Pulmonary system case study

J. S. Patton and R. M. Platz, Routes of drug delivery case studies (2) pulmonary delivery of peptides and proteins for systemic action, Adv. Drug Deliv. Rev, 8, 179 (1992). 

Wall, D.A. Smith, P.L. Inhalation therapy for growth hormone deficiency. In Inhalation Delivery of Therapeutic Peptides and Proteins Adjei, A.L., Gupta, P.R., Eds. Marcel Dekker, Inc. New York, 1997 453-469, Ch. 16. Patton, J.S. Platz, R.M. Routes of dehvery case studies (2) pulmonary delivery of peptides and proteins for systemic action. Adv. Drug Deh. Rev. 1992, 8, 179-186. 

Seventy artificial radioactive isotopes of indium also exist. Radioactive isotopes are produced when very small particles are fired at atoms. These particles stick in the atoms and make them radioactive. Two of these isotopes are used in medicine. Indium-113 is used to examine the liver, spleen, brain, pulmonary ( breathing ) system, and heart and blood system. Indium-111 is used to search for tumors, internal bleeding, abscesses, and infections and to study the gastric (stomach) and blood systems. In both cases, the radioactive isotope is injected into the bloodstream. Inside the body, the isotope gives off radiation. That radiation can be detected by means of a camera or other device. The radiation pattern observed provides information about the organ or system being studied. 

Claims for acute hydrogen sulfide exposure that occurred over a 5-year period (1969-1973) in Alberta, Canada, primarily among petrochemical workers, were reviewed by Burnett et al. (1977). Acute effects noted included coma, disequilibrium, and respiratory insufficiency with pulmonary edema. Of 221 cases, there were 14 deaths. A follow-up study of 250 workers claims for hydrogen sulfide exposure from 1979 to 1983 in Alberta, Canada, found 7 fatalities that usually involved the central nervous and respiratory systems hepatic congestion and cardiac petechiae were also noted (Arnold et al. 1985). The difference in fatality rate (6% down to 2.8%) was attributed to improved first aid training and an increased awareness of the dangers of hydrogen sulfide. 

Cells by themselves or by secreting pharmacologically active substances may have effects on the CNS, cardiac, respiratory, renal, or GI systems. Safety pharmacology should therefore be considered on a case-by-case basis depending on the specific characteristics of the cell-based product [52], In general, specific assessments are made as part of the toxicology assessments rather than as stand-alone studies consistent with the assessments made with protein-based biopharmaceuticals [50]. The fundamental physiological differences (e.g., total blood volume,pulmonary capillary surface area, and volume) should... 

The possibility that talc can cause respiratory failure was explored further in 1997 (24). ARDS occurred in four of 338 patients treated with talc poudrage (2 g) via thoracoscopy. All four had mahgnant effusions and aU developed bilateral pulmonary infiltrates, hjrpoxia, and hypotension within 24—48 hours of talc insufflation. All four required mechanical ventilation and three died. Bronchoalveolar lavage was performed in all four and talc crystals were recovered from lavage fluid in each case. Furthermore, at autopsy in one patient, talc crystals were found in almost every organ, showing that systemic distribution of talc did occur after pleurodesis. However, as the authors acknowledged, it was not possible to definitely attribute the symptoms in these patients to the talc pleurodesis. Studies in animals have shown systemic distribution of talc after pleurodesis (25). However, systemic dissemination may occur in all patients treated with pleurodesis and does not confirm that this is the cause of respiratory failure documented in a small number of patients. 

Animal studies and human case reports have led to several proposed postexposure prophylactic regimens for asymptomatic patients exposed to pulmonary agents, specifically phosgene, to prevent development of complications. Unfortunately, all of these treatments lack evidence in systemic studies, and asymptomatic patients may find at least one of the treatments unacceptable ... 

Modified from Schirosi L, Lantuejoul S, Cavazza A, et al. Pleuro-pulmonary solitary fibrous tumors A clinicopathologic, immunohistochemical, and molecular study of 88 cases confirming the prognostic value of de Perrot staging system and p53 expression, and evaluating the role of c-kit, BRAF, PDCFRs (alpha/beta), c-met, and ECFR. Am j Surg Pathol. 2008 32 1627-1642. 

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