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Sample records for bronchoalveolar lavage

  1. Diagnostic value of bronchoalveolar lavage in interstitial lung diseases

    NARCIS (Netherlands)

    M. Drent (Marjolein)

    1993-01-01

    textabstractBronchoalveolar lavage (BAL) is currently widely applied to sample cells and proteins present in the bronchoalveolar space for subsequent studies. Moreover, this limited invasive technique is a sensitive indicator of infectious and non-infectious inflammatory disorders, such as interstit

  2. BRONCHIAL LAVAGE AND BRONCHOALVEOLAR LAVAGE IN ALLERGEN-INDUCED SINGLE EARLY AND DUAL ASTHMATIC RESPONDERS

    NARCIS (Netherlands)

    AALBERS, R; KAUFFMAN, HF; VRUGT, B; SMITH, M; KOETER, GH; TIMENS, W; DEMONCHY, JGR

    1993-01-01

    The phenotypic cellular profile of bronchial lavage (BL) and bronchoalveolar lavage (BAL) was studied in 7 single early (SR) and 10 dual asthmatic responders (DR). Lavage was performed, after previously having determined bronchial hyperresponsiveness to histamine and the response to house dust mite

  3. Mycoplasma alkalescens demonstrated in bronchoalveolar lavage of cattle in Denmark

    DEFF Research Database (Denmark)

    Kokotovic, Branko; Friis, Niels F.; Ahrens, Peter

    2007-01-01

    Mycoplasma alkalescens is an arginine-metabolizing mycoplasma, which has been found in association with mastitis and arthritis in cattle. Routine bacteriological examination of 17 bronchoalveolar lavage samples from calves with pneumonia in a single herd in Denmark, identified M. alkalescens...

  4. Mycoplasma alkalescens demonstrated in bronchoalveolar lavage of cattle in Denmark

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    Ahrens Peter

    2007-01-01

    Full Text Available Abstract Mycoplasma alkalescens is an arginine-metabolizing mycoplasma, which has been found in association with mastitis and arthritis in cattle. Routine bacteriological examination of 17 bronchoalveolar lavage samples from calves with pneumonia in a single herd in Denmark, identified M. alkalescens in eight samples. The organism was found as a sole bacterilogical findings in five of the samples as well as in combination with Mannheimia haemolytica, Haemophilus somni and Salmonella Dublin. This is the first report of isolation of M. alkalescens in Denmark.

  5. Bronchoalveolar Lavage Proteomics in Patients with Suspected Lung Cancer

    Science.gov (United States)

    Carvalho, Ana Sofia; Cuco, Célia Marina; Lavareda, Carla; Miguel, Francisco; Ventura, Mafalda; Almeida, Sónia; Pinto, Paula; de Abreu, Tiago Tavares; Rodrigues, Luís Vaz; Seixas, Susana; Bárbara, Cristina; Azkargorta, Mikel; Elortza, Felix; Semedo, Júlio; Field, John K.; Mota, Leonor; Matthiesen, Rune

    2017-01-01

    Lung cancer configures as one of the deadliest types of cancer. The future implementation of early screening methods such as exhaled breath condensate analysis and low dose computed tomography (CT) as an alternative to current chest imaging based screening will lead to an increased burden on bronchoscopy units. New approaches for improvement of diagnosis in bronchoscopy units, regarding patient management, are likely to have clinical impact in the future. Diagnostic approaches to address mortality of lung cancer include improved early detection and stratification of the cancers according to its prognosis and further response to drug treatment. In this study, we performed a detailed mass spectrometry based proteome analysis of acellular bronchoalveolar lavage (BAL) fluid samples on an observational prospective cohort consisting of 90 suspected lung cancer cases which were followed during two years. The thirteen new lung cancer cases diagnosed during the follow up time period clustered, based on liquid chromatography-mass spectrometry (LC-MS) data, with lung cancer cases at the time of BAL collection. Hundred and thirty-tree potential biomarkers were identified showing significantly differential expression when comparing lung cancer versus non-lung cancer. The regulated biomarkers showed a large overlap with biomarkers detected in tissue samples. PMID:28169345

  6. Storage alters feline bronchoalveolar lavage fluid cytological analysis.

    Science.gov (United States)

    Nafe, Laura A; DeClue, Amy E; Reinero, Carol R

    2011-02-01

    Bronchoalveolar lavage fluid (BALF) collection is a valuable respiratory diagnostic procedure in cats. This study evaluated effects of BALF storage on total nucleated cell counts (TNCCs) and differential cell counts (DCC), cell morphology, and cytological diagnosis. Forty-five research cats with neutrophilic, eosinophilic, and mixed inflammation, and healthy controls were enrolled. BALF samples were processed within 1h (baseline) or stored at 4°C (4C24) or room temperature (RT24) for 24h, or 4°C (4C48) or room temperature (RT48) for 48h before processing. Stored BALF at RT48 had decreased TNCC compared to baseline. The RT24 and RT48 samples had greater eosinophil % and the RT24, 4C48, and RT48 samples had decreased neutrophil % compared with baseline. Cellular morphology deteriorated in all stored samples. Storage resulted in a change in cytological diagnosis in up to 57% of stored samples. We conclude that cytological analysis of BALF in cats should be performed promptly for optimal results.

  7. Pneumocystis carinii in bronchoalveolar lavage and induced sputum: detection with a nested polymerase chain reaction

    DEFF Research Database (Denmark)

    Skøt, J; Lerche, A G; Kolmos, H J;

    1995-01-01

    To evaluate polymerase chain reaction (PCR) for detection of Pneumocystis carinii, 117 bronchoalveolar lavage (BAL) specimens, from HIV-infected patients undergoing a diagnostic bronchoscopy, were processed and a nested PCR, followed by Southern blot and hybridization with a P32-labelled probe......, but sensitivity dropped markedly with this system. A further 33 patients had both induced sputum and bronchoalveolar lavage performed and the induced sputum was analysed using PCR and routine microbiological methods. The PCR sensitivity on induced sputum was equal to that of routine methods. At present...... the evaluated PCR cannot replace routine microbiological methods for detection of Pneumocystis carinii, on either BAL fluid or induced sputum....

  8. Pneumocystis carinii in bronchoalveolar lavage and induced sputum: detection with a nested polymerase chain reaction

    DEFF Research Database (Denmark)

    Skøt, J; Lerche, A G; Kolmos, H J;

    1995-01-01

    To evaluate polymerase chain reaction (PCR) for detection of Pneumocystis carinii, 117 bronchoalveolar lavage (BAL) specimens, from HIV-infected patients undergoing a diagnostic bronchoscopy, were processed and a nested PCR, followed by Southern blot and hybridization with a P32-labelled probe...

  9. Severity of acute respiratory distress syndrome resulting from tuberculosis correlates with bronchoalveolar lavage CXCL-8 expression

    NARCIS (Netherlands)

    Adcock, I.M.; Hashemian, S.M.R.; Mortaz, E.; Masjedi, M.R.; Folkerts, G.

    2015-01-01

    Tuberculosis (TB) has previously been linked to acute respiratory distress syndrome (ARDS). Here this study investigates the link between inflammation and TB in ARDS by measuring inflammatory cytokine and chemokine levels in bronchoalveolar lavage (BAL) from 90 patients with TB or ARDS alone and in

  10. Clinical course and complications following diagnostic bronchoalveolar lavage in critically ill mechanically ventilated patients

    OpenAIRE

    Schnabel, R.M.; Velden, K. van der; Osinski, A; Rohde, G.; Roekaerts, P.M.H.J.; Bergmans, D C J J

    2015-01-01

    Background Flexible, fibreoptic bronchoscopy (FFB) and bronchoalveolar lavage (BAL) have been used for diagnostic purposes in critically ill ventilated patients. The additional diagnostic value compared to tracheal aspirations in ventilator-associated pneumonia (VAP) has been questioned. Nevertheless, BAL can provide extra information for the differential diagnosis of respiratory disease and good antibiotic stewardship. These benefits should outweigh potential hazards caused by the invasivene...

  11. Bronchoalveolar lavage in pneumoconiosis of coal miners. Cytologic aspects

    Energy Technology Data Exchange (ETDEWEB)

    Voisin, C.; Gosselin, B.; Ramon, P.; Wallaert, B.; Aerts, C.; Lenoir, L.

    1983-01-01

    The cytological characteristics of broncho-alveolar fluid were studied in 94 coal workers and six subjects exposed to varied risks of silicosis. In coal worker's pneumoconiosis with the usual micronodular or nodular type, there was a significant increase in the cellularity of the peripheral airways compared to non-exposed controls, making allowances for smoking habits. There were no striking changes in the white cell count nor any correlation with the possible elevation in the serum angiotensin I-enzyme conversion level. On the other hand a striking elevation of the alveolar lymphocyte count was noted in three cases with rapidly developing silicosis. Where there was the co-existence of another disorder (connective tissue disorders, sarcoid, extrinsic allergic alveolitis, radiation lung or diffuse interstitial fibrosis) the anomalies noted were those occurring during the progress of the associated disease. At the time of collection the alveolar macrophages in the dust exposed subjects showed a similar vitality to these observed in control subjects. After 24 hours of observation '' in vitro '', the vitality of the cells and their phagocytic and bactericidal activity was markedly diminished.

  12. Rapid diagnosis of gram negative pneumonia by assay of endotoxin in bronchoalveolar lavage fluid.

    Science.gov (United States)

    Pugin, J; Auckenthaler, R; Delaspre, O; van Gessel, E; Suter, P M

    1992-01-01

    BACKGROUND: Diagnosis of ventilator associated pneumonia can be made by quantitative cultures of bronchoalveolar lavage fluid or of protected specimen brushings, though cultures require 24-48 hours to provide results. In 80% of cases aerobic Gram negative bacteria are the cause. METHODS: A rapid diagnostic method of assessing the endotoxin content of lavage fluid by Limulus assay is described. Forty samples of lavage fluid were obtained from patients with multiple trauma requiring mechanical ventilation for a prolonged period. Pneumonia was diagnosed on the basis of clinical, radiological, and bacteriological findings, including quantitative cultures of lavage fluid. RESULTS: A relation was observed between the concentration of endotoxin in lavage fluid and the quantity of Gram negative bacteria. The median endotoxin content of lavage fluid in Gram negative bacterial pneumonia was 15 endotoxin units (EU)/ml; the range observed in individual patients was 6 to > 150 EU/ml. In patients with pneumonia due to Gram positive cocci and in non-infected patients the median endotoxin level was 0.17 (range < or = 0.06 to 2) EU/ml. An endotoxin level greater than or equal to 6 EU/ml distinguished patients with Gram negative bacterial pneumonia from colonised patients and from those with pneumonia due to Gram positive cocci. CONCLUSION: The measurement of endotoxin in lavage fluid is a rapid (less than two hours) and accurate diagnostic method. It should allow specific and early treatment of Gram negative bacterial pneumonia. PMID:1412100

  13. Nonfibrous mineralogical analysis of bronchoalveolar lavage fluid from blast-furnace workers.

    Science.gov (United States)

    Corhay, J L; Bury, T; Delavignette, J P; Baharloo, F; Radermecker, M; Hereng, P; Fransolet, A M; Weber, G; Roelandts, I

    1995-01-01

    Steelworkers are exposed to many pollutants, and they are at risk for developing lung cancer. We demonstrated previously that steelworkers may be subject to an occult exposure to amphiboles in the plant environment. In the current study, we further analyzed bronchoalveolar lavage fluid of steelworkers by measuring intramacrophagic trace-metal content and nonfibrous mineral particles, using the particle-induced x-ray emission method and electron microscopy, respectively. Forty-seven blast-furnace workers and 45 healthy white-collar workers volunteered for this study. Significantly increased levels of iron, titanium, zinc, and bromine were found in the steelworkers, and levels of lead, chromium, arsenic, and strontium tended to increase in the macrophages and bronchoalveolar lavage fluid of the steelworkers. Nonfibrous particles, including illite, kaolinite, talc, chlorite, amorphous silica, quartz, iron (compounds), and titanium hydroxide, were found in both groups, but the particle number per ml bronchoalveolar lavage fluid (particularly iron hydroxides and silicates) was more pronounced in blast-furnace workers. These elements and particles may act synergistically with other occupational carcinogens and cigarette smoke, the result of which may be an increased incidence of lung cancer in the ironsteel industry.

  14. Effect of sodium cromoglycate on light racehorses with elevated metachromatic cell numbers on bronchoalveolar lavage and reduced exercise tolerance.

    Science.gov (United States)

    Hare, J E; Viel, L; O'Byrne, P M; Conlon, P D

    1994-06-01

    Some young horses with clinical signs of small airway disease demonstrate increased metachromatic cell numbers on bronchoalveolar lavage. The purpose of this study was to determine the effect of sodium cromoglycate treatment on clinical signs, bronchoalveolar lavage cytology and bronchoalveolar lavage histamine parameters in these horses. Twelve racehorses (age: 3.4 +/- 1.6 years) with a history of respiratory embarrassment at exercise, clinical signs of obstructive airway disease and bronchoalveolar lavage metachromatic cell differential greater than 2% were selected. Horses were randomly assigned to receive either 200 mg sodium cromoglycate or saline placebo nebulized twice daily for 7 days. A clinical respiratory score was assigned and bronchoalveolar lavage was performed on each animal on days 0 and 7. Measurements were made of the following bronchoalveolar lavage fluid parameters: total nucleated cell concentration, differential cell percentage and concentration, supernatant and lysate histamine concentration, lysate: supernatant histamine ratio and metachromatic cell histamine content. Between the two evaluation periods, sodium cromoglycate treated horses demonstrated an improvement in respiratory score (P = 0.01) and a stabilizing of metachromatic cell histamine content (P = 0.04) when compared with placebo treated horses. We concluded that sodium cromoglycate is effective for the treatment of small airway disease in this population of young racehorses although the pharmacodynamics of this drug in the horse require further investigation.

  15. Influenza A/H1N1 Severe Pneumonia: Novel Morphocytological Findings in Bronchoalveolar Lavage

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    Paola Faverio

    2014-01-01

    Full Text Available We present the results of bronchoalveolar lavage (BAL performed in three patients with severe influenza A/H1N1 pneumonia complicated by acute respiratory distress syndrome (ARDS. Light microscopy analysis of BAL cytocentrifugates showed the presence of characteristic large, mononuclear, plasmoblastic/plasmocytoid-like cells never described before. Via transmission electron microscopy, these cells were classified as atypical type II pneumocytes and some of them showed cytoplasmic vesicles and inclusions. We concluded that plasmoblastic/plasmocytoid-like type II pneumocytes might represent a morphologic marker of A/H1N1 influenza virus infection as well as reparative cellular activation after diffuse alveolar damage.

  16. Influenza A/H1N1 Severe Pneumonia: Novel Morphocytological Findings in Bronchoalveolar Lavage

    Science.gov (United States)

    Faverio, Paola; Messinesi, Grazia; Brenna, Ambrogio; Pesci, Alberto

    2014-01-01

    We present the results of bronchoalveolar lavage (BAL) performed in three patients with severe influenza A/H1N1 pneumonia complicated by acute respiratory distress syndrome (ARDS). Light microscopy analysis of BAL cytocentrifugates showed the presence of characteristic large, mononuclear, plasmoblastic/plasmocytoid-like cells never described before. Via transmission electron microscopy, these cells were classified as atypical type II pneumocytes and some of them showed cytoplasmic vesicles and inclusions. We concluded that plasmoblastic/plasmocytoid-like type II pneumocytes might represent a morphologic marker of A/H1N1 influenza virus infection as well as reparative cellular activation after diffuse alveolar damage. PMID:25383078

  17. Changes of cell factor in bronchoalveolar lavage fluid in rats exposed to silica

    Institute of Scientific and Technical Information of China (English)

    张玮

    2014-01-01

    Objective To investigate the changes in the levels of inflammatory cytokines in bronchoalveolar lavage fluid(BALF)in rats exposed to silica dust.Methods Experimental rats were randomly divided into control group and three experimental groups(doses of dust:15,30,and 60mg/ml),with 42 rats in each group.Each rat in the control group was treated with 1 ml of normal saline by intratracheal instillation,while each rat in the experimental groups was exposed to 1

  18. Evaluation of a multiplex PCR for bacterial pathogens applied to bronchoalveolar lavage.

    Science.gov (United States)

    Strålin, K; Korsgaard, J; Olcén, P

    2006-09-01

    The present study assessed the diagnostic usefulness of a multiplex PCR (mPCR) for Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae and Chlamydophila pneumoniae applied to bronchoalveolar lavage (BAL). Fibreoptic bronchoscopy was performed on 156 hospitalised adult patients with lower respiratory tract infection (LRTI) and 36 controls. BAL fluid was analysed with bacterial culture and mPCR. By conventional diagnostic methods, S. pneumoniae, H. influenzae, M. pneumoniae and C. pneumoniae were aetiological agents in 14, 21, 3.2 and 0% of the LRTI patients, respectively. These pathogens were identified by BAL mPCR in 28, 47, 3.2 and 0.6% of cases, respectively, yielding sensitivities of 86% for S. pneumoniae, 88% for H. influenzae, 100% for M. pneumoniae and 0% for C. pneumoniae, and specificities of 81, 64, 100 and 99% for S. pneumoniae, H. influenzae, M. pneumoniae and C. pneumoniae, respectively. Of the 103 patients who had taken antibiotics prior to bronchoscopy, S. pneumoniae was identified by culture in 2.9% and by mPCR in 31%. Among the controls, mPCR identified S. pneumoniae in 11% and H. influenzae in 39%. In lower respiratory tract infection patients, bronchoalveolar lavage multiplex PCR can be useful for identification of Streptococcus pneumoniae, Mycoplasma pneumoniae and Chlamydophila pneumoniae. The method appears to be particularly useful in patients treated with antibiotics.

  19. Cytological analysis of equine bronchoalveolar lavage fluid. Part 1: Comparison of sequential and pooled aliquots.

    Science.gov (United States)

    Pickles, K; Pirie, R S; Rhind, S; Dixon, P M; McGorum, B C

    2002-05-01

    The aim of this study was to investigate whether initial equine bronchoalveolar lavage fluid (BALF) aliquots were more representative of bronchial cytology that bronchiolar and alveolar cytology. Cell viability and total nucleated (TCC), differential (DCC) and absolute cell counts of cytocentrifuged preparations of 3 sequentially collected BALF aliquots (Aliquots 1-3) were compared with those of pooled BALF (Aliquot 4) to assess whether all aliquots were representative of the lavaged lung segment. BALF samples (n = 21) were collected from control horses (n = 5) or heaves-affected horses (n = 5). There were nonsignificant trends of increasing TCC and absolute macrophage count from Aliquot 1 to Aliquot 3 and significant differences in macrophage (Paliquots of all horses; however, no linear trend in this DCC data was observed. There was a significant decrease in mast cell DCC (PAliquot 1 to Aliquot 3 in control horses. Cell viability did not differ significantly among aliquots. There was no diagnostically significant difference in TCC, DCC, absolute cell counts or cell viability, among sequential and pooled BALF aliquots and, therefore, all aliquots can be considered to represent the cytology of the lavaged lung segment. This indicates that even if BALF recoveries are very low, cytological analysis of samples will be of diagnostic value.

  20. Bronchoalveolar lavage as a tool for evaluation of cellular alteration during Aelurostrongylus abstrusus infection in cats

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    Vitor M. Ribeiro

    2014-10-01

    Full Text Available Bronchoalveolar lavage (BAL is a procedure that retrieves cells and other elements from the lungs for evaluation, which helps in the diagnosis of pulmonary diseases. The aim of this study was to perform this procedure for cellular analysis of BAL fluid alterations during experimental infection with Aelurostrongylus abstrusus in cats. Fourteen cats were individually inoculated with 800 third stage larvae of A. abstrusus and five non-infected cats lined as a control group. The BAL procedure was performed through the use of an endotracheal tube on the nineteen cats with a mean age of 18 months, on 0, 30, 60, 90, 120, 180 and 270 days after infection. Absolute cell counts in the infected cats revealed that alveolar macrophages and eosinophils were the predominant cells following infection. This study shows that the technique allows us to retrieve cells and first stage larvae what provides information about the inflammatory process caused by aelurostrongylosis.

  1. Determination of copper, zinc and iron in broncho-alveolar lavages by atomic absorption spectroscopy.

    Science.gov (United States)

    Harlyk, C; Mccourt, J; Bordin, G; Rodriguez, A R; van der Eeckhout, A

    1997-11-01

    Concentrations of Zn, Cu and Fe were measured in 157 broncho-alveolar lavages (BAL), before and after centrifugation, collected at the Leuven University Hospital (Belgium). Zn was measured by flame-atomic absorption spectroscopy, using direct calibration, while Cu and Fe were determined by electrothermal atomic absorption spectroscopy, using the method of standard additions. For Fe only 56 samples were measured. Most of the studied elements are present in the liquid phase (supernatant). About 90% of Cu concentrations lie between 0 and 15 micrograms/kg, while 90% of Zn concentrations are lower than 230 micrograms/kg, with 30% between 30 and 70 micrograms/kg, and 50% between 100 and 200 micrograms/kg. There seems to be a reverse relationship between Cu and Zn levels with high Cu going along with low Zn and vice versa.

  2. The clinical utility of bronchoalveolar lavage in interstitial lung disease - is it really useful?

    Science.gov (United States)

    Meyer, Keith C

    2014-04-01

    Bronchoalveolar lavage (BAL) can be a very useful tool in the diagnosis of interstitial lung disease, but BAL must be performed properly and the retrieved BAL fluid adequately processed and analyzed to allow accurate conclusions to be drawn from BAL analysis. A differential cell count of nucleated immune cells can show cell patterns that suggest or support certain diagnoses, and other testing (stains and cultures for infectious pathogens, malignant cell cytology) can be performed on BAL fluid that can also aid in diagnosis. When combined with the results of a careful history, physical examination, thoracic imaging, and other pertinent laboratory testing, the BAL analysis may allow a confident diagnosis of a specific interstitial lung disease to be made without proceeding to more invasive testing (e.g., surgical lung biopsy) that is associated with increased risk of complications.

  3. PAS staining of bronchoalveolar lavage cells for differential diagnosis of interstital lung disease

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    Zabel Peter

    2009-04-01

    Full Text Available Abstract Bronchoalveolar lavage (BAL is a useful diagnostic tool in interstitial lunge diseases (ILD. However, differential cell counts are often non specific and immunocytochemistry is time consuming. Staining of glyoproteins by periodic acid Schiff (PAS reaction may help in discriminating different forms of ILD. In addition, PAS staining is easy to perform. BAL cells from patients with idiopathic pulmonary fibrosis (IPF (n = 8, sarcoidosis (n = 9, and extrinsic allergic alveolitis (EAA (n = 2 were investigated. Cytospins from BAL cells were made and cells were stained using Hemacolor quick stain and PAS staining. Lymphocytic alveolitis was found in sarcoidosis and EAA whereas in IPF both lymphocytes and neutrophils were increased. PAS positive cells were significantly decreased in EAA compared to IPF and sarcoidosis (25.5% ± 0.7% vs 59.8% ± 25.1% and 64.0% ± 19.7%, respectively (P

  4. [Cytologic features of bronchoalveolar lavage in evaluation of course of exogenous allergic alveolitis].

    Science.gov (United States)

    Lepekha, L N; Aleksandrova, E A; Evgushchenko, G V; Makar'iants, N N; Lovacheva, O V

    2012-01-01

    Application of complex of modern cytologic methods of research bronchoalveolar lavage allowed to allocate most characteristics of development of lymphocytic and macrophagic reaction of bronchial tree in different course of exogenous allergic alveolitis. The most indicative in assessment of origin of exogenous allergic alveolitis development is the characteristics of macrophagic population. In acute course of exogenous allergic alveolitis the considerable number of young activated and non-activated macrophages, increased number of mature phagocytes is observed. Even more significant increase of phagocytic macrophages is observed at dissemination which is primarily is connected with participation of these cells in lymphocytic apoptosis which takes place in high percentage of lymphocytes (up to 49%). Increased number of mature phagocytes is observed at chronic course of exogenous allergic alveolitis that is an important diagnostic pattern of this option of development of exogenous allergic alveolitis in association with the lowest T-helpers/T-supressors index.

  5. Cell populations recovered by bronchoalveolar lavage in pneumoconiosis of coal miners

    Energy Technology Data Exchange (ETDEWEB)

    Voisin, C.; Wallaert, B.; Ramon, P.; Gosselin, B.; Aerts, C.

    1982-01-01

    Studying the cellular products obtained by broncho-alveolar lavage in 81 patients, 77 coal-miners and 4 other subjects exposed to silicotic risks of various origin, the authors could demonstrate the interest of this new method of exploring the peripheral lung tissues. In 57 cases of usual pneumoconiosis and controls matched for the smoking habits, the repartition of the different cellular types was quite similar. On the contrary, the authors observed an increase of the lymphocytes in three cases of accelerated elution of the pneumoconiosis. Moreover various modifications were noticed in cases with morbid associations as conectivitis, sarcoiedosis, allergic alveolitis, and primitive diffuse interstitial fibrosis as well. At the moment they were collected, the alveolar macrophages of the subjects to dust showed the same properties of vitality and adherence capacity as the controls. After 24 hours of survival their vitality and bacterial activity on Staphylococcus aureus was clearly diminished.

  6. Detection of Mycoplasma hyopneumoniae in bronchoalveolar lavage fluids of pigs by PCR

    DEFF Research Database (Denmark)

    Baumeister, A.K.; Runge, M.; Ganter, Martin;

    1998-01-01

    other mycoplasma species and 17 cell-walled bacterial species colonizing the respiratory tracts of pigs was not amplified. In a field study BALFs from 40 pigs from farms with a history of chronic pneumonia were tested for M. hyopneumoniae by cultivation and by PCR (i) with BALFs incubated in Frus medium......In the present investigation we developed a method for the detection of Mycoplasma hyopneumoniae in bronchoalveolar lavage fluid (BALF) of pigs by PCR with a primer pair flanking a DNA fragment of 853 bp specific for M. hyopneumoniae. Several methods were tested to eliminate the amplification...... inhibitors present in BALFs. The best results were obtained by the extraction of the DNA from the BALFs. By the PCR performed with the extracted DNA, 10(2) CFU of M. hyopneumoniae could be detected in 1 ml of BALF from specific-pathogen-free swine experimentally inoculated with M. hyopneumoniae. DNA from 11...

  7. Endotracheal aspirate and bronchoalveolar lavage fluid analysis: interchangeable diagnostic modalities in suspected ventilator-associated pneumonia?

    Science.gov (United States)

    Scholte, Johannes B J; van Dessel, Helke A; Linssen, Catharina F M; Bergmans, Dennis C J J; Savelkoul, Paul H M; Roekaerts, Paul M H J; van Mook, Walther N K A

    2014-10-01

    Authoritative guidelines state that the diagnosis of ventilator-associated pneumonia (VAP) can be established using either endotracheal aspirate (ETA) or bronchoalveolar lavage fluid (BALF) analysis, thereby suggesting that their results are considered to be in accordance. Therefore, the results of ETA Gram staining and semiquantitative cultures were compared to the results from a paired ETA-BALF analysis. Different thresholds for the positivity of ETAs were assessed. This was a prospective study of all patients who underwent bronchoalveolar lavage for suspected VAP in a 27-bed university intensive care unit during an 8-year period. VAP was diagnosed when ≥ 2% of the BALF cells contained intracellular organisms and/or when BALF quantitative culture revealed ≥ 10(4) CFU/ml of potentially pathogenic microorganisms. ETA Gram staining and semiquantitative cultures were compared to the results from paired BALF analysis by Cohen's kappa coefficients. VAP was suspected in 311 patients and diagnosed in 122 (39%) patients. In 288 (93%) patients, the results from the ETA analysis were available for comparison. Depending on the threshold used and the diagnostic modality, VAP incidences varied from 15% to 68%. For the diagnosis of VAP, the most accurate threshold for positivity of ETA semiquantitative cultures was moderate or heavy growth, whereas the optimal threshold for BALF Gram staining was ≥ 1 microorganisms per high power field. The Cohen's kappa coefficients were 0.22, 0.31, and 0.60 for ETA and paired BALF Gram stains, cultures, and BALF Gram stains, respectively. Since the ETA and BALF Gram stains and cultures agreed only fairly, they are probably not interchangeable for diagnosing VAP.

  8. High levels of sulfated mucins in bronchoalveolar lavage fluid of ICU patients with ventilator-associated pneumonia.

    NARCIS (Netherlands)

    Dennesen, P.; Veerman, E.; Nieuw Amerongen, A. van; Jacobs, J.; Kessels, A.G.H.; Keijbus, P. van den; Ramsay, G.; Ven, A.J.A.M. van der

    2003-01-01

    OBJECTIVE: To compare the levels of sulfated mucins in bronchoalveolar lavage fluid (BALF) in ICU patients with ventilator-associated pneumonia (VAP) with those in non-infectious controls, i.e., ventilated ICU patients without VAP, and nonventilated patients. DESIGN AND SETTING: Prospective study in

  9. Lung malignancy: Diagnostic accuracies of bronchoalveolar lavage, bronchial brushing, and fine needle aspiration cytology

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    Rateesh Sareen

    2016-01-01

    Full Text Available Background: Early diagnosis of lung cancer plays a pivotal role in reducing lung cancer death rate. Cytological techniques are safer, economical and provide quick results. Bronchoscopic washing, brushing and fine needle aspirations not only complement tissue biopsies in the diagnosis of lung cancer but also comparable. Objectives: (1 To find out diagnostic yields of bronchioalveolar lavage , bronchial brushings, FNAC in diagnosis of lung malignancy. (2 To compare relative accuracy of these three cytological techniques. (3 To correlate the cytologic diagnosis with clinical, bronchoscopic and CT findings. (4 Cytological and histopathological correlation of lung lesions. Methods: All the patients who came with clinical or radiological suspicion of lung malignancy in two and a half year period were included in study. Bronchoalveolar lavage was the most common type of cytological specimen (82.36%, followed by CT guided FNAC (9.45% and bronchial brushings (8.19%. Sensitivity, specificity, positive and negative predictive value for all techniques and correlation with histopathology was done using standard formulas. Results: The most sensitive technique was CT FNAC – (87.25% followed by brushings (77.78% and BAL (72.69%. CT FNAC had highest diagnostic yield (90.38%, followed by brushings (86.67% and BAL (83.67%. Specificity and positive predictive value were 100 % each of all techniques. Lowest false negatives were obtained in CT FNAC (12.5% and highest in BAL (27.3%. Highest negative predictive value was of BAL 76.95 % followed by BB 75.59% and CT FNAC 70.59%. Conclusion: Before administering antitubercular treatment every effort should be made to rule out malignancy. CT FNAC had highest diagnostic yield among three cytological techniques. BAL is an important tool in screening central as well as in accessible lesions. It can be used at places where CT guided FNAC is not available or could not be done due to technical or financial limitations

  10. [Fiber bronchoscopy and bronchoalveolar lavage in patients with asthma. A description of the method].

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    Pedersen, B; Dahl, R

    1989-11-27

    Fiber bronchoscopy under local anaesthesia is an examination procedure frequently employed in the remainder of Scandinavia, Europe and USA. It requires only few resources and the costs are considerably less than fiber bronchoscopy under general anaesthesia. Bronchoalveolar lavage (BAL) in connection with fiber bronchoscopy is rapidly undertaken but analysis of the material obtained requires considerable time. A method of induction of local anaesthesia, performance of BAL and preparation of the washings obtained is described. Fiber bronchoscopy and BAL are considered to be safe examination procedures in patients with mild asthma in a stable phase. The examination is only associated with slight discomfort for the patients, who will frequently accept repeated investigations, and complications are rare. BAL is a valuable examination procedure in research and the results have increased the knowledge of mechanisms in a series of interstitial pulmonary diseases. Future investigations of the humoral and cellular components in BAL fluid in asthmatic patients will contribute to increase knowledge of the pathological mechanisms in asthmatic disease.

  11. Metastatic prostatic adenocarcinoma diagnosed in a bronchoalveolar lavage specimen: An unusual presentation of a common tumor

    Directory of Open Access Journals (Sweden)

    Adrienne E Moul

    2016-01-01

    Full Text Available Metastatic prostatic adenocarcinoma presenting as a primary lung disease is rare. We present a 52-year-old male with a 3-month history of cough, shortness of breath, and weight loss with clinical and radiological findings suggestive of a primary lung disease: Bilateral interstitial and alveolar opacities with blunting of the costophrenic angles, multiple diffuse foci of consolidations and nodules, predominantly subpleural and located in the lower lobes, and diffuse interlobular septal thickening and peribronchial thickening. The patient underwent bronchoscopy and bronchoalveolar lavage (BAL was obtained. Cytospin smears were diagnostic for a low-grade adenocarcinoma. Clinically, the patient had elevated serum prostate-specific antigen (PSA levels greater than 5,000 ng/mL. Because of this, immunocytochemistry for PSA was performed which was positive, confirming the diagnosis of metastatic prostatic adenocarcinoma. This unusual case of metastatic adenocarcinoma of the prostate first diagnosed by BAL highlights the significance of available clinical information and the use of immunocytochemistry for proper diagnosis.

  12. [Microbiological results of bronchoalveolar lavage that was performed for opportunistic pulmonary infections].

    Science.gov (United States)

    Gülcü, Aylin; Sevinç, Can; Esen, Nuran; Kilinç, Oğuz; Uçan, Eyüp Sabri; Itil, Oya; Cimrin, Arif Hikmet; Kömüs, Nuray; Sener, Gülper; Akkoçlu, Atila; Gülay, Zeynep; Yücesoy, Mine

    2006-01-01

    Between 2001-2002; in 62 cases, 33 (53%) male, 29 (47%) female, mean age 51.4 +/- 18.1 years) bronchoalveolar lavage (BAL) was performed for diagnosis of opportunistic pulmonary infection and specimens were evaluated for results of microbiological examinations. There was hematological malignancy in 18 (29%) and solid organ malignancy in 13 (21%) cases. Thirty-one (50%) cases were immunocompromised for reasons other than malignancy. By endoscopic evaluation endobronchial lesion was seen in 2 (3%) cases, indirect tumor signs were seen in 2 (3%) cases and signs of infection were seen in 11 (18%) cases. Forty-even (76%) cases were endoscopically normal. Acid-fast bacilli (AFB) direct examination was positive in 3 (5%) cases. In 4 (6%) cases mycobacterial culture was positive, Mycobacterium tuberculosis-polymerase chain reaction (PCR) was also positive in these four cases. Examination of gram-stained smears for bacteria was associated with infection in 14 (23%) cases. Bacteriologic cultures were positive for single potential pathogen in 10 (16%) cases, and for mixed pathogens in 7 (11%) cases for a total number of 17 (27%). Fungal cultures were positive in 3 (5%) cases all of which had hematological malignancy. As a result in 24 (39%) cases microbiological agent of infection is determined: in four mycobacteria, in 17 bacteria other than mycobacteria and in three fungi.

  13. Proteomic analysis of bronchoalveolar lavage fluid proteins from mice infected with Francisella tularensis ssp novicida

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    Varnum, Susan M.; Webb-Robertson, Bobbie-Jo M.; Pounds, Joel G.; Moore, Ronald J.; Smith, Richard D.; Frevert, Charles; Skerret, Shawn J.; Wunschel, David S.

    2012-07-06

    Francisella tularensis causes the zoonosis tularemia in humans and is one of the most virulent bacterial pathogens. We utilized a global proteomic approach to characterize protein changes in bronchoalveolar lavage fluid from mice exposed to one of three organisms, F. tularensis ssp. novicida, an avirulent mutant of F. tularensis ssp. novicida (F.t. novicida-ΔmglA); and Pseudomonas aeruginosa. The composition of BALF proteins was altered following infection, including proteins involved in neutrophil activation, oxidative stress and inflammatory responses. Components of the innate immune response were induced including the acute phase response and the complement system, however the timing of their induction varied. Francisella tularensis ssp. novicida infected mice do not appear to have an effective innate immune response in the first hours of infection, however within 24 hours they show an upregulation of innate immune response proteins. This delayed response is in contrast to P. aeruginosa infected animals which show an early innate immune response. Likewise, F.t. novicida-ΔmglA infection initiates an early innate immune response, however this response is dimished by 24 hours. Finally, this study identifies several candidate biomarkers, including Chitinase 3-like-1 (CHI3L1 or YKL-40) and peroxiredoxin 1, that are associated with F. tularensis ssp. novicida but not P. aeruginosa infection.

  14. Bronchoalveolar lavage for evaluation and management of scleroderma disease of the lung.

    Science.gov (United States)

    Behr, J; Vogelmeier, C; Beinert, T; Meurer, M; Krombach, F; König, G; Fruhmann, G

    1996-08-01

    Fibrosing alveolitis (FA) is a frequent and often fatal complication of systemic sclerosis (SSC). Alveolar inflammation has been recognized as a primary event in the pulmonary manifestation of SSC. To evaluate the significance of the alveolitis in SSC, we performed bronchoalveolar lavage (BAL) and correlated the generated data with changes in lung function over time. Seventy nine SSC patients with pulmonary involvement were followed for 56.8 +/- 3.1 wk (mean +/- SEM) with a repeat lung function test at the end of the follow-up period. During follow-up, 38 patients were treated with a systemic immunosuppressive regimen. For evaluation, patients were assigned to two groups according to whether their BAL cell differential was normal (inactive BAL) or abnormal (active BAL: i.e., polymorphonuclear leukocytes > 5% and/or lymphocytes > 15%). Active BAL was associated with more severe lung function impairment than was inactive BAL, and patients with active BAL deteriorated during follow-up if untreated. In contrast, treated patients with active BAL stabilized or improved. In summary, active alveolitis as characterized by BAL is associated with progressive pulmonary disease in SSC patients, and a significant positive effect of immunosuppressive therapy on the course of pulmonary disease was observed in patients with active BAL.

  15. Molecular and Culture-Based Bronchoalveolar Lavage Fluid Testing for the Diagnosis of Cytomegalovirus Pneumonitis.

    Science.gov (United States)

    Tan, Susanna K; Burgener, Elizabeth B; Waggoner, Jesse J; Gajurel, Kiran; Gonzalez, Sarah; Chen, Sharon F; Pinsky, Benjamin A

    2016-01-01

    Background.  Cytomegalovirus (CMV) is a major cause of morbidity and mortality in immunocompromised patients, with CMV pneumonitis among the most severe manifestations of infection. Although bronchoalveolar lavage (BAL) samples are frequently tested for CMV, the clinical utility of such testing remains uncertain. Methods.  Retrospective analysis of adult patients undergoing BAL testing via CMV polymerase chain reaction (PCR), shell vial culture, and conventional viral culture between August 2008 and May 2011 was performed. Cytomegalovirus diagnostic methods were compared with a comprehensive definition of CMV pneumonitis that takes into account signs and symptoms, underlying host immunodeficiency, radiographic findings, and laboratory results. Results.  Seven hundred five patients underwent 1077 bronchoscopy episodes with 1090 BAL specimens sent for CMV testing. Cytomegalovirus-positive patients were more likely to be hematopoietic cell transplant recipients (26% vs 8%, P definition, the sensitivity and specificity of PCR, shell vial culture, and conventional culture were 91.3% and 94.6%, 54.4% and 97.4%, and 28.3% and 96.5%, respectively. Compared with culture, PCR provided significantly higher sensitivity and negative predictive value (P ≤ .001), without significantly lower positive predictive value. Cytomegalovirus quantitation did not improve test performance, resulting in a receiver operating characteristic curve with an area under the curve of 0.53. Conclusions.  Cytomegalovirus PCR combined with a comprehensive clinical definition provides a pragmatic approach for the diagnosis of CMV pneumonitis.

  16. Occult exposure to asbestos in steel workers revealed by bronchoalveolar lavage

    Energy Technology Data Exchange (ETDEWEB)

    Corhay, J.-L.; Delavignette, J.-P.; Bury, T.; Saint-Remy, P.; Radermecker, M.-F. (CHU, Liege (Belgium))

    To investigate the asbestos burden in a steelplant environment, we counted asbestos bodies (ABs) in the bronchoalveolar lavage fluid (BALF) of 65 steel workers who had retired during the previous 5 y. They had worked for at least 15 y in the same area of the plant (coke oven or blast furnace) as maintenance or production workers. On the basis of occupational anamnesis, 28 had occasional past professional exposure to asbestos; the remaining 37 workers denied any contact with asbestos. A total of 54 white-collar workers who had no occupational exposure to asbestos were included in the study as controls. An increased prevalence and concentration of ABs was found in the BALF of steel workers. Electron microscopy and EDAX analysis of AB from steel workers revealed that the core fibers were mainly amphiboles. More ABs were found in the BALF of maintenance workers than in production workers. However, the BALF from steel workers who denied any contact with asbestos revealed an increased AB burden v. controls. This demonstrates that steel workers may be subject to an occult exposure to amphiboles in the steelplant environment.

  17. Mycological evaluation of bronchoalveolar lavage in cats with respiratory signs from Rio de Janeiro, Brazil.

    Science.gov (United States)

    Leme, L R P; Schubach, T M P; Santos, I B; Figueiredo, F B; Pereira, S A; Reis, R S; Mello, M F V; Ferreira, A M R; Quintella, L P; Schubach, A O

    2007-05-01

    Twenty-three cats with respiratory signs who had domiciliary contact with cats with sporotrichosis were studied. Sneezing was the predominant extracutaneous sign. Twelve cats had no skin lesions and 11 had ulcerated skin lesions. Mycological culture of material obtained from the nasal cavity, oral cavity, bronchoalveolar lavage (BAL) and skin lesions, when present, was performed for all cats. In the case of autopsy, lung fragments were cultured. Sporothrix schenckii was isolated from four of the 12 cats without skin lesions: BAL (one cat) and oral and/or nasal cavity (three cats). The latter three animals developed nasal and distant skin lesions within the following 2-4 weeks. The cat with S. schenckii isolated from BAL did not develop skin lesions or lower respiratory tract symptoms during the 6 months of follow-up. S. schenckii was isolated from one or more biological samples of all 11 cats with skin lesions: oral cavity (five), nasal cavity (eight), BAL fluid (four), skin lesions (eight), and blood culture (one). No yeast-like structures were observed upon BAL cytology in any of the 23 cats. The results suggest that S. schenckii can cause infection of skin contiguous to the natural facial orifices through colonisation of the mucosal surfaces of the upper airways.

  18. Sputum is a surrogate for bronchoalveolar lavage for monitoring Mycobacterium tuberculosis transcriptional profiles in TB patients.

    Science.gov (United States)

    Garcia, Benjamin J; Loxton, Andre G; Dolganov, Gregory M; Van, Tran T; Davis, J Lucian; de Jong, Bouke C; Voskuil, Martin I; Leach, Sonia M; Schoolnik, Gary K; Walzl, Gerhard; Strong, Michael; Walter, Nicholas D

    2016-09-01

    Pathogen-targeted transcriptional profiling in human sputum may elucidate the physiologic state of Mycobacterium tuberculosis (M. tuberculosis) during infection and treatment. However, whether M. tuberculosis transcription in sputum recapitulates transcription in the lung is uncertain. We therefore compared M. tuberculosis transcription in human sputum and bronchoalveolar lavage (BAL) samples from 11 HIV-negative South African patients with pulmonary tuberculosis. We additionally compared these clinical samples with in vitro log phase aerobic growth and hypoxic non-replicating persistence (NRP-2). Of 2179 M. tuberculosis transcripts assayed in sputum and BAL via multiplex RT-PCR, 194 (8.9%) had a p-value <0.05, but none were significant after correction for multiple testing. Categorical enrichment analysis indicated that expression of the hypoxia-responsive DosR regulon was higher in BAL than in sputum. M. tuberculosis transcription in BAL and sputum was distinct from both aerobic growth and NRP-2, with a range of 396-1020 transcripts significantly differentially expressed after multiple testing correction. Collectively, our results indicate that M. tuberculosis transcription in sputum approximates M. tuberculosis transcription in the lung. Minor differences between M. tuberculosis transcription in BAL and sputum suggested lower oxygen concentrations or higher nitric oxide concentrations in BAL. M. tuberculosis-targeted transcriptional profiling of sputa may be a powerful tool for understanding M. tuberculosis pathogenesis and monitoring treatment responses in vivo.

  19. Cellular changes in bronchoalveolar lavage fluid in hyperoxia-induced lung injury

    Institute of Scientific and Technical Information of China (English)

    Xinbiao HE; Wei ZHAO

    2008-01-01

    It is well known that high concentration oxy-gen exposure is a model of acute lung injury (ALI). However, controversy exists over the mechanism. This study was designed to clarify the cellular characteristics in bronchoalveolar lavage fluid (BALF) and body weight loss of rats exposed to oxygen(>90%). Young male Wistar rats, aged 6 weeks, were divided into three groups: (1) room air group (exposed to room air, n=22); (2) hyperoxia < 48 h group (exposed to over 90% oxygen for less than 48 h, n=18); (3) hyperoxia 66-72 h group (exposed to over 90% oxygen for 66-72 h group, n=7). Compared to the room air group, the total cell counts in the hyperoxia 66-72 h group decreased, whereas the neu-trophils increased significantly. The body weights of the rats exposed to room air continued to increase. However, the body weights of oxygen-exposed rats increased slightly on the first day and weight loss was seen from the second day. All rats were noted to have bilateral pleural effusion in the hyperoxia 66-72 h group. The data suggests that (1) an increase in neutrophil count is an evident feature of hyperoxia-induced lung injury; (2) high concentration oxygen exposure can give rise to anorexia and malnutri-tion, which may play a role in hyperoxia-induced lung injury. Blocking neutrophil influx into lung tissue in the early phase and improving malnutrition are two effective methods to reduce hyperoxic lung injury.

  20. Bronchoalveolar lavage alterations during prolonged ventilation of patients without acute lung injury.

    Science.gov (United States)

    Tsangaris, I; Lekka, M E; Kitsiouli, E; Constantopoulos, S; Nakos, G

    2003-03-01

    Mechanical ventilation deteriorates previously injured lung, but little is known about its effect on healthy human lung. This work was designed to assess the effect of prolonged mechanical ventilation on bronchoalveolar lavage (BAL) fluid composition of patients without acute lung injury. Twenty-two ventilated patients (tidal volume 8-10 mL x kg(-1), positive end-expiratory pressure 3-5 cmH2O) without lung injury, who did not develop any complication from the respiratory system during the 2-week study period, were studied. They were subjected to three consecutive BALs, the first during 36 h from intubation, the second at the end of the first week of mechanical ventilation and the third at the end of the second week of mechanical ventilation. Total BAL protein increased during mechanical ventilation (148 +/- 62, 381 +/- 288, 353 +/- 215 microg x mL(-1) BAL for the first, second and third BAL, respectively). In contrast, BAL phospholipids decreased (2.7 +/- 1.1, 1.4 +/- 0.6, 1.2 +/- 0.7 microg x mL(-1) BAL, respectively). Large surfactant aggregates were reduced and inflammatory markers, such as platelet activating factor (PAF), PAF-acetylhydrolase and neutrophils, significantly increased after 1 week, but partially remitted after 2 weeks of mechanical ventilation. In summary, this study demonstrates that prolonged mechanical ventilation even of patients without acute lung injury is associated with the presence of inflammatory markers and surfactant alterations.

  1. Amiodarone-induced pulmonary toxicity. Immunoallergologic tests and bronchoalveolar lavage phospholipid content.

    Science.gov (United States)

    Nicolet-Chatelain, G; Prevost, M C; Escamilla, R; Migueres, J

    1991-02-01

    Amiodarone (A) is a widely-used antiarrhythmic drug. Pulmonary toxicity is the most serious adverse effect with an estimated mortality of 1 to 33 percent. In order to determine an element helpful for diagnosis, we examined four patients with amiodarone-induced pulmonary toxicity, three patients treated with A, without evidence of pulmonary toxicity but with a main underlying pulmonary disease, and four healthy volunteers. Daily and cumulative doses or duration of treatment were similar in the first two groups. Pulmonary function tests (spirometry, CO-diffusing capacity, arterial blood gases), roentgenographic examinations, pulmonary biopsies or immunoallergologic tests (skin reaction, lymphoblastic transformation test and human basophile degranulation test) did not provide any discriminatory element. In APT+, we observed an increased cellularity of the bronchoalveolar lavage. Neither the differential cell count nor the presence of foamy macrophages were distinguishable between APT+ and APT-. The phospholipid composition of BAL fluid showed a decreased total phospholipid and phospholipid/protein ratio in all patients compared to normal subjects. These changes reflect more the severity of pulmonary disease than the specificity of the causative agent. However, we observed that the unique PL which decreases in APT- and remains normal in APT+ is phosphatidyl-serine + phosphatidylinositol (PS + PI). This has to be confirmed and should be evaluated at different stages of the disease to determine an eventual specific element. We conclude that there are no data currently available to establish the diagnosis of APT except perhaps for the analysis of BAL PL content.

  2. Sarcoidosis and tuberculosis cytokine profiles: indistinguishable in bronchoalveolar lavage but different in blood.

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    Muhunthan Thillai

    Full Text Available BACKGROUND: The clinical, radiological and pathological similarities between sarcoidosis and tuberculosis can make disease differentiation challenging. A complicating factor is that some cases of sarcoidosis may be initiated by mycobacteria. We hypothesised that immunological profiling might provide insight into a possible relationship between the diseases or allow us to distinguish between them. METHODS: We analysed bronchoalveolar lavage (BAL fluid in sarcoidosis (n = 18, tuberculosis (n = 12 and healthy volunteers (n = 16. We further investigated serum samples in the same groups; sarcoidosis (n = 40, tuberculosis (n = 15 and healthy volunteers (n = 40. A cross-sectional analysis of multiple cytokine profiles was performed and data used to discriminate between samples. RESULTS: We found that BAL profiles were indistinguishable between both diseases and significantly different from healthy volunteers. In sera, tuberculosis patients had significantly lower levels of the Th2 cytokine interleukin-4 (IL-4 than those with sarcoidosis (p = 0.004. Additional serum differences allowed us to create a linear regression model for disease differentiation (within-sample accuracy 91%, cross-validation accuracy 73%. CONCLUSIONS: These data warrant replication in independent cohorts to further develop and validate a serum cytokine signature that may be able to distinguish sarcoidosis from tuberculosis. Systemic Th2 cytokine differences between sarcoidosis and tuberculosis may also underly different disease outcomes to similar respiratory stimuli.

  3. Induced sputum and bronchoalveolar lavage as tools for evaluating the effects of inhaled corticosteroids in patients with asthma.

    Science.gov (United States)

    Nocker, R E; Out, T A; Weller, F R; de Riemer, M J; Jansen, H M; van der Zee, J S

    2000-07-01

    Changes in airway inflammation can be studied with bronchoalveolar lavage, but the widespread use of this procedure is limited by its invasiveness. The aim of this study was to evaluate the usefulness of induced sputum as a non-invasive alternative to bronchoalveolar lavage for studying changes in airway inflammation in patients with asthma. Thirty patients were treated for 12 weeks with an inhaled corticosteroid (fluticasone propionate (FP), 250 microg twice daily) or a short-acting beta-agonist (salbutamol (Sb), 400 microg twice daily) in a double-blind, double-dummy, randomized parallel group study. Sputum induction with hypertonic saline solution was performed twice before treatment and after 4, 8, 10, and 11 weeks of treatment. Bronchoalveolar lavage fluid divided into two pools (first 60 mL portion as bronchoalveolar lavage/bronchial wash (BAL/BW) and subsequent 80 mL as bronchoalveoalar lavage (BAL)) was obtained before and after 12 weeks of treatment. Changes in cell differentials and plasma-protein leakage (alpha2-macroglobulin, albumin, and their ratio (relative coefficient of excretion, RCE)) were analyzed in induced sputum and were compared with changes in BAL/BW and BAL. During treatment with FP, the PC20histamine (interpolated concentration of histamine that caused a fall in FEV1 of 20% of the baseline value) increased (P < .0001), and the percentage of eosinophils (P = .004), levels of (alpha2-macroglobulin (P = .09) and RCE (P = .007) decreased in sputum. These changes were different from those in the Sb group (PC20histamine P< .0001, eosinophils P= .004, alpha2-macroglobulin P= .003, RCE P = .01), in which alpha2-macroglobulin showed a significant increase (P = .015). Changes in the percentage of eosinophils and in the levels of alpha2-macroglobulin in sputum were associated with changes in the PC20histamine (Rs = -0.59, P = .007 and Rs = -0.47, P = .03, respectively). These correlations did not reach significance in BAL/BW and BAL fluid. The

  4. High concentrations of pepsin in bronchoalveolar lavage fluid from children with cystic fibrosis are associated with high interleukin-8 concentrations.

    LENUS (Irish Health Repository)

    McNally, P

    2011-02-01

    Gastro-oesophageal reflux is common in children with cystic fibrosis (CF) and is thought to be associated with pulmonary aspiration of gastric contents. The measurement of pepsin in bronchoalveolar lavage (BAL) fluid has recently been suggested to be a reliable indicator of aspiration. The prevalence of pulmonary aspiration in a group of children with CF was assessed and its association with lung inflammation investigated.

  5. Coinfection of Strongyloides stercoralis and Aspergillus found in bronchoalveolar lavage fluid from a patient with stubborn pulmonary symptoms.

    Science.gov (United States)

    Guo, Jie; Sun, Yi; Man, Yanru; Huang, Xiaochun; Qin, Qin; Zhou, Daoyin; Deng, Anmei

    2015-03-01

    We report a case involving coinfection with Strongyloides stercoralis (S. stercoralis) and Aspergillus found in the bronchoalveolar lavage fluid (BALF) of an elderly male patient who had a medical history of autoimmune pancreatitis (AIP) and who was treated with prednisone therapy 6 months previously. The patient presented with stubborn pulmonary symptoms and signs because of Aspergillus invasion and mechanical destruction caused by larval migration. We found S. stercoralis and Aspergillus in his BALF that provided diagnostic proof.

  6. Peripheral-type benzodiazepine receptors in bronchoalveolar lavage cells of patients with interstitial lung disease

    Energy Technology Data Exchange (ETDEWEB)

    Branley, Howard M. [Imperial College London, Hammersmith Campus, W12 OHS London (United Kingdom)]. E-mail: howard.branley@whittington.nhs.uk; Bois, Roland M. du [Royal Brompton Hospital, SW3 6NP London (United Kingdom); Wells, Athol U. [Royal Brompton Hospital, SW3 6NP London (United Kingdom); Jones, Hazel A. [Imperial College London, Hammersmith Campus, W12 OHS London (United Kingdom)

    2007-07-15

    Introduction: PK11195 is a ligand with high affinity for peripheral benzodiazepine receptors (PBRs), which are present in large numbers in macrophages. PBRs play a role in antioxidant pathways and apoptosis, key factors in control of lung health. Intrapulmonary PBRs, assessed in vivo by positron emission tomography (PET), are decreased in interstitial lung disease (ILD) despite increased macrophage numbers. We wished to ascertain whether the observed decrease in in vivo expression of PBRs in the PET scans could be accounted for by a reduction in PBRs per cell by saturation-binding assays of R-PK11195 in cells obtained by bronchoalveolar lavage (BAL). Methods: We performed receptor saturation-binding assays with [{sup 3}H]-R-PK11195 on a mixed population of cells recovered by BAL to quantify the number of R-PK11195 binding sites per macrophage in 10 subjects with ILD and 10 normal subjects. Results: Receptor affinity [dissociation constant (Kd)] was similar in ILD patients and controls. However, R-PK11195 binding sites per cell [(maximal binding sites available (B {sub max})] were decreased in macrophages obtained by BAL from subjects with ILD compared to normal (P<.0005). Microautoradiography confirmed localization of R-PK11195 to macrophages in a mixed inflammatory cell population obtained by BAL. Conclusion: These results demonstrate that in vitro PBR expression per cell on macrophages obtained by BAL is reduced in patients with ILD indicating a potentially functionally different macrophage phenotype. As PBRs are involved in the orchestration of lung inflammatory responses, this finding offers further insight into the role of macrophages in the pathogenesis of ILDs and offers a potential avenue for pharmacological strategy.

  7. Eicosanoids in Exhaled Breath Condensate and Bronchoalveolar Lavage Fluid of Patients with Primary Lung Cancer

    Directory of Open Access Journals (Sweden)

    Maciej Ciebiada

    2012-01-01

    Full Text Available Although eicosanoids are involved in lung carcinogenesis they were poorly investigated in exhaled breath condensate (EBC and bronchoalveolar lavage fluid (BALf in patients with primary lung cancer. In this study 17 patients with diagnosed non-small cell lung cancer, 10 healthy smokers and 12 healthy nonsmokers were included. The levels of cys-LTs, 8-isoprostane, LTB4 and PGE2 were measured before any treatment in the EBC of all patients and in BALf of patients with lung cancer by enzyme linked immunosorbent assay. 8-isoprostane, LTB4, cys-LTs and PGE2 were detectable in the EBC and BALf. There were no significant differences between healthy smokers and nonsmokers in concentrations of all measured mediators. Compared with both healthy controls, patients with diagnosed lung cancer displayed higher concentrations of cys-LTs (p < 0.05 and LTB4 (p < 0.05 in EBC. In patients with lung cancer, the mean concentrations of all measured mediators were significantly higher in BALf compared with EBC and there was a significant, positive correlation between concentration of cys-LTs, LTB4 and 8-isoprostane in BALf and their concentrations in the EBC (r = 0.64, p < 0.05, r = 0.59, p < 0.05, r = 0.53, p < 0.05 respectively. Since cys-LT, LTB4 and 8-isoprostane concentrations in EBC from patients with lung cancer reflect their concentrations in BALf, they may serve as a possible non-invasive method to monitor the disease and to assess the effectiveness of therapy.

  8. The Diagnosis of Invasive and Noninvasive Pulmonary Aspergillosis by Serum and Bronchoalveolar Lavage Fluid Galactomannan Assay

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    Shuzhen Zhang

    2015-01-01

    Full Text Available The incidence and mortality of invasive pulmonary aspergillosis (IPA are rising, particularly in critically ill patients and patients with severe chronic obstructive pulmonary disease (COPD. Noninvasive aspergillosis occurring in these patients requires special attention because of the possibility of developing subsequent IPA, given the poor health and worsened immune state of these patients. We compared the performance of the Platelia galactomannan (GM enzyme immunoassay in the bronchoalveolar lavage fluid (BALF and serum. The sensitivity, and specificity of BALF-GM were 85.4% and 62.4%, and those of serum-GM were 67.9% and 93.5% at the cutoff index of 0.5. As the cutoff index increased, the specificity of BALF-GM detection was increased with the detriment of sensitivity. The area under the ROC curves was 0.817 (95% CI: 0.718–0.916 for BALF-GM and 0.819 (95% CI: 0.712–0.926 for serum-GM. The optimal cutoff index was 1.19 for BALF-GM, and the sensitivity and specificity were 67.9% and 89.2%. The BALF-GM assay is more sensitive in detecting pulmonary aspergillosis than serum-GM assay and fungal cultures. However, BALF-GM assay has a high false-positive rate at the cutoff index of 0.5. Hence, the diagnostic cutoff index of the BALF-GM assay should be improved to avoid the overdiagnosis of pulmonary aspergillosis in clinic.

  9. Inflammatory and repair pathways induced in human bronchoalveolar lavage cells with ozone inhalation.

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    Pascale Leroy

    Full Text Available Inhalation of ambient levels of ozone causes airway inflammation and epithelial injury.To examine the responses of airway cells to ozone-induced oxidative injury, 19 subjects (7 with asthma were exposed to clean air (0ppb, medium (100ppb, and high (200ppb ambient levels of ozone for 4h on three separate occasions in a climate-controlled chamber followed by bronchoscopy with bronchoalveolar lavage (BAL 24h later. BAL cell mRNA expression was examined using Affymetrix GeneChip Microarray. The role of a differentially expressed gene (DEG in epithelial injury was evaluated in an in vitro model of injury [16HBE14o- cell line scratch assay].Ozone exposure caused a dose-dependent up-regulation of several biologic pathways involved in inflammation and repair including chemokine and cytokine secretion, activity, and receptor binding; metalloproteinase and endopeptidase activity; adhesion, locomotion, and migration; and cell growth and tumorigenesis regulation. Asthmatic subjects had 1.7- to 3.8-fold higher expression of many DEGs suggestive of increased proinflammatory and matrix degradation and remodeling signals. The most highly up-regulated gene was osteopontin, the protein level of which in BAL fluid increased in a dose-dependent manner after ozone exposure. Asthmatic subjects had a disproportionate increase in non-polymerized osteopontin with increasing exposure to ozone. Treatment with polymeric, but not monomeric, osteopontin enhanced the migration of epithelial cells and wound closure in an α9β1 integrin-dependent manner.Expression profiling of BAL cells after ozone exposure reveals potential regulatory genes and pathways activated by oxidative stress. One DEG, osteopontin, promotes epithelial wound healing in an in vitro model of injury.

  10. Alterations in bronchoalveolar lavage fluid during ischemia-induced acute hepatic failure in the pig.

    Science.gov (United States)

    Kostopanagiotou, Georgia; Routsi, Christina; Smyrniotis, Vassilios; Lekka, Marilena E; Kitsiouli, Eirini; Arkadopoulos, Nikolaos; Nakos, George

    2003-05-01

    The objective of this controlled experimental animal study was to evaluate whether acute hepatic failure (AHF) can cause acute lung injury (ALI) and to investigate possible pathophysiologic mechanisms. Seventeen domestic pigs were randomly assigned to AHF and sham groups. AHF was induced by surgical devascularization of liver in 10 animals. Seven animals were sham operated. Hemodynamics, lung mechanics, extravascular lung water (EVLW), and intracranial pressure, blood gas, liver function tests, and serum endotoxin levels were measured. Cells count, total protein, and phospholipids and phospholipases A(2) were determined in the bronchoalveolar lavage (BAL) fluid. Measurements were obtained after the insertion of central lines and 4 hours and 7 hours after the completion of the surgical procedure. Hemodynamic, biochemical, neuromonitoring, and histologic data confirmed the development of liver failure. Seven hours after devascularization, EVLW was higher in AHF (13.7 +/- 1.8 mL/kg) compared with the sham group (5.9 +/- 0.7 mL/kg) (P <.05); in AHF, increase of neutrophils (5% +/- 8% to 25% +/- 8%, P <.001), total protein (6.2 +/- 3.7 to 11.2 +/- 6.5 microg/mL, P <.048), and phospholipase A(2) (1.43 +/- 0.56 to 2.38 +/- 1.38 nmoL/mL/h, P <.03) and decrease in PAF-acetylhydrolase (0.114 +/- 0.128 to 0.039 +/- 0.038 nmol/mL/h, P <.01) compared with baseline were observed; total phospholipids decreased in AHF and increased in the sham model. Histologic examination confirmed lesions compatible with acute lung injury. In conclusion, AHF due to hepatic devascularization induced acute lung injury, confirmed by the increase of inflammatory cells in the alveoli as well as by histologic findings. The decreased PAF-AcH and the increased phospholipase A(2) may play a significant role in the perpetuation of inflammation accompanied by surfactant disorders.

  11. THE PECULARITIES OF THE SOLID PHASE OF BRONCHOALVEOLAR LAVAGES IN CHILDREN WITH THE LUNG DISEASES

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    Yuliya Modna

    2013-10-01

    Full Text Available The acute destructive pneumonias (ADP occupy up to 80% of the total number of pneumonias. They require constant improvement of treatment strategy. Nowadays the use of surfactants is a part of most treatment protocols. The aim was to study the features of the solid phase bronchoalveolar lavage in children with the ADPs in the dynamics of complex treatment with exogenous surfactant.Material and methods: We examined 39 patients of contaminated surgery. We identified 2 groups of patients. The patients of first group (n=27 had pulmonary pleural form of ADP, the second group (n=12 had pulmonary form of ADP. All patients got classical treatment and the earlier draining of pleural cavity. We used as an antiseptic reamberin 1.5% by 10 ml/kg and endobronchially injected exogenous surfactant Bl in dose12 mg/kg body weight a day, 6 mg/kg every 12 hours. All the children were made a bronchoscopy to obtain BAL to study the crystallization properties. The solid phase of BAL was studied by method of cuneal dehydration.Results: All facies before treatment were divided into two groups according to classification of facies of biological fluids. Only the facies of the second and the third types were detected there. It was revealed that the sizes of the zones of the facies were different in the comparison groups before treatment and after. And the level of crystalline structures and amorphous aggregates were different in the groups with different degrees of inflammation.Conclusion: So, we can assume that the change in surfactant system is characterized by changes in the morphological structure of solids phases of BAL. And the morphological structure of BAL depends on the chemical composition of BAL.

  12. Effects of early bronchoalveolar lavage fluid collected from dogs with smoke inhalation injury on the lungs of rats

    Institute of Scientific and Technical Information of China (English)

    NIE Fa-chuan; SU Dong; YANG Zong-cheng; BI Min; HUANG Yue-sheng

    2004-01-01

    Objective: Whether early massive bronchoalveolar lavage can remove the harmful substances from the lungs injured with smoke inhalation remains uncertain. This study was designed to observe the effects of early massive bronchoalveolar lavage fluid (BALF) on the healthy lungs in rats. Methods: Mongrel dogs were inflicted with severe smoke inhalation injury. The injured lungs were lavaged with large amount of normal saline in the first hour after injury and the BALF was collected. The BALF was injected into the healthy lungs of 30 rats (group C) in the dosage of 5 ml/kg. The functions and pathological changes of the lungs were observed 24 h after perfusion with the BALF. The data were compared with those of 23 rats (group B) whose lungs were perfused with the BALF collected from normal dogs and those of 21 rats (group A)whose lungs were perfused with normal saline. Results: The mortality rate 24 h after lung perfusion was higher in group C than in groups A and B. The survivors of group C exhibited fluctuation of respiratory rate (RR), remarkable decrease of PaO2, significantly higher content of lung water, decrease of total static pulmonary compliance and pulmonary expansion index, and increasse of inflammatory cytokines in the tissues of lungs. Only slight mechanic obstructive effect on the airway was observed in rats of group A and B. The pathological changes of the lungs of the rats in group C were similar to those of the dogs with actual smoke inhalation injury. Conclusion: Our findings indicate that the BALF collected from dogs with acute severe smoke inhalation injury in the early stage after injury injured the normal lungs of rats with the bioactive substances in the BALF. These findings show us that it is a valuable therapeutic procedure to apply massive bronchoalveolar fluid lavage in the early stage after inhalation injury.

  13. Comparison of concentrations of two proteinase inhibitors, porcine pancreatic elastase inhibitory capacity, and cell profiles in sequential bronchoalveolar lavage samples.

    Science.gov (United States)

    Morrison, H M; Kramps, J A; Dijkman, J H; Stockley, R A

    1986-06-01

    Bronchoalveolar lavage is used to obtain cells and proteins from the lower respiratory tract for diagnosis and research. Uncertainity exists about which site in the lung is sampled by the lavage fluid and what effect different lavage volumes have on recovery of the constituents of lavage fluid. Dilution of alveolar lining fluid by lavage fluid is variable and results are usually expressed as protein ratios to surmount this problem. We have compared cell profiles and the concentrations of two proteinase inhibitors--the low molecular weight bronchial protease inhibitor antileucoprotease and alpha 1 proteinase inhibitor, together with alpha 1 proteinase inhibitor function and its relationship to the cell profile in sequential bronchoalveolar lavage fluid samples from patients undergoing bronchoscopy. There was no difference in total or differential cell counts or albumin or alpha 1 proteinase inhibitor concentrations between the first and second halves of the lavage. Both the concentration of antileucoprotease and the ratio of antileucoprotease to albumin were, however, lower in the second half of the lavage (2p less than 0.01 and 2p less than 0.05 respectively). There was no difference in the function of alpha 1 proteinase inhibitor (assessed by inhibition of porcine pancreatic elastase--PPE) between aliquots (0.28 mole PPE inhibited/mol alpha 1 proteinase inhibitor; range 0-1.19 for the first half and 0.37 mol PPE inhibited/mol alpha 1 proteinase inhibitor; range 0.10-0.80 for the second half). About 60-70% of alpha 1 proteinase inhibitor in each half of the lavage fluid was inactive as an inhibitor. The function of alpha 1 proteinase inhibitor did not differ between bronchitic smokers and ex-smokers. Alpha 1 proteinase inhibitor function was not related to the number of total white cells, macrophages, or neutrophils in the lavage fluid. Contamination of lavage by red blood cells was found to alter the concentration of alpha 1 proteinase inhibitor but not its

  14. Multiplex protein profiling of bronchoalveolar lavage in idiopathic pulmonary fibrosis and hypersensitivity pneumonitis

    Directory of Open Access Journals (Sweden)

    Willems Stijn

    2013-01-01

    Full Text Available Context: Idiopathic pulmonary fibrosis (IPF and chronic hypersensitivity pneumonitis (HP are diffuse parenchymal lung diseases characterized by a mixture of inflammation and fibrosis, leading to lung destruction and finally death. AIMS: The aim of this study was to compare different pathophysiological mechanisms, such as angiogenesis, coagulation, fibrosis, tissue repair, inflammation, epithelial damage, oxidative stress, and matrix remodeling, in both disorders using bronchoalveolar lavage (BAL. Methods: At diagnosis, patients underwent bronchoscopy with BAL and were divided into three groups: Control ( n = 10, HP ( n = 11, and IPF ( n = 11, based on multidisciplinary approach (clinical examination, radiology, and histology: Multiplex searchlight technology was used to analyze 25 proteins representative for different pathophysiological processes: Eotaxin, basic fibroblast growth factor (FGFb, fibronectin, hepatocyte growth factor (HGF, interleukine (IL-8, IL-12p40, IL-17, IL-23, monocyte chemotactic protein (MCP-1, macrophage-derived chemokine (MDC, myeloperoxidase (MPO, matrix metalloproteinase (MMP-8, MMP-9, active plasminogen activating inhibitor 1 (PAI-1, pulmonary activation regulated chemokine (PARC, placental growth factor (PlGF, protein-C, receptor for advanced glycation end products (RAGE, regulated on activation normal T cells expressed and secreted (RANTES, surfactant protein-C (SP-C, transforming growth factor-β1 (TGF-β1, tissue inhibitor of metalloproteinase-1 (TIMP-1, tissue factor, thymic stromal lymphopoietin (TSLP, and vascular endothelial growth factor (VEGF. Results: All patients suffered from decreased pulmonary function and abnormal BAL cell differential compared with control. Protein levels were increased in both IPF and HP for MMP-8 ( P = 0.022, MMP-9 ( P = 0.0020, MCP-1 ( P = 0.0006, MDC ( P = 0.0048, IL-8 ( P = 0.013, MPO ( P = 0.019, and protein-C ( P = 0.0087, whereas VEGF was decreased ( P = 0.0003 compared with

  15. [Data on the etiology of the liquid of broncho-alveolar lavage in mediastino-pulmonary sarcoidosis (author's transl)].

    Science.gov (United States)

    Mahé, C; Amouroux, J; Turbie, P; Battesti, J P

    1979-01-01

    The cell population of the liquid of broncho-alveolar lavage of 44 cases of mediastino-pulmonary sarcoidosis was compared to that of 12 normal controls, of 14 controls with a localized pulmonary affection, who underwent lavage in healthy contro-lateral segment, and of 33 patients with various diffuse interstitial pneumopathies, except hypersensitivity ones. In sarcoidosis, the total number of cells is significantly higher than in controls; such is the case for neutrophils. It is also higher for lymphocytes in sarcoidosis: 21.8, than in controls: 7.8, or in patients with other diffuse interstitial pneumopathies: 10.3. It is independent of the disease radiological stage, but closely related to its degree of activity; it showed important variations, going from 3 to 50%. The observation of a normal level of lymphocytes is not enough to exclude the diagnosis of sarcoidosis.

  16. An Uncommon Procedure for a Rare Ailment: Massive Bronchoalveolar Lavage in a Patient with Pulmonary Alveolar Proteinosis

    Directory of Open Access Journals (Sweden)

    Belgin Samurkaşoğlu

    2012-09-01

    Full Text Available As a rare procedure, massive bronchoalveolar lavage (MBAL is a large-volume lavage which necessitates general anesthesia and one-lung ventilation (OLV. During MBAL isotonic saline is instilled into one lung and drained through one lumen of a double-lumen tube. MBAL is the most effective treatment for symptomatic pulmonary alveolar proteinosis (PAP. A 27-year-old male with PAP was scheduled for therapeutic MBALs. After standard preoxygenation, monitoring and anesthesia induction, a double-lumen tube was placed. Tube position was verified by a fiberoptic bronchoscope. The internal jugular vein, radial and pulmonary arteries were cannulated. A temperature probe and foley catheter were inserted. The nonventilated lung was filled with 1000 mL saline and then drained in each session. The left and right lung were lavaged with an interval of 2 weeks. A total of 20 L saline was used in each MBAL without retention. MBALs were terminated after the effluent became clear. Duration of the left and right MBALs were 325 and 275 minutes, respectively. Despite increased shunt fraction, oxygenation was within acceptable limits during OLV. The trachea was extubated in the operating room uneventfully after each MBAL. The patient’s clinical and laboratory findings were evidently improved. Consequently, if proper conditions are provided, MBAL is safe and beneficial despite its risks and the long duration.

  17. Analysis of proteins in bronchoalveolar lavage fluids during pulmonary edema resulting from nitrogen dioxide and cadmium exposure

    Energy Technology Data Exchange (ETDEWEB)

    Gurley, L.R.; London, J.E.; Dethloff, L.A.; Lehnert, B.E.

    1988-01-01

    We have developed a new HPLC method by which quantitative measurements can be made on the biochemical constituents of the extracellular fluid lining of the lung as sampled by bronchoalveolar lavage. Nine of the fractions are proteins, two are phospholipids, and two fractions remained unidentified. Rats were subjected to the intrapulmonary deposition of cadmium, a treatment model known to induce pulmonary edema and cause a translocation of blood compartment proteins into the lung's alveolar space compartment. Resulting pulmonary edema was hallmarked by /approximately/25-fold increases in three major blood compartment-derived HPLC protein fractions, two of which have been identified as albumin and immunoglobulin(s). Analysis of lavage fluid from rats exposed to 100 ppM NO/sub 2/ for 15 min, an exposure regimen which also produces pulmonary edema, indicated that the three blood compartment proteins in the lavage fluids were elevated 35- to 72-fold over controls 24 h after exposure. These results demonstrate that HPLC can be used to provide a highly sensitive method for detection and quantitation of pulmonary edema that can occur in acute lung injuries resulting from environmental insults.

  18. Broad-Range Detection of Microorganisms Directly from Bronchoalveolar Lavage Specimens by PCR/Electrospray Ionization-Mass Spectrometry

    Science.gov (United States)

    Ullberg, Måns; Lüthje, Petra; Mölling, Paula; Strålin, Kristoffer

    2017-01-01

    The clinical demand on rapid microbiological diagnostic is constantly increasing. PCR coupled to electrospray ionization-mass spectrometry, PCR/ESI-MS, offers detection and identification of over 750 bacteria and Candida species directly from clinical specimens within 6 hours. In this study, we investigated the clinical performance of the IRIDICA BAC LRT Assay for detection of bacterial pathogens in 121 bronchoalveolar lavage (BAL) samples that were received consecutively at our bacterial laboratory for BAL culture. Commensal or pathogenic microorganisms were detected in 118/121 (98%) BAL samples by PCR/ESI-MS, while in 104/121 (86%) samples by routine culture (PLegionella pneumophila, Bordetella pertussis, Norcadia species and Mycoplasma pneumoniae. In conclusion, PCR/ESI-MS detected a broad range of potential pathogens with equal or superior sensitivity compared to conventional methods within few hours directly from BAL samples. This novel method might thus provide a relevant tool for diagnostics in critically ill patients. PMID:28085931

  19. Human herpes virus-8 DNA in bronchoalveolar lavage samples from patients with AIDS-associated pulmonary Kaposi's sarcoma

    DEFF Research Database (Denmark)

    Benfield, T L; Dodt, K K; Lundgren, Jens Dilling

    1997-01-01

    Kaposi's sarcoma (KS) is the most frequent AIDS-associated neoplasm, and often disseminates to visceral organs, including the lungs. An ante-mortem diagnosis of pulmonary KS is difficult. Recently, DNA sequences resembling a new human herpes virus (HHV-8), have been identified in various forms...... of KS. We hypothesized that these sequences are present in samples obtained by bronchoalveolar lavage (BAL) in patients with pulmonary KS. Utilizing a nested polymerase chain reaction (PCR), 7/12 BAL cell samples from HIV-infected patients with endobronchial KS were positive for HHV-8 DNA. In contrast......, only 2/39 samples from HIV-infected patients without evidence of KS were positive (p = 0.007). Detection of HHV-8 in BAL cells of patients with pulmonary KS was highly specific (95%), with a sensitivity of 58% and a positive predictive value of 78%. In conclusion, HHV-8 is associated with pulmonary KS...

  20. Bacteriological Profile of Patients Undergoing Open Heart Surgery and Evaluation of a Bacterial Filter using Protected Broncho-Alveolar Lavage.

    Science.gov (United States)

    Tempe, D K; Mehta, N; Mishra, B; Tondon, M S; Tomar, A S; Budharaja, P; Nigam, M

    1998-01-01

    Twenty seven patients undergoing elective open heart surgery were included in this prospective study. They were randomly divided into two groups. Group C (n = 12) constituted the control group in whom no breathing filter was used in the anaesthesia circuit in the operating room or in the ICU. Humidification of breathing gases was achieved with the help of conventional heated humidifier. In group F (n = 15), heat and moisture exahanging bacterial / viral filter was incorporated in the breathing circuit at the patient end between the catheter mount and Y connection of the breathing circuit. In both the groups, samples of throat swab, protected broncho-alveolar lavage with double catheter and Ryles tube aspirate were collected preoperatively (in the operation theatre) and postoperatively (in the Intensive Care Unit on day 1). All the samples were sent to the laboratory immediately after the collection for Gram staining and culture and sensitivity. Pathogenic organisms were isolated from a total of 9 patients (33%) preoperatively. Exogenous spread of the organisms to the lungs was considered to have occurred if new pathogenic organisms were isolated from the postoperative bronchoalveolar lavage and the simultaneous samples of the throat swab and Ryles tube did not contain the same organism. By this definition, the exogenous spread of the organisms occurred in one patient in group C and in no patient in group F (P = 0.46, Fishers test). The commonest organisms isolated were Staphylococcus aureus, Klebsiella sp. and Pseudomonas sp. We conclude that colonization of the pathogenic organisms is common (33%) in orophrynx and gastrointestinal tract in hospitalized patients. There was no difference in the exogenous spread of the organisms between the two groups. The unity of the filter, therefore, appears to be limited to prevent contamination of anaesthesia machines or ventilators as has been shown by earlier studies.

  1. Quantification of matrix metalloprotease-9 in bronchoalveolar lavage fluid by selected reaction monitoring with microfluidics nano-liquid-chromatography-mass spectrometry

    NARCIS (Netherlands)

    Prely, Laurette M.; Paal, Krisztina; Hermans, Jos; van der Heide, Sicco; van Oosterhout, Antoon J. M.; Bischoff, Rainer

    2012-01-01

    Quantitative protein analysis by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in the selected reaction monitoring (SRM) mode was used to quantify matrix metalloprotease-9 (MMP-9; similar to 90 kDa) in bronchoalveolar lavage fluid (BALF) from patients having undergone lung transplantatio

  2. Procoagulant, tissue factor-bearing microparticles in bronchoalveolar lavage of interstitial lung disease patients: an observational study.

    Directory of Open Access Journals (Sweden)

    Federica Novelli

    Full Text Available Coagulation factor Xa appears involved in the pathogenesis of pulmonary fibrosis. Through its interaction with protease activated receptor-1, this protease signals myofibroblast differentiation in lung fibroblasts. Although fibrogenic stimuli induce factor X synthesis by alveolar cells, the mechanisms of local posttranslational factor X activation are not fully understood. Cell-derived microparticles are submicron vesicles involved in different physiological processes, including blood coagulation; they potentially activate factor X due to the exposure on their outer membrane of both phosphatidylserine and tissue factor. We postulated a role for procoagulant microparticles in the pathogenesis of interstitial lung diseases. Nineteen patients with interstitial lung diseases and 11 controls were studied. All subjects underwent bronchoalveolar lavage; interstitial lung disease patients also underwent pulmonary function tests and high resolution CT scan. Microparticles were enumerated in the bronchoalveolar lavage fluid with a solid-phase assay based on thrombin generation. Microparticles were also tested for tissue factor activity. In vitro shedding of microparticles upon incubation with H₂O₂ was assessed in the human alveolar cell line, A549 and in normal bronchial epithelial cells. Tissue factor synthesis was quantitated by real-time PCR. Total microparticle number and microparticle-associated tissue factor activity were increased in interstitial lung disease patients compared to controls (84±8 vs. 39±3 nM phosphatidylserine; 293±37 vs. 105±21 arbitrary units of tissue factor activity; mean±SEM; p<.05 for both comparisons. Microparticle-bound tissue factor activity was inversely correlated with lung function as assessed by both diffusion capacity and forced vital capacity (r² = .27 and .31, respectively; p<.05 for both correlations. Exposure of lung epithelial cells to H₂O₂ caused an increase in microparticle-bound tissue factor

  3. Analysis of bronchoalveolar lavage fluid (Balf) from patients with adult respiratory distress syndrome (ARDS)

    Energy Technology Data Exchange (ETDEWEB)

    Henderson, R.F.; Baughman, R.P. [Univ. of Cincinnati College of Medicine, Cincinnati, OH (United States); Waide, J.J.

    1995-12-01

    The pathogenesis of ARDS is largely unknown, but many factors are known to predispose one to ARDS: sepsis, aspiration of gastric contents, pneumonia, fracture, multiple transfusions, cardiopulmonary bypass, burn, dissemination intravascular coagulation, pulmonary contusion, near drowning, and pancreatitis. ARDS is characterized by severe hypoxemia, diffuse pulmonary infiltrates, and decreased pulmonary compliance. Current treatment methods still result in 50% mortality. Studies are underway at the University of Cincinnati to determine if treatment with a synthetic pulmonary surfactant, Exosurf{sup {reg_sign}} (contains dipalmitoyl phosphatidyl choline, Burroughs-Wellcome), improves the prognosis of these patients. BALF from these patients, before and after treatment, was analyzed to determine if the treatment resulted in an increase in disaturated phospholipids (surfactant phospholipids) in the epithelial lining fluid and if the treatments reduced the concentration of markers of inflammation and toxicity in the BALF. This study indicates that the method of administering Exosurf{sup {reg_sign}} did not lead to an increase in surfactant lipid or protein in the bronchoalveolar region of the respiratory tract.

  4. SPECTRUM OF BACTERIA ISOLATED FROM BRONCHOALVEOLAR LAVAGE IN A TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    Sowmya

    2014-07-01

    Full Text Available BACKGROUND/OBJECTIVES: Pneumonia is an inflammatory condition of the lung caused by bacteria, viruses, fungi and parasites. The common bacterial pathogens include Pseudomonas spp., Klebsiella pneumoniae, S. aureus, Acinetobacter spp., Streptococcus pneumoniae. Antibiotic resistance is common among these bacterial isolates. This study was taken up to identify the spectrum of bacteria isolated from bronchoalveolar (BAL samples of patients suffering from lower respiratory tract infections and to determine their antibiogram. MATERIALS and METHODS: The retrospective study was carried out in a tertiary care centre over a period of one year (March 2013-February 2014.Patients above 18 years with clinical suspicion of pneumonia were included in this study. The samples with growth >104 CFU/ml of bacteria were identified and their susceptibility pattern to various antibiotics was performed. RESULTS: Out of 307 BAL samples, 110 were culture positive. The common bacterial pathogens isolated were Pseudomonas spp. (21.8%, Acinetobacter spp. (15.5%, Klebsiella spp.(14.5%, Enterococcus spp.(10.9% and S.aureus (12.7%. Carbapenem resistance was seen in 31.6% of Acinetobacter spp, 22% Klebsiella spp. and 14% in Pseudomonas spp. Methicillin resistance was detected in 21.4% of S.aureus isolates. All strains of S.aureus were sensitive to vancomycin and teicoplanin. All isolates of Enterococci were sensitive to vancomycin, teicoplanin and high level aminoglycosides. CONCLUSION: Pseudomonas and Acinetobacter spp. were the most common bacterial pathogens isolated from BAL. Carbapenem resistance is on the rise among these gram negative bacterial isolates.

  5. Rapid simultaneous identification and quantitation of Staphylococcus aureus and Pseudomonas aeruginosa directly from bronchoalveolar lavage specimens using automated microscopy.

    Science.gov (United States)

    Metzger, Steven; Frobel, Rachel A; Dunne, W Michael

    2014-06-01

    Diagnosis of ventilator-assisted pneumonia (VAP) requires pathogen quantitation of respiratory samples. Current quantitative culture methods require overnight growth, and pathogen identification requires an additional step. Automated microscopy can perform rapid simultaneous identification and quantitation of live, surface-immobilized bacteria extracted directly from patient specimens using image data collected over 3 h. Automated microscopy was compared to 1 μL loop culture and standard identification methods for Staphylococcus aureus and Pseudomonas spp. in 53 remnant bronchoalveolar lavage specimens. Microscopy identified 9/9 S. aureus and 7/7 P. aeruginosa in all specimens with content above the VAP diagnostic threshold. Concordance for specimens containing targets above the diagnostic threshold was 13/16, with concordance for sub-diagnostic content of 86/90. Results demonstrated that automated microscopy had higher precision than 1 μL loop culture (range ~0.55 log versus ≥1 log), with a dynamic range of ~4 logs (~10(3) to 10(6) CFU/mL).

  6. Effects of tylosin, tilmicosin and tulathromycin on inflammatory mediators in bronchoalveolar lavage fluid of lipopolysaccharide-induced lung injury.

    Science.gov (United States)

    Er, Ayse; Yazar, Enver

    2012-12-01

    The aim of this study was to determine the anti-inflammatory effects of macrolides through kinetic parameters in bronchoalveolar lavage fluid (BALF) of lipopolysaccharide-induced lung injury. Rats were divided into four groups: lipopolysaccharide (LPS), LPS + tylosin, LPS + tilmicosin and LPS + tulathromycin. BALF samples were collected at sampling times. TNF, IL-1β, IL-6, IL-10 and 13,14-dihydro-15-keto-prostaglandin F2α (PGM) and C-reactive protein (CRP) were analysed. Area under the curve (AUC) and maximum plasma concentration (Cmax) values of inflammatory mediators were determined by a pharmacokinetic computer programme. When inflammatory mediator concentrations were compared between the LPS group and other groups for each sampling time, the three macrolides had no pronounced depressor effect on cytokine levels, but they depressed PGM and CRP levels. In addition, tylosin and tilmicosin decreased the AUC0-24 level of TNF, while tilmicosin decreased the AUC0-24 level of IL-10. Tylosin and tulathromycin decreased the AUC0-24 of PGM, and all three macrolides decreased the AUC0-24 of CRP. Especially tylosin and tulathromycin may have more expressed anti-inflammatory effects than tilmicosin, via depressing the production of inflammatory mediators in the lung. The AUC may be used for determining the effects of drugs on inflammation. In this study, the antiinflammatory effects of these antibiotics were evaluated with kinetic parameters as a new and different approach.

  7. Levels of Soluble Receptor for Advanced Glycation End Products in Bronchoalveolar Lavage Fluid in Patients with Various Inflammatory Lung Diseases

    Science.gov (United States)

    Kamo, Tetsuro; Tasaka, Sadatomo; Tokuda, Yuriko; Suzuki, Shoji; Asakura, Takanori; Yagi, Kazuma; Namkoong, Ho; Ishii, Makoto; Hasegawa, Naoki; Betsuyaku, Tomoko

    2015-01-01

    Receptor for advanced glycation end products (RAGE) is a multiligand receptor of S100/calgranulins, high-mobility group box 1, and others, and it is associated with the pathogenesis of various inflammatory and circulatory diseases. The soluble form of RAGE (sRAGE) is a decoy receptor and competitively inhibits membrane-bound RAGE activation. In this study, we measured sRAGE levels in bronchoalveolar lavage fluid (BALF) of 78 patients, including 41 with interstitial pneumonia, 11 with sarcoidosis, 9 with respiratory infection, 7 with ARDS, 5 with lung cancer, and 5 with vasculitis. Among them, sRAGE was detectable in BALF of 73 patients (94%). In patients with ARDS and vasculitis, the sRAGE levels were significantly higher than in the control subjects and those with interstitial pneumonia. The sRAGE levels were positively correlated with total cell counts in BALF and serum levels of surfactant protein-D, lactate dehydrogenase, and C-reactive protein. There was an inverse correlation between PaO2/FIO2 ratio and sRAGE levels. These results indicate that sRAGE in BALF might be considered as a biomarker of lung inflammatory disorders, especially ARDS and vasculitis. PMID:27147899

  8. Natural Killer Cell Assessment in Peripheral Circulation and Bronchoalveolar Lavage Fluid of Patients with Severe Sepsis: A Case Control Study

    Science.gov (United States)

    Souza-Fonseca-Guimaraes, Paulo; Guimaraes, Fernando; Natânia De Souza-Araujo, Caroline; Maria Boldrini Leite, Lidiane; Cristina Senegaglia, Alexandra; Nishiyama, Anita; Souza-Fonseca-Guimaraes, Fernando

    2017-01-01

    Sepsis is a complex systemic inflammatory syndrome, the most common cause of which is attributed to systemic underlying bacterial infection. The complete mechanisms of the dynamic pro- and anti-inflammatory processes underlying the pathophysiology of sepsis remain poorly understood. Natural killer (NK) cells play a crucial role in the pathophysiology of sepsis, leading to exaggerated inflammation due their rapid response and production of pro-inflammatory cytokines such as interferon gamma (IFN-γ). Several studies have already shown that NK cells undergo lymphopenia in the peripheral blood of patients with sepsis. However, our understanding of the mechanisms behind its cellular trafficking and its role in disease development is restricted to studies in animal models. In this study, we aimed to compare the human NK cell subset (CD56bright or dim) levels in the peripheral blood and bronchoalveolar lavage (BAL) fluid of sepsis patients. We conducted a case-control study with a sample size consisting of 10 control patients and 23 sepsis patients enrolled at the Hospital Cajuru (Curitiba/PR, Brazil) from 2013 to 2015. Although we were able to confirm previous observations of peripheral blood lymphopenia, no significant differences were detected in NK cell levels in the BAL fluid of these patients. Overall, these findings strengthened the evidence that peripheral blood lymphopenia is likely to be associated with cell death as a consequence of sepsis. PMID:28287491

  9. Ubiquitin and stromal cell-derived factor-1α in bronchoalveolar lavage fluid after burn and inhalation injury.

    Science.gov (United States)

    Baker, Todd A; Davis, Christopher S; Bach, Harold H; Romero, Jacqueline; Burnham, Ellen L; Kovacs, Elizabeth J; Gamelli, Richard L; Majetschak, Matthias

    2012-01-01

    The objective of the study was to determine whether the CXC chemokine receptor (CXCR) 4 ligands ubiquitin and stromal cell-derived factor (SDF)-1α are detectable in bronchoalveolar lavage fluid (BALF) after burn and inhalation injury and whether their concentrations in BALF are associated with injury severity, physiological variables, or clinical outcomes. BALF was obtained on hospital admission from 51 patients (48 ± 18 years) with burn (TBSA: 23 ± 24%) and inhalation injury (controls: 10 healthy volunteers, 42 ± 8 years). BALF was analyzed for total protein and for ubiquitin and SDF-1α by enzyme-linked immunosorbent assay. Ubiquitin/SDF-1α levels were normalized to total BALF protein content. The extent of inhalation injury was determined during bronchoscopy using a standardized scoring system. Percent TBSA, Baux scores, revised Baux scores, and clinical variables were documented. Ubiquitin and SDF-1α were detectable in 40% of normal BALF specimens. After injury, ubiquitin was detectable in 90% (P patients (P burn and inhalation injury. Increases in BALF ubiquitin after inhalation injury may maintain CXCR4-mediated lung protection and repair processes. The finding that BALF ubiquitin decreased with higher grades of inhalation injury may provide a biological correlate for an insufficient local inflammatory response after severe inhalation injury.

  10. The characteristics of bronchoalveolar lavage from a patient with antiphospholipid syndrome who developed acute respiratory distress syndrome.

    Science.gov (United States)

    Nakos, G; Kitsiouli, E; Maneta-Peyret, L; Cassagne, C; Tsianos, E; Lekka, M

    2001-01-01

    The purpose of this study was to investigate the biochemical characteristics as well as the occurrence and specificity of antiphospholipid antibodies in the bronchoalveolar lavage (BAL) fluid from a patient with both antiphospholipid antibodies syndrome (APS) and acute respiratory distress syndrome (ARDS). Proteins, lipids, cells and autoantibodies were determined. Immunoglobulins were purified with affinity chromatography. Autoantibody identification was assessed with enzyme-linked immunosorbent assay (ELISA) and with electrophoresis, followed by immunoblotting and revelation with antihuman IgG-peroxidase conjugate. Antiphospholipid antibodies were found to be present in the BAL fluid as well as in the serum from a patient with APS. Specifically, antiphosphatidylserine and antiphosphatidic acid IgG antibodies in the BAL fluid and antiphosphatidylcholine and anticardiolipin IgG antibodies in the serum were detected at high levels. BAL fluid protein and the percentage of neutrophils were found to be increased. A quantitative as well as qualitative deficiency of surfactant phospholipids was also observed. Antibodies directed against surfactant phospholipids could cause surfactant abnormalities and an inflammatory reaction. These disorders may be one of the causes of the ARDS or a factor in the perpetuation of the inflammation.

  11. [Role of bronchoalveolar lavage and transbronchial biopsy in the diagnosis of pneumonia in patients with organ transplantation].

    Science.gov (United States)

    Arnedillo Muñoz, A; Lopez Moya, M E; de Lucas Ramos, P; Puente Maestu, L; Sanchez Juanes, M J; Rodriguez Gonzalez-Moro, J M; Garcia de Pedro, J; Rodriguez de Guzman, M C

    1996-02-01

    Pneumonia in patients with organ transplantation constitutes a very frequent cause of mortality, as a result precocious aetiologic diagnosis is indispensable. The bronchoscopic techniques, bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB), constitute fundamental procedures for these diagnoses. We begin this study with the aim of evaluating the profitability obtained with these procedures. 36 bronchoscopies were performed on 29 patients with organ transplantation, in all of them we realized BAL and in 20 TBB. We confirm the presence of pneumonia in 30 (in 15 of them we had performed TBB), the BAL was diagnostic in 20 cases (66.6%) and the TBB in 7 (46.6%). With both, BAL and TBB, we obtained a sensitivity of 80% and a specificity of 75%. We isolated 10 bacteria, 8 Citomegalovirus (CMV), 6 Pneumocystis carinii and 2 Aspergillus fumigatus. The BAL and the TBB contributed significantly in the aetiologic diagnosis of pneumonia in patients with organ transplantation, consequently we consider them basic tools in the management of these infections.

  12. [The effect of vaporization with thermal sulfurous water on phospholipids in the broncho-alveolar lavage solution following hypobaric hypoxia in the rat].

    Science.gov (United States)

    Prévost, M C; Montastruc, P; Douste-Blazy, L

    1983-09-01

    We have studied, in the rat, the action of a vaporization with sulphurous water from Bagnères de Luchon on the surfactant modifications caused by hypoxia. The phospholipase activity, subordinate to hypoxia, decreased by 1/5 compared to its value without treatment and the phospholipid composition of the broncho-alveolar lung lavage remained unchanged whereas after hypoxia without treatment the phosphatidylcholines level decreases by 26%. We demonstrated by a dose-response study that this protective action decreased with the thermal water dilution. We also showed that this effect could not be due to the only action of reduced sulphur: different concentrations of sulphur solutions had no action on the phospholipase A activity subordinate to hypoxia. So we can conclude that a vaporization with sulphurous water had a protective action against hypoxia on the broncho-alveolar lavage of rat lung.

  13. sTREM-1 in bronchoalveolar lavage fluid in patients with pulmonary sarcoidosis, effect of smoking and inflammation.

    Science.gov (United States)

    Suchankova, M; Bucova, M; E, Tibenska; Demian, J; Majer, I; Novosadova, H; Tedlova, E; Durmanova, V; Paulovicova, E

    2013-01-01

    Soluble TREM-1 (sTREM-1; Triggering receptor expressed on myelocytes) is a new inflammatory marker indicating the intensity of myeloid cells activation and the presence of infection caused by extracellular bacteria and mould.The aim of our work was to detect and compare the levels of sTREM-1 in bronchoalveolar lavage fluid (BALF) in patients with pulmonary sarcoidosis (PS) and other ILD of non-infectious origin. The sTREM-1 levels were assessed by ELISA in 46 patients suffering from ILD, out of them 22 with PS. The levels of BALF sTREM-1 in PS patients were higher than in control group of ILD patients of non-infectious origin, however, the difference was not statistically significant. Since all PS patients except one were non-smokers we compared non-smokers PS with non-smokers ILD patients and found four times higher levels of BALF sTREM-1 in PS patients (P = 0.001). We also recorded the effect of smoking, ILD smokers had higher sTREM-1 levels than non-smokers (P = 0.0019). Higher concentrations of sTREM-1 were detected in BALF of patients with lymphadenopathy and with elevated inflammatory markers in BALF. Our results show that BALF sTREM-1 could be a good inflammatory marker and could help in diagnosis and PS monitoring. Detection of sTREM-1 in BALF indirectly points to myeloid cells activation in the lungs and helps to complete the information about the number of myeloid cells commonly determined in BALF with additional information concerning the intensity of their activation. This is the first study that analyses BALF sTREM-1 levels in patients with PS (Tab. 8, Ref. 28). Text in PDF www.elis.sk.

  14. Bronchoalveolar lavage is an ideal tool in evaluation of local immune response of pigs vaccinated with Pasteurella multocida bacterin vaccine

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    Shiney George

    2015-04-01

    Full Text Available Aim: The aim was to study the bronchoalveolar lavage (BAL technique in evaluating the local immune response of pig immunized with Pasteurella multocida bacterin vaccine. Materials and Methods: Weaned piglets were immunized with formalin-inactivated P52 strain of P. multocida bacterin and evaluated for pulmonary immune response in BAL fluid. BAL was performed before vaccination and at different post vaccination days. The BAL fluid was assayed using enzyme-linked immunosorbent assay to study the development of P. multocida specific antibody isotypes and also evaluated for different cell populations using standard protocol. Results: The average recovery percentage of BAL fluid varies from 58.33 to 61.33 in vaccinated and control group of piglets. The BAL fluid of vaccinated pigs showed increase in antibody titer up to 60th days post vaccination (8.98±0.33, IgG being the predominant isotype reached maximum titer of 6.12±0.20 on 45th days post vaccination, followed by IgM and a meager concentration of IgA could be detected. An increased concentration of the lymphocyte population and induction of plasma cells was detected in the BAL fluid of vaccinated pigs. Conclusion: Though intranasal vaccination with P. multocida plain bacterin vaccine could not provoke a strong immune response, but is promising as lymphocyte population was increased and plasma cells were detected. BAL can be performed repeatedly up to 3/4 months of age in pigs to study pulmonary immune response without affecting their health.

  15. Amniotic fluid stem cells inhibit the progression of bleomycin-induced pulmonary fibrosis via CCL2 modulation in bronchoalveolar lavage.

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    Orquidea Garcia

    Full Text Available The potential for amniotic fluid stem cell (AFSC treatment to inhibit the progression of fibrotic lung injury has not been described. We have previously demonstrated that AFSC can attenuate both acute and chronic-fibrotic kidney injury through modification of the cytokine environment. Fibrotic lung injury, such as in Idiopathic Pulmonary Fibrosis (IPF, is mediated through pro-fibrotic and pro-inflammatory cytokine activity. Thus, we hypothesized that AFSC treatment might inhibit the progression of bleomycin-induced pulmonary fibrosis through cytokine modulation. In particular, we aimed to investigate the effect of AFSC treatment on the modulation of the pro-fibrotic cytokine CCL2, which is increased in human IPF patients and is correlated with poor prognoses, advanced disease states and worse fibrotic outcomes. The impacts of intravenous murine AFSC given at acute (day 0 or chronic (day 14 intervention time-points after bleomycin injury were analyzed at either day 3 or day 28 post-injury. Murine AFSC treatment at either day 0 or day 14 post-bleomycin injury significantly inhibited collagen deposition and preserved pulmonary function. CCL2 expression increased in bleomycin-injured bronchoalveolar lavage (BAL, but significantly decreased following AFSC treatment at either day 0 or at day 14. AFSC were observed to localize within fibrotic lesions in the lung, showing preferential targeting of AFSC to the area of fibrosis. We also observed that MMP-2 was transiently increased in BAL following AFSC treatment. Increased MMP-2 activity was further associated with cleavage of CCL2, rendering it a putative antagonist for CCL2/CCR2 signaling, which we surmise is a potential mechanism for CCL2 reduction in BAL following AFSC treatment. Based on this data, we concluded that AFSC have the potential to inhibit the development or progression of fibrosis in a bleomycin injury model during both acute and chronic remodeling events.

  16. Repeatability of and relationship between potential COPD biomarkers in bronchoalveolar lavage, bronchial biopsies, serum, and induced sputum.

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    Stefan Röpcke

    Full Text Available Chronic Obstructive Pulmonary Disease (COPD is a chronic inflammatory disease, primarily affecting the airways. Stable biomarkers characterizing the inflammatory phenotype of the disease, relevant for disease activity and suited to predict disease progression are needed to monitor the efficacy and safety of drug interventions. We therefore analyzed a large panel of markers in bronchoalveolar lavage, bronchial biopsies, serum and induced sputum of 23 healthy smokers and 24 smoking COPD patients (GOLD II matched for age and gender. Sample collection was performed twice within a period of 6 weeks. Assays for over 100 different markers were validated for the respective matrices prior to analysis. In our study, we found 51 markers with a sufficient repeatability (intraclass correlation coefficient >0.6, most of these in serum. Differences between groups were observed for markers from all compartments, which extends (von-Willebrand-factor and confirms (e.g. C-reactive-protein, interleukin-6 previous findings. No correlations between lung and serum markers were observed, including A1AT. Airway inflammation defined by sputum neutrophils showed only a moderate repeatability. This could be improved, when a combination of neutrophils and four sputum fluid phase markers was used to define the inflammatory phenotype.In summary, our study provides comprehensive information on the repeatability and interrelationship of pulmonary and systemic COPD-related markers. These results are relevant for ongoing large clinical trials and future COPD research. While serum markers can discriminate between smokers with and without COPD, they do not seem to sufficiently reflect the disease-associated inflammatory processes within the airways.

  17. High concentrations of pepsin in bronchoalveolar lavage fluid from children with cystic fibrosis are associated with high interleukin-8 concentrations.

    LENUS (Irish Health Repository)

    McNally, P

    2012-02-01

    BACKGROUND: Gastro-oesophageal reflux is common in children with cystic fibrosis (CF) and is thought to be associated with pulmonary aspiration of gastric contents. The measurement of pepsin in bronchoalveolar lavage (BAL) fluid has recently been suggested to be a reliable indicator of aspiration. The prevalence of pulmonary aspiration in a group of children with CF was assessed and its association with lung inflammation investigated. METHODS: This was a cross-sectional case-control study. BAL fluid was collected from individuals with CF (n=31) and healthy controls (n=7). Interleukin-8 (IL-8), pepsin, neutrophil numbers and neutrophil elastase activity levels were measured in all samples. Clinical, microbiological and lung function data were collected from medical notes. RESULTS: The pepsin concentration in BAL fluid was higher in the CF group than in controls (mean (SD) 24.4 (27.4) ng\\/ml vs 4.3 (4.0) ng\\/ml, p=0.03). Those with CF who had raised pepsin concentrations had higher levels of IL-8 in the BAL fluid than those with a concentration comparable to controls (3.7 (2.7) ng\\/ml vs 1.4 (0.9) ng\\/ml, p=0.004). Within the CF group there was a moderate positive correlation between pepsin concentration and IL-8 in BAL fluid (r=0.48, p=0.04). There was no association between BAL fluid pepsin concentrations and age, sex, body mass index z score, forced expiratory volume in 1 s or Pseudomonas aeruginosa colonisation status. CONCLUSIONS: Many children with CF have increased levels of pepsin in the BAL fluid compared with normal controls. Increased pepsin levels were associated with higher IL-8 concentrations in BAL fluid. These data suggest that aspiration of gastric contents occurs in a subset of patients with CF and is associated with more pronounced lung inflammation.

  18. Reconstitution of CD4 T Cells in Bronchoalveolar Lavage Fluid after Initiation of Highly Active Antiretroviral Therapy▿

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    Knox, Kenneth S.; Vinton, Carol; Hage, Chadi A.; Kohli, Lisa M.; Twigg, Homer L.; Klatt, Nichole R.; Zwickl, Beth; Waltz, Jeffrey; Goldman, Mitchell; Douek, Daniel C.; Brenchley, Jason M.

    2010-01-01

    The massive depletion of gastrointestinal-tract CD4 T cells is a hallmark of the acute phase of HIV infection. In contrast, the depletion of the lower-respiratory-tract mucosal CD4 T cells as measured in bronchoalveolar lavage (BAL) fluid is more moderate and similar to the depletion of CD4 T cells observed in peripheral blood (PB). To understand better the dynamics of disease pathogenesis and the potential for the reconstitution of CD4 T cells in the lung and PB following the administration of effective antiretroviral therapy, we studied cell-associated viral loads, CD4 T-cell frequencies, and phenotypic and functional profiles of antigen-specific CD4 T cells from BAL fluid and blood before and after the initiation of highly active antiretroviral therapy (HAART). The major findings to emerge were the following: (i) BAL CD4 T cells are not massively depleted or preferentially infected by HIV compared to levels for PB; (ii) BAL CD4 T cells reconstitute after the initiation of HAART, and their infection frequencies decrease; (iii) BAL CD4 T-cell reconstitution appears to occur via the local proliferation of resident BAL CD4 T cells rather than redistribution; and (iv) BAL CD4 T cells are more polyfunctional than CD4 T cells in blood, and their functional profile is relatively unchanged after the initiation of HAART. Taken together, these data suggest mechanisms for mucosal CD4 T-cell depletion and interventions that might aid in the reconstitution of mucosal CD4 T cells. PMID:20610726

  19. Evaluation of PCR on bronchoalveolar lavage fluid for diagnosis of invasive aspergillosis: a bivariate metaanalysis and systematic review.

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    Wenkui Sun

    Full Text Available BACKGROUND: Nucleic acid detection by polymerase chain reaction (PCR is emerging as a sensitive and rapid diagnostic tool. PCR assays on serum have the potential to be a practical diagnostic tool. However, PCR on bronchoalveolar lavage fluid (BALF has not been well established. We performed a systematic review of published studies to evaluate the diagnostic accuracy of PCR assays on BALF for invasive aspergillosis (IA. METHODS: Relevant published studies were shortlisted to evaluate the quality of their methodologies. A bivariate regression approach was used to calculate pooled values of the method sensitivity, specificity, and positive and negative likelihood ratios. Hierarchical summary receiver operating characteristic curves were used to summarize overall performance. We calculated the post-test probability to evaluate clinical usefulness. Potential heterogeneity among studies was explored by subgroup analyses. RESULTS: Seventeen studies comprising 1191 at-risk patients were selected. The summary estimates of the BALF-PCR assay for proven and probable IA were as follows: sensitivity, 0.91 (95% confidence interval (CI, 0.79-0.96; specificity, 0.92 (95% CI, 0.87-0.96; positive likelihood ratio, 11.90 (95% CI, 6.80-20.80; and negative likelihood ratio, 0.10 (95% CI, 0.04-0.24. Subgroup analyses showed that the performance of the PCR assay was influenced by PCR assay methodology, primer design and the methods of cell wall disruption and DNA extraction. CONCLUSIONS: PCR assay on BALF is highly accurate for diagnosing IA in immunocompromised patients and is likely to be a useful diagnostic tool. However, further efforts towards devising a standard protocol are needed to enable formal validation of BALF-PCR.

  20. TGF-β1 in bronchoalveolar lavage fluid in diffuse parenchymal lung diseases and high-resolution computed tomography score

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    Artur Szlubowski

    2010-07-01

    Full Text Available INTRODUCTION: In the pathogenesis of diffuse parenchymal lung diseases (DPLDs, growth factors, including transforming growth factor β1 (TGF-β1, are responsible for cell proliferation, apoptosis, chemotaxis, and angiogenesis, and also for the production and secretion of some components of the extracellular matrix. OBJECTIVES: The aim of the study was to evaluate correlations in DPLDs between TGF-β1 levels in bronchoalveolar lavage (BAL fluid and high-resolution computed tomography (HRCT score. PATIENTS AND METHODS: The study was performed in 31 DPLD patients in whom a selection of lung segments with high and low intensity of abnormalities was estimated by HRCT score. All patients underwent BAL with TGF-β1 measured by an enzyme immunoassay in BAL fluid and video-assisted thoracic surgery lung biopsy from both selected segments. RESULTS: All 31 patients were diagnosed, and based on histopathology, they were classified into 2 groups: idiopathic interstitial pneumonia (usual interstitial pneumonia – 12, nonspecific interstitialpneumonia – 2, cryptogenic organizing pneumonia – 2, and desquamative interstitial pneumonia – 1 and granulomatous disease (sarcoidosis – 7, extrinsic allergic alveolitis – 5, and histiocytosis X – 2. The final analysis was performed in 28 patients who showed nonhomogenous distribution on HRCT. TGF-β1 levels in BAL fluid were significantly higher in the areas with high intensity of abnormalities assessed by HRCT score (P = 0.018, analysis of variance. These levels were not different between the groups, but a trend towards higher levels in idiopathic interstitial pneumonia was observed. CONCLUSIONS: The results confirm that TGF-β1 may be a good but not specific marker of fibrosis in DPLDs. A significant positive correlation between TGF-β1 levels in BAL fluid and the HRCT score was observed.

  1. [Study of cellular inflammatory response with bronchoalveolar lavage in allergic asthma, aspirin asthma and in extrinsic infiltrating alveolitis].

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    Muiño, Juan C; Garnero, Roberto; Caillet Bois, Ricardo; Gregorio, María J; Ferrero, Mercedes; Romero-Piffiguer, Marta

    2002-01-01

    The asthmatic inflammatory responses present different type of cells involved in this process, such as: Lymphocytes and Eosinophils. In experienced hands the bronchoalveolar lavage (BAL) is a well-tolerated and valuable tool for investigation of basic mechanisms in asthma and other immunological respiratory diseases. The purpose of this work was to study the different cells involved in asthmatic inflammatory responses in allergic and aspirin sensitivity patients and compared with Extrinsic Allergic Alveolitis patients (EAA) by BAL procedure. We studied 27 asthmatic patients. This group was divided by etiological conditions in: allergic asthmatic patients (a) (n: 19), (9 male and 10 female) demonstrated by reversible fall of FEV 1 (3) 20% and 2 or more positive skin test for common aeroallergens. The aspirin asthmatic patients (b) (n: 8) (5 male and 3 female) demonstrated by progressive challenge with aspirin and fall of FEV 1 (3) 20%. The third group with compatible symptoms and signs of EAA, demonstrated by lung biopsy, (n: 9) (8 male and 1 female) (c). We determined in all patients: Total IgE serum level by ELISA test. BAL was performed by standard procedure in all patients. The cells count were performed in BAL and were separated in Eosinophils, T lymphocytes defined by monoclonal anti CD 3 antibody, Lymphocytes CD 4 and CD 8 by monoclonal anti CD 4 and CD 8 antibodies respectively. The B lymphocytes defined by surface immunoglobulin isotypes IgG, IgM, IgA and IgE. The IgE level was in (a) 630 +/- 350 kU/L, in (b) it was 85 +/- 62 kU/L and in EAA (c) 55 +/- 23 kU/L, p allergic asthmatic patients as well as in aspirin sensitivity asthmatic patients. The LBA cellular profile of E.AA patients presented eosinophilia and CE8+ Lymphocite predominance when compared with both asthmatic cellular profile.

  2. TRANSFORMING GROWTH FACTOR Β IN BLOOD SERUM AND BRONCHOALVEOLAR LAVAGE FLUID IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

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    E. A. Surkova

    2008-01-01

    Full Text Available Abstract. Progressive obstruction and lung tissue remodeling comprise an important feature of the airways in COPD patients. The main processes involved in tissue remodeling in COPD are protease/antiprotease, oxidant/antioxidant imbalances, like as inflammatory and fibrotic events that contribute to development or progression of disease. TGFβ is a multifunctional growth factor that regulates synthesis of extracellular matrix proteins, primarily collagen and fibronectin, thus inducing fibrosis of respiratory ways. The aim of our study was to determine levels of TGFβ in serum and bronchoalveolar lavage fluid (BALF of COPD patients. All the patients with COPD had increased levels of TGFβ in serum, as compared with subjects without COPD (p < 0.01, but there was no difference in TGFβ concentration between patients at different stages of disease. Increased phagocytic activity of blood monocytes was found in 81% of COPD patients, as compared to controls. Phagocytosis of apoptotic T­cells and bacterial infection of monocytes leads to increased secretion of TGFβ and it may cause higher levels of TGF β in peripheral blood. TGFβ concentration in BALF of patients at stage III of disease was higher than in the patients at stage II (p < 0.05. The level of TGFβ in BALF directly correlates with number of alveolar macrophages (r = 0.39; р = 0.03. These data indicate that TGFβ is involved in chemotaxis of macrophages in COPD patients’ airways. We conclude that increased secretion of TGFβ by peripheral blood monocytes may be a result of their high phagocytic activity. Hence, TGFβ mediates interactions between the two main components underlying lung tissue remodeling, i.e. fibrosis of respiratory airways, and development of emphysema in COPD.

  3. Functional and phenotypical comparison of myofibroblasts derived from biopsies and bronchoalveolar lavage in mild asthma and scleroderma

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    Hansson Lennart

    2006-01-01

    Full Text Available Abstract Background Activated fibroblasts, which have previously been obtained from bronchoalveolar lavage fluid (BALF, are proposed to be important cells in the fibrotic processes of asthma and scleroderma (SSc. We have studied the motility for BALF derived fibroblasts in patients with SSc that may explain the presence of these cells in the airway lumen. Furthermore, we have compared phenotypic alterations in activated fibroblasts from BALF and bronchial biopsies from patients with mild asthma and SSc that may account for the distinct fibrotic responses. Methods Fibroblasts were cultured from BALF and bronchial biopsies from patients with mild asthma and SSc. The motility was studied using a cell migration assay. Western Blotting was used to study the expression of alpha-smooth muscle actin (α-SMA, ED-A fibronectin, and serine arginine splicing factor 20 (SRp20. The protein expression pattern was analyzed to reveal potential biomarkers using two-dimensional electrophoresis (2-DE and sequencing dual matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-TOF. The Mann-Whitney method was used to calculate statistical significance. Results Increased migration and levels of ED-A fibronectin were observed in BALF fibroblasts from both groups of patients, supported by increased expression of RhoA, Rac1, and the splicing factor SRp20. However, these observations were exclusively accompanied by increased expression of α-SMA in patients with mild asthma. Compared to BALF fibroblasts in mild asthma, fibroblasts in SSc displayed a differential protein expression pattern of cytoskeletal- and scavenger proteins. These identified proteins facilitate cell migration, oxidative stress, and the excessive deposition of extracellular matrix observed in patients with SSc. Conclusion This study demonstrates a possible origin for fibroblasts in the airway lumen in patients with SSc and important differences between fibroblast

  4. Correlation between HRCT findings, pulmonary function tests and bronchoalveolar lavage cytology in interstitial lung disease associated with rheumatoid arthritis

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    Biederer, J.; Muhle, C.; Heller, M.; Reuter, M. [Department of Diagnostic Radiology, Christian Albrechts University Kiel, Arnold-Heller-Strasse 9, 24105, Kiel (Germany); Schnabel, A.; Gross, W.L. [Department of Clinical Rheumatology, University of Luebeck, Luebeck (Germany); Rheumaklinik Bad Bramstedt, Bad Bramstedt (Germany)

    2004-02-01

    A prospective study correlating high-resolution computed tomography (HRCT), lung function tests (PFT) and bronchoalveolar lavage (BAL) cytology in patients with interstitial lung disease (ILD) associated with rheumatoid arthritis (RA). Fifty-three RA patients with suspected ILD (19 men, 34 women) underwent 71 HRCT (14 of 53 with sequential HRCT, mean follow-up 24.3 months). The HRCT evaluation by two observers on consensus included a semi-quantitative characterisation of lesion pattern and profusion on representative anatomical levels. Fifty-two HRCT were followed by PFT and BAL. Agreement or discordance of HRCT-, PFT- and BAL findings were analysed with Pearson's correlation, {kappa} score and McNemar's test. Tobacco-fume exposure was estimated in pack years. Smoking/non-smoking groups were compared with Student's t test. In 49 of 53 patients, HRCT was suggestive of ILD associated with RA (66 of 71 HRCT). Reticular lesions were found in 40 of 53 patients, in 15 of 40 presenting as mixed pattern with ground-glass opacities (GGO). Pure reticular patterns predominated in patients with long duration of ILD (p>0.01). Pure GGO were not observed. Lesion profusion was highly variable and correlated moderately negative with diffusion capacity (mean 88.2% (SD{+-}20.9%); r=-0.54; p<0.001) and very weak with vital capacity and FEV1 (mean values 92.2% (SD{+-}18.3%); r=-0.27; p<0.05 and 89.8% (SD{+-}17.5%); r=-0.31; p<0.01). In patients with GGO, BAL differentials tended towards neutrophilia ({kappa}=0.39; p=0.04; McNemar test p>0.2), but not towards lymphocytosis ({kappa}=0.10; p=0.23; McNemar test p>0.2). Differences in smoking history were not significant (p>0.1). The HRCT appears most appropriate for the detection and follow-up of ILD associated with RA. The PFT and BAL correlate only partially with lesion profusion or grading on HRCT, but they contribute valuable information about dynamic lung function and differential diagnoses (pneumonia, medication side

  5. The impact of surfactant protein-A on ozone-induced changes in the mouse bronchoalveolar lavage proteome

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    Floros Joanna

    2009-03-01

    Full Text Available Abstract Background Ozone is a major component of air pollution. Exposure to this powerful oxidizing agent can cause or exacerbate many lung conditions, especially those involving innate immunity. Surfactant protein-A (SP-A plays many roles in innate immunity by participating directly in host defense as it exerts opsonin function, or indirectly via its ability to regulate alveolar macrophages and other innate immune cells. The mechanism(s responsible for ozone-induced pathophysiology, while likely related to oxidative stress, are not well understood. Methods We employed 2-dimensional difference gel electrophoresis (2D-DIGE, a discovery proteomics approach, coupled with MALDI-ToF/ToF to compare the bronchoalveolar lavage (BAL proteomes in wild type (WT and SP-A knockout (KO mice and to assess the impact of ozone or filtered air on the expression of BAL proteins. Using the PANTHER database and the published literature most identified proteins were placed into three functional groups. Results We identified 66 proteins and focused our analysis on these proteins. Many of them fell into three categories: defense and immunity; redox regulation; and protein metabolism, modification and chaperones. In response to the oxidative stress of acute ozone exposure (2 ppm; 3 hours there were many significant changes in levels of expression of proteins in these groups. Most of the proteins in the redox group were decreased, the proteins involved in protein metabolism increased, and roughly equal numbers of increases and decreases were seen in the defense and immunity group. Responses between WT and KO mice were similar in many respects. However, the percent change was consistently greater in the KO mice and there were more changes that achieved statistical significance in the KO mice, with levels of expression in filtered air-exposed KO mice being closer to ozone-exposed WT mice than to filtered air-exposed WT mice. Conclusion We postulate that SP-A plays a role

  6. Distribution of Major Pathogens from Sputum and Bronchoalveolar Lavage Fluid in Patients with Noncystic Fibrosis Bronchiectasis: A Systematic Review

    Institute of Scientific and Technical Information of China (English)

    Xia-Yi Miao; Xiao-Bin Ji; Hai-Wen Lu; Jia-Wei Yang; Jin-Fu Xu

    2015-01-01

    Objective:Noncystic fibrosis (non-CF) bronchiectasis remains as a common health problem in Asia.Pathogens' distribution in airways of patients with non-CF bronchiectasis is important for doctors to make right decision.Data Sources:We performed this systematic review on the English language literatures from 1966 to July 2014,using various search terms included "pathogens" or "bacteria" or "microbiology" and "bronchiectasis" or "non-cystic fibrosis bronchiectasis" or "non-CF bronchiectasis" or "NCFB."Study Selection:We included studies of patients with the confirmed non-CF bronchiectasis for which culture methods were required to sputum or bronchoalveolar lavage fluid (BALF).Weighted mean isolation rates for Haemophilus influenzae,Pseudomonas aeruginosa,Streptococcus pneumoniae,Stapylococcus aureus,Moxarella catarrhails were compared according to different methodology.Results:The total mean bacterial culture positive rates were 63%.For studies using sputum samples,the mean positive culture rates were 74%.For studies using BALF alone or BALF and sputum,it was 48%.The distributions of main bacterial strains were 29% for H.influenzae,28% for P.aeruginosa,1 1% for S.pneumoniae,12% for S.aureus,and 8% for M.catarrhails with methodology of sputum.Meanwhile,the bacterial distributions were 37% for H.influenzae,8% for P.aeruginosa,14% for S.pneumoniae,5% for S.aureus,and 10% for M.catarrhails with methodology of BALF alone or BALF and sputum.Analysis of the effect of different methodology on the isolation rates revealed some statistically significant differences.Conclusions:H.influenzae accounted for the highest percentage in different methodology.Our results suggested that the total positive culture rates and the proportion of P aeruginosa from sputum and BALF specimens had significant differences,which can be used in further appropriate recommendations for the treatment ofnon-CF bronchiectasis.

  7. Clinical significance of quantifying Pneumocystis jirovecii DNA by using real-time PCR in bronchoalveolar lavage fluid from immunocompromised patients.

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    Botterel, Françoise; Cabaret, Odile; Foulet, Françoise; Cordonnier, Catherine; Costa, Jean-Marc; Bretagne, Stéphane

    2012-02-01

    Quantitative PCR (qPCR) is more sensitive than microscopy for detecting Pneumocystis jirovecii in bronchoalveolar lavage (BAL) fluid. We therefore developed a qPCR assay and compared the results with those of a routine immunofluorescence assay (IFA) and clinical data. The assay included automated DNA extraction, amplification of the mitochondrial large-subunit rRNA gene and an internal control, and quantification of copy numbers with the help of a plasmid clone. We studied 353 consecutive BAL fluids obtained for investigation of unexplained fever and/or pneumonia in 287 immunocompromised patients. No qPCR inhibition was observed. Seventeen (5%) samples were both IFA and qPCR positive, 63 (18%) were IFA negative and qPCR positive, and 273 (77%) were both IFA and qPCR negative. The copy number was significantly higher for IFA-positive/qPCR-positive samples than for IFA-negative/qPCR-positive samples (4.2 ± 1.2 versus 1.1 ± 1.1 log(10) copies/μl; P < 10(-4)). With IFA as the standard, the qPCR assay sensitivity was 100% for ≥2.6 log(10) copies/μl and the specificity was 100% for ≥4 log(10) copies/μl. Since qPCR results were not available at the time of decision-making, these findings did not trigger cotrimoxazole therapy. Patients with systemic inflammatory diseases and IFA-negative/qPCR-positive BAL fluid had a worse 1-year survival rate than those with IFA-negative/qPCR-negative results (P < 10(-3)), in contrast with solid-organ transplant recipients (P = 0.88) and patients with hematological malignancy (P = 0.26). Quantifying P. jirovecii DNA in BAL fluids independently of IFA positivity should be incorporated into the investigation of pneumonia in immunocompromised patients. The relevant threshold remains to be determined and may vary according to the underlying disease.

  8. Effect of Ginkgo biloba extract combined with prednisone on bronchoalveolar lavage fluid related cytokines in patients with IPF

    Institute of Scientific and Technical Information of China (English)

    Zhen-Chun Shi

    2016-01-01

    Objective:To explore the effect of Ginkgo biloba extract (EGb) combined with prednisone on bronchoalveolar lavage fluid (BALF) related cytokines in patients with idiopathic pulmonary fibrosis (IPF).Methods: A total of 60 patients with IPF who were admitted in our hospital from March, 2015 to March, 2016 were included in the study and randomized into the observation group and the control group with 30 cases in each group. The patients in the two groups were given oxygen inhalation, bronchodilator agents, phlegm dissipating and asthma relieving, anti-infection, and other supporting treatments. The patients in the control group were orally given prednisone (0.5 mg/kg•d), continuously for 4 weeks, then in a dose of 0.25 mg/kg•d, continuously for 8 weeks, and finally the dosage was reduced to 0.125 mg/kg•d. On this basis, the patients in the observation group were given additional EGb,ie. ginkgo leaf capsule, 1 g/time, 3 times/d, continuously for 12 weeks. The efficacy was evaluated after 12-week treatment. ELISA was used to detect the levels of TNF-α, IL-4, IL-10, and IFN-γ in BALF. The radioimmunoassay was used to determine the levels of serum HA, ColⅢ, PCⅢ, and LN. The pulmonary function detector was used to measure TLC, VC, DLCO, and 6MWT.Results:After treatment, TNF-α level in the control group was significantly reduced when compared with before treatment (P0.05), while HA, ColⅢ, PCⅢ, and LN levels in the observation group were significantly reduced when compared with before treatment (P<0.05), and the difference between the two groups was statistically significant (P<0.05). After treatment, TLC, VC, DLCO, and 6MWT in the two groups were significantly improved when compared with before treatment (P<0.05), and the difference between the two groups was statistically significant (P<0.05).Conclusions:EGb combined with prednisone can effectively enhance the levels of TNF-α, IL-4, IL-10, and IFN-γin BALF in patients with IPF, and improve the pulmonary

  9. Alterations of alveolar type II cells and intraalveolar surfactant after bronchoalveolar lavage and perfluorocarbon ventilation. An electron microscopical and stereological study in the rat lung

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    Burkhardt Wolfram

    2007-06-01

    Full Text Available Abstract Background Repeated bronchoalveolar lavage (BAL has been used in animals to induce surfactant depletion and to study therapeutical interventions of subsequent respiratory insufficiency. Intratracheal administration of surface active agents such as perfluorocarbons (PFC can prevent the alveolar collapse in surfactant depleted lungs. However, it is not known how BAL or subsequent PFC administration affect the intracellular and intraalveolar surfactant pool. Methods Male wistar rats were surfactant depleted by BAL and treated for 1 hour by conventional mechanical ventilation (Lavaged-Gas, n = 5 or partial liquid ventilation with PF 5080 (Lavaged-PF5080, n = 5. For control, 10 healthy animals with gas (Healthy-Gas, n = 5 or PF5080 filled lungs (Healthy-PF5080, n = 5 were studied. A design-based stereological approach was used for quantification of lung parenchyma and the intracellular and intraalveolar surfactant pool at the light and electron microscopic level. Results Compared to Healthy-lungs, Lavaged-animals had more type II cells with lamellar bodies in the process of secretion and freshly secreted lamellar body-like surfactant forms in the alveoli. The fraction of alveolar epithelial surface area covered with surfactant and total intraalveolar surfactant content were significantly smaller in Lavaged-animals. Compared with Gas-filled lungs, both PF5080-groups had a significantly higher total lung volume, but no other differences. Conclusion After BAL-induced alveolar surfactant depletion the amount of intracellularly stored surfactant is about half as high as in healthy animals. In lavaged animals short time liquid ventilation with PF5080 did not alter intra- or extracellular surfactant content or subtype composition.

  10. Lung disease associated with progressive systemic sclerosis. Assessment of interlobar variation by bronchoalveolar lavage and comparison with noninvasive evaluation of disease activity

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    Miller, K.S.; Smith, E.A.; Kinsella, M.; Schabel, S.I.; Silver, R.M. (Medical Univ. of South Carolina, Charleston (USA))

    1990-02-01

    Progressive systemic sclerosis (PSS), or scleroderma, is a disease of unknown etiology that involves many organ systems, including the lungs. The interstitial lung disease of systemic sclerosis is becoming an increasing cause of morbidity and mortality. This process has been previously evaluated with single-site bronchoalveolar lavage (BAL), gallium scanning, pulmonary function testing, and, occasionally, by open lung biopsy. As BAL has been shown to correlate well with open lung biopsy in systemic sclerosis, we sought to determine if single-site BAL accurately reflects alveolitis in a second site in the lung, and if BAL results correlate with other noninvasive tests of lung inflammation: gallium uptake, chest radiography, or arterial blood gas analysis. We performed 17 studies in 13 patients with scleroderma and found no significant lobar differences in lavage results or gallium scanning. By our criteria for normal versus active alveolitis, only two of 17 patient lavages would have been classified as normal by one side and abnormal by the other side. Although percent gallium uptake was equal bilaterally and supported the concept of alveolitis uniformity, gallium uptake intensity did not correlate with activity as measured by BAL. Furthermore, chest radiograph and arterial blood gas analysis did not correlate with BAL results or gallium scanning. We believe these data support the suitability of single-site lavage in the investigation of systemic-sclerosis-associated alveolitis and diminish the importance of gallium scanning in the investigation of systemic sclerosis pulmonary disease.

  11. Legionella pneumophila in bronchoalveolar lavage samples of patients suffering from severe respiratory infections: Role of age, sex and history of smoking in the prevalence of bacterium

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    Faradonbeh Fatemeh Alaei

    2015-01-01

    Full Text Available Introduction. Legionella pneumophila is the most commonly detected cause of legionellosis, which is an acute respiratory tract infection with high morbidity and mortality rates. Objective. The aim of this study was to investigate the prevalence rate of L. pneumophila in bronchoalveolar lavages and study the role of sex, age and history of smoking as risk factors for susceptibility to the bacterium. Methods. One hundred bronchoalveolar lavage samples were collected from the Iranian health centers and immediately transferred to laboratory. The samples were cultured and those that were L. pneumophila positive were subjected to PCR method with respect to the 16S rRNA gene. Results. Twelve out of 100 samples were positive for L. pneumophila (12%. Patients older than 70 years had the highest incidence of L. pneumophila (17.77%. Prevalence of L. pneumophila in male and female patients was 14.81% and 8.69%, respectively. Total incidence of L. pneumophila in patients with and without history of smoking was 18% and 6%, respectively. There were significant differences in the incidence of bacterium between groups of our study. Conclusion. Sex, age and history of smoking are predominant risk factors for the occurrence of L. pneumophila. However, more studies should be undertaken to confirm these results.

  12. Mild hypothermia attenuates changes in respiratory system mechanics and modifies cytokine concentration in bronchoalveolar lavage fluid during low lung volume ventilation.

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    Dostál, P; Senkeřík, M; Pařízková, R; Bareš, D; Zivný, P; Zivná, H; Cerný, V

    2010-01-01

    Hypothermia was shown to attenuate ventilator-induced lung injury due to large tidal volumes. It is unclear if the protective effect of hypothermia is maintained under less injurious mechanical ventilation in animals without previous lung injury. Tracheostomized rats were randomly allocated to non-ventilated group (group C) or ventilated groups of normothermia (group N) and mild hypothermia (group H). After two hours of mechanical ventilation with inspiratory fraction of oxygen 1.0, respiratory rate 60 min(-1), tidal volume 10 ml x kg(-1), positive end-expiratory pressure (PEEP) 2 cm H2O or immediately after tracheostomy in non-ventilated animals inspiratory pressures were recorded, rats were sacrificed, pressure-volume (PV) curve of respiratory system constructed, bronchoalveolar lavage (BAL) fluid and aortic blood samples obtained. Group N animals exhibited a higher rise in peak inspiratory pressures in comparison to group H animals. Shift of the PV curve to right, higher total protein and interleukin-6 levels in BAL fluid were observed in normothermia animals in comparison with hypothermia animals and non-ventilated controls. Tumor necrosis factor-alpha was lower in the hypothermia group in comparison with normothermia and non-ventilated groups. Mild hypothermia attenuated changes in respiratory system mechanics and modified cytokine concentration in bronchoalveolar lavage fluid during low lung volume ventilation in animals without previous lung injury.

  13. Influence of refractory ceramic fibres - asbestos substitute - on the selected parameters of bronchoalveolar lavage 6 months after intratracheal instillation to W-rats.

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    Hurbánková, Marta; Cerná, Silvia; Gergelová, Petra; Wimmerová, Sona

    2005-12-01

    Industrial fibrous dusts are applied in many industrial branches and represent adverse factors in occupational and environmental area. Refractory ceramic fibers (RCFs) - amorphous alumina silicates - are used as one kind of asbestos substitutes. Because RCFs are relatively durable and some RCFs are respirable, they may present a potential health hazard by inhalation. The aim of present work was to find out the subchronic effect of RCFs on selected parameters of bronchoalveolar lavage (BAL) in W-rats, confirm the biopersistence of RCFs after 6 month instillation and contribute to the understanding of the pathomechanism of lung injury after fibrous dust exposure. Wistar rats were intratracheally instilled with 4 mg/animal of RCFs - exposed group and with 0.4 ml saline solution/animal - control group. Animals were sacrificed after 6 month exposure. Bronchoalveolar lavage (BAL) was performed and selected BAL parameters (mainly inflammatory and cytotoxic) were examined. After treatment with RCFs the following changes were observed: statistically significant increase in proportion of lymphocytes and polymorphonuclears as well as in % of immature alveolar macrophages (AM) and phagocytic activity of AM; statistically significant decrease in viability of AM and proportion of AM (from the differential cell count) in comparison with the control group. The results of this study indicated that RCFs even 6 months after intratracheal instillation very significantly changed the majority of examined BAL parameters. The presence of inflammatory and cytotoxic response in lung may signalize beginning or developing disease process.

  14. Changes of Tumor Necrosis Factor, Surfactant Protein A, and Phospholipids in Bronchoalveolar Lavage Fluid in the Development and Progression of Coal Workers' Pneumoconiosis

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    To evaluate the alterations of biomarkers in the development and progression of coal workers'pneumoconiosis (CWP). Methods The type and number of cells, and the levels of tumor necrosis factor-alpha (TNF-α),pulmonary surfactant protein, phospholipids and fibronectin in bronchoalveolar lavage fluid were assayed in 14 health active coal miners, 21 coal miners without CWP and 13 miners with CWP of 0/1 to 1/1. Results Compared to active coal miners without CWP (8.23 μg/mL), TNF-α concentration was gradually decreased when dust exposure was stopped (5.90 μg/mL).Elevated surfactant protein A (SP-A) level and phosphatidylglycerol (PG) to phosphatidylinositol (PI) ratio were found in miners actively exposed to coal dust (6528 ng/mL for SP-A and 10. for PG/PI), and both parameters decreased when CWP progressed from CWP (0/1) (3419 μg/mL for SP-A and 5.9 for PG/PI) to CWP (1/1) (1654 μg/mL for SP-A and 5.5 for PG/PI).Conclusion Biomarkers in bronchoalveolar lavage fluid can be used to screen coal miners at high risk of developing coal workers' pneumoconiosis.

  15. Determination of pulmonary irritant threshold concentrations of hexamethylene-1,6-diisocyanate (HDI) prepolymers by bronchoalveolar lavage in acute rat inhalation studies according to TRGS 430.

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    Ma-Hock, L; Gamer, A O; Deckardt, K; Leibold, E; van Ravenzwaay, B

    2007-02-01

    Pulmonary irritant threshold concentrations of two hexamethylene-1,6-diisocyanate (HDI)-based prepolymers (I: polymeric emulsfier modified and II: oligomeric allophanate modified) were determined in acute inhalation studies according to TRGS 430 (Dangerous Substances Technical Rule, isocyanates, Germany), based on benchmark extrapolation of bronchoalveolar lavage fluid (BALF) total protein. It was also investigated if the method is robust enough to be transferred to an independent laboratory. Five male Wistar rats per group were exposed nose-only to the test substances as liquid aerosols to concentrations of 0, 0.5, 3, 15 mg/m(3) for both test substances with an additional test group at 50 mg/m(3) for test substance I. The duration of the exposure was 6h, followed by serial sacrifices 1 day, 3 days and 7 days post exposure. BALF was analyzed for biochemical and cytological markers indicative for injury of the bronchoalveolar region. The exposure of rats to test substance I and II caused dose depended lung irritation with BALF total protein concentration being the most sensitive indicator of pulmonary effects. The extrapolated no observed adverse effect level of test substance I was 1.1 mg/m(3) and that of test substance II 2.3 mg/m(3). The acute pulmonary irritant threshold concentrations were found to be similar to those reported by [Pauluhn, J., 2004. Pulmonary irritant potency of polyisocyanate aerosols in rats: comparative assessment of irritant threshold concentrations by bronchoalveolar lavage. J. Appl. Toxicol. 24, 231-247] for HDI-homopolymers and other HDI-based polyisocyanates, and were at least 30 times higher than the MAK (occupational exposure limit) value for the HDI monomer (0.035 mg/m(3)). Thus the EBW (exposure assessment value) for these two HDI-based prepolymers can be established at 10x MAK, i.e. at 0.35 mg/m(3).

  16. [Segmental bronchoalveolar lavage with a flexible probe via a rigid bronchoscope in the diagnosis of mediastino-pulmonary sarcoidosis].

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    Faina, A G

    1989-01-01

    Segmentary bronchial-alveolar lavage with flexible catheter connected to rigid bronchoscope might be used in diagnosis of mediastinal-pulmonary sarcoidosis, according to a method used by the authors. Cytologic examination of the lavage fluid shows, in the cases studied, the great abundance in cells, with lymphocytes increase to 30 +/- 12% (in agreement with other authors) making thus possible the disease diagnosis. On the other hand, polymorphonuclears increased to 20 +/- 10%. These higher values than those noticed up to now, pointed that the fibrosing process in sarcoidosis has a higher level than assumed, and appear since the onset of the disease.

  17. High-throughput sequencing of 16S rDNA amplicons characterizes bacterial composition in bronchoalveolar lavage fluid in patients with ventilator-associated pneumonia

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    Yang XJ

    2015-08-01

    Full Text Available Xiao-Jun Yang,1,* Yan-Bo Wang,2,3,* Zhi-Wei Zhou,4,* Guo-Wei Wang,2 Xiao-Hong Wang,1 Qing-Fu Liu,1 Shu-Feng Zhou,4 Zhen-Hai Wang2,3 1Department of Intensive Care Unit, 2Neurology Center, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China; 3Key Laboratory of Brain Diseases of Ningxia, Yinchuan, Ningxia, People’s Republic of China; 4Department of Pharmaceutical Sciences, College of Pharmacy, University of South Florida, Tampa, FL, USA *These authors contributed equally to this work Abstract: Ventilator-associated pneumonia (VAP is a life-threatening disease that is associated with high rates of morbidity and likely mortality, placing a heavy burden on an individual and society. Currently available diagnostic and therapeutic approaches for VAP treatment are limited, and the prognosis of VAP is poor. The present study aimed to reveal and discriminate the identification of the full spectrum of the pathogens in patients with VAP using high-throughput sequencing approach and analyze the species richness and complexity via alpha and beta diversity analysis. The bronchoalveolar lavage fluid samples were collected from 27 patients with VAP in intensive care unit. The polymerase chain reaction products of the hypervariable regions of 16S rDNA gene in these 27 samples of VAP were sequenced using the 454 GS FLX system. A total of 103,856 pyrosequencing reads and 638 operational taxonomic units were obtained from these 27 samples. There were four dominant phyla, including Proteobacteria, Firmicutes, Actinobacteria, and Bacteroidetes. There were 90 different genera, of which 12 genera occurred in over ten different samples. The top five dominant genera were Streptococcus, Acinetobacter, Limnohabitans, Neisseria, and Corynebacterium, and the most widely distributed genera were Streptococcus, Limnohabitans, and Acinetobacter in these 27 samples. Of note, the mixed profile of causative pathogens was observed. Taken

  18. MRP1 expression in bronchoalveolar lavage cells in subjects with lung cancer who were chronically exposed to arsenic.

    Science.gov (United States)

    Recio-Vega, Rogelio; Dena-Cazares, Jose Angel; Ramirez-de la Peña, Jorge Luis; Jacobo-Ávila, Antonio; Portales-Castanedo, Arnulfo; Gallegos-Arreola, Martha Patricia; Ocampo-Gomez, Guadalupe; Michel-Ramirez, Gladis

    2015-12-01

    Alteration of multidrug resistance-associated protein-1 (MRP1) expression has been associated with certain lung diseases, and this protein may be pivotal in protecting the lungs against endogenous or exogenous toxic compounds. The aim of this study was to evaluate and compare the expression of MRP1 in bronchoalveolar cells from subjects with and without lung cancer who had been chronically exposed to arsenic through drinking water. MRP1 expression was assessed in bronchoalveolar cells in a total of 102 participants. MRP1 expression was significantly decreased in those with arsenic urinary levels >50 μg/L when compared with the controls. In conclusion, chronic arsenic exposure negatively correlates with the expression of MRP1 in BAL cells in patients with lung cancer.

  19. Evaluation of different real time PCRs for the detection of Pneumocystis jirovecii DNA in formalin-fixed paraffin-embedded bronchoalveolar lavage samples.

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    de Leeuw, Bertie H C G M; Voskuil, W Sebastiaan; Maraha, Boulos; van der Zee, Anneke; Westenend, Pieter J; Kusters, Johannes G

    2015-06-01

    The presence of Pneumocystis jirovecii in fresh clinical materials can be detected by PCR with high sensitivity and is thus preferred over microscopic methods. However, fresh materials are not always available, and on formalin-fixed paraffin-embedded materials, PCR may result in reduced detection rates. In this study the diagnostic sensitivity of P. jirovecii real time PCR on DNA isolated from fresh bronchoalveolar lavage (BAL) samples versus that from matched FFPE derived DNA is analyzed. Our results indicate that when targeting a small DNA fragment P. jirovecii PCR can be performed on FFPE BAL samples with acceptable sensitivity (up to 83.3%). This is considerably higher than the 33.3% positives observed by classical staining of these samples.

  20. Surfactant proteins SP-B and SP-C and their precursors in bronchoalveolar lavages from children with acute and chronic inflammatory airway disease

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    Winter Tobias

    2008-04-01

    Full Text Available Abstract Background The surfactant proteins B (SP-B and C (SP-C are important for the stability and function of the alveolar surfactant film. Their involvement and down-regulation in inflammatory processes has recently been proposed, but their level during neutrophilic human airway diseases are not yet known. Methods We used 1D-electrophoresis and Western blotting to determine the concentrations and molecular forms of SP-B and SP-C in bronchoalveolar lavage (BAL fluid of children with different inflammatory airway diseases. 21 children with cystic fibrosis, 15 with chronic bronchitis and 14 with pneumonia were included and compared to 14 healthy control children. Results SP-B was detected in BAL of all 64 patients, whereas SP-C was found in BAL of all but 3 children; those three BAL fluids had more than 80% neutrophils, and in two patients, who were re-lavaged later, SP-C was then present and the neutrophil count was lower. SP-B was mainly present as a dimer, SP-C as a monomer. For both qualitative and quantitative measures of SP-C and SP-B, no significant differences were observed between the four evaluated patient groups. Conclusion Concentration or molecular form of SP-B and SP-C is not altered in BAL of children with different acute and chronic inflammatory lung diseases. We conclude that there is no down-regulation of SP-B and SP-C at the protein level in inflammatory processes of neutrophilic airway disease.

  1. Comparison of endotracheal aspirate and non-bronchoscopic bronchoalveolar lavage in the diagnosis of ventilator-associated pneumonia in a pediatric intensive care unit.

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    Yıldız-Atıkan, Başak; Karapınar, Bülent; Aydemir, Şöhret; Vardar, Fadıl

    2015-01-01

    Ventilator-associated pneumonia (VAP) is defined as pneumonia occuring in any period of mechanical ventilation. There is no optimal diagnostic method in current use and in this study we aimed to compare two non-invasive diagnostic methods used in diagnosis of VAP in children. This prospective study was conducted in 8 bedded Pediatric Intensive Care Unit at Ege University Children´s Hospital. Endotracheal aspiration (ETA) and non-bronchoscopic bronchoalveolar lavage (BAL) were performed in case of developing VIP after 48 hours of ventilation. Quantitative cultures were examined in Ege University Department of Diagnostic Microbiology, Bacteriology Laboratory. Fourty-one patients were enrolled in the study. The mean age of study subjects was 47.2±53.6 months. A total of 28 in 82 specimens taken with both methods were negative/negative; 28 had positive result with ETA and a negative result with non-bronchoscopic BAL and both results were negative in 26 specimens. There were no patients whose respiratory specimen culture was negative with ETA and positive with non-bronchoscopic BAL. These results imply that there is a significant difference between two diagnostic methods (p ETA results were compared with this method. ETA's sensitivity, specificity, negative and positive predictive values were 100%, 50%, 100% and 48% respectively. The study revealed the ease of usability and the sensitivity of non-bronchoscopic BAL, in comparison with ETA.

  2. [Mediastino-pulmonary sarcoidosis in children. Clinical study, analysis of data of bronchoalveolar fluid lavage and respiratory function tests, therapeutic trends].

    Science.gov (United States)

    Donato, L; Baculard, A; Boule, M; Boccon-Gibod, L; Grimfeld, A; Tournier, G

    1991-10-01

    A series of 27 children (mean age: 12 yrs, 5 mos.) presenting with thoracic sarcoidosis is reported. This series, collected from 1961 to 1988 shows the rarity of the disease at that age. However the low rate of asymptomatic forms (22%) suggests that the frequency of the disease is underestimated, as it is not diagnosed. The histological proof is necessary for the diagnosis. When peripheral lesions available for biopsy are lacking, a liver needle biopsy is helpful (93% of positivity). This study shows the frequency of multivisceral types, the intensity of the macrophagic and lymphocytic alveolitis. The therapeutic indications depend on the comparison of the radiological stage, the results of pulmonary function tests (PFT), those of the bronchoalveolar lavages (BAL) and of the serum granulomatous activity markers, especially concerning angiotensin converting enzyme (ACE). When present at the beginning of evolution, several risk factors lead to use a corticosteroid treatment: age of onset before 4 years, multivisceral involvement, presence of functional pulmonary signs, delayed diagnosis and onset of treatment, impaired respiratory function (especially concerning the alveolo-capillary diffusion), PMN cells greater than or equal to 2% in the initial BAL, and IgG proteins greater than 4 SD. Thus sarcoidosis in children differs from that seen in adults as it has a more marked evolutive tendency and leaves severe sequelae in one third of patients.

  3. Aerosolized STAT1 Antisense Oligodeoxynucleotides Decrease the Concentrations of Inflammatory Mediators in Bronchoalveolar Lavage Fluid in Bleomycin-Induced Rat Pulmonary Fibrosis

    Institute of Scientific and Technical Information of China (English)

    Ming Zeng; Bin Liao; Chen Zhu; Wenjun Wang; Xiaoqin Zhan; Xianming Fan

    2008-01-01

    It has been demonstrated that alveolar macrophages (AMs) play a key role in the pathogenesis of pulmonary fibrosis by releasing a variety of cytokines and inflammatory mediators. In addition, abnormal signal transducer and activator of transcription-1 (STAT1) activation in AMs may play a pivotal role in the process of alveolitis and pulmonary fibrosis. In this study, we transfected STAT1 antisense oligodeoxynucleotide (ASON) into rats by aerosolization, and then investigated the effect of STAT1 ASON on inflammatory mediators such as TGF-β, PDGF and TNF-α in bronchoalveolar lavage fluid (BALF) from rats with bleomycin (BLM)-induced rat pulmonary fibrosis. Our results showed that STAT1 ASON by aerosolization could enter into lung tissues and AMs. STAT1 ASON could inhibit mRNA and protein expressions of STATI and ICAM-1 in AMs of rat with pulmonary fibrosis, and had no toxic side effect on liver and kidney. Aerosolized STAT1 ASON could ameliorate the alveolitis through inhibiting the secretion of inflammatory mediators in BLM-induced rat pulmonary fibrosis. These results suggest that aerosolized STAT1 ASON might be considered as a promising new strategy in the treatment of pulmonary fibrosis. Cellular & Molecular Immunology. 2008;5(3):219-224.

  4. Microbial interaction between a CTXM-15 -producing Escherichia coli and a susceptible Pseudomonas aeruginosa isolated from bronchoalveolar lavage: influence of cefotaxime in the dual-species biofilm formation.

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    Bessa, Lucinda J; Mendes, Ângelo; Gomes, Rita; Curvelo, Sara; Cravo, Sara; Sousa, Emília; Vasconcelos, Vitor; Martins da Costa, Paulo

    2015-06-01

    Two isolates, Escherichia coli ella00 and Pseudomonas aeruginosa ella01, obtained from bronchoalveolar lavage, were found to be closely associated in clusters in agar medium. Escherichia coli ella00 was multidrug resistant and CTXM-15 extended-spectrum β-lactamase producer, while P. aeruginosa ella01 was susceptible to all antimicrobials tested. These observations impelled for further studies aimed to understand their microbial interaction. The P. aeruginosa ella01 biofilm-forming capacity was reduced and not affected when it was co-cultured with E. coli ella00 and E. coli ATCC 25922 respectively. Interestingly, the co-culture of ella isolates in the presence of high concentrations, such as 160 μg ml(-1) , of cefotaxime allowed the formation of more biofilm than in the absence of the antibiotic. As revealed by fluorescence in situ hybridization, in co-culture, P. aeruginosa ella01 survived and subsequently flourished when exposed to this third-generation cephalosporin at a concentration 10 × higher than its minimum inhibitory concentration (MIC), and this was mostly due to β-lactamases production by E. coli ella00. In fact, it was demonstrated by high-performance liquid chromatography that cefotaxime was absent for the culture medium 4 h after application. In conclusion, we demonstrate that bacterial species can interact differently depending on the surrounding conditions (favourable or stressing), and that those interactions can switch from unprofitable to beneficial.

  5. The Omega-3 Fatty Acid Docosahexaenoic Acid Modulates Inflammatory Mediator Release in Human Alveolar Cells Exposed to Bronchoalveolar Lavage Fluid of ARDS Patients

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    Paolo Cotogni

    2015-01-01

    Full Text Available Background. This study investigated whether the 1 : 2 ω-3/ω-6 ratio may reduce proinflammatory response in human alveolar cells (A549 exposed to an ex vivo inflammatory stimulus (bronchoalveolar lavage fluid (BALF of acute respiratory distress syndrome (ARDS patients. Methods. We exposed A549 cells to the BALF collected from 12 ARDS patients. After 18 hours, fatty acids (FA were added as docosahexaenoic acid (DHA, ω-3 and arachidonic acid (AA, ω-6 in two ratios (1 : 2 or 1 : 7. 24 hours later, in culture supernatants were evaluated cytokines (TNF-α, IL-6, IL-8, and IL-10 and prostaglandins (PGE2 and PGE3 release. The FA percentage content in A549 membrane phospholipids, content of COX-2, level of PPARγ, and NF-κB binding activity were determined. Results. The 1 : 2 DHA/AA ratio reversed the baseline predominance of ω-6 over ω-3 in the cell membranes (P < 0.001. The proinflammatory cytokine release was reduced by the 1 : 2 ratio (P < 0.01 to <0.001 but was increased by the 1 : 7 ratio (P < 0.01. The 1 : 2 ratio reduced COX-2 and PGE2 (P < 0.001 as well as NF-κB translocation into the nucleus (P < 0.01, while it increased activation of PPARγ and IL-10 release (P < 0.001. Conclusion. This study demonstrated that shifting the FA supply from ω-6 to ω-3 decreased proinflammatory mediator release in human alveolar cells exposed to BALF of ARDS patients.

  6. Unique cytokine and chemokine patterns in bronchoalveolar lavage are associated with specific causative pathogen among HIV infected patients with pneumonia, in Medellin, Colombia.

    Science.gov (United States)

    Keynan, Yoav; Rueda, Zulma V; Aguilar, Yudy; Trajtman, Adriana; Vélez, Lázaro A

    2015-06-01

    We wanted to investigate the pro-inflammatory cytokine/chemokine profile associated with the etiological agents identified in HIV patients. Immunosuppressed patients admitted to two hospitals in Medellin, Colombia, with clinical and radiographic diagnosis of pneumonia were enrolled in the study. After consent, bronchoalveolar lavage (BAL) was collected for bacterial, mycobacterial and fungal diagnosis. All patients were followed for a year. A stored BAL sample was used for cytokine/chemokine detection and measurement using commercial, magnetic human cytokine bead-based 19-plex assays. Statistical analysis was performed by assigning cytokine/chemokine concentrations levels into 75 percentile (higher). Principal component analysis (PCA) and Kruskal-Wallis analysis were conducted to identify the clustering of cytokines with the various infectious etiologies (fungi, Mycobacterium tuberculosis - MTB, and bacteria). Average age of patients was 35, of whom 77% were male, and the median CD4 count of 33cells/μl. Of the 57 HIV infected patients, in-hospital mortality was 12.3% and 33% died within a year of follow up. The PCA revealed increased IL-10, IL-12, IL-13, IL-17, Eotaxin, GCSF, MIP-1α, and MIP-1β concentrations to be associated with MTB infection. In patients with proven fungal infection, low concentrations of IL-1RA, IL-8, TNF-α and VEGF were identified. Bacterial infections displayed a distinct cytokine pattern and were not misclassified using the MTB or fungi cytokine patterns (p-value<0.0001). Our results indicate a unique pattern of pro-inflammatory cytokine/chemokine, allowing differentiation between bacterial and non-bacterial pathogens. Moreover, we found distinct, if imperfectly discriminatory, cytokine/chemokine patterns associated with MTB and fungal infections.

  7. Assessment of CCL2 and CXCL8 chemokines in serum, bronchoalveolar lavage fluid and lung tissue samples from dogs affected with canine idiopathic pulmonary fibrosis.

    Science.gov (United States)

    Roels, Elodie; Krafft, Emilie; Farnir, Frederic; Holopainen, Saila; Laurila, Henna P; Rajamäki, Minna M; Day, Michael J; Antoine, Nadine; Pirottin, Dimitri; Clercx, Cecile

    2015-10-01

    Canine idiopathic pulmonary fibrosis (CIPF) is a progressive disease of the lung parenchyma that is more prevalent in dogs of the West Highland white terrier (WHWT) breed. Since the chemokines (C-C motif) ligand 2 (CCL2) and (C-X-C motif) ligand 8 (CXCL8) have been implicated in pulmonary fibrosis in humans, the aim of the present study was to investigate whether these same chemokines are involved in the pathogenesis of CIPF. CCL2 and CXCL8 concentrations were measured by ELISA in serum and bronchoalveolar lavage fluid (BALF) from healthy dogs and WHWTs affected with CIPF. Expression of the genes encoding CCL2 and CXCL8 and their respective receptors, namely (C-C motif) receptor 2 (CCR2) and (C-X-C motif) receptor 2 (CXCR2), was compared in unaffected lung tissue and biopsies from dogs affected with CIPF by quantitative PCR and localisation of CCL2 and CXCL8 proteins were determined by immunohistochemistry. Significantly greater CCL2 and CXCL8 concentrations were found in the BALF from WHWTs affected with CIPF, compared with healthy dogs. Significantly greater serum concentrations of CCL2, but not CXCL8, were found in CIPF-affected dogs compared with healthy WHWTs. No differences in relative gene expression for CCL2, CXCL8, CCR2 or CXCR2 were observed when comparing lung biopsies from control dogs and those affected with CIPF. In affected lung tissues, immunolabelling for CCL2 and CXCL8 was observed in bronchial airway epithelial cells in dogs affected with CIPF. The study findings suggest that both CCL2 and CXCL8 are involved in the pathogenesis of CIPF. Further studies are required to determine whether these chemokines might have a clinical use as biomarkers of fibrosis or as targets for therapeutic intervention.

  8. Validation of a new Aspergillus real-time PCR assay for direct detection of Aspergillus and azole resistance of Aspergillus fumigatus on bronchoalveolar lavage fluid.

    Science.gov (United States)

    Chong, Ga-Lai M; van de Sande, Wendy W J; Dingemans, Gijs J H; Gaajetaan, Giel R; Vonk, Alieke G; Hayette, Marie-Pierre; van Tegelen, Dennis W E; Simons, Guus F M; Rijnders, Bart J A

    2015-03-01

    Azole resistance in Aspergillus fumigatus is increasingly reported. Here, we describe the validation of the AsperGenius, a new multiplex real-time PCR assay consisting of two multiplex real-time PCRs, one that identifies the clinically relevant Aspergillus species, and one that detects the TR34, L98H, T289A, and Y121F mutations in CYP51A and differentiates susceptible from resistant A. fumigatus strains. The diagnostic performance of the AsperGenius assay was tested on 37 bronchoalveolar lavage (BAL) fluid samples from hematology patients and 40 BAL fluid samples from intensive care unit (ICU) patients using a BAL fluid galactomannan level of ≥1.0 or positive culture as the gold standard for detecting the presence of Aspergillus. In the hematology and ICU groups combined, there were 22 BAL fluid samples from patients with invasive aspergillosis (IA) (2 proven, 9 probable, and 11 nonclassifiable). Nineteen of the 22 BAL fluid samples were positive, according to the gold standard. The optimal cycle threshold value for the presence of Aspergillus was Aspergillus species and 14 A. fumigatus samples). This resulted in a sensitivity, specificity, and positive and negative predictive values of 88.9%, 89.3%, 72.7%, and 96.2%, respectively, for the hematology group and 80.0%, 93.3%, 80.0%, and 93.3%, respectively, in the ICU group. The CYP51A real-time PCR confirmed 12 wild-type and 2 resistant strains (1 TR34-L98H and 1 TR46-Y121F-T289A mutant). Voriconazole therapy failed for both patients. The AsperGenius multiplex real-time PCR assay allows for sensitive and fast detection of Aspergillus species directly from BAL fluid samples. More importantly, this assay detects and differentiates wild-type from resistant strains, even if BAL fluid cultures remain negative.

  9. Fluorescent microscopy and Ziehl-Neelsen staining of bronchoalveolar lavage, bronchial washings, bronchoscopic brushing and post bronchoscopic sputum along with cytological examination in cases of suspected tuberculosis

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    Vijay Kumar Bodal

    2015-01-01

    Full Text Available Objectives: Ever since the discovery of Mycobacterium tuberculosis in 1882, many diagnostic methods have been developed. However "The gold standard" for the diagnosis of tuberculosis (TB is still the demonstration of acid fast Bacilli (AFB by microscopic examination of smear or bacteriological confirmation by culture method. Materials and Methods: In suspected 75 patients with active pulmonary TB, the materials obtained bronchoscopically, were bronchoalveolar lavage (BAL, bronchial brushings, bronchial washings and post bronchoscopic sputum. Four smears were made from each of the specimen. Fluorescent Staining, Ziehl–Neelsen (ZN, Pap and May Grunwald-Giemsa (MGG stains were carried out for cytological examination. Results: Fluorescent stain yielded maximum AFB positivity in all the methods, that is 36 (48% in post fibre-optic bronchoscopy (FOB sputum and 19 (25.33% by fluorescence microscopy in both bronchial brushings and bronchial washings. Maximum yield of AFB with ZN staining 12 (16% was equal to the post FOB sputum and bronchial brushings samples. It was followed by 6 cases (8% in BAL and 4 (5.3% in bronchial washings. The cytological examination was suggestive of TB in only 8 (10.66% cases in bronchial washings and 6 (8% cases in post FOB collection. It was equal in BAL and Bronchial brushings each that is 5 (6.67%. Conclusion: Bronchoscopy is a useful diagnostic tool and fluorescent microscopy is more sensitive than ZN and cytology. On X-ray examination, other diseases like malignancy or fungus can also mimick TB. So apart from ZN staining or fluorescence microscopy, Pap and MGG stain will be worthwhile to identify other microorganisms.

  10. PAR-2, IL-4R, TGF-β and TNF-α in bronchoalveolar lavage distinguishes extrinsic allergic alveolitis from sarcoidosis.

    Science.gov (United States)

    Matěj, Radoslav; Smětáková, Magdalena; Vašáková, Martina; Nováková, Jana; Sterclová, Martina; Kukal, Jaromír; Olejár, Tomáš

    2014-08-01

    Sarcoidosis (SARC) and extrinsic allergic alveolitis (EAA) share certain markers, making a differential diagnosis difficult even with histopathological investigation. In lung tissue, proteinase-activated receptor-2 (PAR-2) is primarily investigated with regard to epithelial and inflammatory perspectives. Varying levels of certain chemokines can be a useful tool for distinguishing EAA and SARC. Thus, in the present study, differences in the levels of transforming growth factor (TGF)-β1, tumor necrosis factor (TNF)-α, interleukin-4 receptor (IL-4R) and PAR-2 in bronchoalveolar lavage fluid (BALF) were compared, using an ELISA method, between 14 patients with EAA and six patients with SARC. Statistically significant higher levels of IL-4R, PAR-2 and the PAR-2/TGF-β1 and PAR-2/TNF-α ratios were observed in EAA patients as compared with SARC patients. Furthermore, the ratios of TNF-α/total protein, TGF-β1/PAR-2 and TNF-α/PAR-2 were significantly lower in EAA patients than in SARC patients. The results indicated a higher detection of PAR-2 in EAA samples in association with TNF-α and TGF-β levels. As EAA and PAR-2 in parallel belong to the Th2-mediated pathway, the results significantly indicated an association between this receptor and etiology. In addition, the results indicated that SARC is predominantly a granulomatous inflammatory disease, thus, higher levels of TNF-α are observed. Therefore, the detection of PAR-2 and investigated chemokines in BALF may serve as a useful tool in the differential diagnosis between EAA and SARC.

  11. Effect of low doses of lipopolysaccharide prior to ozone exposure οn bronchoalveolar lavage. Differences between wild type and surfactant protein A-deficient mice

    Directory of Open Access Journals (Sweden)

    Rizwanul Haque

    2009-01-01

    Full Text Available SUMMARY. BACKGROUND: Several aspects of the inflammatory response to a single insult, i.e., exposure to 2 ppm of ozone (O3 for 3 h or 6 h, are less pronounced in surfactant protein A deficient (SP-A -/- mice (KO than in wild type mice (WT. It was hypothesized that a mild insult, specifically low doses of lipopolysaccharide (LPS, would adversely affect host defense and differentially potentiate O3-induced injury in WT and KO mice. METHODS: WT and KO mice were treated with different doses of LPS or LPS (2 ng + O3 (2 ppm or filtered air (FA for 3 h, then sacrificed 4 h following exposure (O3, FA or 20 h after LPS treatment alone. Several endpoints of inflammation were measured in bronchoalveolar lavage (BAL. RESULTS: 1 At 20 h after LPS treatment alone, both WT and KO mice exhibited signs of inflammation, but with differences in the macrophage inflammatory protein 2 (MIP-2 response pattern, total cells (at 0.5 ng LPS and basal levels of oxidized protein and phospholipids; 2 After LPS + O3, KO compared to WT showed decrease in polymorphonuclear leukocytes (PMNs and MIP-2 and increase in phospholipids, and after LPS + FA an increase in total cells; 3 WT after LPS + FA showed an increase in SP-A with no further increase after LPS + O3, and an increase in oxidized SP-A dimer following O3 or LPS + O3. CONCLUSIONS: LPS treatment has negative effects on inflammation endpoints in mouse BAL long after exposure and renders KO mice less capable of responding to a second insult. LPS and O3 affect SP-A, quantitatively and qualitatively, respectively. Pneumon 2009; 22(2:131–155.

  12. Molecular analysis of serum and bronchoalveolar lavage in a mouse model of influenza reveals markers of disease severity that can be clinically useful in humans.

    Directory of Open Access Journals (Sweden)

    Yadunanda Kumar

    Full Text Available BACKGROUND: Management of influenza, a major contributor to the worldwide disease burden, is complicated by lack of reliable methods for early identification of susceptible individuals. Identification of molecular markers that can augment existing diagnostic tools for prediction of severity can be expected to greatly improve disease management capabilities. METHODOLOGY/PRINCIPAL FINDINGS: We have analyzed cytokines, proteome flux and protein adducts in bronchoalveolar lavage (BAL and sera from mice infected with influenza A virus (PR8 strain using a previously established non-lethal model of influenza infection. Through detailed cytokine and protein adduct measurements of murine BAL, we first established the temporal profile of innate and adaptive responses as well as macrophage and neutrophil activities in response to influenza infection. A similar analysis was also performed with sera from a longitudinal cohort of influenza patients. We then used an iTRAQ-based, comparative serum proteome analysis to catalog the proteome flux in the murine BAL during the stages correlating with "peak viremia," "inflammatory damage," as well as the "recovery phase." In addition to activation of acute phase responses, a distinct class of lung proteins including surfactant proteins was found to be depleted from the BAL coincident with their "appearance" in the serum, presumably due to leakage of the protein following loss of the integrity of the lung/epithelial barrier. Serum levels of at least two of these proteins were elevated in influenza patients during the febrile phase of infection compared to healthy controls or to the same patients at convalescence. CONCLUSIONS/SIGNIFICANCE: The findings from this study provide a molecular description of disease progression in a mouse model of influenza and demonstrate its potential for translation into a novel class of markers for measurement of acute lung injury and improved case management.

  13. Correlation and discriminant analysis between clinical, endoscopic, thoracic X-ray and bronchoalveolar lavage fluid cytology scores, for staging horses with recurrent airway obstruction (RAO).

    Science.gov (United States)

    Tilley, P; Sales Luis, J P; Branco Ferreira, M

    2012-10-01

    As recurrent airway obstruction (RAO) is progressive and as medical history is frequently unknown by owners, it's important to suggest a score model to characterize RAO stages for a more accurate diagnosis and treatment. The authors correlated clinical (CS), endoscopic (ES), thoracic X-ray (XRS) and bronchoalveolar lavage fluid (BALFS) scores in horses with RAO, in an attempt to establish relevance of each factor's contribution for the characterization of RAO stages and to suggest a staging method. Thirty horses with RAO and ten healthy controls were studied. Pearson correlation coefficients were determined between CS, ES, XRS and BALFS. Only significant correlation coefficients (>0.60) were considered. One way variance analyses were used to compare the two groups. A discriminant analysis model was adjusted on the RAO staging method suggested. There was a significant correlation coefficient between the CS cough, nostril flare and abdominal lift, all the mucus ES (0.61-0.84), the XRS interstitial pattern, bronchial radiopacity and thickening and tracheal thickening (0.67-0.78) and the BALFS neutrophil percentages (0.63-0.84). These variables (e.g., cough) which presented a significant correlation coefficient were considered relevant and chosen for a score model to characterize RAO stages. The ten healthy controls were attributed stage 0 and the 30 RAO horses were attributed stages 1 (4 horses), 2 (7 horses), 3 (10 horses) and 4 (9 horses). There was also a significant correlation coefficient between all the relevant variables and the RAO stage (0.61-0.89). Furthermore, discriminant analysis of the RAO staging method showed 92.5% of original grouped cases and 85.0% of cross-validated grouped cases correctly classified, having confirmed major contribution of the same variables that had significant correlation coefficients. Even though further confirmation by lung functional testing is desirable, the significant correlation between relevant variables and RAO stage and

  14. Effects of 0.2 ppm ozone on biomarkers of inflammation in bronchoalveolar lavage fluid and bronchial mucosa of healthy subjects

    Energy Technology Data Exchange (ETDEWEB)

    Krishna, M.T.; Madden, J.; Teran, L.M. [and others

    1998-08-01

    Short-term exposure to ozone at peak ambient levels induces neutrophil influx and impairs lung function in healthy humans. In order to investigate the mechanisms contributing to neutrophil recruitment and to examine the role of T-cells in the acute inflammatory response, we exposed 12 healthy humans to 0.2 parts per million (ppm) of ozone and filtered air on two separate occasions for 2 h with intermittent periods of rest and exercise (minute ventilation=30 L x min{sup -1}). Fibreoptic bronchoscopy was performed 6 h after the end of exposures. Total protein, tryptase, histamine, myeloperoxidase, interleukin (IL)-8 and growth-related oncogene-{alpha} (Gro-{alpha}) were measured and total and differential cell counts were performed in bronchoalveolar lavage (BAL) fluid. Flow cytometry was performed on BAL cells to study total T-cells, T-cell receptors ({alpha}{beta} and {gamma}{delta}), T-cell subsets (CD4+ and CD8+ cells) and activated T-cell subsets (CD25+). Using immunohistochemistry, neutrophils, mast cells, total T-cell numbers, T-cell subsets, CD25+ T-cells and leukocyte endothelial adhesion molecules including P-selectin, E-selectin, intercellular adhesion molecule (ICAM)-1 and vascular adhesion molecule (VCAM)-1 were quantified in the bronchial biopsies. Paired samples were available from nine subjects. Following ozone exposure there was a threefold increase in the proportion of polymorphonuclear neutrophils (PMNs) (p=0.07) and epithelial cells (p=0.05) in BAL fluid. This was accompanied by increased concentrations of IL-8 (p=0.01), Gro-{alpha} (p=0.05) and total protein (p=0.058). A significant positive correlation was demonstrated between the two chemokines and proportion of PMNs in BAL fluid. After ozone exposure there was a significant decrease in the CD4/CD8 ratio (p=0.05) and the proportion of activated CD4+ (p=001) and CD8+ T-cells (p=0.04). However, no significant changes were demonstrable in any of the inflammatory markers studied in the biopsies

  15. Rapid detection of Pneumocystis carinii in bronchoalveolar lavage specimens from human immunodeficiency virus-infected patients: use of a simple DNA extraction procedure and nested PCR.

    Science.gov (United States)

    Rabodonirina, M; Raffenot, D; Cotte, L; Boibieux, A; Mayençon, M; Bayle, G; Persat, F; Rabatel, F; Trepo, C; Peyramond, D; Piens, M A

    1997-11-01

    We report on the development of a rapid nested PCR protocol for the detection of Pneumocystis carinii DNA in bronchoalveolar lavage (BAL) specimens in which the protocol included the use of a commercially available DNA extraction kit (GeneReleaser). GeneReleaser enabled us to obtain amplification-ready DNA within 20 min without requiring the purification of the DNA. The nested PCR was performed with the primers pAZ102-E, pAZ102-H, and pAZ102-L2 (A. E. Wakefield, F. J. Pixley, S. Banerji, K. Sinclair, R. F. Miller, E. R. Moxon, and J. M. Hopkin, Lancet 336:451-453, 1990.). Results were obtained in about 4 h with the adoption of denaturation, annealing, and extension steps shortened to 20 seconds. The sensitivity of the nested PCR was tested with a P. carinii cyst suspension and was found to be less than one cyst (one to eight nuclei). The detection limit was the same with the use of GeneReleaser or proteinase K-phenol chloroform for DNA extraction. The nested PCR assay was prospectively compared with staining with Giemsa and methenamine silver stains for the detection of P. carinii in 127 BAL samples from 105 human immunodeficiency virus-infected patients investigated for acute respiratory illness. Twenty-five BAL specimens (20%) were positive by staining and the nested PCR and 25 (20%) were negative by staining and positive by the nested PCR. These 25 BAL specimens with conflicting results were obtained from 23 patients, 82% of whom were receiving prophylactic therapy against P. carinii pneumonia (PCP). Only two patients were diagnosed with possible PCP. The final diagnosis was not PCP for 20 patients who were considered to be colonized or to have a low level of infection. This colonization is not of clinical importance but is of epidemiological importance. Our rapid, simple, and sensitive amplification protocol may be performed in clinical laboratories for the routine diagnosis of PCP with BAL specimens.

  16. Pulmonary toxicity of polyvinyl chloride particles after repeated intratracheal instillations in rats. Elevated CD4/CD8 lymphocyte ratio in bronchoalveolar lavage.

    Science.gov (United States)

    Xu, Haiyan; Vanhooren, Hadewijch M; Verbeken, Erik; Yu, Lisong; Lin, Yuan; Nemery, Benoit; Hoet, Peter H M

    2004-01-15

    Occupational exposure to polyvinyl chloride (PVC) particles has been associated with interstitial lung disease. Our previous study showed that a single intratracheal instillation of emulsion PVC particles, with or without residual additives, induces acute but transient alveolitis in a dose-dependent manner in rats. The aim of the present study was to investigate the pulmonary response after the administration of the same PVC particles (PVC-E3 and PVC-W3) given in the same cumulative doses (10 and 50 mg/kg BW), but fractionated as seven intratracheal instillations (7 x 1.4 and 7 x 7.1 mg/kg BW) in the course of 3 weeks (day 0 to day 21). Pulmonary response was characterized by analysis of lung weight, bronchoalveolar lavage (BAL) fluid for lactate dehydrogenase (LDH), total protein, and cell cytology, and a microscopic evaluation of lung tissue. BAL T lymphocyte phenotypes (CD3 + CD4 +, CD3 + CD8+) were analyzed by flow cytometry. On day 28, lung weights, BAL-LDH, cell numbers in BAL, and CD4/CD8 ratios in BAL T lymphocytes were higher in rats that had received the high dose of PVC-E3 or PVC-W3 than in rats that had received the low dose of PVC particles and control rats. On day 90, the pulmonary response had partially regressed towards control values, but there were still microscopically evident lesions in the lungs and greater CD4/CD8 ratio in the high dose groups. There were significant positive correlations between the CD4/CD8 ratio and a histopathology score of the lung (r = 0.36, P = 0.038 on day 28, and r = 0.46, P = 0.006 on day 90). In conclusion, repeated intratracheal instillations of PVC particles yielded similar results as single instillations. The examined PVC particles have the potential of inducing a limited and transient acute inflammatory reaction in the lung, and possibly a more persistent alteration of pulmonary T lymphocyte subsets towards a high CD4/CD8 ratio.

  17. The number of regulatory T cells in transbronchial lung allograft biopsies is related to FoxP3 mRNA levels in bronchoalveolar lavage fluid and to the degree of acute cellular rejection

    DEFF Research Database (Denmark)

    Krustrup, Dorrit; Madsen, Caroline B; Iversen, Martin;

    2013-01-01

    The transcription factor Forkhead Box P3 (FoxP3) is a marker of regulatory T cells (Tregs) - a subset of T cells known to suppress a wide range of immune responses. These cells are considered to be pivotal for the induction of tolerance to donor antigens in human allografts. We aimed to correlate...... the number of lymphocytes expressing FoxP3 in transbronchial biopsies from lung allografts with the FoxP3 expression in bronchoalveolar lavage fluid (BALF). In addition, we aimed to correlate the number of FoxP3+ cells in transbronchial biopsies with the degree of acute cellular rejection in lung allografts....

  18. Estudo do lavado broncoalveolar em pacientes com comprometimento pulmonar na leptospirose Study of bronchoalveolar lavage in leptospirosis patients with pulmonary involvement

    Directory of Open Access Journals (Sweden)

    Jorge Eduardo Manhães de Carvalho

    2004-04-01

    diffuse bilateral infiltrates in chest X-rays. Such findings may be compatible with alveolar hemorrhage, already described by some authors both in autopsies and bronchoalveolar lavage (BAL. OBJECTIVE: To evaluate the presence of alveolar hemorrhage, diagnosed through BAL, in bearers of leptospirosis patients with pulmonary involvement emphasizing the methodís importance for early detection of this complication. METHOD: Seven patients with leptospirosis were submitted to BAL. All presented respiratory symptoms and/or infiltrates in the chest X-rays and/or hypoxemia.Alveolar hemorrhage was defined by the following findings in BAL: percentage of siderophages eî20% and/ or Golde score >100 and/or hemorrhagic fluid. Culture and direct tests for leptospirosis were performed in BAL. Diagnosis of disease was confirmed by microscopy serum agglutination. RESULTS: The aspect of the bronchoscopy was normal in five patients, showed blood in the bronchial tree in one case and inflammatory manifestations in another. The BAL aspect was hemorrhagic for all patients portraying alveolar hemorrhage. Culture and direct tests were negative for Leptospiras in the BAL. CONCLUSIONS: Leptospirosis must be taken into account in the differential diagnosis of alveolar hemorrhage. The BAL was confirmed as an efficient method for detection of alveolar hemorrhage in leptospirosis, to recommend immediate therapy for the purpose of preventing its evolution to massive hemoptysis and respiratory failure.

  19. Microscopic examination of intracellular organisms in bronchoalveolar lavage fluid for the diagnosis of ventilator-associated pneumonia:a prospective multi-center study

    Institute of Scientific and Technical Information of China (English)

    Liu Chang; Du Zhaohui; Zhou Qing; Hu Bo; Li Zhifeng; Yu Li; Xu Tao

    2014-01-01

    Background The presence of intracellular organisms (ICOs) in polymorphonuclear leukocytes obtained from bronchoalveolar lavage fluid (BALF) is a possible method for rapid diagnosis of ventilator-associated pneumonia (VAP).However,the validity of this diagnostic method remains controversial and the diagnostic thresholds reported by investigators were different.Our objective was to evaluate the accuracy of quantification of ICOs in BALF for the diagnosis of VAP,and to detect the best cutoff percentage of PMNs containing ICOs (PIC) in the microscopic examination of BALF for the diagnosis of VAP.Methods This was a prospective multi-center study conducted in 4 ICUs in Wuhan,China,which involved 181 patients suspected of first episode of VAP.BALF was obtained from all enrolled patients.The BALF samples underwent quantitative culture,cytological and bacteriological analysis to detect the culture results,PIC values and the morphological features of microorganisms.Definite diagnosis of VAP was based on pre-set criteria.The receiver-operating characteristic curve was used to detect the best cutoff point for PIG to diagnose VAP,and the diagnostic accuracy was calculated.Moreover,quantitative culture and Gram's stain of BALF were adopted to diagnose VAP,and their diagnostic accuracy was evaluated as well.Results There were 102 patients definitely diagnosed with VAP (VAP group),and 60 patients definitely diagnosed without VAP (no VAP group).We found that ICOs were present in 96.08% (98 out of 102) of VAP patients and 20.00% (12 out of 60) of no VAP patients.The PICs were significantly higher ((9.53±6.65)% vs.(0.52±1.33)%,P<0.01) in VAP group.In our study,the best cutoff point for PIC to diagnose VAP was 1.5%,which had a sensitivity of 94.12%,a specificity of 88.33%,a positive predictive value (PPV) of 93.20% and a negative predictive value (NPV) of 89.83%.The area under the receiveroperating characteristic curve was 0.956 (95% confidence interval,0

  20. Diagnostic value of bronchoalveolar lavage in immunocompromised patients with pneumonia%支气管肺泡灌洗在免疫抑制患者肺部感染中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    徐翠萍; 张波

    2014-01-01

    肺部感染是导致免疫抑制患者死亡的重要原因之一.支气管肺泡灌洗是研究肺泡表面液细胞成分和可溶性物质的一种方法,被广泛用于免疫抑制宿主肺部病变的诊断中,是下呼吸道微生物取样的标准方法.现将支气管肺泡灌洗在免疫抑制患者肺部感染中的诊断价值作一综述.%Pneumonia is a major cause of mortality in immunocompromised patients.Bronchoalveolar lavage,as a tool for investigation of the cellular and soluble components in alveolar lining fluid,has been extensively used for diagnosis of pulmonary disease in immunocompromised hosts.It has become a standard tool in investigation of lower respiratory pathogens.This paper reviews the diagnostic value of bronchoalveolar lavage in immunocompromised patients with pneumonia.

  1. 纤支镜下支气管肺泡灌洗在多发伤并肺挫伤中的应用%Application of Bronchoalveolar Lavage by Fibrobronchoscopy in Multiple Injury with Pulmonary Contusion

    Institute of Scientific and Technical Information of China (English)

    边革元; 郝江; 罗积慎; 张萍; 杨明浩; 刘军

    2011-01-01

    [Objective]To explore the efficacy of bronchoalveolar lavage by fibrobronchoscopy for the examination and treatment of multiple injury patients with pulmonary contusion. [Methods] Multiple injury patients with pulmonary contusion who needed invasive ventilation were randomly divided into control group and fibrobronchoscopy treatment group. Beside antibiotics, circulatory and respiratory support and corticoids,bronchoalveolar lavage was used in the treatment group. Bronchoalveolar lavage fluid included normal saline 100ml and ambroxol hydrochloride injection 150mg. Bronchoalveolar lavage at bedside was performed for 3times with once a day. Meanwhile sputum smear was performed. The efficacy was compared between two groups. [Results] Compared with the control group, the oxygenation index(PaO2/FiO2) target reaching (≥300mmHg) time, chest-X ray shadow fade time and invasive mechanical ventilation time in the fibrobronchoscopy treatment group decreased, and there were significant differences between two groups( P >0.05). Fibrobronchoscopy could promptly find mucosal injury and airway obstruction, and timely take local irrigate and medication for removing the obstruction. [Conclusion] Mechanical ventilation combined with bronchoalveolar lavage is a safe and effective measure for the treatment of multiple injury complicated with pulmonary contusion.%[目的]探讨纤支镜下支气管肺泡灌洗(BAL)对多发伤并肺挫伤患者的检查与治疗效果.[方法]将多发伤并肺挫伤且需使用有创机械通气患者分为对照与纤支镜治疗组,除抗感染、循环呼吸支持、皮质激素等治疗外,治疗组病程中均采用纤支镜,以生理盐水100 mL+盐酸氨溴索注射液150 mg作为灌洗液,床旁行BAL灌洗3次,每2天1次,并行痰检,比较两组的治疗效果.[结果]经纤支镜治疗组氧合指数(PaO2/FiO2)改善(≥300 mmHg)时间、胸片阴影消退时间、有创机械通气时间三项指标均较对照组有所

  2. Clinical analysis of bronchoalveolar lavage in the treatment of lobar pneumonia in children%支气管肺泡灌洗治疗儿童大叶性肺炎临床分析

    Institute of Scientific and Technical Information of China (English)

    何艳芳; 刘凤艳

    2013-01-01

    Purpose To investigate the clinical value of bronchoalveolar lavage in treatment of children with lobar pneumonia. Method:Randomly selected 50 patients without alveolar lavage of lobar pneumonia (non lavaged group) and 60 cases after bronchoalveolar lavage of lobar pneumonia (lavage group), compared two groups of children with the average hospital stay, average time of using antibiotic and short-term and long-term complications. Result:The treatment group the average hospitalization days and the average time of using antibiotic was shorter than the control group (P<0.01), short term complication rate higher than the treatment group (P<0.05), the long term complication rate of control group was higher than the treatment group P<0.05. Conclusion:Bronchoalveolar lavage for the treatment of lobar pneumonia in children can significantly reduce the average time of hospitalization in children and the use of antibiotics in time, the short-term complication was transient, safe and reliable, and can reduce the long-term complications of lobar pneumonia.%目的:探讨支气管肺泡灌洗术治疗儿童大叶性肺炎的临床价值。方法:随机抽取50例未进行肺泡灌洗的大叶性肺炎患儿(未灌洗组)和60例经过肺泡灌洗的大叶性肺炎的患儿(灌洗组),对比两组患儿的平均住院日,平均抗生素使用时间及短期及远期并发症发生率。结果:灌洗组患儿的平均住院日及平均抗生素使用时间明显短于非灌洗组(P<0.01),短期并发症发生率灌洗组高于非灌洗组(P<0.05),远期并发症发生率非灌洗组高于灌洗组 P<0.05。结论:支气管肺泡灌洗术治疗儿童大叶性肺炎可明显减少患儿平均住院治疗时间及抗生素使用时间,其短期并发症多呈一过性,安全可靠,同时可减少大叶性肺炎的远期并发症。

  3. Primary A (H1N1) pdm09 Influenza Pneumonia Diagnosed on Reverse Transcription-polymerase Chain Reaction (RT-PCR) of Bronchoalveolar Lavage Fluid but not Rapid Tests with Nasopharyngeal Swabs.

    Science.gov (United States)

    Ohkura, Noriyuki; Tani, Mayuko; Nishitsuji, Masaru; Nishi, Koichi

    2015-01-01

    A 47-year-old man with a fever was highly suspected of having influenza A infection since his wife and son who lived with him had been diagnosed with influenza A. Although repeated rapid tests with a nasopharyngeal swab showed negative findings, the patient developed bilateral pneumonia and reverse transcription polymerase chain reaction (PCR) for A (H1N1) pdm09 virus in the bronchoalveolar lavage fluid was positive. We therefore diagnosed him with primary influenza pneumonia and initiated treatment with peramivir plus corticosteroids, which rapidly improved his condition. During the influenza season, sample collection from the lower airway and PCR should be considered for the definitive diagnosis of primary influenza viral pneumonia.

  4. Rapid detection of cytomegalovirus in bronchoalveolar lavage fluid and serum samples by polymerase chain reaction: correlation of virus isolation and clinical outcome for patients with human immunodeficiency virus infection

    DEFF Research Database (Denmark)

    Hansen, K K; Vestbo, Jørgen; Benfield, T;

    1997-01-01

    Bronchoalveolar lavage (BAL) fluids and serum samples from 153 patients with pulmonary symptoms who were infected with human immunodeficiency virus (HIV) and underwent BAL were examined for the presence of cytomegalovirus (CMV) by conventional culture and by polymerase chain reaction (PCR.......0; confidence interval [CI], 3.8-16.8) or the finding of CMV DNA in serum (RR, 7.4; CI, 3.2-17.3) or BAL fluid (RR, 8.0; CI, 3.1-20.7) by PCR. Mortality was found to be similar for patients who did or did not have CMV detected by either culture or PCR. Detection of CMV DNA by PCR was a more rapid and sensitive...

  5. Application of bronchoalveolar lavage in diagnosis and treatnent of childhood prolonged pneumonia%支气管肺泡灌洗术在儿童迁延性肺炎诊治中的作用

    Institute of Scientific and Technical Information of China (English)

    王莹; 黄英; 李渠北; 代继宏; 舒畅; 袁小平; 赵华; 符州

    2011-01-01

    目的 探讨纤维支气管镜及支气管肺泡灌洗术在儿童迁延性肺炎诊治中的作用.方法 收集2009年1月-12月入院的迁延性肺炎患儿,对其中105例行纤维支气管镜检查及支气管肺泡灌洗,与40例未行此术的患儿进行对照分析.结果 105例行纤维支气管镜检查的患儿均显示不同程度的支气管内膜炎症,其中单纯性气管支气管内膜炎43例,62例同时存在呼吸道基础疾病,呼吸中心中气管支气管软化32例、气管支气管狭窄19例、支气管开口异常6例.支气管肺泡灌洗组治愈85例,治愈率80.95%;对照组治愈22例,治愈率55.00%.两组差异有统计学意义(P<0.005).结论 纤维支气管镜术及支气管肺泡灌洗术对儿童迁延性肺炎有重要的病因诊断和治疗价值,且安全性好.%Objective To explore the use of flexible bronchoscopy examination and bronchoalveolar lavage in diagnosis and treatment of childhood prolonged pneumonia. Methods A total of 145 cases with prolonged pneumonia between January 2009 and December 2009 were collected and among them 105 patients were given flexible bronchoscopy examination and bronchoalveolar lavage treatment. Results Flexible bronchoscopy examination showed that all of the 105 children with prolonged pneumonia had endobronchitis, in which 62 cases with other respiratory diseases. Among them, simple endobronchitis were 43 cases, tracheobronchomalacia were 32 cases, tracheobronchial stenosis were 19 cases, bronchial abnormal openings were 6 cases, tracheobronchial foreign body were 2 cases. Old pulmonary hemorrhage, bronchus dysplasia, laryngeal cartilage dysplasia was 1 case, respectively. In lavage group,85 cases were cured, 20 cases were improved; In control group, 22 cases were cured, 17 cases were improved, 1 case had no effect. There is statistical significance between lavage group and control group in effective rate( P <0.005). Conclusions Flexible bronchoscopy examination combined with

  6. Detection of Pneumocystis carinii and Characterization of Mutations Associated with Sulfa Resistance in Bronchoalveolar Lavage Samples from Human Immunodeficiency Virus-Infected Subjects

    Science.gov (United States)

    Zingale, Anna; Carrera, Paola; Lazzarin, Adriano; Scarpellini, Paolo

    2003-01-01

    One hundred ninety-four bronchoalveolar specimens were evaluated by microscopic examination and by amplification of a sequence of a Pneumocystis carinii dihidropteroate synthase gene for identification of mutations linked to sulfa resistance. PCR sensitivity and specificity were 100 and 86.7%, respectively, compared to results of microscopic examination. However, 7 out of 19 microscopy-negative, PCR-positive samples were collected from subjects with a clinically high probability of P. carinii pneumonia, suggesting that PCR may be more sensitive than microscopic examination, although the absolute performance of PCR cannot be determined. Mutations were identified in 28 out of 70 (40%) PCR-positive specimens and were significantly more common in patients exposed to sulfa drugs (21 out of 29 [72.4%]) than in those not exposed to sulfa drugs (4 out of 35 [11.4%]). PMID:12791912

  7. Detection of Mycoplasma mycoides subsp. mycoides SC in bronchoalveolar lavage fluids of cows based on a TaqMan real-time PCR discriminating wild type strains from an lppQ− mutant vaccine strain used for DIVA-strategies

    Science.gov (United States)

    Vilei, Edy M.; Frey, Joachim

    2010-01-01

    Contagious bovine pleuropneumonia (CBPP) is the most serious cattle disease in Africa, caused by Mycoplasma mycoides subsp. mycoides small-colony type (SC). CBPP control strategies currently rely on vaccination with a vaccine based on live attenuated strains of the organism. Recently, an lppQ− mutant of the existing vaccine strain T1/44 has been developed (Janis et al., 2008). This T1lppQ− mutant strain is devoid of lipoprotein LppQ, a potential virulence attribute of M. mycoides subsp. mycoides SC. It is designated as a potential live DIVA (Differentiating Infected from Vaccinated Animals) vaccine strain allowing both serological and etiological differentiation. The present paper reports on the validation of a control strategy for CBPP in cattle, whereby a TaqMan real-time PCR based on the lppQ gene has been developed for the direct detection of M. mycoides subsp. mycoides SC in ex vivo bronchoalveolar lavage fluids of cows and for the discrimination of wild type strains from the lppQ− mutant vaccine strain. PMID:20381545

  8. Rapid detection of cytomegalovirus in bronchoalveolar lavage fluid and serum samples by polymerase chain reaction: correlation of virus isolation and clinical outcome for patients with human immunodeficiency virus infection

    DEFF Research Database (Denmark)

    Hansen, K K; Vestbo, Jørgen; Benfield, T;

    1997-01-01

    Bronchoalveolar lavage (BAL) fluids and serum samples from 153 patients with pulmonary symptoms who were infected with human immunodeficiency virus (HIV) and underwent BAL were examined for the presence of cytomegalovirus (CMV) by conventional culture and by polymerase chain reaction (PCR......) for detection of CMV DNA. PCR detected CMV more frequently than did cultures of BAL fluid (PCR of BAL fluid, 53%; PCR of serum, 40%; and culture, 30%). In a multivariate model, development of extrapulmonary CMV disease was predicted by the finding of CMV in BAL fluid by culture (relative risk [RR], 8.......0; confidence interval [CI], 3.8-16.8) or the finding of CMV DNA in serum (RR, 7.4; CI, 3.2-17.3) or BAL fluid (RR, 8.0; CI, 3.1-20.7) by PCR. Mortality was found to be similar for patients who did or did not have CMV detected by either culture or PCR. Detection of CMV DNA by PCR was a more rapid and sensitive...

  9. Expression of IL-35 in the Bronchoalveolar Lavage Fluid Mononuclear Cells in Patients with Tuberculosis%IL-35在结核患者肺泡灌洗液中的表达

    Institute of Scientific and Technical Information of China (English)

    丁春梅; 张军; 胡成进

    2012-01-01

    Objective To detect the expression level of IL-35 in the bronchoalveolar lavage fluid mononuclear cells in patients with active pulmoanry tuberculosis. Methods 80 patients with active pulmonary tuberculosis were admitted to this study. All patients were examined by fiberoptic bronchoscopy. Bronchoalveolar lavage fluid and peripheral blood were collected,and mononuclear cells were separated with Hypaque-ficoll method. The separated mononuclear cells were stimulated with extracts from inactive mycobacteria for 36h. Secretions of IL-35 in the culture supernatant of mononuclear cells were detected by IL-35 ELISA kit. mRNA level of IL-35 subunit IL-12a and EBI3 were detected by real-time RT-PCR. EBI3 subunit of IL-35 was detected by Western blot and Treg cells were detected by multicolor flow cytometry. Results The concentration of IL-35 in the supernatant of bronchoalveolar lavage fluid mononuclear cells (BLFMC) was 76. 6 + 20. 1 pg/ml, which was significantly higher than the peripheral-blood mononuclear cells (PBMC) ,(£=23. 07,P<0. 01). IL-35 expression was only observed in the culture supernatant of BLFMC by Western blot. mRNA level of IL-12a in BLFMC was about 6 folds of PBMC (t=18. 02,P<0. 01) and EBI3 were about 9 folds(£=17. 85,P<0. 01). Percentage of Treg cells in BLFMC were 12. 6%± 3. 3%,which was higher than in peripheral blood (4. 2%±1. 8%) ,(t=12. 24,P<0. 01). Treg cells in bronchoalveolar lavage fluid expressed a relative higher level of EBI3. Conclusion IL-35 could be detected in BLFMC (mainly Treg) in patients with active pulmonary tuberculosis,which suggests that IL-35 play a regulatory role in the cellular immune reaction of My-cobactenum tuberculosis infection.%目的 检测IL-35在结核患者肺泡灌洗液中的表达.方法 80例诊断为进展期肺结核患者全部采用支气管镜检查,收集肺泡灌洗液和外周血,淋巴细胞分离液分离其中的单个核细胞,经50 μg灭活的结核杆菌提取物刺激36 h后,采用ELISA

  10. Detection of bacterial pathogens in bronchoalveolar lavage fluid by multiplex PCR%多重PCR检测支气管肺泡灌洗液中细菌性病原体的研究

    Institute of Scientific and Technical Information of China (English)

    向彩云; 金海山; 庹照林

    2011-01-01

    Aim To evaluate the accuracy of detection of bronchoalveolar lavage samples from patients with lower respiratory tract infection using multiplex PCR. Methods There 158 child inpatients infected bacteria were selected from 2006 to 2009 and 30 health children needed fiberoptic bronchoscopy were as control. All children received standard fiberoptic bronchoscopy mediated bronchoalveolar lavage within 24h. Multiplex PCR were used for detection of Streptococcus pneumoniae ,Haemophilus influenzae ,Mycoplasma pneumoniae and Chlamydia pneumoniae in bronchoalveolar lavage fluid. The lavage fluid of these patients were also analyzed by bacterial culture. Results The infection rates of Streptococcus pneumoniae ,Haemophilus influenzae ,Mycoplasma pneumoniae ,Chlamydia pneumoniae in patients with lower respiratory tract infections by routine bacteriological diagnosis accounted for 14%, 21%, 3.2%, and 0%;while that of multiplex PCR were accounted for 28% ,47% ,4% and 1%. The sensitivity were 87%,90%, 100% and 0% and the specificity were 81% ,64%, 100% and 99%. Streptococcus pneumoniae infection rate confirmed by bacterial culture was 2.9% ,while compared to 31% by multiple PCR in 104 bronchoscopy patients given antibiotics before examination. The proportion of Streptococcus pneumoniae and Haemophilus influenzae infection identified by multiplex PCR in control group were 17% and 40%. Conclusion Multiplex PCR in combination with bronchoalvcolar lavage fluid could effectively identify Streptococcus pneumoniae,Haemophilus influenzae,Mycoplasma pneumoniae and Chlamydia pneumoniae infection in the patients with lower respiratory tract infections,especially in diagnosis of patients previously treated with antibiotics.%目的 评价呼吸道感染患者肺泡灌洗标本进行多重PCR检测的准确性.方法 选取2006~2009年本院住院的158例儿童为研究对象,同时选用需要接受纤维支气管镜检查的30例同龄非感染

  11. Caracterização imunofenotípica das subpopulações de linfócitos do lavado broncoalveolar de pacientes com silicose Phenotypic characterization of lymphocyte subsets in bronchoalveolar lavage of patients with silicosis

    Directory of Open Access Journals (Sweden)

    ÂNGELA FERREIRA

    2000-06-01

    Full Text Available A lavagem broncoalveolar é um procedimento simples e seguro, na avaliação das pneumopatias relacionadas à exposição a poeiras minerais. O objetivo do estudo foi caracterizar as subpopulações celulares no lavado broncoalveolar (LBA de pacientes silicóticos. A lavagem broncoalveolar foi realizada em 26 trabalhadores com diferentes formas de silicose: forma simples (n = 12, complicada (n = 13 e um paciente com a forma aguda da doença. Como grupo controle, foram incluídos sete indivíduos sadios. Os pacientes com silicose apresentaram intensa pleocitose com predomínio de macrófagos alveolares e tendência à linfocitose. As subpopulações de linfócitos presentes no lavado broncoalveolar (LBA dos indivíduos sadios apresentaram fenótipo de células maduras. A grande maioria era constituída por células CD2+TCRab (87,3% e somente 2,9% das células T apresentaram marcação CD2+TCRgd. A relação CD4/CD8 foi de 1,8, com poucas (16% células T imaturas duplo-negativas CD4-CD8-. Em contraste, pacientes com silicose apresentaram redução acentuada das subpopulações dos linfócitos maduros CD2+CD4+, CD2+CD8+ e aumento marcante (47% de células imaturas (DN duplo-negativas (CD4-CD8-. Não foi observado aumento das células NK (CD56+. A análise do conteúdo protéico e a determinação da relação Ig/albumina permitiram caracterizar produção local de imunoglobulinas no microambiente pulmonar. Como não foi observado aumento percentual de plasmócitos e linfócitos B (CD19+ no LBA desses pacientes, é possível concluir que as células produtoras de imunoglobulinas estão possivelmente localizadas no interstício pulmonar. Estes resultados sugerem que, durante a evolução da silicose, ocorre o desenvolvimento de linfopoese extratímica e surgimento de órgão linfóide terciário, no microambiente pulmonar desses pacientes.Bronchoalveolar lavage is a safe and simple technique to evaluate lung disease related to exposure to mineral

  12. The Study of Mechanical Ventilation Combined Bronchoalveolar Lavage in Treatment of Critical Pneumonia%纤支镜支气管肺泡灌洗治疗机械通气重症肺炎患者临床研究

    Institute of Scientific and Technical Information of China (English)

    毛绍英

    2014-01-01

    目的:观察纤支镜支气管肺泡灌洗治疗重症肺炎的临床疗效。方法56例需机械通气重症肺炎患者分为两组:治疗组28例,采用机械通气并纤支镜灌洗;对照组28例,采用机械通气并单纯纤支镜吸痰治疗。结果在动脉血气分析、气道峰压降低等方面,治疗组优于对照组,差异有统计学意义(P<0.05)。结论需机械通气重症肺炎患者行纤支镜支气管肺泡灌洗治疗能缩短通气时间,降低死亡率。%Objective To observe the clinical ef ect of mechanical ventilation combined with bronchialavage in the treatment of critical pneumonia.Metheds Fifty-six patients with critical pneumonia were divided into two groups,twenty-eight patients were treated with mechanical ventilation combined bronchoalveolar lavage,and the other twenty-eight patients were treated with mechanical ventilation and routine sputum spiration by fiberoptic bronchoscopy.Results Blood gas analysis,P-peak were bet er in the therapy group than in the contrast group(P<0.05).Concision Ventilation time and death rate were decreased in the mechanical ventilation conbined bronchialavage group.

  13. 右美托咪啶辅助表面麻醉用于患者支气管肺泡灌洗术的效果%Efficacy of dexmedetomidine- assisted topical anesthesia in patients undergoing bronchoalveolar lavage

    Institute of Scientific and Technical Information of China (English)

    周金萍; 蔡璐; 陈公锦; 王淼; 刘冬炎; 金原野; 马连军; 袁飞

    2011-01-01

    目的 探讨右美托咪啶辅助表面麻醉用于患者支气管肺泡灌洗术的效果.方法 拟行支气管肺泡灌洗术的ICU患者24例,ASA分级Ⅱ或Ⅲ级,体重50~80 kg,年龄24~64岁,采用随机数字表法,将患者随机分为2组(n=12),A组术前30 min静脉注射0.9%生理盐水5 ml,术前5 min经气管导管或气管套管内注入2%利多卡因5~10 ml,随后按需每15~30 min经纤维支气管镜追加2%利多卡因5 ml,总量控制在20 ml以内;B组术前30 min缓慢静脉注射右美托咪啶0.5~1.0 μg/kg,随后以0.1~0.5 μg·kg-1·h-1速率维持,表面麻醉方法同A组.记录灌洗时间、不良反应及心血管不良事件的发生情况.于灌洗前20 min(T1)、灌洗开始后20 min(T2)、灌洗结束后20 min(T3)时采集血样,测定血浆儿茶酚胺浓度和血清皮质醇浓度.结果 与A组比较,B组血清皮质醇浓度、血浆儿茶酚胺浓度降低、不良反应及心血管不良事件发生率降低,操作时间缩短(P<0.05).与T1时比较,A组T2,3时血清皮质醇及血浆儿茶酚胺浓度升高,B组T2,3时血清皮质醇及血浆儿茶酚胺浓度降低(P<0.05).结论 右美托咪啶辅助表面麻醉可安全有效地用于患者支气管肺泡灌洗术.%Objective To investigate the efficacy of dexmedetomidine-assisted topical anesthesia in patients undergoing bronchoalveolar lavage ( BAL). Methods Twenty-four ASA Ⅱ or Ⅲ patients in ICU, aged 24-64 yr, weighing 50-80 kg, scheduled for BAL, were randomly divided into 2 groups ( n = 12 each) : topical anesthesia group (group A) , topical anesthesia + dexmedetomidine group (group B) . In group A, 0.9% normal saline 5 ml was injected intravenously 30 min before operation, 2% lidocaine 5-10 ml was given via a tracheal tube or cannula 5 min before operation and then an increment of 2% lidocaine 5 ml was given using fibreoptic bronchoscope every 15-30 min as required (the total amount was within 20 ml) . In group B, dexmedetomidine 0.5-1.0 μg/kg was

  14. Clinical analysis of 165 cases whose bronchoalveolar lavage lfuid bacterial culture were positive%支气管肺泡灌洗液细菌培养阳性患儿165例临床分析

    Institute of Scientific and Technical Information of China (English)

    李海燕; 余璐; 叶乐平; 杨锦红; 董琳; 李昌崇

    2016-01-01

    Objective: To investigate the clinical characteristics, pathogen spectrum and antibiotic drug sensitive test of patients whose bronchoalveolar lavage lfuid culture were positive. To provide the theory basis for clinical diagnosis and treatment for lower respiratory infection in children.Methods: A retrospective review was performed on 1 159 hospitalized cases from January 1, 2013 to December 31, 2015. The information of the patients whose BLAF were sent to lab including clinical data, bacterial culture and drug sensitivity was ana-lyzed.Results: The bacterial culture of BALF in 165 cases were positive, among whom 99(60.0%) were male and 66(40.0%) female. Overall, 70.4% cases were suffered from pneumonia, especially bronchopneumonia. 19 cases (11.5%) were diagnosed as bronchiolitis and combined with bacterial infection. And 12 cases (7.3%) had protracted bacterial bronchitis. One hundred and sixty ifve organisms from BALF were collected in the survey period, including 112(67.9%) gram-positive bacteria and 53(32.1%) gram-negative bacteria. The ifve most fre-quently isolated pathogens wereStreptococcus pneumoniae (102 strains),Haemophilus inlfuenza (14 strains), Pseudomonas aeruginosa (13 strains),Escherichia coli (8 strains) andStraphylococcus aureus (8 strains). Sixty ifve cases (39.4%) had underlying disease and the most common one was deformity of respiratory tract (22 cases) such as malacia, stenosis of trachea or bronchus. There were 14 cases suffered from bronchial asthma. Among 102Streptococcus pneumoniae strains, there were 25 strains penicillin-sensitiveS. pneumoniae, 35 strains pen-icillin-intermediateS. pneumonia and 42 penicillin-resistantS. pneumonia. MostStaphylococcus aureus strains were methicillin-resistant and there was no vancomycin and linezolid-resistant strain. The drug resistant rates ofHaemophilus inlfuenzae to penicillin and the second generation of cephalosporin were high. However, it was sensitive to the third generation of cephalosporin

  15. Clinical value of bronchoalveolar lavage in the treatment of severe pneumonia and respiratory failure%支气管肺泡灌洗治疗重症肺炎合并呼吸衰竭的临床价值探讨

    Institute of Scientific and Technical Information of China (English)

    罗裕锋; 瞿嵘; 叶初阳

    2015-01-01

    目的:探讨支气管肺泡灌洗抢救重症肺炎合并呼吸衰竭的临床价值。方法:将40例重症肺炎并呼吸衰竭患者随机分为灌洗组和对照组,每组20例。对照组采用抗感染、化痰及营养支持治疗等常规治疗手段,灌洗组在常规治疗基础上加支气管肺泡灌洗,观察两组病例的治疗效果。结果:灌洗前PaO2、PaCO2和氧合指数差异均无统计学意义( P>0.05),治疗后PaO2、PaCO2明显低于对照组,氧合指数明显高于对照组,差异有统计学意义(P<0.05);灌洗组总有效率为100%,显著高于对照组的65.0%,差异有统计学意义(P<0.05)。结论:支气管肺泡灌洗抢救重症肺炎合并呼吸衰竭,疗效好,可减少使用有创机械通气,有较高的临床价值。%Objective To study the clinical value of the bronchoalveolar lavage in the treatment of severe pneumonia and respiratory fail-ure. Method 40 patients with severe pneumonia and respiratory failure were randomly divided into lavage group and the control group,20 ca-ses in each group,control group adopted anti-infection,eliminating phlegm and nutritional support treatment such as conventional treatments, lavage group on the basis of routine treatment plus bronchoalveolar lavage,the therapeutic effect of two groups of cases was observed. Results The former lavage PaO2,PaCO2 and the oxygenation index were not significant difference(P> 0. 05),PaO2 and PaCO2 were obviously lower than the control group after treatment,oxygenation index was significantly higher than the control group,the difference was statistically signifi-cant( P<0. 05);the total effective rate in lavage group was 100%,which was significantly higher than 65. 0% of control group,the difference was statistically significant( P<0. 05 ). Conclusion Bronchoalveolar lavage rescue severe pneumonia and respiratory failure,good curative effect,can reduce the use of invasive mechanical ventilation

  16. 儿童哮喘急性发作支气管肺泡灌洗液病毒病原学分析%The Bronchoalveolar Lavage Fluid Viral Pathogens Analysis of Acute Asthmatic Attack in Children

    Institute of Scientific and Technical Information of China (English)

    潘俊秀; 范楚平; 范如艳; 陈礼娟; 肖志兵; 刘婵

    2015-01-01

    目的:了解病毒感染与儿童哮喘急性发作相关性。方法:应用直接免疫荧光法(DIF),对实验组(67例哮喘急性发作患儿)和对照组(73例哮喘缓解期患儿)支气管肺泡灌洗液进行7种病毒抗原检测。结果:实验组51例检出至少1种病毒,总检出率76.1%。呼吸道合胞病毒(RSV)检出最多,为32例,检出率47.8%,其余,依次为副流感病毒Ⅲ(PIV Ⅲ)7例(10.4% ),腺病毒(ADV)5例(7.5% ),流感病毒 A(IFA) 3例(4.5% ),流感病毒 B(IFB)2例(3.0% ),副流感病毒Ⅰ(PIV Ⅰ)1例(1.5% ),副流感病毒Ⅱ(PIV Ⅱ) 1例(1.5%)。对照组12例检出至少 1种病毒,总检出率16.4%。 呼吸道合胞病毒(RSV)检出最多,为9例,检出率12.3%,其余,依次为副流感病毒Ⅲ (PIV Ⅲ) 2例(2.7% ),腺病毒(ADV)1例(1.4% ),流感病毒 A(IFA)、流感病毒 B(IFB)、副流感病毒Ⅰ(PIV Ⅰ)、副流感病毒Ⅱ(PIV Ⅱ)均未检测到。两组比较差异有显著性意义(P< 0.01)。结论:病毒感染与儿童哮喘急性发作有密切相关性,RSV 是引起儿童哮喘急性发作的主要病毒。%Objective :To explore the correlation analysis between virus infection and acute asthmatic attack in chil‐dren .Methods :Totally one‐hundred forty children with asthma were recruited ,and divided into experimental group(n=67) with acute asthmatic attack and control group(n= 73) with asthma in remission stage .Seven virus infections were identified by immunofluorescence testing of bronchoalveolar lavage fluid(BALF) .Results :There are at least one virus was detected in experimental group ,(51/67 ,76 .1% ) and control group(12/73 ,16 .4% ) .Respiratory syncytial virus (RSV) was the most (32/67 ,47 .8% in experimental group and 9/73 ,12 .3% in control group) ,and the others were parainfluenza Ⅲ (7

  17. Evolução da pneumonia lipoide exógena em crianças: aspectos clínicos e radiológicos e o papel da lavagem broncoalveolar Evolution of exogenous lipoid pneumonia in children: clinical aspects, radiological aspects and the role of bronchoalveolar lavage

    Directory of Open Access Journals (Sweden)

    Selma Maria de Azevedo Sias

    2009-09-01

    clinical, radiological and bronchoalveolar lavage fluid findings, emphasizing the importance of bronchoalveolar lavage for the diagnosis and treatment. METHODS: We included 28 children, with a mean age of 20 months (range, 1-108 months, diagnosed with chronic pneumonia refractory to antimicrobial therapy, with TB or with a combination of the two. Most of the children had at least one risk factor for aspiration, and all of them had a history of mineral oil ingestion for intestinal constipation (23/28 or complicated ascaridiasis (5/28. Clinical evaluations, tomographic evaluations and analyses of bronchoalveolar lavage fluid were carried out at the beginning of treatment and throughout a follow-up period of 24 months. RESULTS: Tachypnea and cough were the most common symptoms. The most common radiological alterations were areas of consolidation (23/28, perihilar infiltrates (13/28 and hyperinflation (11/28. Chest CT scans showed areas of consolidation with air bronchogram (24/28, decreased attenuation in the areas of consolidation (16/28, ground-glass opacities (3/28 and crazy-paving pattern (1/28. In the analysis of the bronchoalveolar lavage fluid, Sudan staining revealed foamy macrophages, confirming the diagnosis of lipoid pneumonia. After treatment with multiple bronchoalveolar lavages (mean = 9.6, 20 children became asymptomatic, 18 of those presenting normal tomographic images. CONCLUSIONS: A diagnosis of lipoid pneumonia should be considered in patients with chronic refractory pneumonia or TB, especially if there is a history of mineral oil ingestion. Bronchoscopy with multiple bronchoalveolar lavages was an efficient treatment for the clearance of mineral oil from the lung parenchyma and the prevention of fibrosis. This strategy contributed to reducing the morbidity of lipoid pneumonia, which remains a rare diagnosis.

  18. Effect of bronchoalveolar lavage on the heart rhythm and conduction of the children with severe pneumonia%支气管肺泡灌洗术对重度肺炎患儿心脏节律及传导的影响

    Institute of Scientific and Technical Information of China (English)

    高明磊; 崔振泽

    2014-01-01

    Objective To observe the effect of bronchoalveolar lavage on the heart rhythm and conduction of children with severe pneumonia through monitoring the electrocardiogram change of different step of the bronchoalveolar lavage,for proving the safety of the operation of bronchoalveolar lavage from the perspective of cardiac electrophysiology.Method From July 2011 to March 2012,30 patients who were hospitalized in pneumology department of Dalian Children's Hospital and met the inclusion criteria and therapeutic indications of bronchoalveolar lavage were chosen.They were 3 to 12 years old,the average age was 5.3 years,including 17 boys and 13 girls,the ratio of boys and girls is 1.3∶ 1.Continuous sampling the electrocardiogram before and duriug the process including anesthesia,entering into glottis,lavage,aspiration,and revive,and recording the heart rate,rhythm amplitude and width of P wave,the PR interval,the form and width of QRS complex were also measured.The recorded data were analyzed and statistical analysis to reflect the change of the cardiac electrophysiology.Result The incidence of heart rate increase was 100.0%,26 (86.7%) patients began to emerge after anesthesia,the rest of the patients also developed heart rate increase after the start of bronchoscopic operation.All patients had sinus tachycardia,and were most obvious in the progress of lavage and revive.In the process of entering into glottis,lavage,aspiration,13 (43.3%)patients had arrhythmia episodes.Types of arrhythmia included sinus bradycardia,atrioventricular block and premature beat.Incidences of intraoperative arrhythmia compared with the preand post-operation were all statistically significantly different (P =0.00).The most common arrhythmia were premature beat,in 17 of the 30 cases there were premature beat including 9 cases with atrial premature beats and 8 cases ventricular premature contraction.Two patients had Ⅲ ° atrioventricular block accompanied by serious sinus bradycardia

  19. Application of Dellson Fluid-Based Thin-Preparation Cytologic in the Diagnosis of Bronchoalveolar Lavage Fluid (BALF) Cytology%Dellson膜式超薄技术在肺泡灌洗液细胞学诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    王其春; 何磊

    2012-01-01

    目的 探讨Dellson膜式超薄细胞学制片技术(DTC)在肺泡灌洗液细胞学检查中的应用.方法 将临床送检的灌洗液,加处理液等系列处理后,用自动液基细胞制片机制片.同时用传统方法制作涂片,两者同步做瑞氏染色或HE染色,镜检观察.结果 通过对106例肺泡灌洗液标本用两种制片方法的对比观察,液基薄层细胞制片的优良率达90.5% (96/106),而传统制片仅为61.3% (65/106);液基薄层细胞制片癌细胞阳性率为46.2% (49/106),可疑癌细胞5.7% (6/106);传统制片的癌细胞阳性率为24.5% (26/106),可疑癌细胞2.8% (3/106).结论 Dellson膜式超薄细胞学制片技术(DTC)用于肺泡灌洗液细胞学检查,涂片质量及癌细胞检测的阳性率明显高于传统涂片.%Objective To investigate the application of production technology of liquid-based cytology in bronchoalveolar lavage fluid (BALF) cytology diagnosis. Methods Plus digestive to the collected bronchoalveolar lavage fluid, remove the mucus and other substance, the precipitate was transferred to preservation solution. Smear was made with automatic liquid-based cell production machine. Mean while smears were made by traditional methods. They were both dyed by Wright' s staining or hematoxylin eo-sin staining (HE). The effect of the smears was observed under microscope. Results By comparative study of 106 cases of clinical specimens of two kinds of production methods, the good rate of production of liquid-based cytology was 90.5% (96/106),and the traditional production was only 61. 3% (65/106) ;the positive rate of cancer cells in production of liquid-based cytology was 46. 2% (49/106) ,the suspected cancer was 2.8% (3/106) ;the positive rate of traditional production was 24.5% (26/106) .the suspected cancer was 2. 8% (3/106). Conclusion Production technology of liquid-based cytology can be used for bronchoalveolar lavage fluid cytology diagnose,smears quality and detection of

  20. 吸烟对慢性阻塞性肺疾病患者稳定期支气管肺泡灌洗液中T细胞功能影响的临床研究%Effect of smoking on T lymphocytes in bronchoalveolar lavage fluid in patients with chronic obstructive pulmonary disease during their stable periods

    Institute of Scientific and Technical Information of China (English)

    陈菁; 徐清; 杨硕; 刘梦琳; 聂红; 孙洁民

    2011-01-01

    Objective To investigate the effect on T lymphocytes in bronchoalveolar lavage fluid (BALF) influenced by smoking in patients with chronic obstructive pulmonary disease (COPD) during their stable periods.Methods To test the levels of CD3 +,CD4+,CD8+,CD4+ /CD8+ in BALF in patients enrolled by flow cytometry.Results The levels of CD3+,CD4+,CD4+/CD8+ in BALF in patients with COPD during their stable periods decrease compare with normal group ( P < 0.05) while the level of CD8+ increases ( P <0.05).There is no difference among the levels of CD3+,CD4+,CD8+ in patients with COPD ( P > 0.05),yet the level of CD4+/CD8+ decreases apparently in patients who smoke continuedly ( P <0.05).Conclusions Continued smoking leads to the lower T lymphocytes’ function in patients’ airways with COPD during their sable periods.%目的 评价吸烟对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者稳定期支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)中T细胞功能的影响.方法 流式细胞术测定吸烟的COPD患者稳定期BALF中CD3+、CD4+、CD8+T细胞和CD4+/CD8+水平.结果 与非COPD组相比,COPD患者稳定期BALF中CD3+、CD4+、CD4+/CD8+水平明显下降(P<0.05),CD8+明显升高(P<0.05);在COPD患者中,稳定期BALF中CD3+、CD4+、CD8+T细胞无明显差异(P>0.05),但持续吸烟组CD4+/CD8+明显下降(P<0.05).结论 COPD患者稳定期气道T细胞功能明显异常,其中持续吸烟的COPD患者气道CD4+/CD8+下降最为显著.

  1. 75例小儿严重肺部感染支气管肺泡灌洗术疗效及临床分析%Clinical Efficacy and Analysis of Adjuvant Therapy with Bronchoalveolar Lavage in 75 Children with Severe Pulmonary Infection

    Institute of Scientific and Technical Information of China (English)

    王世彪; 翁斌; 陈涵强; 林元

    2016-01-01

    目的:探讨纤维支气管镜下肺泡灌洗术对小儿严重肺部感染的疗效,并进行临床分析。方法:选取本院儿科小儿严重肺部感染患儿150例,分为治疗组与对照组各75例,进行临床对照研究。对照组予全身抗感染治疗,治疗组在此基础上,联合支气管肺泡灌洗术、影像学检查。观察两组患儿治疗效果。结果:治疗组显效率为78.0%(59/75),对照组为12.0%(9/75),两组比较差异有统计学意义(χ2=77.48,P<0.001)。肺泡灌洗液及相关血液检查结果:铜绿假单胞菌感染6例,肺炎克雷杆菌感染5例,鲍曼不动杆菌5例,嗜麦芽寡单胞菌感染3例,肺炎支原体感染3例,甲型流感(H1N1型)2例。腺病毒感染1例,溶血葡萄球菌(耐甲氧西林)感染1例,表皮葡萄球菌感染2例,大肠埃希菌2例,肺炎链球菌感染2例,卡他莫那氏菌感染1例,支气管内膜结核2例,白假丝酵母菌1例。结论:支气管肺泡灌洗术联合全身抗感染综合治疗,对小儿严重肺部感染疗效明确;铜绿假单胞菌感染、肺炎克雷杆菌感染及鲍曼不动杆菌感染较多。%Objective:To investigate the effect of bronchoalveolar lavage in the treatment of severe pulmonary infection in children.Method:One hundred and fifty children with severe pulmonary infection were selected and randomly divided into control group and treatment group,each group had 75 children.Both groups were treated with total body anti-infective therapy,in addition to the basic treatment,the treatment group was given bronchoalveolar lavage according to X-ray image change.The clinical effects were observed.Result:The effective rate of the treatment group was 78.0% (59/75),the control group was 12.0% (9/75),the difference was statistically significant( χ2=77.48,P<0.001).Bronchoalveolar lavage fluid and blood test results:6 cases of Pseudomonas aeruginosa infection, 5 cases of pneumonia

  2. 胸内结节病18F-FPG PET/CT与支气管肺泡灌洗液检查相关性分析%Correlation between 18F-FDG PET/CT scan and bronchoalveolar lavage fluid in patients with thoracic sarcoidosis

    Institute of Scientific and Technical Information of China (English)

    吴昱; 梁英魁; 冯华松; 段蕴铀; 聂舟山; 丁新民

    2013-01-01

    Objective: To study the correlation between 18fluorine deoxyglucose ( F-FDG) positron emission tomography/ computerized tomography(PET/CT) scan and bronchoalveolar lavage fluid(BALF)in patients with thoracic sarcoidosis, and explore the mechanism of 18F-FDG uptake in sarcoidosis. Methods: Nineteen patients with thoracic sarcoidosis underwent18F-FDG PET/CT scan and BALF. The CD4 + /CD8 + T cell ratio and serum angiotensin converting enzyme ( sACE ) , tumor necrosis factor-α ( TNF-α) and soluble interleukin-2 receptor ( sIL-2R) levels in bronchoalveolar lavage fluid were detected. F-FDG PET/CT scan was semi-quantitatively analyzed by maximum standardized uptake value ( SUVmax) and mean standardized uptake value ( SUVmean). The correlation between SUVmax, SUVmean, CD4+/CD8 + T cell ratio, sACE, TNF-α and sIL-2R levels was also analyzed. Results: SUVmax was significantly correlated to SUVmean( P < 0. 01 ) . SUVmax was significantly correlated to sACE ( P < 0. 01) and TNF-α ( P < 0. 01 ) , respectively; SUVmean was also significantly correlated to sACE ( P < 0. 01 ) and TNF-α ( P < 0. 01 ) , respectively. SUVmean was correlated to CD4 + /CD8+ T cell ratio (P <0. 05 ). Conclusions: The 18F-FDG uptake capacity is high in high load of sarcoidosis granuloma; its ability to 18F-FDG uptake may be associated with T cell activation. SUVmean may be superior to SUVmax in determining the activity of sarcoidosis.%目的:了解胸内结节病18氟-脱氧葡萄糖正电子发射断层显像/计算机断层扫描(18F-FDG PET/CT)检查与支气管肺泡灌洗液检查(BALF)相关性,探讨结节病摄取18F-FDG机制.方法:19例病理确诊胸内结节病患者行18F-FDG PET/CT检查及BALF,检测CD4+/CD8+ T细胞比值和血清血管紧张素转化酶(sACE)、肿瘤坏死因子-α(TNF-α)及可溶性白细胞介素-2受体(sIL-2R)含量,18F-FDG PET/CT用最大标准摄取值(SUVmax)和平均标准摄取值(SUVmean)半定量分析,并分别分析SUVmax和SUVmean与CD4+/CD8+ T细

  3. Analysis of the characteristic and classification of the cells from bronchoalveolar lavage fluid in chronic obstructive pulmonary disease acute exacerbation period%慢性阻塞性肺疾病急性加重期支气管肺泡灌洗液的细胞分类特点分析

    Institute of Scientific and Technical Information of China (English)

    李冠华; 李广生; 赵芳; 乔晟; 李月川

    2012-01-01

    中性粒细胞和肺泡巨噬细胞.这些细胞一方面通过吞噬异物和参与免疫调节发挥对肺的保护作用,另一方面又通过分泌细胞因子、蛋白酶等参与肺的损伤过程.COPD患者肺泡巨噬细胞及中性粒细胞在肺内大量聚集,肺防御机制被破坏,抗损伤功能减弱,巨噬细胞及中性粒细胞激活呈失控状态,释放过量炎性介质,导致肺损伤.COPD的患者各种致病因子长期得不到清除,自身修复和防御机能的平衡遭到破坏,下呼吸道无菌状态被扰乱,以致细菌在黏膜上定植.%Objective The characteristics of airway inflammation in chronic obstructive pulmonary disease (COPD) was the infiltration of the airway wall with lymphocytes and alveolar macrophages mainly,but there were mainly neutrophils and alveolar macrophages in airway lumens.Therefore,it was necessary to study more about the characteristics of airway inflammatory cells in COPD acute exacerbation period.Methods 23 patients intubated were treated with mechanically ventilation cause of acute respiratory failure with COPD,were done with bronchoalveolar lavage 32 times,and the lavage fluid were sent to the laboratory for analysis of leukocyte count and cell sorting.Results 14 of 23 patients were recovered and the trachea cannulas were pulled out. 6 of the patients were die,3 of the patients were discharged because of deterioration,23 patients were done with bronchoalveolar lavage 32 times.The recovery of lavage fluid was (12.88±4.98) ml,and the recovery rate was (32.2± 12.45) %,23 patients were lavaged immediately after intubation or in next day.The median of leukocyte count was 50× 106/L,and the median of cell sorting was:epithelial cells 18%, neutrophils 60%, lymphocytes 2%,macrophages 8%,eosinophils 0%,14 of the patients were recovered.The median of leukocyte count was 25× 106/L,and the median of cell sorting was:epithelial cells 19%,neutrophils 60%,lymphocytes 1.5 %,macrophages 6.5

  4. Study of Cytological Classification and pathogenic bacteria screening of bronchoalveolar lavage fluid in patients with refractory asthma%难治性哮喘患者支气管肺泡灌洗液细胞分类及病原菌筛查研究

    Institute of Scientific and Technical Information of China (English)

    张翠翠; 温明春; 杜秀伟; 王寒; 蔺兴娟; 张淑萍; 魏春华

    2013-01-01

    Objective To seek the cytological classification and airway pathogenic bacteria colonization,infection situation of bronchoalveolar lavage fluid (BALF) in patients with refractoryasthma.Methods Select 138 inpatients with refractory asthma which measure upto national standard,to test the BALF cells classification and bacterial culture through the bronchoscope alveolar lavage.Results ① The inflammatory cells classification of BALF:Neutrophile granulocyte 63.78 ± 30.02,Eosinophilic granulocyte 2.70 ± 4.04,Lymphocyte 5.93 ± 6.48,Alveolarmacrophages 27.21 ± 31.87,display neutrophils increased obviously.② Influence of pathogens on airway inflammation:the mean value of Neutrophils in patients with positive pathogens are an increase compared with patients with negative,but no statistically significant differences,Eosinophils mean value are low compared wiht patients with negative,the differences was statically significant (P < 0.01).③ The inflammatory cells classification of BALF:Classification standard by airway inflammation,138 cases of 24 cases of all the 138 cases are Eosinophil asthma,account for 17.38%,46 cases with Neutrophilic asthma,account for 33.33%,26 cases of Myeloid less asthma,18.84%,42 case with Mixed grain cell asthma,30.43%.General status in the group,Neutrophils group and few cell group have a longer course of disease,older ages,lower cortisol,smoking rateis higher in Neutrophils group.④Previous treatment condition of each inflammation type:patients in Neutrophils groupwith used much more systemic hormones are higher than the Eosinophils group,while the volume of inhaled steroids used less than eosinophils group.⑤Etiology test results:23 cases of pathogenic bacteria were checked out in 138 patients,account for 16.7%,Gram negative bacilli isolated from most of them,a total of 16 cases,percent of total pathogen detection 69.6%.Conclusions ① There is a special table types of airway inflammation cells in patients with refractory

  5. Instilación intratraqueal de elastasa en la rata: Cambios electroforéticos de la α1-AT-antitripsina en el lavado broncoalveolar Intratracheal instillation of elastase in the rat: Electrophoretical changes of alphal-antitrypsin in bronchoalveolar lavage fluid

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    ANDREA VECCHIOLA C

    2008-03-01

    Full Text Available Introducción: la antiproteasa alfa 1-antitripsina ( α1-AT constituye el principal inhibidor endógeno de la elastasa instilada por vía intratraqueal en modelos experimentales. Objetivo: Evaluar mediante electroforesis e inmunodetección por western blot, las distintas formas en que se encuentra la α1-AT en el lavado broncoalveolar (IBA de ratas Sprague Dawley después de la instilación de elastasa, con la hipótesis de que el aumento en la actividad antielastasa previamente encontrada se acompaña de niveles altos de α1-AT activa. Resultados: En las primeras horas post-elastasa la concentración de α1-AT en el IBA aumenta más de 7 veces, debido al aumento de la permeabilidad alvéolo-capilar, encontrándose tanto como proteína nativa (~ 52 kDa, como parte de complejos de mayor tamaño (> 75 kDa y > 100 kDa y como producto de proteólisis (α1-AT inactiva formando complejos, el aumento de la permeabilidad alvéolo-capilar contribuye a mantener niveles altos de α1-AT activa. Estos resultados podrían ser extrapolables a distintos procesos inflamatorios pulmonaresIntroduction: Endogenous alphal-antitrypsin ( α1-AT is the main inhibitor of the intratracheally instilled elastase in experimental animals. Objective: To evaluate by electrophoresis and immunodetection using western blot analysis, the different forms of α1-AT in bronchoalveolar lavage fluid (BALF of Sprague Dawley rats after intratracheal instillation of elastase, with the hypothesis that the previously observed increment in antielastase activity is due to high levels of active α1-AT. Results: In the first hours after elastase instillation the concentration of α1-AT increases more than seven times due to an increase in alveolar-capillary permeability. α1-AT in BAIF is found as the native protein (~ 52 kDa, as complexes of different molecular sizes (> 75 kDa and > 100 kDa and as a proteolytic product (α1-AT in the inactive form as part of different complexes, the increase

  6. Clinical significance of the combined determination of Tumour markes in bronchoalveolar lavage fluid to diagnose lung cancer%肺泡灌洗液中肿瘤标志物的联合检测在肺癌诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    张绍武; 宁洁

    2011-01-01

    目的:探讨支气管肺泡灌洗液(BALF)3种肿瘤标志物癌胚抗原(CEA)、细胞角蛋白片段211(CYFRA211) 、神经元特异性烯醇化酶(NSE)对肺癌的临床诊断价值.方法:采用电化学发光法分别检测90例肺癌患者、60例肺部良性病变患者血清及BALF中CEA、CYFRA 211和NSE的含量.结果:肺癌患者BALF中3种肿瘤标志物的含量明显高于肺部良性病变患者(P<0.05),且随着TNM临床分期升高,肿瘤标志物的含量也明显升高.在不同病理类型的肺癌中,3种肺癌肿瘤标志物升高的程度均有所不同.BALF中肿瘤标志物的含量与同期血清中的含量相比,出现更早且浓度更高.结论:肺癌患者BALF中CEA、CYFRA211、NSE联合检测对肺癌诊断有更高的临床参考价值.%Objective: To investigate the clinical value of 3 tumor markers [ carcinoma embryonic antigen ( CEA ),cytokeratin 19 fragments ( CYFRA211 ) and neuron specific enolase( NSE ) ]in bronchoalveolar lavage fluid ( BALF )to diagnose lung cancer. Methods:The levels of CEA、 CYFRA211 and NSE in BALF and serum were measured in 90 patients with lung cancer and 60 patients with benign lung disease by electro chemiluminescence. Results: The levels of 3 tumor markers in BALF were much higher in lung cancer group than that in benign lung disease group ( P <0.05 ) and they were higher in patients in stage Ⅲ and Ⅳ than those in stage Ⅰ and Ⅱ. The tumor markers increased to different degrees among the patients in various pathological classifications. It was also found that the levels of these tumor markers were higher and more sensitive in BALF than those in serum. Conclusion:The measurement of tumor markers in BALF is of more significant value than the measurement in serum, which helps early diagnosis, pathological classification and prognosis evaluation of lung cancer.

  7. Clinical value of real-time fluorescence polymerase chain reaction for Mycobacterium tuberculosis DNA in bronchoalveolar lavage fluid%实时荧光聚合酶链反应检测支气管肺泡灌洗液结核分枝杆菌DNA诊断肺结核价值

    Institute of Scientific and Technical Information of China (English)

    魏巍; 覃林珍; 刘守江; 王健

    2014-01-01

    目的:探讨实时荧光聚合酶链反应(FQ-PCR)检测支气管肺泡灌洗液结核分枝杆菌脱氧核糖核酸(TB-DNA)诊断肺结核的临床价值。方法选取我院收治的115例肺结核患者作为研究对象,所有患者均进行支气管肺泡灌洗液TB-DNA检测、血清结核分枝杆菌特异性抗原(TB-SA)抗体检测、痰涂片抗酸染色镜检等。结果支气管肺泡灌洗液TB-DNA检测、血清 TB-SA 抗体检测、痰涂片抗酸染色镜检诊断肺结核的敏感度分别为65.2%(75/115)、50.4%(58/115)、20.9%(24/115)。支气管肺泡灌洗液检测 TB-DNA诊断肺结核的敏感度显著高于血清 TB-SA抗体、痰涂片抗酸染色镜检(均P<0.05)。结论采用 FQ-PCR检测支气管肺泡灌洗液 TB-DNA诊断肺结核具有较高的敏感度。%Objective To evaluate the value of real-time fluorescence polymerase chain reaction(FQ-PCR )for detection of Mycobacterium tuberculosis DNA in bronchoalveolar lavage fluid (BALF).Methods Mycobacterium tuberculosis DNA in BALF obtained from 1 1 5 patients with tuberculosis pulmonary disease were detected by FQ-PCR, Tuberculosis specific antigen(TB-SA),and smear acid-fast respectivelly.The results were statistically analyzed.Results The sensitiveity of detection of mycobacterium was 65.2%(75/115)in FQ-PCR,50.4%(58/115)in TB-SA,20.9%(24/115)in smear acid-fast.The sensitivity of Mycobacterium tuberculos detected by FQ-PCR was higher than that by TB-SA and smear acid-fast.Conclusion The detection of TB-DNA in BALF by FQ-PCR could significantly improve the diagnosis sensitivity of pulmonary tuberculosis patients.

  8. BRONCHOALVEOLAR LAVAGE FLUID BACTERIAL ISOLATION AND SENSIBILITY IN HEALTH AND SICK DOGS La identificación bacteriana y sensibilidad antimicrobiana de líquido de lavado tracheobronchial de sanos y enfermos perros IDENTIFICAÇÃO BACTERIANA E SENSIBILIDADE ANTIMICROBIANA DO FLUIDO DE LAVAGEM TRAQUEOBRÔNQUICA DE CÃES SADIOS E DOENTES

    Directory of Open Access Journals (Sweden)

    Paula Cristina Basso

    2009-09-01

    Full Text Available Research of antimicrobials use and resistance in food animals have been developed in various countries, although few studies include the bacteria prevalence in respiratory tract of companion animal. The aim of this paper was to verify antimicrobial resistance profile from bronchoalveolar lavage fluid of health and sick dogs. Twenty animals were evaluated, 10 in the health group (group 1 and 10 in respiratory distress group (group 2. The bronchoalveolar lavage was performed through an endotracheal tube or guided by a rigid endoscope. Culture, identification and bacterial sensibility of the fluid were performed through agar diffusion method. The bacterial isolated were: Haemophilus aphrophilus, Staphylococcus aureus, S. epidermidis, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosas e Proteus mirabilis. Of all samples, 63% showed resistance to at least one class of antibiotics. Therefore antibiotic resistance is present in sick as well in health animals and ceftriaxone and amoxicilin associated with clavulanic acid are effective against respiratory tract bacteria.

    KEY WORDS: Antibiotic resistance, bacteria, respiratory distress.

    Nacional de Encuestas sobre el uso de antibióticos y la resistencia a los antibióticos en la producción animal se llevan a cabo en varios países, sin embargo pocos estudios que incluyen agentes bacterianos asociados con las vías respiratorias de los animales domésticos. El objetivo de este estudio fue verificar el perfil de resistencia a los antimicrobianos en el líquido de lavado tracheobronchial sanos y enfermos perros. Hemos utilizado 20 animales, 10 clínicamente sanos (grupo 1 y 10 con trastorno respiratorio (grupo 2. La colecci��n de la tracheobronchial lavado se realizó con el tubo endotraqueal o guiado con la ayuda de un endoscopio rígido. Se han realizado el cultivo y la identificaci

  9. 白藜芦醇对RSV感染BALB/c小鼠肺泡灌洗液TNF-α,IL-1β,IL-6表达的调控趋势%Regulation trend of resveratrol on TNF-α, IL-1β ,IL-6expressions in bronchoalveolar lavage fluid of RSV-infected BALB/c mice

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    李佳曦; 汪受传; 徐建亚; 戴启刚; 徐珊; 孙寒丹; 彭璐璐

    2012-01-01

    Objective: To study the regulation trend of resveratrol on TNF-α, IL-lβ, IL-6 expressions in bronchoalveolar lav-age fluid ( BALF) of RSV-infected BALB/c mice at different time points. Method: RSV-induced BALB/c mice were orally administered with resveratrol. Their BALFs were collected at 24, 72 and 144 h after the first nasal drip with RSV to detect the level of TNF-α, IL-1β, IL-6 by EILSA. Result: The expression of TNF-a, IL-lβ and IL-6 in BALF increased significantly compared with the normal group (P<0.01) in the resveratrol group decreased notably compared with the model group. After 72 hours of infection with RSV, although the expression of TNF-α (P < 0. 05 ) , IL-1β (P < 0.01) and IL-6 (P < 0.01) in BALF in model group were higher than those in the normal group, they were much more lower than at 24 h. The expression of IL-1β and IL-6 (P < 0.05) in the resveratrol groups were down-regulated significantly, but no difference had been shown in TNF-a expression compared with the RSV infection group. After infection with RSV for 144 h, the expression of IL-1β (P<0.01) and IL-6 (P<0. 05) in BALF in the model group were higher than those in the normal group, but there was no difference in the secretion of TNF-α. The expression of TNF-α, IL-1β and IL-6 showed also no remarkable difference between the resveratrol groups and the RSV infection group. Conclusion: Resveratrol can inhibit the over expression of inflammatory factors TNF-α, IL-1β, IL-6 in bronchoalveolar lavage fluid of RSV-induced BALB/c mice and keep them at a low level with the passing of infection time.%目的:研究白藜芦醇(Res)对呼吸道合胞病毒(RSV)感染BALB/c小鼠肺泡灌洗液(BALF)不同时间点肿瘤坏死因子-α(TNF-α),白细胞介素-1β(IL-1β),白细胞介素-6(IL-6)表达的调控趋势.方法:RSV滴鼻感染BALB/c小鼠,白藜芦醇灌胃给药进行干预,并于首次滴鼻后24,72,144 h取各组小鼠支气管肺泡灌洗液,ELISA法检测其中TNF-α,IL-1

  10. Diagnostic value of combination detection of CEA,CYFR21-1,NSE in bronchoalveolar lavage fluid for early lung cancer%肺泡灌洗液中 CEA 、CYFR21-1、NSE 联合检测对早期肺癌的诊断价值

    Institute of Scientific and Technical Information of China (English)

    陈元菁; 顾晔

    2016-01-01

    目的:探讨肺泡灌洗液(BALF)中癌胚抗原(CEA)、细胞角蛋白19片段(CYFR)21‐1、神经元特异性烯醇化酶(NSE)联合检测对早期肺癌的诊断价值,以及其与临床疗效的相关性。方法69例肺癌患者纳入肺癌组,50例肺部良性疾病患者纳入肺良性疾病组。所有患者行肺泡灌洗术(BAL),采用化学发光免疫法检测 BALF 中 CEA 、CYFR21‐1、NSE 水平,比较2组患者及不同临床疗效肺癌患者肿瘤标志物水平的变化。结果肺癌组 BALF 中 CEA 、CYFR21‐1、NSE 水平明显高于肺良性疾病组,差异有统计学意义(P<0.05)。Ⅱ期肺癌患者各肿瘤标志物水平均高于Ⅰ期患者,差异有统计学意义(P<0.05);随着临床疗效的下降,CEA 、CYFR21‐1、NSE 水平逐渐升高(P <0.05);联合检测的灵敏度和特异度分别为62.3%、82.0%,明显高于 CEA 、CY‐FR21‐1、NSE 任一单项的灵敏度和特异度(P<0.05)。结论早期肺癌患者 BALF 中 CEA 、CYFR21‐1、NSE 水平明显升高,且与肺癌病理分期密切相关,联合检测有助于提高早期肺癌检出率及指导临床疗效评估。%Objective To explore the diagnostic value of combination detection of carcino‐embryonic antigen(CEA ) ,cytokeratin 19 fragment 21‐1(CYFR21‐1) ,neuron‐specific enolase(NSE) in bronchoalveolar lavage fluid (BALF) for early lung cancer and its correlation with clinical effects .Methods 69 cases of lung cancer were included into the lung cancer group and 50 cases of benign pulmonary disease were included into the lung benign disease group .All the patients were given bronchoalveolar lavage(BAL) .The chemiluminescence immunoassay was adopted to detect the levels of CEA ,CYFR21‐1 and NSE in BALF .The changes of tumor markers levels were compared between the two groups and among different clinical curative effects in the patients with lung cancer . Results The

  11. Comparison of ventilatory effects between three-way laryngeal mask airway and tracheal catheter on patients during bronchoalveolar lavage%三通喉罩与气管导管用于支气管肺灌洗术时通气效果的比较

    Institute of Scientific and Technical Information of China (English)

    杨天明; 钟军; 陆卫忠; 赵东海; 范新民; 张春宝; 韦海雷

    2011-01-01

    目的 对比研究三通喉罩(three-way laryngeal mask airway,TLMA)与气管导管(tracheal catheter,TC)通气用于全麻支气管肺灌洗术(bronchoalveolar lavage,BAL)对患者血流动力学、呼吸功能和应激激素水平的影响.方法 40例麻醉风险评估(ASA)Ⅰ-Ⅱ级在全麻下实施BAL的成人患者,按分层抽样原则分为TLMA组(T组,n=20)和TC组(C组,n=20),记录麻醉诱导前(To),插入TLMA/TC前(T1),插入TLMA/TC即刻(T2),插入TLMA/TC通气3 min(T3),5 min(T4),10 min(T5),实施BAL 10min(T6),20 min(T7),30 min(T8),拔除TLMA/TC即刻(T9)和拔除TLMA/TC后3 min(T10)的SpO2,SBP,DBP和HR.连续监测呼吸功能指标,记录T2,T4,T6,T7,T8,T10的潮气量(VT),气道峰压(Ppeak)及呼气末二氧化碳分压(PETCO2);应用高效液相色谱分析法测定T0,T2,T3,T4,T6,T9,T10的静脉血浆肾上腺素(AE),去甲肾上腺素(NE)和多巴胺(DA)水平.采用SPSS 10.0统计软件,血液动力学及应激激素指标行重复测量数据的方差分析,以P<0.05为差异具有统计学意义.结果 C组T2,T3,T9时SBP,DBP,HR显著高于T组(P<0.05);C组Ppeak在T6,T7,T8显著高于T组(P<0.05);C组AE,NE在T2,T3和T9均显著高于T组(P<0.05).结论 在全麻BAL中,TLMA通气优于TC通气,其血流动力学更稳定,应激反应更轻微.%Objective To compare the ventilatory effects between three-way laryngeal mask airway (TLMA)and tracheal catheter (TC) on hemodynamics, respiratory function and stress responses on patients during bronchoalveolar lavage (BAL). Method Forty patients scheduled for BAL under general anesthesia were divided (stratified sampling) into either TLMA group (group T,n = 20) or TC group (group C, n = 20) according to the stratified sampling principle. SpO2, SBP, DBP and HR were measured in 5 min after entering the operating theater (To), just before inserting TLMA or TC(T1), immediately after inserting TLMA or TC(T2) ,3 min(T3), 5 min(T4), 10 min(T5)after mechanical ventilation, 10 min(T6),20 min(T7), 30 min

  12. Diagnostic value of Xpert MTB/RIF for smear-negative pulmonary tuberculosis using bronchoalveolar lavage fluid%支气管肺泡灌洗液行Xpert MTB/RIF检测对涂阴肺结核的诊断价值

    Institute of Scientific and Technical Information of China (English)

    高春景; 朱述阳

    2016-01-01

    目的:评价支气管肺泡灌洗液行Xpert MTB/RIF检测对涂阴肺结核的诊断价值。方法选取从2014年11月至2015年12月徐州市传染病医院收治的3次痰涂片阴性的可疑肺结核患者110例,对所有患者行支气管镜检查进行刷检及收集BALF,进行涂片镜检找抗酸杆菌、结核分枝杆菌培养及Xpert MTB/RIF检测,同时进行诊断。分别以BALF的罗氏培养结果及临床诊断标准作为肺结核诊断的阳性标准,计算Xpert MTB/RIF 诊断涂阴肺结核的敏感度、特异度、阳性预测值及阴性预测值。结果以BALF培养阳性结果作为判断肺结核的阳性标准,BALF行Xpert MTB/RIF检测对诊断涂阴肺结核的敏感度、特异度、阳性预测值、阴性预测值分别为100%、97.4%、97.8%、100%。以临床诊断标准为诊断肺结核的阳性标准, BALF 行 Xpert MTB/RIF检测对诊断涂阴肺结核的敏感度、特异度、阳性预测值、阴性预测值分别为81.9%、97.4%、98.3%、74.0%。以DST结果为金标准,Xpert MTB/RIF检测利福平耐药的敏感度、特异度分别为75.0%、96.0%。结论 BALF行Xpert MTB/RIF检测在涂阴肺结核中的敏感度、特异度均较高,且检测快速并能判断是否利福平耐药,对涂阴肺结核的快速诊断及治疗具有较大的应用价值。%Objective To evaluate the diagnostic value of Xpert MTB/RIF for smear-negative pulmonar tu-berculosis using bronchoalveolar lavage fluid. Methods From November 2014 to December 2015 in Xuzhou infec-tious disease hospital, we screened 110 suspected PTB patients with 3 consecutive negative sputum smears, bushed and obtained their BLAF specimen by brochchoscopy. BALF was tested by smear microscopy for acid fast bacilli, my-cobacterium tuberculosis culture and Xpert MTB/RIF assay. The sensitivity, specificity, PPV and NPV for Xpert MTB/RIF test were respectively calculated using culture results and? clinical diagnostic criteria as reference stand

  13. Clinical effects and bronchoalveolar transfer of levofloxacin in patients with community-acquired pneumonia

    Institute of Scientific and Technical Information of China (English)

    林耀广; 苏薇; 徐作军; 白彦

    2001-01-01

    @@To evaluate the clinical effects and bronchoalveolar transfer of levofloxacin (LVFX) in patients with community-acquired pneumonia. Twenty-eight outpatients with community-acquired pneumonia (CAP) were observed in an open-label, noncomparative study. The concentrations of levofloxacin in serum and bronchoalveolar lavage fluid (BALF) were measured  by  high-performance  liquid  chromatography (HPLC) with fluorescence detection in 10 patients and 15 non-levofloxacin users.

  14. The diagnostic value in bronchoalveolar lavage galactomannan antigen detection of invasive pulmonary aspergillosis in patients without granulocyte deficiency%支气管肺泡灌洗液半乳甘露聚糖抗原检测对非粒细胞缺乏患者的侵袭性肺曲霉病诊断价值

    Institute of Scientific and Technical Information of China (English)

    郭庆玲; 郭禹标; 廖康; 朱智文

    2016-01-01

    目的:探讨针对感染的肺组织局部进行支气管肺泡灌洗术得到支气管肺泡灌洗液(BALF)进行半乳甘露聚糖(GM)检测是否能协助提高非粒细胞缺乏的患者并侵袭性肺曲霉病(IPA)的诊断效率,并了解其最佳GM界值. 方法: 收集并分析2011年1月至2013年12月在呼吸科内镜中心检查考虑IPA可能并行BALF GM检测的患者173例. 按照国内外诊断标准,将病例分为4组,IPA组(n=23),肺结核组(n=11),细菌性肺炎组(n = 90),非感染组(n = 49).采用ELISA方法测定血清及BALF GM.用统计学方法了解BALF GM检测在非粒细胞缺乏的患者并发IPA中的诊断价值. 结果:在非粒细胞缺乏的患者并发IPA的诊断中,与非IPA患者相比,IPA患者的BALF GM检测数值高, 组间差异有统计学意义; 与血清GM检测相比, BALF GM检测的IPA诊断效率高.ROC曲线分析发现,当BALF GM检测界值为≥0.95时,IPA的诊断效率最高.结论:BALF GM检测有利于非粒细胞缺乏患者并IPA的早期鉴别与诊断.同时研究发现BALF GM值最佳界值为≥0.95.%Objective To study infection of the lung tissue by bronchoalveolar lavage for BALF and explore whether GM can help improve the he diagnosis efficiency in patients without granulocyte deficiency with IPA, and find the threshold of GM values. Methods Between January 2011 and December 2011, 173 cases of patients were considered possible invasive pulmonary aspergillosis in parallel BALF GM detection in the center of the respiratory endoscopic examination.. According to the diagnostic criteria at home and abroad, all the cases were divided into four groups, including group of IPA, group of tuberculosis, group of bacterial pneumonia and group of non-infection. Using ELISA method for determination of serum and BALF GM. The diagnostic value was made by statistical methods in BALF GM detection without patients of granulocyte deficiency with IPA. Results There were 11 cases in the group of IPA, 23 cases in the

  15. 非小细胞肺癌 BALF 中 RAR-β基因甲基化与p53突变检测及相关性研究∗%Correlation between RAR-βgene methylation and p53 gene mutation in bronchoalveolar lavage fluid in non-small-cell lung cancer

    Institute of Scientific and Technical Information of China (English)

    李琪; 肖贵华; 程长浩; 常芬

    2015-01-01

    Objective To investigate the clinical significance and correlation between RAR-βgene methylation and p53 gene mutation in bronchoalveolar lavage fluid(BALF)in non-small-cell lung cancer.Methods BALF samples from 85 lung cancer pa-tients(lung cancer group)and 70 cases(benign lung diseases group)with benign lung diseases were collected.RAR-βgene methyla-tion in BALF samples was detected by methylation-specific PCR (MSP),and p53 gene mutation was detected by PCR and DNA se-quencing method.Results The rate of RAR-βmethylation and p53 mutation in BALF in lung cancer were 49.4% and 36.5%,re-spectively.Both were higher than in benign lung diseases group(P <0.01).RAR-βmethylation rate(32.5%)of patients with TNM stages(Ⅰ+Ⅱ)(32.5%)was higher than the p53 mutation rate(12.5%)over the same stages (P <0.05).RAR-βmethylation rate and p53 mutation rate of patients with stages(Ⅲ+Ⅳ)were higher than those with stages(Ⅰ+Ⅱ)(P <0.01).p53 mutation rate in lung cancer patients with RAR-βmethylation was higher than those with unmethylated(P <0.01).RAR-βmethylation rate of lung cancer patients with p53 mutation was higher than those without p53 mutation(P <0.01).Conclusion Detection of RAR-βmethyl-ation and p53 mutation in BALF contribute to the diagnosis of lung cancer.%目的:探讨非小细胞肺癌患者支气管肺泡灌洗液(BALF)中 RAR-β基因甲基化与 p53基因突变检测的临床意义及二者的相关性。方法收集非小细胞肺癌患者(肺癌组)85例及良性疾病患者(良性疾病组)70例的 BALF 标本,采用甲基化特异性 PCR(MSP)方法检测 BALF 中的 RAR-β基因甲基化,PCR 结合 DNA 测序法检测 p53基因突变。结果肺癌组 BALF 中RAR-β基因甲基化率及 p53基因突变率分别为49.4%、36.5%,均显著高于良性疾病组(P <0.01);(Ⅰ+Ⅱ)期 RAR-β基因甲基化率(32.5%)高于同期 p53基因突变率(12.5%)(P <0.05);(Ⅲ+Ⅳ)期 RAR-β基因甲基化率及 p53基因突变

  16. 旋毛虫感染对过敏性哮喘小鼠血清及肺泡灌洗液总IgE的影响%Effect of Trichinella spiralis infection on total IgE levels in surum and bronchoalveolar lavage fluid from mice with allergic asthma

    Institute of Scientific and Technical Information of China (English)

    马萍; 闫玉文; 邢杰; 于剑

    2013-01-01

    [Objective] To investigate the effect of Trichinella spiralis infection on allergic asthma, through the study of the change of total IgE levels in surum and bronchoalveolar lavage fluid (BALF) when the mice which were infected with Trichinella spiralis were suffering from allergic asthma. [Methods] Female BALB/c mice were randomly divided into three groups (six mice each), including A as control group, B as allergic asthma group, C as asthma followed by Trichinella spiralis infection. The animals in group C were intragastrically infected with 200-300 Trichinella spiralis muscle larvae. Four weeks later, ovalbumin (OVA) was used to induce allergic asthma for mice in group B and C, in order to establish experimental animal model. After eight weeks, all mice were killed and total IgE levels were measured in serum and BALF.[ Results] Total IgE levels were measured by ELISA. Total IgE levels from serum in group A, B and C were (61.79 ± 25.79) , (437.08 ± 75.68) , (251.64 ± 107.27) ng/ml. Total IgE level in group C was lower than that in group B (P< 0.05). BALF total IgE levels in group A, B and C were (43.70 ± 29.49), (387.49 ± 148.32), (102.50 ± 49.55) ng/ml. Total IgE level in group C was lower than that in group B (P < 0.05). [Conclusion] Trichinella spiralis infection can inhibit the total IgE level of mice with the allergic asthma.%通过研究旋毛虫感染小鼠在过敏性哮喘发病时血清及肺泡灌洗液中总IgE水平变化,探讨旋毛虫感染对过敏性哮喘的影响.[方法]取雌性、8周龄BALB/c小鼠,随机分为3组,A组为空白对照组,B组为单纯过敏性哮喘组,C组为感染旋毛虫后哮喘组.C组经灌胃感染旋毛虫囊包幼虫200 ~ 300条;4周后,以卵清白蛋白(ovalbumin,OVA)分别对B组和C组小鼠进行致敏激发,建立过敏性哮喘模型;8周后,取小鼠血清、肺泡灌洗液,检测总IgE水平.[结果]ELISA法检测血清中A、B、C组小鼠总IgE水平分别为(61.79±25.79)、(437.08±75.68)

  17. 益气化痰方对慢性阻塞性肺疾病大鼠肺泡灌洗液中AQP5、 TNF-α和MUC5AC的影响%Effect of Yiqi Huatan Decoction on Aquaporin 5, Tumor Necrosis Factor-alpha and MUC5AC in Bronchoalveolar Lavage Fluid of Chronic Obstructive Pulmonary Diseases Rats

    Institute of Scientific and Technical Information of China (English)

    冯立志; 单丽囡; 黄纯美; 陈创荣; 詹少峰; 钟亮环

    2016-01-01

    【目的】观察益气化痰方对慢性阻塞性肺疾病(COPD)大鼠肺泡灌洗液(BALF)水通道蛋白5(AQP5)及其上游信号通道调节因子肿瘤坏死因子-α(TNF-α)和下游信号通道调节因子黏蛋白5AC(MUC5AC)的调节作用。【方法】选用SD大鼠,随机分为空白组,模型组,益气化痰方低、中、高剂量组(剂量分别为7.398、36.99、73.98 g·kg-1·g-1)。除空白组外,其他组均采用香烟熏结合脂多糖气管滴入法复制COPD大鼠模型。采用益气化痰中药煎剂治疗COPD大鼠30 d后取材,观察肺组织苏木精—伊红(HE)染色,采用免疫组织化学法观察AQP5、 TNF-α、 MUC5AC的表达,酶联免疫吸附法(ELISA)测定大鼠肺泡灌洗液(BALF)中AQP5、 TNF-α和MUC5AC的含量。【结果】益气化痰汤各剂量组均可改善COPD大鼠的肺组织病理损害,减弱肺组织MUC5AC、 TNF-α表达,增强AQP5表达。与空白组比较,模型组肺组织BALF中AQP5浓度显著下降(P<0.01), TNF-α和MUC5AC浓度显著升高(P<0.01)。与模型组比较,益气化痰方低、中、高剂量组肺组织BALF中AQP5浓度显著升高(P<0.01), TNF-α和MUC5AC浓度显著下降(P<0.01)。与低、中剂量组比较,益气化痰汤高剂量组作用显著(P<0.01)。【结论】益气化痰方对COPD的疗效可能与水通道转运密切相关。%Objective To investigate Yiqi Huatan Decoction(YHD), a compound recipe with the actions of tonifying Qi and resolving phlegm, on aquaporin 5(AQP5), tumor necrosis factor-alpha(TNF-α)and mucin 5AC(MUC5AC)in bronchoalveolar lavage fluid(BALF)of chronic obstructive pulmonary diseases(COPD)rats. Methods SD rats were randomized into blank control group, model group, and low-, middle- and high-dose YHD groups(in the dosage of 7.398, 36.99, 73.98 g·kg-1·d-1 respectively). The rat model of COPD was induced by cigarette smoking combined with intratracheal

  18. Influence of Dexamethasone on IL-25 and IFN-γin Bronchoalveolar Lavage Fluid of Asthmatic Mice%地塞米松对哮喘小鼠支气管肺泡灌洗液中IL-25和IFN-γ的影响

    Institute of Scientific and Technical Information of China (English)

    陆韦; 王蕾; 谯明; 王玉; 江吉富; 吴中明

    2014-01-01

    Objective To investigate the mechanism of therapeutic action of dexamethasone on asthmatic mice by detecting the levels of IL-25 and IFN-γ in bronchoalveolar lavage fluid (BALF). Methods Balb/c mice with SPF grade were randomly divided into normal control group, asthma group and dexamethasone group. Asthma group and dexamethasone group were sensitized and challenged with ovalbumin ( OVA) . Dexamethasone group was intraperitoneally injected with dexamethasone one hour before challenging. The mice were executed 24 hours after the last challenge, and the HE stained pathological sections of the right lung were made. Pathological sections of lung were observed. BALF in the left lung was also collected. The total white blood cell count and absolute eosinophile ( EOS) count were observed, and the percentage of EOS was calculated. The levels of IL-25 and IFN-γwere measured with ELISA, and correlation analyses were made. Results The counts of total white blood cell and EOS, and the percentage of EOS were significantly higher in the asthma group than in the normal control group and dexamethasone group (P<0. 05). No differences were found between the normal control group and dexamethasone group. The IL-25 level was higher in the asthma group than in the normal control group and dexamethasone group (P<0. 05), and its level in the dexamethasone group was also higher than that in the normal control group. The IFN-γlevel was lower in the asthma group than in the normal control group and dexamethasone group (P<0. 05), while there was no significant difference between the normal control group and dexamethasone group. IL-25 was negatively correlated with IFN-γin each group. Conclusion Part of the mechanisms of dexamethasone acting on asthma are related to its inhibition on the pulmonary inflammation and promotion on the expression of IFN-γ, and possible inhibition of IL-25 expression.%目的通过检测支气管肺泡灌洗液(BALF)中白细胞介素-25(IL-25)和γ-干扰

  19. Effect of Loratadine on Expression of Interleukin 5 and Eosinophil Count in Peripheral Blood and Bronchoal-veolar Lavage Fluid of Asthmatic Guinea Pigs%氯雷他定对哮喘豚鼠肺泡灌洗液及血清白细胞介素-5和嗜酸性粒细胞计数的影响

    Institute of Scientific and Technical Information of China (English)

    宋晓丹; 张明; 欧维琳; 郑伟华; 朱春江; 吉艳荣

    2011-01-01

    Objective To observe the influence of loratadine which was the second generation of H1 receptor antagonist on the expressions of interleukin 5 (IL- 5 )and eosinophil (EOS) count in bronchoalveolar lavage fluid(BALF) and peripheral blood in asthmatic guinea pigs,and explore the role of loratadine on airway high response of asthmatic guinea pigs. Methods Thirty -two guinea pigs were divided into normal control group, asthmatic group, low dose and high dose group of loratadine. After ovalbumin irritated, ovalbumin was inhaled to induce asthma breakout, meanwhile giving loratadine 2 mg · kg-1, 10 mg· kg- 1 in low dose group and high dose group. After the last inhaling ovalbumin,the airway pressure was detected by the animal respirator. Enzyme linked immunosorbent assay was used to measure the IL -5 in BALF and peri-pheral blood,meanwhile,EOS count was also detected. Results The serum IL -5 in normal control group,asthmatic group,low dose group and high dose group were(0.27 ±0.04) ng · L-1 ,(0.41 ±0.03) ng · L-1 ,(0. 38 ±0.02) ng · L-1 and (0.31 ±0.03) ng · L-1;IL-5 in BALF were (0. 10 ±0. 01 )ng · L-1 ,(0.38 ±0.04) ng · L-1 ,(0.33 ±0.05) ng · L-1 and (0.23 ±0.09) ng · L-1, respectively;the count of EOS in serum were(4.0 ±0. 6) × 108L-1, (54.6 ± 7.6) × 108L-1 , (44.5 ± 3.9) × l08L-1 and (29.0 ± 5.8) × 108L- 1 ;EOS in BALF in each group were(3.0 ±0. 5) × 108L-1 ,(33.7 ±3.9) × 108L-1 ,(27. 1 ±3.2) × l08L-1 and ( 18.6 ±3.3) × 108L-1. The differences between every 2 groups in each measurements were significant(Pa <0.05,0. 01 ). When inhaled histamine 10 mg · L-1 and 20 mg · L - 1, the differences between asthmatic group and low dose of loratadine group was not remarkable, but the difference between the rest 2 groups were prominent( Pa < 0. 05 ). Conclusions In asthmatic model, loratadine can ameliorate the airway high response, reverse the high IL-5 expressing condition in asthma,at the same time,the count of eosionphil is also

  20. Elevated peptides in lung lavage fluid associated with bronchiolitis obliterans syndrome.

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    Matthew D Stone

    Full Text Available OBJECTIVE: The objective of this discovery-level investigation was to use mass spectrometry to identify low mass compounds in bronchoalveolar lavage fluid from lung transplant recipients that associate with bronchiolitis obliterans syndrome. EXPERIMENTAL DESIGN: Bronchoalveolar lavage fluid samples from lung transplant recipients were evaluated for small molecules using ESI-TOF mass spectrometry and correlated to the development of bronchiolitis obliterans syndrome. Peptides associated with samples from persons with bronchiolitis obliterans syndrome and controls were identified separately by MS/MS analysis. RESULTS: The average bronchoalveolar lavage fluid MS spectrum profile of individuals that developed bronchiolitis obliterans syndrome differed greatly compared to controls. Controls demonstrated close inter-sample correlation (R = 0.97+/-0.02, average+/-SD while bronchiolitis obliterans syndrome showed greater heterogeneity (R = 0.86+/-0.09, average+/-SD. We identified 89 features that were predictive of developing BOS grade 1 and 66 features predictive of developing BOS grade 2 or higher. Fractions from MS analysis were pooled and evaluated for peptide content. Nearly 10-fold more peptides were found in bronchiolitis obliterans syndrome relative to controls. C-terminal residues suggested trypsin-like specificity among controls compared to elastase-type enzymes among those with bronchiolitis obliterans syndrome. CONCLUSIONS: Bronchoalveolar lavage fluid from individuals with bronchiolitis obliterans syndrome has an increase in low mass components detected by mass spectrometry. Many of these features were peptides that likely result from elevated neutrophil elastase activity.

  1. APPLICATION OF CT-GUIDED BRONCHOALVEOLAR LAVAGE IN THE TREATMENT OF PATIENTS WITH SEVERE PNEUMONIA COMBINED SEPSIS SHOCK%CT 导引支气管镜肺泡灌洗对治疗重症肺炎合并脓毒症休克的效果

    Institute of Scientific and Technical Information of China (English)

    白静; 张军伟; 王建军; 程爱斌; 王红阳

    2014-01-01

    目的:探讨CT导引支气管镜肺泡灌洗对治疗肺感染合并脓毒症休克的疗效。方法对重症医学科2012年10月-2013年6月收治的47例重症肺炎合并脓毒症休克患者的临床资料进行回顾性分析。患者入选标准参照2001年国际脓毒症会议。将入选患者随机分为C T 导引支气管镜肺泡灌洗组(A组)和对照组(B组),二组均行早期目标导向治疗(EGDT ),CT 导引支气管镜肺泡灌洗组给予支气管镜肺泡灌洗连续做3d ,1次/d ,而对照组不给予支气管肺泡灌洗。记录患者年龄,性别,开始试验时、治疗后3d、7d的APACHEⅡ评分、肺感染评分、白细胞计数,乳酸降至2mmol/L的时间,机械通气时间,ICU住院时间。结果 A、B二组性别、年龄差异无统计学意义(P>0.05),开始治疗时APACHEⅡ评分、肺感染评分以及开始治疗时二组白细胞计数差异无统计学意义(P>0.05);治疗后3d和7d时 A组 APACHEⅡ评分、肺感染评分、白细胞计数明显低于B组(P<0.05);A组乳酸降至2mmol/L的时间、机械通气时间和ICU住院时间明显短于B组(P<0.05);CT 导引支气管镜肺泡灌洗操作无任何并发症的发生。结论CT导引支气管镜肺泡灌洗对治疗重症肺炎合并脓毒症休克患者安全有效,值得临床推广。%Objective To evaluate the significance of CT -guided bronchoscope alveolar lavage in severe pneumonia with sepsis shock patients .Methods The clinical experience and data of 47 patients of severe pneumonia with sepsis shock from October 2012 to June 2013 in author's hospital were retrospectively ana-lyzed .The selection criteria was in accordance with criteria set by International Conference On Sepsis in 2001 .All patients were randomly divided into treatment group(n=24)and control group(n=23) .Early goal-directed therapy(EGDT)was used in the first 6 hours of fluid resuscitation .In treatment group

  2. Rapid diagnosis of invasive pulmonary aspergillosis by quantitative polymerase chain reaction using bronchial lavage fluid.

    Science.gov (United States)

    Kawazu, Masahito; Kanda, Yoshinobu; Goyama, Susumu; Takeshita, Masataka; Nannya, Yasuhito; Niino, Miyuki; Komeno, Yukiko; Nakamoto, Tetsuya; Kurokawa, Mineo; Tsujino, Shiho; Ogawa, Seishi; Aoki, Katsunori; Chiba, Shigeru; Motokura, Toru; Ohishi, Nobuya; Hirai, Hisamaru

    2003-01-01

    Polymerase chain reaction (PCR) is a sensitive method for detection of Aspergillus DNA in bronchoalveolar lavage fluid, but it has not yet been able to distinguish infection from contamination. We have established a technique to quantify Aspergillus DNA using a real-time PCR method to resolve this problem, and we report herein a successful application of real-time PCR to diagnose invasive pulmonary aspergillosis by comparing the amount of Aspergillus DNA in bronchial lavage fluid from an affected area to that from an unaffected area. This novel tool will provide rapid, sensitive, and specific diagnosis of pulmonary aspergillosis.

  3. 无创通气联合纤维支气管镜肺泡灌洗治疗在慢性阻塞性肺疾病急性加重并呼吸衰竭伴意识障碍患者中的临床应用%Application of noninvasive positive pressure ventilation associated with bronchoalveolar lavage in consciousness disorder patients with severe chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    刘宝欣; 张文艳; 候金兰

    2008-01-01

    positive pressure ventilation(NIPPV)associated with bronchoalveolar lavage(BAL)in consciousness disorder patients due to acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods Sixty-two acute exacerbation of COPD patients were divided into two groups,which were carefully matched for age,sex,COPD course,and body mass index(BMI)I.Thirty patients with impaired consciousness served as treatment group and 32 without impaired consciousness as control group.MV was never administered in these patients before and there were no contraindications.All patients received both NIPPV and standard medical treatment,BAL was administered in treatment group in addition.Changes from baseline in Glasgow coma scale,arterial blood gas (ABG)levels,duration of NIPPV,success rate of sequential invasive positive pressure ventilation(IPPV)and the mortality rate were compared.Results The success rate of NIPPV with BAL was 63.3%(19/30)in greatment group and the NIPPV success rate was 65.63%(21/32)in group B(P>0.05);ABG levels were improved obviously after treatment both in treatment group and controI group.but with no significant difference in ABG levels between treatment group and control group(P>0.05);6 cases received sequential IPPV in treatment group.and 7 cases in control group,the Success rate was 66.67%(4/6)and 71.43%(5/7)respectively(P>0.05);5 cases died in treatment group,and 4 cases in control group,the mortality was 16.67%(5/30)and 12.5%(4/32)respectively(P>0.05).Conclusions Consciousness disorder secondary to AECOPD should not be considered a contraindication to NIPPV.NIPPV can also be preferred in patients with excessive mucus production in conditions of administering NIPPV with BAL.In patients with impaired consciousness,NIPPV effectiveness may be similar to that in conscious patients if carrying OUt BAL before NIPPV.But the process must be monitored closely by experienced respiratory specialists'and the severity of the illness must be evaluated in time.If the disease

  4. Cell recovery in bronchoalveolar lavage fluid in smokers is dependent on cumulative smoking history.

    Directory of Open Access Journals (Sweden)

    Reza Karimi

    Full Text Available BACKGROUND: Smoking is a risk factor for various lung diseases in which BAL may be used as a part of a clinical investigation. Interpretation of BAL fluid cellularity is however difficult due to high variability, in particular among smokers. In this study we aimed to evaluate the effect of smoking on BAL cellular components in asymptomatic smokers. The effects of smoking cessation, age and gender were also investigated in groups of smokers and exsmokers. METHODS: We performed a retrospective review of BAL findings, to our knowledge the largest single center investigation, in our department from 1999 to 2009. One hundred thirty two current smokers (48 males and 84 females and 44 ex-smokers (16 males and 28 females were included. A group of 295 (132 males and 163 females never-smokers served as reference. RESULT: The median [5-95 pctl] total number of cells and cell concentration in current smokers were 63.4 [28.6-132.1]×10(6 and 382.1 [189.7-864.3]×10(6/L respectively and correlated positively to the cumulative smoking history. Macrophages were the predominant cell type (96.7% [90.4-99.0] followed by lymphocytes (2% [0.8-7.7] and neutrophils (0.6% [0-2.9]. The concentration of all inflammatory cells was increased in smokers compared to never smokers and ex-smokers. BAL fluid recovery was negatively correlated with age (p<0.001. Smoking men had a lower BAL fluid recovery than smoking women. CONCLUSION: Smoking has a profound effect on BAL fluid cellularity, which is dependent on smoking history. Our results performed on a large group of current smokers and ex-smokers in a well standardized way, can contribute to better interpretation of BAL fluid cellularity in clinical context.

  5. Reduction of cytokine release of blood and bronchoalveolar mononuclear cells by ambroxol.

    Science.gov (United States)

    Pfeifer, S; Zissel, G; Kienast, K; Müller-Quernheim, J

    1997-03-24

    Ambroxol is a mucolytic agent frequently used in the treatment of chronic bronchitis. It has been reported, following clinical and in-vitro studies, that ambroxol exhibits an anti-inflammatory action. This capability was investigated by activating bronchoalveolar lavage cells and peripheral blood mononuclear cells in-vitro to elicit the release of tumor necrosis factor alpha, interleukin-2 and interferon gamma, whilst simultaneously exposing them to varying pharmacological concentrations of ambroxol (10, 1, and 0.1 microM). After 24 h it was observed that the isolated tissue-culture supernatants showed a dose-dependent reduction in the concentration of the tested cytokines; 10 microM (12 to 37% reduction) and 1 microM to (6 to 27% reduction). At 0.1 microM, a significant reduction could only be observed in the release of interleukin-2 by bronchoalveolar lavage cells. These results demonstrate, that ambroxol exhibits anti-inflammatory actions in concentrations achievable in vivo.

  6. The Physical Properties of a Lavage Mixture of Pulmonary Surfactant, Perfluorodecaline, and Methylprednisolone (Perfactant Lavage)

    Science.gov (United States)

    2014-05-09

    surfactant , perfluorodecaline, and methylprednisolone (perfectant lavage) Timothy F. Haley, MD, LTC, MC Timothy F. Haley, MD, LTC, MC, USA Division...release: distribution unlimited Purpose: To characterize the physical properties of a lavage mixture of pulmonary surfactant , perfluorocarbon and...MIXTURE OF PULMONARY SURFACTANT , PERFLUORODECALINE AND METHYLPREDNISOLONE (PERFACTANT LAVAGE) INVESTIGATOR: Timothy F. Haley, MD, LTC, MC, USA

  7. Bacteria-induced histamine release from human bronchoalveolar cells and blood leukocytes

    DEFF Research Database (Denmark)

    Clementsen, P; Milman, N; Struve-Christensen, E

    1991-01-01

    Histamine release induced by Staphylococcus aureus was examined in cells obtained by bronchoalveolar lavage (BAL) in non-atopic individuals. Approximately half of the individuals responded with mediator release to the bacterium, and the release was found to be time- and concentration dependent....... No difference was found between the patients who responded and those who did not respond in regard to age, sex, smoker/non-smoker, % recovery of BAL-fluid, total cell count, differential cell counts, histamine content per mast cell, or diagnoses. Also stimulation of the BAL-cells with the calcium-ionophore A......23187 resulted in histamine release. S. aureus-induced histamine release from basophils was examined in leukocyte suspensions obtained from the same individuals, and in all experiments release was found. The dose-response curves were similar to those obtained with BAL cells. The bacteria...

  8. Measurement of secretion in nasal lavage

    DEFF Research Database (Denmark)

    Bisgaard, H; Krogsgaard, O W; Mygind, N

    1987-01-01

    secretion to be carried out on the whole sample of lavage fluid, thereby avoiding the necessity of complete admixture between marker and lavage fluid which would be pertinent to marker molecules measured chemically. The radiation from a nasal lavage is minimal and the procedure is fully acceptable...... for repeated use in humans. 4. The nasal lavage technique adopted allowed the return of 99.2% (median value) of the instilled volume. The area irrigated was visualized on a gamma-camera, and was demonstrated to cover an area larger than the area reached by challenge from a pumpspray, i.e. a large part...... of the nose, yet not the oropharynx. 5. A dose related increase in nasal secretion harvested by the nasal lavage in 10 persons challenged with histamine chloride could be demonstrated by this technique. 6. It is concluded that the use of 99mTc-albumin in a nasal washing provides a safe, simple and quick...

  9. [Biochemical characteristics of fluid and cells of bronchoalveolar washings in patients with extrinsic allergic alveolitis].

    Science.gov (United States)

    Kaminskaia, G O; Abdullaev, R Iu; Filippov, V P

    2002-01-01

    In 43 patients with exogenous allergic alveolitis (EAA), including 30 and 13 in its acute and chronic disease, bronchoalveolar lavage was performed, bronchoalveolar washing fluid (BAWF), isolated alveolar macrophages (AM) and unfractionated cellular sediment (NFCS) were separately studied. The BAWF showed high rates of lipid peroxidation (LPO), decreased antiproteolytic defense, and activated local synthesis of haptoglobin (Hp), fibronectin (FN), platelet activation factor (PAF), and enzymes of antioxidative defense (AOD). There was a rise in FN and PAF concentrations in the acute phase of the disease and higher PLO rates and elevated Hp levels in chronic EAA. The rate of oxidative metabolism in AMs was much higher in acute EAA than that in chronic EAA and accompanied by imbalance in the PLO-AOD system. AM levels of PAF was high in patients in both groups. The rate of LPO was higher in NFCS than in AM and was also followed by simultaneous AOD mobilization with preserved imbalance. A particularly significant AOD insufficiency in the NFCS was noted in chronic EAA, which was accompanied by decreased PAF. Thus, local pathochemical processes are of significance in developing the pattern of the process in EAA.

  10. Análise da celularidade do lavado bronco-alveolar em pacientes submetidos à revascularização do miocárdio com circulação extracorpórea: relato de três casos Análisis de la celularidad del lavado bronco-alveolar en pacientes sometidos a revascularización del miocardio con circulación extracorpórea: relato de tres casos Broncho-alveolar lavage cellularity in patients submitted to myocardial revascularization with cardiopulmonary bypass: three case reports

    Directory of Open Access Journals (Sweden)

    Luciano Brandão Machado

    2006-06-01

    response (SIRS during cardiac procedures. It has been shown in an experimental model that CPB may increase cytokine production. This study aimed at evaluating post-CPB lung cell activation by investigating broncho-alveolar lavage (BAL cellularity in patients submitted to myocardial revascularization (MR with CPB. CASE REPORTS: Participated in this prospective study 3 adult patients submitted to MR with CPB. After general anesthesia induction and tracheal intubation, mechanical ventilation was installed with valve circle system; except during CPB, tidal volume was maintained between 8 and 10 mL.kg-1 with 50% O2 and air. Before aortic unclamping, 40 cmH2O pulmonary inflations were performed. Two BAL samples were collected from all patients at beginning and end of procedure, after anticoagulation reversion. BAL was aspired after 60 mL infusion of 0.9% saline through the bronchofibroscope tube. Material was then referred to laboratorial processing. Analysis has evidenced mean increase in total number of cells from 0.6 × 10(6cel.dL-1 to 6.8 × 10(6 cel.dL-1 with increased neutrophils from 0.8% to 4.7%; 0.6% to 6.2% and 0.5% to 5.3% for each patient, respectively. There has been increased pulmonary fluid cellularity after CPB. CONCLUSIONS: Leukocyte inflow is described in different clinical pulmonary inflammatory conditions, such as adult respiratory distress syndrome. It is known that CPB is related to systemic and pulmonary inflammation with increased number of cells after CPB and predominance of macrophages.

  11. Independent risk of mechanical ventilation for AIDS-related Pneumocystis carinii pneumonia associated with bronchoalveolar lavage neutrophilia

    DEFF Research Database (Denmark)

    Bang, D; Emborg, J; Elkjaer, J

    2001-01-01

    The use of mechanical ventilation (MV) for AIDS-related Pneumocystis carinii pneumonia (PCP) has varied over time. The introduction of adjunctive corticosteroid therapy has changed the pathophysiology of PCP. In the present study, we attempted to identify factors predictive of severe respiratory...

  12. Independent risk of mechanical ventilation for AIDS-related Pneumocystis carinii pneumonia associated with bronchoalveolar lavage neutrophilia

    DEFF Research Database (Denmark)

    Bang, D.; Emborg, J.; Elkjaer, J.;

    2001-01-01

    The use of mechanical ventilation (MV) for AIDS-related Pneumocystis carinii pneumonia (PCP) has varied over time. The introduction of adjunctive corticosteroid therapy has changed the pathophysiology of PCP. In the present study, we attempted to identify factors predictive of severe respiratory...... failure requiring MV amongst patients with PCP treated in the era of adjunctive corticosteroid therapy. Furthermore, we studied factors associated with survival in relation to MV. Of 170 consecutive patients with AIDS-related PCP, 18 (11%) required MV. Thirteen of 18 ventilated patients died (72......-term mortality remained high after the introduction of adjunctive corticosteroid therapy. BAL neutrophilia may be a useful prognostic marker to identify patients at high risk of requiring mechanical ventilation Udgivelsesdato: 2001/8...

  13. No evidence of altered alveolar macrophage polarization, but reduced expression of TLR2, in bronchoalveolar lavage cells in sarcoidosis

    Directory of Open Access Journals (Sweden)

    Wikén Maria

    2010-09-01

    Full Text Available Abstract Background Sarcoidosis is a granulomatous inflammatory disease, possibly of infectious aetiology. We aimed to investigate whether the degree of functional polarization of alveolar macrophages (AMs, or Toll-like receptor (TLR expression, is associated with sarcoidosis or with distinct clinical manifestations of this disease. Methods Total BAL cells (cultured four or 24 h in medium, or stimulated 24 h with LPS from 14 patients and six healthy subjects, sorted AMs from 22 patients (Löfgren's syndrome n = 11 and 11 healthy subjects, and sorted CD4+ T cells from 26 patients (Löfgren's syndrome n = 13 and seven healthy subjects, were included. Using real-time PCR, the relative gene expression of IL-10, IL-12p35, IL-12p40, IL-23p19, CCR2, CCR7, iNOS, CXCL10, CXCL11, CXCL16, CCL18, CCL20, CD80, and CD86, and innate immune receptors TLR2, TLR4, and TLR9, was quantified in sorted AMs, and for selected genes in total BAL cells, while IL-17A was quantified in T cells. Results We did not find evidence of a difference with regard to alveolar macrophage M1/M2 polarization between sarcoidosis patients and healthy controls. TLR2 gene expression was significantly lower in sorted AMs from patients, particular in Löfgren's patients. CCL18 gene expression in AMs was significantly higher in patients compared to controls. Additionally, the IL-17A expression was lower in Löfgren's patients' CD4+ T cells. Conclusions Overall, there was no evidence for alveolar macrophage polarization in sarcoidosis. However, there was a reduced TLR2 mRNA expression in patients with Löfgren's syndrome, which may be of relevance for macrophage interactions with a postulated sarcoidosis pathogen, and for the characteristics of the ensuing T cell response.

  14. Human herpes virus-8 DNA in bronchoalveolar lavage samples from patients with AIDS-associated pulmonary Kaposi's sarcoma

    DEFF Research Database (Denmark)

    Benfield, T L; Dodt, K K; Lundgren, Jens Dilling

    1997-01-01

    Kaposi's sarcoma (KS) is the most frequent AIDS-associated neoplasm, and often disseminates to visceral organs, including the lungs. An ante-mortem diagnosis of pulmonary KS is difficult. Recently, DNA sequences resembling a new human herpes virus (HHV-8), have been identified in various forms...

  15. Sensitivity and specificity of bronchoalveolar lavage and protected bronchial brush in the diagnosis of pneumonia in pediatric burn patients

    NARCIS (Netherlands)

    Barret, JP; Ramzy, PI; Wolf, SE; Herndon, DN

    1999-01-01

    Background: Infection is still one of the leading causes of death in burn patients. The diagnosis of respiratory tract infection in critically ill burn patients is still difficult. The diagnostic technique of choice remains uncertain, especially because of the lack of a criterion standard by which o

  16. First reported case of Alcaligenes faecalis isolated from bronchoalveolar lavage in a patient with dengue hemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Arun Agarwal

    2017-01-01

    Full Text Available Bacterial co-infections have been reported in association with dengue fever (DF and can exacerbate dengue infections. However, DF with acute respiratory distress syndrome and co-infection with Alcaligenes faecalis (A. faecalis has not been reported earlier. Most infections caused by A. faecalis are opportunistic. Urinary tract infection, bacterial keratitis, postoperative endophthalmitis, skin and soft tissue infections, bacteremia, meningitis, wound infections, and peritonitis in patients undergoing peritoneal dialysis have been described in association with A. faecalis. A. faecalis, a Gram-negative environmental organism rarely cause significant infections. Treatment can be difficult in some cases due to the high level of resistance to commonly used antibiotics. We report a case of fatal bronchopneumonia caused by extensively drug resistance A. faecalis in a patient of dengue hemorrhagic fever.

  17. Gastric lavage in patients with acute poisoning

    Directory of Open Access Journals (Sweden)

    Montserrat Amigó Tadín

    2012-05-01

    Full Text Available Acute poisonings are a frequent complaint in emergency departments and therapy which prevents the absorption of toxic products taken orally is often indicated: one such option is gastric lavage. Gastric lavage is a digestive decontamination technique whose goal is to remove the maximum amount of poison from the stomach and prevent its absorption. The procedure involves inserting a gastric tube into the stomach through the mouth or nose; firstly to aspirate all the stomach contents and then to perform gastric washing manoeuvres. The effectiveness of gastric lavage is limited and involves a risk of iatrogenesis, and therefore the indications and contraindications should be carefully considered and the technique carried out meticulously to increase its effectiveness and reduce complications, primarily bronchoaspiration. Gastric lavage may be used in conjunction with other digestive decontamination techniques such as administration of activated charcoal. This gastric lavage protocol is based on a review of the literature on this procedure and is supported by the expertise of our research group in gastrointestinal decontamination techniques in patients with acute poisoning.

  18. Microbubble-enriched lavage fluid for treatment of experimental peritonitis

    NARCIS (Netherlands)

    Sharma, P. K.; Rakhorst, G.; Engels, E.; van der Mei, H. C.; Busscher, H. J.; Ploeg, R. J.

    2008-01-01

    Background: Relaparotomies and closed postoperative peritoneal lavage (CPPL) are performed to treat persistent peritonitis. This experimental animal study compared open abdominal lavage with CPPL, and evaluated the potential of microbubble-enriched lavage fluids to improve the efficiency of CPPL and

  19. Physiological and lavage fluid cytological and biochemical endpoints of toxicity in the rat

    Energy Technology Data Exchange (ETDEWEB)

    Lehnert, B.E.

    1992-12-31

    Exposure of the respiratory tract to toxic materials can result in a variety of physiologic disturbances that can serve as endpoints of toxicity. In addition to a brief review of commonly assessed physiologic endpoints, attention is given in the first component of this report to the use of both nose breathing and ``mouth`` breathing rats in toxicity studies that involve measurements of ventilatory functional changes in response to test atmospheres. Additionally, the usefulness of maximum oxygen consumption, or VO{sub 2max}, as a physiologic endpoint of toxicity that uses exercising rats after exposure to test atmospheres is described, along with an introduction to post-exposure exercise as an important behavioral activity that can markedly impact on the severity of acute lung injury caused by pneumoedematogenic materials. The second component of this report focuses on bronchoalveolar lavage and cytological and biochemical endpoints that can be assessed in investigations of the toxicities of test materials. As will be shown herein, some of the biochemical endpoints of toxicity, especially, can sensitively detect subtle injury to the lower respiratory tract that may escape detection by changes in some other conventional endpoints of toxicity, including lung gravimetric increases and histopathological alterations.

  20. Physiological and lavage fluid cytological and biochemical endpoints of toxicity in the rat

    Energy Technology Data Exchange (ETDEWEB)

    Lehnert, B.E.

    1992-01-01

    Exposure of the respiratory tract to toxic materials can result in a variety of physiologic disturbances that can serve as endpoints of toxicity. In addition to a brief review of commonly assessed physiologic endpoints, attention is given in the first component of this report to the use of both nose breathing and mouth'' breathing rats in toxicity studies that involve measurements of ventilatory functional changes in response to test atmospheres. Additionally, the usefulness of maximum oxygen consumption, or VO[sub 2max], as a physiologic endpoint of toxicity that uses exercising rats after exposure to test atmospheres is described, along with an introduction to post-exposure exercise as an important behavioral activity that can markedly impact on the severity of acute lung injury caused by pneumoedematogenic materials. The second component of this report focuses on bronchoalveolar lavage and cytological and biochemical endpoints that can be assessed in investigations of the toxicities of test materials. As will be shown herein, some of the biochemical endpoints of toxicity, especially, can sensitively detect subtle injury to the lower respiratory tract that may escape detection by changes in some other conventional endpoints of toxicity, including lung gravimetric increases and histopathological alterations.

  1. Laparoscopic Lavage for Perforated Diverticulitis With Purulent Peritonitis

    DEFF Research Database (Denmark)

    Thornell, Anders; Angenete, Eva; Bisgaard, Thue

    2016-01-01

    BACKGROUND: Perforated diverticulitis with purulent peritonitis has traditionally been treated with open colon resection and stoma formation with risk for reoperations, morbidity, and mortality. Laparoscopic lavage alone has been suggested as definitive treatment. OBJECTIVE: To compare laparoscopic...

  2. Laparoscopic lavage for perforated diverticulitis: a population analysis.

    LENUS (Irish Health Repository)

    Rogers, Ailín C

    2012-09-01

    Laparoscopic lavage has shown promising results in nonfeculent perforated diverticulitis. It is an appealing strategy; it avoids the complications associated with resection. However, there has been some reluctance to widespread uptake because of the scarcity of large-scale studies.

  3. Anaesthetic management of bilateral alveolar proteinosis for bronchopulmonary lavage.

    Directory of Open Access Journals (Sweden)

    Dixit R

    1998-01-01

    Full Text Available The most hazardous manifestation of pulmonary alveolar proteinosis is progressive hypoxia for which bronchopulmonary lavage (BPL is the single most effective treatment. Unfortunately this procedure under general anesthesia itself increases the risk of hypoxia due to the need for one lung ventilation. It was therefore considered interesting to report the successful anaesthetic management of a patient with pulmonary alveolar proteinosis for Bronchopulmonary lavage.

  4. Whole lung lavage in comparison with bronchoscopic lobar lavage using the rigid bronchoscope in patients with pulmonary alveolar proteinosis: Is it time to change strategy?

    Directory of Open Access Journals (Sweden)

    Hesham Alkady

    2016-12-01

    Conclusion: Whole-lung lavage is more efficient than bronchoscopic lobar lavage in treating PAP as it provides larger lavage volumes in shorter time periods and is also associated with lower rate of recurrence of symptoms and the need of relavage.

  5. Extracellular cadmium in the bronchoalveolar space of long-term tobacco smokers with and without COPD and its association with inflammation

    Directory of Open Access Journals (Sweden)

    Sundblad BM

    2016-05-01

    Full Text Available Britt-Marie Sundblad,1,* Jie Ji,1,* Bettina Levänen,1 Klara Midander,2 Anneli Julander,2 Kjell Larsson,1 Lena Palmberg,1 Anders Lindén1 1Unit for Lung and Airway Research, 2Unit for Occupational and Environmental Dermatology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden *These authors contributed equally to this work Abstract: Tobacco contains cadmium, and this metal has been attributed a causative role in pulmonary emphysema among smokers, although extracellular cadmium has not to date been quantified in the bronchoalveolar space of tobacco smokers with or without COPD. We determined whether cadmium is enhanced in the bronchoalveolar space of long-term tobacco smokers with or without COPD in vivo, its association with inflammation, and its effect on chemokine release in macrophage-like cells in vitro. Bronchoalveolar lavage (BAL, sputum, and blood samples were collected from current, long-term smokers with and without COPD and from healthy nonsmokers. Cadmium concentrations were determined in cell-free BAL fluid using inductively coupled plasma mass spectrometry. Blood monocyte-derived macrophages were exposed to cadmium chloride in vitro. Depending upon the type of sample, molecular markers of inflammation were quantified either as protein (enzyme-linked immunosorbent assay or as mRNA (real-time polymerase chain reaction. Cadmium concentrations were markedly increased in cell-free BAL fluid of smokers compared to that of nonsmokers (n=19–29; P<0.001, irrespective of COPD. In these smokers, the measured cadmium displayed positive correlations with macrophage TNF-α mRNA in BAL, neutrophil and CD8+ cell concentrations in blood, and finally with IL-6, IL-8, and MMP-9 protein in sputum (n=10–20; P<0.05. The cadmium chloride exposure caused a concentration-dependent increase in extracellular IL-8 protein in monocyte-derived macrophages in vitro. In conclusion, extracellular cadmium is enhanced in the

  6. Elevated CXCL-8 expression in bronchoalveolar lavage correlates with disease severity in patients with acute respiratory distress syndrome resulting from tuberculosis

    NARCIS (Netherlands)

    Hashemian, Seyed Mohamad Reza; Mortaz, Esmaeil; Tabarsi, Payam; Jamaati, Hamidreza; Maghsoomi, Zohreh; Khosravi, Adnan; Garssen, Johan; Masjedi, Mohamad Reza; Velayati, Ali Akbar; Folkerts, Gert; Barnes, Peter J; Adcock, Ian M

    2014-01-01

    BACKGROUND: Tuberculosis (TB) is a rare but known cause of acute respiratory distress syndrome (ARDS). The role of inflammatory cytokines in the progression of ARDS in TB patients is unknown. OBJECTIVES: In this study we investigated the possible link between the levels of inflammatory cytokines in

  7. Comparison of methenamine silver nitrate and Giemsa stain for detection of Pneumocystis carinii in bronchoalveolar lavage specimens from HIV infected patients

    DEFF Research Database (Denmark)

    Holten-Andersen, W; Kolmos, H J

    1989-01-01

    found positive with both methods, but a further 10 were diagnosed with Giemsa indicating that the trophozoite stain is more sensitive. As Giemsa stain is simple, quick, cheap and familiar to most microbiological laboratories it should be used for screening of samples to be examined for Pneumocystis...

  8. Lower leukotriene C-4 levels in bronchoalveolar lavage fluid of asthmatic subjects after 2.5 years of inhaled corticosteroid therapy

    NARCIS (Netherlands)

    Oosterhoff, Y; Overbeek, SE; Douma, R; Noordhoek, JA; Postma, DS; Hoogsteden, HC; Zijlstra, FJ

    1995-01-01

    LONG-TERM treatment with inhaled corticosteroids has been shown to result in improvement of symptoms and lung function in subjects with asthma. Arachidonic acid (AA) metabolites are thought to play a role in the pathophysiology of asthma. It was assessed whether differences could be found in broncho

  9. USE OF REPEATED BRONCHOALVEOLAR LAVAGE IN RABBITS TO ASSESS POLLUTANT-INDUCED LUNG CHANGES IN AN ANIMAL MODEL OF CARDIOVASCULAR (CV) DISEASE.

    Science.gov (United States)

    Animal models of coronary heart disease (e.g., hyperlipidemic rabbits) are being used to investigate epidemiologic associations between higher levels of air pollution and adverse CV consequences. Mechanisms by which pollutant-induced lung or systemic inflammation leads to acute C...

  10. Inter-laboratory comparison of three different real-time PCR assays for the detection of Pneumocystis jiroveci in bronchoalveolar lavage fluid samples.

    NARCIS (Netherlands)

    Linssen, C.F.; Jacobs, J.A.; Beckers, P.; Templeton, K.E.; Bakkers, J.; Kuijper, E.J.; Melchers, W.J.; Drent, M.; Vink, C.

    2006-01-01

    Pneumocystis jiroveci pneumonia (PCP) is an opportunistic infection affecting immunocompromised patients. While conventional diagnosis of PCP by microscopy is cumbersome, the use of PCR to diagnose PCP has great potential. Nevertheless, inter-laboratory validation and standardization of PCR assays i

  11. Evaluation of different real time PCRs for the detection of Pneumocystis jirovecii DNA in formalin-fixed paraffin-embedded bronchoalveolar lavage samples

    NARCIS (Netherlands)

    de Leeuw, Bertie H C G M; Voskuil, W Sebastiaan; Maraha, Boulos; van der Zee, Anneke; Westenend, Pieter J; Kusters, Johannes G

    2015-01-01

    The presence of Pneumocystis jirovecii in fresh clinical materials can be detected by PCR with high sensitivity and is thus preferred over microscopic methods. However, fresh materials are not always available, and on formalin-fixed paraffin-embedded materials, PCR may result in reduced detection ra

  12. The microbiota in bronchoalveolar lavage from young children with chronic lung disease includes taxa present in both the oropharynx and nasopharynx

    OpenAIRE

    Marsh, R. L.; Kaestli, M; Chang, A. B.; Binks, M. J.; Pope, C E; Hoffman, L. R.; Smith-Vaughan, H C

    2016-01-01

    Background Invasive methods requiring general anaesthesia are needed to sample the lung microbiota in young children who do not expectorate. This poses substantial challenges to longitudinal study of paediatric airway microbiota. Non-invasive upper airway sampling is an alternative method for monitoring airway microbiota; however, there are limited data describing the relationship of such results with lung microbiota in young children. In this study, we compared the upper and lower airway mic...

  13. Treatment of acute diverticulitis laparoscopic lavage vs. resection (DILALA)

    DEFF Research Database (Denmark)

    Thornell, Anders; Angenete, Eva; Gonzales, Elisabeth

    2011-01-01

    , randomised trial, comparing laparoscopic lavage (LL) to the traditional Hartmann’s Procedure (HP). Primary endpoint is the number of re-operations within 12 months. Secondary endpoints consist of mortality, quality of life (QoL), re-admission, health economy assessment and permanent stoma. Patients...... morbidity. Thus the combined risk of treatment for the patient is high. The aim of the DILALA trial is to evaluate if laparoscopic lavage is a safe, minimally invasive method for patients with perforated diverticulitis Hinchey grade III, resulting in fewer reoperations, decreased morbidity, mortality, costs...... and increased quality of life....

  14. Multi-platform metabolomics assays for human lung lavage fluids in an air pollution exposure study.

    Science.gov (United States)

    Surowiec, Izabella; Karimpour, Masoumeh; Gouveia-Figueira, Sandra; Wu, Junfang; Unosson, Jon; Bosson, Jenny A; Blomberg, Anders; Pourazar, Jamshid; Sandström, Thomas; Behndig, Annelie F; Trygg, Johan; Nording, Malin L

    2016-07-01

    Metabolomics protocols are used to comprehensively characterize the metabolite content of biological samples by exploiting cutting-edge analytical platforms, such as gas chromatography (GC) or liquid chromatography (LC) coupled to mass spectrometry (MS) assays, as well as nuclear magnetic resonance (NMR) assays. We have developed novel sample preparation procedures combined with GC-MS, LC-MS, and NMR metabolomics profiling for analyzing bronchial wash (BW) and bronchoalveolar lavage (BAL) fluid from 15 healthy volunteers following exposure to biodiesel exhaust and filtered air. Our aim was to investigate the responsiveness of metabolite profiles in the human lung to air pollution exposure derived from combustion of biofuels, such as rapeseed methyl ester biodiesel, which are increasingly being promoted as alternatives to conventional fossil fuels. Our multi-platform approach enabled us to detect the greatest number of unique metabolites yet reported in BW and BAL fluid (82 in total). All of the metabolomics assays indicated that the metabolite profiles of the BW and BAL fluids differed appreciably, with 46 metabolites showing significantly different levels in the corresponding lung compartments. Furthermore, the GC-MS assay revealed an effect of biodiesel exhaust exposure on the levels of 1-monostearylglycerol, sucrose, inosine, nonanoic acid, and ethanolamine (in BAL) and pentadecanoic acid (in BW), whereas the LC-MS assay indicated a shift in the levels of niacinamide (in BAL). The NMR assay only identified lactic acid (in BW) as being responsive to biodiesel exhaust exposure. Our findings demonstrate that the proposed multi-platform approach is useful for wide metabolomics screening of BW and BAL fluids and can facilitate elucidation of metabolites responsive to biodiesel exhaust exposure. Graphical Abstract Graphical abstract illustrating the study workflow. NMR Nuclear Magnetic Resonance, LC-TOFMS Liquid chromatography-Time Of Flight Mass Spectrometry, GC Gas

  15. Increased fluoro-deoxy-D-glucose uptake on positron emission tomography-computed tomography postbronchoalveolar lavage: a potential cause of radiologic misinterpretation.

    LENUS (Irish Health Repository)

    Leong, Sum

    2011-08-01

    Cytologic analysis of bronchoalveolar lavage (BAL) fluid is used for lung cancer diagnosis. We describe a patient with a history of rectal carcinoma who presented with a new lung mass. BAL was performed, with positron emission tomography-computed tomography the following day. There was mildly increased fluoro-deoxy-D-glucose uptake in areas of the lung parenchyma with new ground-glass opacification. This created ambiguity in staging, clarified 2 weeks later by a computed tomography showing complete resolution of the ground-glass opacity. Clinicians should be aware that BAL may cause increased pulmonary fluoro-deoxy-D-glucose uptake, making accurate radiologic interpretation problematic. We suggest that to optimize positron emission tomography-computed tomography, studies should not be performed within 24 hours of BAL.

  16. Early experience with laparoscopic lavage for perforated diverticulitis

    NARCIS (Netherlands)

    Swank, H.A.; Mulder, I.M.; Hoofwijk, A.G.; Nienhuijs, S.W.; Lange, J.F.; Bemelman, W.A.; Hoeven, J.G. van der

    2013-01-01

    BACKGROUND: Laparoscopic lavage has recently emerged as a promising alternative to sigmoid resection in the treatment of perforated diverticulitis. This study examined an early experience with this technique. METHODS: The files of all patients with complicated diverticulitis were searched in 34 teac

  17. Maxillary antral lavage using inferior meatal cannula anaesthesia.

    Science.gov (United States)

    Mochloulis, G; Hern, J D; Hollis, L J; Tolley, N S

    1996-08-01

    Antral puncture and lavage through the inferior meatus is a minor but common otolaryngological procedure, usually performed under local anaesthesia. We describe a new method of introducing local anaesthetic into the inferior meatus, via the use of a soft intravenous cannula connected to a syringe containing 10 per cent cocaine paste. We have called this new technique inferior meatal cannula anaesthesia (IMCA).

  18. Cigarette smoking induced liver insult concomitant with inflammatory mediators in serum crevicular fluid and bronchio alveolar lavage of schistosomal diabetic subjects with history of bronchial asthma.

    Science.gov (United States)

    El-Dardiry, Samia A; Shafik, Sherine R; Wagih, Ayman; Amir, El-Amir M; Kassem, Gamal K; Atef, Ghada; El-Toukhy, Heba

    2007-08-01

    Forty five smokers were classified into schistosomal cases with type-2 diabetis mellitus (GI) and with associated history of bronchial asthma (GII) and without T-2 DM (GIII). A control group (GIV) of non-diabetic non schistosomal age matched subjects who quitted smoking for >6 months were included. Assessed parameters included indices of glycemic status (glycated hemoglobin), angiogenesis (vascular endothelial growth factor) hepatic and bronchoalveolar disposition (Liver function test, metallothionein, serum levels of cotinine, cadmium selenium, copper & zinc) and bronchoalveolar lavage) (BAL) levels of surfactant proteins A & D, zinc and copper oxidative stress and fibrogenesis (total antioxidant capacity thiobarbituric acid reactive substance) and vasculopathy (angiotensin converting enzyme, P-selectin, nitrate) and periodontitis (collagenase and elastase in GCF) impact of cigarette smoking associated with trace element disbalance and enzymatic changes in crevicular fluid on altered parameters collaborative out-come. The study reflected the collaborative outcome of immune mediated mechanisms initiated by liver affection, glycemic status and history of predisposed bronchial integrity induced by oxidative stress.

  19. Butyrylcholinesterase in guinea pig lung lavage: a novel biomarker to assess lung injury following inhalation exposure to nerve agent VX.

    Science.gov (United States)

    Graham, Jacob R; Wright, Benjamin S; Rezk, Peter E; Gordon, Richard K; Sciuto, Alfred M; Nambiar, Madhusoodana P

    2006-06-01

    Respiratory disturbances play a central role in chemical warfare nerve agent (CWNA) induced toxicity; they are the starting point of mass casualty and the major cause of death. We developed a microinstillation technique of inhalation exposure to nerve agent VX and assessed lung injury by biochemical analysis of the bronchoalveolar lavage fluid (BALF). Here we demonstrate that normal guinea pig BALF has a significant amount of cholinesterase activity. Treatment with Huperzine A, a specific inhibitor of acetylcholinesterase (AChE), showed that a minor fraction of BALF cholinesterase is AChE. Furthermore, treatment with tetraisopropyl pyrophosphoramide (iso-OMPA), a specific inhibitor of butyrylcholinesterase (BChE), inhibited more than 90% of BChE activity, indicating the predominance of BChE in BALF. A predominance of BChE expression in the lung lavage was seen in both genders. Substrate specific inhibition indicated that nearly 30% of the cholinesterase in lung tissue homogenate is AChE. BALF and lung tissue AChE and BChE activities were strongly inhibited in guinea pigs exposed for 5 min to 70.4 and 90.4 microg/m3 VX and allowed to recover for 15 min. In contrast, BALF AChE activity was increased 63% and 128% and BChE activity was increased 77% and 88% after 24 h of recovery following 5 min inhalation exposure to 70.4 microg/m3 and 90.4 mg/m3 VX, respectively. The increase in BALF AChE and BChE activity was dose dependent. Since BChE is synthesized in the liver and present in the plasma, an increase in BALF indicates endothelial barrier injury and leakage of plasma into lung interstitium. Therefore, a measure of increased levels of AChE and BChE in the lung lavage can be used to determine the chronology of barrier damage as well as the extent of lung injury following exposure to chemical warfare nerve agents.

  20. Cefuroxime, rifampicin and pulse lavage in decontamination of allograft bone.

    Science.gov (United States)

    Hirn, M; Laitinen, M; Pirkkalainen, S; Vuento, R

    2004-03-01

    The risk of bacterial infection through allogenic bone transplantation is one of the major problems facing tissue banks. Different screening methods and decontamination procedures are being used to achieve a safe surgical result. The purpose of this study was to investigate the contamination rate in fresh frozen bone allografts after treating them with different decontamination methods. The allografts were contaminated by rubbing on the operating theatre floor for 60 min, after which they were rinsed either with sterile physiological saline, cefuroxime or rifampicin solution or they were washed with low-pressure pulse lavage of sterile physiological saline. Our findings show that low-pressure pulse lavage with sterile saline solution is very effective in removing bacteria from bone allograft, when compared with the antibiotic solutions tested.

  1. Critical appraisal of laparoscopic lavage for Hinchey Ⅲ diverticulitis

    Institute of Scientific and Technical Information of China (English)

    Pascal Gervaz; Patrick Ambrosetti

    2016-01-01

    Laparoscopic lavage and drainage is a novel approach for managing patients with Hinchey Ⅲ diverticulitis. However, this less invasive technique has important limitations, which are highlighted in this systematic review. We performed a Pub Med search and identified 6 individual series reporting the results of this procedure. An analysis was performed regarding treatment-related morbidity, success rates, and subsequent elective sigmoid resection. Data was available for 287 patients only, of which 213(74%) were actually presenting with Hinchey Ⅲ diverticulitis. Reported success rate in this group was 94%, with 3% mortality. Causes of failure were:(1) ongoing sepsis;(2) fecal fistula formation; and(3) perforated sigmoid cancer. Although few patients developed recurrent diverticulitis in follow-up, 106 patients(37%) eventually underwent elective sigmoid resection. Our data indicate that laparoscopic lavage and drainage may benefit a highly selected group of Hinchey Ⅲ patients. It is unclear whether laparoscopic lavage and drainage should be considered a curative procedure or just a damage control operation. Failure to identify patients with either:(1) feculent peritonitis(Hinchey Ⅳ);(2) persistent perforation; or(3) perforated sigmoid cancer, are causes of concern, and will limit the application of this technique.

  2. Pulse lavage washing in decontamination of allografts improves safety.

    Science.gov (United States)

    Hirn, M; Laitinen, M; Vuento, R

    2003-01-01

    We analyzed the bacterial contamination rate of 140 femoral head allografts after rinsing the allografts in different decontamination solutions. Bacterial screening methods and cleansing effect of antibiotics (cefuroxime and rifampicin) and pulse lavage were compared. Swabbing and taking small pieces of bone for culture were the screening methods used. Both methods proved to be quite unreliable. Approximately one-fourth of the results were false negative. Culturing small pieces of bone gave the most accurate and reliable results and, therefore, can be recommended as a bacterial screening method. The use of antibiotics in allograft decontamination is controversial. In prophylactic use antibiotics include risks of allergic reactions and resistant development and our results in the present study show that antibiotics do not improve the decontamination any better than low-pressure pulse lavage with sterile saline solution. Therefore, pulse lavage with sterile saline solution can be recommended for allograft decontamination. Our results demonstrate that it decreases bacterial bioburden as effectively as the antibiotics without persisting the disadvantages.

  3. Gastric Lavage in Acute Organophosphorus Pesticide poisoning (GLAOP – a randomised controlled trial of multiple vs. single gastric lavage in unselected acute organophosphorus pesticide poisoning

    Directory of Open Access Journals (Sweden)

    Cao YuPing

    2006-10-01

    Full Text Available Abstract Background Organophosphorus (OP pesticide poisoning is the most common form of pesticide poisoning in many Asian countries. Guidelines in western countries for management of poisoning indicate that gastric lavage should be performed only if two criteria are met: within one hour of poison ingestion and substantial ingested amount. But the evidence on which these guidelines are based is from medicine overdoses in developed countries and may be irrelevant to OP poisoning in Asia. Chinese clinical experience suggests that OP remains in the stomach for several hours or even days after ingestion. Thus, there may be reasons for doing single or multiple gastric lavages for OP poisoning. There have been no randomised controlled trials (RCTs to assess this practice of multiple lavages. Since it is currently standard therapy in China, we cannot perform a RCT of no lavage vs. a single lavage vs. multiple lavages. We will compare a single gastric lavage with three gastric lavages as the first stage to assess the role of gastric lavage in OP poisoning. Methods/Design We have designed an RCT assessing the effectiveness of multiple gastric lavages in adult OP self-poisoning patients admitted to three Chinese hospitals within 12 hrs of ingestion. Patients will be randomised to standard treatment plus either a single gastric lavage on admission or three gastric lavages at four hour intervals. The primary outcome is in-hospital mortality. Analysis will be on an intention-to-treat basis. On the basis of the historical incidence of OP at the study sites, we expect to enroll 908 patients over three years. This projected sample size provides sufficient power to evaluate the death rate; and a variety of other exposure and outcome variables, including particular OPs and ingestion time. Changes of OP level will be analyzed in order to provide some toxic kinetic data. Discussion the GLAOP study is a novel, prospective cohort study that will explore to the toxic

  4. Penetrating torso injuries: the role of paracentesis and lavage.

    Science.gov (United States)

    Danto, L A; Thomas, C W; Gorenbein, S; Wolfman, E F

    1977-03-01

    Controversy still exists regarding the proper approach to patients with penetrating torso injuries. Mandatory immediate celiotomy and selective observation both have associated risks. Paracentesis with lavage is a rapid, easily performed and readily available technique which can, with a high degree of accuracy, differentiate on initial evaluation those patients with penetrating visceral injuries from those without such injuries. Complications are minimal. The use of these two procedures in evaluating penetrating torso injuries has led to improved patient care and produced major lowering of medical and socioeconomic costs.

  5. Ductal lavage, nipple aspiration, and ductoscopy for breast cancer diagnosis.

    Science.gov (United States)

    Dooley, William C

    2003-01-01

    The intraductal approach to breast cancer has been invigorated this year by a series of papers exploring ductal-based screening through nipple aspiration and lavage and ductal exploration through endoscopy. The merging of these efforts to define the earliest biologic changes in the progression toward breast cancer is opening new fields for both bench-translational and clinical research. These techniques have already begun to show value in defining the presence and extent of proliferative disease in high-risk patients, allowing for more informed therapeutic decision making.

  6. Status Asthmaticus: use of acetylcysteine during bronchoscopy and lavage to remove mucous plugs.

    Science.gov (United States)

    Millman, M; Goodman, A H; Goldstein, I M; Millman, F M; Van Campen, S S

    1983-02-01

    Three patients suffering from severe, chronic, bronchial asthma underwent bronchoscopy and lavage, using in the irrigant fluid acetylcysteine, isoetharine and Solu-Medrol. All patients had a large amount of thick mucus in the tracheobronchial tree which was removed during the lavage. Following the lavage, all three patients were easily treated with conventional allergic measures and were able to lead normal lives, which they could not do before. A discussion of the precautions to be taken by the medical-surgical team in charge of a patient undergoing bronchoscopy and lavage is made. These conclusions were based on the results of two previous reports by the authors in addition to the present communication.

  7. Ductal lavage and ductoscopy: the opportunities and the limitations.

    Science.gov (United States)

    Khan, Seema A; Baird, Carol; Staradub, Valerie L; Morrow, Monica

    2002-08-01

    Two related techniques of breast epithelial sampling have emerged in the past several years: ductal lavage, in which fluid-yielding nipple ducts are cannulated at their orifices and lavaged with saline while the breast is intermittently massaged; and ductoscopy, in which discharging or fluid-yielding duct orifices are dilated, intubated with a microendoscope, and the lumen directly visualized. Both of these techniques have significant potential in terms of allowing the repeated sampling of ductal epithelium over time and, as such, have generated considerable enthusiasm. However, data regarding the impact of these techniques on the detection of significant breast disease is very scant. It is important at the outset of the assessment of this new technology that breast cancer clinicians and clinical researchers think carefully about the standards of evidence that need to be met regarding the benefits of these procedures before they are widely adopted. In this review of the rationale and early results of these procedures, we attempt to define some of these evidentiary requirements.

  8. PLASMA NA/K CHANGES AFTER GASTRIC LAVAGE WITH TAP WATER IN INGESTION POISONING PATIENTS

    Directory of Open Access Journals (Sweden)

    K MONTAZERI

    2002-06-01

    Full Text Available Introduction. Ingestion poisoning include 79% of all poisoning. Usually the first step in management of these patients is gastric lavage, which in most centers is done by tap water (exepct for children below 4 years old. Due to low Na and K of tap water and daily secretion of Na and K in stomach, one of the probable complications of this lavage is lasting the Na and K, and electrolyte imbalance in patients. Methods. This study was done on 100 poisoned patients undergone Gastric lavage. All of patients were more than 4 years old. Poisoning by toxin or drug contain sodium or potassium, cause to exclude patients from study. For all patients Na/K of plasma before and half hour after gastric lavage were measured. After gastric lavage, volume of lavage, Na/K of lavage liquid and Na/K of tap water were recorded. Results. The changes of plasma Na in all patients were from 7 mmol/lit increasing to 12 mmol/Lit decreasing, and for plasma K were from 1 mmol/lit increasing to 1.2 mmol/lit decreasing. Means changes of Na was 2.74 mmol/lit decreasing and mean change of K was 0.33 mmol/Lit. Decreasing in plasma electrolytes in patients with high volume of gastric lavage was predominant but this relation between. volume of lavage and changing of plasma electrolytes was not considerable. Also total Na and K excretion" in all volumes of lavage was nearly equal. Discussion. In patients without underlying disesae, plasma Na/K changes during gastric lavage is not considerable but in patients with underlying disease or old patients can lead to electrolytes disturbance and to be recommended in these patients plasma elcectrolytes to be measured.

  9. Histamine and tryptase in nasal lavage fluid after allergen challenge

    DEFF Research Database (Denmark)

    Jacobi, H H; Skov, P S; Poulsen, L K

    1999-01-01

    BACKGROUND: Antihistamines (H1-receptor antagonists) act by competitive antagonism of histamine at H1-receptors. In addition, high concentrations of some antihistamines inhibit allergen-induced histamine release from mast cells in vitro. OBJECTIVE: The purpose of this study was to determine......, nasal allergen challenges were performed, and the number of sneezes were counted. In addition, nasal lavage fluid was collected, and the levels of mast-cell mediators (histamine and tryptase) were measured. RESULTS: The allergen challenge of patients allergic to pollen produced sneezing...... and a significant increase in the levels of histamine and tryptase. The challenge of subjects not allergic to pollen produced no such response. Azelastine and cetirizine significantly reduced allergen-induced sneezing and the associated increase in histamine and tryptase levels. No significant differences were...

  10. Serial bronchoscopic lung lavage in pulmonary alveolar proteinosis under local anesthesia

    Directory of Open Access Journals (Sweden)

    K Rennis Davis

    2015-01-01

    Full Text Available Pulmonary alveolar proteinosis (PAP is a rare disease, characterized by alveolar accumulation of surfactant composed of proteins and lipids due to defective surfactant clearance by alveolar macrophages. Mainstay of treatment is whole lung lavage, which requires general anesthesia. Herein, we report a case of primary PAP, successfully treated with serial bronchoscopic lung lavages under local anesthesia.

  11. Detection of cervical neoplasia by DNA methylation analysis in cervico-vaginal lavages, a feasibility study

    NARCIS (Netherlands)

    Eijsink, J. J. H.; Yang, N.; Lendvai, A.; Klip, H. G.; Volders, H. H.; Buikema, H. J.; van Hemel, B. M.; Voll, M.; Bennink, H. J. T. Coelingh; Schuuring, E.; Wisman, G. B. A.; van der Zee, A. G. J.

    2011-01-01

    Objective. To explore the feasibility of DNA methylation analysis for the detection of cervical neoplasia in self-obtained cervico-vaginal lavages. Methods. Lavages collected by a self-sampling device and paired cervical scrapings were obtained from 20 cervical cancer patients and 23 patients referr

  12. Laparoscopic lavage is superior to colon resection for perforated purulent diverticulitis-a meta-analysis

    DEFF Research Database (Denmark)

    Angenete, Eva; Bock, David; Rosenberg, Jacob;

    2016-01-01

    PURPOSE: Perforated diverticulitis often requires surgery with a colon resection such as Hartmann's procedure, with inherent morbidity. Recent studies suggest that laparoscopic lavage may be an alternative surgical treatment. The aim of this study was to compare re-operations, morbidity, and mort......PURPOSE: Perforated diverticulitis often requires surgery with a colon resection such as Hartmann's procedure, with inherent morbidity. Recent studies suggest that laparoscopic lavage may be an alternative surgical treatment. The aim of this study was to compare re-operations, morbidity......, and mortality as well as health economic outcomes between laparoscopic lavage and colon resection for perforated purulent diverticulitis. METHODS: PubMed, Cochrane, Centre for Reviews and Dissemination, and Embase were searched. Published randomized controlled trials and prospective and retrospective cohorts...... compared to colon resection, with overall comparable morbidity and mortality. Furthermore, Hartmann's resection was more costly than laparoscopic lavage. We therefore consider laparoscopic lavage a valid alternative to surgery with resection for perforated purulent diverticulitis....

  13. The Impact of Pleural Lavage Cytology Before and After Resection on Prognosis

    Directory of Open Access Journals (Sweden)

    Serdar Ozkan

    2016-09-01

    Full Text Available Aim: Regardless of pleural effusion, presence of tumor in pleural cavity indicates presence of more aggressive tumor. In this study, we analysed positive tumor results in preoperative pleural lavage in operable malignant cases with no pleural fluid according to the mass and mediastinal lymph node characteristics. Material and Method: Pleural lavage before preoperative dissection and after resection was performed on 199 cases that underwent surgery for non small cell lung cancer (NSCLC. Findings of lavage were statistically evaluated based on gender, lesion shape and size, lymph node involvement in positron emission tomography- computed tomography (PET-CT, SUV-max value of lesion, localisation of the lesion, N1 and N2 metastases, local invasion findings, histopathological type of tumor and type of resection. Results: Cases included in this study were followed for four years. Ten of the cases (5% had tumor recurrence and 12 of them (6% had distant organ metastasis. In multivariable analysis, significant correlation was found between the first positive pleural lavage cytology and postoperative distant organ metastasis; the last pleural lavage cytology and tumor recurrence; postoperative distant organ metastasis and lymph node metastasis and the first positive lavage cytology; tumor recurrence and PET-CT lymph node uptake, lymph node metastasis and the last positive pleural lavage cytology. Discussion: Recently there has been an increase in studies on pleural lavage analysis and there is a need for standardization in lavage timing and sampling. We hope that positive lavage cytology, like malign effusion, will be accepted as a prognostic factor in staging as more studies based on wider series are conducted.

  14. Association between the miRNA Signatures in Plasma and Bronchoalveolar Fluid in Respiratory Pathologies

    Directory of Open Access Journals (Sweden)

    Sonia Molina-Pinelo

    2012-01-01

    Full Text Available The identification of new less invasive biomarkers is necessary to improve the detection and prognostic outcome of respiratory pathological processes. The measurement of miRNA expression through less invasive techniques such as plasma and serum have been suggested to analysis of several lung malignancies including lung cancer. These studies are assuming a common deregulated miRNA expression both in blood and lung tissue. The present study aimed to obtain miRNA representative signatures both in plasma and bronchoalveolar cell fraction that could serve as biomarker in respiratory diseases. Ten patients were evaluated to assess the expression levels of 381 miRNAs. We found that around 50% miRNAs were no detected in both plasma and bronchoalveolar cell fraction and only 20% of miRNAs showed similar expression in both samples. These results show a lack of association of miRNA signatures between plasma and bronchoalveolar cytology in the same patient. The profiles are not comparable; however, there is a similarity in the relative expression in a very small subset of miRNAs (miR-17, miR-19b, miR-195 and miR-20b between both biological samples in all patients. This finding supports that the miRNAs profiles obtained from different biological samples have to be carefully validated to link with respiratory diseases.

  15. Health economic analysis of laparoscopic lavage versus Hartmann's procedure for diverticulitis in the randomized DILALA trial

    DEFF Research Database (Denmark)

    Gehrman, J; Angenete, E; Björholt, I;

    2016-01-01

    BACKGROUND: Open surgery with resection and colostomy (Hartmann's procedure) has been the standard treatment for perforated diverticulitis with purulent peritonitis. In recent years laparoscopic lavage has emerged as an alternative, with potential benefits for patients with purulent peritonitis...

  16. Gastric phytobezoars may be treated by nasogastric Coca-Cola lavage.

    Science.gov (United States)

    Ladas, Spiros D; Triantafyllou, Konstantinos; Tzathas, Charalabos; Tassios, Pericles; Rokkas, Theodore; Raptis, Sotirios A

    2002-07-01

    Large gastric phytobezoars may occur in patients with gastric dysmotility disorders. Treatment options include dissolution with enzymes, endoscopic fragmentation with removal or aspiration, and surgery. We report our experience with nasogastric cola lavage therapy. Over an 8-year period, five consecutive patients were referred to our unit for endoscopic treatment of large gastric phytobezoars. They included one patient with lobectomy for lung cancer and four patients with diabetic gastroparesis. An initial attempt of endoscopic fragmentation and removal was unsuccessful. Patients were treated with 3 l of Coca-Cola nasogastric lavage over 12 h. Nasogastric lavage was very well tolerated by the patients. Complete phytobezoar dissolution was achieved in one session in all cases. There were no procedure-related complications. The dissolution of large gastric phytobezoars with cola nasogastric lavage is a safe, rapid and effective method. Patients may be treated in the medical ward, avoiding therapeutic endoscopy or surgery.

  17. Neutrophil influx measured in nasal lavages of humans exposed to ozone

    Energy Technology Data Exchange (ETDEWEB)

    Graham, D.; Henderson, F.; House, D.

    1988-05-01

    Neutrophils (PMNs) obtained by nasal lavage were counted to determine if ozone, an oxidant air pollutant, induces an acute inflammatory response in the upper respiratory tract (URT) of humans. Background data were obtained by the nasal lavages from 200 nonexperimentally exposed subjects. Then, using a known inflammatory agent for the URT, rhinovirus-type 39, the induction, peak, and resolution of an acute inflammatory response was shown to be documented by the nasal lavage PMN counts. To determined if ozone induces this response, 41 subjects were exposed to either filtered air or 0.5 ppm ozone for 4 hr, on 2 consecutive days. Nasal lavages were taken pre-, immediately post each exposure, and 22 hr following the last exposure. Lavage PMN counts increased significantly (p = .005) in the ozone-exposed group, with 3.5-, 6.5-, and 3.9-fold increases over the air-exposed group at the post 1, pre 2, and post 2 time points, respectively. Ozone induces an inflammatory response in the URT of humans, and nasal lavage PMN counts are useful to assay the inflammatory properties of air pollutants.

  18. Improvements in lung lavage to increase its effectiveness in removing inhaled radionuclides

    Energy Technology Data Exchange (ETDEWEB)

    Muggenburg, B.A.; Guilmette, R.A.; Romero, L.M.; Mewhinney, J.A.

    1991-12-31

    Lung lavage has been shown to be an effective method to remove insoluble radionuclides deposited and retained in the lung, but the treatment has been limited to the effective removal of only about 50% of the retained material. Reported here is change in lavage technique that slightly increases the effectiveness and the addition of high-frequency chest wall oscillation. The latter increased the effectiveness of the lavage procedure but also caused significant physiological complications. These studies were conducted in adult male and female beagles. The aerosol in the first study was {sup 239}PuO{sub 2} heat-treated at 850{degrees}C, obtained as powder from a commercial V-blending process. The dogs briefly inhaled the aerosol per nasi. The tissue content at death and the amount of {sup 239}Pu excreted and in the recovered lung lavage fluid was determined by radiochemical methods{sup 5}. These values were used to reconstruct the initial pulmonary burden of {sup 239} and the amount of {sup 239}Pu removed by lavage. In the second study, with the HFCWO, the aerosol was {sup 85}Sr fused in aluminosilicate particles. The IPB of {sup 85}Sr was determined by whole-body counting. The excreta and recovered lung lavage fluids were also assayed for {sup 85}Sr activity.

  19. Improvements in lung lavage to increase its effectiveness in removing inhaled radionuclides

    Energy Technology Data Exchange (ETDEWEB)

    Muggenburg, B.A.; Guilmette, R.A.; Romero, L.M.; Mewhinney, J.A.

    1991-01-01

    Lung lavage has been shown to be an effective method to remove insoluble radionuclides deposited and retained in the lung, but the treatment has been limited to the effective removal of only about 50% of the retained material. Reported here is change in lavage technique that slightly increases the effectiveness and the addition of high-frequency chest wall oscillation. The latter increased the effectiveness of the lavage procedure but also caused significant physiological complications. These studies were conducted in adult male and female beagles. The aerosol in the first study was {sup 239}PuO{sub 2} heat-treated at 850{degrees}C, obtained as powder from a commercial V-blending process. The dogs briefly inhaled the aerosol per nasi. The tissue content at death and the amount of {sup 239}Pu excreted and in the recovered lung lavage fluid was determined by radiochemical methods{sup 5}. These values were used to reconstruct the initial pulmonary burden of {sup 239} and the amount of {sup 239}Pu removed by lavage. In the second study, with the HFCWO, the aerosol was {sup 85}Sr fused in aluminosilicate particles. The IPB of {sup 85}Sr was determined by whole-body counting. The excreta and recovered lung lavage fluids were also assayed for {sup 85}Sr activity.

  20. The effect of peritoneal lavage on the postoperative course after colonic anastomosis and perforation in the rat.

    Science.gov (United States)

    Arnesjö, B; Breland, U; Petersson, B G

    1975-01-01

    Peritoneal lavage was given during four days to rats subjected either to transection and re-anastomosis or perforation of the descending part of the colon or caecum. Control rats were treated in the smae way but did not receive peritoneal lavage. The rats which were treated with a colonic anastomosis and peritoneal lavage had significantly less abdominal adhesions, peritonitis and peritoneal fluid observed at autopsy 11 or 60 days after surgery. No rats developed anastomosis insufficiency and all survived. Peritoneal lavage in rats subjected to colonic or caecal perforation increased the survival time and reduced the mortality rate, the frequency of adhesions and the signs of peritonitis. An increased frequency of peritoneal adhesions was observed after extensive mobilization of the colon during operation when no peritoneal lavage had been given. The peritoneal lavage catheter per se did not cause adhesions.

  1. Hyperoxygenated solution for improved oxygen supply in patients undergoing lung lavage for pulmonary alveolar proteinosis

    Institute of Scientific and Technical Information of China (English)

    ZHOU Bin; ZHOU Hai-yan; XU Pei-hua; WANG Hong-mei; LIN Xian-ming; WANG Xuan-ding

    2009-01-01

    Background At present,the most effective treatment for pulmonary alveolar proteinosis(PAP)remains whole-lung lavage in spite of the usually accompanying severe hypoxemia,which is expected to be prevented by hyperoxygenated solution improving oxygen supply during lavage.In this study,the efficacy and safety of the effect of hyperoxygenated solution were evaluated.Methods Five patients underwent whole-lung lavage over a 28-month period.Each lung was lavaged with hyperoxygenated(HO)and normal saline solution(plain lactated Ringer's solution,NO)randomly and alternatively until the reclaimed fluid was clear.Random number was generated by computer before every cycle of lavage.If the number was odd,the patient was assigned to receive a lavage cycle with hyperoxygenated solution(HO group,n=109);if the number was even,normal saline solution was used(NO group,n=115).Data of saturation of peripheral oxygen(SPO2),mean arterial pressure(MAP),central venous pressure(CVP),heart rate(HR)and end-tidal carbon dioxide tension (PETCO2)were taken down at 0,30,60,90,120,150,180,210 and 240 seconds from the beginning of the instillation of solution,and frequency and volume of unilateral lung lavage were also recorded.Time interval between the left and the right lung lavage was 1 week.Results No patient was withdrawn from the study due to low SPO2 or leakage.Oxygen pressure was(730.21±7.43)mmHg in the hyperoxygenated solution against(175.73±5.92)mmHg in the normal saline solution(P<0.01).Compared with baseline,SPO2 increased significantly as the instillation of solution began(P<0.01),leveled for about 30 seconds(P>0.05),and then decreased significantly to the lowest at the time of drainage(compared with 120 seconds or peak,P<0.01).SPO2 was higher in HO group than in NO group(P<0.01).There were no significant differences in MAP,HR,CVP and PETCO2 between HO group and NO group(P>0.05)and also among different time points(P>0.05).Conclusion During the lung lavage for pulmonary

  2. Comparison of Irrigation Times Using Gravity and High-Pressure Lavage.

    Science.gov (United States)

    Muscatelli, Stefano; Howe, Andrea; O'Hara, Nathan N; O'Toole, Robert V; Sprague, Sheila A; Slobogean, Gerard P

    2017-01-11

    The benefits of high-pressure pulsatile lavage for open fracture irrigation have been controversial based on conflicting experimental animal research. Recently published data definitively demonstrated that irrigation pressure does not affect the incidence of reoperation for the treatment of open fractures. However, proponents of pulsatile lavage argue a faster irrigation time is an important benefit of the high-pressure treatment. The purpose of this study was to determine the difference in irrigation time between gravity and high-pressure lavage. The experimental setup was designed to mimic clinical practice and compared mean irrigation flow times for high-pressure pulsatile lavage and gravity flow with 2 commonly used tube diameters. Each irrigation setup was tested 5 times at 3 different irrigation bag heights. Analysis of variance and Student's t tests were used to compare the mean flow times of 3 irrigation methods at each height and among the 3 heights for each irrigation method. The mean irrigation flow time in the various experimental models ranged from 161 to 243 seconds. Gravity irrigation with wide tubing was significantly faster than pulsatile lavage or gravity with narrow tubing (P<.001). Increasing irrigation bag height had only a marginal effect on the overall flow times (<9% difference). The difference in mean flow time among the testing techniques was slightly longer than 1 minute, which is unlikely to have a material impact on procedural costs, operating times, and subsequent gains in patient safety. [Orthopedics. 201x; xx(x):xx-xx.].

  3. Cytopathologic diagnosis on joint lavage fluid for patients with temporomandibular joint disorders.

    Science.gov (United States)

    Mikami, Toshinari; Kumagai, Akiko; Aomura, Tomoyuki; Javed, Fawad; Sugiyama, Yoshiki; Mizuki, Harumi; Takeda, Yasunori

    2014-01-01

    Temporomandibular joint (TMJ) disorders (TMD) are usually diagnosed based on the patient's clinical findings and the results of image investigations; however, understanding of the inflammatory process in TMJ is difficult. In addition, many of the TMJ disease types share common principal symptoms. Therefore, TMJ diseases in the early stage can be misdiagnosed with TMD. It is hypothesized that cytopathologic examination of the joint lavage fluids is useful in interpreting the TMD-associated inflammatory process from a cellular aspect. The aim of this study was to assess the TMJ lavage fluid cytopathologically in TMD patients. Thirty-nine patients, clinically diagnosed as TMD, were included in the present study. Clinical symptoms of the patients were recorded. Forty-four samples of TMJ lavage fluid were collected and paraffin-embedded cell sections were made by cell block tissue array method. Cytologic conditions in upper articular cavity of TMJ were cytopathologically diagnosed and were compared with the clinical symptoms of each patient. Cell components were detected in 22 of the 44 analyzed joint lavage fluids. There was a correlation between cytopathologic findings and clinical symptoms. Variety of cytopathology and inflammatory conditions in patients with similar clinical symptoms were also found. The results suggested that cytopathologic examination of the joint lavage fluids from TMD patients is helpful for gaining an understanding of the inner local conditions of TMJ at the cellular level.

  4. Effect of pre-cardiac and adult stages of Dirofilaria immitis in pulmonary disease of cats: CBC, bronchial lavage cytology, serology, radiographs, CT images, bronchial reactivity, and histopathology.

    Science.gov (United States)

    Ray Dillon, A; Tillson, D M; Wooldridge, A; Cattley, R; Hathcock, J; Brawner, W R; Cole, R; Welles, B; Christopherson, P W; Lee-Fowler, T; Bordelon, S; Barney, S; Sermersheim, M; Garbarino, R; Wells, S Z; Diffie, E B; Schachner, E R

    2014-11-15

    A controlled, blind study was conducted to define the initial inflammatory response and lung damage associated with the death of precardiac stages of Dirofilaria immitis in cats as compared to adult heartworm infections and normal cats. Three groups of six cats each were used: UU: uninfected untreated controls; PreS I: infected with 100 D. immitis L3 by subcutaneous injection and treated topically with selamectin 32 and 2 days pre-infection and once monthly for 8 months); IU: infected with 100 D. immitis L3 and left untreated. Peripheral blood, serum, bronchial lavage, and thoracic radiographic images were collected from all cats on Days 0, 70, 110, 168, and 240. CT images were acquired on Days 0, 110, and 240. Cats were euthanized, and necropsies were conducted on Day 240 to determine the presence of heartworms. Bronchial rings were collected for in vitro reactivity. Lung, heart, brain, kidney, and liver tissues were collected for histopathology. Results were compared for changes within each group. Pearson and Spearman correlations were performed for association between histologic, radiographic, serologic, hematologic and bronchoalveolar lavage (BAL) results. Infected cats treated with selamectin did not develop radiographically evident changes throughout the study, were heartworm antibody negative, and were free of adult heartworms and worm fragments at necropsy. Histologic lung scores and CT analysis were not significantly different between PreS I cats and UU controls. Subtle alveolar myofibrosis was noted in isolated areas of several PreS I cats and an eosinophilic BAL cytology was noted on Days 75 and 120. Bronchial ring reactivity was blunted in IU cats but was normal in PreS I and UU cats. The IU cats became antibody positive, and five cats developed adult heartworms. All cats with heartworms were antigen positive at one time point; but one cat was antibody positive, antigen negative, with viable adult females at necropsy. The CT revealed early involvement

  5. Subjective food hypersensitivity: assessment of enterochromaffin cell markers in blood and gut lavage fluid

    Directory of Open Access Journals (Sweden)

    Gregersen K

    2011-08-01

    Full Text Available Kine Gregersen1,2, Jørgen Valeur1,3, Kristine Lillestøl1,3, Livar Frøyland2, Pedro Araujo2, Gülen Arslan Lied1,3, Arnold Berstad1,31Institute of Medicine, University of Bergen, 2National Institute of Nutrition and Seafood Research; 3Department of Medicine, Section for Gastroenterology, Haukeland University Hospital, Bergen, NorwayBackground: Food hypersensitivity is commonly suspected, but seldom verified. Patients with subjective food hypersensitivity suffer from both intestinal and extraintestinal health complaints. Abnormalities of the enterochromaffin cells may play a role in the pathogenesis. The aim of this study was to investigate enterochromaffin cell function in patients with subjective food hypersensitivity by measuring serum chromogranin A (CgA and 5-hydroxytryptamine (5-HT, serotonin in gut lavage fluid.Methods: Sixty-nine patients with subjective food hypersensitivity were examined. Twenty-three patients with inflammatory bowel disease and 35 healthy volunteers were included as comparison groups. CgA was measured in serum by enzyme-linked immunosorbent assay. Gut lavage fluid was obtained by administering 2 L of polyethylene glycol solution intraduodenally. The first clear fluid passed per rectum was collected and 5-HT was analyzed by liquid chromatography tandem mass spectrometry.Results: Serum levels of CgA were significantly lower in patients with subjective food hypersensitivity than in healthy controls (P = 0.04. No differences were found in 5-HT levels in gut lavage fluid between patients with subjective food hypersensitivity and the control groups. There was no correlation between serum CgA and gut lavage 5-HT.Conclusion: Decreased blood levels of CgA suggest neuroendocrine alterations in patients with subjective food hypersensitivity. However, 5-HT levels in gut lavage fluid were normal.Keywords: food hypersensitivity, chromogranin A, serotonin, gut lavage fluid, liquid chromatography

  6. Peritoneal taurolidine lavage in children with localised peritonitis due to appendicitis.

    Science.gov (United States)

    Schneider, Axel; Sack, Ulrich; Rothe, Karin; Bennek, Joachim

    2005-06-01

    Despite aggressive surgical treatment, rational antibiotic therapy, and modern intensive care, generalised peritonitis remains a major threat in the paediatric age group. Several adjuvant strategies such as peritoneal saline lavage and peritoneal drainage have been utilised. Taurolidine, derived from the amino acid taurine, has bactericidic, antiendotoxic, and antiinflammatory properties. It has been introduced previously for intraoperative peritoneal lavage in treating peritonitis in adults. The aim of our study was to evaluate the effect of peritoneal taurolidine lavage on the clinical course and serological inflammation markers in children with perforated appendicitis and localised peritonitis. A series of 27 children presenting with appendicitis between January 1999 and July 2001 were included in the study after parental informed consent. All patients underwent open appendectomy. Taurolidine peritoneal lavage was applied in 15 randomly selected children (eight girls and seven boys; mean age 10 years and 10 months). Twelve children received saline peritoneal lavage and served as the control group (six girls and six boys; mean age 9 years and 7 months). Blood was taken preoperatively and on postoperative days 1, 3, 7, and 14. Full blood cell count, C-reactive protein, endotoxin, interleukin-1, interleukin-6, soluble interleukin-2 receptor, tumour necrosis factor alpha, and procalcitonin were investigated to evaluate the serological course of inflammation. Both groups initially presented with severe inflammation as evidenced clinically and serologically. The clinical postoperative course was uneventful in 13/15 patients in the treatment group and 10/12 patients in the control group. The remaining patients presented complications: intraperitoneal abscess or early postoperative bowel obstruction. With regard to the serological inflammatory parameters, no significant differences were found between the two groups except for the soluble interleukin-2-receptor on the 7

  7. Gastric lavage in the diagnosis of pulmonary tuberculosis in children : a systematic review

    OpenAIRE

    Ethel Leonor Noia Maciel; Léia Damasceno de Aguiar Brotto; Carolina Maia Martins Sales; Eliana Zandonade; Clemax Couto Sant'Anna

    2010-01-01

    Objetivo: Analisar a padronização da coleta do lavado gástrico para diagnóstico de tuberculose em crianças. Métodos: Estudo de revisão sistemática referente aos anos de 1968 a 2008. O levantamento de artigos científicos foi feito nas bases de dados Lilacs, SciELO e Medline, utilizando-se a estratégia de busca ("gastric lavage and tuberculosis" ou "gastric washing and tuberculosis", com o limite "crianças com idade até 15 anos"; e "gastric lavage and tuberculosis and childhood" ou "gastric was...

  8. Physiological, Biochemical, and Biophysical Characterization of the Lung-Lavaged Spontaneously-Breathing Rabbit as a Model for Respiratory Distress Syndrome

    Science.gov (United States)

    Ricci, Francesca; Catozzi, Chiara; Murgia, Xabier; Rosa, Brenda; Amidani, Davide; Lorenzini, Luca; Bianco, Federico; Rivetti, Claudio; Catinella, Silvia; Villetti, Gino; Civelli, Maurizio; Pioselli, Barbara; Dani, Carlo; Salomone, Fabrizio

    2017-01-01

    Nasal continuous positive airway pressure (nCPAP) is a widely accepted technique of non-invasive respiratory support in spontaneously-breathing premature infants with respiratory distress syndrome (RDS). Surfactant administration techniques compatible with nCPAP ventilation strategy are actively investigated. Our aim is to set up and validate a respiratory distress animal model that can be managed on nCPAP suitable for surfactant administration techniques studies. Surfactant depletion was induced by bronchoalveolar lavages (BALs) on 18 adult rabbits. Full depletion was assessed by surfactant component analysis on the BALs samples. Animals were randomized into two groups: Control group (nCPAP only) and InSurE group, consisting of a bolus of surfactant (Poractant alfa, 200 mg/kg) followed by nCPAP. Arterial blood gases were monitored until animal sacrifice, 3 hours post treatment. Lung mechanics were evaluated just before and after BALs, at the time of treatment, and at the end of the procedure. Surfactant phospholipids and protein analysis as well as surface tension measurements on sequential BALs confirmed the efficacy of the surfactant depletion procedure. The InSurE group showed a significant improvement of blood oxygenation and lung mechanics. On the contrary, no signs of recovery were appreciated in animals treated with just nCPAP. The surfactant-depleted adult rabbit RDS model proved to be a valuable and efficient preclinical tool for mimicking the clinical scenario of preterm infants affected by mild/moderate RDS who spontaneously breathe and do not require mechanical ventilation. This population is of particular interest as potential target for the non-invasive administration of surfactant. PMID:28060859

  9. THE VALUE OF BRONCHOALVEOLAR LAVAGE TREATMENT FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASES%支气管肺泡灌洗治疗慢性阻塞性肺疾病的价值探讨

    Institute of Scientific and Technical Information of China (English)

    李家萱

    2003-01-01

    目的:探讨支气管肺泡灌洗治疗慢性阻塞性肺疾病(COPD)患者的应用价值.方法:A组使用氧氟沙星注射液及0.5%甲硝唑注射液灌洗,局部滴入丁胺卡那0.2,地塞米松5mg,B组使用生理盐水灌洗,局部滴入丁胺卡那0.2.疗程:每周2次,连续2周.观察两组患者治疗前后肺功能,血气分析,临床症状,生活质量等.结果:A组治疗后FEV1,PFE高于治疗前及B组,B组虽有改善但不显著(P>0.05),AB两组治疗前后血气分析对比差异具显著性(P<0.05).临床症状及生活质量改善A组明显于B组.结论:支气管肺泡灌洗+滴药可以改善COPD急性期肺功能及临床症状和生活质量,以使用抗生素灌洗加滴入糖皮质激素优于使用生理盐水灌洗,其操作简单易行、创伤少,只要严格把握适应证和禁忌证,就能确保操作安全.

  10. Distribution of endotracheally instilled surfactant protein SP-C in lung-lavaged rabbits.

    NARCIS (Netherlands)

    Bambang Oetomo, Sidarto; de Leij, Louis; Curstedt, T; ter Haar, J G; Schoots, Coenraad; Wildevuur, Charles; Okken, Albert

    1991-01-01

    In lung-lavaged surfactant-deficient rabbits (n = 6) requiring artificial ventilation, porcine surfactant was instilled endotracheally. This resulted in improvement of lung function so that the animals could be weaned off artificial ventilation. The animals were killed 4 1/2 h after surfactant admin

  11. [Treatment of a severe Clostridium difficile infection with colonic lavages. Report of one case].

    Science.gov (United States)

    Quezada, Felipe; Castillo, Richard; Villalón, Constanza; Zúñiga, José Miguel; Manterola, Carla; Molina, María Elena; Bellolio, Felipe; Urrejola, Gonzalo

    2015-05-01

    A loop ileostomy with intraoperative anterograde colonic lavage has been described as an alternative to colectomy in the management of cases of Clostridium difficile infection refractory to medical treatment. We report a 69 years old diabetic women admitted with a septic shock. An abdominal CAT scan showed a pan-colitis that seemed to be infectious. A polymerase chain reaction was positive for Clostridium Difficile. Due to the failure to improve after full medical treatment, a derivative loop ileostomy and intra-operatory colonic lavage were performed, leaving a Foley catheter in the proximal colon. In the postoperative period, anterograde colonic instillations of Vancomycin flushes through the catheter were performed every 6 hours. Forty eight hours after surgery, the patient improved. A colonoscopy prior to discharge showed resolution of the pseudomembranous colitis.

  12. [Iatrogenic extravasations of cytotoxic or hyperosmolar aqueous solutions. Value of surgical emergency by aspiration and lavage].

    Science.gov (United States)

    Lambert, F; Couturaud, B; Arnaud, E; Champeau, F; Revol, M; Servant, J M

    1997-08-01

    Iatrogenic extravasations are characterized by their unpredictable course, the possible repercussions of functional, cosmetic and psychological sequelae, and the absence of a therapeutic consensus. The authors present the protocol used in Hôpital Saint-Louis, based on a synthesis of current procedures, consisting of emergency conservative surgical aspiration and lavage, performed in a context of close collaboration with oncolosits, intensive care physicians and radiologists. From 1994 to March 1997, fifteen patients were operated following extravasation during seven chemotherapeutic protocols, three radiographic examinations with injection of contrast agents and five resuscitation procedures. This simple protocol, applied systematically, achieved cure without cutaneous or functional sequelae in all patients. Aspiration-lavage during the first twelve hours therefore constitutes the treatment of choice of iatrogenic extravasation with cytotoxic or hyperosmolar aqueous solutions.

  13. The real contamination of femoral head allografts washed with pulse lavage.

    Science.gov (United States)

    Salmela, P Mikael; Hirn, Martti Y J; Vuento, Risto E

    2002-06-01

    At the Tampere Bone Bank, all the discarded femoral heads from September 1997 to May 2000 were recultured. The grafts had been washed with pulse lavage at harvesting. 48 grafts had been discarded because of a positive culture and 85 with negative cultures because of positive or insufficient serological information. The femoral heads were split into halves, which were recultured as a whole in thioglycolate broth for 14 days. The contamination of previously culture positive and negative femoral heads did not differ. In only 2 cases did we find the same type of bacteria in the primary as in the new culture. Most of the primary contamination proved to be false positive. The real contamination seems to be very low, at least after pulse lavage washing of the femoral head.

  14. Sarcomatoid collecting duct carcinoma of kidney diagnosed with urine and renal pelvic lavage cytology.

    Science.gov (United States)

    Mimura, Akihiro; Sakuma, Takahiko; Furuta, Michiko; Tanigawa, Naoto; Takamizu, Ryuichi; Kawano, Kiyoshi

    2010-08-01

    A case of sarcomatoid collecting duct carcinoma (CDC) of kidney is presented, in which the diagnosis was made cytologically with voided urine and renal pelvis lavage. Cytology of hemorrhagic voided urine revealed highly atypical adenocarcinoma cells with reminiscent ductal structure, which suggested CDC as the most likely diagnosis. Computed tomography and magnetic resonance imaging demonstrated a left renal tumor, and selective lavage of left renal pelvis yielded spindle-shaped, highly atypical cells that indicated sarcomatoid carcinoma. The diagnosis of renal cancer with urine cytology is challenging because of small number of tumor cells in the urine, which are often associated with degeneration. As the urinary cytologic findings of sarcomatoid CDC have not been reported, the characteristic cytologic findings of sarcomatoid CDC are described in detail, and the differential diagnoses with diagnostic pitfalls were discussed.

  15. Allergen-induced increase of eosinophil cationic protein in nasal lavage fluid

    DEFF Research Database (Denmark)

    Bisgaard, H; Grønborg, H; Mygind, N;

    1990-01-01

    It was our aim to study the effect of nasal allergen provocation on the concentration of eosinophil cationic protein (ECP) in nasal lavage fluid, with and without glucocorticoid pretreatment. Twenty grass-pollen sensitive volunteers were provoked outside the pollen season on 2 consecutive days...... untreated, prechallenge noses was 400 micrograms/L. (3) The ECP level did not increase during the early phase response. (4) There was a late occurring increase in the ECP concentration (6 to 24 hours). (5) This increase was completely inhibited by budesonide pretreatment. (6) The glucocorticoid therapy also...... reduced the prechallenge ECP concentration. In conclusion, allergen provocation in the nose results in a late occurring increase of ECP in nasal lavage fluid, and one of the therapeutic effects of topical glucocorticoid therapy may be an inhibition of the allergen-induced increase of this cytotoxic...

  16. Effect of music on anxiety and pain during joint lavage for knee osteoarthritis.

    Science.gov (United States)

    Ottaviani, Sébastien; Bernard, Jean-Luc; Jean-Luc, Bernard; Bardin, Thomas; Thomas, Bardin; Richette, Pascal; Pascal, Richette

    2012-03-01

    Joint lavage for knee osteoarthritis is an invasive procedure that can be stressful and painful. We aimed to assess the impact of music therapy on perioperative anxiety, pain and tolerability of the procedure in patients undergoing joint lavage performed with two needles. We randomized all patients diagnosed with knee osteoarthritis and undergoing joint lavage in our department from November 2009 to October 2010 to an experimental group listening to recorded music or a control group receiving no music intervention. Perioperative anxiety and pain related to the procedure were self-reported on a visual analogic scale (0-100 mm visual analog scale [VAS]), and heart rate and blood pressure were measured during the procedure. Tolerability was assessed on a four-grade scale directly after the procedure. We included 62 patients (31 in each group). Mean age was 68.8 ± 12.6 years (72% females). As compared with the control group, the music group had lower levels of perioperative anxiety (40.3 ± 31.1 vs. 58.2 ± 26.3 mm; p = 0.046) and pain related to the procedure (26.6 ± 16.2 vs. 51.2 ± 23.7 mm; p = 0.0005). Moreover, heart rate was lower in the music group (69.5 ± 11.4 vs. 77.2 ± 13.2; p = 0.043) but not diastolic or systolic blood pressure. Tolerability was higher in the music group (p = 0.002). Music is a simple and effective tool to alleviate pain and anxiety in patients undergoing joint lavage for knee osteoarthritis.

  17. Peritoneal Lavage in the Diagnosis of Acute Surgical Abdomen Following Thermal Injury.

    Science.gov (United States)

    1995-01-01

    disease, others6𔄂-15 have confirmed his Sepsis syndrome 13 findings. Hoffman16 reviewed the literature on the use of Abdominal distension 11 Ileus 7 DPL...developed sepsis, ileus , and abdominal distention 98 Fourteen of the 17 patients died, a mortality rate of 82%. days following injury. Lavage fluid...the greater omentum. The difficulty in diag- whelming pulmonary sepsis or multisystem organ failure, nosing biliary disease with DPL has been

  18. Radiotherapy Improves Survival in Unresected Stage I-III Bronchoalveolar Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Urban, Damien [Department of Oncology, Sheba Medical Center, Ramat Gan (Israel); Mishra, Mark [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Onn, Amir [Department of Oncology, Sheba Medical Center, Ramat Gan (Israel); Dicker, Adam P. [Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Symon, Zvi; Pfeffer, M. Raphael [Department of Oncology, Sheba Medical Center, Ramat Gan (Israel); Sackler School of Medicine, Tel Aviv University, Tel Aviv (Israel); Lawrence, Yaacov Richard, E-mail: yaacovla@gmail.com [Department of Oncology, Sheba Medical Center, Ramat Gan (Israel); Department of Radiation Oncology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Sackler School of Medicine, Tel Aviv University, Tel Aviv (Israel)

    2012-11-01

    Purpose: To test the hypothesis that radiotherapy (RT) improves the outcome of patients with unresected, nonmetastatic bronchoalveolar carcinoma (BAC) by performing a population-based analysis within the Surveillance, Epidemiology, and End Results (SEER) registry. Methods and Materials: Inclusion criteria were as follows: patients diagnosed with BAC, Stage I-III, between 2001 and 2007. Exclusion criteria included unknown stage, unknown primary treatment modality, Stage IV disease, and those diagnosed at autopsy. Demographic data, treatment details, and overall survival were retrieved from the SEER database. Survival was analyzed using the Kaplan-Meier method and log-rank test. Results: A total of 6933 patients with Stage I-III BAC were included in the analysis. The median age at diagnosis was 70 years (range, 10-101 years). The majority of patients were diagnosed with Stage I (74.4%); 968 patients (14%) did not undergo surgical resection. Unresected patients were more likely to be older (p < 0.0001), male (p = 0.001), black (p < 0.0001), and Stage III (p < 0.0001). Within the cohort of unresected patients, 300 (31%) were treated with RT. The estimated 2-year overall survival for patients with unresected, nonmetastatic BAC was 58%, 44%, and 27% in Stage I, II, and III, respectively. Factors associated with improved survival included female sex, earlier stage at diagnosis, and use of RT. Median survival in those not receiving RT vs. receiving RT was as follows: Stage I, 28 months vs. 33 months (n = 364, p = 0.06); Stage II, 18 months vs. not reached (n = 31, nonsignificant); Stage III, 10 months vs. 17 months (n = 517, p < 0.003). Conclusions: The use of RT is associated with improved prognosis in unresected Stage I-III BAC. Less than a third of patients who could have potentially benefited from RT received it, suggesting that the medical specialists involved in the care of these patients underappreciate the importance of RT.

  19. Successful resuscitation of a patient who developed cardiac arrest from pulsed saline bacitracin lavage during thoracic laminectomy and fusion.

    Science.gov (United States)

    Greenberg, Steven B; Deshur, Mark; Khavkin, Yevgeniy; Karaikovic, Elden; Vender, Jeffery

    2008-06-01

    A patient with a history of T12 burst fracture caused by a fall, and with progressive weakness and sensory loss in the left leg, survived a cardiac arrest after pulsed saline bacitracin lavage irrigation during a posterior spinal fusion.

  20. The role of ultrasound guided percutaneous needle aspiration and lavage (barbotage in the treatment of calcific tendinitis

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    Gamal Niazi

    2015-03-01

    Conclusion: Ultrasound guided aspiration and lavage (barbotage is a highly effective, less aggressive method of treatment in cases of calcific tendinosis, especially for cases with severe pain that does not respond to other conservative methods.

  1. A comparative study between use of arthroscopic lavage and arthrocentesis of temporomandibular joint based on computational fluid dynamics analysis.

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    Yue Xu

    Full Text Available Arthroscopic lavage and arthrocentesis, performed with different inner-diameter lavage needles, are the current minimally invasive techniques used in temporomandibular joint disc displacement (TMJ-DD for pain reduction and functional improvement. In the current study, we aimed to explore the biomechanical influence and explain the diverse clinical outcomes of these two approaches with computational fluid dynamics. Data was retrospectively analyzed from 78 cases that had undergone arthroscopic lavage or arthrocentesis for TMJ-DD from 2002 to 2010. Four types of finite volume models, featuring irrigation needles of different diameters, were constructed based on computed tomography images. We investigated the flow pattern and pressure distribution of lavage fluid secondary to caliber-varying needles. Our results demonstrated that the size of outflow portal was the critical factor in determining irrigated flow rate, with a larger inflow portal and a smaller outflow portal leading to higher intra-articular pressure. This was consistent with clinical data suggesting that increasing the mouth opening and maximal contra-lateral movement led to better outcomes following arthroscopic lavage. The findings of this study could be useful for choosing the lavage apparatus according to the main complaint of pain, or limited mouth opening, and examination of joint movements.

  2. CD161 Expression Defines a Th1/Th17 Polyfunctional Subset of Resident Memory T Lymphocytes in Bronchoalveolar Cells.

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    Yolanda Gonzalez

    Full Text Available Alveolar resident memory T cells (T(RM comprise a currently uncharacterized mixture of cell subpopulations. The CD3(+CD161(+ T cell subpopulation resides in the liver, intestine and skin, but it has the capacity for tissue migration; however, the presence of resident CD3(+CD161(+ T cells in the bronchoalveolar space under normal conditions has not been reported. Bronchoalveolar cells (BACs from healthy volunteers were evaluated and found that 8.6% (range 2.5%-21% of these cells were CD3(+ T lymphocytes. Within the CD3(+ population, 4.6% of the cells (2.1-11.3 expressed CD161 on the cell surface, and 74.2% of the CD161(+CD3(+ T cells expressed CD45RO. The number of CD3(+CD161(+ T cells was significantly lower in the bronchoalveolar space than in the blood (4.6% of BACs vs 8.4% of peripheral blood mononuclear cells (PBMCs; P<0.05. We also found that 2.17% of CD4(+ T lymphocytes and 1.52% of CD8(+ T lymphocytes expressed CD161. Twenty-two percent of the alveolar CD3(+CD161(+ T lymphocytes produced cytokines upon stimulation by PMA plus ionomycin, and significantly more interferon gamma (IFN-γ was produced compared with other cytokines (P = 0.05. Most alveolar CD3(+CD161(+ T cells produced interleukin-17 (IL-17 and IFN-γ simultaneously, and the percentage of these cells was significantly higher than the percentage of CD3(+CD161- T cells. Moreover, the percentage of alveolar CD3(+CD161(+ T lymphocytes that produced IFN-γ/IL-17 was significantly higher than those in the peripheral blood (p<0.05. In conclusion, Th1/Th17-CD3(+CD161(+ TRM could contribute to compartment-specific immune responses in the lung.

  3. Cardiovascular changes after PMMA vertebroplasty in sheep: the effect of bone marrow removal using pulsed jet-lavage.

    Science.gov (United States)

    Benneker, Lorin M; Krebs, Jörg; Boner, Vanessa; Boger, Andreas; Hoerstrup, Simon; Heini, Paul F; Gisep, Armando

    2010-11-01

    Clinically, the displacement of intravertebral fat into the circulation during vertebroplasty is reported to lead to problems in elderly patients and can represent a serious complication, especially when multiple levels have to be treated. An in vitro study has shown the feasibility of removing intravertebral fat by pulsed jet-lavage prior to vertebroplasty, potentially reducing the embolization of bone marrow fat from the vertebral bodies and alleviating the cardiovascular changes elicited by pulmonary fat embolism. In this in vivo study, percutaneous vertebroplasty using polymethylmethacrylate (PMMA) was performed in three lumbar vertebrae of 11 sheep. In six sheep (lavage group), pulsed jet-lavage was performed prior to injection of PMMA compared to the control group of five sheep receiving only PMMA vertebroplasty. Invasive recording of blood pressures was performed continuously until 60 min after the last injection. Cardiac output and arterial blood gas parameters were measured at selected time points. Post mortem, the injected cement volume was measured using CT and lung biopsies were processed for assessment of intravascular fat. Pulsed jet-lavage was feasible in the in vivo setting. In the control group, the injection of PMMA resulted in pulmonary fat embolism and a sudden and significant increase in mean pulmonary arterial pressure. Pulsed jet-lavage prevented any cardiovascular changes and significantly reduced the severity of bone marrow fat embolization. Even though significantly more cement had been injected into the lavaged vertebral bodies, significantly fewer intravascular fat emboli were identified in the lung tissue. Pulsed jet-lavage prevented the cardiovascular complications after PMMA vertebroplasty in sheep and alleviated the severity of pulmonary fat embolism.

  4. Treatment of acute diverticulitis laparoscopic lavage vs. resection (DILALA: study protocol for a randomised controlled trial

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    Rosenberg Jacob

    2011-08-01

    Full Text Available Abstract Background Perforated diverticulitis is a condition associated with substantial morbidity. Recently published reports suggest that laparoscopic lavage has fewer complications and shorter hospital stay. So far no randomised study has published any results. Methods DILALA is a Scandinavian, randomised trial, comparing laparoscopic lavage (LL to the traditional Hartmann's Procedure (HP. Primary endpoint is the number of re-operations within 12 months. Secondary endpoints consist of mortality, quality of life (QoL, re-admission, health economy assessment and permanent stoma. Patients are included when surgery is required. A laparoscopy is performed and if Hinchey grade III is diagnosed the patient is included and randomised 1:1, to either LL or HP. Patients undergoing LL receive > 3L of saline intraperitoneally, placement of pelvic drain and continued antibiotics. Follow-up is scheduled 6-12 weeks, 6 months and 12 months. A QoL-form is filled out on discharge, 6- and 12 months. Inclusion is set to 80 patients (40+40. Discussion HP is associated with a high rate of complication. Not only does the primary operation entail complications, but also subsequent surgery is associated with a high morbidity. Thus the combined risk of treatment for the patient is high. The aim of the DILALA trial is to evaluate if laparoscopic lavage is a safe, minimally invasive method for patients with perforated diverticulitis Hinchey grade III, resulting in fewer re-operations, decreased morbidity, mortality, costs and increased quality of life. Trial registration British registry (ISRCTN for clinical trials ISRCTN82208287http://www.controlled-trials.com/ISRCTN82208287

  5. INTRAARTICULAR INJECTION OF HYALURONIC ACID AFTER ARTHROSCOPIC LAVAGE OF THE KNEE: LONG-TERM RESULTS

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    Lidia Vladimirovna Luchikhina

    2013-01-01

    Full Text Available Objective: to evaluate the efficiency of arthroscopic lavage in combination with subsequent injection of hyaluronic acid into the joint cavity at shortand long-term follow-ups. Subjects and methods. Eighty-two patients with knee osteoarthrosis (OA were examined in accordance with the American College of Rheumatology criteria. Group 1 consisted of 40 patients only after arthroscopic lavage; Group 2 comprised 42 patients who were administered hyaluronic acid after arthroscopic lavage. Clinical evaluation encompassed pain while walking, resting, and moving (by a visual analogue scale, limited ability in covering 100 m (by a 5-point scale, general clinical evaluation (by a 5-point ordinal scale, the presence or absence of pain after 100-m walking, as well as resting pain (its presence or absence. Results. The treatment effect evaluated using different indicators was comparably positive in both groups within 3 months. Following 3 months of therapy, its effect remained stable and even better in Group 2. The latter showed a particularly noticeable superiority a year later. Thus, there were excellent and good results in 88 and 47.5% in Groups 2 and 1, respectively. The clinical symptoms of the disease were absent in 58% in Group 2 and in only 15% in Group 1. Moreover, Group 1 showed worsening and 20% of the patients had no effect. This trend was also seen while evaluating the therapeutic effectiveness in different periods. Thus, after therapy, no substantial difference was found in both groups, but 3 months later this difference was as many as 0.8 scores and a year later Group 2 had many points in its favor (1.2 scores. Conclusion. Arthroscopic lavage followed by the administration of hyaluronic acid makes it possible to prevent the negative effect of a washing liquid on the metabolism and structure of the articular cartilage and to achieve a long-term effect against the major clinical symptoms (joint pain and function affecting the quality of life. The

  6. Surgical uterine drainage and lavage as treatment for canine pyometra : clinical communication

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    K.G.M. De Cramer

    2010-05-01

    Full Text Available Pyometra is a common post-oestral syndrome in bitches. Classical treatment consists of either ovariohystorectomy or medical intervention. Surgical uterine drainage and lavage via direct trans-cervical catheterisation using a 5% povidone-iodine in saline solution was performed successfully in 8 bitches with pyometra. All bitches conceived and whelped without complications subsequent to this treatment. It is concluded that this method offers an effective alternative treatment for canine pyometra with shorter recovery times as well as good clinical recovery and pregnancy rates in bitches destined for further breeding.

  7. [Therapy concepts for diffuse peritonitis: When laparoscopic lavage and when open abdomen?].

    Science.gov (United States)

    Güsgen, C; Schwab, R; Willms, A

    2016-01-01

    Secondary diffuse peritonitis still has a high morbidity and mortality even now; therefore, the various strategies and options for the different surgical therapies are undergoing an evidence-based review. Laparoscopic lavage without resection of the focus of sepsis for example is a profoundly different approach in the treatment of diffuse peritonitis from the damage control-based strategy of surgery with initial laparostomy and deferred anastomosis. The evidential data for minimally invasive therapy are comparatively well-reviewed for appendicitis, cholecystitis and ulcerated perforation of the stomach and duodenum. In contrast, the evidence for laparoscopy and minimally invasive surgery with lavage and deferred anastomosis or damage control in secondary peritonitis has improved but is still low and cannot yet be clearly recommended. This article presents an overview of the currently available therapeutic methods for diffuse peritonitis and a critical consideration of the evidence-based data. The key recommendation is that the decision to use a surgical procedure based on the currently available data depends more on the severity of the abdominal sepsis, the duration, the age of the patient and comorbidities than on the individual technique.

  8. A simple technique to restore needle patency during percutaneous lavage and aspiration of calcific rotator cuff tendinopathy.

    Science.gov (United States)

    Jelsing, Elena J; Maida, Eugene; Smith, Jay

    2013-03-01

    Calcific rotator cuff tendinopathy caused by symptomatic calcium hydroxyapatite crystal deposition is a well-established cause of shoulder pain. In refractory or acutely symptomatic cases, sonographically guided percutaneous lavage and aspiration can significantly reduce pain in approximately 60%-92% of cases. Although the complication rate of sonographically guided percutaneous lavage and aspiration is apparently low, needle clogging attributable to impacted calcific debris has been described by several authors and in our experience can occur in daily practice. Traditionally, an inability to relieve the obstruction via needle repositioning or increased syringe plunger pressure has required needle removal and replacement. In this article, we outline a simple technique that can be used to restore patency of the obstructed lavage needle without necessitating needle removal and replacement.

  9. ICU management of patients with suspected positive findings of diagnostic peritoneal lavage following blunt abdominal trauma

    Institute of Scientific and Technical Information of China (English)

    缑东元; 金燕; 陈丽英; 魏琪

    2005-01-01

    Objective: To explore the management for blunt abdominal trauma victims with probable positive diagnostic peritoneal lavage (DPL) findings. Methods: Data of 76 patients with probable positive DPL findings accepted to ICU in previous 10 years were reviewed. After admission, the patients were evaluated in a settled time according to the protocols of Advanced Trauma Life Support (ATLS). Vital signs were continuously monitored and DPL, ultrasound and/or CT scan were repeated when necessary. Results: Eighteen (24%) of 76 patients presented positive DPL findings after repeated DPL. Surgical findings confirmed 7 cases of spleen rupture, 3 hepatorrhexis (infra-Glisson capsule), 4 intestinal perforation, 2 gastric perforation, 1 colon perforation and 1 injured mesentery.

  10. Pulsatile lavage irrigator tip, a rare radiolucent retained foreign body in the pelvis: a case report

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    Archdeacon Michael T

    2011-05-01

    Full Text Available Abstract Retained foreign bodies after surgery have the potential to cause serious medical complications for patients and bring fourth serious medico-legal consequences for surgeons and hospitals. Standard operating room protocols have been adopted to reduce the occurrence of the most common retained foreign bodies. Despite these precautions, radiolucent objects and uncounted components/pieces of instruments are at risk to be retained in the surgical wound. We report the unusual case of a retained plastic pulsatile lavage irrigator tip in the surgical wound during acetabulum fracture fixation, which was subsequently identified on routine postoperative computed tomography. Revision surgery was required in order to remove the retained object, and the patient had no further complications.

  11. Anaesthesia for serial whole-lung lavage in a patient with severe pulmonary alveolar proteinosis: a case report

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    Webb Stephen T

    2008-11-01

    Full Text Available Abstract Introduction Pulmonary alveolar proteinosis is a rare condition that requires treatment by whole-lung lavage. We report a case of severe pulmonary alveolar proteinosis and discuss a safe and effective strategy for the anaesthetic management of patients undergoing this complex procedure. Case presentation A 34-year-old Caucasian man was diagnosed with severe pulmonary alveolar proteinosis. He developed severe respiratory failure and subsequently underwent serial whole-lung lavage. Our anaesthetic technique included the use of pre-oxygenation, complete lung separation with a left-sided double-lumen endotracheal tube, one-lung ventilation with positive end-expiratory pressure, appropriate ventilatory monitoring, cautious use of positional manoeuvres and single-lumen endotracheal tube exchange for short-term postoperative ventilation. Conclusion Patients with pulmonary alveolar proteinosis may present with severe respiratory failure and require urgent whole-lung lavage. We have described a safe and effective strategy for anaesthesia for whole-lung lavage. We recommend our anaesthetic technique for patients undergoing this complex and uncommon procedure.

  12. Acute toxicity of polyethylene glycol p-isooctylphenol ether in Syrian hamsters exposed by inhalation or bronchopulmonary lavage

    Energy Technology Data Exchange (ETDEWEB)

    Damon, E.G. (Inhalation Toxicology Research Inst., Albuquerque, NM); Halliwell, W.H.; Henderson, T.R.; Mokler, B.V.; Jones, R.K.

    1982-01-01

    Dose-response studies were conducted with Syrian hamsters exposed to polyethylene glycol p-isooctylphenyl ether (Triton X-100) via inhalation or bronchopulmonary lavage. Syrian hamsters were exposed to an aerosol of Triton X-100 with a mass median aerodynamic diameter of 1.5 ..mu..m and a concentration of 3.0 mg/liter. Estimated initial lung burdens of Triton X-100 ranged from 800 to 3100 ..mu..g. Hamsters were lavaged with concentrations of Triton X-100 ranging from 0.01 to 0.10% in isotonic saline resulting in initial lung burdens of Triton X-100 that ranged from 300 to 3200 ..mu..g. The LD50/7 values were 1700 ..mu..g (1300 to 2100 ..mu..g, 95% confidence limits) for the inhalation study and 2100 (1900 to 2700) ..mu..g for the lavage study. The difference between the LD50/7 values for the two methods of exposure was not significant. However, histopathological examination revealed differences in the nature and distribution of pathologic changes observed in animals exposed by the two routes of administration. Animals exposed by inhalation died as a result of ulcerative laryngitis and laryngeal edema with only minimal pulmonary pathologic alterations. Animals exposed by lavage, where the larynx was not exposed to Triton X-100, died from pulmonary edema and acute exudative pneumonia. These results demonstrate the need for careful selection of exposure methods to meet the specific objectives of a toxicology study.

  13. Innovation in surfactant therapy I: surfactant lavage and surfactant administration by fluid bolus using minimally invasive techniques.

    Science.gov (United States)

    Dargaville, Peter A

    2012-01-01

    Innovation in the field of exogenous surfactant therapy continues more than two decades after the drug became commercially available. One such innovation, lung lavage using dilute surfactant, has been investigated in both laboratory and clinical settings as a treatment for meconium aspiration syndrome (MAS). Studies in animal models of MAS have affirmed that dilute surfactant lavage can remove meconium from the lung, with resultant improvement in lung function. In human infants both non-randomised studies and two randomised controlled trials have demonstrated a potential benefit of dilute surfactant lavage over standard care. The largest clinical trial, performed by our research group in infants with severe MAS, found that lung lavage using two 15-ml/kg aliquots of dilute surfactant did not reduce the duration of respiratory support, but did appear to reduce the composite outcome of death or need for extracorporeal membrane oxygenation. A further trial of lavage therapy is planned to more precisely define the effect on survival. Innovative approaches to surfactant therapy have also extended to the preterm infant, for whom the more widespread use of continuous positive airway pressure (CPAP) has meant delaying or avoiding administration of surfactant. In an effort to circumvent this problem, less invasive techniques of bolus surfactant therapy have been trialled, including instillation directly into the pharynx, via laryngeal mask and via brief tracheal catheterisation. In a recent clinical trial, instillation of surfactant into the trachea using a flexible feeding tube was found to reduce the need for subsequent intubation. We have developed an alternative method of brief tracheal catheterisation in which surfactant is delivered via a semi-rigid vascular catheter inserted through the vocal cords under direct vision. In studies to date, this technique has been relatively easy to perform, and resulted in rapid improvement in lung function and reduced need for

  14. Nasal lavage natural killer cell function is suppressed in smokers after live attenuated influenza virus

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    Zhou Haibo

    2011-08-01

    Full Text Available Abstract Background Modified function of immune cells in nasal secretions may play a role in the enhanced susceptibility to respiratory viruses that is seen in smokers. Innate immune cells in nasal secretions have largely been characterized by cellular differentials using morphologic criteria alone, which have successfully identified neutrophils as a significant cell population within nasal lavage fluid (NLF cells. However, flow cytometry may be a superior method to fully characterize NLF immune cells. We therefore characterized immune cells in NLF by flow cytometry, determined the effects of live attenuated influenza virus (LAIV on NLF and peripheral blood immune cells, and compared responses in samples obtained from smokers and nonsmokers. Methods In a prospective observational study, we characterized immune cells in NLF of nonsmokers at baseline using flow cytometry and immunohistochemistry. Nonsmokers and smokers were inoculated with LAIV on day 0 and serial nasal lavages were collected on days 1-4 and day 9 post-LAIV. LAIV-induced changes of NLF cells were characterized using flow cytometry. Cell-free NLF was analyzed for immune mediators by bioassay. Peripheral blood natural killer (NK cells from nonsmokers and smokers at baseline were stimulated in vitro with LAIV followed by flow cytometric and mediator analyses. Results CD45(+CD56(-CD16(+ neutrophils and CD45(+CD56(+ NK cells comprised median 4.62% (range 0.33-14.52 and 23.27% (18.29-33.97, respectively, of non-squamous NLF cells in nonsmokers at baseline. LAIV did not induce changes in total NK cell or neutrophil percentages in either nonsmokers or smokers. Following LAIV inoculation, CD16(+ NK cell percentages and granzyme B levels increased in nonsmokers, and these effects were suppressed in smokers. LAIV inoculation enhanced expression of activating receptor NKG2D and chemokine receptor CXCR3 on peripheral blood NK cells from both nonsmokers and smokers in vitro but did not induce

  15. Peritoneal lavage cytology and carcinoembryonic antigen determination in predicting peritoneal metastasis and prognosis of gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Ji-Kun Li; Miao Zheng; Chuan-Wen Miao; Jian-Hai Zhang; Guang-Han Ding; Wen-Shen Wu

    2005-01-01

    AIM: To evaluate the role of peritoneal lavage cytology (PLC) and carcinoembryonic antigen (CEA) determination of peritoneal washes (pCEA) in predicting the peritoneal metastasis and prognosis after curative resection of gastric cancer.METHODS: PLC and radioimmunoassay of CEA were performed in peritoneal washes from 64 patients with gastric cancer and 8 patients with benign diseases.RESULTS: The positive rate of pCEA (40.6%) was significantly higher than that of PLC (23.4%) (P<0.05).The positive rates of PLC and pCEA correlated with the depth of tumor invasion and lymph node metastasis (P<0.05). pCEA was found to have a higher sensitivity and a lower false-positive rate in predicting peritoneal metastasis after curative resection of gastric cancer as compared to PLC. The 1-, 3-, and 5-year survival rates of patients with positive cytologic findings or positive pCEA results were significantly lower than those of patients with negative cytologic findings or negative pCEA results (P<0.05). Multivariate analysis indicated that pCEA was an independent prognostic factor for the survival of patients with gastric cancer.CONCLUSION: Intraoperative pCEA is a more sensitive and reliable predictor of peritoneal metastasis as well as prognosis in patients with gastric cancer as compared to PLC method.

  16. Alkaline phosphatase levels in diagnostic peritoneal lavage fluid as a predictor of hollow visceral injury.

    Science.gov (United States)

    Jaffin, J H; Ochsner, M G; Cole, F J; Rozycki, G S; Kass, M; Champion, H R

    1993-06-01

    Isolated injuries to hollow viscera may result in equivocal diagnostic peritoneal lavage (DPL) findings. Small bowel injuries cause alkaline phosphatase (AP) levels to increase in DPL effluent. The goal of this study was to better define the role of AP levels in the evaluation of the injured abdomen. We prospectively measured AP levels in 672 patients undergoing DPL. These were retrospectively compared with the clinical findings. All 12 patients with small bowel injuries and three of four with large bowel injuries had an AP level > 10 IU/L. There was one patient with an AP level > 10 IU/L without clinically significant intra-abdominal injury. An AP level > 10 IU/L in the DPL effluent predicted injury requiring laparotomy with a specificity of 99.8% and a sensitivity of 94.7%. We recommend using AP levels only in the management of patients with equivocal findings on DPL who would otherwise not undergo laparotomy. This selective use of AP levels will improve the probability of early diagnosis of bowel injury without increasing the cost of care.

  17. Fungi, β-Glucan, and Bacteria in Nasal Lavage of Greenhouse Workers and Their Relation to Occupational Exposure

    OpenAIRE

    2013-01-01

    The nose and mouth are the first regions of the respiratory tract in contact with airborne microorganisms. Occupational exposures to airborne microorganisms are associated with inflammation and different symptoms of the airways. The purpose of this study is to investigate the relation between occupational exposure to fungi, β-glucan, and bacteria and contents of fungi, β-glucan, and bacteria in nasal lavage (NAL) of greenhouse workers. We also studied whether contents of microorganisms in NAL...

  18. Lobar flexible fiberoptic lung lavage: therapeutic benefit in severe respiratory failure in pulmonary alveolar proteinosis and influenza A H1N1 pneumonia

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    Antonello Nicolini

    2011-07-01

    Full Text Available Lobar fiberoptic lung lavage is a well-known procedure used in primary pulmonary alveolar proteinosis (PAP; the use of this procedure has increased in the recent years. This procedure has also been used in other pulmonary diseases such as desquamative interstitial pneumonia with good results. We describe a case of extremely severe respiratory failure due to concurrence of PAP and Influenza A H1N1 virus pneumonia which resolved with the help of this procedure. The patient, a 41- year-old woman, needed less mechanical ventilation after undergoing lobar fiberoptic bronchoscopic lavage. Moreover, a rapid and progressive improvement in the computed tomography of the lungs was observed. Flexibile fiberoptic bronchoscopic lobar lavage is a simple, safe procedure used not only in milder disease, but also in particular severe cases in which the physiological derangement of whole lung lavage would not be tolerated by patient or when extra-corporeal membrane oxygenation is not available.

  19. Expression of survivin mRNA in peritoneal lavage fluid from patients with gastric carcinoma

    Institute of Scientific and Technical Information of China (English)

    王振宁; 徐惠绵; 姜莉; 周欣; 鲁翀; 张学

    2004-01-01

    Background Peritoneal dissemination is the most common pattern of metastasis in advanced gastric carcinoma with serosal invasion. In the present study, we reported the clinical relevance of a new diagnostic method involving RT-PCR, using survivin as the target gene, for the detection of free cancer cells in peritoneal washes.Methods Intraoperative peritoneal washes were obtained from 48 patients who underwent surgery for gastric cancer. RT-PCR analysis with primers specific for survivin and conventional cytological examinations were both performed.Results Survivin mRNA was not detected in any peritoneal wash samples from patients with benign disease, but was detected in 28 of 48 samples taken from patients with gastric cancer and in all metastastic nodules. Survivin expression in the peritoneal cavity significantly correlated with depth of cancer invasion, lymph node metastasis, and TNM stage. There were 92% of clinically evident peritoneal metastasis cases showed detectable survivin expression. The combination of survivin RT-PCR and cytological examination yielded positive results in 66.7% (32/48) of patients with gastric cancer, much higher than the results produced by cytological method alone. Conclusions Survivin mRNA detected in peritoneal lavage fluid might indicate the presence of free cancer cells in the peritoneal cavity. The high sensitivity of the RT-PCR-based survivin assay suggests that survivin serves as a molecular marker for detecting peritoneal micrometastasis. Its ubiquitous expression in peritoneal cancer cells and metastatic nodules also suggests a promising future therapeutic strategy based on survivin inhibition for cases of gastric cancer involving peritoneal metastasis.

  20. Airborne Fungi in Chronic Rhinosinusitis Patients Maxillary Sinus Lavage at Dr. Saiful Anwar Hospital Malang

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    Iriana Maharani

    2016-05-01

    Full Text Available Background: Chronic rhinosinusitis has a significant impact on the quality of life and health of adult population. Role of airborne fungi remains a controversy and have become the source of discussion for decades. Objective to know the prevalence of airborne fungi in the chronic rhinosinusitis with or without polyps patients and to know the possible effect of airborne fungi on chronic rhinosinusitis inflammation. Methods: This is a cross sectional research in the Saiful Anwar Public Hospital Malang, there were 29 patients involved. We examine fungi culture, H&E staining and DNA fungi by using PCR from sinus lavage sample. From the blood serum we examine allergen specific IgE, IgG3, IL-13 and IL-5. Results: Fungi culture there were 31,03 % of sample growth but only matches the PCR result in 3 samples (10,34 %. From PCR examinations we found all sample were positive with 2-5 species fungi, Alternaria alternata was found positive in 24,13% samples. There was an increment of IgE allergen specific and IL-5, a decrement of IL-13 and IgG3 in all of our samples regardless presence of nasal polyps and species of fungi found in PCR. Conclusions: PCR is a more reliable method compare to fungal culture. The presence of fungi in all of our samples could indicate fungi contribution to the disease pathophysiology. The increased level of Il-5 was not followed by IL-13; it may happen through PRR pathway. 

  1. Assessment of smoking status based on cotinine levels in nasal lavage fluid

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    Cowart Beverly J

    2009-07-01

    Full Text Available Abstract Cotinine is a principal metabolite of nicotine with a substantially longer half-life, and cotinine levels in saliva, urine or serum are widely used to validate self-reported smoking status. The nasal cavity and olfactory system are directly exposed to tobacco smoke in smokers and in non-smokers who live with or work around smokers. However, despite the potential for a direct impact of tobacco smoke on the nasal epithelium and olfactory neurons, no prior studies have assessed cotinine levels in nasal mucus. We sought to determine whether cotinine levels in nasal lavage fluid (NLF would provide a reasonable estimate of smoke exposure. We assayed cotinine using a competitive immunoassay in NLF from 23 smokers, 10 non-smokers exposed to tobacco smoke (ETS and 60 non-smokers who did not report smoke exposure. NLF cotinine levels were significantly higher in smokers than in non-smokers, regardless of their exposure to ambient tobacco smoke. Cotinine levels in this small group of exposed non-smokers were not significantly different than those of non-exposed non-smokers. A cutoff of 1 ng/ml provided a sensitivity of 91% and a specificity of 99% for smoking status in this sample. Data were consistent with self-reported smoking status, and a cutoff of 1.0 ng/ml NLF cotinine may be used to classify smoking status. While saliva is the most easily obtained body fluid, NLF can be used to provide an objective and precise indication of smoking status and more directly reflects smoke exposure in the nasal and olfactory mucosa.

  2. Protein corona formation in bronchoalveolar fluid enhances diesel exhaust nanoparticle uptake and pro-inflammatory responses in macrophages.

    Science.gov (United States)

    Shaw, Catherine A; Mortimer, Gysell M; Deng, Zhou J; Carter, Edwin S; Connell, Shea P; Miller, Mark R; Duffin, Rodger; Newby, David E; Hadoke, Patrick W F; Minchin, Rodney F

    2016-09-01

    In biological fluids nanoparticles bind a range of molecules, particularly proteins, on their surface. The resulting protein corona influences biological activity and fate of nanoparticle in vivo. Corona composition is often determined by the biological milieu encountered at the entry portal into the body, and, can therefore, depend on the route of exposure to the nanoparticle. For environmental nanoparticles where exposure is by inhalation, this will be lung lining fluid. This study examined plasma and bronchoalveolar fluid (BALF) protein binding to engineered and environmental nanoparticles. We hypothesized that protein corona on nanoparticles would influence nanoparticle uptake and subsequent pro-inflammatory biological response in macrophages. All nanoparticles bound plasma and BALF proteins, but the profile of bound proteins varied between nanoparticles. Focusing on diesel exhaust nanoparticles (DENP), we identified proteins bound from plasma to include fibrinogen, and those bound from BALF to include albumin and surfactant proteins A and D. The presence on DENP of a plasma-derived corona or one of purified fibrinogen failed to evoke an inflammatory response in macrophages. However, coronae formed in BALF increased DENP uptake into macrophages two fold, and increased nanoparticulate carbon black (NanoCB) uptake fivefold. Furthermore, a BALF-derived corona increased IL-8 release from macrophages in response to DENP from 1720 ± 850 pg/mL to 5560 ± 1380 pg/mL (p = 0.014). These results demonstrate that the unique protein corona formed on nanoparticles plays an important role in determining biological reactivity and fate of nanoparticle in vivo. Importantly, these findings have implications for the mechanism of detrimental properties of environmental nanoparticles since the principle route of exposure to such particles is via the lung.

  3. Prospective randomized comparison of oral sodium phosphate and polyethylene glycol lavage for colonoscopy preparation

    Institute of Scientific and Technical Information of China (English)

    Kai-Lin Hwang; William Tzu-Liang Chen; Koung-Hong Hsiao; Hong-Chang Chen; Ting-Ming Huang; Chien-Ming Chiu; Ger-Haur Hsu

    2005-01-01

    AIM: To compare the effectiveness, patient acceptability, and physical tolerability of two oral lavage solutions prior to colonoscopy in a Taiwanese population. METHODS: Eighty consecutive patients were randomized to receive either standard 4 L of polyethylene glycol (PEG) or 90 mL of sodium phosphate (NaP) in a split regimen of two 45 mL doses separated by 12 h, prior to colonoscopic evaluation. The primary endpoint was the percent of subjects who had completed the preparation. Secondary endpoints included colonic cleansing evaluated with an overall assessment and segmental evaluation, the tolerance and acceptability assessed by a selfadministered structured questionnaire, and a safety profile such as any unexpected adverse events, electrolyte tests, physical exams, vital signs, and body weights. RESULTS: A significantly higher completion rate was found in the NaP group compared to the PEG group(84.2% vs 27.5%, P<0.001). The amount of fluid suctioned was significantly less in patients taking NaP vs PEG (50.13±54.8 cc vs 121.13±115.4 cc, P<0.001),even after controlling for completion of the oral solution(P = 0.031). The two groups showed a comparable overall assessment of bowel preparation with a rate of "good" or "excellent" in 78.9% of patients in the NaPgroup and 82.5% in PEG group (P = 0.778). Patients taking NaP tended to have significantly better colonic segmental cleansing relative to stool amount observedin the descending (94.7% vs 70%, P = 0.007) andtransverse (94.6% vs 74.4%, P = 0.025) colon. Slightly more patients graded the taste of NaP as "good" or "very good" compared to the PEG patients (32.5% vs 12.5%;P = 0.059). Patients' willingness to take the same preparation in the future was 68.4% in the NaP compared to 75% in the PEG group (P = 0.617). There was a significant increase in serum sodium and a significant decrease in phosphate and chloride levels in NaP group on the day following the colonoscopy without any clinical sequelae. Prolonged (

  4. Detection of disseminated pancreatic cells by amplification of cytokeratin-19 with quantitative RT-PCR in blood, bone marrow and peritoneal lavage of pancreatic carcinoma patients

    Institute of Scientific and Technical Information of China (English)

    Katrin Hoffmann; Christiane Kerner; Wolfgang Wilfert; Marc Mueller; Joachim Thiery; Johann Hauss; Helmut Witzigmann

    2007-01-01

    AIM: To evaluate the diagnostic potential of cytokeratin-19 (CK-19) mRNA for the detection of disseminated tumor cells in blood, bone marrow and peritoneal lavage in patients with ductal adenocarcinoma of the pancreas.METHODS: Sixty-eight patients with pancreatic cancer (n = 37), chronic pancreatitis (n = 16), and non-pancreatic benign surgical diseases (n = 15, control group)were included in the study. Venous blood was taken preoperatively, intraoperatively and at postoperative d 1 and 10. Preoperative bone marrow aspirates and peritoneal lavage taken before mobilization of the tumor were analyzed. All samples were evaluated for disseminated tumor cells by CK-19-specific nested-PCR and quantitative fluorogenic RT-PCR.RESULTS: CK-19 mRNA expression was increased in 24 (64%) blood samples and 11 (30%) of the peritoneal lavage samples in the patients with pancreatic cancer.In 15 (40%) of the patients with pancreatic cancer,disseminated tumor cells were detected in venous blood and bone marrow and/or peritoneal lavage. In the peritoneal lavage, the detection rates were correlated with the tumor size and the tumor differentiation. CK-19 levels were increased in pT3/T4 and moderately/poorly differentiated tumors (G2/G3). Pancreatic cancer patients with at least one CK-19 mRNA-positive sample showed a trend towards shorter survival. Pancreatic cancer patients showed significantly increased detection rates of disseminated tumor cells in blood and peritoneal lavage compared to the controls and the patients with chronic pancreatitis.CONCLUSION: Disseminated tumor cells can be detected in patients with pancreatic ductal adenocarcinoma by CK-19 fluorogenic RT-PCR. In peritoneal lavage, detection rate is correlated with tumor stage and differentiation. In the clinical use, CK-19 is suitable for the distinction between malignant and benign pancreatic disease in combination with other tumor-specific markers.

  5. The Effect of Thermal Double Distilled Water on Gastric Cancer Cell Line and Its Effect in Peritoneal Lavage During Radical Gastrectomy

    Institute of Scientific and Technical Information of China (English)

    CHENJunqing; XUHuimian; 等

    2002-01-01

    Objective:To evaluate the effect andindications of radical gastrectomy combined with peritoneal lavage with thermal double distilled water(DDW)or DDW plus chlorthexidine acetate.Methods:On the bases of the study on the killing effect of 43℃ DDW on human gastric cancer cell line MGC-803 and its inhibiting effect on ascitic tumor of SY86B morse,500 cases of gastric cancer who underwent radical gastectomy from January 1986 to December 1995 were divided into three groups:group A(n=198) subject to radical gastrectomy and peritoneal lavage for 10min with 4000ml DDW at 43℃ ;group B(n=89)subject to radical gastrectomy and peritoneal lavage for 4min with 4000ml DDW plus 0.6g chlorthexidine acetate,and grup C(n=213) subject to radical gastrectomy and peritoneal lavage for 4 min with 4000ml normal saline at room temperature as control.Results Human gastric cancer cells MGC-803 could be completely killed by treatment of either 43℃ DDW for 10min or DDW plus 0.015ml/L chlorhexidine acetate for 4 min.Clinical trials proved group A and group B(called lavage group as a whole)had almost the same curative effects.The 1-year survival rate and 3-year survival rate were similar in different stages among the groups.The 5-year survival rate was 63.8% in the lavage group and 51.2% in the control group respectively.Most of the cases with good effect were at the mid-stage (Ⅱand Ⅲ stage).Conclusion Radical gastrectom combined with peritoneal peritoneal lavage before closing the abdomen has satisfying effect on patients with gastric cancer at stage Ⅱ and stage ⅢA.

  6. Self-collected genital swabs compared with cervicovaginal lavage for measuring HIV-1 and HSV-2 and the effect of acyclovir on viral shedding.

    Science.gov (United States)

    McNicholl, Janet M; Leelawiwat, Wanna; Whitehead, Sara; Hanson, Debra L; Evans-Strickfaden, Tammy; Cheng, Chen Y; Chonwattana, Wannee; Mueanpai, Famui; Kittinunvorakoon, Chonticha; Markowitz, Lauri; Dunne, Eileen F

    2017-03-01

    HIV-1 and HSV-2 are frequent genital co-infections in women. To determine how self-collected genital swabs compare to provider-collected cervicovaginal lavage, paired self-collected genital swabs and cervicovaginal lavage from women co-infected with HIV-1 and HSV-2 were evaluated. Women were in an acyclovir clinical trial and their samples were tested for HIV-1 RNA (361 samples) and HSV-2 DNA (378 samples). Virus shedding, quantity and acyclovir effect were compared. HIV-1 and HSV-2 were more frequently detected in self-collected genital swabs: 74.5% of self-collected genital swabs and 63.6% of cervicovaginal lavage had detectable HIV-1 (p ≤ 0.001, Fisher's exact test) and 29.7% of self-collected genital swabs and 19.3% of cervicovaginal lavage had detectable HSV-2 (p ≤ 0.001) in the placebo month. Cervicovaginal lavage and self-collected genital swabs virus levels were correlated (Spearman's rho, 0.68 for HIV; 0.61 for HSV-2) and self-collected genital swabs levels were generally higher. In multivariate modeling, self-collected genital swabs and cervicovaginal lavage could equally detect the virus-suppressive effect of acyclovir: for HIV-1, proportional odds ratios were 0.42 and 0.47 and for HSV-2, they were 0.10 and 0.03 for self-collected genital swabs and cervicovaginal lavage, respectively. Self-collected genital swabs should be considered for detection and measurement of HIV-1 and HSV-2 in clinical trials and other studies as they are a sensitive method to detect virus and can be collected in the home with frequent sampling.

  7. Technical note: Bacterial diversity and fermentation end products in rumen fluid samples collected via oral lavage or rumen cannula.

    Science.gov (United States)

    Lodge-Ivey, S L; Browne-Silva, J; Horvath, M B

    2009-07-01

    A study was conducted to determine if sampling rumen contents via a ruminal cannula or oral lavage tube would yield similar denaturing gradient gel electrophoresis profiles of the bacterial community. Two species of ruminally cannulated animals were used for this study (cattle, n = 2; sheep, n = 3). All animals were allowed ad libitum access to feed. Cattle were fed baled unprocessed sorghum-sudan hay (12% CP, 68% NDF; DM basis), whereas sheep were maintained on chopped alfalfa (18% CP, 40% NDF; DM basis). Ruminal fluid was collected (approximately 20 mL) once per week for 3 wk from each animal using a poly tube equipped with a suction strainer with a hand-held suction pump through the rumen cannula or oral cavity. The denaturing gradient gel electrophoresis analysis demonstrates that yield of bacterial diversity was not different between the 2 sampling methods (P = 0.73). When samples were grouped according to band pattern similarity, groups were most stable according to individual animal and species rather than sampling method. Total VFA and molar proportions of individual VFA did not differ by sampling method (P > 0.40). Additionally, rumen ammonia concentrations were similar for both sampling methods (19.3 vs. 19.1 mM +/- 8.0 for cannula vs. lavage, respectively; P = 0.98). These data indicate that rumen samples collected via oral lavage or rumen cannula yield similar results. This knowledge will allow sample collection from a greater population of animals and an ability to maintain the value of research livestock that can be lost due to the surgical implantation of a ruminal cannula.

  8. Clinical significance of telomerase activity in peritoneal lavage fluid from patients with gastric cancer and its relationship with cellular proliferation

    Institute of Scientific and Technical Information of China (English)

    Ming-Xu Da; Xiao-Ting Wu; Tian-Kang Guo; Zi-Guang Zhao; Ting Luo; Kun Qian; Ming-Ming Zhang; Jie Wang

    2007-01-01

    AIM: To evaluate the efficacy of telomerase activity assay and peritoneal lavage cytology (PLC) examination in peritoneal lavage fluid for the prediction of peritoneal metastasis in gastric cancer patients, and to explore the relationship between telomerase activity and proliferating cell nuclear antigen expression.METHODS: Telomeric repeated amplification protocol (TRAP)-enzyme-linked immunosorbent assay (ELISA) was performed to measure the telomerase activity in 60 patients with gastric cancer and 50 with peptic ulcer. PLC analysis of the 60 patients with gastric cancer was used for comparison. The proliferating cell nuclear antigen (PCNA) in gastric carcinoma was immunohistochemically examined.RESULTS: The telomerase activity and PLC positive rate in peritoneal lavage fluid from patients with gastric cancer was 41.7% (25/60), and 25.0% (15/60), respectively. The positive rate of telomerase activity was significantly higher than that of PLC in the group Of pT4 (15/16 vs 9/16, P < 0.05), P1-3 (13/13 vs 9/13, P < 0.05) and diffuse type (22/42 vs 13/42, P < 0.05). The patients with positive telomerase activity, peritoneal metastasis, and serosal invasion had significantly higher levels of average PCNA proliferation index (PI), (55.00 ± 6.59 vs 27.43 ± 7.72, 57.26 ± 10.18 vs 29.15 ± 8.31, and 49.82 ± 6.74 vs 24;65 ± 7.33, respectively, P < 0.05).CONCLUSION: The TRAP assay for telomerase activity is a useful adjunct for cytologic method in the diagnosis of peritoneal micrometastasis and well related to higher proliferating activity of gastric cancer. The results of this study also suggest a promising future therapeutic strategy for treating peritoneal dissemination based on telomerase inhibition.

  9. Change of serum and colon lavage fluid related indicators after probiotics combined with zinc preparations treatment of persistent diarrhea in children

    Institute of Scientific and Technical Information of China (English)

    Jing Chen

    2015-01-01

    Objective:To explore the expression change of serum and colon lavage fluid related indicators after probiotics combined with zinc preparations treatment of persistent diarrhea in children.Methods:80 cases of children with diarrhea treated in our hospital were selected. According to clinical symptoms, routine blood and stool test, they were all diagnosed with persistent diarrhea and randomly divided into control group and experimental group, 40 cases in each group. Control group received basic treatment and zinc preparations (zinc gluconate tablets) therapy; experimental group, based on treatment of control group, received probiotics (Siliankang) combined with zinc preparations treatment. Fasting serum and colon lavage fluid of both groups were collected before and after treatment to detect IL-6, IL-8, NO, MDA and SOD expression levels, and differences between two groups were compared.Results:After treatment, IL-6 and IL-8 expression levels in serum and colon lavage fluid of both groups decreased significantly than those before treatment, and those of experimental group decreased more significantly; after treatment, NO, MDA and SOD expression levels in serum and colon lavage fluid of both groups were significantly improved than those before treatment, and those of experimental group were closer to the normal levels than those of control group.Conclusions:Probiotics combined with zinc preparations treatment of persistent diarrhea in children has obvious curative effect; it effectively reduces expression levels of inflammatory cytokines and oxidative stress factors in serum and colon lavage fluid, and is worth popularization in future clinical treatment.

  10. Trefoil factors (TFFs) are increased in bronchioalveolar lavage fluid from patients with chronic obstructive lung disease (COPD).

    Science.gov (United States)

    Viby, Niels-Erik; Nexø, Ebba; Kissow, Hannelouise; Andreassen, Helle; Clementsen, Paul; Thim, Lars; Poulsen, Steen Seier

    2015-01-01

    Trefoil factors (TFFs) 1, 2 and 3 are small polypeptides that are co-secreted with mucin throughout the body. They are up-regulated in cancer and inflammatory processes in the gastrointestinal system, where they are proposed to be involved in tissue regeneration, proliferation and protection. Our aim was to explore their presence in pulmonary secretions and to investigate whether they are up-regulated in pulmonary diseases characterized by mucin hypersecretion. Bronchioalveolar lavage fluid was obtained from 92 individuals referred to bronchoscopy. The patients were grouped according to diagnosis and pulmonary function. The concentrations of TFF1, TFF2 and TFF3 were measured by ELISA. All three peptides were detected in bronchioalveolar lavage fluid. Patients with chronic obstructive pulmonary disease had concentrations two to three times above the levels in the healthy reference group, and patients with pulmonary malignancies had concentrations of TFF1 and TFF2 three times that of the reference group. The results suggest that TFFs are involved in tissue regeneration, proliferation and protection in lung diseases.

  11. The Effectiveness of Local Hypothermia and Peritoneal Lavage-Dialysis in the Treatment of Patients with Acute Destructive Pancreatitis

    Directory of Open Access Journals (Sweden)

    Veniamin I. Shaposhnikov, PhD, ScD

    2012-12-01

    Full Text Available The aim of this study was to improve the principles of the pathogenetic therapy of acute pancreatitis and assess the effectiveness of local hypothermia of the pancreas, as well as peritoneal lavage-dialysis in the treatment of acute destructive pancreatitis. A total of 5889 patients with acute pancreatitis (AP were examined. The leading role played by the lesions of the pancreatic lymphatic system in the development of destructive processes was noted. In experiments done on eight dogs, the first day of experimental acute pancreatitis showed necrosis of the lumbar retroperitoneal lymph nodes with a violation of lymph drainage from the pancreas before the retroperitoneal fat necrosis was initiated. The effectiveness of local hypothermia of the pancreas was experimentally demonstrated. In 32 patients with AP, the perioperative local hypothermia of the pancreas for 20-25 minutes was followed by the reduction of the alpha-amylase activity in the peripheral blood and in the portal system, as well as a significant reduction in the edema of the pancreas, that delayed the progression of the destructive lesions. An effective method of performing lavage-dialysis of the omental bursa, by using a transversely perforated tube with a pollution control device in the lumen, was developed.

  12. Assessment of utility of ductal lavage and ductoscopy in breast cancer-a retrospective analysis of mastectomy specimens.

    Science.gov (United States)

    Badve, Sunil; Wiley, Elizabeth; Rodriguez, Norma

    2003-03-01

    Early detection of breast lesions continues to be an important goal in the management of breast cancer. At present, mammographic imaging in addition to physical examination is the main screening method for the detection of cancer. Fiberoptic ductoscopy and duct lavage are being recently used to evaluate patients at risk for breast cancer. Both techniques examine the nipple and central duct area to identify intraductal lesions. In this study, we examined the frequency of involvement of these structures in mastectomy specimens as a surrogate marker to estimate the utility of these methods in breast cancer patients. The presence and type of involvement of the nipple and central duct area was retrospectively evaluated in 801 mastectomy specimens from a 4-year period that had been performed for infiltrating or in situ carcinoma. Atypical proliferation or cells, when seen in the ducts of this region, was considered as evidence of nipple involvement, even if definite evidence of malignancy was lacking. The review of 801 mastectomies showed nipple and central duct involvement in 179 (22%) cases. Among the 665 cases of infiltrating carcinoma, 17% did not have an intraductal component. The relative rarity of nipple and central duct in mastectomy specimens and the lack of an in situ component in many cases raise questions about the utility of fiberoptic ductoscopy and duct lavage as methods for screening of breast cancer. Additionally, as these methods examine only 1-2 ducts of the 15-20 ducts that open at the nipple, they might fail to detect focal abnormalities.

  13. Lavagem traqueobrônquica por sondagem nasotraqueal em bezerros Tracheobronchial lavage in calves using a nasotracheal technique

    Directory of Open Access Journals (Sweden)

    R.C. Gonçalves

    2004-06-01

    Full Text Available Avaliou-se a técnica de lavagem traqueobrônquica por sondagem nasotraqueal e caracterizou-se a população celular em 10 bezerros clinicamente sadios. Após a contenção dos animais em decúbito lateral e auxílio de sonda guia, foi introduzida uma sonda de menor diâmetro até a bifurcação da traquéia, para produzir tosse e obter o lavado traqueobrônquico. A média de células totais nas amostras de lavado foi de 133.750 células/ml. À citologia, foram observados na contagem diferencial: 77,2% macrófagos, 14,9% células epiteliais cilíndricas, 6,0% neutrófilos e 1,8% linfócitos. Das células epiteliais cilíndricas, 79,0% eram do tipo ciliadas e 21,0% não-ciliadas. A média de contagem de macrófagos binucleados foi de 78,5 células/lâmina, a de macrófagos trinucleados de 20,5/lâmina e a de células gigantes 28,5/lâmina. Concluiu-se que o método de colheita por sondagem nasotraqueal é eficiente para caracterizar a citologia do lavado traqueobrônquico de bezerros clinicamente sadios.Tracheobronchial lavage through nasotracheal via was performed in 10 clinically health calves. They were maintained in lateral recumbence to perform the procedure. A small tube inserted into a guide tube was introduced until the tracheal bifurcation, producing cough, facilitating the collection of the lavage fluid. The mean number of total cells present in the samples was 133,750 cells/ml. The differential counting was represented by 77.2% of macrophages, 14.9% of cylindrical epithelial cells, 6.0% of neutrophils, 1.8% of lymphocytes. The cylindrical ciliated cells represented 79.0% of the sample and the nonciliated cells represented 21.0%. The mean number of macrophages was 78.5 of binucleated cells, 20.5 of trinucleated cells, and 28.5 of giant cells per smear. The tracheobronchial lavage obtained by this technique was an efficient method to characterize the cytological population of the lungs of clinically health calves.

  14. Polyethylene Glycol Electrolyte Lavage Solution versus Colonic Hydrotherapy for Bowel Preparation before Colonoscopy: A Single Center, Randomized, and Controlled Study.

    Science.gov (United States)

    Cao, Yan; Zhang, Kai-Yuan; Li, Jiao; Lu, Hao; Xie, Wan-Ling; Liao, Sheng-Tao; Chen, Dong-Feng; Zeng, Deng-Feng; Lan, Chun-Hui

    2014-01-01

    This single center, randomized, and controlled study aimed to compare the effectiveness and safety of polyethylene glycol electrolyte lavage (PEG-EL) solution and colonic hydrotherapy (CHT) for bowel preparation before colonoscopy. A total of 196 eligible outpatients scheduled for diagnostic colonoscopy were randomly assigned to the PEG-EL (n = 102) or CHT (n = 94) groups. Primary outcome measures included colonic cleanliness and adverse effects. Secondary outcome measures were patient satisfaction and preference, colonoscopic findings, ileocecal arrival rate, examiner satisfaction, and cecal intubation time. The results show that PEG-EL group was associated with significantly better colonic cleanliness than CHT group, fewer adverse effects, and increased examiner satisfaction. However, the CHT group had higher patient satisfaction and higher diverticulosis detection rates. Moreover, the results showed the same ileocecal arrival rate and patient preference between the two groups (P > 0.05). These findings indicate that PEG-EL is the preferred option in patients who followed the preparation instructions completely.

  15. Clinical experiences of treating septic arthritis in the equine by repeated joint lavage: a series of 39 cases.

    Science.gov (United States)

    Meijer, M C; van Weeren, P R; Rijkenhuizen, A B

    2000-08-01

    The condition of septic arthritis was treated in 12 foals with 21 affected joints (Group I) and in 27 adult horses. The adult horses were divided into three groups, based on aetiology of the condition: haematogenous (Group II, n = 6), iatrogenic (Group III, n = 6), and perforating trauma (Group IV, n = 15). The treatment consisted of an initial systemic antibiotic that anticipated the microbial agents that were considered most likely per group, repeated through-and-through joint lavages every other day and non-steroidal anti-inflammatory drugs. The antibiotics were adjusted to the results of bacteriological culture and susceptibility tests. Joint lavages were continued until the white blood cell count dropped below 15 G/l and bacteriological culture was negative, after which a single dose of a short-acting corticosteroid was administered intra-articularly. Joint recovery rate in group I was 71%. Patient recovery rate of the foals, however, was lower (42%). Three foals were killed for reasons other than arthritis; one foal because of an arthritis-related problem and three foals because of persistent arthritis. Overall joint recovery rate, equalling patient recovery rate, in the adult horses was 81%. The expected predominance of Streptococcus spp. in haematogenous arthritis in adult horses was not confirmed, indicating that in these cases also, an initial antibiotic treatment with a broad-spectrum combination is preferable. It is concluded that with intensive treatment, the prognosis of septic arthritis in the adult horse can be classified as fair to even good. Results in the foals are not as good, but this seems to be more due to the specific problems surrounding the equine neonate than to unresponsiveness to the treatment.

  16. Immune responses in mice to oral administration of attenuated Salmonella typhimurium expressing Helicobacter pylori urease B subunit by a lavage technique

    Institute of Scientific and Technical Information of China (English)

    LIU Xiao-feng; LIU Chang-jiang; HU Jia-lu; JIA Ai-qin; SUN Zi-qin

    2006-01-01

    Objective:To determine whether attenuated Salmonella typhimurium producing Helicobacter pylori (Hp) urease subunit B(UreB)can elicit specific immune responses against Hp in mice tested by a lavage technique. Methods: Attenuated Salmonella typhimurium producing Hp UreB immunized orally Balb/c mice twice at a 3-week interval. After 12 weeks,mice intestinal secretions were obtained without harm by administering a lavage solution intragastrically.The mice intestinal secretions of immune group were also directly washed out after the mice were killed. The antibody responses were evaluated by using serum and intestinal fluid with ELISA assay. Results: The multiple oral immunizations with SL3261/pTC01 UreB induced significantly Hp-specific mucosal IgA response as well as serum IgG response. The IgA was also consistently higher in the intestinal fluid obtained by the lavage solution than by direct washout. In addition, no obvious side effects and changes in gastric inflammation were observed in mice.Conclusion: The attenuated Salmonella typhimurium expressing Hp UreB may be used as an oral vaccine against Hp infection. And the lavage technique is an ideal method in the study of mucosal immune responses.

  17. 初探神经网络在电动洗胃中的应用%Preliminary Study on Application of Neural Network in Electric Gastric Lavage

    Institute of Scientific and Technical Information of China (English)

    孙逊

    2012-01-01

    A method is proposed for intelligent gastric lavage design in this paper. The microprocessor collects and computes gastric lavage pressure and its rate of change, liquid level and its rate of change, turbidity, and PH signals in the analogue stomach lavage test, which are processed by neural network algorithm, and then infer gastric lavage work status. Pipe plug, incomplete pipe plug, fault, normal operating, clean etc can be distinguished by neural network. Neural network algorithm can be used for flexible airtight container cleaning.%提出一种智能洗胃的设计方案.利用微处理器采集和计算模拟洗胃试验中的洗胃压力、压力变化率、液位、液位变化率、浑浊度和PH值等信号,通过神经网络算法对信号进行处理,判断洗胃工况.采用神经网络算法能区分管路堵塞、不完全堵塞、故障、洗胃正常和清洁等运行状态.神经网络算法可用于柔性密闭容器的清洗工作.

  18. 改良洗胃法对新生儿洗胃的探讨%Investigation on the modification of gastric lavage in newborn

    Institute of Scientific and Technical Information of China (English)

    颜金花; 周娟

    2011-01-01

    目的 探讨一种新生儿洗胃方式,提高洗胃效果,减轻伤害.方法 将104例咽下综合征新生儿随机分成3组,即时照组、观察1组、观察2组;对照组即采用传统洗胃法;观察1组插入时、洗胃后2h进行非营养性吸吮,长度为前额发际至剑突;观察2组插入时、洗胃后2h进行非营养性吸吮,长度为前额发际至脐部.结果 3组患儿一次性插管成功率、合作性、洗胃效果差异具有统计学意义(P<0.05).结论 新生儿洗胃时增加插入胃管长度,以前额发际至脐部并伴操作中、操作后非营养性吸吮,能提高洗胃的效果,减轻患儿的痛苦,减少临床操作时间.%Objective To explore a neonatal gastric lavage method to improve gastric lavage effect and reduce the damage. Methods 104 newborn with swallowing syndrome randomly divided into 3 groups, namely the control group, observation group 1, observation group 2. The control group namely useded the traditional gastric lavage method; observation group 1 namely carried on the non-trophism suction when feeding tube was being inserted and after 2h of the gastric lavage, and the inserted length was from the forehead hair edge to xiphoid; observation group 2 namely carried on the non-trophism suction when feeding tube was being inserted and after 2h of the gastric lavage, and the inserted length was from the forehead hair edge to navel. Results There were significant differences in one-time success rate of intubation, cooperation, gastric lavage effect among the three groups of newborn(P <0.05 ). Conclusion The effect of gastric lavage can be improved, pain be relieved, the clinical operation time be reduced by increasing the stomach tube length (from the forehead hair edge to navel) and associating non-nutritive sucking during and after operation.

  19. Effects of Jiaomu Oil on IL-4 and IFN-γ in bronchoalveolar lavage fluid and NF-κB in lung tissue of asthmatic model in guinea pig%椒目油对哮喘模型豚鼠肺泡灌洗液IL-4、IFN-γ水平及肺组织NF-κB的影响

    Institute of Scientific and Technical Information of China (English)

    赵睿; 戚好文; 谢柏梅

    2007-01-01

    目的 探讨椒目油对支气管哮喘(哮喘)豚鼠模型肺泡灌洗液(BALF)中IL-4、IFN-γ水平及肺组织中NF-κB的影响,为椒目油治疗哮喘提供理论依据.方法 实验分4组:正常对照组、哮喘模型组、地塞米松治疗组和椒目油治疗组,每组各10只豚鼠.用卵白蛋白(OVA)腹腔注射致敏和雾化吸入激发建立哮喘豚鼠模型.ELISA法检测豚鼠BALF中IL-4,IFN-γ含量.免疫组化法观察NF-κB在豚鼠支气管上皮的表达.结果 哮喘组BALF中的IL-4、IFN-γ含量及PC20水平都与正常对照组有显著的差别(P均<0.05),分别为(41.36±6.71) ng/L 和 (10.58±1.28) ng/L,(21.15±2.75) ng/L 和 (73.52±5.23) ng/L,(0.013±0.014) g/L 和 (0.168±0.186) g/L,而椒目油组及地塞米松治疗组豚鼠BALF中IL-4含量分别为(15.35±4.28) ng/L、(19.20±3.78) ng/L,明显低于哮喘模型组(P<0.05),其IFN-γ含量分别为(50.65±4.19) ng/L、(53.34±5.64) ng/L和PC20[(0.160±0.180) g/L、(0.144±0.154) g/L]水平较后者显著升高(P<0.05).椒目油治疗组和地塞米松治疗组各指标之间无显著性差异(P>0.05).正常对照组、哮喘模型组、椒目油治疗组和地塞米松治疗组豚鼠气道中NF-κB阳性细胞百分比分别为(9.51±2.82)%、(52.71±7.80)%、(32.26±3.70)%、(29.89±2.01)%,两治疗组均和哮喘模型组有显著差异.结论 椒目油能有效降低豚鼠BALF中IL-4水平,升高IFN-γ含量,同时降低气道高反应性和NF-κB在哮喘豚鼠支气管上皮中的表达.

  20. A comparative study on the detection of Mycobacterium tuberculosis complex DNA in bronchoalveolar lavage fluid by two Real-time PCR%两种实时定量PCR技术检测肺泡灌洗液中结核分枝杆菌DNA的比较研究

    Institute of Scientific and Technical Information of China (English)

    张瑞雪; 刘昊; 徐修礼; 郝晓柯; 刘家云

    2016-01-01

    目的 比较结核分枝杆菌及利福平耐药快速检测技术(简称Xpert MTB/RIF)和达安实时定量PCR检测肺泡灌洗液中的结核杆菌DNA对肺结核的诊断和卫生经济学价值.方法 招募2014年3月~2015年11月进入第四军医大学西京医院就诊的疑似肺结核的连续病例112例,收集肺泡灌洗液样本同时进行抗酸染色、MGIT960液体培养和药敏试验、Xpert MTB/RIF和达安实时定量PCR检测.结果 112例纳入的研究对象中经培养确诊的肺结核患者有53例,疑似的肺结核患者15例,非结核患者44例.以MGIT960液体培养为金标准,Xpert MTB/RIF与达安实时定量PCR的灵敏度差异无统计学意义(98.11% vs90.57%,P=0.205),两者的灵敏度均高于抗酸染色灵敏度58.49% (P<0.001);而若以临床诊断为参考标准,Xpert MTB/RIF的灵敏度则高于达安实时定量PCR,且差异有统计学意义(P=0.045).而抗酸染色、达安实时定量PCR和Xpert MTB/RIF的特异性分别为99.73%、88.64%和95.45%,差异无统计学意义(P=0.184).进行成本-效果分析,每检出1例肺结核行1次Xpert MTB/RIF的费用为1 033.85元,远远高于达安实时定量PCR费用196.49元.结论 Xpert MTB/RIF灵敏度高,操作更加简便快速且易于开展,并能同时检测利福平耐药性,可作为检测肺泡灌洗液中结核分枝杆菌DNA的首选方法.但达安实时定量PCR的检测成本较低,更加适用于低收入人群.

  1. Subchronic inhalation of coal dust particulate matter 10 induces bronchoalveolar hyperplasia and decreases MUC5AC expression in male Wistar rats.

    Science.gov (United States)

    Kania, Nia; Setiawan, Bambang; Widjadjanto, Edi; Nurdiana, Nurdiana; Widodo, M Aris; Kusuma, H M S Chandra

    2014-10-01

    Coal dust is a pollutant found in coal mines that are capable of inducing oxidative stress and inflammation, but the effects on lung metaplasia as an early step of carcinogenesis remain unknown. The purpose of the present study was to evaluate the effects of PM10 coal dust on lung histology, MUC5AC expression, epidermal growth factor (EGF) expression, and epidermal growth factor receptor (EGFR) expression. An experimental study was done on male Wistar rats, which were divided into the following groups: control groups exposed to coal dust for 14 days (at doses of 6.25 mg/m(3), 12.5 mg/m(3), and 25 mg/m(3)), and the groups exposed to coal dust for 28 days (at doses of 6.25 mg/m(3), 12.5 mg/m(3), and 25 mg/m(3)). EGF expressions in rat lungs were measured by ELISA. EGFR and MUC5AC were measured by a confocal laser scanning microscope. The bronchoalveolar epithelial image of the group exposed to coal dust for 14 and 28 days showed a epithelial rearrangement, hyperplastic (metaplastic) goblet cells, and scattered massive inflammatory cells. The pulmonary parenchymal image of the group of exposed to coal dust for 14 and 28 days showed scattered inflammatory cells filling up the pulmonary alveolar networks, leading to an appearance of thickened parenchymal alveoli until emphysema-like structure. There was no significant difference in MUC5AC, EGF, and EGFR expressions for 14-d exposure (p>0.05). There was no significant difference in EGF and EGFR expressions for 28-d exposure (p>0.05), but there was a significant difference in MUC5AC expression (pcoal dust particulate matter 10 induces bronchoalveolar reactive hyperplasia and rearrangement of epithelial cells which accompanied by decrease expression MUC5AC in male rats.

  2. Exosomal miRNAs from Peritoneum Lavage Fluid as Potential Prognostic Biomarkers of Peritoneal Metastasis in Gastric Cancer.

    Science.gov (United States)

    Tokuhisa, Motohiko; Ichikawa, Yasushi; Kosaka, Nobuyoshi; Ochiya, Takahiro; Yashiro, Masakazu; Hirakawa, Kosei; Kosaka, Takashi; Makino, Hirochika; Akiyama, Hirotoshi; Kunisaki, Chikara; Endo, Itaru

    2015-01-01

    Peritoneal metastasis is the most frequent type of recurrence in patients with gastric cancer (GC) and is associated with poor prognosis. Peritoneal lavage cytology, used to evaluate the risk of peritoneal metastasis, has low sensitivity. Here, we assessed the diagnostic potential of exosomal miRNA profiles in peritoneal fluid for the prediction of peritoneal dissemination in GC. Total RNA was extracted from exosomes isolated from six gastric malignant ascites (MA) samples, 24 peritoneal lavage fluid (PLF) samples, and culture supernatants (CM) of two human gastric carcinoma cell lines that differ in their potential for peritoneal metastasis. Expression of exosomal miRNAs was evaluated with Agilent Human miRNA microarrays and quantitative reverse transcription polymerase chain reaction (qRT-PCR). The microarray analysis indicated a low variability in the number and signal intensity of miRNAs detected among the samples. In the six MA fluids, miR-21 showed the highest signal intensity. We identified five miRNAs (miR-1225-5p, miR-320c, miR-1202, miR-1207-5p, and miR-4270) with high expression in MA samples, the PLF of serosa-invasive GC, and the CM of a highly metastatic GC cell line; these candidate miRNA species appear to be related to peritoneal dissemination. Differential expression of miR-21, miR-320c, and miR-1225-5p was validated in the PLF of serosa-invasive and non-invasive GC by qRT-PCR and miR-21 and miR-1225-5p were confirmed to be associated with serosal invasion in GC. PLF can be used to profile the expression of exosomal miRNAs. Our findings suggest that miR-21 and miR-1225-5p may serve as biomarkers of peritoneal recurrence after curative GC resection, thus providing a novel approach to early diagnosis of peritoneal dissemination of GC.

  3. Exosomal miRNAs from Peritoneum Lavage Fluid as Potential Prognostic Biomarkers of Peritoneal Metastasis in Gastric Cancer.

    Directory of Open Access Journals (Sweden)

    Motohiko Tokuhisa

    Full Text Available Peritoneal metastasis is the most frequent type of recurrence in patients with gastric cancer (GC and is associated with poor prognosis. Peritoneal lavage cytology, used to evaluate the risk of peritoneal metastasis, has low sensitivity. Here, we assessed the diagnostic potential of exosomal miRNA profiles in peritoneal fluid for the prediction of peritoneal dissemination in GC. Total RNA was extracted from exosomes isolated from six gastric malignant ascites (MA samples, 24 peritoneal lavage fluid (PLF samples, and culture supernatants (CM of two human gastric carcinoma cell lines that differ in their potential for peritoneal metastasis. Expression of exosomal miRNAs was evaluated with Agilent Human miRNA microarrays and quantitative reverse transcription polymerase chain reaction (qRT-PCR. The microarray analysis indicated a low variability in the number and signal intensity of miRNAs detected among the samples. In the six MA fluids, miR-21 showed the highest signal intensity. We identified five miRNAs (miR-1225-5p, miR-320c, miR-1202, miR-1207-5p, and miR-4270 with high expression in MA samples, the PLF of serosa-invasive GC, and the CM of a highly metastatic GC cell line; these candidate miRNA species appear to be related to peritoneal dissemination. Differential expression of miR-21, miR-320c, and miR-1225-5p was validated in the PLF of serosa-invasive and non-invasive GC by qRT-PCR and miR-21 and miR-1225-5p were confirmed to be associated with serosal invasion in GC. PLF can be used to profile the expression of exosomal miRNAs. Our findings suggest that miR-21 and miR-1225-5p may serve as biomarkers of peritoneal recurrence after curative GC resection, thus providing a novel approach to early diagnosis of peritoneal dissemination of GC.

  4. Polyethylene Glycol Electrolyte Lavage Solution versus Colonic Hydrotherapy for Bowel Preparation before Colonoscopy: A Single Center, Randomized, and Controlled Study

    Directory of Open Access Journals (Sweden)

    Yan Cao

    2014-01-01

    Full Text Available This single center, randomized, and controlled study aimed to compare the effectiveness and safety of polyethylene glycol electrolyte lavage (PEG-EL solution and colonic hydrotherapy (CHT for bowel preparation before colonoscopy. A total of 196 eligible outpatients scheduled for diagnostic colonoscopy were randomly assigned to the PEG-EL (n=102 or CHT (n=94 groups. Primary outcome measures included colonic cleanliness and adverse effects. Secondary outcome measures were patient satisfaction and preference, colonoscopic findings, ileocecal arrival rate, examiner satisfaction, and cecal intubation time. The results show that PEG-EL group was associated with significantly better colonic cleanliness than CHT group, fewer adverse effects, and increased examiner satisfaction. However, the CHT group had higher patient satisfaction and higher diverticulosis detection rates. Moreover, the results showed the same ileocecal arrival rate and patient preference between the two groups (P>0.05. These findings indicate that PEG-EL is the preferred option in patients who followed the preparation instructions completely.

  5. pH in exhaled breath condensate and nasal lavage as a biomarker of air pollution-related inflammation in street traffic-controllers and office-workers

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    Thamires Marques de Lima

    2013-12-01

    Full Text Available OBJECTIVE: To utilize low-cost and simple methods to assess airway and lung inflammation biomarkers related to air pollution. METHODS: A total of 87 male, non-smoking, healthy subjects working as street traffic-controllers or office-workers were examined to determine carbon monoxide in exhaled breath and to measure the pH in nasal lavage fluid and exhaled breath condensate. Air pollution exposure was measured by particulate matter concentration, and data were obtained from fixed monitoring stations (8-h work intervals per day, during the 5 consecutive days prior to the study. RESULTS: Exhaled carbon monoxide was two-fold greater in traffic-controllers than in office-workers. The mean pH values were 8.12 in exhaled breath condensate and 7.99 in nasal lavage fluid in office-workers; these values were lower in traffic-controllers (7.80 and 7.30, respectively. Both groups presented similar cytokines concentrations in both substrates, however, IL-1β and IL-8 were elevated in nasal lavage fluid compared with exhaled breath condensate. The particulate matter concentration was greater at the workplace of traffic-controllers compared with that of office-workers. CONCLUSION: The pH values of nasal lavage fluid and exhaled breath condensate are important, robust, easy to measure and reproducible biomarkers that can be used to monitor occupational exposure to air pollution. Additionally, traffic-controllers are at an increased risk of airway and lung inflammation during their occupational activities compared with office-workers.

  6. Effects of respiratory rate, plateau pressure, and positive end-expiratory pressure on PaO2 oscillations after saline lavage.

    Science.gov (United States)

    Baumgardner, James E; Markstaller, Klaus; Pfeiffer, Birgit; Doebrich, Marcus; Otto, Cynthia M

    2002-12-15

    One of the proposed mechanisms of ventilator-associated lung injury is cyclic recruitment of atelectasis. Collapse of dependent lung regions with every breath should lead to large oscillations in PaO2 as shunt varies throughout the respiratory cycle. We placed a fluorescence-quenching PO2 probe in the brachiocephalic artery of six anesthetized rabbits after saline lavage. Using pressure-controlled ventilation with oxygen, ventilator settings were varied in random order over three levels of positive end-expiratory pressure (PEEP), respiratory rate (RR), and plateau pressure minus PEEP (Delta). Dependence of the amplitude of PaO2 oscillations on PEEP, RR, and Delta was modeled by multiple linear regression. Before lavage, arterial PO2 oscillations varied from 3 to 22 mm Hg. After lavage, arterial PO2 oscillations varied from 5 to 439 mm Hg. Response surfaces showed markedly nonlinear dependence of amplitude on PEEP, RR, and Delta. The large PaO2 oscillations observed provide evidence for cyclic recruitment in this model of lung injury. The important effect of RR on the magnitude of PaO2 oscillations suggests that the static behavior of atelectasis cannot be accurately extrapolated to predict dynamic behavior at realistic breathing frequencies.

  7. Studying the effects of reproductive hormones and bacterial vaginosis on the glycome of lavage samples from the cervicovaginal cavity.

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    Linlin Wang

    Full Text Available The cervicovaginal fluid (CVF coating the vaginal epithelium is an important immunological mediator, providing a barrier to infection. Glycosylation of CVF proteins, such as mucins, IgG and S-IgA, plays a critical role in their immunological functions. Although multiple factors, such as hormones and microflora, may influence glycosylation of the CVF, few studies have examined their impact on this important immunological fluid. Herein we analyzed the glycosylation of cervicovaginal lavage (CVL samples collected from 165 women under different hormonal conditions including: (1 no contraceptive, post-menopausal, (2 no contraceptive, days 1-14 of the menstrual cycle, (3 no contraceptive, days 15-28 of the menstrual cycle, (4 combined-oral contraceptive pills for at least 6 months, (5 depo-medroxyprogesterone acetate (Depo-Provera injections for at least 6 months, (6 levonorgestrel IUD for at least 1 month. Glycomic profiling was obtained using our lectin microarray system, a rapid method to analyze carbohydrate composition. Although some small effects were observed due to hormone levels, the major influence on the glycome was the presence of an altered bacterial cohort due to bacterial vaginosis (BV. Compared to normal women, samples from women with BV contained lower levels of sialic acid and high-mannose glycans in their CVL. The change in high mannose levels was unexpected and may be related to the increased risk of HIV-infection observed in women with BV, as high mannose receptors are a viral entry pathway. Changes in the glycome were also observed with hormonal contraceptive use, in a contraceptive-dependent manner. Overall, microflora had a greater impact on the glycome than hormonal levels, and both of these effects should be more closely examined in future studies given the importance of glycans in the innate immune system.

  8. Bowel Preparation for Colonoscopy with Sodium Phosphate Solution versus Polyethylene Glycol-Based Lavage: A Multicenter Trial

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    S. Schanz

    2008-01-01

    Full Text Available Background: Adequate bowel preparation is essential for accurate colonoscopy. Both oral sodium phosphate (NaP and polyethylene glycol-based lavage (PEG-ELS are used predominantly as bowel cleansing modalities. NaP has gained popularity due to low drinking volume and lower costs. The purpose of this randomized multicenter observer blinded study was to compare three groups of cleansing (NaP, NaP + sennosides, PEG-ELS + sennosides in reference to tolerability, acceptance, and cleanliness. Patient and Methods: 355 outpatients between 18 and 75 years were randomized into three groups (A, B, C receiving NaP = A, NaP, and sennosides = B or PEG-ELS and sennosides = C. Gastroenterologists performing colonoscopies were blinded to the type of preparation. All patients documented tolerance and adverse events. Vital signs, premedication, completeness, discomfort, and complications were recorded. A quality score (0–4 of cleanliness was generated. Results: The three groups were similar with regard to age, sex, BMI, indication for colonoscopy, and comorbidity. Drinking volumes (L (A = 4.33 + 1.2, B = 4.56 + 1.18, C = 4.93 + 1.71 were in favor of NaP (P = .005. Discomfort from ingested fluid was recorded in A = 39.8% (versus C: P = .015, B = 46.6% (versus C: P = .147, and C = 54.6%. Differences in tolerability and acceptance between the three groups were statistically not significant. No differences in adverse events and the cleanliness effects occurred in the three groups (P = .113. The cleanliness quality scores 0–2 were calculated in A: 77.7%, B: 86.7%, and C: 85.2%. Conclusions: These data fail to demonstrate significant differences in tolerability, acceptance, and preparation quality between the three types of bowel preparation for colonoscopy. Cleansing with NaP was not superior to PEG-ELS.

  9. Treatment of the calcific tendinopathy of the rotator cuff by ultrasound-guided percutaneous needle lavage. Two years prospective study

    Science.gov (United States)

    Del Castillo-González, Federico; Ramos-Álvarez, Juan José; Rodríguez-Fabián, Guillermo; González-Pérez, José; Calderón-Montero, Javier

    2014-01-01

    Summary Purpose: to evaluate the short and long term effectiveness of ultrasonography (US)-guided percutaneous needle lavage in calcific tendinopathy of the rotator cuff. To study the evolution of the size of calcifications and pain in the two years after treatment. Methods: a 2 year longitudinal prospective study is carried out after applying the UGPL technique on a number of patients diagnosed with calcific tendinitis of the rotator cuff. Clinical, ultrasound and radiology follow-up controls were performed, 3 months, 6 months, one year and two years after the treatment. The Visual Analog Scale (VAS) was used to assess the pain. The degree and point of pain is selected on a 10cm line, arranged horizontally or vertically. The “0” represents no pain and “10” represents worst pain. The population studied was made up of 121 patients that required our service as a result of suffering from a painful shoulder. Results: the pain (VAS) and the size of the calcification significantly decreased with the application of the technique (p< 0,001 in both cases) and regardless of the sex (p: 0.384 for pain and p: 0.578 for the size of the calcification). This occurred from the first check-up (3 months) and was maintained for two year. Conclusion: we consider this technique to be a valid alternative as a first-choice treatment of calcific tendinitis of the shoulder. The intervention is simple, cost-effective, does not require hospitalization, involves no complications, rehabilitation treatment is not required and it shows very few side effects without sequelae, significantly reducing the size of the calcification and pain in the majority of patients. PMID:25767776

  10. Fungi, β-glucan, and bacteria in nasal lavage of greenhouse workers and their relation to occupational exposure.

    Science.gov (United States)

    Madsen, Anne Mette; Tendal, Kira; Thilsing, Trine; Frederiksen, Margit W; Baelum, Jesper; Hansen, Jørgen V

    2013-10-01

    The nose and mouth are the first regions of the respiratory tract in contact with airborne microorganisms. Occupational exposures to airborne microorganisms are associated with inflammation and different symptoms of the airways. The purpose of this study is to investigate the relation between occupational exposure to fungi, β-glucan, and bacteria and contents of fungi, β-glucan, and bacteria in nasal lavage (NAL) of greenhouse workers. We also studied whether contents of microorganisms in NAL were related to gender, time of the work week, and runny nose. NAL samples (n = 135) were taken Monday morning and Thursday at noon and personal exposure to inhalable bioaerosols was measured during a working day. The content of fungi and β-glucan in NAL of men was affected by their exposure to fungi and β-glucan. The content of fungi, β-glucan, and bacteria in NAL was higher Thursday at noon than Monday morning. The ratios of fungi in NAL between Thursday at noon and Monday morning were 14 (median value) for men and 3.5 for women. Gender had no effect on the exposure level but had a significant effect on the content of fungi, β-glucan, and bacteria in NAL, with the highest contents in NAL of men. On Thursdays, the median content of fungi in NAL samples of men without runny noses was 9408 cfu per NAL sample, whereas the same content for women was 595 cfu per NAL sample. Workers with runny noses had fewer fungi in NAL than workers without runny noses. A higher content of β-glucan per fungal spore was found in NAL than in the air. This indicates that mainly the larger fungal spores or pollen grains deposit in the nose. The difference between genders and the fact that the content of fungi in NAL was significantly affected by the exposure indicate that the two genders are affected by the same exposure level differently.

  11. 经纤维支气管镜沐舒坦肺泡灌洗在颈脊髓损伤并发呼吸功能衰竭患者中的应用%Fiberoptic bronchoscopy aspirating sputum and mucovent lavage in the treatment of cervical spinal cord injury with respiratory insufficiency patients

    Institute of Scientific and Technical Information of China (English)

    路闯; 袁宏伟; 刘俊杰; 代振动; 王灿亚; 田俊华; 贾会光; 赵惠强

    2011-01-01

    目的 探讨颈脊髓损伤并发呼吸功能衰竭患者经纤维支气管镜沐舒坦肺泡灌洗的疗效.方法 选择38例经常规吸氧、抗感染、解痉平喘、化痰止咳或人工通气治疗效果不佳,并具有痰液堵塞的颈脊髓损伤并发呼吸衰竭患者进行经纤支镜沐舒坦支气管肺泡灌洗治疗.结果 显效26例(68.4%),有效9例(23.7%),总有效率为92.1%,无效3例(7.9%).结论 对于分泌物较多难以排出气道的颈脊髓损伤并发呼吸衰竭患者,及时给予经纤支镜沐舒坦肺泡灌洗,有利于迅速解除气道阻塞,改善血气交换.支气管吸引灌洗技术是一种安全有效、简便经济、易被患者接受的治疗方法,应用沐舒坦肺泡灌洗治疗颈脊髓损伤并发呼吸衰竭能改善病情.%[Objective]To investigate the clinical values of aspirating sputum by bronchofibroscopy and bronchoalveolar mucovent lavage in cervical fracture with spinal cord injury patients respiratory insufficiency.[Methods]Bronchoscope was inserted into 38 patients cervical spinal cord injury with respiratory insufficiency through nose or tracheal catheter to clear the secretion, phlegm.[Results]35 lives were saved and the mission successful rate was 92.1%.[Conclusions]The clinical values of bedside fiberoptic bronchoscopy for cervical fracture with spinal cord injury patients respiratory insufficiency are grateful.

  12. 40 CFR 799.9135 - TSCA acute inhalation toxicity with histopathology.

    Science.gov (United States)

    2010-07-01

    .... The bronchoalveolar lavage is designed to be a rapid screening test to provide an early indicator of...; stomach; duodenum; jejunum; ileum; cecum; colon; rectum; urinary bladder; representative lymph...

  13. Early activation of the alveolar macrophage is critical to the development of lung ischemia-reperfusion injury.

    NARCIS (Netherlands)

    Naidu, BV; Krishnadasan, B; Farivar, AS; Woolley, SM; Thomas, R; Rooijen, van N.; Verrier, ED; Mulligan, MS

    2003-01-01

    .006) and marked reductions in bronchoalveolar lavage fluid leukocyte accumulation. Alveolar macrophage-depleted animals also demonstrated marked reductions of the elaboration of multiple proinflammatory chemokines and cytokines in the lavage effluent and nuclear transcription factors in lung homoge

  14. Changes in coagulation-fibrinolysis function in alveolar lavage fluid of endotoxemic dogs after partial removal of peripheral leukocytes

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    Shun-gang ZHOU

    2011-06-01

    Full Text Available Objective To observe the effect of partial removal of peripheral leucocytes on the coagulation-fibrinolysis function of alveolar lavage fluid(ALF in endotoxemic dogs,and explore the influence and mechanisms of activated leucocytes on lung injury in endotoxemic dogs.Methods Thirty male mongrel dogs were involved in present study and randomly divided into 3 groups(10 each: LPS group(group L,sham leukocytapheresis group(group S and leukocytapheresis group(group T.Endotoxemic model was reproduced in group L by administration of LPS(2mg/kg,but the animals did not receive leukocytapheresis.Animals in group T received leukocytapheresis using a continuous-flow blood cell separator 12-14 hours after administration of LPS.Animals in group S received sham leukocytapheresis(the end products were transfused back into the dogs at 12-14 hours after administration of LPS.At 36h after administration of LPS,the lung tissues were harvested to obtain ALF,and the levels of neutrophil elastase(NE,soluble thrombomodulin(sTM,activated protein C(APC and plasminogen activator inhibitor-1(PAI-1 in ALF were determined,the expression of thrombomodulin in lung tissue was observed by immunohistochemical staining,while the routine pathological examination and wet/dry ratio of lung tissue were performed.Results The APC level in ALF was significantly higher,while the NE,sTM and PAI-1 levels in ALF and wet/dry ratio of lung tissue were significantly lower in group T than in group L and group S(P < 0.05.Immunohistochemical examination revealed that the expression of thrombomodulin in lung tissue was higher in group T than in group L and group S.No significant difference was found between group L and group S in the indexes mentioned above.Pathological observation showed the incidence of acute lung injury was significantly lower in group T(2/10 than in group L(7/10 and group S(8/10,P < 0.05.Conclusion Partial removal of peripheral leukocytes may lower the level of NE in ALF

  15. Effects of nasal saline lavage on pediatric sinusitis symptoms and disease-specific quality of life: a case series of 10 patients.

    Science.gov (United States)

    Lin, Sandra Y; Baugher, Katherine M; Brown, David J; Ishman, Stacey L

    2015-02-01

    We conducted a prospective study to assess (1) the effects of daily nasal irrigation in children with chronic sinonasal symptoms and (2) the impact that treatment had on disease-specific quality of life as assessed by a validated instrument, the five-item Sinus and Nasal Quality of Life Survey (SN-5), and by an overall nasal quality-of-life (NQL) score based on a 10-point faces scale. Our patient population was made up of 10 children-7 girls and 3 boys, aged 3 to 9 years (mean: 6.1)-who had presented with symptoms of chronic rhinosinusitis for more than 3 months and who had not responded to previous medical management. Patients were administered nasal saline lavage daily for 1 month. These patients and/or their caregivers completed an SN-5 questionnaire upon entry into the study and at the completion of treatment. At study's end, a comparison of pre- and post-treatment scores with paired Student t tests showed that the mean total SN-5 score improved significantly over baseline, falling 45% from 21.4 to 11.7 (p = 0.0002). Moreover, significant overall improvement was seen in each of the five subcategories of the SN-5 survey (p = 0.0009 to 0.038). The NQL scores also improved significantly from 4.7 to 7.7 (p = 0.0034). Compliance with nasal lavage was generally good among the 10 patients, as 8 of them used at least 75% of the recommended quantity of saline at least once a day. During a follow-up period that ranged from 2 to 23 months (mean: 10.4), only 1 patient required an adenoidectomy for symptom control. The results of this pilot study suggest that nasal saline lavage may significantly alleviate chronic sinonasal symptoms and improve disease-specific quality of life in children with symptoms of chronic rhinosinusitis.

  16. Validity and reliability of using a self-lavaging device for cytology and HPV testing for cervical cancer screening: findings from a pilot study.

    Directory of Open Access Journals (Sweden)

    Heidi E Jones

    Full Text Available Self-sampling could increase cervical cancer screening uptake. While methods have been identified for human papillomavirus (HPV testing, to date, self-sampling has not provided adequate specimens for cytology. We piloted the validity and reliability of using a self-lavaging device for cervical cytology and HPV testing. We enrolled 198 women in New York City in 2008-2009 from three ambulatory clinics where they received cervical cancer screening. All were asked to use the Delphi Screener™ to self-lavage 1-3 months after clinician-collected index cytological smear (100 normal; 98 abnormal. Women with abnormal cytology results from either specimen underwent colposcopy; 10 women with normal results from both specimens also underwent colposcopy. We calculated sensitivity of self-collected cytology to detect histologically confirmed high grade lesions (cervical intraepithelial neoplasia, CIN, 2+; specificity for histology-negative (CIN 1 or lower, paired cytology negative, or a third cytology negative; and kappa for paired results. One hundred and ninety-seven (99.5% women self-collected a lavage. Seventy-five percent had moderate to excellent cellularity, two specimens were unsatisfactory for cytology. Seven of 167 (4% women with definitive results had CIN2+; one had normal and six abnormal cytology results with the self-lavage (sensitivity = 86%, 95% Confidence Interval, CI: 42, 100. The kappa for paired cytology was low (0.36; 95% CI: 0.25, 0.47 primarily due to clinician specimens with atypical squamous cells of undetermined significance (ASC-US and low grade squamous intraepithelial lesion (LSIL coded as normal using Screener specimens. However, three cases of HSIL were coded as ASC-US and one as normal using Screener specimens. Seventy-three women had paired high-risk HPV tests with a kappa of 0.66 (95% CI: 0.49, 0.84. Based on these preliminary findings, a larger study to estimate the performance of the Screener for co-testing cytology and

  17. Repeated lung lavage with extracorporeal membrane oxygenation treating severe acute respiratory distress syndrome due to nasogastric tube malposition for enternal nutrition: a case report.

    Science.gov (United States)

    Kao, Xiaoming; Yu, Wenkui; Zhu, Weiming; Li, Ning; Li, Jieshou

    2012-01-01

    Enternal nutritional support, a frequently applied technique for providing nutrition and energy, played a pivotal role in the treatment of high risk patients. However, severe complications induced by malposition of nasogastric tube caused great danger and even death to the patients. In this case report, we present a patient with severe acute respiratory distress syndrome (ARDS) induced by bronchopleural fistula (BPF) due to malposition of nasogastric tube. Repeated lung lavage combined with extracorporeal membrane oxygenation (ECMO) was performed after transferring to the ICU of our hospital. Finally, the patient recovered and discharged 7 days after admission.

  18. [Respective roles of gastric lavage, haemodialysis, haemoperfusion, diuresis and hepatic metabolism in the elimination of a massive meprobamate overdose (author's transl)].

    Science.gov (United States)

    Pontal, P G; Bismuth, C; Baud, F; Galliot, M

    1982-05-01

    A case of massive meprobamate intoxication (100 g) is reported. On admission, 8 hours later, the plasma meprobamate level was 460 mg/l. The initial shock (hours 8-12) was successfully treated with blood volume expansion and dobutamine. The plasma meprobamate level, which was 340 mg/l when haemodialysis and haemoperfusion were started, fell to 110 mg/l at the end of the treatment. Recovery was uneventful. The amounts of drug eliminated by each method were as follows: (a) gastric lavages at 8 and 26 hours: 66 g; (b) haemodialysis (18-29 hours): 8.5 g; (d) haemoperfusion on Hemopur-charcoal (20-28 hours): 7.5 g (as measured by elution); (e) diuresis (26 hours): 2 g. It may be concluded from these data that sizeable amounts of drug can be extracted by haemodialysis and haemoperfusion, that gastric lavage remains the least invasive and most rewarding method of elimination, and that the role of hepatic metabolism in detoxication has to be taken into account.

  19. Chronic calcifying tendinitis of the shoulder-therapy by percutaneous needle aspiration and lavage: a prospective open study of 62 shoulders.

    Science.gov (United States)

    Pfister, J; Gerber, H

    1997-05-01

    In an open study the therapeutic value of percutaneous needle aspiration and lavage performed in local anaesthesia under image intensifier control in patients with chronic calcifying shoulder tendinitis was investigated. 60 patients (62 shoulders) were included in the study. The average age was 48 years, and the median duration of shoulder pain and calcification was 24 months and 7 months respectively. The right shoulder was affected in 34 and the left in 24 patients; two patients had painful calcifications in both shoulders. In 47% X-ray showed calcium deposits in the contralateral shoulder. 77% of the painful deposits projected on the supraspinatus tendon and in most cases image intensifier examination showed multiple calcifications. Calcareous material could be removed by needle aspiration and lavage in 76% of all cases. There was no correlation regarding the preferred working hand and the side of calcifying tendinitis. X-ray controls performed after 2 months revealed a significant reduction of the size of calcifications. The clinical follow-up 2 and 6 months after needling showed a significant reduction of global pain intensity. There were also significant improvements in the areas of pain on movement, pain at night and impairment of sleep. Clinical success was independent of the radiological aspect of the calcifications.

  20. Femur chondrosarcoma misdiagnosed as acute knee arthritis and osteomyelitis--further developing a hitherto unreported complication of tumor embolic ischemic ileal perforation after arthroscopic lavage.

    Science.gov (United States)

    Chow, Louis Tsun Cheung

    2014-12-01

    The differentiation between osteomyelitis and bone tumor may be difficult due to their overlapping clinical and radiological features. A 25-year-old lady presented with left knee pain and joint effusion associated with redness and hotness. A sub-optimally taken plain radiograph showed mixed osteolytic and osteoblastic lesion in the left lower femur with surrounding soft tissue swelling. Since the clinical diagnosis was acute osteomyelitis and arthritis, arthroscopic lavage was performed as a diagnostic and therapeutic procedure. The removed loose bodies and fibrinous tissue showed pathological features suspicious of chondrosarcoma. Subsequent MRI revealed an infiltrative tumor eroding through the cortex and joint cartilage. En bloc excision of the left lower femur, upper tibia including the knee joint and patella was performed, and the final diagnosis was grade 2 chondrosarcoma. The patient developed bilateral pulmonary metastasis 33 months after operation. Five months later, she suffered from a hitherto undescribed complication of ischemic perforation of the terminal ileum secondary to tumor embolic arterial obstruction with no macroscopic intestinal or peritoneal tumor deposit. The patient developed multiple brain metastases and died 43 months after initial presentation. Our case illustrates that malignant bone tumor as a differential diagnosis of acute osteomyelitis and arthritis merits recognition and exclusion before arthroscopic lavage, which may enhance tumor dissemination and in our patient results in embolic ischemic ileal perforation.

  1. Inflammatory mediators in nasal lavage among school-age children from urban and rural areas in São Paulo, Brazil

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    Clóvis Eduardo Santos Galvão

    Full Text Available CONTEXT: Some studies have shown that inflammatory processes in the nasal air passages may reflect or affect those in the lower airways. We decided to indirectly assess the inflammatory status of the nasal airways in two groups of children with different sensitization rates to aeroallergens. OBJECTIVE: To compare the inflammatory activity in the nasal airways, through the determination of mediators in nasal lavage fluid in two distinct populations. TYPE OF STUDY: Cross-sectional study. SETTING: Two public elementary schools, one in an urban setting and the other in a rural setting of the State of São Paulo, Brazil. METHODS: Two groups of 40 elementary school children with different sensitization rates to aeroallergens were formed. Samples of nasal lavage fluid were assessed for eosinophil cationic protein (ECP and tryptase. Non-parametric tests were used for statistical analysis. RESULTS: Significantly higher levels of ECP were observed among students living in the urban area than those in the rural area (p < 0.05. No significant difference in the tryptase levels was observed. Also, the urban children who were sensitized to aeroallergens presented higher levels of ECP in nasal mucosa than the non-sensitized children, while this difference was not observed among the rural children. DISCUSSION: The lack of mast cell activity and increased eosinophil degranulation revealed a chronic inflammatory state in the nasal air passages. The higher eosinophil activity in the urban area, coinciding with higher sensitization to aeroallergens, suggests that there must be some factors in the urban area that can modulate airway inflammation by influencing the activation of inflammatory cells. CONCLUSION: Our findings showed that there was no difference in the concentrations of tryptase in nasal lavage fluids between the two studied groups. However, the children from the urban area presented with higher concentrations of eosinophil cationic protein than did those

  2. Impact of bacterial vaginosis, as assessed by nugent criteria and hormonal status on glycosidases and lectin binding in cervicovaginal lavage samples.

    Directory of Open Access Journals (Sweden)

    Bernard J Moncla

    Full Text Available The objective of this study was to evaluate the impact of hormonal status and bacterial vaginosis (BV on the glycosidases present and glycosylation changes as assessed by lectin binding to cervicovaginal lavage constituents. Frozen cervicovaginal lavage samples from a completed study examining the impact of reproductive hormones on the physicochemical properties of vaginal fluid were utilized for the present study. In the parent study, 165 women were characterized as having BV, intermediate or normal microflora using the Nugent criteria. The presence of glycosidases in the samples was determined using quantitative 4-methyl-umbelliferone based assays, and glycosylation was assessed using enzyme linked lectin assays (ELLA. Women with BV had elevated sialidase, α-galactosidase, β-galactosidase and α-glucosidase activities compared to intermediate or normal women (P<0.001, 0.003, 0.006 and 0.042 respectively. The amount of sialic acid (Sambucus nigra, P = 0.003 and high mannose (griffithsin, P<0.001 were reduced, as evaluated by lectin binding, in women with BV. When the data were stratified according to hormonal status, α-glucosidase and griffithsin binding were decreased among postmenopausal women (P<0.02 when compared to premenopausal groups. These data suggest that both hormonal status and BV impact the glycosidases and lectin binding sites present in vaginal fluid. The sialidases present at increased levels in women with BV likely reduce the number of sialic acid binding sites. Other enzymes likely reduce griffithsin binding. The alterations in the glycosidase content, high mannose and sialic acid binding sites in the cervicovaginal fluid associated with bacterial vaginosis may impact susceptibility to viruses, such as HIV, that utilize glycans as a portal of entry.

  3. 持续灌洗引流治疗慢性骨髓炎护理分析%Continuous lavage drainage treatment of chronic osteomyelitis nursing analysis

    Institute of Scientific and Technical Information of China (English)

    郭云清

    2015-01-01

    目的:观察分析持续灌洗引流治疗慢性骨髓炎护理对术后恢复情况的影响,为临床治疗提供可靠依据。方法随机选取2012年—2014年分析30例慢性骨髓炎患者资料,本组患者均是先行病灶彻底清除手术,关闭创面之后进行敏感抗生素的持续灌洗引流。结果30例慢性脊髓炎经过持续灌洗引流之后,康复情况良好,并且对护理的满意度较高。结论在持续灌洗引流期间进行良好的护理,可以有效降低引流导管堵塞的概率,减少患者治疗时间,对患者康复具有积极意义。%Objective To observe the analysis of continuous irrigation drainage for the treatment of chronic osteomyelitis nursing effect on postoperative recovery, to provide reliable basis for clinical treatment.Methods Randomly selected from 2012-2014 to analyze the data of 30 cases of chronic osteomyelitis patients, all patients in the group is the first complete focal cleaning operation,continuous lavage closed wound drainage after the sensitive antibiotics.Results 30 cases of chronic inflammation of the spinal cord after continuous drainage,recovering well, and higher satisfaction with care.Conclusion Good nursing care during continuous lavage drainage, can effectively reduce the probability of the drainage catheter jam,reduce patient treatment time,the patient rehabilitation has a positive meaning.

  4. Expression of NKp46 Splice Variants in Nasal Lavage Following Respiratory Viral Infection: Domain 1-Negative Isoforms Predominate and Manifest Higher Activity

    Science.gov (United States)

    Shemer-Avni, Yonat; Kundu, Kiran; Shemesh, Avishai; Brusilovsky, Michael; Yossef, Rami; Meshesha, Mesfin; Solomon-Alemayehu, Semaria; Levin, Shai; Gershoni-Yahalom, Orly; Campbell, Kerry S.; Porgador, Angel

    2017-01-01

    The natural killer (NK) cell activating receptor NKp46/NCR1 plays a critical role in elimination of virus-infected and tumor cells. The NCR1 gene can be transcribed into five different splice variants, but the functional importance and physiological distribution of NKp46 isoforms are not yet fully understood. Here, we shed light on differential expression of NKp46 splice variants in viral respiratory tract infections and their functional difference at the cellular level. NKp46 was the most predominantly expressed natural cytotoxicity receptor in the nasal lavage of patients infected with four respiratory viruses: respiratory syncytia virus, adenovirus, human metapneumovirus, or influenza A. Expression of NKp30 was far lower and NKp44 was absent in all patients. Domain 1-negative NKp46 splice variants (i.e., NKp46 isoform d) were the predominantly expressed isoform in nasal lavage following viral infections. Using our unique anti-NKp46 mAb, D2-9A5, which recognizes the D2 extracellular domain, and a commercial anti-NKp46 mAb, 9E2, which recognizes D1 domain, allowed us to identify a small subset of NKp46 D1-negative splice variant-expressing cells within cultured human primary NK cells. This NKp46 D1-negative subset also showed higher degranulation efficiency in term of CD107a surface expression. NK-92 cell lines expressing NKp46 D1-negative and NKp46 D1-positive splice variants also showed functional differences when interacting with targets. A NKp46 D1-negative isoform-expressing NK-92 cell line showed enhanced degranulation activity. To our knowledge, we provide the first evidence showing the physiological distribution and functional importance of human NKp46 splice variants under pathological conditions. PMID:28261217

  5. Influence of Gastric Lavage on Blood Rheology of Patients with Oral Poisoning%洗胃对口服中毒患者血液流变学指标的影响

    Institute of Scientific and Technical Information of China (English)

    仲月霞; 赵丽文; 王亚婷; 张周良

    2001-01-01

    探讨洗胃对口服中毒患者血液流变学指标的影响。方法测定11例口服中毒患者洗胃前后血液流变学指标的变化,并以18例健康体检者做为正常对照。结果洗胃后多项血液粘滞度指标显著下降,红细胞刚性指数明显升高。结论中毒患者常规洗胃后血液处于低粘状态,是易于出现并发症的原因之一。%Objective To investigate the influence of gastric lavage on blood rheology of patients with oral poisoning. Methods Blood theology of 11 patients with oral poisoning was determined before and after gastric lavage. Eighteen healthy people were used as control. Results Blood viscosity,hematocrit and fibrinogen were remarkably decreased after gastric lavage. Conclusion Routine gastic lavage may result in decreased blood viscosity, posing likelihood of developing complications.

  6. Pulmonary levels of high-mobility group box 1 during mechanical ventilation and ventilator-associated pneumonia

    NARCIS (Netherlands)

    van Zoelen, Marieke A D; Ishizaka, Akitoshi; Wolthuls, Esther K; Choi, Goda; van der Poll, Tom; Schultz, Marcus J

    2008-01-01

    High-mobility group box (HMGB) 1 is a recently discovered proinflammatory mediator that contributes to acute lung injury. We determined HMGB-1 levels in bronchoalveolar lavage fluid of patients during mechanical ventilation (MV) and ventilator-associated pneumonia (VAP). Bronchoalveolar lavage fluid

  7. 社区获得性肺炎患者血清及支气管肺泡灌洗液中IL-6、IL-8和IL-10水平变化及其临床意义%The levels of IL-6,IL-8 and IL-10 in serum and bronchoalveolar lavage fluid in patients with community-acquired pneumonia and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    丁静; 魏希强; 孙伟

    2015-01-01

    目的::探讨社区获得性肺炎( CAP)患者血清和支气管肺泡灌洗液( BALF)中炎症因子白细胞介素( IL)-6、IL-8和IL-10水平的变化及其临床意义。方法:选取CAP患者50例( CAP组),入院第1天进行临床肺部感染评分,0.05);而CAP组血清中IL-8水平在入院第30天仍保持较高水平,显著高于对照组(P0. 05). The level of IL-8 in serum of CAP patients remained at a high level on day 30 of admission,which was significantly higher than that in control group(P <0. 01). Conclusions:The IL-6,IL-8 and IL-10 were involved in the pathogenesis of community-acquired pneumonia. The levels of IL-6 and IL-10 in serum and levels of IL-6,IL-8 and IL-10 in BALF can reflect the severity of pulmonary infection. The detection of IL-6,IL-8 and IL-10 in serum has certain clinical value in the early diagnosis of CAP.

  8. 急性有机磷中毒洗胃的护理体会%The experience of nursing for gastric lavage for acute organophosphate poisoning

    Institute of Scientific and Technical Information of China (English)

    王学君

    2012-01-01

      目的探讨并分析对急性有机磷中毒患者进行洗胃的方法及临床效果。方法对于2005年9月至2010年12月间在我院就诊的30例急性有机磷中毒患者的临床资料进行回顾性分析。通过随机的方式将30例患者分为试验组和对照组两组,其中试验组患者15例,对照组患者15例。对试验组的患者通过对胃管进行留置进而反复进行洗胃的方法进行洗胃护理,对照组的患者则接受传统方法进行洗胃护理。比较两组护理临床效果。结果试验组患者的护理总有效率高于对照组,且不良反应少于对照组。结论对急性有机磷中毒患者通过留置反复洗胃的方法可以起到良好的临床效果,值得在临床是进一步的研究和应用。%  Objective: To discuss the different methods and clinical effect of nursing for gastric lavage for acute organophosphate poisoning. Methods: Choosed 60 cases of acute organophosphate poisoning from Sep. 2005 to Dec. 2010 to analyze retrospectly. Divided these 30 patients into study group and controled group for 15 in each other. The study group were treated with gastric tuber detaining for repeating gastric lavage, while controled group were treated with routine methods. Compared the clinical effect of these two groups. Results:The total rate of nursing of study group was higher than controled group with less adverse effect. Conclusion: The clinical effect of using repeating organophosphate poisoning is good to extend in clinical.

  9. Evaluation of Xpert® MTB/RIF Assay in Induced Sputum and Gastric Lavage Samples from Young Children with Suspected Tuberculosis from the MVA85A TB Vaccine Trial.

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    Erick Wekesa Bunyasi

    Full Text Available Diagnosis of childhood tuberculosis is limited by the paucibacillary respiratory samples obtained from young children with pulmonary disease. We aimed to compare accuracy of the Xpert® MTB/RIF assay, an automated nucleic acid amplification test, between induced sputum and gastric lavage samples from young children in a tuberculosis endemic setting.We analyzed standardized diagnostic data from HIV negative children younger than four years of age who were investigated for tuberculosis disease near Cape Town, South Africa [2009-2012]. Two paired, consecutive induced sputa and early morning gastric lavage samples were obtained from children with suspected tuberculosis. Samples underwent Mycobacterial Growth Indicator Tube [MGIT] culture and Xpert MTB/RIF assay. We compared diagnostic yield across samples using the two-sample test of proportions and McNemar's χ2 test; and Wilson's score method to calculate sensitivity and specificity.1,020 children were evaluated for tuberculosis during 1,214 admission episodes. Not all children had 4 samples collected. 57 of 4,463[1.3%] and 26 of 4,606[0.6%] samples tested positive for Mycobacterium tuberculosis on MGIT culture and Xpert MTB/RIF assay respectively. 27 of 2,198[1.2%] and 40 of 2,183[1.8%] samples tested positive [on either Xpert MTB/RIF assay or MGIT culture] on induced sputum and gastric lavage samples, respectively. 19/1,028[1.8%] and 33/1,017[3.2%] admission episodes yielded a positive MGIT culture or Xpert MTB/RIF assay from induced sputum and gastric lavage, respectively. Sensitivity of Xpert MTB/RIF assay was 8/30[26.7%; 95% CI: 14.2-44.4] for two induced sputum samples and 7/31[22.6%; 11.4-39.8] [p = 0.711] for two gastric lavage samples. Corresponding specificity was 893/893[100%;99.6-100] and 885/890[99.4%;98.7-99.8] respectively [p = 0.025].Sensitivity of Xpert MTB/RIF assay was low, compared to MGIT culture, but diagnostic performance of Xpert MTB/RIF did not differ sufficiently between

  10. The interaction between rocuronium in lung lavage in recovery of tube drawing application experience%罗库溴铵在肺灌洗术中复苏拔管时的应用体会

    Institute of Scientific and Technical Information of China (English)

    肖旭; 李光才; 陆英

    2016-01-01

    Objective:To study the interaction between rocuronium applied in lung lavage in the feasibility of tracheal extubation as soon as possible.Methods:in this paper,our hospital lung lavage in 40 patients with lung lavage,randomly divided into two groups:the interaction between rocuronium group (group A) and vecuronium bromide group (group B) to observe the two groups of patients with postoperative muscle relaxant recovery time. Results:compared with control group,the recovery time is less than group B,group A difference compared with the control group with statistical significance (P<0.05).Conclusion:the interaction between rocuronium is applied in the lung were muscle relaxant condition satisfied,fast recovery of muscle strength,wake up fast,can be used as lung lavage and muscle relaxants.%目的:探讨罗库溴铵应用于肺灌洗术中尽快气管拔管的可行性。方法:本文对某医院肺灌洗术中肺灌洗患者40例,随机分罗库溴铵组(A组)和维库溴铵组(B组),观察两组患者术后肌松恢复时间。结果:与对照组相比,A组的恢复时间小于B组,与对照组相比差异具有统计学意义(P<0.05)。结论:罗库溴铵应用于肺灌洗术肌松条件满意,术后肌力恢复迅速,苏醒快,可作为肺灌洗术的肌松药。

  11. Impact of ambroxol hydrochloride combined with bronchoscope lavage on level of lung function of patients with severe pulmonary infections%重症肺部感染患者盐酸氨溴索气管镜灌洗对肺功能水平的影响研究

    Institute of Scientific and Technical Information of China (English)

    尚茜; 商伟娜; 翟琳; 刘淑娟; 李娟

    2015-01-01

    目的:研究盐酸氨溴索联合气管镜灌洗对重症肺部感染患者血氧分压(PaO2)、氧合指数(PaO2/FiO2)及血液氧饱和度(SaO2)等水平的影响,为临床治疗提供参考依据。方法选取2012年10月-2013年10月收治的重症肺部感染行气管切开的患者92例,随机将其分为观察组及对照组,每组46例;对照组患者静脉滴入盐酸氨溴索治疗,观察组在对照组基础上联合纤维支气管镜对支气管肺泡进行灌洗以及吸痰治疗,对比两组患者PaO2、PaO2/FiO2及SaO2等水平变化,数据采用 SPSS 13.0软件进行统计分析。结果观察组患者治疗后 PaO2、PaO2/FiO2及SaO2等水平显著高于治疗前,及对照组治疗后,差异均有统计学意义(P<0.05);观察组患者有效率为93.48%,高于对照组的69.57%,差异有统计学意义( P<0.05)。结论盐酸氨溴索联合气管镜可有效改善重症肺部感染患者PaO2、PaO2/FiO2及SaO2等水平,并缩短各项治疗时间,提高临床治疗效果。%OBJECTIVE To study the impact of ambroxol hydrochloride combined with bronchoscope lavage on the levels of partial pressure of arterial oxygen (PaO2 ) ,the ratio of the partial pressure of oxygen to the inspired frac‐tion of oxygen (PaO2/FiO2 ) ,and arterial oxygen saturation (SaO2 ) of the patients with severe pulmonary infec‐tions so as to provide guidance for the clinical treatment .METHODS A total of 92 patients with severe pulmonary infections who underwent the tracheotomy from Oct 2012 to Oct 2013 were enrolled in the study and randomly di‐vided into the observation group and the control group ,with 46 cases in each .The control group was treated with ambroxol hydrochloride ,while the observation group was treated with ambroxol hydrochloride combined with bronchofibroscope for bronchoalveolar lavage and was treated with sputum suction ,and the statistical analysis was performed with the

  12. 抗纤维化治疗对大鼠支气管肺泡灌洗液中头孢噻肟浓度的影响%Effect of Anti-fibrosis treatment on the Concentration of Cefotaxim in Bronchioalveolar Lavage Fluid in Rats with Bleomycin-Induced Pulmonary Fibrosis

    Institute of Scientific and Technical Information of China (English)

    陈峰

    2011-01-01

    Objective To observe the effect of anti-fibrosis drug on the concentration of cefotaxim in bronchioalveolar lavage fluid.Methods 90 Wister male rats were randomly divided into five groups, including normal control( Group A) 、model( Group B) 、interferon-γ-troated( Group C) 、ambroxol-treated ( Group D) 、Dexamethason-treated( Group E) group.On experimengtal day( day 0), the rats in B,C,D and E were intratracheally instilled with bleomycin(5 mg/Kg body weght) or sterile saline, and then the rats in C, D and E were treated with the interferon-γ(30000 IU/per mouse), ambroxol(75 mg/per mouse), Dexamethason(0.1 mg/per mouse) or sterile saline intraperitoneally respectively.On day 7,14,28 after instillation, six rats form each group were then given a tail vein injection of cefotaxime (600 mg/kg) and bronchoalveolar lavage.The concentration of cefotaxim in the the bronchial alveolar fluids was assayed by liquid chromatography-massspectrometry method.Results On day 7 the concentration of cefotaxim in the the bronchial alveolar fluids of Group D,Group E was lower than Group B and those of Group C higher than group B.The difference between Group E and Group B was significant statistically(P =0.012.On day 14 the concentration of cefotaxim in the the bronchial alveolar fluids of Group D, Group E increased,while Group C decreased.The three groups were all higher than Group B.The diferonce between Group D and Group B was significant statistically( P = 0.000.On day 28 the concentration of cefotaxim in the the bronchial alveolar fluids of Group E increased continuously,which was significanfiy higher than other groups.Group C and Group D decreased continuously, and the concentration of cefotaxim of both groups was lower than Group B.Conclusion Dexamethason could increase the concentration of cefotaxim in the the bronchial alveolar fluids of the fibrosis stage.%目的 观察抗肺纤维化药物对支气管肺泡灌洗液(BALF)中头孢噻肟浓度的影响.方法 将90只

  13. 急诊洗胃中舒适护理的效果分析%Analysis on the effect of comfortable nursing in the emergency gastric lavage

    Institute of Scientific and Technical Information of China (English)

    陈莉

    2013-01-01

    Objective To investigate the clinical effect of gastric lavage in poisoning patients with comfortable nursing in the emergency department. Methods 122 cases of patients with oral poisoning were selected from May 2010 to June 2012 in our hospital emergency department,they were divided into observation group and control group according to different nursing methods,there were 61 cases in each group, two groups of patients were given routine nursing care, routine care and comfort care. Satisfaction rate, degree of comfort and fit, pain. Of two groups were compared. Results Satisfaction rate and the cooperation degree of observation group were significantly higher than control group, the incidence of nausea and vomiting, restlessness were lower, there were significant differences between two groups(P < 0.05). The proportion of Mild pain patients in the observation group were significantly higher than control group , there were significant differences between two groups(P<0.05). Conclusion Patients with poisoning implement comfortable nursing to the psychological and physiological state in good emergency gastric lavage, to eliminate the fear of patients, reduce the discomfort and adverse reaction occurs has important clinical significance to reduce the rate of side effect.%目的探讨对急诊科中毒洗胃患者实施舒适护理后的临床效果。方法收集2010年5月~2012年6月来我院急诊科就诊的口服中毒患者122例,根据不同的护理方法分为观察组及对照组,每组各有61例,两组患者分别实施常规护理、常规护理及舒适护理。比较两组患者的满意率、舒适度及配合度、疼痛情况。结果观察组患者与对照组比较,满意率及配合度明显较高,恶心呕吐、烦躁不安的发生率明显较低,差异具有统计学意义(P<0.05)。观察组中轻度疼痛患者所占的比例与对照组比较明显较高,差异具有统计学意义(P<0.05)。结论中毒患者在

  14. Lavage with allicin in combination with vancomycin inhibits biofilm formation by Staphylococcus epidermidis in a rabbit model of prosthetic joint infection.

    Directory of Open Access Journals (Sweden)

    Haohan Zhai

    Full Text Available BACKGROUND AND AIM: The present anti-infection strategy for prosthetic joint infections (PJI includes the use of antibiotics and surgical treatments, but the bacterial eradication rates are still low. One of the major challenges is the formation of biofilm causing poor bacterial eradication. Recently it has been reported that allicin (diallyl thiosulphinate, an antibacterial principle of garlic, can inhibit bacteria adherence and prevent biofilm formation in vitro. However, whether allicin could inhibit biofilm formation in vivo is unknown. The aim of this study was to investigate the effects of allicin on biofilm formation, and whether allicin could potentiate the bactericidal effect of vancomycin in a rabbit PJI model. METHODS: A sterile stainless-steel screw with a sterile ultra-high molecular weight polyethylene washer was inserted into the lateral femoral condyle of the right hind knee joint of rabbit, and 1 mL inoculum containing 104 colony-forming units of Staphylococcus epidermidis was inoculated into the knee joint (n = 32. Fourteen days later, rabbits randomly received one of the following 4 treatments using continuous lavages: normal saline, vancomycin (20 mcg/mL, allicin (4 mg/L, or allicin (4 mg/L plus vancomycin (20 mcg/mL. Three days later, the washer surface biofilm formation was examined by scanning electron microscopy (SEM. The bacterial counts within the biofilm of implanted screws were determined by bacterial culture. RESULTS: The lowest number of viable bacterial counts of Staphylococcus epidermidis recovered from the biofilm was in the rabbits treated with allicin plus vancomycin (P<0.01 vs. all other groups. The biofilm formation was significantly reduced or undetectable by SEM in rabbits receiving allicin or allicin plus vancomycin. CONCLUSION: Intra-articular allicincan inhibit biofilm formation and enhance the bactericidal effect of vancomycin on implant surface in vivo. Allicin in combination with vancomycin may be

  15. Beer as colon lavage preparation

    Energy Technology Data Exchange (ETDEWEB)

    Kinnunen, J.; Linden, H.; Pietilae, J.; Juutilainen, T.

    1987-09-01

    Six patients received beer preparation prior to double contrast barium enema. The beer group scored slightly better (though not statistically significantly) both in the cleanliness and in the mucosal coating of the bowel than the control group with standard preparation. The fluid balance was unaltered. The patients in the beer group felt surprisingly well, likely due to the good fluid and energy balance provided by the beer. The beer preparation could be used in cases, when the patients are ready to intake beer and want to maintain a good nutritional status.

  16. Whole Lung Lavage Treatment of Chinese Patients with Autoimmune Pulmonary Alveolar Proteinosis:A Retrospective Long-term Follow-up Study

    Institute of Scientific and Technical Information of China (English)

    Yu-Yue Zhao; Hui Huang; Yong-Zhe Liu; Xin-Yu Song; Shan Li; Zuo-Jun Xu

    2015-01-01

    Background:Pulmonary alveolar proteinosis (PAP) is a rare lung disease,the most common type of which is autoimmune PAP.The gold standard therapy for PAP is whole lung lavage (WLL).Few studies have reported the optimal technique with which to evaluate the response to WLL.In this study,we aimed to identify parameters with which to assess the need for repeat WLL during a long-term 8-year follow-up.Methods:We conducted a retrospective analysis of 120 patients with autoimmune PAP with 80 of whom underwent WLL.Physiologic,serologic,and radiologic features of the patients were analyzed during an 8-year follow-up after the first WLL treatment.Results:Of the 40 patients without any intervention,39 patients either achieved remission or remained stable and only one died of pulmonary infection.Of the 56 patients who underwent WLL for 1 time,55 remained free from a second WLL and 1 patient died of cancer.Twenty-four required additional treatments after their first WLL.The baseline PaO2 (P =0.000),PA-aO2 (P =0.000),shunt fraction rate (P =0.00 1),percent of predicted normal diffusing capacity of the lung for carbon monoxide (DLCO%Pred) (P =0.016),6-min walk test (P =0.013),carcinoembryonic antigen (CEA) (P =0.007),and neuron-specific enolase (NSE) (P =0.003) showed significant differences among the three groups.The need for a second WLL was significantly associated with PaO2 (P=0.000),CEA (P =0.050),the 6-minute walk test (P =0.026),and DLCO%Pred (P =0.041).The DLCO%Pred on admission with a cut-offvalue of42.1% (P =0.001) may help to distinguish whether patients with PAP require a second WLL.Conclusions:WLL is the optimal treatment method for PAP and provides remarkable improvements for affected patients.The DLCO%Pred on admission with a cut-off value of 42.1% may distinguish whether patients with PAP require a second WLL.

  17. Respiratory compliance but not gas exchange correlates with changes in lung aeration after a recruitment maneuver: an experimental study in pigs with saline lavage lung injury

    Science.gov (United States)

    Henzler, Dietrich; Pelosi, Paolo; Dembinski, Rolf; Ullmann, Annette; Mahnken, Andreas H; Rossaint, Rolf; Kuhlen, Ralf

    2005-01-01

    Introduction Atelectasis is a common finding in acute lung injury, leading to increased shunt and hypoxemia. Current treatment strategies aim to recruit alveoli for gas exchange. Improvement in oxygenation is commonly used to detect recruitment, although the assumption that gas exchange parameters adequately represent the mechanical process of alveolar opening has not been proven so far. The aim of this study was to investigate whether commonly used measures of lung mechanics better detect lung tissue collapse and changes in lung aeration after a recruitment maneuver as compared to measures of gas exchange Methods In eight anesthetized and mechanically ventilated pigs, acute lung injury was induced by saline lavage and a recruitment maneuver was performed by inflating the lungs three times with a pressure of 45 cmH2O for 40 s with a constant positive end-expiratory pressure of 10 cmH2O. The association of gas exchange and lung mechanics parameters with the amount and the changes in aerated and nonaerated lung volumes induced by this specific recruitment maneuver was investigated by multi slice CT scan analysis of the whole lung. Results Nonaerated lung correlated with shunt fraction (r = 0.68) and respiratory system compliance (r = 0.59). The arterial partial oxygen pressure (PaO2) and the respiratory system compliance correlated with poorly aerated lung volume (r = 0.57 and 0.72, respectively). The recruitment maneuver caused a decrease in nonaerated lung volume, an increase in normally and poorly aerated lung, but no change in the distribution of a tidal breath to differently aerated lung volumes. The fractional changes in PaO2, arterial partial carbon dioxide pressure (PaCO2) and venous admixture after the recruitment maneuver did not correlate with the changes in lung volumes. Alveolar recruitment correlated only with changes in the plateau pressure (r = 0.89), respiratory system compliance (r = 0.82) and parameters obtained from the pressure-volume curve

  18. In Vitro Exposure to PC-1005 and Cervicovaginal Lavage Fluid from Women Vaginally Administered PC-1005 Inhibits HIV-1 and HSV-2 Infection in Human Cervical Mucosa.

    Science.gov (United States)

    Villegas, Guillermo; Calenda, Giulia; Zhang, Shimin; Mizenina, Olga; Kleinbeck, Kyle; Cooney, Michael L; Hoesley, Craig J; Creasy, George W; Friedland, Barbara; Fernández-Romero, José A; Zydowsky, Thomas M; Teleshova, Natalia

    2016-09-01

    Our recent phase 1 trial demonstrated that PC-1005 gel containing 50 μM MIV-150, 14 mM zinc acetate dihydrate, and carrageenan (CG) applied daily vaginally for 14 days is safe and well tolerated. Importantly, cervicovaginal lavage fluid samples (CVLs) collected 4 or 24 h after the last gel application inhibited HIV-1 and human papillomavirus (HPV) in cell-based assays in a dose-dependent manner (MIV-150 for HIV-1 and CG for HPV). Herein we aimed to determine the anti-HIV and anti-herpes simplex virus 2 (anti-HSV-2) activity of PC-1005 in human cervical explants after in vitro exposure to the gel and to CVLs from participants in the phase 1 trial. Single HIV-1BaL infection and HIV-1BaL-HSV-2 coinfection explant models were utilized. Coinfection with HSV-2 enhanced tissue HIV-1BaL infection. In vitro exposure to PC-1005 protected cervical mucosa against HIV-1BaL (up to a 1:300 dilution) in single-challenge and cochallenge models. CG gel (PC-525) provided some barrier effect against HIV-1BaL at the 1:100 dilution in a single-challenge model but not in the cochallenge model. Both PC-1005 and PC-525 at the 1:100 dilution inhibited HSV-2 infection, pointing to a CG-mediated protection. MIV-150 and CG in CVLs inhibited HIV (single-challenge or cochallenge models) and HSV-2 infections in explants in a dose-dependent manner (P < 0.05). Stronger inhibition of HIV-1 infection by CVLs collected 4 h after the last gel administration was observed compared to infection detected in the presence of baseline CVLs. The anti-HIV and anti-HSV-2 activity of PC-1005 gel in vitro and CVLs in human ectocervical explants supports the further development of PC-1005 gel as a broad-spectrum on-demand microbicide.

  19. Peritoneal lavage fluid′s temperature′s affections to neonate′s abdominal postoperative recovery%腹腔冲洗液温度对新生儿腹部手术术后恢复的影响

    Institute of Scientific and Technical Information of China (English)

    高秀珍; 纪会娟; 王彦华; 尹维宁; 刘学英; 石磊

    2012-01-01

    目的:探讨腹腔冲洗液的温度对新生儿腹部手术术后恢复的影响.方法:选择剖腹手术80例,随机分为观察组和对照组,每组40例,对照组腹腔冲洗液的温度与室温相同,即22 ~24 ℃,观察组腹腔冲洗液的温度为37 ℃.均用生理盐水1000 ml冲洗,分别记录手术开始前和腹腔冲洗后20 min的肛温、血压、心率以及术后拔出气管插管时间暨完全清醒时间、体温不升、硬肿症的发生情况,进行统计学分析.结果:两组新生儿一般情况比较无明显差异P>0.05.两组患儿不同温度冲洗液治疗后体温、心率比较有明显差异,P<0.05.由于血压受诸多因素的影响,故在此未作比较.对照组患儿术后拔出气管插管时间暨完全清醒时间较实验组延长约21 min,两组比较P<0.01,有明显差异,对照组术后出现体温不升、硬肿的比率明显增加P<0.05有明显差异.结论:腹腔冲洗液加温至37 ℃有利于新生儿术后恢复.%Objective:To explorer the peritoneal lavage fluid's temperature effection on neonatal abdominal postoperative recovery. Methods:80 cases of Lap-arotomy were randomly divided into control group and the experimental group,40 cases in each group. The control group's peritoneal lavage fluid temperature is 22 -24 ℃ ,the same as room temperature. The experimental group's peritoneal lavage fluid's temperature is 37 ℃. Each group used 1000 ml saline to rinse. Each group recorded the rectal temperature, blood pressure, heart rate before surgery and 20 minutes after peritoneal lavage, and recorded postoperative extubation time, awake time, body temperature does not rise, scleredema occurrence, then had statistical analysis. Results: There was no significant difference of normal status in two groups. The temperature and heart has remarkable differentce of two groups after peritoneal lavage with difference temperature. The control group after surgery ( extubated time ) awake time was delay about 21

  20. Genomic Analysis of Uterine Lavage Fluid Detects Early Endometrial Cancers and Reveals a Prevalent Landscape of Driver Mutations in Women without Histopathologic Evidence of Cancer: A Prospective Cross-Sectional Study

    Science.gov (United States)

    Camacho, Sandra Catalina; Schumacher, Cassie A.; Irish, Jonathan C.; Harkins, Timothy T.; Belfer, Rachel; Kalir, Tamara; Reva, Boris; Dottino, Peter; Martignetti, John A.

    2016-01-01

    Background Endometrial cancer is the most common gynecologic malignancy, and its incidence and associated mortality are increasing. Despite the immediate need to detect these cancers at an earlier stage, there is no effective screening methodology or protocol for endometrial cancer. The comprehensive, genomics-based analysis of endometrial cancer by The Cancer Genome Atlas (TCGA) revealed many of the molecular defects that define this cancer. Based on these cancer genome results, and in a prospective study, we hypothesized that the use of ultra-deep, targeted gene sequencing could detect somatic mutations in uterine lavage fluid obtained from women undergoing hysteroscopy as a means of molecular screening and diagnosis. Methods and Findings Uterine lavage and paired blood samples were collected and analyzed from 107 consecutive patients who were undergoing hysteroscopy and curettage for diagnostic evaluation from this single-institution study. The lavage fluid was separated into cellular and acellular fractions by centrifugation. Cellular and cell-free DNA (cfDNA) were isolated from each lavage. Two targeted next-generation sequencing (NGS) gene panels, one composed of 56 genes and the other of 12 genes, were used for ultra-deep sequencing. To rule out potential NGS-based errors, orthogonal mutation validation was performed using digital PCR and Sanger sequencing. Seven patients were diagnosed with endometrial cancer based on classic histopathologic analysis. Six of these patients had stage IA cancer, and one of these cancers was only detectable as a microscopic focus within a polyp. All seven patients were found to have significant cancer-associated gene mutations in both cell pellet and cfDNA fractions. In the four patients in whom adequate tumor sample was available, all tumor mutations above a specific allele fraction were present in the uterine lavage DNA samples. Mutations originally only detected in lavage fluid fractions were later confirmed to be present

  1. 活性炭洗胃应用于百草枯中毒的疗效观察%The Effect Observation on Applying Gastric Lavage in Combination with Activated Charcoal to Paraquat Pois ioning

    Institute of Scientific and Technical Information of China (English)

    李仲春

    2012-01-01

      目的研究不同的洗胃方法对治疗百草枯中毒疗效的影响.方法在常规治疗的基础上,实验组用活性炭粉末和碳酸氢钠分别加入温水中洗胃;对照组单纯用温水洗胃.结果实验组痊愈率为25%,对照组为6.7%;死亡率实验组为8.3%,对照组为21.6%.肝、肾功能损害的发生率实验组为3.3%,对照组为41.7%.结论活性炭洗胃是影响百草枯中毒患者病情发展的重要因素,并可赢得进一步治疗如血液灌流的最佳时机,从而提高患者的生存率.%  Objective To research the effect of diverse treatments on gastric lavage to paraquat poisioning. Method On the basis of routine therapy, experimental group do gastric lavage with warm water containing activated charocal powder and sodium bicardbonate, while control group merely uses warm water in gastric lavage. Results of experimental group is 25% in comparison with control group's 6.7%. Experimental group's death rate is 8.3% while the rate is 21.6% in control group. The incidence of liver and kindney function lesion in experimental group is 3.3%, but 41.7% in control group. Conclusion Gastric lavage in combination with activated charcoal has foundamental impact on the progress of paraquat poisioning, based on which, the survival rate can be raised for better oppotunity of futher treatment,like hemoperfusion.

  2. Lipopolysaccharide-induced pulmonary inflammation is not accompanied by a release of anandamide into the lavage fluid or a down-regulation of the activity of fatty acid amide hydrolase

    DEFF Research Database (Denmark)

    Holt, S.; J. Fowler, C.; Rocksén, D.;

    2004-01-01

    The effect of lipopolysaccharide inhalation upon lung anandamide levels, anandamide synthetic enzymes and fatty acid amide hydrolase has been investigated. Lipopolysaccharide exposure produced a dramatic extravasation of neutrophils and release of tumour necrosis factor a into the bronchoalveolar......-acyltransferase and N-acylphosphatidylethanolamine phospholipase D and the activity of fatty acid amide hydrolase in lung membrane fractions did not change significantly following the exposure to lipopolysaccharide. The non-selective fatty acid amide hydrolase inhibitor phenylmethylsulfonyl fluoride was a less potent...... inhibitor of lung fatty acid amide hydrolase than expected from the literature, and a dose of 30 mg/kg i.p. of this compound, which produced a complete inhibition of brain anandamide metabolism, only partially inhibited the lung metabolic activity. © 2004 Elsevier Inc. All rights reserved....

  3. Effects of fluticasone propionate inhalation on levels of arachidonic acid metabolites in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Gert T. Verhoeven

    2001-01-01

    Full Text Available Background: In smoking COPD patients the bronchoalveolar lavage (BAL fluid contains high numbers of inflammatory cells. These cells might produce arachidonic acid (AA metabolites, which contribute to inflammation and an increased bronchomotor tone.

  4. Diffuse pulmonary infiltrates in immunocompromised patients

    NARCIS (Netherlands)

    Fijen, JW; van der Werf, TS; Ligtenberg, JJM; Tulleken, JE; Zijlstra, JG

    1999-01-01

    The differential diagnosis of bilateral interstitial pulmonary infiltrates in immunocompromised patients is very extensive. We describe two immunocompromised patients with diffuse pulmonary infiltrative changes. Bronchoscopic bronchoalveolar lavage after orotracheal intubation using topical anaesthe

  5. INTERSTITIAL LUNG-DISEASE AND MYOSITIS IN A PATIENT WITH SIMULTANEOUSLY OCCURRING SARCOIDOSIS AND SCLERODERMA

    NARCIS (Netherlands)

    GROEN, H; POSTMA, DS; KALLENBERG, CGM

    1993-01-01

    A patient initially presented with sarcoidosis in combination with myositis of sarcoid origin and Raynaud's phenomenon. During the course of his disease, he additionally developed scleroderma. Bronchoalveolar lavage, performed because of increase of interstitial markings in the presence of enlarged

  6. Pseudo-outbreak of pseudomonas aeruginosa in HIV-infected patients undergoing fiberoptic bronchoscopy

    DEFF Research Database (Denmark)

    Kolmos, H J; Lerche, A; Kristoffersen, Kirsten Lydia;

    1994-01-01

    Pseudomonas aeruginosa was isolated from bronchoalveolar lavage fluid from 8 consecutive patients undergoing bronchoscopy at an infectious diseases unit. None of the patients developed signs of respiratory tract infection that could be ascribed to the organism. The source of contamination...

  7. Cavitary Lung Disease in an HIV-Positive Patient

    Science.gov (United States)

    2009-04-01

    tuberculosis with three acid-fast bacillus (AFB) smears and cultures. Bronchoalveolar lavage and subsequent respiratory sputum cultures were...polymicrobial; the two most common organisms are Pseudomonas aeruginosa and Staphylococcus aureus [1] [5]. Mycobacterium avium complex, Candida albicans

  8. Clinical study of Shenling lavage solution on Nasopharyngeal lavation for 52 children with adenoid hypertrophy%参苓灌洗液治疗儿童腺样体肥大的临床观察

    Institute of Scientific and Technical Information of China (English)

    朱镇华; 江永忠

    2011-01-01

    目的 观察参芩灌洗液鼻咽腔灌洗治疗儿童腺样体肥大伴慢性鼻窦炎的疗效.方法 采用参苓灌洗液鼻咽腔灌洗治疗儿童腺样体肥大伴慢性鼻窦炎52例为治疗组,设对照组西药治疗51例,对比观察其临床疗效.结果 治疗组总有效率为94.2%,对照组为78.1%,差异有统计学意义(P<0.05).结论 参苓灌洗液局部灌洗有明显促进腺样体缩小和治疗鼻窦炎的作用.%Objective To investigate the curative effects of Shenling lavage solution on na-sopharyngeal lavation in children with adenoid hypertrophy accompanied with chronic sinusitis. Methods 52 patients were treated with this therapy in treatment group; other 51 children were treated with western medicine in control group. The curative effects were compared between two groups. Results The total effective rate was 94.2% in treatment group and 78.1% in control group (P<0.05). Conclusion The therapy of local lavation with Shenling lavage solution is effective to shrink the adenoid and cure the sinuses.

  9. 全肺灌洗治疗尘肺远期疗效评价%Long-term therapeutic effects of whole lung lavage in the management of silicosis

    Institute of Scientific and Technical Information of China (English)

    张映铭; 张海涛; 王彩英; 王伟; 吴静; 王春

    2012-01-01

    矽肺应慎重选择WLL.%Objective To investigate the long-term therapeutic effect of whole lung lavage (WLL) in the treatment of silicosis.Methods A total of 70 patients with silicosis were randomly and equally divided into WLL group and control group based on chest X-ray,silicosis staging,age,and working age of dust exposure.Comparative analysis was performed to evaluate the long-term therapeutic effect of WLL.Moreover,157 patients with silicosis treated by WLL were subject to long-term follow-up.Results Two years after treatment,the cough,expectoration,and asthma improvement rates of the WLL group were 62.5%,75.0%,and 81.8%,respectively,significantly higher than those (24.0%,23.8%,and 26.3%) of the control group (P<0.05).Four years after treatment,the asthma improvement rate (59.1%) of the WLL group was significantly higher than that (21.1%) of the control group (P<0.05).The WLL group showed slight decrease in forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) after treatment (P>0.05),while the control group showed significant decrease in FVC and FEV1 after treatment (P<0.05 or P<0.01).Two and four years after treatment,the WLL group had higher no change rate and lower progression rate and significant progression rate than the control group in terms of chest X-ray (P>0.05).22 cases of accelerated silicosis in the WLL group had significantly higher no change rate than the control group with respect to chest X-ray (75.0% vs.30.0%; 58.3% vs.20.0%).The WLL group had lower progression rate (2 years of treatment) and significant progression rate (4 years after treatment) than the control group (16.7% vs.50.0%,P<0.05; 8.3% vs.30.0%,P<0.05).Followup of 59 cases treated by WLL showed that the cough and asthma improvement rates were 74.4% and 76.3% 2~3 years after treatment and remained 55.0%~57.1% 4~5 years and 6~7 years after treatment.Follow-up of 85 cases treated by WLL showed that FVC remained unchanged or

  10. 漂白土洗胃联合清胰Ⅱ号导泻对口服百草枯中毒兔的治疗观察%Therapeutic effects of gastric lavage with fuller earth combined with QingyiⅡ catharsis in treatment of oral paraquat poisoning in rabbits

    Institute of Scientific and Technical Information of China (English)

    陆元兰; 周满红; 胡杰; 李建国

    2015-01-01

    ObjectiveTo observe the therapeutic effects of gastric lavage with fuller earth combined with QingyiⅡ catharsis in treatment of oral paraquat poisoning in rabbits.Methods Thirty healthy adult Japanese white rabbits were randomly divided into five groups: namely control group, model group, gastric lavage group (lavage of 10%fuller earth suspension), catharsis group (QingyiⅡ catharsis), and combination group (10 minutes after gastric lavage of fuller earth suspension liquid, giving QingyiⅡ for catharsis), with 6 rabbits in each group. All groups were challenged with paraquat (100 mg/kg) diluted to 5 mL with normal saline by lavage to reproduce the model of acute poisoning, while the control group was given 5 mL of normal saline instead. Each treatment group was treated accordingly at 1 hour after gavages of paraquat, and treatment continued for 3 days. The animal survival rate was observed. Venous blood samples were collected from ear marginal vein to determine the plasma concentration of paraquat by ultraviolet spectrophotometer at 1, 2, 4, 8 and 24 hours after the poisoning. The animals were sacrificed by intravenous air injection on the 8th day after the poisoning, and the right lower lobe of lung was harvested to observe the lung tissue pathological changes with hematoxylin-eosin (HE) staining.Results① Survival rate: the surviving rate of the combination group (6 rabbits) was higher than that of gastric lavage group (5 rabbits), catharsis group (2 rabbits) and model group (0 rabbit) on the 2nd day with statistically significant difference (P< 0.001). The survival rate on the 7th day in combination group (5 rabbits) was higher than that of gastric lavage group (3 rabbits), and catharsis group (0 rabbit) with statistically significant difference (P = 0.003).② Plasma concentrations of paraquat: plasma paraquat concentration in all groups peaked at 2 hours after intoxication, and its levels in the gastric lavage, catharsis and combination groups were

  11. Application of Pulsed Lavage in lumbar posterior single-segment fusion surgery%高压脉冲冲洗在腰椎后路手术中的临床应用

    Institute of Scientific and Technical Information of China (English)

    文天用; 阳普山; 季伟; 张超; 何勍

    2014-01-01

    Objective To investigate the clinical efficacy of Pulsed Lavage in lumbar posterior single-segment fu-sion surgery. Methods Eighty patients diagnosed with single-segment lumbar disc herniation or lumbar spinal stenosis and needed a surgery treatment were assigned to receive surgical flush with either pulsed lavage (observation group, n=40) or artificial dumping rinse(the control group, n=40).The surgical flush time, the nature and volume of fluid drainage, the In-flammatory factors(TNF-α, IL-1、6) of the fluid drainage in the 2th day, the Erythrocyte Sedimentation Rata(ESR) and the C-reactive protein(CRP)in the 5th day were compared between the two groups. Results The observation group had short-er surgical flush time, less volume of fluid drainage and inflammatory factor(TNF-α, IL-1, 6)expression(P 0.05). Conclusion These results suggested that pulsed lavage device is effective in lumbar posterior single-segment fusion surgery, and can decrease the concentrations of inflammatory factors in fluid drainage, and should be recommended in patients who are affordable.%目的:探讨脉冲高速冲洗方法对于后路脊柱手术的临床效果。方法选择我科2012年8月至2013年7月因腰椎间盘突出或椎管狭窄而行单节段椎间融合后路内固定治疗患者80例,术中应用高压脉冲冲洗者40例(实验组),应用常规倾倒冲洗者40例(对照组),观察对比两组患者术后伤口引流总量、术后第二天伤口引流液内炎性因子(TNF-α,IL-1,IL-6)表达情况及术后第5天血沉及C反应蛋白变化,并进行统计学分析。结果术后伤口引流总量方面,高压脉冲冲洗组为(389.37±109.89)ml,明显高于常规倾倒冲洗组[(275.77±102.00)ml]。术后早期患者伤口引流液TNF-α,IL-1,IL-6分别为(15.06±3.04)ng/L、(13.83±4.13)ng/L、(12.20±3.41)ng/L,显著低于对照组[(25.40±8.45)ng/L、(22.60±4.49)ng/L、(24.58±7.69)ng/L],

  12. Observation of“white and black”gastric lavages for treatment of paraquat poisoning%“白加黑”洗胃用于百草枯中毒的疗效观察

    Institute of Scientific and Technical Information of China (English)

    庞爱华

    2016-01-01

    目的:探讨不同的洗胃方法对治疗百草枯中毒患者的疗效。方法选取2010年7月~2015年7月在山东省菏泽市立医院治疗被确诊的急性百草枯中毒患者108例,随机分为分为3组。A组37例,常规温清水加碳酸氢钠洗胃;B组35例,在A组的基础上,洗胃后,温清水加白陶土(白)或活性炭(黑)口服;C组36例,是在B组的基础上,洗胃液中加白陶土和洗胃液加活性炭交替洗胃。比较各组患者肝肾功能、中毒性心肌炎、多功能脏器衰竭(Multiple Organ Disfunction Syndrome,MODS)的发生率和病死率等变化。3组间均数比较采用方差或秩和检验,两两比较采用LSD法。多个率比较采用非校正χ2检验。结果 C组患者肝肾功能、中毒性心肌炎、MODS的发生率、病死率和存活时间等指标明显优于B组和A组(P<0.01),而B组患者的各项指标又优于A组(P<0.05)。结论碳酸氢钠稀释液加白陶土与碳酸氢钠稀释液加活性炭交替洗胃和口服,可以减轻百草枯对患者各个器官的损害,降低患者病死率。%Objective To explore the efficacy of different methods to treat patients with paraquat poisoning. Methods A total of 108 cases of patients who were admitted into our hospital from July 2010 to July 2015 due to acute paraquat poisoning were enrolled into the current study. They were randomized into three groups. Group A was subjected to gastric lavage using warm water and sodium bicarbonate (n=37). Group B was orally taken warm water plus white clay (white) or activated carbon (black) (n=35), in addition to routine therapy in Group A. Group C was subjected to gastric lavage using white clay and activated carbon alternatively, based on Group B’s therapy (n=36). Then, these groups were compared for hepatic and renal function, toxic myocarditis, multifunctional organ failure (MODS) incidence and mortality. Results Group C presented the hepatic and renal

  13. 臭氧灌洗疗法应用于阴道炎患者中的效果分析%Ozone Lavage Therapy Applied in Vaginitis Patients the Effect Analysis

    Institute of Scientific and Technical Information of China (English)

    王颖香

    2016-01-01

    目的:分析臭氧灌洗疗法治疗阴道炎的效果,旨在提升该病的临床治疗水平。方法方便选取该院2014年1月―2015年5月收治的102例阴道炎患者作为研究对象,将患者随机均分为观察组(51例﹚与参照组(51例﹚,参照组患者常规药物治疗,观察组患者在参照组治疗基础上联合臭氧灌洗疗法治疗,对比两组治疗效果及症状缓解时间、不良反应,随访1年,观察两组复发率。结果观察组治疗总有效率96.08%,显著高于参照组84.31%,观察组复发率1.96%,低于参照组13.73%,且观察组症状缓解时间(1.57±0.31﹚d短于参照组(2.57±0.35﹚d,差异具有统计学意义(P0.05﹚。结论臭氧灌洗疗法用于辅助性治疗阴道炎效果极好,可明显提升临床疗效,促进患者更快康复,不良反应少,复发率低,可推广应用。%Objective Analysis of ozone lavage therapy for the treatment of vaginitis, aimed at enhancing the level of clini-cal treatment of the disease. Methods Convenient select our hospital from January 2014 to May 2015 treated 102 cases of vaginitis patients as the research object, all patients were randomly divided into observation group (51 cases) and control group (51 cases) and control group with routine drug treatment, observation group of patients in the control group treatment based on joint lavage therapy of ozone treatment, compared two groups of treatment effect and duration of symptoms, adverse reactions, followed up for 1 year, observe two groups of the recurrence rate. Results Observation treatment group total effec-tiveness 96.08%, significantly higher than that of control group 84.31%, observation group recurrence rate was 1.96%, lower than the control group13.73% , and group of symptoms time (1.57±0.31) d shorter than the control group,(2.57 ±0.35)d, the difference is statistically significant P 0.05. Conclusion Ozone lavage therapy for adjuvant treat-ment of vaginitis effect very good, can obviously improve

  14. I期植骨与抗生素灌洗引流治疗慢性骨髓炎%Drainage in the Treatment of Chronic Osteomyelitis with Antibi Ootics Lavage I Stage Bone Grafting

    Institute of Scientific and Technical Information of China (English)

    王福大; 王雪明; 常海林; 马启东

    2015-01-01

    Objective To investigate the thorough debridement of the lesion after one-stage bone grafting and antibiotic lavage clinical ef icacy in the treatment of chronic osteomyelitis. Methods 22 cases of chronic osteomyelitis patients underwent thorough debridement, intraoperative one-stage bone grafting, and on the basis of bacterial culture and drug sensitivity test results, and the sensitive antibiotic solution catheter for closed negative pressure drainage in the treatment of continuous ir igation. Results The 22 patients, 21 cases (95.5%) infection is cured and obtained bone healing; 1 cases (4.5%) of patients with recur ent infection. Fol ow up of 1.5 months to 5 years, average 3.25 years. Conclusion Postoperative osteomyelitis radical debridement, I combined with bone graft for treatment of antibiotic solution lavage continuous negative pressure drainage, can cure rate and bone healing rate of postoperative infection for more than 95%, stable short term and long term ef ect. Is an ef ective clinical method of radical osteomyelitis.%目的探讨彻底病灶清除术后I期植骨与抗生素灌洗引流治疗慢性骨髓炎的临床疗效。方法对22例慢性骨髓炎患者行彻底病灶清除术,术中I期自体骨植骨,并依据细菌培养和药物敏感试验结果,联和敏感抗生素溶液置管行闭式持续灌洗负压引流术治疗。结果22例患者中,21例(95.5豫)感染治愈并获得骨愈合;1例(4.5豫)患者感染复发。随访时间1.5个月~5年,平均3.25年。结论骨髓炎病灶彻底清除术后,I期植骨联合抗生素溶液持续灌洗负压引流术治疗,可以获得95豫以上的术后感染治愈率及骨性愈合率,近远期疗效稳定。是根治骨髓炎的有效临床方法。

  15. Agents Which Mediate Pulmonary Edema

    Science.gov (United States)

    1990-12-01

    directly the effect of mediators in the lavage on pulmonary vascular endothelium using endothelial cell line methods, as well as isolated perfused lungs...inte;wvention and/or protection from pathological chang6s. 8 1 MATERIALS AND METHODS Bronchoalveolar Lavage: The lavage procedure was performed through...have changed our 14 I technique to the following: 1 ) animals are lightly anesthetized with 30 mg/kg sodium arnytal and a #7.5 - 8 F polyvinyl

  16. Polymerized-Type I Collagen Downregulates Inflammation and Improves Clinical Outcomes in Patients with Symptomatic Knee Osteoarthritis Following Arthroscopic Lavage: A Randomized, Double-Blind, and Placebo-Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Janette Furuzawa-Carballeda

    2012-01-01

    Full Text Available Objectives. Polymerized-type I collagen (polymerized collagen is a downmodulator of inflammation and cartilage regenerator biodrug. Aim. To evaluate the effect of intraarticular injections of polymerized collagen after arthroscopic lavage on inflammation and clinical improvement in patients with knee osteoarthritis (OA. Methods. Patients (n=19 were treated with 6 intraarticular injections of 2 mL of polymerized collagen (n=10 or 2 mL of placebo (n=9 during 3 months. Followup was 3 months. The primary endpoints included Lequesne index, pain on a visual analogue scale (VAS, WOMAC, analgesic usage, the number of Tregs and proinflammatory/anti-inflammatory cytokine-expressing peripheral cells. Secondary outcomes were Likert score and drug evaluation. Clinical and immunological improvement was determined if the decrease in pain exceeds 20 mm on a VAS, 20% of clinical outcomes, and inflammatory parameters from baseline. Urinary levels of C-terminal crosslinking telopeptide of collagen type II (CTXII and erythrocyte sedimentation rate (ESR were determined. Results. Polymerized collagen was safe and well tolerated. Patients had a statistically significant improvement (P<0.05 from baseline versus polymerized collagen and versus placebo at 6 months on Lequesne index, VAS, ESR, Tregs IL-1β, and IL-10 peripheral-expressing cells. Urinary levels of CTXII were decreased 44% in polymerized collagen versus placebo. No differences were found on incidence of adverse events between groups. Conclusion. Polymerized collagen is safe and effective on downregulation of inflammation in patients with knee OA.

  17. The effect of external high-frequency thermotherapy on pulmonary function of patients undergoing massive whole-lung lavage%体外高频热疗对大容量肺灌洗患者肺功能影响的研究

    Institute of Scientific and Technical Information of China (English)

    郭献勇; 王月罡; 李国锋; 方国峰

    2013-01-01

    Objective To explore the short time effect of external high-frequency thermotherapy on pulmona-ry function recovery in patients undergoing massive whole-lung lavage ( MWLL ) .Methods Forty-eight male coal workers′pneumoconiosis patients receiving MWLL were randomly divided into treatment group and control group .The treatment group was treated by domestic HG-2000 high-frequency thermotherapy instrument ( controlled temperature:39~43 ℃;therapeutic time:40 min/time;once every other day; for 3 times),and the control group did not receive thermotherapy .The pulmonary function changes between two groups were compared before and after whole -lung lavage about TLC, FVC, MVV, DLCO, FEV 1.0%.Results The difference of pulmonary function changes between two groups before and after lavage were no significant ( P>0.05 ) .Conclusion External high-frequency thermotherapy has no evident effect on the recovery of postoperative pulmonary function in patients undergoing whole -lung lavage , and its effect on the patients undergoing whole-lung lavage or pneumoconiosis patients remains to be observed .%目的:探讨体外高频热疗对大容量肺灌洗患者短期肺功能恢复的影响。方法将48例接受大容量肺灌洗的煤工尘肺Ⅰ期男性患者随机分为治疗组和对照组,治疗组给予体外高频热疗,热疗温度为39~43℃,时间为40 min/次,隔日1次,连续3次。对照组不接受体外高频热疗。比较两组患者灌洗前后TLC、FVC、MVV、DLCO、FEV1.0%肺功能指标的变化。结果两组患者灌洗前后肺功能比较差异无统计学意义( P>0.05)。结论就本研究结果而言体外高频热疗对于肺灌洗患者术后肺功能的恢复无明显影响,其对肺灌洗患者或对尘肺病患者的疗效还有待进一步观察。

  18. 开窗引流术治疗巨大颌骨囊肿的疗效%Curative effect of fenestration drainage lavage in the treatment of giant jaw cyst

    Institute of Scientific and Technical Information of China (English)

    高运来

    2013-01-01

    目的 探讨开窗引流冲洗术在治疗巨大颌骨囊肿中的应用价值.方法 对8例巨大颌骨囊肿患者实施开窗引流冲洗术,观察颌骨骨质情况.术后1、3、6及12个月复查曲面断层片,观察牙及牙胚的情况,并定期复查和随访,并于治疗前后对所有患者进行心理测评.结果 所有病例均未出现长期反复感染,颌骨形态良好,未出现神经及邻近重要结构损伤症状.术后6个月~3年随访,骨质再生情况良好,囊肿未见复发.颌骨、牙、牙胚发育生长良好.治疗后所有患者人际关系、忧郁、焦虑三项的评测结果要优于治疗前(P<0.05),治疗前后所有患者心理评测其他指标比较差异无统计学意义(P>0.05).结论 开窗引流冲洗术是一种简便、经济、安全、效果良好的治疗巨大颌骨囊肿的方法,且颌骨、牙、牙胚生长发育不受影响,值得临床推广.%Objective To investigate the fenestration drainage lavage in the treatment of giant jaw cyst and its clinical application value.Methods The fenestration drainage surgery was done on 8 patients with huge jaw cyst,and observation was made of jaw bone situation.One,three,six and twelve months after treatment,re-examination was made of the panoramic radiograph,observation was done of tooth and tooth buds,and review and follow-ups were regularized.And all patients were psychologically assessed before and after the treatment.Results All patients didn't have long term recurrent infections,jaw shape was good,and no nerve and adjacent important structures damage symptoms occurred.Six months to three years after the operation,follow-ups were done.Bone regeneration was in good condition,with no recurring of cyst.Jaw,teeth,tooth germ developed well.After the treatment,indicators like interpersonal discharge,depression and anxiety of the experimental group were better than before the treatment (P < 0.05).All patients'other psychological indicators before and after the

  19. Determination of presence of Tritrichomonas foetus in uterine lavages from cows with reproductive problems Determinação da presença de Tritrichomonas foetus em lavados uterinos de vacas com problemas reprodutivos

    Directory of Open Access Journals (Sweden)

    Lady Carolina González-Carmona

    2012-09-01

    Full Text Available The aim of this study was to determine the presence of Tritrichomonasfoetus in two dairy herds on the Altiplano Cundiboyacense. Twenty-one low-volume uterine lavages from cows with a history of reproductive problems in two dairy herds located in the municipality of Sibaté (Cundinamarca and Ventaquemada (Boyacá were evaluated. In the first herd, 10 cows were sampled and in the second, 11 cows, based on three inclusion criteria. The uterine lavages were obtained through infusion of physiological saline solution into the uterine body. The samples were centrifuged and seeded in Tritrichomonas basal medium for 10-15 days at 37 ºC. The protozoa were evaluated on the day of sampling and 10 and 15 days after incubation by means of direct viewing under a dark-field microscope. Positive samples were stained with Wright and Lugol to identify the morphological characteristics. This study showed that T. foetus was present in 61.8% of the animals sampled. The determination that T. foetus was present in 61.8% of the samples analyzed is a significant finding given that in the herds evaluated, this agent had not previously been diagnosed.O objetivo do presente estudo, foi determinar a presença de Tritrichomonas foetus em dois rebanhos leiteiros no Altiplano Cundiboyacense. De vacas com um histórico de problemas reprodutivos, foram avaliados 21 lavados uterinos de pequeno volume, em dois rebanhos leiteiros localizados nos municípios de Sibaté (Cundinamarca e Ventaquemada (Boyacá. No primeiro rebanho, 10 vacas foram amostradas e no segundo 11, baseado em três critérios de inclusão. Os lavados uterinos foram obtidos mediante infusão de solução salina fisiológica no corpo do útero. As amostras foram centrifugadas e semeadas em meio de cultura básico para Tritrichomonas por 10-15 dias a 37 ºC. Os protozoários foram avaliados no dia da colheita de amostras e 10 e 15 dias após incubação por meio de visualização direta sob um microscópio de

  20. Acute complicated diverticulitis managed by laparoscopic lavage

    DEFF Research Database (Denmark)

    Alamili, Mahdi; Gögenur, Ismail; Rosenberg, Jacob

    2009-01-01

    PURPOSE: The classic surgical treatment of acute complicated sigmoid diverticulitis with peritonitis is often a two-stage operation with colon resection and a temporary stoma. This approach is associated with high mortality and morbidity and the reversal of the stoma is in many cases not performe...

  1. Activated charcoal alone or after gastric lavage

    DEFF Research Database (Denmark)

    Christophersen, A B; Levin, D; Høgberg, Lotte Christine Groth

    2002-01-01

    interventions 1 h post ingestion, and to determine if activated charcoal was effective in reducing the systemic absorption of a drug, when administered 2 h post ingestion. METHODS: We performed a four-limbed randomized cross-over study in 12 volunteers, who 1 h after a standard meal ingested paracetamol 50 mg....... Serum paracetamol concentrations were determined by h.p.l.c. Percentage reductions in the area under the curve (AUC) were used to estimate the efficacy of each intervention (paired observations). RESULTS: There was a significant (Pparacetamol AUC with activated charcoal at 1 h...... the two interventions (95% confidence interval for the difference -3.8, 34.0). Furthermore, we found a significant (Pparacetamol AUC when activated charcoal was administered 2 h after tablet ingestion when compared with controls (median 22.7%, 95% confidence intervals 13...

  2. PERITONITE FECAL EM RATOS: EFICÁCIA DA LAVAGEM DA CAVIDADE PERITONEAL COM SOLUÇÃO DE CLORETO DE SÓDIO A 0,9% Fecal peritonitis in rats: efficacy of the peritoneal lavage with saline solution

    Directory of Open Access Journals (Sweden)

    Orlando Jorge Martins Torres

    1999-04-01

    Full Text Available O presente estudo tem por objetivo analisar a influência da irrigação da cavidade peritoneal com solução de cloreto de sódio 0,9 % em ratos com peritonite fecal. Foram utilizados 36 ratos da linhagem Wistar, adultos ,machos ,pesando entre 160 e 210g. Estes animais foram alocados em três grupos iguais e submetidos a peritonite com homogeneizado de fezes humanas. No grupo I , o procedimento foi realizado para verificar a eficácia da peritonite fecal e todos os animais morreram após 24 horas da injeção intraperitoneal. Após 6 horas de evolução da peritonite, os ratos do grupo II foram submetidos a laparotomia e irrigação cavidade abdominal com solução de cloreto de sódio a 0,9 %. Neste grupo todos os animais permaneceram vivos após 48 horas da laparotomia. No grupo III, os ratos foram submetidos a laparotomia e limpeza da cavidade peritoneal com gaze estéril. Foi verificado que somente 6 ratos permaneceram vivos após 48 horas da laparotomia. O presente estudo demonstrou que a irrigação da cavidade peritoneal com solução de cloreto de sódio a 0,9 % foi capaz de reduzir os índices de mortalidade em ratos com peritonite fecal.The aim of the present study is to analyze the influence of peritoneal lavage with saline solution in fecal peritonitis in rats. Thirty six Wistar rats were used, adult, male,weighing 160 to 210 g. The animals were allocated into three groups and submitted to peritonitis induced by homogenized human feces. In group I the procedure was carried out to verify the efficacy of the fecal peritonitis and all animals died after 24 hours of the intraperitoneal injection. After 6 hours of peritonitis evolution , the rats of the group II were submitted to laparotomy and irrigation of the abdominal cavity with saline solution. In this group all the animals were alive after 48 hours of the laparotomy. In group III the rats were submitted to laparotomy and cleaning of the peritoneal cavity with gauze. It was verify

  3. BV和VVC患者阴道灌洗液中相关细胞因子水平检测及意义%Detection and significance of cytokines in cervicovaginal lavage fluid in patients with bacterial vaginosis and vulvovaginal candidiasis

    Institute of Scientific and Technical Information of China (English)

    冯贺强; 张学军; 戴随

    2011-01-01

    目的 提高细菌性阴道病(BV)和外阴阴道假丝酵母菌病(VVC)诊疗水平.方法 采集35例健康育龄妇女(对照组)、35例BV患者(BV组)、35例VVC患者(VVC组)阴道灌洗液,用ELISA法检测三组相关细胞因子(IL-2、IL-8、IFN-γ、IL-4、IL-13、IL-10、IgE)水平.结果 与对照组比较,BV组IL-2显著降低,IL-13、IL-4、IL-10显著升高,IL-8、IFN-γ、IgE无明显变化;VVC组IFN-γ显著降低,IL-2、IL-13、IL-4、IgE显著升高,IL-8、IL-10无显著变化.讨论 BV与VVC均存在Th1/Th2平衡失调,检测两种疾病局部细胞因子的变化有助于更好的控制感染.%Objective To improve the diagnosis and treament level of bacterial vaginosis(BV) and vulvovaginal candidiasis(VVC).Methods Cervicovaginal lavage fluid was collected from 35 healthy women in child-bearing age ( control group) ,35 patients with BC(BV group) ,35 patients with VVC (WC group).The level of cytokines (IL-2, IL-8,IFN-γ,IL-4,IL-13 ,IL-10,IgE)of the three groups were detected by ELISA.Results Compared with the control group, the IL-2 of BV group decreased significantly,IL-13,IL-4,IL-10 increased significantly,IL-8,IFN-γ,IgE had no significant change;the IFN-γof VVC group decreased significantly, IL-2,IL-13,IL-4,IgE increased obviously,IL-8,IL-10 had no significant change.Conclusions The un-balance of Th1/Th2 is common in BV and VVC, detecting the changes of local cytokine is helpful for controling their inflammation better.

  4. 国内延长胃管插入长度抢救急性有机磷农药中毒效果的Meta分析%A Meta-analysis for the rescue effects of sever acute organophosphate pesticide poisoning by different of length of gastric lavage tube in China

    Institute of Scientific and Technical Information of China (English)

    毛仁丹吉; 伏旭; 马晓红; 贺莉

    2015-01-01

    Objective To evaluate the rescue effects for sever acute organophosphate pesticide poison (AOPP) by different length of gastric lavage tube .Method The Cochrane library(1994 to March ,2014) ,VIP (1994 to March , 2014) ,CBM (1994 to March ,2014) and Wanfang (1994 to March ,2014) was searched to identify randomized con‐trolled trials (RCTs) related to length of gastric lavage tube for sever AOPP .The quality of included studies as as‐sessed and data analyses were performed by RevMan 5 .0 .Result 9 RCTs involving 1440 patients were included .The results showed that prolong the length of gastric lavage tube for sever AOPP are better than traditional gastric lav‐age in the first gastric lavage time[OR= -0 .38 ,95% CI(-0 .40 , -0 .35)] ,total gastric lavage time[OR=-7 .22 ,95% CI(-7 .67 ,-6 .77)] ,blood gastric juice[OR=0 .16 ,95% CI(0 .09 ,0 .30)] ,abdominal pain[OR=0 .22 ,95% CI(0 .14 ,0 .34)]Conclusion Prolong length of gastric lavage tube for sever AOPP can increase the rescue effect in patients .%目的:评价延长胃管插入长度抢救急性有机磷农药中毒(Acute organophosphate pesticide poisoning , AOPP)患者的效果。方法计算机检索CNKI数据库(1994~2014.3)、VIP数据库(1989~2014.3)、CBMdisc数据库(1980~2014.3)、万方数据库(1998~2014.3),收集延长胃管插入长度后抢救AOPP患者的所有随机对照实验(RCT),按照Cochrane系统评价的方法,纳入符合标准的 RCT ,评价纳入研究的质量,采用RevMan5.0软件进行M eta分析。结果共纳入9个RC T ,共计1440例患者。M eta分析显示:延长胃管插入长度在首次洗出液时间[OR=-0.38,95% CI(-0.40,-0.35)]、总洗胃时间[OR=-7.22,95% CI(-7.67,-6.77)]、发生血性洗出液[OR=0.16,95% CI(0.09,0.30)]、发生上腹不适[OR=0.22,95% CI(0.14,0.34)]均优于传统洗胃胃管插入长度。结论延长

  5. Clinical Observation of Continuous Abdominal Double-cannula Lavage and Drainage for Anastomotic Stoma Fistula of Colorectal%腹腔双套管持续冲洗引流在结直肠吻合口瘘中的临床观察

    Institute of Scientific and Technical Information of China (English)

    2013-01-01

      目的探讨腹腔双套管持续冲洗引流治疗结直肠吻合口瘘的效果,促进其临床推广应用。方法对29例结直肠手术后并发吻合口瘘的患者给予腹腔双套管生理盐水灌洗,低负压吸引引流治疗。结果29例患者给予腹腔双套管持续引流后15~25d(平均22.5d)后均痊愈出院,随访3个月以上,未见吻合口狭窄及肠梗阻等并发症。结论腹腔双套管持续冲洗引流简单易行,是治疗结直肠吻合口瘘的有效措施。%Objective To examine the outcomes of continuous irrigation and drainage by abdominal double-cannula in management of colorectal anastomotic stoma fistula for wider clinical application. Methods 29 cases of anastomotic stoma fistula of colorectal were treated by continuous abdominal double-cannula lavage and low negative pressure drainage. Results 29 patients discharged from the hospital,who were treated by continuous abdominal double-cannula lavage and drainage for15~25 days, on average of 22.5 days. No complications of anastomotic stoma constriction or intestinal obstruction were found during 3 month follow-up. Conclusion Continuous abdominal double-cannula lavage and drainage are easy to conduct, which are the effective way to treat the anastomotic stoma fistula of colorectal.

  6. 持续低负压冲吸在小儿腹部术后肠瘘中的作用及护理%The role and effect of nursing for continuing low negative pressure lavage and suction in pediatric abdominal postoperative intestinal fistula

    Institute of Scientific and Technical Information of China (English)

    郑燕君; 郑燕丹; 赖志鸿

    2014-01-01

    目的:探讨持续低负压冲吸在小儿腹部术后肠瘘中的作用及护理效果。方法:对12例小儿腹部术后并发肠瘘采取持续低负压冲吸治疗与护理,分析护理方法及冲吸效果。结果:持续低负压冲吸治疗能快速吸出肠瘘出物,不但能减少腹腔内污染,而且能有效减少瘘出液对瘘口周围皮肤的刺激,促进伤口愈合,减少换药次数和物品消耗,护理工作量也大为减轻。结论:对于小儿腹部术后并发肠瘘患者,持续低负压冲吸是控制肠瘘出液及保护瘘口皮肤的经济有效的方法。%Objective To study the role and effect of nursing for continuing low negative pressure lavage and suction in pediatric ab-dominal postoperative intestinal fistula. Method To summarize 12 pediatric patients with abdominal postoperative intestinal fistula who had been treated and taken nursing care with continuing low negative pressure lavage and suction,to analyse nursing care methods and impact effect. Results Continuing low negative pressure lavage and suction treatment can quickly suck out intestinal fistula liquid,it not only can reduce the pollution of the abdominal cavity,but also can effectively reduce the fluid in fistula surrounding skin stimulation,promote wound healing and reduce the number of dressing and goods consumption,nursing workload can also be reduced greatly. Conclusion For pediatric abdominal surgery patients with intestinal fistula,continuing low negative pressure lavage and suction of intestinal fistula is economic and ef-fective method to control the liquid and protect skin fistula.

  7. 腹腔灌洗加腹腔注射抗生素治疗难治性自发性腹膜炎的临床评价%Clinical evaluation of peritoneal lavage combined with intraperitoneal injection of antibiotics in the treatment of intractable spontaneous bacterial peritonitis

    Institute of Scientific and Technical Information of China (English)

    赵夏平; 翟卫春; 冯娟; 于晓辉

    2013-01-01

    Objective To analyze the value of peritoneal lavage combined with intraperitoneal injection of antibiotics in the treatment of liver cirrhosis with refractory spontaneous bacterial peritonitis (SBP) and refractory ascites.Methods 28 cases of cirrhosis with SBP and ascites were intravenous infused with antibiotics,diuretic,albumin and so on.Then,peritoneal lavage was done and antibiotics were injected into abdominal cavity.Results After supportive treatment,the SBP symptom in 20 patients had no significant amelioration,ascites PMN was more than 2.5 × 108/L.1 patient aggravated,ascites PMN was less than 2.5 × 108/L in 7 patients.After peritoneal lavage and intraperitoneal injection of antibiotics,peritonitis symptoms disappeared,and ascites resolved in 26 (92.85%) cases.Conclusion Peritoneal lavage combined with intraperitoneal injection of antibiotics is an effective method in the treatment of liver cirrhosis with refractory spontaneous bacterial peritonitis (SBP) and refractory ascites.%目的 为探讨分析腹腔灌洗及腹腔内注入抗生素对肝硬化并发难治性自发性腹膜炎(SBP)及顽固性腹水的治疗价值.方法 28例肝硬化合并SBP腹水的患者,均给予经静滴抗生素、利尿、输注白蛋白等对症支持治疗,之后行腹腔灌洗术,再向腹腔注入抗生素.结果 给予支持治疗后,20例患者SBP症状无明显改善,腹水PMN> 2.5×108/L,1例患者症状明显加重,7例患者腹水PMN<2.5 ×108/L;经腹腔灌洗加腹腔内注射抗生素治疗后,26例(92.86%)患者SBP症状消失,腹水消退.结论 腹腔灌洗加腹腔内注入抗生素是治疗肝硬化合并难治性SBP和顽固性腹水的有效方法之一.

  8. 小容量肺灌洗治疗矽肺合并慢性阻塞性肺疾病的临床研究%Clinical study on small volume lung lavage in treatment of silicosis patients complicated with chronic obstructive pul-monary disease

    Institute of Scientific and Technical Information of China (English)

    王莉; 常小红

    2016-01-01

    Objective To explore clinical efficacy of conventional symptomatic treatment combined with small volume lung lavage in treatment of silicosis patients complicated with severe stable chronic obstructive pulmonary disease (COPD). Methods From 2012 August to 2015 February, selected 108 cases silicosis complicated with severe stable COPD patients in Yan'an University Affiliated Hospital as the research objects, according to the random number table method, these patients were divided into routine group and lavage group (54 cases in each group), and routine group were treated with anti-cough, anti-phlegm, anti-asthma, oxygen therapy, lavage group on the basis of control group therapy, also giving small volume lung lavage therapy, with a course of 3 months.Treatment of 1 month, then detected 2 groups of patients'serum transforming growth factor-β1 (TGF-β1 ), tumor necrosis factor -α(TNF-α) levels, compared the lung function, 6 min walking capacity and quality of life at 1 month, 3 months.Results Compared with before treatment, after treatment, the two groups'TGF-β1, TNF-αlevels decreased ( P 0.05).Compared with before treatment, 2 groups'6 min walking, St.George's score were improved ( P 0.05).与治疗前比较,2组6 min步行量、圣乔治评分均改善(P<0.05),灌洗组患者治疗1个月、3个月后6 min步行量显著高于常规组[(330.5±30.3)m vs.(295.3±27.3)m,(335.6±31.4)m vs.(308.8±29.1)m,P<0.05];治疗3个月后灌洗组圣乔治呼吸问卷(SGRQ)评分显著低于与常规组[(48.8±6.4)vs.(53.6±6.8)分,P<0.05].结论 常规治疗结合小容量肺灌洗对矽肺合并中重度稳定期COPD患者肺通气功能无明显影响,但可降低细胞因子水平,改善活动耐量和生活质量.

  9. Effects of sodium cromoglycate and nedocromil sodium on histamine secretion from human lung mast cells.

    Science.gov (United States)

    Leung, K B; Flint, K C; Brostoff, J; Hudspith, B N; Johnson, N M; Lau, H Y; Liu, W L; Pearce, F L

    1988-01-01

    Sodium cromoglycate and nedocromil sodium produced a dose dependent inhibition of histamine secretion from human pulmonary mast cells obtained by bronchoalveolar lavage and by enzymatic dissociation of lung parenchyma. Both compounds were significantly more active against the lavage cells than against the dispersed lung cells, and nedocromil sodium was an order of magnitude more effective than sodium cromoglycate against both cell types. Tachyphylaxis was observed with the parenchymal cells but not with the lavage cells. Nedocromil sodium and sodium cromoglycate also inhibited histamine release from the lavage cells of patients with sarcoidosis and extrinsic asthma. PMID:2462755

  10. Coleta de lavado gástrico para diagnóstico de tuberculose pulmonar infantil: revisão sistemática Colecta de lavado gástrico para diagnóstico de tuberculosis pulmonar infantil: revisión sistemática Gastric lavage in the diagnosis of pulmonary tuberculosis in children: a systematic review

    Directory of Open Access Journals (Sweden)

    Ethel Leonor Noia Maciel

    2010-08-01

    Full Text Available OBJETIVO: Analisar a padronização da coleta do lavado gástrico para diagnóstico de tuberculose em crianças. MÉTODOS: Estudo de revisão sistemática referente aos anos de 1968 a 2008. O levantamento de artigos científicos foi feito nas bases de dados Lilacs, SciELO e Medline, utilizando-se a estratégia de busca ("gastric lavage and tuberculosis" ou "gastric washing and tuberculosis", com o limite "crianças com idade até 15 anos"; e "gastric lavage and tuberculosis and childhood" ou "gastric washing and tuberculosis and childhood". A análise dos 80 artigos recuperados baseou-se nas informações sobre o protocolo de coleta de lavado gástrico para diagnóstico da tuberculose em crianças: preparo da criança e horas de jejum, horário da coleta, aspiração do resíduo gástrico, volume total aspirado, solução usada para aspiração do conteúdo gástrico, solução descontaminante, solução tampão, e tempo de encaminhamento das amostras para o laboratório. Desses, foram selecionados 14 artigos após análise criteriosa. RESULTADOS: Nenhum artigo explicava detalhadamente todo o procedimento. Em alguns artigos não constavam: quantidade de aspirado gástrico, aspiração antes ou após a instilação de uma solução, solução usada na aspiração gástrica, solução tampão utilizada, tempo de espera entre coleta e processamento do material. Esses resultados mostram inconsistências entre os protocolos de coleta de lavado gástrico. CONCLUSÕES: Embora este seja um método secundário no Brasil, reservado a casos que não alcançaram pontuação diagnóstica pelo sistema preconizado pelo Ministério da Saúde, é necessário padronizar a coleta de lavado gástrico para diagnóstico de tuberculose pulmonar na infância.OBJETIVO: Analizar la estandarización de la colecta del lavado gástrico para diagnóstico de tuberculosis en niños. MÉTODOS: Estudio de revisión sistemático referente a los años de 1968 a 2008. El

  11. In Vitro Characterization of Lavage Splash and Effectiveness of Lavage Shield

    Directory of Open Access Journals (Sweden)

    Steven Nishiyama

    2015-03-01

    DISCUSSION: This is the first study to characterize splash patterns seen with different irrigation systems. The addition of an inexpensive splashguard during high-pressure irrigation drastically reduced splash displacement.  Decreased splash displacement theoretically reduces OR contamination and the resultant risk of nosocomial contamination.

  12. Ureteral catheter antegrade lavage combined with the analysis of the effect of ureteroscopic lithotripsy (report of 58 cases)%输尿管导管顺行灌洗配合输尿管镜碎石的效果分析(附58例报告)

    Institute of Scientific and Technical Information of China (English)

    于金刚

    2015-01-01

    Objective To explore the feasibility of implementing the ureteral catheter antegrade lavage in ureteroscopic lithotripsy in. Methods from 2013 May to ureteral calculi in patients with _2014 in May in our hospital 58 cases, given the ureteroscope lithotripsy for ureteral catheter, F4 antegrade lavage combined intraoperative, study its treatment effect. Results in this group, 58 cases were successfully crushed stone, the success rate of operation is 100%, no patients with ureteral perforation or laceration of disease, average operation time ( 32.7+4.6) min, the time of hospitalization ( 3.02+0.88) d. Conclusion the ureteroscopic lithotripsy in patients with ureteral catheter antegrade lavage has good effect, can avoid the movement of calculus, to ensure the successful operation, suitable for clinical popularization.%目的:探讨在输尿管镜碎石中实施输尿管导管顺行灌洗的可行性。方法选取2013年5月_2014年5月来我院治疗的输尿管结石患者共58例,给予输尿管镜碎石术治疗,术中配合F4输尿管导管顺行灌洗,研究其治疗效果。结果本组58例病例均得到成功碎石,手术成功率是100%,未见患者发生输尿管穿孔或撕裂等症,平均手术时间(32.7±4.6)min,住院时间(3.02±0.88)d。结论对输尿管镜碎石术患者结合输尿管导管顺行灌洗有良好效果,可避免结石上移,确保手术成功,适合临床普及使用。

  13. Twenty-five cases of feline bronchial disease (1995-2000).

    Science.gov (United States)

    Foster, S F; Allan, G S; Martin, P; Robertson, I D; Malik, R

    2004-06-01

    Twenty-five cases of feline bronchial disease were identified retrospectively. The criteria for inclusion were consistent clinical signs or histopathology and no other identifiable aetiology. Patient records were analysed to determine historical, clinical, clinicopathologic and radiographic features. The main presenting complaints were coughing and dyspnoea. The most common physical finding was dyspnoea. The majority of radiographs had a bronchial pattern either as the sole change or as a component of a mixed pattern. Bronchoalveolar lavage cytology was neutrophilic or eosinophilic in the majority of cats. There was no association between age, breed, sex, clinical signs, bronchoalveolar lavage cytology or radiographic severity and disease severity.

  14. Extrinsic allergic alveolitis with an atypical immune expression.

    Science.gov (United States)

    Costa, Teresa; Rodrigues, Cidália; Arrobas, Ana

    2009-01-01

    Extrinsic allergic alveolitis and sarcoidosis are two granulomatosis of the lung characterized by non- -necrotizing granuloma. Both have typical bronchoalveolar lavage immunology, with opposite CD4/CD8 relation. However, sarcoidosis does not have such well defined etiology as extrinsic allergic alveolitis. The authors present two cases with similar clinical course, imagiology, lung function and immunology, although they both had an histology that was not concordant with the bronchoalveolar lavage, and with the peculiarity of being two elements of the same family, co -inhabitants and with a clinical presentation only a few weeks apart.

  15. Acute lung injury probably associated with infusion of propofol emulsion.

    Science.gov (United States)

    Chondrogiannis, K D; Siontis, G C M; Koulouras, V P; Lekka, M E; Nakos, G

    2007-08-01

    We present a case of acute lung injury associated with propofol infusion in a mechanically ventilated patient with intracerebral haemorrhage. Diagnosis was based on the exclusion of other risk factors inducing acute lung injury and on the clinical improvement after discontinuation of the propofol emulsion. Laboratory data such as the increase in total phospholipids, neutral lipids and free fatty acids in the broncho-alveolar lavage fluid, the remarkably high percentage of alveolar macrophages including fat droplets and the similar lipid composition of propofol and broncho-alveolar lavage fluid support the relationship between propofol and acute lung injury.

  16. Relationship between changed alveolar-capillary permeability and angiotensin converting enzyme activity in serum in sarcoidosis.

    OpenAIRE

    Eklund, A; Blaschke, E

    1986-01-01

    The effect of altered alveolar-capillary permeability on angiotensin converting enzyme (ACE) activity in serum (SACE) was studied in 45 patients with sarcoidosis and 21 healthy controls. In sarcoidosis increased albumin concentrations in the bronchoalveolar lavage fluid (L albumin) and increased ratios of L albumin to albumin in serum (S albumin) indicated an increased permeability of the alveolar-capillary membrane. ACE activity in the lavage fluid (LACE) was correlated with the number of al...

  17. Short-term intermittent peritoneal fluid loop peritoneal lavage in the clinical observation of early treatment of severe acute pancreatitis%腹膜透析液短期间歇性闭合式腹腔灌洗治疗早期重症急性胰腺炎

    Institute of Scientific and Technical Information of China (English)

    郭志松; 冯凌霄; 代荣钦; 邵换璋; 张慧峰; 刘卫青; 秦秉玉

    2015-01-01

    目的 探讨早期重症急性胰腺炎(SAP)治疗中,腹膜透析液短期间歇性闭合式腹腔灌洗的临床效果.方法 将54例SAP患者随机分为两组,对照组采用常规基础治疗,灌洗组采用腹膜透析液短期间歇性闭合式腹腔灌洗治疗;观测两组患者治疗前与治疗后第3、7天C反应蛋白(CRP)、系统性炎性反应综合征(SIRS)持续时间、中性粒细胞计数(NUE)水平以及急性生理功能和慢性健康状况评分系统Ⅱ(APACHE-Ⅱ)、出现多器官功能障碍综合征(MODS)器官数和死亡人数.结果 灌洗组治疗后第7天CRP为(42.30 ±23.78) mg/L,APACHE-Ⅱ为(3.31 ±1.81)分,NUE为(4.79±1.82)×109/L,SIRS持续时间为(4.07 ±2.00)d,出现MODS器官数为(0.23±0.43)个,无死亡病例;对照组治疗后第7天CRP为(89.19 ±58.21) mg/L,APACHE-Ⅱ为(4.67±1.72)分,NUE为(9.85±3.27)×109/L,SIRS持续时间为(7.83 ±4.62)d,出现MODS器官数为(0.85±0.94)个,2例死亡;结论 腹膜透析液短期间歇性闭合式腹腔灌洗可有效改善早期SAP的临床症状,控制病死率和MODS的发生率,阻断SIRS的发展.%Objective to study the early severe acute pancreatitis (SAP) treatment, peritoneal dialysate short-term clinical effect of closed type peritoneal lavage intermittently.Methods by randomized controlled study, from our selection of 54 patients with SAP were randomly divided into two groups,control group using conventional foundation treatment, lavage group adopt short-term intermittent peritoneal fluid loop peritoneal lavage treatment;Observed two groups of patients before and after treatment, 3,7 d C reactive protein (CRP), duration of systemic inflammatory response syndrome (SIRS) and neutrophil counts (NUE) levels and Acute Physiology and Chronic Health Evaluation (APACHE)-Ⅱ, multiple organ dysfunction syndrome (MODS) organs and deaths.Results CRP for 7 d after lavage treatment group (42.30 ±23.78) mg/L, APACHE-Ⅱ is (3.31 ± 1.81) points, NUE for 109/L (4.79 ± 1

  18. The curative effect analysis of intractable chronic pelvic pain syndrome by ureteroscopy dredging the seminal duct and lavaging seminal vesicle%小儿输尿管镜下精道疏通加精囊灌洗对难治性Ⅲ型前列腺炎的治疗分析

    Institute of Scientific and Technical Information of China (English)

    高本敏; 黎勇林; 唐正严; 王桂林; 曾铭强; 薛睿智

    2015-01-01

    目的 评价小儿输尿管镜下行精道疏通加精囊灌洗对难治性Ⅲ型前列腺炎的治疗效果.方法 收集45例难治性Ⅲ型前列腺炎患者,随机分为两组,手术组行小儿输尿管镜下精道疏通加精囊灌洗手术,对照组服用前列腺相关药物治疗4周以上,治疗后随访1年并评价其临床疗效.结果 难治性Ⅲ型前列腺炎患者45例,手术组20例,其中伴有血精2例,精囊结石1例,术后20例患者临床症状均有改善,其中显著改善者13例(65%).对照组药物治疗后25例患者临床症状中18例(72%)有改善,显著改善者6例(24%),随访1年,18例改善者中有7例(39%)临床症状反复.结论 手术治疗与药物治疗对难治性前列腺炎临床症状都有一定效果,但是小儿输尿管镜下精道疏通加精囊灌洗对难治性Ⅲ型前列腺炎疗效将更加显著.%Objectives To evaluate the efficacy of intractable chronic pelvic pain syndrome by ureteroscopy dredging the seminal duct and lavaging seminal vesicle.Methods 45 cases of intractable chronic pelvic pain syndrome were collected,which were divided into two groups randomly,Operation group executed operation by ureteroscopy dredging the seminal duct and lavaging seminal vesicle,Control group continued to receive the medication more than 4 weeks.Followed up 1 year and evaluated the curative effect.Results 45 cases of intractable chronic pelvic pain syndrome,In Operation group 20 cases clinlcal symptom was improved and significant improvement was found in 13 cases (65 %) of them.In Control group,18 cases (72%) clinlcal symptom were improved and significant improvement was found in 6 cases(24%).Followed up 1 year,7 cases (39%) recurrent attacks.Conclusions Both operation and medication are effective to intractable chronic pelvic pain syndrome.But the operation by ureteroscopy dredging the seminal duct and lavaging seminal vesicle is more effective.

  19. The clinical exploration of early alveolar lavage in patients with organophosphorous pesticide poisoning complicated with servere inhaled pneumonia%早期肺泡灌洗治疗有机磷农药中毒并重症吸入性肺炎临床分析

    Institute of Scientific and Technical Information of China (English)

    王昌锋; 吴雪花; 贺国文; 张华希

    2013-01-01

    目的:探讨肺泡灌洗治疗有机磷农药中毒并发重症吸入性肺炎的临床疗效.方法:回顾性分析有机磷农药中毒并重症吸入性肺炎38例患者中综合治疗组(对照组)15例与在综合治疗基础上给予早期多次肺泡灌洗治疗(治疗组)23例患者的呼吸频率、体温、白细胞、动脉血氧分压(PaO2)及预后指标.结果:治疗组白细胞、PaO2较对照组改善明显,差异有统计学意义(P<0.05),而呼吸频率、体温差异无统计学意义(P>0.05).治疗组胸片阴影消失时间、呼吸机使用时间和ICU内住院时间、病死率均显著少于对照组(P<0.05).结论:早期肺泡灌洗治疗有机磷农药中毒并重症吸入性肺炎能显著改善患者的临床症状和预后,是一项有效的治疗措施,但呼吸频率、体温不能作为评价疗效指标.%Objective:To investigate the clinical effect of alveolar lavage in organophosphorous pesticide poisoning complicated with servere inhaled pneumonia.Method:A total of 38 organophosphorous pesticide poisoning patients complicated with severe inhaled pneumonia were selected for this study.15 patients accepting comprehensive treatment were in the control group.23 patients accepting comprehensive treatment and early alveolar lavage treatment were in the treatment group.Respiration rate,temperature,leukocytes,PaO2 and prognosis were analyzed.Result:Compared with the control group,treatment group showed significant decrease of leukocytes and increase of PaO2(p<0.05).The differences of respiration rate and temprature were not significant(p>0.05).The X-ray shadow vanishing period,ventilation period,hospitalization period and death rate were remarkably decreased in the treatment group(p<0.05).Conclusion:Early alveolar lavage is an effective treatment to improve the clinical symptoms and prognosis of patients with organophosphorous pesticide poisoning complicated with severe inhaled pneumonia.But the respiration rate and

  20. Curative effect of the electron bronchoscopy alveolar lavage treatment combined with atomization inhalation on COPD pulmonary heart disease combined with pulmonary infection%电子纤维支气管镜肺泡灌洗联合雾化吸入治疗 COPD肺源性心脏病合并肺部感染的临床研究

    Institute of Scientific and Technical Information of China (English)

    林秾威; 林福筹

    2016-01-01

    Objective To study the curative effect of the electron bronchoscopy alveolar lavage treatment combined with at-omization inhalation on COPD pulmonary heart disease combined with pulmonary infection. Methods The patients with COPD pulmonary heart disease combined with pulmonary infection were divided into two groups. The normal-care group was given oxy-gen therapy,anti-infection treatment,spasmolysis treatment and symptomatic treatment. The patients in integrated treatment group were given electron bronchoscopy alveolar lavage combined with atomization inhalation in addition. After 4 days,the X-ray changes,arterial blood gas indexes,improvement condition of lung function was compared. Results Comparing with the normal-care group,pneumonia absorption time of patients in the integrated treatment group decreased obviously;the oxygen saturation in-creased significantly and the time of correcting redress hypoxemia and carbon dioxide retention decreased obviously. The life qual-ity and lung function of the patients in the integrated treatment group improved obviously. Conclusion Electron bronchoscopy alveolar lavage treatment combined with atomization inhalation in treatment of COPD pulmonary heart disease combined with pul-monary infection,can improve the condition of the lung function obviously,shorten the pulmonary infection adsorption time obvi-ously;reduce the total medical costs,alleviate the pain of patients,and reduce the time in hospital. This kind of treatment has a good social benefit.%目的:研究电子纤维支气管镜肺泡灌洗联合雾化吸入治疗慢性阻塞性肺疾病( COPD)肺心病合并肺部感染的疗效。方法将 COPD 肺源性心脏病合并肺部感染患者分两组,常规治疗组给予常规氧疗、抗感染、解痉、对症治疗;综合治疗组在常规治疗基础上,采用电子纤维支气管镜肺泡灌洗联合雾化吸入治疗。治疗4 d 后,对比两组患者胸片变化和动脉血气指标、肺功能改

  1. β-thymosins and interstitial lung disease: study of a scleroderma cohort with a one-year follow-up

    Directory of Open Access Journals (Sweden)

    Messana Irene

    2011-02-01

    Full Text Available Abstract Background β-thymosins play roles in cytoskeleton rearrangement, angiogenesis, fibrosis and reparative process, thus suggesting a possible involvement in the pathogenesis of systemic sclerosis. The aim of the study was to investigate the presence of thymosins β4, β4 sulfoxide, and β10 in bronchoalveolar lavage fluid of scleroderma patients with interstitial lung disease and the relation of these factors with pulmonary functional and radiological parameters. Methods β-thymosins concentrations were determined by Reverse Phase-High Performance Liquid Chromatography-Electrospray-Mass Spectrometry in the bronchoalveolar lavage fluid of 46 scleroderma patients with lung involvement and of 15 controls. Results Thymosin β4, β4 sulfoxide, and β10 were detectable in bronchoalveolar lavage fluid of patients and controls. Thymosin β4 levels were significantly higher in scleroderma patients than in controls. In addition, analyzing the progression of scleroderma lung disease at one-year follow-up, we have found that higher thymosin β4 levels seem to have a protective role against lung tissue damage. Thymosin β4 sulfoxide levels were higher in the smokers and in the scleroderma patients with alveolitis. Conclusions We describe for the first time β-thymosins in bronchoalveolar lavage fluid and their possible involvement in the pathogenesis of scleroderma lung disease. Thymosin β4 seems to have a protective role against lung tissue damage, while its oxidation product mirrors an alveolar inflammatory status.

  2. Assessment and management of elemental mercury poisoning-a case report.

    Science.gov (United States)

    Bazoukis, George; Papadatos, Stamatis S; Michelongona, Paschalia; Fragkou, Archodula; Yalouris, Athanasios

    2017-02-01

    We describe a patient with elemental mercury aspiration and retention in the appendix after elemental mercury ingestion. Conservative management was proved to be successful for the removal of the mercury from the appendix while we do not suggest bronchoalveolar lavage in cases of small amount elemental mercury aspiration.

  3. Multimeric and trimeric subunit SP-D are interconvertible structures with distinct ligand interaction

    DEFF Research Database (Denmark)

    Sørensen, Grith Lykke; Hoegh, Silje V; Leth-Larsen, Rikke;

    2009-01-01

    Surfactant protein-D (SP-D) is a calcium dependent lectin in the innate immune system that facilitates clearance of microbes. The protein is associated with mucosal surfaces, and also found in bronchoalveolar lavage, serum and amniotic fluid. Human SP-D includes trimeric subunits and multimeric a...

  4. Amount of Pneumocystis carinii and degree of acute lung inflammation in HIV-associated P carinii pneumonia

    DEFF Research Database (Denmark)

    Vestbo, Jørgen; Nielsen, T L; Junge, Jette

    1993-01-01

    Correlations between semiquantitative amounts of Pneumocystis carinii (PC), the degree of inflammation, and the severity of pneumonia were analyzed in 58 patients with PC pneumonia (PCP). Material from both transbronchial biopsies (TBBs; n = 39) and bronchoalveolar lavage fluid (BALF; n = 57...

  5. Bovine milk exosome proteome

    Science.gov (United States)

    Exosomes are 40-100 nm membrane vesicles of endocytic origin and are found in blood, urine, amniotic fluid, bronchoalveolar lavage (BAL) fluid, as well as human and bovine milk. Exosomes are extracellular organelles important in intracellular communication/signaling, immune function, and biomarkers ...

  6. Diagnosis of pulmonary infection with Toxoplasma gondii in immunocompromised HIV-positive patients by real-time PCR

    DEFF Research Database (Denmark)

    Petersen, E; Edvinsson, B; Lundgren, B

    2006-01-01

    The aim of the study presented here was to evaluate the use of PCR for improving the diagnosis of Toxoplasma gondii infection in immunocompromised hosts. Three hundred thirty-two bronchoalveolar lavage (BAL) fluid samples were analyzed by real-time PCR targeting a 529 bp element of T. gondii...

  7. Airway cellular response to two different immunosuppressive regimens in lung transplant recipients

    NARCIS (Netherlands)

    Slebos, DJ; Kauffman, HF; Koeter, GH; Verschuuren, EAM; van der Bij, W; Postma, DS

    2005-01-01

    A number of new immunosuppressive drugs have become available in transplant medicine. We investigated the effects of two different immunosuppressive protocols on bronchoalveolar lavage fluid cellular characteristics in 34 lung transplant recipients who were treated with anti-thymocyte globulin induc

  8. Association between circulating DNA, serum (1->3)-β-D-glucan, and pulmonary fungal burden in Pneumocystis pneumonia.

    Science.gov (United States)

    Costa, Jean-Marc; Botterel, Françoise; Cabaret, Odile; Foulet, Françoise; Cordonnier, Catherine; Bretagne, Stéphane

    2012-07-01

    Circulating Pneumocystis jirovecii DNA and (1→3)-β-d-glucan determined in 70 serum samples from immunocompromised patients were compared to fungal load in bronchoalveolar lavage fluids assessed using quantitative polymerase chain reaction. Both serum biomarkers are influenced by pulmonary fungal load, which should be taken into account when diagnosing Pneumocystis infection.

  9. Dual effects of vitamin D-induced alteration of TH1/TH2 cytokine expression: enhancing IgE production and decreasing airway eosinophilia in murine allergic airway disease

    DEFF Research Database (Denmark)

    Matheu, Victor; Bäck, Ove; Mondoc, Emma

    2003-01-01

    allergen-induced T-cell proliferation along with T(H)2 cytokine (IL-4 and IL-13) and IgE production. Surprisingly, the local inflammatory response in bronchoalveolar lavage fluid and lung tissue was significantly ameliorated with impaired recruitment of eosinophils and inferior levels of IL-5...

  10. Pulmonale cyster kan være en sjælden komplikation i forbindelse med kronisk infektion med humant papillomvirus

    DEFF Research Database (Denmark)

    Laurberg, Peter Thaysen; Weinreich, Ulla Møller

    2014-01-01

    A 19-year-old woman with a history of juvenile laryngeal papillomatosis (JLP), treated since childhood with multiple resections, was admitted with symptoms of pneumonia. A chest X-ray and CAT-scan revealed multiple lung cysts and a bronchoalveolar lavage detected human papilloma virus 11. The pat...

  11. Performance of Different Mono- and Multiplex Nucleic Acid Amplification Tests on a Multipathogen External Quality Assessment Panel

    NARCIS (Netherlands)

    Loens, K.; van Loon, A. M.; Coenjaerts, F.; van Aarle, Y.; Goossens, H.; Wallace, P.; Claas, E. J. C.; Ieven, M.

    2012-01-01

    An external quality assessment (EQA) panel consisting of a total of 48 samples in bronchoalveolar lavage (BAL) fluid or transport medium was prepared in collaboration with Quality Control for Molecular Diagnostics (QCMD) (www.qcmd.org). The panel was used to assess the proficiency of the three labor

  12. (18)F-FDG PET patterns and BAL cell profiles in pulmonary sarcoidosis.

    NARCIS (Netherlands)

    Keijsers, R.G.; Grutters, J.C.; Velzen-Blad, H. van; Bosch, J.M. van den; Oyen, W.J.G.; Verzijlbergen, F.J.

    2010-01-01

    PURPOSE: Bronchoalveolar lavage (BAL) and (18)F-fluorodeoxyglucose ((18)F-FDG) PET can both demonstrate sarcoid activity. To assess whether metabolic activity imaged by (18)F-FDG PET represents signs of disease activity as reflected by BAL, (18)F-FDG PET patterns were compared with BAL cell profiles

  13. Rapid identification of Stenotrophomonas maltophilia by peptide nucleic acid fluorescence in situ hybridization

    DEFF Research Database (Denmark)

    Knudsen, Nanna Reumert; Rasmussen, A. K. I.; Fiandaca, M. J.;

    2014-01-01

    representing common bacterial species in the respiratory tract. The probe displayed 100% sensitivity and 100% specificity on pure cultures and allowed detection in sputum from cystic fibrosis patients. The detection limit was 10(4) CFU/mL in spiked tracheal aspirate and bronchoalveolar lavage from healthy...

  14. Efeito da lavagem peritoneal com bupivacaína na sobrevida de ratos com peritonite fecal Efecto del lavado peritoneal con bupivacaína en la sobrevida de ratones con peritonitis fecal Effects of peritoneal lavage with bupivacaine on survival of mice with fecal peritonitis

    Directory of Open Access Journals (Sweden)

    Marcos Célio Brocco

    2008-10-01

    abdominal con 3 mL de solución fisiológica a 0,9% y secado (n = 12; 4 - Lavado de la cavidad abdominal con 8 mg.kg-1 (± 0,5 mL de bupivacaína 0,5%, adicionada a 2,5 mL de solución fisiológica a 0,9% y secado (n = 12. Los animales que murieron fueron llevados a necropsia y el horario del óbito se anotó. Los animales sobrevivientes se sacrificaron al 11º día del postoperatorio y se realizó la necropsia. RESULTADOS: Hubo un 100% de mortalidad en los animales del Grupo 1 en 52 horas, 100% en los animales del Grupo 2, en 126 horas y un 50% en los animales del Grupo 3 en 50 horas. Los animales del Grupo 4 sobrevivieron. La sobrevida, al 11° día del postoperatorio, fue mayor en los grupos 3 y 4 con relación a los grupos 1 y 2 (p BACKGROUND AND OBJECTIVES: Based on the knowledge of the anti-inflammatory and anti-bacterial actions of local anesthetics (LA, the objective of this study was to determine the effects of peritoneal lavage with bupivacaine on survival of mice with fecal peritonitis. METHODS: Forty-eight Wistar mice, weighing between 300 and 330 g (311.45 ± 9.67 g, undergoing laparotomy 6 hours after induction of peritonitis were randomly divided in 4 groups: 1 - Control, without treatment (n = 12; 2 - Drying of the abdominal cavity (n = 12; 3 - Lavage with 3 mL NS and posterior drying of the abdominal cavity (n = 12; and 4 - Lavage with 8 mg.kg-1 (± 0.5 mL of 0.5% bupivacaine added to 2.5 mL of NS followed by drying out of the abdominal cavity (n = 12. Animals that died underwent necropsy and the time of death was recorded. Surviving animals were killed on the 11th postoperative day and underwent necropsy. RESULTS: Group 1 presented a 100% mortality rate in 52 hours, 100% mortality rate in Group 2 in 126 hours, and Group 3 presented a 50% mortality rate in 50 hours. Animals in Group 4 survived. Survival on the 11th day was greater in groups 3 and 4 than in Groups 1 and 2 (p < 0.001 and greater in Group 4 than in Group 3 (p < 0.01. CONCLUSIONS: Peritoneal

  15. 胃癌患者术前腹腔冲洗液中CDH1甲基化状态及其临床意义%Methylation status of CDH1 gene in preoperative abdominal lavage of patients with gastric cancer and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    罗君; 王实; 凌志强; 王新保; 余齐鸣; 赵挺; 方仁桂; 王建军; 郑智国; 余江流; 方铣华

    2012-01-01

    目的 探讨术前腹腔冲洗液中CDH1基因的异常甲基化与胃癌进展的关系.方法 采用实时荧光甲基化特异性聚合酶链反应技术,检测92例胃癌患者术前腹腔冲洗液中CDH1基因启动子区域5′-CpG岛的甲基化状态,并分析其与临床病理因素及预后之间的关系.结果 92例胃癌患者中,有45例(48.9%)检测到了CDH1基因异常甲基化现象,其中完全甲基化12例(13.0%),部分甲基化33例(35.9%).CDH1基因甲基化与肿瘤大小、生长方式、分化程度、淋巴管侵犯、浸润深度、淋巴结转移、远处转移及临床分期有关(均P<0.05),而与性别、年龄、肿瘤部位及幽门螺杆菌感染无关(均P>0.05).CDH1甲基化与非甲基化患者术后中位无进展生存期分别为20和38个月,差异有统计学意义(P<0.01).经Cox模型分析证实,术前腹腔冲洗液DNA中的CDH1甲基化状态是影响胃癌患者术后生存的独立预后因素(P=0.000,RR=332.88, 95%CI:21.71~5105.07).结论 CDH1基因启动子区域5′-CpG岛的异常甲基化在胃癌中属于高频分子事件,术前腹腔冲洗液DNA中CDH1甲基化分析可反映胃癌进展状况.%Objective To explore the association between the progression of gastric cancer and the aberrant methylation of CDH1 gene in preoperative abdominal lavage fluid.Methods Real-time methylation-specific polymerase chain reaction(qMSP) was used to investigate the methylation status of the CDH1 gene promoter 5′-CpG islands from preoperative abdominal lavage fluid in 92 patients with gastric cancer.The associations between methylation of CDH1 genes and clinicopathologic features and prognosis were investigated.Results Among the 92 patients with gastric cancer,aberrant methylation of CDH1 gene was detected in 45 (48.9%) patients,including total aberrant methylation in 12 (13.0%) cases and partly aberrant methylation in 33 (35.9%) cases.Significant associatons were found between CDH1 methylation status

  16. Detection of CDH1 gene methylation of suspension cells in abdominal lavage fluid from colorectal cancer patients and its clinical significance%结直肠癌术中腹腔灌洗液悬浮细胞CDH1甲基化检测及其临床意义

    Institute of Scientific and Technical Information of China (English)

    鲁发龙; 杜刚毅; 郑少康; 彭林; 陈金泉

    2014-01-01

    目的 检测结直肠癌术中腹腔灌洗液悬浮细胞中CDH1基因甲基化状态并探讨其与结直肠癌临床病理资料及预后的关系.方法 前瞻性纳入2011年10月至2013年10月间中山市中医院手术治疗的原发性结直肠癌患者.采用实时荧光甲基化特异性聚合酶链反应技术,检测术中腹腔灌洗液悬浮细胞中CDH1基因启动子区域5'-CpG岛的甲基化状态,将甲基化百分率大于20%定义为甲基化,小于或等于20%为非甲基化;分析CDH1基因甲基化状态与结直肠癌临床病理特征及预后的关系.结果 共102例患者纳入研究,其中CDH1甲基化组47例,非甲基化组55例.与非甲基化组比较,甲基化组患者肿瘤直径更大,浸润型比例更高,分化程度更低,淋巴结转移和远处转移率更高,临床分期更晚(均P<0.05).甲基化组患者中位生存期短于非甲基化组(26.0月比41.4月,P<0.05).Cox模型分析显示,CDH1甲基化状态是结直肠癌患者术后生存的独立危险因素(RR=27.5,95%CI:3.8~51.3,P<0.01].结论 术中腹腔灌洗液悬浮细胞中CDH1基因发生甲基化的结直肠癌患者恶性程度较高,易发生淋巴结转移和远处转移,预后较差.%Objective To detect the CDH1 gene methylation of suspension cells in intraoperative abdominal lavage fluid from colorectal cancer patients,and to examine its association with clinicopathology and prognosis.Methods Real-time methylation-specific polymerase chain reaction (qMSP) was used to investigate the methylation status of the CDH 1 gene promoter 5'-CpG islands from intraoperative abdominal lavage fluid in 102 patients with colorectal cancer.The associations between methylation of CDH1 genes and clinicopathologic features and prognosis were investigated.Results Among the 102 colorectal cancer patients,aberrant methylation of CDH1 gene was detected in 47 patients.Significant associations were found between CDH1 methylation status and tumor size,growth pattern

  17. 关节镜下清理配合术后灌洗治疗膝痛风性关节炎的临床研究%Clinical study of arthroscopic debridement combined with lavage for treating gouty arthritisof the knee

    Institute of Scientific and Technical Information of China (English)

    崔操; 郭一行; 李厚成; 李彬彬

    2014-01-01

    Objective To study the therapeutic effects of the debridement combined with continuous drainage after surgery in the treatment of joint gouty arthritis under arthroscopy and also to explore the value of arthroscopy in the treatment of recurrent gouty ar -thritis of the knee .Methods There were 17 patients with joint gouty arthritis who received joint debridement and synovectomy under arthroscopy combined with lavage and continuous drainage .After surgery, the patients were given routine drug therapy and early func-tional exercise .Lysholm scores of the knee were compared before surgery and 6 months after surgery .Results Gouty arthritis under ar-throscopy displayed specific white ball -like crystal deposited on the surfaces of synovium , cartilage and other joint structure .All the patients had medical follow -ups for a duration of 6 to 24 months, averaging 16.3 months.Last follow-up revealed that there was not a significant recurrent case after surgery .In accordance with the Lysholm knee scores , the patient function scores before surgery were (50.0 ±3.1), and the function scores 6 months after surgery were (90.0 ±4.8) on the average.Significant statistical differences could be noted in Lysholm scores, when comparisons were made before surgery and 6 months after surgery (P<0.01).Conclusion Arthroscopy displayed a high diagnostic rate of gouty arthritis , at the same time , joint debridement and synovectomy under arthroscopy combined with lavage and continuous drainage were a good treatment method with quick response , minimal invasion and positive efficacy for the treatment of joint gouty arthritis .%目的:探讨关节镜在治疗反复发作性痛风性膝关节炎中的应用价值,并探讨和观察运用关节镜下清理术联合术后置管持续引流治疗痛风性关节炎的方法和疗效。方法17例膝关节痛风性关节炎患者,行关节镜下清理及滑膜切除术,术后灌洗并常规服用降血尿酸药物、早期功能锻炼

  18. OBTENTION METHODS OF RESPIRATORY TRACT CELSS IN HEALTHY SHEEP BY THE TRACHEOBRONCHEAL LAVAGE TECHNIQUE BY NASOTRACHEAL VIA METODOLOGIA DE COLHEITA DE CÉLULAS DO TRATO RESPIRATÓRIO EM OVINOS SADIOS ATRAVÉS DA TÉCNICA DE LAVAGEM TRAQUEOBRÔNQUICA POR VIA NASOTRAQUEAL

    Directory of Open Access Journals (Sweden)

    Roberto Calderon Gonçalves

    2008-07-01

    Full Text Available

    The technique of pulmonary cells obtention by nasotracheal intubation was evaluated and the cellular population of 19 healthy sheep was characterized. The animals were hold standing still with head and neck strait; aligned with the vertebral spine and a silicone tube guide till the carina, to introduce a lower caliber tube for precede the tracheobronchial lavage. The average counting of nucleated cells was 64.650 ± 49.674. The cytological analyses of the samples slowed by the average of obtained percentages: 62.74% of macrophages, 15.01% cylindrical epithelial cells, 20.04% of neutrophills, 1.44 of lymphocytes and 0.77% of eosinophills. It was concluded that this methods of sample obtention by nasotracheal intubation to reach the tracheobronchial region was efficient to cytological characterization and cellular differentiation in the obtained samples, being well supported by the animals.

     

    KEY WORDS: Citocentrifugation, cytology, tracheobronchial lavage, sheep.

    Avaliou-se a técnica de colheita de células do trato respiratório em ovinos, por sondagem nasotraqueal, e caracterizou-se a população celular em dezenove ovinos clinicamente sadios. Os animais foram contidos em estação, com cabeça e pescoço estendidos e alinhados com a coluna vertebral. Após a contenção, introduziu-se uma sonda-guia siliconizada até a bifurcação da traquéia, por dentro da qual se passou uma sonda de menor calibre, para realização do lavado traqueobrônquico. A média da contagem de células nucleadas foi de 64.650 ± 49.674. A análise citológica das amostras evidenciou, pelas médias das porcentagens obtidas, 62,74% de macrófagos, 15,01% de células epiteliais cilíndricas, 20,04% de neutrófilos, 1,44% de linfócitos e 0,77% de eosinófilos. Concluiu-se que o método de colheita por sondagem nasotraqueal foi eficiente na obtenção de amostras de regi

  19. Mediadores inflamatórios, citograma em lavado nasal e tomografia computadorizada de seios paranasais em crianças atópicas Inflammatory mediators, cell counts in nasal lavage and computed tomography of the paranasal sinuses in atopic children

    Directory of Open Access Journals (Sweden)

    Loreni C.S. Kovalhuk

    2001-08-01

    mucosa paranasal está associado à eosinofilia periférica e do lavado nasal e à ativação celular. A infiltração e a ativação de neutrófilos não estavam relacionadas com a maior extensão de lesão da mucosa paranasal.OBJECTIVE: The aims of this study were to evaluate inflammatory cells, the profile of inflammatory mediators in nasal lavage (NL, and the involvement of the paranasal mucosa in atopic infants with no symptoms of sinusitis. METHODS: 48 atopic patients with allergic rhinitis (AR, and 33/48 patients with asthma were studied; the control group consisted of 13 nonatopic children. Those individuals with acute, chronic or recurrent sinusitis were excluded. The involvement of the paranasal mucosa was assessed by coronal computed tomography (CT and graded by a standard protocol (0-30. A CT score greater than or equal to 12 indicated extensive involvement. Nasal lavage was used to quantify total and differential nasal cell counts. An aliquot of the supernatant was used for determining inflammatory mediators: interleukin-8 (IL-8, myeloperoxidase (MPO, and eosinophil cationic protein (ECP. Albumin was used as a marker for increased vascular permeability. These measurements were performed on all of the atopic patients and in 6/13 patients in the control group. The three groups were submitted to spirometry and complete blood cell count. RESULTS: Extensive involvement of the paranasal mucosa was observed in 7/33 (21% of asthmatic patients (Group I and 2/15 (13% of those with allergic rhinitis (Group II. The highest CT score in the control group (Group III was 7. Total cell and eosinophil count/ml and albumin concentration in nasal fluid were higher in asthmatic patients whose CT score was greater than 12. Interleukin-8 concentration, number of neutrophils and epithelial cells/ml in nasal fluid were similar in the three groups. A positive correlation between CT score, peripheral blood eosinophilia, number of eosinophils/ml and eosinophil cationic protein

  20. Diagnostic double guarded low-volume uterine lavage in mares

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Brandis, Louise; Samuelsson, Julia;

    2014-01-01

    Endometritis constitutes a major problem in the management of broodmares; hence diagnostic tests with a high sensitivity and specificity are desired. We hypothesize that a double guarded uterine flush technique for bacterial culture and cytology is comparable to standard diagnostic tests, the end...

  1. 矽肺患者肺灌洗液的AM培养上清对人胚肺FB增殖及TGF-β1表达的影响%Effect of AM culture supernatant of lung lavage fluent in patients with pneumoconiosis on proliferation of human embryo lung FB and TGF-β1 expression

    Institute of Scientific and Technical Information of China (English)

    陈刚

    2007-01-01

    目的 分析矽肺病人大容量全肺灌洗回收液(Massive Whole-lung Lavage Fluent,WLLF)中提取的AM中TGF-β1表达情况及AM培养上清对FB刺激后FB增殖和TGF-β1表达的情况.方法 矽肺病人的WLLF中获得AM,用无血清1640培养不同时间后,收集培养上清并作用于FB.采用免疫细胞化学法检测AM与FB的TGF-β1的表达情况,结合自动图像分析系统对其结果进行半定量分析;采用MTT比色法、细胞分裂指数法检测FB的增殖情况.结果 ①矽肺病人的AM表达TGF-β1,随时间点的延长,其表达逐渐增强.②各时间点AM培养上清均有促FB增殖的作用,加入TGF-β1的抗体,这种促FB增殖的作用受到抑制.③AM的24小时培养上清有促进FB增殖及转化生长因子-β1表达的作用.结论 ①矽肺病人灌洗的AM表达TGF-β1,其培养上清对FB有促增殖作用,TGF-β1的抗体对此作用有抑制作用,提示TGF-β1在矽肺发生中起重要作用.②矽肺病人的AM培养上清可以诱导FB的TGF-β1表达,提示FB存在TGF-β1的自分泌机制,在矽肺的发病过程中可能起相当的作用.

  2. 经纤维支气管镜阿米卡星肺泡灌洗治疗多重耐药鲍曼不动杆菌呼吸机相关性肺炎的临床观察%Clinical Observation of Treatment on Multidrug-resistant Acinetobacter Baumannii Ventilator-associated Pneumonia with Amikacin by Fiberoptic Bronchoscopy Lavage

    Institute of Scientific and Technical Information of China (English)

    吕光宇; 蒋文芳; 蔡天斌; 张友华

    2015-01-01

    目的:评估经纤维支气管镜阿米卡星肺泡灌洗治疗多重耐药治疗鲍曼不动杆菌(multidrug-resistant acinetobacter baumanii,MDR-Ab)呼吸机相关肺炎(ventilator-associated pneumonia,VAP)的效果和安全性。方法将42例多重耐药鲍曼不动杆菌呼吸机相关性肺炎的机械通气患者随机分为观察组和对照组,每组21例。两组均使用头孢哌酮舒巴坦钠3.0 g,1次/6小时并每日行支气管肺泡灌洗吸痰,观察组每日支气管肺泡灌洗治疗结束后用阿米卡星0.4 g加10 mL生理盐水灌洗,对照组使用阿米卡星7.5 mg/kg静脉滴注1次/天。记录治疗前后急性生理与慢性健康评分Ⅱ(acute physiology and chronic health evaluation Ⅱ,APACHE Ⅱ)、临床肺部感染评分(clinical pulmonary infection score,CPIS)、血清肌酐(Cr)、C-反应蛋白(CRP),比较两组治疗结束时支气管肺泡灌洗液细菌学检查转阴率、28 d病死率。结果与治疗前相比,两组APACHEⅡ评分、CPIS、CRP治疗后均有下降(P0.05), while the control group has signiifcantly higher levels of Cr than before treatment (P0.05)]. Conclusion Treatment of multidrug-resistant acinetobacter baumannii ventilator-associated pneumonia by ifberoptic bronchoscopy lavage was better than intravenous administration of amikacin, and can achieve higher bacterial clearance rate, while effectively reducing nephrotoxicity.

  3. 冰冻紫地合剂胃内灌注救治急性上消化道出血的临床研究%Therapeutic effect evaluation on the treatment of acute upper gastrointestinal bleeding with freezing Zidi mixture lavage

    Institute of Scientific and Technical Information of China (English)

    郭佳莹; 欧秀娟; 王俏芝

    2014-01-01

    mixture lavage. Method 183 UGIB patients from the First Affiliated Hospital to Guanzhou University of TCM in August 2013 were randomly recruited into a control group with 91cases and a treatment group with 92 cases. The treatment group was treated with intragastric administration of freezing Zidi mixture, while the control group was treated with intragastric administration of cryohydrate and norepinephrine. The changes of clinical effects, blood pressure, hemoglobin, blood urea nitrogen, pulse and dark stool were observed and the bad emotions as anxiety, depression and fear were evaluated. Results ① On therapeutic effect, the total effective rate was 96.7% and 85.7% in the treatment group and the control group respectively, with statistical difference(χ2=2.943,P0.05). ④ On changes of anxiety, depression and fear:the treatment group [the(42.5±9.4), (41.6±9.7), (26.3±5.4)for each]was obviously improved after the treatment than the control group[the score was(51.2±10.1),(50.4±11.5),(30.4±6.9)for each],P<0.05. Conclusion Freezing Zidi mixture lavage can obviously elevate systolic pressure, decrease heart rate, enhance hemoglobin, decrease blood urea nitrogen, relieve body stress reaction and other clinical symptoms. Its effects were better than intragastric administration of cryohydrate and norepinephrine in treating AUGIB.

  4. Cytological detection of pleural lavage during operation for lung cancer and the effect of hyperthermic-chemotherapy in thoracic cavity%肺癌术中冲洗液细胞学检查与腔内温热灌注化疗疗效研究

    Institute of Scientific and Technical Information of China (English)

    肖宏卫; 吴灿; 李远东; 余汉毅; 唐文飞; 黄敏

    2012-01-01

    目的:检测无胸水肺癌患者胸膜腔内在术前或术后是否存在游离癌细胞并探讨术中低渗水热灌注化疗和低渗热灌注治疗对生存期的影响.方法:对380例无胸水肺癌患者术中均在开胸后和关胸前用500ml生理盐水冲洗胸腔,然后留取冲洗液作细胞学检查.阳性者随机分为A组、B组和C组,A组关胸前应用43℃蒸馏水500ml加顺伯(80mg)灌注化疗,B组应用43℃蒸馏水500ml温热灌注,C组未给予治疗常规关胸.结果:阳性患者108例(28.6%),其中腺癌73.2%,磷癌16.7%,其它10.1%,Ⅰ期、Ⅱ期、Ⅲ期的比例分别为2.8%、7.4%、89.8%.A组、B组与C组1、3、5生存率分别为97.4%、76.3%、57.9%;94.4%、69.4%、44.4%;97.1%、38.2%、20.6%.结论:无胸水肺癌患者胸膜腔内在术前或术后有游离癌细胞存在,以腺癌和Ⅲ期的患者居多.术中低渗热灌注化疗和低渗热灌注治疗能提高阳性肺癌患者的3年、5年生存率,但两种治疗方法统计学无显著差异.%Objective:To detect free carcinoma cells in the pleural cavity of lung cancer patients without pleural effusion,to evaluate the effect of intraoperalive pleura] perfusion hyperthermic - chemotherapy ( PPHC) and pleural perfusion hyperthermia therapy(PPHT) on the survival time. Methods:Total of 180 patients with lung cancer were enrolled in the study. Pleural lavage fluid was collected after thoracotomy and evaluated immediately for its cytological characteristics. Positives were randomly divided into three groups( A,B and C). Group A underwent intrapleural perfusion with 43 degrees distiled water( 500ml) containing cisplatin(80mg)for 60minutes,while group B without containing cisplatin and group C did nothing. Results;The cytological results of the pleural lavage fluid were positive for malignant cells in 108 of 380 patients (28. 6% ), including adenocarcinoma (73. 2% ), squamous - cell carcinoma (16.7% ) and others( 10.1% ) . Among

  5. 非肺孢子菌肺炎患者支气管肺泡灌洗液肺孢子菌检出情况%Detection results of Pneumocystis jirovecii from non-Pneumocystis pneumonia patients' bronchial alveolar lavage fluid samples

    Institute of Scientific and Technical Information of China (English)

    任珊珊; 田小军; 齐志群; 安亦军; 范东瀛; 王爱东; 任翊

    2015-01-01

    目的 利用常规PCR、巢式PCR(Nest PCR,nPCR)和定量PCR(Quantitative PCR,qPCR)方法,调查非肺孢子菌肺炎(Non-Pneumocystis pneumonia,non-PCP)患者支气管肺泡灌洗液(Bronchial alveolar lavage fluid,BALF)中耶氏肺孢子菌(Pneumocystis jirovecii,Pj)的检出情况.方法 入选non-PCP患者50例留取BALF,分别以线粒体大亚基rRNA(Mi-tochondrial large subunit rRNA,mtLSUrRNA)为靶基因进行常规PCR(Mt-PCR)和巢氏PCR(Mt-nPCR),以主要表面糖蛋白(Major surface glycoprotein,Msg)为靶基因进行常规PCR(Msg-PCR),检测Mt-PCR,Mt-nPCR和Msg-PCR三种方法的Pj特异性核酸片段检出率,并对PCR检出为阳性的样本分别用以mtLSU rRNA和Msg为靶基因的qPCR来检测相应Pj核酸片段拷贝数.结果 50例BALF中,Mt-nPCR、Mt-PCR及Msg-PCR的检出率分别为56%(28/50)、36%(18/50)和26%(13/50),其中三种检测方法同时阳性5例(10%),任意两种方法阳性13例(26%),任意一种方法阳性18例(36%),三种方法均为阴性14例(28%).36例PCR检测结果阳性的标本分别进行mtLSU rRNA定量PCR(Mt-qPCR)和Msg定量PCR(Msg-qPCR)检测,其中Mt-qPCR检测结果为:1000拷贝/μL~9 999拷贝/μL有36例(100%);Msg-qPCR检测结果为:100拷贝/μL~999拷贝/μL有3例(8.3%),1 000拷贝/μL~9 999拷贝/μL有16例(44.4%),10 000拷贝/μL~99 999拷贝/μL有9例(25%),105拷贝/μL以上8例(22.2%).36例配对检测qPCR样本中,Msg-qPCR拷贝数大于Mt-qPCR拷贝数样本28例(77.8%).结论 在non-PCP患者BALF中,Pj核酸扩增方法的检出率为72%,Mt-qPCR拷贝数主要位于103拷贝/μL数量级,Msg-qPCR拷贝数主要分布于103至105拷贝/μL.用核酸扩增方法在BALF中检测出Pj时,临床意义解读需要谨慎.

  6. 不同类型呼吸衰竭患儿行支气管镜检查灌洗术病例对照观察%Bronchoscopic lavage in children with different types of respiratory failure: case-control analysis

    Institute of Scientific and Technical Information of China (English)

    王亚龙; 饶小春; 马渝燕; 潘跃娜; 孟辰芳; 何南; 焦安夏

    2013-01-01

    Objective To evaluate the value of bronchoscopy in children with different types of respiratory failure. Methods The clinical data of cases with respiratory failure from March 2011 to June 2012 were collected retrospectively. Changes of arterial blood gas, lung imaging and fiberoptic bronchoscopic findings were analysed. Results Finally, the results of the 60 patients were analyzed. Based on the blood gas level children were divided into group A ( ARDS Group, 11 cases) and group B (non-ARDS Group , 49 cases). Group B was divided into three subgroups; type Ⅰ respiratory failure (11 cases) , type Ⅱ respiratory failure( 17 cases) and hypercapnia alone (21cases). ① Under bronchoscope rough mucosa and edema could be found in all 60 patients. In 8/11 cases (72. 7% ) more secretion could be found in ARDS group and in 19/49 cases (38. 8% ) in non-ARDS group. Tracheostenosis could be seen in 16 cases in non-ARDS group. Hypoventilation could be seen in 2/11 cases (18. 2% ) in ARDS group and in 7/49 cases ( 14. 3% ) in non-ARDS group. Mucosal erosion could be found in 5/11 cases (45. 4% ) in ARDS group and in 2/49 cases (4. 1% ) in non-ARDS gropup. ②Etilogical diagnosis was made with bronchoscopy in 26/60 (43. 3% ) , 3/11 (27. 3% ) and 23/49 (46. 9% ) cases in ARDS and non-ARDS groups respectively.③Chest X-ray (CT) pre- and post-bronchoscopic lavage showed in ARDS group consolidation shadow, grind glass shadow and brochial aeration were the main findings, while in non-ARDS group consolidation shadow, fronchial aeration and insufficient aeration of lung were the main presentation. The efficacy rates of imaging were 87.5% (33/40) and 0% in non-ARDS and ARDS groups respectively.④ Blood gas analysis showed that improvement was found in 3/11 (27. 3% ) and 38/47 (80. 8% ) cases pre- and post-bronchoscopy in ARDS and non-ARDS groups respectively.⑤Total efficacy rates were 27. 3% (3/11) and 93.9% (46/49) in ARDS and nonARDS groups, and there was significant difference

  7. Ambient particulate matter induces an exacerbation of airway inflammation in experimental asthma: role of interleukin-33.

    Science.gov (United States)

    Shadie, A M; Herbert, C; Kumar, R K

    2014-08-01

    High levels of ambient environmental particulate matter (PM10 i.e. interleukin (IL)-33 in airway tissues and an increased concentration of IL-33 in bronchoalveolar lavage fluid. Administration of a monoclonal neutralizing anti-mouse IL-33 antibody prior to delivery of particulates significantly suppressed the inflammatory response induced by Sydney PM10, as well as the levels of associated proinflammatory cytokines in lavage fluid. We conclude that IL-33 plays a key role in driving airway inflammation in this novel experimental model of an acute exacerbation of chronic allergic asthma induced by exposure to PM10.

  8. Silicosis in Workers Exposed to Artificial Quartz Conglomerates: Does It Differ From Chronic Simple Silicosis?

    Science.gov (United States)

    Paolucci, Valentina; Romeo, Riccardo; Sisinni, Antonietta Gerardina; Bartoli, Dusca; Mazzei, Maria Antonietta; Sartorelli, Pietro

    2015-12-01

    Recently, a number of reports have been published on silicosis in workers exposed to artificial quartz conglomerates containing high levels of crystalline silica particles (70-90%) used in the construction of kitchen and bathroom surfaces. Three cases of silicosis in workers exposed to artificial quartz conglomerates are reported. The diagnosis was derived from both the International Labour Office and the International Classification of HRCT for Occupational and Environmental Respiratory Diseases (ICOERD) classifications and cytological analysis of bronchoalveolar lavage fluid. In 2 cases, levels of respirable silica greatly in excess of recommended standards were measured in the workplace, and cytological analysis of bronchoalveolar lavage fluid highlighted a prevalence of lymphocytes, meeting criteria for the diagnosis of accelerated silicosis. The prevention of pneumoconiosis caused by the use of innovative materials, such as artificial conglomerates with high crystalline silica content must be addressed.

  9. Subclinical interstitial lung involvement in rheumatic diseases. Correlations of high-resolution Computed Tomography patterns with functional and cytologic findings. L'interessamento polmonare interstiziale subclinico nelle malattie reumatiche. Correlazione fra Tomografia Computerizzata con alta risoluzione e i reperti funzionali e citologici

    Energy Technology Data Exchange (ETDEWEB)

    Salaffi, F. (Ancona Univ. (Italy). Clinica Reumatologica. Cattedra di Reumatologia); Baldelli, S. (Ancona Univ. (Italy). Ist. di Semeiologia, Diagnostica e Terapia Strumentale. Cattedra di Radiologia) (and others)

    The aims of this study were to quantify the severity and extent of subclinical interstitial lung disease as depicted on HRCT and to study the relationship between the patterns of lung disease quantified by HRCT and the functional parameters and bronchoalveolar lavage findings in patients with rheumatic diseases. The results confirm that HRCT is a sensitive tool in detecting interstitial lung disease in patients with rheumatic diseases with no signs and symptoms of pulmonary involvement. The relationship between the different HRCT patterns and bronchoalveolar lavage cell profiles can identify patients at higher risk of developing irreversible lung fibrosis. A long-term, prospective follow-up study is needed to determine whether these patients will develop over pulmonary disease.

  10. Does cytomegalovirus predict a poor prognosis in Pneumocystis carinii pneumonia treated with corticosteroids? A note for caution

    DEFF Research Database (Denmark)

    Jensen, A M; Lundgren, Jens Dilling; Benfield, T;

    1995-01-01

    OBJECTIVE: To examine the importance of cytomegalovirus (CMV) in bronchoalveolar lavage (BAL) fluid of patients with HIV-associated Pneumocystis carinii pneumonia (PCP) treated with adjunctive corticosteroids (CS). DESIGN: Analysis of clinical data during a 5-year period. SETTING: Department of i...... of adjunctive CS in severe PCP, the role of CMV as a pulmonary copathogen may have changed. Active CMV infection may be an important cause of failing treatment of severe PCP in those treated with adjunctive CS....

  11. In vitro biodegradation of chrysotile fibres by alveolar macrophages and mesothelial cells in culture: comparison with a pH effect.

    OpenAIRE

    Jaurand, M C; Gaudichet, A; Halpern, S.; Bignon, J.

    1984-01-01

    The modification of the chemistry of asbestos chrysotile fibres (Mg3(Si2O5)(OH)4) after their ingestion by cultured cells has been studied. Two types of cells involved in asbestos related pulmonary disease were used, rabbit alveolar macrophages (AM), recovered by bronchoalveolar lavage, and pleural mesothelial cells (PMC) obtained from the rat parietal pleura. Chemical characterisation of intracellular fibres was performed on unstained ultrathin sections by electron probe microanalysis. The r...

  12. Changes in the Staphylococcus aureus Transcriptome during Early Adaptation to the Lung

    OpenAIRE

    Chaffin, Donald O.; Destry Taylor; Skerrett, Shawn J.; Craig E Rubens

    2012-01-01

    Staphylococcus aureus is a common inhabitant of the human nasopharynx. It is also a cause of life-threatening illness, producing a potent array of virulence factors that enable survival in normally sterile sites. The transformation of S. aureus from commensal to pathogen is poorly understood. We analyzed S. aureus gene expression during adaptation to the lung using a mouse model of S. aureus pneumonia. Bacteria were isolated by bronchoalveolar lavage after residence in vivo for up to 6 hours....

  13. CXCR2 antagonists block the N-Ac-PGP-induced neutrophil influx in the airways of mice, but not the production of the chemokine CXCL1.

    Science.gov (United States)

    Braber, Saskia; Overbeek, Saskia A; Koelink, Pim J; Henricks, Paul A J; Zaman, Guido J R; Garssen, Johan; Kraneveld, Aletta D; Folkerts, Gert

    2011-10-15

    Neutrophils are innate immune cells in chronic inflammatory diseases including chronic obstructive pulmonary disease (COPD) and can be attracted to the site of inflammation via the collagen breakdown product N-acetyl Proline-Glycine-Proline (N-Ac-PGP). To elucidate whether CXCR2 is involved in N-Ac-PGP-induced neutrophil migration and activation, studies using specific antagonists were performed in vivo. N-Ac-PGP and keratinocyte cell-derived chemokine (KC; CXCL1) were administered in C57Bl/6 mice via oropharyngeal aspiration. Intraperitoneal applications of CXCR2 antagonist SB225002 or SB332235 were administered 1h prior and 1h after oropharyngeal aspiration. Six hours after oropharyngeal aspiration mice were sacrificed. Neutrophil counts and CXCL1 levels were determined in bronchoalveolar lavage fluid, myleoperoxidase (MPO) levels were measured in lung tissue homogenates and an immunohistological staining for neutrophils was performed on lung tissue. N-Ac-PGP and CXCL1 induced a neutrophil influx in the bronchoalveolar lavage fluid and lung tissue, which was also reflected by increased MPO levels in lung tissue. The N-Ac-PGP- and CXCL1-induced neutrophil influx and the increased pulmonary tissue MPO levels were inhibited by the CXCR2 antagonists SB225002 and SB332235. Moreover, N-Ac-PGP administration enhanced the CXCL1 levels in bronchoalveolar lavage fluid, which could not be attenuated by both CXCR2 antagonists. In conclusion, neutrophil migration induced by N-Ac-PGP is mediated via direct CXCR2 interaction. The N-Ac-PGP-induced release of CXCL1 is independent of CXCR2. Related to the maximal effect of CXCL1, N-Ac-PGP is more potent at inducing neutrophil migration in the pulmonary tissue than into the bronchoalveolar lavage fluid, or N-ac-PGP may be more potent at inducing MPO levels in the lung tissue.

  14. Characterization of spontaneous air space enlargement in mice lacking microfibrillar-associated protein 4

    DEFF Research Database (Denmark)

    Holm, Anne Trommelholt; Wulf-Johansson, Helle; Hvidsten, Svend

    2015-01-01

    Microfibrillar-associated protein 4 (MFAP4) is localized to elastic fibers in blood vessels and the interalveolar septa of the lungs and is further present in bronchoalveolar lavage. Mfap4 has been previously suggested to be involved in elastogenesis in the lung. We tested this prediction and aim...... of lung function, which was evident at 6 mo of age, and moderate air space enlargement, with emphysema-like changes....

  15. Cannabidiol, a non-psychotropic plant-derived cannabinoid, decreases inflammation in a murine model of acute lung injury: role for the adenosine A(2A) receptor.

    Science.gov (United States)

    Ribeiro, Alison; Ferraz-de-Paula, Viviane; Pinheiro, Milena L; Vitoretti, Luana B; Mariano-Souza, Domenica P; Quinteiro-Filho, Wanderley M; Akamine, Adriana T; Almeida, Vinícius I; Quevedo, João; Dal-Pizzol, Felipe; Hallak, Jaime E; Zuardi, Antônio W; Crippa, José A; Palermo-Neto, João

    2012-03-05

    Acute lung injury is an inflammatory condition for which treatment is mainly supportive because effective therapies have not been developed. Cannabidiol, a non-psychotropic cannabinoid component of marijuana (Cannabis sativa), has potent immunosuppressive and anti-inflammatory properties. Therefore, we investigated the possible anti-inflammatory effect of cannabidiol in a murine model of acute lung injury. Analysis of total inflammatory cells and differential in bronchoalveolar lavage fluid was used to characterize leukocyte migration into the lungs; myeloperoxidase activity of lung tissue and albumin concentration in the bronchoalveolar lavage fluid were analyzed by colorimetric assays; cytokine/chemokine production in the bronchoalveolar lavage fluid was also analyzed by Cytometric Bead Arrays and Enzyme-Linked Immunosorbent Assay (ELISA). A single dose of cannabidiol (20mg/kg) administered prior to the induction of LPS (lipopolysaccharide)-induced acute lung injury decreases leukocyte (specifically neutrophil) migration into the lungs, albumin concentration in the bronchoalveolar lavage fluid, myeloperoxidase activity in the lung tissue, and production of pro-inflammatory cytokines (TNF and IL-6) and chemokines (MCP-1 and MIP-2) 1, 2, and 4days after the induction of LPS-induced acute lung injury. Additionally, adenosine A(2A) receptor is involved in the anti-inflammatory effects of cannabidiol on LPS-induced acute lung injury because ZM241385 (4-(2-[7-Amino-2-(2-furyl)[1,2,4]triazolo[2,3-a][1,3,5]triazin-5-ylamino]ethyl)phenol) (a highly selective antagonist of adenosine A(2A) receptor) abrogated all of the anti-inflammatory effects of cannabidiol previously described. Thus, we show that cannabidiol has anti-inflammatory effects in a murine model of acute lung injury and that this effect is most likely associated with an increase in the extracellular adenosine offer and signaling through adenosine A(2A) receptor.

  16. [Mediastino-pulmonary localizations of sarcoidosis].

    Science.gov (United States)

    Battesti, J P; Valeyre, D

    1984-01-01

    This study discusses mediastinal and pulmonary involvement in sarcoidosis. The main points of discussion are the clinical consequences of the histopathological changes of the disease, especially the alveolitis, the initial lesion preceding granuloma formation and, new methods of investigation such as measurement of the angiotensin converting enzyme, Gallium 67 scintigraphy and bronchoalveolar lavage. Assessment of the activity of the disease and the indications of steroid therapy are analysed with respect to these informations.

  17. Pseudomembranous tracheobronchitis due to Bacillus cereus.

    Science.gov (United States)

    Strauss, R; Mueller, A; Wehler, M; Neureiter, D; Fischer, E; Gramatzki, M; Hahn, E G

    2001-09-01

    We present a case of a rapidly progressive pseudomembranous tracheobronchitis and pneumonia in a 52-year-old woman with severe aplastic anemia. Bacillus cereus was isolated from bronchoalveolar lavage fluids, blood cultures, and pseudomembrane biopsy specimens; despite intensive antibiotic treatment, the patient's condition deteriorated rapidly. To our knowledge, this is the first report of a B. cereus infection that has caused pseudomembranous tracheobronchitis, possibly because of the production of bacterial toxins.

  18. Micosis pulmonares en pacientes de la Quinta Región: Período 2007-2010

    OpenAIRE

    Cruz CH,Rodrigo; Vieille O,Peggy; Fuentes H,Daniela; Ponce E,Elliete; Piontelli L,Eduardo

    2012-01-01

    Background: The frequency of pulmonary mycoses has increased in the past few years specially in immunocompromised patients. Aim: To determine the frequency of invasive fungal diseases by analyzing lung secretion samples. Material and Methods: Samples of bronchoalveolar lavage (BAL) tracheal aspiration (TA) and induced sputum (IS) were obtained from patients of five hospitals in the Valparaíso Region for the diagnosis of invasive or non-invasive fungal disease, and pneumocystis (PCP), in the p...

  19. Sauna lung: hypersensitivity pneumonitis due to Exophiala jeanselmei.

    Science.gov (United States)

    Huang, Wei-Chen; Lu, Yin-Hsiu; Lin, Zih-Gong; Su, Wen-Lin

    2010-04-01

    A 55-year-old man developed progressive cough and dyspnoea after regular attendance at a public steam bath. Hypoxaemia, diffuse pulmonary infiltrates and a predominance of lymphocytes with an increased percentage of CD8+ T cells in his bronchoalveolar lavage fluid suggested hypersensitivity pneumonitis. Microbial cultures from the steam bath room and tank identified Exophiala jeanselmei. Immunoblotting assays from the patient's serum confirmed the major antigenic stimulus. The patient recovered fully after systemic corticosteroid treatment and cessation of further exposure.

  20. Invasive pulmonary aspergillosis in an immunocompetent patient with severe dengue fever.

    Science.gov (United States)

    Nasa, Prashant; Yadav, Rohit; Nagrani, S K; Raina, Sanjay; Gupta, Ankur; Jain, Shakti

    2014-05-01

    We report a case of a 65-year-old female diagnosed with sever dengue fever. She started showing recovery from dengue fever with medical management. On day 6 of admission, she had leukocytosis, altered mental sensorium, and hemoptysis. Chest tomography showed air space consolidation with multiple nodules in the left upper and middle lobe sputum and bronchoalveolar lavage cultures were positive for Aspergillus flavus. The patient showed improvement with voriconazole and therapy was continued for 6 weeks.

  1. Mycobacterium abscessus morphotype comparison in a murine model.

    Science.gov (United States)

    Caverly, Lindsay J; Caceres, Silvia M; Fratelli, Cori; Happoldt, Carrie; Kidwell, Kelley M; Malcolm, Kenneth C; Nick, Jerry A; Nichols, David P

    2015-01-01

    Pulmonary infections with Mycobacterium abscessus (M. abscessus) are increasingly prevalent in patients with lung diseases such as cystic fibrosis. M. abscessus exists in two morphotypes, smooth and rough, but the impact of morphotype on virulence is unclear. We developed an immune competent mouse model of pulmonary M. abscessus infection and tested the differences in host inflammatory response between the morphotypes of M. abscessus. Smooth and rough morphotypes of M. abscessus were isolated from the same American Type Culture Collection strain. Wild type and cystic fibrosis mice were intratracheally inoculated with known quantities of M. abscessus suspended in fibrin plugs. At the time of sacrifice lung and splenic tissues and bronchoalveolar lavage fluid were collected and cultured. Bronchoalveolar lavage fluid was analyzed for leukocyte count, differential and cytokine expression. Pulmonary infection with M. abscessus was present at both 3 days and 14 days post-inoculation in all groups at greater levels than systemic infection. Inoculation with M. abscessus rough morphotype resulted in more bronchoalveolar lavage fluid neutrophils compared to smooth morphotype at 14 days post-inoculation in both wild type (p = 0.01) and cystic fibrosis (pmorphotype occurred in 12/57 (21%) of mice. These mice trended towards greater weight loss than mice in which morphotype conversion did not occur. In the described fibrin plug model of M. abscessus infection, pulmonary infection with minimal systemic dissemination is achieved with both smooth and rough morphotypes. In this model M. abscessus rough morphotype causes a greater host inflammatory response than the smooth based on bronchoalveolar lavage fluid neutrophil levels.

  2. Diagnosis of pulmonary infection with Toxoplasma gondii in immunocompromised HIV-positive patients by real-time PCR

    DEFF Research Database (Denmark)

    Petersen, E.; Edvinsson, B.; Lundgren, Bettina;

    2006-01-01

    The aim of the study presented here was to evaluate the use of PCR for improving the diagnosis of Toxoplasma gondii infection in immunocompromised hosts. Three hundred thirty-two bronchoalveolar lavage (BAL) fluid samples were analyzed by real-time PCR targeting a 529 bp element of T. gondii...... be performed in all immunosuppressed HIV-positive patients with symptoms of a systemic infection of unknown etiology. Trimethoprim-sulfamethoxazole prophylaxis does not exclude concomitant infection with T. gondii....

  3. Lipids are co-eluted with immunoglobulins G during purification by recombinant streptococcal protein G affinity chromatography.

    Science.gov (United States)

    Kitsiouli, Eirini; Lekka, Marilena E; Nakos, George; Cassagne, Claude; Maneta-Peyret, Lilly

    2002-12-20

    The efficiency of recombinant streptococcal protein G (rec-spG) affinity column chromatography in purifying immunoglobulins G (IgG) from lipids has been studied, with particular reference to IgG fractions from bronchoalveolar lavage (BAL) fluid and serum samples from different sources. It was found that the IgG fractions purified by rec-spG affinity column chromatography also contained cholesterol and phospholipids.

  4. COPD纤维支气管镜肺泡灌洗液中可溶性晚期糖基化终末产物受体水平的临床意义%The Clinical Significances of Soluble Receptor for Advanced Glycation Endproducts in Bronchoscopy Alveolus Lavage Fluid among Patients with COPD

    Institute of Scientific and Technical Information of China (English)

    杨兴官; 雷超; 胡占升

    2014-01-01

    Objective To discuss the clinical significances of soluble receptor for advanced glycation end-products ( sRAGE)in bronchoscopy alveolus lavage fluid( BALF)in patients with COPD. Methods A total of 40 patients with COPD who were admitted to the department of intensive care unit of the First Hospital Affiliated to Liaoning Medical University from Oc-tober 2012 to May 2013,were selected as the COPD group,meanwhile 40 patients with non-COPD were selected as the non-COPD group,and these COPD patients were divided into mild group(12 cases),moderate group(10 cases),severe group (10 cases),very severe group(8 cases). The sRAGE concentrations in BALF were detected by enzyme-linked immunosor-bent assay(ELISA). Results The concentration of sRAGE in BALF of patients in the COPD group(191 ±71)ng/L was sig-nificantly higher than that in the non-COPD group(55 ±56)ng/L(t=9. 44,P<0. 001). The concentration of sRAGE in BALF of COPD patients in the mild group,moderate group,severe group and very severe group was(111 ± 44) ng/L,(184 ±45)ng/L,(226 ±34)ng/L,and(273 ±30)ng/L,respectively,there were significant differences in concentration of sRAGE among these groups(F=30. 48,P<0. 001),and the concentration of sRAGE in very severe COPD group was signifi-cantly higher than that in severe COPD group,the concentration of sRAGE in severe COPD group was significantly higher than that in moderate group,the concentration of sRAGE in moderate group was significantly higher than that in mild group( P <0. 05 ) . Linear correlation analysis results showed that the concentration of sRAGE in BALF of COPD patients were negatively cor-related with FEV1%(r= -0. 738,P <0. 05). Conclusion The concentration of sRAGE in BALF of COPD patients was higher than that of non-COPD patients;The concentration of sRAGE in BALF is related to severity of COPD,it could be used as an index of the prognosis evaluation of COPD.%目的:探讨纤维支气管镜肺泡灌洗液中可溶性晚期

  5. Inhibitory effect of n-butanol fraction of Moringa oleifera Lam. seeds on ovalbumin-induced airway inflammation in a guinea pig model of asthma.

    Science.gov (United States)

    Mahajan, Shailaja G; Banerjee, Aryamitra; Chauhan, Bhupendrasinh F; Padh, Harish; Nivsarkar, Manish; Mehta, Anita A

    2009-01-01

    Moringaceae, which belongs to the Moringa oleifera Lam. family, is a well-known herb used in Asian medicine as an antiallergic drug. In the present study, the efficacy of the n-butanol extract of the seeds of the plant (MONB) is examined against ovalbumin-induced airway inflammation in guinea pigs. The test drugs (MONB or dexamethasone) are administered orally prior to challenge with aerosolized 0.5% ovalbumin. During the experimental period, bronchoconstriction tests are performed, and lung function parameters are measured. The blood and bronchoalveolar lavage fluid are collected to assess cellular content, and serum is used for cytokine (tumor necrosis factor-alpha, interleukin-4, and interleukin-6) assays. Histamine assays of lung tissue are performed using lung tissue homogenate. The results suggest that in ovalbumin-sensitized model control animals, tidal volume is decreased, respiration rate is increased, and both the total and differential cell counts in blood and bronchoalveolar lavage fluid are increased significantly compared with nonsensitized controls. MONB treatment shows improvement in all parameters except bronchoalveolar lavage tumor necrosis factor-alpha and interleukin-4. Moreover, MONB treatment demonstrates protection against acetylcholine-induced bronchoconstriction and airway inflammation. These results indicate that MONB has an inhibitory effect on airway inflammation. Thus, MONB possesses an antiasthmatic property through modulation of the relationship between Th1/Th2 cytokine imbalances.

  6. Enrichment of the lung microbiome with oral taxa is associated with lung inflammation of a Th17 phenotype

    Science.gov (United States)

    Segal, Leopoldo N.; Clemente, Jose C.; Tsay, Jun-Chieh J.; Koralov, Sergei B.; Keller, Brian C.; Wu, Benjamin G.; Li, Yonghua; Shen, Nan; Ghedin, Elodie; Morris, Alison; Diaz, Phillip; Huang, Laurence; Wikoff, William R.; Ubeda, Carles; Artacho, Alejandro; Rom, William N.; Sterman, Daniel H.; Collman, Ronald G.; Blaser, Martin J.; Weiden, Michael D.

    2016-01-01

    Microaspiration is a common phenomenon in healthy subjects, but its frequency is increased in chronic inflammatory airway diseases, and its role in inflammatory and immune phenotypes is unclear. We have previously demonstrated that acellular bronchoalveolar lavage samples from half of the healthy people examined are enriched with oral taxa (here called pneumotypeSPT) and this finding is associated with increased numbers of lymphocytes and neutrophils in bronchoalveolar lavage. Here, we have characterized the inflammatory phenotype using a multi-omic approach. By evaluating both upper airway and acellular bronchoalveolar lavage samples from 49 subjects from three cohorts without known pulmonary disease, we observed that pneumotypeSPT was associated with a distinct metabolic profile, enhanced expression of inflammatory cytokines, a pro-inflammatory phenotype characterized by elevated Th-17 lymphocytes and, conversely, a blunted alveolar macrophage TLR4 response. The cellular immune responses observed in the lower airways of humans with pneumotypeSPT indicate a role for the aspiration-derived microbiota in regulating the basal inflammatory status at the pulmonary mucosal surface. PMID:27572644

  7. Total liquid ventilation reduces oleic acid-induced lung injury in piglets

    Institute of Scientific and Technical Information of China (English)

    ZHU Yao-bin; LIU Dong-hai; ZHANG Yan-bo; LIU Ai-jun; FAN Xiang-ming; QIAO Chen-hui; WANG Qiang

    2013-01-01

    Background Pediatric patients are susceptible to lung injury that does not respond to traditional therapies.Total liquid ventilation has been developed as an alternative ventilatory strategy for severe lung injury.The aim of this study is to investigate the effect of total liquid ventilation on oleic acid (OA)-induced lung injury in piglets.Methods Twelve Chinese immature piglets were induced acute lung injury by OA.Twelve piglets were randomly treated with conventional gas ventilation (control group) or total liquid ventilation (study group) for 240 minutes.Samples for blood gas analysis were collected before,and at 60-minute intervals after OA-induced lung injury.The degree of lung injury was quantified by histologic examination.The inflammatory cells and the levels of IL-1β,IL-6,IL-10 and TNF-α in plasma,tissue and bronchoalveolar lavage were analyzed.Results Neutrophil and macrophage counts in bronchoalveolar lavage were significantly decreased in the study group (P<0.05).The total lung injury score was also reduced in the study group (P<0.05).The cconcentrations of IL-1β,IL-6,IL-10and TNF-α in plasma,tissue and bronchoalveolar lavage were significantly reduced in the study group (P<0.05).Conclusions Total liquid ventilation reduces biochemical and histologic OA-induced lung injury in piglets.

  8. Staphylococcus aureus and influenza A virus stimulate human bronchoalveolar cells to release histamine and leukotrienes

    DEFF Research Database (Denmark)

    Clementsen, P; Bisgaard, H; Pedersen, M

    1989-01-01

    was found to release histamine from cells from 7 of the 13 individuals and influenza A virus in 3 of 5 persons. Furthermore, Staph, aureus stimulated the BAL-cells to release leukotriene B4 in 7 of 11 subjects, whereas no release was found by influenza A virus in 7 examined persons. When cells from 4...... persons were stimulated with Staph. aureus no release of leukotriene C4 was found. The mediator release caused by bacteria and virus might be of importance for the exacerbation of bronchial asthma in upper respiratory tract infections, since histamine is assumed to increase the epithelial permeability...

  9. Effects of inhaled corticosteroids on airway inflammation in chronic obstructive pulmonary disease: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Jen R

    2012-09-01

    Full Text Available Rachel Jen,1 Stephen,1 Rennard,2 Don D Sin1,31Department of Medicine, Respiratory Division, University of British Columbia, Vancouver, BC, Canada; 2Internal Medicine Section of Pulmonary and Critical Care, Nebraska Medical Center, Omaha, NE, USA; 3Institute of Heart and Lung Health and the UBC James Hogg Research Center, St Paul's Hospital, Vancouver, BC, CanadaBackground: Chronic obstructive pulmonary disease (COPD is characterized by chronic inflammation in the small airways. The effect of inhaled corticosteroids (ICS on lung inflammation in COPD remains uncertain. We sought to determine the effects of ICS on inflammatory indices in bronchial biopsies and bronchoalveolar lavage fluid of patients with COPD.Methods: We searched Medline, Embase, Cinahl, and the Cochrane database for randomized, controlled clinical trials that used bronchial biopsies and bronchoalveolar lavage to evaluate the effects of ICS in stable COPD. For each chosen study, we calculated the mean differences in the concentrations of inflammatory cells before and after treatment in both intervention and control groups. These values were then converted into standardized mean differences (SMD to accommodate the differences in patient selection, clinical treatment, and biochemical procedures that were employed across the original studies. If significant heterogeneity was present (P < 0.1, then a random effects model was used to pool the original data; otherwise, a fixed effects model was used.Results: We identified eight original studies that met the inclusion criteria. Four studies used bronchial biopsies (n = 102 participants and showed that ICS were effective in reducing CD4 and CD8 cell counts (SMD, −0.52 units and −0.66 units, 95% confidence interval. The five studies used bronchoalveolar lavage fluid (n = 309, which together showed that ICS reduced neutrophil and lymphocyte counts (SMD, −0.64 units and −0.64 units, 95% confidence interval. ICS on the other hand

  10. Comparison of lung alveolar and tissue cells in silica-induced inflammation.

    Science.gov (United States)

    Sjöstrand, M; Absher, P M; Hemenway, D R; Trombley, L; Baldor, L C

    1991-01-01

    The silicon dioxide mineral, cristobalite (CRS) induces inflammation involving both alveolar cells and connective tissue compartments. In this study, we compared lung cells recovered by whole lung lavage and by digestion of lung tissue from rats at varying times after 8 days of exposure to aerosolized CRS. Control and exposed rats were examined between 2 and 36 wk after exposure. Lavaged cells were obtained by bronchoalveolar lavage with phosphate-buffered saline. Lung wall cells were prepared via collagenase digestion of lung tissue slices. Cells from lavage and lung wall were separated by Percoll density centrifugation. The three upper fractions, containing mostly macrophages, were cultured, and the conditioned medium was assayed for effect on lung fibroblast growth and for activity of the lysosomal enzyme, N-acetyl-beta-D-glucosaminidase. Results demonstrated that the cells separated from the lung walls exhibited different reaction patterns compared with those cells recovered by lavage. The lung wall cells exhibited a progressive increase in the number of macrophages and lymphocytes compared with a steady state in cells of the lung lavage. This increase in macrophages apparently was due to low density cells, which showed features of silica exposure. Secretion of a fibroblast-stimulating factor was consistently high by lung wall macrophages, whereas lung lavage macrophages showed inconsistent variations. The secretion of NAG was increased in lung lavage macrophages, but decreased at most observation times in lung wall macrophages. No differences were found among cells in the different density fractions regarding fibroblast stimulation and enzyme secretion.(ABSTRACT TRUNCATED AT 250 WORDS)

  11. CYTOMORPHOLOGICAL EVALUATION AND PROGNOSIS OF BRONCHOPULMONARY COMPLICATIONS IN ACUTE AND EARLY PERIODS OF SPINAL CORD TRAUMA

    Directory of Open Access Journals (Sweden)

    I.A. Norkin

    2009-09-01

    Full Text Available There were investigated 50 cytological preparations after fibro-optic bronchoscopy of 10 patients with cervical spinal cord injuries. The dynamics of broncho-pulmonary complications of spinal cord injuries was estimated on the basis of cytological broncho-alveolar lavage fluid investigations. In the work there were used clinico-neurologic methods, radiological (computer tomography and magnetic resonance imaging, endoscopic (fibro-optic bronchoscopy and cytomorphological investigations. Cytomorphological investigations of broncho-alveolar lavage fluid were carried out on the 3-4, 7, 14, 30th days. Cellular composition of the broncho-alveolar wash-out (endopulmonary cytogramme was estimated by calculation of more than 100 cells in 3 fields of the immersion microscope coverage. Quantitative changes of cellular elements were taken into account with respect to normal cell amount. The results were analyzed according to the average out method. Quantitative changes of inflammatory elements in endopulmonary cytogramme were determined by the degree of endobronchitic manifestations and were corresponding to clinico-radiological picture of development of broncho-pulmonary complications in different periods of spinal cord injury

  12. Intravenous Selenium Modulates L-Arginine-Induced Experimental Acute Pancreatitis

    Directory of Open Access Journals (Sweden)

    Jonathan Hardman

    2005-09-01

    Full Text Available Context Oxidative stress is understood to have a critical role in the development of acinar injury in experimental acute pancreatitis. We have previously demonstrated that compound multiple antioxidant therapy ameliorates end-organ damage in the intra-peritoneal L-arginine rat model. As the principal co-factor for glutathione, selenium is a key constituent of multiple antioxidant preparations. Objective The intention of this study was to investigate the effect of selenium on pancreatic and remote organ injury in a wellvalidated experimental model of acute pancreatitis. Methods Male Sprague-Dawley rats were randomly allocated to one of 3 groups (n=5/group and sacrificed at 72 hours. Acute pancreatitis was induced by 250 mg per 100 g body weight of 20% L-arginine hydrochloride in 0.15 mol/L sodium chloride. Group allocations were: Group 1, control; Group 2, acute pancreatitis; Group 3, selenium. Main outcome measures Serum amylase, anti-oxidant levels, bronchoalveolar lavage protein, lung myeloperoxidase activity, and histological assessment of pancreatic injury. Results L-arginine induced acute pancreatitis characterised by oedema, neutrophil infiltration, acinar cell degranulation and elevated serum amylase. Selenium treatment was associated with reduced pancreatic oedema and inflammatory cell infiltration. Acinar degranulation and dilatation were completely absent. A reduction in bronchoalveolar lavage protein content was also demonstrated. Conclusion Intravenous selenium given 24 hours after induction of experimental acute pancreatitis was associated with a reduction in the histological stigmata of pancreatic injury and a dramatic reduction in broncho-alveolar lavage protein content. Serum selenium fell during the course of experimental acute pancreatitis and this effect was not reversed by exogenous selenium supplementation.

  13. Characterization of the innate immune response to chronic aspiration in a novel rodent model

    Directory of Open Access Journals (Sweden)

    Lin Shu S

    2007-11-01

    Full Text Available Abstract Background Although chronic aspiration has been associated with several pulmonary diseases, the inflammatory response has not been characterized. A novel rodent model of chronic aspiration was therefore developed in order to investigate the resulting innate immune response in the lung. Methods Gastric fluid or normal saline was instilled into the left lung of rats (n = 48 weekly for 4, 8, 12, or 16 weeks (n = 6 each group. Thereafter, bronchoalveolar lavage specimens were collected and cellular phenotypes and cytokine concentrations of IL-1alpha, IL-1beta, IL-2, IL-4, IL-6, IL-10, GM-CSF, IFN-gamma, TNF-alpha, and TGF-beta were determined. Results Following the administration of gastric fluid but not normal saline, histologic specimens exhibited prominent evidence of giant cells, fibrosis, lymphocytic bronchiolitis, and obliterative bronchiolitis. Bronchoalveolar lavage specimens from the left (treated lungs exhibited consistently higher macrophages and T cells with an increased CD4:CD8 T cell ratio after treatment with gastric fluid compared to normal saline. The concentrations of IL-1alpha, IL-1beta, IL-2, TNF-alpha and TGF-beta were increased in bronchoalveolar lavage specimens following gastric fluid aspiration compared to normal saline. Conclusion This represents the first description of the pulmonary inflammatory response that results from chronic aspiration. Repetitive aspiration events can initiate an inflammatory response consisting of macrophages and T cells that is associated with increased TGF-beta, TNF-alpha, IL-1alpha, IL-1beta, IL-2 and fibrosis in the lung. Combined with the observation of gastric fluid-induced lymphocyitic bronchiolitis and obliterative bronchiolitis, these findings further support an association between chronic aspiration and pulmonary diseases, such as obliterative bronchiolitis, pulmonary fibrosis, and asthma.

  14. Effect of pentoxifylline on lung inflammation and gas exchange in a sepsis-induced acute lung injury model

    Directory of Open Access Journals (Sweden)

    I.S. Oliveira-Junior

    2006-11-01

    Full Text Available Experimental models of sepsis-induced pulmonary alterations are important for the study of pathogenesis and for potential intervention therapies. The objective of the present study was to characterize lung dysfunction (low PaO2 and high PaCO2, and increased cellular infiltration, protein extravasation, and malondialdehyde (MDA production assessed in bronchoalveolar lavage in a sepsis model consisting of intraperitoneal (ip injection of Escherichia coli and the protective effects of pentoxifylline (PTX. Male Wistar rats (weighing between 270 and 350 g were injected ip with 10(7 or 10(9 CFU/100 g body weight or saline and samples were collected 2, 6, 12, and 24 h later (N = 5 each group. PaO2, PaCO2 and pH were measured in blood, and cellular influx, protein extravasation and MDA concentration were measured in bronchoalveolar lavage. In a second set of experiments either PTX or saline was administered 1 h prior to E. coli ip injection (N = 5 each group and the animals were observed for 6 h. Injection of 10(7 or 10(9 CFU/100 g body weight of E. coli induced acidosis, hypoxemia, and hypercapnia. An increased (P < 0.05 cell influx was observed in bronchoalveolar lavage, with a predominance of neutrophils. Total protein and MDA concentrations were also higher (P < 0.05 in the septic groups compared to control. A higher tumor necrosis factor-alpha (P < 0.05 concentration was also found in these animals. Changes in all parameters were more pronounced with the higher bacterial inoculum. PTX administered prior to sepsis reduced (P < 0.05 most functional alterations. These data show that an E. coli ip inoculum is a good model for the induction of lung dysfunction in sepsis, and suitable for studies of therapeutic interventions.

  15. Suppression of ovalbumin-induced Th2-driven airway inflammation by β-sitosterol in a guinea pig model of asthma.

    Science.gov (United States)

    Mahajan, Shailaja G; Mehta, Anita A

    2011-01-10

    In the present study, the efficacy of β-sitosterol isolated from an n-butanol extract of the seeds of the plant Moringa oleifera (Moringaceae) was examined against ovalbumin-induced airway inflammation in guinea pigs. All animals (except group I) were sensitized subcutaneously and challenged with aerosolized 0.5% ovalbumin. The test drugs, β-sitosterol (2.5mg/kg) or dexamethasone (2.5mg/kg), were administered to the animals (p.o.) prior to challenge with ovalbumin. During the experimental period (on days 18, 21, 24 and 29), a bronchoconstriction test (0.25% acetylcholine for 30s) was performed and lung function parameters (tidal volume and respiration rate) were measured for each animal. On day 30, blood and bronchoalveolar lavaged fluid were collected to assess cellular content, and serum was collected for cytokine assays. Lung tissue was utilized for a histamine assay and for histopathology. β-sitosterol significantly increased the tidal volume (V(t)) and decreased the respiration rate (f) of sensitized and challenged guinea pigs to the level of non-sensitized control guinea pigs and lowered both the total and differential cell counts, particularly eosinophils and neutrophils, in blood and bronchoalveolar lavaged fluid. Furthermore, β-sitosterol treatment suppressed the increase in cytokine levels (TNFα, IL-4 and IL-5), with the exception of IL-6, in serum and in bronchoalveolar lavaged fluid detected in model control animals. Moreover, treatment with β-sitosterol protected against airway inflammation in lung tissue histopathology. β-sitosterol possesses anti-asthmatic actions that might be mediated by inhibiting the cellular responses and subsequent release/synthesis of Th2 cytokines. This compound may have therapeutic potential in allergic asthma.

  16. Dibutyryl cAMP effects on thromboxane and leukotriene production in decompression-induced lung injury

    Science.gov (United States)

    Little, T. M.; Butler, B. D.

    1997-01-01

    Decompression-induced venous bubble formation has been linked to increased neutrophil counts, endothelial cell injury, release of vasoactive eicosanoids, and increased vascular membrane permeability. These actions may account for inflammatory responses and edema formation. Increasing the intracellular cAMP has been shown to decrease eicosanoid production and edema formation in various models of lung injury. Reduction of decompression-induced inflammatory responses was evaluated in decompressed rats pretreated with saline (controls) or dibutyryl cAMP (DBcAMP, an analog of cAMP). After pretreatment, rats were exposed to either 616 kPa for 120 min or 683 kPa for 60 min. The observed increases in extravascular lung water ratios (pulmonary edema), bronchoalveolar lavage, and pleural protein in the saline control group (683 kPa) were not evident with DBcAMP treatment. DBcAMP pretreatment effects were also seen with the white blood cell counts and the percent of neutrophils in the bronchoalveolar lavage. Urinary levels of thromboxane B2, 11-dehydrothromboxane B2, and leukotriene E4 were significantly increased with the 683 kPa saline control decompression exposure. DBcAMP reduced the decompression-induced leukotriene E4 production in the urine. Plasma levels of thromboxane B2, 11-dehydrothromboxane B2, and leukotriene E4 were increased with the 683-kPa exposure groups. DBcAMP treatment did not affect these changes. The 11-dehydrothromboxane B2 and leukotriene E4 levels in the bronchoalveolar lavage were increased with the 683 kPa exposure and were reduced with the DBcAMP treatment. Our results indicate that DBcAMP has the capability to reduce eicosanoid production and limit membrane permeability and subsequent edema formation in rats experiencing decompression sickness.

  17. Exposure of neonates to Respiratory Syncytial Virus is critical in determining subsequent airway response in adults

    Directory of Open Access Journals (Sweden)

    Daly Melissa

    2006-08-01

    Full Text Available Abstract Background Respiratory syncytial virus (RSV is the most common cause of acute bronchiolitis in infants and the elderly. Furthermore, epidemiological data suggest that RSV infection during infancy is a potent trigger of subsequent wheeze and asthma development. However, the mechanism by which RSV contributes to asthma is complex and remains largely unknown. A recent study indicates that the age of initial RSV infection is a key factor in determining airway response to RSV rechallenge. We hypothesized that severe RSV infection during neonatal development significantly alters lung structure and the pulmonary immune micro-environment; and thus, neonatal RSV infection is crucial in the development of or predisposition to allergic inflammatory diseases such as asthma. Methods To investigate this hypothesis the present study was conducted in a neonatal mouse model of RSV-induced pulmonary inflammation and airway dysfunction. Seven-day-old mice were infected with RSV (2 × 105 TCID50/g body weight and allowed to mature to adulthood. To determine if neonatal RSV infection predisposed adult animals to enhanced pathophysiological responses to allergens, these mice were then sensitized and challenged with ovalbumin. Various endpoints including lung function, histopathology, cytokine production, and cellularity in bronchoalveolar lavage were examined. Results RSV infection in neonates alone led to inflammatory airway disease characterized by airway hyperreactivity, peribronchial and perivascular inflammation, and subepithelial fibrosis in adults. If early RSV infection was followed by allergen exposure, this pulmonary phenotype was exacerbated. The initial response to neonatal RSV infection resulted in increased TNF-α levels in bronchoalveolar lavage. Interestingly, increased levels of IL-13 and mucus hyperproduction were observed almost three months after the initial infection with RSV. Conclusion Neonatal RSV exposure results in long term

  18. Deficiency of phospholipase A2 receptor exacerbates ovalbumin-induced lung inflammation.

    Science.gov (United States)

    Tamaru, Shun; Mishina, Hideto; Watanabe, Yosuke; Watanabe, Kazuhiro; Fujioka, Daisuke; Takahashi, Soichiro; Suzuki, Koji; Nakamura, Takamitsu; Obata, Jun-Ei; Kawabata, Kenichi; Yokota, Yasunori; Murakami, Makoto; Hanasaki, Kohji; Kugiyama, Kiyotaka

    2013-08-01

    Secretory phospholipase A2 (sPLA2) plays a critical role in the genesis of lung inflammation through proinflammatory eicosanoids. A previous in vitro experiment showed a possible role of cell surface receptor for sPLA2 (PLA2R) in the clearance of extracellular sPLA2. PLA2R and groups IB and X sPLA2 are expressed in the lung. This study examined a pathogenic role of PLA2R in airway inflammation using PLA2R-deficient (PLA2R(-/-)) mice. Airway inflammation was induced by immunosensitization with OVA. Compared with wild-type (PLA2R(+/+)) mice, PLA2R(-/-) mice had a significantly greater infiltration of inflammatory cells around the airways, higher levels of groups IB and X sPLA2, eicosanoids, and Th2 cytokines, and higher numbers of eosinophils and neutrophils in bronchoalveolar lavage fluid after OVA treatment. In PLA2R(-/-) mice, intratracheally instilled [(125)I]-labeled sPLA2-IB was cleared much more slowly from bronchoalveolar lavage fluid compared with PLA2R(+/+) mice. The degradation of the instilled [(125)I]-labeled sPLA2-IB, as assessed by trichloroacetic acid-soluble radioactivity in bronchoalveolar lavage fluid after instillation, was lower in PLA2R(-/-) mice than in PLA2R(+/+) mice. In conclusion, PLA2R deficiency increased sPLA2-IB and -X levels in the lung through their impaired clearance from the lung, leading to exaggeration of lung inflammation induced by OVA treatment in a murine model.

  19. Experimental models of the respiratory distress syndrome : lavage and oleic acid

    NARCIS (Netherlands)

    R.M. van der Heijde (Roos); H.P. Grotjohan (Hans)

    1992-01-01

    textabstractSo far the existing animal models have a lack of long lasting stability. Hardly any attention was paid to standardization of the induction of respiratory distress. We aimed at models in which the individual animals have a comparable respiratory distress for several hours to obtain the op

  20. Peritoneal lavage under udredning for ventrikelcancer prædikterer overlevelsen

    DEFF Research Database (Denmark)

    Strandby, Rune Broni; Svendsen, Lars Bo; Hasselby, Jane Preuss

    2015-01-01

    The aim of this study was to review the current literature regarding prognostic outcome for patients with gastric cancer and positive cytology. We found that positive cytology was correlated with worse overall survival and higher recurrence rate among gastric cancer patients. However, the accurac...... of peritoneal washing cytology (PWC) is found not to be optimal, which is a significant problem when using the modality in a clinical setting. Further studies with more sensitive methods are needed to establish the relevant role of PWC....

  1. Laparoscopic Lavage Is Feasible and Safe for the Treatment of Perforated Diverticulitis With Purulent Peritonitis

    DEFF Research Database (Denmark)

    Angenete, Eva; Thornell, Anders; Burcharth, Jakob

    2016-01-01

    OBJECTIVE: To evaluate short-term outcomes of a new treatment for perforated diverticulitis with purulent peritonitis in a randomized controlled trial. BACKGROUND: Perforated diverticulitis with purulent peritonitis (Hinchey III) has traditionally been treated with surgery including colon resection...

  2. Outcome of Patients with Cholinergic Insecticide Poisoning Treated with Gastric Lavage: A Prospective Observational Cohort Study

    Directory of Open Access Journals (Sweden)

    Mekkattukunnel Andrews

    2014-12-01

    Conclusion: Number or timing of GL does not show any association with mortality while multiple GL had protective effect against development of late RF and IMS. Hence, GL might be beneficial in cholinergic insecticide poisoning.

  3. Nasal lavage natural killer cell function is suppressed in smokers after live attenuated influenza virus

    Science.gov (United States)

    Background Modified function of immune cells in nasal secretions may playa role in the enhanced susceptibility to resp iratory viruses that is seen in smokers. Innate immune cells in nasal secretions have largely been characterized by cellular differentials using morphologic c...

  4. [Efficacy of application of colonic lavage for peritonitis of biliary genesis].

    Science.gov (United States)

    Karlyĭchuk, O A; Sykorchuk, R I; Kulachek, V F; Volianiuk, P M

    2001-06-01

    The species and quantitative composition of the bile microflora, peritoneal exudate, colonic cavity and mucosa was studied in 55 patients and in experiment on 17 mongrel dogs to estimate efficacy of application of colonosanation method in treatment of an acute peritonitis of biliary origin. It was established that in occurrence of peritonitis of biliary origin the essential role play disorders of intestinal microbic landscape and his colonizing resistance. Application of elaborated method of colonosanation had permitted to a considerable extent to eliminate these disorders and to improve result of treatment of the patients.

  5. Iron accumulates in the lavage and explanted lungs of cystic fibrosis patients.

    Science.gov (United States)

    Abstract Oxidative stress participates in the pathophysiology of cystic fibrosis (CF). An underlying disruption in iron homeostasis can frequently be demonstrated in injuries and diseases associated with an oxidative stress. We tested the hypothesis that iron accumulation and ...

  6. Helicobacter Genotyping and Detection in Peroperative Lavage Fluid in Patients with Perforated Peptic Ulcer

    NARCIS (Netherlands)

    N.A.P. Komen (Niels); M.J.O.E. Bertleff (Marietta); J.F. Lange (Johan); P.W. de Graaf

    2008-01-01

    textabstractIntroduction and Objectives Certain Helicobacter pylori genotypes are associated with peptic ulcer disease; however, little is known about associations between the H. pylori genotype and perforated peptic ulcer (PPU). The primary aim of this study was to evaluate which genotypes are pre

  7. Interleukin-5 and eosinophil cationic protein in nasal lavages of rhinitis patients

    NARCIS (Netherlands)

    I.M. Garrelds (Ingrid); T. De Graaf-In 't Veld (T.); M.A. Nahori (Marie Anne); B.B. Vargaftig (B.); R. Gerth van Wijk (Roy); F.J. Zijlstra (Freek)

    1995-01-01

    textabstractThe production of interleukin-5 and eosinophil cationic protein (ECP) in the nasal cavity was examined in 24 patients with rhinitis who were allergic to the house dust mite. During a double-blind placebo-controlled cross-over study, fluticasone propionate aqueous nasal spray (200 μg) was

  8. Surfactant nebulisation : lung function, surfactant distribution and pulmonary blood flow distribution in lung lavaged rabbits

    NARCIS (Netherlands)

    Dijk, Peter H.; Heikamp, A; Bambang Oetomo, Sidarto

    1997-01-01

    Objective: Surfactant nebulisation is a promising alternative to surfactant instillation in newborns with the respiratory distress syndrome. Although less surfactant is deposited in the lung, it improves gas exchange, probably due to a superior distribution. We hypothesize that a more uniform distri

  9. A Case of Acquired Pulmonary Alveolar Proteinosis Successfully Treated with Whole Lung Lavage

    Science.gov (United States)

    2016-05-18

    of your presentation. It is important to update this information so that we can provide quality support for you, your department, and the Medical...within the alveoli . Surfactant phospholipids and proteins are produced by type II alveolar epithelial cells, and subsequently cleared by the

  10. Synthetic surfactant containing SP-B and SP-C mimics is superior to single-peptide formulations in rabbits with chemical acute lung injury

    Directory of Open Access Journals (Sweden)

    Frans J. Walther

    2014-05-01

    Full Text Available Background. Chemical spills are on the rise and inhalation of toxic chemicals may induce chemical acute lung injury (ALI/acute respiratory distress syndrome (ARDS. Although the pathophysiology of ALI/ARDS is well understood, the absence of specific antidotes has limited the effectiveness of therapeutic interventions.Objectives. Surfactant inactivation and formation of free radicals are important pathways in (chemical ALI. We tested the potential of lipid mixtures with advanced surfactant protein B and C (SP-B and C mimics to improve oxygenation and lung compliance in rabbits with lavage- and chemical-induced ALI/ARDS.Methods. Ventilated young adult rabbits underwent repeated saline lung lavages or underwent intratracheal instillation of hydrochloric acid to induce ALI/ARDS. After establishment of respiratory failure rabbits were treated with a single intratracheal dose of 100 mg/kg of synthetic surfactant composed of 3% Super Mini-B (S-MB, a SP-B mimic, and/or SP-C33 UCLA, a SP-C mimic, in a lipid mixture (DPPC:POPC:POPG 5:3:2 by weight, the clinical surfactant Infasurf®, a bovine lung lavage extract with SP-B and C, or synthetic lipids alone. End-points consisted of arterial oxygenation, dynamic lung compliance, and protein and lipid content in bronchoalveolar lavage fluid. Potential mechanism of surfactant action for S-MB and SP-C33 UCLA were investigated with captive bubble surfactometry (CBS assays.Results. All three surfactant peptide/lipid mixtures and Infasurf equally lowered the minimum surface tension on CBS, and also improved oxygenation and lung compliance. In both animal models, the two-peptide synthetic surfactant with S-MB and SP-C33 UCLA led to better arterial oxygenation and lung compliance than single peptide synthetic surfactants and Infasurf. Synthetic surfactants and Infasurf improved lung function further in lavage- than in chemical-induced respiratory failure, with the difference probably due to greater capillary

  11. Sterols of Pneumocystis carinii hominis organisms isolated from human lungs

    DEFF Research Database (Denmark)

    Kaneshiro, E S; Amit, Z; Chandra, Jan Suresh

    1999-01-01

    in conjunction with analyses of chemically synthesized authentic standards. The sterol composition of isolated P. carinii hominis organisms has yet to be reported. If P. carinii from animal models is to be used for identifying potential drug targets and for developing chemotherapeutic approaches to clear human...... infections, it is important to determine whether the 24-alkylsterols of organisms found in rats are also present in organisms in humans. In the present study, sterol analyses of P. carinii hominis organisms isolated from cryopreserved human P. carinii-infected lungs and from bronchoalveolar lavage fluid were...

  12. Others

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    950250 Rapid detection of mycoplasma pneumoniaein clinical samples by the polymerase chain reactiontechnique.LI Ziling(李子玲),et al.General Hosp,Nanjing Command,Nanjing,210002.Chin J Tuberc &Resspir Dis 1995;18(1):41—43.The polymerase chain reaction(PCR) technique wasused to detect Mycoplasma pneumoniae in clinical sam-ples(bronchoalveolar lavage fluids and throat swabs).A specific DNA sequence for M.pneumoniae was se-lected form a genomic library.The amplification targetregion was partial DNA sequence of the 500-bp frag-

  13. Metformin Reduces Bleomycin-induced Pulmonary Fibrosis in Mice

    OpenAIRE

    Choi, Sun Mi; Jang, An-Hee; Kim, Hyojin; Lee, Kyu Hwa; Kim, Young Whan

    2016-01-01

    Metformin has anti-inflammatory and anti-fibrotic effects. We investigated whether metformin has an inhibitory effect on bleomycin (BLM)-induced pulmonary fibrosis in a murine model. A total of 62 mice were divided into 5 groups: control, metformin (100 mg/kg), BLM, and BLM with metformin (50 mg/kg or 100 mg/kg). Metformin was administered to the mice orally once a day from day 1. We sacrificed half of the mice on day 10 and collected the bronchoalveolar lavage fluid (BALF) from their left lu...

  14. Pulmonary metastatic calcification: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Bozi, Lilian Christine Franchiotti [Radiology, Hospital Universitario Antonio Pedro (HUAP), Niteroi, RJ (Brazil); Melo, Alessandro Severo Alves de; Marchiori, Edson, E-mail: edmarchiori@gmail.com [Department of Radiology, School of Medicine, Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil)

    2012-09-15

    The present report describes the case of a 48-year-old female patient suffering from chronic renal failure on dialysis for 13 years. She presented with hemoptysis, fever, productive cough and dyspnoea. Chest radiography showed predominance of ill-defined opacities in the middle and lower lung fields, bilaterally. Chest computed tomography showed ground glass opacities associated with poorly defined centrilobular nodules with ground-glass attenuation. The patient was submitted to bronchoalveolar lavage that was negative for mycobacteria and fungi. On the basis of such findings, open lung biopsy was performed, which revealed metastatic pulmonary calcification. (author)

  15. Microlithiasis of Seminal Vesicles and Severe Oligoasthenospermia in Pulmonary Alveolar Microlithiasis (PAM): Report of An Unusual Sporadic Case.

    Science.gov (United States)

    Castellana, Giuseppe; Carone, Domenico; Castellana, Marco

    2015-01-01

    Pulmonary alveolar microlithiasis (PAM) is classified as an elective dysmetabolic thesaurotic pneumoalveolitis and characterized by the presence within the alveoli of the lungs of myriad of tiny calculi. The classic presentation of the chest radiography is unmistakable with multiple small "sand-like" opacities diffusely involving both lung fields. We present a case of male infertility for hypoposia and severe oligoasthenospermia in a young patient with recurrent haematuria and small calcifications in the seminal vesicles similar to pulmonary microliths. PAM was diagnosed on routine chest radiography, com- puter tomography (CT), transbronchial biopsy and bronchoalveolar lavage (BAL).

  16. Microlithiasis of Seminal Vesicles and Severe Oligoasthenospermia in Pulmonary Alveolar Microlithiasis (PAM: Report of An Unusual Sporadic Case

    Directory of Open Access Journals (Sweden)

    Giuseppe Castellana

    2015-04-01

    Full Text Available Pulmonary alveolar microlithiasis (PAM is classified as an elective dysmetabolic thesaurotic pneumoalveolitis and characterized by the presence within the alveoli of the lungs of myriad of tiny calculi. The classic presentation of the chest radiography is unmistakable with multiple small "sand-like" opacities diffusely involving both lung fields. We present a case of male infertility for hypoposia and severe oligoasthenospermia in a young patient with recurrent haematuria and small calcifications in the seminal vesicles similar to pulmonary microliths. PAM was diagnosed on routine chest radiography, computer tomography (CT, transbronchial biopsy and bronchoalveolar lavage (BAL.

  17. Effects of pentoxifylline on TNF-alpha and lung histopathology in HCL-induced lung injury

    Directory of Open Access Journals (Sweden)

    Itamar Souza de Oliveira-Júnior

    2008-01-01

    Full Text Available OBJECTIVE: To evaluate the effects of pentoxifylline on hydrochloric acid-induced lung lesions in rats subjected to mechanical ventilation. METHODS: Twenty male, adult Wistar-EPM-1 rats were anesthetized and randomly grouped (n=5 animals per group as follows: control-MV (mechanical ventilation, MV group; bilateral instillation of HCl (HCl group; bilateral instillation of HCl followed by pentoxifylline (50 mg/kg bw infusion (HCl+PTX group and pentoxifylline infusion followed by bilateral instillation of HCl (PTX+HCl group. At 20, 30, 90 and 180 min after treatments, the blood partial pressures of CO2 and O2 were measured. The animals were euthanized, and bronchoalveolar lavages were taken to determine the contents of total proteins, corticosterone and TNF-alpha. Samples of lung tissue were used for histomorphometric studies and determining the wet-to-dry (W/D lung weight ratio. RESULTS: In the MV group, rats had alveolar septal congestion, and, in the HCl group, a remarkable recruitment of neutrophils and macrophages into the alveoli was noticed; these events were reduced in the animals with PTX+HCl. The partial pressure of oxygen increased in PTX+HCl animals (121±5 mmHg as compared with the HCl (62±6 mmHg and HCl+PTX (67±3 mmHg groups within 30 minutes. TNF-alpha levels in bronchoalveolar lavage were significantly higher in the HCl group (458±50 pg/mL, reduced in the HCl+PTX group (329±45 pg/mL and lowest in the PTX+HCl group (229±41 pg/mL. The levels of corticosterone in bronchoalveolar lavage were significantly lower in the HCl (8±1.3 ng/mL and HCl+PTX group (16±2 ng/mL and were highest in the PTX+HCl (27±1.9 ng/mL. CONCLUSION: Pretreatment with PTX improves oxygenation, reduces TNF-alpha concentration and increases the concentration of corticosterone in bronchoalveolar lavage upon lung lesion induced by HCl.

  18. Hypersensitivity pneumonitis due to residential mosquito-coil smoke exposure

    Institute of Scientific and Technical Information of China (English)

    Gopall Roshnee; CAO Guo-qiang; CHEN Hong

    2011-01-01

    We reported a previously healthy 25-year-old female patient who developed hypersensitivity pneumonitis following repeated exposures to the smoke of mosquito coils. The patient presented with vague symptoms of cough and fever for 3 days. Diagnostic criteria proposed for clinical use in this case included history, exposure to a recognized antigen, physical examination, consistent radiographic images, bronchoalveolar lavage and lung biopsy. Much symptomatic relief and better radiographic response were noted after short-term use of oral corticosteroid and removal of the offending antigen.

  19. A Case of Organizing Pneumonia (OP) Associated with Pembrolizumab.

    Science.gov (United States)

    Fragkou, Paraskevi; Souli, Maria; Theochari, Maria; Kontopoulou, Christina; Loukides, Stelios; Koumarianou, Anna

    2016-01-01

    Until recently, chemotherapy for metastatic melanoma had disappointing results. The identification of immune checkpoints such as CTLA-4 and PD-1/PD-L1 has led to the development of an array of monoclonal antibodies (Mabs). These immunologic approaches against tumoral cells come with a novel kind of side effects that the clinician needs to be familiarized with. Herein, we report for the first time a case of organizing pneumonia, based on imaging and cytological analyses of bronchoalveolar lavage, possibly associated with the use of pembrolizumab, an anti-PD-1 Mab recently approved for the treatment of metastatic melanoma.

  20. Legionellosis in patients with HIV infection

    DEFF Research Database (Denmark)

    Bangsborg, Jette Marie; Jensen, B N; Friis-Møller, A

    1990-01-01

    During the five-year period 1984-1988 we received 192 specimens from 180 patients infected with the human immunodeficiency virus (HIV) for investigation of Legionella infection. The majority of specimens were bronchoalveolar lavage (BAL) fluids (84%), but tracheal suctions and lung tissue from...... specimens additionally for Pneumocystis carinii and mycobacteria. Legionellosis was not found to be common among HIV-infected patients, as only six specimens (3%) from six patients were found positive by DFA, and no specimens were culture-positive for Legionella species. Dual infection with Legionella and P...

  1. Cisplatin-Induced Eosinophilic Pneumonia

    Directory of Open Access Journals (Sweden)

    Hideharu Ideguchi

    2014-01-01

    Full Text Available A 67-year-old man suffering from esophageal cancer was admitted to our hospital complaining of dyspnea and hypoxemia. He had been treated with cisplatin, docetaxel, and fluorouracil combined with radiotherapy. Chest computed tomography revealed bilateral ground-glass opacity, and bronchoalveolar lavage fluid showed increased eosinophils. Two episodes of transient eosinophilia in peripheral blood were observed after serial administration of anticancer drugs before the admission, and drug-induced lymphocyte stimulation test to cisplatin was positive. Thus cisplatin-induced eosinophilic pneumonia was suspected, and corticosteroid was effectively administered. To our knowledge, this is the first reported case of cisplatin-induced eosinophilic pneumonia.

  2. Virtual reality simulation of basic pulmonary procedures

    DEFF Research Database (Denmark)

    Konge, Lars; Arendrup, Henrik; von Buchwald, Christian;

    2011-01-01

    Background: Virtual reality (VR) bronchoscopy simulators have been available for more than a decade, and have been recognized as an important aid in bronchoscopy training. The existing literature has only examined the role of VR simulators in diagnostic bronchoscopy. The aim of this study......, the physicians answered a questionnaire regarding the realism of the simulator. Results: The realism of the anatomy and the appearance of the scope were rated higher than the movement of the scope, feeling of resistance, and performances of bronchoalveolar lavages and biopsies. Overall, the simulator was judged...

  3. Metastatic breast cancer presenting as air-space consolidation on chest computed tomography.

    Science.gov (United States)

    Ohnishi, Hiroshi; Haruta, Yoshinori; Yokoyama, Akihito; Nakashima, Taku; Hattori, Noboru; Kohno, Nobuoki

    2009-01-01

    A 56-year-old woman suffered from hepatic and bone metastases of breast cancer. Two months after starting combination chemotherapy with trastuzumab and docetaxel, air-space consolidation was observed in the right lower lung lobe on a chest computed tomography (CT) and a high serum KL-6 level was detected. Drug-induced pneumonitis with organizing pneumonia type was suspected, however, a transbronchial lung biopsy and cytological examination of the bronchoalveolar lavage fluid provided evidence of metastatic breast cancer. While the lung is a frequently affected site from metastasis of breast cancer, we report a rare case presenting as air-space consolidation on a chest CT.

  4. Interstitial lung disease

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930124 The effect of glycosaminoglycans inthe genesis of pulmonary interstitial fibrosis.LIBaoyu(李保玉),et al.Dept Pathol,Jilin MedColl,132001.Chin J Tuberc & Respir Dis 1992;15(4):204-205.The pulmonary interstitial fibrosis was causedby injecting Bleomycin into mouse trachea.Afterthe injection,the volume of glycosaminoglycans(GAG)in bronchoalveolar lavage fluid and lungtissues was increased.The observation underhistochemical stain and electron microscopeshowed that the distribution of GAG in lung tis-sues was varied at different time after the injec-tion,and related to the volume of collagen pro-teins and the formation of pulmonary interstitialfibrosis.

  5. Does cytomegalovirus predict a poor prognosis in Pneumocystis carinii pneumonia treated with corticosteroids? A note for caution

    DEFF Research Database (Denmark)

    Jensen, A M; Lundgren, Jens Dilling; Benfield, T

    1995-01-01

    OBJECTIVE: To examine the importance of cytomegalovirus (CMV) in bronchoalveolar lavage (BAL) fluid of patients with HIV-associated Pneumocystis carinii pneumonia (PCP) treated with adjunctive corticosteroids (CS). DESIGN: Analysis of clinical data during a 5-year period. SETTING: Department...... of infectious diseases where clinical and paraclinical data on patients suspected of having PCP have been sampled prospectively. PATIENTS: 148 consecutive patients with a first episode of PCP in a 5-year period. MAIN OUTCOME MEASURE: Vital status 3 months after diagnosis of PCP. RESULTS: Patients with PCP...

  6. Inflammatory reaction and alterations of pulmonary surfactant in Pseudomonas Aeruginosa pneumonia in immunocompromised rats

    Institute of Scientific and Technical Information of China (English)

    瞿介明; 李倬哲; 何礼贤; 孙波; 陈雪华

    2002-01-01

    Pulmonary surfactant (PS) compromises lipids and surfactant proteins (SP) and lines on the alveolar air-liquid interface. It can reduce surface tension, prevent alveoli from collapse and reduce alveoli edema by disaturated dipalmitoylphosphatidylcholine.1 It also modulates the pulmonary immunology by SP-A and SP-D.2 In this study, we established a rat model of immunocompromised host (ICH) with pulmonary infection of Pseudomonas aeruginosa (P. aeruginosa), then studied its pulmonary inflammatory reaction and analyzed the concentration of lipids and SP-A in bronchoalveolar lavage fluid (BALF) during infection.

  7. Protectin D1 promotes resolution of inflammation in a murine model of lipopolysaccharide-induced acute lung injury via enhancing neutrophil apoptosis

    Institute of Scientific and Technical Information of China (English)

    Li Xingwang; Li Chunlai; Liang Wandong; Bi Yuntian; Chen Maohua; Dong Sheng

    2014-01-01

    Background Protectin D1 (PD1),derived from docosahexaenoic acid,has been shown to control and resolve inflammation in some experimental models of inflammatory disorders.We investigated the protective roles of protectin D1 in pulmonary inflammation and lung injury induced by lipopolysaccharide (LPS).Methods Mice were randomly assigned to six groups (n=6 per group):sham-vehicle group,sham-PD1 group,shamzVAD-fmk group,LPS-vehicle group,LPS-PD1 group,and LPS-PD1-zVAD-fmk group.Mice were injected intratracheally with 3 mg/kg LPS or saline,followed 24 hours later by intravenous injection of 200 μg/mouse PD1 or vehicle.At the same time,some mice were also injected intraperitoneally with the pan-caspase inhibitor zVAD-fmk.Seventy-two hours after LPS challenge,samples of pulmonary tissue and bronchoalveolar lavage fluid were collected.Optical microscopy was used to examine pathological changes in lungs.Cellularity and protein concentration in bronchoalveolar lavage fluid were analyzed.Lung wet/dry ratios and myeloperoxidase activity were measured.Apoptosis of neutrophils in bronchoalveolar lavage fluid (BALF) was also evaluated by flow cytometry.Results Intratracheal instillation of LPS increased neutrophil counts,protein concentration in bronchoalveolar lavage fluid and myeloperoxidase activity,it induced lung histological injury and edema,and also suppressed apoptosis of neutrophils in BALF.Posttreatment with PD1 inhibited LPS-evoked changes in BALF neutrophil counts and protein concentration and lung myeloperoxidase activity,with the outcome of decreased pulmonary edema and histological injury.In addition,PD1 promoted apoptosis of neutrophils in BALF.The beneficial effects of PD1 were blocked by zVAD-fmk.Conclusion Posttreatment with PD1 enhances resolution of lung inflammation during LPS-induced acute lung injury by enhancing apoptosis in emigrated neutrophils,which is,at least in part,caspase-dependent.

  8. Suspected Pulmonary Infection with Trichoderma longibrachiatum after Allogeneic Stem Cell Transplantation

    Science.gov (United States)

    Akagi, Tomoaki; Kawamura, Chizuko; Terasawa, Norio; Yamaguchi, Kohei; Kubo, Kohmei

    2017-01-01

    Aspergillus and Candida species are the main causative agents of invasive fungal infections in immunocompromised human hosts. However, saprophytic fungi are now increasingly being recognized as serious pathogens. Trichoderma longibrachiatum has recently been described as an emerging pathogen in immunocompromised patients. We herein report a case of isolated suspected invasive pulmonary infection with T. longibrachiatum in a 29-year-old man with severe aplastic anemia who underwent allogeneic stem cell transplantation. A direct microscopic examination of sputum, bronchoaspiration, and bronchoalveolar lavage fluid samples revealed the presence of fungal septate hyphae. The infection was successfully treated with 1 mg/kg/day liposomal amphotericin B. PMID:28090056

  9. A rare case of community acquired Burkholderia cepacia infection presenting as pyopneumothorax in an immunocompetent individual

    Institute of Scientific and Technical Information of China (English)

    Suman S Karanth; Hariharan Regunath; Kiran Chawla; Mukhyaprana Prabhu

    2012-01-01

    Burkholderia cepacia (B. cepacia) infection is rarely reported in an immunocompetent host. It is a well known occurence in patients with cystic fibrosis and chronic granulomatous disease where it increases both morbidity and mortality. It has also been included in the list of organisms causing nosocomial infections in an immunocompetent host, most of them transmitted from the immunocompromised patient in which this organism harbors. We report a rare case of isolation of B. cepacia from the bronchoalveolar lavage fluid of an immunocompetent agriculturist who presented with productive cough and fever associated with a pyopneumothorax. This is the first case of community acquired infection reported in an immunocompetent person in India.

  10. Pneumonia and empyema caused by Streptococcus intermedius that shows the diagnostic importance of evaluating the microbiota in the lower respiratory tract.

    Science.gov (United States)

    Noguchi, Shingo; Yatera, Kazuhiro; Kawanami, Toshinori; Yamasaki, Kei; Fukuda, Kazumasa; Naito, Keisuke; Akata, Kentarou; Nagata, Shuya; Ishimoto, Hiroshi; Taniguchi, Hatsumi; Mukae, Hiroshi

    2014-01-01

    The bacterial species in the Streptococcus anginosus group (S. constellatus, S. anginosus, S. intermedius) are important causative pathogens of bacterial pneumonia, pulmonary abscesses and empyema. However, the bacteria in this group are primarily oral resident bacteria and unable to grow significantly on ordinary aerobic culture media. We experienced a case of pneumonia and empyema caused by Streptococcus intermedius detected using a 16S rRNA gene sequencing analysis of bronchoalveolar lavage fluid and pleural effusion, but not sputum. Even when applying the molecular method, sputum samples are occasionally unsuitable for identifying the causative pathogens of lower respiratory tract infections.

  11. Necrotizing Lung Infection Caused by the Protozoan Balantidium coli

    Directory of Open Access Journals (Sweden)

    Sat Sharma

    2003-01-01

    Full Text Available Balantidium coli, a ciliated protozoan, is well known to cause intestinal infection in humans. Extraintestinal spread to the peritoneal cavity and genitourinary tract has rarely been reported. There have also been a few cases of lung involvement from this parasite. A case of B coli causing a thick-walled right upper lobe cavity in an organic farmer who had contact with aerosolized pig manure is reported. Bronchoalveolar lavage fluid examined for ova and parasite revealed trophozoites of B coli in large numbers. Treatment with doxycycline hyclate led to marked improvement. Necrotizing lung infection caused by the protozoan B coli should be considered in individuals who report contact with pigs.

  12. Identification of first-stage larvae of metastrongyles from dogs.

    Science.gov (United States)

    McGarry, J W; Morgan, E R

    2009-08-29

    By examining larvae from dogs in which the adult stages had been identified, the morphology of Angiostrongylus vasorum, Filaroides osleri, Filaroides hirthi and Crenosoma vulpis from samples of faeces or bronchoalveolar lavage was compared. The tail morphology of the four species was distinctive: A vasorum had a typical cuticular indentation and projection on the dorsal surface of the tail (referred to as the dorsal notch and dorsal spine, respectively) and a smaller indentation on the ventral surface. The tails of the other species are described. A vasorum was significantly longer (mean [sd] 358.4 microm [10.28], range 334 to 380 microm) than the other species (range 229 to 281 microm).

  13. Complete Remission of Minimal Change Disease Following an Improvement of Lung Mycobacterium avium Infection.

    Science.gov (United States)

    Yamashiro, Aoi; Uchida, Takahiro; Ito, Seigo; Oshima, Naoki; Oda, Takashi; Kumagai, Hiroo

    A 46-year-old woman suddenly developed peripheral edema. Her massive proteinuria, hypoproteinemia, and renal biopsy findings yielded the diagnosis of minimal change disease (MCD). In addition, lung Mycobacterium avium infection was diagnosed according to a positive culture of her bronchoalveolar lavage fluid. The lung lesion was improved by anti-nontuberculous mycobacteria therapy. Surprisingly, her proteinuria also gradually decreased and she attained complete remission of MCD without any immunosuppressive therapy. She has subsequently remained in complete remission. We herein report an interesting case of MCD with lung Mycobacterium avium infection, suggesting a causal relationship among infection, immune system abnormality, and MCD/nephrotic syndrome.

  14. A rare cause of pulmonary infiltrates one should be aware of: a case of daptomycin-induced acute eosinophilic pneumonia.

    Science.gov (United States)

    Rether, C; Conen, A; Grossenbacher, M; Albrich, W C

    2011-12-01

    We report a 69-year-old patient who developed fever and dyspnea 3 weeks after the initiation of daptomycin therapy for spondylodiscitis with lumbar epidural and bilateral psoas abscesses due to ampicillin- and high-level-gentamicin-resistant Enterococcus faecium. There was profound hypoxia and the chest X-ray showed extensive patchy infiltrates bilaterally. A bronchoalveolar lavage revealed 30% eosinophils and results of microbiological studies were normal. Daptomycin-induced eosinophilic pneumonia was diagnosed and the patient rapidly improved after the discontinuation of daptomycin and a brief course of prednisone. Increased attention must be paid to this rare but serious side effect of daptomycin.

  15. Diagnosis and management of interstitial pneumonitis associated with interferon therapy for chronic hepatitis C

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Interstitial pneumonitis(IP) is an uncommon pulmonary complication associated with interferon(IFN) therapy for chronic hepatitis C virus(HCV) infection.Pneumonitis can occur at any stage of HCV treatment,ranging from 2 to 48 wk,usually in the first 12 wk.Its most common symptoms are dyspnoea,dry cough,fever,fatigue,arthralgia or myalgia,and anorexia,which are reversible in most cases after cessation of IFN therapy with a mean subsequent recovery time of 7.5 wk.Bronchoalveolar lavage in combination with ches...

  16. A Case of Sarcoidosis with Unusual Radiographic Findings that Developed 5 Years after Silicone Augmentation Mammoplasty Complicated by Miliary Tuberculosis during Corticosteroid Treatment

    Directory of Open Access Journals (Sweden)

    Tomoko Miyashita

    2011-01-01

    Full Text Available A 54-year-old woman with a past history of silicone augmentation mammoplasty was admitted with fever and dyspnea with diffuse interstitial shadows on computed tomography (CT. Although radiological findings were atypical, we diagnosed sarcoidosis by laboratory, microbiological, and bronchoalveolar lavage fluid analysis. Corticosteroids ameliorated the condition, but she had recurrent of fever and CT revealed miliary nodules while interstitial shadows disappeared. Liver biopsy showed that noncaseating granuloma and Ziehl-Neelsen stain was positive. We diagnosed miliary tuberculosis which developed during corticosteroid therapy. Antituberculotic therapy resulted in favorable outcome. Possibility exists that onset of sarcoidosis was induced by mammoplasty, namely, human adjuvant disease.

  17. Transient receptor potential ankyrin 1 channel localized to non-neuronal airway cells promotes non-neurogenic inflammation

    DEFF Research Database (Denmark)

    Nassini, Romina; Pedretti, Pamela; Moretto, Nadia

    2012-01-01

    and fibroblasts, acrolein and CS extract evoked IL-8 release, a response selectively reduced by TRPA1 antagonists. Capsaicin, agonist of the transient receptor potential vanilloid 1 (TRPV1), a channel co-expressed with TRPA1 by airway sensory nerves, and acrolein or CS (TRPA1 agonists), or the neuropeptide...... substance P (SP), which is released from sensory nerve terminals by capsaicin, acrolein or CS), produced neurogenic inflammation in mouse airways. However, only acrolein and CS, but not capsaicin or SP, released the keratinocyte chemoattractant (CXCL-1/KC, IL-8 analogue) in bronchoalveolar lavage (BAL...

  18. A rare case of community acquired Burkholderia cepacia infection presenting as pyopneumothorax in an immunocompetent individual

    Directory of Open Access Journals (Sweden)

    Suman S Karanth

    2012-02-01

    Full Text Available Burkholderia cepacia (B. cepacia infection is rarely reported in an immunocompetent host. It is a well known occurence in patients with cystic fibrosis and chronic granulomatous disease where it increases both morbidity and mortality. It has also been included in the list of organisms causing nosocomial infections in an immunocompetent host, most of them transmitted from the immunocompromised patient in which this organism harbors. We report a rare case of isolation of B. cepacia from the bronchoalveolar lavage fluid of an immunocompetent agriculturist who presented with productive cough and fever associated with a pyopneumothorax. This is the first case of community acquired infection reported in an immunocompetent person in India.

  19. Experimental study of acute lung injury induced by different tidal volume ventilation in rats

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xin-ri; DU Yong-cheng; JIANG Hong-ying; XU Jian-ying; XU Yong-jian

    2005-01-01

    @@ Mechanical ventilation (MV) is a dual blade sward which if misused could lead to lung injury, called ventilator induced lung injury (VILI). Pathogenesis of VILI is very complex with various manifestations, which is the focus in MV field in recent years.1 In our research, the rats were ventilated with different tidal volume, then the pathological changes of the lungs were observed under macroscopy, light and electronic microscope, and various laboratory tests in blood and bronchoalveolar lavage fluid (BALF) were also carried out in order to probe further the pathologic characteristics and the pathogenesis of VILI.

  20. DNA Damage Following Pulmonary Exposure by Instillation to Low Doses of Carbon Black (Printex 90) Nanoparticles in Mice

    DEFF Research Database (Denmark)

    Kyjovska, Zdenka O.; Jacobsen, Nicklas R.; Saber, Anne T.;

    2015-01-01

    We previously observed genotoxic effects of carbon black nanoparticles at low doses relative to the Danish Occupational Exposure Limit (3.5 mg/m3). Furthermore, DNA damage occurred in broncho-alveolar lavage (BAL) cells in the absence of inflammation, indicating that inflammation is not required ....... Environmental and Molecular Mutagenesis published by Wiley Periodicals, Inc. on behalf of Environmental Mutagen Society...... the comet assay. We interpret the increased DNA strand breaks occurring following these low exposure doses of NPCB as DNA damage caused by primary genotoxicity in the absence of substantial inflammation, cell damage, and acute phase response. Environ. Mol. Mutagen. 56:41-49, 2015. (c) 2014 The Authors...

  1. Chronic hypersensitivity pneumonitis

    Science.gov (United States)

    Pereira, Carlos AC; Gimenez, Andréa; Kuranishi, Lilian; Storrer, Karin

    2016-01-01

    Hypersensitivity pneumonitis (HSP) is a common interstitial lung disease resulting from inhalation of a large variety of antigens by susceptible individuals. The disease is best classified as acute and chronic. Chronic HSP can be fibrosing or not. Fibrotic HSP has a large differential diagnosis and has a worse prognosis. The most common etiologies for HSP are reviewed. Diagnostic criteria are proposed for both chronic forms based on exposure, lung auscultation, lung function tests, HRCT findings, bronchoalveolar lavage, and biopsies. Treatment options are limited, but lung transplantation results in greater survival in comparison to idiopathic pulmonary fibrosis. Randomized trials with new antifibrotic agents are necessary. PMID:27703382

  2. A pulmonary aspergillosis case with fatal course in a patient with SIRS clinic

    Directory of Open Access Journals (Sweden)

    Nedim Çekmen

    2011-01-01

    Full Text Available A 77-year-old male patient with a history of tuberculosis applied to emergency service with complaints of confusion, shortness of breath, tachycardia, hypothermia and hypotension. A bronchoalveolar lavage culture was collected because a fungus ball was seen on repeat chest X-ray and thoracic CT of the patient. Aspergillus fumigatus grew and voricona-zole treatment was started, but the patient was lost from multiple organ failure (MOF. In diagnosis of patients with SIRS clinic, causative factor may be aspergillus located in an old tuberculosis cavity, and this may have a fatal course in an old patient having previous pulmonary and systemic diseases.

  3. [Pulmonary cystic disease may be a rare complication to recurrent respiratory human papilloma virus infection].

    Science.gov (United States)

    Laurberg, Peter Thaysen; Weinreich, Ulla M Øller

    2014-12-01

    A 19-year-old woman with a history of juvenile laryngeal papillomatosis (JLP), treated since childhood with multiple resections, was admitted with symptoms of pneumonia. A chest X-ray and CAT-scan revealed multiple lung cysts and a bronchoalveolar lavage detected human papilloma virus 11. The patient responded well to antibiotics. A body plethysmography showed small lung volumes and low diffusion capacity for carbon monoxide, but normal volume diffusion capacity divided by alveolar volume. Pulmonary cystic disease should be considered when patients with JLP have symptoms of pneumonia.

  4. Diagnostic bronchoscopy: state of the art

    Directory of Open Access Journals (Sweden)

    V. Ninane

    2010-09-01

    Full Text Available Since the introduction of the flexible fibreoptic bronchoscope in the late 1960s there have been relatively few technological advances for three decades, aside from the development of a white light video bronchoscope with a miniature charge-coupled device built in its tip replacing the fibreoptics. White light flexible videobronchoscopy with its ancillary devices (forceps biopsy, bronchial brushing, bronchoalveolar lavage, bronchial washings and transbronchial needle aspiration has long been the only established diagnostic bronchoscopic technique. With the advances in microtechnology over the past two decades, recent technical developments such as autofluorescence bronchoscopy and endoscopic ultrasound allow better evaluation of endobronchial, mediastinal and parenchymal lesions.

  5. Indication for fiberoptic bronchoscopy in HIV-infected patients suspected for Pneumocystis carinii pneumonia

    DEFF Research Database (Denmark)

    Orholm, M; Lundgren, Jens Dilling; Nielsen, T L;

    1990-01-01

    During a six-month period, 40 consecutive fiberoptic bronchoscopic procedures including bronchoalveolar lavage, bronchial brushing and forceps biopsy were performed in local anaesthesia on 34 HIV-infected males presenting symptoms compatible with Pneumocystis carinii pneumonia. In 23 examinations...... did not differ with regard to history, clinical examination, immunology, serology or chest radiograph. We conclude that fiberoptic bronchoscopy should be performed on wide indications in HIV-infected patients with symptoms compatible with P. carinii pneumonia. The procedure is easily performed......, it is safe, and it is highly sensitive. The advantage of an early diagnosis compensates for a rather high frequency of negative examinations....

  6. Cryptococcus gattii fungemia: report of a case with lung and brain lesions mimicking radiological features of malignancy.

    Science.gov (United States)

    Oliveira, Flávio de Mattos; Severo, Cecília Bittencourt; Guazzelli, Luciana Silva; Severo, Luiz Carlos

    2007-01-01

    A 64-year-old apparently immunocompetent white man developed lung and brain lesions of disseminated cryptococcosis. The radiologic features mimicked those of lung cancer metastatic to the central nervous system. C. gattii was recovered from cultures of bronchoalveolar lavage fluid, brain biopsy, and blood. The same fungus was recovered from pulmonary and brain specimens at autopsy. Serum and cerebrospinal fluid cryptococcal antigen tests were diagnostic in our case and should be included in the diagnostic evaluation of unexplained pulmonary and cerebral lesions. A literature search showed few reports of fungemia by this species of Cryptococcus, contrasting to C. neoformans.

  7. Cutaneous cytomegalovirus infection in a child with hyper IgE and specific defects in antibody response to protein vaccines

    Directory of Open Access Journals (Sweden)

    Shahrzad Fallah

    2011-10-01

    Full Text Available Cytomegalovirus (CMV infection is a common opportunistic systemic infection in immunocompromised patients, but skin involvement is rare. Herein, we report a 10 year-old girl from consanguineous parents who was referred to our center because of disseminated maculopapular rash. She had history of upper and lower respiratory tract infections. In immunological studies, increased serum IgE level and decreased responses to tetanus and diphtheria were detected. Polymerase chain reaction (PCR examination of bronchoalveolar lavage and serum sample revealed the presence of CMV. Early diagnosis of cutaneous CMV and appropriate treatment are the key actions in management of patients with underlying immunodeficiencies to avoid further complications.

  8. Community acquired bilateral upper lobe Pneumonia with acute adrenal insufficiency: A new face of Achromobacter xylosoxidans

    Directory of Open Access Journals (Sweden)

    Suman S Karanth

    2012-05-01

    Full Text Available AbstractAchromobacter xylosoxidans is an uncommon pathogen of low virulence known to cause serious nosocomial infection in the immunocompromised. Its inherent multi-drug resistance makes treatment difficult. Community-acquired infections are rare despite its ubiquitous existence. We present a 50-year-old immunocompetent woman who presented with one-month history of coughing with expectoration who was subsequently diagnosed with bilateral upper lobe pneumonia and acute adrenal insufficiency. Achromobacter xylosoxidans was isolated from sputum and bronchoalveolar lavage culture. The acute adrenal insufficiency recovered after appropriate antibiotic therapy. Amongst the myriad of presentations, we highlight the rarity of acute adrenal insufficiency triggered by the infection.

  9. Community acquired bilateral upper lobe pneumonia with acute adrenal insufficiency: A new face of Achromobacter Xylosoxidans.

    Science.gov (United States)

    Karanth, Suman S; Gupta, Anurag; Prabhu, Mukhyaprana

    2012-01-01

    Achromobacter xylosoxidans is an uncommon pathogen of low virulence known to cause serious nosocomial infection in the immunocompromised. Its inherent multi-drug resistance makes treatment difficult. Community-acquired infections are rare despite its ubiquitous existence. We present a 50-year-old immunocompetent woman who presented with one-month history of coughing with expectoration who was subsequently diagnosed with bilateral upper lobe pneumonia and acute adrenal insufficiency. Achromobacter xylosoxidans was isolated from sputum and bronchoalveolar lavage culture. The acute adrenal insufficiency recovered after appropriate antibiotic therapy. Amongst the myriad of presentations, we highlight the rarity of acute adrenal insufficiency triggered by the infection.

  10. Do neutrophils actively participate in airway inflammation and remodeling in asthma?

    Institute of Scientific and Technical Information of China (English)

    SUN Yong-chang 孙永昌; Hong Wei Chu

    2004-01-01

    @@ Previous studies have demonstrated an increase of neutrophils in lung tissues, bronchoalveolar lavage fluid (BALF), and sputum of subjects with severe, often glucocorticoid (GC)-dependent asthma, but the mechanisms behind this are not clear.1-3 Whether neutrophils function to worsen the disease or they are simply 'bystanders' in the process of severe asthma is not certain. However, recent studies suggest a possibly active role of neutrophils in the airway inflammation and potentially in the airway remodeling of asthma.4,5

  11. Intra-tracheal Administration of Haemophilus influenzae in Mouse Models to Study Airway Inflammation.

    Science.gov (United States)

    Venuprasad, K; Theivanthiran, Balamayooran; Cantarel, Brandi

    2016-03-02

    Here, we describe a detailed procedure to efficiently and directly deliver Haemophilus influenzae into the lower respiratory tracts of mice. We demonstrate the procedure for preparing H. influenzae inoculum, intra-tracheal instillation of H. influenzae into the lung, collection of broncho-alveolar lavage fluid (BALF), analysis of immune cells in the BALF, and RNA isolation for differential gene expression analysis. This procedure can be used to study the lung inflammatory response to any bacteria, virus or fungi. Direct tracheal instillation is mostly preferred over intranasal or aerosol inhalation procedures because it more efficiently delivers the bacterial inoculum into the lower respiratory tract with less ambiguity.

  12. Diagnostic use of PCR for detection of Pneumocystis carinii in oral wash samples

    DEFF Research Database (Denmark)

    Helweg-Larsen, J; Jensen, Jens Ulrik Stæhr; Benfield, T;

    1998-01-01

    and was compared to a previously described PCR protocol (mitochondrial RNA) run in a research laboratory. Both PCR methods amplified a sequence of the mitochondrial rRNA gene of P. carinii. Paired bronchoalveolar lavage (BAL) and oral wash specimens from 76 consecutive human immunodeficiency virus type 1-infected...... specimens and 100, 91, 90, and 100%, respectively, for BAL specimens. Our results suggest that oral wash specimens are a potential noninvasive method to obtain a diagnostic specimen during P. carinii pneumonia infection and that it can be applied in a routine diagnostic laboratory....

  13. Strongyloides stercolaris infection mimicking a malignant tumour in a non-immunocompromised patient. Diagnosis by bronchoalveolar cytology

    Science.gov (United States)

    Mayayo, E; Gomez-Aracil, V; Azua-Blanco, J; Azua-Romeo, J; Capilla, J; Mayayo, R

    2005-01-01

    Autoinfective strongyloidiasis is often fatal in immunosuppressed patients or in immunocomprised hosts. An interesting case of Strongyloides stercolaris hyperinfection was seen in an immunocompetent patient. This report describes a case of fatal strogyloidiasis in a 79 year old man, who had suffered gastrointestinal discomfort for years, and who presented because of respiratory illness. A chest radiograph showed an irregular mass close to the mediastinum and interstitial infiltrates, but blood eosinophilia was not observed. Cytological examination of the samples obtained from bronchial aspiration and brushing identified several filariform larvae. Thus, cytology was essential for the correct diagnosis in this patient and is a very reliable method to diagnose lung parasitosis. PMID:15790710

  14. Leucocyte kinesis in blood, bronchoalveoli and nasal cavities during late asthmatic responses in guinea-pigs.

    Science.gov (United States)

    Nabe, T; Shinoda, N; Yamashita, K; Yamamura, H; Kohno, S

    1998-03-01

    Recently, we reported a reproducible model of asthma in guinea-pigs in vivo, which developed a late asthmatic response (LAR) as well as an early response. In this study, time-related changes in the occurrence of the LAR and leucocyte kinesis were assessed. Furthermore, the state of the activation of eosinophils that migrated into the lower airways was characterized in vitro. Guinea-pigs were alternately sensitized/challenged by inhalation with aerosolized ovalbumin adsorbed on aluminium hydroxide and ovalbumin alone, once every 2 weeks. At defined times before and after the fifth challenge, airway resistance was measured, blood was drawn and bronchoalveolar lavage (BAL) and nasal cavity lavage (NCL) were performed. Superoxide anion (.O2-) production of eosinophils was measured with cytochrome c. Occurrence of LAR and considerable increases in circulating eosinophils coincided with each other 5-7 h after the challenge. After 7 h, eosinophil infiltrations into bronchoalveolar spaces were observed. The capacity of eosinophils from the sensitized animals to produce .O2- was higher than those from the non-sensitized ones, when eosinophils were stimulated by platelet-activating factor. Although an increased number of eosinophils in the NCL fluid was observed, it was much less than that in the BAL fluid. Thus, it has been concluded that eosinophilia in the blood and the lung may participate in the occurrence of the late asthmatic response, which is thought to be preferentially evoked in the lower airways in guinea-pigs in vivo.

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

    Science.gov (United States)

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

    2014-02-10

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

  16. Asbestos-Induced Peribronchiolar Cell Proliferation and Cytokine Production Are Attenuated in Lungs of Protein Kinase C-δ Knockout Mice

    Science.gov (United States)

    Shukla, Arti; Lounsbury, Karen M.; Barrett, Trisha F.; Gell, Joanna; Rincon, Mercedes; Butnor, Kelly J.; Taatjes, Douglas J.; Davis, Gerald S.; Vacek, Pamela; Nakayama, Keiichi I.; Nakayama, Keiko; Steele, Chad; Mossman, Brooke T.

    2007-01-01

    The signaling pathways leading to the development of asbestos-associated diseases are poorly understood. Here we used normal and protein kinase C (PKC)-δ knockout (PKCδ−/−) mice to demonstrate multiple roles of PKC-δ in the development of cell proliferation and inflammation after inhalation of chrysotile asbestos. At 3 days, asbestos-induced peribronchiolar cell proliferation in wild-type mice was attenuated in PKCδ−/− mice. Cytokine profiles in bronchoalveolar lavage fluids showed increases in interleukin (IL)-1β, IL-4, IL-6, and IL-13 that were decreased in PKCδ−/− mice. At 9 days, microarray and quantitative reverse transcriptase-polymerase chain reaction analysis of lung tissues revealed increased mRNA levels of the profibrotic cytokine, IL-4, in asbestos-exposed wild-type mice but not PKCδ−/− mice. PKCδ−/− mice also exhibited decreased lung infiltration of polymorphonuclear cells, natural killer cells, and macrophages in bronchoalveolar lavage fluid and lung, as well as increased numbers of B lymphocytes and plasma cells. These changes were accompanied by elevated mRNA levels of immunoglobulin chains. These data show that modulation of PKC-δ has multiple effects on peribronchiolar cell proliferation, proinflammatory and profibrotic cytokine expression, and immune cell profiles in lung. These results also implicate targeted interruption of PKC-δ as a potential therapeutic option in asbestos-induced lung diseases. PMID:17200189

  17. Herpes simplex virus 1 pneumonia: conventional chest radiograph pattern

    Energy Technology Data Exchange (ETDEWEB)

    Umans, U.; Golding, R.P.; Duraku, S.; Manoliu, R.A. [Dept. of Radiology, Academic Hospital ' ' Vrije Universiteit' ' , Amsterdam (Netherlands)

    2001-06-01

    The aim of this study was to describe the findings on plain chest radiographs in patients with herpes simplex virus pneumonia (HSVP). The study was based on 17 patients who at a retrospective search have been found to have a monoinfection with herpes simplex virus. The diagnosis was established by isolation of the virus from material obtained during fiberoptic bronchoscopy (FOB) which also included broncho-alveolar lavage and tissue sampling. Fourteen patients had a chest radiograph performed within 24 h of the date of the FOB. Two radiographs showed no abnormalities of the lung parenchyma. The radiographs of the other 12 patients showed lung opacification, predominantly lobar or more extensive and always bilateral. Most patients presented with a mixed airspace and interstitial pattern of opacities, but 11 of 14 showed at least an airspace consolidation. Lobar, segmental, or subsegmental atelectasis was present in 7 patients, and unilateral or bilateral pleural effusion in 8 patients, but only in 1 patient was it a large amount. In contradiction to the literature which reports a high correlation between HSVP and acute respiratory distress syndrome (ARDS), 11 of 14 patients did not meet the pathophysiological criteria for ARDS. The radiologist may suggest the diagnosis of HSVP when bilateral airspace consolidation or mixed opacities appear in a susceptible group of patients who are not thought to have ARDS or pulmonary edema. The definite diagnosis of HSV pneumonia can be established only on the basis of culture of material obtained by broncho-alveolar lavage. (orig.)

  18. Upregulation of neurokinin-1 receptor expression in the lungs of patients with sarcoidosis.

    LENUS (Irish Health Repository)

    O'Connor, Terence M

    2012-02-03

    Substance P (SP) is a proinflammatory neuropeptide that is secreted by sensory nerves and inflammatory cells. Increased levels of SP are found in sarcoid bronchoalveolar lavage fluid. SP acts by binding to the neurokinin-1 receptor and increases secretion of tumor necrosis factor-alpha in many cell types. We sought to determine neurokinin-1 receptor expression in patients with sarcoidosis compared with normal controls. Neurokinin-1 receptor messenger RNA and protein expression were below the limits of detection by reverse transcriptase-polymerase chain reaction and immunohistochemistry in peripheral blood mononuclear cells of healthy volunteers (n = 9) or patients with stage 1 or 2 pulmonary sarcoidosis (n = 10), but were detected in 1\\/9 bronchoalveolar lavage cells of controls compared with 8\\/10 patients with sarcoidosis (p = 0.012) and 2\\/9 biopsies of controls compared with 9\\/10 patients with sarcoidosis (p = 0.013). Immunohistochemistry localized upregulated neurokinin-1 receptor expression to bronchial and alveolar epithelial cells, macrophages, lymphocytes, and sarcoid granulomas. The patient in whom neurokinin-1 receptor was not detected was taking corticosteroids. Incubation of the type II alveolar and bronchial epithelial cell lines A549 and SK-LU 1 with dexamethasone downregulated neurokinin-1 receptor expression. Upregulated neurokinin-1 receptor expression in patients with sarcoidosis may potentiate substance P-induced proinflammatory cytokine production in patients with sarcoidosis.

  19. Airway surface liquid contains endogenous DNase activity which can be activated by exogenous magnesium

    Directory of Open Access Journals (Sweden)

    Rosenecker J

    2009-07-01

    Full Text Available Abstract Introduction The removal of highly viscous mucus from the airways is an important task in the treatment of chronic lung disease like in cystic fibrosis. The inhalation of recombinant human DNase-I (rhDNase-I is used to facilitate the removal of tenacious airway secretions in different lung diseases and especially in CF. Little is known about endogenous DNase activity in the airway surface liquid. Therefore, we analysed bronchoalveolar lavage fluid (BAL and exhaled breath condensate (EBC for the presence of endogenous DNase activity. Methods The degradation of plasmid DNA by BAL from patients who had diagnostic bronchoscopy and bronchoalveolar lavage was analyzed. In a group of CF patients and healthy control volunteers the exhaled breath condensate was obtained and also analyzed for the ability to degrade plasmid DNA. In addition, the ability of magnesium to activate endogenous DNase activity in BAL and exhaled breath condensate was investigated. Results The analyzed BAL samples degraded plasmid DNA only after preincubation with magnesium. When analyzing the exhaled breath condensate the samples obtained from the healthy volunteers showed no DNase activity even after preincubation with magnesium, whereas in one of the two samples obtained from CF patients we found a DNase activity after preincubation with magnesium. Conclusion Increasing the magnesium concentration in the airway surface liquid by aerosolisation of magnesium solutions or oral magnesium supplements could improve the removal of highly viscous mucus in chronic lung disease by activating endogenous DNase activity.

  20. Chronic aspiration of gastric and duodenal contents and their effects on inflammatory cytokine production in respiratory system of rats.

    Directory of Open Access Journals (Sweden)

    Mitra Samareh Fekri

    2014-02-01

    Full Text Available Gastroesophageal reflux disease (GERD is defined with clinical symptoms of heart burning and regurgitation. It may be associated with external esophageal symptoms such as chronic cough, asthma, laryngitis, chronic lung disease, sinusitis and pulmonary fibrosis. In the present study, rats with chronic aspiration of gastroduodenal contents were studied for cellular phenotypes and cytokine concentrations in bronchoalveolar lavage and lung tissue. Thirty-six male Albino N-MRI rats were randomly divided into six groups. After anesthesia and tracheal intubation, the animals received either 0.5ml/kg of normal saline (control, gastric juice, pepsin, hydrochloric acid or bile salts by injection into their lungs twice a week for 8 weeks. In sham group nothing was injected. Thereafter, cellular phenotypes and cytokine concentrations of Interleukine (IL-1α, IL-1β, Transforming Growth Factor (TGF-β, Tumor Necrosis Factor (TNF-α, and IL-6 were assessed in bronchoalveolar lavage and lung tissue homogenates. The numbers of epithelial cells, macrophages, neutrophils and lymphocytes in BAL and levels of cytokines IL-1α, IL-6, TNF-α and TGF-β in BAL and lung tissue of test groups were significantly higher than the control group. Aspiration of bile salts caused more cytokine levels and inflammatory cells compared to other reflux components. It can be concluded that GERD with increased cytokines and inflammatory cells in lung could cause or exacerbate asthma and pulmonary fibrosis.

  1. Target organ localization of memory CD4(+) T cells in patients with chronic beryllium disease.

    Science.gov (United States)

    Fontenot, Andrew P; Canavera, Scott J; Gharavi, Laia; Newman, Lee S; Kotzin, Brian L