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Sample records for bronchoalveolar lavage

  1. Bronchoalveolar lavage in radiation pneumonitis

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    Cordier, J.F.; Mornex, J.F.; Lasne, Y.; Gerard, J.P.; Cordier, G.; Creyssel, R.; Touraine, R.

    1984-01-01

    Bronchoalveolar lavage (BAL) was carried out in six patients with radiation pneumonitis, the early radiation-induced lung damage that usually leads to radiation fibrosis. Protein analysis by immuno-electrophoresis and polyacrylamide gel electrophoresis of BAL fluid revealed leakage of circulatory proteins, including high molecular weight components. Cell count of BAL fluid showed an increased number of lymphocytes; these proved to be activated on cell cycle analysis in one patient. Collagenolytic activity, assessed by degradation of radiolabelled type I human collagen, was present in BAL fluid of all six patients. The following mechanisms are therefore considered to participate in the pathogenesis of radiation-induced lung damage: 1) permeability oedema, which led to acute respiratory distress syndrome in one case of hyperacute radiation pneumonitis, 2) lymphocyte alveolitis possibly perpetuated by activated lymphocytes, and 3) release of collagenolytic enzymes in alveolar structures contributing to fibrotic processes.

  2. OPTIMIZATION OF REPEATED BRONCHOALVEOLAR LAVAGE IN RABBITS

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    Background. Bronchoalveolar lavage (BAL) is a relatively non-invasive technique used to obtain diagnostic samples from the lower airways of companion animals with respira¬tory disease. BAL is also commonly used in laboratory animals to assess pulmo¬nary changes after expos...

  3. Translational research in pediatrics III: bronchoalveolar lavage.

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    Radhakrishnan, Dhenuka; Yamashita, Cory; Gillio-Meina, Carolina; Fraser, Douglas D

    2014-07-01

    The role of flexible bronchoscopy and bronchoalveolar lavage (BAL) for the care of children with airway and pulmonary diseases is well established, with collected BAL fluid most often used clinically for microbiologic pathogen identification and cellular analyses. More recently, powerful analytic research methods have been used to investigate BAL samples to better understand the pathophysiological basis of pediatric respiratory disease. Investigations have focused on the cellular components contained in BAL fluid, such as macrophages, lymphocytes, neutrophils, eosinophils, and mast cells, as well as the noncellular components such as serum molecules, inflammatory proteins, and surfactant. Molecular techniques are frequently used to investigate BAL fluid for the presence of infectious pathologies and for cellular gene expression. Recent advances in proteomics allow identification of multiple protein expression patterns linked to specific respiratory diseases, whereas newer analytic techniques allow for investigations on surfactant quantification and function. These translational research studies on BAL fluid have aided our understanding of pulmonary inflammation and the injury/repair responses in children. We review the ethics and practices for the execution of BAL in children for translational research purposes, with an emphasis on the optimal handling and processing of BAL samples. Copyright © 2014 by the American Academy of Pediatrics.

  4. Identification of epithelial cells in bronchoalveolar lavage.

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    Finotto, S; Rado, V; Dal Vecchio, A; Milani, G; Fabbri, L M; Maestrelli, P

    1993-01-01

    1. Damage to the bronchial epithelium occurs after the inhalation of toxic substances and allergens, and through virus infections and it may lead to increased desquamation of epithelial cells in bronchoalveolar lavage (BAL). 2. In this study we compared two methods of staining the epithelial cells of BAL, the conventional cytochemical May Grunwald-Giemsa stain (MGG) and an immunocytochemical technique using a monoclonal antibody anti-human cytokeratin (CK) detected with APAAP immuno-alkaline phosphatase. BAL was obtained from 13 subjects and the epithelial cells were cytocentrifuged either immediately after collection (fraction A) or after washing (fraction B). 3. Higher percentages of epithelial cells were identified in fraction A with CK (20.0 +/- 5.1%) than in fraction A with MGG (11.2 +/- 2.3%), which recognized only ciliated epithelial cells. In fact a proportion of CK-positive cells (34%) in fraction A were not ciliated. Underestimation of epithelial cells by MGG compared to CK was more pronounced in fraction B (8.0 +/- 2.9% and 22.9 +/- 3.0%, respectively) as there was a relative loss of ciliated CK+ cells after washings. 4. These results suggest that immunocytochemical staining with an anti-cytokeratin monoclonal antibody is more sensitive than using the MGG stain in detecting epithelial cells in BAL.

  5. [Bronchoalveolar lavage technique in patients with alveolar proteinosis].

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    Luengo Martínez A C, M; Muñoz Sánchez, R; Coca Marcos, P; Romero Paredes, R; Bendito Romero, L; Cuenca Nieto-Márquez, V; López Fernández, M

    2001-01-01

    Bronchoalveolar Lavage (BAL) was first described more than fifteen years ago; it is still the treatment of choice in Alveolar Proteinosis. Despite several clinical therapeutic trials, for new therapeutics none of them has achieved the results of Bronchoalveolar Lavage. It has been proved that, not only are they ineffective, but they can also have dangerous consequences. Alveolar proteinosis is a rare lung illness that implies the patient's hypoxia and progressive incapacity, being clinical dyspnea its most frequent characteristic. The BAL. with sodium chloride by filling and emptying the lungs allows to wash the fosfolipid material. That its on the alveoli giving the patient a great improve in short space of time. The aim of our work is to describe the technique used in Bronchoalveolar Lavage as well as the changes that have taken place since the beginning of its practice in our Critical Care Unit for the last fifteen years and so the nursing work that it is on this technic. This procedure needs to be made on a UCI for the need of mechanical ventilation. The time of instance on UCI is 24 h. In our experience we are able to make the BAL. in both lungs in the same session, there are no important complications and there is no need of readmission. We conclude that there is evidence that these treatment is effective.

  6. Blackened bronchoalveolar lavage fluid in crack smokers. A preliminary study.

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    Greenebaum, E; Copeland, A; Grewal, R

    1993-11-01

    A retrospective study was performed on heavily pigmented pulmonary cytologic specimens from 14 hospital patients to determine the clinical features distinguishing these cases. The lavage fluid or sputum in each case was turbid and gray or black, exceeding the blackness usually seen in heavy tobacco smokers dwelling in the same urban environment. Excessive carbonaceous material was observed in the cytoplasm of pulmonary alveolar macrophages or the extracellular compartment of the smears. The latter feature is not seen in cigarette smokers. Many other pigmentary sources were ruled out, including melanin, hemosiderin, medicinal charcoal, India ink, and hematoxylin crystals. The common feature of the patients was that they recently or currently smoked the crack form of cocaine heavily; five patients also had positive toxicologic results for cocaine at admission. The authors suggest that blackened bronchoalveolar lavage fluid indicates the possibility of crack cocaine smoking and the associated sequelae, particularly when the carbonaceous material is present in the extracellular compartment.

  7. Unilateral radiation pneumonitis in sheep: Physiological changes and bronchoalveolar lavage

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    Tillman, B.F.; Loyd, J.E.; Malcolm, A.W.; Holm, B.A.; Brigham, K.L. (Vanderbilt Univ. School of Medicine, Nashville, TN (USA))

    1989-03-01

    Radiation pneumonitis is a life-threatening result of therapeutic thoracic irradiation, yet its mechanisms are poorly understood. We studied the effects of unilateral lung irradiation (3,000 rad) in sheep from the immediate response to the later development of radiation pneumonitis. We defined radiation pneumonitis by its diagnostic clinical feature, radiographic infiltration of the irradiated zone with a straight margin corresponding to the radiation port. The immediate response in the few hours after irradiation was characterized by cough, labored respiration, hypoxemia (arterial PO{sub 2} decreased 19 Torr), mild pulmonary hypertension (pulmonary arterial pressure increased 20%), and lymphopenia. Hemodynamics and gas exchange returned to normal by day 2 but became abnormal again before or during radiation pneumonitis at 32 +/- 2 days. Respiratory distress, hypoxemia, and pulmonary hypertension recurred during radiation pneumonitis. Bronchoalveolar lavage during radiation pneumonitis contained increased neutrophils (19 +/- 4%, control = 7%), increased protein (0.27 +/- 0.1 g/dl, control = 0.12 +/- 0.03), and severely impaired ability to lower surface tension. Alveolar macrophages from both lungs during unilateral radiation pneumonitis exhibited impaired generation of superoxide after phorbol myristate (only a 30% increase). Normal control alveolar macrophages increased superoxide production after stimulation greater than 400%. We conclude that unilateral lung irradiation in sheep causes a mild immediate response followed by radiation pneumonitis at 1 mo. Unilateral radiation pneumonitis in this model is associated with ipsilateral neutrophilic alveolitis, increased bronchoalveolar lavage protein, and impaired surfactant function, as well as bilateral functional abnormalities of alveolar macrophages.

  8. Interrogating Bronchoalveolar Lavage Samples via Exclusion-Based Analyte Extraction.

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    Tokar, Jacob J; Warrick, Jay W; Guckenberger, David J; Sperger, Jamie M; Lang, Joshua M; Ferguson, J Scott; Beebe, David J

    2017-06-01

    Although average survival rates for lung cancer have improved, earlier and better diagnosis remains a priority. One promising approach to assisting earlier and safer diagnosis of lung lesions is bronchoalveolar lavage (BAL), which provides a sample of lung tissue as well as proteins and immune cells from the vicinity of the lesion, yet diagnostic sensitivity remains a challenge. Reproducible isolation of lung epithelia and multianalyte extraction have the potential to improve diagnostic sensitivity and provide new information for developing personalized therapeutic approaches. We present the use of a recently developed exclusion-based, solid-phase-extraction technique called SLIDE (Sliding Lid for Immobilized Droplet Extraction) to facilitate analysis of BAL samples. We developed a SLIDE protocol for lung epithelial cell extraction and biomarker staining of patient BALs, testing both EpCAM and Trop2 as capture antigens. We characterized captured cells using TTF1 and p40 as immunostaining biomarkers of adenocarcinoma and squamous cell carcinoma, respectively. We achieved up to 90% (EpCAM) and 84% (Trop2) extraction efficiency of representative tumor cell lines. We then used the platform to process two patient BAL samples in parallel within the same sample plate to demonstrate feasibility and observed that Trop2-based extraction potentially extracts more target cells than EpCAM-based extraction.

  9. Proteomic analysis of human bronchoalveolar lavage fluid after subsgemental exposure.

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    Foster, Matthew W; Thompson, J Will; Que, Loretta G; Yang, Ivana V; Schwartz, David A; Moseley, M Arthur; Marshall, Harvey E

    2013-05-03

    The analysis of airway fluid, as sampled by bronchoalveolar lavage (BAL), provides a minimally invasive route to interrogate lung biology in health and disease. Here, we used immunodepletion, coupled with gel- and label-free LC-MS/MS, for quantitation of the BAL fluid (BALF) proteome in samples recovered from human subjects following bronchoscopic instillation of saline, lipopolysaccharide (LPS) or house dust mite antigen into three distinct lung subsegments. Among more than 200 unique proteins quantified across nine samples, neutrophil granule-derived and acute phase proteins were most highly enriched in the LPS-exposed lobes. Of these, peptidoglycan response protein 1 was validated and confirmed as a novel marker of neutrophilic inflammation. Compared to a prior transcriptomic analysis of airway cells in this same cohort, the BALF proteome revealed a novel set of response factors. Independent of exposure, the enrichment of tracheal-expressed proteins in right lower lung lobes suggests a potential for constitutive intralobar variability in the BALF proteome; sampling of multiple lung subsegments also appears to aid in the identification of protein signatures that differentiate individuals at baseline. Collectively, this proof-of-concept study validates a robust workflow for BALF proteomics and demonstrates the complementary nature of proteomic and genomic techniques for investigating airway (patho)physiology.

  10. Bronchoalveolar lavage fluid and progression of scleroderma interstitial lung disease.

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    De Santis, Maria; Bosello, Silvia Laura; Peluso, Giusy; Pinnelli, Michela; Alivernini, Stefano; Zizzo, Gaetano; Bocci, Mario; Capacci, Annunziata; La Torre, Giuseppe; Mannocci, Alice; Pagliari, Gabriella; Varone, Francesco; Pistelli, Roberto; Danza, Francesco Maria; Ferraccioli, Gianfranco

    2012-01-01

    So far no clinical or experimental evidences clearly explain how and which systemic sclerosis (SSc) patients will experience a functional and radiological progression of interstitial lung disease (ILD). The aim of the study was to investigate whether any bronchoalveolar lavage fluid (BALF) characteristic, compared with clinical, functional and radiological parameters, is associated with the risk of progression of ILD and worse survival in SSc patients. Lung involvement was evaluated in 110 consecutively examined SSc patients with pulmonary function tests (PFTs) and high-resolution computed tomography (HRCT); 73 patients with evidence of ILD on HRCT underwent BAL. The progression of ILD was evaluated with PFTs and HRCT after 1-year follow-up. A 36-month survival analysis was assessed. ILD patients with alveolitis had a higher risk to have restrictive lung disease and honeycombing, to experience a worsening in honeycombing score or to develop honeycombing. ILD progression was associated with the evidence of honeycombing on HRCT, with the presence of eosinophils, with an inverted CD4/CD8 ratio and with a higher CD19 percentage count in the BALF or with a positive BALF microbiological culture. The patients with ILD had a worse overall survival. The diffuse disease was the only independent risk factor of overall mortality, and the extent of honeycombing on HRCT was the only independent risk factor of lung disease-related mortality. Our study suggests the importance of evaluating ILD with HRCT and BAL in order to characterize the risk factors of SSc lung involvement progression. © 2010 Blackwell Publishing Ltd.

  11. Isolation of fibroblasts and epithelial cells in bronchoalveolar lavage (BAL).

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    Pollock, Kathryn; Albares, Luke; Wendt, Chris; Hubel, Allison

    2013-04-01

    The long-term outcome of lung transplants is poor with 60%-70% of patients developing chronic rejection. Chronic rejection is manifested histologically by obliterative bronchiolitis with bronchiolitis obliterans syndrome (BOS), the clinical surrogate. Recent studies suggest that fibroblasts and epithelial cells present in bronchoalveolar lavage (BAL) may be a clinically relevant biomarker for BOS. The goal of this investigation was to develop a fast, repeatable method to individually isolate these low-frequency cell types. Fibroblasts and epithelial cells were isolated from BAL using attachment methods and the phenotype of the cells confirmed using immunostaining for vimentin (fibroblasts) and epithelial cell adhesion molecule (EpCAM, epithelial cells). Both fibroblasts and epithelial cells were isolated in every sample of BAL processed with the frequency of fibroblasts ranging from 0.03% to 0.48% and epithelial cells ranging from 0.05% to 1.5% of the total sample. Additional studies were performed using cytospins of cells after macrophages were depleted; cells exhibiting characteristics of both fibroblasts and epithelial cells were observed. The frequency of the cells of interest suggests that conventional methods of immunomagnetic isolation will not be effective in isolating these subpopulations. Finally, some of the low-frequency cells isolated via cytospin exhibit characteristics of epithelial to mesenchymal transition (which was not observed in plating incubations), indicating that the epithelial to mesenchymal cell transition fibroblasts may be nonadherent. In future studies, this technique and dataset may be of use to statistically correlate low-frequency cell type abundance to the onset and development of BOS.

  12. Bronchoalveolar lavage results are independent of season, age, gender and collection site.

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    Helga H Olsen

    Full Text Available BACKGROUND: Clinical interpretation of bronchoalveolar lavage fluid results is dependent on the availability of reference values for healthy individuals. Only a few studies have published such reference values and the applicability of results is restricted by small sample sizes and the limited representativeness of the study population. We aim to investigate the influence of age, gender, collection site and season on bronchoalveolar lavage fluid results and to establish reference values for use in clinical practice. METHODOLOGY/PRINCIPAL FINDINGS: Bronchoalveolar lavage fluid data from 295 healthy never-smoking volunteers, investigated during 1990-2009, were analyzed retrospectively. 47 volunteers had 2-5 repeat lavages during the course of several years. Fluid recovery, total number of cells, cell concentration, and differential cell counts on cytospin prepared slides were recorded. Reference values, as represented by the 5(th to the 95(th percentile, were 72-96% for macrophages, 2-26% for lymphocytes, 0-4% for neutrophils and 0-1% for eosinophils. Basophils and mast cells were rare. When repeat lavages were performed, there was a relatively large intra-individual variability, mainly for macrophages and lymphocytes. An age dependent decrease of lavage fluid return was present, but there was no age dependent correlation with any of the other BALF parameters. The BALF cell parameters were independent of gender, season and site (lingula vs. middle lobe. CONCLUSIONS/SIGNIFICANCE: Our data show that bronchoalveolar lavage fluid cell differential count is independent of age, gender, season and collection site (RML or lingua. It therefore seems acceptable to use the same reference values for all never-smoking individuals.

  13. Evidence for an intracellular niche for Bordetella pertussis in broncho-alveolar lavage cells of mice

    NARCIS (Netherlands)

    Hellwig, SMM; Hazenbos, WLW; van de Winkel, JGJ; Mooi, FR

    1999-01-01

    Bordetella pertussis can attach, invade and survive intracellularly in human macrophages in vitro. To study the significance of this bacterial feature in vivo, we analyzed the presence of viable bacteria in broncho-alveolar lavage (BAL) cells of mice infected with B, pertussis. We found B. pertussis

  14. Longitudinal profile of bronchoalveolar lavage cell characteristics in patients with a good outcome after lung transplantation

    NARCIS (Netherlands)

    Slebos, DJ; Scholma, J; Boezen, HM; Koeter, GH; van der Bij, W; Postma, DS; Kauffman, HF

    2002-01-01

    Bronchoalveolar lavage fluid (BALF) analysis is used in patients after lung transplantation (LTX) to obtain more insight into pathological conditions such as acute and chronic allograft rejection. Information on the normal course of BALF cell characteristics in patients with "good outcome" after LTX

  15. 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

    , 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...

  16. Specificity and sensitivity of hemosiderin-laden macrophages in routine bronchoalveolar lavage in children.

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    Salih, Zeynep N; Akhter, Afreen; Akhter, Javeed

    2006-11-01

    The presence of iron or hemosiderin in macrophages obtained in routine bronchoalveolar lavage is considered crucial in the diagnosis of the clinical syndrome of hemosiderosis. However, there do not appear to be any data on the sensitivity and specificity of the finding of hemosiderin-laden macrophages (HLMs) in bronchoalveolar lavage in children. To review data from bronchoalveolar lavage studies done in children to correlate the presence of HLMs with pneumonia and hemosiderosis and to determine what proportion of HLMs has the optimal sensitivity and specificity for the diagnosis of hemosiderosis. One hundred ten bronchoalveolar lavage specimens obtained via flexible bronchoscopy were reviewed retrospectively. The data collected for demographics, indication for the bronchoscopy, diagnosis of pneumonia, anemia, and bronchoscopy and bronchoalveolar lavage findings were compared between patients diagnosed with hemosiderosis and those diagnosed with other diseases. Six patients were diagnosed with hemosiderosis by clinical findings, lung biopsy, or autopsy. There were no statistical differences in pneumonia (P > .99), anemia (P > .99), or coughing (P = .08) between patients with hemosiderosis and other patients. Hemoptysis was the only symptom that was significantly different between the 2 groups (P = .04). The mean HLM index for patients with hemosiderosis was 56% +/- 16.17% and for other patients, 7.5% +/- 10.74% (P < .001). A HLM index of 35% gave a sensitivity of 1% and a specificity of .96%. These results confirm a strong association between HLM index and diagnosis of hemosiderosis in a pediatric population. Availability of this HLM index will result in accurate and timely diagnosis of pulmonary hemosiderosis, which may influence treatment and long-term prognosis.

  17. Dapsone hypersensitivity syndrome-related lung injury without eosinophilia in the bronchoalveolar lavage fluid.

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    Kinehara, Yuhei; Kijima, Takashi; Inoue, Koji; Hirata, Haruhiko; Takeuchi, Yoshiko; Fukushima, Kiyoharu; Hayama, Yoshitomo; Higashiguchi, Masayoshi; Morimura, Osamu; Miyake, Kotaro; Minami, Toshiyuki; Nagatomo, Izumi; Takeda, Yoshito; Kida, Hiroshi; Kumanogoh, Atsushi

    2015-01-01

    A 73-year-old man was admitted in respiratory failure that had subacutely progressed after five weeks of dapsone treatment for a skin rash. He also presented with fever, systemic erythroderma and liver dysfunction. Chest computed tomography showed diffuse reticular shadows with ground-glass opacity and bilateral mediastinal lymphadenopathy. Lymphocytes, but not eosinophils, were increased in the bronchoalveolar lavage fluid. Moreover, reactivation of human herpes virus-6 was confirmed on a paired serum test. Finally, we diagnosed the patient with dapsone hypersensitivity syndrome (DHS), a rare adverse event of this drug. Lung injury unaccompanied by eosinophilia in the bronchoalveolar lavage fluid is even more rare as a DHS-related lung manifestation.

  18. Cytokine concentrations in serum and bronchoalveolar lavage as marker for pathogenesis and prognosis in systemic sclerosis

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    Schmidt, Katrin

    2010-01-01

    Systemic sclerosis (SSc) is a rare connective tissue disease characterized by increased production of extracellular matrix, endothelial dysfunction and immunity abnormalities. SSc is considered as a devastating multiorgan disease of unknown etiology with an autoimmunological background. In the present work we have measured levels of cytokines and chemokines in bronchoalveolar lavage fluid (BALF) and serum in cohorts of Ssc-patients, patients with other lung diseases and healthy donors. We...

  19. Respiratory mechanics and results of cytologic examination of bronchoalveolar lavage fluid in healthy adult alpacas.

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    Pacheco, Ana P; Bedenice, Daniela; Mazan, Melissa R; Hoffman, Andrew M

    2012-01-01

    To evaluate respiratory mechanical function and bronchoalveolar lavage (BAL) cytologic results in healthy alpacas. 16 client-owned adult alpacas. Measurements of pulmonary function were performed, including functional residual capacity (FRC) via helium dilution, respiratory system resistance via forced oscillatory technique (FOT), and assessment of breathing pattern by use of respiratory inductive plethysmography (RIP) in standing and sternally recumbent alpacas. Bronchoalveolar lavage was performed orotracheally during short-term anesthesia. Mean ± SD measurements of respiratory function were obtained in standing alpacas for FRC (3.19 ± 0.53 L), tidal volume (0.8 ± 0.13 L), and respiratory system resistance at 1 Hz (2.70 ± 0.88 cm H(2)O/L/s), 2 Hz (2.98 ± 0.70 cm H(2)O/L/s), 3 Hz (3.14 ± 0.77 cm H(2)O/L/s), 5 Hz (3.45 ± 0.91 cm H(2)O/L/s), and 7 Hz (3.84 ± 0.93 cm H(2)O/L/s). Mean phase angle, as a measurement of thoracoabdominal asynchrony, was 19.59 ± 10.06°, and mean difference between nasal and plethysmographic flow measurements was 0.18 ± 0.07 L/s. Tidal volume, peak inspiratory flow, and peak expiratory flow were significantly higher in sternally recumbent alpacas than in standing alpacas. Cytologic examination of BAL fluid revealed 58.52 ± 12.36% alveolar macrophages, 30.53 ± 13.78% lymphocytes, 10.95 ± 9.29% neutrophils, 0% mast cells, and several ciliated epithelial cells. Pulmonary function testing was tolerated well in nonsedated untrained alpacas. Bronchoalveolar lavage in alpacas yielded samples with adequate cellularity that had a greater abundance of neutrophils than has been reported in horses.

  20. 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.

  1. [Effect of bile acids on surface tension of bronchoalveolar lavage fluid in rabbits].

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    Wang, Fei; Zhao, Cong; Tian, Yinghong; Yin, Yanru

    2014-10-01

    To observe changes in surface tension of bronchoalveolar lavage fluids (BALF) in rabbits with hyperbilirubinemia and the influence of bile diluents and 5 different bile acids on BALF surface tension to provide better insight into the regulatory role of bile acids on respiratory function. Bronchoalveolar lavage with 0.9% normal saline was carried out in 30 male New Zealand rabbits and the surface tensions of BALF were measured. The changes in BALF surface tension was measured in rabbits with hyperbilirubinemia. Different concentrations of bile diluents, normal saline, or water solutions of 5 bile acids were added into the collected BALF to test their influence on the surface tension of BALF. The BALF from rabbits with hyperbilirubinemia showed a significantly increased surface tension (Psurface tension of the BALF by 21.15%, 26.09%, and 19.64%, respectively. Among the water solutions of the 5 bile acids, UDCA produced no significant influence on the surface tension of BALF while CDCA, CA, LCA, and DCA increased the surface tension by 16.10%, 21.66%, 14.21%, and 13.05%, respectively. The surface tension of BALF increases significantly during hyperbilirubinemia. Bile diluents as well as the free bile acids CDCA, CA, LCA and DCA, but not UDCA, can increase the surface tension of BALF, suggesting that these bile acids may emulsify pulmonary alveolar surfactants to increase the alveolar surface tension.

  2. Comparative analyses of thoracic radiographs and bronchoalveolar lavage of dogs and cats with chronic bronchial diseases

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    Mariana Pavelski

    2017-06-01

    Full Text Available There is a high incidence of bronchitis and asthma cases in veterinary medicine. Thoracic radiographs and bronchoalveolar lavage (BAL are commonly performed for definitive diagnosis in dogs and cats with suspected bronchitis and asthma. It is believed that a combination of diagnostic tools is the best choice to achieve a diagnosis. The aim of this study was to evaluate the efficacy of thoracic radiographs and BAL in the diagnosis of chronic bronchial disease (CBD in dogs and cats and whether there is any specific radiographic finding that could influence the indication for bronchoalveolar lavage. It was performed a cross-sectional, prospective, observational study including forty client-owned dogs and cats with lower respiratory tract signs and positive radiographic opacities that were evaluated with BAL followed by cytology and culture. The radiographic results compared with BAL culture showed a sensitivity of 38%, specificity of 95% and accuracy of 65% in detecting patients with pneumonia associated with chronic bronchial disease. Thoracic radiographs were effective in diagnosing 65% of the patients, radiographs plus BAL cytology diagnosed 75% of patients and the combination of radiographs, BAL cytology and culture diagnosed 95% of the patients with chronic bronchial disease. In conclusion, the combination of radiographic examination with BAL followed by cytological and microbiological analyses increases diagnostic success in CBD.

  3. 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.

  4. Quantitative culture of bronchoalveolar lavage fluid in community-acquired lower respiratory tract infections

    DEFF Research Database (Denmark)

    Rasmussen, TR; Korsgaard, Jens; Møller, Jens Kjølseth

    2001-01-01

    were investigated. Results were compared to the findings in eight healthy control persons investigated in February 1998. There was no difference between study patients and control persons when quantitative culture of total cumulative bacterial findings or bacteria categorized as members...... a primary bronchial washing was compared to a secondary sampling from the same bronchus in the control group. Twenty-four (36%) of 67 patients were cultured as positive in the study group while all control persons were cultured as negative for bacteria categorized as potential pathogens. With a threshold......To evaluate the diagnostic value of quantitative bacterial culture of bronchoalveolar lavage (BAL) fluid obtained by fibreoptic bronchoscopy, 67 consecutive immunocompetent adult patients admitted to hospital with community-acquired lower respiratory tract infections from September 1997 to May 1998...

  5. [Reference values of hemosiderin-laden alveolar macrophages in bronchoalveolar lavage in children].

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    Ahrens, P; Kitz, R; Weimer, B; Hofmann, D

    1999-05-01

    Pulmonary haemosiderosis is a rare disease of unknown etiology, mainly affecting children and adolescents. Pulmonary haemosiderosis may occur in association with several respiratory or other disease (Lupus erythematosus, Goodpastures syndrome). Delay in diagnosing can lead to fatal complications. BAL appears to be the method of choice to detect haemosiderin-laden macrophages. No reference values are available for children to date. 64 bronchoalveolar lavages were performed to establish reference values of haemosiderin-laden macrophages in children. Less haemosiderin was found in children compared to adults, and hence a new haemosiderin score was established for paediatric patients. Compared to healthy children, no elevated haemosiderine levels were found in children with chronic pulmonary disease such as bronchiectasis or chronic aspiration caused by gastro-oesophageal reflux. Therefore even a mildly increased amount of haemosiderin-laden macrophages in children requires medical attention.

  6. Proteomics as the Tool to Search for Lung Disease Markers in Bronchoalveolar Lavage

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    Isabelle Noël-Georis

    2001-01-01

    Full Text Available Most lung disorders are known to be associated to considerable modifications of surfactant composition. Numerous of these abnormalities have been exploited in the past to diagnose lung diseases, allowing proper treatment and follow-up. Diagnosis was then based on phospholipid content, surface tension and cytological features of the epithelial lining fluid (ELF, sampled by bronchoalveolar lavage (BAL during fiberoscopic bronchoscopy. Today, it appears that the protein content of ELF displays a remarkably high complexity, not only due to the wide variety of the proteins it contains but also because of the great diversity of their cellular origins. The significance of the use of proteome analysis of BAL fluid for the search for new lung disease marker proteins and for their simultaneous display and analysis in patients suffering from lung disorders has been examined.

  7. Diagnostic yield of bronchoalveolar lavage in immunocompromised children with malignant and non-malignant disorders.

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    Nadimpalli, Sruti; Foca, Marc; Satwani, Prakash; Sulis, Maria Luisa; Constantinescu, Andrei; Saiman, Lisa

    2017-06-01

    The diagnostic yield of bronchoalveolar lavage (BAL) in the Immunocompromised pediatric population has ranged from 28% to 68%. We hypothesized that the diagnostic yield of BALs would be higher in more recent years due to new diagnostic assays. A retrospective case series was performed among immunocompromised children ≤18 years old who underwent BALs from 2001 to 2012, to assess the yield of microbiologic diagnostic studies and to determine the impact of BAL findings on antimicrobial management. In all, 123 subjects underwent 174 BALs (mean age 9.9 years). Underlying diagnoses included both malignant (n = 79) and non-malignant (n = 44) disorders, and 75 (61.0%) subjects were hematopoietic stem cell transplant (HSCT) recipients. Fifty-four (31.0%) of 174 BAL were positive for ≥1 potential pathogen (n = 58 microorganisms). The diagnostic yield of BALs performed from 2001 to 2006 versus2007-2012 was similar (40.5% vs. 26.6%, respectively, P = 0.07). Most subjects (86.2%) were on ≥1 antimicrobial at the time of BAL. Most (65.8%) negative BALs were associated with narrowing antimicrobial therapy, while most (74.1%) positive BALs were associated with continuing or changing to targeted antimicrobial therapy. In this study population, the diagnostic yield of BAL was similar to that previously described and unchanged in more recent years. Both negative and positive BALs were associated with changes in antimicrobial management. A 10-year retrospective review of bronchoalveolar lavage in 123 immunocompromised children determined that the rate of isolation of potential pathogens was 31% in this population. The majority of BAL was associated with a change in antimicrobial therapy. Pediatr Pulmonol. 2017;52:820-826. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  8. Detection of plant DNA in the bronchoalveolar lavage of patients with ventilator-associated pneumonia.

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    Sabri Bousbia

    Full Text Available BACKGROUND: Hospital-acquired infections such as nosocomial pneumonia are a serious cause of mortality for hospitalized patients, especially for those admitted to intensive care units (ICUs. Despite the number of the studies reported to date, the causative agents of pneumonia are not completely known. Herein, we found by molecular technique that vegetable and tobacco DNA may be detected in the bronchoalveolar lavage from patients with ventilator-associated pneumonia (VAP. METHODOLOGY/PRINCIPAL FINDINGS: In the present study, we studied bronchoalveolar lavage (BAL from patients admitted to ICUs with ventilator-associated pneumonia. BAL fluids were assessed with molecular tests, culture and blood culture. We successfully identified plant DNA in six patients out of 106 (6% with ventilator-associated pneumonia. Inhalation was confirmed in four cases and suspected in the other two cases. Inhalation was significantly frequent in patients with plant DNA (four out of six patients than those without plant DNA (three out of 100 patients (P<0.001. Nicotiana tabacum chloroplast DNA was identified in three patients who were smokers (cases 2, 3 and 6. Cucurbita pepo, Morus bombycis and Triticum aestivum DNA were identified in cases 1, 4 and 5 respectively. Twenty-three different bacterial species, two viruses and five fungal species were identified from among these six patients by using molecular and culture techniques. Several of the pathogenic microorganisms identified are reported to be food-borne or tobacco plant-associated pathogens. CONCLUSIONS/SIGNIFICANCE: Our study shows that plants DNA may be identified in the BAL fluid of pneumonia patients, especially when exploring aspiration pneumonia, but the significance of the presence of plant DNA and its role in the pathogenesis of pneumonia is unknown and remains to be investigated. However, the identification of these plants may be a potential marker of aspiration in patients with pneumonia.

  9. 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

    %). In a logistic regression analysis, higher age, increased bronchoalveolar lavage (BAL) neutrophilia and a positive BAL cytomegalovirus CMV culture were associated with the need of MV. In multivariate analyses, only BAL neutrophilia remained independently predictive of mechanical ventilation. In conclusion, short...

  10. Lactoferrin and secretory IgA in the bronchoalveolar lavage fluid from patients with a stable asthma

    NARCIS (Netherlands)

    van de Graaf, E. A.; Out, T. A.; Kobesen, A.; Jansen, H. M.

    1991-01-01

    We have measured lactoferrin and secretory IgA (sIgA) in the unconcentrated bronchoalveolar lavage fluid (BALF) from nonsmoking healthy volunteers (n = 10) and nonsmoking patients with stable asthma (n = 14). The median concentrations and the ranges of lactoferrin were controls, 0.13 mg/L (0.01-0.43

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

    Science.gov (United States)

    Sareen, Rateesh; Pandey, C L

    2016-01-01

    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 PMID:27890992

  12. Pseudoasbestos bodies and fibers in bronchoalveolar lavage of refractory ceramic fiber users.

    Science.gov (United States)

    Dumortier, P; Broucke, I; De Vuyst, P

    2001-08-01

    Refractory ceramic fibers (RCF) are widely used to replace asbestos in applications requiring high heat resistance. Ferruginous bodies mimicking asbestos bodies (ABs) have been detected in the lungs of RCF production workers. This raises the question about their presence in other occupational groups and whether "typical ABs" still reflect past asbestos exposures in all settings. An AB counting by phase-contrast light microscopy and a screening test by analytical electron microscopy were systematically performed on all bronchoalveolar lavage fluids (BALF) submitted to our laboratory in 1992 through 1997 (n = 1,800). When RCF were detected in electron microscopy, the structures considered as "typical ABs" were marked under light microscopy and prepared for further chemical and structural analysis. Pseudo-ABs on RCF were detected in samples from nine subjects (0.5%). All of them had worked either as foundry workers, steel workers, or welders. In these subjects, alumino-silicate fibers compatible with RCF accounted for 42% of the core fibers analyzed, other nonasbestos fibers for 28%, and asbestos fibers for 30%. ABs thus remain a valid marker of asbestos retention but attention must be paid to a possible occurrence of pseudo-asbestos bodies on RCF and other nonasbestos fibers in end-users of refractory fibers.

  13. [Possible Significance of Bronchoalveolar Lavage Cytology at Initial Diagnosis and Follow-up of Lung Cancer].

    Science.gov (United States)

    Grünewaldt, A; Hügel, C; Hermann, E; Wagner, T O F

    2017-02-01

    Bronchoalveolar lavage [BAL] is an important procedure in the diagnosis of a variety of lung diseases. While it has enormous value in the diagnostics of inflammatory parenchymal diseases, its significance in lung cancer is unclear. Keeping in mind that immune therapy (e. g. application of checkpoint inhibitors) is gaining importance in the management of lung carcinoma, it is important to know if there are typical cellular patterns in BAL of lung cancer patients. Methods In a retrospective proof of principle-study, we analyzed 38 patients who underwent BAL at the initial diagnosis of lung cancer. Results We observed an elevated level of CD25 lymphocytes as well as an increased expression of DR antigen, both signaling lymphocyte activation. We could not find a typical cytologic pattern of inflammatory cells in lung carcinoma patients. Sensitivity of BAL to malignant cells was rare, thus confirming earlier analysis. Conclusion We could not demonstrate typical cellular patterns in BAL of lung cancer patients. Evaluation of specific microRNA patterns might play a supporting role in the initial diagnosis as well as follow-up of lung cancer patients. © Georg Thieme Verlag KG Stuttgart · New York.

  14. 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.

  15. Rapid detection of Candida species in bronchoalveolar lavage fluid from patients with pulmonary symptoms.

    Science.gov (United States)

    Zarrinfar, Hossein; Kaboli, Saeed; Dolatabadi, Somayeh; Mohammadi, Rasoul

    2016-01-01

    Candida species, especially C. albicans, are commensals on human mucosal surfaces, but are increasingly becoming one of the important invasive pathogens as seen by a rise in its prevalence in immunocompromised patients and in antibiotic consumption. Thus, an accurate identification of Candida species in patients with pulmonary symptoms can provide important information for effective treatment. A total of 75 clinical isolates of Candida species were obtained from the bronchoalveolar lavage fluid of both immunocompromised and immunocompetent patients with pulmonary symptoms. Candida cultures were identified based on nuclear ribosomal Internal Transcribed Spacer (ITS1-ITS2 rDNA) sequence analysis by polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP). Molecular identification indicated that the isolates belonged predominantly to C. albicans (52%), followed by C. tropicalis (24%), C. glabrata (14.7%), C. krusei (5.3%), C. parapsilosis (1.3%), C. kefyr (1.3%) and C. guilliermondii (1.3%). Given the increasing complexity of disease profiles and their management regimens in diverse patients, rapid and accurate identification of Candida species can lead to timely and appropriate antifungal therapy. Copyright © 2015 Sociedade Brasileira de Microbiologia. Published by Elsevier Editora Ltda. All rights reserved.

  16. Cytomegalovirus Viral Load in Bronchoalveolar Lavage to Diagnose Lung Transplant Associated CMV Pneumonia.

    Science.gov (United States)

    Lodding, Isabelle Paula; Schultz, Hans Henrik; Jensen, Jens-Ulrik; Kirkby, Nikolai; Perch, Michael; Andersen, Claus; Lundgren, Jens D; Iversen, Martin

    2018-02-01

    The diagnostic yield for cytomegalovirus (CMV) polymerase chain reaction (PCR) viral load in bronchoalveolar lavage (BAL) or in plasma to diagnose CMV pneumonia in lung transplant recipients remains uncertain and was investigated in a large cohort of consecutive lung transplant recipients. Bronchoscopies within the first year of lung transplantation with CMV detectable in BAL by PCR (ie, viral load, ≥273 IU/mL) were included (66 recipients; 145 bronchoscopies); at each bronchoscopy episode, 2 independent experts reviewed clinical and laboratory information to determine whether the patient at that time fulfilled the criteria for CMV pneumonia per current international recommendations. Corresponding plasma CMV PCR viral load determined at time of the bronchoscopy (n = 126) was also studied. Optimal CMV PCR viral load cutoff for CMV pneumonia diagnosis was determined using receiver operating characteristics. CMV was detected in BAL with CMV PCR in 145 episodes, and 34 (23%) of these episodes fulfilled the criteria for CMV pneumonia. The area under the curve-receiver operating characteristics for CMV in BAL was 90% at the optimum cutoff (4545 IU/mL) with a corresponding sensitivity of 91% and specificity of 77% (in plasma the corresponding values were 274 IU/mL, 63% and 76%, respectively). CMV PCR viral load in BAL had a high performance to diagnose CMV pneumonia in lung transplant recipients; plasma CMV viral load did not reliably aid as a diagnostic tool.

  17. Effects on respiratory mechanics of bronchoalveolar lavage in mechanically ventilated patients.

    Science.gov (United States)

    Estella, Angel

    2010-07-01

    Inconsistent findings have been reported about the effects of bronchoalveolar lavage (BAL) on respiratory mechanics. The aims of this study were to study the effects of BAL on respiratory mechanics in mechanically ventilated patients with suspected pneumonia and to find out whether these effects are related to the extension of radiographic infiltrate and preceding respiratory mechanics measurements. Bronchoscopy BAL was performed with 150 mL of sterile isotonic saline in 3 aliquots of 50 mL. Respiratory mechanics parameters were measured by the rapid airway occlusion technique, immediately before and after BAL and 90 minutes later. Patients were classified according to unilateral or bilateral radiological infiltrate occurrence. Fifty critically ill patients undergoing mechanical ventilation were included. Respiratory system compliance (Crs) decreased from 43.32±13.17 mL/cm H2O to 33.02±9.56 mL/cm H2O (Prespiratory mechanics. BAL in mechanically ventilated patients can lead to a significant, although transitory, deterioration in pulmonary mechanics, characterized by a decrease in Crs and by an increase in airway resistance. Patients with better initial Crs showed the most severe affectation.

  18. Characterization of the mouse bronchoalveolar lavage proteome by micro-capillary LC–FTICR mass spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Pounds, Joel G.; Flora, Jason W.; Adkins, Joshua N.; Lee, Kyeonghee M.; Rana, Gaurav S.J.B.; Sengupta, Tapas; Smith, Richard D.; McKinney, Willie J.

    2008-03-15

    Bronchoalveolar lavage fluid (BALF) contains proteins derived from various pulmonary cell types, secretions and blood. As the characterization of the BALF proteome will be instrumental in establishing potential biomarkers of pathophysiology in the lungs, the objective of this study was to contribute to the comprehensive collection of Mus musculus BALF proteins using high resolution and highly sensitive micro-capillary liquid chromatography (microLC) combined with state-of-the-art high resolution mass spectrometry (MS). BALF was collected from ICR and C57BL/6 male mice exposed to nose-only inhalation to either air or cigarette smoke. The tandem mass spectra were analyzed by SEQUEST for peptide identifications with the subsequent application of accurate mass and time tags resulting in the identification of 1797 peptides with high confidence by high resolution MS. These peptides covered 959 individual proteins constituting the largest collection of BALF proteins to date. High throughput monitoring profiles of this extensive collection of BALF proteins will facilitate the discovery and validation of biomarkers that would elucidate pathogenic or adaptive responses of the lungs upon toxic insults.

  19. Comparison of sample preparation methods for detection of Chlamydia pneumoniae in bronchoalveolar lavage fluid by PCR.

    Science.gov (United States)

    Maass, M; Dalhoff, K

    1994-01-01

    Amplification inhibitors can lead to false-negative results for PCR. In order to evaluate the reliability of PCR for the detection of Chlamydia pneumoniae, the presence of PCR inhibitors in 75 bronchoalveolar lavage specimens was assessed after treatment by various sample preparation methods. Specimens were collected from patients with acute respiratory infections, including four cases of proven C. pneumoniae infection. Substances inhibitory to the amplification of chlamydial DNA continued to be present in 12% of the samples treated according to the commonly used single-step proteinase K digestion and in 31% of the samples processed by heat treatment. However, the complexing of DNA-contaminating proteins and polysaccharides from digested specimens to cetyltrimethylammonium bromide (CTAB) followed by DNA extraction efficiently removed inhibitors from all experimental samples and provided subsequent identification of all positive clinical samples by PCR. The CTAB method and proteinase K treatment had comparable detection limits of approximately 0.01 inclusion-forming units. CTAB-based DNA purification of respiratory specimens is recommended to increase the diagnostic sensitivity of PCR and confidence in negative results. Images PMID:7814512

  20. 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.

  1. Airway Microbiota in Bronchoalveolar Lavage Fluid from Clinically Well Infants with Cystic Fibrosis.

    Directory of Open Access Journals (Sweden)

    Theresa A Laguna

    Full Text Available Upper airway cultures guide the identification and treatment of lung pathogens in infants with cystic fibrosis (CF; however, this may not fully reflect the spectrum of bacteria present in the lower airway. Our objectives were to characterize the airway microbiota using bronchoalveolar lavage fluid (BALF from asymptomatic CF infants during the first year of life and to investigate the relationship between BALF microbiota, standard culture and clinical characteristics.BALF, nasopharyngeal (NP culture and infant pulmonary function testing data were collected at 6 months and one year of age during periods of clinical stability from infants diagnosed with CF by newborn screening. BALF was analyzed for total bacterial load by qPCR and for bacterial community composition by 16S ribosomal RNA sequencing. Clinical characteristics and standard BALF and NP culture results were recorded over five years of longitudinal follow-up.12 BALF samples were collected from 8 infants with CF. Streptococcus, Burkholderia, Prevotella, Haemophilus, Porphyromonas, and Veillonella had the highest median relative abundance in infant CF BALF. Two of the 3 infants with repeat BALF had changes in their microbial communities over six months (Morisita-Horn diversity index 0.36, 0.38. Although there was excellent percent agreement between standard NP and BALF cultures, these techniques did not routinely detect all bacteria identified by sequencing.BALF in asymptomatic CF infants contains complex microbiota, often missed by traditional culture of airway secretions. Anaerobic bacteria are commonly found in the lower airways of CF infants.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  3. Flow Cytometry Increases the Sensitivity of Detection of Leukemia and Lymphoma Cells in Bronchoalveolar Lavage Specimens

    Science.gov (United States)

    Song, Joo Y.; Filie, Armando C.; Venzon, David; tevenson, Maryalice Stetler-S; Yuan, Constance M.

    2013-01-01

    Background Recent studies have definitively determined that Flow Cytometry (FC) is significantly more sensitive than cytomorphology (CM) in detection of hematolymphoid neoplasms (HLN). However, its utility in paucicellular bronchoalveolar lavage (BAL) specimens has not been established. Methods FC was performed on BAL specimens submitted from 44 patients with a prior diagnosis of HLN. Panels chosen were based upon cellularity of specimen and patient history. FC results were compared with concurrent CM evaluations. Results All 44 BALs were deemed satisfactory for FC and yielded informative results that assisted in diagnosis. Diagnoses included 22/44 B-cell neoplasms, 16/44 T-cell neoplasms, 4/44 myeloid neoplasms, and 2/44 plasma cell neoplasms. Overall concordance was demonstrated between FC and CM in 77% (34/44) of cases. In 9/44 cases (20%), one technique (FC or CM) clearly detected malignant cells when the other did not. FC was more sensitive than CM in detecting a HLN in 8/9 discordant cases. In only one case (1/44, 2%) were malignant HLN cells suspected by CM, but not identified by FC (1/44, 2%). Conclusion We demonstrate, in the largest series published to date, that FC can be performed on BAL specimens. FC is indicated in evaluation of BAL for HLN and improves sensitivity of detection of HLN over CM alone. An integrated FC and CM approach is superior to either technique alone in diagnostic evaluation of BAL. PMID:22837143

  4. Rapid diagnosis of childhood pulmonary tuberculosis by Xpert MTB/RIF assay using bronchoalveolar lavage fluid.

    Science.gov (United States)

    Yin, Qing-Qin; Jiao, Wei-Wei; Han, Rui; Jiao, An-Xia; Sun, Lin; Tian, Jian-Ling; Ma, Yu-Yan; Rao, Xiao-Chun; Shen, Chen; Li, Qin-Jing; Shen, A-Dong

    2014-01-01

    In order to evaluate the diagnostic accuracy of the Xpert MTB/RIF assay on childhood pulmonary tuberculosis (PTB) using bronchoalveolar lavage fluid (BALF), we evaluated the sensitivity, specificity, positive predictive value, and negative predictive value of Xpert MTB/RIF assay using BALF in comparison with acid-fast bacilli (AFB) microscopy and Mycobacterium tuberculosis (MTB) culture for diagnosing childhood PTB using Chinese "composite clinical reference standard" (CCRS) as reference standard. Two hundred fifty-five children with suspected PTB were enrolled at Beijing Children's Hospital from September 2010 to July 2013. Compared with Chinese CCRS, the sensitivity of AFB microscopy, MTB culture, and Xpert MTB/RIF assay was 8.4%, 28.9%, and 53.0%, respectively. The specificity of three assays was all 100%. Xpert MTB/RIF assay could detect 33.9% of cases with negative MTB culture, and 48.7% of cases with negative AFB microscopy. Younger age (MTB/RIF assay. In conclusion, Xpert MTB/RIF assay using BALF can assist in diagnosing childhood PTB much faster when fiberoptic bronchoscopy is necessary according to the chest radiograph.

  5. Cytologic diagnosis of respiratory syncytial virus infection in a bronchoalveolar lavage specimen from a bone marrow transplant recipient.

    Science.gov (United States)

    Parham, D M; Bozeman, P; Killian, C; Murti, G; Brenner, M; Hanif, I

    1993-05-01

    Cytologic examination of a bronchoalveolar lavage specimen from a 6-year-old bone marrow transplant recipient revealed pulmonary infiltrates and occasional cells containing discrete pink cytoplasmic inclusions on a May-Grunwald-Giemsa stain. Direct immunofluorescence stains of cytospins prepared from the same specimen were positive for respiratory syncytial virus (RSV). Electron microscopy revealed occasional epithelial cells with cytoplasmic inclusions composed of filamentous virions. The patient died 6 months after the specimen was taken. An autopsy showed ongoing bronchiolitis with diffuse alveolar damage. Occasional bronchiolar epithelial cells contained discrete eosinophilic cytoplasmic inclusions, which on ultrastructural examination proved to be compatible with RSV. Examination of bronchoalveolar lavage fluid from bone marrow transplant recipients should include a search for cytopathic changes compatible with RSV infection. Electron microscopy can be helpful in confirming this diagnosis.

  6. 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.

  7. Comparison of Manual and Suction Pump Aspiration Techniques for Performing Bronchoalveolar Lavage in 18 Dogs with Respiratory Tract Disease

    OpenAIRE

    Woods, K. S.; Defarges, A.M.N.; Abrams?Ogg, A.C.G.; Viel, L.; Brisson, B.A.; Bienzle, D

    2014-01-01

    Background Different aspiration techniques to retrieve bronchoalveolar lavage fluid (BALF) affect sample quality in healthy dogs. Studies evaluating these techniques in dogs with respiratory disease are lacking. Objectives To compare sample quality of BALF acquired by manual aspiration (MA) and suction pump aspiration (SPA). Animals Eighteen client?owned dogs with respiratory disease. Methods Randomized, blinded prospective clinical trial. Manual aspiration was performed with a 35?mL syringe ...

  8. Diagnostic Value of Bronchoalveolar Lavage in Leukemic and Bone Marrow Transplant Patients: The Impact of Antimicrobial Therapy

    OpenAIRE

    John Norman Greene; Abraham Tareq Yacoub; Dani Thomas; Carol Yuan; Frank Walsh; David Solomon; Skai Schwartz; Arthur Andrews

    2015-01-01

    Background Pneumonia carries significant morbidity and mortality in leukemic and bone marrow transplant patient.  The development of pulmonary infiltrates in the setting of such immunocompromise raises concern for both infectious and non-infectious etiologies, some of which are potentially treatabl.  Performing bronchoscopy provides several different options for sampling the lower respiratory tract.  Among these, bronchoalveolar lavage (BAL) is especially effective at collecting samples f...

  9. Comparison of the diagnostic performance of bacterial culture of nasopharyngeal swab and bronchoalveolar lavage fluid samples obtained from calves with bovine respiratory disease

    Science.gov (United States)

    Objective: Examine the culture results, gamithromycin susceptibility, predictive values, and agreement of pooled bilateral nasopharyngeal swabs (NPS) and bronchoalveolar lavages (BAL) for identification of Mannheimia haemolytica genotypes, Pasteurella multocida, and Histophilus somni in calves treat...

  10. 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.

  11. FilmArray Respiratory Panel Assay: Comparison of Nasopharyngeal Swabs and Bronchoalveolar Lavage Samples.

    Science.gov (United States)

    Azadeh, Natalya; Sakata, Kenneth K; Brighton, Anjuli M; Vikram, Holenarasipur R; Grys, Thomas E

    2015-12-01

    The FilmArray respiratory panel (FARP) reliably and rapidly identifies 17 viruses and 3 bacterial pathogens. A nasopharyngeal swab FARP (NP FARP) is performed for many patients with respiratory symptoms. For patients who are acutely ill or immunocompromised or fail to improve, a bronchoalveolar lavage sample FARP (BAL FARP) is performed in addition to the NP FARP. To date, no studies have compared the yield of a BAL FARP with that of an NP FARP. We retrospectively studied all patients who had a BAL FARP within 7 days after an NP FARP between June 2013 and May 2014. Demographic information, comorbidities, FARP results, and all microbiologic data from BAL fluid were collected. Eighty-six patients had a BAL FARP performed within 7 days (mean, 1.6; median, 1) after an NP FARP. Of these, 66 (77%) had concordant BAL and NP FARP results: 15 (23%) had the same pathogen identified from the NP and BAL FARPs, and 51 (77%) had concordant negative FARP results. In 18 of the 86 patients (21%), a pathogen was detected from the NP FARP; of these, 15 (83%) had a concordant match on a subsequent BAL FARP, and the remaining 3 had negative BAL FARPs. In 17 of the 86 patients (20%), pathogens were identified from the BAL FARPs that were not detected by the NP FARPs; of these, 16 (94%) had initial negative NP FARPs. The data suggest that once a pathogen is identified by an NP FARP, a subsequent BAL FARP is unlikely to add new microbiologic information. However, a BAL FARP may provide new, useful microbiologic information when performed within 7 days after a negative NP FARP. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  12. Diagnostic Value of Bronchoalveolar Lavage for Diagnosis of Suspected Peripheral Lung Cancer.

    Science.gov (United States)

    Bezel, Pascal; Tischler, Verena; Robinson, Cecile; Baumueller, Stephan; Bode-Lesniewska, Beata; Kohler, Malcolm; Freitag, Lutz; Franzen, Daniel

    2016-09-01

    There is a paucity of data concerning the benefit of bronchoalveolar lavage (BAL) for the diagnosis of suspected peripheral lung cancer (PLC). The aim of this study was to investigate the diagnostic value of BAL for the diagnosis of suspected PLC. All flexible bronchoscopies that included BAL among other modalities (brush, forceps, washing) for the diagnosis of a suspected PLC performed between 2009 and 2013 were analyzed in this retrospective study. A total of 260 patients were included. Malignancy was present in 61%. BAL's sensitivity for the diagnosis of malignancy was 29%, and overall diagnostic yield of BAL was 46%. However, only 1% of cancer diagnoses would have been missed in the absence of BAL. In the multivariable analysis, the size of lesion (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.02-1.33; P = .023), the presence of bronchus sign (OR, 4.73; 95% CI, 1.06-21.08; P = .042), and the presence of mediastinal/hilar lymphadenopathy (OR, 3.37; 95% CI, 1.53-7.41; P = .002) were associated with improved BAL true-positive ratio relating to diagnosis of malignancy. However, the effect of lesion size on sensitivity was small (area under the curve, 0.31; 95% CI, 0.23-0.40; P diagnosis of malignancy or pulmonary infection was 37. Conventional BAL has a low diagnostic value for the diagnosis of suspected PLC, and the low number needed to test does not qualify BAL as a recommended routine investigation for the diagnosis of suspected PLC for either solid or ground-glass lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Soluble Human Leukocyte Antigen-G in the Bronchoalveolar Lavage of Lung Cancer Patients.

    Science.gov (United States)

    Montilla, Dayana; Pérez, Mario; Borges, Lérida; Bianchi, Guillermo; Cova, José-Angel

    2016-08-01

    The main function of the HLA-G molecule in its membrane-bound and soluble forms is to inhibit the immune response by acting on CD4+ T cells, cytotoxic T cells, NK cells and dendritic cells. Lung cancer is a leading cause of death worldwide, and annual incidence is high in both women and men. Some studies have reported an increase of HLA-G serum levels in lung cancer, probably generated by tumor cells escaping the antitumor immune response. In this study the concentration of soluble HLA-G in bronchoalveolar lavage (BAL) in patients with primary and metastatic lung cancer was measured to determine its relation with tumor histological type and overall patient status according to the Karnofsky scale. Thirty-one lung cancer patients were included. A tumor biopsy was obtained by bronchoscopy and the tumor type was determined by hematoxylin and eosin staining. BAL samples were obtained to measure soluble HLA-G concentrations in an ELISA sandwich assay. The average value of soluble HLA-G was 49.04ng/mL. No correlation between soluble HLA-G levels and age, gender or smoking was observed. A highly significant difference was observed in the levels of soluble HLA-G in BAL from patients with different histological types of lung cancer, especially in metastatic tumors. The Karnofsky index showed a significant and inverse correlation with soluble HLA-G levels in BAL. Soluble HLA-G protein is significantly associated with metastatic tumors and patients with lower Karnofsky index and may be useful as a prognostic marker in lung cancer. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Triggering receptor expressed on myeloid cells-1 and 2 in bronchoalveolar lavage fluid in pulmonary sarcoidosis.

    Science.gov (United States)

    Suchankova, Magda; Bucova, Maria; Tibenska, Elena; Tedlova, Eva; Demian, Juraj; Majer, Ivan; Novosadova, Helena; Tedla, Miroslav; Paulovicova, Ema; Kantarova, Daniela

    2013-04-01

    Pulmonary sarcoidosis (PS) is characterized by the formation of granulomas in the lungs and has been associated with infection by microorganisms. Triggering receptor expressed on the surface of myeloid cells (TREM)-1 is overexpressed in response to infection while TREM-2 is involved in granuloma formation. We hypothesized that these receptors are overexpressed in PS and might be useful for diagnostic testing. Cell surface TREM-1 and TREM-2 expression in cells obtained at bronchoalveolar lavage (BAL) was measured in individuals with sarcoidosis (n = 26) and compared with that seen in individuals with other interstitial lung diseases (ILD) (n = 27). TREM-1 and TREM-2 expression was significantly increased in sarcoidosis compared with other ILD: total number of TREM-1, P = 0.0039 (23.81 vs 13.50 cells/μl), TREM-2, P < 0.0001 (32.81 vs 7.76 cells/μl); percentage of TREM-1: P = 0.0002 (41.30% vs 15.70%), TREM-2: P < 0.0001 (34% vs 9.60%); and mean fluorescence of TREM-1: P = 0.0005 (5.43 vs 1.96), TREM-2: P = 0.0011 (6.85 vs 2.77). Increase in both of these receptors seems to be typical for PS. In discriminating sarcoidosis from other ILD, the specificity (96%) and sensitivity (72%) of the combination of TREM-1 and TREM-2 was high. Increased TREM-1 and TREM-2 cell surface expression is observed in sarcoidosis. Evaluation of BAL cell expression of both of these receptors may serve as a diagnostic marker for sarcoidosis. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

  16. Effectiveness of PCR and Immunofluorescence Techniques for Detecting Human Cytomegalovirus in Blood and Bronchoalveolar Lavage Fluid.

    Science.gov (United States)

    Roży, A; Duk, K; Szumna, B; Skrońska, P; Gawryluk, D; Chorostowska-Wynimko, J

    Current diagnostic methods allow a rapid and reliable detection of active human cytomegalovirus (hCMV) infection by identifying the presence of pp65 CMV antigen or CMV DNA in peripheral blood and affected organs. The goal of this study was to evaluate the effectiveness of CMV detection in blood and organ-specific biological material, such as bronchoalveolar lavage fluid (BALF), by comparing two standard diagnostic methods, immunofluorescence (IF) and the real-time polymerase chain reaction (PCR). We evaluated 25 patients with concomitant respiratory disease who were referred to our hospital for diagnosis due to suspected acute CMV infection. The presence of hCMV was concomitantly evaluated by IF and PCR in 16 peripheral blood samples. In two patients, we observed positive results for both IF and PCR, and in two other patients the results were discordant. Of 11 patients, CMV DNA was detected in six BALF samples, and in one blood plasma sample. Real-time PCR detected CMV DNA in 54.6 % of BALF samples and 12.0 % of blood samples, while indirect IF testing confirmed antigenemia in 12.5 % of blood samples. The results from our study suggest that the IF method is as effective as PCR for detecting an ongoing CMV infection in blood samples. However, real-time PCR was much more effective at detecting CMV DNA in BALF compared to blood samples. Our results suggest that the biological material being tested during CMV diagnosis should be derived directly from the virally infected organ(s).

  17. Assessment of EGFR mutation status using cell-free DNA from bronchoalveolar lavage fluid.

    Science.gov (United States)

    Park, Sojung; Hur, Jae Young; Lee, Kye Young; Lee, Jae Cheol; Rho, Jin Kyung; Shin, Sun Hwa; Choi, Chang-Min

    2017-08-28

    Much attention has been focused on epidermal growth factor receptor (EGFR) mutation testing since the introduction of EGFR-tyrosine kinase inhibitors have improved survival in EGFR-positive lung cancer patients. Liquid biopsy using circulating tumor cells or cell-free DNA (cfDNA) has enabled less invasive testing, but requires a highly sensitive method. To date, liquid biopsy using bronchoalveolar lavage (BAL) fluid has rarely been used. From 20 patients with lung adenocarcinoma, we isolated cfDNA from 20 samples of cell-free BAL fluid and 19 cell-free bronchial washing samples. cfDNA was examined for EGFR mutations using peptide nucleic acid (PNA)-mediated PCR clamping method. In cases where the results from the tumor biopsy and BAL-derived cfDNA test were not consistent, PANAMutyper™ R EGFR kit was used along with PNA clamping-assisted fluorescence melting curve analysis. We included 17 patients with advanced stage disease and three with non-advanced stage disease. Tumor biopsy detected EGFR mutations in 12 of the patients. One patient had a p.L858R mutation and a de novo p.T790M mutation. The results from PNA-mediated PCR clamping were 75.0% (9/12) concordant with the tumor biopsy results for EGFR mutation status. PANAMutyper with fluorescence melting curve analysis was performed in three cases, which detected EGFR mutations in two more patients (11/12, 91.7%). EGFR mutations were detected in the cfDNA extracted from two bronchial washing samples. cfDNA from BAL fluid could be used for molecular testing of EGFR mutations and identification of p.T790M mutations, with an easily applicable method.

  18. Osteoprotegerin/sRANKL Signaling System in Pulmonary Sarcoidosis: A Bronchoalveolar Lavage Study.

    Science.gov (United States)

    Naumnik, W; Naumnik, B; Niklińska, W; Ossolińska, M; Chyczewska, E

    2017-01-01

    Osteoprotegerin (OPG), a soluble tumor necrosis factor receptor family molecule, protects endothelial cells from apoptosis in vitro and promotes neovascularization in vivo. Angiogenesis may be crucial for the course and outcome of sarcoidosis. In this study, we evaluated the clinical usefulness of OPG and its ligand, a soluble receptor activator of nuclear factor-kappaB (sRANKL), in bronchoalveolar lavage fluid (BALF) in patients with sarcoidosis (BBS, Besniera-Boeck-Schaumann disease). We studied 22 BBS patients and 15 healthy volunteers as a control group. The levels of OPG, sRANKL, and interleukin-18 (IL-18) were measured by the Elisa method. The BALF levels of sRANKL and IL-18 were higher in the BBS patients compared with controls [sRANKL: 2.12 (0.82-10.23) vs. 1.12 (0.79-4.39) pmol/l, p = 0.03; IL-18: 34.29 (12.50-133.70) vs. 13.05 (12.43-25.88) pg/ml, p = 0.001]. There were no significant differences between the concentration of OPG in the BBS patients and healthy controls [0.22 (0.14-0.81) vs. 0.23 (0.14-0.75) pmol/l]. In the BBS patients we found correlations between sRANKL and IL-18 in BALF (r = 0.742, p = 0.0001) and between OPG and lung diffusing capacity for carbon monoxide (DLCO) (r = -0.528, p = 0.029). Receiver-operating characteristic (ROC) curve was applied to find the cut-off for the BALF level of sRANKL (BBS vs. healthy: 1.32 pmol/l). We conclude that OPG and sRANKL may have usefulness in clinical evaluation of BBS patients.

  19. Secretoglobin and Transferrin Expression in Bronchoalveolar Lavage Fluid of Horses with Chronic Respiratory Disease.

    Science.gov (United States)

    Miskovic Feutz, M; Couetil, L L; Riley, C P; Zhang, X; Adamec, J; Raskin, R E

    2015-01-01

    Lower expression of secretoglobin and transferrin has been found in the bronchoalveolar lavage fluid (BALF) of a small number of horses with experimentally induced signs of recurrent airway obstruction (RAO) compared to healthy controls. Secretoglobin and transferrin BALF expression will be similarly decreased in horses with naturally occurring clinical signs of RAO and in horses with experimentally induced clinical signs of RAO as compared to healthy controls and intermediate in horses with inflammatory airway disease (IAD). Recurrent airway obstruction-affected and control horses were subjected to an experimental hay exposure trial to induce signs of RAO. Client-owned horses with a presumptive diagnosis of RAO and controls from the same stable environments were recruited. Pulmonary function and BALF were evaluated from control and RAO-affected research horses during an experimental hay exposure trial (n = 5 in each group) and from client-owned horses (RAO-affected horses, n = 17; IAD-affected horses, n = 19; healthy controls, n = 5). The concentrations of secretoglobin and transferrin in BALF were assessed using Western blots. Naturally occurring and experimentally induced RAO horses had similar decreases in BALF transferrin expression, but secretoglobin expression was most decreased in naturally occurring RAO. Secretoglobin and transferrin expression were both lower in BALF of RAO-affected horses than in IAD-affected and control horses. Secretoglobin and transferrin expression is decreased in BALF of RAO-affected horses after both experimental and natural exposure. Secretoglobin and transferrin likely play clinically relevant roles in the pathophysiology of RAO, and may thus be used as biomarkers of the disease. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of American College of Veterinary Internal Medicine.

  20. Serum and bronchoalveolar lavage fluid endothelin-1 concentrations as diagnostic biomarkers of canine idiopathic pulmonary fibrosis.

    Science.gov (United States)

    Krafft, E; Heikkilä, H P; Jespers, P; Peeters, D; Day, M J; Rajamäki, M M; Mc Entee, K; Clercx, C

    2011-01-01

    Diagnosis of canine idiopathic pulmonary fibrosis (IPF) is challenging. Endothelin-1 (ET1) is a biomarker of IPF in humans, but whether ET1 can detect and differentiate IPF from other canine respiratory diseases is unknown. To evaluate whether measurement of the concentration of ET1 in serum and bronchoalveolar lavage fluid (BALF) can be used to distinguish canine IPF from chronic bronchitis (CB) and eosinophilic bronchopneumopathy (EBP). Twelve dogs with IPF, 10 dogs with CB, 6 dogs with EBP, 13 privately owned healthy West Highland White Terriers (WHWT), and 9 healthy Beagle dogs. Prospective, case control study. ET1 concentration was determined by ELISA in serum and in BALF. No significant difference in serum ET1 concentration was detected between healthy Beagle dogs and WHWT. Serum ET1 concentration was higher in dogs with IPF (median interquartile range; 2.32 pg/mL, 2.05-3.38) than healthy Beagle dogs (1.28, 1.07-1.53; P < .001), healthy WHWT (1.56, 1.25-1.85; P < .001), dogs with EBP (0.94 0.68-1.01; P = .001), and dogs with CB (1.54 0.74-1.82; P = .005). BALF ET1 concentration was below the detection limit in healthy WHWT and in dogs with CB, whereas it was measurable in all dogs with IPF. A cut-off serum concentration of 1.8 pg/mL had a sensitivity of 100% and a specificity of 81.2% for detection of IPF, with an area under the receiver operating characteristic curve of 0.818. Serum ET1 can differentiate dogs with IPF from dogs with EBP or CB. ET1 can be detected in BALF of dogs with IPF. Copyright © 2011 by the American College of Veterinary Internal Medicine.

  1. Intracellular detection of interleukin 17 and other cytokines in human bronchoalveolar lavage fluid: a first assessment.

    Science.gov (United States)

    De Luca, Anna; Rindi, Laura; Celi, Alessandro; Melosini, Lorenza; Paggiaro, Pierluigi; Nelli, Luca Ceccherini; Garzelli, Carlo; Freer, Giulia

    2012-01-30

    Increasing evidence links pulmonary pathology to cytokines determining an inflammatory environment in the lung. Detection of cells secreting specific cytokines in BALF could be helpful as a diagnostic tool but which cytokines to choose among their great variety may be the first question to solve. The aim of this study was to investigate the Th1, Th2 and Th17 cytokine profile in whole cells within the human bronchoalveolar lavage fluid (BALF) by flow cytometry, with a focus on interleukin (IL)-17-producing cells, in order to assess which cytokines might lend themselves as markers of disease in future studies. BALF and paired peripheral blood samples were collected from 52 patients admitted to hospital for pulmonary pathologies. Cells obtained from BALF and peripheral blood were incubated in vitro in the absence or presence of appropriate stimuli and analyzed for intracellular content of IL-4, -10, -12, -17, interferon (IFN)γ and tumor necrosis factor (TNF)α in association to expression of either HLA-DR or CD4. IL-17-secreting cells were further characterized. Production of IL-17 by unstimulated BALF cells could be detected in 2 of the 32 patients that could be examined; upon PMA/IM stimulation in vitro, IL-17 was produced by varying percentages of lymphocytes, mostly memory CD4(+) cells, in all BALF samples. IL-4 could be detected in a relatively high proportion of unstimulated HLA-DR(+/-), SSC(hi) cells, most probably granulocytes; IL-10 could be found mostly in macrophages in a number of the BALF samples analyzed. Finally, IFNγ and TNFα were only produced by lymphocytes after in vitro stimulation. This study shows that T cells producing IL-17 can be found in the lung of respiratory patients in the absence of ex vivo stimulation, making IL-17 a good candidate marker of specific pathologies of the lung. Upon stimulation, IL-17 production was accounted for by CD4(+) CD45RO(+) cells. Other cytokines are also discussed. An interesting cytokine secretion profile

  2. Evaluating the diagnostic accuracy of the Xpert®MTB/RIF assay on bronchoalveolar lavage fluid: a retrospective study.

    Science.gov (United States)

    Lu, Yanjun; Zhu, Yaowu; Shen, Na; Tian, Lei; Sun, Ziyong

    2018-02-08

    Limited data on the diagnostic accuracy of the Xpert ® MTB/RIF assay using bronchoalveolar lavage fluid in patients with suspected pulmonary tuberculosis (PTB) have been reported in China. Therefore, we designed a retrospective study to evaluate the diagnostic accuracy of this assay. Clinical, radiological, and microbiological characteristics of 238 PTB-suspected patients were retrospectively reviewed. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the diagnosis of active PTB were calculated for the Xpert ® MTB/RIF assay using TB culture or final diagnosis based on clinical and radiological evaluation as a reference standard. The sensitivity and specificity of the Xpert ® MTB/RIF assay were 84.5% and 98.9%, and those for smear microscopy (SM) were 36.2% and 100%, respectively, when compared with those of the culture method. However, compared with the sensitivity and specificity of final diagnosis based on clinical and radiological evaluation, the sensitivity and specificity of the assay were 72.9% and 98.7%, which were significantly higher than those for SM. The Xpert ® MTB/RIF assay on bronchoalveolar lavage fluid could serve as an additional rapid diagnosis tool for PTB in a high TB-burden country and improve the time to TB treatment initiation in patients with PTB. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Comparison of manual and suction pump aspiration techniques for performing bronchoalveolar lavage in 18 dogs with respiratory tract disease.

    Science.gov (United States)

    Woods, K S; Defarges, A M N; Abrams-Ogg, A C G; Viel, L; Brisson, B A; Bienzle, D

    2014-01-01

    Different aspiration techniques to retrieve bronchoalveolar lavage fluid (BALF) affect sample quality in healthy dogs. Studies evaluating these techniques in dogs with respiratory disease are lacking. To compare sample quality of BALF acquired by manual aspiration (MA) and suction pump aspiration (SPA). Eighteen client-owned dogs with respiratory disease. Randomized, blinded prospective clinical trial. Manual aspiration was performed with a 35-mL syringe attached directly to the bronchoscope biopsy channel and SPA was performed with a maximum of 50 mmHg negative pressure applied to the bronchoscope suction valve using the suction trap connection. Both aspiration techniques were performed in each dog on contralateral lung lobes, utilizing 2 mL/kg lavage volumes per site. Samples of BALF were analyzed by percentage of retrieved infusate, total nucleated cell count (TNCC), differential cell count, semiquantitative assessment of slide quality, and diagnosis score. Data were compared by paired Student's t-test, Wilcoxon signed-rank test, chi-squared test, and ANOVA. Cohen's kappa coefficient was used to assess agreement. The percentage of retrieved BALF (P = .001) was significantly higher for SPA than MA. Substantial agreement was found between cytologic classification of BALF obtained with MA and SPA (kappa = 0.615). There was no significant difference in rate of definitive diagnosis achieved with cytologic assessment between techniques (P = .78). Suction pump aspiration, compared to MA, improved BALF retrieval, but did not significantly affect the rate of diagnostic success of bronchoalveolar lavage (BAL) in dogs with pulmonary disease. Copyright © 2014 by the American College of Veterinary Internal Medicine.

  4. Comparison of induced sputum with bronchial wash, bronchoalveolar lavage and bronchial biopsies in COPD

    NARCIS (Netherlands)

    Rutgers, [No Value; Timens, W; Kaufmann, HF; van der Mark, TW; Koeter, GH; Postma, DS

    It is unclear how cellular and soluble inflammatory markers in induced sputum relate to markers in lavage fluid and biopsies in chronic obstructive pulmonary disease (COPD), This was investigated and also the possible differences between subjects with COPD and healthy controls assessed. Eighteen

  5. Bronchiolitis obliterans organising pneumonia syndrome presenting with neutrophilia in bronchoalveolar lavage fluid after breast-conserving therapy.

    Science.gov (United States)

    Chiba, Sahoko; Jinta, Torahiko; Chohnabayashi, Naohiko; Fujie, Toshihide; Sumi, Yuki; Inase, Naohiko

    2012-03-20

    A 61-year-old female presented with a dry cough and fever 4 months after tangential radiation therapy (RT) following conserving surgery for breast cancer. Chest radiography and CT demonstrated consolidation with air bronchogram outside the irradiated area. Neutrophil granulocytes were abundant in bronchoalveolar lavage fluid (BALF) (39.6% of total cells), and transbronchial lung biopsy revealed organising pneumonia (OP) histologically. Antibiotic therapy had no effect, but corticosteroid therapy brought about clinical improvement. Her condition was diagnosed as bronchiolitis obliterans OP (BOOP) syndrome. Lymphocytic BALF has been identified as a characteristic of BOOP syndrome induced after RT for breast cancer. The BALF in this case, however, was neutrophilic. In our analysis of differential cell counts in the BALF of 24 patients with BOOP syndrome, the BALF was neutrophilic (>5%) in 16 (76%) cases, and the neutrophilia was severe in some of those patients.

  6. 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 ......-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......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......%). In a logistic regression analysis, higher age, increased bronchoalveolar lavage (BAL) neutrophilia and a positive BAL cytomegalovirus CMV culture were associated with the need of MV. In multivariate analyses, only BAL neutrophilia remained independently predictive of mechanical ventilation. In conclusion, short...

  7. Positive fungal quantitative PCR and Th17 cytokine detection in bronchoalveolar lavage fluids: Complementary biomarkers of hypersensitivity pneumonitis?

    Science.gov (United States)

    Bellanger, Anne-Pauline; Gbaguidi-Haore, Houssein; Gondoin, Anne; Pallandre, Jean-Rene; Vacheyrou, Mallory; Valot, Benoit; Soumagne, Thibaud; Reboux, Gabriel; Dalphin, Jean-Charles; Millon, Laurence

    2016-07-01

    Interstitial lung disease (ILD) is a large group of diseases, including hypersensitivity pneumonitis (HP), idiopathic pulmonary fibrosis (IPF) and sarcoidosis. In this study, we aimed to identify bronchoalveolar lavage fluid (BALF) biomarkers which could be contributive for HP diagnosis. We analyzed 39 BALF samples from 12 ILD patients with sarcoidosis, 11 with IPF and 16 with HP. We determined the levels of 10 cytokines and carried out quantitative PCR for 10 microorganisms involved in farm-associated or domestic forms of HP. IL-8, IL-6, TNFα, IL-17 and IL-23 levels were significantly higher in BALF samples from HP patients (pEurotium amstelodami and Wallemia sebi were positively significantly more frequently for HP patients (p<0.05, one-way Kruskal-Wallis). The biomarkers identified here can be detected in BALF, which could be routinely obtained as complementary analysis in ILD diagnosis. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Chronic obstructive pulmonary disease: Usefulness of clinical signs, bronchoalveolar lavage, and lung biopsy as diagnostic and prognostic aids

    Science.gov (United States)

    Naylor, Jonathan M.; Clark, Edward G.; Clayton, Hilary M.

    1992-01-01

    We examined 18 horses with clinical signs of chronic obstructive pulmonary disease (COPD) using physical examination, cytological and bacteriological evaluation of bronchoalveolar fluid, and percutaneous lung biopsy. In 16 cases, histological examination of lung tissue confirmed the diagnosis of COPD. Two horses were excluded: one had uncomplicated bacterial pneumonia and in the other a satisfactory lung biopsy could not be obtained. In horses with COPD, the most common historical complaint was coughing, which was reported in 88%. The most frequently detected abnormal finding on physical examination was abnormal lung sounds; these were detected in 69% of horses at rest and in 88% of horses breathing deeply into a bag. A novel finding was that 29% of horses had lung sounds that were quieter than would be expected for the degree of respiratory effort. Horses with COPD had increased percentages of neutrophils and decreased percentages of lymphocytes and macrophages in their bronchoalveolar lavage fluid. Bronchiolar neutrophil infiltration and peribronchiolar mast cell accumulation in lung biopsy tissue had the highest correlation with clinical condition. The severity of pathological changes in biopsies of lung did not predict whether the horse would die in the two to four year follow-up period. Horses that died in the follow-up period were more severely affected clinically at initial presentation than horses that were alive at the end of the follow-up period. PMID:17424075

  9. Role of bronchoalveolar lavage for diagnosing pulmonary infection in patients with rheumatic autoimmune diseases and lung infiltrates.

    Science.gov (United States)

    Sun, Xue-Feng; Liu, Yong-Jian; Xiao, Yi; Xu, Wen-Bing

    2014-10-01

    The aims of the study were to evaluate the effectiveness of bronchoalveolar lavage (BAL) for diagnosing pulmonary infection in patients with rheumatic autoimmune diseases and lung infiltrates and to evaluate factors that affect the diagnostic yield. A retrospective study was performed in patients with rheumatic autoimmune diseases and lung infiltrates whose BALs were sent for microbial assays at Peking Union Medical College Hospital from January 2009 to June 2013. Patient characteristics, clinical symptoms, medication history, laboratory parameters, radiographic findings, lung lobe lavaged, and diagnostic yield were retrieved. Seventy BALs were performed in 69 patients. The overall diagnostic yield of BAL for pulmonary infection was 17.1% (12/70), sensitivity was 35.5%, and specificity was 97.4%. Twelve microorganisms were isolated from 12 different BALs conforming to diagnostic criteria, including 4 Aspergillus, 3 Pneumocystis jirovecii, 3 gram-negative bacilli, 1 gram-positive coccus, and 1 mycobacterium. Patients with clinical symptoms of fever, cough, or expectoration had a higher diagnostic yield than patients without either symptom (25.6% vs 3.7%, P = 0.042). Patients with ground-glass opacity, mass, or consolidation radiographically had a higher yield than did patients with reticular or nodular infiltrates (20.3% vs 0, P rheumatic autoimmune diseases and lung infiltrates, especially in cases where initial antimicrobial therapy is ineffective. Opportunistic pathogens are important in patients with rheumatic autoimmune diseases and lung infiltrates and should be considered when antibacterial treatment is ineffective.

  10. Alveolar macrophage graded hemosiderin score from bronchoalveolar lavage in horses with exercise-induced pulmonary hemorrhage and controls.

    Science.gov (United States)

    Doucet, Michèle Y; Viel, Laurent

    2002-01-01

    The objective of this study was to determine if a quantitative scoring system for evaluation of hemosiderin content of alveolar macrophages obtained by bronchoalevolar lavage provides a more sensitive test for the detection of exercise-induced pulmonary hemorrhage (EIPH) in horses than does endoscopy of the lower airways. A sample population composed of 74 Standardbred racehorses aged 2-5 years was used. Horses were grouped as either control (EIPH-negative) or EIPH-positive based on history and repeated postexertional endoscopic evaluation of the bronchial airways. Bronchoalveolar lavage was performed and cytocentrifuge slides were stained with Perl's Prussian blue. Alveolar macrophages were scored for hemosiderin content by a method described by Golde and associates to obtain the total hemosiderin score (THS). Test performance criteria were determined with a contingency table. All subjects had some degree of hemosiderin in the alveolar macrophages, regardless of group. The distribution of cells among the different grades followed a significantly different pattern for the control group versus horses with EIPH (P hemosiderin by means of the Golde scoring system shows promise as a more sensitive approach than repeated postexertional endoscopy alone to detect EIPH.

  11. INFLAMMATORY CELL NUMBER AND MEDIATORS IN BRONCHOALVEOLAR LAVAGE FLUID AND PERIPHERAL-BLOOD IN SUBJECTS WITH ASTHMA WITH INCREASED NOCTURNAL AIRWAYS NARROWING

    NARCIS (Netherlands)

    OOSTERHOFF, Y; KAUFFMAN, HF; RUTGERS, B; ZIJLSTRA, FJ; KOETER, GH; POSTMA, DS

    Background: Increased nocturnal airways narrowing (NAN) in asthma is thought to occur as the result of intensification of inflammatory processes in the airways. In this study we investigated the presence of inflammatory cells and mediators in bronchoalveolar lavage (BAL) fluid and peripheral blood

  12. Corticosteroid therapy and airflow obstruction influence the bronchial microbiome, which is distinct from that of bronchoalveolar lavage in asthmatic airways

    Energy Technology Data Exchange (ETDEWEB)

    Denner, Darcy R.; Sangwan, Naseer; Becker, Julia B.; Hogarth, D. Kyle; Oldham, Justin; Castillo, Jamee; Sperling, Anne I.; Solway, Julian; Naureckas, Edward T.; Gilbert, Jack A.; White, Steven R.

    2016-05-01

    The lung has a diverse microbiome that is modest in biomass. This microbiome differs in asthmatic patients compared with control subjects, but the effects of clinical characteristics on the microbial community composition and structure are not clear. OBJECTIVES: We examined whether the composition and structure of the lower airway microbiome correlated with clinical characteristics of chronic persistent asthma, including airflow obstruction, use of corticosteroid medications, and presence of airway eosinophilia. METHODS: DNA was extracted from endobronchial brushings and bronchoalveolar lavage fluid collected from 39 asthmatic patients and 19 control subjects, along with negative control samples. 16S rRNA V4 amplicon sequencing was used to compare the relative abundance of bacterial genera with clinical characteristics. RESULTS: Differential feature selection analysis revealed significant differences in microbial diversity between brush and lavage samples from asthmatic patients and control subjects. Lactobacillus, Pseudomonas, and Rickettsia species were significantly enriched in samples from asthmatic patients, whereas Prevotella, Streptococcus, and Veillonella species were enriched in brush samples from control subjects. Generalized linear models on brush samples demonstrated oral corticosteroid use as an important factor affecting the relative abundance of the taxa that were significantly enriched in asthmatic patients. In addition, bacterial α-diversity in brush samples from asthmatic patients was correlated with FEV1 and the proportion of lavage eosinophils. CONCLUSION: The diversity and composition of the bronchial airway microbiome of asthmatic patients is distinct from that of nonasthmatic control subjects and influenced by worsening airflow obstruction and corticosteroid use. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  13. [Current possibilities of the biometrology of dust in specimens of bronchoalveolar lavage fluid].

    Science.gov (United States)

    Sébastien, P

    1982-01-01

    This study attempts to present the current possibilities of investigation of an occupational risk, in particular that of asbestosis, by metrology of dusts in bronchoalveolar washings (BAW). This is a retrospective evaluation of metrological data obtained in a period of six years by study of almost all of the 1338 samples of BAW referred to this laboratory from various pulmonary medicine departments. With regard to the metrology of asbestos fibres in BAW samples, an explanation is given for the fact that routine analytical possibilities are limited to the numbering of asbestos bodies (AB). The specificity of the AB marker is discussed. Reference data are indicated concerning the efficacity of the collection of AB from washings, the relationship between concentrations of AB in BAW samples, parenchyma samples and sputum, and the interpretation of AB concentrations in BAW samples. Current data show that BAW samples are sensitive indications, but there is a lack of specificity. With regard to the biometrological investigation of BAW samples concerning occupational hazards other than asbestos, a large number of studies remain to be undertaken.

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

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    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.

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

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    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

  16. Identification of Oxidative Stress Related Proteins as Biomarkers for Lung Cancer and Chronic Obstructive Pulmonary Disease in Bronchoalveolar Lavage

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    Amancio Carnero

    2013-02-01

    Full Text Available Lung cancer (LC and chronic obstructive pulmonary disease (COPD commonly coexist in smokers, and the presence of COPD increases the risk of developing LC. Cigarette smoke causes oxidative stress and an inflammatory response in lung cells, which in turn may be involved in COPD and lung cancer development. The aim of this study was to identify differential proteomic profiles related to oxidative stress response that were potentially involved in these two pathological entities. Protein content was assessed in the bronchoalveolar lavage (BAL of 60 patients classified in four groups: COPD, COPD and LC, LC, and control (neither COPD nor LC. Proteins were separated into spots by two dimensional polyacrylamide gel electrophoresis (2D-PAGE and examined by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF/TOF. A total of 16 oxidative stress regulatory proteins were differentially expressed in BAL samples from LC and/or COPD patients as compared with the control group. A distinct proteomic reactive oxygen species (ROS protein signature emerged that characterized lung cancer and COPD. In conclusion, our findings highlight the role of the oxidative stress response proteins in the pathogenic pathways of both diseases, and provide new candidate biomarkers and predictive tools for LC and COPD diagnosis.

  17. Identification of oxidative stress related proteins as biomarkers for lung cancer and chronic obstructive pulmonary disease in bronchoalveolar lavage.

    Science.gov (United States)

    Pastor, Maria Dolores; Nogal, Ana; Molina-Pinelo, Sonia; Meléndez, Ricardo; Romero-Romero, Beatriz; Mediano, Maria Dolores; López-Campos, Jose L; García-Carbonero, Rocío; Sanchez-Gastaldo, Amparo; Carnero, Amancio; Paz-Ares, Luis

    2013-02-06

    Lung cancer (LC) and chronic obstructive pulmonary disease (COPD) commonly coexist in smokers, and the presence of COPD increases the risk of developing LC. Cigarette smoke causes oxidative stress and an inflammatory response in lung cells, which in turn may be involved in COPD and lung cancer development. The aim of this study was to identify differential proteomic profiles related to oxidative stress response that were potentially involved in these two pathological entities. Protein content was assessed in the bronchoalveolar lavage (BAL) of 60 patients classified in four groups: COPD, COPD and LC, LC, and control (neither COPD nor LC). Proteins were separated into spots by two dimensional polyacrylamide gel electrophoresis (2D-PAGE) and examined by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF/TOF). A total of 16 oxidative stress regulatory proteins were differentially expressed in BAL samples from LC and/or COPD patients as compared with the control group. A distinct proteomic reactive oxygen species (ROS) protein signature emerged that characterized lung cancer and COPD. In conclusion, our findings highlight the role of the oxidative stress response proteins in the pathogenic pathways of both diseases, and provide new candidate biomarkers and predictive tools for LC and COPD diagnosis.

  18. Sensitivity and specificity of oropharyngeal suction versus bronchoalveolar lavage in identifying respiratory tract pathogens in children with chronic pulmonary infection.

    Science.gov (United States)

    Avital, A; Uwyyed, K; Picard, E; Godfrey, S; Springer, C

    1995-07-01

    The purpose of this study was to compare the pathogens obtained by oropharyngeal suction (OPS) and bronchoalveolar lavage (BAL) in children with chronic pulmonary infections. Forty-four children (mean age of 6.1 years; range 4 months to 15 years) were included in the study (27 children with recurrent localized lung infection, 5 with bronchiectasis, 5 with cystic fibrosis, 2 with foreign body aspiration, 2 with bronchiolitis obliterans, and 3 with recurrent episodes of cough and shortness of breath). In 27 out of 44 BAL samples (61%) bacterial cultures were positive. The sensitivity of OPS in detecting the same BAL pathogen was 89% (24/27 samples), the specificity was 94% (16/17 samples), and the predictive value was 91% (40/44 samples). Hemophilus influenzae beta-lactamase negative was the main organism recovered from BAL in non-cystic fibrosis patients with recurrent or persistent pneumonia. We conclude that OPS is a simple and efficient noninvasive procedure which may be helpful in the diagnosis and treatment of recurrent or chronic pulmonary infection.

  19. Increased level of annexin A1 in bronchoalveolar lavage fluid as a potential diagnostic indicator for lung cancer.

    Science.gov (United States)

    Biaoxue, Rong; Xiguang, Cai; Hua, Liu; Tian, Fu; Wenlong, Gao

    2017-03-02

    Annexin A1 has been implicated in various tumor types, but few studies have investigated its involvement in lung cancer. The purpose of this investigation was to quantify the annexin A1 level in bronchoalveolar lavage fluid (BALF) and analyze its usefulness in lung cancer diagnosis. Annexin A1 expression was measured by immunohistochemistry and enzyme immunoassay. The sensitivity and specificity of annexin A1 for distinguishing lung cancer were determined by receiver operator characteristic (ROC) curves. Tumor tissues, BALF and serum of patients with lung cancer contained higher levels of annexin A1 than those of the control group of patients with benign lung diseases. Moreover, an increased level of BALF annexin A1 was closely correlated with lymphatic invasion and malignant progression of lung cancer. The sensitivity and specificity of BALF annexin A1 for distinguishing lung cancer were 94.2% and 90.2%, respectively. Increased annexin A1 in BALF was correlated with lymphatic invasion and malignant progression of lung cancer, suggesting that it could be an indicator for discerning lung cancer and predicting outcome.

  20. [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.

  1. Elevated IP-10 and IL-6 from bronchoalveolar lavage cells are biomarkers of non-cavitary tuberculosis.

    Science.gov (United States)

    Nolan, A; Condos, R; Huie, M L; Dawson, R; Dheda, K; Bateman, E; Rom, W N; Weiden, M D

    2013-07-01

    Active TB disease can destroy lung parenchyma leading to cavities. Immune responses that predispose or protect individuals from lung damage during TB are poorly defined. To sample lung immune cells and assay bronchoalveolar lavage (BAL) cell cytokine production. Enrolled subjects (n = 73) had bilateral infiltrates and underwent BAL. All had sputum culture demonstrating Mycobacterium tuberculosis and 22/73 (30%) had cavities on their chest radiograph. Those with cavities at presentation had a higher percentage of polymorphonuclear neutrophils (PMN) in BAL as well as lower inducible protein (IP) 10 (P IP-10 was negatively associated with BAL PMN. IP-10 and IL-6 expression above median reduces the odds of cavities by 79% and 78% in logistic regression models. IP-10 and IL-6 clustered with interferon-gamma and tumour necrosis factor-alpha in a principal component analysis, while IL-4 clustered with PMN. Increasing IP-10 and IL-6 production by BAL cells is associated with non-cavitary TB in patients who present with radiographically advanced TB. IP-10 and IL-6 may reflect an effective T-helper 1 immune control pathway for TB, attenuating tuberculous lung destruction.

  2. Genome-wide analysis of aberrantly expressed microRNAs in bronchoalveolar lavage fluid from patients with silicosis.

    Science.gov (United States)

    Zhang, Yang; Wang, Faxuan; Zhou, Dingzi; Ren, Xiaohui; Zhou, Dinglun; Gao, Xiaosi; Lan, Yajia; Zhang, Qin; Xie, Xiaoqi

    2016-08-05

    Background To identify differentially expressed miRNAs profiles in bronchoalveolar lavage fluid (BALF) from patients with silicosis and consider the potential contribution of miRNAs to silicosis.Methods miRNAs expression profiling were performed in the cell fraction of BALF samples obtained from 9 subjects (3 silicosis observation subjects, 3 stage I and stage II silicosis patients, respectively). The differential expression of two selected miRNAs hsa-miR-181c-5p and hsa-miR-29a-3p were confirmed by RT-qPCR. Furthermore, miRNAs Gene Ontology Enrichment categories and target mRNAs were determined based on miRWalk.Results We found 110 dysregulated miRNAs in silicosis samples, most of which showed a down-regulation trend. Microarray results were confirmed by RT-qPCR. With the observation group samples set as standards, stage I samples showed 123 differentially expressed miRNAs, and stage II 46. 23 miRNAs were dysregulated in both stages. Finally, functional enrichment analysis indicated that these miRNAs played an important role in various biological processes, including ECM-receptor interaction and endocytosis.Conclusions This is the first time to acquire the BALF-derived microRNAs expression profiling targeting to human silicosis. These results contribute to unravelling miRNAs involved in the pathogenesis of silicosis, and provide new tools of potential use of as biomarkers for diagnosis and/or therapeutic purposes.

  3. 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 (PPCR/ESI-MS was evaluated in comparison with conventional culture-based or molecular methods. The agreement between positive findings was overall good. Most Staphylococcus aureus-positive PCR/ESI-MS results were confirmed by culture or species-specific PCR (27/33, 82%). The identity of Streptococcus pneumoniae could however be confirmed for only 6/17 (35%) PCR/ESI-MS-positive samples. Non-cultivable and fastidious pathogens, which were not covered by standard culture procedures were readily detected by PCR/ESI-MS, including Legionella 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

  4. Neutrophil and macrophage apoptosis in bronchoalveolar lavage fluid from healthy horses and horses with recurrent airway obstruction (RAO)

    Science.gov (United States)

    2014-01-01

    Background Dysregulation of apoptosis has been implicated in a range of diseases including tumors, neurodegenerative and autoimmine diseases, as well as allergic asthma and chronic obstructive pulmonary disease (COPD) in humans. Although it has a different pathophysiology, delayed apoptosis of various inflammatory cells may play a pivotal role in the development of recurrent airway obstruction (RAO) in horses. Reduction of inflammatory cell apoptosis or a dysregulation of this process could lead to chronic inflammation and tissue injury. Therefore, the aim of this study was to investigate the rate of apoptosis and necrosis of neutrophils and macrophages in bronchoalveolar lavage fluid obtained from seven horses suffering from RAO (study group) and seven control horses. Results We demonstrated that neutrophil/macrophage apoptosis is altered in RAO-affected horses compared with the control group in the BAL fluid. We found a significant difference between the median percentage of early and late apoptosis of neutrophils between the study and control group of horses. Moreover, we found a positive correlation between the rate of apoptosis and the median percentage of macrophages in RAO-affected horses. Conclusion The findings suggest that apoptosis dysregulation may play a significant role in the pathogenesis of RAO. However, further studies are needed to clarify the role of altered apoptosis in the course of equine recurrent airway obstruction. PMID:24460911

  5. Activity testing of alveolar macrophages and changes in surfactant phospholipids after irradiation in bronchoalveolar lavage: Experimental and clinical data

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    Steinberg, F.; Rehn, B.; Kraus, R.; Quabeck, K.; Bruch, J.; Beelen, D.W.; Schaefer, U.W.; Streffer, C. (Univ. Clinics, Essen (Germany))

    1992-07-01

    This study presents results of bronchoalveolar lavage (BAL) after irradiation to the lungs in mice as well as clinical data. The number of BAL cells, mainly macrophages, lymphocytes, and granulocytes, changed in a time-dependent manner. The phagocytic activity of the macrophages measured as the phagocytosis of microbeads and measured as the esterase activity also showed a strong time-dependent increase during the acute phase up to 21 days after irradiation. The contents of surfactant phospholipids (SF) and sphingomyelin (SPH; as a parameter for cell death) were quantified by HPLC. Both were significantly changed between day 2 and 21 after irradiation. Three BALs of a patient with idiopathic interstitial pneumonitis, who had received an allogenic bone marrow graft after total body irradiation with 10 Gy, showed similar effects in the cellular and surfactant parameters. These data indicate that there are positive interactions between the number of different BAL cells, macrophage activity, and SF and SPH content in the preclinical model of the mouse as well as in the clinical situation after lung irradiation. 30 refs., 7 figs., 3 tabs.

  6. 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

    2017-03-12

    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 (CD56 bright 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.

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

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    Paulo Souza-Fonseca-Guimaraes

    2017-03-01

    Full Text Available 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.

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

    Directory of Open Access Journals (Sweden)

    Måns Ullberg

    Full Text Available 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 (P<0.01. Detection of potentially pathogenic microorganisms by PCR/ESI-MS was evaluated in comparison with conventional culture-based or molecular methods. The agreement between positive findings was overall good. Most Staphylococcus aureus-positive PCR/ESI-MS results were confirmed by culture or species-specific PCR (27/33, 82%. The identity of Streptococcus pneumoniae could however be confirmed for only 6/17 (35% PCR/ESI-MS-positive samples. Non-cultivable and fastidious pathogens, which were not covered by standard culture procedures were readily detected by PCR/ESI-MS, including Legionella 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.

  9. Usefulness of bronchoalveolar lavage for diagnosis of acute and persistent respiratory syncytial virus lung infections in guinea pigs.

    Science.gov (United States)

    Dakhama, A; Chan, N G; Ahmad, H Y; Bramley, A M; Vitalis, T Z; Hegele, R G

    1998-12-01

    To investigate whether bronchoalveolar lavage (BAL) fluid specimens can be used to diagnose acute and persistent respiratory syncytial virus (RSV) lung infections in guinea pigs, we tested BAL fluid and lung tissue specimens for evidence of viral infection, and compared BAL cytology between infected and uninfected animals. RSV-inoculated guinea pigs were studied during acute bronchiolitis (days 3 and 7 postinoculation), convalescence (Day 14 postinoculation), and persistent infection (Days 28 and 60 postinoculation), and were compared to the sham-infected control animals. BAL and lung tissue specimens were cultured for virus and tested by immunocytochemistry for viral protein. A reverse transcription-polymerase chain reaction (RT-PCR) method was used to test for viral nucleic acid. Total and differential BAL cell counts were compared between RSV-inoculated and control animals on each study day. In BAL specimens, replicating RSV was isolated by culture in one out of four of the animals on Day 3 postinoculation; immunocytochemistry for RSV antigens was positive in all virus-exposed animals from Days 3-14 postinoculation, and viral nucleic acid was detected by RT-PCR in one-fourth of the animals on Day 3 postinoculation. In contrast, replicating virus, viral antigens, and viral nucleic acid were documented in lung tissues obtained from the same RSV-infected animals on all study days. BAL specimens of RSV-inoculated animals contained more eosinophils on all study days (two-tailed P value helpful for the documentation of acute RSV lung infection when immunocytochemistry may provide a more accurate test for virus detection than RT-PCR or viral culture.

  10. 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.

  11. Usefulness of cellular analysis of bronchoalveolar lavage fluid for predicting the etiology of pneumonia in critically ill patients.

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    Sang-Ho Choi

    Full Text Available The usefulness of bronchoalveolar lavage (BAL fluid cellular analysis in pneumonia has not been adequately evaluated. This study investigated the ability of cellular analysis of BAL fluid to differentially diagnose bacterial pneumonia from viral pneumonia in adult patients who are admitted to intensive care unit.BAL fluid cellular analysis was evaluated in 47 adult patients who underwent bronchoscopic BAL following less than 24 hours of antimicrobial agent exposure. The abilities of BAL fluid total white blood cell (WBC counts and differential cell counts to differentiate between bacterial and viral pneumonia were evaluated using receiver operating characteristic (ROC curve analysis.Bacterial pneumonia (n=24 and viral pneumonia (n=23 were frequently associated with neutrophilic pleocytosis in BAL fluid. BAL fluid median total WBC count (2,815/µL vs. 300/µL, P<0.001 and percentage of neutrophils (80.5% vs. 54.0%, P=0.02 were significantly higher in the bacterial pneumonia group than in the viral pneumonia group. In ROC curve analysis, BAL fluid total WBC count showed the best discrimination, with an area under the curve of 0.855 (95% CI, 0.750-0.960. BAL fluid total WBC count ≥ 510/µL had a sensitivity of 83.3%, specificity of 78.3%, positive likelihood ratio (PLR of 3.83, and negative likelihood ratio (NLR of 0.21. When analyzed in combination with serum procalcitonin or C-reactive protein, sensitivity was 95.8%, specificity was 95.7%, PLR was 8.63, and NLR was 0.07. BAL fluid total WBC count ≥ 510/µL was an independent predictor of bacterial pneumonia with an adjusted odds ratio of 13.5 in multiple logistic regression analysis.Cellular analysis of BAL fluid can aid early differential diagnosis of bacterial pneumonia from viral pneumonia in critically ill patients.

  12. Increased claudin-3, -4 and -18 levels in bronchoalveolar lavage fluid reflect severity of acute lung injury.

    Science.gov (United States)

    Jin, Wenting; Rong, Linyi; Liu, Yinkun; Song, Yuanlin; Li, Yan; Pan, Jue

    2013-05-01

    Acute lung injury (ALI) is characterized by disruption of lung epithelial and endothelial cells, leading to increased membrane permeability and loss of barrier function. Claudins are key components of tight junctions (TJ) that regulate paracellular permeability, and play an important role in alveolar epithelial barrier function and fluid clearance. However, whether claudin-3, -4, -18 or -5 expression changes in Pseudomonas aeruginosa (PA)-induced ALI and the clinical significance of such change is unknown. Rats underwent intratracheal instillation of PA, and samples were collected prior to and 3, 9 and 24 h after instillation. Lung injury was evaluated by bronchoalveolar lavage fluid (BALF) total protein, arterial blood gas analysis, lung injury score, and expression of surfactant protein and von Willebrand factor. Claudin expression in lung was measured with quantitative real-time polymerase chain reaction and western blotting, and in BALF by enzyme-linked immunosorbent assay. The relationship between claudins in BALF and lung injury grade were analysed with Spearman's rank correlation. Alveolar epithelium, endothelium and TJ ultrastructure were observed with electron microscopy. Claudin-4, -18 and -5 mRNA levels increased significantly 24 h after PA instillation in the most severe lung injury cases, whereas there was no significant change in protein levels. Claudin-3, -4 and -18 levels in BALF increased most 24 h after PA instillation; this paralleled alveolar epithelial disruption and lung injury severity. Claudin-3, -4 and -18 released into the alveolar compartment is highly associated with barrier function loss caused by alveolar epithelial injury. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

  13. 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.

  14. Mycoplasma detection by triplex real-time PCR in bronchoalveolar lavage fluid from bovine respiratory disease complex cases.

    Science.gov (United States)

    Cornelissen, Jan B W J; de Bree, Freddy M; van der Wal, Fimme J; Kooi, Engbert A; Koene, Miriam G J; Bossers, Alex; Smid, Bregtje; Antonis, Adriaan F; Wisselink, Henk J

    2017-04-08

    In this study we evaluated the RespoCheck Mycoplasma triplex real-time PCR for the detection in bronchoalveolar lavage fluid (BALF) of Mycoplasma (M.) dispar, M. bovis and M. bovirhinis, all three associated with bovine respiratory disease (BRD). Primers and probes of the RespoCheck Mycoplasma triplex real-time PCR are based on the V3/V4 region of the 16S rRNA gene of the three Mycoplasma species. The analytical sensitivity of the RespoCheck triplex real-time PCR was, as determined by spiking experiments of the Mycoplasma strains in Phosphate Buffered Saline, 300 colony forming units (cfu)/mL for M. dispar, and 30 cfu/mL for M. bovis or M. bovirhinis. The analytical sensitivity of the RespoCheck Mycoplasma triplex real-time PCRwas, as determined on purified DNA, 10 fg DNA per assay for M. dispar and 100 fg fo rM. bovis and M. bovirhinis. The analytical specificity of the RespoCheck Mycoplasma triplex real-time PCR was, as determined by testing Mycoplasmas strains (n = 17) and other bacterial strains (n = 107), 100, 98.2 and 99.1% for M. bovis, M. dispar and M. bovirhinis respectively. The RespoCheck Mycoplasma triplex real-time PCR was compared with the PCR/DGGE analysis for M. bovis, M. dispar and M. bovirhinis respectively by testing 44 BALF samples from calves. In conclusion, the RespoCheck PCR assay can be a valuable tool for timely and accurate detection of three Mycoplasma species associated with in bovine respiratory disease.

  15. Liquid-based and conventional cytology for bronchial washings/bronchoalveolar lavages in the diagnosis of malignancy - An institutional experience

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    Abha Thakur

    2017-01-01

    Full Text Available Background: Liquid-based cytology (LBC has been developed as an alternative for conventional cytology (CC in cervical smears. It is now increasingly being used all over the world for cervical cancer screening. However, its role and diagnostic accuracy in bronchial wash (BW/bronchoalveolar lavage (BAL specimens remains undetermined. Aims: To assess and compare the diagnostic performance and accuracy of LBC with CC for detecting malignancy in bronchial specimens. Settings and Design: This was a retrospective analytical hospital-based study. Materials and Methods: Bronchial specimens (BW/BAL received over a period of 4.5 years were reviewed. The samples were processed by CC from June 2010 to September 2012 (2.25 years and by LBC from October 2012 to December 2014 (2.25 years. Data were retrieved from the records of cytology laboratory and compared among both the groups. Detection rate for histologically or cytologically verified samples was calculated. Results: A total of 559 cases verified by histological and cytological follow-up were evaluated. These included 247 CC cases and 312 LBC cases. The positive diagnostic rate for malignancy in CC was 28.6% whereas that for LBC was 32.9%. The negative diagnostic rates were 66.5% and 66.3% for CC and LBC, respectively. However, unsatisfactory rates had shown a good reduction from 4.4% in CC to 0.6% after LBC introduction. The smears showed more homogeneous distribution of cells with elimination of obscuring factors such as blood, inflammation, and mucus. Conclusions: The diagnostic accuracy of LBC was slightly better than CC. The unsatisfactory rates showed reduction in LBC preparation. Thus, LBC is a viable alternative to CC and has the advantages of standardization of preparation with decrease in unsatisfactory rates.

  16. 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.

  17. Comparison of DNA extraction methods for microbial community profiling with an application to pediatric bronchoalveolar lavage samples.

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    Dana Willner

    Full Text Available Barcoded amplicon sequencing is rapidly becoming a standard method for profiling microbial communities, including the human respiratory microbiome. While this approach has less bias than standard cultivation, several steps can introduce variation including the type of DNA extraction method used. Here we assessed five different extraction methods on pediatric bronchoalveolar lavage (BAL samples and a mock community comprised of nine bacterial genera to determine method reproducibility and detection limits for these typically low complexity communities. Additionally, using the mock community, we were able to evaluate contamination and select a relative abundance cut-off threshold based on the geometric distribution that optimizes the trade off between detecting bona fide operational taxonomic units and filtering out spurious ones. Using this threshold, the majority of genera in the mock community were predictably detected by all extraction methods including the hard-to-lyse Gram-positive genus Staphylococcus. Differences between extraction methods were significantly greater than between technical replicates for both the mock community and BAL samples emphasizing the importance of using a standardized methodology for microbiome studies. However, regardless of method used, individual patients retained unique diagnostic profiles. Furthermore, despite being stored as raw frozen samples for over five years, community profiles from BAL samples were consistent with historical culturing results. The culture-independent profiling of these samples also identified a number of anaerobic genera that are gaining acceptance as being part of the respiratory microbiome. This study should help guide researchers to formulate sampling, extraction and analysis strategies for respiratory and other human microbiome samples.

  18. [Positive bronchoalveolar lavage and quantitative cultures results in suspected late-onset ventilator associated penumonia evaluation--retrospective study].

    Science.gov (United States)

    Vaz, A P; Amorim, A; Espinar, M J; Oliveira, T; Pereira, J M; Paiva, J A

    2011-01-01

    Bronchoalveolar lavage (BAL) with quantitative cultures has been used in order to increase ventilator associated pneumonia (VAP) diagnosis specificity, although the accurate technique for this entity diagnosis remains controversial. To evaluate the influence of using positive BAL and quantitative cultures results in microbiologic diagnosis and treatment of patients with suspected late VAP and prior antibiotherapy. Retrospective analysis of intensive care unit (UCI) patients, during a one year period, with clinical suspicion of late VAP and prior use of antibiotics that presented a growth in BAL cultures. Of 243 BAL performed, there were 71 (29.2%) positive cultures (60 patients, 76.7% male, 54 ± 19 years). BAL was done after 13 days (median) of invasive mechanical ventilation, 11 days of ICU antibiotherapy and in the day in which a new antibiotic for VAP suspicion was started. Colony forming units (CFU)/ml count was performed in 71.8% and endotracheal aspirate (ETA) simultaneously collected for qualitative analysis in 85.9%. Therapeutic approach was changed in 38.0%: correction (16.9%), de-escalation (12.7%) and directed antibiotherapy start (8.4%). Therapeutic changes were made in the presence of CFU > 10(4) in 84.2% and in agreement with ETA in 70.8%. In cases in which antibiotherapy was maintained (62.0%), quantitative cultures would have allowed de-escalation in 9.1%. Changes in prescription were more frequent when CFU was > 10(4) (48.5%), comparing with situations in which counts were lower and BAL analysis was qualitative (28.9%), p = 0.091. There were no significant differences between patients submitted to different therapeutic approaches concerning to ICU mortality or length of stay. In late onset VAP, positive BAL and quantitative cultures allowed therapeutic changes, leading to antibiotic adequacy and consumption reduction, which can however be maximised. Copyright © 2011. Published by Elsevier España.

  19. Effectiveness of the BDProbeTec ET system for detection of Mycobacterium tuberculosis complex in sputum and bronchoalveolar lavage specimens

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    Hung-Chang Hung

    Full Text Available OBJECTIVE: The diagnostic efficacy of the BDProbeTEC ET Mycobacterium tuberculosis (MTB complex direct detection assay (DTB performed on bronchoalveolar lavage (BAL specimens and sputum smears was compared with acid-fast bacilli (AFB smear microscopy. METHOD: AFB smear microscopy, DTB and culture results of 286 patients with pulmonary tuberculosis were retrospectively reviewed. A total of 120 patients provided expectorated sputum samples, and 166 patients provided BAL specimens. Culture results and clinical diagnosis were used as gold standards. RESULTS: The sensitivity and specificity of the DTB assay in detecting MTB in sputum specimens was significantly higher compared to AFB smear microscopy (83.7% and 82.4%, vs. 75.6%, and 41.2%, respectively. The sensitivity and specificity of the DTB assay in detecting MTB in sputum samples was 77.2% and 100% compared to clinical diagnosis, while AFB smear had a sensitivity and specificity of 70.3% and 26.3%, respectively. Compared to culture, DTB had a sensitivity and specificity of 82.8% and 93.2%, respectively, in detecting MTB from BAL specimens; AFB smear had a sensitivity and specificity of 41.9% and 87.7%, respectively. Compared to clinical diagnosis, DTB had a sensitivity and specificity of 67.2% and 100%, respectively, in detecting MTB from BAL specimens; AFB smear had a sensitivity and specificity of 34.8% and 79.5%, respectively. CONCLUSIONS: The superior performance of the DTB assay relative to AFB smear microscopy makes it a valuable tool to enable early diagnosis of MTB, thereby improving patient care and reducing transmission.

  20. 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.

  1. Coinfection and Mortality in Pneumonia-Related Acute Respiratory Distress Syndrome Patients with Bronchoalveolar Lavage: A Prospective Observational Study.

    Science.gov (United States)

    Kao, Kuo-Chin; Chiu, Li-Chung; Hung, Chen-Yiu; Chang, Chih-Hao; Yang, Cheng-Ta; Huang, Chung-Chi; Hu, Han-Chung

    2017-05-01

    Pneumonia is the leading risk factor of acute respiratory distress syndrome (ARDS). It is increasing studies in patients with pneumonia to reveal that coinfection with viral and bacterial infection can lead to poorer outcomes than no coinfection. This study evaluated the role of coinfection identified through bronchoalveolar lavage (BAL) examination on the outcomes of pneumonia-related ARDS. We performed a prospective observational study at Chang Gung Memorial Hospital from October 2012 to May 2015. Adult patients were included if they met the Berlin definition of ARDS. The indications for BAL were clinically suspected pneumonia-related ARDS and no definite microbial sample identified from tracheal aspirate or sputum. The presence of microbial pathogens and clinical outcomes were analyzed. Of the 19,936 patients screened, 902 (4.5%) fulfilled the Berlin definition of ARDS. Of these patients, 255 (22.7%) had pneumonia-related ARDS and were included for analysis. A total of 142 (55.7%) patients were identified to have a microbial pathogen through BAL and were classified into three groups: a virus-only group (n = 41 [28.9%]), no virus group (n = 60 [42.2%]), and coinfection group (n = 41 [28.9%]). ARDS severity did not differ significantly between the groups (P = 0.43). The hospital mortality rates were 53.7% in virus-only identified group, 63.3% in no virus identified group, and 80.5% in coinfection identified group. The coinfection group had significantly higher mortality than virus-only group (80.5% vs. 53.7%; P = 0.01). In patients with pneumonia-related ARDS, the BAL pathogen-positive patients had a trend of higher mortality rate than pathogen-negative patients. Coinfection with a virus and another pathogen was associated with increased hospital mortality in pneumonia-related ARDS patients.

  2. Detection of Mycoplasma fermentans in broncho-alveolar lavage fluid specimens from AIDS patients with lower respiratory tract infection.

    Science.gov (United States)

    Ainsworth, J G; Clarke, J; Lipman, M; Mitchell, D; Taylor-Robinson, D

    2000-10-01

    To investigate the role of Mycoplasma fermentans in lower respiratory tract disease of HIV-positive patients. A polymerase chain reaction (PCR) assay was used to detect M. fermentans in broncho-alveolar lavage (BAL) fluid and peripheral blood mononuclear cells (PBMCs) collected from 78 hospitalized HIV-positive patients with lower respiratory tract disease (the index group). BAL specimens were also assessed from two control groups; 25 HIV-positive patients without respiratory symptoms and 46 patients with a respiratory illness who did not have risk factors for HIV. Seventy-one (91%) of the 78 patients who comprised the index group had AIDS. Sixty-one patients provided BAL and PBMC specimens; 16 provided a BAL specimen and one only a PBMC specimen; 15 (25%) of the 61 patients had M. fermentans positive BAL fluid, of whom 10 (67%) also had a positive PBMC specimen. In contrast, of the 46 patients who had a negative BAL fluid, only three (6.4%) had a positive PBMC sample (P fermentans positive BAL fluid. Of these positive patients, 16 also had another microorganism in the BAL fluid and for five patients M. fermentans was detected alone. Compared with patients in the index group, none of the 46 BAL fluid specimens from patients at low risk of HIV infection was M. fermentans positive (P fermentans positive BAL fluid, positivity that was also statistically different from the index group (P = 0.045, chi2 4.01). M. fermentans frequently invades the lower respiratory tract of AIDS patients as an opportunist and may cause disease in some.

  3. Analysis of culture-dependent versus culture-independent techniques for identification of bacteria in clinically obtained bronchoalveolar lavage fluid.

    Science.gov (United States)

    Dickson, Robert P; Erb-Downward, John R; Prescott, Hallie C; Martinez, Fernando J; Curtis, Jeffrey L; Lama, Vibha N; Huffnagle, Gary B

    2014-10-01

    The diagnosis and management of pneumonia are limited by the use of culture-based techniques of microbial identification, which may fail to identify unculturable, fastidious, and metabolically active viable but unculturable bacteria. Novel high-throughput culture-independent techniques hold promise but have not been systematically compared to conventional culture. We analyzed 46 clinically obtained bronchoalveolar lavage (BAL) fluid specimens from symptomatic and asymptomatic lung transplant recipients both by culture (using a clinical microbiology laboratory protocol) and by bacterial 16S rRNA gene pyrosequencing. Bacteria were identified in 44 of 46 (95.7%) BAL fluid specimens by culture-independent sequencing, significantly more than the number of specimens in which bacteria were detected (37 of 46, 80.4%, P ≤ 0.05) or "pathogen" species reported (18 of 46, 39.1%, P ≤ 0.0001) via culture. Identification of bacteria by culture was positively associated with culture-independent indices of infection (total bacterial DNA burden and low bacterial community diversity) (P ≤ 0.01). In BAL fluid specimens with no culture growth, the amount of bacterial DNA was greater than that in reagent and rinse controls, and communities were markedly dominated by select Gammaproteobacteria, notably Escherichia species and Pseudomonas fluorescens. Culture growth above the threshold of 10(4) CFU/ml was correlated with increased bacterial DNA burden (P culture-independent techniques identified a respiratory pathogen missed by culture and clarified whether a cultured "oral flora" species represented a state of acute infection. In summary, we found that bacterial culture of BAL fluid is largely effective in discriminating acute infection from its absence and identified some specific limitations of BAL fluid culture in the diagnosis of pneumonia. We report the first correlation of quantitative BAL fluid culture results with culture-independent evidence of infection. Copyright © 2014

  4. Bacterial isolates from the bronchoalveolar lavage fluid of patients with pneumonia not responding to initial antimicrobial therapy

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    Rahul Magazine

    2013-01-01

    Full Text Available Background: Patients with community-acquired pneumonia (CAP who are admitted in a hospital but do not respond to initial antimicrobial therapy pose a challenge to the attending physician. The knowledge of the likely pathogens and their sensitivity pattern can help the clinicians to better manage such cases. Aims and Objectives: To study the spectrum of the bacterial isolates and to determine the antimicrobial sensitivity pattern obtained from the bronchoalveolar lavage (BAL fluid of CAP patients who did not respond to initial antimicrobial therapy. Setting and Design: A retrospective study of 87 patients who were admitted in the medical wards of a tertiary care teaching hospital in South India with the diagnosis of CAP and were not responding to initial antimicrobial therapy. Materials and Methods: The patient-related data were obtained from the case records and entered on a pre-designed proforma. This included demographic characteristics and reports of relevant clinical tests. The BAL culture and sensitivity results were also noted on the proforma. Results: The mean age of the patients was 49.28 ± 16.61 years (mean ± SD, range 17-80 years. Fifty-seven patients (65.5% of were male. Also, 98 bacterial isolates were obtained from the BAL fluid of 87 patients. The most prevalent bacterial isolates included Pseudomonas aeruginosa (n = 35, 35.7%, Klebsiella pneumoniae (n = 19, 19.4%, Staphylococcus aureus (n = 15, 15.3% and Acinetobacter species (n = 11, 11.2%. Most bacterial isolates tested showed 100% sensitivity to meropenem except Acinetobacter species (25%. Conclusion: P. aeruginosa and K. pneumoniae were the most common bacterial pathogens isolated from the BAL fluid. The isolates tested showed 100% sensitivity to meropenem except Acinetobacter species. All the methicillin-resistant S. aureus isolates displayed sensitivity to vancomycin, linezolid and teicoplanin.

  5. 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.

  6. 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.

  7. Amniotic Fluid Stem Cells Inhibit the Progression of Bleomycin-Induced Pulmonary Fibrosis via CCL2 Modulation in Bronchoalveolar Lavage

    Science.gov (United States)

    Garcia, Orquidea; Carraro, Gianni; Turcatel, Gianluca; Hall, Marisa; Sedrakyan, Sargis; Roche, Tyler; Buckley, Sue; Driscoll, Barbara; Perin, Laura; Warburton, David

    2013-01-01

    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. PMID:23967234

  8. Cytokine profile of bronchoalveolar lavage fluid from a mouse model of bronchial asthma during seasonal H1N1 infection.

    Science.gov (United States)

    Hasegawa, Shunji; Wakiguchi, Hiroyuki; Okada, Seigo; Gui Kang, Yu; Fujii, Nao; Hasegawa, Masanari; Hasegawa, Hideki; Ainai, Akira; Atsuta, Ryo; Shirabe, Komei; Toda, Shoichi; Wakabayashi-Takahara, Midori; Morishima, Tsuneo; Ichiyama, Takashi

    2014-10-01

    Several studies support the role of viral infections in the pathogenesis of asthma exacerbation. However, several pediatricians believe that influenza virus infection does not exacerbate bronchial asthma, except for influenza A H1N1 2009 pandemic [A(H1N1)pdm09] virus infection. We previously reported that A(H1N1)pdm09 infection possibly induces severe pulmonary inflammation or severe asthmatic attack in a mouse model of bronchial asthma and in asthmatic children. However, the ability of seasonal H1N1 influenza (H1N1) infection to exacerbate asthmatic attacks in bronchial asthma patients has not been previously reported, and the differences in the pathogenicity profiles, such as cytokine profiles, remains unclear in bronchial asthma patients after A(H1N1)pdm09 and H1N1 infections. The cytokine levels and viral titers in the bronchoalveolar lavage (BAL) fluid from mice with and without asthma after H1N1 infection (A/Yamagata and A/Puerto Rico strains) were compared. The interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-α, IL-5, interferon (IFN)-α, IFN-β, and IFN-γ levels were significantly higher in the BAL fluids from the control/H1N1 mice than from the asthmatic/H1N1 mice. The viral titers in the BAL fluid were also significantly higher in the control/H1N1mice than in the asthmatic/H1N1 mice infected with either A/Yamagata or A/Puerto Rico. A(H1N1)pdm09 infection, but not H1N1 infection, can induce severe pulmonary inflammation through elevated cytokine levels in a mouse model of asthma. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. 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.

  10. Soluble thrombomodulin in bronchoalveolar lavage fluid is an independent predictor of severe drug-induced lung injury.

    Science.gov (United States)

    Suzuki, Atsushi; Taniguchi, Hiroyuki; Kondoh, Yasuhiro; Ando, Masahiko; Watanabe, Naohiro; Kimura, Tomoki; Kataoka, Kensuke; Yokoyama, Toshiki; Sakamoto, Koji; Hasegawa, Yoshinori

    2017-05-01

    Drug-induced lung injury (DLI) can result from a vast number of agents, and sometimes presents findings similar to those of acute respiratory distress syndrome (ARDS). Previous studies have reported that circulating levels of soluble thrombomodulin (TM) reflect endothelial injuries, which play key roles in the development of ARDS. We hypothesized that endothelial injuries are an important aspect of pathogenesis in severe DLI. The primary aim of this study was to examine the associations between soluble TM and disease severity in DLI patients. Of the 2580 patients who underwent a bronchoalveolar lavage (BAL) procedure at Tosei General Hospital between May 2007 and February 2015, we retrospectively analysed the data of 68 DLI patients. Soluble TM in plasma and BAL fluid (BALF), and other biomarkers were included in our analysis. At the time of diagnosis, 39 patients (57%) had respiratory failure (partial pressure of oxygen/inspiratory oxygen fraction ratio, PaO2 /FiO2 ratio soluble TM in BALF (r = -0.448, P soluble TM in BALF and surfactant protein D (SP-D) were the only independent determinants of the PaO2 /FiO2 ratio. Additionally, in a multivariate logistic regression model, soluble TM in BALF (adjusted OR (aOR): 7.48, 95% CI: 1.60-34.98) and SP-D (aOR: 5.31, 95% CI: 1.40-20.15) was an independent predictor of respiratory failure (PaO2 /FiO2 ratio Soluble TM in BALF is an independent predictor of severe DLI. These findings underscore the importance of pulmonary endothelial injuries in the pathogenesis of severe DLI. © 2016 Asian Pacific Society of Respirology.

  11. Analysis of Culture-Dependent versus Culture-Independent Techniques for Identification of Bacteria in Clinically Obtained Bronchoalveolar Lavage Fluid

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    Dickson, Robert P.; Erb-Downward, John R.; Prescott, Hallie C.; Martinez, Fernando J.; Curtis, Jeffrey L.; Lama, Vibha N.

    2014-01-01

    The diagnosis and management of pneumonia are limited by the use of culture-based techniques of microbial identification, which may fail to identify unculturable, fastidious, and metabolically active viable but unculturable bacteria. Novel high-throughput culture-independent techniques hold promise but have not been systematically compared to conventional culture. We analyzed 46 clinically obtained bronchoalveolar lavage (BAL) fluid specimens from symptomatic and asymptomatic lung transplant recipients both by culture (using a clinical microbiology laboratory protocol) and by bacterial 16S rRNA gene pyrosequencing. Bacteria were identified in 44 of 46 (95.7%) BAL fluid specimens by culture-independent sequencing, significantly more than the number of specimens in which bacteria were detected (37 of 46, 80.4%, P ≤ 0.05) or “pathogen” species reported (18 of 46, 39.1%, P ≤ 0.0001) via culture. Identification of bacteria by culture was positively associated with culture-independent indices of infection (total bacterial DNA burden and low bacterial community diversity) (P ≤ 0.01). In BAL fluid specimens with no culture growth, the amount of bacterial DNA was greater than that in reagent and rinse controls, and communities were markedly dominated by select Gammaproteobacteria, notably Escherichia species and Pseudomonas fluorescens. Culture growth above the threshold of 104 CFU/ml was correlated with increased bacterial DNA burden (P < 0.01), decreased community diversity (P < 0.05), and increased relative abundance of Pseudomonas aeruginosa (P < 0.001). We present two case studies in which culture-independent techniques identified a respiratory pathogen missed by culture and clarified whether a cultured “oral flora” species represented a state of acute infection. In summary, we found that bacterial culture of BAL fluid is largely effective in discriminating acute infection from its absence and identified some specific limitations of BAL fluid culture in

  12. 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

  13. 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.

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

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    Zhen-Chun Shi

    2016-09-01

    Full Text Available 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-毩, 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-毩 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-毩, IL-4, IL-10, and IFN-γ in BALF in patients with IPF, and

  15. Detection of galactomannan in bronchoalveolar lavage of the intensive care unit patients at risk for invasive aspergillosis

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    Sadegh Khodavaysi

    2015-01-01

    Full Text Available Background and Purpose: Invasive aspergillosis (IA is one of the most common life-threatening fungal infections among the critically ill patients including intensive care unit (ICU patients. Delayed diagnosis and therapy may lead to poor outcomes. Diagnosis may be facilitated by a test for molecular biomarkers, i.e. detection of galactomannan (GM antigen based on enzyme immunoassay, which is of increasing interest in the clinical settings for the diagnosis of IA. In the present study, we assessed GM testing of bronchoalveolar lavage (BAL fluid as a tool for early diagnosis of IA among ICU patients who were at risk for developing IA. Material and Methods: A prospective study was performed in ICU patients with underlying predisposing conditions for IA between August 2010 and September 2011. BAL samples for direct microscopic examination, culture, and GM detection were obtained once or twice weekly. GM in BAL levels was measured using the Platellia Aspergillus EIA test kit. According to modified European Organization for the Research and Treatment of Cancer/ Mycoses Study Group (EORTC/MSG criteria, patients were classified as having probable or possible IA. Results: Out of 43 suspected patients to IA, 13 (30.2% cases showed IA. According to the criteria presented by EORTC/MSG, they were categorized as: 4 cases (30.8% of possible IA and 9 (69.2% of probable IA. Out of 21 BAL samples from patients with IA, 11 (52.4% had at least one positive BAL GM index. Using a cutoff index of 0.5, the sensitivity and specificity, positive and negative predictive values of GM detection in BAL fluid were 100%, 85.7%, 65.7% and 96%, respectively. The sensitivity and specificity was 73% and 92.7% at cutoff ≥1.0, respectively. In 6 of 13 IA cases, BAL culture or direct microscopic examination remained negative, whereas GM in BAL was positive. Conclusion: Our data have revealed that the sensitivity of GM detection in BAL was better than that of conventional tests. It

  16. Bronchoalveolar lavage fluid and serum canine surfactant protein A concentrations in dogs with chronic cough by bronchial and interstitial lung diseases.

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    Yamaya, Yoshiki; Suzuki, Kazuyuki; Watari, Toshihiro; Asano, Ryuji

    2014-04-01

    We measured bronchoalveolar lavage fluid (BALF) and serum canine surfactant protein (cSP)-A concentrations in dogs with chronic cough. There were no significant differences between bronchial and interstitial lung diseases in BALF cSP-A concentrations. However, serum cSP-A concentrations in dogs with the interstitial lung disease as diffuse panbronchiolitis and idiopathic pulmonary fibrosis were significantly higher than those in dogs with the bronchial disease as chronic bronchitis. These results suggest that serum cSP-A concentrations may be a useful and noninvasive biomarker to understand the existence of interstitial lung damage in dogs with chronic cough.

  17. 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.

  18. IL-11 and CCL-1: Novel Protein Diagnostic Biomarkers of Lung Adenocarcinoma in Bronchoalveolar Lavage Fluid (BALF).

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    Pastor, Maria Delores; Nogal, Ana; Molina-Pinelo, Sonia; Quintanal-Villalonga, Álvaro; Meléndez, Ricardo; Ferrer, I; Romero-Romero, Beatrice; De Miguel, Maria José; López-Campos, José Luis; Corral, Jesús; García-Carboner, Rocío; Carnero, Amancio; Paz-Ares, Luis

    2016-12-01

    Lung cancer (LC) and chronic obstructive pulmonary disease (COPD) are smoking-related diseases, with the presence of COPD itself increasing the risk for development of LC, probably owing to underlying inflammation. LC is typically detected at late stages of the disease and carries a poor prognosis. There is an unmet need for methods to facilitate the early detection of LC in high-risk subjects such as smokers. The expression of inflammatory proteins in bronchoalveolar lavage fluid (BALF) samples was studied by antibody arrays in a prospective cohort of 60 smokers of more than 30 pack-years divided into four groups (control, patients with LC, patients with COPD, and patients with LC plus COPD). Relevant biomarkers were validated by Western blot. Additional validation with enzyme-linked immunosorbent assay (ELISA) was carried out on two independent controlled cohorts of 139 patients (control, patients with LC, patients with COPD, and patients with LC plus COPD) and 160 patients (control and patients with LC of all histological types). A total of 16 differentially expressed proteins in samples from patients with LC, COPD, and LC plus COPD were identified by antibody arrays and validated by Western blot and ELISA. C-C motif chemokine ligand 1 (CCL-1) and interleukin-11 (IL)-11 were selectively expressed in samples from patients with adenocarcinoma with or without COPD (p < 0.005). These proteins exhibited a remarkable diagnostic performance for lung adenocarcinoma in an independent cohort of 139 patients. Receiver operating characteristic curves showed that the optimum diagnostic cutoff value for IL-11 was 42 pg/mL (area under the curve = 0.93 [95% confidence interval: 0.896-0.975], sensitivity 90%, specificity 86%), whereas for CCL-1 it was 39.5 pg/mL (0.83 [95% confidence interval: 0.749-0.902], sensitivity 83%, and specificity 74%). Further validation of the ELISA biomarkers at the aforementioned cutoffs was performed in an additional cohort of 160 patients (20

  19. Bronchoalveolar lavage and 99mTc-DTPA clearance as prognostic factors in asbestos workers with and without asbestosis.

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    al Jarad, N; Gellert, A R; Rudd, R M

    1993-07-01

    The aims of this study are to investigate the change-over time of lung function and chest radiographic findings in patients with asbestosis (AS) and asbestos workers without asbestosis (AW). Secondly, to correlate these changes with broncho-alveolar lavage (BAL) profiles and with lung epithelial permeability, as detected by half-time lung-to-blood (t1/2 LB) clearance of an inhaled aerosol of diethylene triamine pentacetate labelled with technetium 99 (99mTc-DTPA) obtained a mean period of 4.2 yr (range 2.3-5.8) previously. Thirty-three patients with asbestosis and 24 asbestos workers with substantial asbestos exposure were followed-up. Nineteen healthy smokers (HS) with no asbestos exposure who were followed up for a mean period of 3.9 yr were taken as a control group for spirometric changes. Compared with AW, FEV1, FVC and TLCO were lower in AS (P < 0.0001 in each case). Smoker AS and AW had lower numbers (P < 0.03) and percentages (P < 0.004) of BAL lymphocytes and higher numbers (P < 0.04) and percentages (P < 0.02) of BAL neutrophils plus eosinophils than ex- and non-smokers. Annual declines of FEV1 (dFEV1 yr-1) and FVC (dFVC yr-1) in AS and AW were significantly greater than in HS and predicted annual declines (P < 0.002 in each case). Annual declines of TLCO (dTLCO yr-1) and KCO (dKCO yr-1) in AS and AW were significantly greater than predicted annual declines (P < 0.002 in each case). No significant differences were noted between AS and AW in annual declines in any lung function measurement. dTLCO yr-1, dKCO yr-1 were significantly greater in smokers than in ex- and non-smokers, (P < 0.05 and P < 0.04 respectively). Annual decline did not relate to base line values for any lung function measurement. Numbers and proportions of BAL lymphocyte were higher (P < 0.008 and P < 0.02, respectively) and numbers and proportions of BAL neutrophils and eosinophils were lower (P < 0.02 and P < 0.03, respectively) in patients in whom dTLCO yr-1 was less than 0.3 mmol min

  20. 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.

  1. 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.

  2. Mass spectrometry-based analysis of murine bronchoalveolar lavage fluid following respiratory exposure to 4,4'-methylene diphenyl diisocyanate aerosol.

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    Hettick, Justin M; Law, Brandon F; Lin, Chen-Chung; Wisnewski, Adam V; Siegel, Paul D

    2017-07-21

    1. Diisocyanates are highly reactive electrophiles utilized in the manufacture of a wide range of polyurethane products and have been identified as causative agents of occupational allergic respiratory disease. However, in spite of the significant occupational health burden associated with diisocyanate-induced asthma, the mechanism of disease pathogenesis remains largely unknown. 2. To better understand the fate of inhaled diisocyanates, a nose-only aerosol exposure system was constructed and utilized to expose a BALB/c mouse model to an aerosol generated from 4,4'-methylene diphenyl diisocyanate (MDI). Tissue and bronchoalveolar lavage samples were evaluated 4 and 24 h post-exposure for evidence of diisocyanate-protein haptenation, and a label-free quantitative proteomics strategy was employed to evaluate relative changes to the protein content of the cellular fraction of the lavage fluid. 3. Following MDI aerosol exposure, expression of the number of proteins with immunological or xenobiotic metabolism relevance is increased, including endoplasmin, cytochrome P450 and argininosuccinate synthase. Western blot analysis indicated MDI-conjugated protein in the lavage fluid, which was identified as serum albumin. 4. Tandem mass spectrometry analysis of MDI-albumin revealed MDI conjugation occurs at a dilysine motif at Lys525, as well as at a glutamine-lysine motif at Lys414, in good agreement with previously published in vitro data on diisocyanate-conjugated serum albumin.

  3. Measuring (1,3)-β-D-glucan in tracheal aspirate, bronchoalveolar lavage fluid, and serum for detection of suspected Candida pneumonia in immunocompromised and critically ill patients: a prospective observational study.

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    Su, Kang-Cheng; Chou, Kun-Ta; Hsiao, Yi-Han; Tseng, Ching-Min; Su, Vincent Yi-Fong; Lee, Yu-Chin; Perng, Diahn-Warng; Kou, Yu Ru

    2017-04-08

    While Candida pneumonia is life-threatening, biomarker measurements to early detect suspected Candida pneumonia are lacking. This study compared the diagnostic values of measuring levels of (1, 3)-β-D-glucan in endotracheal aspirate, bronchoalveolar lavage fluid, and serum to detect suspected Candida pneumonia in immunocompromised and critically ill patients. This prospective, observational study enrolled immunocompromised, critically ill, and ventilated patients with suspected fungal pneumonia in mixed intensive care units from November 2010 to October 2011. Patients with D-glucan confounding factors or other fungal infection were excluded. Endotracheal aspirate, bronchoalveolar lavage fluid and serum were collected from each patient to perform a fungal smear, culture, and D-glucan assay. After screening 166 patients, 31 patients completed the study and were categorized into non-Candida pneumonia/non-candidemia (n = 18), suspected Candida pneumonia (n = 9), and non-Candida pneumonia/candidemia groups (n = 4). D-glucan levels in endotracheal aspirate or bronchoalveolar lavage were highest in suspected Candida pneumonia, while the serum D-glucan level was highest in non-Candida pneumonia/candidemia. In all patients, the D-glucan value in endotracheal aspirate was positively correlated with that in bronchoalveolar lavage fluid. For the detection of suspected Candida pneumonia, the predictive performance (sensitivity/specificity/D-glucan cutoff [pg/ml]) of D-glucan in endotracheal aspirate and bronchoalveolar lavage fluid was 67%/82%/120 and 89%/86%/130, respectively, accounting for areas under the receiver operating characteristic curve of 0.833 and 0.939 (both P pneumonia in the absence of concurrent candidemia. D-glucan levels in both endotracheal aspirate and bronchoalveolar lavage, but not in serum, provide good diagnostic values to detect suspected Candida pneumonia and to serve as potential biomarkers for early detection in this patient population.

  4. DIAGNOSTIC VALUE OF BRONCHOALVEOLAR LAVAGE IN LEUKEMIC AND BONE MARROW TRANSPLANT PATIENTS: THE IMPACT OF ANTIMICROBIAL THERAPY

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    John Norman Greene

    2014-12-01

    Full Text Available Background Pneumonia carries significant morbidity and mortality in leukemic and bone marrow transplant patient.  The development of pulmonary infiltrates in the setting of such immunocompromise raises concern for both infectious and non-infectious etiologies, some of which are potentially treatabl.  Performing bronchoscopy provides several different options for sampling the lower respiratory tract.  Among these, bronchoalveolar lavage (BAL is especially effective at collecting samples from the alveoli and has been shown to be associated with less risk than transbonchial biops. We sought to examine the effect of antimicrobial treatment on BAL results in a large study population of leukemic and bone marrow transplant patients. Subjects and Methods This retrospective chart review was performed at a single academic cancer center.  A power analysis was performed to determine the appropriate sample size. The patients were selected from those who had undergone an inpatient bronchoscopy in reverse chronological order until 300 patients with either a hematopoietic stem cell transplant or hematologic malignancy were identified.  The exclusion criteria were age <18, a diagnosis of HIV or acquired immune deficiency syndrome (AIDS, or outpatient status.  Electronic medical records were reviewed and data extracted by a single investigator, CY.  Data including age, sex, cancer diagnosis, time from HSCT, leukocyte count, neutropenia in addition to medications were collected.  A normal white blood cell (WBC count was considered 4,000-12,000/mm3.  Neutropenia was defined as an absolute neutrophil count (ANC less than 500/mm3.  Medications including antibiotic duration and timing, antifungal use, immunosuppressant use or glucocorticoids were recorded. A positive BAL yield was defined as the culture identification of at least one organism known to be pathogenic in this patient population.  Candida species and coagulase negative staphylocci were

  5. 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

  6. Study of bronchoalveolar lavage fluid in paracoccidioidomycosis: cytopathology and alveolar macrophage function in response to gamma interferon; comparison with blood monocytes.

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    Calvi, Sueli A; Soares, Angela M V C; Peraçoli, Maria Terezinha S; Franco, Marcelo; Ruiz, Raul L; Marcondes-Machado, Jussara; Fecchio, Denise; Mattos, Maria C I; Mendes, Rinaldo P

    2003-12-01

    Patients with paracoccidioidomycosis (PCM) present marked involvement of the lungs during the course of the mycosis. The purpose of this work was to obtain bronchoalveolar lavage (BAL) fluid from these patients to study the cytopathology, TNF levels and the oxidative and fungicidal response of alveolar macrophages (AMs) to in vitro incubation with recombinant IFN-gamma. To compare the lung and blood compartments, these determinations were also made in plasma and blood monocytes (BMs) obtained from the same patients. The cytopathology of BAL fluid revealed a predominance of macrophages, but with the presence of neutrophil exudation, and rare lymphocytes and epithelioid and giant cells. Comparison of the oxidative status and fungicidal activity of AMs and circulating BMs demonstrated that both cell types are highly activated for these two functions when compared to control cells. However, TNF levels were higher in BAL fluid than in plasma. The possible mechanisms involved in the hyperresponsiveness of cells from PCM patients are discussed.

  7. Metabolomic analysis of lung epithelial secretions in rats: an investigation of bronchoalveolar lavage fluid by GC-MS and FT-IR.

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    Qamar, Wajhul; Ahamad, Syed Rizwan; Ali, Raisuddin; Khan, Mohammad Rashid; Al-Ghadeer, Abdul Rahman

    2014-11-01

    Rat bronchoalveolar lavage fluid (BALF) metabolome can be used to obtain valuable, precise, and accurate information about underlying lung conditions in an experiment. The present study focuses on the evaluation of the lung epithelium metabolome in a rat model using techniques including bronchoalveolar lavage, gas chromatography-mass spectroscopy (GC-MS), and Fourier transform infrared spectroscopy (FT-IR). Untargeted metabolites in BALF were extracted in ethyl acetate and derivatized by standard methods for the analysis by GC-MS. FT-IR spectra of ethyl acetate extract of BALF were obtained and read for the characteristic fingerprint of rats under investigation. Analyses were done in individual animals to obtain consistent data. BALF cells were counted by flow cytometry to monitor any inflammatory condition in rats. FT-IR analysis finds two peaks which are characteristically different from the extract medium, which is ethyl acetate. FT-IR peaks correspond to that of amino acids and carbohydrates, including β-D-glucose, α-D-glucose, and β-D-galactose. GC-MS evaluation of the BALF finds several products of the metabolism or its participants. Main compounds in the BALF detected by GC-MS include succinate, fumarate, glycine, alanine, 2-methyl-3-oxovaleric acid, dodecanoic acid, tetradecanoic acid, hexadecanoic acid, octanoic acid, trans-9-octadecanoic acid, octadecanoic acid, and Prostaglandin F1α. Several research reports reveal metabolomic parameters in murine model lung tissue or BALF, but they rarely reported a complete metabolomics model profile, particularly in rats. The present data of GC-MS and FT-IR suggest that the set up can be exploited to study metabolomic alterations in several lung conditions including acute lung toxicity, inflammation, asthma, bronchitis, fibrosis, and emphysema.

  8. 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 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....

  9. 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...

  10. 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.

  11. Comparison between manual aspiration via polyethylene tubing and aspiration via a suction pump with a suction trap connection for performing bronchoalveolar lavage in healthy dogs.

    Science.gov (United States)

    Woods, Katharine S; Defarges, Alice M N; Abrams-Ogg, Anthony C G; Dobson, Howard; Viel, Laurent; Brisson, Brigitte A; Bienzle, Dorothee

    2013-04-01

    To compare the diagnostic quality of bronchoalveolar lavage (BAL) fluid acquired from healthy dogs by manual aspiration via polyethylene tubing (MAPT) and via suction pump aspiration (SPA) with a suction trap connection. 12 healthy adult Beagles. BAL was performed with bronchoscopic guidance in anesthetized dogs. The MAPT was performed with a 35-mL syringe attached to polyethylene tubing wedged in a bronchus via the bronchoscope's biopsy channel. The SPA was performed with 5 kPa of negative pressure applied to the bronchoscope's suction valve via a suction trap. The MAPT and SPA techniques were performed in randomized order on opposite caudal lung lobes of each dog. Two 1 mL/kg lavages were performed per site. Samples of BAL fluid were analyzed on the basis of a semiquantitative quality scale, percentage of retrieved fluid, and total nucleated and differential cell counts. Results were compared with Wilcoxon signed rank tests. Percentage of BAL fluid retrieved (median difference, 16.2%), surfactant score (median difference, 1), and neutrophil count (median difference, 74 cells/μL) were significantly higher for SPA than for MAPT. A higher BAL fluid epithelial cell score was obtained via MAPT, compared with that for samples obtained via SPA (median difference, 1). Results indicated that in healthy dogs, SPA provided a higher percentage of BAL fluid retrieval than did MAPT. The SPA technique may improve the rate of diagnostic success for BAL in dogs, compared with that for MAPT. Further evaluation of these aspiration techniques in dogs with respiratory tract disease is required.

  12. Effect of ambroxol on the concentration of cefotaxime in the bronchoalveolar lavage fluid of rats with pulmonary fibrosis

    Science.gov (United States)

    CHEN, FENG; ZHANG, YUAN-XIA; ZHANG, CAI-QING

    2015-01-01

    This study aimed to investigate the effect of ambroxol on the concentration of cefotaxime in the bronchioalveolar lavage fluid of rats with bleomycin-induced pulmonary fibrosis. A total of 54 Wistar male rats were randomly divided into three groups, namely the normal control group, model group and ambroxol group. On experimental day 0, the rats were intratracheally instilled with bleomycin (5 mg/kg body weight) or sterile saline. The rats in the ambroxol group were then treated with ambroxol (35 mg/kg/day) intraperitoneally. On days 7, 14, 28 after instillation, six rats from each group were sacrificed, bronchial alveolar fluids were recovered and the lungs were collected for histopathological examination following the injection of cefotaxime (600 mg/kg) intravenously. The concentration of cefotaxime in the bronchial alveolar fluids was assayed by a liquid chromatography-mass spectrometry method. On day 7, the concentration of cefotaxime in the bronchial alveolar fluid of the ambroxol group was lower than that of the model group. On day 14, the concentration of cefotaxime in the bronchial alveolar fluids of the ambroxol group was higher than that of the model group, and the difference between these groups was significant statistically (Pambroxol group decreased sharply, and was lower than that of the model group (P=0.126). These results indicate that ambroxol increased the concentration of cefotaxime in the bronchial alveolar fluids at the primary fibrosis stage. PMID:25574230

  13. Direct comparison of galactomannan performance in concurrent serum and bronchoalveolar lavage samples in immunocompromised patients at risk for invasive pulmonary aspergillosis.

    Science.gov (United States)

    Boch, Tobias; Buchheidt, Dieter; Spiess, Birgit; Miethke, Thomas; Hofmann, Wolf-Karsten; Reinwald, Mark

    2016-02-01

    Invasive pulmonary aspergillosis (IPA) is a life-threatening infection mainly affecting immunocompromised patients. Early diagnosis is critical, but the diagnostic gold standard (histopathology and culture) is time consuming and cannot offer early confirmation of IPA. Fungal biomarkers like galactomannan (GM) are a promising extension to the diagnostic repertoire. However, it still remains under discussion if biomarker analysis from the site of the infection is superior to testing blood samples. We retrospectively evaluated the diagnostic performance of concurrent serum GM and bronchoalveolar lavage (BAL) GM (obtained within 24 h) of immunocompromised patients at high risk of IPA. Twenty-six proven/probable patients and eight patients with no IPA according to the EORTC/MSG 2008 criteria were included in this study. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic odds ratio were for BAL GM: 85%, 88%, 96%, 64% and 38.5, and for serum GM: 23%, 88%, 88%, 26% and 2.1 respectively. BAL GM proved to be significantly more sensitive for the detection of IPA compared to same-day serum GM in patients at high risk of IPA (P superior to serum GM implying that diagnostic efforts should focus on specimens from the site of infection. © 2015 Blackwell Verlag GmbH.

  14. A prospective study to evaluate the utility of bronchoalveolar lavage by fiberoptic bronchoscopy in sputum smear negative patients with high suspicion of pulmonary tuberculosis

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    Ritesh Kamal

    2012-01-01

    Full Text Available Aim: To evaluate the utility of bronchoalveolar lavage (BAL by flexible fiberoptic bronchoscopy (FOB in sputum smear negative patients with clinical and radiological characteristics of pulmonary tuberculosis (PTB. Materials and Methods: This prospective study was carried out in 30 sputum smear negative patients of age group 20 to 70 years, who were highly suspicious for PTB by clinical and radiographic criteria. All patients were subjected to sputum culture, BAL stains and cultures, and cytopathology. Patients with moderate to massive pleural effusion, obvious accessible lymph node, history of antitubercular therapy (ATT, and contraindication to FOB were excluded. Results: Sputum culture for acid fast bacilli (AFB was positive in four (12% patients, BAL fluid was positive for Ziehl-Neelsen (ZN stain in nine (27% patients, including four sputum culture patients, while BAL culture for AFB on Lowenstein-Jensen (LJ medium was positive in 18 (60%, including 9 BAL fluid ZN stain positive patients. Six (20% patients had growth on pyogenic culture, while two (7% patients had malignant cell on cytological examination of BAL fluid. Remaining four (13% patients were empirically started on ATT. They had complete response to ATT at 2 months and were retrospectively diagnosed with pulmonary tuberculosis (PTB. All the bacteriologically confirmed PTB patients were given ATT for 6 months and all patients had complete response. Conclusion: We concluded that FOB guided BAL is extremely useful for establishing diagnosis of PTB or other pulmonary diseases in sputum smear negative patients, who have high suspicion for PTB by clinical and radiographic criteria.

  15. Assessment of pulmonary antibodies with induced sputum and bronchoalveolar lavage induced by nasal vaccination against Pseudomonas aeruginosa: a clinical phase I/II study

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    Freihorst Joachim

    2007-08-01

    Full Text Available Abstract Background Vaccination against Pseudomonas aeruginosa is a desirable albeit challenging strategy for prevention of airway infection in patients with cystic fibrosis. We assessed the immunogenicity of a nasal vaccine based on the outer membrane proteins F and I from Pseudomonas aeruginosa in the lower airways in a phase I/II clinical trial. Methods N = 12 healthy volunteers received 2 nasal vaccinations with an OprF-OprI gel as a primary and a systemic (n = 6 or a nasal booster vaccination (n = 6. Antibodies were assessed in induced sputum (IS, bronchoalveolar lavage (BAL, and in serum. Results OprF-OprI-specific IgG and IgA antibodies were found in both BAL and IS at comparable rates, but differed in the predominant isotype. IgA antibodies in IS did not correlate to the respective serum levels. Pulmonary antibodies were detectable in all vaccinees even 1 year after the vaccination. The systemic booster group had higher IgG levels in serum. However, the nasal booster group had the better long-term response with bronchial antibodies of both isotypes. Conclusion The nasal OprF-OprI-vaccine induces a lasting antibody response at both, systemic and airway mucosal site. IS is a feasible method to non-invasively assess bronchial antibodies. A further optimization of the vaccination schedule is warranted.

  16. Usefulness of (1,3) ß-D-glucan detection in bronchoalveolar lavage samples in Pneumocystis pneumonia and Pneumocystis pulmonary colonization.

    Science.gov (United States)

    Damiani, C; Le Gal, S; Goin, N; Di Pizio, P; Da Costa, C; Virmaux, M; Bach, V; Stéphan-Blanchard, E; Nevez, G; Totet, A

    2015-03-01

    Recent data demonstrate the usefulness of (1,3) ß-d-glucan (BG) detection in serum samples to distinguish patients developing Pneumocystis pneumonia and patients who are colonized by the fungus. In contrast, data of BG detection in bronchoalveolar lavage (BAL) samples from these patient populations are still rare. In this context, we determined BG levels in BAL samples from 11 Pneumocystis pneumonia (PCP) patients, 10 colonized patients, and 24 Pneumocystis-uninfected patients. BG levels were determined on each BAL sample using the Fungitell(®) kit (Associates of Cape Cod, Inc., Cape Cod, MA, USA) according to the manufacturer's instructions applied to serum sample examination. The BG levels in BAL samples from the PCP patient group (mean value 20 588 pg/mL) were significantly higher than those in the colonized patient group (mean value 105 pg/mL) (P=0.0001, Mann-Whitney test) and than those in the Pneumocystis-uninfected patient group (mean value 74 pg/mL) (P<0.0001, Mann-Whitney test). The BG levels in BAL samples from the colonized patient group did not differ significantly from those in the Pneumocystis-uninfected patients group (P=0.21). The results suggest that measurements of BAL BG levels may facilitate the differential diagnosis of PCP and pulmonary colonization with Pneumocystis. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  17. Periodontitis-associated septic pulmonary embolism caused by Actinomyces species identified by anaerobic culture of bronchoalveolar lavage fluid: a case report.

    Science.gov (United States)

    Endo, Shun; Mishima, Eikan; Takeuchi, Yoichi; Ohi, Takashi; Ishida, Masatsugu; Yanai, Masaru; Kiyomoto, Hideyasu; Nagasawa, Tasuku; Ito, Sadayoshi

    2015-12-01

    Periodontal disease is a less common but important cause of septic pulmonary embolism (SPE). However, the pathogens causing periodontal disease-associated SPE (PD-SPE) have been poorly understood. Actinomyces species are resident microbiota in the oral cavity. Here we report a case of PD-SPE caused by Actinomyces species, which was identified by anaerobic culture of bronchoalveolar lavage fluid (BAL). A 64-year-old Asian man, complicated with severe chronic periodontitis, was admitted with chest pain and fever. Chest CT revealed multiple bilateral pulmonary nodules located subpleurally. We diagnosed the case as SPE associated with periodontitis. Although blood cultures were negative for the usual 5-day incubation, anaerobic culture of the BAL fluid sample yielded Actinomyces species. Antibacterial therapy alone did not ameliorate the symptoms; however, additional dental treatment, including tooth extraction, promptly did. The patient was discharged 23 days after admission. The 3-month follow-up revealed no recurrence of the symptoms and complete resolution of the lung lesions. This case demonstrated that Actinomyces species can cause PD-SPE. Additionally, clinicians should consider performing appropriate anaerobic culture of BAL fluid to identify the pathogen of SPE, and to ordering dental treatment, if necessary, in addition to antibiotics for the initial management of PD-SPE.

  18. Comparison of bronchoalveolar lavage fluid obtained by manual aspiration with a handheld syringe with that obtained by automated suction pump aspiration from healthy dogs.

    Science.gov (United States)

    Woods, Katharine S; Defarges, Alice M N; Abrams-Ogg, Anthony C G; Dobson, Howard; Brisson, Brigitte A; Viel, Laurent; Bienzle, Dorothee

    2014-01-01

    To compare bronchoalveolar lavage (BAL) fluid obtained by manual aspiration (MA) with a handheld syringe with that obtained by suction pump aspiration (SPA) in healthy dogs. 13 adult Beagles. Each dog was anesthetized and bronchoscopic BAL was performed. The MA technique was accomplished with a 35-mL syringe attached to the bronchoscope biopsy channel. The SPA technique was achieved with negative pressure (5 kPa) applied to the bronchoscope suction valve with a disposable suction trap. Both aspiration techniques were performed in each dog in randomized order on opposite caudal lung lobes. Two 1 mL/kg aliquots of warm saline (0.9% NaCl) solution were infused per site. For each BAL fluid sample, the percentage of retrieved fluid was calculated, the total nucleated cell count (TNCC) and differential cell count were determined, and semiquantitative assessment of slide quality was performed. Comparisons were made between MA and SPA techniques for each outcome. 1 dog was removed from the study because of illness. The mean percentage of fluid retrieved (mean difference, 23%) and median TNCC (median distribution of differences, 100 cells/μL) for samples obtained by SPA were significantly greater than those for samples obtained by MA. In healthy dogs, BAL by SPA resulted in a significantly higher percentage of fluid retrieval and samples with a higher TNCC than did MA. Further evaluation of aspiration techniques in dogs with respiratory tract disease is required to assess whether SPA improves the diagnostic yield of BAL samples.

  19. Clinical utility of bronchoalveolar lavage and respiratory tract biopsies in diagnosis and management of suspected invasive respiratory fungal infections in children.

    Science.gov (United States)

    Batra, Surabhi; Li, Betty; Underhill, Nicole; Maloney, Rebekah; Katz, Ben Z; Hijiya, Nobuko

    2015-09-01

    Bronchoscopy with bronchoalveolar lavage (BAL) and respiratory tract biopsies are important tools for diagnosing fungal infections in children with cancer and hematopoietic stem cell transplant (HSCT) recipients. Our objective was to evaluate the impact of BAL and respiratory tract biopsies on the management of suspected fungal infections in oncology and HSCT patients. We retrospectively reviewed the medical records of oncology and HSCT patients with possible, probable, or proven fungal infection of the respiratory tract and determined whether BAL or biopsy following computed tomography (CT) prompted a change in management. Among 101 patients (0.5-29 years of age), 24 underwent a BAL and 31 had biopsies (27 lung and 4 sinus). The remaining 46 patients had CT scans only. Of these, there were radiographic findings suggestive of a fungal infection in 38 patients (83%). Thirty of these 38 patients (79%) had a change in management. BAL provided a diagnosis in 6 of 24 patients (25%). There was a change in management in 2 of the 6 (33%). Respiratory tract biopsy provided a diagnosis in 12 of 31 patients (39%). Biopsy results led to a change in management in 4 of the 12 patients (33%). Significant postoperative morbidity attributed to biopsy occurred in 3 of 31 patients (10%); 2 patients had pneumothorax requiring chest tube and intubation and a patient had prolonged intubation. BAL and biopsy in children with an oncological diagnosis or those undergoing HSCT only infrequently lead to changes in management in the era of empiric therapy with broad-spectrum anti-fungal agents. © 2015 Wiley Periodicals, Inc.

  20. 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.

  1. 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.

  2. A Comparison of Aspergillus and Mucorales PCR Testing of Different Bronchoalveolar Lavage Fluid Fractions from Patients with Suspected Invasive Pulmonary Fungal Disease.

    Science.gov (United States)

    Springer, Jan; White, P Lewis; Kessel, Johanna; Wieters, Imke; Teschner, Daniel; Korczynski, Daniel; Liebregts, Tobias; Cornely, Oliver A; Schwartz, Stefan; Elgeti, Thomas; Meintker, Lisa; Krause, Stefan W; Posso, Raquel B; Heinz, Werner J; Fuhrmann, Sandra; Vehreschild, Jörg Janne; Einsele, Hermann; Rickerts, Volker; Loeffler, Juergen

    2018-02-01

    In patients with hematological malignancies, bronchoalveolar lavage fluid (BALF) specimens are commonly used for the diagnosis of mold infections. However, it is not clear whether the cell pellet (P) or the supernatant fraction (S) of the BALF specimen is optimal for molecular diagnostic testing. Thus, 99 BALF specimens were collected from 96 hematology patients with or without allogeneic hematopoietic stem cell transplant. The cell pellets and supernatants were processed alone and in combination (S/P) for testing by two fungus-specific real-time PCR assays compliant with international recommendations. The results achieved with S/P were revealed to be superior in comparison to those achieved with S and P alone, with the use of each single fraction showing a reduced sensitivity for the detection of Aspergillus DNA (82% and 43% for S and P, respectively). In 57% of the samples, testing of the combination of S and P generated a lower quantification cycle value than testing of S or P alone. Molds would have been missed in 5 and 16 out of 28 samples if only S or P, respectively, was analyzed. No sample was positive by testing of S or P only. Similar results were obtained for the detection of Mucorales DNA in BALF specimens (reduced sensitivity of 67% and 50% for S and P, respectively). Study patients were categorized according to the current European Organization for the Research and Treatment of Cancer/Mycoses Study Group classification for invasive fungal disease (IFD), revealing that 35 patients had proven/probable IFD (36%), 47 patients had possible IFD (49%), and 14 patients had undetermined IFD (15%). Copyright © 2018 American Society for Microbiology.

  3. 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Effects of positive end-expiratory pressure and 30% inspired oxygen on pulmonary mechanics and atelectasis in cats undergoing non-bronchoscopic bronchoalveolar lavage.

    Science.gov (United States)

    Bernhard, Christa; Masseau, Isabelle; Dodam, John; Outi, Hilton; Krumme, Stacy; Bishop, Kaitlin; Graham, Amber; Reinero, Carol

    2017-06-01

    Objectives The objective of this study was to determine if modification of inspired oxygen concentration or positive end-expiratory pressure (PEEP) would alter bronchoalveolar lavage (BAL)-induced changes in pulmonary mechanics or atelectasis, as measured using ventilator-acquired pulmonary mechanics and thoracic CT. Methods Six experimentally asthmatic cats underwent anesthesia and non-bronchoscopic BAL, each under four randomized treatment conditions: 100% oxygen, zero PEEP; 30% oxygen, zero PEEP; 100% oxygen, PEEP 2 cmH2O; and 30% oxygen, PEEP 2 cmH2O. Pulse oximetry was used to estimate oxygen saturation (SpO2). Ventilator-acquired pulmonary mechanics and thoracic CT scans were collected prior to BAL and at 1, 5 and 15 mins post-BAL. Results While receiving 100% oxygen, no cat had SpO2 90% by 1 min later. There was a significant increase in airway resistance and a decrease in lung compliance following BAL, but there was no significant difference between treatment groups. Cats receiving no PEEP and 30% oxygen conserved better aeration of the lung parenchyma in BAL-sampled areas than those receiving no PEEP and 100% oxygen. Conclusions and relevance Alterations in pulmonary mechanics or atelectasis may not be reflected by SpO2 following BAL. The use of 30% inspired oxygen concentration failed to show any significant improvement in pulmonary mechanics but did diminish atelectasis. In some cats, it was also associated with desaturation of hemoglobin. The use of PEEP in this study did not show any effect on our outcome parameters. Further studies using higher PEEP (5-10 cmH2O) and intermediate inspired oxygen concentration (40-60%) are warranted to determine if they would confer clinical benefit in cats undergoing diagnostic BAL.

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

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    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

  6. Análise do lavado broncoalveolar em vítimas de queimaduras faciais graves Bronchoalveolar lavage analysis in victims of severe facial burns

    Directory of Open Access Journals (Sweden)

    Eucir Rabello

    2009-04-01

    Full Text Available OBJETIVO: Analisar o lavado broncoalveolar (LBA de vítimas de queimaduras que inalaram fumaça a fim de identificar alterações que possam estar associadas à morte ou à sobrevida. MÉTODOS: Dezoito vítimas de queimaduras faciais foram submetidas a LBA até 24 h após o evento, sendo realizadas a análise do conteúdo celular e proteico, incluindo TNF-α, HLA-DR, CD14, CD68 e iNOS. RESULTADOS: Dos 18 pacientes submetidos à broncoscopia, 8 (44,4% morreram durante o seguimento. A média de idade dos pacientes que morreram foi significativamente maior (44,7 vs. 31,5 anos. A superfície corporal queimada foi em média de 60,1% nos pacientes que morreram e de 26,1% nos sobreviventes (p OBJECTIVE: To analyze bronchoalveolar lavage (BAL specimens of burn victims who inhaled smoke, in order to identify alterations associated with mortality or survival. METHODS: Eighteen victims of facial burns were submitted to BAL up to 24 h after the event. We investigated cell and protein content, including TNF-α, HLA-DR, CD14, CD68 and iNOS. RESULTS: Of the 18 patients submitted to bronchoscopy, 8 (44.4% died during the follow-up period. The mean age of patients who died was significantly higher (44.7 vs. 31.5 years. On average, the patients who died had burns covering 60.1% of the total body surface area, compared with 26.1% in the survivors (p < 0.0001. Of the 18 patients submitted to bronchoscopy, 11 (61.1% showed endoscopic signs of smoke inhalation injury, and 4 (36.4% of those 11 died. Of the 7 patients with no signs of smoke inhalation injury, 4 (57.1% died. The mean number of ciliated epithelial cells in the BAL fluid was significantly higher in the patients who died than in the survivors (6.6% vs. 1.4%; p = 0.03. There were no significant differences between the groups in terms of any of the other parameters evaluated. CONCLUSIONS: The total body surface area burned was a predictive factor for mortality. Increased numbers of ciliated epithelial cells

  7. Positive bronchoalveolar lavage and quantitative cultures results in suspected late-onset ventilator associated pneumonia evaluation – retrospective study

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    A.P. Vaz

    Full Text Available Introduction: Bronchoalveolar lavage (BAL with quantitative cultures has been used in order to increase ventilator associated pneumonia (VAP diagnosis specificity, although the accurate technique for this entity diagnosis remains controversial. Objectives: To evaluate the influence of using positive BAL and quantitative cultures results in microbiologic diagnosis and treatment of patients with suspected late VAP and prior antibiotherapy. Material and methods: Retrospective analysis of intensive care unit (UCI patients, during a one year period, with clinical suspicion of late VAP and prior use of antibiotics that presented a growth in BAL cultures. Results: Of 243 BAL performed, there were 71 (29.2 % positive cultures (60 patients, 76.7 % male, 54 ± 19 years. BAL was done after 13 days (median of invasive mechanical ventilation, 11 days of ICU antibiotherapy and in the day in which a new antibiotic for VAP suspicion was started. Colony forming units (CFU/ml count was performed in 71.8 % and endotracheal aspirate (ETA simultaneously collected for qualitative analysis in 85.9 %. Therapeutic approach was changed in 38.0 %: correction (16.9 %, de-escalation (12.7 % and directed antibiotherapy start (8.4 %. Therapeutic changes were made in the presence of CFU > 104 in 84.2 % and in agreement with ETA in 70.8 %. In cases in which antibiotherapy was maintained (62.0 %, quantitative cultures would have allowed de-escalation in 9.1 %. Changes in prescription were more frequent when CFU was > 104 (48.5 %, comparing with situations in which counts were lower and BAL analysis was only qualitative (28.9 %, p = 0.091. There were no significant differences between patients submitted to different therapeutic approaches concerning to ICU mortality or length of stay. Conclusion: In late onset VAP, positive BAL and quantitative cultures allowed therapeutic changes, leading to antibiotic adequacy and consumption reduction, which can

  8. 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.

  9. Diagnóstico citológico de neoplasia pulmonar por meio de lavado broncoalveolar em uma cadela: relato de caso Cytologic diagnosis of pulmonary neoplasm with bronchoalveolar lavage in a bitch: case report

    Directory of Open Access Journals (Sweden)

    P.E. Ferian

    2006-10-01

    Full Text Available Relata-se o caso de uma cadela de raça Poodle, de 12 anos de idade, com quadro clínico de tosse crônica não responsiva à terapia medicamentosa. O exame radiográfico mostrou imagem de consolidação do lobo pulmonar esquerdo. O exame de lavado broncoalveolar pelo broncofibroscópio mostrou células epiteliais com características de malignidade, permitindo firmar o diagnóstico de carcinoma pulmonar sem diferenciação entre neoplasia primária ou metastática.This article reports a case of a bitch, Poodle, 12 year-old with chronic cough, which had insufficient response to medicamentous therapy. Thoracic radiographic revealed a lobar consolidation in left caudal pulmonary lobe. A bronchoalveolar lavage sample was collected by bronchoscopy for cytology examination. Malignant epithelial cells were observed through cytology allowing the diagnosis of carcinoma. The differential diagnosis between primary pulmonary neoplasm and metastatic neoplasm was not possible.

  10. 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

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    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

  11. Association between Mycoplasma-specific polymerase chain reaction assay results and oral bacterial contamination of bronchoalveolar lavage fluid samples from dogs with respiratory tract disease: 121 cases (2005-2012).

    Science.gov (United States)

    Chan, Christina M; Ridgway, Marcella D; Mitchell, Mark A; Maddox, Carol W

    2013-12-01

    To determine whether an association exists between oral bacterial contamination of bronchoalveolar lavage fluid (BALF) and positive PCR assay results for the detection of Mycoplasma spp in BALF samples of dogs with lower respiratory tract (LRT; portion from the trachea to the lungs) disease. Retrospective case series. 121 dogs with LRT disease. Procedures-Medical records from January 2005 to April 2012 were reviewed. Dogs with LRT disease that had BALF samples evaluated by use of Mycoplasma-specific PCR assay, bacterial culture, and cytologic examination were included. Information on signalment, final diagnoses, and BALF testing results was extracted. 83 (68.6%) dogs had BALF samples with negative PCR assay results for Mycoplasma spp, and 38 (31.4%) had positive results. The BALF samples with cytologic evidence of oral bacterial contamination were 5.1 times as likely to have positive Mycoplasma-specific PCR assay results as were noncontaminated samples. Compared with hound or herding dogs, other breeds were 13.6 times as likely to have positive PCR assay results. Dogs with bronchitis were less likely than dogs with other LRT diseases to have positive Mycoplasma-specific PCR assay results. No significant association was found between Mycoplasma-specific PCR assay results and bacterial culture results. In dogs with LRT disease, Mycoplasma-specific PCR assay results for BALF samples should be interpreted in terms of possible oral bacterial contamination. Mycoplasma-specific PCR assay of BALF samples from herding dogs, hound dogs, and dogs with bronchitis may be less rewarding than for other dogs with LRT disease.

  12. Bronchoalveolar Lavage Fluid Cellular and Haematological ...

    African Journals Online (AJOL)

    olayemitoyin

    A bovine respiratory syncytial virus model with high clinical expression in calves with specific passive immunity. BMC Vet Res. 11: 76. Daramola JO, Adeloye AA, Fatoba TA, Soladoye AO. (2005). Haematological and biochemical parameters of West African Dwarf goats. Livest. Res Rural Dev 17 (95). Retrieved December ...

  13. Expression of insulin-like growth factor-I (IGF-I in alveolar macrophages and lymphocytes obtained by bronchoalveolar lavage (BAL in interstitial lung diseases (ILD. Assessment of IGF-I as a potential local mitogen and antiapoptotic cytokine.

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    Barbara Balicka-Slusarczyk

    2007-01-01

    Full Text Available Little is known about IGF-I expression in the alveolar lymphocytes (AL, and about local role of IGF-I in physiological conditions and in interstitial lung diseases. Bronchoalveolar lavage was carried out in patients with silicosis, asbestosis, idiopathic pulmonary fibrosis (IPF and sarcoidosis, as well as in control subjects (n = 13, 9, 12, 56, 15, resp. Alveolar macrophages (AM and lymphocytes (AL were studied for (1 IGF-I, BCL-2, Fas and Fas Ligand expression and (2 cell cycle (incl. sub-G1 peak of late apoptosis with propidium iodide (PI. Flow cytometry (FC and immunocytochemistry were used. AL early apoptosis was detected by Annexin V FITC/PI staining. IGF-I was present in AL of all tested groups. The number of IGF-I positive AL was significantly higher in IPF (52 +/- 6.7% and in later (II and III stages of sarcoidosis (39 +/- 7.8 vs 16 +/- 4.0% in controls, p < 0.05. Increased BCL-2 expression in AL was detected in IPF and sarcoidosis. In all tested groups, AL were almost exclusively Fas+ T cells. Generally, a low number of AL entered apoptosis; no significant differences were found between patient groups, except decreased apoptosis rate in sarcoidosis (0.60 +/- 0.17 vs 1.15 +/- 0.33% in controls, p < 0.05. Proportion of AL positive for IGF-I was significantly correlated with parameters reflecting AL and AM cell proliferation and BCL-2 expression (e.g. AL IGF-I+ vs AM in S phase of cell cycle: r(S = +0.50, p = 0.001, but not with apoptosis. The results show that human alveolar lymphocytes express IGF-I in normal conditions, as well as in ILD. The proportion of IGF-I+ lymphocytes was significantly increased in IPF and at later stages of sarcoidosis. In our material there was no evidence for profibrogenic or antiapoptotic activity of IGF-I. We suggest that IGF-I originating from AL may be locally active as a mitogen for alveolar macrophages and lymphocytes in ILD.

  14. Estudo da Incidência de Fungos Isolados de Amostras de Lavado Bronco Alveolar, Biópsia Transbrônquica e de Escarro / Study of the incidence of fungi isolated from samples of bronchoalveolar lavage, transbronchial biopsy and sputum

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    Thays Gabrielle Lins de Oliveira

    2016-03-01

    Full Text Available Objetivo: Estudar a incidência de fungos isolados de amostras de lavado bronco alveolar, fragmentos de tecido pulmonar e escarro de pacientes assistidos no Hospital Otávio de Freitas. Materiais e métodos: Estudo observacional retrospectivo descritivo com análise dos registros de 756 pacientes que realizaram exame direto e culturas de lavado bronco alveolar, fragmentos de tecido pulmonar e/ou escarro no Laboratório de Micologia Médica do Hospital Otávio de Freitas em Recife-PE, no período de março de 2012 a maio de 2015. Foram também analisados os resultados das sorologias para Aspergillus realizadas no mesmo período no Laboratório de Imunodiagnóstico de Micoses Sistêmicas do Departamento de Micologia da Universidade Federal de Pernambuco. Resultados: Foram isolados 248 (54,14% Candida albicans, 119 (25,98% Candida sp. e 41 (10,04% espécies Candida não albicans, 33 (7,21% Aspergillus fumigatus, dois (0,44% A. niveus, um (0,22% A. niger, 3 (0,65% A. japonicus, dois (0,44% A. flavus, duas (0,44% Paecilomyces variotii, um (0,22% Rhizomucor sp. e um (0,22% Rhizopus sp. Conclusões: Candida albicans e Aspergillus fumigatus continuam sendo as espécies mais comumente isoladas nas amostras estudadas, entretanto C. kefyr, C. dubliniensis, C. krusei, A. niveus, A. japonicus, Paecilomyces variotii, Rhizomucor sp. e Rhizopus sp. indicam sua importância como patógenos oportunistas, sendo relatadas pela primeira vez em estudo realizado com pacientes acompanhados neste hospital. Houve comprovação de doença em cinco pacientes que realizaram cultura de fragmento de tecido pulmonar das quais foram isolados Candida albicans, Paecilomyces variotii, Rhizopus sp. e Aspergillus fumigatus. Objective: To study the incidence of fungi isolated from samples of bronchoalveolar lavage, lung tissue fragments and sputum of patients from Hospital Otavio de Freitas. Materials and methods: Descriptive retrospective observational study with analysis of records

  15. 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

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

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    Matthew D Stone

    Full Text Available 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.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.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.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.

  17. The effect of using blood culture bottle of bronchoalveolar larvage fluid in pneumonia

    OpenAIRE

    Heo, Eun Young; Shin, Sue; Chung, Hee Soon; Jeong, Yun-Jeong; Oh, So Hee; Kim,Deog Kyeom

    2016-01-01

    Background Pneumonia is a primary cause of morbidity and mortality in infectious disease, and increasing antimicrobial resistance has raised concerns of treatment failure. Therefore, we evaluated the value of a blood culture bottle for bronchoalveolar lavage (BAL) samples on pathogen identification and on treatment modification in patients with pneumonia. Methods We conducted a prospective study and enrolled 39 patients who were hospitalized for pneumonia. Enrolled patients underwent BAL; a 1...

  18. Avaliação citológica de lavados traqueobrônquico e broncoalveolar em cavalos clinicamente sadios pelo método de coloração de Rosenfeld Cytological evaluation of Rosenfeld-stained tracheobronchial washes and bronchoalveolar lavages, in healthy horses

    Directory of Open Access Journals (Sweden)

    W.R. Fernandes

    2000-12-01

    Full Text Available Foram realizados estudos comparativos dos exames citológicos obtidos a partir de amostras dos lavados traqueobrônquico (LTB e broncoalveolar (LBA de cavalos clinicamente sadios. Foram colhidas 25 amostras pela técnica do LTB (25 animais e 25 amostras pela técnica do LBA (5 animais. A suspensão celular dos lavados foi centrifugada, confeccionando-se lâminas coradas pelo método de Rosenfeld. A contagem diferencial mostrou predominância de macrófagos em ambas as técnicas de colheita, confirmando a possibilidade de sua utilização para obter amostras celulares das vias aéreas distais. Observou-se diferença na proporção de macrófagos e linfócitos entre as técnicas dos lavados traqueobrônquico e broncoalveolar. As porcentagens de macrófagos e linfócitos observadas foram de 81,51±11,06% e 2,91±3,44% no LTB e de 54,78±15,92% e 33,70±14,41% no LBA, respectivamente. Também notou-se ausência de células epiteliais cilíndricas e produtoras de muco em LBA, indicando que essas amostras são provenientes da população alveolar e que esta técnica não traumatizou as vias aéreas proximais. Os demais tipos celulares foram identificados em proporções semelhantes e em pequenas quantidades em ambas as técnicas. As características morfológicas dos tipos celulares foram semelhantes nas duas técnicas.Comparisons of tracheobronchial (TBW and bronchoalveolar wash (BAL cytologies, using respectively 25 and 5 normal horses were made. Differential cell counts were made on both TBW and BAL fluids on Rosenfeld-stained cytocentrifuged preparations. Macrophages were the predominant cell types seen in both fluid samples and these findings suggest the possibility of an adequate sampling of the distal air passages. Differences were found in lymphocytes and macrophages between TBW and BAL cytologies. The main cell types in BAL fluids were macrophages (54.78±15.92% and lymphocytes (33.70±14.41%. On the other hand, lymphocytes and macrophages

  19. Association of bronchoalveolar lavage yield with chest computed tomography findings and symptoms in immunocompromised patients

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    Kyle R Brownback

    2013-01-01

    Conclusion: CT findings of reticular and nodular infiltrates portend a worse diagnostic yield from BAL than those that are alveolar in nature. Symptomatic patients are more likely to have diagnostic FOB with BAL than asymptomatic patients.

  20. The role of selected cytokines and proteins analyzed in bronchoalveolar lavage fluid in lung injury

    Directory of Open Access Journals (Sweden)

    Monika Jedynak

    2014-06-01

    Full Text Available The early organism response to injury or infection involves activation of the innate immune system, in which pattern recognition receptors (PRRs participate. They recognize highly conservative structures that are called pathogen-associated molecular patterns (PAMPs and damage-associated molecular patterns (DAMPs. The interactions between PRRs and PAMPs or DAMPs lead to the activation of transcriptional factors which are responsible for gene expression of inflammatory mediators and synthesis and release of these factors, and result in the development of inflammation. RAGE (receptor for advanced glycation end products and CD163 belonging to PRRs play a significant role in the early immune response in lungs. They are expressed on alveolar epithelial cells and alveolar macrophages, respectively. NK cells are also involved in lung response to injury, though their maturation and the ability to express PRRs depend on the presence of IL-15. Detailed knowledge about these factors enables us to understand the signal pathways that are activated in the course of infectious and noninfectious lung injury. The analysis of these proteins’ concentrations in body fluids creates new possibilities in monitoring lung injury and predicting the results of treatment. In the future, the discussed mediators may become the targets for new forms of treatment in life-threatening respiratory diseases.

  1. 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

    was performed. The sensitivity and specificity were 85 and 100% 934/40 and 77/77) respectively. A non-radioactive labelling system BluGENE was evaluated on all specimens, and found to be as effective as P32-labelling. To increase the speed and convenience of detection, a dot blot system was tested...

  2. Neutrophil chemotactic activity in bronchoalveolar lavage fluid of patients with AIDS-associated Pneumocystis carinii pneumonia

    DEFF Research Database (Denmark)

    Benfield, T L; Kharazmi, A; Larsen, C G

    1997-01-01

    been shown to confer a poor prognosis in PCP. We therefore investigated the potential of BAL fluid from 17 patients with PCP to induce neutrophil chemotaxis. BAL fluid from patients induced considerable neutrophil chemotactic activity compared to normal controls. Elevated levels of IL-8 were detected...... in patient samples as compared to controls. A specific anti-IL-8 antibody significantly reduced chemotactic activity of patient samples by more than 50%. In conclusion, IL-8 appears to be a significant participant of neutrophil chemotaxis in AIDS-associated PCP, and may participate in the recruitment...

  3. Serum and Bronchoalveolar Lavage Fluid Endothelin‐1 Concentrations as Diagnostic Biomarkers of Canine Idiopathic Pulmonary Fibrosis

    National Research Council Canada - National Science Library

    Krafft, E; Heikkilä, H.P; Jespers, P; Peeters, D; Day, M.J; Rajamäki, M.M; Mc Entee, K; Clercx, C

    2011-01-01

    Background: Diagnosis of canine idiopathic pulmonary fibrosis (IPF) is challenging. Endothelin‐1 (ET1) is a biomarker of IPF in humans, but whether ET1 can detect and differentiate IPF from other canine respiratory diseases is unknown...

  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. Bronchoalveolar inflammation after exposure to diesel exhaust: comparison between unfiltered and particle trap filtered exhaust.

    Science.gov (United States)

    Rudell, B; Blomberg, A; Helleday, R; Ledin, M C; Lundbäck, B; Stjernberg, N; Hörstedt, P; Sandström, T

    1999-08-01

    Air pollution particulates have been identified as having adverse effects on respiratory health. The present study was undertaken to further clarify the effects of diesel exhaust on bronchoalveolar cells and soluble components in normal healthy subjects. The study was also designed to evaluate whether a ceramic particle trap at the end of the tail pipe, from an idling engine, would reduce indices of airway inflammation. The study comprised three exposures in all 10 healthy never smoking subjects; air, diluted diesel exhaust, and diluted diesel exhaust filtered with a ceramic particle trap. The exposures were given for 1 hour in randomised order about 3 weeks apart. The diesel exhaust exposure apperatus has previously been carefully developed and evaluated. Bronchoalveolar lavage was performed 24 hours after exposures and the lavage fluids from the bronchial and bronchoalveolar region were analysed for cells and soluble components. The particle trap reduced the mean steady state number of particles by 50%, but the concentrations of the other measured compounds were almost unchanged. It was found that diesel exhaust caused an increase in neutrophils in airway lavage, together with an adverse influence on the phagocytosis by alveolar macrophages in vitro. Furthermore, the diesel exhaust was found to be able to induce a migration of alveolar macrophages into the airspaces, together with reduction in CD3+CD25+ cells. (CD = cluster of differentiation) The use of the specific ceramic particle trap at the end of the tail pipe was not sufficient to completely abolish these effects when interacting with the exhaust from an idling vehicle. The current study showed that exposure to diesel exhaust may induce neutrophil and alveolar macrophage recruitment into the airways and suppress alveolar macrophage function. The particle trap did not cause significant reduction of effects induced by diesel exhaust compared with unfiltered diesel exhaust. Further studies are warranted to

  6. 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. N......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...

  7. Characterization of inflammation in a rat model of acute lung injury after repeated pulmonary lavage.

    Science.gov (United States)

    Menk, Mario; Graw, Jan Adriaan; Steinkraus, Henrik; Haefen, Clarissa von; Sifringer, Marco; Spies, Claudia D; Lachmann, Burkhard; Schwaiberger, David

    2015-01-01

    Repeated pulmonary lavage allows to reliably reproduce failure of gas exchange and major histological findings of acute lung injury (ALI). However, because the capacity of pulmonary lavage to induce pulmonary inflammation is not well established in rodents, this study aims to characterize the induction of pulmonary inflammation in a rat model of ALI. Male adult rats were divided into a treatment group (n = 9) that received pulmonary lavage with consecutive mechanical ventilation, and a control group that received mechanical ventilation only (n = 9). Arterial blood gas analyses were performed every 30 min throughout the study. Pressure-volume curves, and lung tissue and plasma samples, were obtained at 240 min after the start of mechanical ventilation. Protein content and surface activity of bronchoalveolar lavage fluid was assessed. Transcriptional and translational regulation of pro- and anti-inflammatory cytokines IL-1β, TNF-α, IL-6, and IL-10 was determined in lungs and plasma. Markers of cellular stress were measured in lung tissue. Pulmonary lavage significantly decreased lung compliance, induced hypoxia and hypercapnia, and mediated respiratory acidosis. Protein content of lavage fluid was significantly increased and contained washed out surfactant. Expression of IL-1β, TNF-α, and IL-6 mRNA and protein expression of IL-1β and TNF-α was significantly induced in lavaged lungs, without spillover into the systemic circulation. Markers of cellular stress were significantly upregulated in lavaged lungs. This model of ALI applied in rats can induce pulmonary inflammation. The model might be used to develop therapeutic strategies that target pulmonary inflammation in ALI.

  8. MAP KINASE SIGNALING IN PULMONARY FIBROBLASTS EXPOSED TO PARTICULATE MATTER (PM) AND BRONCHOAL VEOLAR LAVAGE FLUID (BALF) FROM HEALTHY AND HYPERTENSIVE RATS

    Science.gov (United States)

    MAP KINASE SIGNALING IN PULMONARY FIBROBLASTS EXPOSED TO PARTICULATE MATTER (PM) AND BRONCHOALVEOLAR LAVAGE FLUID (BALF) FROM HEALTHY AND HYPERTENSIVE RATS. 1P Zhang, UP Kodavanti. NHEERL, US EPA, Research Triangle Park, 1School of Vet Med, NCSU, Raleigh, NCExposure to PM ma...

  9. Pulmonary alveolar proteinosis and first successful whole lung lavage in Sri Lanka: a case report.

    Science.gov (United States)

    Galhenage, Janith; Weerasinghe, Buddhika; Dilesha, Wadasinghe; Constantine, Roshana; Gunasena, Bandu

    2017-03-08

    Pulmonary alveolar proteinosis is a rare disease characterized by accumulation of lipoproteinaceous material within alveoli. There are three clinically distinct forms: congenital, acquired and secondary. Whole lung lavage is currently the gold standard therapy for severe cases of pulmonary alveolar proteinosis. In Sri Lanka this is the first reported successful whole lung lavage for a patient with pulmonary alveolar proteinosis. We describe the case of a 15-year-old Sri Lankan girl who presented with symptoms of progressive shortness of breath and dry cough for 6 months' duration. She had a history of exposure to silica in her household environment. High-resolution computed tomography revealed crazy paving appearance in both lungs suggestive of pulmonary alveolar proteinosis. An open lung biopsy revealed intra-alveolar granular amphophilic material which was strongly periodic acid-Schiff positive and diastase resistant, which is consistent with pulmonary alveolar proteinosis. She was followed up for 2 years with periodical segmental bronchoalveolar lavages which showed minimal improvement in her symptoms as well as in exercise desaturation. Due to severe dyspnea and hypoxemia on exertion, she underwent whole lung lavage. It resulted in a marked improvement in her symptoms, exercise desaturation, and chest X-ray results. Whole lung lavage was successfully performed for the first time in Sri Lanka for a patient with pulmonary alveolar proteinosis.

  10. 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

    Mediator release was examined from superficially lying cells in the airway epithelium obtained by bronchoalveolar lavage (BAL) in 13 non-atopic individuals. The BAL-cells were incubated (20 min, 37 degrees C) with Staphylococcus (Staph.) aureus or with human influenza A virus Staph. aureus...... 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...

  11. Gastric lavage in patients with acute poisoning

    OpenAIRE

    Montserrat Amigó Tadín

    2012-01-01

    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...

  12. 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.

  13. 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

  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. [Procollagen-III-peptide in bronchoalveolar lavage fluid as an index of fibrosis in sarcoidosis and idiopathic lung fibrosis?].

    Science.gov (United States)

    Teschler, H; Costabel, U; Ziesche, R; Freitag, L; Matthys, H; Konietzko, N

    1990-02-01

    In order to answer the question whether in sarcoidosis and idiopathic pulmonary fibrosis there is a relationship between the activity of alveolitis (T4/T8 ratio in sarcoidosis, number of granulocytes in idiopathic pulmonary fibrosis) and the activity of connective tissue formation (type III procollagen peptide in the BAL fluid) BAL was performed in 12 healthy subjects, 33 patients with type II sarcoidosis, and 26 patients with idiopathic pulmonary fibrosis. In the unconcentrated BAL fluid of the healthy subjects, P3P was not measurable. On the basis of the T4/T8 ratio and P3P in type II sarcoidosis, three groups of patients with possibly different risks of progression were found: 1) T4/T8 normal and P3P not or only mildly elevated, 2) T4/T8 elevated and P3P normal or only mildly elevated, 3) T4/T8 elevated and P3P greatly increased. In patients with idiopathic pulmonary fibrosis, the concentration of P3P correlated significantly with the number of granulocytes and the clinical activity parameters. On the basis of these results, we conclude that P3P levels in the BAL fluid, as a direct measure of connective tissue neogenesis, may be a valuable addition to cellular and immunocytological BAL findings.

  16. Proteomic analysis of bronchoalveolar lavage fluid (BALF from lung cancer patients using label-free mass spectrometry

    Directory of Open Access Journals (Sweden)

    Abduladim Hmmier

    2017-06-01

    General significance: There is good correlation between the trend of protein abundance levels in BALF and that of plasma which validates this approach to develop a blood biomarker to aid lung cancer diagnosis, particularly in the era of lung cancer screening. The protein signatures identified also provide insight into the molecular mechanisms associated with lung malignancy.

  17. A survey on bacterial contamination of lavage water in electric warm-water lavage toilet seats and of the gluteal cleft after lavage.

    Science.gov (United States)

    Katano, Hideki; Yokoyama, Kumi; Takei, Yasushi; Tazume, Seiki; Tsukiji, Mami; Matsuki, Hideaki

    2014-06-01

    Electric warm-water lavage toilet seats are in wide use as an appliance beneficial for the maintenance of hygiene and the prophylaxis and improvement of conditions such as constipation and hemorrhoids. In this study, we surveyed the bacterial content in the lavage water of warm-water lavage toilet seats, and fecal bacterial contamination of the gluteal and genital regions due to droplet infection from post-defecation lavage, to examine the problems inherent to the use of such lavage units. The presence of viable bacteria in lavage water was confirmed in this survey. Viable bacterial counts in lavage water were 3-times higher in household units compared to units in public facilities, suggesting a correlation with the replenishment of lavage tank water with fresh water containing residual free chlorine.

  18. 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.

  19. The effect of using blood culture bottle of bronchoalveolar larvage fluid in pneumonia.

    Science.gov (United States)

    Heo, Eun Young; Shin, Sue; Chung, Hee Soon; Jeong, Yun-Jeong; Oh, So Hee; Kim, Deog Kyeom

    2016-06-06

    Pneumonia is a primary cause of morbidity and mortality in infectious disease, and increasing antimicrobial resistance has raised concerns of treatment failure. Therefore, we evaluated the value of a blood culture bottle for bronchoalveolar lavage (BAL) samples on pathogen identification and on treatment modification in patients with pneumonia. We conducted a prospective study and enrolled 39 patients who were hospitalized for pneumonia. Enrolled patients underwent BAL; a 10-ml aliquot was transferred to a sterile container for standard quantitative culture, and a 5 ml aliquot was transferred to both an aerobic and an anaerobic blood culture bottle. Microbes were detected in all 39 (100 %) specimens and possible pathogens were identified in 34 patients (84.6 %) from BAL blood culture bottles. In contrast, microbes were detected in 10 patients (25.6 %) and possible pathogens were isolated in 8 patients (20.5 %) in BAL fluid using conventional culture methods. Finally, 8 of 39 (20.5 %) patients changed antibiotics according to the BAL blood culture results and pneumonia improved in 6 of these patients. Using blood culture bottles for BAL sampling in patients with pneumonia is a sensitive method to detect pathogens in order to identify an adequate antibiotic treatment regimen.

  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 performed...... because of concurrent diseases and age. Recently, several studies have experimented with laparoscopic lavage as a treatment of acute complicated diverticulitis. The aim of this review was to give an overview of the literature for this new approach and to determine the safety compared with Hartmann......'s procedure for patients with acute complicated sigmoid diverticulitis. METHODS: A PubMed search was performed for publications between 1990 and May 2008. The terms acute, perforated, diverticulitis, lavage, drainage, and laparoscopy were used in combination. The EMBASE and Cochrane databases were also...

  1. Rapid visual colorimetry of peritoneal lavage fluid.

    Science.gov (United States)

    Tandberg, D; Reitmeyer, S T; Cheney, P R

    1990-11-01

    That visual colorimetry can be used to rapidly and precisely estimate the erythrocyte count of 1:5 dilutions of simulated peritoneal lavage fluid. Fifty-four normal adult human subjects. The automated or chamber RBC count is often used on fluid obtained by peritoneal lavage in patients with abdominal trauma to help determine the need for surgery. Unfortunately, this method sometimes results in excessive delay. We designed and built a simple colorimeter that facilitated rapid direct visual comparison of unknown samples with known color standards. A radiograph view box was used as a light source. Standards were prepared in 16-mm glass tubes to simulate peritoneal lavage fluid with RBC counts ranging from 0 to 140,000 in 10,000 cell/microL increments; 1:5 dilutions with water were used throughout to reduce opacity. Thimerosal was added to unknowns and standards to stabilize color; all samples were kept refrigerated at 4 C when not in use. In a double-blind in-vitro study, each subject matched 20 randomly distributed unknowns ranging from 12,000 to 131,000 erythrocytes/microL to the nearest standard. The mean absolute error for all 1,080 determinations was 3,560 RBC/microL (95% CI = 4,290-4,830; SD = 4,560; t = 39.6; df = 1,079; P less than .001). This method correctly predicted the RBC count to within 9,000 cells/microL 95% of the time. Visual comparison of 1:5 dilutions of simulated peritoneal lavage fluid with known color standards can be used to rapidly and precisely estimate the erythrocyte count.

  2. Nitric oxide production by rat bronchoalveolar macrophages or ...

    Indian Academy of Sciences (India)

    Unknown

    contributions of AMs and PMNs to the amounts of NO produced by BAL cells following intratracheal (IT) instillation of ... [Huffman L J, Prugh D J, Millecchia L, Schuller K C, Cantrell S and Porter D W 2003 Nitric oxide production by rat bronchoalveolar macrophages or ..... dase blocking with methanol and H2O2. Slides were ...

  3. Activated charcoal alone or after gastric lavage

    DEFF Research Database (Denmark)

    Christophersen, A B; Levin, D; Høgberg, Lotte Christine Groth

    2002-01-01

    AIMS: Activated charcoal is now being recommended for patients who have ingested potentially toxic amounts of a poison, where the ingested substance adsorbs to charcoal. Combination therapy with gastric lavage and activated charcoal is widely used, although clinical studies to date have...... not provided evidence of additional efficacy compared with the use of activated charcoal alone. There are also doubts regarding the efficacy of activated charcoal, when administered more than 1 h after the overdose. The aim of this study was to examine if there was a difference in the effect of the two...... 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...

  4. Use of urethral catheters for diagnostic peritoneal lavage in blunt ...

    African Journals Online (AJOL)

    Background: Diagnostic peritoneal lavage (DPL) has been reported to be a reliable diagnostic tool in assessing the need for liparotomy in blunt abdominal trauma (BAT) with a diagnostic accuracy of more thin 95% when using a peritoneal lavage catheter (PLC). The aim of this study was to determine the diagnostic ...

  5. 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.

  6. 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.

  7. Effects of roflumilast, a phosphodiesterase-4 inhibitor, on the lung functions in a saline lavage-induced model of acute lung injury.

    Science.gov (United States)

    Kosutova, P; Mikolka, P; Kolomaznik, M; Rezakova, S; Calkovska, A; Mokra, D

    2017-09-22

    Acute lung injury (ALI) is associated with deterioration of alveolar-capillary lining and transmigration and activation of inflammatory cells. Whereas a selective phosphodiesterase-4 (PDE4) inhibitor roflumilast has exerted potent anti-inflammatory properties, this study evaluated if its intravenous delivery can influence inflammation, edema formation, and respiratory parameters in rabbits with a lavage-induced model of ALI. ALI was induced by repetitive saline lung lavage (30 ml/kg). Animals were divided into 3 groups: ALI without therapy (ALI), ALI treated with roflumilast i.v. (1 mg/kg; ALI+Rofl), and healthy ventilated controls (Control), and were ventilated for following 4 h. Respiratory parameters (blood gases, ventilatory pressures, lung compliance, oxygenation indexes etc.) were measured and calculated regularly. At the end of experiment, animals were overdosed by anesthetics. Total and differential counts of cells in bronchoalveolar lavage fluid (BAL) were estimated microscopically. Lung edema was expressed as wet/dry lung weight ratio. Treatment with roflumilast reduced leak of cells (P<0.01), particularly of neutrophils (P<0.001), into the lung, decreased lung edema formation (P<0.01), and improved respiratory parameters. Concluding, the results indicate a future potential of PDE4 inhibitors also in the therapy of ALI.

  8. Contrasting bronchoalveolar leuk ocyte responses in rats inhaling coal mine dust, quartz, or titanium dioxide: Effects of coal rank, airborne mass concentration, and cessation of exposure

    Energy Technology Data Exchange (ETDEWEB)

    Donaldson, K.; Brown, G.M.; Brown, D.M.; Robertson, M.D.; Slight, J.; Cowie, H.; Jones, A.D.; Bolton, R.E.; Davis, J.M.G. (Institute of Occupational Medicine, Edinburgh (UK))

    1990-06-01

    The aim of this study was to determine the bronchoalveolar leukocyte response to airborne coal mine dust; quartz and titanium dioxide were used as positive and negative controls, respectively. Groups of rats were exposed to airborne mass concentrations of 10 and 50 mg/m{sup 3} of the dusts for 7 hr/day, 5 days/week and their bronchoalveolar space was lavaged at time points between 2 and 75 days of exposure, to assess the leukocyte response. This study revealed time-dependent and airborne mass concentration-dependent recruitment of neutrophils and macrophages into the bronchoalveolar region with coal mine dust inhalation but no real difference in the magnitude of the response between coal mine dusts from collieries mining coal of different rank and quartz content although the maximum quartz content in the dusts used was 6%. The inflammatory response was much less than that produced by quartz, at similar airborne mass concentrations, and more than that produced by titanium dioxide which was, in general, a poor inflammogen in the rat lung. Groups of rats were exposed to the airborne dusts for 32 or 75 days, then removed from the exposure chambers, and allowed to recover by breathing room air for a further 64 days. During this recovery period there was marked progression of the leukocyte response with quartz and persistence of the response with coal mine dust. Chronic recruitment of leukocytes to the lungs of individuals inhaling coal mine dust is likely to be an important factor in the development of coal workers' pneumoconiosis. 39 refs., 4 figs., 3 tabs.

  9. 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.

  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.J.A.; Templeton, K.E.; Bakkers, J.M.J.E.; Kuijper, E.J.; Melchers, W.J.G.; Drent, M.; Vink, C.W.

    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

  11. Laboratory diagnosis of pulmonary tuberculosis in TB and HIV endemic settings and the contribution of real time PCR for M. tuberculosis in bronchoalveolar lavage fluid.

    NARCIS (Netherlands)

    Kibiki, G.S.; Mulder, B.; Ven, A.J.A.M. van der; Sam, N.; Boeree, M.J.; Zanden, A. van der; Dolmans, W.M.V.

    2007-01-01

    BACKGROUND: Tuberculosis (TB) in Africa is increasing because of the human immunodeficiency virus (HIV) epidemic, and in HIV/AIDS patients it presents atypically. Pulmonary tuberculosis (PTB) in Africa is mainly diagnosed clinically, by chest radiograph or by sputum smear for acid fast bacilli

  12. Bronchoalveolar lavage fluid surfactant protein-A and surfactant protein-D are inversely related to inflammation in early cystic fibrosis

    NARCIS (Netherlands)

    Noah, TL; Murphy, PC; Alink, JJ; Leigh, MW; Hull, WM; Stahlman, MT; Whitsett, JA

    2003-01-01

    The pulmonary collectins surfactant protein (SP)-A and SP-D play important roles in innate lung defense, enhancing opsonization of microbes and limiting lung inflammatory responses. To quantify relationships among collectins, bacteria, and inflammation in early cystic fibrosis (CF) airway

  13. 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

    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

  14. 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...

  15. A unique presentation of pulmonary disease in advanced systemic mastocytosis, proven by the presence of mast cells in bronchoalveolar lavage: A case report

    NARCIS (Netherlands)

    M.A.W. Hermans (Maud A.W.); A. Broijl (Annemiek); P.L.A. van Daele (Paul)

    2016-01-01

    textabstractBackground: Systemic mastocytosis is a rare myeloproliferative disease characterized by the uncontrolled proliferation of aberrant mast cells. It has varying clinical manifestations. For unknown reasons, pulmonary localization of mastocytosis is extremely rare. Case presentation: In this

  16. Detection of Charcot-Leyden crystals by fluorescence microscopy of Papanicolaou-stained smears of sputum, bronchoalveolar lavage fluid, and bronchial secretions.

    Science.gov (United States)

    Küpper, T; Spies, S; Wehle, K; Pfitzer, P

    1994-10-01

    Fluorescence microscopy was used to examine Papanicolaou-stained smears of sputum and other secretions from the respiratory tract. Under these conditions Charcot-Leyden crystals (CLC) appear as bright yellow-green fluorescing needles. The study was performed to determine the value of this approach for the diagnosis of allergic lung diseases. The time taken to detect the crystals was recorded and the sensitivity of fluorescence microscopy for the detection of CLC was compared with light microscopy of the same samples. The data show that fluorescence microscopy is superior to light microscopy for the detection of CLC. The characteristic needle-shaped crystal can be recognized easily and fragments of crystals could be easily identified. In doubtful cases of allergic lung diseases, fluorescence microscopy may be used to supplement light microscopy for the detection of Charcot-Leyden crystals.

  17. Comparative evaluation of galactomannan test with bronchoalveolar lavage and serum for the diagnosis of invasive aspergillosis in patients with hematological malignancies

    Directory of Open Access Journals (Sweden)

    Ankit Gupta

    2017-01-01

    Conclusions: Our results support BAL GM testing as a reasonably safe test with higher sensitivity compared to serum GM testing in at-risk patients with hematological diseases. A higher OD cutoff is necessary to avoid overdiagnosis of IPA.

  18. 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...... lavage with open colon resection and colostomy (Hartmann procedure) for perforated diverticulitis with purulent peritonitis. DESIGN: Randomized, controlled, multicenter, open-label trial. (ISRCTN registry number: ISRCTN82208287). SETTING: 9 hospitals in Sweden and Denmark. PATIENTS: Patients who have...... confirmed Hinchey grade III perforated diverticulitis with purulent peritonitis at diagnostic laparoscopy. INTERVENTION: Randomization between laparoscopic lavage and the Hartmann procedure. MEASUREMENTS: Primary outcome was the percentage of patients having 1 or more reoperations within 12 months. Key...

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

    DEFF Research Database (Denmark)

    Thornell, Anders; Angenete, Eva; Gonzales, Elisabeth

    2011-01-01

    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...... 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...

  20. Enhanced proliferation and decreased apoptosis in lung lavage cells of sarcoidosis patients.

    Science.gov (United States)

    Petzmann, Susanna; Maercker, Christian; Markert, Eva; Kern, Izidor; Osolnik, Katharina; Pohl, Wolfgang; Popper, Helmut H

    2006-10-01

    Sarcoidosis is a systemic autoimmune disease where an inflammatory reaction involving alveolar macrophages, T-helper lymphocytes, and epitheloid cells is mounted against unknown antigens. A genetic predisposition for sarcoidosis is supposed by studies in twins, by geographical and racial distribution. In the current investigation we compared the expression patterns between slow onset and acute sarcodosis using a whole-genome cDNA array. Bronchoalveolar lavage was performed in six patients with slow onset sarcoidosis and four patients with acute sarcoidosis (Löfgren's disease) and obtained cells were used for gene expression profiling. The results were confirmed by RT- and Taqman-PCR. In addition, protein expression was examined on paraffin sections of sarcoid granulomas by immunohistochemistry. In T-helper lymphocytes and alveolar macrophages we found an upregulation of genes belonging to the phosphoinositol-3-kinase/v-akt murine thymoma viral oncogene homolog/signal transducer and activator of transcription 3 pathway, as well as a downregulation of genes of the extrinsic and intrinsic apoptotic signaling cascades. In addition an upregulation of the genes encoding fatty acid binding protein 4 and 5, as well as peroxisome proliferative activated receptor delta in Löfgren's disease was detected. Differences in gene expression between slow onset sarcoidosis and Löfgren's syndrome were found mainly within genes of the major histocompatibility complex. In sarcoidosis enhanced cell proliferation and decreased apoptosis result in accumulation and prolonged survival of antigen-primed T-helper lymphocytes and activated macrophages. This is enhanced in Löfgren's disease, probably by hyper-stimulation via the peroxisome proliferation signaling, providing a larger pool of antigen-primed immune cells.

  1. 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

  2. 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.

  3. Laparoscopic peritoneal lavage for perforated colonic diverticulitis: a systematic review

    NARCIS (Netherlands)

    Toorenvliet, Boudewijn R.; Swank, Hilko; Schoones, Jan W.; Hamming, Jaap F.; Bemelman, Willem A.

    2010-01-01

    Aim This systematic review aimed to evaluate the efficacy, morbidity and mortality of laparoscopic peritoneal lavage for patients with perforated diverticulitis. Method We searched PubMed, EMBASE, Web of Science, the Cochrane Library and CINAHL databases, Google Scholar and five major publisher

  4. Peritoneal Lavage in Complicated Acute Diverticulitis: Back to the Future.

    Science.gov (United States)

    Escalante G, Ricardo; Bustamante-Lopez, Leonardo; Lizcano, Ana; Acosta M, Bernardo

    2016-10-01

    The aim of this study was to assess laparoscopic lavage in patients with acute diverticulitis. In recent times, laparoscopic peritoneal lavage has been considered a therapeutic alternative to standard resection procedures. In Hinchey III diverticulitis there is the possibility of avoiding ostomies or resection procedures. This retrospective study was conducted in a single-care institution. Patients requiring emergency surgery for perforated diverticulitis and generalized peritonitis between March 2011 and May 2014 were identified from a prospective database. Seventy-two patients underwent surgery for diverticulitis. Forty-three patients presented with generalized peritonitis (Hinchey III) and 29 with gross fecal contamination (Hinchey IV). From the Hinchey III group, 17 patients (39.5%), with a median age of 56.8 years, were selected to undergo peritoneal lavage.Postoperative length of stay was 4.2 days, the rate of minor complications was 35%, that of major complications was 0%, and mortality rate was 0%. Over a median follow-up of 24.6 months none required reoperation. The number of patients selected for laparoscopic lavage in the management of perforated diverticulitis is increasing as it provides an alternative to Hartmann's procedure in emergency cases. This approach should be considered suitable for patients without important comorbidities, and only in centers experienced in laparoscopic surgery. It reduces the length of hospital stay. Morbidity and mortality are lower than in those in whom resection was considered necessary. Longer follow-up and results of other trials will be necessary to draw an adequate conclusion.

  5. Effects of hyperthermic intraoperative peritoneal lavage on intra ...

    African Journals Online (AJOL)

    Background: Hyperthermic Intraoperative Peritoneal Lavage (HIPL) is useful for bacterial decontamination and prevention of hypothermia during damage-control surgery (DCS). Little is known about the effect of HIPL on intraabdominal pressure (IAP) alone or in combination with peritonitis. Aim: To determine the effects of ...

  6. 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.

  7. Mass spectrometry profiling of oxylipins, endocannabinoids, and N-acylethanolamines in human lung lavage fluids reveals responsiveness of prostaglandin E2 and associated lipid metabolites to biodiesel exhaust exposure.

    Science.gov (United States)

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

    2017-04-01

    The adverse effects of petrodiesel exhaust exposure on the cardiovascular and respiratory systems are well recognized. While biofuels such as rapeseed methyl ester (RME) biodiesel may have ecological advantages, the exhaust generated may cause adverse health effects. In the current study, we investigated the responses of bioactive lipid mediators in human airways after biodiesel exhaust exposure using lipidomic profiling methods. Lipid mediator levels in lung lavage were assessed following 1-h biodiesel exhaust (average particulate matter concentration, 159 μg/m 3 ) or filtered air exposure in 15 healthy individuals in a double-blinded, randomized, controlled, crossover study design. Bronchoscopy was performed 6 h post exposure and lung lavage fluids, i.e., bronchial wash (BW) and bronchoalveolar lavage (BAL), were sequentially collected. Mass spectrometry methods were used to detect a wide array of oxylipins (including eicosanoids), endocannabinoids, N-acylethanolamines, and related lipid metabolites in the collected BW and BAL samples. Six lipids in the human lung lavage samples were altered following biodiesel exhaust exposure, three from BAL samples and three from BW samples. Of these, elevated levels of PGE 2 , 12,13-DiHOME, and 13-HODE, all of which were found in BAL samples, reached Bonferroni-corrected significance. This is the first study in humans reporting responses of bioactive lipids following biodiesel exhaust exposure and the most pronounced responses were seen in the more peripheral and alveolar lung compartments, reflected by BAL collection. Since the responsiveness and diagnostic value of a subset of the studied lipid metabolites were established in lavage fluids, we conclude that our mass spectrometry profiling method is useful to assess effects of human exposure to vehicle exhaust.

  8. Plaidoyer pour le lavage de nez dans les pathologies naso ...

    African Journals Online (AJOL)

    Après l'avènement des antibiotiques et leur utilisation massive avec des résultats variables, probants dans certains cas mais mitigés dans d'autres, de nombreuses thérapeutiques adjuvantes ont été proposées ou associées dont le lavage de nez au sérum physiologique qui est d'un appoint voire d'un apport considérable ...

  9. Clearance of 99mTc DTPA from guinea pig nasal, tracheobronchial, and bronchoalveolar airways.

    Science.gov (United States)

    Greiff, L; Wollmer, P; Erjefält, I; Pipkorn, U; Persson, C G

    1990-01-01

    Technetium-99m labelled diethylenetriamine penta-acetate (99mTc-DTPA) was used to compare small solute absorption (clearance) from nasal, tracheobronchial, and bronchoalveolar airways in anaesthetised guinea pigs. 99mTc DTPA dissolved in saline was superfused through nasal and orolaryngeal catheters on to nasal and tracheobronchial airways; a small particle aerosol of nebulised 99mTc DTPA was delivered to the bronchoalveolar airways through a tracheostomy. Radioactivity over the appropriate region was then determined with a gamma camera. Mucociliary transport of 99mTc DTPA appeared not to contribute to the disappearance of 99mTc DTPA. Time-activity curves were obtained and half life values calculated by fitting a monoexponential equation to the experimental data. A progressive reduction in 99mTc DTPA was recorded from the nasal and tracheobronchial airways and from the bronchoalveolar airway, suggesting that absorption was occurring. The disappearance of 99mTc DTPA was fastest from the bronchoalveolar region, which also had the largest mucosal surface. The similar shape of the retention curves for the nasal and tracheobronchial regions suggests that the characteristics of nasal absorption of 99mTc DTPA could prove applicable to the tracheobronchial region. It is proposed that the present methods are suited for comparing the pharmacology of small solute absorption across nasal, tracheobronchial, and bronchoalveolar airway mucosa. Images PMID:2256011

  10. 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

  11. Circulating and broncho-alveolar interleukin-6 in relation to body temperature in an experimental model of bovine Chlamydia psittaci infection.

    Science.gov (United States)

    Prohl, Annette; Ostermann, Carola H; Rummel, Christoph D; Roth, Joachim; Reinhold, Petra

    2017-01-01

    In rodent models of experimentally induced fever, the important role of interleukin-6 (IL-6) as a circulating endogenous pyrogen is well established. Studies employing larger animal species and real infections are scarce. Therefore, we assessed bioactive IL-6 in peripheral blood and in broncho-alveolar lavage fluid (BALF) of calves after intra-bronchial inoculation with vital Chlamydia psittaci (Cp), with inactivated Cp, or with BGM cells. Only calves inoculated with vital Cp developed fever (peak at 2-3 days after challenge) and significantly increased IL-6 activity. Controls inoculated with either inactivated Cp or BGM cells also expressed increased bioactive IL-6, but no fever developed. Activity of IL-6 in BALF was significantly higher compared to blood serum. This experimental model of Cp infection revealed no apparent relation between IL-6 in blood and body temperature, but did reveal a relation between IL-6 and other markers of inflammation in BALF. We conclude that a local inflammatory response in the lungs of infected calves caused fever, which developed by mechanisms including other mediators besides IL-6.

  12. Circulating and broncho-alveolar interleukin-6 in relation to body temperature in an experimental model of bovine Chlamydia psittaci infection.

    Directory of Open Access Journals (Sweden)

    Annette Prohl

    Full Text Available In rodent models of experimentally induced fever, the important role of interleukin-6 (IL-6 as a circulating endogenous pyrogen is well established. Studies employing larger animal species and real infections are scarce. Therefore, we assessed bioactive IL-6 in peripheral blood and in broncho-alveolar lavage fluid (BALF of calves after intra-bronchial inoculation with vital Chlamydia psittaci (Cp, with inactivated Cp, or with BGM cells. Only calves inoculated with vital Cp developed fever (peak at 2-3 days after challenge and significantly increased IL-6 activity. Controls inoculated with either inactivated Cp or BGM cells also expressed increased bioactive IL-6, but no fever developed. Activity of IL-6 in BALF was significantly higher compared to blood serum. This experimental model of Cp infection revealed no apparent relation between IL-6 in blood and body temperature, but did reveal a relation between IL-6 and other markers of inflammation in BALF. We conclude that a local inflammatory response in the lungs of infected calves caused fever, which developed by mechanisms including other mediators besides IL-6.

  13. Detection of bovine leukosis virus in bronchoalveolar lung washings and nasal secretions.

    Science.gov (United States)

    Roberts, D H; Lucas, M H; Wibberley, G; Bushnell, S

    1982-11-27

    Cattle and sheep persistently infected with bovine leukosis virus (BLV) were studied for the presence of the virus in bronchoalveolar lung washings and nasal secretions. The virus was demonstrated in the cellular fraction of the lung washings in six out of nine cattle and in one out of six sheep. In no instance was bovine leukosis isolated from the cell-free bronchoalveolar lung washings. The virus was isolated from the nasal secretion of only one of six naturally infected milking cows despite frequent sampling; the virus-infected nasal secretion was from a sick 10-year-old cow. Bovine leukosis virus was not isolated from cellular fractions of nasal secretions.

  14. Arthrocentesis and lavage for treating temporomandibular joint disorders.

    Science.gov (United States)

    Guo, Chunlan; Shi, Zongdao; Revington, Peter

    2009-10-07

    Temporomandibular joint disorders are important oral health problems, reducing the quality of life of sufferers. It has been estimated that approximately 20% to 30% of the adult population will experience temporomandibular joint dysfunction. Arthrocentesis and lavage has been used to treat temporomandibular joint disorders for about 10 years, but the clinical effectiveness of the therapy has not been summarized in the form of a systematic review. To assess the effectiveness and complications of arthrocentesis and lavage for the treatment of temporomandibular joint disorders compared with controlled interventions. The Cochrane Oral Health Group's Trials Register (to August 2009), CENTRAL (The Cochrane Library 2009, Issue 3), MEDLINE (1950 to August 2009), EMBASE (1980 to August 2009), OpenSIGLE (to August 2009), CBMdisc (1981 to 2007 (in Chinese)) and Chinese Medical Library were searched. All the Chinese professional journals in the oral health field were handsearched and conference proceedings consulted. There was no language restriction. All randomised controlled trials (RCTs) (including quasi-randomised clinical trials) aiming to test the therapeutic effects of arthrocentesis and lavage for treating temporomandibular joint disorders. Two review authors independently extracted data, and three review authors independently assessed the risk of bias of included trials. The first authors of the selected articles were contacted for additional information. Two trials, at unclear to high risk of bias, were included in the review. The two trials, including 81 patients with temporomandibular joint disorders, compared arthrocentesis with arthroscopy. No statistically significant difference was found between the interventions in terms of pain. However, a statistically significant difference in favour of arthroscopy was found in maximum incisal opening (MIO) (weighted mean difference of -5.28 (95% confidence interval (CI) -7.10 to -3.46)).Mild and transient adverse reactions

  15. Therapeutic whole lung lavage for inhaled plutonium oxide revisited

    Energy Technology Data Exchange (ETDEWEB)

    Morgan, C [Anaesthesia and Critical Care Medicine, Royal Brompton Hospital, Sydney Street, London SW3 6NP (United Kingdom); Bingham, D; Jones, D M; Lewis, N J [Atomic Weapons Establishment, Aldermaston RG7 4PR (United Kingdom); Holt, D C B, E-mail: nick.lewis@awe.co.uk [Institute of Naval Medicine, Alverstoke, Gosport PO12 2DL (United Kingdom)

    2010-12-01

    Two reviews in the last 12 years have differed widely in their indications for the use of whole lung lavage (WLL) to remove plutonium from the lung, one recommending its use at relatively low radiation doses to prevent stochastic effects and the other recommending restricting its use to high doses to prevent deterministic effects only. Since the publication of these reviews significant data have accumulated demonstrating the increased safety of WLL, and there are additional data on stochastic and deterministic effects. We discuss deterministic and stochastic risks and the practical aspects of undertaking WLL. We recommend that each case be assessed individually.

  16. Middle meatal vs antral lavage cultures in intensive care unit patients.

    Science.gov (United States)

    Kountakis, Stilianos E; Skoulas, Ioannis G

    2002-04-01

    The study goal was to compare endoscopically guided middle meatal cultures with cultures of antral lavage aspirate in intensive care unit (ICU) patients with sinusitis. Prospective study of febrile ICU patients seen for sinusitis at a tertiary medical center. Of 31 antral lavages performed in 18 patients, 19 lavages yielded purulent or mucopurulent aspirate. Endoscopically guided middle meatal cultures yielded the same pathogen, as did cultures of the lavage aspirate in 4 (21%) of these 19 cases. The antral lavage was negative (absence of purulent/mucopurulent aspirate) in 12 cases, and of those, 5 (42%) of the 12 middle meatal cultures showed no growth (sensitivity = 21%, specificity = 58%, chi(2)-1.52, P = 0.218). Endoscopically guided middle meatal cultures did not correlate well with cultures from the antral lavage aspirate in febrile ICU patients evaluated for sinusitis.

  17. Adherence to international recommendations for gastric lavage in medical drug poisonings in Denmark 2007-2010

    DEFF Research Database (Denmark)

    Westergaard, Bo; Høgberg, Lotte Christine Groth; Groenlykke, Thor Buch

    2012-01-01

    Recent reviews strongly discourage the routine use of gastric lavage in oral poisonings, but the authors suspected that gastric lavage might still be in widespread use in Denmark. We wished to estimate the extent to which gastric lavage in cases of medical drug poisoning, reported in inquiries...... to the Danish Poison Information Centre (DPIC) from 2007 to 2010, was performed according to international recommendations and whether adherence to recommendations improved over the period....

  18. Assessment of the efficacy of joint lavage versus joint lavage plus corticoids in patients with osteoarthritis of the knee.

    Science.gov (United States)

    Frías, Gabriel; Caracuel, Miguel Angel; Escudero, Alejandro; Rumbao, Jose; Pérez-Gujo, Veronica; del Carmen Castro, Maria; Font, Pilar; González, José; Collantes, Eduardo

    2004-06-01

    Joint lavage (JL), involves the passage of cold sterile 0.9% saline through the knee joint in order to have the fluid reach the inside of the joint capsule. This technique was evaluated as a local treatment for osteoarthritis (OA) of the knee alone (JL) and in combination with intra-articular infiltration with glucocorticoids (JLC). An overall 299 knees belonging to 205 patients (22% males, 78% females) with a mean age of 67 +/- 8 years and osteoarthritis of the knee of radiological grade II or III on the Kellgren scale were randomised in the ratio of 1:4 into two therapeutic groups, namely: JL (n = 62) and JLC (n = 237). All patients received joint lavage on day 0; in those of the JLC group, joint lavage was followed by infiltration of 40 mg of triamcinolone acetonide. The efficacy of both treatments was assessed by recording the corresponding values for the following variables: pain strength as measured by a visual analogy scale (VAS), effusion, crepitation, restricted motion, of osteoarthritis of the knee. spontaneous pain, pain on pressure, pain on passive motion and pain on active motion; all of these were recorded at the onset of the study, and after 1 and 3 months. There were no significant differences in the values of the variables at the different followup times. Also, pain severity was similar in both treatment groups. Thus, VAS for pain was 7.3 +/- 0.3 for the JL group and 7.1 +/- 0.2 for the JLC group at the onset, and decreased to 3.0 +/- 0.3 in the former and 2.8 +/- 0.2 in the latter after 1 month; the decrease was statistically significant in both cases. After 3 months, the JL and JLC groups had a VAS of 3.5 +/- 0.3 and 3.8 +/- 0.2, respectively. The results of this work suggest the absence of significant differences between the two treatments, such that both joint lavage alone and with infiltration with corticoids can be concluded as similarly effective for the symptomatic management

  19. 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.

  20. Levels of IL-32 in Serum, Induced Sputum Supernatant, and Bronchial Lavage Fluid of Patients with Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Gasiuniene, Edita; Lavinskiene, Simona; Sakalauskas, Raimundas; Sitkauskiene, Brigita

    2016-10-01

    Interleukin-32 (IL-32) is a newly described cytokine which is expected to have an important role in autoimmune disorders. It was shown that chronic obstructive pulmonary disease (COPD) has a component of autoimmunity, though the role of IL-32 in its pathogenesis is not known. The aim of this study was to estimate IL-32 concentrations in serum, induced sputum (IS) supernatant and bronchoalveolar lavage (BAL) fluid from patients with COPD, and to compare asthma patients with and healthy subjects. Outpatients with COPD (63.7 ± 8.4 years, n = 51), asthma (58.3 ± 12.4 years, n = 31), and healthy subjects (59.8 ± 8.2 years, n = 9) were studied. The levels of IL-32 in serum, BAL fluid, and IS supernatant samples were analyzed by ELISA. Concentrations of IL-32 were higher in all the studied materials from patients with COPD (BAL 22.46 ± 2.48 pg/ml, IS 19.66 ± 1.69 pg/ml, serum 26.77 ± 2.56 pg/ml) in comparison with patients with asthma (BAL 6.25 ± 1.08 pg/ml, IS 5.82 ± 1.15 pg/ml, serum 6.09 ± 1.16 pg/ml, p 32 was higher in COPD smokers than in COPD ex-smokers in investigated respiratory tissue compartments and serum, and correlated with smoking history. Increased level of IL-32 in serum, IS supernatant, and BAL fluid from patients with COPD in comparison with asthma patients and healthy subjects suggest that IL-32 may play an important role in the pathogenesis of COPD, which depends on the smoking history.

  1. Bronchoalveoloar lavage fluid cytokines and chemokines as markers and predictors for the outcome of interstitial lung disease in systemic sclerosis patients

    Science.gov (United States)

    Schmidt, Katrin; Martinez-Gamboa, Lorena; Meier, Susan; Witt, Christian; Meisel, Christian; Hanitsch, Leif G; Becker, Mike O; Huscher, Doerte; Burmester, Gerd R; Riemekasten, Gabriela

    2009-01-01

    Introduction Interstitial lung disease (ILD) is a frequent manifestation of systemic sclerosis (SSc), and cytokines can contribute to the disease pathology. The aim of the current study was to identify specific changes in cytokine levels that may serve as disease markers and possible targets for therapy. Methods Cytokines were measured with bioplex analysis in 38 bronchoalveolar fluids (BALFs) from 32 SSc patients (27 with alveolitis and 11 without alveolitis) and 26 control patients. In the case of SSc patients, cytokines were correlated with the respective bronchoalveolar lavage (BAL) cell differentiation, lung function, and thoracic HR-CT score. For 35 BALF samples derived from 29 SSc patients, follow-up investigations of clinical data, lung-function parameter, or thoracic HR-CT scans were available to evaluate the predictive capacity of BALF cytokines and chemokines. Results High IL-7 levels were characteristic of SSc-associated interstitial lung disease (ILD) and, in addition, when compared with ILD-negative SSc patients, ILD-positive SSc patients revealed higher IL-4, IL-6, IL-8, and CCL2 (MCP-1) BALF levels. High CCL2 and IL-8 BALF concentrations were associated with neutrophilic and mixed alveolitis. Cytokine levels of IL-4, IL-8, and CCL2 correlated negatively with lung-function parameters; CCL2 concentrations also correlated with HR-CT scores. High concentrations of several cytokines were associated with the progress of ILD and end-stage ILD. Univariate analyses revealed high IL-2 and tumor necrosis factor-alpha (TNF-α) levels as the best predictors for progressive disease, together with lung-function parameters, young age, and neutrophilic alveolitis. Multivariate analyses partially confirmed these results but did not sufficiently converge because of the limited number of patients. Conclusions The association of BALF cytokines with lung fibrosis and its progress suggests that cytokines contribute to the pathogenesis of ILD and hence could be regarded as

  2. 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...... the effect of intranasal azelastine or systemic cetirizine (both potent antihistamines) on the allergen-induced release of mast-cell mediators from the human nasal mucosa in vivo. METHODS: Patients allergic to birch pollen (n = 11) and control subjects not allergic to birch pollen (n = 5) were included......, 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...

  3. AUTOMATIC SEGMENTATION AND CLASSIFICATION OF CELLS FROM BRONCHO ALVEOLAR LAVAGE

    Directory of Open Access Journals (Sweden)

    Olivier Lezoray

    2011-05-01

    Full Text Available Broncho alveolar lavage is the most commonly used diagnostic tool for confirming alveolar hemorrhage. Golde has introduced a ranking score, based on the hemosiderin content of macrophages which enables ranking cells from 0 to 4 based on the degree of Prussian blue stain. We propose a complete image analysis scheme to automatically perform both the extraction of the cellular objects and the ranking of each cell according to the Golde score. The image analysis techniques used mainly involve clustering and mathematical morphology. A 2D histogram is clustered to extract the main cellular components, a color watershed is used to determine and refine the regions. Finally, the cellular components of interest are firstly classified according to their hue and secondly according to their staining repartition. The proposed image analysis technique is very fast and produces reliable and accurate results.

  4. 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.

    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

  5. 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.

  6. 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.

  7. Association between the miRNA signatures in plasma and bronchoalveolar fluid in respiratory pathologies.

    Science.gov (United States)

    Molina-Pinelo, Sonia; Suárez, Rocío; Pastor, María Dolores; Nogal, Ana; Márquez-Martín, Eduardo; Martín-Juan, José; Carnero, Amancio; Paz-Ares, Luis

    2012-01-01

    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.

  8. 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.

  9. Practical value of broncholaveolar lavage in evaluation of pulmonary infection

    Directory of Open Access Journals (Sweden)

    Saber S

    1999-06-01

    Full Text Available Aim: It is believed that sampling of the lower airways by BAL in complicated patients with pulmonary infection is often contaminated with upper airways microorganisms. The aim of this study was to assess the value of this procedure and probability of contamination of samples by upper airways flora. Methods: In a prospective study 40 consecutive patients which were candidate for broncholaveolar lavage were choosen for the study, and cultures were obtained from oropharyngeal and peripheral pulmonary airways, respectively. Results: Data showed two different groups of patients, distinctive by wether they have normal flora (group one 55% of total or they have pathogenic microorganisms (group two, 45% of total. Group one had the normal flora in their upper airway tract, while only half of these group showed the same organisms in their lower airway tract, and the rest had negative cultures of the lower airways. The majority of second group had pathogenic microorganisms in their lower airway tract, while only half of them had negative cultures of the upper airways. Conclusion: We assume that the origin of pulmonary infection in our patients is from the peripheral airways. Thus sampling of the lower airways is representative of the actual pathogen, and we recommend that in order to rule out the suspicion of contamination by the upper airway organisms, simultaneous sampling of the upper airways should be obtained. Thus the application of sophisticated sampling methods and their cost effectiveness must be more investigated in view of the efficacy of our simple and inexpensive and practical method

  10. 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......, Hinchey grade III. The aim of this study was to compare laparoscopic lavage and Hartmann's procedure with health economic evaluation within the framework of the DILALA (DIverticulitis – LAparoscopic LAvage versus resection (Hartmann's procedure) for acute diverticulitis with peritonitis) trial. Methods...... were robust as demonstrated in sensitivity analyses. Conclusion: The significant cost reduction in this study, together with results of safety and efficacy from RCTs, support the routine use of laparoscopic lavage as treatment for complicated diverticulitis with purulent peritonitis....

  11. 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.

  12. Management of massive haemoptysis with the rigid bronchoscope and cold saline lavage.

    OpenAIRE

    Conlan, A A; Hurwitz, S S

    1980-01-01

    Twelve successive patients with massive haemoptysis were treated by emergency rigid bronchoscopy and lavage of the bleeding lung with cold saline. All patients stopped bleeding during the procedure and all blood and clot was evacuated from the accessible airways. The bleeding source was localised to a lobe in seven cases, and lateralised in the remaining five patients. Five patients had a second haemorrhage during that hospital stay and cold saline lavage again terminated it. Further therapy,...

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

    Science.gov (United States)

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

    2017-02-01

    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. PubMed, Cochrane, Centre for Reviews and Dissemination, and Embase were searched. Published randomized controlled trials and prospective and retrospective cohorts with laparoscopic lavage and colon resection as interventions were identified. Trial limitations were assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Re-operations, complications at 90 days classified according to Clavien-Dindo and mortality were extracted. Three randomized trials published between 2005 and 2015 were included in the analysis. The studies included a total of 358 patients with 185 patients undergoing laparoscopic lavage. At 12 months, the relative risk of having a re-operation was lower for laparoscopic lavage compared to colon resection in the two trials that had a 12 month follow-up. We found no significant differences in Clavien-Dindo complications classified more than level IIIB or mortality at 90 days. The risk for re-operations within the first 12 months after index surgery was lower for laparoscopic lavage 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.

  14. Nasal lavage leukotrienes in infants with RSV bronchiolitis.

    Science.gov (United States)

    Da Dalt, Liviana; Callegaro, Silvia; Carraro, Silvia; Andreola, Barbara; Corradi, Massimo; Baraldi, Eugenio

    2007-03-01

    Respiratory syncytial virus (RSV) bronchiolitis is a very common infection in infants and, after the acute phase, a number of patients develop a reactive airway disease that lasts for years. Although the pathogenesis of the lung damage after RSV bronchiolitis is still largely unknown, previous studies suggest that leukotrienes may play an active part in it. The aim of this study was to measure leukotriene levels in the nasal lavage fluid (NLF) collected in infants during RSV bronchiolitis and 1 month later. Cysteinyl leukotrienes (Cys-LTs) and leukotriene B(4) (LTB(4)) were measured in the NLF of 22 infants with their first episode of RSV bronchiolitis and 16 healthy infants. A second NLF sample was collected to measure leukotriene levels 1 month after the acute disease. NLF Cys-LT levels were significantly higher in infants with RSV bronchiolitis than in healthy controls [950 pg/ml (285.5-2155.9) vs. 110.5 pg/ml (66.5-451.3), p = 0.01], and they remained so a month after the acute infection (p = 0.02). A subanalysis showed no difference in Cys-LTs concentrations, either between bronchiolitis infants with and without a family history of atopy, or between those with and without passive exposure to cigarette smoke. No significant difference was found between the LTB(4) levels measured in the bronchiolitis cases and the control children. Cys-LTs are significantly increased in the NLF of infants with acute RSV bronchiolitis, and remain so at 1-month follow-up, suggesting a possible role of these eicosanoids in the pathogenesis of the disease.

  15. [Clinicopathological factor analysis of positive cells in peritoneal lavage of gastric carcinoma].

    Science.gov (United States)

    Song, Shubin; Xue, Yingwei

    2015-11-01

    To explore the clinicopathological factors affecting positive cells in peritoneal lavage of gastric carcinoma. Clinicopathological data of 163 patients undergoing radical operation for gastric carcinoma and receiving cytology examination of peritoneal lavage (1000 ml normal saline) in our department from June 2013 to May 2014 were analyzed retrospectively. Pathology and immunohistochemistry were performed for resected lesions and harvested lymph nodes. Affecting factors of peritoneal lavage cytology were evaluated with univariate and multivariate logistic analyses. The positive rate of exfoliative carcinoma cells was 9.2%(15/163). Univariate analysis showed that pathologic staging, depth of invasion, N staging, lymph node metastasis, station of positive lymph node, metastatic rate of lymph node, metastatic rate of the second station of lymph node, and carcinoma differentiation degree were associated with the positive rate of peritoneal lavage cytology (all Pexfoliative cells in peritoneal lavage. The metastatic rate of the second station of lymph node is an independent risk factor of positive exfoliative cells in peritoneal lavage for gastric cancer patients.

  16. Effects of saline lavage temperature on peritoneal fibrinolysis and adhesion formation.

    Science.gov (United States)

    Koca, Yavuz Savaş; Tarhan, Ömer Rıdvan; Kaya, Selçuk; Gökçe Ceylan, Berit

    2016-01-01

    Peritoneal lavage with saline at room temperature causes peritoneal hypothermia, vasoconstriction, hypoxia, and acidosis, which are effects that are known to reduce fibrinolysis. Decreased fibrinolysis causes permanent adhesions. Normothermic lavage may prevent this deleterious process and reduce peritoneal adhesions. A rat model of cecal abrasion was used. Control animals received no medication while hypothermic or normothermic saline lavage were administered intraperitoneally to the experimental groups (n=24 for each group). Cardinal parameters of peritoneal fibrinolysis (tissue plasminogen activator [tPA] and plasminogen activator inhibitor type 1 [PAI-1]) were determined in peritoneal tissue samples on postoperative day 1, 3, and 10. On postoperative day 10, adhesions were graded. In the sham group (n=8), following laparotomy, peritoneal samples were taken to determine basal values of tPA and PAI-1 in healthy peritoneum. Cecal abrasion increased PAI-1 levels about tenfold on postoperative day 1 and caused adhesions. Normothermic saline lavage prevented this traumatic PAI-1 increase and stabilized it to baseline values throughout the experiment and reduced peritoneal adhesion formation. Hypothermic lavage also caused an inhibition of PAI-1 rise but adhesion, prevention was not significant. Our results suggest that normothermic saline lavage reduces adhesions by improving peritoneal fibrinolysis.

  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. Nasal lavage, blood or sputum: Which is best for phenotyping asthma?

    Science.gov (United States)

    de Farias, Camyla F; Amorim, Maria M F; Dracoulakis, Michel; Caetano, Lilian B; Santoro, Ilka L; Fernandes, Ana L G

    2017-05-01

    Determination of asthma phenotypes, particularly inflammatory phenotypes, helps guide treatment and management of this heterogeneous disease. Induced sputum cytology has been the gold standard for determination of inflammatory phenotypes, but sputum induction is fairly invasive and technically challenging. Blood and nasal lavage cytology have been suggested as substitutes, but have not been fully verified. The aim of this study is to determine the accuracy of blood and nasal lavage cytometry as indicators of inflammatory phenotypes in asthma. Clinical evaluation, Asthma Control Questionnaire (ACQ) and spirometry were performed for 121 adult asthma patients, and blood, nasal lavage and induced sputum samples were taken. Eosinophils and neutrophils were counted in three samples from each subject. Inflammatory phenotypes (eosinophilic, neutrophilic, mixed and paucicellular) and cells counts were analysed using Venn diagram and receiver operating characteristic (ROC) curve, respectively. ACQ score, spirometry and bronchodilator response did not differ among subjects with different inflammatory phenotypes. Inflammatory phenotypes defined by nasal lavage cytometry were in better concordance than those defined by blood cell counts with phenotypes determined by sputum cytology, and were significantly correlated with sputum phenotypes. For eosinophilia, nasal lavage cytology showed better accuracy than blood cytology (area under the curve (AUC): 0.89 vs 0.65). For all phenotypes, sensitivity and positive and negative predictive power were higher for nasal lavage cytometry than for blood. Blood cell counts gave a high level of false positives for all inflammatory phenotypes. We recommend nasal lavage cytology over blood cell count as a substitute for sputum cytology to identify inflammatory phenotypes in asthma. © 2016 Asian Pacific Society of Respirology.

  19. 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. Copyright © 2013 Wiley Periodicals, Inc.

  20. 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

    2017-05-01

    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 (Pirrigation 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. 2017; 40(3):e413-e416.]. Copyright 2017, SLACK Incorporated.

  1. 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

  2. Gentamicin submucosal lavage during peroral endoscopic myotomy (POEM): a retrospective analysis.

    Science.gov (United States)

    Bayer, Julia; Vackova, Zuzana; Svecova, Hana; Stirand, Petr; Spicak, Julius; Martinek, Jan

    2017-06-27

    Peroral endoscopic myotomy (POEM) is an evolving therapeutic modality for achalasia. According to the original Inoue's technique, a submucosal lavage with gentamicin has been practiced due to the fear of infection. This single-tertiary center study was intended to assess the clinical significance of the topical antibiotic lavage during POEM. A retrospective analysis of prospectively collected data was conducted. The outcomes of patients who received the gentamicin lavage (group A) during POEM were compared to those who did not (group B). The main outcome variables were infectious adverse events, post-POEM fever, and markers of systemic inflammatory response. One day before and after POEM, all patients received systemic antibiotic prophylaxis with ceftriaxone. Of 124 consecutive patients having undergone POEM, 60 patients received a lavage with 80 mg of gentamicin into the submucosal tunnel before starting the myotomy, while 64 patients did not. The overall treatment success at 3 months did not differ between the two groups (group A 94.7 vs. 97.5% group B). We did not experience any significant infectious adverse events in either group. CRP and WBC levels were lower in patients with lavage versus those without [CRP: median 52.7 (IQR 34.9) vs. 69.5 (54.1); p = 0.01; WBCs: median 10.9 (IQR 3.3) vs. 12.6 (3.9); p POEM, the submucosal lavage with gentamicin prior to the myotomy does not play a role in the prevention of clinically significant infectious adverse events, although the systemic inflammatory response may be decreased.

  3. Low tumor necrosis factor alpha levels and neutrophil counts in nasal lavage after mold exposure.

    Science.gov (United States)

    Hellgren, Ulla-Maija; Leino, Marina; Aarnisalo, Antti A; Mussalo-Rauhamaa, Helena; Alenius, Harri; Reijula, Kari

    2009-03-01

    The results of allergy tests against molds usually remain negative in patients with upper respiratory tract and conjunctival symptoms after microbial exposure in a water-damaged building. Most mold-exposed persons report nasal irritation. Immune mechanisms of the nasal symptoms have not been fully elucidated. To investigate local inflammatory responses after mold exposure in the upper respiratory tract and the feasibility of nasal lavage in diagnosing work-related exposure. Altogether, 26 mold-exposed and 20 nonexposed workers from the same hospital were selected for the present study. The work premises of the exposed workers had detectable moisture and microbial problems. All exposed workers and their nonexposed controls underwent clinical examination, laboratory tests to detect allergy to molds, and nasal lavage. Inflammatory cells and proinflammatory cytokines were measured in the nasal lavage fluid. Nasal lavages were performed again 6 months after a thorough renovation of the building. In the nasal lavage, the neutrophil count and the level of tumor necrosis factor alpha in the exposed employees were lower, whereas the macrophage and epithelial cell counts were higher than in the control group. After the renovation, no difference was found in inflammatory response between the study group and the control group. The mean concentration of serum IgG to Stachybotrys chartarum was higher in the exposed workers. These results suggest that exposure to toxin-producing microbial growth in a water-damaged building caused immunosuppression in nasal mucosa, leading to a decrease in neutrophil counts and tumor necrosis factor alpha levels. Nasal lavage is a suitable method for examining inflammatory responses in work-related mold exposure.

  4. Peritoneal lavage for the evaluation of patients with equivocal signs after abdominal trauma

    DEFF Research Database (Denmark)

    Duus, B R; Hauch, O; Damm, P

    1986-01-01

    The value of peritoneal lavage (PL) in the evaluation of 82 patients with equivocal signs after abdominal trauma was studied. The closed technique using an Intracatch (R) was employed. Fifty-four patients had blunt trauma, the predictive value of a positive PL was 86% and the predictive value...... of a negative PL was 94%, accuracy 94%. Twenty-eight patients had stab wounds, the figures in this group were 100%, 92% and 93%. No complications were seen. There were no retrieval of lavage fluid in 10% of the cases. PL with the closed Intracath (R) technique has the same diagnostic certainty as other methods...

  5. Pulsatile Lavage of Musculoskeletal Wounds Causes Muscle Necrosis and Dystrophic Calcification in a Rat Model.

    Science.gov (United States)

    Chiaramonti, Alexander M; Robertson, Astor D; Nguyen, Thao P; Jaffe, David E; Hanna, E Lex; Holmes, Robert; Barfield, William R; Fourney, William L; Stains, Joseph P; Pellegrini, Vincent D

    2017-11-01

    Adequate irrigation of open musculoskeletal injuries is considered the standard of care to decrease bacterial load and other contaminants. While the benefit of debris removal compared with the risk of further seeding by high-pressure lavage has been studied, the effects of irrigation on muscle have been infrequently reported. Our aim in the present study was to assess relative damage to muscle by pulsatile lavage compared with bulb-syringe irrigation. In an animal model of heterotopic ossification, 24 Sprague-Dawley rats underwent hindlimb blast amputation via detonation of a submerged explosive, with subsequent through-the-knee surgical amputation proximal to the zone of injury. All wounds were irrigated and underwent primary closure. In 12 of the animals, pulsatile lavage (20 psi [138 kPa]) was used as the irrigation method, and in the other 12 animals, bulb-syringe irrigation was performed. A third group of 6 rats did not undergo the blast procedure but instead underwent surgical incision into the left thigh muscle followed by pulsatile lavage. Serial radiographs of the animals were made to monitor the formation of soft-tissue radiopaque lesions until euthanasia at 6 months. Image-guided muscle biopsies were performed at 8 weeks and 6 months (at euthanasia) on representative animals from each group. Histological analysis was performed with hematoxylin and eosin, alizarin red, and von Kossa staining on interval biopsy and postmortem specimens. All animals managed with pulsatile lavage, with or without blast injury, developed soft-tissue radiopaque lesions, whereas no animal that had bulb-syringe irrigation developed these lesions (p = 0.001). Five of the 12 animals that underwent blast amputation with pulsatile lavage experienced wound complications, whereas no animal in the other 2 groups experienced wound complications (p = 0.014). Radiopaque lesions appeared approximately 10 days postoperatively, increased in density until approximately 16 weeks, then

  6. Reduction effect of bacterial counts by preoperative saline lavage of the stomach in performing laparoscopic and endoscopic cooperative surgery.

    Science.gov (United States)

    Mori, Hirohito; Kobara, Hideki; Tsushimi, Takaaki; Fujihara, Shintaro; Nishiyama, Noriko; Matsunaga, Tae; Ayaki, Maki; Yachida, Tatsuo; Tani, Joji; Miyoshi, Hisaaki; Morishita, Asahiro; Masaki, Tsutomu

    2014-11-14

    To investigate the effects of gastric lavage with 2000 mL of saline in laparoscopic and endoscopic cooperative surgery. Twenty two patients who were diagnosed with a gastric gastrointestinal stromal tumor were enrolled. In former term, irrigations of the stomach were conducted whenever it was necessary, not systematically (Non systemic lavage group). In latter term, the stomach was thoroughly cleaned with 2000 mL of saline using an endoscope with a water jet, and Duodenal balloon occlusion was conducted to prevent refluxed bile and pancreatic juice (Systemic lavage+balloon occlusion group). The gastric wall was sprayed with 20 mL of distilled water, and 20 mL of gastric juice was collected in a sterile tube and submitted for culture. 20 mL of ascites was also collected from the laparoscopic ports and submitted for culture. We compared WBC, CRP, BT between two groups, and verify the reduction effect of bacterial counts in Systemic lavage+balloon occlusion group. WBC count before, 1 d after, and 3 d after laparoscopic and endoscopic cooperative surgery (LECS) were 5060 (95%CI: 4250-9640), 12140 (6050-14110), and 6910 (5320-12520) in Non systemic lavage group, 4400 (3660-7620), 8910 (6480-10980), and 5950 (4840-7860) in Systemic lavage+balloon occlusion group. Significant differences between two groups at the day after LECS (P = 0.029) and the 3 d after LECS (P = 0.042). CRP levels in Non systemic lavage group and in Systemic lavage+balloon occlusion group were significantly different at the day after LECS (P = 0.005) and the 3 d after LECS (P = 0.028). BTs (°C) in Non systemic lavage group and in Systemic lavage+balloon occlusion group were also significantly different at the day after LECS (P = 0.004) and the 3 d after LECS (P = 0.006). In a logarithmic comparison, bacterial load before gastric lavage, after lavage, and ascites culture were 6.08 (95%CI: 4.04-6.97), 0.48 (0-0.85), and 0.21 (0-0.56). The bacterial counts before and after gastric lavage were

  7. 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.

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

    DEFF Research Database (Denmark)

    Angenete, Eva; Bock, David; Rosenberg, Jacob

    2017-01-01

    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...

  9. Surgical outcome of video-assisted thoracic surgery for acute thoracic empyema using pulsed lavage irrigation.

    Science.gov (United States)

    Nakamura, Hiroshige; Taniguchi, Yuji; Miwa, Ken; Adachi, Yoshin; Fujioka, Shinji; Haruki, Tomohiro

    2010-03-01

    The essential points of video-assisted thoracic surgery (VATS) for acute thoracic empyema are the decortication of thickened pleura, resection of necrotic tissues and fibrin blocks, and drainage. Pulsed lavage irrigation, which is commonly used in orthopedic surgery as a method of sufficiently performing the technique, was used under a thoracoscope to study the efficacy of the treatment for acute thoracic empyema. The subjects comprised 31 patients who had undergone VATS for acute thoracic empyema. There were 26 men and 5 women with an average age of 60.5 years. For the surgical technique, the thickened pus-producing pleura were decorticated under a thoracoscope. The pulsed lavage irrigation system was used after the intrathoracic space had become a single cavity. Using the tip for an intraspinal space, lavage and suctioning were repeated with 5-10 l of a pressurized warm saline solution. Fibrin blocks and necrotic tissues were easily removed by spray washing with pressurized fluid. The operating time was 150.8 min; the amount of bleeding, including suctioned pleural effusion, was 478.5 g; and the postoperative duration of drainage was 10.7 days. During the postoperative course, the addition of open window thoracotomy due to the relapse of empyema due to methicillin-resistant Staphylococcus aureus was observed in only one patient (3.2%). All of the other patients improved despite their concomitant diseases. The use of pulsed lavage irrigation under a thoracoscope for acute thoracic empyema provides simple, efficient débridement or drainage.

  10. Gastric lavage as a non-lethal method for stingray (Myliobatiformes ...

    African Journals Online (AJOL)

    Gastric lavage as a non-lethal method for stingray (Myliobatiformes) diet sampling. C Elston, R.G. von Brandis, P.D. Cowley. Abstract. Understanding the trophic interactions of ecologically important mesopredators such as Myliobatiformes (stingrays) is vital, but, given their susceptibility to overexploitation, the collection of ...

  11. 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

    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

  12. Is initial (24 hours) lavage necessary in treatment of CAPD peritonitis?

    DEFF Research Database (Denmark)

    Ejlersen, E; Brandi, L; Løkkegaard, H

    1991-01-01

    A randomized trial was conducted to examine the influence of initial lavage on treatment of CAPD peritonitis. Patients with hypotension and shock were excluded from the trial. Thirty-six CAPD patients with acute peritonitis were randomized to treatment with intraperitoneal antibiotics including...... benefit in treatment of CAPD peritonitis in patients without profound hypotension and shock....

  13. Laparoscopic Lavage for Perforated Diverticulitis With Purulent Peritonitis: A Randomized Trial.

    Science.gov (United States)

    Thornell, Anders; Angenete, Eva; Bisgaard, Thue; Bock, David; Burcharth, Jakob; Heath, Jane; Pommergaard, Hans-Christian; Rosenberg, Jacob; Stilling, Nikolaj; Skullman, Stefan; Haglind, Eva

    2016-02-02

    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. To compare laparoscopic lavage with open colon resection and colostomy (Hartmann procedure) for perforated diverticulitis with purulent peritonitis. Randomized, controlled, multicenter, open-label trial. (ISRCTN registry number: ISRCTN82208287). 9 hospitals in Sweden and Denmark. Patients who have confirmed Hinchey grade III perforated diverticulitis with purulent peritonitis at diagnostic laparoscopy. Randomization between laparoscopic lavage and the Hartmann procedure. Primary outcome was the percentage of patients having 1 or more reoperations within 12 months. Key secondary outcomes were number of reoperations, hospital readmissions, total length of hospital stay during 12 months, and adverse events. A total of 43 and 40 patients were randomly assigned to laparoscopic lavage and the Hartmann procedure with a median (first, third quartiles) follow-up of 372 days (336, 394) and 378 days (226, 396), respectively. Fewer patients in the laparoscopic group (12 of 43; 27.9%) than in the Hartmann group (25 of 40; 62.5%) had at least 1 reoperation within 12 months (relative risk reduction, 59%; relative risk, 0.41 [95% CI, 0.23 to 0.72]; P = 0.004). Mortality and severe adverse events did not differ between groups. Total length of hospital stay (days) within 12 months was shorter for the laparoscopic group than the Hartmann group, with a reduction of 35% (relative risk, 0.65 [CI, 0.45 to 0.94]; P = 0.047). After 12 months, 3 patients in the laparoscopic group and 11 in the Hartmann group had a stoma. Not all patients presenting with suspected diverticulitis were enrolled. Laparoscopic lavage reduced the need for reoperations, had a similar safety profile to the Hartmann procedure, and may be an appropriate treatment of

  14. Effect of uterine lavage on neutrophil counts in postpartum dairy cows.

    Science.gov (United States)

    Dini, P; Farhoodi, M; Hostens, M; Van Eetvelde, M; Pascottini, O Bogado; Fazeli, M H; Opsomer, G

    2015-07-01

    Subclinical endometritis affects approximately 30% of lactating dairy cows, causing significant economic losses to the dairy industry. Yet, there is no efficient treatment available for this condition. The present study examines the effect of uterine lavage in clinically normal cows with sterile saline solution at 30 days in milk (DIM) on the percentage of polymorphonuclear cells (PMNs) detected with endometrial cytology as an indicator of subclinical endometritis. It was hypothesized uterine lavage would be a technique to reduce the number of PMNs in the uterus, and hence be beneficial for cows affected by subclinical endometritis. Cytology samples were taken by low-volume flushing from 50 Holstein Friesian cows on 30 and 40 DIM. On Day 30, cows were clinically examined and randomly assigned into a treatment and control group. In the treatment group, the cytology sampling on Day 30 was immediately followed by uterine lavage with 500-600 mL of sterile physiological saline (35-40°C). Cytology sampling was repeated in all cows at 40 DIM. Lactation numbers >2, peripheral progesterone concentrations >1 ng/mL and uterine lavage at 30 DIM all were significantly associated with lesser PMN percentages at 40 DIM (P=0.0041; 0.0187 and 0.0043, respectively). Uterine lavage might, therefore, be a useful and practical method to decrease the number of PMNs in the uterus of cattle. Results from the current study can be used as preliminary data for designing in depth therapeutic protocols for treatment of subclinical endometritis in cattle. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Extending colonic mucosal microbiome analysis-assessment of colonic lavage as a proxy for endoscopic colonic biopsies.

    Science.gov (United States)

    Watt, Euan; Gemmell, Matthew R; Berry, Susan; Glaire, Mark; Farquharson, Freda; Louis, Petra; Murray, Graeme I; El-Omar, Emad; Hold, Georgina L

    2016-11-25

    Sequencing-based analysis has become a well-established approach to deciphering the composition of the gut microbiota. However, due to the complexity of accessing sufficient material from colonoscopic biopsy samples, most studies have focused on faecal microbiota analysis, even though it is recognised that differences exist between the microbial composition of colonic biopsies and faecal samples. We determined the suitability of colonic lavage samples to see if it had comparable microbial diversity composition to colonic biopsies as they are without the limitations associated with sample size. We collected paired colonic biopsies and lavage samples from subjects who were attending for colorectal cancer screening colonoscopy. Next-generation sequencing and qPCR validation were performed with multiple bioinformatics analyses to determine the composition and predict function of the microbiota. Colonic lavage samples contained significantly higher numbers of operational taxonomic units (OTUs) compared to corresponding biopsy samples, however, diversity and evenness between lavage and biopsy samples were similar. The differences seen were driven by the presence of 12 OTUs which were in higher relative abundance in biopsies and were either not present or in low relative abundance in lavage samples, whilst a further 3 OTUs were present in higher amounts in the lavage samples compared to biopsy samples. However, predicted functional community profiling based on 16S ribosomal ribonucleic acid (rRNA) data indicated minimal differences between sample types. We propose that colonic lavage samples provide a relatively accurate representation of biopsy microbiota composition and should be considered where biopsy size is an issue.

  16. Bronchoalveolar sublineage specification of pluripotent stem cells: effect of dexamethasone plus cAMP-elevating agents and keratinocyte growth factor.

    Science.gov (United States)

    Katsirntaki, Katherina; Mauritz, Christina; Olmer, Ruth; Schmeckebier, Sabrina; Sgodda, Malte; Puppe, Verena; Eggenschwiler, Reto; Duerr, Julia; Schubert, Susanne C; Schmiedl, Andreas; Ochs, Matthias; Cantz, Tobias; Salwig, Isabelle; Szibor, Marten; Braun, Thomas; Rathert, Christian; Martens, Andreas; Mall, Marcus A; Martin, Ulrich

    2015-02-01

    Respiratory progenitors can be efficiently generated from pluripotent stem cells (PSCs). However, further targeted differentiation into bronchoalveolar sublineages is still in its infancy, and distinct specifying effects of key differentiation factors are not well explored. Focusing on airway epithelial Clara cell generation, we analyzed the effect of the glucocorticoid dexamethasone plus cAMP-elevating agents (DCI) on the differentiation of murine embryonic and induced pluripotent stem cells (iPSCs) into bronchoalveolar epithelial lineages, and whether keratinocyte growth factor (KGF) might further influence lineage decisions. We demonstrate that DCI strongly induce expression of the Clara cell marker Clara cell secretory protein (CCSP). While KGF synergistically supports the inducing effect of DCI on alveolar markers with increased expression of surfactant protein (SP)-C and SP-B, an inhibitory effect on CCSP expression was shown. In contrast, neither KGF nor DCI seem to have an inducing effect on ciliated cell markers. Furthermore, the use of iPSCs from transgenic mice with CCSP promoter-dependent lacZ expression or a knockin of a YFP reporter cassette in the CCSP locus enabled detection of derivatives with Clara cell typical features. Collectively, DCI was shown to support bronchoalveolar specification of mouse PSCs, in particular Clara-like cells, and KGF to inhibit bronchial epithelial differentiation. The targeted in vitro generation of Clara cells with their important function in airway protection and regeneration will enable the evaluation of innovative cellular therapies in animal models of lung diseases.

  17. 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 af...... after pretreatment for 2 weeks with the glucocorticoid, budesonide, as a nasal spray (400 micrograms/day) and with placebo with a double-blind, crossover design. Nasal lavage fluid was repeatedly collected during a 10-hour period to study both early and late-phase responses. 99m...... 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...

  18. 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.

  19. [Measurement of the deposition of salbutamol in the bronchial lavage fluid of infants and young children].

    Science.gov (United States)

    Nuesslein, T G; Wallis, H; Stephan, V; Rieger, C

    2003-08-01

    Inhaled salbutamol is well known to be effective in obstructive lung disease in the paediatric age group. However, the individually necessary dose cannot be predicted in a single patient. Two inhalation techniques were compared measuring the concentrations of salbutamol in the bronchial lavage fluid. Forty nine children, age 2 to 73 months, inhaled salbutamol immediately before bronchoscopy, either 200 microg using a metered dose inhaler (MDI) or 2000 microg using a nebulizer (NEB). The concentrations of salbutamol were measured in the bronchial lavage fluid. In spite of different inhaled doses the concentrations of salbutamol were similar in the nebulizer group (n = 29) and the metered dose inhaler group (n = 20) (medians 160 vs. 163 ng/ml; p = 0.27) with a wide range in both groups (12 to 1139 and 5.2 to 641 ng/ml, respectively). In a single patient the concentrations differed by the factor 159 between the right and the left lung. The concentrations of salbutamol were not age dependent (p = 0.06 for NEB, p = 0.28 for MDI). In infants and young children the concentrations of salbutamol in the bronchial lavage fluid vary widely after a single inhalation using either a metered dose inhaler or a nebulizer.

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

    Directory of Open Access Journals (Sweden)

    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. Whole lung lavage therapy for pulmonary alveolar proteinosis: a global survey of current practices and procedures.

    Science.gov (United States)

    Campo, Ilaria; Luisetti, Maurizio; Griese, Matthias; Trapnell, Bruce C; Bonella, Francesco; Grutters, Jan; Nakata, Koh; Van Moorsel, Coline H M; Costabel, Ulrich; Cottin, Vincent; Ichiwata, Toshio; Inoue, Yoshikazu; Braschi, Antonio; Bonizzoni, Giacomo; Iotti, Giorgio A; Tinelli, Carmine; Rodi, Giuseppe

    2016-08-31

    Whole lung lavage (WLL) is the current standard of care treatment for patients affected by pulmonary alveolar proteinosis (PAP). However, WLL is not standardized and international consensus documents are lacking. Our aim was to obtain a factual portrayal of WLL as currently practiced with respect to the procedure, indications for its use, evaluation of therapeutic benefit and complication rate. A clinical practice survey was conducted globally by means of a questionnaire and included 27 centers performing WLL in pediatric and/or adult PAP patients. We collected completed questionnaires from 20 centres in 14 countries, practicing WLL in adults and 10 centers in 6 countries, practicing WLL in pediatric patients. WLL is almost universally performed under general anesthesia, with a double-lumen endobronchial tube in two consecutive sessions, with an interval of 1-2 weeks between sessions in approximately 50 % of centres. The use of saline warmed to 37 °C, drainage of lung lavage fluid by gravity and indications for WLL therapy in PAP were homogenous across centres. There was great variation in the choice of the first lung to be lavaged: 50 % of centres based the choice on imaging, whereas 50 % always started with the left lung. The choice of position was also widely discordant; the supine position was chosen by 50 % of centres. Other aspects varied significantly among centres including contraindications, methods and timing of follow up, use of chest percussion, timing of extubation following WLL and lung isolation and lavage methods for small children. The amount of fluid used to perform the WLL is a critical aspect. Whilst a general consensus exists on the single aliquot of fluid for lavage (around 800 ml of warm saline, in adults) great variability exists in the total volume instilled per lung, ranging from 5 to 40 liters, with an average of 15.4 liters/lung. This international survey found that WLL is safe and effective as therapy for PAP. However these

  2. Peritoneal lavage using chlorhexidine gluconate at the end of colon surgery reduces postoperative intra-abdominal infection in mice.

    Science.gov (United States)

    Shams, Wael E; Hanley, Gregory A; Orvik, Andrea; Lewis, Nicole; Shurbaji, M Salah

    2015-05-01

    The use of peritoneal lavage with antiseptic solutions after bowel surgery remains controversial. This study compared peritoneal lavage using chlorhexidine gluconate at low concentrations and normal saline in mice with cecal ligation and perforation. A total of 180 mice were randomized to six groups. Groups A, B, and C received one-time intraperitoneal injections of normal saline, chlorhexidine gluconate 0.05%, and chlorhexidine gluconate 0.025%, respectively. Groups D, E, and F were all subject to cecal ligation and perforation, then underwent partial cecectomy and peritoneal lavage with normal saline only, chlorhexidine gluconate 0.05% followed by normal saline, and chlorhexidine gluconate 0.025% followed by normal saline, respectively. Animals were followed postoperatively then sacrificed and examined at necropsy for occurrence of intra-abdominal abscesses, adhesions, or other pathology. A total of 48 mice (26.7%) developed postoperative intra-abdominal abscesses. Group E mice that had chlorhexidine gluconate 0.05% lavage had significantly lower incidence of postoperative intra-abdominal abscesses compared with that of group D mice that had saline lavage only (P = 0.0113). There was no significant difference in occurrence of macroscopic adhesions among mice groups that had or did not have surgery. (P = 1 and P = 0.3728). Microscopic peritoneal fibrosis occurred significantly more among group E mice that had chlorhexidine gluconate 0.05% lavage compared with group D mice that had saline lavage only (P = Chlorhexidine gluconate 0.05% peritoneal lavage after partial colectomy (cecectomy) in mice reduces postoperative intra-abdominal infection without significant macroscopic adhesion formation. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. In utero infection with porcine reproductive and respiratory syndrome virus modulates leukocyte subpopulations in peripheral blood and bronchoalveolar fluid of surviving piglets.

    Science.gov (United States)

    Nielsen, J; Bøtner, A; Tingstedt, J-E; Aasted, B; Johnsen, C K; Riber, U; Lind, P

    2003-06-20

    It is well known that piglets congenitally infected with porcine reproductive and respiratory syndrome virus (PRRSV) can be viremic at birth, and that preweaning mortality due to secondary infections often increases during acute outbreaks of PRRS. Therefore, an immunosuppressive effect of in utero infection has been suggested. The aim of the present study was to characterise the changes of leukocyte populations in piglets surviving in utero infection with PRRSV. A total of 27 liveborn uninfected control piglets and 22 piglets infected transplacentally with a Danish strain of PRRSV were included. At 2 and 4 weeks of age, 21 of 22 (96%) and 7 of 14 (50%) examined infected piglets were still viremic, whereas PRRSV could not be detected in the six infected piglets examined at 6 weeks of age. Flow cytometry analysis was used to determine the phenotypic composition of leukocytes in peripheral blood and bronchoalveolar lavage fluid (BALF) of 2-, 4- and 6-week-old infected piglets and age-matched uninfected controls. The key observation in the present study is that high levels of CD8(+) cells constitute a dominant feature in peripheral blood and BALF of piglets surviving in utero infection with PRRSV. In BALF, the average high level of CD8(+) cells in 2-week-old infected piglets (33.4 +/- 12.6%) was followed by a decline to 7.3 +/- 3.0 and 11.1 +/- 3.0% at 4 and 6 weeks of age. BALF of control piglets contained 1.6 +/- 0.9, 2.3 +/- 1.8 and 1.9 +/- 0.5% CD8(+) cells, only. In peripheral blood, however, the average number of CD8(+) cells remained at high levels in the infected piglets throughout the post-natal experimental period (2.8 +/- 1.9, 2.9 +/- 1.8 and 3.2 +/- 1.7 x 10(6) CD8(+) cells/ml at 2, 4 and 6 weeks, respectively). In the controls, the average levels of CD8(+) cells were 0.9+/-0.2, 1.9 +/- 1.7 and 1.6 +/- 0.5 x 10(6)/ml, respectively. Furthermore, the numbers of CD2(+) , CD4(+)CD8(+) and SLA-classII(+) cells, respectively, in peripheral blood, together with

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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. [Clinical effect of endotracheal lavage with porcine pulmonary surfactant in term neonates with severe meconium aspiration syndrome].

    Science.gov (United States)

    Lin, Xin-Zhu; Lai, Ji-Dong; Lan, Zhao-Yang; Lin, Ya-Yin

    2014-07-01

    To evaluate the clinical effect of endotracheal lavage with porcine pulmonary surfactant (PS) in term neonates with severe meconium aspiration syndrome (MAS). A total of 136 full-term infants with severe MAS who were admitted to the neonatal intensive care unit between January 2010 and June 2013 were randomly and equally divided into PS lavage and PS injection groups. In the PS lavage group, patients were treated with endotracheal lavage using 3-5 mL of diluted PS (12 mg/mL) each time, and the PS injection group was given PS by intratracheal injection at the first dose of 200 mg/kg. Blood gas, oxygenation index (OI), and PaO2/FiO2 (P/F) of the two groups were evaluated before and 2, 12, 24, and 48 hours after the treatment, and the duration of mechanical ventilation, complication rate, and cure rate were compared between the two groups. Compared with the PS injection group, the PS lavage group had significantly higher PaO2 and P/F ration and significantly lower PaCO2 and OI at 12, 24, and 48 hours post-treatment (Pneonates with severe MAS can increase ventilation and oxygenation efficiency, shorten the duration of mechanical ventilation, reduce the complication rate, and increase the cure rate, indicating that this method is a safe and effective therapeutic strategy.

  8. Treatment of a giant pulmonary emphysematous cyst with primary bronchoalveolar papillary carcinoma in a Shih Tzu dog.

    Science.gov (United States)

    Park, Jiyoung; Lee, Hae-Beom; Jeong, Seong Mok

    2017-01-01

    To report the surgical treatment of a pulmonary emphysematous cyst concurrent with primary pulmonary bronchoalveolar papillary carcinoma in a dog. Clinical case report. 12-year-old 6.4 kg spayed female Shih Tzu dog. The dog presented for surgical treatment of pulmonary emphysema. Radiography revealed that more than half of the left caudal lung lobe was enlarged and hyperlucent and computed tomography (CT) confirmed the presence of an emphysematous space. Thoracoscopic lung lobectomy was attempted but was converted to an intercostal thoracotomy due to poor visualization and pleural adhesions. A left caudal total lung lobectomy was performed using a self-cutting endoscopic stapler. The dog recovered uneventfully and a postoperative histopathologic diagnosis of pulmonary cystic bronchoalveolar papillary carcinoma was made. Re-evaluation using a CT scan with contrast study on postoperative days 27 and 177 revealed no evidence of residual, metastatic, or recurrent lesions. The dog has been doing well since surgery during the 11 month follow-up period. This case report suggests a potential relationship between pulmonary emphysematous diseases and primary lung tumors in dogs. © 2016 The American College of Veterinary Surgeons.

  9. Clinical and experimental study of autologous fat grafting after processing by centrifugation and serum lavage.

    Science.gov (United States)

    Khater, Regina; Atanassova, Pepa; Anastassov, Yorii; Pellerin, Philippe; Martinot-Duquennoy, Veronique

    2009-01-01

    This clinical and experimental study compared adipose tissue transplant behavior after two different techniques of purifying: centrifugation at 3400 rpm for 3 min and serum lavage without centrifugation. Clinical evaluation was performed under standardized conditions for lipofilling on a series of 51 female patients, intentionally selected to have similar characteristics and assigned to two groups based on the method of processing. Experimentally, a culture system in diffusion chambers with vitaline membranes was designed to mimic the behavior and to study the morphology of the adipose tissue used for autografting. Survival, structure, and proliferation of the adipose cells in vitro were examined by classical histologic H&E staining and immunohistochemistry for leptin and cyclin D1. The main differences encountered experimentally were the presence of a greater amount of preadipocytes in the noncentrifuged adipose tissue cultures and more distinctly expressed cell proliferation. The postoperative clinical results favored of the serum lavage purifying technique. Our data suggest that with transplantation of noncentrifuged adipose tissue more active preadipocytes are applied which could possibly lead to better potential chances of survival and even de novo development of fat.

  10. [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.

  11. Successful management of a cesarean scar defect with dehiscence of the uterine incision by using wound lavage.

    Science.gov (United States)

    Ida, Akinori; Kubota, Yoko; Nosaka, Maiko; Ito, Koichi; Kato, Hiroshi; Tsuji, Yoshiyuki

    2014-01-01

    Cesarean scar defects (CSDs) that can be visualized using transvaginal ultrasonography (TVUS) may cause prolonged menstruation, irregular genital bleeding, and secondary infertility; surgical repair is sometimes necessary. We present a case of CSD, with dehiscence of the uterine incision, which was managed using wound lavage. A 38-year-old woman (gravida 4, para 4) had delivered her third and fourth children by cesarean section. Upon the resumption of menstruation, 9 months after her second cesarean section, she demonstrated prolonged menstruation and the presence of a menstrual fistula due to dehiscence of the cesarean section incision from the myometrium to the serosa. We treated the defect by lavaging with a physiological saline solution. After lavaging the wound 3 times, spontaneous healing of the dehiscent muscle layer was successfully achieved. The treatment was complication-free and the healing of the muscle layer has been maintained for more than 8 months.

  12. Successful Management of a Cesarean Scar Defect with Dehiscence of the Uterine Incision by Using Wound Lavage

    Directory of Open Access Journals (Sweden)

    Akinori Ida

    2014-01-01

    Full Text Available Cesarean scar defects (CSDs that can be visualized using transvaginal ultrasonography (TVUS may cause prolonged menstruation, irregular genital bleeding, and secondary infertility; surgical repair is sometimes necessary. We present a case of CSD, with dehiscence of the uterine incision, which was managed using wound lavage. A 38-year-old woman (gravida 4, para 4 had delivered her third and fourth children by cesarean section. Upon the resumption of menstruation, 9 months after her second cesarean section, she demonstrated prolonged menstruation and the presence of a menstrual fistula due to dehiscence of the cesarean section incision from the myometrium to the serosa. We treated the defect by lavaging with a physiological saline solution. After lavaging the wound 3 times, spontaneous healing of the dehiscent muscle layer was successfully achieved. The treatment was complication-free and the healing of the muscle layer has been maintained for more than 8 months.

  13. Effect of Retroperitoneal Lavage with Normal Saline Containing Adrenaline on Carbon Dioxide Absorption in Patients Undergoing Retroperitoneal Laparoscopic Surgery.

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    Zhu, Yong-Feng; Meng, Fan-Min

    2015-11-01

    To determine the effect of lavage with adrenaline solution on CO2 absorption during retroperitoneal laparoscopic surgery. Sixty patients scheduled to undergo retroperitoneal laparoscopic surgery were divided into an AD group (lavage with normal saline containing adrenaline [1:500,000], n = 30) and an NS group (lavage with normal saline only, n = 30). After the establishment of artificial pneumoperitoneum and before the start of the operation, the retroperitoneal space was irrigated with 300 mL of normal saline with or without adrenaline, depending on the group. The lavage fluid was aspirated after 3 minutes. Heart rate (HR), mean arterial pressure (MAP), blood oxygen saturation (SpO2), partial pressure of O2 (PaO2), partial pressure of CO2 (PaCO2), and end-tidal CO2 partial pressure (PETCO2) were recorded before the lavage (T0) and at 10, 30, 60, 90, and 120 minutes (T1-T5, respectively) after the lavage. The CO2 output (VCO2) was calculated, and the incidence of intraoperative arrhythmia and postoperative complications (e.g., headache, palpitations, irritation) was determined. HR, MAP, SpO2, PaO2, PaCO2, PETCO2, and VCO2 at T0 did not significantly differ between the groups (P > .05). HR, PaCO2, PETCO2, and VCO2 at T1-T5 were lower in the AD group than in the NS group (P adrenaline (1:500,000) reduced CO2 absorption during retroperitoneal laparoscopic surgery, prevented hypercapnia, and decreased intra- and postoperative complications.

  14. Laparoscopic lavage versus surgical resection for acute diverticulitis with generalised peritonitis: a systematic review and meta-analysis.

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    Cirocchi, R; Di Saverio, S; Weber, D G; Taboła, R; Abraha, I; Randolph, J; Arezzo, A; Binda, G A

    2017-02-01

    This systematic review and meta-analysis investigates current evidence on the therapeutic role of laparoscopic lavage in the management of diverticular peritonitis. A systematic review of the literature was performed on PubMed until June 2016, according to preferred reporting items for systematic reviews and meta-analyses guidelines. All randomised controlled trials comparing laparoscopic lavage with surgical resection, irrespective of anastomosis or stoma formation, were analysed. After assessment of titles and full text, 3 randomised trials fulfilled the inclusion criteria. Overall the quality of evidence was low because of serious concerns regarding the risk of bias and imprecision. In the laparoscopic lavage group, there was a statistically significant higher rate of postoperative intra-abdominal abscess (RR 2.54, 95% CI 1.34-4.83), a lower rate of postoperative wound infection (RR 0.10, 95% CI 0.02-0.51), and a shorter length of postoperative hospital stay during index admission (WMD = -2.03, 95% CI -2.59 to -1.47). There were no statistically significant differences in terms of postoperative mortality at index admission or within 30 days from intervention in all Hinchey stages and in Hinchey stage III, postoperative mortality at 12 months, surgical reintervention at index admission or within 30-90 days from index intervention, stoma rate at 12 months, or adverse events within 90 days of any Clavien-Dindo grade. The surgical reintervention rate at 12 months from index intervention was significantly lower in the laparoscopic lavage group (RR 0.57, 95% CI 0.38-0.86), but these data included emergency reintervention and planned intervention (stoma reversal). This systematic review and meta-analysis did not demonstrate any significant difference between laparoscopic peritoneal lavage and traditional surgical resection in patients with peritonitis from perforated diverticular disease, in terms of postoperative mortality and early reoperation rate

  15. Temporomandibular Lavage Versus Nonsurgical Treatments for Temporomandibular Disorders: A Systematic Review and Meta-Analysis.

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    Bouchard, Carl; Goulet, Jean-Paul; El-Ouazzani, Mehdi; Turgeon, Alexis F

    2017-07-01

    To investigate the efficacy of temporomandibular joint (TMJ) lavage (arthrocentesis or arthroscopy) for the treatment of temporomandibular disorders in reducing pain and improving jaw motion. We performed a systematic review of the literature and meta-analysis of randomized controlled trials (RCTs) comparing TMJ lavage with conservative measures. The data sources were MEDLINE, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), Scopus, Web of Science, and reference lists of relevant articles. Two independent reviewers identified RCTs by using controlled vocabulary (MeSH, Emtree) and free text terms. Data extracted from the selected studies included population characteristics, interventions, outcomes, and funding sources. Risk of bias was assessed with the Cochrane Collaboration risk assessment tool for RCTs. Five studies met the inclusion criteria, for a total of 308 patients. Of these studies, 3 were categorized as having a high risk of bias and 2 had a low risk. The summary effect of the 5 studies showed a reduction in pain in the intervention group at 6 months (-0.63; 95% confidence interval [CI], -0.90 to -0.37; P < .00001; I2 = 88%) and 3 months (-0.47; 95% CI, -0.75 to -0.19; P = .001; I2 = 85%). This was not the case at 1 month. No difference in mouth opening was observed at 6 months (-0.21; 95% CI, -1.82 to 1.40; P < .80; I2 = 74%), 3 months (0.20; 95% CI, -1.81 to 2.20; P = .85; I2 = 68%), and 1 month (-1.18; 95% CI, -2.90 to 0.55; P = .18; I2 = 0%). Given the relatively small number of patients included in this meta-analysis, the high risk of bias in 3 studies, and the statistical and clinical heterogeneity of the included studies, the use of TMJ lavage for the treatment of temporomandibular disorders should be recommended with caution because of the lack of strong evidence to support its use. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Temporomandibular joint (TMJ) arthroscopic lysis and lavage: Outcomes and rate of progression to open surgery.

    Science.gov (United States)

    Breik, Omar; Devrukhkar, Vishakha; Dimitroulis, George

    2016-12-01

    Arthroscopic lysis and lavage has been shown to be effective in the management of a variety of TMJ (Temporomandibular joint) diseases. The purpose of this study was to evaluate the medium to long-term outcomes of TMJ arthroscopic lysis and lavage and determine factors associated with progression to open surgery. A retrospective cohort study of a single operator series was performed over a 6-year period from 2006 to 2012. The variables of gender, age and category (Dimitroulis classification) were compared to evaluate factors associated with success of arthroscopy and progression to open surgery. The data were analysed via Kaplan Meier method for time-to event analyses and Chi-squared tests for trend analyses. Pre-operative and post-operative Visual analogue scores and maximum inter-incisal opening results were analysed with the Student's t-test. A total of 167 patients and 216 joints underwent arthroscopy with a mean follow up of 6.9 years. Overall 77.7% of joints had a successful result and required no further surgery. There was no gender difference with respect to progression to surgery. Males underwent open surgery after a mean of 6.2 months from arthroscopy and Females after a mean of 15.6 months from arthroscopy (p disease progressing to open surgery (p TMJ is a reliable and effective operation for patients with early stage (i.e., Categories 1, 2 and 3) disorders of the TMJ. Patients with more advanced joint disease (i.e., Categories 4 & 5) gained only temporary relief from TMJ arthroscopy and often progress to open TMJ surgery. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  18. Interleukin 11 is upregulated in uterine lavage and endometrial cancer cells in women with endometrial carcinoma

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    Nicholls Peter K

    2010-06-01

    Full Text Available Abstract Background Interleukin (IL 11 is produced by human endometrium and endometrial cancer tissue. It has roles in endometrial epithelial cell adhesion and trophoblast cell invasion, two important processes in cancer progression. This study aimed to determine the levels of IL11 in uterine lavage fluid in women with endometrial cancer and postmenopausal women. It further aimed to determine the levels of IL11 protein and its signaling molecules in human endometrial cancer of varying grades, and endometrium from postmenopausal women and IL11 signalling mechanisms in endometrial cancer cell lines. Methods IL11 levels in uterine lavage were measured by ELISA. IL11, IL11 receptor(R α, phosphorylated (p STAT3 and SOCS3 were examined by immunohistochemistry in endometrial carcinomas and in control endometrium from postmenopausal women and normal cycling women. The effect of IL11 on pSTAT3/STAT3 and SOCS3 protein abundance in endometrial cancer cell lines and non-cancer endometrial epithelial cells was determined by Western blot. Results IL11 was present in uterine flushings and was significantly higher in women with Grade 1 carcinomas compared to postmenopausal women (p Conclusions The present study suggests that IL11 in uterine washings may be useful as a diagnostic marker for early stage endometrial cancer. It indicates that IL11, along with its specific receptor, IL11Rα, and downstream signalling molecules, STAT3 and SOCS3, are likely to play a role in the progression of endometrial carcinoma. The precise role of IL11 in endometrial cancer remains to be elucidated.

  19. Use of Oral Sodium Phosphate Colonic Lavage Solution by Canadian Colonoscopists: Pitfalls and Complications

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    A Chan

    1997-01-01

    Full Text Available Oral sodium phosphate (NaP has become an attractive alternative to polyethylene glycol (PEG for colonic cleansing before colonoscopy, but it potentially has greater complications. This study surveyed members of the Canadian Association of Gastroenterology (CAG to determine how these colonic lavage agents are used and what complications have been encountered. The Dillman survey technique produced responses from 67% of the 400 members who perform colonoscopy. For the larger out-patient group, respondents used NaP more frequently than PEG (46% versus 35%, respectively, P<0.015. Respondents used NaP and PEG with similar frequencies for the in-patient group (44% versus 43%. Of respondents using NaP, 45% reported excluding its use in patients with renal failure, 30% with heart disease, 13% with incomplete bowel obstruction and 9% with extreme age. Symptoms suggestive of hypovolemia were reported in 9% of those using NaP compared with 3% using PEG (P<0.02. Three patients receiving NaP developed acute renal failure. A greater proportion of those using NaP had small unexplained aphthous ulcers (16% and excessive luminal bubbling (24% compared with PEG users (3%, P<0.00001 and 14%, P<0.03, respectively. These data demonstrate that members of CAG use NaP more frequently than PEG as the colonic lavage solution before colonoscopy. A greater number reported complications with NaP versus PEG, and a significant proportion of the respondents appeared to be unaware of the potential for these complications in specific clinical circumstances.

  20. 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.

  1. Colectomy and immediate anastomosis versus on-table colonic lavage for the management of acutely obstructed left colon

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    Mohamed I Kassem

    2017-09-01

    Conclusions: In favorable situations, omission of on-table lavage may be preferred for immediate anastomosis in obstructed left colonic emergencies. The technique is reliable and well-tolerated with no additional morbidity or mortality. [Arch Clin Exp Surg 2017; 6(3.000: 138-148

  2. Correlation between specific IgA and eosinophil numbers in the lavage fluid of patients with perennial allergic rhinitis.

    Science.gov (United States)

    Oh, Jeong-Hoon; Hur, Gyu-Young; Ye, Young-Min; Kim, Jeong Eun; Park, Keehyun; Park, Hae-Sim

    2008-01-01

    The mechanisms of eosinophil activation in perennial allergic rhinitis (AR) are not fully understood but may be mediated by a series of inflammatory mediators, including locally produced specific antibodies. The aim of this study was to evaluate the role of locally produced allergen-specific antibodies in the nasal lavage fluid during the recruitment of inflammatory cells in AR. Thirteen patients with AR and a positive nasal provocation test (NPT) with Dermatophagoides pteronyssinus and 10 asymptomatic subjects, sensitized to D. pteronyssinus but who had a negative NPT were enrolled. Nasal lavage fluids were collected before and at 10, 30, and 60 minutes and 3, 6, and 24 hours after the NPT. Inflammatory cells were counted, and eosinophil cationic protein (ECP) and specific immunoglobulin E (IgE), IgG, and IgA antibodies were measured by enzyme-linked immunosorbent assay. After NPT, six subjects showed early responses and seven subjects showed dual responses. The eosinophil count and ECP level in lavage fluid were significantly increased after NPT in patients with positive NPTs, and these values were significantly higher than in the negative group. The specific IgA level in lavage fluid was increased after NPT in the positive group, and significant differences were noted for both the early and the late positive responses. Significant correlations were found between specific IgA and ECP levels in lavage fluid during early and late responses. Eosinophil recruitment occurred during both early and late responses after allergen exposure in perennial AR. Locally produced allergen-specific IgA (but not IgE or IgG) may be involved in eosinophil activation in both early and late responses.

  3. 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

  4. Outcomes of denervation, joint lavage and capsular imbrication for painful thumb carpometacarpal joint osteoarthritis.

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    Ehrl, D; Erne, H C; Broer, P N; Metz, C; Falter, E

    2016-11-01

    Pain reduction remains the main aim in the treatment of thumb carpometacarpal joint osteoarthritis. We performed a retrospective analysis of a case series of patients with symptomatic thumb carpometacarpal joint arthritis treated with denervation, joint lavage and capsular imbrication. A total of 60 patients participated in this study. Follow-up, including a clinical examination, was performed on 37 patients at a mean of 46 months (range 12 to 81); an additional 23 patients were followed-up by telephone at a mean of 52 months (range 14 to 93) post-operatively. The patients assessed in person showed a significant decrease in pain and a significant improvement in thumb function. The information gathered by telephone gave similar results. The findings of our study indicate that the presented treatment approach could be a good alternative to more invasive surgical options in patients with earlier stages of thumb carpometacarpal joint osteoarthritis. Advantages include the low rate of complications and invasiveness, as well as short recovery times. IV.

  5. Comparison of reduced volume versus four liters sulfate-free electrolyte lavage solutions for colonoscopy colon cleansing.

    Science.gov (United States)

    DiPalma, Jack A; Wolff, Bruce G; Meagher, Alan; Cleveland, Mark vB

    2003-10-01

    In an attempt to improve patient tolerance for colonoscopy cleansing, a reduced volume lavage regimen with 2 L sulfate-free electrolyte lavage solution (SF-ELS, NuLYTELY, Braintree Laboratories, Braintree, MA) plus 20 mg p.o. bisacodyl (Half Lytely, Braintree Laboratories) was compared with standard 4 L SF-ELS lavage for safety and efficacy. At two centers, 200 patients undergoing colonoscopy for routine indications were randomized to receive the reduced volume or standard 4 L method. The day before scheduled colonoscopy, study subjects were allowed a normal breakfast and clear liquids for lunch and dinner. Those randomized to receive the reduced volume method received four 5-mg bisacodyl tablets p.o. at noon. Six hours later, they received 2 L SF-ELS given as 10 oz every 10 min. Subjects randomized to receive 4 L SF-ELS also drank their solution at 6:00 PM in a similar fashion. Colonoscopists, unaware as to the randomized preparation received, rated efficacy of cleansing. Patient tolerance and various hematological and biochemical parameters were assessed. Physician assessment of colon cleansing showed no differences between those patients randomized to receive reduced volume (n = 93) or 4 L (n = 93) SF-ELS cleansing (p = 0.16). There was a profound reduction in preparation side effects. The reduced volume preparation had less fullness (p < 0.01), nausea (p < 0.01), vomiting (p = 0.01), and overall discomfort (p < 0.01). There were no clinically significant changes in hematology or blood chemistry associated with either preparation. Reduced volume preparation with 2 L SF-ELS and bisacodyl is safe and effective. Clinical symptoms from the reduced volume preparation are significantly reduced compared with traditional 4 L gut lavage.

  6. Prospective comparison of three bowel preparation regimens: fleet phosphosoda, two-liter and four-liter electrolyte lavage solutions.

    Science.gov (United States)

    Ker, Tim S

    2008-10-01

    In an attempt to improve patients' tolerance for colon cleaning, three bowel preparation regimens: 90-mL Fleet phosphosoda (FPS), 2-L electrolyte lavage solution plus 20 mg oral bisacodyl, and 4-L lavage, were compared for efficacy and safety. A total of 912 patients were prospectively nonrandomized into three study groups. In Group A, 304 patients were given 45-mL Fleet phosphosoda at 9 AM and 6 PM the day before colonoscopy. In Group B, 304 patients were given four tablets of 5 mg bisacodyl at 12 PM the day before colonoscopy followed by 2 L electrolyte lavage by mouth at 6:00 PM the evening before colonoscopy. In Group C, 304 patients were given 4 L electrolyte lavage at 6:00 PM the evening before colonoscopy. All patients were kept on a clear liquid diet the day before colonoscopy. The bowel cleanliness was accessed by one colonoscopist. One registered nurse accessed the ease of the patient. In Group A (FPS), every patient finished the 90-mL Fleet phosphosoda. Colon cleanliness was 95.1 per cent. In Group B (2 L), three patients (0.6%) could not finish the laxative. Colon cleanliness was 95.9 per cent. In Group C (4 L), 22 patients (7.3%) could not finish the laxative preparation. Colon cleanliness was 95.3 per cent. The study found these three regimens can achieve equally good results of bowel preparation; however, the small volume laxative (FPS) has been accepted favorably by patients.

  7. Successful Management of a Cesarean Scar Defect with Dehiscence of the Uterine Incision by Using Wound Lavage

    OpenAIRE

    Akinori Ida; Yoko Kubota; Maiko Nosaka; Koichi Ito; Hiroshi Kato; Yoshiyuki Tsuji

    2014-01-01

    Cesarean scar defects (CSDs) that can be visualized using transvaginal ultrasonography (TVUS) may cause prolonged menstruation, irregular genital bleeding, and secondary infertility; surgical repair is sometimes necessary. We present a case of CSD, with dehiscence of the uterine incision, which was managed using wound lavage. A 38-year-old woman (gravida 4, para 4) had delivered her third and fourth children by cesarean section. Upon the resumption of menstruation, 9 months after her second c...

  8. Single dose topical corticosteroid inhibits IL-5 and IL-13 in nasal lavage following grass pollen challenge.

    Science.gov (United States)

    Erin, E M; Leaker, B R; Zacharasiewicz, A S; Higgins, L A; Williams, T J; Boyce, M J; de Boer, P; Durham, S R; Barnes, P J; Hansel, T T

    2005-12-01

    Nasal lavage is a noninvasive method of obtaining inflammatory exudates following nasal allergen challenge (NAC), and permits cells and released mediators to be evaluated. To determine the effects of a single dose of topical steroid on eosinophils and levels of chemokines and cytokines in nasal lavage fluid following NAC in patients with allergic rhinitis. Patients with grass pollen seasonal allergic rhinitis (n = 32) out of the allergy season received either nasal budesonide (100 microg per nostril) or matched placebo before allergen challenge in a double blind two-way crossover design. A semi-automated mixed bead array system was employed to measure multiple chemokines and cytokines in small volumes (50 microl) of nasal lavage supernatants. Following NAC there was a rapid onset of nasal symptoms together with nasal eosinophilia, and the appearance of IL-5 and IL-13 in lavages between 4 and 8 h. Elevated levels of eotaxin, RANTES, IL-8 and MCP-1 were also detected following allergen challenge. A single dose of nasal budesonide caused a decrease in symptoms (P < 0.05) and nasal eosinophils (P < 0.05) with selective abrogation of IL-5 and IL-13 responses (P < 0.05), but a lack of effect on levels of eotaxin, RANTES, IL-8 and MCP-1. This study suggests that a single dose of nasal steroid has the capacity to selectively abolish IL-5 and IL-13 responses following NAC. This model should be convenient for testing novel anti-inflammatory and immunoregulatory agents intended for the treatment of allergic rhinitis.

  9. Intracavity lavage and wound irrigation for prevention of surgical site infection

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    Norman, Gill; Atkinson, Ross A; Smith, Tanya A; Rowlands, Ceri; Rithalia, Amber D; Crosbie, Emma J; Dumville, Jo C

    2017-01-01

    Background Surgical site infections (SSIs) are wound infections that occur after an operative procedure. A preventable complication, they are costly and associated with poorer patient outcomes, increased mortality, morbidity and reoperation rates. Surgical wound irrigation is an intraoperative technique, which may reduce the rate of SSIs through removal of dead or damaged tissue, metabolic waste, and wound exudate. Irrigation can be undertaken prior to wound closure or postoperatively. Intracavity lavage is a similar technique used in operations that expose a bodily cavity; such as procedures on the abdominal cavity and during joint replacement surgery. Objectives To assess the effects of wound irrigation and intracavity lavage on the prevention of surgical site infection (SSI). Search methods In February 2017 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase and EBSCO CINAHL Plus. We also searched three clinical trials registries and references of included studies and relevant systematic reviews. There were no restrictions on language, date of publication or study setting. Selection criteria We included all randomised controlled trials (RCTs) of participants undergoing surgical procedures in which the use of a particular type of intraoperative washout (irrigation or lavage) was the only systematic difference between groups, and in which wounds underwent primary closure. The primary outcomes were SSI and wound dehiscence. Secondary outcomes were mortality, use of systemic antibiotics, antibiotic resistance, adverse events, re-intervention, length of hospital stay, and readmissions. Data collection and analysis Two review authors independently assessed studies for inclusion at each stage. Two review authors also undertook data extraction, assessment of risk of bias and GRADE assessment. We calculated risk ratios or differences in means with 95% confidence intervals where

  10. Airway symptoms and biological markers in nasal lavage fluid in subjects exposed to metalworking fluids.

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    Louise Fornander

    Full Text Available BACKGROUNDS: Occurrence of airway irritation among industrial metal workers was investigated. The aims were to study the association between exposures from water-based metal working fluids (MWF and the health outcome among the personnel, to assess potential effects on the proteome in nasal mucous membranes, and evaluate preventive actions. METHODS: The prevalence of airway symptoms related to work were examined among 271 metalworkers exposed to MWF and 24 metal workers not exposed to MWF at the same factory. At the same time, air levels of potentially harmful substances (oil mist, morpholine, monoethanolamine, formaldehyde generated from MWF was measured. Nasal lavage fluid was collected from 13 workers and 15 controls and protein profiles were determined by a proteomic approach. RESULTS: Airway symptoms were reported in 39% of the workers exposed to MWF although the measured levels of MWF substances in the work place air were low. Highest prevalence was found among workers handling the MWF machines but also those working in the same hall were affected. Improvement of the ventilation to reduce MWF exposure lowered the prevalence of airway problems. Protein profiling showed significantly higher levels of S100-A9 and lower levels of SPLUNC1, cystatin SN, Ig J and β2-microglobulin among workers with airway symptoms. CONCLUSIONS: This study confirms that upper airway symptoms among metal workers are a common problem and despite low levels of MWF-generated substances, effects on airway immune proteins are found. Further studies to clarify the role of specific MWF components in connection to airway inflammation and the identified biological markers are warranted.

  11. Intracavity lavage and wound irrigation for prevention of surgical site infection.

    Science.gov (United States)

    Norman, Gill; Atkinson, Ross A; Smith, Tanya A; Rowlands, Ceri; Rithalia, Amber D; Crosbie, Emma J; Dumville, Jo C

    2017-10-30

    Surgical site infections (SSIs) are wound infections that occur after an operative procedure. A preventable complication, they are costly and associated with poorer patient outcomes, increased mortality, morbidity and reoperation rates. Surgical wound irrigation is an intraoperative technique, which may reduce the rate of SSIs through removal of dead or damaged tissue, metabolic waste, and wound exudate. Irrigation can be undertaken prior to wound closure or postoperatively. Intracavity lavage is a similar technique used in operations that expose a bodily cavity; such as procedures on the abdominal cavity and during joint replacement surgery. To assess the effects of wound irrigation and intracavity lavage on the prevention of surgical site infection (SSI). In February 2017 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase and EBSCO CINAHL Plus. We also searched three clinical trials registries and references of included studies and relevant systematic reviews. There were no restrictions on language, date of publication or study setting. We included all randomised controlled trials (RCTs) of participants undergoing surgical procedures in which the use of a particular type of intraoperative washout (irrigation or lavage) was the only systematic difference between groups, and in which wounds underwent primary closure. The primary outcomes were SSI and wound dehiscence. Secondary outcomes were mortality, use of systemic antibiotics, antibiotic resistance, adverse events, re-intervention, length of hospital stay, and readmissions. Two review authors independently assessed studies for inclusion at each stage. Two review authors also undertook data extraction, assessment of risk of bias and GRADE assessment. We calculated risk ratios or differences in means with 95% confidence intervals where possible. We included 59 RCTs with 14,738 participants. Studies assessed comparisons

  12. Prognostic impact of pleural lavage cytology in patients with primary lung cancer.

    Science.gov (United States)

    Tomizawa, Kenji; Nishino, Masaya; Sesumi, Yuichi; Kobayashi, Yoshihisa; Sato, Katsuaki; Chiba, Masato; Shimoji, Masaki; Suda, Kenichi; Shimizu, Shigeki; Sato, Takao; Takemoto, Toshiki; Mitsudomi, Tetsuya

    2016-12-01

    Positive pleural lavage cytology (PLC) has been reported to have a negative prognostic impact in patients with surgically resected non-small cell lung cancer (NSCLC). However, positive PLC does not upgrade the stage according to the 7th edition of TNM classification for lung cancer. The objectives of this study were to evaluate the prognostic impact of positive PLC in patients with NSCLC and to clarify its contribution to TNM classification. Seven hundred fifty-four patients who underwent surgical resection of NSCLC from January 2007 through December 2013 were retrospectively studied. PLC was performed using 50ml of saline immediately after thoracotomy. Thirty-eight of the 754 patients were positive for PLC (5.1%). The overall survival (OS) of patients with positive PLC was significantly shorter than that of those with negative PLC (P=0.007, log-rank test). In multivariate analyses of OS, positive PLC was a significant independent prognostic factor (hazard ratio=2.21, 95% confidence interval: 1.21-4.04, P=0.009). The OS of patients with positive PLC was significantly shorter than that of those with negative PLC and pT1 (P<0.0001) or negative PLC and pT2 (P<0.0001) and almost overlapped with that of those with negative PLC and pT3 disease (P=0.601). Positive PLC is an independent prognostic factor in patients with resected NSCLC. Based on our analyses, we propose that patients with positive PLC be staged as pT3. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. [Long-term therapeutic effects of whole lung lavage in the management of silicosis].

    Science.gov (United States)

    Zhang, Ying-ming; Zhang, Hai-tao; Wang, Cai-ying; Wang, Wei; Wu, Jing; Wang, Chun

    2012-09-01

    To investigate the long-term therapeutic effect of whole lung lavage (WLL) in the treatment of silicosis. 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. 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), while the control group showed significant decrease in FVC and FEV1 after treatment (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 silicosis stage was, the less FVC decreased. Follow-up of 108 cases treated by WLL showed that the lower silicosis stage was, the higher no change rate was, according to the chest X-ray findings 2 ∼ 3, 4 ∼ 5, and 6 ∼ 7 years after treatment and that there were significant differences in no change rate between stages II and III silicosis groups and stages 0+ and I silicosis groups (P silicosis, especially for early silicosis and accelerated silicosis. However, WLL should be used cautiously in the treatment of advanced silicosis.

  14. Relationship between dynamic respiratory mechanics and disease heterogeneity in sheep lavage injury.

    Science.gov (United States)

    Bellardine Black, Carissa L; Hoffman, Andrew M; Tsai, Larry W; Ingenito, Edward P; Suki, Bela; Kaczka, David W; Simon, Brett A; Lutchen, Kenneth R

    2007-03-01

    Acute respiratory distress syndrome and acute lung injury are characterized by heterogeneous flooding/collapse of lung tissue. An emerging concept for managing these diseases is to set mechanical ventilation so as to minimize the impact of disease heterogeneity on lung mechanical stress and ventilation distribution. The goal of this study was to determine whether changes in lung mechanical heterogeneity with increasing positive end-expiratory pressure in an animal model of acute lung injury could be detected from the frequency responses of resistance and elastance. Prospective, experimental study. Research laboratory at a veterinary hospital. Female sheep weighing 48 +/- 2 kg. In five saline-lavaged sheep, we acquired whole-lung computed tomography scans, oxygenation, static elastance, and dynamic respiratory resistance and elastance at end-expiratory pressure levels of 7.5-20 cm H2O. As end-expiratory pressure increased, computed tomography-determined alveolar recruitment significantly increased but was accompanied by significant alveolar overdistension at 20 cm H2O. An optimal range of end-expiratory pressures (15-17.5 cm H2O) was identified where alveolar recruitment was significantly increased without significant overdistension. This range corresponded to the end-expiratory pressure levels that maximized oxygenation, minimized peak-to-peak ventilation pressures, and minimized indexes reflective of the mechanical heterogeneity (e.g., frequency dependence of respiratory resistance and low-frequency elastance). Static elastance did not demonstrate any significant pressure dependence or reveal an optimal end-expiratory pressure level. We conclude that dynamic mechanics are more sensitive than static mechanics in the assessment of the functional trade-off of recruitment relative to overdistension in a sheep model of lung injury. We anticipate that monitoring of dynamic respiratory resistance and elastance ventilator settings can be used to optimize ventilator

  15. Laparoscopic Lavage Is Feasible and Safe for the Treatment of Perforated Diverticulitis With Purulent Peritonitis: The First Results From the Randomized Controlled Trial DILALA.

    Science.gov (United States)

    Angenete, Eva; Thornell, Anders; Burcharth, Jakob; Pommergaard, Hans-Christian; Skullman, Stefan; Bisgaard, Thue; Jess, Per; Läckberg, Zoltan; Matthiessen, Peter; Heath, Jane; Rosenberg, Jacob; Haglind, Eva

    2016-01-01

    To evaluate short-term outcomes of a new treatment for perforated diverticulitis with purulent peritonitis in a randomized controlled trial. Perforated diverticulitis with purulent peritonitis (Hinchey III) has traditionally been treated with surgery including colon resection and stoma (Hartmann procedure) with considerable postoperative morbidity and mortality. Laparoscopic lavage has been suggested as a less invasive surgical treatment. Laparoscopic lavage was compared with colon resection and stoma in a randomized controlled multicenter trial, DILALA (ISRCTN82208287). Initial diagnostic laparoscopy showing Hinchey III was followed by randomization. Clinical data was collected up to 12 weeks postoperatively. Eighty-three patients were randomized, out of whom 39 patients in laparoscopic lavage and 36 patients in the Hartmann procedure groups were available for analysis. Morbidity and mortality after laparoscopic lavage did not differ when compared with the Hartmann procedure. Laparoscopic lavage resulted in shorter operating time, shorter time in the recovery unit, and shorter hospital stay. In this trial, laparoscopic lavage as treatment for patients with perforated diverticulitis Hinchey III was feasible and safe in the short-term.

  16. A comparison of discectomy and arthroscopic lysis and lavage for the treatment of chronic closed lock of the temporomandibular joint: a randomized outcome study.

    Science.gov (United States)

    Holmlund, A B; Axelsson, S; Gynther, G W

    2001-09-01

    The study compared the efficacy of discectomy or arthroscopic lysis and lavage in patients with chronic closed lock of the temporomandibular joint (TMJ) in a prospective, randomized clinical trial. Twenty-two patients with a clinical diagnosis of chronic closed lock were prospectively randomized to either discectomy or arthroscopic lysis and lavage. The individual outcome in each patient was evaluated with a visual analog scale for pain and a questionnaire concerning mandibular functional impairment. The clinical evaluation included measurement of maximum interincisal opening and protrusion, recording of clicking and crepitation, and palpation for tenderness of the TMJ and jaw muscles. Recordings were made before the operation (baseline) and at the 1-year follow-up. Twenty patients completed the study. Discectomy and arthroscopic lysis and lavage significantly reduced pain and improved mandibular function. Discectomy reduced pain somewhat more effectively than arthroscopic lysis and lavage. The clinical recordings at the 1-year follow-up indicated similarly good outcomes after both procedures. Both discectomy and arthroscopic lysis and lavage are effective surgical methods for treatment of chronic closed lock of the TMJ. Considering that arthroscopic lysis and lavage is a minimally invasive outpatient procedure, it should be used as the first choice in surgical treatment of this condition. Copyright 2001 American Association of Oral and Maxillofacial Surgeons.

  17. Recombinant Mycobacterium bovis BCG producing IL-18 reduces IL-5 production and bronchoalveolar eosinophilia induced by an allergic reaction.

    Science.gov (United States)

    Biet, F; Duez, C; Kremer, L; Marquillies, P; Amniai, L; Tonnel, A-B; Locht, C; Pestel, J

    2005-08-01

    Allergic reactions occur through the exacerbated induction of a Th2 cell type expression profile and can be prevented by agents favoring a Th1 profile. Bacillus Calmette-Guérin (BCG) is able to induce high IFN-gamma levels and has been shown to decrease experimentally induced allergy. The induction of IFN-gamma is mediated by interleukin (IL)-12 known to be secreted upon mycobacterial infections and can be enhanced by IL-18 acting in synergy with IL-12. We evaluated the ability of a recombinant BCG strain producing IL-18 (rBCG) to modify the Th2 type responses in a murine model of ovalbumin (OVA)-dependent allergic reaction. Mice were injected intraperitoneally or intranasally with OVA at days 0 and 15 and exposed to an OVA aerosol challenge at days 29, 30, 31 and 34. At days 0 and 15, two additional groups of mice received OVA together with 5 x 10(6) colony forming units of either rBCG or nonrecombinant BCG. A time-course analysis of OVA-specific immunoglobulin (Ig)E, IgG1 and IgG2a levels indicated no significant difference between the three groups of mice. However, following in vitro stimulation with OVA, lymph node cells from rBCG-treated mice produced less IL-5 and more IFN-gamma than those of mice injected with nonrecombinant BCG. In addition, 48 h after the last OVA challenge, a strong reduction of bronchoalveolar eosinophilia was found in the rBCG-injected mice compared to the nontreated or nonrecombinant BCG-treated groups. These results indicate that the production of IL-18 by rBCG may enhance the immunomodulatory properties of BCG that suppress pulmonary Th2 responses and, in particular, decrease airway eosinophilia.

  18. 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.

  19. Tolerance, effectiveness, and acceptability of sulfate-free electrolyte lavage solution for colon cleaning before colonoscopy.

    Science.gov (United States)

    Raymond, J M; Beyssac, R; Capdenat, E; Pineau, C H; Kerjean, A; Saux, M C; Couzigou, P; Amouretti, M

    1996-09-01

    The unpleasant taste of the solution used for preparation before colonoscopy may limit patients' compliance with the procedure. However, the published results concerning the acceptability of sulfate-free electrolyte lavage solution (SF-ELS) for colon cleansing before colonoscopy are conflicting. The aim of this study was to compare SF-ELS with the standard polyethylene glycol (PEG) solution with regard to tolerance, effectiveness, and acceptability. In the first part of the study, 24 patients were assigned to receive either one liter of SF-ELS or one liter of the standard PEG solution. After two hours, the patients had to choose two further liters (of either the first or second solution), and preparation for colonoscopy was completed. In the second part, fifty further patients were randomized into two groups: 25 patients received four liters of standard solution, and 25 patients received four liters of SF-ELS. The patients' opinions regarding the preparation and their willingness to repeat the use of the same preparation were recorded by questionnaire. The quality of the colon preparation was assessed by the endoscopists. Seventeen patients (71%; P < 0.05) preferred SF-ELS. The compliance rate in the two groups was 96%, and the frequency of occurrence of adverse effects was also similar. Colonoscopy was completed in 24 of the 25 patients in the SF-ELS group and 22 of the 25 patients in the standard PEG group (the difference was not significant). Visualization of the mucosa in the areas explored was perfect in 20 of the 25 patients in the SF-ELS group and in 17 of the 25 patients in the PEG group (not significant). Patients had a significant preference for SF-ELS. Eighteen of the 25 patients in the SF-ELS group were willing to accept the same preparation for a further colonoscopy, compared with 11 of the 25 in the other group (P < 0.05). Improving the acceptability of colonic preparation before colonoscopy could improve patients' compliance and the quality of the

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

    DEFF Research Database (Denmark)

    Madsen, A. M.; Tendal, K.; Thilsing, T.

    2013-01-01

    occupational exposure to fungi, -glucan, and bacteria and contents of fungi, -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....... 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, -glucan, and bacteria in NAL, with the highest contents in NAL of men. On Thursdays...

  1. Is it safe and useful, laparoscopic peritoneal lavage in the treatment of acute diverticulitis of octogenarian patients? A multicenter retroprospective observational study.

    Science.gov (United States)

    Boselli, Carlo; Gemini, Alessandro; Cirocchi, Roberto; Grassi, Veronica; Avenia, Stefano; Polistena, Andrea; Sanguinetti, Alessandro; Pironi, Daniele; Santoro, Alberto; Tabola, Renata; Burattini, Maria Federica; Avenia, Nicola

    2017-02-01

    Diverticular disease of the colon also affects older people. Generally, older patients with diverticulitis may be regarded as too risky to undergo surgery. This retroprospective multicentric observational study aims to assess the safety and benefits of laparoscopic peritoneal lavage (LPL) in elderly patients with perforated sigmoid diverticulitis. We hospitalized in urgency 100 patients, aged over 75, for sigmoid diverticulitis. Sixty-nine patients were treated with conservative medical therapy, while 31 were treated surgically, in which the surgery was performed in urgency in 18 cases, while in election in 13 cases. Laparoscopic peritoneal lavage was made in urgency in five cases. The mean age of the sample was 81.72. Thirty-one patients underwent surgery, and five patients were treated in urgency with laparoscopic peritoneal lavage. Perioperative mortality was zero. None of the patients who underwent laparoscopic peritoneal lavage showed recurrent disease. Diagnostic laparoscopy can be useful in elderly patient, since these patients may benefit from a more conservative surgical strategy. The selection of patients to be subjected to laparoscopic lavage must be very rigorous.

  2. 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.

  3. Loss of heterozygosity at the BRCA1 and BRCA2 loci detected in ductal lavage fluid from BRCA gene mutation carriers and controls.

    Science.gov (United States)

    Locke, Imogen; Kote-Jarai, Zsofia; Bancroft, Elizabeth; Bullock, Sarah; Jugurnauth, Sarah; Osin, Peter; Nerurkar, Ashutosh; Izatt, Louise; Pichert, Gabriella; Gui, Gerald P H; Eeles, Rosalind A

    2006-07-01

    Female BRCA gene mutation carriers are at increased risk for developing breast cancer. Ductal lavage is a novel method for sampling breast ductal fluid, providing epithelial cells for cytologic assessment and a source of free DNA for molecular analyses. Loss of heterozygosity (LOH) at the BRCA loci in ductal lavage fluid is a potential biomarker of breast cancer risk. The LOH rate was measured at the BRCA1/2 loci and compared with that at a control locus (APC) using free DNA from the ductal lavage fluid of BRCA carriers and predictive test negative controls. We evaluated the reproducibility of these analyses. Free DNA sufficient for PCR amplification was obtained from 33 ductal lavage samples of 17 healthy women of known BRCA status (14 BRCA carriers and 3 controls). LOH rates of 36.4% to 56.3% at the BRCA1 locus and 45% to 61.5% at the BRCA2 locus were found among BRCA carriers. The LOH rate at the APC locus was lower (18.5%). The interaliquot reproducibility for the D17S855 marker of the BRCA1 locus was 66.7%. Intraaliquot reproducibility was 90%. Although we successfully isolated sufficient free DNA from ductal lavage fluid for PCR amplification, the degree of reproducibility of these LOH studies raises questions about the robustness of this technique as a risk assessment tool in the evaluation of high-risk women. Further studies are required to evaluate the specificity and predictive value of LOH in ductal lavage fluid for breast cancer development.

  4. 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.

  5. The Impact of 0.9% NaCl on Mesothelial Cells After Intraperitoneal Lavage During Surgical Procedures.

    Science.gov (United States)

    Cwaliński, Jarosław; Bręborowicz, Andrzej; Połubińska, Alicja

    2016-01-01

    Normal saline gained wide popularity in abdominal surgery as a basic compound used in intraoperative drainage of the peritoneal cavity. However, recent studies have revealed that saline solution is not quite biocompatible with the intraperitoneal enviroment and may promote peritoneal adhesions. The aim of the study was to evaluate the function and viability of human mesothelial cells cultured in vitro in 0.9% NaCl solution from intraperitoneal lavage carried out during laparoscopic cholecytectomies. The study included 40 consecutive patients suffering from gallstones who underwent laparoscopic cholecystectomy. Fluid was collected after intraperitoneal lavage during the surgical procedures. The samples obtained were used as a medium for in vitro incubation of primary human mesothelial cells. After 24 h the synthesis of interleukin 6 (IL-6), plasminogen activator inhibitor (PAI) and tissue plasminogen activator (tPA), as well as the index of cell proliferation were assessed in all the experimental groups. All the mesothelium cell cultures treated with fluid samples obtained ex vivo were characterized by elevated levels of IL-6. The highest concentrations of PAI-1 were found in groups of cells exposed to fluid with bile; similarly, tPA synthesis was extremely elevated in groups treaded with fluid containing bile and small amounts of hemolyzed blood. In contrast, cell proliferation was exceedingly high in 2 groups of cells placed in a standard culture medium and in 0.9% NaCl solution. Normal saline introduced into the abdominal cavity modifies the biological and physicochemical conditions of the intraperitoneal environment. The impact of 0.9% NaCl on mesothelial cells is manifested in destabilized tissue regeneration, which supposedly initiates adhesion formation.

  6. In-vitro cytocidal effect of water on bladder cancer cells: The potential role for intraperitoneal lavage during radical cystectomy.

    Science.gov (United States)

    Taoka, Rikiya; Williams, Stephen B; Ho, Philip L; Kamat, Ashish M

    2015-01-01

    We investigate the cytocidal effect of water on bladder cancer cells. Intraperitoneal lavage with sterile water is sometimes used during radical cystectomy to lyse cancer cells that might have escaped the surgical specimen. The efficacy of this approach at the cellular level is unknown. Three bladder cancer cell lines of varying grade, RT4, TCCSUP and T24 were exposed to sterile water, and morphological changes were closely observed under microscopy. Changes of cell membrane integrity, cell viability, and cell number of re-incubated cells after water exposure were measured to determine water induced hypotonic shock. The low-grade RT4 cells started swelling immediately upon exposure to water followed by rupture within 3 minutes. The higher grade TCCSUP and T24 cells demonstrated limited hypotonic swelling with significantly less cell rupture after 10 minutes. The damage to cell membrane of RT4 cells was evident at 1 minute; only 10.0% of cells were intact at 10 minutes. On the other hand, 41.9% and 77.8% of TCCSUP and T24 cells were intact at 10 minutes, respectively. Percentage of viable cells at 10 minutes was 2.1 ± 2.3%, 2.3 ± 0.4%, and 16.1 ± 0.6% for RT4, TCCSUP, and T24, respectively. Cytocidal effect of hypotonic shock can be achieved, to varying degrees, by exposing bladder cancer cells to water for at least 10 minutes. This in vitro study may have bearing on the effects seen with intraperitoneal lavage using sterile water during radical cystectomy.

  7. Lavage Therapy Versus Nonsurgical Therapy for the Treatment of Arthralgia of the Temporomandibular Joint : A Systematic Review of Randomized Controlled Trials

    NARCIS (Netherlands)

    Vos, Lukas M.; Slater, James J. R. Huddleston; Stegenga, Boudewijn

    2013-01-01

    Aims: To carry out a systematic review of randomized controlled trials (RCTs) to investigate in patients with arthralgia of the temporomandibular joint (TMJ) the effectiveness of TMJ lavage compared to nonsurgical treatment with regard to pain intensity and mandibular range of motion. Methods: The

  8. Should three slide-touch print cytology replace pleural lavage cytology for detection of pleural micrometastases in cases of bronchogenic carcinoma?

    Science.gov (United States)

    Alayouty, Hamdy D; Amin, Morsy Mohamed; Aloukda, Ausama W; Bafakeer, Salim S; Sulieman, Dhafir Dawood

    2011-05-01

    A prospective study, including 112 patients, designed to estimate the sensitivity and specificity of slide-touch and pleural lavage cytology for diagnosis of pleural micrometastases in operable non-small cell lung cancer (NSCLC). Histopathologically, excised tumors showed P0 in 22 patients (19%), P1 in 44 patients (39%), P2 in 32 patients (29%), P3 in 14 patients (13%). Cytological examination of the three slide-touch prints from visceral pleura overlying the tumor (slide 1), parietal pleura facing tumor (slide 2), parietal pleura in paravertebral gutter (slide 3) resulted in: slide 1: positive in 60% (66/112) [this included p0 (2 out of 22), p1 (22 out of 44), p2 (32 out of 32) and p3 (10 out of 14)], slide 2: positive in 13% (14/112); all of them had P3, and slide 3 positive in 8% (9/112). Total positive slides 62% (70/112). Pleural lavage: positive in 19% (22/112), all of them were detected with slide 1 and/or slide 2. During follow-up, patients with negative slides had no local or distant metastases (truly negative), six recurrences among those with positive slide 1, including four with positive lavage. Thus, slide touch print is more sensitive than lavage cytology, both of prognostic significance. Slide 1 is a highly sensitive detector of visceral pleural micrometastases; slide 2 is a more sensitive detector of parietal pleural invasion; slide 3 is the least.

  9. 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

    National Research Council Canada - National Science Library

    Paula Cristina Basso; Alceu Gaspar Raiser; Maurício Veloso Brun; Luciana Ruschel Santos; Daniel Curvello de Mendonça Muller; Anelise Bonilla Trindade

    2009-01-01

    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...

  10. Bronchoalveoloar lavage fluid cytokines and chemokines as markers and predictors for the outcome of interstitial lung disease in systemic sclerosis patients

    OpenAIRE

    Schmidt, Katrin; Martinez-Gamboa, Lorena; Meier, Susan; Witt, Christian; Meisel, Christian; Hanitsch, Leif G.; Becker, Mike O; Huscher, Doerte; Burmester, Gerd R; Riemekasten, Gabriela

    2009-01-01

    Introduction Interstitial lung disease (ILD) is a frequent manifestation of systemic sclerosis (SSc), and cytokines can contribute to the disease pathology. The aim of the current study was to identify specific changes in cytokine levels that may serve as disease markers and possible targets for therapy. Methods Cytokines were measured with bioplex analysis in 38 bronchoalveolar fluids (BALFs) from 32 SSc patients (27 with alveolitis and 11 without alveolitis) and 26 control patients. In the ...

  11. 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.

  12. Characterization of the oxidant generation by inflammatory cells lavaged from rat lungs following acute exposure to ozone

    Energy Technology Data Exchange (ETDEWEB)

    Esterline, R.L.; Bassett, D.J.; Trush, M.A.

    1989-06-15

    Following exposure to 2 ppm ozone for 4 hr, two distinct effects on rat lung inflammatory cell oxidant generation were observed. TPA- and opsonized zymosan-stimulated superoxide production by the inflammatory cell population was found to be maximally inhibited 24 hr following ozone exposure. In contrast, luminol-amplified chemiluminescence increased 24 hr following ozone exposure, coinciding with an increase in the percentage of neutrophils and myeloperoxidase in the inflammatory cell population. Supporting the involvement of myeloperoxidase in the enhanced oxidant-generating status of these cells, the luminol-amplified chemiluminescence was found to be azide-, but not superoxide dismutase-inhibitable. Additionally, this cell population was found to generate taurine chloramines, a myeloperoxidase-dependent function which was absent prior to the ozone exposure and also demonstrated enhanced activation of benzo(a)pyrene-7,8-dihydrodiol to its light-emitting dioxetane intermediate. Addition of myeloperoxidase to control alveolar macrophages resulted in enhanced luminol-amplified chemiluminescence, taurine chloramine generation, and enhanced chemiluminescence from benzo(a)pyrene-7,8-dihydrodiol demonstrating that, in the presence of myeloperoxidase, alveolar macrophages are capable of supporting myeloperoxidase-dependent reactions. The possibility of such an interaction occurring in vivo is suggested by the detection of myeloperoxidase activity in the cell-free lavagates of ozone-exposed rats. These studies suggest that neutrophils recruited to ozone-exposed lungs alter the oxidant-generating capabilities in the lung which could further contribute to lung injury or to the metabolism of inhaled xenobiotics.

  13. Reducing the volume of polyethylene glycol electrolyte lavage solution to less than 2 liters for bowel preparation.

    Science.gov (United States)

    Mukai, M; Tajima, T; Suzuki, R; Yamamoto, S; Miyako, H; Hara, T; Morita, M; Makuuchi, H

    2000-04-01

    Smaller volumes of polyethylene glycol electrolyte lavage solution (PEG), an oral whole-bowel irrigation solution employed in colorectal preparation, were given to patients to decrease the discomfort associated with pretreatment. Comparison was made between groups receiving standard and modified preparations. A total of 68 patients (gastrointestinal surgery: 55; total colonoscopy: 13) were enrolled in the study. The mean volume of PEG used was significantly smaller in the modified than in the standard preparation (1,694 ml vs. 2,735 ml, p<0.01). In addition, the mean PEG administration period was significantly shorter for the modified preparation (183 min vs. 237 min, p<0.05). However, the mean PEG excretion time and the number of bowel movements were not significantly different between the two groups. There was also no significant difference between the two groups in terms of the efficacy, safety, usefulness, or tolerability of the preparations. These results suggest that it is possible to reduce the PEG volume by more than 1 L to alleviate patient discomfort without a significant loss of efficacy. The modified method is useful for preparing the large bowel for either gastrointestinal surgery or total colonoscopy.

  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. PMID:24995014

  15. 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.

  16. Randomized Cross-Sectional Study to Compare HIV-1 Specific Antibody and Cytokine Concentrations in Female Genital Secretions Obtained by Menstrual Cup and Cervicovaginal Lavage

    OpenAIRE

    Archary, Derseree; Liebenberg, Lenine J.; Werner, Lise; Tulsi, Sahil; Majola, Nelisile; Naicker, Nivashnee; Dlamini, Sarah; Hope, Thomas J.; Samsunder, Natasha; Abdool Karim, Salim S.; Morris, Lynn; Passmore, Jo-Ann S.; Garrett, Nigel J.

    2015-01-01

    Introduction Optimizing methods for genital specimen collection to accurately characterize mucosal immune responses is a priority for the HIV prevention field. The menstrual cup (MC) has been proposed as an alternative to other methods including cervicovaginal lavage (CVL), but no study has yet formally compared these two methods. Methods Forty HIV-infected, antiretroviral therapy-na?ve women from the CAPRISA 002 acute HIV infection cohort study were randomized to have genital fluid collected...

  17. Effect of peritoneal cavity lavage with 0.9% and 3.0% saline solution in the lung and spleen of gerbils with induced peritonitis.

    Science.gov (United States)

    Nunes, Vinícius Rodrigues Taranto; Barbuto, Rafael Calvão; Vidigal, Paula Vieira Teixeira; Pena, Guilherme Nogueira; Rocha, Silvia Lunardi; de Siqueira, Lucas Tourinho; Caliari, Marcelo Vidigal; de Araujo, Ivana Duval

    2014-04-01

    Peritoneal cavity lavage is used widely in the treatment of peritonitis. Nonetheless, some studies question its rationale and prove it to be deleterious to the mesothelium. The present study aims to determine whether 0.9% and 3.0% saline lavage of the peritoneal cavity have an effect on the early systemic inflammatory response, namely, in the lung injury and splenic cellularity of gerbils with induced peritonitis. Thirty-four male gerbils were divided into four groups: Control (n=9), submitted to laparotomy at time zero, re-laparotomy after 2 h, and sacrificed after a total of 6 h from start; untreated (n=8), submitted to peritonitis induction through cecal ligation and puncture (CLP) at time zero, re-laparotomy intended for drying of abdominal cavity and resection of the ischemic cecum after 2 h, and sacrifice after a total of 6 h from start; saline (n=8), submitted to peritonitis induction through CLP at time zero, re-laparotomy intended for warm 0.9% saline lavage of the abdominal cavity and resection of the ischemic cecum after 2 h, and sacrificed after a total of 6 h from start; and hypertonic (n=9), submitted to peritonitis induction through CLP at time zero, re-laparotomy intended for warm hypertonic saline (3.0%) lavage of the abdominal cavity and resection of the ischemic cecum after 2 h, and sacrificed after a total of 6 h from start. After sacrifice, we collected the left lung and the spleen for morphometric analysis. In the both the saline and hypertonic groups, there was significant decrease in the mean nuclei count in the lungs, compared with the untreated group (p0.05). The present study demonstrated that the peritoneal lavage with large volumes of warm 0.9% and 3.0% saline has a beneficial effect on the early systemic inflammatory response in infected animals, modulating and reducing the lung injury but having no effect on splenic cell count.

  18. High-pressure pulsatile lavage irrigation of fresh intraarticular fractures: effectiveness at removing particulate matter from bone.

    Science.gov (United States)

    Lee, Eric W; Dirschl, Douglas R; Duff, Gregory; Dahners, Laurence E; Miclau, Theodore

    2002-03-01

    To determine the effectiveness of high-pressure pulsatile lavage (HPL) versus bulb syringe (BS) irrigation in removing particulate matter from metaphyseal cancellous bone. Four grams of particulate graphite were placed in twenty distal femoral intraarticular osteotomies performed on New Zealand rabbit hind limbs. Two groups of ten specimens were then irrigated using either HPL or BS irrigation. A representative coronal section from each specimen was then prepared for histologic evaluation using 400x light microscopy. The number and distribution of graphite particles-present as small (less than 20 micrometers), medium (20 to 50 micrometers), and large (greater than 50 micrometers) aggregates-were then recorded. The mean maximum perpendicular distance of graphite aggregates of all sizes from the osteotomy site was 12.4 millimeters (+/-SD 2.5) in the HPL group and 12.5 millimeters (+/-SD 2.0) in the BS group (p > 0.5). The mean number of aggregates within four 400x fields (1.08 millimeters) of the osteotomy site was 21.9 (+/-SD 22.0) in the HPL group and 21.8 (+/-SD 27.5) in the BS group (p > 0.5). The mean total number of aggregates in the area surveyed was 129.4 (+/-SD 79.6) in the HPL group and 137.5 (+/-SD 113.6) in the BS group (p > 0.5). Separate analyses controlling for aggregate size of the specimens also revealed no significant differences between HPL and BS irrigation. HPL and BS irrigation appear equally effective in removing particulate matter from metaphyseal cancellous bone in an intraarticular fracture model. Furthermore, HPL does not appear to drive particulate matter farther into metaphyseal cancellous bone than BS irrigation.

  19. Studying the Effects of Reproductive Hormones and Bacterial Vaginosis on the Glycome of Lavage Samples from the Cervicovaginal Cavity

    Science.gov (United States)

    Wang, Linlin; Koppolu, Sujeethraj; Chappell, Catherine; Moncla, Bernard J.; Hillier, Sharon L.; Mahal, Lara K.

    2015-01-01

    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. PMID:25993513

  20. eQTL of bronchial epithelial cells and bronchial alveolar lavage deciphers GWAS-identified asthma genes.

    Science.gov (United States)

    Li, X; Hastie, A T; Hawkins, G A; Moore, W C; Ampleford, E J; Milosevic, J; Li, H; Busse, W W; Erzurum, S C; Kaminski, N; Wenzel, S E; Meyers, D A; Bleecker, E R

    2015-10-01

    Genome-wide association studies (GWASs) have identified various genes associated with asthma, yet, causal genes or single nucleotide polymorphisms (SNPs) remain elusive. We sought to dissect functional genes/SNPs for asthma by combining expression quantitative trait loci (eQTLs) and GWASs. Cis-eQTL analyses of 34 asthma genes were performed in cells from human bronchial epithelial biopsy (BEC, n = 107) and from bronchial alveolar lavage (BAL, n = 94). For TSLP-WDR36 region, rs3806932 (G allele protective against eosinophilic esophagitis) and rs2416257 (A allele associated with lower eosinophil counts and protective against asthma) were correlated with decreased expression of TSLP in BAL (P = 7.9 × 10(-11) and 5.4 × 10(-4) , respectively) and BEC, but not WDR36. Surprisingly, rs1837253 (consistently associated with asthma) showed no correlation with TSLP expression levels. For ORMDL3-GSDMB region, rs8067378 (G allele protective against asthma) was correlated with decreased expression of GSDMB in BEC and BAL (P = 1.3 × 10(-4) and 0.04) but not ORMDL3. rs992969 in the promoter region of IL33 (A allele associated with higher eosinophil counts and risk for asthma) was correlated with increased expression of IL33 in BEC (P = 1.3 × 10(-6) ) but not in BAL. Our study illustrates cell-type-specific regulation of the expression of asthma-related genes documenting SNPs in TSLP, GSDMB, IL33, HLA-DQB1, C11orf30, DEXI, CDHR3, and ZBTB10 affect asthma risk through cis-regulation of its gene expression. Whenever possible, disease-relevant tissues should be used for transcription analysis. SNPs in TSLP may affect asthma risk through up-regulating TSLP mRNA expression or protein secretion. Further functional studies are warranted. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    Directory of Open Access Journals (Sweden)

    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

  2. Continuous positive airway pressure ventilation during whole lung lavage for treatment of alveolar proteinosis -A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Abdelazeem El-Dawlatly

    2011-01-01

    Full Text Available Pulmonary alveolar proteinosis (PAP is a rare disease that affects young population usually in the age group of 20-40 years, characterized by the deposition of lipoproteinacious material in the alveoli secondary to abnormal processing of surfactant by macrophages. We report a case of a 15-year-old female who had history of cough with sputum for 3 days along with fever. She was seen in another hospital and was treated as a case of pneumonia where she received antibiotic but with no improvement. Computerized tomography (CT chest showed diffuse interlobular septal thickening in the background of ground glass opacity giving a picture of crazy paving pattern which was consistent with the diagnosis of PAP. The patient was scheduled to undergo, first right-sided whole lung lavage (WLL under general anesthesia. Endobronchial intubation using left sided 37 Fr double lumen tube. Continuous positive airway pressure (CPAP as described in our previously published report was connected to the right lumen of the endobronchial tube. CPAP ventilation was used during the suctioning of lavage fluid phase in order to improve oxygenation. WLL was done using 5 L of warm heparinized saline (500 i.u/litre. The same procedure was repeated on the left side using 6 L of heparinized normal saline solution. In conclusion, anesthesia in alveolar proteinosis for patients undergoing WLL is challenging to the anesthesiologist. It requires meticulous preoperative preparation with antibiotics, mucolytics and chest physiotherapy. Also it requires careful intraoperative monitoring and proper oxygenation especially during the suctioning phase of the lavaged fluid. With this second case report of successful anesthetic management using the modified CPAP system we recommend with confidence the application of CPAP ventilation to improve oxygenation during WLL.

  3. 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

  4. Comprehensive multiplexed protein quantitation delineates eosinophilic and neutrophilic experimental asthma

    National Research Council Canada - National Science Library

    Bergquist, M; Jonasson, S; Hjoberg, J; Hedenstierna, G; Hanrieder, Jörg

    2014-01-01

    ...; eosinophilic and neutrophilic asthma, will be reflected in the lung protein expression profile of murine asthma models and can be delineated using proteomics of bronchoalveolar lavage (BAL). Methods...

  5. 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

  6. A randomized clinical study comparing reduced-volume oral sulfate solution with standard 4-liter sulfate-free electrolyte lavage solution as preparation for colonoscopy.

    Science.gov (United States)

    Rex, Douglas K; Di Palma, Jack A; Rodriguez, Reynaldo; McGowan, John; Cleveland, Mark

    2010-08-01

    Low-volume bowel preparations for colonoscopy improve tolerability. We compared the efficacy, tolerability, and safety of a new low-volume sulfate solution with a standard 4-L polyethylene glycol electrolyte lavage solution as bowel preparation for colonoscopy. Multicenter, single-blind, randomized, noninferiority study. Five academic and community endoscopy centers in the United States. One hundred thirty-six outpatients undergoing colonoscopy. Patients were randomized to receive 4 L sulfate-free electrolyte lavage solution (SF-ELS) given the night before colonoscopy versus 12 oz oral sulfate solution (OSS) given in equally divided doses the evening before and the morning of colonoscopy. Successful (ie, good or excellent) bowel preparation. Successful bowel preparation was more frequent with OSS than with SF-ELS (98.4% vs 89.6%; P = .04). Excellent preparation also was achieved more frequently with OSS (71.4% vs 34.3%; P < .001). Patients receiving OSS had less residual stool in the cecum and ascending colon and less residual fluid in the cecum and ascending, transverse, and descending colon compared with SF-ELS. The percentage of patients with GI side effects and adverse events was not significantly different between the 2 groups. The OSS was administered in split doses, whereas the SF-ELS was administered the evening before (which is its FDA-approved regimen). Oral sulfate solution is promising as a safe low-volume preparation for colonoscopy. ( NCT00856843.). Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  7. Protein profiles of nasal lavage fluid from individuals with work-related upper airway symptoms associated with moldy and damp buildings.

    Science.gov (United States)

    Wåhlén, K; Fornander, L; Olausson, P; Ydreborg, K; Flodin, U; Graff, P; Lindahl, M; Ghafouri, B

    2016-10-01

    Upper airway irritation is common among individuals working in moldy and damp buildings. The aim of this study was to investigate effects on the protein composition of the nasal lining fluid. The prevalence of symptoms in relation to work environment was examined in 37 individuals working in two damp buildings. Microbial growth was confirmed in one of the buildings. Nasal lavage fluid was collected from 29 of the exposed subjects and 13 controls, not working in a damp building. Protein profiles were investigated with a proteomic approach and evaluated by multivariate statistical models. Subjects from both workplaces reported upper airway and ocular symptoms. Based on protein profiles, symptomatic subjects in the two workplaces were discriminated from each other and separated from healthy controls. The groups differed in proteins involved in inflammation and host defense. Measurements of innate immunity proteins showed a significant increase in protein S100-A8 and decrease in SPLUNC1 in subjects from one workplace, while alpha-1-antitrypsin was elevated in subjects from the other workplace, compared with healthy controls. The results show that protein profiles in nasal lavage fluid can be used to monitor airway mucosal effects in personnel working in damp buildings and indicate that the profile may be separated when the dampness is associated with the presence of molds. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    Directory of Open Access Journals (Sweden)

    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

  9. Management of pulmonary alveolar proteinosis with whole lung lavage using extracorporeal membrane oxygenation support in a postrenal transplant patient with graft failure

    Directory of Open Access Journals (Sweden)

    Sandeep Chauhan

    2016-01-01

    Full Text Available Pulmonary alveolar proteinosis (PAP is a rare lung disease characterized by accumulation of excessive lung surfactant in the alveoli leading to restrictive lung functions and impaired gas exchange. Whole lung lavage (WLL is the treatment modality of choice, which is usually performed using double lumen endobronchial tube insertion under general anesthesia and alternating unilateral lung ventilation and washing with normal saline. It may be difficult to perform WLL in patients with severe hypoxemia wherein patients do not tolerate single lung ventilation. Extracorporeal membrane oxygenation support (ECMO has been used in such patients. We report a patient with autoimmune PAP following renal transplant who presented with marked hypoxemia and was managed by WLL under ECMO support.

  10. 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.

  11. Evaluation of a multiplex real time PCR assay for the detection of human papillomavirus infections on self-collected cervicovaginal lavage samples.

    Science.gov (United States)

    Jentschke, Matthias; Soergel, Philipp; Hillemanns, Peter

    2013-10-01

    Self-collection of cervical samples for human papillomavirus (HPV) testing can help to raise the participation rate in cervical cancer screening among non-responders. This study was conducted to compare the analytical and clinical performance of the Abbott RealTime High-Risk HPV Test (RealTime) with the Hybrid Capture 2 assay (HC2) on self-collected cervicovaginal lavage samples. One hundred samples from women referred for colposcopy (reference smears and biopsies in case of abnormalities) were included. Fifty-seven women had a normal cytology, 27 had low grade and 16 had high grade squamous intraepithelial lesions. Fourteen of 49 biopsies (28.6%) were benign, 14 (28.6%) cervical intraepithelial neoplasia 1, 11 (22.4%) cervical intraepithelial neoplasia 2, 8 (16.3%) cervical intraepithelial neoplasia 3 and 2 (4.1%) invasive cancer. The agreement between RealTime and HC2 in the self-collected and in the reference samples was 85% (κ=0.665) and 83% (κ=0.620), respectively. The agreement between self-sampling and the reference smears was higher with RealTime (93%; κ=0.849) than with HC2 (89%; κ=0.741). In the self-collected samples, the sensitivity and specificity for cervical intraepithelial neoplasia 2 or worse of RealTime/HC2 were 81.0%/66.7% (p=0.25) and 53.6%/57.1%, respectively. The sensitivity for cervical intraepithelial neoplasia 3 or worse of RealTime and HC2 were 80.0% and 70.0% (p=1.0). The specificity for cervical intraepithelial neoplasia 3 or worse was 43.6% (RealTime) and 51.3% (HC2). This study shows that RealTime can be used for HR-HPV testing of self-collected lavage samples in a referral population with at least equal quality and performance as HC2. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. 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.

    Science.gov (United States)

    Bunyasi, Erick Wekesa; Tameris, Michele; Geldenhuys, Hennie; Schmidt, Bey-Marrie; Luabeya, Angelique Kany Kany; Mulenga, Humphrey; Scriba, Thomas J; Hanekom, Willem A; Mahomed, Hassan; McShane, Helen; Hatherill, Mark

    2015-01-01

    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 induced sputum

  13. The Importance of Extensive Intraoperative Peritoneal Lavage as a Promising Method in Patients with Gastric Cancer Showing Positive Peritoneal Cytology Without Overt Peritoneal Metastasis and Other Therapeutic Approaches.

    Science.gov (United States)

    Ilhan, Enver; Alemdar, Ali; Ureyen, Orhan; Bas, Koray

    2017-10-01

    Peritoneal invasion is more common and has a worse prognosis in gastric cancer than most of other intestinal cancers. Advanced gastric cancers have a poor course in terms of the development of peritoneal carcinomatosis and prognosis, even if the curative resection has been performed. Patients usually die within the first 2 years of the postoperative period mainly due to peritoneal metastasis. It is, therefore, essential to eradicate intraperitoneal free cancer cells to prevent peritoneal recurrences. A standard therapy has not been developed yet for patients with gastric cancer with a positive peritoneal cytology or a gross peritoneal metastasis. Curative resection following neoadjuvant chemotherapy, postoperative oral S-1 chemotherapy, intraoperative intraperitoneal chemotherapy (IPC), and extensive intraoperative peritoneal lavage (EIPL)-IPC are recommended as therapeutic approaches. Although there is a limited number of studies on EIPL, which is a promising and exciting method in this patient population, unexpected results of survival have been demonstrated. We consider that the results of ongoing and further studies would lead to an extensive use of EIPL, which is a simple and easy method which can be applied anywhere and anytime, in patients with advanced gastic cancer and/or peritoneal cytology positive but peritoneal metastasis negative (CY+/P0) gastric cancer.

  14. Expression of asthma susceptibility genes in bronchial epithelial cells and bronchial alveolar lavage in the Severe Asthma Research Program (SARP) cohort.

    Science.gov (United States)

    Li, Xingnan; Hawkins, Gregory A; Moore, Wendy C; Hastie, Annette T; Ampleford, Elizabeth J; Milosevic, Jadranka; Li, Huashi; Busse, William W; Erzurum, Serpil C; Kaminski, Naftali; Wenzel, Sally E; Bleecker, Eugene R; Meyers, Deborah A

    2016-10-01

    Genome-wide association studies (GWASs) have identified genes associated with asthma, however expression of these genes in asthma-relevant tissues has not been studied. This study tested expression and correlation between GWAS-identified asthma genes and asthma or asthma severity. Correlation analyses of expression levels of GWAS-identified asthma genes and asthma-related biomarkers were performed in cells from human bronchial epithelial biopsy (BEC, n = 107) and bronchial alveolar lavage (BAL, n = 94). Expression levels of asthma genes between BEC and BAL and with asthma or asthma severity were weakly correlated. The expression levels of IL18R1 were consistently higher in asthma than controls or in severe asthma than mild/moderate asthma in BEC and BAL (p asthma (P = 0.03). rs17772583 in RAD50 was significantly correlated with RAD50 expression in BAL and BEC (P = 7.4 × 10(-7) and 0.04) but was not associated with asthma. This is the first report studying the expression of GWAS-identified asthma genes in BEC and BAL. IL13, rather than RAD50, IL4, or IL5, is more likely to be the asthma susceptibility gene. Our study illustrates tissue-specific expression of asthma-related genes. Therefore, whenever possible, disease-relevant tissues should be used for transcription analysis.

  15. Complicated diverticular disease: Position statement on outpatient management, Hartmann's procedure, laparoscopic peritoneal lavage and laparoscopic approach. Consensus document of the Spanish Association of Coloproctology and the Coloproctology Section of the Spanish Association of Surgeons.

    Science.gov (United States)

    Rosado-Cobián, Rafael; Blasco-Segura, Teresa; Ferrer-Márquez, Manuel; Marín-Ortega, Héctor; Pérez-Domínguez, Lucinda; Biondo, Sebastiano; Roig-Vila, José Vicente

    The Spanish Association of Coloproctology (AECP) and the Coloproctology Section of the Spanish Association of Surgeons (AEC), propose this consensus document about complicated diverticular disease that could be used for decision-making. Outpatient management, Hartmann's procedure, laparoscopic peritoneal lavage, and the role of a laparoscopic approach in colonic resection are exposed. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Randomized Cross-Sectional Study to Compare HIV-1 Specific Antibody and Cytokine Concentrations in Female Genital Secretions Obtained by Menstrual Cup and Cervicovaginal Lavage.

    Science.gov (United States)

    Archary, Derseree; Liebenberg, Lenine J; Werner, Lise; Tulsi, Sahil; Majola, Nelisile; Naicker, Nivashnee; Dlamini, Sarah; Hope, Thomas J; Samsunder, Natasha; Abdool Karim, Salim S; Morris, Lynn; Passmore, Jo-Ann S; Garrett, Nigel J

    2015-01-01

    Optimizing methods for genital specimen collection to accurately characterize mucosal immune responses is a priority for the HIV prevention field. The menstrual cup (MC) has been proposed as an alternative to other methods including cervicovaginal lavage (CVL), but no study has yet formally compared these two methods. Forty HIV-infected, antiretroviral therapy-naïve women from the CAPRISA 002 acute HIV infection cohort study were randomized to have genital fluid collected using the MC with subsequent CVL, or by CVL alone. Qualitative data, which assessed levels of comfort and acceptability of MC using a 5-point Likert scale, was collected. Luminex multiplex assays were used to measure HIV-specific IgG against multiple gene products and 48 cytokines. The majority (94%) of participants indicated that insertion, wearing and removal of the MC was comfortable. Nineteen MCs with 18 matching, subsequent CVLs and 20 randomized CVLs were available for analysis. Mucosal IgG responses against four HIV-antigens were detected in 99% of MCs compared to only 80% of randomized CVLs (p = 0.029). Higher specific antibody activity and total antibodies were observed in MCs compared to CVL (all p<0.001). In MCs, 42/48 (88%) cytokines were in the detectable range in all participants compared to 27/48 (54%) in CVL (p<0.001). Concentrations of 22/41 cytokines (53.7%) were significantly higher in fluid collected by MC. Both total IgG (r = 0.63; p = 0.005) and cytokine concentrations (r = 0.90; p<0.001) correlated strongly between MC and corresponding post-MC CVL. MC sampling improves the detection of mucosal cytokines and antibodies, particularly those present at low concentrations. MC may therefore represent an ideal tool to assess immunological parameters in genital secretions, without interfering with concurrent collection of conventional CVL samples.

  17. Randomized Cross-Sectional Study to Compare HIV-1 Specific Antibody and Cytokine Concentrations in Female Genital Secretions Obtained by Menstrual Cup and Cervicovaginal Lavage.

    Directory of Open Access Journals (Sweden)

    Derseree Archary

    Full Text Available Optimizing methods for genital specimen collection to accurately characterize mucosal immune responses is a priority for the HIV prevention field. The menstrual cup (MC has been proposed as an alternative to other methods including cervicovaginal lavage (CVL, but no study has yet formally compared these two methods.Forty HIV-infected, antiretroviral therapy-naïve women from the CAPRISA 002 acute HIV infection cohort study were randomized to have genital fluid collected using the MC with subsequent CVL, or by CVL alone. Qualitative data, which assessed levels of comfort and acceptability of MC using a 5-point Likert scale, was collected. Luminex multiplex assays were used to measure HIV-specific IgG against multiple gene products and 48 cytokines.The majority (94% of participants indicated that insertion, wearing and removal of the MC was comfortable. Nineteen MCs with 18 matching, subsequent CVLs and 20 randomized CVLs were available for analysis. Mucosal IgG responses against four HIV-antigens were detected in 99% of MCs compared to only 80% of randomized CVLs (p = 0.029. Higher specific antibody activity and total antibodies were observed in MCs compared to CVL (all p<0.001. In MCs, 42/48 (88% cytokines were in the detectable range in all participants compared to 27/48 (54% in CVL (p<0.001. Concentrations of 22/41 cytokines (53.7% were significantly higher in fluid collected by MC. Both total IgG (r = 0.63; p = 0.005 and cytokine concentrations (r = 0.90; p<0.001 correlated strongly between MC and corresponding post-MC CVL.MC sampling improves the detection of mucosal cytokines and antibodies, particularly those present at low concentrations. MC may therefore represent an ideal tool to assess immunological parameters in genital secretions, without interfering with concurrent collection of conventional CVL samples.

  18. Lavagem nasal como método de avaliação das cavidades nasais Nasal lavage as a tool to evaluate nasal cavities

    Directory of Open Access Journals (Sweden)

    Guilherme P. Caminha

    2001-01-01

    Full Text Available A avaliação das cavidades nasais é extremamente importante nos indivíduos portadores de patologias nasais e nos que estão expostos a substâncias potencialmente nocivas presentes no meio ambiente. Como a histologia da mucosa nasal é similar à das vias respiratórias inferiores, uma resposta inflamatória vista no nariz pode ser um sinal de alerta de inflamação na via aérea inferior. A presença de biomarcadores nas cavidades nasais pode ser facilmente detectada através de inúmeras técnicas. Entretanto, é necessário dispormos de um método para avaliação das alterações encontradas nesta região que seja simples e seguro. A lavagem nasal preenche estes critérios e deve ser considerada sempre que se deseje estudar esta região.The evaluation of the nasal cavities of subjects with nasal pathologies and those exposed to environmental contaminants is very important. Nasal mucosal histology is similar to that in the lower airways. Therefore, an inflammatory response seen in the nasal passages may be a warning signal of inflammation in the lower airways. Biomarkers in the nasal cavities can be easily detected in many ways. However, it is necessary to have a method of quantifying this effects that is safe and simple to perform. Nasal lavage fulfills these criteria and should be considered when studying this area.

  19. 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

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

    Science.gov (United States)

    Zhai, Haohan; Pan, Jianchao; Pang, En; Bai, Bo

    2014-01-01

    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. 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. The lowest number of viable bacterial counts of Staphylococcus epidermidis recovered from the biofilm was in the rabbits treated with allicin plus vancomycin (Pallicin or allicin plus vancomycin. 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 a useful anti-infection strategy for the treatment of PJI.

  1. Bacteria in the nose of young adults during wellness and rhinovirus colds - detection by culture and microarray methods in 100 nasal lavage specimens

    Science.gov (United States)

    Allen, E. Kaitlynn; Pitkäranta, Anne; Mäki, Minna; Hendley, J. Owen; Laakso, Sanna; Sale, Michèle M.; Winther, Birgit

    2013-01-01

    Background Patients with viral respiratory infections/viral rhinitis/common colds are often treated with antibiotic although there is little information on whether or how bacterial microbiota in the nose and nasopharynx might influence the course of viral illnesses. Methods To initiate investigation of possible interaction between viral respiratory illness and microbiota of the nose/nasopharynx, we utilized microarray technology to examine 100 nasal lavage fluid samples (NLF) for bacterial species and recorded the bacterial titer of culturable bacteria. Rhinovirus illnesses were induced by self-inoculation using the “finger to nose or eye natural transmission route” in ten otherwise healthy young adults. NLF samples were collected during wellness and at specific time points following experimental rhinovirus inoculation. Results The rhinovirus infection rate was 70%. There were no consistent changes in the prevalence of different bacterial species determined by microarray and bacterial titer by culture methods during rhinovirus infection. The bacterial profile in NLF samples showed high variability between volunteers but low variability in multiple NLF’s obtained before and following infection from the same volunteer. S. epidermidis/coagulase negative staphylococcus (CNS) were identified in all ten subjects. One or more bacterial sinus/otitis pathogens were identified by microarray in six of the ten volunteers. The microarray identified a few bacteria not included in traditional bacterial cultures. Conclusion Our pilot study showed that each of ten volunteers had a unique bacterial profile in the nose by microarray analysis and that bacterial load did not change during experimental rhinovirus colds. Larger scale studies are warranted. PMID:23801660

  2. Bacteria in the nose of young adults during wellness and rhinovirus colds: detection by culture and microarray methods in 100 nasal lavage specimens.

    Science.gov (United States)

    Allen, E Kaitlynn; Pitkäranta, Anne; Mäki, Minna; Hendley, J Owen; Laakso, Sanna; Sale, Michèle M; Winther, Birgit

    2013-09-01

    Patients  with  viral respiratory infections/viral rhinitis/common colds are often treated with antibiotic; however, there is little information on whether or how bacterial microbiota in the nose and nasopharynx might influence the course of viral illnesses. To initiate investigation of possible interaction between viral respiratory illness and microbiota of the nose/nasopharynx, we used microarray technology to examine 100 nasal lavage fluid (NLF) samples for bacterial species and recorded the bacterial titer of culturable bacteria. Rhinovirus illnesses were induced by self-inoculation using the "finger to nose or eye natural transmission route" in 10 otherwise healthy young adults. NLF samples were collected during wellness and at specific time points following experimental rhinovirus inoculation. The rhinovirus infection rate was 70%. There were no consistent changes in the prevalence of different bacterial species determined by microarray and bacterial titer by culture methods during rhinovirus infection. The bacterial profile in NLF samples showed high variability between volunteers but low variability in multiple NLFs obtained before and following infection from the same volunteer. Streptococcus epidermidis/coagulase-negative staphylococcus (CNS) were identified in all 10 subjects. One or more bacterial sinus/otitis pathogens were identified by microarray in 6 of the 10 volunteers. The microarray identified a few bacteria not included in traditional bacterial cultures. Our pilot study showed that each of the 10 volunteers had a unique bacterial profile in the nose by microarray analysis and that bacterial load did not change during experimental rhinovirus colds. Larger scale studies are warranted. © 2013 The Authors. International Forum of Allergy & Rhinology published by Wiley Periodicals, Inc., on behalf of ARS-AAOA, LLC.

  3. The feasibility of nipple aspiration and duct lavage to evaluate the breast duct epithelium of women with increased breast cancer risk.

    Science.gov (United States)

    Twelves, Dominique; Nerurkar, Ashutosh; Osin, Peter; Ward, Ann; Isacke, Clare M; Gui, Gerald P H

    2013-01-01

    Nipple aspiration (NA) and duct lavage (DL) are modalities for obtaining breast duct fluid for biomarker analyses. The aim of this study was to assess the feasibility of obtaining serial NA and DL samples at consecutive patient visits for cytology assessment and the creation of a biobank. Seventy eligible subjects were enroled at a single institution in the United Kingdom as part of an international multicentre study. Entry criteria were based on a 5-year Gail model risk of ≥2% or Claus score lifetime risk of ≥26%. Women underwent NA and DL in an outpatient clinic under local anaesthesia. The mean patient age was 48 (range 41-69)years. Sixty seven out of 70 women (96%) attended three consecutive 6 monthly visits and follow-up for 2 years. Three women withdrew due to intolerance of the DL procedure. 56/67 (83%) women produced NA fluid from at least one duct. 204/264 (77%) of ducts declared by NA were cannulated for DL. 170/204 (83%) produced DL samples with adequate cellularity. By the final visit 52/67 (78%) women produced DL, 28/52 (54%) of whom were premenopausal and 24/52 (46%) were postmenopausal. 50/52 women (96%) underwent repeated DL of 81 ducts on 3 consecutive visits. NA and DL are well tolerated for repeated assessment to obtain material for cytology and to create a biobank for future biomarker studies in women at high breast cancer risk. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Utility of bronchial lavage fluids for epithelial growth factor receptor mutation assay in lung cancer patients: Comparison between cell pellets, cell blocks and matching tissue specimens.

    Science.gov (United States)

    Asaka, Shiho; Yoshizawa, Akihiko; Nakata, Rie; Negishi, Tatsuya; Yamamoto, Hiroshi; Shiina, Takayuki; Shigeto, Shohei; Matsuda, Kazuyuki; Kobayashi, Yukihiro; Honda, Takayuki

    2018-02-01

    The detection of epidermal growth factor receptor (EGFR) mutations is necessary for the selection of suitable patients with non-small cell lung cancer (NSCLC) for treatment with EGFR tyrosine kinase inhibitors. Cytology specimens are known to be suitable for EGFR mutation detection, although tissue specimens should be prioritized; however, there are limited studies that examine the utility of bronchial lavage fluid (BLF) in mutation detection. The purpose of the present study was to investigate the utility of BLF specimens for the detection of EGFR mutations using a conventional quantitative EGFR polymerase chain reaction (PCR) assay. Initially, quantification cycle (Cq) values of cell pellets, cell-free supernatants and cell blocks obtained from three series of 1% EGFR mutation-positive lung cancer cell line samples were compared for mutation detection. In addition, PCR analysis of BLF specimens obtained from 77 consecutive NSCLC patients, detecting EGFR mutations was validated, and these results were compared with those for the corresponding formalin-fixed paraffin-embedded (FFPE) tissue specimens obtained by surgical resection or biopsy of 49 of these patients. The Cq values for mutation detection were significantly lower in the cell pellet group (average, 29.58) compared with the other groups, followed by those in cell-free supernatants (average, 34.15) and in cell blocks (average, 37.12) for all three series (P<0.05). Mutational status was successfully analyzed in 77 BLF specimens, and the results obtained were concordant with those of the 49 matching FFPE tissue specimens. Notably, EGFR mutations were even detected in 10 cytological specimens that contained insufficient tumor cells. EGFR mutation testing with BLF specimens is therefore a useful and reliable method, particularly when sufficient cancer cells are not obtained.

  5. Randomized Cross-Sectional Study to Compare HIV-1 Specific Antibody and Cytokine Concentrations in Female Genital Secretions Obtained by Menstrual Cup and Cervicovaginal Lavage

    Science.gov (United States)

    Archary, Derseree; Liebenberg, Lenine J.; Werner, Lise; Tulsi, Sahil; Majola, Nelisile; Naicker, Nivashnee; Dlamini, Sarah; Hope, Thomas J.; Samsunder, Natasha; Abdool Karim, Salim S.; Morris, Lynn; Passmore, Jo-Ann S.; Garrett, Nigel J.

    2015-01-01

    Introduction Optimizing methods for genital specimen collection to accurately characterize mucosal immune responses is a priority for the HIV prevention field. The menstrual cup (MC) has been proposed as an alternative to other methods including cervicovaginal lavage (CVL), but no study has yet formally compared these two methods. Methods Forty HIV-infected, antiretroviral therapy-naïve women from the CAPRISA 002 acute HIV infection cohort study were randomized to have genital fluid collected using the MC with subsequent CVL, or by CVL alone. Qualitative data, which assessed levels of comfort and acceptability of MC using a 5-point Likert scale, was collected. Luminex multiplex assays were used to measure HIV-specific IgG against multiple gene products and 48 cytokines. Results The majority (94%) of participants indicated that insertion, wearing and removal of the MC was comfortable. Nineteen MCs with 18 matching, subsequent CVLs and 20 randomized CVLs were available for analysis. Mucosal IgG responses against four HIV-antigens were detected in 99% of MCs compared to only 80% of randomized CVLs (p = 0.029). Higher specific antibody activity and total antibodies were observed in MCs compared to CVL (all p<0.001). In MCs, 42/48 (88%) cytokines were in the detectable range in all participants compared to 27/48 (54%) in CVL (p<0.001). Concentrations of 22/41 cytokines (53.7%) were significantly higher in fluid collected by MC. Both total IgG (r = 0.63; p = 0.005) and cytokine concentrations (r = 0.90; p<0.001) correlated strongly between MC and corresponding post-MC CVL. Conclusions MC sampling improves the detection of mucosal cytokines and antibodies, particularly those present at low concentrations. MC may therefore represent an ideal tool to assess immunological parameters in genital secretions, without interfering with concurrent collection of conventional CVL samples. PMID:26147923

  6. Two liters of polyethylene glycol-electrolyte lavage solution versus sodium phosphate as bowel cleansing regimen for colonoscopy: a prospective randomized controlled trial.

    Science.gov (United States)

    Poon, C M; Lee, D W H; Mak, S K; Ko, C W; Chan, K C; Chan, K W; Sin, K S; Chan, A C W

    2002-07-01

    As a bowel cleansing agent for colonoscopy, sodium phosphate (NaP) has been reported to have equal effectiveness and better patient tolerance in comparison with 4 l polyethylene glycol-electrolyte lavage (PEG-EL) solution. Poor patient tolerance is frequently associated with a large amount of fluid consumed, and better patient tolerance might therefore be expected if the volume of PEG-EL solution could be reduced. This study aimed to compare 2 l PEG-EL solution with NaP in relation to patients' tolerance and its effectiveness as a bowel cleansing agent. Two hundred consecutive patients admitted to the day-procedure ward for elective colonoscopy were prospectively randomized to receive either a 2-l PEG-EL solution or a 90-ml oral NaP regimen. Patients with a history of congestive heart failure, impaired renal function (creatinine > 1.5 mg/dl), or previous colectomy were excluded from the study. The patients completed a questionnaire to assess their tolerance of bowel preparation before the colonoscopy. Endoscopists, who were blinded to the type of regimen that had been used, scored the adequacy of bowel preparation from the rectum to cecum using a defined endoscopic score. Two hundred patients were included in this randomized trial. Nine patients were excluded, due to either an incomplete questionnaire (two in the PEG-EL group, one in the NaP group) or inability to complete the bowel preparation regimen (four in the PEG-EL group and two in the NaP group). The demographic data were comparable in the two groups. There were no differences between the two groups with regard to willingness to repeat the regimen, ease of consumption, acceptability of the bowel preparation regimen, or the endoscopists' satisfaction with the quality of bowel preparation. The NaP group had a better mean endoscopic score at the cecum compared with the PEG-EL group (1.47 +/- 1.15 vs. 1.05 +/- 0.76; P = 0.007). The effectiveness and patient tolerance of the 2-l PEG-EL solution is comparable

  7. 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.

    Directory of Open Access Journals (Sweden)

    Navya Nair

    2016-12-01

    Full Text Available 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.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 in tumor but at

  8. Assessment of the Xpert MTB/RIF assay for diagnosis of tuberculosis with gastric lavage aspirates in children in sub-Saharan Africa: a prospective descriptive study.

    Science.gov (United States)

    Bates, Matthew; O'Grady, Justin; Maeurer, Markus; Tembo, John; Chilukutu, Lophina; Chabala, Chishala; Kasonde, Richard; Mulota, Peter; Mzyece, Judith; Chomba, Mumba; Mukonda, Lukundo; Mumba, Maxwell; Kapata, Nathan; Rachow, Andrea; Clowes, Petra; Hoelscher, Michael; Mwaba, Peter; Zumla, Alimuddin

    2013-01-01

    Rapid and accurate diagnosis of pulmonary tuberculosis in children remains challenging because of difficulties in obtaining sputum samples and the paucibacillary nature of the disease. The Xpert MTB/RIF assay is useful for rapid diagnosis of childhood tuberculosis with sputum and nasopharyngeal samples. We assessed this assay for the detection of tuberculosis and multidrug resistant (MDR) tuberculosis with gastric lavage aspirate (GLA) samples in children admitted to hospital. We did a prospective study to assess the sensitivity and specificity of the Xpert MTB/RIF assay with GLA samples for the detection of pulmonary tuberculosis and MDR tuberculosis in new paediatric inpatient admissions at the University Teaching Hospital, Lusaka, Zambia. Children aged 15 years or younger were recruited between June, 2011, and May, 2012. GLA and sputum were analysed by standard smear-microscopy, mycobacterial growth indicator tube (MGIT) culture, MGIT drug-susceptibility testing, and the Xpert MTB/RIF assay. Sensitivity of the Xpert MTB/RIF assay was assessed with the Pearson χ(2) or Fishers exact test. Of 930 children, 142 produced sputum and GLA was obtained from 788 non-sputum producers. Culture-positive tuberculosis was identified in 58 (6·2%) of 930 children: ten from sputum producers and 48 from GLA of non-sputum producers. The sensitivity and specificity of the Xpert MTB/RIF assay were similar: sensitivity was 68·8% (95% CI 53·6-80·9) for GLA versus 90·0% (54·1-99·5; p=0·1649) for sputum samples; specificity was 99·3% (98·3-99·8) for GLA and 98·5% (94·1-99·7; p=0·2871) for sputum samples. The Xpert MTB/RIF assay detected an extra 28 tuberculosis cases compared with smear microscopy and was significantly more sensitive than smear microscopy for both sputum (90·0% [54·1-99·5] vs 30·0% [8·1-64·6], p=0·01) and GLA (68·8% [53·6-80·9] vs 25·0% [14·1-40·0], p<0·0001). The assay load did not differ significantly by sample type (p=0·791). 22 children

  9. 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....

  10. 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.

  11. ECIL guidelines for treatment of Pneumocystis jirovecii pneumonia in non-HIV-infected haematology patients

    DEFF Research Database (Denmark)

    Maschmeyer, Georg; Helweg-Larsen, Jannik; Pagano, Livio

    2016-01-01

    The initiation of systemic antimicrobial treatment of Pneumocystis jirovecii pneumonia (PCP) is triggered by clinical signs and symptoms, typical radiological and occasionally laboratory findings in patients at risk of this infection. Diagnostic proof by bronchoalveolar lavage should not delay th...

  12. ECIL guidelines for treatment of Pneumocystis jirovecii pneumonia in non-HIV-infected haematology patients

    NARCIS (Netherlands)

    Maschmeyer, G.; Helweg-Larsen, J.; Pagano, L.; Robin, C.; Cordonnier, C.; Schellongowski, P.; Donnelly, J.P.; Brü ggemann, R.J.

    2016-01-01

    The initiation of systemic antimicrobial treatment of Pneumocystis jirovecii pneumonia (PCP) is triggered by clinical signs and symptoms, typical radiological and occasionally laboratory findings in patients at risk of this infection. Diagnostic proof by bronchoalveolar lavage should not delay the

  13. Biomarkers of Oxidative Stress Study IV. Are Antioxidants Markers of Ozone Exposure?

    Science.gov (United States)

    To determine whether the oxidative effects of ozone would result in losses of antioxidants from plasma, and possibly bronchoalveolar lavage fluid (BALF). This research is part of a comprehensive, multilaboratory validation study searching for noninvasive biomarkers of oxidative ...

  14. Research

    African Journals Online (AJOL)

    abp

    2012-07-19

    Jul 19, 2012 ... Mycobacterial pulmonary infections in AIDS are most commonly caused by ... Non tuberculous mycobacteria i.e. Mycobacterium avium complex (MAC), Mycobacterium kansasii and Mycobacterium .... Isolation of Mycoplasma species from bronchoalveolar lavages of patients positive and negative for.

  15. Cellular and mucosal immune responses in the respiratory tract of ...

    African Journals Online (AJOL)

    The bronchoalveolar lavage differential counts and bronchial associated lymphoid tissue (BALT) responses were measured using Giemsa stained thin smear of the cell fraction of the lavage and histomorphometry. ANOVA were employed and significance was at p>0.05. The post-challenge macrophage to neutrophil (M:N) ...

  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. Extracorporeal shock wave therapy, ultrasound-guided percutaneous lavage, corticosteroid injection and combined treatment for the treatment of rotator cuff calcific tendinopathy: a network meta-analysis of RCTs.

    Science.gov (United States)

    Arirachakaran, Alisara; Boonard, Manusuk; Yamaphai, Sarunpong; Prommahachai, Akom; Kesprayura, Suraphol; Kongtharvonskul, Jatupon

    2017-04-01

    Treatment of calcific tendinitis using extracorporeal shock wave therapy (ESWT), ultrasound-guided percutaneous lavage (UGPL or barbotage), subacromial corticosteroid injection (SAI) and combined treatment is still controversial. This systematic review and meta-regression aimed to compare clinical outcomes between treatments. Relevant RCTs were identified using PubMed and Scopus search engines to date of September 23, 2015. Seven of 920 studies identified were eligible. Compared to the other treatments, the results of this study indicate that ESWT significantly improved CMS and VAS when compared to placebo. Barbotage plus ESWT significantly improved CMS, VAS and decreased size of calcium deposit when compared to ESWT, while barbotage plus SAI significantly improved CMS and decreased size of calcium deposit when compared to SAI. There have no different adverse effects of all treatment groups. Multiple active treatment comparisons indicated that barbotage plus SAI significantly improved VAS and size of calcium deposit when compared to other groups, while barbotage plus SAI improved CMS when compared to other groups. But there was no significant difference. The network meta-analysis suggested that combined US-guided needling and subacromial corticosteroid injection significantly decreased shoulder pain VAS, improved CMS score and decreased the size of calcium deposits, while also lowering risks of adverse event when compared to barbotage plus ESWT, ESWT and subacromial corticosteroid injection; therefore, the evidence points to UGPL as being the treatment of choice for nonsurgical options of treatment in calcific tendinitis of the shoulder. Level of evidence I.

  18. 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

  19. Genital herpes evaluation by quantitative TaqMan PCR: correlating single detection and quantity of HSV-2 DNA in cervicovaginal lavage fluids with cross-sectional and longitudinal clinical data.

    Science.gov (United States)

    Aumakhan, Bulbulgul; Hardick, Andrew; Quinn, Thomas C; Laeyendecker, Oliver; Gange, Stephen J; Beyrer, Chris; Cox, Christopher; Anastos, Kathryn; Cohen, Mardge; Greenblatt, Ruth M; Merenstein, Daniel J; Minkoff, Howard; Nowicki, Marek; Gaydos, Charlotte A

    2010-11-18

    To evaluate the utility of a single quantitative PCR (qPCR) measurement of HSV (HSV-1&2) DNA in cervicovaginal lavage (CVL) specimens collected from women with predominantly chronic HSV-2 infection in assessing genital HSV shedding and the clinical course of genital herpes (GH) within a cohort with semiannual schedule of follow up and collection of specimens. Two previously described methods used for detection of HSV DNA in mucocutaneous swab samples were adapted for quantification of HSV DNA in CVLs. Single CVL specimens from 509 women were tested. Presence and quantity of CVL HSV DNA were explored in relation to observed cross-sectional and longitudinal clinical data. The PCR assay was sensitive and reproducible with a limit of quantification of ~50 copies per milliliter of CVL. Overall, 7% of the samples were positive for HSV-2 DNA with median log10 HSV-2 DNA copy number of 3.9 (IQR: 2.6-5.7). No HSV-1 was detected. Presence and quantity of HSV-2 DNA in CVL directly correlated with the clinical signs and symptoms of presence of active symptomatic disease with frequent recurrences. Single qPCR measurement of HSV DNA in CVL fluids of women with chronic HSV-2 infection provided useful information for assessing GH in the setting of infrequent sampling of specimens. Observed positive correlation of the presence and quantity of HSV-2 DNA with the presence of active and more severe course of HSV-2 infection may have clinical significance in the evaluation and management of HSV-2 infected patients.

  20. 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

  1. 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.

  2. Nitric oxide production by rat bronchoalveolar macrophages or ...

    Indian Academy of Sciences (India)

    ... silica treatment, 76%–100% of the NOx was derived from AMs and 0–24% from PMNs. Immunohistochemistry for inducible NO synthase on lung tissue sections supported these findings. We conclude that AMs are the major source of the NO produced by BAL cells during acute pulmonary inflammatory responses to LPS ...

  3. The role of BAL in lung transplantation

    Directory of Open Access Journals (Sweden)

    G.M. Verleden

    2007-10-01

    Full Text Available Broncho-alveolar lavage is an important diagnostic instrument in lung transplantation. It can give insight into the mechanisms of acute and chronic rejection, but can also be of interest to explore the possible effects of new therapies. This has particularly been the case with azithromycin as add-on therapy for chronic rejection.Furthermore BAL after lung transplantation is important to differentiate between infection and rejection and the changes in the cellular profile may be of prognostic significance. Key-words: Broncho-alveolar lavage, lung transplantation, neutrophils

  4. Uncommon evolution of fibrosing alveolitis in a hard metal grinder exposed to cobalt dusts.

    Science.gov (United States)

    Zanelli, R; Barbic, F; Migliori, M; Michetti, G

    1994-06-30

    This study reports a case of fibrosing alveolitis with uncommon evolution in a 27-year-old male non-smoker, working as a hard metal grinder for 10 years. Personal and occupational history, routine clinical and laboratory check-up, chest X-rays, lung function tests, fiberoptic bronchoscopy with bronchoalveolar lavage and open lung biopsy returned a diagnosis of hard metal lung fibrosis. The patient felt greatly improved after removal from the workplace, without any therapy. At present, he is complaining of only mild exertional dyspnea and shows an attenuation of his ventilatory defect. The radiological picture has clearly improved and the cellular pattern of bronchoalveolar lavage was normal.

  5. Effect of the application of a bundle of three measures (intraperitoneal lavage with antibiotic solution, fascial closure with Triclosan-coated sutures and Mupirocin ointment application on the skin staples) on the surgical site infection after elective laparoscopic colorectal cancer surgery.

    Science.gov (United States)

    Ruiz-Tovar, Jaime; Llavero, Carolina; Morales, Vicente; Gamallo, Carlos

    2018-01-18

    Surgical site infection (SSI) prevention bundles include the simultaneous use of different measures, which individually have demonstrated an effect on prevention of SSI. The implementation of bundles can yield superior results to the implementation of individual measures. The aim of this study was to address the effect of the application of a bundle including intraperitoneal lavage with antibiotic solution, fascial closure with Triclosan-coated sutures and Mupirocin ointment application on the skin staples, on the surgical site infection after elective laparoscopic colorectal cancer surgery. A prospective, randomized study was performed, including patients with diagnosis of colorectal neoplasms and plans to undergo an elective laparoscopic surgery. The patients were randomized into two groups: those patients following standard bundles (Group 1) and those ones following the experimental bundle with three additional measures, added to the standard bundle. Incisional and organ space SSI were investigated. The study was assessor-blinded. A total of 198 patients were included in the study, 99 in each group. The incisional SSI rate was 16% in Group 1 and 2% in Group 2 [p = 0.007; RR = 5.6; CI 95% (1.4-17.8)]. The organ-space SSI rate was 4% in Group 1 and 0% in Group 2 [p = 0.039; RR = 1.7; CI 95% (1.1-11.6)]. Median hospital stay was 5.5 days in Group 1 and 4 days in Group 2 (p = 0.028). The addition of intraperitoneal lavage with antibiotic solution, fascial closure with Triclosan-coated sutures and Mupirocin ointment application on the skin staples, to a standard bundle of SSI prevention, reduces the incisional and organ-space SSI and consequently the hospital stay, after elective laparoscopic colorectal cancer surgery (ClinicalTrials.gov Identifier: NCT03081962).

  6. Evaluation of the contribution of tannin to the acute pulmonary inflammatory response against inhaled cotton mill dust.

    OpenAIRE

    Lauque, D. E.; Hempel, S. L.; Schroeder, M. A.; Hyatt, R. E.; Rohrbach, M. S.

    1988-01-01

    Anesthetized, intubated, and mechanically ventilated rabbits were exposed to aerosolized saline, cotton dust extract (CDE), or tannin for 5 minutes and lavaged 4 hours after exposure. Cell numbers and types present in the bronchoalveolar lavage fluid (BALF) were determined and the concentrations of thromboxane A2 (TxA2) and prostaglandin F2-alpha (PGF2-alpha) in the BALF were also analyzed. The saline control animals had increased numbers and percentage of polymorphonuclear leukocytes (PMN) i...

  7. 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

  8. Effect of anti-IL-5 and IL-5 on airway hyperreactivity and eosinophils in guinea pigs

    NARCIS (Netherlands)

    Oosterhout, A.J.M.; Ladenius, A.R.C.; Savelkoul, H.F.J.; Ark, van I.; Delsman, K.C.; Nijkamp, F.P.

    1993-01-01

    Chronic ovalbumin challenge of sensitized guinea pigs induces bronchoalveolar lavage (BAL) eosinophilia, neutrophilia, and tracheal hyperreactivity. In the present study, the influence of monoclonal antibody to murine interleukin-5 (anti-IL-5) on these phenomena is examined. In ovalbumin-sensitized

  9. Heterogeneous effects of histamine on proliferation of lung- and blood-derived T-cell clones from healthy and asthmatic persons

    NARCIS (Netherlands)

    Hol, B. E.; Krouwels, F. H.; Bruinier, B.; Lutter, R.; Bast, A.; Wierenga, E. A.; Jansen, H. M.; Out, T. A.

    1993-01-01

    We have studied the effects of histamine on the proliferation and the intracellular cyclic adenosine monophosphate (cAMP) levels of T-lymphocyte clones (TLC) generated from bronchoalveolar lavage fluid (BALF) or peripheral blood (PB) from healthy and asthmatic persons. TLC from either compartment

  10. 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.

  11. Book 1

    African Journals Online (AJOL)

    CMV, particularly for congenital CMV infection. Although the CNS is .... Congenital toxoplasmosis may mimic congenital CMV infection ... ies such as bronchoalveolar lavage are indicated.17 diagnosis serologic testing: The enzyme-linked immunosorbent as- say (Or ELISA) is the most commonly available serologic test for ...

  12. 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...

  13. Decreased ADAM9 expression in patients with pulmonary sarcoidosis

    African Journals Online (AJOL)

    The pathogenesis of sarcoidosis is still poorly understood. Genome-wide gene expression profiling can provide novel genetic data involved in the pathogenesis of disease. In this study, using normal bronchoalveolar lavage (BAL) and sarcoidosis BAL as models for cDNA microarray analysis, we detected an elevation of ...

  14. [Use of bronchovaxom in the treatment of patients with chronic obstructive bronchitis and bronchial asthma].

    Science.gov (United States)

    Shmelev, E I; Sokolova, L V; Kosmiadi, G A; Abramova, Z P; Filippov, V P; Evgushchenko, G V

    1995-01-01

    Polyvalent vaccine bronchovaxom (BV) was studied for efficacy against chronic obstructive bronchitis and bronchial asthma exacerbation. Good results were reported: reduction of disability duration, number of recurrences, cough intensity, discharged sputum. Laboratory tests discovered that BV brought about IgE decrease, IgA, T3, T4/T8 increase in bronchoalveolar lavage.

  15. Inhibition of adipocyte differentiation by resistin-like molecule alpha. Biochemical characterization of its oligomeric nature

    DEFF Research Database (Denmark)

    Blagoev, Blagoy; Kratchmarova, Irina; Nielsen, Mogens M

    2002-01-01

    of thiazolidinediones. The prototypical member of this family was originally identified from bronchoalveolar lavage fluid of inflamed lungs and designated FIZZ1 ("found in inflammatory zone"). This molecule was also found to be highly expressed in adipose tissue and was named resistin-like molecule alpha (RELMalpha...

  16. Effects of exogenous vitamin E supplementation on the levels of ...

    Indian Academy of Sciences (India)

    Unknown

    (vitamin E, ascorbic acid) have been demonstrated in bronchoalveolar lavage fluid of smokers compared with those in nonsmokers (Pacht et al 1986). Enhanced activi- ties of antioxidant enzymes, superoxide dismutase (SOD) and catalase have also been demonstrated in alveolar macrophages from young smokers ...

  17. Amelioration of hyperoxia-induced lung injury using a sphingolipid-based intervention

    NARCIS (Netherlands)

    J. Tibboel (Jeroen); S. Joza (Stephen); I.K.M. Reiss (Irwin); J.C. de Jongste (Johan); M.R. Post (Martin)

    2013-01-01

    textabstractThe aim of this study was to characterise lung function and bronchoalveolar lavage sphingolipid profile in newborn mice during hyperoxia exposure and recovery in room air, and to examine the effect of D-sphingosine supplementation during recovery. Newborn mice were exposed to 80% oxygen

  18. Combination of Extracorporeal Life Support and Mesenchymal Stem Cell Therapy for Treatment of ARDS in Combat Casualties and Evacuation of Service Members with ARDS

    Science.gov (United States)

    2017-10-01

    Lung and Heart Biopsy • Wet to Dry • Histology • Protein and RNA • Mitochondria function (Clark – Cyto – Mito – Complex assay) -Fiber-optic bronchoscopy...Airway Anatomy Evaluation • Bronchoalveolar lavage (BAL) • Protein, RNA • Fluids quantification • Differential cell counts 13 Impact. Development

  19. 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...

  20. Alveolar recruitment of ficolin-3 in response to acute pulmonary inflammation in humans

    DEFF Research Database (Denmark)

    Plovsing, Ronni R; Berg, Ronan M G; Munthe-Fog, Lea

    2016-01-01

    acute lung and systemic inflammation induce recruitment of lectins in humans. METHODS: Fifteen healthy volunteers received LPS intravenously (IV) or in a lung subsegment on two different occasions. Volunteers were evaluated by consecutive blood samples and by bronchoalveolar lavage 2, 4, 6, 8, or 24h...... acute phase response with an increase in CRP (precruitment...

  1. WU Polyomavirus in Respiratory Epithelial Cells from Lung Transplant Patient with Job Syndrome

    OpenAIRE

    Siebrasse, Erica A.; Pastrana, Diana V.; Nguyen, Nang L.; Wang, Annie; Roth, Mark J.; Holland, Steven M.; Freeman, Alexandra F.; McDyer, John; Buck, Christopher B.; Wang, David,

    2015-01-01

    We detected WU polyomavirus (WUPyV) in a bronchoalveolar lavage sample from lungs transplanted into a recipient with Job syndrome by using immunoassays specific for the WUPyV viral protein 1. Co-staining for an epithelial cell marker identified most WUPyV viral protein 1?positive cells as respiratory epithelial cells.

  2. 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 was the...... indicate faulty disinfection of bronchoscopy equipment and thereby point to a risk of transmission of true respiratory pathogens such as mycobacteria....

  3. 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...... indicate faulty disinfection of bronchoscopy equipment and thereby point to a risk of transmission of true respiratory pathogens such as mycobacteria....

  4. High Prevalence of Respiratory Viral Infections in Patients Hospitalized in an Intensive Care Unit for Acute Respiratory Infections as Detected by Nucleic Acid-Based Assays

    OpenAIRE

    Legoff, Jérôme; Guérot, Emmanuel; Ndjoyi-Mbiguino, Angélique; Matta, Mathieu; Si-Mohamed, Ali; Gutmann, Laurent; Fagon, Jean-Yves; Bélec, Laurent

    2005-01-01

    Forty-seven bronchoalveolar lavages (BAL) were obtained from 41 patients with acute pneumonia attending an intensive care unit. By molecular diagnosis, 30% of total BAL and 63% of bacteria-negative BAL were positive for respiratory viruses. Molecular detection allows for high-rate detection of respiratory viral infections in adult patients suffering from severe pneumonia.

  5. Molecular Identification of Tritrichomonas foetus-Like Organisms as Coinfecting Agents of Human Pneumocystis Pneumonia

    OpenAIRE

    Duboucher, Christophe; Caby,Stéphanie; Dufernez, Fabienne; Chabé, Magali; Gantois, Nausicaa; Delgado-Viscogliosi, Pilar; Billy, Christophe; Barré, Eric; Torabi, Edith; Capron, Monique; Pierce, Raymond J.; Dei-Cas, Eduardo; Viscogliosi, Eric

    2006-01-01

    Trichomonads closely related to the bovid parasite Tritrichomonas foetus were identified in the bronchoalveolar lavage sample from a patient with AIDS in association with Pneumocystis pneumonia. This human case of T. foetus-like infection emphasizes the zoonotic potential of trichomonads, although the existence of a human-host-adapted T. foetus strain cannot be excluded.

  6. 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.

  7. Pulmonary inflammation and crystalline silica in respirable coal ...

    Indian Academy of Sciences (India)

    Data from a previous bronchoalveolar lavage (BAL) study in coal miners ( = 20) and nonminers ( = 16) were used including cell counts of alveolar macrophages (AMs) and polymorphonuclear leukocytes (PMNs), and the antioxidant superoxide dismutase (SOD) levels. Miners' individual working lifetime particulate ...

  8. Phytochemical Composition And Effect Of Aqueous Extract Of ...

    African Journals Online (AJOL)

    The inflammatory responses and effect of the extract were assessed by analysis of leukocytes infiltration in bronchoalveolar lavage fluid at 12 hourly intervals. The aqueous extract of S. sparganophora contained alkaloids, flavonoids, steroids, glycosides, polyphenols, saponins, tannins etc. The aqueous extract significantly ...

  9. Strain Differences in Antioxidants in Rat Models of Cardiovascular Disease Exposed to Ozone

    Science.gov (United States)

    We examined the hypothesis that antioxidant substances and enzymes in lung, heart and in bronchoalveolar lavage fluid (BALF) are altered in response to 03 in cardiovascular disease and/or metabolic syndrome (CVD)-prone rat models. CVD strains [spontaneously hypertensive (SH), SH ...

  10. T-CELL REDISTRIBUTION KINETICS AFTER SECONDARY INFECTION OF BALB/C MICE WITH RESPIRATORY SYNCYTIAL VIRUS

    NARCIS (Netherlands)

    KIMPEN, JLL; OGRA, PL

    BALB/c mice were infected intranasally with live respiratory syncytial virus (RSV) and reinfected 4 weeks later. At regular intervals thereafter groups of animals were killed and T cell subsets were determined in blood, spleen and bronchoalveolar lavage (BAL) with flow cytometry employing T cell

  11. 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

  12. 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

  13. Cold saline lavage for removal of incarcerated porous ingrowth stems.

    Science.gov (United States)

    Ast, Michael P; Cabrera, Bryan J; DiMaio, Frank R; Lementowski, Peter

    2011-12-06

    A patient with a history of total knee arthroplasty and 5 subsequent revisions presented with pain. His preoperative construct consisted of a revision implant with porous in-growth stem extensions. He was indicated for revision surgery for a painful implant with progressive arthrofibrosis. The surgery proceeded uneventfully until we were unable to loosen the proximal portion of the ingrown femoral stem. After the distal femur was removed, a trephine was used to break the bone ingrowth from the distal portion of the stem. Flexible osteotomes were used to loosen the bone-prosthetic interface, but they were unable to penetrate deep enough, and they eventually bent under the applied loads. Nonflexible osteotomes were also used without success, and we were still unable to remove the stem from within the femur. Slap hammers, vice grips, and other devices were used to try to remove the stem, but attempts were unsuccessful. We hung a 3-liter bag of ice-cold (4 °C) saline and ran all 3 liters of saline, under gravity pressure, retrograde down the femoral shaft in an attempt to contract the metal and allow for the removal of the stem. We then attached a stem extension screw to the incarcerated femoral stem and were able to remove it with minimal effort using a back-slap device. We inspected the prosthesis and found no abnormalities of the stem to explain its incarceration and no iatrogenic perforations in the femur. This case demonstrates a useful technique that should be kept in a revision surgeon's armamentarium for the removal of incarcerated porous ingrowth stems. Copyright © 2011, SLACK Incorporated.

  14. Effects of hyperthermic intraoperative peritoneal lavage on intra ...

    African Journals Online (AJOL)

    shobha

    thermal (AT) and peritonitis-thermal. (PT) groups and ... Results: All rabbits in group AT survived for at least 11 hours, while all the rabbits in group PT died between 4 and 8 hours. There was .... and secured to the skin by sutures. The laparotomy.

  15. Use of urethral catheters for diagnostic peritoneal lavage in blunt ...

    African Journals Online (AJOL)

    diazepam. Under aseptic technique, 1% lignocaine with adrenaline 1:100,000 were infiltrated into the anterior abdominal wall, in the midline 3cm below the umbilicus. A 3cm long sub-umbilical incision was made through the skin and subcutaneous tissues. A supra-umbilical incision was used in patients with fractured pelvis ...

  16. 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...

  17. In vivo effects of a synthetic 2-kilodalton macrophage-activating lipopeptide of Mycoplasma fermentans after pulmonary application.

    Science.gov (United States)

    Lührmann, Anke; Deiters, Ursula; Skokowa, Julia; Hanke, Michaela; Gessner, Johannes E; Mühlradt, Peter F; Pabst, Reinhard; Tschernig, Thomas

    2002-07-01

    Mycoplasmas can cause interstitial pneumonias inducing critical illness in humans and animals. Mycoplasma infections are characterized by an influx of neutrophils, followed by an accumulation of macrophages and lymphocytes. The present study deals with the question of which mycoplasmal components cause this host reaction. The mycoplasma-derived, macrophage-activating lipopeptide 2S-MALP-2 was used to mimic the sequelae of a mycoplasma infection. To this end, 2S-MALP-2 was intratracheally instilled into the lungs of Lewis rats, and the bronchoalveolar lavage cells were examined at different times after different doses of 2S-MALP-2. Application of 2.5 microg induced a pronounced leukocyte accumulation in the bronchoalveolar space. At 24 h after 2S-MALP-2 administration, the majority of leukocytes consisted of neutrophils, followed by macrophages, peaking on days 2 and 3. Lymphocyte numbers, although amounting to only a few percent of the total bronchoalveolar lavage cells, also increased significantly, with maximal lymphocyte accumulation occurring by 72 h after instillation. The leukocyte count of the lung interstitium was increased on day 3 after treatment. After 10 days all investigated cell populations returned to control levels. Transient chemotactic activity for neutrophils was detected in the bronchoalveolar lavage fluid early after 2S-MALP-2 application, followed by monocyte chemoattractant protein-1 activity (MCP-1) in lung homogenates. MCP-1 was produced by bronchoalveolar lavage cells upon stimulation with 2S-MALP-2. Our data indicate that mycoplasmal lipoproteins and lipopeptides are probably the most relevant mycoplasmal components for the early host reaction. The primary target cells are likely to be the alveolar macrophages liberating chemokines, which attract further leukocytes.

  18. [45-year old patient with progressive shortness of breath and "crazy paving"].

    Science.gov (United States)

    Langwieler, S; Smektala, E; Waldburg, N; Hachenberg, T; Küster, D; Schreiber, J

    2012-11-01

    A 45-year-old man referred with progressive shortness of breath. Chest X-ray revealed a diffuse parenchymal process in the lungs, which was characterized as a "crazy paving" pattern in the thoracic CT. Pulmonary function test showed severe impairment of diffusion capacity and apparent respiratory insufficiency. Bronchoalveolar lavage and histological examinations of transbronchial lung biopsies revealed alveolar proteinosis. Because of the presence of anti-granulocyte macrophage colony-stimulating factor (GM-CSF) autoantibodies, a primary form of this disorder was diagnosed. Therapeutic whole-lung lavage was performed twice and resulted in a continuing remission.

  19. A Case of Idiopathic Pulmonary Hemosiderosis Presenting With Signs and Symptoms Mimicking Hemolytic Anemia.

    Science.gov (United States)

    Doğruel, Dilek; Erbay, Ayşe; Yazici, Nalan; Arslan, Alev; Hasbay Biçen, Bermal

    2017-01-01

    Idiopathic pulmonary hemosiderosis is primarily a disorder of childhood, which is characterized by hemoptysis, iron deficiency anemia, and diffuse parenchymal infiltrates on chest x-ray secondary to recurrent attacks of alveolar hemorrhage. It can be diagnosed by showing hemosiderin laden macrophages in bronchoalveolar lavage fluid after other specific causes of diffuse alveolar hemorrhage are definitely excluded. A 5-year-old male patient was admitted to our clinic with sudden-onset pallor during iron therapy given for anemia. While he was being investigated for clinical and laboratory signs mimicking hemolytic anemia, he developed cough and dyspnea. He had infiltrates on chest x-ray and scattered patchy infiltrates in both lungs on high-resolution computed tomography. Hemosiderin laden macrophages were identified in fasting gastric juice and bronchoalveolar lavage fluid. The patient was diagnosed with idiopathic pulmonary hemosiderosis and started corticosteroid therapy.

  20. Diminished activity of tartrate resistant acid phosphatase in alveolar macrophages from patients with active sarcoidosis.

    Science.gov (United States)

    Barth, J; Kreipe, H; Kiemle-Kallee, J; Radzun, H J; Parwaresch, M R; Petermann, W

    1988-11-01

    Alveolar macrophages differ from their percursors in blood, monocytes, by expressing strong activity of the tartrate resistant variant of acid phosphatase (TAcP). A study was carried out to analyse the expression of this enzyme cytochemical marker by alveolar macrophages from bronchoalveolar lavage cells from 34 patients with sarcoidosis and 12 control subjects. Alveolar macrophages from control subjects displayed a strong and homogeneous staining pattern and only 0.1% of cells were negative after staining. Macrophages from patients with sarcoidosis showed reduced TAcP activity and up to 7% of the cells were negative. The percentage of TAcP negative macrophages was correlated with the percentage of lymphocytes and with the ratio of CD4 to CD8 lymphocytes among cells recovered by bronchoalveolar lavage. The reduced TAcP activity in alveolar macrophages from patients with sarcoidosis may be due to an increased recruitment of immature precursors from blood.

  1. Diagnostic usefulness of a T-cell-based assay in patients with miliary tuberculosis compared with those with lymph node tuberculosis.

    Science.gov (United States)

    Lee, Yu-Mi; Park, Ki-Ho; Kim, Sun-Mi; Park, Su Jin; Lee, Sang-Oh; Choi, Sang-Ho; Kim, Yang Soo; Woo, Jun Hee; Kim, Sung-Han

    2013-01-01

    Forty-three patients with miliary tuberculosis were evaluated for diagnostic usefulness of enzyme-linked immunospot (ELISPOT) assay. Among noninvasive rapid tests available within 3-5 days, ELISPOT had the highest sensitivity (93%), compared with acid-fast bacilli stain (sputum, 32% and bronchoalveolar lavage, 7%), Mycobacterium tuberculosis polymerase chain reaction (sputum, 53% and bronchoalveolar lavage, 36%), and tuberculin skin test (22%). In comparison with 44 patients with lymph node tuberculosis, the sensitivity of the ELISPOT assay in patients with miliary tuberculosis (93%) was as high as in those with lymph node tuberculosis (95%, P = .63), whereas the sensitivity of the tuberculin skin test was substantially lower in patients with miliary tuberculosis (22%) than in those with lymph node tuberculosis (73%, P < .001).

  2. Evaluation of the automated Becton Dickinson MAX real-time PCR platform for detection of Pneumocystis jirovecii.

    Science.gov (United States)

    Chien, Jung-Yien; Liu, Chia-Jung; Chuang, Pei-Chien; Lee, Tai-Fen; Huang, Yu-Tsung; Liao, Chun-Hsing; Hung, Chien-Ching; Sheng, Wan-Huei; Yu, Chong-Jen; Hsueh, Po-Ren

    2017-01-01

    We evaluated the performance of the automated quantitative BD MAX (Becton Dickinson) real-time PCR platform for detecting Pneumocystis jirovecii. A total of 34 retrospective and 137 prospective samples were included. Retrospectively, all (100%) positive samples were correctly detected by this platform compared with a nested PCR. Among prospective samples, the overall sensitivity, specificity, positive likelihood ratio and negative likelihood ratio were 92.6%, 94.5%, 17.0 and 0.1, respectively. All bronchoalveolar lavage fluid (BALF)/bronchial washing samples were correctly identified by this platform. Samples from patients with colonization had significantly higher median amplification cycle threshold values than patients with P. jirovecii pneumonia. The quantitative BD MAX real-time PCR is a rapid and highly sensitive modality for detecting P. jirovecii, especially in samples from bronchoalveolar lavage fluid/bronchial washing fluid.

  3. 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.

  4. Common Lung Microbiome Identified among Mechanically Ventilated Surgical Patients.

    Directory of Open Access Journals (Sweden)

    Ashley D Smith

    Full Text Available The examination of the pulmonary microbiome in patients with non-chronic disease states has not been extensively examined. Traditional culture based screening methods are often unable to identify bacteria from bronchoalveolar lavage samples. The advancement of next-generation sequencing technologies allows for a culture-independent molecular based analysis to determine the microbial composition in the lung of this patient population. For this study, the Ion Torrent PGM system was used to assess the microbial complexity of culture negative bronchoalveolar lavage samples. A group of samples were identified that all displayed high diversity and similar relative abundance of bacteria. This group consisted of Hydrogenophaga, unclassified Bacteroidetes, Pedobacter, Thauera, and Acinetobacter. These bacteria may be representative of a common non-pathogenic pulmonary microbiome associated within this population of patients.

  5. 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. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  6. Acute eosinophilic pneumonia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Gyoo; Sik; Oh, Kyung Seung; Kim, Jong Min; Huh, Jin Do; Joh, Young Duk; Jang, Tae Won; Jung, Man Hong [Kosin Medical College, Busan (Korea, Republic of)

    1995-10-15

    Acute eosinophilic pneumonia is one of a recently described idiopathic eosinophilic lung disease, which differs from chronic eosinophilic pneumonia. Patients with acute eosinophilic pneumonia develop acute onset of dyspnea, hypoxemia, diffuse pulmonary infiltrates and pleural effusion on chest radiograph, and show an increase in number of eosinophils in bronchoalveolar lavage fluid or lung biopsy specimen. Prompt and complete response to corticosteroid therapy without any recurrence is characteristically seen in patient with this disease. Although the etiology of acute eosinophilic pneumonia is not known, it has been suggested to be related to a hypersensitivity phenomenon to an unidentified inhaled antigen. We report four cases of acute eosinophilic pneumonia presented with acute onset of dyspnea, diffuse pulmonary infiltrates on chest radiograph, and eosinophilia in bronchoalveolar lavage fluid in previously healthy adults.

  7. Regulatory effects of intrinsic IL-10 in IgG immune complex-induced lung injury

    DEFF Research Database (Denmark)

    Shanley, T P; Schmal, H; Friedl, H P

    1995-01-01

    IL-10 has regulatory effects in vitro on cytokine production by activated macrophages. In the IgG immune complex model of lung injury, exogenously administered IL-10 has been shown to suppress in vivo formation of TNF-alpha, up-regulation of vascular ICAM-1, neutrophil recruitment, and ensuing lung...... injury. In the current study, we sought to determine whether endogenous IL-10 is playing a regulatory role in the lung inflammatory response. On the basis of lung mRNA and ELISA measurements, IL-10 induction was found during development of inflammation in the IgG immune complex model of lung injury....... Blocking of IL-10 by Ab resulted in a 52% increase in lung vascular permeability, a 56% increase in TNF-alpha activity in bronchoalveolar lavage fluids, and a 47 to 48% increase in bronchoalveolar lavage neutrophils and lung myeloperoxidase content. These findings suggest that IL-10 is an important natural...

  8. Respiratory Virus Detection in Immunocompromised Patients with FilmArray Respiratory Panel Compared to Conventional Methods

    OpenAIRE

    Hammond, Sarah P.; Gagne, Lisa S.; Stock, Shannon R.; Marty, Francisco M.; Gelman, Rebecca S.; Marasco, Wayne A.; Poritz, Mark A.; Baden, Lindsey R.

    2012-01-01

    Respiratory virus infections cause significant morbidity and mortality in immunocompromised patients. Timely diagnosis is needed to provide optimal clinical care. Diagnostic tests routinely available at most institutions are limited by poor sensitivity and a slow turnaround time. We collected 90 respiratory samples from 87 immunocompromised patients (56 bronchoalveolar lavage and 34 nasopharyngeal aspirate samples) in order to compare the performance of routine respiratory virus testing avail...

  9. Spatial distribution of microbial communities in the cystic fibrosis lung

    OpenAIRE

    Willner, Dana; Haynes, Matthew R.; Furlan, Mike; Schmieder, Robert; Lim, Yan Wei; Rainey, Paul B.; Rohwer, Forest; Conrad, Douglas

    2011-01-01

    Cystic fibrosis (CF) is a common fatal genetic disorder with mortality most often resulting from microbial infections of the lungs. Culture-independent studies of CF-associated microbial communities have indicated that microbial diversity in the CF airways is much higher than suggested by culturing alone. However, these studies have relied on indirect methods to sample the CF lung such as expectorated sputum and bronchoalveolar lavage (BAL). Here, we characterize the diversity of microbial co...

  10. Necrotizing lung infection caused by the protozoan Balantidium coli

    OpenAIRE

    Sat Sharma; Godfrey Harding

    2003-01-01

    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 c...

  11. Interstitial lung disease pattern turned out to be a predominantly lepidic lung adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Irena Hammen, Dr. Med

    2017-01-01

    Full Text Available We report a case of a 46-year-old woman without any medical history who presented to our Respiratory Department with exertional dyspnoea for the last 6 weeks associated with non-productive cough. Chest radiography showed bilateral diffuse interstitial opacity. Bronchoalveolar lavage and transbronchial biopsies performed during flexible bronchoscopy as a step in the diagnostic workup of idiopathic interstitial pneumonia showed cells of pulmonary adenocarcinoma.

  12. Comparison of Six DNA Extraction Methods for Recovery of Fungal DNA as Assessed by Quantitative PCR

    OpenAIRE

    Fredricks, David N.; Smith, Caitlin; Meier, Amalia

    2005-01-01

    The detection of fungal pathogens in clinical samples by PCR requires the use of extraction methods that efficiently lyse fungal cells and recover DNA suitable for amplification. We used quantitative PCR assays to measure the recovery of DNA from two important fungal pathogens subjected to six DNA extraction methods. Aspergillus fumigatus conidia or Candida albicans yeast cells were added to bronchoalveolar lavage fluid and subjected to DNA extraction in order to assess the recovery of DNA fr...

  13. Bilateral Pulmonary Aspergilloma Caused by an Atypical Isolate of Aspergillus terreus

    OpenAIRE

    Z. U. Khan; Kortom, M; Marouf, R.; Chandy, R; Rinaldi, M G; Sutton, D. A.

    2000-01-01

    A case of bilateral pulmonary aspergilloma caused by an atypical isolate of Aspergillus terreus is described. The diagnosis was established by the presence of septate, dichotomously branched fungal elements in freshly collected bronchoalveolar lavage and sputum specimens and by repeated isolation of the fungus in culture. Specific precipitating antibodies against the A. terreus isolate were demonstrated in the patient's serum. The isolate was atypical as it failed to produce fruiting structur...

  14. Diminished activity of tartrate resistant acid phosphatase in alveolar macrophages from patients with active sarcoidosis.

    OpenAIRE

    Barth, J.; Kreipe, H.; Kiemle-Kallee, J; Radzun, H.J.; Parwaresch, M R; Petermann, W.

    1988-01-01

    Alveolar macrophages differ from their percursors in blood, monocytes, by expressing strong activity of the tartrate resistant variant of acid phosphatase (TAcP). A study was carried out to analyse the expression of this enzyme cytochemical marker by alveolar macrophages from bronchoalveolar lavage cells from 34 patients with sarcoidosis and 12 control subjects. Alveolar macrophages from control subjects displayed a strong and homogeneous staining pattern and only 0.1% of cells were negative ...

  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. Copyright © 2012 Elsevier B.V. All rights

  16. Induction of interleukin 6 and interleukin 8 expression by Broncho-Vaxom (OM-85 BV) via C-Fos/serum responsive element.

    OpenAIRE

    Keul, R; Roth, M.; Papakonstantinou, E.; Nauck, M; Perruchoud, A P; Block, L H

    1996-01-01

    BACKGROUND: Broncho-Vaxom (OM-85 BV) increases the resistance of the respiratory tract to bacterial infections by modulating host immune responses. The compound increases serum IgG levels but decreases IgE levels in patients suffering from chronic bronchitis or chronic obstructive pulmonary disease. It increases concentrations of gamma-interferon (IFN-gamma), IgA, and interleukin (IL)-2 in bronchoalveolar lavage fluid of patients with bronchitis. Treatment with OM-85 BV increases the number o...

  17. Antibiotic uptake by alveolar macrophages of smokers.

    OpenAIRE

    Hand, W L; Boozer, R M; King-Thompson, N L

    1985-01-01

    Cigarette smoking, particularly when associated with chronic pulmonary disease, increases the risk of respiratory tract infection. Thus, we elevated the uptake of antibiotics by alveolar macrophages (AM) obtained by bronchoalveolar lavage from persons who smoke and have associated pulmonary abnormalities, circumstances which adversely affect certain macrophage functions. The entry of radiolabeled drugs into AM was determined by a velocity-gradient centrifugation technique, and uptake was expr...

  18. [Chronic meningitis associated with lymph node sarcoidosis].

    Science.gov (United States)

    Thielemans, P; Jann, E

    1989-01-01

    A 59-year-old woman with maturity-onset diabetes presented with symmetrical transient polyarthralgia and acido-cetosis. Bilateral hilar adenopathy and erythematous rash on lower limbs were demonstrated. While low-grade chronic meningeal irritation supervened, lymph node biopsy showed typical sarcoidosis. Administration of corticosteroids resulted in reduction of cerebrospinal fluid albumin content and of lymphocytosis in bronchoalveolar lavage. In this patient, sarcoidosis was therefore associated with Löfgren's syndrome and meningitis.

  19. 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 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....

  20. Airway Inflammation after Bronchial Thermoplasty for Severe Asthma.

    Science.gov (United States)

    Denner, Darcy R; Doeing, Diana C; Hogarth, D Kyle; Dugan, Karen; Naureckas, Edward T; White, Steven R

    2015-09-01

    Bronchial thermoplasty is an alternative treatment for patients with severe, uncontrolled asthma in which the airway smooth muscle is eliminated using radioablation. Although this emerging therapy shows promising outcomes, little is known about its effects on airway inflammation. We examined the presence of bronchoalveolar lavage cytokines and expression of smooth muscle actin in patients with severe asthma before and in the weeks after bronchial thermoplasty. Endobronchial biopsies and bronchoalveolar lavage samples from 11 patients with severe asthma were collected from the right lower lobe before and 3 and 6 weeks after initial bronchial thermoplasty. Samples were analyzed for cell proportions and cytokine concentrations in bronchoalveolar lavage and for the presence of α-SMA in endobronchial biopsies. α-SMA expression was decreased in endobronchial biopsies of 7 of 11 subjects by Week 6. In bronchoalveolar lavage fluid, both transforming growth factor-β1 and regulated upon activation, normal T-cell expressed and secreted (RANTES)/CCL5 were substantially decreased 3 and 6 weeks post bronchial thermoplasty in all patients. The cytokine tumor-necrosis-factor-related apoptosis-inducing ligand (TRAIL), which induces apoptosis in several cell types, was increased in concentration both 3 and 6 weeks post bronchial thermoplasty. Clinical improvement and reduction in α-SMA after bronchial thermoplasty in severe, uncontrolled asthma is associated with substantial changes in key mediators of inflammation. These data confirm the substantial elimination of airway smooth muscle post thermoplasty in the human asthmatic airway and represent the first characterization of significant changes in airway inflammation in the first weeks after thermoplasty.

  1. Interleukin-17A Is Associated With Alveolar Inflammation and Poor Outcomes in Acute Respiratory Distress Syndrome.

    Science.gov (United States)

    Mikacenic, Carmen; Hansen, Elizabeth E; Radella, Frank; Gharib, Sina A; Stapleton, Renee D; Wurfel, Mark M

    2016-03-01

    Interleukin-17A is a proinflammatory cytokine known to play a role in host defense and pathologic inflammation in murine models of lung injury. The relationship between interleukin-17A and inflammation in human lung injury is unknown. Our primary objective was to determine whether interleukin-17A levels are associated with alveolar measures of inflammation and injury in patients with acute respiratory distress syndrome. Our secondary objective was to test whether interleukin-17A levels are associated with acute respiratory distress syndrome-related outcomes. Observational study. Six North American medical centers. We studied two groups of patients with acute respiratory distress syndrome: 1) patients previously enrolled in a placebo-controlled clinical trial of omega-3 fatty acids performed at five North American medical centers (n = 86, acute respiratory distress syndrome 1), and 2) patients with systemic inflammatory response syndrome admitted to an ICU who developed acute respiratory distress syndrome (n = 140, acute respiratory distress syndrome 2). In acute respiratory distress syndrome 1, we used paired serum and bronchoalveolar lavage fluid samples obtained within 48 hours of acute respiratory distress syndrome onset, whereas in acute respiratory distress syndrome 2, we used plasma obtained within the first 24 hours of ICU admission. None. We measured circulating interleukin-17A in acute respiratory distress syndrome 1 and acute respiratory distress syndrome 2. We also measured interleukin-17A, neutrophil counts, and total protein in bronchoalveolar lavage fluid from acute respiratory distress syndrome 1. We found that bronchoalveolar lavage interleukin-17A was strongly associated with higher bronchoalveolar lavage percent neutrophils (p syndrome1. In both acute respiratory distress syndrome 1 and acute respiratory distress syndrome 2, elevated interleukin-17A was associated with higher Sequential Organ Failure Assessment scores (p syndrome.

  2. Novel flow cytometry approach to identify bronchial epithelial cells from healthy human airways

    OpenAIRE

    Danay Maestre-Batlle; Pena, Olga M.; Hirota, Jeremy A.; Evelyn Gunawan; Rider, Christopher F.; Darren Sutherland; Alexis, Neil E.; Chris Carlsten

    2017-01-01

    Sampling various compartments within the lower airways to examine human bronchial epithelial cells (HBEC) is essential for understanding numerous lung diseases. Conventional methods to identify HBEC in bronchoalveolar lavage (BAL) and wash (BW) have throughput limitations in terms of efficiency and ensuring adequate cell numbers for quantification. Flow cytometry can provide high-throughput quantification of cell number and function in BAL and BW samples, while requiring low cell numbers. To ...

  3. Comparison of Anyplex II RV16 with the xTAG Respiratory Viral Panel and Seeplex RV15 for Detection of Respiratory Viruses

    OpenAIRE

    Kim, Hyun-Ki; Oh, Sung-Hee; Yun, Kyung Ah; Sung, Heungsup; Kim, Mi-Na

    2013-01-01

    A novel multiplex real-time PCR approach (Anyplex II RV16 [RV16]; Seegene, South Korea) was compared with a multiplex endpoint PCR kit (Seeplex RV15 ACE detection kit [RV15]; Seegene) and a liquid bead-based assay (xTAG respiratory viral panel [xTAG]; Abbott, United States). Of nasopharyngeal swabs or aspirates and bronchoalveolar lavage fluid samples submitted for RV15 testing, 199 retrospectively collected positive specimens and 283 prospectively collected specimens were further tested with...

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

    OpenAIRE

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

    1992-01-01

    The development of bronchus-associated lymphoid tissue (BALT) was investigated in the pig, which is a species in which BALT is not found constantly. Different routes of contact with a specifically lung-pathogen bacterium Actinobacillus (Haemophilus) pleuropneumoniae were tested. Pigs, selected by bacteriological screening methods and the number of granulocytes in the bronchoalveolar lavage (BAL), were infected by aerosol. They were compared to previously enterally immunized pigs using active ...

  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. 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

    . 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...

  7. 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

  8. Virus-induced airway inflammation and hyperresponsiveness in the guinea-pig is inhibited by levodropropizine.

    Science.gov (United States)

    Folkerts, G; van der Linde, H J; Omini, C; Nijkamp, F P

    1993-08-01

    Intratracheal Parainfluenza type 3 (PI-3) virus inoculation of guinea pigs leads to a non-specific airway hyperresponsiveness in vivo and in vitro which coincides with a significant increase in the number of inflammatory cells in the broncho-alveolar lavage fluid (90% increase, 4 days after inoculation). The activity of the bronchoalveolar cells, as measured by the chemiluminescence production of infected animals is significantly diminished (34.2%, 4 days after inoculation) after renewed stimulation with PI-3 virus in vitro as compared to the chemiluminescence production by bronchoalveolar cells obtained from control guinea pigs. Pretreatment of the guinea-pigs with the antitussive agent levodropropizine, administered intra-peritoneally twice a day for five successive days at a dose of 10 mg/kg, prevents the virus-induced airway hyperresponsiveness in vivo and in vitro, and inhibits the influx of broncho-alveolar cells. Levodropropizine at a dose of 1 mg/kg did not modulate these responses. Further, the decrease in chemiluminescence production of broncho-alveolar cells obtained from virus-infected animals after PI-3 virus stimulation in vitro was inhibited by levodropropizine (10 mg/kg). These data demonstrate the ability of levodropropizine to counteract the hyperresponsiveness phenomenon and the associated inflammatory event induced by PI-3 virus, an effect which may be due to its capacity to act on the peptidergic system or may be due to the anti-allergic/bronchoconstrictor property of this compound.

  9. 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)

  10. Inhaled aerosolized insulin ameliorates hyperglycemia-induced inflammatory responses in the lungs in an experimental model of acute lung injury

    Science.gov (United States)

    2013-01-01

    Introduction Previous studies have shown that patients with diabetes mellitus appear to have a lower prevalence of acute lung injury. We assumed that insulin prescribed to patients with diabetes has an anti-inflammatory property and pulmonary administration of insulin might exert beneficial effects much more than intravenous administration. Methods Twenty-eight mechanically ventilated rabbits underwent lung injury by saline lavage, and then the animals were allocated into a normoglycemia group (NG), a hyperglycemia group (HG), an HG treated with intravenous insulin (HG-VI) group or an HG treated with aerosolized insulin (HG-AI) group with continuous infusion of different fluid solutions and treatments: normal saline, 50% glucose, 50% glucose with intravenous insulin, or 50% glucose with inhaled aerosolized insulin, respectively. After four hours of treatment, the lungs and heart were excised en bloc, and then high-mobility group B1 concentration in bronchoalveolar lavage fluid, interleukin-8 and toll-like receptor 4 mRNA expression in bronchoalveolar lavage fluid cells, and lung myeloperoxidase activity were measured. Results Treatment with both aerosolized insulin and intravenous insulin attenuated toll-like receptor 4 mRNA expressions in the bronchoalveolar lavage fluid cells. Interleukin-8 and toll-like receptor 4 mRNA expression was significantly lower in the HG-AI group than in the HG-IV group. The lung myeloperoxidase activity in the normal healthy group showed significantly lower levels compared to the NG group but not different compared to those of the HG, HG-VI and HG-AI groups. Conclusions The results suggest that insulin attenuates inflammatory responses in the lungs augmented by hyperglycemia in acute lung injury and the insulin's efficacy may be better when administered by aerosol. PMID:23622115

  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. 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...

  13. 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.

  14. Evidence-Based Assignment of Diagnostic Peritoneal Lavage (DPL Sensitivity in Penetrating Abdominal Trauma

    Directory of Open Access Journals (Sweden)

    M. Sharifi

    2008-02-01

    Full Text Available Background:There are a large number of patients with penetrating abdominal trauma who have normal vital signs and negative abdominal examination when referred to trauma centers. Agreat deal of controversy exists between authorities about screening these patients for emergency explorative laparotomy. Many references have reported more than 90% sensitivity for DPL as a diagnostic method to determine whether intraabdominal injuries were present and emergent laparotomy is indicated or not. This study is for reassignment of this sensitivity according to our own evidence. Methods: All of the patients with abdominal stab wounds and normal vital signs plus negative abdominal examination who were referred to Shohada-e-Tajrish hospital between March 2004 to December 2005, underwent local wound exploration and those confirmed to have peritoneal penetration, underwent emergency laparotomy. In the operating room and prior to surgery, under general anesthesia, DPL was performed. Then DPL results were compared with laparotomy findings and DPL sensitivity was assigned. Results: Of the total number of 34 patients, 8 had a positive DPL and positive laparotomy; 2 had a positive DPL and negative laparotomy; 8 had negative DPL and positive laparotomy, and 16 patients had negative DPL and negative laparotomy. Conclusion: According to our study, DPL sensitivity is much less than mentioned in trauma texts (approximately 50%. So, it is not a valuable tool to discriminate between operative and conservative approaches in penetrating abdominal trauma. We suggest more sensitive modalities. Laparotomy is the most sensitive approach but at the price of a high negative laparotomy rate.

  15. Performing Vaginal Lavage, Crystal Violet Staining, and Vaginal Cytological Evaluation for Mouse Estrous Cycle Staging Identification

    Science.gov (United States)

    McLean, Ashleigh C.; Valenzuela, Nicolas; Fai, Stephen; Bennett, Steffany A.L.

    2012-01-01

    A rapid means of assessing reproductive status in rodents is useful not only in the study of reproductive dysfunction but is also required for the production of new mouse models of disease and investigations into the hormonal regulation of tissue degeneration (or regeneration) following pathological challenge. The murine reproductive (or estrous) cycle is divided into 4 stages: proestrus, estrus, metestrus, and diestrus. Defined fluctuations in circulating levels of the ovarian steroids 17-β-estradiol and progesterone, the gonadotropins luteinizing and follicle stimulating hormones, and the luteotropic hormone prolactin signal transition through these reproductive stages. Changes in cell typology within the murine vaginal canal reflect these underlying endocrine events. Daily assessment of the relative ratio of nucleated epithelial cells, cornified squamous epithelial cells, and leukocytes present in vaginal smears can be used to identify murine estrous stages. The degree of invasiveness, however, employed in collecting these samples can alter reproductive status and elicit an inflammatory response that can confound cytological assessment of smears. Here, we describe a simple, non-invasive protocol that can be used to determine the stage of the estrous cycle of a female mouse without altering her reproductive cycle. We detail how to differentiate between the four stages of the estrous cycle by collection and analysis of predominant cell typology in vaginal smears and we show how these changes can be interpreted with respect to endocrine status. PMID:23007862

  16. 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 ...

  17. 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

  18. Therapeutic Lung Lavage with Diluted Surfactant in Neonates with Severe Meconium Aspiration Syndrome

    National Research Council Canada - National Science Library

    Lo, Chiao-Wei; Jeng, Mei-Jy; Chang, Feng-Yu; Yang, Ja-Fang; Lee, Yu-Sheng; Soong, Wen-Jue; Chen, Shu-Jen; Tang, Ren-Bin

    2008-01-01

    ... was still 2.5%. 2 Therefore, an effective therapy to improve outcome is crucial in treating neonates with severe MAS. The pathophysiology of MAS includes airway ob- struction, 3 surfactant inactivation, 4,5 inflammation, 6–8 and pulmonary hypertension. 9,10 Successful treatment of severe MAS relies on effective meconium removal without inactivatin...

  19. 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....

  20. 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...

  1. Inducible nitric oxide synthase expression is increased in the alveolar compartment of asthmatic patients.

    Science.gov (United States)

    Tufvesson, E; Andersson, C; Weidner, J; Erjefält, J S; Bjermer, L

    2017-04-01

    Increased exhaled nitric oxide (NO) levels in asthma are suggested to be through inducible NO synthase (iNOS). The aim of this study was to investigate the expression of iNOS in bronchoalveolar lavage (BAL) cells and tissue from central and peripheral airways and compare it with the exhaled bronchial and alveolar NO levels in patients with asthma vs a control group. Thirty-two patients with asthma (defined as controlled or uncontrolled according to Asthma Control Test score cut-off: 20) and eight healthy controls were included. Exhaled NO was measured, and alveolar concentration and bronchial flux were calculated. iNOS was measured in central and peripheral lung biopsies, as well as BAL cells. Bronchoalveolar lavage macrophages were stimulated in vitro, and iNOS expression and NO production were investigated. Expression of iNOS was increased in central airway tissue and the alveolar compartment in uncontrolled as compared to controlled asthmatics and healthy controls. There were no differences, however, in iNOS mRNA levels in total BAL cells in uncontrolled as compared to controlled asthma. Bronchoalveolar lavage cell mRNA levels of iNOS or iNOS expression in central and alveolar tissue did not relate to alveolar NO, nor to bronchial flux of NO. In vitro stimulation with leukotriene D4 increased iNOS mRNA levels and NO production in cultured BAL macrophages. The levels of both bronchial and alveolar iNOS are increased in uncontrolled as compared to controlled asthma. However, levels of iNOS in BAL macrophages were not reflected by alveolar NO. Both central and distal iNOS levels may reflect responsiveness to steroid treatment. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Reversible control by vitamin D of granulocytes and bacteria in the lungs of mice: an ovalbumin-induced model of allergic airway disease.

    Directory of Open Access Journals (Sweden)

    Shelley Gorman

    Full Text Available Vitamin D may be essential for restricting the development and severity of allergic diseases and asthma, but a direct causal link between vitamin D deficiency and asthma has yet to be established. We have developed a 'low dose' model of allergic airway disease induced by intraperitoneal injection with ovalbumin (1 µg and aluminium hydroxide (0.2 mg in which characteristics of atopic asthma are recapitulated, including airway hyperresponsiveness, antigen-specific immunoglobulin type-E and lung inflammation. We assessed the effects of vitamin D deficiency throughout life (from conception until adulthood on the severity of ovalbumin-induced allergic airway disease in vitamin D-replete and -deficient BALB/c mice using this model. Vitamin D had protective effects such that deficiency significantly enhanced eosinophil and neutrophil numbers in the bronchoalveolar lavage fluid of male but not female mice. Vitamin D also suppressed the proliferation and T helper cell type-2 cytokine-secreting capacity of airway-draining lymph node cells from both male and female mice. Supplementation of initially vitamin D-deficient mice with vitamin D for four weeks returned serum 25-hydroxyvitamin D to levels observed in initially vitamin D-replete mice, and also suppressed eosinophil and neutrophil numbers in the bronchoalveolar lavage fluid of male mice. Using generic 16 S rRNA primers, increased bacterial levels were detected in the lungs of initially vitamin D-deficient male mice, which were also reduced by vitamin D supplementation. These results indicate that vitamin D controls granulocyte levels in the bronchoalveolar lavage fluid in an allergen-sensitive manner, and may contribute towards the severity of asthma in a gender-specific fashion through regulation of respiratory bacteria.

  3. Enhanced cough reflex in a model of bleomycin-induced lung fibrosis in guinea pigs.

    Science.gov (United States)

    Fernández-Blanco, Joan Antoni; Aguilera, Mònica; Domènech, Anna; Tarrasón, Gema; Prats, Neus; Miralpeix, Montse; De Alba, Jorge

    2015-12-01

    Fibrotic lung diseases, such as idiopathic pulmonary fibrosis, are associated with spontaneous dry cough and hypersensitivity to tussive agents. Understanding the pathophysiology driving enhanced cough may help us to define better therapies for patients. We hypothesized that lung fibrosis induced by intratracheal bleomycin would exacerbate the cough reflex induced by tussive agents in guinea pigs. Disease progression in the lungs was characterized at days 1, 7, 14, 21 and 28 after bleomycin administration. Inflammatory and fibrotic markers, as well as neurotrophin levels, were assessed in bronchoalveolar lavage fluid and/or lung tissue. Cough sensitivity to citric acid, capsaicin and allylisothiocyanate was evaluated in conscious animals at days 14 and 21 after bleomycin administration. Pulmonary lesions evolved from an early inflammatory phase (from day 1 to day 7) to a fibrotic stage (between days 14 and 28). Fibrosis was related to increased levels of matrix metalloproteinase-2 in bronchoalveolar lavage fluid (day 21: saline, 0.26 ng/ml; bleomycin, 0.49 ng/ml). At day 14, we also observed increased cough reflexes to citric acid (163%), capsaicin (125%) and allylisothiocyanate (178%). Cough exacerbation persisted, but at a lower extent, by day 21 for capsaicin (100%) and allylisothiocyanate (54%). Moreover, bronchoalveolar lavage fluid concentrations of brain-derived neurotrophic factor, suggested to induce nerve remodelling in chronic cough, were also enhanced (day 1: saline, 14.21 pg/ml; bleomycin, 30.09 pg/ml). In summary, our model of bleomycin-induced cough exacerbation may be a valuable tool to investigate cough hypersensitivity and develop antitussive therapies for fibrotic lung diseases. © 2015 Authors; published by Portland Press Limited.

  4. 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

  5. [Diffuse interstitial pneumopathy after the treatment with gold salts of a patient with rheumatoid polyarthritis].

    Science.gov (United States)

    Strâmbu, I; Stoicescu, I P

    1997-01-01

    We present the case of a male patient with sero-negative rheumatoid arthritis, treated with gold salts, admitted for clinical symptoms and chest X-ray alterations suggesting an interstitial lung disease. This was confirmed by complex lung function tests and fiber bronchoscopy with broncho-alveolar lavage. Considerations are made about the etiology of interstitial lung disease (pulmonary determination of the rheumatoid arthritis or secondary to the gold salts therapy), about the treatment and long-term prognosis, and about the good clinical, functional and radiological evolution under treatment.

  6. Bronchiolitis obliterans with organizing pneumonia.

    Science.gov (United States)

    Nagai, S; Izumi, T

    1996-09-01

    In 1955, Epler and Colby first described idiopathic bronchiolitis obliterans with organizing pneumonia. Davison and colleagues termed the entity cryptogenic organizing pneumonia. Clinically, the disease resembles a flu-like syndrome of acute or subacute onset. Other features include crackles, patchy infiltrates on chest radiograph, restrictive function, and decrease in diffusing capacity. Most cases of idiopathic bronchiolitis obliterans with organizing pneumonia (BOOP) respond dramatically to corticosteroids. However, some patients deteriorate rapidly. Differences between idiopathic or secondary BOOP and other interstitial lung diseases are vast. CT findings and bronchoalveolar lavage fluid lymphocytosis are helpful in differentiating BOOP from idiopathic pulmonary fibrosis.

  7. Rapid identification of Stenotrophomonas maltophilia by peptide nucleic acid fluorescence in situ hybridization.

    Science.gov (United States)

    Hansen, N; Rasmussen, A K I; Fiandaca, M J; Kragh, K N; Bjarnsholt, T; Høiby, N; Stender, H; Guardabassi, L

    2014-05-01

    The objective of this study was to develop a novel peptide nucleic acid (PNA) probe for Stenotrophomonas maltophilia identification by fluorescence in situ hybridization (FISH). The probe was evaluated using 33 human and veterinary clinical S. maltophilia isolates and 45 reference strains 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 horses. Altogether the study shows that this species-specific PNA FISH probe facilitates rapid detection of S. maltophilia in biological specimens.

  8. Necrotizing lung infection caused by the protozoan Balantidium coli.

    Science.gov (United States)

    Sharma, Sat; Harding, Godfrey

    2003-05-01

    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.

  9. 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.

  10. Neurotrophin effects on eosinophils in allergic inflammation.

    Science.gov (United States)

    Nassenstein, Christina; Braun, Armin; Nockher, W Andreas; Renz, Harald

    2005-05-01

    Elevated neurotrophin concentrations have been shown in nasal and bronchoalveolar lavage fluids as well as in the sera of patients with allergic rhinitis and asthma. Concentration of nerve growth factor correlated with disease severity, bronchial hyperreactivity, and levels of mediators released from eosinophils. Due to the release of cationic proteins, oxygen species, and cytokines after degranulation, eosinophils contribute to tissue damage and can influence airway hyperresponsiveness in asthma. It has been hypothesized that neurotrophins may be involved in the development of eosinophilia and in activation of these cells. The aim of this review is to elucidate the direct and indirect mechanisms of neurotrophins contributing to eosinophilia in allergic diseases.

  11. Sub-chronic lung inflammation after airway exposures to Bacillus thuringiensis biopesticides in mice

    DEFF Research Database (Denmark)

    Barfod, Kenneth K; Poulsen, Steen Seier; Hammer, Maria

    2010-01-01

    The aim of the present study was to assess possible health effects of airway exposures to Bacillus thuringiensis (Bt) based biopesticides in mice. Endpoints were lung inflammation evaluated by presence of inflammatory cells in bronchoalveolar lavage fluid (BALF), clearance of bacteria from the lung...... lumen and histological alterations of the lungs. Hazard identifications of the biopesticides were carried out using intratracheal (i.t.) instillation, followed by an inhalation study. The two commercial biopesticides used were based on the Bt. subspecies kurstaki and israelensis, respectively. Groups...

  12. Correlation of severity of sarcoidosis shown by chest CT with clinical and pulmonary functional findings

    Energy Technology Data Exchange (ETDEWEB)

    Toyoshima, Masami; Kaminou, Toshio; Yamada, Hisashi; Sekine, Hiroshi; Furukawa, Takashi; Matsui, Yasuo; Oritsu, Minoru (Japan Red Cross Medical Center, Tokyo (Japan)); Minaguchi, Kazuo; Onoyama, Yasuto

    1991-01-01

    For 39 patients with sarcoidosis, we evaluated the correlation of chest CT findings (granular shadows, nodular shadows, irregular enlargement of pulmonary vascular shadows, infiltrative shadows, reticular shadows, linear shadows, incresed density of lung field areas, and lymphadenopathy) with results of clinical and pulmonary function tests (PFTs). CT detected and delineated lung field involvement and lymphadenopathy better than Ga scanning. The severity of parenchymal changes on the CT scan was correlated with PFTs results for VC% and DLco%. The severity of lymphadenopathy on the CT scan was correlated with the serum levels of angiotensin converting enzyme and OKT4/OKT8 in bronchoalveolar lavage fluid. (author).

  13. 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)

  14. Lung Surfactant Protein D (SP-D) Response and Regulation During Acute and Chronic Lung Injury

    DEFF Research Database (Denmark)

    Gaunsbaek, Maria Quisgaard; Rasmussen, Karina Juhl; Beers, Michael F.

    2013-01-01

    BACKGROUND: Surfactant protein D (SP-D) is a collection that plays important roles in modulating host defense functions and maintaining phospholipid homeostasis in the lung. The aim of current study was to characterize comparatively the SP-D response in bronchoalveolar lavage (BAL) and serum...... in three murine models of lung injury, using a validated ELISA technology for estimation of SP-D levels. METHODS: Mice were exposed to lipopolysaccharide, bleomycin, or Pneumocystis carinii (Pc) and sacrificed at different time points. RESULTS: In lipopolysaccharide-challenged mice, the level of SP...

  15. 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.

  16. Acute effect of glucan-spiked office dust on nasal and pulmonary inflammation in guinea pigs

    DEFF Research Database (Denmark)

    Straszek, Sune; Adamcakova-Dodd, Andrea; Nervana, Metwali

    2007-01-01

    by acoustic rhinometry (AR) and animals were exposed by inhalation for 4 hr to curdlan spiked dust, unspiked dust, purified air (negative controls) or LPS (positive controls). After exposure (+5 hr) or the following day (+18 hr) measurements were repeated by AR and followed by bronchoalveolar lavage (BAL......). Total and differential cell counts, IL-8 in BAL fluid and change in nasal volume was compared between groups. A 5-10% increase in nasal volume was seen for all groups including clean air except for a significant 5% decrease for spiked-dust inhalation (+18 hr). No marked differences were observed in BAL...

  17. Deficiency of the two-pore-domain potassium channel TREK-1 promotes hyperoxia-induced lung injury.

    Science.gov (United States)

    Schwingshackl, Andreas; Teng, Bin; Makena, Patrudu; Ghosh, Manik; Sinclair, Scott E; Luellen, Charlean; Balasz, Louisa; Rovnaghi, Cynthia; Bryan, Robert M; Lloyd, Eric E; Fitzpatrick, Elizabeth; Saravia, Jordy S; Cormier, Stephania A; Waters, Christopher M

    2014-11-01

    We previously reported the expression of the two-pore-domain K channel TREK-1 in lung epithelial cells and proposed a role for this channel in the regulation of alveolar epithelial cytokine secretion. In this study, we focused on investigating the role of TREK-1 in vivo in the development of hyperoxia-induced lung injury. Laboratory animal experiments. University research laboratory. Wild-type and TREK-1-deficient mice. Mice were anesthetized and exposed to 1) room air, no mechanical ventilation, 2) 95% hyperoxia for 24 hours, and 3) 95% hyperoxia for 24 hours followed by mechanical ventilation for 4 hours. Hyperoxia exposure accentuated lung injury in TREK-1-deficient mice but not controls, resulting in increase in lung injury scores, bronchoalveolar lavage fluid cell numbers, and cellular apoptosis and a decrease in quasi-static lung compliance. Exposure to a combination of hyperoxia and injurious mechanical ventilation resulted in further morphological lung damage and increased lung injury scores and bronchoalveolar lavage fluid cell numbers in control but not TREK-1-deficient mice. At baseline and after hyperoxia exposure, bronchoalveolar lavage cytokine levels were unchanged in TREK-1-deficient mice compared with controls. Exposure to hyperoxia and mechanical ventilation resulted in an increase in bronchoalveolar lavage interleukin-6, monocyte chemotactic protein-1, and tumor necrosis factor-α levels in both mouse types, but the increase in interleukin-6 and monocyte chemotactic protein-1 levels was less prominent in TREK-1-deficient mice than in controls. Lung tissue macrophage inflammatory protein-2, keratinocyte-derived cytokine, and interleukin-1β gene expression was not altered by hyperoxia in TREK-1-deficient mice compared with controls. Furthermore, we show for the first time TREK-1 expression on alveolar macrophages and unimpaired tumor necrosis factor-α secretion from TREK-1-deficient macrophages. TREK-1 deficiency resulted in increased sensitivity

  18. An outbreak of tuberculosis by Mycobacterium bovis in coatis (Nasua nasua).

    Science.gov (United States)

    Murakami, Patricia Sayuri; Monego, Fernanda; Ho, John L; Gibson, Andrea; Vilani, Ricardo Guilherme D'Otaviano de Castro; Soresini, Grazielle Cristina Garcia; Brockelt, Sonia Regina; Biesdorf, Sonia Maria; Fuverki, Renata Benicio Neves; Nakatani, Sueli Massumi; Riediger, Irina Nastassja; Grazziotin, Ana Laura; do Santos, Andrea Pires; de Barros Filho, Ivan Roque; Biondo, Alexander Welker

    2012-06-01

    Mycobacterium tuberculosis complex, which includes Mycobacterium bovis, infrequently causes severe or lethal disease in captive wildlife populations. A dead coati from a wildlife triage center showing pulmonary lesions compatible with tuberculosis had raised suspicion of a potential disease caused by mycobacteria species and was further investigated. Four native coatis (Nasua nasua) with suspected mycobacterial infection were sedated, and bronchoalveolar lavages and tuberculin skin tests (TSTs) were performed. All animals tested positive upon TST. Mycobacterial culturing, Ziehl-Neelsen staining, and genetic testing were performed on postmortem samples and the etiologic agent was identified as M. bovis. Molecular genetic identification using a polymerase chain reaction panel was crucial to achieving a definitive diagnosis.

  19. 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.

  20. Cox4i2, Ifit2, and Prdm11 Mutant Mice

    DEFF Research Database (Denmark)

    Horsch, Marion; Aguilar-Pimentel, Juan Antonio; Bönisch, Clemens

    2015-01-01

    We established a selection strategy to identify new models for an altered airway inflammatory response from a large compendium of mutant mouse lines that were systemically phenotyped in the German Mouse Clinic (GMC). As selection criteria we included published gene functional data, as well...... and repeated OVA airway challenge. Challenged Prdm11tm1.1ahl mice exhibited changes in B cell counts, CD4+ T cell counts, and in the number of neutrophils in bronchoalveolar lavages, whereas challenged Ifit2tm1.1Ebsb mice displayed alterations in plasma IgE, IgG1, IgG3, and IgM levels compared...

  1. [Bronchiolitis obliterans with organizing pneumonia in a patient treated with amiodarone].

    Science.gov (United States)

    Boras, Zagorka; Krizanac, Simun; Rakusić, Neven

    2003-01-01

    Bronchiolitis obliterans organizing pneumonia (BOOP) is a well-defined clinicopathological entity. The aetiology of BOOP is generally unknown, although it has been associated with specific diseases or various pharmaceutical drugs. The amiodarone is one of them. We report a patient with BOOP secondary to amiodarone therapy, who presented with cough, fever and sputum production, dyspnoea and night sweats lasting for two months. A chest radiograph showed bilateral patchy and interstitial infiltrates. Lymphocyte phenotyping of bronchoalveolar lavage fluid showed decreased ratio of CD4+:CD8+ lymphocytes. Transbronchial lung biopsy established the diagnosis of BOOP. After stopping amiodarone therapy, symptoms disappeared and the chest radiograph remained normal within two months.

  2. Effects of inhaled plasminogen activator on the balance between coagulation and fibrinolysis in traumatized pigs

    DEFF Research Database (Denmark)

    Münster, A-M B; Rasmussen, L; Sidelmann, Johannes Jakobsen

    2002-01-01

    A profibrinolytic state is normal in the alveoli, but this may change as a result of trauma, possibly leading to fibrin deposition, a characteristic of acute lung injury/acute respiratory distress syndrome. Therefore, the present study investigated in a double-blind, placebo-controlled manner...... the effect of severe trauma on the alveolar fibrinolytic/coagulation balance, and the effect here-upon of inhalation of single-chain urokinase plasminogen activator (scu-PA) in pigs. The study shows an increased concentration of scu-PA in the bronchoalveolar lavage fluid of the treated animals in association...

  3. Bronchopulmonary infection by Lophomonas blattarum in a pediatric patient after hematopoietic progenitor cell transplantation: first report in Mexico.

    Science.gov (United States)

    Saldaña, Napoleón González; Mendoza, Francisco Javier Otero; Larrauri, Francisco Rivas; Trujillo, Diego Mauricio Galvis; Montoya, Edna Venegas; De La Garza, Eduardo Arias; Olguín, Hugo Juárez

    2017-10-01

    Lophomonas blattarum is a multiflagellated protozoon which parasitizes the gut of termites and cockroaches. Although L. blattarum infection is rare, it can affect lung, maxillary sinuses and genitourinary tract. The presentation of bronchopulmonary lophomonas includes nonspecific symptoms such as fever, cough and dyspnea. Diagnosis is based on identification of living protozoan forms in fresh samples from respiratory secretions (bronchoalveolar lavage). We report the case of a 2-year-old male with a history of severe combined immunodeficiency (T-, B-, NK-), post-hematopoietic stem cell transplant and full immune reconstitution 12 months following a successful transplant who thereafter presented lophomonas.

  4. The effects of rhinovirus infections on allergic airway responses.

    Science.gov (United States)

    Gern, J E; Busse, W W

    1995-10-01

    Although it has long been recognized that the common cold is a potent trigger for symptoms of asthma, the mechanisms underlying the association between upper respiratory infection and increased lower airway obstruction remain obscure. The use of experimental infection of volunteers with or without respiratory allergies has enabled direct comparisons of common cold symptoms in these two groups. Furthermore, techniques such as bronchoalveolar lavage and segmental antigen challenge have been used to directly sample lower airway fluids and tissues during acute viral infection. This review summarizes the findings of studies examining the separate and combined effects of rhinovirus infection and allergen exposure on airway physiology and inflammation.

  5. Pulmonary Alveolar Proteinosis in Association with Congenital Dyserythropoietic Anemia: A Case Report

    Directory of Open Access Journals (Sweden)

    Marcus A. Carden

    2012-01-01

    Full Text Available A two-year-old girl with congenital dyserythropoietic anemia (CDA acutely developed fever, tachypnea, and increased oxygen requirement. Chest X-ray revealed bilateral interstitial infiltrates and mild cardiomegaly. Blood cultures grew no infectious agents, while pulmonary specimens grew cytomegalovirus (CMV. Treatment with intravenous ganciclovir was initiated but without response. Final cytologic preparations of bronchoalveolar lavage (BAL fluid revealed eosinophilic amorphous material consistent with pulmonary alveolar proteinosis (PAP. CDA and PAP are extremely rare disorders in pediatrics. PAP should be considered in patients with hematological disorders who present with acute interstitial pneumonia, after infectious causes are ruled out.

  6. Role of CC chemokines (macrophage inflammatory protein-1 beta, monocyte chemoattractant protein-1, RANTES) in acute lung injury in rats

    DEFF Research Database (Denmark)

    Bless, N M; Huber-Lang, M; Guo, R F

    2000-01-01

    . Treatment of rats with anti-MIP-1 beta Ab significantly decreased vascular permeability by 37% (p = 0.012), reduced neutrophil recruitment into lung by 65% (p = 0.047), and suppressed levels of TNF-alpha in bronchoalveolar lavage fluids by 61% (p = 0.008). Treatment of rats with anti-rat MCP-1 or anti......, exogenously MIP-1 beta, but not RANTES or MCP-1, caused enhancement of the lung vascular leak. These data indicate that MIP-1 beta, but not MCP-1 or RANTES, plays an important role in intrapulmonary recruitment of neutrophils and development of lung injury in the model employed. The findings suggest...

  7. Idiopathic pulmonary fibrosis in West Highland white terriers.

    Science.gov (United States)

    Heikkilä-Laurila, Henna P; Rajamäki, Minna M

    2014-01-01

    Canine idiopathic pulmonary fibrosis (CIPF) is a chronic, progressive, interstitial lung disease affecting mainly middle-aged and old West Highland white terriers. Other dogs, especially terriers, have been diagnosed with the disease. The cause is largely unknown, but it is likely to arise from interplay between genetic and environmental factors. CIPF shares several features with human idiopathic pulmonary fibrosis. This article summarizes the current literature; describes the findings in physical examination, arterial blood gas analysis, bronchoscopy, bronchoalveolar lavage, diagnostic imaging, and histopathology; compares the canine and human diseases; gives an overview of potential treatments; and discusses biomarker research. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. 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...... procedures, each on a VR bronchoscopy simulator. They performed 3 diagnostic bronchoscopies, 2 bronchoalveolar lavages, and 3 procedures in which they used all the available biopsy tools (needle, brush, and forceps) that could be used for tumors of increasing procedural difficulty. After the procedures...

  9. [A case of pulmonary alveolar proteinosis presenting with miniscule ground-glass opacity in the apex of the left lung].

    Science.gov (United States)

    Matsushima, Sayomi; Yokomura, Koushi; Matsui, Takashi; Suda, Takafumi; Chida, Kingo

    2011-07-01

    A 66-year-old man was found to have a very small ground-glass opacity in the apex of the left lung. Because the ground-glass opacity had slightly enlarged after 2 years, video-assisted thoracic surgery (VATS) biopsy was performed. The histological findings showed the alveolar spaces to be filled with PAS-positive granular materials, so pulmonary alveolar proteinosis was diagnosed. Although his bronchoalveolar lavage fluid (BALF) did not have a milky appearance, his serum and BALF GM-CSF autoantibody and serum KL-6 levels were elevated. Asymptomatic pulmonary alveolar proteinosis may appear as very small ground-grass opacities.

  10. 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...

  11. Reproduction and evaluation of a rat model of inhalation lung injury caused by black gunpowder smog

    OpenAIRE

    Yi-fan LIU; Hong-wei TANG; Xiao-li WU; Yin-jing XIE; Hong-rui ZHANG; Jin-yan DUAN; Dai-jun XIANG; Xiao-mei LAN; Mian-yang LI; Cheng-bin WANG; Deng-qing LI

    2013-01-01

    Objective To reproduce and evaluate a rat model of inhalation lung injury caused by black gunpowder smog. Methods The smog composition was analyzed and a rat model of inhalation lung injury was reproduced. Forty two healthy male Wistar rats were randomly divided into normal control (NC) group and 1h, 2h, 6h, 24h, 48h and 96h after inhalation group (n=6). The arterial blood gas, wet to dry weight ratio (W/D) of lung, leukocyte count, and protein concentration in broncho-alveolar lavage fluid (...

  12. Hypersensitivity pneumonitis caused by esparto dust in a young plaster worker: a case report and review of the literature.

    Science.gov (United States)

    Flandes, Javier; Heili, Sarah; Gómez Seco, Julio; Sabillón, Oscar; Fernández, Itziar; Ortega, Angel

    2004-01-01

    We report a case of a 25-year-old, white, male plaster worker who started developing fever, severe dyspnea and cough during the manipulation of esparto fibers. The functional lung study showed restrictive lung disease and decreased single-breath carbon monoxide transfer lung capacity. High-resolution computed tomography revealed a diffuse 'ground-glass' pattern. The histopathological findings were interstitial inflammation with a marked predominance of lymphocytes and microgranulomas. Bronchoalveolar lavage showed a significant predominance of lymphocytes, with an increase in the level of CD8. Serum precipitins against fungal antigens confirmed that Aspergillus fumigatus was the cause of the patient's hypersensitivity pneumonitis. Copyright 2004 S. Karger AG, Basel

  13. 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

    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.

  14. [Enzymes of azurophilic neutrophil granules and matrix metalloproteinase-2 as markers of the developmental stages of experimental respiratory distress syndrome].

    Science.gov (United States)

    Prutkina, E V; Sepp, A V; Tsybikov, N N

    2014-01-01

    Acute Respiratory Distress Syndrome was reproduced in the non-linear male rats by the original method. The animals were injected lysate 45-55 thousand rat neutrophils in 0.2 mi 0.9% sodium chloride solution by puncture of the trachea (method patented RF). At each stage of syndrome development concentration of neutrophil elastase, myeloperoxidase and matrix metalloproteinase-2 in serum and bronchoalveolar lavage fluid was determined by ELISA. The increase of the concentration of neutrophil elastase and myeloperoxidase in plasma and lavage fluid has been shown to be a marker of exudative stage. Proliferative phase is marked by high levels of matrix metalloproteinase-2 at a constant content of elastase and myeloperoxidase in both liquids. Reduction of matrix metalloproteinase-2 concentration in both biological fluids is accompanied by the development of fibrotic phase distress syndrome.

  15. Dehydroepiandrosterone inhibits the spontaneous release of superoxide radical by alveolar macrophages in vitro in asbestosis

    Energy Technology Data Exchange (ETDEWEB)

    Rom, W.N.; Harkin, T. (New York Univ. Medical Center, New York (United States))

    1991-08-01

    Asbestosis is characterized by an alveolar macrophage alveolitis with injury and fibrosis of the lower respiratory tract. Alveolar macrophages recovered by bronchoalveolar lavage spontaneously release exaggerated amounts of oxidants including superoxide anion and hydrogen peroxide that may mediate alveolar epithelial cell injury. Dehydroepiandrosterone (DHEA) is a normally occurring adrenal androgen that inhibits glucose-6-phosphate dehydrogenase, the initial enzyme in the pentose phosphate shunt necessary for NADPH generation and superoxide anion formation. In this regard, the authors hypothesized that DHEA may reduce asbestos-induced oxidant release. DHEA added in vitro to alveolar macrophages lavaged from 11 nonsmoking asbestos workers significantly reduced superoxide anion release. DHEA is an antioxidant and potential anticarcinogenic agent that may have a therapeutic role in reducing the increased oxidant burden in asbestos-induced alveolitis of the lower respiratory tract.

  16. Natural-source d-α-tocopheryl acetate inhibits oxidant stress and modulates atopic asthma in humans in vivo.

    Science.gov (United States)

    Hoskins, Aimee; Roberts, Jackson L; Milne, Ginger; Choi, Leena; Dworski, Ryszard

    2012-05-01

    Asthma is associated with oxidant stress and diminished antioxidant defenses. Yet, the mechanistic role of oxidant stress and antioxidant supplementation in human asthmatics remains uncertain. We determined the effect of high doses of the antioxidant natural-source d-α-tocopheryl acetate for 16 weeks on allergen-induced airway oxidant stress, inflammation, and bronchial responsiveness to methacholine and allergen in atopic asthmatics in vivo. Thirty-three mild atopic asthmatics underwent bronchoscopy with baseline bronchoalveolar lavage and segmental allergen challenge. The allergen-challenged airway was lavaged 24 h later. At least 3 weeks later, patients underwent inhaled challenges with methacholine and specific allergen. Volunteers took 1500 IU of natural-source d-α-tocopheryl acetate daily for at least 16 weeks. At the end of the treatment, the two bronchoscopies and inhaled methacholine and allergen challenges were repeated. F(2)-isoprostanes, specific markers of oxidant stress, and selected Th1 and Th2 cytokines were analyzed in the lavage fluid. Following supplementation of natural-source d-α-tocopheryl acetate, plasma concentrations of α-tocopherol increased and γ-tocopherol decreased. Both baseline and allergen-induced F(2)-isoprostanes significantly decreased, providing biochemical evidence for an antioxidant effect. Natural-source d-α-tocopheryl acetate reduced allergen-provoked concentrations of interleukin 3 and interleukin 4 and augmented levels of interleukin 12 in bronchoalveolar lavage fluid. Natural-source d-α-tocopheryl acetate improved airway responsiveness to methacholine but did not alter airway reactivity to specific allergen. Inhibition of oxidant stress by natural-source d-α-tocopheryl acetate modulates allergic inflammation and airway hyperresponsiveness in human atopic asthmatics in vivo. These results need to be confirmed by a randomized placebo-controlled trial. © 2012 John Wiley & Sons A/S.

  17. Marked improvement in autoimmune pulmonary alveolar proteinosis with severe hypoxemia in a patient treated with ambroxol: a case report.

    Science.gov (United States)

    Oda, Nao; Tamai, Koji; Suzuki, Yujiro; Yoshimatsu, Harukazu; Matsuoka, Hirofumi; Matsumoto, Yusuke; Okada, Nobuhiko

    2015-05-06

    Pulmonary alveolar proteinosis is characterized by accumulation of surfactant and phospholipids in the pulmonary alveoli. Whole lung lavage is considered the first-line therapy, which requires special techniques. To the best of our knowledge, there have only been limited reports that have demonstrated the effectiveness of ambroxol on a mild case of pulmonary alveolar proteinosis. A 72-year-old Japanese woman presented to our hospital with a one-year history of productive cough and progressive dyspnea. Her chest computed tomography scan showed a bilateral crazy-paving pattern in both of her lungs. She was diagnosed with autoimmune pulmonary alveolar proteinosis based on bronchoalveolar lavage findings and the presence of serum anti-granulocyte macrophage colony-stimulating factor antibodies. She was severely hypoxemic, so we recommended whole lung lavage or inhaled granulocyte macrophage colony-stimulating factor treatment, which she refused. We initiated treatment with ambroxol and her symptoms markedly improved. Although whole lung lavage is the first-line therapy for pulmonary alveolar proteinosis, oral ambroxol could be an alternative treatment option, even in patients with severe respiratory compromise.

  18. Use of bronchofiberscopy in management of severe tho-racic trauma

    Directory of Open Access Journals (Sweden)

    LIU Chao-pu

    2013-08-01

    Full Text Available 【Abstract】Objective: To investigate the diagnos-tic and therapeutic effect of bronchofiberscopy in the manage-ment of severe thoracic trauma. Methods: A retrospective study was conducted on 207 consecutive patients with severe thoracic trauma enrolled in our hospital between January 2008 and June 2012. During the period, 488 bronchofiberscopies and lavages were done. The bronchofiberscope was inserted through tracheal inci-sion (282, nasal cavity (149 and oral cavity (57. Intensive SaO 2 monitoring as well as blood gas analysis were per-formed pre-, intra- and postoperatively. Simultaneously oxy-gen therapy or ventilatory support was given. Sputum cul-ture was done intraoperatively. Results: Diagnosis in 207 cases was confirmed by bronchofiberscopy. The result of sputum culture was posi-tive in 78 cases. Lavage was performed on 156 cases. SaO 2 significantly increased after bronchofiberscopies as well as lavages and PaO 2 obviously improved 2 h after surgery (both P<0.05. Heart rate and respiratory rate decreased. There was no bronchofiberscopy-related death. Conclusion: Bronchofiberscopy plays an important role in the diagnosis and treatment of severe thoracic trauma, which can not only timely diagnose bronchial injury and collect deep tracheal sputum for bacterial culture but also effectively remove foreign body, secretion, blood and spu-tum crust in the airway, manage obstructive atelectasis and pneumonia, and significantly improve respiratory function and treatment outcome. Key words: Thoracic injuries; Bronchoscopy; Bronchoalveolar lavage; Therapeutics

  19. Inhibition of acid-induced lung injury by hyperosmolar sucrose in rats.

    Science.gov (United States)

    Safdar, Zeenat; Yiming, Maimiti; Grunig, Gabriele; Bhattacharya, Jahar

    2005-10-15

    Acid aspiration causes acute lung injury (ALI). Recently, we showed that a brief intravascular infusion of hyperosmolar sucrose, given concurrently with airway acid instillation, effectively blocks the ensuing ALI. The objective of the present study was to determine the extent to which intravascular infusion of hyperosmolar sucrose might protect against acid-induced ALI when given either before or after acid instillation. Our studies were conducted in anesthetized rats and in isolated, blood-perfused rat lungs. We instilled HCl through the airway, and we quantified lung injury in terms of the extravascular lung water (EVLW) content, filtration coefficient (Kfc), and cell counts and protein concentration in the bronchoalveolar lavage. We infused hyperosmolar sucrose via the femoral vein. In anesthetized rats, airway HCl instillation induced ALI as indicated by a 52% increase of EVLW and a threefold increase in Kfc. However, a 15-min intravenous infusion of hyperosmolar sucrose given up to 1 h before or 30 min after acid instillation markedly blunted the increases in EVLW, as well as the increases in cell count, and in protein concentration in the bronchoalveolar lavage. Hyperosmolar pretreatment also blocked the acid-induced increase of Kfc. Studies in isolated perfused lungs indicated that the protective effect of hyperosmolar sucrose was leukocyte independent. We conclude that a brief period of vascular hyperosmolarity protects against acid-induced ALI when the infusion is administered shortly before, or shortly after, acid instillation in the airway. The potential applicability of hyperosmolar sucrose in therapy for ALI requires consideration.

  20. Thin-section computed tomography findings before and after azithromycin treatment of neutrophilic reversible lung allograft dysfunction

    Energy Technology Data Exchange (ETDEWEB)

    Jong, Pim A. de [Department of Radiology, Katholieke Universiteit Leuven, Leuven (Belgium); Lung Transplantation Unit, Katholieke Universiteit Leuven, Leuven (Belgium); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vos, Robin; Verleden, Geert M.; Vanaudenaerde, Bart M. [Lung Transplantation Unit, Katholieke Universiteit Leuven, Leuven (Belgium); Verschakelen, Johny A. [Department of Radiology, Katholieke Universiteit Leuven, Leuven (Belgium)

    2011-12-15

    Recently a novel subgroup of bronchiolitis obliterans syndrome (BOS) has been described in patients after lung transplantation with high neutrophil counts in broncho-alveolar lavage and recovery of lung functional decline with azithromycin treatment. We aimed to describe the thin-section computed tomography (CT) findings of these neutrophilic reversible allograft dysfunction (NRAD) patients before and after azithromycin. A cohort of 100 lung transplant recipients with BOS were treated with azithromycin and underwent lung function testing, broncho-alveolar lavage and CT before azithromycin treatment and during follow-up. The 200 CT data sets were scored for bronchial dilatation, mucus plugging, centrilobular abnormalities, airway wall thickening, consolidation, ground glass and end-expiratory air trapping. NRAD was characterized by more centrilobular abnormalities on CT (p = 0.03 for prevalence and p = 0.06 for severity) compared to non-responders. At follow-up NRAD patients showed improvement in all CT abnormalities including air trapping, but the degree of improvement in all CT abnormalities was significantly different between responders and non-responders (who showed progression of bronchus dilatation, consolidation and air trapping). Within BOS patients those with NRAD differ from azithromycin non-responders by more centrilobular abnormalities on CT before azithromycin and improvement in bronchus dilatation, consolidation and air trapping during treatment. (orig.)

  1. 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.

  2. Metabolomic biomarkers predictive of early structural lung disease in cystic fibrosis.

    Science.gov (United States)

    Esther, Charles R; Turkovic, Lidija; Rosenow, Tim; Muhlebach, Marianne S; Boucher, Richard C; Ranganathan, Sarath; Stick, Stephen M

    2016-12-01

    Neutrophilic airway inflammation plays a role in early structural lung disease in cystic fibrosis, but the mechanisms underlying this pathway are incompletely understood.Metabolites associated with neutrophilic inflammation were identified by discovery metabolomics on bronchoalveolar lavage fluid supernatant from 20 preschool children (2.9±1.3 years) with cystic fibrosis. Targeted mass-spectrometric detection of relevant metabolites was then applied to 34 children (3.5±1.5 years) enrolled in the Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST CF) who underwent chest computed tomography and bronchoalveolar lavage from two separate lobes during 42 visits. Relationships between metabolites and localised structural lung disease were assessed using multivariate analyses.Discovery metabolomics identified 93 metabolites associated with neutrophilic inflammation, including pathways involved in metabolism of adenyl purines, amino acids and small peptides, cellular energy and lipids. In targeted mass spectrometry, products of adenosine metabolism, protein catabolism and oxidative stress were associated with structural lung disease and predicted future bronchiectasis, and activities of enzymes associated with adenosine metabolism were elevated in the samples with early disease.Metabolomics analyses revealed metabolites and pathways altered with neutrophilic inflammation and destructive lung disease. These pathways can serve as biomarkers and potential therapeutic targets for early cystic fibrosis lung disease. Copyright ©ERS 2016.

  3. A Detailed Characterization of the Dysfunctional Immunity and Abnormal Myelopoiesis Induced by Severe Shock and Trauma in the Aged

    Science.gov (United States)

    Nacionales, Dina C.; Szpila, Benjamin; Ungaro, Ricardo; Lopez, M. Cecilia; Zhang, Jianyi; Gentile, Lori F.; Cuenca, Angela L.; Vanzant, Erin; Mathias, Brittany; Jyot, Jeevan; Westerveld, Donevan; Bihorac, Azra; Joseph, Anna; Mohr, Alicia; Duckworth, Lizette V.; Moore, Frederick A.; Baker, Henry V.; Leeuwenburgh, Christiaan; Moldawer, Lyle L.; Brakenridge, Scott; Efron, Philip A.

    2015-01-01

    The elderly are particularly susceptible to trauma, and their outcomes are frequently dismal. Such patients often have complicated clinical courses and ultimately die from infection and sepsis. Recent research has revealed that although elderly subjects have increased baseline inflammation as compared to their younger counterparts, the elderly do not respond to severe infection/injury with an exaggerated inflammatory response. Initial retrospective analysis of clinical data from the Glue Grant trauma database demonstrated that despite a similar frequency, elderly trauma patients have worse outcomes to pneumonia than younger subjects. Subsequent analysis with a murine trauma model also demonstrated that elderly mice had increased mortality after post-trauma Pseudomonas pneumonia. Blood, bone marrow, and bronchoalveolar lavage sample analyses from juvenile and 20–24 month old mice showed that increased mortality to trauma combined with secondary infection in the aged are not due to an exaggerated inflammatory response. Rather, they are due to a failure of bone marrow progenitors, blood neutrophils, and bronchoalveolar lavage cells to initiate and complete an ‘emergency myelopoietic’ response, engendering myeloid cells that fail to clear secondary infection. In addition, the elderly appeared unable to effectively resolve their inflammatory response to severe injury. PMID:26246141

  4. [A case of chronic hypersensitivity pneumonitis induced by shiitake mushroom spores].

    Science.gov (United States)

    Fujiwara, K; Sato, T; Yonei, T; Genba, K; Nogami, N; Yamadori, I

    2000-12-01

    A 73-year-old woman was admitted to our hospital with a low-grade fever, dry cough and dyspnea on exertion as the chief complaints. She had been a professional shiitake mushroom grower for 50 years. Three years before visiting our hospital, she had been suspected of having hypersensitivity pneumonitis as a result of chest X-ray examination, bronchoalveolar lavage and transbronchial lung biopsy performed at another clinic. No antigens were identified at that time, but prednisolone was administered. On admission to our hospital, chest radiography and chest computed tomography revealed an interstitial shadow with subpleural honey-combing in both lower lung fields. After steroid pulse therapy, dyspnea on exertion and hypoxia improved moderately. Because of recurrence of the dyspnea, however, she was admitted on four separate occasions. On the second admission, an increase in lymphocytes was found by bronchoalveolar lavage, and septal lymphocytic infiltration accompanying fibrosis was demonstrated by transbronchial lung biopsy. On the fourth admission, a detailed immunological examination and an environmental survey were performed. The environmental provocation test yielded clinical symptoms similar to those experienced at the mushroom farm. Furthermore, tests of precipitation and lymphocyte proliferation in response to shiitake mushroom extracts were positive. Finally a diagnosis of chronic hypersensitivity pneumonitis induced by shiitake mushrooms was confirmed.

  5. 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.

  6. [Herpes simplex virus bronchopneumonitis in patient with acute respiratory failure after surgery].

    Science.gov (United States)

    García-Montesinos-De la Peña, M; Oteiza-López, L; Aldunate-Calvo, S; Gómez-Sánchez, M J; Sáenz-Bañuelos, J J; Tihista-Jiménez, J A

    2010-03-01

    Herpes simplex virus bronchopneumonitis is a clinical entity described in critically ill patients and classically associated to immunosuppression. Recent reports have shown a higher frequency of virus detection from samples obtained by bronchoalveolar lavage of immunocompetent critically ill patients undergoing mechanical ventilation. This fact suggests its role as an independent pathogenic substrate. We report the case of a female patient who was admitted after an elective surgery of rectal tumor with suspected bronchoaspiration during anesthetic induction. The patient presented persistent fever despite broad spectrum antibiotic treatment. All cultures were negative for bacterial growth. The chest X-ray did not show opacifities. Prolonged mechanical ventilation with repeated failures to wean made it mandatory to perform percutaneous tracheostomy. A fibrobronchoscopy with bronchoalveolar lavage, performed previously, showed positive result for herpes simplex virus (PCR and specific nuclear inclusions in cells). Thus, treatment was initiated with acyclovir, with clinical improvement and weaning from mechanical ventilation. Copyright 2009 Elsevier España, S.L. y SEMICYUC. All rights reserved.

  7. [Pneumocystis pneumonia biological diagnosis at Fann Teaching Hospital in Dakar, Senegal].

    Science.gov (United States)

    Dieng, Y; Dieng, T; Sow, D; Wlouhou, S; Sylla, K; Tine, R; Ndiaye, M; Ndiaye, J L; Faye, B; Faye, O; Gaye, O

    2016-03-01

    Data relative to Pneumocystis pneumonia in sub-Saharan Africa are not well known. Weakness of the technical material and use of little sensitive biological tools of diagnosis are among the evoked reasons. The objective of this study is to update the data of the disease at the Fann Teaching Hospital in Dakar and to estimate biological methods used in diagnosis. A descriptive longitudinal study was carried out from January 5th, 2009 to October 31st, 2011 in the parasitology and mycology laboratory of the Fann Teaching Hospital in Dakar. The bronchoalveolar lavages received in the laboratory were examined microscopically for Pneumocystis jirovecii by indirect fluorescent assay or after Giemsa or toluidine blue O staining. One hundred and eighty-three bronchoalveolar lavages withdrawn from 183 patients were received in the laboratory. Sixteen were positive for P. jirovecii at 9% frequency. Four among these patients were HIV positive. Indirect fluorescent assay allowed finding of P. jirovecii among 16 patients while Giemsa staining discovered P. jirovecii only in a single patient. No case was diagnosed by toluidine blue O staining. Pneumocystis pneumonia in Parasitology and Mycology Laboratory of Fann Teaching Hospital at Dakar was mainly diagnosed among HIV patients. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  8. [A well-inked pneumonia… can you decrypt it?

    Science.gov (United States)

    Tetart, M; Trosini-Désert, V; Fekkar, A; Chenivesse, C

    2017-01-01

    We report a case of pneumonia associated with necrotic mediastinal lymph nodes in an immunocompetent patient. The case report illustrates the difficulties in making a diagnosis in necrotic mediastinal lymph nodes and discusses strategies to optimize sampling. A 21-year-old immunocompetent woman was admitted to hospital with dyspnea and fever occurring ten days after delivery. Physical examination, biological results and chest X-ray led to the diagnosis of right upper lobe pneumonia. Treatment with three broad-spectrum antibiotics was ineffective. Thoracic CT-scan showed compressive mediastinal and hilar necrotic adenopathies and consolidation of the right upper lobe. Bronchoscopy with bronchoalveolar lavage and transbronchial needle aspiration was non-diagnostic. A second bronchoscopy with bronchoalveolar lavage and transbronchial needle aspiration performed in close collaboration with the mycology laboratory led to the diagnosis of cryptococcosis. Antifungal therapy with fluconazole resulted in a complete resolution of clinical and radiological signs. Although it is extremely rare, pulmonary cryptococcosis should be considered in immunocompetent patients presenting with necrotic pneumonia. Effectiveness of lymph node sampling can be improved by collaboration between clinicians and microbiologists. Copyright © 2016 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  9. Protective effect of ambroxol on pulmonary function after cardiopulmonary bypass.

    Science.gov (United States)

    Ulas, Mahmut Mustafa; Hizarci, Mustafa; Kunt, Aysegul; Ergun, Kumral; Kocabeyoglu, Sabit Sinan; Korkmaz, Kemal; Lafci, Gokhan; Gedik, Selcuk; Cagli, Kerim

    2008-12-01

    To evaluate whether ambroxol administered orally during the perioperative period has a protective effect against postoperative pulmonary dysfunction in on-pump coronary artery bypass surgery. Fifty younger patients without known pulmonary disease were randomly assigned into 2 groups. In ambroxol group (n = 25), patients were given ambroxol for a week before and after the elective coronary artery bypass grafting. In control group (n = 25), placebo was given. Groups were compared with respect to pulmonary function tests (PFTs), lecithin/sphingomyelin (L/S) ratio in the bronchoalveolar lavage fluid, arterial blood gases, and incidence of perioperative morbidity. PFTs were performed before medication and repeated on the postoperative seventh day. Bronchoalveolar lavage fluid was obtained just before cardiopulmonary bypass and within the first postoperative hour. Room air arterial blood gases were checked before and 2 days after the operation. Postoperative lecithin/sphingomyelins were significantly lower than the preoperative values in both groups, but differences between the groups in either preoperative or postoperative measurements were not significant. Although preoperative PaO2 in both groups was similar, it was significantly lower in control group on postoperative second day (62.4 +/- 7.1 vs. 55.2 +/- 6.4 mm Hg, P ambroxol improves postoperative PFTs and PaO2 levels without any significant clinical implication, and it exerts these effects possibly in ways other than surfactant modulation.

  10. Toxoplasmosis complicating lung cancer: a case report

    Directory of Open Access Journals (Sweden)

    Lu NH

    2015-01-01

    Full Text Available Nianhong Lu, Caihong Liu, Jiangyuan Wang, Ying Ding, Qing Ai Department of Clinical Laboratory, The First Hospital of Jilin University, Changchun, People’s Republic of China Abstract: Toxoplasmosis complicating lung cancer has been described only rarely. Here, we report a case of acute Toxoplasma gondii infection in a patient with squamous lung cancer. A 64-year-old woman was admitted to our hospital with a history of cough of 6 months' duration and chest pain of 1 week’s duration. Further examination revealed multiple swollen lymph nodes, palpable on the top of the right collarbone and without tenderness. The chest X-ray, bronchoscopy, and computed tomography scan confirmed squamous carcinoma of the right lung. The Wright-stained bronchoalveolar-lavage fluid cytology diagnosis was positive for T. gondii and tachyzoites were detected. All of them were of free type (ectocytic, without intracellular parasites. Serological examination revealed that the anti-T. gondii immunoglobulin (Ig M and IgG antibodies were positive. Unfortunately the patient did not continue treatment and was lost to follow-up. Toxoplasmosis is a life-threatening opportunistic infection in patients with lung cancer. Prompt recognition of T. gondii infection among cancer patients with subsequent targeted treatment of toxoplasmosis could help alleviate symptoms and improve survival. Keywords: lung cancer, Toxoplasma gondii, bronchoalveolar-lavage fluid, tachyzoite

  11. 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. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  12. 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

    2002-11-01

    Chronic beryllium disease (CBD) is caused by exposure to beryllium in the workplace, and it remains an important public health concern. Evidence suggests that CD4(+) T cells play a critical role in the development of this disease. Using intracellular cytokine staining, we found that the frequency of beryllium-specific CD4(+) T cells in the lungs (bronchoalveolar lavage) of 12 CBD patients ranged from 1.4% to 29% (mean 17.8%), and these T cells expressed a Th1-type phenotype in response to beryllium sulfate (BeSO(4)). Few, if any, beryllium-specific CD8(+) T cells were identified. In contrast, the frequency of beryllium-responsive CD4(+) T cells in the blood of these subjects ranged from undetectable to 1 in 500. No correlation was observed between the frequency of beryllium-responsive bronchoalveolar lavage (BAL) CD4(+) T cells as detected by intracellular staining and lymphocyte proliferation in culture after BeSO(4) exposure. Staining for surface marker expression showed that nearly all BAL T cells exhibit an effector memory cell phenotype. These results demonstrate a dramatically high frequency and compartmentalization of antigen-specific effector memory CD4(+) cells in the lungs of CBD patients. These studies provide insight into the phenotypic and functional characteristics of antigen-specific T cells invading other inaccessible target organs in human disease.

  13. Role of serine proteases in the regulation of interleukin-877 during the development of bronchopulmonary dysplasia in preterm ventilated infants.

    Science.gov (United States)

    Chakraborty, Mallinath; McGreal, Eamon P; Williams, Andrew; Davies, Philip L; Powell, Wendy; Abdulla, Salima; Voitenok, Nikolai N; Hogwood, John; Gray, Elaine; Spiller, Brad; Chambers, Rachel C; Kotecha, Sailesh

    2014-01-01

    The chemokine interleukin-8 is implicated in the development of bronchopulmonary dysplasia in preterm infants. The 77-amino acid isoform of interleukin-8 (interleukin-877) is a less potent chemoattractant than other shorter isoforms. Although interleukin-877 is abundant in the preterm circulation, its regulation in the preterm lung is unknown. To study expression and processing of pulmonary interleukin-877 in preterm infants who did and did not develop bronchopulmonary dysplasia. Total interleukin-8 and interleukin-877 were measured in bronchoalveolar lavage fluid from preterm infants by immunoassay. Neutrophil serine proteases were used to assess processing. Neutrophil chemotaxis assays and degranulation of neutrophil matrix metalloproteinase-9 were used to assess interleukin-8 function. Peak total interleukin-8 and interleukin-877 concentrations were increased in infants who developed bronchopulmonary dysplasia compared to those who did not. Shorter forms of interleukin-8 predominated in the preterm lung (96.3% No-bronchopulmonary dysplasia vs 97.1% bronchopulmonary dysplasia, p>0.05). Preterm bronchoalveolar lavage fluid significantly converted exogenously added interleukin-877 to shorter isoforms (pbronchopulmonary dysplasia infants (pbronchopulmonary dysplasia, due to conversion of interleukin-877 by neutrophil serine proteases and thrombin. Processing of interleukin-8 provides an attractive therapeutic target to prevent development of bronchopulmonary dysplasia.

  14. [Neonatal bronchoscopy: a retrospective analysis of 67 cases and a review of their indications].

    Science.gov (United States)

    Oliveira-Santos, J A; Pereira-da-Silva, L; Clington, A; Serelha, M

    2004-01-01

    The availability of newer, more sophisticated and versatile bronchoscopes has expanded the spectrum and scope of the indications for bronchoscopy in the newborn infant both for diagnostic and therapeutic purposes. The aim of this study was to carry out a retrospective analysis of the bronchoscopies performed on newborn infants, and to review the indications of this procedure in this age group. Sixty-three patients were submitted to 67 bronchoscopies in a period of 13 years, allowing the diagnosis of 45 anomalies and malformations of the tracheo-bronchial tree, and the performance of 24 bronchoalveolar lavages. In six cases, endoscopic removal of secretions helped to resolve resistant atelectasia, while in another case, with esophageal atresia, intra-operative definition of the fistula tract was possible through catheterisation of the fistula with the bronchoscope. The flexible bronchoscope was preferred for diagnosis by direct visualisation, and the rigid bronchoscope for some diagnostic and therapeutic procedures. Stridor, unexplained cyanosis, hemoptysis, persistent or recurrent pulmonary images, difficulties in the intubation or extubation, and persistent disturbances in ventilation are among the main indications for bronchoscopy in the newborn infant. Bronchoscopy also allows the performance of subsidiary techniques, such as bronchoalveolar lavage, biopsy and laser therapy.

  15. Age and sex dimorphisms contribute to the severity of bleomycin-induced lung injury and fibrosis

    Science.gov (United States)

    Redente, Elizabeth F.; Jacobsen, Kristen M.; Solomon, Joshua J.; Lara, Abigail R.; Faubel, Sarah; Keith, Rebecca C.; Henson, Peter M.; Downey, Gregory P.

    2011-01-01

    Fibrotic interstitial pneumonias are more prevalent in males of advancing age, although little is