Sample records for bronchi

  1. Quick Dissection of the Segmental Bronchi (United States)

    Nakajima, Yuji


    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. Pathology of the Trachea and Central Bronchi. (United States)

    Shroff, Girish S; Ocazionez, Daniel; Vargas, Daniel; Carter, Brett W; Wu, Carol C; Nachiappan, Arun C; Gupta, Pushpender; Restrepo, Carlos S


    A wide variety of disorders can affect the trachea and central bronchi. Computed tomography is the imaging modality of choice in the evaluation of tracheobronchial disease. Tracheobronchial abnormalities are sometimes incidentally detected on routine imaging or when imaging is performed for another reason. Abnormalities of the tracheobronchial tree, however, can be easily missed because they can be subtle. Furthermore, because symptoms in patients with tracheobronchial disorders often overlap symptoms of lung disease, radiologists may focus their attention on the lungs and overlook the tracheobronchial tree. In this article, we review a wide range of tracheobronchial diseases with emphasis on their computed tomographic appearances.

  3. Analysis of temperature regimes of hyperthermia of cancer of bronchi (United States)

    Manak, I.; Lisenkova, A.; Nikolaeva, A.


    The model of laser hyperthermia of cancer of glandular epithelium of bronchi is offered. The conditions for achievement of destruction of cancer are determined. Simulation of processes of interaction of the continuous and pulse laser radiation with a multi-layer biotissue taking into account distribution of energy in laser radiation beam, blood stream, heat transfer, processes of absorption and dispersion are realized. Peculiar properties of hyperthermia of cancer of bronch at laser action are considered.

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

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    Robbins, E.S.


    One hundred and forty-seven bronchial samples (generations 3--6) from 66 patients (62 usable; 36 female, 26 male; median age 61) have been dissected by generation from fixed surgical lung specimens obtained after the removal of pathological lesions. In addition, one hundred and fifty-six mongol dog bronchi (generations 2--6) dissected from different lobes of 26 dog lungs have also been similarly prepared. One hundred and twenty-seven human samples have been completely processed for electron microscopy and have yielded 994 electron micrographs of which 655 have been entered into the Computerized Stereological Analysis System (COSAS) and been used for the measurement of the distances of basal and mucous cell nuclei to the epithelial free surface. Similarly 328 micrographs of dog epithelium from 33 bronchial samples have been used to measure the distances of basal and mucous cell nuclei to the epithelial free surface and have been entered into COSAS. Using the COSAS planimetry program, we continue to expand our established data bases which describe the volume density and nuclear numbers per electron micrograph for 5 cell types of the human bronchial epithelial lining of men and women, as well as smokers, non-smokers and ex-smokers and similar parameters for the same 5 epithelial cell types of dog bronchi. Our micrographs of human bronchial epithelium have allowed us to analyze the recent suggestion that the DNA of lymphocytes may be subject to significant damage from Rn progeny while within the lung. Since the last progress report three papers have been submitted for publication. 17 refs., 4 tabs.

  5. [Efferent innervation of pulmonary blood vessels and bronchi in rat (an immunohistochemical study)]. (United States)

    Chumasov, E I; Voronchikhin, P A; Korzhevskiĭ, D É


    In this investigation the peculiarities of innervation of bronchi and blood vessels of the lung were studied in 20 rats using immunohistochemical demonstration of synaptophysin and alpha-actin. The results obtained have showen that the densest innervation is typical for bronchial walls, particularly, for the muscular lamina. Synaptophysin-immunoreactive terminals (SFIT) were detected in the bronchi in close association with both circular bundles of smooth muscle cells and microganglia. Dense network of SFIT was found in the pulmonary vein--in its middle tunic formed by cardiomyocytes. In contrast to the bronchi and pulmonary vein, large branches of the pulmonary artery contained no SFIT. We briefly discuss the problem of the origin of the nerve fibers described and their functions and suggest that SFIT are formed by efferent fibers (axons) of neurons arising from either the intrapulmonary parasympathetic ganglia.

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

    DEFF Research Database (Denmark)


    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...... bronchus was shown to metabolize and bind acyclic and cyclic N-nitrosamines found in the environment and in tobacco smoke....

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

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    Jakub Kwiecinski


    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.

  8. [Inter-organ neural communications in the innervation of bronchi and pulmonary circulation vessels]. (United States)

    Andriesh, V N


    By means of V.P. Vorobiov's preparation in complex of the thoracic cavity organs of persons at various age and sex in fetuses, sources of innervation of bronchi and vessels of the pulmonary circulation have been stated. They make the composition of the cardiac nerves getting off the superior, middle cervical, cervico-thoracic (stellate) and from 3 to 5 thoracic nodes of the sympathetic trunk, superior and inferior cardiac branches of the nervus vagus. Connection between the nerves of the bronchi and vessels of the pulmonary circulation with the cardiac and esophageal nerves and formation of interorganic nervous plexuses are demonstrated. Not always the diaphragmal nerve participates in the innervation of the bronchi and pulmonary vessels. In total preparations and flat sections, elective revealing of the nervous elements with Shiff reagent in M. G. Shubich and A. B. Khodos modification and Gomori thiocholine method, makes it possible to follow connections of the pulmonary veins nerves with the left atrium, intrapulmonary connection of the perivascular and peribronchial plexuses, as well as participation of nervous elements of the pulmonary trunk in innervation of the right ventricle walls. There are multiple vegetative communications participating in innervation of the bronchi and vessels of the pulmonary circulation. The relations of the pulmonary nerves with the nerves of other thoracic organs are very complex; this explains the nature of the repercussive reactions of the lungs after surgical interventions performed in the other organs of the thoracic cavity.

  9. Antagonist profile of ibodutant at the tachykinin NK2 receptor in guinea pig isolated bronchi. (United States)

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


    In this study we have characterized the pharmacological profile of the non-peptide tachykinin NK2 receptor antagonist ibodutant (MEN15596) in guinea pig isolated main bronchi contractility. The antagonist potency of ibodutant was evaluated using the selective NK2 receptor agonist [βAla(8)]NKA(4-10)-mediated contractions of guinea pig isolated main bronchi. In this assay ibodutant (30, 100 and 300nM) induced a concentration-dependent rightward shift of the [βAla(8)]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 behaviour. The calculated apparent antagonist potency as pKB value was 8.31±0.05. Ibodutant (0.3-100nM), 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 (100nM) ibodutant almost abolished the EFS-induced bronchoconstriction (95±4% inhibition), the calculated IC50 value was 2.98nM (95% c.l. 1.73-5.16nM). In bronchi from ovalbumin (OVA) sensitized guinea pigs ibodutant (100nM) 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 demonstrate that ibodutant is a potent NK2 receptor antagonist in guinea pig airways.

  10. Smooth muscle in human bronchi is disposed to resist airway distension. (United States)

    Gazzola, Morgan; Henry, Cyndi; Couture, Christian; Marsolais, David; King, Gregory G; Fredberg, Jeffrey J; Bossé, Ynuk


    Studying airway smooth muscle (ASM) in conditions that emulate the in vivo environment within which the bronchi normally operate may provide important clues regarding its elusive physiological function. The present study examines the effect of lengthening and shortening of ASM on tension development in human bronchial segments. ASM from each bronchial segment was set at a length approximating in situ length (Linsitu). Bronchial tension was then measured during a slow cyclical strain (0.004Hz, from 0.7Linsitu to 1.3Linsitu) in the relaxed state and at graded levels of activation by methacholine. In all cases, tension was greater at longer ASM lengths, and greater during lengthening than shortening. The threshold of methacholine concentration that was required for ASM to account for bronchial tension across the entire range of ASM lengths tested was on average smaller by 2.8 logs during lengthening than during shortening. The length-dependency of ASM tension, together with this lower threshold of methacholine concentration during lengthening versus shortening, suggest that ASM has a greater ability to resist airway dilation during lung inflation than to narrow the airways during lung deflation. More than serving to narrow the airway, as has long been thought, these data suggest that the main function of ASM contraction is to limit airway wall distension during lung inflation.

  11. Horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of upper lobe bronchi. (United States)

    Oguz, Berna; Alan, Serdar; Ozcelik, Ugur; Haliloglu, Mithat


    Horseshoe lung, a rare congenital anomaly, is almost always associated with unilateral (usually right-sided) lung hypoplasia, and, in most cases, in conjunction with the scimitar syndrome. We present an 8-month-old boy with horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of the upper lobe bronchi, diagnosed by multidetector CT (MDCT) imaging. The study also revealed an anomalous origin of the left vertebral artery as the last branch of the aortic arch, distal to the left subclavian artery, and an anomalous origin of the left common carotid artery from the brachiocephalic trunk. A hemivertebral anomaly of the seventh cervical vertebra was incidentally detected. MDCT with high-quality multiplanar and three-dimensional reconstructions is a noninvasive and rapid technique for detecting the complex combination of vascular, tracheobronchial and parenchymal anomalies, and any potential bone anomalies, in one imaging study.

  12. Horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of upper lobe bronchi

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    Oguz, Berna; Haliloglu, Mithat [Hacettepe University Faculty of Medicine, Department of Radiology, Ankara (Turkey); Alan, Serdar; Ozcelik, Ugur [Hacettepe University Faculty of Medicine, Department of Pediatrics, Ankara (Turkey)


    Horseshoe lung, a rare congenital anomaly, is almost always associated with unilateral (usually right-sided) lung hypoplasia, and, in most cases, in conjunction with the scimitar syndrome. We present an 8-month-old boy with horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of the upper lobe bronchi, diagnosed by multidetector CT (MDCT) imaging. The study also revealed an anomalous origin of the left vertebral artery as the last branch of the aortic arch, distal to the left subclavian artery, and an anomalous origin of the left common carotid artery from the brachiocephalic trunk. A hemivertebral anomaly of the seventh cervical vertebra was incidentally detected. MDCT with high-quality multiplanar and three-dimensional reconstructions is a noninvasive and rapid technique for detecting the complex combination of vascular, tracheobronchial and parenchymal anomalies, and any potential bone anomalies, in one imaging study. (orig.)

  13. Cellular morphometry of the bronchi of human and dog lungs. Progress report, April 1, 1991--October 1, 1991

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    Robbins, E.S.


    One hundred and forty-seven bronchial samples (generations 3--6) from 66 patients (62 usable; 36 female, 26 male; median age 61) have been dissected by generation from fixed surgical lung specimens obtained after the removal of pathological lesions. In addition, one hundred and fifty-six mongol dog bronchi (generations 2--6) dissected from different lobes of 26 dog lungs have also been similarly prepared. One hundred and twenty-seven human samples have been completely processed for electron microscopy and have yielded 994 electron micrographs of which 655 have been entered into the Computerized Stereological Analysis System (COSAS) and been used for the measurement of the distances of basal and mucous cell nuclei to the epithelial free surface. Similarly 328 micrographs of dog epithelium from 33 bronchial samples have been used to measure the distances of basal and mucous cell nuclei to the epithelial free surface and have been entered into COSAS. Using the COSAS planimetry program, we continue to expand our established data bases which describe the volume density and nuclear numbers per electron micrograph for 5 cell types of the human bronchial epithelial lining of men and women, as well as smokers, non-smokers and ex-smokers and similar parameters for the same 5 epithelial cell types of dog bronchi. Our micrographs of human bronchial epithelium have allowed us to analyze the recent suggestion that the DNA of lymphocytes may be subject to significant damage from Rn progeny while within the lung. Since the last progress report three papers have been submitted for publication. 17 refs., 4 tabs.

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

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    Vikman Petter


    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.

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

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    Robbins, E.S.


    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.

  16. An interesting view of the trachea and main bronchi as if it is drawn with a pencil: Tracheobronchopathia osteochondroplastica

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    Mustafa Erkoc


    Full Text Available A 62 year old nonsmoker man presented with increasing shortness of breath, wheeze, dry cough and multiple episodes of hemoptysis from past 5 years. His clinical examination and multiple chest X-rays taken over the years were normal. Spirometry revealed a mild obstructive airway disease but bronchoscopy was not performed as the patient did not give consent for the procedure. The CT scan that lead to the diagnosis in our patient showed deformed, thickened and narrowed tracheal wall. There were irregular spaced 1-3 mm calcific submucosal nodules of trachea and the main bronchi extending to small airways which were similar to plaque. Tracheobronchopathia osteochondroplastica is a rare benign disorder with unknown etiology, characterized by the presence of subepithelial osteo cartilaginous nodules projecting into the tracheobronchial lumen. Recently, disease has subdivided as tuberosa (degenerative changes with nodule formation and ossification and peripherica (diffuse degeneration of the trachea which is almost exclusively only found during autopsy according to the type of tracheal ossification and nodule formation. Cough not responding to usual medical treatment, recurrent hemoptysis and breathlessness are the most common symptoms. The treatment of this disease is unknown as it cannot be confirmed by a major control study because of the rarity of the disease. If there is localized disease, possible resection of the affected area may be attempted but most common chose is medical treatment .The patient was discharged with symptomatic treatment and was asked to follow up within 6 months period.

  17. Particle Deposition in Human Lungs due to Varying Cross-Sectional Ellipticity of Left and Right Main Bronchi (United States)

    Roth, Steven; Oakes, Jessica; Shadden, Shawn


    Particle deposition in the human lungs can occur with every breathe. Airbourne particles can range from toxic constituents (e.g. tobacco smoke and air pollution) to aerosolized particles designed for drug treatment (e.g. insulin to treat diabetes). The effect of various realistic airway geometries on complex flow structures, and thus particle deposition sites, has yet to be extensively investigated using computational fluid dynamics (CFD). In this work, we created an image-based geometric airway model of the human lung and performed CFD simulations by employing multi-domain methods. Following the flow simulations, Lagrangian particle tracking was used to study the effect of cross-sectional shape on deposition sites in the conducting airways. From a single human lung model, the cross-sectional ellipticity (the ratio of major and minor diameters) of the left and right main bronchi was varied systematically from 2:1 to 1:1. The influence of the airway ellipticity on the surrounding flow field and particle deposition was determined.

  18. LASER BIOLOGY AND MEDICINE: Combination of fluorescence imaging and local spectrophotometry in fluorescence diagnostics of early cancer of larynx and bronchi (United States)

    Sokolov, Vladimir V.; Filonenko, E. V.; Telegina, L. V.; Boulgakova, N. N.; Smirnov, V. V.


    The results of comparative studies of autofluorescence and 5-ALA-induced fluorescence of protoporphyrin IX, used in the diagnostics of early cancer of larynx and bronchi, are presented. The autofluorescence and 5-ALA-induced fluorescence images of larynx and bronchial tissues are analysed during the endoscopic study. The method of local spectrophotometry is used to verify findings obtained from fluorescence images. It is shown that such a combined approach can be efficiently used to improve the diagnostics of precancer and early cancer, to detect a primary multiple tumours, as well as for the diagnostics of a residual tumour or an early recurrence after the endoscopic, surgery or X-ray treatment. The developed approach allows one to minimise the number of false-positive results and to reduce the number of biopsies, which are commonly used in the white-light bronchoscopy search for occult cancerous loci.

  19. Organ bath in detecting the effect of one-hour warm ischemia on pulmonic arteries and bronchi from non-heart-beating donor lungs

    Institute of Scientific and Technical Information of China (English)

    ZHAO Song; WANG Jia-xiang; YANG Yang; HE Zhan-feng; LIAO Qiu-ming


    Background Non-heart-beating donor lung has been a promising source of lung transplantation. Many studies on non-heart-beating donor lungs are based on animal lung transplantation. In this study, we assessed by organ bath the effect of one-hour warm ischemia on the non-heart-beating donor lung in terms of the integrity of contractile and relaxant functions and tissue structures of pulmonic arteries and bronchi.Methods Sixteen Swedish pigs were randomly classified into two groups: heart-beating donor group and 1-hour warm ischemia non-heart-beating donor group. Pulmonic and bronchial rings were taken from the isolated left lungs of the pigs. The pulmonic rings were stimulated by U-46619 (5.7 mol/L) and acetylcholine (10~(-4) mmol/L) to assess the contractile abilities of smooth muscle and the endothelium-dependent relaxation response, respectively. As such, acetylcholine (10~(-5) mmol/L) and natrium arachidonic acid (0.01%) were used to detect the contraction of bronchial smooth muscle and epithelium-dependent relaxation response. Meanwhile, the variances of precontraction tension of control groups were recorded to measure whether there was spontaneous relaxation during endothelium/epithelium-dependent relaxation course. Finally, papaverine solution (10~(-4) mmol/L) was used to detect the non-endothelium/epithelium-dependent relaxant abilities of pulmonic and bronchial smooth muscles.Results There was no significant difference in the tension values of precontraction of pulmonic rings (P>0.05), endothelium-dependent relaxation (P>0.05), precontraction of bronchial rings (P>0.05) and epithelium-dependent relaxation (P>0.05) between the heart-beating donor group and the 1-hour warm ischemia non-heart-beating donor group. And the pulmonic and bronchial rings of each subgroup B had no spontaneous relaxation. Finally, papaverine solution relaxed the smooth muscle of all the rings completely.Conclusions The results of this experiment suggest that the contractile

  20. 气管舆主支气管肿瘤的影像诊断回顾--附28例病例分析%Imaging Diagnostic reviewing of Neoplasms of the Trachea and Main Bronchi

    Institute of Scientific and Technical Information of China (English)

    李政义; 王锐


    Objective The imaging manifestations of 28 Cases of neoplasms of the trachea and main bronchi pathologicaliy wereanalysed, and evacuated the merits and demerits of routine chest film, tomography and CT in the diagnosis of tumors of trachea and mainbronchi and discussed the role of imaging diagnosis. Methods 28 cases with neoplasms of the trachea and main bronchi underwent X - raychest films, tomography and CT, and analysed its signs. Results The imaging manifestation of 28 cases Patients were divided into threepatterns: imtraluminal, wall - thickening, and intra - extraluminal types. there were the difference of benign, malignant and tissue patternsof the tumors, and their imaging signs were different. Conclusions The wall - thicken and intra- extraluminal, two types suggestedmalignancy, but the sessile imtraluminal type was difficult for differentiation between benign and malignant tumors.

  1. The fibroblast growth factor-2 (F.G.F.-2) expression predicts the tumoral response and the local of non at small cells bronchi cancers after chemoradiotherapy; L'expression de FGF-2 predit la reponse tumorale et le controle local des cancers bronchiques non a petites cellules apres chimioradiotherapie

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    Massabeau, C.; Toulas, C.; Moyal, E. [Institut Claudius-Regaud, 31 - Toulouse (France); Rouquette, I.; Lauwers-Cances, V.; Mazieres, J. [Centre Hospitalier Universitaire, 31 - Toulouse (France)


    The tumoral expression of the fibroblast growth factor-2 is correlated with a bad response to chemotherapy and a strong rate of local recurrence. F.G.F.-2 would define a radioresistant phenotype of non at small cells bronchi carcinoma. (N.C.)

  2. Application of 64-row spiral CT in the evaluation of invasion of trachea,bronchi,and hilar vessels in central type of lung cancer%MSCT在判断中央型肺癌对气管、支气管及肺门血管侵犯中的价值

    Institute of Scientific and Technical Information of China (English)

    黄宝泉; 郑悦; 张庆武; 曾向廷; 林惠如


    Objective: To investigate the value of 64 row spiral computed tomography (MSCT) in the diagnosis of tra chea,bronchi and hilar vascular invasion by central type of lung cancer (CLC). Methods:Seventy five cases of CLC under went MSCT examination with post processing techniques including multiplanar reformation (MPR) ,curved planar reforma tion (CPR) ,volume rendering (VR) ,minimum intensity projection (MinIP) ,maximum intensity projection (MIP) and CT virtual endoscopy (CTVE). The relationship of trachea,bronchi,pulmonary hilar vessels with the neoplasm was studied. Results :Invasion of trachea and bronchi by CLC included extraluminal compression type (38 cases,50. 7%) ,which was showed on CT as compression and/or invasion of bronchi led to uneven stenosis;infiltration of bronchial wall(28 cases,37.3%)12. 0%) showed as protruding of neoplasm into the lumen which led to eccentric stenosis of trachea/bronchi. Altogether 117 hilar vessels were invaded by CLC,of which,95 (81. 2%) could be assessed on CT,showing obvious narrowing or oblitera tion; blood vessels encircled by tumor (n = 12,10. 3%) , and tumor thrombosis (n=10,8. 5%). Conclusion: The anatomic features of trachea,bronchi,and hilar vessels and their spacial relationship with CLC could be accurately assessed on 64 row spiral CT with post processing techniques, which provides significant information in judging whether there are trachea, bronchi, and hilar vessel invasion by CLC.%目的:探讨64排螺旋CT及后处理技术在判断中央型肺癌(CLC)对气管、支气管及肺门血管侵犯中的价值.方法:75例经纤支镜或病理确诊的CLC患者行64排螺旋CT扫描,运用多平面重组、曲面重组、容积再现、最大密度投影、CT仿真内窥镜等后处理技术观察肿瘤与气管、支气管及肺门血管的关系.结果:肿瘤对气管、支气管的侵犯表现为管外压迫型38例(50.7%),CT表现为肿瘤压迫并侵犯支气管,管腔内呈不均匀狭窄;管壁浸润型(28

  3. 亚甲蓝盐水定位气胸与支气管瘘相关支气管的临床研究%Clinical investigation of detecting the bronchi responsible for pulmonary air leakage by injecting methylene blue saline in 27 cases with intractable pneumothorax and bronchial fistula

    Institute of Scientific and Technical Information of China (English)

    金普乐; 葛晖; 彭乱顺; 王国军; 胡文霞; 宋姗


    in cases with intractable pneumothorax and bronchial fistula.Methods From January 2006 to October 2013,a total of 19 cases of intractable spontaneous pneumothorax and 8 cases of bronchial fistula were recruited in the study at the Fourth Hospital affiliated to Hebei Medical University.Of all the cases,15 were diagnosed as having tension pneumothorax and 12 as having communicating pneumothorax.All the cases failed to respond to continuous pleural suction for more than 5 days and consented to the proposed treatment.Before procedure,chest suction was established to allow sustained airflow through the drainage tube while the patients breathed normally.Under direct vision through fiberoptic bronchoscope,injection catheter was inserted into the bronchoscopy channel,and methylene blue saline was slowly injected into the potentially leaking segmental or sub-segmental bronchi.When a steady decline or disappearance in the amount of methylene blue saline in the airways was observed,or methylthionine-tainted saline was detected within the chest drainage tube,the bronchus responsible for air leakage was indicated.Beforc blocking the target bronchus,the negative pressure level of pleural suction should be reduced or stopped,and then porcine fibrin glue or acyanoacrylate was used for sealing the bronchi associated with air leakage.When the air was absent from the drainage tube,and lung recruitment was indicated in the chest Ⅹ-ray for 5 days,and bronchial blockade of air leakage was proved successful.Results The bronchi responsible for air leakage were successfully located in all 27 cases,among them segmental bronchi were located in 16,subsegmental bronchi in 10,and small subsegmental bronchus in only one.Multiple adjacent segmental involvement occurred in 3,and multiple adjacent subsegmental involvement in 5 cases.The average time for locating the target bronchi was (51 ±9) s,among them the average time for tension pneumothorax was(48 ± 15) s compared with(53 ±16) s for

  4. 胸部透视、胸部平片和MSCT对小儿气管、支气管异物的诊断价值分析%The Analysis of Diagnostic Value of Fluoroscopy of Chest, the Chest X-ray and Multislice Computed Tomography (MSCT) to the Foreign Bodies in the Trachea and Bronchi of the Children

    Institute of Scientific and Technical Information of China (English)

    魏相磊; 武玉丽


    Objective To explore the diagnostic value of fluoroscopy of chest, the chest X-ray and multislice computed tomography (MSCT) to the foreign bodies in the trachea and bronchi of the children, and compare the results and diagnosis accuracy to the foreign bodies in the trachea and bronchi. Methods 18 cases of suspected bronchial foreign body all given lfuoroscopy of chest, the chest X-ray and MSCT, even through axis scan images mutiplane restructuring (MPR), curved planar reformation (CPR), minimum density projection method (MinP) and CT virtual endoscopy (CTVE) etc. Image post-processing technology, and compare the images results with what be found by video bronchoscope examination. Results All cases are found foreign bodies by video bronchoscope examination. 1 case directly observed positive foreign body and 10 cases observed typical signs of indirect negative foreign body by lfuoroscopy of chest. 1 case directly observed positive foreign body and 9 cases observed typical signs of indirect negative foreign body by chest X-ray examination .meanwhile 17 cases directly observed positive foreign body by MSCT scan. Conclusion MSCT and image post-processing technology has important value in diagnosing trachea bronchial foreign body in children.%目的:探讨胸部X线透视、胸部平片和MSCT对气管支气管异物的诊断价值,比较三种方法对诊断支气管异物的正确率。方法对18例怀疑支气管异物的病例全部行胸透、胸部平片和MSCT检查,通过图像后处理工作站将MSCT轴位扫描图像进行多平面重组(MPR)、曲面重组(CPR)、最小密度投影法(MinP)和CT仿真内镜(CTVE)等图像重组,检查结果分别与支气管镜对照。结果18例经纤维支气管镜检查均发现异物。胸透直接观察到阳性异物1例,具有典型间接征象的阴性异物10例;胸部平片直接观察到阳性异物1例,具有典型间接征象的阴性异物9例;MSCT诊断支气管异物17

  5. Application of Low-dose Chest 16-slice Spiral CT Scan in Examination of Foreign Bodies in Bronchi of Children%16层螺旋CT低剂量胸部扫描在小儿气道异物检查中的应用

    Institute of Scientific and Technical Information of China (English)



    目的:探讨16层螺旋CT低剂量胸部扫描在小儿气道异物检查中的应用价值.方法:对48例经纤维支气管镜证实有气道异物的患儿行不同荆量检查,其中28倒为低剂量(30 mAs)扫描,20例为常规(100 mAs)剂量扫描,将轴位薄层原始数据传至工作站分别行多平面重组(MPR)、最小密度投影(MinIP)、容积再现(VR)及CT仿真内镜(CTVE)后处理重建成像、分析其敏感性和准确性.结果:28例低剂量扫描患儿中发现异物27例,诊断准确率为96.4%;20例常规刺量扫描患儿中发现异物20例,诊断准确率为100%.两者无显著性差异(P>0.05).结论:16层螺旋CT低剂量胸部扫描不仅减少小儿接受的辐射剂量,后处理图像重建后可清楚显示异物的部位、形态、大小及阻塞部位,是诊断小儿气道异物无创并实用的检查方法.%Objective To discuss the value of low-dose chest 16-slice spiral CT scan in the examination of foreign hodies in bronchi of children. Methods Forty-eight children with foreign bodies aspiration were scanned transversely and reconstructed in different doses of the line check, twenty-eight were scanned witb low-dose, the others were scanned with conventional dose. Then the original axial data were transferred to workstation for image reconsruction by multi-planar reconstruction (MPR), minimum intensity projection (MinIP), volume rendering (VR) and CT virtual endoscopy (CTVE) respectively. The sensitivity and accuracy were analyzed. Results Twenty-seven cases were diagnosed with foreign bodies in those scanned with low-dose, diagnostic accuracy was 96.4%. Twenty cases were diagnosed with foreign bodies diagnostic accuracy was 100%. The difference was not statistically significant (P>0.05). Conclusion Low-dose chest 16-slice spiral CT scan can not only reduce the radiation dose received but also clearly show the site, the shape and the size of foreign body, and even the position of obstruction after post

  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


    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. In vivo endoscopic autofluorescence microspectro-imaging of bronchi and alveoli

    CERN Document Server

    Bourg-Heckly, G; Vever-Bizet, C; Viellerobe, B


    Fibered confocal fluorescence microscopy (FCFM) is a new technique that can be used during a bronchoscopy to analyze the nature of the human bronchial and alveolar mucosa fluorescence microstructure. An endoscopic fibered confocal fluorescence microscopy system with spectroscopic analysis capability was developed allowing real-time, simultaneous images and emission spectra acquisition at 488 nm excitation using a flexible miniprobe that could be introduced into small airways. This flexible 1.4 mm miniprobe can be introduced into the working channel of a flexible endoscope and gently advanced through the bronchial tree to the alveoli. FCFM in conjunction with bronchoscopy is able to image the in vivo autofluorescence structure of the bronchial mucosae but also the alveolar respiratory network outside of the usual field of view. Microscopic and spectral analysis showed that the signal mainly originates from the elastin component of the bronchial subepithelial layer. In non smokers, the system images the elastin...

  8. Anatomical arrangement of the lobar bronchi, broncho-pulmonary segments and their variations

    Directory of Open Access Journals (Sweden)

    Sathidevi V. K.


    Conclusions: In man there is an increase in the number of bronchial generations and alveoli after birth. An increase in their size was noted as well. Thus the study of variations in the pattern of bronchopulmonary segments aids the clinician very much. It is necessary for Thoracic Surgeons, Anaesthetists, Chest physicians, Radiologists, Ultrasonologists, Pathologists and Anatomists for investigative procedures, diagnosis and various treatment modalities including surgeries like segmentectomy. [Int J Res Med Sci 2016; 4(11.000: 4928-4932

  9. Interindividual variation in binding of benzo[a]pyrene to DNA in cultured human Bronchi

    DEFF Research Database (Denmark)

    Harris, C.C.; Autrup, Herman; Connor, R.


    The binding of benzo[a]pyrene to DNA in cultured human bronchus was measured in specimens from 37 patients. The binding values ranged from 2 to 151 picomoles of benzo[a]pyrene per milligram of DNA with an overall mean +/- standard error of 34.2 +/- 5.2. This 75-fold interindividual variation in t...

  10. Inter-radiotherapists variability in the tumor delineation: example of volume intercomparison in the bronchi cancer and training impact; Variabilite inter-radiotherapeutes dans la delineation tumorale: exemple d'intercomparaison de volumes dans le cancer bronchique et impact de la formation

    Energy Technology Data Exchange (ETDEWEB)

    Dewas, S.; Lacornerie, T. [Centre Oscar-Lambret, Dept. Universitaire de Radiotherapie, 59 - Lille (France); Blanchard, P.; Vautravers-dewas, C.; Pointreau, Y. [Societe Francaise des jeunes Radiotherapeutes et Oncologues (SFjRO), 75 - Paris (France); Gibon, D. [Societe Aquilab, 59 - Lille (France); Giraud, P. [Hopital Europeen Georges-Pompidou, 75 - Paris (France)


    No significant volume modification has been found after lecturing. It allows however, an adaptation to margins of expansion and shows a trend to an increase of the prescribed dose as well a decrease of the delineated volume. The good quality of the initial delineation could explain the lack of progression after the teaching. (N.C.)

  11. Radioinduced pulmonary fibrosis: prospective study of clinical, dosimetric and biological predictive factors after conformal irradiation of non at small cells bronchi carcinomas; Fibroses radiques pulmonaires: etude prospective des facteurs predictifs cliniques, dosimetriques et biologiques apres irradiation conformationnelle des carcinomes bronchiques non a petites cellules

    Energy Technology Data Exchange (ETDEWEB)

    Claude, L.; Ginestet, C.; Martel-Lafay, I.; Carrie, C. [Centre Leon-Berard, 69 - Lyon (France); Etienne-Mastroiani, B. [Hopital Louis-Pradel, 69 - Lyon (France); Arpin, D. [Hopital de la Croix-Rousse, 69 - Lyon (France); Vincent, M. [Hopital Saint-Luc-Saint-Joseph, 69 - Lyon (France); Falchero, L. [Hopital de Villefranche, 69 - Villefranche s/Saone (France); Blay, J.Y. [Hopital Edouard-Herriot, 69 - Lyon (France); Perol, D. [Centre Leon-Berard, 69 - Lyon (France)


    This broad prospective study confirms the contribution of dosimetry factors ( pulmonary average dose, V10 to V50) in the predictive part for the delayed radioinduced fibrosis. Contrary to the acute radioinduced pneumopathy, no significant relationship has been underlined between the variations of cytokines and the delayed radioinduced fibrosis risk. (N.C.)

  12. Study of feasibility of the preoperative chemoradiotherapy for stage 2B/3 non at small cells bronchi cancer and histological response: about 107 cases treated at Avignon; Etude de faisabilite de la chimioradiotherapie preoperatoire pour cancer bronchique non a petites cellules de stades 2B/3 et reponse histologique: a propos de 107 cas traites a Avignon

    Energy Technology Data Exchange (ETDEWEB)

    Pourel, N.; Hilgers, W.; Mineur, L.; Reboul, F. [Institut Sainte-Catherine, 84 - Avignon (France); Santelmo, N. [Centre Hospitalier H.-Duffaut, 84 - Avignon (France); Molinari, N. [Laboratoire de biostatistique, faculte de Medecine, 34 - Montpellier (France)


    The preoperative chemoradiotherapy is an induction treatment that is feasible for stage 2B/3 non at small cells for patients whom Who performance index is 0-1. The surgery is to question if a pneumonectomy, particularly right one, is necessary. The histological response to chemoradiotherapy is a factor of forecasting of the global survival. (N.C.)

  13. Behavioral-Physiological Effects of Red Phosphorus Smoke Inhalation on Two Wildlife Species (United States)


    the following organs by APHIS Veterinary Services personnel: nasal passages, trachea, larynx, epiglottis , bronchi, lungs, heart, liver, spleen and...kidneys. Sections of the nasal passages, bronchi, lungs and liver, plus the entire trachea, larynx and epiglottis , from each animal were preserved jointly

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

    DEFF Research Database (Denmark)


    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...

  15. 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


    Recent intrabronchial microdialysis data indicate that the respiratory epithelium is highly permeable to drugs. Of concern is whether intrabronchial microdialysis disrupts the integrity of the respiratory epithelium and thereby alters drug penetration into the pulmonary epithelial lining fluid...... 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......). The microdialysis probe caused overt tissue trauma in distal bronchi, whereas no histopathological lesions were observed in proximal bronchi. A moderate up-regulation of the pro-inflammatory cytokines IL1B, IL6 and acute-phase reactant serum amyloid A was seen in proximal bronchi surrounding the microdialysis...

  16. 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)


    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.)

  17. [The transplantation of revascularized thyroid-trachea-lung complex: the experimental study]. (United States)

    Parshin, V D; Zhidkov, I L; Bazarov, D V; Parshin, V V; Chernyĭ, S S


    The osteoplastic tracheobronchopathy affects the trachea, main, lobar and smaller bronchi, causing their stenosis. Nowadays the mainstay of the treatment of such patients is the cryodestruction, laser destruction and the endoscopic buginage of the trachea and bronchi. The palliative nature and low efficacy of these procedures forces to search new ways of treatment. The traditional lung transplantation or separate trachea and lung transplantation is inappropriate because of the complex affection of both trachea and bronchi. The experimental study aimed the possibility of thyreotracheolung revascularized donor complex transplantation.

  18. Differential diagnosis of several mechanisms of destruction in patients with dust diseases of lungs

    Energy Technology Data Exchange (ETDEWEB)

    Zhumabekova, B.K.; Nikolaeva, L.N.; Milishnikova, V.V.


    In pathogenesis of lung diseases destruction of bronchial passability plays a significant role. Differential diagnosis of the mechanisms of destruction in patients ill with dust diseases was conducted with inhalation of salbutamol, stimulator of beta-adrenoreceptors of bronchi. Investigations of function of breathing included determination of ventilation characteristics, gases of blood and resistance of bronchi. Sixty patients were studied, 30 with pneumoconiosis and 30 with chronic dust bronchitis. Combination of ventilation characteristics and inhalation of salbutamol over 10, 20, 30 and 40 minute periods was used to determine mechanisms causing destruction of function of breathing. Comparisons of results of pneumotaxometry and fibroscopy show changes in mucous envelope of trachea and bronchi, inflammation and hypersecretion causing obstruction of bronchi. It is possible that these mechanisms may be combined with other changes of the tracheobronchial tree (dyskinesia, dystonia, changes in architectonics of bronchial tree and others). Further investigation of these possible mechanisms of destruction of bronchial passability is needed. (5 refs.) (In Russian)

  19. Test Your Asthma Knowledge (United States)

    ... narrowing of the bronchi. This can make breathing difficult, particularly expiration (exhaling) and can cause a feeling of tightness in the chest. Answer: D. All of these can make asthma worse. But some things that make asthma worse ...

  20. Bronchial, alveolar, and vascular-induced anaphylaxis and irritant-induced cardiovascular and pulmonary responses.


    Yeates, D B; Mussatto, D J; Hameister, W M; Daza, A.; Chandra, T; Wong, L B


    We examine the respiratory, bronchomotor, cardiac, and vascular responses to histamine and ragweed allergen delivered to the bronchi or alveoli compartments and the potential role of sensory nerves and reflexes mediating the histamine-induced responses. The masses of aerosols deposited in the bronchi and alveoli were quantitated using radioaerosol techniques. Activation of sensory nerves and/or histamine-induced mediator release were characterized by depositing nedocromil sodium aerosol prior...

  1. 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.

  2. Pulmonary nodules: optimal slice thickness of CT in revealing bronchial imageology

    Institute of Scientific and Technical Information of China (English)

    Shenjiang Li; Yuanyuan Wang; Changcheng Li; Xing Wang; Debin Liu; Wenjie Liang; Feng Zhu; Yan Zhu; Xuefeng Cui; Fangang Hu


    Objective: The aim of our study was to determine an optimal slice thickness that was efficient in revealing bronchial imageology of pulmonary nodules (PNs) on multi-slice spiral computed tomography (MSCT) images preliminarily. Methods: Fifty-four patients with 62 PNs (diameter ≤ 3 cm) underwent multidetector-row computed tomography of the chest in a single-breath-hold technique. The raw data were acquired with a collimation of 0.625 mm. Three sets of contiguous im-ages were reconstructed with 1-, 2-, and 5-mm slice thickness, respectively. Bronchial imageology of SPNs on the CT images presented in 1-, 2-, and 5-mm slice thickness was compared. Using the 1-mm sections as the gold standard, an optimal slice thickness in revealing bronchial imageology of PNs was determined. Results: Bronchial imageology of PNs on the CT im-ages presented in 1 mm slice thickness involved 85 bronchi (35 second-fourth generation bronchi; 50 fifth-eighth generation bronchi). Bronchial imageology on 2-mm-thick sections was as same as that on 1-mm-thick sections in 34 second- fourth generation bronchi. No statistically significant difference in number of second- fourth generation bronchi with same bronchial imageology was found between that on 2-mm-thick images and 1-mm-thick images (P = 0.836 > 0.05). Bronchial imageology on 5-mm-thick sections was as same as that on 1-mm-thick sections in 24 second-fourth generation bronchi. There was statistically significant difference in number of second-fourth generation bronchi with same bronchial imageology between that on 5-mm-thick images and 1-mm-thick images (P = 0.026 < 0.05). Bronchial imageology on 2-mm-thick sections was as same as that on 1-mm-thick sections in 38 fifth-eighth generation bronchi. There was statistically significant difference in number of fifth-eighth generation bronchi with same bronchial imageology between that on 2-mm-thick images and 1-mm-thick images (P = 0.029 < 0.05). Bronchial imageology on 5-mm-thick images was

  3. Alteration of airway responsiveness mediated by receptors in ovalbumin-induced asthmatic E3 rats

    Institute of Scientific and Technical Information of China (English)

    Jing-wen LONG; Xu-dong YANG; Lei CAO; She-min LU; Yong-xiao CAO


    Aim:Airway hyperresponsiveness is a constant feature of asthma.The aim of the present study was to investigate airway hyperreactivity mediated by contractile and dilative receptors in an ovalbumin (OVA)-induced model of rat asthma.Methods:Asthmatic E3 rats were prepared by intraperitoneal injection with OVA/aluminum hydroxide and then challenged with intranasal instillation of OVA-PBS two weeks later.The myograph method was used to measure the responses of constriction and dilatation in the trachea,main bronchi and lobar bronchi.Results:In asthmatic E3 rata,β2 adrenoceptor-mediated relaxation of airway smooth muscle pre-contracted with 5-HT was inhibited,and there were no obvious difference in relaxation compared with normal E3 rats.Contraction of lobar bronchi mediated by 5-HT and sarafotoxin 6c was more potent than in the trachea or main bronchi.Airway contractions mediated by the endothelin (ET)A receptor,ETB receptor and M3 muscarinic receptor were augmented,and the augmented contraction was most obvious in lobar bronchi.The order of efficacy of contraction for lobar bronchi induced by agonists was ET-1,sarafotoxin 6c>ACh>5-HT.OX8 (an antibody against CD8+ T cells) strongly shifted and 0X35 (an antibody against CD4+ T cells) modestly shifted isoprenaline-induced concentration-relaxation curves in a nonparallel fashion to the left with an increased Rmax in asthmatic rats and sarafotoxin 6c-induced concentration-contractile curves to the right with a decreased Emax.Conclusion:The inhibition of airway relaxation and the augmentation of contraction mediated by receptors contribute to airway hyperresponsiveness and involve CD8+ and CD4+ T cells.

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

    Energy Technology Data Exchange (ETDEWEB)

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


    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.

  5. Severe sand aspiration: a case report with complete recovery. (United States)

    Glinjongol, Chanin; Kiatchaipipat, Surachai; Thepcharoenniran, Somchai


    A 5-year-old boy, previously healthy, was admitted to Ratchaburi Hospital after being buried in a sand pile. He presented with dyspnea and tachypnea. Chest radiograph showed opaque particles in both main and segmental bronchi (sand bronchogram). The first attempt of bronchoscopy was unsatisfactory as a considerable amount of sand particles had migrated further into the distal bronchi. A second bronchoscopy was performed with 0.9% saline lavage. Most of the sand particles were successfully removed. Intravenous steroids and antibiotics were administered for treatment. The patient was discharged uneventfully by the end of the first week of hospitalization.

  6. Macrolide maintenance treatment for bronchiectasis

    NARCIS (Netherlands)

    Altenburg, Josje


    Bronchiectasis, pathological widening of the small and medium sized bronchi, may result from various disorders with one common trait; a faltering airway defence system. This allows for persistent bacterial infection and an augmented airway inflammatory response. Patients’ suffering is often consider

  7. Quantitative modelling of the biomechanics of the avian syrinx

    NARCIS (Netherlands)

    Elemans, C.P.H.; Larsen, O.N.; Hoffmann, M.R.; Leeuwen, van J.L.


    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

  8. 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:; Cavalcante, Luciana Porto [Goias Univ., Goiania, GO (Brazil). Faculdade de Medicina


    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)

  9. Can Bronchoscopic Airway Anatomy Be an Indicator of Autism? (United States)

    Stewart, Barbara A.; Klar, Amar J. S.


    Bronchoscopic evaluations revealed that some children have double branching of bronchi (designated "doublets") in the lower lungs airways, rather than normal, single branching. Retrospective analyses revealed only one commonality in them: all subjects with doublets also had autism or autism spectrum disorder (ASD). That is, 49 subjects exhibited…

  10. Lung Aplasia with Pulmonary Artery Sling Like Anomaly

    Directory of Open Access Journals (Sweden)

    Onur Isik


    Full Text Available Unilateraly pulmonary agenesis is an extremely rare documented congenital anomaly. It may be defined as total absence of the pulmonary parencilyma, its vascular supporting structure, and bronchi beyond the bifurcation. The present case with reconstructed images is one of the different cases of agenesis reported in the literature.

  11. Severe tracheobronchial stenosis and cervical vertebral subluxation in X-linked recessive chondrodysplasia punctata

    Energy Technology Data Exchange (ETDEWEB)

    Mundinger, Gerhard S. [Johns Hopkins Hospital, Division of Plastic, Reconstructive, and Maxillofacial Surgery, Baltimore, MD (United States); Weiss, Clifford; Fishman, Elliot K. [Johns Hopkins Hospital, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States)


    Radiologic manifestations of X-linked chondrodysplasia punctata (CDPX1) typically include chondrodysplasia, epiphyseal stippling, punctate calcification of cartilage, distal phalangeal hypoplasia, and nasal/midface hypoplasia. We present an infant with CDPX1 demonstrating calcification and stenosis of the entire trachea and mainstem bronchi, as well as possible anterior C1 subluxation due to progression of congenital vertebral dysplasia. (orig.)

  12. Quantitative modelling of the biomechanics of the avian syrinx

    DEFF Research Database (Denmark)

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


    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...

  13. Mechanisms of avian songs and calls

    DEFF Research Database (Denmark)

    Larsen, Ole Næsbye


    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...

  14. Tracheobronchopathia osteochondroplastica: Case report and literature review

    Directory of Open Access Journals (Sweden)

    Junping Sun


    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.

  15. Broncholithiasis-induced bronchial artery fistula and pulmonary artery fistula in an aged female: a case report

    Institute of Scientific and Technical Information of China (English)

    SHANG Yan; BAI Chong; HUANG Hai-dong; DONG Yu-chao; HUANG Yi; YAO Xiao-peng; LI Qiang


    @@ Broncholithiasis, a rare disorder of the respiratory system, is usually caused by pulmonary fungal infection and tuberculosis occurring in the early years of its victims. Pulmonary fungal infection and tuberculosis can lead to calcification of the hilar and mediastinal lymph nodes; the calcified lymph nodes erode the nearby bronchi and cause clinical and imaging abnormalities.

  16. Interaction between gas cooking and GSTM1 null genotype in bronchial responsiveness: results from the European Community Respiratory Health Survey.

    NARCIS (Netherlands)

    Amaral, A.F.S.; Ramasamy, A.; Castro-Giner, F.; Minelli, C.; Accordini, S.; Sorheim, I.C.; Pin, I.; Kogevinas, M.; Jögi, R.; Balding, D.J.; Norbäck, D.; Verlato, G.; Olivieri, M.; Probst-Hensch, N.; Janson, C.; Zock, J.P.; Heinrich, J.; Jarvis, D.L.


    Background: Increased bronchial responsiveness is characteristic of asthma. Gas cooking, which is a major indoor source of the highly oxidant nitrogen dioxide, has been associated with respiratory symptoms and reduced lung function. However, little is known about the effect of gas cooking on bronchi

  17. Thoracoscopic lung segmentectomy simulated by a tailor-made virtual lung: computed bronchography and angiography. (United States)

    Akiba, Tadashi; Morikawa, Toshiaki; Ohki, Takao


    We describe the benefits of simulating an anatomical lung segmentectomy using multidetector computed tomography bronchography and angiography (tailor-made virtual lung). Preoperative determination of the anatomical intersegmental plane is possible by visualizing the segmental bronchi and pulmonary vein branches. This advanced technique could be useful during thoracoscopic anatomical segmentectomy for lung cancer.

  18. 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 development

  19. Primary diffuse tracheobrochial amyloidosis: case report

    Energy Technology Data Exchange (ETDEWEB)

    Oezer, Caner E-mail:; Nass Duce, Meltem; Yildiz, Altan; Apaydin, F. Demir; Egilmez, Hulusi; Arpaci, Taner


    Respiratory amyloidosis is a rare disease that occurs in three forms: tracheobronchial, nodular parenchymal and diffuse parenchymal involvement. Tracheobronchial amyloidosis is characterized by focal or diffuse deposition of amyloid in the submucosa of the trachea and proximal bronchi. Herein, we report a case of diffuse tracheobronchial amyloidosis with plain radiography and thorax computed tomography findings.

  20. Cavitary Lung Cancer Lined with Normal Bronchial Epithelium and Cancer Cells


    Goto, Taichiro; Maeshima, Arafumi; Oyamada, Yoshitaka; Kato, Ryoichi


    Reports of cavitary lung cancer are not uncommon, and the cavity generally contains either dilated bronchi or cancer cells. Recently, we encountered a surgical case of cavitary lung cancer whose cavity tended to enlarge during long-term follow-up, and was found to be lined with normal bronchial epithelium and adenocarcinoma cells.

  1. Aspects of syringeal mechanics in avian phonation

    NARCIS (Netherlands)

    Larsen, O.N.; Goller, F.; Leeuwen, van J.L.


    The vocal organ of birds, the syrinx, is formed by modified cartilages of the trachea and bronchi. Recently, the use of thin, flexible endoscopes has made direct observation of the syrinx possible in situ. The effects of direct muscle stimulation on the syringeal aperture identified adductor and abd

  2. Lower respiratory tract tumours in Syrian golden hamsters after intratracheal instillations of diethylnitrosamine alone and with ferric oxide

    NARCIS (Netherlands)

    Feron, V.J.; Emmelot, P.; Vossenaar, T.


    A total of 37 tumours of the lower respiratory tract (bronchi, bronchioli and alveoli) was observed in 62 male and female Syrian golden hamsters following 15 weekly intratracheal instillations of diethylnitrosamine (DENA) alone. The number of tumours in this segment of the respiratory system was 3 t

  3. Bronchial anatomy of left lung: a study of multi-detector row CT. (United States)

    Zhao, Xinya; Ju, Yuanrong; Liu, Cheng; Li, Jianfeng; Huang, Min; Sun, Jian; Wang, Tao


    Familiarity with prevailing pattern and variations in the bronchial tree is not only essential for the anatomist to explain bronchial variation in bronchial specimens, but also useful for guiding bronchoscopy and instructing pulmonary segmental resection. The purpose of this study was designed to demonstrate various branching patterns of left lung with 3D images, with special attention given to identify the major types at transverse thin-section CT. Two hundred and sixteen patients with routine thorax scans were enrolled. The images of bronchial tree, virtual bronchoscopy were reconstructed using post-processing technique of multi-detector row CT. We attempted to classify the segmental bronchi by interpreting the post-processing images, and identified them in transverse thin-section CT. Our results showed that the segmental bronchial ramifications of the left superior lobe were classified into three types mainly, i.e., common stem of apical and posterior segmental bronchi (64%, 138/216); trifurcation (23%, 50/216); common stem of apical and anterior segmental bronchi (10%, 22/216), and they could be identified at two typical sections of transverse thin-section CT. There were two major types in left basal segmental bronchi, i.e., bifurcation (75%, 163/216), trifurcation (18%, 39/216), and they could also be identified at two typical sections of transverse thin-section CT. In conclusion, our study have offered simplified branching patterns of bronchi and demonstrated various unusual bronchial branching patterns perfectly with 3D images, and have also revealed how to identify the main branching patterns in transverse thin-section CT.

  4. Pulmonary anatomy in the Nile crocodile and the evolution of unidirectional airflow in Archosauria

    Directory of Open Access Journals (Sweden)

    Emma R. Schachner


    Full Text Available The lungs of birds have long been known to move air in only one direction during both inspiration and expiration through most of the tubular gas-exchanging bronchi (parabronchi. Recently a similar pattern of airflow has been observed in American alligators, a sister taxon to birds. The pattern of flow appears to be due to the arrangement of the primary and secondary bronchi, which, via their branching angles, generate inspiratory and expiratory aerodynamic valves. Both the anatomical similarity of the avian and alligator lung and the similarity in the patterns of airflow raise the possibility that these features are plesiomorphic for Archosauria and therefore did not evolve in response to selection for flapping flight or an endothermic metabolism, as has been generally assumed. To further test the hypothesis that unidirectional airflow is ancestral for Archosauria, we measured airflow in the lungs of the Nile crocodile (Crocodylus niloticus. As in birds and alligators, air flows cranially to caudally in the cervical ventral bronchus, and caudally to cranially in the dorsobronchi in the lungs of Nile crocodiles. We also visualized the gross anatomy of the primary, secondary and tertiary pulmonary bronchi of C. niloticus using computed tomography (CT and microCT. The cervical ventral bronchus, cranial dorsobronchi and cranial medial bronchi display similar characteristics to their proposed homologues in the alligator, while there is considerable variation in the tertiary and caudal group bronchi. Our data indicate that the aspects of the crocodilian bronchial tree that maintain the aerodynamic valves and thus generate unidirectional airflow, are ancestral for Archosauria.

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

    DEFF Research Database (Denmark)


    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...... hydroxylase was inducible by both benz[a]anthracene and BP. Prior exposure of the bronchial expiants to benz[a]anthracene altered the qualitative features of the metabolite profile of BP as analyzed by highpressure liquid chromatography. The metabolite profiles of BP produced by normal-appearing bronchi from...... 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...

  6. Current management of bronchiectasis: review and 3 case studies. (United States)

    Silverman, Enid; Ebright, Linda; Kwiatkowski, Marianne; Cullina, Joanne


    Bronchiectasis is the abnormal, irreversible dilatation of diseased bronchi. Permanently dilated airways, usually in the medium-sized bronchi, are inflamed and often obstructed with thick, purulent secretions. Known causative factors include postinfection bronchial damage, postinhalation injury, hypersensitivity reactions, and congenital airway obstructive disorders. Typical symptoms include sputum overproduction, fever, pleurisy, dyspnea, and chronic cough. Diagnosis involves radiographic studies and pulmonary function testing. Treatment includes oral, aerosolized, or intravenous antibiotic therapy according to the severity of the exacerbation, and mucus clearance by means of bronchial hygiene assistive devices, chest physiotherapy, postural drainage, and high-frequency chest compression. We present a review of bronchiectasis and offer 3 case studies illustrating current management of different presentations, including use of aerosolized antibiotics for patients infected with Pseudomonas aeruginosa. Although an adjunctive program of pulmonary rehabilitation may be useful for patients with bronchiectasis, no confirming studies have been performed to date, and additional research in this area is warranted.

  7. A pilot study evaluating the "STATSCAN" digital X-ray machine in paediatric polytrauma. (United States)

    Pitcher, Richard D; van As, Arjan B; Sanders, Virginia; Douglas, Tania S; Wieselthaler, Nicole; Vlok, Ann; Paverd, Sylvia; Kilborn, Tracy; Rode, Heinz; Potgieter, Herman; Beningfield, Stephen J


    A pilot study evaluating the use in paediatric polytrauma of the STATSCAN, a low-radiation dose, fan-beam digital radiography unit (Lodox Systems, Sandton, South Africa). Over 3 months, 23 polytrauma patients treated at the Emergency Unit of the Red Cross Children's Hospital in Cape Town, South Africa, were imaged on the STATSCAN. Image quality, diagnostic equivalence and clinical efficiency were compared with a computed radiography (CR) system (Fuji FCR 5000, Fuji Photo Film, Tokyo, Japan). The STATSCAN antero-posterior bodygram correlated well technically and diagnostically with CR, showing 96% of the fractures in the cohort. It allowed superior visualisation of the trachea and main bronchi and imaging was, on average, 13% faster than CR. The STATSCAN could play an important role in paediatric polytrauma. The clinical significance of its superior demonstration of the trachea and main bronchi requires further evaluation.

  8. Sarcoidosis with Major Airway, Vascular and Nerve Compromise

    Directory of Open Access Journals (Sweden)

    Hiroshi Sekiguchi


    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.

  9. [Complex therapy of occupational respiratory tract diseases using multifunctional massage device: clinical criteria of efficiency]. (United States)

    Artemova, L V; Sorkina, N S; Rumiantseva, O I; Komarova, S G; Rudyĭ, S S; Petrykina, M V


    Level of efficiency of CERAGEM MASTER CGM-M3500 treatment device applied for occupational patients suffering from bronchi and lung pathological states has been shown in the paper. Positive effects of treatment have been assessed as reliably high and were proved by improvement of clinical and functional indices, subjunctive self-evaluation of health by patients and positive signs in the clinical course of the diseases. Diagnostic complex has been analyzed, including hematological indicators of the peripheral blood, oxygenation of the capillary blood, immunology. Also dynamics of the clinical course has been studied along with the data on self-assessment of health by patients prior and after the therapy by the device. Prospects on treatment of occupational bronchi and lung pathologies with the help of multifunctional massage device are being discussed in the paper.

  10. 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)


    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.

  11. CT features of lymphobronchial tuberculosis in children, including complications and associated abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Lucas, Susan; Andronikou, Savvas [Faculty of Health Sciences, University of the Witwatersrand, Department of Radiology, Johannesburg (South Africa); Goussard, Pierre; Gie, Robert [Stellenbosch University, Department Paediatrics, Stellenbosch (South Africa)


    Lymphobronchial tuberculosis (TB) is tuberculous lymphadenopathy involving the airways, which is particularly common in children. To describe CT findings of lymphobronchial TB in children, the parenchymal complications and associated abnormalities. CT scans of children with lymphobronchial TB were reviewed retrospectively. Lymphadenopathy, bronchial narrowing, parenchymal complications and associations were documented. Infants comprised 51% of patients. The commonest site of lymphadenopathy was the subcarinal mediastinum (97% of patients). Bronchial compression was seen in all children (259 bronchi, of these 28% the bronchus intermedius) with severe or complete stenosis in 23% of affected bronchi. Parenchymal complications were present in 94% of patients, including consolidation (88%), breakdown (42%), air trapping (38%), expansile pneumonia (28%), collapse (17%) and bronchiectasis (9%), all predominantly on the right side (63%). Associated abnormalities included ovoid lesions, miliary nodules, pleural disease and intracavitary bodies. Airway compression was more severe in infants and most commonly involved the bronchus intermedius. Numerous parenchymal complications were documented, all showing right-side predominance. (orig.)

  12. [Tracheo-bronchial foreign bodies in the child. Analysis of 43 cases (author's transl)]. (United States)

    Omanga, U; Shango, L; Ntihinyurwa, M; Muaku, M; Mashako, M; Shako, D


    The authors report 43 cases of the presence of foreign bodies in the respiratory tract seen over a 20 year period in the University Pediatric Clinic of Kinshasa (Republic of Zaïre). In the light of these cases, it would appear that this pathological condition has apredilection for the infant, with a peak in the 1 to 2 year age group. There is a marked predominance for the male sex (60 %). Foreign bodies of organic nature come first (20/43) consisting above all of peanuts (8 cases) and fish bones (6 cases). As far as site is concerned, the bronchi are involved more often than trachea and the right side more than the left. Three children died including two during endoscopic extraction. Bronchial stenosis (1 case) and bronchi estasis (1 case) are the only complications seen in the long term.

  13. Multiple bronchoceles in a non-asthmatic patient with allergic bronchopulmonary aspergillosis. (United States)

    Amin, Muhammad Umar; Mahmood, Rabia


    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.

  14. CT findings of tracheal mucormycosis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Joo, Jong Kwan; Jung, Hyun Seouk; Kim, Ki Jun; Lee, Sung Yong; Kim, Kyung Mi [The Catholic Univ. of Korea, Inchon (Korea, Republic of)


    Pulmonary mucormycosis is a opportunistic mycosis, typically occurring in immunocompromised or diabetic patients. It is characterized as an infection of the pulmonary parenchyma and larger bronchi, and involves extensive vascular thrombosis and tissue necrosis. A variety of CT findings have been reported, but tracheal involvement is extremely rare. We report the case of a patient with tracheal mucormycosis placing particular emphasis on the CT findings.

  15. Pulmonary involvement in juvenile laryngeal papillomatosis: radiological findings; Disseminacao pulmonar na laringopapilomatose juvenil

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, Luciano Lerch; Eickhoff, Karin; Jungblut, Sandra; Furtado, Alvaro Porto Alegre [Hospital das Clinicas de Porto Alegre, RS (Brazil). Servico de Radiologia


    Papillomas are the most common laryngeal tumors in infancy and childhood, and spreads to involve the lung parenchyma and bronchi in less than 2% of cases. The authors report one case of pulmonary spread in laryngeal papillomatosis and describe radiographic and tomographic aspects of these lesions. It is discussed the clinical presentation of this disease, the diagnostic methods, histopathology and therapeutic approaches involving the clinical data related and a recent literature reviewed. (author)

  16. Modified Blalock clamp: a single-hand autostatic device for pulmonary vessel occlusion during lung cancer resection


    Petrella, Francesco; Solli, Piergiorgio; Borri, Alessandro; Spaggiari, Lorenzo


    Vascular clamping during lung cancer resection may be difficult in patients with short vessels or large neoplasms preventing adequate and safe exposure. In addition, the physiological vicinity of some vessels to rigid structures like the bronchi may interfere with ideal clamp positioning even in ordinary procedures. We have modified the original Blalock clamp to facilitate the control of pulmonary vessels and physiologically compress the vessel walls, thereby allowing optimal vascular resecti...

  17. Radiologic findings and follow-up evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Tong; Kim, Cheol Hyun; Kim, Hyung Hwan; Shin, Hyeong Cheol; Bae, Won Kyung; Kim, Il Young [Soonchunhyang University, Chonan (Korea, Republic of)


    In esophageal perforation, fistulous tracts commonly occur between the esophagus and mediastinal or pleural spaces, but rarely between the esophagus and bronchi. The clinical manifestations and radiologic findings of esophageal perforation are nonspecfic, and diagnosis is the often delayed; esophagography is the standard technique for evaluation of its location and degree. CT is useful in demonstrating the extraluminal manifestations of esophageal perforation and for follow-up after medical treatment, and may depict the various manifestations of perforation, according to the causes.

  18. Mounier Kuhn syndrome in adult: a case report

    Directory of Open Access Journals (Sweden)

    Nabanita Deka


    Full Text Available Mounier-Kuhn syndrome or tracheobronchomegaly is a rare congenital abnormality of the trachea and main bronchi characterized by marked cystic dilatation of the tracheobronchial tree, associated with tracheal diverticulosis, bronchiectasis and recurrent lower respiratory tract infections. We report a case of 22 years adult male with history of recurrent lower respiratory tract infection. [Int J Res Med Sci 2015; 3(4.000: 987-989

  19. Management of Open Pneumothorax in Tactical Combat Casualty Care: TCCC Guidelines Change 13-02 (United States)


    identified with thoracic trauma was 10.5%. Patients with flail chest, thoracic vascular in- juries, hemothorax, or pulmonary lacerations had the highest...mortality rates. Contusions , pneumothorax, flail chest, and chest wall trauma were associated with a lower mortality risk when controlling way of the trachea and bronchi that air, with its necessary oxygen, can reach the pulmonary al- veoli. It is evident that the percentage of air

  20. Toxic Hazards Research Unit (United States)


    Spleen Trachea Kidneys Lungs and bronchi Adrenals Heart Bladder Thyroid Seminal vesicles Parathyroids Prostate Esophagus Testes Stomach Ovaries Duodenum...20 2 16 Lungs 18 38 24 Liver 4 6 10 Kidneys 3 4 2 Spleen 0 1 0 In both cases, the organ findings were miscellaneous in nature and generally represent...ponents included methane, nitrogen, ammonia , water, methanol, azomethane and hydrazine. Other peak identifications derived from the computer on the basis

  1. Developing a HER3 Vaccine to Prevent Resistance to Endocrine Therapy (United States)


    pathology assessment. Tissues from the brain, heart , spleen, kidneys, adrenal glands, liver, lymph nodes (mesenteric and mandibular), lungs and bronchi...could lead to developing an infection, skin rash, joint swelling, intestinal inflammation (chronic colitis), or fluid around the heart and lungs...Muller, Ph.D. Professor, Department of Biochemistry The Cancer Research Building McGill University 1160 Pine Avenue Room 516 Montreal, Quebec H3A

  2. First record in South Asia of deer throat bot fly larvae Pharyngomyia picta (Meigen, 1824) (Diptera: Oesteridae) from Sambar deer (Rusa unicolor), a new host record. (United States)

    Sreejith, Radhakrishnan; Ajithkumar, K G; Reghu, Ravindran; Kavitha, Rajagopal


    The Bot fly larvae, identified to be the third instars of the deer throat bot fly Pharyngomyia picta were recovered from the lumen of trachea and secondary bronchi during the necropsy of a female sambar deer (Rusa unicolor) in Kerala, India. This forms the first report of P. picta from India and the whole of South Asia. Sambar deer is a new host record for the larvae of this fly. Morphological description of the third stage larvae with supporting figures are presented.

  3. The Main Technical Points of Thoracoscopic Anatomical Lung Segment Resection

    Directory of Open Access Journals (Sweden)

    Liang CHEN


    Full Text Available Thoracoscopic segmentectomy is technically much more meticulous than lobectomy, due to the complicated anotomical variations of segmental bronchi and vessels. Preoperative three-dimensional computed tomography bronchography and angiography, 3D-CTBA could reveal the anatomical structures and variations of the segmental bronchi/vessels and locate the pulmonary nodules, which is helpful for surgery planning. Preoperative nodule localization is of vital importance for thoracoscopic segmentectomy. Techniques involved in this procedure include dissection of the targeted arteries, bronchus and intra-segmental veins, retention of the inter-segmental veins, identification of the inter-segmental boarder with the inflation-deflation method and seperation of intra-segmental pulmonary tissues by electrotome and/or endoscopic staplers. The incision margin for malignant nodules should be at least 2 cm or the diameter of the tumor. Meanwhile, sampling of N1 and N2 station lymph nodes and intraoperative frozen section is also necessary. The complication rate of thoracoscopic segmentectomy is comparatively low. The anatomic relationship between pulmonary segments and lobes is that a lobe consists of several irregular cone-shaped segments with the inter-segmental veins lies between the segments. Our center has explored a method to separate pulmonary segments from the lobe on the basis of cone-shaped principle, and we named it “Cone-shaped Segmentectomy”. This technique could precisely decide and dissect the targeted bronchi and vessels, and anatomically separate the inter-segmental boarder, which ultimately achieve a completely anatomical segmentectomy.

  4. The Monitoring Features Under Eosinophilic Phenotype of Bronchial Asthma Among the Children

    Directory of Open Access Journals (Sweden)

    Tatiana Bilous


    Full Text Available Abstract Purpose: to study features of monitoring in the dynamics of the basic treatment of eosinophilic phenotype of asthma in school-age children. Materials and methods. Surveyed 88 school-age children with bronchial asthma. The first group included 45 patients who met eosinophilic phenotype (EFBA and group II formed the 43 patients with evidence of neutrophilic phenotype (NFBA. Results and discussion. It should be noted that if the early inflammatory therapy destination exchange only 10.5% of the patients disease was defined as EFBA controlled and the finishing treatment increased the proportion of cases of controlled to 25.6% (Pφ>0,05 and in the second clinical group – at 22.3% of 50.0% patients, Pφ<0,05. Also marked anti-inflammatory effect in both groups in exhaled breath condensate and increase in the lability of the bronchi occurred in 39.1% of children with EFBA, and 60.0% of the representatives of the comparison group. Conclusions. Thus, in patients with signs of eosinophilic phenotype compared with children with neutrophilic airway inflammation markers hyperresponsiveness and inflammation of the bronchi more expressive as the lability of the respiratory tract. Under the influence of the basic anti-inflammatory treatment in patients with eosinophilic asthma phenotype is a reduction of inflammation of the bronchi, but not lability and hyperresponsiveness.

  5. Microscopic anatomy of the lower respiratory tract of the grey short-tailed opossum (Monodelphis domestica). (United States)

    Cope, L A; Henry, R W; Reed, R B


    The respiratory tracts of seven grey short-tailed opossums were histologically examined. Six opossums were prepared by perfusion with buffered formalin. Opossum seven was perfused with gluteraldehyde. Samples taken from the respiratory passages and lungs of specimens 1-6 were stained with haematoxylin and eosin. A mixture of methylene and azure blue was used for specimen 7. The trachea and right and left principal bronchi are lined with a pseudostratified ciliated columnar epithelium with occasional goblet cells. The secondary and tertiary bronchi and the primary and secondary bronchioles are lined by a simple ciliated columnar epithelium. The terminal bronchioles and a portion of the respiratory bronchioles are lined by a simple ciliated cuboidal epithelium. The terminal portion of the respiratory bronchioles and the alveolar ducts are lined with simple squamous epithelium. Alveoli are lined by type I and II pneumocytes. Tracheal glands are present in the tela submucosa. The fibromusculocartilaginous tunic of the trachea consists of c-shaped cartilage rings and the trachealis muscle. A lamina muscularis mucosa begins in the intrapulmonary portion of the principal bronchus and continues into the respiratory bronchioles. Bronchial glands are present in the propria submucosa and tela submucosa of the principal bronchi. The musculocartilaginous tunic is localized to the extrapulmonary portion of the principal bronchus. The bronchial cartilages are irregular shaped plates and limited to the extrapulmonary portion of the principal bronchus. The visceral pleura is a simple squamous mesothelium covering the outer surface of the lung.

  6. 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)


    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.)

  7. Bronchial morphometry in smokers: comparison with healthy subjects by using 3D CT

    Energy Technology Data Exchange (ETDEWEB)

    Montaudon, Michel [Unite d' Imagerie Thoracique, CHU de Bordeaux, Pessac (France); Universite Bordeaux 2, Laboratoire de Physiologie Cellulaire Respiratoire, Bordeaux (France); INSERM, Bordeaux (France); Hopital Cardiologique, Unite d' Imagerie Thoracique, Pessac (France); Berger, Patrick; Marthan, Roger [Universite Bordeaux 2, Laboratoire de Physiologie Cellulaire Respiratoire, Bordeaux (France); INSERM, Bordeaux (France); Service d' Exploration Fonctionnelle Respiratoire, CHU de Bordeaux, Pessac (France); Lederlin, Mathieu [Unite d' Imagerie Thoracique, CHU de Bordeaux, Pessac (France); Tunon-de-Lara, Jose Manuel [Universite Bordeaux 2, Laboratoire de Physiologie Cellulaire Respiratoire, Bordeaux (France); INSERM, Bordeaux (France); Service des Maladies Respiratoires, CHU de Bordeaux, Pessac (France); Laurent, Francois [Unite d' Imagerie Thoracique, CHU de Bordeaux, Pessac (France); Universite Bordeaux 2, Laboratoire de Physiologie Cellulaire Respiratoire, Bordeaux (France); INSERM, Bordeaux (France)


    The assessment of airway dimensions in patients with airway disease by using computed tomography (CT) has been limited by the obliquity of bronchi, the ability to identify the bronchial generation, and the limited number of bronchial measurements. The aims of the present study were (i) to analyze cross-sectional bronchial dimensions after automatic orthogonal reconstruction of all visible bronchi on CT images, and (ii) to compare bronchial morphometry between smokers and nonsmokers. CT and pulmonary function tests were performed in 18 males separated into two groups: 9 nonsmokers and 9 smokers. Bronchial wall area (WA) and lumen area (LA) were assessed using dedicated 3D software able to provide accurate cross-sectional measurements of all visible bronchi on CT. WA/LA and WA/(WA+LA) ratios were computed and all parameters were compared between both groups. Smokers demonstrated greater WA, smaller LA, and consequently greater LA/WA and LA/(WA+LA) ratios than nonsmokers. These differences occurred downward starting at the fourth bronchial generation. 3D quantitative CT method is able to demonstrate significant changes in bronchial morphometry related to tobacco consumption. (orig.)

  8. Use of salbutamol in detection of mechanism destructive to bronchial patency in dust-induced lung disease

    Energy Technology Data Exchange (ETDEWEB)

    Zhumabekova, B.K.


    Different mechanisms destroy the open passibility of the bronchi: bronchospasm, destruction of drop eliminator function of the bronchi, valvular mechanics, change in elastic properties of lungs, dyskinesia of the tracheobronchial tree and inflammatory edema of the mucous envelope. Bronchospasm is the most studied form of bronchial pathology. To detect the bronchospastic component, various bronchodilating means are used: (1) stimulators of adrenergic receptors, (2) blockers of acetylcholine (atropine, bella donna); preparations acting directly on smooth musculature of the bronchi (theophylline, euphylline). The pharmaceutical industry is now making aerosol bronchodilators. Since salbutamol is widely used as an aerosol and opinions of its effectiveness are not uniform, a test was made of it on 35 patients; 22 with chronic bronchitis and 13 with silicosis. The rate of air flow during inspiration and expiration was examined 10, 20, 30 and 40 minutes after administration of salbutamol aerosol. Results of the test are presented in a table and show that the use of a pharmacological test with salbutamol aerosol to detect bronchospasm as a cause of lung obstruction is valid. If 10 minutes after inhalation of salbutamol, a therapeutic effect is observed and inhalation and exhalation increase, bronchospasm as the cause of the pathology is demonstrated. The absence of a measurable reaction to salbutamol after 10 minutes indicates that other mechanisms are the basis of the obstruction. (11 refs.) (In Russian)

  9. 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)


    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.)

  10. Distribution of Crenosoma vulpis and Eucoleus aerophilus in the lung of free-ranging red foxes (Vulpes vulpes). (United States)

    Nevárez, Alicia; López, Alfonso; Conboy, Gary; Ireland, William; Sims, David


    Crenosoma vulpis and Eucoleus aerophilus are nematode parasites that can cause verminous pneumonia in wild carnivores. There is a paucity of information regarding the distribution of parasites in the lungs and the relationship between histopathological and parasitological diagnoses in naturally infected foxes. The objectives of this study were: first, to study the lobar and airway distribution of C. vulpis and E. aerophilus in wild red foxes and second, to investigate the relationship between fecal and histopathological diagnoses. Samples from 6 sites of the lung and fecal contents were obtained from 51 wild foxes in Prince Edward Island. By fecal examination, 78.4% of wild foxes tested positive for C. vulpis and 68.6% for E. aerophilus. In contrast, 66.6% and 49% of foxes had histopathological evidence of C. vulpis and E. aerophilus in the lungs, respectively. Anatomically, C. vulpis was observed in the small bronchi and bronchioles of all pulmonary lobes whereas E. aerophilus was restricted to the large bronchi and the caudal lobes. Affected airways exhibited severe epithelial glandular hyperplasia and bronchiolar mucous metaplasia. It was concluded that C. vulpis is widely distributed in airways of all pulmonary lobes, whereas E. aerophilus is mainly restricted to the bronchi of caudal lobes. Also, this study showed that histological examination of lung underestimates the infection with E. aerophilus.

  11. Experimenatal analysis of the effect of cartilaginous rings on human tracheobronchial flow (United States)

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


    We present a set of high-resolution PIV experiments carried out in a refractive index-matched model of a trachea with cartilage rings at Re 2800. Results show a higher vorticity along the walls of the trachea in the model with cartilaginous rings as well as small recirculation areas on the upstream side of the wall cavities created by the rings. Furthermore, the ringed model experiences higher shear stress in the trachea due to the sudden change in the wall position created by the rings. Additionally, small recirculation areas are identified in the cavities between rings. For the smooth model, a stronger separation bubble is observed at the bronchi entrance, generating a stronger shear layer and increasing the wall shear stress on the bottom bronchi wall. The differences observed go against the notion that the main airway, i.e. trachea and main bronchi, may be modeled as smooth. Our results suggest that cartilage rings will have an impact on the wall shear stress and may affect particle deposition, which is of importance in inhaled drug delivery and pollutant deposition in the airway. Additionally, the effects introduced by the rings may change the flow characteristics in further generations.

  12. Inhibitory effects of putative peptidic urotensin-II receptor antagonists on urotensin-II-induced contraction of cat isolated respiratory smooth muscle. (United States)

    Behm, David J; Ao, Zhaohui; Camarda, Valeria; Aiyar, Nambi V; Johns, Douglas G; Douglas, Stephen A


    Urotensin-II is purported to influence pulmonary function by modulating smooth muscle tone/growth. In the present study, Northern blot and reverse transcription polymerase chain reaction (RT-PCR) analysis indicated the presence of UT receptor mRNA in cat trachea, bronchi and lung parenchyma. Urotensin-II contracted cat isolated trachea and bronchi with similar potencies (pEC(50)s 8.61+/-0.07-8.81+/-0.10). Contractile efficacies ranged from 19+/-9% to 63+/-11% KCl in the primary and secondary bronchi. The peptidic UT receptor antagonists BIM-23127, SB-710411 and GSK248451 (7.18+/-0.12, 7.52+/-0.08 and 9.05+/-0.16 cat recombinant UT pK(i)s) inhibited urotensin-II-induced contraction of cat isolated trachea with pK(b)s 6.36+/-0.11, 6.74+/-0.07 and 9.27+/-0.12, respectively. As such, feline lung contains significant amounts of UT mRNA and this receptor appears to be functionally coupled to bronchoconstriction (the peptidic tool compound GSK248451 representing a sub-nanomolar inhibitor of such effects). These findings suggest that the cat represents a suitable species for future studies designed to assess the effects of the urotensin-II receptor on pulmonary (patho)physiology.

  13. Quantitative computed tomography analysis of the airways in patients with cystic fibrosis using automated software: correlation with spirometry in the evaluation of severity* (United States)

    Santos, Marcel Koenigkam; Cruvinel, Danilo Lemos; de Menezes, Marcelo Bezerra; Teixeira, Sara Reis; Vianna, Elcio de Oliveira; Elias Júnior, Jorge; Martinez, José Antonio Baddini


    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. PMID:28100929

  14. Stereotactic body radiation therapy for centrally located lung lesions

    Energy Technology Data Exchange (ETDEWEB)

    Joyner, Melissa [Univ. of Texas Health Science Center at San Antonio (United States). Dept. of Radiation Oncology; Salter, Bill J. [The Univ. of Utah, Salt Lake City, Utah (United States). Dept. of Radiation Oncology; Papanikolaou, Niko [Cancer Therapy and Research Center, San Antonio, Texas (United States); Fuss, Martin [Oregon Health and Science Univ., Portland (United States). Dept. of Radiation Medicine


    Presentation of outcomes of patients treated by stereotactic body radiation therapy (SBRT) for lung lesions located within or touching a 2 cm zone around major airways. Serial tomotherapeutic SBRT has been planned and delivered at our institution since August 2001. Of 108 patients treated for primary and secondary lung tumors, nine harbored tumors (8 metastases, 1 recurrent NSCLC) located in close proximity to carina, right and left main bronchi, right and left upper lobe bronchi, intermedius, right middle lobe, lingular, or right and left lower lobe bronchi. SBRT was delivered to total doses of 36 Gy in 3 fractions (n=8) or 6 fractions (n=1), using a serial tomotherapy system (Nomos Peacock). We assessed local tumor control, clinical toxicity, normal tissue imaging changes, and overall survival. Median tumor volume was 26 cm{sup 3} (range 1.7 to 135 cm{sup 3}). Tumor locations were hilar (n=3), and parenchymal in six cases. Hilar lesions accounted for the three largest tumor volumes in the series. During a median follow-up of 10.6 months (range 2.5 to 41.5 months), all lesions treated were locally controlled as confirmed by CT or CT/PET imaging. Parenchymal imaging changes included focal lung fibrosis and major airway wall thickening. One occurrence of major airway occlusion (right lower lobe bronchus) was observed. This event was diagnosed by chest x-ray at 36 months, following treatment of the second largest hilar lesion in the present series. Based on the outcomes observed in this small sample series, SBRT for centrally located lung lesions appears feasible, was associated with low incidence of toxicities, and provided sustained local tumor control. However, long-term survival may be associated with major airway injury. As long-term follow-up in larger numbers of patients is lacking at this time, exclusion of patients with centrally located lesions may be considered when patients are treated in curative intent.

  15. Respiratory manifestations in amyloidosis

    Institute of Scientific and Technical Information of China (English)

    XU Ling; CAI Bai-qiang; ZHONG Xu; ZHU Yuan-jue


    Background Amyloidosis is a collection of diseases in which different proteins are deposited. Amyloid deposits occur in systemic and organ-limited forms. In both systemic and localized forms of the disease, lung can be involved. The aim of this study was to explore the different respiratory manifestations of amyloidosis. Methods Chest radiology, clinical presentations, bronchoscopic/laryngoscopic findings and lung function data of 59 patients with amyloidosis involving respiratory tract collected during January 1986 to March 2005, were analysed.Results Of the 16 cases with localized respiratory tract amyloidosis, 8 had the lesions in the trachea and the bronchi, 2 in the larynx and the trachea, 5 in the larynx and/or the pharynx, and 1 in the lung parenchyma. Of 43 systemic amyloidosis with respiratory tract involvement, 3 had the lesions in bronchi, 13 in lung parenchyma, 33 in pleura, 8 in mediastina, 1 in nose and 1 in pharynx. Chest X-rays were normal in most cases of tracheobronchial amyloidosis. CT, unlike chest X-rays, showed irregular luminal narrowing, airway wall thickening with calcifications and soft tissue shadows in airway lumen. Localized lung parenchymal amyloidosis presented as multiple nodules. Multiple nodular opacities, patch shadows and reticular opacities were the main radiological findings in systemic amyloidosis with lung parenchymal involvement. In pleural amyloidosis, pleural effusions and pleural thickening were detected. Mediastinal and/or hilar adenopathy were also a form of lung involvement in systemic amyloidosis. The major bronchoscopic findings of tracheobronchial amyloidosis were narrowing of airway lumen, while nodular, 'tumour like' or 'bubble like' masses, with missing or vague cartilaginous rings, were detected in about half of the patients.Conclusions Localized respiratory tract amyloidosis mostly affects the trachea and the bronchi. Chest X-rays are not sensitive to detect these lesions. Systemic amyloidosis often involves

  16. Dependent Lung Tension Pneumothorax During 1-Lung Ventilation: Treatment by Transmediastinal Thoracentesis. (United States)

    Kenta, Okitsu; Shoko, Arimoto; Takeshi, Iritakenishi; Satoshi, Hagihira; Yuji, Fujino; Yasushi, Shintani; Masato, Minami; Meinoshin, Okumura


    Contralateral tension pneumothorax during 1-lung ventilation is rare but life threatening. We report the case of a patient who developed tension pneumothorax of the dependent lung during 1-lung ventilation while the surgeon was anastomosing the bronchi after sleeve lobectomy. Ventilation was not possible in either the dependent or nondependent lung, leading to severe desaturation and cardiac arrest. While the surgeons were administering direct cardiac compression, we suspected tension pneumothorax. As soon as the surgeons pierced the mediastinal pleura, adequate circulation was restored. Immediate diagnosis and treatment is important for this complication.

  17. Sinonasal inflammation in COPD

    DEFF Research Database (Denmark)

    Håkansson, Kåre; Konge, Lars; Thomsen, Sf


    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....

  18. Tracheobronchopathia osteochondroplastica: four cases

    Institute of Scientific and Technical Information of China (English)

    Dursun Tatar; Gunes Senol; Atike Demir; Gulru Polat


    Tracheobronchopathia osteochondroplastica (TO) is a rare and benign disorder of unknown cause affecting the large airways.It is characterized by the presence of multiple osseous and cartilaginous nodules in the submucosa of the trachea and main bronchi that is characterized by the progression of submucosal bone and/or cartilage including nodules through the lumen of trachea and bronchus.We present four cases that were diagnosed TO while investigating for the causes of hemoptysis and chronic cough.We plan to emphasize TO in differential diagnosis in proper patients.

  19. Endosonography in bronchopulmonary disease

    DEFF Research Database (Denmark)

    Vilmann, Peter; Annema, Jouke; Clementsen, Paul


    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....... a major impact of EUSFNA as well as EBUS-TBNA on management of patients with lung cancer as well as in patients with unknown lesions in the mediastinum. The aim of the present review is to discuss the current role of endosonography in bronchopulmonary diseases focusing on endosonographically guided biopsy...

  20. Trachea: anatomy and physiology. (United States)

    Brand-Saberi, Beate E M; Schäfer, Thorsten


    The windpipe (trachea) is a tube of 12 cm length connecting the larynx to the principal bronchi that lead to the lungs. The main functions of the trachea comprise air flow into the lungs, mucociliary clearance, and humidification and warming of air. Mucociliary clearance is achieved by kinocilia and goblet cells in the mucosa, and by tracheal glands. The trachea develops from the endodermal lining of the foregut in interaction with the visceral mesoderm. During adult life, different types of stem cells reside in the mucosal epithelium and glandular ducts. Recently, cholinergic chemosensory cells have been described in the trachea.


    Duzhiy, I D; Grehsko, I Ya; Kravets, O V; Oleshchenko, G P; Glazunova, N I


    In coincidence of chronic phthisic pleuritis in a rigid stage with pulmonary tuberculosis operative intervention is indicated of a pleuropulmonectomy type, what is a complex situation for performance and preservation of the patient's functional state. Pleuropulmonectomy in some patients is complicated by empyema and pathological processes in bronchi. Possibilities of operative interventions application, alternative to pleuropulmonectomy, were studied. Of 48 patients, to whom pleuropulmonectomy is indicated in accordance to data of clinic-roentgenological investigations, in 7--simultant operative treatment were conducted with positive results.

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

    DEFF Research Database (Denmark)

    Trebbien, Ramona; Larsen, Lars Erik; Viuff, Birgitte M.


    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...... 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...

  3. Expression of heat-shock protein 70 (Hsp70) in the respiratory tract and lungs of fire victims. (United States)

    Marschall, S; Rothschild, M A; Bohnert, M


    Immunohistochemical investigation of the respiratory tract and lungs of 63 fire victims revealed a statistically significant enhanced expression of heat-shock protein 70 (Hsp70) in the epiglottis, the trachea, and the main and the peripheral bronchi compared with a control group. In the fire victims, a strong expression of Hsp70 was discernible not only particularly in the vessels but also in seromucous secretory cells, ciliated epithelial cells, smooth muscle cells, and alveolar cells. The results suggest a vital or supravital reaction due to the inhalation of hot fire fumes.

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

    Directory of Open Access Journals (Sweden)

    Ashish K Jaiswal


    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.

  5. A case report of Mounier-Kuhn syndrome

    Directory of Open Access Journals (Sweden)

    Keerthivasan Sivanmani


    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.

  6. Relapsing Polychondritis Presented with Encephalitis Followed by Brain Atrophy (United States)

    Park, Moo-Seok; Jeong, Hae-Bong; Kwon, Oh-Sang; Yoon, Byung-Nam; Kim, Hee Sung; Choi, Sang Tae


    Relapsing polychondritis (RP) is a rare autoimmune disease that is characterized by inflammatory reaction of unknown etiology and destruction of cartilaginous structures. Characteristic symptoms of this disease include cartilage inflammation of the ear, nose, larynx, trachea, bronchi, joints, eyes, heart and skin. Concomitance with neurologic symptom is very rare in RP, and the detailed underlying mechanism of neurological involvement associated with RP is not fully understood. We herein described an unusual recurrent case of inflammatory brain lesions associated with RP, with attention to clinical manifestations, autoimmune disease involvement, and therapeutic effects. PMID:28243168

  7. 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)


    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)

  8. Crenosoma brasiliense sp. n. (Nematoda: Metastrongyloidea) parasitic in lesser grison, Galictis cuja (Molina, 1782) (Carnivora, Mustelidae) from Brazil, with a key to species of Crenosoma Molin, 1861. (United States)

    Vieira, Fabiano M; Muniz-Pereira, Luis C; de Souza, Lima Sueli; Neto, Antonio H A Moraes; Gonçalves, Pamela R; Luque, José L


    This study describes Crenosoma brasiliense (Nematoda, Metastrongyloidea), a new species parasitic in bronchi and bronchioles of Galictis cuja (Molina) (Carnivora, Mustelidae) from Brazil. This species differs from other 11 species of Crenosoma by having a cuticular projection at the distal end of the spicules, forming a prominent blade at the tip of the spicule, a vulval cuticular appendage with a triangular shape and prominent vulval lips. There are no previous records of species of Metastrongyloidea in G. cuja or species of Crenosoma in South America. Therefore, the new species represents the first host record and first geographical record of species of Crenosoma in South America.

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

    Directory of Open Access Journals (Sweden)

    Santosh Kumar Swain


    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. Azoospermia in two brothers with Kartagener syndrome:a family history and diagnosis

    Institute of Scientific and Technical Information of China (English)

    Yue Huan-xun; Zhang Xun; Jiang Min; Li Fu-ping; Ning Gang; Tian Yu; Lin Li; Zhang Si-xiao


    0This article describes 2 infertile brothers of asoospermia equally associated with co-existing sinusitis,bronchiectasis,and situs inversus and their family history.These two cases were diagnosed as Kartagener syndrome(KS).The patients were not offspring of kin marriages but their family members with scattered bronchi-pulmouary infections were discovered.No one manifests azoospermia,dextrocardia or situs inversus in the paternal family ex-cept two cases reported.No abnormalities were found in their mother-side family.KS should be differentiated from Young's syndrome,cystic fibrosis(CF),and other diseases such as Kallmann's syndrome in male infertility clinic.

  11. 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)


    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.)

  12. 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)



    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)


    Institute of Scientific and Technical Information of China (English)

    李素云; 张升慧; 等


    The dose distribution in the lung is inhomogeneous.The dose to the basal cell layer of trachea and main bronchi is much higher than the dose to total lung both for rabbits at different ages and for different animals.A maximum value of the dose to lung tissue for rabbits at ages of 20-40d is observed.The dose decreases with increasing body weight.The relationship between the dose and body weight can be descreibed by a power function.The dose to total lung increases exponentially with the minute breathing volume per unit of lung weight.

  14. A method of construction of information images of the acoustic signals of the human bronchopulmonary system (United States)

    Bureev, A. Sh.; Zhdanov, D. S.; Zemlyakov, I. Yu.; Kiseleva, E. Yu.; Khokhlova, L. A.


    The present study focuses on the development of a method of identification of respiratory sounds and noises of a human naturally and in various pathological conditions. The existing approaches based on a simple method of frequency and time signal analysis, have insufficient specificity, efficiency and unambiguous interpretation of the results of a clinical study. An algorithm for a phase selection of respiratory cycles and analysis of respiratory sounds resulting from bronchi examination of a patient has been suggested. The algorithm is based on the method of phase timing analysis of bronchi phonograms. The results of the phase-frequency algorithm with high resolution reflects a time position of the traceable signals and the individual structure of recorded signals. This allows using the proposed method for the formation of information images (models) of the diagnostically significant fragments. A weight function, frequency parameters of which can be selectively modified, is used for this purpose. The vision of the weighting function is specific to each type of respiratory noise, traditionally referred to quality characteristics (wet or dry noise, crackling, etc.).

  15. Carinal resection and reconstruction following inflammatory myofibroblastic tumor resection: A case report

    Directory of Open Access Journals (Sweden)

    Julia G. Lyon


    Full Text Available Inflammatory myofibroblastic tumors (IMT are rare tumors of the respiratory tract that most commonly occur in the lung and are rarely seen in the trachea. They present most often in young patients. We report on a case of an IMT of the carina in a seven year old girl, requiring carinal resection and reconstruction with a novel technique in pediatric airway surgery. Attempts at endoscopic excision of the carinal IMT were unsuccessful. An open approach for resection of the involved carina, distal trachea, and proximal mainstem bronchi was performed via sternotomy and cardiopulmonary bypass. The resulting triangular defect in the trachea and bronchi was reconstructed with anastomosis of the proximal trachea and left mainstem bronchus using a rotational flap of the right lateral mainstem bronchial wall. The remaining right mainstem bronchus was anastomosed, end to side, to the intact trachea proximal to the primary anastomosis. Bronchoscopy and MRI 22 months post resection and reconstruction revealed a healthy neo-carina and patent distal airway with no evidence of recurrent IMT. Pediatric patients with carinal inflammatory myofibroblastic tumors can be successfully managed with open resection and reconstruction of the airway.

  16. A Study of Variations of the Branching Patterns of right Upper Lobar Bronchus by Corrosive Cast Method

    Directory of Open Access Journals (Sweden)

    SV Solanki


    Full Text Available Introduction: Respiratory system is the basic prerequisite for living organisms. So precise knowledge of normal anatomy and various dimensions of human respiratory tract is inevitable. The right upper lobe bronchus is prevailingly trifurcates into apical, anterior and posterior segmental bronchi. Material and Methods: The present study was done on 28 tracheo-bronchial casts prepared by corrosive cast method in the anatomy department of B. J. medical college of Ahmedabad, Gujarat, India from 2011 to 2013. Result and Observation: In 16 specimens (57% normal trifurcate branching pattern was seen in right upper lobar bronchus. Most common variation observed was bifurcate pattern in right upper lobar bronchus in 36% of specimens. In 7% specimens quadrivial pattern was seen in right upper lobar bronchus in which it divided into four bronchi. Conclusion: The knowledge of anatomy and variation in branching pattern of the tracheo-bronchial tree enables the physicians to recognize clinical picture and pathology of human lungs, as well as the application of therapeutic and diagnostic methods like tracheal intubation, bronchoscopy, bronchography and postural drainage etc.

  17. The effects of cannabidiol on the antigen-induced contraction of airways smooth muscle in the guinea-pig. (United States)

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


    (-)-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.

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

    Directory of Open Access Journals (Sweden)

    I Kasacka


    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.

  19. 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


    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 ...

  20. Optimization of the spectral design used to detect early carcinoma in the human tracheo-bronchial tree by autofluorescence imaging (United States)

    Gabrecht, Tanja; Glanzmann, Thomas; Freitag, Lutz; Grosjean, Pierre; Weber, Bernd C.; Monnier, Philippe; van den Bergh, Hubert; Wagnieres, Georges A.


    The early detection and localization of bronchial cancer remains a challenging task. Autofluorescence bronchoscopy is emerging as a useful diagnostic tool with improved sensitivity and specificity. Evidence exists that the native fluorescence or autofluorescence of bronchial tissues changes when they turn dysplastic or to carcinoma in situ (CIS). Early lesions in the bronchi tend to show a decrease in autofluorescence in the green region of the spectrum when excited with violet light and a relative increase in the red region of the spectrum. Several endoscopic imaging devices relying on these optical properties of bronchial mucosa have been developed. An industrial endoscopic autofluorescence imaging system for the detection of early cancerous lesions in the bronchi has been developed in collaboration with the firm Richard Wolf Endoskope GmbH, Knittlingen (Germany; its performance has been evaluated in a previous clinical study. A second study, presented in this article, aims to optimize the spectral design of the device. Twenty-four lung cancer or high risk patients were enrolled in this study to assess the influence of additional backscattered red light on the tumor-to-healthy tissue contrast and to compare the effect of a narrow band violet excitation to a large band violet excitation. In our study we observed a three times higher contrast between cancer and healthy tissue, when backscattered red light was added to the violet excitation. The comparison between a narrow and a large band violet excitation indicated an increase of the tumor-to-healthy tissue contrast by the narrow band excitation.

  1. Tendons, Concentric Tubes, and a Bevel Tip: Three Steerable Robots in One Transoral Lung Access System. (United States)

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


    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.

  2. Computed tomography of the thorax in calves from birth to 105 days of age. (United States)

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


    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.

  3. Computed tomography in pulmonary sarcoidosis

    Energy Technology Data Exchange (ETDEWEB)

    Lynch, D.A.; Webb, W.R.; Gamsu, G.; Stulbarg, M.; Golden, J.


    We studied the high resolution CT (HRCT) scans of 15 patients with biopsy-proven sarcoidosis and correlated the findings with pulmonary function tests (12 patients), 67Ga scans (10 patients), bronchoalveolar lavage (five patients), recent transbronchial biopsy (six patients), and recent open lung biopsy (three patients). The HRCT features included small nodules, thickened interlobular septa, patchy focal increase in lung density, honeycombing, and central conglomeration of vessels and bronchi. Active alveolitis was present by gallium scanning criteria in 5 of 10 cases. By bronchoalveolar lavage criteria, activity was present in three of five cases. Patchy increase in density may correlate with active alveolitis as seen on /sup 67/Ga scanning. High resolution CT was better than chest X-radiography for demonstration of patchy increase in density and for distinguishing nodules from septal thickening. Both nodules and patchy density were partly reversible following therapy. Nodular densities seen on CT correlated with the presence of granulomata on histology. Resting pulmonary function tests correlated poorly with presence and extent of lung disease on HRCT. The presence on HRCT of focal fine nodules, patchy focal increase in lung density, and central crowding of bronchi and vessels should suggest the diagnosis of sarcoidosis. In some patients, HRCT can identify unsuspected parenchymal lung disease and document the reversible components of sarcoid lung disease.

  4. [Computed tomography in endobronchial mucus accumulation]. (United States)

    Gaeta, M; Barone, M; Loria, G; Minutoli, F; Stroscio, S


    To investigate the value of CT in depicting endobronchial mucoid collections, the authors retrospectively reviewed the CT scans of 22 patients, 14 with mucous plugs, 7 with mucoid pseudotumors, and one with a bronchocele due to bronchial atresia. Atelectasis could be seen in 11 of 14 patients with mucous plugs. In 12 of 14 patients with mucous plugs CT showed the involved bronchi filled by fluid representing abnormal mucus accumulation. In the patients with atelectasis CT showed mucus-filled bronchi as low-attenuation branching structures (mucoid bronchogram). All the mucoid pseudotumors appeared as low-attenuation (< 20 HU) polypoid wall lesions with no involvement of the bronchial walls. In a patient with bronchial atresia CT showed a solitary pulmonary nodule (representing the obstructed and dilated bronchus filled by mucus) surrounded by peripheral pulmonary hyperinflation. Characteristically, the endobronchial mucoid collections never enhanced after bolus contrast medium. Endobronchial mucoid collections had to be differentiated from endobronchial neoplasms. In some cases bronchoscopy was necessary to make the differential diagnosis. In conclusion, CT is a valuable tool with good sensitivity and specificity in diagnosing endobronchial mucoid collections.

  5. Morphology of the tracheobronchial tree and the route of the pulmonary artery in the fetal minke whale (Balaenoptera acutorostrata). (United States)

    Kida, M Y


    Molecular and statistical studies support the close phylogenetic relation between Cetacea and Artiodactyla. The presence of the tracheal bronchus has been pointed out as one of the common traits between only these groups. Nakakuki (1980) has investigated the mammalian tracheobronchial trees in 50 species based on his new nomenclature, and his study has consequently demonstrated the above-mentioned indication. Therefore, comparative anatomy of the tracheobronchial tree based on the nomenclature seems to be useful for investigations of the cetacean phylogeny. Three pairs of fetal lungs of the minke whale (Balaenoptera acutorostrata) were supplied from the Institute of Cetacean Research, Tokyo (1991) to observe their tracheobronchial trees and the ramification of the pulmonary artery. The fetal tracheobronchial tree consisted of one tracheal, four lateral, four dorsal and one medial secondary bronchi in the right lung, and five or six lateral and four or five dorsal secondary bronchi in the left, using the new nomenclature. The right pulmonary artery crossed the right axial bronchus from the ventral side to the dorsal over the third lateral bronchus. The tracheal bronchus in the fetal minke whale seems to belong to the type II of Nakakuki's nomenclature, and this type is seen in one species of the river dolphins. The other conspicuous traits of the fetal lungs are the defect of the second lateral broncus and the route of the pulmonary artery in the right side. This route is very different from that of many other mammals.

  6. Outcomes of surgical management of tracheobronchial injuries a case series from a developing country

    Institute of Scientific and Technical Information of China (English)

    Saulat H.Fatimi; Hashim M. Hanif; Ameera Ahmed; Ghina Shamsi; Marium Muzaffar


    Objective: Tracheobronchial injuries are defined as injuries involving the trachea and/or bronchi from the level of the cricoid cartilage extending up to the division of the bronchi. We present a case series with most of the tracheobronchial injuries found to be sustained after penetrating trauma.Methods: A retrospective review was performed at the Aga Khan University, Karachi, Pakistan. From January 2004to December 2009, 168 patients with thoracic trauma were treated, of whom 15 were recognized to have major tracheobronchial and pulmonary injuries.Results: The average age was 31 years with most of the patients being male (14:1). Among them,11 patients had penetrating trauma as the main cause of injury, 3 patients had blunt trauma from road traffic accidents, only 1 patient had combined trauma (blunt and penetrating trauma). Eight patients were diagnosed based on radiological findings. All the patients were treated surgically. Lobectomy was the most common intervention performed in 7 patients. The mortality rate was 7% (1 patient). Most patients survived with no sequelae (10 patients) while 5 survived with disability. We found that penetrating trauma was the leading cause of injury in our series. The severity of injury depends upon the weapon causing the trauma. Patients in our series had multiple injuries and required surgical management.Conclusions: Tracheobronchial injuries are rare but potentially life threatening. They require quick diagnosis and management. Diagnosis tends to be difficult since there are no specialised diagnostic modalities available at present.

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

    Directory of Open Access Journals (Sweden)

    Panagiotis Boglou


    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.

  8. 山羊胎期肺的组织发生%Histogenesis of the goat lung

    Institute of Scientific and Technical Information of China (English)

    张涌; 郑月茂


    研究了山羊胎期肺的组织发生,将肺的发育分为5个时期:①胚胎期(3~5周),肺芽分支形成主支气管,主支气管长度不断增长并萌芽出叶支气管,均衬以假复层柱状上皮;②腺状期(6~12周),以支气管树发育为主,小支气管及终蕾衬以假复层和/或单层柱状上皮;③小管期(13~14周),以呼吸部发育为主,原始肺泡开始形成,呼吸性细支气管和原始肺泡衬以未分化的立方上皮;④囊状期(第15周),呼吸部发育显著,肺内细支气管及其末端呈现出“充气”状态;⑤肺泡期(16~22周),以肺泡的形成和分化为主,肺泡上皮分化为扁平的肺泡Ⅰ型细胞和立方形的肺泡Ⅱ型细胞。%50 goat embryoes and/or fetal lungs were observed with LM which showed the embryologic,pseudoglandular,canalicular,saccular and alveolar stages during their development.1.Embryologic stage(3-5wks):The lung bud branching and forming into the two principal bronchi,the principal bronchi growing in length and budding lobar bronchi lined with seudostratified columnar epithelium.2.Pseudoglandular stage(6-12wks):The bronchial divisions were differentiated and their air conducting system became established,lined with seudostratified and/or single-walled columnar epithelium.3.Canalicular stage(13-14wks):The respiratory bronchioles developed quickly,the primitive alveoli had developed,the respiratory bronchioles and primitive alveoli were lined by cuboid cells.4.Saccular stage (15wk):The respiratory divisions developed dramatically,the lung assumed a more “aerated” appearance.5.Alveolar stage (16-22wks):The alveoli developed and differentiated into flattened(type Ⅰ cell)and cuboid (type Ⅱ cell)epithelial cells.

  9. An unusual cause for recurrent chest infections.

    LENUS (Irish Health Repository)

    Lobo, Ronstan


    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.

  10. Tracheal and bronchial involvement in colitis ulcerosa – a colo-bronchitic syndrome? A case report and some additional considerations (United States)

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


    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

  11. Tracheal and bronchial involvement in colitis ulcerosa - a colo-bronchitic syndrome? A case report and some additional considerations. (United States)

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


    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.

  12. Bronchoscopic lung volume reduction in a single-lung transplant recipient with natal lung hyperinflation: a case report. (United States)

    Pato, O; Rama, P; Allegue, M; Fernández, R; González, D; Borro, J M


    After single lung transplantation for emphysema native lung hyperinflation is a common complication that may cause respiratory failure. Herein we have reported satisfactory bronchoscopic lung volume reduction in a left single-lung transplant recipient with native lung hyperinflation, who suffered from Medical Research Council (MRC) class 3 dyspnea and chest pain. Three endobronchial valves (Zephyr; Emphasys Medical, Redwood, Calif, United States) were placed into the segmental bronchi of the right upper lobe, using videobronchoscopy under general anesthesia. Postoperative chest computed tomography revealed subsegmental atelectasis in that lobe. The clinical benefit was an improved MRC dyspnea class from 3 to 2, which was still present at 4 months after the procedure, although there were no remarkable changes in spirometric parameters.

  13. A three-stage method for the 3D reconstruction of the tracheobronchial tree from CT scans. (United States)

    Rosell, Jan; Cabras, Paolo


    This paper proposes a method for segmenting the airways from CT scans of the chest to obtain a 3D model that can be used in the virtual bronchoscopy for the exploration and the planning of paths to the lesions. The method is composed of 3 stages: a gross segmentation that reconstructs the main airway tree using adaptive region growing, a finer segmentation that identifies any potential airway region based on a 2D process that enhances bronchi walls using local information, and a final process to connect any isolated bronchus to the main airways using a morphologic reconstruction process and a path planning technique. The paper includes two examples for the evaluation and discussion of the proposal.

  14. MR imaging appearance of laryngeal atresia (congenital high airway obstruction syndrome): unique course in a fetus

    Energy Technology Data Exchange (ETDEWEB)

    Kuwashima, Shigeko; Kitajima, Kazuhiro; Kaji, Yasushi [Dokkyo Medical University, Department of Radiology, Mibu, Shimotsuga-gun, Tochigi (Japan); Watanabe, Hiroshi [Dokkyo Medical University, Department of Obstetrics and Gynecology, Mibu (Japan); Watabe, Yoshiyuki; Suzumura, Hiroshi [Dokkyo Medical University, Department of Pediatrics, Mibu (Japan)


    Congenital high airway obstruction syndrome (CHAOS) is a rare life-threatening syndrome. Most cases are diagnosed prenatally by US. We report a fetus with this syndrome that showed a unique course revealed on MRI. Ultrasonography at 22 weeks demonstrated that the fetus had ascites and bilaterally enlarged hyperechoic lungs. Congenital infection, congenital cystic adenomatoid malformation or CHAOS was suspected. Subsequent MRI performed at 24 weeks demonstrated bilaterally enlarged high-signal lungs, dilated bronchi, massive ascites, subcutaneous oedema and polyhydramnios. MRI confirmed the diagnosis of CHAOS. A second MRI at 35 weeks showed that the bilateral lung enlargement, ascites, oedema and polyhydramnios had resolved, but that the appearance of the airway was unchanged. The infant was delivered by caesarean section at 38 weeks of gestation and immediate tracheostomy was performed. This spontaneous regression was explained by a tracheo-oesophageal fistula that may have decreased the intrathoracic pressure. (orig.)

  15. Assessment of a Sudden Death Case due to Coronary Artery Disease Based on the PMCT and Forensic Autopsy

    Institute of Scientific and Technical Information of China (English)

    WAN Lei; ZHANG Jian-hua; HUANG Ping; YING Chong-liang; LIU Ning-guo; ZHU Guang-you


    It is never an easy thing to diagnose heart vascular disease only depending on the unenhanced postmortem computed tomography (PMCT).This article reported a case of sudden natural death after the complaint of anterior chest pain in which coronary artery calcification (CAC) was clearly displayed using PMCT scan.The entire coronary artery system was almost reconstructed via multiplanar reformation (MPR) and volume-rendering reconstruction (VR),and the total calcium score of the coronary arteries was obtained with CaScoring automatic analysis software.The results showed that CAC was conspicuous; the total calcium score was 640.3,considerably higher than 400.The pulmonary ground-glass opacity (GGO) and small amount of fluid both in the subglottic trachea and main bronchi were also found.The imaging results confirmed those of autopsy.In addition,the results concluded that PMCT might serve as an invaluable adjunct to the classic autopsy procedure.

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

    Directory of Open Access Journals (Sweden)

    Keiko Mitaka Komatsuzaki


    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.

  17. Pathological and histological findings associated with the feline lungworm Troglostrongylus brevior. (United States)

    Giannelli, Alessio; Passantino, Giuseppe; Ramos, Rafael Antonio Nascimento; Lo Presti, Giuseppe; Lia, Riccardo Paolo; Brianti, Emanuele; Dantas-Torres, Filipe; Papadopoulos, Elias; Otranto, Domenico


    Troglostrongylus brevior is a neglected feline lungworm species, which has been increasingly reported in the Mediterranean area, although scant data are available on the respiratory alterations it causes in cats. Therefore, we describe the gross and histological lesions of a 20-week old kitten that succumbed due to the onset of a fulminant respiratory failure. At necropsy, a catarrhal exudate was observed in the airways, along with nematodes in the trachea and bronchi. The lungs were processed for histological examination and serial pulmonary sections were performed. A total of 14 nematodes were collected, being all morphologically and molecularly identified as T. brevior. Lungworms were histologically localized within the bronchial lumen, surrounded by an eosinophilic infiltrate. The presence of T. brevior in the airways has been histologically documented for the first time and its life-threatening potential is discussed.

  18. Region-based geometric modelling of human airways and arterial vessels. (United States)

    Ding, Songlin; Ye, Yong; Tu, Jiyuan; Subic, Aleksandar


    Anatomically precise geometric models of human airways and arterial vessels play a critical role in the analysis of air and blood flows in human bodies. The established geometric modelling methods become invalid when the model consists of bronchioles or small vessels. This paper presents a new method for reconstructing the entire airway tree and carotid vessels from point clouds obtained from CT or MR images. A novel layer-by-layer searching algorithm has been developed to recognize branches of the airway tree and arterial vessels from the point clouds. Instead of applying uniform accuracy to all branches regardless of the number of available points, the surface patches on each branch are constructed adaptively based on the number of available elemental points, which leads to the elimination of distortions occurring at small bronchi and vessels.

  19. Identification of a novel cetacean polyomavirus from a common dolphin (Delphinus delphis) with Tracheobronchitis. (United States)

    Anthony, Simon J; St Leger, Judy A; Navarrete-Macias, Isamara; Nilson, Erica; Sanchez-Leon, Maria; Liang, Eliza; Seimon, Tracie; Jain, Komal; Karesh, William; Daszak, Peter; Briese, Thomas; Lipkin, W Ian


    A female short-beaked common dolphin calf was found stranded in San Diego, California in October 2010, presenting with multifocal ulcerative lesions in the trachea and bronchi. Viral particles suggestive of polyomavirus were detected by EM, and subsequently confirmed by PCR and sequencing. Full genome sequencing (Ion Torrent) revealed a circular dsDNA genome of 5,159 bp that was shown to form a distinct lineage within the genus Polyomavirus based on phylogenetic analysis of the early and late transcriptomes. Viral infection and distribution in laryngeal mucosa was characterised using in-situ hybridisation, and apoptosis observed in the virus-infected region. These results demonstrate that polyomaviruses can be associated with respiratory disease in cetaceans, and expand our knowledge of their diversity and clinical significance in marine mammals.

  20. Identification of a novel cetacean polyomavirus from a common dolphin (Delphinus delphis with Tracheobronchitis.

    Directory of Open Access Journals (Sweden)

    Simon J Anthony

    Full Text Available A female short-beaked common dolphin calf was found stranded in San Diego, California in October 2010, presenting with multifocal ulcerative lesions in the trachea and bronchi. Viral particles suggestive of polyomavirus were detected by EM, and subsequently confirmed by PCR and sequencing. Full genome sequencing (Ion Torrent revealed a circular dsDNA genome of 5,159 bp that was shown to form a distinct lineage within the genus Polyomavirus based on phylogenetic analysis of the early and late transcriptomes. Viral infection and distribution in laryngeal mucosa was characterised using in-situ hybridisation, and apoptosis observed in the virus-infected region. These results demonstrate that polyomaviruses can be associated with respiratory disease in cetaceans, and expand our knowledge of their diversity and clinical significance in marine mammals.

  1. Should antihistamines be re-considered as antiasthmatic drugs as adjuvants to anti-leukotrienes? (United States)

    Bartho, Lorand; Benko, Rita


    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.

  2. Cellular senescence in normal and premature lung aging. (United States)

    Bartling, B


    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.

  3. Chyloptysis causing plastic bronchitis

    Directory of Open Access Journals (Sweden)

    Alice Stoddart


    Full Text Available Chyloptysis is a rare clinical problem that is associated with conditions affecting lymphatic channels in the thorax. Diagnosis is usually made when the patients present with expectoration of milky-white sputum or of thick tenacious mucus in the shape of smaller bronchi (bronchial cast. Typically the symptoms resolve after coughing up of the bronchial casts. Pleural, mediastinal, pulmonary or lymphatic abnormalities result in chyloptysis. Lymphangiography and detection of lipids (cholesterol or triglycerides in sputum help to establish the diagnosis. However, lymphangiography may not be positive in all patients. We report 2 patients with chyloptysis and bronchial casts with different etiologies. Abnormal lymphatics were demonstrated in one of our cases, but the second patients lymphangiogram was normal. In this patient we suspect that high venous filling pressures due to congestive heart failure had a causative effect in the setting of compromised lymphatic drainage in the thorax due to a prior history of radiation therapy to the chest for lymphoma.

  4. Spirometer-controlled cine magnetic resonance imaging to diagnose tracheobronchomalacia in pediatric patients

    DEFF Research Database (Denmark)

    Ciet, Pierluigi; Wielopolski, Piotr; Manniesing, Rashindra


    Tracheobronchomalacia (TBM) is defined as an excessive collapse of the intrathoracic trachea. Bronchoscopy is the gold standard to diagnose TBM, but bronchoscopy has major disadvantages, such as general anaesthesia. Cine-CT is a non-invasive alternative to diagnose TBM, but its use in children...... is restricted by ionizing radiation. Our aim was to evaluate the feasibility of spirometer-controlled cine-MRI as alternative to cine-CT in a retrospective study.12 children (mean 12 years, range 7-17), suspected to have TBM, underwent cine-MRI. Static scans were acquired at end-inspiration and expiration...... covering the thorax using a 3D SPGR sequence. 3D-Dynamic-scans were performed covering only the central airways. TBM was defined as a decrease of the trachea or bronchi diameter greater than 50% at end-expiration in the static and dynamic scans.The success rate of the cine-MRI protocol was 92%. Cine...

  5. Ectopic calcification in lambs from feeding the plant Cestrum diurnum. (United States)

    Simpson, C F; Bruss, M L


    Hypercalcemia and ectopic calcification were induced in 5 lambs by supplementing the diet with the dried leaves of the plant Cestrum diurnum, for 8 to 9 weeks. Lambs developed mineralization of blood vessels, heart, kidneys, and lungs. These tissues were examined by light and electron microscopy. In the vascular tissue there was calcification of elastic fibers in the hyperplastic intima and the media, along with mineralization of mitochondria of aortic smooth muscle cells. Myocardial cells and their mitochondria were mineralized. In the kidney, there was calcification of the epithelium of the distal convoluted tubules and collecting tubules, Bowman's capsule, and the mesangial cells of the glomeruli. In the lung, there was mineralization of the alveolar septal walls and the bronchi and bronchioles. Feeding of the calcinogenic plant to lambs caused extensive soft tissue calcification. Results of the study indicated that degeneration was the early soft tissue lesion in this plant toxicity.

  6. The pulmonary anatomy of Alligator mississippiensis and its similarity to the avian respiratory system. (United States)

    Sanders, R Kent; Farmer, C G


    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.

  7. Mitral valve replacement in an adult with left pulmonary agenesis. (United States)

    Saskin, Huseyin; Idiz, Mustafa; Duzyol, Cagri; Macika, Huseyin; Aksoy, Rezan


    Pulmonary agenesis is associated with the absence of pulmonary vessels, bronchi, or parenchyma. This condition usually occurs between the 4th and 5th week of gestation during the embryonic phase. Etiopathogenic factors associated with pulmonary agenesis are not fully understood. In the literature, genetic and teratogenic factors, viral infections, and vitamin-A deficiency are shown to be associated with pulmonary agenesis [Malcon 2012]. This condition may be seen unilaterally or bilaterally. Although the precise rate of incidence is unknown, it is estimated to occur in one of every 10,000 to 12,000 live births [Yetim 2011]. There is a 1.3:1 female predominance with unilateral agenesis [Halilbasic 2013].

  8. Coincidence of congenital agenesis of left lung and common atrium: a very rare case. (United States)

    Nabati, Maryam; Bagheri, Babak; Habibi, Valiolla


    Pulmonary agenesis is characterized by undeveloped pulmonary vessels, bronchi as well as lung parenchyma and is a rare congenital anomaly with unknown etiology. It is usually diagnosed during childhood. Nearly, one third of these patients have concomitant congenital heart diseases. While more than 50% of these patients die before the age of 5 years, some other patients may be asymptomatic throughout their life. On the other hand, common atrium, another rare congenital anomaly, is characterized by complete absence of the atrial septum and is usually accompanied by atrioventricular valve malformations. An 18-year-old male presented with concomitant pulmonary agenesis and common atrium and had not undergone surgery due to high risk for mortality.

  9. 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)


    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.)

  10. Inhalation risk and particle size in dust and mist

    Energy Technology Data Exchange (ETDEWEB)

    Davies, C.N.


    This paper presents a critical overview of particle uptake and retention from literature through 1949. Particles > are retained in nose, or by secondary bronchi with mouth breathing. Few > particles are exhaled, trapped mostly in bronchioles (some by alveoli) by sedimentation. Maximal deposition is 0.4- to size in bronchioles and alveoli. Minimim retention is at 0.1 to 0.15; approx. 80% are exhaled. Brownian settling of smaller particles in alveoli occurs. Particles of low density penetrate farther. Slow breathing enhances retention. Soluble toxins may be absorbed at any point along respiratory tract, so deep penetration percentage is moot in most cases.

  11. Parasites of the respiratory tract of Sus scrofa scrofa (wild boar) from commercial breeder in southern Brazil and its relationship with Ascaris suum. (United States)

    da Silva, Diego; Müller, Gertrud


    This study aimed to identify the species of helminths infecting the respiratory tract of Sus scrofa scrofa from commercial breeding and check the existence of a possible antagonistic relationship of these species with Ascaris suum. Forty wild boars were analyzed, and the genus Metastrongylus was recorded in the bronchi and bronchioles of 60 % of these, with the occurrence of the species Metastrongylus apri, Metastrongylus salmi, and Metastrongylus pudendotectus. The highest prevalence found was in M. apri (52.5 %), followed by M. salmi (20 %), and M. pudendotectus (7.5 %), registering the highest prevalence of Metastrongylus in wild boars from commercial breeding so far. M. apri was first reported parasitizing wild boars bred in captivity. There was no observed significant influence of A. suum in the mean intensity of Metastrongylus.

  12. Basal Secretion of Lysozyme from Human Airways in Vitro

    Directory of Open Access Journals (Sweden)

    Patricia Roger


    Full Text Available The aim of this study was to examine the basal release of lysozyme from isolated human lung tissues. Measurements of lysozyme in the fluids derived from lung preparations were performed using a rate-of-lysis assay subsequent to acidification of the biological samples. Lysozyme released from bronchial preparations into fluids was greater than that observed for parenchymal tissues. The lysozyme quantities detected in bronchial fluids were not modified by removal of the surface epithelium. Furthermore, the quantities of lysozyme in bronchial fluids was correlated with the size of the bronchial preparations. These results suggest that the lysozyme was principally secreted by the human bronchi (submucosal layer rather than by parenchyma tissues and that a greater release was observed in the proximal airways.

  13. 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


    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.

  14. CT findings of the patients with bronchial asthma

    Energy Technology Data Exchange (ETDEWEB)

    Katagiri, Shiro; Ohshima, Kazuki [Chiba-Tokusyukai Hospital, Funabashi (Japan); Ohsawa, Takehiko


    CT scans were obtained in 45 patients with bronchial asthma including 23 patients during asthmatic attack. CT findings were as follows. (1) In all cases, thickening of bronchial wall throughout from central to peripheral bronchi and without tapering and/or slight swelling of bronchovascular bundles were observed. (2) Characteristics findings in 23 patients with asthmatic attack, lobular and multilobular high attenuation area were observed in 17 patients (74%) and nonhomogeneous attenuation in lung fields were noticed in 13 patients (57%). (3) Multiple centrilobular sized high attenuation area were observed in 23 patients, but it was difficult to differenciation whether these findings were due to tiny nodules or to small vessels. In conclusion, further studies are needed to know which pathomorphological and/or pathophysiological conditions are underlying these CT findings. (author)

  15. Chronic Pulmonary Aspergillosis Complicating Bronchial Atresia

    Directory of Open Access Journals (Sweden)

    Mazen O. Al-Qadi


    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.

  16. 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:


    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)

  17. 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


    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.

  18. Endoscopic low coherence interferometry in upper airways (United States)

    Delacrétaz, Yves; Boss, Daniel; Lang, Florian; Depeursinge, Christian


    We introduce Endoscopic Low Coherence Interferometry to obtain topology of upper airways through commonly used rigid endoscopes. Quantitative dimensioning of upper airways pathologies is crucial to provide maximum health recovery chances, for example in order to choose the correct stent to treat endoluminal obstructing pathologies. Our device is fully compatible with procedures used in day-to-day examinations and can potentially be brought to bedside. Besides this, the approach described here can be almost straightforwardly adapted to other endoscopy-related field of interest, such as gastroscopy and arthroscopy. The principle of the method is first exposed, then filtering procedure used to extract the depth information is described. Finally, demonstration of the method ability to operate on biological samples is assessed through measurements on ex-vivo pork bronchi.

  19. Sarcoidosis of the upper and lower airways. (United States)

    Morgenthau, Adam S; Teirstein, Alvin S


    Sarcoidosis is a systemic granulomatous disease of undetermined etiology characterized by a variable clinical presentation and disease course. Although clinical granulomatous inflammation may occur within any organ system, more than 90% of sarcoidosis patients have lung disease. Sarcoidosis is considered an interstitial lung disease that is frequently characterized by restrictive physiologic dysfunction on pulmonary function tests. However, sarcoidosis also involves the airways (large and small), causing obstructive airways disease. It is one of a few interstitial lung diseases that affects the entire length of the respiratory tract - from the nose to the terminal bronchioles - and causes a broad spectrum of airways dysfunction. This article examines airway dysfunction in sarcoidosis. The anatomical structure of the airways is the organizational framework for our discussion. We discuss sarcoidosis involving the nose, sinuses, nasal passages, larynx, trachea, bronchi and small airways. Common complications of airways disease, such as, atelectasis, fibrosis, bullous leions, bronchiectasis, cavitary lesions and mycetomas, are also reviewed.

  20. Tracheobronchomalacia post-pneumonectomy: A late complication

    Directory of Open Access Journals (Sweden)

    Ashima Datey


    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.

  1. Pulmonary MRI contrast using Surface Quadrupolar Relaxation (SQUARE) of hyperpolarized (83)Kr. (United States)

    Six, Joseph S; Hughes-Riley, Theodore; Lilburn, David M L; Dorkes, Alan C; Stupic, Karl F; Shaw, Dominick E; Morris, Peter G; Hall, Ian P; Pavlovskaya, Galina E; Meersmann, Thomas


    Hyperpolarized (83)Kr has previously been demonstrated to enable MRI contrast that is sensitive to the chemical composition of the surface in a porous model system. Methodological advances have lead to a substantial increase in the (83)Kr hyperpolarization and the resulting signal intensity. Using the improved methodology for spin exchange optical pumping of isotopically enriched (83)Kr, internal anatomical details of ex vivo rodent lung were resolved with hyperpolarized (83)Kr MRI after krypton inhalation. Different (83)Kr relaxation times were found between the main bronchi and the parenchymal regions in ex vivo rat lungs. The T1 weighted hyperpolarized (83)Kr MRI provided a first demonstration of surface quadrupolar relaxation (SQUARE) pulmonary MRI contrast.

  2. [Endobronchial surgery and photodynamic therapy for the treatment of multiple primary lung cancer]. (United States)

    Sokolov, V V; Telegina, L V; Trakhtenberg, A Kh; Kolbanov, K I; Pikin, O V; Frank, G A


    Endoluminal endoscopic surgery and fotodynamic therapy were used in treatment of 104 patients with multiple primary lung cancer (MPLC), or more exactly, of trachea and lobar and segmental bronchi. Diagnostic division included videobronchoscopy of high resolution in with light and NBI-regimen; autoflourescent and 5-ALA-induced fluorescent videobronchoscopy, endosonography, computed tompgraphy or magnetic resonance imaging of the thorax and epithelial mucine (MUC-1) immunohistochemical analysis of scarificates. Result of treatment strongly depended on the size of primary tumor. Complete regression of cancer was observed for all tumors less then 1 sm in diameter. Endoscopic treatment, including fotodynamic therapy and argon coagulation, proved to be a method of choice in treatment early synchronous or metachronous multiple primary lung cancer in incurable patients.

  3. Unusual congenital pulmonary anomaly with presumed left lung hypoplasia in a young dog. (United States)

    Lee, C M; Kim, J H; Kang, M H; Eom, K D; Park, H M


    A seven-month-old, entire, male miniature schnauzer dog was referred with acute vomiting, inappetence and depression primarily as a result of a gastric foreign body (pine cones). During investigations, thoracic radiographs revealed increased volume of the right lung lobes, deviated cardiomediastinal structures and elevation of the heart from the sternum. Thoracic computed tomography revealed left cranial lung lobe hypoplasia and extension of the right cranial lung parenchyma across the midline to the left hemithorax. Branches of the right pulmonary vessels and bronchi also crossed the midline and extended to the left caudal lung lobe. These findings suggested that the right and left lungs were fused. In humans this finding is consistent with horseshoe lung, which is an uncommon congenital malformation. To the authors' knowledge, this case represents the first report of such a pulmonary anomaly in a dog.

  4. 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


    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.

  5. Local Delivery of Antiproliferative Agents via Stents

    Directory of Open Access Journals (Sweden)

    Hyuck Joon Kwon


    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.

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

    Institute of Scientific and Technical Information of China (English)

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


    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.

  7. [Bronchomotoric in antigen induced airway obstruction (author's transl)]. (United States)

    Zimmermann, I; Ulmer, W T


    Ascaris suum extract inhalation causes bronchoconstriction in dogs. Following this reaction, the bronchi stay oversensitive against acetylcholine for at least 7 h. Electrical stimulation of the peripheral end of a nervus vagus after cutting supports the meaning that the bronchoconstriction will be caused mainly by challenge of sensory receptors. The reflex way runs through the nervus vagus. Sensitization of the bronchial tree means sensitization of the sensory receptors. Results of the arterial blood gases correspond to earlier results which showed two parts of the bronchial tree: the vagus-controlled part is mainly respnsible for the airway resistance, the vagus-noncontrolled part is mainly responsible for the regulation of the ventilation/perfusion relationships.

  8. [Case report: respiratory infection due to Alcaligenes xylosoxidans in a patient with Mounier-Kuhn syndrome]. (United States)

    Arroyo-Cózar, Marta; Ruiz-García, Montserrat; Merlos, Eva M; Vielba, David; Macías, Enrique


    Mounier-Kuhn syndrome is a rare entity characterized by abnormal dilatation of the trachea and main bronchi (tracheobronchomegaly). Alcaligenes xylosoxidans is a non fermenting gram-negative pathogen common in extra-and intra-hospital environment, which may be related to immunosuppression states. We describe the case of a 75 years old male, ex-smoker with moderate functional obstruction, chronic respiratory failure and chronic colonization by Pseudomonas aeuriginosa. He had an infectious exacerbation of his disease, reason that previously required several hospital admissions. The patient was treated with antibiotics and his evolution was favourable with negativization in cultures of the pathogen. This is the first description of the isolation of Alcaligenes xylosoxidans as a cause of respiratory infection in a patient with Mounier-Kuhn syndrome.

  9. Epidermal growth factor in the rat lung

    DEFF Research Database (Denmark)

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


    Epidermal Growth Factor (EGF) in pharmacological doses is able to induce precoccious lung maturation in rabbits and sheeps. As EGF is probably acting in a para- or autocrine way, we have searched for EGF in the lungs. We report EGF immunoreactivity to be present in the type II pneumocytes...... 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....

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

    Directory of Open Access Journals (Sweden)

    Christina E. Brzezniak


    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.

  11. Pulmonary mucormycosis (Cunninghamella bertholletiae) with cavitation diagnosed using ultra-thin fibre-optic bronchoscopy. (United States)

    Yagi, Shin-Ichi; Miyashita, Naoyuki; Fukuda, Minoru; Obase, Yasushi; Yoshida, Koichiro; Miyauchi, Ayaka; Kawasaki, Kouzou; Soda, Hiroshi; Oka, Mikio


    Recently, ultra-thin bronchoscopy has made it possible to observe smaller bronchi not visualized using standard techniques. We describe a case of pulmonary mucormycosis with cavitation, diagnosed using an ultra-thin bronchoscope. A 15-year-old girl with acute myeloid leukaemia had taken oral prednisolone, 60 mg/day, for graft versus host disease after haematopoietic stem cell transplantation. She was admitted to our hospital with fever and a large cavitary lesion in the right hilum. Using an ultra-thin bronchoscope, the interior of the cavity in the superior segment of the right lower lobe was observed. The bronchoscopic findings revealed debris adhering to the cavity wall with a small volume of effusion. Cunninghamella bertholletiae was isolated from the effusion specimen obtained using the bronchoscope. Pulmonary mucormycosis (C. bertholletiae) complicating an immunocompromised state was diagnosed. Ultra-thin bronchoscopy is useful to diagnose complex pulmonary infections and more research is needed to verify its clinical indications and utility.

  12. Roles of secretory leukocyte protease inhibitor amniotic membrane in oral wound healing

    Directory of Open Access Journals (Sweden)

    Elly Munadziroh


    Full Text Available Secretory Leukocyte Protease Inhibitor (SLPI is serine protease inhibitor. Secretory Leukocyte Protease Inhibitor is a protein found in secretions such as whole saliva, seminal fluid, cervical mucus, synovial fluid, breast milk, tears, and cerebral spinal fluid, as in secretions from the nose and bronchi, amniotic fluid and amniotic membrane etc. These findings demonstrate that SLPI function as a potent anti protease, anti inflammatory, bactericidal, antifungal, tissue repair, extra cellular synthesis. Impaired healing states are characterized by excessive proteolysis and often bacterial infection, leading to the hypothesis that SLPI may have a role in the process. The objectives of this article are to investigate the role of SLPI in oral inflammation and how it contributes to tissue repair in oral mucosa. The oral wound healing responses are impaired in the SLPI sufficient mice and matrix synthesis and collagen deposition are delayed. This study indicated that SLPI is a povital factor necessary for optimal wound healing.

  13. 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)


    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.)

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

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    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)


    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.)

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

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    Razavi Seyed Mansour


    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

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

    Institute of Scientific and Technical Information of China (English)

    Seyed Mansour Razavi; Mostafa Ghanei; Payman Salamati; Mehdi Safiabadi


    To review long-term respiratory effects of mustard gas on Iranian veterans having undergone IraqIran 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.Prevalence of pulmonary involvement is approximately 42.5%.The most common complaints are cough and dyspnea.Major respiratory complications are chronic obstructive pulmonary disease,bronchiectasis,and asthma.Spirometry resuits 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 mustard lung.The effective treatment regimens consist of oxygen administration,use of vaporized moist air,respiratory physiotherapy,administration of mucolytic agents,bronchodilators,corticosteroids,and long-acting beta-2 agonists,antioxidants,surfactant,magnesium ions,therapeutic bronchoscopy,laser therapy,placement of respiratory stents,early tracheostomy in laryngospasm,and ultimately 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 defmitely curable.

  17. Differential gene-expression and host-response profiles against avian influenza virus within the chicken lung due to anatomy and airflow. (United States)

    Reemers, Sylvia S; van Haarlem, Daphne A; Groot Koerkamp, Marian J; Vervelde, Lonneke


    Sampling the complete organ instead of defined parts might affect analysis at both the cellular and transcriptional levels. We defined host responses to H9N2 avian influenza virus (AIV) in trachea and different parts of the lung. Chickens were spray-inoculated with either saline or H9N2 AIV. Trachea and lung were sampled at 1 and 3 days post-inoculation (p.i.) for immunocytochemistry, real-time quantitative RT-PCR and gene-expression profiling. The trachea was divided into upper and lower parts and the lung into four segments, according to anatomy and airflow. Two segments contained the primary and secondary bronchi, cranial versus caudal (parts L1 and L3), and two segments contained the tertiary bronchi, cranial versus caudal (parts L2 and L4). Between the upper and lower trachea in both control and infected birds, minor differences in gene expression and host responses were found. In the lung of control birds, differences in anatomy were reflected in gene expression, and in the lung of infected birds, virus deposition enhanced the differences in gene expression. Differential gene expression in trachea and lung suggested common responses to a wide range of agents and site-specific responses. In trachea, site-specific responses were related to heat shock and lysozyme activity. In lung L1, which contained most virus, site-specific responses were related to genes involved in innate responses, interleukin activity and endocytosis. Our study indicates that the anatomy of the chicken lung must be taken into account when investigating in vivo responses to respiratory virus infections.

  18. Respiratory tract changes in guinea pigs, rats, and mice following a single six-hour exposure to methyl isocyanate vapor

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    Fowler, E.H.; Dodd, D.E.


    Groups of male and female Fischer 344 rats, B6C3F1 mice, and Hartley guinea pigs were exposed once for 6 hr to mean concentrations of 10.5, 5.4, 2.4, 1.0, or 0 (control) ppm of methyl isocyanate (MIC) vapor. Rats and mice were also exposed to 20.4 ppm of MIC. The majority of deaths occurred during postexposure days 1 through 3. The 6-hr LC/sub 50/ values were 6.1 ppm for rats, 12.2 ppm for mice, and 5.4 ppm for guinea pigs. Notable clinical observations during and immediately following MIC exposure were lacrimation, perinasal/perioral wetness, respiratory difficulty (e.g., mouth breathing), decreased activity, ataxia, and hypothermia. Body weight losses were common in all species following MIC exposures of 2.4 ppm or greater. Microscopic lesions included acute necrosis of the epithelial lining throughout the respiratory tract in animals that died shortly after exposure, coupled with congestion, edema, and inflammation. A microscopic lesion that appeared unique to guinea pigs was bronchiolitis obliterans. Additional microscopic lesions observed in some animals that died or were sacrificed at the end of the study (postexposure day 14) consisted of squamous metaplasia of respiratory epithelium in the nasal cavity, which extended into the larynx, trachea, and in some cases, the bronchi. In addition, epithelial regeneration throughout the tract and submucosal fibroplasia in the trachea, bronchi, and bronchioles were observed, the latter lesion being primarily confined to rodents. Only in guinea pigs were there lesions in the 1.0 ppm group attributed to MIC exposure. In conclusion, guinea pigs were more sensitive to the MIC vapor than were rats, which were in turn more sensitive than mice.

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

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    Daniel Tzou


    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.

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

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    Benjamin eMauroy


    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.

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

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    Sparrow Malcolm P


    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.

  2. [Gastrontestinal hemorrhage following thoracic surgery]. (United States)

    Durić, O; Tvrtković, R; Budalica, M


    The authors discuss eight cases who suffered hemorrhaging stress ulcers out of 200 cases on whom Thoracotomies were performed. Presented is the common factor of the onset of this complication, it's diagnosis, and therapy. Listed below are the diagnoses and operative procedures used on these eight patients. Cysta Aerea Permagna Lobi Inf. Pulm. Dexter/operation: Mytomis Longitudinalis Ooesophagi. Caverna Bronchiectatica Permagna Lobi Inferior Pulmo Dexter/operation: Lobestomia Typica. Echinococcus Heaptis Complicatus, Empyema Pleurae Dexter/opetation: Decorticatio. Haemathorax Spontaneous Lobus Sinister/operation: Decorticatio Pleurae Sinister. Echi Comp. Cupolae Hepatis Permagnus/operation: Thoracotomia Phrenotomia, evacuatio, Triplex Drainage. Bronchiectasiae Lobi Medius et Inferior Pulmo Dexter/operation: Biblobectomia Typica. Carcinoma Bronchi Lobi Inferior Pulmo Dexter/operation: Lobectomia Typica. Gastric problems had troubled four of these eight patients in their past history. Bleeding in three patients occurred three days postoperatively, and in the remaining five, thirty days following their operation. Six patients had to be treated conservatively because of serious contraindications to reoperation. Four of them expired. Autopsy revealed: Pyothorax, Dehiscention Bronchi, Empyema, and Gastritis Errosiva with multiulcerations, hemoragia, and dilatation of the right heart. Two patients with recent stress ulcers were reoperated on, and were cured. The authors estimate that the occurrence of hemorrhaging stress ulcer following thoracic surgery are basically due to Hypoxia. The chain of events whic brought about the stress ulcer, however, began even before the operation, continued throughout the operation, and appeared postoperatively due to postoperative complications. The authors point out that these complications can be foreseen (early and late), but firstly, an attempt should be made to treat the patient with conservative therapy. Inasmuch as the hemorrhaging

  3. Role of reepithelization in the development of obliterative airway disease after lung transplantation%气道上皮再生对肺移植后闭塞性气道疾病的影响

    Institute of Scientific and Technical Information of China (English)

    徐保彬; 陈昶; 高文; 魏宁; 郑卉; 张容轩


    ,从而预防了OAD的发生.%Objective To investigate the role of airway reepithelization in the development of obliterative airway disease (OAD) after lung transplantation. Methods Donor allograft was obtained as Balb/c trachea and its connecting left bronchi, and it was subsequently orthotopically transplanted into recipient C57BL/6 mouse. Both ends of the donor trachea were anastmosed to the recipient in endto-end mode, and the bronchial branch was ligated distally. In the ligated group, the proximal end of the bronchi was ligated; it was otherwise left open in the unligated group. Allografts were harvested on postoperative day 28, and were examined for OAD manifestations, epithelium integrity and differentiation, submucous lymphocyte infiltration, and fibroproliferation. LCR, submucous fibrous tissue area and ciliated epithelium proportion were measured with computerized morphometry. Epithelium phenotype was examined by immunohistochemical stain. Results Tacheal allografts and unligated bronchi maintained luminal patency and integrated epithelium, while ligated bronchial allografts were obliterated with fibrous tissue, which was characteristic of OAD. LCR and lamina propria of the donor trachea and unligated bronchi were significantly higher than normal tracha (P<0. 01 and P < 0. 05 ). However,ciliated epithelium proportion of the tracheal allografts was intermediate between normal trachea and ligated bronchi (P<0. 05 and P<0. 01). Immunohistochernical stain revealed recipient phenotype in both the tracheal and unligated bronchial allografts; no recipient phenotype expression was noted in the ligated bronchial allografts. Conclusion Reepithelization with recipient-drived mucosa prevents OAD development in orthotopic tracheal and unligated bronchial allografts by changing the epithelium phenotype and regulating fibroblasts proliferation in the lamina propria.

  4. 热、酸刺激豚鼠食管诱导气道血浆渗出及其机制探讨%Airway microvuscular leakage induced by heat and acid stimulated esophagus in guinea pigs and its mechanism

    Institute of Scientific and Technical Information of China (English)

    郑燕冰; 赖克方; 陈如冲; 肖焕


    Objective To observe the effect on airway of hot and acid factor stimulated in guinea pigs esophagus,as well as to investigate the mechanism of transient receptor potential vanilloid 1(TRPVl) and neuropeptide in this process.Methods The esophagus of guinea pigs were perfused with hot saline(45℃)and hydrochloric acid(0.1 mol/L,37℃)pretreatment or without TRPV1 antagonist capsazepine and inhibitor of neutral endopeptidase phosphoramidone.The microvascular leakage of trachea,main bronchi and bronchiole were measured by evens blue dye and the total number and percentage of cells in the bronchoalveolar lavage fluid were calculated by HE dye.Results Stimulation by hot saline and 0.1 mol/L hydrochloric acid of the esophagus significantly increased the microvascular leakage of trachea and main bronchi(all P<0.05),microvascular leakage of bronchiole also increased in hot saline group.Phosphoramidone could significantly potentiated plasma extravasation in the trachea,main bronchi and bronchiole(P<0.05); capsazepine inhibited the plasma extravasation of trachea and bronchial induced by hot saline and acid.The total number and percentage of cells in the bronchoalveolar lavage fluid in different groups showed no significant difference.Conclusions Hot saline and hydrochloric acid stimulation intra esophageal can induce microvasclur leakage of airway.TRPV1 and neuropeptide may play an important role in it.%目的 观察热及酸刺激豚鼠食管对气道的影响,探讨瞬时受体电位香草酸亚型1(TRPV1)及神经肽在发生机制中的作用.方法 构建豚鼠食管灌流模型.进行持续(20 min)热生理盐水(45℃)和盐酸(0.1 mol/L,37℃)灌流刺激食管,通过伊文思蓝染色法检测其气管、支气管及细支气管的血浆渗出,观察支气管肺泡灌洗液中炎症细胞总数及分类,并观察TRPVl特异性受体拮抗剂CPZ和神经内肽酶抑制剂磷阿米酮对刺激效应的影响.结果 与对照组相比(P值均<0.05),热刺激和酸

  5. Studies on the release of leukotrienes and histamine by human lung parenchymal and bronchial fragments upon immunologic and nonimmunologic stimulation. Effects of nordihydroguaiaretic acid, aspirin, and sodium cromoglycate (United States)


    Fragments of human lung parenchyma or bronchi were studied by high performance liquid chromatography, gas chromatography-mass spectrometry, and bioassay for the biosynthesis of 5-lipoxygenase metabolites of arachidonic acid, and by radioenzymatic assay for the release of histamine, upon immunologic and nonimmunologic stimulation. Human lung parenchyma were passively sensitized with serum from timothy- positive allergic patients (radioallergosorbent test, 30-40%) and challenged with 0.5 microgram/ml of timothy allergen. Analysis of the incubation media showed the presence of LTB4, LTC4, LTD4, LTE4, and histamine. Maximum release of LTB4 and LTD4 was observed after 15 min of challenge (92.8 +/- 21, and 67.8 +/- 14 pmol/g tissue wet weight, respectively; mean +/- SEM) whereas maximum release of LTC4 was observed after 5 min of challenge (25 +/- 7.1 pmol). In parallel to leukotriene formation, histamine was released rapidly and reached a maximum after approximately 15 min of challenge (2.85 +/- 0.76 nmol/g tissue). When fragments of human lung parenchyma were stimulated with ionophore A23187 (4 microM), we observed a profile of leukotriene and histamine release similar to that seen in response to the allergen. Ionophore A23187 stimulated the release of two- to fivefold greater amounts of leukotrienes and histamine than did the allergen. Release of LTC4 and histamine was maximal after 5 min of stimulation (83 +/- 22.2 and 5.2 +/- 0.95 nmol/g tissue, respectively), whereas LTB4 and LTD4 release reached a maximum after 15 min (438 +/- 66.6 and 205 +/- 68 nmol/g tissue, respectively). In addition, human lung parenchyma metabolized LTB4 into omega-OH-LTB4 and omega-COOH-LTB4. This tissue also released 5-hydroxy-eicosatetraenoic acid (5-Hete), 12-Hete, and 15- Hete. Fragments of human lung bronchi also released a similar profile of leukotrienes (except LTC4) and histamine when challenged with the allergen or ionophore A23187. Maximum release of LTB4 and LTD4 by allergen or

  6. 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

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    Júlio Mott Ancona Lopez


    , 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.

  7. 青刺果黄酮对糖尿病小鼠肺病理变化的影响%The effects of flavonoids from Prinsepia utilis Royle on the pathologic changes of lung in the diabetic mice

    Institute of Scientific and Technical Information of China (English)

    吕程; 贾仁勇; 殷中琼; 吴小兰; 张雅雪


    目的 观察青刺果黄酮(FPR)对糖尿病小鼠肺病变的影响.方法 用四氧嘧啶建立糖尿病小鼠模型,并ig给予300mg·kg-1 FPR治疗,连续4周.分别于2、4周末于各组随机抽取4只小鼠宰杀,取出肺脏.肺组织用石蜡切片、HE和Gomori染色、显微镜观测.结果 糖尿病小鼠的肺弥漫性出血,肺泡腔缩小,肺泡壁增厚,支气管周围的纤维细胞增生和淋巴细胞浸润,肺间质、支气管周围网状纤维和胶原纤维的含量增加.FPR治疗组小鼠的肺出血得到缓解,肺泡腔增大,肺泡壁基本恢复正常,肺间质、支气管周围有少量的网状纤维和胶原纤维.结论 FPR能明显减轻糖尿病小鼠肺的病理变化,有效延缓糖尿病引起的肺损伤.%OBJECTIVE To observe the effects of flavonoids from Prinsepia utilis Royle on the pathologic changes of lung in diabetic mice. METHODS Diabetic mice induced by alloxan were given flavonoids from Prinsepia utilis Royle orally 300 mg·kg-1 each day for four weeks. Two weeks and four weeks later four mice in each group were randomly sacrificed, and the lungs were taken out and fixed with 4% polyoxym ethylene. The lung tissue was embedded with paraffin and the sections were tained with hematoxylin and eosin ( HE) and Gomori,then observed with microscopy. RESULTS In the model control group,the lung developed to the diffuse hemorrhages , the alveolar space was deflated, the alverolar walls were thickened, the fibrocytes proliferated and lymphocytes infiltrated in the surrounding of bronchi, the amount of reticular fiber and collagen fiber increased in lung interstitium and in the surrounding of bronchi. In the treatment group, the pulmonary haemorrhage was reliefed,the alveolar space was augmented, the alverolar walls were almost recovered to a normal state. Little reticular fiber and collagen fiber appeared in lung interstitium and in the surrounding of bronchi. CONCLUSION Flavonoids from Prinsepia utilis Royle can relieve the

  8. CT Diagnostic Value in Mounier-Kuhn Syndrome%CT在Mounier-Kuhn综合征诊断中的价值

    Institute of Scientific and Technical Information of China (English)



    Purpose To investigate the CT findings of Mounier-Kuhn Syndrome and to improve the diagnosis and differential diagnosis of Mounier-Kuhn Syndrome. Materials and methods 12 patients with Mounier-Kuhn Syndrome confirmed clinically were retrospectively analyzed. The diameters of trachea and bilateral main bronchi were measured respectively and compared with that of age and sex matched healthy controls. Other abnormal appearances were observed simultaneously. Results Anomalous or diffuse dilation of trachea and main bronchi can be demonstrated in all patients, which presented statistical difference compared to the control group (P =0.000). Other CT features included: corrugated sign and diverticular change(6/12), combined with bronchiectasis(7/12), combined with pneumonia(3/12). Conclusion The CT findings of Mounier-Kuhn Syndrome are characteristic. CT findings can not only prompt the diagnosis, but also show the extent of the lesion and secondary changes, which would guide the therapeutic plan. Routing thoracic CT examination is commended for the suspicious patients.%目的 探讨Mounier-Kuhn综合征的CT表现,以提高其诊断及鉴别诊断能力.资料与方法 回顾性分析12例临床明确诊断为Mounier-Kuhn综合征患者的CT影像学资料,分别测量气管及两侧主支气管直径并与正常对照组比较,同时观察其他胸部异常表现.结果 所有患者气管及两侧主支气管均有不规则或弥漫性的扩张,其测量值与对照组比较差异均有统计学意义(P= 0.000),其他CT主要征象有:波浪征及憩室样改变(6/12),合并支气管扩张(7/12),合并肺炎(3/12).结论 Mounier-Kuhn综合征的CT表现有一定特征.CT表现不仅能提示诊断,而且能够显示病变程度及继发改变,对治疗方案选择有指导意义.建议对可疑病例进行常规CT检查.

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

    Energy Technology Data Exchange (ETDEWEB)

    Schueller, G. E-mail:; Neumann, K.; Helbich, T.; Riemer, H.; Backfrieder, W.; Sertl, K.; Herold, C.J


    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

  10. CT Virtual Bronchoscopy: Imaging Method and Clinical Application%螺旋CT仿真支气管内窥镜成像方法及其临床应用

    Institute of Scientific and Technical Information of China (English)

    熊明辉; 张挽时; 王东; 宋云龙; 鲁晓燕; 时惠平


    Purpose: To evaluate imaging methods and clinical application of CT virtual bronchoscopy (VB). Meterials and Methods: Fifty-tvo cases were performed by using spiral CT (Hispeed Advantage CT/i), the data were transferred to computer workstation (Advantage Windows 3.1). The CTVB images were generated from using Navigator Smooth soft-ware and compared with fiberoptic bronchoscopy. 4 cases of them were correlated with pathologic samples. Results: CTVB could reveal 100% segmental bronchi and more than 80% subsegmental bronchi mimicking fiberoptic bron- choscopy. Arnong the 27 patients with lung cancer of center type, bronchial stenosis (n= 23) and occlusions (n= 4) were due to masses. Post-oper- ated residual bronchial sstumps (n=4) sbowed sooth blinds. One case exhibited the bronchial diverticulum in the right bronchus. Conclusions: CTVB provided a noninvasive fiberoptic bronchoscopelike image, but it can not replace fiberoptic endoscopy for demonstrating mucosal abnormalities and for obtaining histologic samples.%评价螺旋CT仿真支气管内窥镜(CTVB)临床应用价值。材料和方法:对52例气管、支气管行螺旋CT(GE HiSoeedAdvantageCT/i)扫描,将其数据传至AdvantageWindows 3.1版本工作站,用NavigatorSmooth软件建成酷似纤维支 气管镜所见的CTVB图像,并与纤维支气管镜对照。其中4例与病理标本对照。结果:CTVB能100%地观察到段以上支 气管和80%以上亚段支气管。27例中心型肺癌发现支气管狭窄23例,闭塞4例,肺癌术后支气管残端4例,气管狭窄2 例,右中间段支气管憩室1例。结论:CTVB是一种新的无创性观察气管、支气管腔的方法,酷似纤维支气管镜所见,但在 观察支气管粘膜的表浅病变和获取组织学标本方面不能取代纤维支气管镜。

  11. Effects of electroacupuncture at Zusanli (ST36) on inflammatory cytokines in a rat model of smoke-induced chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    Wen-ye Geng; Zi-bing Liu; Na-na Song; Gui-hong Zhang; Wei-zhong Jin; Wang Zhou; Li Li


    OBJECITVE:Improvement in lung function was reported after acupuncture treatment of chronic obstructive pulmonary disease (COPD),but little is known about the underlying mechanisms.Because an immune response imbalance could be seen in COPD,we hypothesize that electroacupuncture (EA) may play a role in regulating inflammatory cytokines and contribute to lung protection in a rat model of smoke-induced COPD.METHODS:A COPD model using male Sprague-Dawley rats exposed to cigarette smoke was established.The rats were randomly divided into four groups (control,sham,COPD,and COPD plus EA),and COPD model was evaluated by measuring pulmonary pathological changes and lung function.EA was applied to the acupuncture point Zusanli (ST36) for 30 min/d for 14 d in sham and COPD rats.Bronchoalveolar lavage fluid (BALF) was used to measure levels of tumor necrosis factor-α (TNF-α),interleukin-1β (IL-β),and malonaldehyde (MDA).RESULTS:Compared with the control rats,COPD rats had significant changes in lung resistance (RL) and lung compliance (CL) (both P<0.01),bronchi and bronchiole airway obstruction (P<0.01),and levels of MDA,TNF-α,and IL-1β (P<0.01).There were no significant differences between the control and the sham groups.Compared with the COPD rats,the COPD plus EA rats had decreased RL and increased CL (both P<0.05),and reduced bronchi and bronchiole airway obstruction (P<0.05,P<0.01,respectively),while levels of TNF-α,IL-1β,and MDA in BALF were lowered (P<0.05 and P<0.01,respectively).However,TNF-α and IL-1βlevels of the EA group rats remained higher than those of the control group (P<0.05).CONCLUSION:EA at ST36 can reduce lung injury in a COPD rat model,and beneficial effects may be related to down-regulation of inflammatory cytokines.The anti-inflammatory and antioxidant effects may prolong the clinical benefit of EA.

  12. Diagnostic Value of Multidetector CT and Its Multiplanar Reformation, Volume Rendering and Virtual Bronchoscopy Postprocessing Techniques for Primary Trachea and Main Bronchus Tumors.

    Directory of Open Access Journals (Sweden)

    Mingyue Luo

    Full Text Available To evaluate the diagnostic value of multidetector CT (MDCT and its multiplanar reformation (MPR, volume rendering (VR and virtual bronchoscopy (VB postprocessing techniques for primary trachea and main bronchus tumors.Detection results of 31 primary trachea and main bronchus tumors with MDCT and its MPR, VR and VB postprocessing techniques, were analyzed retrospectively with regard to tumor locations, tumor morphologies, extramural invasions of tumors, longitudinal involvements of tumors, morphologies and extents of luminal stenoses, distances between main bronchus tumors and trachea carinae, and internal features of tumors. The detection results were compared with that of surgery and pathology.Detection results with MDCT and its MPR, VR and VB were consistent with that of surgery and pathology, included tumor locations (tracheae, n = 19; right main bronchi, n = 6; left main bronchi, n = 6, tumor morphologies (endoluminal nodes with narrow bases, n = 2; endoluminal nodes with wide bases, n = 13; both intraluminal and extraluminal masses, n = 16, extramural invasions of tumors (brokethrough only serous membrane, n = 1; 4.0 mm-56.0 mm, n = 14; no clear border with right atelectasis, n = 1, longitudinal involvements of tumors (3.0 mm, n = 1; 5.0 mm-68.0 mm, n = 29; whole right main bronchus wall and trachea carina, n = 1, morphologies of luminal stenoses (irregular, n = 26; circular, n = 3; eccentric, n = 1; conical, n = 1 and extents (mild, n = 5; moderate, n = 7; severe, n = 19, distances between main bronchus tumors and trachea carinae (16.0 mm, n = 1; invaded trachea carina, n = 1; >20.0 mm, n = 10, and internal features of tumors (fairly homogeneous densities with rather obvious enhancements, n = 26; homogeneous density with obvious enhancement, n = 1; homogeneous density without obvious enhancement, n = 1; not enough homogeneous density with obvious enhancement, n = 1; punctate calcification with obvious enhancement, n = 1; low density

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

    Directory of Open Access Journals (Sweden)

    Bikram Shrestha


    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

  14. Acute tracheobronchial injuries: Impact of imaging on diagnosis and management implications

    Energy Technology Data Exchange (ETDEWEB)

    Scaglione, Mariano [Emergency and Trauma CT Section, Department of Radiology, Cardarelli Hospital, Via G. Merliani 31, 80127 Naples (Italy)]. E-mail:; Romano, Stefania [Emergency and Trauma CT Section, Department of Radiology, Cardarelli Hospital, Via G. Merliani 31, 80127 Naples (Italy); Pinto, Antonio [Emergency and Trauma CT Section, Department of Radiology, Cardarelli Hospital, Via G. Merliani 31, 80127 Naples (Italy); Sparano, Amelia [Emergency and Trauma CT Section, Department of Radiology, Cardarelli Hospital, Via G. Merliani 31, 80127 Naples (Italy); Scialpi, Michele [Istituto di Radiologia Diagnostica ed Interventistica Policlinico Monteluce, Universita degli Studi di Perugia, Via Brunamonti 51, 06122 Perugia (Italy); Rotondo, Antonio [Dipartimento Universitario di Internistica Clinica e Sperimentale F. Magrassi-A. Lanzara, Sezione Scientifica di Diagnostica per Immagini, Facolta di Medicina e Chirurgia, Seconda Universita degli Studi di Naples (Italy)


    Purpose: To evaluate the role of chest radiography, single-slice CT and 16-row MDCT in the direct evidence of tracheobronchial injuries. Methods: Patients with acute tracheobronchial injury were identified from the registry of our level 1 trauma center during a 5-year period ending July 2005. Findings at chest radiograph and CT were compared to those shown at bronchoscopy. Results: Eighteen patients with tracheobronchial injury - three patients with cervical trachea injury, eight with thoracic trachea injury and seven with bronchial injury - were identified. Twelve patients had a blunt trauma (67%), six patients had a penetrating (iatrogenic) injury (33%). Chest radiograph directly identified the site of tracheal injury in four cases, showing overdistension of the endotracheal cuff in three cases and displacement of the endotracheal tube in one case. At the level of the bronchi, chest radiograph demonstrated only one injury. CT directly identified the site of tracheal injury in all the cases showing the overdistension of the endotracheal cuff at the level of the thoracic trachea (three cases), posterior herniation of the endotracheal cuff at the thoracic trachea (three cases), lateral endotracheal cuff herniation at the thoracic trachea (one case), tracheal wall discontinuity at the cervical (one case) and at the thoracic trachea (one case) and displacement of endotracheal tube at the cervical trachea (two cases). At the level of the bronchi, CT correctly showed the site of injury in six case including: discontinuity of the left main bronchial wall (two cases), the 'fallen lung' sign (one case), right main bronchial wall enlargement (one case), discontinuity of the right middle bronchial wall (two cases). In one case, CT showed just direct 'air leak' at the level of the carina suggesting main bronchus injury. This finding was confirmed by bronchoscopy. Conclusion: Chest radiograph was helpful for the assessment of iatrogenic tracheal injuries

  15. Preclinical evaluation of an inhibitor of cytosolic phospholipase A2α for the treatment of asthma. (United States)

    Hewson, Christopher A; Patel, Sheena; Calzetta, Luigino; Campwala, Hinnah; Havard, Suzanne; Luscombe, Emma; Clarke, Philip A; Peachell, Peter T; Matera, Maria G; Cazzola, Mario; Page, Clive; Abraham, William M; Williams, Cara M; Clark, James D; Liu, Wai L; Clarke, Nicholas P; Yeadon, Michael


    Asthma is a chronic inflammatory lung disease with considerable unmet medical needs for new and effective therapies. Cytosolic phospholipase A(2)α (cPLA(2)α) is the rate-limiting enzyme that is ultimately responsible for the production of eicosanoids implicated in the pathogenesis of asthma. We investigated a novel cPLA(2)α inhibitor, PF-5212372, to establish the potential of this drug as a treatment for asthma. PF-5212372 was a potent inhibitor of cPLA(2)α (7 nM) and was able to inhibit prostaglandin (PG)D(2) and cysteinyl leukotriene release from anti-IgE-stimulated human lung mast cells (0.29 and 0.45 nM, respectively). In a mixed human lung cell population, PF-5212372 was able to inhibit ionomycin-stimulated release of leukotriene B(4), thromboxane A(2), and PGD(2) (2.6, 2.6, and 4.0 nM, respectively) but was significantly less effective against PGE(2) release (>301 nM; p < 0.05). In an in vitro cell retention assay, PF-5212372 retained its potency up to 24 h after being washed off. In a sheep model of allergic inflammation, inhalation of PF-5212372 significantly inhibited late-phase bronchoconstriction (78% inhibition; p < 0.001) and airway hyper-responsiveness (94% inhibition; p < 0.001), and isolated sheep lung mast cell assays confirmed species translation via effective inhibition of PGD(2) release (0.78 nM). Finally, PF-5212372 was assessed for its ability to inhibit the contraction of human bronchi induced by AMP. PF5212372 significantly inhibited AMP-induced contraction of human bronchi (81% inhibition; p < 0.001); this finding, together with the ability of this drug to be effective in a wide range of preclinical asthma models, suggests that inhibition of cPLA(2)α with PF-5212372 may represent a new therapeutic option for the treatment of asthma.

  16. 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:; Kawata, Naoko, E-mail:; Iesato, Ken, E-mail:; Matsuura, Yukiko, E-mail:; Sugiura, Toshihiko, E-mail:; Kasai, Hajime, E-mail:; Sakurai, Yoriko, E-mail:; Terada, Jiro, E-mail:; Sakao, Seiichiro, E-mail:; Tada, Yuji, E-mail:; Tanabe, Nobuhiro, E-mail:; Tatsumi, Koichiro, E-mail:


    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.

  17. Three-dimensional computational fluid dynamics simulations of particle deposition in the tracheobronchial tree. (United States)

    Isaacs, Kristin K; Schlesinger, R B; Martonen, Ted B


    Simulation of the dynamics and disposition of inhaled particles within human lungs is an invaluable tool in both the development of inhaled pharmacologic drugs and the risk assessment of environmental particulate matter (PM). The goal of the present focused study was to assess the utility of three-dimensional computational fluid dynamics (CFD) models in studying the local deposition patterns of PM in respiratory airways. CFD models were validated using data from published experimental studies in human lung casts. The ability of CFD to appropriately simulate trends in deposition patterns due to changing ventilatory conditions was specifically addressed. CFD simulations of airflow and particle motion were performed in a model of the trachea and main bronchi using Fluent Inc.'s FIDAP CFD software. Particle diameters of 8 microm were considered for input flow rates of 15 and 60 L/min. CFD was able to reproduce the observed spatial heterogeneities of deposition within the modeled bifurcations, and correctly predicted the "hot-spots" of particle deposition on carinal ridges. The CFD methods also predicted observed differences in deposition for high-versus-low flow rates. CFD models may provide an efficient means of studying the complex effects of airway geometry, particle characteristics, and ventilatory parameters on particle deposition and therefore aid in the design of human subject experiments.

  18. Accurate airway segmentation based on intensity structure analysis and graph-cut (United States)

    Meng, Qier; Kitsaka, Takayuki; Nimura, Yukitaka; Oda, Masahiro; Mori, Kensaku


    This paper presents a novel airway segmentation method based on intensity structure analysis and graph-cut. 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 a complete 3-D airway tree structure from a CT volume is quite challenging. Several researchers have proposed automated algorithms basically based on region growing and machine learning techniques. However these methods failed to detect the peripheral bronchi branches. They caused a large amount of leakage. This paper presents a novel approach that permits more accurate extraction of complex bronchial airway region. Our method are composed of three steps. First, the Hessian analysis is utilized for enhancing the line-like structure in CT volumes, then a multiscale cavity-enhancement filter is employed to detect the cavity-like structure from the previous enhanced result. In the second step, we utilize the support vector machine (SVM) to construct a classifier for removing the FP regions generated. Finally, the graph-cut algorithm is utilized to connect all of the candidate voxels to form an integrated airway tree. We applied this method to sixteen cases of 3D chest CT volumes. The results showed that the branch detection rate of this method can reach about 77.7% without leaking into the lung parenchyma areas.

  19. 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


    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.

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

    Directory of Open Access Journals (Sweden)

    Virtanen Ismo


    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.

  1. 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.


    Directory of Open Access Journals (Sweden)

    Simone Speggiorin


    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.

  3. Polonium and lung cancer. (United States)

    Zagà, Vincenzo; Lygidakis, Charilaos; Chaouachi, Kamal; Gattavecchia, Enrico


    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.

  4. Effects of histamine H1R-H4R-agonist on the airway epithelium of rabbits

    Institute of Scientific and Technical Information of China (English)

    Naushad A Dilkash; Trivendra Tripathi; Aijaz Ahmed Khan; Mohd Shahid; Haris M Khan; Mashiatullah Siddiqui; Rahat Ali Khan


    Objective: To explore the exact role of histamine receptors in respiratory system. Methods:The cohort comprised of six groups (group I control and group II-VI treated) containing five rabbits in each group. Control-group received vehicle (sterile distilled water) and treated groups received subcutaneous histamine (100μg/kg, b.i.d.), and H1R-agonist (HTMT), H2R-agonist (amthamine), H3R-agonist (R-(-)-α-methylhistamine) and H4R-agonist (clobenpropit) each in a dose of 10μg/kg, b.i.d. for 30 subsequent days. After completion of treatment, animals were euthanized and perfused with 10%buffered formalin. Small tissue blocks of trachea and lungs were processed for paraffin embedding. Observations were recorded in sample photomicrographs taken from 10μm thick. Haematoxylin and eosin stained sections. Results:It was observed that trachea and bronchi from histamine, H1R and H4R groups had only patches of hyperplastic and hypertrophied epithelium and in general, cells in the affected region were taller heaped up. The bronchiolar epithelia from all treated groups showed hypertrophy and hyperplasia throughout with most of the cells having rounded profile and appeared to bud out from the basal cells. Conclusions:It is concluded that histamine receptors on induction via its specific agonist can induce hypertrophy, hyperplasia of respiratory tract epithelia suggesting its role akin to growth stimulating factor and warranting further long-term study.

  5. Photodynamic Therapy (PDT) with Chemotherapy for Advanced Lung Cancer with Airway Stenosis. (United States)

    Kimura, Masakazu; Miyajima, Kuniharu; Kojika, Masakazu; Kono, Takafumi; Kato, Harubumi


    Intractable advanced lung cancer can be treated palliatively with photodynamic therapy (PDT) combined with chemotherapy to remove central and peripheral (lobar or segmental bronchi) bronchial stenosis and obstruction. We present data for 12 (eight men, four women) consecutive patients with 13 advanced non-small cell lung carcinomas in whom curative operations were contraindicated, who underwent PDT combined with chemotherapy for local control of the intraluminal lesions. The mean age was 73.3 years (range, 58-80 years), and the stages of cancer were IIA-IV. The median stenosis rates before treatment, one week post-treatment, and one month post-treatment were 60% (range, 30%-100%), 15% (range, 15%-99%), and 15% (range 15%-60%), respectively. The mean and median survival times were 9.3 and 5.9 months, respectively. The overall 1-year survival rate was 30.0%. No PDT-related morbidity or mortality occurred. In this single-institution study, all patients experienced improved symptoms and quality of life at one week after treatment; furthermore, an objective response was evidenced by the substantial increase in the openings of the bronchial lumen and prevention of obstructive pneumonia. Therefore, PDT with chemotherapy was useful and safe for the treatment of bronchial obstruction.

  6. Development of the cardiorespiratory system in dogs from days 16 to 46 of pregnancy. (United States)

    Martins, A A; Favaron, P O; de Jesus Oliveira, L; Schäfer, B T; Oliveira, F D; Miglino, M A


    Dogs have been studied for several reasons, such as the genetic improvement, their use as experimental models, in zoonotic research, cell therapy and as a model for human diseases. However, many features relating to the embryonic development of dogs remain unknown because of the absence of embryological studies. Considering the importance of the cardiorespiratory system in the development of embryos, the aim of this study was to investigate the development of the main cardiorespiratory organs of dog embryos and foetuses with estimated gestational ages from 16 to 46 days using macro- and microscopic descriptions. On day 16 of development, the neural tube and crest were formed, the anterior and posterior neuropore closure had begun and the somites had developed. Between days 22 and 27 of gestation, the lung buds and the initial formation of the primary bronchi and heart chambers were observed. The heart chambers exhibited the endo-, myo- and epicardial layers but did not have obvious differences in thickness among each other. Between days 41 and 46 of gestation, the nasal conchae and septa and trachea were formed, which exhibited characteristic epithelia. The lung formation and lobation were complete. The heart and major vessels exhibited mature histological architecture when their anatomical development was complete. The results of this study contribute to a more accurate definition of the embryonic and foetal developmental stages in dogs.

  7. Epithelial binding of 1,1,2,2-tetrachloroethane in the respiratory and upper alimentary tract

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    Eriksson, C.; Brittebo, E.B. (Swedish Univ. of Agricultural Sciences, Uppsala (Sweden). Dept. of Pharmacology and Toxicology)


    The bioactivation and binding of {sup 14}C-labelled 1,1,2,2-tetrachloroethane (TCE) in the tissues of C57B1 mice were studied. As shown by autoradiography with heated and organic solvent-extracted tissue sections of i.v. injected mice, a high and selective localization of bound metabolites occurred in the nasal olfactory mucosa, preferentially in the Bowman's glands. High levels of bound metabolites were also present in epithelia of the trachea, bronchi and bronchioli and in the squamous epithelia of the oral cavity, tongue and esophagus. An epithelial binding was observed in tissue slices incubated with {sup 14}C-TCE. Incubation of {sup 14}C-TCE with homogenates of the olfactory mucosa and liver showed that the olfactory mucosa had a higher ability to activate {sup 14}C-TCE into products that become irreversibly bound to protein. Addition of metyrapone, glutathione or sodium dithionite to the incubations decreased the level of irreversible binding, suggesting that the activation of TCE to reactive products is mediated via an oxidative cytochrome P-450 dependent process in the olfactory mucosa. (orig.).

  8. [Use of antihistamines in a physician's clinical practice]. (United States)

    Luss, L V


    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. Medical image of the week: bronchopleural fistula

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    Desai H


    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 ...

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

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


    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.

  11. Perioperative management of tracheobronchial injury following blunt trauma

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    Nilesh M Juvekar


    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.

  12. Characterization of leukemia-associated Rho guanine nucleotide exchange factor (LARG) expression during murine development. (United States)

    Becknell, Brian; Shen, Tiansheng; Maghraby, Eman; Taya, Shinichiro; Kaibuchi, Kozo; Caligiuri, Michael A; Marcucci, Guido


    LARG (leukemia-associated Rho guanine nucleotide exchange factor, ARHGEF12) was originally identified as a fusion partner of the MLL gene at 11q23 in human acute myeloid leukemia. We have previously demonstrated that the LARG protein activates RhoA, a member of the Rho family of small GTPases, by catalyzing the exchange of GTP for GDP. Experiments in Drosophila melanogaster have implicated RhoA and its regulators in a spectrum of developmental processes-including gastrulation, neurite outgrowth, and epidermal morphogenesis; however, the role of these genes during mammalian development is incompletely understood. Herein, we investigate the expression of the murine LARG homologue during embryogenesis and in adult animals, by a combination of mRNA in situ hybridization and immunohistochemical detection of the LARG protein. We observe that LARG transcript and protein are undetectable prior to embryonic day 14. Beginning at this stage, LARG is expressed in the skin, intestinal epithelium, and smooth muscle layers of the intestine, bronchi, and vasculature. This specific distribution is maintained at later stages of development and into adulthood. Finally, we demonstrate colocalization of the LARG protein with the insulin-like growth factor-I (IGF-1) receptor, suggesting a potential physiologic role for LARG as an activator of RhoA in response to IGF-1.

  13. Disentangling interoception: insights from focal strokes affecting the perception of external and internal milieus

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    Agustin eIbanez


    Full Text Available Interoception is the moment-to-moment sensing of the physiological condition of the body. The multimodal sources of interoception can be classified into two different streams of afferents: an internal pathway of signals arising from core structures (i.e., heart, blood vessels, and bronchi and an external pathway of body-mapped sensations (i.e., chemosensation and pain arising from peripersonal space. This study examines differential processing along these streams within the insular cortex (IC and their subcortical tracts connecting frontotemporal networks. Two rare patients presenting focal lesions of the IC (insular lesion, IL or its subcortical tracts (subcortical lesion, SL were tested. Internally generated interoceptive streams were assessed through a heartbeat detection task, while those externally triggered were tapped via taste, smell, and pain recognition tasks. A differential pattern was observed. The IC patient showed impaired internal signal processing while the SL patient exhibited external perception deficits. Such selective deficits remained even when comparing each patient with a group of healthy controls and a group of brain-damaged patients. These outcomes suggest the existence of distinguishable interoceptive streams. Results are discussed in relation with neuroanatomical substrates, involving a fronto-insulo-temporal network for interoceptive and cognitive contextual integration.

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


    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.

  15. What the pediatrician should know about non-typeable Haemophilus influenzae. (United States)

    Gilsdorf, Janet R


    Non-typeable Haemophilus influenzae (NTHi) live exclusively in the pharynges of humans and are increasingly recognized as pathogens that cause both localized infections of the respiratory tract (middle ear spaces, sinuses, and bronchi) and systemic infections such as bacteraemia and pneumonia. Only one vaccine antigen of NTHi, Protein D, has been extensively studied in humans and its efficacy in preventing NTHi otitis media is modest. Recent genetic analyses reveal that NTHi are closely related to Haemophilus haemolyticus (Hh), previously thought to be a non-pathogenic commensal of the pharynx. This review discusses the differences between the pathogenic potential of encapsulated and non-typeable Hi. In addition, information on the lifestyles and bacterial characteristics of NTHi and Hh as they pertain to their pathogenic capacities and the value of the Haemophilus taxonomy to clinicians are presented. Further, the epidemiology and mechanisms of NTHi antibiotic resistance, which include production of β-lactamase and alterations of penicillin-binding protein 3, are reviewed, as are the challenges of vaccine antigen discovery in NTHi.

  16. Crystallization of recombinant Haemophilus influenzaee (P4) acid phosphatase

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    Ou, Zhonghui [Department of Biochemistry, University of Missouri-Columbia, Columbia, MO 65211 (United States); Felts, Richard L. [Department of Chemistry, University of Missouri-Columbia, Columbia, MO 65211 (United States); Reilly, Thomas J. [Department of Veterinary Pathobiology and Veterinary Medical Diagnostic Laboratory, University of Missouri-Columbia, Columbia, MO 65211 (United States); Nix, Jay C. [Molecular Biology Consortium, Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Tanner, John J., E-mail: [Department of Biochemistry, University of Missouri-Columbia, Columbia, MO 65211 (United States); Department of Chemistry, University of Missouri-Columbia, Columbia, MO 65211 (United States)


    Lipoprotein e (P4) is a class C acid phosphatase and a potential vaccine candidate for nontypeable H. influenzae infections. This paper reports the crystallization of recombinant e (P4) and the acquisition of a 1.7 Å resolution native X-ray diffraction data set. Haemophilus influenzae infects the upper respiratory tract of humans and can cause infections of the middle ear, sinuses and bronchi. The virulence of the pathogen is thought to involve a group of surface-localized macromolecular components that mediate interactions at the host–pathogen interface. One of these components is lipoprotein e (P4), which is a class C acid phosphatase and a potential vaccine candidate for nontypeable H. influenzae infections. This paper reports the crystallization of recombinant e (P4) and the acquisition of a 1.7 Å resolution native X-ray diffraction data set. The space group is P4{sub 2}2{sub 1}2, with unit-cell parameters a = 65.6, c = 101.4 Å, one protein molecule per asymmetric unit and 37% solvent content. This is the first report of the crystallization of a class C acid phosphatase.

  17. Persistent and Recurrent Bacterial Bronchitis—A Paradigm Shift in Our Understanding of Chronic Respiratory Disease (United States)

    Ishak, Alya; Everard, Mark L.


    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

  18. Macroscopic anatomy of the lower respiratory system in mole rats (Spalax leucodon). (United States)

    İlgun, R; Yoldas, A; Kuru, N; Özkan, Z E


    The morphologic and morphometric features of the lower respiratory system in mole rats were examined. It was seen that the low respiratory system of this species leading a special life under highly hypoxic/hypercapnic conditions underground is structurally similar to other mammals living on land in terms of the parts examined; trachea was formed by 29.5 ± 4 oval-formed cartilaginous tracheals arranged backwards and became gradually more stenotic diameter from cranial to the caudal of the neck. The trachea was separated in two principal bronchus at the fourth thoracal intercostal spatium level. The angle between the two main principal bronchi was 60.5 ± 2.35°. The lung constituted 1.29 ± 0.03% of the body weight and the right lung was heavier than the left lung. Fissura inter-lobaris was deep and separated the lung lobes wholly, and the right lung was separated in four lobes, whereas the left lung was not separated into the lobes. Also, the medial lobe of the left lung was the lightest lobe.

  19. A Numerical Model of Viscoelastic Layer Entrainment by Airflow in Cough (United States)

    Mitran, Sorin M.


    Coughing is an alternative mode of ensuring mucus clearance in the lung when normal cilia induced flow breaks down. A numerical model of this process is presented with the following aspects. (1) A portion of the airway comprising the first three bronchus generations is modeled as radially reinforced elastic tubes. Elasticity equations are solved to predict airway deformation under effect of airway pressure. (2) The compressible, turbulent flow induced by rapid lung contraction is modeled by direct numerical simulation for Reynolds numbers in the range 5,000-10,000 and by Large Eddy Simulation for Reynolds numbers in the range 5,000-40,000. (3) A two-layer model of the airway surface liquid (ASL) covering the airway epithelial layer is used. The periciliary liquid (PCL) in direct contact with the epithelial layer is considered to be a Newtonian fluid. Forces modeling cilia beating can act upon this layer. The mucus layer between the PCL and the interior airflow is modeled as an Oldroyd-B fluid. The overall computation is a fluid-structure interaction simulation that tracks changes in ASL thickness and airway diameters that result from impulsive airflow boundary conditions imposed at bronchi ends. In particular, the amount of mucus that is evacuated from the system is computed as a function of cough intensity and mucus rheological properties.

  20. Management of Laryngotracheal and Tracheobronchial Injuries

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    Hamid Reza Davari


    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.

  1. Unilateral pulmonary agenesis: a report of four cases, two diagnosed antenatally and literature review. (United States)

    Kayemba-Kay's, S; Couvrat-Carcauzon, V; Goua, V; Podevin, G; Marteau, M; Sapin, E; Levard, G


    Pulmonary agenesis is a rare congenital malformation of lung development defined as complete absence of lung tissues, bronchi, and pulmonary vessels; it may be uni- or bilateral. The right-sided form carries the poorest prognosis due to severity of co-existent anomalies. Its diagnostic circumstances are variables: first reported cases were diagnosed at autopsy, but early postnatal as well as fortuitous discovery have been reported. In recent years, progress in obstetrical imaging has made antenatal diagnosis possible so that fetal ultrasound and MRI allow early diagnosis and refinement by permitting the elimination of differential diagnoses (diaphragmatic hernia, cystic adenomatoid malformation of the lung, giant lobar emphysema, and situs inversus). This anomaly is compatible with normal life provided co-existent malformations are thoroughly investigated and managed in a multidisciplinary setting. We report four cases of lung agenesis two of which were diagnosed antenatally at 23rd and 30th weeks of gestation respectively. Our aim is to describe the circumstances having led to diagnosis and report both follow-up and outcome of our patients.

  2. FGF signaling pathway in the developing chick lung: expression and inhibition studies.

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    Rute S Moura

    Full Text Available BACKGROUND: Fibroblast growth factors (FGF are essential key players during embryonic development. Through their specific cognate receptors (FGFR they activate intracellular cascades, finely regulated by modulators such as Sprouty. Several FGF ligands (FGF1, 2, 7, 9, 10 and 18 signaling through the four known FGFRs, have been implicated in lung morphogenesis. Although much is known about mammalian lung, so far, the avian model has not been explored for lung studies. METHODOLOGY/PRINCIPAL FINDINGS: In this study we provide the first description of fgf10, fgfr1-4 and spry2 expression patterns in early stages of chick lung development by in situ hybridization and observe that they are expressed similarly to their mammalian counterparts. Furthermore, aiming to determine a role for FGF signaling in chick lung development, in vitro FGFR inhibition studies were performed. Lung explants treated with an FGF receptor antagonist (SU5402 presented an impairment of secondary branch formation after 48 h of culture; moreover, abnormal lung growth with a cystic appearance of secondary bronchi and reduction of the mesenchymal tissue was observed. Branching and morphometric analysis of lung explants confirmed that FGFR inhibition impaired branching morphogenesis and induced a significant reduction of the mesenchyme. CONCLUSIONS/SIGNIFICANCE: This work demonstrates that FGFRs are essential for the epithelial-mesenchymal interactions that determine epithelial branching and mesenchymal growth and validate the avian embryo as a good model for pulmonary studies, namely to explore the FGF pathway as a therapeutic target.

  3. Blocking TRPA1 in Respiratory Disorders: Does It Hold a Promise?

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    Indranil Mukhopadhyay


    Full Text Available Transient Receptor Potential Ankyrin 1 (TRPA1 ion channel is expressed abundantly on the C fibers that innervate almost entire respiratory tract starting from oral cavity and oropharynx, conducting airways in the trachea, bronchi, terminal bronchioles, respiratory bronchioles and upto alveolar ducts and alveoli. Functional presence of TRPA1 on non-neuronal cells got recognized recently. TRPA1 plays a well-recognized role of “chemosensor”, detecting presence of exogenous irritants and endogenous pro-inflammatory mediators that are implicated in airway inflammation and sensory symptoms like chronic cough, asthma, chronic obstructive pulmonary disease (COPD, allergic rhinitis and cystic fibrosis. TRPA1 can remain activated chronically due to elevated levels and continued presence of such endogenous ligands and pro-inflammatory mediators. Several selective TRPA1 antagonists have been tested in animal models of respiratory disease and their performance is very promising. Although there is no TRPA1 antagonist in advanced clinical trials or approved on market yet to treat respiratory diseases, however, limited but promising evidences available so far indicate likelihood that targeting TRPA1 may present a new therapy in treatment of respiratory diseases in near future. This review will focus on in vitro, animal and human evidences that strengthen the proposed role of TRPA1 in modulation of specific airway sensory responses and also on preclinical and clinical progress of selected TRPA1 antagonists.

  4. Lung remodeling in a mouse model of asthma involves a balance between TGF-β1 and BMP-7.

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    Camila Leindecker Stumm

    Full Text Available A key event in chronic allergic asthma is the TGF-β-induced activation of fibroblasts into α-SMA-positive myofibroblasts which synthesize type-I collagen. In the present study we investigated the effect of the anti-fibrotic molecule BMP-7 in asthma. Balb/c mice were immunized i.p. with ovalbumin in alum and challenged every 2 days with ovalbumin aerosol (two or six challenges for acute and chronic protocols, respectively. The lung was evaluated for: α-SMA and type-I collagen by immunohistochemistry; BMP-7 and TGF- β1 gene expression by qRT-PCR; type-I collagen and Smads 2 and 3 by immunoblotting; mucus by PSA staining. Type-I collagen around bronchi, α-SMA, mucus secretion, TGF- β1 and BMP-7 gene expression were all increased in asthma. The TGF- β1/BMP-7 ratio was higher in the chronic group and correlated with higher levels of collagen. Fibroblasts isolated from asthmatic and healthy lungs produced type-I collagen upon stimulation with TGF- β1 via phosphorylation of Smad-2, Smad-3. Pre-treatment of the fibroblasts with BMP-7 reduced collagen production and Smads phosphorylation. Intranasal treatment of asthmatic mice with recombinant BMP-7 during the immunization protocol reduced lung inflammation and type I collagen deposition. These results suggest a protective role for BMP-7 in lung allergic inflammation, opposing the pro-fibrotic effects of TGF- β1.

  5. The respiratory tract deposition model proposed by the ICRP Task Group

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    James, A.C.; Briant, J.K. (Pacific Northwest Lab., Richland, WA (USA)); Stahlhofen, W.; Rudolf, G. (Gesellschaft fuer Strahlen- und Umweltforschung mbH Muenchen, Frankfurt am Main (Germany, F.R.). Abt. fuer Biophysikalische Strahlenforschung); Egan, M.J.; Nixon, W. (AEA Safety and Reliability, Culcheth (UK)); Gehr, P. (Bern Univ. (Switzerland). Anatomisches Inst.)


    The Task Group has developed a new model of the deposition of inhaled aerosols in each anatomical region of the respiratory tract. The model is used to evaluate the fraction of airborne activity that is deposited in respiratory regions having distinct retention characteristics and clearance pathways: the anterior nares, the extrathoracic airways of the naso- and oropharynx and larynx, the bronchi, the bronchioles, and the alveolated airways of the lung. Drawn from experimental data on total and regional deposition in human subjects, the model is based on extrapolation of these data by means of a detailed theoretical model of aerosol transport and deposition within the lung. The Task Group model applies to all practical conditions, and for aerosol particles and vapors from atomic size up to very coarse aerosols with an activity median aerodynamic diameter of 100 {mu}m. The model is designed to predict regional deposition in different subjects, including adults of either sex, children of various ages, and infants, and also to account for anatomical differences among Caucasian and non-Caucasian subjects. The Task Group model represents aerosol inhalability and regional deposition in different subjects by algebraic expressions of aerosol size, breathing rates, standard lung volumes, and scaling factors for airway dimensions. 35 refs., 13 figs., 2 tabs.

  6. Role of acetylcholine and muscarinic receptors in serotonin-induced bronchoconstriction in the mouse. (United States)

    Kummer, Wolfgang; Wiegand, Silke; Akinci, Sibel; Schinkel, Alfred H; Wess, Jürgen; Koepsell, Hermann; Haberberger, Rainer Viktor; Lips, Katrin Susanne


    For the murine trachea, it has been reported that constriction evoked by serotonin (5-HT) is largely dependent on acetylcholine (ACh) released from the epithelium, owing to the sensitivity of the 5-HT response to epithelium removal, sensitivity to atropine, and insensitivity to tetrodotoxin (Moffatt et al., 2003). Consistent with this assumption, the respiratory epithelium contains ACh, its synthesizing enzyme, and the high-affinity choline transporter CHT1 (Reinheimer et al., 1996; Pfeil et al., 2003; Proskocil et al., 2004). Recently, we 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 (Lips et al., 2005). Hence, we proposed that 5-HT evokes release of ACh from epithelial cells via OCTs and that this epithelial-derived ACh induces bronchoconstriction. We tested this hypothesis in a well-established model of videomorphometric analysis of bronchial diameter in precision-cut murine lung slices utilizing epithelium removal to assess the role of the epithelium, OCT mouse knockout (KO) strains to assess the role of OCT isoforms, and muscarinic receptor M2/M3 double-KO mice to assess the cholinergic component of 5-HT induced bronchoconstriction, as bronchi of this strain are entirely unresponsive to cholinergic stimulation(Struckmann et al., 2003).

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

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    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.

  8. Global impact of bronchiectasis and cystic fibrosis

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    Margarida Redondo


    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.

  9. Microanatomy of the terminal air spaces of Baird's beaked whale (Berardius bairdii) lungs. (United States)

    Ninomiya, Hiroyoshi; Inomata, Tomo; Shirouzu, Hiroshi; Katsumata, Etsuko


    The terminal airways and microvasculature of five adult Baird's beaked whales (Berardius bairdii) lungs have been examined by means of light and scanning electron microscopy of corrosion casts. The respiratory system of the Baird's beaked whale has various anatomical features which allow them to attain great depths and remain submerged for long periods. The whale lung has components including hyaline cartilage and smooth muscle throughout, reaching as far as the peripheral bronchi, sphincters surrounding the terminal bronchioles, the thick alveolar septa with a connective tissue core and a bi-layer capillary bed, and a distinctive venous plexus of the pulmonary veins. The well-developed venous plexuses of the pulmonary vein are found in the interlobular connective tissue, and around the airways and pulmonary arteries with close apposition. The hyaline cartilage throughout the airways may increase the effective dead air space that accommodates most of the air forced from the collapsed alveoli during a dive. The sphincter might serve as a cock for regulating buoyancy and for trapping air in the alveoli to prevent their complete collapse and a sucking in of alveolar tissue as the dive becomes deeper. The venous plexuses might be for pooling the large volume of blood in the lung to conserve oxygen for deep and prolonged diving.

  10. Sexual Dimorphism in the Regulation of Estrogen, Progesterone, and Androgen Receptors by Sex Steroids in the Rat Airway Smooth Muscle Cells

    Directory of Open Access Journals (Sweden)

    Abraham Zarazúa


    Full Text Available The role of sex hormones in lung is known. The three main sex steroid receptors, estrogen, progesterone, and androgen, have not been sufficiently studied in airway smooth muscle cells (ASMC, and the sex hormone regulation on these receptors is unknown. We examined the presence and regulation of sex hormone receptors in female and male rat ASMC by Western blotting and flow cytometry. Gonadectomized rats were treated with 17β-estradiol, progesterone, 17β-estradiol + progesterone, or testosterone. ASMC were enzymatically isolated from tracheas and bronchi. The experiments were performed with double staining flow cytometry (anti-α-actin smooth muscle and antibodies to each hormone receptor. ERα, ERβ, tPR, and AR were detected in females or males. ERα was upregulated by E2 and T and downregulated by P4 in females; in males, ERα was downregulated by P4, E + P, and T. ERβ was downregulated by each treatment in females, and only by E + P and T in males. tPR was downregulated by P4, E + P, and T in females. No hormonal regulation was observed in male receptors. AR was downregulated in males treated with E + P and T. We have shown the occurrence of sex hormone receptors in ASMC and their regulation by the sex hormones in female and male rats.


    Directory of Open Access Journals (Sweden)



    Full Text Available This study aimed to characterize the lobation and describe the bronchial tree and vasculariza-tion of the lung collared peccaries. 12 animals that died in Multiplication Center of Wild Animals (CEMAS/UFERSA were used. For analysis of the bronchial tree, the trachea was perfused with latex or vinyl and for identification of arterial vascularization, the pulmonary artery was perfused with red latex. For the visualization of the pulmonary veins, the left atrium was perfused in retrograde direction with blue latex. Likewise we pro-ceeded with perfusion with vinyl. The pieces injected with latex were fixed in 10% formaldehyde for 48 hours and then performed the dissections. Those perfused with vinyl were dipped in a solution of 30% H2SO4 until complete corrosion. The right lung was composed of the cranial, middle, caudal and accessory lobes, while the left lung by cranial (cranial and caudal portions and caudal lobes. The trachea before of the bifurcation in left and right main bronchi, issued a tracheal bronchus towards the right cranial lobe. The right bronchus gave a branch to the middle lobe, one to accessory and another to the right caudal lobe, while the left bronchus gave a branch to the right cranial lobe (cranial and caudal portions and another to the left caudal lobe. The study on bronchial and vascular segmentation is useful in clinical and surgical applications, in particular in cases of per-foration, and stenosis or tumors, which require the completion of partial lobectomy.

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

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    Mortensen, Jann


    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.

  13. The Mounier-Kuhn syndrome

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    Milić Rade


    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.

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

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    Jian He


    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. Improvement with Infliximab of a Disseminated Sarcoidosis in a Patient with Crohn’s Disease

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    Nader Chebib


    Full Text Available Sarcoidosis and Crohn’s disease are systemic granulomatous disorders affecting the lung and the intestine, respectively, with variable involvement of other organs and are seldom associated. While anti-TNFα is a recognized treatment of Crohn’s disease, its usage is discussed in sarcoidosis. A 42-year-old man presented with an 11-year-long history of Crohn’s disease; upon discovery of an abnormal chest CT scan the diagnosis of multivisceral sarcoidosis was made and, later, a treatment with an anti-TNFα agent, infliximab, was started, because of worsening Crohn’s disease recurrences. CT scan demonstrated net regression of pulmonary opacities and hepatosplenic lesions. Pathologies obtained from the intestinal tract and the bronchi of the patient were, respectively, characteristic of Crohn’s disease and sarcoidosis leading to the diagnosis of both diseases. We report a rare case of steroid resistant Crohn’s disease associated with multivisceral sarcoidosis, treated successfully by an anti-TNFα agent, infliximab.

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

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    Güllü Cataldegirmen


    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.

  17. Diseases affecting the peribronchovascular interstitium: CT findings and pathologic correlation. (United States)

    Castañer, Eva; Gallardo, Xavier; Pallardó, Yolanda; Branera, Jordi; Cabezuelo, María Angeles; Mata, Josep María


    Central bronchi and pulmonary arteries are surrounded and enveloped by a strong connective-tissue sheath termed the peribronchovascular interstitium, extending from the level of the pulmonary hila into the peripheral lung. Thickening of the peribronchovascular interstitium can be seen in a wide variety of diseases. The CT appearance can be smooth, nodular, or irregular depending on the underlying cause. Many of the diseases affecting the peribronchovascular interstitium are entities that show a predilection for lymphatic routes, such as sarcoidosis, pulmonary lymphangitic carcinomatosis, silicosis, and lymphoproliferative disorders. There are other entities that mainly affect the peribronchovascular interstitium without a predominant perilymphatic distribution, such as hydrostatic pulmonary edema, cryptogenic organizing pneumonia, Kaposi's sarcoma, interstitial pulmonary emphysema, and interstitial hemorrhage. Although there is an overlap in radiologic features, some CT findings are useful in differentiating among these entities. When CT shows mainly peribronchovascular abnormality, the differential diagnosis is considerably reduced, and it is generally possible to reach the correct diagnosis by considering the clinical context. We illustrate the CT findings and pathologic correlation for a number of different disorders that mainly affect the peribronchovascular interstitium.

  18. Detection of early bronchial carcinoma by imaging of the tissue autofluorescence (United States)

    Goujon, Didier; Glanzmann, Thomas M.; Gabrecht, Tanja; Zellweger, Matthieu; Radu, Alexandre; van den Bergh, Hubert; Monnier, Philippe; Wagnieres, Georges A.


    Early detection and localisation of bronchial cancer remains a challenging task. One approach is to exploit the changes in the autofluorescence characteristics of the bronchial tissue as a diagnostic tool with improved sensitivity. Evidence exists that this native fluorescence or autofluorescence of bronchial tissues changes when they turn dysplastic and to carcinoma in situ. There is an agreement in the literature that the lesions display a decrease of autofluorescence in the green region of the spectrum under illumination with violet light and a relative increase in the red region of the spectrum is often reported. Imaging devices rely on this principle to detect early cancerous lesions in the bronchi. Based on a previous spectroscopic study, an industrial imaging prototype has been developed to detect early cancerous lesions in collaboration with the firm 'Richard Wolf Endoskope GmbH'. A preliminary clinical trial involving 20 patients with this spectrally optimised system proved that autofluorescence can detect lesions that would otherwise have remained invisible even to an experienced endoscopist under white light illumination. A systematic analysis of the autofluorescence images pointed out that real-time decisional functions can be defined in order to reduce the number of false positive results. Using this method, a Positive Predictive Value (PPV) of 75% was achieved using autofluorescence only. A PPV of even 100% were obtained when white light mode and autofluorescence mode were combined under the applied conditions. Furthermore, the sensitivity was estimated to be twice as high in AF mode than in WL mode.

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

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    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)


    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.)

  20. Respiratory nematodiases in raptors in Quebec. (United States)

    Lavoie, M; Mikaelian, I; Sterner, M; Villeneuve, A; Fitzgerald, G; McLaughlin, J D; Lair, S; Martineau, D


    This is a retrospective study on wild raptors submitted to the Université de Montréal (Quebec, Canada) from 1989 to 1996. Cyathostoma spp. (Nematoda: Syngamidae) adults and/or eggs were found in air sacs, lungs, bronchi, and trachea of 12 raptors (Falconiformes and Strigiformes) from Quebec, Canada, belonging to eight different species, five of which are first host records for this parasite: barred owl (Strix varia), snowy owl (Nyctea scandiaca), northern harrier (Circus cyaneus), northern goshawk (Accipiter gentilis), and broad-winged hawk (Buteo platypterus). The infection was considered fatal in four birds, while no significant clinical signs were observed in the other cases. Major pathologic changes included diffuse pyogranulomatous air sacculitis, pneumonia, and bronchitis. A few unidentified larval nematodes embedded in a granuloma were found in the lungs of an additional Coopers' hawk (Accipiter cooperii); they were not considered clinically significant. A dead nematode, surrounded by necrotic inflammatory cells, was found in the air sac of a northern goshawk. The presence of nematodes in air sacs or lungs should be considered in wild raptors demonstrating respiratory problems.

  1. Assessment of pulmonary airway reactivity using high resolution CT after administration of bronchodilator in patients with bronchial asthma

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    Kim, Yang Soo; Kim, Young Goo; Song, In Sup; Kim, Dae Soon; Choi, Youn Sun; Kim, Kun Sang; Choi, Byoung Whui [College of Medicine, Chung Ang University, Seoul (Korea, Republic of); Kim, Jong Hyo [Seoul National University, Seoul (Korea, Republic of)


    The purpose of this study is to assess the pulmonary airway reactivity in asthmatic patients directly and noninvasively by using high-resolution CT(HRCT). 130 bronchial luminal areas were measured by HRCT in 16 asthmatic patients before and after inhalation of bronchodilator (Salbutamol sulfate). The change of bronchial luminal area on HRCT was analyzed and correlated with the change of forced expiratory volume in 1 second(FEV1) on pulmonary function test in each patient. The mean percentage of increase in luminal areas of the 130 bronchi after bronchodilator inhalation was 95.4% {+-} 103.3%. The group with the smallest luminal areas (lesser than 1.35 mm{sup 2}) was more sensitively increased in area than the group with the largest areas (equal or larger than 3.72 mm{sup 2}); 183.5% versus 63.5%. The mean percentage of increase in FEV1 was 21.7% and there was no statistically significant correlation between the increased degrees of luminal areas and that of FEV1 (r= -0.04). We can measure the bronchial luminal area directly and noninvasively with HRCT and can also estimate the degree of airway reactivity in asthmatic patient by measuring of the changes of bronchial luminal areas after administration of bronchodilator.

  2. The role of codeine phosphate premedication in fibre-optic bronchoscopy under insufficient local anaesthesia and midazolam sedation. (United States)

    Tsunezuka, Y; Sato, H; Tsukioka, T; Nakamura, Y; Watanabe, Y


    Midazolam is widely used as a sedative agent to produce amnesia in patients undergoing fibre-optic bronchoscopy. However, if a patient does not receive sufficient local anaesthesia, continuous severe cough and physical movement may interrupt the procedure and reduce its safety. We therefore examined whether codeine phosphate is a useful premedication for bronchoscopy. The study design was a randomized comparison between codeine phosphate and a placebo in patients undergoing light local anaesthesia and midazolam sedation. We used low dose local anaesthesia (5 ml of nebulized 2% xylocaine) on the assumption of insufficient local anaesthesia. Patients were allocated to receive codeine phosphate 0.4 mg kg-1 or a saline placebo 60 min before they were sedated with i.v. midazolam. If the patients exhibited severe cough during bronchoscopy, intrabronchial supplemental local anaesthesia (2% xylocaine solution in 1 ml increments) was instilled via a bronchoscope to the trachea and segmental bronchi to suppress the cough. The dose of supplemental xylocaine was assessed and the requirements were significantly lower in the codeine group compared to the placebo group: 36.4 +/- 10.2 mg vs. 95.1 +/- 24.6 mg, respectively. After bronchoscopy, patients were interviewed by a doctor to assess their willingness to undergo a repeat procedure if one was clinically indicated, but no significant difference was observed between the two groups. If local anaesthesia is insufficient, midazolam together with codeine phosphate premedication is useful for both the patient and the bronchoscopist.

  3. First Reported Case of Fatal Stinging by the Large Carpenter Bee Xylocopa tranquebarica. (United States)

    Kularatne, Senanayake A M; Raveendran, Sathasivam; Edirisinghe, Jayanthi; Karunaratne, Inoka; Weerakoon, Kosala


    In the order Hymenoptera, bees, hornets, and wasps are well-known stinging insects whose envenoming can be fatal. Their stinging attacks are common in rural and forested areas of Sri Lanka. However, fatal stinging by the large-bodied carpenter bees is unreported. We report the first known case of a fatal sting by the large carpenter bee, Xylocopa tranquebarica, in a forested area in Puttalam (North Western Province) in the dry zone of Sri Lanka. A 59-year-old healthy male manual laborer accompanied by a fellow worker had been fixing a fence on a coconut estate bordering a forested area when a flying insect emerged from a dead tree trunk and stung him on his face. His coworker, who was watching the incident, killed the insect. The victim complained of immediate intense pain in the face and collapsed on the ground just after resuming work after 10 minutes of resting. He was found dead on admission to the hospital 90 minutes later. Autopsy showed normal coronary arteries and heart, but the lungs were slightly congested and contained secretions in the bronchi. Acute anaphylaxis was the most likely cause of death. This case presents the habitat, morphology, attack pattern, and the medical importance of large carpenter bees.

  4. Measurements of the three-dimensional oscillatory flow in a double bifurcation (United States)

    Nemes, Andras; Jalal, Sahar; van de Moortele, Tristan; Coletti, Filippo


    Above a certain ventilation frequency, the unsteady nature of the respiratory flow becomes apparent, and inhalation and exhalation cannot be approximated as quasi-stationary processes. This is especially important in the upper and central airways, where length and velocity scales are the largest, making inertia and acceleration effects dominant over viscous dissipation. We experimentally investigate the primary features of the oscillatory flow through a symmetric double bifurcation which models the self-similar branching of the human bronchial tree. We consider a range of Reynolds and Womersley numbers relevant to physiological conditions between the trachea and the lobar bronchi. Three-component, three-dimensional velocity fields are acquired at multiple phases within the ventilation cycle using magnetic resonance imaging (MRI), and are complemented with instantaneous two-dimensional fields obtained by particle image velocimetry (PIV). The phase-averaged volumetric data provide a description of the rich flow topology, characterizing the main secondary flow structures and their spatio-temporal evolution. The instantaneous measurements reveal some of the dynamics of the laminar-to-turbulent transition in the bifurcations, and its aperiodicity throughout the respiratory cycle.

  5. Lesions associated with Halocercus brasiliensis Lins de Almeida, 1933 in the lungs of dolphins stranded in the Northeast of Brazil. (United States)

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


    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.

  6. Not asthma, but GERD: case report. (United States)

    Wang, Zhonggao


    Asthma is a disorder of the lungs characterized by increased responsiveness of the airways, as manifested by episodes of wheezing and increased resistance to expiratory airflow because of varying degrees of smooth muscle contraction, edema of the mucosa, and mucus in the lumen of the bronchi and bronchioles. The stimuli vary widely and include antigens, infection, air pollutants, respiratory tract irrtants, exercise, and emotional factors. This condition is completely different from distress breathing because of laryngotracheal spasm. One of its causes is the gastric content reflux through the pharynx to the larynx because of gastroesophageal reflux disease (GERD), in addition to the typical human avian flu that may cause immediate suffocation by laryngospasm owing to acute larygotrachitis. A patient suffered from GERD without esophageal symptoms, which was diagnosed and treated as bronchial asthma during his five emergency admissions. The admissions were because of episodic attacks of severe air hunger owing to an extreme throat tightening. The patient was being treated for as long as two years. After the correct diagnosis was made and treatment of laporascopic fundaplication was performed, the longstanding "bronchial asthma", after all, completely disappeared. The concept of "not asthma, but GERD" seems undervalued, unappreciated, even misunderstood among patients with intractable asthma. Therefore, such a case is reported in detail, similar cases are mentioned briefly as well, and a mechanism responsible for GERD-originated larryngo-or laryngotracho-spasm is proposed.

  7. Image quality of mixed convolution kernel in thoracic computed tomography. (United States)

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


    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 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 kernel cannot fully substitute the standard CT reconstructions. Hard and soft convolution kernel reconstructions still seem to be mandatory for thoracic CT.

  8. Side effects of endobronchial laser treatment

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    Dierkesmann, R.; Huzly, A.


    Side effects that have occurred in over 250 endobronchial laser treatments are reported. The laser has been used in severe tracheal and in bronchial obstructions. In two cases significant bleeding had to be treated with tamponade. In one patient an emphysema of the mediastinum developed, in 2 further patients a small pneumothorax. Perforation of the airway was not detected and no special treatment was necessary. Three patients with life-threatening tracheal stenoses and one patient with severe stenosis of both the mainstem bronchi due to metastasis in the bifurcation lymph node had a large defect in the tracheal or bronchial wall with a deep necrosis five to twelve weeks after laser treatment; all these patients had extensive radiotherapy in addition. One patient died due to severe respiratory insufficiency, probably caused by smoke intoxication. After the laser treatment, rubber-like fibrin-rich plaques may develop, which can lead to life-threatening obstructions of the airway. It is recommended that laser bronchoscopy should be performed with the rigid bronchoscope. After treatment of tracheal lesion an endoscopic check must be performed within 24 hours. The combination of laser treatment and radiotherapy seems to involve a certain risk of large defects in the bronchial wall due to necrosis of the tumor.

  9. Crenosoma vulpis in dog: first case report in Italy and use of the FLOTAC technique for copromicroscopic diagnosis. (United States)

    Rinaldi, L; Calabria, G; Carbone, S; Carrella, A; Cringoli, G


    Crenosoma vulpis is a metastrongylid nematode that infects the bronchi, bronchioles, and trachea of wild and domestic canids and various other carnivores. It is endemic in the red fox population in the north-eastern parts of North America and in Europe, including Italy. Dogs are susceptible to infection with clinical signs consisting primarily in a chronic cough. The present paper reports-to the authors' knowledge-the first case of spontaneous C. vulpis infection in a dog in Italy. In addition, it also reports, for the first time, the use of the FLOTAC technique for C. vulpis diagnosis in canine fecal samples, with results compared to the following four standard copromicroscopic techniques: the Baermann technique, the McMaster technique, the simple flotation technique, and the Wisconsin technique. The results showed that the FLOTAC technique produced mean larvae per gram of feces greater than that produced by the other more widely used diagnostic tools. After the treatment of the C. vulpis infected dog with a single oral dose of 0.5mg/kg milbemycin oxime, the clinical signs resolved and the shedding of larvae ceased. In conclusion, the discovery of C. vulpis for the first time in a dog in Italy indicates that the fox lungworm should be considered in the differential diagnosis of respiratory disease in dogs; in addition, the findings of the comparison study showed that the FLOTAC technique may improve the ability to accurately diagnose canine lungworm infections.

  10. Alimentary and respiratory tract lesions in eight medically fragile Holstein cattle with bovine leukocyte adhesion deficiency (BLAD). (United States)

    Ackermann, M R; Kehrli, M E; Laufer, J A; Nusz, L T


    Lesions in the alimentary tract were studied in eight medically fragile Holstein cattle homozygous for the bovine leukocyte adhesion deficiency (BLAD) allele as determined by polymerase chain reaction and restriction endonuclease analysis. These cattle received institutional medical care but died or were euthanatized because of chronic debilitation associated with diarrhea (6/8) and pneumonia (4/8). The six cattle with diarrhea had acute (n = 3) or chronic (n = 3) intestinal ulcers, but the other two remained relatively healthy for 3 years and did not develop intestinal tract ulcers. Ulcerated areas were present in the small intestine in six animals, and two of these also had ulcers in the large intestine. Ulcers were covered by thick exudates that, in chronic lesions, partially occluded the intestinal lumen. Intramural and serosal fibrosis also contributed to lumen constriction. Pseudomonas aeruginosa was isolated from the intestine of four cattle. Bovine viral disease virus and Salmonella were not isolated from the five cattle that were tested. Respiratory tract lesions consisted of dense infiltrates of neutrophils in bronchi, bronchioles, and alveoli. This study suggests that intestinal lesions are integral to the demise of BLAD cattle that receive intensive medical care and that neutrophils do infiltrate the lung and enter airway lumina, despite the adhesion deficiency.

  11. Histological changes in hilar lymph glands in relation to coal workers` progressive massive fibrosis and lung coal and quartz contents. Evidence in support of the `central` hypothesis

    Energy Technology Data Exchange (ETDEWEB)

    Leigh, J.; Todorovic, M.; Driscoll, T. [National Institute of Occupational Health and Safety, Sydney, NSW (Australia)


    The pathogenesis of progressive massive fibrosis (PMF) in coal workers is still not fully understood. Principal mechanisms include total dust load, quartz and rheumatoid diathesis. Recently, Seal et al. proposed a further possible mechanism whereby dust and necrotic material in central (hilar) lymph nodes is released into bronchi or vessels (or both) by rupture of the node capsule and erosion through bronchial or vessel walls and then transported to the lung parenchyma where it may act as a `seed` for PMF development. Seal et al. found a statistically significant association between severity of central lymph node pathology grade and presence of PMF lesions {gt} 5 cm diameter and that lungs having smaller areas of PMF also had capsular rupture of central lymph nodes. In an earlier report, where the authors studied only lungs with PMF, no association could be found between the magnitude of PMF and the severity of central lymph node changes. The authors have now extended this study to a larger series of post mortem coal workers` lungs, with and without PMF, and have examined lymph node pathology, PMF lesions and, in a subset, have also analysed lung coal and quartz content. Studies were undertaken on pulmonary tissue from deceased New South Wales coal workers. 6 refs.

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

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    Nishimura, Koichi; Furue, Masuhiro; Kitaichi, Masanori


    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.

  13. Antitussive Medicinal Herbs - An Update Review

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    G. R. Saraswathy


    Full Text Available The cough is a protective reflex mechanism that removes foreign material and secretions from the bronchi and bronchioles of the airways; it is inappropriately stimulated in various situations like inflammation of the respiratory tract or neoplasia. In these cases, cough has a pathological character and it is necessary sometimes to use cough-suppressant drugs. The most frequently used antitussive drugs in clinical conditions produce adverse effects like depression of the respiratory centre, decreased secretion in the bronchioles and inhibition of ciliary activity, increased sputum viscosity, decreased expectoration, hypotension and constipation acts as limitation to the therapy. Use of herbal drugs is increasing all over the world for various ailments including antitussive activity as they are safe and devoid of adverse effects. Medicinal plants are an important source for the discovery of novel bioactive compounds, which have served and continue to serve as lead molecules for the development of new drugs. Thus this review may provide an insight into herbs possessing antitussive activity.

  14. Antiasthmatic Role of "Pentapala -04" a Herbal Formulation Against Ova Albumin and Aluminium HydroxideInduced LungDamage in Rats. (United States)

    Rao, D Srinivasa; Jayaraaj, Indira A; Jayaraaj, R


    Bronchial asthma is a clinical syndrome characterized by proximal dysphasia and wheeze due to increased resistance to the flow of air through the narrowed bronchi. Asthma has become the most common chronic disease in the world and epidemiological studies suggest that its prevalence, severity and mortality are rising at a time when mortality from other common treatable conditions is falling. The reasons for the above statistics are environmental factors such as increased exposure to allergens and atmospheric pollutants. Antiasthmatic treatment includes corticosteroids, which are very effective in the treatment of asthma. But corticosteroids are costly and if given systemically, have many severe adverse effects. Hence, the present research work involves the use of a herbal compound formulation Pentapala -04 prepared from five medicinal plants namely, Adhatoda vasica Need, Ocimum sanctum Linn, Coleus aromaticus Benth, Glycyrrhiza glabra Linn and Alpiania galangal Sw.The effect of "Pentapala-04" on ova albumin and aluminium hydroxide induced lung damage in albino wistar rats was investigated. The rats were divided into three groups of four animals each. Group I, II and III serves as control, toxic and post treatment group respectively. Our results showed that their was increased level of lipid peroxidation and secreased level of antioxidants in toxic group animals. But the levels of antioxidant enzymes were restored in post-treated groups of animals, which might be due to the ability of "ability of "Pentapala-04 to scavenge the reactive oxygen species.

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

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    João Flavio Panattoni Martins


    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.

  16. Numerical analysis of respiratory flow patterns within human upper airway (United States)

    Wang, Ying; Liu, Yingxi; Sun, Xiuzhen; Yu, Shen; Gao, Fei


    A computational fluid dynamics (CFD) approach is used to study the respiratory airflow dynamics within a human upper airway. The airway model which consists of the airway from nasal cavity, pharynx, larynx and trachea to triple bifurcation is built based on the CT images of a healthy volunteer and the Weibel model. The flow characteristics of the whole upper airway are quantitatively described at any time level of respiratory cycle. Simulation results of respiratory flow show good agreement with the clinical measures, experimental and computational results in the literature. The air mainly passes through the floor of the nasal cavity in the common, middle and inferior nasal meatus. The higher airway resistance and wall shear stresses are distributed on the posterior nasal valve. Although the airways of pharynx, larynx and bronchi experience low shear stresses, it is notable that relatively high shear stresses are distributed on the wall of epiglottis and bronchial bifurcations. Besides, two-dimensional fluid-structure interaction models of normal and abnormal airways are built to discuss the flow-induced deformation in various anatomy models. The result shows that the wall deformation in normal airway is relatively small.

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

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    Yasutsugu Fukushima


    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.

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

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    Haahtela Tari


    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.

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

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    Mikhail Vasil'evich Sheyanov


    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.

  20. Polonium and Lung Cancer

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    Vincenzo Zagà


    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.

  1. Effect of chemoreceptor denervation on the pulmonary vascular response to atelectasis. (United States)

    Levitzky, M G; Newell, J C; Dutton, R E


    Six dogs anesthetized with 30 mg/kg pentobarbital were ventilated after differential cannulation of the main stem bronchi. Following sternotomy, blood flow was monitored by electromagnetic flow probes on the left pulmonary artery (QL) and on the pulmonary trunk or aorta (QT). Following 10 min of bilateral 100% O2, QL was 37.4 +/- 5.8% of QT. When left lung atelectasis was induced while the right lung remained on 100% O2, PaO2 remained above 75 mm Hg and QL fell to 26.1 +/- 5.0% of QT. However, when the right lung was ventilated with room air while the left lung remained atelectatic, PaO2 fell to 50.0 +/- 2.6 mm Hg and QL rose to 36.7 +/- 6.2% of QT. Six dogs which had undergone peripheral chemoreceptor denervation prior to these experiments showed a similar decrease in perfusion of the atelectatic left lung when the right lung was ventilated with 100% O2, but did not increase blood flow to the atelectatic lung during systemic hypoxemia. Thus, the increased blood flow to the atelectatic lung which occurs during systemic hypoxemia appears to be mediated by the arterial chemoreceptors.

  2. Chemoreceptor influence on pulmonary blood flow during unilateral hypoxia in dogs. (United States)

    Levitzky, M G; Newell, J C; Krasney, J A; Dutton, R E


    Dogs anesthetized with 30 mg/kg pentobarbital were artificially respired after differential cannulation of the main stem bronchi. Following median sternotomy, blood flow was monitored by electromagnetic flow probes on the left pulmonary artery (QL) and on the pulmonary trunk or aorta, QT. Following 10 min of bilateral 100% O2, QL was 42.5 +/- 7% of QT. When 6% O2, was substituted as the gas mixture inspired by the left lung while the right lung remained on 100% O2, PaO2 was above 70 mm Hg and QL fell to 24.5 +/- 5% of QT. Room air was then used to ventilate the right lung while the left lung remained on 6% O2. This caused PaO2 to fall to 42.3 +/- 3 MM Hg and QL to rise to 38.3 +/- 6% QT. This increase in blood flow to the unilaterally hypoxic lung during systemic hypoxemia did not occur in dogs after peripheral chemoreceptor denervation. Therefore, interference with the local response to alveolar hypoxia during systemic hypoxemia appears to be mediated by the arterial chemoreceptors.

  3. A simple method of selective bronchography

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    Han, Man Chung; Ha, Sung Whan [College of Medicine, Seoul National University, Seoul (Korea, Republic of)


    The value of bronchography in the diagnosis of pulmonary diseases, especially of bronchial diseases, is well known and bronchography is an essential procedure for evaluation of bronchial diseases. And, by visualization of a selected bronchial tree, lobar or segmental, we can obtain roentgenograms of superior quality and of higher diagnostic accuracy. In addition, the procedure can be carried out safely in patients with low respiratory reserve and samples for pathology and bacteriology can be obtained. And there is another therapeutic possibility of introducing drugs intrabronchially through the catheter. Authors introduce a simple new technique of selective bronchography which is a combination of transglottic intubation and Seldinger method. The technique is summarized as follows, 1. Anesthetize oral cavity, pharynx and larynx with 2% lidocaine. 2. Under fluoroscopic control, Nelaton catheter is introduced over a wire mandarin, as authors previously reported. 3. After removal of wire mandarin, angiographic guide wire is inserted through the catheter into the trachea. 4. Then, the Nelaton catheter is withdrawn and is changed with preshaped angiographic catheter, just as in introduction of catheter in arteriography. We carried out 18 cases of selective bronchography with this technique and selection of lobar, segmental and subsegmental bronchi was carried out without difficulty.

  4. Radiodiagnosis of yeast alveolitis (a clinicoexperimental study)

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    Amosov, I.S.; Smirnov, V.A.

    A clinicoroetgenological study was made of 115 workers engaged in yeast production for different periods of time. Disorders of respiration biomechanics were revealed depending on the period of service. These data were obtained as a result of the use of roentgenopneumopolygraphy. An experimental study was conducted to establish the nature of lesions in the bronchopulmonary system in allergic alveolitis. The effect of finely divided yeast dust on the bronchopulmonary system was studied on 132 guinea-pigs usinq microbronchography and morphological examination. As a result of the study it has been established that during the inhalation of yeast dust, noticeable dystrophy of the bronchi develops, the sizes of alveoli enlarge and part of them undergo emphysematous distension with rupture of the interalveolar septa. In the course of the study, it has been shown that yeast alveolitis develops after many years of work. The clinical symptoms are non-specific and insignificant. X-ray and morphological changes are followed by the physical manifestations of yeast alveolitis.

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

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    O. Byanet


    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.

  6. The morphological peculiarities of the glands of human trachea at the bifurcation of this organ

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    B.M. Guseynov


    Full Text Available The aim of the investigation was to study the structurae peculiarites of the glands of human trachea at its bifurcation. The glands of te trachea from 52 people of different age and sex were studied by macro-mocroscopic methods. At the total preparationsof the trachea the multi cellular cells were coloured by R.D. Sinelnikov's method. The localization of the numerous glands at the cartilaginous and membranaceus walls of the trachea is different. Along the cartilaginous wall of the trachea the glands are arranged in one layer, but at the membranaceus wall- in thre layers. At the cartilaginous wall the initial parts of the glands are located at submucosa and fibrous membrane, at the membranaceus wall- at all layers of the trachea and principal bronchi. At the bifurcation of the trachea the initial parts of the glands from the glandular muff. The compactness of the localization of mouth of the glands is more at the bifurca¬tion of trachea than near this region

  7. Kartagener’s syndrome: A case report

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    Taušan Đorđe


    Full Text Available Introduction. Kartagener’s syndrome is a recessive autosomal disease which is mainly seen to affect ciliary movement. The symptoms of the syndrome are the consequence of the defective motility of the cilia found in the respiratory tract and that results with recurrent lung infections caused by mucus stasis in the bronchi. Case report. A 37-year-old married, male father of one child, presented with a history of productive cough, wheezing, dispnea, headache, temporary fever. In his 9th year of age, 1986, situs inversus, sinusitis and pectus excavatum were diagnosed. In 1994 he was operated for correction of pectus excavatum. Bronchial asthma was diagnosed in 2008 when he was 31. In the last 2 years he had episodes of breathlessness, wheezing, cough, expectoration, headache, fever and fast declining lung function. The patient was treated with combination of inhaled bronchodilatators (inhaled corticosteroids + long-acting β-2 agonist, and occasional administration of antibiotics, oral prednisolone, mucolytics in episodes of exacerbations of disease over a period of 7−14 days. Conclusion. Treatment for patients with this syndrome has not been established yet, but it is important to control chronic lung infections and prevent declining of lung function.

  8. Mechanical complication of endobronchial tuberculosis

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    Quratulain Fatima Kizilbash


    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.

  9. Evaluation of wall correction factor of INER's air-kerma primary standard chamber and dose variation by source displacement for HDR ¹⁹²Ir brachytherapy. (United States)

    Lee, J H; Wang, J N; Huang, T T; Su, S H; Chang, B J; Su, C H; Hsu, S M


    The aim of the present study was to estimate the wall effect of the self-made spherical graphite-walled cavity chamber with the Monte Carlo method for establishing the air-kerma primary standard of high-dose-rate (HDR) ¹⁹²Ir brachytherapy sources at the Institute of Nuclear Energy Research (INER, Taiwan). The Monte Carlo method established in this paper was also employed to respectively simulate wall correction factors of the ¹⁹²Ir air-kerma standard chambers used at the National Institute of Standards and Technology (NIST, USA) and the National Physical Laboratory (NPL, UK) for comparisons and verification. The chamber wall correction calculation results will be incorporated into INER's HDR ¹⁹²Ir primary standard in the future. For the brachytherapy treatment in the esophagus or in the bronchi, the position of the isotope may have displacement in the cavity. Thus the delivered dose would differ from the prescribed dose in the treatment plan. We also tried assessing dose distribution due to the position displacement of HDR ¹⁹²Ir brachytherapy source in a phantom with a central cavity by the Monte Carlo method. The calculated results could offer a clinical reference for the brachytherapy within the human organs with cavity.

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

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    Paulo Roberto Wille


    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. [A new balloon-expandable plastic endoprosthesis. Initial report of experience with the malleable thermostent]. (United States)

    Beck, A


    A new system of balloon-expandable stents for different purposes is presented. A special plastic material that can be shaped by a hot balloon technique or other internal or external heating modalities has been developed. The plastic material - a distant derivative of polyurethane - is caprolactone, which is soft from 52 degrees C to 70 degrees C. Using balloon techniques, the "thermo-stent" can be modeled to suit the form of the vessels, the bile ducts or the bronchial tree, as required. The balloon can be heated simply by means of a warm NaCl solution, electric matter in the balloon itself or microwaves. The plastic material can even be heated directly, which is especially beneficial if the stent needs to be thicker, e.g. in the bronchial tree, by an electric network within the plastic material, which heats the material to the necessary temperature by electric current. When the balloon is cooled after the dilatation the new form, the plastic has been modeled to is maintained exactly. The advantages of this thermo-stent will be the perfect adaptation to every individual situation in the intraluminal vessels, the bile ducts, and even the bronchi. The problems encountered hitherto with conventional metallic stents, e.g. high thrombogenicity, risk of metal intoxication or metallic rupture of filaments, have not be seen so far in animal experiments.

  12. Undifferentiated bronchial fibroblasts derived from asthmatic patients display higher elastic modulus than their non-asthmatic counterparts.

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    Michal Sarna

    Full Text Available During asthma development, differentiation of epithelial cells and fibroblasts towards the contractile phenotype is associated with bronchial wall remodeling and airway constriction. Pathological fibroblast-to-myofibroblast transition (FMT can be triggered by local inflammation of bronchial walls. Recently, we have demonstrated that human bronchial fibroblasts (HBFs derived from asthmatic patients display some inherent features which facilitate their FMT in vitro. In spite of intensive research efforts, these properties remain unknown. Importantly, the role of undifferentiated HBFs in the asthmatic process was systematically omitted. Specifically, biomechanical properties of undifferentiated HBFs have not been considered in either FMT or airway remodeling in vivo. Here, we combine atomic force spectroscopy with fluorescence microscopy to compare mechanical properties and actin cytoskeleton architecture of HBFs derived from asthmatic patients and non-asthmatic donors. Our results demonstrate that asthmatic HBFs form thick and aligned 'ventral' stress fibers accompanied by enlarged focal adhesions. The differences in cytoskeleton architecture between asthmatic and non-asthmatic cells correlate with higher elastic modulus of asthmatic HBFs and their increased predilection to TGF-β-induced FMT. Due to the obvious links between cytoskeleton architecture and mechanical equilibrium, our observations indicate that HBFs derived from asthmatic bronchi can develop considerably higher static tension than non-asthmatic HBFs. This previously unexplored property of asthmatic HBFs may be potentially important for their myofibroblastic differentiation and bronchial wall remodeling during asthma development.

  13. Undifferentiated bronchial fibroblasts derived from asthmatic patients display higher elastic modulus than their non-asthmatic counterparts. (United States)

    Sarna, Michal; Wojcik, Katarzyna A; Hermanowicz, Pawel; Wnuk, Dawid; Burda, Kvetoslava; Sanak, Marek; Czyż, Jarosław; Michalik, Marta


    During asthma development, differentiation of epithelial cells and fibroblasts towards the contractile phenotype is associated with bronchial wall remodeling and airway constriction. Pathological fibroblast-to-myofibroblast transition (FMT) can be triggered by local inflammation of bronchial walls. Recently, we have demonstrated that human bronchial fibroblasts (HBFs) derived from asthmatic patients display some inherent features which facilitate their FMT in vitro. In spite of intensive research efforts, these properties remain unknown. Importantly, the role of undifferentiated HBFs in the asthmatic process was systematically omitted. Specifically, biomechanical properties of undifferentiated HBFs have not been considered in either FMT or airway remodeling in vivo. Here, we combine atomic force spectroscopy with fluorescence microscopy to compare mechanical properties and actin cytoskeleton architecture of HBFs derived from asthmatic patients and non-asthmatic donors. Our results demonstrate that asthmatic HBFs form thick and aligned 'ventral' stress fibers accompanied by enlarged focal adhesions. The differences in cytoskeleton architecture between asthmatic and non-asthmatic cells correlate with higher elastic modulus of asthmatic HBFs and their increased predilection to TGF-β-induced FMT. Due to the obvious links between cytoskeleton architecture and mechanical equilibrium, our observations indicate that HBFs derived from asthmatic bronchi can develop considerably higher static tension than non-asthmatic HBFs. This previously unexplored property of asthmatic HBFs may be potentially important for their myofibroblastic differentiation and bronchial wall remodeling during asthma development.

  14. Defining an olfactory receptor function in airway smooth muscle cells (United States)

    Aisenberg, William H.; Huang, Jessie; Zhu, Wanqu; Rajkumar, Premraj; Cruz, Randy; Santhanam, Lakshmi; Natarajan, Niranjana; Yong, Hwan Mee; De Santiago, Breann; Oh, Jung Jin; Yoon, A-Rum; Panettieri, Reynold A.; Homann, Oliver; Sullivan, John K.; Liggett, Stephen B.; Pluznick, Jennifer L.; An, Steven S.


    Pathways that control, or can be exploited to alter, the increase in airway smooth muscle (ASM) mass and cellular remodeling that occur in asthma are not well defined. Here we report the expression of odorant receptors (ORs) belonging to the superfamily of G-protein coupled receptors (GPCRs), as well as the canonical olfaction machinery (Golf and AC3) in the smooth muscle of human bronchi. In primary cultures of isolated human ASM, we identified mRNA expression for multiple ORs. Strikingly, OR51E2 was the most highly enriched OR transcript mapped to the human olfactome in lung-resident cells. In a heterologous expression system, OR51E2 trafficked readily to the cell surface and showed ligand selectivity and sensitivity to the short chain fatty acids (SCFAs) acetate and propionate. These endogenous metabolic byproducts of the gut microbiota slowed the rate of cytoskeletal remodeling, as well as the proliferation of human ASM cells. These cellular responses in vitro were found in ASM from non-asthmatics and asthmatics, and were absent in OR51E2-deleted primary human ASM. These results demonstrate a novel chemo-mechanical signaling network in the ASM and serve as a proof-of-concept that a specific receptor of the gut-lung axis can be targeted to treat airflow obstruction in asthma. PMID:27905542

  15. The Id2+ distal tip lung epithelium contains individual multipotent embryonic progenitor cells. (United States)

    Rawlins, Emma L; Clark, Cheryl P; Xue, Yan; Hogan, Brigid L M


    The conducting airways (bronchi and bronchioles) and peripheral gas exchange (alveolar) regions of the mammalian lung are generated by a process of branching morphogenesis. Evidence suggests that during embryonic development, the undifferentiated epithelial progenitors are located at the distal tips of the branching epithelium. To test this hypothesis, we used an Id2-CreER(T2) knock-in mouse strain to lineage trace the distal epithelial tip cells during either the pseudoglandular or canalicular phases of development. During the pseudoglandular stage, the tip cells both self-renew and contribute descendents to all epithelial cell lineages, including neuroendocrine cells. In addition, individual Id2(+) tip cells can self-renew and contribute descendents to both the bronchiolar and alveolar compartments. By contrast, during the later canalicular stage, the distal epithelial tip cells only contribute descendents to the alveoli. Taken together, this evidence supports a model in which the distal tip of the developing lung contains a multipotent epithelial population, the fate of which changes during development.

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

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    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.

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

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


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

  18. Pathogenesis of Haemorrhagic Septicaemia (HS in cattle and buffalo: clinical signs, pathological changes, reisolation and detection of Pasteurella multocida using culture medium and Polymerase Chain Reaction (PCR}

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    Adin Priadi


    Full Text Available In the study of the pathogenesis of Haemorrhagic Septicaemia (HS, one cattle and one buffalo were infected subcutaneously with a dose of 4 x 108 colony forming units of Pasteurella multocida B:2 in the neck region. The post infection clinical findings were observed. During this observation period, bacterial isolation was carried out from heparinised blood and nasal swabs. The buffalo succumbed 2 hours earlier than the cattle.111e post mortem pathological changes in cattle and buffalo were similar but the lesions most severe in the buffalo. The prominent changes were observed in the lungs and bronchi of both animals. Bacterial reisolation and Polymerase Chain Reaction (PCR for P. multocida were carried out trom various samples kept at room temperature without any preservative for 15, 35 and 59 hours after the death of the animals. After 59 hours, heavily contaminated samples were found in all organs except bone marrow. Reisolation of P. multocida trom these samples was difficult, however, the organism can still be identified by PCRTo improve the viability of Pasteurella multocida and reducing the growth of contaminants, transport medium containing selective antibiotics was developed. Amikacin and Gentamicin were good selective antibiotics to suppress other contaminating organisms.

  19. Comparative pathogenesis of a subtype A with a subtype B avian pneumovirus in turkeys. (United States)

    Van de Zande, S; Nauwynck, H; De Jonghe, S; Pensaert, M


    This paper describes a study in which the pathogenesis of avian pneumovirus strains, isolated in Belgium, and belonging to the two subtypes A and B, were compared in 2-week-old turkeys. After oculonasal inoculation, animals were either observed for clinical signs or killed for pathological and virological examination. Virus titration and immunofluorescence were performed on the conjunctivae, turbinates, sinuses, upper and lower part of the trachea, lungs and air sacs. No differences were seen between the two subtypes concerning respiratory signs, or macroscopic and microscopic lesions in the respiratory tract. Slight variations were found in site and extent of virus replication. First, only subtype A was able to invade the lower parts of the respiratory tract (bronchi), whereas viral antigens were not detected in the lungs with subtype B. Secondly, the subtype A strain infected two times more epithelial cells at all levels of the upper respiratory tract compared to subtype B. Thirdly, the amount of virus produced at different sites along the respiratory tract was lower in subtype B-inoculated turkeys than in subtype A-inoculated ones.

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

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    Daniela S. Rajão


    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.

  1. Acute and chronic respiratory lesions induced by sulfur mustard in guinea pigs: Role of tachykinins

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    Calvet, J.H.; Trouiller, G.; Harf, A.


    We investigated in anesthetized guinea pigs the involvement of tachykinins in respiratory alterations after an airway intoxication by sulfur mustard (SM). Early lesions were evaluated after 5h. Respiratory system resistance (R) and compliance were measured by the occlusion method and airway microvascular permeability by measuring the Evans Blue dye concentration in the trachea and main bronchi. Two groups of animals were studied treated with capsaicin (which induces a tachykinin depletion) or by its vehicle. Capsaicin pretreatment had no effect on the measured parameters. We also measured 14 J after the intoxication tracheal epithelium neutral endopeptidase (NEP) (the main enzyme which degrades tachykinins). In addition bronchial responsiveness to exogenous substance P was studied in two groups of animals intoxicated with SM or not. Tracheal epithelium NEP activity was decreased from 0.448 + or 0.027 nmol.min- protein- 1 in controls to 0. 182 + or 0.038 in intoxicated animals. Response to substance P was greater in intoxicated animals with R=2.98 + or - 1.57 cmH20.MI-1.s versus 0.35 + or 0.02 in controls, after 5.10-5 M aerosolized substance P These results suggest tachykinins are not preponderant in the early stage lesions but that bronchial hyperactivity is present at recovery, related to epithelium NEP depletion.

  2. Sexual Dimorphism in the Regulation of Estrogen, Progesterone, and Androgen Receptors by Sex Steroids in the Rat Airway Smooth Muscle Cells (United States)

    Zarazúa, Abraham; González-Arenas, Aliesha; Ramírez-Vélez, Gabriela; Bazán-Perkins, Blanca; Guerra-Araiza, Christian; Campos-Lara, María G.


    The role of sex hormones in lung is known. The three main sex steroid receptors, estrogen, progesterone, and androgen, have not been sufficiently studied in airway smooth muscle cells (ASMC), and the sex hormone regulation on these receptors is unknown. We examined the presence and regulation of sex hormone receptors in female and male rat ASMC by Western blotting and flow cytometry. Gonadectomized rats were treated with 17β-estradiol, progesterone, 17β-estradiol + progesterone, or testosterone. ASMC were enzymatically isolated from tracheas and bronchi. The experiments were performed with double staining flow cytometry (anti-α-actin smooth muscle and antibodies to each hormone receptor). ERα, ERβ, tPR, and AR were detected in females or males. ERα was upregulated by E2 and T and downregulated by P4 in females; in males, ERα was downregulated by P4, E + P, and T. ERβ was downregulated by each treatment in females, and only by E + P and T in males. tPR was downregulated by P4, E + P, and T in females. No hormonal regulation was observed in male receptors. AR was downregulated in males treated with E + P and T. We have shown the occurrence of sex hormone receptors in ASMC and their regulation by the sex hormones in female and male rats. PMID:27110242

  3. An autopsy case of suicide by acetylene explosion: a case report. (United States)

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


    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.

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

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    Calabrese Cecilia


    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.

  5. Disordered microbial communities in asthmatic airways.

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    Markus Hilty

    Full Text Available BACKGROUND: A rich microbial environment in infancy protects against asthma [1], [2] and infections precipitate asthma exacerbations [3]. We compared the airway microbiota at three levels in adult patients with asthma, the related condition of COPD, and controls. We also studied bronchial lavage from asthmatic children and controls. PRINCIPAL FINDINGS: We identified 5,054 16S rRNA bacterial sequences from 43 subjects, detecting >70% of species present. The bronchial tree was not sterile, and contained a mean of 2,000 bacterial genomes per cm(2 surface sampled. Pathogenic Proteobacteria, particularly Haemophilus spp., were much more frequent in bronchi of adult asthmatics or patients with COPD than controls. We found similar highly significant increases in Proteobacteria in asthmatic children. Conversely, Bacteroidetes, particularly Prevotella spp., were more frequent in controls than adult or child asthmatics or COPD patients. SIGNIFICANCE: The results show the bronchial tree to contain a characteristic microbiota, and suggest that this microbiota is disturbed in asthmatic airways.

  6. Acute cytotoxicity and apoptotic effects after l-Pam exposure in different cocultures of the proximal and distal respiratory system. (United States)

    Pohl, Christine; Hofmann, Helene; Moisch, Michaela; Papritz, Mirko; Iris Hermanns, M; Dei-Anang, Jasmin; Mayer, Eckhard; Kehe, Kai; Kirkpatrick, Charles James


    Sulphur and nitrogen mustard are strong alkylating agents which can cause after inhalation acute lung injury in the larynx, trachea and large bronchi and can lead to alveolar edema. In our study we tested the N-Lost l-Phenylalanine Mustard (l-Pam). Therefore we seeded the alveolar type II cell line NCI H441 on the upper membrane of a Transwell filter plate and the endothelial cell line ISO-Has-1 on the lower side of the membrane for the alveolar model and combined the human bronchial explant-outgrowth cells and fibroblasts in the bronchial model and exposed both models with various concentrations of l-Pam. Treatment with l-Pam led to a concentration-dependent decrease of the transepithelial electrical resistance and therefore impairment of barrier function in both models. Changes in morphology could be observed. In the bronchial model damaged cell organelles whereas in the alveolar model a widening of intercellular spaces could be seen. Loss of cell-matrix adhesion as well as apoptotic and necrotic cell death could be demonstrated. In conclusion, treatment with the nitrogen mustard in the coculture models showed comparable results to sulphur mustard treatment and thus this model could be useful to explore similarities and differences in signal transduction pathways after treatment with both sulphur and nitrogen mustard.

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

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    Lucio Borges Barcelos


    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

  8. Two different types of carcinoid tumors of the lung: immunohistochemical and ultrastructural investigation and their histogenetic consideration. (United States)

    Min, Kyung-Whan


    Carcinoid tumors have been an interesting clinical and pathological entity for pathologists because of their unique histopathologic pattern of "Zellballen" (cell ball) and the hormones they produce demonstrable by histochemical and biochemical methods, including immunohistochemistry, and the presence of cytoplasmic dense-core particles demonstrable by electron microscopy. Since carcinoid tumors were established as an entity more than a century ago by Oberndorfer, who was credited with coining the term "carcinoid," meaning carcinoma-like tumors, tumors presenting with similar characteristics have been reported in most of parenchymal organs, including lungs. Carcinoid tumors in the lungs usually occur as bronchocentric tumors and present with typical histopathologic characteristics of carcinoid tumors, but they may present with significant variation in their cellular compositions, in contrast to the midgut carcinoid tumors. In the latter, tumor cells are quite similar to enterochromaffin granule containing crypt cells, which are regarded as their progenitor cells. Currently, a similar histogenetic explanation is applied to all carcinoid tumors occurring elsewhere. The bronchus is one of the most common anatomic sites in which the carcinoid tumors occur. However, bronchial carcinoid tumors differ from the midgut counterparts in microscopic appearance, showing more variability in cellular shape and composition from the classical form of midgut carcinoid tumors. In the lungs, neuroendocrine cells (NEC) are normally found in two different ways. Firstly, they are found as randomly scattered single cells (Kultchitsky cells) similar to enteric counterparts, and, secondly, they are found in aggregates known as "neuroepithelial bodies" (NEB) usually found in the branching point of bronchi. Interestingly, they keep a close anatomic relationship with parasympathetic nerve structures and even form synapses. NEB are usually found in the early stage of fetal development and are

  9. ASM-024, a piperazinium compound, promotes the in vitro relaxation of β2-adrenoreceptor desensitized tracheas. (United States)

    Israël-Assayag, Evelyne; Beaulieu, Marie-Josée; Cormier, Yvon


    Inhaled β2-adrenoreceptor agonists are widely used in asthma and chronic obstructive pulmonary disease (COPD) for bronchoconstriction relief. β2-Adrenoreceptor agonists relax airway smooth muscle cells via cyclic adenosine monophosphate (cAMP) mediated pathways. However, prolonged stimulation induces functional desensitization of the β2-adrenoreceptors (β2-AR), potentially leading to reduced clinical efficacy with chronic or prolonged administration. ASM-024, a small synthetic molecule in clinical stage development, has shown activity at the level of nicotinic receptors and possibly at the muscarinic level and presents anti-inflammatory and bronchodilator properties. Aerosolized ASM-024 reduces airway resistance in mice and promotes in-vitro relaxation of tracheal and bronchial preparations from animal and human tissues. ASM-024 increased in vitro relaxation response to maximally effective concentration of short-acting beta-2 agonists in dog and human bronchi. Although the precise mechanisms by which ASM-024 promotes airway smooth muscle (ASM) relaxation remain unclear, we hypothesized that ASM-024 will attenuate and/or abrogate agonist-induced contraction and remain effective despite β2-AR tachyphylaxis. β2-AR tachyphylaxis was induced with salbutamol, salmeterol and formoterol on guinea pig tracheas. The addition of ASM-024 relaxed concentration-dependently intact or β2-AR desensitized tracheal rings precontracted with methacholine. ASM-024 did not induce any elevation of intracellular cAMP in isolated smooth muscle cells; moreover, blockade of the cAMP pathway with an adenylate cyclase inhibitor had no significant effect on ASM-024-induced guinea pig trachea relaxation. Collectively, these findings show that ASM-024 elicits relaxation of β2-AR desensitized tracheal preparations and suggest that ASM-024 mediates smooth muscle relaxation through a different target and signaling pathway than β2-adrenergic receptor agonists. These findings suggest ASM-024

  10. Plasma antibodies against heat shock protein 70 correlate with the incidence and severity of asthma in a Chinese population

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    Wei Qingyi


    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.

  11. Study of cyclic and steady particle motion in a realistic human airway model using phase-Doppler anemometry

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    Jícha Miroslav


    Full Text Available Transport and deposition of particles in human airways has been of research interest for many years. Various experimental methods such as constant temperature anemometry, particle image velocimetry and laser-Doppler based techniques were employed for study of aerosol transport in the past. We use Phase-Doppler Particle Analyser (P/DPA for time resolved size and velocity measurement of liquid aerosol particles in a size range 1 to 8 μm. The di-2ethylhexyl sabacate (DEHS particles were produced by condensation monodisperse aerosol generator. A thin-wall transparent model of human airways with non-symmetric bifurcations and non-planar geometry containing parts from throat to 3rd-4th generation of bronchi was fabricated for the study. Several cyclic (sinusoidal breathing regimes were simulated using pneumatic breathing mechanism. Analogous steady-flow regimes were also investigated and used for comparison. An analysis of the particle velocity data was performed with aim to gain deeper understanding of the transport phenomena in the realistic bifurcating airway system. Flows of particles of different sizes in range 1 – 10 μm was found to slightly differ for extremely high Stokes numbers. Differences in steady and cyclic turbulence intensities were documented in the paper. Systematically higher turbulence intensity was found for cyclic flows and mainly in the expiration breathing phase. Negligible differences were found for behaviour of different particle size classes in the inspected range 1 to 8 μm. Possibility of velocity spectra estimation of air flow using the P/DPA data is discussed.

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

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    Rafał L. Górny


    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

  13. Mutation induction by inhaled radon progeny modeled at the tissue level. (United States)

    Madas, Balázs G; Balásházy, Imre


    The observable responses of living systems to ionizing radiation depend on the level of biological organization studied. Understanding the relationships between the responses characteristic of the different levels of organization is of crucial importance. The main objective of the present study is to investigate how some cellular effects of radiation manifest at the tissue level by modeling mutation induction due to chronic exposure to inhaled radon progeny. For this purpose, a mathematical model of the bronchial epithelium was elaborated to quantify cell nucleus hits and cell doses. Mutagenesis was modeled considering endogenous as well as radiation-induced DNA damages and cell cycle shortening due to cell inactivation. The model parameters describing the cellular effects of radiation are obtained from experimental data. Cell nucleus hits, cell doses, and mutation induction were computed for the activity hot spots of the large bronchi at different exposures. Results demonstrate that the mutagenic effect of densely ionizing radiation is dominated by cell cycle shortening due to cell inactivation and not by DNA damages. This suggests that radiation burdens of non-progenitor cells play a significant role in mutagenesis in case of protracted exposures to densely ionizing radiation. Mutation rate as a function of dose rate exhibits a convex shape below a threshold. This threshold indicates the exhaustion of the tissue regeneration capacity of local progenitor cells. It is suggested that progenitor cell hyperplasia occurs beyond the threshold dose rate, giving a possible explanation of the inverse dose-rate effect observed in the epidemiology of lung cancer among uranium miners.

  14. Tracheobronchial epithelium of the sheep: IV. Lectin histochemical characterization of secretory epithelial cells. (United States)

    Mariassy, A T; Plopper, C G; St George, J A; Wilson, D W


    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.

  15. Immunocytochemical localization of the surfactant apoprotein and Clara cell antigen in chemically induced and naturally occurring pulmonary neoplasms of mice. (United States)

    Ward, J. M.; Singh, G.; Katyal, S. L.; Anderson, L. M.; Kovatch, R. M.


    The localization of surfactant apoprotein (SAP) and the Clara cell antigen(s) (CCA) was studied in naturally occurring and experimentally induced pulmonary hyperplasias and neoplasms by avidin-biotin peroxidase complex (ABC) immunocytochemistry. Lungs of B6C3F1 and A strain mice with naturally occurring lesions, B6C3F1 mice given injections of N-nitrosodiethylamine (DEN), BALB/c nu/nu or nu/+ mice exposed transplacentally on Day 16 of gestation to ethylnitrosourea (ENU), or BALB/c nu/+ mice exposed to ENU at 8-12 weeks of age were preserved in formalin or Bouin's fixative. After ABC immunocytochemistry, SAP was found in the cytoplasm of normal alveolar Type II cells; in the majority of cells in focal alveolar and solid hyperplasias originating in peribronchiolar or peripheral locations; and in solid, tubular, papillary, and mixed adenomas and carcinomas. The larger mixed-pattern neoplasms and small or large tubular neoplasms usually had the least number of cells with SAP. The majority of large papillary adenomas and carcinomas in BALB/c mice exposed to ENU and in untreated A strain mice contained SAP in the nuclei of many neoplastic cells but only in the cytoplasm of a few neoplastic cells. CCA was found in normal Clara cells of bronchi and bronchioles but not in any hyperplastic or neoplastic lesion of any mouse studied. This study provided immunocytochemical evidence that the vast majority of naturally occurring and experimentally induced pulmonary neoplasms of mice are alveolar Type II cell adenomas and carcinomas. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 PMID:3883798

  16. Autoradiographic localization of specific [3H]dexamethasone binding in fetal lung. (United States)

    Beer, D G; Butley, M S; Cunha, G R; Malkinson, A M


    The cellular and subcellular localization of specific [3H]dexamethasone binding was examined in fetal mouse lung at various stages of development and in human fetal lung at 8 weeks of gestation using a rapid in vitro steroid incubation technique followed by thaw-mount autoradiography. Competition studies with unlabeled steroids demonstrate the specificity of [3H]dexamethasone labeling, and indicate that fetal lung mesenchyme is a primary glucocorticoid target during lung development. Quantitative binding studies, involving incubation of intact tissue with competing ligand and subsequent subcellular fractionation, show this to be specific, nuclear binding characteristic of glucocorticoid receptors. Autoradiographs of [3H]dexamethasone binding in lung tissue at early stages of development demonstrate that the mesenchyme directly adjacent to the more proximal portions of the bronchiolar network is heavily labeled. In contrast, the epithelium which will later differentiate into bronchi and bronchioles, is relatively unlabeled. Distal portions of the growing epithelium, destined to become alveolar ducts and alveoli, do show nuclear localization of [3H]dexamethasone. Because of the known importance of the mesenchyme in controlling lung development and the ability of glucocorticoids to stimulate lung development, these results suggest that many of the growth-promoting effects of glucocorticoids may be mediated through the mesenchyme. In addition, by utilizing a technique which allows the simultaneous examination of extracellular matrix components and [3H]dexamethasone binding, a relationship is observed between extensive mesenchymal [3H]dexamethasone binding and extensive extracellular matrix accumulation. Since glucocorticoids stimulate the synthesis of many extracellular matrix components, these results suggest a role for these hormones in affecting mesenchymal-epithelial interactions during lung morphogenesis.

  17. Distribution of cells labelled by a novel somatic stem cell-recognizing antibody (A3) in pulmonary genesis and bleomycin induced pulmonary fibrosis in rats. (United States)

    Hori, M; Juniantito, V; Izawa, T; Ichikawa, C; Tanaka, M; Tanaka, K; Takenaka, S; Kuwamura, M; Yamate, J


    Stem cells play important roles in organogenesis and remodelling after tissue injury. A monoclonal antibody (A3) has been produced against rat somatic stem cells. The present study investigated the distribution of cells labelled by A3 in the lung of fetal, neonatal and adult rats, as well as in the lung of rats with bleomycin (BLM) induced pulmonary fibrosis. In developing fetal lungs, A3(+) interstitial cells were present around the bronchi/bronchioles and arterioles, while in neonatal and adult lungs, the A3 reactivity of the interstitial cells gradually disappeared and instead, vascular endothelial cells in alveolar capillaries and arterioles expressed A3. By double immunofluorescence labelling, the A3(+) interstitial cells also expressed vimentin (a mesenchymal marker) and CD34 (a marker of immature mesenchymal cells), indicating that the interstitial cells were immature mesenchymal cells concentrated in organs as precursors to cells of connective tissues. A3(+)endothelial cells were co-expressed RECA-1 (a marker of rat endothelial cells) and A3 was localized to the cell membrane and cytoplasm of these cells by immunoelectron microscopy. In BLM induced fibrotic lesions, there were many A3(+) cells, which also expressed vimentin or RECA-1 by dual immunofluorescence labelling. There were few CD34(+)/A3(+) double positive cells. No cells co-expressed A3 and α-smooth muscle actin (a marker of well-differentiated myofibroblastic cells). Although the detailed properties of cells labelled by A3 remain to be discovered, A3 would appear to be a useful marker of immature mesenchymal cells and vascular endothelial cells in developing lungs and in pulmonary fibrosis.

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

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


    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.

  19. Influence of action of coal dust on metabolism of histamine and serotonin in the body (clinical and experimental study)

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    Gridneva, N.V.; Dainega, V.G.; Talakin, Yu.N.


    Because of the role assigned to the destruction of the metabolism of biogenic amines in the pathogenesis of pneumoconiosis in miners and lack of information on metabolism of histamine and serotonin in first contact with coal dust, it was considered expedient to study peculiarities of their metabolism in the development of dust-induced lung pathology. A table shows results of a clinical study of the changes in the indicators of histamine and serotonin metabolism in miners with pneumoconiosis, those with a long period of service and a healthy control group. Miners with various forms of pneumoconiosis all show a significant increase in the histamine level of blood which may be related to the development in the presence of dust-induced lung disease of autoimmune processes accompanied by the liberation of free histamine from cells. With the increase in histamine, an increase of serotonin appears in blood of diseased miners. Long exposure to dust inflow activates metabolism of serotonin. In addition to the clinical study of diseased miners, an experimental investigation was made of the content of serotonin and histamine in organs of white rats. Table 2 shows that after introduction of coal dust over 1-4 months, the accumulation of serotonin in lungs, brain, kidneys, liver, and small intestine increased and the accumulation of histamine in liver, kidneys and brain decreased. Inhalation of dust produces a greater change in content of serotonin in organs; the intratracheal introduction of dust changes content of histamine. Results of experiment confirm destruction of metabolism of histamine and serotonin by coal/rock dust which proves need to use antiserotonins to cure lung disease. High content of histamine in blood determines need for use of antihistamine preparations especially in the presence of bronchospasms caused by effect of histamine on smooth muscle of bronchi.

  20. Silicone Modeling of the Interior Spaces of Hollow Organs: Use in Dog and Manatee Respiratory Tract and in a Beef Heart

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    Charles J. Grossman


    Full Text Available Problem statement: The mechanism, by which the Florida manatee (Trichechus manatus latirostris vocalizes, remains unknown because the manatee larynx does not contain true vocal cords. Since sound can be generated when air passes through a narrow respiratory structure we needed to visualize the internal anatomy of manatee respiratory tract to locate any candidate regions for study. Approach: To visualize the internal anatomy of upper and lower manatee respiratory tract we have developed a rapid but accurate method of modeling these structures using liquid silicone. We first tested this technique on the respiratory structure of a cadaver dog and then applied it to two small manatees which had died through natural causes. Incisions were made in the trachea of both dog and manatees and commercially available liquid silicone was then forced into the upper and lower respiratory tracts used a slightly modified common automobile grease gun. The animals were then refrigerated overnight and the silicone was allowed to cure for a period of 24 h. Results: In dog, we removed cured silicone model by applying mild force to it after surgically opening the nasal cavity. In the manatees some dissection was necessary for release of mold from the upper nasal cavity, but only mild force was necessary with no dissection to release silicone model from the lower tract. Because the models created exhibited great accuracy and fine structure, including presence of tertiary bronchi in the manatee respiratory tract, we realized that the technique was applicable for use in other hollow organs. We applied this method to the visualization of internal structure of a fresh beef heart and were pleased with the accuracy and detail of model produced. Conclusion: We suggest that this technique can be adopted for three-dimensional visualization of the internal structure and volume estimation of many hollow organs in a wide variety of organisms with both minimal

  1. Distending Pressure Did Not Activate Acute Phase or Inflammatory Responses in the Airways and Lungs of Fetal, Preterm Lambs.

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    Rebecca Y Petersen

    Full Text Available Mechanical ventilation at birth causes airway injury and lung inflammation in preterm sheep. Continuous positive airway pressure (CPAP is being increasingly used clinically to transition preterm infants at birth.To test if distending pressures will activate acute phase reactants and inflammatory changes in the airways of fetal, preterm lambs.The head and chest of fetal lambs at 128±1 day GA were surgically exteriorized. With placental circulation intact, fetal lambs were then randomized to one of five 15 minute interventions: PEEP of 0, 4, 8, 12, or 16 cmH2O. Recruitment volumes were recorded. Fetal lambs remained on placental support for 30 min after the intervention. The twins of each 0 cmH2O animal served as controls. Fetal lung fluid (FLF, bronchoalveolar lavage fluid (BAL, right mainstem bronchi and peripheral lung tissue were evaluated for inflammation.Recruitment volume increased from 0.4±0.04 mL/kg at 4 cmH2O to 2.4±0.3 mL/kg at 16 cmH2O. The lambs were surfactant deficient, and all pressures were below the opening inflection pressure on pressure-volume curve. mRNA expression of early response genes and pro-inflammatory cytokines did not increase in airway tissue or lung tissue at any pressure compared to controls. FLF and BAL also did not have increases in early response proteins. No histologic changes or Egr-1 activation was present at the pressures used.Distending pressures as high as 16 cmH2O did not recruit lung volume at birth and did not increase markers of injury in the lung or airways in non-breathing preterm fetal sheep.

  2. Natural Fissures of Lung- Anatomical Basis of Surgical Techniques and Imaging

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    Sumita Dutta


    Full Text Available Background The fissures in lung enhances uniform expansion.These fissures may be complete, incomplete or absent.A detailed knowledge of variations of classical and accessory fissures is necessary for proper radiological interpretation.It is a guide to cardiothoracic surgeons performing segmental lung resections, lobectomies to have an uncomplicated perioperative outcome. So,the cadaveric study was done to note the morphological variation of the fissures of lung in eastern Indian population and compare it with previous studies. Methods 102 lungs obtained during dissection of formalin fixed cadavers in Calcutta National Medical College,Kolkata and preserved in 10% formalin were thoroughly studied to note every morphological details of fissures present in the lungs. Results 44% of left lungs had classically complete oblique fissure compared to 26.92% on the right. No oblique fissure could be detected in 8% lungs of left and 11.54% of right side. Horizontal fissure was completely absent in 34.6%. Various degree of parenchymal fusion was more common on the right side.None of the oblique fissures had uniform depth. Conclusion Comparison with other studies shows wide regional variations in morphological patterns of lung fissures,implying environmental and genetic factors in its development .Present study unfolds that parenchymal fusion of various extent is a very common entity of oblique fissure of lung. So more lung parenchyma has to be dissected to reach the bronchi and pulmonary arteries during partial lung resection which naturally might lead to peroperative hemorrhage and more postoperative complications.This knowledge of anatomy of fissures of lung may also help clarifying confusing radiographic findings. [Natl J Med Res 2013; 3(2.000: 117-121

  3. Dose reduction in computed tomography of the chest. Image quality of iterative reconstructions at a 50% radiation dose compared to filtered back projection at a 100% radiation dose; Dosisreduktion in der Thorax-CT. Vergleich der Bildqualitaet bei 50% Dosis und iterativer Bildrekonstruktion mit 100% Dosis und gefilterter Rueckprojektion

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    May, M.S.; Eller, A.; Stahl, C. [University Hospital Erlangen (Germany). Dept. of Radiology; and others


    Purpose: The aim of this study was to evaluate the potential of iterative reconstruction (IR) in chest computed tomography (CT) to reduce radiation exposure. The qualitative and quantitative image quality of standard reconstructions with filtered back projection (FBP) and half dose (HD) chest CT data reconstructed with FBP and IR was assessed. Materials and Methods: 52 consecutive patients underwent contrast-enhanced chest CT on a dual-source CT system at 120 kV and automatic exposure control. The tube current was equally split on both tube detector systems. For the HD datasets, only data from one tube detector system was utilized. Thus, FD and HD data was available for each patient with a single scan. Three datasets were reconstructed from the raw data: standard full dose (FD) images applying FBP which served as a reference, HD images applying FBP and IR. Objective image quality analysis was performed by measuring the image noise in tissue and air. The subjective image quality was evaluated by 2 radiologists according to European guidelines. Additional assessment of artifacts, lesion conspicuity and edge sharpness was performed. Results: Image noise did not differ significantly between HD-IR and FD-FBP (p = 0.254) but increased substantially in HD-FBP (p < 0.001). No statistically significant differences were found for the reproduction of anatomical and pathological structures between HD-IR and FD-FBP, subsegmental bronchi and bronchioli. The image quality of HD-FBP was rated inferior because of increased noise. Conclusion: A 50% dose reduction in contrast-enhanced chest CT is feasible without a loss of diagnostic confidence if IR is used for image data reconstruction. Iterative reconstruction is another powerful tool to reduce radiation exposure and can be combined with other dose-saving techniques. (orig.)

  4. Optimal effect-site concentration of remifentanil for preventing cough during removal of the double-lumen endotracheal tube from sevoflurane-remifentanil anesthesia: A prospective clinical trial. (United States)

    Lee, Sook Young; Yoo, Ji Young; Kim, Jong Yeop; Kim, Dae Hee; Lee, Jung Dong; Rho, Go Un; Park, Hyungbae; Park, Sung Yong


    Opioids are used as a treatment for coughing. Recent studies have reported an antitussive effect of remifentanil during recovery from general anesthesia by suppressed coughing. The coughing reflex may differ throughout the respiratory tract from the larynx to the bronchi. But the proper dose of remifentanil to prevent cough during double-lumen tube (DLT) extubation is unknown.Twenty-five ASA physical status 1 and 2 patients, 20 to 65 years of age who were undergoing video-assisted thoracoscopic lung surgery requiring 1-lung ventilation were enrolled. The effective effect-site concentration (Ce) of remifentanil for 50% and 95% of patients (EC50 and EC95) for preventing cough was determined using the isotonic regression method with a bootstrapping approach, following the Dixon up-and-down method. Recovery profiles and hemodynamic values after anesthesia were compared between patients with cough and patients without cough.EC50 and EC95 of remifentanil was 1.670 ng/mL [95% confidence interval (95% CI) 1.393-1.806] and 2.275 ng/mL (95% CI 1.950-2.263), respectively. There were no differences in recovery profiles and hemodynamic values after anesthesia between patients with/without cough. No patients suffered respiratory complications during the emergence period.Remifentanil can be a safe and reliable method of cough prevention during emergence from sevoflurane anesthesia after thoracic surgery requiring DLT. EC50 and EC95 of remifentanil that suppresses coughing is 1.670 and 2.275 ng/mL, respectively.

  5. Chronic graft-versus-host disease in the rat radiation chimera: I. clinical features, hematology, histology, and immunopathology in long-term chimeras

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    Beschorner, W.E.; Tutschka, P.J.; Santos, G.W.


    The clinical features, pathology, and immunopathology of chronic graft-versus-host disease (GVHD) developing in the long-term rat radiation chimera are described. At 6 to 12 months post-transplant, the previously stable ACI/LEW chimeras developed patchy to diffuse severe hair loss and thickened skin folds, and had microscopic features resembling scleroderma, Sjogren's syndrome, and chronic hepatitis. Skin histology showed dermal inflammation and acanthosis with atrophy of the appendages, with progression to dermal sclerosis. The liver revealed chronic hepatitis with bile duct injury and proliferation and periportal piecemeal necrosis. The tongue had considerable submucosal inflammation, muscular necrosis, and atrophy and arteritis. The serous salivary glands, lacrimal glands, and bronchi had lymphocytic inflammation and injury to duct, acinar, and mucosal columnar epithelium. The thymus had lymphocyte depletion of the medulla with prominent epithelium. The spleen and lymph nodes had poorly developed germinal centers but increased numbers of plasma cells. IgM was observed along the basement membrane and around the basal cells of the skin and tongue and along the basement membrane of the bile ducts. IgM was present also in the arteries of the tongue. Immunoglobulins eluted from the skin, cross-reacted with the bile duct epithelium and usually with both ACI and Lewis skin. Increased titers of speckled antinuclear antibodies were present in the serum of rats with chronic (GVHD). Chronic GVHD in the long-term rat radiation chimera is very similar to human chronic GVHD and is a potentially excellent model for autoimmune disorders including scleroderma, Sjorgren's syndrome, and chronic hepatitis.

  6. Effects of selective lobar ventilation on intrapulmonary shunt and inflammatory response in patients with pulmonary dysfunction during thoracotomy%选择性肺叶通气对肺功能不全患者开胸术中肺内分流及炎性反应的影响

    Institute of Scientific and Technical Information of China (English)

    周清河; 肖旺频; 安尔丹


    Objective To investigate the effects of selective lobar ventilation on intrapulmonary shunt and inflammatory response in patients with pulmonary dysfunction during thoracotomy.Methods Thirty-four ASA Ⅱ or Ⅲ patients,aged 64-79 years,weighing 50-85 kg,with moderate or severe impaired pulmonary function,scheduled for esophageal cancer radical correction,were randomly divided into two groups (n =17 each):one-lung ventilation group (group A) and selective lobar ventilation group (group B).In group A,an endobronchial blocker tube was used to obstruct the bronchus principalis and practice one-lung ventilation.In group B,an endobronchial blocker tube was used to obstruct the bronchi Iobares and practice selective lobar ventilation.Blood samples were taken from the arteria radialis and the internal jugular vein for blood gas analysis and determination of plasma concentrations of tumor necrosis factor-alpha (TNF-α),interleukin-6 (IL-6) and IL-8 by enzyme linked immunosorbent assay (ELISA) before anesthesia induction (T0),30 minutes following two-lung ventilation at the lateral position (T1),60 minutes following one-lung ventilation or selective lobar ventilation (T2) and at the end of surgery (T3).Peak airway pressure (Ppeak) and plateau airway pressure (Pplat) were recorded at the same time.Results The incidence of hypoxemia was significantly lower in group B (0) than in group A (18%,P < 0.05).Compared with group A,Pliat and Ppeak at T1-3,the intrapulmonary shunt rate (Qs/Qt) at T2,TNF-α,IL-6 and IL-8 concentrations at T2-3 were significantly decreased in group B (P < 0.05).Conclusion Selective lobar ventilation can reduce intrapulmonary shunt and inhibit inflammatory responses to help lessen mechanical ventilation-related lung injuryduring thoracotomy in patients with pulmonary dysfunction.

  7. Low Level Laser Therapy Reduces the Development of Lung Inflammation Induced by Formaldehyde Exposure.

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    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.

  8. Penguins use the two-voice system to recognize each other. (United States)

    Aubin, T; Jouventin, P; Hildebrand, C


    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.

  9. Unique characteristics of the trachea of the juvenile leatherback turtle facilitate feeding, diving and endothermy (United States)

    Davenport, John; Jones, T. Todd; Work, Thierry M.; Balazs, George H.


    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.

  10. Clinical analysis of bone scanning in solitary lesion

    Institute of Scientific and Technical Information of China (English)


    A rational analysis procedure for solitary lesions on whole bone scan-ning was offered. This study was undertaken to analyze retrospectively solitary le-sions which obtained final diagnose through the following aspects: (1) diagnosis ofbone metastasis, (2) the incidence of bone metastasis in different tumor, (3) the mostpossible lesion sites indicating bone metastasis, (4) morphological analysis of solitarylesions. The results are: (1) The incidence of solitary lesions in 2465 cases on wholebone scanning is 15.3%. (2) The rate of bone metastasis is 24.8% in 282 patientswith primary malignancy. The rate of bone metastasis is 6.3% in 64 patients withoutprimary malignancy, and the total diagnostic rate of bone metastasis is 21.4% in 346patients. (3) In patients with primary malignancy, the incidence of bone metastasis ofsolitary lesions is as follows respectively: bronchi cancer 36.1%(22/61); breast cancer23.8%(20/84); prostate gland 17.2%(5/29); other urinary system cancer 22.2%(4/18):G.I. system cancer 16.9%(10/59); others 29.0%(9/31). There is no significant differ-ence in different cancer. (4) In patients without primary malignancy, 93.7%(60/64) ofsolitary lesions are benign. (5) From anatomical point of view, we found the diagnos-tic rate of bone metastasis is as follow: 30% in spine; 34.2% in pelvis; 36.4% in skull;10.8% in other bones. There are significant differences in four groups. It is concludedthat: (1) The diagnostic rate of bone metastasis in solitary lesions is 21.4%. (2) Themost possible solitary lesions indicating osseous tumor spread are at spine, pelvic andskull. (3) Special attention to "cold" and streak like lesions should be paid. (4) Aclinical analysis procedure for diagnosis of solitary lesions has been summarized outhere.``

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

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    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)


    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.

  12. Estimation of specific absorbed fractions for selected organs due to photons emitted by activity deposited in the human respiratory tract using ICRP/ICRU male voxel phantom in FLUKA. (United States)

    Patni, H K; Akar, D K; Nadar, M Y; Ghare, V P; Rao, D D; Sarkar, P K


    The ICRP/ICRU adult male reference voxel phantom incorporated in Monte Carlo code FLUKA is used for estimating specific absorbed fractions (SAFs) for photons due to the presence of internal radioactive contamination in the human respiratory tract (RT). The compartments of the RT, i.e. extrathoracic (ET1 and ET2) and thoracic (bronchi, bronchioles, alveolar interstitial) regions, lymph nodes of both regions and lungs are considered as the source organs. The nine organs having high tissue weighting factors such as colon, lungs, stomach wall, breast, testis, urinary bladder, oesophagus, liver and thyroid and the compartments of the RT are considered as target organs. Eleven photon energies in the range of 15 keV to 4 MeV are considered for each source organ and the computed SAF values are presented in the form of tables. For the target organs in the proximity of the source organ including the source organ itself, the SAF values are relatively higher and decrease with increase in energy. As the distance between source and target organ increases, SAF values increase with energy and reach maxima depending on the position of the target organ with respect to the source organ. The SAF values are relatively higher for the target organs with smaller masses. Large deviations are seen in computed SAF values from the existing MIRD phantom data for most of the organs. These estimated SAF values play an important role in the estimation of equivalent dose to various target organs of a worker due to intake by inhalation pathway.

  13. 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

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    Moese, J.R.; Fischer, G.


    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.

  14. Cysteinyl-leukotrienes in the regulation of β2-adrenoceptor function: an in vitro model of asthma

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    Milanese Manlio


    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.

  15. Uncertainties in electron-absorbed fractions and lung doses from inhaled beta-emitters. (United States)

    Farfán, Eduardo B; Bolch, Wesley E; Huston, Thomas E; Rajon, Didier A; Huh, Chulhaeng; Bolch, W Emmett


    The computer code LUDUC (Lung Dose Uncertainty Code), developed at the University of Florida, was originally used to investigate the range of potential doses from the inhalation of either plutonium or uranium oxides. The code employs the ICRP Publication 66 Human Respiratory Tract model; however, rather than using simple point estimates for each of the model parameters associated with particle deposition, clearance, and lung-tissue dosimetry, probability density functions are ascribed to these parameters based upon detailed literature review. These distributions are subsequently sampled within LUDUC using Latin hypercube sampling techniques to generate multiple (e.g., approximately 1,000) sets of input vectors (i.e., trials), each yielding a unique estimate of lung dose. In the present study, the dosimetry component of the ICRP-66 model within LUDUC has been extended to explicitly consider variations in the beta particle absorbed fraction due to corresponding uncertainties and biological variabilities in both source and target tissue depths and thicknesses within the bronchi and bronchioles of the thoracic airways. Example dose distributions are given for the inhalation of absorption Type S compounds of 90Sr (Tmax = 546 keV) and 90Y (Tmax = 2,284 keV) as a function of particle size. Over the particle size range of 0.001 to 1 microm, estimates of total lung dose vary by a factor of 10 for 90Sr particles and by a factor of 4 to 10 for 90Y particles. As the particle size increases to 10 microm, dose uncertainties reach a factor of 100 for both radionuclides. In comparisons to identical exposures scenarios run by the LUDEP 2.0 code, Reference Man doses for inhaled beta-emitters were shown to provide slightly conservative estimates of lung dose compared to those in this study where uncertainties in lung airway histology are considered.

  16. Airway hyperresponsiveness; smooth muscle as the principal actor [version 1; referees: 2 approved

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    Anne-Marie Lauzon


    Full Text Available Airway hyperresponsiveness (AHR is a defining characteristic of asthma that refers to the capacity of the airways to undergo exaggerated narrowing in response to stimuli that do not result in comparable degrees of airway narrowing in healthy subjects. Airway smooth muscle (ASM contraction mediates airway narrowing, but it remains uncertain as to whether the smooth muscle is intrinsically altered in asthmatic subjects or is responding abnormally as a result of the milieu in which it sits. ASM in the trachea or major bronchi does not differ in its contractile characteristics in asthmatics, but the more pertinent peripheral airways await complete exploration. The mass of ASM is increased in many but not all asthmatics and therefore cannot be a unifying hypothesis for AHR, although when increased in mass it may contribute to AHR. The inability of a deep breath to reverse or prevent bronchial narrowing in asthma may reflect an intrinsic difference in the mechanisms that lead to softening of contracted ASM when subjected to stretch. Cytokines such as interleukin-13 and tumor necrosis factor-α promote a more contractile ASM phenotype. The composition and increased stiffness of the matrix in which ASM is embedded promotes a more proliferative and pro-inflammatory ASM phenotype, but the expected dedifferentiation and loss of contractility have not been shown. Airway epithelium may drive ASM proliferation and/or molecular remodeling in ways that may lead to AHR. In conclusion, AHR is likely multifactorial in origin, reflecting the plasticity of ASM properties in the inflammatory environment of the asthmatic airway.

  17. Troglostrongylus brevior and Troglostrongylus subcrenatus (Strongylida: Crenosomatidae as agents of broncho-pulmonary infestation in domestic cats

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    Brianti Emanuele


    Full Text Available Abstract Background Aelurostrongylus abstrusus is currently regarded as the main metastrongyloid infesting domestic cats, whereas the reports of Troglostrongylus spp. in domestic and wild felids largely remain anecdotic. This paper reports on pulmonary infestation caused by Troglostrongylus brevior and Troglostrongylus subcrenatus in two kittens and describes, for the first time, associated clinical presentations and pathological features. Morphometrical, molecular and phylogenetic analyses have also been conducted to differentiate here the examined Troglostrongylus species from A. abstrusus, towards a clearer delineation of metastrongyloids affecting cats. Methods Two kittens were referred for respiratory distress and hospitalized with a diagnosis of severe aelurostrongylosis, based on the presence of metastrongyloid larvae in the faeces. Despite prompt treatment, kittens died within 48 hours. Both kittens were submitted to necropsy to determine the cause of death. Results At necropsy, nematode specimens were found in the trachea, bronchi and bronchioles and were associated with respiratory signs (i.e., dyspnoea, polypnea, severe coughing and nasal discharge. Morphology and measurements of adult parasites found allowed the unequivocal identification of T. brevior and T. subcrenatus, even if first stage larvae were rather similar to those of A. abstrusus. Briefly, T. brevior and T. subcrenatus larvae were shorter in length and lacking the typical knob-like terminal end of A. abstrusus. Molecular and phylogenetic analyses corroborated morphological identification and provided data on mitochondrial and ribosomal DNA genes of T. brevior. Conclusions Data presented here indicate that T. brevior and T. subcrenatus may cause major respiratory distress in domestic cats. Consequently, these two species should be included, along with A. abstrusus, in the differential diagnosis of cat bronchopulmonary affections and treatment protocols need to be

  18. Automated integer programming based separation of arteries and veins from thoracic CT images. (United States)

    Payer, Christian; Pienn, Michael; Bálint, Zoltán; Shekhovtsov, Alexander; Talakic, Emina; Nagy, Eszter; Olschewski, Andrea; Olschewski, Horst; Urschler, Martin


    Automated computer-aided analysis of lung vessels has shown to yield promising results for non-invasive diagnosis of lung diseases. To detect vascular changes which affect pulmonary arteries and veins differently, both compartments need to be identified. We present a novel, fully automatic method that separates arteries and veins in thoracic computed tomography images, by combining local as well as global properties of pulmonary vessels. We split the problem into two parts: the extraction of multiple distinct vessel subtrees, and their subsequent labeling into arteries and veins. Subtree extraction is performed with an integer program (IP), based on local vessel geometry. As naively solving this IP is time-consuming, we show how to drastically reduce computational effort by reformulating it as a Markov Random Field. Afterwards, each subtree is labeled as either arterial or venous by a second IP, using two anatomical properties of pulmonary vessels: the uniform distribution of arteries and veins, and the parallel configuration and close proximity of arteries and bronchi. We evaluate algorithm performance by comparing the results with 25 voxel-based manual reference segmentations. On this dataset, we show good performance of the subtree extraction, consisting of very few non-vascular structures (median value: 0.9%) and merged subtrees (median value: 0.6%). The resulting separation of arteries and veins achieves a median voxel-based overlap of 96.3% with the manual reference segmentations, outperforming a state-of-the-art interactive method. In conclusion, our novel approach provides an opportunity to become an integral part of computer aided pulmonary diagnosis, where artery/vein separation is important.

  19. Critical influenza (H1N1) pneumonia: imaging manifestations and histopathological findings

    Institute of Scientific and Technical Information of China (English)

    LI Hong-jun; CHENG Jing-liang; LI Ning; LI Yun-fang; ZHANG Hui-mao


    Background The global outbreak of influenza A (H1N1 ) has led to the Ministry of Health of China listing it as one of the A-class infectious diseases.Pneumonia is the most serious complication of influenza A,commonly causing death.Populations are ordinarily susceptible to influenza A.This study aimed to investigate the imaging manifestation features of cdtical influenza A (H1 N1 ) pneumonia and to improve its diagnostic techniques.Methods A total of seven death cases from critical influenza A (H1 N1 ) pneumonia were retrospectively analyzed on their imaging manifestations and autopsy data.Pulmonary CT scanning was performed for five cases,with one receiving additional chest X-ray and chest CT scanning,and chest postero-anterior position X-ray examination was performed for other two.Autopsy was performed for five cases and postmortem examinations were performed for other two cases.Results The seven cases of influenza A showed critical manifestations in 4-7 days after symptoms onset,with two having basic diseases of diabetes and one being pregnant.Extensive blurry high-density shadows of bilateral lungs were found in three cases,which were most obvious in middle and infedor parts of lungs.Pulmonary CT scanning revealed bilateral flaky parenchymal shadows in peripheral,dorsal and fundus segments of the middle-inferior parts of lungs,with one case of complicated pneumothorax,atelectasis and pleural effusion and another case of thin-walled cavity and dilated bronchi shadows in the superior parts of lungs.Conclusions Diagnostic imaging is an important assessing tool for cdtical influenza A (H1N1) pneumonia The imaging manifestations are characteristic instead of being specific.The definitive diagnosis can be made in combination with clinical examinations and laboratory tests.

  20. Nanomechanical assessment of human and murine collagen fibrils via atomic force microscopy cantilever-based nanoindentation. (United States)

    Andriotis, Orestis G; Manuyakorn, Wiparat; Zekonyte, Jurgita; Katsamenis, Orestis L; Fabri, Sebastien; Howarth, Peter H; Davies, Donna E; Thurner, Philipp J


    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

  1. Outdoor particulate matter and childhood asthma admissions in Athens, Greece: a time-series study

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    Roma Eleftheria S


    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.

  2. Comparing three-dimensional volume-rendered CT images with fibreoptic tracheobronchoscopy in the evaluation of airway compression caused by tuberculous lymphadenopathy in children

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    Plessis, Jaco du; George, Reena [University of Stellenbosch, Department of Radiology, Tygerberg (South Africa); Goussard, Pierre; Gie, Robert [Tygerberg Children' s Hospital, Department of Paediatrics, Cape Town (South Africa); Andronikou, Savvas [University of Cape Town, Department of Radiology, Cape Town (South Africa)


    Lymphobronchial tuberculosis (TB) causes airway compression in 38% of patients. The airway obstruction is conventionally assessed with fibreoptic tracheobronchoscopy (FTB). Multidetector-row spiral computed tomography (MDCT) with three-dimensional volume rendering (3-D VR) has significantly improved the imaging of the airways. No previous studies have assessed the accuracy of 3-D VR in determining the degree of airway compression in children due to TB lymphadenopathy. To compare 3-D VR CT to FTB for the assessment of airway compression due to TB lymphadenopathy in children. Included in the study were 26 children presenting with symptoms of airway compression caused by pulmonary TB. MDCT of the chest and FTB were performed in all patients. Retrospective 3-D VR reconstruction of the major airways was performed from the original CT raw data and used to evaluate the tracheobronchial tree for site and degree of airway compression and then compared to the FTB findings. FTB was used as the reference standard By FTB 87 sites of airway compression were identified. Using the 3-D VR technique, 138 sites of airway compression were identified, of which 78 (90%) matched with the sites identified by FTB. The sensitivity and specificity of 3-D VR when compared with that of FTB was 92% and 85%, respectively. In four patients (15%), severe narrowing of the bronchus intermedius made FTB evaluation of the right middle and right lower lobe bronchi impossible. VR demonstrated significant distal obstruction in three of these four patients 3-D VR demonstrates a very good correlation with FTB in determining airway compression caused by TB lymphadenopathy in children. In combination with FTB, 3-D VR adds confidence to the bronchoscopy findings and complements FTB by adding additional information on the status of the airway distal to severe obstructions unreachable by FTB. (orig.)

  3. Metallic Stents for Tracheobronchial Pathology Treatment

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    Serrano, Carolina, E-mail: [University of Zaragoza, Surgical Pathology Unit, Animal Pathology Department (Spain); Laborda, Alicia, E-mail: [University of Zaragoza, Minimally Invasive Techniques Research Group (GITMI) (Spain); Lozano, Juan M., E-mail: [Marly Clinic, Radiology Department (Colombia); Caballero, Hugo, E-mail: [Marly Clinic, Pulmonology Department (Colombia); Sebastian, Antonio, E-mail: [Lozano Blesa Clinical University Hospital, Pulmonology Department (Spain); Lopera, Jorge, E-mail: [Health Science Center, Interventional Radiology Deparment (United States); Gregorio, Miguel Angel de, E-mail: [University of Zaragoza, Minimally Invasive Techniques Research Group (GITMI) (Spain)


    Purpose: To present the 7-year experience of the treatment of benign and malignant tracheobronchial stenoses using metallic stents. Patients and Methods: One hundred twenty-three stents were inserted in 86 patients (74 benign and 12 malignant stenoses). Ninety-seven stents were placed in the trachea and 26 in the bronchi. The procedures were performed under fluoroscopic and flexible bronchoscopic guidance with the patient under light sedation. In cases of severe stenotic lesions or obstructions, laser resection was performed before stent placement. Clinical and functional pulmonary data were recorded before and 3 months after the procedure. Follow-up involved clinical data and radiographic techniques at 48 h and at 1-, 3-, 6-, and 12-month intervals. Results: The technical success was 100 %. Dyspnea disappearance, forced expiratory volume in the first second, and pulmonary functional data improvement was observed in all patients (p < 0.001). Complications were detected in 23 patients (26.7 %). Mean follow-up time was 6.3 {+-} 1.2 months in patients with malignant lesions and 76.2 {+-} 2.3 months patients with in benign lesions. By the end of the study, 100 % of patients with malignant pathology and 6.7 % of patients with benign lesions had died. Conclusion: Endoluminal treatment of tracheobronchial stenosis with metallic stents is a therapeutic alternative in patients who are poor candidates for surgery. In unresectable malignant lesions, the benefit of metallic stenting is unquestionable. In benign lesions, the results are satisfactory, but sometimes other interventions are required to treat complications. New stent technology may improve these results.

  4. Pathological, immunohistochemical, and molecular findings in commercial laying hens and in backyard chickens naturally infected with the infectious laryngotracheitis virus

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    IS Preis


    Full Text Available Seventy-eight chickens from a very high poultry density (approximately eight million region and twelve backyard chickens from neighboring areas were analyzed by histopathology and additional techniques for the presence of the infectious laryngotracheitis virus. The virus distribution was determined in different tissues using immunohistochemistry (IHC and polymerase chain reaction (PCR. The disease was histopathologically diagnosed in 41.0% (32/78 of the commercial layers. Lesions were mainly characterized by syncytial cells with eosinophilic intranuclear inclusion body formed from the hyperplastic epithelium of the upper respiratory tract, primary and secondary bronchi, and conjunctiva. IHC showed 70% (21/30 positive signal in the larynx/trachea and, 53.8% (14/26 in the lungs, either in epithelial cells or syncytia. In the turbinates and paranasal sinuses, 29.6% (8/27 of samples showed positive signal. PCR detected the following gallid herpesvirus 1-positive percentages: conjunctiva 63.2% (31/49, lungs 57.6% (30/52, turbinates and paranasal sinuses 56% (28/50, and larynx/trachea 50% (39/78. IHC showed to be a useful additional tool for definitive ILT diagnosis, especially during the subacute phase of the disease when syncytial cells with intranuclear inclusion bodies are no longer observed. PCR using specific primers from ICP4 gene, generating a product of 237 base pairs, was sensitive for ILT diagnosis, and very useful for rapid detection of GaHV-1 in chickens. Fixed tissues allowing histopatological examination and detection of GaHV-1 by PCR, are a good option in areas where farms are located several hundred kilometers away from a diagnostic center, reducing problems with conservation of fresh samples and the risk of virus spread.

  5. Tracheobronchopathia Osteochondroplastica (United States)

    Wang, Na; Long, Fei; Jiang, Shujuan


    Abstract Tracheobronchopathia osteochondroplastica (TO) is a relatively rare and benign disease of unknown etiology that is characterized by the accumulation of diffuse cartilaginous and osseous nodules protruding into the anterolateral walls of the trachea and bronchus. However, TO is easy to ignore or misdiagnose due to its nonspecific clinical manifestation. A chest computed tomography (CT) scan with a fiber bronchoscope and pathological biopsy shows the clinical features supporting the ultimate diagnosis. Here, we report 2 misdiagnosed cases of TO and review the literature to further define the diagnosis for clinicians. The first case was a 34-year-old male admitted to the hospital because of recurrent cough and intermittent fever for 10 years. CT scans showed irregular stenosis of the main bronchus and bronchofibroscope showed multiple nodules producing into the lumen. He was initially misdiagnosed of bronchial tuberculosis and received antitubercular agents for nearly half year. Symptoms got no relief and another bronchofibroscope with biopsy tests in our hospital exactly diagnosed of TO. Symptoms were significantly relieved after receiving budesonide associated with antibiotics, etc. Another case was a 46-year-old woman presenting with a history of repeated hoarseness for 8 years and a 2-month exacerbation. She underwent an electronic laryngoscopy 3 times and was diagnosed of laryngitis. Symptoms got no relief after antiinflammatory. CT scan indicated variable degrees of stenosis and calcification of the distal trachea and main bronchi and bronchofibroscope showed dozens of white nodules extruding into the lumen. Histopathologic findings revealed the ultimate diagnosis of TO and antiinflammatories, spasm relievers, and inhaled corticosteroids, showed apparent effects. Poor specificity of TO is observed in clinical manifestation and laboratory inspection. However, a CT scan associated with a bronchoscopy and histopathologic examination greatly contributes to

  6. Not asthma,but GERD:case report

    Institute of Scientific and Technical Information of China (English)

    WANG Zhonggao


    Asthma is a disorder of the lungs characterized by increased responsiveness of the airways,as manifested by episodes of wheezing and increased resistance to expiratory airflow because of varying degrees of smooth muscle contraction,edema of the mucosa,and mucus in the lumen of the bronchi and bronchioles.The stimuli vary widely and include antigens,infection,air pollutants,respiratory tract irritants,exercise,and emotional factors.This condition is completely different from distress breathing because of laryngotracheal spasm.One of its causes is the gastric content reflux through the pharynx to the larynx because of gastroesophageal reflux disease (GERD),in addition to the typical human avian flu that may cause immediate suffocation by laryngospasm owing to acute larygotrachitis.A patient suffered from GERD without esophageal symptoms,which was diagnosed and treated as bronchial asthma during his five emergency admissious.The admissions were because of episodic attacks of severe air hunger owing to an extreme throat tightening.The patient was being treated for as long as two years.After the correct diagnosis was made and treatment of laporascopic fundaplication was performed,the longstanding "bronchial asthma",after all,completely disappeared.The concept of "not asthma,but GERD" seems undervalued,unappreciated,even misunderstood among patients with intractable asthma.Therefore,such a case is reported in detail,similar cases are mentioned briefly as well,and a mechanism responsible for GERD-originated larryngo- or laryngotracho-spasm is proposed.

  7. HCY-2在正常人胚呼吸系统中的表达%The Expression of HCY-2 in Normal Human Embryonic Trachea and Lung

    Institute of Scientific and Technical Information of China (English)

    张元元; 李耀康; 王光明


    Objective:To investigate the expression of homocysteine induced gene(HCY-2)in the normal human embryonic trachea and lung and to reveal the effects of HCY-2 on the development of respiration system. Methods: The immunohistochemistry ABC method was used to detect the HCY-2 expression in the normal human embryonic trachea and lung. Results:HCY-2 expressed during the whole development of the human embryonic trachea and lung and mainly in the epitheliums of trachea and pulmonary bronchi and glandular epitheliums. Conclusion:HCY-2 expression protein could be closely related to the development of trachea and lung.%目的:研究同型半胱氨酸诱导基因(HCY-2)在发育不同时期的正常人胚气管和肺中的表达,揭示HCY-2基因在呼吸系统发育中的作用.方法:取正常人胚气管和肺,采用免疫组织化学ABC法对气管和肺内HCY-2表达变化进行分析.结果:HCY-2在人胚气管和肺发育的整个时期均表达,其表达部位主要在气管及其各级支气管的上皮和气管腺腺细胞内.结论:HCY-2表达蛋白可能与人胚气管及肺的发育密切相关.

  8. [Sterol extracts from Begonia Sinensis Rhizome against respiratory inflammation]. (United States)

    Yao, Yong; Jiang, Wei; Li, Yu-shan


    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.

  9. Modified full-field optical coherence tomography: A novel tool for rapid histology of tissues

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    Manu Jain


    Full Text Available Background: Here, we report the first use of a commercial prototype of full-field optical coherence tomography called Light-CT TM . Based on the principle of white light interferometry, Light-CT TM generates quick high-resolution three-dimensional tomographic images from unprocessed tissues. Its advantage over the current intra-surgical diagnostic standard, i.e. frozen section analysis, lies in the absence of freezing artifacts, which allows real-time diagnostic impressions, and/or for the tissues to be triaged for subsequent conventional histopathology. Materials and Methods: In this study, we recapitulate known normal histology in nine formalin fixed ex vivo rat organs (skin, heart, lung, liver, stomach, kidney, prostate, urinary bladder, and testis. Large surface and virtually sectioned stacks of images at varying depths were acquired by a pair of 10x/0.3 numerical aperture water immersion objectives, processed and visualized in real time. Results: Normal histology of the following organs was recapitulated by identifying various tissue microstructures. Skin: epidermis, dermal-epidermal junction and hair follicles with surrounding sebaceous glands in the dermis. Stomach: mucosa with surface pits, submucosa, muscularis propria and serosa. Liver: hepatocytes separated by sinusoidal spaces, central veins and portal triad. Kidney: convoluted tubules, medullary rays (straight tubules and collecting ducts. Prostate: acini and fibro-muscular stroma. Lung: bronchi, bronchioles, alveolar ducts, alveoli and pleura. Urinary bladder: urothelium, lamina propria, muscularis propria, and serosa. Testis: seminiferous tubules with intra-tubular sperms. Conclusion: Light-CT TM is a powerful imaging tool to perform fast histology on fresh and fixed tissues, without introducing artifacts. Its compact size, ease of handling, fast image acquisition and safe incident light levels makes it well-suited for various intra-operative and intra-procedural triaging and

  10. Full-field optical coherence tomography for the analysis of fresh unstained human lobectomy specimens

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    Manu Jain


    Full Text Available Background: Full-field optical coherence tomography (FFOCT is a real-time imaging technique that generates high-resolution three-dimensional tomographic images from unprocessed and unstained tissues. Lack of tissue processing and associated artifacts, along with the ability to generate large-field images quickly, warrants its exploration as an alternative diagnostic tool. Materials and Methods: One section each from the tumor and from adjacent non-neoplastic tissue was collected from 13 human lobectomy specimens. They were imaged fresh with FFOCT and then submitted for routine histopathology. Two blinded pathologists independently rendered diagnoses based on FFOCT images. Results: Normal lung architecture (alveoli, bronchi, pleura and blood vessels was readily identified with FFOCT. Using FFOCT images alone, the study pathologists were able to correctly identify all tumor specimens and in many cases, the histological subtype of tumor (e.g., adenocarcinomas with various patterns. However, benign diagnosis was provided with high confidence in roughly half the tumor-free specimens (others were diagnosed as equivocal or false positive. Further analysis of these images revealed two major confounding features: (a Extensive lung collapse and (b presence of smoker′s macrophages. On a closer inspection, however, the smoker′s macrophages could often be identified as distinct from tumor cells based on their relative location in the alveoli, size and presence of anthracosis. We posit that greater pathologist experience, complemented with morphometric analysis and color-coding of image components, may help minimize the contribution of these confounders in the future. Conclusion: Our study provides evidence for the potential utility of FFOCT in identifying and differentiating lung tumors from non-neoplastic lung tissue. We foresee its potential as an adjunct to intra-surgical frozen section analysis for margin assessment, especially in limited lung

  11. Persistence of smoking-induced dysregulation of miRNA expression in the small airway epithelium despite smoking cessation.

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    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.

  12. Gammaherpesvirus infection modulates the temporal and spatial expression of SCGB1A1 (CCSP) and BPIFA1 (SPLUNC1) in the respiratory tract (United States)

    Leeming, Gail H; Kipar, Anja; Hughes, David J; Bingle, Lynne; Bennett, Elaine; Moyo, Nathifa A; Tripp, Ralph A; Bigley, Alison L; Bingle, Colin D; Sample, Jeffery T; Stewart, James P


    Murine γ-herpesvirus 68 (MHV-68) infection of Mus musculus-derived strains of mice is an established model of γ-herpesvirus infection. We have previously developed an alternative system using a natural host, the wood mouse (Apodemus sylvaticus), and shown that the MHV-68 M3 chemokine-binding protein contributes significantly to MHV-68 pathogenesis. Here we demonstrate in A. sylvaticus using high-density micro-arrays that M3 influences the expression of genes involved in the host response including Scgb1a1 and Bpifa1 that encode potential innate defense proteins secreted into the respiratory tract. Further analysis of MHV-68-infected animals showed that the levels of both protein and RNA for SCGB1A1 and BPIFA1 were decreased at day 7 post infection (p.i.) but increased at day 14 p.i. as compared with M3-deficient and mock-infected animals. The modulation of expression was most pronounced in bronchioles but was also present in the bronchi and trachea. Double staining using RNA in situ hybridization and immunohistology demonstrated that much of the BPIFA1 expression occurs in club cells along with SCGB1A1 and that BPIFA1 is stored within granules in these cells. The increase in SCGB1A1 and BPIFA1 expression at day 14 p.i. was associated with the differentiation of club cells into mucus-secreting cells. Our data highlight the role of club cells and the potential of SCGB1A1 and BPIFA1 as innate defense mediators during respiratory virus infection. PMID:25531566

  13. Primary endobronchial marginal zone B-cell lymphoma of bronchus-associated lymphoid tissue: CT findings 7 patients

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    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)


    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.

  14. Analysis of the lung microbiome in the "healthy" smoker and in COPD.

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    John R Erb-Downward

    Full Text Available Although culture-independent techniques have shown that the lungs are not sterile, little is known about the lung microbiome in chronic obstructive pulmonary disease (COPD. We used pyrosequencing of 16S amplicons to analyze the lung microbiome in two ways: first, using bronchoalveolar lavage (BAL to sample the distal bronchi and air-spaces; and second, by examining multiple discrete tissue sites in the lungs of six subjects removed at the time of transplantation. We performed BAL on three never-smokers (NS with normal spirometry, seven smokers with normal spirometry ("healthy smokers", HS, and four subjects with COPD (CS. Bacterial 16 s sequences were found in all subjects, without significant quantitative differences between groups. Both taxonomy-based and taxonomy-independent approaches disclosed heterogeneity in the bacterial communities between HS subjects that was similar to that seen in healthy NS and two mild COPD patients. The moderate and severe COPD patients had very limited community diversity, which was also noted in 28% of the healthy subjects. Both approaches revealed extensive membership overlap between the bacterial communities of the three study groups. No genera were common within a group but unique across groups. Our data suggests the existence of a core pulmonary bacterial microbiome that includes Pseudomonas, Streptococcus, Prevotella, Fusobacterium, Haemophilus, Veillonella, and Porphyromonas. Most strikingly, there were significant micro-anatomic differences in bacterial communities within the same lung of subjects with advanced COPD. These studies are further demonstration of the pulmonary microbiome and highlight global and micro-anatomic changes in these bacterial communities in severe COPD patients.

  15. Pulmonary CYP2A13 levels are associated with early occurrence of lung cancer-Its implication in mutagenesis of non-small cell lung carcinoma. (United States)

    Chiang, Huai-Chih; Lee, Huei; Chao, How-Ran; Chiou, Yu-Hu; Tsou, Tsui-Chun


    CYP2A13, a human pulmonary specific cytochrome P450 enzyme, plays an important role in susceptibility to tobacco-specific nitrosamines (TSNAs)-induced lung cancer in humans. The pattern of CYP2A13 distribution in respiratory tract affects the susceptibility of the lung to carcinogens. CYP2A13 is expressed in the epithelium of trachea and bronchi; however its pattern of expression in human lung cancer remains largely unknown. This study aimed to determine the CYP2A13 expression in specimens from human non-small cell lung carcinomas (NSCLCs), i.e., adenocarcinoma and squamous carcinoma, by immunohistochemical (IHC) analysis and to identify the potential linkage between tumor CYP2A13 levels and some clinicopathological characteristics of NSCLC patients in Taiwan. The tumor CYP2A13 IHC staining signal was strong in 76% of the 112 study subjects. Study subjects (especially non-smoking or lung adenocarcinoma patients) with higher tumor CYP2A13 levels were younger. Multiple logistic regression analysis revealed that in younger subjects (age ≤ 66) and heavy smokers (pack-years ≥ 40), the odds ratio (OR) for positive tumor CYP2A13 staining was significantly higher than that for negative tumor CYP2A13 staining. Moreover, the association of EGFR gene mutations and positive tumor CYP2A13 staining was also revealed. In conclusion, these findings suggest the potential involvement of pulmonary CYP2A13 in the early occurrence of NSCLC as well as in the development of EGFR gene mutations.

  16. Pulmonary and intestinal permeabilities in alcoholic hepatic cirrhosis; Permeabilites pulmonaire et intestinal dans la cirrhose hepatique alcoolique

    Energy Technology Data Exchange (ETDEWEB)

    De Botton, S.; Huglo, B.; Canva-Delacambre, V.; Colombel, J.F.; Beauchat, V.; Ziegels, P.; Prangere, T.; Steinling, M.; Machandise, X.; Wallaert, B. [Services de Medecine Nucleaire, des Maladies de l`Appareil Digestif et de Pneumologie, CHU de Lille, 59037 Lille Cedex (France)


    The aim of this prospective study was to evaluate simultaneously the intestinal permeability (IP), usually normal, and the pulmonary permeability, (PP) rather rarely studied, in patients afflicted with hepatic cirrhosis of alcoholic (HCA) origin. Thirty five non-smoker patients, afflicted with HCA, proved by biopsy, without pulmonary pathology and with normal pulmonary scanography were subject to our investigation. The pre-graft hepatic examination contained also respiratory functional explorations as well as bronchi-alveolar clearance (BAC) explorations. After inhalation of the DTPA-{sup 99m}Tc aerosols, a 20 min dynamical study in posterior-front condition was achieved. After exponential matching on the activity/time curve of the right lung, the half life (T{sub 1/2} in min) and the Residual Activity at 10 min (RA in %) were calculated. The PI were than estimated and on the basis of urinary activity of EDTA-{sup 51}Cr obtained on 24 h and expressed in % of the uptake activity, according to the Bjarnasson`s technique. The results were compared (significant non-parametric tests if p < 0.05) with the normal values obtained earlier in control persons. The PI (2.39% {+-} 2.20) has not significantly increased vs controls (1.74% {+-} 0.81). The PP has significantly increased in the patients: 65.9 min {+-} 35.2 vs 85.2 min {+-} 20.8 (p = 0.05) for the T{sub 1/2} and 87.1% {+-} 6.7 vs 92.8% {+-} 2.6 (p < 0.002) for RA. It is significantly correlated with the total number of cells (r = -0.379) and with the number of lymphocytes (r = 0.351) in the BAC. For the first time an enhanced PP was observed in HCA, correlated with the increase in the number of cells at BAC

  17. Lethal influenza virus infection in macaques is associated with early dysregulation of inflammatory related genes.

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    Cristian Cillóniz


    Full Text Available The enormous toll on human life during the 1918-1919 Spanish influenza pandemic is a constant reminder of the potential lethality of influenza viruses. With the declaration by the World Health Organization of a new H1N1 influenza virus pandemic, and with continued human cases of highly pathogenic H5N1 avian influenza virus infection, a better understanding of the host response to highly pathogenic influenza viruses is essential. To this end, we compared pathology and global gene expression profiles in bronchial tissue from macaques infected with either the reconstructed 1918 pandemic virus or the highly pathogenic avian H5N1 virus A/Vietnam/1203/04. Severe pathology was observed in respiratory tissues from 1918 virus-infected animals as early as 12 hours after infection, and pathology steadily increased at later time points. Although tissues from animals infected with A/Vietnam/1203/04 also showed clear signs of pathology early on, less pathology was observed at later time points, and there was evidence of tissue repair. Global transcriptional profiles revealed that specific groups of genes associated with inflammation and cell death were up-regulated in bronchial tissues from animals infected with the 1918 virus but down-regulated in animals infected with A/Vietnam/1203/04. Importantly, the 1918 virus up-regulated key components of the inflammasome, NLRP3 and IL-1beta, whereas these genes were down-regulated by A/Vietnam/1203/04 early after infection. TUNEL assays revealed that both viruses elicited an apoptotic response in lungs and bronchi, although the response occurred earlier during 1918 virus infection. Our findings suggest that the severity of disease in 1918 virus-infected macaques is a consequence of the early up-regulation of cell death and inflammatory related genes, in which additive or synergistic effects likely dictate the severity of tissue damage.

  18. Retention of Teflon particles in hamster lungs: a stereological study. (United States)

    Geiser, M; Gerber, P; Maye, I; Im Hof, V; Gehr, P


    The significance of aerosols in medicine is increased when the distribution of inhaled aerosols in the different respiratory tract compartments and their interaction with lung structures are known. The aim of this study was to investigate the retention of the hydrophobic Teflon spheres used in human beings so as to analyze their regional distribution and to study their interaction with lung structures at the deposition site. Six intubated and anesthetized Syrian Golden hamsters inhaled aerosols of Teflon particles with an aerodynamic diameter of 5.5 microns by continuous negative-pressure ventilation adjusted to slow breathing. Lungs were fixed by intravascular perfusion within 21 minutes after inhalation was started, and tissue samples were taken and processed for light and electron microscopy. The stereological (fractionator) analysis revealed that particle retention was the greatest in alveoli (72.4%), less in intrapulmonary conducting airways (22.9%), and the least in extrapulmonary mainstem bronchi (0.3%) and trachea (4.4%). Particles were found submerged in the aqueous lining layer and in close vicinity to epithelial cells. In intrapulmonary conducting airways, 21.5% of Teflon particles had been phagocytized by macrophages. This study with highly hydrophobic Teflon particles clearly demonstrates that for spheres of this size, surface tension and line tension forces rather than the particles' surface free energy are decisive for the displacement of particles into the aqueous phase by surfactant. It was this displacement that enabled subsequent interaction with macrophages. Refined knowledge of particle retention may help us to better understand the biological response to inhaled particles.

  19. Structural Development, Cellular Differentiation and Proliferation of the Respiratory Epithelium in the Bovine Fetal Lung. (United States)

    Drozdowska, J; Cousens, C; Finlayson, J; Collie, D; Dagleish, M P


    Fetal bovine lung samples of 11 different gestational ages were assigned to a classical developmental stage based on histological morphology. Immunohistochemistry was used to characterize the morphology of forming airways, proliferation rate of airway epithelium and the presence of epithelial cell types (i.e. ciliated cells, club cells, neuroepithelial cells (NECs) and type II pneumocytes). Typical structural organization of pseudoglandular (84-98 days gestational age [DGA]), canalicular (154-168 DGA) and alveolar (224-266 DGA) stages was recognized. In addition, transitional pseudoglandular-canalicular (112-126 DGA) and canalicular-saccular (182 DGA) morphologies were present. The embryonic stage was not observed. A significantly (P epithelium, on average 5.5% and 4.4% in bronchi and bronchioles, respectively, was present in the transitional pseudoglandular-canalicular phase (112-126 DGA) compared with all other phases, while from 8 weeks before term (224-266 DGA) proliferation had almost ceased. The first epithelial cells identified by specific marker proteins in the earliest samples available for study (84 DGA) were ciliated cells and NECs. Club cells were present initially at 112 DGA and type II pneumocytes at 224 DGA. At the latest time points (224-226 DGA) these latter cell types were still present at a much lower percentage compared with adult cattle. This study characterized bovine fetal lung development by histological morphology and cellular composition of the respiratory epithelium and suggests that the apparent structural anatomical maturity of the bovine lung at term is not matched by functional maturity of the respiratory epithelium.


    Institute of Scientific and Technical Information of China (English)

    张先钧; 张晓岩; 蒲小燕


    [目的]探讨久居高海拔地区藏羚羊在高寒低氧环境肺脏的光镜结构.[方法]对两只藏羚羊肺脏光镜结构进行观察、研究.[结果]该动物肺内,高倍镜下小支气管的黏膜上皮为假复层纤毛柱状上皮,杯状细胞明显,纤毛清晰可见.部分小支气管的外膜中,存在一层完整的、较厚的纵行平滑肌层,透明软骨明显.[结论]在低氧环境下,高原土生动物细胞、组织结构的改变,以主动适应高原环境及繁衍的生存机制.%[Objective] To investigate the ultraslrucyure of lung of hide-gazrlls who stag for a long time in a high altitude district in hypso-frigidity and hypoxemia environment. [Methods] Through observing and researching the ultraslructure of the two hide-gazellas's lung. [Results] In the animals's lungs, we found out their bronchis was pseudoslratified ciliatel cdumnar epithelium in high power lens. There were a integrate and thick longitudinal smooth muscle evident hyaiine cartilage. [Conclu--sion] in hypoxia environment, the animals' tissue of hypoxia alters to adapt imitatively hypoxia circutance.

  1. Tissue engineering and the use of stem/progenitor cells for airway epithelium repair

    Directory of Open Access Journals (Sweden)

    GM Roomans


    Full Text Available Stem/progenitor cells can be used to repair defects in the airway wall, resulting from e.g., tumors, trauma, tissue reactions following long-time intubations, or diseases that are associated with epithelial damage. Several potential sources of cells for airway epithelium have been identified. These can be divided into two groups. The first group consists of endogenous progenitor cells present in the respiratory tract. This group can be subdivided according to location into (a a ductal cell type in the submucosal glands of the proximal trachea, (b basal cells in the intercartilaginous zones of the lower trachea and bronchi, (c variant Clara cells (Clarav-cells in the bronchioles and (d at the junctions between the bronchioles and the alveolar ducts, and (e alveolar type II cells. This classification of progenitor cell niches is, however, controversial. The second group consists of exogenous stem cells derived from other tissues in the body. This second group can be subdivided into: (a embryonic stem (ES cells, induced pluripotent stem (iPS cells, or amniotic fluid stem cells, (b side-population cells from bone marrow or epithelial stem cells present in bone marrow or circulation and (c fat-derived mesenchymal cells. Airway epithelial cells can be co-cultured in a system that includes a basal lamina equivalent, extracellular factors from mesenchymal fibroblasts, and in an air-liquid interface system. Recently, spheroid-based culture systems have been developed. Several clinical applications have been suggested: cystic fibrosis, acute respiratory distress syndrome, chronic obstructive lung disease, pulmonary fibrosis, pulmonary edema, and pulmonary hypertension. Clinical applications so far are few, but include subglottic stenosis, tracheomalacia, bronchiomalacia, and emphysema.

  2. Fully automatic segmentation of complex organ systems: example of trachea, esophagus and heart segmentation in CT images (United States)

    Meyer, Carsten; Peters, Jochen; Weese, Jürgen


    Automatic segmentation is a prerequisite to efficiently analyze the large amount of image data produced by modern imaging modalities. Many algorithms exist to segment individual organs or organ systems. However, new clinical applications and the progress in imaging technology will require the segmentation of more and more complex organ systems composed of a number of substructures, e.g., the heart, the trachea, and the esophagus. The goal of this work is to demonstrate that such complex organ systems can be successfully segmented by integrating the individual organs into a general model-based segmentation framework, without tailoring the core adaptation engine to the individual organs. As an example, we address the fully automatic segmentation of the trachea (around its main bifurcation, including the proximal part of the two main bronchi) and the esophagus in addition to the heart with all chambers and attached major vessels. To this end, we integrate the trachea and the esophagus into a model-based cardiac segmentation framework. Specifically, in a first parametric adaptation step of the segmentation workflow, the trachea and the esophagus share global model transformations with adjacent heart structures. This allows to obtain a robust, approximate segmentation for the trachea even if it is only partly inside the field-of-view, and for the esophagus in spite of limited contrast. The segmentation is then refined in a subsequent deformable adaptation step. We obtained a mean segmentation error of about 0.6mm for the trachea and 2.3mm for the esophagus on a database of 23 volumetric cardiovascular CT images. Furthermore, we show by quantitative evaluation that our integrated framework outperforms individual esophagus segmentation, and individual trachea segmentation if the trachea is only partly inside the field-of-view.

  3. Completely thoracoscopic lobectomy for the surgical management of bronchiectasis

    Institute of Scientific and Technical Information of China (English)

    ZHOU Zu-li; ZHAO Hui; LI Yun; LI Jian-feng; JIANG Guan-chao; WANG Jun


    Background The feasibility of completing a Iobectomy by completely video-assisted thoracoscopic surgery (cVATS) in the management of bronchiectasis is unclear.By retrospectively comparing the outcomes from the Iobectomies that used thoracotomy vs.cVATS,we determined the appropriateness of the minimally invasive cVATS approach in the management of bronchiectasis.Methods Between June 2001 and October 2010,60 patients with bronchiectasis underwent surgery,of which 56 Iobectomies were performed.All Iobectomies were carried out by either thoracotomy or cVATS approach.Pulmonary vessels and bronchi were manipulated by ligation or stapler in the thoracotomy group,while they were dissected by endo-cutters in the cVATS group.Results There were 21 patients in the thoracotomy group and 35 patients in the cVATS group.Two cVATS patients (5.7%) converted.The difference in operation time,chest tube duration,lengths of hospitalization,and morbidity were not significantly different between the two groups (P >0.05).The blood loss was less in the cVATS group (P=0.015).A total of 52.4% and 62.9% of patients were postoperatively asymptomatic in the thoracotomy and cVATS groups respectively,and symptomatic improvement was obtained in 38.1% patients by thoracotomy vs.31.4% patients by cVATS.Conclusion cVATS Iobectomy is safe and effective for the management of bronchiectasis,especially for the patients with localized lesions.

  4. 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


    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.

  5. Serial volumetric registration of pulmonary CT studies (United States)

    Silva, José Silvestre; Silva, Augusto; Sousa Santos, Beatriz


    Detailed morphological analysis of pulmonary structures and tissue, provided by modern CT scanners, is of utmost importance as in the case of oncological applications both for diagnosis, treatment, and follow-up. In this case, a patient may go through several tomographic studies throughout a period of time originating volumetric sets of image data that must be appropriately registered in order to track suspicious radiological findings. The structures or regions of interest may change their position or shape in CT exams acquired at different moments, due to postural, physiologic or pathologic changes, so, the exams should be registered before any follow-up information can be extracted. Postural mismatching throughout time is practically impossible to avoid being particularly evident when imaging is performed at the limiting spatial resolution. In this paper, we propose a method for intra-patient registration of pulmonary CT studies, to assist in the management of the oncological pathology. Our method takes advantage of prior segmentation work. In the first step, the pulmonary segmentation is performed where trachea and main bronchi are identified. Then, the registration method proceeds with a longitudinal alignment based on morphological features of the lungs, such as the position of the carina, the pulmonary areas, the centers of mass and the pulmonary trans-axial principal axis. The final step corresponds to the trans-axial registration of the corresponding pulmonary masked regions. This is accomplished by a pairwise sectional registration process driven by an iterative search of the affine transformation parameters leading to optimal similarity metrics. Results with several cases of intra-patient, intra-modality registration, up to 7 time points, show that this method provides accurate registration which is needed for quantitative tracking of lesions and the development of image fusion strategies that may effectively assist the follow-up process.

  6. 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)


    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.)

  7. Chernobylsk: some bothering facts; Tchernobyl: quelques faits derangeants

    Energy Technology Data Exchange (ETDEWEB)

    Belbeach, B


    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.)

  8. A study on pathological changes and the potential role of growth factors in the airway wall remodeling of COPD rat models%慢性阻塞性肺疾病大鼠模型气道重塑及生长因子的研究

    Institute of Scientific and Technical Information of China (English)

    宋一平; 崔德健; 茅培英; 梁延杰; 王德文


    Objective To study the pathological features of the smooth muscles and collagen in small airways of the COPD rat models and their roles in the airway obstruction, to evaluate the relationship between TGF-β1,EGF and bFGF and the airway wall remodeling. Method Rat COPD model (model group) was established by intratracheal instillation of lipopolysaccharide (LPS 200 μg/200 μL) twice and exposure to cigarette smoke daily. Drug intervention groups received either daily inhalation of budesonide, ipratropine or heparin respectively, starting on the 8th day or TGF-β1 monoclonal antibody(TB21)0.5 mg twice (6th and 19th day) via the tail veinous injection. At the end of four weeks, the thickness of the smooth muscles and collagen in bronchi and pulmonary arteriole wall were measured by means of image analyzer (CMIAS). Expression and localization of the 3 growth factors were observed in trachea, bronchi and lung tissues by immunohistochemistry and in situ hybridization. The levels of PCⅢ, Ln and HA in the serum and BALF were determined by the RIA method.Results Significant thickening of the smooth muscles and collagen were found in the bronchi and pulmonary arterioles of the model group in comparison with those of the control group. There was significant decrease in the thickness of the collagen and smooth muscles in the small airways in TB21 group and heparin group. Statistically negative relationships were shown between the thickness of either smooth muscles or collagen in the small airways and FEV0.3 (all P<0.05). The levels of PCⅢ, Ln and HA in COPD rat models were higher than those of control groups to varying extent. Expressions of TGF-β1,EGF and bFGF in the epithelial cells of bronchi,endothelial cells of pulmonary arterioles and in the macrophages of the model group were significantly higher than those of control group. The above mentioned parameters were reduced in different extent in drug intervention groups, in particular, the smooth muscles

  9. [A prospective randomized study of the usefulness of weighted versus unweighted feeding tubes. A comparison of the transpyloric passage capacity, duration time and the signs of intolerance for enteral nutrition]. (United States)

    Jiménez, C; González-Huix, F; Auger, E; Bou, R; Pons, N; Vila, N; Figa, M; Acero, D


    Weighted feeding tubes for parenteral nutrition were designed to facilitate duodenal intubation and to reduce the risk of aspiration into the bronchi. The goal of the study was to compare the effectiveness of two types of tubes, weighted and unweighted, with regard to their ability to pass the pylorus in 24 hours' time, the time they remained, their involuntary detubation percentages, and the appearance of signs of digestive intolerance during enteral nutrition. Only patients who preserved some level of consciousness were included. Thirty-eight were fitted with weighted tubes, and 32 with unweighted tubes. Twenty-four feeding tubes reached the duodenum during the first day. The average time the tubes remained after insertion was 10.2 +/- 1.1 (range of 1-51) days. In 20 patients, the tube left the body unnoticed, and 15 displayed signs of intolerance to enteral nutrition, though it had to be suspended in the case of only 5. Weighted feeding tubes showed greater effectiveness in their duodenal intubation rate (47% versus 19%, p = 0.0058), the time they remained in the body (12.2 +/- 1.7 versus 7.9 +/- 1.1 days; p = 0.037) and their percentage of involuntary detubation (6 weighted tubes and 14 unweighted tubes, p = 0.009). There were no differences between the two tube types with regard to the appearance of signs of digestive intolerance. The weighted tubes that reached the duodenum (n = 18) were those which remained for the longest periods; 73% of them remained for over 8 days.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. 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)


    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.

  11. 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. (United States)

    Mooij, Petra; Koopman, Gerrit; Mortier, Daniëlla; van Heteren, Melanie; Oostermeijer, Herman; Fagrouch, Zahra; de Laat, Rudy; Kobinger, Gary; Li, Yan; Remarque, Edmond J; Kondova, Ivanela; Verschoor, Ernst J; Bogers, Willy M J M


    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.

  12. Characterization of the specificity by immunohistology of a monoclonal antibody to a novel epithelial antigen of ovarian carcinomas. (United States)

    Mariani-Costantini, R; Agresti, R; Colnaghi, M I; Ménard, S; Andreola, S; Rilke, F


    An immunohistological study, using the avidin-biotin-peroxidase complex method, was carried out to define the reactivity profile of a murine monoclonal antibody, MOv2, which recognizes a novel glycoprotidic antigen associated with ovarian epithelial tumors. Among the primary ovarian tumors tested, MOv2 immunostained 93% of mucinous and 75% of serous cystadenomas, 100% of mucinous, 81% of serous and 73% of endometrioid carcinomas. Undifferentiated and clear cell tumors revealed more limited reactivity with the antibody, whereas ovarian sex cord-stromal and germinal tumors were immunonegative. Positive reactions were also documented in omental metastases from primary ovarian carcinomas. No immunoreactivity was detected in normal ovarian epithelium, whereas the cells lining Walthard's nests adjacent to the fallopian tubes and a variety of normal epithelia were consistently immunolabeled. These included the lining epithelia of the gastrointestinal tract, bronchi and endocervix, and the epithelium of salivary, biliary and pancreatic ducts and sweat glands. To a lesser extent, positive reactions were detected in other surface epithelia, such as squamous and transitional epithelia. Among tumors other than ovarian, MOv2 consistently reacted with adenocarcinomas and squamous cell carcinomas from different sites, most notably breast, lung and gastrointestinal tract, and with transitional cell carcinomas. In contrast, no staining was demonstrated in non-epithelial malignancies. The antigen defined by MOv2 may be operationally useful as a marker of epithelial lineage in tumor histopathology. Its pattern of immunohistochemical distribution indicates that an antigenic phenotype shared by normal surface epithelia and non-ovarian carcinomas is strongly associated with common epithelial neoplasms of the ovaries.

  13. 实验动物呼吸系统主要器官比较组织学研究%Comparative study of the histology of respiratory organs in six laboratory animal species

    Institute of Scientific and Technical Information of China (English)

    戴芳; 王丽; 王涛; 宋蜀伶; 赵玺龙; 徐文漭; 胡奇婵; 李涛; 王媛媛


    Objective To obtain histological data of the respiratory organs of laboratory animals and provide standard reference data for pathological inspection, toxicological studies and drug safety evaluation. Methods Thirty ordinary adult rhesus monkeys, 20 KM mice, 20 SD rats, 18 Japanese white rabbits, 16 Beagle dogs, and 20 Tupaia belangeri were included in this study. After intravenous anesthesia, the animals were sacrificed by femoral artery bleeding,and the trachea and lungs were removed, fixed in 10% formalin, and paraffin sections were stained with HE. The histological structure of the trachea and lungs was observed by light microscopy. The similarities and differences of the trachea and lung structures were compared among the different animal species. Results ( 1 ) The goblet cells in the tracheal epithelium; There were more goblet cells in the Beagle dogs and Japanese white rabbits than in the SD rats, KM mice and Tupaia belangeri, and their secretion was mainly neutral mucus in most animal species, but neutral and acidic mucus in Beagle dogs. (2) Distribution of submucosal glandular acini; There were most numerous submucosal glandular acini in the Beagle dogs, less numerous in the rhesus monkeys, SD rats, KM mice, and Tupaia belangeri, and least acini of submucosal mixed glands in the Japanese white rabbits. (3) The bronchial branches; The bronchial tree in the Beagle dogs, rhesus monkeys and Japanese white rabbits was composed of lobar bronchi, segmental bronchi, small bronchi, bronchioles, terminal bronchioles and respiratory bronchioles. In the SD rats, KM mice and Tupaia belangeri, it was composed of only bronchioles, terminal bronchioles and respiratory bronchioles. (4) Histological structure of bronchioles; The bronchioles of Beagle dogs and rhesus monkeys had an intact circular smooth muscle layer, which was a thin circular layer or lack of it in the SD rats, KM mice, Tupaia belangeri and Japanese white rabbits. There was a small amount of goblet cells in

  14. Clinical Application of Photodynamic Therapy

    Institute of Scientific and Technical Information of China (English)

    LIU Hui-long; LIU Duan-qi


    Photodynamic therapy(PDT) is a new medical technology, the study on photodynamic therapy was in full swing in the past two decade. Scientists have made great progress in it. Photosensitizer,oxygen and light source play important role in photodynamic therapy.PDT is a light activated chemotherapy. A photon is adsorbed by a photosensitizer which moves the drug into an excited state. The excited drug can then pass its energy to oxygen to create a chemical radical called "singlet oxygen". Singlet oxygen attacks cellular structures by oxidation. Such oxidative damage might be oxidation of cell membranes or proteins. When the accumulation of oxidative damage exceeds a threshold level,the cell begins to die.Photodynamic therapy allows selective treatment of localized cancer. PDT involves administration of a photosensitizer to the patients, followed by delivery of light to the cancerous region. The light activates the agent which kills the cancer cells. Without light,the agent is harmless.As a new therapy,photodynamic Therapy has great Advantage in treating cancers. 1. PDT avoids systemic treatment. The treatment occurs only where light is delivered, hence the patient does not undergo go needless systemic treatment when treating localized disease. Side-effects are avoided, from losing hair or suffering nausea to more serious complications. 2. PDT is selective. The photosensitizing agent will selectively accumulate in cancer cells and not in surrounding normal tissues.Hence ,there is selective targeting of the cancer and sparing of surrounding tissues.3. when surgery is not possible. PDT kills cancer cells but does not damage collagenous tissue structures,and normal cells will repopulate these structures. Hence,if a patient has cancer in a structure that cannot be removed surgically(eg. ,the upper bronchi of the lung) ,PDT can still treat the site. 4. PDT is repeatable. Unilke radiation therapy, PDT can be used again and again. Hence,it offers a means of longterm management

  15. 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: [First Department of Medicine, Hokkaido University School of Medicine, N-15 W-7, Kita-Ku, Sapporo 060-8638 (Japan)


    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 ( ( No. UMIN 000002668)

  16. 新生儿肺透明膜病的多层螺旋CT诊断%The MSCT Diagnosis of Neonatal Hyaline Membrane Disease

    Institute of Scientific and Technical Information of China (English)

    韦学; 谭俊扬; 胡琪琳; 廖保荣


    Objective To explore the Spiral CT signs of neonatal hyaline membrane disease .Analysis its Pathogenesis and clinical manifestation through literature review in order to improve the understanding of the disease. Methods Analyze our hospital 18 cases of neonatal hyaline membrane disease from May 2008 to March 2011 especially focus on the multislice CT imaging features. Results Grinding glass phenomenon of double lung among all cases, including air-filled bronchi imaging levy in 12 cases, white lung change 1 case, pneumothorax 4 cases, pneumomediastinum 2 cases, among them, including Neck soft tissue emphysema 2 cases, pulmonary hemorrhage 1 case. Conclusion The MDCT performance of neonatal hyaline membrane disease has certain characteristic, and can supply the evidence for imaging diagnosis this lesion.%目的 探讨新生儿肺透明膜病的螺旋CT征象特点,分析其发病机制及临床表现,通过复习文献,提高对该病的认识.方法 分析我院自2008年5月至2011年3月具有完整资料的肺透明膜病18例,着重分析多层螺旋CT对其肺部的病灶显示能力及影像学特征.结果 本组病例中全部出现双肺透亮度降低的磨玻璃样影及小颗粒样影,其中合并出现支气管充气造影征12例,白肺改变1例,气胸4例,纵隔气肿2例,其中1例合并颈部软组织内气肿.合并肺出血1例.结论 新生儿肺透明膜病多层螺旋CT表现有一定的特征性,可为临床提供重要的影像学依据.

  17. Radiotherapy and receptor of epidermal growth factor; Radiotherapie et recepteur de l'Epidermal Growth Factor

    Energy Technology Data Exchange (ETDEWEB)

    Deberne, M. [Institut Gustave-Roussy, 94 - Villejuif (France)


    The expression level of the receptor of the epidermal growth factor is in correlation with the tumor cells radiosensitivity. An overexpression of the E.G.F.R. is often present in the bronchi cancer, epidermoid carcinomas of the O.R.L. sphere, esophagus, uterine cervix, and anal duct but also in the rectum cancers and glioblastomas. At the clinical level, the E.G.F.R. expression is in correlation with an unfavourable prognosis after radiotherapy in numerous tumoral localizations. In the rectum cancers it is an independent prognosis factor found in multifactorial analysis: increase of the rate of nodes and local recurrence when the E.G.F.R. is over expressed. In the uterine cervix cancers, the survival is is negatively affected in multifactorial analysis by the E.G.F.R. membranes expression level. At the therapy level, the development of anti E.G.F.R. targeted therapies (tyrosine kinase inhibitors and monoclonal antibodies) opens a new therapy field at radio-sensitivity potentiality. The irradiation makes an activation of the E.G.F.R. way that would be partially responsible of the post irradiation tumoral repopulation. This activation leads the phosphorylation of the PI3 kinase ways and M.A.P. kinase ones, then the Akt protein one that acts an apoptotic modulator part. It has been shown that blocking the E.G.F.R. way acts on three levels: accumulation of ells in phase G1, reduction of the cell repair and increasing of apoptosis. he inhibition of post irradiation action of the E.G.F.R. signal way is a factor explaining the ionizing radiation - anti E.G.F.R. synergy. The preclinical data suggest that the E.G.F.R. blocking by the monoclonal antibodies is more important than the use of tyrosine kinase inhibitors. A first positive randomized study with the cetuximab, published in 2006 in the epidermoid carcinomas of the O.R.L. sphere lead to its authorization on the market with the radiotherapy for this localization. The use of cetuximab in other indication with or in

  18. 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)


    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

  19. Anti-angiogenic Nanotherapy Inhibits Airway Remodeling and Hyper-responsiveness of Dust Mite Triggered Asthma in the Brown Norway Rat (United States)

    Lanza, Gregory M.; Jenkins, John; Schmieder, Anne H.; Moldobaeva, Aigul; Cui, Grace; Zhang, Huiying; Yang, Xiaoxia; Zhong, Qiong; Keupp, Jochen; Sergin, Ismail; Paranandi, Krishna S.; Eldridge, Lindsey; Allen, John S.; Williams, Todd; Scott, Michael J.; Razani, Babak; Wagner, Elizabeth M.


    Although angiogenesis is a hallmark feature of asthmatic inflammatory responses, therapeutic anti-angiogenesis interventions have received little attention. Objective: Assess the effectiveness of anti-angiogenic Sn2 lipase-labile prodrugs delivered via αvβ3-micellar nanotherapy to suppress microvascular expansion, bronchial remodeling, and airway hyper-responsiveness in Brown Norway rats exposed to serial house dust mite (HDM) inhalation challenges. Results: Anti-neovascular effectiveness of αvβ3-mixed micelles incorporating docetaxel-prodrug (Dxtl-PD) or fumagillin-prodrug (Fum-PD) were shown to robustly suppress neovascular expansion (p<0.01) in the upper airways/bronchi of HDM rats using simultaneous 19F/1H MR neovascular imaging, which was corroborated by adjunctive fluorescent microscopy. Micelles without a drug payload (αvβ3-No-Drug) served as a carrier-only control. Morphometric measurements of HDM rat airway size (perimeter) and vessel number at 21d revealed classic vascular expansion in control rats but less vascularity (p<0.001) after the anti-angiogenic nanotherapies. CD31 RNA expression independently corroborated the decrease in airway microvasculature. Methacholine (MCh) induced respiratory system resistance (Rrs) was high in the HDM rats receiving αvβ3-No-Drug micelles while αvβ3-Dxtl-PD or αvβ3-Fum-PD micelles markedly and equivalently attenuated airway hyper-responsiveness and improved airway compliance. Total inflammatory BAL cells among HDM challenged rats did not differ with treatment, but αvβ3+ macrophages/monocytes were significantly reduced by both nanotherapies (p<0.001), most notably by the αvβ3-Dxtl-PD micelles. Additionally, αvβ3-Dxtl-PD decreased BAL eosinophil and αvβ3+ CD45+ leukocytes relative to αvβ3-No-Drug micelles, whereas αvβ3-Fum-PD micelles did not. Conclusion: These results demonstrate the potential of targeted anti-angiogenesis nanotherapy to ameliorate the inflammatory hallmarks of asthma in a

  20. Cancer incidence and mortality in Chukotka, 1997–2010

    Directory of Open Access Journals (Sweden)

    Alexey A. Dudarev


    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

  1. Estenose benigna dos brônquios principais Bilateral benign mainstem bronchus stenosis

    Directory of Open Access Journals (Sweden)



    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.

  2. Influenza H5N1 and H1N1 virus replication and innate immune responses in bronchial epithelial cells are influenced by the state of differentiation.

    Directory of Open Access Journals (Sweden)

    Renee W Y Chan

    Full Text Available Influenza H5N1 virus continues to be enzootic in poultry and transmits zoonotically to humans. Although a swine-origin H1N1 virus has emerged to become pandemic, its virulence for humans remains modest in comparison to that seen in zoonotic H5N1 disease. As human respiratory epithelium is the primary target cells for influenza viruses, elucidating the viral tropism and host innate immune responses of influenza H5N1 virus in human bronchial epithelium may help to understand the pathogenesis. Here we established primary culture of undifferentiated and well differentiated normal human bronchial epithelial (NHBE cells and infected with highly pathogenic influenza H5N1 virus (A/Vietnam/3046/2004 and a seasonal influenza H1N1 virus (A/Hong Kong/54/1998, the viral replication kinetics and cytokine and chemokine responses were compared by qPCR and ELISA. We found that the in vitro culture of the well differentiated NHBE cells acquired the physiological properties of normal human bronchi tissue which express high level of alpha2-6-linked sialic acid receptors and human airway trypsin-like (HAT protease, in contrast to the low expression in the non-differentiated NHBE cells. When compared to H1N1 virus, the H5N1 virus replicated more efficiently and induced a stronger type I interferon response in the undifferentiated NHBE cells. In contrast, in well differentiated cultures, H5N1 virus replication was less efficient and elicited a lower interferon-beta response in comparison with H1N1 virus. Our data suggest that the differentiation of bronchial epithelial cells has a major influence in cells' permissiveness to human H1N1 and avian H5N1 viruses and the host innate immune responses. The reduced virus replication efficiency partially accounts for the lower interferon-beta responses in influenza H5N1 virus infected well differentiated NHBE cells. Since influenza infection in the bronchial epithelium will lead to tissue damage and associate with the

  3. Gambaran Jumlah Eosinofil Darah Tepi Penderita Asma Bronkial di Bangsal Paru RSUP Dr. M. Djamil Padang

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    Demas Nico M Manurung


    Full Text Available AbstrakAsma merupakan penyakit gangguan inflamasi kronis saluran pernapasan dengan banyak sel serta elemen seluler yang berperan. Asma dihubungkan dengan hiperresponsif bronkus, keterbatasan aliran udara dan gejala pernapasan yang bersifat reversibel. Salah satu sel yang diketahui berperan besar dalam patogenesis asma adalah eosinofil. Eosinofil melepaskan berbagai mediator seperti Major Basic Protein, Eosinophil Cationic Protein, peroksidase eosinofil, leukotrien C4, serta Platelet-Activating Faktor yang akan merusak epitel saluran napas serta menyebabkan peradangan. Penelitian ini dilaksanakan pada bulan Januari sampai Desember 2012 di Bagian Rekam Medik RSUP Dr. M. Djamil Padang dengan tujuan untuk melihat gambaran jumlah eosinofil darah tepi pada penderita asma bronkial yang dirawat inap. Penelitian yang dilakukan bersifat deskriptif dengan tinjauan retrospektif. Penelitian dilakukan dengan melihat data rekam medis penderita asma bronkial yang dirawat inap di Bangsal Paru RSUP Dr. M. Djamil Padang periode Januari 2010-Desember 2012. Dalam periode dua tahun tersebut, diperoleh 18 sampel yang digunakan pada penelitian ini. Hasil yang diperoleh ialah 4 penderita memiliki jumlah eosinofil darah tepi normal (40-400/mm3 (22,22% dan 14 penderita memiliki jumlah eosinofil darah tepi dibawah normal (<40/mm3 (77,78%. Tidak ditemukan penderita asma dengan eosinofilia (>400/mm3. Jumlah eosinofil darah tepi pada penderita asma bronkial lebih banyak dibawah normal.Kata kunci: Asma Bronkial, EosinofilAbstractAsthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. Asthma is associated with hyperresponsif bronchi, airflow limitation, and respiratory symptomps that are reversible. One of cells which is known to play a major role in asthma pathogenesis is eosinophil. Eosinophil release a variety of mediators such as Major Basic Protein, Eosinophil Cationic Protein, Eosinophil Peroxidase, Leukotriene C4

  4. Analysis of clinical features and current therapy for aspiration pneumonia in the elderly%老年吸入性肺炎125例临床分析

    Institute of Scientific and Technical Information of China (English)

    程真顺; 杨炯; 林宇辉; 叶燕青; 杨亦斌


    Totally, 125 elderly inpatients with aspiration pneumonia (AP) were enrolled from departments of respiratory medicine and neurology at Zhongnan Hospital, Wuhan during June 2005 to October 2009 for analysis. Results showed that listlessness was manifested in 70 cases (56%), primary neurological illness in 80 cases (64%), 57 of them (46%) complicated with respiratory failure and 26 died with case-fatality of 21%. Main pathogen for them was Gram-negative bacillus, accounting for 57% of the total. Two kinds or more of antibiotics had ever been administered in 98 cases (78%), with an average length of antibiotics use for 28 days, ranging from one day to 128 days. Nasal feeding was instituted for those with choking over their feeding and coughing, and their inspired feeding was aspirated from the trachea or bronchi and lavished with bronchoscopy, with 38 cases by tracheal intubation, 26 by tracheotomy and 42 with artificial ventilation. Their average duration of hospital stay spanned 28 days with an average cost of 25 000 RMB yuan per capita, significantly higher than that for those with common pneumonia. In conclusion, clinical features of these elderly patients with AP were not so typical, most of them manifest severe, with lots of medical cost and bad prognosis.%收集2005年6月至2009年10月间呼吸科和神经内科住院治疗的老年吸人性肺炎患者125例做观察.分析发现,老年吸人性肺炎临床表现不典型,以精神萎靡为主(占56%),最多见的基础疾病为神经系统疾病(占64%),并发呼吸衰竭的比例高达46%,且死亡率达21%;病原菌以革兰阴性杆菌为主,占57%;平均住院时间为28 d,平均住院费用2.5万元,均明显高于普通肺炎.说明老年吸入性肺炎临床症状不典型、重症患者多、治疗费用大、预后差.

  5. Similarity of Crocodilian and Avian Lungs Indicates Unidirectional Flow Is Ancestral for Archosaurs. (United States)

    Farmer, C G


    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

  6. Prevalence and pathogenesis of sleep apnea and lung disease in acromegaly. (United States)

    Fatti, L M; Scacchi, M; Pincelli, A I; Lavezzi, E; Cavagnini, F


    Respiratory disorders are common and important complications in acromegaly. Patients suffering from acromegaly display a 1.6-3.3 fold increase in mortality rate, which is due to respiratory disorders in 25% of cases. In these patients, mortality for lung disease is 2-3 fold higher than in the general population. Every portion of the respiratory system may be involved. Deformities of facial bones, edema and hypertrophy of the mucosae and pharyngeal and laryngeal cartilages, enlargement of the tongue and inspiratory collapse of the hypopharinx, all may contribute to respiratory alterations. Nasal polyps, "hormonal rhinitis", changes of the voice and snoring are common occurrences. Though rarely, a laryngocele may ensue. Pneumomegaly is frequently observed and, as suggested by functional studies, might be due to an increased number rather than volume of the alveoli. An obstructive respiratory syndrome caused by mucosal thickening of the upper airways and bronchi is observed in 25% of female and 70% of male patients. The sleep apnea syndrome (SAS) affects 60-70% of acromegalic patients. SAS may be of obstructive, central or mixed type. Obstructive SAS is the prevailing form in acromegaly. It is due to intermittent obstruction of upper airways with preserved activity of the respiratory center, as testified by the remarkable thoracic and abdominal respiratory efforts. The pathogenesis of the central type of SAS is more complex. Narrowing of the upper airways may induce reflex inhibition of the respiratory center. Moreover, increased GH levels and, possibly, defects in the somatostatinergic pathways, may increase the ventilatory response of the respiratory center to carbon dioxide, thereby leading to respiratory arrest. In the mixed type of SAS, the phenomena underlying the other two forms coexist. Oxygen desaturation concomitant with the apneic episodes accounts for the frequent nocturnal wakening and diurnal drowsiness. Among the clinical correlates of SAS, arterial

  7. Cancer incidence and mortality in Chukotka, 1997–2010 (United States)

    Dudarev, Alexey A.; Chupakhin, Valery S.; Odland, Jon Øyvind


    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

  8. Multidetector CT angiography with volumetric three-dimentional rendering to evaluate bronchial arteries in primary lung cancer

    Institute of Scientific and Technical Information of China (English)

    YU Hong; LI Hui-min; LIU Shi-yuan; XIAO Xiang-sheng; TAO Xiao-feng


    Objective:To evaluate the imageologic characteristics of the bronchial arteries (BAs) in primary lung cancer (PLC) with multidetector CT (MDCT) angiography. Methods: Thin-section enhanced CT scanning (with an Toshiba Aquilion 16 scanner) was performed in 164 PLC patients, of whom 123were confirmed by pathology and the remaining 41 were confirmed by typical radiological and clinical findings. Another 46 patients with normal thoracic CT presentations were served as control. Three-dimensional (3D) images of the BAs were processed at workstation (Vitrea 2, Vital Corp, USA). Spatial anatomical characters of the BAs were observed using volume rendering (VR) and multiplanar reconstruction (MPR) or maximum intensity projection (MIP). Results: At least one bronchial artery was displayed clearly on VR in 152 (92.7%) of the 164 PLC patients and 32 (69.6%) of the 46 controls. There were 48. 92% of the right BAs originating from the descending aorta and 46. 24% from the right intercostal artery. 97.53% of the left BAs originated from the descending aorta, and 94.87% of the common trunk from the descending aorta. There were 10 distribution patterns of the BAs, with one on the right and one on the left predominating (48. 68%). More BA branches were found to reach far from the segmental bronchi or enter into the lesions in the PLC group than those in the control group (25.8% vs 1.7%), and also the ipsilateral side of the PLC than the contralateral side (40% vs 8.8% ). The diameter and the total transaxial areas of the BAs on the ipsilateral side of the PLC lesions were significantly larger than those on the contralateral side or those of the control group (P<0.05). Conclusion:The anatomic characters and pathologic changes can be depicted in vivo stereographically and clearly by CTA with volumetric 3D rendering. Dilation of the BAs and increase of total blood flow in patients with PLC can be evaluated quantitatively, which may be useful in the diagnosis and assessment of PLC, and

  9. Particulate Concentration Levels in Chinatown, Oakland, California (United States)

    Chen, B.; Yeung, A.; Yu, J. F.


    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

  10. 雾化吸入低分子量肝素对慢性阻塞性肺疾病大鼠血栓前状态干预的实验研究%Effects of inhaled low molecular weight heparin on prethrombotic state in rat model of chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    孙妮娜; 韩伟忠; 佟丽; 程兆忠


    Objective To investigate the activity of coagulation and fibrinolysis in blood, and to observe the precautionary effect of inhaled low molecular weight heparin (LMWH) on rat of chronic obstructive pulmonary disease(COPD). Methods The rat of COPD model (model group) was established byi ntratracheal instillation of lipopolysaccharide(LPS) twice and exposured to cigarette smoke, meanwhile given LMWH inhaled. The activity of coagulation and fibrinolysis in blood, the blood gas analysis, the pathologic characteristics of bronchial walls, the total and different white blood cell counts of bronchoalveolar iavage fluid were determined. Results The model group rats shared specific pathological features in trachea, bronchi and lung tissues with that of human chronic bronchitis and obstructive emphesema; significant increase of total white blood cells and neutrophils in BALF was found in COPD group compared with those of control group (P<0.05). The total white blood cells and neutrophils in BALF in precaution group decreased obviously than in COPD group(P improved significantly(P<0.05). Conclusions There is preventive and protective effect of LMWH inhaled in the early state of COPD in some extent.%目的 探讨早期雾化吸入低分子量肝素(low molecular weight heparin,LMWH)对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)大鼠模型发生发展的预防保护作用.方法 采用香烟熏吸加气道内注入脂多糖法建立大鼠COPD模型,并用LMWH雾化吸人,观察支气管肺泡灌洗液(BALF)的细胞计数及分类、动脉血气、有关血液学指标、肺组织病理学改变.结果 本实验建立被动吸烟致肺损伤大鼠模型的肺组织病理学改变基本符合人类COPD组织病理学改变特点,应用LMWH后,BALF中白细胞总数及巨噬细胞数较模型组显著降低,血液中vWF因子含量明显减低,PaO2、PaCO2明显改善.结论 早期雾化吸入LMWH对大鼠COPD模型的发生发展有一定的预防保护作用.

  11. 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

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    Luciano da Anunciação Pimentel


    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

  12. 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: [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)


    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

  13. Automatic lung segmentation in CT images with accurate handling of the hilar region. (United States)

    De Nunzio, Giorgio; Tommasi, Eleonora; Agrusti, Antonella; Cataldo, Rosella; De Mitri, Ivan; Favetta, Marco; Maglio, Silvio; Massafra, Andrea; Quarta, Maurizio; Torsello, Massimo; Zecca, Ilaria; Bellotti, Roberto; Tangaro, Sabina; Calvini, Piero; Camarlinghi, Niccolò; Falaschi, Fabio; Cerello, Piergiorgio; Oliva, Piernicola


    A fully automated and three-dimensional (3D) segmentation method for the identification of the pulmonary parenchyma in thorax X-ray computed tomography (CT) datasets is proposed. It is meant to be used as pre-processing step in the computer-assisted detection (CAD) system for malignant lung nodule detection that is being developed by the Medical Applications in a Grid Infrastructure Connection (MAGIC-5) Project. In this new approach the segmentation of the external airways (trachea and bronchi), is obtained by 3D region growing with wavefront simulation and suitable stop conditions, thus allowing an accurate handling of the hilar region, notoriously difficult to be segmented. Particular attention was also devoted to checking and solving the problem of the apparent 'fusion' between the lungs, caused by partial-volume effects, while 3D morphology operations ensure the accurate inclusion of all the nodules (internal, pleural, and vascular) in the segmented volume. The new algorithm was initially developed and tested on a dataset of 130 CT scans from the Italung-CT trial, and was then applied to the ANODE09-competition images (55 scans) and to the LIDC database (84 scans), giving very satisfactory results. In particular, the lung contour was adequately located in 96% of the CT scans, with incorrect segmentation of the external airways in the remaining cases. Segmentation metrics were calculated that quantitatively express the consistency between automatic and manual segmentations: the mean overlap degree of the segmentation masks is 0.96 ± 0.02, and the mean and the maximum distance between the mask borders (averaged on the whole dataset) are 0.74 ± 0.05 and 4.5 ± 1.5, respectively, which confirms that the automatic segmentations quite correctly reproduce the borders traced by the radiologist. Moreover, no tissue containing internal and pleural nodules was removed in the segmentation process, so that this method proved to be fit for the use in the

  14. The evaluation of radiological and clinical findings of bronchiectasis

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    Yoo, Jung Keun; Kang, Sung Ihn; Kim, Kil Jung; Ko, Seung Sook; Kim, Young Sook; Kim, Young Chul [Chosun University College of Medicine, Kwangju (Korea, Republic of)


    Bronchiectasis means a permanent abnormal dilatation off one or more large bronchi owing to destruction of the elastic and muscular components of the bronchial wall. Radiological study is the most important and mandatory procedure. Especially bronchography is essential for the definitive diagnosis of bronchiectasis and for the precise delineation of the type and extent of the disease. The radiological and clinical findings of 48 cases of bronchiectasis diagnosed by bronchography and treated at Chosun University Hospital during the 5 years from January 1980 to December 1984 were analyzed retrospectively. The results were as follows; 1. Among the 48 cases, 34 cases (70.8%) were male and 14 cases (29.2%) were female. Peak incidence was in second decade. 2. Chronic cough productive sputum and hemoptysis are main symptoms and others are chest pain, dyspnea and recurrent bouts of pneumonia. The most common physical sign is persistent moist rales over the involved area in 23 cases (47.9%). Others are no sign in 17 cases (35.4%), wheezing in 11 cases (22.9%) and digit clubbing in 3 cases (6.3%). 3. The presumed causes were composed of not known in 30 cases (62.5%)> and complications of measles in 7 cases (14.6%), pertussis in 5 cases (10.4%) and pneumonia in 4 cases (8.3%). Two cases were Kartagener's syndrome and unilateral hyperlucent lung. 4. Plain chest common radiological findings was accentuation of lung marking in 36 cases (85.7%), the others are include in order of frequency; pneumonic infiltration, linear radiolucencies, cystic radiolucencies, decreased affected lung volume, air-fluid, level and pleural thickening. 5. Bilateral bronchiectasis was demonstrated in 11 cases (22.9%) and the disease was much more often involved left lung than right. The most commonly involved lobe is left lower lobe, and the most common site of involvement was the posterior basal segment of the lower lobe. The type of bronchiectasis is cylindrical in 22 cases (45.8%), varicose in

  15. The Value of Multislice Spiral Computed Tomography in Demonstrating the Relationship between Bronchial and Peripheral Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    Jinwei Qiang; Kangrong Zhou; Yaping Jiang; Xuanguang Ye; Qun Wang; Songtao Xu; Lijie Tan


    OBJECITVE To investigate the value of multislice spiral computed tomography (MSCT) in demonstrating the relationship between bronchial and peripheral lung cancer.METHODS MSCT was used to conduct volumetric targeted scans of 0.5 mm collimation for 53 cases of peripheral lung cancer and to demonstrate the relationship between bronchial and peripheral lung cancer by multiplanar reconstrUctions(MPR) images, curved multiplanar reformations(CMPR) and surface shaded display(SSD). The results were compared with macroscopic and microscopic specimens.RESULTS 1) All the bronchi at the 3rd to 7th order were displayed clearly and completely with this CT protocol. The tumors that were related to the bronchus included 29 (96.7%) adenocarcinomas and 13 (76.5%) squamous-cell carcinomas. Statistical analysis showed that there was no significant difference between the two groups (x2 =2.8, P >0.05). 2) The tumorbronchus relationship was divided into four subtypes, i.e. type Ⅰ: the bronchus was obstructed by a tumor, type Ⅱ: the bronchus was obstructed when penetrated by a tumor with tapered narrowing; type Ⅲ: the bronchial lumen shown within the tumor was unobstructed and intact, type Ⅳ: the bronchus ran at the periphery of a tumor, with an intact or narrowed lumen.3) Type Ⅰ occurred in 58.5% (31 cases), in which squamous-cell carcinoma was slightly more common than adenocarcinoma. Both type Ⅱ and type Ⅲ were seen in 15.1%(eight cases of each), of which all were adenocarcinomas. The incidence rate of type Ⅳ was 28.3% (15 cases), of which adenocarcinoma was slightly more frequent than squamous-cell carcinoma. 4)Squamous-cell carcinoma was more common than adenocarcinoma in the tumors in the fourth-order bronchus, whereas adenocarcinoma was more common than squamous-cell carcinoma in tumors with a relationship to the sixth-order bronchus.CONCLUSION MSCT with volumetric targeted scans of ultra-thin sections were conducted followed by MPR,CMPR and SSD reconstruction

  16. Therapeutic arthropods and other, largely terrestrial, folk-medicinally important invertebrates: a comparative survey and review. (United States)

    Meyer-Rochow, V Benno


    Traditional healing methods involving hundreds of insect and other invertebrate species are reviewed. Some of the uses are based on the tenet of "similia similibus" (let likes be cured by likes), but not all non-conventional health promoting practices should be dismissed as superstition or wishful thinking, for they have stood the test of time. Two questions are addressed: how can totally different organ systems in a human possibly benefit from extracts, potions, powders, secretions, ashes, etc. of a single species and how can different target organs, e.g. bronchi, lungs, the urinary bladder, kidneys, etc. apparently respond to a range of taxonomically not even closely related species? Even though therapeutically used invertebrates are generally small, they nevertheless possess organs for specific functions, e.g. digestion, gas exchange, reproduction. They have a nervous system, endocrine glands, a heart and muscle tissue and they contain a multitude of different molecules like metabolites, enzymes, hormones, neurotransmitters, secretions, etc. that have come under increased scientific scrutiny for pharmacological properties. Bearing that in mind it seems likely that a single species prepared and used in different ways could have a multitude of uses. But how, for example, can there be remedies for breathing and other problems, involving earthworms, molluscs, termites, beetles, cockroaches, bugs, and dragonflies? Since invertebrates themselves can suffer from infections and cancers, common defence reactions are likely to have evolved in all invertebrates, which is why it would be far more surprising to find that each species had evolved its own unique disease fighting system. To obtain a more comprehensive picture, however, we still need information on folk medicinal uses of insects and other invertebrates from a wider range of regions and ethnic groups, but this task is hampered by western-based medicines becoming increasingly dominant and traditional healers being

  17. The Relationships Between Weather and Climate and Attacks of Bronchitis (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

  18. Total artificial heart in the pediatric patient with biventricular heart failure. (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


    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. Central airways remodeling in COPD patients

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    Pini L


    Full Text Available Laura Pini,1 Valentina Pinelli,2 Denise Modina,1 Michela Bezzi,3 Laura Tiberio,4 Claudio Tantucci1 1Unit of Respiratory Medicine, Department of Clinical and Experimental Sciences, University of Brescia, 2Department of Respiratory Medicine, Spedali Civili di Brescia, 3Department Bronchoscopy, Spedali Civili di Brescia, 4Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy Background: The contribution to airflow obstruction by the remodeling of the peripheral airways in chronic obstructive pulmonary disease (COPD patients has been well documented, but less is known about the role played by the large airways. Few studies have investigated the presence of histopathological changes due to remodeling in the large airways of COPD patients. Objectives: The aim of this study was to verify the presence of airway remodeling in the central airways of COPD patients, quantifying the airway smooth muscle (ASM area and the extracellular matrix (ECM protein deposition, both in the subepithelial region and in the ASM, and to verify the possible contribution to airflow obstruction by the above mentioned histopathological changes. Methods: Biopsies of segmental bronchi spurs were performed in COPD patients and control smoker subjects and immunostained for collagen type I, versican, decorin, biglycan, and alpha-smooth muscle actin. ECM protein deposition was measured at both subepithelial, and ASM layers. Results: The staining for collagen I and versican was greater in the subepithelial layer of COPD patients than in control subjects. An inverse correlation was found between collagen I in the subepithelial layer and both forced expiratory volume in 1 second and ratio between forced expiratory volume in 1 second and forced vital capacity. A statistically significant increase of the ASM area was observed in the central airways of COPD patients versus controls. Conclusion: These findings indicate that airway remodeling also affects

  20. 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

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    Lívia Zulmyra Cintra Andrade


    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.

  1. 肺癌主支气管癌的全胸腔镜支气管成形术%Complete thoracoscopic bronchoplasty for treating lung cancer and main-stem bronchial cancer

    Institute of Scientific and Technical Information of China (English)

    尹荣; 许林; 邱宁雷; 杨欣; 蒋峰; 黄建峰; 张治; 张楼乾


    目的 探讨全胸腔镜支气管成形术的可行性,详细介绍支气管新缝合技术“弯针直缝法”的临床应用.方法 2008年7月至2012年7月.江苏省肿瘤医院胸外科为7例支气管中心型非小细胞肺癌和1例左主支气管癌患者行全胸腔镜下肺癌切除及支气管成形术治疗.男5例,女3例;年龄48~73岁,平均(63.33 ±7.14)岁.5例全胸腔镜肺叶切除支气管楔形切除术,2例支气管袖状切除,1例左主支气管袖状切除±次级隆凸成形术.均采用王氏手术切口,在切除肿瘤及清扫纵隔淋巴结后,将传统缝合技术与“弯针直缝”新缝合技术相结合,完成8例全胸腔镜支气管成形术.结果 全组手术过程均顺利,未发生术中严重并发症、中转开胸情况.手术平均(2.53±1.92)h,出血量平均(110±80) ml,术后平均住院(11.3±1.4)天.远期随访均未发生支气管胸膜瘘等严重并发症.术后随访2~36个月,均恢复满意.结论 有丰富经验的胸腔镜外科医师行全胸腔镜支气管成形术治疗肺癌、主支气管癌是安全、可行的.“弯针直缝法”成功消灭了胸腔镜下复杂支气管吻合的缝合死角,简化了手术操作,缩短了手术时间,确实是一种简单实用,安全可靠的胸部微创缝合新方法.%Objective Investigating the feasibility of bronchoplasty in a complete video-assisted thoracic surgery (VATS) and introducing the clinical application of a novel technique,"sutura harmonia with a curve needle",for VATS bronchoplasty.Methods From July 2008 to July 2012,seven patients with central non-small-cell lung caner invading bronchi and one patient with left main bronchus (LMB) carcinoma accepted the tumor resection and bronchoplasty in complete VATS.The age of these patients ranged from 48 to 73 years old with an average age of(63.33 ± 7.14) years.There were 5 male patients and 3 female patients in our series.Five patients received the wedge resection of the tumor-invaded bronchi

  2. Endoscopia respiratória em 89 pacientes com neoplasia pulmonar Respiratory endoscopy in 89 patients of lung neoplasms

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    . 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.

  3. 细支气管肺泡癌1BF FDG PET/CT SUV值与HRCT形态学的相关性研究%Study of the Relationship between 18F-FDG PET/CT SUV and HRCT Morphology in Bronchial Alveolar Carcinoma (BAC)

    Institute of Scientific and Technical Information of China (English)

    何宝明; 王志忠; 刘晓飞; 姚昊; 欧阳晓辉; 苏家贵


    ( re = 5 ) and solid nodule (re = 8 ) . The GGO nodules that the diameter was usually 1. 1-2. 8cm and the mean values SUVlml was less than 1. 5 ,that had the characters of morphology such as tabulation (re =4) , pleural indentation (re =2) , vascular aggregated sign (re = 2). The solid nodules which had a higher uptake(SUVmax: 4. 8-8. 3) , diameter 1. 8-3. 8 cm with short speculation ( re = 8 ) , tabulation ( re = 7 ) , aerated bronchi ( re = 6 ) , vacuoles ( re = 5 ) , pleural indentation ( re = 3 ). Vascular aggregated sign (re =7) , nodules accumulate (re =3). There were 9 cases of multi-nodules which included 4 case of Miliary nodules noduled and 5 case of the number of nodules more than 2. GGO and samll Miliary nodules ( nodule which diameter <3 mm) were without FDG uptake, melt noudle and larger miliary nodules (nodule which diameter <3 mm) had FDG uptake,the SUVmax 2.1-3.9. The pneumonia type;The consolidation was observed in one (n =4) , or two lobes (re =2) , with "aerated bronchi" sign (re =7) , or "honeycomb" sign (re = 1) , bronchial marginal cutoff(re = 1). Radioactive distribution was inhomogeneous, SUVmax 4.5-11, FDG uptake of part lesions is negative results. It conclused there are a correlation between F-FDG PET/CT SUV and HRCT morphology in Bronchial alveolar carcinoma ( BAC). Miliary nodules nodule which diameter less than 3 mm and ground-glass opacity normally are without FDG uptake meanwhile the type of pneumonia and mass almost have higher uptake.

  4. [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)"]. (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


    (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.

  5. Ativação da proteína TGFbetaI latente em pulmão irradiado in vivo Latent TGFbeta1 activation in the lung irradiated in vivo

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    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.


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    -up was observed a total regression of the bilioptysis and disappearance of the jaundice after the seventh postoperative day. The patient was submitted to bronchography that did not reveal anatomical changes on the right lowers bronchi by biliary flood. The patient is on the seventh postoperative year without any evidence of the disease.

  7. Application of single-shot fast spin-echo sequence in MRimaging of normal fetus%单次激发快速自旋回波序列MR检查在正常胎儿中的应用

    Institute of Scientific and Technical Information of China (English)

    胡晓华; 罗先富; 陈娟; 傅剑雄; 王军; 吴晶涛


    Objective To investigate the ability of single-shot fast spin-echo (SSFSE) sequence in delineating the anatomic structures of fetus, and to explore the clinical value of this sequence. Methods Fourteen normal fetuses with gestational age larger than 20 weeks underwent MR imaging 1 week within ultrasonic examination. SSFSE sequence was performed at the coronal, sagittal and axial view of the fetus body and the head. The normal fetus anatomy of brain, lungs, heart, liver,spleen, gastrointestinal tract, etc. and their MR manifestations were observed. Results The main organs of fetus had developed in 20 weeks gestation. In the central nervous system, against the high signal of the ventricular system, three layers of the cerebrum were identified, including the hypointense cortical gray matter, the hyperintense white matter, and the lower-signal-intensity germinal matrix. Cortical gyri and sulci developed significantly after 30 weeks gestation. The lungs, trachea, bronchi, stomach bubble, renal collecting system and bladder showed as high signal intensities, while gastrointestinal tract displayed mixed signal, the heart, great vessels, liver, spleen and kidneys appeared as hypointensities. Conclusion SSFSE sequence MR imaging can clearly show the normal anatomy of main fetal organs.%目的 观察单次激发快速自旋回波序列(SSFSE)在胎儿解剖结构方面的显示能力,探讨其在胎儿MR检查中的临床应用价值.方法 对14胎20周以上正常胎儿行MR检查,采用SSFSE序列对胎儿头颅、躯干行轴位、冠状位、矢状位扫描,观察胎儿各系统主要器官,包括脑、肺、心脏、肝、脾、胃肠道等的解剖和MR表现.结果孕20周时,胎儿各主要器官均已发育.中枢神经系统:在SSFSE图像脑室系统高信号的衬托下,大脑三层结构清晰可辨,皮层及脑室旁生发层呈低信号,白质呈稍高信号.脑室系统呈生理性扩大状态,30周后脑沟、回形成逐渐明显;非神经系统:SSFSE图

  8. Detection of aspiration using 99Tcm-sulfur colloid salivary scintigraphy in patients with respiratory tract diseases%99Tcm-硫胶体唾液显像方法学建立及在成年呼吸道疾病患者误吸中的应用

    Institute of Scientific and Technical Information of China (English)

    陈萍; 侯鹏; 郑则广; 吴志达; 刘海平; 王丽娟


    Objective To establish and assess the utility of 99Tcm-sulfur colloid (SC) salivary imaging in the routine evaluation of pulmonary aspiration in adult patients with respiratory tract diseases.Methods Eight patients (7 men,1 woman; age range 68 to 80 years,mean age (76 ± 4) years) with respiratory tract disease and history of aspiration by clinical assessment were evaluated prospectively by 99Tcm-SC salivary imaging from April to July 2012.A dose of 74.0 MBq 99Tcm-SC was added to 20 ml saline,mixed well,and administered orally to patients.Dynamic imaging was acquired with posterior projection for 30 min at a rate of 30 s per frame.Two experienced physicians assessed all examination results and reached consensus for final diagnosis.Radioactivity detected at either the bronchi or within the lung fields was reported as positive for aspiration.This study was approved by the institutional review board of Hospital Ethical Committee,and the written informed consent was obtained from patients or their guardians.Results All patients were positive for aspiration by 99Tcm-SC salivary imaging (8/8).Aspiration into bilateral main bronchus was seen in 2 cases,right main bronchus and branch in 4 cases,and left main bronchus and branch in 2 cases.Aspirated tracer could be visualized as early as 3 min,latest at 24 min,and the median was 19 min.Conclusion 99Tcm-SC salivary imaging is useful for the detection of aspiration in adult patients with respiratory tract diseases.%目的 建立99Tcm-SC唾液显像方法学,并探讨其在检测成年呼吸道疾病患者误吸中的应用价值.方法 前瞻性研究2012年4月至2012年7月间临床确诊存在误吸的成年呼吸道疾病患者8例[男7例,女1例,年龄68 ~ 80岁,平均(76±4)岁],均进行99Tcm-SC唾液显像.将74.0 MBq99Tcm-SC恒量注入患者口腔,用SPECT/CT进行后位动态采集口腔至胃部图像.由2位高年资核医学科医师共同阅片诊断,意见不一致时协商决定.左和(或)右主支气管

  9. Efficacy of Nourishing Yin and Lowering Adverse Qi Therapy in Treating COPD%中医滋阴降逆法治疗慢性阻塞性肺疾病的疗效观察

    Institute of Scientific and Technical Information of China (English)



    Objective:Under the guidance of TCM theory of evidence-based medicine , explore clinical efficacy of Yin-nourishing , qi-re-versing method in patients with chronic obstructive pulmonary disease .Methods:A total of 106 patients of chronic obstructive pulmonary disease were divided into the control group ( treated with conventional western medications such as oxygen , anti-infection meds , anti-spasmolysis and anti-asthma meds , meds for reduce cough phlegm and dilate bronchi );treatment group were treated with TCM decoction of Yin-nourishing, qi-reversing effect, in addition to conventional western medicine treatment .After a treatment course of 14 days, clini-cal efficacy was evaluated.Results:Symptoms (cough, sputum color and breathing, chest tightness,heart function change, white blood cells and neutrophils) improved significantly in treatment group than the control group (P<0.05).Conclusion:The clinical observa-tion showed that Yin-nourishing , qi-reversing method can promote improvement of clinical symptoms of chronic obstructive pulmonary disease, therefore provide new method and thoughts for COPD treatment .%目的:在中医辨证论治理论指导下,结合临床疗效,为滋阴降逆法在慢性阻塞性肺疾病患者的临床应用提供依据。方法:对106例慢性阻塞性肺疾病患者依据其意愿,分为对照组(用西医疗法)采用吸氧、抗感染、解痉平喘、止咳化痰、扩张支气管等西医常规治疗措施:治疗组(加用中医药疗法)在西医常规治疗措施基础上,加用滋阴降逆法中药汤剂治疗。14 d为1疗程,观察1个疗程结束后就临床疗效作出评价。结果:两组症状体征比较:治疗组在咳嗽、咳痰色、喘息、胸闷、心功能转归、白细胞及中性粒细胞的转归改善明显好于对照组症状改善。两组疗效比较,治疗组疗效优于对照组( P<0.05)。结论:本次临床观察结果表明,滋阴降逆法可以促进

  10. 复发性多软骨炎气道受累的临床特征及其早期诊断%Clinical characteristics and early diagnosis of patients with relapsing polychondritis with airway involvement

    Institute of Scientific and Technical Information of China (English)

    陈楠; 王振刚; 崔莉; 高圆; 王艳妮


    Objective To investigate the clinical characteristics and early diagnosis of patients with relapsing polychondritis(RP) with airway involvement.MethodAccording to the presenting symptom, seventy RP patients with airway involvement were divided into two groups, airway-onset group and non-airway-onset group. The clinical characteristics and necessity of assistant examinations were discussed. Result Dyspnea and stridor was the most common symptom of airway involvement in 55 patients(78.6%), followed by hoarseness in 40 patients(57.1%), cough and sputum in 40 patients(57.1%). Larynx, trachea and main bronchi were affected simultaneously in 24 patients(34.3%), being the most common pattern. Larynx involvement was more frequent in airway-onset group, with a higher tracheostomy rate before diagnosis. Airway chondritis was evident on CT scan characterized by tracheobronchial wall thickening or calcification in 10.0% of the patients despite the absence of airway symptoms. Asymptomatic hearing loss and vestibular dysfunction were seen in 40.0% and 51.4% of the patients respectively.Conclusion Airway involvement is common in RP. Airway chondritis may be asymptomatic in some patients. More widespread airway involvement and aggressive disease course are seen in those who presenting with airway chondritis. Asymptomatic airway involvement and inner ear damage are frequent.Radiological examination and functional evaluation are essential for the early recognition of RP.%目的:探讨复发性多软骨炎(relapsing polychondritis,RP)气道受累的临床特征及早期诊断。方法将2010年1月至2016年2月于本院就诊的累及气道的70例RP患者分为气道首发组及非气道首发组,分析其临床特点及辅助检查的必要性。结果前三位气道表现为呼吸困难或喘憋55例(78.6%)、声嘶40例(57.1%)、咳嗽咳痰40例(57.1%)。喉、气管、主支气管同时受累最常见(24例,34.3%)。气道首发组喉部受累及

  11. Etiological analysis of pediatric chronic cough%小儿慢性咳嗽的病因分析

    Institute of Scientific and Technical Information of China (English)

    李治昌; 吕茵; 王义; 刘小权; 楚建萍


    Objective To investigate the causes of the chronic cough in children .Methods The clinical data of 245 cases of chronic cough in children were retrospectively studied .Results The causes of 245 cases of infantile cough included cough after respiratory tract infection(26.67%), foreign body in bronchus(20.83%), upper airway cough syndrome (15.00%), and cough variant asthma (CVA) (12.92%).Cough after respiratory tract infection and breast milk aspiration gave priority to chronic cough in baby under 1 year old(62. 71%) .The foreign body in trachea and bronchi and cough after respiratory tract infection were main causes in children aged 1-3 years old (70.09%).CVA and upper airway cough syndrome .(68.92%) were major causes of children over 3 years.Conclusion The etiology of pediatric chronic cough is different for children of different age .The major causes include cough after respiratory tract infection , upper airway cough syndrome , CVA, foreign body in bronchus , and so on.It should be further diagnosed according to cough characteristics , auxiliary examination and therapy because of complex etiology .%目的了解小儿慢性咳嗽的病因。方法对245例慢性咳嗽患儿的临床资料进行回顾性研究。结果245例小儿咳嗽的原因有呼吸道感染后咳嗽(26.67%),支气管异物(20.83%),上气道咳嗽综合征(15.00%),咳嗽变异性哮喘(12.92%)。小于1岁婴儿慢性咳嗽以呼吸道炎症后咳嗽和误吸母乳为主(62.71%),1~3岁小儿以气管、支气管异物和呼吸道感染后咳嗽为主(占70.09%),大于3岁儿童以咳嗽变异性哮喘和上气道咳嗽综合征为主(68.92%)。结论小儿慢性咳嗽的病因根据年龄段不同而异,主要病因有呼吸道炎症后咳嗽、上气道咳嗽综合征、咳嗽变异性哮喘、支气管异物等,其病因较复杂,须根据咳嗽特征、辅助检查、治疗反应来进一步确定。

  12. Achados de fibrobroncoscopia em pacientes com diagnóstico de neoplasia pulmonar Fiberoptic bronchoscopy findings in patients diagnosed with lung cancer

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    Marcelo Fouad Rabahi


    involving 212 patients with a confirmed diagnosis of lung cancer by cytological evaluation of BAL specimens or by histopathological evaluation of endobronchial or transbronchial biopsy specimens. The data were collected at the Respiratory Endoscopy Sector of Hospital São Salvador, located in the city of Goiânia, Brazil, between 2005 and 2010. The endoscopic findings were classified as endoscopically visible tumor, endoscopically invisible tumor, mucosal injury, as well as being classified by the presence/type of secretion. The visible tumors were also classified according to their location in the tracheobronchial tree. RESULTS: Endobronchial mass (64% and mucosal infiltration (35% were the main endoscopic findings. The histological type was determined in 199 cases, the most prevalent types being squamous carcinoma, in 78 (39%, adenocarcinoma, in 42 (21% small cell carcinoma, in 24 (12%, and large cell carcinoma, in 2 (1%. More than 45% of the visible tumors were at the upper bronchi. Squamous carcinoma (n = 78 was most commonly visualized as an endobronchial mass (in 74%, mucosal infiltration (in 36%, luminal narrowing (in 10%, or external compression (in 6%. CONCLUSIONS: Our results show that the endobronchial mass is the most common bronchoscopic finding that is suggestive of malignancy. Proportionally, mucosal infiltration is the most common finding in small cell carcinoma. In adenocarcinoma, luminal narrowing, external compression, mucosal injury, and endobronchial secretion prevail.

  13. Manifestations of 18F-FDG PET/CT in Mucoepidermoid Carcinoma of Trachea and Bronchus%气管、支气管黏液表皮样癌的18F-FDG PET/CT表现

    Institute of Scientific and Technical Information of China (English)

    彭辽河; 丁久荣; 胡晓燕; 邱大胜; 李杰; 朱佳; 周静


      目的探讨气管、支气管黏液表皮样癌(MEC)的 PET/CT 影像表现及其诊断价值.资料与方法收集5例经病理证实的气管、支气管 MEC 患者的临床资料,患者均行18F-FDG PET/CT 显像检查,并进行 CT 图像、PET 图像和 PET/CT 融合图像帧对帧对比分析,结合最大密度投影、多平面重组等图像后处理技术进一步观察,分析 MEC PET/CT 的影像表现.结果5例 MEC 患者中,1例位于气管,2例位于右主支气管,1例位于右下叶支气管,1例位于左下叶支气管.1例伴纵隔、右上肺门淋巴结转移,1例伴右肺上叶转移.PET 显像示气管、支气管内结节状、椭圆状或长条状放射性浓聚影,肺内转移灶、纵隔和肺门淋巴结转移呈结节状放射性浓聚影,边界清晰.CT 于相应部位见气管、支气管腔内类圆形软组织密度结节或肿块影,密度较均匀,其中2例病灶内见斑点状钙化,2例伴阻塞性肺不张,1例伴阻塞性肺炎.结论气管、支气管 MEC 的 PET/CT 影像表现为气管内椭圆形、柱状等代谢或密度改变,PET/CT 能够完整、清晰地显示肿瘤的功能代谢信息与解剖形态学影像特点,对临床诊疗有重要的提示意义.%Purpose To investigate the features and diagnostic value of PET/CT imaging in mucoepidermoid carcinoma (MEC) of trachea and bronchus. Materials and Methods Five patients with pathology proven MEC were retrospectively studied. 18F-FDG PET image and CT scan were performed in all cases. CT images, PET images and PET/CT fusion images of the same patient were analyzed frame by frame. Maximum intensity projection (MIP) and multiplanar reconstruction (MPR) were processed for further investigation. Results In five cases of MEC, one case in trachea, two cases in right main bronchi, one case in right lower lobar bronchus, and one case in left lower lobar bronchus were found, including one case with lymph node metastasis in mediastinum and right upper hilum and one case

  14. Investigations of initial airtightness after non-anatomic resection of lung parenchyma using a thulium-doped laser with different optical fibres. (United States)

    Kirschbaum, Andreas; Höchsmann, N; Steinfeldt, T; Seyfer, P; Pehl, A; Bartsch, D K; Palade, E


    resection levels, the risk of cutting small segmental bronchi is considerably increased. They must always be closed with sutures.

  15. Research on 2005-2012 Single Disease Misdiagnosis Document of Misdiagnosed Disease Database:Foreign Bodies in Child Trachea%误诊疾病数据库2005-2012年单病种误诊文献研究:小儿气管异物

    Institute of Scientific and Technical Information of China (English)

    国献素; 刘芳; 徐通; 王红艳


    气管、支气管异物是小儿常见急症,可造成患儿突然死亡,临床表现缺乏特异性,虽然临床诊疗技术快速发展,但本病误诊率仍居高不下。2005—2012年发表在中文医学期刊并经遴选纳入误诊疾病数据库的小儿气管异物文献共99篇,对纳入文献研究分析显示,误诊病例2184例,平均误诊率25.44%;误诊范围涉及29种疾病,其中居前3位的误诊疾病是肺炎、支气管炎、急性喉炎,占误诊疾病总数的86.21%。首位误诊原因为患儿主述或代述病史不确切,占总误诊原因的25.56%。2184例误诊病例中,2178例(99.73%)未因误诊造成明显不良后果,6例(0.27%)造成严重后果。提示临床对高度怀疑气管异物者应尽快行支气管镜检查及治疗,以降低患儿病死率。%Foreign bodies in the trachea and bronchi are common pediatric emergencies and cause sudden death. Al-though clinical orthopedic treatment techniques develop rapidly, the misdiagnosis rate remains very high as the clinical mani-festation of this disease lacks specificity. Articles about foreign bodies in child trachea entered into misdiagnosed disease data-base count for 99 copies, which were selected from the articles published in Chinese medical periodicals during 2005-2012. Analysis on 99 articles shows that misdiagnosed cases count for 2184, with an average of misdiagnosis rate of 25. 44% . The misdiagnosed cases cover 29 types of diseases, and the top three are: pneumonia, bronchitis and acute laryngitis, accounting for 86. 21% of the total number of misdiagnosed cases. Based on the 99 articles, the frequency and the constituent ratio of misdiagnosis causes are determined, and the top is the imprecise description of the patient's history, accounting for 25. 56% . Among 2184 cases, there are 2178 cases with bad consequences because of misdiagnosis, accounting for 99. 73% , and 6 ca-ses with severe consequences, accounting for 0. 27% . This shows that some infants with

  16. Bronquiectasia e fisioterapia desobstrutiva: ênfase em drenagem postural e percussão Bronchiectasis and clearence physiotherapy: emphasis in postural drainage and percussion

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    Neuseli Marino Lamari


    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

  17. Effects of quorum sensing system lasR/rhlR gene on the expression of Foxp3, TGF-β1 and IL-10 of lung tissue in tracheal intubation model rat with Pseudomonas aeruginosa biofilm infection

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    Qing-qing XIANG


    Full Text Available Objective  To investigate the effects of lasR/rhlR gene on Foxp3, TGF-β1 and IL-10 of lung tissue in rat tracheal intubation model with biofilm infection of Pseudomonas aeruginosa (Ps. aer wild strain (PAO1 and quorum sensing (QS deficient strain (ΔlasRΔrhlR. Methods  Twenty-one SD rats were randomly assigned into 3 groups (7 each: ΔlasRΔrhlR-treated group, PAO1-treated group and sterile control group. Biofilms (BF were cultured in vitro, and the BF coated tube (infected respectively with Ps. aer PAO1 strain, ΔlasRΔrhlR strain, or with asepsis was inserted into the trachea to establish the rat model. The rats were sacrificed on the 7th day after intubation. Colony count of lung tissue homogenate (cfu and lung HE staining were performed, and IL-10 content in bronchoalveolar lavage fluid (BALF, TGF-β1 in lung tissue, and the expression of Foxp3 mRNA in lung cells were determined. Results  The bacterial counts were significantly higher in PAO1 and ΔlasRΔrhlR groups than that in sterile control group, and the counts were obviously higher in PAO1 group (10 400.00±6313.70/g lung tissue than that in ΔlasRΔrhlR group (975.00±559.97/g lung tissue, P<0.05. There was no significant pathological changes in lung tissue in sterile control group, while the bronchi and blood vessels in PAO1 group were infiltrated by a large number of inflammatory cells and complicated with alveolar septum thickening and local abscess and necrosis. The pathological changes were milder in ΔlasRΔrhlR group than in PAO1 group; the expression of Foxp3 mRNA was higher in the two Ps. aer infected groups than that in sterile control group (0.65±0.32, and it was significantly higher in PAO1 group (4.62±1.07 than in ΔlasRΔrhlR group (2.15±1.43, P<0.05. The accumulated optical density value of TGF-β1 was significantly higher in the two Ps. aer infected groups than in sterile control group (3721.66±1412.95, and significantly higher in PAO1 group (65 090.56±33

  18. Effects of artesunate on the expression level of TLR-4 and TGF-β with asthma rats%青蒿琥酯对哮喘大鼠肺组织TLR-4及TGF-β1表达的影响

    Institute of Scientific and Technical Information of China (English)

    黄发军; 詹光杰; 张宏


    Objective To analyze the therapeutic effect of artesunate on the expression of TLR-4 and TGF-P in asthma rats.Methods The asthma model was established by ovalbumin (OVA) sensitizing-challenging SD rats. Thirty-two rats were randomly divided into four groups: the control group, the asthma model group, the dexamethasone treating group and artesunate treating group. The anti-asthmatic effects were assessed by histopathological examination and Western blot was applied to analyze the expression of TLR-4 and TGF-p" in lung tissues.Results In asthma group, the membrana mucosa plica became multiple, the thickness of airway smooth muscle increased. A great quantity of EOS infiltrated to membrana mucosa, bronchi wall and pulmonary alveoli. Inflammatory reactions of dexamethasone treating group and artesunate treating groups were obviously extenuated. The expression levels of TLR-4 and TGF-P in artesunate treating group were reduced.Conclusion Artesunate can release asthma through decreasing the expression of TLR-4 and TGF-P 1.%目的 通过对大鼠肺组织中Toll样受体4(TLR-4)和转化生长因子β1 (TGF-β1)表达影响的研究及对大鼠肺组织病理形态的观察,评价青蒿琥酯对哮喘大鼠的药理作用.方法 清洁级SD雄性大鼠32只,随机分为对照组、哮喘组、地塞米松组和青蒿琥酯组,采用激发和雾化吸入的方法建立哮喘模型.观察各组大鼠肺组织病理改变;取相关组织分别进行外周血白细胞计数、肺泡灌洗液(BALF)白细胞计数;Western blot法和RT-PCR法检测TLR-4和TGF-β1蛋白表达情况.结果 与哮喘组相比较,青蒿琥酯组大鼠肺部组织的炎症细胞浸润较少,肺泡的组织结构较为完整;外周血和BALF白细胞计数结果表明,青蒿琥酯组各项指标与哮喘组比较均有所改善;在蛋白水平上,青蒿琥酯组TLR-4和TGF-β1蛋白表达均下降.结论 青蒿琥酯逆转哮喘大鼠组织病理变化,降低TLR-4蛋

  19. Hibridación in situ del virus respiratorio syncytial bovino en pulmón de cordero a diferentes tiempos postinfección Bovine respiratory syncytial virus in-situ hybridization from sheep lungs at different times postinfection

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    were slaughtered 1,3,7,11 and 15 postinoculation days (PID. Bronchial and bronchiolar epithelial cells were positive for BRSV nucleic acid by ISH at 1, 3, 7 and 11 PID. However, alveolar epithelial cells contained positive hybridization signals cells at 1,3 and 7 PID. Cells containing viral RNA were detected from 1 to 11 PID, in exudate within bronchial and bronchiolar lumina; and from 3 to 7 PID in alveolar exudates. Positive hybridization signals were identified in interstitial mononuclear cells and in bronchi associated lymphoid tissue from 3 to 11 PID. The highest signal intensity of positive cells were observed at 3 and 7 PID, coinciding with high virus antibodies titres and with the most important histopathological findings

  20. Retrospective epidemiological study of the X-Ray exposure

    Energy Technology Data Exchange (ETDEWEB)

    Ivanov, E. V.; Kalnitsky, S. A.; Shubic, V. M.


    proved differences in disease and mortality cancer among people younger than 40 years old. The maximum values and differences were performed by lung, trachea, bronchi, stomach, thyroid and breast cancer, and also by skin neoplasm, i. e. the most irradiated organs in the process of X-ray exposure. There are no statistically proved differences in rarely irradiated organs (prostate etc.). Thrice repeated rise of malignant neoplasms of hogemonic tissues should be specially pointed out. The considerable part of these neoplasms are lecucaemias, some types of which are usually connected by researches with radiation influence. The analysis of the correlation between X-ray doses,saved for 50 years, and cancer demonstrated the high degree of their relation. We cant absolutely reject the influence of other negative ecological factors on the rise of the observed cancer in the regions taken. Nevertheless, the uniformity of conditions there and the similarity of general disease rate witness against that. Thus the findings enable us to presume the possible relation between the rise of disease and mortality cancer in a region and the high level of X-ray exposure.

  1. SPLUNC1基因在人体组织中的表达分布特征%Expressions of short palate, lung and nasal epithelium clone 1 in different human tissues

    Institute of Scientific and Technical Information of China (English)

    王爽; 李文路; 吕丽春; 姚开泰


    Objective To examine the expression patterns of short palate, lung and nasal epithelium clone 1 (SPLUNC1) gene in human tissues. Methods In situ hybridization was used to detect the expression of SPLUNC1 gene in 37 different human tissues. Results We found that SPLUNC1 gene was not expressed in squamous epithelial cells of the palate, epidermis, esophagus, or the esophagus-cardia junction, metaplastic squamous cells in the nasopharynx, trachea, or uterus cervix, or tumor cells of esophageal squamous cell carcinoma or lung squamous cell carcinoma. SPLUNC1 gene was not expressed in the single layer columnar epithelia cells in the stomach, gallbladder, jejunum, colon, endometrium, or uterus cervix. SPLUNC1 expression was detected mainly in pseudostratified columnar epithelial cells in the nasopharynx, trachea and bronchi, and was gradually down-regulated from the upper to lower end of the respiratory tract, but was not detected in the lung tissues. SPLUNC1 expression was detected not only in the duct and serous gland cells in the parotid and submandibular glands, but also in cells of submucosal serous glands in the nasopharynx and lung, but not in the cells of the mucosal glands. The parietal cells of the gastric submucosa and epithelial cells of the lobula and ducts of the mammary glands expressed SPLUNC1. The adenocarcinoma cells in the lung, stomach, colon, mammary gland, uterus endometrium and cervix showed strong expressions of SPLUNC1 gene. Conclusion SPLUNC1 expression is highly cell-specific in association with the cell functions.%目的:探讨人SPLUNC1基因在人体组织中的表达分布特征。方法采用原位杂交方法检测人体37种组织中SPLUNC1基因的细胞学定位。结果原位杂交结果显示:SPLUNC1在上腭、表皮、食管及食管-贲门部的鳞状上皮,鼻咽部、气管、宫颈部化生的鳞状上皮及食管和肺的鳞状细胞癌中均不表达;在胃粘膜、胆囊、空肠、结肠、子宫内膜及腺体

  2. 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

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    Daniela S. Rajão


    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

  3. The application value of 64 layers CT low-dose scanning technology in the chest check%64层螺旋 CT低剂量扫描技术在胸部检查中的应用价值

    Institute of Scientific and Technical Information of China (English)

    陈绵荣; 陈志远; 吴辉


    Objective Through this research we aimed to explore the application value of 64 layers CT low-dose scanning technology in the chest check.Methods Totally 84 cases of people, who received chest examination by 64 layers CT for medical examination in our hospital during July 2014 and July 2016, were selected as the research objects, according to random number table method all selected objects were divided into low dose group, forty cases in each group.The people in low dose group received low dose 64 layers CT scan, those in routine dose group adopted regular doses of 64 layer CT scan, comparing the diagnosed rate of chest lesions of the two dose groups.Results The diagnosis rate of low dose group was 92.00%, and it was 92.50%of the conventional dose group, the difference between the two groups has no statistical significance (P>0.05). Image quality of both low dose group and conventional dose group are excellent, air-filled bronchi, pleural adhesion, spicule sign, sign of lobulation, nodular density cavity, uneven and calcification can clear display in both groups.Conclusions Diagnose rate of routine dose 64 spiral CT scans was equal to that of low dose 64 spiral CT scans.Compared to conventional treatment, low dose scan can reduce the radiation hazards, reduce the loss of the ball tube, has important application value in clinical.%目的:通过本研究探讨64层螺旋CT低剂量扫描技术在胸部检查中的应用价值。方法选取2013年7月至2016年7月期间在本院行胸部64层螺旋CT检查的80例体检者作为研究对象,按照随机法将所有入选对象分为低剂量组与常规剂量组(各40例),低剂量组行低剂量64层螺旋CT扫描,常规剂量组行常规剂量64层螺旋CT扫描,比较两种剂量对胸部病变的诊出率。结果两组分别经低剂量和常规剂量64层螺旋CT扫描诊断后,低剂量组诊出率为92.00%,常规剂量组诊出率为92.50%,两组间诊出率比

  4. Effects of simvastatin on airway inflammation and airway mucus hypersecretion in rats with chronic obstructive pulmonary disease%辛伐他汀对慢性阻塞性肺疾病模型大鼠气道炎症和气道黏液高分泌的防治作用及其机制

    Institute of Scientific and Technical Information of China (English)

    王胜; 熊玲玲; 邓雪; 任薇; 朱春冬; 李春颖; 周群


    ,减轻气道炎症和气道黏液高分泌.%Objective To explore the preventive and therapeutic effects of simvastatin on rats with chronic obstructive pulmonary disease (COPD) and examine the mechanism of airway inflammation and airway mucus hypersecretion.Methods The rat model of COPD was established by cigarette smoking and an intratracheal injection of lipopolysaccharide (LPS).A total of 18 male Sprague-Dawley rats were randomly divided into control,COPD and simvastatin groups (n =6 each).The control and COPD groups received normal saline once daily via intragastric administration (i.g.) while the simvastatin group had simvastatin (0.5 g/L) 1 ml/100 g once daily via i.g.Pulmonary function was tested and pathological changes in bronchus and lung were observed.The bronchoalveolar lavage fluid (BALF) levels of interleukin-8 (IL-8),interleukin-17 (IL-17) and tumor necrosis factor (TNF)-α were measured by enzyme-linked immunosorbent assay (ELISA).The protein expressions of intercellular adhesion molecule 1 (ICAM-1),nuclear factor κB (NF-κB),mucin 5AC (MUC5AC) and Toll-like receptor 4 (TLR4) in rat airway were detected by immunohistochemical staining.The mRNA and protein expressions of TLR4 and MUC5AC in bronchi and lung tissue were detected by fluorescent real time quantitative polymerase chain reaction (RT-PCR) and Western blot.Results The changes of bronchi and lung tissues in COPD group were consistent with typical pathological manifestations of COPD.As compared with the COPD group,the degree of pulmonary pathological damage and the decline of pulmonary function in the simvastatin group were significantly lessened,but still remarkable as compared with the control group.The BALF levels of IL-8,IL-17 and TNF-α in the smvastatin group [(484.4 ± 11.1),(78.9 ± 2.0),(192.7 ± 2.0) ng/L] were significantly lower than those in the COPD group [(605 ±48.7),(89.9 ±6.9),(212.6 ± 10.7) ng/L],but still higher than those in the control group [(341.2 ± 21.4),(56.0 ± 2

  5. Establishment and Improvement of SD Rat Model of Left Lung Transplantation%SD 大鼠左肺移植模型的建立与改进

    Institute of Scientific and Technical Information of China (English)

    戴斌; 唐建; 吴起才; 黄磊; 古亮


    SD rats weighing 300-350 g were used in this study.Among them,60 were used as donors and acceptors(acceptors were slightly larger than donors,and weight difference did not exceed 20 g),and 30 as controls.Three-cuff method was used for the anastomosis of left pulmona-ry arteries,veins and bronchi to establish the rat model of left lung transplantation.Pulmonary venous blood was collected 48 hours after transplantation for blood gas analysis in acceptors,as well as in controls.Donor lung harvesting time,cuffing time and transplant time were recorded, and blood circulation and inflation situation of the transplanted lung were observed.Results Lung transplantationwere completed in 30 rats.Among them,the transplantation was successful in 27,and failed in 3(pulmonary vein tear in 1,weaning failure in 1,and pulmonary artery torsion in 1).The donor lung harvesting time,cuffing time and anastomosis time were(13.5±2.0),(15.5± 2.5)and(18.5±4.0)minutes,respectively.The time for dissociating arteries,veins and bronchi in the left lung hilum,suturing and ligating was(19.2±2.0)minutes.After opening pulmonary arteries and veins successively,the lobe of transplanted lung showed a uniform ruddy color with sufficient blood perfusion,good venous filling and unobstructed venous return.After restoring mechanical ventilation,all the rats undergoing successful transplantation had good lung inflation. At 48 hours after left lung transplantation,PO2 and PCO2 were,respectively,(8.55±0.97)and (6.20±0.88)kPa in controls,and(7.88±0.84)and(6.67±1.09)kPa in acceptors after right hi-lus was clipped for 5 minutes.The difference in PO2 ,but not in PCO2 ,was significant between the two groups(P <0.05).Conclusion The improved lung transplantation technique can provide a stable,reliable and repeatable animal model for lung transplantation-related research.

  6. Toll 样受体2介导的 JNK 信号分子在小鼠支气管哮喘发病中的作用机制%Mechanism of c-Jun N-terminal kinase mediated by Toll like receptor 2 in murine asthma

    Institute of Scientific and Technical Information of China (English)

    沈佩婷; 方磊; 吴惠梅; 沈启英; 何芳; 刘荣玉


    asthma group,HE-staining showed more obvious inflammatory cell infiltration around bron-chi and airway smooth muscle hyperplasia than the other three groups. The relative protein expressions were meas-ured by mean absorbance(mA). Immunohistochemistry indicated that mean absorbance values of TLR2 was signifi-cantly higher in C57 asthma group than those of C57 control group (P < 0. 01). There was no obvious difference of JNK protein expression between each group. The immunoexpression of P-JNK in C57 asthma group was notablely higher than those of C57 control group, TLR2 - / - asthma group, TLR2 - / - control group (F = 43. 261,P < 0. 01). Conclusion TLR2-mediated JNK signaling molecules may be involved in the process of murine asthma.

  7. Exposure assessment of particulates originating from diesel and CNG fuelled engines

    Energy Technology Data Exchange (ETDEWEB)

    Oravisjaervi, K.; Pietikaeinen, M.; Keiski, R. L. (Univ. of Oulu, Dept. of Process and Environmental Engineering (Finland)). email:; Voutilainen, A. (Univ. of Kuopio, Dept. of Physics (Finland)); Haataja, M. (Oulu Univ. of Applied Sciences (Finland); Univ. of Oulu, Dept. of Mechanical Engineering (Finland)); Ruuskanen, J. (Univ. of Kuopio, Dept. of Environmental Sciences (Finland)); Rautio, A. (Univ. of Oulu, Thule Inst. (Finland))


    given mass, and the surface may be able to act as a catalyst for specific reactions with cells or as a carrier for co-pollutants. They also penetrate deeper into the lungs. Hydrocarbons, as lipid soluble compounds, can also penetrate the cell membranes of the lung cells, enter into the blood circulation and influence the whole organ system, even reach the brain. The aim of this study was to compare children's exposure to diesel and compressed natural gas (CNG) exhaust particulates, which have been formed and then distributed into the human lung. Particulate measurements were carried out in the Technical Research Centre of Finland for two Euro 2 diesel buses with an oxidation catalyst on one and a partial-DPF catalyst on the other vehicle (DI-OC and DI-pDPF, respectively), and one Euro 3 natural gas bus with an oxidation catalyst on the vehicle (CNG-OC). For the evaluation of particulate emissions in an urban bus route the Braunschweig City Driving Cycle, a transient chassis dynamometer test cycle was used. Particulate number size distributions were measured using an Electric Low Pressure Impactor (ELPI) instrument (Dekati Ltd, Finland) with the size range of 7 nm to 10 mum. The ELPI measurement system yields particulate number concentrations in 12 nonoverlapping size bins covering the whole measurement size range. Estimation of deposited particles into human lung system was computed with a lung deposition model based on a ICRP 66 lung deposition model published by the International Commission on Radiological Protection (ICRP). The model includes specific information related to the subjects (including age, ventilation rate, breathing pattern, gender). The respiratory tract is divided into five main deposition regions: the anterior nasal region (ET1), the main extra thoracic region (ET2, including the posterior nasal region, mouth, pharynx and larynx), the bronchial region (BB, consisting of the trachea and bronchi), the bronchiolar region (bb, consisting of the

  8. 严重胸部撞击伤后肺泡细胞NIX表达与肺泡细胞凋亡的关系及意义%Relationship of NIX expression with pulmonary alveolus apoptosis after severe thoracic collision injury

    Institute of Scientific and Technical Information of China (English)

    黄一; 闵家新; 陈小波; 吴秋平


    Objective To explore the relationship between the mRNA and protein expressions of NIX and the pulmonary alveolus apoptosis following severe acute lung injury (ALI). Methods Rat models of severe collision injury on the chest were built.The mRNA and protein expressions of NIX in the alveolar cells at 6,12,24,48,72 and 96 hours after injury were detected using immunohistochemistry,immunoblotting and RT-PCR.Meanwhile,apoptosis of the alveolar cells was checked at different time points with Tunel assay. Results The protein expression of NIX in the alveolar cells was observed both in experimental and control groups,which increased at 6 h post injury,peaked at 48 h and then declined till approaching the pre-injury level at 96 h.In the meantime,NIX showed a high expression both in the vascular endothelial cells (VECs) and the renal interstitial fibroblasts.The apoptosis of alveolar cells mainly presented in bronchi,blood vessel endothelium (BVE) and alveolar epithelium at 24 h post injury.The post-injury apoptosis rate of the alveolar cells was significantly higher than the pre-injury rate ( P < 0.01 ),which reached the peak at 72 h and then decreased gradually.The changes of NIX protein in lung tissue showed a positive correlation with the apoptosis rate of alveolar cells after injury (r =0.303,P < 0.01 ). Conclusions The up-regulated expression of NIX takes part in the pathophysiological process of apoptosis of the alveolar cells and shows consistency with the apoptosis rate change of the alveolar cells,as may be the molecular basis for apoptosis of the alveolar cells after ALI.%目的 探讨急性肺损伤(acute lung injury,ALI)后肺泡细胞的NIX基因及蛋白表达水平与创伤后肺泡细胞凋亡的关系及意义. 方法 建立大鼠严重胸部撞击伤模型,利用免疫组化、免疫印迹、RT-PCR等分子生物学技术分别检测创伤后6,12,24,48,72,96 h肺泡细胞NIX基因及其蛋白表达,通过Tunel试剂盒检测各时相点的肺

  9. Paramyxovirus Infection Mimics In Vivo Cellular Dynamics in Three-Demensional Human Bronchio-Epithelial Tissue-Like Assemblies (United States)

    Deatly, Anne M.; Lin, Yen-Huei; McCarthy, Maureen; Chen, Wei; Miller, Lynn Z.; Quiroz, Jorge; Nowak, Becky M.; Lerch, Robert A.; Udem, Stephen A.; Goodwin, Thomas J.


    , cotton rat, guinea pig, ferret, and hamster) fail to accurately imitate viral replication and human disease states (8). Lacking an authentic model has impeded the development and evaluation of live, attenuated vaccine candidates. Development of a physiologically relevant in vitro tissue culture model that reproduces characteristics of the HRE, the primary target of RSV and PIV3, would aid in predicting clinical attenuation and safety of vaccine candidates. Successful tissue engineering of a 3D human intestinal model using novel NASA technology inspired the development of a tri-culture 3D model for the HRE. Sequential layering of primary mesenchymal cells (comprised of normal human fibroblasts and endothelial cells) followed by BEAS-2B epithelial cells derived from human bronchi and tracheae were recapitulated on Cultisphere and/or cytodex3 microcarriers in cylindrical vessels that rotate horizontally creating an organized epithelial structure. Horizontal rotation randomizes the gravity vector modeling aspects of microgravity. Mesenchymal and epithelial cells grown under these conditions reproduce the structural organization, multi-cellular complexity, and differentiation state of the HRE. The opportunity to study respiratory viruses in a nasal epithelium model is invaluable because the most promising respiratory virus vaccine candidates are live attenuated viruses for intranasal administration. Here we characterize the interactions of respiratory viruses and epithelial cells grown under modeled microgravity in comparison to gravity-ladened monolayers. 3D HBE TLAs and traditional monolayers (2D) are infected at 35 C, the upper temperature of the upper HRE, to simulate in vivo infection conditions. Growth kinetics of wild type (wt) RSV and PIV3 viruses were compared in 2D and 3D cells to that of strains attenuated in humans or rhesus macaques. This novel 3D HBE model also offers an opportunity to study whether the epithelial cell function, especially in host defenses

  10. 重组腺病毒气管途径反复转染大鼠肺组织人类eNOS基因的转导效果%Efficiency of transduction of recombinant adenovirus-mediated human endothelial nitric oxide synthase gene into lung tissue by repeated intratracheal transfection in rats

    Institute of Scientific and Technical Information of China (English)

    周锦; 曹惠鹃; 张铁铮; 金强; 王俊科


    Objective To investigate the efficiency of transduction of recombinant adenovirus-mediated human endothelial nitric oxide synthase (eNOS) into lung tissue by repeated intratracheal transfection in rats.Methods Sixty 3-4 month old male Wistar rats weighing 220-280 g were randomly divided into 2 groups:control group (group C,n =10) and eNOS gene transduction group (group T,n =50).The animals were anesthetized with intraperitoneal 10% chloral hydrate 35 mg/kg,tracheally intubated and mechanically ventilated (VT 2.5 ml,RR 60 bpm,FiO2 1.0).Recombinant adenovirus carrying human eNOS gene was given as gift by Professor Gerard from Texas University,Southwest Medical Center.In group T 50 μl of the recombinant adenovirus in concentration of 5 × 109 PFU/ml was instilled into trachea every 5 minutes for 12 times,while in group C equal volume of vector conservation solution was instilled instead.Pulmonary arterial blood samples were obtained at 2,5,7,14 and 21 d after intratracheal transfection (n =10 at each time point) for determination of serum NO concentration.The animals were immediately sacrificed after blood sample collection for determination of expression of eNOS protein in the lung tissue and RNA.The eNOS expression in the trachea,bronchus,lung,liver,spleen and kidney was detected by immuno-histochemistry.Results The serum NO concentrations were significantly higher at all time points in group T than in group C.The eNOS expression was detected in the epithelial cells of trachea and bronchi,and endothelial cells of alveoli and pulmonary blood vessels in group T but not in group C.eNOS expression was not detected in liver,spleen and kidney at 7 d after intratracheal transfection in group T.Conclusion Human eNOS gene mediated by recombinant adenovirus was transducted into rat lung tissue with normal enzyme activity by repeated intratracheal administration without being detected in distant organs.%目的 重组腺病毒气管途径反复转染大鼠肺组织人类内

  11. 小鼠胚胎气道平滑肌发育的形态学观察%Morphological observation on the development of the airway smooth muscle in mouse embryos

    Institute of Scientific and Technical Information of China (English)

    曹锡梅; 杨艳萍; 李海荣; 景雅


    Objective To investigate the developmental pattern of the airway smooth muscle in mice and the expression characteristics of different muscle-specific proteins. Methods Serial sections of mouse embryos from embryonic day 10 (ED10) to embryonic day 18 (ED18) were stained with monoclonal antibodies against α-SMA, α-SCA and Desmin. Results With the foregut gradually separating into trachea and esophagus, α-SMA positive cells were detected in the posterior wall of the initial segment of the trachea at ED12 and the expression intensity was tapered off towards the caudal segment. A few a-SMA and a-SCA positive cells were observed in the mesenchyme surrounding the developing pulmonary vein. At ED13, the expression intensity of α-SMA in the posterior wall of the trachea became stronger, while the very weaker expression of α-SCA and Desmin was only initiated. At ED14, strong α-SMA expression showed C-shaped patterns in the wall of the left and right bronchi. However, staining intensity of a-SCA and Desmin at the same segment was weaker than that of α-SMA. In addition, the muscle cells of the pulmonary vein showed strong expression of α-SMA. At ED15 , α-SMA positive cells were found in the wall of small bronchioles. Between ED17 and ED18, with progression towards the terminal bronchioles, expression intensity of a-SCA and Desmin became weaker in trie airway smooth muscle while the expression of a-SMA became stronger. Conclusion The development of the airway smooth muscle begins from the upper segment of the trachea at ED12 and gradually extends distally. At ED18 , airway smooth muscle cells have extended to the terminal bronchioles. The expression of Desmin marks the formation of smooth muscle cytoskeleton structures and implies the further maturation of the airway smooth muscle. Besides, it may help airway smooth muscle to improve peristaltic contraction function with the slow shortening speed. The appearance of the airway smooth muscle precedes the pulmonary vein

  12. Repouso da junção neuromuscular no tratamento de crises miastênicas e colinérgicas Management of the myasthenic and cholinergic crisis by neuromuscular junction rest

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    J. Lamartine de Assis


    second group, in addition to this management, were submitted to prolonged curarization by galamine (Flaxedil by intramuscular injection; all of them presented an initial curare supersensitivity which always decreased shortly. In both methods the reinstitution of the drug therapy was progressive. The respirator weanned of progressively and the patients were kept under observation for adequate ventilation. The doses were variable but subsequent doses of antimyasthenic medications were determined by clinical findings and response to the tensilon or prostigmine tests. The doses were increased or decreased accordingly in each individual case, rapid changes of drug doses to perfect adjustment being undesirable in this transition period. Partial or temporary remission occurred in some patients. Others were able to sustain satisfactory ventilation for a long period or definitively. Most of the crisis improved and most of the patients benefited from the therapeutic method of the neuromuscular junction rest. There was a remarkable reduction in the mortality rate from the crisis. One patient had a thymoma which was malignant; in spite of this the evolution of this case has been good after the treatment. Those patients who had immediate good response to the treatment of the crisis had a favorable fellow up, even a complete remission. Respiratory infections were very common in spite of all cares. Culture of tracheal secretions and wound exsudates were made. Bactericidal and broad-spectrum antibiotics were used, depending of the laboratory report cf patient's sensitivity. Physiotherapy besides other prophylactic measures was used against bronchopneumonia. Atelectasis was a common complication in the crisis and all efforts to prevent it were made, including daily clinical examination of pulmonary conditions, Vt,, blood pressure and bed side chest films. The routine use of atropine sulfate promoved inspissation of bronchial secretions, plugging of the bronchi, and attendant atelectasis

  13. 三维适形放疗对80岁以上老年食管癌患者的疗效与安全性评价%The safety and efficacy of 3DCRT in treating elderly patients with esophageal carcinoma

    Institute of Scientific and Technical Information of China (English)

    李德凡; 杨帆; 蒋淑年; 徐秀娟; 严庆芳


    /28), and partial response was 75% (21/28). All patients had improved post-treatment functions status compared with base-line, in regard of physical function, role function, emotional function, cognitive function, social function and overall symptoms, with significant difference (P<0.001). Acute adverse events were mainly radiation esophagitis and bronchi-tis, which were reversible; advanced adverse events included 1 case of esophageal stenosis and 3 cases of radiation pneumonitis. Conclusion 3DCRT is effective in short term and well tolerated in esophageal cancer patients aged over 80, and most patients have achieved symptom remission as well as quality of life improvement.

  14. Effects of selective lobar ventilation on intrapulmonary shunt and inflammatory response in patients with pulmonary dysfunction during thoracotomy%选择性肺叶通气对肺功能不全患者开胸术中肺内分流及炎性反应的影响

    Institute of Scientific and Technical Information of China (English)

    周清河; 肖旺频; 安尔丹; 周红梅; 沈颖彦


    Objective To investigate the effects of selective lobar ventilation on intrapulmonary shunt and inflammatory response in patients with pulmonary dysfunction during thoracotomy.Methods Thirty-four ASA Ⅱ or Ⅲ patients,aged 64-79 yr,weighing 50-85 kg,with moderate and severe impaired pulmonary function,scheduled for esophageal cancer radical correction,were randomly divided into 2 groups( n =17 each): one-lung ventilation group (group A) and selective lobar ventilation group (group B).In group A,endobronchial blocker tube was used to obstruct bronchus principalis and practice one-lung ventilation.In group B,endobronchial blocker tube was used to obstruct bronchi lobares and practice selective lobar ventilation.The blood samples were taken from arteria radialis and internal jugular vein for blood gas analysis and determination of the plasma concentrations of TNF-α,IL-6 and IL-8 by ELISA before anesthesia induction(T0 ),at 30 min following two-lung ventilation at lateral position (T1),at 60 min following one-lung ventilation or selective lobar ventilation (T2) and at the end of surgery (T3).Ppeak and Plat.were recordeded at the same time.Results The incidence of hypoxemia was significantly lower in group B (0) than in group A(18% )( P <0.05).Compared with group A,Pplat and Ppeak at T1-3,Qs/Qt at T2,TNF-α,IL-6 and IL-8 concentrations at T2-3 were significantly decreased in group B( P < 0.05 ).Conclusion The selective lobar ventilation can reduce intrapulmonary shunt,inhibit inflammatory response to help lessen mechanical ventilation related lung injury during thoracotomy in patients with pulmonary function.%目的 评价选择性肺叶通气对肺功能不全患者开胸术中肺内分流和炎性反应的影响.方法 择期行食管癌根治术患者34例,年龄64~79岁,体重50~85 kg,ASA分级Ⅱ或Ⅲ级,合并中重度肺功能不全,采用随机数字表法,将其随机分为2组(n=17):单肺通气组(A组)和选择性肺叶通气组(B组).A组患

  15. Ectopic corticotroph syndrome

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    Penezić Zorana


    carcinoids, it might be called ectopic corticotroph syndrome. In contrast, when it is caused by aggressive, poorly differentiated tumors, with much lower expression of V3 receptor, like SCCL, it might be called aberrant ACTH secretion syndrome. Carcinoid tumors have been reported in a wide range of organs but most commonly involve the lungs, bronchi, and gastrointestinal tract. They arise from neuroendocrine cells and are characterized by positive reactions to markers of neuroendocrine tissue, including neuron specific enolase, synaptophysin, and chromogranina [11]. Carcinoid tumors are typically found to contain numerous membrane-bound neurosecretory granules composed of variety of hormones and biogenic amines. One of the best characterized is serotonin, subsequently metabolized to 5-hydrohy-indolacetic acid (5-HIAA, which is excreted in the urine. In addition to serotonin, carcinoid tumors have been found to secrete ACTH, histamine, dopamine, substance P, neurotensin, prostaglandins and kallikrein. The release of serotonin and other vasoactive substances is thought to cause carcinoid syndrome, which manifestations are episodic flushing, weezing, diarrhea, and eventual right-sided valvular heart disease. These tumors have been classified as either well-differentiated or poorly differentiated neuroendocrine carcinomas. The term „pulmonary tumorlets" describes multiple microscopic nests of neuroendocrine cells in the lungs [12]. Pulmonary carcinoids make up approximately 2 percents of primary lung tumors. The majority of these tumors are perihilar in location, and patients often presents with recurrent pneumonia, cough, hemoptisis, or chest pain. The carcinoid syndrome occurs in less than 5 percent of cases. Ectopic secretion of ACTH from pulmonary carcinoid accounts for 1 percent of all cases of Cushing's syndrome. They are distinct clinical and pathologic entity, generally peripheral in location. Although they are usually typical by standard histologie criteria, they have

  16. Smoking status in lung cancer patients of a coal mine and clinical analysis%某煤矿肺癌患者吸烟状况与临床分析

    Institute of Scientific and Technical Information of China (English)

    江勇; 张志平; 罗义根; 肖新明


    Objective To investigate and analyze the smoking status, dust contact history,clinical features and survival status in the patients with lung cancer among the coal mine workers so as to provide reference for the prevention and treatment of lung cancer. Methods 169 patients with lung cancer among the workers of Jiangxi Fengcheng Coal Mine from January 2006 to December 2009 were selected,among them,119 cases of smoking history were taken as the observation group and 50 cases of non-smoking history were taken as the control group. The dust contact history,pneumoconiosis history,history of chronic bronchi-tis,tuberculosis history,gender and age structure and genetic factors were compared between the two groups. The clinical features and survival status were analyzed. Results In Fengcheng coal mine workers,the age group of 60-70 years old had the high inci-dence of lung cancer,the onset age in the observation group was smaller than that in the control group ,the difference was statisti-cally significant(P<0.01);the most of lung cancer patients in the two groups had the dust exposure history ,the majority of individu-als with smoking and dust contact history were easier to suffer from pneumoconiosis ,chronic bronchitis and pulmonary tuberculo-sis;cough was the commonest symptom in the lung cancer patients of the two groups ,the proportion of emaciation patients in the observation group was higher than that in the control group,the difference was statistically significant (P<0.01). The survival rate in the control group was significantly higher than that in the observation group with statistically significant difference (P<0.01). Con-clusion Cigarette smoking is the major cause of lung cancer ,the dust exposure and pneumoconiosis histories are positively cor-related with lung cancer occurrence,smoking control is an effective measure for preventing lung cancer and increasing the survival rate.%目的:调查和分析煤矿职工肺癌患者的吸烟状况、粉尘接触

  17. 牦牛胎儿肺脏发育的形态学研究%Morphological study on the lung of the fetal yak

    Institute of Scientific and Technical Information of China (English)

    杨琨; 余四九; 何俊峰; 崔燕


    Lung tissue from 40 yak fetuses of different age groups were collected to investigate their development process u-sing histological and histochemical methods. The aim is to provide morphological data on developmental biology and find the hypoxia adaptive structure of the lung in yak fetus. The results showed that the developmental period of yak lung can be divided into five stages. (1) Embryologic stage (30-50 days) : a lung bud was found. Its branches formed into the primary bronchi, and then into the lobar bronchus. The bud had the pseudostratified columnar epithelium. (2) Pseudoglandular stage (50-120 days) : the bronchial tree clearly developed and its terminal bud shaped like the gland. The bud possessed the pseudostratified columnar epithelium. (3) Canalicular stage (120-180 days) ; the respiratory region has rapidly grown, no glandular structure is found in terminal buds. There were many tubular branches with the single-walled columnar epithelium or cuboid epithelium. (4) Saccular stage (180 -220 days) : terminal sac (original alveolar) was formed by the ridge of dissepiment, and a few primitive alveoli epithelia differentiated into flat type Ⅰ alveolar cells and cubical type Ⅱ alveolar cells. (5) Alveolar stage (220 -260 days) ; the alveolus was formed. Much of the epithelium differentiated into flat type I alveolar cells and cubical type Ⅱ alveolar cells. We concluded from the present study that the epithelium of bronchial and terminal buds were full of glycogen in the Embryologic stage and the Pseudoglandular stage, and beginning from the Canalicular stage, the glycogen declined sharply. Several epithelium cells in the air conductivity portion were positive for PAS in the later stages. The developmental process of lung in yak fetuses is similar to that in cattle, although the yak has a longer saccular stage and a shorter alveolar stage. The results suggest that the lung of yak fetus matures even earlier than that of cattle.%本实验选取40份不

  18. 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

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    M. Antònia Barceló


    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.


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    Borshchevskiy GI


    Full Text Available 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 administered antimicrobial preservatives, which is especially important for medicines as aqueous solutions. Because microbial contamination can cause infection of the patient or damage to the finished product, antimicrobial preservatives are designed to prevent microbial contamination of the finished medicinal product during storage and use, especially in the case of multi-container packaging. Rationale of composition and technology of spray “Efial” was conducted by us using physical, chemical and technological methods. An important task in creating new medicines is the study of preservatives choice. The aim of this work is to test the effectiveness of antimicrobial preservatives of spray “Efial”. Material & methods The object of the test – “Efial”containing preservatives on the lower: series 10814 (holding inoculated samples at a temperature of 20-25 º C and series 10914 (holding inoculated samples at 2-8 º C. Materials: 1. Nutrient medium: soy-casein agar, sabourodextrose agar. 2. Solutions: buffer solution of sodium chloride and peptone pH =7.0, containing 50 g/l of polysorbate-80, 5 g/l of lecithin, 1 g/l of histidine hydrochloride. Test-microorganisms: Staphylococcus aureus ATCC 6538; Pseudomonas aeruginosa ATCC 9027; Candida albicans ATCC 10231; Aspergillus brasiliensis АТСС 16404. Preparation of inoculums was carried by State Pharmacopoeia of Ukraine, p. 5.1.3. Results & discussion The checks of methods for determining total viable microorganisms

  20. To observe the clinical effect of Pulmicort Respules atomizing air compressor pump and oxygen drive atomizationtreatment of infant bronchiolitis%普米克令舒空气压缩泵雾化与氧气驱动雾化治疗较小婴儿毛细支气管炎的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    梁光明; 伍建平


    Objective:To explore the clinical effect of application of Pulmicort Respules:Atomizing air compressor pump and oxygen drive atomization treatment of infant bronchiolitis caused by smaller, more effective method for the treatment of clear .Methods:Bronchi-olitis is small in our hospital as the research objects and were divided into two groups , based on the received the same conventional treat-ment, the control group were treated with Pulmicort Respules air compressor pump atomizing inhalation therapy , the study group were trea-ted with Pulmicort oxygenatomization inhalation therapy .Comparing the clinical efficacy of two groups of children .Results: After treat-ment , the study group with wheezing , coughing , wheezing , wet rales disappearance time were significantly less than the control group , the hospitalization time was significantly less than that in the control group , the differences were statistically significant (P<0.05).The two groups before treatment in children with respiratory rate were higher , after treatment , the study group were decreased , respiratory rate was significantly lower than the control group(P<0.05);the two groups before treatment, the blood oxygen saturation was low, after treat-ment were increased,the study group was significantly higher than the control group (P<0.05).Conclusion: With the application of Pulmicort Respules inhalation therapy compared with air compressor pump , small for bronchiolitis infants , Pulmicortinhalation therapy effect is better, can significantly improve the blood oxygen saturation of children , help childrenrecover as soon as possible , which has great popularization and application value .%目的:探索分析应用普米克令舒空气压缩泵雾化以及氧气驱动雾化治疗较小婴儿毛细支气管炎所产生的临床作用和效果,明确更有效的治疗方法。方法:选择我院收治的毛细支气管炎较小患儿作为研究对象并进行分组治疗,在接受相同常规

  1. 茶多酚对哮喘大鼠气道炎症和气道重塑的干预研究%The Effects of Tea Polyphenols on Airway Inflammation and Airway Remodeling in Asthmatic Rats

    Institute of Scientific and Technical Information of China (English)

    杨青; 王尧; 李里香; 况九龙


    目的:研究茶多酚(TP)对支气管哮喘大鼠早期和晚期气道氧化应激水平及气道炎症、气道重塑的影响.方法:48只大鼠随机分对照组、哮喘组、早布地奈德(BUD)组、晚BUD组、早TP组和晚TP组,每组8只.早BUD组、早TP组在造模前2周药物干预,晚BUD组、晚TP组在造模5周后药物干预.造模12周时观察各项指标.测定支气管壁的平滑肌面积、胶原沉积面积,以及肺组织转化生长因子-β1 (TGF-β1)的表达.测定肺组织TGF-β1含量、丙二醛(MDA)含量及超氧化物歧化酶(SOD)活力.结果:早TP组、晚TP组、早BUD组干预后支气管壁平滑肌面积、胶原沉积面积和TGF-β1含量较哮喘组均有改善(P<0.05或P<0.01).晚BUD组较哮喘组无明显改善(P>0.05).哮喘组肺组织中MDA含量明显上升,SOD活性显著下降,与对照组比较差异有统计学意义(P<0.01);各药物干预后SOD活性均上升,MDA含量均下降,以早TP组最明显(P<0.01).SOD活性与MDA含量呈负相关,TGF-β1含量与MDA含量呈正相关.结论:茶多酚可能通过清除氧自由基,减少气道炎症及氧化应激,从而改善或延缓气道重塑的发生.%Objective: To observe the effects of tea polyphenols (TP) on oxidative stress level, airway inflammation and airway remodeling of early stage and late stage in asthmatic rats. Methods: Forty-eight rats were randomly divided into 6 groups, normal saline group, asthma group, early budesonide (early BUD) group, late BUD group, early TP group and late TP group. Drugs were administrated 2 weeks before sensitizing in early BUD group and early TP group, and administrated 5 weeks after sensitizing in late BUD group and late TP group. The lung tissues were harvested from rats 12 weeks after sensitizing. The smooth muscle area, collagen deposition area and the expression of transforming growth factor-β1 (TGF-βl) were assessed in bronchi and lung tissues. The contents of TGF-β1, malondialdehyde (MDA) and

  2. Inhaled different Concentrations of Budesonide in Early Phase Interfere in Airway Inflammation and Remodeling in Asthmatic Rats%早期吸入不同浓度布地奈德对哮喘大鼠气道炎症和重构的干预

    Institute of Scientific and Technical Information of China (English)

    梁蕊; 金寿德; 邵玉霞; 张新; 刘立杰; 荣海芳


    Objective: To investigate the effect of inhaled different concentrations of budesonide in early phase on the airway inflammation and remodeling in asthmatic rats. Methods: Thirty-two rats were randomly divided into 4 groups: group A (n=8,control with saline), groupB (n=8,asthma with OVA),group C (n=8, asthma with OVA treated with low concentrations of budesonide in early phase), group D (n=8, asthma with OVA treated with high concentrations of budesonide in early phase). The bronchoalveolar lavage fluids (BALF) were classification in BALF studied in each group . The pathologic alteration of the bronchi and lung tissue was observed by HE staining. Expression of NGF and TGF-β1 were detected by immunohistochemistry, collagen deposition by Masson staining. The Morphological parameters including the number of inflammatory cell per unit airway area, bronchial basement membrane perimeter (Pbm), smooth muscle area( Wam), inner airway area( Wai), collagen area( Wcol) by computer image analysis software. Results: The total cell counts and the percentage of EOS in BALF the level of TNF-α , ET-1 increased compared with group A (P<0.01), group C and D reduced significantly compared with group B (P<0.01). The expression of NGF and TGF-β1, inflammatory cell counts around bronchus, airway smooth muscle hypertrophy ,the collagen deposition of reticular basement, airway inner wall area were significant higher than those groupA( P<0.01), the data in group C and D were significant lower than those in group B(P<0.01), there were apparent difference between group C and group D compared with group A (P<0.05,P<0.01). The difference between group C and group D.(P<0.05,P<0.01) Conclusion: Inhaled different concentrations of budesonide in early phase could apparently inhibit airway inflammation and remodeling, high concentrations of budesonide than low concentrations.%目的:研究早期吸入不同浓度布地奈德对哮喘大鼠气道炎症和气道重构的干预情况.方法:32

  3. Clinical features of moderate to severe asthma exacerbation in school-age children%中重度支气管哮喘急性发作学龄期儿童的临床特征

    Institute of Scientific and Technical Information of China (English)

    许巍; 向莉; 申昆玲


    categorized into 2 groups:asthma with pneumonia group(group A,n =88)and asthma group(group B,n = 126). Results There were 214 cases enrolled,the median age was 9(6 - 18) years old,and the male - female ratio was 1. 5: 1. 0,78. 0%(167 / 214 cases)of the patients enrolled had moderate asthma exacerbation,and 22. 0%(47 / 214 cases)were defined as severe episodes,7. 0%(15 / 214 cases)were on me-chanical ventilation. Compared with group B,group A had more systemic corticosteroids use(53. 4% vs 38. 9% ,χ2 =4. 416,P = 0. 036),higher proportion of cases needing mechanical ventilation(12. 5% vs 3. 3% ,χ2 = 5. 476,P =0. 019),longer durations in hospital(9. 0 d vs 8. 0 d,Z = - 3. 063,P = 0. 002),and higher hospitalization expenses (10 000 yuan vs 9 000 yuan,Z = - 2. 058,P = 0. 000). The prescription of Aminophylline didn't help to shorten the duration of wheeze days(5. 7 d vs 5. 9 d,t = - 0. 233,P = 0. 817). Twenty - four cases received bronchial lavage through bronchoscope during wheezing days,in which 22 cases(91. 7% )of wheezing disappeared within 3 days after the lavage. There were more sensitized allergens detected in those patients who showed hypersecretion status under bronchos-copy(3. 3 ±1. 4 vs 2. 2 ±1. 2,t =2. 190,P =0. 036),compared with those without such signs. Conclusions Pneumonia may increase the demand for systemic use of corticosteroids in asthma exacerbations. The early use of systemic corticoste-roids may have an effect on reducing the severity of asthma attack,especially those with pneumonia. Multi - sensitization may contribute to the hypersecretion in bronchi. The bronchial lavage may help improve the bronchial ventilation caused by mucous plugin. The clinical usage of Aminophylline is still controversial,and it needs to be optimized.

  4. Emergency treatment of endobronchial stent placement for serious main bronchial stenosis following high-risk orthotopic heart allotransplantation: One case report%高风险原位同种异体心脏移植术后支气管狭窄的急诊支架置入治疗:1例报告

    Institute of Scientific and Technical Information of China (English)

    赵永祥; 欧阳文; 朱岳; 赵玲玲; 单忠贵; 唐琪; 阳玲; 范钦明; 易波; 廖崇先; 周志明


    , which resulted in the aggravation of illness. In order to improve the post-transplant cardiac function, to relieve bronchial collapse and stenosis, and correct the obstructive type of ventilation, an emergency bronchial stent placement surgery was carried out on the sixth day after heart transplantation. Under monitoring of electrocardiogram (EGG) and percutaneaous oxygen saturation (SpO2), patient was awake and in supine to relieve left main bronchial stenosis with a nickel-titanium shape memory alloy stent (Diameter: 12 mm; length: 20 mm) by D20 fiberoptic bronchoscope. Fibrobronchoscopy was used to observe the proximal end of bronchostenosis and set the proximate location mark by using video fluoroscopy; the patency of distal end was explored by stricture, and set the distal location mark; guidewire was inserted into working path of bronchofibroscope and led through the stricture; then loaded the Ni-Ti stent on a special placement apparatus, and led in bronchial stent implantation apparatus along guidewire. When targeting well, the stent was slowly released and adjusted properly. When it was completely released, the stent implantation apparatus was drawn out. Bronchofibroscope was performed postoperatively to observe the adherence of stent; immediately photographed to observe its unfolding. Synchronized intermittent mandatory ventilation (SIMV) was given postoperatively as supportive treatment.MAIN OUTCOME MEASURES: Ameliorations of the cardiac and pulmonary functions of the patient.RESULTS: ①Carbon dioxide retention and hypercapnia were remarkably improved as compared with those preoperatively; hypertensive pulmonary vascular disease was alleviated gradually, and MPAP reduced to 30 mm Hg. One week later, re-examination of bronchofibroscopy was carried out, and the results showed that bronchi of left upper lobe, lingual lobe as well as left lower lobe could be seen distinctly, mucous membrane had slightly congested edema, and lumens were unobstructed