Low levels of air pollution induce changes of lung function in a panel of schoolchildren.

In search of sensitive screening parameters for assessing acute effects of ambient air pollutants in young schoolchildren, the impact of 8-h average air pollution before lung function testing was investigated by oscillatory measurements of resistance and spirometry with flow-volume loops. At a central elementary school in Linz, the capital of Upper Austria, 163 children aged 7-10 yrs underwent repeated examinations at the same time of day during 1 school year, yielding a total of 11-12 lung function tests per child. Associations to mass concentrations of particulate matter and nitrogen dioxide (NO(2)) measured continuously at a nearby monitoring station were tested, applying the Generalised Estimating Equations model. Reductions per 10 microg.m(-3) (both for particles and for NO(2)) were in the magnitude of 1% for most lung function parameters. The most sensitive indicator for acute effects of combustion-related pollutants was a change in maximal expiratory flow in small airways. NO(2) at concentrations below current standards reduced (in the multipollutant model) the forced expiratory volume in one second by 1.01%, maximal instantaneous forced flow when 50% of the forced vital capacity remains to be exhaled (MEF(50%)) by 1.99% and MEF(25%) by 1.96%. Peripheral resistance increased by 1.03% per 10 microg.m(-3) of particulate matter with a 50% cut-off aerodynamic diameter of 2.5 mum (PM(2.5)). Resistance is less influenced by the child's cooperation and should be utilised more often in environmental epidemiology when screening for early signs of small airway dysfunction from urban air pollution, but cannot replace the measurement of MEF(50%) and MEF(25%). In the basic model, the reduction of these parameters per 10 microg.m(-3) was highest for NO(2), followed by PM(1), PM(2.5) and PM(10), while exposure to coarse dust (PM(10)-PM(2.5)) did not change end-expiratory flow significantly. All acute effects of urban air pollution found on the lung function of healthy pupils were evident at levels below current European limit values for nitrogen dioxide. Thus, planned reduction of nitrogen dioxide emission (Euro 5; vehicles that comply with the emission limits as defined in Directive 99/96/EC) of 20% in 2010 would seem to be insufficient.

Multiple endometrial stromal nodules with sparse cysts and glands in the lung--a nodular variation of endometriosis that may mimic metastases of sarcoma.

We report an unusual case of a nodular variation of pulmonary endometriosis. To our knowledge, there is no previous report on a morphological investigation of this entity. The etiology of this rare condition is still a matter of discussion. The well-circumscribed nodular mass is composed of cells identical to, or closely resembling, those of endometrial stroma containing sparse cysts and glands. Immunohistochemically, the cells showed an extensive co-expression of cytokeratin AE1/AE3 and vimentin and were highly positive for progesterone receptor (PRICA) and estrogen receptor (ERICA). Cells lining the cysts and glands as a monolayer were reactive for Ber-Ep4, cytokeratin Pan and cytokeratin AE1/AE3 and negative to all other markers used including PRICA and ERICA. The differential diagnosis of this entity included fibrous tumor of the pleura and metastatic low-grade-endometrial-stromal-sarcoma. The morphological findings are correlated with immunohistochemical studies and results of cell image analysis. This study details the clinicopathological features of the nodular variation of pulmonary endometriosis.

Revision of ambient air quality standards for PM?

Recent epidemiologic findings gave rise to new approaches in setting ambient air quality guidelines for particulate matter in various countries. Because of the complexity of this system defined by many parameters like size distribution, chemical composition, geometry, formation, hygroscopy, or concentration the toxicologic base for acute and chronic effects, especially in the low dose range, is not yet adequate for the formulation of air quality guidelines. Open questions as there is existence of a threshold, shape of the dose-response curve, causative models for the mechanisms and health effects outcome in connection with relatively low doses and groups at higher risks are still under discussion at an international level, thus making political decisions very difficult.

Natural history of bronchopleural fistula after pneumonectomy: a review of 96 cases.

BACKGROUND: Various therapeutic approaches to bronchopleural fistula have been reported. Its natural history, which may be key to the best therapeutic management, early detection, and possibly, prevention of fistula formation, has received little attention. METHODS: The cases of 96 patients with bronchopleural fistula after pneumonectomy seen over a 13-year period (1982 to 1995) were retrospectively analyzed. Cancer, TNM stage and histology, age, sex, side and size of the fistula at primary bronchoscopic diagnosis, time of occurrence after operation (days), cause of death, and survival after fistula formation (days) were analyzed. Management consisted of bronchoscopic closure with fibrin sealant or decalcified spongy calf bone or both, repeat thoracotomy with resection of the bronchial stump, thoracoplasty, or open window thoracostomy. RESULTS: Except for one instance, all total stump dehiscences occurred within 90 days after operation. Sixty-four patients (67%) died during the observation period; in 25, the cause of death was aspiration pneumonia. Only 2 patients who died of aspiration pneumonia had development of a fistula after 90 postoperative days. The aspiration rate dropped with increasing interval between operation and fistula occurrence (p = 0.000). Patient survival after fistula formation was positively correlated to this interval (p = 0.002). Successful fistula closure was achieved by surgical intervention in 21 patients and endoscopically in 11 patients. The overall postoperative mortality rate irrespective of treatment method was 31%. CONCLUSIONS: The incidence of aspiration pneumonia declines sharply if bronchopleural fistula occurs more than 3 months after operation. Formation of fibrothorax apparently represents a natural protection against fistula formation and subsequent fatal aspiration pneumonia. Close follow-up during the first 3 postoperative months should detect bronchopleural fistula before aspiration occurs.

[Reduced lung function parameters after physical exertion in Austrian Alps in ozone concentrations below the legal warning limit]. / Reduktion von Lungenfunktionsparametern nach körperlicher Belastung in den österreichischen Alpen bei Ozonkonzentrationen unterhalb der gesetzlichen Vorwarnstufe.

The ambient ozone concentration has increased greatly over the past decades, which may lead to environmental health problems, especially during the summer. WHO guidelines recommend an 8 hour mean value of < or = 60 ppb ozone without health risk. The aim of the present study was to investigate if elevated zone concentrations at moderate altitudes in the Austrian Alps, characteristic of the situation in the summer months, influence pulmonary function after physical exercise. 24 male non-smokers (mean age 26.7 +/- 4 years) were investigated in the Tyrol (Pitztal) at a mean sea level of 2434 m. During a mountain-guide course lasting for 6 days the subjects were physically active all day long. Spirometry was performed in the morning and in the evening after 8 h of exercise. Ozone and PM10 concentrations were measured on site. The ozone 24 hour mean values ranged between 53 and 71 ppb. A mean decrease of 5.3% (p < 0.00001) was measured in forced vital capacity (FVC) and forced expiratory volume (FEV1) at t3,m in immediately after the highest ozone 24 hour mean value had been registered (71 ppb). A clinically relevant decrease of FVC and FEV1 > 10% was observed at t3,m in 35% of the subjects. However, a linear dependence of lung function changes on the ozone 8 hour mean values was demonstrable for all measuring points only in 10% of these subjects. In 90% of the subjects with a decrease of lung function parameters > 10%, this reduction was at least not monocausally linked to ozone.

Thin-layer chromatographic analysis of phenols on TLC aluminium sheets RP-18 F(254s).

The thin-layer chromatographic properties of phenolic compounds on TLC aluminium sheets RP-18 have been investigated in different eluent systems. Moreover, a method for the qualitative and quantitative thin-layer chromatographic determination of pentachlorophenol (PCP) in leather goods has been developed. This procedure includes sample preparation by solid phase extraction (SPE) using LiChrolut(R) EN columns.

Complicated pneumothorax: short- and long-term results of endoscopic fibrin pleurodesis.

Complicated pneumothorax is defined as a recurrent or persistent air leak in the pleural interspace beyond 5 days despite adequate tube drainage. Up to now, this disorder could only be corrected by open thoracotomy. Endoscopic fibrin pleurodesis is shown to be a method that could obviate, in most cases, the need for thoracotomy. In the last 6 years, 138 of 153 patients presenting with complicated spontaneous pneumothorax were treated with this method. The fibrin sealant consists of 2 components: fibrinogen, factor XIII, and albumin dissolved in aprotinin (3,000 KIU/ml), and a thrombin calcium chloride solution, which is applied through the working channel of a thoracoscope and vaporized with nitrous oxide. In this observation period, 6 (4.4%) recurrences were observed, which were subsequently treated with thoracotomy; a second attempt at fibrin pleurodesis was not undertaken. In all cases, endoscopic sealing was followed by prompt reexpansion of the collapsed lung. Long-term follow-up was satisfactory, pulmonary function tests showed no signs of restrictive dysfunction, and pleural fibrosis was not observed on x-ray as reported in other modes of treatment. Following these results, it is concluded that this method is useful in cases of persistent, therapy-resistant, complicated spontaneous pneumothorax; its effects are durable and it has a low rate of recurrence. It produces a physiological healing process without damage to the pleura.

[Specific IgE antibodies to Pityrosporum orbiculare in patients with atopic dermatitis]. / Spezifische IgE-Antikörper gegen Pityrosporon orbiculare bei Patienten mit atopischem Ekzem.

By means of RAST investigations, we detected specific IgE antibodies against Pityrosporon orbiculare in the plasma of patients with atopic dermatitis. The patients suffering from the so-called head and neck dermatitis showed an average specific IgE antibody titer of RAST class 3, whereas in those with predominant involvement of the extremities we found an average antibody titer of RAST class 1.

Parameters influencing carbon monoxide kinetics.

Carbon monoxide exchange via the lungs can be satisfactorily described by mathematical models. More complex models allow consideration of various parameters influencing this process. Particularly for special situations like for high risk groups or for extreme environments such a model can be used successfully.

[Effect of serum factors on the intracellular killing of Trichophyton mentagrophytes microconidia by human polymorphonuclear leukocytes]. / Einfluss von Serumfaktoren auf die intrazelluläre Abtötung von Trichophyton mentagrophytes Mikrokonidien durch menschliche polymorphkernige Neutrophile.

The rate of intracellular killing of T. mentagrophytes microconidia by polymorphonuclear leucocytes (PMNL) was investigated in 35 patients with anamnestic or actually present tinea infections under various conditions: in autologous serum, in serum of healthy controls, and in heat-inactivated serum. If the PMNL were incubated in serum from "immunologically experienced" persons, we found acceleration of the intracellular killing rate. Differences regarding killing rates were seen in the first hour of incubation (13 +/- 7.7% against 1 +/- 0.8%), becoming even more pronounced after heat-inactivation of the serum. Absorption of the patient's serum with T. mentagrophytes microconidia markedly reduced the rate of intracellular killing during the first hour of incubation, whereas microconidia pre-incubated in patients serum were readily killed even if a negative control serum was present.

Carbon monoxide uptake and the resulting carboxyhemoglobin in man.

In order to calculate the carboxyhemoglobin concentration in human blood under various circumstances and for particular groups or individuals, the model proposed originally by Coburn and coworkers in a slightly revised form was tested. The relevant breathing parameters were measured as minute averages and used for computation of COHb time course. At the same time blood samples were taken and analysed for carboxyhemoglobin. For four different subjects, various breathing conditions and work rates the average deviation of experimental data from theoretical predictions is 7.4%. Some data are presented graphically. Excellent conformity of all the results indicate, that the model is suitable to show the influence of most physiological and breathing parameters on the dynamics of carbon monoxide uptake.

A modified high-performance thin-layer plate for the separation of purines and pyrimidines.

Several ways of using the recently developed high-performance thin-layer chromatography (HPTLC) precoated plate NH2 F 254s to separate purines and pyrimidines are described. This precoated plate is coated with silica gel 60 which has been chemically modified with alkylamino groups. In view of the chemical properties of the functional groups bonded to the silica gel matrix, the HPTLC precoated plate NH2 F 254s can be considered to be a weak basic ion-exchange plate. In aqueous eluants the substances are separated principally according to charge differences. The HPTLC precoated plate NH2 F 254s can, however, also be used to separate uncharged, polar compounds with organic solvents. Examples of separations and chromatograms for its use in both aqueous and organic eluants are given.