Search PubMed⌕ Search

Biomedical subjects

U Costabel

Publications and source records attributed to U Costabel.

At least 19 recordsLinked to original sources
PubMed2003

[How are interstitial lung diseases diagnosed in Germany? Results of the scientific registry for the exploration of interstitial lung diseases ("Fibrosis registry") of the WATL].

From 1995 to 1999 we evaluated questionnaires sent by pulmonologists and departments of pulmonology in order to register interstitial lung diseases. On the whole 1142 patients (579 males, 563 females, mean age 51.1 +/- 15.3 years, sarcoidosis, n = 511, extrinsic allergic alveolitis, n = 145, idiopathic pulmonary fibrosis, n = 308, bronchiolitis obliterans organizing pneumonia (BOOP), n = 93, others, n = 85) were recorded in the registry. With reference to the mean age sarcoidosis occurred most frequently in the fourth decade and idiopathic pulmonary fibrosis in the sixth decade. In all these diseases bronchoscopy with bronchoalveolar lavage and transbronchial biopsy was predominantly used for further diagnosis. It was striking that high-resolution computed tomography of the thorax was still rarely used when diagnosing these diseases. Apart from the group with BOOP the number of non-smokers in men and women was decisively higher than the average of the population of Germany.

Biopsy↗
PubMed2003

Bronchoalveolar lavage fluid findings in children with hypersensitivity pneumonitis.

Bronchoalveolar lavage (BAL) has been shown to be useful in the diagnosis of hypersensitivity pneumonitis (HP) in adults, the typical constellation being lymphocytosis with a decrease in the CD4/CD8 ratio. Only limited data exist for the diagnostic value of BAL cytology in paediatric patients with this disorder. Children aged 6-15 yrs (n=9) with acute HP were studied. BAL was performed before initiation of anti-inflammatory treatment via a flexible bronchoscope in the middle lobe with 3 mL x kg body weight(-1) normal saline warmed to body temperature; BAL cytology and lymphocyte surface markers were compared with age-matched controls. The percentage of lymphocytes was significantly increased in all patients with HP. No significant differences were observed in the CD4/CD8 ratio between children without lung disease and those with HP. Increased expression of human leukocyte antigen-DR was found in seven of eight children with HP, whereas natural killer cells were elevated in five of eight children. Every patient had at least one of these two alterations in BAL fluid in addition to lymphocytosis. It was concluded that while lymphocytosis is generally present in children with hypersensitivity pneumonitis, the CD4/CD8 ratio is not increased in these patients. Assessing natural killer cells and human leukocyte antigen-DR expression appears to be a helpful adjunct in the diagnosis of paediatric patients with this disorder.

Alveolitis, Extrinsic Allergic↗
PubMed2002

[Comparability of various measurement methods in nasal provocation with allergens].

Defined criteria for nasal provocation exist only for the anterior Rhinomanometrie (aRM). During the last years there are other techniques for nasal provocation in use. In this study the new instruments were compared with the established aRM. We examined 14 patients with perennial rhinitis. All showed positive skin test and RAST against D. pteronyssinus. The controls were 13 atopic patients sensitized against pollen but not against D. pteronyssinus and 20 healthy volunteers. All subjects underwent nasal provocation with D. pteronyssinus. On the first day the provocation was unilateral. The instruments were the aRM, the Oscilloresistometry (ORM), the Peak Nasal Inspiratory Flowmeter (PNIF) and the Acoustic Rhinometry (Rhinoklack). On the second day the provocation was bilateral with ORM and PNIF. First we determined the limits for separation between a positive and negative nasal provocation test for the different instruments. Then we calculated the sensitivity and specificity for the instruments. By unilateral provocation there was a good sensitivity for all devices. The specificity was very good with the aRM, ORM and PNIF. In conclusion the PNIF is as good as the other instruments, but the Rhinoklack was less specific than the others.

Adult↗
PubMed2001

Computer program supporting the diagnostic accuracy of cellular BALF analysis: a new release.

Recently we developed a validated computer program based on polychotomous logistic regression analysis using bronchoalveolar avage fluid (BALF) results to distinguish between the three most common interstitial lung diseases (ILD): sarcoidosis, idiopathic pulmonary fibrosis (IPF) and extrinsic allergic alveolitis (EAA) or drug-induced pneumonitis. One of the limitations of this program was that it was not useful in discriminating between infectious disorders and non-infectious disorders. Therefore, we added BALF samples obtained from patients with a confirmed bacterial pulmonary infection based on culture results > or = 10(4) cfum l(-1) (group I: n=31) to the study population mentioned above (group II: n=272). Notably, just one variable, i.e. the percentage of polymorphonuclear neutrophils, allowed us to distinguish between infectious and non-infectious disorders. The agreement of predicted with the actual diagnostic group membership was 99.67% (groups I and II). Additionally, 91.2% of the cases with ILD were correctly classified. In conclusion, this updated Windows version 2000 of the validated computer program provides a very reliable prediction of the correct diagnosis for an arbitrary patient with suspected pneumonia or with ILD given information obtained from BALF analysis results, and is thought to improve the diagnostic power of BALF analysis.

Alveolitis, Extrinsic Allergic↗
PubMed2001

Bronchoalveolar lavage in interstitial lung disease.

Bronchoalveolar lavage (BAL) has become a standard diagnostic procedure for the majority of patients with interstitial disease. The technique is safe, minimally invasive, and reveals specific information in some disorders such as pulmonary alveolar proteinosis, Langerhans cell histiocytosis, alveolar hemorrhage, malignant infiltrates, or dust exposure. Here BAL can often replace lung biopsy. The results of BAL cell differentials with a lymphocytic, a neutrophilic, an eosinophilic, or a mixed cellular pattern can be used as an adjunct to diagnosis. If a BAL finding is compatible with the suspected diagnosis in the context of an appropriate disease history and clinical and radiologic findings, this can then be sufficient for disease confirmation. Recent research focused on the pathogenesis of various types of interstitial lung disorders. In this regard, BAL findings contributed to the characterization of idiopathic pulmonary fibrosis (IPF) as a condition with a predominant T-helper-2 (Th2) cytokine profile, whereas BAL findings in sarcoidosis and hypersensitivity pneumonitis are characterized by a Th1-dominant profile. The clinical value of BAL to assess the activity of disease processes and to provide prognostic information is still under debate. The routine performance of serial BAL is not recommended at present.

Alveolitis, Extrinsic Allergic↗