Effect of oral salbutamol on mucociliary clearance mechanisms in the lungs

The purpose of the study was to investigate whether or not orally administered salbutamol would affect mucociliary clearance function in the lungs. Salbutamol, 4 mg, was given orally 3 times a day for 7 days to 10 and 9 patients with various chest diseases in stable stage, respectively; the former were also currently taking other medications and the latter, none. Lung function tests, chest x-rays and radioaerosol inhalation lung cine-scintigraphy were performed before and after the administration of salbutamol. There was little qualitative or quantitative difference in mucociliary clearance function in either group before and after the administration of oral salbutamol, although it induced some increases in VC and FEV1.0 and a decrease in RV/TLC ratio in the former and some increases in FEV1.0, FEV1.0% and MMF in the latter. Oral salbutamol seems little to affect the mucociliary clearance function in the lungs.     

Effect of chronic inhalation of sulfuric acid mist upon mucociliary clearance from the lungs of donkeys

The effect of chronic inhalation exposures to sulfuric acid mist upon mucociliary clearance from the lungs was studied, using the donkey as an analogue for man. Four animals were exposed 1 hr/day, 5 days/week, for 6 months. The mean mass concentration of acid mist was 102 microgram/m3 for two animals, and 106 microgram/m3 for the other two. The mass median aerodynamic diameter was approximately 0.5 micrometer. Clearance was monitored by serial, external in vivo measurements of the retention of an insoluble, radioactively tagged ferric oxide aerosol which was inhaled following exposure to the acid mist. Bronchial clearance became erratic within the first week of exposure; rates were significantly different, usually slower than control on many test days, although the degree of response varied among the four animals. Two animals exhibited a sustained impairment of clearance towards the end of the 6-month exposure period and continued to have erratic clearance during a 3-month follow-up period. No changes in the regional deposition of the ferric oxide occurred during the course of the study in any of the animals. It is proposed that alterations in bronchial mucociliary clearance may be an early, if not the first, physiologic effect resulting from the inhalation of sulfuric acid mist, and this may be a factor in the pathogenesis of chronic bronchitis in populations exposed to the sulfur oxide-particulate-complex in the ambient air, which often includes sulfuric acid.     

Normal values of prosthetic valve Doppler echocardiographic parameters: a review

Doppler echocardiography plays an important role in the evaluation of patients with prosthetic valves. The evaluation of flow velocities across prosthetic valves is more complicated compared with native valves, and flow velocities are specific for various types, positions, and sizes of prostheses. Because all prosthetic valves are at least mildly stenotic and a significant proportion is regurgitant, information regarding normally functioning prosthetic valves is important. Eighteen studies resulting in data on 1105 patients with normally functioning prosthetic valves were reviewed. Significant differences among the various types and sizes of prosthetic valves were found in both the aortic and mitral positions. The results are summarized in tables and figures that can be used for reference in a clinical laboratory.     

Effects of septoplasty and septal deviation on nasal mucociliary clearance

To evaluate the effect of septal pathology and surgery on nasal mucociliary clearance. A radioisotope method was used to measure the velocity of nasal mucociliary transport. Nasal mucociliary clearance was measured before and after septal surgery using technetium-99m macroaggregated albumin. Fifteen patients (mean age: 20 +/- 8 years; 11 males, four females) were studied pre-operatively, but scintigraphy could be repeated only in 10 patients, 2 months after surgery. A group of 10 healthy volunteers were also studied. The clearance values obtained from the preoperative period (26.25 +/- 9.45 min) were significantly higher than those of the post-operative period (15.05 +/- 6.35 min). The values obtained of control group (13.30 +/- 3.15 min) were not significantly different from the post-operative values of the patient group. Septal deviation affects the mucociliary activity. It is improved by surgery. This study showed that nasal septal deviation reduced the nasal mucociliary activity, and this can easily evaluated with scintigraphy.     

Normal values and reproducibility of left ventricular filling parameters by radionuclide angiography

Background. In physiologic situations age, heart rate (HR) and left ventricular ejection fraction (EF) may influence left ventricular filling rate. In this study, we determined normal values for radionuclide angiography (RNA) derived diastolic filling parameters, the correlations with age, HR and EF and their reproducibility. Methods. The study was performed in 20 patients, 40–76 years old (mean 57), with normal findings at coronary angiography and left ventriculography. The first RNA was performed at rest (RNA1). Then, five minutes bicycle ergometry was performed and the patients were allowed five minutes rest before RNA was repeated (RNA2). From the left ventricular time activity curve we determined peak filling rate (PFR), time to peak filling rate (TPFR) and atrial contribution (AC) to ventricular filling. Results. Values for PFR1 were 2.2 ± 0.6 EDV/sec (PFR2 2.4 ± 0.7 EDV/sec, r = 0.82), for TPFR1 198 ± 22 msec (TPFR2 203 ± 24 msec, r = 0.45) and for AC1 31 ± 11% (AC2 31 ± 10%, r = 0.72). The correlations of PFR and TPFR with age were statistically significant (respectively r = - 0.68 and r = 0.48, P < 0.05). PFR was also influenced by HR and EF (resp. r = 0.51 and r = 0.50, P < 0.05). TPFR however was not influenced by HR and EF, whereas AC was positively correlated with HR (r = 0.79, P < 0.01). Conclusions. Radionuclide angiography is a reliable and reproducible method to assess parameters of diastolic left ventricular filling in individual patients. It may therefore be used to serially follow diastolic function. When used for interindividual comparison the dependency of RNA derived left ventricular filling parameters on age, HR and EF should however be considered.     

Assessment of mucociliary clearance using the radioaerosol method in chronic lung diseases

The radioaerosol technique with the use of radioalbumin from the TSK-5 kit and of an ultrasonic inhaler makes it possible to determine primarily the mucociliary clearance of the central parts of the tracheobronchial tree. In patients without any pathology of the respiratory organs, the clearance of the inhaled radiopharmaceutical constitutes 45.5 +/- 9.5 percent for an hour. In patients with pulmonary pathology, the characteristics of the mucociliary clearance vary from dramatically decreased to normal ones depending on the disease pattern, exacerbation phase or remission.     

Reduced clearance of leukocytes from lungs in septic rats

Leukocytes have previously been shown to sequestrate in the lungs and liver in association with traumatic and septic shock. In a rat model of gram-negative sepsis of intra-abdominal origin, a previously described in vivo technique was used for dynamic studies of leukocyte sequestration in different organs using white blood cells labeled with 111-indium-oxine. One group of rats was either studied immediately after induction of sepsis or for 6 h under a scintillation camera for continuous registration of the activity distribution (i.e., presence of leukocytes). Another group was studied 12 h after induction of sepsis for 60 min. The activity increased immediately over the lungs, indicating sequestration of the leukocytes during the first 6 h, but there was no significant difference in this respect between septic and control animals. It does not seem possible to study leukocyte sequestration dynamically in this way. When the labeled leukocytes were administered 12 h after induction of sepsis, however, the activity of septic animals' lungs was seen to remain elevated over the time period studied compared with control rats, in which the activity slowly decreased. In the liver and spleen, the activity increased in both groups, but significantly more so in control animals, which may be explained by disturbed leukocyte margination and cell turnover in the septic animals. This study has indicated that leukocyte distribution in different organs is affected by sepsis and this reaction can be studied using radiolabeled leukocytes.     

Effect of aromatics on lung mucociliary clearance in patients with chronic airways obstruction

BACKGROUND: Complementary and alternative medicine have become an increasingly topical theme in respiratory medicine. Aromatics are a commonly used ingredient in a number of proprietary medicines. It is well established that lung mucus clearance is impaired in patients with chronic airways obstruction. This study investigated whether aromatics delivered by inunction could be objectively shown to enhance lung clearance. METHODS: We studied 12 patients with chronic bronchitic with a mean standard error (SE) age of 67 (2) years (mean [SE] tobacco consumption history of 64 [12] pack-years). We used a randomized, single-blinded, placebo-controlled crossover trial within patient design assessing the effect of 7.5 g of aromatics inunction (compared to a "no-treatment baseline" and to a petrolatum "placebo") on lung mucus clearance measured by a standard radioaerosol technique. RESULTS: Aromatic treatment significantly enhanced clearance at two time points 30 (p < 0.05) and 60 (p < 0.02) minutes postradioaerosol inhalation but had no demonstrable further effect over the following 5 hours despite further application of the inunction. The clearance improvement (relative to a baseline) observed during the first hour of testing was significantly correlated (p < 0.01) with the concentration level of aromatics. CONCLUSION: Our data, thus, provide objective evidence of a positive effect of aromatics inunction on mucus clearance in chronic airways obstruction.     

Normal values for cardiovascular magnetic resonance in adults and children

Morphological and functional parameters such as chamber size and function, aortic diameters and distensibility, flow and T1 and T2* relaxation time can be assessed and quantified by cardiovascular magnetic resonance (CMR). Knowledge of normal values for quantitative CMR is crucial to interpretation of results and to distinguish normal from disease. In this review, we present normal reference values for morphological and functional CMR parameters of the cardiovascular system based on the peer-reviewed literature and current CMR techniques and sequences.

Electronic supplementary material

The online version of this article (doi:10.1186/s12968-015-0111-7) contains supplementary material, which is available to authorized users.     

The effect of forced expirations on mucociliary clearance in patients with chronic bronchitis and in healthy subjects

Summary. Animal studies have shown that frequent coughing may damage the mucociliary apparatus in flow-limiting segments of the central airways. To determine whether mucociliary clearance in humans is affected by repeated dynamic compression associated with forced expirations, we measured pulmonary deposition and mucociliary clearance for 2 h of inhaled [⁹⁹Tc^m]albumin. The subjects inhaled [⁹⁹Tc^m]albumin on 2 study days (randomized) using (A) slow inspirations and forced expirations, while inhalation using (B) forced inspirations and slow expirations served as control. The study was conducted using 10 patients with chronic hypersecretory/obstructive bronchitis and six normal subjects. We found that inhalation of [⁹⁹Tc^m]albumin by the two manoeuvres (A and B) resulted in similar patterns of aerosol deposition. There was no significant difference in retention of radioactivity in the central lung region at 1 h in the patients with chronic bronchitis after inhalation with manoeuvre A (102%) and with manoeuvre B (91.5%), or in the healthy subjects after manoeuvre A (74%) and manoeuvre B (77%). There was also no difference in the retention at 2 h or in overall mucociliary clearance in any of the groups. We conclude that dynamic compression in the central airways associated with forced expiration does not affect bronchial clearance in the airways of healthy subjects or in patients with chronic bronchitis.     

宫颈癌诊断中动态增强MRI半定量参数与磁共振扩散加权成像ADC值的相关性研究

目的研究宫颈癌诊断中应用动态增强核磁共振成像(MRI)半定量参数与磁共振扩散加权成像(DWI)的扩散系数(ADC)之间的相关性,探讨DWI在宫颈癌诊断和放疗疗效监测方面的价值。方法对2010年1月至2016年1月收集整理的87例宫颈癌患者临床资料作回顾性分析。将入选宫颈癌患者作为观察组,并选取30例非宫颈癌患者作为对照组。其中观察组有24例选择了放化疗进行治疗。对所有患者术前术后以及放化疗前后进行MRI和DWI;计算宫颈癌病灶MRI半定量参数,包括最大相对增强率(MRE)、流入速率(WIR)、流出速率(WOR)及达峰时间(TTP),并记录ADC与两者的相关性。结果观察组的MRE、WIR高于对照组;而TTP低于对照组;观察组的ADC也高于对照组;差异均有统计学意义(P0.05)。放化疗后除半定量参数WOR外其他指标及ADC与放化疗前比较,差异均有统计学意义(P0.05)。放化疗后ADC与MRE、WIR均呈现负相关(r=-0.31、-0.29,P0.05),与TTP呈现正相关(r=0.58,P0.05)。而WOR与ADC未呈现出任何相关性。结论 ADC与宫颈癌MRI半定量参数存在一定的相关性。     

大鼠烧伤后肺炎性细胞清除方式研究

目的探讨中性粒细胞在炎症吸收过程中的清除方式。方法用实验大鼠３０只均分为两组,背部浸润于沸水中１０ｓ,造成背部 １５％ＴＢＳＡⅢ度烧伤．分别于烧伤后 ４ ｈ和烧伤后 １６ ｈ进行肺支气管灌洗,检查肺巨噬细胞吞噬中性粒细胞的阳性比例。结果 炎症吸收期烧伤后（１６ ｈ）巨噬细胞吞噬中性粒细胞比例明显高于炎症急性期（烧伤后４ ｈ）（Ｐ＜０．０５）。结论烧伤后肺炎症反应过程中出现的中性粒细胞转归为凋亡,且被巨噬细胞识别和清除。这一机制可能是集体调控炎症过程的一种重要方式。