f. Dry the bronchoscope and suction adapter. Rinse mucus off the cleaning brushes. 
g. Completely immerse the bronchoscope, brushes, and suction adapters in the cold 
disinfectant solution (Cidex). 
3. The scope must be soaked according to the cold disinfectant manufacturer’s 
recommendations for disinfection. 
4. Using a syringe with green bubble tubing, draw cold disinfectant through the suction 
channel during procedure. 
5. After disinfection, the scope must be rinsed thoroughly with sterile water. 
6. Attach a clean suction tubing to the bronchoscope and rinse suction channel 
thoroughly. 
7. Draw lOOcc of alcohol through bronchoscope. 
8. Connect an airflowmeter to the wall outlet. Attach green bubble supply tubing to the 
flowmeter and the bronchoscope. Turn flowmeter on to 10 1pm. Blow air through 
scope 3-5 minutes. 
9. Place cleaned/dry bronchoscope in protective wrap. (Rolls of protective wrap can be 
found in security cabinet.) 
10. Place the bronchoscope in the security cabinet (located outside the endoscopy suite 
beside the door) for storage. 
5.2.5 Blood specimens: The study subjects will have blood drawn a total of 21 times during 
the study. Blood will be drawn by venipuncture with no more than 20 ml taken at one time. 
This is less than 1 % of the total blood volume for patients of this age. 
ill 1 
5.2.6 Patient participation in concurrent studies: Study subjects will not be participating in 
concurrent protocols. 
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5.2.7 Facilities: Study patients will be evaluated initially in the cystic fibrosis clinic (Treatment 
Center 6), and the clinical research center (CRC). Spirometry will be performed in the pediatric 
pulmonary function laboratory (ASB-4). Fiberoptic bronchoscopy will be performed in the 
pediatric endoscopy suite located in Treatment Center 6. Throughout the admissions, patients 
will be isolated in a negative pressure room in the clinical research center (Room P1-16A). In 
this room, the air is filtered and exhausted to the outside. Full respiratory precautions will be 
observed, and anyone entering the room will wear a mask, a gown, gloves, and protective eye 
shields. When subjects leave the room for special procedures such as pulmonary function testing 
or fiberoptic bronchoscopy, they will wear fine particle respirators. It is anticipated that a 
second class A isolation room will be made available by the CRC for this study. 
5.2.8 Special considerations 
Radiation Safety: Participants in this protocol will receive AP and lateral chest x-rays 12 times 
in 5 months, with an exposure of 25mrem per pair of chest x-rays (AP lOmrem, lateral 
15mrem). The total radiation dose from chest radiographs will therefore be 300mrem, which 
is increased compared to our routine clinical care that involves 25-50mrem per annum for 1-2 
sets of AP and lateral chest radiographs. The annual public exposure limits recommended by 
the National Council for Radiation Protection are lOOmrem per year for continuous or frequent 
exposure and 500mrem per year for infrequent exposure. 
Recombinant DNA Research, Volume 17 
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