ABSTRACT
The aim of the work was to assess the value of biopsy techniques for fibrobronchoscopy under local anesthesia in patients with pulmonary pathology at the prehospital level. It included 706 subjects with lobular, segmental or diffuse lesions in the lungs of specific (tuberculosis), non-specific (pneumonia, exogenous alveolitis), and other origin. All known methods of endobronchial biopsy were employed (bronchoalveolar lavage or liquid lung biopsy, tissue biopsy, transbronchial biopsy, brush biopsy, puncture and aspiration biopsy) with subsequent cytomorphological and bacteriological studies of bioptates. Diagnostic efficiency of direct biopsy was estimated at 97%, transbronchial biopsy at 5-90% depending on nosological form of lung disease, brush and puncture biopsy 20-50 and 6% respectively. Reversible complications occurred in 1.4% and were resolved by therapeutic methods. Cost effectiveness of prehospital instrumental examination of patients with pulmonary pathology is 10 times the intrahospital one.
Subject(s)
Lung Diseases/diagnosis , Lung/pathology , Adult , Ambulatory Care/economics , Ambulatory Care/methods , Biopsy/adverse effects , Biopsy/economics , Biopsy/methods , Bronchoscopy , Female , Humans , Lung Diseases/economics , Lung Diseases/pathology , Male , Middle Aged , Young AdultABSTRACT
Microbiology, X-ray study, and bronchoscopy, including the examination of bronchoalveolar lavage and histology of thransbronchial lung biopsy specimens have proven to be of the greatest informative value in the differential diagnosis of different forms of systemic vasculitis and tuberculosis in 52 patients. Focal pulmonary tuberculosis was detected in the phase of S(II) infiltration on the right in a patient with rheumatic arthritis; Mycobacterium tuberculosis was bacterioscopically detected. The patient underwent specific antituberculous therapy that provided beneficial effects.
Subject(s)
Tuberculosis, Pulmonary/diagnosis , Vasculitis/diagnosis , Adult , Aged , Bronchoscopy , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Radiography, Thoracic , Retrospective StudiesSubject(s)
Alveolitis, Extrinsic Allergic/complications , Bronchial Diseases/complications , Osteochondritis , Tracheal Diseases/complications , Aged , Alveolitis, Extrinsic Allergic/diagnosis , Biopsy , Bronchial Diseases/diagnosis , Bronchoalveolar Lavage , Bronchoscopy , Diagnosis, Differential , Female , Humans , Osteochondritis/complications , Osteochondritis/diagnosis , Radiography, Thoracic , Tracheal Diseases/diagnosisSubject(s)
Adenocarcinoma, Bronchiolo-Alveolar/diagnosis , Lung Neoplasms/diagnosis , Female , Humans , Middle Aged , Time FactorsSubject(s)
Bronchial Diseases/etiology , Calcinosis/complications , Calculi/etiology , Lung Diseases/complications , Adolescent , Adult , Aged , Female , Humans , Lymph Nodes , Lymphatic Diseases/complications , Male , Middle Aged , SyndromeSubject(s)
Bronchi , Lung Diseases/diagnosis , Pulmonary Alveoli , Therapeutic Irrigation , Cytodiagnosis , HumansSubject(s)
Bronchial Diseases/etiology , Calcinosis/complications , Calculi/etiology , Lymphatic Diseases/complications , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , SyndromeSubject(s)
Histiocytosis, Langerhans-Cell/diagnosis , Lung Diseases/diagnosis , Adolescent , Adult , Aged , Bronchoalveolar Lavage Fluid/pathology , Bronchoscopy , Diagnosis, Differential , Female , Histiocytosis, Langerhans-Cell/pathology , Humans , Lung/pathology , Lung/ultrastructure , Lung Diseases/pathology , Male , Microscopy, Electron , Middle AgedSubject(s)
Bronchi/pathology , Bronchoscopy/methods , Lung/pathology , Adolescent , Adult , Aged , Biopsy/methods , Child , Diagnosis, Differential , Female , Fiber Optic Technology , Humans , Lung Neoplasms/diagnosis , Male , Middle Aged , Tuberculosis, Pulmonary/diagnosisSubject(s)
Biopsy/methods , Catheterization , Lung Diseases/diagnosis , Lung/pathology , Adolescent , Adult , Aged , Diagnosis, Differential , Humans , Lung Diseases/pathology , Male , Middle AgedABSTRACT
Histological and electron-microscopic studies of intact lung specimens were carried out in 30 patients with pulmonary tuberculosis developing in the presence of type I (insulin-dependent) diabetes mellitus. Material for investigation was obtained by intrapulmonary biopsy carried out during diagnostic bronchoscopy. Signs of adenopathy were detected in lung areas distant from tuberculous in foci all the cases. The diabetic origin of this condition was confirmed by expressed correlation with changes in the retinal and renal vessels and absence of correlation with the duration of tuberculous process. The degree of pulmonary adenopathy has a negative impact on the course of tuberculosis and efficacy of its therapy.
Subject(s)
Diabetes Mellitus, Type 1/complications , Diabetic Angiopathies/etiology , Lung/blood supply , Tuberculosis, Pulmonary/complications , Adolescent , Adult , Bronchoscopy , Capillaries/ultrastructure , Diabetes Mellitus, Type 1/pathology , Diabetic Angiopathies/pathology , Female , Humans , Male , Middle Aged , Tuberculosis, Pulmonary/pathologyABSTRACT
In 43 patients with exogenous allergic alveolitis (EAA), including 30 and 13 in its acute and chronic disease, bronchoalveolar lavage was performed, bronchoalveolar washing fluid (BAWF), isolated alveolar macrophages (AM) and unfractionated cellular sediment (NFCS) were separately studied. The BAWF showed high rates of lipid peroxidation (LPO), decreased antiproteolytic defense, and activated local synthesis of haptoglobin (Hp), fibronectin (FN), platelet activation factor (PAF), and enzymes of antioxidative defense (AOD). There was a rise in FN and PAF concentrations in the acute phase of the disease and higher PLO rates and elevated Hp levels in chronic EAA. The rate of oxidative metabolism in AMs was much higher in acute EAA than that in chronic EAA and accompanied by imbalance in the PLO-AOD system. AM levels of PAF was high in patients in both groups. The rate of LPO was higher in NFCS than in AM and was also followed by simultaneous AOD mobilization with preserved imbalance. A particularly significant AOD insufficiency in the NFCS was noted in chronic EAA, which was accompanied by decreased PAF. Thus, local pathochemical processes are of significance in developing the pattern of the process in EAA.