КОМПЛЕКСНАЯ ЭНДОСКОПИЧЕСКАЯ ДИАГНОСТИКА РАННИХ РЕЦИДИВОВ У БОЛЬНЫХ, ОПЕРИРОВАННЫХ ПО ПОВОДУ РАКА ЛЕГКОГО

The purpose of the study: to evaluate the effectiveness of postoperative management of the bronchial stump in lung cancer patients. material and methods. Forty-four patients with stage III lung cancer underwent endoscopic examination of the bronchial tree 3, 6, 9 and 12 months after surgery. The EVIS EXERAII and LUCERA videoendoscopic complexes with consistent use of white light mode, autofluorescence and narrow- spectrum mode were used. Endoscopic results were compared with morphological findings. Results. X-ray of the chest was negative for tumor recurrence in 3 (6.8 %) cases and early metachronous tumor of the trachea was revealed in 1 (2.3 %) case. The main endoscopic symptoms of early local recurrence in the bronchial stump were the marked lilac glow identified in the AFI mode and the mucosal vascular pattern deformation Timely diagnosis of recurrence allows a special treatment to be performed.Цель исследования - оценка эффективности комплексного послеоперационного мониторинга состояния культи оперированного бронха у больных раком легкого. Материал и методы. У 44 больных, оперированных по поводу рака легкого III стадии, в сроки через 3, 6, 9 и 12 мес после лечения проводилось комплексное эндоскопическое исследование бронхиального дерева на видеоэндоскопических комплексах EVIS EXERAII и LUCERA с последовательным использованием режима белого света, аутофлуоресценции и режима узкого спектра. Результаты эндоскопии сопоставляли с данными морфологического исследования. результаты. В 3 (6,8 %) случаях на различных этапах послеоперационного мониторинга были обнаружены рентгенонегативные рецидивы опухоли, в 1 (2,3 %) - ранняя метахронная опухоль трахеи. Основными эндоскопическими симптомами ранних местных рецидивов в культе оперированного бронха являются выраженное сиреневое свечение, выявляемое в режиме AFI, и различная деформация сосудистого рисунка слизистой оболочки. Своевременная диагностика рецидивного процесса позволяет провести специальное лечени

ENDOSCOPIC DIAGNOSIS OF EARLY RECURRENCE IN PATIENTAS UNDERGOING SURGERY FOR LUNG CANCER

The purpose of the study: to evaluate the effectiveness of postoperative management of the bronchial stump in lung cancer patients. material and methods. Forty-four patients with stage III lung cancer underwent endoscopic examination of the bronchial tree 3, 6, 9 and 12 months after surgery. The EVIS EXERAII and LUCERA videoendoscopic complexes with consistent use of white light mode, autofluorescence and narrow- spectrum mode were used. Endoscopic results were compared with morphological findings. Results. X-ray of the chest was negative for tumor recurrence in 3 (6.8 %) cases and early metachronous tumor of the trachea was revealed in 1 (2.3 %) case. The main endoscopic symptoms of early local recurrence in the bronchial stump were the marked lilac glow identified in the AFI mode and the mucosal vascular pattern deformation Timely diagnosis of recurrence allows a special treatment to be performed

Ambient level of NO2 augments the inflammatory response to inhaled allergen in asthmatics

AbstractAir pollution constitutes an important factor for asthma aggravation, and there is increased concern about respiratory health effects of common air pollutants. The purpose of this study was to examine how exposure to a high ambient concentration nitrogen dioxide (NO2) prior to a bronchial allergen challenge modulated the inflammatory response in the bronchi. Thirteen subjects with mild asthma and allergy were exposed at rest to either purified air or 500 μg×m−3 NO2 for 30 min, followed 4 h later by an allergen inhalation challenge. The exposures (NO2 or air) were performed in random order and at least 4 weeks apart. Lung function during NO2/air exposure and allergen challenge was measured by plethysmography, and then hourly by portable spirometry after exposures. Subjective symptoms were recorded during and after exposure. Bronchoscopy with bronchial wash (BW) and bronchoalveolar lavage (BAL) was performed 19 h after allergen challenge. NO2+allergen enhanced the percentage of neutrophils in both BW and BAL compared to air+allergen (BW 19 vs. 11, P=0.05; BAL 3 vs. 1, P=0.02 median values). The levels of eosinophil cationic protein (ECP) in BW was higher after NO2+allergen compared to air+allergen (9.0 vs. 3.6 μg/l; P=0.02, median values). There was no NO2-associated effect on symptoms or pulmonary function. These data suggest that ambient NO2 can enhance allergic inflammatory reaction in the airways without causing symptoms or pulmonary dysfunction

Basophil allergen threshold sensitivity: a useful approach to anti-IgE treatment efficacy evaluation

Background: Monitoring of the allergen sensitivity of a patient is most important for optimal patient care and a basic prerequisite for immunomodulating treatment. The objective of this study was to investigate how basophil allergen sensitivity can be applied in the monitoring of anti-immunoglobulin E (IgE) treatment. Methods: Basophils from timothy grass pollen allergic patients were, by flow cytometry, analysed for allergen threshold sensitivity (CD-sens) by measuring CD63 up-regulation on CD203c-identified basophils. The results were compared with maximal percentage CD63 up-regulation at one allergen dose (CD-max), skin prick test end-point allergen titration, (SPT-sens), nasal provocation titration tests (nasal provocation titre) and serum IgE and IgE antibody concentrations. Results: There was a significant correlation (r = 0.50, P = 0.01) between CD-sens and SPT-sens, CD-sens and the IgE antibody concentration in percentage of 'total IgE' (relative IgE antibody concentration) (r = 0.72, P < 0.001) as well as between CD-sens and nasal provocation titre (r = 0.54, P < 0.05) but, in contrast, CD-max did not correlate with any of the sensitization parameters, i.e. SPT-sens, nasal provocation titre, absolute and relative IgE antibody concentration or CD-sens. CD-sens could be used to monitor omalizumab treatment efficacy while, based on CD-max, four of seven symptom-free patients on omalizumab would have been classified as having ongoing allergy. Conclusions: CD-sens seems to be very useful for the determination of a patient's allergen sensitivity and should be evaluated for the measurement and monitoring of anti-IgE treatment efficacy. CD-max, the conventional approach to basophil allergen challenge, which mirrors cell reactivity, gives incorrect information

Basophil allergen threshold sensitivity: a useful approach to anti-IgE treatment efficacy evaluation

Background: Monitoring of the allergen sensitivity of a patient is most important for optimal patient care and a basic prerequisite for immunomodulating treatment. The objective of this study was to investigate how basophil allergen sensitivity can be applied in the monitoring of anti-immunoglobulin E (IgE) treatment. Methods: Basophils from timothy grass pollen allergic patients were, by flow cytometry, analysed for allergen threshold sensitivity (CD-sens) by measuring CD63 up-regulation on CD203c-identified basophils. The results were compared with maximal percentage CD63 up-regulation at one allergen dose (CD-max), skin prick test end-point allergen titration, (SPT-sens), nasal provocation titration tests (nasal provocation titre) and serum IgE and IgE antibody concentrations. Results: There was a significant correlation (r = 0.50, P = 0.01) between CD-sens and SPT-sens, CD-sens and the IgE antibody concentration in percentage of 'total IgE' (relative IgE antibody concentration) (r = 0.72, P < 0.001) as well as between CD-sens and nasal provocation titre (r = 0.54, P < 0.05) but, in contrast, CD-max did not correlate with any of the sensitization parameters, i.e. SPT-sens, nasal provocation titre, absolute and relative IgE antibody concentration or CD-sens. CD-sens could be used to monitor omalizumab treatment efficacy while, based on CD-max, four of seven symptom-free patients on omalizumab would have been classified as having ongoing allergy. Conclusions: CD-sens seems to be very useful for the determination of a patient's allergen sensitivity and should be evaluated for the measurement and monitoring of anti-IgE treatment efficacy. CD-max, the conventional approach to basophil allergen challenge, which mirrors cell reactivity, gives incorrect information

Towards a wood based material biorefinery - A demonstrator

Wood, the most abundant ligno-cellulosic raw material available, is a key potential feedstock for production of more sustainable alternatives to fossil-based materials. However advances within the fields of extraction and treatment processes within what is often referred to as the biorefinery concept is essential to allow for such transition. In this study, several different methods for the extraction and separation of wood constituents have been combined in a single process with the purpose of achieving a high overall efficiency of material extraction and utilisation. The work builds on several activities within the Wallenberg Wood Science Center (WWSC). The aim is to present a laboratory-scale demonstrator that illustrates how the different constituents can be separated from the wood matrix for later use in the production of bio-based materials and chemicals. The process steps involved have been tested as integral steps in a linked process for a scale of operations that range from the kilogram-scale down to the gram-scale. Industrially chipped softwood, containing mainly spruce with some pine, was used as raw material