O colapso traqueal é uma obstrução parcial ou total da traqueia caracterizado pelo achatamento dorsoventral dos anéis cartilaginosos e pela frouxidão da membrana traqueal dorsal. Acomete principalmente cães de raças pequenas, de meia idade a idosos, embora também possa ocorrer em cães jovens. O diagnóstico é feito com base nos sinais clínicos e exames complementares. A traqueobroncoscopia permite avaliar o diâmetro da traqueia e dos segmentos brônquicos, principalmente quando as radiografias e fluoroscopia não forem conclusivas e ainda permite a coleta de amostras para citologia, histopatologia e culturas. O objetivo deste estudo foi correlacionar a infecção traqueal com a inflamação da traqueia em cães com colapso de traqueia. A pesquisa foi realizada no HOVET da FMVZ-USP e no Hospital Veterinário Clinivet em Curitiba. A amostra foi constituída por 28 cães, sendo 12 com colapso de traqueia e 16 hígidos para o grupo controle, que propiciou parâmetros de normalidade em relação ao grupo colapso traqueal. Para a coleta de dados utilizou-se a traqueobroncoscopia, com a qual visualizamos a traqueia e graduamos o colapso, colhemos material para cultura bacteriana e citologia. Após a análise dos resultados foi observado diferença estatística significativa nos cães com inflamação e colapso de traqueia. Não foi observado correlação entre a infecção bacteriana e a inflamação na traqueia. Com um teste de dissimilaridade verificou-se que a população bacteriana da orofaringe foi semelhante a da traqueia nos cães do mesmo grupo. Portanto, concluímos que cães com colapso de traqueia tendem a ter a traqueia inflamada, porém não apresentam infecção bacteriana. A composição das bactérias na traqueia pode ser devido à aspiração do conteúdo da orofaringe. / The Tracheal collapse is a partial or total obstruction of the trachea, featured by dorsoventral flattening of the cartilaginous rings and by the laxity of the dorsal tracheal membrane. It mainly affects small breeds, middle-aged and older dogs, although it can also occur in young dogs. The diagnosis is made based on clinical signs and additional exams. The trachealbronchoscopy allows evaluating the trachea diameter and bronchial segments, especially when radiographic and fluoroscopy is not conclusive and still allows the collection of samples for cytology, histopathology and cultures. The objective of this study was correlating the tracheal infection with the tracheal inflammation in dogs with tracheal collapse. The research was conducted in the HOVET FMVZ-USP and Clinivet Veterinary Hospital in Curitiba. The sample consisted of 28 dogs, including 12 with collapsing trachea and 16 healthy subjects in the control group, which allowed normal parameters in relation to the group tracheal collapse. For data collection was used the trachealbronchoscopy, in which was visualized the trachea and the grade of the tracheal collapse was recorded. We also collected samples for cytology and bacterial culture. After analyzing the results we found statistically significant difference in dogs with tracheal collapse and inflammation of the trachea. There was no correlation between bacterial infection and inflammation in the trachea. With dissimilarity test was observed that the bacterial population of the pharynx was similar to the trachea in dogs of the same group. n this study, therefore, concluded that dogs with collapsing trachea tend to have the inflamed trachea, but it does not have bacterial infection. The composition of the bacteria in the trachea may be due to aspiration of pharynx\'s contents.

Background: Ambient air pollution is associated with adverse health effects, but the sources and components, which cause these effects is still incompletely understood. The aim of this thesis was to investigate the pulmonary effects of a variety of common air pollutants, including diesel exhaust, biomass smoke, and road tunnel and subway station environments. Healthy non-smoking volunteers were exposed in random order to the specific air pollutants and air/control, during intermittent exercise, followed by bronchoscopy. Methods and results: In study I, exposures were performed with diesel exhaust (DE) generated at transient engine load and air for 1 hour with bronchoscopy at 6 hours post-exposure. Immunohistochemical analyses of bronchial mucosal biopsies showed that DE exposure significantly increased the endothelial adhesion molecule expression of p-selectin and VCAM-1, together with increased bronchoalveolar lavage (BAL) eosinophils. In study II, the subjects were exposed for 1 hour to DE generated during idling with bronchoscopy at 6 hours. The bronchial mucosal biopsies showed significant increases in neutrophils, mast cells and lymphocytes together with bronchial wash neutrophils. Additionally, DE exposure significantly increased the nuclear translocation of the aryl hydrocarbon receptor (AhR) and phosphorylated c-jun in the bronchial epithelium. In contrast, the phase II enzyme NAD(P)H-quinone oxidoreductase 1 (NQO1) decreased after DE. In study III, the 2-hour exposures took place in a road tunnel with bronchoscopy 14 hours later. The road tunnel exposure significantly increased the total numbers of lymphocytes and alveolar macrophages in BAL, whereas NK cell and CD56+/T cell numbers significantly decreased. Additionally, the nuclear expression of phosphorylated c-jun in the bronchial epithelium was significantly increased after road tunnel exposure. In study IV, the subjects were exposed to metal-rich particulate aerosol for 2 hours at a subway station with bronchial biopsy and BAL sampling at 14 hours. The subway exposure significantly increased the concentration of glutathione disulphide (GSSG) in BAL, with no airway inflammatory responses. In contrast, the number of neutrophils in the bronchial mucosa and the nuclear expression of phosphorylated c-jun in the bronchial epithelium tended to decrease after the subway exposure. In study V, the exposure to biomass smoke lasted 3 hours. Bronchoscopy was conducted 24 hours post exposure. The investigated biomass combustion emissions resulted in a significant increase in total glutathione and reduced glutathione in BAL, without any evident acute airway inflammatory responses.     Conclusion: The present thesis presents data from exposures of healthy subjects to a variety of common air pollutants, as compared with an air reference. Oxidative as well as bronchial mucosal and bronchoalveolar responses differed between these air pollutants, with the most pronounced airway effects seen after exposure to diesel exhaust. This may be due to differences in pulmonary deposition, physicochemical characteristics, toxicological pathways and potency. Additional studies will assist in addressing dose-response and time kinetic aspects of the airway responses.

Στο πρώτο και δεύτερο κεφάλαιο γίνεται μια λεπτομερή ανάλυση της ανατομίας και φυσιολογίας του ανθρώπινου οφθαλμού ενώ στο τρίτο και τέταρτο γίνεται αναφορά στην ανατομία του βρογχικού δένδρου, μια εισαγωγή στην ένοια της επεμβατικής πνευμονολογίας καθώς και μια εκτενής ανάλυση για τις μεθόδους βρογχοσκόπισης με ιδιέταιρη έμφαση στην μεθόδο αυτοφθορισμού για την ανίχνευση πρώιμου πνευμονικού καρκίνου. Στο πέμπτο κεφάλαιο γίνεται μια εισαγωγή στην επεξεργασία ψηφιακής εικόνας. Γίνεται μια αναφορά στους τρόπους επεξεργασίας εικόνας, καταλήγοντας στην ειδική μέθοδο επεξεργασίας ψηφιακής εικόνας που είναι η τμηματοποίηση. Στο έκτο κεφάλαιο γίνεται ορισμός της τμηματοποίησης ψηφιακής εικόνας. Οι διάφορες μέθοδοι που αναλύονται εκτενώς είναι : 1. Εφαρμογή κατωφλίου 2. Ανίχνευση ασυνεχειών 3. Region-based τμηματοποίηση 4. Edge linking and boundary detection 5. Μορφολογικά watersheds Τελειώνοντας το έκτο κεφάλαιο γίνεται αναφορά σε εξειδικευμένες εφαρμογές σύγχρονων μεθόδων για οφθαλμιατρικές και εικόνες video-βρογχοσκοπίου. Ελπίζω να έχω αποδώσει σωστά το αντικείμενο της εργασίας ώστε να χρησιμοποιηθεί ως βοήθημα σε όποιον επιθυμεί να εμβαθύνει στους τόμεις που αναφέρομαι. Το πνεύμα της εργασίας είναι να οδηγήσει στην κατανόηση, όχι να διδάξει / The project can introduce us in the field of medical image processing. In the first and the second section there is a detailed reference about the anatomy and fusiology of the retina. In the third and fourth you can find information about bronchous anatomy and general methods for bronchoscopy. In the fifth there are several methods for image processing and especialy the segmentation method. In the sixth section there is an analysis of the segmentation method and finaly there are some examples of the above methods.

Habilitacijos procedūrai teikiamoje darbų apžvalgoje apibendrinti po daktaro disertacijos apgynimo (1999 m.) atliktų mokslinių tyrimų, skirtų intersticinėms plaučių ligoms, darbų rezultatai. Šioje apžvalgoje remiamasi autoriaus atliktų ir su bendraautoriais vykdytų intersticinių plaučių ligų tyrimų nuo 1999 m. iki 2008 m. Vilniaus universiteto Medicinos fakulteto Krūtinės ligų, alergologijos ir radiologijos klinikoje, Viešojoje įstaigoje Vilniaus universiteto ligoninės Santariškių klinikose, rezultatais. Svarbiausias darbo tikslas buvo nustatyti optimalią intersticinių plaučių ligų diagnostikos ir diferencinės diagnostikos seką kasdienėje klinikinėje praktikoje, pateikti praktines dažniausių intersticinių plaučių ligų diagnostikos rekomendacijas. Darbo uždaviniai buvo nustatyti klinikinių simptomų, radiologinių požymių, plaučių funkcijos rodiklių, bronchoalveolinio lavažo skysčio tyrimo ir bronchoskopinės plaučių biopsijos histologinio tyrimo diagnostinę vertę. Šioje apžvalgoje apibendrinamas 30 mokslinių straipsnių, paskelbtų 1999–2009 m. Dauguma straipsnių parengta kartu su kitais bendraautoriais (23 iš jų apžvalgos autorius buvo pirmasis autorius). Darbo rezultatų pagrindu perskaityta 14 pranešimų nacionalinėse ir 19 pranešimų tarptautinėse konferencijose (14 iš jų užsienio šalyse). / The results of scientific research published since acquisition of PhD degree in 1999 are reviewed in this survey for habilitation procedure. The interstitial lung diseases research was conducted and performed by author together with other researchers at Clinic of Chest Diseases, Allergology and Radiology of Vilnius Univesity and Vilnius University Hospital Santariškių klinikos in 1999–2008. The aim of this research was to determine optimal diagnostic pathway for interstitial lung diseases in daily clinical practice, to propose practical recommendations for diagnostic of the most common interstitial lung disorders. The tasks of the research were to evaluate diagnostic value of clinical symptoms, radiological signs, indices of respiratory function, examination of bronchoalveolar lavage fluid and bronchoscopic lung biopsy material. The review material covers 30 scientific papers published during 1999–2009. The most of papers were prepared together with co-authors, but in 23 of them the author of this survey was the first author. On the base of obtained scientific material 14 presentations at national conferences and 19 presentations at international conferences (14 of them in foreign countries) were done.

Allergic airway disease, i.e. allergic rhinitis (AR) and asthma, is a common health problem. The prevalence is increasing in most countries of the world. Traffic-related air pollution has been found to induce and enhance allergic airway disease, but the underlying mechanisms are not known. Oxylipins are fatty acid metabolites, of which several have been linked to asthmatic airway inflammation. Oxylipin profiles have previously been investigated in bronchoalveolar lavage (BAL), mainly reflecting the peripheral lung, but not in bronchial wash (BW), which better reflect the proximal airways. The airway epithelium is covered by a respiratory tract lining fluid (RTLF) The RTLF contains antioxidants to protect from oxidative stress, which may be caused by exposure to air pollution. Previous studies have reported diminished levels of the antioxidant ascorbate (vitamin C) in the RTLF of patients with asthma. Little is known about the regulation of vitamin C in the lung. The aim of this thesis was to investigate airway inflammatory responses to diesel exhaust exposure in patients with AR and allergic asthma; to evaluate oxylipin profiles in different regions of the lung in patients with allergic asthma; and to study the distribution of vitamin C transporters in the airways of patients with allergic asthma. Diesel exhaust (PM10 100 μg/m3 for 2 h) induced a neutrophilic airway inflammation in healthy individuals evaluated 18 h after exposure. Patients with AR and asthma did not respond with an enhanced airway inflammation. However, a small increase in myeloperoxidase was found in BAL from patients with AR, as well as decreases in epithelial tryptase and BW stem cell factor. This indicates that other mechanisms than classical inflammation are responsible for the increased sensitivity to traffic-related air pollution in patients with allergic airway disease. Oxylipin baseline profiles differed between peripheral and proximal airways in both allergic asthmatics and healthy individuals. Total oxylipin concentrations, and five individual oxylipins, primarily from the lipoxygenase (LOX) pathway, were elevated in BW from asthmatics compared to healthy controls, supported by immunohistochemical staining of 15-LOX-1 in the bronchial epithelium. This suggests that lung compartment-specific sampling should be considered in future studies. Sodium dependent vitamin C transporter 2 (SVCT2) was, for the first time, found present in the human lung epithelium, localised mainly within goblet cells. A negative correlation between SVCT2+ goblet cells and vitamin C suggests that these cells may play a hitherto unknown function in ascorbate re-uptake and recycling at the air-lung interface.

Thesis (M.S.)--University of Michigan, 1980.

Thesis (M.S.)--University of Michigan, 1980.

Master of Science / Department of Electrical and Computer Engineering / Punit Prakash / Microwave ablation (MWA) is a minimally invasive thermal therapy predominantly used in the treatment of localized cancer. Previous studies have demonstrated clinical use of MWA for treating lung tumors, however, these procedures have relied upon the use of rigid percutaneous MWA applicators which can limit the range of accessible tumors and may have inherent disadvantages for use in lung tissue. The objective of this work was to develop and characterize a bronchoscopic MWA applicator suitable for use in a system that enables bronchoscopic transparencymal nodule access (BTPNA). A 3D coupled FEM electromagnetic-heat transfer model was implemented to optimize the antenna design and evaluate the expected ablation size and shape. A prototype device was fabricated and experimentally evaluated in ex vivo tissue to verify simulation results and demonstrate proof-of-concept. Simulated and experimental results indicate the proposed device could create ablation zones 19.3 – 31.0 mm in diameter with 30 – 45 W of power applied for 5 – 10 minutes. Future bronchoscopic MWA applicators based on the design proposed in this study could allow physicians an even less invasive treatment option for lung cancer with increased accuracy and efficacy and reduced risk of procedural complications immediately following a positive bronchoscopic lung biopsy.

O colapso traqueal é uma obstrução parcial ou total da traqueia caracterizado pelo achatamento dorsoventral dos anéis cartilaginosos e pela frouxidão da membrana traqueal dorsal. Acomete principalmente cães de raças pequenas, de meia idade a idosos, embora também possa ocorrer em cães jovens. O diagnóstico é feito com base nos sinais clínicos e exames complementares. A traqueobroncoscopia permite avaliar o diâmetro da traqueia e dos segmentos brônquicos, principalmente quando as radiografias e fluoroscopia não forem conclusivas e ainda permite a coleta de amostras para citologia, histopatologia e culturas. O objetivo deste estudo foi correlacionar a infecção traqueal com a inflamação da traqueia em cães com colapso de traqueia. A pesquisa foi realizada no HOVET da FMVZ-USP e no Hospital Veterinário Clinivet em Curitiba. A amostra foi constituída por 28 cães, sendo 12 com colapso de traqueia e 16 hígidos para o grupo controle, que propiciou parâmetros de normalidade em relação ao grupo colapso traqueal. Para a coleta de dados utilizou-se a traqueobroncoscopia, com a qual visualizamos a traqueia e graduamos o colapso, colhemos material para cultura bacteriana e citologia. Após a análise dos resultados foi observado diferença estatística significativa nos cães com inflamação e colapso de traqueia. Não foi observado correlação entre a infecção bacteriana e a inflamação na traqueia. Com um teste de dissimilaridade verificou-se que a população bacteriana da orofaringe foi semelhante a da traqueia nos cães do mesmo grupo. Portanto, concluímos que cães com colapso de traqueia tendem a ter a traqueia inflamada, porém não apresentam infecção bacteriana. A composição das bactérias na traqueia pode ser devido à aspiração do conteúdo da orofaringe. / The Tracheal collapse is a partial or total obstruction of the trachea, featured by dorsoventral flattening of the cartilaginous rings and by the laxity of the dorsal tracheal membrane. It mainly affects small breeds, middle-aged and older dogs, although it can also occur in young dogs. The diagnosis is made based on clinical signs and additional exams. The trachealbronchoscopy allows evaluating the trachea diameter and bronchial segments, especially when radiographic and fluoroscopy is not conclusive and still allows the collection of samples for cytology, histopathology and cultures. The objective of this study was correlating the tracheal infection with the tracheal inflammation in dogs with tracheal collapse. The research was conducted in the HOVET FMVZ-USP and Clinivet Veterinary Hospital in Curitiba. The sample consisted of 28 dogs, including 12 with collapsing trachea and 16 healthy subjects in the control group, which allowed normal parameters in relation to the group tracheal collapse. For data collection was used the trachealbronchoscopy, in which was visualized the trachea and the grade of the tracheal collapse was recorded. We also collected samples for cytology and bacterial culture. After analyzing the results we found statistically significant difference in dogs with tracheal collapse and inflammation of the trachea. There was no correlation between bacterial infection and inflammation in the trachea. With dissimilarity test was observed that the bacterial population of the pharynx was similar to the trachea in dogs of the same group. n this study, therefore, concluded that dogs with collapsing trachea tend to have the inflamed trachea, but it does not have bacterial infection. The composition of the bacteria in the trachea may be due to aspiration of pharynx\'s contents.

Introduction: Small Cell Lung Cancer (SCLC) is an aggressive malignancy with poor prognosis that accounts for 10% of all clinical lung cancer. SCLC commonly metastasizes to the mediastinum, liver, bone, adrenals, and the brain but secondary endotracheal metastasis is an especially rare occurrence. We discuss the case of a 74-year-old male with principal complaint of cough, wheezing and hemoptysis found to have secondary endotracheal lesions on bronchoscopy. Case report: A 74-year-old male, former smoker with a past medical history of pulmonary embolism, bullous emphysema, and limited stage small cell lung cancer with wedge resection and chemotherapy 3 years ago presented with cough, wheezing, weight loss and intermittent hemoptysis ongoing for few weeks. CT scan of the chest showed multiple polypoid masses arising in the anterior wall of the trachea. He underwent bronchoscopy with biopsy. Pathology was consistent with small-cell lung cancer. Conclusion: Secondary tracheal metastasis from early stage small cell cancer is a rare occurrence. The likelihood of tracheal metastasis of lung cancer is amplified when an endotracheal nodule or eccentric thickening of the tracheal wall is seen on CT of patients with high suspicion. It is important for clinicians to suspect endotracheal lesions when a patient presents with recurrent respiratory complaints despite stable surveillance CT scan of chest in patients with history of lung cancer.