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3221. Lung defenses against opportunistic infections.
This review has examined the possible role of CMI in providing protection against three pathogens that can be opportunists in the lung. Monoclonal antibodies that identify the cellular components of the immune response and recombinant cytokines are important tools to better understand how pulmonary immunity is regulated. Although not discussed in detail, recombinant microbial antigens are useful for understanding various aspects of protective immunity and immunosuppression as well as for advancing vaccine development. There are important problems to address in order to continue steady progress in understanding pulmonary defenses, including some of those mentioned in this brief review. There should be an increased use of infectious models that more closely mimic naturally occurring infections, and comparisons should be made between results obtained with parenteral versus intrapulmonary routes of infection.
3229. Diagnosis of gastrobronchial fistula by measurement of bronchial secretion pH. Case report and literature review.
A patient with prior GBF and new-onset hemoptysis was diagnosed as having recurrent GBF by measurement of bronchial secretion pH. This is a previously unreported means of diagnosing this process. Bronchoscopic findings were substantiated by upper GI contrast study and surgical findings.
3232. New concepts in the pathogenesis and modalities of the chemoprophylaxis of native valve endocarditis.
Recommendations for the prophylaxis of BE have changed over the last 10-15 years toward fewer-dose and oral regimens. An advisory committee of the AHA is currently formulating new guidelines for the prevention of BE that will likely be promulgated in 1990 or 1991. It is anticipated that such recommendations will feature the new information on MVP and focus on oral prophylactic regimens.
3234. Bronchoscopic localization and treatment of occult lung cancer.
The flexible fiberoptic bronchoscope is currently the standard tool for localization of radiographically occult carcinomas of the tracheobronchial tree. It allows direct inspection of proximal airways and can establish the location of most occult lung cancers. A small percentage of patients present with bronchoscopically as well as radiographically occult carcinoma, particularly challenging because definitive localizations is required before a therapeutic plan can be outlined. Selective cytologic brushing of each lobar segment, taking random biopsy specimens, has been used to assist in localization of these early cancers. Recently, fluorescent compounds have been used to assist in localizing early lung cancers and in the treatment of radiographically occult carcinoma. We review the current methods of bronchoscopic localization and treatment of radiographically occult lung cancer.
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