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Biomedical subjects

P Tukiainen

Publications and source records attributed to P Tukiainen.

18 recordsLinked to original sources
PubMed1992

Fibres and asbestos bodies in bronchoalveolar lavage fluids of asbestos sprayers.

The alveolar content of fibres and asbestos bodies was assessed by bronchoalveolar lavage (BAL) in 21 asbestos sprayers. Transmission and scanning electron microscopy (TEM and SEM) and two light microscopical (LM) methods, cytocentrifugation, and Millipore filtration were used. The subjects had been exposed mainly to crocidolite asbestos for an average of 2.8 (range 0.2-13) years in 1950-75. The mean (median) total fibre count (of asbestos bodies and uncoated fibres) per ml of BAL fluid was 5500 (2800) by TEM and 2900 (1000) by SEM. The mean (median) count of asbestos bodies per ml with LM was 810 (500) with cytocentrifugation and 750 (480) with Millipore filtration, 840 (320) by TEM, and 1750 (420) by SEM. The mean proportion of coated fibres was 35% by TEM and 45% by SEM. The mean length of the coated fibres was 22 (range 4-65) microns by TEM and 34 (range 4.5-170) microns by SEM. The total fibre count exceeded 1000 fibres per ml in 70% of the cases by TEM. Asbestos body counts exceeded 1 per ml in 95% of the cases by LM. The fibre counts by SEM were in good accordance with counts by TEM except in a few cases in which the TEM result was considerably higher. In these cases the proportion of coated fibres was also low. All four counting methods appeared to give consistent results in heavily exposed cases when fibre load in the lungs was high. The counting of asbestos bodies may, however, underestimate the total alveolar fibre load in some cases.

Adult↗
PubMed1990

Cytomegalovirus is frequently isolated in bronchoalveolar lavage fluid of bone marrow transplant recipients without pneumonia.

We prospectively studied the presence of cytomegalovirus in bronchoalveolar lavage through virus isolation in 21 bone marrow transplant recipients before and after transplantation. All 14 lavage specimens collected before bone marrow transplantation were negative for cytomegalovirus. During the period from 20 to 90 days after transplantation, 12 of 24 lavage specimens (50%) from 14 patients without lung problems were positive for cytomegalovirus. Cytomegalovirus was isolated from 4 of 10 lavage specimens (40%) in 7 patients with pneumonia during the same interval. We conclude that culture for cytomegalovirus in bronchoalveolar lavage fluid is not a reliable method for establishing the virus's causative role in pneumonia soon after bone marrow transplantation. Among 14 patients in whom bronchoalveolar lavage was done at an asymptomatic stage, 6 of 9 patients with cytomegalovirus and none of 5 without cytomegalovirus in the lavage fluid later developed pneumonia. All of the patients subsequently developing pneumonia also had acute graft-versus-host disease, suggesting an immunopathologic mechanism, possibly triggered by cytomegalovirus, for cytomegalovirus-associated pneumonia.

Adult↗
PubMed1990

Use of bronchoalveolar lavage cytology and determination of protein contents in pulmonary complications of bone marrow transplant recipients.

Bronchoalveolar lavage (BAL) cytology and immunoglobulin components of lavage fluid were studied during non-bacterial/non-fungal interstitial pneumonitis, bacterial/fungal pneumonia, and Pneumocystis carinii infection. Lavages done before bone marrow transplantation and in asymptomatic phases were used as controls. The total cell recovery was increased during lung processes of any aetiology. Non-bacterial/non-fungal pneumonitis caused a significant increase in the number of lymphocytes; the number of neutrophils increased particularly during bacterial pneumonia. In Pneumocystis carinii pneumonia the typical cell picture was an increased percentage of lymphocytes together with blasts. During acute graft-versus-host disease without respiratory symptoms the cytology in lavage fluids did not differ from the controls. Cytomegalovirus (CMV) isolation was frequently positive in lavage fluids regardless of the presence or absence of pulmonary symptoms, but most of the symptom-free CMV-positive patients did not have any marked changes in BAL cytology. The albumin content of BAL fluid increased during infectious and immunological processes in lungs.

Bone Marrow Transplantation↗
PubMed1979

Miliary tuberculosis.

Twenty-six cases of miliary tuberculosis were studied in retrospect. The mean age of the patients was 62 years. Eighteen patients suffered from another underlying chronic disease. Nine had been treated with corticosteroids or cytotoxic agents. A limited manifestation of tuberculosis had been previously verified or suspected in ten cases. Fever was present in 85% of the patients, frequently combined with fatigue or abdominal pain. Serum alkaline phosphatase was elevated in 81% of the cases. Minor haematological abnormalities (anaemia, etc.) were found in 16 cases and pancytopenia, stimulated lymphocytes or chronic myeloid leucaemia in six. Miliary mottling was found in the chest radiographs of 13 patients. Other findings were pleural effusion, mediastinal node enlargement, opacities suggesting pneumonia or old, possibly tuberculous lesions. Antituberculosis therapy was initiated in 12 patients, two of whom died within a few days. There was a high frequency of liver or system involvements. It is concluded that laparoscopy or liver needle biopsy are valuable diagnostic procedures in patients with fever and elevated alkaline phosphatases of unknown aetiology. A therapeutic test with antituberculous drugs should be undertaken in suspected cases.

Adult↗
PubMed1978

TruCutR needle biopsy in asbestosis and silicosis: correlation of histological changes with radiographic changes and pulmonary function in 41 patients.

A percutaneous needle biopsy was performed with a TruCut needle on 41 patients with suspected pneumoconiosis. Patients selected for biopsy tended to have brief or unusual dust exposure, as well as questionable radiographic opacities. Sixteen had been exposed to asbestos, 13 to silica and 12 to mixed dust containing quartz, coal, iron, asbestos and talc. All patients in the asbestos group and most in the other two groups had a reduced transfer factor. Most patients in the asbestos group and about 25% of the other patients had restrictive ventilatory impairment. Chest radiographs were assessed according to standard films of the ILO U/C International Classification (International Labour Office, 1972). In 25 patients radiographic opacities were absent or acanty (categories 0--1/1). The dominant radiographic feature of many patients exposed to asbestos was a ground-glass appearance or a bilateral elevation of the diaphragm, or both, features difficult to assess according to the ILO U/C scheme. Most histological changes were those usually seen in pneumoconiosis. However, in only two patients with silicosis were silicotic nodules detected. The specimens of seven patients showed a granulomatous inflammation. The severity of alveolar wall involvement correlated well with the transfer factor value but poorly with radiographic changes. The profusion of radiographic opacities also correlated poorly with functional impairment. As a diagnostic tool the needle biopsy was valuable in asbestosis and slightly less so in mixed-dust fibrosis. The biopsy specimens showed changes compatible with asbestosis in 75% of the suspected cases and in 86% of those in which asbestosis was the final diagnosis. In the mixed-dust group pneumoconiosis was confirmed in 67% and 80%, respectively. In the diagnosis of silicosis an open biopsy is probably more reliable than a percutaneous one, particularly if radiographic changes are minimal. Histological changes in the needle biopsy specimen were compatible with silicosis in only 36% of the suspected cases and in 63% of those in which the final diagnosis was silicosis.

Adult↗
PubMed1977

Nitrofurantoin-induced alterations in pulmonary tissue. A report on five patients with acute or subacute reactions.

Three patients with acute and two with subacute nitrofarantoin-induced pulmonary reactions were studied clinically and by examinining microcoscopically needle biopsy specimens of their lungs. In all five patients slight vasculitis and a few interstitial eosinophils were found in the pulmonary tissue 1-2 weeks after the withdrawal of nitrofurantion therapy. Alveolitis, fibrinous alveolar exudate and perivascular granulomas were also seen in some specimens. The patients with acute reactions had marked blood eosinophilia. In all patients, pulmonary diffusing capacity (DLCO) was below normal, but ventilatory function was not appreciably affected. Withdrawal of nitrofurantion resulted in complete or partial improvement in 4-8 weeks. Our clinical and histological findings support the suggestion that a type III immune-complex-mediated reactions is involved in acute and subacute hypersensitivity reactions to nitrofurantoin.

Adult↗
PubMed1975

Double-blind cross-over comparison of clenbuterol and salbutamol tablets in asthmatic out-patients.

A double-blind cross-over comparison of a new beta2-sympathomimetic bronchodilator, clenbuterol, with salbutamol and placebo has been made during a 24 day period of out-patient treatment of 19 adults with moderately severe asthma. Oral clenbuterol (10 mug 3 times a day) and salbutamol (4 mg 3 times a day) were equally and significantly (p less than 0.001) more effective than placebo, when daily records of peak expiratory flow or use of isoprenaline inhalations were the criteria of activity. Daily records of symptoms according to a questionnaire also suggested relief of the subjective effects of asthma during treatment with both active drugs (p less than 0.01).

Adrenergic beta-Agonists↗
PubMedDate not supplied

Bronchoalveolar lavage. Influence of cytologic methods on the cellular picture.

Bronchoalveolar lavage (BAL) was applied to 803 subjects who had various lung diseases or were healthy controls. Combined Millipore (MiPo) filtration of alcohol-fixed cells and cytocentrifugation (CCF) of fresh, air-dried cells was used for the cytologic studies. On the MiPo preparations the proportions (mean +/- SD) of lymphocytes (30.6 +/- 23.7), neutrophils (5.4 +/- 11) and respiratory epithelial cells (2.4 +/- 3.8) were significantly (P less than .001) higher when compared with those on the CCF slides (21.0 +/- 2.3, 3.6 +/- 1.0 and 0.4 +/- 1.5, respectively). The proportions of eosinophils and basophils were nearly the same on the CCF (1.9 +/- 5.3) and MiPo slides (1.6 +/- 6.1). In MiPo filtration the loss and degeneration of cells can be avoided if the cell suspension is fixed prior to filtration. In cellular morphology the two methods complemented each other, and the specificity and sensitivity were the same. In nonparenchymal lung diseases false pathologic cell findings due to bronchial content contamination can be more reliably excluded from MiPo specimens than from CCF ones.

Bronchoalveolar Lavage Fluid↗