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At least 865 records · Page 48Linked to original sources
PubMed2003

[Lung biopsy in the diagnosis of causes of lung involvement in hemoblastosis].

AIM: To ascertain the role of lung biopsy in diagnosis of lung lesions in hemoblastosis (HB) patients. MATERIAL AND METHODS: The results of diagnostic biopsies of the lungs obtained from 22 HB patients are presented. Ten patients had no respiratory insufficiency (RI), twelve patients had RI. The biopsy was transbronchial in 1 case, thoracoscopic in 10 and open in 11 cases. RESULTS: In RI-free patients lung biopsy was informative in all the cases. The biopsy provided information which allowed therapy modification resulting in improvement of the patient condition. In RI patients biopsy was informative in 8 of 12 patients. Nonspecific changes in the lungs were identified histologically in 2 of 12 patients. In 2 RI patients lung biopsy confirmed the diagnosis made after examination of the bronchoalveolar lavage. Modification of therapy after the biopsy was conducted in 58.3% HB patients with RI. Improvement was seen in 2 of them. 10 of 12 patients with RI died within 1-2 weeks after biopsy. CONCLUSION: Lung biopsy in HB patients should be obtained only after examination with noninvasive methods and before development of RI as prognosis after lung biopsy in the presence of RI is unfavourable. The histological material should be examined for all expected pathogens.

Adolescent↗
PubMed2004

[NF-kappaB expression in lung tissue of acute lung injury rat model and the influence by antioxidant N-acetylcysteine].

AIM: To observe the NF-kappaB expression in the lung tissue of LPS-induced acute lung injury(ALI) rat model and the influence of N-acetylcysteine (NAC) on NF-kappaB expression. METHODS: The expression of NF-kappaB in lung tissue in ALI rat model and the influence of NAC on NF-kappaB expression were detected by immunohistochemical (ABC) staining and Western blot. RESULTS: There were a small amount of sporadic NF-kappaB cells in airway epithelium and interstitium in normal control group. In contrast, nuclear NF-kappaB expression-positive cells increased obviously in airway mucosa, lung interestium, alveolar cavity and vascular wall of ALI rats. NF-kappaB(+) cells were mainly airway mucosa epithelial cells, infiltrating inflammatory cells, alveolar epithelial cells, and vascular endothelial cells. The NF-kappaB expression-positive cells in NAC therapy group notably decreased compared with ALI group and control group(P<0.01). Western blot analysis showed that the expression of NF-kappaB was different at various time points, reaching the peak at 3 h and then decreased (P<0.01) after LPS induced lung injury. CONCLUSION: In LPS induced acute lung injury rat model, the NF-kappaB nuclear expression increased obviously in airway mucosa, lung interestium and alveolar cavity. Most cells in lung tissue participated in the activation of NF-kappaB. NAC could alleviate inflammation by inhibiting activation of NF-kappaB.

Acetylcysteine↗
PubMed2005

[Selective heterologous communication among human lung epithelial cells, fibroblasts, and lung cancer PG cells].

OBJECTIVE: To further understand the roles of gap junctional intercellular communication in carcinogenesis and progression of human lung cancer. METHODS: The heterologous communication was characterized among human lung epithelial cells HLEC, human lung fibroblasts HLF, human lung giant carcinoma PG cells and its Cx43 transfectants PG/C4 by using a preloading assay. Cx43 immunofluorescent staining and Northern blot were performed to examine Cx43 gene expression. RESULTS: Although both human lung fibroblasts HLF and epithelial cells HLEC expressed Cx43 and had very strong homologous communication, HLEC cells were unable to communicate with HLF cells. The human lung carcinoma cell line PG was defective of both homologous communication, and heterologous communication with its epithelial origin HLEC. Transfection of Cx43 into PG cells, which rescued PG cells' homologous communication and enhanced heterologous communication with HLF cells, could restore heterologous coupling with HLEC cells. CONCLUSION: Selective heterologous communication exists among different kinds of human lung cells, when human lung carcinoma cells lost coupling with its epithelial origin, Cx43 gene expression is not enough to establish heterologous communication between them.

Cell Communication↗
PubMed2005

Prognostic risk factors in patients with interstitial lung disease referred for lung transplantation.

The aim of the study was to identify prognostic factors that would differentiate patients with interstitial lung disease between those with and without a chance to survive until lung transplantation. A retrospective study was performed in patients with interstitial lung disease referred for lung transplantation between September 1999 and April 2005. The analysis included the demographic data, the time from referral to transplantation, the functional tests (FVC, FEV1, FEV1%VC, the PaO(2) at rest and after oxygen supplementation via a nasal catheter), the count of NYHA functional classes, the left ventricular ejection fraction (EF), the distance covered during a 6-min walk test, and the pathogens in the respiratory tract. The patients were divided into two groups: Group 1 - lung transplant candidates who survived until the successful procedure and Group 2 - lung transplant candidates who died while on the waiting list. There were statistical differences between the two groups in PaO2 after supplementation (P=0.005), EF (P=0.002), and the 6-min walk distance (P=0.001). It appears that simple functional tests of the cardiorespiratory system may define survival of patients with interstitial lung disease waiting for lung transplantation.

Adult↗
PubMed2006

[Influence and mechanism of peroxisome proliferation activated receptor-alpha expression induced by WY14643 in rat lung with acute lung injury].

OBJECTIVE: To investigate the effect of WY14643 [peroxisome proliferation activated receptor-alpha (PPAR-alpha) activator, 4-cholro-6-(2.3-xylidino)-2-pyrimidinylthio acetic acid] on PPAR-alpha expression in lung of acute lung injury (ALI) induced by lipopolysaccharide (LPS) and its mechanism. METHODS: One hundred and four male Wistar rats were randomly divided into four groups: control group, ALI group, WY14643 1 mg group and WY14643 3 mg group. Wistar rats were given LPS (5 mg/kg) before intratracheal challenge with WY14643 (1 mg/kg and 3 mg/kg). Rats of all groups were sacrificed at 1, 2, 4, 8 hours after LPS challenge. The levels of PPAR-alpha mRNA in lung were measured by semi quantitative reverse transcription-polymerase chain reaction, the levels of PPAR-alpha protein in rats lung homogenate were measured by Western blot. RESULTS: The levels of PPAR-alpha mRNA at 2,4 and 8 hours in WY14643 1 mg group and WY14643 3 mg group were significantly higher than that in ALI group (P<0.05 or P<0.01). The levels of PPAR-alpha mRNA at all time in ALI group was significantly lower than that in control group (P<0.01). Meanwhile,the levels of PPAR-alpha protein at all time in WY14643 1 mg group and WY14643 3 mg group were significantly higher than that in ALI group (P<0.01). The level of PPAR-alpha mRNA at 4 hours and 8 hours in WY14643 1 mg group and at 2,4 and 8 hours in WY14643 3 mg group were significantly higher than those in control group too (P<0.05 or P<0.01). CONCLUSION: The expressions of PPAR-alpha mRNA and protein are all significantly low in the lung of rats with acute lung injury. WY14643 may upregulate the level of PPAR-alpha in the lung tissue in rats with acute lung injury.

Acute Lung Injury↗
PubMed1991

Qualitative and quantitative changes of human tenascin expression in transformed lung fibroblast and lung tumor tissues: comparison with fibronectin.

Qualitative and quantitative alterations of human tenascin (TN) expression in virally transformed lung fibroblasts and in lung tumor tissues were investigated using S1 nuclease protection analysis in comparison with those of fibronectin (FN). Transformed fibroblasts and fetal lung tissues expressed more TN mRNA with an extra sequence encoding the sixth FN type III repeat than did normal cells and adult tissues. The splicing pattern of TN mRNA was also altered in many lung cancer tissues, showing increased or sometimes decreased expression of the TN mRNA with the extra sequence when compared with their surrounding normal tissues. These results provide additional evidence for the oncodevelopmental regulation of alternative RNA splicing in human lung tissues, first observed with FN mRNA (F. Oyama, et al., Cancer Res., 50: 1075-1078, 1990). Quantitative analysis of the levels of TN and FN mRNAs showed that the ratio of TN mRNA to FN mRNA was significantly increased in transformed fibroblasts and in some lung tumor tissues, when compared with their normal counterparts. Among different types of lung tumors, a significant increase of the TN/FN ratio was observed with most squamous cell carcinoma but with only a small fraction of adenocarcinoma. Since TN has been shown to inhibit cell adhesion to FN, the altered ratio of TN mRNA to FN mRNA may well affect the adhesive and migratory properties of tumor cells in lung cancer tissues.

Base Sequence↗
PubMed1991

[Lung ventilation imaging with TECHNEGAS: clinical study of lung deposition and ventilation/perfusion].

In order to optimize inhalation method for lung ventilation imaging with Tc-99m-gas (TECHNEGAS), relation between lung deposition of TECHNEGAS and inhalation method was evaluated. Submaximal inhalation with breath-holding (BH), continuous submaximal inhalation (C) and tidal inhalation (TV) were compared in 35 patients (36 studies) with various lung diseases. Mean lung deposition of TECHNEGAS was 6.6-7.4%/LD in BH group and was significantly higher than other groups of inhalation method (p less than 0.05-0.001). Lung deposition increased according to the times of inhalation in C group. TV group resulted in the lowest lung deposition which was same as 5 times of inhalation in C group. Lung/filter ratio (L/F) was highest in BH group. Image quality of TECHNEGAS was significantly better in BH group. Hot spot in central airway was seen in 15% of patients. All of them was in TV or C groups. In order to improve lung deposition and image quality of the TECHNEGAS, sufficient breath-holding was important. L/F seemed to be the index of effective inhalation of the TECHNEGAS. TV was suitable for poorly cooperative or dyspneic patients. TECHNEGAS was useful for evaluation of lung ventilation to provide good quality image with safety and simplicity.

Administration, Inhalation↗
PubMedDate not supplied

Inflation-fixed lungs: pathologic-radiologic (CT) correlation of lung transplantation.

Pulmonary infections and lung rejection are the two major complications of lung transplantation. Although the therapies for these two processes differ greatly, they often cannot be differentiated using standard radiography. We applied high resolution CT (HRCT) to seven lung specimens that were obtained from patients who had received a heart-lung transplant. The lungs were fixed by a method that allows for direct one-to-one pathologic-radiologic correlation. We found: (a) that in contrast to the extensive changes present microscopically, acute lung allograft rejection was characterized by only minor changes on HRCT; (b) that bronchiolitis obliterans, the hallmark of chronic lung allograft rejection, was not reliably identifiable on HRCT; (c) that bronchiectasis with associated peribronchial inflammation and fibrosis, a common finding in lung allograft rejection, was identifiable on HRCT, but that the HRCT appearance of this lesion was not specific for rejection; and (d) that pulmonary infections were often identifiable as a mixed airway-interstitial process on HRCT.

Adult↗
PubMed1990

Reproduction of transfusion-related acute lung injury in an ex vivo lung model.

Leukoagglutinins are implicated in transfusion-related acute lung injury (TRALI). In the present study, severe lung vascular leakage was reproduced by application of a leukoagglutinating antibody of anti-5b specificity in an ex vivo lung model. The antibody originated from a multiparous donor-plasma, observed to cause noncardiogenic edema during transfusion therapy. Heated full plasma (anti-5b-titer 1/128) or purified immunoglobulin G fraction was used for the studies. Ex vivo isolated rabbit lungs were perfused with albumin buffer, and human granulocytes (PMN) were admixed to the recirculating perfusate. In presence of anti-5b antibody plus 5b-positive PMN plus rabbit plasma as complement-source, severe lung edema occurred after a latent period of 3 to 6 hours. Pulmonary artery pressure was only transiently and moderately increased, and the leakage reaction could be traced back to a several-fold increase in lung vascular permeability. In contrast, no vascular leakage was noted in lungs perfused in the absence of anti-5b antibody, PMN, or rabbit plasma. Moreover, no permeability increase occurred on use of 5b-negative PMN. This reproduction of TRALI in an ex vivo lung model corroborates the role of leukoagglutinating antibodies in initiating PMN-dependent respiratory distress and suggests a contribution of concomitant complement activation.

Agglutinins↗
PubMed1990

[Glycosaminoglycans in human normal lung tissues and lung cancer tissues].

The quantitative changes of glycosaminoglycans in tumor tissue of human lung cancers (6 squamous cell carcinomas, 7 small cell carcinomas and 10 adenocarcinomas) were studied. Normal lung tissues contained of 3.38 mumol uronic acid/g dry weight glycosaminoglycans which consisted of hyaluronic acid, chondroitin sulfates, dermatan sulfate and heparan sulfate. The total amount of glycosaminoglycans in human lung cancer tissues increased 1.7 to 3.5 times in comparison with that in normal lung tissues. The increase in tissue content of glycosaminoglycans was accompanied by an increase in the chondroitin sulfate level in every histologic type of lung cancer, as well as marked increase in hyaluronic acid level in squamous cell carcinomas, and a moderate increase in small cell carcinomas. The concentrations of dermatan sulfate and heparan sulfate in lung cancer tissues did not show any significant changes compared with those in normal lung tissues. The increase in total amount and changes in the composition of glycosaminoglycans in human lung cancer tissue were closely related to the histologic type of the tumor. In adenocarcinomas, some acid glycoprotein with sialic acid was simultaneously detected during the separating course of glycosaminoglycans, which was considered to be derived from mucinous substances related to adenocarcinoma cells.

Adenocarcinoma↗
PubMed1987

Regional lung function in long-term survivors after chemotherapy for small cell lung cancer.

In order to evaluate the regional lung function in patients with small cell lung cancer with long-term survival, we measured the regional lung function in 17 patients. We studied the patients with 81m-krypton ventilation scans and 99m-technetium perfusion scans, as well as measurements of static lung volumes (VC, RV, TLC), flow volume indices (FEV1, FVC, MEF50), and carbon monoxide diffusing capacity (DLCO). We found both the ventilation and the perfusion of the affected lung to be slightly but significantly lower (P less than 0.05), while no obvious ventilation or perfusion defects could be identified at the former tumor site. The static volumes of the lungs, the FVC and the FEV1 were within predicted normal values, while a significant decrease was seen in the PEF, MEF50, and DLCO. It is concluded that patients with small cell lung cancer who obtain complete remission with normalization of the chest X-ray and long-term survival after 18 months of intensive chemotherapy also have a nearly normal lung function.

Aged↗
PubMed1980

Specific blastogenic response of peripheral blood lymphocytes from lung cancer patients to a fetal lung antigen.

A human lung tumor fetal-associated antigen (LTFA) has been purified from lung tumor tissue by a combination of salt precipitation and ion-exchange chromatography. The purification steps were monitored by double immunodiffusion with the use of a rabbit anti-LTFA-specific antiserum. The isolated protein was tested for its blastogenic properties toward peripheral blood lymphocytes (PBL) by [3H]thymidine incorporation. PBL obtained from 25 healthy individuals, 34 patients with tumors other than lung tumors, 13 patients with lung diseases other than lung tumors, and 51 lung tumor-bearing patients were tested. Only PBL with an in vitro positive response to phytohemagglutinin were employed. Whereas PBL of lung tumor patients showed a significant blastogenic response to the purified antigen in 14 of 22 patients tested (60%), PBL of other patients were completely unreactive (P less than 0.005). The present data suggested that a specific immune response toward an LTFA was present in patients with lung cancers.

Antigens, Neoplasm↗
PubMed1995

Allogeneic bronchoalveolar lavage cells induce the histology of acute lung allograft rejection, and deposition of IgG2a in recipient murine lungs.

The immunologic and histologic changes associated with lung allograft rejection are believed to result from the presentation of donor lung alloantigens to recipient lymphocytes resulting in up-regulated Th1 lymphocyte activity. The ability of allogeneic lung immune cells to induce the pathologic and immunologic changes associated with acute lung allograft rejection are unknown. The current study determined whether allogeneic (C57BL/6, I-a(b)) bronchoalveolar lavage (BAL) cells (> or = 97% macrophages), when instilled into the lungs of recipient BALB/c mice (I-a(d)), induced the histology and immunology associated with acute lung allograft rejection. BALB/c mice received BAL cells from either C57BL/6 mice (allogeneic instillate) or BALB/c mice (autologous instillate) or PBS (control) by nasal insufflation weekly for 4 wk. Allogeneic BAL cells resulted in a lymphocytic bronchitis and vasculitis analogous to grade 1 to 2 lung allograft rejection. The mice given allogeneic instillates had a greater percentage of lymphocytes in the BAL fluid than those given autologous instillates. After instillation of allogeneic BAL cells, the Th1 cytokines, IL-2 and IFN-gamma (IFN-gamma), were produced locally in greater quantities and more frequently than Th2 cytokine IL-10. IL-4, another Th2 cytokine, was not detected. The local production of IgG1 and IgG2a, which are dependent on IL-4 and IFN-gamma, respectively, were increased. However, only IgG2a was deposited in the perivascular and peribronchiolar tissues. These data show that installation of allogeneic BAL cells into the airways of recipient mice induced up-regulated Th1 lymphocyte activity and caused the histologic changes associated with lung allograft rejection.

Animals↗
PubMedDate not supplied

Assessment of forced expiratory volume in one second-fraction of the engrafted lung with 133-Xe radiospirometry improves the diagnosis of bronchiolitis obliterans syndrome in single lung transplant recipients.

BACKGROUND: Staging of bronchiolitis obliterans syndrome is based on the decline of forced expiratory volume in 1 second, a measure of overall ventilatory capacity. A single staging system is applied to all lung recipients, regardless of the bias which can be caused by the native lung after single lung transplantation. METHODS: We determined the decline of graft function in single lung recipients by a combination of two methods: 133-Xe radiospirometry and dynamic spirometry. The forced expiratory volume in 1 second fraction of the transplant (FEV1tx) was calculated from the proportion of ventilation of the transplant (Vtx) and forced expiratory volume in 1 second. Eight single lung recipients were followed up for a median observation period of 17 months; bronchiolitis obliterans syndrome developed in four of them. RESULTS: The fractional decline of forced expiratory volume in 1 second of the transplant was significantly greater than the decline of forced expiratory volume in 1 second (p = 0.016) in all patients during the follow-up. In the patients with bronchiolitis obliterans syndrome, the mean decline in forced expiratory volume in 1 second was 1.1 L (39.5%), and in forced expiratory volume in 1 second of the transplant it was 0.9 L (55.8%). The measurement of forced expiratory volume in 1 second of the transplant suggested stage 2a and 3a dysfunction in two grafts in which the assessment of forced expiratory volume in 1 second indicated stage 1a bronchiolitis obliterans syndrome. In one patient, decrease of forced expiratory volume in 1 second of the transplant was suggestive of chronic dysfunction 4 months before it was diagnosed by biopsy and declined lung function. CONCLUSIONS: The assessment of forced expiratory volume in 1 second seems to underestimate the severity of chronic dysfunction in single lung grafts. Instead, the determination of forced expiratory volume in 1 second of the transplant with radioactive tracers provides selective information of the graft function, which could be used for clinical evaluation of bronchiolitis obliterans syndrome in single lung recipients.

Adult↗
PubMed1994

Survival and functional outcome after single and bilateral lung transplantation. Loyola Lung Transplant Team.

BACKGROUND: The experience at Loyola University Chicago was retrospectively reviewed to evaluate survival and functional outcome after single lung transplantation (SLT) and bilateral lung transplantation (BLT). METHODS: Ninety patients underwent lung transplantation at Loyola University Chicago between April 1990 and December 1993. Mean age was 45 years (range, 13 to 66 years). Fifty percent were male. Pre-lung transplant pulmonary diseases were as follows: emphysema and/or chronic obstructive pulmonary disease in 43 patients, pulmonary fibrosis in 13, cystic fibrosis in 14, pulmonary hypertension in eight, repeated transplantation for obliterative bronchiolitis in four, bronchiectasis in two, bronchoalveolar cell carcinoma in two, sarcoidosis in one, primary obliterative bronchiolitis in one, histiocytosis X in one, and lymphangiomyomatosis in one. Fifty-seven patients underwent SLT, and 33 had BLT. Maintenance immunosuppression medications consisted of cyclosporine, azathioprine, and prednisone. RESULTS: Perioperative complications were as follows: seven of 33 patients bled after BLT, and two of 57 bled after SLT. Bronchial complications were found in six of 66 (9%) BLT anastomoses and eight of 57 (14%) SLT anastomoses. Nine operative deaths occurred in SLT patients: six from allograft failure, one from infection, one from intrapulmonary hemorrhage, and one from bronchial dehiscence. Only two patients died in the perioperative period after BLT and that was of infection. Three late deaths occurred after BLT, all as a result of infection; 13 recipients died late after SLT: five of infection, four patients from lymphoma, two of pancreatitis, one of tension pneumothorax, and one of pulmonary embolism. For the entire patient population the actuarial 1- and 2-year survival rates were 72% and 68%, respectively. One-year survival rates were significantly better for patients undergoing lung transplantation for obstructive and nonrestrictive lung diseases than those of patients undergoing lung transplantation for vascular or restrictive pulmonary disease. Recipients of BLT had a trend toward better survival than recipients of SLT. Lung function 6 months after transplantation measured by forced expiratory volume in 1 second was significantly better in BLT than SLT, 71% of predicted versus 54%. CONCLUSIONS: Patients who undergo BLT have significantly better postoperative pulmonary function than those who undergo SLT. On the basis of the study there was a trend toward better survival with BLT.

Adolescent↗
PubMed1996

[Lung volume reduction surgery (VRS) for lung diffuse emphysema].

The lung volume reduction surgery is now being accepted for patients with lung diffuse emphysema. The basic concept of this procedure is based on reducing overall lung volume by multiple pneumectomy. The lungs are resected on both pathologic and non-pathologic lesions. As a result, elastic pull on the small airway may be achieved and normal underlying compressed lung can be re-expanded. Additionally, the compliance of thoracic wall is ameliorated with normalized thoracic volume. On the other hand, laser ablation of emphysematous lung with bullaectomy under video assisted thoracoscopy (VATS) has been performed recently. This procedure is based on reducing the non-functional air volume due to bullae underlying the pleural surface. Both procedures have still having been under consideration in last three years. In this report, the latest result of both methods in the USA are reported and discussed. Additionally, comparative data with lung transplantation, the other surgical strategy for lung emphysema, is also discussed.

Catheter Ablation↗
PubMed1997

Volume reduction surgery in the native lung after single lung transplantation for emphysema.

The natural history of emphysema suggests that progression of disease in the native lung may contribute to late deterioration in respiratory function after single lung transplantation. In this report, we describe our experience with unilateral volume reduction surgery in three single lung transplant recipients with emphysema. Each patient had had a late decline in lung function with a recurrence of symptoms. Chest radiographs demonstrated hyperinflation of the native lungs with encroachment on the grafts. Serial pulmonary function testing documented progressive reduction in expiratory flows with increases in residual volumes. Exercise testing confirmed severe intolerance to maximal exercise. Unilateral volume reduction surgery was undertaken at 36, 39, and 55 months after transplantation without incident. Radiographs obtained after the procedures demonstrated restoration of normal diaphragmatic contour, decreased aeration of the native lungs, and improved inflation of the allografts. Exercise testing at 3 months documented a mean improvement in maximal oxygen consumption of 35%. Expiratory flows improved by a mean of 60%. Quantitative ventilation and perfusion scans, however, were essentially unchanged. This experience suggests that unilateral volume reduction surgery may be considered as an alternative strategy in single lung transplant recipients with emphysema who exhibit clinically significant functional deterioration. Differentiation of the adverse effects of hyperinflation of the native lung from other potential causes of late deterioration might not be necessary but may be predictive of the degree of functional improvement after volume reduction. The relief of thoracic overdistention seems to play a primary role in the improvement pulmonary function.

Aged↗
PubMed1998

Pulmonary rehabilitation in the surgical patient. Lung transplantation and lung volume reduction surgery.

Prior to lung transplantation or lung volume reduction surgery, patients complete a comprehensive pulmonary rehabilitation program. The program aids physicians in the selection of appropriate surgical candidates and prepares patients physically and psychologically for the stress of surgery. Because lung transplantation often involves relocation and prolonged waiting, stress levels can be particularly high. Rehabilitation continues through the perioperative and postoperative period to facilitate recovery and bring patients to the highest possible level of function. Studies of lung transplant recipients suggest that most patients who survive to hospital discharge enjoy a significant improvement in pulmonary function and many resume work and household responsibilities. Initial experiences with lung volume reduction surgery also suggest that many patients experience improved dyspnea symptoms and functional status after the procedure. As lung transplantation and lung volume reduction surgery emerge as viable therapeutic options for many patients with end-stage lung disease, comprehensive pulmonary rehabilitation programs are essential to address the complex medical, surgical, and psychological issues that surround these procedures and to produce optimal therapeutic outcomes.

Humans↗