Left Main Bronchus Stenosis Lesion, Neutrophil Count, and Platelet Count Are Predictors of Post-Tuberculosis Bronchomalacia.

BACKGROUND Post-tuberculosis bronchomalacia (PTBM) is one of the main conditions occurring in patients after tracheobronchial tuberculosis (TBTB), and is also associated with the recurrence of symptoms. The present study aimed to investigate the predictors of PTBM in patients who had been undergoing appropriate TB treatment. MATERIAL AND METHODS Clinical data of 104 patients with symptomatic airway stenosis after TBTB between January 01, 2019 and June 31, 2020 were recorded and analyzed. The association between baseline clinical characteristics, laboratory results, and PTBM was calculated with logistical regression. The time from onset of bronchoscopic intervention was examined by Kaplan-Meier estimates; differences between the 2 groups were tested by the log-rank test. RESULTS Fifty-seven patients (54.81%) had PTBM. In the multivariate logistical analysis, the left main bronchus stenosis lesion (odds ratio [OR]=3.763), neutrophil (NEUT) count (OR=1.527), and platelet (PLT) (OR=1.010) count were predictors of PTBM. During follow-up, patients with BM had a significantly longer duration from onset of bronchoscopic intervention than patients without BM (hazard ratio=2.412, P<0.0001). Further, all patients needing long-term bronchoscopic intervention therapy were subsequently identified as having PTBM. Additionally, blood PLT counts were significantly decreased to normal levels in the non-BM group (P<0.05), but not in the BM group (P>0.05). CONCLUSIONS PTBM is most likely to occur in the left main bronchus. The inflammatory and immune responses associated with NEUT and PLT may represent therapeutic targets of PTBM. Our study is the first to report that decreased blood PLT count has the potential to monitor the treatment response.

[Proteasomes and their role in the extracellular space].

The presented review concerns the intracellular proteasome and their possible functions. The ubiquitin-proteasome system (UPS) is responsible for the common regulated proteolysis in the cell. 26S proteasome is a central proteolytic unit of UPS and is a multisubunit protein complex consisting of a core catalytic complex, called 20S proteasome, capped at one or both ends by 19S regulatory complex. Proteasomes have been shown in the extracellular space: in alveolar and cerebrospinal fluids, blood plasma. Extracellular proteasomes are intact intracellular particles that exhibit three types of specific peptidase activity. Extracellular proteasomes have been detected in both healthy people and patients with different diseases. Its concentration has been found to be increased in patients suffering from autoimmune diseases, malignant tumors, trauma or sepsis and to correlate with the disease progression, which has both diagnostic and prognostic value.

[Management of malignant and benign airway stenosis by stent implantation]. / Malignus és benignus légúti szukületek megoldása légúti protézis (stent) beültetésével.

INTRODUCTION: In the last few decades the different bronchoscopic procedures have gained an important role in the treatment of airway stenosis, and the number of implanted airway stents has also greatly increased. PATIENTS: Between 1998 and 2004 the authors implanted altogether 108 airway prosthesis in 90 patients at the Institute of Pulmonology of Pest County. 58% of the patients were males, 42% females, the average age was 57.5 years, the average follow-up time was 7 months. RESULTS: On the basis of different etiology the patients were separated into two main groups. In 57% the airway stenosis was caused by malignant illnesses, in these cases stents can be used only with palliative purpose. However, in case of benign lesions they can offer a long-term solution and require an adequate follow-up of the patients. The authors' main aim was to get an overall picture of the interventions they had done by processing the data, with the help of the measurable characteristics that make possible to follow the airways' permeability and its changes. Analysing the results of the respiratory function and blood gas examinations they didn't find a significant difference inspite of the subjective improvement.

Low fasting serum triglyceride and high free fatty acid levels in pulmonary fibrosis: a previously unreported finding.

OBJECTIVE: The authors describe here the occurrence of low fasting serum triglyceride (TG) and high free fatty acid (FFA) levels in pulmonary fibrosis, a finding that has never been reported before. PATIENTS AND METHODS: TGs were measured in: (a) 44 patients (3 male and 41 female; mean age SEM: 63.06 +/- 4.04 years) who have been hospitalized in the authors' department in the past 2 years for chronic interstitial or fibrosing pulmonary disease (FP); (b) 20 patients (4 male and 16 female; mean age: 69.80 +/- 2.96 years) affected by various nonfibrosing pneumopathies or bronchopathies (NFP); (c) 110 control subjects (CS), composed of 15 male and 95 female consecutive patients (mean age: 67.52 +/- 1.52 years) hospitalized in 1999 for minor nonlung-related illnesses. In 24 FP and 36 CS patients, FFA have also been measured. All subjects investigated had no clinical or laboratory evidences of liver, kidney, or thyroid diseases, nor a history of hormonal treatment, alcohol consumption, smoking, or dietary disorders. None of the subjects investigated was under treatment with lipid lowering agents or with other drugs that could affect the levels of TG or FFA or their measurement (including ascorbic acid). RESULTS: Compared with CS, the FP group showed a 61% reduction of TG (0.64 +/- 0.03 vs 1.63 +/- 0.08 mmol/L; P <.001), whereas no significant difference was observed between NFP and CS groups. Serum FFA in FP showed a 63% increase compared with CS (P <.01). In the FP group, TGs were also low in 5 patients with type 2 diabetes (0.76 +/- 0.11 mmol/L, -53%, P <.001) and in 6 obese (body mass index [BMI] > 29 kg/m2) subjects (0.51 +/- 0.03, -69%, P <.01), although it is known that TGs are often elevated in diabetes and obesity. CONCLUSIONS: Chronic interstitial or pulmonary fibrosis is associated with low TG and high FFA levels. Although it is known that the lung contains lipoprotein lipase and is a significant source of plasma postheparin lipase activity, the mechanisms of this change remain to be clarified. Since insulin-like growth factor-I (IGF-I) is known to lower TG and increase FFA, a role could be played by the enhanced production of IGF-I that has been reported to occur in pulmonary fibrosis.

Tracheobronchopathia osteochondroplastica.

Tracheobronchopathia osteochondroplastica (TO) is a rare disorder with unknown aetiology. We report one case of TO in a patient with non-Hodgkin pulmonary lymphoma and benign epidermal and trichylemmal cysts on the periorbital region and scalp. To the authors' knowledge, the coincidence of these processes has never been described before. The case was evaluated with conventional X-ray, computed tomography, magnetic resonance imaging, fibre-optic bronchoscopy with 2 months interval, histopathological evaluation, Tc-99 m MDP bone scintigraphy and microbiological studies including PCR testing of bronchial biopsy and lavage specimens for Mycobacterium tuberculosis. Additionally, case reports of TO in the Turkish literature are summarized.

Priming of blood neutrophils in children with cystic fibrosis: correlation between functional and phenotypic expression of opsonin receptors before and after platelet-activating factor priming.

Blood phagocyte opsonin receptor CR1 (CD35) and CR3 (CD11b) functions were examined in cystic fibrosis (CF) patients with endobronchial Staphylococcus aureus or Pseudomonas aeruginosa chronic infection, CF patients without infection, heterozygous, non-CF patients with chronic pulmonary infection, and healthy controls. Circulating and platelet-activating factor (PAF)-primed phagocyte luminol luminescence responses to complement-opsonized zymosan were increased in both groups of infected CF and non-CF children relative to uninfected CF children and healthy control children and adults. The ratio between circulating and PAF-primed phagocyte responses was significantly elevated in all children with CF, and in these, the ratio could serve as an indicator of response to antibiotic treatment. The ratios of circulating and PAF-primed phenotypic expression for CR1, CR3, and FcgammaRIII (CD16), but not FcgammaRII (CD32), correlated with the functional ratios. Phagocyte opsonin receptor response capacity might be used for evaluation of inflammation and infection in CF patients.

[CYFRA 21-1 and bronchial cancer]. / CYFRA 21-1 et cancers bronchiques.

CYFRA is a new marker which measures a fragment of cytokeratin 19 in the serum by an immune radiometric method. The test is based on the preservation of the cytokeratin expression on the epithelial cells during the course of malignant transformation. In immuno-histochemistry the antibodies which selectively recognise cytokeratin react with all histological types of bronchial cancer. The presence of cytokeratin in the serum of patients suffering from cancer would be linked to their liberation during the course of cellular death. The threshold of specificity for CYFRA 21-1 is 3.3.3.6 ng/ml in a population suffering from benign respiratory diseases. The study performed in bronchial cancer produced the following conclusions: the marker is, above all, useful for epidermoid cancer; it is more discriminating than other markers to separate bronchial cancers and non-malignant respiratory disease. An elevated level of CYFRA 21-1 is predictive of advanced disease but does not permit any prediction as to inoperability. In 65% of cases, variations of CYFRA 21-1 are concordant with the stage of the disease during chemotherapy. Finally, elevated levels of CYFRA 21-1 predict a poor prognosis independent of the state of the disease.

[Disorders of interferon status in bronchopulmonary diseases in children living under conditions of elevated background radiation]. / Narushenie interferonovogo statusa pri bronkholegochnykh zabolevaniikh u detei, prozhivaiushchikh v usloviiakh povyshennogo radiatsionnogo fona.

Impairments in the interferon status of children with chronic and recurring diseases of the respiratory organs were investigated and its correction was shown possible with the use of alpha 2-interferon (reaferon). Suppression of the interferon-producing capacity of the immunocytes was observed in all the cases of the disease aggravation. The level of the suppression correlated with the severity of the infection. In the patients affected by radiation the suppression of the interferonogenesis was more marked. However, in these cases no dependence of the detected impairments in the interferon status on the level of the radiation pollution of the territory of the children residence was shown. The inclusion of reaferon to the basal therapy resulted in a significant increase of the alpha-interferon production in the cases of bronchial asthma and asthmatic bronchitis as well as its recovery to the normal in the cases of recurring bronchitis and chronic pneumonia. In all the cases of bronchopulmonary diseases only a tendency towards normalization of the alpha-interferon indices was recorded.

[Study of cells harvested in nasal secretions after lavage. Improvement of the cytologic technique and application to ORL and bronchial pathology]. / Etude des cellules recueillies dans les secrétions nasales apres lavage. Mise au point de la technique cytologique et application aux pathologies orl et bronchiques.

The study of the cells found in the nasal lavage fluid is now a very used method. It has many advantages and it is better than the study of nasal smears obtained by nose blowing and/or swabbing. In this work, we have studied the nasal cytology of patients with a nasal or bronchial pathology. A count of inflammatory cells in a hemocytometer is performed in 301 noses then the percentage of various cell types (eosinophils, lymphocytes and neutrophils) is performed on a glass slide stained by May Grunwald Giemsa. The results are correlated with the literature. The patients with a known NARES have a mean nasal eosinophilia of 26.8%; in the allergic rhinitis, the eosinophilia is 41.4%; the patients with a Fernand Widal Syndrome or with a nasosinusal polyposis have respectively a eosinophil percentage of 24.2% and 18.8%.

[Effect of infusion hemodilution on the indicators of the blood coagulation system in children during planned thoracic operations]. / Vliianie infuzionnoi gemodiliutsii na pokazateli svertyvaiushchei sistemy krovi u detei pri provedenii planovykh torakal'nykh operatsii.

The blood coagulation system and fibrinolysis were studied in 16 children with chronic bronchopulmonary diseases, aged from 4 to 15 years, before surgery, immediately, and on the first day after the operation. The method of infusion hemodilution, under the control of hematocrit, hemoglobin and total protein, was used for the treatment of operation hemorrhage. The investigations conducted have revealed hypercoagulation signs in the patients before the beginning of the operation (as compared to normal children). Operative intervention has intensified many signs of hypercoagulation, however, in the postoperative period no clinical signs of hypercoagulation were observed in all the cases, that was associated with the positive effect of hemodilution.

A quantitative and qualitative study of the transglutaminase-mediated insertion of polyamines into plasma proteins from patients with bronchopulmonary cancer.

The transglutaminase-mediated incorporation of putrescine into proteins of plasma derived from 44 patients with histologically defined bronchopulmonary cancer was compared with that from an age-matched group of 18 patients hospitalized with non-malignant diseases. Two types of kinetic data were obtained over a range of putrescine concentrations 0.09 mM to 0.6 mM. Whereas the plasma from all the patients of the control group showed linear kinetics, that from only 24 patients of the cancer group showed linear kinetics. The remaining 20 showed kinetics typical of inhibition by excess substrate. PAGE analysis of [14C] putrescine-bound plasma proteins showed around 15 different bands. Among these putrescine-binding proteins, we identified, with the help of corresponding specific antisera, four protease inhibitors: alpha 2-macroglobulin, alpha 1-antitrypsin, alpha 1-antichymotrypsin and antithrombin III.