Science.gov

Sample records for bronchi endobronchial irradiation

  1. Endobronchial ultrasound.

    PubMed

    Falcone, Franco; Fois, Flavio; Grosso, Daniele

    2003-01-01

    Complex technical problems interfered with the application of thoracic ultrasound (US) for studies and clinical research. Moreover, in contrast to radiologists, cardiologists, gastroenterologists, internists, obstetricians, gynecologists and others, pulmonologists were not trained in the basics of US images. However, endoscopic US methods were developed in the last 20 years and these methods also provided important results for pulmonologists. As soon as the technical problems interfering with US application in air-containing spaces were solved, endobronchial US (EBUS) became a valuable technique as well. With EBUS, the delicate multilayer structure of the tracheobronchial wall can be analyzed. This knowledge became decisive for the management of early cancer in the central airways. These lesions can undergo local treatment instead of surgical intervention if the bronchial cartilage is intact and if the adjacent lymph nodes are not involved. EBUS proved valuable as well for the staging of more advanced lung cancer, especially with regard to endoluminal, intramural and extraluminal tumor spread. Endobronchial endosonographers are able to diagnose mediastinal lymph nodes similar to the experience of gastrointestinal endosonographers. EBUS-guided transbronchial needle aspiration (TBNA) improved the results of N-staging of lung cancer, especially in difficult lymph node levels without any clear endoscopic landmarks. The possibility of identifying N2 and N3 stages by means of a nonsurgical procedure can modify the management of lung cancer and decrease the number of unnecessary surgical interventions. EBUS can reduce the need for more invasive procedures such as thoracoscopy or mediastinoscopy. It is also useful for biopsying peripheral lesions or solitary pulmonary nodules instead of fluoroscopic guidance and also plays an important role in the strategy of interventional endoscopy.

  2. [Endobronchial use of hemostatic drugs feracryl and amifer].

    PubMed

    Agaev, F F; Badalov, R K; Aliev, A A

    1990-01-01

    The results of endoscopic administration of hemostatic agents feracryl and Amifer in 147 cases are analysed. In 123 patients 5-10 ml of 1% feracryl were administered after endobronchial bioptic manipulations. Bleeding after collection of bioptic material from the bronchial mucosa was arrested by this method in 69 cases. Moderate bleeding in 42 cases was arrested by pressing to the wound surface a tampon saturated with a feracryl solution. Endoscopic occlusion of a bleeding bronchus by means of feracryl and Amifer was conducted in 16 patients with various forms of lung tuberculosis complicated by hemoptysis and pulmonary hemorrhage. In 9 cases with massive pulmonary hemorrhage 3-4 ml of 20% Amifer solution was administered by endobronchial route into the bleeding area. In 7 cases up to 10 ml of feracryl was introducedby ++endobronchial route. Temporary endoscopic hemostasis in patients with various forms of pulmonary tuberculosis made it possible to postpone an emergency operation for a period of up to 2 weeks in all cases. For the prevention of aspiration pneumonia the bronchi were repeatedly cleansed in 8 patients and therapeutic lavage of the bronchi was carried out in 7 patients.

  3. Pulmonary artery sarcoma diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration.

    PubMed

    Shingyoji, Masato; Ikebe, Dai; Itakura, Meiji; Nakajima, Takahiro; Itami, Makiko; Kimura, Hideki; Iizasa, Toshihiko

    2013-08-01

    Pulmonary artery sarcoma (PAS) is a rare tumor that is often detected at an advanced stage, when disease is so widespread that a radical surgical procedure is no longer indicated. Therefore, less invasive biopsy techniques are required to establish a definitive preoperative diagnosis. Endobronchial ultrasound (EBUS) is useful for producing real-time images of both lymph nodes and the interior of pulmonary arteries adjacent to the bronchi. We report a case with masslike lesions in the pulmonary artery that were observed by EBUS and from which tissue was obtained by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) to establish a diagnosis of PAS.

  4. Quick Dissection of the Segmental Bronchi

    ERIC Educational Resources Information Center

    Nakajima, Yuji

    2010-01-01

    Knowledge of the three-dimensional anatomy of the bronchopulmonary segments is essential for respiratory medicine. This report describes a quick guide for dissecting the segmental bronchi in formaldehyde-fixed human material. All segmental bronchi are easy to dissect, and thus, this exercise will help medical students to better understand the…

  5. Quick Dissection of the Segmental Bronchi

    ERIC Educational Resources Information Center

    Nakajima, Yuji

    2010-01-01

    Knowledge of the three-dimensional anatomy of the bronchopulmonary segments is essential for respiratory medicine. This report describes a quick guide for dissecting the segmental bronchi in formaldehyde-fixed human material. All segmental bronchi are easy to dissect, and thus, this exercise will help medical students to better understand the…

  6. Longstanding Endobronchial Foreign Body

    PubMed Central

    Trisolini, R.; Dore, R.; Bertolini, R.; Pasturenzi, L.; Catania, A. Fede; Gualtieri, G.; Torre, M.

    1999-01-01

    There are many circumstances in which the diagnosis of endobronchial inhalation of a foreign body (FB) can be missed. Generally, in such cases, within weeks or at most months from the event, clinical bronchopulmonary symptoms develop which allow a correct diagnosis to be made and significant complications to be avoided. We report the case of a patient in whom an endobronchial FB remained undiagnosed, because of lack of symptoms, for almost three years, and then caused signifiicant complications before being identified and removed. Problems related to diagnosis and therapy are discussed. PMID:18493510

  7. Endobronchial pleomorphic adenoma

    PubMed Central

    Ali, Syed Rizwan; Arrossi, Andrea Valeria; Mehta, Atul C.; Frye, Laura; Mazzone, Peter; Almeida, Francisco

    2016-01-01

    Pleomorphic adenomas are the most common tumors of the salivary glands. Rarely, they occur as benign lesions in the lungs in both the central airways and the lung parenchyma. Herein, we present a case of a 60-year-old smoker who was incidentally found to have an endobronchial mass while undergoing evaluation for a lung nodule. During bronchoscopy, a smooth globular nodule was identified at the main carina and removed using electrocautery snare. Histopathology examination revealed this to be a pleomorphic adenoma. PMID:28031854

  8. Endobronchial occlusive disease: Nd:YAG or PDT?

    NASA Astrophysics Data System (ADS)

    Regal, Anne-Marie; Takita, Hiroshi

    1991-06-01

    Patients with endobronchial occlusion commonly experience dyspnea, cough, hemoptysis, pneumonitis, and atelectasis. If luminal patency is not re-established, obstructive symptoms may progress to sepsis and death. Although the overall survival of patients with lung cancer may not be altered by relief of airway obstruction, the prognosis for this subset of patients may be improved by eliminating the septic complications of bronchial occlusion. Techniques to treat occluded bronchi include electro-fulguration, cryotherapy, brachytherapy, laser (CO2, Nd-YAG) therapy, and photodynamic therapy (PDT). These represent local forms of treatment and are intended to be palliative. Nd-YAG and PDT are the modalities more frequently utilized in this setting. Comparison of the two treatment forms may furnish insight regarding the appropriate role for each as individual therapies and as part of the armamentarium of cancer therapies.

  9. Endobronchial solitary fibrous tumor

    PubMed Central

    de Moraes, Marcelo Padovani Toledo; Colby, Thomas; Oliveira, Gilmar Felisberto; Hasimoto, Erica Nishida; Cataneo, Daniele Cristina; Cataneo, Antônio José Maria; De Faveri, Julio

    2016-01-01

    Solitary fibrous tumor (SFT) is a mesenchymal neoplasm that appears primarily in the pleura and rarely in intrapulmonary or endobronchial topography. The authors report the case of a 47-year-old woman who presented obstructive respiratory symptoms for 4 years. The chest computed tomography and bronchoscopy showed an obstructive polypoid lesion located between the trachea and the left main bronchus associated with distal atelectasis of the left lung. A resection of the lesion was performed and, macroscopically, the mass was oval, encapsulated, and firm, measuring 2.3 × 1.7 × 1.5 cm. Histology revealed low-grade mesenchymal spindle cell neoplasm, with alternating cellularity, myxoid areas, and mature adipose tissue outbreaks, as well as blood vessels with irregular walls. The immunohistochemical study was positive for CD34, CD99, and BCL2. The diagnosis was SFT in an unusual topography. The patient’s symptoms remitted after tumor excision, and no systemic problems were evident. SFTs primarily affect adults and often follow a benign course; however, their behavior is unpredictable. The presence of necrosis and mitotic activity may portend a poor prognosis. Endobronchial SFTs are rare but should be evaluated and monitored similar to SFTs at other sites, with a long-term follow-up. PMID:28210572

  10. Endobronchial radiation therapy (EBRT) in the management of lung cancer

    SciTech Connect

    Roach, M. III; Leidholdt, E.M. Jr.; Tatera, B.S.; Joseph, J. )

    1990-06-01

    Between October 1987 and November 1988, 19 endobronchial Iridium-192 line source placements were attempted in 17 patients with advanced incurable lung cancer. Approximately 30 Gy was delivered to the endobronchus using a low dose rate (LDR) afterloading technique delivering a mean dose of 70 cGy/hr at 5 mm. Improvement in subjective symptoms was noted in 67% of evaluable patients whereas objective responses defined by chest X ray and bronchoscopy were noted in 26% and 60%, respectively. No significant morbidity was observed. The radiation exposure to health care workers was low ranging from 10 to 40 mRem per treatment course with most of the staff receiving less than 10 mRem per treatment course (minimal detectable level 10 mRem). The results of this series are compared with selected series using low dose rate as well as intermediate dose rate (IDR) and high dose rate (HDR) endobronchial radiation therapy (EBRT). Based on bronchoscopic responses from the selected series reviewed, both HDR low total dose per treatment (range 7.5-10 Gy) and LDR high total dose per treatment (range 30-50 Gy) are effective in palliating the vast majority of patients with endobronchial lesions. Intermediate dose rate is also effective using fractions similar to high dose rate but total dose similar to low dose rate. The efficacy of endobronchial radiation therapy in the palliative setting suggest a possible role for endobronchial radiation therapy combined with external beam irradiation with or without chemotherapy in the initial management of localized lung cancer. Defining the optimal total dose, dose rate, and the exact role of endobronchial radiation therapy in the management of lung cancer will require large cooperative trials with standardization of techniques and definitions.

  11. The challenge of pulmonary endobronchial chondromatous hamartomas.

    PubMed

    Dimitrakakis, Georgios; Challoumas, Dimitrios; Rama Rao Podila, Sita; Mainwaring, Anne-Marie; Kolettis, Theophilos; Kornazewska, Margaret

    2014-01-01

    Pulmonary chondromatous (or chondroid) hamartomas are common benign tumours of the lung and may be either parenchymal or endobronchial. The latter are only rarely encountered and have a variation in their clinical presentation related to the endobronchial obstructive lesion, including atelectasis, pneumonia, hemoptysis. If not diagnosed early and treated properly, endobronchial hamartomas can cause irreversible lung damage. We present a review of the recent English literature over the diagnostic approach and management of pulmonary endobronchial chondromatous hamartomas.

  12. Endobronchial valves for advanced emphysema: an endobronchial follow-up.

    PubMed

    Salcedo, Pablo S; Seijo, Luis M; Zulueta, Javier J

    2014-01-01

    Lung volume reduction surgery is a therapeutic option for selected patients with advanced emphysema. However, it is an invasive procedure benefitting only a selected group of patients with heterogeneous upper lobe predominant disease and limited exercise capacity. The most widely studied alternatives are endobronchial valves. Hundreds of patients worldwide have undergone endobronchial valve placement. Although short-term outcomes have been described, little is known about the long-term side effects following this treatment, and endoscopic follow-up is virtually nonexistent. The images, biopsies, and microbiologic evidence accrued from this patient are witnesses to the natural evolution of endobronchial valves in the airways and should offer a word of caution with regard to valve placement in patients with life expectancies exceeding those typical of severe chronic obstructive lung disease.

  13. Second line palliative endobronchial radiotherapy with HDR Ir 192 in recurrent lung carcinoma.

    PubMed

    Zorlu, A Faruk; Selek, Ugur; Emri, Salih; Gurkaynak, Murat; Akyol, Fadil H

    2008-08-30

    To observe the efficiency of reirradiation with high dose rate intraluminal brachytherapy in symptomatic palliation of recurrent endobronchial tumors. Between January 1994 and June 1998, 21 patients diagnosed with recurrent endobronchial tumors following external beam radiotherapy were treated palliatively with high dose rate intraluminal irradiation at Hacettepe University Oncology Institute. A single fraction of 10 Gy was prescribed to the specified area in 9 patients and 15 Gy to 12. Endobronchial treatment improved the performance and reduced symptomatology in 17 (81%) patients. Ten dyspneic patients (10/14, 71%) recovered clinically with an accompanying radiological downstaging. The median symptomatic palliation was 45 days (range, 0-9 months), and the overall median survival was 5.5 months (range, 4-12 months). The palliative intrabronchial brachytherapy was well tolerated, with the exception of in one patient with a fatal hemorrhage, and another with medically salvaged bronchospasm and intrabronchial edema. Recurrent patients with a history of previous thoracic external beam irradiation can be effectively palliated with high dose rate endobronchial reirradiation if the symptoms are directly related to the endobronchial tumor.

  14. Endobronchial brachytherapy in the treatment of malignant lung tumours.

    PubMed

    Escobar-Sacristán, J A; Granda-Orive, J I; Gutiérrez Jiménez, T; Delgado, J M; Rodero Baños, A; Saez Valls, R

    2004-09-01

    A prospective study was made to assess the short-term clinical and endoscopic response to high-dose-rate endobronchial brachytherapy (HDREB) in patients with malignant endobronchial tumours. From July 1995 to May 2000, 288 HDREB sessions were carried out on 81 patients. The mean patient age was 61.57 yrs (range 34-82); males were predominant (87.65%). Tumours were primary in 76 patients (93.82%) and metastatic in five patients (6.18%). The inclusion criteria were malignant endobronchial tumour and either palliative treatment for incurable disease or intent-to-cure treatment for residual malignancy on the bronchial resection surface after surgery or an inoperable tumour. The exclusion criteria were as follows: impediments to catheter placement, expected survival <2 months, Karnofsky index <60, or absence of informed consent. The clinical response of a symptom was categorised as complete (disappearance of the symptom), partial (less than complete) or absent. The endoscopic response was considered to be complete if lesions disappeared and biopsy findings remained negative 1 month after the last radiation session; partial if lesions improved to some extent, but the biopsy findings were positive; and absent if there was no change in relation to baseline. The technique consisted of delivering high-dose irradiation from an Ir192 source to a target volume using one or two endobronchial catheters inserted under optical or video bronchoscopic guidance. Four sessions were scheduled at weekly intervals and 500 cGy was applied per session over a length of 1-9 cm, measured 0.5-1 cm from the centre of the source. In total, 85% of the symptoms analysed (haemoptysis, cough, dyspnoea, expectoration, and stridor) disappeared with HDREB, which was categorised as a complete response. The endoscopic response was complete in 56.79% of patients, partial or less than complete in 40.74% and absent in 2.46%. One major complication occurred (bronchial fistula 1.2%), but no lethal haemoptysis

  15. Endobronchial tuberculosis—a review

    PubMed Central

    Shahzad, Talha

    2016-01-01

    Endobronchial tuberculosis (EBTB) is a tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence. Patients may present with symptoms secondary to disease itself or from the complication of disease like endobronchial obstruction. Diagnosis requires a high index of suspicion. Computed tomography (CT) and bronchoscopy along with microbiological investigations are the most useful diagnostic tools for the confirmation as well as for the evaluation of the tracheobronchial stenosis. The goals of treatment are eradication of tubercle bacilli with anti-tubercular medications and the prevention of airway stenosis. Interventional Bronchoscopic techniques and surgery is required for those patients who develop severe tracheobronchial stenosis that causing significant symptoms including dyspnea, repeated post obstructive pneumonia or bronchiectasis. PMID:28149579

  16. Method for endobronchial video parsing

    NASA Astrophysics Data System (ADS)

    Byrnes, Patrick D.; Higgins, William E.

    2016-03-01

    Endoscopic examination of the lungs during bronchoscopy produces a considerable amount of endobronchial video. A physician uses the video stream as a guide to navigate the airway tree for various purposes such as general airway examinations, collecting tissue samples, or administering disease treatment. Aside from its intraoperative utility, the recorded video provides high-resolution detail of the airway mucosal surfaces and a record of the endoscopic procedure. Unfortunately, due to a lack of robust automatic video-analysis methods to summarize this immense data source, it is essentially discarded after the procedure. To address this problem, we present a fully-automatic method for parsing endobronchial video for the purpose of summarization. Endoscopic- shot segmentation is first performed to parse the video sequence into structurally similar groups according to a geometric model. Bronchoscope-motion analysis then identifies motion sequences performed during bronchoscopy and extracts relevant information. Finally, representative key frames are selected based on the derived motion information to present a drastically reduced summary of the processed video. The potential of our method is demonstrated on four endobronchial video sequences from both phantom and human data. Preliminary tests show that, on average, our method reduces the number of frames required to represent an input video sequence by approximately 96% and consistently selects salient key frames appropriately distributed throughout the video sequence, enabling quick and accurate post-operative review of the endoscopic examination.

  17. [Endobronchial hamartoma revealed by hemoptysis].

    PubMed

    Smati, Belhassen; Boudaya, Mohamed Sadok; Mestiri, Taher; Djilani, Habiba; Mezni, Faouzi; Kilani, Tarek

    2005-05-01

    Hamartoma is the most frequent benign tumor of the lung. Its endo bronchial location is rare. We report two cases of endo bronchial hamartoma occurring in 2 men aged 68 and 60 years respectively. The two cases were revealed by hemoptysis. Bronchial fibroscopy showed a bud respectively in the left stump and in the lower left bronchus. Treatment consisted in a pneumonectomy and a lower lobectomy. A histological examination confirmed the diagnosis of endo bronchial hamartoma. Diagnosis of endobronchial hamartoma before surgery is difficult. Pulmonary resections are often necessary because of parenchyma lelions caused bronchial obstruction.

  18. Recurrent endobronchial actinomycosis following an interventional procedure

    PubMed Central

    Padmanabhan, Arjun; Thomas, Abin Varghese

    2017-01-01

    Actinomycosis is an indolent, slowly progressive infection caused by anaerobic or microaerophilic bacteria, primarily from the genus Actinomyces. Thoracic involvement is observed in approximately 15% of cases of infection with actinomycosis. Here, we present a case of a 61-year-old male who presented with recurrent endobronchial actinomycosis. The case is being presented because of its rarity on three counts – endobronchial involvement, which is uncommon, recurrence in different sites in the bronchial tree, which is even rarer and development of the disease following an endobronchial procedure. PMID:28360473

  19. [Endobronchial anaplastic large cell lymphoma in childhood].

    PubMed

    Escobosa Sánchez, O M; Herrero Hernández, A; Acha García, T

    2009-05-01

    Anaplastic large cell lymphoma is a very rare disease in childhood. The most common location of this lymphoma is lymph node and skin, with endobronchial involvement being extremely rare. We report a case of a 10-year-old boy diagnosed by chance with an endobronchial anaplastic large cell lymphoma, while he was being investigated for a a benign bone disease, due to the initial absence of respiratory symptoms.

  20. Efficiency of use endobronchial laser doppler-flowmetry in patients with chronic leukemia

    NASA Astrophysics Data System (ADS)

    Vanina, E. A.; Voitsekhovskiy, V. V.; Landyshev, Y. S.; Tkacheva, S. I.

    2016-11-01

    In this work indicatorsendobronchial microcirculation were investigated in patients with chronic myeloid leukemia (CML), chronic lymphocytic leukemia (CLL), multiple myeloma (MM), polycythemia vera (PV), idiopathic myelofibrosis (IMF). A diagnostic bronchoscopy was performed using fibreoptic «Olympus» (Japan).Endobronchial laser Doppler flowmetry was carried out on the laser analyzer capillary blood LAK-02 (Russia). Laser Doppler flowmetry indicators such as parameter of microcirculation, the oscillation amplitude in the endothelial, neurogenic, myogenic, cardiac and respiratory ranges were calculated by continuous the Wavelet transforms. Reduced cardiac and respiratory amplitudes in CML and CLL are primarily due to the development leukostasis. If PV is the case, this is due to sludge syndrome. And when MM occurs, it is caused by protein stasis in the vessels of the bronchial tubes. Increased endothelial oscillation amplitudes in the range in CML, PV, IMF and their reduction in MM indicate the presence of endothelial dysfunction in these patients. Increasing the amplitude of oscillations in the range of neurogenic indicates the development of arteriolar vasodilation as a compensatory response to the violation of blood flow. Increasing the amplitude of oscillations of myogenic tone indicating decrease precapillaries as a compensatory reaction to improve blood flow. It is concluded that endobronchial laser Doppler flowmetry is an important method allowing diagnosing the pathology of the microvasculature of the bronchi in chronic leukemia.

  1. Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for the Diagnosis of Central Lung Parenchymal Lesions

    PubMed Central

    Verma, Akash; Jeon, Kyeongman; Koh, Won-Jung; Suh, Gee Young; Chung, Man Pyo; Kim, Hojoong; Kwon, O Jung

    2013-01-01

    Purpose The purpose of this study was to evaluate the usefulness of convex probe endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for detecting malignancy in parenchymal pulmonary lesions located adjacent to the central airways. Materials and Methods We retrospectively reviewed the diagnostic performance of EBUS-TBNA in consecutive patients with high clinical suspicion of a centrally located primary lung cancer who had undergone EBUS-TBNA at the Samsung Medical Center between May 2009 and June 2011. Results Thirty-seven patients underwent EBUS-TBNA for intrapulmonary lesions adjacent to the central airways. Seven lesions were located adjacent to the trachea and 30 lesions were located adjacent to the bronchi. Cytologic and histologic samples obtained via EBUS-TBNA were diagnostic in 32 of 37 (86.4%) of patients. The final diagnosis was lung cancer in 30 patients (7 small cell lung cancer, 23 non-small cell lung cancer), lymphoma in one and malignant fibrous histiocytoma in one patient. The diagnostic sensitivity of EBUS-TBNA in detecting malignancy and detecting both malignancy and benignity was 91.4% and 86.5%, respectively. Two patients experienced minor complications. Conclusion EBUS-TBNA is an effective and safe method for tissue diagnosis of parenchymal lesions that lie centrally close to the airways. EBUS-TBNA should be considered the procedure of choice for patients with centrally located lesions without endobronchial involvement. PMID:23549813

  2. Endobronchial Tuberculosis in Anthracotic Bronchitis.

    PubMed

    Rezaeetalab, Fariba; Farrokh, Donya

    2016-01-01

    Endobronchial tuberculosis (EBTB) is a serious form of pulmonary tuberculosis. In EBTB, mycobacterium tuberculosis involves trachea, large airways and bronchial trees Combustion of biomass fuels causes anthracotic bronchitis that is characterized by black pigmentation in bronchial tissue. The majority of anthracotic bronchitis are in aged patients, particularly rural women, that use biomass fuel for cooking or traditional bakery .The aim of this study was to evaluate the endobronchial tuberculosis in anthracotic bronchitis. In total, 483 EBTB patients who underwent flexible bronchoscopy (FB), for various indications, were included. Tuberculosis was confirmed by microbiological analysis of bronchoalveolar (smear and culture for Koch's bacillus) and histopathological methods. EBTB patients were divided in two groups: subjects with anthracotic bronchitis (group 1) and without anthracosis (group 2). Demographic data and important clinical, radiological and bronchoscopic findings were recorded. Chi-squre test and Spss 11.5 software were used for statistical analysis. 483 out of 1824 patients who underwent FB had EBTB. 73.7% patients had EBTB and anthracotic bronchitis (versus 27.3% EBTB without anthracosis). The mean age was significantly higher in EBTB and anthracotic bronchitis (68.45 ± 16.31 versus 49.08 ± 14.7). Female/male ratio was 1.4:4 in EBTB and anthracotic group versus 1:1 in non anthracotic patients. Dyspnea, cough, hemoptysis and wheezing were higher in group 1. History of biomass fuel was more significant in EBTB and anthracotic bronchitis. Mass, diffuse infiltration in lower lobes were revealed higher in radiography of group 1. Bronchoscopy showed the higher frequency of bronchial stenosis in EBTB with anthracosis (P value < 0.05). This study suggested significant association between EBTB and anthracotic bronchitis. Unusual findings in radiological and bronchoscopic features were seen in EBTB with anthracosis.

  3. Analysis of temperature regimes of hyperthermia of cancer of bronchi

    NASA Astrophysics Data System (ADS)

    Manak, I.; Lisenkova, A.; Nikolaeva, A.

    2006-02-01

    The model of laser hyperthermia of cancer of glandular epithelium of bronchi is offered. The conditions for achievement of destruction of cancer are determined. Simulation of processes of interaction of the continuous and pulse laser radiation with a multi-layer biotissue taking into account distribution of energy in laser radiation beam, blood stream, heat transfer, processes of absorption and dispersion are realized. Peculiar properties of hyperthermia of cancer of bronch at laser action are considered.

  4. Autoradiographic visualization of muscarinic receptors in human bronchi

    SciTech Connect

    van Koppen, C.J.; Blankesteijn, W.M.; Klaassen, A.B.; Rodrigues de Miranda, J.F.; Beld, A.J.; van Ginneken, C.A.

    1988-02-01

    To visualize muscarinic receptors in human bronchi, the stripping film method was used which permits direct autoradiographic localization of tissue labeling. Cryostate sections of human bronchi were fixed in 0.5% glutaraldehyde in Krebs-Ringer buffer, pH 7.0 for 30 min at 0/sup 0/C, washed in Krebs-Ringer buffer for 20 min at 0/sup 0/C and incubated with (-)-(/sup 3/H)Quinuclidinyl benzilate ((-)-(/sup 3/H)QNB) for 90 min at 37/sup 0/C. Specific (-)-(/sup 3/H)QNB binding to tissue sections was saturable (receptor density of 0.14 +/- 0.03 fmol/tissue section) and of high affinity (Kd of 40 +/- 9 pM). For autoradiography, labeled tissue sections were covered with stripping film and exposed for 5 months. Muscarinic receptors in human bronchi were located predominantly in submucosal glands and parasympathetic ganglia. There was less labeling in smooth muscle cells and nerve bundles. Epithelium and blood vessels located within the bronchial wall were devoid of specific labeling.

  5. Image-guided endobronchial ultrasound

    NASA Astrophysics Data System (ADS)

    Higgins, William E.; Zang, Xiaonan; Cheirsilp, Ronnarit; Byrnes, Patrick; Kuhlengel, Trevor; Bascom, Rebecca; Toth, Jennifer

    2016-03-01

    Endobronchial ultrasound (EBUS) is now recommended as a standard procedure for in vivo verification of extraluminal diagnostic sites during cancer-staging bronchoscopy. Yet, physicians vary considerably in their skills at using EBUS effectively. Regarding existing bronchoscopy guidance systems, studies have shown their effectiveness in the lung-cancer management process. With such a system, a patient's X-ray computed tomography (CT) scan is used to plan a procedure to regions of interest (ROIs). This plan is then used during follow-on guided bronchoscopy. Recent clinical guidelines for lung cancer, however, also dictate using positron emission tomography (PET) imaging for identifying suspicious ROIs and aiding in the cancer-staging process. While researchers have attempted to use guided bronchoscopy systems in tandem with PET imaging and EBUS, no true EBUS-centric guidance system exists. We now propose a full multimodal image-based methodology for guiding EBUS. The complete methodology involves two components: 1) a procedure planning protocol that gives bronchoscope movements appropriate for live EBUS positioning; and 2) a guidance strategy and associated system graphical user interface (GUI) designed for image-guided EBUS. We present results demonstrating the operation of the system.

  6. Endobronchial metastases from extrathoracic malignancies.

    PubMed

    Akoglu, Sebahat; Uçan, Eyüp S; Celik, Gülperi; Sener, Gülper; Sevinç, Can; Kilinç, Oğuz; Itil, Oya

    2005-01-01

    Endobronchial metastases (EBM) from extrapulmonary malignant tumors are rare. The most common extrathoracic malignancies associated with EBM are breast, renal and colorectal carcinomas. In this study, we aimed to evaluate the clinical, radiographic and bronchoscopic aspects of patients with EBM who were diagnosed between 1992 and 2002. Data about patients' clinical conditions, symptoms, radiographic and endoscopic findings, and histopathological examination results were investigated. EBM was defined as bronchoscopically visible lesions histopathologically identical to the primary tumor in patients with extrapulmonary malignancies. We found 15 cases with EBM. Primary tumors included breast (3), colorectal (3), and renal (2) carcinomas; Malignant Melanoma (2); synovial sarcoma (1), ampulla of Vater adenocarcinoma (1), pheochromocytoma (1), hypernephroma (1), and Hodgkin's Disease (1). The most common symptoms were dyspnea (80%), cough (66.6%) and hemoptysis (33.3%). Multiple (40%) or single (13.3%) pulmonary nodules, mediastinal or hilar lymphadenopathy (40%), and effusion (40%) were the most common radiographic findings. The mean interval from initial diagnosis to diagnosis of EBM was 32.8 months (range, 0-96 months) and median survival time was 18 months (range, 4-84). As a conclusion, various extrapulmonary tumors can metastasize to the bronchus. Symptoms and radiographic findings are similar with those in primary lung cancer. Therefore, EBM should be discriminated from primary lung cancer histopathologically. Although mean survival time is usually short, long-term survivors were reported. Consequently, treatment must be planned according to the histology of the primary tumor, evidence of metastasis to other sites and medical status of the patient.

  7. Pulmonary Schizophyllum Commune Infection Developing Mucoid Impaction of the Bronchi

    PubMed Central

    Ishiguro, Takashi; Takayanagi, Noboru; Tokunaga, Daidou; Kurashima, Kazuyoshi; Matsushita, Aya; Harasawa, Keiji; Yoneda, Koichiro; Tsuchiya, Noriko; Yamaguchi, Shozaburo; Miyahara, Yousuke; Yano, Ryozo; Saito, Hiroo; Ubukata, Mikio; Yanagisawa, Tsutomu; Sugita, Yutaka; Kawabata, Yoshinori

    2008-01-01

    A 54-year-old woman was admitted for cough, sputum, and an abnormal chest X-ray shadow. Bronchoscopy showed mucoid impaction of the bronchi (MIB). Histopathologic evidence of mucous plugs was consistent with one component of allergic bronchopulmonary mycosis. Schizophyllum commune (S. commune) was identified. Two attempts at removal of the mucous plugs were unsuccessful. Itraconazole was then administered, and the mucous plugs disappeared. There are few reports of MIB due to S. commune; we herein report a case of MIB due to S. commune infection. PMID:18299722

  8. [Fiberoptic bronchoscopy in childhood endobronchial tuberculosis].

    PubMed

    Tagarro García, A; Barrio Gómez de Agüero, María I; Martínez Carrasco, C; Antelo Landeira, C; Díez Dorado, R; del Castillo, F; García de Miguel, María J

    2004-10-01

    Endobronchial tuberculosis is a classical manifestation of primary tuberculosis in childhood. Fiberoptic bronchoscopy (FB) is an ancillary diagnostic tool, but its utility and indications are not well established. To analyze the FB performed over 11 years (1992-2003) in children with a diagnosis of tuberculosis and to review the literature. A further aim was to establish the current usefulness of FB in children with tuberculosis and propose criteria to determine the indications for FB in this population. We report a retrospective series (n 5 16). FB was indicated in children who showed any of the following findings in chest roentgenogram: a) persistent parenchymal consolidation; b) lymphadenopathy and consolidation; c) hyperinsufflation (emphysema); d) atelectasias, and e) airway narrowing caused by lymphadenopathies. Published series on the topic were reviewed and six studies were suitable for comparison with our own. Endobronchial tuberculosis was found in seven children (43 %) and extrinsic compression was found in three (18 %). The microbiological results obtained from FB samples were not superior to those obtained from classical diagnostic methods. The sensitivity of the proposed criteria for suspicion of endobronchial tuberculosis was 71 %. Endoscopic findings justified a change in therapy in 50 % of the children (addition of corticoids or surgery) and this percentage was similar to that reported in other series. FB does not usually improve microbiological diagnosis of tuberculosis but can be useful when choosing the most appropriate therapy in children with suspected endobronchial tuberculosis. In some cases, computed tomography may make FB unnecessary, but in others this procedure can be therapeutic (obstruction due to caseum, atelectasias). Establishing the indications for FB in childhood tuberculosis is difficult, but the proposed criteria may be an acceptable guide to identifying which patients could benefit most from this procedure. Not all children

  9. [Thin-section computed tomography of the bronchi; 2. Right upper lobe and left upper division].

    PubMed

    Matsuoka, Y; Ookubo, T; Ohtomo, K; Nishikawa, J; Kojima, K; Oyama, K; Yoshikawa, K; Iio, M

    1990-02-01

    Thin (2mm) section contiguous computed tomographic (CT) scans were obtained through the bronchi of the right upper lobe and the left upper division in 30 patients. All segmental bronchi were identified. The right subsegmental bronchi were identified in 100%, and the left subsegmental bronchi in 97%. The type of the orifice of the right bronchus was trifurcated (53%), the extension of B1 was apicoanterior (50%), and the size of B2b was equal to B3a (63%). The extension of the left B3 was subapicoanterior (38%), and the size of B1+2c was equal to B3a (62%).

  10. Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Increases the Yield of Transbronchial Lung Biopsy for the Evaluation of Peribronchial Lesions

    PubMed Central

    Chen, Cheng; Mu, Chuan-Yong; Su, Mei-Qin; Mao, Jing-Yu; Zhu, Ye-Han; Huang, Jian-An

    2017-01-01

    Background: Due to absence of visible endobronchial target, the diagnostic yield of flexible bronchoscopy for peribronchial lesions has been unsatisfactory. Convex probe endobronchial ultrasound (CP-EBUS) has allowed for performing real-time transbronchial needle aspiration (TBNA) of enlarged hilar and mediastinal lymph nodes and therefore could also be used as a means of diagnosing proximal peribronchial lesions. Methods: We retrospectively analyzed the results related to 72 patients who underwent CP-EBUS for peribronchial lesions without endobronchial involvement and adjacent to three-grade bronchi based on chest computed tomography (CT) scan. We recorded the images during EBUS as well as the diagnostic results of TBNA and conventional-transbronchial lung biopsy/brush (C-TBLB/b), and final diagnoses were based on pathologic analysis and follow-up. Results: In all cases, the mass was able to be identified using EBUS in 97.2% patients (70/72) who were performed with EBUS-TBNA + C-TBLB/b. Sixty-six patients had a final diagnosis, 80.0% patients (56/70) had malignancies, and 14.3% patients (10/70) had benign disease. In malignancies, the diagnostic yield of C-TBLB/b was 57.1% (32/56) and in EBUS-TBNA was 85.7% (48/56), whereas pathologic diagnosis reached 94.6% when EBUS-TBNA was combined with C-TBLB/b. C-TBLB/b + EBUS-TBNA also exhibited stronger potency of histolytic diagnosis for malignancies than either EBUS-TBNA or C-TBLB/b alone. Furthermore, there are data supporting the value of EBUS-TBNA for the diagnosis of benign lung disease. Conclusion: The combined endoscopic approach with EBUS-TBNA and C-TBLB/b is an accurate and effective method for the evaluation of peribronchial lesions, with better results than using each technique alone. PMID:28051017

  11. Surgical treatment of benign endobronchial tumours

    PubMed Central

    Halttunen, P; Meurala, H; Standertskjöld-Nordenstam, C-G

    1982-01-01

    Four cases of benign endobronchial tumour are reported which were successfully treated by bronchial resection. In two cases (of fibroma and leiomyoma respectively) a cylinder of bronchus alone was resected; in one case (lipoma) a healthy right upper lobe was preserved by a bronchoplastic procedure and in the other (chondroma) the tumour was removed with the right lower lobe, which was irreversibly damaged. It is important to recognise that such tumours are unsuitable for treatment by endoscopic means alone. Images PMID:7157223

  12. Cellular morphometry of the bronchi of human and dog lungs

    SciTech Connect

    Robbins, E.S.

    1991-09-01

    One hundred and forty-seven bronchial samples (generations 3--6) from 66 patients (62 usable; 36 female, 26 male; median age 61) have been dissected by generation from fixed surgical lung specimens obtained after the removal of pathological lesions. In addition, one hundred and fifty-six mongol dog bronchi (generations 2--6) dissected from different lobes of 26 dog lungs have also been similarly prepared. One hundred and twenty-seven human samples have been completely processed for electron microscopy and have yielded 994 electron micrographs of which 655 have been entered into the Computerized Stereological Analysis System (COSAS) and been used for the measurement of the distances of basal and mucous cell nuclei to the epithelial free surface. Similarly 328 micrographs of dog epithelium from 33 bronchial samples have been used to measure the distances of basal and mucous cell nuclei to the epithelial free surface and have been entered into COSAS. Using the COSAS planimetry program, we continue to expand our established data bases which describe the volume density and nuclear numbers per electron micrograph for 5 cell types of the human bronchial epithelial lining of men and women, as well as smokers, non-smokers and ex-smokers and similar parameters for the same 5 epithelial cell types of dog bronchi. Our micrographs of human bronchial epithelium have allowed us to analyze the recent suggestion that the DNA of lymphocytes may be subject to significant damage from Rn progeny while within the lung. Since the last progress report three papers have been submitted for publication. 17 refs., 4 tabs.

  13. Tracheal and endobronchial involvement in disseminated histoplasmosis: a case report.

    PubMed

    Youness, Houssein; Michel, Ross G; Pitha, Jan V; Jones, Kellie R; Kinasewitz, Gary T

    2009-12-01

    Histoplasmosis is an endemic fungal infection that can involve any organ when disseminated. Although oral, pharyngeal, laryngeal, and endobronchial involvement have been described, direct tracheal involvement has not been reported. We describe the first case of disseminated histoplasmosis with direct involvement of the trachea. The endobronchial manifestations of histoplasmosis are reviewed.

  14. Acid-induced secretory cell metaplasia in hamster bronchi

    SciTech Connect

    Christensen, T.G.; Lucey, E.C.; Breuer, R.; Snider, G.L.

    1988-02-01

    Hamsters were exposed to an intratracheal instillation of 0.5 ml of 0.08 N nitric, hydrochloric, or sulfuric acid to determine their airway epithelial response. Three weeks after exposure, the left intrapulmonary bronchi in Alcian blue/PAS-strained paraffin sections were evaluated for the amount of secretory product in the airway epithelium as a measure of secretory cell metaplasia (SCM). Compared to saline-treated control animals, all three acids caused statistically significant SCM. In addition to the bronchial lesion, all three acids caused similar interstitial fibrosis, bronchiolectasis, and bronchiolization of alveoli that varied in individual animals from mild to severe. In a separate experiment to study the persistence of the SCM, hamsters treated with a single instillation of 0.1 N nitric acid showed significant SCM 3, 7, and 17 weeks after exposure. There was a high correlation (r = 0.96) between a subjective assessment of SCM and objective assessment using a digital image-analysis system. We conclude that protons induce SCM independently of the associated anion; the SCM persists at least 17 weeks. Sulfuric acid is an atmospheric pollutant and nitric acid may form locally on the mucosa of lungs exposed to nitrogen dioxide. These acids may contribute to the development of maintenance of the SCM seen in the conducting airways of humans with chronic obstructive pulmonary disease.

  15. Successful bronchoscopic cryorecanalization in a case of endobronchial lipoma.

    PubMed

    Lamprecht, B; Hutarew, G; Porsch, P; Wegleitner, B; Studnicka, M

    2011-01-01

    Endobronchial lipomas are rare benign tumors; less than 150 cases have been reported so far. Bronchial occlusion usually leads to a misdiagnosis of asthma/COPD or malignancy. We report the case of a 67-year-old man with a history of heavy smoking (100 pack years), dyspnea on exertion, cough, and malaise who was treated for pneumonia for three weeks. Due to nonresolving atelectasis of the superior segment of the right lower lobe, a malignant endobronchial tumor was suspected. Rigid bronchoscopy with cryorecanalization led to both the definite histopathological diagnosis of endobronchial lipoma and the reopening of an endoluminal airway obstruction during one procedure.

  16. Endobronchial non-Hodgkin's lymphoma presenting as mass lesion.

    PubMed

    Mohapatra, P R; Bhuniya, S; Garg, S; Dimri, K; Janmeja, A K

    2009-01-01

    A 40-year-old male presented with clinical and radiological manifestations of right lung atelectasis and post-obstructive pneumonia. Flexible bronchoscopy revealed gross narrowing of the right upper lobe bronchus and a smooth, white endobronchial mass completely occluding the right lower lobe bronchus. Endobronchial biopsy from the mass lesion yielded low grade B-cell non-Hodgkin's lymphoma. This is one of the rarest presentation of non-Hodgkin's lymphoma.

  17. [Endobronchial granular cell tumor - what approach to take].

    PubMed

    Rego, Ana; Amado, Joana; Esteves, Idália; Almeida, José; Furtado, Antónia; Couceiro, António; Moura e Sá, João

    2006-01-01

    Granular cell tumor is a mesenchymal neoplasm almost always benign, with tendency to recurrence. Although it is more frequent in in the head and neck it has been described in almost all areas of the body. Its occurrence in the lung is extremely rare. The authors describe two cases of endobronchial granular cell tumours, discuss the particularities of this pathology as well as the treatment options, with particular attention to the use of endobronchial excision and criotherapy.

  18. Endobronchial Photoacoustic Microscopy for Staging of Lung Cancer

    DTIC Science & Technology

    2016-08-01

    AWARD NUMBER: W81XWH-14-1-0183 TITLE: Endobronchial Photoacoustic Microscopy for Staging of Lung Cancer PRINCIPAL INVESTIGATOR: Dr. Huabei...W81XWH-14-1-0183 Endobronchial Photoacoustic Microscopy for Staging of Lung Cancer 5b. GRANT NUMBER W81XWH-14-1-0183 5c. PROGRAM ELEMENT NUMBER 6...SUPPLEMENTARY NOTES Photoacoustic imaging, photoacoustic microscopy, lung cancer 14. ABSTRACT This research is aimed at developing a new endoscopic

  19. Do endobronchial valves improve outcomes in patients with emphysema?

    PubMed

    Barua, Anupama; Vaughan, Paul; Wotton, Robin; Naidu, Babu

    2012-12-01

    A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether endobronchial valves improve outcomes in patients with severe emphysema. Eighty-seven papers were found using the reported search, of which seven represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Endobronchial Valve for Emphysema Palliation Trial demonstrated that endobronchial valve increased forced expiratory volume in one second by 4.3% (95% confidence interval 1.4-7.2) and decreased by 2.5% in the control group (95% confidence interval -5.4 to 0.4) at a 6-month interval. This benefit is more marked in patients who do not have collateral ventilation into the area of lung being isolated as mapped by bronchoscopic physiological mapping (Chartis) or by computed tomography imaging documenting intact fissures. This evidence is reflected in the Endobronchial Valve for Emphysema Palliation Trial. Patients treated with endobronchial valve with high heterogeneity and complete fissures had greater improvement in forced expiratory volume in one second at 6- and 12-month intervals. We conclude that endobronchial valve placement improves lung function, exercise capacity and quality of life in selected patients with emphysematous diseases.

  20. PHACES syndrome associated with carcinoid endobronchial tumor.

    PubMed

    Mama, Nadia; H'mida, Dorra; Lahmar, Imen; Yacoubi, Mohamed Tahar; Tlili-Graiess, Kalthoum

    2014-05-01

    PHACES syndrome consists of the constellation of manifestations including posterior fossa anomalies of the brain (most commonly Dandy-Walker malformations), hemangiomas of the face and scalp, arterial abnormalities, cardiac defects, eye anomalies and sternal defects. We present a case with a possible PHACES syndrome including sternal cleft and supraumbilical raphé, precordial skin tag, persistent left superior vena cava and subtle narrowing of the aorta with an endobronchial carcinoid tumor. All these anomalies were discovered on chest multi-detector CT. This is a unique case of PHACES syndrome associated with carcinoid tumor. Review of the literature revealed 3 cases of PHACES syndrome with glial tumor. The authors tried to find the relationship between PHACES syndrome and carcinoid tumors or gliomas, which all derive from the neural crest cells.

  1. [Endobronchial ultrasonography (EBUS) for the internist].

    PubMed

    Stern, J-B; Wyplosz, B; Girard, P; Validire, P; Escaut, L; Caliandro, R

    2016-11-01

    Endobronchial ultrasonography (EBUS) is a recent mini-invasive technique allowing transbronchial needle aspiration (TBNA) of mediastinal lymph nodes as well as peribronchial lesions. EBUS was initially developed for lung cancer mediastinal staging. Over the years, indications for EBUS have been progressively extended to the scope of inflammatory disorders, mediastinal lymphomas, and infectious diseases. Particularly in immunosuppressed patients, including HIV-infected patients, EBUS allows the diagnosis of several diseases that involve the mediastinum, avoiding invasive surgical explorations such as mediastinoscopy or thoracoscopy. This review aims at discussing the technical aspects, and specifies indications, results, and limits of EBUS for the internist. Copyright © 2016 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  2. Rare Endobronchial metastasis from uterine leiomyosarcoma

    PubMed Central

    Ghosh, Saswata; Kundu, Susmita; Pal, Amitava; Paul, Suman

    2015-01-01

    Uterine sarcomas are rare and represent approximately 3.2% of all invasive uterine cancers. The annual incidence rate is less than two per 100,000 women. The median age at which uterine sarcoma diagnosed is 56 years. The most common histologic pattern is leiomyosarcoma (LMS) which originates from the myometrium or myometrial vessels. Uterine LMSs are aggressive tumors with high rates of recurrence. The most common mode of spread is hematogenous, with lymphatic spread being rare. Recurrences of up to 70% are reported in stage I and II disease with the site of recurrence being distal, most commonly the lungs or the upper abdomen. But the intra bronchial spread is extremely rare. Here we are reporting a case of uterine LMS with endobronchial metastasis causing whole lung collapse. PMID:25814801

  3. A system for endobronchial video analysis

    NASA Astrophysics Data System (ADS)

    Byrnes, Patrick D.; Higgins, William E.

    2017-03-01

    Image-guided bronchoscopy is a critical component in the treatment of lung cancer and other pulmonary disorders. During bronchoscopy, a high-resolution endobronchial video stream facilitates guidance through the lungs and allows for visual inspection of a patient's airway mucosal surfaces. Despite the detailed information it contains, little effort has been made to incorporate recorded video into the clinical workflow. Follow-up procedures often required in cancer assessment or asthma treatment could significantly benefit from effectively parsed and summarized video. Tracking diagnostic regions of interest (ROIs) could potentially better equip physicians to detect early airway-wall cancer or improve asthma treatments, such as bronchial thermoplasty. To address this need, we have developed a system for the postoperative analysis of recorded endobronchial video. The system first parses an input video stream into endoscopic shots, derives motion information, and selects salient representative key frames. Next, a semi-automatic method for CT-video registration creates data linkages between a CT-derived airway-tree model and the input video. These data linkages then enable the construction of a CT-video chest model comprised of a bronchoscopy path history (BPH) - defining all airway locations visited during a procedure - and texture-mapping information for rendering registered video frames onto the airwaytree model. A suite of analysis tools is included to visualize and manipulate the extracted data. Video browsing and retrieval is facilitated through a video table of contents (TOC) and a search query interface. The system provides a variety of operational modes and additional functionality, including the ability to define regions of interest. We demonstrate the potential of our system using two human case study examples.

  4. Suture or Stapling Are Superior in Comparison to Bipolar Sealing for Closing the Bronchi.

    PubMed

    Kirschbaum, Andreas; Waubke, Katharina; Pehl, Anika; Steinfeldt, Thorsten; Bartsch, Detlef K

    2016-07-05

    Background Every anatomical lung resection requires the airtight closure of at least one bronchus. In current clinical practice, these bronchi are sealed with sutures or staplers. This study investigated in an ex vivo pig model whether a new bipolar sealing device MARSEAL (KLS Martin, Tuttlingen, Germany) could be an alternative for this purpose. Methods Complete bronchial trees were prepared free from pig heart-lung blocks that were removed at a slaughterhouse. These preparations were taken to the laboratory, and main, lobar, and segmental bronchi were closed using sutures, staples, or bipolar sealing. Each trachea was then intubated and connected to a ventilating device. The initial airtight closure of the bronchus was first tested with lung-protective ventilation. After 15 minutes of ventilation, the inspiratory ventilation pressure was slowly increased and the burst pressure (in mbar) was recorded. Each group included 12 bronchus closures. Group mean burst pressures were compared using a nonparametric test (Mann-Whitney U test). The significance level was p < 0.05. Results The main bronchi closed both stapler magazines or sutures were all initially airtight during ventilation. The mean burst pressure was 60 ± 0 mbar for staplers and 57.92 ± 5.8 mbar for sutures. In contrast, 50% of main bronchi sealed with MARSEAL devices (5 or 10 mm) leaked air from the beginning. This was also noted in all lobar bronchi sealed with the MARSEAL 5-mm device and 80% of those sealed with the MARSEAL 10-mm device. The mean burst pressure of initially airtight lobar bronchi was 12.7 ± 7.25 mbar. In contrast, all segmental bronchi (mean width: 1.6 cm) were airtight when ventilated. Mean burst pressure was 14.64 ± 9.1 mbar with the MARSEAL 5-mm device and 29.64 ± 21.3 mbar with the MARSEAL 10-mm device. Histological investigation of the preparations (with hematoxylin and eosin staining) showed intact cartilaginous structures that were largely

  5. Cell Counting in Human Endobronchial Biopsies - Disagreement of 2D versus 3D Morphometry

    PubMed Central

    Bratu, Vlad A.; Erpenbeck, Veit J.; Fehrenbach, Antonia; Rausch, Tanja; Rittinghausen, Susanne; Krug, Norbert; Hohlfeld, Jens M.; Fehrenbach, Heinz

    2014-01-01

    Question Inflammatory cell numbers are important endpoints in clinical studies relying on endobronchial biopsies. Assumption-based bidimensional (2D) counting methods are widely used, although theoretically design-based stereologic three-dimensional (3D) methods alone offer an unbiased quantitative tool. We assessed the method agreement between 2D and 3D counting designs in practice when applied to identical samples in parallel. Materials and Methods Biopsies from segmental bronchi were collected from healthy non-smokers (n = 7) and smokers (n = 7), embedded and sectioned exhaustively. Systematic uniform random samples were immunohistochemically stained for macrophages (CD68) and T-lymphocytes (CD3), respectively. In identical fields of view, cell numbers per volume unit (NV) were assessed using the physical disector (3D), and profiles per area unit (NA) were counted (2D). For CD68+ cells, profiles with and without nucleus were separately recorded. In order to enable a direct comparison of the two methods, the zero-dimensional CD68+/CD3+-ratio was calculated for each approach. Method agreement was tested by Bland-Altmann analysis. Results In both groups, mean CD68+/CD3+ ratios for NV and NA were significantly different (non-smokers: 0.39 and 0.68, p<0.05; smokers: 0.49 and 1.68, p<0.05). When counting only nucleated CD68+ profiles, mean ratios obtained by 2D and 3D counting were similar, but the regression-based Bland-Altmann analysis indicated a bias of the 2D ratios proportional to their magnitude. This magnitude dependent deviation differed between the two groups. Conclusions 2D counts of cell and nuclear profiles introduce a variable size-dependent bias throughout the measurement range. Because the deviation between the 3D and 2D data was different in the two groups, it precludes establishing a ‘universal conversion formula’. PMID:24663339

  6. Detection of endobronchial intubation by monitoring the CO2 level above the endotracheal cuff.

    PubMed

    Efrati, Shai; Deutsch, Israel; Weksler, Nathan; Gurman, Gabriel M

    2015-02-01

    Early detection of accidental endobronchial intubation (EBI) is still an unsolved problem in anesthesia and critical care daily practice. The aim of this study was to evaluate the ability of monitoring above cuff CO2 to detect EBI (the working hypothesis was that the origin of CO2 is from the unventilated, but still perfused, lung). Six goats were intubated under general anesthesia and the ETT positioning was verified by a flexible bronchoscope. The AnapnoGuard system, already successfully used to detect air leak around the ETT cuff, was used for continuous monitoring of above-the-cuff CO2 level. When the ETT distal tip was located in the trachea, with an average cuff pressure of 15 mmHg, absence of CO2 above the cuff was observed. The ETT was then deliberately advanced into one of the main bronchi under flexible bronchoscopic vision. In all six cases the immediate presence of CO2 above the cuff was identified. Further automatic inflation of the cuff, up to a level of 27 mmHg, did not affect the above-the-cuff measured CO2 level. Withdrawal of the ETT and repositioning of its distal tip in mid-trachea caused the disappearance of CO2 above the cuff in a maximum of 3 min, confirming the absence of air leak and the correct positioning of the ETT. Our results suggest that measurement of the above-the-cuff CO2 level could offer a reliable, on-line solution for early identification of accidental EBI. Further studies are planned to validate the efficacy of the method in a clinical setup.

  7. [Endobronchial Hamartoma Requiring Lobectomy;Report of a Case].

    PubMed

    Matsunaga, Kyosuke; Takanashi, Yusuke; Oiki, Hironobu; Hayakawa, Takamitsu; Matsuura, Shun; Neyatani, Hiroshi

    2016-12-01

    We present a rare case of endobronchial hamartoma that required right middle and lower lobectomy. A 59-year-old man presented with cough and sputum lasting for 9 months. Chest X-ray revealed obstructive pneumonia of the right inferior lobe. Chest computed tomography demonstrated an intrabronchial mass lesion, size 12×12 mm, occluding the entrance of the right lower lobe bronchus associated with obstructive pneumonia of the right inferior lobe. Because transbronchial biopsy could not confirm the diagnosis, we performed a right middle and lower lobectomy to diagnose and treat obstructive pneumonia. Histopathological diagnosis of the tumor was hamartoma. Hamartoma, the most common benign lung tumor, is classified into the following 2 types:pulmonary parenchyma and endobronchial, the latter is relatively rare. Although hamartomas have benign characteristics, cases of endobronchial hamartomas associated with obstructive pneumonia may require lobectomy.

  8. Pre-surgical bronchoscopic treatment for typical endobronchial carcinoids.

    PubMed

    Guarino, Carmine; Mazzarella, Gennaro; De Rosa, Nicolina; Cesaro, Cristiano; La Cerra, Giuseppe; Grella, Edoardo; Perrotta, Fabio; Curcio, Carlo; Guerra, Germano; Bianco, Andrea

    2016-09-01

    Carcinoids are tumors that originate from diffuse neuroendocrine system cells (APUD cells) and represent 1-2% of all pulmonary tumors. Although surgical resection remains the mainstay of treatment, bronchoscopic radical resection of typical carcinoids in selected cases exhibiting endoluminal growth and small implant base has also been explored. Bronchoscopic removal of endobronchial lesions may also reduce the risk of post-obstructive infections and improve pulmonary function, allowing the patient to undergo surgery in better clinical and respiratory state. In this paper we have evaluated the impact on surgical planning and outcome of preoperative bronchoscopic resection in treatment of endobronchial typical carcinoids. Our observations further support the role of bronchoscopic treatment before surgery in endobronchial typical carcinoids.

  9. Endobronchial Carcinoid and Concurrent Carcinoid Syndrome in an Adolescent Female

    PubMed Central

    Swanson, Jonathan; Ong, Thida

    2016-01-01

    Endobronchial carcinoid tumors are the most common intrabronchial tumors in children and adolescents. Common signs and symptoms include persistent cough and wheezing not responsive to bronchodilators, hemoptysis, and recurrent fever. Diagnosis is frequently made by imaging and direct visualization with flexible bronchoscopy; surgery remains the gold standard treatment, and lung-sparing resections should be performed whenever possible. Though carcinoid syndrome—characterized by flushing, palpitations, wheezing, shortness of breath, and diarrhea—has been found in association with adult bronchial carcinoid tumors, to our knowledge only one previous study has reported the presence of carcinoid syndrome in a pediatric patient with an endobronchial carcinoid. Here, we report a case of a 14-year-old girl with chronic cough found to have an endobronchial carcinoid tumor and signs and symptoms consistent with carcinoid syndrome. PMID:27895950

  10. Endobronchial ultrasound: morphological predictors of benign disease.

    PubMed

    Gogia, Pratibha; Insaf, Tabassum Z; McNulty, William; Boutou, Afroditi; Nicholson, Andrew G; Zoumot, Zaid; Shah, Pallav L

    2016-01-01

    The objective of this study was to assess the utility of endobronchial ultrasound (EBUS) morphology of lymph nodes in predicting benign cytology of transbronchial needle aspirates in a prospective observational study. Five ultrasonic morphological characteristics of mediastinal and hilar lymph nodes were recorded: size, shape, margins, echogenic appearance and the presence of a central blood vessel. These characteristics were correlated with the final diagnosis. A total of 402 consecutive patients (237 males and 165 females) undergoing EBUS were studied. The final diagnosis was malignant disease in 244 (60.6%) and benign disease in 153 (38.05%) subjects. Out of 740 sampled nodes, in 463 (62.6%) malignant cells were identified, whereas in 270 (36.5%) nodes, no malignant cells were identified. On univariate analysis small size, triangular shape and the presence of a central vessel were predictive of a benign aetiology. In the final multivariate model, a predictive probability of 0.811 (95% CI 0.72-0.91) for benign disease was found if lymph node size was <10 mm and a central vessel was present. Sonographic appearances of lymph nodes improve the predictive probability of EBUS for benign aetiologies, and may reduce the number of nodes requiring sampling and the need for further invasive investigations.

  11. Computer aided detection of endobronchial valves

    NASA Astrophysics Data System (ADS)

    Ochs, Robert A.; Goldin, Jonathan G.; Abtin, Fereidoun; Ghurabi, Raffi; Rao, Ajay; Ahmad, Shama; da Costa, Irene; Brown, Matthew

    2008-03-01

    The ability to automatically detect and monitor implanted devices may serve an important role in patient care and the evaluation of device and treatment efficacy. The purpose of this research was to develop a system for the automated detection of one-way endobronchial valves implanted as part of a clinical trial for less invasive lung volume reduction. Volumetric thin section CT data was obtained for 275 subjects; 95 subjects implanted with 246 devices were used for system development and 180 subjects implanted with 354 devices were reserved for testing. The detection process consisted of pre-processing, pattern-recognition based detection, and a final device selection. Following the pre-processing, a set of classifiers were trained using AdaBoost to discriminate true devices from false positives (such as calcium deposits). The classifiers in the cascade used simple features (the mean or max attenuation) computed near control points relative to a template model of the valve. Visual confirmation of the system output served as the gold standard. FROC analysis was performed for the evaluation; the system could be set so the mean sensitivity was 96.5% with a mean of 0.18 false positives per subject. These generic device modeling and detection techniques may be applicable to other devices and useful for monitoring the placement and function of implanted devices.

  12. First images of respiratory system in ancient Egypt: Trachea, bronchi and pulmonary lobes.

    PubMed

    Kwiecinski, Jakub

    2012-01-01

    Examination of ancient Egyptians' depictions of the respiratory tract, dating back to the 30th century BC, reveals their awareness of the pulmonary anatomy: reinforced with cartilaginous rings, the trachea is split into two main bronchi, which then enter the lungs (lungs being divided into pulmonary lobes).

  13. Lingual nerve paralysis after endobronchial ultrasound utilizing laryngeal mask airway.

    PubMed

    Dhillon, Samjot Singh; O'Leary, Kathleen

    2012-01-01

    A 52-year-old woman developed loss of sensation and taste in the anterior two thirds of her tongue after undergoing endobronchial ultrasound-guided transbronchial needle aspiration using a laryngeal mask airway (LMA). This was believed to be due to bilateral lingual nerve injury, likely caused by stretching of tissue of the upper airway because of repetitive movements of LMA during attempts to obtain a clearer ultrasound image to direct needle insertion. To the best of our knowledge, this is the first report of lingual nerve injury after an endobronchial ultrasound procedure using LMA.

  14. [Endobronchial brachytherapy: state of the art in 2013].

    PubMed

    Derhem, N; Sabila, H; Mornex, F

    2013-04-01

    Endobronchial brachytherapy is an invasive technique, which allows localizing radioactive sources at the tumour contact. Therefore, high doses are administered to tumour while healthy tissues can be spared. Initially dedicated to a palliative setting, improvements helped reaching 60 to 88% symptoms alleviation and 30 to 100% of endoscopic macroscopic response. New diagnostic techniques and early diagnosis extended the indications to a curative intent: endoluminal primitive tumour, post radiation endobronchial recurrence, inoperable patients. CT-based dosimetry is a keypoint to optimize treatment quality and to minimize potential side effects, making this treatment a safe and efficient technique for specific indications.

  15. Unstable endobronchial intubation in a cat undergoing tracheal laceration repair.

    PubMed

    Kästner, Sabine B R; Grundmann, Stefan; Bettschart-Wolfensberger, Regula

    2004-07-01

    A peri-carinal tracheal laceration was produced in a 11-year-old cat during tracheal intubation. Before reconstructive surgery began, the leak was bypassed with an endobronchial tube positioned using endoscopy and direct vision. However, single-lung ventilation could not be sustained because the tube became dislodged and could not be repositioned. Consequently, surgery was completed with periods of intermittent apnoea interspersed with manually controlled hyperventilation. Cardiovascular variables were stable during anaesthesia and no signs of hypoxia were detected. The difficulties in maintaining endobronchial tube position resulted from the animal's small size relative to the dimensions of the endotracheal tube.

  16. Nociceptin inhibits vanilloid TRPV-1-mediated neurosensitization induced by fenoterol in human isolated bronchi.

    PubMed

    Faisy, Christophe; Naline, Emmanuel; Rouget, Céline; Risse, Paul-André; Guerot, Emmanuel; Fagon, Jean-Yves; Chinet, Thierry; Roche, Nicolas; Advenier, Charles

    2004-09-01

    Chronic exposure to beta(2)-adrenoceptor agonists, especially fenoterol, has been shown to increase smooth muscle contraction to endothelin-1 in human bronchi partly through tachykinin-mediated pathways. The purpose of this work was to further investigate the role of sensory nerves in fenoterol-induced sensitization of human airways and the effect of nociceptin, a nociceptin/orphanin FQ (NOP) receptor agonist, on the increase in contraction after fenoterol exposure. Human bronchi from 62 patients were sensitized to endothelin-1 by prolonged incubation with fenoterol (0.1 microM, 15 h). The sensitizing effect of fenoterol was inhibited by high concentration of capsaicin (10 microM, 30 min before fenoterol sensitization), which induces depletion of mediators from sensory nerves, or co-incubation of fenoterol and capsazepine (1 microM), a vanilloid TRPV-1 receptor antagonist. Moreover, short pretreatment of bronchi with capsaicin (10 microM) or capsazepine (1 microM) after sensitization by fenoterol decreased the rise in smooth muscle contraction to endothelin-1. Nociceptin (1 microM) also inhibited the increased contraction in fenoterol-sensitized bronchi. Tertiapin (10 microM), an inhibitor of the inward-rectifier K(+) channels, but not naloxone (0.1 microM), a DOP/KOP/MOP receptor antagonist, prevented the inhibitory effect of nociceptin. In conclusion, fenoterol induces sensitization of human isolated bronchi to endothelin-1 in part through the stimulation of the vanilloid TRPV-1 receptor on tachykininergic sensory nerves. Nociceptin inhibits airway hyperresponsiveness via NOP receptor activation. This effect involves inward-rectifier K(+) channels.

  17. Endobronchial therapy with a thulium fiber laser (1940 nm).

    PubMed

    Gesierich, Wolfgang; Reichenberger, Frank; Fertl, Andreas; Haeussinger, Karl; Sroka, Ronald

    2014-06-01

    Nd:YAG laser (1064 nm) is standard in bronchology. The thulium fiber laser (1940 nm) has a nearly 1000-fold increased absorption in water, enabling precise tissue ablation with a small margin of coagulation, whereas 1064-nm laser light penetrates deeper into tissue with less controllable effects. To assess the safety, feasibility, and versatility of endobronchial thulium laser therapy in an observational cohort study. Endobronchial treatment with the thulium fiber laser was performed in a cohort study of 187 bronchoscopies on 132 consecutive patients with 135 endobronchial lesions amenable to laser resection. The thulium fiber laser produced superficial, precise, and rapid tissue ablation. Eighty-one lesions were completely vaporized; 82 lesions were treated by deep tissue destruction by inserting the fiber into tissue followed by mechanical resection. Tumor bleeding was coagulated with rapid and sustained hemostasis (n = 28). Nitinol stents were removed after resection of severe granulation tissue overgrowth (n = 10). Intact stents were maintained after ablation of in-stent tissue (n = 47). In 11 cases, bleeding occurred during laser treatment (n = 11 of 187). Power settings between 5 and 20 W were found to be safe. Endobronchial therapy with the thulium laser at 1940 nm seems to be safe, feasible, and highly versatile for treatment of airway stenosis and stent obstruction caused by tissue ingrowth. Further studies are warranted. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  18. Endobronchial valves in the management of recurrent haemoptysis.

    PubMed

    Koegelenberg, Coenraad F N; Bruwer, Johannes W; Bolliger, Chris T

    2014-01-01

    Minimally invasive treatment modalities for life-threatening haemoptysis in patients unresponsive to medical interventions and/or in patients deemed functionally inoperable are limited. We describe the implantation of endobronchial valves in a patient with recurrent haemoptysis, which presents both a novel indication for the use of these devices and a novel intervention for haemoptysis. Our patient is a 30-year-old male who developed bilateral upper lobe aspergillomata following previous pulmonary tuberculosis. The patient had a history of multiple hospitalisations for life-threating haemoptysis despite repeated bronchial artery embolisations. He was deemed to be inoperable given the bilateral nature of his disease and very poor pulmonary reserves. We proceeded to identify the segments involved with the aid of computed tomography reconstruction and implanted 3 endobronchial valves. Our patient remained haemoptysis free for 6 months and experienced no stent-related complications. Moreover, he was subsequently employed as a manual labourer and showed significant improvements in his functional capacity. Endobronchial valves may therefore represent a viable medium-term treatment option as a blockade device in patients unresponsive to medical interventions and/or in patients deemed functionally inoperable. Prospective studies are indicated to better delineate the role of endobronchial valves in this setting. © 2013 S. Karger AG, Basel.

  19. Endobronchial Photoacoustic Microscopy for Staging of Lung Cancer

    DTIC Science & Technology

    2015-06-01

    Microscopy for Staging of Lung Cancer PRINCIPAL INVESTIGATOR: Huabei Jiang CONTRACTING ORGANIZATION: University of Florida Gainsville, FL 32611...TYPE Annual report 3. DATES COVERED 1 Jun 2014 - 31 May 2015 4. TITLE AND SUBTITLE Endobronchial Photoacoustic Microscopy for Staging of Lung ...Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT This project is to propose an endoscopic photoacoustic imaging method for lung cancer staging. In order

  20. Can endobronchial or endotracheal metastases appear from rectal adenocarcinoma?

    PubMed Central

    Serbanescu, GL; Anghel, RM

    2017-01-01

    Background: Endobronchial and endotracheal metastases from extra-pulmonary solid tumors are rare. Patients and methods: We reported the case of a patient diagnosed with endobronchial and endotracheal metastases from rectal adenocarcinoma. Case report: Patient P.G., 62 years old, was diagnosed with a rectal tumor in 2011, for which, a surgical intervention was performed (pT3 pN2a M0, stage IIIB). Afterwards, she underwent adjuvant chemotherapy and concomitant radiochemotherapy. In September 2013, the chest CT showed 2 nodules for which, an incomplete surgical resection was done and which were histopathologically diagnosed as metastases from rectal cancer. The patient continued the treatment with chemotherapy associated with Bevacizumab and after 6 months only Bevacizumab for maintenance. In June 2015, the chest CT pointed out a nodule in the right upper lobe and the bronchoscopy highlighted a 4-5 mm lesion at the level of the right primary bronchus, whose biopsy proved the rectal origin. Afterwards, another surgical intervention was performed. Unfortunately, the postoperative chest CT revealed an intratracheal tissue mass (11/ 7mm) and multiple metastases in the right lung. The bronchoscopy showed 2 endotracheal lesions, out of which one was biopsied (histopathological result of metastasis from rectal cancer). Despite the fact that chemotherapy was continued, other endobronchial lesions appeared. All of them were removed and the patient started radiotherapy on the tracheal area. Afterwards, she refused to continue chemotherapy. The last bronchoscopy highlighted one endobronchial and two endotracheal secondary malignant lesions. Conclusion: Endobronchial and endotracheal metastases must be taken into consideration in all the patients with a history of extra-pulmonary cancer. Abbreviations: CT = computed tomography, MRI = magnetic resonance imaging, IMRT = intensity-modulated radiotherapy, ESMO = European Society for Medical Oncology, NCCN = National Comprehensive

  1. Endobronchial occlusion with one-way endobronchial valves: a novel technique for persistent air leaks in children.

    PubMed

    Toth, Jennifer W; Podany, Abigail B; Reed, Michael F; Rocourt, Dorothy V; Gilbert, Christopher R; Santos, Mary C; Cilley, Robert E; Dillon, Peter W

    2015-01-01

    In children, persistent air leaks can result from pulmonary infection or barotrauma. Management strategies include surgery, prolonged pleural drainage, ventilator manipulation, and extracorporeal membrane oxygenation (ECMO). We report the use of endobronchial valve placement as an effective minimally invasive intervention for persistent air leaks in children. Children with refractory prolonged air leaks were evaluated by a multidisciplinary team (pediatric surgery, interventional pulmonology, pediatric intensive care, and thoracic surgery) for endobronchial valve placement. Flexible bronchoscopy was performed, and air leak location was isolated with balloon occlusion. Retrievable one-way endobronchial valves were placed. Four children (16 months to 16 years) had prolonged air leaks following necrotizing pneumonia (2), lobectomy (1), and pneumatocele (1). Patients had 1-4 valves placed. Average time to air leak resolution was 12 days (range 0-39). Average duration to chest tube removal was 25 days (range 7-39). All four children had complete resolution of air leaks. All were discharged from the hospital. None required additional surgical interventions. Endobronchial valve placement for prolonged air leaks owing to a variety of etiologies was effective in these children for treating air leaks, and their use may result in resolution of fistulae and avoidance of the morbidity of pulmonary surgery. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Endobronchial Lipomatous Hamartoma: An Incidental Finding in a Patient with Atrial Fibrillation—A Case Report

    PubMed Central

    Schneider, Friederike; Winter, Hauke; Schwarz, Florian; Niederhagen, Manuel; Arias-Herrera, Vivian; Martens, Eimo; Kääb, Stefan; Theiss, Hans

    2012-01-01

    Introduction. Lung hamartomas are the most common benign tumors of the lung. Typically, they are located in the peripheral lung, while an endobronchial localisation is rare. Case Presentation. We present a case with the rare diagnosis of an endobronchial hamartoma as incidental finding in a 69-year-old male, caucasian patient with atrial fibrillation. At first admission, the patient's exertional dyspnea was caused by atrial fibrillation. Relapse of exertional dyspnea in the absence of arrhythmia was due to postobstructive pneumonia caused by an endobronchial hamartoma. Conclusion. Endobronchial tumors such as endobronchial lipoma or hamartoma should be considered as potential causes of exertional dyspnea and thus as differential diagnosis of atrial fibrillation. Although endobronchial hamartomas are benign, resection is recommended to prevent postobstructive lung damage. PMID:22431943

  3. Late complication of a renal calculus: fistulisation to the psoas muscle, skin and bronchi.

    PubMed

    Snoj, Ziga; Savic, Nenad; Regvat, Jaka

    2015-01-01

    Kidney disease presenting with cutaneous fistula is a rare condition. We present a case of a 90-year-old woman with dementia who had no prior urological problems and had a cutaneous fistula in the left lumbar region. A fistulogram and computer tomography examination revealed a large staghorn calculus with signs of xanthogranulomatous pyelonephritis in the left kidney and renal fistulisation to the psoas muscle, skin and bronchi. To our knowledge this is the first report in the literature of coexisting renal fistulisation to the psoas major muscle, skin and bronchi. This report illustrates how computed tomography in combination with fistulography can resolve the diagnostic dilemma that pertains to the complex spread of the disease in cases involving nephrocutaneous fistula. Furthermore, the report shows how a renal calculus, even asymptomatic, can cause a serious medical condition, and highlights the importance of early medical intervention.

  4. Late complication of a renal calculus: fistulisation to the psoas muscle, skin and bronchi

    PubMed Central

    Snoj, Ziga; Savic, Nenad; Regvat, Jaka

    2015-01-01

    ABSTRACT Kidney disease presenting with cutaneous fistula is a rare condition. We present a case of a 90-year-old woman with dementia who had no prior urological problems and had a cutaneous fistula in the left lumbar region. A fistulogram and computer tomography examination revealed a large staghorn calculus with signs of xanthogranulomatous pyelonephritis in the left kidney and renal fistulisation to the psoas muscle, skin and bronchi. To our knowledge this is the first report in the literature of coexisting renal fistulisation to the psoas major muscle, skin and bronchi. This report illustrates how computed tomography in combination with fistulography can resolve the diagnostic dilemma that pertains to the complex spread of the disease in cases involving nephrocutaneous fistula. Furthermore, the report shows how a renal calculus, even asymptomatic, can cause a serious medical condition, and highlights the importance of early medical intervention. PMID:26401876

  5. Congestive cardiomyopathy and endobronchial granulomas as manifestations of Churg-Strauss syndrome.

    PubMed Central

    Alvarez-Sala, R.; Prados, C.; Armada, E.; Del Arco, A.; Villamor, J.

    1995-01-01

    Churg-Strauss syndrome is a systemic vasculitis. Its most frequent complications are heart diseases and asthma. Usually, cardiological manifestations are pericarditis, cardiac failure and myocardial infarction. Endobronchial granulomas identified by bronchoscopy are unusual. We present the case of a man with congestive cardiomyopathy and endobronchial granulomas macroscopically visible at bronchoscopy. After a review of medical literature, we found one case of congestive cardiomyopathy and no cases of endobronchial granulomas observed by bronchoscopy associated with Churg-Strauss syndrome. Images Figure PMID:7644400

  6. Biomechanical behaviour of native and sutured bronchi: An in-vitro study.

    PubMed

    Gervasi, Gian Luca; Vannucci, Jacopo; Tiribuzi, Roberto; Freddolini, Marco

    2016-01-01

    Biomechanical behaviour evaluation of a suture is an important information for the surgeon to choose the best technique to perform. To assess the biomechanical behavior of the native and mechanically sutured bronchi. Ten bronchi were harvested from slaughtered pigs and then randomly separated in two groups, a control intact group and a sutured group where specimens were cut in half and sutured, to evaluate mechanical properties during a tensile test using a loading frame machine. In addition optoelectric motion tracking system was used to evaluate suture profile motion during the test. Significant differences (p < 0.05) were found between the two groups for the parameters investigated. The control group showed a higher maximal stress resistance and stiffness than the suture group, while elongation at rupture was increased in the sutured group. All the sutures broke in symmetric manner, as the mean of the side difference of the sutured specimens was 0.93 ± 0.80 mm at rupture. Biomechanical behaviour of native and sutured bronchi was evaluated, giving highly reproducible parameters regarding mechanical properties that may help clinicians and bioengineers to rationalize the choice for a particular suture material or suture technique, increasing surgical outcomes.

  7. Prostate cancer presenting as an endobronchial mass: a case report with literature review.

    PubMed

    Garai, Shakhee; Pandey, Urmila

    2010-12-01

    Endobronchial metastasis from a prostate cancer is uncommon. Diagnosis of prostate carcinoma after primary presentation with an endobronchial mass is very rare. The authors describe the case of an 84-year-old man with endobronchial metastases from prostatic carcinoma presenting primarily with pulmonary symptoms. The diagnosis of prostate cancer and endobronchial metastases was made by a bronchoscopic bronchial biopsy and confirmed by immunohistological staining with prostate-specific antigen. The importance of this manifestation along with clinical and therapeutic implications is discussed here.

  8. Effectiveness of a Load-Imposing Device for Cyclic Stretching of Isolated Human Bronchi: A Validation Study

    PubMed Central

    Le Guen, Morgan; Naline, Emmanuel; Grassin-Delyle, Stanislas; Devillier, Philippe; Faisy, Christophe

    2015-01-01

    Background Mechanical ventilation may induce harmful effects in the airways of critically ill patients. Nevertheless, the effects of cyclic stretching caused by repetitive inflation-deflation of the bronchial compartment have not been well characterized in humans. The objective of the present study was to assess the effectiveness of a load-imposing device for the cyclic stretching of human bronchi. Methods Intact bronchial segments were removed from 128 thoracic surgery patients. After preparation and equilibration in an organ bath, bronchi were stretched repetitively and cyclically with a motorized transducer. The peak force imposed on the bronchi was set to 80% of each individual maximum contraction in response to acetylcholine and the minimal force corresponded to the initial basal tone before stretching. A 1-min cycle (stretching for 15 sec, relaxing for 15 sec and resting for 30 sec) was applied over a time period ranging from 5 to 60 min. The device's performance level was assessed and the properties of the stretched bronchi were compared with those of paired, non-stretched bronchi. Results Despite the intrinsic capacities of the device, the targets of the tension adjustments remained variable for minimal tension (156–178%) while the peak force set point was unchanged (87–115%). In the stretched bronchi, a time-dependent rise in basal tone (P <.05 vs. non-stretched) was apparent after as little as 5 min of cyclic stretching. The stretch-induced rise in basal tone continued to increase (P <.01) after the stretching had ended. Only 60 min of cyclic stretching was associated with a significant (P <.05) increase in responsiveness to acetylcholine, relative to non-stretched bronchi. Conclusions Low-frequency, low-force, cyclic loading of human bronchi is associated with elevated basal tone and acetylcholine responsiveness. The present experimental model is likely to be a useful tool for future investigations of the bronchial response to repetitive stress

  9. Primary Mediastinal Large B-cell Lymphoma Exhibiting Endobronchial Involvement

    PubMed Central

    Shimada, Midori; Fukuda, Minoru; Horio, Kensuke; Suyama, Takayuki; Kitazaki, Takeshi; Hashiguchi, Kohji; Fukuda, Masaaki; Shigematsu, Kazuto; Nakamura, Yoichi; Honda, Takuya; Ashizawa, Kazuto; Mukae, Hiroshi

    2016-01-01

    Primary mediastinal large B-cell lymphoma (PMLBCL) is one of the subtypes of diffuse large B-cell lymphoma. We experienced a rare case of PMLBCL that exhibited endobronchial involvement. A 33-year-old Japanese female with the chief complaints of epigastralgia, back pain, and nausea visited a primary care hospital. Computed tomography of the chest and abdomen demonstrated a bulky mass in the left anterior mediastinum, multiple pulmonary nodules, axillary lymph node swelling, and a pancreatic tumor. Fiberoptic bronchoscopy showed a white-tinged irregularly shaped endobronchial tumor accompanied by capillary vessel dilation in the left upper lobar bronchus. Taken together, these findings resulted in a diagnosis of PMLBCL. PMID:27803409

  10. Convex probe endobronchial ultrasound: applications beyond conventional indications

    PubMed Central

    Li, Peng; Zheng, Wei

    2015-01-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is maturing and gaining acceptance by more and more clinicians for lymph node staging of lung cancer and diagnosis of mediastinal and hilar masses or lymph node enlargement by convex probe endobronchial ultrasound (CP-EBUS). The application of CP-EBUS, however, is not limited to conventional indications. Diagnostically, elastography is a new technology for the differentiation of benign and malignant lymph nodes before aspiration. CP-EBUS can also be used for pulmonary vascular diseases, such as pulmonary embolism (PE) and non-thrombotic endovascular lesions (NELs). Therapeutically, CP-EBUS can be used for cyst drainage and drug injections. CP-EBUS is not limited to observation and aspiration of mediastinal masses and lymph nodes, but is also suitable for exploration of other tissues external to the central airway, which necessitates unprecedented skills for the bronchoscopist. PMID:26543618

  11. Long-term results of endobronchial brachytherapy: A curative treatment?

    SciTech Connect

    Hennequin, Christophe . E-mail: christophe.hennequin@sls.ap-hop-paris.fr; Bleichner, Olivier; Tredaniel, Jean; Quero, Laurent; Sergent, Guillaume; Zalcman, Gerard; Maylin, Claude

    2007-02-01

    Purpose: To evaluate outcomes after high-dose-rate endobronchial brachytherapy (HDR-EBBT) for limited lung carcinoma. Methods: A total of 106 patients with endobronchial lung cancer and not eligible for surgery or external beam radiotherapy, without nodal or visceral metastases, were treated with HDR-EBBT. They had developed disease relapse after surgery (n = 43) or external beam radiotherapy (n = 27) or had early lung cancer with respiratory insufficiency (n = 36). Treatment consisted of six fractions of 5 or 7 Gy, usually delivered 1 cm from the source. Results: The complete histologic response rate, evaluated at 3 months after HDR-EBBT, was 59.4%. At 3 and 5 years, the local control, overall survival, and cause-specific survival rates were 60.3% and 51.6%, 47.4 and 24%, and 67.9 and 48.5%, respectively. Factors significantly associated with local failure were high tumor volume (tumor length >2 cm, bronchial obstruction >25%, tumor visibility on CT scan) and previous endoscopic treatment. Cause-specific survival, but not overall survival, was significantly associated with local control, probably because of the high rate of deaths not related to lung cancer. Five deaths were attributed to the HDR-EBBT procedure (two from fatal hemoptysis and three from bronchial necrosis). Conclusion: High-dose-rate-EBBT achieved a long-term cause-specific survival rate of 50% of the patients with localized endobronchial carcinoma and could be considered curative.

  12. Rare Endobronchial Inflammatory Myofibroblastic Tumor in Pediatric Patient Detected on PET/CT Imaging.

    PubMed

    Kara, Pelin Ozcan; Koc, Zehra Pinar; Citak, Elvan Caglar; Nayci, Ali; Bahadir, Gokhan Berktug; Kara, Taylan

    2017-09-01

    Inflammatory myofibroblastic tumor (IMT) can be seen in all age groups, although it is more common in children and adolescents. We report the FDG PET/CT findings in an 8-year-old boy with endobronchial IMT. Endobronchial IMT is more commonly seen in young adults.

  13. Nerve endings in bronchi of the dog that react with antibodies against neurofilament protein.

    PubMed Central

    Yamamoto, Y; Atoji, Y; Suzuki, Y

    1995-01-01

    Tree-like nerve endings in the smooth muscle layer of bronchi of the dog were examined by immunohistochemical staining with antibodies against neurofilament protein (NFP). The endings were revealed as ramified axon terminals, with arborisation at their termini. The endings were 100-300 microns in maximal length and 50-100 microns in minimal length. Most of the endings were arranged parallel to the smooth muscle strands. The endings were densely distributed in the proximal region but their density decreased towards the alveoli. In the histological sections, the endings were seen between smooth muscle cells. Terminal Schwann cells, which reacted with antibodies against glial fibrillary acidic protein and S-100 protein, and putative 'septal cells' with vimentin-like immunoreactivity were distributed near the endings. In addition, the nerve endings with NFP-like immunoreactivity were surrounded dense connective tissue that contained large amounts of fine elastic fibres. These findings indicate the nerve endings with NFP-like immunoreactivity are similar to other slowly adapting receptors (i.e. Golgi tendon organs, Ruffini endings). Some degenerated endings, which found in the unilaterally vagotomised dog, suggest the endings in the bronchi are originated from vagal nerves. Images Fig. 1 Fig. 3 Fig. 4 Fig. 5 PMID:7591986

  14. Endobronchial Primitive Neuroectodermal Tumor With Pneumothorax Ex Vacuo.

    PubMed

    Han, Wongyeong; Huh, Dongmyung; Kim, Byoungho; Kwak, Eunkyoung; Lee, Sunah

    2015-10-01

    We experienced a rare case of an endobronchial primitive neuroectodermal tumor of the left main bronchus. Initially we suspected pneumothorax caused by a collapsed left upper lobe and an air-entrapped lower lobe. After tube thoracostomy, the pneumothorax persisted without air leakage. A tumor was detected at the left main bronchus on computed tomography and bronchoscopy, and diagnosed pathologically as small cell lung cancer. Under the presumed diagnosis of limited-stage small cell lung cancer, we performed a left pneumonectomy. The tumor was eventually identified pathologically as a primitive neuroectodermal tumor. Although adjuvant chemoradiotherapy was not performed, no recurrence was observed.

  15. Effect of high laser output on the central bronchi and pulmonary artery.

    PubMed

    Kirschbaum, A; Rexin, P; Bartsch, D K; Quint, K

    2017-05-01

    A diode-pump Nd:YAG high-power laser (wavelength 1320 nm, power 100 W) is routinely used to surgically remove lung metastases. Even pulmonary lesions in central locations are resectable via this method, yet it also carries a potential risk of damaging the larger bronchi and vessels in the vicinity. Studies investigating the safety of using high-power lasers are lacking. We therefore aimed to examine the direct effects of a 100-watt laser on the bronchi and pulmonary artery at a standard working velocity. From freshly slaughtered pigs, we isolated cylindrical specimens of the trachea, the main and lobar bronchi, and the central pulmonary artery from the both lungs. These specimens were fixed consecutively in rows behind each other on a Styrofoam surface in the laboratory. The laser's handle was clamped into a hydraulic feed unit so that the laser was focused at constant distance perpendicular to the tissue and would move at 10 mm/s over the specimens. The Nd:YAG Laser LIMAX® 120 functioned at a consistent power of 100 W during all the experiments. The lasered specimens were examined macroscopically and histologically for tissue damage. None of the trachea or bronchial walls were perforated. Compared to the pulmonary parenchyma, we observed no vaporization effects-only minor superficial coagulation (with a mean depth of 2.1 ± 0.8 mm). This finding was histologically confirmed in each specimen, which revealed mild superficial coagulation and no damage to the cartilage. In the presence of a residual peribronchial fatty tissue, the laser effect was even attenuated. The pulmonary arteries presented no lumen openings whatsoever, merely a discrete trace of coagulation. The vessel wall revealed increased vacuolization without alteration of the remaining vessel wall. In conclusion, laser resection at 100 W of the central lung areas is safe with respect to airways and blood vessels and the laser output does not need to be reduced when treating these areas.

  16. [Bronchial injury due to double-lumen endobronchial tube].

    PubMed

    Nagahiro, I; Miyamoto, M; Sugiyama, H; Nouso, H; Kawai, T; Toda, K; Nobuhisa, T; Endo, Y; Watanabe, T; Matsumoto, Y; Kai, K; Sato, S

    2011-05-01

    A 68-years-old and 148 cm tall female with lung cancer was operated on a left lower lobectomy via posterolateral thoracotomy. A 35 Fr double-lumen endobronchial tube was smoothly inserted and the tip was placed in the left main bronchus whose position was confirmed by fiberoptic bronchoscope. After lobectomy and lymph node dissection were completed, 1-lung ventilation was terminated, the left chest cavity was filled with saline, and an air-leak test was performed. Immediately after the initiation of bilateral lung ventilation, massive air-leak was observed in the left hilar region and the saline in the chest regurgitated into the airway, and she fell into critical ventilatory insufficiency. After sucking the saline in the chest, thorough observation revealed a 3 cm-long rupture of the membranous portion of the left main bronchus. The rupture was manually occluded and ventilatory insufficiency was avoided, then the tip of the endobronchial tube was re-inserted into the right main bronchus and right single lung ventilation was initiated. The rupture was closed by a 4-0 polydioxanone (PDS) running suture with no coverage. The patient was extubated immediately after the operation. Ten days later, she had a tiny bronchial fistula, and it was cured by chest drainage only, and she discharged home on the 48th postoperative day.

  17. [Anesthetic management of massive endobronchial hemorrhage after pulmonary embolectomy].

    PubMed

    Nakayama, Shin; Miyabe, Masayuki; Tabata, Kouya; Toyooka, Hidenori

    2003-08-01

    We report a case of massive endobronchial hemorrhage after pulmonary embolectomy. A 63-year-old woman underwent emergency pulmonary embolectomy with cardiopulmonary bypass (CPB). During partial CPB, we found massive blood gushing out from the endotracheal tube. Approximately 2,000 ml of blood was aspirated in 10 minutes. To ensure adequate oxygenation, emergent percutaneous cardiopulmonary support system (PCPS) was started. After neutralization of heparin and the institution of 10 cmH2O of positive end-expiratory pressure, the bleeding diminished. Institution of PCPS allows performance of unhurried bronchoscopy to identify the actual bleeding point and to lavage the airway. In addition to this management, we administrated steroids and neutrophil elastase inhibitor to stabilize pulmonary capillary membrane. Without complications, the patient was extubated 2 days after operation and the following course was uneventful. Immediate institution of PEEP and pharmacological interventions to reduce pulmonary blood pressure were beneficial in arresting hemorrhage. The bleeding begins usually at the time of discontinuation of CPB. We should recognize the possible occurrence of endobronchial bleeding after pulmonary embolectomy and prepare to protect the airway and to maintain oxygenation and cardiac function.

  18. Oral Iloprost Improves Endobronchial Dysplasia in Former Smokers

    PubMed Central

    Keith, Robert L.; Blatchford, Patrick J.; Kittelson, John; Minna, John D.; Kelly, Karen; Massion, Pierre P.; Franklin, Wilbur A.; Mao, Jenny; Wilson, David O.; Merrick, Daniel T.; Hirsch, Fred R.; Kennedy, Timothy C.; Bunn, Paul A.; Geraci, Mark W.; Miller, York E.

    2011-01-01

    There are no established chemopreventive agents for lung cancer, the leading cause of cancer death in the United States. Prostacyclin levels are low in lung cancer and supplementation prevents lung cancer in preclinical models. We carried out a multicenter double-blind, randomized, phase II placebo-controlled trial of oral iloprost in current or former smokers with sputum cytologic atypia or endobronchial dysplasia. Bronchoscopy was performed at study entry and after completion of six months of therapy. Within each subject, the results were calculated by using the average score of all biopsies (Avg), the worst biopsy score (Max), and the dysplasia index (DI). Change in Avg was the primary end point, evaluated in all subjects, as well as in current and former smokers. The accrual goal of 152 subjects was reached and 125 completed both bronchoscopies (60/75 iloprost, 65/77 placebo). Treatment groups were well matched for age, tobacco exposure, and baseline histology. Baseline histology was significantly worse for current smokers (Avg 3.0) than former smokers (Avg 2.1). When compared with placebo, former smokers receiving oral iloprost exhibited a significantly greater improvement in Avg (0.41 units better, P = 0.010), in Max (1.10 units better, P = 0.002), and in DI (12.45%, P = 0.006). No histologic improvement occurred in current smokers. Oral iloprost significantly improves endobronchial histology in former smokers and deserves further study to determine if it can prevent the development of lung cancer. PMID:21636546

  19. Bilateral Choroidal Metastases from Endobronchial Carcinoid Treated with Somatostatin Analogues

    PubMed Central

    De Bruyn, Deborah; Lamont, Jan; Vanderstraeten, Erik; Van Belle, Simon; Platteau, Elise; De Zaeytijd, Julie; Hoornaert, Kristien P.

    2016-01-01

    Objective: To describe a patient with bilateral multifocal choroidal metastases from an endobronchial carcinoid treated with a somatostatin analogue. Method: A 60-year-old woman presenting with photopsia in the left eye underwent an extensive ophthalmic examination, including fluorescein angiography, OCT and ultrasound. Results: Fundoscopy revealed a small retinal tear in the left eye, for which she received laser treatment. In addition, choroidal masses were detected in both eyes. Her medical history of a pneumectomy for a bronchial carcinoid six years earlier together with recent elevated chromogranin A blood levels prompted a diagnosis of choroidal metastases. Subsequently, a Gallium-68 DOTANOC positron emitting tomography/computer tomography scan revealed a spinal cord metastasis and mediastinal as well as mesenterial lymph node invasion. Systemic treatment with Sandostatin®, a somatostatin analogue was started. Up until two years after the initial presentation and treatment, these choroidal lesions remained stable without any signs of growth. Conclusion: Endobronchial carcinoid tumors have an indolent nature and long-term follow-up is recommended for early detection of metastases. Although treatment with somatostatin analogues rarely induces complete tumor regression, tumor stabilization and prevention of symptoms related to hormone secretion is achieved. This well-tolerated systemic treatment provides a worthy alternative treatment for choroidal metastasis compared to classic radiotherapy without any risk of radiation or laser-related visual loss. PMID:27843513

  20. Mucoid impaction of the bronchi in relation to asthma and plastic bronchitis

    PubMed Central

    Morgan, A. D.; Bogomoletz, W.

    1968-01-01

    Mucoid impaction of the bronchi is a condition which deserves wider recognition in this country. It should be considered in any asthmatic subject who may be suspected on clinical or radiological grounds to be suffering from pulmonary tuberculosis or neoplasm. Although 120 cases have been reported since 1951, there are no reports from this country in the British literature. As we have seen three cases in one hospital, we believe that mucoid impaction is being diagnosed under other headings, for example plastic bronchitis. Most of the changes in lungs removed for mucoid impaction are those of asthma, although other factors may play a part. We have compared the pathologies of mucoid impaction, asthma, and plastic bronchitis, and conclude that, while they overlap considerably, they are not identical. Mucoid impaction is an uncommon complication of asthma and certain forms of bronchitis; plastic bronchitis has a much wider aetiological background and is not a pathological entity. Images PMID:5736360

  1. [Biomechanics of respiration in patients with expiratory stenosis of trachea and main bronchi (author's transl)].

    PubMed

    Joffe, L Z; Rechtmann, A G

    1981-01-01

    The results of mechanical examinations of breathing (pneumotachogram, esophagopressure, intrabronchial pressure) in 62 patients with endoscopically and roentgenologically proved expiratory stenosis of the trachea and main bronchi by invagination of the pars membranacea are given. The localization of the obstructive syndrome was mainly central in 26 cases and mainly peripheral in another 36. The examinations of mechanics of breathing allowed a quantitative estimation of the role of the expiratory stenosis in ventilation disturbance, the differentiation of functional mechanisms and the distinction of a primary and a secondary type of invagination of the pars membranacea caused by emphysema. The results serve to give indications for conservative and operative treatment as well as to check the therapeutical results.

  2. Epithelial surfaces of the trachea and principal bronchi in the rat.

    PubMed Central

    Alexander, I; Ritchie, B C; Maloney, J E; Hunter, C R

    1975-01-01

    The epithelial surfaces in the trachea and principal bronchi of healthy rats were examined by scanning electron microscopy. A system of four cell types, ciliated, microvillous, brush, and goblet cells, in this order of frequency, were found and intermediate type cells were not seen. An extensive area of the surface examined was covered by densely ciliated epithelium. The presence of other cell types beneath the cilia was confirmed by transmission electron microscopy. Areas up to 1 mm in diameter and randomly distributed were observed where microvillous cells predominated and only occasional ciliated cells were found. Most ciliated cells in these areas were adjacent to glandular openings or goblet cells. The larger microvilli of the brush cells were arranged in a coronal configuration elucidated by the scanning electron microscope. Preparatory techniques recently introduced for the examination of soft tissue in the scanning electron microscope facilitated the confirmation of cell types present and the microarchitecture of the epithelial surface. Images PMID:1179314

  3. Relationship between bradykinin-induced relaxation and endogenous epoxyeicosanoid synthesis in human bronchi.

    PubMed

    Tabet, Yacine; Sirois, Marco; Sirois, Chantal; Rizcallah, Edmond; Rousseau, Éric

    2013-04-15

    Epoxyeicosanoids (EETs) are produced by cytochrome P-450 epoxygenase; however, it is not yet known what triggers their endogenous production in epithelial cells. The relaxing effects of bradykinin are known to be related to endogenous production of epithelial-derived hyperpolarizing factors (EpDHF). Because of their effects on membrane potential, EETs have been reported to be EpDHF candidates (Benoit C, Renaudon B, Salvail D, Rousseau E. Am J Physiol Lung Cell Mol Physiol 280: L965-L973, 2001.). Thus, we hypothesized that bradykinin (BK) may stimulate endogenous EET production in human bronchi. To test this hypothesis, the relaxing and hyperpolarizing effects of BK and 14,15-EET were quantified on human bronchi, as well as the effects of various enzymatic inhibitors on these actions. One micromolar BK or 1 μM 14,15-EET induced a 45% relaxation on the tension induced by 30 nM U-46619 [a thromboxane-prostanoid (TP)-receptor agonist]. These BK-relaxing effects were reduced by 42% upon addition of 10 nM iberiotoxin [a large-conductance Ca(2+)-sensitive K(+) (BK(Ca)) channel blocker], by 27% following addition of 3 μM 14,15-epoxyeicosa-5(Z)-enoic acid (an EET antagonist), and by 32% with 3 μM N-methanesulfonyl-6-(2-propargyloxyphenyl)hexanamide (MS-PPOH, an epoxygenase inhibitor). Hence, BK and 14,15-EET display net hyperpolarizing effects on airway smooth muscle cells that are related to the activation of BK(Ca) channels and ultimately yielding to relaxation. Data also indicate that 3 μM MS-PPOH reduced the hyperpolarizing effects of BK by 43%. Together, the present data support the current hypothesis suggesting a direct relationship between BK and the production of EET regioisomers. Because of its potent anti-inflammatory and relaxing properties, epoxyeicosanoid signaling may represent a promising target in asthma and chronic obstructive pulmonary disease.

  4. Exudation of plasma and production of thromboxane in human bronchi after local bradykinin challenge.

    PubMed

    Arvidsson, P; Löfdahl, C G; Skoogh, B E; Lötvall, J

    2001-05-01

    Plasma exudation has been suggested to be an important component of the inflammatory response in asthma. Bradykinin elicits many of the features of asthma, including bronchoconstriction, cough, plasma exudation and mucus secretion. In an attempt to quantify local plasma exudation, we have employed a novel low-trauma technique with the aim of challenging and lavaging a central part of the bronchial tree, by selecting a medium sized bronchus. A fibreoptic bronchoscopy was performed in non-smoking healthy volunteers. The instrument was placed proximally in the right upper lobe bronchus. A plastic catheter, equipped with an inflatable latex balloon, was inflated with air (2-4 cmH2O). A solution (100 microl of either two different concentrations of bradykinin: 0.09 and 0.9 mg ml(-1) or normal saline) was instilled through the catheter and distal to the balloon. Eight minutes later a lavage procedure with 10 ml of saline was performed through the catheter. The procedure was then repeated twice, with the other solutions, but from the lingular and middle lobe bronchi. All solutions were given in a blinded fashion, and two different studies were performed. Lavage concentrations of albumin and IgG were quantified as measurements of plasma exudation. In our first study we found that bradykinin challenge significantly increased concentrations of albumin and IgG. In study two, there was no numeric increase in plasma proteins after local bradykinin challenge, but the concentration of thromboxane was significantly increased in lavages from bradykinin-challenged bronchi. Thus, local bronchial administration of bradykinin has the capacity to induce exudation of large plasma macromolecules into the bronchial lumen, as well as local thromboxane production.

  5. Intrapulmonary schwannoma diagnosed with endobronchial ultrasound-guided transbronchial needle aspiration: case report.

    PubMed

    Watanabe, Keisuke; Shinkai, Masaharu; Shinoda, Masahiro; Ishigatsubo, Yoshiaki; Kaneko, Takeshi

    2014-11-01

    A 47-year-old woman was referred to our hospital for further examination of a lung tumor. CT of the chest revealed a round, well-defined 2.4-cm nodule in S2, adjacent to right superior lobe bronchus. Endobronchial ultrasonography showed a well-defined, hypoechoic tumor with echogenic capsule and posterior acoustic enhancement. Diagnosis of schwannoma was confirmed from the specimen obtained by endobronchial ultrasound-guided transbronchial needle aspiration. She underwent tumorectomy due to the possibility of obstructive pneumonia. Pathology diagnosis from the surgical specimen was also schwannoma. Endobronchial ultrasound-guided transbronchial needle aspiration and findings with endobronchial ultrasonography might be helpful in the diagnosis of intrapulmonary schwannoma. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  6. Two Cases of Diagnosis and Removal of Endobronchial Hamartoma by Cryotherapy via Flexible Bronchoscopy

    PubMed Central

    Sim, Jae Kyeom; Choi, Jong Hyun; Oh, Jee Youn; Cho, Jae Young; Moon, Eul Sun; Min, Hye Sook; Lee, Byung Hyun; Park, Min Seon; Hur, Gyu Young; Lee, Sung Yong; Shim, Jae Jeong; Kang, Kyung Ho

    2014-01-01

    Although endobronchial hamartoma is a rare benign tumor, most patients with endobronchial hamartoma have respiratory symptoms such as obstructive pneumonia, hemoptysis, cough, or dyspnea due to bronchial obstruction. It can cause irreversible post-obstructive pulmonary destruction, thus early diagnosis and treatment is very important. Recently, there have been cases of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser and electrocautery procedures for bronchoscopic treatment of malignant or benign central airway obstruction with comparable therapeutic efficacy and few complications. Bronchoscopic cryotherapy is a newly developed technique for management of central airway obstruction. Moreover, it provides diagnostic methods with improving diagnostic yield and safety. We report two cases of endobronchial hamartoma, each diagnosed and definitively treated with bronchoscopic techniques. Endobronchial biopsy and removal was successfully performed by cryotherapy via flexible bronchoscopy without notable complications. Follow-up bronchoscopic examinations excluded residual or recurrent disease. PMID:24734103

  7. Past, present, and future of endobronchial laser photoresection

    PubMed Central

    Khemasuwan, Danai; Wang, Ko-Pen

    2015-01-01

    Laser photoresection of central airway obstruction is a useful tool for an Interventional Pulmonologist (IP). Endobronchial therapy of the malignant airway obstruction is considered as a palliative measure or a bridge therapy to the definite treatment of cancer. Several ablative therapies such as electrocautery, argon plasma coagulation (APC), cryotherapy and laser photoresection exist in the armamentarium of IP to tackle such presentations. Besides Neodymium-Yttrium, Aluminum, Garnet (Nd:YAG) laser, there are several different types of laser that have been used by the pulmonologist with different coagulative and cutting properties. This chapter focuses on the historical perspective, current status, and potentials of lasers in the management of central airway lesions. PMID:26807285

  8. Endotracheal tuberculous granuloma formation following endobronchial ultrasound transbronchial needle aspiration.

    PubMed

    Lee, Jeong-Won; Kim, Woo-Jin; Park, Chan-Woo; Kang, Hyun-Wook; Ban, Hee-Jung; Oh, In-Jae; Kwon, Yong-Soo; Kim, Kyu-Sik; Kim, Yu-Il; Lim, Sung-Chul; Kim, Young-Chul; Choi, Yoo-Duk

    2013-01-01

    Endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) is a useful and safe diagnostic test. We herein report a case of endotracheal granuloma formation that occurred after EBUS-TBNA in a 73-year-old woman. The patient was admitted due to coughing and dyspnea after 70 days of antituberculous therapy for mediastinal lymphadenitis. Computed tomography revealed decreases in the size of the lymph nodes with a new mass protruding into the tracheal lumen. The mass originated from the right paratracheal area, which was a previous puncture site. This case suggests that clinicians should pay attention to complications because tuberculosis can produce new granulomas via the sinus tract after EBUS-TBNA.

  9. Four cases of pulmonary thromboembolism diagnosed by endobronchial ultrasound.

    PubMed

    Erer, Onur Fevzi; Cimen, Pinar; Unlu, Mehmet; Katgi, Nuran

    2017-09-01

    Endobronchial ultrasound (EBUS) is a technique for the detection of mediastinal abnormalities. A total of 548 EBUS procedures were performed for various indications, and in four cases (0.7%), filling defects in central pulmonary arteries were demonstrated fortuitously during the procedure. Subsequently, all patients underwent contrast-enhanced CT of the thorax to confirm the diagnosis of pulmonary thromboembolism (PTE). In three of the four cases, there was a concomitant lung cancer. PTE can be incidentally detected during EBUS; therefore, pulmonary arteries should be examined carefully during EBUS in all patients, particularly in patients with suspected or proven malignancy. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:441-444, 2017. © 2016 Wiley Periodicals, Inc.

  10. Visceral Leishmaniasis with Endobronchial Involvement in an Immunocompetent Adult

    PubMed Central

    Kotsifas, Konstantinos; Metaxas, Eugenios; Koutsouvelis, Ioannis; Skoutelis, Athanassios; Kara, Panayiota; Tatsis, George

    2011-01-01

    Visceral leishmaniasis is characterized by fever, cachexia, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia. Cough may be a presenting symptom as well. However, pulmonary involvement is considered rare and mainly described in immunocompromised patients. We describe a case of an immunocompetent adult whose clinical presentation was dominated by cough and hemoptysis. Bronchoscopy revealed a discreet polypoid mucosal endobronchial lesion whose biopsy yielded Leishmania amastigotes within histiocytes. Transbronchial needle biopsy of a right paratracheal lymph node was also positive. Leishmania amastigotes were also found on bone marrow and liver biopsies. Treatment with IV Amphotericin B was successful. In conclusion, cough should not be overlooked as a presenting symptom of visceral leishmaniasis and may be a sign of pulmonary involvement. PMID:21577261

  11. A case of endobronchial NUT midline carcinoma with intraluminal growth.

    PubMed

    Watanabe, Sho; Hirano, Satoshi; Mine, Sohtaro; Yoshida, Akihiko; Motoi, Toru; Ishii, Satoshi; Naka, Go; Takeda, Yuichiro; Igari, Toru; Sugiyama, Haruhito; Kobayashi, Nobuyuki

    2015-03-01

    NUT midline carcinoma (NMC) is a rare, lethal form of differentiated squamous cell carcinoma characterized by chromosomal rearrangement of the NUT gene. Its highly aggressive nature commonly leads to unresectable and metastatic lesions. We report on a case of endobronchial NMC in a middle-aged man who was treated by bronchoscopic electrocautery followed by Ewing sarcoma-based chemotherapy with concurrent chemoradiotherapy. The patient's disease continued to be stable 31 months after diagnosis. NMC is a challenging disease entity, which is difficult to diagnose and treat, and has a dismal overall survival. Most cases of NMC are widely metastatic or unresectable when diagnosed. This is the first reported case that involves intraluminal tumour growth of NMC and demonstrates the effectiveness of early intensive local therapy aided by bronchoscopic techniques. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  12. Computational fluid dynamics simulation of airflow in the trachea and main bronchi for the subjects with left pulmonary artery sling.

    PubMed

    Qi, Shouliang; Li, Zhenghua; Yue, Yong; van Triest, Han J W; Kang, Yan

    2014-06-24

    Left pulmonary artery sling (LPAS) is a rare but severe congenital anomaly, in which the stenoses are formed in the trachea and/or main bronchi. Multi-detector computed tomography (MDCT) provides useful anatomical images, but does not offer functional information. The objective of the present study is to quantitatively analyze the airflow in the trachea and main bronchi of LPAS subjects through computational fluid dynamics (CFD) simulation. Five subjects (four LPAS patients, one normal control) aging 6-19 months are analyzed. The geometric model of the trachea and the two main bronchi is extracted from the MDCT images. The inlet velocity is determined based on the body weight and the inlet area. Both the geometric model and personalized inflow conditions are imported into CFD software, ANSYS. The pressure drop, mass flow ratio through two bronchi, wall pressure, flow velocity and wall shear stress (WSS) are obtained, and compared to the normal control. Due to the tracheal and/or bronchial stenosis, the pressure drop for the LPAS patients ranges 78.9-914.5 Pa, much higher than for the normal control (0.7 Pa). The mass flow ratio through the two bronchi does not correlate with the sectional area ratio if the anomalous left pulmonary artery compresses the trachea or bronchi. It is suggested that the C-shaped trachea plays an important role on facilitating the air flow into the left bronchus with the inertia force. For LPAS subjects, the distributions of velocities, wall pressure and WSS are less regular than for the normal control. At the stenotic site, high velocity, low wall pressure and high WSS are observed. Using geometric models extracted from CT images and the patient-specified inlet boundary conditions, CFD simulation can provide vital quantitative flow information for LPAS. Due to the stenosis, high pressure drops, inconsistent distributions of velocities, wall pressure and WSS are observed. The C-shaped trachea may facilitate a larger flow of air into the

  13. [Mucoid impaction of the bronchi caused by Schizophyllum commune which developed after discontinuation of itraconazole administration].

    PubMed

    Ishiguro, Takashi; Takayanagi, Noboru; Harasaw, Keiji; Yoshii, Yutaka; Matsushita, Aya; Yoneda, Koichiro; Miyahara, Yousuke; Kagiyama, Naho; Tokunaga, Daido; Aoki, Fumiaki; Saito, Hiroo; Ubukata, Mikio; Kurashima, Kazuyoshi; Yanagisawa, Tsutomu; Sugita, Yutaka; Kawabata, Yoshinori; Kamei, Katsuhiko

    2009-04-01

    We report the case of a 75-year-old woman with mucoid impaction of the bronchi (MIB) due to Schizophyllum commune who improved with itraconazole (ITCZ) administration and relapsed after discontinuation of the drug. She improved again after readministration of ITCZ, and MIB has not recurred. This patient was not suffering from asthma and has been well without steroid administration. Reports of respiratory disorders due to S. commune have been increasing, and cases of allergic bronchopulmonary mycosis (ABPM), fungus ball, lung abscess, and pneumonia have been reported. Including this report, 12 cases of ABPM and MIB due to S. commune have been reported by Japanese authors. Treatment in these 12 cases included anti-fungal agent in 6, single steroid therapy in 3, combination therapy in 2, and bronchial toilet in 1 case. S. commune is not well recognized; however, one should suspect this fungus to be the causative pathogen when Aspergillus species are not detected or anti-Aspergillus antibody is negative.

  14. Liver Hydatid Cyst with Transdiaphragmatic Rupture and Lung Hydatid Cyst Ruptured into Bronchi and Pleural Space

    SciTech Connect

    Ar Latin-Small-Letter-Dotless-I bas, Bilgin Kadri Dingil, Guerbuez; Koeroglu, Mert; Uenguel, Uemit; Zaral Latin-Small-Letter-Dotless-I , Aliye Ceylan

    2011-02-15

    The aim of this case study is to present effectiveness of percutaneous drainage as a treatment option of ruptured lung and liver hydatid cysts. A 65-year-old male patient was admitted with complicated liver and lung hydatid cysts. A liver hydatid cyst had ruptured transdiaphragmatically, and a lung hydatid cyst had ruptured both into bronchi and pleural space. The patient could not undergo surgery because of decreased respiratory function. Both cysts were drained percutaneously using oral albendazole. Povidone-iodine was used to treat the liver cyst after closure of the diaphragmatic rupture. The drainage was considered successful, and the patient had no recurrence of signs and symptoms. Clinical, laboratory, and radiologic recovery was observed during 2.5 months of catheterization. The patient was asymptomatic after catheter drainage. No recurrence was detected during 86 months of follow-up. For inoperable patients with ruptured liver and lung hydatid cysts, percutaneous drainage with oral albendazole is an alternative treatment option to surgery. The percutaneous approach can be life-saving in such cases.

  15. Isolated Endobronchial Mycobacterium avium Disease Associated with Lobar Atelectasis in an Immunocompetent Young Adult: A Case Report and Literature Review.

    PubMed

    Kim, Hye In; Kim, Ji Won; Kim, Jun Young; Kim, Young Nam; Kim, Jin Hae; Jeong, Byeong-Ho; Chung, Myung Jin; Koh, Won-Jung

    2015-10-01

    The prevalence of lung diseases caused by nontuberculous mycobacteria (NTM) is increasing worldwide. Unlike pulmonary tuberculosis, endobronchial NTM diseases are very rare with the majority of cases reported in patients with human immunodeficiency virus infection and acquired immune deficiency syndrome. We reported a rare case of endobronchial Mycobacterium avium disease associated with lobar atelectasis in a young immunocompetent patient and reviewed the relevant iterature.

  16. A novel technique of needle setting for curvilinear endobronchial ultrasound: Improved efficiency with no cost

    PubMed Central

    Meena, Nikhil; Innabi, Ayoub; Alzghoul, Bashar; Bartter, Thaddeus

    2016-01-01

    Background: Standard instructions for biopsy using the convex curvilinear endobronchial ultrasound scope include visualization and adjustment of the sheath housing the biopsy needle before every puncture. In our practice, we pre-set this relationship before inserting the endobronchial ultrasound scope and leave it fixed for every puncture. Objective: We postulated that this approach is more efficient than repeated re-adjustment and aimed to show that it would not increase the frequency of endobronchial ultrasound scope damage. Methods: Retrospective review of every biopsy using the endobronchial ultrasound scope over a 6-year period with documentation of damages and costs. Results: There were 15 scope damages out of 1792 procedures (0.8%). Eight damages were determined to be due to needle damage, one due to patient bite, three due to Williams airway abrasions, and three were camera failures. All damages occurred during the first 5 years of the study. Costs totaled US$138,725, for an average of US$23,120 per year. This rate of damages appears to be similar to or lower than that reported when standard instructions are followed. Conclusion: Pre-setting of the biopsy needle when the endobronchial ultrasound scope is used leads to greater efficiency and no increase in scope damages. PMID:27974969

  17. PGE(2) receptor (EP(4)) agonists: potent dilators of human bronchi and future asthma therapy?

    PubMed

    Benyahia, C; Gomez, I; Kanyinda, L; Boukais, K; Danel, C; Leséche, G; Longrois, D; Norel, X

    2012-02-01

    Asthma and chronic obstructive pulmonary disease are characterized by inappropriate constriction of the airway smooth muscle. In this context, the physiological response of the human airways to selective relaxant agonists like PGE(2) is highly relevant. The aim of this study was thus to characterize the PGE(2) receptor subtypes (EP(2) or EP(4)) involved in the relaxation of human bronchial preparations. Human bronchial preparations cut as rings were mounted in organ baths for isometric recording of tension and a pharmacological study was performed using selective EP(2) or EP(4) ligands. In the presence of a thromboxane TP receptor antagonist and indomethacin, PGE(2) induced the relaxation of human bronchi (E(max) = 86 ± 04% of papaverine response; pEC(50) value = 7.06 ± 0.13; n = 6). This bronchodilation was significantly blocked by a selective EP(4) receptor antagonist (GW627368X, 1 and 10 μmol/L) with a pK(B) value of 6.38 ± 0.19 (n = 5). In addition, the selective EP(4) receptor agonists (ONO-AE1-329; L-902688), but not the selective EP(2) receptor agonist (ONO-AE1-259), induced potent relaxation of bronchial preparations pre-contracted with histamine or anti-IgE. PGE(2) and EP(4) agonists induced potent relaxations of human bronchial preparations via EP(4) receptor. These observations suggest that EP(4) receptor agonists could constitute therapeutic agents to treat the increased airway resistance in asthma. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. A Case of Pulmonary Artery Hydatid Cyst Observed on Endobronchial Ultrasound

    PubMed Central

    Senturk, Aysegul; Er, Mukremin; Karalezli, Aysegul; Yakut, Zeynep Ilerisoy; Soyturk, Ayse Nur; Cetin, Huseyin; Canan Hasanoglu, Hatice

    2015-01-01

    Hydatid cyst (HC) is a parasitic disease that may involve many organs, especially the lung and the liver. Pulmonary artery location of the hydatid cyst is extremely rare, but it may cause life-threatening complications. We report a case of a hydatid cyst that completely filled the left main pulmonary artery and its distal part without cardiac involvement. Thoracic computed tomography showed filling defects in the pulmonary arteries. Endobronchial ultrasound was performed for differential diagnosis and it showed a cystic lesion. Hydatid cyst-specific IgE and hem agglutination test results were positive. In the literature, cases like this in which the diagnosis of pulmonary hydatid cyst is made by endobronchial ultrasound are not usually seen. Although many imaging modalities such as plain chest radiography, cross-sectional imaging (MDCT and MRI), echocardiography and conventional pulmonary angiography have been used in the diagnostic approach, we recommend endobronchial ultrasound for the differential diagnosis of cases with cystic formation. PMID:25793087

  19. Endobronchial closure of bronchopleural fistulas with Amplatzer vascular plug.

    PubMed

    Fruchter, Oren; Bruckheimer, Elchanan; Raviv, Yael; Rosengarten, Dror; Saute, Milton; Kramer, Mordechai R

    2012-01-01

    Bronchopulmonary fistula (BPF) is a severe complication following lobectomy or pneumonectomy and is associated with a high rate of morbidity and mortality. We have developed a novel minimally invasive method of central BPF closure using Amplatzer vascular plug (AVP) device that was originally designed for the transcatheter closure of vascular structures in patients with small BPF. Patients with BPFs were treated under conscious sedation by bronchoscopic closure of BPFs using AVP. After locating the fistula using bronchography, the self-expanding nitinol made AVP occluder to be delivered under direct bronchoscopic guidance over a loader wire into the fistula followed by bronchography to assure correct device positioning and sealing of the BPF. Six AVPs were placed in five patients, four males and one female, with a mean age of 62.3 years (range: 51-82 years). The underlying disorders and etiologies for BPF development were lobectomy (two patients), pneumonectomy for lung cancer (one patient), lobectomy due to necrotizing pneumonia (one patient), and post-tracheostomy tracheo-pleural fistula (one patient). In all the patients, the bronchoscopic procedure was successful and symptoms related to BPF disappeared following closure by the AVP. The results were maintained over a median follow-up of 9 months (range: 5-34 months). Endobronchial closure using the AVP is a safe and effective method for treatment of small postoperative BPF. The ease of their implantation by bronchoscopy under conscious sedation adds this novel technique to the armatorium of minimally invasive modalities for the treatment of small BPF.

  20. The Role of Airway and Endobronchial Ultrasound in Perioperative Medicine

    PubMed Central

    Votruba, Jiri; Zemanová, Petra; Lambert, Lukas; Vesela, Michaela Michalkova

    2015-01-01

    Recent years have witnessed an increased use of ultrasound in evaluation of the airway and the lower parts of the respiratory system. Ultrasound examination is fast and reliable and can be performed at the bedside and does not carry the risk of exposure to ionizing radiation. Apart from use in diagnostics it may also provide safe guidance for invasive and semi-invasive procedures. Ultrasound examination of the oral cavity structures, epiglottis, vocal cords, and subglottic space may help in the prediction of difficult intubation. Preoperative ultrasound may diagnose vocal cord palsy or deviation or stenosis of the trachea. Ultrasonography can also be used for confirmation of endotracheal tube, double-lumen tube, or laryngeal mask placement. This can be achieved by direct examination of the tube inside the trachea or by indirect methods evaluating lung movements. Postoperative airway ultrasound may reveal laryngeal pathology or subglottic oedema. Conventional ultrasound is a reliable real-time navigational tool for emergency cricothyrotomy or percutaneous dilational tracheostomy. Endobronchial ultrasound is a combination of bronchoscopy and ultrasonography and is used for preoperative examination of lung cancer and solitary pulmonary nodules. The method is also useful for real-time navigated biopsies of such pathological structures. PMID:26788507

  1. Endobronchial valve treatment of destructive multidrug-resistant tuberculosis

    PubMed Central

    Levin, A.; Felker, I.; Tceymach, E.; Krasnov, D.

    2016-01-01

    SUMMARY BACKGROUND: In accordance with the existing hypothesis, the application of an endobronchial valve (EbV) leads to selective curative atelectasis of the affected part of the lung, contributing to early closure of cavities. OBJECTIVE: To assess the effect of EbV treatment on the course of tuberculosis (TB). METHODS: We compared the efficacy of EbV treatment and complex second-line treatment in treating patients with destructive pulmonary multidrug-resistant TB (MDR-TB). Bacteriological conversion and closure of cavities were selected as criteria to assess the effectiveness of EbV application. A total of 102 patients with destructive MDR-TB were enrolled into the study and randomly divided into two groups: 49 patients had an EbV installed (intervention group) and 53 patients received complex second-line treatment (control group). Complex chemotherapy was administered to both groups throughout the study period. RESULTS: The cure rate in the short- and long-term follow-up periods in the intervention group was shown to be much higher, 95.9% by bacteriological conversion and 67.3% by cavity closure. On comparison with the control group, this was respectively 37.7% and 20.7% (P < 0.0001). CONCLUSIONS: The application of EbV treatment can significantly improve the effectiveness of second-line chemotherapy regimens in MDR-TB patients. PMID:27776598

  2. The Role of Airway and Endobronchial Ultrasound in Perioperative Medicine.

    PubMed

    Votruba, Jiri; Zemanová, Petra; Lambert, Lukas; Vesela, Michaela Michalkova

    2015-01-01

    Recent years have witnessed an increased use of ultrasound in evaluation of the airway and the lower parts of the respiratory system. Ultrasound examination is fast and reliable and can be performed at the bedside and does not carry the risk of exposure to ionizing radiation. Apart from use in diagnostics it may also provide safe guidance for invasive and semi-invasive procedures. Ultrasound examination of the oral cavity structures, epiglottis, vocal cords, and subglottic space may help in the prediction of difficult intubation. Preoperative ultrasound may diagnose vocal cord palsy or deviation or stenosis of the trachea. Ultrasonography can also be used for confirmation of endotracheal tube, double-lumen tube, or laryngeal mask placement. This can be achieved by direct examination of the tube inside the trachea or by indirect methods evaluating lung movements. Postoperative airway ultrasound may reveal laryngeal pathology or subglottic oedema. Conventional ultrasound is a reliable real-time navigational tool for emergency cricothyrotomy or percutaneous dilational tracheostomy. Endobronchial ultrasound is a combination of bronchoscopy and ultrasonography and is used for preoperative examination of lung cancer and solitary pulmonary nodules. The method is also useful for real-time navigated biopsies of such pathological structures.

  3. The Cohen flexitip endobronchial blocker: an alternative to a double lumen tube.

    PubMed

    Cohen, Edmond

    2005-12-01

    One-lung ventilation (OLV) is usually achieved by the use of a double-lumen tubes (DLTs). With increasing need for use of OLV for video-assisted thoracoscopic procedures, the limitations of traditional DLT's, including difficult insertion and positioning, have become evident. This has led to renewed interest in devising alternative methods of achieving lung separation, such as the Univent tube or Arndt endobronchial blocker. This report describes the technical features and clinical use of a new tip-deflecting endobronchial blocker.

  4. Endobronchial amyloidosis mimicking bronchial asthma: a case report and review of the literature

    PubMed Central

    Kang, Hyun-Wook; Oh, Hyung-Joo; Park, Ha Young; Park, Cheol-Kyu; Shin, Hong-Joon; Lim, Jung-Hwan; Kwon, Yong-Soo; Choi, Yoo-Duk

    2016-01-01

    Abstract Among two tracheobronchial forms (local and diffuse) and two parenchymal forms (nodular and alveolar septal) that were reported in previous literature, localized endobronchial amyloidosis is an uncommon disease of unknown cause. Bronchial amyloid deposits can occur as focal nodules or multifocal infiltration of the submucosa. We report the case of a 47-year-old man who had complained of dyspnea and wheezing for 1 month and who had been treated for severe asthma at another hospital. Endobronchial amyloidosis was confirmed by histological examination of the bronchial biopsies.

  5. Endobronchial ultrasound convex probe for lymphoma, sarcoidosis, lung cancer and other thoracic entities. A case series.

    PubMed

    Zarogoulidis, Paul; Huang, Haidong; Bai, Chong; Kosmidis, Christoforos; Trakada, Georgia; Veletza, Lemonia; Tsiouda, Theodora; Barbetakis, Nikolaos; Paliouras, Dimitrios; Athanasiou, Evangelia; Hatzibougias, Dimitris; Kallianos, Anastasios; Panagiotopoulos, Nikolaos; Papaemmanouil, Liana; Hohenforst-Schmidt, Wolfgang

    2017-01-01

    Endobronchial ultrasound endoscopy is a state of the art diagnostic endoscopic procedure for the thorax. Firstly it was designed mainly for the staging of lung cancer and of course for the diagnosis of suspicious findings in large central airways. The main limitation of the equipment is the diameter of the instrument and therefore it can only be guided through large airways. However; the diameter of the working channel also provides a large tissue sample nowadays with the 19G biopsy needle. We will provide our experience with the 22G needle of the endobronchial convex-probe in several medical situations of the thorax.

  6. Mucous solids and liquid secretion by airways: studies with normal pig, cystic fibrosis human, and non-cystic fibrosis human bronchi

    PubMed Central

    Martens, Chelsea J.; Inglis, Sarah K.; Valentine, Vincent G.; Garrison, Jennifer; Conner, Gregory E.

    2011-01-01

    To better understand how airways produce thick airway mucus, nonvolatile solids were measured in liquid secreted by bronchi from normal pig, cystic fibrosis (CF) human, and non-CF human lungs. Bronchi were exposed to various secretagogues and anion secretion inhibitors to induce a range of liquid volume secretion rates. In all three groups, the relationship of solids concentration (percent nonvolatile solids) to liquid volume secretion rate was curvilinear, with higher solids concentration associated with lower rates of liquid volume secretion. In contrast, the secretion rates of solids mass and water mass as functions of liquid volume secretion rates exhibited positive linear correlations. The y-intercepts of the solids mass-liquid volume secretion relationships for all three groups were positive, thus accounting for the higher solids concentrations in airway liquid at low rates of secretion. Predictive models derived from the solids mass and water mass linear equations fit the experimental percent solids data for the three groups. The ratio of solids mass secretion to liquid volume secretion was 5.2 and 2.4 times higher for CF bronchi than for pig and non-CF bronchi, respectively. These results indicate that normal pig, non-CF human, and CF human bronchi produce a high-percent-solids mucus (>8%) at low rates of liquid volume secretion (≤1.0 μl·cm−2·h−1). However, CF bronchi produce mucus with twice the percent solids (∼8%) of pig or non-CF human bronchi at liquid volume secretion rates ≥4.0 μl·cm−2·h−1. PMID:21622844

  7. Pharmacological characterization of the interaction between umeclidinium and vilanterol in human bronchi.

    PubMed

    Calzetta, Luigino; Rogliani, Paola; Facciolo, Francesco; Rendina, Erino; Cazzola, Mario; Matera, Maria Gabriella

    2017-10-05

    The long-acting β2-agonist (LABA) / long-acting muscarinic antagonist (LAMA) fixed dose combination (FDC) therapy represents the cornerstone for the treatment of chronic obstructive pulmonary disease (COPD). Nevertheless, conflicting clinical findings still exist on the real benefit of the LABA/LAMA FDCs. Therefore, we investigated whether combining the LABA vilanterol with the LAMA umeclidinium may induce synergistic bronchorelaxant effect in isolated airways. The effect of umeclidinium and vilanterol, administered alone, in combination at the ratio of concentrations reproducing the doses delivered by Anoro(®) Ellipta(®) (55:22), or at isoeffective low concentrations, was investigated on the cholinergic contractile tone induced by the parasympathetic activation of human isolated airways. The interaction was analyzed by using the Bliss Independence and Unified Theory models. Umeclidinium and vilanterol induced a concentration-dependent relaxation of isolated bronchi, with umeclidinium significantly (P < 0.05) more potent than vilanterol (Emax at 10Hz: umeclidium 102.6 ± 6.8%, vilanterol 75.1 ± 13.8%; pEC50 at 10Hz: umeclidinium 8.6 ± 0.4, vilanterol 6.9 ± 0.6). When administered at 55:22 concentration-ratio, umeclidinium plus vilanterol completely relaxed the isolated airways (Emax at 10Hz: 99.6 ± 8.0%; pEC50 at 10Hz: 8.2 ± 0.4). No synergistic interaction was detected for umeclidinium/vilanterol combined at 55:22 ratio, whereas strong synergism was elicited when the drugs were administered at low isoeffective concentrations (+ 41.4 ± 5.8% vs. monocomponents), leading to submaximal relaxant effect (81.4 ± 5.8%). Umeclidinium and vilanterol are imbalanced when combined at 55:22 ratio, with umeclidinium over-dosed, or vice versa vilanterol under-dosed. Specific studies are needed to identify the dose ratio of umeclidinium/vilanterol combination to guarantee equipotency concentrations of each component into the lung, and induce synergistic bronchodilation

  8. Pro-Resolving Effects of Resolvin D2 in LTD4 and TNF-α Pre-Treated Human Bronchi

    PubMed Central

    Khaddaj-Mallat, Rayan; Sirois, Chantal; Sirois, Marco; Rizcallah, Edmond; Marouan, Sofia; Morin, Caroline; Rousseau, Éric

    2016-01-01

    Inflammation is a major burden in respiratory diseases, resulting in airway hyperresponsiveness. Our hypothesis is that resolution of inflammation may represent a long-term solution in preventing human bronchial dysfunctions. The aim of the present study was to assess the anti-inflammatory effects of RvD2, a member of the D-series resolving family, with concomitant effects on ASM mechanical reactivity. The role and mode of action of RvD2 were assessed in an in vitro model of human bronchi under pro-inflammatory conditions, induced either by 1 μM LTD4 or 10 ng/ml TNF-α pre-treatment for 48h. TNF-α and LTD4 both induced hyperreactivity in response to pharmacological stimuli. Enhanced 5-Lipoxygenase (5-LOX) and cysteinyl leukotriene receptor 1 (CysLTR1) detection was documented in LTD4 or TNF-α pre-treated human bronchi when compared to control (untreated) human bronchi. In contrast, RvD2 treatments reversed 5-LOX/β-actin and CysLTR1/β-actin ratios and decreased the phosphorylation levels of AP-1 subunits (c-Fos, c-Jun) and p38-MAP kinase, while increasing the detection of the ALX/FPR2 receptor. Moreover, various pharmacological agents revealed the blunting effects of RvD2 on LTD4 or TNF-α induced hyper-responsiveness. Combined treatment with 300 nM RvD2 and 1 μM WRW4 (an ALX/FPR2 receptor inhibitor) blunted the pro-resolving and broncho-modulatory effects of RvD2. The present data provide new evidence regarding the role of RvD2 in a human model of airway inflammation and hyperrresponsiveness. PMID:27935998

  9. Inadvertent insertion of a nasogastric tube into both main bronchi of an awake patient: a case report

    PubMed Central

    2009-01-01

    The use of nasogastric tube is desirable for the short-term administration of calories when oral feeding is not possible. Although the insertion of nasogastric tubes has been described as being easy this is not without risks. An unusual case of malpositioning of a fine bore nasogastric tube into both main bronchi in a patient that was awake is reported. Respiratory complications of misplaced nasogastric tubes and the importance of a check chest x-ray following tube placement are discussed. PMID:19829883

  10. Prostanoid receptors of the EP3 subtype mediate inhibition of evoked [3H]acetylcholine release from isolated human bronchi

    PubMed Central

    Reinheimer, Torsten; Harnack, Eva; Racke, Kurt; Wessler, Ignaz

    1998-01-01

    The release of neuronal [3H]acetylcholine (ACh) from isolated human bronchi after labelling with [3H]choline was measured to investigate the effects of prostanoids.A first period of electrical field stimulation (S1) caused a [3H]ACh release of 320±70 and 200±40 Becquerel (Bq) g−1 in epithelium-denuded and epithelium-containing bronchi respectively (P>0.05). Subsequent periods of electrical stimulation (Sn, n=2, 3, and 4) released less [3H]ACh, i.e. decreasing Sn/S1 values were obtained (0.76±0.09, 0.68±0.07 and 0.40±0.04, respectively).Cumulative concentrations (1–1000 nM) of EP-receptor agonists like prostaglandin E2, nocloprost, and sulprostone (EP1 and EP3 selective) inhibited evoked [3H]ACh release in a concentration dependent manner with IC50 values between 4–14 nM and maximal inhibition of about 70%.The inhibition of evoked [3H]ACh release by prostaglandin E2, nocloprost and sulprostone was not affected by the DP-, EP1- and EP2-receptor antagonist AH6809 at a concentration of 3 μM, i.e. a 3–30 times greater concentration than its affinity (pA2 values) at the respective receptors.Circaprost (IP-receptor agonist; 1–100 nM), iloprost (IP- and EP1-receptor agonist; 10-1000 nM) and U-46619 (TP-receptor agonist; 100–1000 nM) did not significantly affect [3H]ACh release.Blockade of cyclooxygenase by 3 μM indomethacin did not significantly modulate evoked [3H]ACh release in epithelium-containing and epithelium-denuded bronchi. Likewise, the combined cyclo- and lipoxygenase inhibitor BW-755C (20 μM) did not affect evoked [3H]ACh release.In conclusion, applied prostanoids appear to inhibit [3H]ACh release in epithelium-denuded human bronchi under the present in vitro conditions, most likely via prejunctional prostanoid receptors of the EP3 subtype. PMID:9786498

  11. Endobronchial closure of bronchopleural fistulas with Amplatzer vascular plug

    PubMed Central

    Fruchter, Oren; Bruckheimer, Elchanan; Raviv, Yael; Rosengarten, Dror; Saute, Milton; Kramer, Mordechai R.

    2012-01-01

    OBJECTIVE Bronchopulmonary fistula (BPF) is a severe complication following lobectomy or pneumonectomy and is associated with a high rate of morbidity and mortality. We have developed a novel minimally invasive method of central BPF closure using Amplatzer vascular plug (AVP) device that was originally designed for the transcatheter closure of vascular structures in patients with small BPF. METHODS Patients with BPFs were treated under conscious sedation by bronchoscopic closure of BPFs using AVP. After locating the fistula using bronchography, the self-expanding nitinol made AVP occluder to be delivered under direct bronchoscopic guidance over a loader wire into the fistula followed by bronchography to assure correct device positioning and sealing of the BPF. RESULTS Six AVPs were placed in five patients, four males and one female, with a mean age of 62.3 years (range: 51–82 years). The underlying disorders and etiologies for BPF development were lobectomy (two patients), pneumonectomy for lung cancer (one patient), lobectomy due to necrotizing pneumonia (one patient), and post-tracheostomy tracheo-pleural fistula (one patient). In all the patients, the bronchoscopic procedure was successful and symptoms related to BPF disappeared following closure by the AVP. The results were maintained over a median follow-up of 9 months (range: 5–34 months). CONCLUSIONS Endobronchial closure using the AVP is a safe and effective method for treatment of small postoperative BPF. The ease of their implantation by bronchoscopy under conscious sedation adds this novel technique to the armatorium of minimally invasive modalities for the treatment of small BPF. PMID:21600781

  12. Endobronchial Valves in the Treatment of Persistent Air Leaks.

    PubMed

    Hance, John M; Martin, Jeremiah T; Mullett, Timothy W

    2015-11-01

    Endobronchial valves (EBVs) are a useful adjunct in the management algorithm of patients with persistent pulmonary air leaks. They are increasingly used in the management of postsurgical parenchymal air leaks and carry a humanitarian use device exemption for this purpose. We report our experience with EBVs in the management of patients with bronchopleural fistula secondary to postsurgical intervention and spontaneous pneumothorax from medical comorbidities. An institutional review board-approved retrospective review was conducted of our single-center EBV experience. Patients were categorized as postsurgical versus medical. Data collected included demographic characteristics, indication for and number of valves placed, and chest tube duration before and after valve placement to evaluate overall resolution of air leak. Success was defined as resolution of air leak. A total of 14 valve placement procedures were performed. Mean age was 60 years and 10 patients were men. Eight represented prolonged leaks secondary to postsurgical complications and six were secondary to medical comorbidities. Indications for placement of valves in medical patients included persistent leak secondary to lung biopsy, ruptured bleb disease, and pneumothorax after cardiopulmonary resuscitation. Postsurgical indications included leaks secondary to lung biopsy, lobectomy, and ruptured bleb disease. A median of two valves were placed per procedure. A postprocedure median length of stay of 14.5 days was observed in the surgical group compared with 15 days in the medical group. Overall success rate was 57% (surgical group, 62.5%; medical group, 50%). EBVs are a useful adjunct in the management of persistent pulmonary air leaks, particularly when conventional interventions are contraindicated or not ideal. EBVs are well tolerated in the critically ill, have few known complications, are removable, and do not preclude future surgical intervention. Future studies should evaluate EBV efficacy versus

  13. Endobronchial metastasis from hepatocellular carcinoma – a case description with literature review

    PubMed Central

    Szumera-Ciećkiewicz, Anna; Olszewski, Włodzimierz T; Piech, Krzysztof; Głogowski, Maciej; Prochorec-Sobieszek, Monika

    2013-01-01

    Endobronchial metastases from hepatocellular carcinoma are very rare. Up to date, no more than 7 cases were reported. The authors present a case of 20-year old female with metastatic hepatocellular carcinoma to superior lobar bronchus. Examination of cytological and small biopsy specimens obtained from bronchoscopy revealed characteristic microscopic features and immunohistochemical profile of hepatocellular carcinoma. PMID:24040462

  14. Endobronchial Carcinoid Tumor in a Girl with Initial Histologic Diagnosis of Leiomyoma

    PubMed Central

    Arshad, Muhammad; Haq, Mehmood-ul; Ali, Syed Waqas

    2015-01-01

    Endobronchial tumors represent the rarest cause of airway obstruction in pediatric population. Due to rarity of the condition, a high index of suspicion is required for early diagnosis. We report a patient in whom diagnostic bronchoscopic biopsy was reported as leiomyoma while post resection histopathology showed an atypical carcinoid. PMID:26623257

  15. Cost minimization analysis for combinations of sampling techniques in bronchoscopy of endobronchial lesions.

    PubMed

    Roth, Kjetil; Hardie, Jon Andrew; Andreassen, Alf Henrik; Leh, Friedemann; Eagan, Tomas Mikal Lind

    2009-06-01

    The choice of sampling techniques in bronchoscopy with sampling from a visible lesion will depend on the expected diagnostic yields and the costs of the sampling techniques. The aim of this study was to determine the most economical combination of sampling techniques when approaching endobronchial visible lesions. A cost minimization analysis was performed. All bronchoscopies from 2003 and 2004 at Haukeland university hospital, Bergen, Norway, were reviewed retrospectively for diagnostic yields. 162 patients with endobronchial disease were included. Potential sampling techniques used were biopsy, brushing, endobronchial needle aspiration (EBNA) and washings. Costs were estimated based on registration of equipment costs and personnel costs. Sensitivity analyses were performed to determine threshold values. The combination of biopsy, brushing and EBNA was the most economical strategy with an average cost of Euro 893 (95% CI: 657, 1336). The cost of brushing had to be below Euro 83 and it had to increase the diagnostic yield more than 2.2%, for biopsy and brushing to be more economical than biopsy alone. The combination of biopsy, brushing and EBNA was more economical than biopsy and brushing when the cost of EBNA was below Euro 205 and the increase in diagnostic yield was above 5.2%. In the current study setting, biopsy, brushing and EBNA was the most economical combination of sampling techniques for endobronchial visible lesions.

  16. Mature results of a randomized trial comparing two fractionation schedules of high dose rate endoluminal brachytherapy for the treatment of endobronchial tumors.

    PubMed

    Niemoeller, Olivier M; Pöllinger, Barbara; Niyazi, Maximilian; Corradini, Stefanie; Manapov, Farkhad; Belka, Claus; Huber, Rudolf M

    2013-01-07

    To determine the efficacy of high dose rate endobronchial brachytherapy (HDR-BT) for the treatment of centrally located lung tumors, two different fractionation schedules were compared regarding local tumor response, side effects and survival. Mature retrospective results with longer follow-up and more patients were analyzed. Initial results were published by Huber et al. in 1995. 142 patients with advanced, centrally located malignant tumors with preferential endoluminal growth were randomized to receive 4 fractions of 3.8 Gy (time interval: 1 week, n = 60, group I) or 2 fractions of 7.2 Gy (time interval: 3 weeks, n = 82, group II) endobronchial HDR-BT.Age, gender, tumor stage, Karnofsky Performance Score and histology were equally distributed between both groups. Local tumor response with 2 fractions of 7.2 Gy was significantly higher as compared to 4 fractions of 3.8 Gy (median 12 vs. 6 weeks; p ≤ 0.015). Median survival was similar in both groups (19 weeks in the 4 fractions group vs. 18 weeks in the 2 fractions group). Fatal hemoptysis was less frequent following irradiation with 2 × 7.2 Gy than with 4 × 3.8 Gy, although the difference did not achieve statistical significance (12.2% vs. 18.3%, respectively. p = 0,345). Patients presenting with squamous cell carcinoma were at higher risk of bleeding compared to other histology (21.9% vs. 9%, p = 0,035).Multivariate analysis with regard to overall survival, revealed histology (p = 0.02), Karnofsky Performance Score (p < 0.0001) and response to therapy (p < 0.0001) as significant prognostic factors. For patients showing complete response the median survival was 57 weeks, while for patients with progressive disease median survival time was 8 weeks, p < 0.0001.The KPS at the start of the treatment was significantly correlated with survival. Patients presenting with a KPS ≤ 60 at the start had a significantly (p = 0,032) shorter survival time (10 weeks) than

  17. Utility of rapid on-site cytologic evaluation during endobronchial ultrasound with a guide sheath for peripheral pulmonary lesions.

    PubMed

    Izumo, Takehiro; Matsumoto, Yuji; Sasada, Shinji; Chavez, Christine; Nakai, Toshiyuki; Tsuchida, Takaaki

    2017-03-01

    The utility of rapid on-site evaluation during endobronchial ultrasound with a guide sheath for peripheral pulmonary lesions is unclear. The aim of this study was to evaluate the role of rapid on-site evaluation during endobronchial ultrasound with a guide sheath for peripheral pulmonary lesions. Consecutive patients who underwent endobronchial ultrasound with a guide sheath for the diagnosis of peripheral pulmonary lesions at our hospital between September 2012 and July 2014 were included in this retrospective study. Cytology slides were air-dried, and modified Giemsa (Diff-Quik) staining was used for rapid on-site evaluation. Additional smears were prepared for Papanicolaou staining and tissue samples were placed in formalin for histologic evaluation. The results of rapid on-site evaluation were compared with the final diagnoses of endobronchial ultrasound with a guide sheath. A total of 718 cases were included in the study population. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of rapid on-site evaluation during endobronchial ultrasound with a guide sheath for peripheral pulmonary lesions was 88.6%, 65.9%, 81.2%, 77.7% and 80.1%, respectively. There were no procedure-related deaths. Rapid on-site evaluation during endobronchial ultrasound with a guide sheath had high sensitivity for peripheral pulmonary lesions. When carrying out rapid on-site evaluation of transbronchial biopsy samples from peripheral pulmonary lesions, careful interpretation and clinical correlation are necessary.

  18. Horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of upper lobe bronchi.

    PubMed

    Oguz, Berna; Alan, Serdar; Ozcelik, Ugur; Haliloglu, Mithat

    2009-09-01

    Horseshoe lung, a rare congenital anomaly, is almost always associated with unilateral (usually right-sided) lung hypoplasia, and, in most cases, in conjunction with the scimitar syndrome. We present an 8-month-old boy with horseshoe lung associated with left-lung hypoplasia, left pulmonary artery sling and bilateral agenesis of the upper lobe bronchi, diagnosed by multidetector CT (MDCT) imaging. The study also revealed an anomalous origin of the left vertebral artery as the last branch of the aortic arch, distal to the left subclavian artery, and an anomalous origin of the left common carotid artery from the brachiocephalic trunk. A hemivertebral anomaly of the seventh cervical vertebra was incidentally detected. MDCT with high-quality multiplanar and three-dimensional reconstructions is a noninvasive and rapid technique for detecting the complex combination of vascular, tracheobronchial and parenchymal anomalies, and any potential bone anomalies, in one imaging study.

  19. Combination of fluorescence imaging and local spectrophotometry in fluorescence diagnostics of early cancer of larynx and bronchi

    SciTech Connect

    Sokolov, Vladimir V; Filonenko, E V; Telegina, L V; Boulgakova, N N; Smirnov, V V

    2002-11-30

    The results of comparative studies of autofluorescence and 5-ALA-induced fluorescence of protoporphyrin IX, used in the diagnostics of early cancer of larynx and bronchi, are presented. The autofluorescence and 5-ALA-induced fluorescence images of larynx and bronchial tissues are analysed during the endoscopic study. The method of local spectrophotometry is used to verify findings obtained from fluorescence images. It is shown that such a combined approach can be efficiently used to improve the diagnostics of precancer and early cancer, to detect a primary multiple tumours, as well as for the diagnostics of a residual tumour or an early recurrence after the endoscopic, surgery or X-ray treatment. The developed approach allows one to minimise the number of false-positive results and to reduce the number of biopsies, which are commonly used in the white-light bronchoscopy search for occult cancerous loci. (laser biology and medicine)

  20. Cellular morphometry of the bronchi of human and dog lungs. Progress report, April 1, 1991--October 1, 1991

    SciTech Connect

    Robbins, E.S.

    1991-09-01

    One hundred and forty-seven bronchial samples (generations 3--6) from 66 patients (62 usable; 36 female, 26 male; median age 61) have been dissected by generation from fixed surgical lung specimens obtained after the removal of pathological lesions. In addition, one hundred and fifty-six mongol dog bronchi (generations 2--6) dissected from different lobes of 26 dog lungs have also been similarly prepared. One hundred and twenty-seven human samples have been completely processed for electron microscopy and have yielded 994 electron micrographs of which 655 have been entered into the Computerized Stereological Analysis System (COSAS) and been used for the measurement of the distances of basal and mucous cell nuclei to the epithelial free surface. Similarly 328 micrographs of dog epithelium from 33 bronchial samples have been used to measure the distances of basal and mucous cell nuclei to the epithelial free surface and have been entered into COSAS. Using the COSAS planimetry program, we continue to expand our established data bases which describe the volume density and nuclear numbers per electron micrograph for 5 cell types of the human bronchial epithelial lining of men and women, as well as smokers, non-smokers and ex-smokers and similar parameters for the same 5 epithelial cell types of dog bronchi. Our micrographs of human bronchial epithelium have allowed us to analyze the recent suggestion that the DNA of lymphocytes may be subject to significant damage from Rn progeny while within the lung. Since the last progress report three papers have been submitted for publication. 17 refs., 4 tabs.

  1. Radiation bronchitis and stenosis secondary to high dose rate endobronchial irradiation

    SciTech Connect

    Speiser, B.L. ); Spratling, L.

    1993-03-15

    The purpose of the study was to describe a new clinical entity observed in follow-up bronchoscopies in patients who were treated with high dose rate and medium dose rate remote afterloading brachytherapy of the tracheobronchial tree. Patients were treated by protocol with medium dose rate, 47 patients receiving 1000 cGy at a 5 mm depth times three fractions, high dose rate 144 patients receiving 1000 cGy at a 10 mm depth for three fractions and high dose rate 151 patients receiving cGy at a 10 mm depth for three fractions followed by bronchoscopy. Incidence of this entity was 9% for the first group, 12% for the second, and 13% for the third group. Reactions were grade 1 consisting of mild inflammatory response with a partial whitish circumferential membrane in an asymptomatic patient; grade 2, thicker complete white circumferential membrane with cough and/or obstructive problems requiring intervention; grade 3, severe inflammatory response with marked membranous exudate and mild fibrotic reaction; and grade 4 a predominant fibrotic reaction with progressive stenosis. Variables associated with a slightly increased incidence of radiation bronchitis and stenosis included: large cell carcinoma histology, curative intent, prior laser photoresection, and/or concurrent external radiation. Survival was the strongest predictor of the reaction. Radiation bronchitis and stenosis is a new clinical entity that must be identified in bronchial brachytherapy patients and treated appropriately. 23 refs., 3 figs., 7 tabs.

  2. Computed tomography of lobar collapse: 2. Collapse in the absence of endobronchial obstruction

    SciTech Connect

    Naidich, D.P.; McCauley, D.I.; Khouri, N.F.; Leitman, B.S.; Hulnick, D.H.; Siegelman, S.S.

    1983-10-01

    The computed tomographic appearance of collapse without endobronchial obstruction is reviewed. These 57 cases were classified by the etiology of collapse. The largest group consisted of 29 patients with passive atelectasis, i.e., collapse secondary to fluid, air, or both in the pleural space. Twenty-three of 29 proved secondary to malignant pleural disease. Computed tomography accurately predicted a malignant etiology in 22 of 23 cases. The second largest group of patients had lobar collapse secondary to cicatrization from chronic inflammation. In all cases the underlying etiology was tuberculosis. Radiation caused adhesive atelectasis in six patients secondary to a lack of production of surfactant. In each case a sharp line of demarcation could be defined between normal and abnormal collapsed pulmonary parenchyma. Three cases of unchecked tumor growth caused a peripheral form of collapse (replacement atelectasis). This form of collapse was characterized by an absence of endobronchial obstruction and extensive tumor not delineated by the normal boundaries of the pulmonary lobes.

  3. Successful Removal of Endobronchial Blood Clots Using Bronchoscopic Cryotherapy at Bedside in the Intensive Care Unit

    PubMed Central

    Lee, Hongyeul; Leem, Cho Sun; Lee, Jae Ho; Lee, Choon-Taek

    2014-01-01

    Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in life-threatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots. PMID:25368667

  4. Endobronchial cryotherapy facilitates end-stage treatment options in patients with bronchial stenosis: A case series

    PubMed Central

    Fitzmaurice, Gerard J.; Redmond, Karen C.; Fitzpatrick, David A.; Bartosik, Waldemar

    2014-01-01

    In keeping with international trends, lung cancer incidence and mortality are increasing among the Irish population with many patients presenting with advanced disease that excludes the potential for curative management. Consequently palliative treatment options for this patient group are being increasingly explored with various degrees of success. Endobronchial stenosis represents a particularly challenging area of management among these patients and a number of techniques have been described without the identification of a single gold standard. We report our experience of the first time use of endobronchial cryotherapy in Ireland with reference to a case series, including an example of its use in the management of benign disease, in order to support patients with borderline lung function and enable definitive palliative treatment. PMID:24791176

  5. Resection of endobronchial hamartoma causing recurrent hemoptysis by electrocautery and cryotherapy

    PubMed Central

    Ucar, N; Akpinar, S; Aktas, Z; Sipit, T; Ozaydin, E

    2014-01-01

    Background: Pulmonary hamartomas are rare benign tumors of the lung with an incidence of 0.025%-0.32%. Endobronchial benign lesions can cause bronchial obstruction and recurrent respiratory infections or obstructive pneumonia and recurrent hemopthysis. Case report: A 66-year-old male with recurrent hemoptysis and pneumonias for a year, was referred to our department for an endoscopic resection of an endobronchial hamartoma. Initially he refused any intervention but, as he suffered additional episodes of hemoptysis and chest infections during a year on follow up, he finally underwent interventional bronchoscopy and the lesion was cauterized using snare electrocautery probe and removed with cryoextraction. The patient has been followed for two years in our outpatient clinic, with no further problems. Conclusion: Endoscopic treatment with flexible bronchoscope, electrocautery and cryotherapy provides an excellent outcome. Surgical therapy, should be reserved for the hamartomas that cannot be approached through endoscopy. Hippokratia 2014; 18 (4): 355-356. PMID:26052204

  6. [Clinical investigation of detecting the bronchi responsible for pulmonary air leakage by injecting methylene blue saline in 27 cases with intractable pneumothorax and bronchial fistula].

    PubMed

    Jin, Pule; Ge, Hui; Peng, Luanshun; Wang, Guojun; Hu, Wenxia; Song, Shan

    2014-11-01

    To establish a new method for detecting the bronchus responsible for pulmonary air leakage by injecting methylene blue saline and to evaluate its efficacy and safety in cases with intractable pneumothorax and bronchial fistula. From January 2006 to October 2013, a total of 19 cases of intractable spontaneous pneumothorax and 8 cases of bronchial fistula were recruited in the study at the Fourth Hospital affiliated to Hebei Medical University. Of all the cases, 15 were diagnosed as having tension pneumothorax and 12 as having communicating pneumothorax. All the cases failed to respond to continuous pleural suction for more than 5 days and consented to the proposed treatment. Before procedure, chest suction was established to allow sustained airflow through the drainage tube while the patients breathed normally. Under direct vision through fiberoptic bronchoscope, injection catheter was inserted into the bronchoscopy channel, and methylene blue saline was slowly injected into the potentially leaking segmental or sub-segmental bronchi. When a steady decline or disappearance in the amount of methylene blue saline in the airways was observed, or methylthionine-tainted saline was detected within the chest drainage tube, the bronchus responsible for air leakage was indicated. Before blocking the target bronchus, the negative pressure level of pleural suction should be reduced or stopped, and then porcine fibrin glue or a-cyanoacrylate was used for sealing the bronchi associated with air leakage. When the air was absent from the drainage tube, and lung recruitment was indicated in the chest X-ray for 5 days, and bronchial blockade of air leakage was proved successful. The bronchi responsible for air leakage were successfully located in all 27 cases, among them segmental bronchi were located in 16, subsegmental bronchi in 10, and small subsegmental bronchus in only one. Multiple adjacent segmental involvement occurred in 3, and multiple adjacent subsegmental involvement in

  7. Contrast-enhanced endobronchial ultrasound: Potential value of a new method

    PubMed Central

    Dietrich, Christoph F.

    2017-01-01

    Endobronchial ultrasound (EBUS) has gained importance for mediastinal lymph node staging. Contrast-enhanced EBUS is so far not a discussed technique including contrast-enhanced high mechanical index (MI)-EBUS and potentially contrast-enhanced low MI-EBUS. Possible use could include characterization of mediastinal lymph nodes for better selection of biopsies, differential diagnosis of the primary tumor, and evaluation of thrombosis or tumor in vein infiltration. PMID:28218200

  8. A new needle on the block: EchoTip ProCore endobronchial ultrasound needle

    PubMed Central

    Dincer, H Erhan; Andrade, Rafael; Zamora, Felix; Podgaetz, Eitan

    2016-01-01

    Endobronchial ultrasound has become the first choice standard of care procedure to diagnose benign or malignant lesions involving mediastinum and lung parenchyma adjacent to the airways owing to its characteristics of being real-time and minimally invasive. Although the incidence of lung cancer has been decreasing, it is and will be the leading cause of cancer-related mortality in the next few decades. When compared to other cancers, lung cancer kills more females than breast and colon cancers combined and more males than colon and prostate cancers combined. The type of lung cancer has changed in recent decades and adenocarcinoma has become the most frequent cell type. Prognosis of lung cancer depends upon the cell type and the staging at the time of diagnosis. The cell type and molecular characteristics of adenocarcinoma may allow individualized targeted treatment. Other malignant conditions in the mediastinum and lung (eg, metastatic lung cancers and lymphoma) can be biopsied using endobronchial ultrasound needles. Endobronchial ultrasound needle biopsies provides mostly cytology specimens due to its small sizes of needles (22 gauge or larger) which may not give enough tissue to make a definitive diagnosis in malignant (eg, lymphoma) or benign conditions (eg, sarcoidosis). EchoTip ProCore endobronchial needle released in early 2014 provides histologic biopsy material. Larger tissue biopsies may potentially provide a higher diagnostic yield and it eliminates mediastinoscopy or other surgical interventions. Here we aim to review bronchoscopic approach in the diagnosis of mediastinal lesions with emphasis of EchoTip ProCore needles. PMID:27099535

  9. LigaSure meets endobronchial valve in a case of lung cancer with pneumoconiosis

    PubMed Central

    Fiorelli, Alfonso; Accardo, Marina; Vicidomini, Giovanni

    2013-01-01

    Resection of lung cancer associated with pneumoconiosis may be difficult since fibrosis limits the exposure of hilum, and the use of stapler; yet, surgery may be complicated by persistent air leaks due to the underlying disease. In this setting, LigaSure was used to perform the tumor resection, and the postoperative treatment of air leaks in the same patient was treated with placement of endobronchial valves. PMID:25806247

  10. Pharmacological characterisation of the interaction between glycopyrronium bromide and indacaterol fumarate in human isolated bronchi, small airways and bronchial epithelial cells.

    PubMed

    Cazzola, Mario; Calzetta, Luigino; Puxeddu, Ermanno; Ora, Josuel; Facciolo, Francesco; Rogliani, Paola; Matera, Maria Gabriella

    2016-06-13

    Nowadays, there is a considerable gap in knowledge concerning the mechanism(s) by which long-acting β2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) interact to induce bronchodilation. This study aimed to characterise the pharmacological interaction between glycopyrronium bromide and indacaterol fumarate and to identify the mechanism(s) leading to the bronchorelaxant effect of this interaction. The effects of glycopyrronium plus indacaterol on the contractile tone of medium and small human isolated bronchi were evaluated, and acetylcholine and cAMP concentrations were quantified. The interaction was assessed by Bliss Independence approach. Glycopyrronium plus indacaterol synergistically inhibited the bronchial tone (medium bronchi, +32.51 % ± 7.86 %; small bronchi, +28.46 % ± 5.35 %; P < 0.05 vs. additive effect). The maximal effect was reached 140 min post-administration. A significant (P < 0.05) synergistic effect was observed during 9 h post-administration on the cholinergic tone, but not on the histaminergic contractility. Co-administration of glycopyrronium and indacaterol reduced the release of acetylcholine from the epithelium but not from bronchi, and enhanced cAMP levels in bronchi and epithelial cells (P < 0.05 vs. control), an effect that was inhibited by the selective KCa(++) channel blocker iberiotoxin. The role of cAMP-dependent pathway was confirmed by the synergistic effect elicited by the adenylate cyclase activator forskolin on glycopyrronium (P < 0.05 vs. additive effect), but not on indacaterol (P > 0.05 vs. additive effect), with regard of the bronchial relaxant response and cAMP increase. Glycopyrronium/indacaterol co-administration leads to a synergistic improvement of bronchodilation by increasing cAMP concentrations in both airway smooth muscle and bronchial epithelium, and by decreasing acetylcholine release from the epithelium.

  11. Toward endobronchial Ir-192 high-dose-rate brachytherapy therapeutic optimization

    NASA Astrophysics Data System (ADS)

    Gay, H. A.; Allison, R. R.; Downie, G. H.; Mota, H. C.; Austerlitz, C.; Jenkins, T.; Sibata, C. H.

    2007-06-01

    A number of patients with lung cancer receive either palliative or curative high-dose-rate (HDR) endobronchial brachytherapy. Up to a third of patients treated with endobronchial HDR die from hemoptysis. Rather than accept hemoptysis as an expected potential consequence of HDR, we have calculated the radial dose distribution for an Ir-192 HDR source, rigorously examined the dose and prescription points recommended by the American Brachytherapy Society (ABS), and performed a radiobiological-based analysis. The radial dose rate of a commercially available Ir-192 source was calculated with a Monte Carlo simulation. Based on the linear quadratic model, the estimated palliative, curative and blood vessel rupture radii from the center of an Ir-192 source were obtained for the ABS recommendations and a series of customized HDR prescriptions. The estimated radius at risk for blood vessel perforation for the ABS recommendations ranges from 7 to 9 mm. An optimized prescription may in some situations reduce this radius to 4 mm. The estimated blood perforation radius is generally smaller than the palliative radius. Optimized and individualized endobronchial HDR prescriptions are currently feasible based on our current understanding of tumor and normal tissue radiobiology. Individualized prescriptions could minimize complications such as fatal hemoptysis without sacrificing efficacy. Fiducial stents, HDR catheter centering or spacers and the use of CT imaging to better assess the relationship between the catheter and blood vessels promise to be useful strategies for increasing the therapeutic index of this treatment modality. Prospective trials employing treatment optimization algorithms are needed.

  12. Clinical application of direct bronchial ultrasound to visualize and determine endobronchial tumor margins for surgical resection.

    PubMed

    Sarraf, Khaled M; Belcher, Elizabeth; Price, Susanna; Lim, Eric

    2008-10-01

    We describe the first experience of direct bronchial (epi-bronchial) ultrasound to visualize and determine the endobronchial tumor margins for surgical resection. An ultrasound probe was applied onto the membranous portion of the right main bronchus directly over a pedunculated tumor. The tumor was visualized due to the water content, with a total loss of signal (air-tumor interface) at the tumor edge. A sterile marker was used to outline the air-tumor interface. Traditionally, surgical technique involves palpation of the tumor with an incision to inspect the endobronchial lumen determining the position of the pedicle, thus estimating the amount of airway to resect. Using direct bronchial ultrasound, the right main palpated margin was 0.5-cm proximal to the ultrasound margin, which correctly identified the tumor margin. The upper lobe palpated margin was 1 cm proximal to the ultrasound margin, which correctly identified the tumor margin. In the intermediate bronchus, the palpated and ultrasound margin were the same and correct. By using the air-tumor interface, epi-bronchial ultrasound scanning can accurately demarcate the base of endobronchial tumors for surgical resection and reconstruction.

  13. Safety and ethics of bronchoscopy and endobronchial biopsy in difficult asthma

    PubMed Central

    Payne, D; McKenzie, S; Stacey, S; Misra, D; Haxby, E; Bush, A

    2001-01-01

    AIM—To investigate the safety of bronchoscopy and endobronchial biopsy in children with difficult asthma, and discuss the ethical issues associated with the procedure.
METHODS—A three year prospective observational study was performed in two tertiary paediatric respiratory centres specialising in the management of children with difficult asthma. A total of 48children with difficult asthma and 35 non-asthmatic children were studied.
RESULTS—Flexible bronchoscopy was performed under general anaesthesia in 38 children with difficult asthma, and rigid bronchoscopy was performed in 10, following a two week course of prednisolone. Endobronchial biopsy was performed in 47 patients. Perioperative complications occurred in one asthmatic undergoing flexible bronchoscopy (desaturation) and in two undergoing rigid bronchoscopy (desaturation in one, and bronchospasm and desaturation in one). There were no cases of significant bleeding or pneumothorax among the asthmatics. Flexible bronchoscopy was performed in 35 non-asthmatic patients with a variety of clinical indications. The total number of perioperative complications was greater in the non-asthmatics undergoing flexible bronchoscopy than in the asthmatics (17 complications in 35 children versus one in 38). Fever requiring hospital admission was documented in two asthmatics following bronchoscopy. Four asthmatics reported an increase in symptoms in the week following bronchoscopy.
CONCLUSIONS—Bronchoscopy and endobronchial biopsy under general anaesthesia can be performed safely in children with difficult asthma, when the bronchoscopist and anaesthetist are suitably trained. The procedure is acceptable to the families involved.

 PMID:11316690

  14. Toward endobronchial Ir-192 high-dose-rate brachytherapy therapeutic optimization.

    PubMed

    Gay, H A; Allison, R R; Downie, G H; Mota, H C; Austerlitz, C; Jenkins, T; Sibata, C H

    2007-06-07

    A number of patients with lung cancer receive either palliative or curative high-dose-rate (HDR) endobronchial brachytherapy. Up to a third of patients treated with endobronchial HDR die from hemoptysis. Rather than accept hemoptysis as an expected potential consequence of HDR, we have calculated the radial dose distribution for an Ir-192 HDR source, rigorously examined the dose and prescription points recommended by the American Brachytherapy Society (ABS), and performed a radiobiological-based analysis. The radial dose rate of a commercially available Ir-192 source was calculated with a Monte Carlo simulation. Based on the linear quadratic model, the estimated palliative, curative and blood vessel rupture radii from the center of an Ir-192 source were obtained for the ABS recommendations and a series of customized HDR prescriptions. The estimated radius at risk for blood vessel perforation for the ABS recommendations ranges from 7 to 9 mm. An optimized prescription may in some situations reduce this radius to 4 mm. The estimated blood perforation radius is generally smaller than the palliative radius. Optimized and individualized endobronchial HDR prescriptions are currently feasible based on our current understanding of tumor and normal tissue radiobiology. Individualized prescriptions could minimize complications such as fatal hemoptysis without sacrificing efficacy. Fiducial stents, HDR catheter centering or spacers and the use of CT imaging to better assess the relationship between the catheter and blood vessels promise to be useful strategies for increasing the therapeutic index of this treatment modality. Prospective trials employing treatment optimization algorithms are needed.

  15. Endobronchial valves in the treatment of persistent air leak, an alternative to surgery.

    PubMed

    Cordovilla, Rosa; Torracchi, Aldo Mateo; Novoa, Nuria; Jiménez, Marcelo; Aranda, Jose Luis; Varela, Gonzalo; Barrueco, Miguel

    2015-01-01

    Persistent air leak is frustrating for both patients and physicians, above all leaks with a high risk of surgery. Insertion of endobronchial valves could be an alternative to surgery. The aim of this study is to describe our experience in these valves and analyse their efficacy in a series of patients with persistent air leaks. The valves are inserted by means of flexible bronchoscopy under conscious sedation and local anesthesia. A preliminary bronchoscopy identifies the air leak by bronchial occlusion using a balloon catheter. A successful outcome is defined as complete disappearance of the leak following removal of the chest drain, without the need for further surgery. From November 2010 to December 2013, 8 patients with persistent air leaks were treated with endobronchial valves. The number of valves used ranged from 1 to 4 (median 2), with a median duration of air leak prior to placement of 15.5 days. There were no complications and the resolution of the leak was complete in 6 of 8 patients (75%). The median duration of drainage after insertion of the valves was 13 days and the median time to removal of 52.5 days. Insertion of endobronchial valves is a safe and effective method for treating persistent air leaks, and a valid alternative to surgery. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  16. Bronchoscopic diagnostic procedures and microbiological examinations in proving endobronchial tuberculosis.

    PubMed

    Şimşek, Abdullah; Yapıcı, İlhami; Babalık, Mesiha; Şimşek, Zekiye; Kolsuz, Mustafa

    2016-01-01

    To determine the proportional distribution of endobronchial tuberculosis (EBTB) subtypes and to evaluate the types of bronchoscopic diagnostic procedures that can prove granulomatous inflammation. This was a retrospective study of 18 HIV-negative patients with biopsy-proven EBTB treated between 2010 and 2014. The most common EBTB subtypes, as classified by the bronchoscopic features, were tumorous and granular (in 22.2% for both). Sputum smear microscopy was performed in 11 patients and was positive for AFB in 4 (36.3%). Sputum culture was also performed in 11 patients and was positive for Mycobacterium tuberculosis in 10 (90.9%). Smear microscopy of BAL fluid (BALF) was performed in 16 patients and was positive for AFB in 10 (62.5%). Culture of BALF was also performed in 16 patients and was positive for M. tuberculosis in 15 (93.7%). Culture of BALF was positive for M. tuberculosis in 93.7% of the 16 patients tested. Among the 18 patients with EBTB, granulomatous inflammation was proven by the following bronchoscopic diagnostic procedures: bronchial mucosal biopsy, in 8 (44.4%); bronchial brushing, in 7 (38.8%); fine-needle aspiration biopsy, in 2 (11.1%); and BAL, in 2 (11.1%). Bronchial anthracofibrosis was observed in 5 (27.7%) of the 18 cases evaluated. In our sample of EBTB patients, the most common subtypes were the tumorous and granular subtypes. We recommend that sputum samples and BALF samples be evaluated by smear microscopy for AFB and by culture for M. tuberculosis, which could increase the rates of early diagnosis of EBTB. We also recommend that bronchial brushing be employed together with other bronchoscopic diagnostic procedures in patients suspected of having EBTB. Determinar a distribuição proporcional dos subtipos de tuberculose endobrônquica (TBEB) e avaliar os tipos de procedimentos diagnósticos broncoscópicos que podem revelar inflamação granulomatosa. Este foi um estudo retrospectivo com 18 pacientes HIV negativos com TBEB comprovada

  17. The impact of low-frequency, low-force cyclic stretching of human bronchi on airway responsiveness.

    PubMed

    Le Guen, Morgan; Grassin-Delyle, Stanislas; Naline, Emmanuel; Buenestado, Amparo; Brollo, Marion; Longchampt, Elisabeth; Kleinmann, Philippe; Devillier, Philippe; Faisy, Christophe

    2016-11-14

    In vivo, the airways are constantly subjected to oscillatory strain (due to tidal breathing during spontaneous respiration) and (in the event of mechanical ventilation) positive pressure. This exposure is especially problematic for the cartilage-free bronchial tree. The effects of cyclic stretching (other than high-force stretching) have not been extensively characterized. Hence, the objective of the present study was to investigate the functional and transcriptional response of human bronchi to repetitive mechanical stress caused by low-frequency, low-force cyclic stretching. After preparation and equilibration in an organ bath, human bronchial rings from 66 thoracic surgery patients were stretched in 1-min cycles of elongation and relaxation over a 60-min period. For each segment, the maximal tension corresponded to 80% of the reference contraction (the response to 3 mM acetylcholine). The impact of cyclic stretching (relative to non-stretched controls) was examined by performing functional assessments (epithelium removal and incubation with sodium channel agonists/antagonists or inhibitors of intracellular pathways), biochemical assays of the organ bath fluid (for detecting the release of pro-inflammatory cytokines), and RT-PCR assays of RNA isolated from tissue samples. The application of low-force cyclic stretching to human bronchial rings for 60 min resulted in an immediate, significant increase in bronchial basal tone, relative to non-cyclic stretching (4.24 ± 0.16 g vs. 3.28 ± 0.12 g, respectively; p < 0.001). This cyclic stimulus also increased the affinity for acetylcholine (-log EC50: 5.67 ± 0.07 vs. 5.32 ± 0.07, respectively; p p < 0.001). Removal of airway epithelium and pretreatment with the Rho-kinase inhibitor Y27632 and inward-rectifier K+ or L-type Ca(2+) channel inhibitors significantly modified the basal tone response. Exposure to L-NAME had opposing effects in all cases. Pro-inflammatory pathways were not

  18. Pharmacological assessment of the onset of action of aclidinium and glycopyrronium versus tiotropium in COPD patients and human isolated bronchi.

    PubMed

    Rogliani, Paola; Calzetta, Luigino; Ora, Josuel; Lipsi, Roberto; Segreti, Andrea; Matera, Maria Gabriella; Cazzola, Mario

    2015-08-15

    Preclinical studies suggested that aclidinium and glycopyrronium might have a faster onset of action than tiotropium. In this study we assessed the onset of action of aclidinium and glycopyrronium versus tiotropium, all administered at the approved clinical doses, in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) and in human isolated bronchi by using different concentrations. Sixteen COPD patients inhaled single doses of aclidinium 400µg, glycopyrronium 50μg and tiotropium 18µg and FEV1 was measured to assess their onset of action. In human isolated bronchi the time to evoke half maximal relaxation of transmural stimulation was tested from 10nM to 1µM for each drug. Nine, eight and twelve patients did not achieve 15% increase of FEV1 after inhalation of aclidinium, glycopyrronium and tiotropium, respectively. Aclidinium (15.6±7.5min) and glycopyrronium (17.9±10.4min) enhanced 15% FEV1 more rapidly than tiotropium (42.5±19.4min), with no significant difference (P>0.05). In isolated airways, glycopyrronium elicited a dose-dependent onset of action (10nM: 8.2±1.3min, 100nM: 7.1±2.1min, 1μM: 3.4±0.4min) that was faster compared to that induced by aclidinium (1μM: 6.4±0.5min) and tiotropium (1μM: 8.4±1.1min) (P<0.05), that halved the contractile tone only at the highest concentration. Bronchodilation induced by aclidinium and glycopyrronium was faster than that induced by tiotropium, but since our analysis was restricted to the acute effect of these LAMAs and the inhaled doses were not isoeffective, the real differences in their impact on the onset of bronchodilation will be definitely determined after a long-term challenge of these treatments at isoeffective doses in COPD patients.

  19. Endobronchial ultrasound—guidance for interstitial photodynamic therapy of locally advanced lung cancer—a new interventional concept

    PubMed Central

    Oakley, Emily; Bellnier, David; Shafirstein, Gal

    2017-01-01

    Recent advances in interventional pulmonology led to a significant expansion of the diagnostic and therapeutic role of endobronchial ultrasound. In this paper, we describe a new concept for using endobronchial ultrasound to guide interstitial photodynamic therapy (PDT). For this purpose, we conducted in vitro and in vivo experiments using a phantom and animal models, respectively. A new 0.5 mm optical fiber, with cylindrical diffuser end, was used to deliver the therapeutic light through the 21-gauge endobronchial ultrasound needle. The animal experiments were performed under real-time ultrasonography guidance in mice and rabbits’ tumor models. Safe and effective fiber placements and tumor illumination was accomplished. In addition, computer simulation of light propagation suggests that locally advanced lung cancer tumor can be illuminated. This study demonstrates the potential feasibility of this new therapeutic modality approach, justifying further investigation in the treatment of locally advanced lung cancers. PMID:28932569

  20. Particle Deposition in Human Lungs due to Varying Cross-Sectional Ellipticity of Left and Right Main Bronchi

    NASA Astrophysics Data System (ADS)

    Roth, Steven; Oakes, Jessica; Shadden, Shawn

    2015-11-01

    Particle deposition in the human lungs can occur with every breathe. Airbourne particles can range from toxic constituents (e.g. tobacco smoke and air pollution) to aerosolized particles designed for drug treatment (e.g. insulin to treat diabetes). The effect of various realistic airway geometries on complex flow structures, and thus particle deposition sites, has yet to be extensively investigated using computational fluid dynamics (CFD). In this work, we created an image-based geometric airway model of the human lung and performed CFD simulations by employing multi-domain methods. Following the flow simulations, Lagrangian particle tracking was used to study the effect of cross-sectional shape on deposition sites in the conducting airways. From a single human lung model, the cross-sectional ellipticity (the ratio of major and minor diameters) of the left and right main bronchi was varied systematically from 2:1 to 1:1. The influence of the airway ellipticity on the surrounding flow field and particle deposition was determined.

  1. Cellular morphometry and cycling cell populations of human and dog bronchi. Annual progress report, April 1, 1994--March 31, 1995

    SciTech Connect

    Robbins, E.S.

    1994-12-01

    Quantitative data of the human bronchial epithelial cells at possible risk for malignant transformation in lung cancer is crucial for accurate radon dosimetry and risk analysis. The nuclei of these cells may be targets for damage by {alpha} particles. Then it is important to determine the locations and other parameters of these nuclei in different airway generations, among smokers, non-smokers and ex-smokers, between men and women and in people of different ages. This proposal includes extended morphometric studies on electron micrographs of human bronchial epithelium of defined airway generations. The second part of this proposal describes the continuation of studies to quantitate the cycling tracheo-bronchial epithelial population(s) using proliferation markers and immunocytochemistry on paraffin sections. The proliferative potential of the airway mucosa of smokers, non-smokers, and ex-smokers, men and women, as well as individuals of different ages are being compared. Normal human bronchial linings are also being compared with normal adult dog bronchi and metaplastic and repairing human airways. Since cycling cells can be more sensitive to damage from carcinogens and radioactivity, the quantitative data from this project will allow the development of more accurate radon risk analysis.

  2. The comparison of the lengths and diameters of main bronchi measured from two-dimensional and three-dimensional images in the same patients

    PubMed Central

    Lee, Jeong Woo; Choi, Jin-Wook; Han, Young-Jin; Lee, Jun-Rae

    2014-01-01

    Background Recently, multi-planar reconstruction of the three-dimensional (3D) spiral chest CT scan has demonstrated superiority in the evaluation of the tracheobronchial tree. The goal of this study was to measure the lengths of the right and left main bronchi and their anteroposterior (AP) and transverse (TR) diameters using the 3D and two-dimensional (2D) images in the same adult respectively, and to evaluate the degree of correlation between them. Methods We measured the lengths of the right and left main bronchi from the carina to the first of their branches and the AP and TR diameters at the mid-portion of the right main bronchus and 2 cm below the carina in the left main bronchus. We determined the size of the left-sided double-lumen tube (DLT) based on the measured AP diameter of the left main bronchus from the 3D and 2D images, respectively. Results There was moderate correlation between the lengths of both main bronchi obtained from the 3D images and the 2D images, and between the AP diameter of the left main bronchus obtained from the 3D images and the 2D images. Same sized DLTs were estimated in 69% of the men and 34% of the women. Conclusions The lengths of the right and left main bronchi and their AP and TR diameters obtained from 3D images were not strongly correlated with those from 2D images. Therefore, a further study is needed to verify the superiority of 3D images in selecting the appropriate size of left-sided DLT. PMID:24729839

  3. [Comparison of hot versus cold biopsy forceps in the diagnosis of endobronchial lesions].

    PubMed

    Firoozbakhsh, Shahram; Seifirad, Soroush; Safavi, Enayat; Dinparast, Reza; Taslimi, Shervin; Derakhshandeilami, Gholamreza

    2011-11-01

    Traditionally cold biopsy forceps were used for endobronchial biopsy, and recently electrocautery (hot) bronchoscopy biopsy forceps are introduced. It is hypothesized that hot biopsy forceps may decrease procedure related bleeding and also may decrease the quality of obtained samples. Patients with different indications for endobronchial biopsy during fiberoptic bronchoscopy underwent three hot and three cold biopsies with a random fashion. All biopsies were obtained with a single biopsy forceps with and without the application of an electrocoagulation current, set on soft coagulation mode (40W). A four point scale was used for quantification of bleeding. A single pathologist blinded to the patients' history was requested to review all samples. A three point scale was used to assess electrocoagulation damage. A total of 240 biopsies were obtained from 40 patients. Frequency of positive concordance between the two methods was 85%. The degree of electrocoagulation damage of the samples was as follows: grade 1=52.5%, grade 2=32.5%, and grade 3=15%. The average bleeding score following hot biopsy was significantly lower compared to the cold biopsy (P=.006). The concordance between diagnostic yield of hot and cold biopsies was 85%. There was no significant difference between the diagnostic yields of two biopsy methods (P=.687). Hot biopsy forceps significantly decreased the procedure related bleeding. The quality of samples was not impaired significantly. Regarding low prevalence of bleeding following endobronchial biopsy, routine use of hot bronchoscopy forceps is not reasonable. However, familiarity of bronchoscopists with this method may improve bronchoscopy safety. Copyright © 2011 SEPAR. Published by Elsevier Espana. All rights reserved.

  4. Solitary Endobronchial Papilloma with Malignant Transformation and Concomitant TB Infection: Case Report and Literature Review

    PubMed Central

    2017-01-01

    We are reporting a case of solitary endobronchial papilloma located in posterior segment of the left upper lobe of the lung with malignant transformation and negative human papilloma virus (HPV) strains in a 40-year-old Saudi nonsmoker man. The patient had a concomitant tuberculosis (TB) infection. The patient received appropriate treatment in the form of anti-TB medication and surgical resection of the squamous cell carcinoma followed by chemotherapy. There was no evidence of tumor recurrence, resulting in a complete cure. We are reporting the case as well as a literature review related to the topic. PMID:28270942

  5. Capsaicin-like effects of N-arachidonoyl-dopamine in the isolated guinea pig bronchi and urinary bladder.

    PubMed

    Harrison, Selena; De Petrocellis, Luciano; Trevisani, Marcello; Benvenuti, Francesca; Bifulco, Maurizio; Geppetti, Pierangelo; Di Marzo, Vincenzo

    2003-08-15

    A capsaicin-like endogenous ligand of vanilloid (VR1) receptors, N-arachidonoyl-dopamine, was recently identified in bovine and rat nervous tissue, and found to be almost as potent as capsaicin, and 5-10-fold more potent than anandamide, on these receptors, both in isolated cells and in vivo. Here we have investigated if N-arachidonoyl-dopamine also exerts other capsaicin-like effects at VR1 receptors in some isolated organ preparations. N-arachidonoyl-dopamine exerted a potent contractile response of guinea pig isolated bronchi (EC50=12.6 +/- 1.7 microM, Emax=69.2 +/- 2.4% of carbachol Emax), which was blocked by pre-treatment with capsaicin or with the VR1 antagonist capsazepine, as well as by a combination of tachykinin NK1 and NK2 receptor antagonists. In this assay, N-arachidonoyl-dopamine was less and more potent and/or efficacious than capsaicin (EC50=40.0 nM; Emax=93.5%) and anandamide (EC50=15.2 microM, Emax=38.0%), respectively. Unlike capsaicin and anandamide, forskolin or ethanol did not enhance N-arachidonoyl-dopamine effect in this preparation, whereas epithelial denudation resulted in a 2.5-fold increase in potency without affecting the efficacy. N-arachidonoyl-dopamine also contracted the isolated guinea pig urinary bladder, although in this preparation, as well as in the isolated rat urinary bladder, the potency (EC50=3.7 +/- 0.3 and 19.9 +/- 0.1 microM) and/or efficacy (Emax=12.0 +/- 0.1% and 20.7 +/- 0.7% of carbachol Emax) of the compound were significantly lower than those of both capsaicin and anandamide. These data suggest that the extent to which exogenous N-arachidonoyl-dopamine activates VR1 receptor in isolated organs is largely dependent on pharmacodynamics and bioavailability.

  6. Endobronchial fibroma in a pneumoconiosis patient with a history of tuberculosis: A case report and literature review

    PubMed Central

    Wang, Meifang; Liu, Yuquan; Li, Dan; Xiong, Chang; Qian, Xin; Tang, Yijun

    2016-01-01

    Bronchial fibroma is uncommon, with only 18 cases reported since 1948. The current study presents a rare case of endobronchial fibroma, along with a relevant literature review. A 54-year-old male patient with pneumoconiosis and a history of tuberculosis was admitted to the Taihe Hospital Affiliated With Hubei University of Medicine, Shiyan, China, due to refractory dry cough. Computed tomography of the chest showed multiple nodular and confluent opacities in the lung and one cavitation in the right upper lobe region. Bronchoscopy revealed an endobronchial mass in the left main bronchus. A bronchoscopic resection was performed, and the pathological evaluation confirmed fibroma. The patient's dry cough resolved following the removal of the fibroma, and no recurrence was detected during 6 months of follow-up. Endobronchial fibroma is an extremely rare disease, for which a pathological analysis is typically required for an accurate diagnosis. Bronchoscopic treatments, including removal by forceps, argon plasma coagulation and laser or electrocautery snares, may be used to treat patients affected by endobronchial fibroma. PMID:27446391

  7. Retrieval of Tip-embedded Inferior Vena Cava Filters by Using the Endobronchial Forceps Technique: Experience at a Single Institution.

    PubMed

    Stavropoulos, S William; Ge, Benjamin H; Mondschein, Jeffrey I; Shlansky-Goldberg, Richard D; Sudheendra, Deepak; Trerotola, Scott O

    2015-06-01

    To evaluate the use of endobronchial forceps to retrieve tip-embedded inferior vena cava (IVC) filters. This institutional review board-approved, HIPAA-compliant retrospective study included 114 patients who presented with tip-embedded IVC filters for removal from January 2005 to April 2014. The included patients consisted of 77 women and 37 men with a mean age of 43 years (range, 18-79 years). Filters were identified as tip embedded by using rotational venography. Rigid bronchoscopy forceps were used to dissect the tip or hook of the filter from the wall of the IVC. The filter was then removed through the sheath by using the endobronchial forceps. Statistical analysis entailed calculating percentages, ranges, and means. The endobronchial forceps technique was used to successfully retrieve 109 of 114 (96%) tip-embedded IVC filters on an intention-to-treat basis. Five failures occurred in four patients in whom the technique was attempted but failed and one patient in whom retrieval was not attempted. Filters were in place for a mean of 465 days (range, 31-2976 days). The filters in this study included 10 Recovery, 33 G2, eight G2X, 11 Eclipse, one OptEase, six Option, 13 Günther Tulip, one ALN, and 31 Celect filters. Three minor complications and one major complication occurred, with no permanent sequelae. The endobronchial forceps technique can be safely used to remove tip-embedded IVC filters. © RSNA, 2014.

  8. Endobronchial Enigma: A Clinically Rare Presentation of Nocardia beijingensis in an Immunocompetent Patient

    PubMed Central

    Abdel-Rahman, Nader; Izhakain, Shimon; Wasser, Walter G.; Fruchter, Oren; Kramer, Mordechai R.

    2015-01-01

    Nocardiosis is an opportunistic infection caused by the Gram-positive weakly acid-fast, filamentous aerobic Actinomycetes. The lungs are the primary site of infection mainly affecting immunocompromised patients. In rare circumstances even immunocompetent hosts may also develop infection. Diagnosis of pulmonary nocardiosis is usually delayed due to nonspecific clinical and radiological presentations which mimic fungal, tuberculous, or neoplastic processes. The present report describes a rare bronchoscopic presentation of an endobronchial nocardial mass in a 55-year-old immunocompetent woman without underlying lung disease. The patient exhibited signs and symptoms of unresolving community-acquired pneumonia with a computed tomography (CT) scan that showed a space-occupying lesion and enlarged paratracheal lymph node. This patient represents the unusual presentation of pulmonary Nocardia beijingensis as an endobronchial mass. Pathology obtained during bronchoscopy demonstrated polymerase chain reaction (PCR) confirmation of nocardiosis. Symptoms and clinical findings improved with antibiotic treatment. This patient emphasizes the challenge in making the diagnosis of pulmonary nocardiosis, especially in a low risk host. A literature review presents the difficulties and pitfalls in the clinical assessment of such an individual. PMID:26819795

  9. Inadvertent Endobronchial Intubation in a Patient With a Short Neck Length.

    PubMed

    Cornelius, Bryant; Sakai, Tetsuro

    2015-01-01

    Inadvertent placement of the endotracheal tube into the right bronchus during intubation for general anesthesia is a fairly common occurrence. Many precautions should be taken by the anesthesia provider in order to minimize the incidence of endobronchial intubation, including bilateral auscultation of the lungs, use of the 21/23 rule, and palpation of the inflated endotracheal cuff at the sternal notch. These provisions, however, are not foolproof; anesthesia providers should realize that endobronchial intubation may occur from time to time because of variations in patient anatomy, changes in patient positioning, and cephalad pressures exerted during surgery. A 58-year-old man with chronic obstructive pulmonary disease received general endotracheal anesthesia for a laparoscopic cholecystectomy. His height was 165 cm (5 ft, 5 in) and the endotracheal tube was secured at his incisors at 21 cm after placement with a rigid laryngoscope. Bilateral breath sounds were confirmed with auscultation, although they were distant because of his chronic obstructive pulmonary disease. After radiographic examination in the postanesthesia care unit, a right main-stem intubation was revealed to have taken place, resulting in complete atelectasis of the left lung. After repositioning of the endotracheal tube, radiography confirmed that the patient had an anatomically short tracheal length.

  10. 3D endobronchial ultrasound reconstruction and analysis for multimodal image-guided bronchoscopy

    NASA Astrophysics Data System (ADS)

    Zang, Xiaonan; Bascom, Rebecca; Gilbert, Christopher R.; Toth, Jennifer W.; Higgins, William E.

    2014-03-01

    State-of-the-art image-guided intervention (IGI) systems for lung-cancer management draw upon high-resolution three-dimensional multi-detector computed-tomography (MDCT) images and bronchoscopic video. An MDCT scan provides a high-resolution three-dimensional (3D) image of the chest that is used for preoperative procedure planning, while bronchoscopy gives live intraoperative video of the endobronchial airway tree structure. However, because neither source provides live extraluminal information on suspect nodules or lymph nodes, endobronchial ultrasound (EBUS) is often introduced during a procedure. Unfortunately, existing IGI systems provide no direct synergistic linkage between the MDCT/video data and EBUS data. Hence, EBUS proves difficult to use and can lead to inaccurate interpretations. To address this drawback, we present a prototype of a multimodal IGI system that brings together the various image sources. The system enables 3D reconstruction and visualization of structures depicted in the 2D EBUS video stream. It also provides a set of graphical tools that link the EBUS data directly to the 3D MDCT and bronchoscopic video. Results using phantom and human data indicate that the new system could potentially enable smooth natural incorporation of EBUS into the system-level work flow of bronchoscopy.

  11. Pulmonary synovial sarcoma with polypoid endobronchial growth: a case report, immunohistochemical and cytogenetic study.

    PubMed

    Niwa, Hideki; Masuda, Shinji; Kobayashi, Chikashi; Oda, Yoshinao

    2004-08-01

    A rare case of primary pulmonary synovial sarcoma with polypoid endobronchial growth in a 42-year-old Japanese woman is described. Left upper sleeve lobectomy was performed for the polypoid tumor measuring 2.5 cm in the left major bronchus and the patient was treated with adjuvant chemotherapy. Three years later, a recurrent tumor was discovered. Microscopically, this tumor was characterized by a proliferation of oval to spindle-shaped cells arranged in sheets and fascicles and covered by the thin normal bronchial epithelium. Immunohistochemically, tumor cells were positive for vimentin, and focally positive for pancytokeratin recognized by AE1/AE3, cytokeratin 7 and epithelial membrane antigen. A chimera gene, SYT-SSX1, was detected. Recently, primary pulmonary synovial sarcoma is an increasingly recognized clinical entity; however, most of these tumors present as a parenchymal mass. The present case is a unique example of primary synovial sarcoma of endobronchial polypoid type. This case suggests that pulmonary synovial sarcoma might originate from bronchial submucosal stromal tissue.

  12. Safety and efficacy of using high-dose topical and nebulized anesthesia to obtain endobronchial cultures.

    PubMed

    Berger, R; McConnell, J W; Phillips, B; Overman, T L

    1989-02-01

    We evaluated the safety and efficacy of high-dose topical and nebulized airway anesthesia in normal volunteers and in patients undergoing diagnostic fiberoptic bronchoscopy. Lidocaine solution (4 percent) was used for gargling, for spraying the palate and oropharynx with an atomizer, and for nebulization with an air-powered nebulizer (mean total dose, 1,682 mg) and 2 percent lidocaine (Xylocaine) jelly for anesthetizing nasal passages. In six normal subjects and in eight patients, lidocaine blood levels were measured at baseline, after gargling, after spraying, after nebulization, and then at 5, 10, 15, 30, and 60 min; 19 normal subjects and ten patients underwent the same anesthesia protocol but had no blood drawn. Fiberoptic bronchoscopy was performed in 21 normal volunteers and in 18 patients and cultures obtained using the protected specimen brush. Additional endobronchial lidocaine (mean 256 mg) was given to the 18 patients after collecting the microbiology specimens. Peak lidocaine blood levels remained below 6 micrograms/ml in all cases. Cough and discomfort during bronchoscopic examination was absent or minimal in 17 of 21 normal subjects (80 percent) and in 14 of 18 patients (77 percent) and was severe in only one instance (5 percent). There were no related complications. Using only topical and nebulized anesthesia is safe and effective for performing fiberoptic bronchoscopy, especially when bacterial cultures are to be obtained and endobronchial instillation of lidocaine must be avoided.

  13. Effective Bolus Dose of Sufentanil to Attenuate Cardiovascular Responses in Laryngoscopic Double-Lumen Endobronchial Intubation

    PubMed Central

    Choi, Byung-Hee; Lee, Yong-Cheol

    2016-01-01

    Background Sufentanil is a potent opioid analgesic frequently used in clinical anesthesia. Double-lumen endobronchial intubation induces profound cardiovascular responses in comparison with ordinary endotracheal intubation because of the larger tube diameter and direct irritation of the carina. Objectives The purpose of this study was to determine the effective bolus dose of sufentanil to attenuate hemodynamic changes in response to laryngoscopic double-lumen endobronchial intubation. Patients and Methods We randomly assigned 72 patients aged 18 - 65 years and with an American Society of Anesthesiologists physical status of 1 or 2 to one of four sufentanil dose groups: NS, S0.1, S0.2, or S0.3. The respective doses for the groups were as follows: normal saline, 0.1 mcg/kg of sufentanil, 0.2 mcg/kg of sufentanil, and 0.3 mcg/kg of sufentanil. Blood pressure and heart rate were recorded during the pre-anesthesia period at baseline, pre-intubation, immediate post-intubation, and every minute during 5 minutes after intubation. Results Baseline mean arterial pressures in the NS, S0.1, S0.2, and S0.3 groups were 89.8 ± 12.1, 89.2 ± 10.9, 88.8 ± 13.6, and 90.7 ± 11.1, respectively. At immediate post-intubation, the mean arterial pressures in the NS, S0.1, S0.2, and S0.3 groups were 129.7 ± 14.7, 120.7 ± 14.2, 120.8 ± 17.2, and 96.7 ± 10.4, respectively. At immediate post-intubation, the mean arterial pressure in the NS, S0.1, and S0.2 groups significantly increased from baseline (P < 0.001), but the S0.3 group showed no difference. In the time point comparison at immediate post- intubation, the S0.3 group had a significantly lower mean arterial pressure than did the NS, S0.1, and S0.2 groups (P < 0.001). Conclusions We found that 0.3 mcg/kg of sufentanil attenuates cardiovascular responses to double-lumen endobronchial intubation without adverse effects. PMID:27252903

  14. [A case of pulmonary malignant lymphoma with endobronchial involvement with repeated improvement or progress of atelectasis].

    PubMed

    Ohe, Miki; Kohno, Hidekazu; Deguti, Naoko; Kanda, Hibiki; Kondo, Keiichi; Isobe, Takeshi

    2008-12-01

    A 68-year-old woman, presented to the emergency department with dry cough and increased shortness of breath. Her chest X-ray showed complete atelectasis of the right upper lobe. Her chest examination was significant for diffuse wheezing, and she was treated with corticosteroids. Fourteen hours after her arrival, wheezing and atelectasis on the chest X-ray disappeared. However, 10 days after admission, her chest X-ray showed atelectasis of the right lower lobe, and right middle and lower lobes atelectasis on 17 days, then became complete atelectasis of the lung on 22 days after admission. Bronchoscopic findings showed severe stenosis of the right upper lobe bronchus and truncus intermedius. Pathologic examination of the transbronchoscopic biopsy specimen showed diffuse large B-cell lymphoma. We diagnosed primary pulmonary malignant lymphoma because she had no extrapulmonary diseases. An extremely rare case of pulmonary malignant lymphoma with endobronchial involvement in which the site of atelectasis changed rapidly was reported.

  15. Bronchogenic Cyst Rupture and Pneumonia after Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Case Report

    PubMed Central

    Hong, Goohyeon; Song, Junwhi; Lee, Kyung-Jong; Jeon, Kyeongman; Koh, Won-Jung; Suh, Gee Young; Chung, Man Pyo; Kim, Hojoong; Kwon, O Jung

    2013-01-01

    We report a 54-year-old woman who presented with a well-defined, homogeneous, and non-enhancing mass in the retrobronchial region of the bronchus intermedius. The patient underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for histological confirmation. Serous fluid was aspirated by EBUS-TBNA. Cytological examination identified an acellular smear with negative microbiological cultures. The patient was finally diagnosed with bronchogenic cysts by chest computed tomography (CT) and EBUS-TBNA findings. However, 1 week after EBUS-TBNA, the patient developed bronchogenic cyst rupture and pneumonia. Empirical antibiotics were administered, and pneumonia from the bronchogenic cyst rupture had resolved on follow-up chest CT. To our knowledge, this is the first reported case of pneumonia from bronchogenic cyst rupture after EBUS-TBNA. PMID:23678359

  16. Severe Endobronchial Inflammation Induced by Aspiration of a Ferrous Sulfate Tablet.

    PubMed

    Lim, Sang Youn; Sohn, Sung Birm; Lee, Jung Min; Lee, Ji Ae; Chung, Sangmi; Kim, Junga; Choi, Juwhan; Kim, Sehwa; Yoo, Ah Young; Roh, Jong Ah; Park, Haein; Kim, Won Shik; Sim, Jae Kyeom; Shim, Jae Jeong; Min, Kyung Hoon

    2016-01-01

    Iron supplements such as ferrous sulfate tablets are usually used to treat iron-deficiency anemia in some elderly patients with primary neurologic disorders or decreased gag reflexes due to stroke, senile dementia, or parkinsonism. While the aspiration of ferrous sulfate is rarely reported, it is a potentially life-threatening condition that can lead to airway necrosis and bronchial stenosis. A detailed history and high suspicion of aspiration are required to avoid delays in diagnosis and treatment. The diagnosis can be confirmed by bronchoscopic examination and a tissue biopsy. Early removal of the aspirated tablet prevents acute complications, such as bronchial necrosis, hemoptysis, and lobar consolidation. Tablet removal is also necessary to prevent late bronchial stenosis. We presented the first case in Korea of a ferrous sulfate tablet aspiration that induced severe endobronchial inflammation.

  17. Pulmonary artery sarcoma diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration.

    PubMed

    Chan, Johnny W M; Chu, Stephanie Y Y; Lam, Connie H K; O, W H; Cheung, O Y; Kwan, T L; Leung, Alex K C; Law, W L

    2014-04-01

    Pulmonary artery sarcoma is a rare disease with poor prognosis that has not been reported in Hong Kong. Its clinical and radiological presentation frequently mimics pulmonary embolism. Diagnosis is usually delayed until surgery, which is the treatment option that provides the best survival. Endobronchial ultrasound-guided transbronchial needle aspiration is an effective non-surgical technique for lymph node staging of lung cancer and diagnosis of mediastinal lesions via bronchoscopy. Here we discuss a case of pulmonary artery sarcoma diagnosed by this method, the second one in the literature, which serves to illustrate its potential use for early and minimally invasive diagnosis of the condition. Although such aspiration is a safe procedure, tissue sampling of extravascular extensions is advisable wherever possible.

  18. Pulmonary artery intimal sarcoma diagnosed using endobronchial ultrasound-guided transbronchial needle aspiration

    PubMed Central

    Caraway, Nancy P.; Salina, Davide; Deavers, Michael T.; Morice, Rodolfo; Landon, Gene

    2015-01-01

    Intimal sarcoma of the pulmonary artery is a rare intraluminal malignant neoplasm that has an aggressive biological behavior, and early diagnosis may improve patient outcome. We describe a case of pulmonary artery intimal sarcoma diagnosed on cytologic material obtained by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy with rapid on-site evaluation (ROSE). The aspirate showed loosely cohesive clusters of pleomorphic malignant spindled and epithelioid cells. An immunostain panel did not demonstrate any definitive mesenchymal or epithelial differentiation. The tumor's intraluminal origin was supported by radiographic imaging studies. Subsequently, the patient received preoperative chemotherapy and underwent tumor resection with reconstruction. This report describes the cytomorphologic features of this rare intravascular tumor and demonstrates how EBUS-TBNA with ROSE was instrumental in obtaining optimal cytologic sampling for ancillary studies, thus expediting the management. PMID:25745502

  19. From cytology to histology: diagnosis of a relapsed mediastinal lymphoma by endobronchial ultrasound transbronchial histological needle

    PubMed Central

    Ariza-Prota, Miguel Angel; Bango Álvarez, Antonio; Pérez, Liliana; Pando-Sandoval, Ana; Fuentes, Nelson; Casan, Pere

    2015-01-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is highly accurate in diagnosing mediastinal lymphadenopathies of lung cancer and benign disorders, with the advantage that it is a minimally invasive technique, unlike open surgery and mediastinoscopy. However, the diagnostic accuracy of EBUS-TBNA for the diagnosis of lymphoma in patients with mediastinal lymphadenopathy is not well defined. The lack of tissue architecture obtained by cytological needles decreases the diagnostic accuracy for diagnosis and subtyping of de novo and relapsed mediastinal lymphomas. We present the first described case in the literature of an anaplastic large cell lymphoma relapsed, diagnosed on tissue fragments obtained by EBUS-TBNA with the particularity of using a histological needle. PMID:26090115

  20. Pulmonary artery intimal sarcoma diagnosed using endobronchial ultrasound-guided transbronchial needle aspiration.

    PubMed

    Caraway, Nancy P; Salina, Davide; Deavers, Michael T; Morice, Rodolfo; Landon, Gene

    2015-01-01

    Intimal sarcoma of the pulmonary artery is a rare intraluminal malignant neoplasm that has an aggressive biological behavior, and early diagnosis may improve patient outcome. We describe a case of pulmonary artery intimal sarcoma diagnosed on cytologic material obtained by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy with rapid on-site evaluation (ROSE). The aspirate showed loosely cohesive clusters of pleomorphic malignant spindled and epithelioid cells. An immunostain panel did not demonstrate any definitive mesenchymal or epithelial differentiation. The tumor's intraluminal origin was supported by radiographic imaging studies. Subsequently, the patient received preoperative chemotherapy and underwent tumor resection with reconstruction. This report describes the cytomorphologic features of this rare intravascular tumor and demonstrates how EBUS-TBNA with ROSE was instrumental in obtaining optimal cytologic sampling for ancillary studies, thus expediting the management.

  1. Pulmonary mucormycosis diagnosed by convex probe endobronchial ultrasound-guided fine needle aspiration of cavity wall

    PubMed Central

    Nair, Vidya; Sharma, Rahul Kumar; Khanna, Arjun; Talwar, Deepak

    2017-01-01

    Pulmonary mucormycosis is an opportunistic fungal infection in immunocompromised individuals. It is difficult to diagnose as it requires tissue biopsy, and generally these patients are unfit to undergo invasive lung biopsies. We describe a novel technique in a case with uncontrolled diabetes mellitus with nonresolving pulmonary cavitary disease where convex probe endobronchial ultrasound (EBUS)-guided aspiration of lung cavity wall showed classical histopathological picture establishing the diagnosis of mucorale infection. EBUS being real-time, minimally invasive technique with minimal risk of complications, led to early diagnosis, and prompt treatment. This appears to be a novel diagnostic modality in pulmonary mucormycosis with minimal complications as compared with other biopsy methods with very high complication risk. PMID:28360470

  2. Use of Narrow Band Imaging in the Diagnosis of Hypovascular Endobronchial Sarcoidosis.

    PubMed

    Hakim, Rimoun; Sabath, Bruce; Kaplan, Tugba; Yung, Rex

    2017-10-01

    Narrow band imaging (NBI) has been widely applied for the evaluation of numerous disease conditions that present with increased vascularity of the mucosa, most often malignancies. It is increasingly being used in benign conditions as well. We present the first case in which NBI was used, rather, to detect areas of bronchial hypovascularity due to its ability to increase the visual contrast between normal and hypovascular mucosa. Endobronchial biopsy of these nodules led to the diagnosis of sarcoidosis. Had conventional white light alone been utilized, the diagnosis would likely have been missed because not only were these lesions difficult to visualize under white light but transbronchial lung biopsy and transbronchial needle aspiration were unremarkable. We propose that NBI should be considered in the bronchoscopic evaluation of possible sarcoidosis or any other condition that could present with airway hypovascularity.

  3. Bronchoscopic treatment of complex persistent air leaks with endobronchial one-way valves.

    PubMed

    Fiorelli, Alfonso; Costanzo, Saveria; Carelli, Emanuele; Di Costanzo, Emilio; Santini, Mario

    2016-04-01

    We reported a case series including 5 patients with persistent air-leaks refractory to standard treatment. All patients were unfit for surgery for the presence of co-morbidities and/or severe respiratory failure due to underlying lung diseases. They were successfully treated with bronchoscopic placement of endobronchial one-way valves. Air-leaks stopped in the first 24 h after the procedure in three patients and 3 and 5 days later, respectively, in the remaining two. No complications were observed and follow-up was uneventful in all patients but one died 25 days after the procedure for systemic sepsis due to peritonis. Patients with important, refractory air leaks having clinical repercussions and unfit for surgery should be early reviewed for bronchoscopic valves treatment.

  4. Circulating tumour cells in patients with lung cancer undergoing endobronchial cryotherapy.

    PubMed

    Chudasama, Dimple; Rice, Alexandra; Soppa, Gopal; Anikin, Vladimir

    2015-08-01

    Early diagnosis of lung cancer still poses a major issue, with a large proportion of patients diagnosed at late stages. Therapeutic options and treatment remain limited in these patients. In most cases only palliative therapies are available to alleviate any severe symptoms. Endobronchial cryotherapy (EC) is one form of palliative treatment offered to patients with obstructive airway tumours. Although successful, the impact on circulating tumour cell (CTCs) spread has not been investigated in detail. This study recruited 20 patients awaiting EC treatment. Baseline and post EC blood samples were analysed for presence of CTCs. Results showed an increase in CTCs following EC in 75% of patients. Significant increases were noticeable in some cases. Although EC is a well-accepted modality of treatment to alleviate symptoms, it may lead to an increase in CTCs, which in turn may have implications for tumour dissemination and metastatic spread.

  5. Diagnosis of non-nodal paratracheobronchial lesions by linear endobronchial ultrasound.

    PubMed

    Lourido, Tamara; Botana, Maribel; Leiro, Virginia; Núñez, Manuel; Fernández-Villar, Alberto

    2013-08-01

    Linear endobronchial ultrasound (EBUS) allows samples of lesions close to the airways to be obtained, as it enables aspiration to be performed under visual control in real time, opening new possibilities for minimally invasive examination of the mediastinum. While there are many publications on its usefulness in the study of mediastinal or hilar lymphadenopathies, there are few that analyse the role of EBUS-guided transbronchial needle aspiration for the diagnosis of other lesions adjacent to the airways or digestive tract. We describe the characteristics and results obtained in a series of 26 cases of non-nodal lesions of different aetiologies studied by EBUS- guided transbronchial needle aspiration through the airways or oesophagus, demonstrating the usefulness and safety of this technique in the diagnosis of these types of lesions.

  6. Fractured closed suction catheter: an unusual cause of endobronchial obstruction in a ventilated patient.

    PubMed

    Rogan, M P; Marsh, B

    2010-03-01

    A 32-year-old HIV-positive man required ventilation for seizures secondary to viral encephalitis. He had a prolonged care unit stay and had percutaneous tracheostomy performed on day 14 of his admission. He subsequently developed persistent right basal infiltrates and atelectasis on chest radiographs that were slow to respond to antibiotic treatment. Fiberoptic bronchoscopy revealed the cause of his infiltrates to be a 14-cm tip section of closed suction catheter tubing that had presumably fractured during suctioning and became lodged in his trachea and right main bronchus. Foreign body aspiration should be considered in the differential diagnosis of persisting lung infiltrates or atelectasis in all patients. This case describes a rare cause of endobronchial obstruction in a ventilated patient. Medical staff requires education about the importance of ensuring that suction catheters and other airway adjuncts are intact following use to prevent possible airway foreign bodies.

  7. Endobronchial lipomatous tumors: clinicopathologic analysis of 12 cases with molecular cytogenetic evidence supporting classification as "lipoma".

    PubMed

    Boland, Jennifer M; Fritchie, Karen J; Erickson-Johnson, Michele R; Oliveira, Andre M; Colby, Thomas V; Folpe, Andrew L

    2013-11-01

    Lipomatous lesions rarely involve the bronchial tree, and detailed morphologic and molecular cytogenetic analysis of these tumors is lacking. The clinicopathologic features of 12 endobronchial lipomatous neoplasms were studied, with ancillary fluorescence in situ hybridization performed in subsets of cases for CPM, which is amplified in atypical lipomatous tumors/well-differentiated liposarcomas (ALT/WDL), and HMGA1 and HMGA2, which are often rearranged in lipomas. The cases occurred predominately in older men (91%) (age range 44 to 80 y, mean 65 y). Most patients (80%) had a former or current history of heavy smoking (20 to 100 pack-years). Three patients had concurrent pulmonary squamous cell carcinoma, and 1 had a history of multiple lung cancers. Most lesions were small (<2.5 cm) and discovered incidentally. A subset of tumors showed atypical morphologic features that would be suggestive of ALT/WDL in soft tissue sites, including regions of fibrosis and scattered hyperchromatic stromal cells. However, all cases with atypia were CPM negative and behaved in a clinically benign manner. Seven cases were tested for HMGA1 and HMGA2 rearrangement; 4 showed HMGA2 rearrangement, and 1 showed HMGA1 rearrangement, consistent with lipomas. Two cases were negative for HMGA1/2 rearrangements. We conclude that endobronchial lipomatous neoplasms represent lipomas, even in the presence of morphologic features suggestive of ALT/WDL. Ancillary fluorescence in situ hybridization testing may be very valuable in the analysis of these rare tumors, as true ALT/WDL seem to be very rare or nonexistent at this anatomic site.

  8. Baseline regional perfusion impacts exercise response to endobronchial valve therapy in advanced pulmonary emphysema.

    PubMed

    Argula, Rahul G; Strange, Charlie; Ramakrishnan, Viswanathan; Goldin, Jonathan

    2013-11-01

    Advanced heterogeneous emphysema with hyperinflation impacts exercise tolerance in COPD. Bronchoscopic lung volume reduction using Zephyr endobronchial valves (EBVs) has been shown to improve lung function in patients with heterogeneous emphysema. It is unclear whether the target lobe perfusion of patients receiving EBV therapy impacts exercise tolerance as measured by the 6-min walk test distance (6MWTD). We performed a retrospective analysis on the treatment group of the Endobronchial Valve for Emphysema Palliation Trial (VENT) to evaluate the impact of perfusion, measured by 99mTc-MAA-perfusion scintigraphy, on the 6-month improvement in 6MWTD. A mixed-model analysis was performed for the treatment outcome, adjusting for other variables such as age, target lobe position, fissure integrity, BMI, sex, destruction score, and lobar exclusion. Dichotomized at the median, of the 169 patients who received EBV therapy, 88 had a low target lobe regional perfusion and 81 had high target lobe regional perfusion at baseline. Patients with a low target lobe regional perfusion had a significant improvement in 6MWTD when compared with those with a high baseline target lobe regional perfusion (30.24 m vs 3.72 m, P = .03). Shifts in perfusion after EBV therapy occurred only in patients with high baseline perfusion and did not correlate with improved 6MWTD. Patients having heterogeneous emphysema with a low baseline target lobe regional perfusion benefit from EBV therapy, independent of the degree of target lobe destruction. This effect is attenuated if the EBV therapy is not occlusive. Characterization of baseline perfusion may enhance clinical results of patients with emphysema undergoing EBV therapy. ClinicalTrials.gov; No.: NCT00000606; URL: www.clincialtrials.gov.

  9. Comparing Adrenaline with Tranexamic Acid to Control Acute Endobronchial Bleeding: A Randomized Controlled Trial

    PubMed Central

    Fekri, Mitra Samareh; Hashemi-Bajgani, Seyed Mehdy; Shafahi, Ahmad; Zarshenas, Rozita

    2017-01-01

    Background: Hemoptysis occurs due to either pulmonary diseases or bronchoscopy interventions. The aim of the present study was to compare the efficacy of the endobronchial instillation of adrenaline with that of tranexamic acid. Methods: Fifty patients were randomly selected as 2 double-blinded sample groups (n=25). In these patients, bleeding could not be controlled with cold saline lavage during bronchoscopy and they, therefore, required prescription of another medicine. Adrenaline (1 mg) in one group and tranexamic acid (500 mg) in the other group were diluted in 20 mL of normal saline and instilled through the bronchoscope. This technique was repeated 3 times at 90-second intervals, if necessary. In the case of persistent bleeding, 90 seconds after the last dose, a second medicine was given for bleeding control. Observation of clot through the bronchoscope meant that the bleeding had stopped. The efficacy of tranexamic acid and adrenaline was evaluated and then compared using the Mann–Whitney test. Results: The time of bleeding control had no significant difference between tranexamic acid and adrenaline (P=0.908). Another analysis was done to evaluate bleeding control with a second medicine; the results showed that 1 (4%) patient in the tranexamic acid and 8 (32%) in the adrenaline group needed the second medicine and there was no significant difference between the 2 groups (P=0.609). Conclusion: Our results suggested that tranexamic acid by endobronchial instillation was as efficient as adrenaline in controlling hemoptysis and required less frequent use of a second medicine. Trial Registration Number: IRCT2014120220188 PMID:28360438

  10. Endobronchial resection with the Nd-YAG laser--two years experience in an Australian unit.

    PubMed

    Pierce, R J; Mestitz, H; Simpson, L W; Daniel, F J

    1990-04-01

    In a two year period 44 endobronchial resections using the Neodymium-YAG laser have been performed in 28 patients. The majority of cases had either bronchogenic carcinoma (57%) or metastatic carcinoma (18%) involving the bronchial tree. Adenoid cystic carcinoma, benign tumours, lymphoma, tracheal papillomatosis, Wegener's granulomatosis and benign stricture comprised the other cases. Rigid bronchoscopy and general anaesthesia were used in the majority. Symptomatic improvement of dyspnoea when relief of bronchial obstruction occurred was marked in ten of 17 cases, moderate in four and absent in three. Haemoptysis was markedly improved in two of three cases and obstructive pneumonitis resolved in one of two cases. Significant respiratory function improvement was observed in Raw (most sensitive), FEV11, FVC and TLC. Laser treatment restored the lumen to normal calibre in 52% (including all patients with tracheal lesions), to greater than half normal in 28% and to less than half normal in 20% of cases. Re-expansion of a collapsed lung or lobe occurred in seven of eight patients. In six of these patients laser treatment was the initial therapy resulting in immediate re-expansion and symptomatic relief prior to further therapy. In patients with bronchogenic carcinoma the mean time to retreatment or death was 72 days. For metastatic carcinoma this was 60 days. Two early deaths (3 hours, 36 hours) due to respiratory failure occurred in patients with very severe bilateral bronchial obstruction too advanced for effective clearance. Other complications included laryngeal oedema requiring prolonged intubation (1), bronchospasm (1), atrial fibrillation (1), and acute pulmonary oedema (1). Laser treatment provides effective palliation for bronchial obstruction and haemoptysis in selected proximal endobronchial cancers.

  11. [Endobronchial surgery and photodynamic therapy for the treatment of multiple primary lung cancer].

    PubMed

    Sokolov, V V; Telegina, L V; Trakhtenberg, A Kh; Kolbanov, K I; Pikin, O V; Frank, G A

    2010-01-01

    Endoluminal endoscopic surgery and fotodynamic therapy were used in treatment of 104 patients with multiple primary lung cancer (MPLC), or more exactly, of trachea and lobar and segmental bronchi. Diagnostic division included videobronchoscopy of high resolution in with light and NBI-regimen; autoflourescent and 5-ALA-induced fluorescent videobronchoscopy, endosonography, computed tompgraphy or magnetic resonance imaging of the thorax and epithelial mucine (MUC-1) immunohistochemical analysis of scarificates. Result of treatment strongly depended on the size of primary tumor. Complete regression of cancer was observed for all tumors less then 1 sm in diameter. Endoscopic treatment, including fotodynamic therapy and argon coagulation, proved to be a method of choice in treatment early synchronous or metachronous multiple primary lung cancer in incurable patients.

  12. Bronchopleural Fistula Resolution with Endobronchial Valve Placement and Liberation from Mechanical Ventilation in Acute Respiratory Distress Syndrome: A Case Series

    PubMed Central

    2017-01-01

    Patients who have acute respiratory distress syndrome (ARDS) with persistent air leaks have worse outcomes. Endobronchial valves (EBV) are frequently deployed after pulmonary resection in noncritically ill patients to reduce and eliminate bronchopleural fistulas (BPFs) with persistent air leak (PAL). Information regarding EBV placement in mechanically ventilated patients with ARDS and high volume persistent air leaks is rare and limited to case reports. We describe three cases where EBV placement facilitated endotracheal extubation in patients with severe respiratory failure on prolonged mechanical ventilation with BPFs. In each case, EBV placement led to immediate resolution of PAL. We believe endobronchial valve placement is a safe method treating persistent air leak with severe respiratory failure and may reduce days on mechanical ventilation. PMID:28367339

  13. Pulmonary plasmacytoma with endobronchial extension: A rare presentation of solitary extramedullary plasmacytoma: A case report and brief review of literature.

    PubMed

    Agrawal, Sachin R; Chaudhary, Priyanka; Rajput, Atulsingh; Jain, A P

    2015-01-01

    Extramedullary plasmacytoma is the malignant proliferation of single clone of plasma cells arising outside the bone marrow. Solitary extramedullary plasmacytoma (SEP) are solitary lesion mostly located in upper respiratory tract and nasopharynx. Involvement of lower respiratory tract is rarely seen in case of SEP. Here, we report a rare case of pulmonary plasmacytoma in a 50-year-old male presenting as left lower lobe lung mass with endobronchial extension. Subsequent investigations, histological and immunohistochemical examination of tumor confirmed the diagnosis of plasmacytoma. Work-up for the multiple myeloma came out to be negative, thus confirming the diagnosis of SEP. Pulmonary plasmacytoma, a rare presentation of extramedullary plasmacytoma should be kept in mind by dealing with the patients of lung mass and endobronchial extension.

  14. Endobronchial ultrasound in the evaluation of lung cancer: a practical review and cost analysis for the practicing pulmonologist.

    PubMed

    Bowling, Mark R; Perry, C David; Chin, Robert; Adair, Norman; Chatterjee, Arjun; Conforti, John

    2008-05-01

    Flexible bronchoscopy remains an important tool in the staging, diagnosis, and treatment of primary and metastatic lung malignancies. Endobronchial ultrasound is a new technology utilized with bronchoscopy that has been shown to identify bronchial wall invasion by malignant tumors, aid in the fine needle aspiration of peripheral lung lesions and mediastinal/hilar lymph nodes, and determine the course of treatment in patients with pulmonary carcinoma in situ. The decision to invest both time and money in this technology is determined by several factors such as the cost of the equipment, reimbursement for the procedure, availability of training, the number of bronchoscopies one performs in a year, and access to endoscopic ultrasound and mediastinoscopy. This article reviews the literature to determine the utility of endobronchial ultrasound in the management of patients with lung cancer and to provide information to practicing pulmonologists that may aid in determining whether and where this technology fits into their clinical armamentarium.

  15. Endobronchial allergen challenge in asthma. Demonstration of cellular source of granulocyte macrophage colony-stimulating factor by in situ hybridization.

    PubMed Central

    Broide, D H; Firestein, G S

    1991-01-01

    Airway inflammation is thought to play an important role in the pathogenesis of asthma. We have used in situ hybridization and an immunoassay to determine whether granulocyte macrophage colony-stimulating factor (GM-CSF) (a cytokine capable of eosinophil activation) is present in the airway of asthmatics (n = 6) who have 37.0 +/- 15.1% airway eosinophilia after endobronchial allergen challenge. Levels of immunoreactive GM-CSF (less than 4 pg/ml pre-allergen versus 180.5 +/- 46.9 pg/ml post-allergen) increased significantly 24 h after endobronchial allergen stimulation. The cellular source of bronchoalveolar lavage (BAL) GM-CSF, as determined by in situ hybridization and immunoperoxidase staining, was derived predominantly from UCHL-1 positive BAL lymphocytes, as well as from a smaller population of alveolar macrophages. Before local endobronchial allergen challenge, less than 1% of lymphocytes and alveolar macrophages recovered by BAL expressed GM-CSF mRNA, whereas after allergen stimulation 92.6 +/- 3.4% of lymphocytes and 17.5 +/- 22.7% of alveolar macrophages expressed GM-CSF mRNA. This study provides evidence that in an experimental model of allergen-induced asthma, activation of the immune and inflammatory response (BAL lymphocyte and alveolar macrophage production of GM-CSF) is temporally associated with an inflammatory cell influx of eosinophils into the airway. Images PMID:1885766

  16. Experimental tuberculosis in the European badger (Meles meles) after endobronchial inoculation with Mycobacterium bovis: II. Progression of infection.

    PubMed

    Corner, L A L; Costello, E; Lesellier, S; O'Meara, D; Gormley, E

    2008-12-01

    The aim of the study was to describe, over a period of 24 weeks, the pathological and bacteriological changes in badgers experimentally infected with Mycobacterium bovis. The badgers were infected by endobronchial instillation of 2.5 x10(4) colony forming units (cfu) M. bovis. After infection, the badgers were examined at 3 weekly intervals when blood and tracheal aspirates were collected. At 6, 12, 18 and 24 weeks post-infection (pi) three animals were euthanized and a detailed pathological and bacteriological examination was performed to assess the nature of the experimental disease. During the course of the study only one badger developed clinical signs of disease: a subcutaneous swelling on its head, first observed at 18 weeks pi. At post-mortem examination gross and histological lesions of tuberculosis were observed and M. bovis was recovered from all, except one badger. In the majority of badgers the endobronchial route of inoculation resulted in the establishment of infection that over 24 weeks was non-progressive with limited dissemination of infection from the thoracic cavity, mainly to the hepatic and mesenteric lymph nodes. However, in one of the badgers examined at 18 weeks pi and one at 24 weeks pi, infection was widely disseminated. The disease induced by the endobronchial inoculation displayed the characteristics of disease observed in naturally infected badgers.

  17. Segmental bronchi collapsibility: computed tomography-based quantification in patients with chronic obstructive pulmonary disease and correlation with emphysema phenotype, corresponding lung volume changes and clinical parameters

    PubMed Central

    Thaiss, Wolfgang Maximilian; Ditt, Hendrik; Hetzel, Jürgen; Schülen, Eva; Nikolaou, Konstantin; Horger, Marius

    2016-01-01

    Background Global pulmonary function tests lack region specific differentiation that might influence therapy in severe chronic obstructive pulmonary disease (COPD) patients. Therefore, the aim of this work was to assess the degree of expiratory 3rd generation bronchial lumen collapsibility in patients with severe COPD using chest-computed tomography (CT), to evaluate emphysema-phenotype, lobar volumes and correlate results with pulmonary function tests. Methods Thin-slice chest-CTs acquired at end-inspiration & end-expiration in 42 COPD GOLD IV patients (19 females, median-age: 65.9 y) from November 2011 to July 2014 were re-evaluated. The cross-sectional area of all segmental bronchi was measured 5 mm below the bronchial origin in both examinations. Lung lobes were semi-automatically segmented, volumes calculated at end-inspiratory and end-expiratory phase and visually defined emphysema-phenotypes defined. Results of CT densitometry were compared with lung functional tests including forced expiratory volume at 1 s (FEV1), total lung capacity (TLC), vital capacity (VC), residual volume (RV), diffusion capacity parameters and the maximal expiratory flow rates (MEFs). Results Mean expiratory bronchial collapse was 31%, stronger in lobes with homogenous (38.5%) vs. heterogeneous emphysema-phenotype (27.8%, P=0.014). The mean lobar expiratory volume reduction was comparable in both emphysema-phenotypes (volume reduction 18.6%±8.3% in homogenous vs. 17.6%±16.5% in heterogeneous phenotype). The degree of bronchial lumen collapsibility, did not correlate with expiratory volume reduction. MEF25 correlated weakly with 3rd generation airway collapsibility (r=0.339, P=0.03). All patients showed a concentric expiratory reduction of bronchial cross-sectional area. Conclusions Changes in collapsibility of 3rd generation bronchi in COPD grade IV patients is significantly lower than that in the trachea and the main bronchi. Collapsibility did not correlate with the reduction in

  18. LASER BIOLOGY AND MEDICINE: Combination of fluorescence imaging and local spectrophotometry in fluorescence diagnostics of early cancer of larynx and bronchi

    NASA Astrophysics Data System (ADS)

    Sokolov, Vladimir V.; Filonenko, E. V.; Telegina, L. V.; Boulgakova, N. N.; Smirnov, V. V.

    2002-11-01

    The results of comparative studies of autofluorescence and 5-ALA-induced fluorescence of protoporphyrin IX, used in the diagnostics of early cancer of larynx and bronchi, are presented. The autofluorescence and 5-ALA-induced fluorescence images of larynx and bronchial tissues are analysed during the endoscopic study. The method of local spectrophotometry is used to verify findings obtained from fluorescence images. It is shown that such a combined approach can be efficiently used to improve the diagnostics of precancer and early cancer, to detect a primary multiple tumours, as well as for the diagnostics of a residual tumour or an early recurrence after the endoscopic, surgery or X-ray treatment. The developed approach allows one to minimise the number of false-positive results and to reduce the number of biopsies, which are commonly used in the white-light bronchoscopy search for occult cancerous loci.

  19. Usefulness of endobronchial ultrasound in patients with previously treated thoracic malignancy

    PubMed Central

    Chen, Fengshi; Miyahara, Ryo; Sato, Toshihiko; Sonobe, Makoto; Sakai, Hiroaki; Bando, Toru; Date, Hiroshi

    2012-01-01

    Diagnosis of mediastinal/hilar lymph nodes and tumours is often challenging for patients with previously treated thoracic malignancy, especially when they have a history of thoracotomy. Endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA) has been proposed as a safe, less-invasive modality for such patients. We retrospectively evaluated the role of EBUS-TBNA in the assessment of newly developed mediastinal/hilar abnormalities in patients with previously treated thoracic malignancy. Of 79 patients who underwent EBUS-TBNA between July 2009 and July 2011, 14 patients (18%) had a history of treatment for thoracic malignancy. In all patients, malignancy was confirmed again for the newly developed mediastinal/hilar abnormalities and three of them (21%) presented with a different pathology from the previous malignancy. Out of 14 patients, 12 had a history of thoracotomy and EBUS-TBNA was a useful, less-invasive diagnostic method particularly for these patients. Out of 14 patients, 11 (79%) had a history of lung cancer and 10 of them (91%) had received surgical resection. In conclusion, we confirmed that EBUS-TBNA obtained the pathological diagnosis in a less-invasive manner in all cases. Despite the small number of cases, our results can reveal the usefulness of EBUS-TBNA particularly in patients with previously treated thoracic malignancy. PMID:22108942

  20. Can endobronchial biopsy analysis be recommended to discriminate between asthma and COPD in routine practice?

    PubMed Central

    Bourdin, A; Serre, I; Flamme, H; Vic, P; Neveu, D; Aubas, P; Godard, P; Chanez, P

    2004-01-01

    Background: International guidelines stress the importance of accurately discriminating between asthma and chronic obstructive pulmonary disease (COPD). Although characteristic pathological features have been described for both conditions, their discriminatory power has never been systematically assessed. Methods: Endobronchial biopsy (EBB) specimens from patients with a clear clinical diagnosis of asthma and COPD (50 per group) were examined by three pathologists in a double blind manner. They were asked to propose a pathological diagnosis of either asthma or COPD and to analyse qualitatively the most frequent abnormalities reported in the literature. Results: The sensitivity and specificity of EBB ranged from 36% to 48% and from 56% to 79%, respectively. Eosinophils strongly biased the pathological diagnoses in favour of asthma, whereas their estimated prevalence was similar (11–37% in asthma and 13–41% in COPD). Metaplasia (11–39% in COPD, 1–18% in asthma) and epithelial inflammation (28–61% in COPD, 11–38% in asthma) tended to be specific to COPD, whereas epithelial desquamation (80–98% in asthma, 61–88% in COPD) and basement membrane thickening (71–94% in asthma, 53–88% in COPD) tended to be associated with asthma. There was acceptable intra- and inter-observer agreement only for metaplasia and epithelial eosinophils. Conclusions: Specific histopathological features of asthma and COPD probably exist, but current routine analysis procedures to assess EBB specimens are not sufficiently discriminatory. This might be rectified by improving pathological definitions. PMID:15170031

  1. Methods for 2-D and 3-D Endobronchial Ultrasound Image Segmentation.

    PubMed

    Zang, Xiaonan; Bascom, Rebecca; Gilbert, Christopher; Toth, Jennifer; Higgins, William

    2016-07-01

    Endobronchial ultrasound (EBUS) is now commonly used for cancer-staging bronchoscopy. Unfortunately, EBUS is challenging to use and interpreting EBUS video sequences is difficult. Other ultrasound imaging domains, hampered by related difficulties, have benefited from computer-based image-segmentation methods. Yet, so far, no such methods have been proposed for EBUS. We propose image-segmentation methods for 2-D EBUS frames and 3-D EBUS sequences. Our 2-D method adapts the fast-marching level-set process, anisotropic diffusion, and region growing to the problem of segmenting 2-D EBUS frames. Our 3-D method builds upon the 2-D method while also incorporating the geodesic level-set process for segmenting EBUS sequences. Tests with lung-cancer patient data showed that the methods ran fully automatically for nearly 80% of test cases. For the remaining cases, the only user-interaction required was the selection of a seed point. When compared to ground-truth segmentations, the 2-D method achieved an overall Dice index = 90.0% ±4.9%, while the 3-D method achieved an overall Dice index = 83.9 ± 6.0%. In addition, the computation time (2-D, 0.070 s/frame; 3-D, 0.088 s/frame) was two orders of magnitude faster than interactive contour definition. Finally, we demonstrate the potential of the methods for EBUS localization in a multimodal image-guided bronchoscopy system.

  2. The Use of Endobronchial Ultrasound in the Diagnosis of Subacute Pulmonary Histoplasmosis

    PubMed Central

    Egressy, Katarine von Lang; Mohammed, Mohammed; Ferguson, J. Scott

    2015-01-01

    Objective. Endobronchial ultrasound (EBUS) utility in diagnosis in malignant and granulomatous mediastinal disease has been well demonstrated. We propose to examine the role of EBUS transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of subacute pulmonary histoplasmosis (SPH) with mediastinal lymphadenopathy in an area where histoplasmosis is endemic. Methods. A retrospective review was performed in a single academic institution between 2009 and 2012 of patients referred for EBUS-TBNA who had radiographic imaging and clinical symptomatology suspicious for SPH. Seven patients were reviewed. TBNA results showing granulomatous disease with areas of necrosis in the appropriate clinical setting were considered to be adequate for the diagnosis of SPH when alternative diagnosis was excluded. Patients underwent further clinical follow-up of 12 months to determine the final diagnosis. Results. All seven patients were felt to have SPH diagnosis reached by a combination of clinical presentation, EBUS-TBNA results, fungal serologies, and antigen testing. None of the patients needed further invasive procedures. Conclusions. EBUS-TBNA is a minimally invasive tool that can be used to support a diagnosis of SPH in patients with a high degree of clinical suspicion. EBUS-TBNA should be considered as an adjunctive diagnostic procedure for patients with SPH in an appropriate clinical setting. PMID:26543344

  3. Virtual bronchoscopic navigation combined with endobronchial ultrasound to diagnose small peripheral pulmonary lesions: a randomised trial.

    PubMed

    Ishida, Takashi; Asano, Fumihiro; Yamazaki, Koichi; Shinagawa, Naofumi; Oizumi, Satoshi; Moriya, Hiroshi; Munakata, Mitsuru; Nishimura, Masaharu

    2011-12-01

    Bronchoscopy using endobronchial ultrasound (EBUS) can help to diagnose small peripheral pulmonary lesions. However, although biopsy sites can be confirmed, a bronchoscope cannot be guided in EBUS. Virtual bronchoscopic navigation (VBN) can guide a bronchoscope with virtual images, but its value has not been confirmed. This prospective multicentre study examines the value of VBN-assisted EBUS for diagnosing small peripheral pulmonary lesions. 199 patients with small peripheral pulmonary lesions (diameter ≤30 mm) were randomly assigned to VBN-assisted (VBNA) or non-VBN-assisted (NVBNA) groups. A bronchoscope was introduced into the target bronchus of the VBNA group using the VBN system. Sites of specimen sampling were verified using EBUS with a guide sheath under fluoroscopy. The diagnostic yield was higher for the VBNA than for the NVBNA group (80.4% vs 67.0%; p = 0.032). The duration of the examination and time elapsed until the start of sample collection were reduced in the VBNA compared with the NVBNA group (median (range), 24.0 (8.7-47.0) vs 26.2 (11.6-58.6) min, p = 0.016) and 8.1 (2.8-39.2) vs 9.8 (2.3-42.3) min, p = 0.045, respectively). The only adverse event was mild pneumothorax in a patient from the NVBNA group. The diagnostic yield for small peripheral pulmonary lesions is increased when VBN is combined with EBUS. Clinical trial number UMIN000000569.

  4. Immunological responses and protective immunity in BCG vaccinated badgers following endobronchial infection with Mycobacterium bovis.

    PubMed

    Lesellier, Sandrine; Corner, Leigh; Costello, Eamon; Lyashchenko, Konstantin; Greenwald, Rena; Esfandiari, Javan; Singh, Mahavir; Hewinson, R Glyn; Chambers, Mark; Gormley, Eamonn

    2009-01-14

    European badgers (Meles meles) are a reservoir host of Mycobacterium bovis and are implicated in the transmission of tuberculosis to cattle in Ireland and Great Britain. The development of a vaccine for use in badgers is considered a key element of any campaign to eradicate the disease in livestock in both countries. In this study we have vaccinated groups of badgers with approximately 5 x 10(5)cfu of the BCG vaccine delivered via two alternative routes, subcutaneous and mucosal (intranasal/conjunctival). Following experimental endobronchial infection with approximately 10(4)cfu of M. bovis, all badgers were euthanised at 12 weeks post-infection. At post-mortem examination both vaccinated groups had significantly reduced severity of disease compared with the non-vaccinated controls. The analysis of immune responses throughout the study showed that vaccination with BCG did not generate any detectable immunological responses as measured by IFN-gamma production in antigen-stimulated peripheral blood mononuclear cells (PBMC) and IgG serological responses. However, the levels of the responses increased following M. bovis infection, and the kinetic profiles corresponded to the severity of lesions recorded post-mortem. Significant differences were observed in the timing of development of the immune responses between vaccinates and controls. The results suggest that the immunological responses are associated with the levels of protective immunity and could be used as markers to monitor control of disease in badgers following vaccination.

  5. Immunological responses following experimental endobronchial infection of badgers (Meles meles) with different doses of Mycobacterium bovis.

    PubMed

    Lesellier, Sandrine; Corner, Leigh; Costello, Eamon; Sleeman, Paddy; Lyashchenko, Konstantin P; Greenwald, Rena; Esfandiari, Javan; Glyn Hewinson, R; Chambers, Mark; Gormley, Eamonn

    2009-01-15

    The Eurasian badger (Meles meles) is a wildlife reservoir for Mycobacterium bovis infection in Ireland and Great Britain and has been implicated in the transmission of tuberculosis to cattle. Vaccination of badgers is an option that could be used as part of a strategy to control the disease. In this study we used an endobronchial infection procedure to inoculate groups of badgers with three different doses (3x10(3), 2x10(2) and <10 Colony Forming Units (CFUs)) of M. bovis. After 17 weeks the disease status of each animal was determined by post-mortem pathology and culture for M. bovis. Each of the inoculum doses resulted in establishment of infection in the badgers. The cell-mediated immune (CMI) responses were measured by lymphocyte transformation assay (LTA) of peripheral blood mononuclear cells (PBMCs) cultured with bovine tuberculin (PPD-B). In each infected group the CMI responses increased with a kinetic profile corresponding to the delivered dose and the post-mortem pathology. The serological responses were measured by ELISA and a multi-antigen print immunoassay (MAPIA) in order to investigate any changes in the antigenic repertoire associated with different infective doses. In contrast to the CMI responses, the ELISA and MAPIA showed that the recognition of antigens by the badgers was intermittent and not strongly influenced by the dose of M. bovis.

  6. Endobronchial closure of bronchopleural fistulae using amplatzer devices: our experience and literature review.

    PubMed

    Fruchter, Oren; Kramer, Mordechai R; Dagan, Tamir; Raviv, Yael; Abdel-Rahman, Nader; Saute, Milton; Bruckheimer, Elchanan

    2011-03-01

    Bronchopulmonary fistulae (BPFs) are a severe complication of lobectomy and pneumonectomy and are associated with high rates of morbidity and mortality. We have developed a novel, minimally invasive method of central BPF closure using Amplatzer devices (ADs) that were originally designed for the transcatheter closure of cardiac defects. Ten patients with 11 BPFs (eight men and two women, aged 66.3±10.1 years [mean±SD]) were treated under conscious sedation with bronchoscopic closure of the BPFs using ADs. A nitinol double-disk occluder device was delivered under direct bronchoscopic guidance over a guidewire into the fistula. By extruding a disk on either side of the BPF, the fistula was occluded. Bronchography was performed by injecting contrast medium through the delivery sheath following the procedure to ensure correct device positioning. In nine patients, the procedure was successful and symptoms related to the BPF disappeared following closure by the AD. The results were maintained over a median follow-up period of 9 months. Therefore, we state that endobronchial closure using an AD is a safe and effective method for treatment of a postoperative BPF.

  7. Removal of Endobronchial Malignant Mass by Cryotherapy Improved Performance Status to Receive Chemotherapy

    PubMed Central

    Hsieh, Meng-Heng; Wang, Tsai-Yu; Yu, Chih-Teng; Chou, Chun-Liang; Lin, Shu-Min; Kuo, Chih-Hsi; Chung, Fu-Tsai

    2014-01-01

    Although malignant endobronchial mass (MEM) has poor prognosis, cryotherapy is reportedly a palliative treatment. Clinical data on postcryotherapy MEM patients in a university-affiliated hospital between 2007 and 2011 were evaluated. Survival curve with or without postcryotherapy chemotherapy and performance status (PS) improvement of these subjects were analyzed using the Kaplan-Meier method. There were 59 patients (42 males), with median age of 64 years (range, 51–76, and median performance status of 2 (interquartile range [IQR], 2-3). Postcryotherapy complications included minor bleeding (n = 12) and need for multiple procedures (n = 10), while outcomes were relief of symptoms (n = 51), improved PS (n = 45), and ability to receive chemotherapy (n = 40). The survival of patients with chemotherapy postcryotherapy was longer than that of patients without such chemotherapy (median, 534 versus 106 days; log-rank test, P = 0.007; hazard ratio, 0.25; 95% confidence interval, 0.10–0.69). The survival of patients with PS improvement postcryotherapy was longer than that of patients without PS improvement (median, 406 versus 106 days; log-rank test, P = 0.02; hazard ratio, 0.28; 95% confidence interval, 0.10–0.81). Cryotherapy is a feasible treatment for MEM. With better PS after cryotherapy, further chemotherapy becomes possible for patients to improve survival when MEM caused dyspnea and poor PS. PMID:25383370

  8. Ten Years of Linear Endobronchial Ultrasound: Evidence of Efficacy, Safety and Cost-effectiveness.

    PubMed

    Fernández-Villar, Alberto; Mouronte-Roibás, Cecilia; Botana-Rial, Maribel; Ruano-Raviña, Alberto

    2016-02-01

    Real-time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is one of the major landmarks in the history of bronchoscopy. In the 10 years since it was introduced, a vast body of literature on the procedure and its results support the use of this technique in the study of various mediastinal and pulmonary lesions. This article is a comprehensive, systematic review of all the available scientific evidence on the more general indications for this technique. Results of specific studies on efficacy, safety and cost-effectiveness available to date are examined. The analysis shows that EBUS-TBNA is a safe, cost-effective technique with a high grade of evidence that is a valuable tool in the diagnosis and mediastinal staging of patients with suspected or confirmed lung cancer. However, more studies are needed to guide decision-making in the case of a negative result. Evidence on the role of EBUS-TBNA in the diagnosis of sarcoidosis and extrathoracic malignancies is also high, but much lower when used in the study of tuberculosis, lymphoma and for the re-staging of lung cancer after neoadjuvant chemotherapy. Nevertheless, due to its good safety record and lack of invasiveness compared to surgical techniques, the grade of evidence for recommending EBUS-TBNA as the initial diagnostic test in patients with these diseases is very high in most cases. Copyright © 2015 SEPAR. Published by Elsevier Espana. All rights reserved.

  9. Training for Linear Endobronchial Ultrasound Among US Pulmonary/Critical Care Fellowships

    PubMed Central

    Pastis, Nicholas J.; Silvestri, Gerard A.

    2013-01-01

    Background: Endobronchial ultrasound (EBUS) has revolutionized the ability of bronchoscopists to visualize and sample structures surrounding the tracheobronchial tree. It has been shown to be safe, minimally invasive, and highly accurate in the staging and diagnosing of mediastinal diseases. A prior survey of pulmonary fellowship program directors conducted in 2004 showed that only 2% of programs offered EBUS training. Methods: Surveys were mailed to 154 pulmonary/critical care fellowship directors in the United States and Puerto Rico. Demographics of the fellowship and details of EBUS training were recorded. A comparison of EBUS volume was made between programs with and without an identifiable interventional pulmonologist (IP). Results: The survey response rate was 71%. EBUS equipment was available at 89% of programs. Of those without EBUS, 100% expressed the goal of obtaining equipment within the year. An identifiable IP was present in 70% of programs. This was associated with more EBUS procedures performed by trainees (P < .01). Only 30% of programs have a formal protocol in place to evaluate EBUS competency. Conventional transbronchial needle aspiration is routinely taught in 89% of fellowship programs. Conclusions: EBUS exposure has rapidly disseminated into fellowship training programs, and programs with an identifiable IP are more likely to provide fellows with more EBUS procedures. The findings of this survey point out the need to develop a standardized protocol for EBUS competency that includes current recommendations and may require training with simulation. PMID:22878834

  10. Diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal staging in lung cancer*

    PubMed Central

    Fernández-Bussy, Sebastián; Labarca, Gonzalo; Canals, Sofia; Caviedes, Iván; Folch, Erik; Majid, Adnan

    2015-01-01

    OBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic test with a high diagnostic yield for suspicious central pulmonary lesions and for mediastinal lymph node staging. The main objective of this study was to describe the diagnostic yield of EBUS-TBNA for mediastinal lymph node staging in patients with suspected lung cancer. METHODS: Prospective study of patients undergoing EBUS-TBNA for diagnosis. Patients ≥ 18 years of age were recruited between July of 2010 and August of 2013. We recorded demographic variables, radiological characteristics provided by axial CT of the chest, location of the lesion in the mediastinum as per the International Association for the Study of Lung Cancer classification, and definitive diagnostic result (EBUS with a diagnostic biopsy or a definitive diagnostic method). RESULTS: Our analysis included 354 biopsies, from 145 patients. Of those 145 patients, 54.48% were male. The mean age was 63.75 years. The mean lymph node size was 15.03 mm, and 90 lymph nodes were smaller than 10.0 mm. The EBUS-TBNA method showed a sensitivity of 91.17%, a specificity of 100.0%, and a negative predictive value of 92.9%. The most common histological diagnosis was adenocarcinoma. CONCLUSIONS: EBUS-TBNA is a diagnostic tool that yields satisfactory results in the staging of neoplastic mediastinal lesions. PMID:26176519

  11. Diagnostic utility of peripheral endobronchial ultrasound with electromagnetic navigation bronchoscopy in peripheral lung nodules.

    PubMed

    Chee, Alex; Stather, David R; Maceachern, Paul; Martel, Simon; Delage, Antoine; Simon, Mathieu; Dumoulin, Elaine; Tremblay, Alain

    2013-07-01

    This study aimed to investigate the diagnostic utility of peripheral endobronchial ultrasound (pEBUS) followed by as-needed electromagnetic navigation bronchoscopy (ENB) for sampling peripheral lung nodules. The study was a single-arm, prospective cohort study of patients with peripheral lung nodules. Peripheral lung lesion localization was initially performed using a pEBUS probe with guide sheath. If localization failed with pEBUS alone, ENB was used to help identify the lesion. Transbronchial biopsy, bronchial brush, transbronchial needle aspiration and bronchial washings were performed. Sixty patients were enrolled with average lesion size of 27 mm and mean pleural distance of 20 mm. Lesions were found with pEBUS alone in 75% of cases. The addition of ENB improved lesion localization to 93%. However, diagnostic yield for pEBUS alone and pEBUS with ENB were 43% and 50%, respectively. Factors predicting need for ENB use included smaller lesion size and absence of an air bronchus sign on computed tomography. ENB improves localization of lung lesions after unsuccessful pEBUS but is often not sufficient to ensure confirmation of a specific diagnosis. Technical improvements in sampling methods could improve the diagnostic yield. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

  12. Training and certification in endobronchial ultrasound-guided transbronchial needle aspiration.

    PubMed

    Naur, Therese Maria Henriette; Konge, Lars; Nayahangan, Leizl Joy; Clementsen, Paul Frost

    2017-07-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) plays a key role in the staging of lung cancer, which is crucial for allocation to surgical treatment. EBUS-TBNA is a complicated procedure and simulation-based training is helpful in the first part of the long learning curve prior to performing the procedure on actual patients. New trainees should follow a structured training programme consisting of training on simulators to proficiency as assessed with a validated test followed by supervised practice on patients. The simulation-based training is superior to the traditional apprenticeship model and is recommended in the newest guidelines. EBUS-TBNA and oesophageal ultrasound-guided fine needle aspiration (EUS-FNA or EUS-B-FNA) are complementary to each other and the combined techniques are superior to either technique alone. It is logical to learn and to perform the two techniques in combination, however, for lung cancer staging solely EBUS-TBNA simulators exist, but hopefully in the future simulation-based training in EUS will be possible.

  13. Analysis of airway epithelial regeneration and repair following endobronchial brush biopsy in sheep.

    PubMed

    Yahaya, B; Baker, A; Tennant, P; Smith, S H; Shaw, D J; McLachlan, G; Collie, D D S

    2011-11-01

    Understanding the fundamental processes involved in repairing the airway wall following injury is fundamental to understanding the way in which these processes are perturbed during disease pathology. Indeed complex diseases such as asthma and chronic obstructive pulmonary disease (COPD) have at their core evidence of airway wall remodeling processes that play a crucial functional role in these diseases. The authors sought to understand the dynamic cellular events that occur during bronchial airway epithelial repair in sheep. The injury was induced by endobronchial brush biopsy (BBr), a process that causes epithelial débridement and induces a consequential repair process. In addition, the current experimental protocol allowed for the time-dependent changes in airway wall morphology to be studied both within and between animals. The initial débridement was followed by evidence of dedifferentiation in the intact epithelium at the wound margins, followed by proliferation of cells both within the epithelium and in the deeper wall structures, notably in association with the submucosal glands and smooth muscle bundles. Seven days after injury, although the airway wall was thickened at the site of damage, the epithelial layer was intact, with evidence of redifferentiation. These studies, in demonstrating broad agreement with previous studies in small animals, indicate the wider relevance of this system as a comparative model and should provide a solid basis upon which to further characterize the critical cellular and molecular interactions that underlie both effective restitution and pathological repair.

  14. Endobronchial Ultrasound-directed Transbronchial Needle Aspiration in Diagnosis of Mediastinal Lesions: Initial Egyptian Experience.

    PubMed

    Safwat, Tarek; Khattab, Adel; Haddad, Salwa El; Mostafa, Yasser; Korraa, Emad; Madkour, Ashraf; Fattah, Wael Abd El

    2009-01-01

    Mediastinal lesions represent a diagnostic challenge and often require invasive approaches. We evaluated the role of radial probe endobronchial ultrasound-directed transbronchial needle aspiration (EBUS-TBNA) in the evaluation of mediastinal lesions. Between March 2005 to February 2006, 30 consecutive patients with enlarged mediastinal lymph nodes from unknown etiologies or suspicious for metastatic bronchogenic carcinoma and mediastinal masses underwent EBUS-TBNA and were clinically followed up. EBUS-TBNA was applied under topical anesthesia, midazolam sedation with a mean dose of 4.6+1.7 mg and prolonged the examination by 14.7 minutes on average. EBUS-directed TBNA was performed in 17 lymph nodes and 13 mediastinal masses, achieving specific diagnosis in 82.3% (14/17) and 84.6% (11/13) of examined lesions, respectively, with an overall yield of 83%. The sensitivity, specificity, and accuracy of EBUS-TBNA in distinguishing benign from malignant mediastinal lesions were 89.4%, 100%, and 93.3%, respectively. EBUS was well tolerated by most of the patients with no TBNA-related complications. In conclusion, EBUS-TBNA of mediastinal lesions is a minimally invasive safe diagnostic technique with high yield, even in the hands of those with initial experience. This initial study is convincing and stimulating for widespread application of EBUS-TBNA in Egyptian bronchoscopy practice.

  15. Atypical Endobronchial Carcinoid with Postobstructive Pneumonia Obscuring the Diagnosis of Granulomatosis with Polyangiitis

    PubMed Central

    Ali, Robert; Baldeo, Candice; Onyenekwe, Jesse; Lala, Roshan; Landa, Cristian; Siddiqi, Anwer

    2015-01-01

    Granulomatosis with polyangiitis (GPA), previously termed Wegener's Granulomatosis, is an autoimmune small vessel vasculitis which is highly associated with antineutrophil cytoplasmic antibodies (ANCA) and has varied clinical manifestations. Diagnosis hinges on identifying a combination of clinical features of systemic vasculitis, positive ANCA serology, and histological evidence of necrotizing vasculitis, necrotizing glomerulonephritis, or granulomatous inflammation from a relevant organ biopsy. The American College of Rheumatology has also developed a classification criteria focusing specifically on nasal or oral inflammation, abnormal chest radiograph, and abnormal urinary sediment, along with granulomatous inflammation, which helps to distinguish GPA from other forms of systemic vasculitis. In the case presented below, the diagnosis of GPA was delayed as the patient had a concomitant atypical endobronchial carcinoid which predisposed to postobstructive pneumonia. Fortunately, the papular lesions that developed across her lower limbs prompted further investigations. The return of appropriate serology coincided with progression to alveolar hemorrhage, offering a more complete clinical picture, and when she responded to the combination of steroid, cyclophosphamide, and plasma exchange, the diagnosis of GPA was cinched. PMID:26347844

  16. Real-time prediction of mediastinal lymph node malignancy by endobronchial ultrasound.

    PubMed

    Shafiek, Hanaa; Fiorentino, Federico; Peralta, Alejandro David; Serra, Enrique; Esteban, Blanca; Martinez, Rocío; Noguera, Maria Angels; Moyano, Pere; Sala, Ernest; Sauleda, Jaume; Cosío, Borja G

    2014-06-01

    To evaluate the utility of different ultrasonographic (US) features in differentiating benign and malignant lymph node (LN) by endobronchial ultrasound (EBUS) and validate a score for real-time clinical application. 208 mediastinal LN acquired from 141 patients were analyzed. Six different US criteria were evaluated (short axis ≥10 mm, shape, margin, echogenicity, and central hilar structure [CHS], and presence of hyperechoic density) by two observers independently. A simplified score was generated where the presence of margin distinction, round shape and short axis ≥10 mm were scored as 1 and heterogeneous echogenicity and absence of CHS were scored as 1.5. The score was evaluated prospectively for real-time clinical application in 65 LN during EBUS procedure in 39 patients undertaken by two experienced operators. These criteria were correlated with the histopathological results and the sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated. Both heterogenicity and absence of CHS had the highest sensitivity and NPV (≥90%) for predicting LN malignancy with acceptable inter-observer agreement (92% and 87% respectively). On real-time application, the sensitivity and specificity of the score >5 were 78% and 86% respectively; only the absence of CHS, round shape and size of LN were significantly associated with malignant LN. Combination of different US criteria can be useful for prediction of mediastinal LN malignancy and valid for real-time clinical application. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  17. Methods for 2D and 3D Endobronchial Ultrasound Image Segmentation

    PubMed Central

    Zang, Xiaonan; Bascom, Rebecca; Gilbert, Christopher; Toth, Jennifer

    2016-01-01

    Endobronchial ultrasound (EBUS) is now commonly used for cancer-staging bronchoscopy. Unfortunately, EBUS is challenging to use and interpreting EBUS video sequences is difficult. Other ultrasound imaging domains, hampered by related difficulties, have benefited from computer-based image-segmentation methods. Yet, so far, no such methods have been proposed for EBUS. We propose image-segmentation methods for 2D EBUS frames and 3D EBUS sequences. Our 2D method adapts the fast-marching level-set process, anisotropic diffusion, and region growing to the problem of segmenting 2D EBUS frames. Our 3D method builds upon the 2D method while also incorporating the geodesic level-set process for segmenting EBUS sequences. Tests with lung-cancer patient data showed that the methods ran fully automatically for nearly 80% of test cases. For the remaining cases, the only user-interaction required was the selection of a seed point. When compared to ground-truth segmentations, the 2D method achieved an overall Dice index = 90.0%±4.9%, while the 3D method achieved an overall Dice index = 83.9±6.0%. In addition, the computation time (2D, 0.070 sec/frame; 3D, 0.088 sec/frame) was two orders of magnitude faster than interactive contour definition. Finally, we demonstrate the potential of the methods for EBUS localization in a multimodal image-guided bronchoscopy system. PMID:26529748

  18. Role of endobronchial ultrasound in diagnosis and molecular assessment of metastatic melanoma.

    PubMed

    Jennings, Barton R; Millward, Michael J; Amanuel, Benhur; Mulrennan, Siobhain; Joosten, Simon A; Phillips, Martin J

    2012-08-01

    Vemurafenib is a new inhibitor of the mutated BRAF oncogene. In the presence of mutated BRAF in metastatic melanoma, treatment with vemurafenib leads to a reduction in mortality and in tumour progression when compared with chemotherapy. This study describes nine cases in which endobronchial ultrasound (EBUS) guided transbronchial needle aspiration (TBNA) was used to assess mediastinal and hilar lymph nodes for the presence of metastatic melanoma and demonstrates the ability to detect mutations in BRAF on the tissue obtained. A retrospective review was performed of all patients who had a history of melanoma and underwent EBUS TBNA to investigate hilar or mediastinal lymphadenopathy for the presence of metastatic melanoma. In seven of the nine cases, metastatic melanoma was confirmed on cytology. The two negative cases were proven to be true negatives by follow up or by demonstrating an alternate diagnosis. In five cases, analysis for BRAF mutation was performed. Four cases were positive for mutation and one demonstrated wild-type BRAF. Tissue samples obtained from EBUS TBNA are adequate to diagnose metastatic melanoma in hilar and mediastinal lymph nodes and to detect the presence or absence of mutations in the BRAF gene. Our findings suggest that close collaboration between bronchoscopists and pathologists will be needed to implement BRAF testing in routine practice in the era of targeted therapy. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

  19. Role of the Endobronchial Landmarks Guiding TBNA and EBUS-TBNA in Lung Cancer Staging

    PubMed Central

    Arias, S.; Liu, Q. H.; Frimpong, B.; Lee, H.; Feller-Kopman, D.; Yarmus, L.

    2016-01-01

    Background. Lung cancer is the leading cause of malignancy related mortality in the United States. Accurate staging of NSCLC influences therapeutic decisions. Transbronchial needle aspiration (TBNA) and endobronchial ultrasound-guided TBNA (EBUS-TBNA) has been accepted as a procedure for the diagnosis and staging of lung cancer. The aim of this study is to evaluate the efficacy and adequacy of TBNA and EBUS-TBNA for sampling of mediastinal adenopathy using the Wang's eleven lymph node map stations. Methods. We retrospectively reviewed 99 consecutive cases diagnosed with malignancy by EBUS-TBNA and a series 74 patients evaluated for mediastinal adenopathy or a pulmonary lesion using conventional transbronchial needle aspiration. The IASLC lymph node map was correlated with Wang's map. Results. A total of 182 lymph node stations were sampled using EBUS-TBNA. 96 were positive for nodal metastasis. A total of four cases of samples taken from station 2R showed malignant cells. From the 74 cases series using cTBNA 167 nodes were sampled in 222 passes. Lymphoid or malignant tissue was obtained in 67 (91.8%) cases; 55.1% of the nodes were 1 cm or less. Conclusions. The use of the eleven stations described in Wang's map to guide TBNA of the mediastinal nodes allows sampling of radiologically considered nonpathological nodes. These data suggest that Wang's map covers the most frequent IASLC nodal stations compromised with metastasis. PMID:28058035

  20. Comparison of the efficacy of four endobronchial ablation techniques in dogs

    PubMed Central

    Tong, Linrong; Zhang, Koudong; Huang, Haidong; Zhang, Wei; Zhang, Xingxing; Wang, Qin; Li, Qiang; Bai, Chong

    2017-01-01

    The present study aimed to evaluate the safety and efficacy of four commonly used ablation techniques, namely neodymium-doped yttrium aluminium garnet (Nd:YAG) laser therapy, argon plasma coagulation (APC), high-frequency electrocautery and CO2 cryotherapy. The techniques were performed at various powers or impedance settings, and for various durations, on the trachea of beagle dogs. Pathological changes of the tracheal wall were assessed by bronchoscopy. The endoscopic gross appearance of lesions induced by ablation treatments was consistent with the histopathological changes. The results suggested that cryotherapy was relatively safe, whereas APC induced superficial tissue coagulative necrosis. Furthermore, Nd:YAG laser therapy was the most efficient technique and showed the greatest penetration potential. In general, tissue injury was exacerbated with extended application time, at constant power or impedance. The safest application parameters were 20 W for ≤1 sec for Nd:YAG laser therapy, 40 W for ≤3 sec for electrocautery, 40 W for ≤5 sec for APC and 100 Ω for ≤120 sec for cryotherapy. At the maximum times, these settings resulted in identical pathological changes. Healing of the lesions following ablation was achieved within 3 weeks. The Nd:YAG laser, APC, electrocautery and cryotherapy endobronchial ablation techniques differed according to their potential and limitations for application on the trachea. However, when applied at specific combinations of power or impedance and duration, they exhibited similar efficacies. PMID:28123486

  1. Endobronchial ultrasound-guided transbronchial needle aspiration of hilar and mediastinal lymph nodes detected on 18F-fluorodeoxyglucose positron emission tomography/computed tomography

    PubMed Central

    Minami, Daisuke; Takigawa, Nagio; Oda, Naohiro; Ninomiya, Takashi; Kubo, Toshio; Ohashi, Kadoaki; Sato, Akiko; Hotta, Katsuyuki; Tabata, Masahiro; Kaji, Mitsumasa; Tanimoto, Mitsune; Kiura, Katsuyuki

    2016-01-01

    Objective Endobronchial ultrasound-guided transbronchial needle aspiration is of diagnostic value in hilar/mediastinal (N1/N2) lymph node staging. We assessed the utility of endobronchial ultrasound-guided transbronchial needle aspiration in lung cancer patients with N1/N2 lymph nodes detected on 18F-fluorodeoxyglucose positron emission tomography/computed tomography. Methods Fifty lung cancer patients with N1/N2 disease on 18F-fluorodeoxyglucose positron emission tomography/computed tomography underwent endobronchial ultrasound-guided transbronchial needle aspiration for pathological lymph nodes between November 2012 and April 2015. The diagnostic performance of endobronchial ultrasound-guided transbronchial needle aspiration, lymph node site and size, number of needle passes and complications were evaluated retrospectively from patients' medical records. Malignancy was defined as a maximum standardized uptake value (SUVmax) >2.5. Results The median longest diameter of the 61 lymph nodes (29 subcarinal, 21 right lower paratracheal, 6 left lower paratracheal, 4 right hilar and 1 upper paratracheal) was 23.4 mm (range: 10.4–45.7); the median number of needle passes was 2 (range: 1–5). There were no severe complications. A definitive diagnosis was made by endobronchial ultrasound-guided transbronchial needle aspiration in 39 patients (31 adenocarcinomas, 3 small-cell carcinomas, 2 squamous-cell carcinomas, 3 large-cell neuroendocrine carcinomas). In the remaining 11 patients, the diagnosis was indefinite: insufficient endobronchial ultrasound-guided transbronchial needle aspiration material was collected in two patients and non-specific lymphadenopathy was confirmed by endobronchial ultrasound-guided transbronchial needle aspiration or thoracotomy in the other nine patients. The mean lymph node SUVmax was 7.09 (range: 2.90–26.9) and was significantly higher in true-positive than in false-positive nodes (P < 0.05, t-test). Non-specific lymphadenopathy was

  2. Fluoroscopic-Guided Radial Endobronchial Ultrasound Without Guide Sheath For Peripheral Pulmonary Lesions: A Safe And Efficient Combination.

    PubMed

    Casutt, Alessio; Prella, Maura; Beigelman-Aubry, Catherine; Fitting, Jean-William; Nicod, Laurent; Koutsokera, Angela; Lovis, Alban

    2015-07-01

    Several guidelines recommend computed tomography scans for populations with high-risk for lung cancer. The number of individuals evaluated for peripheral pulmonary lesions (PPL) will probably increase, and with it non-surgical biopsies. Associating a guidance method with a target confirmation technique has been shown to achieve the highest diagnostic yield, but the utility of bronchoscopy with radial probe endobronchial ultrasound using fluoroscopy as guidance without a guide sheath has not been reported. We conducted a retrospective analysis of bronchoscopy with radial probe endobronchial ultrasound using fluoroscopy procedures for the investigation of PPL performed by experienced bronchoscopists with no specific previous training in this particular technique. Operator learning curves and radiological predictors were assessed for all consecutive patients examined during the first year of application of the technique. Fifty-one PPL were investigated. Diagnostic yield and visualization yield were 72.5 and 82.3% respectively. The diagnostic yield was 64.0% for PPL ≤20mm, and 80.8% for PPL>20mm. No false-positive results were recorded. The learning curve of all diagnostic tools showed a DY of 72.7% for the first sub-group of patients, 81.8% for the second, 72.7% for the third, and 81.8% for the last. Bronchoscopy with radial probe endobronchial ultrasound using fluoroscopy as guidance is safe and simple to perform, even without specific prior training, and diagnostic yield is high for PPL>and ≤20mm. Based on these findings, this method could be introduced as a first-line procedure for the investigation of PPL, particularly in centers with limited resources. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  3. Validation and pilot clinical study of a new bronchoscopic method to measure collateral ventilation before endobronchial lung volume reduction.

    PubMed

    Aljuri, Nikolai; Freitag, Lutz

    2009-03-01

    Endobronchial lung volume reduction (ELVR) may be helpful in a selected group of patients with advanced stages of emphysema. However, collateral ventilation (CV) from adjacent lobes through collateral channels often prevents target lobe atelectasis, which presumably mediates clinical responses after ELVR. With the goal of identifying patients who are more or less likely to benefit, we propose endobronchial CV assessment (ECVA), a novel catheter-based endobronchial approach, to quantitatively determine the resistance of collateral channels (R(coll)). ECVA relies on the measurement of spontaneous airflow from the sealed and isolated target compartment during spontaneous respiration in an awake subject, thereby providing a direct, simple, and minimally invasive method of assessing R(coll) in lungs. In this study, we validated ECVA in a controlled laboratory setup and tested ECVA's clinical feasibility in 11 emphysematous human subjects undergoing ELVR treatment. To evaluate ECVA in a controlled laboratory setup with known CV levels, we built a benchtop model mimicking a simple one-compartment model of the lungs during temporary compartmental occlusion and spontaneous respiration, which could be adapted to hold restrictors of different sizes representing collateral airways, and applied ECVA to estimate the resistance of various benchtop model restrictors. We then rated ECVA's performance by direct comparison between estimated and actual restrictor resistance and found a correlation coefficient near one. To test ECVA's clinical performance, post-ELVR radiological assessments were made to determine the occurrence of atelectasis in the treated lobe, and interlobar R(coll) was estimated in the target lobe via ECVA pre-ELVR. ECVA could be completed in all patients with no adverse events, and a high R(coll) by ECVA predicted absorption atelectasis following ELVR ( P = 0.005). We believe that ECVA may be helpful to distinguish those patients with and without interlobar CV by

  4. High dose rate endobronchial brachytherapy (HDR-EB) in recurrent benign complex tracheobronchial stenosis: experience in two cases.

    PubMed

    Tscheikuna, Jamsak; Disayabutr, Supparerk; Kakanaporn, Chumpot; Tuntipumi-Amorn, Lalida; Chansilpa, Yaowalak

    2013-02-01

    Benign complex tracheobronchial stenosis (BCTS) is a tracheobronchial stenosis that is longer than 1 cm or has more than one site of stenotic area. The most common etiology of the stenosis is endobronchial tuberculosis. BCTS causes challenge in diagnosis and management because of nonspecific presentation and usually precluded surgical treatment. Available interventional bronchoscopic techniques fail to manage BCTS because of high rate of restenosis. Experience in using HDR brachytherapy to prevent restenosis in two cases of BCTS is reported. There were two cases of BCTS who received HDR brachytherapy in order to prevent restenosis. First case was a 39 year-old female who had 5 cms tracheal and 2 cms left main bronchial stenosis from previous endobronchial tuberculosis. After 36 procedures of tracheobronchial dilatation by rigid bronchoscopy and two tracheal stents placement, her trachea became restenosis in an average time of 1 month. She also developed anaphylactic reaction with lidocaine. She received HDR brachytherapy with the dose of 10 Gy and no restenosis was found after 5 months follow-up. The second case was a 18 year-old male who had 4 cms tracheal stenosis result from post intubation. He was done dilatation and stenting of the trachea by regid bronchoscopy because he refused surgery. After 1 year the tracheal stent was removed and rapid restenosis of the trachea resulted in respiratory failure occurred in 7 days. The tracheal stent was reimplanted and 1 year later 7.0 Gy HDR brachytherapy was done after stent removal. He was doing well 4 months after with 50% tracheal stenosis and occasional stridor. Failure of intervention bronchoscopic techniques in management of BCTS was significantly shown by the restenosis even after endobronchial stent placement. HDR brachytherapy had a beneficial role in preventing granulation tissue formation and delay or prevent restenosis after bronchoscopic dilatation in selected case of BCTS patients. The case selection and

  5. Radial endobronchial ultrasound for the diagnosis of bronchoscopically invisible lesions: First case series from India

    PubMed Central

    Hibare, Kedar Ravi; Goyal, Rajiv; Nemani, Chetan; Avinash, Rao; Ram, Bajpai; Ullas, Batra

    2017-01-01

    Background: A peripheral, bronchoscopically invisible pulmonary lesion is a diagnostic challenge. Transthoracic needle aspiration has long been the investigation of choice but runs the risk of pneumothorax (up to 44%). Newer technologies like radial endobronchial ultrasound (R-EBUS) offer a safer approach. We present our results of R-EBUS in the diagnosis of bronchoscopically invisible lesions. This is the first large case series from India. Aims: (1) To determine the yield of R-EBUS for the diagnosis of bronchoscopically invisible lesions. (2) To compare the yields of forceps versus cryobiopsies in the diagnosis of these lesions. Setting: Tertiary care cancer center. Design: Prospective study. Methods: Consecutive patients presenting between January and October 2015 with bronchoscopically invisible peripheral pulmonary lesions were included. R-EBUS was used to localize and sample the lesion and the yields were analyzed. Yields of cryo and forceps biopsy were compared where both methods had been used. Data were analyzed using SPSS version 22. Results: A definite diagnosis obtained in 67.3% (37/55) patients with no major complications. No significant difference was found in yield between: (1) small (<3 cm) and large (>3 cm) lesions: (46.2% versus 78.6%, P = 0.38). (2) central and adjacent lesions: 61.5% versus 70%. (3) forceps and cryobiopsy (n = 28, 75% versus 67.9% P = 0.562). Conclusions: R-EBUS is a safe procedure in our setting and its yield is comparable to that reported in literature. The yield of central and adjacent lesions and forceps or cryobiopsy appears similar. Further refinements in the technique could improve yield. PMID:28144060

  6. Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in various lung diseases

    PubMed Central

    Ortakoylu, Mediha Gonenc; Iliaz, Sinem; Bahadir, Ayse; Aslan, Asuman; Iliaz, Raim; Ozgul, Mehmet Akif; Urer, Halide Nur

    2015-01-01

    Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new method for the diagnosis and staging of lung disease, and its use is increasing worldwide. It has been used as a means of diagnosing lung cancer in its initial stages, and there are data supporting its use for the diagnosis of benign lung disease. The aim of this study was to share our experience with EBUS-TBNA and discuss its diagnostic value. Methods: We retrospectively analyzed the results related to 159 patients who underwent EBUS-TBNA at our pulmonary medicine clinic between 2010 and 2013. We recorded the location and size of lymph nodes seen during EBUS. Lymph nodes that appeared to be affected on EBUS were sampled at least twice. We recorded the diagnostic results of EBUS-TBNA and (for cases in which EBUS-TBNA yielded an inconclusive diagnosis) the final diagnoses after further investigation and follow-up. Results: We evaluated 159 patients, of whom 89 (56%) were male and 70 (44%) were female. The mean age was 54.6 ± 14.2 years among the male patients and 51.9 ± 11.3 years among the female patients. Of the 159 patients evaluated, 115 (84%) were correctly diagnosed by EBUS. The diagnostic accuracy of EBUS-TBNA was 83% for benign granulomatous diseases and 77% for malignant diseases. Conclusions: The diagnostic value of EBUS-TBNA is also high for benign pathologies, such as sarcoidosis and tuberculosis. In patients with mediastinal disorders, the use of EBUS-TBNA should be encouraged, primarily because it markedly reduces the need for mediastinoscopy. PMID:26578131

  7. Endobronchial ultrasonography with a guide sheath in the diagnosis of benign peripheral diseases.

    PubMed

    Shinagawa, Naofumi; Nakano, Kosuke; Asahina, Hajime; Kikuchi, Eiki; Ito, Tomoo; Matsuno, Yoshihiro; Oizumi, Satoshi; Nasuhara, Yasuyuki; Nishimura, Masaharu

    2012-03-01

    For appropriate treatment, such as the selection of antibiotics or initiation of steroid therapy, correctly diagnosing benign pulmonary diseases located at the periphery is vital. This study assessed the usefulness of bronchoscopy using endobronchial ultrasonography with a guide sheath (EBUS-GS) in the diagnosis of benign pulmonary diseases, especially those presenting peripheral nodular lesions. We retrospectively reviewed 159 patients with 171 peripheral pulmonary lesions (PPLs) that were subsequently diagnosed as benign diseases. To examine the role of bronchoscopy with EBUS-GS, the contribution of bronchoscopy was classified into 4 categories. We also retrospectively reviewed 24 patients with 25 PPLs that were subsequently diagnosed as benign diseases by bronchoscopy without EBUS-GS (historical control). The ultimate diagnosis of 171 PPLs included 45 cases of mycobacteriosis, 45 cases of bronchiolitis obliterans organizing pneumonia/chronic organized pneumonia (BOOP), 23 cases of bacterial pneumonia, 13 abscesses, 11 cases of sarcoidosis, and 34 other benign diseases. Among them, a definitive diagnosis was obtained by bronchoscopy with EBUS-GS in 99 lesions (58%). Lesions in which the probe was positioned within the lesion had a higher diagnostic yield (64%) than did lesions in which the probe was positioned adjacent to the lesion (52%) or outside the lesion (20%; P=0.01). The diagnostic yield of bronchoscopy with EBUS-GS was higher compared with that of the historical control (58% versus 28%; P=0.04). Bronchoscopy using EBUS-GS is a reasonable option as a diagnostic procedure for PPLs, even if they are suspected to be benign in nature. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Transbronchial Biopsy for Peripheral Pulmonary Lesions Under Real-time Endobronchial Ultrasonographic Guidance.

    PubMed

    Shinagawa, Naofumi; Yamada, Noriyuki; Asahina, Hajime; Kikuchi, Eiki; Oizumi, Satoshi; Kurimoto, Noriaki; Nishimura, Masaharu

    2009-10-01

    Transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS) is a promising technique for small peripheral pulmonary lesions (PPLs), but is not a real-time procedure. We attempted to examine the practicality of TBB under real-time EBUS guidance for PPLs. We performed TBB under real-time EBUS and x-ray fluoroscopic guidance using flexible bronchoscopy with 2 working channels for PPLs (mean diameter,>30 mm). Between January 2007 and May 2007, we recruited 6 patients for this trial. On computed tomography images, the mean±SD diameter of the lesions was 37.4±4.5 mm (range: 32.0 to 45.0 mm). All lesions were detected by EBUS and could eventually be diagnosed. However, an image of the biopsy forceps or brush was obtained on real-time EBUS in only 4 cases. The other 2 cases involved technical limitations in inserting both the EBUS probe and biopsy forceps simultaneously into the lesion. Unfortunately, even in the 4 cases in which biopsy forceps images could be obtained on real-time EBUS, we could not recognize the position of the tip of the forceps on EBUS images, because the EBUS images of the tip of the forceps and the body of forceps were very similar. Our attempt to perform TBB under real-time EBUS guidance for PPLs was successful in 4 of 6 patients. There were some technical limitations using flexible bronchoscopy with 2 working channels. Improvement of instruments will be necessary for future trials of TBB under real-time EBUS guidance.

  9. Bronchoscopic lung volume reduction by endobronchial valve in advanced emphysema: the first Asian report

    PubMed Central

    Park, Tai Sun; Hong, Yoonki; Lee, Jae Seung; Oh, Sang Young; Lee, Sang Min; Kim, Namkug; Seo, Joon Beom; Oh, Yeon-Mok; Lee, Sang-Do; Lee, Sei Won

    2015-01-01

    Purpose Endobronchial valve (EBV) therapy is increasingly being seen as a therapeutic option for advanced emphysema, but its clinical utility in Asian populations, who may have different phenotypes to other ethnic populations, has not been assessed. Patients and methods This prospective open-label single-arm clinical trial examined the clinical efficacy and the safety of EBV in 43 consecutive patients (mean age 68.4±7.5, forced expiratory volume in 1 second [FEV1] 24.5%±10.7% predicted, residual volume 208.7%±47.9% predicted) with severe emphysema with complete fissure and no collateral ventilation in a tertiary referral hospital in Korea. Results Compared to baseline, the patients exhibited significant improvements 6 months after EBV therapy in terms of FEV1 (from 0.68±0.26 L to 0.92±0.40 L; P<0.001), 6-minute walk distance (from 233.5±114.8 m to 299.6±87.5 m; P=0.012), modified Medical Research Council dyspnea scale (from 3.7±0.6 to 2.4±1.2; P<0.001), and St George’s Respiratory Questionnaire (from 65.59±13.07 to 53.76±11.40; P=0.028). Nine patients (20.9%) had a tuberculosis scar, but these scars did not affect target lobe volume reduction or pneumothorax frequency. Thirteen patients had adverse events, ten (23.3%) developed pneumothorax, which included one death due to tension pneumothorax. Conclusion EBV therapy was as effective and safe in Korean patients as it has been shown to be in Western countries. (Trial registration: ClinicalTrials.gov: NCT01869205). PMID:26251590

  10. Technical Aspects of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: CHEST Guideline and Expert Panel Report.

    PubMed

    Wahidi, Momen M; Herth, Felix; Yasufuku, Kazuhiro; Shepherd, Ray Wesley; Yarmus, Lonny; Chawla, Mohit; Lamb, Carla; Casey, Kenneth R; Patel, Sheena; Silvestri, Gerard A; Feller-Kopman, David J

    2016-03-01

    Endobronchial ultrasound (EBUS) was introduced in the last decade, enabling real-time guidance of transbronchial needle aspiration (TBNA) of mediastinal and hilar structures and parabronchial lung masses. The many publications produced about EBUS-TBNA have led to a better understanding of the performance characteristics of this procedure. The goal of this document was to examine the current literature on the technical aspects of EBUS-TBNA as they relate to patient, technology, and proceduralist factors to provide evidence-based and expert guidance to clinicians. Rigorous methodology has been applied to provide a trustworthy evidence-based guideline and expert panel report. A group of approved panelists developed key clinical questions by using the PICO (population, intervention, comparator, and outcome) format that addressed specific topics on the technical aspects of EBUS-TBNA. MEDLINE (via PubMed) and the Cochrane Library were systematically searched for relevant literature, which was supplemented by manual searches. References were screened for inclusion, and well-recognized document evaluation tools were used to assess the quality of included studies, to extract meaningful data, and to grade the level of evidence to support each recommendation or suggestion. Our systematic review and critical analysis of the literature on 15 PICO questions related to the technical aspects of EBUS-TBNA resulted in 12 statements: 7 evidence-based graded recommendations and 5 ungraded consensus-based statements. Three questions did not have sufficient evidence to generate a statement. Evidence on the technical aspects of EBUS-TBNA varies in strength but is satisfactory in certain areas to guide clinicians on the best conditions to perform EBUS-guided tissue sampling. Additional research is needed to enhance our knowledge regarding the optimal performance of this effective procedure. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights

  11. Endobronchial Ultrasound–guided Transbronchial Needle Aspiration Prevents Mediastinoscopies in the Diagnosis of Isolated Mediastinal Lymphadenopathy

    PubMed Central

    Lawrence, David R.; Kolvekar, Shyam; Hayward, Martin; McAsey, Dorcas; Kocjan, Gabrijela; Falzon, Mary; Capitanio, Arrigo; Shaw, Penny; Morris, Stephen; Omar, Rumana Z.; Janes, Sam M.

    2012-01-01

    Rationale: Patients with isolated mediastinal lymphadenopathy (IML) are a common presentation to physicians, and mediastinoscopy is traditionally considered the “gold standard” investigation when a pathological diagnosis is required. Endobronchial ultrasound–guided transbronchial needle aspiration (EBUS-TBNA) is established as an alternative to mediastinoscopy in patients with lung cancer. Objective: To determine the efficacy and health care costs of EBUS-TBNA as an alternative initial investigation to mediastinoscopy in patients with isolated IML. Methods: Prospective multicenter single-arm clinical trial of 77 consecutive patients with IML from 5 centers between April 2009 and March 2011. All patients underwent EBUS-TBNA. If EBUS-TBNA did not provide a diagnosis, then participants underwent mediastinoscopy. Measurements and Main Results: EBUS-TBNA prevented 87% of mediastinoscopies (95% confidence interval [CI], 77–94%; P < 0.001) but failed to provide a diagnosis in 10 patients (13%), all of whom underwent mediastinoscopy. The sensitivity and negative predictive value of EBUS-TBNA in patients with IML were 92% (95% CI, 83–95%) and 40% (95% CI, 12–74%), respectively. One patient developed a lower respiratory tract infection after EBUS-TBNA, requiring inpatient admission. The cost of the EBUS-TBNA procedure per patient was £1,382 ($2,190). The mean cost of the EBUS-TBNA strategy was £1,892 ($2,998) per patient, whereas a strategy of mediastinoscopy alone was significantly more costly at £3,228 ($5,115) per patient (P < 0.001). The EBUS-TBNA strategy is less costly than mediastinoscopy if the cost per EBUS-TBNA procedure is less than £2,718 ($4,307) per patient. Conclusions: EBUS-TBNA is a safe, highly sensitive, and cost-saving initial investigation in patients with IML. Clinical trial registered with ClinicalTrials.gov (NCT00932854). PMID:22652031

  12. Diagnosis of peripheral pulmonary lesions with radial probe endobronchial ultrasound-guided bronchoscopy.

    PubMed

    Boonsarngsuk, Viboon; Kanoksil, Wasana; Laungdamerongchai, Sarangrat

    2014-09-01

    The diagnosis of peripheral pulmonary lesions (PPLs) is a challenging task for pulmonologists. Radial probe endobronchial ultrasound (R-EBUS) has been developed to enhance diagnostic yield. The objective of this study was to evaluate the effectiveness of R-EBUS in the diagnosis of PPLs. A retrospective study was conducted on 174 patients diagnosed with PPLs who underwent EBUS-guided bronchoscopy. Histological examination of specimens obtained by transbronchial lung biopsy (TBLB) and cytological examinations of brushing smear, brush rinse fluid and bronchoalveolar lavage fluid (BALF) were evaluated for the diagnosis. The mean diameter of the PPLs was 25.1 ± 10.7 mm. The final diagnoses included 129 malignancies and 45 benign lesions. The overall diagnostic yield of EBUS-guided bronchoscopy was 79.9%. Neither size nor etiology of the PPLs influenced the diagnostic performance of EBUS-guided bronchoscopy (82.9% vs. 74.6% for PPLs>20mm and PPLs≤20mm; p=0.19, and 82.9% vs. 71.1% for malignancy and benign diseases; p=0.09). TBLB rendered the highest yield among these specimens (69.0%, 50.6%, 42.0%, and 44.3% for TBLB, brushing smear, brush rinse fluid, and BALF, respectively; p<0.001). The combination of TBLB, brush smear, and BALF provided the greatest diagnostic yield, while brush rinse fluid did not add benefits to the outcomes. R-EBUS-guided bronchoscopy is a useful technique in the diagnosis of PPLs. To achieve the highest diagnostic performance, TBLB, brushing smear and bronchoalveolar lavage should be performed together. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  13. Incidence of Fever Following Endobronchial Ultrasound–Guided Transbronchial Needle Aspiration

    PubMed Central

    Kim, Seo Yun; Lee, Jin woo; Park, Young Sik; Lee, Chang-Hoon; Lee, Sang-Min; Yim, Jae-Joon; Kim, Young Whan; Han, Sung Koo

    2017-01-01

    Background Endobronchial ultrasound–guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic method for mediastinal and hilar lymphadenopathy. This study aimed to investigate the incidence of fever following EBUS-TBNA. Methods A total of 684 patients who underwent EBUS-TBNA from May 2010 to July 2012 at Seoul National University Hospital were retrospectively reviewed. The patients were evaluated for fever by a physician every 6–8 hours during the first 24 hours following EBUS-TBNA. Fever was defined as an increase in axillary body temperature over 37.8℃. Results Fever after EBUS-TBNA developed in 110 of 552 patients (20%). The median onset time and duration of fever was 7 hours (range, 0.5–32 hours) after EBUS-TBNA and 7 hours (range, 1–52 hours), respectively, and the median peak body temperature was 38.3℃ (range, 37.8–39.9℃). In most patients, fever subsided within 24 hours; however, six cases (1.1%) developed fever lasting longer than 24 hours. Infectious complications developed in three cases (0.54%) (pneumonia, 2; mediastinal abscess, 1), and all three patients had diabetes mellitus. The number or location of sampled lymph nodes and necrosis of lymph node were not associated with fever after EBUS-TBNA. Multiple logistic regression analysis did not reveal any risk factors for developing fever after EBUS-TBNA. Conclusion Fever is relatively common after EBUS-TBNA, but is transient in most patients. However, clinicians should be aware of the possibility of infectious complications among patients with diabetes mellitus. PMID:28119746

  14. Diagnostic value of blood clot core during endobronchial ultrasound-guided transbronchial needle aspirate.

    PubMed

    Amin, Emily N; Russell, Christopher D; Shilo, Konstantin; Islam, Shaheen; Wood, Karen L

    2013-06-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is being increasingly used in the sampling of pulmonary masses and mediastinal lymphadenopathy. The blood clot core (BCC) often obtained during EBUS-TBNA may not be a true core and therefore may not be submitted for histological analysis. The frequency in which the blood clot core is positive in patients with negative cytology undergoing EBUS-TBNA is not known. The purpose of this study was to evaluate the diagnostic role of the blood clot core obtained during EBUS-TBNA. An Institutional Review Board-approved retrospective chart review was performed from January through September 2011 for all patients who underwent EBUS-TBNA at The Ohio State University. The data collection included cytology and histology results for each procedure. Blood clot cores obtained from the EBUS-TBNA needle were sent in formalin for histological examination. Seventy patients underwent EBUS-TBNA and 51 (72.8 %) patients had procedures that yielded a BCC for histology and aspirate for cytology. Forty-nine percent of patients with a BCC were diagnosed with malignancy. Of those with a BCC obtained, five (9.8 %) patients diagnosed with malignancy were done so based only on the results of blood clot core alone with negative cytology. Blood clot cores obtained at EBUS-TBNA contain diagnostic material and should be subjected histopathological examination. When blood clot cores are sent for analysis, there is the potential to spare up to 10 % of patients more invasive diagnostic biopsy procedures.

  15. A novel, stepwise approach combining conventional and endobronchial ultrasound needle aspiration for mediastinal lymph node sampling.

    PubMed

    Liran, Levy; Rottem, Kuint; Gregorio, Fridlender Zvi; Avi, Abutbul; Neville, Berkman

    2017-09-07

    Since the introduction of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), most pulmonary centers use this technique exclusively for mediastinal lymph node (LN) sampling. Conventional "blind" TBNA (cTBNA), however, is cheaper, more accessible, provides more tissue, and requires less training. We evaluated whether sampling of mediastinal LN using EBUS-TBNA or cTBNA according to a predefined set of criteria provides acceptable diagnostic yield. Sampling method was determined prospectively according to a predefined set of criteria based on LN station, LN size, and presumed diagnosis. Sensitivity, specificity, positive, and negative predictive value were evaluated for each modality. One hundred and eighty-six biopsies were carried out over a 3-year period (86 cTBNA, 100 EBUS-TBNA). Seventy-seven percent of LN biopsied by EBUS-TBNA were <20 mm, while 83% of cTBNA biopsies were ≥20 mm. Most common sites of cTBNA sampling were station 7, 4R, and 11R as opposed to 7, 11R, 4R, and 4 L in the case of EBUS-TBNA. Most common EBUS-TBNA diagnosis was malignancy versus sarcoidosis in cTBNA. EBUS-TBNA and cTBNA both had a true positive yield of 65%, but EBUS-TBNA had a higher true negative rate (21% vs. 2% for cTBNA) and a lower false negative rate (7% vs. 28%). Sensitivity, specificity, positive predictive value, and negative predictive value for EBUS-TBNA were 90%, 100%, 100%, and 75%, respectively, and for cTBNA were 68%, 100%, 100%, and 7%, respectively. A stepwise approach based on LN size, station, and presumed diagnosis may be a reasonable, cost-effective approach in choosing between cTBNA and EBUS-TBNA.

  16. Greater physician involvement improves coding outcomes in endobronchial ultrasound-guided transbronchial needle aspiration procedures.

    PubMed

    Pillai, Anilkumar; Medford, Andrew R L

    2013-01-01

    Correct coding is essential for accurate reimbursement for clinical activity. Published data confirm that significant aberrations in coding occur, leading to considerable financial inaccuracies especially in interventional procedures such as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Previous data reported a 15% coding error for EBUS-TBNA in a U.K. service. We hypothesised that greater physician involvement with coders would reduce EBUS-TBNA coding errors and financial disparity. The study was done as a prospective cohort study in the tertiary EBUS-TBNA service in Bristol. 165 consecutive patients between October 2009 and March 2012 underwent EBUS-TBNA for evaluation of unexplained mediastinal adenopathy on computed tomography. The chief coder was prospectively electronically informed of all procedures and cross-checked on a prospective database and by Trust Informatics. Cost and coding analysis was performed using the 2010-2011 tariffs. All 165 procedures (100%) were coded correctly as verified by Trust Informatics. This compares favourably with the 14.4% coding inaccuracy rate for EBUS-TBNA in a previous U.K. prospective cohort study [odds ratio 201.1 (1.1-357.5), p = 0.006]. Projected income loss was GBP 40,000 per year in the previous study, compared to a GBP 492,195 income here with no coding-attributable loss in revenue. Greater physician engagement with coders prevents coding errors and financial losses which can be significant especially in interventional specialties. The intervention can be as cheap, quick and simple as a prospective email to the coding team with cross-checks by Trust Informatics and against a procedural database. We suggest that all specialties should engage more with their coders using such a simple intervention to prevent revenue losses. Copyright © 2013 S. Karger AG, Basel.

  17. Specimen acquisition training with a new biosimulator in endobronchial ultrasound-guided transbronchial needle aspiration

    PubMed Central

    Nakajima, Takahiro; Fujiwara, Taiki; Saegusa, Fumie; Inage, Terunaga; Sakairi, Yuichi; Wada, Hironobu; Suzuki, Hidemi; Iwata, Takekazu; Yoshida, Shigetoshi; Nakatani, Yukio; Yoshino, Ichiro

    2017-01-01

    Abstract Training for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has focused on the procedure itself; however, the techniques for obtaining adequate sample are also important for achieving a pathological diagnosis as well as for molecular testing. The aim of this study was to evaluate the feasibility and efficacy of a biosimulator for training subjects in adequate sample acquisition during EBUS-TBNA. A total of 19 bronchoscopists voluntarily participated in this study. A biosimulator (ArtiCHEST, HARADA Corporation, Tokyo, Japan) was used for the training. After a 10-minute briefing, the first pass was performed by pairs of trainees. The trainees then received a 30-minute lecture that focused on the acquisition of samples using EBUS-TBNA. The trainees next performed their second pass under the supervision of the trainers. Each participant obtained a cytological smear that was coded and evaluated for quantity as well as quality by an independent cytotechnologist. The trainees had an average of 5.9 years of bronchoscopy experience. With regard to the quantity evaluation, 9 (47.4%) subjects sampled a greater number of lymphocytes on the second pass than on the first, whereas 2 were better on the first pass, and the others sampled roughly the same amount both times. With regard to the quality assessment, 9 (47.4%) subjects obtained better quality samples on the second pass, whereas the quality of the first and second pass was deemed to be roughly the same for the remaining subjects. A biosimulator can be used to train doctors in specimen acquisition and evaluate their skills with sampling using EBUS-TBNA. PMID:28353607

  18. Characteristics of endobronchial tuberculosis patients with negative sputum acid-fast bacillus.

    PubMed

    Sahin, Füsun; Yıldız, Pınar

    2013-12-01

    Endobronchial tuberculosis (EBTB) is defined as a tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence, with or without parenchymal involvement. In this study, clinical, radiological and bronchoscopic characteristics of cases diagnosed to have EBTB were evaluated. Sixteen patients with at least three negative sputum examinations for acid-fast bacillus (AFB) and diagnosed as having EBTB on the histopathological examination of bronchoscopically obtained specimens showing granulomatous structures with caseation necrosis and/or positive AFB-culture on the microbiological examination of bronchoscopically obtained specimens were included in our study. Age, sex, symptoms, tuberculin skin test (TST), microbiological examination results and radiological findings were recorded. Bronchoscopical lesions were classified according to Chung classification. EBTB was found to be more common in females. Most common symptoms were cough (100%), sputum (75%), weight loss (62.5%), hemoptisis (37.5%), chest pain (25%) and dyspnea (12.5%). Radiological examination findings revealed consolidations/infiltrations (87.5%), nodular lesions (37.5%), cavitary lesions (25%), unilateral (43.7%) or bilateral hilar widening (31.2%) and atelectasia (25%). Middle lob syndrome was seen in three cases. Most common lesions observed bronchoscopically were active caseous lesions, granular lesions, edematous hyperemic lesions, tumorous lesions, fibrostenotic lesions respectively. In all cases "granulomatous inflammation showing caseation" was shown in the histopathological examination of biopsy specimens. EBTB can cause various radiological and bronchoscopical findings. In most of the cases distinct response is seen to antituberculous treatment. Bronchial stenosis is an important complication. Treatment should be given as soon as possible to avoid it.

  19. Characteristics of endobronchial tuberculosis patients with negative sputum acid-fast bacillus

    PubMed Central

    Yıldız, Pınar

    2013-01-01

    Objective Endobronchial tuberculosis (EBTB) is defined as a tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence, with or without parenchymal involvement. In this study, clinical, radiological and bronchoscopic characteristics of cases diagnosed to have EBTB were evaluated. Methods Sixteen patients with at least three negative sputum examinations for acid-fast bacillus (AFB) and diagnosed as having EBTB on the histopathological examination of bronchoscopically obtained specimens showing granulomatous structures with caseation necrosis and/or positive AFB-culture on the microbiological examination of bronchoscopically obtained specimens were included in our study. Age, sex, symptoms, tuberculin skin test (TST), microbiological examination results and radiological findings were recorded. Bronchoscopical lesions were classified according to Chung classification. Results EBTB was found to be more common in females. Most common symptoms were cough (100%), sputum (75%), weight loss (62.5%), hemoptisis (37.5%), chest pain (25%) and dyspnea (12.5%). Radiological examination findings revealed consolidations/infiltrations (87.5%), nodular lesions (37.5%), cavitary lesions (25%), unilateral (43.7%) or bilateral hilar widening (31.2%) and atelectasia (25%). Middle lob syndrome was seen in three cases. Most common lesions observed bronchoscopically were active caseous lesions, granular lesions, edematous hyperemic lesions, tumorous lesions, fibrostenotic lesions respectively. In all cases “granulomatous inflammation showing caseation” was shown in the histopathological examination of biopsy specimens. Conclusions EBTB can cause various radiological and bronchoscopical findings. In most of the cases distinct response is seen to antituberculous treatment. Bronchial stenosis is an important complication. Treatment should be given as soon as possible to avoid it. PMID:24409353

  20. Endobronchial ultrasound for the diagnosis of peripheral pulmonary lesions. A controlled study with fluoroscopy.

    PubMed

    Sánchez-Font, Albert; Giralt, Laia; Vollmer, Ivan; Pijuan, Lara; Gea, Joaquim; Curull, Víctor

    2014-05-01

    Fluoroscopy-guided bronchoscopy is usually performed for the diagnosis of peripheral pulmonary lesions (PPL), but the diagnostic yield varies widely among studies. Endobronchial ultrasound (EBUS) can increase the diagnostic yield of bronchoscopic diagnosis of PPL. To compare the diagnostic yield of fluoroscopy-guided bronchoscopy and EBUS with fluoroscopy-guided bronchoscopy in the study of PPL. All patients who underwent bronchoscopy to study PPL from January 2009 to December 2012 were prospectively included. 145 consecutive patients were randomly distributed in two groups: EBUS and fluoroscopy (50 patients, 71.3 ± 8.2 years) or fluoroscopy alone (95 patients, 68 ± 10.5 years). The mean diameter of the lesions was 41.97 ± 19.22 mm. Cytological brushing and transbronchial biopsies were obtained. All procedures were performed under fluoroscopic guidance with intravenous conscious sedation. EBUS was performed using an endoscopic ultrasound system equipped with a 20-MHz radial miniprobe introduced via a guide-sheath. Bronchoscopist, cytologist, study protocol, techniques and tools were the same throughout the whole study. 129 (89%) patients had malignant disease. A diagnosis with bronchoscopy was established in 105 (72.4%) patients. EBUS plus fluoroscopy obtained a diagnostic yield in 78% of patients and fluoroscopy alone in 69.5% (non-significant). In contrast, for lesions smaller than 30 mm, EBUS plus fluoroscopy guidance provided significantly greater diagnostic performance than fluoroscopy alone (90 vs. 52%; P=.05). Bronchoscopy under EBUS plus fluoroscopy guidance is a technique that has become useful for the diagnostic of LPPs, especially those smaller than 30 mm in diameter. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  1. [Endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer diagnosis and staging in 179 patients].

    PubMed

    Bugalho, A; Ferreira, D; Barata, R; Rodrigues, C; Dias, S S; Medeiros, F; Carreiro, L

    2013-01-01

    Linear endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an important minimally invasive procedure for non-small cell lung cancer (NSCLC) staging. It is also a valid method for diagnosing extraluminal lesions adjacent to the tracheobronchial tree. To evaluate our EBUS-TBNA performance regarding diagnostic yield, safety and learning curve for lung cancer diagnosis and staging. All patients undergoing EBUS-TBNA for lung cancer diagnosis or staging were included. They were divided into three different groups: paratracheal and parabronchial masses sent for diagnosis (Group 1); peripheral lung lesions with abnormal mediastinal lymph nodes sent for diagnosis and staging (Group 2); NSCLC patients sent for mediastinal staging (Group 3). The learning curve was assessed for yield, accuracy, procedure time, size and number of lesions punctured per patient. A total of 179 patients were included and 372 lesions were punctured. The overall yield and accuracy were 88% and 92.7%, respectively. In Group 1, EBUS-TBNA was performed in 48 patients and sensitivity was 86.1% and accuracy was 87.5%. For the 87 patients included in Group 2, yield was 86.7%, accuracy was 93.1% and cancer prevalence was 51.7%. The diagnostic yield and accuracy in Group 3 was 95% and 97.7% respectively. EBUS-TBNA practice led to an increase number of sites punctured per patient in a shorter time, without complications. EBUS-TBNA is an effective method for diagnosing and staging lung cancer patients. The procedure is clearly safe. Handling and performance improves with the number of procedures executed. Copyright © 2012 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

  2. Spectrum Analysis of Endobronchial Ultrasound Radiofrequency of Lymph Nodes in Patients With Lung Cancer.

    PubMed

    Nakajima, Takahiro; Shingyoji, Masato; Anayama, Takashi; Kimura, Hideki; Yasufuku, Kazuhiro; Yoshino, Ichiro

    2016-06-01

    The aim of this study was to analyze the spectral features of the radiofrequency of lymph nodes during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and to determine its diagnostic value for detecting metastatic nodes in patients with lung cancer. Ultrasound spectrums of lymph nodes during EBUS-TBNA were retrospectively analyzed. A linear regression of frequency spectrum and the ultrasonic spectral parameters midband-fit, slope, and intercept were calculated. Mean values for these parameters within lymph nodes were computed. The cutoff values for each parameter for distinguishing metastatic vs benign lymph nodes were first determined within the training set; these cutoff values were then applied to the testing set for validation. Overall, 362 lymph nodes (112 metastatic, 250 benign) were analyzed as the training set, and 284 lymph nodes (74 metastatic, 210 benign) were evaluated as the testing set. In the training set, all of the parameters showed a significant difference between metastatic and benign lymph nodes (P < .001). The metastatic nodes tended to show low midband-fit, high slope, and low intercept. When midband-fit and intercept were combined, the diagnostic accuracy was maximized in the training set. In the testing set, the combination of intercept and slope produced the highest diagnostic accuracy, with the following outcomes: sensitivity, 79.7%; specificity, 84.3%; diagnostic accuracy, 83.1%; positive predictive value, 64.1%; and negative predictive value, 92.2%. Metastatic lymph nodes possess unique ultrasonic spectrum features, and spectrum analysis can be used as a novel diagnostic tool for differentiating between benign and malignant nodes in patients with lung cancer. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  3. Endobronchial ultrasound guided needle aspiration of a paraspinal mass with prior failed multiple diagnostic interventions: A case report and literature review

    PubMed Central

    Sinha, Nishant; Padegal, Vivek; Jermely, Deepthi; Satyanarayana, Satish; Santosh, H. K.

    2014-01-01

    The increasing frequency of tuberculosis (TB) in both developed and developing countries has continued to make spinal TB an important health problem. The present case report is about a patient who presented to us with progressive back pain and paraspinal mass. We performed endobronchial ultrasound guided needle aspiration from the paraspinal mass. The cytology showed granulomatous inflammation suggestive of TB. PMID:25378853

  4. Elastic Deformation Properties of Implanted Endobronchial Wire Stents in Benign and Malignant Bronchial Disease: A Radiographic In Vivo Evaluation

    SciTech Connect

    Hautmann, Hubert; Rieger, Johannes; Huber, Rudolf M.; Pfeifer, Klaus J.

    1999-03-15

    Purpose: To evaluate the long-term mechanical behavior in vivo of expandable endobronchial wire stents, we imaged three different prostheses in the treatment of tracheobronchial disease. Methods: Six patients with bronchial stenoses (three benign, three malignant) underwent insertion of metallic stents. Two self-expandable Wallstents, two balloon-expandable tantalum Strecker stents and two self-expandable nitinol Accuflex stents were used. Measurements of deformation properties were performed during voluntary cough by means of fluoroscopy, at 1 month and 7-10 months after implantation. The procedures were videotaped, their images digitized and the narrowing of stent diameters calculated at intervals of 20 msec. Results: After stent implantation all patients improved with respect to ventilatory function. Radial stent narrowing during cough reached 53% (Wallstent), 59% (tantalum Strecker stent), and 52% (nitinol Accuflex stent) of the relaxed post-implantation diameter. Stent compression was more marked in benign compared with malignant stenoses. In the long term permanent deformation occurred with the tantalum Strecker stents; the other stents were unchanged. Conclusion: Endobronchial wire stents can be helpful in the treatment of major airway collapse and obstructing bronchial lesions. However, evidence of material fatigue as a possible effect of exposure to recurrent mechanical stress on the flexible mesh tube may limit their long-term use. This seems to be predominantly important in benign bronchial collapse.

  5. The sonographic features of malignant mediastinal lymph nodes and a proposal for an algorithmic approach for sampling during endobronchial ultrasound.

    PubMed

    Alici, Ibrahim Onur; Yılmaz Demirci, Nilgün; Yılmaz, Aydın; Karakaya, Jale; Özaydın, Esra

    2016-09-01

    There are several papers on the sonographic features of mediastinal lymph nodes affected by several diseases, but none gives the importance and clinical utility of the features. In order to find out which lymph node should be sampled in a particular nodal station during endobronchial ultrasound, we investigated the diagnostic performances of certain sonographic features and proposed an algorithmic approach. We retrospectively analyzed 1051 lymph nodes and randomly assigned them into a preliminary experimental and a secondary study group. The diagnostic performances of the sonographic features (gray scale, echogeneity, shape, size, margin, presence of necrosis, presence of calcification and absence of central hilar structure) were calculated, and an algorithm for lymph node sampling was obtained with decision tree analysis in the experimental group. Later, a modified algorithm was applied to the patients in the study group to give the accuracy. The demographic characteristics of the patients were not statistically significant between the primary and the secondary groups. All of the features were discriminative between malignant and benign diseases. The modified algorithm sensitivity, specificity, and positive and negative predictive values and diagnostic accuracy for detecting metastatic lymph nodes were 100%, 51.2%, 50.6%, 100% and 67.5%, respectively. In this retrospective analysis, the standardized sonographic classification system and the proposed algorithm performed well in choosing the node that should be sampled in a particular station during endobronchial ultrasound. © 2015 John Wiley & Sons Ltd.

  6. Clinical applications of image-based airway computational fluid dynamics: assessment of inhalation medication and endobronchial devices

    NASA Astrophysics Data System (ADS)

    De Backer, Jan W.; Vos, Wim G.; Germonpré, Paul; Salgado, Rodrigo; Parizel, Paul M.; De Backer, Wilfried

    2009-02-01

    Computational fluid dynamics (CFD) is a technique that is used increasingly in the biomedical field. Solving the flow equations numerically provides a convenient way to assess the efficiency of therapies and devices, ranging from cardiovascular stents and heart valves to hemodialysis workflows. Also in the respiratory field CFD has gained increasing interest, especially through the combination of three dimensional image reconstruction which results in highend patient-specific models. This paper provides an overview of clinical applications of CFD through image based modeling, resulting from recent studies performed in our center. We focused on two applications: assessment of the efficiency of inhalation medication and analysis of endobronchial valve placement. In the first application we assessed the mode of action of a novel bronchodilator in 10 treated patients and 4 controls. We assessed the local volume increase and resistance change based on the combination of imaging and CFD. We found a good correlation between the changes in volume and resistance coming from the CFD results and the clinical tests. In the second application we assessed the placement and effect of one way endobronchial valves on respiratory function in 6 patients. We found a strong patientspecific result of the therapy where in some patients the therapy resulted in complete atelectasis of the target lobe while in others the lobe remained inflated. We concluded from these applications that CFD can provide a better insight into clinically relevant therapies.

  7. Novel One Lung Ventilation Strategy (OLV) for a Patient with Complete Unilateral Endobronchial Obstruction Causing Hypoxic Respiratory Failure

    PubMed Central

    Kanitkar, Amaraja; Lee, Sarah J.

    2017-01-01

    Patient: Male, 67 Final Diagnosis: Lung cancer Symptoms: Short of breath Medication: — Clinical Procedure: Mechanical ventilation Specialty: Critical Care Medicine Objective: Unusual setting of medical care Background: Mechanical ventilation strategies for one lung ventilation (OLV) differ from conventional modalities in that it can adapt to greater degrees of ventilation/perfusion (V/Q) mismatch. We present a case of cancer causing complete unilateral endobronchial obstruction with refractory hypoxia that improved with OLV strategy. Case Report: Our patient was an elderly male, admitted to our intensive care unit (ICU) on mechanical ventilation with worsening hypoxic respiratory failure secondary to lung mass and post-obstructive atelectasis. The patient developed refractory hypoxia on high conventional ventilator settings. Chest x-ray (CXR) showed opacification on left lung with ipsilateral mediastinal shift. Bronchoscopy revealed complete obstruction of the left main stem bronchus by a fungating mass. OLV strategy was then implemented. The patient had improved hypoxia despite unchanged CXR. Conclusions: We propose that ventilating a patient with a complete unilateral endobronchial obstruction is physiologically similar to ventilating a patient with OLV. In such cases, OLV strategies may improve refractory hypoxia by minimizing V/Q mismatch and should be considered. PMID:28126982

  8. Treatment of multiple-level tracheobronchial stenosis secondary to endobronchial tuberculosis using bronchoscopic balloon dilatation with topical mitomycin-C.

    PubMed

    Faisal, Mohamed; Harun, Hafaruzi; Hassan, Tidi M; Ban, Andrea Y L; Chotirmall, Sanjay H; Abdul Rahaman, Jamalul Azizi

    2016-04-14

    Tracheobronchial stenosis is a known complication of endobronchial tuberculosis. Despite antituberculous and steroid therapy, the development of bronchial stenosis is usually irreversible and requires airway patency to be restored by either bronchoscopic or surgical interventions. We report the use of balloon dilatation and topical mitomycin-C to successful restore airway patency. We present a 24-year old lady with previous pulmonary tuberculosis and laryngeal tuberculosis in 2007 and 2013 respectively who presented with worsening dyspnoea and stridor. She had total left lung collapse with stenosis of both the upper trachea and left main bronchus. She underwent successful bronchoscopic balloon and manual rigid tube dilatation with topical mitomycin-C application over the stenotic tracheal segment. A second bronchoscopic intervention was performed after 20 weeks for the left main bronchus stenosis with serial balloon dilatation and topical mitomycin-C application. These interventions led to significant clinical and radiographic improvements. This case highlights that balloon dilatation and topical mitomycin-C application should be considered in selected patients with tracheobronchial stenosis following endobronchial tuberculosis, avoiding airway stenting and invasive surgical intervention.

  9. Novel One Lung Ventilation Strategy (OLV) for a Patient with Complete Unilateral Endobronchial Obstruction Causing Hypoxic Respiratory Failure.

    PubMed

    Kanitkar, Amaraja; Lee, Sarah J

    2017-01-27

    BACKGROUND Mechanical ventilation strategies for one lung ventilation (OLV) differ from conventional modalities in that it can adapt to greater degrees of ventilation/perfusion (V/Q) mismatch. We present a case of cancer causing complete unilateral endobronchial obstruction with refractory hypoxia that improved with OLV strategy. CASE REPORT Our patient was an elderly male, admitted to our intensive care unit (ICU) on mechanical ventilation with worsening hypoxic respiratory failure secondary to lung mass and post-obstructive atelectasis. The patient developed refractory hypoxia on high conventional ventilator settings. Chest x-ray (CXR) showed opacification on left lung with ipsilateral mediastinal shift. Bronchoscopy revealed complete obstruction of the left main stem bronchus by a fungating mass. OLV strategy was then implemented. The patient had improved hypoxia despite unchanged CXR. CONCLUSIONS We propose that ventilating a patient with a complete unilateral endobronchial obstruction is physiologically similar to ventilating a patient with OLV. In such cases, OLV strategies may improve refractory hypoxia by minimizing V/Q mismatch and should be considered.

  10. Imaging demonstration of a flexible micro-OCT endobronchial probe (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Cui, Dongyao; Chu, Kengyeh K.; Ford, Timothy N.; Hyun, Daryl Chulho; Leung, Hui Min; Yin, Biwei; Birket, Susan E.; Solomon, George M.; Rowe, Steven M.; Tearney, Guillermo J.

    2017-04-01

    The human respiratory system is protected by a defense mechanism termed mucociliary clearance (MCC). Deficiency in MCC leads to respiratory obstruction and pulmonary infection, which often are the main causes of morbidity and mortality in diseases such as cystic fibrosis and chronic obstructive pulmonary disease (COPD). Studying key parameters that govern MCC, including ciliary beat frequency, velocity and volume of airway mucus transport, as well as periciliary liquid layer thickness are therefore of great importance in understanding human respiratory health. However, direct, in vivo visualization of ciliary function and MCC has been challenging, hindering the diagnosis of disease pathogenesis and mechanistic evaluation of novel therapeutics. Our laboratory has previously developed a 1-µm resolution optical coherence tomography method, termed Micro-OCT, which is a unique tool for visualizing the spatiotemporal features of ciliary function and MCC. We have previously described the design of a flexible 2.5 mm Micro-OCT probe that is compatible with standard flexible bronchoscopes. This device utilizes a common-path interferometer and annular sample arm apodization to attain a sharply focused spot over an extended depth of focus. Here, we present the most recent iteration of this probe and demonstrate its imaging performance in a mouse trachea tissue culture model. In addition, we have developed an ergonomic assembly for attaching the probe to a standard bronchoscope. The ergonomic assembly fixes the Micro-OCT probe's within the bronchoscope and contains a means transducing linear motion through the sheath so that the Micro-OCT beam can be scanned along the trachea. We have tested the performance of these devices for Micro-OCT imaging in an anatomically correct model of the human airway. Future studies are planned to use this technology to conduct Micro-OCT in human trachea and bronchi in vivo.

  11. Photodetection of early cancer in the upper aerodigestive tract and the bronchi using photofrin II and colorectal adenocarcinoma with fluoresceinated monoclonal antibodies

    NASA Astrophysics Data System (ADS)

    Wagnieres, Georges A.; Braichotte, Daniel; Chatelain, Andre; Depeursinge, Christian D.; Monnier, Philippe; Savary, Jean-Francois; Fontolliet, Charlotte; Calmes, J.-M.; Givel, Jean-Claude; Chapuis, G.; Folli, S.; Pelegrin, A.; Buchegger, F.; Mach, J.-P.; van den Bergh, Hubert

    1991-11-01

    The performance of a fluorescence endoscope for the detection of early cancer is clinically evaluated. the apparatus is based on the imaging of the laser-induced fluorescence (LIF) of a dye which localizes in the tumor after IV injection with a higher concentration than in the surrounding normal tissue. The tests are carried out in several of the hollow organs, such as the upper aerodigestive tract, the bronchi, and the colon. In the two former cases the dye used is photofrin II, whereas in the latter case conjugates between monoclonal antibodies (Mab) directed against carcinoembrionic antigen (CEA) and fluorescein molecules are injected. The fluorescence contrast between tumor and surrounding tissue is enhanced by real-time image processing which eliminates most of the tissue autofluorescence as well as the fluorescence due to the relatively small amount of dye localized in the normal tissue. This is done by recording the fluorescence image in two spectral domains, after which these two images are digitized and manipulated with a mathematical operator (lookup-table). The sources of false positives and false negatives are evaluated in terms of the fluorescent dye and tissue optical properties.

  12. The role of sedation in endobronchial ultrasound-guided transbronchial needle aspiration: Systematic review

    PubMed Central

    Aswanetmanee, Pantaree; Limsuwat, Chok; Kabach, Mohamad; Alraiyes, Abdul Hamid; Kheir, Fayez

    2016-01-01

    Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure that has become an important tool in diagnosis and staging of mediastinal lymph node (LN) lesions in lung cancer. Adequate sedation is an important part of the procedure since it provides patient's comfort and potentially increases diagnostic yield. We aimed to compare deep sedation (DS) versus moderate sedation (MS) in patients undergoing EBUS-TBNA procedure. Methods: PubMed, EMBASE, MEDLINE, and Cochrane Library were searched for English studies of clinical trials comparing the two different methods of sedations in EBUS-TBNA until December 2015. The overall diagnostic yield, LN size sampling, procedural time, complication, and safety were evaluated. Results: Six studies with 3000 patients which compared two different modalities of sedation in patients performing EBUS-TBNA were included in the study. The overall diagnostic yield of DS method was 52.3%–100% and MS method was 46.1%–85.7%. The overall sensitivity of EBUS-TBNA of DS method was 98.15%–100% as compared with 80%–98.08% in MS method. The overall procedural times were 27.2–50.9 min and 20.6-44.1 min in DS and MS groups, respectively. The numbers of LN sampled were between 1.33–3.20 nodes and 1.36–2.80 nodes in DS and MS groups, respectively. The numbers of passes per LN were 3.21–3.70 passes in DS group as compared to 2.73–3.00 passes in MS group. The mean of LN size was indifferent between two groups. None of the studies included reported serious adverse events. Conclusions: Using MS in EBUS-TBNA has comparable diagnostic yield and safety profile to DS. The decision on the method of sedation for EBUS-TBNA should be individually selected based on operator experience, patient preference, as well as duration of the anticipated procedure. PMID:27803902

  13. A Multicenter RCT of Zephyr® Endobronchial Valve Treatment in Heterogeneous Emphysema (TRANSFORM).

    PubMed

    Kemp, Samuel V; Slebos, Dirk-Jan; Kirk, Alan; Kornaszewska, Malgorzata; Carron, Kris; Ek, Lars; Broman, Gustav; Hillerdal, Gunnar; Mal, Herve; Pison, Christophe; Briault, Amandine; Downer, Nicola; Darwiche, Kaid; Rao, Jagan; Hübner, Ralf-Harto; Ruwwe-Glosenkamp, Christof; Trosini-Desert, Valéry; Eberhardt, Ralf; Herth, Felix J; Derom, Eric; Malfait, Thomas; Shah, Pallav L; Garner, Justin L; Ten Hacken, Nick H; Fallouh, Hazem; Leroy, Sylvie; Marquette, Charles H

    2017-09-08

    Single-center RCTs of Zephyr Endobronchial Valve (EBV) treatment have demonstrated benefit in severe heterogeneous emphysema. This is the first multicenter study evaluating this treatment approach. To evaluate the efficacy and safety of Zephyr EBVs in patients with heterogeneous emphysema and absence of collateral ventilation. Prospective, multicenter 2:1 RCT of EBVs plus standard of care or standard of care (SoC) alone. Primary outcome at 3 months post-procedure was the percent of subjects with a FEV1 improvement from baseline of ≥12%. Changes in FEV1, RV, 6MWD, SGRQ, and mMRC were assessed at 3 and 6 months, and target lobe volume reduction (TLVR) on chest CT at 3 months. Ninety seven subjects were randomized to EBV (n=65) or SoC (n=32). At 3 months, 55.4% of EBV and 6.5% of SoC subjects had an FEV1 improvement ≥12% (p<0.001). Improvements were maintained at 6 months: EBV 56.3% vs SoC 3.2% (p<0.001), with a mean change in FEV1 at 6 months of 20.7±29.6% and -8.6±13.0%, respectively. 89.8% of EBV subjects had TLVR ≥350ml, mean 1.09±0.62L (p<0.001). Between group differences for changes at 6 months were statistically and clinically significant: ΔEBV-SoC for RV -700ml; 6MWD +78.7m; SGRQ -6.5 points; mMRC Dyspnea score -0.6 points; BODE Index -1.8 points (all p<0.05). Pneumothorax was the commonest adverse event, occurring in 19/65 (29.2%) of EBV subjects. EBV treatment in hyperinflated patients with heterogeneous emphysema without collateral ventilation resulted in clinically meaningful benefits in lung function, dyspnea, exercise tolerance, and quality of life, with an acceptable safety profile. Clinical trial registration available at www.clinicaltrials.gov, ID NCT02022683.

  14. Predicting Optimal Insertion Depth of a Left-sided Double-Lumen Endobronchial Tube.

    PubMed

    Lin, Wei-Lin; Cherng, Chen-Hwan

    2016-08-01

    Appropriate placement of the double-lumen endobronchial tube (DLT) is essential for one-lung ventilation. Several formulae based on body height (BH) have been used for estimating the optimal insertion depth of a left-sided DLT. In this study, the authors examined the following 5 formulae for accuracy of prediction: 0.11×BH+10.53 (cm) from Brodsky et al(1); 0.15×BH+3.96 (cm) from Bahk and Oh(2); 0.148×BH+3.8 (cm) from Chow et al;(3) 0.1×BH+12.5 (cm) from Takita et al(4); and 0.1977×BH - 4.2423 (cm) (authors' formula). Single-center, retrospective, observational study. University hospital. Anesthetic records of patients older than 20 years who received one-lung ventilation using a left-sided DLT were included. The patients' sex, age, body weight, BH, and the final correct insertion depth of the left-sided DLT after fiberscope verification were recorded. Linear regression and correlation were used to analyze the data. One hundred seventy anesthetic records were analyzed. The insertion depth was distributed normally in 4 groups with different BH intervals. The correlations between the correct insertion depth and all the lengths calculated using each formula were significant (p<0.001), with a similar high coefficient of determination (r = 0.809). The regression line derived from the authors' formula-0.1977×BH - 4.2423 (cm)-showed the most accuracy in predicting the correct insertion depth. The height-based formula of 170 - 29.5 - 5 - 1 (the insertion depth is 29.5 cm for patients who are 170 cm tall, and the insertion length is increased or decreased by 1 cm for every 5 cm increase or decrease in BH) modified by the equation of 0.1977×BH - 4.2423 is a useful tool to predict the optimal insertion depth in initially blind left-sided DLT insertion. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Diagnosis of sarcoidosis in the endobronchial ultrasound-guided transbronchial needle aspiration era.

    PubMed

    Ribeiro, C; Oliveira, A; Neves, S; Campainha, S; Nogueira, C; Torres, S; Brito, M C; Almeida, J; e Sá, J M

    2014-01-01

    Sarcoidosis is a multisystemic disorder of unknown etiology. Its diagnosis is based on compatible clinical and radiological features and supported by histological demonstration of epithelioid cell noncaseating granulomas with exclusion of other causes. Endobronchial ultrasound combined with transbronchial needle aspiration (EBUS-TBNA) has been proposed as a valuable tool in obtaining suitable tissue sample. The aim of this study was to evaluate the contribution of EBUS-TBNA to the diagnosis of stages I and II thoracic sarcoidosis in a community-based hospital. A prospective study was conducted in patients with suspected stages I and II pulmonary sarcoidosis, based on clinical and radiological data, who were being followed in our Interstitial Lung Disorders Outpatient Clinic or sent from other hospitals to our Respiratory Endoscopy Unit for diagnostic procedures. All suitable and fit patients underwent EBUS-TBNA between March 2010 and June 2013. We assessed demographic characteristics, radiological stages, cytological/histological examination and diagnostic techniques performed. In the period considered 39 patients underwent EBUS-TBNA for suspected stages I and II thoracic sarcoidosis and adequate samples were obtained in 38 (97.4%). Within this population, 33 (84.6%) patients had a definite diagnosis of sarcoidosis, of which 31 patients (93.9%) were confirmed to have epithelioid noncaseating granulomas by EBUS-TBNA. Four patients were submitted to surgical procedures (three to mediastinoscopy and one to open surgical lung biopsy). Data analysis allowed to calculate a sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of 93.9%, 100%, 100%, 75.0% and 94.8%, respectively. No complications were observed. EBUS-TBNA is a valuable tool in the diagnostic workup of patients with suspected stages I and II thoracic sarcoidosis providing a substantial number of pathological confirmations and with few complications. Its high

  16. Reversal of IL-13-induced inflammation and Ca(2+) sensitivity by resolvin and MAG-DHA in association with ASA in human bronchi.

    PubMed

    Khaddaj-Mallat, Rayan; Sirois, Chantal; Sirois, Marco; Rizcallah, Edmond; Morin, Caroline; Rousseau, Éric

    2015-09-01

    The aim of this study was to investigate the effects of resolvin D1 (RvD1), as well as the combined treatment of docosahexaenoic acid monoglyceride (MAG-DHA) and acetylsalicylic acid (ASA), on the resolution of inflammation markers and Ca(2+) sensitivity in IL-13-pretreated human bronchi (HB). Tension measurements performed with 300 nM RvD1 largely abolished (50%) the over-reactivity triggered by 10 ng/ml IL-13 pretreatment and reversed hyper Ca(2+) sensitivity. Addition of 300 nM 17(S)-HpDoHE, the metabolic intermediate between DHA and RvD1, displayed similar effects. In the presence of 100 μM ASA (a COX inhibitor), the inhibitory effect of 1 μM MAG-DHA on muscarinic tone was further amplified, but not in the presence of Ibuprofen. Western blot analysis revealed that the combined treatment of MAG-DHA and ASA upregulated GPR-32 expression and downregulated cytosolic TNFα detection, hence preventing IκBα degradation and p65-NFκB phosphorylation. The Ca(2+) sensitivity of HB was also quantified on β-escin permeabilized preparations. The presence of ASA potentiated the inhibitory effects of MAG-DHA in reducing the Ca(2+) hypersensitivity triggered by IL-13 by decreasing the phosphorylation levels of the PKC-potentiated inhibitor protein-17 regulatory protein (CPI-17). In summary, MAG-DHA combined with ASA, as well as exogenously added RvD1, may represent valuable assets against critical AHR disorder.

  17. A comparison of the disconnection technique with continuous bronchial suction for lung deflation when using the Arndt endobronchial blocker during video-assisted thoracoscopy: A randomised trial.

    PubMed

    El-Tahan, Mohamed R

    2015-06-01

    The use of the Arndt endobronchial blocker has not gained widespread acceptance during video-assisted thoracoscopic surgery (VATS) because of its high cost and longer time to operative lung collapse especially in patients with chronic obstructive pulmonary disease (COPD). The use of a ventilator disconnection technique has been shown to produce a comparable degree of lung collapse when used with either a double-lumen tube or an Arndt endobronchial blocker. We hypothesised that the use of bronchial suction through the suction port of the endobronchial blocker would be associated with a comparable time to achieve optimum lung collapse as the disconnection technique. A randomised, double-blind study. Single university hospital. Fifty-eight patients with spontaneous pneumothorax scheduled for elective VATS using the Arndt endobronchial blocker for one-lung ventilation (OLV). Patients were randomly assigned to one of two groups (n = 29 per group) to deflate the operative lung with either disconnection of the endotracheal tube from the ventilator for 60 s prior to inflation of the endobronchial blocker or connection of a suction pressure of -30 cmH2O to the suction port of the endobronchial blocker through the barrel of a 1 ml syringe. The primary outcome was the time to total lung collapse. Secondary outcomes included surgeon rating of lung collapse, overall surgeon satisfaction, need for further fibreoptic bronchial suction manoeuvres and intraoperative hypoxaemia. The bronchial suction technique was associated with a significantly shorter time to total lung collapse than the disconnection method [93 (95% confidence interval, 95% CI 81.3 to 103.7) vs. 197 (95% CI 157.4 to 237) s respectively; P < 0.001]. Both the disconnection and bronchial suction groups had a comparable surgical rating of excellent lung collapse 40 min after the start of OLV (65.5 vs. 79.3%, respectively; P = 0.24), overall surgeon satisfaction [median (interquartile range, IQR) 9 (8 to 10) vs. 9 (8

  18. Small-caliber endobronchial ultrasonic videoscope: successful transesophageal and transgastric FNA after failed passage of a standard ultrasonic endoscope.

    PubMed

    Gupta, Kapil; Mallery, Shawn

    2007-09-01

    EUS-guided tissue acquisition is a valuable technique. Obstructing lesions of the oropharynx or esophagus may preclude passage of a standard echoendoscope. In the past this has prevented EUS-guided tissue sampling. The recently introduced small-caliber ultrasonic bronchovideoscope (developed for endobronchial ultrasound) may allow EUS-guided FNA in this setting. Our purpose was to assess the possible use of the ultrasonic bronchovideoscope to perform upper GI EUS in patients where passage of standard EUS scope was unsuccessful. A descriptive case series. A tertiary referral center. Two patients were evaluated after failure of passage of a standard echoendoscope (1 with congenital narrowing of the esophageal inlet, 1 with postoperative deformity). In both cases, sonographic visualization of the lesion of concern was achieved and FNA was performed successfully. The ultrasonic bronchovideoscope may be a valuable tool to perform FNA of mediastinal and GI lesions in situations when a standard ultrasonic endoscope cannot be passed because of luminal narrowing.

  19. Lung isolation in patients with previous lung resections: Selective sequential lobar blockade using a Fuji Uniblocker(®) endobronchial blocker.

    PubMed

    Valencia Orgaz, O; Real Navacerrada, M I; Cortés Guerrero, M; García Gutierrez, A F; Marrón Fernández, C; Pérez-Cerdá Silvestre, F

    2016-11-01

    Lung isolation is essential during thoracic surgery, as it allows the thoracic surgeon to visualise and work in the surgical field. The occurrence of hypoxaemia during lung isolation is common, and is even more so in patients with decreased pulmonary functional reserve. The clinical cases are presented of 2 patients with a history of left pulmonary resections (1st left lower lobectomy, 2nd left lower lobectomy and left upper lobe segmentectomy), in which sequential selective lobar blockade was performed with Fuji Uniblocker(®) endobronchial blocker for performing right lung atypical resections (right upper lobe, middle lobe, and right lower lobe). In our experience the technique was successful, the surgical field was optimal and no intra- or post-operative complications were found. This technique may be an alternative to traditional lung isolation in patients with compromised respiratory function (low functional reserve or previous contralateral lung resections).

  20. Flexible, high-resolution micro-optical coherence tomography endobronchial probe toward in vivo imaging of cilia.

    PubMed

    Cui, Dongyao; Chu, Kengyeh K; Yin, Biwei; Ford, Timothy N; Hyun, Chulho; Leung, Hui Min; Gardecki, Joseph A; Solomon, George M; Birket, Susan E; Liu, Linbo; Rowe, Steven M; Tearney, Guillermo J

    2017-02-15

    We report the design and fabrication of a flexible, longitudinally scanning high-resolution micro-optical coherence tomography (μOCT) endobronchial probe, optimized for micro-anatomical imaging in airways. The 2.4 mm diameter and flexibility of the probe allows it to be inserted into the instrument channel of a standard bronchoscope, enabling real-time video guidance of probe placement. To generate a depth-of-focus enhancing annular beam, we utilized a new fabrication method, whereby a hollow glass ferrule was angle-polished and gold-coated to produce an elongated annular reflector. We present validation data that verifies the preservation of linear scanning, despite the use of flexible materials. When utilized on excised, cultured mouse trachea, the probe acquired images of comparable quality to those obtained by a benchtop μOCT system.

  1. Endobronchial Ultrasound-guided Aspiration of an Endotracheal Bronchogenic Cyst: Case Report and Systematic Review of the Literature.

    PubMed

    Maturu, Venkata N; Dhooria, Sahajal; Agarwal, Ritesh; Behera, Digambar

    2016-04-01

    The most common location of bronchogenic cysts is the mediastinum, adjacent to the major airways. Endotracheal bronchogenic cysts are rare and most present in infancy with respiratory failure. Although surgical resection has remained the treatment of choice, there is increasing interest in the management of these cysts with therapeutic aspiration alone. In this article, we describe a 68-year-old man with endotracheal bronchogenic cyst who was managed with endobronchial ultrasound-guided needle aspiration. We also systematically review the literature for reports of endotracheal bronchogenic cysts. The review identified 9 reports (10 patients) with endotracheal bronchogenic cysts. The most common age at presentation was infancy (n=8) and surgical resection was the most common treatment modality used (n=7).

  2. Endobronchial dental prosthesis retrieval by a snare technique using a flexible bronchoscope and fluoroscopy: Two case reports and technical tips.

    PubMed

    Ichimura, Hideo; Maeda, Michihiro; Kikuchi, Shinji; Ozawa, Yuichiro; Kanemoto, Koji; Kurishima, Koichi; Iijima, Hiroaki; Ishikawa, Hiroichi; Sato, Yukio

    2016-01-01

    We describe two cases in each of which a dental prosthesis, presenting as an endobronchial foreign body (FB), was successfully retrieved using a snare technique employing a flexible bronchoscope and fluoroscopy that enabled us to avoid the need for rigid bronchoscope and thoracotomy. In one case, the FB was peripherally lodged and bronchoscopically invisible. In the other case, the FB was observed in the right intermediate bronchus, but the grasping basket and forceps were unable to retrieve it. The combination of a flexible bronchoscope and fluoroscopy extended the application of the snare technique to bronchoscopically invisible FBs and facilitated placement of an encircling loop around the FB. Since dental prostheses are rigid and irregular in shape, the snare loop technique can be used. For patients in a stable condition with a dental prosthesis FB, using the snare technique with a flexible bronchoscope and fluoroscopy is a good option. We provide technical tips based on our experiences.

  3. Case report of medical thoracoscopy and endobronchial ultrasound bronchoscopy in the workup of giant solitary fibrous tumor of the pleura

    PubMed Central

    Dammad, Tarek; Duchesne, Joshua; Pasnick, Susan

    2016-01-01

    Abstract Solitary fibrous tumor of the pleura (SFTP) is a rare tumor of fibroblastic origin. It can be quite vascular, and its surgical management carries the risk of a major intra-operative bleed. The pre-operative use of endobronchial ultrasound (EBUS) to visualize the vascular supply of the tumor has not been reported. We report a case of a patient presenting with progressive shortness of breath and cough who was found to have a very large pleural-based tumor. We describe the use of medical thoracoscopy and EBUS to establish the diagnosis of SFTP and to characterize the blood supply of the tumor. In the future, EBUS may provide an alternative to conventional angiography for both mapping and embolizing tumor blood supply. PMID:27399107

  4. Temporary Endobronchial Stent as a Bridge to Corrective Surgery For Severe Kyphoscoliosis-associated Central-Airway Extrinsic Compression.

    PubMed

    Sriratanaviriyakul, Narin; Nguyen, Lam-Phuong; Ismail, Heba; Roberto, Rolando F; Yoneda, Ken Y

    2016-10-01

    Kyphoscoliosis is known to compromise lung function, with the primary mechanism being reduced chest wall compliance with a resultant restrictive pulmonary physiology. Severe scoliosis can also cause extrinsic compression of the central airways, leading to recurrent respiratory infections, lobar atelectasis, and potentially acute respiratory failure. Definitive therapy is corrective surgery of the spine. However, patients with severe scoliosis are at a potentially high risk of perioperative pulmonary complications. To our knowledge, we report the first successful use of retrievable endobronchial stents as a bridge to corrective surgery for kyphoscoliosis-associated complete central-airway extrinsic compression in a patient who was considered as too high risk for surgical correction due to her respiratory status. After surgery, the stents were removed and our patient experienced sustained improvement in pulmonary function and the clinical respiratory status.

  5. Comparative cost analysis of endobronchial ultrasound-guided and blind TBNA in the evaluation of hilar and mediastinal lymphadenopathy.

    PubMed

    Grove, Daniel A; Bechara, Rabih I; Josephs, Josh S; Berkowitz, David M

    2012-07-01

    The superior accuracy of endobronchial ultrasound (EBUS) averts many diagnostic surgical procedures. This likely leads to significant cost savings despite an increased per procedure cost. We sought to compare the true costs of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) compared with "blind" fiberoptic bronchoscopy-transbronchial needle aspiration (FB-TBNA) factoring in the impact of diagnostic surgical procedures in the diagnosis of mediastinal lymphadenopathy. In this retrospective case study, we selected 294 patients with thoracic lymphadenopathy as diagnosed by computed tomography at a university hospital. Information was extracted from the electronic record. Costs were determined from the Centers for Medicare and Medicaid Services resource-based relative value scale. We defined a positive diagnosis as one where benign or malignant disease was found. A negative biopsy was one where lymph node sampling was confirmed, but no pathology (benign or malignant) was seen. A nondiagnostic biopsy was one where no pathology was seen and lymph node sampling could not be confirmed. The total cost of endoscopic and surgical diagnostic procedures was tallied for each patient to obtain mean costs per patient. Thirty-seven patients underwent FB-TBNA and 257 underwent EBUS-TBNA. A diagnosis was found in 90% of patients in the EBUS group and 62.2% of patients in the FB-TBNA group (P<0.001). More patients in the FB-TBNA group underwent a diagnostic surgical procedure (HR= -0.1573, 95% confidence interval, -0.30 to -0.15; P<0.001). After accounting for all diagnostic procedures, the mean savings with EBUS was $1071.09 (P=0.09) per patient. EBUS-TBNA is less expensive than blind FB-TBNA in the evaluation of thoracic lymphadenopathy when accounting for diagnostic surgical procedures.

  6. Experimental tuberculosis in the European badger (Meles meles) after endobronchial inoculation of Mycobacterium bovis: I. Pathology and bacteriology.

    PubMed

    Corner, L A L; Costello, E; Lesellier, S; O'Meara, D; Sleeman, D P; Gormley, E

    2007-08-01

    The aim was to develop an endobronchial infection procedure for the study of Mycobacterium bovis infection in badgers. The badgers were anaesthetised and a cannula was passed per os to the tracheal bifurcation. When in place 1 ml of M. bovis suspension was inoculated. Three concentrations of M. bovis suspension were used; <10 colony forming units (cfu), approximately 10(2) cfu and approximately 3 x 10(3) cfu. The badgers were examined at three weekly intervals for clinical signs of disease and a tracheal aspirate was collected at each examination. The badgers were euthanased 17 weeks post infection (pi) and at the post mortem examination a wide range of tissues were examined for gross and histopathological lesions of tuberculosis and cultured for M. bovis. A sample of bronchial alveolar lavage (BAL) fluid was collected at post mortem for culture. At post mortem examination 17 weeks after infection, gross and histopathological lesions of tuberculosis were observed in all badgers inoculated with the high and medium dose and 1/3 inoculated with the low dose. M. bovis was recovered from all inoculated badgers. Infection in the high dose group was more widely disseminated than in the other groups. The number of sites with gross and histopathological lesions increased with increasing dose of M. bovis. All tracheal aspirates were negative on culture and only one BAL, collected from a badger of the high dose group, was positive on culture. No clinical signs due to the experimental infection were observed. The endobronchial route of inoculation is an effective route for establishing experimental infection, and could be used for studies of tuberculosis pathogenesis, immunology of M. bovis infection in badgers and for challenging badgers in vaccine protection studies. Badgers appeared to be very susceptible to infection by this procedure even with a dose of < 10 cfu but appear to control and limit the resulting infection.

  7. Tissue irradiator

    DOEpatents

    Hungate, F.P.; Riemath, W.F.; Bunnell, L.R.

    1975-12-16

    A tissue irradiator is provided for the in-vivo irradiation of body tissue. The irradiator comprises a radiation source material contained and completely encapsulated within vitreous carbon. An embodiment for use as an in- vivo blood irradiator comprises a cylindrical body having an axial bore therethrough. A radioisotope is contained within a first portion of vitreous carbon cylindrically surrounding the axial bore, and a containment portion of vitreous carbon surrounds the radioisotope containing portion, the two portions of vitreous carbon being integrally formed as a single unit. Connecting means are provided at each end of the cylindrical body to permit connections to blood- carrying vessels and to provide for passage of blood through the bore. In a preferred embodiment, the radioisotope is thulium-170 which is present in the irradiator in the form of thulium oxide. A method of producing the preferred blood irradiator is also provided, whereby nonradioactive thulium-169 is dispersed within a polyfurfuryl alcohol resin which is carbonized and fired to form the integral vitreous carbon body and the device is activated by neutron bombardment of the thulium-169 to produce the beta-emitting thulium-170.

  8. [Food irradiation].

    PubMed

    Migdał, W

    1995-01-01

    A worldwide standard on food irradiation was adopted in 1983 by Codex Alimentarius Commission of the Joint Food Standard Programme of the Food and Agriculture Organization (FAO) of the United Nations and the World Health Organization (WHO). As a result, 41 countries have approved the use of irradiation for treating one or more food items and the number is increasing. Generally, irradiation is used to: food loses, food spoilage, disinfestation, safety and hygiene. The number of countries which use irradiation for processing food for commercial purposes has been increasing steadily from 19 in 1987 to 33 today. In the frames of the national programme on the application of irradiation for food preservation and hygienization an experimental plant for electron beam processing has been established in Institute of Nuclear Chemistry and Technology. The plant is equipped with a small research accelerator Pilot (19MeV, 1 kW) and an industrial unit Elektronika (10MeV, 10 kW). On the basis of the research there were performed at different scientific institutions in Poland, health authorities have issued permission for irradiation for: spices, garlic, onions, mushrooms, potatoes, dry mushrooms and vegetables.

  9. Cardiovascular and arousal responses to single-lumen endotracheal and double-lumen endobronchial intubation in the normotensive and hypertensive elderly.

    PubMed

    Yoo, Kyung Yeon; Jeong, Cheol Won; Kim, Woong Mo; Lee, Hyung Kon; Jeong, Seongtae; Kim, Seok Jae; Bae, Hong Beum; Lim, Dong Yun; Chung, Sung Su

    2011-02-01

    Endotracheal intubation usually causes transient hypertension and tachycardia. The cardiovascular and arousal responses to endotracheal and endobronchial intubation were determined during rapid-sequence induction of anesthesia in normotensive and hypertensive elderly patients. Patients requiring endotracheal intubation with (HT, n = 30) or without hypertension (NT, n = 30) and those requiring endobronchial intubation with (HB, n = 30) or without hypertension (NB, n = 30) were included in the study. Anesthesia was induced with intravenous thiopental 5 mg/kg followed by succinylcholine 1.5 mg/kg. After intubation, all subjects received 2% sevoflurane in 50% nitrous oxide and oxygen. Mean arterial pressure (MAP), heart rate (HR), plasma catecholamine concentration, and Bispectral Index (BIS) values, were measured before and after intubation. The intubation significantly increased MAP, HR, BIS values and plasma catecholamine concentrations in all groups, the peak value of increases was comparable between endotracheal and endobronchial intubation. However, pressor response persisted longer in the HB group than in the HT group (5.1 ± 1.6 vs. 3.2 ± 0.9 min, P < 0.05). The magnitude of increases in MAP and norepinephrine from pre-intubation values was greater in the hypertensive than in the normotensive group (P < 0.05), while there were no differences in those of HR and BIS between the hypertensive and normotensive groups. Cardiovascular response and arousal response, as measured by BIS, were similar in endobronchial and endotracheal intubation groups regardless of the presence or absence of hypertension except for prolonged pressor response in the HB group. However, the hypertensive patients showed enhanced cardiovascular responses than the normotensive patients.

  10. Cardiovascular and arousal responses to single-lumen endotracheal and double-lumen endobronchial intubation in the normotensive and hypertensive elderly

    PubMed Central

    Jeong, Cheol Won; Kim, Woong Mo; Lee, Hyung Kon; Jeong, Seongtae; Kim, Seok Jae; Bae, Hong Beum; Lim, Dong Yun; Chung, Sung Su

    2011-01-01

    Background Endotracheal intubation usually causes transient hypertension and tachycardia. The cardiovascular and arousal responses to endotracheal and endobronchial intubation were determined during rapid-sequence induction of anesthesia in normotensive and hypertensive elderly patients. Methods Patients requiring endotracheal intubation with (HT, n = 30) or without hypertension (NT, n = 30) and those requiring endobronchial intubation with (HB, n = 30) or without hypertension (NB, n = 30) were included in the study. Anesthesia was induced with intravenous thiopental 5 mg/kg followed by succinylcholine 1.5 mg/kg. After intubation, all subjects received 2% sevoflurane in 50% nitrous oxide and oxygen. Mean arterial pressure (MAP), heart rate (HR), plasma catecholamine concentration, and Bispectral Index (BIS) values, were measured before and after intubation. Results The intubation significantly increased MAP, HR, BIS values and plasma catecholamine concentrations in all groups, the peak value of increases was comparable between endotracheal and endobronchial intubation. However, pressor response persisted longer in the HB group than in the HT group (5.1 ± 1.6 vs. 3.2 ± 0.9 min, P < 0.05). The magnitude of increases in MAP and norepinephrine from pre-intubation values was greater in the hypertensive than in the normotensive group (P < 0.05), while there were no differences in those of HR and BIS between the hypertensive and normotensive groups. Conclusions Cardiovascular response and arousal response, as measured by BIS, were similar in endobronchial and endotracheal intubation groups regardless of the presence or absence of hypertension except for prolonged pressor response in the HB group. However, the hypertensive patients showed enhanced cardiovascular responses than the normotensive patients. PMID:21390163

  11. Endobronchial valves for patients with heterogeneous emphysema and without interlobar collateral ventilation: open label treatment following the BeLieVeR-HIFi study

    PubMed Central

    Zoumot, Zaid; Davey, Claire; Jordan, Simon; McNulty, William H; Carr, Denis H; Hind, Matthew D; Polkey, Michael I; Shah, Pallav L

    2017-01-01

    Outcomes in early trials of bronchoscopic lung volume reduction using endobronchial valves for the treatment of patients with advanced emphysema were inconsistent. However improvements in patient selection with focus on excluding those with interlobar collateral ventilation and homogeneous emphysema resulted in significant benefits in the BeLieVeR-HIFi study compared with sham treated controls. In this manuscript we present data from the control patients in the BeLieVeR-HIFi study who went on to have open label endobronchial valve treatment after completion of the clinical trial (n=12), combined with data from those in the treatment arm who did not have collateral ventilation (n=19). Three months after treatment FEV1 increased by 27.3 (36.4)%, residual volume reduced by 0.49 (0.76) L, the 6 min walk distance increased by 32.6 (68.7) m and the St George Respiratory Questionnaire for COPD score improved by 8.2 (20.2) points. These data extend the evidence for endobronchial valve placement in appropriately selected patients with COPD. Trial registration number: ISRCTN04761234; Results. PMID:27999170

  12. Irradiation subassembly

    DOEpatents

    Seim, O.S.; Filewicz, E.C.; Hutter, E.

    1973-10-23

    An irradiation subassembly for use in a nuclear reactor is described which includes a bundle of slender elongated irradiation -capsules or fuel elements enclosed by a coolant tube and having yieldable retaining liner between the irradiation capsules and the coolant tube. For a hexagonal bundle surrounded by a hexagonal tube the yieldable retaining liner may consist either of six segments corresponding to the six sides of the tube or three angular segments each corresponding in two adjacent sides of the tube. The sides of adjacent segments abut and are so cut that metal-tometal contact is retained when the volume enclosed by the retaining liner is varied and Springs are provided for urging the segments toward the center of the tube to hold the capsules in a closely packed configuration. (Official Gazette)

  13. [Ultrahigh dose-rate, "flash" irradiation minimizes the side-effects of radiotherapy].

    PubMed

    Favaudon, V; Fouillade, C; Vozenin, M-C

    2015-10-01

    Pencil beam scanning and filter free techniques may involve dose-rates considerably higher than those used in conventional external-beam radiotherapy. Our purpose was to investigate normal tissue and tumour responses in vivo to short pulses of radiation. C57BL/6J mice were exposed to bilateral thorax irradiation using pulsed (at least 40 Gy/s, flash) or conventional dose-rate irradiation (0.03 Gy/s or less) in single dose. Immunohistochemical and histological methods were used to compare early radio-induced apoptosis and the development of lung fibrosis in the two situations. The response of two human (HBCx-12A, HEp-2) tumour xenografts in nude mice and one syngeneic, orthotopic lung carcinoma in C57BL/6J mice (TC-1 Luc+), was monitored in both radiation modes. A 17 Gy conventional irradiation induced pulmonary fibrosis and activation of the TGF-beta cascade in 100% of the animals 24-36 weeks post-treatment, as expected, whereas no animal developed complications below 23 Gy flash irradiation, and a 30 Gy flash irradiation was required to induce the same extent of fibrosis as 17 Gy conventional irradiation. Cutaneous lesions were also reduced in severity. Flash irradiation protected vascular and bronchial smooth muscle cells as well as epithelial cells of bronchi against acute apoptosis as shown by analysis of caspase-3 activation and TUNEL staining. In contrast, the antitumour effectiveness of flash irradiation was maintained and not different from that of conventional irradiation. Flash irradiation shifted by a large factor the threshold dose required to initiate lung fibrosis without loss of the antitumour efficiency, suggesting that the method might be used to advantage to minimize the complications of radiotherapy. Copyright © 2015 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  14. [Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in stage Ⅰ and stage Ⅱ of sarcoidosis].

    PubMed

    Zeng, H; Huang, J A

    2016-06-14

    To evaluate the diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in stage Ⅰ and stage Ⅱ of sarcoidosis. There were 55 patients of sarcoidosis selected from January 2012 to October 2014 in the First Affiliated Hospital of Soochow University. The diagnostic positive rate and the positive rate in stage Ⅰ and Ⅱ patients with sarcoidosis through EBUS-TBNA, conventional transbronchial needle aspiration (cTBNA), endobronchial biopsy (EBB) combined with transbronchial lung biopsy (TBLB) were calculated. The positive rate of single lymph node puncture and the positive rate of different size of lymph node were compared. The difference of the positive rate of lymph nodes in different stations was checked. By calculating the diagnostic yield of EBUS-TBNA in sarcoidosis patients, the practicality and safety of EBUS-TBNA in diagnosing stage Ⅰ or stage Ⅱ sarcoidosis was assessed. Among 55 patients, 46 patients obtained positive results through EBUS-TBNA or cTBNA. There were 18 patients who had only received EBUS-TBNA among a total of 55 patients diagnosed with sarcoidosis, positive results appeared in 17 cases, while cTBNA was 9/15. There were 20 cases diagnosed in which both had EBUS-TBNA and cTBNA. The diagnostic rate of cTBNA combined with EBB and TBLB was 25/26, while combined with EBUS-TBNA was 21/21. Totally 90 lymph nodes were punctured by EBUS-TBNA, in which 65 lymph nodes got the positive results (65/90) while 49 lymph nodes got the positive results by TBNA in 93 punctured lymph nodes (49/93). The diagnostic positive rate in the lymph nodes with a short diameter ≥2 cm was 33/37 by EBUS-TBNA, while it was 12/19 in those whose short diameter 1-<2 cm. By cTBNA, the diagnostic positive rate was 15/26 and 11/28. No serious adverse events occurred. The diagnosis of sarcoidosis in stage Ⅰ and stage Ⅱ by EBUS-TBNA is safe and effective, while choosing the most noticeable swelling lymph node to puncture is

  15. Endobronchial ultrasonography-guided transbronchial needle aspiration biopsy for preoperative nodal staging of lung cancer in a veteran population.

    PubMed

    Cornwell, Lorraine D; Bakaeen, Faisal G; Lan, Charlie K W; Omer, Shuab; Preventza, Ourania; Pickrell, Brent; Nguyen, Alex; Casal, Roberto F

    2013-11-01

    Recently, preoperative lung cancer staging has evolved to include endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA) biopsies of the hilar and mediastinal lymph nodes, but the feasibility and usefulness of the procedure have not been well studied in the veteran population. To determine the safety and effectiveness of EBUS-TBNA as a key component of a preoperative staging algorithm for lung cancer in veterans. Review of a prospectively maintained thoracic surgery database that includes patients who underwent lung resection for lung cancer between January 1, 2009, and December 31, 2012, at a single Veterans Affairs medical center among a consecutive cohort of 166 patients with clinically early-stage (I or II) lung cancer who underwent lobectomy with nodal dissection. Endobronchial ultrasonography-guided transbronchial needle aspiration mediastinal staging (EBUS group) in 62 patients (37.3%) was compared with noninvasive nodal staging plus integrated positron emission tomography-computed tomography only (PET/CT-only group) in 104 patients (62.7%). The accuracy of nodal staging was assessed by comparison with the final pathological staging after complete nodal dissection (the gold standard). Primary outcomes were feasibility, safety, accuracy, and negative predictive value of EBUS-TBNA for preoperative nodal staging. A secondary outcome was the rate of nontherapeutic lung resection for occult N2 disease, with comparison between the EBUS group and the PET/CT-only group. No significant complications were attributable to the EBUS-TBNA procedure. In the EBUS group, 258 lymph node stations were sampled. N1 hilar metastases were diagnosed in 8 patients (12.9%) before surgery, and the remainder were staged N0. Accuracy and negative predictive value of EBUS-TBNA were 93.5% (58 of 62) and 92.6% (50 of 54), respectively. The overall rate of nontherapeutic lung resection performed in patients with occult N2 disease was 10.8% (18 of 166) (8.1% in the

  16. Irradiated foods

    MedlinePlus

    ... it reduces the risk for food poisoning . Food irradiation is used in many countries. It was first approved in the U.S. to prevent sprouts on white potatoes, and to control insects on wheat and in certain spices and seasonings.

  17. Endobronchial ultrasound with a guide sheath for small malignant pulmonary nodules: a retrospective comparison between central and peripheral locations

    PubMed Central

    Chavez, Christine; Izumo, Takehiro; Watanabe, Junko; Katsurada, Masahiro; Matsumoto, Yuji; Tsuchida, Takaaki

    2015-01-01

    Objective Radial endobronchial ultrasound with a guide sheath (EBUS-GS) has improved the diagnostic accuracy of transbronchial biopsy (TBB) for malignant peripheral pulmonary nodules (PPNs). Many underscore the importance of tumor localization but reproducible results on other aspects that affect yield are few. We aimed to analyze the diagnostic performance of TBB with EBUS-GS and to know what group of patients can benefit most. Methods The database of patients with malignant PPNs (≤30 mm) who underwent EBUS-GS TBB at the National Cancer Center Hospital, Tokyo, Japan from April 2012 to March 2013 was retrospectively reviewed and analysed based on lesion and procedural characteristics. Results Most PPNs (N=212) were adenocarcinoma, measuring 20 mm [mean, standard deviation (SD) 5.45]. Overall diagnostic accuracy was 67.5% (143 of 212 cases). Factors that significantly affected and predicted diagnostic success were EBUS probe within (P=0.001) and parenchymal location that was not adjacent to the costal visceral pleura (P=0.001). When combined, these variables achieved an 87% (59 of 68 lesions) diagnostic yield. CT scan characteristic, lesion size, lobe location, and GS size were non-contributory. Conclusions EBUS-GS TBB is an acceptable diagnostic method for small peripheral lung cancer. It can be maximized for PPNs that are away from the pleura and when the EBUS probe can be placed within the lesion. PMID:25973225

  18. Training for linear endobronchial ultrasound among US pulmonary/critical care fellowships: a survey of fellowship directors.

    PubMed

    Tanner, Nichole T; Pastis, Nicholas J; Silvestri, Gerard A

    2013-02-01

    Endobronchial ultrasound (EBUS) has revolutionized the ability of bronchoscopists to visualize and sample structures surrounding the tracheobronchial tree. It has been shown to be safe, minimally invasive, and highly accurate in the staging and diagnosing of mediastinal diseases. A prior survey of pulmonary fellowship program directors conducted in 2004 showed that only 2% of programs offered EBUS training. Surveys were mailed to 154 pulmonary/critical care fellowship directors in the United States and Puerto Rico. Demographics of the fellowship and details of EBUS training were recorded. A comparison of EBUS volume was made between programs with and without an identifiable interventional pulmonologist (IP). The survey response rate was 71%. EBUS equipment was available at 89% of programs. Of those without EBUS, 100% expressed the goal of obtaining equipment within the year. An identifiable IP was present in 70% of programs. This was associated with more EBUS procedures performed by trainees ( P , .01). Only 30% of programs have a formal protocol in place to evaluate EBUS competency. Conventional transbronchial needle aspiration is routinely taught in 89% of fellowship programs. EBUS exposure has rapidly disseminated into fellowship training programs, and programs with an identifiable IP are more likely to provide fellows with more EBUS procedures. The findings of this survey point out the need to develop a standardized protocol for EBUS competency that includes current recommendations and may require training with simulation.

  19. Endobronchial ultrasound-guided transbronchial needle aspiration is useful as an initial procedure for the diagnosis of lymphoma.

    PubMed

    Korrungruang, Potjanee; Oki, Masahide; Saka, Hideo; Kogure, Yoshihito; Tsuboi, Rie; Oka, Saori; Nakahata, Masashi; Hori, Kazumi; Murakami, Yasushi; Ise, Yuko; Ahmed, Shimaa Nour Moursi; Kitagawa, Chiyoe

    2016-01-01

    The usefulness of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for evaluating hilar, mediastinal and central parenchymal lesions has been well established. However, its utility for diagnosing lymphoma is controversial. The aim of this study was to evaluate the diagnostic utility of EBUS-TBNA for the definitive diagnosis of de novo lymphoma with subtype classification. Patients with lymphoma who underwent EBUS-TBNA for diagnostic purposes at a single institution between March 2004 and May 2013 were retrospectively reviewed. Of the 971 patients who underwent EBUS-TBNA during the study period, 19 patients, who did not have a previous history of lymphoma, had a final diagnosis of lymphoma. EBUS-TBNA provided a diagnosis accompanied with subtype classification in 6 patients (32%), a suspicious but not definitive classification in 10 patients (53%), and a negative classification in 3 patients (16%). Immunohistochemical staining for definitive diagnosis was performed in 15 of 16 patients (94%), with suspicious results from routine hematoxylin and eosin staining. No procedure-related complications occurred. EBUS-TBNA is a useful initial diagnostic procedure, aiding decisions for the management of patients with suspected lymphoma, even though the sensitivity of EBUS-TBNA for diagnosing lymphoma with subtype classification was lower than previously reported. Copyright © 2015 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

  20. Endobronchial Valves for Endoscopic Lung Volume Reduction: Best Practice Recommendations from Expert Panel on Endoscopic Lung Volume Reduction

    PubMed Central

    Slebos, Dirk-Jan; Shah, Pallav L.; Herth, Felix J.F.; Valipour, Arschang

    2017-01-01

    Endoscopic lung volume reduction (ELVR) is being adopted as a treatment option for carefully selected patients suffering from severe emphysema. ELVR with the one-way endobronchial Zephyr valves (EBV) has been demonstrated to improve pulmonary function, exercise capacity, and quality of life in patients with both heterogeneous and homogenous emphysema without collateral ventilation. In this “expert best practices” review, we will highlight the practical aspects of this therapy. Key selection criteria for ELVR are hyperinflation with a residual volume >175% of predicted, forced expiratory volume <50% of predicted, and a 6-min walking distance >100 m. Patients with repeated infectious complications, severe bronchiectasis, and those with unstable cardiovascular comorbidities should be excluded from EBV treatment. The procedure may be performed with either conscious sedation or general anesthesia and positive pressure mechanical ventilation using a flexible endotracheal tube or a rigid bronchoscope. Chartis and EBV placement should be performed in 1 procedure when possible. The sequence of valve placement should be orchestrated to avoid obstruction and delivery of subsequent valves. If atelectasis has not occurred by 1 month after procedure, evaluate valve position on CT and consider replacing the valves that are not optimally positioned. Pneumothorax is a common complication and typically occurs in the first 2 days following treatment. A management algorithm for pneumothorax has been previously published. Long-term sequelae from EBV therapy do occur but are easily manageable. PMID:27992862

  1. The complimentary role of transbronchial lung cryobiopsy and endobronchial ultrasound fine needle aspiration in the diagnosis of sarcoidosis.

    PubMed

    Aragaki-Nakahodo, Alejandro Adolfo; Baughman, Robert P; Shipley, Ralph T; Benzaquen, Sadia

    2017-10-01

    Transbronchial lung cryobiopsy (TBLC) is a novel technique that has proved to be useful in diagnosing various interstitial lung diseases (ILD). The use of TBLC to diagnose sarcoidosis in an unselected patient population is unknown, and could be complimentary to endobronchial ultrasound fine needle aspiration (EBUS-FNA). A retrospective analysis of 36 patients in a single, tertiary-care, academic medical center was conducted to describe the yield of both EBUS-FNA and TBLC in the diagnosis of suspected sarcoidosis over a three year period. A grading system to evaluate the presence and extent of specific radiographic features on computed tomography chest imaging studies was compared to the results of EBUS-FNA and TBLC. Complications associated with the procedures were also noted. The overall diagnostic yield in our cohort (all pathologic diagnosis considered) was 80.6% (29 out of 36 patients had a definite pathologic diagnosis). Eighteen patients referred for possible sarcoidosis had a positive bronchoscopic specimen confirming the diagnosis of sarcoidosis. For those patients with a pathologic diagnosis of sarcoidosis, the diagnostic yield for EBUS-FNA and TBLC was 66.7% each (12 out of 18 patients), while the combined diagnostic yield for EBUS-FNA and TBLC increased to 100%. For all cases, the pneumothorax rate was 11.1%. TBLC appears to be a safe and complimentary technique to diagnose sarcoidosis and could be considered part of the diagnostic armamentarium in bronchoscopic centers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. [New possibilities in radiotherapy of endobronchial tumors using the afterloading method in combination with laser technics].

    PubMed

    Schumacher, W; Koch, K; Frost, D; Michel, L; Plümecke, M; Lübbert, K; Mai, J; Krumhaar, D; Macha, H N; Stadler, M

    1985-11-01

    New possibilities for radiotherapy of bronchial carcinomas are provided by the combined application of the recently introduced afterloading method used hitherto in the treatment of stenosing processes of bronchial carcinomas and the neodyme-YAG laser which opens the stenosis in such a manner that the afterloading probe can be inserted. This new method allows to perform without complications or disadvantages further combined therapies such as percutaneous irradiation (telecobalt, linear accelerator or betatron). An irradiation scheme leading to a decisive tumor regression can be established due to the fast reventilation of the lung obtained by both methods. Surprisingly, three patients could be submitted despite the small-field radiotherapy to rather important lung operations such as lobectomy and pneumonectomy which were performed without complications or disadvantages. The patients were not operable without laser and afterloading therapy. This method was applied several times in the treatment of other diseases such as oesophageal cancer and stenosing cancer of the antrum. In these cases, a normal ingestion due to tumor regression was obtained rapidly.

  3. Results of combined photodynamic therapy (PDT) and high dose rate brachytherapy (HDR) in treatment of obstructive endobronchial non-small cell lung cancer

    NASA Astrophysics Data System (ADS)

    Weinberg, Benjamin D.; Allison, Ron R.; Sibata, Claudio; Parent, Teresa; Downie, Gordon

    2009-06-01

    We reviewed the outcome of combined photodynamic therapy (PDT) and high dose rate brachytherapy (HDR) for patients with symptomatic obstruction from endobronchial non-small cell lung cancer. Methods: Nine patients who received combined PDT and HDR for endobronchial cancers were identified and their charts reviewed. The patients were eight males and one female aged 52-73 at diagnosis, initially presenting with various stages of disease: stage IA (N=1), stage IIA (N=1), stage III (N=6), and stage IV (N=1). Intervention was with HDR (500 cGy to 5 mm once weekly for 3 weeks) and PDT (2 mg/kg Photofrin, followed by 200 J/cm2 illumination 48 hours post infusion). Treatment group 1 (TG-1, N=7) received HDR first; Treatment group 2 (TG-2, N=2) received PDT first. Patients were followed by regular bronchoscopies. Results: Treatments were well tolerated, all patients completed therapy, and none were lost to follow-up. In TG-1, local tumor control was achieved in six of seven patients for: 3 months (until death), 15 months, 2+ years (until death), 2+ years (ongoing), and 5+ years (ongoing, N=2). In TG-2, local control was achieved in only one patient, for 84 days. Morbidities included: stenosis and/or other reversible benign local tissue reactions (N=8); photosensitivity reaction (N=2), and self-limited pleural effusion (N=2). Conclusions: Combined HDR/PDT treatment for endobronchial tumors is well tolerated and can achieve prolonged local control with acceptable morbidity when PDT follows HDR and when the spacing between treatments is one month or less. This treatment regimen should be studied in a larger patient population.

  4. The early detection of lung cancer during follow-up of patients undergoing endobronchial one-way valve treatment for emphysema.

    PubMed

    Fiorelli, Alfonso; Costanzo, Saveria; di Costanzo, Emilio; Santini, Mario

    2015-03-01

    We describe the early detection of lung cancer during the follow-up of two emphysematous patients undergoing endobronchial treatment with one-way valves for severe dyspnea. In both cases, the lung function improvement achieved after the valves placement allowed their surgical treatment. In additional to standard follow-up for evaluating the progression of emphysema, such patients should be enrolled in a screening program. It may allow the early detection of lung cancer with the possibility for surgery in accordance with respiratory function of patient.

  5. Application of Endobronchial Ultrasonography for the Preoperative Detecting Recurrent Laryngeal Nerve Lymph Node Metastasis of Esophageal Cancer

    PubMed Central

    Shan, Hong-Bo; Zhang, Rong; Li, Yin; Gao, Xiao-Yan; Lin, Shi-Yong; Luo, Guang-Yu; Li, Jian-Jun; Xu, Guo-Liang

    2015-01-01

    Background The preoperative detection of recurrent laryngeal nerve lymph node (RLN LN) metastasis provides important information for the treatment of esophageal cancer. We investigated the possibility of applying endobronchial ultrasonography (EBUS) with conventional preoperative endoscopic ultrasonography (EUS) and computerized tomography (CT) examination to evaluate RLN LN metastasis in patients with esophageal cancer. Methods A total of 115 patients with advanced thoracic esophageal cancer underwent EBUS examinations. Patients also underwent EUS and CT imaging as reference diagnostic methods. Positron emission tomography /computed tomography (PET/CT) was also introduced in partial patients as reference method. The preoperative evaluation of RLN LN metastasis was compared with the surgical and pathological staging in 94 patients who underwent radical surgery. Results The sensitivities of the preoperative evaluations of RLN LN metastasis by EBUS, EUS and CT were 67.6%, 32.4% and 29.4%, respectively. The sensitivity of EBUS was significantly different from that of EUS or CT, especially in the detection of right RLN LNs. In addition, according to the extra data from reference method, PET/CT was not superior to EBUS or EUS in detecting RLN LN metastasis. Among all 115 patients, 21 patients who were diagnosed with tracheal invasions by EUS or EBUS avoided radical surgery. Another 94 patients who were diagnosed as negative for tracheobronchial tree invasion by EUS and EBUS had no positive findings in radical surgery. Conclusions EBUS can enhance the preoperative sensitivity of the detection of RLN LN metastasis in cases of thoracic esophageal cancer and is a useful complementary examination to conventional preoperative EUS and CT, which can alert thoracic surgeons to the possibility of a greater range of preoperative lymph node dissection. EBUS may also indicate tracheal invasion in cases of esophageal stricture. PMID:26372339

  6. Oral vaccination of badgers (Meles meles) with BCG and protective immunity against endobronchial challenge with Mycobacterium bovis.

    PubMed

    Corner, Leigh A L; Costello, Eamon; O'Meara, Damien; Lesellier, Sandrine; Aldwell, Frank E; Singh, Mahavir; Hewinson, R Glyn; Chambers, Mark A; Gormley, Eamonn

    2010-08-31

    Eurasian badgers (Meles meles) are a reservoir host of Mycobacterium bovis and are implicated in the transmission of tuberculosis to cattle in Ireland and Great Britain. The development of a vaccine for use in badgers is considered a key element of any long-term sustainable campaign to eradicate the disease from livestock in both countries. The aim of this study was to investigate the protective response of badgers vaccinated orally with Bacille Calmette-Guérin (BCG) encapsulated in a lipid formulation, followed by experimental challenge with M. bovis. A group of badgers was vaccinated by inoculating the BCG-lipid mixture containing approximately 10(8)colony forming units (cfu) of BCG into the oesophagus. The control group was sham inoculated with the lipid formulation only. Thirteen weeks after vaccination all the badgers were challenged with approximately 10(4)cfu of M. bovis delivered by endobronchial inoculation. Blood samples were taken throughout the study and the cell mediated immune (CMI) responses in peripheral blood were monitored by the IFN-gamma ELISA and ELISPOT assay. At 17 weeks after infection all the badgers were examined post-mortem to assess the pathological and bacteriological responses to challenge. All badgers in both groups were found to be infected. However, a significant protective effect of BCG vaccination was measured as a decrease in the number and severity of gross lesions, lower bacterial load in the lungs, and fewer sites of infection. The analysis of immune responses showed that vaccination with BCG did not generate any detectable CMI immunological responses, however the levels of the responses increased in both groups following M. bovis infection. The results of the study showed that vaccination with oral BCG in the lipid formulation generated a protective effect in the badgers.

  7. Endobronchial ultrasound-guided transbronchial needle aspiration rinse fluid polymerase chain reaction in the diagnosis of intrathoracic tuberculous lymphadenitis.

    PubMed

    Boonsarngsuk, Viboon; Saengsri, Siriwan; Santanirand, Pitak

    2017-03-01

    Intrathoracic tuberculous (TB) lymphadenitis is a diagnostic challenge to the clinician. Although endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can obtain a sample from the affected lymph node, the diagnosis of TB lymphadenitis by cytopathology remains inaccurate. To evaluate the efficacy of EBUS-TBNA rinse fluid TB polymerase chain reaction (PCR) assay for the diagnosis of intrathoracic TB lymphadenitis. A retrospective study was conducted on 102 patients who underwent EBUS-TBNA for diagnostic evaluation of intrathoracic lymphadenopathy. EBUS-TBNA specimens were evaluated by cytopathological examination. Rinse fluid of the needle was routinely submitted for acid-fast bacillus (AFB) staining, mycobacterial culture, and TB-PCR using the Anyplex(TM) MTB/NTM real-time detection kit. Of 102 patients, 16 were diagnosed with intrathoracic TB lymphadenitis by either microbiology, cytopathology, or on clinical grounds. The sensitivity, specificity, positive predictive value, and negative predictive value of rinse fluid TB PCR assay were 56.2%, 100.0%, 100.0%, and 92.5%, respectively. Using the area under the ROC curve (AUC) as a measure of a diagnostic performance, TB-PCR had the highest AUC, compared with mycobacterial culture, AFB smear, and finding of necrotizing granulomatous inflammation (0.78, 0.75, 0.56, and 0.72, respectively). A combination of TB PCR, mycobacterial culture, and finding of necrotizing granulomatous inflammation provided the best diagnostic performance (sensitivity, specificity, positive predictive value, negative predictive value, and AUC of 75.0%, 100.0%, 100.0%, 95.6%, and 0.88, respectively). EBUS-TBNA rinse fluid TB-PCR is useful in the diagnosis of intrathoracic TB lymphadenitis. Combining TB-PCR with mycobacterial culture and cytopathological findings improved the diagnosis performance.

  8. Stylet Use Does Not Improve Diagnostic Outcomes in Endobronchial Ultrasonographic Transbronchial Needle Aspiration: A Randomized Clinical Trial.

    PubMed

    Scholten, Eric L; Semaan, Roy; Illei, Peter; Mallow, Christopher; Arias, Sixto; Feller-Kopman, David; Oakjones-Burgess, Karen; Frimpong, Bernice; Ortiz, Ricardo; Lee, Hans; Yarmus, Lonny

    2017-03-01

    Endobronchial ultrasonographically guided transbronchial needle aspiration (EBUS-TBNA) of thoracic structures is a commonly performed tissue sampling technique. The use of an inner-stylet in the EBUS needle has never been rigorously evaluated and may be unnecessary. In a prospective randomized single-blind controlled clinical trial, patients with a clinical indication for EBUS-TBNA underwent lymph node sampling using both with-stylet and without-stylet techniques. Sample adequacy, diagnostic yield, and various cytologic quality measures were compared. One hundred twenty-one patients were enrolled, with 194 lymph nodes sampled, each using both with-stylet and without-stylet techniques. There was no significant difference in sample adequacy or diagnostic yield between techniques. The without-stylet technique resulted in adequate samples in 87% of the 194 study lymph nodes, which was no different from the with-stylet adequacy rate (82%; P = .371). The with-stylet technique resulted in a diagnosis in 50 of 194 samples (25.7%), which was similar to the without-stylet group (49 of 194 [25.2%]; P = .740). There was a high degree of concordance in the determination of adequacy (84.0%; 95% CI, 78.1-88.9) and diagnostic sample generation (95.4%; 95% CI, 91.2-97.9) between the two techniques. A similar qualitative number of lymphocytes, malignant cells, and bronchial respiratory epithelia were recovered using each technique. Omitting stylet use during EBUS-TBNA does not affect diagnostic outcomes and reduces procedural complexity. ClinicalTrials.Gov: No. NCT 02201654; URL:www.clinicaltrials.gov. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  9. Usefulness of lymphoid granulomatous inflammation culture obtained by endobronchial ultrasound-guided transbronchial needle aspiration in a fungal endemic area

    PubMed Central

    Berger, John; Zamora, Felix; Podgaetz, Eitan; Andrade, Rafael; Dincer, H. Erhan

    2016-01-01

    Background and Objectives: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the procedure of choice for the evaluation of mediastinal/hilar lymph node enlargements. Granulomatous inflammation of the mediastinal/hilar lymph nodes is often identified on routine histology. In addition, mediastinal lymphadenopathy may be present with undiagnosed infection. We sought to determine the usefulness of routine cultures and histology for infectious etiologies in a fungal endemic area when granulomatous inflammation is identified. Materials and Methods: We identified 56 of 210 patients with granulomatous inflammation on EBUS-TBNA biopsies from October 2012 through October 2014. An onsite cytologist evaluated all biopsies and an additional TBNA pass for microbiologic stains and cultures were obtained in those with granulomatous inflammation. Results: Of the 56 patients with granulomatous inflammation, 20 patients had caseating (necrotizing) granulomas while noncaseating (nonnecrotizing) granulomas were detected in 36 of the remainder patients. In patients with caseating granulomas, fungal elements were identified in 6 of 20 (30%) patients (histoplasma; N = 5, blastomyces; N = 1) on Grocott methenamine silver (GMS) stain. Lymph node cultures identified 3 of 20 (20%) patients as being positive for Mycobacterium tuberculosis (N = 1), Histoplasma capsulatum (N = 1), and Blastomyces dermatitidis (N = 1). Among patients with noncaseating granulomas, only 2 out of 36 (5%) were positive for fungal elements on GMS stain, identified as Histoplasma, although the lymph node cultures remained negative. Conclusion: The incidence of granulomatous inflammation of mediastinal lymph nodes was 26.6% in our series. Of these patients, noncaseating granulomas were more common (64% vs. 36%). Infectious organisms, fungal or acid-fast bacilli (AFB), on either staining or lymph node culture were rarely identified in noncaseating granulomas, 5% and none, respectively

  10. Pulmonologist-performed transoesophageal sampling for lung cancer staging using an endobronchial ultrasound video-bronchoscope: an Australian experience.

    PubMed

    Wimaleswaran, Hari; Farmer, Michael W; Irving, Louis B; Jennings, Barton R; Steinfort, Daniel P

    2017-02-01

    Transoesophageal endobronchial ultrasound (EBUS) video-bronchoscope insertion provides pulmonologists access to conduct endoscopic fine-needle aspiration (EUS-B-FNA) of mediastinal lymph node (LN) lesions and also assist in lung cancer staging by sampling left adrenal gland (LAG) lesions. Limited literature has described additional diagnostic value whilst maintaining patient safety. To elicit whether combining endoscopic transoesophageal fine-needle aspiration using convex probe bronchoscope (EUS-B-FNA) and EBUS bronchoscopy enhances the diagnostic yield of mediastinal nodal staging in lung cancer, whilst maintaining safety. All eligible patients with paraoesophageal lesions on thoracic computed tomography (CT) underwent pulmonologist-performed EUS-B-FNA at two tertiary centres and were included in this prospective observational cohort study. EUS-B-FNA sampling was performed at 69 mediastinal LN lesion sites, including 17 sites inaccessible to bronchoscopic sampling. Four LAG lesions were sampled via EUS-B-FNA. There were no complications. EBUS-TBNA was augmented by EUS-B-FNA because of accessibility of sampling lesions otherwise unamenable bronchoscopically, thereby increasing diagnostic utility. Diagnostic sensitivity of EUS-B-FNA for malignancy in mediastinal LN lesions was 88% (51 of 58). For mediastinal LN lesions not amenable to EBUS-TBNA, the sensitivity for diagnosis of malignancy via EUS-B-FNA was 88% (15 of 17). Diagnostic sensitivity of EUS-B-FNA for malignancy in LAG lesions was 50% (2 of 4). EUS-B-FNA is a precise and safe approach in the evaluation and staging of lung cancer when performed by a pulmonologist. It complements and increases the diagnostic utility of EBUS-TBNA by further coverage of mediastinal LN stations and access to LAG lesions. © 2016 Royal Australasian College of Physicians.

  11. Meta-analysis of 21- versus 22-G aspiration needle during endobronchial ultrasound-guided transbronchial needle aspiration.

    PubMed

    Giri, Smith; Pathak, Ranjan; Yarlagadda, Vivek; Karmacharya, Paras; Aryal, Madan R; Martin, Mike G

    2015-04-01

    Two different needle gauges (21 and 22 G) are currently used for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Few studies have compared the diagnostic utility of EBUS-TB107NA using 21 versus 22 G needles. We aimed to systematically analyze all existing literature comparing the diagnostic benefit of these 2 needles. A systematic search for the identification of all relevant studies comparing 21 and 22 G needles in EBUS-TBNA was performed using the MEDLINE, EMBASE, SCOPUS databases up to September 21, 2014. All the extracted data underwent meta-analysis using Review Manager 5.3 and Comprehensive Meta-analysis 3.3. Study-specific odds ratios (OR) were calculated and combined using random-effects model. Between study heterogeneity was assessed using the I statistic. A total of 5 studies involving 1720 patients were identified. The sample adequacy rate was 89.1% in the 21 G group and 90.0% in the 22 G group and this difference was not statistically significant [OR, 0.94; 95% confidence interval (CI), 0.56-1.59; P=0.82]. Similarly, there was no significant difference in the diagnostic yield (73.7% vs. 58.5%; OR, 1.04; 95% CI, 0.80-1.35; P=0.80) or the mean number of needle passes (mean difference -0.31; 95% CI, -1.1 to 0.47; P=0.44). There were no major complications reported in any of these studies. There were no differences in the diagnostic yield, sample adequacy, or the mean number of needle passes between the 21 and 22 G groups during EBUS-TBNA. Similarly, the complication rates were low and similar between the 2 groups.

  12. Yield of new versus reused endobronchial ultrasound-guided transbronchial needle aspiration needles: A retrospective analysis of 500 patients

    PubMed Central

    Dhooria, Sahajal; Sehgal, Inderpaul Singh; Gupta, Nalini; Ram, Babu; Aggarwal, Ashutosh Nath; Behera, Digambar; Agarwal, Ritesh

    2016-01-01

    Background: Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) requires a dedicated needle for aspiration of mediastinal lesions. There is no data on reuse of these needles. Methods: This is a retrospective study of patients who underwent EBUS-TBNA with either new or reused EBUS-TBNA needles. The needles were reused after thorough cleaning with filtered water and organic cleaning solution, disinfection with 2.4% glutaraldehyde solution followed by ethylene oxide sterilization. The yield of EBUS-TBNA was compared between the two groups. Results: A total of 500 EBUS-TBNA procedures (351 new, 149 reused needles) were performed. The baseline characteristics were different in the two groups with suspected granulomatous disorders (sarcoidosis or tuberculosis) being significantly more common in the new compared to the reused needle group. Similarly, the median, interquartile range number of lymph node stations sampled, and the total number of passes were significantly higher in the new versus the reused needle group. The diagnostic yield was significantly higher with new needle as compared to reused needle (65.2% vs. 53.7%, P = 0.02). On multivariate logistic regression analysis, clinical suspicion of granulomatous disorders (odds ratio 1.86 [95% confidence interval, 1.20-2.87], P = 0.005) was the only predictor of diagnostic yield, after adjusting for the type of needle (new or reused), total number of passes and the number of lymph node stations sampled. No case of mediastinitis was encountered in either group. Conclusions: The yield of EBUS-TBNA might be similar with single reuse of needles as compared to new needles. However, reuse of needle should be performed only when absolutely necessary. PMID:27578927

  13. Performance of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for the Diagnosis of Isolated Mediastinal and Hilar Lymphadenopathy.

    PubMed

    Tyan, Chung-Chun; Machuca, Tiago; Czarnecka, Kasia; Ko, Hyang Mi; da Cunha Santos, Gilda; Boerner, Scott L; Pierre, Andrew; Cypel, Marcelo; Waddell, Tom; Darling, Gail; de Perrot, Marc; Keshavjee, Shaf; Geddie, William; Yasufuku, Kazuhiro

    2017-01-01

    Although many studies have assessed the diagnostic utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the context of a specific disease, few studies have assessed the overall diagnostic yield, sensitivity, and negative predictive value in patients with isolated mediastinal and hilar lymphadenopathy (IMHL). We evaluated the performance of EBUS-TBNA for diagnosing IMHL in a population with a high prevalence of concurrent or preexisting non-pulmonary malignancy. A retrospective chart review of patients who underwent EBUS-TBNA from October 2008 to April 2014 was performed to identify patients with IMHL. Patients with known or suspected primary pulmonary malignancy were excluded. When available, EBUS-TBNA results were cross-referenced with further diagnostic investigation or clinical diagnosis based on follow-up. EBUS-TBNA was used to sample 765 lymph nodes from 350 patients. One hundred and fourteen (33.3%) patients had a concurrent or preexisting non-pulmonary malignancy. The overall yield of EBUS-TBNA for specific diagnosis was 300/350 (86%). The diagnostic yield for sarcoidosis, lymphoproliferative disease, metastatic lymphadenopathy from extrathoracic malignancy, and necrotizing granuloma was 123/149 (83%), 27/33 (82%), 20/25 (80%), and 13/19 (68%), respectively. Amongst 50 patients with non-diagnostic EBUS-TBNA, 25 yielded an insufficient sample and another 25 yielded only benign lymphoid material which was not representative of the underlying pathology. Overall, EBUS-TBNA had a sensitivity of 89%, a diagnostic yield of 86%, and a negative predictive value of 79%. For patients with isolated hilar or mediastinal lymphadenopathy and a high background prevalence of concurrent and preexisting non-pulmonary malignancy, EBUS-TBNA is a reliable first-line diagnostic investigation. © 2017 S. Karger AG, Basel.

  14. The IBV Valve trial: a multicenter, randomized, double-blind trial of endobronchial therapy for severe emphysema.

    PubMed

    Wood, Douglas E; Nader, Daniel A; Springmeyer, Steven C; Elstad, Mark R; Coxson, Harvey O; Chan, Andrew; Rai, Navdeep S; Mularski, Richard A; Cooper, Christopher B; Wise, Robert A; Jones, Paul W; Mehta, Atul C; Gonzalez, Xavier; Sterman, Daniel H

    2014-10-01

    Lung volume reduction surgery improves quality of life, exercise capacity, and survival in selected patients but is accompanied by significant morbidity. Bronchoscopic approaches may provide similar benefits with less morbidity. In a randomized, sham procedure controlled, double-blind trial, 277 subjects were enrolled at 36 centers. Patients had emphysema, airflow obstruction, hyperinflation, and severe dyspnea. The primary effectiveness measure was a significant improvement in disease-related quality of life (St. George's Respiratory Questionnaire) and changes in lobar lung volumes. The primary safety measure was a comparison of serious adverse events. There were 6/121 (5.0%) responders in the treatment group at 6 months, significantly >1/134 (0.7%) in the control group [Bayesian credible intervals (BCI), 0.05%, 9.21%]. Lobar volume changes were significantly different with an average decrease in the treated lobes of -224 mL compared with -17 mL for the control group (BCI, -272, -143). The proportion of responders in St. George's Respiratory Questionnaire was not greater in the treatment group. There were significantly more subjects with a serious adverse event in the treatment group (n=20 or 14.1%) compared with the control group (n=5 or 3.7%) (BCI, 4.0, 17.1), but most were neither procedure nor device related. This trial had technical and statistical success but partial-bilateral endobronchial valve occlusion did not obtain clinically meaningful results. Safety results were acceptable and compare favorably to lung volume reduction surgery and other bronchial valve studies. Further studies need to focus on improved patient selection and a different treatment algorithm. ClinicalTrials.gov NCT00475007.

  15. A novel combination of the Arndt endobronchial blocker and the laryngeal mask airway ProSeal™ provides one-lung ventilation for thoracic surgery.

    PubMed

    Li, Qiong; Li, Peiying; Xu, Jianghui; Gu, Huahua; Ma, Qinyun; Pang, Liewen; Liang, Weimin

    2014-11-01

    In this study, the feasibility and performance of the combination of the Arndt endobronchial blocker and the laryngeal mask airway (LMA) ProSeal™ in airway establishment, ventilation, oxygenation and lung isolation was evaluated. Fifty-five patients undergoing general anesthesia for elective thoracic surgeries were randomly allocated to group Arndt (n=26) or group double-lumen tube (DLT; n=29). Data concerning post-operative airway morbidity, ease of insertion, hemodynamics, lung collapse, ventilators, oxygenation and ventilation were collected for analysis. Compared with group DLT, group Arndt showed a significantly attenuated hemodynamic response to intubation (blood pressure, 149±31 vs. 115±16 mmHg; heart rate, 86±15 vs. 68±15 bpm), less severe injuries to the bronchus (injury score, 1.4±0.2 vs. 0.4±0.1) and vocal cords (injury score, 1.3±0.2 vs. 0.6±0.1), and lower incidences of post-operative sore throat and hoarseness. Furthermore, the novel combination of the Arndt and the LMA ProSeal showed similar ease of airway establishment, comparable ventilation and oxygenation performance, and an analogous lung isolation effect to DLT. The novel combined use of the Arndt endobronchial blocker and the LMA ProSeal can serve as a promising alternative for thoracic procedures requiring one-lung ventilation. The less traumatic properties and equally ideal lung isolation are likely to promote its use in rapidly spreading minimally invasive thoracic surgeries.

  16. Phytosanitary Irradiation

    PubMed Central

    Hallman, Guy J.; Blackburn, Carl M.

    2016-01-01

    Phytosanitary treatments disinfest traded commodities of potential quarantine pests. Phytosanitary irradiation (PI) treatments use ionizing radiation to accomplish this, and, since their international commercial debut in 2004, the use of this technology has increased by ~10% annually. Generic PI treatments (one dose is used for a group of pests and/or commodities, although not all have been tested for efficacy) are used in virtually all commercial PI treatments, and new generic PI doses are proposed, such as 300 Gy, for all insects except pupae and adult Lepidoptera (moths). Fresh fruits and vegetables tolerate PI better than any other broadly used treatment. Advances that would help facilitate the use of PI include streamlining the approval process, making the technology more accessible to potential users, lowering doses and broadening their coverage, and solving potential issues related to factors that might affect efficacy. PMID:28231103

  17. Use of Irradiated Foods

    NASA Technical Reports Server (NTRS)

    Brynjolfsson, A.

    1985-01-01

    The safety of irradiated foods is reviewed. Guidelines and regulations for processing irradiated foods are considered. The radiolytic products formed in food when it is irradiated and its wholesomeness is discussed. It is concluded that food irradiation processing is not a panacea for all problems in food processing but when properly used will serve the space station well.

  18. Use of Irradiated Foods

    NASA Technical Reports Server (NTRS)

    Brynjolfsson, A.

    1985-01-01

    The safety of irradiated foods is reviewed. Guidelines and regulations for processing irradiated foods are considered. The radiolytic products formed in food when it is irradiated and its wholesomeness is discussed. It is concluded that food irradiation processing is not a panacea for all problems in food processing but when properly used will serve the space station well.

  19. Lung cancer diagnosis and staging with endobronchial ultrasound-guided transbronchial needle aspiration compared with conventional approaches: an open-label, pragmatic, randomised controlled trial

    PubMed Central

    Navani, Neal; Nankivell, Matthew; Lawrence, David R; Lock, Sara; Makker, Himender; Baldwin, David R; Stephens, Richard J; Parmar, Mahesh K; Spiro, Stephen G; Morris, Stephen; Janes, Sam M

    2015-01-01

    Summary Background The diagnosis and staging of lung cancer is an important process that identifies treatment options and guides disease prognosis. We aimed to assess endobronchial ultrasound-guided transbronchial needle aspiration as an initial investigation technique for patients with suspected lung cancer. Methods In this open-label, multicentre, pragmatic, randomised controlled trial, we recruited patients who had undergone a CT scan and had suspected stage I to IIIA lung cancer, from six UK centres and randomly assigned them to either endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) or conventional diagnosis and staging (CDS), for further investigation and staging. If a target node could not be accessed by EBUS-TBNA, then endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) was allowed as an alternative procedure. Randomisation was stratified according to the presence of mediastinal lymph nodes measuring 1 cm or more in the short axis and by recruiting centre. We used a telephone randomisation method with permuted blocks of four generated by a computer. Because of the nature of the intervention, masking of participants and consenting investigators was not possible. The primary endpoint was the time-to-treatment decision after completion of the diagnostic and staging investigations and analysis was by intention-to-diagnose. This trial is registered with ClinicalTrials.gov, number NCT00652769. Findings Between June 10, 2008, and July 4, 2011, we randomly allocated 133 patients to treatment: 66 to EBUS-TBNA and 67 to CDS (one later withdrew consent). Two patients from the EBUS-TBNA group underwent EUS-FNA. The median time to treatment decision was shorter with EBUS-TBNA (14 days; 95% CI 14–15) than with CDS (29 days; 23–35) resulting in a hazard ratio of 1·98, (1·39–2·82, p<0·0001). One patient in each group had a pneumothorax from a CT-guided biopsy sample; the patient from the CDS group needed intercostal drainage

  20. Detection of irradiated liquor

    NASA Astrophysics Data System (ADS)

    Shengchu, Qi; Jilan, Wu; Rongyao, Yuan

    D-2,3-butanediol is formed by irradiation processes in irradiated liquors. This radiolytic product is not formed in unirradiated liquors and its presence can therefore be used to identify whether a liquor has been irradiated or not. The relation meso/dl≈1 for 2,3-butanediol and the amount present in irradiated liquors may therefore be used as an indication of the dose used in the irradiation.

  1. The diagnostic challenge of a tracheal tear with a double-lumen endobronchial tube: massive air leak developing from the mouth during mechanical ventilation.

    PubMed

    Venkataramanappa, Vani; Boujoukos, Arthur J; Sakai, Tetsuro

    2011-02-01

    The case of a 78 year-old woman who underwent a right lower lobectomy using a 35-French, left-sided, double-lumen endobronchial tube (DLET) is presented. Multiple adjustments were needed for the DLET's proper placement. At the end of surgery, sudden loss of tidal volume with a large air leak from the patient's mouth was noted. Fiberoptic bronchoscopic examination through the DLET was negative. Rupture of the tracheal cuff was suspected, and the DLET was replaced with a single-lumen tube. In the intensive care unit, the massive air leak from the mouth recurred during mechanical ventilation. Nasal fiberoptic bronchoscopic examination showed a longitudinal laceration of the membranous portion of the trachea extending from the subglottic area to the orifice of the right bronchus. Surgical repair of the tear was performed. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Vaccination of European badgers (Meles meles) with BCG by the subcutaneous and mucosal routes induces protective immunity against endobronchial challenge with Mycobacterium bovis.

    PubMed

    Corner, Leigh A L; Costello, Eamon; Lesellier, Sandrine; O'Meara, Damien; Gormley, Eamonn

    2008-11-01

    Mycobacterium bovis is endemic in badger (Meles meles) populations of Ireland and the United Kingdom and infected badgers are a potential source of infection for cattle. In domestic livestock tuberculosis causes economic losses from lost production and the costs associated with eradication programmes, and in addition there is a risk of zoonotic infection. Whereas culling is currently used to control tuberculous badger populations in Ireland, vaccination, if it were available, would be preferred. A study was undertaken to examine the protective responses of badgers vaccinated either by the subcutaneous or mucosal (intranasal and conjunctival) routes with bacille Calmette-Guérin (BCG), when challenged with M. bovis by the endobronchial route. Three groups of badgers were used. The first group (n=4) was vaccinated with approximately 5 x 10(5) colony forming units (cfu) of BCG by subcutaneous injection. In the second group (n=5) badgers were vaccinated via the mucosal route by instilling 1.0 x 10(5)cfu into each conjunctival sac and spraying 1.0 x 10(5)cfu into each nostril (final vaccine dose of 4 x 10(5)cfu). The control (n=5) badgers served as a non-vaccinated group. Twelve weeks post-vaccination all badgers in the three groups were challenged with approximately 10(4)cfu of M. bovis by endobronchial inoculation. At 12 weeks post-infection all badgers were examined post-mortem to assess the pathological and bacteriological responses to challenge. Gross and histological lesions of tuberculosis were seen in all challenged badgers and M. bovis was recovered from all challenged badgers. However, across six of the eight parameters used to measure disease severity, the infection in the vaccinated badgers was significantly less severe than in the control group. The BCG vaccine induced a significant protective effect in the badgers and the protective immunity was generated by subcutaneous and mucosal vaccination.

  3. Commercial food irradiation

    SciTech Connect

    Black, E.F.; Libby, L.M.

    1983-06-01

    Food irradiation is discussed. Irradiation exposes food to gamma rays from a cobalt-60 or a cesium-137 source, or to high-energy electrons emitted by an electron accelerator. A major advantage is that food can be packaged either before or after treatment. FDA regulations with regard to irradiation are discussed. Comments on an 'Advance Notice' on irradiation, published by the FDA in 1981 are summarized.

  4. A case report of local treatment of inoperable squamous cell lung carcinoma with convex-probe endobronchial ultrasound-guided intratumoral injection of cisplatin in a patient with severe COPD.

    PubMed

    Li, Xiaochen; Liu, Xiansheng; Rao, Xiaoling; Zhao, Jianping; Xu, Yongjian; Xie, Min

    2017-06-01

    Endobronchial ultrasound as a powerful diagnostic technology can also be used to perform intratumoral chemotherapy for extraluminal tumor. A 69-year-old man with chronic obstructive pulmonary disease (COPD) presented with worsening dyspnea. A pulmonary function test showed severe airway obstruction and that forced expiratory volume in 1 s was 43% of the predicted value after a bronchodilator. A bronchoscopy and histopathological analyses revealed a squamous cell carcinoma mostly located outside of the lumen with central airway obstruction. Due to the poor pulmonary function, he cannot tolerate conventional active treatments, such as surgery, full dose systemic chemotherapy, or radiotherapy. Local treatments including argon plasma coagulation, cryotherapy, and bronchoscopic endobronchial intratumoral chemotherapy with cisplatin were performed to debulk intraluminal component of the tumor and recanalize occlusive airways in the left upper lobe. Convex-probe endobronchial ultrasound-guided transbronchial needle injection (EBUS-TBNI) delivered cisplatin into the extraluminal component of the tumor to relieve the symptom of dyspnea and opened up the opportunity for systemic chemotherapy without severe systemic complications. The patient had a good response to the comprehensive therapy of 4 cycles of low-dose intravenous chemotherapy and bronchoscopic interventions. EBUS-TBNI is proven an effective and safe method to treat inoperable extraluminal central pulmonary carcinoma complicated with severe COPD. In the future, EBUS-TBNI may offer more treatment indications outlined in the existing publications.

  5. Welding irradiated stainless steel

    SciTech Connect

    Kanne, W.R. Jr.; Chandler, G.T.; Nelson, D.Z.; Franco-Ferreira, E.A.

    1993-12-31

    Conventional welding processes produced severe underbead cracking in irradiated stainless steel containing 1 to 33 appm helium from n,a reactions. A shallow penetration overlay technique was successfully demonstrated for welding irradiated stainless steel. The technique was applied to irradiated 304 stainless steel that contained 10 appm helium. Surface cracking, present in conventional welds made on the same steel at the same and lower helium concentrations, was eliminated. Underbead cracking was minimal compared to conventional welding methods. However, cracking in the irradiated material was greater than in tritium charged and aged material at the same helium concentrations. The overlay technique provides a potential method for repair or modification of irradiated reactor materials.

  6. Bronchoscopic lung volume reduction with endobronchial valves for patients with heterogeneous emphysema and intact interlobar fissures (the BeLieVeR-HIFi study): a randomised controlled trial.

    PubMed

    Davey, Claire; Zoumot, Zaid; Jordan, Simon; McNulty, William H; Carr, Dennis H; Hind, Matthew D; Hansell, David M; Rubens, Michael B; Banya, Winston; Polkey, Michael I; Shah, Pallav L; Hopkinson, Nicholas S

    2015-09-12

    Lung volume reduction surgery improves survival in selected patients with emphysema, and has generated interest in bronchoscopic approaches that might achieve the same effect with less morbidity and mortality. Previous trials with endobronchial valves have yielded modest group benefits because when collateral ventilation is present it prevents lobar atelectasis. We did a single-centre, double-blind sham-controlled trial in patients with both heterogeneous emphysema and a target lobe with intact interlobar fissures on CT of the thorax. We enrolled stable outpatients with chronic obstructive pulmonary disease who had a forced expiratory volume in 1 s (FEV1) of less than 50% predicted, significant hyperinflation (total lung capacity >100% and residual volume >150%), a restricted exercise capacity (6 min walking distance <450 m), and substantial breathlessness (MRC dyspnoea score ≥3). Participants were randomised (1:1) by computer-generated sequence to receive either valves placed to achieve unilateral lobar occlusion (bronchoscopic lung volume reduction) or a bronchoscopy with sham valve placement (control). Patients and researchers were masked to treatment allocation. The study was powered to detect a 15% improvement in the primary endpoint, the FEV1 3 months after the procedure. Analysis was on an intention-to-treat basis. The trial is registered at controlled-trials.com, ISRCTN04761234. 50 patients (62% male, FEV1 [% predicted] mean 31·7% [SD 10·2]) were enrolled to receive valves (n=25) or sham valve placement (control, n=25) between March 1, 2012, and Sept 30, 2013. In the bronchoscopic lung volume reduction group, FEV1 increased by a median 8·77% (IQR 2·27-35·85) versus 2·88% (0-8·51) in the control group (Mann-Whitney p=0·0326). There were two deaths in the bronchoscopic lung volume reduction group and one control patient was unable to attend for follow-up assessment because of a prolonged pneumothorax. Unilateral lobar occlusion with endobronchial

  7. Thermoluminescence of irradiated foodstuffs

    NASA Astrophysics Data System (ADS)

    Oduko, J. M.; Spyrou, N. M.

    Measurements have been made of the thermoluminescent response of a number of foodstuffs, namely spices, chicken bone, eggshell and strawberries. From the results, irradiated samples can be clearly distinguished from unirradiated ones for several weeks after irradiation of 5-10 kGy, or in the case of some spices for up to 20 months. It is concluded that measurement of thermoluminescence is a promising technique for detecting the irradiation of foodstuffs.

  8. A foreign body reaction to Surgicel® in a lymph node diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration

    PubMed Central

    Badenes, Diana; Pijuan, Lara; Curull, Víctor; Sánchez-Font, Albert

    2017-01-01

    Surgicel® (Ethicon, North Ryde, NSW, Australia) is an absorbable sheet of oxidized cellulose polyanhydroglucuronic acid polymer used as an hemostatic in cardiovascular and thoracic surgery. In some cases, the retained material may cause foreign body granulomatous reactions and simulate tumor recurrence, an abscess, an hematoma, or an infection. We report the case of a 55-year-old patient who was operated of a lung adenocarcinoma. In the thoracic computed tomography scan 1 year after the surgery, a right paratracheal lymph node was detected, so endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was performed suspecting recurrence of the tumor. The cytology results of the lymph node showed a nonnecrotizing granulomatous reaction secondary to Surgicel®, used as an hemostatic during the surgery. The objective of presenting this case is to consider foreign body reaction to Surgicel® in the differential diagnosis of postoperative suspicion of neoplastic recurrence, and on the other hand, to note that EBUS-TBNA enables diagnosis. PMID:28197224

  9. Contribution of cell block obtained by endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of malignant diseases and sarcoidosis.

    PubMed

    Erer, Onur Fevzi; Erol, Serhat; Anar, Ceyda; Aydoğdu, Zekiye; Özkan, Serir Aktoğu

    2017-01-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a safe and minimally invasive procedure that can be performed in outpatient settings. Several studies have demonstrated the usefulness of EBUS-TBNA in the diagnosis of sarcoidosis and malignant diseases. This study focused on the role of cell block (CB) analysis in determining the diagnostic yield of EBUS-TBNA in malignant diseases and sarcoidosis. The study was conducted at a training and research hospital. Records of patients who underwent EBUS-TBNA between March 2011 and December 2014 for diagnosed sarcoidosis or malignancy were retrospectively analyzed. Results of all EBUS-TBNA smears and CB were separately evaluated to determine the diagnostic value of each. There were 84 sarcoidosis and 179 malignancy patients. In the malignancy group, CB contributed to cancer diagnosis in 15 (8.3%) patients and subclassification in 19 (10.6%) patients. In the sarcoidosis group, for 45.2% of patients (38/84), smears were not diagnostic but CB showed granulomatous inflammation. CB significantly increases the diagnostic yield of EBUS-TBNA for sarcoidosis. In our study, in the malignancy group the diagnostic yield was low but it was helpful for subclassification, especially for adenocarcinoma.

  10. Role of radial endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of pulmonary nodules: Case report and literature review

    PubMed Central

    Dhooria, Sahajal; Sehgal, Inderpaul Singh; Gupta, Nalini; Aggarwal, Ashutosh Nath; Behera, Digambar; Agarwal, Ritesh

    2017-01-01

    The diagnosis of pulmonary nodules can be made using several methods including computed tomography (CT)-guided fine-needle aspiration (FNA), radial endobronchial ultrasound (EBUS)-guided sampling techniques (transbronchial lung biopsy [TBLB], transbronchial brush, bronchoalveolar lavage, or transbronchial needle aspiration [TBNA]), or occasionally with convex probe (CP) EBUS-TBNA. While CT-guided FNA is associated with a high (25%) rate of pneumothorax, the CP-EBUS cannot reach lesions beyond the interlobar region. Radial EBUS-guided TBLB and transbronchial brushing are excellent modalities in the evaluation of peripheral pulmonary lesions. However, these techniques cannot access lesions that are located adjacent to the proximal segmental bronchus, due to the presence of a cartilaginous wall. Herein, we describe a 58-year-old man, who presented with a lung nodule in the right middle lobe, wherein radial EBUS-guided TBNA proved to be the most appropriate diagnostic modality. We also discuss the current utility of radial EBUS-guided TBNA in day-to-day practice. PMID:28144062

  11. Significant lung volume reduction with endobronchial valves in a patient despite the presence of microcollaterals masked by low-flow Chartis phenotype

    PubMed Central

    Yin, Yan; Hou, Gang; Herth, Felix J; Wang, Xiao-bo; Wang, Qiu-yue; Kang, Jian

    2016-01-01

    Satisfactory functional outcomes following bronchoscopic lung volume reduction (BLVR) using endobronchial valves (EBVs) depend on the absence of collateral ventilation (CV) between the target and adjunct lobes. The Chartis system has proven to be useful for determining whether CV is present or absent, but this system can also erroneously indicate the absence of CV, which can lead to BLVR failure. Here, we describe low-flow Chartis phenotype in the target lobe resulted in difficult judgment of existence of CV. Consequently, BLVR with EBVs implanted into the right upper bronchus failed to reduce lung volume or induce atelectasis. Inserting another EBV into the right middle bronchus blocked the latent CV, which led to significant lung volume reduction in the right upper lobe (RUL) and right middle lobe (RML) and to improve the pulmonary function, 6-min walking distance, and St George respiratory questionnaire scores over a 2-week follow-up period. Low flow in the target lobe is a unique Chartis phenotype and represents the uncertainty of CV, which is a risk factor for the failure of BLVR using EBVs. Clinicians should be aware of this possibility and might be able to resolve the problem by blocking the RUL and RML between which the CV occurs. PMID:27920518

  12. Comminuting irradiated ferritic steel

    DOEpatents

    Bauer, Roger E.; Straalsund, Jerry L.; Chin, Bryan A.

    1985-01-01

    Disclosed is a method of comminuting irradiated ferritic steel by placing the steel in a solution of a compound selected from the group consisting of sulfamic acid, bisulfate, and mixtures thereof. The ferritic steel is used as cladding on nuclear fuel rods or other irradiated components.

  13. MASSIVE LEAKAGE IRRADIATOR

    DOEpatents

    Wigner, E.P.; Szilard, L.; Christy, R.F.; Friedman, F.L.

    1961-05-30

    An irradiator designed to utilize the neutrons that leak out of a reactor around its periphery is described. It avoids wasting neutron energy and reduces interference with the core flux to a minimum. This is done by surrounding all or most of the core with removable segments of the material to be irradiated within a matrix of reflecting material.

  14. Perspective on food irradiation

    SciTech Connect

    Not Available

    1987-02-01

    Recent US Food and Drug Administration approval of irradiation treatment for fruit, vegetables and pork has stimulated considerable discussion in the popular press on the safety and efficacy of irradiation processing of food. This perspective is designed to summarize the current scientific information available on this issue.

  15. Irradiation Creep in Graphite

    SciTech Connect

    Ubic, Rick; Butt, Darryl; Windes, William

    2014-03-13

    An understanding of the underlying mechanisms of irradiation creep in graphite material is required to correctly interpret experimental data, explain micromechanical modeling results, and predict whole-core behavior. This project will focus on experimental microscopic data to demonstrate the mechanism of irradiation creep. High-resolution transmission electron microscopy should be able to image both the dislocations in graphite and the irradiation-induced interstitial clusters that pin those dislocations. The team will first prepare and characterize nanoscale samples of virgin nuclear graphite in a transmission electron microscope. Additional samples will be irradiated to varying degrees at the Advanced Test Reactor (ATR) facility and similarly characterized. Researchers will record microstructures and crystal defects and suggest a mechanism for irradiation creep based on the results. In addition, the purchase of a tensile holder for a transmission electron microscope will allow, for the first time, in situ observation of creep behavior on the microstructure and crystallographic defects.

  16. Investigation on the potential of thulium-fibre-laser irradiation for in-stent tissue ablation (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Sroka, Ronald; Frank, Johannes; Reichenberger, Frank; Behr, J.; Gesierich, Wolfgang

    2017-04-01

    Granulation and tumor regrowth in the area of bronchi stent implants may result in restenosis. It had been shown that by means of Thulium-Fibre-Laser (TFL) a controlled ablation and reduction of the tissue within the stent could be performed. When using Nd:YAG irradiation there is risk for explosive flames, burns of fibre and stent, ruptures of stent meshes as well as perforation of stent and cover. Therefore it was the aim to investigate the safety margin when using TFL. Four different types of clinical used stents (with/without cover) were fixed to pig trachea tissue. Irradiation was performed by fibre assisted TFL-1940nm-laser irradiation while laser power, light application duration and distance, as well as oxygen percentage and contamination were varied. In case of Nitinol-stents rupture were observed at power levels >=7W or distances of <5mm, oxygen conc. of 40% result in increased flame appearance. Polyurethan-covers were ruptured at each variable, flame appeared at 5W. Silicon-stents were destroyed at power levels of about 5W and distances of <5mm and additionally 30%-oxygen or contamination either by blood or soot result in increased appearance of burns and flames. Based upon these observations in clinical TFL-irradiation the distance should >=5 mm and the power level should be <=6W. Furthermore the oxygen conc. should not exceed 30% and short term continuous irradiation of less than 15s exposition should be considered. In case of Silicon-stents light application on contaminated area should be avoided.

  17. Combined endobronchial and esophageal endosonography for the diagnosis and staging of lung cancer: European Society of Gastrointestinal Endoscopy (ESGE) Guideline, in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS).

    PubMed

    Vilmann, Peter; Frost Clementsen, Paul; Colella, Sara; Siemsen, Mette; De Leyn, Paul; Dumonceau, Jean-Marc; Herth, Felix J; Larghi, Alberto; Vazquez-Sequeiros, Enrique; Hassan, Cesare; Crombag, Laurence; Korevaar, Daniël A; Konge, Lars; Annema, Jouke T

    2015-07-01

    This is an official guideline of the European Society of Gastrointestinal Endoscopy (ESGE), produced in cooperation with the European Respiratory Society (ERS) and the European Society of Thoracic Surgeons (ESTS). It addresses the benefit and burden associated with combined endobronchial and esophageal mediastinal nodal staging of lung cancer. The Scottish Intercollegiate Guidelines Network (SIGN) approach was adopted to define the strength of recommendations and the quality of evidence.The article has been co-published with permission in Endoscopy and the European Respiratory Journal.

  18. Alaskan Commodities Irradiation Project

    SciTech Connect

    Zarling, J.P.; Swanson, R.B.; Logan, R.R.; Das, D.K.; Lewis, C.E.; Workman, W.G.; Tumeo, M.A.; Hok, C.I.; Birklid, C.A.; Bennett, F.L.

    1988-12-01

    The ninety-ninth US Congress commissioned a six-state food irradiation research and development program to evaluate the commercial potential of this technology. Hawaii, Washington, Iowa, Oklahoma and Florida as well as Alaska have participated in the national program; various food products including fishery products, red meats, tropical and citrus fruits and vegetables have been studied. The purpose of the Alaskan study was to review and evaluate those factors related to the technical and economic feasibility of an irradiator in Alaska. This options analysis study will serve as a basis for determining the state's further involvement in the development of food irradiation technology. 40 refs., 50 figs., 53 tabs.

  19. Test reactor irradiation coordination

    SciTech Connect

    Heartherly, D.W.; Siman Tov, I.I.; Sparks, D.W.

    1995-10-01

    This task was established to supply and coordinate irradiation services needed by NRC contractors other than ORNL. These services include the design and assembly of irradiation capsules as well as arranging for their exposure, disassembly, and return of specimens. During this period, the final design of the facility and specimen baskets was determined through an iterative process involving the designers and thermal analysts. The resulting design should permit the irradiation of all test specimens to within 5{degrees}C of their desired temperature. Detailing of all parts is ongoing and should be completed during the next reporting period. Procurement of the facility will also be initiated during the next review period.

  20. CD4/CD8 Ratio in Mediastinal Lymph Nodes Involved by Sarcoidosis: Analysis of Flow Cytometry Data Obtained by Endobronchial Ultrasound-guided Transbronchial Needle Aspiration.

    PubMed

    Ruiz, Sory J; Zhang, Yaxia; Mukhopadhyay, Sanjay

    2016-10-01

    Despite mixed results in the literature, some clinicians continue to consider an elevated CD4/CD8 ratio in bronchoalveolar lavage (BAL) fluid to be supportive of a diagnosis of sarcoidosis. However, the CD4/CD8 ratio in mediastinal lymph nodes involved by sarcoidosis has not been extensively studied. The primary aim of this study was to evaluate the utility of the CD4/CD8 ratio in mediastinal lymph node aspirates obtained by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for diagnosing sarcoidosis. Our archives were searched for EBUS-TBNAs in which mediastinal lymph node aspirates had been submitted for flow cytometry (n=160). Clinical and pathologic findings in these cases were reviewed retrospectively. Cases were included in the study if they had (1) a clinical diagnosis of sarcoidosis supported by cytopathologic confirmation of non-necrotizing granulomas in EBUS-TBNA-derived lymph node aspirates (23 cases), or (2) a pathologically confirmed non-neoplastic diagnosis other than sarcoidosis (7 cases). Cases that did not fulfil these criteria were excluded (130 cases). The CD4/CD8 ratios in mediastinal lymph nodes and BAL fluid were compared. The CD4/CD8 ratio was elevated in mediastinal lymph nodes in 12/23 (52%) cases of sarcoidosis and 3/7 (43%) pathologically confirmed nonsarcoid cases. BAL fluid had been concurrently submitted for flow cytometry in 20/23 cases of sarcoidosis and 5/7 nonsarcoid cases. CD4/CD8 was elevated in BAL fluid in 9/20 (45%) cases of sarcoidosis and 2/5 (40%) nonsarcoid cases. As in BAL fluid, the CD4/CD8 ratio in mediastinal lymph nodes involved by sarcoid granulomas is highly variable and does not reliably confirm or exclude sarcoidosis.

  1. Improved laboratory resource utilization and patient care with the use of rapid on-site evaluation for endobronchial ultrasound fine-needle aspiration biopsy.

    PubMed

    Collins, Brian T; Chen, Alexander C; Wang, Jeff F; Bernadt, Cory T; Sanati, Souzan

    2013-10-01

    Endobronchial ultrasound guided (EBUS) fine-needle aspiration (FNA) biopsy has become widely used to evaluate patients with thoracic abnormalities. Rapid on-site evaluation (ROSE) can provide the bronchoscopist with immediate evaluation findings during the procedure. This study examines EBUS FNA biopsy procedures with and without ROSE, and investigates the impact of ROSE service on the EBUS procedure and laboratory resource utilization. The cytopathology database at Washington University Medical Center, St. Louis, Missouri, was searched for EBUS FNA biopsy cases before and after introduction of ROSE service, and a matched cohort was collected. Reports were reviewed and pertinent data was collected, such as sites biopsied, ROSE performance, slide smears, cell blocks, and diagnostic categories. Statistical analysis of the results was performed. A matched case-controlled EBUS FNA cohort of 340 patients (680 total) for each category of non-ROSE and ROSE service were identified. There was a 33% reduction in the number of sites biopsied with ROSE. A total of 68% of patients with ROSE had just one biopsy site compared to only 36% of non-ROSE patients. There was a 30% decrease in total slides (mean, 5.27 slides) after the introduction of ROSE. All of these improvements were statistically significant. EBUS FNA biopsy ROSE service benefits patients by contributing to significantly fewer biopsies and improved utilization of health care resources. ROSE service results in substantially fewer total slides, which has a significant impact on the cytopathology laboratory work effort. The use of ROSE for EBUS FNA biopsy provides significant improvements in patient care and laboratory resource utilization. © 2013 American Cancer Society.

  2. Treatment of isolated mediastinal and hilar recurrence of lung cancer with bronchoscopic endobronchial ultrasound guided intratumoral injection of chemotherapy with cisplatin.

    PubMed

    Mehta, Hiren J; Begnaud, Abbie; Penley, Andrea M; Wynne, John; Malhotra, Paras; Fernandez-Bussy, Sebastian; Cope, Jessica M; Shuster, Jonathan J; Jantz, Michael A

    2015-12-01

    A common pattern of recurrence in lung cancer after receiving full dose external beam radiation therapy (EBRT) to targeted sites is isolated mediastinal and hilar recurrence (IMHR). Treatment options for these patients are limited to palliative radiation, chemotherapy, and/or best supportive care. We describe our experience with treating IMHR with bronchoscopic endobronchial ultrasound (EBUS) guided intratumoral injection of cisplatin (ITC). Patients treated between Jan 2009-September 2014 with ITC for IMHR were included. Patient demographics, tumor histology, size, concurrent therapy, location, number of sites treated, treatment sessions, and encounters were abstracted. Responses were analyzed on follow-up scans 8-12 weeks after the last treatment session using RECIST 1.1 criteria. Locoregional recurrence, progression-free survival (PFS), and overall survival were measured. 50 sites were treated in 36 patients (19 males, 17 females) with mean age 61.9±8.5 years. Eight sites treated on subsequent encounters were excluded and one patient had an unevaluable response, leaving 35 patients and 41 sites for final analysis. 24/35 (69%) had complete or partial response (responders), whereas 11/35 (31%) had stable or progressive disease (non-responders). There were no significant differences in response based on histology, size, and concurrent therapy. Median survival for the group was 8 months (95% CI of 6-11 mo). Responders had significantly higher survival and PFS than non-responders. Two patients treated with concurrent EBRT, developed broncho-mediastinal fistula. EBUS guided intratumoral cisplatin for IMHR appears to be safe and effective, and may represent a new treatment paradigm for this patient population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Combined Bone Marrow‐Derived Mesenchymal Stromal Cell Therapy and One‐Way Endobronchial Valve Placement in Patients with Pulmonary Emphysema: A Phase I Clinical Trial

    PubMed Central

    de Oliveira, Hugo Goulart; Cruz, Fernanda Ferreira; Antunes, Mariana Alves; de Macedo Neto, Amarilio Vieira; Oliveira, Guilherme Augusto; Svartman, Fabio Munhoz; Borgonovo, Tamara; Rebelatto, Carmen Lucia Kuniyoshi; Weiss, Daniel J.; Brofman, Paulo Roberto Slud; Morales, Marcelo Marcos; Lapa e Silva, José Roberto

    2016-01-01

    Abstract One‐way endobronchial valves (EBV) insertion to reduce pulmonary air trapping has been used as therapy for chronic obstructive pulmonary disease (COPD) patients. However, local inflammation may result and can contribute to worsening of clinical status in these patients. We hypothesized that combined EBV insertion and intrabronchial administration of mesenchymal stromal cells (MSCs) would decrease the inflammatory process, thus mitigating EBV complications in severe COPD patients. This initial study sought to investigate the safety of this approach. For this purpose, a phase I, prospective, patient‐blinded, randomized, placebo‐controlled design was used. Heterogeneous advanced emphysema (Global Initiative for Chronic Lung Disease [GOLD] III or IV) patients randomly received either allogeneic bone marrow‐derived MSCs (108 cells, EBV+MSC) or 0.9% saline solution (EBV) (n = 5 per group), bronchoscopically, just before insertion of one‐way EBVs. Patients were evaluated 1, 7, 30, and 90 days after therapy. All patients completed the study protocol and 90‐day follow‐up. MSC delivery did not result in acute administration‐related toxicity, serious adverse events, or death. No significant between‐group differences were observed in overall number of adverse events, frequency of COPD exacerbations, or worsening of disease. Additionally, there were no significant differences in blood tests, lung function, or radiological outcomes. However, quality‐of‐life indicators were higher in EBV + MSC compared with EBV. EBV + MSC patients presented decreased levels of circulating C‐reactive protein at 30 and 90 days, as well as BODE (Body mass index, airway Obstruction, Dyspnea, and Exercise index) and MMRC (Modified Medical Research Council) scores. Thus, combined use of EBV and MSCs appears to be safe in patients with severe COPD, providing a basis for subsequent investigations using MSCs as concomitant therapy. Stem Cells Translational

  4. Fine-needle aspiration of histoplasmosis in the era of endoscopic ultrasound and endobronchial ultrasound: cytomorphologic features and correlation with clinical laboratory testing.

    PubMed

    Gailey, Michael P; Klutts, J Stacey; Jensen, Chris S

    2013-09-01

    Histoplasmosis has a textbook cytologic description with numerous intracellular organisms that are readily apparent on routine stains. This is based on series and reports describing histoplasmosis in immunosuppressed patients with disseminated disease. With the advent of ultrasound-guided (US) fine-needle aspiration (FNA) techniques, a marked increase in the cytologic diagnosis of histoplasmosis in immunocompetent patients is noted. A search identified all cytology cases diagnosed with Histoplasma within the past 10 years. Cases were reviewed, along with patient demographic, clinical, and laboratory data. A total of 40 FNA cases of histoplasmosis were identified. Patients ranged in age from 15 years to 86 years. There were 23 female patients and 17 male patients; 37 were immunocompetent and 3 were immunosuppressed. Sixteen patients were being staged for primary tumors of other sites; others presented with primary pulmonary symptoms or histoplasmosis was noted incidentally. Specimens were composed of bland acellular necrosis, most commonly with granulomas (77.5%); only rare intracellular organisms were present on routine stains, and variable extracellular organisms were noted on Grocott methenamine silver stain (GMS) stain. GMS stain on direct smears was found to be more sensitive than cell block. Laboratory studies for urine antigen, yeast, and mycelial antibody (by compliment fixation), serum antibody (by immunodiffusion), and culture were positive in 11.8%, 59.1%, 4.5%, 47.6%, and 3.4% of cases, respectively. In an endemic region, histoplasmosis presents more commonly in immunocompetent patients as localized fibrocaseous disease on FNA and is often identified by high-resolution imaging. FNA is increasingly used in the diagnosis because of endoscopic ultrasound and endobronchial ultrasound. GMS stain on direct smears is more sensitive than cell block. In general, laboratory tests have low sensitivity in this patient population. Copyright © 2013 American Cancer

  5. Impact of Endobronchial Ultrasound (EBUS) Training on the Diagnostic Yield of Conventional Transbronchial Needle Aspiration for Lymph Node Stations 4R and 7

    PubMed Central

    Sehgal, Inderpaul Singh; Dhooria, Sahajal; Gupta, Nalini; Bal, Amanjit; Ram, Babu; Aggarwal, Ashutosh Nath; Behera, Digambar; Agarwal, Ritesh

    2016-01-01

    Background There is sparse literature on whether training in endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) improves the diagnostic yield of conventional TBNA (cTBNA). Objectives The aim of this study was to evaluate the diagnostic yield of cTBNA before and after the introduction of EBUS. Methods This was a retrospective analysis of patients who underwent cTBNA at our center. The study was divided into two periods, before and after the introduction of EBUS at our facility. The diagnostic yield of cTBNA was compared between the study periods. Rapid on-site cytological examination was not available. Results A total of 1,050 patients (61.6% men; mean age 45.6 years) underwent cTBNA during the study period (849 before EBUS; 201 after EBUS). Sarcoidosis (n = 527) followed by bronchogenic carcinoma (n = 222) formed the most common indications for performing cTBNA. There was a significant increase in both the success of obtaining a representative sample (from 71% to 85%), and the diagnostic yield (from 33% to 49.5%) of cTBNA, after the introduction of EBUS. The increase in the diagnostic yield of cTBNA after introduction of EBUS remained significant even after adjusting for years of performing cTBNA and the type of anesthesia (topical vs. sedation and topical) on a multivariate analysis. Conclusion The diagnostic yield of cTBNA at our facility increased after the introduction of EBUS-TBNA. However, given the retrospective nature of the study, prospective studies are required to confirm our findings. PMID:27083009

  6. Combined Bone Marrow-Derived Mesenchymal Stromal Cell Therapy and One-Way Endobronchial Valve Placement in Patients with Pulmonary Emphysema: A Phase I Clinical Trial.

    PubMed

    de Oliveira, Hugo Goulart; Cruz, Fernanda Ferreira; Antunes, Mariana Alves; de Macedo Neto, Amarilio Vieira; Oliveira, Guilherme Augusto; Svartman, Fabio Munhoz; Borgonovo, Tamara; Rebelatto, Carmen Lucia Kuniyoshi; Weiss, Daniel J; Brofman, Paulo Roberto Slud; Morales, Marcelo Marcos; Lapa E Silva, José Roberto; Rocco, Patricia Rieken Macedo

    2017-03-01

    One-way endobronchial valves (EBV) insertion to reduce pulmonary air trapping has been used as therapy for chronic obstructive pulmonary disease (COPD) patients. However, local inflammation may result and can contribute to worsening of clinical status in these patients. We hypothesized that combined EBV insertion and intrabronchial administration of mesenchymal stromal cells (MSCs) would decrease the inflammatory process, thus mitigating EBV complications in severe COPD patients. This initial study sought to investigate the safety of this approach. For this purpose, a phase I, prospective, patient-blinded, randomized, placebo-controlled design was used. Heterogeneous advanced emphysema (Global Initiative for Chronic Lung Disease [GOLD] III or IV) patients randomly received either allogeneic bone marrow-derived MSCs (10(8) cells, EBV+MSC) or 0.9% saline solution (EBV) (n = 5 per group), bronchoscopically, just before insertion of one-way EBVs. Patients were evaluated 1, 7, 30, and 90 days after therapy. All patients completed the study protocol and 90-day follow-up. MSC delivery did not result in acute administration-related toxicity, serious adverse events, or death. No significant between-group differences were observed in overall number of adverse events, frequency of COPD exacerbations, or worsening of disease. Additionally, there were no significant differences in blood tests, lung function, or radiological outcomes. However, quality-of-life indicators were higher in EBV + MSC compared with EBV. EBV + MSC patients presented decreased levels of circulating C-reactive protein at 30 and 90 days, as well as BODE (Body mass index, airway Obstruction, Dyspnea, and Exercise index) and MMRC (Modified Medical Research Council) scores. Thus, combined use of EBV and MSCs appears to be safe in patients with severe COPD, providing a basis for subsequent investigations using MSCs as concomitant therapy. Stem Cells Translational Medicine 2017;6:962-969.

  7. Rapid On-Site Evaluation of Endobronchial Ultrasound-Guided Transbronchial Needle Aspirations for the Diagnosis of Lung Cancer: A Perspective From Members of the Pulmonary Pathology Society.

    PubMed

    Jain, Deepali; Allen, Timothy Craig; Aisner, Dara L; Beasley, Mary Beth; Cagle, Philip T; Capelozzi, Vera Luiza; Hariri, Lida P; Lantuejoul, Sylvie; Miller, Ross; Mino-Kenudson, Mari; Monaco, Sara E; Moreira, Andre; Raparia, Kirtee; Rekhtman, Natasha; Roden, Anja Christiane; Roy-Chowdhuri, Sinchita; da Cunha Santos, Gilda; Thunnissen, Erik; Troncone, Giancarlo; Vivero, Marina

    2017-06-22

    - Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has emerged as a very useful tool in the field of diagnostic respiratory cytology. Rapid on-site evaluation (ROSE) of EBUS-TBNA not only has the potential to improve diagnostic yield of the procedure but also to triage samples for predictive molecular testing to guide personalized treatments for lung cancer. - To provide an overview of the current status of the literature regarding ROSE of EBUS-TBNA in the diagnosis of lung cancer. - An electronic literature search in PubMed and Google databases was performed using the following key words: cytology, lung cancer, on-site evaluation, rapid on-site evaluation, and ROSE EBUS-TBNA. Only articles published in English were included in this review. - Rapid on-site evaluation can ensure that the targeted lesion is being sampled and can enable appropriate specimen triage. If available, it should be used with EBUS-TBNA in the diagnosis of lung cancer because it can minimize repeat procedures for additional desired testing (ie, molecular studies). Some studies have shown that while ROSE does not adversely affect the number of aspirations, total procedure time of EBUS-TBNA, or the rate of postprocedure complications, it is helpful in providing a preliminary diagnosis that can reduce the number of additional invasive procedures, such as mediastinoscopy. As EBUS technology continues to evolve, our knowledge of the role of ROSE in EBUS-TBNA for the diagnosis of lung cancer will also continue to grow and evolve.

  8. [The irradiation process].

    PubMed

    Barillot, I; Chauvet, B; Hannoun Lévi, J M; Lisbona, A; Leroy, T; Mahé, M A

    2016-09-01

    The purpose of this article is to describe the regulatory framework of the radiotherapy practice in France, the external irradiation and brachytherapy process and the guidelines for patient follow-up.

  9. Food irradiation in perspective

    NASA Astrophysics Data System (ADS)

    Henon, Y. M.

    1995-02-01

    Food irradiation already has a long history of hopes and disappointments. Nowhere in the world it plays the role that it should have, including in the much needed prevention of foodborne diseases. Irradiated food sold well wherever consumers were given a chance to buy them. Differences between national regulations do not allow the international trade of irradiated foods. While in many countries food irradiation is still illegal, in most others it is regulated as a food additive and based on the knowledge of the sixties. Until 1980, wholesomeness was the big issue. Then the "prerequisite" became detection methods. Large amounts of money have been spent to design and validate tests which, in fact, aim at enforcing unjustified restrictions on the use of the process. In spite of all the difficulties, it is believed that the efforts of various UN organizations and a growing legitimate demand for food safety should in the end lead to recognition and acceptance.

  10. AGC-2 Irradiation Report

    SciTech Connect

    Rohrbaugh, David Thomas; Windes, William; Swank, W. David

    2016-06-01

    The Next Generation Nuclear Plant (NGNP) will be a helium-cooled, very high temperature reactor (VHTR) with a large graphite core. In past applications, graphite has been used effectively as a structural and moderator material in both research and commercial high temperature gas cooled reactor (HTGR) designs.[ , ] Nuclear graphite H 451, used previously in the United States for nuclear reactor graphite components, is no longer available. New nuclear graphites have been developed and are considered suitable candidates for the new NGNP reactor design. To support the design and licensing of NGNP core components within a commercial reactor, a complete properties database must be developed for these current grades of graphite. Quantitative data on in service material performance are required for the physical, mechanical, and thermal properties of each graphite grade with a specific emphasis on data related to the life limiting effects of irradiation creep on key physical properties of the NGNP candidate graphites. Based on experience with previous graphite core components, the phenomenon of irradiation induced creep within the graphite has been shown to be critical to the total useful lifetime of graphite components. Irradiation induced creep occurs under the simultaneous application of high temperatures, neutron irradiation, and applied stresses within the graphite components. Significant internal stresses within the graphite components can result from a second phenomenon—irradiation induced dimensional change. In this case, the graphite physically changes i.e., first shrinking and then expanding with increasing neutron dose. This disparity in material volume change can induce significant internal stresses within graphite components. Irradiation induced creep relaxes these large internal stresses, thus reducing the risk of crack formation and component failure. Obviously, higher irradiation creep levels tend to relieve more internal stress, thus allowing the

  11. Total lymphoid irradiation

    SciTech Connect

    Sutherland, D.E.; Ferguson, R.M.; Simmons, R.L.; Kim, T.H.; Slavin, S.; Najarian, J.S.

    1983-05-01

    Total lymphoid irradiation by itself can produce sufficient immunosuppression to prolong the survival of a variety of organ allografts in experimental animals. The degree of prolongation is dose-dependent and is limited by the toxicity that occurs with higher doses. Total lymphoid irradiation is more effective before transplantation than after, but when used after transplantation can be combined with pharmacologic immunosuppression to achieve a positive effect. In some animal models, total lymphoid irradiation induces an environment in which fully allogeneic bone marrow will engraft and induce permanent chimerism in the recipients who are then tolerant to organ allografts from the donor strain. If total lymphoid irradiation is ever to have clinical applicability on a large scale, it would seem that it would have to be under circumstances in which tolerance can be induced. However, in some animal models graft-versus-host disease occurs following bone marrow transplantation, and methods to obviate its occurrence probably will be needed if this approach is to be applied clinically. In recent years, patient and graft survival rates in renal allograft recipients treated with conventional immunosuppression have improved considerably, and thus the impetus to utilize total lymphoid irradiation for its immunosuppressive effect alone is less compelling. The future of total lymphoid irradiation probably lies in devising protocols in which maintenance immunosuppression can be eliminated, or nearly eliminated, altogether. Such protocols are effective in rodents. Whether they can be applied to clinical transplantation remains to be seen.

  12. Blood irradiation: Rationale and technique

    SciTech Connect

    Lewis, M.C. )

    1990-01-01

    Upon request by the local American Red Cross, the Savannah Regional Center for Cancer Care irradiates whole blood or blood components to prevent post-transfusion graft-versus-host reaction in patients who have severely depressed immune systems. The rationale for blood irradiation, the total absorbed dose, the type of patients who require irradiated blood, and the regulations that apply to irradiated blood are presented. A method of irradiating blood using a linear accelerator is described.

  13. ORNL irradiation creep facility

    SciTech Connect

    Reiley, T.C.; Auble, R.L.; Beckers, R.M.; Bloom, E.E.; Duncan, M.G.; Saltmarsh, M.J.; Shannon, R.H.

    1980-09-01

    A machine was developed at ORNL to measure the rates of elongation observed under irradiation in stressed materials. The source of radiation is a beam of 60 MeV alpha particles from the Oak Ridge Isochronous Cyclotron (ORIC). This choice allows experiments to be performed which simulate the effects of fast neutrons. A brief review of irradiation creep and experimental constraints associated with each measurement technique is given. Factors are presented which lead to the experimental choices made for the Irradiation Creep Facility (ICF). The ICF consists of a helium-filled chamber which houses a high-precision mechanical testing device. The specimen to be tested must be thermally stabilized with respect to the temperature fluctuations imposed by the particle beam which passes through the specimen. Electrical resistance of the specimen is the temperature control parameter chosen. Very high precision in length measurement and temperature control are required to detect the small elongation rates relevant to irradiation creep in the test periods available (approx. 1 day). The apparatus components and features required for the above are presented in some detail, along with the experimental procedures. The damage processes associated with light ions are discussed and displacement rates are calculated. Recent irradiation creep results are given, demonstrating the suitability of the apparatus for high resolution experiments. Also discussed is the suitability of the ICF for making high precision thermal creep measurements.

  14. Fuel or irradiation subassembly

    DOEpatents

    Seim, O.S.; Hutter, E.

    1975-12-23

    A subassembly for use in a nuclear reactor is described which incorporates a loose bundle of fuel or irradiation pins enclosed within an inner tube which in turn is enclosed within an outer coolant tube and includes a locking comb consisting of a head extending through one side of the inner sleeve and a plurality of teeth which extend through the other side of the inner sleeve while engaging annular undercut portions in the bottom portion of the fuel or irradiation pins to prevent movement of the pins.

  15. FOOD IRRADIATION REACTOR

    DOEpatents

    Leyse, C.F.; Putnam, G.E.

    1961-05-01

    An irradiation apparatus is described. It comprises a pressure vessel, a neutronic reactor active portion having a substantially greater height than diameter in the pressure vessel, an annular tank surrounding and spaced from the pressure vessel containing an aqueous indium/sup 1//sup 1//sup 5/ sulfate solution of approximately 600 grams per liter concentration, means for circulating separate coolants through the active portion and the space between the annular tank and the pressure vessel, radiator means adapted to receive the materials to be irradiated, and means for flowing the indium/sup 1//sup 1//sup 5/ sulfate solution through the radiator means.

  16. Economics of food irradiation

    NASA Astrophysics Data System (ADS)

    Kunstadt, Peter; Eng, P.; Steeves, Colyn; Beaulieu, Daniel; Eng, P.

    1993-07-01

    The number of products being radiation processed worldwide is constantly increasing and today includes such diverse items as medical disposables, fruits and vegetables, spices, meats, seafoods and waste products. This range of products to be processed has resulted in a wide range of irradiator designs and capital and operating cost requirements. This paper discusses the economics of low dose food irradiation applications and the effects of various parameters on unit processing costs. It provides a model for calculating specific unit processing costs by correlating known capital costs with annual operating costs and annual throughputs. It is intended to provide the reader with a general knowledge of how unit processing costs are derived.

  17. Bending the rules: a novel approach to placement and retrospective experience with the 5 French Arndt endobronchial blocker in children <2 years.

    PubMed

    Templeton, T Wesley; Downard, Martina G; Simpson, Christopher R; Zeller, Kristen A; Templeton, Leah B; Bryan, Yvon F

    2016-05-01

    One-lung ventilation (OLV) is frequently employed to improve surgical exposure during video-assisted thoracoscopic surgery (VATS) and thoracotomy in adults and children. Because of their small size, children under the age of 2 years are not candidates for some of the methods typically used for OLV in adults and older children, such as a double-lumen endotracheal (DLT) tube or intraluminal use of a bronchial blocker. Due to this, the clinician is left with few options. One of the most robust approaches to OLV in infants and small children has been the extraluminal placement of a 5 French (5F) Arndt endobronchial blocker (AEB). The aim of this retrospective study was to examine and describe our experience with placement and management of an extraluminal 5F AEB for thoracic surgery in children <2 years of age. We retrospectively examined the anesthetic records for details of AEB placement, arterial blood gas (ABG) data, and intraoperative analgesic prescription in 15 children under the age of 2 years undergoing OLV with a 5F AEB for thoracic surgery at our institution from January 2010 through January 2016. We were able to successfully achieve lung isolation in 14 of 15 patients using a 5F AEB that was bent 35-45° 1.5 cm proximal to the inflatable cuff. In 13 of 15 patients, we were able to place the AEB into final position with the aid of video-assisted fiberoptic bronchoscopy. In two patients, fluoroscopy was required to place the 5F AEB into the left mainstem due to poor visualization of the carina and rapid desaturation during bronchoscopy. In one of these patients, even though the blocker appeared to be correctly placed by fluoroscopy, adequate lung isolation was not observed. Intraoperatively, we observed significant degrees of hypercarbia in most patients without oxygen desaturation. Analgesic regimens lacked consistency and varied among patients. Open thoracotomy procedures tended to receive more aggressive narcotic regimens than video-assisted thoracoscopic

  18. Endobronchial ultrasonography with guide sheath versus computed tomography guided transthoracic needle biopsy for peripheral pulmonary lesions: a propensity score matched analysis

    PubMed Central

    Wang, Chong; Li, Xiao; Zhou, Zuli; Zhao, Hui; Li, Zhixin; Wang, Jun

    2016-01-01

    Background Computed tomography guided transthoracic needle aspiration (CT-TTNA) and endobronchial ultrasonography with guide sheath (EBUS-GS) transbronchial lung biopsy are important methods for the diagnosis of peripheral pulmonary lesions (PPLs). Without enough evidence, it is controversial which is a better choice for diagnosing PPLs. In this study, we hypothesized that the complication rate of EBUS-GS would be lower than CT-TTNA and the diagnostic accuracy of EBUS-GS were not inferior to CT-TTNA. Methods This study was a retrospective analysis of a prospective registry with propensity matching. Patients with PPLs were divided into EBUS-GS group and CT-TTNA group according to patients’ intent to treatment. Pathological results and procedure related complications of EBUS-GS and CT-TTNA were recorded. Propensity score matching(PSM) was used to eliminate the intergroup bias. Diagnostic yields and complications of two groups were compared. Subgroup analysis was performed to conclude the indications of different procedures. Results A total of 187 patients (CT-TTNA: 130; EBUS-GS: 57) were enrolled. After propensity score matching, 54 paired patients were included. Diagnostic yield was 81% (44/54) for EBUS-GS and 87% (47/54) for CT-TTNA (P=0.43), respectively. Diagnostic sensitivity in malignancy was 93% (42/45) for CT-TTNA and 79% (37/47) for EUBS-GS (P=0.04). Subgroup analysis revealed that the sensitivity of CT-TTNA was significantly higher in diagnosing of lesions close to the chest wall (100% vs. 80%, P=0.04), and bronchus sign on CT was a predictive factor for accurate diagnosis by EBUS-GS. The overall complication rate was 13% (7/54) for CT-TTNA group, which was not significantly higher than that of EBUS-GS group (2%, P=0.06). Subgroup analysis showed that patients combined with pulmonary comorbidities and lesions apart from chest wall were risk factors for complications of CT-TTNA. Conclusions Both of the two procedures are effective for the diagnosis of PPLs

  19. Effect of prophylactic benzydamine hydrochloride on postoperative sore throat and hoarseness after tracheal intubation using a double-lumen endobronchial tube: a randomized controlled trial.

    PubMed

    Chang, Jee-Eun; Min, Seong-Won; Kim, Chong-Soo; Han, Sung-Hee; Kwon, Yong-Suk; Hwang, Jin-Young

    2015-10-01

    We evaluated the prophylactic effect of benzydamine hydrochloride (BH) spray on postoperative sore throat and hoarseness secondary to intubation with a double-lumen endobronchial tube (DLT). Ninety-two adult patients undergoing thoracic surgery using DLT intubation were studied. The DLT cuff and oropharyngeal cavity were sprayed with normal saline (Group S; n = 46) or BH (Group BH; n = 46) prior to intubation. Postoperative sore throat and hoarseness were evaluated at one, six, and 24 hr after surgery. Sore throat was evaluated using a 0-100 mm visual analogue scale (VAS). Hoarseness was defined as a change in voice quality. Compared with Group S, postoperative sore throat occurred less frequently in Group BH at one hour (mean difference, 28.3%; 95% confidence interval [CI], 8.7 to 45.1; P = 0.01), at six hours (mean difference, 32.6%; 95% CI, 12.6 to 49.2; P < 0.01), and at 24 hr (mean difference, 28.3%; 95% CI, 9.3 to 44.7; P = 0.01) after surgery. Group BH had lower VAS scores for postoperative sore throat at one hour (mean difference, 12.8; 95% CI, 4.9 to 20.7), at six hours (mean difference, 11.9; 95% CI, 4.8 to 19.1; P < 0.01), and at 24 hr (mean difference, 5.3; 95% CI, 0.9 to 9.7; P = 0.01) after surgery. Hoarseness also occurred less frequently in Group BH at one hour (mean difference, 23.9%; 95% CI, 6.8 to 39.6; P = 0.01), at six hours (mean difference, 23.9%; 95% CI, 7.4 to 39.3; P = 0.01), and at 24 hr (mean difference, 21.7%; 95% CI, 5.5 to 37.0; P = 0.02) after surgery (P < 0.01). Prophylactic application of BH to the DLT cuff and oropharyngeal cavity reduces the incidence and severity of postoperative sore throat and the incidence of hoarseness associated with DLT intubation. The trial was registered at the Clinical Research Information Service (KCT0001068).

  20. Comparison of radial endobronchial ultrasound with a guide sheath and with distance by thin bronchoscopy for the diagnosis of peripheral pulmonary lesions: a prospective randomized crossover trial

    PubMed Central

    Zhou, Jun; Zhang, Qiu-Di; Xu, Qian-Qian; Xu, Xiong

    2016-01-01

    Background Transbronchial biopsy (TBB) using radial endobronchial ultrasound with a guide sheath (REBUS-GS) has improved the diagnosis of peripheral pulmonary lesions (PPLs). Because of the high cost of the GS, REBUS with distance (REBUS-D) has certain advantages. The aim of this study was to compare the diagnostic yield of the REBUS-GS and REBUS-D by thin bronchoscopy for PPLs. Methods Patients with PPLs were enrolled in a prospective randomized crossover study from August 2014 and July 2015. Once the lesion was localized, TBB using REBUS-GS and TBB using REBUS-D were performed sequentially in a randomized order in each patient. Each patient received four to five transbronchial biopsies with REBUS-GS as well as four to five transbronchial biopsies with REBUS-D. All brushing was performed through GS. Results A total of 54 patients were enrolled in this study. After excluding seven participants with PPLs that were not detected by REBUS, a total of 47 subjects underwent REBUS-TBB. The diagnostic yield of REBUS-GS-TBB and REBUS-D-TBB was 72.2% (39/54) and 75.9% (41/54) respectively (P=0.625). Moreover, there was no statistically significant difference in diagnostic yield between REBUS-GS and REBUS-D in different lobe lesions and lesion sizes. Two cases of adenocarcinoma were only diagnosed with REBUS-GS-TBB. Two cases of tuberculosis, one case of mucosa-associated lymphoid tissue lymphoma (MALT) and one case of adenocarcinoma were only diagnosed by REBUS-D-TBB. The mean biopsy time after visualization of PPLs for REBUS-GS-TBB and REBUS-D-TBB were 5.17±2.34 and 7.36±3.18 min (P=0.00053). Conclusions Using thin bronchoscopy, the diagnostic yield for PPLs with REBUS-D-TBB is not inferior to the yield with REBUS-GS-TBB. The diagnosis rate of small subpleural lesions with REBUS-D is lower than the rate with REBUS-GS. Although it is associated with shorter operation time and less bleeding, REBUS-GS has a higher cost and sometimes leads to check failure due to small

  1. Generic phytosanitary irradiation treatments

    USDA-ARS?s Scientific Manuscript database

    The history of the development of generic phytosanitary irradiation (PI) treatments is discussed beginning with its initial proposal in 1986. Generic PI treatments in use today are 150 Gy for all hosts of Tephritidae, 250 Gy for all arthropods on mango and papaya shipped from Australia to New Zeala...

  2. NSUF Irradiated Materials Library

    SciTech Connect

    Cole, James Irvin

    2015-09-01

    The Nuclear Science User Facilities has been in the process of establishing an innovative Irradiated Materials Library concept for maximizing the value of previous and on-going materials and nuclear fuels irradiation test campaigns, including utilization of real-world components retrieved from current and decommissioned reactors. When the ATR national scientific user facility was established in 2007 one of the goals of the program was to establish a library of irradiated samples for users to access and conduct research through competitively reviewed proposal process. As part of the initial effort, staff at the user facility identified legacy materials from previous programs that are still being stored in laboratories and hot-cell facilities at the INL. In addition other materials of interest were identified that are being stored outside the INL that the current owners have volunteered to enter into the library. Finally, over the course of the last several years, the ATR NSUF has irradiated more than 3500 specimens as part of NSUF competitively awarded research projects. The Logistics of managing this large inventory of highly radioactive poses unique challenges. This document will describe materials in the library, outline the policy for accessing these materials and put forth a strategy for making new additions to the library as well as establishing guidelines for minimum pedigree needed to be included in the library to limit the amount of material stored indefinitely without identified value.

  3. Irradiating insect pests

    USDA-ARS?s Scientific Manuscript database

    This is a non-technical article focusing on phytosanitary uses of irradiation. In a series of interview questions, I present information on the scope of the invasive species problem and the contribution of international trade in agricultural products to the movement of invasive insects. This is foll...

  4. Phytosanitary applications of irradiation

    USDA-ARS?s Scientific Manuscript database

    Phytosanitary treatments are used to disinfest agricultural commodities of quarantine pests so the commodities can be shipped across quarantine barriers to trade. Ionizing irradiation is a promising treatment that is increasing in use. Almost 19,000 tons of sweet potatoes and several fruits, plus ...

  5. Update on meat irradiation

    SciTech Connect

    Olson, D.G.

    1997-12-01

    The irradiation of meat and poultry in the United States is intended to eliminate pathogenic bacteria from raw product, preferably after packaging to prevent recontamination. Irradiation will also increase the shelf life of raw meat and poultry products approximately two to three times the normal shelf life. Current clearances in the United States are for poultry (fresh or frozen) at doses from 1.5 to 3.0 kGy and for fresh pork at doses from 0.3 to 1.0 kGy. A petition for the clearance of all red meat was submitted to the Food and Drug Administration (FDA) in July 1994. The petition is for clearances of fresh meat at doses from 1.5 to 4.5 kGy and for frozen meat at {approximately}2.5 to 7.5 kGy. Clearance for red meat is expected before the end of 1997. There are 28 countries that have food irradiation clearances, of which 18 countries have clearances for meat or poultry. However, there are no uniform categories or approved doses for meat and poultry among the countries that could hamper international trade of irradiated meat and poultry.

  6. Food irradiation: Activities and potentialities

    NASA Astrophysics Data System (ADS)

    Doellstaedt, R.; Huebner, G.

    After the acceptance of food irradiation up to an overall average dose of 10 kGy recommended by the Joint FAO/IAEA/WHO Expert Committee on the Wholesomeness of Irradiated Food in October 1980, the G.D.R. started a programme for the development of techniques for food irradiation. A special onion irradiator was designed and built as a pilot plant for studying technological and economic parameters of the irradiation of onions. The new principle of bulk-cargo irradiation allows the integration of this technology into the usual harvest technology for onions on the way from field to storage. Scientific and applied research work has been carried out in the past 3 yr on the irradiation of spices, potatoes, eviscerated chicken, animal feeds, fodder yeast, drugs and vaccines. In connection with the irradiation of eviscerated chicken, fodder yeast and animal feeds the basis of an antisalmonella programme has been discussed. Germ-count-reduced spices were employed for the production of test charges of preserves and tinned products. The results have led to the decision to design and build a new multipurpose irradiator for food irradiation. In order to cover the legal aspects of food irradiation the Ministry of Health issued regulations concerning the recommendation of irradiated food in the G.D.R.

  7. Storage of pork by irradiation

    NASA Astrophysics Data System (ADS)

    Shupei, Liu; Renli, Yang; Chixum, Chen; Yongzhi, Wang; Zhen, Sun

    In this paper the study of storage of pork, irradiated with Co-60 gamma rays, is recommended. The changes of the appearance and the main qualitative, indexes of pork, irradiated with 1.5 M rad radiation and after two month's storage, were analysed. The evaluation of storage. Transportation and nutritional acceptability of the two kinds of irradiated pork products was made. Systematic toxicological tests of rats and dogs, fed with irradiated pork, were given. The comparison of the economic facilitation of refrigerated pork and irradiated pork was made

  8. ELECTRON IRRADIATION OF SOLIDS

    DOEpatents

    Damask, A.C.

    1959-11-01

    A method is presented for altering physical properties of certain solids, such as enhancing the usefulness of solids, in which atomic interchange occurs through a vacancy mechanism, electron irradiation, and temperature control. In a centain class of metals, alloys, and semiconductors, diffusion or displacement of atoms occurs through a vacancy mechanism, i.e., an atom can only move when there exists a vacant atomic or lattice site in an adjacent position. In the process of the invention highenergy electron irradiation produces additional vacancies in a solid over those normally occurring at a given temperature and allows diffusion of the component atoms of the solid to proceed at temperatures at which it would not occur under thermal means alone in any reasonable length of time. The invention offers a precise way to increase the number of vacancies and thereby, to a controlled degree, change the physical properties of some materials, such as resistivity or hardness.

  9. BIOLOGICAL IRRADIATION FACILITY

    DOEpatents

    McCorkle, W.H.; Cern, H.S.

    1962-04-24

    A facility for irradiating biological specimens with neutrons is described. It includes a reactor wherein the core is off center in a reflector. A high-exposure room is located outside the reactor on the side nearest the core while a low-exposure room is located on the opposite side. Means for converting thermal neutrons to fast neutrons are movably disposed between the reactor core and the high and low-exposure rooms. (AEC)

  10. Surface segregation during irradiation

    SciTech Connect

    Rehn, L.E.; Lam, N.Q.

    1985-10-01

    Gibbsian adsorption is known to alter the surface composition of many alloys. During irradiation, four additional processes that affect the near-surface alloy composition become operative: preferential sputtering, displacement mixing, radiation-enhanced diffusion and radiation-induced segregation. Because of the mutual competition of these five processes, near-surface compositional changes in an irradiation environment can be extremely complex. Although ion-beam induced surface compositional changes were noted as long as fifty years ago, it is only during the past several years that individual mechanisms have been clearly identified. In this paper, a simple physical description of each of the processes is given, and selected examples of recent important progress are discussed. With the notable exception of preferential sputtering, it is shown that a reasonable qualitative understanding of the relative contributions from the individual processes under various irradiation conditions has been attained. However, considerably more effort will be required before a quantitative, predictive capability can be achieved. 29 refs., 8 figs.

  11. ATF Neutron Irradiation Program Irradiation Vehicle Design Concepts

    SciTech Connect

    Geringer, J. W.; Katoh, Yutai; Howard, Richard H.; Cetiner, N. O.; Petrie, Christian M.; Smith, Kurt R.; McDuffee, J. M.

    2016-03-01

    The Japan Atomic Energy Agency (JAEA) under the Civil Nuclear Energy Working Group (CNWG) is engaged in a cooperative research effort with the U.S. Department of Energy (DOE) to explore issues related to nuclear energy, including research on accident-tolerant fuels and materials for use in light water reactors. This work develops a draft technical plan for a neutron irradiation program on the candidate accident-tolerant fuel cladding materials and elements using the High Flux Isotope Reactor (HFIR). The research program requires the design of a detailed experiment, development of test vehicles, irradiation of test specimens, possible post irradiation examination and characterization of irradiated materials and the shipment of irradiated materials to Japan. This report discusses the conceptual design, the development and irradiation of the test vehicles.

  12. FDA perspective on food irradiation

    SciTech Connect

    Pauli, G.H.

    1994-12-31

    The Center for Food Safety and Applied Nutrition (CFSAN) monitors the safety of food irradiation. A few limited uses are regulated, and occasionally CFSAN receives a petition for a new use. Despite extensive studies (more than 400) showing the safety of food irradiation, a cloud of suspicion continues to hang over this issue in the mind of the public. People perceive food irradiation and direct body irradiation as having similar implications. Food irradiation is banned in two states in the United States. Food is irradiated for the following purposes: delay of ripening, prevention of sprouting, eradication of pests and sterilization, and allowing commodities to be stored unrefrigerated for long periods of time. The dosage depends on the purpose of the irradiation. Radiolytic products are formed during irradiation and during storage afterward. Most of these products are also formed during conventional preservation. In 1980, CFSAN, then the Bureau of Foods, introduced the term unique radiolytic products for compounds not identified in foods after conventional processing. Although the existence of URPs was never proven chemically, the term has caused anxiety. Irradiation of foods in the commercially useful range does not generate radioactivity above natural background. Because radiolytic products formed from beef, chicken, and pork are primarily the same, irradiated foods of similar food groups may be evaluated generically.

  13. Post-irradiation effects in polyethylenes irradiated under various atmospheres

    NASA Astrophysics Data System (ADS)

    Suljovrujic, E.

    2013-08-01

    If a large amount of polymer free radicals remain trapped after irradiation of polymers, the post-irradiation effects may result in a significant alteration of physical properties during long-term shelf storage and use. In the case of polyethylenes (PEs) some failures are attributed to the post-irradiation oxidative degradation initiated by the reaction of residual free radicals (mainly trapped in crystal phase) with oxygen. Oxidation products such as carbonyl groups act as deep traps and introduce changes in carrier mobility and significant deterioration in the PEs electrical insulating properties. The post-irradiation behaviour of three different PEs, low density polyethylene (LDPE), linear low density polyethylene (LLDPE) and high density polyethylene (HDPE) was studied; previously, the post-irradiation behaviour of the PEs was investigated after the irradiation in air (Suljovrujic, 2010). In this paper, in order to investigate the influence of different irradiation media on the post-irradiation behaviour, the samples were irradiated in air and nitrogen gas, to an absorbed dose of 300 kGy. The annealing treatment of irradiated PEs, which can substantially reduce the concentration of free radicals, is used in this study, too. Dielectric relaxation behaviour is related to the difference in the initial structure of PEs (such as branching, crystallinity etc.), to the changes induced by irradiation in different media and to the post-irradiation changes induced by storage of the samples in air. Electron spin resonance (ESR), differential scanning calorimetry (DSC), infra-red (IR) spectroscopy and gel measurements were used to determine the changes in the free radical concentration, crystal fraction, oxidation and degree of network formation, respectively.

  14. Replacement of 137Cs irradiators with x-ray irradiators.

    PubMed

    Dodd, Brian; Vetter, Richard J

    2009-02-01

    Self-shielded 137Cs irradiators have been used for many years to irradiate blood products to prevent graft vs. host disease and to irradiate cells and small animals in research. A report by the National Academy of Sciences recommends that careful consideration be given to replacement of 137Cs irradiators with x-ray irradiators. Several manufacturers and users of x-ray irradiators were contacted to determine costs of replacing and maintaining 137Cs irradiators with x-ray units and to assess users' experience with x-ray irradiators. Purchase costs of x-ray units are similar to 137Cs irradiators, but maintenance costs are significantly higher if annual service contracts are used. Performance of the two irradiator types appears to be equivalent, but in some cases x-ray irradiations may need to be performed in multiple configurations to achieve adequate uniformity in dose. No literature reports were found that evaluated the biological effectiveness of x rays vs. 137Cs gamma rays; therefore, a careful study should be conducted to determine the biological effectiveness of x rays vs. 137Cs gamma rays for biological responses relevant to transfusion medicine and immunological research. Throughput may be problematic for large transfusion medicine programs, and back-up plans may be necessary in case the x-ray unit needs to be taken out of service for extended maintenance. Disposition of a 137Cs irradiator will add to the cost of replacement with an x-ray unit, but disposal may be possible through the U.S. Department of Energy's Off-Site Source Recovery Program.

  15. Models of Solar Irradiance Variability

    NASA Astrophysics Data System (ADS)

    Solanki, Sami K.

    2015-08-01

    Models of solar irradiance variability have an important role to play due to the relatively short (although steadily increasing) length of measured irradiance time series. Advanced models also allow identifying the source of solar irradiance variations and give insight into the variation of irradiance as a function of wavelength. The first generation of models of solar irradiance were proxy-based, i.e. purely empirical. These were followed by models that combine spectra computed from semi-empirical model atmospheres, with a measure of solar activity variations. In future, models will build increasingly on 3D MHD simulations instead of 1D model atmospheres to compute the spectra. On longer timescales models are generally simpler, although there too considerable progress has been made, with irradiance reconstructions now available for multiple millennia, albeit with lower resolution and accuracy than at shorter timescales.

  16. Craniospinal irradiation techniques

    SciTech Connect

    Scarlatescu, Ioana Avram, Calin N.; Virag, Vasile

    2015-12-07

    In this paper we present one treatment plan for irradiation cases which involve a complex technique with multiple beams, using the 3D conformational technique. As the main purpose of radiotherapy is to administrate a precise dose into the tumor volume and protect as much as possible all the healthy tissues around it, for a case diagnosed with a primitive neuro ectoderm tumor, we have developed a new treatment plan, by controlling one of the two adjacent fields used at spinal field, in a way that avoids the fields superposition. Therefore, the risk of overdose is reduced by eliminating the field divergence.

  17. Endobronchial cryotherapy for a mycetoma.

    PubMed

    Rojas-Tula, Diego Germán; Gómez-Fernández, Máximo; García-López, José Javier; Cobos-Ceballos, María Jesús; Gil-Fuentes, América; Pérez-Laya, Jesús Manuel; Serrano-Rebollo, José Carlos; Ortega-González, Angel; Vargas-Hidalgo, Teresa; Ruíz de Oña-Lacasta, José María; Celdrán-Gil, José

    2013-10-01

    Mycetoma is defined as a fungus ball that fills a preexisting lung cavity, most frequently being of tuberculous or sarcoid etiology. The most frequently isolated fungus is the species of Aspergillus, but other fungi such as Fusarium or Zygomycetes can also be present. Most patients lack symptoms. However, presentation may also be with hemoptysis, which can be massive and life-threatening. We describe the case of a 50-year-old man with a history of prior pulmonary tuberculosis, with recurrent episodes of cough and hemoptysis. He was diagnosed to have mycetoma in the left upper lobe cavity. The mycetoma was extracted through bronchoscopy under general anesthesia using a cryoprobe. Treatment was completed with amphotericin B instilled in the cavity and the patient was placed on oral itraconazole. This is the first case report to date in which cryotherapy was used to remove a mycetoma.

  18. Food irradiation and the consumer

    NASA Astrophysics Data System (ADS)

    A Thomas, P.

    The poster presents a review of research work undertaken on the perception and understanding that consumers have of food irradiation. Food irradiation is not a revolutionary new food processing technique, in fact it is probably one of the most investigated methods presently available. Many countries such as Belgium, France, Denmark, Italy, Spain, the Netherlands and the United States of America permit food irradiation. In Britain it is presently banned although this is currently under review. Awareness of food irradiation by the general public in Britain, although not extensively researched would appear to be increasing, especially in the light of recent media coverage. New quantitative and qualitative work indicates that the general public are concerned about the safety and effectiveness of food irradiation. Research has shown that a large proportion of consumers in Britain, if given the opportunity to purchase irradiated food, would not do so. Further exploration into this response revealed the fact that consumers are confused over what food irradiation is. In addition, there is concern over the detection of irradiated food. The views presented in this paper, of the consumer reaction to irradiated food are of great importance to those involved in the food industry and industries allied to it, which are ultimately dependent on the consumer for their commercial survival.

  19. Irradiation of northwest agricultural products

    NASA Astrophysics Data System (ADS)

    Eakin, D. E.; Tingey, G. I.

    1985-02-01

    Irradiation of food for disinfestation and preservation is increasing in importance because of increasing restrictions on various chemical treatments. Irradiation treatment is of particular interest in the Northwest because of a growing supply of agricultural products and the need to develop new export markets. Several products have, or could potentially have, significant export markets if stringent insect ocntrol procedures are developed and followed. Due to the recognized potential benefits of irradiation, this program was conducted to evaluate the benefits of using irradiation on Northwest agricultural products. Commodities currently included in the program are cherries, apples, asparagus, spices, hay, and hides.

  20. Food irradiation and sterilization

    NASA Astrophysics Data System (ADS)

    Josephson, Edward S.

    Radiation sterilization of food (radappertization) requires exposing food in sealed containers to ionizing radiation at absorbed doses high enough (25-70 kGy) to kill all organisms of food spoilage and public health significance. Radappertization is analogous to thermal canning is achieving shelf stability (long term storage without refrigeration). Except for dry products in which autolysis is negligible, the radappertization process also requires that the food be heated to an internal temperature of 70-80°C (bacon to 53°C) to inactivate autolytic enzymes which catalyze spoilage during storage without refrigeration. To minimize the occurence of irradiation induced off-flavors and odors, undesirable color changes, and textural and nutritional losses from exposure to the high doses required for radappertization, the foods are vacuum sealed and irradiated frozen (-40°C to -20°C). Radappertozed foods have the characteristic of fresh foods prepared for eating. Radappertization can substitute in whole or in part for some chemical food additives such as ethylene oxide and nitrites which are either toxic, carcinogenic, mutagenic, or teratogenic. After 27 years of testing for "wholesomeness" (safety for consumption) of radappertized foods, no confirmed evidence has been obtained of any adverse effecys of radappertization on the "wholesomeness" characteristics of these foods.

  1. Wholesomeness of irradiated food

    NASA Astrophysics Data System (ADS)

    Ehlermann, Dieter A. E.

    2016-12-01

    Just with the emergence of the idea to treat food by ionizing radiation, the concerns were voiced whether it would be safe to consume such food. Now, we look back on more than hundred years of research into the 'wholesomeness', a terminology developed during those efforts. This review will cover the many questions which had been raised, explaining the most relevant ones in some detail; it will also give place to the concerns and elucidate their scientific relevance and background. There has never been any other method of food processing studied in such depth and in such detail as food irradiation. The conclusion based on science is: Consumption of any food treated at any high dose is safe, as long as the food remains palatable. This conclusion has been adopted by WHO, also by international and national bodies. Finally, this finding has also been adopted by Codex Alimentarius in 2003, the international standard for food. However, this conclusion has not been adopted and included at its full extent in most national regulations. As the literature about wholesomeness of irradiated food is abundant, this review will use only a few, most relevant references, which will guide the reader to further reading.

  2. Irradiation hardening of pure tungsten exposed to neutron irradiation

    NASA Astrophysics Data System (ADS)

    Hu, Xunxiang; Koyanagi, Takaaki; Fukuda, Makoto; Kumar, N. A. P. Kiran; Snead, Lance L.; Wirth, Brian D.; Katoh, Yutai

    2016-11-01

    Pure tungsten samples have been neutron irradiated in HFIR at 90-850 °C to 0.03-2.2 dpa. A dispersed barrier hardening model informed by the available microstructure data has been used to predict the hardness. Comparison of the model predictions and the measured Vickers hardness reveals the dominant hardening contribution at various irradiation conditions. For tungsten samples irradiated in HFIR, the results indicate that voids and dislocation loops contributed to the hardness increase in the low dose region (<0.3 dpa), while the formation of intermetallic second phase precipitation, resulting from transmutation, dominates the radiation-induced strengthening beginning with a relatively modest dose (>0.6 dpa). The precipitate contribution is most pronounced for the HFIR irradiations, whereas the radiation-induced defect cluster microstructure can rationalize the entirety of the hardness increase observed in tungsten irradiated in the fast neutron spectrum of Joyo and the mixed neutron spectrum of JMTR.

  3. Consumer acceptance of irradiated poultry.

    PubMed

    Hashim, I B; Resurreccion, A V; McWatters, K H

    1995-08-01

    A simulated supermarket setting (SSS) test was conducted to determine whether consumers (n = 126) would purchase irradiated poultry products, and the effects of marketing strategies on consumer purchase of irradiated poultry products. Consumer preference for irradiated poultry was likewise determined using a home-use test. A slide program was the most effective educational strategy in changing consumers' purchase behavior. The number of participants who purchased irradiated boneless, skinless breasts and irradiated thighs after the educational program increased significantly from 59.5 and 61.9% to 83.3 and 85.7% for the breasts and thighs, respectively. Using a label or poster did not increase the number of participants who bought irradiated poultry products. About 84% of the participants consider it either "somewhat necessary" or "very necessary" to irradiate raw chicken and would like all chicken that was served in restaurants or fast food places to be irradiated. Fifty-eight percent of the participants would always buy irradiated chicken if available, and an additional 27% would buy it sometimes. About 44% of the participants were willing to pay the same price for irradiated chicken as for nonirradiated. About 42% of participants were willing to pay 5% or more than what they were currently paying for nonirradiated chicken. Seventy-three percent or more of consumers who participated in the home-use test (n = 74) gave the color, appearance, and aroma of the raw poultry products a minimum rating of 7 (= like moderately). After consumers participated in a home-use test, 84 and 88% selected irradiated thighs and breasts, respectively, over nonirradiated in a second SSS test.

  4. Consumer attitude toward food irradiation

    SciTech Connect

    Bruhn, C.M.M.

    1986-01-01

    Consumer attitudes toward food irradiation were evaluated. The influence of educational efforts on consumer concern for the safety of irradiated products and willingness to buy irradiated foods were measured. Demographic and psychological factors were studied in relation to attitudes. An educational leaflet describing current scientific information regarding the safety, advantages, and disadvantages of food irradiation was developed and used in two studies evaluating attitude change. In the first study, attitude change among two groups of consumers with different philosophic orientations was measured. In a second study, the effectiveness of an educational leaflet received through the mail and a poster display were examined. In a third study response to food irradiation was related to value hierarchy, locus of control, innovativeness, and demographic parameters. Initially, subjects showed a higher concern for other areas of food safety, particularly the use of chemicals and sprays on food, than toward food irradiation. After educational efforts, conventional consumers expressed minor concern toward irradiation whereas ecologically sensitive alternative consumers obtained from a food cooperative expressed major concern. A knowledgeable discussion leader lowered irradiation concern among conventional consumers. In contrast, concern among alternative consumers did not diminish when given the opportunity to discuss safety issues with a knowledgeable person.

  5. Commercial implementation of food irradiation

    NASA Astrophysics Data System (ADS)

    Welt, M. A.

    In July 1981, the first specifically designed multi-purpose irradiation facility for food irradiation was put into service by the Radiation Technology, Inc. subsidiary Process Technology, Inc. in West Memphis, Arkansas. The operational experience gained, resulted in an enhanced design which was put into commercial service in Haw River, North Carolina, by another subsidiary, Process Technology (N.C.), Inc. in October 1983. These facilities have enabled the food industry to assess the commercial viability of food irradiation. Further impetus towards commercialization of food irradiation was gained in March 1981 with the filing in the Federal Register, by the FDA, of an Advanced Proposed Notice of Rulemaking for Food Irradiation. Two years later in July 1983, the FDA approved the first food additive regulation involving food irradiation in nineteen years, when they approved the Radiation Technology, Inc. petition calling for the sanitization of spices, onion powder and garlic powder at a maximum dosage of 10 kGy. Since obtaining the spice irradiation approval, the FDA has accepted four additional petitions for filing in the Federal Register. One of the petitions which extended spice irradiation to include insect disinfestation has issued into a regulation while the remaining petitions covering the sanitization of herbs, spice blends, vegetable seasonings and dry powdery enzymes as well as the petition to irradiate hog carcasses and pork products for trichinae control at 1 kGy, are expected to issue either before the end of 1984 or early in 1985. More recently, food irradiation advocates in the United States received another vote of confidence by the announcement that a joint venture food irradiation facility to be constructed in Hawaii by Radiation Technology, is backed by a contractual committment for the processing of 40 million pounds of produce per year. Another step was taken when the Port of Salem, New Jersey announced that the Radiation Technology Model RT-4104

  6. Irradiation of fresh fish

    NASA Astrophysics Data System (ADS)

    Yueh-jen, Yen; Jin-lai, Zhou; Shao-chun, Lai

    Occasionally, in China, marine products can not be provided for the markets in good quality, for during the time when they are being transported from the sea port to inland towns or even at the time when they are unloaded from the ship, they are beginning to spoil. Obviously, it is very important that appropiate measures should be taken to prevent them from decay. Our study has proved that the shelf life of fresh Flatfish (Cynoglossue robustus) and Silvery pomfret (stromateoides argenteus), which, packed in sealed containers, are irradiated by 1.5 kGy, 2.2 kGy and 3.0 kGy, can be stored for about 13-26 days at 3° - 5° C.

  7. Pallet irradiators for food processing

    NASA Astrophysics Data System (ADS)

    McKinnon, R. G.; Chu, R. D. H.

    This paper looks at the various design concepts for the irradiation processing of food products, with particular emphasis on handling the products on pallets. Pallets appear to offer the most attractive method for handling foods from many considerations. Products are transported on pallets. Warehouse space is commonly designed for pallet storage and, if products are already palletized before and after irradiation, then labour could be saved by irradiating on pallets. This is also an advantage for equipment operation since a larger carrier volume means lower operation speeds. Different pallet irradiator design concepts are examined and their suitability for several applications are discussed. For example, low product holdup for fast turn around will be a consideration for those operating an irradiation "service" business; others may require a very large source where efficiency is the primary requirement and this will not be consistent with low holdup. The radiation performance characteristics and processing costs of these machines are discussed.

  8. Phytosanitary irradiation - Development and application

    NASA Astrophysics Data System (ADS)

    Hallman, Guy J.; Loaharanu, Paisan

    2016-12-01

    Phytosanitary irradiation, the use of ionizing radiation to disinfest traded agricultural commodities of regulated pests, is a growing use of food irradiation that has great continued potential for increase in commercial application. In 2015 approximately 25,000 t of fresh fruits and vegetables were irradiated globally for phytosanitary purposes. Phytosanitary irradiation has resulted in a paradigm shift in phytosanitation in that the final burden of proof of efficacy of the treatment has shifted from no live pests upon inspection at a port of entry (as for all previous phytosanitary treatments) to total dependence on certification that the treatment for target pests is based on adequate science and is commercially conducted and protected from post-treatment infestation. In this regard phytosanitary irradiation is managed more like a hazard analysis and critical control point (HACCP) approach more consistent with food safety than phytosanitation. Thus, phytosanitary irradiation offers a more complete and rigorous methodology for safeguarding than other phytosanitary measures. The role of different organizations in achieving commercial application of phytosanitary irradiation is discussed as well as future issues and applications, including new generic doses.

  9. Proton irradiation of simple gas mixtures: Influence of irradiation parameters

    NASA Technical Reports Server (NTRS)

    Sack, Norbert J.; Schuster, R.; Hofmann, A.

    1990-01-01

    In order to get information about the influence of irradiation parameters on radiolysis processes of astrophysical interest, methane gas targets were irradiated with 6.5 MeV protons at a pressure of 1 bar and room temperature. Yields of higher hydrocarbons like ethane or propane were found by analysis of irradiated gas samples using gas chromatography. The handling of the proton beam was of great experimental importance for determining the irradiation parameters. In a series of experiments current density of the proton beam and total absorbed energy were shown to have a large influence on the yields of produced hydrocarbons. Mechanistic interpretations of the results are given and conclusions are drawn with regard to the chemistry and the simulation of various astrophysical systems.

  10. New facility for post irradiation examination of neutron irradiated beryllium

    SciTech Connect

    Ishitsuka, Etsuo; Kawamura, Hiroshi

    1995-09-01

    Beryllium is expected as a neutron multiplier and plasma facing materials in the fusion reactor, and the neutron irradiation data on properties of beryllium up to 800{degrees}C need for the engineering design. The acquisition of data on the tritium behavior, swelling, thermal and mechanical properties are first priority in ITER design. Facility for the post irradiation examination of neutron irradiated beryllium was constructed in the hot laboratory of Japan Materials Testing Reactor to get the engineering design data mentioned above. This facility consist of the four glove boxes, dry air supplier, tritium monitoring and removal system, storage box of neutron irradiated samples. Beryllium handling are restricted by the amount of tritium;7.4 GBq/day and {sup 60}Co;7.4 MBq/day.

  11. AFIP-4 Irradiation Summary Report

    SciTech Connect

    Danielle M Perez; Misti A Lillo; Gray S. Chang; Glenn A Roth; Nicolas Woolstenhulme; Daniel M Wachs

    2011-09-01

    The Advanced Test Reactor (ATR) Full size plate In center flux trap Position (AFIP) experiment AFIP-4 was designed to evaluate the performance of monolithic uranium-molybdenum (U-Mo) fuels at a scale prototypic of research reactor fuel plates. The AFIP-4 test further examine the fuel/clad interface and its behavior under extreme conditions. After irradiation, fission gas retention measurements will be performed during post irradiation (PIE). The following report summarizes the life of the AFIP-4 experiment through end of irradiation, including a brief description of the safety analysis, as-run neutronic analysis results, hydraulic testing results, and thermal analysis results.

  12. AFIP-4 Irradiation Summary Report

    SciTech Connect

    Danielle M Perez; Misti A Lillo; Gray S. Chang; Glenn A Roth; Nicolas Woolstenhulme; Daniel M Wachs

    2012-01-01

    The Advanced Test Reactor (ATR) Full size plate In center flux trap Position (AFIP) experiment AFIP-4 was designed to evaluate the performance of monolithic uranium-molybdenum (U-Mo) fuels at a scale prototypic of research reactor fuel plates. The AFIP-4 test further examine the fuel/clad interface and its behavior under extreme conditions. After irradiation, fission gas retention measurements will be performed during post irradiation (PIE)1,2. The following report summarizes the life of the AFIP-4 experiment through end of irradiation, including a brief description of the safety analysis, as-run neutronic analysis results, hydraulic testing results, and thermal analysis results.

  13. (Irradiation creep of graphite)

    SciTech Connect

    Kennedy, C.R.

    1990-12-21

    The traveler attended the Conference, International Symposium on Carbon, to present an invited paper, Irradiation Creep of Graphite,'' and chair one of the technical sessions. There were many papers of particular interest to ORNL and HTGR technology presented by the Japanese since they do not have a particular technology embargo and are quite open in describing their work and results. In particular, a paper describing the failure of Minor's law to predict the fatigue life of graphite was presented. Although the conference had an international flavor, it was dominated by the Japanese. This was primarily a result of geography; however, the work presented by the Japanese illustrated an internal program that is very comprehensive. This conference, a result of this program, was better than all other carbon conferences attended by the traveler. This conference emphasizes the need for US participation in international conferences in order to stay abreast of the rapidly expanding HTGR and graphite technology throughout the world. The United States is no longer a leader in some emerging technologies. The traveler was surprised by the Japanese position in their HTGR development. Their reactor is licensed and the major problem in their graphite program is how to eliminate it with the least perturbation now that most of the work has been done.

  14. Generic phytosanitary irradiation treatments

    NASA Astrophysics Data System (ADS)

    Hallman, Guy J.

    2012-07-01

    The history of the development of generic phytosanitary irradiation (PI) treatments is discussed beginning with its initial proposal in 1986. Generic PI treatments in use today are 150 Gy for all hosts of Tephritidae, 250 Gy for all arthropods on mango and papaya shipped from Australia to New Zealand, 300 Gy for all arthropods on mango shipped from Australia to Malaysia, 350 Gy for all arthropods on lychee shipped from Australia to New Zealand and 400 Gy for all hosts of insects other than pupae and adult Lepidoptera shipped to the United States. Efforts to develop additional generic PI treatments and reduce the dose for the 400 Gy treatment are ongoing with a broad based 5-year, 12-nation cooperative research project coordinated by the joint Food and Agricultural Organization/International Atomic Energy Agency Program on Nuclear Techniques in Food and Agriculture. Key groups identified for further development of generic PI treatments are Lepidoptera (eggs and larvae), mealybugs and scale insects. A dose of 250 Gy may suffice for these three groups plus others, such as thrips, weevils and whiteflies.

  15. Respiratory Cytology--Current Trends Including Endobronchial Ultrasound-Guided Biopsy and Electromagnetic Navigational Bronchoscopy: Analysis of Data From a 2013 Supplemental Survey of Participants in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytology.

    PubMed

    Sturgis, Charles D; Marshall, Carrie B; Barkan, Guliz A; Booth, Christine N; Kurtycz, Daniel F I; Souers, Rhona J; Keylock, Joren B; Tabatabai, Z Laura; Russell, Donna K; Moriarty, Ann T; Doyle, Mary A; Thomas, Nicole; Yildiz-Aktas, Isil Z; Collins, Brian T; Laucirica, Rodolfo; Crothers, Barbara A

    2016-01-01

    Nongynecologic cytology (NGC) practices are expanding in relationship to historical gynecologic cytology screening programs. Bronchopulmonary cytology is experiencing an evolution regarding new procedural types. The College of American Pathologists (CAP) tracks practice patterns in NGC by developing questionnaires, surveying participants, and analyzing respondent data. To analyze responses to a 2013 CAP supplemental survey from the Interlaboratoy Comparison Program on bronchopulmonary NGC. The "NGC 2013 Supplemental Questionnaire: Demographics in Performance and Reporting of Respiratory Cytology" was mailed to 2074 laboratories. The survey response rate was 42% (880 of 2074) with 90% of respondents (788 of 880) indicating that their laboratories evaluated cytology bronchopulmonary specimens. More than 95% of respondents indicated interpreting bronchial washings (765 of 787) and bronchial brushings (757 of 787). A minority of laboratories (43%, 340 of 787) dealt with endobronchial ultrasound-guided samples, and an even smaller fraction of laboratories (14%, 110 of 787) saw cases from electromagnetic navigational bronchoscopy. Intraprocedural adequacy assessments by pathologists (and less often by cytotechnologists or pathologists-in-training) were routinely performed in percutaneous transthoracic aspiration cases (74%, 413 of 560) with less involvement for other case types. Most laboratories reported that newly diagnosed primary pulmonary adenocarcinomas were triaged for molecular testing of epidermal growth factor receptor and anaplastic lymphoma kinase. The parameters examined in this 2013 survey provide a snapshot of current pulmonary cytopathology practice and may be used as benchmarks in the future.

  16. Relationship of the Content of Systemic and Endobronchial Soluble Molecules of CD25, CD38, CD8, and HLA-I-CD8 and Lung Function Parameters in COPD Patients.

    PubMed

    Kubysheva, Nailya; Postnikova, Larisa; Soodaeva, Svetlana; Novikov, Viкtor; Eliseeva, Tatyana; Batyrshin, Ildar; Li, Timur; Klimanov, Igor; Chuchalin, Alexander

    2017-01-01

    The definition of new markers of local and systemic inflammation of chronic obstructive pulmonary disease (COPD) is one of the priority directions in the study of pathogenesis and diagnostic methods improvement for this disease. We investigated 91 patients with COPD and 21 healthy nonsmokers. The levels of soluble CD25, CD38, CD8, and HLA-I-CD8 molecules in the blood serum and exhaled breath condensate (EBC) in moderate-to-severe COPD patients during exacerbation and stable phase were studied. An unidirectional change in the content of sCD25, sCD38, and sCD8 molecules with increasing severity of COPD was detected. The correlations between the parameters of lung function and sCD8, sCD25, and sHLA-I-CD8 levels in the blood serum and EBC were discovered in patients with severe COPD. The findings suggest a pathogenetic role of the investigated soluble molecules of the COPD development and allow considering the content of sCD8, sCD25, and sHLA-I-CD8 molecules as additional novel systemic and endobronchial markers of the progression of chronic inflammation of this disease.

  17. Comparison between endobronchial ultrasound-guided transbronchial biopsy and CT-guided transthoracic lung biopsy for the diagnosis of peripheral lung cancer: a systematic review and meta-analysis

    PubMed Central

    Zhan, Ping; Zhu, Qing-Qing; Miu, Ying-Ying; Liu, Ya-Fang; Wang, Xiao-Xia; Zhou, Ze-Jun; Jin, Jia-Jia; Li, Qian; Sasada, Shinji; Izumo, Takehiro; Tu, Chih-Yen; Cheng, Wen-Chien; Evison, Matthew

    2017-01-01

    Background With the release of the National Lung Screening Trial results, the detection of peripheral pulmonary lesions (PPLs) is likely to increase. Computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) and radial probe endobronchial ultrasound (r-EBUS)-guided transbronchial lung biopsy (TBLB) are recommended for tissue diagnosis of PPLs. Methods A systematic review of published literature evaluating the accuracy of r-EBUS-TBLB and CT-PTNB for the diagnosis of PPLs was performed to determine point sensitivity and specificity, and to construct a summary receiver-operating characteristic curve. Results This review included 31 publications dealing with EBUS-TBLB and 14 publications dealing with CT-PTNB for the diagnosis of PPLs. EBUS-TBLB had point sensitivity of 0.69 (95% CI: 0.67–0.71) for the diagnosis of peripheral lung cancer (PLC), which was lower than the sensitivity of CT-PTNB (0.94, 95% CI: 0.94–0.95). However, the complication rates observed with EBUS-TBLB were lower than those reported for CT-PTNB. Conclusions This meta-analysis showed that EBUS-TBLB is a safe and relatively accurate tool in the investigation of PLC. Although the yield remains lower than that of CT-PTNB, the procedural risks are lower. PMID:28331821

  18. Relationship of the Content of Systemic and Endobronchial Soluble Molecules of CD25, CD38, CD8, and HLA-I-CD8 and Lung Function Parameters in COPD Patients

    PubMed Central

    Postnikova, Larisa; Soodaeva, Svetlana; Li, Timur; Klimanov, Igor; Chuchalin, Alexander

    2017-01-01

    The definition of new markers of local and systemic inflammation of chronic obstructive pulmonary disease (COPD) is one of the priority directions in the study of pathogenesis and diagnostic methods improvement for this disease. We investigated 91 patients with COPD and 21 healthy nonsmokers. The levels of soluble CD25, CD38, CD8, and HLA-I-CD8 molecules in the blood serum and exhaled breath condensate (EBC) in moderate-to-severe COPD patients during exacerbation and stable phase were studied. An unidirectional change in the content of sCD25, sCD38, and sCD8 molecules with increasing severity of COPD was detected. The correlations between the parameters of lung function and sCD8, sCD25, and sHLA-I-CD8 levels in the blood serum and EBC were discovered in patients with severe COPD. The findings suggest a pathogenetic role of the investigated soluble molecules of the COPD development and allow considering the content of sCD8, sCD25, and sHLA-I-CD8 molecules as additional novel systemic and endobronchial markers of the progression of chronic inflammation of this disease. PMID:28848245

  19. Irradiation pretreatment for coal desulfurization

    NASA Technical Reports Server (NTRS)

    Hsu, G. C.

    1979-01-01

    Process using highly-penetrating nuclear radiation (Beta and Gamma radiation) from nuclear power plant radioactive waste to irradiate coal prior to conventional desulfurization procedures increases total extraction of sulfur.

  20. Irradiation pretreatment for coal desulfurization

    NASA Technical Reports Server (NTRS)

    Hsu, G. C.

    1979-01-01

    Process using highly-penetrating nuclear radiation (Beta and Gamma radiation) from nuclear power plant radioactive waste to irradiate coal prior to conventional desulfurization procedures increases total extraction of sulfur.

  1. Irradiation of Northwest agricultural products

    SciTech Connect

    Eakin, D.E.; Tingey, G.L.

    1985-02-01

    Irradiation of food for disinfestation and preservation is increasing in importance because of increasing restrictions on various chemical treatments. Irradiation treatment is of particular interest in the Northwest because of a growing supply of agricultural products and the need to develop new export markets. Several products have, or could potentially have, significant export markets if stringent insect control procedures are developed and followed. Due to the recognized potential benefits of irradiation, Pacific Northwest Laboratory (PNL) is conducting this program to evaluate the benefits of using irradiation on Northwest agricultural products under the US Department of Energy (DOE) Defense Byproducts Production and Utilization Program. Commodities currently included in the program are cherries, apples, asparagus, spices, hay, and hides.

  2. Slag recycling of irradiated vanadium

    SciTech Connect

    Gorman, Patrick K.

    1995-04-05

    An experimental inductoslag apparatus to recycle irradiated vanadium was fabricated and tested. An experimental electroslag apparatus was also used to test possible slags. The testing was carried out with slag materials that were fabricated along with impurity bearing vanadium samples. Results obtained include computer simulated thermochemical calculations and experimentally determined removal efficiencies of the transmutation impurities. Analyses of the samples before and after testing were carried out to determine if the slag did indeed remove the transmutation impurities from the irradiated vanadium.

  3. The PIREX proton irradiation facility

    SciTech Connect

    Victoria, M.

    1995-10-01

    The proton Irradiation Experiment (PIREX) is a materials irradiation facility installed in a beam line of the 590 MeV proton accelerator at the Paul Scherrer Institute. Its main purpose is the testing of candidate materials for fusion reactor components. Protons of this energy produce simultaneously displacement damage and spallation products, amongst them helium and can therefore simulate any possible synergistic effects of damage and helium, that would be produced by the fusion neutrons.

  4. Consumer attitudes toward irradiated food

    SciTech Connect

    Conley, S.

    1994-12-31

    Throughout history, new methods of food preservation have been met with skepticism and fear. Such processes as pasteurization and canning were denounced as being dangerous, detrimental to nutrients, or an excuse for dirty products. Now comes irradiation, and activists argue against this new process for the same reasons. Publicly, the perception is that consumers, distrustful of nuclear power, will never buy or accept irradiated food.

  5. Irradiation Induced Creep of Graphite

    SciTech Connect

    Burchell, Timothy D; Murty, Prof K.L.; Eapen, Dr. Jacob

    2010-01-01

    The current status of graphite irradiation induced creep strain prediction is reviewed and the major creep models are described. The ability of the models to quantitatively predict the irradiation induced creep strain of graphite is reported. Potential mechanisms of in-crystal creep are reviewed as are mechanisms of pore generation under stress. The case for further experimental work is made and the need for improved creep models across multi-scales is highlighted.

  6. Calculating Irradiance For Photosynthesis In The Ocean

    NASA Technical Reports Server (NTRS)

    Collins, Donald J.; Davis, Curtiss O.; Booth, C. Rockwell; Kiefer, Dale A.; Stallings, Casson

    1990-01-01

    Mathematical model predicts available and usable irradiances. Yields estimates of irradiance available for photosynthesis (Epar) and irradiance usable for photosynthesis (Epur) as functions of depth in ocean. Describes Epur and Epar in terms of spectral parameters measured remotely (from satellites or airplanes). These irradiances useful in studies of photosynthetic productivity of phytoplankton in euphotic layer.

  7. Calculating Irradiance For Photosynthesis In The Ocean

    NASA Technical Reports Server (NTRS)

    Collins, Donald J.; Davis, Curtiss O.; Booth, C. Rockwell; Kiefer, Dale A.; Stallings, Casson

    1990-01-01

    Mathematical model predicts available and usable irradiances. Yields estimates of irradiance available for photosynthesis (Epar) and irradiance usable for photosynthesis (Epur) as functions of depth in ocean. Describes Epur and Epar in terms of spectral parameters measured remotely (from satellites or airplanes). These irradiances useful in studies of photosynthetic productivity of phytoplankton in euphotic layer.

  8. Computing Solar EUV Irradiance Variability

    NASA Astrophysics Data System (ADS)

    Warren, H. P.

    2014-12-01

    The solar EUV irradiance plays a central role in determining the state of the Earth's upper atmosphere. The EUV irradiance at the shortest wavelengths, which is highly variable over time scales from seconds to decades, is particularly important for many aspects of space weather. Systematic spectrally resolved observations at the shortest EUV wavelengths, however, have been rare and there is a need to develop a methodology for estimating and forecasting the solar irradiance at all EUV wavelengths from sparse data sets. In this presentation we report on our efforts to use AIA DEM calculations to estimate the solar EUV irradiance at wavelength below 450 Å, where the emission is predominately optically thin. To validate our AIA DEM calculations we have performed extensive comparisons with simultaneous observations from the EVE instrument on SDO and the EIS instrument on Hinode and find that with the proper constraints we can generally reproduce the results obtained with detailed spectroscopic observations. Using a proxy for solar activity derived from photospheric magnetic field measurements we extend our model calculations to previous solar cycles and discuss how the model can be used to forecast EUV irradiance variability over short time scales. Finally, we speculate on what is needed to further develop semi-empirical and physical models for use in understanding the solar spectral irradiance at these wavelengths.

  9. Targeted cytoplasmic irradiation and autophagy.

    PubMed

    Wu, Jinhua; Zhang, Bo; Wuu, Yen-Ruh; Davidson, Mercy M; Hei, Tom K

    2017-03-01

    The effect of ionizing irradiation on cytoplasmic organelles is often underestimated because the general dogma considers direct DNA damage in the nuclei to be the primary cause of radiation induced toxicity. Using a precision microbeam irradiator, we examined the changes in mitochondrial dynamics and functions triggered by targeted cytoplasmic irradiation with α-particles. Mitochondrial dysfunction induced by targeted cytoplasmic irradiation led to activation of autophagy, which degraded dysfunctional mitochondria in order to maintain cellular energy homeostasis. The activation of autophagy was cytoplasmic irradiation-specific and was not detected in nuclear irradiated cells. This autophagic process was oxyradical-dependent and required the activity of the mitochondrial fission protein dynamin related protein 1 (DRP1). The resultant mitochondrial fission induced phosphorylation of AMP activated protein kinase (AMPK) which leads to further activation of the extracellular signal-related kinase (ERK) 1/2 with concomitant inhibition of the mammalian target of rapamycin (mTOR) to initiate autophagy. Inhibition of autophagy resulted in delayed DNA damage repair and decreased cell viability, which supports the cytoprotective function of autophagy. Our results reveal a novel mechanism in which dysfunctional mitochondria are degraded by autophagy in an attempt to protect cells from toxic effects of targeted cytoplasmic radiation.

  10. STRAIN LOCALIZATION IN IRRADIATED MATERIALS

    SciTech Connect

    Byun, Thak Sang; Hashimoto, Naoyuki

    2006-01-01

    Low temperature irradiation can significantly harden metallic materials and often lead to strain localization and ductility loss in deformation. This paper provides a review on the radiation effects on the deformation of metallic materials, focusing on microscopic and macroscopic strain localization phenomena. The microscopic strain localization often observed in irradiated materials are dislocation channeling and deformation twinning, in which dislocation glides are evenly distributed and well confined in the narrow bands, usually a fraction of a micron wide. Dislocation channeling is a common strain localization mechanism observed virtually in all irradiated metallic materials with ductility, while deformation twinning is an alternative localization mechanism occurring only in low stacking fault energy materials. In some high stacking fault energy materials where cross slip is easy, curved and widening channels can be formed depending on dose and stress state. Irradiation also prompts macroscopic strain localization (or plastic instability). It is shown that the plastic instability stress and true fracture stress are nearly independent of irradiation dose if there is no radiation-induced phase change or embrittlement. A newly proposed plastic instability criterion is that the metals after irradiation show necking at yield when the yield stress exceeds the dose-independent plastic instability stress. There is no evident relationship between the microscopic and macroscopic strain localizations; which is explained by the long-range back-stress hardening. It is proposed that the microscopic strain localization is a generalized phenomenon occurring at high stress.

  11. Irradiance-dependent UVB Photocarcinogenesis

    PubMed Central

    Lan, Cheng-Che E.; Wu, Ching-Shuang; Huang, Shu-Mei; Wu, Chin-Han; Lai, Hsiao-Chi; Peng, Yu-Ting; Hou, Pao-Sheng; Yang, Hui-Jun; Chen, Gwo-Shing

    2016-01-01

    Ultraviolet B (UVB) radiation from the sun may lead to photocarcinogenesis of the skin. Sunscreens were used to protect the skin by reducing UVB irradiance, but sunscreen use did not reduce sunburn episodes. It was shown that UVB-induced erythema depends on surface exposure but not irradiance of UVB. We previously showed that irradiance plays a critical role in UVB-induced cell differentiation. This study investigated the impact of irradiance on UVB-induced photocarcinogenesis. For hairless mice receiving equivalent exposure of UVB radiation, the low irradiance (LI) UVB treated mice showed more rapid tumor development, larger tumor burden, and more keratinocytes harboring mutant p53 in the epidermis as compared to their high irradiance (HI) UVB treated counterpart. Mechanistically, using cell models, we demonstrated that LI UVB radiation allowed more keratinocytes harboring DNA damages to enter cell cycle via ERK-related signaling as compared to its HI UVB counterpart. These results indicated that at equivalent exposure, UVB radiation at LI has higher photocarcinogenic potential as compared to its HI counterpart. Since erythema is the observed sunburn at moderate doses and use of sunscreen was not found to associate with reduced sunburn episodes, the biological significance of sunburn with or without sunscreen use warrants further investigation. PMID:27869214

  12. Re-irradiation for locoregionally recurrent tumors of the thorax: a single-institution, retrospective study.

    PubMed

    Sumita, Kiyomi; Harada, Hideyuki; Asakura, Hirofumi; Ogawa, Hirofumi; Onoe, Tsuyoshi; Murayama, Shigeyuki; Nakamura, Satoaki; Tanigawa, Noboru; Takahashi, Toshiaki; Nishimura, Tetsuo

    2016-08-02

    Re-irradiation (re-RT) of the thorax is challenging due to the impact of prior therapies on normal tissues, and there are few reports of definitive re-RT. The treatment toxicities and efficacy of re-RT are not well known. The aim of the present study was to assess the safety and efficacy of definitive re-RT of the thorax. Patients who were treated with thoracic re-RT between March 2007 and December 2014 were retrospectively analyzed. Primary and re-irradiation plans were required to have an overlap of dose distributions for the 80 % isodose level. All doses were recalculated to an equivalent dose of 2 Gy per fraction (EQD2). When possible, analysis of dose accumulation was carried out using the medical image merge (MIM) (®) software program (version 6.5, MIM Software Inc., Cleveland, OH). Administration dosages for organs at risk were defined. Fourteen (67 %) and seven (33 %) patients with non-small cell carcinoma (NSCLC) and small cell carcinoma (SCLC), respectively, were identified. The patients' median age was 72 (range 53-85) years. Fifteen patients (71 %) had "proximal" tumors, defined as tumors at the distal 2 cm of the trachea, carina, and main bronchi. The median interval from initial RT to re-RT was 26.8 (range 11.4-92.3) months. Re-RT was delivered by X-ray beam and proton beam therapy in 20 (95 %) patients and 1 (5 %) patient, respectively. The median radiation dose of re-RT was 60 (range 54-87.5) Gy10 and 50 (range 50.0-87.5) Gy10 for patients with NSCLC and SCLC, respectively. Grade 3 acute radiation pneumonitis occurred in only one patient. There were no other serious complications. The median follow-up time was 22.1 (range 2.3-56.4) months. The median local progression-free survival time (LPFS) and overall survival time (OS) were 12.9 (95 % confidence interval (CI): 8.9-27.9) months and 31.4 (95 % CI: 16.9-45.9) months, respectively. Patients receiving ≥ 60 Gy10 at re-RT had longer LPFS (p = 0.04). Good safety with longer OS than in previous

  13. Proton irradiation on materials

    NASA Technical Reports Server (NTRS)

    Chang, C. Ken

    1993-01-01

    A computer code is developed by utilizing a radiation transport code developed at NASA Langley Research Center to study the proton radiation effects on materials which have potential application in NASA's future space missions. The code covers the proton energy from 0.01 Mev to 100 Gev and is sufficient for energetic protons encountered in both low earth and geosynchronous orbits. With some modification, the code can be extended for particles heavier than proton as the radiation source. The code is capable of calculating the range, stopping power, exit energy, energy deposition coefficients, dose, and cumulative dose along the path of the proton in a target material. The target material can be any combination of the elements with atomic number ranging from 1 to 92, or any compound with known chemical composition. The generated cross section for a material is stored and is reused in future to save computer time. This information can be utilized to calculate the proton dose a material would receive in an orbit when the radiation environment is known. It can also be used to determine, in the laboratory, the parameters such as beam current of proton and irradiation time to attain the desired dosage for accelerated ground testing of any material. It is hoped that the present work be extended to include polymeric and composite materials which are prime candidates for use as coating, electronic components, and structure building. It is also desirable to determine, for ground testing these materials, the laboratory parameters in order to simulate the dose they would receive in space environments. A sample print-out for water subject to 1.5 Mev proton is included as a reference.

  14. Proton irradiation on materials

    NASA Astrophysics Data System (ADS)

    Chang, C. Ken

    1993-12-01

    A computer code is developed by utilizing a radiation transport code developed at NASA Langley Research Center to study the proton radiation effects on materials which have potential application in NASA's future space missions. The code covers the proton energy from 0.01 Mev to 100 Gev and is sufficient for energetic protons encountered in both low earth and geosynchronous orbits. With some modification, the code can be extended for particles heavier than proton as the radiation source. The code is capable of calculating the range, stopping power, exit energy, energy deposition coefficients, dose, and cumulative dose along the path of the proton in a target material. The target material can be any combination of the elements with atomic number ranging from 1 to 92, or any compound with known chemical composition. The generated cross section for a material is stored and is reused in future to save computer time. This information can be utilized to calculate the proton dose a material would receive in an orbit when the radiation environment is known. It can also be used to determine, in the laboratory, the parameters such as beam current of proton and irradiation time to attain the desired dosage for accelerated ground testing of any material. It is hoped that the present work be extended to include polymeric and composite materials which are prime candidates for use as coating, electronic components, and structure building. It is also desirable to determine, for ground testing these materials, the laboratory parameters in order to simulate the dose they would receive in space environments. A sample print-out for water subject to 1.5 Mev proton is included as a reference.

  15. Irradiation hardening of pure tungsten exposed to neutron irradiation

    SciTech Connect

    Hu, Xunxiang; Koyanagi, Takaaki; Fukuda, Makoto; Kumar, N. A. P. Kiran; Snead, Lance L.; Wirth, Brian D.; Katoh, Yutai

    2016-08-26

    In this paper, pure tungsten samples have been neutron irradiated in HFIR at 90–850 °C to 0.03–2.2 dpa. A dispersed barrier hardening model informed by the available microstructure data has been used to predict the hardness. Comparison of the model predictions and the measured Vickers hardness reveals the dominant hardening contribution at various irradiation conditions. For tungsten samples irradiated in HFIR, the results indicate that voids and dislocation loops contributed to the hardness increase in the low dose region (<0.3 dpa), while the formation of intermetallic second phase precipitation, resulting from transmutation, dominates the radiation-induced strengthening beginning with a relatively modest dose (>0.6 dpa). Finally, the precipitate contribution is most pronounced for the HFIR irradiations, whereas the radiation-induced defect cluster microstructure can rationalize the entirety of the hardness increase observed in tungsten irradiated in the fast neutron spectrum of Joyo and the mixed neutron spectrum of JMTR.

  16. Irradiation hardening of pure tungsten exposed to neutron irradiation

    SciTech Connect

    Hu, Xunxiang; Koyanagi, Takaaki; Fukuda, Makoto; Kumar, N. A. P. Kiran; Snead, Lance L.; Wirth, Brian D.; Katoh, Yutai

    2016-08-26

    In this paper, pure tungsten samples have been neutron irradiated in HFIR at 90–850 °C to 0.03–2.2 dpa. A dispersed barrier hardening model informed by the available microstructure data has been used to predict the hardness. Comparison of the model predictions and the measured Vickers hardness reveals the dominant hardening contribution at various irradiation conditions. For tungsten samples irradiated in HFIR, the results indicate that voids and dislocation loops contributed to the hardness increase in the low dose region (<0.3 dpa), while the formation of intermetallic second phase precipitation, resulting from transmutation, dominates the radiation-induced strengthening beginning with a relatively modest dose (>0.6 dpa). Finally, the precipitate contribution is most pronounced for the HFIR irradiations, whereas the radiation-induced defect cluster microstructure can rationalize the entirety of the hardness increase observed in tungsten irradiated in the fast neutron spectrum of Joyo and the mixed neutron spectrum of JMTR.

  17. Irradiation hardening of pure tungsten exposed to neutron irradiation

    DOE PAGES

    Hu, Xunxiang; Koyanagi, Takaaki; Fukuda, Makoto; ...

    2016-08-26

    In this paper, pure tungsten samples have been neutron irradiated in HFIR at 90–850 °C to 0.03–2.2 dpa. A dispersed barrier hardening model informed by the available microstructure data has been used to predict the hardness. Comparison of the model predictions and the measured Vickers hardness reveals the dominant hardening contribution at various irradiation conditions. For tungsten samples irradiated in HFIR, the results indicate that voids and dislocation loops contributed to the hardness increase in the low dose region (<0.3 dpa), while the formation of intermetallic second phase precipitation, resulting from transmutation, dominates the radiation-induced strengthening beginning with a relativelymore » modest dose (>0.6 dpa). Finally, the precipitate contribution is most pronounced for the HFIR irradiations, whereas the radiation-induced defect cluster microstructure can rationalize the entirety of the hardness increase observed in tungsten irradiated in the fast neutron spectrum of Joyo and the mixed neutron spectrum of JMTR.« less

  18. Laser irradiation effects on gold

    NASA Astrophysics Data System (ADS)

    Khaleeq-Ur-Rahman, M.; Bhatti, K. A.; Rafique, M. S.; Latif, A.; Lee, P.; Mahmood, S.

    2007-12-01

    Investigations on the laser irradiation effects on gold are explored in terms of plasma-plume dynamics and morphological and crystallographic changes. Annealed 4N gold samples were irradiated with a Q-switched Nd:YAG laser (53 mJ, 21 MW, 532 nm, and pulse width 6-8 ns) for plume dynamics using 10-ns gated fast photography. A Q-switched pulsed Nd:YAG laser (10 mJ, 1.1 MW, 1064 nm, and pulse width 9 ns) was used to irradiate the surface of the samples for morphological and crystallographic studies of laser-irradiated gold in a vacuum ˜10-3 Torr. The annealed samples were exposed to 50 shots of a Nd:YAG laser (10 mJ, 1.1 MW, 1064 nm, and pulse width 9 ns). The investigation on the plume was done by using an intensified charged-couple device ICCD-5760/IR-UV camera. The morphological investigation of the irradiated surface was carried out by analyzing micrographs obtained using an Hitachi S 3000 H scanning-electron microscope (SEM). The crystallographic studies of the irradiated samples were performed by analyzing the XRD patterns obtained using an X’ Pert Pro Pan Analytical X-ray diffractometer. The investigation on gated ICCD images of the plume reveal that, at very earlier times, the plasma-plume expansion has a linear trend, whereas, at later times, the plasma-plume expansion is nonuniform. SEM micrographs exhibit the primary mechanisms of pulsed-laser ablation (PLA), such as hydrodynamic sputtering, thermal sputtering, exfoliation sputtering, and splashing. The surface morphology was explained in terms of crater formation, swelling, burning, nucleation, grain growth, and nonsymmetric heat conduction. The nonuniform thermal expansion of gold due to thermal-energy transfer is also studied by SEM micrographs, which was supported by XRD analysis. The structural analysis on the basis of XRD shows that the composition of the irradiated samples is not disturbed even after laser irradiation. The grain sizes also changed due to laser irradiation.

  19. Food irradiation: Public opinion surveys

    SciTech Connect

    Kerr, S.D.

    1987-01-01

    The Canadian government are discussing the legislation, regulations and practical protocol necessary for the commercialization of food irradiation. Food industry marketing, public relations and media expertise will be needed to successfully introduce this new processing choice to retailers and consumers. Consumer research to date including consumer opinion studies and market trials conducted in the Netherlands, United States, South Africa and Canada will be explored for signposts to successful approaches to the introduction of irradiated foods to retailers and consumers. Research has indicated that the terms used to describe irradiation and information designed to reduce consumer fears will be important marketing tools. Marketers will be challenged to promote old foods, which look the same to consumers, in a new light. Simple like or dislike or intention to buy surveys will not be effective tools. Consumer fears must be identified and effectively handled to support a receptive climate for irradiated food products. A cooperative government, industry, health professional, consumer association and retailer effort will be necessary for the successful introduction of irradiated foods into the marketplace. Grocery Products Manufacturers of Canada is a national trade association of more than 150 major companies engaged in the manufacture of food, non-alcoholic beverages and array of other national-brand consumer items sold through retail outlets.

  20. Irradiation damage to the lung

    SciTech Connect

    Fennessy, J.J.

    1987-07-01

    While some degree of injury to normal, non-tumor-bearing, intrathoracic structures always occurs following irradiation for cure or palliation of neoplastic disease, clinical expression of this injury is uncommon. However, under certain circumstances, clinical manifestations may be severe and life threatening. Acute radiographic manifestations of pulmonary injury usually appear either synchronous with or, more typically, seven to ten days after the onset of the clinical syndrome. The acute signs of edema and slight volume loss within the irradiated zone are nonspecific except for their temporal and spatial relationship to the irradiation of the patient. Resolution of the acute changes is followed by pulmonary cicatrization, which is almost always stable within one year after completion of therapy. Change in postirradiation scarring following stabilization of the reaction must always be assumed to be due to some other process. While the radiograph primarily reveals pulmonary injury, all tissues, including the heart and major vessels, are susceptible, and the radiologist must recognize that any change within the thorax of a patient who has undergone thoracic irradiation may be a complication of that treatment. Differentiation of irradiation injury from residual or recurrent tumor, drug reaction, or opportunistic infection may be difficult and at times impossible.

  1. Prospects of international trade in irradiated foods

    NASA Astrophysics Data System (ADS)

    Loaharanu, P.

    Irradiation is gaining recognition as a physical process for reducing food losses, enhancing hygienic quality of food and facilitating food trade. At present, 36 countries have approved the use of irradiation for processing collectively over 40 food items either on an unconditional or restricted basis. Commercial use of irradiated foods and food ingredients is being carried out in 22 countries. Technology transfer on food irradiation is being intensified to local industry in different regions. worldwide, a total of 40 commercial/demonstration irradiators available for treating foods have been or are being constructed. Acceptance and control of international trade in irradiated foods were discussed at the International Conference on the Acceptance, Control of and Trade in Irradiated Food, jointly convened by FAO, IAEA, WHO and ITC-UNCTAD/GATT in Geneva, Switzerland, 12-16 December 1988. An "International Document on Food Irradiation" was adopted by consensus at this Conference which will facilitate wider acceptance and control of international trade in irradiated foods.

  2. Neutron irradiation of beryllium pebbles

    SciTech Connect

    Gelles, D.S.; Ermi, R.M.; Tsai, H.

    1998-03-01

    Seven subcapsules from the FFTF/MOTA 2B irradiation experiment containing 97 or 100% dense sintered beryllium cylindrical specimens in depleted lithium have been opened and the specimens retrieved for postirradiation examination. Irradiation conditions included 370 C to 1.6 {times} 10{sup 22} n/cm{sup 2}, 425 C to 4.8 {times} 10{sup 22} n/cm{sup 2}, and 550 C to 5.0 {times} 10{sup 22} n/cm{sup 2}. TEM specimens contained in these capsules were also retrieved, but many were broken. Density measurements of the cylindrical specimens showed as much as 1.59% swelling following irradiation at 500 C in 100% dense beryllium. Beryllium at 97% density generally gave slightly lower swelling values.

  3. Fracture surfaces of irradiated composites

    NASA Technical Reports Server (NTRS)

    Milkovich, Scott M.; Sykes, George F., Jr.; Herakovich, Carl T.

    1987-01-01

    Electron microscopy was used to analyze the fracture surfaces of T300/934 graphite/epoxy unidirectional off-axis tensile coupons which were subjected to 1.0-MeV electron radiation at a rate of 50 Mrad/h for a total dose of 10 Grad. Fracture surfaces from irradiated and nonirradiated specimens tested at 116 K, room temperature, and 394 K were analyzed to assess the influence of radiation and temperature on the mode of failure and variations in constituent material as a function of environmental exposure. Micrographs of fracture surfaces indicate that irradiated specimens are more brittle than nonirradiated specimens at low temperatures. However, at elevated temperatures the irradiated specimens exhibit significantly more plasticity than nonirradiated specimens.

  4. Directional irradiances and fractional clouds

    NASA Astrophysics Data System (ADS)

    Pagh Nielsen, Kristian; Andersen, Elsa; Dragsted, Janne; Furbo, Simon

    2017-04-01

    For large scale implementation of solar energy, better understanding of the directional and temporal variations in the solar resource is needed. This includes understanding the shading within a multiple row field of solar panels and how this affects the electricity or heat production. We have studied directional irradiances measured simultaneously from 16 downward directions at 1 minute temporal resolution. Also, we have performed measurements of the variations in the field of view across individual solar heating panels in the operational solar district heating plant in Hedehusene in Denmark. By combining a model of directional diffuse irradiances with the field of view variation across a solar panel in a solar panel field we can quantify the effect of shading of diffuse irradiances on the heat flow from the panel.

  5. Effects of irradiation on PVC compounds

    NASA Astrophysics Data System (ADS)

    Bataille, P.; Ulkem, I.; Schreiber, H. P.

    1995-11-01

    PVC compounds containing CaCO 3 filler and plasticizers were prepared with or without a trifunctional acrylic crosslinking agent and irradiated by 60Co γ-rays under air or nitrogen atmosphere. The samples without crosslinking agent did not respond to irradiation. The mechanical properties of the other samples such as tensile strength, yield strength and % elongation showed a great sensitivity to irradiation. Lower values of Young's modulus were observed for samples irradiated in air compared with samples irradiated in nitrogen indicating the effect of atmosphere in the range of irradiation studied.

  6. Irradiated icecreams for immunosuppressed patients

    NASA Astrophysics Data System (ADS)

    Adeil Pietranera, M. S.; Narvaiz, P.; Horak, C.; Kairiyama, E.

    2003-04-01

    Vanilla, raspberry, peach and milk jam icecreams were gamma irradiated with 3, 6 and 9 kGy doses in order to achieve microbial decontamination. Microbiological, sensory and some chemical analysis (acidity, peroxides, ultraviolet and visible absorption, thin-layer chromatography and sugar determination) were performed. Water-based icecreams (raspberry and peach) were more resistant to gamma radiation than cream-based ones (vanilla and milk jam). Gamma irradiation with 3 kGy reduced remarkably the microbial load of these icecreams without impairing the quality of the icecreams.

  7. Healing in the irradiated wound

    SciTech Connect

    Miller, S.H.; Rudolph, R. )

    1990-07-01

    Poor or nonhealing of irradiated wounds has been attributed to progressive obliterative endarteritis. Permanently damaged fibroblasts may also play an important part in poor healing. Regardless of the cause, the key to management of irradiated skin is careful attention to prevent its breakdown and conservative, but adequate, treatment when wounds are minor. When wounds become larger and are painful, complete excision of the wound or ulcer is called for and coverage should be provided by a well-vascularized nonparasitic distant flap.16 references.

  8. Modeling Solar Lyman Alpha Irradiance

    NASA Technical Reports Server (NTRS)

    Pap, J.; Hudson, H. S.; Rottman, G. J.; Willson, R. C.; Donnelly, R. F.; London, J.

    1990-01-01

    Solar Lyman alpha irradiance is estimated from various solar indices using linear regression analyses. Models developed with multiple linear regression analysis, including daily values and 81-day running means of solar indices, predict reasonably well both the short- and long-term variations observed in Lyman alpha. It is shown that the full disk equivalent width of the He line at 1083 nm offers the best proxy for Lyman alpha, and that the total irradiance corrected for sunspot effect also has a high correlation with Lyman alpha.

  9. Comparison of the GTV coverage by PTV and isodose of 90% in 2D and 3D planning during endobronchial brachytherapy in the palliative treatment of patients with advanced lung cancer. Pilot study

    PubMed Central

    Łyczek, Jarosław; Kowalik, Łukasz; Sawicki, Marcin

    2012-01-01

    Purpose Endobronchial brachytherapy (EB) is one way of treatment of patients with advanced lung cancer. Technological progress and the introduction of computed tomography for use in 3D planning allows one to define the area being treated very precisely, which gives an opportunity to extend survival, even in groups of patients receiving palliative care. Material and methods In 2011, in the Brachytherapy Department of the Subcarpathian Oncological Center, a group of 12 consecutive patients with advanced cancer of the bronchus underwent palliative EB. We compared the coverage of GTV (gross tumor volume), seen in the computed tomography study with intravenous contrast, by the PTV (planning target volume) planned in 3D and 2D. Results In 2D planning GTV coverage ranged from 15% to 89%. By analyzing the isodose of 90%, it was found that 2D planning covered GTV in 15-35% of the dose. In 3D planning, this coverage changed positively, and ranged from 85% to 100%. The GTV coverage in 3D planning was 100% by definition. In addition, it should be noted that in the 3D planning one can spare critical organs or pacemakers. Conclusions Planning for HDR brachytherapy in all locations should be based on dynamic imaging at present, especially in centers that are equipped with CT. Evaluation should be a routine test in treatment planning. The use of CT, even in palliative treatment planning, allows for much better coverage of GTV areas as well, which is very important to reduce radiation doses to critical organs and thereby reduce the toxic effects of treatment. PMID:23349654

  10. A comparison of ketamine-midazolam and ketamine-propofol combinations used for sedation in the endobronchial ultrasound-guided transbronchial needle aspiration: a prospective, single-blind, randomized study

    PubMed Central

    Dal, Tülay; Sazak, Hilal; Şahin, Şaziye; Yılmaz, Aydın

    2014-01-01

    Objective We aimed to compare the effectiveness and safety of ketamine-midazolam and ketamine-propofol combinations for procedural sedation in endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA). Methods Sixty patients who were undergoing EBUS-TBNA were included in this study. Patients were randomly divided into two groups. Group 1 was given 0.25 mg/kg intravenous (iv) ketamine, 2 min later than 0.05 mg/kg iv midazolam. Group 2 received 0.125 mg/kg ketamine-propofol mixture (ketofol), 2 min subsequent to injection of 0.25 mg/kg each. Sedation was maintained with additional doses of ketamine 0.25 mg/kg, and ketofol 0.125 mg/kg each in Group 1 and Group 2, respectively. Blood pressure, heart rate (HR), peripheral oxygen saturation, respiratory rate (RR), Ramsay Sedation Score (RSS), and severity of cough were recorded prior to and after administration of sedation agent in the beginning of fiberoptic bronchoscopy (FOB) and every 5 min of the procedure. The consumption of the agents, the satisfactions of the bronchoscopist and the patients, and the recovery time were also recorded. Results HR in the 10th min and RSS value in the 35th min of induction in Group 1 were higher than the other group (P<0.05). The recovery time in Group 1 was statistically longer than Group 2 (P<0.05). There was no statistically significant difference between groups with respect to other parameters (P>0.05). Conclusions It was concluded that both ketamine-midazolam and ketamine-propofol combinations for sedation during EBUS-TBNA were similarly effective and safe without remarkable side effects. PMID:24976998

  11. Centurion — a revolutionary irradiator

    NASA Astrophysics Data System (ADS)

    McKinney, Dan; Perrins, Robert

    2000-03-01

    The facility characteristics for irradiation of red meat and poultry differ significantly from those of medical disposables. This paper presents the results of the market requirement definition which resulted in an innovative conceptual design. The process and the "state of the art tools" used to bring this abstract idea into a proof of concept are presented.

  12. Irradiance Variability of the Sun

    NASA Technical Reports Server (NTRS)

    Froehlich, Claus

    1990-01-01

    Direct measurements of the solar constant--the total irradiance at mean Sun-Earth distance--during the last ten years from satellites show variations over time scales from minutes to years and decades. At high frequencies the spectral power is determined by granulation, super- and mesogranulation. In the 5-minute range, moreover, it is dominated by power from the solar p-mode oscillations. Their power and frequencies change with time, yielding information about changes in the convection zone. During periods of several hours, the power is steadily increasing and may be partly due to solar gravity modes. The most important variance is in the range from days to several months and is related to the photospheric features of solar activity, decrease of the irradiance during the appearance of sunspots, and increasing by faculae and the magnetic network. Long-term modulation by the 11-year activity cycle are observed conclusively with the irradiance being higher during solar maximum. All these variations can be explained--at least qualitatively--by their manifestation on the photosphere. For the long-term changes, the simultaneous changes of the frequencies of solar p-mode oscillations suggest a more global origin of the variations. Indeed, it seems that the observed irradiance modulation is a true luminosity change with the magnetic cycle of the Sun.

  13. Microstructural processes in irradiated materials

    NASA Astrophysics Data System (ADS)

    Byun, Thak Sang; Morgan, Dane; Jiao, Zhijie; Almer, Jonathan; Brown, Donald

    2016-04-01

    These proceedings contain the papers presented at two symposia, the Microstructural Processes in Irradiated Materials (MPIM) and Characterization of Nuclear Reactor Materials and Components with Neutron and Synchrotron Radiation, held in the TMS 2015, 144th Annual Meeting & Exhibition at Walt Disney World, Orlando, Florida, USA on March 15-19, 2015.

  14. Irradiation enhancement of biomass conversion

    NASA Astrophysics Data System (ADS)

    Smith, G. S.; Kiesling, H. E.; Galyean, M. L.; Bader, J. R.

    The vast supply of cellulosic agricultural residues and industrial by-products that is produced each year is a prospective resource of biomass suitable for conversion to useful products such as feedstock for the chemicals industry and feedstuffs for the livestock industry. Conversions of such biomass is poor at present, and utilization is inefficient, because of physio-chemical barriers to biological degradation and (or) anti-quality components such as toxicants that restrict biological usages. Improvements in biodegradability of ligno-cellulosic materials have been accomplished by gamma-ray and electron-beam irradiation at intermediate dosage (˜ 50 Mrad; .5 MGy); but applications of the technology have been hampered by questionable interpretations of results. Recent research with organic wastes such as sewage sludge and straw suggests opportunity for important applications of irradiation technology in enhancement of biomass conversion. Data from experiments using irradiated straw as feed for ruminants are presented and discussed in relation to research on prospective usage of sewage products as feed for ruminants. Findings are discussed in regard to prospective applications in industrial fermentation processes. Possible usage of irradiation technology for destruction of toxicants in exotic plants is considered in regard to prospective new feedstuffs.

  15. Food Irradiation Research and Technology

    USDA-ARS?s Scientific Manuscript database

    Food Irradiation is a safe and effective U.S. Food and Drug Administration (FDA) approved process that can be used to disinfest or delay the maturation of fruits and vegetables, improve the microbiological safety of shellfish, eggs, raw meat and poultry, spices, and seeds used for sprouting. FDA ap...

  16. Food irradiation research and technology

    USDA-ARS?s Scientific Manuscript database

    Food Irradiation is a safe and effective U.S. Food and Drug Administration (FDA) approved process that can be used to disinfest or delay the maturation of fruits and vegetables, improve the microbiological safety of shellfish, eggs, raw meat and poultry, spices, and seeds used for sprouting. FDA ap...

  17. Internal irradiation for cystic craniopharyngioma

    SciTech Connect

    Kobayashi, T.; Kageyama, N.; Ohara, K.

    1981-12-01

    The authors report the results of internal irradiation with labeled chromic phosphate (32P) and gold-198 (198Au) colloid in eight cases of cystic craniopharyngiomas. They used a newly developed dosimetric formula, by which the radiation dose at the cyst wall and at any point far from the radioactive source can be calculated. Ten courses of irradiation in eight patients were carried out by injection of either 32P or 198Au colloid into the cyst through an Ommaya drainage system that had been placed at craniotomy. Follow-up studies ranging from 13 to 156 months revealed that all cysts were effectively treated, with elimination of fluid or collapse of the cyst. This was confirmed by Conray cystography and/or computerized tomography. Not only the dose delivered to the wall but also the thickness of the cyst wall and the location of the cyst are important factors in planning internal irradiation. A safe and adequate dose to the cyst wall could range between 9000 to 30,000 rads for craniopharyngioma. This treatment is suitable for large cysts that are thought to be difficult to remove radically, recurrent cysts resistant to previous treatment, or multiple cysts. Internal irradiation may also be applicable in other cystic intracranial tumors if dosimetry is calculated accurately.

  18. Food Irradiation: What You Need to Know

    MedlinePlus

    ... you know? National Aeronautics and Space Administration (NASA) astronauts eat meat that has been sterilized by irradiation ... you know? National Aeronautics and Space Administration (NASA) astronauts eat meat that has been sterilized by irradiation ...

  19. Statistical criteria for characterizing irradiance time series.

    SciTech Connect

    Stein, Joshua S.; Ellis, Abraham; Hansen, Clifford W.

    2010-10-01

    We propose and examine several statistical criteria for characterizing time series of solar irradiance. Time series of irradiance are used in analyses that seek to quantify the performance of photovoltaic (PV) power systems over time. Time series of irradiance are either measured or are simulated using models. Simulations of irradiance are often calibrated to or generated from statistics for observed irradiance and simulations are validated by comparing the simulation output to the observed irradiance. Criteria used in this comparison should derive from the context of the analyses in which the simulated irradiance is to be used. We examine three statistics that characterize time series and their use as criteria for comparing time series. We demonstrate these statistics using observed irradiance data recorded in August 2007 in Las Vegas, Nevada, and in June 2009 in Albuquerque, New Mexico.

  20. Bronchorelaxation of the human bronchi by CFTR activators.

    PubMed

    Norez, Caroline; Jayle, Christophe; Becq, Frédéric; Vandebrouck, Clarisse

    2014-02-01

    The airway functions are profoundly affected in many diseases including asthma, COPD and cystic fibrosis (CF). CF the most common lethal autosomal recessive genetic disease is caused by mutations of the CFTR (Cystic Fibrosis transmembrane Conductance Regulator) gene, which normally encodes a multifunctional and integral membrane cAMP regulated and ATP gated Cl(-) channel expressed in airway epithelial cells. Using human lung tissues obtained from patients undergoing surgery for lung cancer, we demonstrated that CFTR participates in bronchorelaxation. Using human bronchial smooth muscle cells (HBSMC), we applied iodide influx assay to analyze the CFTR-dependent ionic transport and immunofluorescence technique to localize CFTR proteins. Moreover, the relaxation was studied in isolated human bronchial segments after pre-contraction with carbachol to determine the implication of CFTR in bronchodilation. We found in HBSMC that the pharmacology and regulation of CFTR is similar to that of its epithelial counterpart both for activation (using forskolin/genistein or a benzo[c]quinolizinium derivative) and for inhibition (CFTR(inh)-172 and GPinh5a). With human bronchial rings, we observed that whatever the compound used including salbutamol, the activation of muscular CFTR leads to a bronchodilation after constriction with carbachol. Altogether, these observations revealed that CFTR in the human airways is expressed in bronchial smooth muscle cells and can be pharmacologically manipulated leading to the hypothesis that this ionic channel could contribute to bronchodilation in human.

  1. Cellular morphometry of the bronchi of human and dog lungs

    SciTech Connect

    Robbins, E.S.

    1992-09-01

    Quantitative data of the human bronchial epithelial cells at possible risk for malignant transformation in lung cancer is crucial for accurate radon dosimetry and risk analysis. The locations and other parameters of the nuclei which may be damaged by [alpha] particles must be determined and compared in different airway generations, among smokers, non-smokers and ex-smokers, between men and women and in people of different ages. This proposal includes extended morphometric studies on electron micrographs of human epithelium of defined airway generations and in parallel on electron micrographs of the dog bronchial lining. The second part of this proposal describes studies to quantitate the cycling bronchial epithelial population(s) using proliferation markers and immunocytochemistry on frozen and paraffin sections and similar labeling of isolated bronchial epithelial cells sorted flow cytometry.

  2. Elevated Matrix Metalloproteinase Levels in Bronchi Infected with Periodontopathogenic Bacteria

    PubMed Central

    Bernasconi, Luca; Ramenzoni, Liza L.; Al-Majid, Ahmed; Tini, Gabrielo M.; Graber, Sereina M.; Schmidlin, Patrick R.; Irani, Sarosh

    2015-01-01

    Objectives To determine whether bronchial colonisations/infections with periodontopathogenic bacteria are associated with elevated inflammatory markers such as MMPs, interleukins and Tumor necrosis factor alpha in the bronchial fluid. Methods Periodontal status was assessed in consecutive outpatients planned for elective bronchoscopies, and PCR for periodontopathogenic bacteria was performed from a protected specimen brush sample taken from the bronchial mucosa. Additionally, MMPs, interleukins and Tumor necrosis factor alpha were measured in the bronchial fluid. Results Out of the four species assessed, one species was found in 13 of 91 (14%) patients, and two in 12 (13%), three in 13 (14%) and all four in 1 (1%) patient, respectively. In multiple linear regression models the presence of Treponema denticola showed a consistent pattern of positive effects in bronchial fluid (Bonferroni adjusted p-values) on the levels of MMP9 (p adj.: 0.028) and MMP12 (p adj.: 0.029). Active smoking was independently associated with increased levels of aMMP8 (p adj.: 0.005) and MMP9 (p adj.: 0.009). Levels of IL-1 ß, IL-8 and Tumor necrosis factor alpha measured in the bronchial fluid were not affected by the presence of periodontopathogenic bacteria. Conclusions Bronchial colonisation/infection with Treponema denticola and smoking are independently associated with elevated MMPs (MMP9/MMP12 and MMP8/MMP9, respectively) in the bronchial fluid. PMID:26656474

  3. Ultrasonic Transducer Irradiation Test Results

    SciTech Connect

    Daw, Joshua; Palmer, Joe; Ramuhalli, Pradeep; Keller, Paul; Montgomery, Robert; Chien, Hual-Te; Kohse, Gordon; Tittmann, Bernhard; Reinhardt, Brian; Rempe, Joy

    2015-02-01

    Ultrasonic technologies offer the potential for high-accuracy and -resolution in-pile measurement of a range of parameters, including geometry changes, temperature, crack initiation and growth, gas pressure and composition, and microstructural changes. Many Department of Energy-Office of Nuclear Energy (DOE-NE) programs are exploring the use of ultrasonic technologies to provide enhanced sensors for in-pile instrumentation during irradiation testing. For example, the ability of small diameter ultrasonic thermometers (UTs) to provide a temperature profile in candidate metallic and oxide fuel would provide much needed data for validating new fuel performance models. Other ongoing efforts include an ultrasonic technique to detect morphology changes (such as crack initiation and growth) and acoustic techniques to evaluate fission gas composition and pressure. These efforts are limited by the lack of identified ultrasonic transducer materials capable of long term performance under irradiation test conditions. For this reason, the Pennsylvania State University (PSU) was awarded an ATR NSUF project to evaluate the performance of promising magnetostrictive and piezoelectric transducers in the Massachusetts Institute of Technology Research Reactor (MITR) up to a fast fluence of at least 1021 n/cm2. The goal of this research is to characterize and demonstrate magnetostrictive and piezoelectric transducer operation during irradiation, enabling the development of novel radiation-tolerant ultrasonic sensors for use in Material Testing Reactors (MTRs). As such, this test is an instrumented lead test and real-time transducer performance data is collected along with temperature and neutron and gamma flux data. The current work bridges the gap between proven out-of-pile ultrasonic techniques and in-pile deployment of ultrasonic sensors by acquiring the data necessary to demonstrate the performance of ultrasonic transducers. To date, one piezoelectric

  4. Neutron irradiation effects on plasma facing materials

    NASA Astrophysics Data System (ADS)

    Barabash, V.; Federici, G.; Rödig, M.; Snead, L. L.; Wu, C. H.

    2000-12-01

    This paper reviews the effects of neutron irradiation on thermal and mechanical properties and bulk tritium retention of armour materials (beryllium, tungsten and carbon). For each material, the main properties affected by neutron irradiation are described and the specific tests of neutron irradiated armour materials under thermal shock and disruption conditions are summarized. Based on current knowledge, the expected thermal and structural performance of neutron irradiated armour materials in the ITER plasma facing components are analysed.

  5. Food irradiation: research and technology, preface

    USDA-ARS?s Scientific Manuscript database

    Many interesting and exciting developments have occurred in the field of food irradiation since the publication of the first edition of Food Irradiation: Research and Technology in 2006. The 2nd edition of the book reviews our latest knowledge on food irradiation, highlights the current developments...

  6. Schedule and status of irradiation experiments

    SciTech Connect

    Rowcliffe, A.F.; Grossbeck, M.L.

    1997-04-01

    To provide an updated summary of the status of irradiation experiments for the neutron-interactive materials program. The current status of reactor irradiation experiments is presented in tables summarizing the experimental objectives, conditions, and schedule. Currently, the program has two irradiation experiments in reactor; and 8 experiments in the planning or design stages. Postirradiation examination and testing is in progress on 18 experiments.

  7. Food irradiation for phytosanitary and quarantine treatment

    USDA-ARS?s Scientific Manuscript database

    Irradiation at doses less than 1 kGy is an effective phytosanitary measure with minimal adverse effects on the quality of most fresh produce. There are internationally recognized guidelines for the use of irradiation as a phytosanitary measure and for the conduct of trade in irradiated fresh produce...

  8. Biological effects of ultraviolet irradiation on bees

    SciTech Connect

    Es`kov, E.K.

    1995-09-01

    The influence of natural solar and artificial ultraviolet irradiation on developing bees was studied. Lethal exposures to irradiation at different stages of development were determined. The influence of irradiation on the variability of the morphometric features of bees was revealed. 5 refs., 1 fig.

  9. Calculation of direct normal irradiation from global horizontal irradiation

    NASA Astrophysics Data System (ADS)

    Rodrigo, Pedro; Pérez-Higueras, Pedro J.; Almonacid, Florencia; Hontoria, Leocadio; Fernández, Eduardo F.; Rus, Catalina; Fernández, Juan I.; Gómez, Pedro; Almonacid, Gabino

    2012-10-01

    Concentrator Photovoltaic (CPV) systems only work with the Direct Normal Irradiance (DNI), so a knowledge of DNI data is required for the design and evaluation of these kinds of systems. DNI is not always measured at ground meteorological stations due to equipment costs. In recent years, several spatial databases that estimate DNI from satellite data have been developed. These databases are a very useful tool for CPV applications. However, the databases present uncertainty and provide different values of DNI. This lack of DNI data and the uncertainty of available data contrast with the availability of reliable global horizontal irradiation data, which is easy to find or measure. In this paper, a simple procedure for estimating DNI from global horizontal irradiation is presented. It does not try to improve the existing methods, but meets the basic requirements for the analysis of CPV systems. The method can be easily implemented in a spreadsheet or in computer programs in renewable energy and its accuracy is similar than that of the existing databases.

  10. Effect of microwave irradiation on TATB explosive.

    PubMed

    Yu, Weifei; Zhang, Tonglai; Huang, Yigang; Yang, Li; Li, Gang; Li, Haibo; Li, Jinshan; Huang, Hui

    2009-09-15

    Finished TATB (1,3,5-triamino-2,4,6-trinitrobenzene) explosive safety under 800W microwave irradiation was experimented. No burning, deflagration and detonation were observed during 30-min continuous irradiation and no remarkable change were observed after irradiation according to HPLC, particles size analysis, and differential thermal analysis. Wet TATB sampled from synthesis line was irradiated with microwave vacuum method and irradiated TATB was measured to accord with military standard specifications including appearance, moisture and volatile, chloride content, HPLC, mean particle size, DTA exothermic peak, ash, acetone soluble content, PH value, etc. Microwave vacuum desiccation was deemed laborsaving, energy-efficient, and practicable compared to conventional processing method.

  11. Laser irradiation to produce amorphous pharmaceuticals.

    PubMed

    Titapiwatanakun, Varin; Tankul, Junlathip; Basit, Abdul W; Gaisford, Simon

    2016-11-30

    Using a high-power CO2 laser to irradiate powder beds, it was possible to induce phase transformation to the amorphous state. Irradiation of a model drug, indometacin, resulted in formation of a glass. Varying the settings of the laser (power and raster speed) was shown to change the physicochemical properties of the glasses produced and all irradiated glasses were found to be more stable than a reference glass produced by melt-quenching. Irradiation of a powder blend of paracetamol and polyvinylpyrrolidone K30 was found to produce a solid amorphous dispersion. The results suggest that laser-irradiation might be a useful method for making amorphous pharmaceuticals.

  12. Design of YCF-1 mobile γ irradiator

    NASA Astrophysics Data System (ADS)

    Hehu, Zhang; Chuanzhen, Wang

    1993-07-01

    YCF-1 Mobile irradiator is designed by BINE of China. It has been put into running in YanJi city of Jilin province. It is able to be moved to border and distance places and area lumped and spreading out of agricultural products to service. It can play a important role in demonstration and extending irradiation technology in food irradiation, disinfestation, sterilization and quarantine, etc. This paper describes the features and design considerations of mobile irradiator. This irradiator adopted Cesium-137 source. The design capacity of loading source is 9.25PBq (250kCi), A half-time of Cs- 137 is 30.2 years long, exchanging source is not needed utilization rate of energy is higher, and the shielding is thinner, The Weight is lighter, The dose rate on the surface of it is 0.0025mSv/h in accordance with national standard. The internal size of irradiation room is 1800×1800×900mm (L×W×H), The sheilding of irradiation room is a steel shell filled with lead. The thickness of lead is 18cm. The irradiator is installed on a special flat truck. The size of the truck is 7000×3400×4200mm (L×W×H). The weight of irradiator is more than 80 150kw. The main components and parts of irradiator are: source, source racks and hoist, irradiation chamber, storage source chamber, the product's transport system, dose monitoring system, ventilation system and safety interlock system, etc.

  13. Hepatobiliary kinetics after whole-body irradiation

    SciTech Connect

    Durakovic, A.

    1986-09-01

    The purpose of this investigation was to study hepatobiliary kinetics after whole-body gamma irradiation. Two groups of nine male beagle dogs were irradiated with a single whole body dose of 4- and 8-Gy cobalt-60 photons. Each animal was injected with 2 mCi Tc-99m DISIDA and scintigraphic studies were obtained with a gamma camera with a parallel hole multipurpose collimator. The parameters studied included: peak activity of the liver and gall bladder and gall bladder and intestinal visualization from the time of Tc-99m DISIDA administration. Total and indirect bilirubin, LDH, SGOT, and SGPT determined as baseline studies before irradiation and at different time intervals after irradiation were not changed in irradiated animals. Whole body Co-60 irradiation with 4 and 8 Gy produced no significant changes in the Tc-99m DISIDA visualization of the gall bladder or in the peak activity in the gall bladder or the liver 1 and 7 days after irradiation. Intestinal visualization occurred significantly earlier in 8 Gy Co-60 irradiated animals on both day 1 and day 7 post irradiation, compared to baseline values where it was never observed before 195.0 minutes. Gall bladder emptying is significantly accelerated after 8 Gy but not after 4-Gy Co-60 gamma irradiation. These observations suggest that gamma irradiation stimulates gall bladder contractility without modifying intrahepatic biliary kinetics.

  14. GTL-1 Irradiation Summary Report

    SciTech Connect

    D. M. Perez; G. S. Chang; N. E. Woolstenhulme; D. M. Wachs

    2012-01-01

    The primary objective of the Gas Test Loop (GTL-1) miniplate experiment is to confirm acceptable performance of high-density (i.e., 4.8 g-U/cm3) U3Si2/Al dispersion fuel plates clad in Al-6061 and irradiated under the relatively aggressive Booster Fast Flux Loop (BFFL) booster fuel conditions, namely a peak plate surface heat flux of 450 W/cm2. As secondary objectives, several design and fabrication variations were included in the test matrix that may have the potential to improve the high-heat flux, high-temperature performance of the base fuel plate design.1, 2 The following report summarizes the life of the GTL-1 experiment through end of irradiation, including as-run neutronic analysis, thermal analysis and hydraulic testing results.

  15. Food irradiation development in Pakistan

    NASA Astrophysics Data System (ADS)

    Khan, I.

    The large scale trials were held to extend the storage life of potatoes, onions and dry fruits by gamma radiation. It was concluded that radiation preservation of potatoes and onions was much cheaper as compared to conventional methods. A dose of 1 kGy can control the insects in dry fruits and nuts. The consumers' acceptability and market testing performed during the last four years are also conducive to the commercialization of the technology in this country. The Government of Pakistan has accorded clearance for the irradiation of some food items like potatoes, onions, garlic and spices for human consumption. The Pakistan Radiation Services (PARAS), the commercial irradiator (200 Kci) at Lahore, has already started functioning in April, 1987. It is planned to start large scale sterilization of spices by gamma radiation in PARAS shortly.

  16. Proton Irradiation Creep in Pyrocarbon

    SciTech Connect

    Was, Gary S.; Campbell, Anne

    2011-10-01

    This project aims to understand irradiation creep in pyrocarbon using proton irradiation under controlled stresses and temperatures. Experiments will be conducted over a range of temperatures and stresses per the proposal submitted. The work scope will include the preparation of samples, measurement of deposition thickness, thickness uniformity, and anisotropy. The samples produced will be made in strips, which will be used for the creep experiments. Materials used will include pyrolytic carbon (PyC), Highly Oriented Pyrolytic Graphite (HOPG), or graphite strip samples in that order depending upon success. Temperatures tested under will range from 800°C to 1200°C, and stresses from 6MPa to 20.7MPa. Optional testing may occur at 900°C and 1100°C and stresses from 6MPa to 20.7MPa if funding is available.

  17. Particular applications of food irradiation fresh produce

    NASA Astrophysics Data System (ADS)

    Prakash, Anuradha

    2016-12-01

    On fresh fruits and vegetables, irradiation at low and medium dose levels can effectively reduce microbial counts which can enhance safety, inhibit sprouting to extend shelf-life, and eliminate or sterilize insect pests which can serve to facilitate trade between countries. At the dose levels used for these purposes, the impact on quality is negligible. Despite the fact that regulations in many countries allow the use of irradiation for fresh produce, the technology remains under-utilized, even in the light of an increase in produce related disease outbreaks and the economic benefits of extended shelf life and reduced food waste. Putative concerns about consumer acceptance particularly for produce that is labeled as irradiated have deterred many companies from using irradiation and retailers to carry irradiated produce. This section highlights the commercial use of irradiation for fresh produce, other than phytosanitary irradiation which is covered in supplementary sections.

  18. Future Satellite Observations of Solar Irradiance

    NASA Technical Reports Server (NTRS)

    Cahalan, R. F.; Rottman, G.; Woods, T.; Lawrence, G.; Harder, J.; McClintock, W.; Kopp, G.

    2003-01-01

    Required solar irradiance measurements for climate studies include those now being made by the Total Irradiance Monitor (TIM) and the Spectral Irradiance Monitor (SIM) onboard the SORCE satellite, part of the Earth Observing System fleet of NASA satellites. Equivalent or better measures of Total Solar Irradiance (TSI) and Spectral Solar Irradiance (SSI, 200 to 2000 nm) are planned for the post-2010 satellites of the National Polar-orbiting Operational Environmental Satellite System ("OESS). The design life of SORCE is 5 years, so a "Solar Irradiance Gap Filler" EOS mission is being planned for launch in the 2007 time frame, to include the same TSI and SSI measurements. Besides avoiding any gap, overlap of the data sources is also necessary for determination of possible multi-decadal trends in solar irradiance. We discuss these requirements and the impacts of data gaps, and data overlaps, that may occur in the monitoring of the critical solar radiative forcing.

  19. Blood Irradiator Interactive Tool Beta Version

    SciTech Connect

    Howington, John; Potter, Charles; DeGroff, Tavias; Best, Derek

    2016-04-15

    The “Blood Irradiator Interactive Tool” compares a typical Cs-137 Blood Irradiator with that of the capabilities of an average X-ray Irradiator. It is designed to inform the user about the potential capabilities that an average X-ray Irradiator could offer them. Specifically the tool compares the amount of blood bags that can be irradiated by the users’ machine with that of the average X-ray capability. It also forcasts the amount of blood that can be irradiated on yearly basis for both the users’ machine and an average X-ray Device. The Average X-ray capabilities are taken from the three X-ray devices currently on the market: The RS 3400 Rad Source X-ray Blood Irradiator and both the 2.0L and 3.5 L versions of the Best Theratronis Raycell MK2

  20. Microstructure evolution in irradiated materials

    SciTech Connect

    Caturla, M

    1999-11-30

    Study the interaction of defects produced during irradiation or deformation of a metal with the microstructure of that particular material, such as dislocations and grain boundaries. In particular we will study the interaction of dislocation with interstitial loops and stacking fault tetrahedral, and the production of displacement cascades close to dislocations and grain boundaries. The data obtained from these simulations will be used as input to diffusion models and dislocation dynamics models.

  1. Radical Irradiation of Extracranial Oligometastases

    PubMed Central

    Salama, Joseph K.; Milano, Michael T.

    2014-01-01

    Advances in radiotherapy planning and delivery have been used to treat patients with limited metastatic disease. With these techniques, high rates of treated metastasis control and low toxicity have been reported. Some patients have long disease-free intervals after radiotherapy similar to those seen after surgical resection. Ongoing studies will determine the benefit of these irradiation techniques to treat limited metastases, identify appropriate candidates, and assist in integrating these treatments into management strategies for specific diseases. PMID:25113765

  2. RERTR-8 Irradiation Summary Report

    SciTech Connect

    D. M. Perez; M. A. Lillo; G. S. Chang; G. A. Roth; N. E. Woolstenhulme; D. M. Wachs

    2011-12-01

    The Reduced Enrichment for Research and Test Reactor (RERTR) experiment RERTR-8, was designed to test monolithic mini-fuel plates fabricated via hot isostatic pressing (HIP), the effect of molybdenum (Mo) content on the monolithic fuel behavior, and the efficiency of ternary additions to dispersion fuel particles on the interaction layer behavior at higher burnup. The following report summarizes the life of the RERTR-8 experiment through end of irradiation, including as-run neutronic analysis, thermal analysis and hydraulic testing results.

  3. RERTR-6 Irradiation Summary Report

    SciTech Connect

    D. M. Perez; M. A. Lillo; G. S. Chang; G. A. Roth; N. E. Woolstenhulme; D. M. Wachs

    2011-12-01

    The Reduced Enrichment for Research and Test Reactor (RERTR) experiment RERTR-6 was designed to evaluate several modified fuel designs that were proposed to address the possibility of breakaway swelling due to porosity within the (U. Mo) Al interaction product observed in the full-size plate tests performed in Russia and France1. The following report summarizes the life of the RERTR-6 experiment through end of irradiation, including as-run neutronic analyses, thermal analyses and hydraulic testing results.

  4. Microstructural processes in irradiated materials

    SciTech Connect

    Byun, Thak Sang; Morgan, Dane; Jiao, Zhijie; Almer, Jonathan; Brown, Donald

    2016-04-01

    This is an editorial article (preface) for the publication of symposium papers in the Journal of Nuclear materials: These proceedings contain the papers presented at two symposia, the Microstructural Processes in Irradiated Materials (MPIM) and Characterization of Nuclear Reactor Materials and Components with Neutron and Synchrotron Radiation, held in the TMS 2015, 144th Annual Meeting & Exhibition at Walt Disney World, Orlando, Florida, USA on March 15–19, 2015.

  5. RERTR-13 Irradiation Summary Report

    SciTech Connect

    D. M. Perez; M. A. Lillo; G. S. Chang; D. M. Wachs; G. A. Roth; N. E. Woolstenhulme

    2012-09-01

    The Reduced Enrichment for Research and Test Reactor (RERTR) experiment RERTR-13 was designed to assess performance of different types of neutron absorbers that can be potentially used as burnable poisons in the low enriched uranium-molybdenum based dispersion and monolithic fuels.1 The following report summarizes the life of the RERTR-13 experiment through end of irradiation, including as-run neutronic analysis results, thermal analysis results and hydraulic testing results.

  6. FFTF utilization for irradiation testing

    SciTech Connect

    Corrigan, D.C.; Julyk, L.J.; Hoth, C.W.; McGuire, J.C.; Sloan, W.R.

    1980-01-01

    FFTF utilization for irradiation testing is beginning. Two Fuels Open Test Assemblies and one Vibration Open Test Assembly, both containing in-core contact instrumentation, are installed in the reactor. These assemblies will be used to confirm plant design performance predictions. Some 100 additional experiments are currently planned to follow these three. This will result in an average core loading of about 50 test assemblies throughout the early FFTF operating cycles.

  7. Licensing a new industrial irradiator.

    PubMed

    Bates, Nicolas K; Entwistle, Frederick B

    2010-02-01

    After nearly three decades of medical product sterilization, 3M launched a major new project to build and license an irradiator facility. 3M Corporate Health Physics was responsible for the licensing aspect of this project. The licensing process consisted of six amendments, over 30 submissions to the U.S. Nuclear Regulatory Commission (U.S. NRC) and four U.S. NRC site visits. It took approximately 22 months to complete. The six license amendments are reviewed and several of the submissions are discussed. These include 3M's response to the U.S. NRC's interest in the shielding calculations used for the bioshield, the development of a protocol of radiation safety system test methods, and an analysis to show that a dropped cask during loading operations would not fall on sealed sources. A number of lessons were learned during the course of licensing the new irradiator. Among these were the importance of understanding the U.S. NRC license reviewer's perspective, the need to thoroughly review the irradiator manufacturer's licensing package during project negotiations, the benefits of leaving the Health Physics Office and meeting with the non-health physicists involved in the project, and the necessity of maintaining the solid relationships that already existed with the site Radiation Safety Officer and Sterilization Engineer.

  8. Irradiation performance of nitride fuels

    SciTech Connect

    Matthews, R.B.

    1993-01-01

    The properties and advantages of nitride fuels are well documented in the literature. Basically the high thermal conductivity and uranium density of nitride fuels permit high power density, good breeding ratios, low reactivity swings, and large diameter pins compared to oxides. Nitrides are compatible with cladding alloys and liquid metal coolants, thereby reducing fuel/cladding chemical interactions and permitting the use of sodium-bonded pins and the operation of breached pins. Recent analyses done under similar operating conditions show that - compared to metal - fuels mixed nitrides operate at lower temperatures, produce less cladding strain, have greater margins to failure, result in lower transient temperatures, and have lower sodium void reactivity. Uranium nitride fuel pellet fabrication processes were demonstrated during the SP-100 program, and irradiated nitride fuels can be reprocessed by the PUREX process. Irradiation performance data suggest that nitrides have low fission gas release and swelling rates thereby permitting favorable pin designs and long lifetime. The objective of this report is to summarize the available nitride irradiation performance data base and to recommend optimum nitride characteristics for use in advanced liquid metal reactors.

  9. Status of Post Irradiation Examination of FCAB and FCAT Irradiation Capsules

    SciTech Connect

    Field, Kevin G.; Yamamoto, Yukinori; Howard, Richard H.

    2016-09-29

    A series of irradiation programs are ongoing to address the need for determining the radiation tolerance of FeCrAl alloys. These irradiation programs, deemed the FCAT and FCAB irradiation programs, use the High Flux Isotope Reactor (HFIR) to irradiate second generation wrought FeCrAl alloys and early-generation powder-metallurgy (PM) oxide dispersion-strengthened (ODS) FeCrAl alloys. Irradiations have been or are being performed at temperatures of 200°C, 330°C, and 550°C from doses of 1.8 dpa up to 16 dpa. Preliminary post-irradiation examination (PIE) on low dose (<2 dpa) irradiation capsules of tensile specimens has been performed. Analysis of co-irradiated SiC thermometry have shown reasonable matching between the nominal irradiation temperatures and the target irradiation temperatures. Room temperature tensile tests have shown typical radiation-induced hardening and embrittlement at irradiations of 200°C and 330°C, but a propensity for softening when irradiated to 550°C for the wrought alloys. The PM-ODS FeCrAl specimens showed less hardening compared to the wrought alloys. Future PIE includes high temperature tensile tests on the low dose irradiation capsules as well as the determination of reference fracture toughness transition temperature, To, in alloys irradiated to 7 dpa and higher.

  10. 2-alkylcyclobutanones as irradiation dose indicators in irradiated ground beef patties.

    PubMed

    Gadgil, Priyadarshini; Hachmeister, Kathleen A; Smith, J Scott; Kropf, Donald H

    2002-09-25

    Alkylcyclobutanones have been recognized as chemical markers of irradiated lipid-containing foods since 1970. They are important because they are produced solely as a result of irradiation and not any other processing method. This study investigated the formation of 2-dodecylcyclobutanone (2-DCB) and 2-tetradec-5'-enylcyclobutanone (2-TDCB) in irradiated ground beef patties from commercial and noncommercial sources. Patties were irradiated using a (60)C source (gamma-irradiation) and electron beam irradiation, at five targeted absorbed doses of 0.5, 1.0, 2.5, 5.0, and 7.0 kGy. Commercially available irradiated patties were also studied. A supercritical fluid extraction (SFE) procedure was optimized and used for the extraction and isolation of the alkylcyclobutanones. Samples can be used for extraction without a prior cleanup step, which makes this procedure rapid and convenient to use. Identification and quantitation of the cyclobutanones were done by gas chromatography-mass spectroscopy. 2-DCB was detected in all of the irradiated samples (including commercial patties), and its concentration increased linearly with the irradiation dose. Electron beam irradiation produced a greater amount of 2-DCB compared to gamma-irradiation at dose levels >2.5 kGy. 2-TDCB was detected only at the two higher irradiation doses, whereas both marker compounds were not detected in the non-irradiated samples.

  11. EPR Investigation of Irradiated Curry Powder

    SciTech Connect

    Duliu, O. G.; Ali, S. I.; Georgescu, R.

    2007-04-23

    Gamma-ray irradiated curry powder, a well priced oriental spice was investigated in order to establish the ability of EPR to detect the presence and time stability of free irradiation free-radicals. Accordingly, curry powder aliquots were irradiated with gradually increasing absorbed doses up to 11.3 kGy. The EPR spectra of all irradiated samples show the presence of al last two different species of free radicals, whose concentration increased monotonously with the absorbed doses. A 100 deg. C isothermal annealing of irradiated samples has shown a differential reduction of amplitude of various components of the initial spectra, but even after 3.6 h of thermal treatment, the remaining amplitude represents no less then 30% of the initial ones. The same peculiarities have been noticed after more than one year storage at room temperature, all of them being very useful in establishing the existence of any previous irradiation treatment.

  12. Early esophageal carcinoma treated with intracavitary irradiation

    SciTech Connect

    Hishikawa, Y.; Tanaka, S.; Miura, T.

    1985-08-01

    Five patients with early esophageal carcinoma were treated by 6-12 Gy of intracavitary irradiation following 50-60 Gy of external irradiation as a boost therapy. Surgery was not performed in these cases. None of the patients had local recurrence after radiation therapy, as demonstrated by esophagography and endoscopy. Three patients have been alive for 1-3 years 10 months. Esophageal ulceration induced by intracavitary irradiation has occurred in three of the five patients; however, intracavitary irradiation is still a beneficial treatment because of its efficacy in controlling local lesions and because radiation ulceration can eventually be cured. Intracavitary irradiation is recommended to follow external irradiation as a boost therapy for the treatment of early esophageal carcinoma.

  13. A new multipurpose gamma-irradiation facility

    NASA Astrophysics Data System (ADS)

    Huebner, G.

    In the past 3 yr much work has been done in the G.D.R. on food irradiation. The experiments have shown that this treatment gives favourable results in many products such as spices, onions, potatoes, chicken, animal feeds, fodder yeast, drugs and vaccines. Economic aspects of food irradiation require the effective use of an irradiation plant and cobalt-60. Therefore, a new multipurpose irradiation facility was developed, applicable as an onion irradiator with a capacity of about 15 ton/h and for the simultaneous irradiation of different products (spices, animal feed, chicken, etc.) in closed product ☐es with a size of 1.2 m x 1.0 m x 1.2 m. A microcomputer controls the transport of product ☐es around the gamma sources.

  14. HRB-22 irradiation phase test data report

    SciTech Connect

    Montgomery, F.C.; Acharya, R.T.; Baldwin, C.A.; Rittenhouse, P.L.; Thoms, K.R.; Wallace, R.L.

    1995-03-01

    Irradiation capsule HRB-22 was a test capsule containing advanced Japanese fuel for the High Temperature Test Reactor (HTTR). Its function was to obtain fuel performance data at HTTR operating temperatures in an accelerated irradiation environment. The irradiation was performed in the High Flux Isotope Reactor (HFIR) at the Oak Ridge National Laboratory (ORNL). The capsule was irradiated for 88.8 effective full power days in position RB-3B of the removable beryllium (RB) facility. The maximum fuel compact temperature was maintained at or below the allowable limit of 1300{degrees}C for a majority of the irradiation. This report presents the data collected during the irradiation test. Included are test thermocouple and gas flow data, the calculated maximum and volume average temperatures based on the measured graphite temperatures, measured gaseous fission product activity in the purge gas, and associated release rate-to-birth rate (R/B) results. Also included are quality assurance data obtained during the test.

  15. (Irradiation embrittlement of reactor pressure vessels)

    SciTech Connect

    Corwin, W.R.

    1990-09-24

    The traveler served as a member of the two-man US Nuclear Regulatory Commission sponsored team who visited the Prometey Complex in Leningrad to assess the potential for expanded cooperative research concerning integrity of the primary pressure boundary in commercial light-water reactors. The emphasis was on irradiation embrittlement, structural analysis, and fracture mechanics research for reactor pressure vessels. At the irradiation seminar in Cologne, presentations were made by German, French, Finnish, Russian, and US delegations concerning many aspects of irradiation of pressure vessel steels. The traveler made presentations on mechanisms of irradiation embrittlement and on important aspects of the Heavy-Section Steel Irradiation Program results of irradiated fracture mechanics tests.

  16. Thermal analysis applied to irradiated propolis

    NASA Astrophysics Data System (ADS)

    Matsuda, Andrea Harumi; Machado, Luci Brocardo; del Mastro, Nélida Lucia

    2002-03-01

    Propolis is a resinous hive product, collected by bees. Raw propolis requires a decontamination procedure and irradiation appears as a promising technique for this purpose. The valuable properties of propolis for food and pharmaceutical industries have led to increasing interest in its technological behavior. Thermal analysis is a chemical analysis that gives information about changes on heating of great importance for technological applications. Ground propolis samples were 60Co gamma irradiated with 0 and 10 kGy. Thermogravimetry curves shown a similar multi-stage decomposition pattern for both irradiated and unirradiated samples up to 600°C. Similarly, through differential scanning calorimetry , a coincidence of melting point of irradiated and unirradiated samples was found. The results suggest that the irradiation process do not interfere on the thermal properties of propolis when irradiated up to 10 kGy.

  17. Methods for detection of irradiation of spices.

    PubMed

    Sjöberg, A M; Manninen, M; Härmälä, P; Pinnioja, S

    1990-02-01

    Three types of methods for the identification of irradiation of spices were tested as potential control methods. The methods were microbiological, combining a direct epifluorescent filter technique (DEFT) with a total aerobic plate count (APC), a chemiluminescence method and chemical gas-chromatographic (GC) and GC mass-spectrometric (MS) methods for analysis of volatile oils of spices isolated by steam distillation. Twelve samples of spices, mainly peppers, were analysed before and after gamma-irradiation with doses of 10 and 50 kGy. The chemiluminescence measurements were performed before the irradiation and 10 and 100 days after the irradiation. The best methods for control purposes were the microbiological (DEFT + APC) methods combined with chemiluminescence measurements. No differences were detected between the irradiated and non-irradiated samples with the chemical methods.

  18. EPR Investigation of Irradiated Curry Powder

    NASA Astrophysics Data System (ADS)

    Duliu, O. G.; Ali, S. I.; Georgescu, R.

    2007-04-01

    Gamma-ray irradiated curry powder, a well priced oriental spice was investigated in order to establish the ability of EPR to detect the presence and time stability of free irradiation free-radicals. Accordingly, curry powder aliquots were irradiated with gradually increasing absorbed doses up to 11.3 kGy. The EPR spectra of all irradiated samples show the presence of al last two different species of free radicals, whose concentration increased monotonously with the absorbed doses. A 100° C isothermal annealing of irradiated samples has shown a differential reduction of amplitude of various components of the initial spectra, but even after 3.6 h of thermal treatment, the remaining amplitude represents no less then 30% of the initial ones. The same peculiarities have been noticed after more than one year storage at room temperature, all of them being very useful in establishing the existence of any previous irradiation treatment.

  19. Renal graft irradiation in acute rejection

    SciTech Connect

    Pilepich, M.V.; Sicard, G.A.; Breaux, S.R.; Etheredge, E.E.; Blum, J.; Anderson, C.B.

    1983-03-01

    To evaluate the effect of graft irradiation in the treatment of acute rejection of renal transplants, a randomized study was conducted from 1978 to 1981. Patients with acute rejection were given standard medical management in the form of intravenous methylprednisolone, and were chosen randomly to receive either graft irradiation (175 rads every other day, to a total of 525 rads) or simulated (sham) irradiation. Eighty-three rejections occurring in 64 grafts were randomized to the protocol. Rejection reversal was recorded in 84.5% of control grafts and 75% of the irradiated grafts. Recurrent rejections were more frequent and graft survival was significantly lower in the irradiated group (22%) than in the control group (54%). Graft irradiation does not appear to be beneficial in the treatment of acute rejection of renal transplants when used in conjunction with high-dose steroids.

  20. STM investigation of irradiated carbon nanotubes

    NASA Astrophysics Data System (ADS)

    Osváth, Z.; Vértesy, G.; Pető, G.; Szabó, I.; Gyulai, J.; Maser, W.; Biró, L. P.

    2004-09-01

    Multi-wall and single wall carbon nanotubes (MWCNTs, SWCNTs) dispersed on graphite (HOPG) and gold substrates were irradiated with two different doses of Ar+ ions. The irradiated samples were investigated by scanning tunneling microscopy (STM) and spectroscopy (STS). The investigation of SWCNTs irradiated with low-dose Ar+ ions revealed isolated defects in the nanotube-walls, similar to the hillocks observed earlier on ion irradiated HOPG. These results are in agreement with recent predictions, which attribute the STM features produced by ion irradiation to local modifications of the local electronic structure. The high-dose irradiation of MWCNTs produced numerous defects in the nanotube-walls, and the surface of the nanotubes appeared rugged in the STM images. The rugged surface can be regarded as a summation of the individual hillocks, measured at the defect sites.

  1. Irradiation preservation of seafood: Literature review

    SciTech Connect

    Molton, P.M.

    1987-10-01

    The application of gamma-irradiation for extending the shelf life of seafood has been of interest for many years. This report reviews a number of studies on seafood irradiation conducted over the past several years. Topics covered include seafood irradiation techniques and dosages, species applicability and differences, the effects of packaging on seafood preservation, and changes in organoleptic acceptability as a result of irradiation. Particular attention is given to radiation effects (likely and unlikely) of concern to the public. These include the potential for generation of toxic chemical products, botulinum toxin production, and other health concerns. No scientifically defensible evidence of any kind was found for any harmful effect of irradiation of seafoods at the doses being considered (less than 300 krad), and all indications are that irradiation is an acceptable and needed additional tool for seafood preservation. 49 refs., 14 figs., 14 tabs.

  2. Irradiation Testing of Ultrasonic Transducers

    SciTech Connect

    Daw, Joshua; Tittmann, Bernhard; Reinhardt, Brian; Kohse, Gordon E.; Ramuhalli, Pradeep; Montgomery, Robert O.; Chien, Hual-Te; Villard, Jean-Francois; Palmer, Joe; Rempe, Joy

    2014-07-30

    Ultrasonic technologies offer the potential for high accuracy and resolution in-pile measurement of a range of parameters, including geometry changes, temperature, crack initiation and growth, gas pressure and composition, and microstructural changes. Many Department of Energy-Office of Nuclear Energy (DOE-NE) programs are exploring the use of ultrasonic technologies to provide enhanced sensors for in-pile instrumentation during irradiation testing. For example, the ability of single, small diameter ultrasonic thermometers (UTs) to provide a temperature profile in candidate metallic and oxide fuel would provide much needed data for validating new fuel performance models. Other efforts include an ultrasonic technique to detect morphology changes (such as crack initiation and growth) and acoustic techniques to evaluate fission gas composition and pressure. These efforts are limited by the lack of existing knowledge of ultrasonic transducer material survivability under irradiation conditions. For this reason, the Pennsylvania State University (PSU) was awarded an Advanced Test Reactor National Scientific User Facility (ATR NSUF) project to evaluate promising magnetostrictive and piezoelectric transducer performance in the Massachusetts Institute of Technology Research Reactor (MITR) up to a fast fluence of at least 1021 n/cm2 (E> 0.1 MeV). The goal of this research is to characterize magnetostrictive and piezoelectric transducer survivability during irradiation, enabling the development of novel radiation tolerant ultrasonic sensors for use in Material and Test Reactors (MTRs). As such, this test will be an instrumented lead test and real-time transducer performance data will be collected along with temperature and neutron and gamma flux data. The current work bridges the gap between proven out-of-pile ultrasonic techniques and in-pile deployment of ultrasonic sensors by acquiring the data necessary to demonstrate the performance of ultrasonic transducers.

  3. Irradiation Testing of Ultrasonic Transducers

    SciTech Connect

    Daw, Joshua; Tittmann, Bernhard; Reinhardt, Brian; Kohse, Gordon E.; Ramuhalli, Pradeep; Montgomery, Robert O.; Chien, Hual-Te; Villard, Jean-Francois; Palmer, Joe; Rempe, Joy

    2013-12-01

    Ultrasonic technologies offer the potential for high accuracy and resolution in-pile measurement of a range of parameters, including geometry changes, temperature, crack initiation and growth, gas pressure and composition, and microstructural changes. Many Department of Energy-Office of Nuclear Energy (DOE-NE) programs are exploring the use of ultrasonic technologies to provide enhanced sensors for in-pile instrumentation during irradiation testing. For example, the ability of single, small diameter ultrasonic thermometers (UTs) to provide a temperature profile in candidate metallic and oxide fuel would provide much needed data for validating new fuel performance models. Other efforts include an ultrasonic technique to detect morphology changes (such as crack initiation and growth) and acoustic techniques to evaluate fission gas composition and pressure. These efforts are limited by the lack of existing knowledge of ultrasonic transducer material survivability under irradiation conditions. For this reason, the Pennsylvania State University (PSU) was awarded an Advanced Test Reactor National Scientific User Facility (ATR NSUF) project to evaluate promising magnetostrictive and piezoelectric transducer performance in the Massachusetts Institute of Technology Research Reactor (MITR) up to a fast fluence of at least 1021 n/cm2 (E> 0.1 MeV). The goal of this research is to characterize magnetostrictive and piezoelectric transducer survivability during irradiation, enabling the development of novel radiation tolerant ultrasonic sensors for use in Material and Test Reactors (MTRs). As such, this test will be an instrumented lead test and real-time transducer performance data will be collected along with temperature and neutron and gamma flux data. The current work bridges the gap between proven out-of-pile ultrasonic techniques and in-pile deployment of ultrasonic sensors by acquiring the data necessary to demonstrate the performance of ultrasonic transducers.

  4. Ion irradiation of astrophysical ices

    NASA Astrophysics Data System (ADS)

    Palumbo, M. E.; Baratta, G. A.; Fulvio, D.; Garozzo, M.; Gomis, O.; Leto, G.; Spinella, F.; Strazzulla, G.

    2008-02-01

    Ices, silicates and carbonaceous materials have been detected in several astrophysical environments such as interstellar molecular clouds, comets, and planetary surfaces. These solids are continuously exposed to ion irradiation and UV photolysis. Our knowledge on the properties of solids and molecules and on the modification induced by fast ions (keV-MeV) and UV photons is mainly based on laboratory experiments and on the comparison of experimental results with observations. Here we will give a few examples of the role of laboratory experiments to our understanding of the physical and chemical properties of ices in space.

  5. Thymus irradiation for myasthenia gravis

    SciTech Connect

    Currier, R.D.; Routh, A.; Hickman, B.T.; Douglas, M.A.

    1983-01-01

    Twenty-eight patients with progressive myasthenia gravis without thymoma received treatment of 3000 rads (30 Gy) to the anterior mediastinum, and a followup was conducted for five to 18 years. Twenty-four patients had generalized myasthenia, and four had ocular myasthenia gravis. Twenty patients with generalized myasthenia survived the several month post-treatment period and improved, but four died during that period. The improvement lasted a median of 1.5 years, and older patients had longer remissions than younger patients. The four patients who had ocular myasthenia did not change after treatment. Mediastinal irradiation produces a temporary remission in generalized myasthenia.

  6. AFIP-6 Irradiation Summary Report

    SciTech Connect

    Danielle M Perez; M. A. Lillo; G. S. Chang; G. A. Roth; N. E. Woolstenhulme; D. M. Wachs

    2011-09-01

    The Advanced Test Reactor (ATR) Full size plate In center flux trap Position (AFIP) experiment AFIP-6 was designed to evaluate the performance of monolithic uranium-molybdenum (U-Mo) fuels at a length prototypic to that of the ATR fuel plates (45 inches in length). The AFIP-6 test was the first test with plates in a swaged condition with longer fuel zones of approximately 22.5 inches in length1,2. The following report summarizes the life of the AFIP-6 experiment through end of irradiation, including a brief description of the safety analysis, as-run neutronic analysis results, hydraulic testing results, and thermal analysis results.

  7. Food irradiation and airline catering

    SciTech Connect

    Preston, F.S.

    1988-04-01

    Food poisoning from contaminated airline food can produce serious consequences for airline crew and passengers and can hazard flight. While irradiation of certain foodstuffs has been practised in a number of countries for some years, application of the process has not been made to complete meals. This paper considers the advantages, technical considerations, costs and possible application to airline meals. In addition, the need to educate the public in the advantages of the process in the wake of incidents such as Chernobyl is discussed.

  8. Electron spin resonance identification of irradiated fruits

    NASA Astrophysics Data System (ADS)

    Raffi, Jacques J.; Agnel, Jean-Pierre L.

    The electron spin resonance spectrum of achenes, pips, stalks and stones from irradiated fruits (strawberry, raspberry, red currant, bilberry, apple, pear, fig, french prune, kiwi, water-melon and cherry) always displays, just after γ-treatment, a weak triplet ( aH≈30 G) due to a cellulose radical; its left line (lower field) can be used as an identification test of irradiation, at least for strawberries, rapsberries, red currants or bilberries irradiated in order to improve their storage time.

  9. Effects of irradiation of skin flaps

    SciTech Connect

    Sumi, Y.; Ueda, M.; Oka, T.; Torii, S.

    1984-07-01

    The reaction of skin flaps to irradiation and the optimum postoperative time for irradiation was studied in the rat. Flaps showed different reactions depending on the time of irradiation. There was a correlation between the radiosensitivity and the vascularity of the flap. Those flaps in the marginal hypovascular stage of revascularization showed reactions similar to normal skin. However, severe adverse reactions were observed in the marginal hypervascular stage.

  10. Healing burns using atmospheric pressure plasma irradiation

    NASA Astrophysics Data System (ADS)

    Hirata, Takamichi; Kishimoto, Takumi; Tsutsui, Chihiro; Kanai, Takao; Mori, Akira

    2014-01-01

    An experiment testing the effects of plasma irradiation with an atmospheric-pressure plasma (APP) reactor on rats given burns showed no evidence of electric shock injuries upon pathology inspection of the irradiated skin surface. In fact, the observed evidence of healing and improvement of the burns suggested healing effects from plasma irradiation. The quantities of neovascular vessels in the living tissues at 7 days were 9.2 ± 0.77 mm-2 without treatment and 18.4 ± 2.9 mm-2 after plasma irradiation.

  11. Aqueous marker penetration into ion irradiated polyimide

    NASA Astrophysics Data System (ADS)

    Fink, D.; Müller, M.; Petrov, A.; Klett, R.; Palmetshofer, L.; Hnatowicz, V.; Vacik, J.; Cervena, J.; Chadderton, L. T.

    2002-05-01

    The penetration of aqueous 6Li + markers into low energy ion irradiated polyimide (PI) foils was examined by the neutron depth profiling technique in combination with a modified tomographic approach. The ion irradiation always leads to an enhancement in marker uptake. After irradiation at low fluence the marker profiles follow the nuclear damage distribution even in three dimensions. At elevated fluences saturation in the marker uptake is clearly seen. The polymer's penetrant uptake can be described well by regular diffusion, with nuclear damage centres acting as saturable traps. These observations are strikingly different from the marker penetration into high-energy heavy-ion irradiated PI.

  12. The irradiation effects on zirconium alloys

    NASA Astrophysics Data System (ADS)

    Negut, Gh.; Ancuta, M.; Radu, V.; Ionescu, S.; Stefan, V.; Uta, O.; Prisecaru, I.; Danila, N.

    2007-05-01

    Pressure tube samples were irradiated under helium atmosphere in the TRIGA Steady State Research and Material Test Reactor of the Romanian Institute for Nuclear Research (INR). These samples are made of the Zr-2.5%Nb alloy used as structural material for the CANDU Romanian power reactors. After irradiation, mechanical tests were performed in the Post Irradiation Examination Laboratory (PIEL) to study the influence of irradiation on zirconium alloys mechanical behaviour. The tensile test results were used for structural integrity assessment. Results of the tests are presented. The paper presents, also, pressure tube structural integrity assessment.

  13. Analytical screening studies on irradiated food packaging.

    PubMed

    Driffield, M; Bradley, E L; Leon, I; Lister, L; Speck, D R; Castle, L; Potter, E L J

    2014-01-01

    Foods may be irradiated in their final packaging and this process may affect the composition of the packaging and in turn affect the migration of substances into food. Headspace and liquid injection GC-MS and HPLC with time-of-flight MS have been used to identify and estimate levels of radiolytic products in irradiated finished plastic packaging materials. Fifteen retail packaging materials were studied. Investigations were carried out into the effect of different irradiation types (gamma and electron beam), irradiation doses (1, 3, 7 and 10 kGy) and dose rates (5 kGy s(-1) for electron beam and 0.4 and 1.85 kGy h(-1) for gamma) on the radiolytic products. Any differences seen in comparing the two ionising radiation types were attributed largely to the very different dose rates; for electron beam a 10 kGy dose was delivered in just 2 s whereas using gamma it took 5.4 h. Differences were also seen when comparing the same samples irradiated at different doses. Some substances were not affected by irradiation, others decreased in concentration and others were formed upon increasing doses of irradiation. These results confirm that irradiation-induced changes do occur in substances with the potential to migrate and that the safety of the finished packaging material following irradiation should be assessed.

  14. Study of irradiation creep of vanadium alloys

    SciTech Connect

    Tsai, H.; Strain, R.V.; Smith, D.L.

    1997-08-01

    Thin-wall tubing was produced from the 832665 (500 kg) heat of V-4 wt.% Cr-4 wt.% Ti to study its irradiation creep behavior. The specimens, in the form of pressurized capsules, were irradiated in Advanced Test Reactor and High Flux Isotope Reactor experiments (ATR-A1 and HFIR RB-12J, respectively). The ATR-A1 irradiation has been completed and specimens from it will soon be available for postirradiation examination. The RB-12J irradiation is not yet complete.

  15. Data on total and spectral solar irradiance

    SciTech Connect

    Mecherikunnel, A.T.; Gatlin, J.A.; Richmond, J.C.

    1983-05-01

    This paper presents a brief survey of the data available on solar constant and extraterrestrial solar spectral irradiance. The spectral distribution of solar radiation at ground surface, computed from extraterrestrial solar spectral irradiance for several air mass values and for four levels of atmospheric pollution, is also presented. The total irradiance at ground level is obtained by integration of the area under the spectral irradiance curves. It is significant that, as air mass increases or as turbidity increases, the amount of energy in the infrared relative to the total increases and that the energy in the UV and visible decreases.

  16. Food irradiation facilities: Requirements and technical aspects

    NASA Astrophysics Data System (ADS)

    Mittendorfer, Josef

    2016-12-01

    This survey presents some aspects and requirement for food irradiation facilities. Topics like radiation source, dose ranges and dose rate are discussed, together with logistics and operational considerations

  17. Free radical kinetics on irradiated fennel

    NASA Astrophysics Data System (ADS)

    Yamaoki, Rumi; Kimura, Shojiro; Ohta, Masatoshi

    2008-09-01

    Herein, an electron spin resonance study on the behavior of organic radicals in fennel before and after irradiation is reported. The spectrum of irradiated fennel composed of the spectrum component derived from the un-irradiated sample (near g=2.005) and the spectra components derived from carbohydrates. The time decay of intensity spectral components was well explained by first-order kinetics with a variety of rate constants. Especially, the signal at near g=2.02 ascribed to stable cellulose-derivative components is expected to be a good indicator in the identification of irradiated plant samples.

  18. Food irradiation: Key research needs

    SciTech Connect

    Morehouse, K.M. )

    1993-01-01

    Treatment of foods with ionizing radiation reduces microbial infection and insect infestations, inhibits sprouting, and delays maturation, thereby extending the shelf life of foods. The treatment of different types of foods with ionizing radiation for specific purposes is accepted in several countries, although it is prohibited in others. The US Food and Drug Administration has established regulations to allow the treatment of several different foods with ionizing radiation and has received petitions for the approval of radiation treatment of additional foods. When carried out according to established good manufacturing practices, food irradiation yields safe, wholesome foods. The irradiated product may be often chemically or microbiologically [open quotes]safer[close quotes] than the nonirradiated product. This paper presents several areas of scientific research in which more information would facilitate the expansion of this technology and points out major areas of concern. The question of the public acceptance of foods that have been treated with ionizing radiation is discussed only briefly in order to make the presentation complete.

  19. Correlation of irradiation data using activation fluences and irradiation temperature.

    NASA Technical Reports Server (NTRS)

    Lynch, J. H.

    1972-01-01

    A new method of correlating radiation damage data is tested using actual measured data taken from the open literature. This method, the activation fluence method, was found to be as accurate as other contemporary models with which it was compared. The new method also has several advantages over the other methods. The method employs a new entity, the activation fluence (time-integrated specific activation rate), as the independent variables in a regression model. Temperature at which the irradiation takes place is also a variable. Although the method was tested for a specific type of damage (change in nil-ductility transition temperature for A302-B steel) it has no inherent restrictions and is limited only by the imagination of the user.

  20. A SU-8 dish for cell irradiation

    NASA Astrophysics Data System (ADS)

    Arteaga-Marrero, N.; Auzelyte, V.; Olsson, M. G.; Pallon, J.

    2007-10-01

    The objective of the CELLION project is radiation research at low doses. The main cell responses to low dose irradiation are bystander effects, genomic instability and adaptive responses. In order to study these effects it is convenient to make the cells addressable in space and time through locking the cell position. A new alternative dish has been developed for irradiation procedures at the Lund Nuclear Probe. The versatile dish can be used both to cultivate and to hold the cells during the irradiation procedure. The irradiation dish is made of an epoxy-based photopolymer named SU-8 chosen by its flexibility, non-toxicity and biological compatibility to cell attachment. It has been fabricated using a UV lithographic technique. The irradiation dish forms a 2 × 2 mm 2 grid which contains 400 squares. Each square has 80 μm side and is separated from neighbouring ones by 20 μm wide walls. The location of each square is marked by a row letter and column number patterned outside the grid. The Cell Irradiation Facility at the Lund Nuclear Probe utilizes protons to irradiate living cells. A post-cell detection set up is used to control the applied dose, detecting the number of protons after passing through the targeted cell. The transmission requirement is fulfilled by our new irradiation dish. So far, the dish has been used to perform non-targeted irradiation of Hepatoma cells. The cells attach and grow easily on the SU-8 surface. In addition, the irradiation procedure can be performed routinely and faster since the cells are incubated and irradiated in the same surface.

  1. Immune reactivity after high-dose irradiation

    SciTech Connect

    Gassmann, W.; Wottge, H.U.; von Kolzynski, M.; Mueller-Ruchholtz, W.

    1986-03-01

    Immune reactivity after total-body irradiation was investigated in rats using skin graft rejection as the indicator system. After sublethal irradiation with 10.5 Gy (approximately 50% lethality/6 weeks) the rejection of major histocompatibility complex allogeneic skin grafts was delayed significantly compared with nonirradiated control animals (28 versus 6.5 days). In contrast, skin grafts were rejected after 7.5 days in sublethally irradiated animals and 7 days in lethally irradiated animals if additional skin donor type alloantigens--namely, irradiated bone marrow cells--were given i.v. either simultaneously or with a delay of not more than 24 hr after the above conditioning regimen. These reactions were alloantigen-specific. They were observed in six different strain combinations with varying donors and recipients. Starting on day 2 after irradiation, i.v. injection of bone marrow gradually lost its effectivity and skin grafts were no longer rejected with uniform rapidity; skin donor marrow given on days 4 or 8 did not accelerate skin graft rejection at all. These data show that for approximately 1-2 days after high-dose total-body irradiation rats are still capable of starting a vigorous immune reaction against i.v.-injected alloantigens. The phenomenon of impaired rejection of skin grafted immediately after high-dose irradiation appears to result from the poor accessibility of skin graft alloantigens during the early postirradiation phase when vascularization of the grafted skin is insufficient.

  2. Schedule and status of irradiation experiments

    SciTech Connect

    Rowcliffe, A.F.; Grossbeck, M.L.; Robertson, J.P.

    1998-09-01

    The current status of reactor irradiation experiments is presented in tables summarizing the experimental objectives, conditions, and schedule. Currently, the program has one irradiation experiment in reactor and five experiments in the design or construction stages. Postirradiation examination and testing is in progress on ten experiments.

  3. Electron irradiation of dry food products

    NASA Astrophysics Data System (ADS)

    Grünewald, Th.

    The interest of the industrial food producer is increasing in having the irradiation facility installed in the food processing chain. The throughput of the irradiator should be high and the residence time of the product in the facility should be short. These conditions can be accomplished by electron irradiators. To clarify the irradiation conditions spices taken out of the industrial process, food grade salt, sugar, and gums as models of dry food products were irradiated. With a radiation dose of 10 kGy microbial load can be reduced on 10∗∗4 microorganisms/g. The sensory properties of the spices were not changed in an atypical way. For food grade salt and sugar changes of colour were observed which are due to lattice defects or initiated browning. The irradiation of several gums led only in some cases to an improvement of the thickness properties in the application below 50°C, in most cases the thickness effect was reduced. The products were packaged before irradiation. But it would be possible also to irradiate the products without packaging moving the product through the iradiation field in a closed conveyor system.

  4. Reprocessing technology development for irradiated beryllium

    SciTech Connect

    Kawamura, H.; Sakamoto, N.; Tatenuma, K.

    1995-09-01

    At present, beryllium is under consideration as a main candidate material for neutron multiplier and plasma facing material in a fusion reactor. Therefore, it is necessary to develop the beryllium reprocessing technology for effective resource use. And, we have proposed reprocessing technology development on irradiated beryllium used in a fusion reactor. The preliminary reprocessing tests were performed using un-irradiated and irradiated beryllium. At first, we performed beryllium separation tests using un-irradiated beryllium specimens. Un-irradiated beryllium with beryllium oxide which is a main impurity and some other impurities were heat-treated under chlorine gas flow diluted with Ar gas. As the results high purity beryllium chloride was obtained in high yield. And it appeared that beryllium oxide and some other impurities were removed as the unreactive matter, and the other chloride impurities were separated by the difference of sublimation temperature on beryllium chloride. Next, we performed some kinds of beryllium purification tests from beryllium chloride. And, metallic beryllium could be recovered from beryllium chloride by the reduction with dry process. In addition, as the results of separation and purification tests using irradiated beryllium specimens, it appeared that separation efficiency of Co-60 from beryllium was above 96%. It is considered that about 4% Co-60 was carried from irradiated beryllium specimen in the form of cobalt chloride. And removal efficiency of tritium from irradiated beryllium was above 95%.

  5. Electron Spin Relaxation in Irradiated Solids.

    DTIC Science & Technology

    1996-03-01

    the development and use of ELDOR techniques to study the spectral diffusion in irradiated L-alanine and other irradiated organic solids. Pulsed STELDOR...and pulsed two-frequency ELDOR methods were developed and the details of the implementation is reported. The assignment of relaxation times that gave

  6. Schedule and status of irradiation experiments

    SciTech Connect

    Rowcliffe, A.F.; Grossbeck, M.L.; Robertson, J.P.

    1998-03-01

    The current status of reactor irradiation experiments is presented in tables summarizing the experimental objectives, conditions, and schedule. Currently, the program has four irradiation experiments in reactor, and five experiments in the design or construction stages. Postirradiation examination and testing is in progress on ten experiments.

  7. A Retailer's Experience with Irradiated Foods

    SciTech Connect

    James P. Corrigan

    2000-11-12

    A food irradiation success story comes from Northbrook, Illinois, where Carrot Top, Inc., has been routinely carrying irradiated food for more than 7 yr. This paper presents the experiences of Carrot Top during those years, details the marketing approaches used, and summarizes the resulting sales figures.

  8. Identification of irradiated apples for phytosanitary purposes

    NASA Astrophysics Data System (ADS)

    Horak, Celina I.; Di Giorgio, Marina; Kairiyama, Eulogia

    2009-07-01

    The irradiation treatment of fresh fruits and vegetables for phytosanitary purposes is a satisfactory alternative method to others like fumigation and cold and hot treatments. Its use is increasing in several countries, and at present its approval is under revision by the National Regulatory Authorities. To verify the control process, apart from irradiation and dosimetry certificates, National Authorities require complementary evidence to show the efficacy of this treatment, especially when the documentation is not clear. The irradiation of fresh fruits produces single and double fragmentation in the DNA molecule, which can be measured using the microgel electrophoresis of individual cell (comet assay). The purpose of this work was to evaluate if it is possible to identify the irradiated apples for phytosanitary purposes from the others that were not treated. The possibility to estimate the absorbed dose was also evaluated. The methodology was carried out on the cell suspension obtained from irradiated seed cells with incremental doses (100, 200 and 300 Gy). The irradiation treatment for phytosanitary purposes to avoid emergency of codling moth ( Cydia pomonella) is 200 Gy. The fragmentation produced in the irradiated samples was proportional with the incremental doses applied. These results show that with this methodology it can be determined if the apple was irradiated or not. This comet assay is a simple, economical and interesting method that can be used, in case of necessity, by the National Authorities.

  9. Proton irradiation study of GFR candidate ceramics

    NASA Astrophysics Data System (ADS)

    Gan, Jian; Yang, Yong; Dickson, Clayton; Allen, Todd

    2009-06-01

    This work investigated the microstructural response of SiC, ZrC and ZrN irradiated with 2.6 MeV protons at 800 °C to a fluence of 2.75 × 10 19 protons/cm 2, corresponding to 0.71-1.8 displacement per atom (dpa), depending on the material. The change of lattice constant evaluated using HOLZ patterns is not observed. In comparison to Kr ion irradiation at 800 °C to 10 dpa from the previous studies, the proton irradiated ZrC and ZrN at 1.8 dpa show less irradiation damage to the lattice structure. The proton irradiated ZrC exhibits faulted loops which are not observed in the Kr ion irradiated sample. ZrN shows the least microstructural change from proton irradiation. The microstructure of 6H-SiC irradiated to 0.71 dpa consists of black dot defects at high density.

  10. Passive SiC irradiation temperature monitor

    SciTech Connect

    Youngblood, G.E.

    1996-04-01

    A new, improved passive irradiation temperature monitoring method was examined after an irradiation test at 627{degrees}C. The method is based on the analysis of thermal diffusivity changes during postirradiation annealing of polycrystalline SiC. Based on results from this test, several advantages for using this new method rather than a method based on length or lattice parameter changes are given.

  11. Cherry Irradiation Studies. 1984 annual report

    SciTech Connect

    Eakin, D.E.; Hungate, F.P.; Tingey, G.L.; Olsen, K.L.; Fountain, J.B.; Burditt, A.K. Jr.; Moffit, H.R.; Johnson, D.A.; Lunden, J.D.

    1985-04-01

    Fresh cherries, cherry fruit fly larvae, and codling moth larvae were irradiated using the PNL cobalt-60 facility to determine the efficacy of irradiation treatment for insect disinfestation and potential shelf life extension. Irradiation is an effective disinfestation treatment with no significant degradation of fruit at doses well above those required for quarantine treatment. Sufficient codling moth control was achieved at projected doses of less than 25 krad; cherry fruit fly control, at projected doses of less than 15 krad. Dose levels up to 60 krad did not adversely affect cherry quality factors tested. Irradiation above 60 krad reduced the firmness of cherries but had no significant impact on other quality factors tested. Irradiation of cherries below 80 krad did not result in any significant differences in sensory evaluations (appearance, flavor, and firmness) in tests conducted at OSU. Irradiation up to 200 krad at a temperature of about 25/sup 0/C (77/sup 0/F) did not measurably extend shelf life. Irradiation at 500 krad at 25/sup 0/C (77/sup 0/F) increased mold and rotting of cherries tested. There is no apparent advantage of irradiation over low-temperature fumigation.

  12. AGR-1 Post Irradiation Examination Final Report

    SciTech Connect

    Demkowicz, Paul Andrew

    2015-08-01

    The post-irradiation examination (PIE) of the Advanced Gas Reactor (AGR)-1 experiment was a multi-year, collaborative effort between Idaho National Laboratory (INL) and Oak Ridge National Laboratory (ORNL) to study the performance of UCO (uranium carbide, uranium oxide) tristructural isotropic (TRISO) coated particle fuel fabricated in the U.S. and irradiated at the Advanced Test Reactor at INL to a peak burnup of 19.6% fissions per initial metal atom. This work involved a broad array of experiments and analyses to evaluate the level of fission product retention by the fuel particles and compacts (both during irradiation and during post-irradiation heating tests to simulate reactor accident conditions), investigate the kernel and coating layer morphology evolution and the causes of coating failure, and explore the migration of fission products through the coating layers. The results have generally confirmed the excellent performance of the AGR-1 fuel, first indicated during the irradiation by the observation of zero TRISO coated particle failures out of 298,000 particles in the experiment. Overall release of fission products was determined by PIE to have been relatively low during the irradiation. A significant finding was the extremely low levels of cesium released through intact coatings. This was true both during the irradiation and during post-irradiation heating tests to temperatures as high as 1800°C. Post-irradiation safety test fuel performance was generally excellent. Silver release from the particles and compacts during irradiation was often very high. Extensive microanalysis of fuel particles was performed after irradiation and after high-temperature safety testing. The results of particle microanalysis indicate that the UCO fuel is effective at controlling the oxygen partial pressure within the particle and limiting kernel migration. Post-irradiation examination has provided the final body of data that speaks to the quality of the AGR-1 fuel, building

  13. AFIP-2 Irradiation Summary Report

    SciTech Connect

    Danielle M Perez

    2011-04-01

    The Advanced Test Reactor (ATR) Full size plate In center flux trap Position (AFIP) experiment AFIP-2 was designed to evaluate the performance of monolithic fuels at a prototypic scale of 2.25 inches x 21.5 inches x 0.050 inches (5.75 cm x 54.6 cm x 0.13cm). The AFIP-2 experiment was fabricated by friction bond (FB) and consists of two plates, one with a zirconium (Zr) diffusion barrier and one with a silicon (Si) enhanced fuel/clad interface1,2. The following report summarizes the life of the AFIP-2 experiment through end of irradiation, including a brief description of the safety analysis, as-run neutronic analysis results, hydraulic testing results, and thermal analysis results. The safety analyses performed for AFIP-2 are summarized in Table 5 of the following report.

  14. AFIP-2 Irradiation Summary Report

    SciTech Connect

    Danielle M Perez; M. A. Lillo; G. S. Chang; G. A. Roth; N. E. Woolstenhulme; D. M. Wachs

    2011-05-01

    The Advanced Test Reactor (ATR) Full size plate In center flux trap Position (AFIP) experiment AFIP-2 was designed to evaluate the performance of monolithic fuels at a prototypic scale of 2.25 inches x 21.5 inches x 0.050 inches (5.75 cm x 54.6 cm x 0.13cm). The AFIP-2 experiment was fabricated by friction bond (FB) and consists of two plates, one with a zirconium (Zr) diffusion barrier and one with a silicon (Si) enhanced fuel/clad interface1,2. The following report summarizes the life of the AFIP-2 experiment through end of irradiation, including a brief description of the safety analysis, as-run neutronic analysis results, hydraulic testing results, and thermal analysis results. The safety analyses performed for AFIP-2 are summarized in Table 5 of the following report.

  15. RERTR-7 Irradiation Summary Report

    SciTech Connect

    D. M. Perez; M. A. Lillo; G. S. Chang; G. A. Roth; N. E. Woolstenhulme; D. M. Wachs

    2011-12-01

    The Reduced Enrichment for Research and Test Reactor (RERTR) experiment RERTR-7A, was designed to test several modified fuel designs to target fission densities representative of a peak low enriched uranium (LEU) burnup in excess of 90% U-235 at peak experiment power sufficient to generate a peak surface heat flux of approximately 300 W/cm2. The RERTR-7B experiment was designed as a high power test of 'second generation' dispersion fuels at peak experiment power sufficient to generate a surface heat flux on the order of 230 W/cm2.1 The following report summarizes the life of the RERTR-7A and RERTR-7B experiments through end of irradiation, including as-run neutronic analyses, thermal analyses and hydraulic testing results.

  16. AFIP-1 Irradiation Summary Report

    SciTech Connect

    D. M. Perez; M. A. Lillo; G. S. Chang; G. A. Roth; N. E. Woolstenhulme; D. M. Wachs

    2011-05-01

    The Advanced Test Reactor (ATR) Full size plate In center flux trap Position (AFIP) experiment AFIP-1 was designed to demonstrate the performance of second-generation dispersion fuels at a prototypic scale with a length of 21.5 inches (54.6 cm), width of 2.25 inches (5.75 cm) and a thickness of 0.050 inch (0.13 cm). The experiment was fabricated using commercially standard practices at BWX Technology, Inc. (BWXT). The U-7Mo fuel particles were supplied by the Korean Atomic Energy Research Institute (KAERI) using equipment intended for commercial supply. Two fuel plates were tested that incorporated two different matrix compositions, Al-2Si and Al-4043.1 The following report summarizes the life of the AFIP-1 experiment through end of irradiation, including a brief description of the safety analysis, as-run neutronic analysis results, hydraulic testing results, and thermal analysis results

  17. Variability of solar ultraviolet irradiance

    NASA Technical Reports Server (NTRS)

    Pap, J. M.; Donnelly, R. F.; Hudson, H. S.; Rottman, G. J.; Willson, R. C.

    1991-01-01

    A model of solar Lyman alpha irradiance developed by multiple linear regression analysis, including the daily values and 81-day running means of the full disk equivalent width of the Helium line at 1083 nm, predicts reasonably well both the short- and long-term variations observed in Lyman alpha. In contrast, Lyman alpha models calculated from the 10.7-cm radio flux overestimate the observed variations in the rising portion and maximum period of solar cycle, and underestimates them during solar minimum. Models are shown of Lyman alpha based on the He-line equivalent width and 10.7-cm radio flux for those time intervals when no satellite observations exist, namely back to 1974 and after April 1989, when the measurements of the Solar Mesosphere Satellite were terminated.

  18. AFIP-3 Irradiation Summary Report

    SciTech Connect

    Danielle M Perez; M. A. Lillo; G. S. Chang; G. A. Roth; N. E. Woolstenhulme; D. M. Wachs

    2011-05-01

    The Advanced Test Reactor (ATR) Full size plate In center flux trap Position (AFIP) experiment AFIP-3 was designed to evaluate the performance of monolithic fuels at a prototypic scale of 2.25 inches x 21.5 inches x 0.050 inches (5.75 cm x 54.6 cm x 0.13cm). The AFIP-3 experiment was fabricated by hot isostatic pressing (HIP) and consists of two plates, one with a zirconium (Zr) diffusion barrier and one with a silicon (Si) enhanced fuel/clad interface1,2. The following report summarizes the life of the AFIP-3 experiment through end of irradiation, including a brief description of the safety analysis, as-run neutronic analysis results, hydraulic testing results, and thermal analysis results.

  19. AFIP-3 Irradiation Summary Report

    SciTech Connect

    Danielle M Perez

    2011-04-01

    The Advanced Test Reactor (ATR) Full size plate In center flux trap Position (AFIP) experiment AFIP-3 was designed to evaluate the performance of monolithic fuels at a prototypic scale of 2.25 inches x 21.5 inches x 0.050 inches (5.75 cm x 54.6 cm x 0.13cm). The AFIP-3 experiment was fabricated by hot isostatic pressing (HIP) and consists of two plates, one with a zirconium (Zr) diffusion barrier and one with a silicon (Si) enhanced fuel/clad interface1,2. The following report summarizes the life of the AFIP-3 experiment through end of irradiation, including a brief description of the safety analysis, as-run neutronic analysis results, hydraulic testing results, and thermal analysis results.

  20. AFIP-3 Irradiation Summary Report

    SciTech Connect

    Danielle M Perez; M. A. Lillo; G. S. Chang; G. A. Roth; N. E. Woolstenhulme; D. M. Wachs

    2012-03-01

    The Advanced Test Reactor (ATR) Full size plate In center flux trap Position (AFIP) experiment AFIP-3 was designed to evaluate the performance of monolithic fuels at a prototypic scale of 2.25 inches x 21.5 inches x 0.050 inches (5.75 cm x 54.6 cm x 0.13cm). The AFIP-3 experiment was fabricated by hot isostatic pressing (HIP) and consists of two plates, one with a zirconium (Zr) diffusion barrier and one with a silicon (Si) enhanced fuel/clad interface1,2. The following report summarizes the life of the AFIP-3 experiment through end of irradiation, including a brief description of the safety analysis, as-run neutronic analysis results, hydraulic testing results, and thermal analysis results.

  1. RERTR-10 Irradiation Summary Report

    SciTech Connect

    D. M. Perez

    2011-05-01

    The Reduced Enrichment for Research and Test Reactor (RERTR) experiment RERTR-10 was designed to further test the effectiveness of modified fuel/clad interfaces in monolithic fuel plates. The experiment was conducted in two campaigns: RERTR-10A and RERTR-10B. The fuel plates tested in RERTR-10A were all fabricated by Hot Isostatic Pressing (HIP) and were designed to evaluate the effect of various Si levels in the interlayer and the thickness of the Zr interlayer (0.001”) using 0.010” and 0.020” nominal foil thicknesses. The fuel plates in RERTR-10B were fabricated by Friction Bonding (FB) with two different thickness Si layers and Nb and Zr diffusion barriers.1 The following report summarizes the life of the RERTR-10A/B experiment through end of irradiation, including as-run neutronic analysis results, thermal analysis results and hydraulic testing results.

  2. Microbiological decontamination of natural honey by irradiation

    NASA Astrophysics Data System (ADS)

    Migdał, W.; Owczarczyk, H. B.; K ȩdzia, B.; Hołderna-K ȩdzia, E.; Madajczyk, D.

    2000-03-01

    Degree of microbiological decontamination, organoleptic and physico-chemical properties of natural honeys were investigated after radiation treatment. Seven kinds of honeys were irradiated with the beams of 10 MeV electrons from a 10 kW linear accelerator "Elektronika 10-10" at the dose 10 kGy. It was shown, that after irradiation, the total count of aerobic and anaerobic bacteria and moulds decrease by 99%. The antibiotic value in investigated honeys increased in turn from 1.67 to 2.67 after irradiation. Such factors and parameters of investigated honeys as their consistency, content of water and saccharose, acidity, the diastase and 5-HMF values were not changed significantly after irradiation. Decontamination by irradiation is a process which allows us to obtain high microbiological purity of honeys. It is especially needed, when honeys are used in surgical treatment of injuries and in nutrition of babies with food deficiency.

  3. Parameterization of daily solar global ultraviolet irradiation.

    PubMed

    Feister, U; Jäkel, E; Gericke, K

    2002-09-01

    Daily values of solar global ultraviolet (UV) B and UVA irradiation as well as erythemal irradiation have been parameterized to be estimated from pyranometer measurements of daily global and diffuse irradiation as well as from atmospheric column ozone. Data recorded at the Meteorological Observatory Potsdam (52 degrees N, 107 m asl) in Germany over the time period 1997-2000 have been used to derive sets of regression coefficients. The validation of the method against independent data sets of measured UV irradiation shows that the parameterization provides a gain of information for UVB, UVA and erythemal irradiation referring to their averages. A comparison between parameterized daily UV irradiation and independent values of UV irradiation measured at a mountain station in southern Germany (Meteorological Observatory Hohenpeissenberg at 48 degrees N, 977 m asl) indicates that the parameterization also holds even under completely different climatic conditions. On a long-term average (1953-2000), parameterized annual UV irradiation values are 15% and 21% higher for UVA and UVB, respectively, at Hohenpeissenberg than they are at Potsdam. Daily global and diffuse irradiation measured at 28 weather stations of the Deutscher Wetterdienst German Radiation Network and grid values of column ozone from the EPTOMS satellite experiment served as inputs to calculate the estimates of the spatial distribution of daily and annual values of UV irradiation across Germany. Using daily values of global and diffuse irradiation recorded at Potsdam since 1937 as well as atmospheric column ozone measured since 1964 at the same site, estimates of daily and annual UV irradiation have been derived for this site over the period from 1937 through 2000, which include the effects of changes in cloudiness, in aerosols and, at least for the period of ozone measurements from 1964 to 2000, in atmospheric ozone. It is shown that the extremely low ozone values observed mainly after the eruption of Mt

  4. AGC-1 Irradiation Experiment Test Plan

    SciTech Connect

    R. L. Bratton

    2006-05-01

    The Advanced Graphite Capsule (AGC) irradiation test program supports the acquisition of irradiated graphite performance data to assist in the selection of the technology to be used for the VHTR. Six irradiations are planned to investigate compressive creep in graphite subjected to a neutron field and obtain irradiated mechanical properties of vibrationally molded, extruded, and iso-molded graphites for comparison. The experiments will be conducted at three temperatures: 600, 900, and 1200°C. At each temperature, two different capsules will be irradiated to different fluence levels, the first from 0.5 to 4 dpa and the second from 4 to 7 dpa. AGC-1 is the first of the six capsules designed for ATR and will focus on the prismatic fluence range.

  5. Li + grafting of ion irradiated polyethylene

    NASA Astrophysics Data System (ADS)

    Švorčík, V.; Rybka, V.; Vacík, J.; Hnatowicz, V.; Öchsner, R.; Ryssel, H.

    1999-02-01

    Foils of oriented polyethylene (PE) were irradiated with 63 keV Ar + and 155 keV Xe + ions to different fluences at room temperature and then doped from water solution of LiCl. The as irradiated and irradiated plus doped samples were examined by IR, EPR and neutron depth profiling (NDP) technique. The sheet resistance was also measured by the standard two points method. After Li salt doping of ion modified layer of PE, a reaction between degraded macromolecules and Li occur and thus a new chemical structure C-Li + is formed. Owing to the presence of these cations on the polymer chain, the irradiated plus doped layer exhibits higher electric conductivity compared to as-irradiated ones.

  6. Modeling of Irradiation Hardening of Polycrystalline Materials

    SciTech Connect

    Li, Dongsheng; Zbib, Hussein M.; Garmestani, Hamid; Sun, Xin; Khaleel, Mohammad A.

    2011-09-14

    High energy particle irradiation of structural polycrystalline materials usually produces irradiation hardening and embrittlement. The development of predict capability for the influence of irradiation on mechanical behavior is very important in materials design for next generation reactors. In this work a multiscale approach was implemented to predict irradiation hardening of body centered cubic (bcc) alpha-iron. The effect of defect density, texture and grain boundary was investigated. In the microscale, dislocation dynamics models were used to predict the critical resolved shear stress from the evolution of local dislocation and defects. In the macroscale, a viscoplastic self-consistent model was applied to predict the irradiation hardening in samples with changes in texture and grain boundary. This multiscale modeling can guide performance evaluation of structural materials used in next generation nuclear reactors.

  7. Cost effective alternative to low irradiance measurements

    NASA Technical Reports Server (NTRS)

    Oleary, Scott T.

    1988-01-01

    Martin Marietta's Space Simulation Laboratory (SSL) has a Thermal Environment Simulator (TES) with 56 individually controlled heater zones. The TES has a temperature range of approximately minus 129 C to plus 149 C. Because of the ability of TES to provide complex irradiance distributions, it is necessary to be able to measure a wide range of irradiance levels. SSL currently uses ambient temperature controlled radiometers with the capacity to measure sink irradiance levels of approximately 42.6 mw/sq cm, sink temperature equals 21 C and up. These radiometers could not be used to accurately measure the lower irradiance levels of the TES. Therefore, it was necessary to obtain a radiometer or develop techniques which could be used to measure lower irradiance levels.

  8. ATF Neutron Irradiation Program Technical Plan

    SciTech Connect

    Geringer, J. W.; Katoh, Yutai

    2016-03-01

    The Japan Atomic Energy Agency (JAEA) under the Civil Nuclear Energy Working Group (CNWG) is engaged in a cooperative research effort with the U.S. Department of Energy (DOE) to explore issues related to nuclear energy, including research on accident-tolerant fuels and materials for use in light water reactors. This work develops a draft technical plan for a neutron irradiation program on the candidate accident-tolerant fuel cladding materials and elements using the High Flux Isotope Reactor (HFIR). The research program requires the design of a detailed experiment, development of test vehicles, irradiation of test specimens, possible post-irradiation examination and characterization of irradiated materials and the shipment of irradiated materials to JAEA in Japan. This report discusses the technical plan of the experimental study.

  9. Effect of Laser Irradiation on Enzyme Activity

    NASA Astrophysics Data System (ADS)

    Murakami, Satoshi; Kashii, Masafumi; Kitano, Hiroshi; Adachi, Hiroaki; Takano, Kazufumi; Matsumura, Hiroyoshi; Inoue, Tsuyoshi; Mori, Yusuke; Doi, Masaaki; Sugamoto, Kazuomi; Yoshikawa, Hideki; Sasaki, Takatomo

    2005-11-01

    We previously developed a protein crystallization technique using a femtosecond laser and protein crystal processing and detaching techniques using a pulsed UV laser. In this study, we examine the effect of laser irradiation on protein integrity. After several kinds of laser were irradiated on part of a solution of glycerol-6-phosphate dehydrogenase from Leuconostoc mesenteroides, we measured the enzyme activity. Femtosecond and deep-UV laser irradiations have little influence on the whole enzyme activity, whereas the enzyme lost its activity upon high-power near-infrared laser irradiation at a wavelength of 1547 nm. These results suggest that suitable laser irradiation has no remarkable destructive influence on protein crystallization or crystal processing.

  10. Relief of vasospasm by intravascular ultraviolet irradiation

    NASA Astrophysics Data System (ADS)

    Nakai, Kanji; Morimoto, Yuji; Ito, Hirotaka; Kominami, Kimito; Matsuo, Hirotaka; Arai, Tsunenori; Kikuchi, Makoto

    1998-05-01

    We investigated the photovasorelaxation with intravascular transluminal irradiation using in vivo model. A 2.5 Fr. catheter was inserted in the femoral artery of a rabbit under anesthesia. A 400 micrometers diameter quartz fiber was inserted through the catheter. The catheter was withdrawn from the distal end to the proximal end of the exposed femoral artery without laser irradiation in order to observe the mechanical dilation by the procedure. The femoral artery lumen was irradiated by a Helium-Cadmium(He-Cd) laser (wavelength; 325 nm) with 8 mW through the fiber during 30 s. We carried out that the laser irradiation produced vasorelaxation (185% on the average) compared with mechanical vasodilation (150% on the average) with angiography. The results suggest that intravascular transluminal irradiation with low-power UV laser might be applicable to the relief of acute arterial vasospasm.

  11. Characterisation and disintegration properties of irradiated starch.

    PubMed

    De Kerf, M; Mondelaers, W; Lahorte, P; Vervaet, C; Remon, J P

    2001-06-19

    Irradiation treatment could provide a quick and simple way to modify the physical, chemical and pharmaceutical properties of biopolymers such as starch. Corn, potato and drum dried corn starch were exposed to X-ray and electron beam (e-beam) irradiation treatment at doses of 10, 50 and 100 kGy. The disintegration properties of these starches were compared using alpha-lactose monohydrate tablets containing 5% (w/w) starch as disintegrant. Starch solubility increased, while its swelling capacity decreased with increasing irradiation dose. The irradiation treatment caused fragmentation of the amylopectin fraction. Irradiation modified the different starches thoroughly, showing remarkable differences in disintegration properties after X-ray treatment and e-beam modification. The e-beam modification resulted in significantly higher disintegration times of the tablets.

  12. Production of modified starches by gamma irradiation

    NASA Astrophysics Data System (ADS)

    Kang, Il-Jun; Byun, Myung-Woo; Yook, Hong-Sun; Bae, Chun-Ho; Lee, Hyun-Soo; Kwon, Joong-Ho; Chung, Cha-Kwon

    1999-04-01

    As a new processing method for the production of modified starch, gamma irradiation and four kinds of inorganic peroxides were applied to commercial corn starch. The addition of inorganic peroxides without gamma irradiation or gamma irradiation without the addition of inorganic peroxides effectively decreased initial viscosity, but did not sufficiently keep viscosity stable. The combination of adding ammonium persulfate (APS) and gamma irradiation showed the lowest initial viscosity and the best stability out of the tested four kinds of inorganic peroxides. Among the tested mixing methods of APS, soaking was found to be more effective than dry blending or spraying. Therefore, the production of modified starch with low viscosity as well as with sufficient viscosity stability became feasible by the control of gamma irradiation dose levels and the amount of added APS to starch.

  13. Tensile properties of irradiated surveillance coupons

    SciTech Connect

    Huang, F.H.; Blackburn, L.D.

    1994-06-01

    Tensile testing of austenitic steel and superalloy samples irradiated in the HMO 13 assembly was performed in support of the Fast Flux Test Facility (FFTF) Surveillance Program. Postirradiation yield stress, ultimate tensile stress, uniform elongation, total elongation, and reduction in area of 304 stainless steel (SS), 308 SS weld, 316 SS, A286, In718, and In718 weld were determined. Results showed the strength of austenitic steels increased while the ductility decreased as a result of irradiation. Low irradiation exposure produced little property change in In718. Overall, the tensile properties of HMO 13 surveillance coupons showed a lower magnitude of irradiation-induced property change than was expected based on earlier studies. Results from these tests gave no indications of unexpectedly severe irradiation damage to FFTF components.

  14. Historical Variations in Solar UV Irradiance

    NASA Astrophysics Data System (ADS)

    DeLand, M. T.

    2011-12-01

    Satellite measurements of solar UV variability have been made by at least fifteen different instruments since 1978. While it is difficult to keep a single UV irradiance instrument operating throughout a complete solar cycle, many of these instruments (Nimbus-7 SBUV, SME, NOAA-9 SBUV/2, NOAA-11 SBUV/2, UARS SUSIM, UARS SOLSTICE) were able to observe both maximum and minimum irradiance levels during either rising or declining phases of solar activity. Comparisons of these published results for solar cycles 21, 22, and 23 show consistent solar cycle irradiance changes at key wavelengths for terrestrial effects (e.g. 205 nm, 240 nm) within instrumental uncertainties. All historical data sets also show the same relative spectral dependence in the ultraviolet for both short-term (rotational) and long-term (solar cycle) variations. Empirical solar irradiance models that employ multiple proxy data sets to represent spectral irradiance produce long-term solar UV variations that are in good agreement with merged observational data through 2005. Recent UV irradiance data from the SORCE mission covering the declining phase of Cycle 23 present a different picture of long-term solar variations, with significantly larger temporal changes and different spectral dependence. We present comparisons of the SORCE irradiance data with previous solar UV observations and current model predictions. Scaling factors for use with solar UV proxy indexes have been derived from SORCE SIM and SORCE SOLSTICE data during 2004-2005. These scale factors, based on short-term irradiance variations, agree very well with results derived from concurrent NOAA-17 SBUV/2 and UARS SUSIM measurements. The 2004-2005 scale factors are consistent with previously derived scale factors that produce calculated long-term irradiance changes in good agreement with observations. The SORCE long-term solar UV irradiance results, corresponding to the early part of the mission, are consistent with undercorrection of

  15. Irradiation creep of dispersion strengthened copper alloy

    SciTech Connect

    Pokrovsky, A.S.; Barabash, V.R.; Fabritsiev, S.A.

    1997-04-01

    Dispersion strengthened copper alloys are under consideration as reference materials for the ITER plasma facing components. Irradiation creep is one of the parameters which must be assessed because of its importance for the lifetime prediction of these components. In this study the irradiation creep of a dispersion strengthened copper (DS) alloy has been investigated. The alloy selected for evaluation, MAGT-0.2, which contains 0.2 wt.% Al{sub 2}O{sub 3}, is very similar to the GlidCop{trademark} alloy referred to as Al20. Irradiation creep was investigated using HE pressurized tubes. The tubes were machined from rod stock, then stainless steel caps were brazed onto the end of each tube. The creep specimens were pressurized by use of ultra-pure He and the stainless steel caps subsequently sealed by laser welding. These specimens were irradiated in reactor water in the core position of the SM-2 reactors to a fluence level of 4.5-7.1 x 10{sup 21} n/cm{sup 2} (E>0.1 MeV), which corresponds to {approx}3-5 dpa. The irradiation temperature ranged from 60-90{degrees}C, which yielded calculated hoop stresses from 39-117 MPa. A mechanical micrometer system was used to measure the outer diameter of the specimens before and after irradiation, with an accuracy of {+-}0.001 mm. The irradiation creep was calculated based on the change in the diameter. Comparison of pre- and post-irradiation diameter measurements indicates that irradiation induced creep is indeed observed in this alloy at low temperatures, with a creep rate as high as {approx}2 x 10{sup {minus}9}s{sup {minus}1}. These results are compared with available data for irradiation creep for stainless steels, pure copper, and for thermal creep of copper alloys.

  16. Irradiation growth in zirconium and its alloys

    NASA Astrophysics Data System (ADS)

    Rogerson, A.

    1988-10-01

    The UKAEA Northern Research Laboratories (Risley) have recently completed an underlying research study on irradiation growth in zirconium and its alloys. During this study, irradiation growth measurements have been made on a range of well-characterized single-crystal and polycrystalline iodide zirconium, commercial alloys Zircaloy-2 and Zr-2.5 wt% Nb, and high-purity zirconium-tin alloys in different metallurgical conditions following irradiation in the DIDO reactor at AERE Harwell. Irradiations were performed in three rigs operating at irradiation temperatures between 353 and 673 K. An important feature of the experimental programme was the capability to perform repeat length measurements on individual growth specimens at intervals during their irradiation programme. This facility has allowed accurate monitoring of the growth phenomenon and changes in growth behaviour induced by the combined effects of irradiation temperature and accumulated fast neutron dose over large dose ranges. This paper reviews the main experimental results from this programme and discusses them in terms of current understanding of the growth process. Thus, it has been observed that, in annealed Zircaloy-2 at temperatures between 553 and 673 K, a transition from saturating growth to accelerating growth rates occurs with increasing dose. The dose above which this "growth breakaway" takes place is seen to be inversely dependent on irradiation temperature in mis temperature range. The well-documented difference in growth behaviour between annealed and cold-worked Zircaloy-2 observed at relatively low irradiation temperatures, in which cold-worked material grows at a high linear rate over large dose ranges, is not observed at 673 K. Comparison is made with reported results on similar material irradiated in other irradiation facilities. The growth data are interpreted in terms of recent theories regarding the development during fast neutron irradiation of a cold-worked microstructure consisting

  17. Parameterization of Solar Global Uv Irradiation

    NASA Astrophysics Data System (ADS)

    Feister, U.; Jaekel, E.; Gericke, K.

    Daily doses of solar global UV-B, UV-A, and erythemal irradiation have been param- eterized to be calculated from pyranometer data of global and diffuse irradiation as well as from atmospheric column ozone measured at Potsdam (52 N, 107 m asl). The method has been validated against independent data of measured UV irradiation. A gain of information is provided by use of the parameterization for the three UV compo- nents (UV-B, UV-A and erythemal) referring to average values of UV irradiation. Ap- plying the method to UV irradiation measured at the mountain site Hohenpeissenberg (48 N, 977 m asl) shows that the parameterization even holds under completely differ- ent climatic conditions. On a long-term average (1953 - 2000), parameterized annual UV irradiation values are by 15 % (UV-A) and 21 % (UV-B), respectively, higher at Hohenpeissenberg, than they are at Potsdam. Using measured input data from 27 Ger- man weather stations, the method has been also applied to estimate the spatial distribu- tion of UV irradiation across Germany. Daily global and diffuse irradiation measured at Potsdam (1937 -2000) as well as atmospheric column ozone measured at Potsdam between1964 - 2000 have been used to derive long-term estimates of daily and annual totals of UV irradiation that include the effects of changes in cloudiness, in aerosols and, at least for the period 1964 to 2000, also in atmospheric ozone. It is shown that the extremely low ozone values observed mainly after the volcanic eruptions of Mt. Pinatubo in 1991 have substantially enhanced UV-B irradiation in the first half of the 90ies of the last century. The non-linear long-term changes between 1968 and 2000 amount to +4% ...+5% for annual global and UV-A irradiation mainly due to changing cloudiness, and +14% ... +15% for UV-B and erythemal irradiation due to both chang- ing cloudiness and decreasing column ozone. Estimates of long-term changes in UV irradiation derived from data measured at other German sites are

  18. Rheological changes in irradiated chicken eggs

    NASA Astrophysics Data System (ADS)

    Ferreira, Lúcia F. S.; Del Mastro, Nélida L.

    1998-06-01

    Pathogenic bacteria may cause foodborne illnesses. Humans may introduce pathogens into foods during production, processing, distribution and or preparation. Some of these microorganisms are able to survive conventional preservation treatments. Heat pasteurization, which is a well established and satisfactory means of decontamination/disinfection of liquid foods, cannot efficiently achieve a similar objective for solid foods. Extensive work carried out worldwide has shown that irradiation is efficient in eradicating foodborne pathogens like Salmonella spp. that can contaminate poultry products. In this work Co-60 gamma irradiation was applied to samples of industrial powder white, yolk and whole egg at doses between 0 and 25 kGy. Samples were rehydrated and the viscosity measured in a Brookfield viscosimeter, model DV III at 5, 15 and 25°C. The rheological behaviour among the various kinds of samples were markedly different. Irradiation with doses up to 5 kGy, known to reduced bacterial contamination to non-detectable levels, showed almost no variation of viscosity of irradiated egg white samples. On the other hand, whole or yolk egg samples showed some changes in rheological properties depending on the dose level, showing the predominance of whether polimerization or degradation as a result of the irradiation. Additionally, irradiation of yolk egg powder reduced yolk color as a function of the irradiation exposure implemented. The importance of these results are discussed in terms of possible industrial applications.

  19. Irradiation exposure modulates central opioid functions

    SciTech Connect

    Dougherty, P.M.; Dafny, N.

    1987-11-01

    Exposure to low doses of gamma irradiation results in the modification of both the antinociceptive properties of morphine and the severity of naloxone-precipitated withdrawal in morphine-dependent rats. To better define the interactions between gamma irradiation and these opiate-mediated phenomena, dose-response studies were undertaken of the effect of irradiation on morphine-induced antinociception, and on the naloxone-precipitated withdrawal syndrome of morphine-dependent rats. In addition, electrophysiologic studies were conducted in rats after irradiation exposure and morphine treatment correlating with the behavioral studies. The observations obtained demonstrated that the antinociceptive effects of morphine as well as naloxone-precipitated withdrawal were modified in a dose-dependent manner by irradiation exposure. In addition, irradiation-induced changes in the evoked responses obtained from four different brain regions demonstrated transient alterations in both baseline and morphine-treated responses that may reflect the alterations observed in the behavioral paradigms. These results suggest that the effects of irradiation on opiate activities resulted from physiologic alterations of central endogenous opioid systems due to alterations manifested within peripheral targets.

  20. The Next Spaceflight Solar Irradiance Sensor: TSIS

    NASA Astrophysics Data System (ADS)

    Kopp, Greg; Pilewskie, Peter; Richard, Erik

    2016-05-01

    The Total and Spectral Solar Irradiance Sensor (TSIS) will continue measurements of the solar irradiance with improved accuracies and stabilities over extant spaceflight instruments. The two TSIS solar-observing instruments include the Total Irradiance Monitor (TIM) and the Spectral Irradiance Monitor (SIM) for measuring total- and spectral- solar-irradiance, respectively. The former provides the net energy powering the Earth’s climate system while the latter helps attribute where that energy is absorbed by the Earth’s atmosphere and surface. Both spaceflight instruments are assembled and being prepared for integration on the International Space Station. With operations commencing in late 2017, the TSIS is intended to overlap with NASA’s ongoing SOlar Radiation and Climate Experiment (SORCE) mission, which launched in 2003 and contains the first versions of both the TIM and SIM instruments, as well as with the TSI Calibration Transfer Experiment (TCTE), which began total solar irradiance measurements in 2013. We summarize the TSIS’s instrument improvements and intended solar-irradiance measurements.