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Abstract Background Pulmonary tuberculosis (TB) lesion is acidic, and changing this acidic pH may affect growth of TB bacilli and response to therapy. We aimed to assess the effect of adjuvant inhalation of sodium bicarbonate (SB) 8.4% on clinical, radiological, and microbiological responses in patients with sputum-positive drug-sensitive pulmonary TB. Patients and methods One hundred and three patients with pulmonary TB completed the study, and they were classified into two groups: group I included 55 patients who received standard anti-TB regimen plus SB inhalation, and group II included 48 patients who received anti-TB regimen only. The responses in both groups were evaluated clinically, microbiologically, and radiologically. Results There was no statistically significant difference between both groups in baseline bacillary load, clinical picture, and radiology. Both groups improved clinically 1 month after start of therapy. In group I only, there was a statistically significant improvement in chest radiograph after 1 month (P

Background: Stem cells therapy is a new therapeutic approach for pulmonary emphysema. Granulocyte colony-stimulating factor (G-CSF) is effective in tissue regeneration through mobilization of stem cells to different organs. So, in this study we compared the effect of filgrastim (175 amino acid recombinant human G-CSF) versus bone marrow mononuclear cells on apoptosis and repair of air spaces in lipopolysaccharide induced emphysema in C57Bl/6 mice. Methods: The mice were classified into 4 groups: group A: mice not received any treatment, group B: mice received intranasal instillation of lipopolysaccharide repeated three times per week for 8 weeks, group C: mice received a dose of intravenous bone marrow mononuclear cells (0.3 ml of cell suspension at a concentration of 2 × 106 cells/ml) after instillation and evaluated 5 weeks later and group D: mice received subcutaneous filgrastim three subcutaneous injections a week for 7 weeks (100 microgram/kg/injection) after lipopolysaccharide instillation. Imaging analysis was done using imagej program. Results: Concerning the mean of air space equivalent diameter (D0) and (D1), no differences were observed between the bone marrow mononuclear cells treated mice and filgrastim treated mice. As regard apoptotic index, no significant difference was found between filgrastim and BMMNCs treated groups. Conclusion: These results indicate nearly similar effectiveness of both filgrastim and BMMNCs in treatment of lipopolysaccharide induced pulmonary emphysema.

Abstract Objectives Early diagnosis of lung cancer carries a good prognosis. The aim of the present study was early detection of lung cancer among heavy smokers using immunohistochemical staining and chest computed tomography (CT). Patients and methods This descriptive cross-sectional study comprised 80 heavy smokers with smoking index more than 40 pack-years. They were recruited from the Smoking Cessation Clinic, Mansoura University Hospital. All participants were subjected to (a) chest radiography followed by high-resolution chest CT, (b) sputum sample collection, and (c) fiberoptic bronchoscopy evaluation of bronchoalveolar lavage (BAL) and bronchial mucosal biopsies from suspicious areas. All pathological samples were stained with hematoxylin and eosin followed by immunostaining using antibodies for p53 and thyroid transcription factor-1 (TTF-1). Data were analyzed using statistical package for social sciences, version 16. Results The majority of heavy smokers were male, withamean age of 53.42±11.30 years. A solitary pulmonary nodule was detectedin1.3%of cases withchest radiographyandin5%with high-resolution CT. Hematoxylin and eosin staining of sputum, BAL, and mucosal biopsies was positive for premalignant changes in 35, 27, and 17.56%of cases, respectively. Sputum, BAL, and mucosal biopsies showed expression of p53 in 30, 37.8, and 35.1% of cases, respectively. Sputum, BAL, and mucosal biopsy showed expression of TTF-1 in 12.5, 10.8, and 14.9% of cases, respectively. Conclusion The immunohistochemical technique using p53 and TTF-1 is useful in the early detection of bronchial mucosal changes in heavy smokers. There is still need for a largescale study to highlight its validity and acceptability. Meanwhile, chest CT is beneficial for the detection of peripheral small lesions.

Background Smear-negative pulmonary tuberculosis (PTB) represents 42% of PTB cases and is responsible for ∼20% of tuberculosis (TB) transmission cases. Early recognition of TB cases is important to limit TB transmission. This study was planned to assess validity and safety of bronchoscopic transbronchial cryobiopsy in diagnosis of patients with smear-negative PTB. Patients and methods Patients with smear-negative PTB were enrolled. Bronchoalveolar lavage (BAL) and transbronchial cryobiopsy were taken. BAL was sent for microbiological examination (Ziehl–Neelsen for acid-fast bacilli and TB culture). Results A total of 24 patients were included in the study. BAL Ziehl–Neelsen staining result was positive in four (16.7%) patients, and TB culture finding was positive in five (20.8%) patients. Among those who had a positive cryobiopsy result, the probability of TB disease was 100% (no false-positive results). Among those who had a negative cryobiopsy result, the probability of being TB free was 89.5%. So, sensitivity of transbronchial cryobiopsy in diagnosis of pulmonary TB was 85% and specificity was 100%. Conclusion Transbronchial lung cryobiopsy is rapid and safe procedures in diagnosis of smear-negative pulmonary TB. However, further studies on a large number of patients are recommended.

Abstract Introduction Chemical ablation with acetic acid or ethanol is effective against hepatocellular carcinoma and therefore its application in peripheral non-small-cell lung cancer (NSCLC) may be beneficial. Aim The aim of the study was to assess the efficacy and safety of percutaneous chemical ablation using acetic acid or ethanol in peripheral NSCLC cases. Patients and methods This was a prospective randomized control study conducted at the Chest and Clinical Oncology Departments, Mansoura, Egypt, from 2011 to 2014. Thirty-three patients were included with a mean age of 60 years, and were randomly divided into three groups: group A (acetic acid plus chemotherapy group) consisted of nine patients; group B (ethanol plus chemotherapy group) consisted of nine patients; and the control group C (chemotherapy alone group) consisted of 15 patients. Patients who were operable, who had tumors infiltrating the main stem bronchi or mediastinum, and those who refused to complete the study were excluded. Clinical and radiological data were evaluated before treatment and 3 and 6 months after treatment. Results There was a significant reduction in both cough score and chest pain in group A after 6 months of treatment, in the hemoptysis score in group A and group B after 6 months of treatment, and in dyspnea score in groups A and B after 3 and 6 months of treatment. There was a statistically significant difference in the tumor response results in both groups after 3 and 6 months of treatment when compared with the control group. There were one or more immediate complications but all were controllable with no mortality. Survival was better in groups A and B than in the control group. The cost of acetic acid and ethanol palliation for each patient was 10 $US. Conclusion Chemical ablation is an effective and inexpensive adjuvant palliative treatment for patients with inoperable peripheral NSCLC.