Respiratory investigation
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Respiratory investigation · Jul 2014
Formoterol and budesonide inhibit rhinovirus infection and cytokine production in primary cultures of human tracheal epithelial cells.
Long-acting β(2) agonists (LABAs) and inhaled corticosteroids (ICSs) reduce the frequency of exacerbations of chronic obstructive pulmonary disease and bronchial asthma. However, inhibitory effects of LABAs and ICSs on the replication of rhinovirus (RV), the major cause of exacerbations, have not been demonstrated. ⋯ Formoterol and budesonide may inhibit RV infection by reducing the ICAM-1 levels and/or acidic endosomes and modulate airway inflammation associated with RV infections.
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Respiratory investigation · Jul 2014
Comparing surrogates of oxygenation and ventilation between airway pressure release ventilation and biphasic airway pressure in a mechanical model of adult respiratory distress syndrome.
No objective data directly comparing the 2 modes are available. Based on a simple mathematical model, APRV and BIPAP can presumably be set to achieve the same mean airway pressure (mPaw), end expiratory pressure, and tidal volume (V(T)). Herein, we tested this hypothesis when using a real ventilator and clinically relevant settings based on expiratory time constants. ⋯ We found that neither mode was superior to the other, and that a real ventilator does not behave like a mathematical model. Extreme prolongation of T high generated a higher mPaw at the expense of V(E), and vice versa. The lower V(T) with APRV was due to the higher total PEEP, which was higher than expected. Setting the T low according to the respiratory system time constant for either mode resulted in an unpredictable total PEEP.
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Respiratory investigation · May 2014
Case ReportsReversed halo sign in pulmonary infarction with tumor emboli: a case report.
We describe the case of a 79-year-old woman with pulmonary infarction due to tumor emboli whose high-resolution CT (HRCT) scan demonstrated the reversed halo sign. The patient had gastric cancer and died because of cancer-related cerebral infarction. On autopsy, the central ground-glass area of the reversed halo sign on HRCT corresponded to pulmonary edema associated with alveolar septal capillary metastasis, whereas the peripheral ring-like consolidation consisted of a hemorrhagic infarct with tumor emboli. The present case is important because a detailed pathologic correlation with this unique HRCT appearance was revealed.
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Respiratory investigation · May 2014
Relationship between the ratios of CD4/CD8 T-lymphocytes in the bronchoalveolar lavage fluid and lymph nodes in patients with sarcoidosis.
Evaluating the ratio of CD4/CD8 T-lymphocytes in the bronchoalveolar lavage fluid (BALF) is important for understanding the clinical and pathological conditions of patients with sarcoidosis. However, few studies have thus far demonstrated the usefulness of evaluating the relationship between the ratios of CD4/CD8 T-lymphocytes in the mediastinal lymph nodes and BALF. This study aimed to investigate and identify the relationships between CD4/CD8 T-lymphocyte ratio in the mediastinal lymph nodes and BALF in patients with sarcoidosis. ⋯ Performing EBUS-TBNA in patients with sarcoidosis allows correct diagnosis as well as the estimation of the ratio of CD4/CD8 T-lymphocytes in BALF.
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Respiratory investigation · May 2014
Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of small cell lung cancer.
Massive lymphadenopathy and direct mediastinal invasion are well-recognized phenomena in patients with small cell lung cancer (SCLC). The aim of this study was to assess the utility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of SCLC. ⋯ EBUS-TBNA provided a high diagnostic yield in SCLC with or without ROSE. EBUS-TBNA can be recommended for patients suspected to have SCLC, even if other diagnostic tests have failed.