RESUMEN
AIM: Measurement of heavy elements in alveolar macrophages (AM) of bronchoalveolar lavage (BAL) and pulmonary tumor tissue (PTT); investigation of spacial distribution of the heavy particles in the tissues. MATERIALS AND METHODS: Laser mass-spectrometry estimated quantitative and qualitative characteristics of heavy elements (Mn, Fe, Co, Cu, Zr, etc.) in diagnostic and therapeutic BAL of 6 patients exposed to radiation after the Chernobyl accident and in pulmonary tumor tissue of patients operated for central small-cell and peripheral bronchoalveolar cancer who also had been exposed to radiation after the Chernobyl. RESULTS: Heavy elements concentration in the secondary BAL was less than in the primary one. This shows effectiveness of the procedures aimed at removal of heavy particles from the respiratory organs. Heavy elements content was quite different in two histologically different tumors. CONCLUSION: Laser mass-spectrometry proved its usefulness in simultaneous study of the quantity and quality of heavy elements in AM of BAL and tumors in radiation-exposed subjects, in investigation of the elements distribution in the pulmonary tissues and changes of elements composition in the tissues in the course of tumors development.
Asunto(s)
Adenocarcinoma Bronquioloalveolar/química , Líquido del Lavado Bronquioalveolar/citología , Carcinoma de Células Pequeñas/química , Neoplasias Pulmonares/química , Metales Pesados/análisis , Neoplasias Inducidas por Radiación/química , Adenocarcinoma Bronquioloalveolar/patología , Carcinoma de Células Pequeñas/patología , Humanos , Neoplasias Pulmonares/patología , Macrófagos Alveolares/química , Neoplasias Inducidas por Radiación/patología , Reactores Nucleares , Centrales Eléctricas , Liberación de Radiactividad Peligrosa , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , UcraniaRESUMEN
Bronchoalveolar lavage fluid (BALF), broncho- and transbronchial biopsies were examined in Chernobyl wreckers eleven years after the accident. Cytologically and electron-microscopically, there was predominance of alveolar macrophages (AM) with many cytoplasmic foreign bodies containing clear needle-like crystals. Roentgenospectral analysis and laser mass-spectrometry revealed chemical elements which are part of non-active "hot particles" (Al, Si, Ca, Fe) as well as reactor fuel elements and the station constructive materials which are the active part of "hot particles". Programmed BALF allowed to decrease cytosis and the amount of AM containing foreign-body particles as well as concentration of the majority of chemical elements in AM.
Asunto(s)
Líquido del Lavado Bronquioalveolar/química , Pulmón/efectos de la radiación , Macrófagos Alveolares/efectos de la radiación , Centrales Eléctricas , Traumatismos por Radiación/patología , Liberación de Radiactividad Peligrosa , Adulto , Humanos , Pulmón/patología , Macrófagos Alveolares/patología , Masculino , Exposición Profesional , UcraniaRESUMEN
The high prevalence of chronic respiratory problems in cleaning technicians (so-called "liquidators") of the destroyed reactor at Chernobyl and prolonged persistence of inhaled radioactive particles in their lungs suggested a substantial link between radioactive exposure and the diseases observed. Taking into account the importance of the problem, we started this study with the aim of establishing an effective and useful therapeutic program and assessing its efficacy during a one-year period of treatment. Chernobyl liquidators (n = 20) were screened by clinical history, physical examination, lung function test, chest radiograph, electrocardiogram, complete blood cell counts, serum chemistry, immunological blood tests, and complete BAL fluid investigation. One group of the patients (n = 10) underwent a special one-year treatment including polyvitamins, N-acetylcysteine, and therapeutic BAL every 3 months. The technique of therapeutic BAL has proven to be a promising and effective tool in the treatment of lung diseases induced by inhalation of radioactive particles.
Asunto(s)
Lavado Broncoalveolar , Pulmón/efectos de la radiación , Centrales Eléctricas , Traumatismos por Radiación/terapia , Liberación de Radiactividad Peligrosa , Adulto , Descontaminación , Humanos , Masculino , Traumatismos por Radiación/diagnóstico , Ceniza Radiactiva , Pruebas de Función Respiratoria , Resultado del Tratamiento , UcraniaRESUMEN
The paper presents morphological, morphometric and densitometric evidence obtained on cytoplasmic inclusions of alveolar macrophages from bronchoalveolar lavage of chronic obstructive bronchitis (COB) sufferers. All of them previously worked in the zone contaminated after the Chernobyl accident. The control consisted of nonexposed to radiation COB patients. In the exposed subjects alveolar macrophages were more active, 20% of cytoplasm was occupied by numerous phagolysosomes varying in form. Their densitometric evaluation has been performed. Further bronchoalveolar lavages will be conducted to follow up the above changes in alveolar macrophages.
Asunto(s)
Macrófagos Alveolares/patología , Exposición Profesional/efectos adversos , Centrales Eléctricas , Liberación de Radiactividad Peligrosa , Adulto , Bronquitis/patología , Líquido del Lavado Bronquioalveolar/citología , Enfermedad Crónica , Densitometría , Humanos , Cuerpos de Inclusión/patología , Cuerpos de Inclusión/efectos de la radiación , Macrófagos Alveolares/efectos de la radiación , Masculino , Persona de Mediana Edad , Exposición Profesional/estadística & datos numéricos , Liberación de Radiactividad Peligrosa/estadística & datos numéricos , Factores de Tiempo , UcraniaRESUMEN
A man of 66 participated in the emergency works after the Chernobyl accident. His official dose of radiation comprised 24 roentgens. In March, 1993, he underwent prophylactic examination including computed tomography which revealed peripheral tumor in the lower part of the left lung with penetration in the lymph nodes of the lung root. Biopsy showed it to be adenocarcinoma. Moreover, electron-microscopically, more than 40% of alveolar macrophages contained large optically dense particles in the cytoplasm. After lobectomy in March 1993 x-ray and gamma spectrometry of the removed lung tissue recorded high content of 137Cs (0.1-0.18 Bq). This finding evidences possible long-term deposition of radionuclides in the bronchopulmonary system of radiation-exposed subjects.
Asunto(s)
Adenocarcinoma/patología , Radioisótopos de Cesio/efectos adversos , Neoplasias Pulmonares/patología , Neoplasias Inducidas por Radiación/patología , Enfermedades Profesionales/patología , Centrales Eléctricas , Liberación de Radiactividad Peligrosa , Adenocarcinoma/etiología , Adenocarcinoma/cirugía , Anciano , Radioisótopos de Cesio/análisis , Enfermedad Crónica , Humanos , Pulmón/química , Pulmón/patología , Pulmón/efectos de la radiación , Neoplasias Pulmonares/etiología , Neoplasias Pulmonares/cirugía , Metástasis Linfática , Masculino , Neoplasias Inducidas por Radiación/etiología , Neoplasias Inducidas por Radiación/cirugía , Enfermedades Profesionales/etiología , Enfermedades Profesionales/cirugía , Neumonectomía , Dosis de Radiación , UcraniaRESUMEN
Cytological analysis of bronchoalveolar lavage (BAL) and x-ray energy dispersive spectrometry of intercellular compounds were evaluated in 19 workers ("liquidators") commissioned to clean and contain the nuclear waste after the Chernobyl catastrophe in comparison with ten control subjects. Results showed a significant increase of neutrophils, small monocyte-like alveolar macrophages (AM) and AM with large black cytoplasmic inclusions. In addition, such mineral elements as Zr, Ce, Pr, Sm, Pa, PU and Cs were detected in AM phagosomes in liquidators. These elements were reported as markers of Chernobyl-type nuclear fuel. It is recognized that BAL gives access to particulate matter present in lung parenchyma. Thus, spectrometric analysis of AM inclusions can provide reliable information about the exposure to inhaled radionuclides seven years after the catastrophe.
Asunto(s)
Liberación de Radiactividad Peligrosa , Radioisótopos/efectos adversos , Sistema Respiratorio/efectos de la radiación , Administración por Inhalación , Adulto , Líquido del Lavado Bronquioalveolar/química , Líquido del Lavado Bronquioalveolar/citología , Humanos , Cuerpos de Inclusión/metabolismo , Cuerpos de Inclusión/ultraestructura , Masculino , Microscopía Electrónica , Minerales/metabolismo , Centrales Eléctricas , Residuos Radiactivos/efectos adversos , Radioisótopos/administración & dosificación , Sistema Respiratorio/metabolismo , Sistema Respiratorio/patología , UcraniaRESUMEN
The mechanisms of non-immune and immune injuries in chronic nonspecific lung inflammation are analysed on the basis of authors' research and literature. The data given concern the changes of the bronchial mucociliary transport system, incomplete functions of alveolar macrophages and polymorphonuclear neutrophils in chronic inflammatory foci, increase in the number of intra- and extracellular bacteria, metabolism of lung phagocytes in different chronic inflammatory lung diseases. The urgency of lung phagocyte and lymphocyte investigation both in specific cellular and humoral immune reactions, as well as in realization of immunopathologic mechanisms developing in chronic inflammation is emphasized.
Asunto(s)
Enfermedades Pulmonares/inmunología , Formación de Anticuerpos/inmunología , Enfermedad Crónica , Humanos , Inmunidad Celular/inmunología , Inflamación/inmunología , Inflamación/microbiología , Inflamación/patología , Enfermedades Pulmonares/microbiología , Enfermedades Pulmonares/patología , Macrófagos Alveolares/inmunología , Depuración Mucociliar , Neutrófilos/inmunologíaRESUMEN
The bronchoalveolar fluid (BAF) cytology of 63 patients with bronchiectasis has been studied. BAF from 8 subjects without pulmonary pathology served as control. BAF samples were obtained after preliminary cleaning of the bronchial tree from the purulent contents. BAF cytosis was found significantly increased in bronchiectasis as compared to the control being observed even at minimal inflammatory activity in the lungs and due to elevated neutrophil count. Alveolar macrophage numbers reduced only in advanced inflammation. Lymphocyte count remained unchanged. BAF cytologic evidence objectively reflects the degree of the bronchoalveolar inflammation.
Asunto(s)
Bronquios/patología , Bronquiectasia/patología , Líquido del Lavado Bronquioalveolar/patología , Esputo/citología , Adulto , Bronquios/metabolismo , Broncoscopios , Femenino , Humanos , Masculino , Persona de Mediana Edad , Succión/instrumentación , Succión/métodos , Irrigación Terapéutica/métodosRESUMEN
Bronchoalveolar lavage fluid neutrophils were studied by the cytologic methods in 58 patients with chronic bronchitis, 63 ones with bronchiectasis, and 8 normal controls. The study included cytospectrophotometry of myeloperoxidase and alkaline phosphatase activity and estimation of active oxygen-producing cells in the NBT test. Neutrophilic functional activity was different in the patients with chronic bronchitis and bronchiectasis. Neutrophilic myeloperoxidase and alkaline phosphatase activities were lower in the patients with chronic bronchitis than in those with bronchiectasis, whereas the counts of cells active in the NBT test were low in both patient populations.
Asunto(s)
Bronquiectasia/sangre , Bronquitis/sangre , Líquido del Lavado Bronquioalveolar/citología , Neutrófilos/fisiología , HumanosRESUMEN
The alveolar macrophages and neutrophils of the bronchoalveolar fluid from 37 patients with acute focal pneumonia were studied cytochemically. A comparison group consisted of 20 patients with primary chronic bronchitis, 11 subjects without pulmonary affections served control. Phagocytes with a high motile, oxygen-dependent bactericidal and hydrolytic activity as well as with increased level of absorptive capacity prevailed during the peak of the disease and its regression. At the phase of convalescence the number of phagocytes with a high oxygen-dependent bactericidal and hydrolytic activity decreased but their high absorptive activity was retained.
Asunto(s)
Líquido del Lavado Bronquioalveolar/citología , Fagocitos/patología , Neumonía/patología , Enfermedad Aguda , Adolescente , Adulto , Convalecencia , Femenino , Histocitoquímica , Humanos , Hidrólisis , Masculino , Persona de Mediana Edad , Neutrófilos/patología , Oxígeno/fisiologíaRESUMEN
The method suggested includes the use of homogenizer terrilytin for removing excessive mucus from broncho-alveolar lavage (BAL). Cytochemical investigation of BAL neutrophils is reasonable to be performed if the viability of the cell suspension is not lower than 60%. Cytospectrophotometric examination is recommended for an unbiased evaluation of the neutrophil functional state.
Asunto(s)
Líquido del Lavado Bronquioalveolar/citología , Neumonía/patología , Amilasas , Supervivencia Celular/fisiología , Enfermedad Crónica , Combinación de Medicamentos , Histocitoquímica , Humanos , Métodos , Neutrófilos/fisiología , Péptido Hidrolasas , Neumonía/complicacionesRESUMEN
Bronchoalveolar washings (BAWs) from 30 patients with nonobstructive chronic bronchitis (CB) were examined cytologically. On the basis of the taxonomic analysis of the data on the cytological examination of the BAWs, all the observations were classified as belonging to degrees I, II and III of the cytological activity of the inflammatory process in the lungs. It was revealed that the minimal degree of the activity of the inflammatory process was characterized by a marked increase in the relative numbers of the cells of the desquamated cylindrical epithelium and destroyed cells along with a significant decrease in the proportion of macrophages and an increase in the relative count of neutrophils. The increased activity of the inflammatory process in the lungs was accompanied by a progressing increase in the proportion of neutrophils and a decrease in the relative count of macrophages and the cells of the cylindrical epithelium. Clinico-cytological analysis of the observations was also performed. The most complete and objective estimation of the degree of the inflammatory process activity in the lungs in the patients with CB was provided by the cytological indices of the BAWs.