• Title/Summary/Keyword: Bronchoalveolar lavage

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CHANGES IN SUBPOPULATION OF BRONCHOALVEOLAR LAVAGE FLUID IN THE PULMONARY FIBROSIS INDUCED BY BLEOMYCIN OR PEPLOMYCIN

  • Kim, Dae-Joong
    • Toxicological Research
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    • v.9 no.2
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    • pp.241-251
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    • 1993
  • Present studies were carried out in order to estabilish the bronchoalveolar lavage method and to examine the response of bleomycin and peplomycin on the total cell number and the subpoulations of bronchoalveolar lavage fluid. A total of 24 male F344 rats, weighing 300-350 mg, were divided into 3 groups. Animals recelved either belomycin (BLM` 0.75 mg/0.2 ml/rat), peplomycin (PLM` 0.25mg/0.2ml/rat) for groups 2 and 3 or an equal volume of sterile saline lacking drugs for controls (group 1).

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The Diagnostic Value of Bronchoalveolar lavage fluid microscopic study and PCR in Pulmonary tuberculosis (폐결핵에 있어서 기관지폐포세척액 결핵균검사 및 PCR의 진단적 가치)

  • Park, Moon-Hwan;Choi, Choon-Han;Kim, Nam-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.128-137
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    • 1996
  • Background : We can diagnose pulmonary tuberculosis with sputum AFB smear and culture, but sputum AFB smear has low sensitivity and culture needs long period, and they are not available in the patients who can not expectorate effectively. Recently developed, PCR is a fast diagnostic tool in tuberculosis, but false positive and false negative are important problems. So, we studied the diagnostic value of bronchoalveolar lavage fluid AFB smear, culture, PCR through the bronchoscopy. Methods : The 67 pulmonary tuberculosis patients and 43 non-pulmonary tuberculosis patients were analyzed with their sputum specimen AFB smear and culture. Also, bronchoscopy and bronchoalveolar lavage were done, and bronchoalveolar lavage fluid AFB smear, culture and PCR were done. Results: 1) In the cases of pulmonary tuberculosis, the sensitivity of sputum AFB smear and culture were 32.8% and 57.4%, respectively. And the sensitivity of bronchoalveolar lavage fluid AFB smear and culture were 47.8% and 80.6%. respectively. 2) In the cases of pulmonary tuberculosis, the sensitivity and the positive predictive value(for predicting a positive culture) of PCR were 80.6% and 81.5%, respectively. 3) In the cases of sputum AFB smear-negative and culture-negative pulmonary tuberculosis, the sensitivity of bronchoalveolar lavage fluid AFB smear, culture, PCR, and the positive predictive value(for predicting a positive culture) of PCR were 23.1%, 100%, 88.5%, and 82.4%, respectively. 4) The specificity of bronchoalveolar lavage fluid PCR was 77.0%. 5) The median number of days between obtaining a specimen and starting therapy was 5 days for sputum AFB smear, 9 days for bronchoalveolar lavage fluid AFB smear, 26 days for bronchoalveolar lavage fluid PCR, 32 days for sputum culture, 56 days for bronchoalveolar lavage fluid culture. Conclusion : The sensitivity of bronchoalveolar lavage fluid AFB smear and culture are higher than sputum AFB smear and culture. So, the bronchoscopy must be considered for evaluating suspected cases of pulmonary tuberculosis in patients from whom smears of expectorated sputum do not reveal mycobacteria or from whom no sputum can be obtained. Especially, combined with PCR, it is expected that pulmonary tuberculosis can be diagnosed more rapidly and more accurately, so bronchoalveolar lavage fluid APB smear and PCR can be helpful in the early treatment of pulmonary tuberculosis.

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A Study on the Early Diagnosis of Pneumoconiosis (진폐증의 조기진단에 관한 연구)

  • Lim, Young;Yun, Im-Goung
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.3
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    • pp.262-273
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    • 1990
  • In order to assess the method which is more sensitive one to detect the early change of lung tissue by the inhaled dust, we have performed the various medical examinations such as chest radiography, pulmonary function test, high resolution chest CT, brnchoalveolar lavage and lung biopsy used bronchoscope and ultrathin bronchoscopy examination to 48 persons. The control group were 8 persons who did not exposed to dust, 40 cases of the experimental group have professionally exposed to the mineral dust. The results were as follows 1. The total number of cells in bronchoalveolar lavage was significantly increased in all of the pneumoconiosis group classified by chest and high resolution chest CT. 2. The composition rate of macrophage to the total number of cells in bronchoalveolar lavage fluid was significantly decreased in all of the pneumoconiosis group compared with the control group. 3. The composition rate of neutophils and lymphocytes to the total number of cells in bronchoalveolar lavage fluid was significantly increased in all of the pneumoconiosis group compared with the control group. 4. The forced expiratory volume in one second ($FEV_{1-0}$), maximal mid-expiratory flow (MMF), and maximal voluntary ventilation (MVV) were significantly increased only in the group of the progressed pneumoconiosis relatively. 5. We observed submucosal edema, anthracotic pigmentation and granuloma formation in transbronchial lung biopsy of the suspected pneumoconiosis (category 0/1) case which is thought to the early change of coal workers' pneumoconiosis.

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The Clinical Assessment of Protease-Activated Receptor-2 Expression in Inflammatory Cells from Peripheral Blood and Bronchoalveolar Lavage Fluid in Idiopathic Pulmonary Fibrosis

  • Park, Young Sik;Yoo, Chul-Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.6
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    • pp.264-268
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    • 2013
  • Background: Idiopathic pulmonary fibrosis (IPF) is a lethal pulmonary fibrotic disease. In general, the exaggerated activation of the coagulation cascade has been observed during initiation or maintenance of the fibrotic disease. In our recent study, immunohistochemical expression of protease-activated receptor-2 (PAR-2), which plays a key role in coagulation cascade, was observed in surgical specimen of IPF patients, and associated with poor clinical outcome. The aim of this study was to evaluate the overexpression of PAR-2 in inflammatory cells from peripheral blood and bronchoalveolar lavage fluid in IPF patients. Methods: From May 2011 to March 2012, IPF patients and controls were enrolled in Seoul National University Hospital. Peripheral blood and bronchoalveolar lavage fluid were collected for analysis of PAR-2 expression. Flow cytometry and reverse transcription polymerase chain reaction were used for PAR-2 receptor and mRNA assessment. Results: Twelve IPF patients and 14 controls were included in this study. Among them, flow cytometry analysis was conducted from 26 peripheral blood (patient group, 11; control group, 13) and 7 bronchoalveolar lavage fluid (patient group, 5; control group, 2). The expression of PAR-2 receptor was not different between patient and control groups (p=0.074). Among all 24 population, PAR-2 mRNA assessment was performed in 19 persons (patient group, 10; control group, 9). The mRNA expression of PAR-2 was not significant different (p=0.633). Conclusion: In IPF patients, PAR-2 receptor and mRNA expression were not different from control group.

Immunocytochemical Detection of Pneumocystis carinii in Bronchoalveolar Lavage (기관지 폐포 세정액에서 뉴우모시스티스 카리니의 면역세포화학적 검출)

  • Kwon, Kun-Young;Cho, Seung-Che;Kim, Sang-Pyo;Park, Kwan-Kyu;Chang, Eun-Sook;Kim, Chung-Sook
    • The Korean Journal of Cytopathology
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    • v.8 no.1
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    • pp.27-34
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    • 1997
  • Pneumocystis carinli is an established cause of pulmonary infections in immuno-compromised hosts. Several cytoiogical stains, such as Papanicolaou, Gomori methenamine sliver(GMS) and Diff-Quik have been used for detection of the organism, but occasionally can be laborious and, due to a degree of nonspecificity, may be misleading. We evaluated the diagnostic utility of immunocytochenmical stains that recognize P. carinii in bornchoalveolar lavage from experimentally Induced P. carinii pneumonia rats(n=15). In audition to routine stains for diagnosis by morphologic recognition of P. carinii on Papanicolaou, GMS and Diff-Quik stains, bronchoalveolar lavage samples were reacted with immunocytochemical stains using monoclonal antibodies(MAB) 092 and 902. In bronchoalveolar lavage P. carinii organisms were detected In 9 of 10 cases(90%) using each MAB 092 and 902, whereas GMS and Diff-Quik stains demonstrated P. carinii in 13(86%) and 11(73%) of 15 cases respectively. In lung tissue specimens(n=15) P. carinii organisms were well identified on GMS stain and immunohistochemical stains using MAB 092 and 902 in ail cases. We believe that the immunocytochemical staining using MAB 092 and/or 902 is a very useful and diagnostic tool In addition to GMS and Diff-Qulk stain to detect P. carinii organisms in bronchoalveolar lavage.

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Pulmonary Alveolar Proteinosis - A Case Report with Diagnostic Features in Bronchoalveolar Lavage Specimen - (폐포 단백증의 세포학적 소견 - 1예 보고 -)

  • Ha, Seung-Yeon;Cho, Hyun-I;Oh, Young-Ha
    • The Korean Journal of Cytopathology
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    • v.11 no.2
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    • pp.103-108
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    • 2000
  • Pulmonary alveolar proteinosis(PAP) is a rare disease in which the alveolar spaces are filled with an eosinophilic, PAS-positive material, whereas the interstitial architecture of the lung usually remains unaffected. Although a definitive diagnosis is usually made by an open lung biopsy, bronchoalveolar lavage(BAL) cytology may play a decisive role in the diagnosis and therapy of these patients and may spare a patient a more invasive diagnostic procedure. The author presents a patient in whom BAL cytology specimen contained the characteristic globules of amorphous proteinaceous PAS-positive material accompanied by background of rare macrophages and inflammatory cells. Ultrastructural study using BAL specimen can confirm the diagnosis of PAP.

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Cytologic Findings of Bronchoalveolar Lavage (기관지 폐포 세정액의 세포학적 소견)

  • Kwon, Kun-Young;Cho, Seung-Che;Park, Kwan-Kyu;Chang, Eun-Sook
    • The Korean Journal of Cytopathology
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    • v.1 no.2
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    • pp.129-138
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    • 1990
  • Bronchoalveolar lavage (BAL) has emerged as a useful technique for the study of pulmonary interstitial disorders. Several types of Information are provided by the evaluation of lavage fluid identification of cellular constituents helps to separate inflammatory process. Recently we have studied cellular constituents of BAL from three cases with histologically confirmed pulmonary sarcoidosis, idiopathic pulmonary fibrosis and hypereosinophilic syndrome. Pulmonary sarcoidosis showed a marked increase in lymphocytes, idiopathic pulmonary fibrosis revealed a predominance of neutrophils, and hypereosinophilic syndrome presented a marked increase in eosinophils in the lavage fluids.

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The Bronchoalveolar Lavage Fluid Cell Analysis with Normal Lung and Unaffected Side Lung of Patients with Minor Symptoms or Radiologic Abnormalities (경미한 호흡기질환 환자에서 정상 및 건측 폐에서의 기관지폐포 세척액내 세포 분포에 관한 연구)

  • Kim, Byung-Il;Cho, Chul-Ho;Kang, Shin-Wook;Cheon, Seon-Hee;Jang, Sang-Ho;Lee, Jang-Hoon;Chang, Joon;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.2
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    • pp.155-163
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    • 1991
  • Bronchoalveolar lavage had been done as the treatment of some diseases such as alveolar proteinsois, bronchiectasis, and severe asthma to remove excessive secretion or mucus. But in the recent decade it has been done as a diagnostic method and a tool to understand and evaluate the pathophysiology of diffuse interstitial lung diseases such as sarcoidosis, pneumoconiosis and hypersensitivity pneumonitis. To analyse the bronchoalveolar fluid, it might be useful to have a standard reference (especially cell counts and differetial count of the cells from bronchoalveolar lavage fluid) of normal person. But it is difficult to study the normal volunteers. We investgated the bronchoalveolar lavage fluid of 48 patients (28 nonsmokers, 20 smokers) who visited Severance Hospital because of minor pulmonary symptoms such as cough and sputum. They did neither complain of dyspnea nor cyanosis, and had normal or unilateral minor lesion on physical examination and chest X-ray. We analysed the recovery rate, viability, total cell count and differential count of the cells in fluid obtained by bronchoalveolar lavage. The following results were obtained: 1) Age ranged from 17 to 72 years-old with the mean age of 36.7; there was no difference of age between the nonsmoker and the smoker gorup. Male to female ratio was 2.43:1 for total group, 1.15:1 for nonsmokers, and 19:1 for smokers. 2) The diagnoses of the patients were undetermined in 41.9%, healed pulmonary tuberculosis in 37.5%, laryngitis or pharyngitis in 10.4% and others in 10.4%. 3) Total cell number of the recovered fluid by bronchoalveolar lavage was significantly higher in male[$9.6{\pm}6.2({\times}10^6)$] than in female[$5.1{\pm}3.0({\times}10^6)$](p<0.05), and there was no significant difference in the total cell number between the smokers and nonsmokers [$9.3{\pm}5.8({\times}10^6)$ vs $7.5{\pm}5.8({\times}10^6)$]. 4) The differential count of the cells from bronchoalveolar lavage fluid had no difference between the nonsmokers and the smokers. 5) There was no correlation between the total cell count and smoking or age. 6) In the smoker group, there was no correlation between the amount of smoking and the total cell count of the bronchoalveolar fluid. In conclusion, it should be careful to regard the patients with symptoms or minor radiologic abnormalities as a control group in bronchoalveolar lavage study and further study of cell analysis in bronchoalveolar lavage will be needed between smoker and nonsmoker in the male and female healthy people.

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Effect of Korean Chrysotile on the Lung Function of Rats (한국산 백석면이 랫드의 폐 기능에 미치는 영향 평가 연구)

  • Chung, Yong Hyun;Kang, Min Gu;Han, Jeong Hee
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.24 no.2
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    • pp.130-136
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    • 2014
  • Objectives: To evaluate the pulmonary toxicity of Korean Chrysotile(KC), the lung function and the number of fibers in the bronchoalveolar lavage fluid of Sprague-Dawley rats instilled with KC were estimated. Materials: Rats were administered 1 mg KC by a single intratracheal instillation. At each time point(5 days, 5 weeks, 10 weeks), the lung function of the rats was analyzed by pressure transducer and the amount of asbestos in the bronchoalveolar lavage fluid of the rats was calculated by transmission electron microscope equipped with energy dispersive X-ray spectrometer. Results: The lung function of the rats at 5 days after instillation of KC was confirmed to be degraded. However, after 5 weeks the test groups showed a tendency to recover lung function. Still, after 10 weeks the lung function of the test groups had not recovered completely. The number of fibers in the bronchoalveolar lavage fluid of the rats instilled with KC rapidly decreased. At 5 weeks the number of fibers had reduced to approximately 1/2 of that found at 5 days. Over time, at 10 weeks it had rapidly decreased to 1/100 that found at 5 days. Conclusions: Korean chrysotile fibers rapidly decreased in the lungs of rats, but the lung function of rats instilled KC does had not completely recovered by 10 weeks.

Comparative Assessment of the Diagnostic Value of Transbronchial Lung Biopsy and Bronchoalveolar Lavage Fluid Cytology in Lung Cancer

  • Binesh, Fariba;Pirdehghan, Azar;Mirjalili, Mohammad Reza;Samet, Mohammad;Majomerd, Zahra Amini;Akhavan, Ali
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.201-204
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    • 2015
  • Background: This study was designed to determine the accuracy of bronchoalveolar lavage fluid cytology (BAL) using histopathologic examination of transbronchial biopsy specimens as the gold standard in diagnosis of lung carcinoma at our center. Materials and Methods: A retrospective study was conducted to investigate a total of 388 patients who were suspected of having lung cancer and had undergone fiberoptic bronchoscopy in Shahid Sadoughi hospital from 2006 to 2011. Lung masses were proven to be malignant by histology. Results: Transbronchial lung biopsy (TBLB) identified malignancy in 183 of the 388 cases, including 48 cases (26.2%) with adenocarcinoma, 4(2.1%) with bronchioloalveolar carcinoma, 47(25.6%)with squamous cell carcinoma, 34(18.5%) with well-diffentiated neuroendocrine carcinoma, 35(19.1%) with small cell carcinoma, 14 (7.6%) with non-small cell carcinoma, and 1 (0.54%) with large cell carcinoma. A total of 205 cases were correctly classified as negative. BAL was also performed in 388 patients; 86/103 cases were consistent with the final diagnosis of lung cancer and 188/285 cases were correctly classified as negative. The sensitivity of BAL was 46.9%(CI:41.9%, 51.8%)) and its specificity was 91.6%(CI:88.8%, 94.3%). BAL had a positive predictive value (PPV) of 83.4%(CI:79.7%, 87.1%) and a negative predictive value (NPV) of 65.8%(CI:61%, 70.5%). The overall accuracy of BAL was 70.5% and the exact concordance was 39%. Conclusions: Our findings suggest that BAL cytology is not sensitive but is a specific test for diagnosis of lung carcinoma. If transbronchial lung biopsy is combined with bronchoalveolar lavage, the positive diagnostic rate will be further elevated.