Lobe-wise assessment of lung volume and density distribution in lung transplant patients and value for early detection of bronchiolitis obliterans syndrome.

PURPOSE: To evaluate quantitative computed tomography (CT) measurements of the lung parenchyma in lung transplant (LTx) patients for early detection of the bronchiolitis obliterans syndrome (BOS). MATERIALS AND METHODS: 359 CT scans of 122 lung transplant patients were evaluated. Measurements of lung volume and density were performed for the whole lung and separately for each lobe. For longitudinal analysis the difference between the baseline at 6 months after LTx and follow-up examinations was calculated. Patients with and without BOS (matched 1:2) were compared at two different time points, the last examination before the BOS onset and the first examination within one year after BOS onset. RESULTS: 30 patients developed BOS during the follow-up period. Longitudinal changes in the lung volume and lung density measured on CT differed significantly between those patients with and without early BOS, in particular the difference of the inspiratory and expiratory lung volume (p < 0.001), the ratio of the expiratory and inspiratory lung volume (p < 0.001-p = 0.001) and MLD (p < 0.001-p = 0.001), the volume on expiration (p < 0.001-p = 0.007), the MLD on expiration (p < 0.001-p = 0.007), and the percentiles on expiration (p < 0.001-p = 0.002) with an increase of lung volume and a decrease of lung density. Changes were pronounced in the lower lobes. Before BOS onset, patients with and without future development of BOS showed no significant differences. CONCLUSION: Longitudinal changes of lung volume and lung density measured on CT start markedly at BOS onset with increased lung volume and decreased lung density indicating increased inflation levels. Even though this method may help to diagnose BOS at onset it is not useful as a predictor for BOS before disease onset.

Lipid metabolism in pigs fed beef tallow or high-oleic acid sunflower oil.

The objectives of this study were to establish the effects of high-oleic sunflower oil (HOSO) and beef tallow on tissue fatty acids and stearoyl-CoA desaturase activities in swine; and to compare effects of HOSO and tallow on swine plasma triglycerides and lipoprotein-cholesterol fractions. Sixteen gilts were divided into two groups: eight fed a control diet containing 10 g/100 g beef tallow, and eight fed a diet containing 10 g/100 g HOSO. Plasma samples were obtained before feeding began and at 4 weeks and 8 weeks of dietary treatment. Samples were obtained from longissimus dorsi muscle, liver, adipose and duodenal mucosa for the measurement of fatty acid composition and stearoyl-CoA desaturase activity. The HOSO diet increased (P < 0.05) the concentrations (mumol/g wet weight of tissue) of 18:1 and 18:2 (n-6) in adipose tissue. In muscle from pigs fed the HOSO diet, concentrations of 14:0, 16:0, 16:1, 18:0, 18:1, and 18:2 (n-6) decreased (P < 0.05) relative to muscle from pigs fed the beef tallow diet; only 14:0 and 16:1 were reduced in liver by the HOSO diet. Stearoyl-CoA desaturase specific activity [(pmol 7 min-1 mg-1 microsomal protein)] was 40 percent lower, and activity expressed as pmol 7 min-1 g-1 tissue) was 20 percent lower, in adipose tissue of pigs fed HOSO (P < 0.05). No differences due to dietary treatment were observed for desaturase activity from muscle, liver or intestinal mucosa. Plasma triglycerides declined steadily in the tallow-fed pigs, possibly reflecting the lower percentages of liver 18:0 and 18:1 acids, relative to the HOSO-fed pigs. The animals responded similarly to the addition of fat (beef tallow or HOSO) to their diets with increased (P < 0.05) plasma total, LDL- and HDL-cholesterol by 4 weeks of treatment. Total cholesterol, LDL-, VLDL- or HDL-cholesterol were not different between pigs fed beef tallow or HOSO. Thus, differences in fatty acid composition of the diets were sufficient to alter tissue fatty acid composition and adipose tissue desaturase activity, but insufficient to alter plasma lipoprotein cholesterol.