Biomedical subjects

J Linder

Publications and source records attributed to J Linder.

167 records · Page 10Linked to original sources

PubMedDate not supplied

Bronchoalveolar lavage fluid processing. Effect of membrane filtration preparation on neutrophil recovery.

Two common methods for the preparation of bronchoalveolar lavage (BAL) fluid for cytologic examination, cytocentrifugation and membrane filtration, have been found to yield different results in the quantitation of lymphocytes. To compare these two methods for the quantitation of neutrophils, the differential counts from 640 consecutive clinical specimens were analyzed retrospectively. The percentage of neutrophils resulting from the preparation of the BAL fluids by the two methods were highly correlated (r2 = .72). However, cytocentrifugation yielded consistently higher neutrophil percentages than did membrane filtration (means for all samples: 18.5 +/- 1.0% vs. 14.7 +/- 0.9%; P less than .001). To investigate the source of the variation in neutrophil quantitation by the two methods, two series of mixing experiments were performed in which neutrophil-rich cell suspensions were added to BAL fluids. Determination of the cellular differentials before and after mixing the cell suspensions demonstrated that membrane filtration preparation tends to lose neutrophils while cytocentrifugation accurately recovers neutrophils. Thus, accurate quantitation of the two cells recovered by BAL may require use of both cytocentrifugation and membrane filtration.

Adult↗

PubMedDate not supplied

Infection as a complication of heart transplantation.

Infection and cardiac rejection are the most significant causes of morbidity and mortality after heart transplantation. At some transplant centers, more than half of the early transplantation-related deaths are the result of infection. The infectious agents may be transmitted to the host by means of the allograft, through blood transfusion, by nosocomial or environmental routes, or they may represent endogenous microbial flora or reactivation of a prior infection. The frequency of infectious complications is generally related to the degree of immunosuppressive therapy required to prevent graft rejection. Both the composition of the immunosuppressive regimen and the dosage of the immunosuppressive drugs affect the infection rate. Recent protocols, employing a combination of cyclosporine, steroids, and azathioprine cause less toxicity and lower infection rates than protocols that rely solely on cyclosporine and steroids or protocols utilized in the 1970s, which did not contain cyclosporine. A literature review of data reported from 12 transplant centers, encompassing 384 patients who received their transplantation in the era of cyclosporine, revealed infections in 221 patients (57.6%), with 20 infection-related deaths (5.2%). All classes of microorganisms infected the heart transplant recipients. The most frequent agents included staphylococci, gram-negative enteric, Nocardia (bacterial); Aspergillus, Candida, Cryptococcus (fungal); cytomegalovirus, herpes simplex, herpes zoster (viral); and Pneumocystis carinii, Toxoplasma gondii (protozoal). The respiratory tract, urinary tract, and skin were the most common sites of infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Heart Transplantation↗

PubMedDate not supplied

Bronchoalveolar lavage in the cytologic diagnosis of carcinoma of the lung.

To assess the utility of bronchoalveolar lavage as a technique for diagnosing lung cancer, 850 lavages from 421 patients were reviewed. Biopsy-proven lung carcinoma was present in 35 cases. Of these, 24 (68.6%) had cells diagnostic of malignancy on cytologic preparations of the bronchoalveolar lavage fluid. Agreement between cancer subtypes determined by lavage and by tissue biopsy was 79.1%; variation usually occurred between large cell undifferentiated carcinoma and adenocarcinoma, not with small cell anaplastic carcinoma. The subtype of tumors was most accurately determined by examination of Papanicolaou-stained slides. Reactive bronchial epithelium often mimicked carcinoma, but could be correctly identified by its characteristic cytomorphology. No false-positive diagnoses of lung cancer occurred in 386 patients. The sensitivity of bronchoalveolar lavage for the diagnosis of lung carcinoma is similar to that of transbronchial biopsy and Wang needle biopsy. Because bronchoalveolar lavage may detect opportunistic infections, interstitial lung diseases and malignant cells with a low morbidity, it is a useful tool to assess patients with pulmonary infiltrates.

Bronchi↗

PubMedDate not supplied

Cytomorphology of Alternaria in bronchoalveolar lavage specimens.

Review of the bronchoalveolar lavage specimens from 326 patients resulted in the identification of Alternaria in 28 (8.6%) of the specimens. On Papanicolaou-stained Millipore filters, the most common finding was a yellow-brown-pigmented muriform conidium with characteristic transverse and longitudinal septations. Four of the patients had floccose branched and septated hyphae of Alternaria in addition to conidia. Budding yeast or yeast forms were also present in the lavage fluid of 14 of the patients with Alternaria. Two patients had concurrent Pneumocystis carinii pneumonia, and one patient had cytomegalovirus pneumonitis. No patient developed clinical features of systemic Alternaria infection, and autopsy of four patients did not reveal pneumonia. Alternaria conidia in a bronchoalveolar lavage fluid will usually represent laboratory contaminants or nonpathogenic saprophytes, and their significance lies in distinguishing them from other fungi. However, the expanded use of immunosuppressive therapy and the increasing prevalence of acquired immune deficiency syndrome may render such saprophytes clinically important.

Alternaria↗

PubMedDate not supplied

Cytomorphology of primary small-cell (Merkel-cell) carcinoma of the skin in fine needle aspirates.

The histologic appearance of primary small-cell carcinoma of the skin (the so-called Merkel-cell tumor) is similar to other small-cell tumors that may metastasize to the dermis. Significance has been placed on the electron microscopic appearance of this tumor since the ultrastructural features of this neoplasm are helpful in distinguishing it from most of the other neoplasms considered in the differential diagnosis. To determine whether any additional morphologic criteria might exist to distinguish this neoplasm, the fine needle aspirate appearance of a primary small-cell carcinoma of the skin was studied and compared to that of similar preparations of other small-cell tumors that could potentially involve the dermis. Cells of this unusual tumor were round and showed neither cohesiveness nor nuclear molding. Mitoses were numerous. The chromatin pattern was bland. The cytologic features of this tumor can aid in the distinction of primary small-cell carcinoma of the skin from other metastatic small-cell neoplastic lesions in the dermis of adults.

Aged↗