ability to detect and localize air/gas in the body, offers a rapid, noninvasive tool for assessment.Four baby deaths (20 to 25 weeks' gestation) in which the hydrostatic test, radiographs, and CT were performed before autopsy are presented. In 2 cases, considered stillbirths, the lungs and liver sank, and there was no air seen in the lungs or gas in the liver on CT. Histology of the lungs showed collapsed alveoli. In 1 case, concluded to be a live birth, the lungs floated, the liver sank, and air was seen in the trachea, bronchi, and both lungs on CT. Histology of the lungs showed multiple areas of expanded alveoli. In 1 case, where both the lungs and liver floated, the CT showed gas widely distributed in the soft tissues. This reflected decomposition, and no conclusion could be made regarding birth status.Assessment of live birth is a critical and difficult decision. Postmortem CT offers another technique to consider in this determination, and it has significant advantages over radiography. Continued study and correlation with existing methods seem warranted.

  19. Rabies among African wild dogs (Lycaon pictus) in the Masai Mara, Kenya.

    Science.gov (United States)

    Kat, P W; Alexander, K A; Smith, J S; Richardson, J D; Munson, L

    1996-10-01

    A pack of African wild dogs (Lycaon pictus) ranging to the north of the Masai Mara National Reserve in southwestern Kenya was monitored from 1988 to 1989. During a 6-week period (August 1-September 13, 1989), 21 of 23 members of this pack died. Seven carcasses were retrieved, of which 4 were suitable for necropsy and histopathologic examination. Gross findings varied among individuals and included multiple bite wounds, synovitis, lymphadenopathy, submandibular, cervical, and vocal cord edema, blood in bronchi, bronchioles, stomach, and intestine, and interioventral lung lobe consolidation. Histologic examination of 2 available brain samples revealed nonsuppurative encephalitis with eosinophilic intracytoplasmic inclusions (Negri bodies). An additional brain sample tested positive for rabies via a fluorescent antibody test. Other histologic features included severe suppurative bronchopneumonia, myocarditis, and lymphoid depletion of the lymph nodes, tonsils, and spleen. A 304-base pair (bp) nucleotide sequence from the N gene and a 310-bp sequence from the G gene from rabies isolates of 4 wild dogs indicated that infection was with a rabies variant common among domestic dogs in Kenya and Tanzania.

  20. Efficiency of use endobronchial laser doppler-flowmetry in patients with chronic leukemia

    Science.gov (United States)

    Vanina, E. A.; Voitsekhovskiy, V. V.; Landyshev, Y. S.; Tkacheva, S. I.

    2016-11-01

    In this work indicatorsendobronchial microcirculation were investigated in patients with chronic myeloid leukemia (CML), chronic lymphocytic leukemia (CLL), multiple myeloma (MM), polycythemia vera (PV), idiopathic myelofibrosis (IMF). A diagnostic bronchoscopy was performed using fibreoptic «Olympus» (Japan).Endobronchial laser Doppler flowmetry was carried out on the laser analyzer capillary blood LAK-02 (Russia). Laser Doppler flowmetry indicators such as parameter of microcirculation, the oscillation amplitude in the endothelial, neurogenic, myogenic, cardiac and respiratory ranges were calculated by continuous the Wavelet transforms. Reduced cardiac and respiratory amplitudes in CML and CLL are primarily due to the development leukostasis. If PV is the case, this is due to sludge syndrome. And when MM occurs, it is caused by protein stasis in the vessels of the bronchial tubes. Increased endothelial oscillation amplitudes in the range in CML, PV, IMF and their reduction in MM indicate the presence of endothelial dysfunction in these patients. Increasing the amplitude of oscillations in the range of neurogenic indicates the development of arteriolar vasodilation as a compensatory response to the violation of blood flow. Increasing the amplitude of oscillations of myogenic tone indicating decrease precapillaries as a compensatory reaction to improve blood flow. It is concluded that endobronchial laser Doppler flowmetry is an important method allowing diagnosing the pathology of the microvasculature of the bronchi in chronic leukemia.

  1. Oscillatory Flow in the Human Airways from the Mouth through Several Bronchial Generations

    Science.gov (United States)

    Banko, Andrew; Coletti, Filippo; Elkins, Chris; Eaton, John

    2014-11-01

    The time-varying flow is studied experimentally in an anatomically accurate model of the human airways from the mouth through the fourth to eighth generation of the bronchi. The airway geometry is obtained from the CT scan of a healthy adult male of normal height and build. The three-component, three-dimensional mean velocity field is obtained throughout the entire model using phase-locked magnetic resonance velocimetry. A pulsatile pump drives a sinusoidal waveform (inhalation and exhalation) with frequency and stroke-length such that the mean trachea Reynolds number at peak inspiration is Re = 4200 and the Womersley number is α = 7. This represents a regime of moderate exertion. Integral parameters are defined to quantify the degree of velocity profile non-uniformity (which correlates with axial dispersion) and secondary flow strength (which correlates with lateral dispersion). It is found that the streamwise momentum flux and secondary flow strength increase and decrease in proportion throughout most of the breathing cycle. On the other hand, the strength of secondary flows during the 10% of the breathing cycle surrounding flow reversal remains approximately half of that at peak inspiration while the streamwise momentum flux goes to zero. The strong and persistent secondary flows have important implications for dispersion of scalar or particulate contaminants in the lungs.

  2. Oslerus osleri (metastrongyloidea; filaroididae) in gray wolves (Canis lupus) from Banff National Park, Alberta, Canada.

    Science.gov (United States)

    Verocai, Guilherme G; Schock, Danna M; Lejeune, Manigandan; Warren, Amy L; Duignan, Pádraig J; Kutz, Susan J

    2013-04-01

    Oslerus osleri is a filaroid parasite of the respiratory tract of canids. In North America, it is most commonly reported from coyotes (Canis latrans) and domestic dogs (Canis lupus familiaris), but reports in gray wolves (Canis lupus) are infrequent. We report a new geographic record for O. osleri in four gray wolves from Banff National Park, Alberta, Canada. Adult nematodes found in nodules in the submucosa of the trachea and bronchi were identified as O. osleri based on morphometry of spicules of males. We sequenced two segments of the genome of adult nematodes: a 1,111-base pair (bp) segment of the 18S region that was 100% identical to the 18S region of O. osleri from a coyote in California and a 537-bp segment that included the ITS-2 region and partial 5.8S and 28S genes. Histopathologically, there were submucosal nodules of adult nematodes surrounded by fibrosis and lymphoplasmacytic inflammation. These findings are consistent with O. osleri infections in other canids. The importance of this parasite in wild canid populations is unknown, but prevalence may be underestimated because many studies have focused on gastrointestinal parasites or used routine fecal flotation that has low sensitivity for this parasite. The ecology and population genetics of this parasite where multiple species of canids are sympatric warrant closer investigation to determine potential for interspecies transmission.

  3. Printed three-dimensional airway model assists planning of single-lung ventilation in a small child.

    Science.gov (United States)

    Wilson, C A; Arthurs, O J; Black, A E; Schievano, S; Hunt, C; van Hoog, S; Wallis, C; Sury, M R J

    2015-10-01

    Single-lung ventilation in infants and small children is challenging because suitable sizes of double-lumen cuffed tracheal tubes are not available. A 6-yr-old child required pulmonary saline washout for primary alveolar proteinosis, and therefore needed sequential single-lung ventilation in order to achieve safe oxygenation. Before undertaking this potentially hazardous procedure, we practised bronchial intubation on an anatomical model of her airway constructed from computed tomography (CT) data. We created a full-scale, anatomically accurate, transparent plastic model of the trachea and main bronchi on a three-dimensional printer using data from a CT scan. We then performed several different airway approaches to identify those likely to be most suitable, ex vivo, before the clinical procedure was carried out on the patient. The model helped us to choose the type and size of bronchial tubes and to practise their insertion beforehand. Subsequently, during anaesthesia, the chosen technique was successful. Three-dimensional printing of a model of the airway of a small child aided planning of bronchial intubation and single-lung ventilation. Three-dimensional printing of airway structures may have wider application in anaesthesia practice. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Bronchoscintigraphy and pulmonary clearance of {sup 99{sup m}}Tc-albumin colloid in study of mucociliary clearance

    Energy Technology Data Exchange (ETDEWEB)

    Mortensen, Jann

    1998-12-31

    A radioaerosol based method for measuring MC was introduced. It included an inhalation protocol that resulted in a predominant deposition of radioaerosol in the central bronchi and two simple procedures of evaluation: 1) a visual semi-quantitative bronchoscintigraphic analysis, and 2) a quantitative analysis of the retention of the radioactivity at different points after the inhalation. The results showed that bronchoscintigraphy was a simple technique that may be used to visualize a stimulation of mucociliary transport in the central airways of individuals that do not suffer from too much mucus hypersecretion. Comparison of the MC between individuals, however, should preferably be performed by the method of quantitative analysis of the radioactivity disappearance. A change of MC was found to be one of the first detectable effects on lung function of tobacco smoking. It could be effectively detected by measurement of radioaerosol clearance both by bronchoscintigraphy and simple quantification of the MC. The MC may be either acutely enhanced, reduced or not changed by smoking. Long-term smoking impairs MC. The enhancement of MC by {beta}{sub 2}-agonists was very limited in most patients with CF. In the hope of increasing mucus transport in patients with CF, these are treated with various chest physiotherapy techniques. The radioaerosol based method of measurement of MC could assess mucus clearance by chest physiotherapy and cough. (au) 141 refs.

  5. A three-microphone acoustic reflection technique using transmitted acoustic waves in the airway.

    Science.gov (United States)

    Fujimoto, Yuki; Huang, Jyongsu; Fukunaga, Toshiharu; Kato, Ryo; Higashino, Mari; Shinomiya, Shohei; Kitadate, Shoko; Takahara, Yutaka; Yamaya, Atsuyo; Saito, Masatoshi; Kobayashi, Makoto; Kojima, Koji; Oikawa, Taku; Nakagawa, Ken; Tsuchihara, Katsuma; Iguchi, Masaharu; Takahashi, Masakatsu; Mizuno, Shiro; Osanai, Kazuhiro; Toga, Hirohisa

    2013-10-15

    The acoustic reflection technique noninvasively measures airway cross-sectional area vs. distance functions and uses a wave tube with a constant cross-sectional area to separate incidental and reflected waves introduced into the mouth or nostril. The accuracy of estimated cross-sectional areas gets worse in the deeper distances due to the nature of marching algorithms, i.e., errors of the estimated areas in the closer distances accumulate to those in the further distances. Here we present a new technique of acoustic reflection from measuring transmitted acoustic waves in the airway with three microphones and without employing a wave tube. Using miniaturized microphones mounted on a catheter, we estimated reflection coefficients among the microphones and separated incidental and reflected waves. A model study showed that the estimated cross-sectional area vs. distance function was coincident with the conventional two-microphone method, and it did not change with altered cross-sectional areas at the microphone position, although the estimated cross-sectional areas are relative values to that at the microphone position. The pharyngeal cross-sectional areas including retropalatal and retroglossal regions and the closing site during sleep was visualized in patients with obstructive sleep apnea. The method can be applicable to larger or smaller bronchi to evaluate the airspace and function in these localized airways.

  6. Distribution of Major Basic Protein on Human Airway following In Vitro Eosinophil Incubation

    Directory of Open Access Journals (Sweden)

    Ailing Xue

    2010-01-01

    Full Text Available Major basic protein (MBP released from activated eosinophils may influence airway hyperresponsiveness (AHR by either direct effects on airway myocytes or by an indirect effect. In this study, human bronchi, freshly isolated human eosinophils, or MBP purified from human eosinophil granules were incubated for studying eosinophil infiltration and MBP localization. Eosinophils immediately adhered to intact human airway as well as to cultured human airway myocytes and epithelium. Following incubation 18–24 h, eosinophils migrated into the airway media, including the smooth muscle layer, but had no specific recruitment to airway neurons. Eosinophils released significant amounts of MBP within the airway media, including areas comprising the smooth muscle layer. Most deposits of MBP were focally discrete and restricted by immunologic detection to a maximum volume of ∼300 μm3 about the eosinophil. Native MBP applied exogenously was immediately deposited on the surface of the airway, but required at least 1 h to become detected within the media of the airway wall. Tissue MBP infiltration and deposition increased in a time- and concentration-dependent manner. Taken together, these findings suggest that eosinophil-derived cationic proteins may alter airway hyperresponsiveness (AHR in vivo by an effect that is not limited to the bronchial epithelium.

  7. Respiratory impedance is correlated with airway narrowing in asthma using three-dimensional computed tomography.

    Science.gov (United States)

    Karayama, M; Inui, N; Mori, K; Kono, M; Hozumi, H; Suzuki, Y; Furuhashi, K; Hashimoto, D; Enomoto, N; Fujisawa, T; Nakamura, Y; Watanabe, H; Suda, T

    2018-01-06

    Respiratory impedance comprises the resistance and reactance of the respiratory system and can provide detailed information on respiratory function. However, details of the relationship between impedance and morphological airway changes in asthma are unknown. We aimed to evaluate the correlation between imaging-based airway changes and respiratory impedance in patients with asthma. Respiratory impedance and spirometric data were evaluated in 72 patients with asthma and 29 reference subjects. We measured the intraluminal area (Ai) and wall thickness (WT) of third- to sixth-generation bronchi using three-dimensional computed tomographic analyses, and values were adjusted by body surface area (BSA, Ai/BSA, and WT/the square root (√) of BSA). Asthma patients had significantly increased respiratory impedance, decreased Ai/BSA, and increased WT/√BSA, as was the case in those without airflow limitation as assessed by spirometry. Ai/BSA was inversely correlated with respiratory resistance at 5 Hz (R5) and 20 Hz (R20). R20 had a stronger correlation with Ai/BSA than did R5. Ai/BSA was positively correlated with forced expiratory volume in 1 second/forced vital capacity ratio, percentage predicted forced expiratory volume in 1 second, and percentage predicted mid-expiratory flow. WT/√BSA had no significant correlation with spirometry or respiratory impedance. Respiratory resistance is associated with airway narrowing. © 2018 John Wiley & Sons Ltd.

  8. ReCOMmendations for management of Preschool ASthma for General Practitioners – COMPAS GP

    Directory of Open Access Journals (Sweden)

    Zbigniew Doniec

    2016-06-01

    Full Text Available Asthma is a chronic, inflammatory, heterogenic disease of the bronchi. It is characterised by bronchial obstruction in the form of wheezing, coughing, shortness of breath and breathing difficulty, showing variable intensity and resolving after medication, or sometimes spontaneously. Making the diagnosis of asthma in children under 5 years of age is based on clinical criteria – the presence of symptoms of bronchial constriction, confirmation of its reversibility and lack of symptoms suggestive of other clinical diagnosis. The criterion for diagnosis are usually three episodes of bronchial obstruction, or a single episode of severe intensity. A detailed history and physical examination allows in most cases to rule out other diseases with similar clinical course. Frequent recurrence of symptoms is an indication for the initial differential diagnosis in primary health care, including a chest X-ray, blood count, often an ENT and/or allergological consultation. However severe, frequent and not responding to treatment episodes of bronchoconstriction indicate the need for diagnostics in specialist hospital wards. Chronic treatment of asthma is based on the administration of anti-inflammatory drugs, inhaled therapy is the treatment of choice in most patients. The assessment of the severity of asthma exacerbation determines the range of treatment, on an outpatient basis consisting of bronchodilators, corticosteroids and oxygen therapy. An important element of treatment is appropriate patient education, with particular attention to the exacerbation risk factors and correct inhalation technique. Children suffering from asthma should be vaccinated against pneumococcal disease and against influenza annually.

  9. EVALUATION OF CLINICAL, DIAGNOSTIC AND TREATMENT OUTCOME IN ACUTE EXACERBATION OF BRONCHIECTASIS IN ADULTS

    Directory of Open Access Journals (Sweden)

    Vinod Kolla

    2017-08-01

    Full Text Available BACKGROUND Bronchiectasis is defined as “abnormal and permanent dilatation of one or more bronchi due to weakening or destruction of the muscular and elastic components of the bronchial walls.” HRCT has become the gold standard to diagnose bronchiectasis. Antibiotics and chest physiotherapy are main forms of management. The aim of the study is to study the outcome of treatment in acute exacerbation of bronchiectasis in adults. MATERIALS AND METHODS This study was done prospectively in the Department of Respiratory Medicine in Rajarajeswari Medical College and Hospital from November 1, 2015, to April 30, 2017. Out of 55 cases admitted during the study period, 44 cases (10 females were eligible for participation in the study. 2 cases of Kartagener’s syndrome under follow up in our department for past 3 years were included. Flexible bronchoscopy was done in 31 patients. RESULTS Cough with sputum was the commonest symptom. Breathlessness was documented in 32 patients. Arterial blood gas analysis was abnormal in 29 patients. Haemoptysis in 13 cases. History of antituberculous therapy was present in 34 patients. Digital clubbing was present in 30 patients. Pedal oedema was documented in 14 cases. Associated cultures were positive in 28 cases. CONCLUSION The most frequent form of bronchiectasis is post-tuberculous. Pseudomonas aeruginosa is the most frequently isolated bacteria. The most frequent concomitant disease in bronchiectasis is COPD. Piperacillin/tazobactum is the most effective antibiotic for initial empirical treatment of acute exacerbations of bronchiectasis.

  10. Flow recirculation in cartilaginous ring cavities of a human trachea model

    Science.gov (United States)

    Montoya Segnini, Jose; Bocanegra Evans, Humberto; Castillo, Luciano

    2017-11-01

    Most flow studies of the human respiratory tract assume that the trachea and bronchi have smooth walls despite the fact that the walls in both of these airway generations are lined with cartilaginous rings. Recent studies demonstrate that the rings do have an impact in the flow behavior and particle deposition, but there is still a lack of detailed knowledge of the effect the rings have on the flow evolution. To uncover the flow dynamics near the rings, we employed particle image velocimetry (PIV) and particle tracking velocimetry (PTV) measurements in a Refractive Index-matched facility at a flow rate comparable to a resting state; with a trachea-based Reynolds number Re = 2800. We have carried out high-resolution experiments to capture the velocity field inside the cavity created by the rings in the trachea model. Our data indicate that a small recirculation is created inside the cavities. The recirculation is found in the upstream side of the cavities throughout the trachea. This recirculation will affect the dispersion and collision of particles with the wall. This observation is consistent with previous studies, which have shown an increase in the collision of particles within the ring cavity.

  11. Diagnosis and clinic-pathological findings of influenza virus infection in Brazilian pigs

    Directory of Open Access Journals (Sweden)

    Daniela S. Rajão

    2013-01-01

    Full Text Available Influenza A virus (IAV is a respiratory pathogen of pigs and is associated with the porcine respiratory disease complex (PRDC, along with other respiratory infectious agents. The aim of this study was to diagnose and to perform a clinic-pathological characterization of influenza virus infection in Brazilian pigs. Lung samples from 86 pigs in 37 farrow-to-finish and two farrow-to-feeder operations located in the States of Minas Gerais, São Paulo, Paraná, Rio Grande do Sul, Santa Catarina, and Mato Grosso were studied. Virus detection was performed by virus isolation and quantitative real time reverse-transcription PCR (qRT-PCR. Pathologic examination and immunohistochemistry (IHC were performed in 60 lung formalin-fixed paraffin-embedded tissue fragments. Affected animals showed coughing, sneezing, nasal discharge, hyperthermia, inactivity, apathy, anorexia, weight loss and growth delay, which lasted for five to 10 days. Influenza virus was isolated from 31 (36.0% lung samples and 36 (41.9% were positive for qRT-PCR. Thirty-eight (63.3% lung samples were positive by IHC and the most frequent microscopic lesion observed was inflammatory infiltrate in the alveoli, bronchiole, or bronchi wall or lumen (76.7%. These results indicate that influenza virus is circulating and causing disease in pigs in several Brazilian states.

  12. Infection of the upper respiratory tract of hamsters by the bovine parainfluenza virus type 3 BN-1 strain expressing enhanced green fluorescent protein.

    Science.gov (United States)

    Ohkura, Takashi; Minakuchi, Moeko; Sagai, Mami; Kokuho, Takehiro; Konishi, Misako; Kameyama, Ken-Ichiro; Takeuchi, Kaoru

    2015-02-01

    Bovine parainfluenza virus type 3 (BPIV3) is an important pathogen associated with bovine respiratory disease complex (BRDC). We have generated a recombinant BPIV3 expressing enhanced green fluorescent protein (rBPIV3-EGFP) based on the BN-1 strain isolated in Japan. After intranasal infection of hamsters with rBPIV3-EGFP, EGFP fluorescence was detected in the upper respiratory tract including the nasal turbinates, pharynx, larynx, and trachea. In the nasal turbinates, rBPIV3-EGFP attained high titers (>10(6) TCID50/g of tissue) 2-4 days after infection. Ciliated epithelial cells in the nasal turbinates and trachea were infected with rBPIV3-EGFP. Histopathological analysis indicated that mucosal epithelial cells in bronchi were shed by 6 days after infection, leaving non-ciliated cells, which may have increased susceptibility to bacterial infection leading to the development of BRDC. These data indicate that rBPIV3-EGFP infection of hamsters is a useful small animal model for studying the development of BPIV3-associated BRDC. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. [The accidental aspiration and ingestion of petroleum in a "fire eater"].

    Science.gov (United States)

    Ewert, R; Lindemann, I; Romberg, B; Petri, F; Witt, C

    1992-10-16

    A 26-year-old man, practicing for a variety performance as "fire-eater", accidentally inhaled and ingested about 10 ml petroleum. Soon afterwards he developed dyspnoea, an urge to cough, fever up to 39 degrees C and loss of retentiveness. He was treated as an out-patient with doxycycline, 100 mg daily, and aspirin, 500 mg three times daily. While this reduced the dyspnoea, the elevated temperature persisted and he had haemoptysis. Chest x-ray and computed tomography 12 days after the aspiration revealed areas of atelectasis and of liquefaction necroses. Bronchoscopic and cytological examinations showed eosinophilic alveolitis and mucosal necrosis in both main bronchi. The symptoms were improved by two inhalations of beclomethasone four times daily, and systemic treatment with prednisolone, 50 mg daily, together with parenteral antibiotic administration (cefotaxime, 1.0 g twice daily). The focal lung lesions regressed completely within a few weeks. Five months after the aspiration computed tomography merely demonstrated discrete scarring of the previously necrotic lesions. This case illustrates that, even with extensive necrotic lung changes after petroleum aspiration, conservative treatment is justified and likely to be effective.

  14. The effects of emphysema on airway disease: Correlations between multi-detector CT and pulmonary function tests in smokers

    Energy Technology Data Exchange (ETDEWEB)

    Yahaba, Misuzu, E-mail: mis_misuzu@yahoo.co.jp; Kawata, Naoko, E-mail: chumito_03@yahoo.co.jp; Iesato, Ken, E-mail: iesato_k@yahoo.co.jp; Matsuura, Yukiko, E-mail: matsuyuki_future@yahoo.co.jp; Sugiura, Toshihiko, E-mail: sugiura@js3.so-net.ne.jp; Kasai, Hajime, E-mail: daikasai6075@yahoo.co.jp; Sakurai, Yoriko, E-mail: yoliri@nifty.com; Terada, Jiro, E-mail: jirotera@chiba-u.jp; Sakao, Seiichiro, E-mail: sakao@faculty.chiba-u.jp; Tada, Yuji, E-mail: ytada@faculty.chiba-u.jp; Tanabe, Nobuhiro, E-mail: ntanabe@faculty.chiba-u.jp; Tatsumi, Koichiro, E-mail: tatsumi@faculty.chiba-u.jp

    2014-06-15

    Background: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation caused by emphysema and small airway narrowing. Quantitative evaluation of airway dimensions by multi-detector computed tomography (MDCT) has revealed a correlation between airway dimension and airflow limitation. However, the effect of emphysema on this correlation is unclear. Objective: The goal of this study was to determine whether emphysematous changes alter the relationships between airflow limitation and airway dimensions as measured by inspiratory and expiratory MDCT. Methods: Ninety-one subjects underwent inspiratory and expiratory MDCT. Images were evaluated for mean airway luminal area (Ai), wall area percentage (WA%) from the third to the fifth generation of three bronchi (B1, B5, B8) in the right lung, and low attenuation volume percent (LAV%). Correlations between each airway index and airflow limitation were determined for each patient and compared between patients with and without evidence of emphysema. Results: In patients without emphysema, Ai and WA% from both the inspiratory and expiratory scans were significantly correlated with FEV{sub 1.} No correlation was detected in patients with emphysema. In addition, emphysematous COPD patients with GOLD stage 1 or 2 disease had significantly lower changes in B8 Ai than non-emphysematous patients. Conclusions: A significant correlation exists between airway parameters and FEV{sub 1} in patients without emphysema. Emphysema may influence airway dimensions even in patients with mild to moderate COPD.

  15. Allergic rhinitis and asthma: inflammation in a one-airway condition

    Directory of Open Access Journals (Sweden)

    Haahtela Tari

    2006-11-01

    Full Text Available Abstract Background Allergic rhinitis and asthma are conditions of airway inflammation that often coexist. Discussion In susceptible individuals, exposure of the nose and lungs to allergen elicits early phase and late phase responses. Contact with antigen by mast cells results in their degranulation, the release of selected mediators, and the subsequent recruitment of other inflammatory cell phenotypes. Additional proinflammatory mediators are released, including histamine, prostaglandins, cysteinyl leukotrienes, proteases, and a variety of cytokines, chemokines, and growth factors. Nasal biopsies in allergic rhinitis demonstrate accumulations of mast cells, eosinophils, and basophils in the epithelium and accumulations of eosinophils in the deeper subepithelium (that is, lamina propria. Examination of bronchial tissue, even in mild asthma, shows lymphocytic inflammation enriched by eosinophils. In severe asthma, the predominant pattern of inflammation changes, with increases in the numbers of neutrophils and, in many, an extension of the changes to involve smaller airways (that is, bronchioli. Structural alterations (that is, remodeling of bronchi in mild asthma include epithelial fragility and thickening of its reticular basement membrane. With increasing severity of asthma there may be increases in airway smooth muscle mass, vascularity, interstitial collagen, and mucus-secreting glands. Remodeling in the nose is less extensive than that of the lower airways, but the epithelial reticular basement membrane may be slightly but significantly thickened. Conclusion Inflammation is a key feature of both allergic rhinitis and asthma. There are therefore potential benefits for application of anti-inflammatory strategies that target both these anatomic sites.

  16. In silico analyses and global transcriptional profiling reveal novel putative targets for Pea3 transcription factor related to its function in neurons.

    Directory of Open Access Journals (Sweden)

    Başak Kandemir

    Full Text Available Pea3 transcription factor belongs to the PEA3 subfamily within the ETS domain transcription factor superfamily, and has been largely studied in relation to its role in breast cancer metastasis. Nonetheless, Pea3 plays a role not only in breast tumor, but also in other tissues with branching morphogenesis, including kidneys, blood vasculature, bronchi and the developing nervous system. Identification of Pea3 target promoters in these systems are important for a thorough understanding of how Pea3 functions. Present study particularly focuses on the identification of novel neuronal targets of Pea3 in a combinatorial approach, through curation, computational analysis and microarray studies in a neuronal model system, SH-SY5Y neuroblastoma cells. We not only show that quite a number of genes in cancer, immune system and cell cycle pathways, among many others, are either up- or down-regulated by Pea3, but also identify novel targets including ephrins and ephrin receptors, semaphorins, cell adhesion molecules, as well as metalloproteases such as kallikreins, to be among potential target promoters in neuronal systems. Our overall results indicate that rather than early stages of neurite extension and axonal guidance, Pea3 is more involved in target identification and synaptic maturation.

  17. Selection and fabrication of a non-woven polycarbonate urethane cover for a tissue engineered airway stent.

    Science.gov (United States)

    Chen, Weiluan; Clauser, Johanna; Thiebes, Anja Lena; McGrath, Donnacha J; McHugh, Peter E; Steinseifer, Ulrich; Jockenhoevel, Stefan; Hennink, Wim E; Kok, Robbert Jan

    2016-11-30

    One of the major problems in end-stage bronchotracheal cancer is stenosis of the upper airways, either due to luminal ingrowth of the tumor or mucus plugging. Airway stents that suppress tumor ingrowth and sustain mucociliary transport can alleviate these problems in end-stage bronchial cancer. We evaluated different types of polymeric covers for a tissue engineered airway stent. The distinguishing feature of this stent concept is that respiratory epithelial cells can grow on the luminal surface of the stent which facilitates mucociliary clearance. To facilitate growth of epithelial cells at the air-liquid interface of the stent, we developed a polyurethane cover that allows transport of nutrients to the cells. Nonwoven polycarbonate urethane (PCU) covers were prepared by a spraying process and evaluated for their porosity and glucose permeability. Respiratory epithelial cells harvested from sheep trachea were cultured onto the selected PCU cover and remained viable at the air-liquid interface when cultured for 21days. Lastly, we evaluated the radial force of a PCU-covered nitinol stent, and showed the PCU covers did not adversely affect the mechanical properties of the stents for their intended application in the smaller bronchi. These in vitro data corroborate the design of a novel airway stent for palliative treatment of bronchotracheal stenosis by combination of stent-technology with tissue-engineered epithelial cells. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. [Dust lung or dust-induced lung disease ( discussion on chronic dust-induced lung disease)].

    Science.gov (United States)

    Kosarev, V V

    1989-01-01

    The comment on the article by D. M. Zislin (Occupational Hygiene and Industrial Diseases, 1988, N 10) is presented. Proceeding from the author's own experience and literary data, the main statement of D. M. Zislin disputing the concept of dust pulmonary disease (DPD) in the modern occupational pulmonology, is analyzed. The common cause of pneumoconiosis and dust bronchitis has been identified as fibrogenic dust, allergic, carcinogenic and toxic characteristics of which can be only condition affecting the disease clinical character. The article shows that neither generality, nor the differences in the functional changes of external respiration can serve as a convincing argument for or against the existence of the concept of DPD. Modern histomorphologic studies give evidence that low-fibrogenic dusts practically simultaneously cause the onset of the pathologic process both in the interstitial tissue and in the bronchi, the outcome of the process being diffuse pneumosclerosis. The concept of DPD caused by low-fibrogenic dusts has been substantiated on the basis of common etiology and similar pathogenetic, clinical and functional manifestations.

  19. Use of the virtual slide and the dynamic real-time telepathology systems for a consultation and the frozen section intra-operative diagnosis in thoracic/pulmonary pathology.

    Directory of Open Access Journals (Sweden)

    Lech Chyczewski

    2010-05-01

    Full Text Available We report the results of a study designed for assessment of the diagnostic accuracy and usability of internet-based digital microscopy: the dynamic real-time telepathology system (Coolscope and the Virtual microscopy (Aperio Scan Scope system, in the context of pulmonary pathology. The systems were implemented to the routine pulmonary pathology workflows and used for the intra-operative frozen-section primary diagnosis as well as for the secondary (consultative diagnosis. The histological material presented for the teleconsultations included the samples of lung parenchyma, bronchial biopsy and resected lung/bronchi tumours. For the primary diagnosis 4 categories of material can be distinguished (304 samples: 1 the frozen sections of lung tumours, resected bronchial margins and lymph nodes; 2 fine needle aspiration [FNA] biopsies (TBNA; EBUS-TBNA, EUS-FNA; 3 oligobiopsies of bronchus, oesophagus, skin; and 4 exfoliative cytology. The telepathology diagnoses compared with conventional light microscopy diagnoses showed very high concordance for the Coolscope and Aperio Virtual Slide modality: 87.5% and 100%, respectively - within the group of teleconsultations. For the frozen sections, the primary telediagnoses were concordant with the light microscopy paraffin sections diagnoses in 100% for Aperio; and in 97.5% for Coolscope. An excellent agreement (100% was seen in the telediagnoses and conventional slides diagnoses for FNA, oligobiopsies and cytology - for both telepathology systems. These results provide some encouragement for the implementation of Coolscope and virtual slide-based telepathology (Aperio system to the routine histopathological diagnostics.

  20. Diagnosis of drowning using post-mortem computed tomography – state of the art

    Directory of Open Access Journals (Sweden)

    Catherine Raux

    2014-12-01

    Full Text Available Aim of the study: Recent studies using post-mortem computed tomography (PMCT have suggested this imaging modality is of value in the positive diagnosis of drowning. We summarize the data from the literature regarding the diagnostic value of CT in cases of drowning. Material and methods: We performed an all-language search of literature published from 1999 to 2013 with the key words “post-mortem CT scan”, “drowning and CT scan”, “near-drowning diagnosis”, and “drowning diagnosis”. Results : Only 11 articles, whose data enabled complementary statistical analysis, were included. The presence of fluid and sediment in paranasal sinuses appear to be the determinants of the diagnosis of drowning. The presence of fluid in the sinuses had a sensitivity of 100%, and of 90% in the trachea and main bronchi. The results were completed by the high specificity of the presence of sediment in the paranasal sinuses, upper airways and stomach, which was 100% for all three. Haemodilution was present in cases of drowning (p < 0.001. The values made it possible to formulate a decision algorithm for the diagnosis of drowning.

  1. [Organic compounds in urban aerosols and their mutagenicity].

    Science.gov (United States)

    Ketseridis, G; Wullenweber, M; Rüden, H

    1982-08-01

    The determination of the total particulate matter (TPM), the ether extractable organic matter (EEOM) and the polycyclic aromatic hydrocarbons (PAH) in urban aerosols of Berlin-Wedding and their biological testing (Ames test) has shown that: 1. the concentrations of EEOM and TPM are probably dependent on the wind direction whereas an influence of wind velocity and temperature cannot be stated on basis of our data. 2. in most cases the concentrations of EEOM and TPM are higher on workdays than on weekends, 3. the concentration of EEOM decreases from January till May, 4. the main portion of EEOM and nearly all PAH are concentrated in the smaller particles (aerodynamic diameters less than 1.4 micrometer), 5. the PAH with four and less than four benzene nuclei show maximal concentrations on workdays whereas higher condensed PAH show a maximum on weekends, 6. most of the ether-extracts exhibits mutagenicity in the Ames test, 7. extracts of the probably lung penetrating fractions 5 and 6 (impactor stages) mostly cause higher rates of mutation than those of the combined fractions 2-4 (main site of impaction: nose and bronchi), 8. the highest rates of mutations are received with EEOM from february-samples.

  2. OPTIMAL USE OF BETA-BLOCKERS IN CASE OF CHRONIC HEART FAILURE

    Directory of Open Access Journals (Sweden)

    N. A. Shostak

    2016-01-01

    Full Text Available Objective – review current data on the use of beta-blockers (BB in chronic heart failure (CHF.Materials and methods. This article discusses beneficial effects of BB administration in CHF patients. It has been demonstrated that decrease in heart rate underlies clinical efficacy of BB therapy in patients with chronic heart failure. We reviewed the question of the necessity to achieve target doses of BB in the treatment of CHF patients. It has been shown that administration of BB in patients with chronic heart failure and reduced left ventricular ejection fraction increase pumping function of heart, and thus reduce the number of hospitalizations for decompensated heart failure, reducing the risk of total and sudden mortality. We demonstrated substantial advantages of β1-selective BB over nonselective ones with respect to their impact on hemodynamics, metabolic processes, rheological parameters of blood and bronchi. We also considered therapeutic tactics in case of BB administration in CHF patients.Results. Based on the data of the current studies we proved high efficiency and safety of β1-selective BBs in CHF patients.Conclusion. Correct choice of BB in patients with CHF and decrease in heart rate during the treatment can significantly increase an effectiveness of the treatment.

  3. The origin of dyspnea and its role in the reduction of exercise endurance in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Mikhail Vasil'evich Sheyanov

    2010-01-01

    Results. Dyspnea during exercise was reported by 54 (52% patients with RA and 9 (9% control patients (p < 0.001. Dyspnea was more frequently detected and more significant in RA patients with other symptoms of respiratory organ lesions (cough, sputum discharge, chest pain on breathing and coughing, anemia, and emotional disorders of the anxious-depressive type. The degree of dyspnea correlated with DAS 28 scores (r = 0.33; p < 0.01. No correlation was found between lung function parameters and blood gas composition. Pulmonary MSCT in RA patients with dyspnea more frequently revealed signs of bronchiolitis and lesion of the lung as its interstitial fibrotic type. Conclusion. Dyspnea is a common symptom and an important factor in reducing EE and QL in patients with RA. Dyspnea in these patients has a multifactorial origin. Of importance in its occurrence are the involvement of the lung and bronchi in the pathological process irrespective of the lung function, as well as RA-associated factors (including anemia, and nosogenic emotional disorders (anxiety and/or depression.

  4. Pictorial essay: Allergic bronchopulmonary aspergillosis

    Directory of Open Access Journals (Sweden)

    Ritesh Agarwal

    2011-01-01

    Full Text Available Allergic bronchopulmonary aspergillosis (ABPA is the best-known allergic manifestation of Aspergillus-related hypersensitivity pulmonary disorders. Most patients present with poorly controlled asthma, and the diagnosis can be made on the basis of a combination of clinical, immunological, and radiological findings. The chest radiographic findings are generally nonspecific, although the manifestations of mucoid impaction of the bronchi suggest a diagnosis of ABPA. High-resolution CT scan (HRCT of the chest has replaced bronchography as the initial investigation of choice in ABPA. HRCT of the chest can be normal in almost one-third of the patients, and at this stage it is referred to as serologic ABPA (ABPA-S. The importance of central bronchiectasis (CB as a specific finding in ABPA is debatable, as almost 40% of the lobes are involved by peripheral bronchiectasis. High-attenuation mucus (HAM, encountered in 20% of patients with ABPA, is pathognomonic of ABPA. ABPA should be classified based on the presence or absence of HAM as ABPA-S (mild, ABPA-CB (moderate, and ABPA-CB-HAM (severe, as this classification not only reflects immunological severity but also predicts the risk of recurrent relapses.

  5. L-ornithine derived polyamines in cystic fibrosis airways.

    Directory of Open Access Journals (Sweden)

    Hartmut Grasemann

    Full Text Available Increased arginase activity contributes to airway nitric oxide (NO deficiency in cystic fibrosis (CF. Whether down-stream products of arginase activity contribute to CF lung disease is currently unknown. The objective of this study was to test whether L-ornithine derived polyamines are present in CF airways and contribute to airway pathophysiology. Polyamine concentrations were measured in sputum of patients with CF and in healthy controls, using liquid chromatography-tandem mass spectrometry. The effect of spermine on airway smooth muscle mechanical properties was assessed in bronchial segments of murine airways, using a wire myograph. Sputum polyamine concentrations in stable CF patients were similar to healthy controls for putrescine and spermidine but significantly higher for spermine. Pulmonary exacerbations were associated with an increase in sputum and spermine levels. Treatment for pulmonary exacerbations resulted in decreases in arginase activity, L-ornithine and spermine concentrations in sputum. The changes in sputum spermine with treatment correlated significantly with changes in L-ornithine but not with sputum inflammatory markers. Incubation of mouse bronchi with spermine resulted in an increase in acetylcholine-induced force and significantly reduced nitric oxide-induced bronchial relaxation. The polyamine spermine is increased in CF airways. Spermine contributes to airways obstruction by reducing the NO-mediated smooth muscle relaxation.

  6. Lung mechanical changes following bronchoaspiration in a porcine model: differentiation of direct and indirect mechanisms.

    Science.gov (United States)

    Fodor, Gergely H; Peták, Ferenc; Erces, Dániel; Balogh, Adám L; Babik, Barna

    2014-08-01

    Bronchoaspiration results in local deterioration of lung function through direct damage and/or indirect systemic effects related to neurohumoral pathways. We distinguished these effects by selectively intubating the two main bronchi in pigs while a PEEP of 4 or 10cm H2O was maintained. Gastric juice was instilled only into the right lung. Lung mechanical and ventilation defects were assessed by measuring unilateral pulmonary input impedance (ZL,s) and the third phase slope of the capnogram (SIII) for each lung side separately before the aspiration and for 120min thereafter. Marked transient elevations in ZL,s parameters and SIII were observed in the affected lung after aspiration. Elevating PEEP did not affect these responses in the ZL,s parameters, whereas it prevented the SIII increases. None of these indices changed in the intact left lung. These findings furnish evidence of the predominance of the local direct damage over the indirect systemic effects in the development of the deterioration of lung function, and demonstrate the benefit of an initially elevated PEEP following aspiration. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Airway Obstruction Due to Bronchial Vascular Injury after Sulfur Mustard Analog Inhalation

    Science.gov (United States)

    Veress, Livia A.; O'Neill, Heidi C.; Hendry-Hofer, Tara B.; Loader, Joan E.; Rancourt, Raymond C.; White, Carl W.

    2010-01-01

    Rationale: Sulfur mustard (SM) is a frequently used chemical warfare agent, even in modern history. SM inhalation causes significant respiratory tract injury, with early complications due to airway obstructive bronchial casts, akin to those seen after smoke inhalation and in single-ventricle physiology. This process with SM is poorly understood because animal models are unavailable. Objectives: To develop a rat inhalation model for airway obstruction with the SM analog 2-chloroethyl ethyl sulfide (CEES), and to investigate the pathogenesis of bronchial cast formation. Methods: Adult rats were exposed to 0, 5, or 7.5% CEES in ethanol via nose-only aerosol inhalation (15 min). Airway microdissection and confocal microscopy were used to assess cast formation (4 and 18 h after exposure). Bronchoalveolar lavage fluid (BALF) retrieval and intravascular dye injection were done to evaluate vascular permeability. Measurements and Main Results: Bronchial casts, composed of abundant fibrin and lacking mucus, occluded dependent lobar bronchi within 18 hours of CEES exposure. BALF contained elevated concentrations of IgM, protein, and fibrin. Accumulation of fibrin-rich fluid in peribronchovascular regions (4 h) preceded cast formation. Monastral blue dye leakage identified bronchial vessels as the site of leakage. Conclusions: After CEES inhalation, increased permeability from damaged bronchial vessels underlying damaged airway epithelium leads to the appearance of plasma proteins in both peribronchovascular regions and BALF. The subsequent formation of fibrin-rich casts within the airways then leads to airways obstruction, causing significant morbidity and mortality acutely after exposure. PMID:20639443

  8. Morphology of the bronchial tree of coati lungs (Nasua nasua, Linnaeus, 1966

    Directory of Open Access Journals (Sweden)

    Amilton Cesar dos Santos

    2011-06-01

    Full Text Available The coati (Nasua nasua is a diurnal, terrestrial and arboricola procionidae. It feeds extensively on the ground and uses trees to procriate, to sleep overnight and to take refuge. Its diet is omnivorous and it feeds on fruits, small vertebrates and invertebrates, nectar, eggs and vegetables. The aim of this work was to characterize microscopically the bronchial tree of the coati. Four coatis (two males and two females, fixed in formaldehyde solution 10%, were used from previous research conducted at CECRIMPAS – UNIFEOB (IBAMA-02027.003731/04-76. For this work, the tissue samples were embedded in paraffin by routine technique and processed for light microscopy in HE staining for analysis under a light microscope. It was found that microscopically, the bronchial tree of the coati is similar to that of other mammals described in the literature, i.e. it has great variations in its architecture, such as a reduced height of the epithelium which changes from ciliated pseudostratified in the larger bronchi to being cubic in the smaller bronchioles, an absence of cilia and glands in the smaller bronchioles, and a decrease in diameter and thickness of its walls.

  9. Morphological study of the respiratory system of the brown-nosed coati (Nasua nasua

    Directory of Open Access Journals (Sweden)

    João Flavio Panattoni Martins

    2012-03-01

    Full Text Available The goal of this study was to describe, macroscopically and with light microscopy, the respiratory organs of the brown-nosed coati (Nasua nasua. Five animals were euthanized, fixed in 10% formaldehyde solution and stored for dissection. The respiratory tracts of the coati were examined, measured and photographed. For the light microscopy study, fragments were collected from the respiratory organs, processed using standard techniques for histology and stained with HE and toluidine blue. The nose of the coati is pointed and turned upward. Internally it has ethmoidal, dorsal nasal and ventral nasal conchae that are separated by the dorsal and ventral nasal meatuses. The larynx has four cartilaginous structures: arytenoid, cricoid, epiglottis and thyroid. The trachea contains 34 tracheal rings and tracheal ligaments that are covered with ciliated pseudostratified epithelial tissue. The lungs are divided into lobes by interlobular fissures. The right lung is divided into four lobes and is larger than the left lung, whereas the left lung has only two lobes. Microscopically, the primary, secondary and tertiary bronchi have epithelial tissue that is similar to the trachea. We conclude that the respiratory tract of the brown-nosed coati resembles the respiratory tracts described for domestic carnivores.

  10. CFD heat transfer simulation of the human upper respiratory tract for oronasal breathing condition

    Directory of Open Access Journals (Sweden)

    Kambiz Farahmand

    2012-01-01

    Full Text Available Injuries due to inhalation of hot gas are commonly encountered when dealing with fire and combustible material, which is harmful and threatens human life. In the literature, various studies have been conducted to investigate heat and mass transfer characteristics in the human respiratory tract (HRT. This study focuses on assessing the injury taking place in the upper human respiratory tract and identifying acute tissue damage, based on level of exposure. A three-dimensional heat transfer simulation is performed using Computational Fluid Dynamics (CFD software to study the temperature profile through the upper HRT consisting of the nasal cavity, oral cavity, trachea, and the first two generations of bronchi. The model developed is for the simultaneous oronasal breathing during the inspiration phase with a high volumetric flow rate of 90 liters/minute and the inspired air temperature of 100 degrees Celsius. The geometric model depicting the upper HRT is generated based on the data available and literature cited. The results of the simulation give the temperature distribution along the center and the surface tissue of the respiratory tract. This temperature distribution will help to assess the level of damage induced in the upper respiratory tract and appropriate treatment for the damage. A comparison of nasal breathing, oral breathing, and oronasal breathing is performed. Temperature distribution can be utilized in the design of the respirator systems where inlet temperature is regulated favoring the human body conditions.

  11. Management of Laryngotracheal and Tracheobronchial Injuries

    Directory of Open Access Journals (Sweden)

    Hamid Reza Davari

    2010-09-01

    Full Text Available Laryngotracheal and tracheobronchial injuries are uncommon,and their successful diagnosis and management often require ahigh level of expertise. This paper aimed at retrospectiveanalysis of a thoracic surgeon's experience in the diagnosisand management of traumatic injuries to the larynx, tracheaand major bronchi. Forty one patients with major airwaytrauma were managed from March 1994 to November 2008.Their demographic characteristics including age, gender,mechanisms and locations of injuries, associated other organinjuries as well as surgical airway managements and the outcomeswere recorded. Seven patients had re-implantation ofthe main bronchus, and one patient had a repair of the rightupper lobe bronchus with concomitant bilobectomy. In casesof tracheal injury, 16 patients had a primary repair of trachea.However, seven patients with tracheal injury first conservativeapproaches, but 4 of them were later subjected to sleeve resectionof trachea. In patients with laryngotracheal injuries, and ina patient with thermal injury, Montgomery T-Tube was usedwith or without repair and/or reconstruction. Four patients died,but no significant morbidity was seen in others. The analysis ofthe cases suggests that laryngotracheal and tracheobronchialinjuries require early correct diagnosis, skillful management,and prompt individualized surgical airway repair.

  12. Virtual landmarks

    Science.gov (United States)

    Tong, Yubing; Udupa, Jayaram K.; Odhner, Dewey; Bai, Peirui; Torigian, Drew A.

    2017-03-01

    Much has been published on finding landmarks on object surfaces in the context of shape modeling. While this is still an open problem, many of the challenges of past approaches can be overcome by removing the restriction that landmarks must be on the object surface. The virtual landmarks we propose may reside inside, on the boundary of, or outside the object and are tethered to the object. Our solution is straightforward, simple, and recursive in nature, proceeding from global features initially to local features in later levels to detect landmarks. Principal component analysis (PCA) is used as an engine to recursively subdivide the object region. The object itself may be represented in binary or fuzzy form or with gray values. The method is illustrated in 3D space (although it generalizes readily to spaces of any dimensionality) on four objects (liver, trachea and bronchi, and outer boundaries of left and right lungs along pleura) derived from 5 patient computed tomography (CT) image data sets of the thorax and abdomen. The virtual landmark identification approach seems to work well on different structures in different subjects and seems to detect landmarks that are homologously located in different samples of the same object. The approach guarantees that virtual landmarks are invariant to translation, scaling, and rotation of the object/image. Landmarking techniques are fundamental for many computer vision and image processing applications, and we are currently exploring the use virtual landmarks in automatic anatomy recognition and object analytics.

  13. An approach to segment lung pleura from CT data with high precision

    Science.gov (United States)

    Angelats, E.; Chaisaowong, K.; Knepper, A.; Kraus, T.; Aach, T.

    2008-03-01

    A new approach to segment pleurae from CT data with high precision is introduced. This approach is developed in the segmentation's framework of an image analysis system to automatically detect pleural thickenings. The new technique to carry out the 3D segmentation of lung pleura is based on supervised range-constrained thresholding and a Gibbs-Markov random field model. An initial segmentation is done using the 3D histogram by supervised range-constrained thresholding. 3D connected component labelling is then applied to find the thorax. In order to detect and remove trachea and bronchi therein, the 3D histogram of connected pulmonary organs is modelled as a finite mixture of Gaussian distributions. Parameters are estimated using the Expectation-Maximization algorithm, which leads to the classification of that pulmonary region. As consequence left and right lungs are separated. Finally we apply a Gibbs-Markov random field model to our initial segmentation in order to achieve a high accuracy segmentation of lung pleura. The Gibbs- Markov random field is combined with maximum a posteriori estimation to estimate optimal pleural contours. With these procedures, a new segmentation strategy is developed in order to improve the reliability and accuracy of the detection of pleural contours and to achieve a better assessment performance of pleural thickenings.

  14. [Trace elements in the pathogenesis and treatment of chronic bronchitis (a clinico-experimental study)].

    Science.gov (United States)

    Tadzhiev, F S

    1991-01-01

    Experiments on healthy male rats and those with chronic inflammation in the bronchi (CIB) were made to measure the content of testosterone, estradiol, zinc and copper in the blood and in the liquid of bronchoalveolar lavage (LBAL) as well as in the vitally important organs. Attempts were also made to equalize the content of trace elements by means of medicamentous correction in patients suffering from chronic obstructive bronchitis (COB). In CIB, there was a decrease of testosterone concentration in the blood and of zinc concentration in the plasma and formed elements of the blood, lungs, heart, liver, testes and adrenals (p less than 0.05). The zinc level in the LBAL was two times higher, that of copper was three times lower. After zinc sulfate was included into a complex of treatment measures for COB patients, zinc and copper concentrations in the plasma and formed elements of the blood returned to normal in addition to the improvement of the general health status. In the reference group of patients who received conventional symptomatic treatment, the given parameters did not noticeably change.

  15. CYTOLOGICAL AND MORPHOMETRIC ESTIMATE OF THE INFLAMMATION AMONG THE CHILDREN, SUFFERING FROM MODERATELY SEVERE BRONCHIAL ASTHMA

    Directory of Open Access Journals (Sweden)

    T.R. Dulina

    2007-01-01

    Full Text Available The search for the new noninvasive and information methods to estimate the intensity of the inflammatory processes during the bronchial asthma is an important task for the modern medicine, pediatrics, in particular. We have examined 20 children, suffering from moderately severe bronchial asthma in remission. patients underwent the induction of the sputum by means of nail hypertonic solution, bronchoscopic examination along with the sampling of the lavage fluid and bronchial biopsy, cytometry of the induced sputum and bronchoalveolar lavage fluid, morphometric examination of the biopsy samples of bronchi walls, determination of the nitric oxide contents in the expired air. We revealed high self descriptiveness of the cytological characteristics of the induced sputum. High percentage of neutrophiles and eosinophiles in the induced sputum disclosed during remission of the bronchial asthma, as well as thickness increase of the basilemma, ratio distortion of the ciliated and cyathiform cells in the favor of the latter, especially along with the high nitric oxide contents in the expired air indicate the continuous persistence in the allergic respiratory inflammation.Key words: induced sputum, bronchial asthma, children.

  16. Clinical commentary --COPD is not a systemic disease. Results from the AIMAR Expert Opinion Consensus/Dissensus Seminar "COPD is/is not a systemic disease?", Venice, Italy, 13-14 November 2008.

    Science.gov (United States)

    Donner, Claudio F; Bjermer, Leif

    2009-09-01

    Although COPD is a major disease worldwide there is a perplexing current uncertainty about the nature of this disease. COPD is characterized at onset and prevalently by the involvement of the lungs and bronchi, but as the disease evolves abnormalities develop in other organs and systems and the question arises: what is the pathogenesis of these respiratory and systemic impairments? Are the alterations that occur outside the respiratory system in the course of COPD a direct consequence of the lung pathology or is the lung simply the local expression of a pathological event whose origin lies in the organism as a whole? To tease out this issue, the Expert Opinion Consensus/Dissensus Seminar "COPD is/is not a systemic disease?" took place in Venice, on 13-14 November 2008. The Seminar was conceived and organized by the Italian Interdisciplinary Association for Research in Lung Disease, AIMAR. Top international opinion leaders in the respiratory field were invited to participate, the aim being to bring together sustainers of the two sides in a format allowing the best opportunity for an in-depth debate. Over the two days, different aspects of the issue 'upstream' (pathophysiology and biology) and 'downstream' (treatment and outcome assessment) were discussed. The general consensus that emerged, based on the still limited evidence available, was that COPD begins as a local inflammation in the lungs and this leads - through differentiated pathways yet to be fully clarified - to systemic consequences.

  17. Extracellular Assembly of the Elastin Cable Line Element in the Developing Lung.

    Science.gov (United States)

    Valenzuela, Cristian D; Wagner, Willi L; Bennett, Robert D; Ysasi, Alexandra B; Belle, Janeil M; Molter, Karin; Straub, Beate K; Wang, Dong; Chen, Zi; Ackermann, Maximilian; Tsuda, Akira; Mentzer, Steven J

    2017-09-01

    In the normal lung, a dominant structural element is an elastic "line element" that originates in the central bronchi and inserts into the distal airspaces. Despite its structural importance, the process that leads to development of the cable line element is unknown. To investigate the morphologic events contributing to its development, we used optical clearing methods to examine the postnatal rat lung. An unexpected finding was numerous spheres, with a median diameter of 1-2 µm, within the primary septa of the rat lung. The spheres demonstrated green autofluorescence, selective fluorescent eosin staining, reactivity with carboxyfluorescein succinimidyl ester, and specific labeling with anti-tropoelastin monoclonal antibody-findings consistent with tropoelastin. The sphere number peaked on rat postnatal day 4 (P4) and were rare by P14. The disappearance of the spheres was coincident with the development of the cable line element in the rat lung. Transmission electron microscopy demonstrated no consistent association between parenchymal cells and sphere alignment. In contrast, the alignment of tropoelastin spheres appeared to be the direct result of interactions of scaffold proteins including collagen fibers and fibrillin microfibrils. We conclude that the spatial organization of the cable line element appears to be independent of tropoelastin deposition, but dependent on crosslinking to scaffold proteins within the primary septa. Anat Rec, 300:1670-1679, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  18. Transmediastinal Trachea Closure after Dilational Tracheotomy Positioned Too Low Down

    Science.gov (United States)

    Kirschbaum, Andreas; Maier, Tanja; Teymoortash, Afsin

    2015-01-01

    Dilational tracheotomy is a minimally invasive method that can be performed at the bedside on patients requiring long-term mechanical ventilation. In our 70-year-old male patient, percutaneous dilational tracheotomy (Ciaglia Blue Rhino, Cook Medical Inc., Bloomington, Indiana, United States) was performed because of bilateral pneumonia with sepsis. There were no initial problems. Nine days later, while the patient was being repositioned, the tracheal cannula became dislocated. Despite extending the cervical incision it was not possible to recannulate. The tracheal hole could not be felt with certainty by palpating through the incision. After several unsuccessful attempts, the patient was intubated orally. The only way to achieve sufficient ventilation was to hold the tracheostoma closed. Bronchoscopy showed that the entry point of the tracheal cannula was ventral and ∼1.5 cm above the main carina. The tube was then advanced into the right main bronchus and the patient was thus ventilated unilaterally. On exposure of the trachea, a grade 3 goiter was revealed. Total neck length was short. Only after the video mediastinoscope had been inserted was it possible to show the tracheal defect below the brachiocephalic trunk. After blunt mobilization of both main bronchi, it was possible to close the tracheal defect with simple interrupted sutures. Conventional tracheotomy was then performed at the level of the second tracheal ring. As a result, mechanical ventilation was once again possible without difficulty and thoracotomy was not necessary. PMID:28018810

  19. Electronic cigarettes: age-specific generation-resolved pulmonary doses.

    Science.gov (United States)

    Manigrasso, Maurizio; Buonanno, Giorgio; Fuoco, Fernanda Carmen; Stabile, Luca; Avino, Pasquale

    2017-05-01

    Particle size-number distributions of aerosol from e-cigarettes (0 and 14 mg mL(-1) nicotine) were compared with conventional cigarettes. Results were used to provide age-specific (9-21 years) dosimetry estimates applying the MMPD model. After a 2-s puff, total number doses (D Tot ) were highest for 9 years of age (6.01 × 10(10)-1.31 × 10(11) particles) and lowest for 18 years of age (4.69 × 10(10)-1.06 × 10(11) particles). Such doses represented about 19-45 and 25-100% of the relevant daily doses of not smoking individuals, respectively, in tracheobronchial (TB) and alveolar (A) regions. D Tot for the e-cigarettes were about double that for conventional cigarette. Deposition densities and daily volume of e-cigarette liquid deposited per unit surface area were maximum at lobar bronchi, highest for 9 years and lowest for 21 years age.

  20. Asthma: Eosinophil Disease, Mast Cell Disease, or Both?

    Directory of Open Access Journals (Sweden)

    Bradding Peter

    2008-06-01

    Full Text Available Although there is much circumstantial evidence implicating eosinophils as major orchestrators in the pathophysiology of asthma, recent studies have cast doubt on their importance. Not only does anti-interleukin-5 treatment not alter the course of the disease, but some patients with asthma do not have eosinophils in their airways, whereas patients with eosinophilic bronchitis exhibit a florid tissue eosinophilia but do not have asthma. In contrast, mast cells are found in all airways and localize specifically to key tissue structures such as the submucosal glands and airway smooth muscle within asthmatic bronchi, irrespective of disease severity or phenotype. Here they are activated and interact exclusively with these structural cells via adhesive pathways and through the release of soluble mediators acting across the distance of only a few microns. The location of mast cells within the airway smooth muscle bundles seems particularly important for the development and propagation of asthma, perhaps occurring in response to, and then serving to aggravate, an underlying abnormality in asthmatic airway smooth muscle function. Targeting this mast cell-airway smooth muscle interaction in asthma offers exciting prospects for the treatment of this common disease.

  1. Role of eosinophilic airway inflammation in models of asthma

    Directory of Open Access Journals (Sweden)

    Lapa e Silva José R

    1997-01-01

    Full Text Available Eosinophils play a central role in the establishment and outcome of bronchial inflammation in asthma. Animal models of allergy are useful to answer questions related to mechanisms of allergic inflammation. We have used models of sensitized and boosted guinea pigs to investigate the nature of bronchial inflammation in allergic conditions. These animals develop marked bronchial infiltration composed mainly of CD4+ T-lymphocytes and eosinophils. Further provocation with antigen leads to degranulation of eosinophils and ulceration of the bronchial mucosa. Eosinophils are the first cells to increase in numbers in the mucosa after antigen challenge and depend on the expression of alpha 4 integrin to adhere to the vascular endothelium and transmigrate to the mucosa. Blockage of alpha4 integrin expression with specific antibody prevents not only the transmigration of eosinophils but also the development of bronchial hyperresponsiveness (BHR to agonists in sensitized and challenged animals, clearly suggesting a role for this cell type in this altered functional state. Moreover, introduction of antibody against Major Basic Protein into the airways also prevents the development of BHR in similar model. BHR can also be suppressed by the use of FK506, an immunosuppressor that reduces in almost 100% the infiltration of eosinophils into the bronchi of allergic animals. These data support the concept that eosinophil is the most important pro-inflammatory factor in bronchial inflammation associated with allergy.

  2. A Patient with Bronchial Asthma in Whom Eosinophilic Bronchitis and Bronchiolitis Developed during Treatment

    Directory of Open Access Journals (Sweden)

    Yasutsugu Fukushima

    2010-01-01

    Full Text Available A 56-year-old woman was referred to our hospital because of dyspnea, wheezing, and a productive cough. Eight years before presentation, bronchial asthma was diagnosed and the patient received inhaled corticosteroids plus antiasthmatic agents (a long-acting inhaled p2-agonist, leukotriene modifiers, and theophylline. Chest radiography showed small diffuse nodular shadows, and a computed tomographic scan showed thickening of the bronchi and bronchioles, with diffuse centrilobular nodules in both lung fields. A blood test and microscopic examination of the bronchoalveolar fluid revealed marked eosinophilia. Transbronchial lung biopsy and transbronchial biopsy showed eosinophilic bronchitis and bronchiolitis. After treatment with oral prednisolone (40 mg daily and inhaled corticosteroids, the symptoms, blood eosinophilia, and radiographic findings improved. Recently, several similar cases of eosinophilic bronchiolitis have been reported. Studies of further cases and elucidation of the pathophysiology of eosinophilic bronchiolitis are necessary to establish a concept for this disease and to determine whether it should be classified as a subtype of bronchial asthma or as a distinct entity.

  3. Computed tomographic appearance of primary lung tumors in dogs.

    Science.gov (United States)

    Marolf, Angela J; Gibbons, Debra S; Podell, Brendan K; Park, Richard D

    2011-01-01

    Canine primary lung tumors typically appear radiographically as a well-circumscribed solitary mass in the periphery of a caudal lung lobe. Consolidated and diffuse forms of primary lung tumors have also been described. Nineteen dogs with computed tomographic (CT) images of the thorax and a histological diagnosis of primary lung tumor (17 primary carcinomas and two primary sarcomas) were evaluated retrospectively to characterize the CT findings. All primary lung tumors were bronchocentric in origin with internal air bronchograms. The bronchi were typically narrowed, displaced, and often obstructed by the tumor. Eighteen of 19 (95%) of the tumors were solitary and there was one pneumonic/alveolar form. Most solitary tumors were well circumscribed (17/18), located in the central to periphery of the lung (14/18), and in a cranial or caudal lobe (16/19). Most primary lung tumors (11/17) had mild to moderate heterogeneous contrast enhancement. Five of 19 dogs (26%) had evidence of pulmonary metastasis. Internal mineralization (3/19) and tracheobronchial lymphadenopathy (4/19) were also identified. On CT examination, solitary, well circumscribed, bronchocentric masses with internal air bronchograms are consistent with a primary pulmonary tumor in dogs. © 2010 Veterinary Radiology & Ultrasound.

  4. Lesions associated with Halocercus brasiliensis Lins de Almeida, 1933 in the lungs of dolphins stranded in the Northeast of Brazil.

    Science.gov (United States)

    Guimarães, J P; Febronio, A M B; Vergara-Parente, J E; Werneck, M R

    2015-04-01

    The parasitic fauna of cetaceans is an important tool for ecological studies, including analyses on the causes of death. Halocercus brasiliensis is a nematode frequently found in the bronchi and bronchioles of some cetaceans, and it is commonly associated with focal inflammation of the respiratory tract leading to bacterial pneumonia and septicemia and, sometimes, to death. The objective of this study was to report infections by H. brasiliensis in the respiratory tract of Delphinidae stranded on the northern seaside of Bahia, Sergipe, and south of Alagoas, all states in the northeast region of Brazil. A total of 30 individuals, 1 Feresa attenuate (pygmy killer whale), 9 Stenella clymene (Clymene dolphin), and 20 Sotalia guianensis (Guiana dolphin) were studied. In 16 of them, the presence of H. brasiliensis was observed with a mean intensity of 3.5 ± 0.6 (range 1-9) in the hosts. Macroscopically, parasitic calcified nodules, lung congestion, edema, and emphysema were observed. Histopathological examination showed interstitial and granulomatous pneumonia with multifocal infiltrates, discrete to moderate edema, congestion, diffuse hemorrhage, and foci of calcification. We conclude that parasitic pneumonia in the sampled individuals may have directly contributed to stranding and death of the animals.

  5. High-resolution computed tomography bronchial lumen to pulmonary artery diameter ratio in anesthetized ventilated cats with normal lungs.

    Science.gov (United States)

    Reid, Lauren E; Dillon, A Ray; Hathcock, John T; Brown, Lawrence A; Tillson, Michael; Wooldridge, Anne A

    2012-01-01

    High-resolution computed tomography (CT) is the preferred noninvasive tool for diagnosing bronchiectasis in people. A criterion for evaluating dilation of the bronchus is the bronchial lumen to pulmonary artery diameter (bronchoarterial ratio [BA ratio]). A ratio of > 1.0 in humans or > 2.0 in dogs has been suggested as a threshold for identifying bronchiectasis. The purpose of this study was to establish the BA ratio in normal cats. Fourteen specific pathogen-free cats were selected for analysis of thoracic CT images. The BA ratios of the lobar bronchi of the left cranial (cranial and caudal parts), right cranial, right middle, left caudal, and right caudal lung lobes were measured. The mean of the mean BA ratio of all lung lobes was 0.71 +/- 0.05. Individual BA ratios ranged from 0.5 to 1.11. Comparing individual lobes for each cat, there was no significant difference (P = 0.145) in mean BA ratio between lung lobes. A mean BA ratio for these normal cats was 0.71 +/- 0.1, which suggests an upper cut-off normal value > 0.91 (mean +/- 2 standard deviations) between normal and abnormal cats.

  6. Mortality associated with melarsomine dihydrochloride administration in two North American river otters (Lontra canadensis) and a red panda (Ailurus fulgens fulgens).

    Science.gov (United States)

    Neiffer, Donald L; Klein, Edwin C; Calle, Paul P; Linn, Michael; Terrell, Scott P; Walker, Rodney L; Todd, Donna; Vice, Carol C; Marks, Steven K

    2002-09-01

    Two adult North American river otters (Lontra canadensis) and an adult red panda (Ailurus fulgens fulgens) at three separate institutions died within 22 hr after receiving single 2.5- to 2.7-mg/kg doses of melarsomine dihydrochloride administered in the epaxial musculature as a treatment for filarid nematodes. One otter had a suspected Dirofilaria immitis infection, the other had a confirmed D. lutrae infection, and the red panda had a confirmed Dirofilaria sp. infection, presumably with D. immitis. Postmortem examinations revealed similar gross lesions, although they were less severe in the red panda. The trachea and primary bronchi contained abundant foamy fluid, the lungs were mottled with areas of consolidation, and the pulmonary parenchyma exuded abundant fluid at the cut section. Histologic evaluation revealed acute pulmonary edema, which resulted in respiratory failure and death. There may have been direct pulmonary cellular toxicity of melarsomine dihydrochloride or a severe systemic anaphylactic reaction to antigens released after parasite death. An idiosyncratic drug reaction or a low therapeutic index of melarsomine probably caused the death of the three individuals. Melarsomine dihydrochloride use should be avoided in North American river otters and red pandas.

  7. Off-the-job training for VATS employing anatomically correct lung models.

    Science.gov (United States)

    Obuchi, Toshiro; Imakiire, Takayuki; Miyahara, Sou; Nakashima, Hiroyasu; Hamanaka, Wakako; Yanagisawa, Jun; Hamatake, Daisuke; Shiraishi, Takeshi; Moriyama, Shigeharu; Iwasaki, Akinori

    2012-02-01

    We evaluated our simulated major lung resection employing anatomically correct lung models as "off-the-job training" for video-assisted thoracic surgery trainees. A total of 76 surgeons voluntarily participated in our study. They performed video-assisted thoracic surgical lobectomy employing anatomically correct lung models, which are made of sponges so that vessels and bronchi can be cut using usual surgical techniques with typical forceps. After the simulation surgery, participants answered questionnaires on a visual analogue scale, in terms of their level of interest and the reality of our training method as off-the-job training for trainees. We considered that the closer a score was to 10, the more useful our method would be for training new surgeons. Regarding the appeal or level of interest in this simulation surgery, the mean score was 8.3 of 10, and regarding reality, it was 7.0. The participants could feel some of the real sensations of the surgery and seemed to be satisfied to perform the simulation lobectomy. Our training method is considered to be suitable as an appropriate type of surgical off-the-job training.

  8. Tolerability and Pharmacokinetic Evaluation of Inhaled Dry Powder Tobramycin Free Base in Non-Cystic Fibrosis Bronchiectasis Patients.

    Directory of Open Access Journals (Sweden)

    Marcel Hoppentocht

    Full Text Available Bronchiectasis is a condition characterised by dilated and thick-walled bronchi. The presence of Pseudomonas aeruginosa in bronchiectasis is associated with a higher hospitalisation frequency and a reduced quality of life, requiring frequent and adequate treatment with antibiotics.To assess local tolerability and the pharmacokinetic parameters of inhaled excipient free dry powder tobramycin as free base administered with the Cyclops dry powder inhaler to participants with non-cystic fibrosis bronchiectasis. The free base and absence of excipients reduces the inhaled powder dose.Eight participants in the study were trained in handling the device and inhaling correctly. During drug administration the inspiratory flow curve was recorded. Local tolerability was assessed by spirometry and recording adverse events. Serum samples were collected before, and 15, 30, 45, 60, 75, 90, 105, 120 min; 4, 8 and 12 h after inhalation.Dry powder tobramycin base was well tolerated and mild tobramycin-related cough was reported only once. A good drug dose-serum concentration correlation was obtained. Relatively small inhaled volumes were computed from the recorded flow curves, resulting in presumably substantial deposition in the central airways-i.e., at the site of infection.In this first study of inhaled dry powder tobramycin free base in non-cystic fibrosis bronchiectasis patients, the free base of tobramycin and the administration with the Cyclops dry powder device were well tolerated. Our data support further clinical studies to evaluate safety and efficacy of this compound in this population.

  9. Stridor and respiratory failure due to tracheobronchomalacia: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Ramon Andrade de Mello

    Full Text Available CONTEXT: Tracheobronchomalacia (TBM results from structural and functional abnormalities of the respiratory system. It is characterized by excessive collapse: at least 50% of the cross-sectional area of the trachea and main bronchi. In this paper, we present a rare case of a patient with TBM who first presented with stridor and respiratory failure due to exacerbation of chronic bronchitis. CASE REPORT: An 81-year-old Caucasian man was admitted presenting coughing, purulent sputum, stridor and respiratory failure. He had a medical history of chronic obstructive pulmonary disease (COPD and silicosis and was a former smoker. Axial computed tomography on the chest revealed marked collapse of the trachea in its middle third. Bronchoscopy showed characteristics compatible with TBM. He was treated with noninvasive ventilation, without any good response. Subsequently, a Dumon Y stent was placed by means of rigid bronchoscopy. After the procedure, he was discharged with a clinical improvement. CONCLUSION: TBM is fatal and often underdiagnosed. In COPD patients, stridor and respiratory failure may be helpful signs that should alert physicians to consider TBM as an early diagnosis. Thus, these signs may be important for optimizing the treatment and evolution of such patients.

  10. Lysyl Oxidase Is Essential for Normal Development and Function of the Respiratory System and for the Integrity of Elastic and Collagen Fibers in Various Tissues

    Science.gov (United States)

    Mäki, Joni M.; Sormunen, Raija; Lippo, Sari; Kaarteenaho-Wiik, Riitta; Soininen, Raija; Myllyharju, Johanna

    2005-01-01

    Lysyl oxidases, a family comprising LOX and four LOX-like enzymes, catalyze crosslinking of elastin and collagens. Mouse Lox was recently shown to be crucial for development of the cardiovascular system because null mice died perinatally of aortic aneurysms and cardiovascular dysfunction. We show here that Lox is also essential for development of the respiratory system and the integrity of elastic and collagen fibers in the lungs and skin. The lungs of E18.5 Lox−/− embryos showed impaired development of the distal and proximal airways. Elastic fibers in E18.5 Lox−/− lungs were markedly less intensely stained and more disperse than in the wild type, especially in the mesenchyme surrounding the distal airways, bronchioles, bronchi, and trachea, and were fragmented in pulmonary arterial walls. The organization of individual collagen fibers into tight bundles was likewise abnormal. Similar elastic and collagen fiber abnormalities were seen in the skin. Lysyl oxidase activity in cultured Lox−/− skin fibroblasts and aortic smooth muscle cells was reduced by ∼80%, indicating that Lox is the main isoenzyme in these cells. LOX abnormalities may thus be critical for the pathogenesis of several common diseases, including pulmonary, skin, and cardiovascular disorders. PMID:16192629

  11. Treatment of laryngeotracheal papillomatosis with the CO2 and Nd:YAG laser

    Science.gov (United States)

    Sedlmaier, Benedikt W.; Jovanovic, Sergije

    2000-06-01

    Papillomas are the most common benign neoplasms of the larynx and trachea. There are two types with different biological behavior, both caused by the human papilloma virus: the form that usually manifest itself in adults as a solitary, rarely recurring lesion, whereas one form that manifests in children and adults. It involves multiple lesions with a tendency to spread and recur. There is still no alternative to repeated surgical removal of the papillomas. In a retrospective study the results of laser surgery are compared with the results of instrumental removal of papillomas. The larynges were treated with the CO2 laser applied via high-precision micromanipulators combined with different scanner systems. In cases where the disease has spread into the cervical trachea, the papilloma foci were exposed by special subglottoscopes prior to transglottic removal with the CO2 laser via the operating microscope. The Nd:YAG laser applied through a jet ventilation tracheoscope via optical fibers has proven useful for involvement of the intrathoracic trachea. The use of the laser has not reduce the recurrency rate but the rate of late complications such as anterior synechia. Furthermore in extensive disease laser therapy enables a controlled bloodless removal even in the thoracic trachea and bronchi.

  12. Metastatic squamous-cell carcinoma of the lung arising in a 12-year-old boy with juvenile recurrent respiratory papillomatosis of neonatal onset.

    Science.gov (United States)

    Boudjemaa, Sabah; Leboulanger, Nicolas; Daınese, Linda; Cremoux, Patricia De; Pointe, Hubert Ducou Le; Coulomb, Aurore

    2014-01-01

    Juvenile recurrent respiratory papillomatosis is the most common benign neoplastic disease of the larynx in children, characterized by numerous squamous papillomas caused by Human Papilloma Virus type 6 and 11. HPV is thought to be acquired at the time of vaginal delivery from maternal genital condylomas. Juvenile recurrent respiratory papillomatosis can be protracted by surgical interventions performed to avoid airway obstruction and extend below the vocal cords as far as the main stem bronchi. Lung involvement in Juvenile recurrent respiratory papillomatosis seems to be more prevalent than non-systematic reviews have reported until now and progression to cancer occurs in a significant proportion of these cases at a younger age than previously reported. This would suggest that closer attention should be paid to these children. We report a case of malignant transformation in a 12 year-old boy followed-up since the birth for an invasive juvenile recurrent respiratory papillomatosis with pulmonary involvement. The presence of HPV 6/11 was demonstrated by PCR analysis performed on material obtained from a metastatic vertebral lesion.

  13. Investigation on the potential of thulium-fibre-laser irradiation for in-stent tissue ablation (Conference Presentation)

    Science.gov (United States)

    Sroka, Ronald; Frank, Johannes; Reichenberger, Frank; Behr, J.; Gesierich, Wolfgang

    2017-04-01

    Granulation and tumor regrowth in the area of bronchi stent implants may result in restenosis. It had been shown that by means of Thulium-Fibre-Laser (TFL) a controlled ablation and reduction of the tissue within the stent could be performed. When using Nd:YAG irradiation there is risk for explosive flames, burns of fibre and stent, ruptures of stent meshes as well as perforation of stent and cover. Therefore it was the aim to investigate the safety margin when using TFL. Four different types of clinical used stents (with/without cover) were fixed to pig trachea tissue. Irradiation was performed by fibre assisted TFL-1940nm-laser irradiation while laser power, light application duration and distance, as well as oxygen percentage and contamination were varied. In case of Nitinol-stents rupture were observed at power levels >=7W or distances of burns and flames. Based upon these observations in clinical TFL-irradiation the distance should >=5 mm and the power level should be case of Silicon-stents light application on contaminated area should be avoided.

  14. Steady Flow in Subject-Specific Human Airways from Mouth to Sixth Bronchial Generation

    Science.gov (United States)

    Banko, Andrew; Coletti, Filippo; Schiavazzi, Daniele; Elkins, Christopher; Eaton, John

    2013-11-01

    Understanding the complex flow topology within the human lung is critical to assess gas exchange and particle transport as they relate to the development and treatment of respiratory diseases. While idealized airway models have been investigated extensively, only limited information is available for anatomically accurate geometries. We have measured the full three-dimensional, mean velocity field from the mouth to the sixth bronchial generation in a patient-specific geometry at steady inspiration. Magnetic resonance velocimetry is used to measure the flow of water at realistic Reynolds number in a 3D-printed model derived from the CT scan of a healthy subject. The canonical laryngeal jet is observed; however, its structure is altered by an upstream jet behind the tongue, which is not discussed in the literature. Regions of separation in the supraglottic space are found to generate streamwise vortices. The resulting swirl persists to the first bifurcation and modifies the vorticity distribution in the main bronchi relative to that of a symmetric bifurcation with uniform inlet conditions. An integral momentum distortion parameter is calculated along several complete bronchial paths to assess the impact of branching angle and generation length on the flow field.

  15. Computed tomographic bronchioarterial ratio for brachycephalic dogs without pulmonary disease.

    Science.gov (United States)

    Won, Sungjun; Lee, Ahra; Choi, Jihye; Choi, Mincheol; Yoon, Junghee

    2015-01-01

    The bronchoarterial (BA) ratio measured with computed tomography is widely used in human medicine to diagnose bronchial dilation or collapse. Although use of the BA ratio in veterinary medicine has been recently studied, this has not been evaluated in brachycephalic dogs predisposed to bronchial diseases including bronchial collapse. The purpose of this study was to establish BA ratios for brachycephalic dogs and compare the values with those of non-brachycephalic dogs. Twenty-three brachycephalic dogs and 15 non-brachycephalic dogs without clinical pulmonary disease were evaluated. The BA ratio of the lobar bronchi in the left and right cranial as well as the right middle, left, and right caudal lung lobes was measured. No significant difference in mean BA ratio was observed between lung lobes or the individual animals (p = 0.148). The mean BA ratio was 1.08 ± 0.10 (99%CI = 0.98~1.18) for brachycephalic dogs and 1.51 ± 0.05 (99% CI = 1.46~1.56) for the non-brachycephalic group. There was a significant difference between the mean BA ratios of the brachycephalic and non-brachycephalic groups (p = 0.00). Defining the normal limit of the BA ratio for brachycephalic breeds may be helpful for diagnosing bronchial disease in brachycephalic dogs.

  16. The avian lung-associated immune system: a review.

    Science.gov (United States)

    Reese, Sven; Dalamani, Grammatia; Kaspers, Bernd

    2006-01-01

    The lung is a major target organ for numerous viral and bacterial diseases of poultry. To control this constant threat birds have developed a highly organized lung-associated immune system. In this review the basic features of this system are described and their functional properties discussed. Most prominent in the avian lung is the bronchus-associated lymphoid tissue (BALT) which is located at the junctions between the primary bronchus and the caudal secondary bronchi. BALT nodules are absent in newly hatched birds, but gradually developed into the mature structures found from 6-8 weeks onwards. They are organized into distinct B and T cell areas, frequently comprise germinal centres and are covered by a characteristic follicle-associated epithelium. The interstitial tissue of the parabronchial walls harbours large numbers of tissue macrophages and lymphocytes which are scattered throughout tissue. A striking feature of the avian lung is the low number of macrophages on the respiratory surface under non-inflammatory conditions. Stimulation of the lung by live bacteria but not by a variety of bacterial products elicits a significant efflux of activated macrophages and, depending on the pathogen, of heterophils. In addition to the cellular components humoral defence mechanisms are found on the lung surface including secretory IgA. The compartmentalisation of the immune system in the avian lung into BALT and non BALT-regions should be taken into account in studies on the host-pathogen interaction since these structures may have distinct functional properties during an immune response.

  17. Developing cell therapy techniques for respiratory disease: intratracheal delivery of genetically engineered stem cells in a murine model of airway injury

    Science.gov (United States)

    Leblond, Anne-Laure; Naud, Patrice; Forest, Virginie; Gourden, Clothilde; Sagan, Christine; Romefort, Bénédicte; Mathieu, Eva; Delorme, Bruno; Collin, Christine; Pagès, Jean-Christophe; Sensebé, Luc; Pitard, Bruno; Lemarchand, Patricia

    2009-01-01

    Over the past decade, interest has increased in the use of exogenous stem cells to optimize lung repair and serve as carriers of a therapeutic gene for genetic airway disease such as cystic fibrosis. We investigated the survival and the engraftment of exogenous stem cells after intratracheal injection, in a murine model of acute epithelial airway injury already used in gene therapy experiments on cystic fibrosis. Embryonic stem cells and mesenchymal stem cells were intratracheally injected 24hr after 2% polidocanol administration, when epithelial airway injury was maximal. Stem cells were transfected with reporter genes immediately prior to administration. Reporter gene expression was analyzed in trachea-lungs and bronchoalveolar lavages using non-fluorescent, quantitative and sensitive methods. ELISA quantitative results showed that 0.4 to 5.5% stem cells survived in the injured airway. Importantly, no stem cells survived in healthy airway or in the epithelial lining fluid. Using X-Gal staining, transduced mesenchymal stem cells were detected in injured trachea and bronchi lumen. When the epithelium was spontaneously regenerated, the in vivo amount of engrafted mesenchymal stem cells from cell line decreased dramatically. No stem cells from primary culture were located within lungs at 7 days. This study demonstrated the feasibility of the intratracheal cell delivery for airway diseases with acute epithelial injury. PMID:19606934

  18. Effect of Cilia Beat Frequency on Mucociliary Clearance

    Directory of Open Access Journals (Sweden)

    Sedaghat M. H.

    2016-12-01

    Full Text Available Background: The airway surface liquid (ASL, which is a fluid layer coating the interior epithelial surface of the bronchi and bronchiolesis, plays an important defensive role against foreign particles and chemicals entering lungs. Objective: Numerical investigation has been employed to solve two-layer model consisting of mucus layer as a viscoelastic fluid and periciliary liquid layer as a Newtonian fluid to study the effects of cilia beat frequency (CBF at various amounts of mucus properties on muco-ciliary transport problem. Methods: Hybrid finite difference-lattice Boltzmann-method (FB-LBM has been used to solve the momentum equations and to simulate cilia forces, and also the PCLmucus interface more accurately, immersed boundary method (IBM has been employed. The main contribution of the current study is to use an Oldroyd-B model as the constitutive equation of mucus. Results: Our results show that increasing CBF and decreasing mucus viscosity ratio have great effects on mucus flow, but the effect of viscosity ratio is more significant. The results also illustrate that the relation between cilia beat frequency and mean mucus velocity is almost linear and it has similar behavior at different values of viscosity ratio. Conclusion: Numerical investigation based on hybrid IB-FD-LBM has been used to study the effect of CBF at various mounts of mucus viscosity ratio on the muco-ciliary clearance. The results showed that the effect of viscosity ratio on the muco-ciliary transport process is more significant compared with CBF.

  19. VIRTUAL 3-D MODELLING OF AIRWAYS IN CONGENITAL HEART DEFECTS

    Directory of Open Access Journals (Sweden)

    Simone Speggiorin

    2016-10-01

    Full Text Available The involvement of the airway is not uncommon in the presence of complex cardiovascular malformations. In these cases, a careful inspection of the relationship between the airway and the vasculature is paramount to plan the surgical procedure. Three-dimentional printing enhanced the visualization of the cardio-vascualr structure. Unfortunately IT does not allow to remove selected anatomy to improve the visualization of the surrounding ones. Computerized modelling (CM of has the potential to fill this gap by allowing a dynamic handling of different anatomies, increasing the exposure of vessels or bronchi to show their relationship.. We started to use this technique to plan the surgical repair in these complex cases where the airway is affected. This technique is routinely used in our Institution as an additional tool in the pre-surgical assessment. We report 4 cases in which the airways were compressed by vascular structures : ascending aorta in 1, left pulmonary artery sling in 1, Patent ductus arteriosus (PDA in 1 and major aorto-pulmonary collateral artery in 1. We believe this technique can enhance the understanding of the causes of airway involvement and facilitate the creation of an appropriate surgical plan.

  20. Mechanical complication of endobronchial tuberculosis

    Directory of Open Access Journals (Sweden)

    Quratulain Fatima Kizilbash

    2015-01-01

    Full Text Available A 19-year-old Vietnamese lady was diagnosed with culture positive, left upper lobe pulmonary tuberculosis for which medical treatment was initiated. Four months into treatment, she developed a 'rubber-band-like' stretching sensation in her left chest with wheezing and shortness of breath. Decreased respiratory excursion over the left lung was present on physical-examination. Chest-Xray revealed left-upper-lobe collapse with leftward deviation of the trachea and mediastinum. CT thorax revealed a long segment of stenosis in the left mainstem bronchus. FEV1 was 1.26 L (45% predicted, FVC 1.53 L (49% predicted, FEV1/FVC 82% (95% predicted indicating airway limitation. Ventilation-perfusion scan noted 9.8% ventilation to the left lung and 92.8% to the right lung and 7.6% perfusion to the left lung and 92.4% to the right lung. Bronchoscopy was notable for pin point stenosis of the left mainstem bronchus beyond which was inflamed mucosa and abnormal cartilage rings in the left upper and middle lobe bronchi. Nine months of medical therapy for tuberculosis along with oral steroid taper was completed successfully; however the patient has required six serial bronchscopies with dilatations without stent placement at four to six week intervals due to partial restenosis, with the last bronchoscopy at four months after completion of tuberculosis therapy.

  1. Role of FDG-PET scan in staging of pulmonary epithelioid hemangioendothelioma

    Directory of Open Access Journals (Sweden)

    Calabrese Cecilia

    2016-01-01

    Full Text Available In this report we describe a case of pulmonary epithelioid hemangioendothelioma (PEH in a young woman. The neoplasm manifested with dry cough, chest pain, finger clubbing, and multiple bilateral pulmonary nodules on chest x-ray and computed tomographic (CT scan. She underwent thoracoscopy, and the histological features of the lung biopsies were initially interpreted as consistent with a not-well-defined interstitial lung disease. Our patient was clinically and radiologically stable over a period of four years, after which the disease progressed to involve not only the lung but also mediastinal lymph nodes, liver and bone. Fiberoptic bronchoscopy showed subtotal occlusion of the right middle and lower lobe bronchi. The histologic examination of bronchial biopsies revealed a poorly differentiated neoplasm immunohistochemically positive for vimentin and vascular markers CD31, CD34 and Factor VIII. A diagnosis of malignant hemangioendothelioma was made. Positron emission tomography (PET is more sensitive than CT scan and bone scintigraphy in detecting PEH metastases. Furthermore, 18-fluorodeoxyglucose (FDG uptake seems to be related to the grade of malignancy of PEH lesions. Therefore, we suggest that FDG-PET should be included in the staging system and follow-up of PEH.

  2. The simple bread tag - a menace to society?

    Science.gov (United States)

    Karro, Ryan; Goussard, Pierre; Loock, James; Gie, Robert

    2015-04-07

    Foreign bodies are potentially life-threatening when inhaled by a child, depending on where they lodge. Symptoms can range from acute upper airway obstruction to mild, vague respiratory complaints. Between 80% and 90% of inhaled foreign bodies occlude the bronchi, while the larynx is a less common site. The commonest inhaled paediatric foreign bodies are organic, e.g. seeds or nuts. Plastic foreign bodies are less common and more difficult to diagnose. They are generally radiolucent on lateral neck radiographs and are often clear and thin. We report three cases of an unusual plastic laryngeal foreign body, the bread tag. Plastic bread tags were first reported in the medical literature as an ingested gastrointestinal foreign body in 1975. Since then, over 20 cases of gastrointestinal complications have been described. We report what is to our knowledge the first paediatric case of an inhaled bread tag, and also the first case series, briefly discuss the symptoms and options for removal of laryngeal foreign bodies, and highlight the dangers of the apparently harmless bread tag. Images of the bread tags in situ and after their removal are included.

  3. Gene expression programs of human smooth muscle cells: tissue-specific differentiation and prognostic significance in breast cancers.

    Directory of Open Access Journals (Sweden)

    Jen-Tsan Chi

    2007-09-01

    Full Text Available Smooth muscle is present in a wide variety of anatomical locations, such as blood vessels, various visceral organs, and hair follicles. Contraction of smooth muscle is central to functions as diverse as peristalsis, urination, respiration, and the maintenance of vascular tone. Despite the varied physiological roles of smooth muscle cells (SMCs, we possess only a limited knowledge of the heterogeneity underlying their functional and anatomic specializations. As a step toward understanding the intrinsic differences between SMCs from different anatomical locations, we used DNA microarrays to profile global gene expression patterns in 36 SMC samples from various tissues after propagation under defined conditions in cell culture. Significant variations were found between the cells isolated from blood vessels, bronchi, and visceral organs. Furthermore, pervasive differences were noted within the visceral organ subgroups that appear to reflect the distinct molecular pathways essential for organogenesis as well as those involved in organ-specific contractile and physiological properties. Finally, we sought to understand how this diversity may contribute to SMC-involving pathology. We found that a gene expression signature of the responses of vascular SMCs to serum exposure is associated with a significantly poorer prognosis in human cancers, potentially linking vascular injury response to tumor progression.

  4. Polonium and Lung Cancer

    Directory of Open Access Journals (Sweden)

    Vincenzo Zagà

    2011-01-01

    Full Text Available The alpha-radioactive polonium 210 (Po-210 is one of the most powerful carcinogenic agents of tobacco smoke and is responsible for the histotype shift of lung cancer from squamous cell type to adenocarcinoma. According to several studies, the principal source of Po-210 is the fertilizers used in tobacco plants, which are rich in polyphosphates containing radio (Ra-226 and its decay products, lead 210 (Pb-210 and Po-210. Tobacco leaves accumulate Pb-210 and Po-210 through their trichomes, and Pb-210 decays into Po-210 over time. With the combustion of the cigarette smoke becomes radioactive and Pb-210 and Po-210 reach the bronchopulmonary apparatus, especially in bifurcations of segmental bronchi. In this place, combined with other agents, it will manifest its carcinogenic activity, especially in patients with compromised mucous-ciliary clearance. Various studies have confirmed that the radiological risk from Po-210 in a smoker of 20 cigarettes per day for a year is equivalent to the one deriving from 300 chest X-rays, with an autonomous oncogenic capability of 4 lung cancers per 10000 smokers. Po-210 can also be found in passive smoke, since part of Po-210 spreads in the surrounding environment during tobacco combustion. Tobacco manufacturers have been aware of the alpha-radioactivity presence in tobacco smoke since the sixties.

  5. Upregulation of TMEM16A Protein in Bronchial Epithelial Cells by Bacterial Pyocyanin.

    Directory of Open Access Journals (Sweden)

    Emanuela Caci

    Full Text Available Induction of mucus hypersecretion in the airway epithelium by Th2 cytokines is associated with the expression of TMEM16A, a Ca2+-activated Cl- channel. We asked whether exposure of airway epithelial cells to bacterial components, a condition that mimics the highly infected environment occurring in cystic fibrosis (CF, also results in a similar response. In cultured human bronchial epithelial cells, treatment with pyocyanin or with a P. aeruginosa culture supernatant caused a significant increase in TMEM16A function. The Ca2+-dependent Cl- secretion, triggered by stimulation with UTP, was particularly enhanced by pyocyanin in cells from CF patients. Increased expression of TMEM16A protein and of MUC5AC mucin by bacterial components was demonstrated by immunofluorescence in CF and non-CF cells. We also investigated TMEM16A expression in human bronchi by immunocytochemistry. We found increased TMEM16A staining in the airways of CF patients. The strongest signal was observed in CF submucosal glands. Our results suggest that TMEM16A expression/function is upregulated in CF lung disease, possibly as a response towards the presence of bacteria in the airways.

  6. Upregulation of TMEM16A Protein in Bronchial Epithelial Cells by Bacterial Pyocyanin.

    Science.gov (United States)

    Caci, Emanuela; Scudieri, Paolo; Di Carlo, Emma; Morelli, Patrizia; Bruno, Silvia; De Fino, Ida; Bragonzi, Alessandra; Gianotti, Ambra; Sondo, Elvira; Ferrera, Loretta; Palleschi, Alessandro; Santambrogio, Luigi; Ravazzolo, Roberto; Galietta, Luis J V

    2015-01-01

    Induction of mucus hypersecretion in the airway epithelium by Th2 cytokines is associated with the expression of TMEM16A, a Ca2+-activated Cl- channel. We asked whether exposure of airway epithelial cells to bacterial components, a condition that mimics the highly infected environment occurring in cystic fibrosis (CF), also results in a similar response. In cultured human bronchial epithelial cells, treatment with pyocyanin or with a P. aeruginosa culture supernatant caused a significant increase in TMEM16A function. The Ca2+-dependent Cl- secretion, triggered by stimulation with UTP, was particularly enhanced by pyocyanin in cells from CF patients. Increased expression of TMEM16A protein and of MUC5AC mucin by bacterial components was demonstrated by immunofluorescence in CF and non-CF cells. We also investigated TMEM16A expression in human bronchi by immunocytochemistry. We found increased TMEM16A staining in the airways of CF patients. The strongest signal was observed in CF submucosal glands. Our results suggest that TMEM16A expression/function is upregulated in CF lung disease, possibly as a response towards the presence of bacteria in the airways.

  7. Global impact of bronchiectasis and cystic fibrosis

    Directory of Open Access Journals (Sweden)

    Margarida Redondo

    2016-09-01

    To understand variation in the aetiology, microbiology and burden of bronchiectasis and cystic fibrosis across different global healthcare systems.; Bronchiectasis is the term used to refer to dilatation of the bronchi that is usually permanent and is associated with a clinical syndrome of cough, sputum production and recurrent respiratory infections. It can be caused by a range of inherited and acquired disorders, or may be idiopathic in nature. The most well recognised inherited disorder in Western countries is cystic fibrosis (CF, an autosomal recessive condition that leads to progressive bronchiectasis, bacterial infection and premature mortality. Both bronchiectasis due to CF and bronchiectasis due to other conditions are placing an increasing burden on healthcare systems internationally. Treatments for CF are becoming more effective leading to more adult patients with complex healthcare needs. Bronchiectasis not due to CF is becoming increasingly recognised, particularly in the elderly population. Recognition is important and can lead to identification of the underlying cause, appropriate treatment and improved quality of life. The disease is highly diverse in its presentation, requiring all respiratory physicians to have knowledge of the different “bronchiectasis syndromes”. The most common aetiologies and presenting syndromes vary depending on geography, with nontuberculous mycobacterial disease predominating in some parts of North America, post-infectious and idiopathic disease predominating in Western Europe, and post-tuberculosis bronchiectasis dominating in South Asia and Eastern Europe. Ongoing global collaborative studies will greatly advance our understanding of the international impact of bronchiectasis and CF.

  8. [Use of antihistamines in a physician's clinical practice].

    Science.gov (United States)

    Luss, L V

    2014-01-01

    Histamine that belongs to one of the most important mediators involved in the regulation of the body's vital functions plays a great role in the pathogenesis of different diseases. Histamine is released during inflammatory and allergic reactions, anaphylactic and anaphylactoid shock, pseudoallergic reactions, and others. Acting through histamine receptors, it leads to increased intracellular concentration of cyclic guanosine monophosphate, enhanced chemotaxis of eosinophils and neutrophils, production of prostaglandins and thromboxane B, suppressed synthesis of lymphokines, etc. and causes contraction of smooth muscles of particularly the bronchi and intestine, dilation of vessels and their increased permeability, mucus hypersecretion in the upper airways, lower blood pressure, angioedema and itch, etc. In this connection, antihistamines that block histamine-induced reactions in various ways: by inhibiting its biosynthesis, enhancing its neutralization, blocking the access to receptors, and suppressing the release from mast cells, occupy a prominent place in clinical practice. The review covers the classification, main mechanisms of pharmacological action, and indications for the use of antihistamines that not only have the well-known antihistamine properties, but have also a broad spectrum of anti-inflammatory activity. There are data on the benefits of a group of antihistamines, the quinuclidine derivatives (quifenadine, sequifenadine) that were designed by Academician M.D. Mashkovsky and are one of the first examples of designing new classes of multifunctional non-sedating antihistamines, which combines a high selective activity to block histamine type 1 receptors and an ability to block serotonin and to break down histamine directly in tissues.

  9. Comparative study of computed tomography and pulmonary pathology in diffuse panbronchiolitis

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Koichi; Furue, Masuhiro; Kitaichi, Masanori

    1987-06-01

    We have reported that characteristic CT findings of diffuse panbronchiolitis are (1) hyperinflation of the lungs, (2) diffuse small nodular lesions located in the peripheral regions of the airways, (3) thickening of the bronchial wall and (4) dilation of small bronchi and bronchioles. The nodular lesions are supposed to be centrilobular in location, because they are always separated from the pleura and pulmonary veins (the edge of the pulmonary lobule) with a constant distance ( < 5 mm). In this article we tried to correlate those CT findings with pathological findings of the lungs in an autopsy case of diffuse panbronchiolitis. The lungs were inflated and fixed after Heitzman's method, then sliced lung specimens were examined by contact radiography and stereomicroscopy to select the tissues for histology. The small nodular shadows found in CT corresponded to the lesions located at the end of peripheral airways where walls were thickened by infiltrated lymphocytes and foamy cells. The lesions were distributed diffusely in both lungs and separateol from the pleura, interlobular septa and pulmonary vein at a distance of 2 to 3 mm, showing their locatin to be centrilobular. The bronchioles within the lesions were narrowed, while those proximal to the lesions were dilated. Mural thickenings of the extralobular airways suggested in CT were not recognized in the post mortem lungs, possibly because it reflected mucous secretion which was markedly improved before death.

  10. Plasma extravasation mediated by lipopolysaccharide-induction of kinin B1 receptors in rat tissues

    Directory of Open Access Journals (Sweden)

    Paulo Roberto Wille

    2001-01-01

    Full Text Available The present study was performed to: (a evaluate the effects of kinin B1 (Sar{D-Phe8}-des-Arg9-BK; 10 nmol/kg and B2 (bradykinin (BK; 10 nmol/kg receptor agonists on plasma extravasation in selected rat tissues; (b determine the contribution of a lipopolysaccharide (LPS (100 μ g/kg to the effects triggered by B1 and B2 agonists; and (c characterize the selectivity of B1 ({Leu8}desArg9-BK; 10 nmol/kg and B2 (HOE 140; 10 nmol/kg antagonists as inhibitors of this kinin-induced phenomenon. B1 and B2 agonists were shown to increase plasma extravasation in the duodenum, ileum and also in the urinary bladder of the rat. LPS pretreatment enhanced the plasma extravasation mediated only by the B1 agonist in the duodenum, ileum, trachea, main and segmentar bronchi. These effects were prevented by the B1. but not the B2 antagonist. In normal rats, the B2 antagonist inhibited the effect of B2 agonist in all the tissues analyzed. However, in LPS-treated rats, the B2 antagonist was ineffective in the urinary bladder.

  11. Distribution Analysis via Mass Spectrometry Imaging of Ephedrine in the Lungs of Rats Orally Administered the Japanese Kampo Medicine Maoto.

    Science.gov (United States)

    Matsumoto, Takashi; Kushida, Hirotaka; Matsushita, Shoko; Oyama, Yoshiyuki; Suda, Takafumi; Watanabe, Junko; Kase, Yoshio; Setou, Mitsutoshi

    2017-03-08

    Maoto, a traditional Japanese Kampo medicine, has been used to treat various respiratory diseases, including respiratory infections and influenza. Ephedrine (EPD), the main ingredient in maoto, is also clinically used to treat respiratory diseases. However, the pharmacokinetics and distribution of EPD in the lungs after the administration of maoto have not been demonstrated. This study aimed to determine the concentrations, distribution, and pharmacokinetics of EPD and its precursor methylephedrine (MEPD) in the lungs of rats orally administered maoto (1 and 4 g/kg). We used liquid chromatography-electrospray ionization-tandem mass spectrometry to measure the ingredient concentrations. Both ingredients were detected in maoto-treated lung homogenates. Next, we examined the distribution of both ingredients in lung sections by using matrix-assisted laser desorption/ionization-mass spectrometry imaging, a powerful tool for the visualization of the distribution of biological molecules. The mass spectrometry imaging analysis detected only EPD and provided the first visual demonstration that EPD is distributed in the alveoli, bronchi, and bronchioles in the lungs of rats orally administered maoto (4 g/kg, three times at 2-h intervals). These results suggest that the pharmacological efficacy of maoto for the amelioration of respiratory symptoms is related to the distribution of EPD in the lung.

  12. Respiratory response of guinea pigs to sulfuric acid mist

    Energy Technology Data Exchange (ETDEWEB)

    Amdur, M.O.

    1958-01-01

    Guinea pigs were exposed to 23 to 42 mg/m/sup 3/ acid mist with a mass median diameter of 0.8, 2.5, or 7 ..mu..m for 1-h periods. Significant increase in resistance at all levels and sizes was observed. There was a concurrent decrease in compliance for 2.5- and 7-..mu..m sizes with exception of lowest level of exposure. Dose-effect with resistance vs concentration shows smaller sizes were more deleterious. The 2.5 ..mu..m were more harmful at higher concentrations (above approx. 15 mg/m/sup 3/). The 0.8-..mu..m particles produced a rapid response suggesting bronchoconstriction as the mechanism (change in resistance proportionately greater than change in compliance). This was similar to irritant gases. Conversely, 2.5- and 7-..mu..m particles acted slower and change in resistance paralleled the drop in compliance. High concentrations evoked edema and atelectasis. This was interpreted as closure of main bronchi rather than general constriction. Response was consistent with expected penetration.

  13. Short-term effects of subchronic low-level hydrogen sulfide exposure on oil field workers.

    Science.gov (United States)

    Mousa, Haider Abdul-Lateef

    2015-01-01

    To investigate the short-term effects of low-level hydrogen sulfide (H2S) exposure on oil field workers. Observational study included 34 patients who work at an oil field. All patients were males with age range of 22-60 years (mean 37 years). The data were collected by systematic questionnaire about symptoms. The inclusion criteria of patients were symptoms related to inhalation of H2S gas in the oil field. The complaints should be frequent and relapsed after each gas exposure and disappeared when there was no gas exposure. Exclusion criteria were the symptoms which experienced with or without H2S exposure. The presence of H2S gas was confirmed by valid gas detector devices. The most frequent presenting symptom was nasal bleeding. It was revealed in 18 patients (52.9%). This followed by pharyngeal bleeding, gum bleeding, and bloody saliva (mouth bleeding) which were encountered in five cases for each complaint (14.7%). Other less frequent presenting symptoms were tongue bleeding, bloody sputum, headache, abdominal colic, pharyngeal soreness, fatigue, and sleepiness. Nasal mucosa was the most vulnerable part to H2S effect. Inhalation of H2S produced upper respiratory tract epithelial damage that led to bleeding from nose, pharynx, gum, tongue, trachea, and bronchi. There were no complaints of asthmatic attack upon exposure to low level of H2S. Sunlight had a significant role in reduction of ambient air H2S level.

  14. Field Cancerisation of the Upper Aerodigestive Tract: Screening for Second Primary Cancers of the Oesophagus in Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Güllü Cataldegirmen

    2015-03-01

    Full Text Available Tobacco, alcohol, and betel quid are the main causes of squamous cell cancers of the upper aerodigestive tract. These substances can cause multifocal carcinogenesis leading to multiple synchronous or metachronous cancers of the oesophagus, head and neck region, and lungs (‘field cancerisation’. Globally there are several million people who have survived either head and neck squamous cell cancer (HNSCC or lung cancer (LC. HNSCC and LC survivors are at increased risk of developing second primary malignancies, including second primary cancers of the oesophagus. The risk of second primary oesophageal squamous cell cancer (OSCC ranges from 8-30% in HNSCC patients. LC and HNSCC survivors should be offered endoscopic surveillance of the oesophagus. Lugol chromoendoscopy is the traditional and best evaluated screening method to detect early squamous cell neoplasias of the oesophagus. More recently, narrow band imaging combined with magnifying endoscopy has been established as an alternative screening method in Asia. Low-dose chest computed tomography (CT is the best evidencebased screening technique to detect (second primary LC and to reduce LC-related mortality. Low-dose chest CT screening is therefore recommended in OSCC, HNSCC, and LC survivors. In addition, OSCC survivors should undergo periodic pharyngolaryngoscopy for early detection of second primary HNSCC. Secondary prevention aims at quitting smoking, betel quid chewing, and alcohol consumption. As field cancerisation involves the oesophagus, the bronchi, and the head and neck region, the patients at risk are best surveilled and managed by an interdisciplinary team.

  15. Spirometer-controlled cine magnetic resonance imaging used to diagnose tracheobronchomalacia in paediatric patients.

    Science.gov (United States)

    Ciet, Pierluigi; Wielopolski, Piotr; Manniesing, Rashindra; Lever, Sandra; de Bruijne, Marleen; Morana, Giovanni; Muzzio, Pier Carlo; Lequin, Maarten H; Tiddens, Harm A W M

    2014-01-01

    Tracheobronchomalacia (TBM) is defined as an excessive collapse of the intrathoracic trachea. Bronchoscopy is the gold standard for diagnosing TBM; however it has major disadvantages, such as general anaesthesia. Cine computed tomography (CT) is a noninvasive alternative used to diagnose TBM, but its use in children is restricted by ionising radiation. Our aim was to evaluate the feasibility of spirometer-controlled cine magnetic resonance imaging (MRI) as an alternative to cine-CT in a retrospective study. 12 children with a mean age (range) of 12 years (7-17 years), suspected of having TBM, underwent cine-MRI. Static scans were acquired at end-inspiration and expiration covering the thorax using a three-dimensional spoiled gradient echo sequence. Three-dimensional dynamic scans were performed covering only the central airways. TBM was defined as a decrease of the trachea or bronchi diameter >50% at end-expiration in the static and dynamic scans. The success rate of the cine-MRI protocol was 92%. Cine-MRI was compared with bronchoscopy or chest CT in seven subjects. TBM was diagnosed by cine-MRI in seven (58%) out of 12 children and was confirmed by bronchoscopy or CT. In four patients, cine-MRI demonstrated tracheal narrowing that was not present in the static scans. Spirometer controlled cine-MRI is a promising technique to assess TBM in children and has the potential to replace bronchoscopy.

  16. CT findings in two cats with broncholithiasis

    Directory of Open Access Journals (Sweden)

    Patrick Byrne

    2016-11-01

    Full Text Available Case series summary Chronic inflammatory airway disease with secondary broncholithiasis was diagnosed in two cats from CT and bronchoalveolar lavage cytological findings. In one cat with progressively worsening lower respiratory tract signs, more than 80 discrete, highly attenuating endobronchial opacities were detected on thoracic CT. The broncholiths were distributed throughout the right middle, and left and right caudal lung lobes, and the caudal part of the left cranial and accessory lobes. In the other cat broncholithiasis was an incidental finding on thoracic radiographs taken during diagnostic investigation of inappetence. On thoracic CT, 25 calcified endobronchial opacities were detected in the left caudal lung lobe in secondary and tertiary bronchi. CT features of chronic inflammatory airway disease were present in both cases, including bronchiectasis, atelectasis, flattening of the diaphragm and bronchial wall thickening. Relevance and novel information This is the first report to document CT features of broncholithiasis in cats. Feline broncholithiasis should be considered as a differential diagnosis in any case where calcified endobronchial material is evident on thoracic radiographs or CT.

  17. [Correlation between Haemostatic and Vegetate Nervous System Parameters under Examination Stress].

    Science.gov (United States)

    Zhdanov, R I; Doinikova, A N; Zhdanova, S I; Chernokhvostov, Yu V; Gadzhieva, E S; Dvoenosov, V G

    2016-01-01

    The work is aimed to an assessment of the correlation between of autonomic nervous system tone and the level of reactivity of the students' cardiovascular system and hemostasis system under examination stress. It was found that the students under exam stress are characterized with high values of respiration rate and with lower ones of tidal volume. The value of respiratory minute volume decreases in male students due to the bronchoconstrictor effects of stress at the tracheobronchial tree. This finding confirms a statistically significant reduction in the flow of small, medium and large bronchi, indicating an increased parasympathetic nervous system tone. A statistically significant increase in the power of fast waves as a result of determining heart rate variability in students of both hender during the exam also testifies the activation of the vagus nerve and can be used as a marker of exam stress. While exam stress, trombocrite value decreases and only femail students show a statistically significant reduction in the platelet number and increase of their volume. The tendency to increased thrombotic events under exam stress is demonstarated, being reached statistically significant differences in the case of female students--an increase in the initial thrombosis rate. In the case of mail students, an increase of prothrombin time value is testified under exam stress.

  18. Multiscale Centerline Detection.

    Science.gov (United States)

    Sironi, Amos; Turetken, Engin; Lepetit, Vincent; Fua, Pascal

    2016-07-01

    Finding the centerline and estimating the radius of linear structures is a critical first step in many applications, ranging from road delineation in 2D aerial images to modeling blood vessels, lung bronchi, and dendritic arbors in 3D biomedical image stacks. Existing techniques rely either on filters designed to respond to ideal cylindrical structures or on classification techniques. The former tend to become unreliable when the linear structures are very irregular while the latter often has difficulties distinguishing centerline locations from neighboring ones, thus losing accuracy. We solve this problem by reformulating centerline detection in terms of a regression problem. We first train regressors to return the distances to the closest centerline in scale-space, and we apply them to the input images or volumes. The centerlines and the corresponding scale then correspond to the regressors local maxima, which can be easily identified. We show that our method outperforms state-of-the-art techniques for various 2D and 3D datasets. Moreover, our approach is very generic and also performs well on contour detection. We show an improvement above recent contour detection algorithms on the BSDS500 dataset.

  19. Dog and cat respiratory capilariasis - clinical, parasitological and epidemiological significance

    Directory of Open Access Journals (Sweden)

    Ilić Tamara

    2015-01-01

    Full Text Available Respiratory capillariasis is a disease of domestic and wild carnivores as well as of people, caused by nematode Eucoleus aerophilus syn. Capillaria aerophila, which lives as a parasite in mucosa of trachea, bronchi and bronchioles, rarely in nasal and frontal sinuses of the host. This parasite has either direct or indirect development cycle which includes optional transition hosts - earthworms. Clinical picture is manifested in the form of a very severe respiratory disease, which is accompanied by an increased bronchovesicular sound, sneezing, gasping and chronic dry cough. Despite the fact that this nematode is widespread in all the parts of the world, that it causes a disease followed by a severe clinical picture and has a zoonotic potential as well, it has been insufficiently investigated and moreover from clinical and parasitological aspect it has not been given enough attention so far. The reason for this is the fact that C. aerophila had been considered to be a strain of very low level of pathogenicity causing only sporadic respiratory infections in dogs and cats. The interest of scientific community for this parasitosis increased the moment when its causative agent spread outside the endemic areas. From the standpoint of monitoring and health protection of both carnivores and peorle, knowledge of basic epizootiological and epidemiological characteristics of these nematodes is of crucial importance, having in mind that its prevalence has significantly increased in dogs and cats in the last ten years, both in Europe and worldwide.

  20. Airway remodeling in a mouse asthma model assessed by in-vivo respiratory-gated micro-computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Lederlin, Mathieu; Montaudon, Michel [Universite Bordeaux 2, Laboratoire de Physiologie Cellulaire Respiratoire, Bordeaux (France); Institut National de la Sante et de la Recherche Medicale (INSERM), U885, Bordeaux (France); CHU Bordeaux, Unite d' Imagerie Thoracique, Pessac (France); Ozier, Annaig; Begueret, Hugues; Ousova, Olga; Marthan, Roger; Berger, Patrick [Universite Bordeaux 2, Laboratoire de Physiologie Cellulaire Respiratoire, Bordeaux (France); Institut National de la Sante et de la Recherche Medicale (INSERM), U885, Bordeaux (France); Laurent, Francois [Universite Bordeaux 2, Laboratoire de Physiologie Cellulaire Respiratoire, Bordeaux (France); Institut National de la Sante et de la Recherche Medicale (INSERM), U885, Bordeaux (France); CHU Bordeaux, Unite d' Imagerie Thoracique, Pessac (France); CHU de Bordeaux, Hopital du Haut-Leveque, Hopital Cardiologique, Unite d' Imagerie Thoracique et Cardiovasculaire, Pessac (France)

    2010-01-15

    The aim of our study was to evaluate the feasibility of non-invasive respiratory-gated micro-computed tomography (micro-CT) for assessment of airway remodelling in a mouse asthma model. Six female BALB/c mice were challenged intranasally with ovalbumin. A control group of six mice received saline inhalation. All mice underwent plethysmographic study and micro-CT. For each mouse, peribronchial attenuation values of 12 bronchi were measured, from which a peribronchial density index (PBDI) was computed. Mice were then sacrificed and lungs examined histologically. Final analysis involved 10 out of 12 mice. Agreement of measurements across observers and over time was very good (intraclass correlation coefficients: 0.94-0.98). There was a significant difference in PBDI between asthmatic and control mice (-210 vs. -338.9 HU, P=0.008). PBDI values were correlated to bronchial muscle area (r=0.72, P=0.018). This study shows that respiratory-gated micro-CT may allow non-invasive monitoring of bronchial remodelling in asthmatic mice and evaluation of innovative treatment effects. (orig.)

  1. Increased polysomy of chromosome 7 in bronchial epithelium from patients at high risk for lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Belinsky, S.A.; Neft, R.E.; Lechner, J.F. [and others

    1995-12-01

    Current models of carcinogenesis suggest that tissues progress through multiple genetic and epigenetic changes which ultimately lead to development of invasive cancer. Epidemiologic studies of Peto, R.R. and J.A. Doll indicate that the accumulation of these genetic changes over time, rather than any single unique genetic change, is probably responsible for development of the malignant phenotype. The bronchial epithelium of cigarette smokers is diffusely exposed to a broad spectrum of carcinogens, toxicants, and tumor promoters contained in tobacco smoke. This exposure increases the risk of developing multiple, independent premalignant foci throughout the lower respiratory tract that may contain independent gene aberrations. This {open_quotes}field cancerization{close_quotes} theory is supported by studies that have demonstrated progressive histologic changes distributed throughout the lower respiratory tract of smokers. A series of autopsy studies demonstrated that cigarette smokers exhibit premalignant histologic changes ranging from hyperplasia and metaplasia to severe dysplasia and carcinoma in situ diffusely throughout the bronchial mucosa. The proximal bronchi appear to exhibit the greatest number of changes, particularly at bifurcations. The results described are the first to quantitate the frequency for a chromosome aberration in {open_quotes}normal{close_quotes} bronchial epithelial cells.

  2. Intermittent Haemoptysis due to an Aortobronchial Fistula in a Warmblood Mare.

    Science.gov (United States)

    Versnaeyen, H; Saey, V; Vermeiren, D; Chiers, K; Ducatelle, R

    2016-01-01

    A 7-year-old warmblood mare showed sudden onset of mild intermittent haemoptysis. Clinical examination revealed no significant abnormalities. Haematological examination showed mild anaemia, hypoalbuminaemia and neutrophilia. Coagulation tests were normal. Endoscopic examination revealed unilateral pulmonary haemorrhage with blood clots in the bronchi and trachea. Treatment with antibiotics was started and the horse was given stable rest. Two weeks later, the horse was found dead with blood and frothy sputum leaking from the nostrils. Post-mortem examination revealed a large thoracic aortic aneurysm communicating with a pseudoaneurysm that had formed a fistula into a right bronchial branch. Microscopical examination of the aneurysm showed extensive medial fibrosis with prominent degeneration, fragmentation and mineralization of the elastic fibres and deposition of mucoid material in the tunica media. The pseudoaneurysm was lined by collagen bundles admixed with fibroblasts and a small amount of adipose tissue. Aortobronchial fistula is a rare condition in man that is usually associated with primary aortic pathology, most often aneurysms. To the authors' knowledge this is the first case of a fatal aortobronchial fistula in a horse or any other animal species. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Medical image of the week: bronchopleural fistula

    Directory of Open Access Journals (Sweden)

    Desai H

    2016-09-01

    Full Text Available No abstract available. Article truncated at 150 words. A 58-year-old man with past medical history significant for chronic smoking and seizures was referred to the emergency room after a chest x-ray done by his primary care physician for evaluation of cough showed a hydropneumothorax. His symptoms included dry cough for past 2 months without fever, chills or other associated symptoms. He did not have any thoracic procedures performed and had no past history of recurrent infections. He was hemodynamically stable. Physical examination was only significant with decreased breath sounds on the right side of the chest. Thoracic CT with contrast was performed which showed complete collapse of the right lower lobe, near complete collapse of right middle lobe as well as an air-fluid level. There was a suspicion of a direct communication between bronchi and pleural space at the posterior lateral margin of the collapsed right lower lobe (Figure 1. The presence of bronchopleural fistula (BPF was confirmed ...

  4. Aerosol deposition doses in the human respiratory tree of electronic cigarette smokers.

    Science.gov (United States)

    Manigrasso, Maurizio; Buonanno, Giorgio; Fuoco, Fernanda Carmen; Stabile, Luca; Avino, Pasquale

    2015-01-01

    Aerosols from eight e-cigarettes at different nicotine levels and flavoring were characterized as particle number size distributions in the range 5.6-560 nm by FMPS and CPC. Results were used to provided osimetry estimates applying the MMPD model.Particle number concentrations varied between 3.26 x 10(9) and 4.09 x 10(9) part cm(-3) for e-liquids without nicotine and between 5.08 x 10(9) and 5.29 x 10(9) part cm(-3) for e-liquids with nicotine. No flavor effects were detected on particle concentration data. Particle size distributions were unimodal with modes between 107-165 nm and 165-255 nm, for number and volume metrics, respectively. Averagely, 6.25 x 10(10) particles were deposited in respiratory tree after a single puff. Highest deposition densities and mean layer thickness of e-cigarette liquid on the lung epithelium were estimated at lobar bronchi. Our study shows that e-cigarette aerosol is source of high particle dose in respiratory system, from 23%to 35% of the daily dose of a no-smoking individual.

  5. Integrin α6β4 identifies human distal lung epithelial progenitor cells with potential as a cell-based therapy for cystic fibrosis lung disease.

    Directory of Open Access Journals (Sweden)

    Xiaopeng Li

    Full Text Available To develop stem/progenitor cell-based therapy for cystic fibrosis (CF lung disease, it is first necessary to identify markers of human lung epithelial progenitor/stem cells and to better understand the potential for differentiation into distinct lineages. Here we investigated integrin α6β4 as an epithelial progenitor cell marker in the human distal lung. We identified a subpopulation of α6β4(+ cells that localized in distal small airways and alveolar walls and were devoid of pro-surfactant protein C expression. The α6β4(+ epithelial cells demonstrated key properties of stem cells ex vivo as compared to α6β4(- epithelial cells, including higher colony forming efficiency, expression of stem cell-specific transcription factor Nanog, and the potential to differentiate into multiple distinct lineages including basal and Clara cells. Co-culture of α6β4(+ epithelial cells with endothelial cells enhanced proliferation. We identified a subset of adeno-associated virus (AAVs serotypes, AAV2 and AAV8, capable of transducing α6β4(+ cells. In addition, reconstitution of bronchi epithelial cells from CF patients with only 5% normal α6β4(+ epithelial cells significantly rescued defects in Cl(- transport. Therefore, targeting the α6β4(+ epithelial population via either gene delivery or progenitor cell-based reconstitution represents a potential new strategy to treat CF lung disease.

  6. Flexible bronchoscopy and mechanical ventilation in managing Mounier-Kuhn syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Aslihan Gürün Kaya

    2017-04-01

    Full Text Available ABSTRACT CONTEXT: Mounier-Kuhn syndrome is a rare congenital condition with distinct dilatation and diverticulation of the tracheal wall. The symptoms may vary and the treatment usually consists of support. CASE REPORT: The patient was a 60-year-old male with recurrent hospital admission. He was admitted in this case due to dyspnea, cough and sputum production. An arterial blood sample revealed decompensated respiratory acidosis with moderate hypoxemia. A chest computed tomography (CT scan showed dilatation of the trachea and bronchi, tracheal diverticula and bronchiectasis. Flexible bronchoscopy was performed, which revealed enlarged airways with expiratory collapse. Furthermore, orifices of tracheal diverticulosis were also detected. Non-invasive positive pressure ventilation (NPPV was added, along with long-term oxygen therapy. At control visits, the patient’s clinical and laboratory findings were found to have improved. CONCLUSION: Flexible bronchoscopy can be advocated for establishing the diagnosis and non-invasive mechanical ventilation can be used with a high success rate, for clinical wellbeing in Mounier-Kuhn syndrome.

  7. Airway extraction from 3D chest CT volumes based on iterative extension of VOI enhanced by cavity enhancement filter

    Science.gov (United States)

    Meng, Qier; Kitasaka, Takayuki; Oda, Masahiro; Mori, Kensaku

    2017-03-01

    Airway segmentation is an important step in analyzing chest CT volumes for computerized lung cancer detection, emphysema diagnosis, asthma diagnosis, and pre- and intra-operative bronchoscope navigation. However, obtaining an integrated 3-D airway tree structure from a CT volume is a quite challenging task. This paper presents a novel airway segmentation method based on intensity structure analysis and bronchi shape structure analysis in volume of interest (VOI). This method segments the bronchial regions by applying the cavity enhancement filter (CEF) to trace the bronchial tree structure from the trachea. It uses the CEF in each VOI to segment each branch and to predict the positions of VOIs which envelope the bronchial regions in next level. At the same time, a leakage detection is performed to avoid the leakage by analysing the pixel information and the shape information of airway candidate regions extracted in the VOI. Bronchial regions are finally obtained by unifying the extracted airway regions. The experiments results showed that the proposed method can extract most of the bronchial region in each VOI and led good results of the airway segmentation.

  8. Orange-Pigmented Sputum as a Manifestation of Smoke Grenade Inhalation Injury.

    Science.gov (United States)

    Chatzivasiloglou, Fotini; Katsenos, Stamatis; Psara, Anthoula; Tsintiris, Konstantinos

    2016-01-01

    A 34-year-old man presented with scanty hemoptysis, orange-colored expectoration, and mild dyspnea. He was in an enclosed building taking part in a military training exercise inhaling an orange-colored smoke from a smoke grenade ignition. His symptoms developed immediately after the initial exposure but he sought medical assistance 20 hours later because of their persistence. Fiberoptic bronchoscopy was performed revealing diffuse inflammatory tracheobronchial tree with streaky orange-pigmented secretions in the trachea and both main-stem bronchi. Acute tracheobronchitis was diagnosed and the patient was treated with nebulized bronchodilators and intravenous corticosteroids showing complete recovery. To our knowledge, this is the first well-documented report of inhalation injury induced by a smoke bomb explosion including potassium chlorate oxidizer and Sudan I and presenting with orange-pigmented sputum production. Smoke inhalation injury is associated with significant morbidity and mortality. The heterogeneity of the smoke and the large variety of the resulting symptoms may be the reason why a definition, specific diagnostic criteria, and therapeutic guidelines are still lacking.

  9. Persistent and Recurrent Bacterial Bronchitis-A Paradigm Shift in Our Understanding of Chronic Respiratory Disease.

    Science.gov (United States)

    Ishak, Alya; Everard, Mark L

    2017-01-01

    The recent recognition that the conducting airways are not "sterile" and that they have their own dynamic microbiome, together with the rapid advances in our understanding of microbial biofilms and their roles in the causation of respiratory diseases (such as chronic bronchitis, sinusitis, and chronic otitis media), permit us to update the "vicious circle" hypothesis of the causation of bronchiectasis. This proposes that chronic inflammation driven by persistent bacterial bronchitis (PBB) causes damage to both the epithelium, resulting in impaired mucociliary clearance, and to the airway wall, which eventually manifests as bronchiectasis. The link between a "chronic bronchitis" and a persistence of bacterial pathogens, such as non-typable Haemophilus influenzae , was first made more than 100 years ago, and its probable role in the causation of bronchiectasis was proposed soon afterward. The recognition that the "usual suspects" are adept at forming biofilms and hence are able to persist and dominate the normal dynamically changing "healthy microbiome" of the conducting airways provides an explanation for the chronic colonization of the bronchi and for the associated chronic neutrophil-dominated inflammation characteristic of a PBB. Understanding the complex interaction between the host and the microbial communities of the conducting airways in health and disease will be a key component in optimizing pulmonary health in the future.

  10. Persistent and Recurrent Bacterial Bronchitis—A Paradigm Shift in Our Understanding of Chronic Respiratory Disease

    Science.gov (United States)

    Ishak, Alya; Everard, Mark L.

    2017-01-01

    The recent recognition that the conducting airways are not “sterile” and that they have their own dynamic microbiome, together with the rapid advances in our understanding of microbial biofilms and their roles in the causation of respiratory diseases (such as chronic bronchitis, sinusitis, and chronic otitis media), permit us to update the “vicious circle” hypothesis of the causation of bronchiectasis. This proposes that chronic inflammation driven by persistent bacterial bronchitis (PBB) causes damage to both the epithelium, resulting in impaired mucociliary clearance, and to the airway wall, which eventually manifests as bronchiectasis. The link between a “chronic bronchitis” and a persistence of bacterial pathogens, such as non-typable Haemophilus influenzae, was first made more than 100 years ago, and its probable role in the causation of bronchiectasis was proposed soon afterward. The recognition that the “usual suspects” are adept at forming biofilms and hence are able to persist and dominate the normal dynamically changing “healthy microbiome” of the conducting airways provides an explanation for the chronic colonization of the bronchi and for the associated chronic neutrophil-dominated inflammation characteristic of a PBB. Understanding the complex interaction between the host and the microbial communities of the conducting airways in health and disease will be a key component in optimizing pulmonary health in the future. PMID:28261574

  11. Perioperative management of tracheobronchial injury following blunt trauma.

    Science.gov (United States)

    Juvekar, Nilesh M; Deshpande, Sharmila S; Nadkarni, Anand; Kanitkar, Shreedhar

    2013-01-01

    We describe tracheobronchial injury (TBI) in a 17-year-old teenager following blunt trauma resulting from a road traffic accident. The patient presented to a peripheral hospital with swelling over the neck and face associated with bilateral pneumothorax for which bilateral intercostal drains were inserted and the patient was transferred to our institute. Fiber-optic videobronchoscopy (FOB) was performed, the trachea and bronchi were visualized, and the site and extent of injury was assessed. Spontaneous respiration was maintained till assessment of the airway. Then the patient was anesthetized with propofol and paralyzed using succinylcholine and a double-lumen endobronchial tube was inserted; thereafter, the adequacy of controlled manual ventilation and air-leak through intercostal drains was assessed and the patient was transferred to operating room (OR) for repair of the airway injury. The OR was kept ready during FOB to manage any catastrophe. This case describes the need for proper preparation and communication between health care team members to manage all possible scenarios of traumatic TBI.

  12. Perioperative management of tracheobronchial injury following blunt trauma

    Directory of Open Access Journals (Sweden)

    Nilesh M Juvekar

    2013-01-01

    Full Text Available We describe tracheobronchial injury (TBI in a 17-year-old teenager following blunt trauma resulting from a road traffic accident. The patient presented to a peripheral hospital with swelling over the neck and face associated with bilateral pneumothorax for which bilateral intercostal drains were inserted and the patient was transferred to our institute. Fiber-optic videobronchoscopy (FOB was performed, the trachea and bronchi were visualized, and the site and extent of injury was assessed. Spontaneous respiration was maintained till assessment of the airway. Then the patient was anesthetized with propofol and paralyzed using succinylcholine and a double-lumen endobronchial tube was inserted; thereafter, the adequacy of controlled manual ventilation and air-leak through intercostal drains was assessed and the patient was transferred to operating room (OR for repair of the airway injury. The OR was kept ready during FOB to manage any catastrophe. This case describes the need for proper preparation and communication between health care team members to manage all possible scenarios of traumatic TBI.

  13. Subendocardial hemorrhages in a case of extrapercardial cardiac tamponade: A possible mechanism of appearance

    Directory of Open Access Journals (Sweden)

    Nikolić Slobodan

    2016-01-01

    Full Text Available Introduction. Subendocardial hemorrhages are grossly visible bleedings in the inner surface of the left ventricle, the interventricular septum, and the opposing papillary muscles and adjacent columnae carneae of the free wall of the ventricle. These are commonly seen in sudden profound hypotension either from severe blood loss from “shock” in the widest sense and, even more often, in combination with brain injuries. Case Outline. We present a case of a 38-year-old man, injured as a car driver in a frontal collision, who died c. 45 minutes after the accident. The autopsy revealed severe chest trauma, including multiple right-sided direct rib fractures with the torn parietal pleura and right-sided pneumothorax, several right lung ruptures, and a rupture of one of the lobar bronchi with pneumomediastinum, and prominent subcutaneous emphysema of the trunk, shoulders, neck and face. The patchy subendocardial hemorrhage of the left ventricle was observed. The cause of death is attributed to severe blunt force chest trauma. Conclusion. We postulate pneumomediastinum leading to extrapericardial tamponade as the underlying mechanism of this subendocardial hemorrhage. [Projekat Ministarstva nauke Republike Srbije, br. 45005

  14. Acute effects of cigarette smoking on pulmonary function.

    Science.gov (United States)

    Unverdorben, M; Mostert, A; Munjal, S; van der Bijl, A; Potgieter, L; Venter, C; Liang, Q; Meyer, B; Roethig, H-J

    2010-01-01

    Chronic smoking related changes in pulmonary function are reflected as accelerated decrease in FEV1 although histologic changes occur in the peripheral bronchi earlier. More sensitive pulmonary function parameters might mirror those early changes and might show a dose response. In a randomized three-period cross-over design 57 male adult conventional cigarette (CC)-smokers (age: 45.1+/-7.1 years) smoked either CC (tar:11 mg, nicotine:0.8 mg, carbon monoxide:11 mg [Federal Trade Commission (FTC)]), or used as a potential reduced-exposure product the electrically heated smoking system (EHCSS) (tar:5 mg, nicotine:0.3 mg, carbon monoxide:0.45 mg (FTC)) or did not smoke (NS). After each 3-day exposure period, hematology and exposure parameters were determined preceding body plethysmography. Cigarette smoke exposure was significantly (psmoke exposures and no-smoking on mid to small size pulmonary airways in a dose dependent manner. Copyright 2010 Elsevier Inc. All rights reserved.

  15. Expression of an X-family DNA polymerase, pol lambda, in the respiratory epithelium of non-small cell lung cancer patients with habitual smoking.

    Science.gov (United States)

    Ohba, Taro; Kometani, Takurou; Shoji, Fumihiro; Yano, Tokujiro; Yoshino, Ichiro; Ichiro, Yoshino; Taguchi, Kenichi; Kuraoka, Isao; Oda, Shinya; Maehara, Yoshihiko

    2009-01-01

    DNA polymerase lambda, pol lambda, is a eukaryotic member of the X-family DNA polymerases that is involved in two modes of DNA repair, i.e. base excision repair (BER) or non-homologous end joining (NHEJ). Using immunohistochemical approaches, we have observed pol lambda expression in human tissues, particularly in the respiratory system of lung cancer patients. pol lambda proteins were distributed in the nuclei of the epithelial cells in the bronchi, bronchioles and alveoli. Intriguingly, the level of pol lambda expression in the bronchiolar epithelia significantly correlated with the amount of habitual smoking in the individuals. Conversely, pol lambda expression in cancer tissues did not correlate with the smoking status of the patients. Pol lambda expression was sometimes discrepant between the tumor tissues and adjacent bronchioles. More importantly, tumors without pol lambda expression that occurred in heavy smokers significantly tended to be at an advanced clinical stage. Pol lambda may thus be involved in the DNA repair processes counteracting DNA damage caused by tobacco smoke in the respiratory system.

  16. A Quantitative Study on the Trachea of the Red Sokoto (Maradi Goat (Capra hircus

    Directory of Open Access Journals (Sweden)

    O. Byanet

    2014-01-01

    Full Text Available The trachea forms the part of the conducting system which transports air from the external environment to the lungs. The aim of this study was to provide quantitative dimensions of the trachea of Red Sokoto goat (Capra hircus. Quantitative analysis was conducted on nine tracheas from goats (ages were ranged between eight months and three years without sex variation in this study. The results showed that tracheas were extended from the cricoid cartilage of larynx to the hilus of the lungs, where they were divided into the right and left bronchi. They were structurally composed of the cartilaginous rings that were incomplete dorsally but bridged by tracheal muscles at the ends of the tracheal cartilages. The mean length of the trachea from the first to the last ring was 257 ± 7.11 mm and the number of tracheal rings varied from 35 to 57, with a mean value of 49.33 ± 2.78. The left bronchial mean length (19.78 ± 2.66 mm was significantly longer than the right (10.44 ± 1.79 mm. The cross-sectional area (CSA was wider at the intrathoracic area (221.5 ± 0.2 mm2 than cervical area (176 ± 0.1 mm2.

  17. Airway blood flow response to dry air hyperventilation in sheep

    Energy Technology Data Exchange (ETDEWEB)

    Parsons, G.H.; Baile, E.M.; Pare, P.D.

    1986-03-01

    Airway blood flow (Qaw) may be important in conditioning inspired air. To determine the effect of eucapneic dry air hyperventilation (hv) on Qaw in sheep the authors studied 7 anesthetized open-chest sheep after 25 min. of warm dry air hv. During each period of hv the authors have recorded vascular pressures, cardiac output (CO), and tracheal mucosal and inspired air temperature. Using a modification of the reference flow technique radiolabelled microspheres were injected into the left atrium to make separate measurements after humid air and dry air hv. In 4 animals a snare around the left main pulmonary artery was used following microsphere injection to prevent recirculation (entry into L lung of microspheres from the pulmonary artery). Qaw to the trachea and L lung as measured and Qaw for the R lung was estimated. After the final injection the sheep were killed and bronchi (Br) and lungs removed. Qaw (trachea plus L lung plus R lung) in 4 sheep increased from a mean of 30.8 to 67.0 ml/min. Airway mucosal temp. decreased from 39/sup 0/ to 33/sup 0/C. The authors conclude that dry air hv cools airway mucosa and increases Qaw in sheep.

  18. Real-time endoscopic image orientation correction system using an accelerometer and gyrosensor.

    Directory of Open Access Journals (Sweden)

    Hyung-Chul Lee

    Full Text Available The discrepancy between spatial orientations of an endoscopic image and a physician's working environment can make it difficult to interpret endoscopic images. In this study, we developed and evaluated a device that corrects the endoscopic image orientation using an accelerometer and gyrosensor. The acceleration of gravity and angular velocity were retrieved from the accelerometer and gyrosensor attached to the handle of the endoscope. The rotational angle of the endoscope handle was calculated using a Kalman filter with transmission delay compensation. Technical evaluation of the orientation correction system was performed using a camera by comparing the optical rotational angle from the captured image with the rotational angle calculated from the sensor outputs. For the clinical utility test, fifteen anesthesiology residents performed a video endoscopic examination of an airway model with and without using the orientation correction system. The participants reported numbers written on papers placed at the left main, right main, and right upper bronchi of the airway model. The correctness and the total time it took participants to report the numbers were recorded. During the technical evaluation, errors in the calculated rotational angle were less than 5 degrees. In the clinical utility test, there was a significant time reduction when using the orientation correction system compared with not using the system (median, 52 vs. 76 seconds; P = .012. In this study, we developed a real-time endoscopic image orientation correction system, which significantly improved physician performance during a video endoscopic exam.

  19. Application of light sheet microscopy for qualitative and quantitative analysis of bronchus-associated lymphoid tissue in mice.

    Science.gov (United States)

    Mzinza, David Twapokera; Fleige, Henrike; Laarmann, Kristin; Willenzon, Stefanie; Ristenpart, Jasmin; Spanier, Julia; Sutter, Gerd; Kalinke, Ulrich; Valentin-Weigand, Peter; Förster, Reinhold

    2018-02-12

    Bronchus-associated lymphoid tissue (BALT) develops at unpredictable locations around lung bronchi following pulmonary inflammation. The formation and composition of BALT have primarily been investigated by immunohistology that, due to the size of the invested organ, is usually restricted to a limited number of histological sections. To assess the entire BALT of the lung, other approaches are urgently needed. Here, we introduce a novel light sheet microscopy-based approach for assessing lymphoid tissue in the lung. Using antibody staining of whole lung lobes and optical clearing by organic solvents, we present a method that allows in-depth visualization of the entire bronchial tree, the lymphatic vasculature and the immune cell composition of the induced BALT. Furthermore, three-dimensional analysis of the entire lung allows the qualitative and quantitative enumeration of the induced BALT. Using this approach, we show that a single intranasal application of the replication-deficient poxvirus MVA induces BALT that constitutes up to 8% of the entire lung volume in mice deficient in CCR7, in contrast to wild type mice (WT). Furthermore, BALT induced by heat-inactivated E. coli is dominated by a pronounced T cell infiltration in Cxcr5-deficient mice, in contrast to WT mice.Cellular and Molecular Immunology advance online publication, 12 February 2018; doi:10.1038/cmi.2017.150.

  20. Subpopulations of lymphoid and non-lymphoid cells in bronchus-associated lymphoid tissue (BALT) of the mouse.

    Science.gov (United States)

    Breel, M; Van der Ende, M; Sminia, T; Kraal, G

    1988-01-01

    Lymphoid and non-lymphoid subpopulations were investigated in the lung of the mouse with immunocyto-, immunohisto- and enzyme-histochemical methods. Special attention was paid to the cell populations in bronchus-associated lymphoid tissue (BALT), which is positioned between a bronchus and an artery. In BALT, discrete T- and B-cell areas can be found. The majority of the T cells belong to the L3T4+ (T-helper) subpopulation. In the T-cell area interdigitating cells can be recognized by anti-class II antibodies as well as by specific monoclonal antibodies, NLDC-145 and MIDC-8. Macrophage subpopulations can be discriminated by location, enzyme reactivity and various macrophage-specific monoclonal antibody markers. On the outer rim of BALT macrophages are recognized by the MOMA-1 and ERTR9 antibody. Macrophages dispersed in BALT can only be discriminated with the MOMA-2 antibody. The macrophage markers F4/80 and Mac-1 show no reactivity in BALT. In lung, tissue macrophages around bronchi and blood vessels are predominantly recognized by the MOMA-1 and MOMA-2 antibody, and a minor population by the ERTR9 antibody. Alveolar macrophages show heterogeneity with the MOMA-1, MOMA-2 and NLDC-145 antibody. The relationship between alveolar macrophages and antigen-presenting cells is discussed here. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:3259206

  1. Uncoordinated production of Laminin-5 chains in airways epithelium of allergic asthmatics

    Directory of Open Access Journals (Sweden)

    Virtanen Ismo

    2005-09-01

    Full Text Available Abstract Background Laminins are a group of proteins largely responsible for the anchorage of cells to basement membranes. We hypothesized that altered Laminin chain production in the bronchial mucosa might explain the phenomenon of epithelial cell shedding in asthma. The aim was to characterize the presence of Laminin chains in the SEBM and epithelium in allergic and non-allergic asthmatics. Patients and methods Biopsies were taken from the bronchi of 11 patients with allergic and 9 patients with non-allergic asthma and from 7 controls and stained with antibodies against the Laminin (ln chains alpha1-alpha5, beta1-beta2 and gamma1-gamma2. Results Lns-2,-5 and -10 were the main Laminins of SEBM. The layer of ln-10 was thicker in the two asthmatic groups while an increased thickness of lns-2 and -5 was only seen in allergic asthmatics. The ln gamma2-chain, which is only found in ln 5, was exclusively expressed in epithelial cells in association with epithelial injury and in the columnar epithelium of allergic asthmatics. Conclusion The uncoordinated production of chains of ln-5 in allergic asthma could have a bearing on the poor epithelial cell anchorage in these patients.

  2. Drowning - post-mortem imaging findings by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Christe, Andreas [University Hospital, Institute of Diagnostic Radiology, Bern (Switzerland); University of Bern, Center Forensic Imaging and Virtopsy, Institute of Forensic Medicine, Bern (Switzerland); Aghayev, Emin; Jackowski, Christian; Thali, Michael J. [University of Bern, Center Forensic Imaging and Virtopsy, Institute of Forensic Medicine, Bern (Switzerland); Vock, Peter [University Hospital, Institute of Diagnostic Radiology, Bern (Switzerland)

    2008-02-15

    The aim of this study was to identify the classic autopsy signs of drowning in post-mortem multislice computed tomography (MSCT). Therefore, the post-mortem pre-autopsy MSCT- findings of ten drowning cases were correlated with autopsy and statistically compared with the post-mortem MSCT of 20 non-drowning cases. Fluid in the airways was present in all drowning cases. Central aspiration in either the trachea or the main bronchi was usually observed. Consecutive bronchospasm caused emphysema aquosum. Sixty percent of drowning cases showed a mosaic pattern of the lung parenchyma due to regions of hypo- and hyperperfused lung areas of aspiration. The resorption of fresh water in the lung resulted in hypodensity of the blood representing haemodilution and possible heart failure. Swallowed water distended the stomach and duodenum; and inflow of water filled the paranasal sinuses (100%). All the typical findings of drowning, except Paltau's spots, were detected using post-mortem MSCT, and a good correlation of MSCT and autopsy was found. The advantage of MSCT was the direct detection of bronchospasm, haemodilution and water in the paranasal sinus, which is rather complicated or impossible at the classical autopsy. (orig.)

  3. OMALIZUMAB: EXPANDED OPPORTUNITIES FOR THE ATOPIC DISEASES TREATMENT

    Directory of Open Access Journals (Sweden)

    T.V. Kulichenko

    2009-01-01

    Full Text Available The review highlights experience and administration perspectives of the immunobiological medication Omalizumab in allergy. Omalizumab is the anti'IgE monoclonal antibody. Growing successful experience of anti'IgE application confirms the assumption that treatment by Omalizumab may modify the course of bronchial asthma, by preventing the remodeling processes in the respiratory tracts and reducing hyperactivity of bronchi. Today, it is widely discussed what other possible areas of anti'IgE therapy there might be. Omalizumab might be very important in treatment of different potentially IgE'dependent diseases, among which there is urticaria and angioneurotic edema, allergic rhinitis, nasal polyposis and severe forms of allergic conjunctivitis. Besides, Omalizumab, as part of the allergen specific immunotherapy protocol, may also provide sizable advantages. The author reveals potential role of Omalizumab in treatment of other atopic diseases, such as allergic bronchopulmonary aspergillosis, atopic dermatitis and food allergy.Key words: Omalizumab, anti'IgE therapy, biological agents, IgЕ, bronchial asthma, allergic rhinitis, atopic dermatitis, idiopathic urticaria fever, treatment, children.

  4. Incidência de mortalidade por câncer no Rio Grande do Sul, Brasil Cancer: incidente and mortality in Rio Grande do Sul - Brazil

    Directory of Open Access Journals (Sweden)

    Lucio Borges Barcelos

    1983-10-01

    Full Text Available Apresenta-se estudo dos casos e óbitos de câncer notificados à Unidade de Informática da Secretaria da Saúde e do Meio Ambiente do do Rio Grande do Sul, Brasil no ano de 1979. A distribuição etária da morbimortalidade apresentou tendência, acentuadamente crescente com a idade. No sexo masculino, as localizações anatômicas de maior mortalidade, em ordem decrescente, foram: traquéia, brônquios e pulmão; estômago; esôfago; próstata e leucemias. Na incidência repetiram-se as mesmas localizações com introdução da pele em segundo lugar e saída das leucemias. No sexo feminino, mama; estômago; útero, outras localizações especificadas e as não especificadas; traquéia, brônquios e pulmão; e colo do útero, foram as cinco primeiras localizações de maior mortalidade. As neoplasias malignas da mama foram as que apresentaram maior incidência. Seguiram-se as neoplasias malignas da pele, do colo do útero, das outras localizações especificadas e as não especificadas do útero e do estômago. A distribuição geográfica mostrou uma morbimortalidade maior na 1ª, 3ª, 7ª, 10ª e 13ª Delegacia Regional de Saúde, em regiões caracterizadas ou por um elevado índice de industrialização ou pela existência de grandes propriedades rurais onde é praticada a pecuária extensiva. Uma vez feita a padronização, as neoplasias malignas de esôfago e laringe, apresentaram-se com coeficientes elevados, superando, no caso do esôfago, os coeficientes de outros países.A study of the incidence of, and deaths from, cancer as reported to the Welfare Ministry of Rio Grande do Sul State, Brazil, in 1979, is presented. The distribution of morbimortality showed an accentuated increase with age. In males the anatomic sites associated with higher mortality were (in decreasing order: trachea, bronchi and lungs, stomach, esophagus, prostate and leukemias. In incidence related to the same sites, however, skin cancer moved into second place and

  5. Cell counting in human endobronchial biopsies--disagreement of 2D versus 3D morphometry.

    Directory of Open Access Journals (Sweden)

    Vlad A Bratu

    Full Text Available QUESTION: Inflammatory cell numbers are important endpoints in clinical studies relying on endobronchial biopsies. Assumption-based bidimensional (2D counting methods are widely used, although theoretically design-based stereologic three-dimensional (3D methods alone offer an unbiased quantitative tool. We assessed the method agreement between 2D and 3D counting designs in practice when applied to identical samples in parallel. MATERIALS AND METHODS: Biopsies from segmental bronchi were collected from healthy non-smokers (n = 7 and smokers (n = 7, embedded and sectioned exhaustively. Systematic uniform random samples were immunohistochemically stained for macrophages (CD68 and T-lymphocytes (CD3, respectively. In identical fields of view, cell numbers per volume unit (NV were assessed using the physical disector (3D, and profiles per area unit (NA were counted (2D. For CD68+ cells, profiles with and without nucleus were separately recorded. In order to enable a direct comparison of the two methods, the zero-dimensional CD68+/CD3+-ratio was calculated for each approach. Method agreement was tested by Bland-Altmann analysis. RESULTS: In both groups, mean CD68+/CD3+ ratios for NV and NA were significantly different (non-smokers: 0.39 and 0.68, p<0.05; smokers: 0.49 and 1.68, p<0.05. When counting only nucleated CD68+ profiles, mean ratios obtained by 2D and 3D counting were similar, but the regression-based Bland-Altmann analysis indicated a bias of the 2D ratios proportional to their magnitude. This magnitude dependent deviation differed between the two groups. CONCLUSIONS: 2D counts of cell and nuclear profiles introduce a variable size-dependent bias throughout the measurement range. Because the deviation between the 3D and 2D data was different in the two groups, it precludes establishing a 'universal conversion formula'.

  6. Bronchopulmonary Neuroendocrine Neoplasms and Their Precursor Lesions in Multiple Endocrine Neoplasia Type 1.

    Science.gov (United States)

    Bartsch, Detlef K; Albers, Max B; Lopez, Caroline L; Apitzsch, Jonas C; Walthers, Eduard M; Fink, Ludger; Fendrich, Volker; Slater, Emily P; Waldmann, Jens; Anlauf, Martin

    2016-01-01

    The prevalence and clinical behavior of bronchopulmonary neuroendocrine tumors (bNET) associated with multiple endocrine neoplasia type 1 (MEN1) are not well defined. This study aimed to determine the prevalence, potential precursor lesions and prognosis of bNET in patients with MEN1. A database of 75 prospectively collected MEN1 cases was retrospectively analyzed for bNET. Patient characteristics, imaging and treatment were evaluated. Resection specimens of operated patients were reassessed by two specialized pathologists. Available CT scans of the whole cohort were reviewed to determine the prevalence of bronchopulmonary nodules. Five of the 75 MEN1 patients (6.6%; 2 male, 3 female) developed histologically confirmed bNET after a median follow-up of 134 months. The median age at diagnosis of bNET was 47 years (range 31-67), and all patients were asymptomatic. Four patients underwent anatomic lung resections with lymphadenectomy; the remaining patient with multiple lesions had only a wedge resection of the largest bNET. Tumor sizes ranged from 7 to 32 mm in diameter, and all bNET were well differentiated. Two patients had lymph node metastases. Two of 4 reevaluated resection specimens revealed multifocal bNET, and 3 specimens showed tumorlets (up to 3) associated with multifocal areas of a neuroendocrine cell hyperplasia within the subsegmental bronchi. One bNET-related death (1.3%) occurred during long-term follow-up. Review of the available CT scans of the patients without proven bNET revealed small bronchopulmonary lesions (≥3 mm) in 16 of 53 cases (30.2%). bNET in MEN1 might be more common than previously recognized. Their natural course seems to be rather benign. Multifocal tumorlets and multifocal neuroendocrine cell hyperplasia might represent their precursor lesions. © 2015 S. Karger AG, Basel.

  7. Endotracheal tube biofilm translocation in the lateral Trendelenburg position.

    Science.gov (United States)

    Li Bassi, Gianluigi; Fernandez-Barat, Laia; Saucedo, Lina; Giunta, Valeria; Marti, Joan Daniel; Tavares Ranzani, Otavio; Aguilera Xiol, Eli; Rigol, Montserrat; Roca, Ignasi; Muñoz, Laura; Luque, Nestor; Esperatti, Mariano; Saco, Maria Adela; Ramirez, Jose; Vila, Jordi; Ferrer, Miguel; Torres, Antoni

    2015-02-27

    Laboratory studies demonstrated that the lateral Trendelenburg position (LTP) is superior to the semirecumbent position (SRP) in the prevention of ventilator-associated pulmonary infections. We assessed whether the LTP could also prevent pulmonary colonization and infections caused by an endotracheal tube (ETT) biofilm. Eighteen pigs were intubated with ETTs colonized by Pseudomonas aeruginosa biofilm. Pigs were positioned in LTP and randomized to be on mechanical ventilatin (MV) up to 24 hour, 48 hour, 48 hour with acute lung injury (ALI) by oleic acid and 72 hour. Bacteriologic and microscopy studies confirmed presence of biofilm within the ETT. Upon autopsy, samples from the proximal and distal airways were excised for P.aeruginosa quantification. Ventilator-associated tracheobronchitis (VAT) was confirmed by bronchial tissue culture ≥3 log colony forming units per gram (cfu/g). In pulmonary lobes with gross findings of pneumonia, ventilator-associated pneumonia (VAP) was confirmed by lung tissue culture ≥3 log cfu/g. P.aeruginosa colonized the internal lumen of 16 out of 18 ETTs (88.89%), and a mature biofilm was consistently present. P.aeruginosa colonization did not differ among groups, and was found in 23.6% of samples from the proximal airways, and in 7.1% from the distal bronchi (P = 0.001). Animals of the 24 hour group never developed respiratory infections, whereas 20%, 60% and 25% of the animals in group 48 hour, 48 hour-ALI and 72 hour developed P.aeruginosa VAT, respectively (P = 0.327). Nevertheless, VAP never developed. Our findings imply that during the course of invasive MV up to 72 hour, an ETT P.aeruginosa biofilm hastily colonizes the respiratory tract. Yet, the LTP compartmentalizes colonization and infection within the proximal airways and VAP never develops.

  8. Ezrin/Exocyst complex regulates mucin 5AC secretion induced by neutrophil elastase in human airway epithelial cells.

    Science.gov (United States)

    Li, Qi; Li, Na; Liu, Chun-Yi; Xu, Rui; Kolosov, Victor P; Perelman, Juliy M; Zhou, Xiang-Dong

    2015-01-01

    Increased mucin secretion is a characteristic feature of many chronic airway diseases, particularly during periods of exacerbation; however, the exact mechanism of mucin secretion remains unclear. Ezrin, which is a specific marker of apical membranes, is predominantly concentrated in exocyst-rich cell surface structures, crosslinking the actin cytoskeleton with the plasma membrane. In the present study, we examined whether Ezrin is involved in mucin 5AC (MUC5AC) secretion after neutrophil elastase (NE) attack, and we investigated the role of the exocyst complex docking protein Sec3 in this process. NE was used as a stimulator in a 16HBE14o- cell culture model. The expression and location of Ezrin and Sec3 were investigated, and the interaction between Ezrin and Sec3 in 16HBE14o-cells was assayed after treatment with NE, Ezrin siRNA, Sec3 siRNA, neomycin or PIP2-Ab. We found that Ezrin was highly expressed in the bronchi of humans with chronic airway diseases. NE induced robust MUC5AC protein secretion. The Ezrin siRNA, Sec3 siRNA, and neomycin treatments led to impaired MUC5AC secretion in cells. Both Ezrin and Sec3 were recruited primarily to the cytoplasmic membrane after NE stimulation, and the neomycin and PIP2-Ab treatments abrogated this effect. Immunoprecipitation analysis revealed that Ezrin and Sec3 combined to form complexes; however, these complexes could not be detected in Ezrin∆1-333 mutant-transfected cells, even when PIP2 was added. These results demonstrate that Ezrin/Sec3 complexes are essential for MUC5AC secretion in NE-stimulated airway epithelial cells and that PIP2 is of critical importance in the formation of these complexes. © 2015 S. Karger AG, Basel.

  9. Ezrin/Exocyst Complex Regulates Mucin 5AC Secretion Induced by Neutrophil Elastase in Human Airway Epithelial Cells

    Directory of Open Access Journals (Sweden)

    Qi Li

    2015-01-01

    Full Text Available Background/Aim: Increased mucin secretion is a characteristic feature of many chronic airway diseases, particularly during periods of exacerbation; however, the exact mechanism of mucin secretion remains unclear. Ezrin, which is a specific marker of apical membranes, is predominantly concentrated in exocyst-rich cell surface structures, crosslinking the actin cytoskeleton with the plasma membrane. In the present study, we examined whether Ezrin is involved in mucin 5AC (MUC5AC secretion after neutrophil elastase (NE attack, and we investigated the role of the exocyst complex docking protein Sec3 in this process. Methods: NE was used as a stimulator in a 16HBE14o- cell culture model. The expression and location of Ezrin and Sec3 were investigated, and the interaction between Ezrin and Sec3 in 16HBE14o-cells was assayed after treatment with NE, Ezrin siRNA, Sec3 siRNA, neomycin or PIP2-Ab. Results: We found that Ezrin was highly expressed in the bronchi of humans with chronic airway diseases. NE induced robust MUC5AC protein secretion. The Ezrin siRNA, Sec3 siRNA, and neomycin treatments led to impaired MUC5AC secretion in cells. Both Ezrin and Sec3 were recruited primarily to the cytoplasmic membrane after NE stimulation, and the neomycin and PIP2-Ab treatments abrogated this effect. Immunoprecipitation analysis revealed that Ezrin and Sec3 combined to form complexes; however, these complexes could not be detected in Ezrin∆1-333 mutant-transfected cells, even when PIP2 was added. Conclusions: These results demonstrate that Ezrin/Sec3 complexes are essential for MUC5AC secretion in NE-stimulated airway epithelial cells and that PIP2 is of critical importance in the formation of these complexes.

  10. Prenatal exposure to p,p'-DDE and p,p'-DDT in relation to lower respiratory tract infections in boys from a highly exposed area of Mexico.

    Science.gov (United States)

    Cupul-Uicab, Lea A; Terrazas-Medina, Efraín A; Hernández-Ávila, Mauricio; Longnecker, Matthew P

    2014-07-01

    Prenatal exposure to 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (p,p'-DDE), the major breakdown product of DDT, has been associated with recurrent lower respiratory tract infections (LRTIs) in infants. However, epidemiological investigations are limited. To assess the association of prenatal exposure to p,p'-DDE and p,p'-DDT with the occurrence of LRTI in boys from Chiapas, a highly exposed area of Mexico. We analyzed data from 747 singleton boys whose prenatal exposure to p,p'-DDE and p,p'-DDT was determined in maternal serum drawn at delivery (2002-2003). LRTI (i.e., pneumonia, bronchiolitis, and other illness of the bronchi) experienced by the children were reported by their mothers during in-person interviews. The median age of the children when they were last seen was 21.4 months (quartiles 19.1 and 25.3 months). Median exposure to p,p'-DDE in this population was higher (2.7 µg/g lipid) than recent U.S. levels (0.20 µg/g). There were 0.19 episodes of LRTI per child-year. After adjusting for potential confounders, children in the highest category of p,p'-DDE (>9.00 µg/g) exposure compared to those in the lowest (≤ 3.00 µg/g) had an adjusted incidence rate ratio (aIRR) of LRTI of 0.77 (95% confidence interval [CI], 0.41-1.46). The corresponding aIRR for p,p'-DDT (≥ 2.00 µg/g compared to ≤ 0.25 µg/g) was 0.65 (95% CI: 0.30-1.39). An association of prenatal exposure to p,p'-DDE and p,p'-DDT with LRTI during childhood was not supported in this population with relatively high levels of exposure. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Cell surface marker profiling of human tracheal basal cells reveals distinct subpopulations, identifies MST1/MSP as a mitogenic signal, and identifies new biomarkers for lung squamous cell carcinomas.

    Science.gov (United States)

    Van de Laar, Emily; Clifford, Monica; Hasenoeder, Stefan; Kim, Bo Ram; Wang, Dennis; Lee, Sharon; Paterson, Josh; Vu, Nancy M; Waddell, Thomas K; Keshavjee, Shaf; Tsao, Ming-Sound; Ailles, Laurie; Moghal, Nadeem

    2014-12-31

    The large airways of the lungs (trachea and bronchi) are lined with a pseudostratified mucociliary epithelium, which is maintained by stem cells/progenitors within the basal cell compartment. Alterations in basal cell behavior can contribute to large airway diseases including squamous cell carcinomas (SQCCs). Basal cells have traditionally been thought of as a uniform population defined by basolateral position, cuboidal cell shape, and expression of pan-basal cell lineage markers like KRT5 and TP63. While some evidence suggests that basal cells are not all functionally equivalent, few heterogeneously expressed markers have been identified to purify and study subpopulations. In addition, few signaling pathways have been identified that regulate their cell behavior. The goals of this work were to investigate tracheal basal cell diversity and to identify new signaling pathways that regulate basal cell behavior. We used flow cytometry (FACS) to profile cell surface marker expression at a single cell level in primary human tracheal basal cell cultures that maintain stem cell/progenitor activity. FACS results were validated with tissue staining, in silico comparisons with normal basal cell and lung cancer datasets, and an in vitro proliferation assay. We identified 105 surface markers, with 47 markers identifying potential subpopulations. These subpopulations generally fell into more (~ > 13%) or less abundant (~ markers in the total population, and immunostaining of large airway tissue suggested that some of these markers are relevant in vivo. 24 markers were enriched in lung SQCCs relative to adenocarcinomas, with four markers having prognostic significance in SQCCs. We also identified 33 signaling receptors, including the MST1R/RON growth factor receptor, whose ligand MST1/MSP was mitogenic for basal cells. This work provides the largest description to date of molecular diversity among human large airway basal cells. Furthermore, these markers can be used to further

  12. Lung cancer at a university hospital in Saudi Arabia: A four-year prospective study of clinical, pathological, radiological, bronchoscopic, and biochemical parameters

    Directory of Open Access Journals (Sweden)

    Alamoudi Omer

    2010-01-01

    Full Text Available Objectives and Background: Lung cancer accounts for 4% of all newly diagnosed cancers in Saudi Arabia. The pattern of presentation is unknown. The objectives of this study were to assess the clinical, radiological, pathological, biochemical and bronchoscopic abnormalities in lung cancer patients and to compare our findings with those reported in the literature. Methods: A total of 114 patients with proven lung cancer were selected for the study. A questionnaire concerning patients′ demographic data was obtained; the abnormalities and the cell types of lung cancer were recorded prospectively in each subject. Results: A total of 114 patients with lung cancer were studied. Mean age ± SD was (59.8 ± 10.8 years, and (71.1% were smokers and 95.1% of them were male, (90.1% smoked> 20 pack/yr (96.2% for 20 years or more. Cough (76.3% and clubbing (40.4% were the most common symptom and physical abnormality respectively. The right lung (64.9% was more commonly affected than the left (37.7%. Metastases were present in (49.1% at presentation. The right and left upper bronchi (24% vs. 16% were the mostly affected. Hypercalcemia was more common in squamous cell, while hyponatremia was more common in adenocarcinoma, and small cell. Squamous cell carcinoma was the most common cell type (51.8% and significantly associated with smoking (P ≤ 0.001 Conclusion: Squamous cell carcinoma was the most common cell type, and significantly associated with smoking. The incidence of metastasis was high at presentation. The right lung and right upper bronchus were often affected. Hypercalcemia and hyponatremia were the most common biochemical abnormalities.

  13. Exposure to culturable and total microbiota in cultural heritage conservation laboratories.

    Science.gov (United States)

    Górny, Rafał L; Harkawy, Aleksander S; Ławniczek-Wałczyk, Anna; Karbowska-Berent, Joanna; Wlazło, Agnieszka; Niesler, Anna; Gołofit-Szymczak, Małgorzata; Cyprowski, Marcin

    2016-01-01

    To date, the scientific source materials usually focus on microbial contamination of the museum or library collections themselves, while the exposure of persons who professionally deal with this type of objects in cultural heritage conservation laboratories is ignored. The study was carried out in 9 naturally ventilated conservation laboratories with no history of water damage. Viable (understood as culturable) bioaerosol stationary samples were collected in both outdoor and indoor environments using 6-stage Andersen impactor. Simultaneously, stationary and personal indoor bioaerosol measurements were carried out using both Gesamtstaubprobenahme an der Person (GSP) and Button filter samplers. These measurements were complemented by evaluation of microbial content in the dust settled on conserved works of art. All impactor, filter, and settled dust samples were quantitatively examined to obtain viable and total concentrations of bacteria and fungi. All isolated microbial strains were taxonomically identified. At workplaces, the concentrations of viable microorganisms in air were below 2000 cfu/m3 and accounted for not more than 5.5% of total microbiota. The study showed that quantitative assessment of viable bioaerosol can be made with an Andersen impactor as well as by using Button and GSP filter samplers, irrespective of whether they are applied for personal or stationary measurements. Compared to the impactor, however, the use of filter samplers for microbial contamination monitoring substantially limits the scope of qualitative information which can be obtained. Size distribution analysis revealed that the largest "load" of microorganisms can penetrate into the respiratory tract between the trachea and terminal bronchi, and thereby may be responsible for allergic inflammations in exposed workers. The precise assessment of microbial hazards in conservation laboratories should comprise control of both viable and total particle counts. The hermetization of such

  14. AVE 0991, a non-peptide mimic of angiotensin-(1–7) effects, attenuates pulmonary remodelling in a model of chronic asthma

    Science.gov (United States)

    Rodrigues-Machado, M G; Magalhães, G S; Cardoso, J A; Kangussu, L M; Murari, A; Caliari, M V; Oliveira, M L; Cara, D C; Noviello, M L M; Marques, F D; Pereira, J M; Lautner, R Q; Santos, R A S; Campagnole-Santos, M J

    2013-01-01

    BACKGROUND AND PURPOSE AVE 0991 (AVE) is a non-peptide compound, mimic of the angiotensin (Ang)-(1–7) actions in many tissues and pathophysiological states. Here, we have investigated the effect of AVE on pulmonary remodelling in a murine model of ovalbumin (OVA)-induced chronic allergic lung inflammation. EXPERIMENTAL APPROACH We used BALB/c mice (6–8 weeks old) and induced chronic allergic lung inflammation by OVA sensitization (20 μg·mouse−1, i.p., four times, 14 days apart) and OVA challenge (1%, nebulised during 30 min, three times per·week, for 4 weeks). Control and AVE groups were given saline i.p and challenged with saline. AVE treatment (1 mg·kg−1·per day, s.c.) or saline (100 μL·kg−1·per day, s.c.) was given during the challenge period. Mice were anaesthetized 72 h after the last challenge and blood and lungs collected. In some animals, primary bronchi were isolated to test contractile responses. Cytokines were evaluated in bronchoalveolar lavage (BAL) and lung homogenates. KEY RESULTS Treatment with AVE of OVA sensitised and challenged mice attenuated the altered contractile response to carbachol in bronchial rings and reversed the increased airway wall and pulmonary vasculature thickness and right ventricular hypertrophy. Furthermore, AVE reduced IL-5 and increased IL-10 levels in the BAL, accompanied by decreased Ang II levels in lungs. CONCLUSIONS AND IMPLICATIONS AVE treatment prevented pulmonary remodelling, inflammation and right ventricular hypertrophy in OVA mice, suggesting that Ang-(1–7) receptor agonists are a new possibility for the treatment of pulmonary remodelling induced by chronic asthma. PMID:23889691

  15. AVE 0991, a non-peptide mimic of angiotensin-(1-7) effects, attenuates pulmonary remodelling in a model of chronic asthma.

    Science.gov (United States)

    Rodrigues-Machado, M G; Magalhães, G S; Cardoso, J A; Kangussu, L M; Murari, A; Caliari, M V; Oliveira, M L; Cara, D C; Noviello, M L M; Marques, F D; Pereira, J M; Lautner, R Q; Santos, R A S; Campagnole-Santos, M J

    2013-10-01

    AVE 0991 (AVE) is a non-peptide compound, mimic of the angiotensin (Ang)-(1-7) actions in many tissues and pathophysiological states. Here, we have investigated the effect of AVE on pulmonary remodelling in a murine model of ovalbumin (OVA)-induced chronic allergic lung inflammation. We used BALB/c mice (6-8 weeks old) and induced chronic allergic lung inflammation by OVA sensitization (20 μg·mouse(-1) , i.p., four times, 14 days apart) and OVA challenge (1%, nebulised during 30 min, three times per·week, for 4 weeks). Control and AVE groups were given saline i.p and challenged with saline. AVE treatment (1 mg·kg(-1) ·per day, s.c.) or saline (100 μL·kg(-1) ·per day, s.c.) was given during the challenge period. Mice were anaesthetized 72 h after the last challenge and blood and lungs collected. In some animals, primary bronchi were isolated to test contractile responses. Cytokines were evaluated in bronchoalveolar lavage (BAL) and lung homogenates. Treatment with AVE of OVA sensitised and challenged mice attenuated the altered contractile response to carbachol in bronchial rings and reversed the increased airway wall and pulmonary vasculature thickness and right ventricular hypertrophy. Furthermore, AVE reduced IL-5 and increased IL-10 levels in the BAL, accompanied by decreased Ang II levels in lungs. AVE treatment prevented pulmonary remodelling, inflammation and right ventricular hypertrophy in OVA mice, suggesting that Ang-(1-7) receptor agonists are a new possibility for the treatment of pulmonary remodelling induced by chronic asthma. © 2013 The British Pharmacological Society.

  16. Quantitative analysis of rib movement based on dynamic chest bone images: preliminary results

    Science.gov (United States)

    Tanaka, R.; Sanada, S.; Oda, M.; Mitsutaka, M.; Suzuki, K.; Sakuta, K.; Kawashima, H.

    2014-03-01

    Rib movement during respiration is one of the diagnostic criteria in pulmonary impairments. In general, the rib movement is assessed in fluoroscopy. However, the shadows of lung vessels and bronchi overlapping ribs prevent accurate quantitative analysis of rib movement. Recently, an image-processing technique for separating bones from soft tissue in static chest radiographs, called "bone suppression technique", has been developed. Our purpose in this study was to evaluate the usefulness of dynamic bone images created by the bone suppression technique in quantitative analysis of rib movement. Dynamic chest radiographs of 10 patients were obtained using a dynamic flat-panel detector (FPD). Bone suppression technique based on a massive-training artificial neural network (MTANN) was applied to the dynamic chest images to create bone images. Velocity vectors were measured in local areas on the dynamic bone images, which formed a map. The velocity maps obtained with bone and original images for scoliosis and normal cases were compared to assess the advantages of bone images. With dynamic bone images, we were able to quantify and distinguish movements of ribs from those of other lung structures accurately. Limited rib movements of scoliosis patients appeared as reduced rib velocity vectors. Vector maps in all normal cases exhibited left-right symmetric distributions, whereas those in abnormal cases showed nonuniform distributions. In conclusion, dynamic bone images were useful for accurate quantitative analysis of rib movements: Limited rib movements were indicated as a reduction of rib movement and left-right asymmetric distribution on vector maps. Thus, dynamic bone images can be a new diagnostic tool for quantitative analysis of rib movements without additional radiation dose.

  17. The cardiac sodium current Na(v)1.5 is functionally expressed in rabbit bronchial smooth muscle cells.

    Science.gov (United States)

    Bradley, E; Webb, T I; Hollywood, M A; Sergeant, G P; McHale, N G; Thornbury, K D

    2013-08-15

    A collagenase-proteinase mixture was used to isolate airway smooth muscle cells (ASMC) from rabbit bronchi, and membrane currents were recorded using the whole cell patch-clamp technique. Stepping from -100 mV to a test potential of -40 mV evoked a fast voltage-dependent Na(+) current, sometimes with an amplitude of several nanoamperes. The current disappeared within 15 min of exposure to papain + DTT (n = 6). Comparison of the current in ASMC with current mediated by NaV1.5 α-subunits expressed in human embryonic kidney cells revealed similar voltage dependences of activation (V1/2 = -42 mV for NaV1.5) and sensitivities to TTX (IC50 = 1.1 and 1.2 μM for ASMC and NaV1.5, respectively). The current in ASMC was also blocked by lidocaine (IC50 = 160 μM). Although veratridine, an agonist of voltage-gated Na(+) channels, reduced the peak current by 33%, it slowed inactivation, resulting in a fourfold increase in sustained current (measured at 25 ms after onset). In current-clamp mode, veratridine prolonged evoked action potentials from 37 ± 9 to 1,053 ± 410 ms (n = 8). Primers for NaV1.2-1.9 were used to amplify mRNA from groups of ∼20 isolated ASMC and from whole bronchial tissue by RT-PCR. Transcripts for NaV1.2, NaV1.3, and NaV1.5-1.9 were detected in whole tissue, but only NaV1.2 and NaV1.5 were detected in single cells. We conclude that freshly dispersed rabbit ASMC express a fast voltage-gated Na(+) current that is mediated mainly by the NaV1.5 subtype.

  18. Neutron equivalent doses and associated lifetime cancer incidence risks for head & neck and spinal proton therapy

    Science.gov (United States)

    Athar, Basit S.; Paganetti, Harald

    2009-08-01

    In this work we have simulated the absorbed equivalent doses to various organs distant to the field edge assuming proton therapy treatments of brain or spine lesions. We have used computational whole-body (gender-specific and age-dependent) voxel phantoms and considered six treatment fields with varying treatment volumes and depths. The maximum neutron equivalent dose to organs near the field edge was found to be approximately 8 mSv Gy-1. We were able to clearly demonstrate that organ-specific neutron equivalent doses are age (stature) dependent. For example, assuming an 8-year-old patient, the dose to brain from the spinal fields ranged from 0.04 to 0.10 mSv Gy-1, whereas the dose to the brain assuming a 9-month-old patient ranged from 0.5 to 1.0 mSv Gy-1. Further, as the field aperture opening increases, the secondary neutron equivalent dose caused by the treatment head decreases, while the secondary neutron equivalent dose caused by the patient itself increases. To interpret the dosimetric data, we analyzed second cancer incidence risks for various organs as a function of patient age and field size based on two risk models. The results show that, for example, in an 8-year-old female patient treated with a spinal proton therapy field, breasts, lungs and rectum have the highest radiation-induced lifetime cancer incidence risks. These are estimated to be 0.71%, 1.05% and 0.60%, respectively. For an 11-year-old male patient treated with a spinal field, bronchi and rectum show the highest risks of 0.32% and 0.43%, respectively. Risks for male and female patients increase as their age at treatment time decreases.

  19. Tuberculosis as a three-act play: A new paradigm for the pathogenesis of pulmonary tuberculosis.

    Science.gov (United States)

    Hunter, Robert L

    2016-03-01

    Lack of access to human tissues with untreated tuberculosis (TB) has forced generations of researchers to use animal models and to adopt a paradigm that granulomas are the characteristic lesion of both primary and post primary TB. An extended search of studies of human lung tissues failed to find any reports that support this paradigm. We found scores of publications from gross pathology in 1804 through high resolution CT scans in 2015 that identify obstructive lobular pneumonia, not granulomas, as the characteristic lesion of developing post-primary TB. This paper reviews this literature together with other relevant observations to formulate a new paradigm of TB with three distinct stages: a three-act play. First, primary TB, a war of attrition, begins with infection that spreads via lymphatics and blood stream before inducing systemic immunity that contains and controls the organisms within granulomas. Second, post-primary TB, a sneak attack, develops during latent TB as an asymptomatic obstructive lobular pneumonia in persons with effective systemic immunity. It is a paucibacillary process with no granulomas that spreads via bronchi and accumulates mycobacterial antigens and host lipids for 1-2 years before suddenly undergoing caseous necrosis. Third, the fallout, is responsible for nearly all clinical post primary disease. It begins with caseous necrotic pneumonia that is either retained to become the focus of fibrocaseous disease or is coughed out to leave a cavity. This three-stage paradigm suggests testable hypotheses and plausible answers to long standing questions of immunity to TB. Copyright © 2015 The Author. Published by Elsevier Ltd.. All rights reserved.

  20. High Expression of Twist Is Positively Correlated with the Differentiation of Lung Cancer

    Directory of Open Access Journals (Sweden)

    Linping HUI

    2009-04-01

    Full Text Available Background and objective Twist has been identified as a promoting factor for epithelialmesenchymal transition (EMT, which enhances the metastatic potential of cancer. The aim of this study is to detect the expression of Twist in lung cancer tissues and cell lines, and analyze its relationship with clinicopathologiccharacteristics and biological behavior of lung cancer. Methods Twist expression was examined in 68 lung cancer specimens and 8 normal lung specimens using immunohistochemistry (S-P method. Expression levels of Twist1 and Twist2 mRNA were detected using transcription-polymerase chain reaction (RT-PCR in HBE and 8 lung cancer cell lines. Immunofluorescence was used to detect the Twist protein expression levels and subcellular localization in lungcancer cells and HBE (human normal bronchi epithelium cells. Results Among 68 lung cancer specimens, 9 samples showed weak expression of Twist 13.24% (9 of 68, 75.00% (51 of 68 lung cancer specimens showed moderate to strong Twist staining whereas 8 corresponding normal lung specimens showed weak staining extent. Twist expression level was positively correlated with differentiation (P =0.002 and age (P =0.012. Twist1 and Twist2 mRNA expression levels were incompatible in different histology types. The fluorescence signal of Twist protein was conspicuous in lung squamous cell carcinoma cells and adencarcinoma cells, primarily in cytoplasm, but low in HBE. Conclusion High expression of Twist in lung cancer was associated with differentiation. Twist could be used as a valuable biomarker to evaluate the progressionof lung cancer.

  1. Two forensic autopsy cases of death from unexpected lesions of the pituitary gland.

    Science.gov (United States)

    Suzuki, Hideto; Hayashi, Kino; Fukunaga, Tatsushige

    2014-01-01

    Herein, we report the findings of 2 forensic autopsy cases, in which unexpected pituitary lesions were the underlying cause of death. Case 1: A 56-year-old woman was found dead at her home during a cold winter spell. Macroscopic autopsy findings included a difference in the color of blood that filled her left and right cardiac chambers (deep red and dark red, respectively), collapse of both lungs, atrophy of the thyroid gland, and a large tumor arising from the sella turcica. Microscopic examination revealed a pituitary adenoma along with extensive bleeding. The cause of death was considered to be hypothermia, resulting from dysregulation of thermogenesis due to the pituitary adenoma. Case 2: An 86-year-old man with a history of pollakiuria was found dead in a bathtub, with his face and chest submerged in bathwater and his legs positioned outside the bathtub. The macroscopic findings of the autopsy included hyper-inflated lungs, fluid collection in the thoracic cavity, and aspiration of gastric contents in the bronchi. The atherosclerotic changes of the man's coronary and cerebral arteries were considered mild for his age. Microscopic examination showed a marked infiltration of lymphocytes and plasma cells in the posterior pituitary gland, as well as in the liver, pancreas, and submandibular gland. Considering the results of the autopsy and the findings from the investigation conducted at the death scene, we concluded that the man probably lost consciousness following a neurally mediated syncope, which was induced by diabetes insipidus (lymphocytic hypophysitis). After losing consciousness, the man likely fell in the filled bathtub and then drowned. These 2 cases highlight the need for a thorough post-mortem investigation, including a microscopic examination of the pituitary gland. In addition, forensic pathologists should carefully study the pituitary gland in cases where the cause of death is thought to be related to dysfunction of thermoregulation or

  2. Contrast enhancement for portal images by combination of subtraction and reprojection processes for Compton scattering.

    Science.gov (United States)

    Hariu, Masatsugu; Suda, Yuhi; Chang, Weishan; Myojoyama, Atsushi; Saitoh, Hidetoshi

    2017-11-01

    For patient setup of the IGRT technique, various imaging systems are currently available. MV portal imaging is performed in identical geometry with the treatment beam so that the portal image provides accurate geometric information. However, MV imaging suffers from poor image contrast due to larger Compton scatter photons. In this work, an original image processing algorithm is proposed to improve and enhance the image contrast without increasing the imaging dose. Scatter estimation was performed in detail by MC simulation based on patient CT data. In the image processing, scatter photons were eliminated and then they were reprojected as primary photons on the assumption that Compton interaction did not take place. To improve the processing efficiency, the dose spread function within the EPID was investigated and implemented on the developed code. Portal images with and without the proposed image processing were evaluated by the image contrast profile. By the subtraction process, the image contrast was improved but the EPID signal was weakened because 15.2% of the signal was eliminated due to the contribution of scatter photons. Hence, these scatter photons were reprojected in the reprojection process. As a result, the tumor, bronchi, mediastinal space and ribs were observed more clearly than in the original image. It was clarified that image processing with the dose spread functions provides stronger contrast enhancement while maintaining a sufficient signal-to-noise ratio. This work shows the feasibility of improving and enhancing the contrast of portal images. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  3. A systematic study on the influence of the main ingredients of an ivy leaves dry extract on the β2-adrenergic responsiveness of human airway smooth muscle cells.

    Science.gov (United States)

    Greunke, Christian; Hage-Hülsmann, Anne; Sorkalla, Thomas; Keksel, Nelli; Häberlein, Felix; Häberlein, Hanns

    2015-04-01

    The bronchospasmolytic and secretolytic effects of ivy leaves dry extracts can be explained by an increased β2-adrenergic responsiveness of the bronchi. Recently, it was shown that α-hederin inhibits the internalization of β2-adrenergic receptors (ß2AR) under stimulating conditions. α-Hederin pretreated alveolar type II cells and human airway smooth muscle cells revealed an increased ß2AR binding and an elevated intracellular cAMP level, respectively. In order to identify whether additional compounds also mediate an increased β2-adrenergic responsiveness, we examined the ingredients of an ivy leaves dry extract (EA 575) protocatechuic acid, neochlorogenic acid, chlorogenic acid, cryptochlorogenic acid, rutin, kaempferol-3-O-rutinoside, 3,4-, 3,5- and 4,5-dicaffeoylquinic acid, hederacoside B, and β-hederin. Within all the tested substances, only β-hederin inhibited the internalization of GFP-tagged ß2AR in stably transfected HEK293 cells. Using fluorescence correlation spectroscopy β-hederin (1 μM, 24 h) pretreated HASM cells showed a statistically significant increase in the ß2AR binding from 33.0 ± 8.9% to 44.1 ± 11.5% which was distributed with 36.0 ± 9.5% for τbound1 and 8.1 ± 2.6% for τbound2, respectively (n = 8, p dry extract on HASM cells it was possible to identify β-hederin as further component presumably responsible for the β2-mimetic effects. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. The histopathologic reaction of rabbit lungs after intrabronchial application of contrast agents

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Hyo Soon; Kim, Jae Kyu; Shen, Yu Lan; Oh, Jeong Won; Chang, Nam Kyu; Shin, Sang Soo; Park, Jin Gyoon; Kang, Heoung Keun [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2006-05-15

    The aim of this study was to determine a safe gastrointestinal contrast agent that could be used in various clinical situations where there is a risk of aspiration using a rabbit model. 30 healthy white rabbits were used. The rabbits were divided into 5 groups containing six animals each, one control group (anesthesia only) and 4 groups receiving various contrast agents [Solotop (Barium sulphate suspension), Gastrografin (sodium and meglumine amidotrizoate), and Telebrix (Meglumine ioxitalamate), Visipaque (Iodixanol)]. The contrast agents were injected selectively into a main bronchus via a catheter inserted under fluoroscopy guidance. The rabbits were sacrificed either 1 day or 7 days after injecting the contrast agents, and the tissue reaction of the bronchi and lungs were examined both macro-and microscopically. The level of alveolar septal thickening, peribronchiolar lymphocytic infiltration, pulmonary congestion and edema, inflammatory exudate in the alveoli or bronchiolar lumina, microabscess formation, necrosis, pigmentation of materials injected, and fibropurulent pleurisy were evaluated and graded according to the severity as follows: no change, mild, moderate, marked in degree. The common microscopic findings were alveolar septal thickening and peribronchiolar lymphocytic infiltration. Pulmonary congestion and edema, inflammatory exudate in the alveoli of bronchiolar lumina were observed in 21 out of 24 rabbits receiving the contrast agents. Pigmentation of the materials injected was observed only in the group receiving Solotop. An inflammatory exudate in the alveoli and bronchiolar/bronchial lumina, microabscess formation, and necrosis were noted in most groups, but was more frequent and severe in the group receiving Gastrografin. The histopathological reactions of the rabbit lungs after the intrabronchial application of a contrast agent showed variable degrees of inflammatory reaction. Gastrografin produced most severe and extensive reaction, Solotop

  5. Expandable metallic stents in the palliative treatment of malignant tracheobronchial stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jong Woong; Jung, Gyoo Sik; Kim, Seong Min; Lee, Seung Ryong; Kim, Hyun Sook; Huh, Jin Do; Joh, Young Duk [Kosin Medical College, Pusan (Korea, Republic of)

    1998-05-01

    The purpose of this study is to report the outcome of using expandable metallic stent in the management of malignant tracheobronchial stenosis with dyspnea. Under fluoroscopic and bronchoscopic guidance, seven patients with malignant airway stenosis were treated with ten expandable metallic stents. The cause of stenosis was metastasis from esophageal cancer in five patients, recurrent adenoid cystic carcinoma of the trachea in one, and primary lung cancer in one. The major sites of obstruction were the trachea in four patients, the left main bronchus in one, the trachea and left main bronchus in one, and the trachea and both bronchi in one. Chest radiography (n=7), bronchoscopy (n=5), pulmonary function test (PFT)(n=3), and spirometry(n=1) were performed before and after stent placement. In all seven patients, the stent was successfully placed at the lesion sites and dyspnea began to improve immediately. After the procedure, chest radiography and bronchoscopy showed an increase in airway diameter. After the procedure, chest radiography and bronchoscopy showed an increase in airway diameter. After stent placement, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) improved 53% and 56%, respectively. Peak flow velocity also changed from 46 L/min to 200 L/min. During median follow-up of 67 (41-1565) days, one stent migration occurred. In one patient, proximal tumor overgrowth occurred, and in one, tumor ingrowth was treated with balloon dilatation. For in the palliative treatment of malignant tracheobronchial stenosis with dyspnea, placement of expandable metal stents is safe and effective. (author). 21 refs., 1 tabs., 3 figs.

  6. Troglostrongylus brevior in an Eurasian lynx (Lynx lynx) from Bosnia and Herzegovina.

    Science.gov (United States)

    Alić, Amer; Traversa, Donato; Duscher, Georg Gerhard; Kadrić, Mirsad; Di Cesare, Angela; Hodžić, Adnan

    2015-12-21

    In the past few years the interest of the scientific community on lungworms of the genus Troglostrongylus has grown due to the increased number of unexpected cases of infections with Troglostrongylus brevior in domestic cats from Mediterranean Europe, likely due to a spill-over from wild reservoirs. Thus, there is a merit to increase our knowledge on the occurrence of this parasite in felids from European regions. The present paper describes lung lesions associated with T. brevior infection in the endangered Eurasian lynx (Lynx lynx) from Bosnia and Herzegovina. The carcass of an illegally killed 3-year-old male Eurasian lynx was presented for necropsy at the Faculty of Veterinary Medicine of Sarajevo (Bosnia and Herzegovina). Grossly, multiple, multinodular, consolidated and firm, tan to grey areas, occupying the caudal third of caudal lung lobes, were observed. At cut section, the catarrhal fluid was draining from the airways. Larvae of T. brevior were found in tracheal scraping. The histopathological examination revealed multifocal to coalescing areas, centered on bronchi and bronchioles, and expanded alveoli filled with necrotic debris, degenerated inflammatory cells, mostly neutrophils and macrophages, and multiple cross sections of parasite larvae and thin-walled morulated eggs of lungworms. The paraffin-embedded lung samples were molecularly positive for T. brevior. This paper describes the first record of T. brevior in the Eurasian lynx and the associated host lung pathology. Given its pathogenic potential and the lack of data on troglostrongylosis in lynx populations, the occurrence and impact of Troglostrongylus spp. on wildlife health as well as the role of L. lynx as reservoir of infection for other felids, should be further investigated.

  7. Airway inflammatory markers in individuals with cystic fibrosis and non-cystic fibrosis bronchiectasis

    Directory of Open Access Journals (Sweden)

    Bergin DA

    2013-01-01

    Full Text Available David A Bergin, Killian Hurley, Adwait Mehta, Stephen Cox, Dorothy Ryan, Shane J O’Neill, Emer P Reeves*, Noel G McElvaney*Respiratory Research Division, Department of Medicine, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland*These authors share joint senior authorshipAbstract: Bronchiectasis is an airway disease characterized by thickening of the bronchial wall, chronic inflammation, and destruction of affected bronchi. Underlying etiologies include severe pulmonary infection and cystic fibrosis (CF; however, in a substantial number of patients with non-CF-related bronchiectasis (NCFB, no cause is found. The increasing armamentarium of therapies now available to combat disease in CF is in stark contrast to the limited tools employed in NCFB. Our study aimed to evaluate similarities and differences in airway inflammatory markers in patients with NCFB and CF, and to suggest potential common treatment options. The results of this study show that NCFB bronchoalveolar lavage fluid samples possessed significantly increased NE activity and elevated levels of matrix metalloproteinases 2 (MMP-2 and MMP-9 compared to healthy controls (P < 0.01; however, the levels detected were lower than in CF (P < 0.01. Interleukin-8 (IL-8 concentrations were significantly elevated in NCFB and CF compared to controls (P < 0.05, but in contrast, negligible levels of IL-18 were detected in both NCFB and CF. Analogous concentrations of IL-10 and IL-4 measured in NCFB and CF were statistically elevated above the healthy control values (P < 0.05 and P < 0.01, respectively. These results indicate high levels of important proinflammatory markers in both NCFB and CF and support the use of appropriate anti-inflammatory therapies already employed in the treatment of CF bronchiectasis in NCFB.Keywords: bronchiectasis, cystic fibrosis, proteases, inflammation

  8. Barium sulfate micro- and nanoparticles as bioinert reference material in particle toxicology.

    Science.gov (United States)

    Loza, Kateryna; Föhring, Isabell; Bünger, Jürgen; Westphal, Götz A; Köller, Manfred; Epple, Matthias; Sengstock, Christina

    2016-12-01

    The inhalation of particles and their exposure to the bronchi and alveoli constitute a major public health risk. Chemical as well as particle-related properties are important factors for the biological response but are difficult to separate from each other. Barium sulfate is a completely inert chemical compound, therefore it is ideally suited to separate these two factors. The biological response of rat alveolar macrophages (NR8383) was analyzed after exposure to barium sulfate particles with three different diameters (40 nm, 270 nm, and 1.3 μm, respectively) for 24 h in vitro (particle concentrations from 12.5 to 200 μg mL(-)(1)). The particles were colloidally stabilized as well as fluorescently-labeled by carboxymethylcellulose, conjugated with 6-aminofluorescein. All kinds of barium sulfate particles were efficiently taken up by NR8383 cells and found inside endo-lysosomes, but never in the cell nucleus. Neither an inflammatory nor a cytotoxic response was detected by the ability of dHL-60 and NR8383 cells to migrate towards a chemotactic gradient (conditioned media of NR8383 cells) and by the release of inflammatory mediators (CCL2, TNF-α, IL-6). The particles neither caused apoptosis (up to 200 μg mL(-)(1)) nor necrosis (up to 100 μg mL(-)(1)). As only adverse reaction, necrosis was found at a concentration of 200 μg mL(-)(1) of the largest barium sulfate particles (1.3 μm). Barium sulfate particles are ideally suited as bioinert control to study size-dependent effects such as uptake mechanisms of intracellular distributions of pure particles, especially in nanotoxicology.

  9. The detection of pharyngeal incoordination and aspiration by radiosalivagram in cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Baikie, G.; Reddihough, D.; Olinsky, A.; South, M.J.; Bowe, J.; Cook, D.J. [Royal Children`s Hospital, Parkville, VIC, (Australia)

    1997-09-01

    Full text: Children with cerebral palsy (CP) may have abnormal respiratory function because of aspiration pneumonitis, chest deformity, upper airways obstruction or central respiratory control abnormalities. The diagnosis of aspiration has long confounded clinicians and is often made indirectly after exclusion of other causes of respiratory disease in susceptible individuals. The radiosalivagram is a technique which permits the demonstration of aspiration of pharyngeal contents in individuals with pharyngeal incoordination. It is a simple procedure which provides both qualitative and quantitative evidence of aspiration. Over an hour and while supine, 20 mL of {sup 99m}Tc-sulphur colloid is instilled into the pharynx via a thin plastic tube using a syringe pump. The neck, thorax and upper abdomen are imaged continuously In normal individuals, radioactivity is demonstrated in the pharynx, oesophagus and stomach; in the presence of pharyngeal incoordination, radioactivity is seen within one or both main bronchi and adjacent lung fields. The rate of clearance from the lungs varies and can be quantified. We have studied 31 children with severe non-ambulant CR The time to first aspiration, maximum quantity aspirated, and retention of aspirated material at 2h have been determined. These data have been compared with measurements of respiratory function. Preliminary results of this ongoing study reveal a broad range of outcomes. Seventeen children (17/31) had aspiration, in 15/17 aspiration was unilateral and in 14/17 there was spontaneous early clearance. The investigation was well tolerated by patients. The radiosalivagram is a simple, quantifiable investigation for demonstrating or excluding pharyngeal incoordination and aspiration in children with unexplained respiratory disease.

  10. Imaging demonstration of a flexible micro-OCT endobronchial probe (Conference Presentation)

    Science.gov (United States)

    Cui, Dongyao; Chu, Kengyeh K.; Ford, Timothy N.; Hyun, Daryl Chulho; Leung, Hui Min; Yin, Biwei; Birket, Susan E.; Solomon, George M.; Rowe, Steven M.; Tearney, Guillermo J.

    2017-04-01

    The human respiratory system is protected by a defense mechanism termed mucociliary clearance (MCC). Deficiency in MCC leads to respiratory obstruction and pulmonary infection, which often are the main causes of morbidity and mortality in diseases such as cystic fibrosis and chronic obstructive pulmonary disease (COPD). Studying key parameters that govern MCC, including ciliary beat frequency, velocity and volume of airway mucus transport, as well as periciliary liquid layer thickness are therefore of great importance in understanding human respiratory health. However, direct, in vivo visualization of ciliary function and MCC has been challenging, hindering the diagnosis of disease pathogenesis and mechanistic evaluation of novel therapeutics. Our laboratory has previously developed a 1-µm resolution optical coherence tomography method, termed Micro-OCT, which is a unique tool for visualizing the spatiotemporal features of ciliary function and MCC. We have previously described the design of a flexible 2.5 mm Micro-OCT probe that is compatible with standard flexible bronchoscopes. This device utilizes a common-path interferometer and annular sample arm apodization to attain a sharply focused spot over an extended depth of focus. Here, we present the most recent iteration of this probe and demonstrate its imaging performance in a mouse trachea tissue culture model. In addition, we have developed an ergonomic assembly for attaching the probe to a standard bronchoscope. The ergonomic assembly fixes the Micro-OCT probe's within the bronchoscope and contains a means transducing linear motion through the sheath so that the Micro-OCT beam can be scanned along the trachea. We have tested the performance of these devices for Micro-OCT imaging in an anatomically correct model of the human airway. Future studies are planned to use this technology to conduct Micro-OCT in human trachea and bronchi in vivo.

  11. An iterative method for airway segmentation using multiscale leakage detection

    Science.gov (United States)

    Nadeem, Syed Ahmed; Jin, Dakai; Hoffman, Eric A.; Saha, Punam K.

    2017-02-01

    There are growing applications of quantitative computed tomography for assessment of pulmonary diseases by characterizing lung parenchyma as well as the bronchial tree. Many large multi-center studies incorporating lung imaging as a study component are interested in phenotypes relating airway branching patterns, wall-thickness, and other morphological measures. To our knowledge, there are no fully automated airway tree segmentation methods, free of the need for user review. Even when there are failures in a small fraction of segmentation results, the airway tree masks must be manually reviewed for all results which is laborious considering that several thousands of image data sets are evaluated in large studies. In this paper, we present a CT-based novel airway tree segmentation algorithm using iterative multi-scale leakage detection, freezing, and active seed detection. The method is fully automated requiring no manual inputs or post-segmentation editing. It uses simple intensity based connectivity and a new leakage detection algorithm to iteratively grow an airway tree starting from an initial seed inside the trachea. It begins with a conservative threshold and then, iteratively shifts toward generous values. The method was applied on chest CT scans of ten non-smoking subjects at total lung capacity and ten at functional residual capacity. Airway segmentation results were compared to an expert's manually edited segmentations. Branch level accuracy of the new segmentation method was examined along five standardized segmental airway paths (RB1, RB4, RB10, LB1, LB10) and two generations beyond these branches. The method successfully detected all branches up to two generations beyond these segmental bronchi with no visual leakages.

  12. Analysis of interlobar (between upper and middle lobes) lymph node enlargement on hilar tomography

    Energy Technology Data Exchange (ETDEWEB)

    Hirose, Takao (Yamaguchi Univ., Ube (Japan). School of Medicine)

    1989-06-01

    We examined interlobar (between upper and middle lobes) lymph node enlargement by compensating filter hilar tomography in cases of central vein type right upper lobe vein. The control group consisted of 100 randomly selected specimens, in which hilar lymphadenopathy such as malignant lymphoma or sarcoidosis, and displacement of interlobar fissure due to atlectasis or tuberculosis were excluded. Eighty-four of the control cases were central vein type. As a lung cancer group, 18 cases were analyzed. These cases consisted of central vein type, and interlobar lymph node enlargement was noted on operation, in the course of therapy or on enhanced CT study. The right hilum bordered by the upper lobe bronchus (medial to the orfice of B/sup 1/) and segmental bronchus (B/sup 2/ or B/sup 3/) above, central vein lateral and intermedial arterial trunk on the mediastinal side were evaluated. The shadows that obscured the inner margin of the central vein and lower margin of the upper-lobe and segmental bronchi were analyzed. The inner margin of the central vein was visible in 75 cases (89.3%) in the control group, compared to 1 (5.6%) of 18 cases in the lung cancer group. Decreased radioluceny beneath the upper lobe bronchus and segmental bronchus was found in 10 cases (11.9%) in the control, compared to 16 cases (88.9%) in the lung cancer group. In conclusion, obliteration of the inner margin of the central vein and the opacity that decreased the radiolucency extending to the peripheral side of the upper lobe bronchus are strongly suggestive of interlobar lymph node enlargement. Recognition of interlobar lymph node enlargement is useful for the staging of lung cancer and diagnosis of the disease that accompanies systemic hilar lymphadenopathy. (author).

  13. The effect of disease and respiration on airway shape in patients with moderate persistent asthma.

    Directory of Open Access Journals (Sweden)

    Spyridon Montesantos

    Full Text Available Computational models of gas transport and aerosol deposition frequently utilize idealized models of bronchial tree structure, where airways are considered a network of bifurcating cylinders. However, changes in the shape of the lung during respiration affect the geometry of the airways, especially in disease conditions. In this study, the internal airway geometry was examined, concentrating on comparisons between mean lung volume (MLV and total lung capacity (TLC. A set of High Resolution CT images were acquired during breath hold on a group of moderate persistent asthmatics at MLV and TLC after challenge with a broncho-constrictor (methacholine and the airway trees were segmented and measured. The airway hydraulic diameter (Dh was calculated through the use of average lumen area (Ai and average internal perimeter (Pi at both lung volumes and was found to be systematically higher at TLC by 13.5±9% on average, with the lower lobes displaying higher percent change in comparison to the lower lobes. The average internal diameter (Din was evaluated to be 12.4±6.8% (MLV and 10.8±6.3% (TLC lower than the Dh, for all the examined bronchi, a result displaying statistical significance. Finally, the airway distensibility per bronchial segment and per generation was calculated to have an average value of 0.45±0.28, exhibiting high variability both between and within lung regions and generations. Mixed constriction/dilation patterns were recorded between the lung volumes, where a number of airways either failed to dilate or even constricted when observed at TLC. We conclude that the Dh is higher than Din, a fact that may have considerable effects on bronchial resistance or airway loss at proximal regions. Differences in caliber changes between lung regions are indicative of asthma-expression variability in the lung. However, airway distensibility at generation 3 seems to predict distensibility more distally.

  14. Pandemic Swine-Origin H1N1 Influenza Virus Replicates to Higher Levels and Induces More Fever and Acute Inflammatory Cytokines in Cynomolgus versus Rhesus Monkeys and Can Replicate in Common Marmosets.

    Directory of Open Access Journals (Sweden)

    Petra Mooij

    Full Text Available The close immunological and physiological resemblance with humans makes non-human primates a valuable model for studying influenza virus pathogenesis and immunity and vaccine efficacy against infection. Although both cynomolgus and rhesus macaques are frequently used in influenza virus research, a direct comparison of susceptibility to infection and disease has not yet been performed. In the current study a head-to-head comparison was made between these species, by using a recently described swine-origin pandemic H1N1 strain, A/Mexico/InDRE4487/2009. In comparison to rhesus macaques, cynomolgus macaques developed significantly higher levels of virus replication in the upper airways and in the lungs, involving both peak level and duration of virus production, as well as higher increases in body temperature. In contrast, clinical symptoms, including respiratory distress, were more easily observed in rhesus macaques. Expression of sialyl-α-2,6-Gal saccharides, the main receptor for human influenza A viruses, was 50 to 73 times more abundant in trachea and bronchus of cynomolgus macaques relative to rhesus macaques. The study also shows that common marmosets, a New World non-human primate species, are susceptible to infection with pandemic H1N1. The study results favor the cynomolgus macaque as model for pandemic H1N1 influenza virus research because of the more uniform and high levels of virus replication, as well as temperature increases, which may be due to a more abundant expression of the main human influenza virus receptor in the trachea and bronchi.

  15. Plasma antibodies against heat shock protein 70 correlate with the incidence and severity of asthma in a Chinese population

    Directory of Open Access Journals (Sweden)

    Wei Qingyi

    2005-02-01

    Full Text Available Abstract Background The heat shock proteins (Hsps are induced by stresses such as allergic factors and inflammatory responses in bronchi epithelial cells and therefore may be detectable in patients with asthma. However, the etiologic link between anti-Hsps and asthma (its severity and related inflammatory responses such as interleukin-4 and immunoglobulin E has not been established. We determined whether antibodies against Hsp60 and Hsp70 were present in patients with asthma and evaluated their associations with risk and severity of asthma. Methods We determined the levels of anti-Hsp60 and anti-Hsp70 by immunoblot and their associations with risk and symptom severity of asthma in 95 patients with asthma and 99 matched non-symptomatic controls using multivariate logistic regression analysis. Results Compared to the controls, asthma patients were more likely to have detectable anti-Hsp60 (17.2% vs 5.1% and anti-Hsp70 (33.7% vs 8.1% (p ≤ 0.001. In particular, the presence of anti-Hsp70 was associated with a greater than 2 fold risk for asthma (adjusted OR = 2.21; 95% CI = 1.35~3.59. Furthermore, both anti-Hsp60 and anti-Hsp70 levels were positively correlated with symptom severity (p Conclusions These data suggest that anti-Hsp60 and especially anti-Hsp70 correlate with the attacks and severity of asthma. The underlying molecular mechanisms linking antibodies to heat shock proteins and asthma remain to be investigated.

  16. First Evaluation of the New Thin Convex Probe Endobronchial Ultrasound Scope: A Human Ex Vivo Lung Study.

    Science.gov (United States)

    Patel, Priya; Wada, Hironobu; Hu, Hsin-Pei; Hirohashi, Kentaro; Kato, Tatsuya; Ujiie, Hideki; Ahn, Jin Young; Lee, Daiyoon; Geddie, William; Yasufuku, Kazuhiro

    2017-04-01

    Endobronchial ultrasonography (EBUS)-guided transbronchial needle aspiration allows for sampling of mediastinal lymph nodes. The external diameter, rigidity, and angulation of the convex probe EBUS renders limited accessibility. This study compares the accessibility and transbronchial needle aspiration capability of the prototype thin convex probe EBUS against the convex probe EBUS in human ex vivo lungs rejected for transplant. The prototype thin convex probe EBUS (BF-Y0055; Olympus, Tokyo, Japan) with a thinner tip (5.9 mm), greater upward angle (170 degrees), and decreased forward oblique direction of view (20 degrees) was compared with the current convex probe EBUS (6.9-mm tip, 120 degrees, and 35 degrees, respectively). Accessibility and transbronchial needle aspiration capability was assessed in ex vivo human lungs declined for lung transplant. The distance of maximum reach and sustainable endoscopic limit were measured. Transbronchial needle aspiration capability was assessed using the prototype 25G aspiration needle in segmental lymph nodes. In all evaluated lungs (n = 5), the thin convex probe EBUS demonstrated greater reach and a higher success rate, averaging 22.1 mm greater maximum reach and 10.3 mm further endoscopic visibility range than convex probe EBUS, and could assess selectively almost all segmental bronchi (98% right, 91% left), demonstrating nearly twice the accessibility as the convex probe EBUS (48% right, 47% left). The prototype successfully enabled cytologic assessment of subsegmental lymph nodes with adequate quality using the dedicated 25G aspiration needle. Thin convex probe EBUS has greater accessibility to peripheral airways in human lungs and is capable of sampling segmental lymph nodes using the aspiration needle. That will allow for more precise assessment of N1 nodes and, possibly, intrapulmonary lesions normally inaccessible to the conventional convex probe EBUS. Copyright © 2017 The Society of Thoracic Surgeons. Published

  17. Signalment, clinical presentation, concurrent diseases, and diagnostic findings in 28 dogs with dynamic pharyngeal collapse (2008-2013).

    Science.gov (United States)

    Rubin, J A; Holt, D E; Reetz, J A; Clarke, D L

    2015-01-01

    Most information about pharyngeal collapse in dogs is anecdotal and extrapolated from human medicine. A single case report describing dynamic pharyngeal collapse in a cat has been published, but there is no literature describing this disease process in dogs. To describe the signalment, clinical presentation, concurrent disease processes, and imaging findings of a population of client-owned dogs with pharyngeal collapse. Twenty-eight client-owned dogs with pharyngeal collapse. Radiology reports of dogs for which fluoroscopy of the respiratory system was performed were reviewed retrospectively. Patients with a fluoroscopic diagnosis of pharyngeal collapse were included in the study population. Data regarding clinical signs, diagnostic, and pathologic findings were evaluated. Twenty-eight dogs met the inclusion criteria. The median age of affected patients was 6.6 years, whereas median body condition score was 7/9. The most common clinical signs were coughing (n = 20) and stertor (n = 5). In 27 of 28 cases, a concurrent or previously diagnosed cardiopulmonary disorder was detected. The most common concurrent disease processes were mainstem bronchi collapse (n = 18), tracheal collapse (n = 17), and brachycephalic airway syndrome (n = 8). Fluoroscopy identified complete pharyngeal collapse in 20 of 28 dogs. Pharyngeal collapse is a complex disease process that likely is secondary to long-term negative pressure gradients and anatomic and functional abnormalities. Based on the findings of this study, pharyngeal fluoroscopy may be useful diagnostic test in patients with suspected tracheal and mainstem bronchial collapse to identify concurrent pharyngeal collapse. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  18. Bronchoscopy, Imaging, and Concurrent Diseases in Dogs with Bronchiectasis: (2003-2014).

    Science.gov (United States)

    Johnson, L R; Johnson, E G; Vernau, W; Kass, P H; Byrne, B A

    2016-01-01

    Bronchiectasis is a permanent and debilitating sequel to chronic or severe airway injury, however, diseases associated with this condition are poorly defined. To evaluate results of diagnostic tests used to document bronchiectasis and to characterize underlying or concurrent disease processes. Eighty-six dogs that had bronchoscopy performed and a diagnosis of bronchiectasis. Retrospective case series. Radiographs, computed tomography, and bronchoscopic findings were evaluated for features of bronchiectasis. Clinical diagnoses of pneumonia (aspiration, interstitial, foreign body, other), eosinophilic bronchopneumopathy (EBP), and inflammatory airway disease (IAD) were made based on results of history, physical examination, and diagnostic testing, including bronchoalveolar lavage fluid analysis and microbiology. Bronchiectasis was diagnosed in 14% of dogs (86/621) that had bronchoscopy performed. Dogs ranged in age from 0.5 to 14 years with duration of signs from 3 days to 10 years. Bronchiectasis was documented during bronchoscopy in 79/86 dogs (92%), thoracic radiology in 50/83 dogs (60%), and CT in 34/34 dogs (100%). Concurrent airway collapse was detected during bronchoscopy in 50/86 dogs (58%), and focal or multifocal mucus plugging of segmental or subsegmental bronchi was found in 41/86 dogs (48%). Final diagnoses included pneumonia (45/86 dogs, 52%), EBP (10/86 dogs, 12%) and IAD (31/86 dogs, 36%). Bacteria were isolated in 24/86 cases (28%), with Streptococcus spp, Pasteurella spp, enteric organisms, and Stenotrophomonas isolated most frequently. Bronchiectasis can be anticipated in dogs with infectious or inflammatory respiratory disease. Advanced imaging and bronchoscopy are useful in making the diagnosis and identifying concurrent respiratory disease. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  19. Low Level Laser Therapy Reduces the Development of Lung Inflammation Induced by Formaldehyde Exposure.

    Directory of Open Access Journals (Sweden)

    Cristiane Miranda da Silva

    Full Text Available Lung diseases constitute an important public health problem and its growing level of concern has led to efforts for the development of new therapies, particularly for the control of lung inflammation. Low Level Laser Therapy (LLLT has been highlighted as a non-invasive therapy with few side effects, but its mechanisms need to be better understood and explored. Considering that pollution causes several harmful effects on human health, including lung inflammation, in this study, we have used formaldehyde (FA, an environmental and occupational pollutant, for the induction of neutrophilic lung inflammation. Our objective was to investigate the local and systemic effects of LLLT after FA exposure. Male Wistar rats were exposed to FA (1% or vehicle (distillated water during 3 consecutive days and treated or not with LLLT (1 and 5 hours after each FA exposure. Non-manipulated rats were used as control. 24 h after the last FA exposure, we analyzed the local and systemic effects of LLLT. The treatment with LLLT reduced the development of neutrophilic lung inflammation induced by FA, as observed by the reduced number of leukocytes, mast cells degranulated, and a decreased myeloperoxidase activity in the lung. Moreover, LLLT also reduced the microvascular lung permeability in the parenchyma and the intrapulmonary bronchi. Alterations on the profile of inflammatory cytokines were evidenced by the reduced levels of IL-6 and TNF-α and the elevated levels of IL-10 in the lung. Together, our results showed that LLLT abolishes FA-induced neutrophilic lung inflammation by a reduction of the inflammatory cytokines and mast cell degranulation. This study may provide important information about the mechanisms of LLLT in lung inflammation induced by a pollutant.

  20. Autoradiographic visualization of muscarinic receptor subtypes in human and guinea pig lung

    Energy Technology Data Exchange (ETDEWEB)

    Mak, J.C.; Barnes, P.J. (National Heart and Lung Institute, London (England))

    1990-06-01

    Muscarinic receptor subtypes have been localized in human and guinea pig lung sections by an autoradiographic technique, using (3H)(-)quinuclidinyl benzilate (( 3H)QNB) and selective muscarinic antagonists. (3H)QNB was incubated with tissue sections for 90 min at 25 degrees C, and nonspecific binding was determined by incubating adjacent serial sections in the presence of 1 microM atropine. Binding to lung sections had the characterization expected for muscarinic receptors. Autoradiography revealed that muscarinic receptors were widely distributed in human lung, with dense labeling over submucosal glands and airway ganglia, and moderate labeling over nerves in intrapulmonary bronchi and of airway smooth muscle of large and small airways. In addition, alveolar walls were uniformly labeled. In guinea pig lung, labeling of airway smooth muscle was similar, but in contrast to human airways, epithelium was labeled but alveolar walls were not. The muscarinic receptors of human airway smooth muscle from large to small airways were entirely of the M3-subtype, whereas in guinea pig airway smooth muscle, the majority were the M3-subtype with a very small population of the M2-subtype present. In human bronchial submucosal glands, M1- and M3-subtypes appeared to coexist in the proportions of 36 and 64%, respectively. In human alveolar walls the muscarinic receptors were entirely of the M1-subtype, which is absent from the guinea pig lung. No M2-receptors were demonstrated in human lung. The localization of M1-receptors was confirmed by direct labeling with (3H)pirenzepine. With the exception of the alveolar walls in human lung, the localization of muscarinic receptor subtypes on structures in the lung is consistent with known functional studies.

  1. Two new radiological findings to improve the diagnosis of bronchial foreign-body aspiration in children.

    Science.gov (United States)

    Girardi, Guido; Contador, Ana M; Castro-Rodríguez, José A

    2004-09-01

    Our objective was to report on two new chest X-ray signs (hyperinflation or obstructive emphysema with atelectasis in the same hemithorax, and aeration within an area of atelectasis) in children with foreign-body aspiration (FBA). We performed a retrospective review of clinical characteristics and chest X-ray films of 133 children with FBA. Of 133 children, 45% were under 3 years old. History of a choking crisis was present in 101 (75.8%); however, it was only elicited upon follow-up questioning in 33 children (32.7%). Early foreign-body (FB) extraction (<24 hr) was performed in 17.3%; removal took place between 1-7 days in 29.3%. The site of aspirated FBs was bronchial in 78.9%, laryngeal in 6%, and tracheal in 4.5%, with mobile FB in the trachea/bronchi in 4.5%. The chest X-ray was normal in 11.3%. Positive findings included: radiopaque FB (23.3%); hyperinflation or obstructive emphysema (21.8%); hyperinflation or obstructive emphysema with atelectasis in the same hemithorax (18%); lobar atelectasis (12.8%); whole-lung atelectasis (6.8%); shift of mediastinal shadow (11%); and aeration within an area of atelectasis (6%). In conclusion, if a history of choking crisis is not present in a child with suspected FBA, two previously undescribed radiological signs (hyperinflation or obstructive emphysema with atelectasis in the same hemithorax, and aeration within an area of atelectasis) should be sought in order to improve the utility of chest-X ray for early diagnosis of FBA. Copyright 2004 Wiley-Liss, Inc.

  2. Wegener granulomatosis (granulomatosis with polyangiitis): evolving concepts in treatment.

    Science.gov (United States)

    Lynch, Joseph P; Tazelaar, Henry

    2011-06-01

    Wegener granulomatosis (WG), the most common of the pulmonary granulomatous vasculitides, typically involves the upper respiratory tract, lower respiratory tract (bronchi and lung), and kidney, with varying degrees of disseminated vasculitis. THE TERM GRANULOMATOSIS WITH POLYANGIITIS (WEGENER) WAS RECENTLY PROPOSED TO REPLACE THE OLDER TERM, WG. THE TERM GRANULOMATOSIS WITH POLYANGIITIS CAN BE ABBREVIATED TO GPA, WITH THE IDEA THAT THE EPONYM WEGENER WOULD BE OMITTED OVER TIME. Cardinal histologic features include a necrotizing vasculitis involving small vessels, extensive "geographic" necrosis, and granulomatous inflammation. Clinical manifestations of WG are protean; virtually any organ can be involved. The spectrum and severity of the disease are heterogeneous, ranging from indolent disease involving only one site to fulminant, multiorgan vasculitis. The pathogenesis of WG has not been elucidated, but both cellular and humoral components are involved. Circulating antibodies against cytoplasmic components of neutrophils [anti-neutrophil cytoplasmic antibodies (c-ANCAs)] likely play a role in the pathogenesis, and often correlate with activity of the disease. Treatment strategies are evolving. Cyclophosphamide (CYC) plus corticosteroids (CSs) is the mainstay of therapy for generalized, multisystemic WG. Historically, the combination of CYC plus CS was used for a minimum of 12 months, but concern about late toxicities associated with CYC has led to novel treatment approaches. Currently, short-course (3 to 6 months) induction treatment with CYC plus CS, followed by maintenance therapy with less toxic agents (e.g., methotrexate, azathioprine) is recommended. Further, methotrexate combined with CS may be adequate for limited, non-life-threatening WG. Recent studies suggest that rituximab may be useful for induction therapy or CYC-refractory WG. The role of other immunomodulatory agents (including trimethoprim-sulfamethoxazole) is also explored. © Thieme Medical

  3. Tuberculosis presenting as isolated bronchonodal fistula in a patient with systemic lupus erythematosus: Case report.

    Science.gov (United States)

    Bae, Kyungsoo; Jeon, Kyung Nyeo; Kim, Ho Cheol; Suh, Young Sun; Lee, Gi Dong; Kim, Ju-Young; Song, Dae Hyun

    2017-11-01

    Lymph node is a preferred site for extrapulmonary tuberculosis (TB). In the thorax, mediastinal tuberculous lymph nodes can erode adjacent structures such as heart, aorta, and esophagus, forming fistula, and causing fatal consequences. However, tuberculous bronchonodal fistula as a complication of lymph node TB in adults is rarely known in terms of imaging or clinical findings. Here, a case of isolated tuberculous bronchonodal fistula appearing as the first presentation of TB in a 74-year-old male with systemic lupus erythematosus (SLE) is reported. A 74-year-old male with SLE visited the hospital with dry cough. In family history, his son was treated for pulmonary TB 9 years previously. Laboratory test revealed increased C-reactive protein level and erythrocyte sedimentation rate. Chest computed tomography (CT) scan revealed a necrotic lymph node in the right hilar area connected to the inferior wall of the right upper lobe bronchus and the lateral wall of bronchus intermedius. On bronchoscopy performed under guidance of 3-dimensionally reconstructed CT image, fistula formation between the right hilar lymph node and 2 bronchi (the right upper lobe and intermediate bronchus) was confirmed. Sputum culture revealed growth of Mycobacterium tuberculosis. Anti-TB medication with isoniazid, ethambutol, pyrazinamide, and moxifloxacin for 9 months. The patient's symptom was gradually improved. Follow-up bronchoscopy performed at 3 months after starting the medication revealed decreased size of the fistula. This is a rare case of bronchonodal fistula appearing as the first presentation of TB in a 74-year-old male patient with SLE. CT provided useful information regarding the origin and progress of the disease.

  4. Effect of Cilia Beat Frequency on Muco-ciliary Clearance

    Science.gov (United States)

    Sedaghat, M.H.; Shahmardan, M.M.; Norouzi, M.; Heydari, M.

    2016-01-01

    Background: The airway surface liquid (ASL), which is a fluid layer coating the interior epithelial surface of the bronchi and bronchiolesis, plays an important defensive role against foreign particles and chemicals entering lungs. Objective: Numerical investigation has been employed to solve two-layer model consisting of mucus layer as a viscoelastic fluid and periciliary liquid layer as a Newtonian fluid to study the effects of cilia beat frequency (CBF) at various amounts of mucus properties on muco-ciliary transport problem. Methods: Hybrid finite difference-lattice Boltzmann-method (FB-LBM) has been used to solve the momentum equations and to simulate cilia forces, and also the PCL-mucus interface more accurately, immersed boundary method (IBM) has been employed. The main contribution of the current study is to use an Oldroyd-B model as the constitutive equation of mucus. Results: Our results show that increasing CBF and decreasing mucus viscosity ratio have great effects on mucus flow, but the effect of viscosity ratio is more significant. The results also illustrate that the relation between cilia beat frequency and mean mucus velocity is almost linear and it has similar behavior at different values of viscosity ratio. Conclusion: Numerical investigation based on hybrid IB-FD-LBM has been used to study the effect of CBF at various mounts of mucus viscosity ratio on the muco-ciliary clearance. The results showed that the effect of viscosity ratio on the muco-ciliary transport process is more significant compared with CBF. PMID:28144596

  5. Chernobylsk: some bothering facts; Tchernobyl: quelques faits derangeants

    Energy Technology Data Exchange (ETDEWEB)

    Belbeach, B

    2005-07-01

    First, are some preliminary comments about the official sanitary assessment of the Chernobyl disaster. The second point concerns the liquidators with the hot particles ( very radioactive particles of some microns) knowledge got from autopsies, from the bronchi pulmonary washing made on sick persons. Always about the liquidators the neurological disorders as post radiative encephalopathy. A third point is relative to the hot particles and the populations. The fourth point is devoted to the birth malformations, in Belarus and Ukraine with an incidence in report with the level of soil contamination (Belarus). The fifth point concerns the alteration of the genome (animals and humans), new mutations appear. The sixth point is devoted to the leukemia in Greece, increase of leukemia incidence among the infants in utero irradiated following Chernobylsk accident. The incidence leukemia of babies ( less than one year old) exposed in utero increases with the soil contamination ( 32.2/10{sup 6}/year in low contaminated soils, 71.4/10{sup 6}/year for average contaminated areas and 141.3/10{sup 6}/year for the most contaminated areas). A final point treats the question of the contamination situation in France and if there is a correlation with an increase of thyroid cancers in Corsica, East and South East of France. The lack of registers that inscribe the cancer cases in the different regions does not allow to make comparison between before and after Chernobylsk accident. But a comparison using the British incidence (0.5/10{sup 6}/year) before Chernobylsk ( in agreement with the incidence found in Belarus before Chernobylsk) shows an increase to 1.17/10{sup 6}/year for the Lorraine area and to 2.25/10{sup 6}/year for the South East and Corsica areas. (N.C.)

  6. Association Between Airway Caliber Changes With Lung Inflation and Emphysema Assessed by Volumetric CT Scan in Subjects With COPD

    Science.gov (United States)

    Come, Carolyn E.; Ross, James C.; San José Estépar, Raúl; Han, MeiLan K.; Loring, Stephen H.; Silverman, Edwin K.; Washko, George R.

    2012-01-01

    Background: An increase in airway caliber (airway distensibility) with lung inflation is attenuated in COPD. Furthermore, some subjects have a decrease in airway caliber with lung inflation. We aimed to test the hypothesis that airway caliber increases are lower in subjects with emphysema-predominant (EP) compared with airway-predominant (AP) CT scan subtypes. Additionally, we compared clinical and CT scan features of subjects with (airway constrictors) and without a decrease in airway caliber. Methods: Based on GOLD (Global Initiative for Chronic Obstructive Lung Disease) stages and CT scan subtypes, we created a control group (n = 46) and the following matched COPD groups (n = 23 each): GOLD-2-AP, GOLD-2-EP, GOLD-4-AP, and GOLD-4-EP. From the CT scans of all 138 subjects, we measured emphysema, lung volumes, and caliber changes in the third and fourth airway generations of two bronchi. We expressed airway distensibility (ratio of airway lumen diameter change to lung volume change from end tidal breathing to full inspiration) as a global or lobar measure based on normalization by whole-lung or lobar volume changes. Results: Global distensibility in the third and fourth airway generations was significantly lower in the GOLD-2-EP and GOLD-4-EP groups than in control subjects. In GOLD-2 subjects, lobar distensibility of the right-upper-lobe fourth airway generation was significantly lower in those with EP than in those with AP. In multivariate analysis, emphysema was an independent determinant of global and lobar airway distensibility. Compared with nonconstrictors, airway constrictors experienced more dyspnea, were more hyperinflated, and had a higher percentage of emphysema. Conclusions: Distensibility of large- to medium-sized airways is reduced in subjects with an EP CT scan subtype. Emphysema seems to alter airway-parenchyma interdependence. Trial registry: ClinicalTrials.gov; No.: NCT00608764; URL: www.clinicaltrials.gov PMID:21940776

  7. Interleukin-33 from Monocytes Recruited to the Lung Contributes to House Dust Mite-Induced Airway Inflammation in a Mouse Model.

    Directory of Open Access Journals (Sweden)

    Hiroki Tashiro

    Full Text Available Interleukin-33 (IL-33 activates group 2 innate lymphoid cells (ILC2, resulting in T-helper-2 inflammation in bronchial asthma. Airway epithelial cells were reported as sources of IL-33 during apoptosis and necrosis. However, IL-33 is known to be from sources other than airway epithelial cells such as leukocytes, and the mechanisms of IL-33 production and release are not fully understood. The aim of this study was to clarify the role of IL-33 production by monocytes in airway inflammation.BALB/c mice were sensitized and challenged with a house dust mite (HDM preparation. Airway inflammation was assessed by quantifying inflammatory cells in bronchoalveolar lavage (BAL fluid, and IL-25, IL-33, and thymic stromal lymphopoietin (TSLP levels in lung. Immunohistochemistry for IL-33 in lung sections was also performed. Ly6c, CD11b, and CD11c expression was examined by flow cytometry. Clodronate liposomes were used in the HDM-airway inflammation model to deplete circulating monocytes.The IL-33, but not IL-25 or TSLP, level in lung homogenates was markedly increased in HDM mice compared to control mice. IL-33-positive cells in the lungs were identified using immunohistochemistry and were increased in areas surrounding bronchi and vasculature. Furthermore, IL-33 levels were increased in mononuclear cells derived from lungs of HDM mice compared to controls. The expression of Ly6c in mononuclear cells was significantly higher in HDM mice than in controls. Treatment with clodronate liposomes led to inhibition of not only inflammatory cells in BAL fluid, airway hyper reactivity and Th2 cytokines in lung, but also IL-33 in lung.IL-33 from monocytes recruited to the lung may contribute to the pathogenesis of HDM-induced airway inflammation.

  8. Multi-detector CT evaluation in patients suspected of tracheobronchomalacia: Comparison of end-expiratory with dynamic expiratory volumetric acquisitions

    Energy Technology Data Exchange (ETDEWEB)

    Ferretti, Gilbert R. [Department of Radiology (France)], E-mail: gferretti@chu-grenoble.fr; Jankowski, Adrien [Department of Radiology (France)], E-mail: ajankowski@chu-grenoble.fr; Perrin, Marie Amelie [Department of Radiology (France)], E-mail: maperrin@chu-grenoble.fr; Chouri, Nathalie [Department of Respiratory Diseases (France)], E-mail: nchouri@chu-grenoble.fr; Arnol, Nathalie [Sleep Laboratory and EFCR, University Hospital, Grenoble (France); HP2 Laboratory, INSERM ERI 0017 (Hypoxia: Pathophysiology), Joseph Fourier University, Grenoble (France)], E-mail: narnold@chu-grenoble.fr; Aubaud, Laurent [Department of Radiology (France)], E-mail: laubaud@chu-grenoble.fr; Pepin, Jean-Louis [Sleep Laboratory and EFCR, University Hospital, Grenoble (France); HP2 Laboratory, INSERM ERI 0017 (Hypoxia: Pathophysiology), Joseph Fourier University, Grenoble (France)], E-mail: jlpepin@chu-grenoble.fr

    2008-11-15

    Purpose: The aim of this study was to compare dynamic expiratory imaging and end-expiratory imaging using multi-detector CT (MDCT) of the central airways in patients suspected of tracheobronchomalacia (TBM). Methods: This study had local ethical committee approval. Seventy patients suspected of TBM were prospectively included. All patients underwent evaluation of central airways by three different low-dose MDCT acquisitions: end inspiration, end expiration, and dynamic expiration. Degree of airway collapse was measured by calculating the percentage change in the area and diameter of the airways between inspiratory and the two expiratory techniques at three levels of the trachea and in the sagittal diameter of the right and left main bronchi. Three threshold levels of percentage reduction in diameter or area (30%, 50%, and 70%) for defining TBM were evaluated. Results: In the entire population, the mean percentage of airway collapse was significantly greater with dynamic expiratory imaging than with the end-expiratory imaging at three different levels: lower thoracic trachea (26% vs. 16.6%, p < 0.009), right (25.2% vs. 14%, p < 0.01) and left main (24.7% vs. 13.3%, p < 0.01) bronchus. Whatever the threshold value for defining TBM, dynamic expiratory imaging always resulted in diagnosing TBM in more patients than end-expiratory imaging. Conclusions: Dynamic expiratory imaging shows a significantly greater degree and a significantly greater extent of airway collapse than standard end-expiratory imaging in patients suspected of TBM. Further evaluation of the clinical relevance of such findings is warranted.

  9. Cysteinyl-leukotrienes in the regulation of β2-adrenoceptor function: an in vitro model of asthma

    Directory of Open Access Journals (Sweden)

    Milanese Manlio

    2006-07-01

    Full Text Available Abstract Background The response to β2-adrenoceptor agonists is reduced in asthmatic airways. This desensitization may be in part due to inflammatory mediators and may involve cysteinyl-leukotrienes (cysteinyl-LTs. Cysteinyl-LTs are pivotal inflammatory mediators that play important roles in the pathophysiology of asthma, allergic rhinitis, and other inflammatory conditions. We tested the hypothesis that leukotriene D4 (LTD4 and allergen challenge cause β2-adrenoceptor desensitization through the activation of protein kinase C (PKC. Methods The isoproterenol-induced cAMP accumulation was evaluated in human airway smooth muscle cell cultures challenged with exogenous LTD4 or the PKC activator phorbol-12-myristate-13-acetate with or without pretreatments with the PKC inhibitor GF109203X or the CysLT1R antagonist montelukast. The relaxant response to salbutamol was studied in passively sensitized human bronchial rings challenged with allergen in physiological salt solution (PSS alone, or in the presence of either montelukast or GF109203X. Results In cell cultures, both LTD4 and phorbol-12-myristate-13-acetate caused significant reductions of maximal isoproterenol-induced cAMP accumulation, which were fully prevented by montelukast and GF109203X, respectively. More importantly, GF109203X also prevented the attenuating effect of LTD4 on isoproterenol-induced cAMP accumulation. In bronchial rings, both montelukast and GF109203X prevented the rightward displacement of the concentration-response curves to salbutamol induced by allergen challenge. Conclusion LTD4 induces β2-adrenoceptor desensitization in human airway smooth muscle cells, which is mediated through the activation of PKC. Allergen exposure of sensitized human bronchi may also cause a β2-adrenoceptor desensitization through the involvement of the CysLT1R-PKC pathway.

  10. Surgical treatment of organising pneumonia mimicking lung cancer: experience of 27 patients.

    Science.gov (United States)

    Wu, Chen-Tu; Chang, Yih-Leong; Chen, Wei-Chou; Lee, Yung-Chie

    2010-04-01

    Organising pneumonia as a localised process has sometimes been managed by surgery. This poorly defined entity has been mistaken clinically, roentgenographically and usually at exploratory thoracotomy for lung cancer. This series details our experiences with surgical resections in 27 patients during the past 13 years. Surgical lung resection was performed through wedge resection or lobectomy with or without video-assisted thoracoscopic surgery. Resected specimens were swabbed for aerobic and anaerobic bacterial, fungal and mycobacterial cultures. Clinical presentation, roentgenological examination, location and size of the tumourous lesions, pathological finding and treatment were investigated. The patients were between 41 and 80 years of age. Most of the patients (81.5%) presented with cough, haemoptysis and weight loss. The common radiographic findings were round or oval mass with occasionally air bronchogram. Thirteen patients underwent non-invasive biopsy without conclusive diagnosis. The tumour size ranged from 1.5 cm to 8.5 cm. The typically grossly involved area was sharply outlined, firm and extended to the pleura, which was invariably thickened. The microscopic pattern was also rather similar, with inflammation in various degrees of organisation, sometimes accompanied by necrotising changes in the bronchi. Viridans Streptococci and Neisseria spp. were identified as the aetiologic agents in 15 cases (55.6%). All patients had an excellent outcome. The usual investigative procedures for pulmonary mass were of little aid in establishing the differential diagnosis of organising pneumonia from neoplasm. Surgical resection should be considered in the absence of a positive diagnosis of a persistent pulmonary mass. Copyright (c) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

  11. Validating Whole-Airway CFD Predictions of DPI Aerosol Deposition at Multiple Flow Rates.

    Science.gov (United States)

    Longest, P Worth; Tian, Geng; Khajeh-Hosseini-Dalasm, Navvab; Hindle, Michael

    2016-12-01

    The objective of this study was to compare aerosol deposition predictions of a new whole-airway CFD model with available in vivo data for a dry powder inhaler (DPI) considered across multiple inhalation waveforms, which affect both the particle size distribution (PSD) and particle deposition. The Novolizer DPI with a budesonide formulation was selected based on the availability of 2D gamma scintigraphy data in humans for three different well-defined inhalation waveforms. Initial in vitro cascade impaction experiments were conducted at multiple constant (square-wave) particle sizing flow rates to characterize PSDs. The whole-airway CFD modeling approach implemented the experimentally determined PSDs at the point of aerosol formation in the inhaler. Complete characteristic airway geometries for an adult were evaluated through the lobar bronchi, followed by stochastic individual pathway (SIP) approximations through the tracheobronchial region and new acinar moving wall models of the alveolar region. It was determined that the PSD used for each inhalation waveform should be based on a constant particle sizing flow rate equal to the average of the inhalation waveform's peak inspiratory flow rate (PIFR) and mean flow rate [i.e., AVG(PIFR, Mean)]. Using this technique, agreement with the in vivo data was acceptable with <15% relative differences averaged across the three regions considered for all inhalation waveforms. Defining a peripheral to central deposition ratio (P/C) based on alveolar and tracheobronchial compartments, respectively, large flow-rate-dependent differences were observed, which were not evident in the original 2D in vivo data. The agreement between the CFD predictions and in vivo data was dependent on accurate initial estimates of the PSD, emphasizing the need for a combination in vitro-in silico approach. Furthermore, use of the AVG(PIFR, Mean) value was identified as a potentially useful method for characterizing a DPI aerosol at a constant flow rate.

  12. Three-dimensional image reconstruction with free open-source OsiriX software in video-assisted thoracoscopic lobectomy and segmentectomy.

    Science.gov (United States)

    Yao, Fei; Wang, Jian; Yao, Ju; Hang, Fangrong; Lei, Xu; Cao, Yongke

    2017-03-01

    The aim of this retrospective study was to evaluate the practice and the feasibility of Osirix, a free and open-source medical imaging software, in performing accurate video-assisted thoracoscopic lobectomy and segmentectomy. From July 2014 to April 2016, 63 patients received anatomical video-assisted thoracoscopic surgery (VATS), either lobectomy or segmentectomy, in our department. Three-dimensional (3D) reconstruction images of 61 (96.8%) patients were preoperatively obtained with contrast-enhanced computed tomography (CT). Preoperative resection simulations were accomplished with patient-individual reconstructed 3D images. For lobectomy, pulmonary lobar veins, arteries and bronchi were identified meticulously by carefully reviewing the 3D images on the display. For segmentectomy, the intrasegmental veins in the affected segment for division and the intersegmental veins to be preserved were identified on the 3D images. Patient preoperative characteristics, surgical outcomes and postoperative data were reviewed from a prospective database. The study cohort of 63 patients included 33 (52.4%) men and 30 (47.6%) women, of whom 46 (73.0%) underwent VATS lobectomy and 17 (27.0%) underwent VATS segmentectomy. There was 1 conversion from VATS lobectomy to open thoracotomy because of fibrocalcified lymph nodes. A VATS lobectomy was performed in 1 case after completing the segmentectomy because invasive adenocarcinoma was detected by intraoperative frozen-section analysis. There were no 30-day or 90-day operative mortalities CONCLUSIONS: The free, simple, and user-friendly software program Osirix can provide a 3D anatomic structure of pulmonary vessels and a clear vision into the space between the lesion and adjacent tissues, which allows surgeons to make preoperative simulations and improve the accuracy and safety of actual surgery. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  13. Pulmonary choristoma associated with calf meningocele Coristoma pulmonar e meningocele em um bezerro

    Directory of Open Access Journals (Sweden)

    Diego Medeiros de Oliveira

    2009-12-01

    Full Text Available Pulmonary choristoma is a rare malformation reported in different animal species defined as a mass of normal histological pulmonary tissue in an abnormal location. A case of pulmonary choristoma and meningocele is reported in a calf that presented a fluctuating subcutaneous fluid containing mass, measuring 15 x 15 x 20cm in the skull frontal region. The skin covering the sac was surgically removed. Macroscopically, subcutaneous nodules up to 2cm in diameter with irregular whitish areas mixed with red areas were observed. In the histological examination, pulmonary lobules tissue composed by alveoli, bronchi, bronchioles and cartilage were observed. Dilated blood vessels and hemorrhages were present between the lobules. In this case the pulmonary choristoma was associated with meningocele, and probably was the mechanical cause for the failure of the skull closure.Coristoma pulmonar é uma malformação rara, reportada em diferentes espécies animais. Este trabalho descreve um caso de coristoma pulmonar associado à meningocele em uma bezerra. O animal apresentava uma massa flutuante contendo transudato e medindo 15 x 15 x 20cm na região frontal do crânio. A pele que formava o saco cheio de líquido foi removida cirurgicamente. Por baixo da pele observavam-se nódulos subcutâneos de até 2cm, irregulares e com áreas esbranquiçadas entremeadas com áreas vermelhas. Na microscopia, observaram-se lóbulos de tecido pulmonar compostos por alvéolos, bronquíolos, brônquios e cartilagem. Nesse caso, o coristoma pulmonar estava associado à meningocele, e provavelmente foi a causa mecânica do não fechamento do crânio.

  14. Allergic bronchopulmonary aspergillosis in Japan: A nationwide survey.

    Science.gov (United States)

    Oguma, Tsuyoshi; Taniguchi, Masami; Shimoda, Terufumi; Kamei, Katsuhiko; Matsuse, Hiroto; Hebisawa, Akira; Takayanagi, Noboru; Konno, Satoshi; Fukunaga, Koichi; Harada, Kazuki; Tanaka, Jun; Tomomatsu, Katsuyoshi; Asano, Koichiro

    2018-01-01

    Allergic bronchopulmonary aspergillosis (ABPA) is an allergic pulmonary disease characterized by a hypersensitivity reaction to Aspergillus species colonizing the airways. The clinical characteristics of ABPA may differ depending on genetic and environmental background. We performed a nationwide survey to determine the clinical characteristics of ABPA in Japan. In 2013, a questionnaire on physician-diagnosed ABPA/allergic bronchopulmonary mycosis was sent to 903 medical centers specializing in respiratory or allergic diseases. Cases fulfilling the following criteria were categorized as possible ABPA-central bronchiectasis (ABPA-CB): 1) presence of specific serum immunoglobulin E (IgE) antibodies or a positive skin reaction to Aspergillus, and 2) bronchiectasis or mucoid impaction in the central bronchi. Of 499 physician-diagnosed cases reported by 132 clinical centers, 358 cases met the criteria for possible ABPA-CB. Median age of ABPA-CB onset was 57 (interquartile range, 44-68) years; later-onset disease, developing ≥50 years of age, accounted for 66% of the cases and was associated with female sex, delayed onset of asthma, and lower levels of serum IgE. A third of the patients (120 patients, 34%) exhibited low levels of serum total IgE (<1000 IU/mL). Aspergillus species were isolated from sputum in 126/213 cases (59%), and Schizophyllum commune was identified in 12 (6%) patients. During the course of the treatment, ABPA recurred in 169 (48%) cases. This nationwide survey identified several unique clinical characteristics of ABPA in Japan, such as late-onset, relatively lower serum IgE levels, and frequent recurrences/flares. Copyright © 2017 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  15. Pharmacological characterization of abediterol, a novel inhaled β(2)-adrenoceptor agonist with long duration of action and a favorable safety profile in preclinical models.

    Science.gov (United States)

    Aparici, Mònica; Gómez-Angelats, Mireia; Vilella, Dolors; Otal, Raquel; Carcasona, Carla; Viñals, Marisa; Ramos, Israel; Gavaldà, Amadeu; De Alba, Jorge; Gras, Jordi; Cortijo, Julio; Morcillo, Esteban; Puig, Carlos; Ryder, Hamish; Beleta, Jorge; Miralpeix, Montserrat

    2012-08-01

    Abediterol is a novel potent, long-acting inhaled β(2)-adrenoceptor agonist in development for the treatment of asthma and chronic obstructive pulmonary disease. Abediterol shows subnanomolar affinity for the human β(2)-adrenoceptor and a functional selectivity over β(1)-adrenoceptors higher than that of formoterol and indacaterol in both a cellular model with overexpressed human receptors and isolated guinea pig tissue. Abediterol is a full agonist at the human β(2)-adrenoceptor (E(max) = 91 ± 5% of the maximal effect of isoprenaline). The potency and onset of action that abediterol shows in isolated human bronchi (EC(50) = 1.9 ± 0.4 nM; t½ onset = 7-10 min) is not significantly different from that of formoterol, but its duration of action (t½ ∼ 690 min) is similar to that of indacaterol. Nebulized abediterol inhibits acetylcholine-induced bronchoconstriction in guinea pigs in a concentration-dependent manner, with higher potency and longer duration of action (t½ = 36 h) than salmeterol (t½ = 6 h) and formoterol (t½ = 4 h) and similar duration of action to indacaterol up to 48 h. In dogs, the bronchoprotective effect of abediterol is more sustained than that of salmeterol and indacaterol at doses without effects on heart rate, thus showing a greater safety margin (defined as the ratio of dose increasing heart rate by 5% and dose inhibiting bronchospasm by 50%) than salmeterol, formoterol, and indacaterol (5.6 versus 3.3, 2.2, and 0.3, respectively). In conclusion, our results suggest that abediterol has a preclinical profile for once-daily dosing in humans together with a fast onset of action and a favorable cardiovascular safety profile.

  16. Control of Neurotransmission by NaV1.7 in Human, Guinea Pig, and Mouse Airway Parasympathetic Nerves.

    Science.gov (United States)

    Kocmalova, Michaela; Kollarik, Marian; Canning, Brendan J; Ru, Fei; Adam Herbstsomer, R; Meeker, Sonya; Fonquerna, Silvia; Aparici, Monica; Miralpeix, Montserrat; Chi, Xian Xuan; Li, Baolin; Wilenkin, Ben; McDermott, Jeff; Nisenbaum, Eric; Krajewski, Jeffrey L; Undem, Bradley J

    2017-04-01

    Little is known about the neuronal voltage-gated sodium channels (NaVs) that control neurotransmission in the parasympathetic nervous system. We evaluated the expression of the α subunits of each of the nine NaVs in human, guinea pig, and mouse airway parasympathetic ganglia. We combined this information with a pharmacological analysis of selective NaV blockers on parasympathetic contractions of isolated airway smooth muscle. As would be expected from previous studies, tetrodotoxin potently blocked the parasympathetic responses in the airways of each species. Gene expression analysis showed that that NaV 1.7 was virtually the only tetrodotoxin-sensitive NaV1 gene expressed in guinea pig and human airway parasympathetic ganglia, where mouse ganglia expressed NaV1.1, 1.3, and 1.7. Using selective pharmacological blockers supported the gene expression results, showing that blocking NaV1.7 alone can abolish the responses in guinea pig and human bronchi, but not in mouse airways. To block the responses in mouse airways requires that NaV1.7 along with NaV1.1 and/or NaV1.3 is blocked. These results may suggest novel indications for NaV1.7-blocking drugs, in which there is an overactive parasympathetic drive, such as in asthma. The data also raise the potential concern of antiparasympathetic side effects for systemic NaV1.7 blockers. Copyright © 2017 by The American Society for Pharmacology and Experimental Therapeutics.

  17. Indoor aerosol size distributions in a gymnasium.

    Science.gov (United States)

    Castro, Amaya; Calvo, Ana I; Alves, Célia; Alonso-Blanco, Elisabeth; Coz, Esther; Marques, Liliana; Nunes, Teresa; Fernández-Guisuraga, Jose Manuel; Fraile, Roberto

    2015-08-15

    In this study, an indoor/outdoor monitoring program was carried out in a gymnasium at the University of Leon, Spain. The main goal was a characterization of aerosol size distributions in a university gymnasium under different conditions and sports activities (with and without magnesia alba) and the study of the mass fraction deposited in each of the parts of the respiratory tract. The aerosol particles were measured in 31 discrete channels (size ranges) using a laser spectrometer probe. Aerosol size distributions were studied under different conditions: i) before sports activities, ii) activities without using magnesia alba, iii) activities using magnesia alba, iv) cleaning procedures, and v) outdoors. The aerosol refractive index and density indoors were estimated from the aerosol composition: 1.577-0.003i and 2.055 g cm(-3), respectively. Using the estimated density, the mass concentration was calculated, and the evolution of PM1, PM2.5 and PM10 for different activities was assessed. The quality of the air in the gymnasium was strongly influenced by the use of magnesia alba (MgCO3) and the number of gymnasts who were training. Due to the climbing chalk and the constant process of resuspension, average PM10 concentrations of over 440 μg m(-3) were reached. The maximum daily concentrations ranged from 500 to 900 μg m(-3). Particle size determines the place in the respiratory tract where the deposition occurs. For this reason, the inhalable, thoracic, tracheobronchial and respirable fractions were assessed for healthy adults and high risk people, according to international standards. The estimations show that, for healthy adults, up to 300 μg m(-3) can be retained by the trachea and bronchi, and 130 μg m(-3) may reach the alveolar region. The different physical activities and the attendance rates in the sports facility have a significant influence on the concentration and size distributions observed. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Developmental expression patterns of Beta-ig (betaIG-H3) and its function as a cell adhesion protein.

    Science.gov (United States)

    Ferguson, Jill W; Mikesh, Michelle F; Wheeler, Esther F; LeBaron, Richard G

    2003-08-01

    Beta-ig is a secretory protein embodied by fasciclin I-like repeats containing sequences that might bind integrins and glycosaminoglycans in vivo. Expression of Beta-ig is responsive to Transforming Growth Factor-beta and the protein is found to be associated with extracellular matrix (ECM) molecules, implicating Beta-ig as an ECM adhesive protein of developmental processes. The spatiotemporal distribution of Beta-ig during various stages of murine development was examined and its ability to support adhesion of various cell types assessed. In situ hybridization of mouse embryos (E12.5-E18.5) indicated a prominent, distinct expression pattern for Beta-ig message in connective tissue. Beta-ig transcripts were abundantly expressed during mesenchymal cell condensation in areas of axial, craniofacial and appendicular primordial cartilage from E12.5-E14.5. Beginning at E15.5, Beta-ig transcripts appeared in collagen-rich tissues, including dura mater and corneal stroma. During E16.5-E18.5, Beta-ig transcripts were observed in proliferating chondrocytes and areas of endochondral ossification in joint and articular cartilage formation. Connective tissues expressed Beta-ig transcripts within the nasal septum and surrounding cartilage primordia, and in the pericardium, optic cup, kidney, ovary, esophagus, diaphragm, bronchi, trachea and corneal epithelium, and during cardiac valve formation. These patterns of expression indicate that Beta-ig may be involved in tissue morphogenesis. Cells derived from mesenchyme attached onto a substratum comprised of purified recombinant Beta-ig. Taken together, the results indicate that Beta-ig is expressed principally in collagen-rich tissues where it may interact with cells and ECM molecules, perhaps playing a role in tissue morphogenesis.

  19. Adenomas broncopulmonares

    Directory of Open Access Journals (Sweden)

    Vítor Sousa

    2004-05-01

    Full Text Available RESUMO: Os adenomas do tipo das glândulas salivares juntamente com os papilomas são os tumores benignos que surgem ocupando o lúmen ou a parede da árvore brônquica. O adenoma alveolar e o adenoma papilar são mais frequentemente observados no parênquima periférico, embora todos estes tumores sejam muito raros e diagnosticados incidentalmente.Apresentando-se como nódulos solitários nos adultos com mais de 45 anos, são facilmente reconhecidos pela sua morfologia, mas o adenoma alveolar é de difícil interpretação num exame intra-operatório.Dois casos, de adenoma pleomórfico e de adenoma alveolar, são apresentados, e faz-se revisão da literatura.REV PORT PNEUMOL 2004; X (3: 235-243 ABSTRACT: Adenomas of solitary gland type together with papillomas are the true benign tumours in or arround the bronchial tree. Alveolar adenoma and papillary adenoma are more frequently observed in peripheral parenchime although this group of tumours is very rare and often incidentally diagnosed.Presenting usually as solitary nodules in adults after 45 years, are easily recognized because of distinct morphology but alveolar adenomas may be difficult to evaluate in frozen sections.Two cases of pleomorphic adenoma and alveolar adenoma are presented and a review of literature is made.REV PORT PNEUMOL 2004; X (3: 235-243 Palavras-chave: pulmão, brônquio, adenoma, Key-words: lung, bronchi, adenoma

  20. Visualization of ex vivo human ciliated epithelium and induced flow using optical coherence tomography (Conference Presentation)

    Science.gov (United States)

    Ling, Yuye; Gamm, Uta A.; Yao, Xinwen; Arteaga-Solis, Emilio; Emala, Charles W.; Choma, Michael A.; Hendon, Christine P.

    2017-04-01

    The ciliated epithelium is important to the human respiratory system because it clears mucus that contains harmful microorganisms and particulate matter. We report the ex vivo visualization of human trachea/bronchi ciliated epithelium and induced flow characterized by using spectral-domain optical coherence tomography (SD-OCT). A total number of 17 samples from 7 patients were imaged. Samples were obtained from Columbia University Department of Anesthesiology's tissue bank. After excision, the samples were placed in Gibco Medium 199 solution with oxygen at 4°C until imaging. The samples were maintained at 36.7°C throughout the experiment. The imaging protocol included obtaining 3D volumes and 200 consecutive B-scans parallel to the head-to-feet direction (superior-inferior axis) of the airway, using Thorlabs Telesto system at 1300 nm at 28 kHz A-line rate and a custom built high resolution SDOCT system at 800nm at 32 kHz A-line rate. After imaging, samples were processed with H and E histology. Speckle variance of the time resolved datasets demonstrate significant contrast at the ciliated epithelium sites. Flow images were also obtained after injecting 10μm polyester beads into the solution, which shows beads traveling trajectories near the ciliated epithelium areas. In contrary, flow images taken in the orthogonal plane show no beads traveling trajectories. This observation is in line with our expectation that cilia drive flow predominantly along the superior-inferior axis. We also observed the protective function of the mucus, shielding the epithelium from the invasion of foreign objects such as microspheres. Further studies will be focused on the cilia's physiological response to environmental changes such as drug administration and physical injury.

  1. Deposition and clearance of inhaled {sup 18}FDG powder in patients with chronic obstructive pulmonary disease

    Energy Technology Data Exchange (ETDEWEB)

    Yanai, M.; Sasaki, H. [Tohoku Univ. School of Medicine, Dept. of Geriatric Medicine, Sendai (Japan); Hatazawa, J.; Ojima, F.; Itoh, M.; Ido, T. [Tohoku Univ. School of Medicine, Cyclotron and Radioisotope Center, Sendai (Japan)

    1998-12-31

    As freon is limited in its use as a generator for aerosol inhalation, powder particles are used as an alternative for inhalation therapy. The pulmonary deposition and clearance of inhaled powder particles was studied by positron emission tomography (PET) in ten patients with chronic obstructive pulmonary disease (COPD) and in five normal controls. The powder, 5 {mu}m in mean diameter, was water soluble and labelled with 2-deoxy-2[{sup 18}F]-fluoro-D-glucose ({sup 18}FDG). Powder inhalation was done with single deep inspiration from residual volume to total lung capacity. The initial deposition ratio in the right or left lung field to total inhaled dose, measured by an anteroposterior rectilinear scan, did not differ between normal and COPD patients. Ratios of radioactivity detected within the central and peripheral regions (the central to peripheral ratio) measured by the PET scan was not significantly different between COPD patients (4.8{+-}2.6, mean{+-}SD) and normals (2.6{+-}0.8, mean{+-}SD). However, the regional powder deposition in peripheral lung fields measured by the PET scan was significantly more uneven in COPD patients than in normal patients. The clearance rate of {sup 18}FDG, defined as the retention ratio of {sup 18}FDG activity to the initially deposited {sup 18}FDG at 60 and 120 min after inhalation, in the trachea, large bronchi or peripheral lung fields measured by tomographic scan showed a wider variation in COPD patients than in normals. To conclude, inhaled powder tended to be deposited more centrally and was distributed more unevenly in the peripheral lung in chronic obstructive pulmonary disease patients than in normals. This could be a limitation of powder inhalation used for therapy in chronic obstructive pulmonary disease patients. (au) 26 refs.

  2. Virtual 3-D {sup 18}F-FDG PET/CT panendoscopy for assessment of the upper airways of head and neck cancer patients: a feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Buchbender, Christian; Heusner, Till A. [University Duesseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Duesseldorf (Germany); University Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Treffert, Jon [Siemens Health Care, Molecular Imaging, Knoxville, TN (United States); Lehnerdt, Goetz; Mattheis, Stefan [University Duisburg-Essen, Medical Faculty, Department of Otorhinolaryngology, Essen (Germany); Geiger, Bernhard [Siemens Corporate Research Inc., Princeton, NJ (United States); Bockisch, Andreas [University Duisburg-Essen, Medical Faculty, Department of Nuclear Medicine, Essen (Germany); Forsting, Michael [University Duisburg-Essen, Medical Faculty, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Antoch, Gerald [University Duesseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Duesseldorf (Germany)

    2012-09-15

    The aim of this study was to evaluate whether a virtual 3-D {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT panendoscopy is feasible and can be used for noninvasive imaging of the upper airways and pharyngeal/laryngeal tumours. From {sup 18}F-FDG PET/CT data sets of 40 patients (29 men, 11 women; age 61 {+-} 9 years) with pharyngeal or laryngeal malignancies virtual 3-D {sup 18}F-FDG PET/CT panendoscopies were reconstructed and the image processing time was measured. The feasibility of assessing the oral cavity, nasopharynx, tongue base, soft palate, pharyngeal tonsils, epiglottis, aryepiglottic folds, piriform sinus, postcricoid space, glottis, subglottis, trachea, bronchi and oesophagus and of detecting primary tumours was tested. Results of fibre-optic bronchoscopy and histology served as the reference standard. The nasopharynx, tongue base, soft palate, pharyngeal tonsils, epiglottis, subglottis and the tracheobronchial tree were accessible in all 40, and the aryepiglottic folds, posterior hypopharyngeal wall, postcricoid space, piriform sinus, glottis, oral cavity and oesophagus in 37, 37, 37, 37, 33, 16 and 0 patients, respectively. In all 12 patients with restricted fibre-optic evaluation due to being primarily intubated, the subglottis was accessible via virtual panendoscopy. The primary tumour was depicted in 36 of 40 patients (90 %). The mean processing time for virtual {sup 18}F-FDG PET/CT panendoscopies was 145 {+-} 98 s. Virtual {sup 18}F-FDG PET/CT panendoscopy of the upper airways is technically feasible and can detect pharyngeal and laryngeal malignancies. This new tool can aid in the complete evaluation of the subglottic space in intubated patients and may be used for planning optical panendoscopies, biopsies and surgery in the future. (orig.)

  3. Unique characteristics of the trachea of the juvenile leatherback turtle facilitate feeding, diving and endothermy

    Science.gov (United States)

    Davenport, John; Jones, T. Todd; Work, Thierry M.; Balazs, George H.

    2014-01-01

    The adult leatherback turtle Dermochelys coriacea overlaps in body size (300–500 kg) with many marine mammals, yet develops from a 50 g hatchling. Adults can dive deeper than 1200 m and have core body temperatures of 25 °C; hatchlings are near-surface dwellers. Juvenile leatherbacks have rarely been studied; here we present anatomical information for the upper respiratory tract of 3 turtles (66.7–83.0 cm straight carapace length; 33.2–53.4 kg body mass) incidentally captured by long-line fisheries. Combined with existing information from adults and hatchlings, our data show that there is an ontogenic shift in tracheal structure, with cartilaginous rings becoming broader and eventually fusing anteriorly. This ontogenic shift during independent existence is unique among extant deep-diving air breathing vertebrates. Tract wall thickness is graded, becoming progressively thinner from larynx to bronchi. In addition, cross-sectional shape becomes increasingly dorsoventrally flattened (more elliptical) from anterior to posterior. These characteristics ensure that the tract will collapse from posterior to anterior during dives. This study contains the first report of a double (= internally bifurcated) posterior section of the trachea; it is suggested that this allows continuous food movement along the esophagus without tracheal collapse. The whole upper respiratory tract (from larynx to lungs) has a vascular lining (thicker anteriorly than posteriorly) that appears to be a simple analog of the complex turbinates of birds and mammals. Our study confirmed that the leatherback tracheal structure represents a distinctive way of dealing with the challenges of diving in deep, cold sea water.

  4. Computed tomographic measurement of airway remodeling and emphysema in advanced chronic obstructive pulmonary disease. Correlation with pulmonary hypertension.

    Science.gov (United States)

    Dournes, Gaël; Laurent, François; Coste, Florence; Dromer, Claire; Blanchard, Elodie; Picard, François; Baldacci, Fabien; Montaudon, Michel; Girodet, Pierre-Olivier; Marthan, Roger; Berger, Patrick

    2015-01-01

    Pulmonary hypertension (PH) is an established complication of advanced chronic obstructive pulmonary disease (COPD) associated with increased mortality. The mechanisms coupling PH and bronchial obstruction are unknown; in particular, PH appears to be unrelated to emphysema. We hypothesized that computed tomographic (CT) measurement of airway remodeling instead of emphysema may correlate with PH in COPD. We aimed to describe the clinical and CT characteristics of patients with COPD with or without PH and to correlate CT measurements of airway remodeling and emphysema with PH. Data were retrieved from 60 COPD patients who underwent both right heart catheterization and computed tomography in a period of stability and had no other disease known to cause PH. CT measurement of airway wall thickness (WT-Pi10) was used to assess airway remodeling and low lung area percentage (LAA%) to quantify emphysema extent. Thirty-four of the sixty patients with COPD had PH (mean pulmonary arterial pressure [PAPm] ≥ 25 mm Hg). There was no difference between the two groups regarding age, sex, and spirometric results, whereas there was more profound hypoxemia in the PH group. WT-Pi10 was increased in the patients with COPD and PH and correlated with PAPm (ρ = 0.62; P pulmonary arterial enlargement (diameter ratio between the pulmonary arterial truncus and the ascending aorta). This study demonstrates, for the first time to our knowledge, an association between structural alterations of bronchi and PH in COPD. Unlike quantification of emphysema, CT measurement of airway remodeling correlates with PAPm and could be used to estimate the severity of PH in COPD. Airway remodeling burden is not limited to airflow limitation in the assessment of COPD severity and mortality.

  5. EFFICIENCY OF HYPERTONIC SOLUTION INHALATION IN CHILDREN WITH BRONCHITIS AND BRONCHIOLITIS

    Directory of Open Access Journals (Sweden)

    O. I. Simonova

    2014-01-01

    Full Text Available Background: Chronic bronchitis and bronchiolitis in children with congenital malformation are often characterized by the severe course of disease. The efficiency of treatment of those conditions can be increased through addition of sodium chloride (NaCl, hypertonic saline which takes a hydrostatic and osmotic effect on mucous membrane of the bronchial tree in broncholytic therapy. Aim: To evaluate the efficiency of 3% NaCl hypertonic solution inhalation in children with chronic bronchitis/bronchiolitis in the setting of bronchi congenital malformation (Kartagener's syndrome and primary ciliary dyskinesia. Patients and methods: The participantsof this study were 28 children in the age of 4–17.5 years with chronic bronchitis/bronchiolitis in the setting of Kartagener's syndrome and primary ciliary dyskinesia in the first days o facute exacerbation of the disease (15 patients in treatment group and 13 patients in control group. In the therapy scheme of treatment group the 3 NaCl hypertonic solution in administered dose of 2 ml was applied 2 times/day during 14 days besides other treatment methods. Results: In patients with chronic bronchiolitis 3% NaCl hypertonic saline inhalation in administered dose of 2 ml twice a day had improved the clinical presentation of disease; by the 14th day of studythe FEV-1 value improved from 70.0 ± 2.1 to 82 ± 3.2% (p = 0.024. The side effects in form of cough aggravation were registered in 13% cases. Among additional criteria of efficiency the improvement of MОС-75 from 52.1 ± 5.2 to 71.2 ± 1.4% (p = 0.011 was also marked in patients. The adverse experience, such as shivering, hypoexcitability and sleep disturbance, were registered in 7% of cases. Conclusion: Inhalation of 3% NaCl hypertonic saline allows the fast arresting of wheezing and eliminates the mycostasis in children with chronic bronchitis/bronchiolitis.

  6. Persistence of smoking-induced dysregulation of miRNA expression in the small airway epithelium despite smoking cessation.

    Directory of Open Access Journals (Sweden)

    Guoqing Wang

    Full Text Available Even after quitting smoking, the risk of the development of chronic obstructive pulmonary disease (COPD and lung cancer remains significantly higher compared to healthy nonsmokers. Based on the knowledge that COPD and most lung cancers start in the small airway epithelium (SAE, we hypothesized that smoking modulates miRNA expression in the SAE linked to the pathogenesis of smoking-induced airway disease, and that some of these changes persist after smoking cessation. SAE was collected from 10th to 12th order bronchi using fiberoptic bronchoscopy. Affymetrix miRNA 2.0 arrays were used to assess miRNA expression in the SAE from 9 healthy nonsmokers and 10 healthy smokers, before and after they quit smoking for 3 months. Smoking status was determined by urine nicotine and cotinine measurement. There were significant differences in the expression of 34 miRNAs between healthy smokers and healthy nonsmokers (p1.5, with functions associated with lung development, airway epithelium differentiation, inflammation and cancer. After quitting smoking for 3 months, 12 out of the 34 miRNAs did not return to normal levels, with Wnt/β-catenin signaling pathway being the top identified enriched pathway of the target genes of the persistent dysregulated miRNAs. In the context that many of these persistent smoking-dependent miRNAs are associated with differentiation, inflammatory diseases or lung cancer, it is likely that persistent smoking-related changes in SAE miRNAs play a role in the subsequent development of these disorders.

  7. Increased myoepithelial cells of bronchial submucosal glands in fatal asthma.

    Science.gov (United States)

    Green, F H Y; Williams, D J; James, A; McPhee, L J; Mitchell, I; Mauad, T

    2010-01-01

    Fatal asthma is characterised by enlargement of bronchial mucous glands and tenacious plugs of mucus in the airway lumen. Myoepithelial cells, located within the mucous glands, contain contractile proteins which provide structural support to mucous cells and actively facilitate glandular secretion. To determine if myoepithelial cells are increased in the bronchial submucosal glands of patients with fatal asthma. Autopsied lungs from 12 patients with fatal asthma (FA), 12 patients with asthma dying of non-respiratory causes (NFA) and 12 non-asthma control cases (NAC) were obtained through the Prairie Provinces Asthma Study. Transverse sections of segmental bronchi from three lobes were stained for mucus and smooth muscle actin and the area fractions of mucous plugs, mucous glands and myoepithelial cells determined by point counting. The fine structure of the myoepithelial cells was examined by electron microscopy. FA was characterised by significant increases in mucous gland (p = 0.003), mucous plug (p = 0.004) and myoepithelial cell areas (p = 0.017) compared with NAC. When the ratio of myoepithelial cell area to total gland area was examined, there was a disproportionate and significant increase in FA compared with NAC (p = 0.014). Electron microscopy of FA cases revealed hypertrophy of the myoepithelial cells with increased intracellular myofilaments. The NFA group showed changes in these features that were intermediate between the FA and NAC groups but the differences were not significant. Bronchial mucous glands and mucous gland myoepithelial cell smooth muscle actin are increased in fatal asthma and may contribute to asphyxia due to mucous plugging.

  8. Respiratory dust retention in small animals

    Energy Technology Data Exchange (ETDEWEB)

    Palm, P.E.; McNerney, J.M.; Hatch, T.

    1956-01-01

    Guinea pigs were indirectly measured for retention of 9 dusts (mean 0.1 to 3.0 ..mu..m) in various serial fractions. Total retention varies from approx. 90% for 3 ..mu..m dropping systematically with decreasing particle size to approx. 45% at 0.1 ..mu..m. Upper respiratory retention drops rapidly from approx. 70% at 3 ..mu..m to 10 to 20% at 1 ..mu..m or less. Alveolar retention drops somewhat with wide scatter from approx. 75 to approx. 50%. Alveolar deposition showed peak at approx. 1 ..mu..m. With monkeys, retention is similar to that of man although there is somewhat less deposition in 1 to 2 ..mu..m range. Retention was directly measured by killing experimental animals at different intervals after exposure to antimony trioxide dust and measuring antimony. Within 1 h after exposure, 80 to 82% was retained in entire system, 1/2 of which was in upper respiratory including bronchi. Retention after 6 h was approx. 45% in entire tract, 30% in upper tract alone, so lung retention was approx. 15% after 6 h. After 8 and up to 18 h, lung retention was about 10%, and that left in upper tract was only about 5% of original inhaled. Upper respiratory clearance was essentially completed in 2 to 6 h (subsiquent small removal from alveoli), so lung retention of 15% probably represents initial alveolar retention.Direct and indirect methods compared well. Smaller test animals have greater retention because of smaller dimensions of upper tract, especially the nose.

  9. Quantification of Pulmonary Fibrosis in a Bleomycin Mouse Model Using Automated Histological Image Analysis.

    Science.gov (United States)

    Gilhodes, Jean-Claude; Julé, Yvon; Kreuz, Sebastian; Stierstorfer, Birgit; Stiller, Detlef; Wollin, Lutz

    2017-01-01

    Current literature on pulmonary fibrosis induced in animal models highlights the need of an accurate, reliable and reproducible histological quantitative analysis. One of the major limits of histological scoring concerns the fact that it is observer-dependent and consequently subject to variability, which may preclude comparative studies between different laboratories. To achieve a reliable and observer-independent quantification of lung fibrosis we developed an automated software histological image analysis performed from digital image of entire lung sections. This automated analysis was compared to standard evaluation methods with regard to its validation as an end-point measure of fibrosis. Lung fibrosis was induced in mice by intratracheal administration of bleomycin (BLM) at 0.25, 0.5, 0.75 and 1 mg/kg. A detailed characterization of BLM-induced fibrosis was performed 14 days after BLM administration using lung function testing, micro-computed tomography and Ashcroft scoring analysis. Quantification of fibrosis by automated analysis was assessed based on pulmonary tissue density measured from thousands of micro-tiles processed from digital images of entire lung sections. Prior to analysis, large bronchi and vessels were manually excluded from the original images. Measurement of fibrosis has been expressed by two indexes: the mean pulmonary tissue density and the high pulmonary tissue density frequency. We showed that tissue density indexes gave access to a very accurate and reliable quantification of morphological changes induced by BLM even for the lowest concentration used (0.25 mg/kg). A reconstructed 2D-image of the entire lung section at high resolution (3.6 μm/pixel) has been performed from tissue density values allowing the visualization of their distribution throughout fibrotic and non-fibrotic regions. A significant correlation (pfibrosis in mice, which will be very valuable for future preclinical drug explorations.

  10. [The role of psychic factors in the pathogenesis of bronchial asthma].

    Science.gov (United States)

    Vucević, Danijela; Radosavljević, Tatjana; Mladenović, Dusan; Todorović, Vera

    2011-01-01

    Bronchial asthma is a chronic inflammatory disorder of the airways in which many cells play a role, in particular mast cells, eosinophils, neutrophils, T-lymphocytes and epithelial cells. In susceptible individuals this inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness and cough, particularly at night and/or in the early morning. These symptoms are usually associated with variable and extensive limitations of airflow in the bronchi reversible spontaneously or by treatment. It has been shown that restrain of the effectors of stress response participate in the pathogenesis of bronchial asthma. Anger that is not expressed and frustrations may activate the limbic stress pathway. Thus, the released neurotransmitters followed by excitation thus causing psychogenic (mental or emotional) stress. It is also known that emotional stress may be responsible for the exacerbation of asthma. Namely, pronounced emotions cause hyperventilation and hypocapnia inducing bronchospasm. Certain psychological personality features are related to adaptive or inadequate body response to numerous life events. Thus, until the beginning of the last century, bronchial asthma was referred to as asthma nervosa, because clinicians clearly observed the psychological profile of patients with predominant fear of asphyxia and recurrent attacks of paroxysmal dyspnoea. Besides, increased sensitivity, repression of aggressive feelings and expressive empathy have been identified as the most frequent psychological characteristics of asthmatic patients. However, scientists are still far from a full understanding of bronchial asthma pathogenesis. The contribution of psychic factors has become meaningful in the understanding of the development of bronchial asthma. Having in mind that in the majority of patients asthma is a lifelong condition, there is a hope that further investigations of bronchial asthma psychogenesis will improve prevention and treatment of this disease.

  11. The role of psychic factors in the pathogenesis of bronchial asthma

    Directory of Open Access Journals (Sweden)

    Vučević Danijela

    2011-01-01

    Full Text Available Bronchial asthma is a chronic inflammatory disorder of the airways in which many cells play a role, in particular mast cells, eosinophils, neutrophils, T-lymphocytes and epithelial cells. In susceptible individuals this inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness and cough, particularly at night and/or in the early morning. These symptoms are usually associated with variable and extensive limitations of airflow in the bronchi reversible spontaneously or by treatment. It has been shown that restrain of the effectors of stress response participate in the pathogenesis of bronchial asthma. Anger that is not expressed and frustrations may activate the limbic stress pathway. Thus, the released neurotransmitters followed by excitation thus causing psychogenic (mental or emotional stress. It is also known that emotional stress may be responsible for the exacerbation of asthma. Namely, pronounced emotions cause hyperventilation and hypocapnia inducing bronchospasm. Certain psychological personality features are related to adaptive or inadequate body response to numerous life events. Thus, until the beginning of the last century, bronchial asthma was referred to as asthma nervosa, because clinicians clearly observed the psychological profile of patients with predominant fear of asphyxia and recurrent attacks of paroxysmal dyspnoea. Besides, increased sensitivity, repression of aggressive feelings and expressive empathy have been identified as the most frequent psychological characteristics of asthmatic patients. However, scientists are still far from a full understanding of bronchial asthma pathogenesis. The contribution of psychic factors has become meaningful in the understanding of the development of bronchial asthma. Having in mind that in the majority of patients asthma is a lifelong condition, there is a hope that further investigations of bronchial asthma psychogenesis will improve prevention and treatment of

  12. Interindividual variability in the expression of surfactant protein A and B in the human lung during development

    Directory of Open Access Journals (Sweden)

    F. Cau

    2016-09-01

    Full Text Available The surfactant complex, thanks to its multiple actions including decrease of surface- tension and antimicrobial activity, plays a fundamental role in newborn survival, lowering the risk of respiratory distress syndrome. The aim of this work was to determine if the synthesis of two surfactant proteins (SP, SPA and pro-SPB, shows some inter-individual variability during lung development in the intrauterine life. Immunoreactivity for SPA and pro-SPB was investigated in the lungs of  40 subjects, including 15 fetuses, ranging from 14 to 22 weeks of gestation, and 25 neonates, from 24 to 41 weeks. Lung samples were formalin fixed, paraffin-embedded and routinely processed. SPA and pro-SPB were detected utilizing commercial antibodies.  A semi-quantitative grading system (1 to 4 was applied, based on the number of reactive cells and the intensity of immunostaining. Surfactant protein immunostaining was found in  three compartments: bronchi, bronchioles and alveoli, starting from 14 weeks of gestation in the bronchial epithelium and from the 21st week in the alveolar spaces. Differences were found regarding SPA and pro-SPB expression in the vast majority of subjects: in some lungs, SPA was more expressed whereas in others pro-SPB showed an higher degree of immunoreactivity. The expression of both surfactant proteins was not strictly correlated with gestational age. Whereas the highest levels of reactivity were detected in at term neonates, on the other hand one case with grade 3 was detected at 22 weeks and one negative case for both proteins was observed at 31 weeks. Our data clearly show a marked inter-individual variability regarding the production of SPA and pro-SPB and suggest the existence of other epigenetic factors, acting during gestation, that might influence surfactant production and, consequently, the survival potential of  neonates at birth. 

  13. Connexin43 Controls the Myofibroblastic Differentiation of Bronchial Fibroblasts from Patients with Asthma.

    Science.gov (United States)

    Paw, Milena; Borek, Izabela; Wnuk, Dawid; Ryszawy, Damian; Piwowarczyk, Katarzyna; Kmiotek, Katarzyna; Wójcik-Pszczoła, Katarzyna A; Pierzchalska, Małgorzata; Madeja, Zbigniew; Sanak, Marek; Błyszczuk, Przemysław; Michalik, Marta; Czyż, Jarosław

    2017-07-01

    Pathologic accumulation of myofibroblasts in asthmatic bronchi is regulated by extrinsic stimuli and by the intrinsic susceptibility of bronchial fibroblasts to transforming growth factor-β (TGF-β). The specific function of gap junctions and connexins in this process has remained unknown. Here, we investigated the role of connexin43 (Cx43) in TGF-β-induced myofibroblastic differentiation of fibroblasts derived from bronchoscopic biopsy specimens of patients with asthma and donors without asthma. Asthmatic fibroblasts expressed considerably higher levels of Cx43 and were more susceptible to TGF-β1-induced myofibroblastic differentiation than were their nonasthmatic counterparts. TGF-β1 efficiently up-regulated Cx43 levels and activated the canonical Smad pathway in asthmatic cells. Ectopic Cx43 expression in nonasthmatic (Cx43low) fibroblasts increased their predilection to TGF-β1-induced Smad2 activation and fibroblast-myofibroblast transition. Transient Cx43 silencing in asthmatic (Cx43high) fibroblasts by Cx43 small interfering RNA attenuated the TGF-β1-triggered Smad2 activation and myofibroblast formation. Direct interactions of Smad2 and Cx43 with β-tubulin were demonstrated by co-immunoprecipitation assay, whereas the sensitivity of these interactions to TGF-β1 signaling was confirmed by Förster Resonance Energy Transfer analyses. Furthermore, inhibition of the TGF-β1/Smad pathway attenuated TGF-β1-triggered Cx43 up-regulation and myofibroblast differentiation of asthmatic fibroblasts. Chemical inhibition of gap junctional intercellular communication with 18 α-glycyrrhetinic acid did not affect the initiation of fibroblast-myofibroblast transition in asthmatic fibroblasts but interfered with the maintenance of their myofibroblastic phenotype. Collectively, our data identified Cx43 as a new player in the feedback mechanism regulating TGF-β1/Smad-dependent differentiation of bronchial fibroblasts. Thus, our observations point to Cx43 as a novel

  14. Exposure to culturable and total microbiota in cultural heritage conservation laboratories

    Directory of Open Access Journals (Sweden)

    Rafał L. Górny

    2016-04-01

    Full Text Available Objectives: To date, the scientific source materials usually focus on microbial contamination of the museum or library collections themselves, while the exposure of persons who professionally deal with this type of objects in cultural heritage conservation laboratories is ignored. Material and Methods: The study was carried out in 9 naturally ventilated conservation laboratories with no history of water damage. Viable (understood as culturable bioaerosol stationary samples were collected in both outdoor and indoor environments using 6-stage Andersen impactor. Simultaneously, stationary and personal indoor bioaerosol measurements were carried out using both Gesamtstaubprobenahme an der Person (GSP and Button filter samplers. These measurements were complemented by evaluation of microbial content in the dust settled on conserved works of art. All impactor, filter, and settled dust samples were quantitatively examined to obtain viable and total concentrations of bacteria and fungi. All isolated microbial strains were taxonomically identified. Results: At workplaces, the concentrations of viable microorganisms in air were below 2000 cfu/m3 and accounted for not more than 5.5% of total microbiota. The study showed that quantitative assessment of viable bioaerosol can be made with an Andersen impactor as well as by using Button and GSP filter samplers, irrespective of whether they are applied for personal or stationary measurements. Compared to the impactor, however, the use of filter samplers for microbial contamination monitoring substantially limits the scope of qualitative information which can be obtained. Size distribution analysis revealed that the largest “load” of microorganisms can penetrate into the respiratory tract between the trachea and terminal bronchi, and thereby may be responsible for allergic inflammations in exposed workers. Conclusions: The precise assessment of microbial hazards in conservation laboratories should comprise

  15. Comparison of Active Drug Concentrations in the Pulmonary Epithelial Lining Fluid and Interstitial Fluid of Calves Injected with Enrofloxacin, Florfenicol, Ceftiofur, or Tulathromycin.

    Directory of Open Access Journals (Sweden)

    Derek M Foster

    , with over 900% penetration to the airways. Despite high diffusion into the bronchi, the tulathromycin concentrations achieved were lower than the MIC of susceptible bacteria at most time points.

  16. [On the evaluation of health factors in high-rise buildings. 2. Bioclimatological consequences resulting from comparative measurements of the air ionisation in a high-rise building located in a heavily contaminated suburban area and at certain altitudes (author's transl)].

    Science.gov (United States)

    Möse, J R; Fischer, G

    1981-01-01

    According to accepted scientific theories inhaled small ions deliver their charges in the pulmonary alveoli and this leads to local recharges. This process stimulates structures of the central nervous system and the activity of the endocrine is excited, resulting in an enhancement of the general well-being. These possibilities of interpretation regarding a biological ionic effect are supported, with reservations (e.g. effects produced by a change in climate), by positive medical effects during and after a stay in a well-ventilated mountain climate or also in a sea-climate. Owing to their lower mobility the large ions are inhaled as small ions to an increasing extent. The chemical and physical noxa are delivered and deposited in the respiratory tract. They "stick" the epithelia in the trachea and in the bronchi as well as the endothelia in the lung vesicles. The number of the ciliary movements is reduced. Similar effects are known to be caused also by nicotine abuse. This results in a decreased ability of expectoration and a lower intake of oxygen by the alveoli. These facts could furnish an explanation for the increased vulnerability of city dwellers to infections diseases and to catarrh. The changed ionisation of air in urbanised areas (mainly large ions in high concentrations) definitely represents only one of the many risk factors. In addition to the attempt to characterize bioclimatically local weather conditions by means of the non-conventional parameter "air ionisation" our study has also been intended to establish biologically oriented criteria for the living in a high-rise building in a particularly unfavourable location. Under specific microclimatic conditions the uppermost storeys were at times bioclimatically favoured over the lowermost, especially when shallow air inversion is present. In such cases, small ions exclusively were registered in the upper storeys and large ions in the lower floors.

  17. Evaluation of health factors in high-rise buildings. 2. Bioclimatological consequences resulting from comparative measurements of the air ionisation in a high-rise building located in a heavily contaminated suburban area and at certain altitudes

    Energy Technology Data Exchange (ETDEWEB)

    Moese, J.R.; Fischer, G.

    1981-01-01

    According to accepted scientific theories inhaled small ions deliver their charges in the pulmonary alveoli and this leads to local recharges. This process stimulates structures of the central nervous system and the activity of the endocrine is excited, resulting in an enhancement of the general well-being. These possibilities of interpretation regarding a biological ionic effect are supported, with reservations by positive medical effects during and after a stay in a well-ventilated mountain climate or also in a sea-climate. Owing to their lower mobility the large ions are inhaled as small ions to an increasing extent. The chemical and physical noxa are delivered and deposited in the respiratory tract. They stick the epithelia in the trachea and in the bronchi as well as the endothelia in the lung vesicles. The number of the ciliary movements is reduced. Similar effects are known to be caused also by nicotine abuse. This results in a decreased ability of expectoration and a lower intake of oxygen by the alveoli. These facts could furnish an explanation for the increased vulnerability of city dwellers to infections diseases and to catarrh. The changed ionisation of air in urbanised areas definitely represents only one of the many risk factors. In addition to the attempt to characterize bioclimatically local weather conditions by means of the non-conventional parameter air ionisation our study has also been intended to establish biologically oriented criteria for the living in a high-rise building in a particularly unfavourable location. Under specific microclimatic conditions the uppermost storeys were at times bioclimatically favoured over the lowermost, especially when shallow air inversion is present. In such cases, small ions exclusively were registered in the upper storeys and large ions in the lower floors.

  18. Tracheobronchial epithelium of the sheep: IV. Lectin histochemical characterization of secretory epithelial cells.

    Science.gov (United States)

    Mariassy, A T; Plopper, C G; St George, J A; Wilson, D W

    1988-09-01

    Conventional histochemical characterization of the mucus secretory apparatus is often difficult to reconcile with the biochemical analysis of respiratory secretions. This study was designed to examine the secretory glycoconjugates in airways using lectins with biochemically defined affinities for main sugar residues of mucus. We used five biotinylated lectins--DBA (Dolichos biflorus) and SBA (Glycine max) for N-acetyl galactosamine (galNAc), BSA I (Bandeiraea simplicifolia) and PNA (Arachis hypogea) for galactose (gal), and UEA I (Ulex europeus)--for detection of fucose (fuc) in HgCl2-fixed, paraffin-embedded, serially sectioned trachea, lobar and segmental bronchi and bronchioles of nine sheep. Lectins selectively localized the carbohydrate residues in luminal secretions, on epithelial cell surfaces, and in secretory cells. In proximal airways, the major carbohydrate residues in luminal secretions, cell surfaces, goblet cells, and glands were fuc and gal-NAc. PNA reacted mainly with apical granules of less than 10% of goblet cells, and gal residues were only detected in some of the mucous cells and on basolateral cell surfaces. Distal airways contained sparse secretion in the lumen, mucous cells contained weakly reactive fuc and gal-NAc, and the epithelial surfaces of Clara cells contained gal. Sugars abundant in the airway secretions were also the major component of cells in glands. We conclude that there is a correlation between specific sugar residues in secretory cells, glycocalyx, and luminal secretions in proximal and distal airways. This suggests that lectins may be used to obtain information about airway secretory cell composition from respiratory secretions.

  19. Effect of terbutaline on mucociliary clearance in asthmatic and healthy subjects after inhalation from a pressurised inhaler and a dry powder inhaler.

    Science.gov (United States)

    Mortensen, J; Groth, S; Lange, P; Hermansen, F

    1991-01-01

    BACKGROUND: beta Agonists have been shown to increase mucociliary clearance in some studies but not all. Whether the formulation of beta agonists affects mucociliary clearance is not known but may be important as the use of dry powder inhalers increases. METHODS: The effect of different methods of administration of inhaled terbutaline on mucociliary clearance and forced expiratory volume in one second (FEV1) was assessed in 10 patients with asthma and 10 healthy subjects. Terbutaline (1 mg) was administered through a metered dose inhaler with a spacer (Nebuhaler) or a dry powder inhaler (Turbuhaler), or both treatments were given, in a four way double blind, double dummy trial. Mucociliary clearance was measured by bronchoscintigraphy. RESULTS: Clearance of radioactivity from the lobar bronchi increased in the asthmatic patients by a median of 32% after terbutaline was given by metered dose inhaler and 55% after a combined dose of 2 mg from both inhalers (1 mg from each) compared with placebo but by only 9% after 1 mg of terbutaline was given by a dry powder inhaler. In the healthy subjects mucociliary clearance increased by 51% when terbutaline was given by a dry powder inhaler, by 66% when given by a metered dose inhaler, and by 66% when given by both inhalers combined. The effect of terbutaline on FEV1 was the same with each of the inhalers. CONCLUSION: Despite similar changes in FEV1 with the two formulations terbutaline increased mucociliary clearance significantly in asthmatic and healthy subjects when inhaled from a metered dose inhaler whereas when it was inhaled from a dry powder inhaler its effect was significant only in healthy subjects. The reason for the difference in asthmatic subjects is unclear, but may be associated with differences in the deposition of terbutaline. Images PMID:1771605

  20. [Sterol extracts from Begonia Sinensis Rhizome against respiratory inflammation].

    Science.gov (United States)

    Yao, Yong; Jiang, Wei; Li, Yu-shan

    2015-08-01

    The acute and chronic respiratory tract inflammation models were made to investigate the effect and mechanism of sterol extracts from Begonia Sinensis Rhizome (BSR). The first model of acute lung injury was made with Kunming mice by inhaling cigarette smoke, then the mice were treated with different concentrations of BSR sterol extracts. Lung tissue morphology was detected by HE staining, TNF-alpha/MPO were detected by Elisa, and cPLA2 protein were, detected by Western blotting respectively. Results showed that in model group, lung sheet became real, alveolar space shrank or disappeared, alveolar septum was thickened, plenty of inflammatory cells were infiltrated, capillary blood vessels were congestive and the expression of TNF-α, MPO, cPLA2 increased; after administration, a small amount of inflammatory cells were infiltrated, alveolar septum became obvious, capillary congestion status was significantly relieved and the expression of TNF-α, MPO, cPLA2 decreased (P < 0.05). The second model of chronic respiratory tract inflammation in BALB/c mice with bronchial asthma was induced by OVA, then the mice were treated with different concentrations of BSR sterol extracts. Lung tissue morphology was detected by HE staining, indexes such as IL-4, IL-5, IL-13 were detected by Elisa, and the cPLA2 protein expression was detected by Western blotting respectively. Results showed that in model group, a lot of inflammatory cells around lung vessels and bronchi exuded, bronchial goblet cells proliferated and the expression of IL-4, IL-5, IL-13, cPLA2 increased; after administration, inflammatory and goblet cell hyperplasia reduced, the expression of IL-4, IL-5, IL-13, cPLA2 also decreased (P < 0.05). The above results showed BSR sterol extracts could resist against respiratory inflammation by inhibiting cPLA2 in a dose-dependent manner.

  1. Condroma pulmonar isolado: caso incompleto da tríade de Carney? Isolated pulmonary chondroma: a case of incomplete Carney triad?

    Directory of Open Access Journals (Sweden)

    Raul Lopes Ruiz Júnior

    2005-08-01

    Full Text Available Um homem, de 45 anos, com infecções pulmonares de repetição havia quatro anos apresentou-se com tosse, secreção amarelada, escarros hemópticos e dor torácica não pleural. A tomografia revelou nódulo calcificado ocluindo brônquio lobar inferior direito. Realizada bilobectomia inferior e média, o exame histopatológico revelou condroma endobrônquico, bem circunscrito. O condroma pulmonar é um tumor raro, em geral associado à tríade de Carney (condroma, leiomiossarcoma gástrico e paraganglioma extra-adrenal, sendo o menos freqüente dos três componentes. No presente caso, os outros dois componentes não foram observados. Podem, entretanto, se manifestar tardiamente, sendo, assim, necessário seguimento clínico em longo prazo do paciente.A 45-year-old man presented with recurrent pulmonary infection for four years, cough, bloody sputum, yellowish excretion and nonpleuritic chest pain. Tomography of the chest revealed a calcified nodule occluding the right lower lobe bronchus. A right lower and middle lobectomy was performed, and the histopathological examination of the bronchi revealed chondroma, a rare pulmonary tumor usually associated with the Carney triad (pulmonary chondroma, gastric leiomyosarcoma and extra-adrenal paraganglioma, being the less common of the three components. In the present case, the other two components of the triad were not observed. Since these components may appear years later, long-term follow-up care is necessary.

  2. BACTERIAL COLONISATION IN NON-CYSTIC FIBROSIS BRONCHIECTASIS IN A TERTIARY CARE CENTER IN CENTRAL KERALA

    Directory of Open Access Journals (Sweden)

    Kiran Vishnu Narayan

    2017-07-01

    Full Text Available BACKGROUND Bronchiectasis is an abnormal dilatation of the bronchi resulting in permanent damage to the pulmonary architecture and function. This disease expresses itself as chronic cough and expectoration, haemoptysis and with recurrent exacerbations of symptoms. The aim of the study is to study the prevalence of chronic bacterial colonisation in the lower respiratory tract of patients with non-cystic fibrosis bronchiectasis in the Pulmonary Medicine Department of Government Medical College, Kottayam, Kerala, India. MATERIALS AND METHODS A longitudinal observational study was conducted during a period of 1 year from April 2015 to March 2016 in patients with highresolution CT thorax evidence of bronchiectasis. The sputum was collected for bacterial cultures during exacerbations. Those with coexisting pulmonary diseases and diabetes mellitus were excluded from the study. The patients were treated with empirical antibiotics and bronchial toileting, chest physiotherapy and postural drainage. All patients were kept under follow up and a repeat sputum culture was sent 6 weeks after the episode of exacerbation to determine initial colonisation of the respiratory tract. In stable patients, induced spot sputum samples were sent for culture and when exacerbations occurred during the follow up period, new sputum samples were given. RESULTS Among 46 patients enrolled into the study, 10 gave a positive culture isolate during exacerbations, while 78% culture samples yielded normal pharyngeal flora. The organisms during exacerbations were namely Pseudomonas aeruginosa, Klebsiella pneumonia, Haemophilus influenzae, E. coli and one was Burkholderia mallei in a person with Kartagener’s syndrome. 10.8% showed evidence of colonisation and 4 among them showed chronic colonisation with Pseudomonas aeruginosa on repeated cultures taken a month apart when not on any antibiotics. CONCLUSION The prevalence of colonisation of the lower respiratory tract is 10.8% in the

  3. Computed tomography assessment of pharmacological lung volume reduction induced by bronchodilators in COPD.

    Science.gov (United States)

    Tanabe, Naoya; Muro, Shigeo; Oguma, Tsuyoshi; Sato, Susumu; Kiyokawa, Hirofumi; Takahashi, Tamaki; Kudo, Megumi; Kinose, Daisuke; Kubo, Takeshi; Hoshino, Yuma; Ogawa, Emiko; Hirai, Toyohiro; Mishima, Michiaki

    2012-08-01

    Pharmacological lung volume reduction in COPD is an important goal in treatment with long-acting bronchodilators because in addition to airflow limitation, lung hyperinflation considerably affects COPD symptoms. Quantitative computed tomography (CT) simultaneously provides structural information about airway dimensions, emphysematous changes, and lung volumes, some of which are difficult to be evaluated by pulmonary function. Here, we evaluated changes in CT parameters and pulmonary function in 30 patients with COPD who underwent CT scans before and one year after starting tiotropium treatment and in 12 patients with COPD who were not treated with long-acting bronchodilators. Baseline pulmonary function and CT parameters did not differ between the two groups. One-year tiotropium therapy improved physiological-indices including residual volume (RV) and ratio of RV to total lung capacity (RV/TLC) (-235 mL, p = 0.005, and -2.9%, p = 0.0001, respectively), and CT-indices including wall area percent (WA%) and inner luminal area in right upper lobe apical and lower lobe basal segmental bronchi (-1.59%, p = 0.01, 2.27 mm(2), p = 0.0005; and -1.33%, p = 0.0008, 3.42 mm(2), p volume (LAV) and total lung volume (CT-TLV) (-92 mL, p = 0.0003, and -211 mL, p = 0.002, respectively). Changes in LAV, CT-TLV, RV, and RV/TLC were significantly greater in the tiotropium, than the non-bronchodilator group. The tiotropium-induced reduction in LAV correlated with the decrease in RV (ρ = 0.45, p = 0.01). Our findings not only indicate the value of the comprehensive CT measurements in assessing the effects of bronchodilators, including pharmacological lung volume reduction, but also further understanding of the structural changes underlying physiological improvements induced by bronchodilators.

  4. Photodynamic therapy (PDT) in advanced inoperable bronchial carcinoma

    Science.gov (United States)

    Moghissi, Keyvan; Dixon, Kate; Stringer, Mark R.; Brown, Stanley B.

    1996-12-01

    Objective: To assess the efficacy of PDT to: Palliate symptoms, control disease and extend survival in patients with advanced inoperable cancer. Subject and Method: 55 Males and 23 females aged between 45-81 years (mean 66 years) with inoperable and advanced lung cancer with > 5O. obstructive lesions of the main, lobar or segmental bronchi. Patients had pre-treatment routine clinical radiological, functional and endoscopic assessment with proven histological diagnosis. Protocol of PDT was; Intravenous injection of 2 mg/Kg bodyweight Polyhaematoporphyrin (equivalent to Photofrin) or Photofrin followed 24-72 hours later by illumination of tumour using 630 nm light (Oxford Laser) delivered via an optical fibre with end diffuser. Treatments were carried out under general anaesthesia as a day case procedure. Patients were rebronchoscoped for debridement/retreatment 4-7 days later. Results: There was no treatment related mortality. Two patients developed mild photosensitivity reaction. All patients showed symptomatic improvement with good initial functional and radiological amelioration. Every patient responded to treatment. Seven patients had complete response and negative histology for 3-12 months. After the first treatment average Forced Vital Capacity (FVC) and Forced Expiratory Volume in one second (FEV1) improvement was 0.5 litres and 0.4 litres respectively. Twenty five percent of patients (nr 19) survived more than 2 years, 10'. (nr=8) between 1-2 years and the remaining 51 patients less than a year. Conclusion: PDT should be considered as a therapeutic modality for all stages of lung cancer and is an excellent treatment modality for palliation in advanced bronchial malignancies.

  5. [Human lung topography in the early fetal period of ontogenesis].

    Science.gov (United States)

    Zheleznov, L M; Shcherbakov, S M

    2012-01-01

    Lung holotopy, skeletotopy and syntopy were studied in 70 human fetuses at developmental weeks 16-24 with N. I. Pirogov method, macro-microscopical preparation and using histotopographical sections in three imutually perpendicular planes. It was found that during weeks 16-18, the apex of the left lung was located posteriorly at the level of I intercostal space, at weeks 22-24--at the level of lower surface of I rib. At the right side, the apex was located at the level of upper surface of I rib during the whole period. The lower margin of the right lung was located at the level of IV rib during the whole period, while that of the left lung was detected at the level of III rib only during the beginning of the period. In the early fetal period, the projection of the root of the right lung extended from the lower margin of T(III) vertebral body toT(VI), while that one of the left lung was located at the level of the upper margins of T(IV)-T(VII) vertebral bodies. In the late period, these projections were found at the level of T(IV) (upper vertebral margin)--T(VII) (lower vertebral margin), and T(IV) (lower vertebral margin)--T(VIII) (upper vertebral margin) respectively. Intraorgan bronchi and pulmonary vessels were most clearly visualized in horizontal sections at T(III) -T(IX) levels. The results obtained should be taken into account when carrying out of diagnostic ultrasound and magnetic resonance studies of the fetus and surgical interventions on fetuses.

  6. Cigarette smoke extracts promote vascular smooth muscle cell proliferation and enhances contractile responses in the vasculature and airway.

    Science.gov (United States)

    Xu, Cang-Bao; Lei, Ying; Chen, Qingwen; Pehrson, Christina; Larsson, Lennart; Edvinsson, Lars

    2010-12-01

    Cigarette smoke exposure is a strong risk factor for cardiovascular and respiratory diseases. However, the knowledge about how cigarette smoke induces damage to vasculature and airway is limited. The present study was designed to examine the effects of cigarette smoke particles extracted by heptane (heptane-soluble smoke particles, HSP), by water (water-soluble smoke particles, WSP) and by DMSO (DMSO-soluble smoke particles, DSP), which represent lipophilic, hydrophilic and ambiphoteric constituents from the cigarette smoke, respectively. Human aortic smooth muscle cell (HASMC) proliferation was assessed in cell culture. Rat resistance artery and airway contractile responses to serotonin, U46619, phenylephrine, noradrenaline, acetylcholine, des-Arg⁹-bradykinin, bradykinin, sarafotoxin 6c and endothelin-1 were monitored by a sensitive myograph system. Immunocytochemistry and cell-based phosphoELISA assay were used to demonstrate activation of extracellular signal-regulated kinases 1/2 (ERK1/2). For the first time, our results demonstrate that although all the three extracts promote HASMC proliferation, the HSP and DSP effects occur earlier. HSP and DSP, but not WSP, increase the contractile responses to sarafotoxin 6c, U46619 or bradykinin in rat mesenteric artery and/or in bronchi. ERK1/2 is activated by HSP and DSP in HASMCs and inhibition of ERK1/2 abrogated the smoke extracts-induced HASMC proliferation, while blockage of nicotinic receptors had no effects, suggesting that the toxic effects of the smoke extracts occur via activation of intracellular ERK1/2 signalling, but not nicotinic receptors. © 2010 The Authors. Basic & Clinical Pharmacology & Toxicology © 2010 Nordic Pharmacological Society.

  7. Epidemiological evaluation of occupational diseases in Poland, 2002; Sytuacja epidemiologiczna w zakresie chorob zawodowych w Polsce w roku 2002

    Energy Technology Data Exchange (ETDEWEB)

    Peplonska, B.; Szeszenia-Dabrowska, N.; Szymczak, W. [Instytutu Medycyny Pracy, Lodzi (Poland). Z Zakladu Epidemiologii Srodowiskowej

    2003-07-01

    This paper shows the data of the Central Register of Occupational Diseases presenting the incidence in the year 2002. All cases of the occupational diseases reported to the Registry on the special individual form by the sanitary-hygienic stations were analyzed. 4915 cases of occupational diseases were registered in 2002 with the incidence rate of 53.6 per 100000 employees. The highest incidence rates were noted for 7 groups of occupational diseases: vocal organ diseases due to an excessive voice effort (13.4 per 100000 employees); noise-induced hearing loss (10.0); pneumoconioses (7.5); contagious and invasive diseases (7.5); dermatoses (3.5); chronic diseases of bronchi (2.5); and vibration syndrome (2.4). Most occupational diseases were induced by a long-term exposure to pathogenic factors occurring in the occupational environment. As much as 93.5% of these diseases were manifested after a 10-year exposure duration. The highest incidence levels were found to occur in forestry (707.65), mining and quarrying (348.46), coal mining (405.43), manufacture of metals (267.34), manufacture of transport equipment (156.08), and education (123.0). Occupational diseases in males represents 60.5% of new cases. The data of the Registry indicate a decreasing number of the registered occupational diseases that could be observed in Poland. Four types of occupational diseases have accounted mostly for this decline: noise-induced hearing loss, chronic vocal organ diseases, contagious and invasive diseases, and dermatoses. The vocal organ diseases are the most frequently recorded with the highest incidence since the year 1997. 8 refs.

  8. Regional Heterogeneity in Murine Lung Fibroblasts from Normal Mice or Mice Exposed Once to Cigarette Smoke

    Science.gov (United States)

    Preobrazhenska, Olena; Wright, Joanne L.; Churg, Andrew

    2012-01-01

    Chronic obstructive lung disease (COPD) is characterized by matrix deposition in the small airways but matrix loss from the parenchyma, phenomena which must depend on the ability of local fibroblasts to produce matrix after smoke exposure. To investigate this idea, we exposed C57Bl/6 mice once to cigarette smoke or to air (control) and prepared primary cultures of lung fibroblasts by microdissecting large airways (trachea, LAF), medium size airways (major bronchi, MAF) and parenchyma (PF). Control PF showed the lowest rate of wound closure and wound closure was depressed in all lines by a single in vivo smoke exposure. Gene expression of matrix proteins differed considerably among the sites; decorin, which may sequester TGFβ, was markedly higher in PF. PF showed higher intrinsic ratios of pSmad2/Smad2. Smoke caused much greater increases in secreted and matrix deposited collagens 1 and 3 in PF than in LAF or MAF. Expression of Thy-1, a gene that suppresses myofibroblast differentiation, was increased by smoke in PF. We conclude that there is considerable regional heterogeneity in murine lung fibroblasts in terms of matrix production, either basally or after in vivo smoke exposure; that PF have lower ability to repair wounds and higher intrinsic TGFβ signaling; and that a single exposure to smoke produces lasting changes in the pattern of matrix production and wound repair, changes that may be mediated in part by smoke-induced release of TGFβ. However, PF still retain the ability to repair by producing new matrix after a single in vivo smoke exposure. PMID:22761892

  9. Penguins use the two-voice system to recognize each other.

    Science.gov (United States)

    Aubin, T; Jouventin, P; Hildebrand, C

    2000-06-07

    The sound-producing structure in birds is the syrinx, which is usually a two-part organ located at the junction of the bronchi. As each branch of the syrinx produces sound independently, many birds have two acoustic sources. Thirty years ago, we had anatomical, physiological and acoustical evidence of this two-voice phenomenon but no function was known. In songbirds, often these two voices with their respective harmonics are not activated simultaneously but they are obvious in large penguins and generate a beat pattern which varies between individuals. The emperor penguin breeds during the Antarctic winter, incubating and carrying its egg on its feet. Without the topographical cue of a nest, birds identify each other only by vocal means when switching duties during incubation or chick rearing. To test whether the two-voice system contains the identity code, we played back the modified call of their mate to both adults and also the modified call of their parents to chicks. Both the adults and the chicks replied to controls (two voices) but not to modified signals (one voice being experimentally suppressed). Our experiments demonstrate that the beat generated by the interaction of these two fundamental frequencies conveys information about individual identity and also propagates well through obstacles, being robust to sound degradation through the medium of bodies in a penguin colony. The two-voice structure is also clear in the call of other birds such as the king penguin, another non-nesting species, but not in the 14 other nesting penguins. We concluded that the two-voice phenomenon functions as an individual recognition system in species using few if any landmarks to meet. In penguins, this coding process, increasing the call complexity and resisting sound degradation, has evolved in parallel with the loss of territoriality.

  10. Outdoor particulate matter and childhood asthma admissions in Athens, Greece: a time-series study

    Directory of Open Access Journals (Sweden)

    Roma Eleftheria S

    2010-07-01

    Full Text Available Abstract Background Particulate matter with diameter less than 10 micrometers (PM10 that originates from anthropogenic activities and natural sources may settle in the bronchi and cause adverse effects possibly via oxidative stress in susceptible individuals, such as asthmatic children. This study aimed to investigate the effect of outdoor PM10 concentrations on childhood asthma admissions (CAA in Athens, Greece. Methods Daily counts of CAA from the three Children's Hospitals within the greater Athens' area were obtained from the hospital records during a four-year period (2001-2004, n = 3602 children. Mean daily PM10 concentrations recorded by the air pollution-monitoring network of the greater Athens area were also collected. The relationship between CAA and PM10 concentrations was investigated using the Generalized Linear Models with Poisson distribution and logistic analysis. Results There was a statistically significant (95% CL relationship between CAA and mean daily PM10 concentrations on the day of exposure (+3.8% for 10 μg/m3 increase in PM10 concentrations, while a 1-day lag (+3.4% for 10 μg/m3 increase in PM10 concentrations and a 4-day lag (+4.3% for 10 μg/m3 increase in PM10 concentrations were observed for older asthmatic children (5-14 year-old. High mean daily PM10 concentration (the highest 10%; >65.69 μg/m3 doubled the risk of asthma exacerbations even in younger asthmatic children (0-4 year-old. Conclusions Our results provide evidence of the adverse effect of PM10 on the rates of paediatric asthma exacerbations and hospital admissions. A four-day lag effect between PM10 peak exposure and asthma admissions was also observed in the older age group.

  11. Primary Endobronchial Marginal Zone B-Cell Lymphoma of Bronchus-Associated Lymphoid Tissue: CT Findings in 7 Patients

    Science.gov (United States)

    Yoon, Ra Gyoung; Song, Jae Woo; Chae, Eun Jin; Choi, Chang Min; Jang, SeJin

    2013-01-01

    Objective To investigate CT and 18F-flurodeoxyglucose (18F-FDG) positron-emission tomography/CT findings of primary endobronchial marginal zone B-cell lymphoma of the bronchus-associated lymphoid tissue (BALT). Materials and Methods From June 2006 through April 2012, seven patients (six female, one male; age range, 21-61 years; mean age, 49 years) were examined who were pathologically diagnosed with the primary endobronchial marginal zone B-cell lymphoma of BALT. We evaluated the locations and characteristics of the lesions on CT and 18F-FDG-PET/CT scans. The lesions were classified into the following three patterns: 1) solitary intraluminal nodule; 2) several tiny nodular protrusions; and 3) diffuse wall thickening. Results A solitary intraluminal nodule was observed in four patients (57.1%), several tiny nodular protrusion in two patients (28.6%), and diffuse wall thickening in one patient (14.3%). The lesions were categorized into 3 major locations: confined to the trachea (n = 3), confined to the lobar bronchus (n = 2), and diffuse involvement of the trachea and both main bronchi (n = 2). All lesions demonstrated homogeneous iso-attenuation as compared with muscle on pre- and post-enhancement scans. Secondary findings in the lungs (n = 3; 42.9%) included postobstructive lobar atelectasis (n = 1), air trapping (n = 1), and pneumonia (n = 1). On 18F-FDG-PET/CT (n = 5), 4 lesions showed homogeneous uptake with maximum standardized uptake values (mSUV), ranging 2.3-5.7 (mean mSUV: 3.3). One lesion showed little FDG uptake. Conclusion Primary endobronchial marginal zone B-cell lymphoma of the BALT manifests as three distinct patterns on CT, with the solitary intraluminal nodule presenting as the main pattern. Most lesions demonstrate homogeneous but weak FDG uptake on 18F-FDG-PET/CT. PMID:23483549

  12. Primary endobronchial marginal zone B-cell lymphoma of bronchus-associated lymphoid tissue: CT findings 7 patients

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Ra Gyoung; Kim, Mi Young; Song, Jae Woo; Chae, Eun Jin; Choi, Chang Min; Jang, Se Jin [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2013-04-15

    To investigate CT and 1{sup 8F}-fluorodeoxyglucose (1{sup 8F}-FDG) positron-emission tomography/CT findings of primary endobronchial marginal zone B-cell lymphoma of the bronchus-associated lymphoid tissue (BALT). From June 2006 through April 2012, seven patients (six female, one male; age range, 21-61 years; mean age, 49 years) were examined who were pathologically diagnosed with the primary endobronchial marginal zone B-cell lymphoma of BALT. We evaluated the locations and characteristics of the lesions on CT and 1{sup 8F}-FDG-PET/CT scans. The lesions were classified into the following three patterns: 1) solitary intraluminal nodule; 2) several tiny nodular protrusions; and 3) diffuse wall thickening. A solitary intraluminal nodule was observed in four patients (57.1%), several tiny nodular protrusion in two patients (28.6%), and diffuse wall thickening in one patient (14.3%). The lesions were categorized into 3 major locations: confined to the trachea (n 3), confined to the lobar bronchus (n = 2), and diffuse involvement of the trachea and both main bronchi (n = 2). All lesions demonstrated homogeneous iso-attenuation as compared with muscle on pre- and post-enhancement scans. Secondary findings in the lungs (n = 3; 42.9%) included postobstructive lobar atelectasis (n = 1), air trapping (n = 1), and pneumonia (n = 1). On 1{sup 8F}-FDG-PET/CT (n = 5), 4 lesions showed homogeneous uptake with maximum standardized uptake values (mSUV), ranging 2.3-5.7 (mean mSUV: 3.3). One lesion showed little FDG uptake. Primary endobronchial marginal zone B-cell lymphoma of the BALT manifests as three distinct patterns on CT, with the solitary intraluminal nodule presenting as the main pattern. Most lesions demonstrate homogeneous but weak FDG uptake on 1{sup 8F}-FDG-PET/CT.

  13. Improved accuracy of markerless motion tracking on bone suppression images: preliminary study for image-guided radiation therapy (IGRT)

    Science.gov (United States)

    Tanaka, Rie; Sanada, Shigeru; Sakuta, Keita; Kawashima, Hiroki

    2015-05-01

    The bone suppression technique based on advanced image processing can suppress the conspicuity of bones on chest radiographs, creating soft tissue images obtained by the dual-energy subtraction technique. This study was performed to evaluate the usefulness of bone suppression image processing in image-guided radiation therapy. We demonstrated the improved accuracy of markerless motion tracking on bone suppression images. Chest fluoroscopic images of nine patients with lung nodules during respiration were obtained using a flat-panel detector system (120 kV, 0.1 mAs/pulse, 5 fps). Commercial bone suppression image processing software was applied to the fluoroscopic images to create corresponding bone suppression images. Regions of interest were manually located on lung nodules and automatic target tracking was conducted based on the template matching technique. To evaluate the accuracy of target tracking, the maximum tracking error in the resulting images was compared with that of conventional fluoroscopic images. The tracking errors were decreased by half in eight of nine cases. The average maximum tracking errors in bone suppression and conventional fluoroscopic images were 1.3   ±   1.0 and 3.3   ±   3.3 mm, respectively. The bone suppression technique was especially effective in the lower lung area where pulmonary vessels, bronchi, and ribs showed complex movements. The bone suppression technique improved tracking accuracy without special equipment and implantation of fiducial markers, and with only additional small dose to the patient. Bone suppression fluoroscopy is a potential measure for respiratory displacement of the target. This paper was presented at RSNA 2013 and was carried out at Kanazawa University, JAPAN.

  14. Estenose benigna dos brônquios principais Bilateral benign mainstem bronchus stenosis

    Directory of Open Access Journals (Sweden)

    MANOEL XIMENES-NETTO

    2001-11-01

    Full Text Available É descrito o caso de uma paciente de 37 anos de idade atendida em virtude de dispnéia progressiva com duração de 18 meses. O diagnóstico inicial foi de asma brônquica. Teve 10 episódios de pneumonia envolvendo principalmente a língula nos últimos sete anos. Dezessete anos antes da admissão foi submetida a intubação orotraqueal por 15 dias, devido a coma por meningite meningocócica. A broncofibroscopia revelou alargamento da carina e estenose dos brônquios principais, confirmado pela broncoscopia virtual. A estenose era mais acentuada e curta à direita (1cm e menos cerrada e mais longa à esquerda (2cm. Foi submetida a ressecção da carina e anastomose do brônquio principal direito à traquéia e do brônquio principal esquerdo ao brônquio intermediário. Quinze meses depois do procedimento a paciente apresenta boa evolução clínica, radiológica e funcional.We report on a 37-year-old female patient who was first seen on account of a progressive dyspnea of 18 month's duration. Admission diagnosis was bronchial asthma. Over the past seven years, the patient has had seven pneumonia episodes involving mainly the lingular segment. Seventeen years prior to admission (1982 she was orally intubated for 15 days due to meningococcus meningitis and coma. Fiberoptic bronchoscopy revealed marked widening of the carina and stenosis of the main bronchi, confirmed by virtual bronchoscopy. The stenosis was shorter and more severe to the right side (1 cm and longer and less severe on the left side (2 cm. The patient was submitted to carina resection and anastomosis of the right mainstem bronchus to the trachea and the left main bronchus to the bronchus intermedius. Fifteen months after surgery the patient shows good clinical, radiological and functional evolution.

  15. Differential inhibitory effects of CysLT(1 receptor antagonists on P2Y(6 receptor-mediated signaling and ion transport in human bronchial epithelia.

    Directory of Open Access Journals (Sweden)

    Wendy Ka-hoi Lau

    Full Text Available BACKGROUND: Cysteinyl leukotriene (CysLT is one of the proinflammatory mediators released by the bronchi during inflammation. CysLTs exert their biological effects via specific G-protein-coupled receptors. CysLT(1 receptor antagonists are available for clinical use for the treatment of asthma. Recently, crosstalk between CysLT(1 and P2Y(6 receptors has been delineated. P2Y receptors are expressed in apical and/or basolateral membranes of virtually all polarized epithelia to control the transport of fluid and electrolytes. Previous research suggests that CysLT(1 receptor antagonists inhibit the effects of nucleotides acting at P2Y receptors. However, the detailed molecular mechanism underlying the inhibition remains unresolved. METHODOLOGY/PRINCIPAL FINDINGS: In this study, western blot analysis confirmed that both CysLT(1 and P2Y(6 receptors were expressed in the human bronchial epithelial cell line 16HBE14o-. All three CysLT(1 antagonists inhibited the uridine diphosphate (UDP-evoked I(SC, but only montelukast inhibited the UDP-evoked [Ca(2+](i increase. In the presence of forskolin or 8-bromoadenosine 3'5' cyclic monophosphate (8-Br-cAMP, the UDP-induced I(SC was potentiated but was reduced by pranlukast and zafirlukast but not montelukast. Pranlukast inhibited the UDP-evoked I(SC potentiated by an Epac activator, 8-(4-Chlorophenylthio-2'-O-methyladenosine-3',5'-cyclic monophosphate (8-CPT-2'-O-Me-cAMP, while montelukast and zafirlukast had no such effect. Pranlukast inhibited the real-time increase in cAMP changes activated by 8-CPT-2'-O-Me-cAMP as monitored by fluorescence resonance energy transfer imaging. Zafirlukast inhibited the UDP-induced I(SC potentiated by N(6-Phenyladenosine-3',5'-cyclic monophosphorothioate, Sp-isomer (Sp-6-Phe-cAMP; a PKA activator and UDP-activated PKA activity. CONCLUSIONS/SIGNIFICANCE: In summary, our data strongly suggest for the first time that in human airway epithelia, the three specific CysLT(1 receptor

  16. Computed tomography of the mediastinal lesion

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ho Joon; Suh, Jung Hyek; Chun, Byung Hee; Suh, Soo Jhi [Kosin Mediacal College, Busan (Korea, Republic of)

    1984-09-15

    Authors retrospectively analyzed the CT findings of mediastinal lesions in surgically or clinically confirmed 37 cases at Kosin Medical College during recent 4 years from September 1979 to August 1983. 1. Among 37 caes, malignant lymphoma were 7 cases, thymoma and vascular lesion or anomaly were 5 cases respectively, benign teratoma and tuberculous mediastinal lymphadenitis and neurogenic tumor were 4 cases respectively, pericardial cyst were 2 cases, bronchogenic cyst, non-specific cyst, pancreatic pseudocyst, mesothelioma, Bochdalek hernia was 1 case respectively. 2. The sex ratio between male and female was about 1 : 1 and the majority of the patients with malignant lymphoma and teratoma was under 20 years old. 3. CT findings of the each mediastinal lesion. 1) Primary mediastinal malignant lymphoma. (1) A large, matted, continuous and midline-crossing mass was observed in the superior and the anterior mediastinums in all cases. (2) In 3 cases, irregular lower densities were seen in the center of the mass, representing the tumor necrosis. (3) CT was also able to show involvement of other mediastinal lymph nodes and adjacent structures such as pleura, anterior chest wall and lung parenchyma. (4) Involving pleura, homogeneous band-like shadows were seen along the pleura, appearing denser than the associated pleural effusion. (5) Involving lung parenchyma, irregular- shaped nodules and band-like densities were seen along the courses of the bronchi and the vessels. 2) Thyoma. (1) A discrete, soft tissue mass was seen in the superior and the anterior mediastinums (mainly posterior to manubrium and anterior to aortic arch) replacing the normal mediastinal fat. (2) In benign thymoma, the margin of the mass was smooth and the normal fat plane between the mass and the vascular structures was well preserved, but invasive thymoma showed obliteration of the normal fat plane, irregular and ragged tumor-lung interface, and irregular thickening of pleura and pericardium by

  17. Caveolin-1 and -2 in airway epithelium: expression and in situ association as detected by FRET-CLSM

    Directory of Open Access Journals (Sweden)

    Kummer Wolfgang

    2006-08-01

    Full Text Available Abstract Background Caveolae are involved in diverse cellular functions such as signal transduction, cholesterol homeostasis, endo- and transcytosis, and also may serve as entry sites for microorganisms. Hence, their occurrence in epithelium of the airways might be expected but, nonetheless, has not yet been examined. Methods Western blotting, real-time quantitative PCR analysis of abraded tracheal epithelium and laser-assisted microdissection combined with subsequent mRNA analysis were used to examine the expression of cav-1 and cav-2, two major caveolar coat proteins, in rat tracheal epithelium. Fluorescence immunohistochemistry was performed to locate caveolae and cav-1 and -2 in the airway epithelium of rats, mice and humans. Electron-microscopic analysis was used for the identification of caveolae. CLSM-FRET analysis determined the interaction of cav-1α and cav-2 in situ. Results Western blotting and laser-assisted microdissection identified protein and transcripts, respectively, of cav-1 and cav-2 in airway epithelium. Real-time quantitative RT-PCR analysis of abraded tracheal epithelium revealed a higher expression of cav-2 than of cav-1. Immunoreactivities for cav-1 and for cav-2 were co-localized in the cell membrane of the basal cells and basolaterally in the ciliated epithelial cells of large airways of rat and human. However, no labeling for cav-1 or cav-2 was observed in the epithelial cells of small bronchi. Using conventional double-labeling indirect immunofluorescence combined with CLSM-FRET analysis, we detected an association of cav-1α and -2 in epithelial cells. The presence of caveolae was confirmed by electron microscopy. In contrast to human and rat, cav-1-immunoreactivity and caveolae were confined to basal cells in mice. Epithelial caveolae were absent in cav-1-deficient mice, implicating a requirement of this caveolar protein in epithelial caveolae formation. Conclusion These results show that caveolae and caveolins

  18. Sequence of pathogenic events in cynomolgus macaques infected with aerosolized monkeypox virus.

    Science.gov (United States)

    Tree, J A; Hall, G; Pearson, G; Rayner, E; Graham, V A; Steeds, K; Bewley, K R; Hatch, G J; Dennis, M; Taylor, I; Roberts, A D; Funnell, S G P; Vipond, J

    2015-04-01

    To evaluate new vaccines when human efficacy studies are not possible, the FDA's "Animal Rule" requires well-characterized models of infection. Thus, in the present study, the early pathogenic events of monkeypox infection in nonhuman primates, a surrogate for variola virus infection, were characterized. Cynomolgus macaques were exposed to aerosolized monkeypox virus (10(5) PFU). Clinical observations, viral loads, immune responses, and pathological changes were examined on days 2, 4, 6, 8, 10, and 12 postchallenge. Viral DNA (vDNA) was detected in the lungs on day 2 postchallenge, and viral antigen was detected, by immunostaining, in the epithelium of bronchi, bronchioles, and alveolar walls. Lesions comprised rare foci of dysplastic and sloughed cells in respiratory bronchioles. By day 4, vDNA was detected in the throat, tonsil, and spleen, and monkeypox antigen was detected in the lung, hilar and submandibular lymph nodes, spleen, and colon. Lung lesions comprised focal epithelial necrosis and inflammation. Body temperature peaked on day 6, pox lesions appeared on the skin, and lesions, with positive immunostaining, were present in the lung, tonsil, spleen, lymph nodes, and colon. By day 8, vDNA was present in 9/13 tissues. Blood concentrations of interleukin 1ra (IL-1ra), IL-6, and gamma interferon (IFN-γ) increased markedly. By day 10, circulating IgG antibody concentrations increased, and on day 12, animals showed early signs of recovery. These results define early events occurring in an inhalational macaque monkeypox infection model, supporting its use as a surrogate model for human smallpox. Bioterrorism poses a major threat to public health, as the deliberate release of infectious agents, such smallpox or a related virus, monkeypox, would have catastrophic consequences. The development and testing of new medical countermeasures, e.g., vaccines, are thus priorities; however, tests for efficacy in humans cannot be performed because it would be unethical and

  19. Virtual autopsy: two- and three-dimensional multidetector CT findings in drowning with autopsy comparison.

    Science.gov (United States)

    Levy, Angela D; Harcke, H Theodore; Getz, John M; Mallak, Craig T; Caruso, James L; Pearse, Lisa; Frazier, Aletta A; Galvin, Jeffrey R

    2007-06-01

    To retrospectively determine the multidetector computed tomographic (CT) virtual autopsy findings of death by drowning in comparison with autopsy findings. The institutional review board of the Armed Forces Institute of Pathology approved this HIPAA-compliant study and did not require informed consent by the next of kin. Total-body multidetector CT was performed, immediately prior to routine autopsy, in 28 consecutive male subjects (mean age, 24.2 years) who died of drowning and a control group of 12 consecutive male subjects (mean age, 50.8 years) who died of sudden death from atherosclerotic coronary artery disease. Images were evaluated for the presence of fluid and sediment in the paranasal sinuses and airways, mastoid air cell fluid, frothy fluid in the airways, pulmonary opacity (ground-glass opacity or airspace consolidation), interlobular septal thickening, and gastric distention and contents (fluid or sediment). Image findings were compared with findings from autopsy reports and photographs. All drowning subjects had fluid in the paranasal sinuses and mastoid air cells and had ground-glass opacity within the lungs. Twenty-six subjects (93%) had fluid in the subglottic trachea and main bronchi. Fourteen subjects (50%) had high-attenuation sediment in the subglottic airways. Frothy fluid in the airways was present in six subjects (21%). Twenty-five (89%) of the drowning subjects had pulmonary ground-glass opacity with septal lines, which was mild with apical and perihilar distribution in 12 subjects, severe and diffuse in nine, posterior and basilar in three, and limited to the apices in one (not assessed in three of 28 subjects because of decomposition). Control subjects showed mastoid cell fluid (25%), sinus fluid (83%), subglottic airway fluid (92%), and pulmonary ground-glass opacity (100%) but did not have evidence of frothy airway fluid or high-attenuation sediment in the airways. The multidetector CT finding of frothy airway fluid or high

  20. Inhibition of urethane-induced genotoxicity and cell proliferation in CYP2E1-null mice

    Energy Technology Data Exchange (ETDEWEB)

    Hoffler, Undi [Department of Pharmacology, Meharry Medical College, Nashville, TN (United States); Laboratory of Pharmacology and Chemistry, National Institute of Environmental Health Sciences, National Institute of Health, Research Triangle Park, NC 27709 (United States); Dixon, Darlene [Laboratory of Experimental Pathology, National Institute of Environmental Health Sciences, National Institute of Health, Research Triangle Park, NC 27709 (United States); Peddada, Shyamal [Biostatics Branch, National Institute of Environmental Health Sciences, National Institute of Health, Research Triangle Park, NC 27709 (United States); Ghanayem, Burhan I. [Department of Pharmacology, Meharry Medical College, Nashville, TN (United States) and Laboratory of Pharmacology and Chemistry, National Institute of Environmental Health Sciences, National Institute of Health, Research Triangle Park, NC 27709 (United States)]. E-mail: ghanayem@niehs.nih.gov

    2005-05-02

    Urethane is a multi-site animal carcinogen and was classified as 'reasonably anticipated to be a human carcinogen.' Urethane is a fermentation by-product and found at appreciable levels in alcoholic beverages and foods such as bread and cheese. Recent work in this laboratory demonstrated for the first time that CYP2E1 is the principal enzyme responsible for urethane metabolism. The current studies were undertaken to assess the relationships between CYP2E1-mediated metabolism and urethane-induced genotoxicity and cell proliferation as determined by induction of micronucleated erythrocytes (MN) and expression of Ki-67, respectively, using CYP2E1-null and wild-type mice. Urethane was administered at 0 (vehicle), 1, 10, or 100 mg/kg/day (p.o.), 5 days/week for 6 weeks. A significant dose-dependent increase in MN was observed in wild-type mice; however, a slight increase was measured in the MN-polychromatic erythrocytes in CYP2E1-null mice treated with 100 mg/kg. A significant increase in the expression of Ki-67 was detected in the livers and the lungs (terminal bronchioles, alveoli, and bronchi) of wild-type mice administered 100 mg urethane/kg in comparison to controls. In contrast, CYP2E1-null mice administered this dose exhibited negligible alterations in Ki-67 expression in the livers and lungs compared to controls. Interestingly, while Ki-67 expression in the forestomach decreased in wild-type mice, it increased in CYP2E1-null mice. Subsequent comparative metabolism studies demonstrated that total urethane-derived radioactivity in the plasma, liver, and lung was significantly higher in CYP2E1-null versus wild-type mice and un-metabolized urethane constituted greater than 83% of the radioactivity in CYP2E1-null mice. Un-metabolized urethane was not detectable in the plasma, liver, and lung of wild-type mice. In conclusion, these data demonstrated that CYP2E1-mediated metabolism of urethane, presumably via epoxide formation, is necessary for the induction

  1. Respiratory squamous cell carcinomas in vibroacoustic disease.

    Science.gov (United States)

    Reis Ferreira, José; Mendes, Carla P; Alves-Pereira, Mariana; Castelo Branco, Nuno A A

    2006-01-01

    In 1987, the autopsy of a vibroacoustic disease (VAD) patient disclosed two tumours: a renal cell carcinoma and a malignant glioma in the brain. Since 1987, malignancy in VAD patients has been under close surveillance. To date, in a universe of 945 individuals, there are 46 cases of malignancies, of which 11 are multiple. Of the 11 cases of respiratory tract tumours, all were squamous cell carcinomas (SqCC). This report focuses on the morphological features of these tumours. Tumour fragments were collected (endoscopic biopsy or surgery) from 11 male VAD patients (ave. age: 58+/-9 years, 3 non-smokers): 2 in glottis and 9 in the lung. In the 3 non-smokers, 2 had lung tumours and 1 had a glottis tumour. All were employed as or retired aircraft technicians, military or commercial pilots. Fragments were fixed either for light and electron microscopy. Immunohistochemistry studies used chromagranine and synaptophysine staining. All lung tumours were located in the upper right lobe bronchi and were histologically poorly differentiated SqCC (Figs. 1, 2). The search with neuroendocrine markers was negative. The average age of tumour onset in helicopter pilots was below 50 years old while for the other professional groups it was above 50. Nine patients are deceased. The 2 surviving patients are heavy smokers (> 2 packs/day). Smoking habits had no influence on tumour outcome and progression. Epidemiological studies indicate that squamous cell carcinomas account for approximately 40% of all lung tumours in men. It seems to be highly relevant that all VAD patient respiratory tract tumours are squamous cell carcinomas. It is not surprising that helicopter pilots are the ones who are affected the earliest because previous studies have shown that helicopter pilots exhibited the highest values for the frequency of sister chromatid exchanges. Generally, epidemiological tumor studies do not take histological tumor type into account, but given the results herein, it would seem of the

  2. Particulate Concentration Levels in Chinatown, Oakland, California

    Science.gov (United States)

    Chen, B.; Yeung, A.; Yu, J. F.

    2007-12-01

    Chinatown is located near the center of the busy business district of downtown Oakland, California. It is one of the most inhabited and congested areas in the City of Oakland, averaging 4,000 vehicles and 3,000 pedestrians per hour at a key intersection in the center of the neighborhood. Particles produced by automobiles and construction can settle into the bronchi of lungs and induce asthma attacks, irritate cardiovascular tissue, and possibly lead to lung cancer and death. Particulate pollution is a serious problem that is estimated to cause between 20,000 and 50,000 deaths per year in the US alone. Hence, evaluation of the air quality of the Chinatown neighborhood is important, because it helps to address issues that are of great concern to residents of the area. The primary goal of our project was to measure particulate concentration levels at various intersections in Oakland's Chinatown to determine if the air quality met U.S. EPA standards, and to take note of any trends that may occur over a period of months. We were primarily concerned with particles that are 2.5 micrometers diameter and smaller, as smaller particles are easily inhaled and directly affect the respiratory system. We were interested in identifying any intersections that may have had significantly higher levels than other intersections. Using a map of Chinatown, we chose 12 intersections and made measurements at these points over the course of six months, beginning in February and ending in July of 2007. Particulate matter measurements were made using a FLUKE 893 Particle Counter. Measurements recorded on the first day of our study, February 4, 2007, which was the day of an annual street festival, yielded the highest values for particulate matter concentration in our dataset. This was followed by a significant drop in concentration the following week, and then a gradual increase of concentration as the months progressed. No one location yielded values significantly higher than any other, and

  3. [The new possibility for the treatment of acute cough].

    Science.gov (United States)

    Klyachkina, I L

    2015-01-01

    Acute cough associated with influenza and acute respiratory viral infection (ARVI) is one of the most common complaints prompting the patient to visit a general practitioner or an otorhinolaryngologist based at the outpatient clinic. Acute cough during ARVI in the practically healthy subjects is as a rule non-productive, frequently dry, and becomes resolved within 2-3 weeks. In certain cases, however, the cough during ARVI can be productive with the well apparent abnormal expectoration of sputum especially in the aged and elderly subjects, young children, and patients suffering from the chest injuries, dry pleuritis, and other disorders. The early prescription of mucoactive preparations can prevent the development of subacute cough. In such cases, it is recommended to use the mucokinetic ambroxol that improves the mucociliary clearance (MCC) and does not require strong exertion for sputum expectoration. An important aspect in the mechanism of action of ambroxol is the stimulation of surfactant production, antioxidation effect, the improvement of rheological properties of bronchial mucus, ant-inflammatory and antiviral effects. The application of the new pharmaceutical dose form of ambroxol, neo-bronchol (orally disintegrating tablets), produces a very rapid effect (within 1 day after the intake) due to the fast absorption of this medication in the oral cavity, its rapid penetration into the circulatory system and achievement of the high concentration in blood plasma. The volatile metabolites of ambroxol that form as a result of tablet disintegration, such as ambroxol itself, menthol, and cineol, exert the mucolytic, antiseptic, and antibacterial actions, after they reach the trachea and bronchi. Irrigation of the receptors present in the inflamed mucous membrane of the larynx, pharynx, and nasal cavity, with these volatile substances produces an immediate cough-suppressive effect. It is concluded that the preparations of neo-bronchol (orally disintegrating tablets

  4. Aspergillus-associated hypersensitivity respiratory disorders.

    Science.gov (United States)

    Shah, Ashok

    2008-01-01

    The mould Aspergillus is responsible for a gamut of respiratory diseases ranging from saprobic colonisation to rapidly invasive disseminated disease. The clinical spectrum of Aspergillus-associated hypersensitivity respiratory disorders includes Aspergillus induced asthma, allergic bronchopulmonary aspergillosis (ABPA), allergic Aspergillus sinusitis (AAS) and hypersensitivity pneumonitis. Inhalant allergens, in patients with allergic asthma, play a key role in bringing about the inflammation present in the airways, and fungi are increasingly being recognised as important inhalant allergens. Aspergillus is linked to asthma in more ways than one. In the asthmatic subjects, the fungal spores are trapped in the thick and viscid secretions that are usually present in the airways. This generally develops in atopic subjects and is sustained by continuous inhalation of Aspergillus antigens, triggering asthma that may be more severe in form. Aspergillus induced asthma is yet to receive the recognition that it deserves. Allergic bronchopulmonary aspergillosis is the best known form of allergic aspergillosis and is an emerging disease in India. An immunologically mediated lung disease, ABPA occurs predominantly in patients with asthma. A set of diagnostic criteria is required as there is no single test that establishes the diagnosis apart from demonstration of central bronchiectasis with normal tapering bronchi, a feature considered to be pathognomonic of ABPA. Radiologically, ABPA is characterised by 'transient pulmonary infiltrates' or 'fleeting shadows', often confused with pulmonary tuberculosis. A comparatively more recently recognised clinical entity, AAS is characterised by mucoid impaction in the paranasal sinuses which is akin to that in ABPA. Although it appears that the patient with ABPA provides a favourable milieu for the occurrence of AAS, it is perhaps surprising that in spite of similar histopathological features the co-existence of both these diseases has

  5. Regional bronchodilator response assessed by computed tomography in chronic obstructive pulmonary disease

    Energy Technology Data Exchange (ETDEWEB)

    Shimizu, Kaoruko; Makita, Hironi; Hasegawa, Masaru; Kimura, Hirokazu; Fuke, Satoshi; Nagai, Katsura; Yoshida, Takayuki; Suzuki, Masaru; Konno, Satoshi [First Department of Medicine, Hokkaido University School of Medicine, N-15 W-7, Kita-Ku, Sapporo 060-8638 (Japan); Ito, Yoichi M. [Department of Biostatistics, Hokkaido University Graduate School of Medicine, N-15 W-7, Kita-Ku, Sapporo 060-8638 (Japan); Nishimura, Masaharu, E-mail: ma-nishi@med.hokudai.ac.jp [First Department of Medicine, Hokkaido University School of Medicine, N-15 W-7, Kita-Ku, Sapporo 060-8638 (Japan)

    2015-06-15

    Background and objective: The reliability of CT assessment of regional bronchodilation is not universally accepted. In this study, using our proprietary 3D-CT software, we first examined airway inner luminal area (Ai) before and after inhalation of SFC in a group of COPD patients and then evaluated the same parameters for two sets of CT data obtained from clinically stable subjects with no intervention. Methods: We conducted CT at deep inspiration and pulmonary function tests before and one week after inhalation of SFC in 23 COPD patients. As a non-intervention group, we used two sets of CT data obtained with one-year interval in another group of subjects who demonstrated stable pulmonary function (n = 8). We measured Ai at the mid-portions of 3rd to 6th generation in 8 bronchi of the right lung, a total of 32 identical sites before and after intervention. Results: The average bronchodilation at all sites (ΔAi%: 28.2 ± 4.1 (SE)%) (r = 0.65, p < 0.001) and that of each generation significantly correlated with % improvement of FEV1 (ΔFEV1%), which increased from 1.40 ± 0.10 L to 1.58 ± 0.10 L. When subjects were classified into two groups in terms of mean ΔFEV1%, even the poor responders (ΔFEV1% <14% above baseline, n = 13) displayed significantly larger ΔAi% compared with the non-intervention group (19.1 ± 4.6% versus 2.1 ± 3.9%). Inter-observer variability for overall ΔAi% was within acceptable levels. Conclusions: CT can reliably detect the regional bronchodilation in 3rd to 6th generation airways when ΔFEV1 is as small as 180 ml on average. This study was registered in the UMIN Clinical Trials Registry (UMIN-CTR) system ( (http://www.umin.ac.jp/). No. UMIN 000002668)

  6. Efficacy and safety of moxifloxacin in acute exacerbations of chronic bronchitis: a prospective, multicenter, observational study (AVANTI

    Directory of Open Access Journals (Sweden)

    Chuchalin Alexander

    2013-01-01

    Full Text Available Abstract Background Acute exacerbations of chronic bronchitis (AECB, including chronic obstructive pulmonary disease (AECOPD, represent a substantial patient burden. Few data exist on outpatient antibiotic management for AECB/AECOPD in Eastern/South Eastern Europe, in particular on the use of moxifloxacin (Avelox®, although moxifloxacin is widely approved in this region based on evidence from international clinical studies. Methods AVANTI (AVelox® in Acute Exacerbations of chroNic bronchiTIs was a prospective, observational study conducted in eight Eastern European countries in patients > 35 years with AECB/AECOPD to whom moxifloxacin was prescribed. In addition to safety and efficacy outcomes, data on risk factors and the impact of exacerbation on daily life were collected. Results In the efficacy population (N = 2536, chronic bronchitis had been prevalent for > 10 years in 31.4% of patients and 66.0% of patients had concomitant COPD. Almost half the patients had never smoked, in contrast to data from Western Europe and the USA, where only one-quarter of COPD patients are non-smokers. The mean number of exacerbations in the last 12 months was 2.7 and 26.3% of patients had been hospitalized at least once for exacerbation. Physician compliance with the recommended moxifloxacin dose (400 mg once daily was 99.6%. The mean duration of moxifloxacin therapy for the current exacerbation (Anthonisen type I or II in 83.1%; predominantly type I was 6.4 ± 1.9 days. Symptom improvement was reported after a mean of 3.4 ± 1.4 days. After 5 days, 93.2% of patients reported improvement and, in total, 93.5% of patients were symptom-free after 10 days. In the safety population (N = 2672, 57 (2.3% patients had treatment-emergent adverse events (TEAEs and 4 (0.15% had serious TEAEs; no deaths occurred. These results are in line with the known safety profile of moxifloxacin. Conclusions A significant number of patients in this

  7. The Impact of Local and Regional Disease Extent on Overall Survival in Patients With Advanced Stage IIIB/IV Non-Small Cell Lung Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Higginson, Daniel S., E-mail: daniel.higginson@gmail.com [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Chen, Ronald C.; Tracton, Gregg; Morris, David E.; Halle, Jan; Rosenman, Julian G.; Stefanescu, Mihaela; Pham, Erica [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Socinski, Mark A. [Department of Medicine, Division of Hematology and Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Marks, Lawrence B. [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States)

    2012-11-01

    Purpose: Patients with advanced stage IIIB or stage IV non-small cell lung carcinoma are typically treated with initial platinum-based chemotherapy. A variety of factors (eg, performance status, gender, age, histology, weight loss, and smoking history) are generally accepted as predictors of overall survival. Because uncontrolled pulmonary disease constitutes a major cause of death in these patients, we hypothesized that clinical and radiographic factors related to intrathoracic disease at diagnosis may be prognostically significant in addition to conventional factors. The results have implications regarding the selection of patients for whom palliative thoracic radiation therapy may be of most benefit. Methods and Materials: We conducted a pooled analysis of 189 patients enrolled at a single institution into 9 prospective phase II and III clinical trials involving first-line, platinum-based chemotherapy. Baseline clinical and radiographic characteristics before trial enrollment were analyzed as possible predictors for subsequent overall survival. To assess the relationship between anatomic location and volume of disease within the thorax and its effect on survival, the pre-enrollment computed tomography images were also analyzed by contouring central and peripheral intrapulmonary disease. Results: On univariate survival analysis, multiple pulmonary-related factors were significantly associated with worse overall survival, including pulmonary symptoms at presentation (P=.0046), total volume of intrathoracic disease (P=.0006), and evidence of obstruction of major bronchi or vessels on prechemotherapy computed tomography (P<.0001). When partitioned into central and peripheral volumes, central (P<.0001) but not peripheral (P=.74) disease was associated with worse survival. On multivariate analysis with known factors, pulmonary symptoms (hazard ratio, 1.46; P=.042), central disease volume (hazard ratio, 1.47; P=.042), and bronchial/vascular compression (hazard ratio, 1

  8. Immunomodulation of afferent neurons in guinea-pig isolated airway.

    Science.gov (United States)

    Riccio, M M; Myers, A C; Undem, B J

    1996-01-01

    1. The trachea, larynx and main bronchi with the right vagus nerve and nodose ganglion were isolated from guinea-pigs passively immunized 24 h previously with serum containing anti-ovalbumin antibody. 2. The airways were placed in one compartment of a Perspex chamber for recording of isometric tension while the nodose ganglion and attached vagus nerve were pulled into another compartment. Action potentials arriving from single airway afferent nerve endings were monitored extracellularly using a glass microelectrode positioned near neuronal cell bodies in the ganglion. Mechanosensitivity of the nerve endings was quantified using calibrated von Frey filaments immediately before and after exposure to antigen (10 micrograms ml-1 ovalbumin). 3. Ten endings responded to the force exerted by the lowest filament (0.078 mN) and were not further investigated. In airways from thirteen immunized guinea-pigs, the mechanical sensitivity of A delta afferent fibres (conduction velocity = 4.3 +/- 0.6 m s-1) was enhanced 4.1 +/- 0.9-fold following airway exposure to antigen (P afferent fibres (conduction velocity = 4.3 +/- 0.6 m s-1) from non-immunized control guinea-pig airways were unaffected by antigen (n = 13). 4. Antigen did not overtly cause action potential generation except in one instance when the receptive field was located over the smooth muscle. This ending also responded to methacholine suggesting that spatial changes in the receptive field, induced by muscle contraction, were responsible for the activation. 5. The mediators responsible for these effects are unknown, although histamine, prostaglandins, leukotrienes and tachykinins do not appear to be essential. The increase in mechanical responsiveness was not associated with the smooth muscle contraction since leukotriene C4, histamine and tachykinins, which all caused a similar contraction to antigen, did not affect mechanical thresholds. Moreover, the antigen-induced increases in excitability persisted beyond the

  9. Evolution of surface-based deformable image registration for adaptive radiotherapy of non-small cell lung cancer (NSCLC

    Directory of Open Access Journals (Sweden)

    Richter Anne

    2009-12-01

    Full Text Available Abstract Background To evaluate the performance of surface-based deformable image registration (DR for adaptive radiotherapy of non-small cell lung cancer (NSCLC. Methods Based on 13 patients with locally advanced NSCLC, CT images acquired at treatment planning, midway and the end of the radio- (n = 1 or radiochemotherapy (n = 12 course were used for evaluation of DR. All CT images were manually [gross tumor volume (GTV] and automatically [organs-at-risk (OAR lung, spinal cord, vertebral spine, trachea, aorta, outline] segmented. Contours were transformed into 3D meshes using the Pinnacle treatment planning system and corresponding mesh points defined control points for DR with interpolation within the structures. Using these deformation maps, follow-up CT images were transformed into the planning images and compared with the original planning CT images. Results A progressive tumor shrinkage was observed with median GTV volumes of 170 cm3 (range 42 cm3 - 353 cm3, 124 cm3 (19 cm3 - 325 cm3 and 100 cm3 (10 cm3 - 270 cm3 at treatment planning, mid-way and at the end of treatment. Without DR, correlation coefficients (CC were 0.76 ± 0.11 and 0.74 ± 0.10 for comparison of the planning CT and the CT images acquired mid-way and at the end of treatment, respectively; DR significantly improved the CC to 0.88 ± 0.03 and 0.86 ± 0.05 (p = 0.001, respectively. With manual landmark registration as reference, DR reduced uncertainties on the GTV surface from 11.8 mm ± 5.1 mm to 2.9 mm ± 1.2 mm. Regarding the carina and intrapulmonary vessel bifurcations, DR reduced uncertainties by about 40% with residual errors of 4 mm to 6 mm on average. Severe deformation artefacts were observed in patients with resolving atelectasis and pleural effusion, in one patient, where the tumor was located around large bronchi and separate segmentation of the GTV and OARs was not possible, and in one patient, where no clear shrinkage but more a decay of the tumor was observed

  10. Nanomechanical assessment of human and murine collagen fibrils via atomic force microscopy cantilever-based nanoindentation.

    Science.gov (United States)

    Andriotis, Orestis G; Manuyakorn, Wiparat; Zekonyte, Jurgita; Katsamenis, Orestis L; Fabri, Sebastien; Howarth, Peter H; Davies, Donna E; Thurner, Philipp J

    2014-11-01

    The nanomechanical assessment of collagen fibrils via atomic force microscopy (AFM) is of increasing interest within the biomedical research community. In contrast to conventional nanoindentation there exists no common standard for conducting experiments and analysis of data. Currently used analysis approaches vary between studies and validation of quantitative results is usually not performed, which makes comparison of data from different studies difficult. Also there are no recommendations with regards to the maximum indentation depth that should not be exceeded to avoid substrate effects. Here we present a methodology and analysis approach for AFM cantilever-based nanoindentation experiments that allows efficient use of captured data and relying on a reference sample for determination of tip shape. Further we show experimental evidence that maximum indentation depth on collagen fibrils should be lower than 10-15% of the height of the fibril to avoid substrate effects and we show comparisons between our and other approaches used in previous works. While our analysis approach yields similar values for indentation modulus compared to the Oliver-Pharr method we found that Hertzian analysis yielded significantly lower values. Applying our approach we successfully and efficiently indented collagen fibrils from human bronchi, which were about 30 nm in size, considerably smaller compared to collagen fibrils obtained from murine tail-tendon. In addition, derived mechanical parameters of collagen fibrils are in agreement with data previously published. To establish a quantitative validation we compared indentation results from conventional and AFM cantilever-based nanoindentation on polymeric samples with known mechanical properties. Importantly we can show that our approach yields similar results when compared to conventional nanoindentation on polymer samples. Introducing an approach that is reliable, efficient and taking into account the AFM tip shape, we anticipate

  11. The clinical and integrated management of COPD. An official document of AIMAR (Interdisciplinary Association for Research in Lung Disease), AIPO (Italian Association of Hospital Pulmonologists), SIMER (Italian Society of Respiratory Medicine), SIMG (Italian Society of General Medicine).

    Science.gov (United States)

    Bettoncelli, Germano; Blasi, Francesco; Brusasco, Vito; Centanni, Stefano; Corrado, Antonio; De Benedetto, Fernando; De Michele, Fausto; Di Maria, Giuseppe U; Donner, Claudio F; Falcone, Franco; Mereu, Carlo; Nardini, Stefano; Pasqua, Franco; Polverino, Mario; Rossi, Andrea; Sanguinetti, Claudio M

    2014-01-01

    COPD is a chronic pathological condition of the respiratory system characterized by persistent and partially reversible airflow obstruction, to which variably contribute remodeling of bronchi (chronic bronchitis), bronchioles (small airway disease) and lung parenchyma (pulmonary emphysema). COPD can cause important systemic effects and be associated with complications and comorbidities. The diagnosis of COPD is based on the presence of respiratory symptoms and/or a history of exposure to risk factors, and the demonstration of airflow obstruction by spirometry. GARD of WHO has defined COPD "a preventable and treatable disease". The integration among general practitioner, chest physician as well as other specialists, whenever required, assures the best management of the COPD person, when specific targets to be achieved are well defined in a diagnostic and therapeutic route, previously designed and shared with appropriateness. The first-line pharmacologic treatment of COPD is represented by inhaled long-acting bronchodilators. In symptomatic patients, with pre-bronchodilator FEV1 treatment. Long term oxygen therapy (LTOT) is indicated in stable patients, at rest while receiving the best possible treatment, and exhibiting a PaO2 ≤ 55 mmHg (SO2  55%. Respiratory rehabilitation is addressed to patients with chronic respiratory disease in all stages of severity who report symptoms and limitation of their daily activity. It must be integrated in an individual patient tailored treatment as it improves dyspnea, exercise performance, and quality of life. Acute exacerbation of COPD is a sudden worsening of usual symptoms in a person with COPD, over and beyond normal daily variability that requires treatment modification. The pharmacologic therapy can be applied at home and includes the administration of drugs used during the stable phase by increasing the dose or modifying the route, and adding, whenever required, drugs as antibiotics or systemic corticosteroids. In

  12. The clinical and integrated management of COPD.

    Science.gov (United States)

    Bettoncelli, G; Blasi, F; Brusasco, V; Centanni, S; Corrado, A; De Benedetto, F; De Michele, F; Di Maria, G U; Donner, C F; Falcone, F; Mereu, C; Nardini, S; Pasqua, F; Polverino, M; Rossi, A; Sanguinetti, C M

    2014-05-12

    COPD is a chronic pathological condition of the respiratory system characterized by persistent and partially reversible airflow obstruction, to which variably contribute remodeling of bronchi (chronic bronchitis), bronchioles (small airway disease) and lung parenchyma (pulmonary emphysema). COPD can cause important systemic effects and be associated with complications and comorbidities. The diagnosis of COPD is based on the presence of respiratory symptoms and/or a history of exposure to risk factors, and the demonstration of airflow obstruction by spirometry. GARD of WHO has defined COPD "a preventable and treatable disease". The integration among general practitioner, chest physician as well as other specialists, whenever required, assures the best management of the COPD person, when specific targets to be achieved are well defined in a diagnostic and therapeutic route, previously designed and shared with appropriateness. The first-line pharmacologic treatment of COPD is represented by inhaled long-acting bronchodilators. In symptomatic patients, with pre-bronchodilator FEV1 treatment. Long term oxygen therapy (LTOT) is indicated in stable patients, at rest while receiving the best possible treatment, and exhibiting a PaO2 ≤ 55 mmHg (SO2 55%. Respiratory rehabilitation is addressed to patients with chronic respiratory disease in all stages of severity who report symptoms and limitation of their daily activity. It must be integrated in an individual patient tailored treatment as it improves dyspnea, exercise performance, and quality of life. Acute exacerbation of COPD is a sudden worsening of usual symptoms in a person with COPD, over and beyond normal daily variability that requires treatment modification. The pharmacologic therapy can be applied at home and includes the administration of drugs used during the stable phase by increasing the dose or modifying the route, and adding, whenever required, drugs as antibiotics or systemic corticosteroids. In case of

  13. SQUAMOUS CELL CARCINOMA OF THE HEAD AND NECK: NEW AVENUES OF TREATMENT?

    Directory of Open Access Journals (Sweden)

    T. Braunschweig

    2013-01-01

    , e. g. FGF receptors, PTEN, PIK3CA. In a similar group of squamous cell carcinomas, those of the lower airways, trachea, bronchi and lung parenchyma, also massively caused by inhaled toxins, a subset of 20 % show these driver mutations. Tumors with driver mutations, especially related to tyrosin kinases and depending pathways are eligible for small molecule therapeutics, inhibitors of tyrosin kinases and signalling kinases, e. g. Erlotinib in EGF receptor or Vemurafininb for B-RAF. There is much need for further stratification of head and neck squamous cell carcinoma to introduce the wide field of inhibitors at least to a subset of these patients.

  14. Quantification and visualization of injury and regeneration in the developing ciliated epithelium using quantitative flow imaging and speckle variance optical coherence tomography (Conference Presentation)

    Science.gov (United States)

    Gamm, Ute A.; Huang, Brendan K.; Mis, Emily K.; Khokha, Mustafa K.; Choma, Michael A.

    2017-02-01

    Premature infants are at a high risk for respiratory diseases owing to an underdeveloped respiratory system that is very susceptible to infection and inflammation. One aspect of respiratory health is the state of the ciliated respiratory epithelium which lines the trachea and bronchi. The ciliated epithelium is responsible for trapping and removing pathogens and pollutants from the lungs and an impairment of ciliary functionality can lead to recurring respiratory infections and subsequent lung damage. Mechanisms of cilia-driven fluid flow itself but also factors influenced by development like ciliary density and flow generation are incompletely understood. Furthermore, medical interventions like intubation and accidental aspiration can lead to focal or diffuse loss of cilia and disruption of flow. In this study we use two animal models, Xenopus embryo and ex vivo mouse trachea, to analyze flow defects in the injured ciliated epithelium. Injury is generated either mechanically with a scalpel or chemically by calcium chloride (CaCl2) shock, which efficiently but reversibly deciliates the embryo skin. In this study we used optical coherence tomography (OCT) and particle tracking velocimetry (PTV) to quantify cilia driven fluid flow over the surface of the Xenopus embryo. We additionally visualized damage to the ciliated epithelium by capturing 3D speckle variance images that highlight beating cilia. Mechanical injury disrupted cilia-driven fluid flow over the injured site, which led to a reduction in cilia-driven fluid flow over the whole surface of the embryo (n=7). The calcium chloride shock protocol proved to be highly effective in deciliating embryos (n=6). 3D speckle variance images visualized a loss of cilia and cilia-driven flow was halted immediately after application. We also applied CaCl2-shock to cultured ex vivo mouse trachea (n=8) and found, similarly to effects in Xenopus embryo, an extensive loss of cilia with resulting cessation of flow. We

  15. Comparison of Macintosh and Intubrite laryngoscopes for intubation performed by novice physicians in a difficult airway scenario.

    Science.gov (United States)

    Szarpak, Lukasz; Smereka, Jacek; Ladny, Jerzy R

    2017-05-01

    In the difficult airway, the intubation skills are critically important. In selected cases, particularly in airway edema, laryngeal or tongue edema, endotracheal intubation can turn out very difficult, and repeated attempts may even worsen the airway edema, causing trauma and bleeding, and finally leading to complete airway obstruction and inability to ventilate the patient. The aim of the study was to compare the efficacy of endotracheal intubation performed by novice physicians using a standard Macintosh laryngoscope and an Intubrite videolaryngoscope. The study was designed as a prospective, randomized, crossover, simulation study and continues our research assessing the effectiveness of selected endotracheal intubation techniques in prehospital settings. All participants were experienced with the Macintosh direct laryngoscope but remained novice to videolaryngoscopy. Instructions on the correct use of the Macintosh and Intubrite laryngoscopes were given before the procedure, and all the 30 novice physicians were allowed to practice at least 10 times before the study on manikin with normal airways. We employed an airway manikin (Trucorp Airsim Bronchi; Trucorp Ltd., Belfast, Northern Ireland) to simulate difficult airway, with was obtained by inflating the tongue with 50mL of air. The participants were asked to perform tracheal intubation using an endotracheal tube with 7.5mm of internal diameter (Portex; Smiths Medical, Hythe, UK) through the vocal cords, applying either a conventional Macintosh laryngoscope with a size 3 blade (MAC; Mercury Medical, Clearwater, FL, USA) or the Intubrite videolaryngoscope, also with a Macintosh No. 3 blade (INT; Intubrite Llc, Vista, CA, USA). In both intubation techniques, a guide stylet (Rusch Inc., Duluth, GA, USA) was introduced into the endotracheal tube in order to obtain a C-shape curve to facilitate tracheal intubation. Each participating physician was randomly assigned to three attempts of tracheal intubation with each

  16. Genotoxic effects and oxidative stress induced by organic extracts of particulate matter(PM 10)collected from a subway tunnel in Seoul, Korea.

    Science.gov (United States)

    Jung, Mi Hyun; Kim, Ha Ryong; Park, Yong Joo; Park, Duck Shin; Chung, Kyu Hyuck; Oh, Seung Min

    2012-12-12

    Particulate matter (PM) has become an important health risk factor in our society. PM can easily deposit in the bronchi and lungs, causing diverse diseases such as respiratory infections, lung cancers and cardiovascular diseases. In recent days, more and more toxicological studies have been dealing with air particles in distinctive areas including industrial areas, transportation sites, or indoors. Studies on subway PM in particular, have been recognizing PM as an important health risk factor because many people use subways as a major mode of public transportation (4 million people a day in Korea). The main aim of the present study was to evaluate the genotoxic effects of organic extract (OE) of subway PM10 and potential attribution of PAHs to these effects. Particles were collected in the subway tunnel at Kil-eum station(Line 4) for one month and then extracted with Dichloromethane (DCM). Chinese Hamster Ovary cells(CHO-K1) and human normal bronchial cells (BEAS-2B) were exposed to OE, and MN and Comet assays were conducted to analyze the genotoxicity. The results showed that OE increased DNA or chromosome damages in both cell lines. In the modified Comet assay and MN assay with free radical scavengers, we confirmed that the genotoxic effect of OE was partially due to the oxidative damage on DNA. DCFHD Aassay also indicated that OE induced ROS generation in BEAS-2B cells. PAHs [benzo(a)anthracene,benzo(k)fluoranthrene, etc.], the most well-known carcinogens in polluted air, were detected in Kil-eum PM10. In conclusion, our findings confirmed that OE of subway PM10 has genotoxic effects on normal human lung cells, and oxidative stress could be one of the major mechanisms of these genotoxic effects.In addition, some genotoxic and carcinogenic PAHs were detected in OE by GC/MS/MS, even though PAHs level was not enough to increase CYP1A1 gene. Therefore, we suggest that additive or synergistic effects by unidentified chemicals as well as PAHs contained in OE of subway

  17. Inhalation toxicity of sulfuryl fluoride in rats and rabbits.

    Science.gov (United States)

    Eisenbrandt, D L; Nitschke, K D

    1989-04-01

    The inhalation toxicity of the structural fumigant sulfuryl fluoride (SO2F2) was evaluated in rats and rabbits. Exposures for a preliminary 2-week study were 6 hr/day, 5 days/week, to 0, 100, 300, or 600 ppm SO2F2. Nine of ten rats at 600 ppm died or were moribund between the second and sixth exposures. Extensive kidney lesions were present in all rats exposed to 600 ppm, whereas only minimal renal changes were noted in rats at 300 ppm. Upper and lower respiratory tissues were inflamed in the single rat that survived the 2-week exposure to 600 ppm. Rabbits exposed to 600 ppm SO2F2 were hyperactive and one animal had a convulsion. Exposure to 300 or 600 ppm for 2 weeks resulted in vacuolation and/or malacia in the cerebrum of all rabbits and most of these rabbits also had moderate inflammation of nasal tissues; a few rabbits at 600 ppm had inflammation of the trachea or bronchi. A subsequent 13-week study evaluated rats and rabbits exposed to 0, 30, 100, or 300 ppm SO2F2 (337 ppm TWA for rabbits). Rabbits initially were exposed to a high concentration of 600 ppm; however, convulsions were noted in two animals after nine exposures and the concentration subsequently was reduced to 300 ppm. Vacuolation and/or malacia were observed in the cerebrum of all rabbits at the highest concentration; one rabbit exposed to 100 ppm also had cerebral vacuolation. Rabbits at the highest concentration, as well as one rabbit exposed to 100 ppm, had inflammation of the nasal tissues. Rats exposed to 300 ppm SO2F2 for 13 weeks had mottled incisor teeth, minimal renal effects, pulmonary histiocytosis, inflammation of nasal tissues, and cerebral vacuolation. Also, rats exposed to 100 ppm SO2F2 for 13 weeks had mottled teeth. Fluoride toxicity was suggested by mottled teeth in rats as well as elevation of serum fluoride levels in rats and rabbits exposed to SO2F2 for 13 weeks. Although repeated exposure of rats and rabbits to 100-600 ppm SO2F2 resulted in toxicity of the kidneys (rats only

  18. Total artificial heart in the pediatric patient with biventricular heart failure.

    Science.gov (United States)

    Park, S S; Sanders, D B; Smith, B P; Ryan, J; Plasencia, J; Osborn, M B; Wellnitz, C M; Southard, R N; Pierce, C N; Arabia, F A; Lane, J; Frakes, D; Velez, D A; Pophal, S G; Nigro, J J

    2014-01-01

    Mechanical circulatory support emerged for the pediatric population in the late 1980s as a bridge to cardiac transplantation. The Total Artificial Heart (TAH-t) (SynCardia Systems Inc., Tuscon, AZ) has been approved for compassionate use by the Food and Drug Administration for patients with end-stage biventricular heart failure as a bridge to heart transplantation since 1985 and has had FDA approval since 2004. However, of the 1,061 patients placed on the TAH-t, only 21 (2%) were under the age 18. SynCardia Systems, Inc. recommends a minimum patient body surface area (BSA) of 1.7 m(2), thus, limiting pediatric application of this device. This unique case report shares this pediatric institution's first experience with the TAH-t. A 14-year-old male was admitted with dilated cardiomyopathy and severe biventricular heart failure. The patient rapidly decompensated, requiring extracorporeal life support. An echocardiogram revealed severe biventricular dysfunction and diffuse clot formation in the left ventricle and outflow tract. The decision was made to transition to biventricular assist device. The biventricular failure and clot formation helped guide the team to the TAH-t, in spite of a BSA (1.5 m(2)) below the recommendation of 1.7 m(2). A computed tomography (CT) scan of the thorax, in conjunction with a novel three-dimensional (3D) modeling system and team, assisted in determining appropriate fit. Chest CT and 3D modeling following implantation were utilized to determine all major vascular structures were unobstructed and the bronchi were open. The virtual 3D model confirmed appropriate device fit with no evidence of compression to the left pulmonary veins. The postoperative course was complicated by a left lung opacification. The left lung anomalies proved to be atelectasis and improved with aggressive recruitment maneuvers. The patient was supported for 11 days prior to transplantation. Chest CT and 3D modeling were crucial in assessing whether the device would

  19. The Relationships Between Weather and Climate and Attacks of Bronchitis

    Science.gov (United States)

    Talaia, M. A. R.; Saraiva, M. A. C.; Vieira da Cruz, A. A.

    The area of Aveiro, more concretely Aveiro lagoon, a natural laboratory has been con- sidered, for promoting the development and the application of several investigations worked. The importance of the influences of weather and climate on human health has been well known since ancient teams and many decisions concerning human be- haviour it are clearly weather related. However, decisions related to weather criteria can be important and economically significant, but the real economic effect of the weather is difficult to assess. Talaia et al. (2000) and Talaia and Vieira da Cruz (2001) have shown the possible harmful effect of certain meteorological factors on respiratory conditions. Bronchitis is a disease caused by inflammation of the bronchi as a result of infectious agents or air pollutants. In this study our attention is to relate, the be- ginning of bronchitis attacks in the services of urgency of the Hospital of Aveiro with meteorological factors, and the risk group are studied. We used the medical records and the database of meteorological factors. The obtained analysis allows to conclude that some meteorological factors have correlation with the occurrences of the disease and to allow improving the work in the urgency services in the requested periods. The knowledge that will be extracted of this study can be used later in studies that inte- grate other important components for the characterisation of the environmental impact in the area. References: Talaia, M.A.R., Vieira da Cruz, A.A., Saraiva, M.A.C., Amaro, G.S., Oliveira, C.J. and Carvalho, C.F., 2000, The Influence of Meteorological Fac- tors on Pneumonia Emergencies in Aveiro, International Symposium on Human- Biometeorology, St. Petersburg (Pushkin), Russia, pp. 67-68. Talaia, M.A.R. and Vieira of Cruz, A.A., (2001), Meteorological Effects on the Resistance of the Body to Influenza - One Study in Aveiro Region, Proceedings 2nd Symposium of Meteorol- ogy and Geophysics of APMG and 3rd Meeting

  20. Efficacy and safety of moxifloxacin in acute exacerbations of chronic bronchitis: a prospective, multicenter, observational study (AVANTI).

    Science.gov (United States)

    Chuchalin, Alexander; Zakharova, Maryna; Dokic, Dejan; Tokić, Mahir; Marschall, Hans-Peter; Petri, Thomas

    2013-01-23

    Acute exacerbations of chronic bronchitis (AECB), including chronic obstructive pulmonary disease (AECOPD), represent a substantial patient burden. Few data exist on outpatient antibiotic management for AECB/AECOPD in Eastern/South Eastern Europe, in particular on the use of moxifloxacin (Avelox®), although moxifloxacin is widely approved in this region based on evidence from international clinical studies. AVANTI (AVelox® in Acute Exacerbations of chroNic bronchiTIs) was a prospective, observational study conducted in eight Eastern European countries in patients > 35 years with AECB/AECOPD to whom moxifloxacin was prescribed. In addition to safety and efficacy outcomes, data on risk factors and the impact of exacerbation on daily life were collected. In the efficacy population (N = 2536), chronic bronchitis had been prevalent for > 10 years in 31.4% of patients and 66.0% of patients had concomitant COPD. Almost half the patients had never smoked, in contrast to data from Western Europe and the USA, where only one-quarter of COPD patients are non-smokers. The mean number of exacerbations in the last 12 months was 2.7 and 26.3% of patients had been hospitalized at least once for exacerbation. Physician compliance with the recommended moxifloxacin dose (400 mg once daily) was 99.6%. The mean duration of moxifloxacin therapy for the current exacerbation (Anthonisen type I or II in 83.1%; predominantly type I) was 6.4 ± 1.9 days. Symptom improvement was reported after a mean of 3.4 ± 1.4 days. After 5 days, 93.2% of patients reported improvement and, in total, 93.5% of patients were symptom-free after 10 days. In the safety population (N = 2672), 57 (2.3%) patients had treatment-emergent adverse events (TEAEs) and 4 (0.15%) had serious TEAEs; no deaths occurred. These results are in line with the known safety profile of moxifloxacin. A significant number of patients in this observational study had risk factors for poor outcome, justifying

  1. Evaluation of pharmacodynamic activities of EPs® 7630, a special extract from roots of Pelargonium sidoides, in animals models of cough, secretolytic activity and acute bronchitis.

    Science.gov (United States)

    Bao, Yanyan; Gao, Yingjie; Koch, Egon; Pan, Xin; Jin, Yahong; Cui, Xiaolan

    2015-04-15

    EPs(®) 7630 is a proprietary aqueous-ethanolic extract from roots of Pelargonium sidoides DC and has been demonstrated to dispose among others of antibacterial, antiviral, immunomodulatory, antioxidant, and tissue-protective activity. It is an approved medicinal product in more than 50 countries for the treatment of airway infections such as acute bronchitis, common cold, and sinusitis. While the pharmacological effects of EPs(®) 7630 have extensively been evaluated in diverse in vitro test systems, the number of publications reporting results from in vivo models is limited. In the present study antitussive, secretolytic, and anti-inflammatory effects of EPs(®) 7630 were assessed in animal experiments following oral administration at human equivalent doses. Antitussive effects were evaluated using ammonia- and citric acid-induced models of cough in mice (20, 40, 120 mg/kg) and guinea pigs (10, 20, 45 mg/kg), respectively. For the determination of secretolytic activity tracheobronchial secretion of intraperitoneally injected phenol red was determined in mice, while antiinflammatory action was assessed in an acute bacterial bronchitis model in rats. A significant and dose-dependent reduction of cough frequency was observed in both cough models, which was accompanied by a prolongation of cough latency time. Similarly, the extract exerted a marked secretolytic activity in mice. Induction of acute bacterial bronchitis caused characteristic histopathological changes in lung tissue adjacent to trachea and bronchi. The degree of these lesions was significantly reduced in rats treated with EPs(®) 7630 at doses of 30 and 60 mg/kg. This protective effect at least partially seems to be mediated by an up-regulation of superoxide dismutase and a subsequent protective effect against oxidative stress as indicated by a reduced serum level of malondialdehyde. The present data further support the therapeutic use of EPs(®) 7630 in respiratory tract infections and provide a basis

  2. Similarity of Crocodilian and Avian Lungs Indicates Unidirectional Flow Is Ancestral for Archosaurs.

    Science.gov (United States)

    Farmer, C G

    2015-12-01

    Patterns of airflow and pulmonary anatomy were studied in the American alligator (Alligator mississippiensis), the black caiman (Melanosuchus niger), the spectacled caiman (Caiman crocodilus), the dwarf crocodile (Osteolaemus tetraspis), the saltwater crocodile (Crocodylus porosus), the Nile crocodile (Crocodylus niloticus), and Morelet's crocodile (Crocodylus moreletii). In addition, anatomy was studied in the Orinoco crocodile (Crocodylus intermedius). Airflow was measured using heated thermistor flow meters and visualized by endoscopy during insufflation of aerosolized propolene glycol and glycerol. Computed tomography and gross dissection were used to visualize the anatomy. In all species studied a bird-like pattern of unidirectional flow was present, in which air flowed caudad in the cervical ventral bronchus and its branches during both lung inflation and deflation and craniad in dorsobronchi and their branches. Tubular pathways connected the secondary bronchi to each other and allowed air to flow from the dorsobronchi into the ventrobronchi. No evidence for anatomical valves was found, suggesting that aerodynamic valves cause the unidirectional flow. In vivo data from the American alligator showed that unidirectional flow is present during periods of breath-holding (apnea) and is powered by the beating heart, suggesting that this pattern of flow harnesses the heart as a pump for air. Unidirectional flow may also facilitate washout of stale gases from the lung, reducing the cost of breathing, respiratory evaporative water loss, heat loss through the heat of vaporization, and facilitating crypsis. The similarity in structure and function of the bird lung with pulmonary anatomy of this broad range of crocodilian species indicates that a similar morphology and pattern of unidirectional flow were present in the lungs of the common ancestor of crocodilians and birds. These data suggest a paradigm shift is needed in our understanding of the evolution of this

  3. MO-AB-BRA-09: Temporally Realistic Manipulation a 4D Biomechanical Lung Phantom for Evaluation of Simultaneous Registration and Segmentation

    Energy Technology Data Exchange (ETDEWEB)

    Markel, D; Levesque, I R.; Larkin, J; Leger, P; El Naqa, I [McGill University, Montreal, QC (Canada)

    2015-06-15

    Purpose: To produce multi-modality compatible, realistic datasets for the joint evaluation of segmentation and registration with a reliable ground truth using a 4D biomechanical lung phantom. The further development of a computer controlled air flow system for recreation of real patient breathing patterns is incorporated for additional evaluation of motion prediction algorithms. Methods: A pair of preserved porcine lungs was pneumatically manipulated using an in-house computer controlled respirator. The respirator consisted of a set of bellows actuated by a 186 W computer controlled industrial motor. Patient breathing traces were recorded using a respiratory bellows belt during CT simulation and input into a control program incorporating a proportional-integral-derivative (PID) feedback controller in LabVIEW. Mock tumors were created using dual compartment vacuum sealed sea sponges. 65% iohexol,a gadolinium-based contrast agent and 18F-FDG were used to produce contrast and thus determine a segmentation ground truth. The intensity distributions of the compartments were then digitally matched for the final dataset. A bifurcation tracking pipeline provided a registration ground truth using the bronchi of the lung. The lungs were scanned using a GE Discovery-ST PET/CT scanner and a Phillips Panorama 0.23T MRI using a T1 weighted 3D fast field echo (FFE) protocol. Results: The standard deviation of the error between the patient breathing trace and the encoder feedback from the respirator was found to be ±4.2%. Bifurcation tracking error using CT (0.97×0.97×3.27 mm{sup 3} resolution) was found to be sub-voxel up to 7.8 cm displacement for human lungs and less than 1.32 voxel widths in any axis up to 2.3 cm for the porcine lungs. Conclusion: An MRI/PET/CT compatible anatomically and temporally realistic swine lung phantom was developed for the evaluation of simultaneous registration and segmentation algorithms. With the addition of custom software and mock tumors, the

  4. Heterosubtypic immunity to H7N9 influenza virus in isogenic guinea pigs after infection with pandemic H1N1 virus.

    Science.gov (United States)

    Wiersma, Lidewij C M; Vogelzang-van Trierum, Stella E; Kreijtz, Joost H C M; van Amerongen, Geert; van Run, Peter; Ladwig, Mechtild; Banneke, Stefanie; Schaefer, Hubert; Fouchier, Ron A M; Kuiken, Thijs; Osterhaus, Albert D M E; Rimmelzwaan, Guus F

    2015-12-08

    Heterosubtypic immunity is defined as immune-mediated (partial) protection against an influenza virus induced by an influenza virus of another subtype to which the host has not previously been exposed. This cross-protective effect has not yet been demonstrated to the newly emerging avian influenza A viruses of the H7N9 subtype. Here, we assessed the induction of protective immunity to these viruses by infection with A(H1N1)pdm09 virus in a newly developed guinea pig model. To this end, ten female 12-16 week old strain 2 guinea pigs were inoculated intratracheally with either A(H1N1)pdm09 influenza virus or PBS (unprimed controls) followed 4 weeks later with an A/H7N9 influenza virus challenge. Nasal swabs were taken daily and animals from both groups were sacrificed on days 2 and 7 post inoculation (p.i.) with A/H7N9 virus and full necropsies were performed. Nasal virus excretion persisted until day 7 in unprimed control animals, whereas only two out of seven H1N1pdm09-primed animals excreted virus via the nose. Infectious virus was recovered from nasal turbinates, trachea and lung of all animals at day 2 p.i., but titers were lower for H1N1pdm09-primed animals, especially in the nasal turbinates. By day 7 p.i., relatively high virus titers were found in the nasal turbinates of all unprimed control animals but infectious virus was isolated from the nose of only one of four H1N1pdm09-primed animals. Animals of both groups developed inflammation of variable severity in the entire respiratory tract. Viral antigen positive cells were demonstrated in the nasal epithelium of both groups at day 2. The bronchi(oli) and alveoli of unprimed animals showed a moderate to strong positive signal at day 2, whereas H1N1pdm09-primed animals showed only minimal positivity. By day 7, only viral antigen positive cells were found after H7N9 virus infection in the nasal turbinates and the lungs of unprimed controls. Thus infection with H1N1pdm09 virus induced partially protective

  5. [Effects of cytosine-arabinofuranoside on the development of reptilian embryos (Lacerta viridis, Laur. and Anguis fragilis, L.)].

    Science.gov (United States)

    Raynaud, A

    1982-01-01

    Administered into the yolk sac of eggs of Lacerta viridis as a single dose of 17 to 40 micrograms, cytosine-arabinoside (Ara-C) was compatible with survival of the embryo, from the sixth day of incubation, for at least 20 to 25 days. The LD50 was 40 to 50 micrograms per egg. Doses of 20 to 40 micrograms of Ara-C introduced in the yolk sac of eggs of the slow-worm (Anguis fragilis) cultured in vitro, at stages of the allantoid bud of 0,5 mm to 2,5 mm long, killed the embryo in 4 to 8 days (possibly due to alterations of capillary blood vessels of allantois and area vasculosa). In the two species, these doses caused cytotoxic effects on embryonic proliferating tissues, growth inhibition and a variety of developmental defects. In young embryos of Anguis fragilis, similar doses of 20 to 40 micrograms of Ara-C caused, in 2 to 4 days, death of many cells in the anlagen of growing organs: neural tube, sensory organs, bronchi, mesoderm of the limb bud, subcutaneous mesenchyme, anlage of dorsal skeletal structures, etc.; followed by growth inhibition and malformations. On the other hand, in the limb bud, the apical ridge was less retrogressed than in control embryos; the limb buds showed slightly better development in treated embryos than in controls, but, Ara-C induced severe damage in their mesoderm. In all embryos of Lacerta viridis, treated at the stage of 6 days or of 10 days of incubation by doses of 20 to 40 micrograms of Ara-C and killed 15 to 35 days later, there was a general reduction of size and of weight and external and internal malformations, more or less severe, were present: modifications of the form of the head, shortening of the lower jaw, labial clefts, microphthalmia, micromelia and other limbs defects, developmental defects of the tail. In some embryos, the only external defects observed were missing fingers and toes; in three of these embryos, the same digits were missing in the four limbs. Modifications of limb morphogenesis induced by Ara-C are

  6. Quantification of Pulmonary Fibrosis in a Bleomycin Mouse Model Using Automated Histological Image Analysis.

    Directory of Open Access Journals (Sweden)

    Jean-Claude Gilhodes

    Full Text Available Current literature on pulmonary fibrosis induced in animal models highlights the need of an accurate, reliable and reproducible histological quantitative analysis. One of the major limits of histological scoring concerns the fact that it is observer-dependent and consequently subject to variability, which may preclude comparative studies between different laboratories. To achieve a reliable and observer-independent quantification of lung fibrosis we developed an automated software histological image analysis performed from digital image of entire lung sections. This automated analysis was compared to standard evaluation methods with regard to its validation as an end-point measure of fibrosis. Lung fibrosis was induced in mice by intratracheal administration of bleomycin (BLM at 0.25, 0.5, 0.75 and 1 mg/kg. A detailed characterization of BLM-induced fibrosis was performed 14 days after BLM administration using lung function testing, micro-computed tomography and Ashcroft scoring analysis. Quantification of fibrosis by automated analysis was assessed based on pulmonary tissue density measured from thousands of micro-tiles processed from digital images of entire lung sections. Prior to analysis, large bronchi and vessels were manually excluded from the original images. Measurement of fibrosis has been expressed by two indexes: the mean pulmonary tissue density and the high pulmonary tissue density frequency. We showed that tissue density indexes gave access to a very accurate and reliable quantification of morphological changes induced by BLM even for the lowest concentration used (0.25 mg/kg. A reconstructed 2D-image of the entire lung section at high resolution (3.6 μm/pixel has been performed from tissue density values allowing the visualization of their distribution throughout fibrotic and non-fibrotic regions. A significant correlation (p<0.0001 was found between automated analysis and the above standard evaluation methods. This correlation

  7. Detection of epithelial to mesenchymal transition in airways of a bleomycin induced pulmonary fibrosis model derived from an α-smooth muscle actin-Cre transgenic mouse

    Directory of Open Access Journals (Sweden)

    Yang Xiao

    2007-01-01

    Full Text Available Abstract Background Epithelial to mesenchymal transition (EMT in alveolar epithelial cells (AECs has been widely observed in patients suffering interstitial pulmonary fibrosis. In vitro studies have also demonstrated that AECs could convert into myofibroblasts following exposure to TGF-β1. In this study, we examined whether EMT occurs in bleomycin (BLM induced pulmonary fibrosis, and the involvement of bronchial epithelial cells (BECs in the EMT. Using an α-smooth muscle actin-Cre transgenic mouse (α-SMA-Cre/R26R strain, we labelled myofibroblasts in vivo. We also performed a phenotypic analysis of human BEC lines during TGF-β1 stimulation in vitro. Methods We generated the α-SMA-Cre mouse strain by pronuclear microinjection with a Cre recombinase cDNA driven by the mouse α-smooth muscle actin (α-SMA promoter. α-SMA-Cre mice were crossed with the Cre-dependent LacZ expressing strain R26R to produce the double transgenic strain α-SMA-Cre/R26R. β-galactosidase (βgal staining, α-SMA and smooth muscle myosin heavy chains immunostaining were carried out simultaneously to confirm the specificity of expression of the transgenic reporter within smooth muscle cells (SMCs under physiological conditions. BLM-induced peribronchial fibrosis in α-SMA-Cre/R26R mice was examined by pulmonary βgal staining and α-SMA immunofluorescence staining. To confirm in vivo observations of BECs undergoing EMT, we stimulated human BEC line 16HBE with TGF-β1 and examined the localization of the myofibroblast markers α-SMA and F-actin, and the epithelial marker E-cadherin by immunofluorescence. Results βgal staining in organs of healthy α-SMA-Cre/R26R mice corresponded with the distribution of SMCs, as confirmed by α-SMA and SM-MHC immunostaining. BLM-treated mice showed significantly enhanced βgal staining in subepithelial areas in bronchi, terminal bronchioles and walls of pulmonary vessels. Some AECs in certain peribronchial areas or even a small

  8. Cancer incidence and mortality in Chukotka, 1997–2010

    Science.gov (United States)

    Dudarev, Alexey A.; Chupakhin, Valery S.; Odland, Jon Øyvind

    2013-01-01

    Objectives The general aim was to assess cancer incidence and mortality among the general population of Chukotka in 1997–2010 and to compare it with the population of Russia. Methods Cancer data were abstracted from the annual statistical reports of the P.A. Hertzen Research Institute of Oncology in Moscow. The annual number and percent of cases, crude and age-standardized cancer incidence (ASIR) and mortality (ASMR) rates per 100,000 among men and women in the Chukotka Autonomous Okrug were determined for the period 1997–2010 for incidence and 1999–2010 for mortality. Two years’ data were aggregated to generate temporal trends during the period. In age-standardization, the Segi-Doll world standard population used by the International Agency for Research on Cancer was used. Results The higher incidence and mortality rate of cancer (all sites combined) among men compared to women, which was observed in Russia nationally, was reflected also in Chukotka, although the difference between men and women was not statistically significant. Overall, the patterns of cancer sites are similar between Chukotka and Russia, with cancer of the lung/trachea/bronchus and stomach occupying the top ranks among men. Oesophageal cancer is common in Chukotka but not in Russia, whereas prostate cancer is common in Russia but not in Chukotka. Among women, breast cancer is either the commonest or second commonest cancer in terms of incidence or mortality in both Chukotka and Russia. Cancer of the lung/trachea/bronchi ranks higher in Chukotka than in Russia. The rate of cancer incidence and mortality for all sites combined during the 13-year period was relatively stable in Russia. Dividing the period into two halves, an increase among both men and women was observed in Chukotka for all sites combined, and also for colorectal cancer. Conclusions This paper presents previously unavailable cancer epidemiological data on Chukotka. They provide a basis for comparative studies across

  9. Cancer incidence and mortality in Chukotka, 1997–2010

    Directory of Open Access Journals (Sweden)

    Alexey A. Dudarev

    2013-03-01

    Full Text Available Objectives. The general aim was to assess cancer incidence and mortality among the general population of Chukotka in 1997–2010 and to compare it with the population of Russia. Methods. Cancer data were abstracted from the annual statistical reports of the P.A. Hertzen Research Institute of Oncology in Moscow. The annual number and percent of cases, crude and age-standardized cancer incidence (ASIR and mortality (ASMR rates per 100,000 among men and women in the Chukotka Autonomous Okrug were determined for the period 1997–2010 for incidence and 1999–2010 for mortality. Two years’ data were aggregated to generate temporal trends during the period. In age-standardization, the Segi-Doll world standard population used by the International Agency for Research on Cancer was used. Results. The higher incidence and mortality rate of cancer (all sites combined among men compared to women, which was observed in Russia nationally, was reflected also in Chukotka, although the difference between men and women was not statistically significant. Overall, the patterns of cancer sites are similar between Chukotka and Russia, with cancer of the lung/trachea/bronchus and stomach occupying the top ranks among men. Oesophageal cancer is common in Chukotka but not in Russia, whereas prostate cancer is common in Russia but not in Chukotka. Among women, breast cancer is either the commonest or second commonest cancer in terms of incidence or mortality in both Chukotka and Russia. Cancer of the lung/trachea/bronchi ranks higher in Chukotka than in Russia. The rate of cancer incidence and mortality for all sites combined during the 13-year period was relatively stable in Russia. Dividing the period into two halves, an increase among both men and women was observed in Chukotka for all sites combined, and also for colorectal cancer. Conclusions. This paper presents previously unavailable cancer epidemiological data on Chukotka. They provide a basis for comparative

  10. Cancer incidence and mortality in Chukotka, 1997-2010.

    Science.gov (United States)

    Dudarev, Alexey A; Chupakhin, Valery S; Odland, Jon Øyvind

    2013-01-01

    The general aim was to assess cancer incidence and mortality among the general population of Chukotka in 1997-2010 and to compare it with the population of Russia. Cancer data were abstracted from the annual statistical reports of the P.A. Hertzen Research Institute of Oncology in Moscow. The annual number and percent of cases, crude and age-standardized cancer incidence (ASIR) and mortality (ASMR) rates per 100,000 among men and women in the Chukotka Autonomous Okrug were determined for the period 1997-2010 for incidence and 1999-2010 for mortality. Two years' data were aggregated to generate temporal trends during the period. In age-standardization, the Segi-Doll world standard population used by the International Agency for Research on Cancer was used. The higher incidence and mortality rate of cancer (all sites combined) among men compared to women, which was observed in Russia nationally, was reflected also in Chukotka, although the difference between men and women was not statistically significant. Overall, the patterns of cancer sites are similar between Chukotka and Russia, with cancer of the lung/trachea/bronchus and stomach occupying the top ranks among men. Oesophageal cancer is common in Chukotka but not in Russia, whereas prostate cancer is common in Russia but not in Chukotka. Among women, breast cancer is either the commonest or second commonest cancer in terms of incidence or mortality in both Chukotka and Russia. Cancer of the lung/trachea/bronchi ranks higher in Chukotka than in Russia. The rate of cancer incidence and mortality for all sites combined during the 13-year period was relatively stable in Russia. Dividing the period into two halves, an increase among both men and women was observed in Chukotka for all sites combined, and also for colorectal cancer. This paper presents previously unavailable cancer epidemiological data on Chukotka. They provide a basis for comparative studies across circumpolar regions and countries. With its small

  11. Functional significance of air trapping detected in moderate asthma

    Energy Technology Data Exchange (ETDEWEB)

    Laurent, F. [Unite d' Imagerie Thoracique et Cardiovasculaire, CHU Bordeaux, Pessac (France); Service des Maladies Respiratoires, CHU Bordeaux, Pessac (France); Latrabe, V. [Unite d' Imagerie Thoracique et Cardiovasculaire, CHU Bordeaux, Pessac (France); Raherison, C. [Service des Maladies Respiratoires, CHU Bordeaux, Pessac (France); Marthan, R. [Laboratoire de Physiologie Cellulaire Respiratoire, INSERM E 9937, Univ. Victor Segalen Bordeaux 2 (France); Tunon-de-Lara, J.M. [Service des Maladies Respiratoires, CHU Bordeaux, Pessac (France); Laboratoire de Physiologie Cellulaire Respiratoire, INSERM E 9937, Univ. Victor Segalen Bordeaux 2 (France)

    2000-09-01

    The aim of this study was to evaluate bronchial and lung abnormalities in patients suffering from moderate asthma as defined by international guidelines, with special attention to air trapping on CT in comparison with that detected in smoking and non-smoking normal subjects. Twenty-two patients classified as moderate asthma and control subjects including healthy volunteers, smokers (n = 10) or non-smokers (n = 12) were prospectively explored by high-resolution CT (HRCT) performed at suspended full inspiration and expiration. The same expiratory protocol was performed 15 min after inhalation of 200 {mu}g of salbutamol. Patients underwent pulmonary function tests within the same week and bronchodilator response was assessed following inhalation of salbutamol. Abnormalities of bronchi and lung parenchyma on inspiratory CT and air trapping on expiratory CT, in dependent and non-dependent areas, were assessed and scored semi-quantitatively by two independent observers. Comparison of score mean values between the different groups was performed using Mann-Whitney test and Spearman correlation between CT findings and pulmonary function tests were calculated. Mosaic perfusion was observed in 23 % of asthmatics. Air-trapping scores were significantly higher in asthmatic patients than in non-smoking control subjects (p = 0.003), but not than in smokers. This difference was ascribed to non-dependent zones of the lung for which air-trapping scores were also higher in asthmatic patients (p = 0.003) and in smoking subjects (p = 0.004) than in normal controls. In the asthmatic group, a significant positive correlation was found between airways resistance and bronchial dilatation score (p = 0.01), and between small airways obstruction index and mosaic perfusion score (p = 0.05). In addition, both FEV1 and reversibility of small airways obstruction values correlated with air-trapping score (p = 0.03 and p = 0.007, respectively). No change could be detected in air-trapping score

  12. True tracheal bronchus: Classification and anatomical relationship on multi-detector computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Jeong; Kim, Young Tong; Jou, Sung Shick; Lee, Woong Hee [Dept. of Radiology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan (Korea, Republic of)

    2017-04-15

    To propose the imaging classification of true tracheal bronchus (TTB) on multi-detector computed tomography (MDCT), and to evaluate its anatomical relationship with surrounding structures. This study included 44 patients who were diagnosed with TTB on MDCT for 6 years. We classified TTB into five types, based on the existence of the right upper lobe bronchus originating from the right main bronchus and the number of segmental bronchi of TTB. We analyzed the site of origin and the running direction of TTB based on its anatomical relationship with surrounding structures and some ancillary findings. The imaging classification of TTB included Type I (47.7%), Type II (13.6%), Type III (11.4%), Type IV (25.0%), and Type V (2.0%). According to the site of origin of TTB, below the aortic arch (52.3%) and at the level of the aortic arch (43.1%) were the two main sites of origin, whereas the frequency of the site of origin above the azygos arch, at the level of the azygos arch, and below the azygos arch was 27.3%, 38.6%, and 34.1%, respectively. Considering both aortic and azygos arches, below the aortic arch and below the azygos arch were the most common sites of origin (27.3%). With respect to the running direction of TTB, in all cases, TTB passed below the azygos arch to the right upper lobe. There was no statistically significant (p > 0.05) difference in age or sex between types of TTB. Ancillary findings included tracheal stenosis (n = 2), narrowing of the right main bronchus (n = 2), luminal narrowing of TTB and bronchiectasis at the distal portion (n = 1), and a highly located azygos arch above the aortic arch (n = 2). The proposed imaging classification of TTB and its anatomical relationship with surrounding structures will improve our understanding of various imaging features and embryological development of TTB. Radiologists should pay careful attention to evaluation of the airway including the trachea on thoracic imaging.

  13. Chronic pneumonia in calves after experimental infection with Mycoplasma bovis strain 1067: Characterization of lung pathology, persistence of variable surface protein antigens and local immune response

    Directory of Open Access Journals (Sweden)

    Hermeyer Kathrin

    2012-02-01

    that infection of calves with M. bovis results in various lung lesions including caseonecrotic pneumonia originating from bronchioli and bronchi. There is long-term persistence of M. bovis as demonstrated by bacteriology and immunohistochemistry for M. bovis antigens, i.e. Vsp antigens and pMB67. The persistence of the pathogen and its ability to evade the specific immune response may in part result from local downregulation of antigen presenting mechanisms and an ineffective humoral immune response with prevalence of IgG1 antibodies that, compared to IgG2 antibodies, are poor opsonins.

  14. Genotoxic and inflammatory effects of nanofibrillated cellulose in murine lungs.

    Science.gov (United States)

    Catalán, Julia; Rydman, Elina; Aimonen, Kukka; Hannukainen, Kati-Susanna; Suhonen, Satu; Vanhala, Esa; Moreno, Carlos; Meyer, Valérie; Perez, Denilson da Silva; Sneck, Asko; Forsström, Ulla; Højgaard, Casper; Willemoes, Martin; Winther, Jacob R; Vogel, Ulla; Wolff, Henrik; Alenius, Harri; Savolainen, Kai M; Norppa, Hannu

    2017-01-01

    Nanofibrillated cellulose (NFC) is a sustainable and renewable nanomaterial, with diverse potential applications in the paper and medical industries. As NFC consists of long fibres of high aspect ratio, we examined here whether TEMPO-(2,2,6,6-tetramethyl-piperidin-1-oxyl) oxidised NFC (length 300-1000nm, thickness 10-25nm), administrated by a single pharyngeal aspiration, could be genotoxic to mice, locally in the lungs or systemically in the bone marrow. Female C57Bl/6 mice were treated with four different doses of NFC (10, 40, 80 and 200 µg/mouse), and samples were collected 24h later. DNA damage was assessed by the comet assay in bronchoalveolar lavage (BAL) and lung cells, and chromosome damage by the bone marrow erythrocyte micronucleus assay. Inflammation was evaluated by BAL cell counts and analysis of cytokines and histopathological alterations in the lungs. A significant induction of DNA damage was observed at the two lower doses of NFC in lung cells, whereas no increase was seen in BAL cells. No effect was detected in the bone marrow micronucleus assay, either. NFC increased the recruitment of inflammatory cells to the lungs, together with a dose-dependent increase in mRNA expression of tumour necrosis factor α, interleukins 1β and 6, and chemokine (C-X-C motif) ligand 5, although there was no effect on the levels of the respective proteins. The histological analysis showed a dose-related accumulation of NFC in the bronchi, the alveoli and some in the cytoplasm of macrophages. In addition, neutrophilic accumulation in the alveolar lung space was observed with increasing dose. Our findings showed that NFC administered by pharyngeal aspiration caused an acute inflammatory response and DNA damage in the lungs, but no systemic genotoxic effect in the bone marrow. The present experimental design did not, however, allow us to determine whether the responses were transient or could persist for a longer time. © The Author 2016. Published by Oxford University

  15. Pigmentation of the viscera and carcasses (chromatosis in sheep in the Brazilian northeastern region Pigmentação das vísceras e carcaças (cromatose em ovinos na região Nordeste do Brasil

    Directory of Open Access Journals (Sweden)

    Luciano da Anunciação Pimentel

    2013-02-01

    Full Text Available We report exogenous pigmentation in sheep grazing in native pastures in northeastern Brazil. The sheep carcasses from a farm were condemned at the slaughterhouse due to pigmentation of the carcasses and viscera. In visits to the farm, bluish-purple pigmentation of the mucosa was observed in the sheep. In two necropsied sheep, a bluish-purple pigment was observed in the skin, subcutaneous tissue, fat, muscles, cartilage, bones, serous membranes of the forestomachs, kidneys, adrenal glands, and the mucosa of the uterus, urinary bladder, urethra, vagina, trachea, bronchi, and bronchioles. Some bone surfaces, the intima of large arteries, tendons, muscle insertions, and ligaments had a yellow-brown or light brown pigment. However, the pigment was not observed upon histologic examination of tissues, suggesting that the pigmentation is caused by a plant. Two plants, Rhamnidium molle and Pereskia bahiensis, were fed to experimental sheep and rabbits, but did not cause pigmentation.Descreve-se pigmentação exógena em ovinos, pastejando numa área de pastagem nativa da região nordeste do Brasil. Os ovinos de uma fazenda, destinados ao abate, tiveram as carcaças rejeitadas pelo frigorífico em virtude da pigmentação apresentada nos tecidos. Em visitas à fazenda, foi observada pigmentação azul-violeta nas mucosas de ovelhas. Em dois ovinos necropsiados, pigmento azul-violeta foi observado na pele, tecido subcutâneo, gordura, músculos, cartilagens, ossos, serosa dos pré-estômagos, rins, glândulas adrenais, mucosa do útero, bexiga urinária, uretra, vagina, traqueia, brônquios e bronquíolos. Algumas superfícies ósseas, íntima de grandes artérias, tendões, inserções musculares e ligamentos tinham pigmento castanho-amarelo ou castanho claro. No entanto, o pigmento não foi observado nos tecidos após processamento para o exame histológico, o que sugere que a pigmentação é causada por uma substância exógena, provavelmente presente

  16. Diagnósticos de enfermagem respiratórios para crianças com infecção respiratória aguda Diagnósticos de enfermería respiratorios para niños con infección respiratoria aguda Respiratory nursing diagnoses for children with acute respiratory infection

    Directory of Open Access Journals (Sweden)

    Lívia Zulmyra Cintra Andrade

    2012-01-01

    las características definidoras más prevalentes. Los ruidos adventicios respiratorios aumentan en 80% la oportunidad para la DIVA. Entre los factores relacionados, se destacaron: secreciones en los bronquios y secreciones retenidas. Las secreciones en los bronquios favorecen en 80% la ocurrencia del PRI y en 60% la DIVA. Se verificó la asociación estadísticamente significativa entre las características y factores relacionados con los diagnósticos estudiados. CONCLUSIÓN: Los cuatro diagnósticos fueron identificados en niños con infecciones respiratorias agudas, presentando distintas prevalancias.OBJECTIVES: To identify the prevalence of nursing diagnoses: ineffective breathing pattern (IBP (00032, ineffective airway clearance (IAC (00031, impaired gas exchange (IGE (00030 and impaired spontaneous ventilation (ISP (00033, their defining characteristics and related factors, in children with acute respiratory infection. METHODS: A quantitative, transversal approach with 151 children. Data were collected by means of interviews and pulmonary evaluation. For data analysis, we used descriptive and inferential statistics. RESULTS: The most prevalent diagnosis was IBP. Adventitious breath sounds and ineffective cough were the most prevalent defining characteristics. Adventitious breath sounds increased by 80% the chance for IAC. Among the related factors, the highlights were: secretions in the bronchi and retained secretions. Secretions in the bronchi favored in 80% the occurrence of IBP and in 60% of IAC. This verified a statistically significant association between the defining characteristics and related factors of the diagnoses studied. CONCLUSION: The four diagnoses were identified in children with acute respiratory infections, with different prevalences.

  17. Endoscopia respiratória em 89 pacientes com neoplasia pulmonar Respiratory endoscopy in 89 patients of lung neoplasms

    Directory of Open Access Journals (Sweden)

    PAULO JOSÉ LORENZONI

    2001-03-01

    . The objective of this survey is to evaluate the diagnosis of these neoplasms using fiberoptics bronchoscopy. Methods: 89 patients were analyzed retrospectively in a period of five years. They were divided into two groups: Group 1 (n = 53 -- the presence of visible lesion on endoscopy, Group 2 (n = 36 -- the absence of visible lesion on endoscopy. Epidemiological elements, endoscopic discoveries, cytopathologic and anatomopathologic examination were performed in the review, as well the examination that provided the final diagnosis. Results: The findings of indirect endoscopies of neoplasms corresponded to 59.5% and the presence of tumor inside bronchi was 48.8%. The most frequent histologic type was the epidermoid carcinoma (59.5%, followed by adenocarcinoma (15.7%, small-cell carcinoma (10.1%, and others (14.7%. In endoscopically visible or not visible tumors, the anatomopathologic study of bronchial biopsy and/or the cytopathologic examination of the bronchial washing and brushing showed a sensitivity of 83.1% in the diagnosis of lung neoplasms. When the lesion was visible on endoscopy, the sensitivity was 96.2%: positive biopsy was 94.2%, and cytology was 43.75%. When the lesion in the bronchi is not observed, its addition was significantly small (63.8%, namely: biopsy registered 72.7% and cytopathology 38.4%. Not significant complications resulting from the endoscopic examination occurred in 11.2% of patients and there were no serious complications. Conclusion: The fiberoptics bronchoscopy was an excellent method to investigate patients with suspicion of lung neoplasms, with 83.1% of sensitivity. This sensitivity was higher in visible lesions and in non-visible lesions when endobronchial biopsy was used.

  18. Rapid shallow breathing evoked by selective stimulation of airway C fibres in dogs.

    Science.gov (United States)

    Coleridge, H M; Coleridge, J C; Roberts, A M

    1983-07-01

    rate were complex and appeared to result from the interplay of several reflexes. Marked cardiac slowing was evoked by bradykinin aerosol.6. Bradykinin injected into a bronchial artery is known to stimulate bronchial (intrapulmonary) C fibres. Results of recording afferent vagal impulses in the present study indicated that bradykinin administered as an aerosol stimulated bronchial C fibres and also C fibres with endings in the lower trachea and extrapulmonary bronchi. Irritant and pulmonary stretch receptors were not stimulated unless aerosols were administered repeatedly and in higher concentration. Hence airway C fibres appeared to be responsible for the reflex effects of bradykinin aerosol.7. Bronchial C fibres are stimulated by substances (bradykinin, prostaglandins and histamine) known to be released by the lungs and airways in a variety of pathophysiological circumstances. Results of this and previous studies are compatible with the hypothesis that stimulation of bronchial C fibres plays a major role in evoking the rapid shallow breathing, bronchoconstriction and increased secretion by airway submucosal glands that are part of the pulmonary defence response.

  19. Ativação da proteína TGFbetaI latente em pulmão irradiado in vivo Latent TGFbeta1 activation in the lung irradiated in vivo

    Directory of Open Access Journals (Sweden)

    MARCOS DUARTE MATTOS

    2002-12-01

    significant increase of collagen deposition in all time periods after irradiation; 3 weak latent TGFbeta1 activation 1 day and strong activation 14 days after irradiation in the bronchi and alveoli. Our results suggest that some bronchial and alveolar cells may have a role in the complex process of radiation-induced lung fibrosis acting as cellular sources of active TGFbeta.

  20. Changing prevalence and resistance patterns in children with drug-resistant tuberculosis in Mumbai.

    Science.gov (United States)

    Shah, Ira; Shah, Forum

    2017-05-01

    The prevalence of drug-resistant (DR) tuberculosis (TB) in children is increasing. Although, in India, multi-drug-resistant (MDR) TB rates have been relatively stable, the number of children with pre-extensively drug-resistant and extensively drug-resistant (XDR) TB is increasing. To determine whether the prevalence of DR TB in children in Mumbai is changing and to study the evolving patterns of resistance. A retrospective study was undertaken in 1311 paediatric patients referred between April 2007 and March 2013 to the Paediatric TB clinic at B. J. Wadia Hospital for Children, Mumbai. Children were defined as having DR TB on the basis of drug susceptibility testing (DST) of Mycobacterium tuberculosis grown on culture of body fluids (in the case of extra pulmonary TB) or from gastric lavage/bronchi-alveolar lavage/sputum in patients with pulmonary TB or from DST of the contacts. The prevalence of DR TB was calculated and the type of DR was evaluated yearly and in the pre-2010 and post-2010 eras. The overall prevalence of DR TB was 86 (6.6%) with an increase from 23 (5.6%) patients pre-2010 to 63 (7%) post-2010 (P = 0.40). Nine (10.4%) patients were diagnosed on the basis of contact with a parent with DR TB. Overall fluoroquinolone resistance increased from 9 (39.1%) pre-2010 to 59 (93.7%) post-2010 (P = 0.0001): moxifloxacin resistance increased from 2 (8.7%) to 29 (46%) (P = 0.0018) and ofloxacin resistance increased from 7 (30.4%) to 30 (47.6%) (P = 0.14). Ethionamide resistance also increased from 6 (26.1%) to 31 (49.2%) (P = 0.04), aminoglycoside resistance was one (4.3%) pre-2010 and 12 (19%) post-2010 (P = 0.17) and resistance remained virtually the same for both amikacin [0 pre-2010 and 6 (9.5%) after 2010] and kanamycin [one (4.3%) pre- and 6 (9.5%) post-2010]. Of the first-line drugs, resistance remained the same for isoniazid [23 (100%) to 61 (96.8%)], rifampicin [22 (95.7%) to 51 (80.9%),P = 0.17], pyrazinamide [15 (65.2%) to

  1. DIAGNOSIS OF SPUTUM CULTURE POSITIVE ORGANISMS AND THEIR ANTIMICROBIAL SENSITIVITY PROFILE IN A TERTIARY CARE CENTRE- KANYAKUMARI

    Directory of Open Access Journals (Sweden)

    Prince Sree Kumar Pius

    2017-01-01

    chest radiograph shadowing accompanied by acute clinical illness (unspecified without other obvious cause. Acute Exacerbation of COPD (AECOPD- An event in the natural course of the disease characterised by a worsening of the patient’s baseline dyspnoea, cough and/or sputum beyond day-to-day variability sufficient to warrant a change in management. If chest radiograph shadowing consistent with infection is present, the patient is considered to have CAP. Acute Exacerbation of Bronchiectasis (AEBX- In a patient with features suggestive of bronchiectasis, an event in the natural course of the disease characterised by a worsening in the patient’s baseline dyspnoea and/or cough and/or sputum beyond day-to-day variability sufficient to warrant a change in management. If chest radiograph shadowing, consistent with infection is present, the patient is considered to have CAP. MATERIALS AND METHODS Sputum is the thick mucus or phlegm that is expelled from the lower respiratory tract (bronchi and lungs through coughing; it is not saliva or spit. Care must be taken in the sample collection process to ensure that the sample is from the lower airways and not from the upper respiratory tract. In this study, we collected 851samples from the patients in whom lower respiratory tract infections were suspected in a tertiary care centre- Kanyakumari district during the year January 2016-June 2016. RESULTS Sputum cultures were positive for 29% of the patients. Among these cultures, Klebsiella pneumonia (73%, Pseudomonas aeruginosa (19%, Staphylococcus aureus (4% and others (Acinetobacter and Streptococcus pneumonia (5% were the common organisms found. Highest antimicrobial sensitivity amongst these pathogens was found with cefoperazone/sulbactam and amikacin. CONCLUSION Cefoperazone/sulbactam and amikacin were the highly sensitive systemic antibiotics while ciprofloxacin and co-trimoxazole were the sensitive oral antibiotics in our locality

  2. Effect of Heat Moisture Exchanger on Aerosol Drug Delivery and Airway Resistance in Simulated Ventilator-Dependent Adults Using Jet and Mesh Nebulizers.

    Science.gov (United States)

    Ari, Arzu; Dang, Truong; Al Enazi, Fahad H; Alqahtani, Mohammed M; Alkhathami, Abdulrahman; Qoutah, Rowaida; Almamary, Ahmad S; Fink, James B

    2017-08-22

    Placement of a heat moisture exchanger (HME) between aerosol generator and patient has been associated with greatly reduced drug delivery. The purpose of this study was to evaluate the effect of filtered and nonfiltered HMEs placed between nebulizer and patient on aerosol deposition and airway resistance (Raw) in simulated ventilator-dependent adults. An in vitro lung model was developed to simulate a mechanically ventilated adult (Vt 500 mL, RR 15/min, and PEEP 5 cmH2O, using two inspiratory flow rates 40 and 50 L/min) using an intubated adult manikin with an endotracheal tube (8 mmID). The bronchi of the manikin were connected to a Y-adapter through a collecting filter (Respirgard II) attached to a test lung through a heated humidifier (37°C producing 100% relative humidity) to simulate exhaled humidity. For treatment conditions, a nonfiltered HME (ThermoFlo™ 6070; ARC Medical) and filtered HMEs (ThermoFlo™ Filter; ARC Medical and PALL Ultipor; Pall Medical) were placed between the ventilator circuit at the endotracheal tube and allowed to acclimate to the exhaled heat and humidity for 30 minutes before aerosol administration. Airway resistance (cmH2O/L/s) was taken at 0, 10, 20, and 30 minutes after HME placement and after each of four aerosol treatments. Albuterol sulfate (2.5 mg/3 mL) was administered with jet (Misty Max 10; Airlife) and mesh (Aerogen Solo; Aerogen) nebulizers positioned in the inspiratory limb proximal to the Y-adapter. Control consisted of nebulization with no HME. Drug was eluted from filter at the end of the trachea and measured using spectrophotometry (276 nm). Greater than 60% of the control dose was delivered through the ThermoFlo. No significant difference was found between the first four treatments given by the jet (p = 0.825) and the mesh (p = 0.753) nebulizers. There is a small increase in Raw between pre- and post-four treatments with the jet (p = 0.001) and mesh (p = 0.015) nebulizers. Aerosol

  3. Diagnosis and clinic-pathological findings of influenza virus infection in Brazilian pigs Diagnóstico, achados clínicos e patológicos da infecção pelo vírus influenza em suínos no Brasil

    Directory of Open Access Journals (Sweden)

    Daniela S. Rajão

    2013-01-01

    Full Text Available Influenza A virus (IAV is a respiratory pathogen of pigs and is associated with the porcine respiratory disease complex (PRDC, along with other respiratory infectious agents. The aim of this study was to diagnose and to perform a clinic-pathological characterization of influenza virus infection in Brazilian pigs. Lung samples from 86 pigs in 37 farrow-to-finish and two farrow-to-feeder operations located in the States of Minas Gerais, São Paulo, Paraná, Rio Grande do Sul, Santa Catarina, and Mato Grosso were studied. Virus detection was performed by virus isolation and quantitative real time reverse-transcription PCR (qRT-PCR. Pathologic examination and immunohistochemistry (IHC were performed in 60 lung formalin-fixed paraffin-embedded tissue fragments. Affected animals showed coughing, sneezing, nasal discharge, hyperthermia, inactivity, apathy, anorexia, weight loss and growth delay, which lasted for five to 10 days. Influenza virus was isolated from 31 (36.0% lung samples and 36 (41.9% were positive for qRT-PCR. Thirty-eight (63.3% lung samples were positive by IHC and the most frequent microscopic lesion observed was inflammatory infiltrate in the alveoli, bronchiole, or bronchi wall or lumen (76.7%. These results indicate that influenza virus is circulating and causing disease in pigs in several Brazilian states.O vírus influenza A (IAV é um patógeno respiratório comum de suínos e faz parte do complexo de doenças respiratórias do suíno (PRDC junto com outros agentes infecciosos. O objetivo deste estudo foi diagnosticar e realizar a caracterização clínica e patológica de casos/surtos de influenza em suínos brasileiros. Foram utilizadas amostras de tecido pulmonar de 86 suínos de 37 granjas de ciclo completo e duas unidades produtoras de leitões localizadas em Minas Gerais, São Paulo, Paraná, Rio Grande do Sul, Santa Catarina e Mato Grosso. A detecção viral em fragmentos pulmonares frescos foi realizada através do

  4. Clinical Features of Acute Respiratory Viral Infections in Infants with Thymomegaly

    Directory of Open Access Journals (Sweden)

    T.V. Sorokman

    2016-02-01

    Full Text Available Introduction. Peculiarities of acute respiratory viral infections (ARVI in children with increased size of the thymus are associated with the presence of more or less significant immunodeficiency and dyshormonosis with manifestations of adrenal insufficiency. Objective — to study the features of acute respiratory viral infections and to investigate adrenal function in infants with thymomegaly. Material and methods. 41 children aged 1 month to 3 years with thymomegaly and complicated forms of ARVI were involved in clinical studies. Etiological decoding of ARVI has been carried out with the use of paired serum samples. The content of cortisol in the blood plasma was determined by immunoenzyme method. 36 children with thymomegaly without ARVI manifestations within at least 3 months were in comparison group. Results. Analysis of the anamnesis in patients with thymomegaly showed that most of them experienced adverse conditions at different stages of antenatal, intrapartum and postnatal development. Analysis of the data on the size of the thymus gland showed that 3rd — 4th degree of thymomegaly is often observed in children with signs of constrictive laryngotracheitis (75.0 %. 23.5 % of patients with obstructive bronchitis had 1st degree thymomegaly, the rest — 3rd and 4th degrees. In case of nonobstructive lesions of the bronchi, the opposite trend took place: the least degree of thymomegaly was diagnosed in 62.5 %, and 3rd and 4th — in 37.5 % (p < 0.05 of patients. The lowest supply of cortisol was noted in the acute period of constrictive laryngotracheitis (409.4 ± 10.2 nmol/ml against 537.7 ± 11.5 nmol/ml in the comparison group; p < 0.05. In the acute period of ARVI complicated by bronchitis, cortisol levels were not increased — 432.3 ± 32.3 nmol/ml. In the group of patients with pneumonia, we have recorded reliable, probably compensatory increase of cortisol level (787.3 ± 2.0 nmol/ml, p < 0.05. In the acute period of

  5. Quantitative computed tomography measurements to evaluate airway disease in chronic obstructive pulmonary disease: Relationship to physiological measurements, clinical index and visual assessment of airway disease

    Energy Technology Data Exchange (ETDEWEB)

    Nambu, Atsushi, E-mail: nambu-a@gray.plala.or.jp [Department of Radiology, National Jewish Health, 1400 Jackson Street, Denver, CO, 80206 (United States); Zach, Jordan, E-mail: ZachJ@NJHealth.org [Department of Radiology, National Jewish Health, 1400 Jackson Street, Denver, CO, 80206 (United States); Schroeder, Joyce, E-mail: Joyce.schroeder@stanfordalumni.org [Department of Radiology, National Jewish Health, 1400 Jackson Street, Denver, CO, 80206 (United States); Jin, Gongyoung, E-mail: gyjin@chonbuk.ac.kr [Department of Radiology, National Jewish Health, 1400 Jackson Street, Denver, CO, 80206 (United States); Kim, Song Soo, E-mail: haneul88@hanmail.net [Department of Radiology, National Jewish Health, 1400 Jackson Street, Denver, CO, 80206 (United States); Kim, Yu-IL, E-mail: kyionly@chonnam.ac.kr [Department of Medicine, National Jewish Health, Denver, CO (United States); Schnell, Christina, E-mail: SchnellC@NJHealth.org [Department of Medicine, National Jewish Health, Denver, CO (United States); Bowler, Russell, E-mail: BowlerR@NJHealth.org [Division of Pulmonary Medicine, Department of Medicine, National Jewish Health (United States); Lynch, David A., E-mail: LynchD@NJHealth.org [Department of Radiology, National Jewish Health, 1400 Jackson Street, Denver, CO, 80206 (United States)

    2016-11-15

    Purpose: To correlate currently available quantitative CT measurements for airway disease with physiological indices and the body-mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index in patients with chronic obstructive pulmonary disease (COPD). Materials and methods: This study was approved by our institutional review board (IRB number 2778). Written informed consent was obtained from all subjects. The subjects included 188 current and former cigarette smokers from the COPDGene cohort who underwent inspiratory and expiratory CT and also had physiological measurements for the evaluation of airflow limitation, including FEF25-75%, airway resistance (Raw), and specific airway conductance (sGaw). The BODE index was used as the index of clinical symptoms. Quantitative CT measures included % low attenuation areas [% voxels ≤ 950 Hounsfield unit (HU) on inspiratory CT, %LAA{sub −950ins}], percent gas trapping (% voxels ≤ −856 HU on expiratory CT, %LAA {sub −856exp}), relative inspiratory to expiratory volume change of voxels with attenuation values from −856 to −950 HU [Relative Volume Change (RVC){sub −856} {sub to} {sub −950}], expiratory to inspiratory ratio of mean lung density (E/I-ratio {sub MLD}), Pi10, and airway wall thickness (WT), luminal diameter (LD) and airway wall area percent (WA%) in the segmental, subsegmental and subsubsegmental bronchi on inspiratory CT. Correlation coefficients were calculated between the QCT measurements and physiological measurements in all subjects and in the subjects with mild emphysema (%LAA{sub −950ins} <10%). Univariate and multiple variable analysis for the BODE index were also performed. Adjustments were made for age, gender, smoking pack years, FEF25-75%, Raw, and sGaw. Results: Quantitative CT measurements had significant correlations with physiological indices. Among them, E/I-ratio {sub MLD} had the strongest correlations with FEF25-75% (r = −0.648, <0.001) and sGaw (r = −0

  6. Chronic cough due to chronic bronchitis: ACCP evidence-based clinical practice guidelines.

    Science.gov (United States)

    Braman, Sidney S

    2006-01-01

    Chronic bronchitis is a disease of the bronchi that is manifested by cough and sputum expectoration occurring on most days for at least 3 months of the year and for at least 2 consecutive years when other respiratory or cardiac causes for the chronic productive cough are excluded. The disease is caused by an interaction between noxious inhaled agents (eg, cigarette smoke, industrial pollutants, and other environmental pollutants) and host factors (eg, genetic and respiratory infections) that results in chronic inflammation in the walls and lumen of the airways. As the disease advances, progressive airflow limitation occurs, usually in association with pathologic changes of emphysema. This condition is called COPD. When a stable patient experiences a sudden clinical deterioration with increased sputum volume, sputum purulence, and/or worsening of shortness of breath, this is referred to as an acute exacerbation of chronic bronchitis as long as conditions other than acute tracheobronchitis are ruled out. The purpose of this review is to present the evidence for the diagnosis and treatment of cough due to chronic bronchitis, and to make recommendations that will be useful for clinical practice. Recommendations for this section of the review were obtained from data using a National Library of Medicine (PubMed) search dating back to 1950, performed in August 2004, of the literature published in the English language. The search was limited to human studies, using the search terms "cough," "chronic bronchitis," and "COPD." The most effective way to reduce or eliminate cough in patients with chronic bronchitis and persistent exposure to respiratory irritants, such as personal tobacco use, passive smoke exposure, and workplace hazards is avoidance. Therapy with a short-acting inhaled beta-agonist, inhaled ipratropium bromide, and oral theophylline, and a combined regimen of inhaled long-acting beta-agonist and an inhaled corticosteroid may improve cough in patients with

  7. Multi-slice CT for visualization of pulmonary embolism using perfusion weighted color maps

    Energy Technology Data Exchange (ETDEWEB)

    Wildberger, J.E.; Wein, B.B.; Guenther, R.W. [Univ. of Technology, Aachen (Germany). Dept. of Diagnostic Radiology; Niethammer, M.U.; Klotz, E.; Schaller, S. [Siemens Medical Engineering, Computed Tomography, Forchheim (Germany)

    2001-04-01

    klinischen Routine. Material und Methode: Die Untersuchungen bei klinisch vermuteter LE wurden an einem MSCT (Somatom Volume Zoom; Siemens, Forchheim) nach intravenoeser Gabe von 120 ml nichtionischem Konstrastmittels ueber einen Power-Injektor durchgefuehrt. Die Acquisitionsparameter waren 140 kV und 100 mAs mit duenner Kollimation (4x1 mm) und einen Tischvorschub von 7 mm (Pitch: 1,75). Anhand duenne axialer Primaerschichten (Eff. Schichtdicke: 1,25 mm, Rekonstruktionsinkrement: 0,8 mm) wurde eine neue Nachverarbeitungstechnik angewandt. Anhand der Quellschichten erfolgte eine automatisierte 3D-Segmentierung der Lungen, gefolgt von einer schwellwertbasierten Eliminierung groesserer Bronchi und Gefaesse. Die so gefilterten Volumendatensaetze wurden farbkodiert, um eine differenzierte Visualisierung der Dichteverteilung im Lungenparenchym in axialer, coronarer und sagittaler Raumebene zu ermoeglichen. Diese neue Technik wurde bei vier Patienten ohne LE sowie bei zwei Patienten mit nachgewiesener LE untersucht. Ergebnisse: Bei den vier Patienten ohne LE-Nachweis in der MSCT zeigte die farbkodierte Darstellung des Lungenparenchyms eine homogene Dichteverteilung ohne umschriebene dichtegeminderte oder-angehobene Bezirke, abgesehen von einem ventro-dorsalen Dichtegradienten. Bei den beiden Patienten mit LE wurden Bezirke verminderter Dichte distal der verschlossenen Pulmo-nalarterien nachgewiesen. (orig.)

  8. [Guideline (S2k, AWMF) of the Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin and the Deutsche Gesellschaft für Arbeitsmedizin und Umweltmedizin "Diagnostics and Expert Opinion in the Occupational Disease No. 4101 Silicosis (Including Coal Worker's Pneumoconiosis)"].

    Science.gov (United States)

    Baur, X; Heger, M; Bohle, R M; Hering, K G; Hofmann-Preiß, K; Nowak, D; Tannapfel, A; Teschler, H; Voshaar, T; Kraus, T

    2016-12-01

    (and sometimes mediastinial) lymph nodes; according to the guideline working group they do not closely correlate with the degree of pulmonary involvement. Extended conglomerating and enduring lymph-node processes may lead to dislocation of the hili with impairment of large bronchi and vessels. Shell-like calcifications dominating in the periphery of lymph nodes produce so-called egg-shell hili.The paragraph on exercise testing is now extended: if neither ergometry nor spiroergometry can be performed a 6 minute walking test by measuring oxygen saturation should be done.Furthermore, in individual expert opinion examinations right heart catheterization (the patient is not obliged to give informed consent) may be recommended, if echo cardiography gives evidence for pulmonary hypertension or if it is difficult to differentiate between right and left heart failure. The presence of pulmonary hypertension which is of prognostic relevance has to be considered when grading reduction in earning capacity.For interpretation of spirometry values the new GLI reference values has to be applied. Grading of impairment is due to the recommendation of the DGP.According to current medical scientific knowledge it is unclear, whether certain disorders of the rheumatic group such is scleroderma or Caplan syndrome which are sometimes associated with silicosis (or coal workers' pneumoconiosis) belong in toto to the occupational disease number 4101 (silicosis). Within this context, additional studies are needed to clarify the role of occupational quartz exposure and other risk factors.The guideline working group hopes that this update will help to optimize diagnostics and expert opinion of silicotic patients. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Effects in man and rabbits of inhalation of cotton dust or extracts and purified endotoxins1

    Science.gov (United States)

    Cavagna, G.; Foá, V.; Vigliani, E. C.

    1969-01-01

    pulmonary resistance lasting more than two hours. In control rabbits a challenging aerosol of 1 mg. endotoxin or 100 mg. cotton extract caused only a moderate increase in pulmonary resistance, which returned to normal in less than one hour. It may be concluded that the repeated inhalation of endotoxins induces in rabbits a state of hypersensitivity and at the same time the appearance of inflammatory reactions in the bronchi and alterations in the mechanical properties of the lung. These changes may be significant in the pathogenesis of byssinosis. Images PMID:4899667

  10. Risk factors predict frequent hospitalization in patients with acute exacerbation of COPD

    Directory of Open Access Journals (Sweden)

    Wei X

    2017-12-01

    Full Text Available Xia Wei,1,2,* Zhengquan Ma,2,* Nan Yu,3 Jingting Ren,2 Chenwang Jin,1 Jiuyun Mi,2 Meijuan Shi,1 Libin Tian,2 Yanzhong Gao,4 Youmin Guo1 1Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University, 2Department of Respiratory Medicine, The Ninth Hospital of Xi’an Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 3Department of Radiology, The Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Shaanxi, 4Department of Radiology, The Ninth Hospital of Xi’an Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China *These authors contributed equally to this work Purpose: COPD is a heterogeneous disease, and the available prognostic indexes are therefore limited. This study aimed to identify the factors associated with acute exacerbation leading to hospitalization.Patients and methods: This was a retrospective study of consecutive patients with COPD (meeting the Global Initiative for Chronic Obstructive Lung Disease [GOLD] diagnostic criteria hospitalized at the Ninth Hospital of Xi’an Affiliated Hospital of Xi’an Jiaotong University between October 2014 and September 2016. During follow-up after first hospitalization, the patients who had been rehospitalized within 1 year for acute exacerbation were grouped into the frequent exacerbation (FE group, while the others were grouped into the infrequent exacerbation (IE group. The baseline demographic, clinical, laboratory, pulmonary function, and imaging data were compared between the two groups.Results: Compared with the IE group, the FE group had lower forced expiratory volume in 1 second (FEV1/forced vital capacity (FVC (P=0.005, FEV1%pred (P=0.002, maximal mid-expiratory flow (MMEF25–75%pred (P=0.003, and ratio of carbon monoxide diffusion capacity to alveolar ventilation (DLCO/VA (P=0.03 and higher resonant frequency (Fres; P=0.04. According to generations of bronchi, the percentage of the wall area

  11. A carga das neoplasias no Brasil: mortalidade e morbidade hospitalar entre 2002-2004 The burden of neoplasm in Brazil: mortality and hospital morbidity from 2002 to 2004

    Directory of Open Access Journals (Sweden)

    Antonio Fernando Boing

    2007-08-01

    triennial 2002-2004, with the most recent mortality data in Brazil. The average of this period was calculated to ensure greater stability of the rates. RESULTS: Between 2002 and 2004, 405,415 deaths from neoplasias occurred in Brazil. The highest rates of mortality were identified in the South and South-East regions. For men, cancer of the trachea, bronchi and lungs were the malignant neoplasias with the highest mortality rate while for women breast cancer was highest. Breast cancer and cancer of the uterine cervix are those requiring the largest number of in-hospital admissions. In internments, leukemia presented the highest average cost and total cost. CONCLUSION: The burden of neoplasms is extremely high in Brazil and public policies focused on the population must be given priority for an effective control of mortality and morbidity.

  12. Corpos estranhos sólidos das vias aéreas em adultos

    Directory of Open Access Journals (Sweden)

    Elizabethe Fonseca

    1995-05-01

    visualisation of the foreign body in 14 patients while in two, observations were suggestive of tumour. Diagnosis and extraction were made with the second and third bronchoscopies, respectively. Extraction of the foreign body was achieved with a fiberoptic bronchoscope in 14 patients and rigid bronchoscope in the remaining. Follow-up after extraction was possible in 7 patients: 6 had no clinical problems and 1 had hemoptysis due to bronchiectasis unrelated to the bronchoscopy.There is a low degree of diagnostic suspicion in the absence of choking or predisposing pathology. Endoscopic findings may be misleading in the diagnosis of foreign body with granuloma formation. The majority of cases were resolved with fiberoptic bronchoscopy. Key-Words: Foreign- Bodies, Adult, Trachea, Bronchi, Bronchoscopy, Fiber-Optics-instrumentation, Foreign-Bodies-diagnosis, Foreign­ Bodies-radiography, Foreign- Bodies-therapy, Palavras-chave: Corpos estranhos, Adulto, Traqueia, Brônquios, Broncoscopia, Broncofibroscopia-instrumentação, Corpos-Estranhos-diagnóstico, Corpos-Estranhos-radiografia, Corpos-Estranhos-tratamento

  13. CYTOKINE GENES AS GENETIC MARKERS OF CONTROLLED AND UNCONTROLLED ATOPIC BRONCHIAL ASTHMA

    Directory of Open Access Journals (Sweden)

    M. V. Smolnikova

    2017-01-01

    Full Text Available Atopic bronchial asthma (ABA is a multifactorial disease; its development is dependent on many environmental and genetic factors. Genetic risk factors can affect the clinical phenotype of ABA and the level of therapeutic control over the disease. Cytokine genes are crucially important in pathogenesis of ABA as they encode proteins participating in immune response and development of inflammation in bronchi. It was suggested that the therapeutic control of the disease is genetically mediated and depends on the presence of one or another allele in genes of mediators, participating in ABA pathogenesis. The knowledge about genetic markers will allow to predict clinical course of ABA in children. We carried out the analysis of association between genes of pro- and anti-inflammatory cytokines with the level of therapeutic control of ABA. In children with controlled and uncontrolled ABA (CABA and UABA, respectively; n = 110, and in general a population sample (n = 138, we analysed 11 polymorphisms: IL2 (rs2069762, IL4 (rs2070874 и rs2243250, IL5 (rs2069812, IL10 (rs1800872 and rs1800896, IL12B (rs3212227, TNFA (rs1800629 and rs1800630, TGFB1 (rs1800469, and IFNG (rs2069705, encoding cytokines actively participating at the development of allergic inflammation. According to results of present study, the prevalence of alleles and genotypes of the analysed loci in the East Siberia Caucasians is consistent with the data in other world Caucasian populations. We have found statistically significant differences between UABA and control groups for the prevalence of IL2 (rs2069762 polymorphism: GG genotype was more common in control group (14.1% compared to 5.9%, р = 0.03. It was shown that the IL2*T allele and ТТ genotype of the rs2069762 are associated with the increased risk of uncontrolled ABA. A comparison of the haplotypes of IL4 (rs2070874 and rs2243250 gene with correction for sex and age within an additive model revealed that the most common

  14. Bronquiectasia e fisioterapia desobstrutiva: ênfase em drenagem postural e percussão Bronchiectasis and clearence physiotherapy: emphasis in postural drainage and percussion

    Directory of Open Access Journals (Sweden)

    Neuseli Marino Lamari

    2006-06-01

    Full Text Available Bronquiectasia consiste em dilatação anormal, permanente e irreversível de brônquios e bronquíolos, com infecções recorrentes, inflamações, hipersecreção e redução da limpeza mucociliar. Acomete predominantemente o sexo feminino, entre 28 e 48 anos de idade e afeta com maior freqüência os lobos inferiores bilateralmente. Manifestações clínicas da doença são a tosse crônica, febre e expectoração volumosa, purulenta, com odor fétido. Etiologia é inespecífica e representada pelo estádio final de diversos processos patológicos. Pode ser classificada em cilíndrica, varicosa e sacular, e ainda, em localizada e multissegmentar. Drenagem postural e percussão são técnicas desobstrutivas usuais na prática clínica diária, no entanto, há escassez de estudos comparativos enfatizando-as com amostras populacionais e recursos metodológicos. Tomando por base as considerações, teve-se como objetivo verificar a eficácia da drenagem postural e da percussão na higiene brônquica de pacientes bronquiectásicos, bem como seus efeitos e associação com outras técnicas apontadas pela literatura atual. Os principais achados comprovaram que a drenagem postural e a percussão são efetivas na mobilização da secreção pulmonar, uma vez que aumentam a velocidade do muco transportado, melhoram a função pulmonar e as trocas gasosas. A efetividade requer ajuda de um profissional, o que pode dificultar a prática clínica diária. Por esta razão, fisioterapeutas têm selecionado técnicas que propiciem independência ao paciente.Bronchiectasis consists of abnormal, permanent and irreversible dilation of bronchi and bronchia, with recurrent infections, inflammation, hypersecretion and reduction of mucus clearance. It predominantly affects women of between 28 and 48 years old and more frequently affects the inferior lobes. Clinical manifestations are chronic cough, fever and voluminous expectoration, with a fetid odor. The etiology

  15. Métodos para la suavización de indicadores de mortalidad: aplicación al análisis de desigualdades en mortalidad en ciudades del Estado español (Proyecto MEDEA Methods to smooth mortality indicators: application to analysis of inequalities in mortality in Spanish cities (the MEDEA Project

    Directory of Open Access Journals (Sweden)

    M. Antònia Barceló

    2008-12-01

    observa en las zonas con un mayor nivel socioeconómico.Although there is some experience in the study of mortality inequalities in Spanish cities, there are large urban centers that have not yet been investigated using the census tract as the unit of territorial analysis. The coordinated project «Socioeconomic and environmental inequalities in mortality in Spanish cities. The MEDEA project» was designed to fill this gap, with the participation of 10 groups of researchers in Andalusia, Aragon, Catalonia, Galicia, Madrid, Valencia, and the Basque Country. The MEDEA project has four distinguishing features: a the census tract is used as the basic geographical area; b statistical methods that include the geographical structure of the region under study are employed for risk estimation; c data are drawn from three complementary data sources (information on air pollution, information on industrial pollution, and the records of mortality registrars, and d a coordinated, large-scale analysis, favored by the implantation of coordinated research networks, is carried out. The main objective of the present study was to explain the methods for smoothing mortality indicators in the context of the MEDEA project. This study focusses on the methodology and the results of the Besag, York and Mollié model (BYM in disease mapping. In the MEDEA project, standardized mortality ratios (SMR, corresponding to 17 large groups of causes of death and 28 specific causes, were smoothed by means of the BYM model; however, in the present study this methodology was applied to mortality due to cancer of the trachea, bronchi and lung in men and women in the city of Barcelona from 1996 to 2003. As a result of smoothing, a different geographical pattern for SMR in both genders was observed. In men, a SMR higher than unity was found in highly deprived areas. In contrast, in women, this pattern was observed in more affluent areas.

  16. Traqueobroncopatia osteocondroplástica

    Directory of Open Access Journals (Sweden)

    João Moura e Sá

    2002-07-01

    ão.REV PORT PNEUMOL 2002; VIII(4: 329-339 ABSTRACT: Tracheobronchopathia osteochondroplastica (TO is a rare disease of unknown pathogenesis and etiology. It is characterized by the presence of multiple submucosal osteocartilaginous nodules that involve luminal surfaces of anterior and lateral walls of the laryngotracheobronchial tree. In most cases the dis ease is benign and silent and its incidence in vivo (1:125 - 1:6000 is probably underestimated.Typical bronchoscopic examination of submucosal hard nodules and histologic confirmation in biopsy specimens are essential in establishing the diagnosis. In the absence of specific treatment, management is aimed at symptoms relieve. A minority of patients develop serious complications — infection, hemoptysis and obstruction — and surgical or endoscopic excision may be necessary.Incidence, clinical and bronchoscopic presentation of TO cases diagnosed in the Bronchology Unit of Centro Hospitalar de Vila Nova de Gaia during 14 years (since 1987 to 2001 were reviewed.In this period, 16 888 bronchoscopies were performed. TO was incidentally diagnosed in 13 patients (11 men, 2 women; mean age - 59,5±12,4 years. Bronchoscopy showed the characteristic endoscopic findings and all cases were histopathologically proven. None of the patients received treatment. Four patients presented with concomitant malignant lung cancer.The incidence of TO in our series (1: 1299 bronchoscopies is similar to that reported in the literature and several cases of malignant neoplasms associated with TO were identified as has been observed by other authors.REV PORT PNEUMOL 2002; VIII(4: 329-339 Palavras-chave: traqueobroncopatia osteocondroplástica, broncoscopia rígida, broncofibroscopia, traqueia, brônquios, Key-words: tracheobronchopathia osteochondroplastica, rigid bronchoscopy, flexible bronchoscopy, trachea, bronchi

  17. Genes associated with MUC5AC expression in small airway epithelium of human smokers and non-smokers

    Directory of Open Access Journals (Sweden)

    Wang Guoqing

    2012-06-01

    Full Text Available Abstract Background Mucus hypersecretion contributes to the morbidity and mortality of smoking-related lung diseases, especially chronic obstructive pulmonary disease (COPD, which starts in the small airways. Despite progress in animal studies, the genes and their expression pattern involved in mucus production and secretion in human airway epithelium are not well understood. We hypothesized that comparison of the transcriptomes of the small airway epithelium of individuals that express high vs low levels of MUC5AC, the major macromolecular component of airway mucus, could be used as a probe to identify the genes related to human small airway mucus production/secretion. Methods Flexible bronchoscopy and brushing were used to obtain small airway epithelium (10th to 12th order bronchi from healthy nonsmokers (n=60 and healthy smokers (n=72. Affymetrix HG-U133 plus 2.0 microarrays were used to assess gene expression. Massive parallel sequencing (RNA-Seq was used to verify gene expression of small airway epithelium from 5 nonsmokers and 6 smokers. Results MUC5AC expression varied 31-fold among the healthy nonsmokers. Genome-wide compa