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1

Pulmonary lymph flow and the uptake of liquid from the lungs of the lamb at the start of breathing  

PubMed Central

1. Lymph from the lungs of lambs and sheep was found to enter both the right lymph duct and the thoracic duct. Right lymph duct flow was collected by constructing a venous sac, the venous tributaries of which were ligated but which the right lymph duct entered; thoracic duct flow was collected by cannulating the duct. Lymph from sites other than the lungs was excluded from the collections. 2. Measurements were made of the surface tension characteristics of lung extracts and of the liquid present in foetal lungs. These values were used together with gestational age and crown-rump length to designate the foetal lambs into mature and immature groups. 3. Lymph flow from the lungs averaged 0·99 ml./kg body wt./hr in immature foetal lambs, and 1·81 ml./kg/hr in mature foetal lambs before the start of ventilation. Lymph flow from the lungs of spontaneously delivered new-born lambs (mean age 51 hr) averaged 0·86 ml./kg/hr. In adult ewes right lymph duct flow averaged 0·11 ml./kg/hr and total lung lymph flow was estimated indirectly to be 0·33 ml./kg/hr. Calculated rates of protein flow in lung lymph (flow × protein concentration) were greater in foetal lambs than in adult sheep. 4. Total thoracic duct flow averaged 2·48 ml./kg/hr in immature foetal lambs, 5·30 ml./kg/hr in mature foetal lambs, 3·65 ml./kg/hr in new-born lambs, and 2·92 ml./kg/hr in adult ewes. 5. At the start of ventilation there was an increase in lymph flow from the lungs, which at 15-30 min reached a mean of 6·4 ml./kg/hr in mature lambs and 2·6 ml./kg/hr in immature lambs. At the same time the protein concentration of lymph decreased but the calculated protein flow increased. 6. The lungs of foetal lambs weighed more than the lungs of spontaneously delivered new-born lambs, and the difference could be accounted for by liquid which could be aspirated through the trachea of the foetal lamb. On ventilation of the lungs for 2 hr, without first allowing the escape of any lung liquid, lung weight measurements indicated that about 66% of the lung liquid had been taken up in mature lambs and about 50% in immature lambs. 7. It was concluded that the rate at which lymph is formed in the lungs is greater per kilogram body weight in foetal than in new-born lambs and greater in them than in ewes. The increase in lymph flow at the start of ventilation could account for the removal of about 40% of the liquid present in the lungs of the mature foetus and about 25% of the liquid in the lungs of the immature foetus.

Humphreys, P. W.; Normand, I. C. S.; Reynolds, E. O. R.; Strang, L. B.

1967-01-01

2

Pulmonary Venous Blood Flow.  

National Technical Information Service (NTIS)

Pulsatile characteristics of blood flow in major pulmonary veins were determined from chronically implanted dogs. From these data, five distinct positive flow maxima or waves are proposed to describe the variety of waveforms observed over a cardiac cycle....

E. Kinnen A. J. Stankus

1968-01-01

3

Lymph flow and lung weight in isolated sheep lungs.  

PubMed

To study the relationship between lung weight and lymph flow, we used an in situ, isolated sheep lung preparation that allowed these two variables to be measured simultaneously. All lungs were perfused for 4.5 h at a constant rate of 100 ml X min-1 X kg-1. In control lungs, the left atrial pressure (Pla) was kept at atmospheric pressure. In experimental lungs, Pla was kept atmospheric except for a 50-min elevation to 18 mmHg midway through the perfusion. During this period of left atrial hypertension, pulmonary arterial pressure rose from 18 to 31 mmHg, lymph flow rose from 3 to 12 ml/h, and the lymph-to-plasma oncotic pressure ratio (pi L/pi P) fell from 0.7 to 0.48. After left atrial pressure was returned to control, pulmonary arterial pressure, lymph flow, and pi L/pi P all returned to control levels. The rate of weight gain after the return of left atrial pressure to control was also the same as that in the control group. However, during the period of left atrial hypertension 135 ml of fluid were filtered into the lung, and this large increase in lung weight remained after the pressure was lowered. The presence of this substantial excess lung water despite control values for vascular pressures, lymph flow, rate of weight gain, and pi L/pi P suggests that the absolute amount of lung water has little influence on the dynamic aspects of lung fluid balance. These results are consistent with a two-compartment model of the interstitial space, where only one of the compartments is readily drained by the lymphatics. PMID:3781991

Mitzner, W; Sylvester, J T

1986-11-01

4

Modelling pulmonary blood flow  

PubMed Central

Computational model analysis is a method that has been used widely to understand and interpret complexity of interactions in the pulmonary system. Pulmonary blood transport is a multi-scale phenomenon that involves scale-dependent structure and function, therefore requiring different model assumptions for the microcirculation and the arterial or venous flows. The blood transport systems interact with the surrounding lung tissue, and are dependent on hydrostatic pressure gradients, control of vasoconstriction, and the topology and material composition of the vascular trees. This review focuses on computational models that have been developed to study the different mechanisms contributing to regional perfusion of the lung. Different models for the microcirculation and the pulmonary arteries are considered, including fractal approaches and anatomically-based methods. The studies that are reviewed illustrate the different complementary approaches that can be used to address the same physiological question of flow heterogeneity.

Tawhai, Merryn H.; Burrowes, Kelly S.

2008-01-01

5

Modelling pulmonary blood flow.  

PubMed

Computational model analysis has been used widely to understand and interpret complexity of interactions in the pulmonary system. Pulmonary blood transport is a multi-scale phenomenon that involves scale-dependent structure and function, therefore requiring different model assumptions for the microcirculation and the arterial or venous flows. The blood transport systems interact with the surrounding lung tissue, and are dependent on hydrostatic pressure gradients, control of vasoconstriction, and the topology and material composition of the vascular trees. This review focuses on computational models that have been developed to study the different mechanisms contributing to regional perfusion of the lung. Different models for the microcirculation and the pulmonary arteries are considered, including fractal approaches and anatomically-based methods. The studies that are reviewed illustrate the different complementary approaches that can be used to address the same physiological question of flow heterogeneity. PMID:18434260

Tawhai, Merryn H; Burrowes, Kelly S

2008-03-16

6

Reduction of lymph tissue false positives in pulmonary embolism detection  

NASA Astrophysics Data System (ADS)

Pulmonary embolism (PE) is a serious medical condition, characterized by the partial/complete blockage of an artery within the lungs. We have previously developed a fast yet effective approach for computer aided detection of PE in computed topographic pulmonary angiography (CTPA),1 which is capable of detecting both acute and chronic PEs, achieving a benchmark performance of 78% sensitivity at 4 false positives (FPs) per volume. By reviewing the FPs generated by this system, we found the most dominant type of FP, roughly one third of all FPs, to be lymph/connective tissue. In this paper, we propose a novel approach that specifically aims at reducing this FP type. Our idea is to explicitly exploit the anatomical context configuration of PE and lymph tissue in the lungs: a lymph FP connects to the airway and is located outside the artery, while a true PE should not connect to the airway and must be inside the artery. To realize this idea, given a detected candidate (i.e. a cluster of suspicious voxels), we compute a set of contextual features, including its distance to the airway based on local distance transform and its relative position to the artery based on fast tensor voting and Hessian "vesselness" scores. Our tests on unseen cases show that these features can reduce the lymph FPs by 59%, while improving the overall sensitivity by 3.4%.

Ghanem, Bernard; Liang, Jianming; Bi, Jinbo; Salganicoff, Marcos; Krishnan, Arun

2008-04-01

7

Prognostic impact of lymph node involvement in pulmonary metastases from colorectal cancer  

Microsoft Academic Search

Objective: The purpose of this study was to identify the prognostic impact of unexpected lymph node metastases in patients undergoing resection of pulmonary metastases from colorectal cancer and specify the influence of pulmonary and mediastinal nodal involvement according to the modified Narukes lymph node mapping [Mountain CF, Dresler CM. Regional lymph node classification for lung cancer. Chest 1997;111(6):1718–23.]. Methods: From

Stefan Welter; Jan Jacobs; Thomas Krbek; Christoph Poettgen; Georgios Stamatis

2007-01-01

8

Imaging of lymph flow in single microvessels in vivo  

NASA Astrophysics Data System (ADS)

In this study parameters of lymph microcirculation are investigated. The microcirculation was studied on small intestine mesentery in norm and during Dimethyl sulfoxide (DMSO) application. The direct measurement of lymph flow velocity (parameter V) in individual microvessels was based on the technique of light intravital videomicroscopy. The first spectral moments of Doppler signal, characterizing the mean velocities of lymph flow in microvessels (parameter M1), were measured by speckle-interferometrical method. Simultaneously, diameters of lymph microvessels as well as parameters of phasic contractions and valve function of lymphatics were registered. The value of V was very changeable; the mean V was equal to 270+/- 24micrometers /s. The M1 was the varying characteristic of the lymph flow too. The temporal dynamic of M1 was reflected alternating- translation motion of lymph flow. DMSO application during 15 min caused the constriction in a majority of lymphatics and the phasic contractions. DMSO induced lymphostatis in 20% of cases. But the other microvessels responded to the rise of lymph flow velocity. These changes led to the stimulation of drainage function of lymph microcirculation function.

Galanzha, Ekateryna I.; Ulyanov, Sergey S.; Tuchin, Valery V.; Brill, Grigory E.; Solov'eva, Anastasiya V.

2000-10-01

9

Pathways of lymph flow from the intestine of the horse.  

PubMed

The intestine of horses differs from that of most other domestic animals in having a huge ascending colon and cecum, which together act as a large fermentation vat. The lymph drainage from this intestine occurs through a complex network of lymph vessels and lymph nodes, of which there are several thousand. The pathways taken by lymph through these vessels and nodes were studied by tracing injections of dye, by examining Microfil casts, and with light and transmission electron microscopy. Lymph vessels transporting lymph from the intestinal wall generally terminate on a single node within a group of primary nodes. Efferent lymphatics form networks in the immediate vicinity of groups of nodes. In these networks, the vessels branch, anastomose, entwine amongst one another, and sometimes form recirculating loops. Usually 2-9 lymphatic vessels course away from these networks to secondary or higher-order nodes in both local and more central locations. Vessels reaching these nodes generally terminate on more than one node within each group. This pattern of lymph distribution is repeated as lymph passes through a succession of five or more nodes before flowing into the cisterna chyli. The complexity of the lymph pathways, it is suggested, would promote the mixing of lymph from different parts of the intestine and from different nodes, thus collating, integrating, and potentiating the immunological responses of these nodes. The walls of lymphatic vessels are well endowed with smooth muscle cells and elastic fibres, suggesting that intrinsic contractility of these vessels is a major mechanism in the propulsion of lymph from the intestine of the horse. PMID:2048756

Nikles, S A; Heath, T J

1991-04-01

10

The flow and composition of lymph from the caudal mediastinal lymph node of sheep.  

PubMed Central

By cannulating the efferent duct of the caudal mediastinal lymph node in sheep, lymph from the lower respiratory tract was collected under physiological conditions for several days. In 18 such preparations the flow rate varied from 4 to 12 ml/hr between individuals and the lymphocyte count between 4000 and 117,000/mm3. The protein content of the lymph plasma averaged nearly 60% of that of the blood, and this indication of the high permeability of the capillary bed of the lungs was confirmed by measuring the time taken for intravenous doses of 125I-albumin to equilibrate between the blood and mediastinal lymph plasma. The concentration of immunoglobulin A was higher in the mediastinal lymph than in blood serum, while the reverse was true of the concentrations of IgG1, IgG2, and IgM. This evidence for the local production of IgA by the intra thoracic lymphoid tissue was supported by the demonstration by immunoperoxidase techniques of IgA-containing plasma cells in sections cut from the caudal mediastinal nodes, and of IgA-containing immunoblasts in the lymph. Images Figure 3

Spencer, J; Hall, J G

1984-01-01

11

Flow cytometric immunophenotype of canine lymph node aspirates.  

PubMed

Increasing availability of reagents able to distinguish subtypes of lymphocytes and other leukocytes has enabled greater understanding of lymphocyte biology and pathology in the dog. Lymphocytes in circulation most commonly are subjected to immunophenotypic assessment by flow cytometry, but needle aspirates of lymph nodes can be similarly suitable for immunophenotypic examination. In this investigation, the feasibility of immunophenotyping samples obtained by needle aspiration of lymph nodes from 32 dogs with no physical abnormalities and 6 dogs with lymphoma was determined. In addition, samples from 6 dogs were stored overnight at 4 degrees C and reanalyzed 24 hours later. For each sample, stained smear preparations were examined microscopically for lymphocyte morphology, neoplasia, and the presence of inflammatory cells. Expression of antigens on a corresponding sample of aspirated cells was determined by flow cytometric detection of antibody binding on a minimum of 10,000 events. The distribution of data was determined with Anderson-Darling tests, and reference intervals incorporating the central 95% of values were established. Adequate samples were obtained from 30 of 32 clinically normal dogs. Immunophenotypic results after 24 hours of storage were consistent with those obtained immediately after sampling. Reference intervals for lymphocyte subsets from normal dog lymph nodes were similar to the proportions of CD3+, CD4+, CD8+, and CD21+ lymphocytes found in blood. Aspirates of enlarged lymph nodes from dogs with lymphoma were readily classified by this technique. Aspiration of lymph nodes from dogs for comprehensive analysis by flow cytometry is feasible and applicable to immunophenotyping of lymphoma. PMID:15515589

Gibson, D; Aubert, I; Woods, J P; Abrams-Ogg, A; Kruth, S; Wood, R D; Bienzle, D

12

Pulmonary blood flow distribution in anesthetized ponies.  

PubMed

Results of recent investigations in humans and dogs indicate that gravity-independent factors may be important in determining the distribution of pulmonary blood flow. To further evaluate the role of gravity-independent factors, pulmonary blood flow distribution was examined using 15-microns radionuclide-labeled microspheres in five prone ponies over 5 h of pentobarbital sodium anesthesia. The ponies were killed, and the lungs were excised and dried by air inflation (pressure 45 cmH2O). The dry lungs were cut into transverse slices 1-2 cm thick along the dorsal-ventral axis, parallel to gravity. Radioactivity of pieces cut from alternate slices was measured with a gamma well counter. The main finding was a preferential distribution of pulmonary blood flow to dorsal-caudal regions and higher flow in the center of each lung slice when compared with the slice periphery. Flow was lowest in cranial and ventral areas. Differences of +/- 2 SD were observed between core and peripheral blood flow. No medial-lateral differences were found. Pulmonary blood flow distribution did not change over 5 h of anesthesia, and the basic flow pattern was not different in the left vs. right lung. These results suggest that in the intact prone mechanically ventilated pony (inspired O2 fraction greater than or equal to 0.95) factors other than gravity are primary determinants of pulmonary blood flow. PMID:1568972

Jarvis, K A; Steffey, E P; Tyler, W S; Willits, N; Woliner, M

1992-03-01

13

Biomedical applications of coherent-optical methods for the analysis of lymph flow in microvessels  

NASA Astrophysics Data System (ADS)

In the present study the characteristics of lymph microcirculation are investigated. The lymph microcirculation was studied on small intestine mesentery during NG=nitro=L-arginine (L-NNA) application on intact microvessels and after stress. The direct measurement of lymph flow velocity (parameter V) in individual microvessels was based on the technique of light intravital videomicroscopy. The first spectral moments of Doppler signal characterizing the mean velocities of lymph flow in microvessels (parameters M1) were measured by the laser- speckle method. Simultaneously, diameters of lymph microvessels as well as parameters of phasic contractions and valve functioning were registered.

Solov'eva, Anastasiya V.; Brill, Grigory E.; Galanzha, Ekateryna I.; Ulyanov, Sergey S.; Tuchin, Valery V.; Stepanova, Tatyana V.; Sedykh, Alexey V.

2001-10-01

14

Pulmonary cryptococcosis presenting as wandering multiple bilateral shadows and hilar and mediastinal lymph node enlargement in the lungs.  

PubMed

We present a case of pulmonary cryptococcosis presenting as wandering multiple bilateral shadows and hilar and mediastinal lymph node enlargement in which the fluconazole treatment suppressed the symptoms. This case illustrates the complex nature of immunological responses in the lungs and highlights the need to consider the existence of cryptococcal allergies. PMID:24096908

Pan, Jiong-Wei; Zhang, Ning; Jin, Yuan-Hong; Ye, Zai-Ting; Ma, Miao-Qun; Cai, Xiao-Ping; Cao, Zhuo

2013-10-04

15

Plasma Appearance Rate of Intraperitoneal Macromolecular Tracer Underestimates Peritoneal Lymph Flow  

PubMed Central

The magnitude of peritoneal lymph flow is an issue of great controversy in peritoneal dialysis (PD) research. Because no single lymphatic duct drains the entire peritoneal cavity, peritoneal lymph flow is indirectly measured as lymphatic removal of intraperitoneal macromolecular tracer. In rats, the peritoneal clearance (K) of such a tracer is 5 times the approximately 8 ?L/min determined from the tracer appearance rate in blood (Cl). The fractional contribution of tissues bordering the peritoneal cavity to the overall Cl was determined to be diaphragm, 55%; viscera, 30%; and abdominal wall, 15%. The present study determines whether direct measurement of visceral peritoneal lymph flow matches the 30% (approximately 2.5 ?L/min) contribution of the visceral peritoneal lymph flow as measured indirectly by the Cl method. The mesenteric lymph duct that exclusively drains lymph from the gut, liver, and mesentery was cannulated in 15 rats, and lymph flow from the duct was collected at hourly intervals up to 6 hours under near-normal physiologic conditions and under conditions of simulated PD. Changes in mesenteric lymph flow that resulted from a challenge with 3 mL intravenous saline were captured using real-time video. We observed no significant differences between the hourly lymph volumes collected over 6 hours in naďve animals (n = 5, p > 0.05). Under conditions of simulated PD with dialysis fluid in the peritoneal cavity, the mesenteric duct lymph flow averaged 8.67 ± 1.41 ?L/min (n = 10). That flow is similar to reported data on total peritoneal Cl in rats; and 4 times the 2.5 ?L/min visceral peritoneal contribution to the total peritoneal Cl. The intravenous saline challenge significantly increased mesenteric lymph duct output to 30.9 ± 1.6 ?L/min (n = 5, p < 0.01) and reduced the lymph-to-plasma concentration ratio (L/P) by 43%. The reflection coefficient for total proteins (?prot) across the intestinal capillaries as calculated from the filtration rate–dependent L/P ratio when the transcapillary fluid escape rate and the mesenteric lymph flow were both high was more than 0.87. We concluded that (A) under near-normal physiologic conditions, the mesenteric lymph duct flow is steady, but quite low; (B) under conditions of simulated PD, the mesenteric lymph duct flow increases significantly from the physiologic norm; (C) mesenteric lymph duct flow is sensitive to the peritoneal fill volume; (D) during simulated PD, the fractional visceral peritoneal lymph flow measured indirectly from plasma appearance of intraperitoneal tracer underestimates the directly measured mesenteric duct lymph flow; and (E) the increased transcapillary fluid escape rate is rapidly buffered by augmentation of mesenteric lymph duct output.

Rasheid Zakaria, El; Mays, Chester J.; Matheson, Paul J.; Hurt, Ryan T.; Garrison, Richard N.

2008-01-01

16

Measurement of Pulmonary Flow Reserve and Pulmonary Index of Microcirculatory Resistance for Detection of Pulmonary Microvascular Obstruction  

Microsoft Academic Search

BackgroundThe pulmonary microcirculation is the chief regulatory site for resistance in the pulmonary circuit. Despite pulmonary microvascular dysfunction being implicated in the pathogenesis of several pulmonary vascular conditions, there are currently no techniques for the specific assessment of pulmonary microvascular integrity in humans. Peak hyperemic flow assessment using thermodilution-derived mean transit-time (Tmn) facilitate accurate coronary microcirculatory evaluation, but remain unvalidated

Rahn Ilsar; Chirapan Chawantanpipat; Kim H. Chan; Timothy A. Dobbins; Richard Waugh; Annemarie Hennessy; David S. Celermajer; Martin K. C. Ng; Jose A. L. Calbet

2010-01-01

17

Altered lymphatics in an ovine model of congenital heart disease with increased pulmonary blood flow.  

PubMed

Abnormalities of the lymphatic circulation are well recognized in patients with congenital heart defects. However, it is not known how the associated abnormal blood flow patterns, such as increased pulmonary blood flow (PBF), might affect pulmonary lymphatic function and structure. Using well-established ovine models of acute and chronic increases in PBF, we cannulated the efferent lymphatic duct of the caudal mediastinal node and collected and analyzed lymph effluent from the lungs of lambs with acutely increased PBF (n = 6), chronically increased PBF (n = 6), and age-matched normal lambs (n = 8). When normalized to PBF, we found that lymph flow was unchanged following acute increases in PBF but decreased following chronic increases in PBF. The lymph:plasma protein ratio decreased with both acute and chronic increases in PBF. Lymph bioavailable nitric oxide increased following acute increases in PBF but decreased following chronic increases in PBF. In addition, we found perturbations in the transit kinetics of contrast material through the pleural lymphatics of lambs with chronic increases in PBF. Finally, there were structural changes in the pulmonary lymphatic system in lambs with chronic increases in PBF: lymphatics from these lambs were larger and more dilated, and there were alterations in the expression of vascular endothelial growth factor-C, lymphatic vessel endothelial hyaluronan receptor-1, and Angiopoietin-2, proteins known to be important for lymphatic growth, development, and remodeling. Taken together these data suggest that chronic increases in PBF lead to both functional and structural aberrations of lung lymphatics. These findings have important therapeutic implications that warrant further study. PMID:22207591

Datar, Sanjeev A; Johnson, Eric G; Oishi, Peter E; Johengen, Michael; Tang, Eric; Aramburo, Angela; Barton, Jubilee; Kuo, Hsuan-Chang; Bennett, Stephen; Xoinis, Konstantine; Reel, Bhupinder; Kalkan, Gokhan; Sajti, Eniko; Osorio, Oscar; Raff, Gary W; Matthay, Michael A; Fineman, Jeffrey R

2011-12-29

18

Altered lymphatics in an ovine model of congenital heart disease with increased pulmonary blood flow  

PubMed Central

Abnormalities of the lymphatic circulation are well recognized in patients with congenital heart defects. However, it is not known how the associated abnormal blood flow patterns, such as increased pulmonary blood flow (PBF), might affect pulmonary lymphatic function and structure. Using well-established ovine models of acute and chronic increases in PBF, we cannulated the efferent lymphatic duct of the caudal mediastinal node and collected and analyzed lymph effluent from the lungs of lambs with acutely increased PBF (n = 6), chronically increased PBF (n = 6), and age-matched normal lambs (n = 8). When normalized to PBF, we found that lymph flow was unchanged following acute increases in PBF but decreased following chronic increases in PBF. The lymph:plasma protein ratio decreased with both acute and chronic increases in PBF. Lymph bioavailable nitric oxide increased following acute increases in PBF but decreased following chronic increases in PBF. In addition, we found perturbations in the transit kinetics of contrast material through the pleural lymphatics of lambs with chronic increases in PBF. Finally, there were structural changes in the pulmonary lymphatic system in lambs with chronic increases in PBF: lymphatics from these lambs were larger and more dilated, and there were alterations in the expression of vascular endothelial growth factor-C, lymphatic vessel endothelial hyaluronan receptor-1, and Angiopoietin-2, proteins known to be important for lymphatic growth, development, and remodeling. Taken together these data suggest that chronic increases in PBF lead to both functional and structural aberrations of lung lymphatics. These findings have important therapeutic implications that warrant further study.

Datar, Sanjeev A.; Johnson, Eric G.; Oishi, Peter E.; Johengen, Michael; Tang, Eric; Aramburo, Angela; Barton, Jubilee; Kuo, Hsuan-Chang; Bennett, Stephen; Xoinis, Konstantine; Reel, Bhupinder; Kalkan, Gokhan; Sajti, Eniko; Osorio, Oscar; Raff, Gary W.; Matthay, Michael A.

2012-01-01

19

The effects of catecholamines and adrenoceptor blocking drugs on the canine peripheral lymph flow.  

PubMed Central

Blood flow through the femoral artery, lymph flow in a lymphatic vessel in the femoral triangle and metatarsal distal venous pressure were measured simultaneously in a canine moving hind limb. 2. Low intra-arterial doses of adrenaline and noradrenaline increased lymph flow even in the presence of marked arterial vasoconstriction. In contrast, isoprenaline increased arterial blood flow without affecting lymph flow rate. 3. Phenoxybenzamine, dihydroergotoxine, and nicergoline did not inhibit the lymphatic flow increase induced by adrenaline at doses active on arterial or venous vascular alpha-adrenoceptors. 4. Propranolol given intra-arterially into animals pretreated with alpha-adrenoceptor blocking agents restored the vasoconstrictor effect of adrenaline (reversal of adrenaline reversal).

De Micheli, P; Glasser, A H

1975-01-01

20

Mechanism of pulmonary venous pressure and flow waves  

Microsoft Academic Search

Summary  The pulmonary venous systolic flow wave has been attributed both to left heart phenomena, such as left atrial relaxation and\\u000a descent of the mitral annulus, and to propagation of the pulmonary artery pressure pulse through the pulmonary bed from the\\u000a right ventricle. In this study we hypothesized that all waves in the pulmonary veins originate in the left heart, and

L. R. Hellevik; P. Segers; N. Stergiopulos; F. Irgens; P. Verdonck; C. R. Thompson; K. Lo; R. T. Miyagishima; O. A. Smiseth

1999-01-01

21

Inhibition of the active lymph pump by flow in rat mesenteric lymphatics and thoracic duct  

PubMed Central

There are only a few reports of the influence of imposed flow on an active lymph pump under conditions of controlled intraluminal pressure. Thus, the mechanisms are not clearly defined. Rat mesenteric lymphatics and thoracic ducts were isolated, cannulated and pressurized. Input and output pressures were adjusted to impose various flows. Lymphatic systolic and diastolic diameters were measured and used to determine contraction frequency and pump flow indices. Imposed flow inhibited the active lymph pump in both mesenteric lymphatics and in the thoracic duct. The active pump of the thoracic duct appeared more sensitive to flow than did the active pump of the mesenteric lymphatics. Imposed flow reduced the frequency and amplitude of the contractions and accordingly the active pump flow. Flow-induced inhibition of the active lymph pump followed two temporal patterns. The first pattern was a rapidly developing inhibition of contraction frequency. Upon imposition of flow, the contraction frequency immediately fell and then partially recovered over time during continued flow. This effect was dependent on the magnitude of imposed flow, but did not depend on the direction of flow. The effect also depended upon the rate of change in the direction of flow. The second pattern was a slowly developing reduction of the amplitude of the lymphatic contractions, which increased over time during continued flow. The inhibition of contraction amplitude was dependent on the direction of the imposed flow, but independent of the magnitude of flow. Nitric oxide was partly but not completely responsible for the influence of flow on the mesenteric lymph pump. Exposure to NO mimicked the effects of flow, and inhibition of the NO synthase by NG-monomethyl-l-arginine attenuated but did not completely abolish the effects of flow.

Gashev, Anatoliy A; Davis, Michael J; Zawieja, David C

2002-01-01

22

Comparison of lymph and blood flow in microvessels: coherent optical measurements  

NASA Astrophysics Data System (ADS)

In the present study the characteristics of blood and lymph microcirculation are investigated. The microcirculation was studied on small intestine mesentery in norm and during NG-notro-L-arginine (L- NNA) application. The direct measurement of lymph flow velocity (parameter V) in individual microvessels was based on the technique of light intravital videomicroscopy. The first spectral moments of Doppler signal characterizing the mean velocities of lymph and blood flow in microvessels (parameters M1L and M1B) were measured by speckle- interferometrical method. Simultaneously, diameters of blood and lymph microvessels as well as parameters of phasic contractions and valve function of lymphatics were registered. The mean diamters of investigated lymphatics and venules were 170+/- 20 micrometers and 8+/- 0.5 micrometers , correspondingly. In 24% of lymph microvessels phasic contractions were observed. The mean flow velocity in blood microvessels was 10 times more than the one in lymphatics. L-NNA application led to variable effects on diameter of lymphatics, increased the number of microvessels with phasic contractions and modified parameters of these contractions. The mean velocity of lymph flow (V) was increased. The mean value of M1L was not changed; the M1L maximum in 75% of the lymphatics was increased. In 88% of venules M1B was decreased on 25+/- 7%.

Galanzha, Ekateryna I.; Ulyanov, Sergey S.; Tuchin, Valery V.; Brill, Grigory E.; Solov'eva, Anastasiya V.; Sedykh, Alexey V.

2000-11-01

23

The flow and lipoid composition of thoracic duct lymph in the grazing cow  

PubMed Central

1. A technique is described for the collection of thoracic duct lymph from the grazing cow. 2. The effects of continuing drainage of lymph were overcome by establishing an exteriorized lymphatico-venous shunt from which lymph and blood samples were obtained when required. The shunt functioned satisfactorily for periods of 10, 14 and 28 days in the three cows. 3. The rate of lymph flow and concentration of lipids in the lymph were low during and immediately after the operation. Higher sustained levels of flow of 1·37 ± 0·43 (S.D.), 1·88 ± 0·40 (S.D.) and 1·90 ± 0·45 (S.D.) 1./hr, for the dry and two lactating cows respectively, were observed during the period 3-9 days after the operation. 4. More than 200% of the volume and 100% of the protein of the blood plasma compartment passed through the thoracic duct each day. 5. Chlyomicron triglyceride comprised 50-70% and phospholipid 20% of the total lipid in lymph. 6. The results indicated that at least 200 and 400 g of esterified fatty acid were transported daily in the lymph of the dry and lactating cows respectively.

Hartmann, P. E.; Lascelles, A. K.

1966-01-01

24

Isolation of human skin-derived lymph: flow and output of cells following sodium lauryl sulphate-induced contact dermatitis  

Microsoft Academic Search

By means of microsugery a peripheral subcutaneous lymph vessel draining a defined skin area was isolated and cannulated on the lower leg of six healthy volunteers. Lymph was collected over a period of 8 days. During the first 2 days baseline values for lymph flow and output of cells were established. A contact dermatitis was then induced in the drained

C. U. Brand; T. Hunziker; L. R. Braathen

1992-01-01

25

Lagrangian transport properties of pulmonary interfacial flows.  

PubMed

Disease states characterized by airway fluid occlusion and pulmonary surfactant insufficiency, such as respiratory distress syndrome, have a high mortality rate. Understanding the mechanics of airway reopening, particularly involving surfactant transport, may provide an avenue to increase patient survival via optimized mechanical ventilation waveforms. We model the occluded airway as a liquid-filled rigid tube with the fluid phase displaced by a finger of air that propagates with both mean and sinusoidal velocity components. Finite-time Lyapunov exponent (FTLE) fields are employed to analyse the convective transport characteristics, taking note of Lagrangian coherent structures (LCSs) and their effects on transport. The Lagrangian perspective of these techniques reveals flow characteristics that are not readily apparent by observing Eulerian measures. These analysis techniques are applied to surfactant-free velocity fields determined computationally, with the boundary element method, and measured experimentally with micro particle image velocimetry (?-PIV). We find that the LCS divides the fluid into two regimes, one advected upstream (into the thin residual film) and the other downstream ahead of the advancing bubble. At higher oscillatory frequencies particles originating immediately inside the LCS experience long residence times at the air-liquid interface, which may be conducive to surfactant transport. At high frequencies a well-mixed attractor region is identified; this volume of fluid cyclically travels along the interface and into the bulk fluid. The Lagrangian analysis is applied to velocity data measured with 0.01 mg ml(-1) of the clinical pulmonary surfactant Infasurf in the bulk fluid, demonstrating flow field modifications with respect to the surfactant-free system that were not visible in the Eulerian frame. PMID:23049141

Smith, Bradford J; Lukens, Sarah; Yamaguchi, Eiichiro; Gaver, Donald P

2011-11-01

26

Size-dependent uptake of particles by pulmonary antigen-presenting cell populations and trafficking to regional lymph nodes.  

PubMed

The respiratory tract is an attractive target organ for novel diagnostic and therapeutic applications with nano-sized carriers, but their immune effects and interactions with key resident antigen-presenting cells (APCs) such as dendritic cells (DCs) and alveolar macrophages (AMs) in different anatomical compartments remain poorly understood. Polystyrene particles ranging from 20 nm to 1,000 nm were instilled intranasally in BALB/c mice, and their interactions with APC populations in airways, lung parenchyma, and lung-draining lymph nodes (LDLNs) were examined after 2 and 24 hours by flow cytometry and confocal microscopy. In the main conducting airways and lung parenchyma, DC subpopulations preferentially captured 20-nm particles, compared with 1,000-nm particles that were transported to the LDLNs by migratory CD11blow DCs and that were observed in close proximity to CD3? T cells. Generally, the uptake of particles increased the expression of CD40 and CD86 in all DC populations, independent of particle size, whereas 20-nm particles induced enhanced antigen presentation to CD4? T cells in LDLNs in vivo. Despite measurable uptake by DCs, the majority of particles were taken up by AMs, irrespective of size. Confocal microscopy and FACS analysis showed few particles in the main conducting airways, but a homogeneous distribution of all particle sizes was evident in the lung parenchyma, mostly confined to AMs. Particulate size as a key parameter determining uptake and trafficking therefore determines the fate of inhaled particulates, and this may have important consequences in the development of novel carriers for pulmonary diagnostic or therapeutic applications. PMID:23492193

Blank, Fabian; Stumbles, Philip A; Seydoux, Emilie; Holt, Patrick G; Fink, Alke; Rothen-Rutishauser, Barbara; Strickland, Deborah H; von Garnier, Christophe

2013-07-01

27

Coanda effect on ductal flow in the pulmonary artery.  

PubMed

The Coanda effect (the tendency of a jet stream to adhere to a boundary wall), and the relevant anatomy, may explain the location of ductal jets within the main pulmonary artery. With the usual insertion of the duct close to the left pulmonary artery, during right ventricular ejection, the ductal jet adheres to the left wall of the main pulmonary artery. When right ventricular ejection is absent in pulmonary atresia, the ductal jet streams down the right wall of the pulmonary artery to the pulmonary valve, reverses, and maintains a parallel column back toward the bifurcation. If the reversed flow is mistaken for ejection from the right ventricle, the diagnosis of pulmonary atresia may be missed. PMID:10082354

Guntheroth, W; Miyaki-Hull, C

1999-03-01

28

Endogenous hydrogen sulfide regulates pulmonary artery collagen remodeling in rats with high pulmonary blood flow.  

PubMed

The mechanisms responsible for the structural remodeling of pulmonary vasculature induced by increased pulmonary blood flow are not fully understood. This study explores the effect of endogenous hydrogen sulfide (H2S), a novel gasotransmitter, on collagen remodeling of the pulmonary artery in rats with high pulmonary blood flow. Thirty-two Sprague-Dawley rats were randomly divided into sham, shunt, sham+PPG (D,L-propargylglycine, an inhibitor of cystathionine-gamma-lyase), and shunt+PPG groups. After 4 weeks of shunting, the relative medial thickness (RMT) of pulmonary arteries and H2S concentration in lung tissues were investigated. Collagen I and collagen III were evaluated by hydroxyproline assay, sirius-red staining, and immunohistochemistry. Pulmonary artery matrix metalloproteinase-13 (MMP-13), tissue inhibitor of metalloproteinase-1 (TIMP-1), and connective tissue growth factor (CTGF) were evaluated by immunohistochemistry. After 4 weeks of aortocaval shunting, resulting in an elevation of lung tissue H2S to 116.4%, rats exhibited collagen remodeling and increased CTGF expression in the pulmonary arteries. Compared with those of the shunt group, lung tissue H2S production was lowered by 23.4%, RMT of the pulmonary artery further increased by 39.5%, pulmonary artery collagen accumulation became obvious, and pulmonary artery CTGF expression elevated (P<0.01) in the shunted rats treated with PPG. However, pulmonary artery MMP-13 and TIMP-1 expressions decreased significantly in rats of shunt+PPG group (P<0.01). This study suggests that endogenous H2S exerts an important regulatory effect on pulmonary collagen remodeling induced by high pulmonary blood flow. PMID:19234054

Li, Xiaohui; Jin, Hongfang; Bin, Geng; Wang, Li; Tang, Chaoshu; Du, Junbao

2009-02-20

29

Determination of Pulmonary Parenchymal Tissue Volume and Pulmonary Capillary Blood Flow by a Partial Rebreathing Technique.  

National Technical Information Service (NTIS)

A new method is reported on measuring pulmonary tissue volume and pulmonary blood flow volume by means of partial rebreathing technique using a mass spectrometer. This technique is an altered method of Cander and others' technique, and according to the fo...

O. Nishida

1971-01-01

30

Recording of lymph flow dynamics in microvessels using correlation properties of scattered coherent radiation  

SciTech Connect

The direction-sensitive method of microflow velocity measurements based on the space - time correlation properties of the dynamic speckle field is described and used for in vivo monitoring of lymph flow in the vessels of rat mesentery. The results of measurements are compared with the data obtained from functional video microscopy of the microvessel region. (laser biology and medicine)

Fedosov, I V; Tuchin, Valerii V; Galanzha, E I [N.G. Chernyshevskii Saratov State University, Saratov (Russian Federation); Solov'eva, A V; Stepanova, T V [Saratov State Medical University, Saratov (Russian Federation)

2002-11-30

31

Adverse pacemaker hemodynamics evaluated by pulmonary venous flow monitoring.  

PubMed

The pacemaker syndrome refers to symptoms and signs in the pacemaker patient caused by an inadequate timing of atrial and ventricular contractions. The lack of normal atrioventricular synchrony may result in a decreased cardiac output and venous cannon A waves. The objective of this study was to define the left atrial and pulmonary venous flow response to ventricular pacing in a group of 14 unselected consecutive patients with total heart block and sinus rhythm. Pulmonary venous flow was assessed by transesophageal pulsed Doppler echocardiography in the VVI and DDD pacing modes. An inappropriate atrial timing caused a marked augmentation of the normally small pulmonary venous z wave in all patients ("negative atrial kick," peak z wave in DDD pacing 14.5 +/- 4.6 cm/s, VVI pacing 51.8 +/- 15.0 cm/s). Restoration of AV synchrony (DDD pacing, AV interval 100 ms) abolished these "cannon z waves" in all patients, and a normal pattern of pulmonary venous flow was achieved. Abnormal pulmonary venous flow characteristics were observed in 2 of 14 patients during DDD pacing with short AV intervals (100 ms). The Doppler pattern was similar to the findings seen in VVI pacing. Assessment of pulmonary venous flow by transesophageal pulsed Doppler echocardiography may provide a simple, sensitive, and relatively noninvasive technique to evaluate patients with suspected pacing induced adverse hemodynamics. PMID:8552517

Stierle, U; Krüger, D; Mitusch, R; Potratz, J; Taubert, G; Sheikhzadeh, A

1995-11-01

32

The measurement of skin lymph flow by isotope clearance--reliability, reproducibility, injection dynamics, and the effect of massage.  

PubMed

The measurement of skin lymph flow was investigated using an isotope clearance technique (ICT). Multiple lymph flow determinations were undertaken in the skin of anaesthetized large white pigs to test for reproducibility, ascertain the most suitable tracer, study the influence of injection dynamics, and observe the effect of massage as a stimulus to lymph flow. Blood clearance of tracer was also investigated. Results demonstrated that lymphatic clearance is a monoexponential function with good reproducibility under controlled laboratory conditions. 99mTc-colloid (TCK17 Cis) compared favorably with 131I-human serum albumin as a tracer and both performed better than colloid gold (198Au). Lymph flow was significantly faster in one pig than in the other. No difference existed between left and right sides or between caudal and rostral sites on each flank, but clearance was significantly slower in thigh than flank skin. Sub-epidermal injections cleared faster and more consistently than either deep or subcutaneous injections. Neither injection volume nor needle tract backflow of tracer influenced results, but local massage significantly enhanced clearance. Escape of 99mTc-colloid by the blood was negligible. These results indicate that skin lymph flow can be reliably measured when conditions are controlled. Extrinsic factors such as massage strongly influence lymph flow. Greater sensitivity in detecting degrees of lymphatic insufficiency may be achieved if a standardized stimulus to lymph flow is administered during isotope clearance measurement. PMID:2250109

Mortimer, P S; Simmonds, R; Rezvani, M; Robbins, M; Hopewell, J W; Ryan, T J

1990-12-01

33

Feasibility of Computed Tomography Pulmonary Angiography with Low Flow Rates  

PubMed Central

Computed tomography pulmonary angiography (CTPA) is the imaging test of choice in suspected pulmonary embolism. High flow rates for the administration of contrast medium are recommended, but these cannot be achieved in a number of patients due to poor peripheral venous access or when using certain central venous catheters. This small feasibility study has examined the CTPA data in a set of 22 patients in whom contrast medium was given at low flow rates (2.0 or 2.5 mL/s). Subjectively, all but one of the patients was judged to be diagnostic. Objectively, enhancement values ?200 HU were reached in 92% of the examined central vessels (pulmonary trunk, main pulmonary arteries, and lobar arteries). In conclusion, even with a low injection rate CTPA is of diagnostic value in most patients.

Gossner, J.

2012-01-01

34

Effects of Pathological Flow on Pulmonary Artery Endothelial Production of Vasoactive Mediators and Growth Factors  

Microsoft Academic Search

Background: Alterations in pulmonary blood flow are often associated with the initiation and progression of pulmonary vascular disease. However, the cellular mechanisms involved in mediating flow effects in the pulmonary circulation remain unclear. Depending on the disease condition, flow may be extremely low or high. We therefore examined effects of pathologically low and high flow on endothelial production of factors

Min Li; Kurt R. Stenmark; Robin Shandas; Wei Tan

2009-01-01

35

Regional pulmonary blood flow in the lung of the chicken.  

PubMed

It is known that alterations in respiratory gases in birds can cause a nonhomogenous redistribution of pulmonary blood flow between the 2 separate gas-exchanging regions of the avian lung, the paleopulmo (PALEO) and neopulmo (NEO); however, the effect of alterations in respired gas content on the distribution of pulmonary blood flow in birds, such as the chicken, that possess a highly developed NEO is not known. This study used a colorimetric microsphere method to determine the effects of hypoxia and hypercapnia on the relative distribution of pulmonary blood flow in anesthetized chickens (Gallus domesticus) during control (normoxic) and experimental (hypoxic or hypercapnic) conditions, where the relative regional distribution of blood flow in the lung is expressed as the ratio NEO/PALEO. Administration of a hypoxic gas mixture (16.0% O(2)) produced a 13.4% increase in NEO/PALEO, and, administration of a hypercapnic gas mixture (5.0% CO(2)) resulted in a 27.8% increase in NEO/PALEO. Our results are consistent with a mechanism in which the regional redistribution of pulmonary blood flow is mediated by local intrapulmonary factors. PMID:22582305

Weidner, W J; Bradbury, C A; Le, S P; Wallace, S R

2012-06-01

36

Photothermal imaging of moving cells in lymph and blood flow in vivo  

NASA Astrophysics Data System (ADS)

The in vivo capabilities of a new, integrated optical system for studying lymph and blood flow were explored, including imaging of moving red and white blood cells. This system combined transmission microscopy with different dual-beam photothermal (PT) techniques, such as PT imaging, PT thermolens method, and PT deflection velocimetry. All of these PT techniques are based on irradiation of rat mesenteric microvessels with a short laser pulse and on detection of temperature-dependent variations of the refractive index with a second, probe laser beam. In general, the concept of in vivo PT flow cytometry was developed, with a focus on real-time monitoring of moving blood cells in their natural states without labeling (e.g., fluorescent), including obtaining PT images of the cells and determining their flow velocity and response to different interventions. Preliminary experiments revealed many potential applications of this integrated system: (1) quantitation of lymph and blood flow without probes; (2) imaging of moving red and white blood cells; (3) visualization and tracking of PT nanoprobes and sensitizers; (4) comparison of laser-tissue interactions in vivo and in vitro, especially optimization of laser treatment of vascular lesions (port-wine stains, lymphatic malformations, etc.); and (5) determination of the link between in vitro and in vivo cytotoxicity studies.

Zharov, Vladimir P.; Galanzha, Ekaterina I.; Tuchin, Valery V.

2004-07-01

37

Computational predictions of pulmonary blood flow gradients: gravity versus structure.  

PubMed

A computational model of blood flow through the human pulmonary arterial tree has been developed to investigate the mechanisms contributing to regional pulmonary perfusion in the isolated network when the lung is in different orientations. The arterial geometric model was constructed using a combination of computed tomography and a volume-filling branching algorithm. Equations governing conservation of mass, momentum, and vessel distension, incorporating gravity, were solved to predict pressure, flow, and vessel radius. Analysis of results in the upright posture, with and without gravity, and in the inverted, prone, and supine postures reveals significant flow heterogeneity and a persistent decrease in flow in the cranial and caudal regions for all postures suggesting that vascular geometry makes a major contribution to regional flow with gravity having a lesser role. Results in the isolated arterial tree demonstrate that the vascular path lengths and therefore the positioning of the pulmonary trunk relative to the rest of the network play a significant role in the determination of flow. PMID:16386472

Burrowes, Kelly S; Tawhai, Merryn H

2005-12-28

38

[Pressure-flow relationships interpretation in idiophatic pulmonary arterial hypertension.  

PubMed

Objectives: We analyze exercise-derived mean pulmonary artery pressure/cardiac index relationship to expand the concepts regarding its nature and to better identify "responders" in idiopathic pulmonary arterial hypertension patients. Methods: Mean pulmonary artery pressure/cardiac index relationship and extrapolated presure to zero flow were obtained in 40 patients' breathing room air, oxygen 99.5% and hydralazine. The emodynamic characteristics were analyzed for the cohort and separate for responders (n = 20) and non responders (n = 20) according to the acute response to vasodilator. We tested this previous criteria versus the Task Force on diagnosis and treatment prescribed by the European Society of Cardiology. Results: The mean pulmonary arterial pressure-flow diagram of the total cohort (p < 0.01). No alterations in gas exchange or lung mechanics. For patients responders versus non-responders, the slope was abnormal 2.2(95%CI: 1.1-3.3) vs 5.89 (95% CI: 4.69 - 7.11), mmHg/L min/m2 and increased extrapolated presure to zero flow (38.2 + 7.5 to 66.3 + 7.5 mmHg, p < 0.01). Without difference with oxygen 99.5%. With vasodilator effect, mean pulmonary arterial pressure decreased (52.1+9.5 a 40 + 5.5 mm Hg, p< 0.01) versus it did not change (96.2 + 8.5 vs 90 + 7.5 mmHg, p = 0.3), slope 1.15 (95% CI: 0.68 - 1.62) vs. 1.28 (95% CI: 0.78-1.78) mmHg/L min/m2, the extrapolated pressure to zero flow did not change (69.4 + 7.8 a 85.1 + 8.5 mmHg), p < 0.01 compared to control. In non-responders with vasodilator, mean pulmonary arterial pressure/cardiac index (90 + 7.5 mmHg, pendiente: 1.28, 95%IC: 0.78 - 1.78 mmHg/L min/m2) was different between responders 40 mm Hg mean pulmonary arterial pressure. Pressure were 34 + 3 vs 45 + 4mmHg and slopes 1.14 (95%IC: 0.67 - 1.61 vs 2.22 (95%IC: 1.35 - 3.09 mm Hg/L min/m2) p < 0.01 respectively. Conclusions: Abnormalities of the mean pulmonary arterial pressure/cardiac index relationship exercise-derived seems to reflect "mainly arteriolar" increased lineal pulmonary vascular resistance in idiopathic pulmonary arterial hypertension patients. Both acute vasodilator response criteria are useful to identify responders and not responders in this patient population. PMID:21147582

Lupi-Herrera, Eulo; Santos-Martínez, Luis Efren; Pulido, Tomás; Sandoval, Julio

39

LASER BIOLOGY AND MEDICINE: Recording of lymph flow dynamics in microvessels using correlation properties of scattered coherent radiation  

NASA Astrophysics Data System (ADS)

The direction-sensitive method of microflow velocity measurements based on the space — time correlation properties of the dynamic speckle field is described and used for in vivo monitoring of lymph flow in the vessels of rat mesentery. The results of measurements are compared with the data obtained from functional video microscopy of the microvessel region.

Fedosov, I. V.; Tuchin, Valerii V.; Galanzha, E. I.; Solov'eva, A. V.; Stepanova, T. V.

2002-11-01

40

A comparative study of frozen-section immunoperoxidase and flow cytometry for immunophenotypic analysis of lymph node biopsies.  

PubMed Central

Immunophenotyping by flow cytometry and frozen-section immunoperoxidase was compared on 21 consecutive lymph node biopsy specimens, of which a diagnosis of lymphoma was made for 11 specimens. Samples for flow cytometry were obtained by a fine-needle aspiration technique. Concordance between frozen-section immunoperoxidase and flow cytometry for all routine markers on all specimens ranged from 76 to 100%. In general, B-cell markers showed poorer concordance than T-cell markers, with kappa and lambda light chains having the poorest concordance, at 76% each. Flow cytometry was significantly more sensitive (90 versus 30%; P < 0.006) and had a significantly higher negative predictive value (100 versus 63%; P < 0.006) than frozen-section immunoperoxidase for demonstrating light-chain restriction. There was no significant difference in the specificities (100 versus 91%) or positive predictive values (100% each) between the two methods. Both methods demonstrated characteristic immunophenotypes for intermediate cell lymphomas, small lymphocytic lymphomas, and T-cell lymphoblastic lymphomas. Frozen-section immunoperoxidase and flow cytometry appear to be significantly concordant methods for immunophenotypic analysis of lymph node biopsies. Light-chain restriction is more readily demonstrated by flow cytometry than frozen-section immunoperoxidase. We believe that ex vivo fine-needle aspiration is a simple and reliable method of obtaining cell suspensions of lymph nodes for flow cytometry.

Biesemier, K W; Dent, G A; Pryzwansky, K B; Folds, J D

1994-01-01

41

The influence of atrioventricular conduction and heart rate on the pulmonary venous flow pattern  

Microsoft Academic Search

The pulmonary venous flow (PVQ) pattern usually has two antegrade flow waves, corresponding to ventricular systole and diastole, respectively, and is used to assess left atrial pressure. To study the effects of atrioventricular conduction (AVD) and heart rate (HR) on the PVQ pattern, transthoracic pulsed Doppler recordings of pulmonary venous, transmitral, and aortic flow were made in five healthy subjects

Torkel Steen; Erik Kongsgaard; Einar Sřyland; Halfdan Ihlen

1996-01-01

42

D6 facilitates cellular migration and fluid flow to lymph nodes by suppressing lymphatic congestion.  

PubMed

Lymphatic endothelial cells are important for efficient flow of antigen-bearing fluid and antigen-presenting cells (APCs) from peripheral sites to lymph nodes (LNs). APC movement to LNs is dependent on the constitutive chemokine receptor CCR7, although how conflicting inflammatory and constitutive chemokine cues are integrated at lymphatic surfaces during this process is not understood. Here we reveal a previously unrecognized aspect of the regulation of this process. The D6 chemokine-scavenging receptor, which is expressed on lymphatic endothelial cells (LECs), maintains lymphatic surfaces free of inflammatory CC-chemokines and minimizes interaction of inflammatory leukocytes with these surfaces. D6 does not alter the level of CCR7 ligands on LECs, thus ensuring selective presentation of homeostatic chemokines for interaction with CCR7(+) APCs. Accordingly, in D6-deficient mice, inflammatory CC-chemokine adherence to LECs results in inappropriate perilymphatic accumulation of inflammatory leukocytes at peripheral inflamed sites and draining LNs. This results in lymphatic congestion and impaired movement of APCs, and fluid, from inflamed sites to LNs. We propose that D6, by suppressing inflammatory chemokine binding to lymphatic surfaces, and thereby preventing inappropriate inflammatory leukocyte adherence, is a key regulator of lymphatic function and a novel, and indispensable, contributor to the integration of innate and adaptive immune responses. PMID:21979941

Lee, Kit Ming; McKimmie, Clive S; Gilchrist, Derek S; Pallas, Kenneth J; Nibbs, Robert J; Garside, Paul; McDonald, Victoria; Jenkins, Christopher; Ransohoff, Richard; Liu, Liping; Milling, Simon; Cerovic, Vuk; Graham, Gerard J

2011-10-06

43

D6 facilitates cellular migration and fluid flow to lymph nodes by suppressing lymphatic congestion  

PubMed Central

Lymphatic endothelial cells are important for efficient flow of antigen-bearing fluid and antigen-presenting cells (APCs) from peripheral sites to lymph nodes (LNs). APC movement to LNs is dependent on the constitutive chemokine receptor CCR7, although how conflicting inflammatory and constitutive chemokine cues are integrated at lymphatic surfaces during this process is not understood. Here we reveal a previously unrecognized aspect of the regulation of this process. The D6 chemokine-scavenging receptor, which is expressed on lymphatic endothelial cells (LECs), maintains lymphatic surfaces free of inflammatory CC-chemokines and minimizes interaction of inflammatory leukocytes with these surfaces. D6 does not alter the level of CCR7 ligands on LECs, thus ensuring selective presentation of homeostatic chemokines for interaction with CCR7+ APCs. Accordingly, in D6-deficient mice, inflammatory CC-chemokine adherence to LECs results in inappropriate perilymphatic accumulation of inflammatory leukocytes at peripheral inflamed sites and draining LNs. This results in lymphatic congestion and impaired movement of APCs, and fluid, from inflamed sites to LNs. We propose that D6, by suppressing inflammatory chemokine binding to lymphatic surfaces, and thereby preventing inappropriate inflammatory leukocyte adherence, is a key regulator of lymphatic function and a novel, and indispensable, contributor to the integration of innate and adaptive immune responses.

Lee, Kit Ming; McKimmie, Clive S.; Gilchrist, Derek S.; Pallas, Kenneth J.; Nibbs, Robert J.; Garside, Paul; McDonald, Victoria; Jenkins, Christopher; Ransohoff, Richard; Liu, LiPing; Milling, Simon; Cerovic, Vuk

2011-01-01

44

EFFECTS OF PATHOLOGIC FLOW ON PULMONARY ARTERY ENDOTHELIAL PRODUCTION OF VASOACTIVE MEDIATORS AND GROWTH FACTORS  

PubMed Central

Background Alterations in pulmonary blood flow are often associated with the initiation and progression of pulmonary vascular disease. However, the cellular mechanisms involved in mediating flow effects in the pulmonary circulation remain unclear. Depending on the disease condition flow may be extremely low or high. We therefore examined effects of pathologically low and high flow on endothelial production of factors capable of affecting pulmonary vascular tone and structure and on potential underlying mechanisms. Methods Flow effects on pulmonary endothelial release of NO, PGF1a, ET-1 and TxB2, and on expression of total and phosphorylated eNOS and Akt, and VEGF were examined. Additionally, in a co-culture system, effects of flow-exposed endothelial cells on smooth muscle (SM) proliferation and contractile protein were studied. Results Compared to physiological flow, pathologically high and low flow attenuated endothelial release of NO, PGF1a, and enhanced release of ET-1. Physiological flow activated Akt/eNOS pathway while pathological flow depressed it. Pathologically high flow altered VE-cadherin expression. Pathologically high flow on the endothelium upregulated alpha-SM-actin and SM-MHC without affecting SM proliferation. Conclusion Physiological flow leads to production of mediators which favor vasodilation. Pathological flow alters the balance of mediator production which favors vasoconstriction.

Li, Min; Stenmark, Kurt R.; Shandas, Robin; Tan, Wei

2011-01-01

45

Generating a Pulsatile Pulmonary Flow after Fontan Operation by Means of Computational Fluid Dynamics (CFD)  

NASA Astrophysics Data System (ADS)

This study considers blood flow in total cavopulmonary connection (TCPC) morphology, which is created in Fontan surgical procedure in patients with single ventricle heart disease. Ordinary process of TCPC operation reduces pulmonary blood flow pulsatility; because of right ventricle being bypassed. This phenomenon causes a lot of side effects for patients. A cardiac surgeon has suggested that keeping main pulmonary artery (MPA) partially open, would increase pulmonary flow pulsations. MPA gets closed in ordinary TCPC operation. The purpose of current study is to verify the effects of keeping MPA partially open on pulmonary flow pulsations, by means of computational fluid dynamics (CFD). 3D geometry is reconstructed from CT Angiography (CTA) scan of a patient who has undergone an ordinary TCPC procedure. The stenosed MPA or pulmonary stenosis (PS) is virtually added to the original geometry. Flow field is studied in six different models in which average antegrade flow (AF) -coming through PS- increases gradually. Results show that adding AF increases flow pulsations in both pulmonary arteries. Moreover, power loss increases with respect to average AF. We conclude that adding AF is an impressive way to increase pulsations of pulmonary flow, but energy losses should be considered too.

Ghoreyshi, Mostafa

2011-03-01

46

Pulmonary angiography  

MedlinePLUS

The test is used to detect blood clots ( pulmonary embolism ) and other blockages in the blood flow in ... of pulmonary vessels Blood clot in the lungs (pulmonary embolism) Narrowed blood vessel Primary pulmonary hypertension Tumor in ...

47

Effects of a localized high-flow anastomosis between aorta and left lower lobe pulmonary artery on great vessel flow and pulmonary arterial reactivity in the contralateral lung  

PubMed Central

Objectives To assess effects of a localized anastomosis between the aorta and left lower lobe pulmonary artery (LLLPA) on flows through central vessels, and on vascular reactivity of small PAs distal or contralateral to the shunt. Methods Flow rates in major vessels and tensions from small PAs from left and right lower lobes were determined 48 hours after creation of an end-to-side anastomosis of the LLLPA to the aorta. Results Anastomoses increased flow through the LLLPA from 194 ± 6 to 452 ± 18 ml/min immediately after anastomosis and to 756 ± 19 ml/min by the time of harvest (n=88, p<0.05). Flow rates in main PAs from hosts with anastomoses were lower (557 ± 26 versus1033 ± 244 ml/min) while aortic root flows were not different from controls (1370 ± 53 compared to 1120 ± 111 ml/min; p = 0.07). Wet-to-dry weights of the both lungs and aortic flow rates were proportional to shunt flow rates. PA rings harvested from the right (unshunted) lobe of high flow hosts exhibited increased reactivity to the thromboxane agonist U46619 and phenylephrine relative to those of left PAs from the same animal or those of control hosts. Conclusions Our studies are the first to identify enhanced reactivity of PAs in a lung contralateral to a localized high output shunt between an aorta and pulmonary artery. These observations suggest that patients with localized systemic-to-pulmonary shunt could exhibit modified vascular tone in remote pulmonary arteries.

Somberg, Lewis; Nirula, Ram; Bousamra, Michael; Friesema, Jill; Zhu, Daling; Medhora, Meetha; Jacobs, Elizabeth R.

2010-01-01

48

Problems in cerebral blood flow calculation using xenon-133 in patients with pulmonary diseases  

SciTech Connect

We used the end-tidal concentration of xenon-133 (air curve) to estimate the profile of its arterial concentration in calculating cerebral blood flow. We examined the effects of pulmonary disease and artificial ventilation on the air curve and the calculated cerebral blood flow. We studied the relation between arterial and end-tidal xenon activities in 19 subjects, of whom 15 had pulmonary dysfunction. The t 1/2 of the declining phases of the arterial and air curves were used to express their shapes. The mean +/- SD reference t 1/2 from 15 normal volunteers was 26.8 +/- 8.4 seconds. The mean +/- SD t 1/2 s of the air and arterial curves from the 15 patients with pulmonary dysfunction were 10.4 +/- 2.9 and 33.8 +/- 10.9 seconds. The degree of pulmonary dysfunction (expressed as the pulmonary shunt percentage) correlated with distortion of the air curve. Substituting the arterial for the air curve, mean calculated cerebral blood flow (as the initial slope index) increased from 40 to 61 for the 12 patients with chronic obstructive pulmonary disease. The degree of underestimation of cerebral blood flow using the air curve correlated with the pulmonary shunt percentage. Our work confirms the problems of estimating cerebral blood flow in subjects with pulmonary dysfunction.

Hansen, M.; Jakobsen, M.; Enevoldsen, E.; Egede, F. (Odense Univ. Hospital (Denmark))

1990-05-01

49

Pulmonary rehabilitation program including respiratory conditioning for chronic obstructive pulmonary disease (COPD): Improved hyperinflation and expiratory flow during tidal breathing  

PubMed Central

Background Pulmonary rehabilitation has generally relieved symptoms, strengthened exercise endurance and improved health-related quality of life (QOL) in patients with COPD, but recovery of pulmonary function remains questionable. This analysis of our innovative rehabilitation program is directed at documenting changes in patients’ expiratory airflow limitation, pulmonary symptoms and QOL. This program is designed to provide “respiratory conditioning”, a physical therapist-assisted intensive flexibility training that focuses on stretching and rib cage mobilization. Methods Thirty-one patients with COPD who attended rehabilitation sessions at Juntendo University Hospital from 1999 to 2006 were analyzed. Pulmonary function, expiratory flow limitation during tidal breathing, six minute walk distance (6MWD), respiratory muscle strength, and St. George Respiratory Questionnaire (SGRQ) were measured before and after pulmonary rehabilitation. Results In participants ages 68±7 years, the FEV1% predicted was 39.3±15.7%. 6MWD, SGRQ and respiratory muscle strength were significantly improved after pulmonary rehabilitation. Although neither FEV1% predicted nor FEV1/FVC was affected to a significant extent, indicating little effect on airflow limitation, expiratory flow limitation in supine as well as seated during tidal breathing improved significantly. Moreover, rehabilitation significantly diminished TLC% predicted, FRC% predicted, RV% predicted and RV/TLC values, thus indicating a reduction of hyperinflation of the lungs at rest. Conclusions The present results suggest that our rehabilitation program with respiratory conditioning significantly lowered the hyperinflation of lungs at rest as well as the expiratory flow limitation during tidal breathing. In patients with COPD, overall pulmonary function improved, exercise endurance increased and health-related QOL was enhanced.

Ueki, Jun; Seyama, Kuniaki; Takizawa, Makiko; Yamaguchi, Seiko; Kitahara, Eriko; Fukazawa, Shinji; Takahama, Yukiko; Ichikawa, Masako; Takahashi, Kazuhisa; Fukuchi, Yoshinosuke

2012-01-01

50

Pulmonary and systemic blood flow contributions to upper airways in canine lung  

SciTech Connect

The blood flow contributions and drainage patterns of the pulmonary and systemic circulations in the upper airways (trachea and main bronchi) were assessed in anesthetized dogs by injecting 15-{mu}m radiolabeled microspheres into the right and left heart, respectively. After the animals were killed, the tracheal cartilage, tracheal muscle-mucosa, and main bronchi were excised. The tracheal cartilage and tracheal muscle-mucosa were divided into lower, middle, and upper segments for blood flow determinations. The pulmonary contribution to tracheal blood flow was very small, being higher in the lower segments. The systemic contribution to these same tracheal regions was significantly higher, and higher in the upper segments. The pulmonary and systemic circulations each contributed {approximately}50% to the main bronchi blood flow. The pulmonary blood flow contribution alone to the trachea and main bronchi was also determined in subsequent experiments that utilized the isolated lung, and these blood flows were not significantly different from the pulmonary contribution measured in the intact lungs. The present results indicate that the systemic (bronchial) circulation is the primary source of tracheal blood flow and that both the pulmonary and systemic circulations may contribute {approximately}50% of the blood flow to the main bronchi in dog lungs.

Barman, S.A.; Ardell, J.L.; Parker, J.C.; Perry, M.L.; Taylor, A.E. (Univ. of South Alabama, Mobile (USA))

1988-11-01

51

Effects of Antenatal Betamethasone on Human Fetal Branch Pulmonary Artery Flow Velocity Waveforms  

Microsoft Academic Search

Objective: To evaluate the effect of antenatal betamethasone on fetal branch pulmonary artery flow velocity waveforms. Methods: Betamethasone 12 mg i.m. in 2 injections 24 h apart was given to 25 pregnant women at risk of preterm delivery. Pulsatility (PI) and resistance (RI) indexes were measured at the proximal, middle and distal segments of the fetal pulmonary artery before and

José L. Bartha; Marta Largo-Heinrich; María J. Machado; Fernando González-Bugatto; Blas Hervías-Vivancos

2008-01-01

52

Measurement of pulmonary capillary blood flow in infants by plethysmography.  

PubMed Central

An accurate method for measuring effective pulmonary capillary blood flow (Qc eff) in infants has been developed with an adaptation of the plethysmographic technique. Measurements were made on 19 preterm. 14 small-for-dates, and 7 fullterm normal infants with a constant volume whole body plethysmograph in which the infant rebreathed nitrous oxide. There was a highly significant correlation between Qc eff and body weight, and this relationship was unaffected by premature delivery or intrauterine growth retardation. Mean Qc eff in preterm, small-for dates, and fullterm infants was 203, 208 and 197 ml min-1 kg-1, respectively, with no significant differences between the groups. A significant negative correlation existed between Qc eff and haematocrit in the preterm infants. There was no relationship between weight standardized Qc eff and postnatal age in any of the groups. With this technique, it was possible to readily recognise the presence of rapid recirculation (indicative of shunting) in several of the infants, suggesting that rebreathing methods for the assessment of Qc eff should not be applied indiscriminately during the neonatal period. By taking care to overcome the potential sources of technical error, it was possible to obtain highly reproducible results of Qc eff in infants over a wider age range than has been previously reported.

Stocks, J; Costeloe, K; Winlove, C P; Godfrey, S

1977-01-01

53

Simulated Flow Pattern in Massive Pulmonary Embolism: Significance for Selective Intrapulmonary Thrombolysis  

SciTech Connect

Purpose: The flow pattern in the central pulmonary arteries proximal to large pulmonary emboli was studied experimentally. The currents to which thrombolytic agents are exposed when administered via an intrapulmonary catheter were visualized in order to explain the lack of benefit of local versus systemic administration. Methods: By illumination of suspended microspheres, the flow pattern proximal to an obstructing embolus was visualized in an in vitro pulmonary arterial flow model. In six dogs massive pulmonary embolism was created. A pigtail catheter was positioned in the pulmonary artery immediately proximal to the central edge of the occluding embolus. To allow visualization of the local flow pattern, a small amount of contrast material (4 ml) was injected through the catheter at a high flow rate (25 ml/sec). The course of the radiopaque spot that emerged from the catheter tip within 160 msec was monitored with digital subtraction angiography at a frame rate of 12.5 frames/sec. In two dogs, the study was repeated after embolus fragmentation with the same catheter position. Results: The flow model study revealed formation of a vortex proximal to the occluding embolus. In vivo experiments showed that the radiopaque spot was whirled by the vortex proximal to the embolus and made only evanescent contact with the edge of the embolus. Regardless of the embolus location, the contrast spot was washed into the non-occluded ipsilateral and contralateral pulmonary arteries within 0.40-0.64 sec. After embolus fragmentation, the contrast spot was carried completely into the formerly occluded artery. Conclusion: Flow studies explain why thrombolytic agents administered via a catheter positioned adjacent to the embolus may have no more effect than systemically administered agents. An enhanced local effect is precluded by the rapid washout into the non-occluded pulmonary arteries and subsequent systemic dilution. These results support the practice of direct intrathrombic injection of thrombolytics or local thrombolysis as an adjunct to embolus fragmentation.

Schmitz-Rode, Thomas; Kilbinger, Markus; Guenther, Rolf W. [Radiologische Diagnostik, Universitaetsklinikum der RWTH Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany)

1998-05-15

54

Pulse Wave Reflection: Can It Explain the Differences Between Systemic and Pulmonary Pressure and Flow Waves? A Study in Dogs  

Microsoft Academic Search

SUMMARY. We have studied the effect of changes in pulse wave reflection on the configurations of pressure and flow in systemic and pulmonary circulation. Electromagnetic flow transducers, atrial catheters, and pacing leads were implanted in 10 dogs. In four animals, the flow transducer was placed on the pulmonary artery, in another four on the ascending aorta, and in two additional

G. C. van den Bos; N. Westerhof; O. S. Randall; F. O. M. Pot

2010-01-01

55

Detection of changes in diastolic function by pulmonary venous flow analysis in women athletes  

Microsoft Academic Search

Background Left ventricular cavity dimension, wall thickness, relaxation, and filling increase with exercise training and have a role in enhancing physical performance. We probed whether changes in diastole may develop separately from those in cardiac morphometry and still contribute to improve physical performance. Challenging diastole by preload reduction with standing and integrating mitral flow analysis with the pulmonary venous flow

M. Guazzi; F. C. Musante; H. L. Glassberg; J. R. Libonati

2001-01-01

56

In vivo Raman flow cytometry for real-time detection of carbon nanotube kinetics in lymph, blood, and tissues  

NASA Astrophysics Data System (ADS)

Nanoparticles are intensively being explored as contrast agents for medical diagnostics and therapies using various optical methods. We present the first demonstration of the use of time-resolved Raman spectroscopy for in vivo real-time detection of circulating carbon nanotubes (CNTs) or cancer cells labeled with CNTs in the lymph, blood, and tissues of live animals with fast spectral acquisition times of down to few milliseconds. After intravenously administering CNTs in the tail vein of the rat, this technique provides the ability to detect the circulation of CNTs in the blood microvessels of the intact rat ear. The capability of Raman spectroscopy is also demonstrated to monitor, identify, and image the CNTs during their transportation by lymphatics in the rat ear and mesentery. The strong and specific Raman scattering properties of CNTs make it possible to detect in vitro and in vivo single cancer cells (HeLa) tagged with CNTs. In vivo Raman flow cytometry opens a new avenue for multiparameter analysis of circulating nanoparticles with strong Raman scattering properties and their pharmokinetics in blood and lymph systems. Moreover, this technology has the potential for molecular detection and identification of circulating tumor cells, and infections labeled with CNTs.

Biris, Alexandru S.; Galanzha, Ekaterina I.; Li, Zhongrui; Mahmood, Meena; Xu, Yang; Zharov, Vladimir P.

2009-03-01

57

Estimating Mean Pulmonary Wedge Pressure in Patients With Chronic Atrial Fibrillation From Transthoracic Doppler Indexes of Mitral and Pulmonary Venous Flow Velocity  

Microsoft Academic Search

Objectives. We sought to obtain a noninvasive estimation of mean pulmonary wedge pressure (MPWP) in patients with chronic atrial fibrillation (AF).Background. It has previously been demonstrated that MPWP can be reliably estimated from Doppler indexes of mitral and pulmonary venous flow (PVF) in patients with sinus rhythm. Doppler estimation of MPWP has not been validated in patients with AF.Methods. MPWP

Fabio Chirillo; Maria Cristiana Brunazzi; Mario Barbiero; Davide Giavarina; Mario Pasqualini; Enrico Franceschini-Grisolia; Angelo Cotogni; Antonio Cavarzerani; Giorgio Rigatelli; Paolo Stritoni; Carlo Longhini

1997-01-01

58

[A case of Paragonimus westermani with elevated FDG uptake into a pulmonary nodular lesion and right hilar and mediastinal lymph nodes on FDG-positron-emission tomography].  

PubMed

A 47-year-old Chinese woman living in Japan was referred with a 2-month history of cough with hemoptysis. 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) showed increased FDG uptake into a pulmonary nodular lesion 25 mm in greatest dimension in the right upper lobe, and right hilar and mediastinal lymph nodes. Laboratory investigation did not reveal either eosinophilia or a marked elevation of serum IgE titer. A culture of bronchial lavage fluid was sterile and culture for mycobacteria was negative. Cytological examination results of transbronchial brushing samples were Class III. A partial resection of the right upper lobe was performed because of the possibility of primary lung cancer. Pathological examination of the nodular lesion showed helminthic eggs surrounded by dense inflammatory infiltrates, which mainly consisted of lymphocytes and eosinophils. Based on the findings of a serological study for helminth, the morphological characteristics of the eggs and the patient's history of eating raw crab, the patient was given a diagnosis of Paragonimus westermani, which can mimic primary lung cancer. PMID:21591459

Tanimura, Kazuya; Kita, Hideo; Kanemitsu, Yoshihiro; Fuseya, Yoshinori; Katayama, Yuko; Nishihara, Yumi; Chiba, Wataru; Suga, Michiharu

2011-04-01

59

Systolic pulmonary and hepatic vein flow reversal due to pacemaker-induced retrograde ventriculoatrial conduction.  

PubMed

Systolic pulmonary and hepatic vein flow reversals can typically be seen with severe atrioventricular (AV) valve regurgitation and during atrial fibrillation (AF). We report the case of a 67-year-old woman who presented with recent-onset exertional dyspnea. Her pacemaker was near end-of-life and reverted to a VVI mode from the preset DDDR mode. Electrocardiography demonstrated retrograde 1:1 ventriculoatrial (VA) conduction and spectral Doppler analysis revealed prominent systolic pulmonary and hepatic vein flow reversals. Symptoms, electrocardiogram (ECG) findings, and the spectral Doppler abnormalities resolved completely following a generator replacement and resumption of DDDR pacing. PMID:23305160

Shaikh, Amir Y; Meyer, Theo E; Robotis, Dionyssios A; Aurigemma, Gerard P; Tighe, Dennis A

2013-01-11

60

Quantification of regional pulmonary flow with 99m Tc-MAA SPECT and cine phase contrast MR imaging  

Microsoft Academic Search

The purpose of this study was to evaluate the relationship between left and right pulmonary arterial flow measured by cine\\u000a phase contrast magnetic resonance imaging (cine PCMRI) and the distribution of perfusion on99mTc-MAA SPECT and to determine whether the regional pulmonary flow quantification was feasible with the combined use of these\\u000a techniques. Twenty patients with different pulmonary diseases were evaluated.

Hisato Osada; Kikuo Machida; Norinari Honda

2002-01-01

61

Analysis of blood flow in pulmonary hypertension with the pulsed Doppler flowmeter combined with cross sectional echocardiography  

Microsoft Academic Search

Blood flow patterns were analysed at nine points in the pulmonary area using the pulsed Doppler technique combined with cross-sectional echocardiography in 53 patients with heart disease and 10 healthy subjects. In subjects with a normal pulmonary artery pressure the blood flow pattern in systole showed a gradual acceleration and deceleration with a rounded summit in mid systole, designated the

M Okamoto; K Miyatake; N Kinoshita; H Sakakibara; Y Nimura

1984-01-01

62

Usefulness of left and right oblique subcostal view in the echo-Doppler investigation of pulmonary arterial blood flow in patients with chronic obstructive pulmonary disease. The subxiphoid view in the echo-Doppler evaluation of pulmonary blood flow.  

PubMed

Fifty-nine adult patients with chronic obstructive pulmonary disease (COPD) underwent Doppler and two-dimensional echocardiographic examination to determine the variability of pulmonary arterial blood flow (PABF) from multiple views. Measurement of peak flow velocity (PFV), acceleration time (AT), right ventricular ejection time (RVET), and pulmonary arterial diameter (PAD) was possible in 52 patients (88 percent) by left oblique subcostal view (LOSV), in 38 patients (64.4 percent) by right oblique subcostal view (ROSV), and in only 12 patients (20.3 percent) by short axis parasternal view (SAPV) (p less than 0.05). Overall, PABF was measured in 55 patients (93.2 percent). The LOSV gave consistently higher values of PVF than those obtained either by ROSV (p less than 0.05) or by SAPV (p less than 0.05). We conclude that LOSV and ROSV allow measurement of PABF in the majority of patients with COPD. PMID:2376159

Ferrazza, A; Marino, B; Giusti, V; Affinito, V; Ragonese, P

1990-08-01

63

Flash pulmonary edema in a post arterial switch operation - High flow oxygen as a treatment modality.  

PubMed

We report a case of a 3-year-old boy who underwent an arterial switch operation with relief of left ventricular outflow tract obstruction and later presented with recurrent episodes of flash pulmonary edema. High-flow humidified oxygen with positive pressure support (Vapotherm) was used as a treatment modality, thereby avoiding intubation and mechanical ventilation. PMID:20808637

Kumar, Jamuna; Hegde, Rajesh; Maheshwari, Sunita; Rao, Shekar

2009-07-01

64

Flow velocity profile of the pulmonary artery measured by the continuous cardiac output monitoring catheter  

Microsoft Academic Search

The KATS catheter (continuous arterial thermodeprivation system catheter) measures the blood flow velocity of the pulmonary\\u000a artery (PA) by thermodeprivation which enables continuous determination of cardiac output. The accuracy of this system may\\u000a depend on the degree of uniformity of flow velocity in the PA, because small movements of the catheter within the PA are inevitable\\u000a with a beating heart.

Keiko Miyasaka; Masao Takata; Katsuyuki Miyasaka MO

1993-01-01

65

Blood flow redistribution and ventilation-perfusion mismatch during embolic pulmonary arterial occlusion.  

PubMed

Acute pulmonary embolism causes redistribution of blood in the lung, which impairs ventilation/perfusion matching and gas exchange and can elevate pulmonary arterial pressure (PAP) by increasing pulmonary vascular resistance (PVR). An anatomically-based multi-scale model of the human pulmonary circulation was used to simulate pre- and post-occlusion flow, to study blood flow redistribution in the presence of an embolus, and to evaluate whether reduction in perfused vascular bed is sufficient to increase PAP to hypertensive levels, or whether other vasoconstrictive mechanisms are necessary. A model of oxygen transfer from air to blood was included to assess the impact of vascular occlusion on oxygen exchange. Emboli of 5, 7, and 10 mm radius were introduced to occlude increasing proportions of the vasculature. Blood flow redistribution was calculated after arterial occlusion, giving predictions of PAP, PVR, flow redistribution, and micro-circulatory flow dynamics. Because of the large flow reserve capacity (via both capillary recruitment and distension), approximately 55% of the vasculature was occluded before PAP reached clinically significant levels indicative of hypertension. In contrast, model predictions showed that even relatively low levels of occlusion could cause localized oxygen deficit. Flow preferentially redistributed to gravitationally non-dependent regions regardless of occlusion location, due to the greater potential for capillary recruitment in this region. Red blood cell transit times decreased below the minimum time for oxygen saturation (<0.25 s) and capillary pressures became high enough to initiate cell damage (which may result in edema) only after ~80% of the lung was occluded. PMID:22140626

Burrowes, K S; Clark, A R; Tawhai, M H

66

Blood flow redistribution and ventilation-perfusion mismatch during embolic pulmonary arterial occlusion  

PubMed Central

Acute pulmonary embolism causes redistribution of blood in the lung, which impairs ventilation/perfusion matching and gas exchange and can elevate pulmonary arterial pressure (PAP) by increasing pulmonary vascular resistance (PVR). An anatomically-based multi-scale model of the human pulmonary circulation was used to simulate pre- and post-occlusion flow, to study blood flow redistribution in the presence of an embolus, and to evaluate whether reduction in perfused vascular bed is sufficient to increase PAP to hypertensive levels, or whether other vasoconstrictive mechanisms are necessary. A model of oxygen transfer from air to blood was included to assess the impact of vascular occlusion on oxygen exchange. Emboli of 5, 7, and 10 mm radius were introduced to occlude increasing proportions of the vasculature. Blood flow redistribution was calculated after arterial occlusion, giving predictions of PAP, PVR, flow redistribution, and micro-circulatory flow dynamics. Because of the large flow reserve capacity (via both capillary recruitment and distension), approximately 55% of the vasculature was occluded before PAP reached clinically significant levels indicative of hypertension. In contrast, model predictions showed that even relatively low levels of occlusion could cause localized oxygen deficit. Flow preferentially redistributed to gravitationally non-dependent regions regardless of occlusion location, due to the greater potential for capillary recruitment in this region. Red blood cell transit times decreased below the minimum time for oxygen saturation (<0.25 s) and capillary pressures became high enough to initiate cell damage (which may result in edema) only after ~80% of the lung was occluded.

Burrowes, K. S.; Clark, A. R.; Tawhai, M. H.

2011-01-01

67

A method for quantifying pulmonary Legionella pneumophila infection in mouse lungs by flow cytometry  

PubMed Central

Background Pulmonary load of Legionella pneumophila in mice is normally determined by counting serial dilutions of bacterial colony forming units (CFU) on agar plates. This process is often tedious and time consuming. We describe a novel, rapid and versatile flow cytometric method that detects bacteria phagocytosed by neutrophils. Findings Mice were infected with L. pneumophila via intratracheal or intranasal administration. At various times after bacteria inoculation, mouse lungs were harvested and analysed concurrently for bacterial load by colony counting and flow cytometry analysis. The number of L. pneumophila-containing neutrophils correlated strongly with CFU obtained by bacteriological culture. Conclusions This technique can be utilised to determine pulmonary bacterial load and may be used in conjunction with other flow cytometric based analyses of the resulting immune response.

2012-01-01

68

PULMONARY HEPATIC FLOW DISTRIBUTION IN TOTAL CAVOPULMONARY CONNECTIONS: EXTRA CARDIAC VS INTRA CARDIAC  

PubMed Central

Background Pulmonary arteriovenous malformations (PAVMs) can occur after the Fontan and are believed to be associated with disproportionate pulmonary distribution of hepatic venous effluent. We studied the impact of total cavo-pulmonary connection (TCPC) geometry and the effect of increased cardiac output (CO) on distribution of inferior vena caval (IVC) return to the lungs. Methods 10 Fontan patients – 5 with extra-cardiac (EC) and 5 with intra-cardiac (IC) configurations of the TCPC previously analyzed for power loss were processed for calculating the distribution of inferior vena caval return to the lungs (2nd order accuracy). One idealized TCPC was similarly analyzed under parametric variation of IVC offset and CO flow split Results Streaming of the IVC return in the idealized TCPC model was dependent on both IVC offset magnitude and CO flow split ratio. For patient-specific TCPCs, preferential streaming of the IVC return was directly proportional to CO flow split ratio in the IC type TCPCs (p < 0.0001). Preferential streaming in EC TCPCs correlated to the IVC offset (p<0.05) and did not correlate to CO flow split. Enhanced mixing in IC is speculated to explain the contrasting results. Exercising tends to reduce streaming towards LPA in IC, while for EC, exercising tends to equalize the streaming. Conclusions EC and IC TCPCs have inherently different streaming characteristics due to contrasting mixing characteristics owing to their geometric differences. PA diameters and IVC offsets may together determine hepatic flow streaming.

Dasi, Lakshmi P.; Whitehead, Kevin; Pekkan, Kerem; de Zelicourt, Diane; Sundareswaran, Kartik; Kanter, Kirk; Fogel, Mark A.; Yoganathan, Ajit P.

2010-01-01

69

Numerical Simulation of Flow in Anatomically Realistic Total Cavo-Pulmonary Connections  

NASA Astrophysics Data System (ADS)

Total cavo-pulmanory connection (TCPC) is a palliative surgical procudure employed to treat the single ventricle congential heart defects. We simulate the flow in patient-specific TCPC anatomies using two different numerical approaches: a Chimera overset grid method and a sharp-interface, hybrid Cartesian/Immersed Boundary approach. Laboratory experiments have shown that even under steady inflow conditions and at relatively low Reynolds number, the flow in the surgically created pouch, where the flows from the inferior and superior vena cave collide, becomes unstable and gives rise to a chaotic flow that flutters randomly between the left and right pulmonary arteries. Both numerical approaches capture this important feature of the flow and also yield results in good quantitative agreement with PIV measurements. The relative advantages and disantvantages of the two numerical approaches for complex cardiovascular flows will also be discussed. This work was supported by a grant from the National Heart, Lung, and Blood Institute, HL67622.

Gilmanov, Anvar; Ge, Liang; Wang, Chang; de Zelicourt, Diane; Pekkan, Kerem; Sotiropoulos, Fotis; Yoganathan, Ajit P.

2004-11-01

70

Quantification of regional pulmonary flow with 9mTc-MAA SPECT and cine phase contrast MR imaging.  

PubMed

The purpose of this study was to evaluate the relationship between left and right pulmonary arterial flow measured by cine phase contrast magnetic resonance imaging (cine PCMRI) and the distribution of perfusion on 99mTc-MAA SPECT and to determine whether the regional pulmonary flow quantification was feasible with the combined use of these techniques. Twenty patients with different pulmonary diseases were evaluated. Left and right lung counts on 99mTc-MAA SPECT images were separately summed and the left-to-total count ratio was calculated. The left-to-total pulmonary flow ratio was calculated from the left and right main pulmonary flows measured with cine PCMRI. We evaluated the correlation and agreement between the ratio determined with 99mTc-MAA SPECT and cine PCMRI by linear regression analysis and Bland-Altman analysis. The left-to-total ratios obtained by 99mTc-MAA and cine PCMRI were 52.0 +/- 22.1% and 52.2 +/- 20.8%, respectively, and showed a strong correlation (r = 0.99, p < 0.001). The mean difference between the two methods in the ratio was 0.25 +/- 2.3% with a 95% confidence interval from -0.84 to 1.34. The results showed that the regional pulmonary flow was calculated with both the left and right pulmonary flow measured with cine PCMRI and the ratio of regional distribution on 99Tc-MAA SPECT images. PMID:12416583

Osada, Hisato; Machida, Kikuo; Honda, Norinari

2002-09-01

71

Tidal variation of pulmonary blood flow and blood volume in piglets during mechanical ventilation during hyper-, normo- and hypovolaemia  

Microsoft Academic Search

Effects of changes in blood volume on changes in pulmonary blood flow and pulmonary blood volume during the ventilatory cycle during mechanical ventilation with a positive end-expiratory pressure of 2 cm H2O were determined in six pentobarbital anaesthetized, curarized pigs weighing about 10 kg. Haemodynamic variables were analysed for each cardiac cycle in eight ventilatory cycles in four consecutive series

Adrian Versprille; Jos R. C. Jansen

1993-01-01

72

Exogenous ghrelin improves blood flow distribution in pulmonary hypertension-assessed using synchrotron radiation microangiography.  

PubMed

Ghrelin has cardioprotective properties and, recently, has been shown to improve endothelial function and reduce endothelin-1 (ET-1)-mediated vasoconstriction in peripheral vascular disease. Recently, we reported that ghrelin attenuates pulmonary hypertension (PH) caused by chronic hypoxia (CH), which we hypothesized in this study may be via suppression of the ET-1 pathway. We also aimed to determine whether ghrelin's ability to prevent alterations of the ET-1 pathway also prevented adverse changes in pulmonary blood flow distribution associated with PH. Sprague-Dawley rats were exposed to CH (10% O(2) for 2 weeks) with daily subcutaneous injections of ghrelin (150 ?g/kg) or saline. Utilizing synchrotron radiation microangiography, we assessed pulmonary vessel branching structure, which is indicative of blood flow distribution, and dynamic changes in vascular responsiveness to (1) ET-1 (1 nmol/kg), (2) the ET-1(A) receptor antagonist, BQ-123 (1 mg/kg), and (3) ACh (3.0 ?g kg?ą min?ą). CH impaired blood flow distribution throughout the lung. However, this vessel "rarefaction" was attenuated in ghrelin-treated CH-rats. Moreover, ghrelin (1) reduced the magnitude of endothelial dysfunction, (2) prevented an increase in ET-1-mediated vasoconstriction, and (3) reduced pulmonary vascular remodeling and right ventricular hypertrophy-all adverse consequences associated with CH. These results highlight the beneficial effects of ghrelin for maintaining optimal lung perfusion in the face of a hypoxic insult. Further research is now required to establish whether ghrelin is also an effective therapy for restoring normal pulmonary hemodynamics in patients that already have established PH. PMID:21744075

Schwenke, Daryl O; Gray, Emily A; Pearson, James T; Sonobe, Takashi; Ishibashi-Ueda, Hatsue; Campillo, Isabel; Kangawa, Kenji; Umetani, Keiji; Shirai, Mikiyasu

2011-07-09

73

Understanding Pulmonary Vascular Disease  

MedlinePLUS

... the major types of pulmonary vascular disease follows: Pulmonary Embolism A pulmonary embolism happens when the blood flow through the lung's ... pain, fainting and a rapid heart rate. A pulmonary embolism can damage the heart, and if not treated ...

74

Comparison of continuous-flow and pulsatile-flow blood pumps on reducing pulmonary artery pressure in patients with fixed pulmonary hypertension.  

PubMed

Pulmonary hypertension (PH) is considered as a risk factor for morbidity and mortality in patients undergoing heart transplantation. Recently, left ventricular assist device (LVAD) implantation has been increasingly used in reducing pulmonary artery pressure (PAP) in patients with PH unresponsive to medical therapy. Herein, we aimed to compare the efficacy of continuous-flow and pulsatile-flow blood pumps on the improvement of PH in mechanical circulatory support patients. Twenty-seven patients with end-stage heart failure who underwent LVAD implantation surgery were enrolled. Fifteen of them (55.6%) had continuous-flow pump (HeartWare Ventricular Assist System, HeartWare, Inc., Miramar, FL, USA), and 12 of them (44.4%) had pulsatile pump (Berlin Heart EXCOR ventricular assist device, Berlin Heart AG, Berlin, Germany). The efficacy of LVADs on the improvement of PH was compared between continuous-flow and pulsatile pumps by the evaluation of systolic PAP, tricuspid annular plane systolic excursion (TAPSE), right ventricular systolic motion (RVSM), right ventricular ejection fraction (RVEF), and grade of tricuspid insufficiency (TI) for each of the study participants. All of the 15 patients who underwent continuous-flow blood pump implantation surgery (Group 1) were male with a mean age of 46.9?±?11.7 years, and in pulsatile-flow blood pump implanted participants (Group 2), the mean age was 40.6?±?16.8 years, all of whom were also male (P?=?0.259). Mean follow-up was 313.7?±?241.3 days in Group 1 and 448.7?±?120.7 days in Group 2 (P?=?0.139). In Group 1, mean preoperative and postoperative systolic PAP were measured as 51.7?±?12.2?mm?Hg and 22.2?±?3.4?mm?Hg, respectively, while those in Group 2 were 54.5?±?7.5?mm?Hg and 33.9?±?6.4?mm?Hg, respectively. A significantly greater decrease in systolic PAP was noticed in patients with continuous-flow blood pumps (P?=?0.023); however, no statistically significant difference was found when we considered the change in TAPSE between study groups (P?=?0.112). A statistical significance in the alteration of RVEF, RVSM, and the grade of TI during study visits was not found between the study groups (P?=?0.472, P?=?0.887, and P?=?0.237, respectively). Although the two studied types of LVADs were found to be effective in reducing PAP in heart transplantation candidates with PH, lesser postoperative systolic PAP values were achieved in patients who underwent continuous-flow pump implantation surgery. PMID:24033601

Ozturk, Pelin; Engin, Aysen Yaprak; Nalbantgil, Sanem; Oguz, Emrah; Ayik, Fatih; Engin, Cagatay; Yagdi, Tahir; Erkul, Sinan; Balcioglu, Ozlem; Ozbaran, Mustafa

2013-09-11

75

Pulmonary and systemic blood flow contributions to upper airways in canine lung  

Microsoft Academic Search

The blood flow contributions and drainage patterns of the pulmonary and systemic circulations in the upper airways (trachea and main bronchi) were assessed in anesthetized dogs by injecting 15-ÎĽm radiolabeled microspheres into the right and left heart, respectively. After the animals were killed, the tracheal cartilage, tracheal muscle-mucosa, and main bronchi were excised. The tracheal cartilage and tracheal muscle-mucosa were

S. A. Barman; J. L. Ardell; J. C. Parker; M. L. Perry; A. E. Taylor

1988-01-01

76

Long-term inhibition of Rho kinase with fasudil attenuates high flow induced pulmonary artery remodeling in rats  

Microsoft Academic Search

Accumulating evidences have demonstrated that RhoA\\/Rho-kinase pathway plays a pivotal role in various cellular functions. The aim of this study was to explore whether RhoA\\/Rho-kinase pathway is involved in the pathogenesis of high flow induced pulmonary hypertension and whether long-term inhibition of RhoA\\/Rho-kinase pathway with fasudil could attenuate high flow induced pulmonary artery remodeling in rats. Wistar rats in the

Fuhai Li; Wei Xia; Aiwu Li; Cuifen Zhao; Ruopeng Sun

2007-01-01

77

Small-Scale Respiratory Flows in a Space-Filling Model of the Pulmonary Acinus  

NASA Astrophysics Data System (ADS)

Respiratory flows in the lung periphery are governed by low Reynolds number quasi-Stokes flow induced by the wall motion of sub-millimeter airways marked by the presence of alveoli. Following Fung's model of lung structure (J. Appl. Physiol, 1988), CFD simulations of respiratory flows are investigated in a dichotomous asymmetric three-dimensional space-filling model of a pulmonary acinus. Resulting alveolar flow patterns, induced by kinematic wall motion, are complex and intrinsically three-dimensional. The alveolar flow topology is quasi-steady, due to low Womersley numbers, and largely governed by the ratio of alveolar to ductal flow rates. This ratio describes the interplay between alveolar recirculation, induced by ductal shear flow over the alveolus opening, and alveolar radial flow, induced by the expansion/contraction wall motion. Lagrangian particle tracking of massless particles is conducted over cumulative breathing cycles to investigate the influence of alveolar flows on aerosol kinematics and the existence of irreversible chaotic mixing. Furthermore, our space-filling model is well suited to consider the influence on acinar flows of openings in the alveolar wall between adjacent alveoli (pores of Kohn).

Sznitman, Josue; Schmuki, Sebastian; Sutter, Reto; Tsuda, Akira; Roesgen, Thomas

2006-11-01

78

Simulation of pulmonary air flow with a subject-specific boundary condition  

PubMed Central

We present a novel image-based technique to estimate a subject-specific boundary condition (BC) for computational fluid dynamics (CFD) simulation of pulmonary air flow. The information of regional ventilation for an individual is derived by registering two computed tomography (CT) lung datasets and then passed to the CT-resolved airways as the flow BC. The CFD simulations show that the proposed method predicts lobar volume changes consistent with direct image-measured metrics, whereas the other two traditional BCs (uniform velocity or uniform pressure) yield lobar volume changes and regional pressure differences inconsistent with observed physiology.

Yin, Youbing; Choi, Jiwoong; Hoffman, Eric A.; Tawhai, Merryn H.; Lin, Ching-Long

2011-01-01

79

Increased pulmonary blood flow does not alter surfactant protein gene expression in lambs within the first week of life.  

PubMed

Neonates and infants with congenital heart disease with increased pulmonary blood flow suffer morbidity from poor oxygenation and decreased lung compliance. In a previous experiment involving 4-wk-old lambs with pulmonary hypertension secondary to increased pulmonary blood flow following an in utero placement of an aortopulmonary vascular graft, we found a decrease in surfactant protein (SP)-A gene expression as well as a decrease in SP-A and SP-B protein contents. To determine the timing of these changes, the objective of the present study was to characterize the effect of increased pulmonary blood flow and pulmonary hypertension on SP-A, -B, and -C gene expressions and protein contents within the first week of life. Of eight fetal lambs that underwent the in utero placement of the shunt, there was no difference in the expression of SP-A, -B, and -C mRNA levels or SP-A and -B protein contents compared with age-matched controls. The results showed that, in this model of congenital heart disease with pulmonary hypertension and increased pulmonary blood flow, the effect of the shunt on SP gene expression and protein content was not apparent within the first week of life. PMID:14751849

Lee, Jae W; Ovadia, Boaz; Azakie, Anthony; Salas, Sonia; Goerke, Jon; Fineman, Jeffrey R; Gutierrez, Jorge A

2004-01-29

80

Assessing potential errors of MRI-based measurements of pulmonary blood flow using a detailed network flow model  

PubMed Central

MRI images of pulmonary blood flow using arterial spin labeling (ASL) measure the delivery of magnetically tagged blood to an image plane during one systolic ejection period. However, the method potentially suffers from two problems, each of which may depend on the imaging plane location: 1) the inversion plane is thicker than the imaging plane, resulting in a gap that blood must cross to be detected in the image; and 2) ASL includes signal contributions from tagged blood in conduit vessels (arterial and venous). By using an in silico model of the pulmonary circulation we found the gap reduced the ASL signal to 64–74% of that in the absence of a gap in the sagittal plane and 53–84% in the coronal. The contribution of the conduit vessels varied markedly as a function of image plane ranging from ?90% of the overall signal in image planes that encompass the central hilar vessels to <20% in peripheral image planes. A threshold cutoff removing voxels with intensities >35% of maximum reduced the conduit vessel contribution to the total ASL signal to ?20% on average; however, planes with large contributions from conduit vessels underestimate acinar flow due to a high proportion of in-plane flow, making ASL measurements of perfusion impractical. In other image planes, perfusion dominated the resulting ASL images with good agreement between ASL and acinar flow. Similarly, heterogeneity of the ASL signal as measured by relative dispersion is a reliable measure of heterogeneity of the acinar flow distribution in the same image planes.

Buxton, R. B.; Prisk, G. K.

2012-01-01

81

Assessing potential errors of MRI-based measurements of pulmonary blood flow using a detailed network flow model.  

PubMed

MRI images of pulmonary blood flow using arterial spin labeling (ASL) measure the delivery of magnetically tagged blood to an image plane during one systolic ejection period. However, the method potentially suffers from two problems, each of which may depend on the imaging plane location: 1) the inversion plane is thicker than the imaging plane, resulting in a gap that blood must cross to be detected in the image; and 2) ASL includes signal contributions from tagged blood in conduit vessels (arterial and venous). By using an in silico model of the pulmonary circulation we found the gap reduced the ASL signal to 64-74% of that in the absence of a gap in the sagittal plane and 53-84% in the coronal. The contribution of the conduit vessels varied markedly as a function of image plane ranging from ?90% of the overall signal in image planes that encompass the central hilar vessels to <20% in peripheral image planes. A threshold cutoff removing voxels with intensities >35% of maximum reduced the conduit vessel contribution to the total ASL signal to ?20% on average; however, planes with large contributions from conduit vessels underestimate acinar flow due to a high proportion of in-plane flow, making ASL measurements of perfusion impractical. In other image planes, perfusion dominated the resulting ASL images with good agreement between ASL and acinar flow. Similarly, heterogeneity of the ASL signal as measured by relative dispersion is a reliable measure of heterogeneity of the acinar flow distribution in the same image planes. PMID:22539167

Burrowes, K S; Buxton, R B; Prisk, G K

2012-04-26

82

In situ enhancement of pulmonary surfactant function using temporary flow reversal  

PubMed Central

Acute respiratory distress syndrome is a pulmonary disease with a mortality rate of ?40% and 75,000 deaths annually in the United States. Mechanical ventilation restores airway patency and gas transport but leads to ventilator-induced lung injury. Furthermore, surfactant replacement therapy is ineffective due to surfactant delivery difficulties and deactivation by vascular proteins leaking into the airspace. Here, we demonstrated that surfactant function can be substantially improved (up to 50%) in situ in an in vitro pulmonary airway model using unconventional flows that incorporate a short-term retraction of the air-liquid interface, leading to a net decrease in cellular damage. Computational fluid dynamic simulations provided insights into this method and demonstrated the physicochemical hydrodynamic foundation for the improved surfactant microscale transport and mobility. This study may provide a starting point for developing novel ventilation waveforms to improve surfactant function in edematous airways.

Glindmeyer, Henry W.; Smith, Bradford J.

2012-01-01

83

Doppler echocardiographic study of pulmonary venous flow in mitral stenosis and early after mitral valve replacement.  

PubMed

The aim of the study was Doppler echocardiographic assessment of the effect of mitral stenosis (MS) on pulmonary venous flow (PVF), and of any changes occurring after mitral valve replacement. Fifty patients with MS (22 in atrial fibrillation (AF)) and 28 healthy subjects (control group) underwent transthoracic echocardiographic evaluation of PVF. Fourteen of the 22 patients in AF were submitted in addition to transesophageal echo study before and after mitral valve replacement. Pulmonary wedge pressure was measured in 18 patients. Patients in sinus rhythm (SR) and more than mild MS showed significantly decreased peak velocity and flow velocity time integral of the systolic forward PVF. This finding was more exaggerated in MS with AF. Concerning diastolic forward PVF, patients in SR showed significantly decreased peak velocity and velocity time integral, irrelevant of the degree of MS, while patients with AF exhibited adequate signs of flow. In all patients duration, deceleration time (D-DT) and pressure half-time (D-PHT) of the diastolic forward PVF were significantly increased. The last two parameters correlated with the corresponding variables of mitral flow and with echocardiographically determined mitral valve area and the D-DT of the pulmonary wedge pressure. Concerning reversed PVF, patients with more than mild MS exhibited significantly increased peak velocity and velocity time integral. After mitral valve replacement, a significant increase of diastolic forward peak velocity and velocity time of the PVF were detected. The duration of diastolic forward peak velocity of PVF, D-DT and D-PHT decreased. The systolic forward phase did not change significntly after the valve replacement.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7952318

Kranidis, A I; Kostopoulos, K G; Filippatos, G B; Kardaras, F G; Kappos, K G; Koulouris, S N; Fehske, W; Lolas, C T; Anthopoulos, L P

1994-07-01

84

Effects of antihistamines on the lung vascular response to histamine in unanesthetized sheep. Diphenhydramine prevention of pulmonary edema and increased permeability.  

PubMed Central

To see whether antihistamines could prevent and reverse histamine-induced pulmonary edema and increased lung vascular permeability, we compared the effects of a 4-h intravenous infusion of 4 mug/kg per min histamine phosphate on pulmonary hemodynamics, lung lymph flow, lymph and plasma protein content, arterial blood gases, hematocrit, and lung water with the effects of an identical histamine infusion given during an infusion of diphenhydramine or metiamide on the same variables in unanesthetized sheep. Histamine caused lymph flow to increase from 6.0+/-0.5 to 27.0+/-5.5 (SEM) ml/h (P less than 0.05), lymph; plasma globulin concentration ratio to increase from 0.62+/-0.01 to 0.67+/-0.02 (P less than 0.05), left atrial pressure to fall from 1+/-1 to -3+/-1 cm H2O (P less than 0.05), and lung lymph clearance of eight protein fractions ranging from 36 to 96 A molecular radius to increase significantly. Histamine also caused increases in lung water, pulmonary vascular resistance, arterial PCO2, pH, and hematocrit, and decreases in cardiac output and arterial PO2. Diphenhydramine (3 mg/kg before histamine followed by 1.5 mg/kg per h intravenous infusion) completely prevented the histamine effect on hematocrit, lung lymph flow, lymph protein clearance, and lung water content, and reduced histamine effects on arterial blood gases and pH. 6 mg/kg diphenhydramine given at the peak histamine response caused lymph flow and lymph: plasma protein concentration ratios to fall. Metiamide (10 mg/kg per h) did not affect the histamine lymph response. We conclude that diphenhydramine can prevent histamine-induced pulmonary edema and can prevent and reverse increased lung vascular permeability caused by histamine, and that histamine effects on lung vascular permeability are H1 actions.

Brigham, K L; Bowers, R E; Owen, P J

1976-01-01

85

THE FLOW OF BLOOD TO LYMPH NODES AND ITS RELATION TO LYMPHOCYTE TRAFFIC AND THE IMMUNE RESPONSE  

Microsoft Academic Search

The immune response of single lymph nodes encompasses a complex interac- tion of the blood vascular and lymphatic microcirculations. An appropriate environment exists or is created for the interaction of various lymphocyte populations and mononuclear phagocytic cells. In addition, the vascular endo- thelial cells are directly involved in the response, insomuch as they facilitate the movement of lymphocytes from the

JOHN B. HAY; BARRY B. HOBBS

1977-01-01

86

Myocardial Flow Reserve in Long-Term Survivors of Repair of Anomalous Left Coronary Artery From Pulmonary Artery  

Microsoft Academic Search

Objectives. This study sought to evaluate regional myocardial flow reserve in long-term survivors of repair of anomalous left coronary artery from pulmonary artery (ALCAPA) and to relate the flow abnormalities to the patients' exercise performance. Background. Patients with ALCAPA usually present during infancy with severe ischemic cardiomyopathy. The left ventricular function recovers after surgical repair. However, the extent of recovery

TAJINDER P. SINGH; MARCELO F. DI CARLI; NANCY M. SULLIVAN; MARLO F. LEONEN; W. ROBERT MORROW

87

High Pulsatility Flow Induces Adhesion Molecule and Cytokine mRNA Expression in Distal Pulmonary Artery Endothelial Cells  

PubMed Central

Background Arterial stiffening or reduced compliance of proximal pulmonary vessels has been shown to be an important predictor of outcomes in patients with pulmonary hypertension. Though current evidence indicates that arterial stiffening modulates flow pulsatility in downstream vessels and is likely related to microvascular damage in organs without extensive distributing arteries, the cellular mechanisms underlying this relationship in the pulmonary circulation are unexplored. Thus, this study was designed to examine the responses of the microvascular pulmonary endothelium to changes in flow pulsatility. Methods A flow system was developed to reproduce arterial-like pulse flow waves with the capability of modulating flow pulsatility through regulation of upstream compliance. Pulmonary microvascular endothelial cells (PMVECs) were exposed to steady flow and pulse flow waves of varied pulsatility with varied hemodynamic energy (low: pulsatility index or PI=1.0; medium: PI=1.7; high: PI=2.6) at flow frequency of 1Hz or 2Hz for different durations (1 and 6 hours). The mean flow rates in all the conditions were kept the same with shear stress at 14 dynes/cm2. Gene expression was evaluated by analyzing mRNA levels of adhesion molecules (ICAM-1, E-selectin), chemokine (MCP-1) and growth factor/receptor (VEGF, Flt-1) in PMVECs. Functional changes were observed with monocyte adhesion assay. Results 1) Compared to either steady flow or low pulsatility flow, increased flow pulsatility for 1hr induced significant increases in mRNA levels of ICAM-1, E-selectin and MCP-1. 2) Sustained high pulsatility flow perfusion induced increases in ICAM, E-selectin, MCP-1, VEGF and its receptor Flt-1 expression. 3) Flow pulsatility effects on PMVECs were frequency-dependent with greater responses at 2Hz and likely associated with the hemodynamic energy level. 4) Pulse flow waves with high flow pulsatility at 2Hz induced leukocyte adhesion and recruitment to PMVECs. Conclusion Increased upstream pulmonary arterial stiffness increases flow pulsatility in distal arteries and induces inflammatory gene expression, leukocyte adhesion and cell proliferation in the downstream PMVECs.

Li, Min; Scott, Devon E.; Shandas, Robin; Stenmark, Kurt R.; Tan, Wei

2011-01-01

88

The benefits of high-flow management in children with pulmonary atresia.  

PubMed

The high-flow management of cardiopulmonary bypass (CPB; >or=2.4 L/min/m(2)) is a standard strategy used at this institute for children with pulmonary atresia (PA) due to a fear that the blood flow may be diverted by the major/minor aortopulmonary-collateral-arteries and hypervascularization due to long-term hypoxia. The purpose of this study was to describe the validity of high-flow management in children with PA. The CPB records of 23 children with PA who underwent a definitive biventricular repair between Feb 2006 and Nov 2008 were retrospectively reviewed. The mean age at the operation was 33 +/- 22 months. The blood-pressure during bypass was controlled with the same protocol. The mean cooling-temperature was 28.4 +/- 3.7 degrees C. The mean minimum hematocrit was 25.0 +/- 3.4%. The mean maximum bypass flow index at the initiation, the mean maximum flow index during aortic cross-clamping, the mean minimum flow index during aortic cross-clamping, and the mean maximum flow index after rewarming were 3.1 +/- 0.5, 3.1 +/- 0.5, 2.6 +/- 0.4, and 3.2 +/- 0.4 L/min/m(2), respectively. The higher bypass flow indexes significantly correlated with the lower serum lactate levels. The lowest oxygen delivery during CPB had significant influences on the urine output during bypass (R = 0.547, P = 0.007), the serum lactate levels at the end of CPB (R = -0.442, P = 0.035), and the postoperative thoracic effusion (R = -0.459, P = 0.028). A bypass flow index of 2.4 L/min/m(2) may not be sufficient and the maximum requirement of bypass flow index may be 3.2 L/min/m(2) or more in this patient population. PMID:19817735

Fujii, Yasuhiro; Kotani, Yasuhiro; Kawabata, Takuya; Ugaki, Shinya; Sakurai, Shigeru; Ebishima, Hironori; Itoh, Hideshi; Nakakura, Mahito; Arai, Sadahiko; Kasahara, Shingo; Sano, Shunji; Iwasaki, Tatsuo; Toda, Yuichiro

2009-10-10

89

Effect of high flow oxygen on mortality in chronic obstructive pulmonary disease patients in prehospital setting: Randomised controlled trial  

Microsoft Academic Search

Objectives: To compare standard high flow oxygen treatment with titrated oxygen treatment for patients with an acute exacerbation of chronic obstructive pulmonary disease in the prehospital setting.\\u000aDesign: Cluster randomised controlled parallel group trial.\\u000aSetting: Ambulance service in Hobart, Tasmania, Australia.\\u000aParticipants: 405 patients with a presumed acute exacerbation of chronic obstructive pulmonary disease who were treated by paramedics, transported,

Michael A Austin; Karen E Wills; Leigh Blizzard; Haydn Walters; Richard Wood-Baker

2010-01-01

90

Dynamic pulmonary hyperinflation occurs without expiratory flow limitation in chronic heart failure during exercise.  

PubMed

To assess the occurrence of tidal expiratory flow limitation (EFL) and/or dynamic pulmonary hyperinflation (DH) in chronic heart failure (CHF) during exercise 15 patients with stable systolic CHF, aged 69±6yr, underwent pulmonary function testing and incremental cardio-pulmonary exercise testing. They subsequently performed constant load exercise testing at 30, 60 and 90% of respective maximum workload. At each step the presence of EFL, by negative expiratory pressure technique, and changes in inspiratory capacity (IC) were assessed. Ejection fraction amounted to 36±6% and [Formula: see text] , peak (77±19% pred.) was reduced. EFL was absent at any step during constant load exercise. In 6 patients IC decreased more than 10% pred. at highest step. Only in these patients TLC, FRC, RV FEF25-75% and DLCO were decreased at rest. [Formula: see text] , peak correlated with DLCO, TLC and IC at rest and with IC (r(2)=0.59; p<0.001) and decrease in IC (r(2)=0.44; p<0.001) at 90% of maximum workload. During exercise CHF patients do not exhibit EFL, but some of them develop DH that is associated with lower [Formula: see text] , peak. PMID:23851110

Chiari, Stefania; Torregiani, Chiara; Boni, Enrico; Bassini, Sonia; Vizzardi, Enrico; Tantucci, Claudio

2013-07-09

91

Nasal nitric oxide and regulation of human pulmonary blood flow in the upright position.  

PubMed

There are a number of evidences suggesting that lung perfusion distribution is under active regulation and determined by several factors in addition to gravity. In this work, we hypothesised that autoinhalation of nitric oxide (NO), produced in the human nasal airways, may be one important factor regulating human lung perfusion distribution in the upright position. In 15 healthy volunteers, we used single-photon emission computed tomography technique and two tracers (99mTc and 113mIn) labeled with human macroaggregated albumin to assess pulmonary blood flow distribution. In the sitting upright position, subjects first breathed NO free air through the mouth followed by the administration of the first tracer. Subjects then switched to either nasal breathing or oral breathing with the addition of exogenous NO-enriched air followed by the administration of the second tracer. Compared with oral breathing, nasal breathing induced a blood flow redistribution of approximately 4% of the total perfusion in the caudal to cranial and dorsal to ventral directions. For low perfused lung regions like the apical region, this represents a net increase of 24% in blood flow. Similar effects were obtained with the addition of exogenous NO during oral breathing, indicating that NO and not the breathing condition was responsible for the blood flow redistribution. In conclusion, these results provide evidence that autoinhalation of endogenous NO from the nasal airways may ameliorate the influence of gravity on pulmonary blood flow distribution in the upright position. The presence of nasal NO only in humans and higher primates suggest that it may be an important part of the adaptation to bipedalism. PMID:19875719

Sánchez Crespo, Alejandro; Hallberg, Jenny; Lundberg, Jon O; Lindahl, Sten G E; Jacobsson, Hans; Weitzberg, Eddie; Nyrén, Sven

2009-10-29

92

Flow-sensitive four-dimensional velocity-encoded magnetic resonance imaging reveals abnormal blood flow patterns in the aorta and pulmonary trunk of patients with transposition.  

PubMed

Background and objectives Flow profiles are important determinants of fluid-vessel wall interactions. The aim of this study was to assess blood flow profiles in the aorta and pulmonary trunk in patients with transposition and different ventriculoarterial connection, and hence different mechanics of the coherent pump. METHODS: In all, 29 patients with operated transposition - concordant atrioventricular and discordant ventriculoarterial connection, and no other cardiac malformation - and eight healthy volunteers were assessed with cardiac magnetic resonance imaging: n = 17 patients after atrial redirection, with a morphologic right ventricle acting as systemic pump and a morphologic left ventricle connected to the pulmonary trunk, and n = 12 patients after the arterial switch procedure, with physiologic ventriculoarterial connections. Flow-sensitive four-dimensional velocity-encoded magnetic resonance imaging was used to analyse systolic flow patterns in the aorta and pulmonary trunk, relating to helical flow and vortex formation. RESULTS: In the aorta, overall helicity was present in healthy volunteers, but it was absent in all patients independent on the operation technique. Partial helices were observed in the ascending aorta of 58% of patients after arterial switch. In the pulmonary trunk, mostly parallel flow was seen in healthy volunteers and in patients after arterial switch, whereas vortex formation was present in 88% of patients after atrial redirection. Conclusion Blood flow patterns differ substantially between the groups. In addition to varying mechanics of the coherent pumping ventricles, the absent overall helicity in all patients might be explained by the missing looping of the aorta in transposition. PMID:23327710

Riesenkampff, Eugénie; Nordmeyer, Sarah; Al-Wakeel, Nadya; Kropf, Siegfried; Kutty, Shelby; Berger, Felix; Kuehne, Titus

2013-01-18

93

Detection and quantification of IgM+ lymphocytes in fetal lamb spleen, liver and lymph nodes by flow cytometry  

Microsoft Academic Search

The first stage in Peyer's patch development in the fetal lamb is characterized by the colonization of the rudimentary Peyer's patches by precursor cells expressing the IgM surface receptor. In the fetal lamb, the spleen has been implicated as the source of gene-rearranged IgM+ B lymphocytes. This study was intended to quantitate IgM+ lymphocytes in the spleen, lymph nodes and

Noorjahan Alitheen; Susan McClure; Peter McCullagh

2007-01-01

94

Estimation of pulmonary blood flow from sinusoidal gas exchange during anaesthesia: a theoretical study.  

PubMed

We simulated the use of simultaneous sinusoidal changes of inspired O2 and N2O (Williams et al., J Appl Physiol, 1994; 76: 2130-9) at fractional concentrations up to 0.3 and 0.7, respectively, to estimate FRC and pulmonary blood flow (PBF) during anaesthesia, using O2 as an insoluble indicator. Hahn's approximate equations, which neglect the effect of pulmonary uptake and excretion on expiratory flow, estimate dead space and alveolar volume (VA) with systematic errors less than 10%, but yield systematic errors in PBF which are approximately proportional to FIN2O in magnitude. A correction factor (1 - P)-1 for Hahn's equations for PBF (where P is the mean partial pressure of the soluble indicator) reduces the dependence of PBF estimates of FIN2O, and the solution of equations describing the simultaneous mass balance of both indicators yields accurate results for a wide range of mean FIN2O. However, PBF estimates are sensitive to measurement errors and a third gas must be present to ensure that the indicator gases behave independently. PMID:11103177

Turner, M J; Weismann, D; Járos, G G; Baker, A B

2000-09-01

95

PPAR-? Regulates Carnitine Homeostasis and Mitochondrial Function in a Lamb Model of Increased Pulmonary Blood Flow  

PubMed Central

Objective Carnitine homeostasis is disrupted in lambs with endothelial dysfunction secondary to increased pulmonary blood flow (Shunt). Our recent studies have also indicated that the disruption in carnitine homeostasis correlates with a decrease in PPAR-? expression in Shunt lambs. Thus, this study was carried out to determine if there is a causal link between loss of PPAR-? signaling and carnitine dysfunction, and whether the PPAR-? agonist, rosiglitazone preserves carnitine homeostasis in Shunt lambs. Methods and Results siRNA-mediated PPAR-? knockdown significantly reduced carnitine palmitoyltransferases 1 and 2 (CPT1 and 2) and carnitine acetyltransferase (CrAT) protein levels. This decrease in carnitine regulatory proteins resulted in a disruption in carnitine homeostasis and induced mitochondrial dysfunction, as determined by a reduction in cellular ATP levels. In turn, the decrease in cellular ATP attenuated NO signaling through a reduction in eNOS/Hsp90 interactions and enhanced eNOS uncoupling. In vivo, rosiglitazone treatment preserved carnitine homeostasis and attenuated the development of mitochondrial dysfunction in Shunt lambs maintaining ATP levels. This in turn preserved eNOS/Hsp90 interactions and NO signaling. Conclusion Our study indicates that PPAR-? signaling plays an important role in maintaining mitochondrial function through the regulation of carnitine homeostasis both in vitro and in vivo. Further, it identifies a new mechanism by which PPAR-? regulates NO signaling through Hsp90. Thus, PPAR-? agonists may have therapeutic potential in preventing the endothelial dysfunction in children with increased pulmonary blood flow.

Rafikov, Ruslan; Kumar, Sanjiv; Hou, Yali; Oishi, Peter E.; Datar, Sanjeev A.; Raff, Gary; Fineman, Jeffrey R.; Black, Stephen M.

2012-01-01

96

Pulmonary blood flow and its distribution in highly trained endurance athletes and healthy control subjects.  

PubMed

Pulmonary blood flow (PBF) is an important determinant of endurance sports performance, yet studies investigating adaptations of the pulmonary circulation in athletes are scarce. In the present study, we investigated PBF, its distribution, and heterogeneity at baseline and during intravenous systemic adenosine infusion in 10 highly trained male endurance athletes and 10 untrained but fit healthy controls, using positron emission tomography and [(15)O]water at rest and during adenosine infusion at supine body posture. Our results indicate that PBF at rest and during adenosine stimulation was similar in both groups (213 ± 55 and 563 ± 138 ml·100 ml(-1)·min(-1) in athletes and 206 ± 83 and 473 ± 212 ml·100 ml(-1)·min(-1) in controls, respectively). Although the PBF response to adenosine was thus unchanged in athletes, overall PBF heterogeneity was reduced from rest to adenosine infusion (from 84 ± 18 to 70 ± 19%, P < 0.05), while remaining unchanged in healthy controls (77 ± 16 to 85 ± 33%, P = 0.4). Additionally, there was a marked gravitational influence on general PBF distribution so that clear dorsal dominance was observed both at rest and during adenosine infusion, but training status did not have an effect on this distribution. Regional blood flow heterogeneity was markedly lower in the high-perfusion dorsal areas, both at rest and during adenosine, in all subjects, but flow heterogeneity in dorsal area tended to further decrease in response to adenosine in athletes. In conclusion, reduced blood flow heterogeneity in response to adenosine in endurance athletes may be a reflection of capillary reserve, which is more extensively recruitable in athletes than in matched healthy control subjects. PMID:23221954

Heinonen, Ilkka; Savolainen, Anna M; Han, Chunlei; Kemppainen, Jukka; Oikonen, Vesa; Luotolahti, Matti; Duncker, Dirk J; Merkus, Daphne; Knuuti, Juhani; Kalliokoski, Kari K

2012-12-06

97

Non-Contrast SSFP Pulmonary Vein MRA: Impact of Off-Resonance and Flow  

PubMed Central

Purpose To investigate pulmonary vein (PV) off-resonance and blood flow as causes of signal void artifacts in non-contrast steady-state-free-precession (SSFP) PV MR angiography (MRA). Materials and Methods PV blood off-resonance was measured on 11 healthy adult subjects and 10 atrial fibrillation (AF) patients. Non-contrast PV MRA was performed using a three-dimensional slab-selective SSFP sequence at 1.5T on 7 healthy subjects with signal profile shifts of 0-125Hz. The time-resolved blood flow velocity of the PVs was measured on 5 healthy subjects. The impact of flow was studied on 6 healthy subjects, on whom SSFP PV MRA was acquired twice with the ECG trigger delay corresponding to low and high flow, respectively. Results The PV off-resonance were 97±27Hz, 65±20Hz, 74±25Hz, and 52±17Hz for right inferior, left inferior, right superior and left superior PVs, respectively, on healthy subjects, and were 74±20Hz, 38±9Hz, 51±20Hz, and 28±11Hz on AF patients (P<0.01 for all). The off-resonance caused severe signal voids in the PVs. Signal acquired during mid-diastole with high PV flow caused additional signal voids in the left atrium, which was reduced by setting the ECG trigger delay to late-diastole. Conclusion PV off-resonance and flow causes signal void artifacts in non-contrast three-dimensional slab-selective SSFP PV MRA.

Hu, Peng; Stoeck, Christian T.; Smink, Jouke; Peters, Dana C.; Ngo, Long; Goddu, Beth; Kissinger, Kraig V.; Goepfert, Lois A.; Chan, Jonathan; Hauser, Thomas H.; Rofsky, Neil M.; Manning, Warren J.; Nezafat, Reza

2010-01-01

98

The effects of regional pulmonary blood flow on protein flux measurements with PET.  

PubMed

We used PET to evaluate whether changes in regional pulmonary blood flow (PBF) or plasma volume (PV) affect calculations of the pulmonary transcapillary escape rate (PTCER) for 68Ga-labeled transferrin. We reduced PBF in five dogs by inflating a right atrial balloon. Regional PBF decreased 25% to 174 +/- 40 ml/min/100 ml lung without a change in PV or PTCER. In eight other dogs, we decreased PBF and PV via controlled arterial hemorrhage. PBF decreased 45% to 110 +/- 33 ml/min/100 ml lung and PV decreased 22% without a change in PTCER. We also used a series of computer simulations to evaluate the effect of even greater reductions in regional PBF on PTCER calculations. These simulations showed, in support of the experimental data, that if PBF was greater than 40 ml/min/100 ml lung, PTCER could be accurately measured. However, below this level, PV was increasingly under-estimated and PTCER overestimated. The results indicate the sensitivity of the PTCER calculation to errors in the PV measurement, especially in regions of markedly reduced regional PBF. PMID:1517841

Hamvas, A; Kaplan, J D; Markham, J; Schuster, D P

1992-09-01

99

Assessment of left atrial appendage function and its relationship to pulmonary venous flow pattern by transesophageal echocardiography  

Microsoft Academic Search

We evaluated left atrial appendage function and its relationship to pulmonary venous flow in 53 patients divided into four groups. Group 1 consisted of 10 normal subjects. Group 2 included 15 patients with significant pure mitral stenosis in sinus rhythm. In group 3, there were 13 patients with pure significant mitral stenosis and atrial fibrillation. Group 4 consisted of 15

Tufan Tükek; Dursun Atilgan; Vakur Akkaya; Hasan Kudat; Seref Demirel; Mustafa Özcan; Ferruh Korkut

2001-01-01

100

Scintigraphy for Pulmonary Capillary Protein Leak.  

National Technical Information Service (NTIS)

Pulmonary gamma scintigraphy is a rapid, non-invasive technique for measuring a pulmonary capillary protein leak in ARDS. In these studies, the method demonstrated that the acute anesthetized lung lymph fistula sheep model was associated with a significan...

H. J. Sugerman J. L. Tatum J. I. Hirsch A. M. Strash

1983-01-01

101

Serum and pulmonary vascular endothelial growth factor/receptors and haemodynamic measurements in cyanotic congenital heart disease with decreased pulmonary blood flow.  

PubMed

Tetralogy of Fallot is the most common cyanotic congenital heart disease with decreased pulmonary blood flow. Right-to-left shunt and infundibular pulmonary stenosis in this disease lead to a decrease in arterial O(2) saturation. Hypoxia is a strong stimulus for angiogenesis; however, the reason for insufficiency in the pulmonary vascular growth in patients despite chronic arterial hypoxia is still not known. This study was planned considering that the impairment in vascular endothelial growth factor-receptor relationship or the vascular endothelial growth factor-receptor deficiency in the pulmonary vascular bed during development may cause insufficiency of pulmonary vascular growth. A total of 24 patients were grouped as cyanotic - including 13 patients with tetralogy of Fallot - and acyanotic - including 11 patients with left-to-right shunt lesions. During cardiac catheterisation, vascular endothelial growth factor measurements were performed; and oxygen saturations, pressures, and haemoglobin levels were measured. Perioperative lung biopsy for vascular endothelial growth factor receptors was performed in the cyanotic group. Vascular endothelial growth factor of the aorta was higher in the acyanotic group. There was a significant negative correlation between vascular endothelial growth factor levels and aortic O(2) saturation in the cyanotic group (p < 0.05). Vascular endothelial growth factor tissue staining was negative in 11 out of 13 (84.6%) patients. KDR/Flk-1 receptor was positive in four out of 13 (30.7%) patients; Flt-1 receptor was positive in six out of 13 (46.1%) patients. Vascular endothelial growth factor values were found to be lower than those of the acyanotic patients in this study. Low serum vascular endothelial growth factor levels of the cyanotic group, in spite of the hypoxia, demonstrated the importance of studying vascular endothelial growth factor tissue levels and vascular endothelial growth factor receptors in these patients. PMID:21774842

Tolunay, Ilknur; Tunaoglu, Sedef; Akyürek, Nalan; Halid, Velit; Olgunturk, Rana; Kula, Serdar

2011-07-21

102

Smoke aldehyde component influences pulmonary edema  

SciTech Connect

The pulmonary edema of smoke inhalation is caused by the toxins of smoke and not the heat. We investigated the potential of smoke consisting of carbon in combination with either acrolein or formaldehyde (both common components of smoke) to cause pulmonary edema in anesthetized sheep. Seven animals received acrolein smoke, seven animals received a low-dose formaldehyde smoke, and five animals received a high-dose formaldehyde smoke. Pulmonary arterial pressure, pulmonary capillary wedge pressure, and cardiac output were not affected by smoke in any group. Peak airway pressure increased after acrolein (14 +/- 1 to 21 +/- 2 mmHg; P less than 0.05) and after low- and high-dose formaldehyde (14 +/- 1 to 21 +/- 1 and 20 +/- 1 mmHg, respectively; both P less than 0.05). The partial pressure of O2 in arterial blood fell sharply after acrolein (219 +/- 29 to 86 +/- 9 (SE) Torr; P less than 0.05) but not after formaldehyde. Only acrolein resulted in a rise in lung lymph flow (6.5 +/- 2.2 to 17.9 +/- 2.6 ml/h; P less than 0.05). Lung lymph-to-plasma protein ratio was unchanged for all three groups, but clearance of lymph protein was increased after acrolein. After acrolein, the blood-free extravascular lung water-to-lung dry weight ratio was elevated (P less than 0.05) compared with both low- and high-dose formaldehyde groups (4.8 +/- 0.4 to 3.3 +/- 0.2 and 3.6 +/- 0.2, respectively). Lymph clearance (ng/h) of thromboxane B2, leukotriene B4, and the sulfidopeptide leukotrienes was elevated after acrolein but not formaldehyde.(ABSTRACT TRUNCATED AT 250 WORDS)

Hales, C.A.; Musto, S.W.; Janssens, S.; Jung, W.; Quinn, D.A.; Witten, M. (Department of Medicine (Pulmonary/Critical Care Unit), Massachusetts General Hospital, Boston (United States))

1992-02-01

103

Usefulness of Diastolic Dominant Pulmonary Vein Flow to Predict Hospitalization for Heart Failure and Mortality in Ambulatory Patients with Coronary Heart Disease (From the Heart and Soul Study)  

PubMed Central

Diastolic dysfunction is usually identified by the combination of characteristic mitral and pulmonary vein flow patterns. However, obtaining a complete set of echocardiographic parameters can be technically difficult and data may conflict. We hypothesized that, as a stand alone variable, diastolic (ventricular diastole) dominant pulmonary vein flow predicts heart failure (HF) hospitalizations and cardiovascular (CV) death. Standard transthoracic echocardiograms were performed in 906 participants from the Heart and Soul Study, a prospective study of the effects of depression on coronary heart disease. Pulmonary vein flow pattern was determined by the dominant velocity time integral. Cardiac events were determined by two independent adjudicators and Cox proportional hazards models were used. Systolic dominant pulmonary vein flow was present in 89% of the participants, and diastolic dominant in the remaining 11%. During an average 4.1 years of follow-up, participants with diastolic dominant pulmonary vein flow had a 25% rate of HF hospitalization and 9% rate of CV death. After multivariate adjustment including left ventricular ejection fraction, diastolic pulmonary vein flow was associated with a three-fold risk for HF hospitalization (p=0.001) and a two-fold risk for HF hospitalization or death (p=0.004). In conclusion, diastolic dominant pulmonary vein flow pattern is a stand alone predictor of adverse cardiac events and its presence is associated with significantly higher rates of HF hospitalizations and CV death.

Ren, Xiushui; Na, Beeya; Ristow, Bryan; Whooley, Mary A.; Schiller, Nelson B.

2009-01-01

104

Recent Advance in Lymph Dynamic Analysis in Lymphatics and Lymph Nodes  

PubMed Central

Lymphatics are a unidirectional transport system that carries fluid from the interstitial space and back into the blood stream. Initial lymphatics take up not only fluid but also high-molecular-weight substances, such as plasma proteins and hyaluronan; immune cells, such as lymphocytes, macrophages, and dendritic cells; and colloidal particles, such as carbon particles, bacteria, and tattoo dye. Interstitially injected colloidal particles are known to accumulate in the regional lymph nodes. This phenomenon is applied to find sentinel lymph nodes in cancer patients. Lymph flow rate and composition are influenced by interstitial fluid, lymphatic pump activity, and intra-lymphatic pressure. Lymph composition is changed during its flow downstream. In this review, the main focus is on the mechanisms of lymph formation at the initial lymphatics and lymph transport through the collecting lymphatics and lymph nodes. (*English Translation of J Jpn Coll Angiol, 2008, 48: 113-123.)

2012-01-01

105

How to find a thrombus in a small pulmonary vein that is not enhanced by contrast agents because of a lack of arterial blood flow.  

PubMed

It is unknown how to identify a small pulmonary vein thrombosis that is not contrasted because of loss of blood flow. Ischaemic stroke is an important clinical problem, and its prevention is a clinical target for the treatment of atrial fibrillation (AF). Because cardiac thrombus, a thrombus in the left atrial appendage and the left atrium, is well known, pulmonary vein thrombosis is thought to be a rare complication following lung surgery and catheter ablation. However, we have reported some cases of pulmonary vein thrombus without surgery, indicating that pulmonary vein thrombosis is not rare. In this case, we provide the details of an unenhanced pulmonary vein thrombus on 64-slice multidetector CT, which was largely illustrated in our previous case report. Because we understand the processes of the formation of pulmonary vein thrombus, we recognise an important implication of pulmonary vein thrombus; it alters hypoxic circumstances and under-nourished state. PMID:23897381

Takeuchi, Hidekazu

2013-07-29

106

Bidirectional Glenn Shunt as an Adjunct to Surgical Repair of Congenital Heart Disease Associated with Pulmonary Outflow Obstruction: Relevance of the Fluid Pressure Drop–Flow Relationship  

Microsoft Academic Search

A bidirectional Glenn shunt (BGS) was successfully incorporated into a two-ventricle repair for 10 patients (age, 3–17 years)\\u000a who had congenital heart disease associated with severe pulmonary outflow obstruction. The BGS was used to volume-unload the\\u000a pulmonary ventricle faced with residual outflow obstruction, thereby avoiding the need for insertion of a ventricle-to-pulmonary\\u000a artery conduit. Transthoracic Doppler flow velocity analysis was used

Robert Ascuitto; Nancy Ross-Ascuitto; Joshua Wiesman; Serafin DeLeon

2008-01-01

107

Circulation of lymph (image)  

MedlinePLUS

... the bloodstream during normal circulation is filtered through lymph nodes to remove bacteria, abnormal cells and other ... then transported back into the bloodstream via the lymph vessels. Lymph only moves in one direction, toward ...

108

Swollen lymph nodes  

MedlinePLUS

Swollen glands; Glands - swollen; Lymph nodes - swollen; Lymphadenopathy ... Common areas where the lymph nodes can be felt (with the fingers) include: Groin Armpit Neck (there is a chain of lymph nodes on either ...

109

Role of Rho-kinase signaling and endothelial dysfunction in modulating blood flow distribution in pulmonary hypertension.  

PubMed

Rho-kinase-mediated vasoconstriction and endothelial dysfunction are considered two primary instigators of pulmonary arterial hypertension (PAH). However, their contribution to the adverse changes in pulmonary blood flow distribution associated with PAH has not been addressed. This study utilizes synchrotron radiation microangiography to assess the specific role, and contribution of, Rho-kinase-mediated vasoconstriction and endothelial dysfunction in PAH. Male adult Sprague-Dawley rats were injected with saline (Cont-rats) or monocrotaline (MCT-rats) 3 wk before microangiography was performed on the left lung. We assessed dynamic changes in vessel internal diameter (ID) in response to 1) the Rho-kinase inhibitor fasudil (10 mg/kg iv); or 2) ACh (3 ?g · kg?ą · min?ą), sodium nitroprusside (SNP, 5 ?g · kg?ą · min?ą), and N(?)-nitro-l-arginine methyl ester (l-NAME, 50 mg/kg iv). We observed that MCT-rats had fewer vessels of the microcirculation compared with Cont-rats. The fundamental result of this study is that fasudil improved pulmonary blood flow distribution and reduced pulmonary pressure in PAH rats, not only by dilating already-perfused vessels (ID > 100 ?m), but also by restoring blood flow to vessels that had previously been constricted closed (ID < 100 ?m). Endothelium-dependent vasodilation was impaired in MCT-rats primarily in vessels with an ID < 200 ?m. Moreover the vasoconstrictor response to l-NAME was accentuated in MCT-rats, but only in the 200- to 300-?m vessels. These results highlight the importance of Rho-kinase-mediated control and endothelial control of pulmonary vascular tone in PAH. Indeed, an effective therapeutic strategy for treating PAH should target both the smooth muscle Rho-kinase and endothelial pathways. PMID:21212241

Schwenke, Daryl O; Pearson, James T; Sonobe, Takashi; Ishibashi-Ueda, Hatsue; Shimouchi, Akito; Kangawa, Kenji; Umetani, Keiji; Shirai, Mikiyasu

2011-01-06

110

Pulmonary blood flow measured by inspiratory inert gas concentration forcing oscillations.  

PubMed

The aim of this study was to discover if the forced inspired inert gas sinewave technique could be used to measure pulmonary blood flow, using nitrous oxide as the indicator gas, following inotropic stimulation of the heart by dobutamine, in the presence of a constant alveolar ventilation. Cardiac output (range 1-4.5 L min(-1)) was measured in six dogs by thermodilution and by calculation from the sinusoidal expired partial pressures of argon and nitrous oxide using: (i) analytical equations and a conventional continuous ventilation three-compartment lung model, which did not include recirculation; and (ii) a digital simulation tidal ventilation lung model (Gavaghan and Hahn, 1996. Respir. Physiol. 106, 209-221) which was adapted to include nitrous oxide mixed-venous recirculation from a combined single viscera compartment. The continuous ventilation model calculations always underestimated thermodilution cardiac output, with the bias error increasing to almost -1 L min(-1) at the longest forcing periods, 4-5 min. In contrast, the tidal ventilation model calculations were in close agreement to thermodilution cardiac output, with biases of -0.04 and -0.26 L min(-1) at forcing periods of 2 and 3 min, respectively. PMID:9776550

Williams, E M; Sainsbury, M C; Sutton, L; Xiong, L; Black, A M; Whiteley, J P; Gavaghan, D J; Hahn, C E

1998-07-01

111

Diastolic function abnormalities in rheumatoid arthritis. Evaluation by echo Doppler transmitral flow and pulmonary venous flow: relation with duration of disease  

PubMed Central

OBJECTIVE—The aim of this study was to evaluate left ventricular filling in patients with rheumatoid arthritis (RA), analysing transmitral flow and pulmonary venous flow, with special regard to age and disease duration.?METHODS—32 patients affected by RA according to ARA criteria were selected, without evidence of cardiac disease, and compared with matched control subjects. All patients and the control group were submitted to M-mode, two dimensional, Doppler and colour Doppler (continuous and pulsed wave) echocardiography. The following diastolic parameters were evaluated: transmitralic flow (E/A ratio), pulmonary venous flow (S/D ratio), a-Pw, IVRT and DT.?RESULTS—In RA patients left ventricular filling abnormalities were found characterised by a reduced E/A ratio (mean (SD) 1.16 (0.31) v controls 1.37 (0.32); p =0.02) and an increased S/D ratio (1.43 (0.40) v controls 1.22 (0.29); p = 0.017). In the group of patients a relation was found between E/A ratio and disease duration (r= 0.40, p =0.01 Spearman rank correlation).?CONCLUSIONS—At present, it is concluded that RA patients, in absence of clinical evidence of heart disease, show diastolic dysfunction characterised by impaired E/A and S/D ratio. The relation between transmitral flow alteration and disease duration suggests a sub-clinical myocardial involvement.??

Di, F; Paradiso, M.; Mammarella, A.; Paoletti, V.; Labbadia, G.; Coppotelli, L.; Taccari, E.; Musca, A.

2000-01-01

112

The sonographic evaluation of lymph nodes.  

PubMed

Ultrasound can be used to detect and evaluate both normal and abnormal lymph nodes, as well as aid in biopsy sampling procedures, an important part of staging procedures in cancer patients. Several parameters can be evaluated using ultrasound; lymph node size, margins, echogenicity, echopattern (echotexture), acoustic transmission, presence and distribution of vascular flow, and vascular flow indices. The most diagnostically helpful include the short/long axis ratio of the lymph node, the pattern of distribution of the blood vessels within the lymph node, and to some extent the resistive and pulsatility indices. This review discusses the use of ultrasound for detecting, evaluating, and sampling peripheral, abdominal and thoracic lymph nodes in small animals. PMID:17844819

Nyman, Helena T; O'Brien, Robert T

2007-08-01

113

Systemic to Pulmonary Collateral Flow as Measured by Cardiac Magnetic Resonance Imaging is Associated with Acute Post-Fontan Clinical Outcomes  

PubMed Central

Background Systemic-pulmonary collateral (SPC) flow occurs commonly in single ventricle patients after superior cavo-pulmonary connection, with unclear clinical significance. We sought to evaluate the association between SPC flow and acute post-Fontan clinical outcomes using a novel method of quantifying SPC flow by cardiac magnetic resonance (CMR). Methods and Results All patients who had SPC flow quantified by CMR prior to Fontan were retrospectively reviewed to assess for acute clinical outcomes after Fontan completion. Forty-four subjects were included who had Fontan completion between May, 2008 and September, 2010. SPC flow prior to Fontan measured 1.5 ± 0.9 L/min/m2, accounting for 31 ± 11% of total aortic flow and 44 ± 15% of total pulmonary venous flow. There was a significant linear association between natural log-transformed duration of hospitalization and SPC flow as a proportion of total aortic (rho=0.31, p=0.04) and total pulmonary venous flow (rho=0.29, p=0.05). After adjustment for Fontan type and presence of a fenestration, absolute SPC flow was significantly associated with hospital duration ? 7 days (OR=9.2, p=0.02) and chest tube duration ? 10 days (OR=22.7, p=0.009). Similar associations exist for SPC flow as a percentage of total aortic (OR=1.09, p=0.048 for hospitalization ? 7 days; OR=1.24, p=0.007 for chest tube duration ? 10 days) and total pulmonary venous flow (OR=1.07, p=0.048 for hospitalization ? 7 days; OR=1.18, p=0.006 for chest tube duration ? 10 days). Conclusions Increasing SPC flow before Fontan, as measured by CMR, is associated with increased duration of hospitalization and chest tube following Fontan completion.

Glatz, Andrew C.; Rome, Jonathan J.; Small, Adam J.; Gillespie, Matthew J.; Dori, Yoav; Harris, Matthew A.; Keller, Marc S.; Fogel, Mark A.; Whitehead, Kevin K.

2012-01-01

114

Inspiratory flows through dry powder inhaler in chronic obstructive pulmonary disease: age and gender rather than severity matters  

PubMed Central

Background: Dry powder inhalers (DPIs) are inspiratory flow driven and hence flow dependent. Most patients with chronic obstructive pulmonary disease (COPD) are elderly and have poor lung function. The factors affecting their inspiratory flows through inhalers are unclear. Objective: To study peak inspiratory flows (PIFs) and their determinants through a DPI in COPD patients of varying age and severity. Methods: Flow-volume spirometry was performed in 93 COPD patients. Maximum PIF rates were recorded through an empty Easyhaler® (PIFEH; Orion Corporation, Espoo, Finland), a DPI that provides consistent dose delivery at inhalation rates through the inhaler of 28 L/min or higher. Results: The mean PIFEH was 54 L/min (range 26–95 L/min) with a coefficient of variation of 7%. All but two patients were able to generate a flow of ?28 L/min. In a general linear model, the independent determinants for PIFEH were age (P = 0.02) and gender (P = 0.01), and forced expiratory volume in 1 s (FEV1) expressed as percent predicted was not a significant factor. The regression model accounted only for 18% of the variation in PIFEH. Conclusion: In patients with COPD, age and gender are more important determinants of inspiratory flow through DPIs than the degree of expiratory airway obstruction. Most COPD patients with varying age and severity are able to generate inspiratory flows through the test inhaler that is sufficient for optimal drug delivery to the lower airways.

Malmberg, L Pekka; Rytila, Paula; Happonen, Pertti; Haahtela, Tari

2010-01-01

115

Systemic-to-pulmonary collateral flow in patients with palliated univentricular heart physiology: measurement using cardiovascular magnetic resonance 4D velocity acquisition  

PubMed Central

Background Systemic-to-pulmonary collateral flow (SPCF) may constitute a risk factor for increased morbidity and mortality in patients with single-ventricle physiology (SV). However, clinical research is limited by the complexity of multi-vessel two-dimensional (2D) cardiovascular magnetic resonance (CMR) flow measurements. We sought to validate four-dimensional (4D) velocity acquisition sequence for concise quantification of SPCF and flow distribution in patients with SV. Methods 29 patients with SV physiology prospectively underwent CMR (1.5?T) (n?=?14 bidirectional cavopulmonary connection [BCPC], age 2.9?±?1.3?years; and n?=?15 Fontan, 14.4?±?5.9?years) and 20 healthy volunteers (age, 28.7?±?13.1?years) served as controls. A single whole-heart 4D velocity acquisition and five 2D flow acquisitions were performed in the aorta, superior/inferior caval veins, right/left pulmonary arteries to serve as gold-standard. The five 2D velocity acquisition measurements were compared with 4D velocity acquisition for validation of individual vessel flow quantification and time efficiency. The SPCF was calculated by evaluating the disparity between systemic (aortic minus caval vein flows) and pulmonary flows (arterial and venour return). The pulmonary right to left and the systemic lower to upper body flow distribution were also calculated. Results The comparison between 4D velocity and 2D flow acquisitions showed good Bland-Altman agreement for all individual vessels (mean bias, 0.05±0.24?l/min/m2), calculated SPCF (?0.02±0.18?l/min/m2) and significantly shorter 4D velocity acquisition-time (12:34?min/17:28?min,p?pulmonary estimator for SPFC; (2) significant SPCF in patients (BCPC 0.79±0.45?l/min/m2; Fontan 0.62±0.82?l/min/m2) and not in controls (0.01?+?0.16?l/min/m2), (3) inverse relation of right/left pulmonary artery perfusion and right/left SPCF (Pearson?=??0.47,p?=?0.01) and (4) upper to lower body flow distribution trend related to the weight (r?=?0.742, p?flow acquisition to quantify SPCF. There is considerable SPCF in BCPC and Fontan patients. SPCF was more pronounced towards the respective lung with less pulmonary arterial flow suggesting more collateral flow where less anterograde branch pulmonary artery perfusion.

2012-01-01

116

Swollen lymph node (image)  

MedlinePLUS

Lymph nodes play an important part in the body's defense against infection. Swelling might occur even if ... infection is trivial or not apparent. Swelling of lymph nodes generally results from localized or systemic infection, ...

117

Contribution of serial and parallel microperfusion to spatial variability in pulmonary inter- and intra-acinar blood flow  

PubMed Central

This study presents a theoretical model of combined series and parallel perfusion in the human pulmonary acinus that maintains computational simplicity while capturing some important features of acinar structure. The model provides a transition between existing models of perfusion in the large pulmonary blood vessels and the pulmonary microcirculation. Arterioles and venules are represented as distinct elastic vessels that follow the branching structure of the acinar airways. These vessels are assumed to be joined at each generation by capillary sheets that cover the alveoli present at that generation, forming a “ladderlike” structure. Compared with a model structure in which capillary beds connect only the most distal blood vessels in the acinus, the model with combined serial and parallel perfusion provides greater capacity for increased blood flow in the lung via capillary recruitment when the blood pressure is elevated. Stratification of acinar perfusion emerges in the model, with red blood cell transit time significantly larger in the distal portion of the acinus compared with the proximal portion. This proximal-to-distal pattern of perfusion may act in concert with diffusional screening to optimize the potential for gas exchange.

Burrowes, K. S.; Tawhai, M. H.

2010-01-01

118

Contribution of serial and parallel microperfusion to spatial variability in pulmonary inter- and intra-acinar blood flow.  

PubMed

This study presents a theoretical model of combined series and parallel perfusion in the human pulmonary acinus that maintains computational simplicity while capturing some important features of acinar structure. The model provides a transition between existing models of perfusion in the large pulmonary blood vessels and the pulmonary microcirculation. Arterioles and venules are represented as distinct elastic vessels that follow the branching structure of the acinar airways. These vessels are assumed to be joined at each generation by capillary sheets that cover the alveoli present at that generation, forming a "ladderlike" structure. Compared with a model structure in which capillary beds connect only the most distal blood vessels in the acinus, the model with combined serial and parallel perfusion provides greater capacity for increased blood flow in the lung via capillary recruitment when the blood pressure is elevated. Stratification of acinar perfusion emerges in the model, with red blood cell transit time significantly larger in the distal portion of the acinus compared with the proximal portion. This proximal-to-distal pattern of perfusion may act in concert with diffusional screening to optimize the potential for gas exchange. PMID:20110543

Clark, A R; Burrowes, K S; Tawhai, M H

2010-01-28

119

Noninvasive Quantification of Systemic To Pulmonary Collateral Flow: A Major Source of Inefficiency in Patients with Superior Cavopulmonary Connections  

PubMed Central

Background Systemic to pulmonary collateral flow (SPCF) is common in single ventricle patients (pts) with superior cavopulmonary connections (BDG). Because no validated method to quantify SPCF exists, neither its hemodynamic burden nor clinical impact can be systematically evaluated. We hypothesize that (1) the difference in total ascending aortic (Ao) and caval flow (SVC+IVC) and (2) the difference between pulmonary vein and artery flow (PV ? PA) provide two independent estimators of SPCF. Methods and Results We measured Ao, SVC, IVC, right (RPA) and left (LPA) PA, left (LPV), and right (RPV) PV flows in 17 BDG pts during routine cardiac magnetic resonance imaging studies using through-plane phase contrast velocity mapping. Two independent measures of SPCF were obtained: (1) Ao ? (SVC + IVC). (2) (LPV?LPA) + (RPV?RPA). Values were normalized to body surface area (BSA), Ao, and PV and comparisons made using linear regression and Bland-Altman analysis. SPCF ranged from 0.2–1.4 L/min for (1) and 0.2–1.6 L/min for (2) for an average indexed SPCF of 0.5–2.8 L/min/m2 : 11–53% (mean 37%) of Ao and 19–77% (mean 54%) of PV. The mean difference between (1) and (2) was 0.01 L/min (p=0.40, 2 S.D. range ?0.45–0.47 L/min). Conclusions We present a noninvasive method for the SPCF quantification in pts with BDG. It should provide an important clinical tool in managing these patients. Furthermore, we show that SPCF is a significant hemodynamic burden in many patients with BDG physiology. Future investigations will allow objective study of the impact of collateral flow on outcome.

Whitehead, Kevin K.; Gillespie, Matthew J.; Harris, Matthew A.; Fogel, Mark A.; Rome, Jonathan J.

2009-01-01

120

A comprehensive flow-cytometric analysis of graft infiltrating lymphocytes, draining lymph nodes and serum during the rejection phase in a fully allogeneic rat cornea transplant model  

PubMed Central

Purpose To establish a cornea transplant model in a pigmented rat strain and to define the immunologic reaction toward corneal allografts, by studying the cellular and humoral immune response after keratoplasty. Methods Full thickness penetrating keratoplasty was performed on Brown Norway (RT1n) recipients using fully major histocompatibility complex (MHC)-mismatched Piebald-Viral-Glaxo (PVG; RT1c) donors. Using multicolor flow cytometry (FACS) we quantified and compared the cellular composition of draining versus non-draining lymph nodes (LN). Furthermore, we developed an isolation method to release viable graft infiltrating lymphocytes (GIL) and subjected them to phenotypic analysis and screened serum from transplanted animals for allo-antibodies. Results Assessing ipsi-lateral submandibular LN we find ample evidence for post surgical inflammation such as elevated absolute numbers of cluster of differentiation (CD)4+, CD8+, B-cells, and differential expression of CD134. However, we could not unequivocally identify an allo-antigen-specific immune response. FACS analysis of lymphocytes isolated from collagenase digested rejected corneas revealed the following six distinct subpopulations: MHC-2+ cells, CD4+ T-cells, CD8+ T-cells, CD161dull large granular lymphocytes, CD3+ CD8+ CD161dull natural killer (NK)-T-cells and CD161high CD3- NK cells. At post-operation day (POD)-07 only CD161dull MHC-2neg large granular lymphocytes (LGLs) were detected in syngeneic and allo-grafts. In concordance with an increase in B-cell numbers we often detected copious amounts of allo-antibodies in serum of rejecting animals, in particular immunoglobulin (Ig) M (IgM), immunoglobulin (Ig) G1 (IgG1), and IgG2a. Conclusions Our results demonstrate that despite its immune privileged status and low-responder characteristics of the strain combination, allogeneic corneal grafts mount a full fledged T helper1 (Th1) and Th2 response. The presence of NK-T-cells and NK-cells in rejecting corneas shows the synergy between innate and adaptive immunity during allograft destruction.

Maenz, Martin; Morcos, Mourice

2011-01-01

121

Detection of invasive pulmonary aspergillosis in haematological malignancy patients by using lateral-flow technology.  

PubMed

Invasive pulmonary aspergillosis (IPA) is a leading cause of morbidity and mortality in haematological malignancy patients and hematopoietic stem cell transplant recipients(1). Detection of IPA represents a formidable diagnostic challenge and, in the absence of a 'gold standard', relies on a combination of clinical data and microbiology and histopathology where feasible. Diagnosis of IPA must conform to the European Organization for Research and Treatment of Cancer and the National Institute of Allergy and Infectious Diseases Mycology Study Group (EORTC/MSG) consensus defining "proven", "probable", and "possible" invasive fungal diseases(2). Currently, no nucleic acid-based tests have been externally validated for IPA detection and so polymerase chain reaction (PCR) is not included in current EORTC/MSG diagnostic criteria. Identification of Aspergillus in histological sections is problematic because of similarities in hyphal morphologies with other invasive fungal pathogens(3), and proven identification requires isolation of the etiologic agent in pure culture. Culture-based approaches rely on the availability of biopsy samples, but these are not always accessible in sick patients, and do not always yield viable propagules for culture when obtained. An important feature in the pathogenesis of Aspergillus is angio-invasion, a trait that provides opportunities to track the fungus immunologically using tests that detect characteristic antigenic signatures molecules in serum and bronchoalveolar lavage (BAL) fluids. This has led to the development of the Platelia enzyme immunoassay (GM-EIA) that detects Aspergillus galactomannan and a 'pan-fungal' assay (Fungitell test) that detects the conserved fungal cell wall component (1 ?3)-?-D-glucan, but not in the mucorales that lack this component in their cell walls(1,4). Issues surrounding the accuracy of these tests(1,4-6) has led to the recent development of next-generation monoclonal antibody (MAb)-based assays that detect surrogate markers of infection(1,5). Thornton(5) recently described the generation of an Aspergillus-specific MAb (JF5) using hybridoma technology and its use to develop an immuno-chromatographic lateral-flow device (LFD) for the point-of-care (POC) diagnosis of IPA. A major advantage of the LFD is its ability to detect activity since MAb JF5 binds to an extracellular glycoprotein antigen that is secreted during active growth of the fungus only(5). This is an important consideration when using fluids such as lung BAL for diagnosing IPA since Aspergillus spores are a common component of inhaled air. The utility of the device in diagnosing IPA has been demonstrated using an animal model of infection, where the LFD displayed improved sensitivity and specificity compared to the Platelia GM and Fungitell (1 ? 3)-?-D-glucan assays(7). Here, we present a simple LFD procedure to detect Aspergillus antigen in human serum and BAL fluids. Its speed and accuracy provides a novel adjunct point-of-care test for diagnosis of IPA in haematological malignancy patients. PMID:22473419

Thornton, Christopher; Johnson, Gemma; Agrawal, Samir

2012-03-22

122

Role of platelets in maintenance of pulmonary vascular permeability to protein  

SciTech Connect

The authors examined the role of platelets in maintenance of pulmonary vascular integrity by inducing thrombocytopenia in sheep using antiplatelet serum (APS). A causal relationship between thrombocytopenia and increase in pulmonary vascular permeability was established by platelet repletion using platelet-rich plasma (PRP). Sheep were chronically instrumented and lung lymph fistulas prepared to monitor pulmonary lymph flow (Q{sub lym}). A balloon catheter was positioned in the left atrium to assess pulmonary vascular permeability to protein after raising the left atrial pressure (P{sub la}). Thrombocytopenia was maintained for 3 days by daily intramuscular APS injections. In studies using cultured bovine pulmonary artery endothelial monolayers, transendothelia permeability of {sup 125}I-labeled albumin was reduced 50 and 95%, respectively, when 2.5 {times} 10{sup 7} or 5 {times} 10{sup 7} platelets were added onto endothelial monolayers. However, addition of 5 {times} 10{sup 6} platelets or 5 {times} 10{sup 7} red blood cells did not reduce endothelial monolayer albumin permeability. Results indicate that platelets are required for the maintenance of pulmonary vascular permeability. Reduction in permeability appears to involve an interaction of platelets with the endothelium.

Lo, S.K.; Burhop, K.E.; Kaplan, J.E.; Malik, A.B. (Albany Medical College of Union Univ., NY (USA))

1988-04-01

123

Ovine Model for Studying Pulmonary Immune Responses.  

National Technical Information Service (NTIS)

Anatomical features of the sheep lung make it an excellent model for studying pulmonary immunity. Four specific lung segments were identified which drain exclusively to three separate lymph nodes. One of these segments, the dorsal basal segment of the rig...

D. D. Joel A. D. Chanana

1984-01-01

124

Video-assisted thoracoscopic surgery (VATS) right upper lobectomy and systematic lymph node dissection for lung cancer.  

PubMed

Video-assisted thoracoscopic surgery (VATS) represents a new trend in the development of minimally invasive thoracic surgery. When applied in lung cancer surgeries, VATS can be used for both pulmonary lobectomy and regional lymph node dissection. Currently the main concerns are focused on the completeness of lymph node dissection for lung cancer and the safety of surgery. The lymph node dissection includes two parts: (I) dissection of interlobar and hilar lymph nodes; and (II) dissection of mediastinal lymph nodes. The demonstrated surgical procedures are featured by: (I) the interlobar and hilar lymph nodes are not removed separately; rathr, they are taken out en bloc with the pulmonary lobes during the surgery; and (II) systematic lymph node dissection, instead of systematic sampling, is applied for the removal of mediastinal lymph nodes. Also, during the fully anatomical resection, each blood vessel and bronchus underwent anatomical dissociation, indicating that this surgery is safe. PMID:24040542

Li, Xiao-Dong; Yang, Hong; Zheng, Ying-Bin; Huang, Qing-Yuan

2013-08-01

125

Video-assisted thoracoscopic surgery (VATS) right upper lobectomy and systematic lymph node dissection for lung cancer  

PubMed Central

Video-assisted thoracoscopic surgery (VATS) represents a new trend in the development of minimally invasive thoracic surgery. When applied in lung cancer surgeries, VATS can be used for both pulmonary lobectomy and regional lymph node dissection. Currently the main concerns are focused on the completeness of lymph node dissection for lung cancer and the safety of surgery. The lymph node dissection includes two parts: (I) dissection of interlobar and hilar lymph nodes; and (II) dissection of mediastinal lymph nodes. The demonstrated surgical procedures are featured by: (I) the interlobar and hilar lymph nodes are not removed separately; rathr, they are taken out en bloc with the pulmonary lobes during the surgery; and (II) systematic lymph node dissection, instead of systematic sampling, is applied for the removal of mediastinal lymph nodes. Also, during the fully anatomical resection, each blood vessel and bronchus underwent anatomical dissociation, indicating that this surgery is safe.

Yang, Hong; Zheng, Ying-Bin; Huang, Qing-Yuan

2013-01-01

126

Phase-Contrast MRI and CFD Modeling of Apparent 3He Gas Flow in Rat Pulmonary Airways  

SciTech Connect

Phase-contrast (PC) magnetic resonance imaging (MRI) with hyperpolarized 3He is potentially useful for developing and testing patient-specific models of pulmonary airflow. One challenge, however, is that PC-MRI provides apparent values of local 3He velocity that not only depend on actual airflow but also on gas diffusion. This not only blurs laminar flow patterns in narrow airways but also introduces anomalous airflow structure that reflects gas-wall interactions. Here, both effects are predicted in a live rat using computational fluid dynamics (CFD), and for the first time, simulated patterns of apparent 3He gas velocity are compared with in-vivo PC-MRI. Results show (1) that correlations (R2) between measured and simulated airflow patterns increase from 0.23 to 0.79 simply by accounting for apparent 3He transport, and that (2) remaining differences are mainly due to uncertain airway segmentation and partial volume effects stemming from relatively coarse MRI resolution. Higher-fidelity testing of pulmonary airflow predictions should therefore be possible with future imaging improvements.

Minard, Kevin R.; Kuprat, Andrew P.; Kabilan, Senthil; Jacob, Rick E.; Einstein, Daniel R.; Carson, James P.; Corley, Richard A.

2012-08-01

127

Phase-contrast MRI and CFD modeling of apparent 3He gas flow in rat pulmonary airways  

NASA Astrophysics Data System (ADS)

Phase-contrast (PC) magnetic resonance imaging (MRI) with hyperpolarized 3He is potentially useful for developing and testing patient-specific models of pulmonary airflow. One challenge, however, is that PC-MRI provides apparent values of local 3He velocity that not only depend on actual airflow but also on gas diffusion. This not only blurs laminar flow patterns in narrow airways but also introduces anomalous airflow structure that reflects gas-wall interactions. Here, both effects are predicted in a live rat using computational fluid dynamics (CFD), and for the first time, simulated patterns of apparent 3He gas velocity are compared with in vivo PC-MRI. Results show (1) that correlations (R2) between measured and simulated airflow patterns increase from 0.23 to 0.79 simply by accounting for apparent 3He transport, and (2) that remaining differences are mainly due to uncertain airway segmentation and partial volume effects stemming from relatively coarse MRI resolution. Higher-fidelity testing of pulmonary airflow predictions should therefore be possible with future imaging improvements.

Minard, Kevin R.; Kuprat, Andrew P.; Kabilan, Senthil; Jacob, Richard E.; Einstein, Daniel R.; Carson, James P.; Corley, Richard A.

2012-08-01

128

Expiratory Flow-Volume Loop Profile and Patient Outcome in Chronic Obstructive Pulmonary Disease in Acute Respiratory Failure: A Prospective Observational Study in a Single Intensive Care Unit  

Microsoft Academic Search

Background: Expiratory flow-volume (EFV) loops are continuously displayed on the screen of intensive care unit (ICU) ventilators. Objectives: It was the aim of this study to investigate the relationships of EFV to chronic obstructive pulmonary disease (COPD) patient outcome. Methods: This is a prospective study on COPD patients who received invasive mechanical ventilation for acute respiratory failure in the ICU.

Véronique Porot; Sylvie Ernesto; Véronique Leray; Bertrand Delannoy; Gael Bourdin; Frédérique Bayle; Jean-Christophe Richard; Claude Guérin

2012-01-01

129

Increased initial flow rate reduces inspiratory work of breathing during pressure support ventilation in patients with exacerbation of chronic obstructive pulmonary disease  

Microsoft Academic Search

Objective: To investigate whether the level of initial flow rate alters the work of breathing in chro- nic obstructive pulmonary disease (COPD) patients ventilated in pres- sure support ventilation (PSV). Design: Prospective study. Settings: Medical ICU in Univer- sity hospital. Patients: Eleven intubated COPD patients. Methods.\\

G. Bonmarchand; V. Chevron; D. Jusserand; C. Girault; F. Moritz; J. Leroy; P. Pasquis; C. Chopin

1996-01-01

130

Reversal of flow in the pulmonary artery: high-pitch spiral as a new method for dose reduction in functional imaging.  

PubMed

Advancements in CT technology lave led to substantial dose reductions for anatomic imaging of the heart. Here we illustrate an example where rapid repeat imaging with a high pitch spiral technique can image physiologic function. By optimal timing, and repeat sub second scanning, we illustrate an unusual case where direction of blood flow in the right pulmonary artery is reversed. PMID:22682263

Boswell, Gilbert E; Cathey, Michael; Campin, Richard; Nayak, Keshav

2012-05-11

131

Calculating blood flow from Doppler measurements in the systemic-to-pulmonary artery shunt after the Norwood operation: a method based on computational fluid dynamics  

Microsoft Academic Search

Hypoplastic left heart syndrome is currently the most lethal cardiac malformation of the newborn infant. Survival following a Norwood operation depends on the balance between systemic and pulmonary blood flow, which is highly dependent on the fluid dynamics through the interposition shunt between the two circulations. We used computational fluid dynamic (CFD) models to determine the velocity profile in a

Francesco Migliavacca; Robert Yates; Giancarlo Pennati; Gabriele Dubini; Roberto Fumero; Marc R. de Leval

2000-01-01

132

Evaluation of the effect of postural and gravitational variations on the distribution of pulmonary blood flow via an image-based computational model  

Microsoft Academic Search

We have developed an image-based computational model of blood flow within the human pulmonary circulation in order to investigate the distribution of flow under various conditions of posture and gravity. Geometric models of the lobar surfaces and largest arterial and venous vessels were derived from multi-detector row X-ray computed tomography. The remaining blood vessels were generated using a volume-filling branching

K. S. Burrowes; P. J. Hunter; M. H. Tawhai

2005-01-01

133

4D cardiovascular magnetic resonance velocity mapping of alterations of right heart flow patterns and main pulmonary artery hemodynamics in tetralogy of Fallot  

PubMed Central

Background To assess changes in right heart flow and pulmonary artery hemodynamics in patients with repaired Tetralogy of Fallot (rTOF) we used whole heart, four dimensional (4D) velocity mapping (VM) cardiovascular magnetic resonance (CMR). Methods CMR studies were performed in 11 subjects with rTOF (5M/6F; 20.1 ± 12.4 years) and 10 normal volunteers (6M/4F; 34.2 ± 13.4 years) on clinical 1.5T and 3.0T MR scanners. 4D VM-CMR was performed using PC VIPR (Phase Contrast Vastly undersampled Isotropic Projection Reconstruction). Interactive streamline and particle trace visualizations of the superior and inferior vena cava (IVC and SVC, respectively), right atrium (RA), right ventricle (RV), and pulmonary artery (PA) were generated and reviewed by three experienced readers. Main PA net flow, retrograde flow, peak flow, time-to-peak flow, peak acceleration, resistance index and mean wall shear stress were quantified. Differences in flow patterns between the two groups were tested using Fisher's exact test. Differences in quantitative parameters were analyzed with the Kruskal-Wallis rank sum test. Results 4D VM-CMR was successfully performed in all volunteers and subjects with TOF. Right heart flow patterns in rTOF subjects were characterized by (a) greater SVC/IVC flow during diastole than systole, (b) increased vortical flow patterns in the RA and in the RV during diastole, and (c) increased helical or vortical flow features in the PA's. Differences in main PA retrograde flow, resistance index, peak flow, time-to-peak flow, peak acceleration and mean wall shear stress were statistically significant. Conclusions Whole heart 4D VM-CMR with PC VIPR enables detection of both normal and abnormal right heart flow patterns, which may allow for comprehensive studies to evaluate interdependencies of post-surgically altered geometries and hemodynamics.

2012-01-01

134

Shear flow over a self-similar expanding pulmonary alveolus during rhythmical breathing  

Microsoft Academic Search

Alternating shear flow over a self-similar, rhythmically expanding hemispherical depression is investigated. It provides a fluid-mechanical model for an alveolated respiratory unit, by means of which the effect of lung rhythmical expansion on gas mixing as well as aerosol dispersion and deposition can be studied. The flow is assumed to be very slow and governed by the quasi-steady linear Stokes

S. Haber; J. P. Butler; H. Brenner; I. Emanuel; A. Tsuda

2000-01-01

135

Shear flow over a self-similar expanding pulmonary alveolus during rhythmical breathing  

NASA Astrophysics Data System (ADS)

Alternating shear flow over a self-similar, rhythmically expanding hemispherical depression is investigated. It provides a fluid-mechanical model for an alveolated respiratory unit, by means of which the effect of lung rhythmical expansion on gas mixing as well as aerosol dispersion and deposition can be studied. The flow is assumed to be very slow and governed by the quasi-steady linear Stokes equations. Consequently, superposition of the following two cases provides an easy route toward characterizing the aforementioned flow field. The first case treats the flow field that is generated by a rhythmically expanding spherical cap (the alveolus). The cap is attached at its rim to a circular opening in an expanding unbounded plane bounding a semi-infinite fluid region. The rate of expansion of the cap and the plane are chosen such as to maintain the system's configurational self-similarity. The second case addresses the flow disturbance that is generated by an alternating shear flow encountering a rigid hemispherical cavity in a plane bounding a semi-infinite fluid domain.

Haber, S.; Butler, J. P.; Brenner, H.; Emanuel, I.; Tsuda, A.

2000-02-01

136

Mediastinal lymph node size in lung cancer  

SciTech Connect

Using a size criterion of 1 cm or greater as evidence for abnormality, the size of mediastinal lymph nodes identified by computed tomography (CT) was a poor predictor of mediastinal lymph node metastases in a series of 86 patients who had surgery for bronchogenic carcinoma. The surgery included full nodal sampling in all patients. Of the 86 patients, 36 had nodes greater than or equal to 1 cm identified by CT. Of the 21 patients with mediastinal metastases proven at surgery, 14 had nodes greater than or equal to 1 cm (sensitivity = 67%). Of the 65 patients without mediastinal metastases, 22 had nodes greater than or equal to 1 cm. Obstructive pneumonia and/or pulmonary collapse distal to the cancer was present in 39 patients (45%). Obstructive pneumonia and/or pulmonary collapse is a common occurrence in bronchogenic carcinoma, but mediastinal nodes greater than or equal to 1 cm in this circumstance cannot be presumed to represent metastatic disease. Metastatic mediastinal lymph node involvement was related to nodal size also in patients with evidence of prior granulomatous disease and in patients with no putative benign cause for nodes greater than or equal to 1 cm.

Libshitz, H.I.; McKenna, R.J. Jr.

1984-10-01

137

Significant differences in flow standardised breath sound spectra in patients with chronic obstructive pulmonary disease, stable asthma, and healthy lungs.  

PubMed Central

BACKGROUND--Spectral characteristics of breath sounds in asthma and chronic obstructive pulmonary disease (COPD) have not previously been compared, although the structural differences in these disorders might be reflected in breath sounds. METHODS--Flow standardised inspiratory breath sounds in patients with COPD (n = 17) and stable asthma (n = 10) with significant airways obstruction and in control patients without any respiratory disorders (n = 11) were compared in terms of estimates of the power spectrum. Breath sounds were recorded simultaneously at the chest and at the trachea. RESULTS--The median frequency (F50) of the mean (SD) breath sound spectra recorded at the chest was higher in asthmatics (239 (19) Hz) than in both the control patients (206 (14) Hz) and the patients with COPD (201 (21) Hz). The total spectral power of breath sounds recorded at the chest in terms of root mean square (RMS) was higher in asthmatics than in patients with COPD. In patients with COPD the spectral parameters were not statistically different from those of control patients. The F50 recorded at the trachea in the asthmatics was significantly related to forced expiratory volume in one second (FEV1) (r = -0.77), but this was not seen in the other groups. CONCLUSIONS--The observed differences in frequency content of breath sounds in patients with asthma and COPD may reflect altered sound generation or transmission due to structural changes of the bronchi and the surrounding lung tissue in these diseases. Spectral analysis of breath sounds may provide a new non-invasive method for differential diagnosis of obstructive pulmonary diseases.

Malmberg, L P; Pesu, L; Sovijarvi, A R

1995-01-01

138

Effects of an aging pulmonary system on expiratory flow limitation and dyspnoea during exercise in healthy women.  

PubMed

Aging related changes in pulmonary function may make older women (OW) more susceptible to expiratory flow limitation (EFL) and lead to higher dyspnoea ratings during exercise relative to young women (YW). Accordingly, the purpose of this study was to compare sensory responses and EFL susceptibility and magnitude in 8 YW (29 ± 7 years) and 8 healthy OW (64 ± 3 years) matched for percentage-predicted forced vital capacity (% predicted FVC) and % predicted forced expiratory volume in 1 s. EFL was calculated as the percent overlap between tidal flow-volume loops during maximal exercise and the maximal expiratory flow-volume (MEFV) curve. Peak oxygen consumption (V'O(2peak)) was lower in the OW compared to the YW (29.4 ± 3.6 vs. 49.1 ± 8.9 ml kg(-1) min(-1), P < 0.05) as was maximal ventilation (73.7 ± 18.4 vs. 108.7 ± 14.1 l min(-1), P < 0.05). EFL at maximal exercise was present in 2 of 8 YW and in 5 of 8 OW. There were no significant differences in the magnitude of EFL between OW (23 ± 24, range: 0-69 %EFL) and YW (9 ± 18, range: 0-46 %EFL, P = 0.21). The magnitude of EFL in OW was inversely related to % predicted FVC (r = -0.69, P = 0.06), but this relationships was not observed in the YW (r = -0.23, P = 0.59). The OW consistently reported greater dyspnoea and leg discomfort for any given absolute work rate, but not when work was expressed as a percentage of maximum. Reduced ventilatory and exercise capacities may cause OW to be more susceptible to EFL during exercise and experience greater dyspnoea relative to YW for a standardized physical task. PMID:21971945

Wilkie, Sabrina S; Guenette, Jordan A; Dominelli, Paolo B; Sheel, A William

2011-10-05

139

Pulmonary embolism  

SciTech Connect

Pulmonary embolism is a common medical problem whose incidence is likely to increase in our aging population. Although it is life-threatening, effective therapy exists. The treatment is not, however, without significant complications. Thus, accurate diagnosis is important. Unfortunately, the clinical manifestations of pulmonary embolism are nonspecific. Furthermore, in many patients the symptoms of an acute embolism are superimposed on underlying chronic heart or lung disease. Thus, a high index of suspicion is needed to identify pulmonary emboli. Laboratory parameters, including arterial oxygen tensions and electrocardiography, are as nonspecific as the clinical signs. They may be more useful in excluding another process than in diagnosing pulmonary embolism. The first radiologic examination is the chest radiograph, but the clinical symptoms are frequently out of proportion to the findings on the chest films. Classic manifestations of pulmonary embolism on the chest radiograph include a wedge-shaped peripheral opacity and a segmental or lobar diminution in vascularity with prominent central arteries. However, these findings are not commonly seen and, even when present, are not specific. Even less specific findings include cardiomegaly, pulmonary infiltrate, elevation of a hemidiaphragm, and pleural effusion. Many patients with pulmonary embolism may have a normal chest radiograph. The chest radiograph is essential, however, for two purposes. First, it may identify another cause of the patient's symptoms, such as a rib fracture, dissecting aortic aneurysm, or pneumothorax. Second, a chest radiograph is essential to interpretation of the radionuclide V/Q scan. The perfusion scan accurately reflects the perfusion of the lung. However, a perfusion defect may result from a variety of etiologies. Any process such as vascular stenosis or compression by tumor may restrict blood flow. 84 references.

Dunnick, N.R.; Newman, G.E.; Perlmutt, L.M.; Braun, S.D.

1988-11-01

140

Ovine model for studying pulmonary immune responses  

SciTech Connect

Anatomical features of the sheep lung make it an excellent model for studying pulmonary immunity. Four specific lung segments were identified which drain exclusively to three separate lymph nodes. One of these segments, the dorsal basal segment of the right lung, is drained by the caudal mediastinal lymph node (CMLN). Cannulation of the efferent lymph duct of the CMLN along with highly localized intrabronchial instillation of antigen provides a functional unit with which to study factors involved in development of pulmonary immune responses. Following intrabronchial immunization there was an increased output of lymphoblasts and specific antibody-forming cells in efferent CMLN lymph. Continuous divergence of efferent lymph eliminated the serum antibody response but did not totally eliminate the appearance of specific antibody in fluid obtained by bronchoalveolar lavage. In these studies localized immunization of the right cranial lobe served as a control. Efferent lymphoblasts produced in response to intrabronchial antigen were labeled with /sup 125/I-iododeoxyuridine and their migrational patterns and tissue distribution compared to lymphoblasts obtained from the thoracic duct. The results indicated that pulmonary immunoblasts tend to relocate in lung tissue and reappear with a higher specific activity in pulmonary lymph than in thoracic duct lymph. The reverse was observed with labeled intestinal lymphoblasts. 35 references, 2 figures, 3 tables.

Joel, D.D.; Chanana, A.D.

1984-11-25

141

Associated inflammation or increased flow-mediated shear stress, but not pressure alone, disrupts endothelial caveolin-1 in infants with pulmonary hypertension.  

PubMed

Endothelial caveolin-1 loss is an important feature of pulmonary hypertension (PH); the rescue of caveolin-1 abrogates experimental PH. Recent studies in human PH suggest that the endothelial caveolin-1 loss is followed by an enhanced expression of caveolin-1 in smooth muscle cells (SMC) with subsequent neointima formation. In order to evaluate caveolin-1 expression in infants with PH, we examined the available clinical histories, hemodynamic data, and the expression of caveolin-1, PECAM-1, vWF, and smooth muscle ?-actin in the lung biopsy/autopsy specimens obtained from infants with congenital heart disease (CHD, n = 8) and lung disease (n = 9). In CHD group, PH associated with increased pulmonary blood flow exhibited loss of endothelial caveolin-1 and PECAM-1 in pulmonary arteries; additional vWF loss was associated with enhanced expression of caveolin-1 in SMC. In the absence of PH, increased or decreased pulmonary blood flow did not disrupt endothelial caveolin-1, PECAM-1, or vWF; nor was there any enhanced expression of caveolin-1 in SMC. In Lung Disease + PH group, caveolin-1, PECAM-1, and vWF were well preserved in seven infants, and importantly, SMC in these arteries did not exhibit enhanced caveolin-1 expression. Two infants with associated inflammatory disease exhibited loss of endothelial caveolin-1 and PECAM-1; additional loss of vWF was accompanied by enhanced expression of caveolin-1 in SMC. Thus, associated flow-induced shear stress or inflammation, but not elevated pulmonary artery pressure alone, disrupts endothelial caveolin-1. Subsequent vWF loss, indicative of extensive endothelial damage is associated with enhanced expression of caveolin-1 in SMC, which may worsen the disease. PMID:23372934

Dereddy, Narendra; Huang, Jing; Erb, Markus; Guzel, Sibel; Wolk, John H; Sett, Suvro S; Gewitz, Michael H; Mathew, Rajamma

2012-10-01

142

Intramammary lymph nodes.  

PubMed Central

AIMS: To determine the prevalence and pathology of intramammary lymph nodes in breast specimens. METHODS: All breast specimens examined by a single pathologist over 70 months in a large teaching hospital were studied retrospectively. All the surgical pathology reports were reviewed. Relevant glass slides from cases in which intramammary lymph nodes were identified were also reexamined. RESULTS: Breast specimens (n = 682) were examined. Seven lymph nodes were found in five patients. The specimens comprised 533 biopsy specimens, 29 segmental resections, 22 reduction mammoplasties, 77 modified radical mastectomies and 20 gynecomastia mastectomies. No clinically relevant microscopical abnormalities were found in four lymph nodes and slight sinus histiocytosis was seen in two nodes. One node contained metastatic adenocarcinoma and benign glandular epithelial inclusions. CONCLUSION: Although rare, intramammary lymph nodes may be detected by careful gross examination of breast specimens even in the absence of clinical identification. They can occur in any quadrant of the breast and can display a variety of pathological conditions. Pathologists should be alert to the existence and potential importance of these lymph nodes. Images

Jadusingh, I. H.

1992-01-01

143

Quantification of pulmonary blood flow (PBF): validation of perfusion MRI and nonlinear contrast agent (CA) dose correction with H(2)15O positron emission tomography (PET)  

Microsoft Academic Search

Validation of quantification of pulmonary blood flow (PBF) with dynamic, contrast-enhanced MRI is still missing. A possible reason certainly lies in difficulties based on the nonlinear dependence of signal intensity (SI) from contrast agent (CA) concentration. Both aspects were addressed in this study. Nine healthy pigs were examined by first-pass perfusion MRI using gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) and H(2)(15)O

Daniel Neeb; Rainer Peter Kunz; Sebastian Ley; Gabor Szabo; Ludwig G. Strauss; Hans-Ulrich Kauczor; Karl-Friedrich Kreitner; Laura Maria Schreiber

2009-01-01

144

Dynamic spiral MRI of pulmonary gas flow using hyperpolarized (3)He: preliminary studies in healthy and diseased lungs.  

PubMed

An optimized interleaved-spiral pulse sequence, providing high spatial and temporal resolution, was developed for dynamic imaging of pulmonary ventilation with hyperpolarized (3)He, and tested in healthy volunteers and patients with lung disease. Off-resonance artifacts were minimized by using a short data-sampling period per interleaf, and gradient-fidelity errors were compensated for by using measured k-space trajectories for image reconstruction. A nonsequential acquisition order was implemented to improve image quality during periods of rapid signal change, such as early inspiration. Using a sliding-window reconstruction, cine-movies with a frame rate of 100 images per second were generated. Dynamic images demonstrating minimal susceptibility- and motion-induced artifacts were obtained in sagittal, coronal, and axial orientations. The pulse sequence had the flexibility to image multiple slices almost simultaneously. Our initial experience in healthy volunteers and subjects with lung pathology demonstrated the potential of this new tool for capturing the features of lung gas-flow dynamics. PMID:11590642

Salerno, M; Altes, T A; Brookeman, J R; de Lange, E E; Mugler, J P

2001-10-01

145

Pulmonary Artery Catheter (PAC) Accuracy and Efficacy Compared with Flow Probe and Transcutaneous Doppler (USCOM): An Ovine Cardiac Output Validation  

PubMed Central

Background. The pulmonary artery catheter (PAC) is an accepted clinical method of measuring cardiac output (CO) despite no prior validation. The ultrasonic cardiac output monitor (USCOM) is a noninvasive alternative to PAC using Doppler ultrasound (CW). We compared PAC and USCOM CO measurements against a gold standard, the aortic flow probe (FP), in sheep at varying outputs. Methods. Ten conscious sheep, with implanted FPs, had measurements of CO by FP, USCOM, and PAC, at rest and during intervention with inotropes and vasopressors. Results. CO measurements by FP, PAC, and USCOM were 4.0 ± 1.2?L/min, 4.8 ± 1.5?L/min, and 4.0 ± 1.4?L/min, respectively, (n = 280, range 1.9?L/min to 11.7?L/min). Percentage bias and precision between FP and PAC, and FP and USCOM was ?17 and 47%, and 1 and 36%, respectively. PAC under-measured Dobutamine-induced CO changes by 20% (relative 66%) compared with FP, while USCOM measures varied from FP by 3% (relative 10%). PAC reliably detected ?30% but not +40% CO changes, as measured by receiver operating characteristic area under the curve (AUC), while USCOM reliably detected ±5% changes in CO (AUC > 0.70). Conclusions. PAC demonstrated poor accuracy and sensitivity as a measure of CO. USCOM provided equivalent measurements to FP across a sixfold range of outputs, reliably detecting ±5% changes.

Phillips, Robert A.; Hood, Sally G.; Jacobson, Beverley M.; West, Malcolm J.; Wan, Li; May, Clive N.

2012-01-01

146

Use of Flow Focusing® technology to produce tobramycin-loaded PLGA microparticles for pulmonary drug delivery.  

PubMed

In the present work, a promising formulation of an inhaled powder based on tobramycin-loaded microparticles has been reported. Biodegradable microparticles with controlled diameters in the range of 1-5 ?m and narrow size distribution were synthesized by Flow Focusing® technology. Particles production was planned and optimized with the aid of a well-established mathematic model. Close agreements between theoretical an experimental sizes were obtained. To deliver a high payload of tobramycin to the lungs, the influence of surfactant concentration, polymer-drug ratio and initial drug concentration were investigated. For chosen formulations, drug delivery profiles were also studied. In some cases, it was found a controlled drug delivery for more than ten days, which could represent an important advance in the treatment of chronic lung infections. Other particles factors affecting deposit of an aerosol in the lung were also studied, such as surface charge and density. PMID:22571192

Martín-Banderas, Lucia; Holgado, Maria Angeles; Álvarez-Fuentes, Josefa; Fernández-Arévalo, Mercedes

2012-07-01

147

Characterization of human afferent lymph dendritic cells from seroma fluids.  

PubMed

Dendritic cells (DCs) migrate from peripheral tissues to secondary lymphoid organs (SLOs) through the afferent lymph. Owing to limitations in investigating human lymph, DCs flowing in afferent lymph have not been properly characterized in humans until now. In this study, DCs present in seroma, an accrual of human afferent lymph occurring after lymph node surgical dissection, were isolated and analyzed in detail. Two main DC subsets were identified in seroma that corresponded to the migratory DC subsets present in lymph nodes, that is, CD14(+) and CD1a(+). The latter also included CD1a(bright) Langerhans cells. The two DC subsets appeared to share the same monocytic precursor and to be developmentally related; both of them spontaneously released high levels of TGF-? and displayed similar T cell-activating and -polarizing properties. In contrast, they differed in the expression of surface molecules, including TLRs; in their phagocytic activity; and in the expression of proteins involved in Ag processing and presentation. It is worth noting that although both subsets were detected in seroma in the postsurgical inflammatory phase, only CD1a(+) DCs migrated via afferent lymph under steady-state conditions. In conclusion, the high numbers of DCs contained in seroma fluids allowed a proper characterization of human DCs migrating via afferent lymph, revealing a continuous stream of DCs from peripheral regions toward SLOs under normal conditions. Moreover, we showed that, in inflammatory conditions, distinct subsets of DCs can migrate to SLOs via afferent lymph. PMID:24078697

Morandi, Barbara; Bonaccorsi, Irene; Mesiti, Mario; Conte, Romana; Carrega, Paolo; Costa, Gregorio; Iemmo, Raffaella; Martini, Stefania; Ferrone, Soldano; Cantoni, Claudia; Mingari, Maria Cristina; Moretta, Lorenzo; Ferlazzo, Guido

2013-09-27

148

Systemic mediastinal lymph node dissection of right lung cancer: surgical quality control and analysis of mediastinal lymph node metastatic patterns.  

PubMed

Standardization of systemic mediastinal lymph node dissection (SMLD) of lung cancer requires further investigation. A consecutive 124 right lung cancer patients were recruited for pulmonary resection plus SMLD. Three mediastinal lymph node compartments, (i) the upper compartment (station 1-4), (ii) the middle compartment (station 7-8) and (iii) the lower compartment (station 9), were en bloc collected to achieve surgical quality control and to analyze mediastinal lymph node metastatic patterns. The number of total harvested lymph nodes, N1 nodes and N2 nodes were 21.9+/-8.7, 9.2+/-4.7 and 12.8+/-6.7, respectively. Tumor location (peripheral or central) (P=0.023) and status of blood vessel invasion (P=0.002) were identified as risk factors for nodal involvement. Right upper lobe (RUL) cancer with N2 disease primarily metastasized to the upper compartment (27.3%) (P=0.001). For right lower lobe (RLL) cancer, lymph node metastasis most commonly detected in the middle compartment (48.8%) (P=0.001). Single mediastinal compartment metastasis occurred in 64.7% (11/17) of adenocarcinomas from RUL and RML, whereas multiple compartments metastasis occurred in all adenocarcinoma cases (12/12) from RLL (P=0.001). SMLD needs to standardize the extent of lymphadenectomy and number of removed lymph nodes for surgical quality control. Simplifying mediastinal lymph node stations to three compartments may benefit surgical excision. PMID:18077504

Wu, Nan; Lv, Chao; Yan, Shi; Duan, Hongwei; Zheng, Qingfeng; Wang, Jia; Xiong, Hongchao; Yang, Yue

2007-12-12

149

Mechanical limitation of pulmonary blood flow facilitates heart transplantation in older infants with hypoplastic left heart syndrome  

Microsoft Academic Search

Objectives: Progression of pulmonary vascular disease limits heart transplantation for hypoplastic left heart syndrome (HLHS) to early infancy. Our objective was to assess the impact of bilateral pulmonary artery banding (PAB) on the operative courses of HLHS infants transplanted at ages older than 4 months. Methods: Courses of all HLHS patients in our center who remained listed to age ?120

Max B Mitchell; David N Campbell; Mark M Boucek; Henry M Sondheimer; Kak C Chan; David D Ivy; Biagio Pietra; Todd Mackenzie

2003-01-01

150

Pulmonary Vascular Responsiveness at Rest and during Exercise in Idiopathic Pulmonary Fibrosis: Effects of Oxygen and Nifedipine  

Microsoft Academic Search

To detect whether pulmonary vascular responsiveness is a factor which can aggravate the pulmonary hypertension induced by irreversible pulmonary fibrosis, we examined the acute hemodynamic effects of low-flow oxygen and of nifedipine both at rest and during exercise in 8 patients with idiopathic pulmonary fibrosis (IPF). During exercise, the increments in pulmonary artery pressure, pulmonary vascular resistance (PVR), and right

Carlo Sturani; Spyridion Papiris; Vanni Galavotti; Giuseppe Gunella

1986-01-01

151

Transvascular fluid shift and thoracic duct lymph: analysis of lymph formation in the rat.  

PubMed

To analyze the effect of changes in interstitial fluid on lymph production, intravascular infusions of saline were given to splenectomized rats under pentobarbital anesthesia at 3 different rates (2, 3, and 4 ml/100 g of body weight) over 10 min. Change of blood volume was continuously monitored and, simultaneously, thoracic duct lymph was collected during and after the infusion. Equilibrium was attained approximately 40 min after the infusion; regardless of the infusion rate, 10% of the infused volume was incorporated into the vascular space and 90% was filtered into the extravascular space. Thus, the amount of transvascular fluid shift showed a linear relationship with the infused volume. However, the drainage from thoracic duct lymph amounted to 5.9%, 11.4%, and 17.8% of the infused saline volume when given at the rate of 2, 3, and 4 ml/100 g, respectively. The relation of lymph flow and infused volume could be regarded as a nonlinear system. By means of a simulation study, this relation was found to be attributed to the nonlinearity of conductance for fluid movement from tissue to lymph duct, which was only one sixth of that determined for the capillary membrane. The drainage of lymph protein following the infusion was only about 50% of that expected from the interstitial protein concentration in even distribution of the infused saline. These characteristics of interstitial fluid space play an important role in absorbing water and, hence, buffering changes in circulating blood volume after volume loading. PMID:6503032

Nose, H; Yamada, S; Morimoto, T

1984-01-01

152

PULMONARY CIRCULATION AT EXERCISE  

PubMed Central

The pulmonary circulation is a high flow and low pressure circuit, with an average resistance of 1 mmHg.min.L?1 in young adults, increasing to 2.5 mmHg.min.L?1 over 4–6 decades of life. Pulmonary vascular mechanics at exercise are best described by distensible models. Exercise does not appear to affect the time constant of the pulmonary circulation or the longitudinal distribution of resistances. Very high flows are associated with high capillary pressures, up to a 20–25 mmHg threshold associated with interstitial lung edema and altered ventilation/perfusion relationships. Pulmonary artery pressures of 40–50 mmHg, which can be achieved at maximal exercise, may correspond to the extreme of tolerable right ventricular afterload. Distension of capillaries that decrease resistance may be of adaptative value during exercise, but this is limited by hypoxemia from altered diffusion/perfusion relationships. Exercise in hypoxia is associated with higher pulmonary vascular pressures and lower maximal cardiac output, with increased likelihood of right ventricular function limitation and altered gas exchange by interstitial lung edema. Pharmacological interventions aimed at the reduction of pulmonary vascular tone have little effect on pulmonary vascular pressure-flow relationships in normoxia, but may decrease resistance in hypoxia, unloading the right ventricle and thereby improving exercise capacity. Exercise in patients with pulmonary hypertension is associated with sharp increases in pulmonary artery pressure and a right ventricular limitation of aerobic capacity. Exercise stress testing to determine multipoint pulmonary vascular pressures-flow relationships may uncover early stage pulmonary vascular disease.

NAEIJE, R; CHESLER, N

2012-01-01

153

States of low pulmonary blood flow can be detected non-invasively at the bedside measuring alveolar dead space.  

PubMed

We tested whether the ratio of alveolar dead space to alveolar tidal volume (VD(alv)/VT(alv)) can detect states of low pulmonary blood flow (PBF) in a non-invasive way. Fifteen patients undergoing cardiovascular surgeries with cardiopulmonary bypass (CPB) were studied. CPB is a technique that excludes the lungs from the general circulation. The weaning of CPB is a model that manipulates PBF in vivo because each time blood flow through the CPB decreases, expected PBF (ePBF) increases. Patients were liberated from CPB in steps of 20 % every 2' starting from 100 % CPB (very low ePBF) to 0 % CPB (100 % ePBF). During constant ventilation, volumetric capnograms were recorded and Bohr's dead space ratio (VD(Bohr)/VT), VD(alv)/VT(alv) and the ratio of airway dead space to tidal volume (VD(aw)/VT) were calculated. Before CPB, VD(Bohr)/VT was 0.36 ± 0.05, VD(aw)/VT 0.21 ± 0.04 and VD(alv)/VT(alv) 0.18 ± 0.06 (mean ± SD). During weaning from CPB, VD(aw)/VT remained unchanged while VD(Bohr)/VT and VD(alv)/VT(alv) decreased with increasing ePBF. At CPB of 80, 60, 40 and 20 % VD(Bohr)/VT was 0.64 ± 0.06, 0.55 ± 0.06, 0.47 ± 0.05 and 0.40 ± 0.04, respectively; p < 0.001 and VD(alv)/VT(alv) 0.53 ± 0.07, 0.40 ± 0.07, 0.29 ± 0.06 and 0.25 ± 0.04, respectively; p < 0.001). After CPB, VD(Bohr)/VT and VD(alv)/VT(alv) reached values similar to baseline (0.37 ± 0.04 and 0.19 ± 0.06, respectively). At constant ventilation the alveolar component of VD(Bohr)/VT increased in proportion to the deficit in lung perfusion. PMID:22484920

Tusman, Gerardo; Suarez-Sipmann, Fernando; Paez, Gabriel; Alvarez, Jorge; Bohm, Stephan H

2012-04-07

154

Primary Plasmacytoma of Lymph Nodes  

Microsoft Academic Search

Most plasmacytomas of lymph nodes are secondary metastases from myeloma or from primary plasmacytoma of the upper air passages. Primary plasmacytomas of lymph nodes are very rare. A case of primary plasmacytoma of mediastinal, cervical and para-aortic lymph nodes is reported. Bence Jones proteinuria of 8 g\\/24 h was present. Repeated bone marrow examinations were normal. When the patient died,

J. Jansen; P. Blok

1979-01-01

155

Expiratory flow limitation and the response to breathing a helium-oxygen gas mixture in a canine model of pulmonary emphysema.  

PubMed Central

The pathophysiology of reduced maximum expiratory flow in a canine model of pulmonary emphysema was studied, and the results interpreted in terms of the wave-speed theory of flow limitation. According to this theory, maximum expiratory flow is related both to the cross-sectional area and compliance at an airway site where a critical gas velocity is first reached ("choke-point") and to gas density. Pulmonary emphysema was produced by the repeated instillations of the enzyme papain into the airways of six dogs. In five control dogs, a saline solution was instilled. During forced vital capacity deflation, in an open-chest preparation, maximum expiratory flow, choke-point locations, and the response to breathing an 80:20 helium/oxygen gas mixture were determined at multiple lung volumes. To locate choke-points, a pressure measuring device was positioned in the airway to measure lateral and end-on intrabronchial pressures, from which the relevant wave-speed parameters were obtained. In general, the reduced maximum expiratory flow in emphysema can be explained by diminished lung elastic recoil pressure and by altered bronchial pressure-area behavior, which results in a more peripheral location of choke-points that have smaller cross-sectional areas than controls. With respect to the density dependence of maximum expiratory flow, this response did not differ from control values in four dogs with emphysema in which frictional pressure losses upstream from choke-points did not differ on the two gas mixtures. In two dogs with emphysema, however, upstream frictional pressure losses were greater on helium/oxygen than on air, which resulted in a smaller cross-sectional area on helium/oxygen; hence density dependence decreased.

Mink, S N

1984-01-01

156

Lymph node macrophages  

PubMed Central

Summary Lymph node (LN) macrophages have long been known for their efficient uptake of lymph-borne antigens. A convergence of studies on innate and adaptive immune responses has led to exciting recent advances in understanding their more specialized properties: presenting antigens to B cells, dendritic cells and T cells, producing trophic factors and cytokines, and, remarkably, being permissive for viral infection, a property critical for mounting anti-viral responses. LN macrophages have been traditionally divided into subsets based on their subcapsular sinus and medullary locations. Here we classify LN macrophages into three subsets: subcapsular sinus macrophages (SSMs), medullary sinus macrophages (MSMs) and medullary cord macrophages (MCMs). We review the literature regarding the roles of these cells in innate and adaptive immune responses and requirements for their development. We also discuss challenges associated with their purification as well as the existence of additional heterogeneity among LN macrophages.

Gray, Elizabeth E.; Cyster, Jason G.

2013-01-01

157

Evaluation of the effect of postural and gravitational variations on the distribution of pulmonary blood flow via an image-based computational model.  

PubMed

We have developed an image-based computational model of blood flow within the human pulmonary circulation in order to investigate the distribution of flow under various conditions of posture and gravity. Geometric models of the lobar surfaces and largest arterial and venous vessels were derived from multi-detector row X-ray computed tomography. The remaining blood vessels were generated using a volume-filling branching algorithm. Equations representing conservation of mass and momentum are solved within the vascular geometry to calculate pressure, radius, and velocity distributions. Flow solutions are obtained within the model in the upright, inverted, prone, and supine postures and in the upright posture with and without gravity. Additional equations representing large deformation mechanics are used to calculate the change in lung geometry and pressure distributions within the lung in the various postures - creating a coupled, co-dependent model of mechanics and flow. The embedded vascular meshes deform in accordance with the lung geometry. Results illustrate a persistent flow gradient from the top to the bottom of the lung even in the absence of gravity and in all postures, indicating that vascular branching structure is largely responsible for the distribution of flow. PMID:17281665

Burrowes, K S; Hunter, P J; Tawhai, M H

2005-01-01

158

Methods to study pulmonary dendritic cell migration.  

PubMed

Dendritic cell migration from the airway to the lymph nodes is a key event in the development of airway immunity during infection, allergy, and vaccination. With judicial selection of materials, there are two approaches to study dendritic cell migration to the mediastinal lymph nodes without the induction of inflammation: airway administration of fluorescent OVA and latex beads. Our protocol describes how to label and track pulmonary dendritic cells from the airway and lung to the mediastinal lymph nodes and reveals how to avoid pitfalls and suboptimal assays. PMID:19941125

Jakubzick, Claudia; Randolph, Gwendalyn J

2010-01-01

159

Pulmonary Rehabilitation  

MedlinePLUS

Pulmonary rehabilitation (rehab) is a medically supervised program to help people who have chronic breathing problems, including COPD (chronic obstructive pulmonary disease) Sarcoidosis Idiopathic pulmonary fibrosis Cystic fibrosis During ...

160

Pulmonary Embolism  

MedlinePLUS

... page from the NHLBI on Twitter. What Is Pulmonary Embolism? Pulmonary embolism (PULL-mun-ary EM-bo-lizm), or PE, ... prevent the complications of PE. Rate This Content: Pulmonary Embolism Clinical Trials Clinical trials are research studies that ...

161

In-vivo lymph dynamic monitoring using speckle-correlation technique and light microscopy  

NASA Astrophysics Data System (ADS)

In this work we described the new modification of experimental setup designed on the basis of transmission microscopy and high-resolution speckle-correlation technique. This combined technique provides the simultaneous speckle and video registration of lymph dynamics that allows one to calibrate the speckle-correlation velocity sensor and to determine an absolute flow velocity and its direction. As a result many parameters of lymph dynamic were measured quickly, conveniently and simultaneously and a new data about the lymph flow velocity and other functions of microcirculation were received. The results of the experimental study of lymph microcirculation in small intestine mesentery of rat in vivo are presented.

Galanzha, Ekateryna I.; Fedosov, Ivan V.; Solov'eva, Anastasiya V.; Stepanova, Tatyana V.; Tuchin, Valery V.; Brill, Gregory E.

2002-05-01

162

Pulmonary disorders complicating pregnancy.  

PubMed

The pulmonary physiologic changes associated with pregnancy increase oxygen transport to the developing fetus. Because of these changes, the fetus is allowed an extra measure of protection against insults that would decrease blood or oxygen flow to the uteroplacental unit. The goal of treating a patient with pulmonary disease in pregnancy should be to maximize pulmonary function throughout gestation. Experts in pulmonary disease should be readily available for patients with significant pulmonary disorders or worsening disease during pregnancy. Pregnancy affords all providers the opportunity to address the major respiratory health problem in the United States, which is smoking. This concerns not only the patient's personal health, but also that of her unborn offspring. PMID:1484655

McColgin, S W; Glee, L; Brian, B A

1992-12-01

163

Label free in vivo laser speckle imaging of blood and lymph vessels  

NASA Astrophysics Data System (ADS)

The peripheral lymphatic vascular system is a part of the immune body system comprising a complex network of lymph vessels and nodes that are flowing lymph toward the heart. Traditionally the imaging of lymphatic vessels is based on the conventional imaging modalities utilizing contrast fluorescence materials. Given the important role of the lymphatic system there is a critical need for the development of noninvasive imaging technologies for functional quantitative diagnosis of the lymph vessels and lymph flow without using foreign chemicals. We report a label free methodology for noninvasive in vivo imaging of blood and lymph vessels, using long-exposure laser speckle imaging approach. This approach entails great promise in the noninvasive studies of tissues blood and lymph vessels distribution in vivo.

Kalchenko, Vyacheslav; Kuznetsov, Yuri; Meglinski, Igor; Harmelin, Alon

2012-05-01

164

Primary pulmonary adenocarcinoma mimicking papillary thyroid carcinoma.  

PubMed

We herein reported a primary pulmonary papillary carcinoma with colloid-like luminal content in the glandular cavity and classic nuclear features such as pseudo-inclusions, intranuclear grooves in the tumor cell nuclei and ground glass nuclei which closely mimics papillary thyroid carcinoma. Meanwhile, lymph node in the left pulmonary hilum was involved and showed similar features to the primary pulmonary papillary carcinoma. This specific histopathological presentation caused a diagnostic dilemma.The patient didn't show previous concomitant or subsequent evidence of a thyroid tumor. Immunohistochemistry further confirmed pulmonary origin and excluded a metastasis from the thyroid, as it was thyroglobulin negative, thyroid transcription factor 1 and surfactant apoprotein A positive, which was consistent with the imageology and history.Based on the above features, the diagnosis of primary pulmonary papillary carcinoma was confirmed. Understanding the existence of papillary thyroid carcinoma-like pulmonary papillary carcinoma will avoid misdiagnosis or unnecessary clinical and radiologic investigations in future. PMID:23684153

Zhu, Ya-Zhen; Li, Wei-Ping; Wang, Zhi-Yuan; Yang, Hai-Feng; He, Qing-Lian; Zhu, Hong-Guang; Zheng, Guang-Juan

2013-05-17

165

Changes in ventilatory capacity, exercise capacity, and pulmonary blood flow after lobectomy in patients with lung cancer--which lobectomy has the most loss in exercise capacity?  

PubMed

The aim of this study was to compare the changes in ventilatory capacity, exercise capacity, and pulmonary blood flow (PBF) in the operated lung after lobectomy according to the lobe resected. Thirty-one patients underwent right upper lobectomy (RUL), 26 left upper lobectomy (LUL), 24 right lower lobectomy (RLL), and 25 left lower lobectomy (LLL). Pulmonary function tests, exercise capacity tests, and perfusion lung scans were performed preoperatively and six months to one year after lobectomy. RUL was associated with significantly less loss in forced vital capacity (FVC) than RLL or LLL (P<0.05). LUL was associated with the greatest loss in maximum oxygen consumption (VO2) (P<0.05). LUL was associated with significantly greater loss in PBF in the operated lung than RUL (P<0.05). LUL had a significantly higher negative value in percentage change in (VO2) --percentage change in FVC, and percentage change in PBF--percentage change in FVC than RLL or LLL (P<0.05). LUL was not associated with the greatest loss in ventilatory capacity or PBF, although it was associated with the greatest loss in . Each lobectomy has its own peculiarity in magnitude of loss in (VO2), PBF or FVC. PMID:18682428

Kushibe, Keiji; Kawaguchi, Takeshi; Kimura, Michitaka; Takahama, Makoto; Tojo, Takashi; Taniguchi, Shigeki

2008-08-05

166

[Lymphoscintigraphy of separate lymph nodes for radiotherapy planning in breast cancer].  

PubMed

Determination of lymph flow from breast cancer can be used as effective tool for individualization of radiation portals for regional radiotherapy. We evaluated this technique in 86 patients with lymph nodes (LN) scintigraphy which was performed 20-240 min after intratumoural injection of 50-100 MBq of 99mTc-nanocolloids. After visualisation of lymph flow patterns standard radiation portals were modified in 75% of patients with external and 85%--with internal localisation of primary tumours, In addition we recognised that extent and wideness of radiation portals for internal mammary lymph LN must be arranged in accordance with individual lymph flow pattern. In particularly irradiation of LN on both sides of the sternum was performed only in 3 of 27 (11%) evaluated cases. PMID:22238932

Kanaev, S V; Novikov, S N; Zhukova, L A; Zotova, O V; Semiglazov, V F; Krivorot'ko, P V

2011-01-01

167

[Skewed shape of the maximal expiratory flow volume curve and bronchoscopic signs of lower airway collapse in chronic obstructive pulmonary disease].  

PubMed

We compared endoscopical signs of airway collapse seen during tidal breathing with the shape of the maximal-expiratory flow volume curve and selected functional parameters in 16 cases of chronic obstructive pulmonary disease (COPD). Depending on localization of airway collapse the group was divided into two. 12 patients with central collapse involving the trachea and main stem bronchi formed group A. The remaining 4 patients with peripheral collapse (lobar and segmental bronchi) formed group B. In the former group the MEFV curve had a characteristic biphasic shape. The shape of this curve in the group B patients was more curvilinear. In group A patients an increase of Raw, TGV and fall of FEV1 was seen which could not be demonstrated in group B. The biphasic shape of the MEFV curve seems to be characteristic of airway collapse, but due to a small number of patients included we can not assess the specificity of it in diagnosing airway collapse. PMID:2638001

Radwan, L; Pirozy?ski, M; Müller, J

168

Erythropoietin induces lymph node lymphangiogenesis and lymph node tumor metastasis.  

PubMed

Cancer therapy often produces anemia, which is treated with erthropoietin (EPO) to stimulate erythrocyte production. However, concerns have recently arisen that EPO treatment may promote later tumor metastasis and mortality. The mechanisms underlying such effects are unknown, but it is clear that EPO has pleiotropic effects in cell types other than hematopoietic cells. In this study, we investigated how EPO affects lymphangiogenesis and lymph node tumor metastasis in mouse models of breast cancer and melanoma. In these models, EPO increased lymph node lymphangiogenesis and lymph node tumor metastasis in a manner associated with increased migration, capillary-like tube formation, and dose- and time-dependent proliferation of human lymphatic endothelial cells. EPO increased sprouting of these cells in a thoracic duct lymphatic ring assay. These effects were abrogated by cotreatment with specific inhibitors of phosphoinositide 3-kinase or mitogen-activated protein kinase, under conditions in which EPO increased Akt and extracellular signal-regulated kinase 1/2 phosphorylation. Intraperitoneal administration of EPO stimulated peritoneal lymphangiogenesis, and systemic treatment of EPO increased infiltration of CD11b(+) macrophages in tumor-draining lymph nodes. Finally, EPO increased VEGF-C expression in lymph node-derived CD11b(+) macrophages as well as in bone marrow-derived macrophages in a dose- and time-dependent manner. Our results establish that EPO exerts a powerful lymphangiogenic function and can drive both lymph node lymphangiogenesis and nodal metastasis in tumor-bearing animals. PMID:21586615

Lee, Ae Sin; Kim, Duk Hoon; Lee, Jung Eun; Jung, Yu Jin; Kang, Kyung Pyo; Lee, Sik; Park, Sung Kwang; Kwak, Jae Yong; Lee, Sang Yong; Lim, Suk Tae; Sung, Mi Jung; Yoon, Suk Ran; Kim, Won

2011-05-17

169

Pulmonary Fibrosis  

MedlinePLUS

Pulmonary fibrosis harms the tissues deep in your lungs. The air sacs in your lungs and their supporting structures ... not get enough oxygen. One cause of pulmonary fibrosis is interstitial lung disease. Interstitial lung disease is ...

170

Pulmonary Embolism  

MedlinePLUS

A pulmonary embolism is a sudden blockage in a lung artery. The cause is usually a blood clot in the ... and travels through the bloodstream to the lung. Pulmonary embolism is a serious condition that can cause Permanent ...

171

Pulmonary embolus  

MedlinePLUS

... blood clot; Blood clot - lung; Embolus; Tumor embolus; Embolism - pulmonary ... is low. In cases of severe, life-threatening pulmonary embolism, treatment may involve dissolving the clot. This is ...

172

Quantification of pulmonary blood flow (PBF): validation of perfusion MRI and nonlinear contrast agent (CA) dose correction with H(2)15O positron emission tomography (PET).  

PubMed

Validation of quantification of pulmonary blood flow (PBF) with dynamic, contrast-enhanced MRI is still missing. A possible reason certainly lies in difficulties based on the nonlinear dependence of signal intensity (SI) from contrast agent (CA) concentration. Both aspects were addressed in this study. Nine healthy pigs were examined by first-pass perfusion MRI using gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) and H(2)(15)O positron emission tomography (PET) imaging. Calculations of hemodynamic parameters were based on a one-compartment model (MR) and a two-compartment model (PET). Simulations showed a significant error when assuming a linear relation between MR SI and CA dose in the arterial input function (AIF), even at low doses of 0.025 mmol/kg body weight (BW). To correct for nonlinearity, a calibration curve was calculated on the basis of the signal equation. The required accuracy of equation parameters (like longitudinal relaxation time) was evaluated. Error analysis estimates <5% over-/underestimation of the corrected SI. Comparison of PET and MR flow values yielded a significant correlation (P < 0.001) in dorsal regions where signal-to-noise ratio (SNR) was sufficient. Changes in PBF due to the correction method were significant (P < 0.001) and resulted in a better agreement: mean values (standard deviation) in units of ml/min/100 ml lung tissue were 59 (15) for PET, 112 (28) for uncorrected MRI, and 80 (21) for corrected MRI. PMID:19488992

Neeb, Daniel; Kunz, Rainer Peter; Ley, Sebastian; Szábo, Gábor; Strauss, Ludwig G; Kauczor, Hans-Ulrich; Kreitner, Karl-Friedrich; Schreiber, Laura Maria

2009-08-01

173

A new form of alpha-chain disease with generalized lymph node involvement.  

PubMed

An autopsy case of alpha-chain disease (ACD) clinically manifesting generalized lymph node swelling, slight splenomegaly and long-standing ichthyosiform skin eruptions, was reported. Autopsy revealed systemic superficial and profound lymph node swelling and slight splenomegaly, but little or no tumorous lesion in any part of the alimentary tract or pulmonary tissue. The histologic picture of the lymph nodes showed a diffuse monomorphic plasmocytic lymphoma, and there was tumor cell infiltration in the spleen and bone marrow. Immunohistochemistry demonstrated that the tumor cells contained IgA devoid of light chains, i.e. ACD protein. Immunoelectron microscopy revealed that this abnormal immunoglobulin was localized in the rough endoplasmic reticulum and perinuclear space. Persistent chronic inflammation with infiltration mainly of helper-inducer T cells were found in the skin and dermatopathic lymphadenopathy was confirmed in the lymph node biopsies. From these peculiar clinicopathological features, this case is considered to be a previously unknown form of ACD. PMID:3222174

Takahashi, K; Naito, M; Matsuoka, Y; Takatsuki, K

1988-11-01

174

Pulmonary vascular permeability changes in an ovine model of methicillin-resistant Staphylococcus aureus sepsis  

PubMed Central

Introduction Endothelial dysfunction is a hallmark of sepsis, associated with lung transvascular fluid flux and pulmonary dysfunction in septic patients. We tested the hypothesis that methicillin-resistant Staphylococcus aureus (MRSA) sepsis following smoke inhalation increases pulmonary transvascular fluid flux via excessive nitric oxide (NO) production. Methods Ewes were chronically instrumented, and randomised into either a control or MRSA sepsis (MRSA and smoke inhalation) group. Results Pulmonary function remained stable in the control group, whereas the MRSA sepsis group developed impaired gas exchange and significantly increased lung lymph flow, permeability index and bloodless wet-to-dry weight-ratio (W/D ratio). The plasma nitrate/nitrite (NOx) levels, lung inducible nitric oxide synthases (iNOS) and endothelial nitric oxide synthases (eNOS), vascular endothelial growth factor (VEGF) protein expressions and poly-(ADP)-ribose (PAR) were significantly increased by MRSA challenge. Conclusions These results provide evidence that excessive NO production may mediate pulmonary vascular hyperpermeability in MRSA sepsis via up regulation of reactive radicals and VEGF.

Jonkam, Collette C; Bansal, Kamna; Traber, Daniel L; Hamahata, Atsumori; Maybauer, Marc O; Maybauer, Dirk M; Cox, Robert A; Lange, Matthias; Connelly, Rhykka L; Traber, Lillian D; Djukom, Clarisse D; Salsbury, John R; Herndon, David N; Enkhbaatar, Perenlei

2009-01-01

175

[Pulmonary cryptococcosis].  

PubMed

Cryptococcosis is a deep mycosis that develops in immunosuppressed individuals. Isolated pulmonary cryptococcosis is a rare disease. The authors describe an autopsy case of pulmonary cryptococcosis in a 69-year-old woman with diabetes mellitus suppressing the immune system. Pulmonary inflammatory changes were characterized by disseminated destructive changes, a weak exudative reaction and the formation of epithelioid cell granulomas with the presence of Pirogov-Langerhans giant multinucleate cells. Round fungal cells weakly stained with hematoxylin and eosin can be mistakenly taken as artifacts. The diagnosis of chronic pulmonary cryptococcosis was established only after histological study using the selective staining. PMID:19938707

Rogov, K A; Ivashneva, I L; Grishina, A V

176

Lymphangiogenesis in Regional Lymph Nodes Is an Independent Prognostic Marker in Rectal Cancer Patients after Neoadjuvant Treatment  

PubMed Central

One of the major prognostic factors in rectal cancer is lymph node metastasis. The formation of lymph node metastases is dependent on the existence of a premetastatic niche. An important factor preceding metastasis are lymph vessels which are located in the lymph node. Accordingly, the occurrence of intranodal lymphangiogenesis is thought to indicate distant metastasis and worse prognosis. To evaluate the significance of lymph node lymphangiogenesis, we studied formalin fixed, paraffin embedded adenocarcinomas and regional lymph nodes of 203 rectal cancer patients who were treated with neoadjuvant radiochemotherapy and consecutive curative surgery with cancer free surgical margins (R0). Regional lymph node lymph vessels were detected by immunohistochemistry for podoplanin (D2-40). Our results show that the presence of lymphatic vessels in regional lymph nodes significantly affects the disease-free survival in univariate and multivariate analyses. In contrast, there was no correlation between peritumoral or intratumoral lymph vessel density and prognosis. Indeed, our study demonstrates the importance of lymphangiogenesis in regional lymph nodes after neoadjuvant radiochemotherapy and consecutive surgery as an independent prognostic marker. Staining for intranodal lymphangiogenesis and methods of intravital imaging of lymphangiogenesis and lymphatic flow may be a useful strategy to predict long-term outcome in rectal cancer patients. Furthermore, addition of VEGF-blocking agents to standardized neoadjuvant treatment schemes might be indicated in advanced rectal cancer.

Jakob, Christiane; Aust, Daniela E.; Liebscher, Birgit; Baretton, Gustavo B.; Datta, Kaustubh; Muders, Michael H.

2011-01-01

177

Pulmonary blood velocity patterns in lamb models of pulmonary vascular impairment  

Microsoft Academic Search

Summary To provide a comprehensive picture of the interaction between abnormal pulmonary hemodynamics and pulmonary blood velocity patterns in the young, we have developed infant animal models of pulmonary hypertension and\\/or elevated pulmonary blood flow. This report focuses on relationships between selected velocity waveform shape-dependent variables — i.e., the time between the onset of systole and peak velocity (rise time),

Carol L. Lucas; G. William Henry; Belinda Ha; Jose I. Ferreiro; Hiroshi Katayama; Elman G. Frantz; Benson R. Wilcox

1994-01-01

178

Absent pulmonary valve  

MedlinePLUS

Absent pulmonary valve syndrome; Congenital absence of the pulmonary valve; Pulmonary valve agenesis ... Absent pulmonary valve occurs when the pulmonary valve doesn't form or develop properly while the baby is in ...

179

Sentinel lymph node biopsy alone without axillary lymph node dissection – follow up of sentinel lymph node negative breast cancer patients  

Microsoft Academic Search

Aims: To evaluate the rate of axillary recurrences in sentinel lymph node (SLN) negative breast cancer patients after sentinel lymph node biopsy (SLNB) alone without further axillary lymph node dissection (ALND).Methods: Between May 1999 and February 2001 all patients who had primary invasive breast cancer and were SLN negative were eligible for this prospective study. SLNB was performed by using

R Reitsamer; F Peintinger; E Prokop; C Menzel; W Cimpoca; L Rettenbacher

2003-01-01

180

The impact of complete lymph node dissection for lung cancer on the postoperative course.  

PubMed

The role of lymph node dissection (LND) for non-small cell lung cancers (NSCLCs) remains controversial. LND adds little morbidity to a pulmonary resection for NSCLC, although it requires an additional 15 to 20 minutes of operative time. Four prospective randomized trials have been performed to compare lymph node sampling and LND; 3 trials showed no difference in survival and 1 showed survival benefit of LND. It is recommended that all patients with resectable NSCLC undergo LND because the procedure provides patients with the most accurate staging and the opportunity for effective adjuvant therapy. PMID:22520291

Date, Hiroshi

2011-12-16

181

Convective diffusion of nanoparticles from the epithelial barrier toward regional lymph nodes.  

PubMed

Drug delivery using nanoparticles as drug carriers has recently attracted the attention of many investigators. Targeted delivery of nanoparticles to the lymph nodes is especially important to prevent cancer metastasis or infection, and to diagnose disease stage. However, systemic injection of nanoparticles often results in organ toxicity because they reach and accumulate in all the lymph nodes in the body. An attractive strategy would be to deliver the drug-loaded nanoparticles to a subset of draining lymph nodes corresponding to a specific site or organ to minimize systemic toxicity. In this respect, mucosal delivery of nanoparticles to regional draining lymph nodes of a selected site creates a new opportunity to accomplish this task with minimal toxicity. One example is the delivery of nanoparticles from the vaginal lumen to draining lymph nodes to prevent the transmission of HIV in women. Other known examples include mucosal delivery of vaccines to induce immunity. In all cases, molecular and particle transport by means of diffusion and convective diffusion play a major role. The corresponding transport processes have common inherent regularities and are addressed in this review. Here we use nanoparticle delivery from the vaginal lumen to the lymph nodes as an example to address the many aspects of associated transport processes. In this case, nanoparticles penetrate the epithelial barrier and move through the interstitium (tissue) to the initial lymphatics until they finally reach the lymph nodes. Since the movement of interstitial liquid near the epithelial barrier is retarded, nanoparticle transport was found to take place through special foci present in the epithelium. Immediately after nanoparticles emerge from the foci, they move through the interstitium due to diffusion affected by convection (convective diffusion). Specifically, the convective transport of nanoparticles occurs due to their convection together with interstitial fluid through the interstitium toward the initial lymph capillaries. Afterwards, nanoparticles move together with the lymph flow along the initial lymph capillaries and then enter the afferent lymphatics and ultimately reach the lymph node. As the liquid moves through the interstitium toward the initial lymph capillaries due to the axial movement of lymph along the lymphatics, the theory for coupling between lymph flow and concomitant flow through the interstitium is developed to describe this general case. The developed theory is applied to interpret the large uptake of Qdots by lymph nodes during inflammation, which is induced by pre-treating mouse vagina with the surfactant Nonoxynol-9 prior to instilling the Qdots. Inflammation is viewed here to cause broadening of the pores within the interstitium with the concomitant formation of transport channels which function as conduits to transport the nanoparticles to the initial lymph capillaries. We introduced the term "effective channels" to denote those channels which interconnect with foci present in the epithelial barrier and which function to transport nanoparticles to initial lymph capillaries. The time of transport toward the lymph node, predicated by the theory, increases rapidly with increasing the distance y0 between the epithelial barrier and the initial lymph capillaries. Transport time is only a few hours, when y0 is small, about some R (where R is the initial lymph capillary radius), due to the predomination of a rather rapid convection in this case. This transport time to the lymph nodes may be tens of hours (or longer) when y0 is essentially larger and the slow diffusion controls the transport rate in a zone not far from the epithelial barrier, where convection is weak at large y0. Accounting for transport by diffusion only, which is mainly considered in many relevant publications, is not sufficient to explain our nanoparticle uptake kinetics because the possibility of fast transport due to convection is overlooked. Our systematic investigations have revealed that the information about the main transport condition

Dukhin, Stanislav S; Labib, Mohamed E

2013-06-10

182

Pulmonary hypertension in chronic obstructive pulmonary disease  

Microsoft Academic Search

Pulmonary hypertension in chronic obstructive pulmonary disease. J.A. Barbera `, V.I. Peinado, S. Santos. #ERS Journals Ltd 2003. ABSTRACT: Pulmonary hypertension is a common complication of chronic obstructive pulmonary disease (COPD). Its presence is associated with shorter survival and worse clinical evolution. In COPD, pulmonary hypertension tends to be of moderate severity and progresses slowly. However, transitory increases of pulmonary

J. A. Barbera; V. I. Peinado; S. Santos

2003-01-01

183

Catheter rehabilitation of occluded aberrant pulmonary artery.  

PubMed

A 10-year old girl underwent a CT angiogram to investigate right lung hypoplasia. This showed a normal bronchial tree, lung parenchyma and pulmonary venous drainage, but an absent right pulmonary artery. Cardiac catheterization with pulmonary vein wedge injections identified a disconnected hypoplastic right pulmonary artery system supplied by an occluded right-sided ductus arteriosus. Transcatheter recanalization of the ductus re-established right pulmonary artery flow and growth. Ultimately, this allowed for complete surgical repair and restoration of normal perfusion of the right lung, leading to complete functional rehabilitation. PMID:23529755

Noonan, Patrick M E; Ramchandani, Bharat; Barron, David J; Stumper, Oliver

2013-03-25

184

Axillary Lymph Nodes and Breast Cancer  

MedlinePLUS

Axillary Lymph Nodes FACTS FOR LIFE For more information, call Susan G. Komen for the Cure ® at 1-877 ... www.komen.org. Lymphatic system and axillary nodes Lymph nodes are small clumps of immune cells that ...

185

Swollen lymph nodes in the groin (image)  

MedlinePLUS

Lymph nodes play an important part in the body's defense against infection. Swelling might occur even if ... infection is trivial or not apparent. Swelling of lymph nodes generally results from localized or systemic infection, ...

186

Primary lymph node invasive aspergillosis  

Microsoft Academic Search

Summary A case of apparently primary lymph node granulomatous aspergillosis is described. A review of the so-called primary aspergillosis cases since 1977 shows that granulomatous instead of exudative inflammation patterns have been observed in histological sections only when neither major nor minor predisposing factors have been detected in the clinical history of the patients. A possible pathogenetic role of selectively

A. Mazzoni; Anna Nanetti; R. Manfredi; A. Facchini; M. Ferrarese; C. Sturani

1996-01-01

187

Functional Anatomy of Lymph Nodes  

Microsoft Academic Search

Histological alterations in the paracortical zones of rabbit lymph nodes were produced by the intravenous injection of the acridine dye euchrysin. The paracortical parenchyma was reduced to narrow bands of lymphoid tissue which cuffed and outlined the venules against a distended and cell-filled sinus system. These perivenous lymphocyte cuffs, termed the paracortical cords, represented the basic anatomical unit of the

R. H. Kelly

1975-01-01

188

Pulmonary homograft  

Microsoft Academic Search

Objective: Retrospective analysis was performed to determine the suitability of pulmonary homograft as an aortic valve substitute. Methods: From January 1994 through June 1999, 147 patients (mean age, 32.2 ± 17.3 years) underwent aortic valve replacement with either an aortic homograft (group 1: n = 103, 25 fresh antibiotic preserved and 78 cryopreserved) or a pulmonary homograft (group 2: n

Shiv Kumar Choudhary; Anita Saxena; Bharat Dubey; A. Sampath Kumar

2000-01-01

189

Pulmonary embolism  

Microsoft Academic Search

Pulmonary embolism is a common medical problem whose incidence is likely to increase in our aging population. Although it is life-threatening, effective therapy exists. The treatment is not, however, without significant complications. Thus, accurate diagnosis is important. Unfortunately, the clinical manifestations of pulmonary embolism are nonspecific. Furthermore, in many patients the symptoms of an acute embolism are superimposed on underlying

N. R. Dunnick; G. E. Newman; L. M. Perlmutt; S. D. Braun

1988-01-01

190

Pulmonary resection of lung cancer in a patient with partial anomalous pulmonary venous connection.  

PubMed

We report a case of a 64-year-old man in whom a partial anomalous pulmonary venous connection (PAPVC) was found before right lower lobectomy for lung cancer. In addition to lung cancer, there was a right superior pulmonary vein that drained into the superior vena cava (SVC). There was a concern of right ventricular heart failure resulting from increased left-to-right shunt flow after lobectomy. Therefore cardiac catheterization was performed to calculate the pulmonary-to-systemic flow rate in the presence of blocked blood flow to the lower lobe pulmonary artery. As a result, we successfully performed lobectomy without correcting the PAPVC. PMID:23608268

Mikubo, Masashi; Ikeda, Shingo; Hoshino, Tatsuhiro; Yokota, Toshiya; Fujii, Akiko; Mori, Masaya

2013-05-01

191

Chylothorax as a complication of pulmonary tuberculosis in children  

Microsoft Academic Search

Chylothorax is a rare clinical entity characterized by a milky white aspirate with increased triglyceride levels. The commonest\\u000a aetiology is malignancy and trauma. Pulmonary tuberculosis is an extremely rare cause of chylothorax. Two children with chylothorax\\u000a and pulmonary tuberculosis are described. One child had bilateral and the other unilateral chylous effusions. Extensive mediastinal\\u000a and hilar lymphadenopathy was demonstrated. Diseased lymph

Marie Grobbelaar; Savvas Andronikou; Pierre Goussard; Salomine Theron; Ayanda Mapukata; Reena George

2008-01-01

192

Axillary lymph node analysis using Raman spectroscopy  

NASA Astrophysics Data System (ADS)

Raman Spectroscopy is an optical diagnostic technique applied in this study to classify axillary lymph nodes from breast cancer patients as positive or negative for metastases. The mapping technique in this study is 81% sensitive and 97% specific for the correct classification of positive lymph nodes. Raman spectral images of lymph node sections are constructed to facilitate interpretation of tissue features.

Smith, Jenny; Christie-Brown, Jonathan; Sammon, Alastair; Stone, Nicholas

2004-07-01

193

Misdiagnosis of left supraclavicular lymph node metastasis of hepatocellular carcinoma: A case report  

PubMed Central

Left supraclavicular lymph node metastasis is a rare presentation of hepatocellular carcinoma (HCC). This phenomenon is easily neglected in the clinic. A 56-year-old man presented with HCC. On examination, a 1cm long left supraclavicular lymph node was palpated. Auxiliary examination indicated a lesion located in the right lobe of the liver. Fine needle aspiration cytology (FNAC) of the enlarged lymph node was performed; however, only necrosis was found. Hepatectomy was performed and HCC was confirmed by Hematoxylin-Eosin staining. However, 14 d after surgery, significantly enlarged left supraclavicular lymph nodes, a new intrahepatic lesion, and pulmonary and mediastinal metastasis appeared. An excisional biopsy of the left supraclavicular lymph node was performed, and its findings confirmed metastatic HCC. The patient’s HCC rapidly progressed and he died one month later. It is possible for HCC to metastasize to the left supraclavicular lymph node. Surgeons should always consider an overall physical examination. When left supraclavicular lymphadenopathy of unknown origin is encountered, FNAC should be performed initially. If the results are negative, an excisional biopsy and subsequent Positron emission tomography - computed tomography scanning should be performed. These are very important for making the correct diagnosis and for selecting reasonable therapies.

Liu, Tao; Gao, Jun-Fang; Yi, Yong-Xiang; Ding, Hai; Liu, Wei

2013-01-01

194

Reference values of Forced Expiratory Volumes and pulmonary flows in 3-6 year children: a cross-sectional study  

PubMed Central

Background The aims of this study were to verify the feasibility of respiratory function tests and to assess their validity in the diagnosis of respiratory disorders in young children. Methods We performed spirometry and collected information on health and parents' lifestyle on a sample of 960 children aged 3–6. Results The cooperation rate was 95.3%. Among the valid tests, 3 or more acceptable curves were present in 93% of cases. The variability was 5% within subjects in 90.8% of cases in all the parameters. We propose regression equations for FVC (Forced Vital Capacity), FEV1, FEV0.5, FEV0.75 (Forced Expiratory Volume in one second, in half a second and in 3/4 of a second), and for Maximum Expiratory Flows at different lung volume levels (MEF75, 50, 25). All parameters are consistent with the main reference values reported in literature. The discriminating ability of respiratory parameters versus symptoms always shows a high specificity (>95%) and a low sensitivity (<20%) with the highest OR (10.55; IC95% 4.42–25.19) for MEF75. The ability of FEV0.75 to predict FEV1 was higher than that of FEV0.50: FEV0.75 predicts FEV1 with a determination coefficient of 0.95. Conclusion Our study confirms the feasibility of spirometry in young children; however some of the current standards are not well suited to this age group. Moreover, in this restricted age group the various reference values have similar behaviour.

Piccioni, Pavilio; Borraccino, Alberto; Forneris, Maria Pia; Migliore, Enrica; Carena, Carlo; Bignamini, Elisabetta; Fassio, Stefania; Cordola, Giorgio; Arossa, Walter; Bugiani, Massimiliano

2007-01-01

195

Interlaboratory and interstudy reproducibility of a novel lateral-flow device and influence of antifungal therapy on detection of invasive pulmonary aspergillosis.  

PubMed

Interest in lateral-flow devices (LFDs) as potential point-of-care assays for the diagnosis of infectious diseases has increased. Our objective was to evaluate the interlaboratory and interstudy reproducibility and the effects of antifungal therapy on an LFD developed for invasive pulmonary aspergillosis (IPA) detection. An established neutropenic guinea pig model of IPA caused by Aspergillus fumigatus was used. At predetermined time points (1 h and 3, 5, and 7 days postinoculation), blood and bronchoalveolar lavage (BAL) fluid were collected from infected and uninfected animals. In a separate experiment, guinea pigs were treated with posaconazole (10 mg/kg of body weight orally [p.o.] twice a day [BID]), voriconazole (10 mg/kg p.o. BID), liposomal amphotericin B (10 mg/kg intraperitoneally [i.p.] once a day [QD]), or caspofungin (2 mg/kg i.p. QD), and samples were collected on days 7 and 11. Each laboratory independently evaluated the IgG monoclonal antibody-based LFD. Galactomannan and (1 ? 3)-?-D-glucan were also measured using commercially available kits. Good interlaboratory agreement was observed with the LFD, as the results for 97% (32/33) of the serum and 78.8% (26/33) of the BAL fluid samples from infected animals were in agreement. Good interstudy agreement was also observed. The serum sensitivity of each surrogate-marker assay was reduced in animals treated with antifungals. In contrast, these markers remained elevated within the BAL fluids of treated animals, which was consistent with the fungal burden and histopathology results. These results demonstrate that the LFD assay is reproducible between different laboratories and studies. However, the sensitivity of this assay and other markers of IPA may be reduced with serum in the presence of antifungal therapy. PMID:23175252

Wiederhold, Nathan P; Najvar, Laura K; Bocanegra, Rosie; Kirkpatrick, William R; Patterson, Thomas F; Thornton, Christopher R

2012-11-21

196

Mitral valve repair at the time of continuous-flow left ventricular assist device implantation confers meaningful decrement in pulmonary vascular resistance.  

PubMed

We hypothesized that the addition of mitral valve replacement or repair (MVR) to implantation of continuous-flow left ventricular assist device (cf-LVAD) may further decrease pulmonary vascular resistance (PVR) over Heartmate II (HMII) implantation alone. Patients undergoing MVR with concomitant HMII implantation were compared with those undergoing HMII implantation alone. Of the 57 patients undergoing cf-LVAD implantation, 21 (36.8%) underwent concomitant MVR and 36 (63.2%) underwent cf-LVAD implantation alone. Patients receiving MVR had greater decrement in PVR (59.4% vs. 35.2%, p = 0.01). Decrease in end-diastolic diameter was greater for patients receiving MVR but did not reach statistical significance (18.2 vs. 13.5 mm, p = 0.33). Duration of mechanical ventilation (121.6 vs. 181.4 hours, p = 0.45) and inotropic support (162.4 vs. 153.2 hours, p = 0.86), change in creatinine (0.19 vs. -0.26 mg/dl, p = 0.34), increase in bilirubin (2.54 vs. 1.55 mg/dl, p = 0.63), intensive care unit stay (168.0 vs. 231.5 hours, p = 0.38), and overall length of stay (32.0 vs. 42.5 days, p = 0.75) were similar. There was no difference in survival at 3 months (89.7% vs. 83.3%) and 1 year (83.7 vs. 67.3%, p = 0.34). Addition of MVR may result in greater decrement of PVR than HMII implantation alone. This may permit certain patients thought to be ineligible for transplantation to become candidates. PMID:23896769

Taghavi, Sharven; Hamad, Eman; Wilson, Lynn; Clark, Rachael; Jayarajan, Senthil N; Uriel, Nir; Goldstein, Daniel J; Takayama, Hiroo; Naka, Yoshifumi; Mangi, Abeel A

197

Lymph node cytology.  

PubMed

In clinical practice, animals with lymphadenopathy are eminently suitable candidates for cytology sample collection by FNAB from several enlarged nodes; or, if surgical biopsies are made, imprint smears from the tissue may yield diagnostically useful information to supplement the histological findings. Cytology may reveal the lesion to be reactive, inflammatory, or neoplastic. Cytologically, reactive nodes will contain increased numbers of plasma cells, possibly with some inflammatory cells, along with the resident lymphoid population. If inflammation is present, neutrophils and macrophages also will be found and the type of inflammation may be classified. Any infectious agent such as fungal hyphae, yeasts, bacteria, and protozoa also may be demonstrated. Aspirates may be cultured directly onto blood agar plates or transported in nutrient broth for culture at a referral laboratory. In chronic dermatopathic nodes, a mixed inflammatory cell infiltrate is expected, and in pruritic skin disorders, eosinophils usually are plentiful in node aspirates. Increased numbers of eosinophils also may be found in dogs that are microfilaremic with heartworm infection. Background debris of hemosiderin and melanin pigment and other fine particles may occur in some chronic inflammatory lymphadenopathies. Metastatic lesions are identified by the presence of foreign neoplastic cells, but this diagnosis may be missed in early metastatic spread or if the aspirate is not sufficiently cellular. A cytological guide to the classification of the more common diffuse canine lymphomas is provided but full characterization of the lymphoma type may require histology and immunocytochemistry. In practice, a simple differential Romanowsky stain such as Diff Quik is suitable for most purposes. Supplementary stains using 1 per cent toluidine blue may increase the detection of mast cells. Aspirates also may be transferred into suitable media for transport to a referral diagnostic laboratory for cytocentrifugation or further tests such as electron microscopy, immunocytochemistry, flow cytometry, and culture. Although definitive diagnosis by histopathology and other tests still may be required, in many routine cases, diagnoses can be achieved expediently in clinical practice by aspiration cytology. PMID:2672536

Mills, J N

1989-07-01

198

[Pulmonary dirofilariasis].  

PubMed

Dirofilariosis usually concerns dogs among which it is transmitted by mosquito bites. Human infection is rare and we describe here a case observed in a 75 years old woman in New Caledonia. A systematic pulmonary radiograph showed suspicious pulmonary nodules. At microscopic examination one can see pulmonary infarctus with thrombosis and Dirofilaria immitis inside a vessel. Diagnosis is usually made by histologic examination because biological investigations are of a little interest. Surgical treatment is enough. Chemioprophylaxia for dogs can reduce the risks of man infection. PMID:7904713

Monchy, D; Levenes, H; Guegan, H; Poey, C; Dubourdieu, D

199

Pulmonary Fibrosis  

MedlinePLUS

... therapies can sometimes help ease symptoms and improve quality of life. For some people, a lung transplant might be ... or slow the disease's progress. Others help improve quality of life. Medications Many people diagnosed with pulmonary fibrosis are ...

200

Pulmonary coccidioidomycosis.  

PubMed

Coccidioidomycosis refers to the spectrum of disease caused by the dimorphic fungi Coccidioides immitis and Coccidioides posadasii. Clinical manifestations vary depending upon both the extent of infection and the immune status of the host. Coccidioidomycosis has been reported to involve almost all organ systems; however, pulmonary disease is the most common clinical manifestation. The incidence of coccidioidomycosis continues to rise, and primary coccidioidal pneumonia accounts for 17 to 29% of all cases of community-acquired pneumonia in endemic regions. The majority of patients with coccidioidomycosis resolve their initial infection without sequelae; however, several patients develop complications of disease ranging in severity from complicated pulmonary coccidioidomycosis to widely disseminated disease with immediately life-threatening manifestations. This review focuses on complications of pulmonary coccidioidomycosis with an emphasis on the management of primary coccidioidal infection, solitary pulmonary nodules, pleural effusions, cavitary disease, acute respiratory distress syndrome (ARDS), miliary disease, and sepsis. PMID:22167403

Thompson, George R

2011-12-13

201

Pulmonary nodule.  

PubMed

A pulmonary nodule is a frequent and often incidental finding, and still represents a diagnostic challenge for radiologists. Although most solitary nodules are related to benign disease, some represent stage I lung cancers. and need to be distinguished from benign nodules in a cost-effective manner. The aim of diagnostic assessment should be to allow early treatment of small malignant nodules but avoid unnecessary biopsy or surgery, with their attendant risks, in patients with benign disease. The advent of Multislice Computed Tomography (MSCT) technology has sparked new interest in the non-invasive assessment of pulmonary nodules. Thanks to its ability to scan the whole thoracic volume with thinner collimations, this technology allows a more accurate identification and characterisation of pulmonary nodules, as well as the determination of perfusion patterns and growth rates. In this paper we present an algorithm for the diagnostic workup of incidentally detected small pulmonary nodules in subjects without known malignancy. PMID:16292237

Feragalli, Beatrice; Guido, Francesca; Larici, Anna Rita; Storto, Maria Luigia; Bonomo, Lorenzo

2005-10-01

202

Mycobacterial lineages causing pulmonary and extrapulmonary tuberculosis, Ethiopia.  

PubMed

Molecular typing of 964 specimens from patients in Ethiopia with lymph node or pulmonary tuberculosis showed a similar distribution of Mycobacterium tuberculosis strains between the 2 disease manifestations and a minimal role for M. bovis. We report a novel phylogenetic lineage of M. tuberculosis strongly associated with the Horn of Africa. PMID:23622814

Firdessa, Rebuma; Berg, Stefan; Hailu, Elena; Schelling, Esther; Gumi, Balako; Erenso, Girume; Gadisa, Endalamaw; Kiros, Teklu; Habtamu, Meseret; Hussein, Jemal; Zinsstag, Jakob; Robertson, Brian D; Ameni, Gobena; Lohan, Amanda J; Loftus, Brendan; Comas, Ińaki; Gagneux, Sebastien; Tschopp, Rea; Yamuah, Lawrence; Hewinson, Glyn; Gordon, Stephen V; Young, Douglas B; Aseffa, Abraham

2013-03-01

203

Is tuberculosis a lymphatic disease with a pulmonary portal  

Technology Transfer Automated Retrieval System (TEKTRAN)

Tuberculosis (TB) is commonly viewed as a pulmonary disease, in which infection, persistence, induction of pathology and bacterial expulsion all occur in the lungs. In this model, enlarged lymph nodes represent reactive adenitis and spread of organisms to extrapulmonary sites results in a non-transm...

204

Species transport dynamics for clinical pulmonary evaluation  

Microsoft Academic Search

Various chemical species having different physicochemical properties (e.g., solubility) can be used to characterize many aspects\\u000a of the pulmonary system. These include (a) gas distribution (or ventilation) inhomogeneity, (b) effective alveolar-capillary\\u000a transport, (c) pulmonary blood flow, (d) pulmonary tissue (and capillary) volume, and (e) ventilation-perfusion inhomogeneity.\\u000a Experimentally, the quickest methods to obtain these characteristics are based on the dynamic response

Gerald M. Saidel

1981-01-01

205

Phenotypic and functional characterization of lymphocytes derived from normal and HIV-1-infected human lymph nodes  

PubMed Central

Lymph nodes are the major site of cell-to-cell transmission and replication of HIV-1. Trafficking of CD4+ T lymphocytes into lymph nodes provides a continual supply of susceptible target lymphocytes, and conversely, recruitment of CD8+ T lymphocytes may be critical for the host response that attempts to control HIV-1 replication. The present study was undertaken as no detailed assessment of lymphocyte subpopulations in HIV-1-infected lymph nodes has previously been reported. Peripheral blood and single-cell suspensions prepared from lymph nodes of patients with HIV-1 and control subjects were analysed using three-colour flow cytometry. Approximately 80% of the lymphocytes in control lymph nodes were CD3+ T lymphocytes, of which over 65% were CD4+. The majority of the CD4+ and CD8+ T lymphocytes obtained from both lymph nodes and blood of control subjects were immunologically naive (CD45RA+). By contrast, in HIV-1-infected patients there was a significant reduction in the proportion of CD4+ T lymphocytes and an expansion of the CD8+ T lymphocyte subset in both lymph nodes and peripheral blood. Furthermore, a high proportion of these T lymphocytes displayed a marker for immunological memory (CD45RO+). T lymphocytes derived from HIV-1-infected lymph nodes also showed altered expression of the adhesion molecules, l-selectin and very late antigen-4 (VLA-4), but not leucocyte function-associated antigen-1 (LFA-1). In an in vitro adhesion assay, lymphocytes from HIV-1-infected nodes were significantly more adhesive than control lymphocytes on fibronectin, as well as recombinant human intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) substrates. This combination of altered lymphocyte subpopulations in the HIV-1-infected lymph nodes, as well as enhanced adhesion phenotype and function, suggests that T lymphocyte traffic to lymph nodes in HIV disease may be an important determinant of pathogenesis.

TEDLA, N; DWYER, J; TRUSKETT, P; TAUB, D; WAKEFIELD, D; LLOYD, A

1999-01-01

206

Phenotypic and functional characterization of lymphocytes derived from normal and HIV-1-infected human lymph nodes.  

PubMed

Lymph nodes are the major site of cell-to-cell transmission and replication of HIV-1. Trafficking of CD4+ T lymphocytes into lymph nodes provides a continual supply of susceptible target lymphocytes, and conversely, recruitment of CD8+ T lymphocytes may be critical for the host response that attempts to control HIV-1 replication. The present study was undertaken as no detailed assessment of lymphocyte subpopulations in HIV-1-infected lymph nodes has previously been reported. Peripheral blood and single-cell suspensions prepared from lymph nodes of patients with HIV-1 and control subjects were analysed using three-colour flow cytometry. Approximately 80% of the lymphocytes in control lymph nodes were CD3+ T lymphocytes, of which over 65% were CD4+. The majority of the CD4+ and CD8+ T lymphocytes obtained from both lymph nodes and blood of control subjects were immunologically naive (CD45RA+). By contrast, in HIV-1-infected patients there was a significant reduction in the proportion of CD4+ T lymphocytes and an expansion of the CD8+ T lymphocyte subset in both lymph nodes and peripheral blood. Furthermore, a high proportion of these T lymphocytes displayed a marker for immunological memory (CD45RO+). T lymphocytes derived from HIV-1-infected lymph nodes also showed altered expression of the adhesion molecules, L-selectin and very late antigen-4 (VLA-4), but not leucocyte function-associated antigen-1 (LFA-1). In an in vitro adhesion assay, lymphocytes from HIV-1-infected nodes were significantly more adhesive than control lymphocytes on fibronectin, as well as recombinant human intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) substrates. This combination of altered lymphocyte subpopulations in the HIV-1-infected lymph nodes, as well as enhanced adhesion phenotype and function, suggests that T lymphocyte traffic to lymph nodes in HIV disease may be an important determinant of pathogenesis. PMID:10403921

Tedla, N; Dwyer, J; Truskett, P; Taub, D; Wakefield, D; Lloyd, A

1999-07-01

207

Distribution of lung-associated lymphocytes from the caudal mediastinal lymph node: effect of antigen.  

PubMed Central

Lymphocytes from the efferent lymph of the caudal mediastinal lymph node (CMLN) were labelled in vitro with 125I-iododeoxyuridine [125I]UdR and Na2(51)CrO4. The labelled cells were re-infused i.v. and their distribution in organs/tissues was determined 20-24 hr later. As indicated by tissue 125I-activity, pulmonary lymphoblasts had a marked tendency to relocate in the lung, regional pulmonary lymph nodes and spleen. Localization of efferent CMLN lymphoblasts was greater in antigenically stimulated segments compared to unstimulated segments of the lung. Dual antigen experiments indicated that the increased localization was not specific for the antigen which stimulated production of lymphoblasts used for in vitro labelling and reinfusion. Intranodal labelling of blasts by the direct injection of [125I]UdR supported the results obtained from in vitro labelling. In these studies, comparisons were made with the localization of lymphocytes obtained from thoracic duct lymph.

Joel, D D; Chanana, A D

1987-01-01

208

Distribution of lung-associated lymphocytes from the caudal mediastinal lymph node: effect of antigen.  

PubMed

Lymphocytes from the efferent lymph of the caudal mediastinal lymph node (CMLN) were labelled in vitro with 125I-iododeoxyuridine [125I]UdR and Na2(51)CrO4. The labelled cells were re-infused i.v. and their distribution in organs/tissues was determined 20-24 hr later. As indicated by tissue 125I-activity, pulmonary lymphoblasts had a marked tendency to relocate in the lung, regional pulmonary lymph nodes and spleen. Localization of efferent CMLN lymphoblasts was greater in antigenically stimulated segments compared to unstimulated segments of the lung. Dual antigen experiments indicated that the increased localization was not specific for the antigen which stimulated production of lymphoblasts used for in vitro labelling and reinfusion. Intranodal labelling of blasts by the direct injection of [125I]UdR supported the results obtained from in vitro labelling. In these studies, comparisons were made with the localization of lymphocytes obtained from thoracic duct lymph. PMID:3428927

Joel, D D; Chanana, A D

1987-12-01

209

Understanding Pulmonary Fibrosis  

MedlinePLUS

... Disparities Reports Lung Disease Finder Lung Disease List Lung HelpLine Questions about your lung health? Ask an ... for ENews Home > Lung Disease > Pulmonary Fibrosis Understanding Pulmonary Fibrosis What is Pulmonary Fibrosis? Pulmonary fibrosis is ...

210

Living with Pulmonary Fibrosis  

MedlinePLUS

... Home > Lung Disease > Pulmonary Fibrosis Living with Pulmonary Fibrosis If you have pulmonary fibrosis there are steps you can take to stay ... get you help. In depth resources on pulmonary fibrosis A A A Share Print Lung Cancer Education ...

211

Hantavirus Pulmonary Syndrome  

MedlinePLUS

... for ENews Home > Lung Disease > Hantavirus Pulmonary Syndrome Hantavirus Pulmonary Syndrome Hantavirus pulmonary syndrome (HPS) is a disease that comes ... may improve a person's chances of recovery. Understanding Hantavirus Pulmonary Syndrome Symptoms, Diagnosis and Treatment Preventing Hantavirus ...

212

Pulmonary embolism: predicting disease severity.  

PubMed

Pulmonary embolism (PE) is the most common cause of acute pulmonary hypertension, yet it is commonly undiagnosed, with risk of death if not recognized promptly and managed accordingly. Patients typically present with hypoxemia and hypomania, although the presentation varies greatly, being confounded by co-morbidities such as pre-existing cardio-respiratory disease. Previous studies have demonstrated variable patient outcomes in spite of similar extent and distribution of pulmonary vascular occlusion, but the path physiological determinants of outcome remain unclear. Computational models enable exact control over many of the compounding factors leading to functional outcomes and therefore provide a useful tool to understand and assess these mechanisms. We review the current state of pulmonary blood flow models. We present a pilot study within 10 patients presenting with acute PE, where patient-derived vascular occlusions are imposed onto an existing model of the pulmonary circulation enabling predictions of resultant haemodynamic after embolus occlusion. Results show that mechanical obstruction alone is not sufficient to cause pulmonary arterial hypertension, even when up to 65 per cent of lung tissue is occluded. Blood flow is found to preferentially redistribute to the gravitationally non-dependent regions. The presence of an additional downstream occlusion is found to significantly increase pressures. PMID:21969675

Burrowes, K S; Clark, A R; Marcinkowski, A; Wilsher, M L; Milne, D G; Tawhai, M H

2011-11-13

213

Pulmonary tumor embolism syndrome from occult colonic adenocarcinoma.  

PubMed

Pulmonary tumor embolism syndrome is a rare phenomenon that can occur in patients who have an occult neoplasm that metastasizes. We describe a case of an elderly woman with an undiagnosed colon cancer who suffered from respiratory distress and compromised pulmonary blood flow from micrometastasis in the pulmonary arteries. PMID:23814395

Heithaus, Robert Evans; Hitchcock, Michael A; Guileyardo, Joseph M

2013-07-01

214

Pulmonary artery banding; adequacy and long-term outcome  

Microsoft Academic Search

Objective: Pulmonary artery banding remains a palliative option for patients with congenital heart disease and excessive pulmonary blood flow, if there is unfavourable anatomy or frail condition. In contrast to more developed countries, our patients at Red Cross Children's Hospital, Cape Town, often present to medical services late and in poor nutritional condition. We retrospectively reviewed patients undergoing pulmonary artery

Paulo Pinho; Ulrich O Von Oppell; Johan Brink; John Hewitson

1997-01-01

215

Risk of pulmonary tuberculosis in children with congenital heart disease  

Microsoft Academic Search

Children with low-flow congenital heart lesions are reported to have an increased incidence of pulmonary tuberculosis. The aim of this study was to investigate if children with congenital heart disease have an increased incidence of pulmonary tuberculosis and to determine if patients with certain heart conditions are more susceptible to pulmonary tuberculosis than others. This retrospective study over a 6-year

P.-L. Merwe; N. Kalis; H. S. Schaaf; E. H. Nel; R. P. Gie

1995-01-01

216

Downregulation of Key Early Events in the Mobilization of Antigen-bearing Dendritic Cells by Leukocyte Immunoglobulin-like Receptor B4 in a Mouse Model of Allergic Pulmonary Inflammation  

PubMed Central

Leukocyte Immunoglobulin-like Receptor B4 (LILRB4) null mice have an exacerbated T helper cell type 2 (Th2) immune response and pulmonary inflammation compared with Lilrb4+/+ animals when sensitized intranasally with ovalbumin (OVA) and low-dose lipopolysaccharide (LPS) followed by challenge with OVA. Moreover, OVA-challenged Lilrb4?/? mice exhibit greater migration of antigen (Ag)-bearing dendritic cells (DCs) to lymph nodes and accumulation of interleukin 4- and interleukin 5-producing lymph node lymphocytes. The main objective of this study was to determine how the absence of LILRB4 leads to a greater number of DCs in the lymph nodes of Ag-challenged mice and increased lung Th2 inflammation. Mice were sensitized intranasally with PBS alone or containing OVA and LPS; additional cohorts were subsequently challenged with OVA. Expression of chemokine (C-C motif) ligand 21 (CCL21) in the lung was assessed immunohistologically. OVA ingestion and expression of LILRB4 and chemokine (C-C motif) receptor 7 (CCR7) were quantified by flow cytometry. Inhalation of OVA and LPS induced upregulation of LILRB4 selectively on lung Ag-bearing DCs. After sensitization and challenge, the lung lymphatic vessels of Lilrb4?/? mice expressed more CCL21, a chemokine that directs the migration of DCs from peripheral tissue to draining lymph nodes, compared with Lilrb4+/+ mice. In addition, lung DCs of challenged Lilrb4?/? mice expressed more CCR7, the CCL21 receptor. The lungs of challenged Lilrb4?/? mice also contained significantly greater numbers of CD4+ cells expressing interleukin-4 or interleukin-5, consistent with the greater number of Ag-bearing DCs and Th2 cells in lymph nodes and the attendant exacerbated Th2 lung pathology. Our data establish a new mechanism by which LILRB4 can downregulate the development of pathologic allergic inflammation: reduced upregulation of key molecules needed for DC migration leading to decreases in Th2 cells in lymph nodes and their target tissue.

Fanning, Laura B.; Buckley, Carolyn C.; Xing, Wei; Breslow, Rebecca G.; Katz, Howard R.

2013-01-01

217

Smallpox Vaccine, Dried, Calf Lymph Type  

Center for Biologics Evaluation and Research (CBER)

... Smallpox Vaccine, Dried, Calf Lymph Type. -. Product. Dryvax Wyeth Pharmaceuticals, Inc. -. Contact FDA. (800) 835-4709. ... More results from www.fda.gov/biologicsbloodvaccines/vaccines/approvedproducts

218

Automatic definition of the central-chest lymph-node stations  

PubMed Central

Purpose Lung cancer remains the leading cause of cancer death in the United States. Central to the lung-cancer diagnosis and staging process is the assessment of the central-chest lymph nodes. This assessment requires two steps: (1) examination of the lymph-node stations and identification of diagnostically important nodes in a three-dimensional (3D) multidetector computed tomography (MDCT) chest scan; (2) tissue sampling of the identified nodes. We describe a computer-based system for automatically defining the central-chest lymph-node stations in a 3D MDCT chest scan. Methods Automated methods first construct a 3D chest model, consisting of the airway tree, aorta, pulmonary artery, and other anatomical structures. Subsequent automated analysis then defines the 3D regional nodal stations, as specified by the internationally standardized TNM lung-cancer staging system. This analysis involves extracting over 140 pertinent anatomical landmarks from structures contained in the 3D chest model. Next, the physician uses data mining tools within the system to interactively select diagnostically important lymph nodes contained in the regional nodal stations. Results Results from a ground-truth database of unlabeled lymph nodes identified in 32 MDCT scans verify the system’s performance. The system automatically defined 3D regional nodal stations that correctly labeled 96% of the database’s lymph nodes, with 93% of the stations correctly labeling 100% of their constituent nodes. Conclusions The system accurately defines the regional nodal stations in a given high-resolution 3D MDCT chest scan and eases a physician’s burden for analyzing a given MDCT scan for lymph-node station assessment. It also shows potential as an aid for preplanning lung-cancer staging procedures.

Lu, Kongkuo; Taeprasartsit, Pinyo; Bascom, Rebecca; Mahraj, Rickhesvar P. M.

2011-01-01

219

Lymph Node Tumor Volumes in Patients Undergoing Sentinel Lymph Node Biopsy for Cutaneous Melanoma  

Microsoft Academic Search

Background: Regional lymph node tumor volumes in patients undergoing sentinel lymph node (SN) biopsy (SNB) for treatment of cutaneous melanoma have not been described. The objectives of this study were to describe the lymph node tumor volumes typically seen in this population and to correlate tumor volumes with tumor thickness and positive SN characteristics. Methods: Review of a consecutive series

Jeffrey D. Wagner; Darrell Davidson; John J. Coleman III; Gary Hutchins; Donald Schauwecker; Hee-Myung Park; Robert J. Havlik

1999-01-01

220

Palliating severe arteriovenous fistulae using absorbable pulmonary artery bands.  

PubMed

We report the use of an absorbable pulmonary artery band to limit postoperative cyanosis due to severe pulmonary arteriovenous fistulae in a 5-year-old girl with post-Fontan palliation takedown to a two-ventricle repair. At 1-year postoperatively, her fistulae had nearly resolved with no distortion of her pulmonary artery anatomy. This case demonstrates a novel approach to limiting cyanosis while pulmonary arteriovenous fistulae resolved after redirection of hepatic blood flow to the affected lung. PMID:20338368

Schumacher, Kurt R; Rocchini, Albert; Ohye, Richard G

2010-04-01

221

Alcohol Exacerbates Murine Pulmonary Tuberculosis  

PubMed Central

Alcohol consumption has been described as a risk factor for infection with Mycobacterium tuberculosis, but its contribution to tuberculosis has been difficult to isolate from other adverse socioeconomic factors. Our objective was to evaluate the impact of alcohol consumption on pulmonary infection with M. tuberculosis in a murine model. BALB/c mice were maintained on the Lieber-DeCarli liquid ethanol diet or a liquid control diet and infected intratracheally with low-dose M. tuberculosis H37Rv. Lung organism burdens, lung and lung-associated lymph node CD4+- and CD8+- lymphocyte numbers and rates of proliferation, and CD4+-lymphocyte cytokine production levels were compared between the groups. The alcohol-consuming mice had significantly higher lung organism burdens than the control mice, and the CD4+- and CD8+-lymphocyte responses to pulmonary infection with M. tuberculosis were blunted in the alcohol group. Lymphocyte proliferation and production of gamma interferon were decreased in the CD4+ lymphocytes from the alcohol-consuming mice. Additionally, lung granulomas were significantly smaller in the alcohol-consuming mice. In conclusion, murine alcohol consumption is associated with decreased control of pulmonary infection with M. tuberculosis, which is accompanied by alterations in the region-specific CD4+- and CD8+-lymphocyte responses and defective lung granuloma formation.

Mason, Carol M.; Dobard, Elizabeth; Zhang, Ping; Nelson, Steve

2004-01-01

222

Lymphatic Pump Treatment Mobilizes Leukocytes from the Gut Associated Lymphoid Tissue into Lymph  

PubMed Central

Abstract Background Lymphatic pump techniques (LPT) are used clinically by osteopathic practitioners for the treatment of edema and infection; however, the mechanisms by which LPT enhances lymphatic circulation and provides protection during infection are not understood. Rhythmic compressions on the abdomen during LPT compress the abdominal area, including the gut-associated lymphoid tissues (GALT), which may facilitate the release of leukocytes from these tissues into the lymphatic circulation. This study is the first to document LPT-induced mobilization of leukocytes from the GALT into the lymphatic circulation. Methods and Results Catheters were inserted into either the thoracic or mesenteric lymph ducts of dogs. To determine if LPT enhanced the release of leukocytes from the mesenteric lymph nodes (MLN) into lymph, the MLN were fluorescently labeled in situ. Lymph was collected during 4?min pre-LPT, 4?min LPT, and 10?min following cessation of LPT. LPT significantly increased lymph flow and leukocytes in both mesenteric and thoracic duct lymph. LPT had no preferential effect on any specific leukocyte population, since neutrophil, monocyte, CD4+ T cell, CD8+ T cell, IgG+B cell, and IgA+B cell numbers were similarly increased. In addition, LPT significantly increased the mobilization of leukocytes from the MLN into lymph. Lymph flow and leukocyte counts fell following LPT treatment, indicating that the effects of LPT are transient. Conclusions LPT mobilizes leukocytes from GALT, and these leukocytes are transported by the lymphatic circulation. This enhanced release of leukocytes from GALT may provide scientific rationale for the clinical use of LPT to improve immune function.

Bearden, Melissa K.; Schander, Artur; Huff, Jamie B.; Williams, Arthur; King, Hollis H.; Downey, H. Fred

2010-01-01

223

Detection of septal coronary collaterals by color flow Doppler mapping is a marker for anomalous origin of a coronary artery from the pulmonary artery  

Microsoft Academic Search

Between August 1991 and September 2000, 15 patients received a diagnosis of the anomalous origin of the coronary artery from the pulmonary artery, at the Children's Hospital of Wisconsin. All were evaluated initially by transthoracic echocardiography, with subsequent diagnosis confirmation at cardiac catheterization and\\/or surgery. Seven of the 15 patients were referred in infancy (mean age 4.3 months) with symptoms

Michele A. Frommelt; Elaine Miller; Jeff Williamson; Sarita Bergstrom

2002-01-01

224

Changes in symptoms, peak expiratory flow, and sputum flora during treatment with antibiotics of exacerbations in patients with chronic obstructive pulmonary disease in general practice  

Microsoft Academic Search

BACKGROUND--Bacterial infections of the lower airways during an exacerbation in patients with asthma or chronic obstructive pulmonary disease (COPD) may be the cause of an exacerbation or the consequence of a viral infection or an increase in airways limitation. To determine whether bacterial infection is an important component in the pathogenesis of an exacerbation, the effects of antimicrobial treatment must

A P Sachs; G H Koëter; K H Groenier; D van der Waaij; J Schiphuis; B Meyboom-de Jong

1995-01-01

225

The role of oxidative stress in the development of pulmonary arteriovenous malformations after cavopulmonary anastomosis  

Microsoft Academic Search

Background: Cavopulmonary anastomosis is used for palliation of cyanotic heart disease. Clinically significant pulmonary arteriovenous malformations occur in up to 25% of patients after surgical intervention. Cavopulmonary anastomosis creates several modifications to pulmonary physiology that may contribute to the development of pulmonary arteriovenous malformations, including reduced pulmonary blood flow and the exclusion of inferior vena caval effluent. Objective: By comparing

Sunil P. Malhotra; V. Mohan Reddy; Stephan Thelitz; You-Ping He; D. Michael McMullan; Frank L. Hanley; R. Kirk Riemer

2002-01-01

226

Supraventricular tachycardia and pulmonary hypertension at the presentation of Hodgkin's disease.  

PubMed

A 27-year-old pregnant woman was admitted with supraventricular tachycardia (SVT) and symptoms of heart failure. Echocardiography revealed pulmonary hypertension due to a tumour infiltrating the left atrium and compressing the pulmonary veins. After delivery by Caesarean section, the paroxysmal SVT was controlled by amiodarone. Thoracic CT scan showed mediastinal masses compressing the pulmonary arteries and veins, and a preliminary diagnosis of Hodgkin's disease was later confirmed by mediastinoscopy and lymph node biopsy. Following two courses of chemotherapy the masses diminished. The lumen of the left atrium increased, pulmonary hypertension and SVTs receded. PMID:16385929

Korecki, Janusz; Kami?ski, Karol A; Lisowska, Anna; Musia?, W?odzimierz J

2005-12-01

227

[Pulmonary paragonimiasis].  

PubMed

Paragonimiasis is a food-borne zoonosis caused by a trematode of the genus Paragonimus(1,2). Infestation is rare in Spain, but the influx of people from endemic areas should make us keep this condition in the differential diagnosis of our patients(2,5). We report the case a patient from Ecuador and resident in Spain for 7 years with active pulmonary tuberculosis on arrival in Spain and later diagnosed with of pulmonary paragonimiasis due to persistent haemoptysis. The diagnosis was established by surgical lung specimen showing granulomas containing parasite eggs and the macroscopic view of the fluke within a lung cavity. Initial tuberculosis treatment and current treatment with praziquantel controlled both conditions. PMID:21420222

Gómez-Seco, Julio; Rodríguez-Guzmán, Marcel José; Rodríguez-Nieto, María Jesús; Gómez-Escolar, Pablo Fernández; Presa-Abos, Teresa; Fortes-Alen, José

2011-03-21

228

Pulmonary calcinosis.  

PubMed Central

The clinical and pathological features are described of a case of pulmonary calcinosis complicating cystic disease of the renal medulla. A histopathological study of the lung revealed calcification in the alveolar walls and in the blood vessels, predominantly in the pulmonary veins and venules. The calcified deposits were also studied by electron microscopy, and appearances suggestive of active growth of the deposits were recognised. Chemical analysis of the lung revealed a calcium content some 55 times greater than that of a normal lung. There was a five-fold increase in magnesium content. Reference is made to the literature demonstrating that the chemical composition of metastic calcification differs according to whether it is visceral or non-visceral in type. Images

Heath, D; Robertson, A J

1977-01-01

229

Total anomalous pulmonary venous return with intact atrial septum and associated mitral stenosis  

Microsoft Academic Search

Total anomalous pulmonary venous return with an intact atrial septum is an uncommon lesion. With associated mitral stenosis each lung has a different pulmonary flow, individual vascular resistance, and function. This represents the first reported case of this anomaly treated by total correction and mitral valve replacement. Pulmonary flow reverted to normal distribution and heart size decreased, with a reversion

Walter G. Wolfe; Paul A. Ebert

1970-01-01

230

Animal Models Related to Congenital Heart Disease and Clinical Research in Pulmonary Hypertension  

Microsoft Academic Search

There are several animal models for studying human pulmonary hypertension (PH). An increased flow model in pigs was developed at the University Hospital in Heidelberg in order to simulate congenital heart disease. The high pulmonary blood flow is achieved by installation of a Blalock-Taussig anastomosis. In order to further improve this model by adding a pressure component, the left pulmonary

Tsvetomir Loukanov; Ralf Geiger; Rahul Agrawal

2010-01-01

231

Effect of sildenafil on ventilatory efficiency and exercise tolerance in pulmonary hypertension  

Microsoft Academic Search

Background: The pulmonary vasculopathy in pulmonary arterial hypertension (PAH) results in increased resistance to pulmonary blood flow, limiting the cardiac output required for the increased O2 demands of exercise. Aims: We sought to determine the physiologic basis for clinical improvement in PAH patients receiving sildenafil, hypothesizing that the key mechanisms of improvement are improved blood flow and ventilatory efficiency, leading

Ronald J. Oudiz; Giorgio Roveran; James E. Hansen; Xing-Guo Sun; Karlman Wasserman

232

Massive pulmonary embolism and thrombophilia.  

PubMed

A 32-year-old man presented overnight to the accident and emergency unit with mild breathlessness on exertion. He was found to be hypoxic on room air and his chest x-ray revealed areas of patchy lung consolidation. He was given intravenous antibiotics for presumed community-acquired pneumonia. Unfortunately his condition deteriorated and he remained significantly hypoxic despite high-flow oxygen with ECG evidence of right heart strain. Further questioning revealed a history of protein S deficiency and a strong family history of venous thromboembolic disease. An urgent CT pulmonary angiogram showed an evidence of massive pulmonary embolism and the patient was successfully thrombolysed. PMID:23345503

Qureshi, Iman; Meshaka, Riwa; Donohue, Claire; Ali, Asad

2013-01-22

233

Perspectives in nuclear medicine: pulmonary studies  

SciTech Connect

Since the introduction of I-131 labeled macroaggregates in 1964, noninvasive techniques involving injection of radiolabeled agents and remote detection of emitted radiation have become well established in detecting pulmonary disorders in routine clinical medicine. In the past, pulmonary nuclear medicine has been dominated by studies that depict the distribution of pulmonary perfusion and/or ventilation-perfusion balance (e.g., for the detection of pulmonary embolism, obstructive airway disease, lung carcinoma). With the recent development of emission tomography and the potential for new, function-oriented radiopharmaceuticals, however, pulmonary nuclear medicine is entering a new era. The status of contemporary pulmonary nuclear medicine is briefly reviewed in several areas of major interest and applications and focus on areas where new developments are needed and seem feasible in the near future. Several important regional physiological processes measurable by these techniques include: (a) the presence or absence of pulmonary embolism, (b) relative pulmonary blood flow, (c) permeability to specific molecules, (d) lung tissue metabolism, (e) ventilation distribution and (f) the relationship between ventilation and blood flow (perfusion). (JMT)

Budinger, T.F. (Univ. of California, Berkeley); McNeil, B.J.; Alderson, P.O.

1982-01-01

234

Significance of normal septal motion in total anomalous pulmonary venous drainage.  

PubMed Central

Paradoxical septal motion is considered to be a characteristic feature of total anomalous pulmonary venous drainage, reflecting the right ventricular volume overload in this condition. Patients with additional pulmonary venous obstruction have reduced pulmonary blood flow, and would be expected to show normal septal motion. We have studied the haemodynamic and echocardiographic findings in 21 patients with proven total anomalous pulmonary venous drainage and found paradoxical septal motion in only 11 instances. Paradoxical septal motion was present in all nine patients over the age of 1 month. Of the 12 neonates, 10 showed normal septal motion. Patients with normal septal motion had clinical features of pulmonary venous obstruction, with significantly higher pulmonary artery pressures and lower pulmonary artery saturations than patients with paradoxical septal motion. It is concluded that in total anomalous pulmonary venous drainage, septal motion reflects pulmonary blood flow, allowing separation of patients into those with or those without pulmonary venous obstruction. Images

Shiu, M F; Miles, M; Silove, E D

1981-01-01

235

Topography of the major superficial lymph nodes and their efferent lymph pathways in the koala (Phascolarctos cinereus).  

PubMed Central

The koala has an inguinoaxillary lymph trunk on either side of the ventral midline, and this carries efferent lymph from the superficial inguinal lymph node directly to the deep axillary lymph node. The superficial lymph nodes are large and soft compared with those of the domestic species, and each lymph centre usually contains only one or two large lymph nodes. Koalas have a rostral mandibular lymph node which has not been described in other species, but lack popliteal and subiliac lymph nodes. The superficial lymph nodes which are readily palpable in the live koala are the facial, rostral mandibular, mandibular, superficial axillary and superficial inguinal. All superficial lymph pathways terminate at the confluence of the common jugular and subclavian veins.

Hanger, J J; Heath, T J

1991-01-01

236

Mathematical Model for the Study of Hemorrhagic Shock and Fluid Resuscitation: The Systemic and Pulmonary Vasculature.  

National Technical Information Service (NTIS)

In systemic and pulmonary circuit models, the number and configuration of vascular compartments may affect predictions of vascular volume and blood flow. In this paper, we consider various models of the pulmonary and systemic vascular circuits to identify...

T. J. Doherty

1993-01-01

237

Mechanoinduction of lymph vessel expansion  

PubMed Central

In the mammalian embryo, few mechanical signals have been identified to influence organ development and function. Here, we report that an increase in the volume of interstitial or extracellular fluid mechanically induces growth of an organ system, that is, the lymphatic vasculature. We first demonstrate that lymph vessel expansion in the developing mouse embryo correlates with a peak in interstitial fluid pressure and lymphatic endothelial cell (LEC) elongation. In ‘loss-of-fluid' experiments, we then show that aspiration of interstitial fluid reduces the length of LECs, decreases tyrosine phosphorylation of vascular endothelial growth factor receptor-3 (VEGFR3), and inhibits LEC proliferation. Conversely, in ‘gain-of-fluid' experiments, increasing the amount of interstitial fluid elongates the LECs, and increases both VEGFR3 phosphorylation and LEC proliferation. Finally, we provide genetic evidence that ?1 integrins are required for the proliferative response of LECs to both fluid accumulation and cell stretching and, therefore, are necessary for lymphatic vessel expansion and fluid drainage. Thus, we propose a new and physiologically relevant mode of VEGFR3 activation, which is based on mechanotransduction and is essential for normal development and fluid homeostasis in a mammalian embryo.

Planas-Paz, Lara; Strilic, Boris; Goedecke, Axel; Breier, Georg; Fassler, Reinhard; Lammert, Eckhard

2012-01-01

238

Contraindications of sentinel lymph node biopsy: Áre there any really?  

Microsoft Academic Search

BACKGROUND: One of the most exciting and talked about new surgical techniques in breast cancer surgery is the sentinel lymph node biopsy. It is an alternative procedure to standard axillary lymph node dissection, which makes possible less invasive surgery and side effects for patients with early breast cancer that wouldn't benefit further from axillary lymph node clearance. Sentinel lymph node

George M Filippakis; George Zografos

2007-01-01

239

Robotic-assisted inguinal lymph node dissection: A preliminary report  

PubMed Central

Penile cancer with inguinal lymph node metastasis is a common cancer in India. Open inguinal lymphadenectomy is the gold standard treatment of metastatic inguinal lymph nodes. We report our experience and technique of robotic assisted inguinal lymph node dissection in two patients presented with palpable inguinal lymph nodes, which to our knowledge is the first reported case series from India.

Dogra, P. N.; Saini, Ashish Kumar; Singh, Prabhjot

2011-01-01

240

Laparoscopic Retroperitoneal Lymph Node Dissection: Extraperitoneal Approach  

Microsoft Academic Search

We review our early experience with laparoscopic retroperitoneal lymph node dissection (RPLND) via extraperitoneal approach\\u000a to assess the precise pathological status of retroperitoneal lymph nodes in early-stage testicular cancer. A total of 32 patients\\u000a (23 with stage I, 4 with stage IIa, and 5 with stage IIb) with testicular cancer underwent extraperitoneal laparoscopic RPLND\\u000a in the supine position. After developing

Makoto Satoh; Akihiro Ito; Yoichi Arai

241

Sentinel lymph node mapping with GI cancer  

Microsoft Academic Search

Precise evaluation of lymph node status is one of the most important factors in determining clinical outcome in treating gastro-intestinal\\u000a (GI) cancer. Sentinel lymph node (SLN) mapping clearly has become highly feasible and accurate in staging GI cancer. The lunchtime\\u000a symposium focused on the present status of SLN mapping for GI cancer. Dr. Kitigawa proposed a new strategy using sentinel

Takashi Aikou; Yuko Kitagawa; Masaki Kitajima; Yoshikazu Uenosono; Anton J. Bilchik; Steve R. Martinez; Sukamal Saha

2006-01-01

242

Cyclic stretch increases VEGF expression in pulmonary arterial smooth muscle cells via TGF-1 and reactive oxygen species: a requirement for NAD(PH) oxidase  

Microsoft Academic Search

We have previously shown that TGF-1 and VEGF expression are increased in the smooth muscle cell (SMC) layer of the pulmonary vessels of lambs with pulmonary hypertension secondary to increased pulmonary blood flow. Further we found that TGF-1 expression increased prior to VEGF. Due to the increased blood flow in these lambs the SMC in the pulmonary vessels are exposed

Stephen M. Black; Albert Grobe; Eugenia Mata-Greenwood; Yelina Noskina

2004-01-01

243

Haemorrhagic pulmonary oedema: post-pulmonary embolectomy.  

PubMed Central

A case of haemorrhagic pulmonary oedema after successful pulmonary embolectomy is presented. The relevant literature is reviewed. Thirteen cases are analysed as well as the four survivors. The aetiology appears to be ischaemic damage of the capillary bed. This had previously been called incomplete infarction by Castleman. The incidence is low after acute pulmonary embolectomies but appears to be much higher after chronic endarterectomies, especially with severe pulmonary hypertension. Therapy is outlined. Images

Garvey, J W; Wisoff, G; Voletti, C; Hartstein, M

1976-01-01

244

Pulmonary benign metastasizing leiomyoma from the uterus in a postmenopausal woman: report of a case  

Microsoft Academic Search

Benign Metastatic Leiomyoma (BML) is a disease that stems from pulmonary smooth muscles and it is generally observed in multiple\\u000a locations, including uterine leiomyomas. Apart from lungs it has been reported in lymph nodes, peritoneum, myocardium, eye,\\u000a brain and spinal cord. We report a case of pulmonary BML from the uterus in a 50-year-old woman. Multiple nodules were identified\\u000a in

Atilla Pekçolaklar; Muzaffer Metin; Necati Ç?tak; Nevin I??k; Sibel Yurt; Nur Ürer; Filiz Ko?ar; Atilla Gürses

2011-01-01

245

New method to assess manual lymph drainage using lymphoscintigraphy.  

PubMed

The aim of this study was to describe a new variation of the technique to evaluate lymph drainage utilizing lymphoscintigraphy. A LS scan marks the route of lymphatic vessels and may be used to assess both manual lymph drainage and lymph drainage after using some apparatuses. This evaluation may be dynamic, collecting images whilst performing lymph drainage or static, with scans before and after the lymph drainage procedure. PMID:22951956

de Godoy, José Maria Pereira; Iozzi, Adriana Joaquim; Azevedo, Walter Ferreira; Godoy, Maria de Fátima Guerreiro

2012-08-27

246

Pulmonary mucormycosis.  

PubMed

Mucormycosis (formerly zygomycosis) is a life-threatening opportunistic mycosis that infects a broad range of hosts with qualitative or quantitative defects in innate immunity, including patients with severe neutropenia, recipients of corticosteroids or other immunosuppressive medications, poorly controlled diabetes mellitus, and those with iron overload states. Mucormycosis has recently emerged as breakthrough sinopulmonary infection in hematologic patients and recipients of transplantation being on antifungal prophylaxis with Aspergillus-active antifungals that lack activity against Mucorales. Unlike pulmonary aspergillosis, the prognosis and outcome of pulmonary mucormycosis have not improved significantly over the last decade, mainly because of difficulties in early diagnosis and the limited activity of current antifungal agents against Mucorales. Recent evidence suggests a critical role for iron metabolism and fungal-endothelial cell interactions in pathogenesis of mucormycosis, and holds promise for development of novel therapeutic strategies. Currently, prompt initiation of antifungal therapy with a lipid amphotericin B-based regimen, reversal of underlying host factors, and aggressive surgical approach offers the best chances for survival of patients infected with this devastating mycosis. PMID:22167397

Hamilos, Georgios; Samonis, George; Kontoyiannis, Dimitrios P

2011-12-13

247

[Pulmonary endometriosis].  

PubMed

Endometriosis in less common locations can become a diagnostic pitfall both from the clinical and morphological point of view, as this diagnosis is only seldom considered in the first series of differential diagnoses. This was true also for our patient reported. 48-year-old woman underwent left superior lobectomy for the clinical diagnosis of pulmonary neoplasm. Slightly prominent subpleural whitish nodular partly cystic tissue was histologically identified as pulmonary endometriosis. It consisted of proliferative to hyperproliferative endometrial glands surrounded by proliferation type stroma. Focally slight cytological glandular atyplas and immature squamous metaplasia were present. Later another focus was located by x-ray examination. Without any surgery, it responded to six month treatment with competitive gonadoliberin agonist (GnRH analogue) Zoladex. Three years after the treatment no signs of the disease have been present. The correct clinical diagnosis accompanied with cautious morphological verification may prevent unnecessary extensive surgery. However, even some correctly diagnosed and morphologically verified cases may require radical operative removal. Either approach (conservative therapy and surgery) completed with subsequent dispensarisation may prevent both the common (cycle related progressive tissue damage) and rare (tissue destruction, malignant transformation) complications. PMID:11374226

Dusková, J; Vítková, I

2001-04-12

248

Pulmonary artery segmentation and quantification in sickle cell associated pulmonary hypertension  

NASA Astrophysics Data System (ADS)

Pulmonary arterial hypertension is a known complication associated with sickle-cell disease; roughly 75% of sickle cell disease-afflicted patients have pulmonary arterial hypertension at the time of death. This prospective study investigates the potential of image analysis to act as a surrogate for presence and extent of disease, and whether the size change of the pulmonary arteries of sickle cell patients could be linked to sickle-cell associated pulmonary hypertension. Pulmonary CT-Angiography scans from sickle-cell patients were obtained and retrospectively analyzed. Randomly selected pulmonary CT-Angiography studies from patients without sickle-cell anemia were used as negative controls. First, images were smoothed using anisotropic diffusion. Then, a combination of fast marching and geodesic active contours level sets were employed to segment the pulmonary artery. An algorithm based on fast marching methods was used to compute the centerline of the segmented arteries. From the centerline, the diameters at the pulmonary trunk and first branch of the pulmonary arteries were measured automatically. Arterial diameters were normalized to the width of the thoracic cavity, patient weight and body surface. Results show that the pulmonary trunk and first right and left pulmonary arterial branches at the pulmonary trunk junction are significantly larger in diameter with increased blood flow in sickle-cell anemia patients as compared to controls (p values of 0.0278 for trunk and 0.0007 for branches). CT with image processing shows great potential as a surrogate indicator of pulmonary hemodynamics or response to therapy, which could be an important tool for drug discovery and noninvasive clinical surveillance.

Linguraru, Marius George; Mukherjee, Nisha; Van Uitert, Robert L.; Summers, Ronald M.; Gladwin, Mark T.; Machado, Roberto F.; Wood, Bradford J.

2008-04-01

249

Identifying additional lymph nodes in radical cystectomy lymphadenectomy specimens.  

PubMed

Lymph node count has prognostic implications in bladder cancer patients who are treated with radical cystectomy. Lymph nodes that are too small to identify grossly can easily be missed, potentially leading to missed nodal metastases and inaccurate nodal counts, resulting in inaccurate prognoses. We investigated whether there is a benefit to submitting the entire lymph node packet for histological examination to identify additional lymph nodes. We prospectively assessed 61 pelvic lymphadenectomy specimens in 14 consecutive patients undergoing radical cystectomy. The specimens were placed in Carnoy's solution overnight, then analyzed for lymph nodes. The residual tissue was entirely submitted to assess for additional lymph nodes. In 61 specimens, we identified 391 lymph nodes, ranging from 4-44 nodes per patient. We identified 238 (61%) lymph nodes with standard techniques and 153 (39%) lymph nodes in submitted residual tissue. The number of additional lymph nodes found in the residual tissue ranged from 0 to 26 (0-75%) per patient. These lymph nodes ranged in size from 0.05 to 1 cm. All additional lymph nodes were negative for metastatic disease. Submitting the entire specimen for histological examination allowed for identification of more lymph nodes in radical cystectomy pelvic lymphadenectomy specimens. However, as none of the additional lymph nodes contained metastatic disease, it is unclear if there is a clinical benefit in evaluating lymph nodes that are neither visible nor palpable in lymphadenectomy specimens. PMID:21909079

Gordetsky, Jennifer; Scosyrev, Emelian; Rashid, Hani; Wu, Guan; Silvers, Christopher; Golijanin, Dragan; Messing, Edward M; Yao, Jorge L

2011-09-09

250

Surgical management of chronic pulmonary embolism.  

PubMed Central

The clinical course of most patients with pulmonary embolism is one of gradual resolution with re-establishment of flow in the pulmonary arteries. In a small but definite group of patients, the emboli do not resolve and a state of chronic pulmonary embolism ensues. The primary thrombotic process in the systemic venous system may persist, and in some instances may be unrecognized. Such patients experience recurrent showers of emboli which may ultimately occlude a large part of the pulmonary arterial circulation with development of severe respiratory insufficiency. Six patients with this syndrome are described, and in each there was a history of dyspnea, cyanoiss, and exercise intolerance associated with a low arterial PO2, right ventricular hypertrophy, and pulmonary hypertension. Pulmonary scans and arteriograms demonstrated that more than half of the major pulmonary arteries were occluded and, in addition, smaller vessels were also obstructed. Pulmonary embolectomy was performed in each patient. Five of the 6 obtained a highly gratifying response, including relief of the dyspnea and cyanosis, an increase in arterial PO2, and a decrease in pulmonary arterial pressure. In each of the five in whom improvement occurred, the back-bleeding from the pulmonary artery at the time of embolectomy was quite good. In the sixth patient, the back-bleeding was very poor, and despite embolectomy, the vessel thrombosed postoperatively with no improvement in the patient's clinical course. Follow-up studies in these patients range up to 8 years with demonstration of continued patency of the pulmonary arteries as well as continued improvement in clinical symptoms and in the arterial PO2. Images Fig. 1. Fig. 2. Fig. 3. Fig. 6. Fig. 6C Fig. 7. Fig. 8. Fig. 9. Fig. 10. Fig. 11. Fig. 11D. Fig. 12. Fig. 12B. Fig. 13 Fig. 1. Fig. 17. Fig. 18. Fig. 19..

Sabiston, D C; Wolfe, W G; Oldham, H N; Wechsler, A S; Crawford, F A; Jones, K W; Jones, R H

1977-01-01

251

Retinoids and Pulmonary Hypertension  

Microsoft Academic Search

Background—Retinoic acid has antimitogenic effects on smooth muscle cells. Studies on the systemic circulation suggest that it may reduce vascular thickening. Relationships between retinoids and pulmonary hypertension\\/pulmonary vascular remodeling, however, have not been explored. Thus, the present study examined retinoid levels in plasma of patients with idiopathic pulmonary arterial hypertension and the effects of retinoic acid on human pulmonary artery

Ioana R. Preston; Guangwen Tang; Jason U. Tilan; Nicholas S. Hill; Yuichiro J. Suzuki

2010-01-01

252

Assessment of pulmonary artery pressure by pulsed Doppler echocardiography in patients with chronic pulmonary diseases.  

PubMed

Doppler echocardiography was recently developed for obtaining a flow velocity profile at any point in the cardiac chamber. A pulsed Doppler technique combined with cross sectional echocardiography was used to examine the flow velocity pattern in the right ventricular outflow tract in 32 patients with chronic pulmonary disease (CPD) and in 15 healthy subjects as controls. All patients underwent cardiac catheterization. Pulmonary flow velocity profiles in the right ventricular outflow tract were recorded simultaneously with electrocardiograms and pre-ejection periods (PEP), right ventricular ejection time (RVET), acceleration time (AT), and calculated PEP/RVET, AT/RVET were determined. All normal subjects had "dome-like" flow velocity patterns with a peak flow at the midsystole. In patients with CPD, there was a significant correlation between log10MPAP (mean pulmonary arterial pressure) and AT/RVET, the coefficient being r = -0.623, between PVR (pulmonary vascular resistance) and AT/RVET (r = -0.52), and between SVI (stroke volume index) and PEP (r = -0.645). Complications of pulmonary hypertension in CPD were relatively mild, but the pulsed Doppler technique was found useful for evaluating pulmonary arterial pressure and other right heart hemodynamics of CPD patients. PMID:8437344

Yamasa, T; Imamura, T; Nakashima, T; Kurobe, K

1993-01-01

253

Pulmonary Atresia with Intact Ventricular Septum and Major Aortopulmonary Collaterals: Association with Deletion 22q11.2  

Microsoft Academic Search

We describe the first association of pulmonary atresia, intact ventricular septum, and absent central pulmonary arteries with deletion 22q11.2. The pulmonary blood flow was derived from major aortopulmonary collaterals. The role of the deletion in pulmonary arborization is discussed.

C. Li; A. E. Chudley; R. Soni; A. Divekar

2003-01-01

254

Risk of pulmonary tuberculosis in children with congenital heart disease.  

PubMed

Children with low-flow congenital heart lesions are reported to have an increased incidence of pulmonary tuberculosis. The aim of this study was to investigate if children with congenital heart disease have an increased incidence of pulmonary tuberculosis and to determine if patients with certain heart conditions are more susceptible to pulmonary tuberculosis than others. This retrospective study over a 6-year period showed that pulmonary tuberculosis was 2.5-fold more common in children with congenital heart disease than in normal children from the same community. Children with congenital pulmonary stenosis had a prevalence equal to those with acyanotic (ventricular and atrial septal defects) and cyanotic (transposition of the great arteries) high-flow heart lesions, whereas there were no cases of tuberculosis in children with low-flow cyanotic heart lesions such as tetralogy of Fallot. Cardiac surgery had to be postponed as a result of pulmonary tuberculosis in 7.2% of all patients in whom it was required. Over the 6-year period of the study, cardiac surgery had to be delayed in 60% of cases with pulmonary tuberculosis and congenital heart lesions so antituberculosis therapy could be completed. Physicians treating children with congenital heart lesions should maintain a high index of suspicion for the development of pulmonary tuberculosis, especially in those with acyanotic and cyanotic high-flow lesions and pulmonary stenosis. PMID:7567661

van der Merwe, P L; Kalis, N; Schaaf, H S; Nel, E H; Gie, R P

255

Impairment of Lymph Drainage in Subfascial Compartment of Forearm in Breast Cancer-Related Lymphedema  

PubMed Central

Background: In arm lymphedema secondary to axillary surgery and radiotherapy (breast cancer-related lymphedema), the swelling is largely epifascial and lymph flow per unit epifascial volume is impaired. The subfascial muscle compartment is not measurably swollen despite the iatrogenic damage to its axillary drainage pathway, but this could be due to its low compliance. Our aim was to test the hypothesis that subfascial lymph drainage too is impaired. Methods and Results: Quantitative lymphoscintigraphy was used to measure the removal rate constant (local lymph flow per unit distribution volume) for technetium-99m-human immunoglobulin G injected intramuscularly in the forearms of nine women with unilateral lymphedema. The removal rate constant was on average 31% lower in the ipsilateral swollen forearm than in the contralateral forearm (swollen arm: ?0.096 ± 0.041% min?1, contralateralarm: ?0.138 ± 0.037% min?1; mean ± SD, p = 0.037). The decrease in subfascial rate constant correlated strongly with increase in arm volume (r 0.88, p = 0.002), even though the swelling is mainly epifascial. There was no convincing evidence of dermal backflow. Conclusions: Lymph flow in the subfascial muscle compartment is decreased in breast cancer-related lymphedema. The correlation between impairment of subfascial drainage and epifascial arm swelling could be because both depend on the severity of axillary damage, or because loss of function in subfascial lymphatics impairs drainage from the epifascial to the subfascial system.

MELLOR, R.H.; COOK, G.J.; SVENSSON, W.E.; PETERS, A.M.; LEVICK, J.R.; MORTIMER, P.S.

2005-01-01

256

Predicting residual lymph node basin disease in melanoma patients with sentinel lymph node metastases  

Microsoft Academic Search

BackgroundThe incidence of residual occult disease in nonsentinel lymph nodes (NSLN) after a positive sentinel lymph node (SLN) biopsy in patients with melanoma is relatively low. The purpose of this study is to identify factors that may be predictive of occult NSLN metastases after positive SLN biopsy.

George I Salti; Tapas K Das Gupta

2003-01-01

257

Exogenous normal lymph alleviates microcirculation disturbances and abnormal hemorheological properties in rats with disseminated intravascular coagulation.  

PubMed

Disturbances of the microcirculation and abnormal hemorheological properties are important factors that play an important role in disseminated intravascular coagulation (DIC) and result in organ dysfunction or failure. In the present study, we established an animal model of DIC using intravenous Dextran 500 in rats, and used exogenous normal lymph corresponding to 1/15 of whole blood volume for injection through the left jugular vein. We found that normal lymph could improve the blood pressure and survival time of rats with DIC. The results regarding the mesenteric microcirculation showed that the abnormality of the diameter of mesenteric microvessels and micro-blood flow speed in the DIC+lymph group was significantly less than in the DIC+saline group. Whole blood viscosity, relative viscosity, plasma viscosity, hematocrit (Hct), erythrocyte sedimentation rate (ESR), and electrophoresis time of erythrocytes were significantly increased in the DIC+saline group compared to the control group. The electrophoretic length and migration of erythrocytes from the DIC+saline and DIC+lymph groups were significantly slower than the control group. Blood relative viscosity, Hct, ESR, and electrophoretic time of erythrocytes were significantly increased in the DIC+lymph group compared to the control group. Whole blood viscosity, relative viscosity and reduced viscosity were significantly lower in the DIC+lymph group than in the DIC+saline group, and erythrocyte deformability index was also significantly higher than in the DIC+saline and control groups. These results suggest that exogenous normal lymph could markedly improve the acute microcirculation disturbance and the abnormal hemorheological properties in rats with DIC induced by Dextran 500. PMID:23369973

Niu, Chun-Yu; Zhao, Zi-Gang; Zhang, Yu-Ping; Hou, Ya-Li; Li, Jun-Jie; Jiang, Hua; Zhang, Jing

2013-02-01

258

Neutrophil elastase activity in pulmonary venous blood during lung resection  

PubMed Central

OBJECTIVES Neutrophil elastase has been reported to play an important role in acute lung injury, which is a major cause of postoperative mortality after pulmonary resection. Neutrophil elastase released in the lungs reaches the peripheral circulation via the pulmonary veins. This study was performed to compare neutrophil elastase activity in pulmonary venous blood (collected during lobectomy) with that in the peripheral blood, and to determine the perioperative changes of neutrophil elastase activity. METHODS In 34 patients undergoing lobectomy with mediastinal lymph node dissection, the leucocyte count, neutrophil count, neutrophil elastase activity and levels of tumour necrosis factor-?, interleukin-6 and interleukin-8 were measured in the pulmonary venous blood and peripheral arterial blood before and after surgery. Then, these parameters were compared between before and after surgery with peripheral and pulmonary blood. RESULTS Neutrophil elastase activity was found to be significantly higher in pulmonary venous blood at the completion of surgery than at the start (during thoracotomy), while the neutrophil elastase activity of peripheral arterial blood showed no significant change between the start and completion of surgery. CONCLUSIONS In conclusion, measurement of neutrophil elastase activity in pulmonary venous blood revealed changes associated with lobectomy.

Nagamatsu, Yoshinori; Iwasaki, Yasunori; Omura, Harutaka; Hayashida, Ryozo; Kashihara, Masaki; Nishi, Tatsuya; Yoshiyama, Koichi; Shirouzu, Kazuo

2012-01-01

259

Pulmonary tumor thrombotic microangiopathy: the challenge of the antemortem diagnosis.  

PubMed

Pulmonary tumor thrombotic microangiopathy (PTTM) is known as a rare and severe cancer-related pulmonary complication. Nowadays, fewer than 80 cases have been reported in the literature and very few cases have been diagnosed antemortem. We describe an autopsy case of PTTM associated with cancer of unknown origin. A 56-year-old male patient came to our attention due to a 2-day history of dyspnea. Analysis of the clinical context in combination with laboratory and imaging tests led us to suspect acute pulmonary thromboembolism. However, the computed tomography pulmonary angiogram was negative for thromboembolism; on the contrary it revealed multiple lymphadenopathy. Microscopic pulmonary tumor embolism was suspected and a lymph node biopsy was planned. However, the patient's condition progressively worsened; death occurred 3 days after admission. After autopsy, histologically extensive neoplastic emboli involved the small pulmonary arteries and arterioles, often admixed with fibrin thrombi. The involved and noninvolved arteries also demonstrated fibrocellular intimal proliferation causing marked luminal stenosis and occlusion. These pathological features were characteristic of PTTM, which should be distinguished from microscopic tumor embolism and should be considered in the differential diagnosis of acute/subacute cor pulmonale and pulmonary hypertension in cancer as well as in noncancer patients. We propose a review of the literature and an algorithm to improve PTTM antemortem diagnosis. PMID:22710763

Patrignani, Anna; Purcaro, Augusto; Calcagnoli, Francesca; Mandolesi, Alessandra; Bearzi, Italo; Ciampani, Nino

2013-02-22

260

The cellular composition of lymph nodes in the earliest phase of inflammatory arthritis  

PubMed Central

Objectives Rheumatoid arthritis (RA) is an immune-mediated inflammatory disease of unknown aetiology. Recent work has shown that systemic autoimmunity precedes synovial inflammation, and animal models have suggested that changes in the lymph nodes may precede those in the synovial tissue. Therefore, we investigated the cellular composition of the lymph node in the earliest phases of inflammatory arthritis. Methods Thirteen individuals positive for immunoglobulin M (IgM) rheumatoid factor and/or anticitrullinated protein antibodies without arthritis were included. Additionally, we studied 14 early arthritis patients (arthritis duration ?6?months, naďve for disease-modifying antirheumatic drugs), and eight healthy controls. All subjects underwent ultrasound-guided inguinal lymph node biopsy. Different T- and B-lymphocyte subsets were analysed by multicolour flow cytometry. Results There was an increase in activated CD69 CD8 T cells and CD19 B cells in early arthritis patients compared with healthy controls. We also observed a trend towards increased CD19 B cells in autoantibody-positive individuals without arthritis compared with healthy controls. Conclusions This exploratory study suggests that there is increased immune cell activation within lymph nodes of early arthritis patients as well as in autoantibody-positive individuals at risk of developing RA. This method provides a unique tool to investigate immunological changes in the lymph node compartment in the earliest phases of inflammatory arthritis.

van Baarsen, L G M; de Hair, M J H; Ramwadhdoebe, T H; Zijlstra, IJ A J; Maas, M; Gerlag, D M; Tak, P P

2013-01-01

261

The Role of Heparanase in Lymph Node Metastatic Dissemination: Dynamic Contrast-Enhanced MRI of Eb Lymphoma in Mice1  

PubMed Central

Abstract Heparanase expression has been linked to increased tumor invasion, metastasis, and angiogenesis and with poor prognosis. The aim of the study was to monitor the effect of heparanase expression on lymph node metastasis, in heparanase-overexpressing subcutaneous Eb mouse T-lymphoma tumors, and their draining lymph node. Dynamic contrast-enhanced magnetic resonance imaging (MRI) using biotin-BSA-GdDTPA-FAM/ROX was applied for analysis of blood volume, vascular permeability, and interstitial convection, and for detection of very early stages of such metastatic dissemination. Eb tumors increased extravasation, interstitial convection, and lymphatic drain of the contrast material. Interstitial flow directions were mapped by showing radial outflow interrupted in some tumors by directional flow toward the popliteal lymph node. Heparanase expression significantly increased contrast enhancement of the popliteal lymph node but not of the primary tumor. Changes in MR contrast enhancement preceded the formation of pathologically detectable metastases, and were detectable when only a few enhanced green fluorescent protein (EGFP)-expressing Eb cells were found near and within the nodes. These results demonstrate very early, heparanase-dependent vascular changes in lymph nodes that were visible by MRI following administration of biotin-BSA-GdDTPA-FAM/ROX, and can be used for studying the initial stages of lymph node infiltration.

Dafni, Hagit; Cohen, Batya; Ziv, Keren; Israely, Tomer; Goldshmidt, Orit; Nevo, Nava; Harmelin, Alon; Vlodavsky, Israel; Neeman, Michal

2005-01-01

262

Heterogeneity of Dendritic Cells in Human Superficial Lymph Node  

PubMed Central

A two-color immunofluorescent analysis indicated that dendritic cells (DCs) in the human axillar lymph nodes (ie, lymph nodal DCs (LnDCs)) can be classified into three subsets. The first subset consists of CD1a+/CD86? or dim/CD83? or dim nondendriform DCs found mainly in lymph sinuses, the second is of CD1a?/CD86+/CD83+ dendriform DCs scattered in normal T zones, and the third is of large CD1abright/CD86+/CD83+ dendriform DCs occasionally found in hyperplastic T zones. A three-color flow cytometric analysis, immunoperoxidase staining, and electron microscopic observation indicated that the majority of LnDCs corresponded to the first subset, which showed distinctive characteristics of DCs but did not fulfill the ultrastructural criteria for interdigitating reticulum cells (IDCs) and did not contain Birbeck granules. When LnDCs were cultured for 7 days, they became large CD1adim/CD86+/CD83+ dendriform cells, which formed large complexes with many T cells and exhibited distinctive ultrastructural features of interdigitating reticulum cells. LnDCs cultured in the presence of granulocyte/macrophage colony-stimulating factor became markedly larger CD1abright/CD86+/CD83+ dendriform cells forming large complexes with numerous T cells. These findings suggest that cells of the first subset represent immature LnDCs just migrating from epidermis, those of the second subset represent interdigitating reticulum cells, and those of the third subset represent interdigitating reticulum cells probably stimulated with certain immunostimulatory cytokines such as granulocyte/macrophage colony-stimulating factor. It is also suggested that either the second or the third subsets of LnDCs are derived from the first subset.

Takahashi, Kiyoshi; Asagoe, Kenji; Zaishun, Jin; Yanai, Hiroyuki; Yoshino, Tadashi; Hayashi, Kazuhiko; Akagi, Tadaatsu

1998-01-01

263

Differentiating Blood, Lymph, and Primo Vessels by Residual Time Characteristic of Fluorescent Nanoparticles in a Tumor Model  

PubMed Central

Fluorescent nanoparticles (FNPs) which were injected into a tumor tissue flowed out through the blood and lymph vessels. The FNPs in blood vessels remained only in the order for few minutes while those in lymph vessels remained for a long time disappearing completely in 25 hours. We found a primo vessel inside a lymph vessel near a blood vessel, and FNPs remained in the primo vessel for longer than 25 hours. In addition, we examined in detail the residual time characteristics of lymph vessels because it could be useful in a future study of fluid dynamical comparison of the three conduits. These residual time characteristics of FNPs in the three kinds of vessels may have implications for the dynamics of nanoparticle drugs for cancer chemotherapy.

Lee, Sungwoo; Lim, Jaekwan; Cha, Jinmyung; Lee, Jin-Kyu; Ryu, Yeon Hee; Kim, SungChul; Soh, Kwang-Sup

2013-01-01

264

Detection of parasternal metastatic lymph nodes by sentinel lymph node methods in a patient with recurrence in the conserved breast.  

PubMed

We herein report a case of second sentinel lymph node biopsy (SLNB). A 57-year-old woman underwent breast-conserving surgery including axillary clearance at Aichi Cancer Center on October 20, 2003. Recurrent tumor in the conserved breast was diagnosed in March 2006. She received SLNB using radioactive tracer. Preoperative lymphoscintigraphy detected 2 parasternal lymph nodes as hot spots. No abnormal lymph nodes were revealed on preoperative computed tomography. Salvage mastectomy was performed along with dissection of the Rotter and infraclavicular lymph nodes and biopsy of the detected parasternal lymph nodes. Micrometastases were discovered in both parasternal lymph nodes detected as sentinel lymph nodes. No more metastases were seen in the other lymph nodes. Reoperative SLNB offers the possibility of detecting metastasis in residual lymph nodes and determining whether chemotherapy should be used. PMID:21213080

Yamashita, Toshinari; Fujita, Takashi; Hayashi, Hironori; Ando, Yoshiaki; Hato, Yukari; Horio, Akiyo; Toyoshima, Chieko; Yamada, Mai; Iwata, Hiroji

2011-01-01

265

NO2 inhalation induces maturation of pulmonary CD11c+ cells that promote antigenspecific CD4+ T cell polarization  

PubMed Central

Background Nitrogen dioxide (NO2) is an air pollutant associated with poor respiratory health, asthma exacerbation, and an increased likelihood of inhalational allergies. NO2 is also produced endogenously in the lung during acute inflammatory responses. NO2 can function as an adjuvant, allowing for allergic sensitization to an innocuous inhaled antigen and the generation of an antigen-specific Th2 immune response manifesting in an allergic asthma phenotype. As CD11c+ antigen presenting cells are considered critical for naďve T cell activation, we investigated the role of CD11c+ cells in NO2-promoted allergic sensitization. Methods We systemically depleted CD11c+ cells from transgenic mice expressing a simian diphtheria toxin (DT) receptor under of control of the CD11c promoter by administration of DT. Mice were then exposed to 15 ppm NO2 followed by aerosolized ovalbumin to promote allergic sensitization to ovalbumin and were studied after subsequent inhaled ovalbumin challenges for manifestation of allergic airway disease. In addition, pulmonary CD11c+ cells from wildtype mice were studied after exposure to NO2 and ovalbumin for cellular phenotype by flow cytometry and in vitro cytokine production. Results Transient depletion of CD11c+ cells during sensitization attenuated airway eosinophilia during allergen challenge and reduced Th2 and Th17 cytokine production. Lung CD11c+ cells from wildtype mice exhibited a significant increase in MHCII, CD40, and OX40L expression 2 hours following NO2 exposure. By 48 hours, CD11c+MHCII+ DCs within the mediastinal lymph node (MLN) expressed maturation markers, including CD80, CD86, and OX40L. CD11c+CD11b- and CD11c+CD11b+ pulmonary cells exposed to NO2 in vivo increased uptake of antigen 2 hours post exposure, with increased ova-Alexa 647+ CD11c+MHCII+ DCs present in MLN from NO2-exposed mice by 48 hours. Co-cultures of ova-specific CD4+ T cells from naďve mice and CD11c+ pulmonary cells from NO2-exposed mice produced IL-1, IL-12p70, and IL-6 in vitro and augmented antigen-induced IL-5 production. Conclusions CD11c+ cells are critical for NO2-promoted allergic sensitization. NO2 exposure causes pulmonary CD11c+ cells to acquire a phenotype capable of increased antigen uptake, migration to the draining lymph node, expression of MHCII and co-stimulatory molecules required to activate naďve T cells, and secretion of polarizing cytokines to shape a Th2/Th17 response.

2010-01-01

266

STUDIES ON PULMONARY EDEMA  

PubMed Central

1. Guinea pigs die shortly after bilateral cervical vagotomy, even when continuous artificial respiration effected through a tracheal cannula is carried out. Death is caused by severe pulmonary edema and congestion. 2. Direct observation of the lungs after bilateral vagotomy demonstrates that pulmonary edema develops gradually and increases slowly in amount and severity. Congestion precedes and accompanies the development of the edema. 3. Neuropathic pulmonary edema in the guinea pig is caused by disturbance to or abolition of the pulmonary vasomotor nerves. 4. The evidence obtained by experiments on animals suggests that neuropathic pulmonary edema in man is caused by disturbances, either central or peripheral, to the vasomotor control of the pulmonary vessels.

Farber, Sidney

1937-01-01

267

JAMA Patient Page: Pulmonary Hypertension  

MedlinePLUS

... the American Medical Association JAMA PATIENT PAGE Pulmonary Hypertension T he pulmonary artery is the main vessel ... mercury (mm Hg). In an individual with pulmonary hypertension , the average pressure in the pulmonary artery can ...

268

How to measure pulmonary vascular and right ventricular function  

Microsoft Academic Search

Long-standing pulmonary hypertension causes significant peripheral and proximal arterial remodeling and right ventricular dysfunction. The clinical metric most often used to assess the progression of PH is the pulmonary vascular resistance (PVR). However, even when measured from multipoint pressure-flow curves, PVR provides information only on the peripheral arterial function, not the proximal arterial function and gives only an incomplete description

Naomi C. Chesler; Alejandro Roldan; Rebecca R. Vanderpool; Robert Naeije

2009-01-01

269

Unilateral Pulmonary Hilar Tumor Mass: Is It Always Lung Cancer?  

PubMed Central

ABSTRACT Sarcoidosis is a multisystem inflammatory disease of unknown etiology, characterized by noncaseating epithelioid cell granulomas. In sarcoidosis, the most common radiological findings are mediastinal and bilateral hilar lymph node enlargement. We present a case of sarcoidosis with a rare radiological aspect of pulmonary hilar tumor mass. A 54-year-old female patient, active smoker (40 packs/year), with a history of cutaneous lupus, was admitted in our institute for progressive dyspnea and dry cough. At admission physical examination and laboratory tests were normal. Pulmonary function tests diagnosed an obstructive syndrome. Chest X-ray showed a tumor mass of the right pulmonary hilum. Transbronchial biopsy was nondiagnostic. HRCT-scan showed a tumor mass in the right hilum, which raised the suspicion of a lung cancer. PET-CT scan revealed a high metabolic activity of the tumor mass and of a paratracheal right lymphadenopathy. Lymph node biopsy by mediastinoscopy showed noncaseating epithelioid-cell granulomas, sustaining the diagnosis of sarcoidosis. The outcome was favorable, with spontaneous remission without treatment, but with a relapse that responded after systemic corticotherapy. In conclusion, even if a tumor mass in the pulmonary hilum is highly suggestive of lung cancer, a positive diagnosis should be made only after histological examination, because other benign conditions, like sarcoidosis, could have such an aspect.

TOMA, Claudia Lucia; DUMITRACHE-RUJINSKI, Stefan; BELACONI, Ionela Nicoleta; PARASCHIV, Bianca; ALEXE, Mihai; SERBESCU, Aneta; LEONTE, Diana; BOGDAN, Miron Alexandru

2013-01-01

270

Pulmonary disposition of pethidine in postoperative patients.  

PubMed Central

1. Two methods of pethidine administration, namely constant-rate infusion and single i.v. injection, were used to assess the pulmonary disposition of the drug in 10 postoperative patients. Using two sites of blood sampling, the pulmonary extraction ratio was determined. 2. Pronounced pulmonary uptake of pethidine was found in all patients (n = 10). On the other hand, there was no significant evidence of pulmonary clearance. 3. The mean total plasma clearance was 810 ml min-1 and the volume of distribution was 3.11 kg-1. 4. A flow model was used to describe the disposition of pethidine in man. The concentration-time profiles calculated by the model were in accordance with observed data. The data showed that both pulmonary uptake and pulmonary release of pethidine were rapid. 5. Constant-rate infusion was found advantageous in the determination of pulmonary extraction, with respect to the accuracy and precision of the results. The extraction obtained after a single injection may be overestimated on account of uptake of the drug by the lungs.

Persson, M P; Hartvig, P; Wiklund, L; Paalzow, L

1988-01-01

271

Lymph Node Metastases and Prognosis in Penile Cancer  

PubMed Central

Lymph node status is a key prognostic factor in penile squamous cell carcinoma. Recently, growing evidence indicates a multimodality approach consisting of neoadjuvant chemotherapy followed by consolidation surgery improves the outcome of locally advanced penile cancer. Thus, accurate estimation of survival probability in node-positive penile cancer is critical for treatment decision making, counseling of patients and follow-up scheduling. This article reviewed evolving developments in assessing the risk for cancer progression based on lymph node related variables, such as the number of metastatic lymph nodes, bilateral lymph node metastases, the ratio of positive lymph nodes, extracapsular extension of metastatic lymph nodes, pelvic lymph node metastases, metastatic deposit in sentinel lymph nodes and N stage in TNM classification. Controversial issues surrounding the prognostic value of these nodal related predictors were also discussed.

Zhu, Yao; Ye, Ding-wei

2012-01-01

272

LYMPH NODES AS A SOURCE OF NEUTRALIZING PRINCIPLE FOR VACCINIA  

PubMed Central

An antiviral principle is elaborated within the regional lymph nodes draining skin into which vaccinia is injected. The immunity conferred by clinical Jennerian vaccination may be largely of lymph node origin.

McMaster, Philip D.; Kidd, John G.

1937-01-01

273

[Evaluation of the hemodynamic reaction to thromboembolism of the pulmonary artery].  

PubMed

Characteristic hemodynamic manifestations of pulmonary artery thromboembolism include a decrease in both the volume and the time of pulmonary blood flow. The reaction of the cardiac output in response to pulmonary artery thromboembolism may assume the form of three types of circulation attended by volumetric alterations. PMID:6656087

Kostenko, I G; Antonova, N Iu; Buianova, N N; Kirienko, A I

1983-11-01

274

Reappraisal of Quantitative Evaluation of Pulmonary Regurgitation and Estimation of Pulmonary Artery Pressure by Continuous Wave Doppler Echocardiography  

Microsoft Academic Search

This study assessed the usefulness of continuous wave Doppler echocardiography and color flow mapping in evaluating pulmonary regurgitation (PR) and estimating pulmonary artery (PA) pressure. Forty-three patients were examined, and high quality Doppler spectral recordings of PR were obtained in 32. All patients underwent cardiac catheterization, and simultaneous PA and right ventricular (RV) pressures were recorded in 17. Four Doppler

Meng-Huan Lei; Jin-Jer Chen; Yu-Lin Ko; Jun-Jack Cheng; Peiliang Kuan; Wen-Pin Lien

1995-01-01

275

Pulmonary and thoracic macrophage subpopulations and clearance of particles from the lung.  

PubMed Central

Pulmonary macrophages consist of several subpopulations that can be defined by their anatomical locations as well as by other criteria. In addition to the well-known alveolar macrophages that reside on the alveolar surface, pulmonary macrophages also occur in the conducting airways, in various pulmonary interstitial regions, and, in some mammalian species, in the lung's intravascular compartment. Other thoracic macrophages of relevance to pulmonary defense and some lung disease processes are the pleural macrophages resident in the pleural space and macrophages present in regional lymph nodes that receive lymphatic drainage from the lung. Of the above subpopulations of pulmonary and thoracic macrophages, the alveolar macrophages have received the most experimental attention in the context of the pulmonary clearance and retention of deposited particles. Accordingly, less information is currently available regarding the roles other pulmonary and thoracic populations of macrophages may play in the removal of particles from the lower respiratory tract and associated tissue compartments. This report provides an overview of the various subpopulations of pulmonary and thoracic macrophages, as defined by their anatomical locations. The known and postulated roles of macrophages in the pulmonary clearance and retention of particles are reviewed, with particular emphasis on macrophage-associated processes involved in the pulmonary clearance of relatively insoluble particles. Images FIGURE 1. FIGURE 2. FIGURE 3. FIGURE 5. FIGURE 8. FIGURE 12. FIGURE 14. FIGURE 15. FIGURE 16. FIGURE 17. FIGURE 18. FIGURE 19. A FIGURE 19. B FIGURE 21. FIGURE 22.

Lehnert, B E

1992-01-01

276

Ultrastaging of lymph node in uterine cancers  

Microsoft Academic Search

BACKGROUND: Lymph node status is an important prognostic factor and a criterion for adjuvant therapy in uterine cancers. While detection of micrometastases by ultrastaging techniques is correlated to prognosis in several other cancers, this remains a matter of debate for uterine cancers. The objective of this review on sentinel nodes (SN) in uterine cancers was to determine the contribution of

Corinne Bézu; Charles Coutant; Marcos Ballester; Jean-Guillaume Feron; Roman Rouzier; Serge Uzan; Emile Daraď

2010-01-01

277

Intraoperative Imaging of Sentinel Lymph Nodes.  

National Technical Information Service (NTIS)

The main objective of this investigation is to determine the feasibility and value of the intraperative use of a small field of view (FOV) camera gamma camera for sentinel lymph node (SLN) localization in breast cancer patients. Two cameras, on with a 1' ...

C. M. Greene N. E. Hertel

2003-01-01

278

Intraoperative Imaging for Sentinel Lymph Nodes.  

National Technical Information Service (NTIS)

The main objective of this investigation is to determine the feasibility and value of the use of a small field of view camera gamma camera intraoperatively for sentinel lymph node (SLN) localization in breast cancer patients. A camera with a 5 in. x 5 in....

C. M. Greene J. N. Aarsvold N. Hertel

2004-01-01

279

Reversibility of the Pulmonary Function Based on the Partial Flow-volume Curve Predicts the Efficacy of Bronchodilator Therapy for Treating Chronic Cough.  

PubMed

Objective Partial expiratory flow-volume curves have the potential to detect mild bronchoconstriction because they are not affected by the modulatory effects of deep inspiration. The aim of this study was to investigate the relationship between the efficacy of bronchodilator therapy (BDT) in treating the cough and to assess the increase in the expiratory flow of the partial flow-volume curve at 40% above the residual volume level (PEF40) caused by treatment with a short-acting beta-2 agonist (SABA) in patients with chronic nonproductive cough. Methods We measured the reversibility of PEF40 caused by a SABA in 42 patients with chronic nonproductive cough at visit 1 (day 0). The patients received BDT for six days. The visual analogue scale (VAS) was used to assess the efficacy of BDT in treating coughing at visit 2 (day 7) (0 mm, 'no cough;' 100 mm, 'no change in coughing'). Results Reversibility of the PEF40 was correlated (r=0.690, p<0.001) with the VAS score determined at visit 2 and was higher in the patients with cough variant asthma (CVA) (44.9±18.3%) than in those with atopic cough (13.4±10.4%) (p<0.01). Conclusion Reversibility of the PEF40 predicted the efficacy of BDT in patients with chronic nonproductive cough and helped to identify patients with CVA. PMID:24042507

Nakade, Yusuke; Fujimura, Masaki; Ohkura, Noriyuki; Nakata, Masako; Nanbu, Yuko; Oe, Hiroyasu; Horita, Hiroshi; Sakai, Yoshio; Wada, Takashi

2013-01-01

280

Sentinel Lymph Node Biopsy for Breast Cancer: Our Technique and Future Directions in Lymph Node Staging  

PubMed Central

Breast cancer remains a major cause of cancer death for women in the United States. Accurate cancer staging, especially of the axillary lymph nodes, is essential for predicting the prognosis of patients and for determining the appropriate multimodality treatment strategy. Historically, the traditional approach for staging the lymphatic metastasis in breast cancer has been Axillary lymph node dissection (ALND). However, as the understanding of the lymphatic drainage of the breast has improved, the Sentinel lymph node (SLN) biopsy has replaced ALND as the gold standard for lymph node staging in breast cancer. Multiple studies have demonstrated the benefits of SLN biopsy compared to ALND in terms of morbidity, while maintaining the clinical ability to appropriately stage patients, but without any loss in therapeutic impact. In this review, we discuss the historical development of SLN biopsy, describe our technique in detail, and discuss the possible future directions of the lymphatic staging of breast cancer.

Rashid, Omar M.; Takabe, Kazuaki

2012-01-01

281

HIV and Pulmonary Hypertension  

MedlinePLUS

... lead to PH. A direct cause and effect relation between HIV infection and pulmonary hypertension has not ... in bringing pulmonary hypertension into the national and international consciousness. PHA is constantly increasing its services to ...

282

Pulmonary alveolar proteinosis  

MedlinePLUS

Alveolar proteinosis; Pulmonary alveolar phospholipoproteinosis ... In some cases, the cause of pulmonary alveolar proteinosis is unknown. In others, it occurs with lung infection or an immune problem. It also can occur with cancers of ...

283

Coalition for Pulmonary Fibrosis  

MedlinePLUS

... Education Resources Accomplishments About Us Coalition for Pulmonary Fibrosis 10866 W. Washington Blvd #343 • Culver City, CA ... their respective owners. ©2001 – 2011 Coalition for Pulmonary Fibrosis Site Last Updated: October 25, 2013

284

Hantavirus Pulmonary Syndrome  

MedlinePLUS

... Diseases Division of High-Consequence Pathogens and Pathology Hantavirus Pulmonary Syndrome Hantavirus Pulmonary Syndrome (HPS) is a rare but severe, ... respiratory disease in humans caused by infection with hantavirus. What are the symptoms of HPS? Early Symptoms: • ...

285

Living with Pulmonary Embolism  

MedlinePLUS

... on Twitter. Living With Pulmonary Embolism Pulmonary embolism (PE) usually is treated in a hospital. After leaving ... you're taking medicine. Medicines used to treat PE can thin your blood too much. This can ...

286

Predictors of nonsentinel lymph node metastasis in breast cancer patients  

Microsoft Academic Search

Background: In order to define a future subset of breast cancer patients in whom the axilla may be staged by sentinel lymph node biopsy alone, the conditions under which nonsentinel axillary lymph node metastases occur must be delineated.Methods: A prospective database including 212 breast cancer patients who underwent sentinel lymph node biopsy followed by completion axillary dissection at our institution

Ulka Sachdev; Kara Murphy; Alain Derzie; Shabnam Jaffer; Ira J Bleiweiss; Steven Brower

2002-01-01

287

HIGH CONCENTRATION OF INJECTED TITANIUM DIOXIDE IN ABDOMINAL LYMPH NODES  

PubMed Central

In the rat the greatest accumulation, in any anatomical structure, of titanium dioxide following its intravenous injection was found in two small clusters of lymph nodes in upper abdomen behind the peritoneum. These are the lymph nodes of the liver. This extraordinary quantitative characteristic of the abdominal clusters is attributed to their topography which results in progressive filtration of particulate matter from hepatic lymph.

Huggins, Charles B.; Froehlich, Jeffrey P.

1966-01-01

288

Lymphotrophic nanoparticle enhanced MR imaging (LNMRI) for lymph node imaging  

Microsoft Academic Search

The accurate staging of lymph nodes in various primary tumors continues to pose a major diagnostic challenge. Following the detection of lymph nodes, the next arduous task is the characterization of nodes into benign and malignant categories. Cross-sectional modalities like CT and MRI rely on nodal size as the primary yardstick for differentiating benign from malignant lymph nodes. Other parameters

Anuradha Saokar; Marta Braschi; Mukesh G. Harisinghani

289

Salmonella prevalence in bovine lymph nodes differs among feedyards  

Technology Transfer Automated Retrieval System (TEKTRAN)

Lymphatic tissue, specifically lymph nodes, is commonly incorporated into ground beef products as a component of lean trimmings. Salmonella and other pathogenic bacteria have been identified in bovine lymph nodes. Although Salmonella prevalence has been examined among lymph nodes within an animal,...

290

How a Clot Can Become a Pulmonary Embolism  

MedlinePLUS Videos and Cool Tools

... in a vein may detach from its point of origin and travel through the heart to the lungs where it becomes wedged, preventing adequate blood flow. This is called a pulmonary (lung) embolism and can be extremely dangerous.

291

[Pulmonary manifestations of malaria].  

PubMed

We report on the two different types of pulmonary manifestations in acute plasmodium falciparum malaria. The more severe variant shows long standing interstitial pulmonary infiltrates, whereas in the more benign courses only short-term pulmonary edemas are visible. PMID:3035632

Rauber, K; Enkerlin, H L; Riemann, H; Schoeppe, W

1987-05-01

292

Evaluation of pulmonary embolism  

SciTech Connect

Pulmonary embolism is a common disease entity that is difficult to diagnose accurately by noninvasive methods. Ventilation-perfusion is a pivotal study in the evaluation of patients with suspected pulmonary embolism. The role of standard and newer modalities in evaluating pulmonary embolism is discussed in this article. 65 references.

Blinder, R.A.; Coleman, R.E.

1985-09-01

293

Pulmonary physiology in pregnancy.  

PubMed

This section reviews anatomic and functional changes of the respiratory system during pregnancy. Pulmonary function during exercise in pregnancy and in the obese gravida, sleep-disordered breathing during pregnancy, and pulmonary changes in the pregnant woman living at altitude are discussed in detail. Assessment of pulmonary function and interpretation of the arterial blood gas during pregnancy are also discussed. PMID:20436304

Bobrowski, Renee A

2010-06-01

294

Pulmonary hemodynamics modify the rat pulmonary artery response to injury. A neointimal model of pulmonary hypertension.  

PubMed

Hemodynamic factors have profound influences on blood vessels. To test the hypothesis that hemodynamic conditions modify the pattern of remodeling in response to injury, monocrotaline (MCT) injury in Sprague-Dawley rats was followed 1 week later by left pneumonectomy to increase blood flow to the right lung. Right pulmonary artery remodeling in these MCT plus pneumonectomy animals was compared with animals receiving MCT or pneumonectomy alone. Neointimal changes developed in more than 90% of all right lung intra-acinar vessels 5 weeks after MCT injury (4 weeks after pneumonectomy). Neointimal lesions did not develop in untreated animals or in animals receiving MCT or pneumonectomy only. Animals with a neointimal pattern of remodeling developed severe right ventricular hypertrophy (RVH) whereas animals with a medial hypertrophy pattern of remodeling (MCT only) developed moderate RVH compared with control animals. Neointimal lesions and RVH were similar whether injury preceded pneumonectomy or vice versa. To exclude the possibility that neointimal lesions resulted from injury plus post-pneumonectomy compensatory lung growth, rather than injury plus increased flow, a left subclavian-pulmonary artery anastomosis was substituted for pneumonectomy. Neointimal lesions and severe RVH developed in these animals but were not seen in animals receiving either MCT or anastomosis only. These studies demonstrate an important role for hemodynamics in determining the pattern of pulmonary vascular remodeling after injury. PMID:9327735

Okada, K; Tanaka, Y; Bernstein, M; Zhang, W; Patterson, G A; Botney, M D

1997-10-01

295

Pulmonary hemodynamics modify the rat pulmonary artery response to injury. A neointimal model of pulmonary hypertension.  

PubMed Central

Hemodynamic factors have profound influences on blood vessels. To test the hypothesis that hemodynamic conditions modify the pattern of remodeling in response to injury, monocrotaline (MCT) injury in Sprague-Dawley rats was followed 1 week later by left pneumonectomy to increase blood flow to the right lung. Right pulmonary artery remodeling in these MCT plus pneumonectomy animals was compared with animals receiving MCT or pneumonectomy alone. Neointimal changes developed in more than 90% of all right lung intra-acinar vessels 5 weeks after MCT injury (4 weeks after pneumonectomy). Neointimal lesions did not develop in untreated animals or in animals receiving MCT or pneumonectomy only. Animals with a neointimal pattern of remodeling developed severe right ventricular hypertrophy (RVH) whereas animals with a medial hypertrophy pattern of remodeling (MCT only) developed moderate RVH compared with control animals. Neointimal lesions and RVH were similar whether injury preceded pneumonectomy or vice versa. To exclude the possibility that neointimal lesions resulted from injury plus post-pneumonectomy compensatory lung growth, rather than injury plus increased flow, a left subclavian-pulmonary artery anastomosis was substituted for pneumonectomy. Neointimal lesions and severe RVH developed in these animals but were not seen in animals receiving either MCT or anastomosis only. These studies demonstrate an important role for hemodynamics in determining the pattern of pulmonary vascular remodeling after injury. Images Figure 1 Figure 4

Okada, K.; Tanaka, Y.; Bernstein, M.; Zhang, W.; Patterson, G. A.; Botney, M. D.

1997-01-01

296

Mechanism of lymph node metastasis in prostate cancer  

PubMed Central

Detection of lymph node metastases indicates poor prognosis for prostate cancer patients. Therefore, elucidation of the mechanism(s) of lymph node metastasis is important to understand the progression of prostate cancer and also to develop therapeutic interventions. In this article, the known mechanisms for lymph node metastasis are discussed and the involvement of lymphatic vessels in prostate cancer lymph node metastasis is comprehensively summarized. In addition, contradictory findings regarding the importance of lymphangiogenesis in facilitating lymph node metastasis in prostate cancer are pointed out and reconcilation is attempted.

Datta, Kaustubh; Muders, Michael; Zhang, Heyu; Tindall, Donald J

2010-01-01

297

Digital subtraction pulmonary angiography  

SciTech Connect

Digital subtraction pulmonary angiography was performed in 14 patients suspected of having pulmonary embolism. In 13 of 14, useful clinical information was obtained. Four patients were found to have pulmonary emboli. In nine patients, digital subtraction angiography was performed through pulmonary artery catheters already in place for monitoring critically ill patients. Conventional angiography in nine patients confirmed the findings by digital angiography. This initial experience suggests that digital subtraction pulmonary angiography provides adequate image quality in certain circumstances with several advantages over conventional angiography.

Goodman, P.C.; Brant-Zawadski, M.

1982-08-01

298

Specific Migratory Dendritic Cells Rapidly Transport Antigen from the Airways to the Thoracic Lymph Nodes  

Microsoft Academic Search

Antigen transport from the airway mucosa to the thoracic lymph nodes (TLNs) was studied in vivo by intratracheal instillation of fluorescein isothiocyanate (FITC)-conjugated macromole- cules. After instillation, FITC 1 cells with stellate morphology were found deep in the TLN T cell area. Using flow cytometry, an FITC signal was exclusively detected in CD11c med-hi \\/major histocompatibility complex class II (MHCII)

Karim Y. Vermaelen; Ines Carro-Muino; Bart N. Lambrecht; Romain A. Pauwels

299

Evaluation of lymph nodes with RECIST 1.1.  

PubMed

Lymph nodes are common sites of metastatic disease in many solid tumours. Unlike most metastases, lymph nodes are normal anatomic structures and as such, normal lymph nodes will have a measurable size. Additionally, the imaging literature recommends that lymph nodes be measured in the short axis, since the short axis measurement is a more reproducible measurement and predictive of malignancy. Therefore, the RECIST committee recommends that lymph nodes be measured in their short axis and proposes measurement values and rules for categorising lymph nodes as normal or pathologic; either target or non-target lesions. Data for the RECIST warehouse are presented to demonstrate the potential change in response assessment following these rules. These standardised lymph node guidelines are designed to be easy to implement, focus target lesion measurements on lesions that are likely to be metastatic and prevent false progressions due to minimal change in size. PMID:19091550

Schwartz, L H; Bogaerts, J; Ford, R; Shankar, L; Therasse, P; Gwyther, S; Eisenhauer, E A

2008-12-16

300

Hsp70 vaccination-induced primary immune responses in efferent lymph of the draining lymph node.  

PubMed

Bovine paratuberculosis is a highly prevalent chronic infection of the small intestine in cattle, caused by Mycobacterium avium subspecies paratuberculosis (MAP). In earlier studies we showed the protective effect of Hsp70/DDA subunit vaccination against paratuberculosis. In the current study we set out to measure primary immune responses generated at the site of Hsp70 vaccination. Lymph vessel cannulation was performed to obtain efferent lymph from the prescapular lymph node draining the neck area where the vaccine was applied. Hsp70 vaccination induced a significant increase of CD21(+) B cells in efferent lymph, accounting for up to 40% of efferent cells post-vaccination. Proliferation (Ki67(+)) within the CD21(+) B cell and CD4(+) T cell populations peaked between day 3 and day 5 post-vaccination. From day 7, Hsp70-specific antibody secreting cells (ASCs) could be detected in efferent lymph. Hsp70-specific antibodies, mainly of the IgG1 isotype, were also detected from this time point onwards. However, post-vaccination IFN-? production in efferent lymph was non-sustained. In conclusion, Hsp70-vaccination induces only limited Th1 type immune responsiveness as reflected in efferent lymph draining the vaccination site. This is in line with our previous observations in peripheral blood. The main primary immunological outcome of the Hsp70/DDA subunit vaccination is B cell activation and abundant Hsp70-specific IgG1 production. This warrants the question whether Hsp70-specific antibodies contribute to the observed protective effect of Hsp70 vaccination in calves. PMID:23973322

Vrieling, Manouk; Santema, Wiebren; Vordermeier, Martin; Rutten, Victor; Koets, Ad

2013-08-20

301

Pleomorphic malignant histiocytoma of pulmonary arteries presenting as pulmonary aneurysms.  

PubMed

Pulmonary aneurysms and primary neoplasms of the great vessels are very rare entities; pulmonary aneurysms are commonly associated with congenital heart diseases, and less frequently in atherosclerosis, medial cystic necrosis, trauma, infection, and inflammatory processes. Many patients have pulmonary hypertension, most frequently resulting from pulmonary artery sarcomas mimicking pulmonary thromboembolism. Symptoms are vague. In 30% of cases, rupture and death occur, related to pulmonary aneurysms. We present the case of a patient with a diagnosis of pulmonary artery pleomorphic malignant histiocytoma that presented as a right pulmonary aneurysm thrombosis and a contained rupture of a left pulmonary aneurysm. PMID:23438543

De La Cerda Belmont, Gustavo Armando; Lezama Urtecho, Carlos Alberto

2013-03-01

302

[Lymphosarcoma of abdominal lymph nodes in children].  

PubMed

We investigated 79 patients (76.0%) with lymphosarcoma of abdominal lymph nodes among all 104 with general abdominal lymphosarcoma. Ultrasound tomography was used in 98.1 % cases; also, in the urgent cases cancer transcutaneal puncture was performed with the purpose of cytological investigation. In complicated situations computer tomography was considered as a highly informative method of investigation. Surgical intervention and radial therapy is inexpedient in a treatment program of lymphosarcoma of abdominal lymph nodes in children. Besides, it is shown the superiority of intensive program of polychemical therapy OMDV: vincristine (oncovin) -- 1.5 mg/m(2) i/v in the 1 day; metotrexate -- 250 mg/m(2) i/v drop by drop in the I day; dexamethazone 10 mg/m(2) per os 1-5 day; vepesid -- 100 mg/m(2) i/v drop by drop in the 4 and 5 days.) in comparison with the ACOP scheme: adriamicine or rubomicine - 30 mg/m(2) i/v 1 time in week (N 4-6); cyclophosphane -- 600 mg/m(2) i/v 1 time in week (N 4-6); vincristine (oncovin) -- 1.4 mg/m(2) i/v 1 time in week (N 4-6); prednisolone -- 40 mg/m(2) every day 4-6 week quitting gradually) for treatment of lymphosarcoma of abdominal lymph nodes in childhood age. General recovery without recurrence in children with lymphosarcoma of abdominal lymph nodes was occurred in 44.2% cases. In the case of polychemical therapy according to ACOP scheme, recovery was 20% and in the case of polychemical therapy following OMDV scheme, 78.1% of the children recovered. PMID:16510909

Kvirikashvili, T O

2006-01-01

303

Axillary recurrence after sentinel lymph node biopsy  

Microsoft Academic Search

Sentinel lymph node biopsy (SLNB) without further axillary dissection in patients with sentinel node-negative breast carcinoma appears to be a safe procedure to ensure locoregional control. During a median follow-up of 35 months the false-negative rate was 1% in our study population of 185 patients.Background. The objective of this prospective study is to provide data on follow-up of patients with

B van der Vegt; M. H. E Doting; P. L Jager; J Wesseling; J de Vries

2004-01-01

304

Sentinel Lymph Node Biopsy in Colon Cancer  

PubMed Central

Introduction: The clinical impact of sentinel lymph node biopsy (SLNB) in colon cancer is still controversial. The purpose of this prospective multicenter trial was to evaluate its clinical value to predict the nodal status and identify factors that influence these results. Methods: Colon cancer patients without prior colorectal surgery or irradiation were eligible. The sentinel lymph node (SLN) was identified intraoperatively by subserosal blue dye injection around the tumor. The SLN underwent step sections and immunohistochemistry (IHC), if classified free of metastases after routine hematoxylin and eosin examination. Results: At least one SLN (median, n = 2) was identified in 268 of 315 enrolled patients (detection rate, 85%). Center experience, lymphovascular invasion, body mass index (BMI), and learning curve were positively associated with the detection rate. The false-negative rate to identify pN+ patients by SLNB was 46% (38 of 82). BMI showed a significant association to the false-negative rate (P < 0.0001), the number of tumor-involved lymph nodes was inversely associated. If only slim patients (BMI ?24) were investigated in experienced centers (>22 patients enrolled), the sensitivity increased to 88% (14 of 16). Moreover, 21% (30 of 141) of the patients, classified as pN0 by routine histopathology, revealed micrometastases or isolated tumor cells (MM/ITC) in the SLN. Conclusions: The contribution of SLNB to conventional nodal staging of colon cancer patients is still unspecified. Technical problems have to be resolved before a definite conclusion can be drawn in this regard. However, SLNB identifies about one fourth of stage II patients to reveal MM/ITC in lymph nodes. Further studies must clarify the clinical impact of these findings in terms of prognosis and the indication of adjuvant therapy.

Bembenek, Andreas E.; Rosenberg, Robert; Wagler, Elke; Gretschel, Stephan; Sendler, Andreas; Siewert, Joerg-Ruediger; Nahrig, Jorg; Witzigmann, Helmut; Hauss, Johann; Knorr, Christian; Dimmler, Arno; Grone, Jorn; Buhr, Heinz-Johannes; Haier, Jorg; Herbst, Hermann; Tepel, Juergen; Siphos, Bence; Kleespies, Axel; Koenigsrainer, Alfred; Stoecklein, Nikolas H.; Horstmann, Olaf; Grutzmann, Robert; Imdahl, Andreas; Svoboda, Daniel; Wittekind, Christian; Schneider, Wolfgang; Wernecke, Klaus-Dieter; Schlag, Peter M.

2007-01-01

305

Sensitive, Noninvasive Detection of Lymph Node Metastases  

Microsoft Academic Search

BackgroundMany primary malignancies spread via lymphatic dissemination, and accurate staging therefore still relies on surgical exploration. The purpose of this study was to explore the possibility of semiautomated noninvasive nodal cancer staging using a nanoparticle-enhanced lymphotropic magnetic resonance imaging (LMRI) technique.Methods and FindingsWe measured magnetic tissue parameters of cancer metastases and normal unmatched lymph nodes by noninvasive LMRI using a

Mukesh G. Harisinghani; Ralph Weissleder

2004-01-01

306

[Transdermal and lymph targeting transfersomes of vincristine].  

PubMed

Vincristine (VCR) is mainly used to treat acute lymphocytic leukemia, Hodgkin and non-Hodgkin lymphoma in clinic with definite therapeutic effect. But the obvious neurotoxicity and local stimulation of which limit its clinic use. In order to increase the lymph targeting to enhance the curative effect and to lower the adverse reaction of VCR, the VCR loaded transfersomes (VCR-T) were prepared with dry-film and ultrasonic dispersing methods, and the corresponding pharmaceutical properties, pharmacokinetical characteristics and the targeting ability were studied. The average particle size of VCR-T prepared was 63 nm with an entrapment ratio of 59%. The in vitro transdermal research with modified Franz cell showed that VCR-T permeated through the skin in accordance with polynomial equation, and with an accumulation permeation percentage of 67.4% up to 12 h. An HPLC method was utilized to determine the pharmacokinetics and tissue distribution of VCR. Compared with the iv injection of VCR solution, the retention time of VCR in blood was extended by 12 times with VCR-T, and the targeting index in rat lymph was increased by 2.75 times. As a result, transfersomes could penetrate the skin and enter into the systemic circulation carrying VCR with good lymph targeting ability, which makes it probably a new lymphtic targeting drug delivery system. PMID:18229621

Lu, Yi; Hou, Shi-xiang; Zhang, Liang-ke; Li, Ye; He, Jun-yao; Guo, Dan-dan

2007-10-01

307

Role of Nitric Oxide in the Regulation of Pulmonary Vascular Tone  

Microsoft Academic Search

\\u000a The pulmonary circulation is a low pressure, low resistance, high flow system regulated through both active and passive factors\\u000a [1–4]. Active factors alter pulmonary vascular resistance and tone by causing contraction or relaxation of vascular smooth muscle\\u000a and include neural and humoral mechanisms, and gaseous regulators. Passive factors alter pulmonary vascular resistance and\\/or\\u000a blood flow independently of changes in vascular

Shu F. Liu; Timothy W. Evans

308

Influenza vaccine with Surfacten, a modified pulmonary surfactant, induces systemic and mucosal immune responses without side effects in minipigs  

Microsoft Academic Search

Immune responses and side effects of intranasally administered flu vaccine with the commercial product Surfacten, a modified bovine pulmonary surfactant, were investigated in minipigs. The use of minipigs was based on the anatomical resemblance of nasal lymph nodes, the principal antigen uptake site of respiratory mucosal immunity, between pig and human. Intranasal instillation of HA vaccine adjuvanted with Surfacten elicited

Maki Nishino; Dai Mizuno; Takashi Kimoto; Wakako Shinahara; Akiho Fukuta; Tsunetomo Takei; Kaori Sumida; Seiichiro Kitamura; Hiroshi Shiota; Hiroshi Kido

2009-01-01

309

Pulmonary vascular resistance during unilateral pulmonary arterial occlusion in ducks.  

PubMed

We measured mean pulmonary arterial pressure (Ppa) during temporary unilateral pulmonary arterial occlusion (TUPAO) in 10 ducks. Ppa increased from 11.4 +/- 0.8 mmHg during control conditions to 18.8 +/- 1.8 during TUPAO. In 5 of the 10 ducks we also measured mean left atrial pressure (Pla) and cardiac output (Q). In these ducks Ppa significantly increased with TUPAO from 13.9 +/- 0.4 to 22.0 +/- 1.2 mmHg, whereas Pla and Q did not change significantly. Pulmonary vascular resistance (PVR) increased from 10.6 +/- 1.3 to 24.1 +/- 5.3 mmHg X min X 1(-1) on TUPAO. By assuming equal vascular resistance in either lung it can be calculated that the vascular resistance in only one lung was 22.5 +/- 3.5 mmHg X min X 1(-1) during control conditions. Thus doubling flow resulted in no significant change in one lung's vascular resistance. A morphometric study of both lungs of a domestic goose that were rapidly frozen during TUPAO indicated very little compliance in pulmonary blood capillaries. The relative volume of exchange tissue occupied by blood capillaries was 0.28 in the occluded lung and 0.36 in the perfused lung. Surface-to-volume ratios of blood capillaries were 12,524 cm-1 in the occluded lung and 11,056 cm-1 in the perfused lung. We conclude that PVR in birds is relatively insensitive to changes in Q, in contrast to mammals. PMID:4014495

Powell, F L; Hastings, R H; Mazzone, R W

1985-07-01

310

A single orally administered dose of almitrine improves pulmonary gas exchange during exercise in patients with chronic air-flow obstruction.  

PubMed

To verify if the improvement in gas exchange observed at rest with almitrine in patients with chronic air-flow obstruction is maintained at exercise, we studied 10 patients on a randomized, crossover, double-blind exercise protocol. After assessment of steady state of their disease, patients with FEV 1 less than 1.5 L.s-1 and PaCO2 less than 70 mmHg cycled 8 to 11 min at 80% of their previously determined maximal O2 uptake. Blood gases, arterial lactate (La), expired ventilation, (VE), O2 uptake (Vo2), Co2 production (VCO2), heart rate (HR), and arterial blood pressure (BP) were measured at rest, at mid-exercise, at end-exercise, and at 2, 14, 15, and 35 min of recovery. We found that at all stages of the study PaO2 was significantly higher in those who had received almitrine than in those who had received placebo; the mean increment was 11.9 torr at rest, 8.9 at end-exercise, and 13.7 at 15 min of recovery. Changes in PaCO2 and arterial (H+) were the opposite of those in PaO2; at end-exercise PaCO2 was 5.9 torr lower in those who had received almitrine, and pH was 7.36 versus 7.32 in those who had received placebo. No significant difference was found at all stages of the study between drug and placebo with respect to VE, VO2, VCO2, HR, and BP. But the ventilatory equivalent for oxygen, VE/VO2, was slightly higher in those who had received almitrine than in those who had received placebo during exercise.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3083741

Escourrou, P; Simonneau, G; Ansquer, J C; Duroux, P; Lockhart, A

1986-04-01

311

Prediction of therapeutic response in steroid-treated pulmonary sarcoidosis. Evaluation of clinical parameters, bronchoalveolar lavage, gallium-67 lung scanning, and serum angiotensin-converting enzyme levels  

SciTech Connect

To find a pretreatment predictor of steroid responsiveness in pulmonary sarcoidosis the authors studied 21 patients before and after steroid treatment by clinical evaluation, pulmonary function tests, bronchoalveolar lavage (BAL), gallium-67 lung scan, and serum angiotensin-converting enzyme (SACE) level. Although clinical score, forced vital capacity (FVC), BAL percent lymphocytes (% lymphs), quantitated gallium-67 lung uptake, and SACE levels all improved with therapy, only the pretreatment BAL % lymphs correlated with the improvement in FVC (r = 0.47, p less than 0.05). Pretreatment BAL % lymphs of greater than or equal to 35% predicted improvement in FVC of 10/11 patients, whereas among 10 patients with BAL % lymphs less than 35%, 5 patients improved and 5 deteriorated. Clinical score, pulmonary function parameters, quantitated gallium-67 lung uptake, and SACE level used alone, in combination with BAL % lymphs or in combination with each other, did not improve this predictive value. The authors conclude that steroid therapy improves a number of clinical and laboratory parameters in sarcoidosis, but only the pretreatment BAL % lymphs are useful in predicting therapeutic responsiveness.

Hollinger, W.M.; Staton, G.W. Jr.; Fajman, W.A.; Gilman, M.J.; Pine, J.R.; Check, I.J.

1985-07-01

312

Afferent lymph–derived T cells and DCs use different chemokine receptor CCR7–dependent routes for entry into the lymph node and intranodal migration  

Microsoft Academic Search

Little is known about the molecular mechanisms that determine the entry into the lymph node and intranodal positioning of lymph-derived cells. By injecting cells directly into afferent lymph vessels of popliteal lymph nodes, we demonstrate that lymph-derived T cells entered lymph-node parenchyma mainly from peripheral medullary sinuses, whereas dendritic cells (DCs) transmigrated through the floor of the subcapsular sinus on

Asolina Braun; Tim Worbs; G Leandros Moschovakis; Stephan Halle; Katharina Hoffmann; Jasmin Bölter; Anika Münk; Reinhold Förster

2011-01-01

313

[Lymphatic vascular system, development and lymph formation. Review].  

PubMed

The lymphatic vascular system is widely developed among vertebrates. Lymphatic vessels provide the interstitial fluid (20% of the body weight) drainage through interstitial prelymphatic channels, capillaries, precollectors and collectors flowing into the venous blood. Endothelial cells of capillaries are overlapped and fixed to interstitial collagen and elastic fibres by anchoring filaments facilitating the fluid transfer. Precollectors and collectors have valves controlling the lymph flux direction. In addition to external mechanisms, the lymphangions of collectors have contracting muscle cells driving the flow. Lymphatic endothelial cells are routinely identified by the expression of podoplanin, LYVE-1 and VEGFR3. In the embryo, prelymphatic endothelial cells emerge from the cardinal veins and migrate into the mesenchyma forming embryonic lymphatic sacs. Prox1, Sox18 and COUP-TFII play a major role in the endothelial speciation, VEGFC as VEGFD combined to VEGFR3 in cell migration and proliferation and FoxC2 in valves development. In cancer or inflammation, various factors secreted by cancer cells and/or inflammatory cells induce a neolymphangiogenesis. Recently it has been shown that cells from the bone marrow could be potential precursors for lymphatic endothelial cells. PMID:23474100

Bernaudin, J-F; Kambouchner, M; Lacave, R

2013-03-06

314

[Pulmonary fibrosis and emphysema].  

PubMed

We report a case of combined pulmonary fibrosis and emphysema. This syndrome, including upper-lobe emphysema and pulmonary fibrosis of the lower lung was recently described in smokers or ex-smokers (mean age: 65 years). Exertional dyspnea is always present. Pulmonary functions are subnormal while carbon monoxyde transfer is reduced and exercise hypoxemia is present. High resolution CT-scan is key of diagnosis with upper lobes emphysema with diffuse infiltrating fibrosing disease at the bases. Pulmonary hypertension is present is almost 50% of patients, representing the principal negative pronostic factor. Five years survival is 54.6% (median survival 6, 1 years). PMID:21595311

Frey, Jean-Georges

2011-04-13

315

Primary pulmonary hypertension  

Microsoft Academic Search

SUMMARY Toevaluate theeffects ofprostacyclin (prostaglandin 12) on pulmonary vascular tonein primary pulmonary hypertension (PPH), we performed right-heart catheterization on sevenpatients with PPHandmadehemodynamic measurements before andafter infusing incremental doses ofprostacyclin. In maximaldoses of2-12ng\\/kg\\/min (mean5.7± 3.1ng\\/kg\\/min), prostacyclin reduced mean pulmonary arterial pressurefrom62± 15to55± 16mm Hg(p< 0.05) andtotal pulmonary resistance from17.1 8.7to9.7+ 5.9units (p< 0.005), andincreased cardiac output from4.22 ± 1.64to6.57 ± 2.041\\/min

LEWISJ. RUBIN; BERTRON M. GROVES; MICHAEL FROSOLONO; FRANKLIN HANDEL

1993-01-01

316

Pulmonary veno-occlusive disease  

MedlinePLUS

Pulmonary vaso-occlusive disease ... In most cases, the cause of pulmonary veno-occlusive disease is unknown. The high blood pressure occurs in the pulmonary arteries, which are the lung arteries directly connected to ...

317

Noninvasive Diagnosis of Pulmonary Embolism.  

National Technical Information Service (NTIS)

The previous work demonstrated that reflected ultrasound was a sensitive method for the detection of pulmonary embolism. However, the established pulmonary surface reflection coefficient measurement was not specific to pulmonary embolism. The overall obje...

K. B. Sagar T. Rhyne

1980-01-01

318

How Is Pulmonary Embolism Treated?  

MedlinePLUS

... page from the NHLBI on Twitter. How Is Pulmonary Embolism Treated? Pulmonary embolism (PE) is treated with medicines, procedures, and other ... blood from pooling and clotting. Rate This Content: Pulmonary Embolism Clinical Trials Clinical trials are research studies that ...

319

Acute Pulmonary Embolism Decreases Adenosine Plasma Levels in Anesthetized Pigs  

PubMed Central

Adenosine plays a role in pulmonary arterial (PA) resistance due to its vasodilator properties. However, the behavior of adenosine plasma levels (APLs) during pulmonary embolism remains unknown. We investigated the effects of gradual pulmonary embolism on right ventricular (RV) contractility and PA coupling and on APLs in an piglet experimental model of RV failure. PA distal resistance by pressure-flow relationships and pulmonary vascular impedance were measured. RV contractility was determined by the end-systolic pressure-volume relationship (Ees), PA effective elastance by the end-diastolic to end-systolic relationship (Ea), and RV-PA coupling efficiency by the Ees/Ea ratio. APLs were measured before and during gradual pulmonary embolization. PA embolism increased PA resistance and elastance, increased Ea from 1.08 ± 0.15 to 5.62 ± 0.32?mmHg/mL, decreased Ees from 1.82 ± 0.10 to 1.20 ± 0.23?mmHg/mL, and decreased Ees/Ea from 1.69 ± 0.15 to 0.21 ± 0.07. APLs decreased from 2.7 ± 0.26 to 1.3 ± 0.12??M in the systemic bed and from 4.03 ± 0.63 to 2.51 ± 0.58??M in the pulmonary bed during embolism procedure. Pulmonary embolism worsens PA hemodynamics and RV-PA coupling. APLs were reduced, both in the systemic and in the pulmonary bed, leading then to pulmonary vasoconstriction.

Kerbaul, Francois; By, Youlet; Gariboldi, Vlad; Mekkaoui, Choukri; Fesler, Pierre; Collart, Frederic; Brimioulle, Serge; Jammes, Yves; Ruf, Jean; Guieu, Regis

2011-01-01

320

Tumour cell trapping in rat mesenteric lymph nodes.  

PubMed Central

We describe a new experimental model of mesenteric lymph node metastasis in the rat, involving afferent mesenteric lymphatic inoculation of tumour cell suspensions via glass microcannulae. This model has been used to perform a series of experiments to investigate whether the rat mesenteric lymph node trapped tumour cells. Afferent mesenteric lymphatic inoculation of suspensions of transplantable sarcoma cells in inbred hooded Lister rats resulted in tumour growth in the inoculated lymph node in 100% of rats, with no tumour growth at any other site. The same procedure performed on rats which had previously undergone mesenteric lymphadenectomy resulted in growth of tumour in the lungs. Using 125Iododeoxyuridine (IDUR) labelled sarcoma cells we have shown that although radioactivity decreased significantly in the mesenteric lymph node up to 24 h following afferent lymphatic inoculation, there was no evidence that tumour cells reached thoracic duct lymph. We conclude that the rat mesenteric lymph node trapped sarcoma cells. Images Fig. 2 Fig. 3 Fig. 4

Cobb, R. A.; Steer, H. W.

1987-01-01

321

A new agent for sentinel lymph node detection: preliminary results  

Microsoft Academic Search

Sentinel lymph node detection is widely used to identify lymph nodes that receive lymphatic drainage from a primary tumor.\\u000a 99mTc labeled iron oxide nanoparticles were prepared to invent a new colorful radioactive agent for sentinel lymph node detection.\\u000a Iron oxide nanoparticles were produced by co-precipitation of FeCl3 and FeCl2 in the presence of NaOH. Then iron oxide nanoparticles were labeled

Recep Beki?; ?lker Medine; Ka?an Da?deviren; Türkan Ertay; Perihan Ünak

322

Sentinel lymph node mapping with GI cancer.  

PubMed

Precise evaluation of lymph node status is one of the most important factors in determining clinical outcome in treating gastro-intestinal (GI) cancer. Sentinel lymph node (SLN) mapping clearly has become highly feasible and accurate in staging GI cancer. The lunchtime symposium focused on the present status of SLN mapping for GI cancer. Dr. Kitigawa proposed a new strategy using sentinel node biopsy for esophageal cancer patients with clinically early stage disease. Dr. Uenosono reported on whether the SLN concept is applicable for gastric cancer through his analysis of more than 180 patients with cT1-2, N0 tumors. The detection rate was 95%, the false negative rate of lymph node metastasis including micro-metastasis was 4%, and accuracy was 99% in gastric cancer patients with cT1N0. Dr. Bilchik recommended the best technique for identifying SLNs in colorectal cancer: a combination of radiotracer and blue dye method, emphasizing that this technique will become increasingly popular because of the SLN concept, with improvement in staging accuracy. He stressed that this novel procedure offers the potential for significant upstaging of GI cancer. Dr. Saha emphasized that SLN mapping for colorectal cancer is highly successful and accurate in predicting the presence or absence of nodal disease with a relatively low incidence of skip metastases. It provided the "right nodes" to the pathologists for detailed analysis for appropriate staging and treatment with adjuvant chemotherapy. Although more evidence from large-scale multicenter clinical trials is required, SLN mapping may be very useful for individualizing multi-modal treatment for esophageal cancer and might be widely acceptable even for GI cancer. PMID:16770539

Aikou, Takashi; Kitagawa, Yuko; Kitajima, Masaki; Uenosono, Yoshikazu; Bilchik, Anton J; Martinez, Steve R; Saha, Sukamal

2006-06-01

323

Lymph node staging in non-small cell lung cancer: evaluation by [18F]FDG positron emission tomography (PET)  

PubMed Central

BACKGROUND: A study was undertaken to investigate the accuracy of positron emission tomography (PET) with 2-[18F]-fluoro-2-deoxy-D- glucose (FDG) in the thoracic lymph node staging of non-small cell lung cancer (NSCLC). METHODS: Forty six patients with focal pulmonary tumours who underwent preoperative computed tomographic (CT) and FDG- PET scanning were evaluated retrospectively. Thirty two patients had NSCLC and 14 patients had a benign process. The final diagnosis was established by means of histopathological examination at thoracotomy, and the nodal classification in patients with lung cancer was performed by thorough dissection of the mediastinal nodes at surgery. RESULTS: FDG-PET was 80% sensitive, 100% specific, and 87.5% accurate in staging thoracic lymph nodes in patients with NSCLC, whereas CT scanning was 50% sensitive, 75% specific, and 59.4% accurate. The absence of lymph node tumour involvement was identified by FDG-PET in all 12 patients with NO disease compared with nine by CT scanning. Lymph node metastases were correctly detected by FDG-PET in three of five patients with N1 disease compared with two by CT scanning, in nine of 11 with N2 disease compared with six by CT scanning, an in all four with N3 nodes compared with two by CT scanning. CONCLUSIONS: FDG-PET provides a new and effective method for staging thoracic lymph nodes in patients with lung cancer and is superior to CT scanning in the assessment of hilar and mediastinal nodal metastases. With regard to resectability, FDG-PET could differentiate reliably between patients with N1/N2 disease and those with unresectable N3 disease. ???

Guhlmann, A.; Storck, M.; Kotzerke, J.; Moog, F.; Sunder-Plassmann, L.; Reske, S. N.

1997-01-01

324

Black sentinel lymph node and 'scary stickers'.  

PubMed

An unusual case is presented of a young adult patient with two black-stained, radio-nucleotide tracer-active sentinel lymph nodes biopsied following her primary cutaneous melanoma treatment. This was subsequently confirmed to be secondary to cutaneous tattoos, averting the need of an elective regional node dissection. History of tattooing and tattoo removal should therefore be obtained as a routine in all melanoma patients considered for sentinel node biopsy (SLN). SLN biopsy and any subsequent completion node dissection should be strictly staged so that proper histologic diagnosis of the sentinel node is available for correct decision making and treatment. PMID:23010587

Yang, Arthur S; Creagh, Terrence A

2012-09-24

325

Risk of lymph node metastases after en bloc cold steel, en bloc laser-, and piecemeal laser surgical resection of auricular VX2 carcinoma.  

PubMed

There is some controversy in the literature if lymph vessels are enduring sealed during piecemeal CO2 laser surgery of squamous cell carcinomas of the head and neck or a propagation of tumor cells into the lymphatics occurs. The aim of the present study was to analyze the incidence of lymph node and distant metastases after different methods of resection of a VX2 carcinoma in an animal model. A solid auricular VX2 carcinoma was induced in 200 rabbits. Seven days later, an en bloc cold steel (group A), en bloc laser surgical resection with CO2 laser in continuous wave mode with 2 W (group B), or piecemeal laser surgical resection after transection of the tumor with CO2 laser in continuous wave mode with 2 W (group C) or 20 W (group D) was performed. The animals were killed and the incidence of lymph node and distant metastases was compared between the different groups. Of the rabbits, 21.1 % developed lymph node metastases and 10 % pulmonary metastases. The incidence of lymph node metastases was 17.4 % in group A, 20.4 % in group B, 26 % in group C, and 20 % in group D. These differences were not statistically significant. En bloc cold steel, en bloc laser-, or piecemeal laser surgical resections include similar risk of postoperative metastases. Propagation of tumor cells cannot be excluded with certainty by any of these methods. PMID:23053248

Wiegand, Susanne; Wiemers, Christian; Murthum, Tobias; Zimmermann, Annette P; Bette, Michael; Mandic, Robert; Werner, Jochen A

2012-10-03

326

Lymph node metastasis in gastric cardiac adenocarcinoma in male patients  

PubMed Central

AIM: To reveal the clinicopathological features and risk factors for lymph node metastases in gastric cardiac adenocarcinoma of male patients. METHODS: We retrospective reviewed a total of 146 male and female patients with gastric cardiac adenocarcinoma who had undergone curative gastrectomy with lymphadenectomy in the Department of Surgery, Xin Hua Hospital and Rui Jin Hospital of Shanghai Jiaotong University Medical School between November 2001 and May 2012. Both the surgical procedure and extent of lymph node dissection were based on the recommendations of Japanese gastric cancer treatment guidelines. Univariate and multivariate analyses of lymph node metastases and the clinicopathological features were undertaken. RESULTS: The rate of lymph node metastases in male patients with gastric cardiac adenocarcinoma was 72.1%. Univariate analysis showed an obvious correlation between lymph node metastases and tumor size, gross appearance, differentiation, pathological tumor depth, and lymphatic invasion in male patients. Multivariate logistic regression analysis revealed that tumor differentiation and pathological tumor depth were the independent risk factors for lymph node metastases in male patients. There was an obvious relationship between lymph node metastases and tumor size, gross appearance, differentiation, pathological tumor depth, lymphatic invasion at pN1 and pN2, and nerve invasion at pN3 in male patients. There were no significant differences in clinicopathological features or lymph node metastases between female and male patients. CONCLUSION: Tumor differentiation and tumor depth were risk factors for lymph node metastases in male patients with gastric cardiac adenocarcinoma and should be considered when choosing surgery.

Ren, Gang; Chen, Ying-Wei; Cai, Rong; Zhang, Wen-Jie; Wu, Xiang-Ru; Jin, Ye-Ning

2013-01-01

327

Inflammation-Induced Lymph Node Lymphangiogenesis Is Reversible  

PubMed Central

The extent of lymph node metastasis is a prognostic indicator of disease progression in many malignancies. Current noninvasive imaging technologies for the clinical assessment of lymph node metastases are based on the detection of cancer cells and commonly suffer from a lack of sensitivity. Recent evidence has indicated that the expansion of lymphatic networks (ie, lymphangiogenesis) within tumor-draining lymph nodes might be the earliest sign of metastasis. Therefore, we recently developed a noninvasive imaging method to visualize lymph node lymphangiogenesis in mice using radiolabeled antibodies against the lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1) as well as positron emission tomography (PET). This technique, termed anti-LYVE-1 immuno-PET, was found to be very sensitive in the detection of metastasis to the lymph nodes. However, lymphatic vessel expansion to the lymph nodes can also be induced by inflammation, and it is currently unclear whether such vessel expansion is reversed once inflammation has resolved. Detection of residual inflammation-induced lymph node lymphangiogenesis, thus, might hamper the identification of metastasized lymph nodes. In this study, we therefore used a well-established mouse model of inflammation in the skin to investigate whether lymphatic vessels in the lymph nodes regress on resolution of inflammation. Our data reveal that the lymphatic network indeed regresses on the resolution of inflammation and that we can image this process by anti-LYVE-1 immuno-PET.

Mumprecht, Viviane; Roudnicky, Filip; Detmar, Michael

2012-01-01

328

Assessment of systemic-pulmonary collateral arteries in children with cyanotic congenital heart disease using multidetector-row computed tomography: Comparison with conventional angiography  

Microsoft Academic Search

BackgroundThe present study aimed to assess the feasibility of multidetector-row computed tomography (MDCT) for the evaluation of systemic-pulmonary collateral (SPC) arteries in children with congenital heart disease associated with reduced pulmonary blood flow.

Yasunobu Hayabuchi; Miki Inoue; Noriko Watanabe; Miho Sakata; Manal Mohamed Helmy Nabo; Tetsuya Kitagawa; Takashi Kitaichi; Shoji Kagami

2010-01-01

329

Detection of parasternal metastatic lymph nodes by sentinel lymph node methods in a patient with recurrence in the conserved breast  

Microsoft Academic Search

We herein report a case of second sentinel lymph node biopsy (SLNB). A 57-year-old woman underwent breast-conserving surgery\\u000a including axillary clearance at Aichi Cancer Center on October 20, 2003. Recurrent tumor in the conserved breast was diagnosed\\u000a in March 2006. She received SLNB using radioactive tracer. Preoperative lymphoscintigraphy detected 2 parasternal lymph nodes\\u000a as hot spots. No abnormal lymph nodes

Toshinari Yamashita; Takashi Fujita; Hironori Hayashi; Yoshiaki Ando; Yukari Hato; Akiyo Horio; Chieko Toyoshima; Mai Yamada; Hiroji Iwata

330

Pulmonary Function Tests  

PubMed Central

Pulmonary function tests are valuable investigations in the management of patients with suspected or previously diagnosed respiratory disease. They aid diagnosis, help monitor response to treatment and can guide decisions regarding further treatment and intervention. The interpretation of pulmonary functions tests requires knowledge of respiratory physiology. In this review we describe investigations routinely used and discuss their clinical implications.

Ranu, Harpreet; Wilde, Michael; Madden, Brendan

2011-01-01

331

Congenital pulmonary lymphangiectasia  

Microsoft Academic Search

Congenital pulmonary lymphangiectasia (PL) is a rare developmental disorder involving the lung, and characterized by pulmonary subpleural, interlobar, perivascular and peribronchial lymphatic dilatation. The prevalence is unknown. PL presents at birth with severe respiratory distress, tachypnea and cyanosis, with a very high mortality rate at or within a few hours of birth. Most reported cases are sporadic and the etiology

Carlo Bellini; Francesco Boccardo; Corradino Campisi; Eugenio Bonioli

2006-01-01

332

Pulmonary Thromboembolectomy for Acute Pulmonary Thromboembolism  

PubMed Central

Background Acute pulmonary thromboembolism is fatal because of abruptly occurring hypoxemia and right ventricular failure. There are several treatment modalities, including anticoagulation, thrombolytics, ECMO (extracorporeal membrane oxygenator), and thromboembolectomy, for managing acute pulmonary thromboembolism. Materials and Methods Medical records from January 1999 to December 2004 at our institution were retrospectively reviewed for pulmonary thromboembolectomy. There were 7 patients (4 men and 3 women), who underwent a total of 8 operations because one patient had post-operative recurrent emboli and underwent reoperation. Surgery was indicatedfor mild hypoxemia and performed with CPB (cardiopulmonary bypass) in a beating heart state. Results The patients had several symptoms, such as dyspnea, chest discomfort, and palpitation. Four patients had deep vein thromboembolisms and 3 had psychotic problems, specifically schizophrenia. Post-operative complications included hemothorax, pleural effusion, and pericardial effusion. There were two hospital deaths, one each by brain death and right heart failure. Conclusion Emergency operation should be performed when medical treatments are no longer effective.

Yi, Inho; Cho, Kyu Seok; Kim, Bum Shik; Kim, Soo-Cheol; Kim, Dae Hyun; Kim, Jung-Heon; Youn, Hyo Chul

2011-01-01

333

Sensitive, Noninvasive Detection of Lymph Node Metastases  

PubMed Central

Background Many primary malignancies spread via lymphatic dissemination, and accurate staging therefore still relies on surgical exploration. The purpose of this study was to explore the possibility of semiautomated noninvasive nodal cancer staging using a nanoparticle-enhanced lymphotropic magnetic resonance imaging (LMRI) technique. Methods and Findings We measured magnetic tissue parameters of cancer metastases and normal unmatched lymph nodes by noninvasive LMRI using a learning dataset consisting of 97 histologically proven nodes. We then prospectively tested the accuracy of these parameters against 216 histologically validated lymph nodes from 34 patients with primary cancers, in semiautomated fashion. We found unique magnetic tissue parameters that accurately distinguished metastatic from normal nodes with an overall sensitivity of 98% and specificity of 92%. The parameters could be applied to datasets in a semiautomated fashion and be used for three-dimensional reconstruction of complete nodal anatomy for different primary cancers. Conclusion These results suggest for the first time the feasibility of semiautomated nodal cancer staging by noninvasive imaging.

2004-01-01

334

Salmonella infection of afferent lymph dendritic cells.  

PubMed

The interactions of Salmonella enterica subspecies I serotype Abortusovis (S. Abortusovis) with ovine afferent lymph dendritic cells (ALDCs) were investigated for their ability to deliver Maedi visna virus (MVV) GAG p25 antigens to ALDCs purified from afferent lymph. Salmonellae were found to enter ALDC populations by a process of cell invasion, as confirmed by electron and confocal microscopy. This led to phenotypical changes in ALDC populations, as defined by CD1b and CD14 expression. No differences in the clearance kinetics of intracellular aroA-negative Salmonella from CD1b+ CD14lo and CD1b+ CD14(-) ALDC populations were noted over 72 h. ALDCs were also shown to present MVV GAG p25 expressed by aroA-negative S. Abortusovis to CD4+ T lymphocytes. Thus, the poor immune responses that Salmonella vaccines elicited in large animal models compared with mice are neither a result of an inability of Salmonella to infect large animal DCs nor an inability of these DCs to present delivered antigens. However, the low efficiency of infection of ALDC compared with macrophages or monocyte-derived DCs may account for the poor immune responses induced in large animal models. PMID:17986631

Chan, Simon S M; Mastroeni, Pietro; McConnell, Ian; Blacklaws, Barbara A

2007-11-06

335

Pulmonary Transfusion Reactions  

PubMed Central

Summary Background In recent years, pulmonary transfusion reactions have gained increasing importance as serious adverse transfusion events. Methods Review of the literature. Results Pulmonary transfusion reactions are not extremely rare and, according to hemovigilance data, important causes of transfusion-induced major morbidity and death. They can be classified as primary with predominant pulmonary injury and secondary as part of another transfusion reaction. Primary reactions include transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO) and transfusion-associated dyspnea (TAD). Secondary pulmonary reactions are often observed in the wake of hemolytic transfusion reactions, hypotensive/anaphylactic reactions, and transfusion-transmitted bacterial infections. Conclusion Knowledge and careful management of cases of pulmonary transfusion reactions are essential for correct reporting to blood services and hemovigilance systems. Careful differentiation between TRALI and TACO is important for taking adequate preventive measures.

Bux, Jurgen; Sachs, Ulrich J. H.

2008-01-01

336

Percutaneous balloon pulmonary valvuloplasty.  

PubMed Central

Percutaneous pulmonary valvuloplasty was performed in 27 patients with congenital pulmonary valve stenosis. A fall in the transvalve gradient of at least 15 mm Hg occurred in 22 patients. In five there was little change in the severity of the stenosis; in three of these the pulmonary valve was dysplastic. None of the successfully treated patients had a dysplastic valve. The two other failures, early in the series, were probably due to inadequate balloon size. In one patient the procedure was performed twice, with a successful result from the second dilatation with a larger balloon. Follow up studies in a further six patients showed no evidence of restenosis in those who had been successfully treated and no late improvement in the remainder. There were no important complications. Percutaneous pulmonary valvuloplasty should be the initial treatment for congenital pulmonary valve stenosis, although when the valve is dysplastic the result is less likely to be satisfactory. Images

Tynan, M; Baker, E J; Rohmer, J; Jones, O D; Reidy, J F; Joseph, M C; Ottenkamp, J

1985-01-01

337

Exercise induced pulmonary vasoconstriction.  

PubMed Central

Pulmonary vascular resistance normally falls or remains unchanged during exercise. Seven children with pulmonary hypertension were exercised during cardiac catheterisation after operative correction of ventricular septal defect (6) and truncus arteriosus (1). Except for the presence of moderate pulmonary hypertension, resting haemodynamics in these seven children were similar to those of normal children of equal age, but during exercise the postoperative patients showed a rise rather than a fall (+2% vs -18%) in total pulmonary vascular resistance. Two of the seven children had a substantial increase in pulmonary arteriolar resistance during exercise (from 509 to 715 dyne s cm-5 in one patient and from 606 to 828 dyne s cm-5 in the other). These two patients did not differ from normal children in respect of arterial or mixed venous oxygen saturations or of pH with exercise, nor was left atrial pressure related to the rise in pulmonary resistance. These two patients, however, had only a small rise in cardiac output during exercise (6.8% and 43.1%) in spite of a substantial increase in oxygen consumption (121% and 373%). One of the patients with exercise-induced pulmonary vasoconstriction had an 82% increase in resting pulmonary vascular resistance over a five year period subsequent to her first exercise study. Analysis of these data, and those previously reported, suggests that exercise induced pulmonary vasoconstriction may occur in 10 to 25% of patients who survive correction of certain congenital cardiac defects. The vasoconstriction cannot be attributed to abnormal changes in blood gases or left atrial pressure, and may be an early sign of progressive pulmonary hypertension.

Kulik, T J; Bass, J L; Fuhrman, B P; Moller, J H; Lock, J E

1983-01-01

338

Familial Congenital Nonimmune Hydrops, Chylothorax and Pulmonary Lymphangiectasia  

PubMed Central

Pulmonary lymphangiectasia is an uncommon congenital anomaly, and familial occurrence has rarely been reported. We report on two sibs with bilateral pleural effusion/chylothorax and hydrops who died neonatally. One sib required prenatal intrauterine hemithoracic drainage. Autopsy confirmed congenital pulmonary lymphangiectiasia (CPL) histologically in the first case. Hydrops, characterized as subcutaneous edema and effusions in two or more body cavities, may be due to a variety of factors, but the co-occurrence of CPL in one of these sibs, although rare, supports the notion that chylothorax and hydrops may be caused by structural lesions of lymph channels. Although most cases of CPL are sporadic, the reported sibs support autosomal recessive inheritance, with intrafamilial variability of a lymphatic disorder on a genetic basis. Mutations in VEGFR3 in families with Milroy disease, mutations of FOXC2 in the lymphedema-distichiasis syndrome, and fatal chylothorax in ?9-deficient mice are potential candidate genes.

Stevenson, David A.; Pysher, Theodore J.; Ward, Robert M.; Carey, John C.

2008-01-01

339

Pulmonary lipogranulomatosis due to excessive consumption of apples.  

PubMed

A 55-year-old man was admitted for treatment of unstable angina. Chest x-ray films showed a micronodular pattern, but there were no respiratory symptoms. Autopsy, carried out following sudden death, revealed pulmonary granulomas surrounding lipid crystals. The same crystals were found elsewhere: lymph nodes, spleen, liver, adrenal glands, and were composed of aliphatic hydrocarbons of vegetal origin, mainly C29H60. Investigation of the case history revealed excessive consumption of apples, to which the hydrocarbon deposition could be attributed, since C29H60 is a natural constituent of the cuticular wax in apple peel. This is a unique example of pulmonary granulomatosis due to storage of vegetal hydrocarbons of dietary origin. PMID:3757573

Duboucher, C; Escamilla, R; Rocchiccioli, F; Negre, A; Lageron, A; Migueres, J

1986-10-01

340

Lymph node pathology in primary combined immunodeficiency diseases  

Microsoft Academic Search

Conclusions  This study has provided information on the spectrum of changes which can occur in different PID. Using a pattern-based approach for the analysis of the lymph node parenchyma, it is obvious that there are no morphological features specifically associated with a single disease. This indicates that the lymph node biopsy is per se insufficient to identify any specific form of

Fabio Facchetti; Laura Blanzuoli; Marco Ungari; Olga Alebardi; William Vermi

1998-01-01

341

Hyperplastic mesothelial cells in subpleural lymph nodes mimicking metastatic carcinoma.  

PubMed

We describe a patient with a history of poorly differentiated adenocarcinoma of the stomach in whom hyperplastic mesothelial cell inclusions were present in subpleural lymph nodes. The involved lymph nodes were embedded in a lipoma in the parietal pleura. The role of histochemistry and immunohistochemistry in the differentiation of these inclusions from metastatic carcinoma is discussed. PMID:15614744

Sion-Vardy, Netta; Diomin, Victor; Benharroch, Daniel

2004-12-01

342

Anatomic study of the lymph nodes of the mesorectum  

Microsoft Academic Search

PURPOSE: Lymph node involvement is the most important prognostic factor when staging patients with colorectal cancer. The probability of detecting metastasis grows with the number of nodes examined. However, the number of nodes found in surgical specimens varies substantially. We have therefore determined the number and distribution of lymph nodes in the mesorectum by cadaveric dissection. METHODS: Twenty formalin-fixed cadaveric

César E. Canessa; Federica Badía; Socorro Fierro; Verónica Fiol; Gastón Háyek

2001-01-01

343

Mesenteric Lymph: The Bridge to Future Management of Critical Illness  

Microsoft Academic Search

Summary Toxic factors released from the intestine have been implicated in the pathophysiology of severe acute illness, including acute pancreatitis, trauma and hemorrhagic shock, and burns. Toxic factors in mesenteric lymph may induce an inflammatory systemic response while bypassing the portal circulation and liver. This paper reviews current knowledge of the anatomy, physiology and pathophysiology of mesenteric lymph and focuses

Medhat YZ Fanous; Anthony J Phillips; John A Windsor

344

Radioguided Sentinel Lymph Node Biopsy in Breast Cancer Surgery  

Microsoft Academic Search

The concept of sentinel lymph node biopsy in breast cancer surgery relates to the fact that the tumor drains in a logical way through the lymphatic system, from the first to upper levels. Therefore, the first lymph node met (the sentinel node) will most likely be the first to be affected by metastasis, and a negative sentinel node makes it

Giuliano Mariani; Luciano Moresco; Giuseppe Viale; Giuseppe Villa; Marcello Bagnasco; Giuseppe Canavese; John Buscombe; H. William Strauss; Giovanni Paganelli

345

Tumor lymphangiogenesis predicts melanoma metastasis to sentinel lymph nodes  

Microsoft Academic Search

Cutaneous melanoma is a common melanocytic neoplasm that can quickly metastasize to regional lymph nodes. Currently, prognosis is determined by measuring tumor thickness but more reliable markers for metastatic spread are urgently needed. We investigated whether the extent of tumor lymphangiogenesis can predict melanoma metastasis to sentinel lymph nodes. We quantified the extent of tumor lymphangiogenesis, as well as other

Soheil S Dadras; Bernhard Lange-Asschenfeldt; Paula Velasco; Lynh Nguyen; Anish Vora; Alona Muzikansky; Katharina Jahnke; Axel Hauschild; Satoshi Hirakawa; Martin C Mihm; Michael Detmar

2005-01-01

346

Salmonella in lymph nodes of cattle presented for harvest  

Technology Transfer Automated Retrieval System (TEKTRAN)

Introduction: Salmonella can invade and survive within host immune cells. Once internalized, these pathogens have the potential to disseminate throughout the lymphatic system and reside within lymph nodes. If so, because some lymph nodes are located within muscle and fat tissues, Salmonella-positiv...

347

Automatic mediastinal lymph node detection in chest CT  

Microsoft Academic Search

Computed tomography (CT) of the chest is a very common staging investigation for the assessment of mediastinal, hilar, and intrapulmonary lymph nodes in the context of lung cancer. In the current clinical workflow, the detection and assessment of lymph nodes is usually performed manually, which can be error-prone and timeconsuming. We therefore propose a method for the automatic detection of

Marco Feuerstein; Daisuke Deguchi; Takayuki Kitasaka; Shingo Iwano; Kazuyoshi Imaizumi; Yoshinori Hasegawa; Yasuhito Suenaga; Kensaku Mori

2009-01-01

348

A prognostic biomarker for gastric cancer with lymph node metastases.  

PubMed

Gastric cancer is one of the leading causes of tumor-related deaths in China. The tumor, node, metastasis (TNM) classification system is useful for predicting clinical prognosis of patients with gastric cancer. However, determining the presence of lymph node involvement in the early stages of gastric cancer is difficult without biopsy. Therefore, it is necessary to identify novel serum biomarkers for TNM cancer staging and prognostic follow-up. In this study, we have reported fibrinopeptide-A (FPA) with alanine truncation at the N-terminal as a novel biomarker to differentiate gastric cancer with and without lymph node metastases. We analyzed 369 individual serum samples including gastric cancer patients without lymph node metastases (n = 33), gastric cancer patients with lymph node metastases (n = 157; confirmed by pathology), and age- and sex-matched healthy individuals (n = 179). The data showed that 85.4% of patients with lymph node metastases were positive for FPA with alanine truncation at the N-terminal (degAla-FPA, 1,465.63 Da), as determined by tandem mass spectrometry (MS). Using degAla-FPA as the biomarker, the sensitivity was 85.4% for gastric cancer patients with lymph node metastases, and the specificity was 100% for gastric cancer patients without lymph node metastases. The high sensitivity and specificity achieved with serum degAla-FPA levels indicated that MS technology could facilitate the discovery of a novel and quantitative prognostic biomarker for gastric cancer with lymph node involvement. PMID:23382154

Zhang, Mei-Hua; Xu, Xiao-Hong; Wang, Yue; Linq, Qi-Xin; Bi, Yun-Tao; Miao, Xiao-Jie; Ye, Chao-Fu; Gao, Shang-Xian; Gong, Cheng-Yu; Xiang, Hang; Dong, Mao-Sheng

2013-02-04

349

Dendritic-cell trafficking to lymph nodes through lymphatic vessels  

Microsoft Academic Search

Antigen-presenting dendritic cells often acquire foreign antigens in peripheral tissues such as the skin. Optimal encounter with naive T cells for the presentation of these antigens requires that the dendritic cells migrate to draining lymph nodes through lymphatic vessels. In this article, we review important aspects of what is known about dendritic-cell trafficking into and through lymphatic vessels to lymph

Veronique Angeli; Melody A. Swartz; Gwendalyn J. Randolph

2005-01-01

350

Genetic diagnosis of lymph-node metastasis in colorectal cancer  

Microsoft Academic Search

If a regional lymph node taken during surgery for colorectal cancer is found to be free of tumour on histological examination this is taken to be a good sign. However, conventional staining may not be sensitive enough. Mutant-allele-specific amplification (MASA) is a technique that can detect, at the level of an individual cell, micrometastases to lymph nodes that are histologically

N. Hayashi; I. Ito; Y. Nakamura; A. Yanagisawa; Y. Kato; S. Nakamori; S. Imaoka; H. Watanabe; M. Ogawa

1995-01-01

351

Pulmonary artery sarcoma mimicking pulmonary embolism: successful surgical intervention.  

PubMed

Because of its rarity and the similarity of its presentation to that of pulmonary thromboembolic disease, the diagnosis of pulmonary artery sarcoma is often not considered early in patients presenting with recurrent or chronic pulmonary emboli. We present a case of pulmonary artery sarcoma that was treated as pulmonary embolism for 3 years before surgical resection was carried out. Two years after the resection the patient is well with no clinical or radiologic evidence of recurrent or metastatic disease. PMID:8633981

Akomea-Agyin, C; Dussek, J E; Anderson, D R; Hartley, R B

1996-05-01

352

Increased pulmonary arterial pressure in children with nephrotic syndrome  

PubMed Central

Aims: To evaluate the pulmonary arterial pressure in children with nephrotic syndrome (NS). Methods: Doppler echocardiography was performed in 40 children with NS (aged 1.5–13 years) at NS onset (n = 28) or relapse (n = 12), and 40 normal controls. Pulmonary pressure was estimated by: (1) measuring the systolic transtricuspid gradient from tricuspid regurgitation; and (2) measuring the time to peak velocity of pulmonary flow. Results: Thirty five of the 40 patients with NS had measurable tricuspid regurgitation with a pulmonary systolic pressure ranging from 21 to 48 mm Hg. Pulmonary systolic pressure was >40 mm Hg in seven patients. The pulmonary time to peak velocity was shortened and the ratio of time to peak velocity and right ventricular ejection time decreased compared with controls. The patients with increased pulmonary pressure had a longer time since onset of NS. One patient developed thrombus in the inferior vena cava during hospitalisation. Conclusion: Pulmonary arterial pressure was increased in children with NS. Further work is needed to evaluate the aetiology and clinical implications of this abnormality.

Du, Z; Cao, L; Liang, L; Chen, D; Li, Z

2004-01-01

353

Pulmonary vascular imaging  

SciTech Connect

A wide range of pulmonary vascular imaging techniques are available for the diagnostic evaluation of patients with suspected pulmonary vascular disease. The characteristics of any ideal technique would include high sensitivity and specificity, safety, simplicity, and sequential applicability. To date, no single technique meets these ideal characteristics. Conventional pulmonary angiography remains the gold standard for the diagnosis of acute thromboembolic disease despite the introduction of newer techniques such as digital subtraction angiography and magnetic resonance imaging. Improved noninvasive lower extremity venous testing methods, particularly impedance plethysmography, and ventilation-perfusion scanning can play significant roles in the noninvasive diagnosis of acute pulmonary emboli when properly applied. Ventilation-perfusion scanning may also be useful as a screening test to differentiate possible primary pulmonary hypertension from chronic thromboembolic pulmonary hypertension. And, finally, angioscopy may be a useful adjunctive technique to detect chronic thromboembolic disease and determine operability. Optimal clinical decision-making, however, will continue to require the proper interpretation of adjunctive information obtained from the less-invasive techniques, applied with an understanding of the natural history of the various forms of pulmonary vascular disease and with a knowledge of the capabilities and shortcomings of the individual techniques.

Fedullo, P.F.; Shure, D.

1987-03-01

354

Pulmonary rehabilitation: An overview  

PubMed Central

The burden of chronic obstructive pulmonary disease (COPD) has increased recently in developing countries. On the other hand, structured or non-structured rehabilitation services for COPD patients are not routinely available in these countries. We, therefore, planned this review to re-emphasize the emerging benefits of pulmonary rehabilitation in COPD population. Aim of this review is to stimulate pulmonary physicians in India and other resource-poor areas of the world so that they start using pulmonary rehabilitation or its components more often. The search included standard english literature PubMed citation of relevant original articles, review articles and practice guidelines. The articles and reviews were searched including standard MeSH terms – Rehabilitation (TIAB) and pulmonary disease, chronic obstructive/therapy (MAJOR) and guidelines (TIAB). Available 58 articles in English including 23 reviews from July 2001 to October 2010 were screened for evidence-based benefits regarding respiratory rehabilitation as a whole or its different components. The cross references and current citations relating to primary articles were also included for description. No attempt was done to make a systematic analysis because our purpose was not to derive evidence-based recommendations from database and because sufficient evidence is already available for benefits of selected components of pulmonary rehabilitation in COPD patients. Pulmonary rehabilitation has emerged as an important modality as an adjunct to other therapies in patients of COPD. Limited and more cost-effective protocols are to be developed and executed by healthcare providers, especially in developing countries like India.

Sharma, Bharat Bhushan; Singh, Virendra

2011-01-01

355

Familial Fibrocystic Pulmonary Dysplasia  

PubMed Central

At least 31 cases of familial fibrocystic pulmonary dysplasia, within 10 families, have been described in the world literature. The mode of genetic transmission of this disease, however, has been uncertain until now. The author observed three unequivocal and five probable cases of familial fibrocystic pulmonary dysplasia among 56 members of one family. Diagnostic criteria included progressive dyspnea and cyanosis, digital clubbing, pulmonary hypertension, negative sweat tests, polycythemia, arterial hypoxia and hypocapnia, chest radiographs showing diffuse bilateral pulmonary fibrosis, and diffuse fibrocystic pulmonary dysplasia at postmortem examination (two cases). Among the three unequivocal cases one father-to-son transmission was observed. Non-sex-linked dominant transmission of familial fibrocystic pulmonary dysplasia is thereby proved for the first time. One patient also developed a bronchial carcinoma in addition to fibrocystic pulmonary dysplasia; this is considered to be a cause-and-effect relationship and not a coincidental complication. ImagesFig. 2Fig. 3aFig. 3bFig. 4Fig. 5Fig. 6Fig. 7Fig. 8Fig. 9Fig. 10Fig. 11

Koch, Bernd

1965-01-01

356

Automatic detection and segmentation of axillary lymph nodes.  

PubMed

Lymph node detection and measurement is a difficult and important part of cancer treatment. In this paper we present a robust and effective learning-based method for the automatic detection of solid lymph nodes from Computed Tomography data. The contributions of the paper are the following. First, it presents a learning based approach to lymph node detection based on Marginal Space Learning. Second, it presents an efficient MRF-based segmentation method for solid lymph nodes. Third, it presents two new sets of features, one set self-aligning to the local gradients and another set based on the segmentation result. An extensive evaluation on 101 volumes containing 362 lymph nodes shows that this method obtains a 82.3% detection rate at 1 false positive per volume, with an average running time of 5-20 seconds per volume. PMID:20879211

Barbu, Adrian; Suehling, Michael; Xu, Xun; Liu, David; Zhou, S Kevin; Comaniciu, Dorin

2010-01-01

357

[Surgery for bronchial carcinoma with mediastinal lymph node involvement].  

PubMed

Or the 3000 patients analyzed in the prospective bronchial carcinoma field study, 1086 were operated between 1984 and 1989. Complete systematic mediastinal lymphadenectomy was performed in 661 patients to assess the PTNM stage as exactly as possible, and to improve prognosis. Lymphadenectomy removes all hylarand mediastinal lymph nodes. Although the operation is technically quite easy on the clearly structured right side, it is more difficult on the left side due to the aortic arch and its branches. The lymph nodes of the upper mediastinum of the left and right side can be completely dissected by mobilizing the aortic arch with the left subclavian artery. In contrast to what is frequently assumed, the histological findings indicate that there is no general pattern of metastatic spread in the lymph nodes. The metastases can leave out varying numbers of lymph nodes craniad as well as caudad. For this reason, the lymph nodes have to be completely resected to ensure a real R0-resection. PMID:7702346

Schirren, J; Cuénoud, P F; Bülzebruck, H; Krysa, S; Branscheid, D; Müller, K M; Vogt-Moykopf, I

1994-01-01

358

The lymph as a pool of self antigens  

PubMed Central

Prenodal lymph is generated from the interstitial fluid that surrounds organs, and thus contains products of organ metabolism and catabolism. New proteomic analyses have identified in lymph proteins and peptides that are derived from capillary extravasation and tissue-specific proteins. Many of these peptides are detected at nanomolar concentrations in the lymph prior to passage through a regional lymph node. Before entering the node and once inside proteins and processed peptides are filtered from the lymph by circulating immature DC or non-activated nodal APC (macrophages, B cells and immature DC). Here, we suggest that this process ensures organ-specific self-antigens are displayed to circulating and nodal antigen-presenting cells, thus contributing to the maintenance of peripheral tolerance.

Clement, Cristina C.; Rotzschke, Olaf; Santambrogio, Laura

2010-01-01

359

CT pulmonary angiography during veno-arterial extracorporeal membrane oxygenation in an adult.  

PubMed

Veno-arterial extracorporeal membrane oxygenation (VA ECMO) causes changes in the filling and blood flow of the cardiac chambers and pulmonary vessels as well as alterations in the path of intravenous contrast injected during CT. We present a patient with a potentially misleading CT pulmonary angiogram while on full VA ECMO. We demonstrate circulatory changes as well as alterations in contrast flow when ECMO flows are reduced. PMID:23721144

Al-Ogaili, Zeyad; Foulner, Deryck; Passage, Jurgen; Weightman, William M; Torre, Luke; Baker, Sharyn; Sanders, Lucas H A

2012-07-25

360

Diffuse pulmonary meningotheliomatosis.  

PubMed

Minute pulmonary meningothelial nodules are rare lesions histologically composed of small nests of epithelioid cells located within the interstitium of the lung. These nodules are generally asymptomatic and are usually found incidentally at autopsy or in surgical specimens resected for unrelated causes. The lesions are most often single, although multiple lesions with unilateral involvement of one or even all lobes of the same lung have been described. To our knowledge, cases of meningothelial nodules with disseminated bilateral pulmonary involvement associated with clinical symptoms of restrictive pulmonary disease and radiologic evidence of diffuse reticulonodular pulmonary infiltrates have not been previously documented. We have studied 5 patients presenting with diffuse bilateral pulmonary involvement by numerous minute pulmonary meningothelial nodules. The patients were 4 women and a man aged 54 to 75 years who presented clinically with dyspnea and shortness of breath and the lesions were discovered on open lung biopsies performed for the evaluation of diffuse bilateral interstitial lung infiltrates found on chest x-rays and computed tomography scans. In 3 patients, there was a previous history of malignancy and the radiologic findings were suspected of representing diffuse metastatic disease. Histologically, the lesions were composed of small clusters of epithelioid cells with round to oval nuclei devoid of atypia and surrounded by abundant eosinophilic cytoplasm. Immunohistochemical studies showed positivity of the tumor cells for epithelial membrane antigen and vimentin, and negative staining for cytokeratin, actin, S-100 protein, CD34, chromogranin, and synaptophysin. Electron microscopic examination in 1 case confirmed the ultrastructural features of meningothelial cells, including complex cytoplasmic interdigitations joined by well-developed desmosomes and abundant intracytoplasmic intermediate filaments. The diffuse bilateral involvement of lung parenchyma in the present cases can lead to confusion on clinical and radiologic grounds with a variety of interstitial pulmonary processes, including idiopathic interstitial pneumonia and lymphangitis carcinomatosa. Diffuse pulmonary meningotheliomatosis should be considered in the clinical differential diagnosis of diffuse interstitial pulmonary infiltrates. PMID:17414111

Suster, Saul; Moran, Cesar A

2007-04-01

361

Characterization of sheep lung lymph lipoproteins: chemical and physical properties  

SciTech Connect

The authors have determined the composition and distribution of plasma and lung lymph lipoproteins from unanesthetized ewes. Cholesterol, triglyceride, and phospholipid levels in lung lymph were 45%, 50%, and 50%, respectively, of those in plasma. Lipoproteins from both lymph and plasma were separated into two major fractions: d < 1.063 g/ml or LDL, and d 1.063-1.21 g/ml or HDL. HDL was the major lipoprotein species in the plasma and lymph. Gradients gel electrophoresis of HDL on 4-30% gels showed that, in lymph, HDL particles were shifted to larger sizes; in addition to a peak at 8.5 nm, which was similar to plasma HDL, there were two additional components of larger size, one at 9.2 nm and the other at 12 nm. Electron microscopy revealed that lymph HDL contained two new particles not seen in plasma: large, round particles, 13.6 nm diameter, and discoidal particles, 18.7 by 4.9 nm, long and short axis, respectively. Compositional analysis of lymph HDL revealed a relative enrichment in free cholesterol as well as an enrichment in apolipoprotein E. Lymph LDL on gradient gel electrophoresis was extremely heterogeneous. Several peaks were evident in the 23-30 nm size range (similar to plasma LDL), but a supplementary component at approximately 15-16 nm was also present. Whereas plasma LDL on electron microscopy contained only round particles 26 nm in diameter, lymph contained an additional, unusual particle which was close-packed, with square geometry, and was 15 nm in diameter. Changes in the physical and chemical properties of lung lymph lipoproteins suggest that these particles are metabolically modified.

Forte, T.M.; Cross, C.E.; Gunther, R.A.; Kramer, G.C.

1983-01-01

362

Pulmonary disorders in athletes.  

PubMed

Exercise is rarely limited by pulmonary causes in normal individuals. Cardiac output and peripheral muscle disease are usually the limiting factors. Although minute ventilation rises steeply during exercise, normal individuals maintain a substantial breathing reserve. Exercise in patients, however, can be limited by pulmonary disorders. Acute pulmonary causes (exercise-induced bronchospasm, vocal cord dysfunction, exercise-induced anaphylaxis, and exercise-induced urticaria) or chronic disorders (obstructive and restrictive lung disorders) reduce exercise tolerance. Exercise testing has proved the mainstay for diagnosis and treatment of these disorders. PMID:21658546

Weder, Max M; Truwit, Jonathon D

2011-07-01

363

Ureteric and pulmonary endometriosis.  

PubMed

Pulmonary lesions and ureter involvement are rare complications of endometriosis. We describe the first case with an involvement of both sites in this condition. The radiographs showed "pulmonary metastases" together with clinical findings of a hydronephrosis, mimicing a malignant metastatic gynecologic tumor of unknown primary. A laparoscopy showed severe endometriotic lesions; therefore the findings were most likely related to the condition of endometriosis. The patient was treated with gosereline acetate for six months (Zoladex). Control radiographs showed complete regression of the pulmonary lesions and the patient is symptom free at 36 months after diagnosis. PMID:11561747

Ludwig, M; Bauer, O; Wiedemann, G J; Diedrich, K

2001-08-01

364

Surgery and Sentinel Lymph Node Biopsy  

PubMed Central

In patients with melanoma, surgery is pivotal not only for the primary tumor but also for regional and often distant metastases. The minimally invasive technique of sentinel node biopsy has become standard for detection of occult regional node metastasis in patients with intermediate-thickness primary melanoma; in these patients it has a central role in determining prognosis and a significant impact on survival when biopsy results are positive. Its role in thin melanoma remains under evaluation. The regional tumor-draining sentinel node is also a useful model for studies of melanoma-induced immunosuppression. Although completion lymphadenectomy remains the standard of care for patients with sentinel node metastasis, results of ongoing phase III trials will indicate whether sentinel node biopsy without further lymph node surgery is adequate therapy for certain patients with minimal regional node disease.

Faries, Mark B.; Morton, Donald L.

2008-01-01

365

Pancreatic endocrine tumour with disseminated pulmonary thromboembolism in an owl monkey (Aotus nancymae).  

PubMed

Pulmonary thromboembolism associated with pancreatic endocrine neoplasia is extremely uncommon in man and animals. Post-mortem examination of an adult owl monkey (Aotus nancymae) revealed extensive pulmonary arterial thromboembolism and a well-demarcated mass attached to the pancreas. Microscopically, the mass consisted of areas of interstitial fibrosis with loss of acini and islets and replacement by nests and sheets of polygonal cells with amphophilic cytoplasm, an eccentric round nucleus with stippled chromatin and, in some cells, with a single prominent eccentric nucleolus. Clusters of these cells were noted within vessels and adjacent lymph nodes. The cells did not express S100 or insulin, but were labelled strongly with SP-1/chromogranin. Rare individual cells expressed glucagon and somatostatin. A few cells in pulmonary thrombi/emboli and the adjacent lymph node also expressed SP-1/chromogranin. Based on cell morphology, location and immunohistochemistry the tumour was classified as pancreatic endocrine (islet cell) carcinoma with metastasis to regional lymph nodes and lung. PMID:23453490

Gozalo, A S; Zerfas, P M; Starost, M F; Lambert, L E; Elkins, W R

2013-02-28

366

Sentinel Lymph Node Tumor Load: An Independent Predictor of Additional Lymph Node Involvement and Survival in Melanoma  

Microsoft Academic Search

Background  Even though 60% to 80% of melanoma patients with a positive sentinel lymph node (SLN) have no positive additional lymph nodes (ALNs), all these patients are subjected to an ALN dissection (ALND) with its associated morbidity. The aim of this study was to predict the absence of ALN metastases in patients with a positive SLN by using features of the

Ronald J. C. L. M. Vuylsteke; Paul J. Borgstein; Paul A. M. van Leeuwen; Hester A. Gietema; Barbara G. Molenkamp; Markwin G. Statius Muller; Paul J. van Diest; Joost R. M. van der Sijp; Sybren Meijer

2005-01-01

367

Subcapsular sinus macrophages in lymph nodes clear lymph-borne viruses and present them to antiviral B cells  

Microsoft Academic Search

Lymph nodes prevent the systemic dissemination of pathogens such as viruses that infect peripheral tissues after penetrating the body's surface barriers. They are also the staging ground of adaptive immune responses to pathogen-derived antigens. It is unclear how virus particles are cleared from afferent lymph and presented to cognate B cells to induce antibody responses. Here we identify a population

Tobias Junt; E. Ashley Moseman; Matteo Iannacone; Steffen Massberg; Philipp A. Lang; Marianne Boes; Katja Fink; Sarah E. Henrickson; Dmitry M. Shayakhmetov; Nelson C. di Paolo; Nico van Rooijen; Thorsten R. Mempel; Sean P. Whelan; Ulrich H. von Andrian

2007-01-01

368

Lymph node metastases in the lower neck.  

PubMed

Current knowledge suggests that lymph node metastases in the lower neck (supraclavicular fossa and posterior triangle) are associated with a poor survival. Very little systematic work has been published on this subject. This was a retrospective study carried out on a database where all patients were entered in a prospective manner over a 35-year period using a standard pro-forma. Data on 168 patients presenting with a lower neck node metastasis were retrieved. The main outcome measures were: association between variables and tumour-specific survival. Data were displayed in contingency tables and analysed by chi-square and categorical modelling. Recurrence and survival were plotted in a cause-specific manner using the Kaplan Meir method. Differences in curves were analysed using the log rank test. Multivariate analysis was carried out using Cox's proportional hazard model. The only association was between site and node level and histology. Head and neck tumours were associated with squamous histology (P = 0.0004) and supraclavicular nodes (P = 0.0047). Survival time was not significantly different when lower-neck lymph node metastasis from the head and neck was compared to non-head and neck metastasis: 5-year survival 30% and 10% respectively (P = 0.1363). Survival with posterior triangle metastases was significantly better than supraclavicular metastases (P = 0. 0059), confirmed on multivariate analysis. Laterality of metastasis had no effect on survival (P < 0.0001). There was no significant difference in survival between squamous and non-squamous metastases on Cox regression (P = not significant). There were 85 head and neck primaries including lymphomas, 53 infraclavicular primaries and 30 unknown primaries. There were 73 squamous cell carcinomas, 27 adenocarcinomas, 34 lymphomas, 28 undifferentiated tumours and six other tumours. Nearly half the primary tumours were below the clavicle. Survival was unaffected by laterality, primary site or histology, but was better for posterior triangle nodes. PMID:12755760

Giridharan, W; Hughes, J; Fenton, J E; Jones, A S

2003-06-01

369

Efficient Generation of Mucosal and Systemic Antigen-Specific CD8+ T-Cell Responses following Pulmonary DNA Immunization?  

PubMed Central

Although mucosal CD8+ T-cell responses are important in combating mucosal infections, the generation of such immune responses by vaccination remains problematic. In the present study, we evaluated the ability of plasmid DNA to induce local and systemic antigen-specific CD8+ T-cell responses after pulmonary administration. We show that the pulmonary delivery of plasmid DNA formulated with polyethyleneimine (PEI-DNA) induced robust systemic CD8+ T-cell responses that were comparable in magnitude to those generated by intramuscular (i.m.) immunization. Most importantly, we observed that the pulmonary delivery of PEI-DNA elicited a 10-fold-greater antigen-specific CD8+ T-cell response in lungs and draining lymph nodes of mice than that of i.m. immunization. The functional evaluation of these pulmonary CD8+ T cells revealed that they produced type I cytokines, and pulmonary immunization with PEI-DNA induced lung-associated antigen-specific CD4+ T cells that produced higher levels of interleukin-2 than those induced by i.m. immunization. Pulmonary PEI-DNA immunization also induced CD8+ T-cell responses in the gut and vaginal mucosa. Finally, pulmonary, but not i.m., plasmid DNA vaccination protected mice from a lethal recombinant vaccinia virus challenge. These findings suggest that pulmonary PEI-DNA immunization might be a useful approach for immunizing against pulmonary pathogens and might also protect against infections initiated at other mucosal sites.

Bivas-Benita, Maytal; Bar, Liat; Gillard, Geoffrey O.; Kaufman, David R.; Simmons, Nathaniel L.; Hovav, Avi-Hai; Letvin, Norman L.

2010-01-01

370

Species-specific pulmonary arterial asymmetry determines species differences in regional pulmonary perfusion.  

PubMed

The functional significance of differences in pulmonary vascular branching and diameter asymmetry between the human and quadruped lung has not previously been addressed. To evaluate the contribution of branching asymmetry to observable species differences in blood flow gradients, computed distributions of blood flow were compared in structure-based models of the human and ovine pulmonary arteries. The models were derived using a combination of computed tomography and a volume-filling algorithm. Pressure, flow, and deformed vessel diameter were calculated in both species models using equations representing conservation of mass and momentum, and a pressure-diameter relationship. The major difference between the human and ovine results was the presence of a large region of "zone 4" flow and higher mean flows in the central region of the ovine lung compared to that in the human. Heterogeneity in tissue perfusion and the contribution of gravity were similar in both species models; however, the gravitationally directed gradients of perfusion in the human and ovine models were different and each consistent with human and quadruped measurements, respectively. The results suggest that measured species differences in pulmonary perfusion gradients are largely determined by differences in branching asymmetry. PMID:19768544

Burrowes, K S; Hoffman, E A; Tawhai, M H

2009-09-19

371

Tracheal venous blood and lymph collection: a model to study airway injury in sheep.  

PubMed

Airway injury is a frequent result of the inhalation or aspiration of toxic material. Although upper airway damage can be identified endoscopically, pathophysiological changes are difficult to evaluate. This paper describes an animal model in which changes in tracheal blood and lymph flow rates, wet-to-dry weight ratios, and lymph-to-plasma protein ratios can be evaluated after injury. In this model, 12 cm of the cervical trachea were isolated using a double-cuffed endotracheal tube and injured with cotton smoke at near room temperature. Injury to the trachea was evaluated in twenty-five anesthetized sheep 4 (n = 3), 8 (n = 3), 24 (n = 3), 48 (n = 3), 96 (n = 3), and 192 (n = 2) h after smoke exposure and compared with sham control animals (n = 8). A significant increase in tracheal venous blood flow from 1.3 +/- 0.4 (SD) ml.min-1.cm-1 for the noninjured trachea to 2.8 +/- 1.2 was noted 24 h after injury (P less than 0.01). Lymph flow significantly increased from 1.3 +/- 0.4 microliters.min-1.cm-1 for the noninjured trachea to 9.8 +/- 3.3 24 h after injury while wet-to-dry weight ratios were elevated from 3.0 +/- 0.2 for noninjured trachea to 4.6 +/- 0.9 from 4 to 24 h after injury (P less than 0.01) and decreased to 3.7 +/- 0.5 by 96 h. Cast material consisting of airway exudate, cellular debris, and intact ciliated epithelial cells was both expectorated and found in the trachea when the animals were killed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2055845

Barrow, R E; Morris, S E; Linares, H A; Herndon, D N

1991-04-01

372

Chronic thromboembolic pulmonary hypertension  

PubMed Central

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rapidly progressive and deadly disease, resulting from incomplete resolution of acute pulmonary embolism. Historically, the incidence of CTEPH was significantly underestimated but it may be as high as 3.8% following acute pulmonary embolism. Although the medical management of CTEPH may be supportive, the only curative treatment is pulmonary endarterectomy (PEA). However, a careful screening programme is mandatory to select CTEPH patients who are likely to benefit from PEA. In this review we discuss the pathophysiology, clinical and diagnostic pitfalls, surgical treatment, outcome after surgery, and the potential benefit of medical treatment in inoperable CTEPH patients. ImagesFigure 1Figure 2Figure 3Figure 4

Reesink, H.J.; Kloek, J.J.; Bresser, P.

2006-01-01

373

Pulmonary function tests  

MedlinePLUS

PFTs; Spirometry; Spirogram; Lung function tests ... Pulmonary function tests are done to: Diagnose certain types of lung disease (such as asthma , bronchitis , and emphysema) Find the cause of shortness of breath Measure whether exposure ...

374

Defining Pulmonary Fibrosis  

MedlinePLUS

PULMONARY FIBROSIS (PF) DESCRIBES A CONDITION in which the lung tissue becomes thickened, stiff, and scarred. 1 The medical terminology used to describe this scar tissue is fibrosis. The alveoli (air sacs) and the blood vessels ...

375

Hantavirus Pulmonary Syndrome (HPS)  

MedlinePLUS

... FAQ: Non-U.S. Visitors to Yosemite Outbreak of Hantavirus Infection in Yosemite National Park As of November ... to... Ańadir en... Favorites Delicious Digg Google Bookmarks Hantavirus Pulmonary Syndrome (HPS) Severe HPS. Image courtesy D. ...

376

Pulmonary ventilation during hemodialysis.  

PubMed

During hemodialysis a decrease in pulmonary ventilation has been reported. The elimination of CO2 across the dialyzer has been suggested as the cause of the pulmonary hypoventilation. Our purpose was to analyze the factors that could have influenced the pulmonary ventilation of 7 patients with chronic renal failure during hemodialysis, performed against an acetate dialysate with constant addition of CO2, bubbling into the dialysis bath. In spite of the large volume of CO2 mainly as bicarbonate, eliminated across the dialyzer there was no significant decrease of ventilation. The values of pH in the venous line were extremely low and the values of PvCO2 were artificially maintained around 35.0 mm Hg. Thus, the total CO2 delivered to the lungs, but mainly the levels of pH and PCO2 in the venous line play an important role in the control of pulmonary ventilation of these patients. PMID:6817152

Romaldini, H; Stabile, C; Faro, S; Lopes Dos Santos, M; Ramos, O L; Ratto, O R

1982-01-01

377

Pharmacotherapy of Pulmonary Hypertension  

PubMed Central

Pulmonary arterial hypertension is a serious disease with significant morbidity and mortality. While it can occur idiopathically, it is more commonly associated with other cardiac or lung diseases. While most of the available therapies were tested in adult populations, and most therapies in children remain off-label, new reports and randomized trials are emerging that inform the treatment of pediatric populations. This review discusses currently available therapies for pediatric pulmonary hypertension, their biologic rationales, and evidence for their clinical effectiveness.

Steinhorn, Robin H.

2012-01-01

378

Diagnosis of Pulmonary Embolism  

Microsoft Academic Search

Pulmonary embolism (PE)is a relevant clinical occurrence. Despite advances in diagnostic modalities,PE remains a commonly\\u000a under diagnosed and lethal disease. In North America it has been reported that the occurrence of 600 000 PE cases are accountable\\u000a for 50 000 to 200 000 deaths annually [1–4 ]. Unexpected deaths due to pulmonary embolism are frequently diagnosed post mortem. When diagnosis

R. G. G. Terzi; M. Mello Moreira

379

[Pulmonary allergic reactions].  

PubMed

Allergic diseases of the lungs may affect the airways, the pulmonary parenchyma and the pulmonary vessels. The most relevant representatives are allergic asthma, hypersensitivity pneumonitis, bronchopulmonary aspergillosis and the Churg-Strauss syndrome. The type of allergic reaction and the pathophysiological consequences vary considerably between these entities. New drugs target specific mechanisms based on new insights into the pathogenetic processes of the underlying disease. PMID:22806148

Koczulla, A R; Beutel, B; Greulich, T; Jerrentrup, A; Vogelmeier, C

2012-08-01

380

Pulmonary Mycobacterium szulgai infection.  

PubMed

There has been an increase in the number of pulmonary infections caused by non-tuberculous mycobacteria (NTM) in the non HIV-infected population with a heightened awareness clinically and in the laboratory of the significance of these respiratory isolates and newer identification techniques. As far as we are aware, this is the first case report of pulmonary Mycobacteium szulgai infection in Ireland. PMID:23155916

McSweeney, F G B; O'Brien, M E; Sheehan, S; Plant, B; Corcoran, G

2012-09-01

381

Chronic Thromboembolic Pulmonary Hypertension  

Microsoft Academic Search

Opinion statement  The pulmonary hypertension (PH) and right heart dysfunction that results from chronic thromboembolic involvement of the pulmonary\\u000a vascular bed is potentially curable with surgical endarterectomy. Over the past several decades, growing clinical experience\\u000a has brought about increased recognition of this treatable form of PH. Moreover, advances in cardiothoracic surgical techniques\\u000a have given an increasing number of patients with chronic

Lara M. Wittine; William R. Auger

2010-01-01

382

Arginase and pulmonary diseases  

Microsoft Academic Search

Recent studies have indicated that arginase, which converts l-arginine into l-ornithine and urea, may play an important role in the pathogenesis of various pulmonary disorders. In asthma, chronic obstructive\\u000a pulmonary disease (COPD) and cystic fibrosis, increased arginase activity in the airways may contribute to obstruction and\\u000a hyperresponsiveness of the airways by inducing a reduction in the production of bronchodilatory nitric

Harm Maarsingh; Tonio Pera; Herman Meurs

2008-01-01

383

Primary pulmonary Hodgkin's lymphoma  

PubMed Central

A 21-year-old man presented to hospital with a two-month history of productive cough with no other symptoms. Radiology revealed a cavitating lesion in the left upper lobe for which a variety of diagnoses were considered. A biopsy revealed primary pulmonary Hodgkin’s lymphoma. Primary pulmonary Hodgkin’s lymphoma is an uncommon initial presentation; lung lesions usually occur later in the course of the disease. Following diagnosis, the patient began chemotherapy and full remission was achieved.

Lluch-Garcia, R; Briones-Gomez, A; Castellano, E Monzo; Sanchez-Toril, F; Lopez, A; Brotons, B

2010-01-01

384

Hemodynamic effects of nifedipine and oxygen in children with pulmonary hypertension  

Microsoft Academic Search

Fourteen patients, 2 to 20 years old were investigated. Two had primary pulmonary hypertension, 11 had congenital heart disease and post-tricuspid shunts, and 1, a 20-year-old patient, was investigated after he had undergone surgical correction of truncus arteriosus I. Pulmonary arterial pressure, pulmonary flow index, peripheral systolic blood pressure and heart rate were measured before, and several times after intrapulmonary

Maria Wimmer; Michael Schlemmer; Franz Ebner

1988-01-01

385

Pulmonary Rehabilitation in Emphysema  

PubMed Central

Pulmonary rehabilitation is an established treatment for patients with chronic lung disease. Benefits include improvement in exercise tolerance, symptoms, and quality of life, with a reduction in the use of health care resources. As an adjunct to surgical programs, such as lung volume reduction surgery, pulmonary rehabilitation plays an important role not just in preparing patients for surgery and facilitating recovery but also in selecting patients and ensuring informed choices about treatment options after optimal medical care. In the National Emphysema Treatment Trial (NETT), subjects completed 6–10 weeks of comprehensive pulmonary rehabilitation before randomization and continued rehabilitation throughout the trial, both at home and with intermittent supervision at either an NETT center or an NETT-certified satellite center. Sessions included a combination of upper and lower extremity exercise, education, and psychosocial support. Before randomization, pulmonary rehabilitation resulted in highly significant changes in exercise capacity, dyspnea, and quality of life. As expected, improvements were significantly greater in those without prior rehabilitation experience. Results for patients completing rehabilitation at satellites were similar to those at NETT centers. Prerandomization pulmonary rehabilitation had a significant effect on outcome after lung volume reduction surgery. NETT identified subgroups with differential outcome by treatment (surgical vs. nonsurgical), defined in part by postrehabilitation maximum exercise capacity. Overall, NETT demonstrated the effectiveness of pulmonary rehabilitation in improving function, symptoms, and health status in a large cohort of patients with advanced emphysema treated in a cross-section of programs in the United States.

Ries, Andrew L.; Make, Barry J.; Reilly, John J.

2008-01-01

386

Urban air particulate inhalation alters pulmonary function and induces pulmonary inflammation in a rodent model of chronic bronchitis.  

PubMed

Epidemiological studies have reported increased morbidity in human populations following inhalation of elevated levels of urban particulate matter. These responses are especially prevalent in populations with chronic obstructive pulmonary diseases, including chronic bronchitis. Toxicological studies have reported altered pulmonary function and increased pulmonary inflammation following particulate inhalation in the laboratory setting. However, most of these studies have utilized artificial particles that may not accurately mimic outdoor air pollutant conditions. Few studies have utilized actual urban air particle samples in inhalation studies. In the present study, the effects of inhaled concentrated urban air particulates on pulmonary function and pulmonary inflammation are addressed. Normal rats and rats with chronic bronchitis induced by approximately 200 ppm SO(2) for 6 wk were subsequently subjected to filtered air or concentrated air particles (CAPs). Twelve rats per group in 4 groups (48 rats total) were exposed for 5 h/day for 3 consecutive days. The CAPs aerosol levels were 206, 733, and 607 microg/m(3) (MMAD = 0.18 microm, sigma(g) = 2.9) on days 1, 2, and 3, respectively. Following the final day of exposure, pulmonary function parameters, including peak expiratory flow (PEF), tidal volume (TV), respiratory frequency (RF), and minute volume (MV), were measured and compared to preexposure baseline levels. Twenty-four hours following the final day of exposure, bronchoalveolar lavage was performed for total cell counts, differential cell counts, and total lavage protein levels. Pulmonary responses to CAPs in chronic bronchitic animals indicated a significant increase in tidal volume as well as peak expiratory flow. In CAPs-exposed animals without underlying bronchitis, significantly increased tidal volume was observed. Significant pulmonary inflammation was observed in the CAPs-exposed animals, particularly those with chronic bronchitis. Significant increases in neutrophils, lymphocytes, and total lavage protein were observed. These results suggest two distinct mechanistic responses to inhaled particles: a stress-type pulmonary function response marked by increases in flow and volume, that is, deeper breathing; and acute pulmonary inflammation marked by cellular influx, particularly neutrophils. From these data it is concluded that inhaled urban air particles alter pulmonary breathing parameters and increase pulmonary inflammation. PMID:10477440

Clarke, R W; Catalano, P J; Koutrakis, P; Murthy, G G; Sioutas, C; Paulauskis, J; Coull, B; Ferguson, S; Godleski, J J

1999-08-01

387

Head-to-head comparison of lymph node density and number of positive lymph nodes in stratifying the outcome of patients with lymph node-positive prostate cancer submitted to radical prostatectomy and extended lymph node dissection.  

PubMed

OBJECTIVE: The aim of this study was to compare the predictive ability of lymph node density (LND) and number of positive lymph nodes in patients with prostate cancer and lymph node invasion. MATERIALS AND METHODS: We included 568 patients with lymph node invasion treated with radical prostatectomy and extended pelvic lymph node dissection between January 1990 and July 2011 at a single center. The Kaplan-Meier method and multivariable Cox regression models tested the association between the number of positive lymph nodes or LND and cancer-specific survival (CSS). The predictive accuracy of a baseline model was assessed using Harrell's concordance index and then compared with that of a model including either the number of positive nodes or LND. RESULTS: The median number of positive lymph nodes was 2, whereas the median LND was 11.1%. At 5, 8, and 10 years, CSS rates were 92.5%, 83.9%, and 82.8%, respectively. At multivariable analyses, number of positive lymph nodes and LND, considered as continuous variables, were independent predictors of CSS (all P?0.01). A 30% LND cutoff was found to be highly predictive of CSS (P = 0.004), and a cutoff of 2 positive nodes was confirmed to be a strong predictor of CSS (P = 0.02). The number of positive nodes and LND similarly, continuous or dichotomized, increased the accuracy for CSS predictions (0.68-0.69 vs. 0.61 of baseline model). LND cutoff of 30% increased the discrimination the most (0.69; +0.083). CONCLUSIONS: The number of positive lymph nodes and LND showed comparable discriminative power for long-term CSS predictions. A cutoff of 30% LND might be suggested for the selection of patients candidate for adjuvant systemic therapy, because it increased the model's discrimination the most. PMID:23490908

Passoni, Niccolň Maria; Abdollah, Firas; Suardi, Nazareno; Gallina, Andrea; Bianchi, Marco; Tutolo, Manuela; Fossati, Nicola; Gandaglia, Giorgio; Salonia, Andrea; Freschi, Massimo; Rigatti, Patrizio; Montorsi, Francesco; Briganti, Alberto

2013-03-12

388

Thromboembolism in pulmonary artery sarcoma.  

PubMed

Pulmonary artery sarcoma, although rare, must be considered in the differential diagnosis of pulmonary thromboembolism. Clinically and radiologically, it may imitate pulmonary embolism, making diagnosis difficult and delaying treatment. Patients often have no symptom resolution despite therapeutic anticoagulation. Visualization of filling defects within a pulmonary artery on contrast-enhanced CT cannot reliably differentiate between pulmonary thromboembolism and malignant lesions like leiomyosarcoma. FDG PET-CT offers the potential for identification of malignant lesions. The authors report a case with pulmonary artery thromboembolism due to thrombi formed on a pulmonary artery leiomyosarcoma. Integrated FDG PET-CT showed no FDG-uptake along the major part of the filling defect within the right main pulmonary artery suggesting blood clot and increased uptake along the posterior wall of the right main pulmonary artery and the left lower lobar artery suggesting malignancy. PMID:19300057

Farsad, Mohsen; Pernter, Patrizia; Triani, Antonio; Osele, Luzian; Wiedermann, Christian J

2009-04-01

389

Afferent lymph-derived T cells and DCs use different chemokine receptor CCR7-dependent routes for entry into the lymph node and intranodal migration.  

PubMed

Little is known about the molecular mechanisms that determine the entry into the lymph node and intranodal positioning of lymph-derived cells. By injecting cells directly into afferent lymph vessels of popliteal lymph nodes, we demonstrate that lymph-derived T cells entered lymph-node parenchyma mainly from peripheral medullary sinuses, whereas dendritic cells (DCs) transmigrated through the floor of the subcapsular sinus on the afferent side. Transmigrating DCs induced local changes that allowed the concomitant entry of T cells at these sites. Signals mediated by the chemokine receptor CCR7 were absolutely required for the directional migration of both DCs and T cells into the T cell zone but were dispensable for the parenchymal entry of lymph-derived T cells and dendrite probing of DCs. Our findings provide insight into the molecular and structural requirements for the entry into lymph nodes and intranodal migration of lymph-derived cells of the immune system. PMID:21841786

Braun, Asolina; Worbs, Tim; Moschovakis, G Leandros; Halle, Stephan; Hoffmann, Katharina; Bölter, Jasmin; Münk, Anika; Förster, Reinhold

2011-08-14

390

Pulmonary artery endothelium resident endothelial colony-forming cells in pulmonary arterial hypertension.  

PubMed

Proliferative pulmonary vascular remodeling is the pathologic hallmark of pulmonary arterial hypertension (PAH) that ultimately leads to right heart failure and death. Highly proliferative endothelial cells known as endothelial colony-forming cells (ECFC) participate in vascular homeostasis in health as well as in pathological angiogenic remodeling in disease. ECFC are distinguished by the capacity to clonally proliferate from a single cell. The presence of ECFC in the human pulmonary arteries and their role in PAH pathogenesis is largely unknown. In this study, we established a simple technique for isolating and growing ECFC from cultured pulmonary artery endothelial cells (PAEC) to test the hypothesis that ECFC reside in human pulmonary arteries and that the proliferative vasculopathy of PAH is related to greater numbers and/or more proliferative ECFC in the pulmonary vascular wall. Flow cytometric forward and side scatter properties and aggregate correction were utilized to sort unmanipulated, single PAEC to enumerate ECFC in primary PAEC cultures derived from PAH and healthy lungs. After 2 weeks, wells were assessed for ECFC formation. ECFC derived from PAH PAEC were more proliferative than control. A greater proportion of PAH ECFC formed colonies following subculturing, demonstrating the presence of more ECFC with high proliferative potential among PAH PAEC. Human androgen receptor assay showed clonality of progeny, confirming that proliferative colonies were single cell-derived. ECFC expressed CD31, von Willebrand factor, endothelial nitric oxide synthase, caveolin-1 and CD34, consistent with an endothelial cell phenotype. We established a simple flow cytometry method that allows ECFC quantification using unmanipulated cells. We conclude that ECFC reside among PAEC and that PAH PAEC contain ECFC that are more proliferative than ECFC in control cultures, which likely contributes to the proliferative angiopathic process in PAH. PMID:22530103

Duong, Heng T; Comhair, Suzy A; Aldred, Micheala A; Mavrakis, Lori; Savasky, Benjamin M; Erzurum, Serpil C; Asosingh, Kewal

391

Current status of sentinel lymph node biopsy in solid malignancies  

PubMed Central

Lymphatic mapping and sentinel lymph node biopsy were first reported in 1977 by Cabanas for penile cancer. Since that time, the technique has become rapidly assimilated into clinical practice. The sentinel node concept has been validated in cutaneous melanoma and breast cancer. However, follow-up data of patients from randomised trials is needed to establish the clinical significance of sentinel lymph node biopsy before accepting the procedure as a standard of care. This technique has the potential to be utilised in all solid tumours like colon, gastric, oesophageal, lung, gynaecologic, and head and neck cancer. This paper reviews the current status of sentinel lymph node biopsy in solid tumours.

Goyal, Amit; Mansel, Robert E

2004-01-01

392

Histopathological, lymphoscintigraphical, and immunological changes in the inguinal lymph nodes of rhesus monkeys during the early course of infection with Brugia malayi.  

PubMed

The relationship of the early lymphatic pathophysiological alterations with those of tissue inflammatory and cellular responses in the inguinal lymph nodes of Brugia malayi-infected rhesus monkeys was examined. Each of five animals was inoculated subcutaneously in the right calf with 200 third stage larvae (L3) and 5 weeks later, before the onset of patency [10 to 12 weeks postinoculation (PI)], their right inguinal nodes began to show signs of enlargement, becoming most prominent between weeks 10 to 16 PI. Histopathologically, the right nodes had eosinophilic lymphadenitis, lymphoid hyperplasia, and pronounced germinal centers. Lymphoscintigraphy using 99mTc-antimony trisulfide colloid showed pathophysiological alterations of the lymph flow rate in the right leg but not in the left leg at weeks 7 and 15 PI. In vitro blastogenesis to B. malayi antigens at week 10 PI showed the inguinal lymph node cells proliferated more vigorously than did peripheral blood cells early in infection. However, at week 24 PI both lymph node and peripheral blood cells proliferated to antigens. Flow cytometry showed an upregulation of HLA-DR+ lymphocytes in right lymph node cells from infected animals when compared to those from control animals. No changes in CD2, CD4, CD8, CD20, CD29, and CD45R cell numbers in lymph node of infected animals were seen when compared to control animals. Our results show that lymphatic pathology occurs early before the onset of patency, correlating with a marked tissue inflammatory and cellular responses of lymph node cells in B. malayi-infected rhesus monkeys. The rhesus could be an extremely useful model for understanding the evolution of pathology and pathogenesis of the disease. PMID:9635437

Dennis, V A; Lasater, B L; Blanchard, J L; Lowrie, R C; Campeau, R J

1998-06-01

393

Development of pulmonary vascular response to oxygen  

SciTech Connect

The ability of the pulmonary circulation of the fetal lamb to respond to a rise in oxygen tension was studied from 94 to 146 days of gestation. The unanesthetized ewe breathed room air at normal atmospheric pressure, followed by 100% oxygen at three atmospheres absolute pressure in a hyperbaric chamber. In eleven near-term lambs, fetal arterial oxygen tension (Pa{sub O{sub 2}}) increased from 25 to 55 Torr, which increased the proportion or right ventricular output distributed to the fetal lungs from 8 to 59%. In five very immature lambs fetal Pa{sub O{sub 2}} increased from 27 to 174 Torr, but the proportion of right ventricular output distributed to the lung did not change. In five of the near-term lambs, pulmonary blood flow was measured. For each measurement of the distribution of blood flow, approximately 8 {times} 10{sup 5} spheres of 15-{mu}m diameter, labeled with either {sup 153}Gd, {sup 113}Sn, {sup 103}Ru, {sup 95}Nb, or {sup 46}Sc were injected. It increased from 34 to 298 ml {center dot} kg fetal wt{sup {minus}1} {center dot} min{sup {minus}1}, an 8.8-fold increase. The authors conclude that the pulmonary circulation of the fetal lamb does not respond to an increase in oxygen tension before 101 days of gestation; however, near term an increase in oxygen tension alone can induce the entire increase in pulmonary blood flow that normally occurs after the onset of breathing at birth.

Morin, F.C. III, Egan, E.A.; Ferguson, W.; Lundgren, C.E. (State Univ. of New York, Buffalo (USA))

1988-03-01

394

Pulmonary involvement in inflammatory bowel disease  

PubMed Central

AIM: To determine the relationship of pulmonary abnormalities and bowel disease activity in inflammatory bowel disease (IBD). METHODS: Thirty ulcerative colitis (UC) and nine Crohn’s disease patients, and 20 control subjects were enrolled in this prospective study. Detailed clinical information was obtained. Extent and activity of the bowel disease were established endoscopically. Each patient underwent pulmonary function tests and high-resolution computed tomography (HRCT). Blood samples for measurement of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), angiotensin converting enzyme and total IgE were delivered by the patients. RESULTS: Ten (25.6%) patients had respiratory symptoms. A pulmonary function abnormality was present in 22 of 39 patients. Among all patients, the most prevalent abnormalities in lung functions were a decrease in forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity (FVC), forced expiratory flow (FEF) 25%-75%, transfer coefficient for carbon monoxide (DLCO), DLCO/alveolar volume. Increased respiratory symptoms score was associated with high endoscopic activity index in UC patients. Endoscopic and clinical activities in UC patients were correlated with FEV1, FEV1/FVC, and FEF 25%-75%. Smoking status, duration of disease and medication were not correlated with pulmonary physiological test results, HRCT abnormalities, clinical/endoscopic disease activity, CRP, ESR or total IgE level or body mass index. CONCLUSION: It is important that respiratory manifestations are recognized and treated early in IBD. Otherwise, they can lead to destructive and irreversible changes in the airway wall.

Y?lmaz, Ayd?n; Demirci, Nilgun Y?lmaz; Hosgun, Derya; Uner, Enver; Erdogan, Yurdanur; Gokcek, Atila; Caglar, Atalay

2010-01-01

395

Pulmonary Nontuberculous Mycobacterial Disease Prospective Study of a Distinct Preexisting Syndrome  

Microsoft Academic Search

Rationale: Pulmonary nontuberculous mycobacterial (PNTM) dis- ease is increasing, but predisposing features have been elusive. Objectives: To prospectively determine the morphotype, immuno- phenotype, and cystic fibrosis transmembrane conductance regula- tor genotype in a large cohort with PNTM. Methods: We prospectively enrolled 63 patients with PNTM infec- tion, each of whom had computerized tomography, echocardio- gram, pulmonary function, and flow cytometry

Richard D. Kim; David E. Greenberg; Mary E. Ehrmantraut; Li Ding; Yvonne Shea; Margaret R. Brown; Milica Chernick; Wendy K. Steagall; Connie G. Glasgow; JingPing Lin; Clara Jolley; Lynn Sorbara; M ark Raffeld; Lisa A. Barnhart; L. Anderson; Reginald Claypool; Dianne M. Hilligoss; Mary Garofalo; Dirk Darnell; Rosamma DeCastro; Heather M. Menning; Kenneth N. Olivier; Joel Moss; Steven M. Holland

396

Left Atrial and Ventricular Filling in Chronic Obstructive Pulmonary Disease An Echocardiographic and Doppler Study  

Microsoft Academic Search

Abnormal left ventricular (LV) diastolic function has frequently been reported in patients with chronic obstructive pulmonary dis- ease (COPD). In the present work, diastolic function was studied by a combined analysis of pulmonary venous and mitral blood flow velocities in 34 patients with COPD clinically stable and with- out history of heart disease, and 20 control subjects. We con- firmed

ALAIN BOUSSUGES; CHRISTOPHE PINET; FLORENCE MOLENAT; HENRI BURNET; PIERRE AMBROSI; MONIQUE BADIER; JEAN-MARIE SAINTY; JEAN OREHEK

397

Total repair of pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals: An integrated approach  

Microsoft Academic Search

Background: Predicting postrepair right ventricular\\/left ventricular pressure ratio has prognostic relevance for patients undergoing total repair of pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries. To this purpose, we currently rely on 2 novel parameters: (1) preoperative total neopulmonary arterial index and (2) mean pulmonary artery pressure changes during an intraoperative flow study. Methods: Since January 1994, 15

Adriano Carotti; Roberto M. Di Donato; Cosimo Squitieri; Paolo Guccione; Glauco Catena

1998-01-01

398

Considerations for numerical modeling of the pulmonary circulation--a review with a focus on pulmonary hypertension.  

PubMed

Both in academic research and in clinical settings, virtual simulation of the cardiovascular system can be used to rapidly assess complex multivariable interactions between blood vessels, blood flow, and the heart. Moreover, metrics that can only be predicted with computational simulations (e.g., mechanical wall stress, oscillatory shear index, etc.) can be used to assess disease progression, for presurgical planning, and for interventional outcomes. Because the pulmonary vasculature is susceptible to a wide range of pathologies that directly impact and are affected by the hemodynamics (e.g., pulmonary hypertension), the ability to develop numerical models of pulmonary blood flow can be invaluable to the clinical scientist. Pulmonary hypertension is a devastating disease that can directly benefit from computational hemodynamics when used for diagnosis and basic research. In the present work, we provide a clinical overview of pulmonary hypertension with a focus on the hemodynamics, current treatments, and their limitations. Even with a rich history in computational modeling of the human circulation, hemodynamics in the pulmonary vasculature remains largely unexplored. Thus, we review the tasks involved in developing a computational model of pulmonary blood flow, namely vasculature reconstruction, meshing, and boundary conditions. We also address how inconsistencies between models can result in drastically different flow solutions and suggest avenues for future research opportunities. In its current state, the interpretation of this modeling technology can be subjective in a research environment and impractical for clinical practice. Therefore, considerations must be taken into account to make modeling reliable and reproducible in a laboratory setting and amenable to the vascular clinic. Finally, we discuss relevant existing models and how they have been used to gain insight into cardiopulmonary physiology and pathology. PMID:23699723

Kheyfets, V O; O'Dell, W; Smith, T; Reilly, J J; Finol, E A

2013-06-01

399

Sentinel lymph node biopsy in Japan.  

PubMed

Similar to the practice in Western countries, intraoperative lymphatic mapping and selected lymphadenectomy (SLNB) have been validated and are widely performed for the staging of melanoma in Japan. Recent studies have shown that approximately 90% (73/81) of university hospitals and several cancer hospitals routinely perform SLNB, and half of all melanoma patients receive this examination. SLNB is performed according to a variation of the standard procedure described by Morton and Cochran. The most frequently used tracers are Tc(99m)-tin colloid or Tc(99m)-phytate for scintigraphy and patent blue violet or indigo carmine as a blue dye. Some institutions use indocyanine green, which is fluorescent and can be used to visualize sentinel lymph node(s) (SLNs) under an infrared camera. The recent detection rate of SLNs has increased to more than 95% with the method using blue dye, lymphoscintigraphy, and a handheld gamma probe. In a multicenter study, the rates of metastasis in SLN were as follows: pTis, 0% (0/36); pT1, 10.7% (6/56); pT2, 21.0% (13/63); pT3, 34.0% (35/103); and pT4, 62.4% (63/101). The metastasis rate was also significantly related to ulceration of the primary tumor. Here, we discuss data from Japanese patients and the present status of SLNB in Japan. PMID:19967483

Uhara, Hisashi; Takata, Minoru; Saida, Toshiaki

2009-12-05

400

Pulmonary Hypertension in Hemolytic Disorders  

PubMed Central

The inherited hemoglobin disorders sickle cell disease and thalassemia are the most common monogenetic disorders worldwide. Pulmonary hypertension is one of the leading causes of morbidity and mortality in adult patients with sickle cell disease and thalassemia, and hemolytic disorders are potentially among the most common causes of pulmonary hypertension. The pathogenesis of pulmonary hypertension in hemolytic disorders is likely multifactorial, including hemolysis, impaired nitric oxide (NO) bioavailability, chronic hypoxemia, chronic thromboembolic disease, chronic liver disease, and asplenia. In contrast to patients with traditional forms of pulmonary arterial hypertension, patients with hemolytic disorders have a mild-to-moderate degree of elevation in mean pulmonary pressures, with mild elevations in pulmonary vascular resistance. The hemodynamic etiology of pulmonary hypertension in these patients is multifactorial and includes pulmonary arterial hypertension, pulmonary venous hypertension, and pulmonary hypertension secondary to a hyperdynamic state. Currently, there are limited data on the effects of any specific treatment modality for pulmonary hypertension in patients with hemolytic disorders. It is likely that maximization of treatment of the primary hemoglobinopathy in all patients and treatment with selective pulmonary vasodilators and antiproliferative agents in patients with pulmonary arterial hypertension would be beneficial. However, there is still a major need for large multinational trials of novel therapies for this patient population.

Gladwin, Mark T.

2010-01-01

401

The Prognostic Significance of the Lymph Node Ratio in Axillary Lymph Node Positive Breast Cancer  

PubMed Central

Purpose This study evaluated the prognostic impact of the lymph node ratio (LNR; i.e., the ratio of positive to dissected lymph nodes) on recurrence and survival in breast cancer patients with positive axillary lymph nodes (LNs). Methods The study cohort was comprised of 330 breast cancer patients with positive axillary nodes who received postoperative radiotherapy between 1987 and 2004. Ten-year Kaplan-Meier locoregional failure, distant metastasis, disease-free survival (DFS) and disease-specific survival (DSS) rates were compared using Kaplan-Meier curves. The prognostic significance of the LNR was evaluated by multivariate analysis. Results Median follow-up was 7.5 years. By minimum p-value approach, 0.25 and 0.55 were the cutoff values of LNR at which most significant difference in DFS and DSS was observed. The DFS and DSS rates correlated significantly with tumor size, pN classification, LNR, histologic grade, lymphovascular invasion, the status of estrogen receptor and progesterone receptor. The LNR based classification yielded a statistically larger separation of the DFS curves than pN classification. In multivariate analysis, histologic grade and pN classification were significant prognostic factors for DFS and DSS. However, when the LNR was included as a covariate in the model, the LNR was highly significant (p<0.0001), and pN classification was not statistically significant (p>0.05). Conclusion The LNR predicts recurrence and survival more accurately than pN classification in our study. The pN classification and LNR should be considered together in risk estimates for axillary LNs positive breast cancer patients.

Kim, Ji-Yoon; Ryu, Mi-Ryeong; Choi, Byung-Ock; Park, Woo-Chan; Oh, Se Jeong; Won, Jong-Man

2011-01-01

402

Gene expression pattern in oral cancer cervical lymph node metastasis.  

PubMed

Treatment protocols for malignant tumors in the oral cavity differ greatly based on the presence of cervical lymph node metastasis. We applied gene expression profiling to the pathological lymph node status and used a training-test approach to evaluate the reliability of cDNA microarray-based classifications of 15 matched resected primary oral squamous cell carcinomas (OSCCs) and corresponding normal oral tissues. The clustering of all the microarray data was separated into two groups based on metastatic node positivity and node negativity. Furthermore, a 20-gene signature was identified that differentiated the testing set (n=8) with high classification accuracy (88%). Our findings support the hypothesis that the lymph node metastasis status can be predicted using the gene expression patterns of the primary OSCC, and may be a powerful tool in identifying patients at high risk of lymph node metastasis. PMID:17016585

Kato, Yoshikuni; Uzawa, Katsuhiro; Saito, Kengo; Nakashima, Dai; Kato, Masaki; Nimura, Yoshinori; Seki, Naohiko; Tanzawa, Hideki

2006-11-01

403

The endolymphatic perfusion of lymph nodes with toxic materials.  

PubMed Central

Individual lymph nodes of sheep were perfused, via a cannula in one of their afferent lymphatics, with a variety of toxic materials. This procedure was designed to ablate the parenchyma of the nodes so that the macrophage-rich afferent lymph would pass unaltered into the efferent duct, which also had been cannulated. Although many materials caused transient inflammation and/or immunoblastic responses, few caused lasting alterations in the cellular composition of the efferent lymph. Only melphalan, an alkylating agent, succeeded in damaging the internal structure of the nodes so that true afferent lymph appeared in the efferent duct and abundant dendritic macrophages could be collected. In the doses necessary to achieve this enough of the melphalan became systematized to produce a transient alopecia.

Hall, J. G.; Sinnett, H. D.

1989-01-01

404

Pulmonary endarterectomy is possible and effective without the use of complete circulatory arrest—the UK experience in over 150 patients  

Microsoft Academic Search

Objective: Pulmonary endarterectomy is the best treatment for patients with chronic thromboembolic pulmonary hypertension. Traditionally pulmonary endarterectomy has been performed utilising deep hypothermic circulatory arrest to provide a bloodless field, but some recent reports have challenged this concept. We reviewed our experience with selective antegrade cerebral perfusion as the initial strategy of controlling bronchial collateral flow to avoid complete circulatory

Bruce Thomson; Steven S. L. Tsui; John Dunning; Andrew Goodwin; Alain Vuylsteke; Ray Latimer; Joanna Pepke-Zaba; David P. Jenkins

2010-01-01

405

Pulmonary endarterectomy is possible and effective without the use of complete circulatory arrest—the UK experience in over 150 patients  

Microsoft Academic Search

Objective: Pulmonary endarterectomy is the best treatment for patients with chronic thromboembolic pulmonary hypertension. Traditionally pulmonary endarterectomy has been performed utilising deep hypothermic circulatory arrest to provide a bloodless field, but some recent reports have challenged this concept. We reviewed our experience with selective antegrade cerebral perfusion as the initial strategy of controlling bronchial collateral flow to avoid complete circulatory

Bruce Thomson; Steven S. L. Tsui; John Dunning; Andrew Goodwin; Alain Vuylsteke; Ray Latimer; Joanna Pepke-Zaba; David P. Jenkins

2008-01-01

406

THE RESPONSE OF THE POPLITEAL LYMPH NODE OF THE SHEEP TO SWINE INFLUENZA VIRUS  

Microsoft Academic Search

The response of the political lymph node of the sheep to influenza virus has been studied by following the changes in the cell population and antibody content of the efferent lymph. Antibody did not appear in the lymph in the primary response until about 140 hr. after challenge; this was well after the blast cell response in the lymph had

JB Smith; Bede Morris

1970-01-01

407

Intraoperative Evaluation of Sentinel Lymph Nodes for Metastatic Breast Carcinoma by Imprint Cytology  

Microsoft Academic Search

Background: The increasing utilization of lymphatic mapping techniques for breast carcinoma has made intraoperative evaluation of sentinel lymph nodes attractive. Axillary lymph node dissection can be performed during the initial surgery if the sentinel lymph node is positive, potentially avoiding a second operative procedure. At present the optimal technique for rapid sentinel lymph node assessment has not been determined. Both

Andrew J. Creager; Kim R. Geisinger; Stephen A. Shiver; Nancy D. Perrier; Perry Shen; Jo Ann Shaw; Peter R. Young; Edward A. Levine

2002-01-01

408

Characterization of sheep lung lymph lipoproteins: chemical and physical properties.  

PubMed

We have determined the composition and distribution of plasma and lung lymph lipoproteins from unanesthetized ewes. Cholesterol, triglyceride, and phospholipid levels in lung lymph were 45%, 50%, and 50%, respectively, of those in plasma. Lipoproteins from both lymph and plasma were separated into two major fractions: d less than 1.063 g/ml or "LDL", and d 1.063-1.21 g/ml or HDL. HDL was the major lipoprotein species in the plasma and lymph. Gradient gel electrophoresis of HDL on 4-30% gels showed that, in lymph, HDL particles were shifted to larger sizes; in addition to a peak at 8.5 nm, which was similar to plasma HDL, there were two additional components of larger size, one at 9.2 nm and the other at 12 nm. Electron microscopy revealed that lymph HDL contained two new particles not seen in plasma: large, round particles, 13.6 nm diameter, and discoidal particles, 18.7 by 4.9 nm, long and short axis, respectively. Compositional analysis of lymph HDL revealed a relative enrichment in free cholesterol as well as an enrichment in apolipoprotein E. Lymph "LDL" on gradient gel electrophoresis was extremely heterogeneous. Several peaks were evident in the 23-30 nm size range (similar to plasma "LDL"), but a supplementary component at approximately 15-16 nm was also present. Whereas plasma "LDL" on electron microscopy contained only round particles 26 nm in diameter, lymph contained an additional, unusual particle which was close-packed, with square geometry, and was 15 nm in diameter. Lymph apolipoprotein composition differed from that of plasma by the appearance of apoE and A-I as well as apoB. Particles containing apoE and A-I were separated from apoB-containing particles in a fraction of d 1.047-1.063 g/ml by density gradient centrifugation. On electron microscopy, this fraction revealed square-packing particles; the density and apolipoprotein composition suggest that these unusual particles are a continuum of HDL. Changes in the physical and chemical properties of lung lymph lipoproteins suggest that these particles are metabolically modified. PMID:6644186

Forte, T M; Cross, C E; Gunther, R A; Kramer, G C

1983-10-01

409

Isolation of Moraxella canis from an Ulcerated Metastatic Lymph Node  

PubMed Central

Moraxella canis was isolated in large numbers from an ulcerated supraclavicular lymph node of a terminal patient, who died a few days later. Although the patient presented with septic symptoms and with a heavy growth of gram-negative diplococci in the lymph node, blood cultures remained negative. M. canis is an upper-airway commensal from dogs and cats and is considered nonpathogenic for humans, although this is the third reported human isolate of this species.

Vaneechoutte, Mario; Claeys, Geert; Steyaert, Sophia; De Baere, Thierry; Peleman, Renaat; Verschraegen, Gerda

2000-01-01

410

Lymph node hyalinisation in rheumatoid arthritis and systemic sclerosis  

Microsoft Academic Search

AIMS--To review the histological features of lymph nodes excised from seven patients with rheumatoid arthritis and one with systemic sclerosis. METHODS--Lymph nodes excised from seven patients with rheumatoid arthritis and one patient with systemic sclerosis over a 10 year period were examined using the stains haematoxylin and eosin, periodic acid Schiff (PAS), Masson-trichrome, and Congo red for amyloid. RESULTS--Of the

W G McCluggage; H Bharucha

1994-01-01

411

Laparoscopic Pelvic and Paraaortic Lymph Node Dissection in the Obese  

Microsoft Academic Search

Objective. The aim of this study was to determine the utility of laparoscopic pelvic and paraaortic lymph node dissection in obese women.Methods. We performed a retrospective analysis from 1\\/8\\/96 to 1\\/14\\/01 at the University of Oklahoma Health Science Center, evaluating patients who had a Quetelet index (QI) ?28 and had planned laparoscopic bilateral pelvic and paraaortic lymph node dissections (lnd)

Dennis R. Scribner Jr.; Joan L. Walker; Gary A. Johnson; D. Scott McMeekin; Michael A. Gold; Robert S. Mannel

2002-01-01

412

Computer-aided lymph node detection in abdominal CT images  

NASA Astrophysics Data System (ADS)

Many malignant processes cause abdominal lymphadenopathy, and computed tomography (CT) has become the primary modality for its detection. A lymph node is considered enlarged (swollen) if it is more than 1 centimeter in diameter. Which lymph nodes are swollen depends on the type of disease and the body parts involved. Identifying their locations is very important to determine the possible cause. In the current clinical workflow, the detection and diagnosis of enlarged lymph nodes is usually performed manually by examining all slices of CT images, which can be error-prone and time consuming. 3D blob enhancement filter is a usual way for computer-aided node detection. We proposed a new 3D blob detector for automatic lymph node detection in contrast-enhanced abdominal CT images. Since lymph nodes are usually next to blood vessels, abdominal blood vessels were first segmented as a reference to set the search region for lymph nodes. Then a new detection response measure, blobness, is defined based on eigenvalues of the Hessian matrix and the object scale in our new blob detector. Voxels with higher blobness were clustered as lymph node candidates. Finally some prior anatomical knowledge was utilized for false positive reduction. We applied our method to 5 patients and compared the results with the performance of the original blobness definition. Both methods achieved sensitivity of 83.3% but the false positive rates per patient were 14 and 26 for our method and the original method, respectively. Our results indicated that computer-aided lymph node detection with this new blob detector may yield a high sensitivity and a relatively low FP rate in abdominal CT.

Liu, Jiamin; White, Jacob M.; Summers, Ronald M.

2010-03-01

413

Clinical significance of sentinel lymph node involvement in malignant melanoma  

Microsoft Academic Search

In the period 1997–2002, sentinel lymph node (SLN) surgery was performed on 179 primary skin melanoma patients, one to two\\u000a months after the removal of the primary. Staining with patent blue was combined with an isotope technique. Histological evaluation\\u000a of the sentinel lymph nodes was performed in serial sections. Immunohistochemical detection of S100, HMB-45, or Melan-A was\\u000a used in the

Gabriella Liszkay; Gábor Péley; István Sinkovics; Ilona Péter; Zsolt Orosz; Zsuzsa Fejôs; Béla Horváth; István Köves; Katalin Gilde; Miklós Kásler

2003-01-01

414

The Applications of Sentinel Lymph Node to Cancer  

Microsoft Academic Search

\\u000a It is likely that every solid neoplasm drains to an initial lymph node (sentinel lymph node – SLN) before spreading to regional\\u000a nodes or systemically. Focused evaluation of the SLN as originally described by Morton et al. in 1990 [1] has improved staging\\u000a accuracy in melanoma and breast cancer and has been applied to other solid neoplasms with the purpose

Anton J. Bilchik; Maria M. Gonzalez; Alexander Stojadinovic

415