Exudative Changes Research Articles

Chest Radiographic Findings in Newly Diagnosed Pulmonary Tuberculosis Cases in Iwo, Nigeria

A clinical study was carried out on newly diagnosed pulmonary tuberculosis cases seen at Iwo Tuberculosis Control Clinic in Nigeria between January 1996 and December 1997. Five hundred newly diagnosed cases of Pulmonary Tuberculosis were treated with directly observed short-course treatment and 100 of them had chest radiographic examination done. The various chest radiographic patterns in the 100 subjects were studied and included: Fluffy exudative changes 80(80%), fibrosis 70(70%), pleural effusion 10(1%), emphysema 30(30%), lymphadenopathy 10(10%), cavitation 10(10%), consolidation 10(10%) and destroyed lung syndrome 5(5%). The cases of pulmonary tuberculosis with Human immunodeficiency virus seropositivity (30) showed a less significantly higher percentages of fluffy exudative changes 30(37.5%), fibrosis 30(32.8%) pleural effusion 6(60%) emphysema 10(33.3%), lymphadenopathy 80(80%), consolidation 8(80%), and destroyed lung syndrome 4(80%), as compared with 70 in the seronegative group (62.5%, 57.1%, 40%, 66.6%, 20%, 20% and 20% respectively). Cavitation 1(10%) was significantly less common in the HIV sero-positive group than in the HIV sero-negative group 9(90%), Upper lobe infiltrates and cavitations are the most frequent radiographic presentations in both the HIV-infected and non-HIV infected pulmonary tuberculosis cases. Left upper lung lobe 48(48%) is more frequently affected than the right upper lung lobe 24(24%). Tuberculosis frequently affects the upper lung lobes more than the other lung lobes. The left upper lung lobe was more frequently involved than the right HIV-seropositive pulmonary tuberculosis subjects showed more significant (P

Organic acid exudation and pH changes by Gordonia sp. and Pseudomonas fluorescens grown with P adsorbed to goethite

The actinomycete Gordonia sp. and the bacterium Pseudomonas fluorescens Pf-5 were grown in liquid media (pH 6.5) with phosphate adsorbed to the Fe-oxide/hydroxide goethite (Goe-P) and with soluble phosphate (0.1 mM or 1.0 mM P as KH2PO4). The two isolates showed distinct differences in their physiology. The pH of the medium was increased by Gordonia sp. by 1.1-1.7 units while it was decreased by P. fluorescens by 1.4-2.4 units. In all treatments the concentration of organic acids in the media with Gordonia sp. was up to 10 times lower (0.4-10.9 micromol L(-1)) than in media with P. fluorescens (33.4-84.4 micromol L(-1)). Gordonia sp. produced five different organic acids in varying amounts depending on P source and time. In contrast, P. fluorescens exuded mainly citrate and only small amounts of two to three other organic acids irrespective of P source or time.

Prospective evaluation of digital non-stereo color fundus photography as a screening tool in age-related macular degeneration

To evaluate mydriatic, non-stereo digital color fundus photographs as a screening tool for identifying and classifying exudative age-related macular degeneration (AMD). Prospective case series. Digital color fundus photographs were obtained from patients seen in the AMD screening clinic over a 9-month period at the Ivey Eye Institute in London, Ontario. Photographs for eligible patients were separated by eye, cataloged, blinded, and randomly labeled before interpretation by an experienced vitreoretinal surgeon. Exact agreement, sensitivity, specificity, positive predictive value, and negative predictive value of the fundus photographs in diagnosing, classifying, and managing cases of suspected exudative AMD were then calculated against gold standard clinical examination and fluorescein angiography. A total of 223 images were used from 118 eligible patients. Exact agreement between photographic evaluation and gold standard ranged from 89.2% (presence of pigment epithelial detachment (PED)) to 82.5% (evidence of retinal pigment epithelium geographic atrophy). Sensitivities ranged from 89.2% (presence of choroidal neovascular membrane (CNVM)) to 40.0% (presence of PED). Specificities ranged from 94.1% (presence of PED) to 86.8% (presence of retinal pigment epithelium geographic atrophy). Positive predictive value ranged from 86.1% (presence of CNVM) to 40.0% (presence of PED). Negative predictive value ranged from 94.1% (presence of PED) to 88.9% (presence of CNVM). As a screening tool for high-risk dry changes and active exudative changes, overall sensitivity specificity, positive predictive value, and negative predictive value were 82.1%, 79.1%, 70.4%, and 88.0%, respectively. Digital, non-stereo color fundus photographs are highly sensitive and have high negative predictive value as a screening tool. Very few treatable lesions are missed using telemedicine in age-related macular degeneration.

Changes in fundus autofluorescence in patients with age-related maculopathy. Correlation to visual function: a prospective study

As members of the Fundus Autofluorescence in Age-related Macular Degeneration Study Group (FAM Study Group), we report changes of fundus autofluorescence (AF) in patients with multiple soft drusen in correlation to visual function. Inclusion criteria were age >50 years, the presence of soft drusen, visual acuity of 20/100 or better, and no previous laser treatment in the study eye. All patients underwent a detailed ophthalmological examination including ETDRS visual acuity, binocular funduscopy, and color fundus photography. AF imaging was performed with a confocal scanning laser ophthalmoscope following a standard protocol. We used the classification of the International Fundus Autofluorescence Classification Group (IFAG) for the description of the AF patterns. One hundred and twenty-five patients (81 women, 44 men) aged from 55 to 86 years (mean 70+/-7 years) were included in this prospective study. During follow-up (mean 18+/-6 months), 6 of 35 eyes with patchy AF pattern developed exudative changes, as well as 2 eyes with focal-plaque-like AF pattern and 1 eye with reticular pattern at baseline. Geographic atrophy was seen in two eyes with focal AF pattern and one eye with focal-plaque-like pattern at baseline. A total of 11 eyes presented with severe visual loss (> or = 6 ETDRS lines). Ten (91%) of these had patchy AF pattern. Imaging of fundus AF in patients with age-related maculopathy allows identification of different patterns of fundus AF. Our preliminary data suggest that a patchy pattern of AF indicates a relatively high risk of progression to age-related macular degeneration with visual loss.

Cerebral arterial pathology of CADASIL and CARASIL (Maeda syndrome)

Two familial cerebro-vascular diseases characterized by different cerebral arterial pathologies and presenting in non-hypertensive young and middle-aged adults are described. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is characterized by the deposition of smudged periodic acid-Schiff (PAS)-positive granules known as granular osmiophilic materials (GOM) in the media of small arteries and arterioles. The medial smooth muscle cells are completely lost, and intense adventitial fibrosis is present. Cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL), or Maeda syndrome, is characterized by intense arteriolosclerosis without GOM deposition. Fibrous intimal proliferation, hyaline degeneration of the media, thickening and splitting of the internal elastic lamina, and concentric narrowing of the lumen are characteristic features. In PAS preparation, small arteries are occasionally stained homogeneously due to exudative changes, but never exhibit granular appearance in CARASIL (Maeda syndrome). Each of the small arterial changes is intense in the cerebral medullary and leptomeningeal arteries, leading to multifocal, confluent, or diffuse ischemic changes in the cerebrum. The authors suggest that CARASIL be referred to as 'Maeda syndrome' or 'CARASIL (Maeda syndrome)' to avoid confusion with CADASIL.

Experimental acute glomerulonephritis induced in the rabbit with a specific streptococcal antigen.

FITC-labelled IgG obtained from patients convalescing from acute poststreptococcal glomerulonephritis (APSGN) stains glomeruli of patients with early APSGN. We previously reported a streptococcal antigen (preabsorbing antigen (PA-Ag)) that preabsorbed the stain out of sera from the convalescent patients and thus prevented glomerular staining. To confirm the nephritogenicity of PA-Ag, we administered up to 40 mg of this antigen to rabbits for 8 days and observed them for up to 9 weeks. Immunohistological analysis showed diffuse and global glomerular staining for C3 without notable staining for gamma-globulin. Light microscopic examinations revealed slight to moderate proliferative glomerulonephritis with exudative change. Control rabbits, which received similar doses of bovine serum albumin, did not show significant staining for C3. A transient and significant decrease in CH50 was observed from weeks 3 to 7 (9.7 +/- 0.3 U/ml at week 3; normal range 12.9 +/- 0.6 U/ml). This experimental model showed a resemblance to immunological and immunohistological features of APSGN in humans. Although the precise mechanisms are yet to be determined, complement activation by PA-Ag seems to hold a key position in this model and in the human disease.

Anti-inflammatory activity of Jatropha curcas roots in mice and rats

Anti-inflammatory activity of topical application of Jatropha curcas L. root powder in paste form in TPA-induced ear inflammation was confirmed in albino mice and the successive solvent extraction of these roots was carried out by ether and methanol. The methanol extract exhibited systemic and significant anti-inflammatory activity in acute carrageenan-induced rat paw edema. It also showed activity against formalin-induced rat paw edema, as well as, turpentine-induced exudative changes and cotton pellet-induced granular tissue formation after oral treatment for 7 days in albino rats. Thus, resultant anti-inflammatory activity might be due to effects on several mediators and arachidonic acid metabolism involving cyclo-oxygenase pathway resulting in prostaglandin formation, anti-proliferative activity leading to reduction in granular tissue formation and leukocyte migration from the vessels.

Importance of rhizodeposition in the coupling of plant and microbial productivity

SummaryPlant roots influence the biological, chemical and physical properties of rhizosphere soil. These effects are a consequence of their growth, their activity and the exudation of organic compounds from them. In natural ecosystems, the linkages between inputs of carbon from plants and microbial activity driven by these inputs are central to our understanding of nutrient cycling in soil and the productivity of these systems. This coupling of plant and microbial productivity is also of increasing importance in agriculture, where the shift towards low‐input systems increases the dependence of plant production on nutrient cycling, as opposed to fertilizers. This review considers the processes by which plants can influence the cycling of nutrients in soil, and in particular the importance of organic inputs from roots in driving microbially mediated transformations of N. This coupling of plant inputs to the functioning of the microbial community is beneficial for acquisition of N by plants, particularly in low‐input systems. This occurs through stimulation of microbes that produce exoenzymes that degrade organic matter, and by promoting cycling of N immobilized in the microbial biomass via predation by protozoa. Also, plants increase the cycling of N by changes in exudation in response to nitrogen supply around roots, and in response to browsing by herbivores. Plants can release compounds in exudates that directly affect the expression of genes in microbes, and this may be an important way of controlling their function to the benefit of the plant.

Characterization of leakage activity in exudative chorioretinal disease with three-dimensional confocal angiography

Purpose A novel angiographic technique providing topographic imaging of chorioretinal fluorescence is applied to the characterization of leakage dynamics in exudative chorioretinopathy. The three-dimensional imaging is evaluated with respect to results with conventional two-dimensional fluorescence angiography. Design Prospective observational case series. Participants Thirty eyes of 30 patients with different exudative maculopathies (pigment epithelium detachment, branch retinal vein occlusion, central serous chorioretinopathy, each n = 10) and 11 eyes of 10 patients with clinically normal appearance. Methods Depth-resolved fluorescence angiography using a confocal scanning laser system was performed after complete ophthalmologic examination. The axial distribution of fluorescein and indocyanine green fluorescence at each x/y position within a tomographic scan of 32 images was analyzed. The chorioretinal fluorescence topography was reconstructed by localizing a defined threshold value of fluorescence and displayed as topographic relief. Qualitative description and quantitative measurements of exudation or structural alterations were performed topographically and conventionally. Main outcome measures Qualitative and quantitative analysis of structural or exudative changes in time course in topographic illustration compared with conventional angiography. Results Clinically physiologic eyes were presented topographically as a smooth concave surface of fluorescence with defined illustration of retinal vascular structures and the optic disc. Retinal vascular pathologic conditions induce a precisely demarcated pattern of intraretinal edema with a characteristic temporal evolution. In central serous retinopathy the underlying pathologic condition was identified as a perfusion defect, which was subsequently filled with a peak of exudation with differences in the time of maximum in fluorescein/indocyanine green angiography. Pigment epithelium detachment appeared as a high and well defined elevation, with the origin of exudation within the base of the detachment. Differences in the time of maximum prominence were found in indocyanine green angiography within the pigment epithelium detachment group. Conclusions Confocal topographic angiography allows for the first time precise three-dimensional functional imaging of fundus alterations caused by leakage or barrier dysfunction. Compared with conventional angiography, depth-resolved angiographic imaging is less impaired by masking phenomena or low fluorescence intensity, which improves the diagnostic yield of angiography. The characterization and quantification of leakage activity is a promising tool in the assessment of exudative maculopathy.

Altered clearance of gadolinium diethylenetriaminepentaacetic acid aerosol from bleomycin-injured dog lungs: initial observations.

To characterize altered alveolar transfer to solute in bleomycin (BLM)-injured lungs, eight dogs underwent a gadolinium diethylenetriaminepentaacetic acid aerosol (Gd-AS) magnetic resonance imaging study before and on Days 7 and 40 after tracheal instillation of BLM (0.75 mg) in the left lungs. Consecutive fast-gradient echo magnetic resonance imaging was acquired during and after spontaneous inhalation of 200-mM Gd-AS. The slope (Kep) and clearance half-time (T1/2) of logarithmic regression lines for clearance curves were estimated. Histology on Day 40 was compared with that on Day 7 in another three dogs. On Days 7 and 40, Gd-AS deposition was heterogeneously reduced in the affected lungs. On Day 7 with multifocal intraalveolar exudative changes, Kep in affected areas was significantly increased compared with baseline (2.5 x 10(-3) minutes(-1) +/- 0.3 versus 1.7 x 10(-3) minutes(-1) +/- 0.2, p < 0.0001), with significant decrease in T1/2 (121.6 +/- 19.7 minutes vs. 170.4 +/- 15.8 minutes, p < 0.001). However, on Day 40 with multifocal interstitial fibrosis, Kep and T1/2 were recovered toward baseline. BLM-injured lungs can be characterized by accelerated Gd-AS clearance during the acute exudative phase and their recovery during the chronic fibrotic phase. This technique is acceptable for monitoring alveolar transfer changes in BLM-injured lungs.

Immunohistochemical Study of Epiretinal Proliferative Cellular Tissue From a Patient With Sarcoidosis

Background Sarcoidosis is a granulomatous disease causing uveitis. Although steroid therapy is usually effective for many patients, some are resistant to this therapy. In such cases, vitrectomy may be chosen as the therapeutic method to treat intraocular inflammation. Case A 26-year-old Japanese man was diagnosed as having sarcoidosis by clinical findings and histological examination of bronchoalveolar lavage. Observations One year after diagnosis, vitreous opacity worsened and pars plana vitrectomy (PPV) was performed. Six months later, recurrence of vitreous opacity appeared and severe retinal exudative changes with proliferative vitreoretinopathy developed. One year after the first operation, PPV was repeated and the epiretinal proliferative tissue was removed and examined. Conclusions Histologic examination of the specimen showed scattered noncaseating granulomatous inflammation mainly consisting of epithelioid histiocytes and lymphocytes. Plasma cells as well as T cells were identified and the predominance of CD8-positive T cells was demonstrated. Taking everything into consideration, a new finding of CD8 predominance in the epiretinal proliferative tissue was demonstrated.

Polypoidal choroidal vasculopathy.

Polypoidal choroidal vasculopathy seems to be a distinct clinical entity that should be differentiated from other types of CNV associated with AMD and other known choroidal degenerative, inflammatory, and ischemic disorders. The principle abnormality seen in PCV, notably the branching vascular network and polypoidal structures at the borders of the lesion, seem to be unique to the disorder. In patients with serosanguineous detachment of the pigment epithelium, particularly in those with increased risk factors such as African American or Asian race, ICG should be performed to evaluate the choroidal vascular abnormality to establish a more definitive diagnosis. If the characteristic vascular lesion of PCV is seen, a conservative approach to management should be taken unless there is a persistent or progressive exudative change that threatens the central macula. In that event, there may be a rationale for photo-coagulation treatment of leaking aneurysmal or polypoidal components within the vascular lesion, but not the entire vascular complex. Photodynamic therapy seems to be a promising therapeutic modality, but randomized clinical trials are needed to establish the efficacy and safety of the PDT treatment in the management of these patients.

Distribution pattern of versican, link protein and hyaluronic acid in the rat periodontal ligament during experimental tooth movement.

The ability of the periodontal ligament (PDL) to rapidly remodel is the basis of orthodontic tooth movement. During the tooth movement, matrix proteoglycans (PGs) may play important roles in spatial, mechanical and biological aspects for the maintenance and repair of the PDL. The aim of this study was to characterize the distribution of a large hyaluronic acid (HA)-binding proteoglycan, versican, link protein (LP) and HA in the rat molar PDL during experimental tooth movement by histochemical and immunohistochemical methods. Experimental tooth movement was performed according to Waldo's method. Histologically, regressive changes, such as decrease of fibroblasts and collagen fibers and exudative change of edema were observed in the compressive side and progressive changes, such as proliferation of fibroblasts and collagen fibers, in the strain side one day after treatment. By 3 days after tooth movement, regressive or progressive changes were not observed in either side. Using monoclonal antibodies specific to versican core protein or LP, the positive immunoreactivity for both molecules was constantly observed throughout the PDL. After the experimental force was applied to the tooth, however, the immunostainings of versican and LP became significantly intense only in the compressive side but decreased in the strain side. The intensity in the compressive side was strongest one day after the force was applied and gradually diminished thereafter. HA of both sides did not change during experimental tooth movement. Since HA is present in the PDL, large amounts of versican and LP expressed in the compressive side may create large hydrated aggregates via their association with HA that dissipates the compressive force applied to this tissue.

Indocyanine green angiography-guided laser photocoagulation for occult choroidal neovascularization in age-related macular degeneration

Resolution of exudative manife stations and changes in vision were compared in patients who had indocyanine green angiography-guided laser photocoagulation versus those who had no laser. A retrospective, nonrandomized study was conducted in 176 patients who had laser photocoagulation therapy for occult choroidal neovascularization in age-related macular degeneration. Forty-three percent of 93 treated patients had complete resolution of exudative manifestations and 29% obtained better vision, versus 13% and 11%, respectively, for patients without laser treatment.

Polypoidal choroidal vasculopathy and central serous chorioretinopathy: author’s reply

I was pleased to learn that Doctors Ahuga, et al, have also had experience with “polypoidal choroidal vasculopathy” (PCV) in association with central serous chorioretinopathy (CSC). Their cases, although predominantly white, are not dissimilar from those in our report. They do stress two features to this alleged association that are also in agreement with our observations. First, two of their patients had CSC in the fellow eye without evidence of PCV. We, too, have noticed this peculiar relationship in a few patients. It suggests that the PCV may be a secondary rather than a primary factor in the evolution of exudative changes. Clinicians should keep in mind that ICG angiography will be helpful in discriminating this causal versus coincidental relationship by detection of one or more islands of inner choroidal hyperfluorescence reported to be seen bilaterally in patients with CSC in as many as 98.6% of these patients.1Spaide R.F. Hall L. Haas A. et al.Indocyanine green videoangiography of older patients with central serous chorioretinopathy.Retina. 1996; 16: 203-213Crossref PubMed Scopus (320) Google Scholar With respect to the nature of the PCV, primary or secondary, in patients with CC, we should keep in mind two points. The first is that choroidal neovascularization (CNV) of any type may evolve from nonspecific disturbance of the retinal pigment epithelium.2Yannuzzi L.A. Shakin J.L. Fisher Y.L. Altomonte M.A. Peripheral retinal detachments and retinal pigment epithelial atrophic tracts secondary to central serous pigment epitheliopathy.Ophthalmology. 1984; 91: 1554-1572Abstract Full Text PDF PubMed Scopus (215) Google Scholar Polypoidal-CNV does not appear to be an exception. However, polypoidal CNV tends to regress spontaneously more predictably and dramatically than other forms of neovascularization without evidence of fibrovascular scarring. Furthermore, the regression may be so pronounced that ICG angiographic evidence of preexisting PCV virtually vanishes. We believe that this is due to regression, or possibly even infarction, of the membrane and by reconstitution of its endothelial structures so that the leakage disappears, and consequently, the affinity for the ICG dye to conjugate with tissue or pool into associated exudative spaces no longer exists. I thank the authors for their appropriate and valuable comments, and I join them in suggesting that PCV should be considered in any patient with CSC when the clinical manifestations are unusual.3Yannuzzi L.A. Ciardella A. Spaide R.F. et al.The expanding clinical spectrum of idiopathic polypoidal choroidal vasculopathy.Arch Ophthalmol. 1997; 115: 478-485Crossref PubMed Scopus (389) Google Scholar

Vasoproliferative tumours of the retina

BACKGROUNDVasoproliferative tumours of the retina (VPTR) are benign tumours of unknown origin, occurring mostly in otherwise healthy patients. VPTR may be associated with other chorioretinal diseases, such as uveitis. The...

Pars plana vitrectomy for regression of choroidal neovascularization with age-related macular degeneration.

In age-related macular degeneration, the posterior vitreous surface often remains attached to a higher degree than expected for the patient's age, suggesting the involvement of the posterior vitreous membrane in the pathophysiology of choroidal neovascularization. Thus, we performed simple pars plana vitrectomy and artificial posterior vitreous detachment in order to induce regression of choroidal neovascularization. Vitrectomy was performed in 12 eyes of 11 patients with age-related macular degeneration in whom the posterior vitreous surface remained attached, and in whom there was evidence of highly active choroidal neovascularization. The posterior vitreous membrane was artificially detached during surgery, but photocoagulation and/or a subretinal procedure for choroidal neovascularization was not performed. Patients underwent fluorescein and indocyanine green angiography both pre- and postoperatively to assess the status of choroidal neovascularization. Six months after surgery, 6 of the 12 eyes showed regression of choroidal neovascularization, and in 2 eyes it had disappeared completely. Subretinal exudative changes in 8 eyes had improved. Visual acuity testing showed improved vision in 4 eyes, unchanged vision in 4 eyes, and worsening of vision in 4 eyes. The final best corrected visual acuity was 10/20 or better in one eye, 10/ 20 to 20/200 in 7 eyes, and 20/200 or worse in 4 eyes. The results of the present study suggest the involvement of the posterior vitreous membrane in the pathophysiology of age-related macular degeneration. Furthermore, the minimally invasive pars plana vitrectomy may represent a new treatment for age-related macular degeneration.

A comparison of digital nonmydriatic fundus imaging with standard 35-millimeter slides for diabetic retinopathy

Purpose The purpose of this study was to compare nonmydriatic digital images with 35-mm slide images for the detection of diabetic retinal findings. Study design Comparative, observational case series. Participants Forty patients with diabetes. Methods Diabetic patients underwent digital (nonmydriatic fundus camera attached to a digital back) and standard dilated 35-mm retinal photography of three areas: posterior pole, nasal retina, and temporal retina. The images were reviewed by a single masked grader for the presence or absence of specific retinal findings. Primary outcome measures Presence or absence of neovascularization of the disc (NVD), neovascularization elsewhere (NVE), venous beading (VB), nerve fiber layer (NFL) hemorrhage, dot–blot hemorrhage, microaneurysm (MA), clinically significant macular edema, cotton wool spot, intraretinal microvascular anomaly (IRMA), hard exudate (HE), and retinal pigment epithelial (RPE) pigmentary changes. Results Forty eyes of 22 patients underwent both imaging procedures. The agreement between image type was highest for IRMA (97.5%) and VB (95%) and lowest for RPE pigmentary changes (65%) and MA (62.5%). Sensitivity ranged from 25% (NVD) to 100% (VB). Specificity ranged from 90% (RPE pigmentary changes) to 100% (NVD, NVE, VB, NFL hemorrhage, HE). Positive predictive value ranged from 50% (IRMA) to 100% (NVD, NVE, HE, NFL, VB). Negative predictive value ranged from 48% (MA) to 100% (IRMA). Conclusions Nonmydriatic digital fundus imaging for detection of diabetic retionopathy has a low sensitivity rate and a high specificity rate and is less clinically useful than standard dilated 35-mm fundus slide images.

Coronavirus and Pasteurella infections in bovine shipping fever pneumonia and Evans' criteria for causation.

Respiratory tract infections with viruses and Pasteurella spp. were determined sequentially among 26 cattle that died during two severe epizootics of shipping fever pneumonia. Nasal swab and serum samples were collected prior to onset of the epizootics, during disease progression, and after death, when necropsies were performed and lung samples were collected. Eighteen normal control cattle also were sampled at the beginning of the epizootics as well as at weekly intervals for 4 weeks. Respiratory bovine coronaviruses (RBCV) were isolated from nasal secretions of 21 and 25 cattle before and after transport. Two and 17 cattle nasally shed Pasteurella spp. before and after transport, respectively. RBCV were isolated at titers of 1 x 10(3) to 1.2 x 10(7) PFU per g of lung tissue from 18 cattle that died within 7 days of the epizootics, but not from the lungs of the remaining cattle that died on days 9 to 36. Twenty-five of the 26 lung samples were positive for Pasteurella spp., and their CFU ranged between 4.0 x 10(5) and 2.3 x 10(9) per g. Acute and subacute exudative, necrotizing lobar pneumonia characterized the lung lesions of these cattle with a majority of pneumonic lung lobes exhibiting fibronecrotic and exudative changes typical of pneumonic pasteurellosis, but other lung lobules had histological changes consisting of bronchiolitis and alveolitis typical of virus-induced changes. These cattle were immunologically naive to both infectious agents at the onset of the epizootics, but those that died after day 7 had rising antibody titers against RBCV and Pasteurella haemolytica. In contrast, the 18 clinically normal and RBCV isolation-negative cattle had high hemagglutinin inhibition antibody titers to RBCV from the beginning, while their antibody responses to P. haemolytica antigens were delayed. Evans' criteria for causation were applied to our findings because of the multifactorial nature of shipping fever pneumonia. This analysis identified RBCV as the primary inciting cause in these two epizootics. These viruses were previously not recognized as a causative agent in this complex respiratory tract disease of cattle.

Intravital laser confocal microscopy of pulmonary edema resulting from intestinal ischemia-reperfusion injury in the rat.

To observe pulmonary edema resulting from intestinal ischemia-reperfusion injury. We used a newly developed laser confocal microscope to observe the subpleural capillary network and the superficial alveoli under intravital conditions, and created three-dimensional images of the pulmonary microcirculation to analyze the time course and spatial pattern of pulmonary exudative changes during intestinal ischemia-reperfusion injury in vivo. Prospective, randomized, unblinded study. Laboratory of a university hospital. Male Sprague-Dawley rats. The rats were injected intravenously with bovine serum albumin labeled with fluorescein isothiocyanate and subjected to 60 mins of intestinal ischemia, followed by 180 mins of reperfusion. During mechanical ventilation, the upper lobe of the right lung was examined in the intravital state using a high-speed confocal fluorescence microscope. Interstitial edema and alveolar leakage were recognized as changes of interstitial fluorescence in the subpleural capillary network and as changes of alveolar fluorescence in the alveolar cross-sectional view. Although exudative changes in the interstitium and alveoli were observed during intestinal ischemia, there was a marked increase in both interstitial edema and alveolar leakage after intestinal reperfusion. We observed pulmonary edema under intravital conditions and demonstrated the utility of a newly developed laser confocal microscope. This system not only enabled us to analyze the development of pulmonary edema three-dimensionally, but also allowed us to evaluate the pulmonary microcirculation.