Airway versus transbronchial biopsy and BAL in lung transplant recipients: different but complementary

Lung transplantation is now an established therapeutic intervention for end-stage cardiopulmonary disease in humans. Chronic rejection, in the form of bronchiolitis obliterans syndrome (BOS), remains the commonest cause of morbidity and mortality in those surviving more than 3 months. The pathology of BOS involves airway changes. We have evaluated the potential for endobronchial biopsies (EBB) to complement existing sampling methods used in allograft monitoring and have compared the results of EBB findings with those of bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB) in 18 clinically stable patients. We found that all the EBB had inflammatory cells present but that only five TBB specimens had evidence of inflammation, with airway material being present in 78% of the TBB. Paired BAL and EBB yielded different results, with no correlations between total macrophages, lymphocytes, CD4+ cells or CD8+ cells. We conclude that endobronchial biopsies are potentially useful as an additional sample for the monitoring of inflammation in lung allografts, since they yield different, and potentially complimentary, information to bronchoalveolar lavage and transbronchial biopsy.     

Morphological effects in rats following a 22-day space flight

A morphological examination of 27 rats flown onboard the biosatellite and sacrificed on the 1st-2nd and 26-27th postflight days demonstrated no significant changes in the structural organization of the vital organs and systems of the animal body. It was, however, found that the space exposure induced morphologically detectable changes in the musculo-skeletal system, hemo- and lymphopoiesis, hypothalamic-pituitary-adrenal system and the juxtaglomerular apparatus of the kidneys. The changes were reversible and nonspecific, and could be seen in animals exposed to ground-based hypokinetic and other stress experiments. Postflight the animals developed some reactions that were similar to those in humans. This helps to identify the morphological substrate of certain changes in the human body and to investigate their pathogenesis.     

Prospective controlled randomized study of in vitro fertilization versus intracytoplasmic sperm injection in the treatment of tubal factor infertility with normal semen parameters

We report a case of aortitis syndrome, in which carotid ultrasonography was a useful approach for the diagnosis. A 21-year-old woman was admitted to our hospital for persistent fever. No specific physical findings or laboratory abnormalities were observed except high fever and marked increase of erythrocyte sedimentation rate and c reactive protein. Since clinical trial of antibiotics and antituberculosis agents resulted in no effectiveness, prednisolone was started, but the effect was limited. After that, she complained of the neck pain, and vascular murmur became apparently audible at the pain site. Ultrasonography of the carotid artery revealed the smooth lumen and homogeneous, non-hyperechoic intimal thickening. Then aortography confirmed the diagnosis of aortitis syndrome. Cyclophosphamide combined with steroid therapy diminished the disease activity. In this case, carotid ultrasonography gave us the important information to enforce the aortography. If ultrasonography of the carotid artery has been popularized for aortitis syndrome, and its findings have been standardized, non-invasive diagnosis of this disease will be taken a step forward.     

Dietary thiamin supply during gestation effects thiamin status of lactating rats and their suckling offspring

A paired-comparison study of manual and automated (PAPNET) screenings of cervico-vaginal smears (Pap tests) was conducted to determine whether primary PAPNET screening was a reliable alternative to manual screening. A series of 5,037 consecutive Pap tests was first screened by the manual method. Next they were scanned by the PAPNET system, the DAT tapes were reviewed, and using a nonspecific triage protocol, abnormal tests were identified for limited, manual rescreening. False-negative rates (FNR) for each method were calculated and analyzed for due cause. By manual and PAPNET screening, respectively, there were 436 (8.6%) and 250 (4.9%) abnormal results. Manual screening missed 18 abnormals (5 SIL) and PAPNET 202 (7 SIL). The primary, manual screenings relating to the PAPNET false-negative tests were reviewed and revised to normal in 30. Based on the changes in the other 172 tests, cellular features ostensibly missed by the PAPNET system were listed to form part of a specific triage protocol, and were used to scrutinize the companion 172 DAT tapes: 150 tapes were abnormal. The manual FNR for an abnormal (SIL) result was 4% and (8.8%), respectively. Equivalent FNR pre- and postreviews for the PAPNET system were 44.6% (10.6%) and 5.2% (1.3%), respectively. This study discovered that the evaluation of some cell features in monitor-based, video images was the most important factor limiting the application of the PAPNET system as a primary screener. When governed by a specific triage protocol incorporating these features, primary PAPNET screening has the potential to equal the laboratory threshold of manual screening and be a better detector of SIL.