Lung
-
Chlorine is a widely used industrial chemical. Individuals can be exposed to chlorine through transportation accidents, industrial exposures or misuse of domestic cleaners. ⋯ Residual effects of chlorine exposure are a function of intensity of exposure, minute ventilation during exposure, and host characteristics such as cigarette smoking and atopy. This monograph will summarize uses of chlorine, the potential for accidents, the mechanism of chlorine toxicity in the lung, and review acute and chronic effects of chlorine exposure on the lung, as well as systemic effects of massive chlorine exposure.
-
Comparative Study
Alterations of adhesion molecule expression and inflammatory mediators in acute lung injury induced by septic and non-septic challenges.
The lung is frequently the first failing organ during the sequential development of multiple organ dysfunction under both septic or non-septic conditions. The present study compared polymorphisms of tumor necrosis factor (TNFalpha), monocyte chemoattractant protein-1 (MCP-1), and adhesion molecule (AM) expression on circulating, recruited, and migrating leukocytes in the development of lung injury after induction of acute pancreatitis (AP) or abdominal sepsis by cecal ligation and puncture (CLP). Pulmonary alveolar barrier and endothelial barrier permeability dysfunction were measured. ⋯ Alterations in expression of adhesion molecules on bronchoalveolar lavage (BAL) leukocytes can represent a marker reflecting leukocyte activation in the lung tissue, since both BAL and lung tissue leukocytes showed similar patterns of changes. Expression of adhesion molecules on circulating leukocytes increased 1 hour after induction of pancreatitis. Activating phenotypes of circulating, lung tissue and bronchoalveolar leukocytes may thus be responsible for the-development and severity of secondary lung injury.
-
Comparative Study
Temperature and serum proinflammatory cytokine changes in patients with NSCLC after BAL.
We examined the effects of bronchoalveolar lavage (BAL) and BAL fluid characteristics on the systemic proinflammatory cytokine expression and their relation to clinical and laboratory findings. Thirty patients suspected to have lung cancer were subjected to fiber-optic bronchoscopy (FOB) and BAL. Clinical and laboratory findings were determined at baseline, 4 h, and 24 h, including lung auscultation, temperature, chest X-ray, WBC, neutrophils, and serum IL-1beta, IL-6, and TNF-alpha. ⋯ Significant temperature increase was observed in 36.6% of the patients undergoing BAL and associated with significant serum TNF-alpha and IL-6 increase at 4 h. Lung cytokines levels, alveolar macrophages, and BAL fluid characteristics are not related to temperature and serum proinflammatory cytokine increase. The hypothesis of alveolar macrophages derive from cytokine production and shift to the systemic circulation cannot be supported by our data.
-
Comparative Study
Assessing transient pulmonary injury induced by volatile anesthetics by increased lung uptake of technetium-99m hexamethylpropylene amine oxime.
Volatile anesthetics such as halothane and isoflurane have long been thought to affect pulmonary function. The purpose of this study was to examine whether volatile anesthetics (halothane and isoflurane) can induce pulmonary vascular endothelium damage. Before surgery, 1 h after surgery, and 1 week after surgery, the degree of pulmonary vascular endothelium damage was represented as increased lung/liver uptake ratios (L/L ratio) and measured on technetium-99m hexamethylpropylene amine oxime (Tc-99m HMPAO) lung scan in 3 groups of the patients. ⋯ No significant change of L/L ratio was found from before surgery, 1 h after surgery, to 1 week after surgery in group 3 patients. In groups 1 and 2 patients, significantly transient increased L/L ratio was found 1 h after surgery. We conclude that volatile anesthesia (halothane and isoflurane) can induce transient pulmonary vascular endothelium damage, represented as transiently increased L/L ratios on Tc-99m HMPAO lung scan.
-
High-resolution computed tomography (HRCT) is a useful method for quantifying the extent of emphysema. Few reports have mentioned the relationships between HRCT scans and pulmonary function tests in chronic obstructive pulmonary disease (COPD). For diagnosis, COPD requires chronic airflow limitation and emphysema and/or chronic bronchitis. ⋯ The middle left part of the lung during expiration correlated statistically significant with MVV (r = -0.673, p = 0.001), FVC (r = -0.493, p = 0.027), FEV1 (r = -0.629, p = 0.003), resistance (r = 0.593,p = 0.005), RV (r = 0.601, p = 0.005), TLC (r = 0.546, p = 0.012), FRC (r = 0.594, p = 0.006) and peak VO2 (r = -0.525, p = 0.015). Forced expiratory volume in 1 sec (FEV1), which is a well-established measure of airflow obstruction, correlated with the HRCT grade (1) in the middle left part of the lung during inspiration (r = -0.468, p = 0.035) and during expiration (r = - 0.629, p = 0.003) (2) in the lower right lung during inspiration (r = -0.567, p = 0.007) and during expiration (r = -0.558, p = 0.008) (3) in the lower left lung during inspiration (r = -0.542, p = 0.011) and during expiration (r = -0.558, p = 0.008) (4) in the upper right lung during expiration (r = -0.469, p = 0.037) (5) in the upper left lung during expiration (r = -0.463, p = 0.035) and (6) in the middle right lung during expiration (r = -0.632, p = 0.002). According to our results HRCT was a valuable tool for evaluating the severity of COPD--especially the middle right and left part of the lungs, during expiration--and correlated well with pulmonary function tests.