Granulocyte marker protein is increased in stools from rats with azoxymethane-induced colon cancer.

BACKGROUND: We wanted to investigate the relationship between the fecal levels of granulocyte marker protein (GMP) and the presence of aberrant crypt foci (ACF) and colorectal cancer in rats given injections of azoxymethane (AOM) and fed either of two different diets, a basal diet plus 20% corn oil or 20% beef suet, respectively. METHODS: The rats received intraperitoneal injections of AOM, 15 mg/kg, once weekly for 6 weeks and were killed after 22 weeks. RESULTS: In the group fed beef suet 17 of 19 rats developed colon cancer, whereas in the group fed corn oil 4 of 14 rats developed cancer. None of the 20 control rats fed either the beef suet or corn oil diets developed cancer or aberrant crypts, and GMP remained unchanged. Surprisingly, the numbers of ACF were significantly higher (467 versus 295; P = 0.004) in the group fed corn oil than in the group fed beef suet. On the other hand, the size (crypts/focus) of the ACF was significantly higher (P = 0.03) in the beef suet group. Furthermore, fecal GMP was significantly higher in the beef suet group than in the corn oil group after 18 weeks, and this difference increased further toward the end of the study. GMP was greatly increased in all rats with colorectal cancer. CONCLUSIONS: Fecal GMP may have provided us with a valuable tool for further studies of the induction and progression of neoplasia in rats and, possibly, in mice, since the anti-GMP antibody cross-reacts with feces extracts from mice.

Human en bloc double-lung transplantation: bronchial artery revascularization improves airway perfusion.

BACKGROUND: Ischemic airway complications are common after en bloc double-lung transplantation with tracheal anastomosis. The aim of this study was to evaluate the effects of a direct revascularization of the donor bronchial artery with the recipient internal thoracic artery on airway perfusion. METHODS: Seven patients undergoing double-lung transplantation with tracheal anastomosis were investigated intraoperatively and postoperatively (12 to 36 hours) with endoscopic laser Doppler flowmetry. Sixteen patients undergoing coronary artery bypass grafting served as a control group. RESULTS: Two patients who had double-lung transplantation with tracheal anastomosis died of sepsis and multiorgan failure 1 week after transplantation. In the remaining 5 patients healing of the anastomosis was excellent during the observation period of 3 to 52 months. In 5 patients clamping of the attached internal thoracic artery induced a reduction of the laser Doppler flowmetry signal from 10% to 60%. In the 2 patients with the highest graft perfusion level, no clamping effect could be detected. Compared with the control group, perfusion was significantly higher in the transplanted airways intraoperatively, at 71 versus 55 arbitrary perfusion units (p < 0.01). Postoperative transplant airway perfusion values were not significantly different from the intraoperative value. The coefficient of variation of repeated measurements was higher in the transplanted airways, with a coefficient of variation of 0.22 versus 0.17 in the control group (p < 0.01), indicating heterogeneous transplant airway perfusion. CONCLUSIONS: This study has documented that revascularization with the internal thoracic artery supplies the transplanted airway with additional oxygenated blood.

Human bronchial perfusion evaluated with endoscopic laser Doppler flowmetry.

Endoscopic laser Doppler flowmetry (LDF) was used to study human bronchial microvascular perfusion in 25 healthy subjects. In total 617 recordings with good signal to noise ratio were obtained and, in the hands of an experienced bronchoscopist, the procedure did not cause major technical problems. Curve fluctuations synchronous to heart rate and respiration were identified. The spatial variation of measurements in one region was considerable, but when the mean of four measurements was used, acceptable precision levels were obtained. Regional differences were observed between 40.3 arbitrary perfusion units (PU) (34.0-46.6) in the right upper lobe bronchus and 77.3 PU (63.6-91.0) at the main carina. Measurements were obtained from the main carina, the right upper lobe bronchus, the apical segment of the right and left lower lobe bronchus. In all bronchi, recordings were performed at two locations distal to the bifurcation; 1-5 mm (central) and 6-10 mm (peripheral). The peripheral flux levels were significantly higher than the central (p < 0.001). Analysis of the short and long term temporal variation showed no significant differences, when the data was analyzed on a group basis. We conclude that LDF seems to be a promising method for future clinical investigations.

[Embolization of bronchial arteries in severe and recurrent hemoptysis]. / Embolisering av bronkialarterier ved alvorlige og residiverende hemoptyser.

Bronchial artery embolization is an established treatment for massive and serious haemoptysis. We review etiology, pathogenesis and different treatment modalities of major haemoptysis, and discuss indications and outcome. Massive haemoptysis, defined as > 300 ml/24 hrs., is a rare condition with a high mortality rate (30-80%) if treated conservatively. We describe seven patients treated with bronchial artery embolization. Three patients had massive haemoptysis, and four patients were treated for recurrent and severe haemoptysis. Two patients had haemorrhage because of inactive tuberculosis, five had cystic fibrosis. All patients were successfully treated by embolization, one patient suffered recurrent haemoptysis after four weeks. The other patients have shown no further haemoptysis during the observation period (mean 20 months). No complications were observed other than the common, self-limited post-embolization syndrome (mild fever and chest pain). In patients with severely reduced lung function and progressive disease, recurrent haemoptysis of even smaller amounts might interfere with postural drainage and cause infections and deteriorate lung function. Bronchial artery embolization should be considered for these patients as well. Unless localized lesions can be cured through surgical resection, we consider bronchial artery embolization to be the treatment of choice.

[Methotrexate induced pulmonary disease]. / Metotrexatindusert lungesykdom.

Methotrexate may cause pulmonary side effects. Two cases of methotrexate-induced fibrosing alveolitis are reported. One of the patients died from perforated gastric ulcer, the other was successfully treated with systemic steroids. The pulmonary side effects of methotrexate are reviewed. The most common clinical manifestation is fibrosing alveolitis. Pulmonary fibrosis and acute, non-cardiogenic pulmonary oedema are rare.